| Abdomen 2 views (74019) |
$144.22 |
$228.92 |
1.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$352.58 |
$559.65 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$2,015.87 |
$3,199.80 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$3,140.85 |
$2,592.24 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$3,140.85 |
$4,985.48 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,373.85 |
$8,529.92 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$107.10 |
$170 |
0.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,373.85 |
$8,529.92 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$85.68 |
$136 |
0.0× |
| Aortogram thoracic (75605) |
$5,373.85 |
$8,529.92 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,061.48 |
$1,684.90 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$2,015.87 |
$3,199.80 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,604.73 |
$3,774.55 |
1.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$440.29 |
$698.88 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$226.99 |
$360.30 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$379.25 |
$601.98 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$94.28 |
$149.65 |
1.2× |
| Chest 1 view (71045) |
$94.28 |
$149.65 |
1.2× |
| Chest 3 views (71047) |
$94.28 |
$149.65 |
1.2× |
| Cineradiography/videoradiography (76120) |
$75.60 |
$120 |
0.8× |
| Clavicle complete (73000) |
$136.36 |
$216.45 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,331 |
$3,700 |
7.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,331 |
$3,700 |
10.6× |
| CT abdomen w contrast (74160) |
$1,165.50 |
$1,850 |
7.2× |
| CT abdomen w wo contrast (74170) |
$1,165.50 |
$1,850 |
7.2× |
| CT abdomen w/o contrast (74150) |
$1,165.50 |
$1,850 |
12.1× |
| CT angio hrt w/3d image (75574) |
$1,165.50 |
$1,850 |
3.6× |
| CT angiography upper extremity lt (73206) |
$1,165.50 |
$1,850 |
7.2× |
| CT c-spine w/o contrast (72125) |
$1,165.50 |
$1,850 |
12.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,165.50 |
$1,850 |
7.2× |
| CT cervical spine with contrast (72126) |
$1,165.50 |
$1,850 |
3.6× |
| CT chest w/wo contrast (71270) |
$1,165.50 |
$1,850 |
7.2× |
| CT chest with contrast (71260) |
$1,165.50 |
$1,850 |
7.2× |
| CT head/brain with contrast (70460) |
$1,165.50 |
$1,850 |
7.2× |
| CT head/brain without and with contrast (70470) |
$1,165.50 |
$1,850 |
7.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,165.50 |
$1,850 |
3.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$72.45 |
$115 |
0.9× |
| CT hrt w/3d image congen (75573) |
$1,165.50 |
$1,850 |
3.6× |
| CT iac w contrast (70481) |
$1,165.50 |
$1,850 |
7.2× |
| CT limited/localized follow up study (76380) |
$1,165.50 |
$1,850 |
14.5× |
| CT lower ext w/o (73700) |
$1,165.50 |
$1,850 |
12.1× |
| CT lower extremity w wo contrast (73702) |
$1,165.50 |
$1,850 |
7.2× |
| CT lower extremity with contrast (73701) |
$1,165.50 |
$1,850 |
7.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,165.50 |
$1,850 |
7.2× |
| CT lumbar spine w/o contrast (72131) |
$1,165.50 |
$1,850 |
12.1× |
| CT lumbar spine with contrast (72132) |
$1,165.50 |
$1,850 |
3.6× |
| CT maxillofacial w contrast (70487) |
$1,165.50 |
$1,850 |
7.2× |
| CT maxillofacial w/o contrast (70486) |
$1,165.50 |
$1,850 |
12.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,165.50 |
$1,850 |
7.2× |
| CT neck soft tissue w contrast (70491) |
$1,165.50 |
$1,850 |
7.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,165.50 |
$1,850 |
7.2× |
| CT orbits w/o contrast (70480) |
$1,165.50 |
$1,850 |
12.1× |
| CT pelvis w & w/o contrast (72194) |
$1,165.50 |
$1,850 |
7.2× |
| CT pelvis w/o contrast (72192) |
$1,165.50 |
$1,850 |
12.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,165.50 |
$1,850 |
7.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,165.50 |
$1,850 |
12.1× |
| CT thoracic spine w/contrast (72129) |
$1,165.50 |
$1,850 |
7.2× |
| CT thoracic spine w/o contrast (72128) |
$1,165.50 |
$1,850 |
12.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,165.50 |
$1,850 |
7.2× |
| CT thorax w/o contrast (71250) |
$1,165.50 |
$1,850 |
12.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,165.50 |
$1,850 |
7.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,165.50 |
$1,850 |
12.1× |
| CT upper extremity with contrast (73201) |
$1,165.50 |
$1,850 |
3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,165.50 |
$1,850 |
7.2× |
| Cta Abdomen (74175) |
$1,165.50 |
$1,850 |
7.2× |
| CTA abdomen pelvis (74174) |
$2,331 |
$3,700 |
7.3× |
| CTA chest (71275) |
$1,165.50 |
$1,850 |
7.2× |
| Cta Head (70496) |
$1,165.50 |
$1,850 |
7.2× |
| CTA lwr ext w&w/o contrast (73706) |
$1,165.50 |
$1,850 |
7.2× |
| Cta Neck (70498) |
$1,165.50 |
$1,850 |
7.2× |
| Cta Pelvis (72191) |
$1,165.50 |
$1,850 |
7.2× |
| Fluoroscopy up to 1 hr (76000) |
$206.26 |
$327.39 |
0.9× |
| Foot 2 views (73620) |
$94.28 |
$149.65 |
1.2× |
| Forearm 2 views (73090) |
$94.28 |
$149.65 |
1.2× |
| Gated Heart Planar Single (78472) |
$612.17 |
$971.70 |
1.7× |
| Hand 2 views (73120) |
$177.55 |
$281.83 |
1.8× |
| Hand 3 views (73130) |
$94.28 |
$149.65 |
1.2× |
| Heart infarct image w ef (78468) |
$847.78 |
$1,345.68 |
1.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$422.38 |
$670.45 |
0.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$422.38 |
$670.45 |
1.1× |
| Ht muscle image spect sing (78451) |
$697.82 |
$1,107.65 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$100.58 |
$159.65 |
1.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$320.56 |
$508.83 |
0.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$570.88 |
$906.16 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$570.88 |
$906.16 |
1.1× |
| Knee 3 views (73562) |
$68.67 |
$109 |
0.9× |
| Lung perf&ventilat diferentl (78598) |
$455.49 |
$723 |
0.9× |
| Lung perfusion differential (78597) |
$291.43 |
$462.58 |
0.8× |
| Lung Ventilation Imaging (78579) |
$291.43 |
$462.58 |
0.8× |
| Myocardial infarct spect (78469) |
$847.59 |
$1,345.38 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,143.64 |
$1,815.30 |
1.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,203.30 |
$1,909.99 |
0.9× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,836.14 |
$2,914.50 |
0.9× |
| Nm gastric emptying study (78264) |
$353.62 |
$561.30 |
1.0× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,209.61 |
$1,920.02 |
0.9× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,143.64 |
$1,815.30 |
1.0× |
| Nuclear medicine of heart pumping function (78473) |
$81.90 |
$130 |
0.2× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,201.09 |
$1,906.49 |
0.9× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,143.64 |
$1,815.30 |
1.0× |
| Parathyroid imaging (78070) |
$451.93 |
$717.35 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$94.28 |
$149.65 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$440.29 |
$698.88 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$455.49 |
$723 |
0.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$177.55 |
$281.83 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$94.28 |
$149.65 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$94.28 |
$149.65 |
1.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,681.71 |
$2,669.38 |
3.4× |
| Scapula complete (73010) |
$144.22 |
$228.92 |
1.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$612.17 |
$971.70 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$111.46 |
$176.92 |
1.2× |
| Unlisted cardiovascular procedure, diagnostic nuclear medicine UNSCHEDULED (78499) |
$63 |
$100 |
0.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$48 |
$76.19 |
0.6× |
| Us abdl aorta screen aaa (76706) |
$115.55 |
$183.42 |
1.2× |
| Us chest (76604) |
$131.32 |
$208.45 |
1.4× |
| Us guided compression repair (76936) |
$216.62 |
$343.83 |
1.1× |
| Us pelvic non ob complete (76856) |
$151.09 |
$239.83 |
1.6× |
| Us retroperitoneal complete (76770) |
$122.99 |
$195.22 |
1.3× |
| Us retroperitoneal limited (76775) |
$119.07 |
$189 |
1.2× |
| Us scrotum and contents (76870) |
$171.63 |
$272.43 |
1.8× |
| Us soft tissue head/neck (76536) |
$205.33 |
$325.92 |
2.1× |
| Us xtr non-vasc lmtd (76882) |
$69.16 |
$109.78 |
0.7× |
| Venogram extremity bilateral (75822) |
$2,341.48 |
$1,908.32 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$4,691.88 |
$7,447.43 |
1.6× |
| Venography caval superior serialography rs&i (75827) |
$1,737.66 |
$2,758.19 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$1,253.58 |
$260 |
0.9× |
| Venography Renal Bilateral (75833) |
$2,883.67 |
$4,577.25 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,140.85 |
$4,985.48 |
1.1× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$37.80 |
$60 |
0.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$94.28 |
$149.65 |
1.2× |
| X-ray exam hip uni 1 view (73501) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$177.55 |
$281.83 |
1.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$100.71 |
$159.86 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$177.55 |
$281.83 |
1.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$144.22 |
$228.92 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$177.55 |
$281.83 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$177.55 |
$281.83 |
1.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$177.55 |
$281.83 |
1.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$94.28 |
$149.65 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$177.55 |
$281.83 |
1.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$177.55 |
$281.83 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$94.28 |
$149.65 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$177.55 |
$281.83 |
1.8× |
| Xr chest 4+ views (71048) |
$144.22 |
$228.92 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$94.28 |
$149.65 |
1.2× |
| Xr tibia/fibula 2 views (73590) |
$94.28 |
$149.65 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$94.28 |
$149.65 |
1.2× |