| Abdomen 2 views (74019) |
$413.22 |
$413.22 |
3.8× |
| Ankle 2 views (73600) |
$287.06 |
$287.06 |
3.2× |
| Arthrogram hip (73525) |
$371 |
$371 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,235 |
$1,235 |
3.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,382 |
$1,382 |
3.3× |
| Bone &/joint imaging whole body (78306) |
$2,015.96 |
$2,015.96 |
4.9× |
| Bone age studies (77072) |
$221 |
$221 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$2,188.75 |
$2,188.75 |
5.3× |
| Bone survey complete (77075) |
$1,052.37 |
$1,052.37 |
9.7× |
| Cervical spine 2 or 3 views (72040) |
$373.42 |
$373.42 |
4.1× |
| Chest 1 view (71045) |
$296.75 |
$296.75 |
3.3× |
| Clavicle complete (73000) |
$314.54 |
$314.54 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$899 |
$899 |
8.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,573.85 |
$5,573.85 |
15.4× |
| CT abdomen and pelvis without contrast (74176) |
$4,016.18 |
$4,016.18 |
16.2× |
| CT abdomen w contrast (74160) |
$2,800.56 |
$2,800.56 |
15.4× |
| CT abdomen w wo contrast (74170) |
$3,358.15 |
$3,358.15 |
18.4× |
| CT abdomen w/o contrast (74150) |
$2,374.94 |
$2,374.94 |
21.9× |
| CT angiography upper extremity lt (73206) |
$3,376.50 |
$3,376.50 |
18.5× |
| CT c-spine w/o contrast (72125) |
$2,443.86 |
$2,443.86 |
22.5× |
| CT cervical spine w&w/o contrast (72127) |
$2,357 |
$2,357 |
12.9× |
| CT cervical spine with contrast (72126) |
$2,189 |
$2,189 |
6.0× |
| CT chest w/wo contrast (71270) |
$3,167.14 |
$3,167.14 |
17.4× |
| CT chest with contrast (71260) |
$2,817.52 |
$2,817.52 |
15.5× |
| CT head/brain with contrast (70460) |
$2,463.87 |
$2,463.87 |
13.5× |
| CT head/brain without and with contrast (70470) |
$2,621.26 |
$2,621.26 |
14.4× |
| CT iac w contrast (70481) |
$2,654.26 |
$2,654.26 |
14.6× |
| CT lower ext w/o (73700) |
$2,109.29 |
$2,109.29 |
19.4× |
| CT lower extremity w wo contrast (73702) |
$3,504.50 |
$3,504.50 |
19.2× |
| CT lower extremity with contrast (73701) |
$2,525.80 |
$2,525.80 |
13.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,891.95 |
$2,891.95 |
15.9× |
| CT lumbar spine w/o contrast (72131) |
$2,473.63 |
$2,473.63 |
22.8× |
| CT lumbar spine with contrast (72132) |
$2,776.18 |
$2,776.18 |
7.7× |
| CT maxillofacial w contrast (70487) |
$2,342.92 |
$2,342.92 |
12.9× |
| CT maxillofacial w/o contrast (70486) |
$2,022.30 |
$2,022.30 |
18.6× |
| CT maxillofacial w/wo contrast (70488) |
$2,587.07 |
$2,587.07 |
14.2× |
| CT neck soft tissue w contrast (70491) |
$2,558.01 |
$2,558.01 |
14.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,158 |
$2,158 |
11.8× |
| CT orbits w/o contrast (70480) |
$2,273.99 |
$2,273.99 |
20.9× |
| CT pelvis w & w/o contrast (72194) |
$2,944.95 |
$2,944.95 |
16.2× |
| CT pelvis w/o contrast (72192) |
$2,222.89 |
$2,222.89 |
20.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,932.83 |
$2,932.83 |
16.1× |
| CT soft tissue neck w/o contrast (70490) |
$2,265.46 |
$2,265.46 |
20.9× |
| CT thoracic spine w/contrast (72129) |
$2,616 |
$2,616 |
14.4× |
| CT thoracic spine w/o contrast (72128) |
$2,466.32 |
$2,466.32 |
22.7× |
| CT thoracic spine w/wo contrast (72130) |
$2,349 |
$2,349 |
12.9× |
| CT thorax w/o contrast (71250) |
$2,250.44 |
$2,250.44 |
20.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,227 |
$2,227 |
12.2× |
| CT upper extremity w/o contrast rt (73200) |
$2,154.84 |
$2,154.84 |
19.8× |
| CT upper extremity with contrast (73201) |
$2,496.14 |
$2,496.14 |
6.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,537.45 |
$3,537.45 |
19.4× |
| Cta Abdomen (74175) |
$3,646.58 |
$3,646.58 |
20.0× |
| CTA abdomen pelvis (74174) |
$5,255.68 |
$5,255.68 |
14.5× |
| CTA chest (71275) |
$3,481.05 |
$3,481.05 |
19.1× |
| Cta Head (70496) |
$3,041.90 |
$3,041.90 |
16.7× |
| CTA lwr ext w&w/o contrast (73706) |
$3,341 |
$3,341 |
18.3× |
| Cta Neck (70498) |
$3,125.86 |
$3,125.86 |
17.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$539.08 |
$539.08 |
5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$193 |
$193 |
2.1× |
| Echoencephalography real time imaging (76506) |
$539 |
$539 |
5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$510.90 |
$510.90 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$718.36 |
$718.36 |
2.9× |
| Foot 2 views (73620) |
$344.54 |
$344.54 |
3.8× |
| Forearm 2 views (73090) |
$336.18 |
$336.18 |
3.7× |
| Gated Heart Planar Single (78472) |
$1,607 |
$1,607 |
3.9× |
| Hand 2 views (73120) |
$402.22 |
$402.22 |
3.7× |
| Hand 3 views (73130) |
$370.34 |
$370.34 |
4.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,278.51 |
$2,278.51 |
4.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,420 |
$1,420 |
3.4× |
| Ht muscle image spect sing (78451) |
$1,026 |
$1,026 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$341.87 |
$341.87 |
3.8× |
| Hysterosalpingogram (74740) |
$640 |
$640 |
2.6× |
| Kidney imaging morphology (78700) |
$310 |
$310 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,114 |
$1,114 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,114 |
$1,114 |
2.0× |
| Knee 3 views (73562) |
$403.15 |
$403.15 |
4.5× |
| Meckels Diverticulum (78290) |
$1,071 |
$1,071 |
2.6× |
| MRA head w & w/o contrast (70546) |
$3,804.85 |
$3,804.85 |
10.5× |
| MRA head w/o contrast (70544) |
$3,676.80 |
$3,676.80 |
14.8× |
| MRA head with contrast (70545) |
$3,646 |
$3,646 |
10.1× |
| MRA neck w contrast (70548) |
$3,399 |
$3,399 |
9.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,024 |
$4,024 |
11.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,291.22 |
$4,291.22 |
11.8× |
| MRI abdomen w/o contrast (74181) |
$3,289 |
$3,289 |
13.3× |
| MRI any jnt lwr ext with con lt (73722) |
$2,433 |
$2,433 |
3.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,293 |
$2,293 |
2.8× |
| MRI c-spine with contrast (72142) |
$3,357.80 |
$3,357.80 |
9.3× |
| MRI cervical spine w/o contrast (72141) |
$3,339.35 |
$3,339.35 |
13.5× |
| MRI chest w/o & w/contrast material (71552) |
$3,739.20 |
$3,739.20 |
10.3× |
| MRI chest w/o contrast (71550) |
$2,823 |
$2,823 |
11.4× |
| MRI chest with contrast (71551) |
$2,947 |
$2,947 |
3.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,313 |
$2,313 |
6.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,466 |
$2,466 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,878.28 |
$2,878.28 |
11.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,012 |
$3,012 |
12.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,256.70 |
$4,256.70 |
11.8× |
| MRI pelvis w contrast (72196) |
$3,315.20 |
$3,315.20 |
9.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,779.40 |
$3,779.40 |
10.4× |
| MRI pelvis w/o contrast (72195) |
$3,238.13 |
$3,238.13 |
13.1× |
| MRI scan of arm joint before and after contrast (73223) |
$3,067.50 |
$3,067.50 |
8.5× |
| MRI scan of leg joint before and after contrast (73723) |
$3,893.54 |
$3,893.54 |
10.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,578.05 |
$4,578.05 |
12.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,171 |
$3,171 |
8.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,360.70 |
$4,360.70 |
12.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,105 |
$3,105 |
8.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,493.12 |
$4,493.12 |
12.4× |
| MRI thoracic spine w/o contrast (72146) |
$3,646.18 |
$3,646.18 |
14.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,726.74 |
$2,726.74 |
11.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,559.90 |
$3,559.90 |
9.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,144 |
$2,144 |
8.7× |
| Myocardial Spect Multiple Studies (78452) |
$4,712.11 |
$4,712.11 |
3.5× |
| Neck soft tissue (70360) |
$380.21 |
$380.21 |
4.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$409.07 |
$409.07 |
3.8× |
| Osseous survey infant (77076) |
$597 |
$597 |
5.5× |
| Parathyroid imaging (78070) |
$1,400 |
$1,400 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$357.79 |
$357.79 |
3.3× |
| PET image w/CT, skull-thigh (78815) |
$7,423.20 |
$7,423.20 |
5.0× |
| PET imaging for CT attenuation whole body (78816) |
$5,129 |
$5,129 |
3.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,583.96 |
$3,583.96 |
9.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,706 |
$1,706 |
4.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,706 |
$1,706 |
3.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$520.82 |
$520.82 |
4.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$503.32 |
$503.32 |
4.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$334 |
$334 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$506.23 |
$506.23 |
4.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$326.79 |
$326.79 |
3.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$347.85 |
$347.85 |
3.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$378.62 |
$378.62 |
4.2× |
| Ribs bilateral 3 views (71110) |
$422 |
$422 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$211 |
$211 |
1.9× |
| Scanogram (77073) |
$355 |
$355 |
3.3× |
| Scapula complete (73010) |
$355.36 |
$355.36 |
3.3× |
| Screening digital breast tomosynthesis (77063) |
$85.80 |
$85.80 |
3.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$293 |
$293 |
2.7× |
| Spine thoracic 3 views (72072) |
$506.46 |
$506.46 |
4.7× |
| Ultrasound, abdomen limited (76705) |
$734.72 |
$734.72 |
6.8× |
| Umbilical-artery Doppler (OB) (76820) |
$283 |
$283 |
2.6× |
| Upper Extremity Infant (73092) |
$319 |
$319 |
2.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$623 |
$623 |
3.4× |
| Us abdl aorta screen aaa (76706) |
$760 |
$760 |
7.0× |
| Us breast unilateral complete (76641) |
$580.03 |
$580.03 |
5.3× |
| Us breast unilateral limited (76642) |
$453.95 |
$453.95 |
5.0× |
| Us chest (76604) |
$386 |
$386 |
3.6× |
| Us infant hips dynamic (76885) |
$366 |
$366 |
4.1× |
| Us ob transvaginal (76817) |
$580 |
$580 |
5.3× |
| Us pelvic non ob complete (76856) |
$870.87 |
$870.87 |
8.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$307.65 |
$307.65 |
2.8× |
| Us pregnancy ltd (76815) |
$487.39 |
$487.39 |
4.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$730.05 |
$730.05 |
6.7× |
| Us retroperitoneal complete (76770) |
$927.92 |
$927.92 |
8.5× |
| Us retroperitoneal limited (76775) |
$520 |
$520 |
4.8× |
| Us scrotum and contents (76870) |
$758.74 |
$758.74 |
7.0× |
| Us soft tissue head/neck (76536) |
$680.27 |
$680.27 |
6.3× |
| Us xtr non-vasc lmtd (76882) |
$593.79 |
$593.79 |
5.5× |
| Wrist 2 views (73100) |
$360.52 |
$360.52 |
4.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$569.27 |
$569.27 |
5.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$340.47 |
$340.47 |
3.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$352.30 |
$352.30 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$300.56 |
$300.56 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$369.92 |
$369.92 |
4.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$475 |
$475 |
4.4× |
| X-ray exam hip uni 1 view (73501) |
$255.49 |
$255.49 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$323.50 |
$323.50 |
3.6× |
| X-ray exam hip uni 4/> views (73503) |
$242 |
$242 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$498.75 |
$498.75 |
4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$604.10 |
$604.10 |
5.6× |
| X-ray exam of femur 1 (73551) |
$259.20 |
$259.20 |
2.9× |
| X-ray eye for foreign body (70030) |
$253 |
$253 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$510.52 |
$510.52 |
4.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$302.16 |
$302.16 |
3.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$370 |
$370 |
4.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$274.71 |
$274.71 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$253 |
$253 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$415.17 |
$415.17 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$279 |
$279 |
3.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$311.02 |
$311.02 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$462.79 |
$462.79 |
4.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$691 |
$691 |
6.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$396.95 |
$396.95 |
4.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$293 |
$293 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$459.80 |
$459.80 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$400 |
$400 |
3.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$421 |
$421 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$342.81 |
$342.81 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$437.55 |
$437.55 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$586.38 |
$586.38 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$380.90 |
$380.90 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$337.46 |
$337.46 |
3.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$368.69 |
$368.69 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$408 |
$408 |
4.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$338.03 |
$338.03 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$417 |
$417 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$394.47 |
$394.47 |
3.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$277 |
$277 |
3.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$422 |
$422 |
4.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$336.57 |
$336.57 |
3.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$393.10 |
$393.10 |
3.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$450 |
$450 |
4.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$253.83 |
$253.83 |
2.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$348.73 |
$348.73 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$716.34 |
$716.34 |
6.6× |
| Xr chest 4+ views (71048) |
$391 |
$391 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$258.74 |
$258.74 |
2.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$253 |
$253 |
2.3× |
| Xr optic foramina (70190) |
$254 |
$254 |
2.8× |
| Xr shoulder 1 view (73020) |
$270.43 |
$270.43 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$550.74 |
$550.74 |
5.1× |
| Xr tibia/fibula 2 views (73590) |
$343.67 |
$343.67 |
3.8× |
| Xray knee 1 or 2 views rt (73560) |
$391.81 |
$391.81 |
4.3× |