| Abdomen 2 views (74019) |
$432 |
$432 |
4.0× |
| Ankle 2 views (73600) |
$278 |
$278 |
3.1× |
| Arthrogram shoulder (73040) |
$933 |
$933 |
2.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,423 |
$1,423 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$1,779 |
$1,779 |
4.3× |
| Bone age studies (77072) |
$258 |
$258 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$1,985 |
$1,985 |
4.8× |
| Bone survey complete (77075) |
$881 |
$881 |
8.1× |
| Cervical spine 2 or 3 views (72040) |
$364 |
$364 |
4.0× |
| Chest 1 view (71045) |
$317 |
$317 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$607 |
$607 |
3.3× |
| Clavicle complete (73000) |
$319 |
$319 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,347 |
$1,347 |
12.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,237 |
$4,237 |
11.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,842 |
$2,842 |
11.5× |
| CT abdomen w contrast (74160) |
$3,086 |
$3,086 |
16.9× |
| CT abdomen w wo contrast (74170) |
$3,396 |
$3,396 |
18.6× |
| CT abdomen w/o contrast (74150) |
$2,670 |
$2,670 |
24.6× |
| CT c-spine w/o contrast (72125) |
$2,495 |
$2,495 |
23.0× |
| CT chest w/wo contrast (71270) |
$3,399 |
$3,399 |
18.7× |
| CT chest with contrast (71260) |
$3,000 |
$3,000 |
16.5× |
| CT head/brain with contrast (70460) |
$2,104 |
$2,104 |
11.6× |
| CT head/brain without and with contrast (70470) |
$2,895 |
$2,895 |
15.9× |
| CT iac w contrast (70481) |
$2,625 |
$2,625 |
14.4× |
| CT lower ext w/o (73700) |
$2,550 |
$2,550 |
23.5× |
| CT lower extremity w wo contrast (73702) |
$3,213 |
$3,213 |
17.6× |
| CT lower extremity with contrast (73701) |
$2,747 |
$2,747 |
15.1× |
| CT lumbar spine w/o contrast (72131) |
$2,669 |
$2,669 |
24.6× |
| CT maxillofacial w contrast (70487) |
$2,351 |
$2,351 |
12.9× |
| CT maxillofacial w/o contrast (70486) |
$2,057 |
$2,057 |
18.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,709 |
$2,709 |
14.9× |
| CT neck soft tissue w contrast (70491) |
$2,716 |
$2,716 |
14.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,696 |
$2,696 |
14.8× |
| CT orbits w/o contrast (70480) |
$2,286 |
$2,286 |
21.1× |
| CT pelvis w/o contrast (72192) |
$2,618 |
$2,618 |
24.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,130 |
$3,130 |
17.2× |
| CT soft tissue neck w/o contrast (70490) |
$2,383 |
$2,383 |
22.0× |
| CT thoracic spine w/o contrast (72128) |
$2,626 |
$2,626 |
24.2× |
| CT thorax w/o contrast (71250) |
$2,618 |
$2,618 |
24.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,568 |
$3,568 |
19.6× |
| CT upper extremity w/o contrast rt (73200) |
$2,436 |
$2,436 |
22.4× |
| CT upper extremity with contrast (73201) |
$2,623 |
$2,623 |
7.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,061 |
$4,061 |
22.3× |
| Cta Abdomen (74175) |
$3,785 |
$3,785 |
20.8× |
| CTA abdomen pelvis (74174) |
$5,358 |
$5,358 |
14.8× |
| CTA chest (71275) |
$3,824 |
$3,824 |
21.0× |
| Cta Head (70496) |
$3,180 |
$3,180 |
17.5× |
| Cta Neck (70498) |
$3,130 |
$3,130 |
17.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$276 |
$276 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$263 |
$263 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$509 |
$509 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$711 |
$711 |
2.9× |
| Foot 2 views (73620) |
$282 |
$282 |
3.1× |
| Forearm 2 views (73090) |
$312 |
$312 |
3.5× |
| Hand 2 views (73120) |
$265 |
$265 |
2.4× |
| Hand 3 views (73130) |
$342 |
$342 |
3.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,141 |
$2,141 |
3.8× |
| Humerus Min 2 Views Left (73060) |
$340 |
$340 |
3.8× |
| Knee 3 views (73562) |
$425 |
$425 |
4.7× |
| MRA head w/o contrast (70544) |
$3,751 |
$3,751 |
15.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,009 |
$4,009 |
11.1× |
| MRA neck w/o contrast (70547) |
$3,357 |
$3,357 |
13.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,407 |
$4,407 |
12.2× |
| MRI abdomen w/o contrast (74181) |
$3,741 |
$3,741 |
15.1× |
| MRI any jnt lwr ext with con lt (73722) |
$3,704 |
$3,704 |
4.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,254 |
$1,254 |
1.5× |
| MRI cervical spine w/o contrast (72141) |
$4,002 |
$4,002 |
16.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,936 |
$2,936 |
11.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,116 |
$4,116 |
11.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,141 |
$4,141 |
11.4× |
| MRI pelvis w/o contrast (72195) |
$3,355 |
$3,355 |
13.5× |
| MRI scan of arm joint before and after contrast (73223) |
$4,371.50 |
$4,371.50 |
12.1× |
| MRI scan of leg joint before and after contrast (73723) |
$3,714 |
$3,714 |
10.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,555 |
$4,555 |
12.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,582 |
$4,582 |
12.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,622 |
$4,622 |
12.8× |
| MRI thoracic spine w/o contrast (72146) |
$4,047 |
$4,047 |
16.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,944 |
$2,944 |
11.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,518 |
$3,518 |
9.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,936 |
$2,936 |
11.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,809 |
$4,809 |
3.6× |
| Neck soft tissue (70360) |
$371 |
$371 |
4.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$401 |
$401 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$314 |
$314 |
2.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,569 |
$3,569 |
9.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$364 |
$364 |
3.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$537 |
$537 |
4.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$440 |
$440 |
4.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$314 |
$314 |
3.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$391 |
$391 |
4.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$372 |
$372 |
4.1× |
| Ribs bilateral 3 views (71110) |
$485 |
$485 |
4.5× |
| Scapula complete (73010) |
$362 |
$362 |
3.3× |
| Screening digital breast tomosynthesis (77063) |
$107 |
$107 |
4.6× |
| Spine thoracic 3 views (72072) |
$510 |
$510 |
4.7× |
| Ultrasound, abdomen limited (76705) |
$735 |
$735 |
6.8× |
| Umbilical-artery Doppler (OB) (76820) |
$350 |
$350 |
3.2× |
| Us abdl aorta screen aaa (76706) |
$711 |
$711 |
6.5× |
| Us breast unilateral complete (76641) |
$437 |
$437 |
4.0× |
| Us breast unilateral limited (76642) |
$339 |
$339 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$274 |
$274 |
2.5× |
| Us infant hips dynamic (76885) |
$400 |
$400 |
4.4× |
| Us kidney transplant (76776) |
$893 |
$893 |
8.2× |
| Us ob transvaginal (76817) |
$588 |
$588 |
5.4× |
| Us pelvic non ob complete (76856) |
$909 |
$909 |
8.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$319 |
$319 |
2.9× |
| Us pregnancy ltd (76815) |
$504 |
$504 |
4.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$618 |
$618 |
5.7× |
| Us retroperitoneal complete (76770) |
$937 |
$937 |
8.6× |
| Us retroperitoneal limited (76775) |
$656 |
$656 |
6.0× |
| Us scrotum and contents (76870) |
$650 |
$650 |
6.0× |
| Us soft tissue head/neck (76536) |
$714 |
$714 |
6.6× |
| Us xtr non-vasc lmtd (76882) |
$657 |
$657 |
6.1× |
| Wrist 2 views (73100) |
$271 |
$271 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$545 |
$545 |
5.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$301 |
$301 |
3.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$337 |
$337 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$301 |
$301 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$355 |
$355 |
3.9× |
| X-ray exam hip uni 1 view (73501) |
$280 |
$280 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$345 |
$345 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$501 |
$501 |
4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$561 |
$561 |
5.2× |
| X-ray exam of femur 1 (73551) |
$372 |
$372 |
4.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$463 |
$463 |
4.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$343 |
$343 |
3.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$280 |
$280 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$382 |
$382 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$265 |
$265 |
2.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$249 |
$249 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$449 |
$449 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$371 |
$371 |
4.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$332 |
$332 |
3.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$485 |
$485 |
4.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$601 |
$601 |
5.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$390 |
$390 |
3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$340 |
$340 |
3.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$379 |
$379 |
4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$432 |
$432 |
4.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$317 |
$317 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$332 |
$332 |
3.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$334 |
$334 |
3.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$404 |
$404 |
3.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$264 |
$264 |
2.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$331 |
$331 |
3.7× |
| Xr c-spine 6 or more views (72052) |
$653 |
$653 |
6.0× |
| Xr finger(s) 2+ views (73140) |
$252 |
$252 |
2.8× |
| Xr shoulder 1 view (73020) |
$265 |
$265 |
2.9× |
| Xr spine cervical 4 or 5 views (72050) |
$593 |
$593 |
5.5× |
| Xr tibia/fibula 2 views (73590) |
$301 |
$301 |
3.3× |
| Xray knee 1 or 2 views rt (73560) |
$319 |
$319 |
3.5× |