| Abdomen 2 views (74019) |
$321 |
$401 |
3.0× |
| Ankle 2 views (73600) |
$200 |
$250 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$1,521 |
$1,901 |
3.7× |
| Bone age studies (77072) |
$119 |
$149 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$1,621 |
$2,026 |
3.9× |
| Bone survey complete (77075) |
$606 |
$757 |
5.6× |
| Cervical spine 2 or 3 views (72040) |
$288 |
$360 |
3.2× |
| Chest 1 view (71045) |
$246 |
$307.50 |
2.7× |
| Chest 3 views (71047) |
$243 |
$304 |
2.7× |
| Clavicle complete (73000) |
$244 |
$305 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,847 |
$2,309 |
17.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,506 |
$5,633 |
12.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,291 |
$4,114 |
13.3× |
| CT abdomen w contrast (74160) |
$2,202 |
$2,752 |
12.1× |
| CT abdomen w wo contrast (74170) |
$2,569 |
$3,211 |
14.1× |
| CT abdomen w/o contrast (74150) |
$1,966 |
$2,457 |
18.1× |
| CT c-spine w/o contrast (72125) |
$2,029 |
$2,536 |
18.7× |
| CT cervical spine w&w/o contrast (72127) |
$2,152 |
$2,690 |
11.8× |
| CT cervical spine with contrast (72126) |
$2,012 |
$2,515 |
5.6× |
| CT chest w/wo contrast (71270) |
$2,292 |
$2,865 |
12.6× |
| CT chest with contrast (71260) |
$2,175 |
$2,719 |
11.9× |
| CT head/brain with contrast (70460) |
$1,874 |
$2,343 |
10.3× |
| CT head/brain without and with contrast (70470) |
$2,146 |
$2,683 |
11.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$92 |
$115 |
1.0× |
| CT iac w contrast (70481) |
$1,954 |
$2,443 |
10.7× |
| CT lower ext w/o (73700) |
$1,907 |
$2,384 |
17.6× |
| CT lower extremity w wo contrast (73702) |
$2,012 |
$2,515 |
11.0× |
| CT lower extremity with contrast (73701) |
$1,874 |
$2,343 |
10.3× |
| CT lumbar spine w & w/o contrast (72133) |
$2,152 |
$2,690 |
11.8× |
| CT lumbar spine w/o contrast (72131) |
$1,994 |
$2,493 |
18.4× |
| CT lumbar spine with contrast (72132) |
$2,012 |
$2,515 |
5.6× |
| CT maxillofacial w contrast (70487) |
$1,900 |
$2,375 |
10.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,086 |
$2,607 |
11.5× |
| CT neck soft tissue w contrast (70491) |
$2,015 |
$2,519 |
11.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,168 |
$2,710 |
11.9× |
| CT orbits w/o contrast (70480) |
$1,842 |
$2,302 |
17.0× |
| CT pelvis w & w/o contrast (72194) |
$2,236 |
$2,795 |
12.3× |
| CT pelvis w/o contrast (72192) |
$1,887 |
$2,359 |
17.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,434 |
$3,042 |
13.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,762 |
$2,202 |
16.2× |
| CT thoracic spine w/contrast (72129) |
$2,012 |
$2,515 |
11.0× |
| CT thoracic spine w/o contrast (72128) |
$1,996 |
$2,495 |
18.4× |
| CT thoracic spine w/wo contrast (72130) |
$2,152 |
$2,690 |
11.8× |
| CT thorax w/o contrast (71250) |
$2,003 |
$2,504 |
18.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,012 |
$2,515 |
11.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,777.50 |
$2,222 |
16.4× |
| CT upper extremity with contrast (73201) |
$1,874 |
$2,343 |
5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,791 |
$2,239 |
9.8× |
| Cta Abdomen (74175) |
$2,829 |
$3,536 |
15.5× |
| CTA abdomen pelvis (74174) |
$3,214 |
$4,018 |
8.9× |
| CTA chest (71275) |
$2,792 |
$3,490 |
15.3× |
| Cta Head (70496) |
$2,622 |
$3,278 |
14.4× |
| Cta Neck (70498) |
$2,609 |
$3,261 |
14.3× |
| Cta Pelvis (72191) |
$2,685 |
$3,356 |
14.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$393 |
$491 |
3.6× |
| Fluoroscopy up to 1 hr (76000) |
$469 |
$586 |
1.9× |
| Foot 2 views (73620) |
$207 |
$259 |
2.3× |
| Forearm 2 views (73090) |
$238 |
$297 |
2.6× |
| Hand 2 views (73120) |
$201 |
$251 |
1.9× |
| Hand 3 views (73130) |
$268 |
$335 |
3.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,992 |
$2,490 |
3.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,455 |
$1,819 |
3.5× |
| Ht muscle image spect sing (78451) |
$658 |
$823 |
0.5× |
| Humerus Min 2 Views Left (73060) |
$262 |
$328 |
2.9× |
| Knee 3 views (73562) |
$301 |
$376 |
3.3× |
| MRA head w & w/o contrast (70546) |
$3,089 |
$3,861 |
8.5× |
| MRA head w/o contrast (70544) |
$2,794 |
$3,492 |
11.3× |
| MRA head with contrast (70545) |
$2,629 |
$3,286 |
7.3× |
| MRA neck w contrast (70548) |
$2,460 |
$3,075 |
6.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,527 |
$3,159 |
7.0× |
| MRA neck w/o contrast (70547) |
$2,292 |
$2,865 |
9.3× |
| MRI abdomen w contrast (74182) |
$2,794 |
$3,492 |
7.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,484 |
$4,355 |
9.6× |
| MRI abdomen w/o contrast (74181) |
$2,629 |
$3,286 |
10.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,292 |
$2,865 |
2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,126 |
$2,657 |
2.6× |
| MRI c-spine with contrast (72142) |
$2,629 |
$3,286 |
7.3× |
| MRI cervical spine w/o contrast (72141) |
$2,920 |
$3,650 |
11.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,712 |
$3,390 |
7.5× |
| MRI chest w/o contrast (71550) |
$2,460 |
$3,075 |
9.9× |
| MRI chest with contrast (71551) |
$2,629 |
$3,286 |
3.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,126 |
$2,657 |
5.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,126 |
$2,657 |
5.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,126 |
$2,657 |
8.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,365 |
$2,956 |
9.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,073 |
$3,841 |
8.5× |
| MRI orbit/face/neck w/contrast (70542) |
$2,629 |
$3,286 |
7.3× |
| MRI pelvis w contrast (72196) |
$2,629 |
$3,286 |
7.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,794 |
$3,492 |
7.7× |
| MRI pelvis w/o contrast (72195) |
$2,635 |
$3,294 |
10.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,292 |
$2,865 |
6.3× |
| MRI scan of leg joint before and after contrast (73723) |
$3,092 |
$3,865 |
8.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,794 |
$3,492 |
7.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,964 |
$3,705 |
8.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,425 |
$4,281 |
9.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,629 |
$3,286 |
7.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,794 |
$3,492 |
7.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,935 |
$3,669 |
11.8× |
| MRI tmj (70336) |
$1,958 |
$2,448 |
7.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,158 |
$2,697 |
8.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,292 |
$2,865 |
6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,757 |
$2,196 |
7.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,569 |
$4,461 |
2.7× |
| Neck soft tissue (70360) |
$258 |
$323 |
2.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$244 |
$305 |
2.2× |
| Osseous survey limited (77074) |
$680 |
$850 |
6.3× |
| Parathyroid imaging (78070) |
$1,120 |
$1,400 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$259 |
$324 |
2.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,292 |
$2,865 |
6.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$223 |
$279 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$192 |
$240 |
1.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$281 |
$351 |
2.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$344 |
$430 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$251 |
$314 |
2.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$282 |
$353 |
3.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$277.50 |
$347 |
3.1× |
| Ribs bilateral 3 views (71110) |
$348 |
$435 |
3.2× |
| Sacroiliac Joints < 3 Views (72200) |
$299 |
$374 |
2.8× |
| Scapula complete (73010) |
$266 |
$333 |
2.5× |
| Screening digital breast tomosynthesis (77063) |
$82 |
$102 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$559 |
$699 |
5.1× |
| Us abdl aorta screen aaa (76706) |
$530 |
$530 |
4.9× |
| Us breast unilateral complete (76641) |
$430 |
$537 |
4.0× |
| Us breast unilateral limited (76642) |
$343 |
$429 |
3.8× |
| Us chest (76604) |
$486 |
$607 |
4.5× |
| Us compl joint r-t w/image documentation (76881) |
$525 |
$656 |
4.8× |
| Us kidney transplant (76776) |
$684 |
$855 |
6.3× |
| Us ob transvaginal (76817) |
$474 |
$592 |
4.4× |
| Us pelvic non ob complete (76856) |
$665 |
$831 |
6.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$400 |
$500 |
3.7× |
| Us pregnancy ltd (76815) |
$319 |
$399 |
2.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$589 |
$736 |
5.4× |
| Us retroperitoneal complete (76770) |
$678 |
$848 |
6.2× |
| Us retroperitoneal limited (76775) |
$460 |
$575 |
4.2× |
| Us scrotum and contents (76870) |
$556 |
$695 |
5.1× |
| Us soft tissue head/neck (76536) |
$511 |
$639 |
4.7× |
| Us transrectal (76872) |
$543 |
$679 |
5.0× |
| Us xtr non-vasc lmtd (76882) |
$457 |
$571 |
4.2× |
| Wrist 2 views (73100) |
$195.50 |
$244.50 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$442 |
$552 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$219 |
$274 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$265 |
$331.50 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$224 |
$280 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$277 |
$346 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$181.50 |
$226.50 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$282 |
$353 |
3.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$358 |
$448 |
3.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$277 |
$346 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$207 |
$259 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$312 |
$390 |
2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$362 |
$452 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$680 |
$850 |
6.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$427 |
$534 |
3.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$211 |
$264 |
2.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$353 |
$441 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$265 |
$331 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$344 |
$430 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$263 |
$329 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$290 |
$363 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$222 |
$278 |
2.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$222 |
$278 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$374 |
$467 |
3.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$204 |
$255 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$269 |
$336 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$307 |
$384 |
2.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$249 |
$311 |
2.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$191 |
$239 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$258 |
$323 |
2.9× |
| Xr finger(s) 2+ views (73140) |
$193 |
$241 |
2.1× |
| Xr shoulder 1 view (73020) |
$202.50 |
$253 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$430 |
$537 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$264 |
$330 |
2.9× |
| Xr tmj bilateral (70330) |
$252 |
$315 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$264 |
$330 |
2.9× |