| Abdomen 2 views (74019) |
$360.43 |
$480.57 |
3.5× |
| Acute gi blood loss imaging (78278) |
$1,397.18 |
$1,862.90 |
3.5× |
| Angio Adrenal Bilat Select (75733) |
$4,982.05 |
$6,642.73 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,805.13 |
$3,740.17 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,484.02 |
$3,312.03 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$4,847.54 |
$6,463.39 |
1.6× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,503.16 |
$3,337.54 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,827.16 |
$3,769.54 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,553.67 |
$3,404.89 |
0.8× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,576.67 |
$3,435.56 |
0.5× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,315.06 |
$1,753.41 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,315.06 |
$1,753.41 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,227.40 |
$2,969.86 |
0.7× |
| Ankle 2 views (73600) |
$221.62 |
$295.49 |
2.6× |
| Aortogram thoracic (75605) |
$10,433.03 |
$13,910.71 |
1.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,791.16 |
$5,054.88 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$2,527.97 |
$3,370.63 |
0.8× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$2,102.86 |
$2,803.81 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$2,193.02 |
$2,924.02 |
0.7× |
| Arthrogram ankle (73615) |
$609.66 |
$812.88 |
1.8× |
| Arthrogram hip (73525) |
$717.74 |
$956.99 |
2.1× |
| Arthrogram knee (73580) |
$559.76 |
$746.35 |
1.6× |
| Arthrogram shoulder (73040) |
$760.52 |
$1,014.02 |
2.2× |
| Arthrogram wrist (73115) |
$746.03 |
$994.71 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,416.66 |
$1,888.88 |
3.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,734.21 |
$2,312.28 |
4.4× |
| Bone &/joint imaging whole body (78306) |
$1,575.91 |
$2,101.21 |
4.0× |
| Bone age studies (77072) |
$249.63 |
$332.84 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$1,750.30 |
$2,333.73 |
4.4× |
| Bone Marrow Imaging Limited Area (78102) |
$559.07 |
$745.42 |
1.4× |
| Bone survey complete (77075) |
$963.85 |
$1,285.13 |
9.3× |
| Bone survey infant (77076) |
$963.03 |
$1,284.04 |
9.3× |
| Bowel imaging (78290) |
$1,549.18 |
$2,065.58 |
3.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,067.72 |
$1,423.63 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,252.85 |
$9,670.47 |
5.1× |
| Brain Imaging Vascular Flow Only (78610) |
$1,472.50 |
$1,963.33 |
2.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$104.45 |
$139.27 |
0.3× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,582.02 |
$2,109.36 |
4.0× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$4,416.27 |
$5,888.36 |
5.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,832.24 |
$3,776.32 |
8.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$943.60 |
$1,258.13 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$373.44 |
$497.92 |
4.3× |
| Chest 1 view (71045) |
$272.44 |
$363.26 |
3.2× |
| Chest xray 3 views (71047) |
$350.97 |
$467.96 |
4.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$781.93 |
$1,042.57 |
4.5× |
| Clavicle complete (73000) |
$292.83 |
$390.44 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,794.44 |
$2,392.59 |
17.4× |
| Continuing medical physics consltj pr wk (77336) |
$357.61 |
$476.81 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,794.50 |
$6,392.67 |
13.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,808.44 |
$3,744.58 |
11.9× |
| CT abdomen w contrast (74160) |
$2,337.77 |
$3,117.03 |
13.5× |
| CT abdomen w wo contrast (74170) |
$2,453.05 |
$3,270.73 |
14.2× |
| CT abdomen w/o contrast (74150) |
$1,784.28 |
$2,379.04 |
17.3× |
| CT angio hrt w/3d image (75574) |
$2,773.31 |
$3,697.75 |
8.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,270.16 |
$3,026.88 |
13.1× |
| CT angiography upper extremity lt (73206) |
$2,230.67 |
$2,974.23 |
12.9× |
| CT c-spine w/contrast (72126) |
$2,189.13 |
$2,918.84 |
6.4× |
| CT c-spine w/o contrast (72125) |
$1,643.75 |
$2,191.67 |
15.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,356.90 |
$3,142.53 |
13.6× |
| CT chest w contrast (71260) |
$2,648 |
$3,530.67 |
15.3× |
| CT chest w/wo contrast (71270) |
$3,215.71 |
$4,287.61 |
18.6× |
| CT colonography screening (74263) |
$308.23 |
$410.97 |
1.3× |
| CT colonography w/o cntrst (74261) |
$2,187.65 |
$2,916.87 |
21.2× |
| CT head/brain with contrast (70460) |
$1,574.13 |
$2,098.84 |
9.1× |
| CT head/brain without and with contrast (70470) |
$2,009.62 |
$2,679.50 |
11.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$5,099.79 |
$6,799.72 |
14.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$287.74 |
$383.65 |
3.3× |
| CT hrt w/3d image congen (75573) |
$4,897.29 |
$6,529.72 |
14.2× |
| CT iac w contrast (70481) |
$1,512.88 |
$2,017.18 |
8.7× |
| CT lower ext w/o (73700) |
$1,426.54 |
$1,902.06 |
13.8× |
| CT lower extremity w wo contrast (73702) |
$1,888.16 |
$2,517.55 |
10.9× |
| CT lower extremity w/contrast material (73701) |
$1,755.87 |
$2,341.16 |
10.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,415.64 |
$3,220.86 |
13.9× |
| CT lumbar spine w/contrast (72132) |
$2,210 |
$2,946.67 |
6.4× |
| CT lumbar spine w/o contrast (72131) |
$1,862.72 |
$2,483.62 |
18.0× |
| CT maxillofacial w contrast (70487) |
$1,906.68 |
$2,542.24 |
11.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,204.55 |
$2,939.40 |
12.7× |
| CT maxillofacial wo contrast (70486) |
$1,392.26 |
$1,856.34 |
13.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,572.87 |
$2,097.16 |
9.1× |
| CT orbits w/o contrast (70480) |
$1,318.72 |
$1,758.29 |
12.8× |
| CT pelvis w/o contrast (72192) |
$1,823.56 |
$2,431.42 |
17.7× |
| CT pelvis w/wo contrast (72194) |
$2,628.98 |
$3,505.30 |
15.2× |
| CT scan of arm combo (73202) |
$2,016.71 |
$2,688.95 |
11.6× |
| CT soft tissue neck w contrast (70491) |
$1,831.22 |
$2,441.63 |
10.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,178.53 |
$2,904.71 |
12.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,500.88 |
$2,001.18 |
14.5× |
| CT thoracic spine w/contrast (72129) |
$2,279.98 |
$3,039.98 |
13.2× |
| CT thoracic spine w/o contrast (72128) |
$1,604.89 |
$2,139.85 |
15.5× |
| CT thoracic spine w/wo contrast (72130) |
$2,811.78 |
$3,749.04 |
16.2× |
| CT thorax w/o contrast (71250) |
$1,644.57 |
$2,192.76 |
15.9× |
| CT upper ext wo (73200) |
$1,479.14 |
$1,972.19 |
14.3× |
| CT upper extremity with contrast (73201) |
$1,781.14 |
$2,374.85 |
5.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,923.82 |
$2,565.10 |
11.1× |
| Cta Abdomen (74175) |
$2,136.25 |
$2,848.33 |
12.3× |
| CTA abdomen pelvis (74174) |
$2,651.20 |
$3,534.94 |
7.7× |
| CTA chest (71275) |
$2,374.08 |
$3,165.44 |
13.7× |
| Cta Head (70496) |
$2,034.36 |
$2,712.48 |
11.7× |
| Cta Neck (70498) |
$2,223.65 |
$2,964.87 |
12.8× |
| Cta Pelvis (72191) |
$2,145.58 |
$2,860.78 |
12.4× |
| Cystography minimum 3 views rs&i (74430) |
$494.28 |
$659.04 |
1.4× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$2,300.58 |
$3,067.44 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$455.71 |
$607.61 |
4.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$378.20 |
$504.26 |
4.4× |
| Dxa bone density study axial skeleton (77085) |
$468.98 |
$625.31 |
4.5× |
| Esophagus (74220) |
$552.57 |
$736.76 |
3.2× |
| Facial bones min 3 views (70150) |
$473.90 |
$631.87 |
4.6× |
| Fetal biophysical profile non-stress testing (76818) |
$367.92 |
$490.55 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$319.12 |
$425.50 |
3.1× |
| Fluoroscopy up to 1 hr (76000) |
$554.66 |
$739.55 |
2.4× |
| Foot 2 views (73620) |
$219.42 |
$292.56 |
2.6× |
| Forearm 2 views (73090) |
$282.69 |
$376.92 |
3.3× |
| Functional MRI brain by phys/psych (70555) |
$3,960.17 |
$5,280.23 |
16.8× |
| Functional MRI brain by tech (70554) |
$3,658.54 |
$4,878.06 |
15.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$361.08 |
$481.44 |
0.7× |
| Hand 2 views (73120) |
$220.46 |
$293.94 |
2.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,454.21 |
$3,272.28 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,636.60 |
$2,182.14 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,623.90 |
$2,165.20 |
4.1× |
| Hysterosalpingogram (74740) |
$673.39 |
$897.85 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$330.80 |
$441.06 |
3.2× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$527.28 |
$703.04 |
1.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,313.46 |
$1,751.28 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,611.73 |
$2,148.97 |
3.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,535.35 |
$2,047.13 |
2.9× |
| Knee 3 views (73562) |
$361.94 |
$482.58 |
4.2× |
| Liver & spleen imaging static only (78215) |
$650.14 |
$866.85 |
1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$3,564.16 |
$4,752.21 |
9.0× |
| Liver imaging static only (78201) |
$574.32 |
$765.76 |
1.1× |
| Lung perf&ventilat diferentl (78598) |
$1,369.18 |
$1,825.57 |
2.6× |
| Lung perfusion differential (78597) |
$1,238.12 |
$1,650.83 |
3.1× |
| Lung ventilation imaging (78579) |
$756.91 |
$1,009.21 |
1.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,884.28 |
$3,845.71 |
0.9× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,670.46 |
$2,227.28 |
0.5× |
| Lymphoscintigraphy (78195) |
$1,418.80 |
$1,891.74 |
2.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,826.81 |
$3,769.08 |
3.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,665.66 |
$3,554.22 |
7.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,782.26 |
$5,043.02 |
11.0× |
| Magnetic Resonance Elastography (76391) |
$1,267.58 |
$1,690.11 |
5.4× |
| MRA head w & w/o contrast (70546) |
$3,474.77 |
$4,633.03 |
10.1× |
| MRA head w/o contrast (70544) |
$2,527.61 |
$3,370.15 |
10.7× |
| MRA head with contrast (70545) |
$2,208.85 |
$2,945.13 |
6.4× |
| MRA neck w contrast (70548) |
$2,902.68 |
$3,870.24 |
8.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,931.43 |
$5,241.91 |
11.4× |
| MRA neck w/o contrast (70547) |
$2,487.16 |
$3,316.22 |
10.6× |
| MRI abdomen w contrast (74182) |
$3,033.82 |
$4,045.09 |
8.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,764.80 |
$5,019.73 |
10.9× |
| MRI abdomen w/o contrast (74181) |
$2,633.37 |
$3,511.16 |
11.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,016.17 |
$4,021.56 |
3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,429.02 |
$4,572.03 |
9.9× |
| MRI breast w/o contrast bilateral (77047) |
$2,888.48 |
$3,851.30 |
12.3× |
| MRI breast wo contrast unilateral (77046) |
$1,514.03 |
$2,018.71 |
6.4× |
| MRI c-spine with contrast (72142) |
$3,101.54 |
$4,135.38 |
9.0× |
| MRI cardiac w/o cont stress (75559) |
$2,738.96 |
$3,651.94 |
5.1× |
| MRI cervical spine w/o contrast (72141) |
$3,033.95 |
$4,045.27 |
12.9× |
| MRI chest w/o & w/contrast material (71552) |
$3,831.46 |
$5,108.62 |
11.1× |
| MRI chest w/o contrast (71550) |
$2,647.82 |
$3,530.43 |
11.2× |
| MRI chest with contrast (71551) |
$2,533.91 |
$3,378.55 |
3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,389.06 |
$3,185.42 |
6.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,388.27 |
$4,517.69 |
9.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,520.40 |
$3,360.53 |
10.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,794.44 |
$3,725.92 |
11.9× |
| MRI orbit face neck w contrast (70542) |
$3,462.71 |
$4,616.95 |
10.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,207.36 |
$5,609.82 |
12.2× |
| MRI pelvis w/contrast (72196) |
$2,595.02 |
$3,460.03 |
7.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,648.44 |
$3,531.26 |
7.7× |
| MRI pelvis w/o contrast (72195) |
$2,693.92 |
$3,591.90 |
11.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,249.73 |
$5,666.30 |
12.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,214.55 |
$4,286.07 |
9.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,232.92 |
$5,643.90 |
12.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,002.26 |
$4,003.02 |
8.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,046.02 |
$5,394.70 |
11.7× |
| MRI temporomandibular joint (70336) |
$2,252.10 |
$3,002.80 |
9.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,804.39 |
$3,739.19 |
11.9× |
| MRI up ext w/o contrast (73218) |
$2,547.17 |
$3,396.23 |
10.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,335.61 |
$3,114.15 |
9.9× |
| MRI, joint upper extrem combo (73223) |
$3,387.10 |
$4,516.14 |
9.8× |
| Myelogram Cervical (72240) |
$896.37 |
$1,195.16 |
1.2× |
| Myelogram Lumbar (72265) |
$1,272.32 |
$1,696.43 |
1.6× |
| Myelogram thoracic (72255) |
$1,423.04 |
$1,897.38 |
1.8× |
| Myelography 2 or more regions (72270) |
$1,841.78 |
$2,455.70 |
2.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,867.50 |
$7,823.34 |
4.6× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78433) |
$5,468.14 |
$7,290.85 |
2.5× |
| Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) |
$5,751.41 |
$7,668.55 |
4.1× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$7,237.89 |
$9,650.52 |
3.3× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$4,239.94 |
$5,653.26 |
3.0× |
| Myocardial infarct spect (78469) |
$1,748.78 |
$2,331.70 |
3.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,781.37 |
$5,041.83 |
3.0× |
| Myocardial spect single study at rest or stress (78451) |
$3,292.96 |
$4,390.62 |
2.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$5,946.83 |
$7,929.11 |
4.2× |
| Neck soft tissue (70360) |
$284.13 |
$378.84 |
3.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$312.05 |
$416.07 |
0.8× |
| Nm bone marrow wb (78104) |
$766.60 |
$1,022.14 |
1.9× |
| Nm cisternogram (78630) |
$1,491.74 |
$1,988.99 |
2.8× |
| Nm csf leak detection (78650) |
$1,030.90 |
$1,374.53 |
0.8× |
| Nm gastric emptying study (78264) |
$1,370.86 |
$1,827.81 |
3.5× |
| Nm gastroesophageal reflux study (78262) |
$1,359.80 |
$1,813.07 |
3.4× |
| Noncardiac Vascular Flow Imaging (78445) |
$1,191.10 |
$1,588.13 |
3.0× |
| Nonvascular shunt X-ray (75809) |
$627.68 |
$836.91 |
6.1× |
| Nuclear Rx Oral Admin (79005) |
$2,327.19 |
$3,102.92 |
10.1× |
| Ob us nuchal meas 1 gest (76813) |
$894.13 |
$1,192.17 |
8.7× |
| Orthopantogram (70355) |
$161.14 |
$214.85 |
1.9× |
| Osseous survey limited (77074) |
$595.07 |
$793.43 |
5.8× |
| Parathyrd planar w/spect&CT (78072) |
$2,285.24 |
$3,046.98 |
4.3× |
| Parathyroid Planar Imaging (78070) |
$1,194.56 |
$1,592.74 |
3.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,493.23 |
$1,990.97 |
3.8× |
| Pelvis 1 or 2 views (72170) |
$277.04 |
$369.38 |
2.7× |
| Perineogram (74775) |
$898.22 |
$1,197.62 |
3.8× |
| Peritoneogram after injection (74190) |
$378.37 |
$504.49 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$7,341.15 |
$9,788.20 |
5.2× |
| PET imaging for CT attenuation whole body (78816) |
$8,396.26 |
$11,195.02 |
5.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,639.58 |
$3,519.44 |
0.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,301.64 |
$3,068.85 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$941.20 |
$1,254.94 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,617.98 |
$2,157.30 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$831.26 |
$1,108.34 |
1.5× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$360.73 |
$480.97 |
4.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$295.97 |
$394.63 |
3.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$376.21 |
$501.61 |
4.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$286.15 |
$381.54 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$452.08 |
$602.78 |
4.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$459.39 |
$612.52 |
4.4× |
| Radex fingr minimum 2 views (73140) |
$275.51 |
$367.35 |
3.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$360.42 |
$480.56 |
4.2× |
| Radex Hand Minimum 3 Views (73130) |
$351.39 |
$468.52 |
4.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$321.96 |
$429.28 |
3.7× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$833.53 |
$1,111.37 |
8.1× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,307.68 |
$1,743.57 |
12.7× |
| Radex Humerus Minimum 2 Views (73060) |
$326.76 |
$435.68 |
3.8× |
| Radex Kne 1/2 Views (73560) |
$254.22 |
$338.96 |
3.0× |
| Radex Kne Compl 4/More Views (73564) |
$384.98 |
$513.30 |
3.7× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$476.26 |
$635.02 |
4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$344.24 |
$458.99 |
4.0× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$401.81 |
$535.75 |
3.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$370.52 |
$494.02 |
4.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$332.24 |
$442.99 |
3.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$394.72 |
$526.29 |
3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$428.54 |
$571.38 |
5.0× |
| Radex Toe Minimum 2 Views (73660) |
$295.76 |
$394.35 |
3.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$243.63 |
$324.84 |
2.4× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$368.31 |
$491.08 |
4.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$802.34 |
$1,069.78 |
7.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$275.08 |
$366.78 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$332.26 |
$443.01 |
3.2× |
| Radiologic exam chest 2 views (71046) |
$322.06 |
$429.41 |
3.7× |
| Radiologic exam colon single contrast study (74270) |
$914.24 |
$1,218.99 |
5.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$580.21 |
$773.61 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,117.28 |
$1,489.71 |
6.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$767.22 |
$1,022.96 |
4.4× |
| Radiologic examination femur 1 view (73551) |
$245.80 |
$327.74 |
2.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$290.20 |
$386.94 |
3.4× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$255.39 |
$340.52 |
2.5× |
| Radiological examination surgical specimen (76098) |
$271.60 |
$362.13 |
0.5× |
| Ribs bilateral 3 views (71110) |
$496.23 |
$661.64 |
4.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,971.67 |
$2,628.89 |
3.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,032.53 |
$1,376.70 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,969.24 |
$2,625.66 |
3.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,632.52 |
$2,176.70 |
1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,901.46 |
$2,535.28 |
1.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,969.24 |
$2,625.66 |
1.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,829.14 |
$2,438.86 |
7.9× |
| Rp Therapy Intravenous Administration (79101) |
$861.35 |
$1,148.47 |
3.7× |
| Sacroiliac Joints < 3 Views (72200) |
$394.40 |
$525.86 |
3.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$699.09 |
$932.12 |
3.0× |
| Scapula (73010) |
$356.38 |
$475.17 |
3.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$104.26 |
$139.02 |
4.5× |
| Sella turcica (70240) |
$155.97 |
$207.96 |
1.8× |
| Shoulder 1 view (73020) |
$278.73 |
$371.64 |
3.2× |
| Sialogram (70390) |
$784.50 |
$1,046 |
3.3× |
| Small bowel series (74250) |
$753.01 |
$1,004.01 |
4.3× |
| Special dosimetry (77331) |
$431.30 |
$575.07 |
3.2× |
| Spine thoracic 3 views (72072) |
$371.96 |
$495.95 |
3.6× |
| Splenoportograpy rs&i (75810) |
$2,277.80 |
$3,037.07 |
0.7× |
| Superior sagittal sinus venogram (75870) |
$1,853.34 |
$2,471.12 |
0.6× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$175.88 |
$234.50 |
2.0× |
| Tbs technical calculation only (77091) |
$168.78 |
$225.04 |
2.0× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$741.62 |
$988.82 |
3.1× |
| Thoracolumbar 2 views (72080) |
$447.82 |
$597.09 |
5.2× |
| Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) |
$1,452.75 |
$1,937 |
3.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,778.51 |
$2,371.35 |
3.3× |
| Thyroid imaging w/blood flow (78013) |
$1,299.46 |
$1,732.62 |
3.3× |
| Thyroid uptake measurement (78012) |
$554.78 |
$739.70 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,874.65 |
$2,499.53 |
4.7× |
| Ultrasound breast complete (76641) |
$1,374.24 |
$1,832.32 |
13.3× |
| Ultrasound elastography first target lesion (76982) |
$572.50 |
$763.33 |
5.5× |
| Ultrasound Exam Aaa Screen (76706) |
$270.66 |
$360.88 |
2.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$488.60 |
$651.47 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$537.38 |
$716.51 |
5.2× |
| Umbilical-artery Doppler (OB) (76820) |
$381.60 |
$508.80 |
3.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$432.94 |
$577.25 |
5.0× |
| Unlisted fluoroscopic procedure (76496) |
$1,472.68 |
$1,963.58 |
17.1× |
| Unlisted magnetic resonance procedure (76498) |
$3,809.03 |
$5,078.71 |
44.3× |
| Unlisted ultrasound procedure (76999) |
$300.80 |
$401.07 |
3.5× |
| Ureteral reflux study (78740) |
$887.30 |
$1,183.06 |
2.2× |
| Urethrocystogram voiding (74455) |
$545.44 |
$727.25 |
2.3× |
| Urethrocystography retrograde rs&i (74450) |
$533.79 |
$711.72 |
2.3× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,000.33 |
$1,333.77 |
5.8× |
| Us breast unilateral limited (76642) |
$807.26 |
$1,076.34 |
9.4× |
| Us chest (76604) |
$452.28 |
$603.04 |
4.4× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$224.57 |
$299.43 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$507.29 |
$676.39 |
4.9× |
| Us elastography parenchyma (76981) |
$914.27 |
$1,219.03 |
8.9× |
| Us encephalogram (76506) |
$602.84 |
$803.78 |
5.8× |
| Us hips infant static (76886) |
$28.05 |
$37.40 |
0.3× |
| Us infant hips w manipulation (76885) |
$551.99 |
$735.99 |
6.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$473.56 |
$631.42 |
4.6× |
| Us ob detailed single fetus (76811) |
$802.44 |
$1,069.92 |
3.4× |
| Us ob limited (76815) |
$300.15 |
$400.20 |
2.9× |
| Us ob transvaginal (76817) |
$465.65 |
$620.87 |
4.5× |
| Us pelvic non ob complete (76856) |
$521.52 |
$695.36 |
5.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$491.96 |
$655.95 |
4.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$545.19 |
$726.92 |
5.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$447.12 |
$596.16 |
4.3× |
| Us retroperitoneal complete (76770) |
$584.51 |
$779.35 |
5.7× |
| Us retroperitoneal limited (76775) |
$450.69 |
$600.92 |
4.4× |
| Us scrotum and contents (76870) |
$487.92 |
$650.56 |
4.7× |
| Us soft tissue head/neck (76536) |
$524.24 |
$698.99 |
5.1× |
| Us spinal canal and contents (76800) |
$711.02 |
$948.02 |
6.9× |
| Us, eye b-scan (76512) |
$180.82 |
$241.10 |
1.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$567.56 |
$756.75 |
5.5× |
| Venogram adrenal unilat (75840) |
$1,817.28 |
$2,423.04 |
0.6× |
| Venogram extremity bilateral (75822) |
$1,615.17 |
$2,153.56 |
1.0× |
| Venogram Extremity Unilateral (75820) |
$1,248.78 |
$1,665.04 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$5,222.08 |
$6,962.77 |
1.7× |
| Venography caval superior serialography rs&i (75827) |
$1,425.87 |
$1,901.16 |
0.9× |
| Venography Renal Bilateral (75833) |
$2,493.59 |
$3,324.79 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,591.44 |
$3,455.25 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,316.07 |
$1,754.76 |
0.4× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$1,212.03 |
$1,616.04 |
0.2× |
| Wrist 2 views (73100) |
$232.28 |
$309.71 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$435.23 |
$580.31 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$393.76 |
$525.01 |
4.6× |
| X-ray b.e. reductn intuss (74283) |
$691.16 |
$921.55 |
4.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$971.48 |
$1,295.31 |
5.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$218.40 |
$291.20 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$727.72 |
$970.30 |
8.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$870.38 |
$1,160.51 |
8.4× |
| X-ray exam of femur 2/> (73552) |
$332.70 |
$443.60 |
3.9× |
| X-ray eye for foreign body (70030) |
$25.96 |
$34.61 |
0.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$389.76 |
$519.68 |
4.5× |
| X-ray IV pyelogram (ivp) (74400) |
$794.60 |
$1,059.46 |
4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$363.60 |
$484.80 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$302.98 |
$403.98 |
3.5× |
| X-ray leg, infant (73592) |
$255.52 |
$340.69 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$371.07 |
$494.76 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$494.32 |
$659.09 |
4.8× |
| X-ray nose-rectum child f.b. (76010) |
$230.72 |
$307.62 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$588.16 |
$784.21 |
5.7× |
| X-ray retrograde pyelogram (74420) |
$716.43 |
$955.24 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$310.11 |
$413.48 |
3.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$392.25 |
$523 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$552.14 |
$736.19 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$445.16 |
$593.54 |
4.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$403.82 |
$538.42 |
4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$477.52 |
$636.70 |
5.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$472.03 |
$629.37 |
4.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$416.03 |
$554.71 |
4.0× |
| X-Ray Small Bowel Enteroclysis (74251) |
$921.68 |
$1,228.90 |
5.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$316.52 |
$422.02 |
3.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$411.76 |
$549.02 |
4.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$375.51 |
$500.68 |
4.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$362.98 |
$483.98 |
3.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$384.38 |
$512.50 |
3.7× |
| Xr bone length studies (77073) |
$491.37 |
$655.16 |
4.8× |
| Xr c-spine 4 or 5 views (72050) |
$447.52 |
$596.69 |
4.3× |
| Xr c-spine 6 or more views (72052) |
$675.55 |
$900.73 |
6.5× |
| Xr chest 4+ views (71048) |
$427.52 |
$570.02 |
4.1× |
| Xr urogram antegrade (74425) |
$647.41 |
$863.21 |
1.9× |