| Abdomen 2 views (74019) |
$424 |
$424 |
3.9× |
| Ankle 2 views (73600) |
$226 |
$226 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,423 |
$1,423 |
3.4× |
| Bone age studies (77072) |
$210 |
$210 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,349 |
$1,349 |
3.3× |
| Bone survey complete (77075) |
$516 |
$516 |
4.8× |
| Cervical spine 2 or 3 views (72040) |
$341 |
$341 |
3.8× |
| Chest 1 view (71045) |
$213 |
$213 |
2.4× |
| Chest xray 3 views (71047) |
$423 |
$423 |
4.7× |
| Clavicle complete (73000) |
$256 |
$256 |
2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,832 |
$1,832 |
17.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,542 |
$3,542 |
9.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,755 |
$2,755 |
11.2× |
| CT abdomen w contrast (74160) |
$1,986 |
$1,986 |
11.0× |
| CT abdomen w wo contrast (74170) |
$2,333 |
$2,333 |
12.9× |
| CT abdomen w/o contrast (74150) |
$2,025 |
$2,025 |
18.8× |
| CT angiography upper extremity lt (73206) |
$1,168 |
$1,168 |
6.5× |
| CT c-spine w/contrast (72126) |
$1,689 |
$1,689 |
4.7× |
| CT c-spine w/o contrast (72125) |
$1,688 |
$1,688 |
15.6× |
| CT chest w contrast (71260) |
$1,918 |
$1,918 |
10.6× |
| CT chest w/wo contrast (71270) |
$1,990 |
$1,990 |
11.0× |
| CT head/brain with contrast (70460) |
$1,415 |
$1,415 |
7.8× |
| CT head/brain without and with contrast (70470) |
$1,726 |
$1,726 |
9.5× |
| CT iac w contrast (70481) |
$1,789 |
$1,789 |
9.9× |
| CT limited/localized follow up study (76380) |
$685 |
$685 |
7.6× |
| CT lower ext w/o (73700) |
$1,399 |
$1,399 |
13.0× |
| CT lower extremity w/contrast material (73701) |
$1,557 |
$1,557 |
8.6× |
| CT lumbar spine w/contrast (72132) |
$1,695 |
$1,695 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$1,677 |
$1,677 |
15.5× |
| CT maxillofacial w contrast (70487) |
$1,842 |
$1,842 |
10.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,608 |
$1,608 |
8.9× |
| CT maxillofacial wo contrast (70486) |
$1,397 |
$1,397 |
12.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,183 |
$2,183 |
12.1× |
| CT orbits w/o contrast (70480) |
$1,401 |
$1,401 |
13.0× |
| CT pelvis w/o contrast (72192) |
$1,229 |
$1,229 |
11.4× |
| CT pelvis w/wo contrast (72194) |
$1,926 |
$1,926 |
10.6× |
| CT scan of arm combo (73202) |
$1,666 |
$1,666 |
9.2× |
| CT soft tissue neck w contrast (70491) |
$1,625 |
$1,625 |
9.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,032 |
$2,032 |
11.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,152 |
$1,152 |
10.7× |
| CT thoracic spine w/contrast (72129) |
$1,817 |
$1,817 |
10.0× |
| CT thoracic spine w/o contrast (72128) |
$1,626 |
$1,626 |
15.1× |
| CT thorax w/o contrast (71250) |
$1,527 |
$1,527 |
14.2× |
| CT upper ext wo (73200) |
$1,389 |
$1,389 |
12.9× |
| CT upper extremity with contrast (73201) |
$1,498 |
$1,498 |
4.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,205 |
$2,205 |
12.2× |
| Cta Abdomen (74175) |
$2,217 |
$2,217 |
12.2× |
| CTA abdomen pelvis (74174) |
$2,960 |
$2,960 |
8.2× |
| CTA chest (71275) |
$2,464 |
$2,464 |
13.6× |
| Cta Head (70496) |
$2,027 |
$2,027 |
11.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,900 |
$3,900 |
10.8× |
| Cta Neck (70498) |
$2,027 |
$2,027 |
11.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$612 |
$612 |
5.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$247 |
$247 |
2.7× |
| Facial bones min 3 views (70150) |
$389 |
$389 |
3.6× |
| Fetal biophysical profile non-stress testing (76818) |
$268 |
$268 |
2.5× |
| Foot 2 views (73620) |
$223 |
$223 |
2.5× |
| Forearm 2 views (73090) |
$244 |
$244 |
2.7× |
| Hand 2 views (73120) |
$194 |
$194 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,310 |
$2,310 |
4.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,514 |
$1,514 |
3.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$486 |
$486 |
0.9× |
| Knee 3 views (73562) |
$280 |
$280 |
3.1× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,401 |
$2,401 |
3.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,216 |
$1,216 |
3.4× |
| MRA head w & w/o contrast (70546) |
$3,361 |
$3,361 |
9.3× |
| MRA head w/o contrast (70544) |
$2,495 |
$2,495 |
10.1× |
| MRA neck w contrast (70548) |
$855 |
$855 |
2.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,199 |
$3,199 |
8.9× |
| MRA neck w/o contrast (70547) |
$2,121 |
$2,121 |
8.6× |
| MRI abdomen w contrast (74182) |
$3,275 |
$3,275 |
9.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,661 |
$3,661 |
10.2× |
| MRI abdomen w/o contrast (74181) |
$2,927 |
$2,927 |
11.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,401 |
$2,401 |
3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,977 |
$2,977 |
8.3× |
| MRI c-spine with contrast (72142) |
$2,792 |
$2,792 |
7.8× |
| MRI cervical spine w/o contrast (72141) |
$2,406 |
$2,406 |
9.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,680 |
$2,680 |
7.4× |
| MRI chest w/o contrast (71550) |
$1,994 |
$1,994 |
8.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,100 |
$3,100 |
8.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,030 |
$3,030 |
8.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,101 |
$3,101 |
12.6× |
| MRI orbit face neck w contrast (70542) |
$3,361 |
$3,361 |
9.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,017 |
$3,017 |
8.4× |
| MRI pelvis w/contrast (72196) |
$2,075 |
$2,075 |
5.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,217 |
$2,217 |
6.2× |
| MRI pelvis w/o contrast (72195) |
$2,226 |
$2,226 |
9.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,209 |
$3,209 |
8.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,073 |
$3,073 |
8.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,655 |
$3,655 |
10.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,562 |
$3,562 |
9.9× |
| MRI temporomandibular joint (70336) |
$2,780 |
$2,780 |
11.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,881 |
$2,881 |
11.7× |
| MRI up ext w/o contrast (73218) |
$2,285 |
$2,285 |
9.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,376 |
$2,376 |
9.6× |
| MRI, joint upper extrem combo (73223) |
$3,025 |
$3,025 |
8.4× |
| Neck soft tissue (70360) |
$257 |
$257 |
2.9× |
| Orthopantogram (70355) |
$291 |
$291 |
3.2× |
| Osseous survey limited (77074) |
$511 |
$511 |
4.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$852 |
$852 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$280 |
$280 |
2.6× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$280 |
$280 |
3.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$224 |
$224 |
2.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$280 |
$280 |
3.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$379 |
$379 |
4.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$403 |
$403 |
3.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$427 |
$427 |
4.0× |
| Radex fingr minimum 2 views (73140) |
$224 |
$224 |
2.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$292 |
$292 |
3.3× |
| Radex Hand Minimum 3 Views (73130) |
$280 |
$280 |
3.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$244 |
$244 |
2.7× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$295 |
$295 |
2.7× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$361 |
$361 |
3.3× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$411 |
$411 |
3.8× |
| Radex Humerus Minimum 2 Views (73060) |
$280 |
$280 |
3.1× |
| Radex Kne 1/2 Views (73560) |
$280 |
$280 |
3.1× |
| Radex Kne Compl 4/More Views (73564) |
$355 |
$355 |
3.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$544 |
$544 |
5.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$389 |
$389 |
4.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$418 |
$418 |
3.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$281 |
$281 |
3.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$291 |
$291 |
3.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$380 |
$380 |
3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$544 |
$544 |
6.1× |
| Radex Toe Minimum 2 Views (73660) |
$224 |
$224 |
2.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$244 |
$244 |
2.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$269 |
$269 |
3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$452 |
$452 |
4.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$292 |
$292 |
3.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$473 |
$473 |
4.4× |
| Radiologic exam chest 2 views (71046) |
$318 |
$318 |
3.5× |
| Radiologic examination femur 1 view (73551) |
$275 |
$275 |
3.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$280 |
$280 |
3.1× |
| Ribs bilateral 3 views (71110) |
$424 |
$424 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$271 |
$271 |
2.5× |
| Scapula (73010) |
$314 |
$314 |
2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$221 |
$221 |
9.5× |
| Shoulder 1 view (73020) |
$233 |
$233 |
2.6× |
| Small bowel series (74250) |
$273 |
$273 |
1.5× |
| Spine thoracic 3 views (72072) |
$414 |
$414 |
3.8× |
| Thoracolumbar 2 views (72080) |
$379 |
$379 |
4.2× |
| Thyroid imaging w/blood flow (78013) |
$904 |
$904 |
2.2× |
| Tmj unilateral (70328) |
$257 |
$257 |
2.9× |
| Ultrasound Exam Aaa Screen (76706) |
$373 |
$373 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$426 |
$426 |
3.9× |
| Us chest (76604) |
$416 |
$416 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$501 |
$501 |
4.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$447 |
$447 |
4.1× |
| Us ob limited (76815) |
$322 |
$322 |
3.0× |
| Us ob transvaginal (76817) |
$558 |
$558 |
5.2× |
| Us pelvic non ob complete (76856) |
$539 |
$539 |
5.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$360 |
$360 |
3.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$549 |
$549 |
5.1× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$268 |
$268 |
2.5× |
| Us retroperitoneal complete (76770) |
$557 |
$557 |
5.2× |
| Us retroperitoneal limited (76775) |
$399 |
$399 |
3.7× |
| Us scrotum and contents (76870) |
$395 |
$395 |
3.7× |
| Us soft tissue head/neck (76536) |
$475 |
$475 |
4.4× |
| Wrist 2 views (73100) |
$247 |
$247 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$530 |
$530 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$319 |
$319 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$236 |
$236 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$284 |
$284 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$385 |
$385 |
3.6× |
| X-ray exam of femur 2/> (73552) |
$275 |
$275 |
3.1× |
| X-ray eye for foreign body (70030) |
$321 |
$321 |
3.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$321 |
$321 |
3.6× |
| X-ray IV pyelogram (ivp) (74400) |
$758 |
$758 |
4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$505 |
$505 |
5.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$280 |
$280 |
3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$380 |
$380 |
3.5× |
| X-ray nose-rectum child f.b. (76010) |
$235 |
$235 |
2.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$510 |
$510 |
4.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$333 |
$333 |
3.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$413 |
$413 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$479 |
$479 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$380 |
$380 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$280 |
$280 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$426 |
$426 |
4.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$569 |
$569 |
5.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$364 |
$364 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$134 |
$134 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$300 |
$300 |
3.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$280 |
$280 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$379 |
$379 |
3.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$449 |
$449 |
4.2× |
| Xr bone length studies (77073) |
$623 |
$623 |
5.8× |
| Xr c-spine 4 or 5 views (72050) |
$459 |
$459 |
4.3× |
| Xr c-spine 6 or more views (72052) |
$555 |
$555 |
5.1× |