| Abdomen 2 views (74019) |
$412 |
$412 |
3.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$913.60 |
$1,142 |
2.2× |
| Ankle 2 views (73600) |
$227 |
$227 |
2.5× |
| Arthrogram wrist (73115) |
$605 |
$605 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$908 |
$1,135 |
2.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$856 |
$1,070 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$1,399.20 |
$1,749 |
3.3× |
| Bone age studies (77072) |
$277 |
$277 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,571.20 |
$1,964 |
3.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,340.80 |
$3,344 |
6.4× |
| Cervical spine 2 or 3 views (72040) |
$406 |
$406 |
4.4× |
| Chest 1 view (71045) |
$298 |
$298 |
3.2× |
| Chest 3 views (71047) |
$439 |
$439 |
4.8× |
| Clavicle complete (73000) |
$293 |
$293 |
3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,374.40 |
$3,392 |
21.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,395.40 |
$5,659 |
9.2× |
| CT abdomen and pelvis without contrast (74176) |
$3,055.50 |
$4,365 |
12.1× |
| CT abdomen w contrast (74160) |
$1,818.60 |
$2,598 |
9.8× |
| CT abdomen w wo contrast (74170) |
$2,183.30 |
$3,119 |
11.8× |
| CT abdomen w/o contrast (74150) |
$1,850.40 |
$2,313 |
16.8× |
| CT angiography upper extremity lt (73206) |
$1,912.40 |
$2,732 |
10.3× |
| CT c-spine w/o contrast (72125) |
$1,777.30 |
$2,539 |
16.1× |
| CT cervical spine with contrast (72126) |
$1,843.10 |
$2,633 |
5.0× |
| CT chest w/wo contrast (71270) |
$2,374.40 |
$3,392 |
12.8× |
| CT chest with contrast (71260) |
$1,874.60 |
$2,678 |
10.1× |
| CT head/brain with contrast (70460) |
$1,935.20 |
$2,419 |
10.5× |
| CT head/brain without and with contrast (70470) |
$1,891.40 |
$2,702 |
10.2× |
| CT iac w contrast (70481) |
$1,756.80 |
$2,196 |
9.5× |
| CT lower ext w/o (73700) |
$1,470.40 |
$1,838 |
13.3× |
| CT lower extremity w wo contrast (73702) |
$1,602.40 |
$2,003 |
8.7× |
| CT lower extremity with contrast (73701) |
$1,734.40 |
$2,168 |
9.4× |
| CT lumbar spine w/o contrast (72131) |
$1,723.20 |
$2,154 |
15.6× |
| CT maxillofacial w contrast (70487) |
$1,532.80 |
$1,916 |
8.3× |
| CT maxillofacial w/o contrast (70486) |
$1,337.60 |
$1,672 |
12.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,684 |
$2,105 |
9.1× |
| CT neck soft tissue w contrast (70491) |
$1,785 |
$2,550 |
9.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,876.70 |
$2,681 |
10.1× |
| CT orbits w/o contrast (70480) |
$1,571.20 |
$1,964 |
14.2× |
| CT pelvis w & w/o contrast (72194) |
$2,183.30 |
$3,119 |
11.8× |
| CT pelvis w/o contrast (72192) |
$1,713.60 |
$2,142 |
15.5× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$324 |
$324 |
3.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,880.20 |
$2,686 |
10.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,436 |
$1,795 |
13.0× |
| CT thoracic spine w/o contrast (72128) |
$1,701.60 |
$2,127 |
15.4× |
| CT thorax w/o contrast (71250) |
$1,917.60 |
$2,397 |
17.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,980 |
$2,475 |
10.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,543.20 |
$1,929 |
14.0× |
| CT upper extremity with contrast (73201) |
$1,748 |
$2,185 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,957.20 |
$2,796 |
10.6× |
| Cta Abdomen (74175) |
$2,519.30 |
$3,599 |
13.6× |
| CTA abdomen pelvis (74174) |
$2,519.30 |
$3,599 |
6.8× |
| CTA chest (71275) |
$2,856 |
$4,080 |
15.4× |
| Cta Head (70496) |
$1,925.60 |
$2,407 |
10.4× |
| Cta Neck (70498) |
$1,925.60 |
$2,407 |
10.4× |
| Cystography minimum 3 views rs&i (74430) |
$852 |
$852 |
2.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$536 |
$536 |
4.9× |
| Echoencephalography real time imaging (76506) |
$472 |
$472 |
4.3× |
| Esophagus (74220) |
$537 |
$537 |
2.9× |
| Fetal biophysical profile non-stress testing (76818) |
$434 |
$434 |
3.9× |
| Foot 2 views (73620) |
$297 |
$297 |
3.2× |
| Forearm 2 views (73090) |
$267 |
$267 |
2.9× |
| Gated Heart Planar Single (78472) |
$1,300 |
$1,625 |
3.1× |
| Hand 2 views (73120) |
$202 |
$202 |
1.8× |
| Hand 3 views (73130) |
$344 |
$344 |
3.7× |
| Heart Infarct Image (78466) |
$1,055.20 |
$1,319 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,833.60 |
$2,292 |
3.2× |
| Ht muscle image spect sing (78451) |
$2,889.60 |
$4,128 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$288 |
$288 |
3.1× |
| Kidney imaging morphology (78700) |
$813.60 |
$1,017 |
1.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,178.40 |
$1,473 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,176 |
$1,470 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,118.40 |
$1,398 |
2.0× |
| Knee 3 views (73562) |
$411 |
$411 |
4.5× |
| Liver & spleen imaging static only (78215) |
$910.40 |
$1,138 |
2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,326.40 |
$1,658 |
3.1× |
| Liver imaging static only (78201) |
$1,094.40 |
$1,368 |
1.9× |
| Liver imaging w/vascular flow (78202) |
$1,326.40 |
$1,658 |
2.3× |
| Lymphoscintigraphy (78195) |
$1,243.20 |
$1,554 |
2.2× |
| Meckels Diverticulum (78290) |
$930.40 |
$1,163 |
2.2× |
| MRA head w & w/o contrast (70546) |
$2,394.70 |
$3,421 |
6.5× |
| MRA head w/o contrast (70544) |
$2,104.90 |
$3,007 |
8.4× |
| MRA head with contrast (70545) |
$1,992.80 |
$2,491 |
5.4× |
| MRA neck w contrast (70548) |
$2,104.90 |
$3,007 |
5.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,128.70 |
$3,041 |
5.8× |
| MRA neck w/o contrast (70547) |
$1,868.30 |
$2,669 |
7.4× |
| MRI abdomen w contrast (74182) |
$2,135 |
$3,050 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,392.60 |
$3,418 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$2,088.10 |
$2,983 |
8.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,919.40 |
$2,742 |
2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,919.40 |
$2,742 |
2.3× |
| MRI bone marrow blood supply (77084) |
$2,027.90 |
$2,897 |
8.1× |
| MRI c-spine with contrast (72142) |
$2,608.90 |
$3,727 |
7.1× |
| MRI cardiac w/o contrast (75557) |
$2,340.80 |
$3,344 |
9.3× |
| MRI cervical spine w/o contrast (72141) |
$2,405.90 |
$3,437 |
9.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,739.10 |
$3,913 |
7.4× |
| MRI chest w/o contrast (71550) |
$2,474.50 |
$3,535 |
9.8× |
| MRI chest with contrast (71551) |
$2,474.50 |
$3,535 |
3.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,158.80 |
$3,084 |
5.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,918 |
$2,740 |
5.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,958.60 |
$2,798 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,878.10 |
$2,683 |
7.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,121.70 |
$3,031 |
5.8× |
| MRI orbit/face/neck w/contrast (70542) |
$1,904 |
$2,720 |
5.2× |
| MRI pelvis w contrast (72196) |
$2,382.80 |
$3,404 |
6.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,410.80 |
$3,444 |
6.6× |
| MRI pelvis w/o contrast (72195) |
$1,999.90 |
$2,857 |
7.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,340.80 |
$3,344 |
6.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,568.30 |
$3,669 |
7.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,718.10 |
$3,883 |
7.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,503.20 |
$3,576 |
6.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,977.10 |
$4,253 |
8.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,280.60 |
$3,258 |
6.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,349.20 |
$3,356 |
6.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,036.30 |
$2,909 |
8.1× |
| MRI tmj (70336) |
$2,109.10 |
$3,013 |
8.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,000.60 |
$2,858 |
7.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,340.80 |
$3,344 |
6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,062.20 |
$2,946 |
8.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,005.80 |
$4,294 |
2.2× |
| Neck soft tissue (70360) |
$348 |
$348 |
3.8× |
| Nm gastric emptying study (78264) |
$1,532.80 |
$1,916 |
3.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,342.20 |
$3,346 |
1.7× |
| Nuclear medicine of heart pumping function (78473) |
$1,904.80 |
$2,381 |
4.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,237.20 |
$3,196 |
1.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,013.60 |
$1,267 |
2.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$425 |
$425 |
3.9× |
| Parathyroid imaging (78070) |
$605 |
$605 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$428 |
$428 |
3.9× |
| Pr heart first pass single,planar (78481) |
$1,374.40 |
$1,718 |
2.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,340.80 |
$3,344 |
6.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,028 |
$1,285 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$724 |
$724 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$264 |
$264 |
2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$587 |
$587 |
5.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$376 |
$376 |
3.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$791 |
$791 |
7.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$367 |
$367 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$333 |
$333 |
3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$501 |
$501 |
4.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$364 |
$364 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$423 |
$423 |
4.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$290 |
$290 |
3.2× |
| Ribs bilateral 3 views (71110) |
$448 |
$448 |
4.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,176 |
$1,470 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$387 |
$387 |
3.5× |
| Scanogram (77073) |
$380 |
$380 |
3.4× |
| Scapula complete (73010) |
$349 |
$349 |
3.2× |
| Screening digital breast tomosynthesis (77063) |
$62 |
$62 |
2.7× |
| Sella turcica (70240) |
$229 |
$229 |
2.5× |
| Spine thoracic 3 views (72072) |
$546 |
$546 |
5.0× |
| Testicular Imaging With Vascular Flow (78761) |
$908 |
$1,135 |
2.2× |
| Tmj unilateral (70328) |
$290 |
$290 |
3.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$915.20 |
$1,144 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$778 |
$778 |
7.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$972.80 |
$1,216 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$660 |
$660 |
6.0× |
| Us breast unilateral complete (76641) |
$715 |
$715 |
6.5× |
| Us breast unilateral limited (76642) |
$518 |
$518 |
5.6× |
| Us compl joint r-t w/image documentation (76881) |
$709 |
$709 |
6.4× |
| Us ob transvaginal (76817) |
$577 |
$577 |
5.2× |
| Us pelvic non ob complete (76856) |
$698 |
$698 |
6.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$582 |
$582 |
5.3× |
| Us pregnancy ltd (76815) |
$497 |
$497 |
4.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$677 |
$677 |
6.1× |
| Us retroperitoneal complete (76770) |
$759 |
$759 |
6.9× |
| Us retroperitoneal limited (76775) |
$759 |
$759 |
6.9× |
| Us scrotum and contents (76870) |
$559 |
$559 |
5.1× |
| Us soft tissue head/neck (76536) |
$652 |
$652 |
5.9× |
| Us spinal canal and contents (76800) |
$715 |
$715 |
6.5× |
| Us xtr non-vasc lmtd (76882) |
$596 |
$596 |
5.4× |
| Wrist 2 views (73100) |
$207 |
$207 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$546 |
$546 |
5.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$300 |
$300 |
3.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$355 |
$355 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$295 |
$295 |
3.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$300 |
$300 |
3.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$723 |
$723 |
6.6× |
| X-ray exam hip uni 1 view (73501) |
$248 |
$248 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$404 |
$404 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$586 |
$586 |
5.3× |
| X-ray eye for foreign body (70030) |
$264 |
$264 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$408 |
$408 |
3.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$376 |
$376 |
4.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$377 |
$377 |
4.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$288 |
$288 |
3.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$552 |
$552 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$290 |
$290 |
3.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$541 |
$541 |
4.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$377 |
$377 |
4.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$494 |
$494 |
4.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$663 |
$663 |
6.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$489 |
$489 |
4.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$290 |
$290 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$408 |
$408 |
3.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$436 |
$436 |
4.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$930 |
$930 |
2.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$272 |
$272 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$465 |
$465 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$544 |
$544 |
4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$411 |
$411 |
3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$351 |
$351 |
3.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$350 |
$350 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$376 |
$376 |
4.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$271 |
$271 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$439 |
$439 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$355 |
$355 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$274 |
$274 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$253 |
$253 |
2.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$293 |
$293 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$406 |
$406 |
3.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$668 |
$668 |
6.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$259 |
$259 |
2.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$355 |
$355 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$723 |
$723 |
6.6× |
| Xr chest 4+ views (71048) |
$492 |
$492 |
4.5× |
| Xr finger(s) 2+ views (73140) |
$229 |
$229 |
2.5× |
| Xr optic foramina (70190) |
$376 |
$376 |
4.1× |
| Xr shoulder 1 view (73020) |
$272 |
$272 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$590 |
$590 |
5.4× |
| Xr tibia/fibula 2 views (73590) |
$397 |
$397 |
4.3× |
| Xr tmj bilateral (70330) |
$408 |
$408 |
4.4× |
| Xray knee 1 or 2 views rt (73560) |
$391 |
$391 |
4.3× |