| Abdomen 2 views (74019) |
$81.90 |
$234 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$849.80 |
$2,428 |
2.4× |
| Ankle 2 views (73600) |
$85.05 |
$243 |
1.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$687.40 |
$1,964 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$729.14 |
$2,083.25 |
2.1× |
| Bone age studies (77072) |
$61.25 |
$175 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$912.32 |
$2,606.64 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$232.05 |
$663 |
3.0× |
| Chest 1 view (71045) |
$33.16 |
$94.75 |
0.4× |
| Clavicle complete (73000) |
$167.30 |
$478 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$357 |
$1,019.99 |
3.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,125.38 |
$8,929.66 |
10.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,158.95 |
$6,168.43 |
10.3× |
| CT abdomen w contrast (74160) |
$1,272.60 |
$3,636 |
8.3× |
| CT abdomen w wo contrast (74170) |
$946.75 |
$2,705 |
6.2× |
| CT abdomen w/o contrast (74150) |
$883.75 |
$2,525 |
9.6× |
| CT angiography upper extremity lt (73206) |
$558.25 |
$1,595 |
3.6× |
| CT c-spine w/o contrast (72125) |
$610.16 |
$1,743.30 |
6.7× |
| CT cervical spine w&w/o contrast (72127) |
$717.50 |
$2,050 |
4.7× |
| CT cervical spine with contrast (72126) |
$453.60 |
$1,296 |
1.5× |
| CT chest w/wo contrast (71270) |
$674.10 |
$1,926 |
4.4× |
| CT chest with contrast (71260) |
$1,665.88 |
$4,759.65 |
10.8× |
| CT head/brain with contrast (70460) |
$418.60 |
$1,196 |
2.7× |
| CT head/brain without and with contrast (70470) |
$739.20 |
$2,112 |
4.8× |
| CT iac w contrast (70481) |
$577.46 |
$1,649.90 |
3.8× |
| CT lower ext w/o (73700) |
$730.80 |
$2,088 |
8.0× |
| CT lower extremity w wo contrast (73702) |
$883.75 |
$2,525 |
5.7× |
| CT lower extremity with contrast (73701) |
$941.85 |
$2,691 |
6.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,319.50 |
$3,770 |
8.6× |
| CT lumbar spine w/o contrast (72131) |
$761.78 |
$2,176.52 |
8.3× |
| CT lumbar spine with contrast (72132) |
$558.25 |
$1,595 |
1.8× |
| CT maxillofacial w contrast (70487) |
$1,261.40 |
$3,604 |
8.2× |
| CT maxillofacial w/o contrast (70486) |
$720.72 |
$2,059.20 |
7.9× |
| CT maxillofacial w/wo contrast (70488) |
$507.50 |
$1,450 |
3.3× |
| CT neck soft tissue w contrast (70491) |
$1,453.62 |
$4,153.20 |
9.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$507.15 |
$1,449 |
3.3× |
| CT orbits w/o contrast (70480) |
$423.48 |
$1,209.95 |
4.6× |
| CT pelvis w & w/o contrast (72194) |
$507.50 |
$1,450 |
3.3× |
| CT pelvis w/o contrast (72192) |
$408.16 |
$1,166.17 |
4.5× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$164.85 |
$471 |
2.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,260.35 |
$3,601 |
8.2× |
| CT soft tissue neck w/o contrast (70490) |
$567 |
$1,620 |
6.2× |
| CT thoracic spine w/contrast (72129) |
$589.75 |
$1,685 |
3.8× |
| CT thoracic spine w/o contrast (72128) |
$957.93 |
$2,736.94 |
10.5× |
| CT thoracic spine w/wo contrast (72130) |
$634.20 |
$1,812 |
4.1× |
| CT thorax w/o contrast (71250) |
$425.08 |
$1,214.50 |
4.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$420 |
$1,200 |
2.7× |
| CT upper extremity w/o contrast rt (73200) |
$427.35 |
$1,221 |
4.7× |
| CT upper extremity with contrast (73201) |
$544.25 |
$1,555 |
1.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,708.70 |
$4,882 |
11.1× |
| Cta Abdomen (74175) |
$725.55 |
$2,073 |
4.7× |
| CTA abdomen pelvis (74174) |
$892.85 |
$2,551 |
2.9× |
| CTA chest (71275) |
$1,725.51 |
$4,930.04 |
11.2× |
| Cta Head (70496) |
$1,382.50 |
$3,950 |
9.0× |
| CTA lwr ext w&w/o contrast (73706) |
$888.30 |
$2,538 |
5.8× |
| Cta Neck (70498) |
$1,651.39 |
$4,718.25 |
10.7× |
| Cta Pelvis (72191) |
$558.25 |
$1,595 |
3.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$143.10 |
$408.85 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$72.45 |
$207 |
1.0× |
| Esophagus (74220) |
$838.95 |
$2,397 |
5.5× |
| Fetal biophysical profile non-stress testing (76818) |
$254.45 |
$727 |
2.8× |
| Fluoroscopy up to 1 hr (76000) |
$124.25 |
$355 |
0.6× |
| Foot 2 views (73620) |
$98.35 |
$281 |
1.3× |
| Forearm 2 views (73090) |
$252.27 |
$720.77 |
3.3× |
| Gated Heart Planar Single (78472) |
$854.70 |
$2,442 |
2.4× |
| Hand 2 views (73120) |
$213.42 |
$609.77 |
2.3× |
| Hand 3 views (73130) |
$95.40 |
$272.57 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$902.30 |
$2,578 |
1.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$795.90 |
$2,274 |
2.3× |
| Ht muscle image spect sing (78451) |
$1,071.88 |
$3,062.50 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$116.05 |
$331.58 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$925.75 |
$2,645 |
1.9× |
| Knee 3 views (73562) |
$160.82 |
$459.50 |
2.1× |
| Liver & spleen imaging static only (78215) |
$782.95 |
$2,237 |
2.2× |
| Liver imaging w/vascular flow (78202) |
$872.55 |
$2,493 |
1.8× |
| Meckels Diverticulum (78290) |
$673.75 |
$1,925 |
1.9× |
| MRA head w & w/o contrast (70546) |
$1,116.50 |
$3,190 |
3.7× |
| MRA head w/o contrast (70544) |
$1,116.50 |
$3,190 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,116.50 |
$3,190 |
3.7× |
| MRA neck w/o contrast (70547) |
$1,116.50 |
$3,190 |
5.3× |
| MRI abdomen w contrast (74182) |
$490 |
$1,400 |
1.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,516.38 |
$4,332.50 |
5.0× |
| MRI abdomen w/o contrast (74181) |
$532 |
$1,520 |
2.5× |
| MRI any jnt lwr ext with con lt (73722) |
$455 |
$1,300 |
0.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$682.50 |
$1,950 |
1.0× |
| MRI cervical spine w/o contrast (72141) |
$648.55 |
$1,853 |
3.1× |
| MRI chest w/o & w/contrast material (71552) |
$964.25 |
$2,755 |
3.2× |
| MRI chest w/o contrast (71550) |
$456.75 |
$1,305 |
2.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,075.52 |
$3,072.90 |
3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$805 |
$2,300 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$561.75 |
$1,605 |
2.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$456.75 |
$1,305 |
2.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$700 |
$2,000 |
2.3× |
| MRI pelvis w contrast (72196) |
$490 |
$1,400 |
1.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,050.65 |
$5,859 |
6.7× |
| MRI pelvis w/o contrast (72195) |
$456.75 |
$1,305 |
2.2× |
| MRI scan of arm joint before and after contrast (73223) |
$964.25 |
$2,755 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,043.35 |
$2,981 |
3.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$964.25 |
$2,755 |
3.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,470 |
$4,200 |
4.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,108.80 |
$3,168 |
3.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$609 |
$1,740 |
2.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,032.10 |
$5,806 |
6.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,433.25 |
$4,095 |
6.9× |
| MRI tmj (70336) |
$609 |
$1,740 |
2.9× |
| MRI upper ext joint w/o contrast (73221) |
$525.18 |
$1,500.50 |
2.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,060.50 |
$3,030 |
3.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$456.75 |
$1,305 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,136.22 |
$6,103.50 |
1.9× |
| Neck soft tissue (70360) |
$100.80 |
$288 |
1.3× |
| Nm gastric emptying study (78264) |
$682.50 |
$1,950 |
1.9× |
| Osseous survey infant (77076) |
$164.85 |
$471 |
1.8× |
| Osseous survey limited (77074) |
$304.50 |
$870 |
3.3× |
| Parathyroid imaging (78070) |
$683.55 |
$1,953 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$104.65 |
$299 |
1.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,782.55 |
$5,093 |
5.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$913.85 |
$2,611 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$76.62 |
$218.90 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$145.23 |
$414.95 |
1.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$68.60 |
$196 |
0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$87.50 |
$250 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$116.05 |
$331.58 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$110.25 |
$315 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$169.05 |
$483 |
2.2× |
| Ribs bilateral 3 views (71110) |
$145.82 |
$416.64 |
1.6× |
| Scanogram (77073) |
$118.65 |
$339 |
1.3× |
| Scapula complete (73010) |
$65.10 |
$186 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$265.30 |
$758 |
11.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$205.80 |
$588 |
2.2× |
| Spine thoracic 3 views (72072) |
$238.44 |
$681.25 |
2.6× |
| Therapeutic Enema (74283) |
$186.20 |
$532 |
1.2× |
| Thyroid uptake measurement (78012) |
$630 |
$1,800 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$660.45 |
$1,887 |
1.9× |
| Tmj unilateral (70328) |
$69.96 |
$199.90 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$317.67 |
$907.63 |
3.5× |
| Upper Extremity Infant (73092) |
$63.35 |
$181 |
0.7× |
| Us abdl aorta screen aaa (76706) |
$88.90 |
$254 |
1.0× |
| Us breast unilateral complete (76641) |
$238 |
$680 |
2.6× |
| Us breast unilateral limited (76642) |
$257.60 |
$736 |
3.4× |
| Us chest (76604) |
$157.50 |
$450 |
1.7× |
| Us compl joint r-t w/image documentation (76881) |
$232.05 |
$663 |
2.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$155.05 |
$443 |
1.7× |
| Us ob transvaginal (76817) |
$125.65 |
$359 |
1.4× |
| Us pelvic non ob complete (76856) |
$294.56 |
$841.60 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$118.65 |
$339 |
1.3× |
| Us pregnancy ltd (76815) |
$280.70 |
$802 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$134.40 |
$384 |
1.5× |
| Us retroperitoneal complete (76770) |
$158.20 |
$452 |
1.7× |
| Us retroperitoneal limited (76775) |
$310.10 |
$886 |
3.4× |
| Us scrotum and contents (76870) |
$489.78 |
$1,399.38 |
5.3× |
| Us soft tissue head/neck (76536) |
$424.38 |
$1,212.52 |
4.6× |
| Us spinal canal and contents (76800) |
$158.55 |
$453 |
1.7× |
| Us xtr non-vasc lmtd (76882) |
$150.85 |
$431 |
1.6× |
| Vertebral fracture assessment via dxa (77086) |
$82.60 |
$236 |
1.1× |
| Wrist 2 views (73100) |
$136.15 |
$389 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$86.06 |
$245.88 |
0.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$48.65 |
$139 |
0.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$157.36 |
$449.60 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$157.50 |
$450 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$139.39 |
$398.26 |
1.8× |
| X-ray exam hip uni 1 view (73501) |
$68.92 |
$196.90 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$186.90 |
$534 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$126.52 |
$361.50 |
1.4× |
| X-ray eye for foreign body (70030) |
$44.45 |
$127 |
0.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$179.05 |
$511.56 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$144.43 |
$412.66 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$75.95 |
$217 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$202.30 |
$578 |
2.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$63.35 |
$181 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$363.10 |
$1,037.42 |
4.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$143.50 |
$410 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$51.45 |
$147 |
0.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$139.96 |
$399.90 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$75.95 |
$217 |
0.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$420 |
$1,200 |
4.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$143.46 |
$409.90 |
0.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$152.60 |
$436 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$61.25 |
$175 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$151.90 |
$434 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$33.25 |
$95 |
0.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$82.78 |
$236.50 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$60.90 |
$174 |
0.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$72.45 |
$207 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$95.20 |
$272 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$189 |
$540 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$110.95 |
$317 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$33.25 |
$95 |
0.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$182.66 |
$521.88 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$75.46 |
$215.60 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$129.38 |
$369.66 |
1.7× |
| Xr c-spine 6 or more views (72052) |
$151.90 |
$434 |
1.7× |
| Xr Cholecystography Oral Contrast (74290) |
$102.16 |
$291.90 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$75.60 |
$216 |
1.0× |
| Xr shoulder 1 view (73020) |
$33.25 |
$95 |
0.4× |
| Xr spine cervical 4 or 5 views (72050) |
$391.58 |
$1,118.80 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$110.95 |
$317 |
1.5× |
| Xr tmj bilateral (70330) |
$106.75 |
$305 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$157.15 |
$449 |
2.1× |