| Abdomen 2 views (74019) |
$239.20 |
$1,196 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,360 |
$6,800 |
3.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,995.40 |
$9,977 |
0.7× |
| Angiography Spinal Selective Rs&I (75705) |
$3,544.40 |
$17,722 |
0.7× |
| Ankle 2 views (73600) |
$184.20 |
$921 |
2.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$484.40 |
$2,422 |
1.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,166.80 |
$10,834 |
0.7× |
| Arthrogram elbow (73085) |
$444.20 |
$2,221 |
1.3× |
| Arthrogram hip (73525) |
$666 |
$3,330 |
2.0× |
| Arthrogram shoulder (73040) |
$1,300.80 |
$6,504 |
3.9× |
| Arthrogram wrist (73115) |
$399.80 |
$1,999 |
1.2× |
| Arthrography knee lt (73580) |
$518 |
$2,590 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$748.20 |
$3,741 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$823.80 |
$4,119 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$1,285.40 |
$6,427 |
3.3× |
| Bone age studies (77072) |
$190.40 |
$952 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,485.40 |
$7,427 |
3.9× |
| Bone survey complete (77075) |
$427.60 |
$2,138 |
4.2× |
| Brain image w/flow 4 + views (78606) |
$621 |
$3,105 |
1.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$585 |
$2,925 |
1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,397.20 |
$6,986 |
1.0× |
| Brain Imaging Vascular Flow Only (78610) |
$464.80 |
$2,324 |
0.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,236.40 |
$6,182 |
3.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$594 |
$2,970 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$177 |
$885 |
2.1× |
| Chest 1 view (71045) |
$304.20 |
$1,521 |
3.6× |
| Chest 3 views (71047) |
$97.40 |
$487 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$750.60 |
$3,753 |
4.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$738 |
$3,690 |
1.0× |
| Clavicle complete (73000) |
$212 |
$1,060 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$817.20 |
$4,086 |
8.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,795 |
$13,975 |
8.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,604.80 |
$8,024 |
7.0× |
| CT abdomen w contrast (74160) |
$1,333.20 |
$6,666 |
7.9× |
| CT abdomen w wo contrast (74170) |
$1,648.20 |
$8,241 |
9.7× |
| CT abdomen w/o contrast (74150) |
$1,121 |
$5,605 |
11.1× |
| CT angio hrt w/3d image (75574) |
$1,427.20 |
$7,136 |
4.2× |
| CT angiography upper extremity lt (73206) |
$797.40 |
$3,987 |
4.7× |
| CT c-spine w/o contrast (72125) |
$1,129 |
$5,645 |
11.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,609.80 |
$8,049 |
9.5× |
| CT cervical spine with contrast (72126) |
$1,307.60 |
$6,538 |
3.9× |
| CT chest w/wo contrast (71270) |
$1,406.60 |
$7,033 |
8.3× |
| CT chest with contrast (71260) |
$1,019 |
$5,095 |
6.0× |
| CT colonography w/dye (74262) |
$268.40 |
$1,342 |
1.6× |
| CT colonography w/o cntrst (74261) |
$137 |
$685 |
1.4× |
| CT head/brain with contrast (70460) |
$1,019 |
$5,095 |
6.0× |
| CT head/brain without and with contrast (70470) |
$1,369.60 |
$6,848 |
8.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$961.40 |
$4,807 |
2.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$209.80 |
$1,049 |
2.5× |
| CT hrt w/3d image congen (75573) |
$798.60 |
$3,993 |
2.4× |
| CT iac w contrast (70481) |
$911.40 |
$4,557 |
5.4× |
| CT limited/localized follow up study (76380) |
$321.40 |
$1,607 |
3.8× |
| CT lower ext w/o (73700) |
$1,173.10 |
$5,865.50 |
11.6× |
| CT lower extremity w wo contrast (73702) |
$974.20 |
$4,871 |
5.8× |
| CT lower extremity with contrast (73701) |
$974.20 |
$4,871 |
5.8× |
| CT lumbar spine w & w/o contrast (72133) |
$1,490.20 |
$7,451 |
8.8× |
| CT lumbar spine w/o contrast (72131) |
$1,129 |
$5,645 |
11.2× |
| CT lumbar spine with contrast (72132) |
$1,307.60 |
$6,538 |
3.9× |
| CT maxillofacial w contrast (70487) |
$911.40 |
$4,557 |
5.4× |
| CT maxillofacial w/o contrast (70486) |
$817.20 |
$4,086 |
8.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,067 |
$5,335 |
6.3× |
| CT neck soft tissue w contrast (70491) |
$1,019 |
$5,095 |
6.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,019 |
$5,095 |
6.0× |
| CT orbits w/o contrast (70480) |
$653.20 |
$3,266 |
6.5× |
| CT pelvis w & w/o contrast (72194) |
$1,002.20 |
$5,011 |
5.9× |
| CT pelvis w/o contrast (72192) |
$653.20 |
$3,266 |
6.5× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$434.80 |
$2,174 |
5.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,097.40 |
$5,487 |
6.5× |
| CT soft tissue neck w/o contrast (70490) |
$817.20 |
$4,086 |
8.1× |
| CT thoracic spine w/contrast (72129) |
$1,307.60 |
$6,538 |
7.7× |
| CT thoracic spine w/o contrast (72128) |
$1,129 |
$5,645 |
11.2× |
| CT thoracic spine w/wo contrast (72130) |
$842.80 |
$4,214 |
5.0× |
| CT thorax w/o contrast (71250) |
$1,201 |
$6,005 |
11.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$943.20 |
$4,716 |
5.6× |
| CT upper extremity w/o contrast rt (73200) |
$817.40 |
$4,087 |
8.1× |
| CT upper extremity with contrast (73201) |
$1,019 |
$5,095 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$797.40 |
$3,987 |
4.7× |
| Cta Abdomen (74175) |
$1,300.20 |
$6,501 |
7.7× |
| CTA abdomen pelvis (74174) |
$1,419.60 |
$7,098 |
4.2× |
| CTA chest (71275) |
$1,245 |
$6,225 |
7.4× |
| Cta Head (70496) |
$797.40 |
$3,987 |
4.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$424.40 |
$2,122 |
1.3× |
| CTA lwr ext w&w/o contrast (73706) |
$797.40 |
$3,987 |
4.7× |
| Cta Neck (70498) |
$797.40 |
$3,987 |
4.7× |
| Cta Pelvis (72191) |
$480.60 |
$2,403 |
2.8× |
| Cystography minimum 3 views rs&i (74430) |
$382.20 |
$1,911 |
1.1× |
| Diskogram cervical (72285) |
$1,576.80 |
$7,884 |
0.8× |
| Diskography lumbar (72295) |
$1,676.20 |
$8,381 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$174.80 |
$874 |
1.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$174.80 |
$874 |
1.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$107.40 |
$537 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$186.60 |
$933 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$177 |
$885 |
2.1× |
| Echo exam of fetal heart (76825) |
$472.80 |
$2,364 |
0.9× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$472.80 |
$2,364 |
2.1× |
| Echoencephalography real time imaging (76506) |
$267 |
$1,335 |
2.6× |
| Esophageal motility (78258) |
$423.80 |
$2,119 |
1.1× |
| Esophagus (74220) |
$212 |
$1,060 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$280 |
$1,400 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$278 |
$1,390 |
2.8× |
| Fluoroscopy up to 1 hr (76000) |
$192.20 |
$961 |
0.8× |
| Foot 2 views (73620) |
$200.40 |
$1,002 |
2.4× |
| Forearm 2 views (73090) |
$178.80 |
$894 |
2.1× |
| Functional MRI brain by tech (70554) |
$863.40 |
$4,317 |
3.8× |
| Gated Heart Planar Single (78472) |
$1,367 |
$6,835 |
3.5× |
| Hand 2 views (73120) |
$119.60 |
$598 |
1.2× |
| Hand 3 views (73130) |
$212 |
$1,060 |
2.5× |
| Heart Infarct Image (78466) |
$658 |
$3,290 |
1.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,272.40 |
$6,362 |
2.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,205.20 |
$6,026 |
3.1× |
| Ht muscle image spect sing (78451) |
$1,355.80 |
$6,779 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$193 |
$965 |
2.3× |
| Hysterosalpingogram (74740) |
$375 |
$1,875 |
1.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$195.80 |
$979 |
1.9× |
| Kidney imaging morphology (78700) |
$593.20 |
$2,966 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$775.40 |
$3,877 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,024 |
$5,120 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$898.40 |
$4,492 |
1.7× |
| Knee 3 views (73562) |
$274.40 |
$1,372 |
3.3× |
| Liver & spleen imaging static only (78215) |
$456 |
$2,280 |
1.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$236.20 |
$1,181 |
0.6× |
| Liver imaging static only (78201) |
$915 |
$4,575 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$1,615.20 |
$8,076 |
3.1× |
| Lung perfusion differential (78597) |
$605 |
$3,025 |
1.6× |
| Lung Ventilation Imaging (78579) |
$855.80 |
$4,279 |
2.2× |
| Lymphoscintigraphy (78195) |
$587.40 |
$2,937 |
1.1× |
| Mammary ductogram or galactogram single (77053) |
$845.80 |
$4,229 |
3.7× |
| Meckels Diverticulum (78290) |
$522.20 |
$2,611 |
1.4× |
| MRA head w & w/o contrast (70546) |
$831.80 |
$4,159 |
2.5× |
| MRA head w/o contrast (70544) |
$998.40 |
$4,992 |
4.3× |
| MRA head with contrast (70545) |
$871.80 |
$4,359 |
2.6× |
| MRA neck w contrast (70548) |
$1,073.60 |
$5,368 |
3.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,406 |
$7,030 |
4.2× |
| MRA neck w/o contrast (70547) |
$998.40 |
$4,992 |
4.3× |
| MRI abdomen w contrast (74182) |
$600.40 |
$3,002 |
1.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$732.40 |
$3,662 |
2.2× |
| MRI abdomen w/o contrast (74181) |
$998.40 |
$4,992 |
4.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,073.60 |
$5,368 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,073.60 |
$5,368 |
1.4× |
| MRI breast w/o contrast bilateral (77047) |
$900.40 |
$4,502 |
3.9× |
| MRI breast w/o contrast unilat (77046) |
$900.40 |
$4,502 |
3.9× |
| MRI c-spine with contrast (72142) |
$1,406 |
$7,030 |
4.2× |
| MRI cardiac w/o contrast (75557) |
$862.20 |
$4,311 |
3.7× |
| MRI cervical spine w/o contrast (72141) |
$998.40 |
$4,992 |
4.3× |
| MRI chest w/o & w/contrast material (71552) |
$1,406 |
$7,030 |
4.2× |
| MRI chest w/o contrast (71550) |
$864 |
$4,320 |
3.8× |
| MRI chest with contrast (71551) |
$850.20 |
$4,251 |
1.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,073.60 |
$5,368 |
3.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,307.60 |
$6,538 |
3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$803 |
$4,015 |
3.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,405.80 |
$7,029 |
6.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$873.40 |
$4,367 |
2.6× |
| MRI orbit/face/neck w/contrast (70542) |
$878 |
$4,390 |
2.6× |
| MRI pelvis w contrast (72196) |
$1,073.60 |
$5,368 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$906.60 |
$4,533 |
2.7× |
| MRI pelvis w/o contrast (72195) |
$583.80 |
$2,919 |
2.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,210 |
$6,050 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,210.20 |
$6,051 |
3.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,406 |
$7,030 |
4.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,406 |
$7,030 |
4.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,406 |
$7,030 |
4.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,406 |
$7,030 |
4.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,406 |
$7,030 |
4.2× |
| MRI thoracic spine w/o contrast (72146) |
$998.40 |
$4,992 |
4.3× |
| MRI tmj (70336) |
$998.40 |
$4,992 |
4.3× |
| MRI upper ext joint w/o contrast (73221) |
$998.40 |
$4,992 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,210.20 |
$6,051 |
3.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$998.40 |
$4,992 |
4.3× |
| Myocardial infarct spect (78469) |
$1,150.80 |
$5,754 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,308 |
$6,540 |
1.0× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,793 |
$8,965 |
2.2× |
| Neck soft tissue (70360) |
$145.40 |
$727 |
1.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$242.60 |
$1,213 |
0.6× |
| Nm adrenal scan (78075) |
$1,280.80 |
$6,404 |
1.0× |
| Nm bone marrow wb (78104) |
$1,207.60 |
$6,038 |
3.1× |
| Nm cisternogram (78630) |
$1,070.60 |
$5,353 |
2.0× |
| Nm csf leak detection (78650) |
$1,347.80 |
$6,739 |
1.1× |
| Nm gastric emptying study (78264) |
$411.60 |
$2,058 |
1.1× |
| Nm gastroesophageal reflux study (78262) |
$1,092 |
$5,460 |
2.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$748.60 |
$3,743 |
1.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,161.80 |
$5,809 |
3.0× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$1,005 |
$5,025 |
1.9× |
| Nuclear Rx Oral Admin (79005) |
$651.80 |
$3,259 |
2.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$278 |
$1,390 |
2.8× |
| Orthopantogram (70355) |
$184.60 |
$923 |
2.2× |
| Osseous survey infant (77076) |
$132 |
$660 |
1.3× |
| Osseous survey limited (77074) |
$254.20 |
$1,271 |
2.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,135.80 |
$5,679 |
2.9× |
| Parathyroid imaging (78070) |
$928.80 |
$4,644 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$228.40 |
$1,142 |
2.3× |
| Peritoneogram rs&i (74190) |
$526.60 |
$2,633 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$2,724.60 |
$13,623 |
2.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,210.20 |
$6,051 |
3.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$855.80 |
$4,279 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$563.40 |
$2,817 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$375 |
$1,875 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$360.60 |
$1,803 |
4.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$204 |
$1,020 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$143.80 |
$719 |
1.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$282.20 |
$1,411 |
2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$244.20 |
$1,221 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$215.60 |
$1,078 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$409.60 |
$2,048 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$293.60 |
$1,468 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$371.40 |
$1,857 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$715.80 |
$3,579 |
4.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$581.60 |
$2,908 |
3.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$230.20 |
$1,151 |
2.7× |
| Radiological examination surgical specimen (76098) |
$375 |
$1,875 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,919.60 |
$9,598 |
0.6× |
| Ribs bilateral 3 views (71110) |
$409.60 |
$2,048 |
4.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$636.20 |
$3,181 |
1.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$995.40 |
$4,977 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$353 |
$1,765 |
0.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$818.60 |
$4,093 |
0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,825.80 |
$9,129 |
1.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,825.80 |
$9,129 |
1.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$530.80 |
$2,654 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$397.80 |
$1,989 |
1.8× |
| Sacroiliac Joints < 3 Views (72200) |
$167.20 |
$836 |
1.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$265.40 |
$1,327 |
1.2× |
| Salivary gland imaging (78230) |
$1,244.20 |
$6,221 |
3.2× |
| Salivary gland imaging serial images (78231) |
$1,244.20 |
$6,221 |
3.2× |
| Scanogram (77073) |
$72.40 |
$362 |
0.7× |
| Scapula complete (73010) |
$110.40 |
$552 |
1.1× |
| Screening digital breast tomosynthesis (77063) |
$193.80 |
$969 |
8.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$143.80 |
$719 |
1.4× |
| Small bowel series (74250) |
$338.60 |
$1,693 |
2.0× |
| Spine thoracic 3 views (72072) |
$409.60 |
$2,048 |
4.1× |
| Testicular Imaging With Vascular Flow (78761) |
$505.60 |
$2,528 |
1.3× |
| Therapeutic Enema (74283) |
$247.20 |
$1,236 |
1.5× |
| Thoracolumbar 2 views (72080) |
$161 |
$805 |
1.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$701.40 |
$3,507 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$587 |
$2,935 |
1.5× |
| Tmj unilateral (70328) |
$86.60 |
$433 |
1.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,403 |
$12,015 |
4.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$773 |
$3,865 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$293.80 |
$1,469 |
2.9× |
| Umbilical-artery Doppler (OB) (76820) |
$291.80 |
$1,459 |
2.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$211.40 |
$1,057 |
2.5× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$681.80 |
$3,409 |
1.8× |
| Unlisted Ultrasound Procedure (76999) |
$381.80 |
$1,909 |
4.5× |
| Upper Extremity Infant (73092) |
$137.20 |
$686 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$845.80 |
$4,229 |
3.7× |
| Urethrocystography voiding (74455) |
$538 |
$2,690 |
2.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,181 |
$5,905 |
7.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$204.40 |
$1,022 |
1.2× |
| Us abdl aorta screen aaa (76706) |
$305.40 |
$1,527 |
3.0× |
| Us breast unilateral complete (76641) |
$168 |
$840 |
1.7× |
| Us breast unilateral limited (76642) |
$214.20 |
$1,071 |
2.6× |
| Us chest (76604) |
$278 |
$1,390 |
2.8× |
| Us compl joint r-t w/image documentation (76881) |
$152.40 |
$762 |
1.5× |
| Us elastography parenchyma (76981) |
$230.60 |
$1,153 |
2.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$172 |
$860 |
1.7× |
| Us guided compression repair (76936) |
$268 |
$1,340 |
1.3× |
| Us infant hips dynamic (76885) |
$426 |
$2,130 |
5.1× |
| Us infant hips limited static (76886) |
$130 |
$650 |
1.5× |
| Us kidney transplant (76776) |
$399 |
$1,995 |
4.0× |
| Us ob detailed single fetus (76811) |
$646.60 |
$3,233 |
2.8× |
| Us ob transvaginal (76817) |
$169 |
$845 |
1.7× |
| Us pelvic non ob complete (76856) |
$278 |
$1,390 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$225 |
$1,125 |
2.2× |
| Us pregnancy ltd (76815) |
$278 |
$1,390 |
2.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$297.40 |
$1,487 |
2.9× |
| Us retroperitoneal complete (76770) |
$479.20 |
$2,396 |
4.8× |
| Us retroperitoneal limited (76775) |
$409.60 |
$2,048 |
4.1× |
| Us scrotum and contents (76870) |
$473.20 |
$2,366 |
4.7× |
| Us soft tissue head/neck (76536) |
$253.80 |
$1,269 |
2.5× |
| Us spinal canal and contents (76800) |
$409.60 |
$2,048 |
4.1× |
| Us transrectal (76872) |
$278 |
$1,390 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$305.40 |
$1,527 |
3.0× |
| Vascular flow imaging (78445) |
$347.20 |
$1,736 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$268.60 |
$1,343 |
3.2× |
| Wrist 2 views (73100) |
$172.10 |
$860.50 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$437 |
$2,185 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$203.40 |
$1,017 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$235 |
$1,175 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$850.20 |
$4,251 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$178.40 |
$892 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$248.80 |
$1,244 |
3.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$409.60 |
$2,048 |
4.1× |
| X-ray exam hip uni 1 view (73501) |
$137.40 |
$687 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$102.80 |
$514 |
1.2× |
| X-ray exam hip uni 4/> views (73503) |
$465.20 |
$2,326 |
4.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$409.60 |
$2,048 |
4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$409.60 |
$2,048 |
4.1× |
| X-ray eye for foreign body (70030) |
$136.60 |
$683 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$305.60 |
$1,528 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$177 |
$885 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$235.40 |
$1,177 |
2.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,712.40 |
$8,562 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$139.80 |
$699 |
1.7× |
| X-ray IV pyelogram+drip infusn (74410) |
$798.80 |
$3,994 |
4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$241.20 |
$1,206 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$274.40 |
$1,372 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$171.40 |
$857 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$119.60 |
$598 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$352.40 |
$1,762 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$244.40 |
$1,222 |
2.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$171.60 |
$858 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$153.20 |
$766 |
1.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$490 |
$2,450 |
5.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$152.60 |
$763 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$473.80 |
$2,369 |
4.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$382.20 |
$1,911 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$214.20 |
$1,071 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$200 |
$1,000 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$143.60 |
$718 |
1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$113.20 |
$566 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$196.40 |
$982 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$212.70 |
$1,063.50 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$352.40 |
$1,762 |
4.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$111.40 |
$557 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$417.60 |
$2,088 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$233 |
$1,165 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$119.60 |
$598 |
1.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$186.40 |
$932 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$172.40 |
$862 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$335.20 |
$1,676 |
3.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$381.60 |
$1,908 |
3.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$119.60 |
$598 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$208 |
$1,040 |
2.5× |
| Xr arthrogram ankle (73615) |
$468.60 |
$2,343 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$190.40 |
$952 |
1.9× |
| Xr chest 4+ views (71048) |
$409.60 |
$2,048 |
4.1× |
| Xr Cholecystography Oral Contrast (74290) |
$273.80 |
$1,369 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$184.20 |
$921 |
2.2× |
| Xr internal auditory meati complete (70134) |
$110 |
$550 |
0.2× |
| Xr shoulder 1 view (73020) |
$106.30 |
$531.50 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$409.60 |
$2,048 |
4.1× |
| Xr tibia/fibula 2 views (73590) |
$212 |
$1,060 |
2.5× |
| Xr tmj bilateral (70330) |
$178.80 |
$894 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$227.80 |
$1,139 |
2.7× |