| Abdomen 2 views (74019) |
$504.90 |
$1,009.80 |
4.8× |
| Angiography extremity bilateral rs&i (75716) |
$5,849 |
$11,698 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$5,849 |
$11,698 |
1.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,102.50 |
$18,205 |
1.6× |
| Ankle 2 views (73600) |
$473.10 |
$946.20 |
5.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$927 |
$1,854 |
2.6× |
| Aortography abdominal serialography rs&i (75625) |
$8,882.44 |
$17,764.88 |
2.8× |
| Bone age studies (77072) |
$559.80 |
$1,119.60 |
5.3× |
| Bone survey complete (77075) |
$861.30 |
$1,722.60 |
8.2× |
| Cervical spine 2 or 3 views (72040) |
$544.20 |
$1,088.40 |
6.2× |
| Chest 1 view (71045) |
$596.40 |
$1,192.80 |
6.8× |
| Chest 3 views (71047) |
$691.20 |
$1,382.40 |
7.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$894.30 |
$1,788.60 |
5.1× |
| Clavicle complete (73000) |
$552.90 |
$1,105.80 |
6.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,561.60 |
$13,123.20 |
18.7× |
| CT abdomen and pelvis without contrast (74176) |
$4,996.80 |
$9,993.60 |
20.8× |
| CT abdomen w contrast (74160) |
$3,890.40 |
$7,780.80 |
22.0× |
| CT abdomen w wo contrast (74170) |
$750 |
$1,500 |
4.2× |
| CT abdomen w/o contrast (74150) |
$3,564.90 |
$7,129.80 |
33.9× |
| CT angio hrt w/3d image (75574) |
$1,244.70 |
$2,489.40 |
3.5× |
| CT angiography upper extremity lt (73206) |
$2,564.63 |
$5,129.25 |
14.5× |
| CT c-spine w/o contrast (72125) |
$3,564.90 |
$7,129.80 |
33.9× |
| CT cervical spine w&w/o contrast (72127) |
$4,860.60 |
$9,721.20 |
27.5× |
| CT cervical spine with contrast (72126) |
$3,890.40 |
$7,780.80 |
11.1× |
| CT chest w/wo contrast (71270) |
$4,860.60 |
$9,721.20 |
27.5× |
| CT chest with contrast (71260) |
$3,954 |
$7,908 |
22.4× |
| CT colonography w/dye (74262) |
$1,373.40 |
$2,746.80 |
7.8× |
| CT colonography w/o cntrst (74261) |
$902.70 |
$1,805.40 |
8.6× |
| CT head/brain with contrast (70460) |
$3,387.60 |
$6,775.20 |
19.2× |
| CT head/brain without and with contrast (70470) |
$4,050.60 |
$8,101.20 |
23.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,244.70 |
$2,489.40 |
3.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$210 |
$420 |
2.4× |
| CT hrt w/3d image congen (75573) |
$1,244.70 |
$2,489.40 |
3.5× |
| CT iac w contrast (70481) |
$4,522.80 |
$9,045.60 |
25.6× |
| CT lower ext w/o (73700) |
$3,564.90 |
$7,129.80 |
33.9× |
| CT lower extremity w wo contrast (73702) |
$4,860.60 |
$9,721.20 |
27.5× |
| CT lower extremity with contrast (73701) |
$3,890.40 |
$7,780.80 |
22.0× |
| CT lumbar spine w & w/o contrast (72133) |
$4,860.60 |
$9,721.20 |
27.5× |
| CT lumbar spine w/o contrast (72131) |
$3,564.90 |
$7,129.80 |
33.9× |
| CT lumbar spine with contrast (72132) |
$3,890.40 |
$7,780.80 |
11.1× |
| CT maxillofacial w contrast (70487) |
$2,632.20 |
$5,264.40 |
14.9× |
| CT maxillofacial w/o contrast (70486) |
$3,327.60 |
$6,655.20 |
31.6× |
| CT maxillofacial w/wo contrast (70488) |
$3,442.20 |
$6,884.40 |
19.5× |
| CT neck soft tissue w contrast (70491) |
$3,564.90 |
$7,129.80 |
20.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,404.25 |
$2,808.50 |
8.0× |
| CT orbits w/o contrast (70480) |
$3,512.40 |
$7,024.80 |
33.4× |
| CT pelvis w & w/o contrast (72194) |
$3,890.40 |
$7,780.80 |
22.0× |
| CT pelvis w/o contrast (72192) |
$3,098.10 |
$6,196.20 |
29.4× |
| CT soft tissue neck w/o contrast (70490) |
$3,078.90 |
$6,157.80 |
29.3× |
| CT thoracic spine w/contrast (72129) |
$3,890.40 |
$7,780.80 |
22.0× |
| CT thoracic spine w/o contrast (72128) |
$3,564.90 |
$7,129.80 |
33.9× |
| CT thoracic spine w/wo contrast (72130) |
$4,860.60 |
$9,721.20 |
27.5× |
| CT thorax w/o contrast (71250) |
$2,839.35 |
$5,678.70 |
27.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,191.20 |
$4,382.40 |
12.4× |
| CT upper extremity w/o contrast rt (73200) |
$2,965.80 |
$5,931.60 |
28.2× |
| CT upper extremity with contrast (73201) |
$2,965.80 |
$5,931.60 |
8.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,838.70 |
$9,677.40 |
27.4× |
| Cta Abdomen (74175) |
$2,025.25 |
$4,050.50 |
11.5× |
| CTA chest (71275) |
$4,860.60 |
$9,721.20 |
27.5× |
| Cta Head (70496) |
$4,212.60 |
$8,425.20 |
23.9× |
| Cta Neck (70498) |
$4,212.60 |
$8,425.20 |
23.9× |
| Cta Pelvis (72191) |
$3,890.40 |
$7,780.80 |
22.0× |
| Cystography minimum 3 views rs&i (74430) |
$927 |
$1,854 |
2.6× |
| Diskography lumbar (72295) |
$4,483.28 |
$8,966.55 |
2.3× |
| Echo exam of eye (76529) |
$685.50 |
$1,371 |
7.8× |
| Esophagus (74220) |
$633.60 |
$1,267.20 |
3.6× |
| Fluoroscopy up to 1 hr (76000) |
$575.30 |
$1,150.60 |
2.4× |
| Foot 2 views (73620) |
$495.30 |
$990.60 |
5.7× |
| Forearm 2 views (73090) |
$603 |
$1,206 |
6.9× |
| Hand 2 views (73120) |
$570 |
$1,140 |
5.4× |
| Hand 3 views (73130) |
$603 |
$1,206 |
6.9× |
| Humerus Min 2 Views Left (73060) |
$522.60 |
$1,045.20 |
6.0× |
| Hysterosalpingogram (74740) |
$1,234.20 |
$2,468.40 |
5.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$311.10 |
$622.20 |
3.0× |
| Knee 3 views (73562) |
$603 |
$1,206 |
6.9× |
| MRA head w & w/o contrast (70546) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRA head w/o contrast (70544) |
$2,494.80 |
$4,989.60 |
10.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRA neck w/o contrast (70547) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI abdomen w contrast (74182) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI abdomen w/o contrast (74181) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI any jnt lwr ext with con lt (73722) |
$7,290 |
$14,580 |
9.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$7,290 |
$14,580 |
9.2× |
| MRI c-spine with contrast (72142) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI cervical spine w/o contrast (72141) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI chest w/o & w/contrast material (71552) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI chest w/o contrast (71550) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI chest with contrast (71551) |
$7,290 |
$14,580 |
9.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI orbit/face/neck w/contrast (70542) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI pelvis w contrast (72196) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI pelvis w/o contrast (72195) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI scan of arm joint before and after contrast (73223) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI scan of leg joint before and after contrast (73723) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,494.80 |
$4,989.60 |
10.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,093.20 |
$8,186.40 |
11.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,494.80 |
$4,989.60 |
10.4× |
| Neck soft tissue (70360) |
$262.20 |
$524.40 |
3.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$1,069.20 |
$2,138.40 |
8.0× |
| Osseous survey infant (77076) |
$557.10 |
$1,114.20 |
5.3× |
| Osseous survey limited (77074) |
$1,411.20 |
$2,822.40 |
13.4× |
| Pelvis 1 or 2 views (72170) |
$552.90 |
$1,105.80 |
5.3× |
| Pr gi endoscopic ultrasound (76975) |
$1,216.80 |
$2,433.60 |
5.1× |
| Pr MRI brain w/ dye (70558) |
$1,954.80 |
$3,909.60 |
11.1× |
| Pr MRI brain w/o & w/ dye (70559) |
$1,954.80 |
$3,909.60 |
11.1× |
| Pr MRI brain w/o dye (70557) |
$5,162.40 |
$10,324.80 |
9.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,093.20 |
$8,186.40 |
11.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$447 |
$894 |
4.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$731.40 |
$1,462.80 |
7.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$612.30 |
$1,224.60 |
5.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$678.30 |
$1,356.60 |
7.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$504.90 |
$1,009.80 |
4.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$679.80 |
$1,359.60 |
7.8× |
| Radiologic exam colon single contrast study (74270) |
$1,104.60 |
$2,209.20 |
6.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,039.20 |
$2,078.40 |
5.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,110.60 |
$2,221.20 |
6.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$522.90 |
$1,045.80 |
6.0× |
| Scanogram (77073) |
$444.90 |
$889.80 |
4.2× |
| Scapula complete (73010) |
$402 |
$804 |
3.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$707.52 |
$1,415.04 |
6.7× |
| Small bowel series (74250) |
$952.20 |
$1,904.40 |
5.4× |
| Spine thoracic 3 views (72072) |
$552.90 |
$1,105.80 |
5.3× |
| Therapeutic Enema (74283) |
$840.60 |
$1,681.20 |
4.8× |
| Thoracolumbar 2 views (72080) |
$608.40 |
$1,216.80 |
6.9× |
| Tmj unilateral (70328) |
$651.60 |
$1,303.20 |
7.4× |
| Ultrasound, abdomen limited (76705) |
$1,479.60 |
$2,959.20 |
14.1× |
| Upper Extremity Infant (73092) |
$321 |
$642 |
3.1× |
| Urethrocystography retrograde rs&i (74450) |
$927 |
$1,854 |
3.9× |
| Urethrocystography voiding (74455) |
$927 |
$1,854 |
3.9× |
| Us breast unilateral complete (76641) |
$570 |
$1,140 |
5.4× |
| Us chest (76604) |
$721.50 |
$1,443 |
6.9× |
| Us compl joint r-t w/image documentation (76881) |
$721.50 |
$1,443 |
6.9× |
| Us ob detailed single fetus (76811) |
$954.90 |
$1,909.80 |
4.0× |
| Us ob transvaginal (76817) |
$954.90 |
$1,909.80 |
9.1× |
| Us pelvic non ob complete (76856) |
$1,282.05 |
$2,564.10 |
12.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$570 |
$1,140 |
5.4× |
| Us pregnancy ltd (76815) |
$666.90 |
$1,333.80 |
6.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$585.30 |
$1,170.60 |
5.6× |
| Us retroperitoneal complete (76770) |
$1,104.60 |
$2,209.20 |
10.5× |
| Us retroperitoneal limited (76775) |
$699.30 |
$1,398.60 |
6.6× |
| Us scrotum and contents (76870) |
$1,197.15 |
$2,394.30 |
11.4× |
| Us soft tissue head/neck (76536) |
$519.75 |
$1,039.50 |
4.9× |
| Us transrectal prostate volume (76873) |
$926.70 |
$1,853.40 |
8.8× |
| Us xtr non-vasc lmtd (76882) |
$469.80 |
$939.60 |
4.5× |
| Us, eye b-scan (76512) |
$732 |
$1,464 |
7.0× |
| Venogram extremity bilateral (75822) |
$2,938.50 |
$5,877 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$4,729 |
$9,458 |
1.5× |
| Wrist 2 views (73100) |
$489.60 |
$979.20 |
5.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$210.38 |
$420.75 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$382.80 |
$765.60 |
4.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$712.50 |
$1,425 |
8.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,169.40 |
$2,338.80 |
6.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$726.90 |
$1,453.80 |
8.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$570 |
$1,140 |
6.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$540 |
$1,080 |
5.1× |
| X-ray exam hip uni 1 view (73501) |
$457.05 |
$914.10 |
5.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$376.80 |
$753.60 |
4.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$757.20 |
$1,514.40 |
4.3× |
| X-ray eye for foreign body (70030) |
$255 |
$510 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$683.10 |
$1,366.20 |
6.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$376.20 |
$752.40 |
4.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$552.90 |
$1,105.80 |
6.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$431.40 |
$862.80 |
4.9× |
| X-ray IV pyelogram+drip infusn (74410) |
$880.20 |
$1,760.40 |
5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$480.30 |
$960.60 |
5.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$633.60 |
$1,267.20 |
6.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$731.40 |
$1,462.80 |
8.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$450.60 |
$901.20 |
5.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$780.60 |
$1,561.20 |
7.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$633.60 |
$1,267.20 |
6.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$633.60 |
$1,267.20 |
6.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$408.30 |
$816.60 |
4.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$618.30 |
$1,236.60 |
7.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$489.60 |
$979.20 |
4.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$603 |
$1,206 |
5.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$927 |
$1,854 |
2.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$464.10 |
$928.20 |
5.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$418.20 |
$836.40 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$304.75 |
$609.50 |
2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$457.20 |
$914.40 |
5.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$612 |
$1,224 |
7.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$603 |
$1,206 |
6.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$310.80 |
$621.60 |
3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$781.20 |
$1,562.40 |
7.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$681.90 |
$1,363.80 |
6.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$489.60 |
$979.20 |
5.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$424.50 |
$849 |
4.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$408.30 |
$816.60 |
4.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$603 |
$1,206 |
5.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$855.60 |
$1,711.20 |
8.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$496.35 |
$992.70 |
5.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$748.50 |
$1,497 |
8.5× |
| Xr c-spine 6 or more views (72052) |
$757.20 |
$1,514.40 |
7.2× |
| Xr chest 4+ views (71048) |
$729.30 |
$1,458.60 |
6.9× |
| Xr finger(s) 2+ views (73140) |
$328.65 |
$657.30 |
3.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$357.30 |
$714.60 |
3.4× |
| Xr optic foramina (70190) |
$489.60 |
$979.20 |
5.6× |
| Xr shoulder 1 view (73020) |
$457.20 |
$914.40 |
5.2× |
| Xr tibia/fibula 2 views (73590) |
$514.80 |
$1,029.60 |
5.9× |
| Xr tmj bilateral (70330) |
$605.40 |
$1,210.80 |
6.9× |
| Xray knee 1 or 2 views rt (73560) |
$570 |
$1,140 |
6.5× |