| Abdomen 2 views (74019) |
$636.24 |
$964 |
5.9× |
| Acute gi blood loss imaging (78278) |
$1,210.44 |
$1,834 |
2.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,246.74 |
$1,889 |
3.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,246.74 |
$1,889 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,628.22 |
$2,467 |
3.9× |
| Bone age studies (77072) |
$267.96 |
$406 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,452 |
$2,200 |
3.5× |
| Bone survey complete (77075) |
$1,135.20 |
$1,720 |
10.5× |
| Bone survey infant (77076) |
$257.40 |
$390 |
2.4× |
| Bowel imaging (78290) |
$1,185.36 |
$1,796 |
2.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,187.34 |
$1,799 |
2.9× |
| Cervical spine 2 or 3 views (72040) |
$495 |
$750 |
5.5× |
| Chest 1 view (71045) |
$396 |
$600 |
4.4× |
| Chest xray 3 views (71047) |
$502.26 |
$761 |
5.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$171.60 |
$260 |
0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$501.60 |
$760 |
4.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$291.72 |
$442 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,726.26 |
$7,161 |
13.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,954.16 |
$4,476 |
12.0× |
| CT abdomen w contrast (74160) |
$1,634.82 |
$2,477 |
9.0× |
| CT abdomen w wo contrast (74170) |
$2,152.92 |
$3,262 |
11.9× |
| CT abdomen w/o contrast (74150) |
$1,381.38 |
$2,093 |
12.8× |
| CT c-spine w/contrast (72126) |
$1,886.94 |
$2,859 |
5.2× |
| CT c-spine w/o contrast (72125) |
$1,473.78 |
$2,233 |
13.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,974.72 |
$2,992 |
10.9× |
| CT chest w contrast (71260) |
$2,028.18 |
$3,073 |
11.2× |
| CT chest w/wo contrast (71270) |
$2,302.74 |
$3,489 |
12.7× |
| CT head/brain with contrast (70460) |
$1,895.52 |
$2,872 |
10.5× |
| CT head/brain without and with contrast (70470) |
$2,159.52 |
$3,272 |
11.9× |
| CT iac w contrast (70481) |
$1,564.20 |
$2,370 |
8.6× |
| CT limited/localized follow up study (76380) |
$588.06 |
$891 |
6.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,974.72 |
$2,992 |
10.9× |
| CT lumbar spine w/contrast (72132) |
$1,556.28 |
$2,358 |
4.3× |
| CT lumbar spine w/o contrast (72131) |
$1,379.40 |
$2,090 |
12.8× |
| CT maxillofacial w contrast (70487) |
$1,749.66 |
$2,651 |
9.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,930.50 |
$2,925 |
10.7× |
| CT maxillofacial wo contrast (70486) |
$1,249.38 |
$1,893 |
11.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,733.16 |
$2,626 |
9.6× |
| CT orbits w/o contrast (70480) |
$1,239.48 |
$1,878 |
11.5× |
| CT pelvis w/o contrast (72192) |
$1,381.38 |
$2,093 |
12.8× |
| CT pelvis w/wo contrast (72194) |
$2,152.92 |
$3,262 |
11.9× |
| CT soft tissue neck w contrast (70491) |
$1,910.04 |
$2,894 |
10.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,903.44 |
$2,884 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,805.10 |
$2,735 |
16.7× |
| CT thoracic spine w/contrast (72129) |
$1,733.16 |
$2,626 |
9.6× |
| CT thoracic spine w/o contrast (72128) |
$1,382.70 |
$2,095 |
12.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,822.92 |
$2,762 |
10.1× |
| CT thorax w/o contrast (71250) |
$1,448.70 |
$2,195 |
13.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,162.16 |
$3,276 |
11.9× |
| Cta Abdomen (74175) |
$1,644.72 |
$2,492 |
9.1× |
| CTA abdomen pelvis (74174) |
$1,843.38 |
$2,793 |
5.1× |
| CTA chest (71275) |
$1,665.84 |
$2,524 |
9.2× |
| Cta Head (70496) |
$1,598.52 |
$2,422 |
8.8× |
| Cta Neck (70498) |
$2,003.76 |
$3,036 |
11.1× |
| Cta Pelvis (72191) |
$1,598.52 |
$2,422 |
8.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$450.78 |
$683 |
4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$441.54 |
$669 |
4.9× |
| Esophagus (74220) |
$462.66 |
$701 |
2.6× |
| Facial bones min 3 views (70150) |
$425.04 |
$644 |
3.9× |
| Fetal biophysical profile non-stress testing (76818) |
$716.10 |
$1,085 |
6.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$675.84 |
$1,024 |
6.3× |
| Fluoroscopy up to 1 hr (76000) |
$345.84 |
$524 |
1.4× |
| Heart first pass single,planar (78481) |
$891.66 |
$1,351 |
1.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,277.10 |
$1,935 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,246.74 |
$1,889 |
3.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$974.82 |
$1,477 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$955.02 |
$1,447 |
1.7× |
| Lung ventilation imaging (78579) |
$817.74 |
$1,239 |
2.0× |
| Lymphoscintigraphy (78195) |
$1,349.04 |
$2,044 |
2.4× |
| MRA head w & w/o contrast (70546) |
$3,345.54 |
$5,069 |
9.3× |
| MRA head w/o contrast (70544) |
$2,943.60 |
$4,460 |
12.0× |
| MRA head with contrast (70545) |
$3,263.70 |
$4,945 |
9.1× |
| MRA neck w contrast (70548) |
$3,345.54 |
$5,069 |
9.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,416.16 |
$5,176 |
9.5× |
| MRA neck w/o contrast (70547) |
$3,274.92 |
$4,962 |
13.3× |
| MRI abdomen w contrast (74182) |
$2,943.60 |
$4,460 |
8.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,430.02 |
$5,197 |
9.5× |
| MRI abdomen w/o contrast (74181) |
$2,871 |
$4,350 |
11.7× |
| MRI c-spine with contrast (72142) |
$3,502.62 |
$5,307 |
9.7× |
| MRI cervical spine w/o contrast (72141) |
$3,100.02 |
$4,697 |
12.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,871 |
$4,350 |
8.0× |
| MRI chest w/o contrast (71550) |
$2,928.42 |
$4,437 |
11.9× |
| MRI chest with contrast (71551) |
$2,928.42 |
$4,437 |
3.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,871 |
$4,350 |
11.7× |
| MRI orbit face neck w contrast (70542) |
$2,871 |
$4,350 |
8.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,943.60 |
$4,460 |
8.2× |
| MRI pelvis w/contrast (72196) |
$2,871 |
$4,350 |
8.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,183.18 |
$4,823 |
8.8× |
| MRI pelvis w/o contrast (72195) |
$2,871 |
$4,350 |
11.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,565.32 |
$5,402 |
9.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,673.56 |
$5,566 |
10.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,765.96 |
$5,706 |
10.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,871 |
$4,350 |
8.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,482.82 |
$5,277 |
9.7× |
| MRI temporomandibular joint (70336) |
$2,871 |
$4,350 |
11.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,943.60 |
$4,460 |
12.0× |
| Myocardial Spect Multiple Studies (78452) |
$3,350.16 |
$5,076 |
2.5× |
| Myocardial spect single study at rest or stress (78451) |
$1,708.74 |
$2,589 |
1.3× |
| Neck soft tissue (70360) |
$297 |
$450 |
3.3× |
| Nm gastric emptying study (78264) |
$1,274.46 |
$1,931 |
3.1× |
| Ob us nuchal meas 1 gest (76813) |
$667.92 |
$1,012 |
6.2× |
| Osseous survey limited (77074) |
$941.16 |
$1,426 |
8.7× |
| Parathyroid Planar Imaging (78070) |
$613.80 |
$930 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$511.50 |
$775 |
4.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,452 |
$2,200 |
3.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$959.64 |
$1,454 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$403.92 |
$612 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$100.32 |
$152 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$164.34 |
$249 |
1.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$304.26 |
$461 |
2.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$604.56 |
$916 |
5.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$924.66 |
$1,401 |
8.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$425.04 |
$644 |
3.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$354.42 |
$537 |
3.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$628.98 |
$953 |
5.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$130.02 |
$197 |
1.4× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$661.32 |
$1,002 |
6.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$317.46 |
$481 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$304.26 |
$461 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$432.96 |
$656 |
4.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$629.97 |
$954.50 |
5.8× |
| Radiologic exam chest 2 views (71046) |
$401.61 |
$608.50 |
4.5× |
| Radiologic exam colon single contrast study (74270) |
$653.40 |
$990 |
3.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$695.64 |
$1,054 |
3.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$545.82 |
$827 |
3.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$332.64 |
$504 |
3.7× |
| Radiological examination surgical specimen (76098) |
$69.30 |
$105 |
0.1× |
| Ribs bilateral 3 views (71110) |
$619.74 |
$939 |
5.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,694.78 |
$4,083 |
4.8× |
| Sacroiliac Joints < 3 Views (72200) |
$364.98 |
$553 |
3.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$594.66 |
$901 |
2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$61.38 |
$93 |
2.6× |
| Sella turcica (70240) |
$302.28 |
$458 |
3.4× |
| Small bowel series (74250) |
$476.52 |
$722 |
2.6× |
| Spine thoracic 3 views (72072) |
$554.40 |
$840 |
5.1× |
| Testicular Imaging With Vascular Flow (78761) |
$875.16 |
$1,326 |
2.1× |
| Thoracolumbar 2 views (72080) |
$495 |
$750 |
5.5× |
| Thyroid imaging w/blood flow (78013) |
$750.42 |
$1,137 |
1.8× |
| Ultrasound Exam Aaa Screen (76706) |
$403.26 |
$611 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$425.04 |
$644 |
3.9× |
| Umbilical-artery Doppler (OB) (76820) |
$474.54 |
$719 |
4.4× |
| Urethrocystogram voiding (74455) |
$503.58 |
$763 |
2.0× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,015.74 |
$1,539 |
5.6× |
| Us chest (76604) |
$477.84 |
$724 |
4.4× |
| Us infant hips w manipulation (76885) |
$301.62 |
$457 |
3.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$414.48 |
$628 |
3.8× |
| Us ob limited (76815) |
$465.96 |
$706 |
4.3× |
| Us ob transvaginal (76817) |
$518.76 |
$786 |
4.8× |
| Us pelvic non ob complete (76856) |
$731.94 |
$1,109 |
6.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$644.16 |
$976 |
6.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$565.62 |
$857 |
5.2× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$428.01 |
$648.50 |
4.0× |
| Us retroperitoneal complete (76770) |
$595.32 |
$902 |
5.5× |
| Us retroperitoneal limited (76775) |
$403.26 |
$611 |
3.7× |
| Us scrotum and contents (76870) |
$518.76 |
$786 |
4.8× |
| Us soft tissue head/neck (76536) |
$206.58 |
$313 |
1.9× |
| Us spinal canal and contents (76800) |
$594.66 |
$901 |
5.5× |
| Us transrectal (76872) |
$626.34 |
$949 |
5.8× |
| Us transrectal prostate volume (76873) |
$594.66 |
$901 |
5.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$616.44 |
$934 |
5.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$656.04 |
$994 |
6.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$435.27 |
$659.50 |
4.8× |
| X-ray b.e. reductn intuss (74283) |
$718.74 |
$1,089 |
4.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$821.04 |
$1,244 |
4.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$739.86 |
$1,121 |
6.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$320.10 |
$485 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$327.36 |
$496 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$459.36 |
$696 |
5.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$556.38 |
$843 |
5.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$878.46 |
$1,331 |
8.1× |
| X-ray nose-rectum child f.b. (76010) |
$347.82 |
$527 |
3.9× |
| X-ray retrograde pyelogram (74420) |
$1,015.74 |
$1,539 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$586.08 |
$888 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$346.50 |
$525 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$376.86 |
$571 |
4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$150.48 |
$228 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$506.88 |
$768 |
4.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$384.78 |
$583 |
3.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$227.70 |
$345 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$329.34 |
$499 |
3.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$407.22 |
$617 |
4.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$417.12 |
$632 |
3.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$720.06 |
$1,091 |
6.7× |
| Xr c-spine 4 or 5 views (72050) |
$667.92 |
$1,012 |
6.2× |
| Xr c-spine 6 or more views (72052) |
$667.92 |
$1,012 |
6.2× |
| Xr chest 4+ views (71048) |
$470.91 |
$713.50 |
4.4× |