| Abdomen 2 views (74019) |
$356 |
$356 |
3.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,290 |
$1,290 |
3.1× |
| Ankle 2 views (73600) |
$275 |
$275 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,267 |
$1,267 |
3.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,416 |
$1,416 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$1,657 |
$1,657 |
3.9× |
| Bone Imaging 3 Phase (78315) |
$1,887 |
$1,887 |
4.5× |
| Bone survey complete (77075) |
$393 |
$393 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$393 |
$393 |
4.3× |
| Chest 1 view (71045) |
$299 |
$299 |
3.3× |
| Chest 3 views (71047) |
$370 |
$370 |
4.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$511 |
$511 |
2.8× |
| Clavicle complete (73000) |
$275 |
$275 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$397 |
$397 |
3.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,019 |
$2,019 |
5.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,224 |
$2,224 |
8.8× |
| CT abdomen w contrast (74160) |
$2,138 |
$2,138 |
11.6× |
| CT abdomen w wo contrast (74170) |
$2,260 |
$2,260 |
12.2× |
| CT abdomen w/o contrast (74150) |
$2,019 |
$2,019 |
18.3× |
| CT c-spine w/o contrast (72125) |
$2,204 |
$2,204 |
20.0× |
| CT chest w/wo contrast (71270) |
$1,507 |
$1,507 |
8.1× |
| CT chest with contrast (71260) |
$2,408 |
$2,408 |
13.0× |
| CT head/brain with contrast (70460) |
$2,019 |
$2,019 |
10.9× |
| CT head/brain without and with contrast (70470) |
$2,260 |
$2,260 |
12.2× |
| CT iac w contrast (70481) |
$1,140 |
$1,140 |
6.2× |
| CT lower ext w/o (73700) |
$2,019 |
$2,019 |
18.3× |
| CT lower extremity w wo contrast (73702) |
$2,506 |
$2,506 |
13.5× |
| CT lower extremity with contrast (73701) |
$2,506 |
$2,506 |
13.5× |
| CT lumbar spine w/o contrast (72131) |
$2,019 |
$2,019 |
18.3× |
| CT maxillofacial w contrast (70487) |
$1,537 |
$1,537 |
8.3× |
| CT maxillofacial w/o contrast (70486) |
$2,019 |
$2,019 |
18.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,537 |
$1,537 |
8.3× |
| CT neck soft tissue w contrast (70491) |
$2,138 |
$2,138 |
11.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,285 |
$1,285 |
6.9× |
| CT orbits w/o contrast (70480) |
$1,115 |
$1,115 |
10.1× |
| CT pelvis w & w/o contrast (72194) |
$2,138 |
$2,138 |
11.6× |
| CT pelvis w/o contrast (72192) |
$2,019 |
$2,019 |
18.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,537 |
$1,537 |
8.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,537 |
$1,537 |
13.9× |
| CT thoracic spine w/o contrast (72128) |
$2,019 |
$2,019 |
18.3× |
| CT thorax w/o contrast (71250) |
$2,099 |
$2,099 |
19.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,506 |
$2,506 |
13.5× |
| CT upper extremity w/o contrast rt (73200) |
$4,038 |
$4,038 |
36.6× |
| CT upper extremity with contrast (73201) |
$2,631 |
$2,631 |
7.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,380 |
$2,380 |
12.9× |
| Cta Abdomen (74175) |
$2,138 |
$2,138 |
11.6× |
| CTA chest (71275) |
$2,466 |
$2,466 |
13.3× |
| Cta Head (70496) |
$2,138 |
$2,138 |
11.6× |
| Cta Neck (70498) |
$2,138 |
$2,138 |
11.6× |
| Cystography minimum 3 views rs&i (74430) |
$1,078 |
$1,078 |
2.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$597 |
$597 |
5.4× |
| Esophagus (74220) |
$865 |
$865 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$802 |
$802 |
3.2× |
| Foot 2 views (73620) |
$275 |
$275 |
3.0× |
| Forearm 2 views (73090) |
$260 |
$260 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,880 |
$1,880 |
4.5× |
| Hand 3 views (73130) |
$310 |
$310 |
3.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,898 |
$1,898 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,019 |
$2,019 |
4.8× |
| Ht muscle image spect sing (78451) |
$4,380 |
$4,380 |
3.2× |
| Humerus Min 2 Views Left (73060) |
$275 |
$275 |
3.0× |
| Kidney imaging morphology (78700) |
$1,267 |
$1,267 |
3.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,625 |
$1,625 |
2.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,625 |
$1,625 |
2.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,693 |
$1,693 |
3.0× |
| Knee 3 views (73562) |
$357 |
$357 |
3.9× |
| Liver & spleen imaging static only (78215) |
$1,267 |
$1,267 |
3.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,267 |
$1,267 |
3.0× |
| Lung Ventilation Imaging (78579) |
$1,330 |
$1,330 |
3.2× |
| Lymphoscintigraphy (78195) |
$1,663 |
$1,663 |
2.9× |
| Meckels Diverticulum (78290) |
$1,267 |
$1,267 |
3.0× |
| MRA head w & w/o contrast (70546) |
$3,796 |
$3,796 |
10.3× |
| MRA head w/o contrast (70544) |
$3,164 |
$3,164 |
12.6× |
| MRA head with contrast (70545) |
$3,368 |
$3,368 |
9.2× |
| MRA neck w contrast (70548) |
$3,164 |
$3,164 |
8.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,796 |
$3,796 |
10.3× |
| MRA neck w/o contrast (70547) |
$3,344 |
$3,344 |
13.3× |
| MRI abdomen w contrast (74182) |
$2,544 |
$2,544 |
6.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,911 |
$2,911 |
7.9× |
| MRI abdomen w/o contrast (74181) |
$2,251 |
$2,251 |
8.9× |
| MRI any jnt lwr ext with con lt (73722) |
$3,003 |
$3,003 |
3.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,358 |
$2,358 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$3,603 |
$3,603 |
14.3× |
| MRI chest w/o & w/contrast material (71552) |
$3,796 |
$3,796 |
10.3× |
| MRI chest w/o contrast (71550) |
$2,251 |
$2,251 |
8.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,464 |
$3,464 |
13.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,251 |
$2,251 |
8.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,102 |
$3,102 |
8.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,344 |
$3,344 |
9.1× |
| MRI pelvis w/o contrast (72195) |
$3,224 |
$3,224 |
12.8× |
| MRI scan of arm joint before and after contrast (73223) |
$3,102 |
$3,102 |
8.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,344 |
$3,344 |
9.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,224 |
$3,224 |
8.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,344 |
$3,344 |
9.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,344 |
$3,344 |
9.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,544 |
$2,544 |
10.1× |
| MRI tmj (70336) |
$2,929 |
$2,929 |
11.6× |
| MRI upper ext joint w/o contrast (73221) |
$3,586 |
$3,586 |
14.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,344 |
$3,344 |
9.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,464 |
$3,464 |
13.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,380 |
$4,380 |
3.2× |
| Neck soft tissue (70360) |
$277 |
$277 |
3.0× |
| Nm gastric emptying study (78264) |
$1,341 |
$1,341 |
3.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$393 |
$393 |
3.6× |
| Parathyroid imaging (78070) |
$1,537 |
$1,537 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$386 |
$386 |
3.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,464 |
$3,464 |
9.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,267 |
$1,267 |
3.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,315 |
$2,315 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$335 |
$335 |
3.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$446 |
$446 |
4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$386 |
$386 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$236 |
$236 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$399 |
$399 |
3.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$308 |
$308 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$865 |
$865 |
4.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$865 |
$865 |
4.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$795 |
$795 |
4.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$297 |
$297 |
3.2× |
| Ribs bilateral 3 views (71110) |
$419 |
$419 |
3.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,791 |
$1,791 |
4.2× |
| Scanogram (77073) |
$491 |
$491 |
4.5× |
| Scapula complete (73010) |
$393 |
$393 |
3.6× |
| Screening digital breast tomosynthesis (77063) |
$145 |
$145 |
6.2× |
| Small bowel series (74250) |
$511 |
$511 |
2.8× |
| Spine thoracic 3 views (72072) |
$393 |
$393 |
3.6× |
| Testicular Imaging With Vascular Flow (78761) |
$1,267 |
$1,267 |
3.0× |
| Thyroid uptake measurement (78012) |
$1,267 |
$1,267 |
3.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,267 |
$1,267 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$776 |
$776 |
7.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,267 |
$1,267 |
3.0× |
| Urethrocystography voiding (74455) |
$802 |
$802 |
3.2× |
| Us breast unilateral complete (76641) |
$345 |
$345 |
3.1× |
| Us compl joint r-t w/image documentation (76881) |
$393 |
$393 |
3.6× |
| Us pelvic non ob complete (76856) |
$513 |
$513 |
4.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$393 |
$393 |
3.6× |
| Us pregnancy ltd (76815) |
$393 |
$393 |
3.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$513 |
$513 |
4.7× |
| Us retroperitoneal complete (76770) |
$769 |
$769 |
7.0× |
| Us retroperitoneal limited (76775) |
$393 |
$393 |
3.6× |
| Us scrotum and contents (76870) |
$452 |
$452 |
4.1× |
| Us soft tissue head/neck (76536) |
$637 |
$637 |
5.8× |
| Us xtr non-vasc lmtd (76882) |
$345 |
$345 |
3.1× |
| Us, eye b-scan (76512) |
$376 |
$376 |
3.4× |
| Wrist 2 views (73100) |
$275 |
$275 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$480 |
$480 |
4.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$243 |
$243 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$351 |
$351 |
3.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$824 |
$824 |
4.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$275 |
$275 |
3.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$297 |
$297 |
3.2× |
| X-ray exam hip uni 1 view (73501) |
$275 |
$275 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$457 |
$457 |
5.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$334 |
$334 |
3.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$393 |
$393 |
3.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$275 |
$275 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$430 |
$430 |
4.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$275 |
$275 |
3.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$865 |
$865 |
4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$275 |
$275 |
3.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$393 |
$393 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$785 |
$785 |
8.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$450 |
$450 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$275 |
$275 |
3.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$393 |
$393 |
3.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$393 |
$393 |
3.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$275 |
$275 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$393 |
$393 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$393 |
$393 |
3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$275 |
$275 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$341 |
$341 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$393 |
$393 |
4.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$275 |
$275 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$393 |
$393 |
3.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$393 |
$393 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$243 |
$243 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$445 |
$445 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$275 |
$275 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$341 |
$341 |
3.7× |
| Xr finger(s) 2+ views (73140) |
$275 |
$275 |
3.0× |
| Xr shoulder 1 view (73020) |
$275 |
$275 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$426 |
$426 |
3.9× |
| Xr tibia/fibula 2 views (73590) |
$320 |
$320 |
3.5× |
| Xray knee 1 or 2 views rt (73560) |
$344 |
$344 |
3.7× |