| Abdomen 1 View (74018) |
$314 |
$314 |
3.5× |
| Abdomen 2 views (74019) |
$432 |
$432 |
4.0× |
| Ankle 2 views (73600) |
$278 |
$278 |
3.1× |
| Bone age studies (77072) |
$258 |
$258 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$1,985 |
$1,985 |
4.8× |
| Bone Imaging Limited Area (78300) |
$1,423 |
$1,423 |
3.4× |
| Bone Imaging Whole Body (78306) |
$1,779 |
$1,779 |
4.3× |
| Chest 1 view (71045) |
$317 |
$317 |
3.5× |
| Chest 2 views (71046) |
$391 |
$391 |
4.3× |
| 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 Angio Abdomen and Pelvis (74174) |
$5,358 |
$5,358 |
14.8× |
| CT Angio Chest (71275) |
$3,824 |
$3,824 |
21.0× |
| CT Angio Head (70496) |
$3,180 |
$3,180 |
17.5× |
| CT Angio Neck (70498) |
$3,130 |
$3,130 |
17.2× |
| CT cervical spine w/o contrast (72125) |
$2,495 |
$2,495 |
23.0× |
| CT chest w contrast (71260) |
$3,000 |
$3,000 |
16.5× |
| CT chest w/wo contrast (71270) |
$3,399 |
$3,399 |
18.7× |
| 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/contrast material (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 wo contrast (70486) |
$2,057 |
$2,057 |
18.9× |
| CT neck tissue combo (70492) |
$3,130 |
$3,130 |
17.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (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 scan of leg combo (73702) |
$3,213 |
$3,213 |
17.6× |
| CT scans face/jaw combo (70488) |
$2,709 |
$2,709 |
14.9× |
| CT soft tissue neck w contrast (70491) |
$2,716 |
$2,716 |
14.9× |
| 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 ext wo (73200) |
$2,436 |
$2,436 |
22.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,568 |
$3,568 |
19.6× |
| 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× |
Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$21–$531 |
$21–$531 |
varies |
| 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× |
| Hepatobil Syst Image W/Drug (78227) |
$2,141 |
$2,141 |
3.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$400 |
$400 |
4.4× |
| 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 contrast (74181) |
$3,741 |
$3,741 |
15.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,704 |
$3,704 |
4.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,714 |
$3,714 |
10.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,254 |
$1,254 |
1.5× |
| MRI cervical spine w/o cont (72141) |
$4,002 |
$4,002 |
16.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,569 |
$3,569 |
9.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,936 |
$2,936 |
11.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,555 |
$4,555 |
12.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,116 |
$4,116 |
11.4× |
| MRI pelvis w/o & w contrast (72197) |
$4,141 |
$4,141 |
11.4× |
| MRI pelvis w/o contrast (72195) |
$3,355 |
$3,355 |
13.5× |
| MRI thoracic spine w/o contrast (72146) |
$4,047 |
$4,047 |
16.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,936 |
$2,936 |
11.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,518 |
$3,518 |
9.7× |
| MRI, abdomen, combo (74183) |
$4,407 |
$4,407 |
12.2× |
| MRI, dorsal spine combo (72157) |
$4,622 |
$4,622 |
12.8× |
| MRI, joint upper extrem (73221) |
$2,944 |
$2,944 |
11.9× |
MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$4,307–$4,436 |
$4,307–$4,436 |
varies |
| MRI, lumbar spine combo (72158) |
$4,582 |
$4,582 |
12.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,809 |
$4,809 |
3.6× |
| Neck soft tissue (70360) |
$371 |
$371 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$314 |
$314 |
2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$545 |
$545 |
5.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$337 |
$337 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$280 |
$280 |
3.1× |
| Radex elbow complete minimum 3 views (73080) |
$355 |
$355 |
3.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$463 |
$463 |
4.3× |
| Radex fingr minimum 2 views (73140) |
$252 |
$252 |
2.8× |
| Radex foot complete minimum 3 views (73630) |
$343 |
$343 |
3.8× |
| Radex Hand Minimum 3 Views (73130) |
$342 |
$342 |
3.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$249 |
$249 |
2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$371 |
$371 |
4.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$332 |
$332 |
3.7× |
| Radex shoulder complete minimum 2 views (73030) |
$379 |
$379 |
4.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$317 |
$317 |
3.5× |
| Radex Sternum Minimum 2 Views (71120) |
$334 |
$334 |
3.7× |
| Radex Toe Minimum 2 Views (73660) |
$264 |
$264 |
2.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$331 |
$331 |
3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$440 |
$440 |
4.1× |
| Radiologic exam knee complete 4/more views (73564) |
$382 |
$382 |
3.5× |
| Radiologic exam swallow function contrast study (74230) |
$607 |
$607 |
3.3× |
| Radiologic examination femur 1 view (73551) |
$372 |
$372 |
4.1× |
| Radiologic examination femur minimum 2 views (73552) |
$372 |
$372 |
4.1× |
| Radiologic examination knee 1/2 views (73560) |
$319 |
$319 |
3.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$301 |
$301 |
3.3× |
| Ribs bilateral 3 views (71110) |
$485 |
$485 |
4.5× |
| Scapula (73010) |
$362 |
$362 |
3.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$107 |
$107 |
4.6× |
| Shoulder 1 view (73020) |
$265 |
$265 |
2.9× |
| Shoulder Arthrography (73040) |
$933 |
$933 |
2.6× |
| Skull less than 4 views (70250) |
$332 |
$332 |
3.1× |
| Thoracic spine 2 views (72070) |
$404 |
$404 |
3.7× |
| Thoracic spine 3 views (72072) |
$510 |
$510 |
4.7× |
| Ultrasound Breast Limited (76642) |
$339 |
$339 |
3.8× |
| Ultrasound Exam Aaa Screen (76706) |
$711 |
$711 |
6.5× |
| Ultrasound, abdomen limited (76705) |
$735 |
$735 |
6.8× |
| Umbilical-artery Doppler (OB) (76820) |
$350 |
$350 |
3.2× |
| Us breast unilateral complete (76641) |
$437 |
$437 |
4.0× |
| Us complete joint (76881) |
$274 |
$274 |
2.5× |
| Us exam, pelvic, limited (76857) |
$319 |
$319 |
2.9× |
| Us kidney transplant (76776) |
$893 |
$893 |
8.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$657 |
$657 |
6.1× |
| Us ob limited 1 or more fetuses (76815) |
$504 |
$504 |
4.6× |
| Us ob transvaginal (76817) |
$588 |
$588 |
5.4× |
| Us pelvic non ob complete (76856) |
$909 |
$909 |
8.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$618 |
$618 |
5.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$401 |
$401 |
3.7× |
| 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 thyroid (76536) |
$714 |
$714 |
6.6× |
Wrist 2 views (73100) range across 5 matching MRF lines |
$271–$407 |
$271–$407 |
varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$301 |
$301 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$301 |
$301 |
3.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$364 |
$364 |
3.4× |
| 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 2 Views (73521) |
$537 |
$537 |
4.9× |
| 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 Neck Spine 2-3 Vw (72040) |
$364 |
$364 |
4.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$653 |
$653 |
6.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$485 |
$485 |
4.5× |
| X-ray humerus (73060) |
$340 |
$340 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$265 |
$265 |
2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$449 |
$449 |
4.1× |
| 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 Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$432 |
$432 |
4.8× |
| X-Rays Bone Survey Complete (77075) |
$881 |
$881 |
8.1× |
| Xr c-spine 4 or 5 views (72050) |
$593 |
$593 |
5.5× |