| Abdomen 2 views (74019) |
$320.41 |
$376.95 |
2.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$812.64 |
$956.05 |
1.9× |
| Ankle 2 views (73600) |
$203.15 |
$239 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$938.40 |
$1,104 |
2.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$869.64 |
$1,023.10 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$1,228.25 |
$1,445 |
2.9× |
| Bone age studies (77072) |
$280.38 |
$329.86 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,406.75 |
$1,655 |
3.3× |
| Bone survey complete (77075) |
$490.89 |
$577.52 |
4.5× |
| Cervical spine 2 or 3 views (72040) |
$394.40 |
$464 |
4.3× |
| Chest 1 view (71045) |
$194.65 |
$229 |
2.1× |
| Chest 3 views (71047) |
$250.04 |
$294.17 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$258.57 |
$304.20 |
1.4× |
| Clavicle complete (73000) |
$233.75 |
$275 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$415.86 |
$489.25 |
3.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,482 |
$2,920 |
6.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,188.75 |
$2,575 |
8.7× |
| CT abdomen w contrast (74160) |
$1,207.01 |
$1,420.01 |
6.5× |
| CT abdomen w wo contrast (74170) |
$1,327.44 |
$1,561.69 |
7.2× |
| CT abdomen w/o contrast (74150) |
$963.05 |
$1,133 |
8.7× |
| CT c-spine w/o contrast (72125) |
$1,551.25 |
$1,825 |
14.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,997.50 |
$2,350 |
10.8× |
| CT cervical spine with contrast (72126) |
$1,632 |
$1,920 |
4.4× |
| CT chest w/wo contrast (71270) |
$1,997.50 |
$2,350 |
10.8× |
| CT chest with contrast (71260) |
$1,627.75 |
$1,915 |
8.8× |
| CT head/brain with contrast (70460) |
$1,513 |
$1,780 |
8.2× |
| CT head/brain without and with contrast (70470) |
$1,827.50 |
$2,150 |
9.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$85 |
$100 |
0.9× |
| CT iac w contrast (70481) |
$959.32 |
$1,128.62 |
5.2× |
| CT limited/localized follow up study (76380) |
$402.73 |
$473.80 |
4.4× |
| CT lower ext w/o (73700) |
$912.27 |
$1,073.26 |
8.3× |
| CT lower extremity w wo contrast (73702) |
$926.50 |
$1,090 |
5.0× |
| CT lower extremity with contrast (73701) |
$913.75 |
$1,075 |
4.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,997.50 |
$2,350 |
10.8× |
| CT lumbar spine w/o contrast (72131) |
$1,496 |
$1,760 |
13.6× |
| CT lumbar spine with contrast (72132) |
$1,632 |
$1,920 |
4.4× |
| CT maxillofacial w contrast (70487) |
$780.07 |
$917.73 |
4.2× |
| CT maxillofacial w/o contrast (70486) |
$768.28 |
$903.86 |
7.0× |
| CT maxillofacial w/wo contrast (70488) |
$907.32 |
$1,067.44 |
4.9× |
| CT neck soft tissue w contrast (70491) |
$864.12 |
$1,016.61 |
4.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,035.54 |
$1,218.29 |
5.6× |
| CT orbits w/o contrast (70480) |
$1,151.75 |
$1,355 |
10.4× |
| CT pelvis w & w/o contrast (72194) |
$1,997.50 |
$2,350 |
10.8× |
| CT pelvis w/o contrast (72192) |
$1,496 |
$1,760 |
13.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,207.01 |
$1,420.01 |
6.5× |
| CT soft tissue neck w/o contrast (70490) |
$563.52 |
$662.96 |
5.1× |
| CT thoracic spine w/contrast (72129) |
$1,632 |
$1,920 |
8.8× |
| CT thoracic spine w/o contrast (72128) |
$1,483.25 |
$1,745 |
13.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,997.50 |
$2,350 |
10.8× |
| CT thorax w/o contrast (71250) |
$1,513 |
$1,780 |
13.7× |
| CT unlisted procedure (76497) |
$402.73 |
$473.80 |
4.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$926.50 |
$1,090 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$563.52 |
$662.96 |
5.1× |
| CT upper extremity with contrast (73201) |
$1,287.67 |
$1,514.90 |
3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,207.01 |
$1,420.01 |
6.5× |
| Cta Abdomen (74175) |
$1,207.01 |
$1,420.01 |
6.5× |
| CTA abdomen pelvis (74174) |
$1,769.61 |
$2,081.89 |
4.8× |
| CTA chest (71275) |
$1,692.34 |
$1,990.99 |
9.1× |
| Cta Head (70496) |
$1,207.01 |
$1,420.01 |
6.5× |
| Cta Neck (70498) |
$1,207.01 |
$1,420.01 |
6.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$489.06 |
$575.36 |
4.4× |
| Dxa bone density study axial skeleton (77085) |
$731.04 |
$860.05 |
6.6× |
| Fetal biophysical profile non-stress testing (76818) |
$683.77 |
$804.43 |
6.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$275.78 |
$324.45 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$503.41 |
$592.25 |
2.0× |
| Foot 2 views (73620) |
$203.15 |
$239 |
2.2× |
| Forearm 2 views (73090) |
$233.75 |
$275 |
2.5× |
| Gastric mucosa imaging (78261) |
$812.64 |
$956.05 |
1.9× |
| Gated Heart Planar Single (78472) |
$908.24 |
$1,068.52 |
2.2× |
| Hand 2 views (73120) |
$204 |
$240 |
1.8× |
| Hand 3 views (73130) |
$233.75 |
$275 |
2.5× |
| Heart Infarct Image (78466) |
$908.24 |
$1,068.52 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,309.97 |
$1,541.14 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,170.93 |
$1,377.56 |
2.8× |
| Ht muscle image spect sing (78451) |
$2,099.63 |
$2,470.15 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$228.65 |
$269 |
2.5× |
| Hysterosalpingogram (74740) |
$941.59 |
$1,107.75 |
3.7× |
| Kidney imaging morphology (78700) |
$784.14 |
$922.52 |
1.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$810.80 |
$953.88 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,202.75 |
$1,415 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,111.18 |
$1,307.27 |
1.9× |
| Knee 3 views (73562) |
$277.10 |
$326 |
3.0× |
| Liver & spleen imaging static only (78215) |
$936.74 |
$1,102.05 |
2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$936.74 |
$1,102.05 |
2.2× |
| Meckels Diverticulum (78290) |
$812.64 |
$956.05 |
1.9× |
| MRA head w & w/o contrast (70546) |
$1,507.61 |
$1,773.66 |
4.1× |
| MRA head w/o contrast (70544) |
$1,367.88 |
$1,609.27 |
5.4× |
| MRA neck w contrast (70548) |
$2,477.75 |
$2,915 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,720 |
$3,200 |
7.4× |
| MRA neck w/o contrast (70547) |
$2,341.75 |
$2,755 |
9.3× |
| MRI abdomen w contrast (74182) |
$2,337.50 |
$2,750 |
6.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,635 |
$3,100 |
7.2× |
| MRI abdomen w/o contrast (74181) |
$2,125 |
$2,500 |
8.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,415.68 |
$1,665.51 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,608.74 |
$1,892.63 |
1.9× |
| MRI c-spine with contrast (72142) |
$2,125 |
$2,500 |
5.8× |
| MRI cervical spine w/o contrast (72141) |
$1,955 |
$2,300 |
7.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,415.68 |
$1,665.51 |
3.8× |
| MRI chest w/o contrast (71550) |
$781.39 |
$919.28 |
3.1× |
| MRI chest with contrast (71551) |
$1,286.99 |
$1,514.10 |
1.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,286.99 |
$1,514.10 |
3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,608.74 |
$1,892.63 |
4.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,367.88 |
$1,609.27 |
5.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,367.88 |
$1,609.27 |
5.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,507.61 |
$1,773.66 |
4.1× |
| MRI pelvis w contrast (72196) |
$2,380 |
$2,800 |
6.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,635 |
$3,100 |
7.2× |
| MRI pelvis w/o contrast (72195) |
$1,870 |
$2,200 |
7.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,769.61 |
$2,081.89 |
4.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,851.68 |
$2,178.45 |
5.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,635 |
$3,100 |
7.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,125 |
$2,500 |
5.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,635 |
$3,100 |
7.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,635 |
$3,100 |
7.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,955 |
$2,300 |
7.8× |
| MRI tmj (70336) |
$1,093.94 |
$1,286.99 |
4.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,373.66 |
$1,616.07 |
5.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,544.38 |
$1,816.92 |
4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,235.68 |
$2,630.21 |
8.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,805.10 |
$3,300.12 |
2.1× |
| Neck soft tissue (70360) |
$291.54 |
$342.99 |
3.2× |
| Nm gastric emptying study (78264) |
$992.80 |
$1,168 |
2.4× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,143.40 |
$1,345.18 |
0.8× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,143.40 |
$1,345.18 |
0.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$784.14 |
$922.52 |
1.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$449.52 |
$528.85 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$449.52 |
$528.85 |
0.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$252.80 |
$297.41 |
2.3× |
| Osseous survey infant (77076) |
$238.51 |
$280.60 |
2.2× |
| Parathyroid imaging (78070) |
$1,138.15 |
$1,339 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$295.09 |
$347.16 |
2.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,769.61 |
$2,081.89 |
4.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$717.03 |
$843.57 |
1.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,166.56 |
$1,372.42 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$941.59 |
$1,107.75 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$281.35 |
$331 |
3.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$486.29 |
$572.11 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$601.21 |
$707.30 |
5.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$280.38 |
$329.86 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$285.60 |
$336 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$249.44 |
$293.45 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$317.73 |
$373.80 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$272.94 |
$321.10 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$249.90 |
$294 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$299.23 |
$352.03 |
3.3× |
| Radiological examination surgical specimen (76098) |
$969.83 |
$1,140.98 |
1.7× |
| Sacroiliac Joints < 3 Views (72200) |
$258.60 |
$304.24 |
2.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$459.64 |
$540.75 |
1.8× |
| Salivary gland imaging (78230) |
$812.64 |
$956.05 |
1.9× |
| Scanogram (77073) |
$300.90 |
$354 |
2.7× |
| Scapula complete (73010) |
$234.41 |
$275.78 |
2.1× |
| Screening digital breast tomosynthesis (77063) |
$55.16 |
$64.89 |
2.4× |
| Spine thoracic 3 views (72072) |
$298.58 |
$351.27 |
2.7× |
| Thoracolumbar 2 views (72080) |
$241.40 |
$284 |
2.6× |
| Tmj unilateral (70328) |
$165.11 |
$194.25 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$574.55 |
$675.94 |
5.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$165.11 |
$194.25 |
1.8× |
| Unlisted magnetic resonance procedure (76498) |
$781.39 |
$919.28 |
8.5× |
| Unlisted Ultrasound Procedure (76999) |
$344.73 |
$405.56 |
3.8× |
| Upper Extremity Infant (73092) |
$280.38 |
$329.86 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$718.46 |
$845.25 |
3.9× |
| Us breast unilateral complete (76641) |
$295.04 |
$347.11 |
2.7× |
| Us breast unilateral limited (76642) |
$242.51 |
$285.31 |
2.6× |
| Us chest (76604) |
$344.73 |
$405.56 |
3.1× |
| Us ob transvaginal (76817) |
$557.69 |
$656.11 |
5.1× |
| Us pelvic non ob complete (76856) |
$536.35 |
$631 |
4.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$187.85 |
$221 |
1.7× |
| Us pregnancy ltd (76815) |
$485.03 |
$570.62 |
4.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$584.80 |
$688 |
5.3× |
| Us retroperitoneal complete (76770) |
$684.86 |
$805.72 |
6.2× |
| Us scrotum and contents (76870) |
$552.50 |
$650 |
5.0× |
| Us soft tissue head/neck (76536) |
$702.10 |
$826 |
6.4× |
| Us xtr non-vasc lmtd (76882) |
$482.62 |
$567.79 |
4.4× |
| Venography extremity unilateral rs&i (75820) |
$1,789.46 |
$2,105.25 |
1.1× |
| Wrist 2 views (73100) |
$204 |
$240 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$408.85 |
$481 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$236.39 |
$278.10 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$260.10 |
$306 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$203.15 |
$239 |
2.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$334.05 |
$393 |
3.6× |
| X-ray exam hip uni 1 view (73501) |
$284.98 |
$335.27 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$400.80 |
$471.53 |
4.4× |
| X-ray eye for foreign body (70030) |
$153 |
$180 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$219.30 |
$258 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$203.15 |
$239 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$317.90 |
$374 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$233.75 |
$275 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$170.07 |
$200.08 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$483.65 |
$569 |
4.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$319.46 |
$375.83 |
3.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$170.07 |
$200.08 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$360.40 |
$424 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$525.30 |
$618 |
4.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$215.73 |
$253.80 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$300.90 |
$354 |
2.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$312.77 |
$367.97 |
2.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$308.55 |
$363 |
3.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$470.14 |
$553.11 |
4.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$487.22 |
$573.20 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$367.20 |
$432 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$299.20 |
$352 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$251.60 |
$296 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$368.59 |
$433.63 |
4.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$273.95 |
$322.29 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$315.31 |
$370.95 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$471.89 |
$555.17 |
4.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$216.18 |
$254.32 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$170.07 |
$200.08 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$252.80 |
$297.40 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$281.35 |
$331 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$203.15 |
$239 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$251.60 |
$296 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$708.28 |
$833.27 |
6.4× |
| Xr chest 4+ views (71048) |
$285.90 |
$336.35 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$203.15 |
$239 |
2.2× |
| Xr optic foramina (70190) |
$170.07 |
$200.08 |
1.9× |
| Xr shoulder 1 view (73020) |
$266.59 |
$313.64 |
2.9× |
| Xr spine cervical 4 or 5 views (72050) |
$483.65 |
$569 |
4.4× |
| Xr tibia/fibula 2 views (73590) |
$299.20 |
$352 |
3.3× |
| Xr tmj bilateral (70330) |
$315.31 |
$370.95 |
3.4× |
| Xray knee 1 or 2 views rt (73560) |
$343.50 |
$404.12 |
3.7× |