| Abdomen 2 views (74019) |
$383.04 |
$399 |
3.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,065.92 |
$2,152 |
5.0× |
| Ankle 2 views (73600) |
$250.56 |
$261 |
2.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,095.36 |
$1,141 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,965.12 |
$2,047 |
4.7× |
| Bone age studies (77072) |
$242.88 |
$253 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$2,118.72 |
$2,207 |
5.1× |
| Bone survey complete (77075) |
$1,965.12 |
$2,047 |
18.1× |
| Brain image w/flow 4 + views (78606) |
$1,512 |
$1,575 |
2.7× |
| Cervical spine 2 or 3 views (72040) |
$346.56 |
$361 |
3.8× |
| Chest 1 view (71045) |
$260.16 |
$271 |
2.9× |
| Chest 3 views (71047) |
$250.56 |
$261 |
2.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$636.48 |
$663 |
3.5× |
| Clavicle complete (73000) |
$293.76 |
$306 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,388 |
$2,487.50 |
22.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,995.36 |
$5,203.50 |
13.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,793.60 |
$2,910 |
11.3× |
| CT abdomen w contrast (74160) |
$2,383.68 |
$2,483 |
13.1× |
| CT abdomen w wo contrast (74170) |
$2,646.72 |
$2,757 |
14.5× |
| CT abdomen w/o contrast (74150) |
$2,206.08 |
$2,298 |
20.3× |
| CT c-spine w/o contrast (72125) |
$1,951.68 |
$2,033 |
18.0× |
| CT cervical spine with contrast (72126) |
$2,049.60 |
$2,135 |
5.7× |
| CT chest w/wo contrast (71270) |
$2,852.16 |
$2,971 |
15.7× |
| CT chest with contrast (71260) |
$2,495.04 |
$2,599 |
13.7× |
| CT head/brain with contrast (70460) |
$2,112 |
$2,200 |
11.6× |
| CT head/brain without and with contrast (70470) |
$2,412.48 |
$2,513 |
13.2× |
| CT iac w contrast (70481) |
$2,159.04 |
$2,249 |
11.9× |
| CT lower ext w/o (73700) |
$1,973.76 |
$2,056 |
18.2× |
| CT lower extremity w wo contrast (73702) |
$2,367.36 |
$2,466 |
13.0× |
| CT lower extremity with contrast (73701) |
$2,072.64 |
$2,159 |
11.4× |
| CT lumbar spine w/o contrast (72131) |
$1,417.44 |
$1,476.50 |
13.1× |
| CT lumbar spine with contrast (72132) |
$1,475.52 |
$1,537 |
4.1× |
| CT maxillofacial w contrast (70487) |
$1,825.92 |
$1,902 |
10.0× |
| CT maxillofacial w/o contrast (70486) |
$1,740.48 |
$1,813 |
16.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,088 |
$2,175 |
11.5× |
| CT neck soft tissue w contrast (70491) |
$2,071.68 |
$2,158 |
11.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,466.24 |
$2,569 |
13.5× |
| CT orbits w/o contrast (70480) |
$2,056.32 |
$2,142 |
18.9× |
| CT pelvis w & w/o contrast (72194) |
$2,607.36 |
$2,716 |
14.3× |
| CT pelvis w/o contrast (72192) |
$2,173.44 |
$2,264 |
20.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,565.12 |
$2,672 |
14.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,939.20 |
$2,020 |
17.9× |
| CT thoracic spine w/contrast (72129) |
$1,226.88 |
$1,278 |
6.7× |
| CT thoracic spine w/o contrast (72128) |
$1,180.32 |
$1,229.50 |
10.9× |
| CT thorax w/o contrast (71250) |
$2,379.84 |
$2,479 |
21.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,447.04 |
$2,549 |
13.4× |
| CT upper extremity w/o contrast rt (73200) |
$2,040 |
$2,125 |
18.8× |
| CT upper extremity with contrast (73201) |
$2,141.76 |
$2,231 |
5.9× |
| Cta Abdomen (74175) |
$3,349.44 |
$3,489 |
18.4× |
| CTA abdomen pelvis (74174) |
$4,049.28 |
$4,218 |
11.2× |
| CTA chest (71275) |
$3,322.56 |
$3,461 |
18.2× |
| Cta Head (70496) |
$3,477.12 |
$3,622 |
19.1× |
| CTA lwr ext w&w/o contrast (73706) |
$2,122.56 |
$2,211 |
11.7× |
| Cta Neck (70498) |
$3,495.36 |
$3,641 |
19.2× |
| Cystography minimum 3 views rs&i (74430) |
$654.72 |
$682 |
1.8× |
| Diskography lumbar (72295) |
$1,400.64 |
$1,459 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$437.76 |
$456 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$178.56 |
$186 |
2.0× |
| Fetal biophysical profile non-stress testing (76818) |
$817.92 |
$852 |
7.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$447.36 |
$466 |
4.1× |
| Fluoroscopy up to 1 hr (76000) |
$613.44 |
$639 |
2.5× |
| Foot 2 views (73620) |
$262.08 |
$273 |
2.9× |
| Forearm 2 views (73090) |
$284.16 |
$296 |
3.1× |
| Hand 2 views (73120) |
$258.24 |
$269 |
2.4× |
| Hand 3 views (73130) |
$333.12 |
$347 |
3.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,899.84 |
$1,979 |
3.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,597.44 |
$1,664 |
3.8× |
| Ht muscle image spect sing (78451) |
$2,119.20 |
$2,207.50 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$316.80 |
$330 |
3.5× |
| Hysterosalpingogram (74740) |
$600.96 |
$626 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,928.64 |
$2,009 |
3.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,109.12 |
$2,197 |
3.7× |
| Knee 3 views (73562) |
$394.56 |
$411 |
4.4× |
| Liver & spleen imaging static only (78215) |
$1,715.52 |
$1,787 |
4.1× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$250.56 |
$261 |
2.8× |
| Meckels Diverticulum (78290) |
$1,424.64 |
$1,484 |
3.4× |
| MRA head w & w/o contrast (70546) |
$3,782.40 |
$3,940 |
10.4× |
| MRA head w/o contrast (70544) |
$3,049.92 |
$3,177 |
12.3× |
| MRA head with contrast (70545) |
$3,049.92 |
$3,177 |
8.4× |
| MRA neck w contrast (70548) |
$2,860.80 |
$2,980 |
7.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,288 |
$3,425 |
9.1× |
| MRA neck w/o contrast (70547) |
$2,634.24 |
$2,744 |
10.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,860.80 |
$2,980 |
7.9× |
| MRI abdomen w/o contrast (74181) |
$3,004.80 |
$3,130 |
12.1× |
| MRI any jnt lwr ext with con lt (73722) |
$2,614.08 |
$2,723 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,562.24 |
$2,669 |
3.1× |
| MRI cervical spine w/o contrast (72141) |
$3,401.28 |
$3,543 |
13.7× |
| MRI chest w/o & w/contrast material (71552) |
$2,846.40 |
$2,965 |
7.9× |
| MRI chest w/o contrast (71550) |
$1,901.76 |
$1,981 |
7.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,463.36 |
$2,566 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,549.76 |
$2,656 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,594.88 |
$2,703 |
10.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,336 |
$3,475 |
9.2× |
| MRI pelvis w contrast (72196) |
$3,004.80 |
$3,130 |
8.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,606.72 |
$3,757 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$2,040 |
$2,125 |
8.2× |
| MRI scan of arm joint before and after contrast (73223) |
$3,706.56 |
$3,861 |
10.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,685.12 |
$2,797 |
7.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,047.36 |
$4,216 |
11.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,348.48 |
$3,488 |
9.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,930.24 |
$4,094 |
10.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,460.80 |
$3,605 |
9.6× |
| MRI thoracic spine w/o contrast (72146) |
$3,401.28 |
$3,543 |
13.7× |
| MRI tmj (70336) |
$1,901.76 |
$1,981 |
7.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,549.76 |
$2,656 |
10.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,952.96 |
$3,076 |
8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,994.40 |
$2,077.50 |
8.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,600.80 |
$4,792.50 |
3.4× |
| Neck soft tissue (70360) |
$305.28 |
$318 |
3.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,527.36 |
$1,591 |
3.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$441.60 |
$460 |
4.1× |
| Osseous survey infant (77076) |
$643.20 |
$670 |
5.9× |
| Osseous survey limited (77074) |
$1,049.28 |
$1,093 |
9.7× |
| Parathyrd planar w/wo subtrj (78071) |
$1,860.48 |
$1,938 |
4.5× |
| Parathyroid imaging (78070) |
$1,715.52 |
$1,787 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$288.96 |
$301 |
2.7× |
| PET image w/CT, skull-thigh (78815) |
$6,611.52 |
$6,887 |
4.5× |
| PET imaging for CT attenuation whole body (78816) |
$6,936.96 |
$7,226 |
4.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,614.08 |
$2,723 |
7.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,905.60 |
$1,985 |
3.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$191.04 |
$199 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$534.72 |
$557 |
4.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$515.52 |
$537 |
4.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$422.40 |
$440 |
3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$242.88 |
$253 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$287.04 |
$299 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$448.32 |
$467 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$337.92 |
$352 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$338.88 |
$353 |
3.7× |
| Radiological examination surgical specimen (76098) |
$212.16 |
$221 |
0.4× |
| Ribs bilateral 3 views (71110) |
$287.04 |
$299 |
2.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,853.12 |
$2,972 |
5.1× |
| Sacroiliac Joints < 3 Views (72200) |
$365.76 |
$381 |
3.4× |
| Scapula complete (73010) |
$318.72 |
$332 |
2.9× |
| Screening digital breast tomosynthesis (77063) |
$334.08 |
$348 |
14.3× |
| Sella turcica (70240) |
$245.76 |
$256 |
2.7× |
| Testicular Imaging With Vascular Flow (78761) |
$1,541.76 |
$1,606 |
3.7× |
| Tmj unilateral (70328) |
$215.04 |
$224 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$672.96 |
$701 |
6.2× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) |
$2,853.12 |
$2,972 |
6.9× |
| Upper Extremity Infant (73092) |
$293.76 |
$306 |
2.7× |
| Urethrocystography voiding (74455) |
$518.40 |
$540 |
2.1× |
| Us abdl aorta screen aaa (76706) |
$641.28 |
$668 |
5.9× |
| Us breast unilateral complete (76641) |
$466.56 |
$486 |
4.3× |
| Us breast unilateral limited (76642) |
$313.92 |
$327 |
3.5× |
| Us chest (76604) |
$617.28 |
$643 |
5.7× |
| Us compl joint r-t w/image documentation (76881) |
$676.80 |
$705 |
6.2× |
| Us infant hips dynamic (76885) |
$279.36 |
$291 |
3.1× |
| Us kidney transplant (76776) |
$539.52 |
$562 |
5.0× |
| Us ob detailed single fetus (76811) |
$609.60 |
$635 |
2.5× |
| Us ob transvaginal (76817) |
$560.64 |
$584 |
5.2× |
| Us pelvic non ob complete (76856) |
$792 |
$825 |
7.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$356.16 |
$371 |
3.3× |
| Us pregnancy ltd (76815) |
$459.84 |
$479 |
4.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$478.08 |
$498 |
4.4× |
| Us retroperitoneal complete (76770) |
$782.40 |
$815 |
7.2× |
| Us retroperitoneal limited (76775) |
$571.20 |
$595 |
5.3× |
| Us scrotum and contents (76870) |
$706.56 |
$736 |
6.5× |
| Us soft tissue head/neck (76536) |
$586.56 |
$611 |
5.4× |
| Us transrectal (76872) |
$570.24 |
$594 |
5.3× |
| Us xtr non-vasc lmtd (76882) |
$628.80 |
$655 |
5.8× |
| Wrist 2 views (73100) |
$228.48 |
$238 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$541.44 |
$564 |
5.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$217.92 |
$227 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$319.68 |
$333 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$256.32 |
$267 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$331.20 |
$345 |
3.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$674.88 |
$703 |
6.2× |
| X-ray exam hip uni 1 view (73501) |
$208.32 |
$217 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$330.24 |
$344 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$604.80 |
$630 |
5.6× |
| X-ray exam of femur 1 (73551) |
$179.52 |
$187 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$440.64 |
$459 |
4.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$291.84 |
$304 |
3.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$337.92 |
$352 |
3.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$202.56 |
$211 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$212.16 |
$221 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$394.56 |
$411 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$203.52 |
$212 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$208.32 |
$217 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$449.28 |
$468 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$326.40 |
$340 |
3.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$307.20 |
$320 |
3.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$329.28 |
$343 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$307.20 |
$320 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$570.24 |
$594 |
5.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$325.44 |
$339 |
3.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$363.84 |
$379 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$373.44 |
$389 |
4.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$161.28 |
$168 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$390.72 |
$407 |
3.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$277.44 |
$289 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$166.08 |
$173 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$215.04 |
$224 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$321.60 |
$335 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$329.28 |
$343 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$158.40 |
$165 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$321.60 |
$335 |
3.6× |
| Xr c-spine 6 or more views (72052) |
$428.16 |
$446 |
3.9× |
| Xr chest 4+ views (71048) |
$300.48 |
$313 |
2.8× |
| Xr finger(s) 2+ views (73140) |
$225.60 |
$235 |
2.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$389.76 |
$406 |
3.6× |
| Xr optic foramina (70190) |
$245.76 |
$256 |
2.7× |
| Xr shoulder 1 view (73020) |
$202.56 |
$211 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$448.32 |
$467 |
4.1× |
| Xr tibia/fibula 2 views (73590) |
$306.24 |
$319 |
3.4× |
| Xr tmj bilateral (70330) |
$263.04 |
$274 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$329.28 |
$343 |
3.6× |