| Abdomen 2 views (74019) |
$524.45 |
$617 |
4.5× |
| Angiography extremity bilateral rs&i (75716) |
$327.25 |
$385 |
0.1× |
| Angiography extremity unilateral rs&i (75710) |
$301.75 |
$355 |
0.1× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$272.85 |
$321 |
0.0× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$328.95 |
$387 |
0.1× |
| Ankle 2 views (73600) |
$456.88 |
$537.50 |
4.7× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$235.45 |
$277 |
0.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$569.50 |
$670 |
0.2× |
| Aortography abdominal serialography rs&i (75625) |
$95.20 |
$112 |
0.0× |
| Arthrogram ankle (73615) |
$871.25 |
$1,025 |
2.2× |
| Arthrogram elbow (73085) |
$722.50 |
$850 |
1.9× |
| Arthrogram hip (73525) |
$935.42 |
$1,100.50 |
2.4× |
| Arthrogram knee (73580) |
$985.15 |
$1,159 |
2.5× |
| Arthrogram shoulder (73040) |
$1,133.05 |
$1,333 |
2.9× |
| Arthrogram wrist (73115) |
$862.75 |
$1,015 |
2.2× |
| Bone age studies (77072) |
$374 |
$440 |
3.2× |
| Bone survey complete (77075) |
$1,334.50 |
$1,570 |
11.5× |
| Bone survey infant (77076) |
$318.75 |
$375 |
2.7× |
| Cervical spine 2 or 3 views (72040) |
$552.50 |
$650 |
5.7× |
| Chest 1 view (71045) |
$226.10 |
$266 |
2.3× |
| Chest xray 3 views (71047) |
$675.75 |
$795 |
7.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$841.50 |
$990 |
4.3× |
| Clavicle complete (73000) |
$462.40 |
$544 |
4.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,623.50 |
$1,910 |
13.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,367.75 |
$6,315 |
13.8× |
| CT abdomen and pelvis without contrast (74176) |
$4,505 |
$5,300 |
16.9× |
| CT abdomen w contrast (74160) |
$2,830.50 |
$3,330 |
14.5× |
| CT abdomen w wo contrast (74170) |
$3,094 |
$3,640 |
15.8× |
| CT abdomen w/o contrast (74150) |
$2,018.75 |
$2,375 |
17.3× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,166.20 |
$1,372 |
6.0× |
| CT angiography upper extremity lt (73206) |
$1,180.65 |
$1,389 |
6.0× |
| CT c-spine w/contrast (72126) |
$2,660.50 |
$3,130 |
6.8× |
| CT c-spine w/o contrast (72125) |
$2,303.50 |
$2,710 |
19.8× |
| CT chest w contrast (71260) |
$3,706 |
$4,360 |
19.0× |
| CT chest w/wo contrast (71270) |
$2,928.25 |
$3,445 |
15.0× |
| CT head/brain with contrast (70460) |
$2,465 |
$2,900 |
12.6× |
| CT head/brain without and with contrast (70470) |
$3,017.50 |
$3,550 |
15.4× |
| CT iac w contrast (70481) |
$2,155.60 |
$2,536 |
11.0× |
| CT lower ext w/o (73700) |
$2,128.40 |
$2,504 |
18.3× |
| CT lower extremity w/contrast material (73701) |
$2,579.75 |
$3,035 |
13.2× |
| CT lumbar spine w/contrast (72132) |
$2,881.50 |
$3,390 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$2,465 |
$2,900 |
21.2× |
| CT maxillofacial w contrast (70487) |
$2,048.50 |
$2,410 |
10.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,337.50 |
$2,750 |
12.0× |
| CT maxillofacial wo contrast (70486) |
$1,612.02 |
$1,896.50 |
13.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,363.85 |
$2,781 |
12.1× |
| CT orbits w/o contrast (70480) |
$1,708.50 |
$2,010 |
14.7× |
| CT pelvis w/o contrast (72192) |
$2,054.02 |
$2,416.50 |
17.6× |
| CT pelvis w/wo contrast (72194) |
$2,975 |
$3,500 |
15.2× |
| CT soft tissue neck w contrast (70491) |
$3,441.65 |
$4,049 |
17.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,295 |
$2,700 |
11.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,437.35 |
$1,691 |
12.3× |
| CT thoracic spine w/contrast (72129) |
$3,043 |
$3,580 |
15.6× |
| CT thoracic spine w/o contrast (72128) |
$2,439.50 |
$2,870 |
20.9× |
| CT thorax w/o contrast (71250) |
$2,201.50 |
$2,590 |
18.9× |
| CT upper ext wo (73200) |
$1,664.30 |
$1,958 |
14.3× |
| CT upper extremity with contrast (73201) |
$2,370.65 |
$2,789 |
6.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$5,287 |
$6,220 |
27.0× |
| Cta Abdomen (74175) |
$3,723 |
$4,380 |
19.0× |
| CTA abdomen pelvis (74174) |
$5,367.75 |
$6,315 |
13.8× |
| CTA chest (71275) |
$3,298 |
$3,880 |
16.9× |
| Cta Head (70496) |
$3,578.50 |
$4,210 |
18.3× |
| Cta Neck (70498) |
$3,506.25 |
$4,125 |
17.9× |
| Cta Pelvis (72191) |
$2,796.50 |
$3,290 |
14.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$494.70 |
$582 |
4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$289 |
$340 |
3.0× |
| Esophagus (74220) |
$723.35 |
$851 |
3.7× |
| Facial bones min 3 views (70150) |
$658.75 |
$775 |
5.7× |
| Fetal biophysical profile non-stress testing (76818) |
$142.80 |
$168 |
1.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$178.50 |
$210 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$807.50 |
$950 |
3.0× |
| Foot 2 views (73620) |
$451.78 |
$531.50 |
4.7× |
| Forearm 2 views (73090) |
$487.90 |
$574 |
5.0× |
| Hand 2 views (73120) |
$480.25 |
$565 |
4.1× |
| Hysterosalpingogram (74740) |
$1,008.95 |
$1,187 |
3.8× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$31.45 |
$37 |
0.3× |
| Knee 3 views (73562) |
$611.15 |
$719 |
6.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$4,160.75 |
$4,895 |
4.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$4,377.50 |
$5,150 |
11.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$5,291.25 |
$6,225 |
13.6× |
| MRA head w & w/o contrast (70546) |
$4,513.50 |
$5,310 |
11.6× |
| MRA head w/o contrast (70544) |
$3,289.50 |
$3,870 |
12.4× |
| MRA head with contrast (70545) |
$3,493.50 |
$4,110 |
9.0× |
| MRA neck w contrast (70548) |
$3,595.50 |
$4,230 |
9.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,360.50 |
$5,130 |
11.2× |
| MRA neck w/o contrast (70547) |
$3,043 |
$3,580 |
11.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,602.75 |
$5,415 |
11.8× |
| MRI abdomen w/o contrast (74181) |
$3,901.50 |
$4,590 |
14.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,259.75 |
$3,835 |
3.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,206.25 |
$6,125 |
13.4× |
| MRI breast w/o contrast bilateral (77047) |
$2,868.75 |
$3,375 |
10.8× |
| MRI breast wo contrast unilateral (77046) |
$1,912.50 |
$2,250 |
7.2× |
| MRI c-spine with contrast (72142) |
$3,697.50 |
$4,350 |
9.5× |
| MRI cervical spine w/o contrast (72141) |
$3,289.50 |
$3,870 |
12.4× |
| MRI chest w/o & w/contrast material (71552) |
$4,692 |
$5,520 |
12.1× |
| MRI chest w/o contrast (71550) |
$3,162 |
$3,720 |
11.9× |
| MRI chest with contrast (71551) |
$3,493.50 |
$4,110 |
4.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,366.88 |
$5,137.50 |
11.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$6,045.62 |
$7,112.50 |
15.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,111.88 |
$4,837.50 |
15.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,493.50 |
$4,110 |
13.1× |
| MRI orbit face neck w contrast (70542) |
$4,012 |
$4,720 |
10.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,862.85 |
$5,721 |
12.5× |
| MRI pelvis w/contrast (72196) |
$3,553 |
$4,180 |
9.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,934.25 |
$5,805 |
12.7× |
| MRI pelvis w/o contrast (72195) |
$3,289.50 |
$3,870 |
12.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,032 |
$5,920 |
12.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,697.50 |
$4,350 |
9.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,032 |
$5,920 |
12.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,842 |
$4,520 |
9.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,032 |
$5,920 |
12.9× |
| MRI temporomandibular joint (70336) |
$2,958 |
$3,480 |
11.1× |
| MRI thoracic spine w/o contrast (72146) |
$3,289.50 |
$3,870 |
12.4× |
| MRI up ext w/o contrast (73218) |
$3,051.50 |
$3,590 |
11.5× |
| MRI upper ext joint w/o contrast (73221) |
$3,633.75 |
$4,275 |
13.7× |
| MRI, joint upper extrem combo (73223) |
$5,450.62 |
$6,412.50 |
14.0× |
| Neck soft tissue (70360) |
$336.60 |
$396 |
3.5× |
| Ob us nuchal meas 1 gest (76813) |
$221 |
$260 |
1.9× |
| Osseous survey limited (77074) |
$684.25 |
$805 |
5.9× |
| Pelvis 1 or 2 views (72170) |
$395.25 |
$465 |
3.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$568.65 |
$669 |
5.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$414.38 |
$487.50 |
4.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$584.38 |
$687.50 |
6.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$314.50 |
$370 |
3.2× |
| Radex fingr minimum 2 views (73140) |
$314.50 |
$370 |
3.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$568.65 |
$669 |
5.9× |
| Radex Hand Minimum 3 Views (73130) |
$563.12 |
$662.50 |
5.8× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$280.50 |
$330 |
2.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$447.10 |
$526 |
3.8× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$709.75 |
$835 |
6.1× |
| Radex Humerus Minimum 2 Views (73060) |
$515.52 |
$606.50 |
5.3× |
| Radex Kne 1/2 Views (73560) |
$488.75 |
$575 |
5.0× |
| Radex Kne Compl 4/More Views (73564) |
$717.40 |
$844 |
6.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$568.65 |
$669 |
4.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$389.30 |
$458 |
4.0× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$613.70 |
$722 |
5.3× |
| Radex Sho Compl Minimum 2 Views (73030) |
$605.62 |
$712.50 |
6.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$359.12 |
$422.50 |
3.7× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$476 |
$560 |
4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$522.75 |
$615 |
5.4× |
| Radex Toe Minimum 2 Views (73660) |
$342.55 |
$403 |
3.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$327.25 |
$385 |
2.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$568.65 |
$669 |
5.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$383.35 |
$451 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$556.75 |
$655 |
4.8× |
| Radiologic exam chest 2 views (71046) |
$425 |
$500 |
4.4× |
| Radiologic exam colon single contrast study (74270) |
$1,100.75 |
$1,295 |
5.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$960.50 |
$1,130 |
4.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,009.80 |
$1,188 |
5.2× |
| Radiologic examination femur 1 view (73551) |
$357 |
$420 |
3.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$500.65 |
$589 |
5.2× |
| Radiological examination surgical specimen (76098) |
$480.25 |
$565 |
0.8× |
| Ribs bilateral 3 views (71110) |
$654.50 |
$770 |
5.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$221 |
$260 |
0.8× |
| Scapula (73010) |
$503.62 |
$592.50 |
4.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$99.45 |
$117 |
4.3× |
| Shoulder 1 view (73020) |
$294.95 |
$347 |
3.0× |
| Small bowel series (74250) |
$841.50 |
$990 |
4.3× |
| Spine thoracic 3 views (72072) |
$595 |
$700 |
5.1× |
| Thoracolumbar 2 views (72080) |
$522.75 |
$615 |
5.4× |
| Tmj unilateral (70328) |
$300.05 |
$353 |
3.1× |
| Ultrasound Exam Aaa Screen (76706) |
$223.55 |
$263 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$301.75 |
$355 |
2.6× |
| Umbilical-artery Doppler (OB) (76820) |
$54.40 |
$64 |
0.5× |
| Urethrocystogram voiding (74455) |
$923.10 |
$1,086 |
3.5× |
| Us breast unilateral limited (76642) |
$386.75 |
$455 |
4.0× |
| Us chest (76604) |
$215.05 |
$253 |
1.8× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$133.45 |
$157 |
0.6× |
| Us compl joint r-t w/image documentation (76881) |
$154.70 |
$182 |
1.3× |
| Us encephalogram (76506) |
$378.39 |
$445.17 |
3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$220.96 |
$259.94 |
1.9× |
| Us ob detailed single fetus (76811) |
$141.10 |
$166 |
0.5× |
| Us ob limited (76815) |
$147.90 |
$174 |
1.3× |
| Us ob transvaginal (76817) |
$124.52 |
$146.50 |
1.1× |
| Us pelvic non ob complete (76856) |
$318.44 |
$374.63 |
2.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$182.75 |
$215 |
1.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$158.10 |
$186 |
1.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$221 |
$260 |
1.9× |
| Us retroperitoneal complete (76770) |
$394.61 |
$464.25 |
3.4× |
| Us retroperitoneal limited (76775) |
$55.25 |
$65 |
0.5× |
| Us scrotum and contents (76870) |
$361.25 |
$425 |
3.1× |
| Us soft tissue head/neck (76536) |
$301.86 |
$355.13 |
2.6× |
| Us spinal canal and contents (76800) |
$212.50 |
$250 |
1.8× |
| Us transrectal (76872) |
$339.15 |
$399 |
2.9× |
| Us, eye b-scan (76512) |
$207.82 |
$244.50 |
1.8× |
| Venogram extremity bilateral (75822) |
$259.25 |
$305 |
0.1× |
| Venogram Extremity Unilateral (75820) |
$238 |
$280 |
0.1× |
| Venography caval superior serialography rs&i (75827) |
$76.50 |
$90 |
0.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$246.50 |
$290 |
0.1× |
| Vertebral fracture assessment via dxa (77086) |
$267.75 |
$315 |
2.8× |
| Wrist 2 views (73100) |
$363.80 |
$428 |
3.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$646 |
$760 |
5.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$442.85 |
$521 |
4.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,368.50 |
$1,610 |
7.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$441.15 |
$519 |
4.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$578 |
$680 |
6.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$561.85 |
$661 |
4.8× |
| X-ray exam of femur 2/> (73552) |
$579.28 |
$681.50 |
6.0× |
| X-ray eye for foreign body (70030) |
$261.80 |
$308 |
2.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$395.25 |
$465 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$328.10 |
$386 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$344.25 |
$405 |
3.5× |
| X-ray leg, infant (73592) |
$297.50 |
$350 |
3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$552.50 |
$650 |
4.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$998.75 |
$1,175 |
8.6× |
| X-ray nose-rectum child f.b. (76010) |
$374 |
$440 |
3.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$531.25 |
$625 |
4.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$480.25 |
$565 |
5.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$595 |
$700 |
5.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$675.75 |
$795 |
5.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$522.75 |
$615 |
4.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$514.25 |
$605 |
5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$633.25 |
$745 |
6.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$688.50 |
$810 |
5.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$454.75 |
$535 |
3.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$256.70 |
$302 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$420.75 |
$495 |
4.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$396.95 |
$467 |
4.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$531.25 |
$625 |
4.6× |
| Xr bone length studies (77073) |
$514.25 |
$605 |
4.4× |
| Xr c-spine 4 or 5 views (72050) |
$773.50 |
$910 |
6.6× |
| Xr c-spine 6 or more views (72052) |
$799 |
$940 |
6.9× |
| Xr chest 4+ views (71048) |
$633.25 |
$745 |
5.4× |