| Abdomen 2 views (74019) |
$406 |
$406 |
3.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,596 |
$1,596 |
3.8× |
| Ankle 2 views (73600) |
$250 |
$250 |
2.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,080 |
$1,080 |
2.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,762 |
$1,762 |
4.2× |
| Bone &/joint imaging whole body (78306) |
$1,896 |
$1,896 |
4.6× |
| Bone age studies (77072) |
$259 |
$259 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$2,227 |
$2,227 |
5.4× |
| Bone survey complete (77075) |
$876 |
$876 |
8.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,725 |
$4,725 |
3.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,949 |
$3,949 |
10.9× |
| Cervical spine 2 or 3 views (72040) |
$356 |
$356 |
3.9× |
| Chest 1 view (71045) |
$315 |
$315 |
3.5× |
| Chest 3 views (71047) |
$410 |
$410 |
4.5× |
| Clavicle complete (73000) |
$307 |
$307 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$347 |
$347 |
3.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,627 |
$5,627 |
15.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,281 |
$4,281 |
17.3× |
| CT abdomen w contrast (74160) |
$2,780 |
$2,780 |
15.3× |
| CT abdomen w wo contrast (74170) |
$3,213 |
$3,213 |
17.6× |
| CT abdomen w/o contrast (74150) |
$2,375 |
$2,375 |
21.9× |
| CT c-spine w/o contrast (72125) |
$2,619 |
$2,619 |
24.1× |
| CT cervical spine w&w/o contrast (72127) |
$3,928 |
$3,928 |
21.6× |
| CT cervical spine with contrast (72126) |
$2,655 |
$2,655 |
7.3× |
| CT chest w/wo contrast (71270) |
$2,947 |
$2,947 |
16.2× |
| CT chest with contrast (71260) |
$2,765 |
$2,765 |
15.2× |
| CT head/brain with contrast (70460) |
$2,418 |
$2,418 |
13.3× |
| CT head/brain without and with contrast (70470) |
$2,699 |
$2,699 |
14.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$130 |
$130 |
1.4× |
| CT iac w contrast (70481) |
$2,497 |
$2,497 |
13.7× |
| CT lower ext w/o (73700) |
$2,296 |
$2,296 |
21.1× |
| CT lower extremity w wo contrast (73702) |
$2,807 |
$2,807 |
15.4× |
| CT lower extremity with contrast (73701) |
$2,563 |
$2,563 |
14.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,007 |
$3,007 |
16.5× |
| CT lumbar spine w/o contrast (72131) |
$2,516 |
$2,516 |
23.2× |
| CT lumbar spine with contrast (72132) |
$2,692 |
$2,692 |
7.4× |
| CT maxillofacial w contrast (70487) |
$2,417 |
$2,417 |
13.3× |
| CT maxillofacial w/o contrast (70486) |
$1,985 |
$1,985 |
18.3× |
| CT maxillofacial w/wo contrast (70488) |
$2,590 |
$2,590 |
14.2× |
| CT neck soft tissue w contrast (70491) |
$2,532 |
$2,532 |
13.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,819 |
$2,819 |
15.5× |
| CT orbits w/o contrast (70480) |
$2,267 |
$2,267 |
20.9× |
| CT pelvis w & w/o contrast (72194) |
$3,092 |
$3,092 |
17.0× |
| CT pelvis w/o contrast (72192) |
$2,391 |
$2,391 |
22.0× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$520 |
$520 |
5.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,982 |
$2,982 |
16.4× |
| CT soft tissue neck w/o contrast (70490) |
$2,309 |
$2,309 |
21.3× |
| CT thoracic spine w/contrast (72129) |
$2,749 |
$2,749 |
15.1× |
| CT thoracic spine w/o contrast (72128) |
$2,450 |
$2,450 |
22.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,644 |
$2,644 |
14.5× |
| CT thorax w/o contrast (71250) |
$2,496 |
$2,496 |
23.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,518 |
$2,518 |
13.8× |
| CT upper extremity w/o contrast rt (73200) |
$2,234 |
$2,234 |
20.6× |
| CT upper extremity with contrast (73201) |
$2,500 |
$2,500 |
6.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,690 |
$3,690 |
20.3× |
| Cta Abdomen (74175) |
$3,428 |
$3,428 |
18.8× |
| CTA abdomen pelvis (74174) |
$5,754 |
$5,754 |
15.9× |
| CTA chest (71275) |
$3,571 |
$3,571 |
19.6× |
| Cta Head (70496) |
$3,228 |
$3,228 |
17.7× |
| Cta Neck (70498) |
$3,050 |
$3,050 |
16.7× |
| Cta Pelvis (72191) |
$3,345 |
$3,345 |
18.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$493 |
$493 |
4.5× |
| Fluoroscopy up to 1 hr (76000) |
$597 |
$597 |
2.4× |
| Foot 2 views (73620) |
$261 |
$261 |
2.9× |
| Forearm 2 views (73090) |
$297 |
$297 |
3.3× |
| Gated Heart Planar Single (78472) |
$2,137 |
$2,137 |
5.1× |
| Hand 2 views (73120) |
$263 |
$263 |
2.4× |
| Hand 3 views (73130) |
$339 |
$339 |
3.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,938 |
$1,938 |
3.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,734 |
$1,734 |
4.2× |
| Ht muscle image spect sing (78451) |
$4,094 |
$4,094 |
3.0× |
| Humerus Min 2 Views Left (73060) |
$333 |
$333 |
3.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$298 |
$298 |
2.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,709 |
$1,709 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,772 |
$1,772 |
3.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,973 |
$1,973 |
3.5× |
| Knee 3 views (73562) |
$387 |
$387 |
4.3× |
| Liver & spleen imaging static only (78215) |
$1,467 |
$1,467 |
3.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,136 |
$1,136 |
2.7× |
| Liver imaging w/vascular flow (78202) |
$1,407 |
$1,407 |
2.5× |
| Lung perf&ventilat diferentl (78598) |
$1,412 |
$1,412 |
2.5× |
| Lung perfusion differential (78597) |
$1,400 |
$1,400 |
3.4× |
| Lung Ventilation Imaging (78579) |
$927 |
$927 |
2.2× |
| Meckels Diverticulum (78290) |
$1,245 |
$1,245 |
3.0× |
| MRA head w & w/o contrast (70546) |
$4,060 |
$4,060 |
11.2× |
| MRA head w/o contrast (70544) |
$3,465 |
$3,465 |
14.0× |
| MRA head with contrast (70545) |
$3,779 |
$3,779 |
10.4× |
| MRA neck w contrast (70548) |
$3,647 |
$3,647 |
10.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,724 |
$3,724 |
10.3× |
| MRA neck w/o contrast (70547) |
$3,030 |
$3,030 |
12.2× |
| MRI abdomen w contrast (74182) |
$3,507 |
$3,507 |
9.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,033 |
$5,033 |
13.9× |
| MRI abdomen w/o contrast (74181) |
$3,261 |
$3,261 |
13.2× |
| MRI any jnt lwr ext with con lt (73722) |
$2,764 |
$2,764 |
3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,807 |
$2,807 |
3.4× |
| MRI c-spine with contrast (72142) |
$4,027 |
$4,027 |
11.1× |
| MRI cardiac w/o cont stress (75559) |
$2,968 |
$2,968 |
5.2× |
| MRI cardiac w/o contrast (75557) |
$2,970 |
$2,970 |
12.0× |
| MRI cervical spine w/o contrast (72141) |
$3,590 |
$3,590 |
14.5× |
| MRI chest w/o & w/contrast material (71552) |
$3,910 |
$3,910 |
10.8× |
| MRI chest w/o contrast (71550) |
$3,363 |
$3,363 |
13.6× |
| MRI chest with contrast (71551) |
$3,602 |
$3,602 |
4.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,875 |
$2,875 |
7.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,729 |
$2,729 |
7.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,703 |
$2,703 |
10.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,940 |
$2,940 |
11.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,931 |
$3,931 |
10.9× |
| MRI orbit/face/neck w/contrast (70542) |
$3,301 |
$3,301 |
9.1× |
| MRI pelvis w contrast (72196) |
$3,190 |
$3,190 |
8.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,897 |
$4,897 |
13.5× |
| MRI pelvis w/o contrast (72195) |
$3,126 |
$3,126 |
12.6× |
| MRI scan of arm joint before and after contrast (73223) |
$3,980 |
$3,980 |
11.0× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$4,107 |
$4,107 |
5.0× |
| MRI scan of leg joint before and after contrast (73723) |
$3,491 |
$3,491 |
9.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,240 |
$5,240 |
14.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,403 |
$3,403 |
9.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,019 |
$5,019 |
13.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,865 |
$3,865 |
10.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,466 |
$5,466 |
15.1× |
| MRI thoracic spine w/o contrast (72146) |
$3,651 |
$3,651 |
14.7× |
| MRI tmj (70336) |
$2,334 |
$2,334 |
9.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,725 |
$2,725 |
11.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,384 |
$3,384 |
9.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,701 |
$2,701 |
10.9× |
| Myocardial Spect Multiple Studies (78452) |
$5,719 |
$5,719 |
4.3× |
| Neck soft tissue (70360) |
$317 |
$317 |
3.5× |
| Nm gastric emptying study (78264) |
$1,865 |
$1,865 |
4.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$381 |
$381 |
3.5× |
| Osseous survey infant (77076) |
$548 |
$548 |
5.0× |
| Osseous survey limited (77074) |
$760 |
$760 |
7.0× |
| Parathyrd planar w/wo subtrj (78071) |
$1,592 |
$1,592 |
3.8× |
| Parathyroid imaging (78070) |
$1,361 |
$1,361 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$327 |
$327 |
3.0× |
| PET image w/CT, skull-thigh (78815) |
$6,971 |
$6,971 |
4.7× |
| PET imaging CT for attenuation limited area (78814) |
$7,681 |
$7,681 |
5.2× |
| PET imaging for CT attenuation whole body (78816) |
$6,935 |
$6,935 |
4.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,403 |
$3,403 |
9.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,198 |
$1,198 |
2.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,350 |
$2,350 |
4.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$327 |
$327 |
3.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$537 |
$537 |
4.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$475 |
$475 |
4.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$422 |
$422 |
3.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$324 |
$324 |
3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$538 |
$538 |
5.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$375 |
$375 |
4.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$349 |
$349 |
3.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,141 |
$2,141 |
5.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,807 |
$2,807 |
5.0× |
| Scapula complete (73010) |
$322 |
$322 |
3.0× |
| Screening digital breast tomosynthesis (77063) |
$109 |
$109 |
4.7× |
| Spine thoracic 3 views (72072) |
$516 |
$516 |
4.8× |
| Testicular Imaging With Vascular Flow (78761) |
$853 |
$853 |
2.1× |
| Thoracolumbar 2 views (72080) |
$348 |
$348 |
3.9× |
| Tmj unilateral (70328) |
$215 |
$215 |
2.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,479 |
$1,479 |
3.6× |
| Ultrasound, abdomen limited (76705) |
$738 |
$738 |
6.8× |
| Umbilical-artery Doppler (OB) (76820) |
$337 |
$337 |
3.1× |
| Upper Extremity Infant (73092) |
$361 |
$361 |
3.3× |
| Us abdl aorta screen aaa (76706) |
$624 |
$624 |
5.7× |
| Us breast unilateral complete (76641) |
$496 |
$496 |
4.6× |
| Us breast unilateral limited (76642) |
$427 |
$427 |
4.7× |
| Us chest (76604) |
$578 |
$578 |
5.3× |
| Us compl joint r-t w/image documentation (76881) |
$666 |
$666 |
6.1× |
| Us ob transvaginal (76817) |
$573 |
$573 |
5.3× |
| Us pelvic non ob complete (76856) |
$836 |
$836 |
7.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$384 |
$384 |
3.5× |
| Us pregnancy ltd (76815) |
$471 |
$471 |
4.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$668 |
$668 |
6.2× |
| Us retroperitoneal complete (76770) |
$857 |
$857 |
7.9× |
| Us retroperitoneal limited (76775) |
$638 |
$638 |
5.9× |
| Us scrotum and contents (76870) |
$694 |
$694 |
6.4× |
| Us soft tissue head/neck (76536) |
$630 |
$630 |
5.8× |
| Us transrectal (76872) |
$211 |
$211 |
1.9× |
| Us xtr non-vasc lmtd (76882) |
$574 |
$574 |
5.3× |
| Wrist 2 views (73100) |
$260 |
$260 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$322 |
$322 |
3.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$346 |
$346 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$291 |
$291 |
3.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$344 |
$344 |
3.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,067 |
$1,067 |
9.8× |
| X-ray exam hip uni 1 view (73501) |
$291 |
$291 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$363 |
$363 |
4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$552 |
$552 |
5.1× |
| X-ray exam of femur 1 (73551) |
$330 |
$330 |
3.7× |
| X-ray eye for foreign body (70030) |
$255 |
$255 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$442 |
$442 |
4.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$293 |
$293 |
3.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$354 |
$354 |
3.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$258 |
$258 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$287 |
$287 |
3.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$363 |
$363 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$263 |
$263 |
2.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$330 |
$330 |
3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$461 |
$461 |
4.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$525 |
$525 |
4.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$452 |
$452 |
4.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$342 |
$342 |
3.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$318 |
$318 |
3.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$457 |
$457 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$410 |
$410 |
3.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$354 |
$354 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$424 |
$424 |
3.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$511 |
$511 |
4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$429 |
$429 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$319 |
$319 |
3.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$376 |
$376 |
4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$391 |
$391 |
4.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$253 |
$253 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$446 |
$446 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$282 |
$282 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$264 |
$264 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$329 |
$329 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$328 |
$328 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$385 |
$385 |
3.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$618 |
$618 |
5.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$243 |
$243 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$324 |
$324 |
3.6× |
| Xr c-spine 6 or more views (72052) |
$542 |
$542 |
5.0× |
| Xr chest 4+ views (71048) |
$416 |
$416 |
3.8× |
| Xr finger(s) 2+ views (73140) |
$232 |
$232 |
2.6× |
| Xr shoulder 1 view (73020) |
$235 |
$235 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$517 |
$517 |
4.8× |
| Xr tibia/fibula 2 views (73590) |
$322 |
$322 |
3.6× |
| Xr tmj bilateral (70330) |
$294 |
$294 |
3.3× |
| Xray knee 1 or 2 views rt (73560) |
$321 |
$321 |
3.6× |