| Abdomen 2 views (74019) |
$312.01 |
$367.07 |
2.9× |
| Acute gi blood loss imaging (78278) |
$434.25 |
$510.88 |
1.1× |
| Ankle 2 views (73600) |
$269.63 |
$317.21 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,486.60 |
$1,748.94 |
3.6× |
| Bone age studies (77072) |
$119.94 |
$141.11 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$434.25 |
$510.88 |
1.1× |
| Bone survey complete (77075) |
$1,746.62 |
$2,054.85 |
16.2× |
| Bone survey infant (77076) |
$119.94 |
$141.11 |
1.1× |
| Bowel imaging (78290) |
$1,300.99 |
$1,530.58 |
3.2× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$434.25 |
$510.88 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$335.45 |
$394.65 |
3.7× |
| Chest 1 view (71045) |
$363.41 |
$427.54 |
4.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$439.16 |
$516.66 |
2.4× |
| Clavicle complete (73000) |
$215.53 |
$253.56 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,578.99 |
$1,857.64 |
14.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,113.86 |
$4,839.83 |
11.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,061.50 |
$3,601.76 |
12.4× |
| CT abdomen w contrast (74160) |
$1,712.45 |
$2,014.65 |
9.5× |
| CT abdomen w wo contrast (74170) |
$2,162.43 |
$2,544.04 |
11.9× |
| CT abdomen w/o contrast (74150) |
$1,474.38 |
$1,734.57 |
13.7× |
| CT c-spine w/contrast (72126) |
$1,946.01 |
$2,289.42 |
5.4× |
| CT c-spine w/o contrast (72125) |
$1,799.93 |
$2,117.56 |
16.7× |
| CT cervical spine w&w/o contrast (72127) |
$2,306.71 |
$2,713.78 |
12.7× |
| CT chest w contrast (71260) |
$1,771.07 |
$2,083.61 |
9.8× |
| CT chest w/wo contrast (71270) |
$2,009.14 |
$2,363.69 |
11.1× |
| CT head/brain with contrast (70460) |
$2,045.10 |
$2,406 |
11.3× |
| CT head/brain without and with contrast (70470) |
$2,260.15 |
$2,659 |
12.5× |
| CT iac w contrast (70481) |
$1,691.71 |
$1,990.25 |
9.3× |
| CT lower ext w/o (73700) |
$1,478 |
$1,738.82 |
13.7× |
| CT lower extremity w wo contrast (73702) |
$2,403.21 |
$2,827.30 |
13.3× |
| CT lower extremity w/contrast material (73701) |
$1,698.02 |
$1,997.67 |
9.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,615.12 |
$3,076.61 |
14.4× |
| CT lumbar spine w/contrast (72132) |
$2,359.92 |
$2,776.38 |
6.6× |
| CT lumbar spine w/o contrast (72131) |
$1,478 |
$1,738.82 |
13.7× |
| CT maxillofacial w contrast (70487) |
$1,771.07 |
$2,083.61 |
9.8× |
| CT maxillofacial w/wo contrast (70488) |
$2,077.66 |
$2,444.31 |
11.5× |
| CT maxillofacial wo contrast (70486) |
$1,555.54 |
$1,830.05 |
14.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,271.54 |
$2,672.40 |
12.5× |
| CT orbits w/o contrast (70480) |
$1,569.07 |
$1,845.97 |
14.5× |
| CT pelvis w/o contrast (72192) |
$1,747.60 |
$2,056 |
16.2× |
| CT pelvis w/wo contrast (72194) |
$2,266.10 |
$2,666 |
12.5× |
| CT scan of arm combo (73202) |
$1,996.51 |
$2,348.83 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$2,255.05 |
$2,653 |
12.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,398.70 |
$2,822 |
13.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,709.35 |
$2,011 |
15.8× |
| CT thoracic spine w/contrast (72129) |
$1,568.17 |
$1,844.91 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$1,387.82 |
$1,632.73 |
12.9× |
| CT thoracic spine w/wo contrast (72130) |
$1,658.35 |
$1,951 |
9.2× |
| CT thorax w/o contrast (71250) |
$1,578.99 |
$1,857.64 |
14.6× |
| CT upper ext wo (73200) |
$1,340.03 |
$1,576.50 |
12.4× |
| CT upper extremity with contrast (73201) |
$1,865.75 |
$2,195 |
5.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,708.85 |
$2,010.41 |
9.4× |
| Cta Abdomen (74175) |
$1,874.77 |
$2,205.61 |
10.4× |
| CTA abdomen pelvis (74174) |
$3,337.43 |
$3,926.39 |
9.3× |
| CTA chest (71275) |
$2,168.74 |
$2,551.46 |
12.0× |
| Cta Head (70496) |
$2,104.72 |
$2,476.14 |
11.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,104.72 |
$2,476.14 |
5.8× |
| Cta Neck (70498) |
$2,104.72 |
$2,476.14 |
11.6× |
| Cta Pelvis (72191) |
$2,020.86 |
$2,377.48 |
11.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$492.03 |
$578.86 |
4.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$492.03 |
$578.86 |
5.5× |
| Facial bones min 3 views (70150) |
$383.25 |
$450.88 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$670.01 |
$788.25 |
6.2× |
| Fluoroscopy up to 1 hr (76000) |
$445.25 |
$523.82 |
1.8× |
| Foot 2 views (73620) |
$235.36 |
$276.89 |
2.6× |
| Forearm 2 views (73090) |
$229.95 |
$270.53 |
2.6× |
| Hand 2 views (73120) |
$238.07 |
$280.08 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,430.57 |
$1,683.02 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,300.99 |
$1,530.58 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$563.82 |
$663.32 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,765.01 |
$2,076.48 |
3.1× |
| Knee 3 views (73562) |
$267.83 |
$315.09 |
3.0× |
| Lymphoscintigraphy (78195) |
$563.82 |
$663.32 |
1.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,070.51 |
$3,612.36 |
3.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,726.94 |
$3,208.16 |
7.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,061.50 |
$3,601.76 |
8.5× |
| MRA head w & w/o contrast (70546) |
$3,175.12 |
$3,735.43 |
8.8× |
| MRA head w/o contrast (70544) |
$2,129.97 |
$2,505.85 |
8.6× |
| MRA neck w contrast (70548) |
$2,807.55 |
$3,303 |
7.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,116.10 |
$3,666 |
8.7× |
| MRA neck w/o contrast (70547) |
$2,523.65 |
$2,969 |
10.2× |
| MRI abdomen w contrast (74182) |
$2,905.94 |
$3,418.75 |
8.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,061.50 |
$3,601.76 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$2,487.97 |
$2,927.02 |
10.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,313.30 |
$3,898 |
4.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,841.15 |
$4,519 |
10.7× |
| MRI c-spine with contrast (72142) |
$2,886.55 |
$3,395.94 |
8.0× |
| MRI cervical spine w/o contrast (72141) |
$2,700.46 |
$3,177.01 |
11.0× |
| MRI chest w/o & w/contrast material (71552) |
$3,123.72 |
$3,674.96 |
8.7× |
| MRI chest w/o contrast (71550) |
$2,287.78 |
$2,691.50 |
9.3× |
| MRI chest with contrast (71551) |
$2,662.01 |
$3,131.78 |
3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,060 |
$3,600 |
8.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,471.40 |
$4,084 |
9.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,592.50 |
$3,050 |
10.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,238.18 |
$2,633.15 |
9.1× |
| MRI orbit face neck w contrast (70542) |
$2,418.53 |
$2,845.33 |
6.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,487.97 |
$2,927.02 |
6.9× |
| MRI pelvis w/contrast (72196) |
$2,458.20 |
$2,892 |
6.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,422.10 |
$4,026 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$2,568.70 |
$3,022 |
10.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,509.61 |
$2,952.48 |
7.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,061.50 |
$3,601.76 |
8.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,061.50 |
$3,601.76 |
8.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,119.20 |
$3,669.65 |
8.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,447.39 |
$2,879.28 |
6.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,487.97 |
$2,927.02 |
10.1× |
| MRI up ext w/o contrast (73218) |
$2,392.38 |
$2,814.57 |
9.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,487.97 |
$2,927.02 |
10.1× |
| MRI, joint upper extrem combo (73223) |
$2,938.85 |
$3,457.47 |
8.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,715.62 |
$4,371.32 |
2.8× |
| Myocardial spect single study at rest or stress (78451) |
$1,482.22 |
$1,743.79 |
1.1× |
| Neck soft tissue (70360) |
$295.78 |
$347.98 |
3.3× |
| Nm gastric emptying study (78264) |
$1,538.25 |
$1,809.71 |
3.7× |
| Parathyroid Planar Imaging (78070) |
$1,304.50 |
$1,534.70 |
3.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$434.25 |
$510.88 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$247.09 |
$290.69 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$4,727.70 |
$5,562 |
3.2× |
| PET imaging for CT attenuation whole body (78816) |
$5,253 |
$6,180 |
3.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$434.25 |
$510.88 |
1.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$563.82 |
$663.32 |
1.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$335.45 |
$394.65 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$254.29 |
$299.17 |
2.8× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$255.20 |
$300.23 |
2.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$215.53 |
$253.56 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$124.74 |
$146.75 |
1.2× |
| Radex fingr minimum 2 views (73140) |
$227.25 |
$267.35 |
2.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$295.78 |
$347.98 |
3.3× |
| Radex Hand Minimum 3 Views (73130) |
$237.17 |
$279.02 |
2.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$312.01 |
$367.07 |
3.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$603.28 |
$709.74 |
5.6× |
| Radex Humerus Minimum 2 Views (73060) |
$257.01 |
$302.36 |
2.9× |
| Radex Kne 1/2 Views (73560) |
$257.01 |
$302.36 |
2.9× |
| Radex Kne Compl 4/More Views (73564) |
$339.97 |
$399.96 |
3.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$241.67 |
$284.32 |
2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$271.43 |
$319.33 |
3.0× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$286.76 |
$337.37 |
2.7× |
| Radex Sho Compl Minimum 2 Views (73030) |
$257.01 |
$302.36 |
2.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$101.07 |
$118.90 |
1.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$440.30 |
$518 |
4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$162.98 |
$191.74 |
1.8× |
| Radex Toe Minimum 2 Views (73660) |
$242.57 |
$285.38 |
2.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$239.87 |
$282.20 |
2.2× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$254.29 |
$299.17 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$267.83 |
$315.09 |
3.0× |
| Radiologic exam chest 2 views (71046) |
$342.22 |
$402.61 |
3.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$287.67 |
$338.43 |
3.2× |
| Radiological examination surgical specimen (76098) |
$584.55 |
$687.71 |
1.0× |
| Ribs bilateral 3 views (71110) |
$407.60 |
$479.53 |
3.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,482.22 |
$1,743.79 |
2.6× |
| Scapula (73010) |
$292.17 |
$343.73 |
2.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$46.44 |
$54.63 |
2.0× |
| Shoulder 1 view (73020) |
$216.43 |
$254.62 |
2.4× |
| Small bowel series (74250) |
$366.94 |
$431.69 |
2.0× |
| Spine thoracic 3 views (72072) |
$383.25 |
$450.88 |
3.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$451.62 |
$531.32 |
1.1× |
| Ultrasound breast complete (76641) |
$623.12 |
$733.08 |
5.8× |
| Ultrasound Exam Aaa Screen (76706) |
$780.03 |
$917.68 |
7.2× |
| Ultrasound, abdomen limited (76705) |
$789.95 |
$929.35 |
7.3× |
| Umbilical-artery Doppler (OB) (76820) |
$119.94 |
$141.11 |
1.1× |
| Us breast unilateral limited (76642) |
$527.54 |
$620.63 |
5.9× |
| Us chest (76604) |
$315.66 |
$371.37 |
2.9× |
| Us elastography parenchyma (76981) |
$441.25 |
$519.12 |
4.1× |
| Us encephalogram (76506) |
$119.94 |
$141.11 |
1.1× |
| Us infant hips w manipulation (76885) |
$97.18 |
$114.33 |
1.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$269.80 |
$317.42 |
2.5× |
| Us ob limited (76815) |
$347.51 |
$408.84 |
3.2× |
| Us ob transvaginal (76817) |
$574.42 |
$675.79 |
5.3× |
| Us pelvic non ob complete (76856) |
$765.60 |
$900.70 |
7.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$583.44 |
$686.40 |
5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$698.87 |
$822.20 |
6.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$612.30 |
$720.35 |
5.7× |
| Us retroperitoneal complete (76770) |
$842.70 |
$991.41 |
7.8× |
| Us retroperitoneal limited (76775) |
$718.71 |
$845.54 |
6.7× |
| Us scrotum and contents (76870) |
$385.70 |
$453.76 |
3.6× |
| Us soft tissue head/neck (76536) |
$646.56 |
$760.66 |
6.0× |
| Us spinal canal and contents (76800) |
$119.94 |
$141.11 |
1.1× |
| Us transrectal (76872) |
$700.67 |
$824.32 |
6.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$731.33 |
$860.39 |
6.8× |
| Wrist 2 views (73100) |
$249.79 |
$293.87 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$421.12 |
$495.44 |
3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$234.46 |
$275.83 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$242.57 |
$285.38 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$335.45 |
$394.65 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$287.67 |
$338.43 |
2.7× |
| X-ray exam of femur 2/> (73552) |
$254.29 |
$299.17 |
2.8× |
| X-ray eye for foreign body (70030) |
$195.69 |
$230.22 |
2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$229.05 |
$269.47 |
2.6× |
| X-ray leg, infant (73592) |
$239.87 |
$282.20 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$383.25 |
$450.88 |
3.6× |
| X-ray nose-rectum child f.b. (76010) |
$289.47 |
$340.55 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$124.74 |
$146.75 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$325.53 |
$382.98 |
3.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$358.90 |
$422.24 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$448.18 |
$527.27 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$229.45 |
$269.94 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$255.20 |
$300.23 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$441.86 |
$519.84 |
4.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$124.74 |
$146.75 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$363.41 |
$427.54 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$317.42 |
$373.44 |
3.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$301.19 |
$354.34 |
3.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$287.67 |
$338.43 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$335.45 |
$394.65 |
3.1× |
| Xr c-spine 4 or 5 views (72050) |
$390.46 |
$459.37 |
3.6× |