| Abdomen 2 views (74019) |
$158.34 |
$263.90 |
1.4× |
| Ankle 2 views (73600) |
$319.12 |
$531.86 |
3.4× |
| Bone age studies (77072) |
$352.26 |
$587.10 |
3.2× |
| Bone survey complete (77075) |
$493.78 |
$822.97 |
4.4× |
| Cervical spine 2 or 3 views (72040) |
$337.38 |
$562.31 |
3.6× |
| Chest 1 view (71045) |
$197.32 |
$328.86 |
2.1× |
| Clavicle complete (73000) |
$216.80 |
$361.34 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$330.08 |
$550.13 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,380.52 |
$8,967.52 |
14.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,842.79 |
$6,404.65 |
15.1× |
| CT abdomen w contrast (74160) |
$1,615.07 |
$2,691.78 |
8.6× |
| CT abdomen w wo contrast (74170) |
$3,675.32 |
$6,125.52 |
19.6× |
| CT abdomen w/o contrast (74150) |
$1,375.73 |
$2,292.88 |
12.3× |
| CT angio hrt w/3d image (75574) |
$2,264.35 |
$3,773.92 |
6.1× |
| CT angiography upper extremity lt (73206) |
$1,604.33 |
$2,673.88 |
8.6× |
| CT c-spine w/o contrast (72125) |
$2,654.93 |
$4,424.88 |
23.8× |
| CT cervical spine w&w/o contrast (72127) |
$2,138.90 |
$3,564.83 |
11.4× |
| CT cervical spine with contrast (72126) |
$3,018.52 |
$5,030.86 |
8.1× |
| CT chest w/wo contrast (71270) |
$3,462.04 |
$5,770.06 |
18.5× |
| CT chest with contrast (71260) |
$2,925.02 |
$4,875.04 |
15.6× |
| CT head/brain with contrast (70460) |
$1,482.92 |
$2,471.52 |
7.9× |
| CT head/brain without and with contrast (70470) |
$3,124.17 |
$5,206.95 |
16.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,731.02 |
$2,885.03 |
4.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$556.82 |
$928.03 |
6.0× |
| CT hrt w/3d image congen (75573) |
$750.87 |
$1,251.45 |
2.0× |
| CT iac w contrast (70481) |
$2,326.88 |
$3,878.12 |
12.4× |
| CT lower ext w/o (73700) |
$1,912.26 |
$3,187.10 |
17.1× |
| CT lower extremity with contrast (73701) |
$2,189.36 |
$3,648.92 |
11.7× |
| CT lumbar spine w & w/o contrast (72133) |
$2,675.94 |
$4,459.91 |
14.3× |
| CT lumbar spine w/o contrast (72131) |
$3,210.04 |
$5,350.06 |
28.8× |
| CT lumbar spine with contrast (72132) |
$2,392.38 |
$3,987.30 |
6.4× |
| CT maxillofacial w contrast (70487) |
$2,181.54 |
$3,635.90 |
11.7× |
| CT maxillofacial w/o contrast (70486) |
$2,338.56 |
$3,897.60 |
21.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,009.09 |
$3,348.48 |
10.7× |
| CT neck soft tissue w contrast (70491) |
$2,507.86 |
$4,179.77 |
13.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,010.35 |
$3,350.59 |
10.7× |
| CT orbits w/o contrast (70480) |
$1,342.24 |
$2,237.06 |
12.0× |
| CT pelvis w & w/o contrast (72194) |
$468.57 |
$780.95 |
2.5× |
| CT pelvis w/o contrast (72192) |
$3,135.13 |
$5,225.22 |
28.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,118.71 |
$3,531.18 |
11.3× |
| CT soft tissue neck w/o contrast (70490) |
$2,602.40 |
$4,337.33 |
23.3× |
| CT thoracic spine w/contrast (72129) |
$2,370.07 |
$3,950.12 |
12.7× |
| CT thoracic spine w/o contrast (72128) |
$1,668.05 |
$2,780.08 |
15.0× |
| CT thoracic spine w/wo contrast (72130) |
$2,635.75 |
$4,392.92 |
14.1× |
| CT thorax w/o contrast (71250) |
$1,853.80 |
$3,089.66 |
16.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,464.64 |
$2,441.08 |
13.1× |
| CT upper extremity with contrast (73201) |
$2,440.87 |
$4,068.12 |
6.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,238.68 |
$3,731.14 |
12.0× |
| Cta Abdomen (74175) |
$1,583.40 |
$2,639 |
8.5× |
| CTA chest (71275) |
$2,868.39 |
$4,780.65 |
15.3× |
| Cta Head (70496) |
$1,788.64 |
$2,981.06 |
9.6× |
| CTA lwr ext w&w/o contrast (73706) |
$3,571.42 |
$5,952.37 |
19.1× |
| Cta Neck (70498) |
$2,157.68 |
$3,596.14 |
11.5× |
| Cta Pelvis (72191) |
$738.51 |
$1,230.85 |
3.9× |
| Fetal biophysical profile non-stress testing (76818) |
$600.35 |
$1,000.58 |
5.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$280.57 |
$467.62 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$381.24 |
$635.39 |
1.5× |
| Foot 2 views (73620) |
$333.12 |
$555.20 |
3.6× |
| Forearm 2 views (73090) |
$160.78 |
$267.96 |
1.7× |
| Hand 2 views (73120) |
$239.34 |
$398.90 |
2.1× |
| Hand 3 views (73130) |
$293.54 |
$489.23 |
3.2× |
| Humerus Min 2 Views Left (73060) |
$238.12 |
$396.86 |
2.6× |
| Knee 3 views (73562) |
$393.42 |
$655.69 |
4.2× |
| MRA head w & w/o contrast (70546) |
$2,251.99 |
$3,753.32 |
6.0× |
| MRA head w/o contrast (70544) |
$2,039.84 |
$3,399.74 |
8.0× |
| MRA head with contrast (70545) |
$3,492.94 |
$5,821.56 |
9.4× |
| MRA neck w contrast (70548) |
$2,928.08 |
$4,880.14 |
7.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,272.46 |
$2,120.77 |
3.4× |
| MRA neck w/o contrast (70547) |
$1,048.70 |
$1,747.83 |
4.1× |
| MRI abdomen w contrast (74182) |
$3,424.96 |
$5,708.26 |
9.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,150.96 |
$5,251.61 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$2,108.36 |
$3,513.93 |
8.3× |
| MRI any jnt lwr ext with con lt (73722) |
$2,975.67 |
$4,959.45 |
3.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,234.61 |
$5,391.02 |
3.9× |
| MRI c-spine with contrast (72142) |
$2,835.38 |
$4,725.64 |
7.6× |
| MRI cervical spine w/o contrast (72141) |
$3,454.86 |
$5,758.10 |
13.6× |
| MRI chest w/o & w/contrast material (71552) |
$3,876.71 |
$6,461.19 |
10.4× |
| MRI chest w/o contrast (71550) |
$3,145.62 |
$5,242.70 |
12.4× |
| MRI chest with contrast (71551) |
$3,424.96 |
$5,708.26 |
4.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,891.55 |
$6,485.91 |
10.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,590.66 |
$4,317.76 |
7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,305.68 |
$3,842.79 |
9.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,182.16 |
$3,636.93 |
8.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,007.22 |
$6,678.70 |
10.8× |
| MRI orbit/face/neck w/contrast (70542) |
$2,661.11 |
$4,435.18 |
7.1× |
| MRI pelvis w contrast (72196) |
$2,347.16 |
$3,911.94 |
6.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,504.80 |
$5,841.32 |
9.4× |
| MRI pelvis w/o contrast (72195) |
$2,685.75 |
$4,476.25 |
10.5× |
| MRI scan of arm joint before and after contrast (73223) |
$3,644.96 |
$6,074.94 |
9.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,039.54 |
$3,399.24 |
5.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,007.22 |
$6,678.70 |
10.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,630.13 |
$6,050.22 |
9.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,767.33 |
$6,278.88 |
10.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,630.13 |
$6,050.22 |
9.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,066.44 |
$6,777.40 |
10.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,442.07 |
$5,736.78 |
13.5× |
| MRI upper ext joint w/o contrast (73221) |
$3,062.66 |
$5,104.44 |
12.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,654.63 |
$4,424.38 |
7.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,068.45 |
$3,447.41 |
8.1× |
| Neck soft tissue (70360) |
$133.98 |
$223.30 |
1.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$464.40 |
$774 |
4.2× |
| Osseous survey infant (77076) |
$611.44 |
$1,019.06 |
5.5× |
| Pelvis 1 or 2 views (72170) |
$196.70 |
$327.84 |
1.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,817.84 |
$4,696.40 |
7.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$226.81 |
$378.01 |
2.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$174.18 |
$290.29 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$444.34 |
$740.57 |
4.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$118.66 |
$197.76 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$208.88 |
$348.14 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$152.25 |
$253.75 |
1.6× |
| Scapula complete (73010) |
$186.36 |
$310.59 |
1.7× |
| Thoracolumbar 2 views (72080) |
$293.55 |
$489.25 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$1,102.90 |
$1,838.16 |
9.9× |
| Us abdl aorta screen aaa (76706) |
$343.26 |
$572.10 |
3.1× |
| Us chest (76604) |
$593.28 |
$988.80 |
5.3× |
| Us compl joint r-t w/image documentation (76881) |
$701.57 |
$1,169.28 |
6.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$190.96 |
$318.27 |
1.7× |
| Us kidney transplant (76776) |
$624.18 |
$1,040.30 |
5.6× |
| Us pelvic non ob complete (76856) |
$1,334.32 |
$2,223.86 |
12.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$583.42 |
$972.37 |
5.2× |
| Us pregnancy ltd (76815) |
$422.40 |
$704 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$704 |
$1,173.34 |
6.3× |
| Us retroperitoneal complete (76770) |
$726.54 |
$1,210.90 |
6.5× |
| Us scrotum and contents (76870) |
$723.49 |
$1,205.82 |
6.5× |
| Us soft tissue head/neck (76536) |
$739.94 |
$1,233.22 |
6.6× |
| Us xtr non-vasc lmtd (76882) |
$364.55 |
$607.58 |
3.3× |
| Venography caval superior serialography rs&i (75827) |
$1,133.60 |
$1,889.33 |
0.7× |
| Wrist 2 views (73100) |
$286.84 |
$478.06 |
3.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$371.49 |
$619.15 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$275.01 |
$458.35 |
3.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$330.08 |
$550.13 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$177.22 |
$295.36 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$316.07 |
$526.78 |
3.4× |
| X-ray exam hip uni 1 view (73501) |
$236.29 |
$393.82 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$350.18 |
$583.62 |
3.8× |
| X-ray exam of femur 1 (73551) |
$209.50 |
$349.16 |
2.3× |
| X-ray eye for foreign body (70030) |
$208.88 |
$348.14 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$196.10 |
$326.83 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$401.94 |
$669.90 |
4.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$150.42 |
$250.70 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$260.04 |
$433.40 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$332.52 |
$554.19 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$241.78 |
$402.96 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$470.15 |
$783.58 |
4.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$810.58 |
$1,350.96 |
7.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$302.82 |
$504.70 |
2.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$411.38 |
$685.64 |
4.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$323.99 |
$539.98 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$394.02 |
$656.70 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$251.52 |
$419.20 |
2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$367.84 |
$613.06 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$199.14 |
$331.90 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$350.18 |
$583.62 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$316.42 |
$527.36 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$473.70 |
$789.50 |
4.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$251.53 |
$419.21 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$189.97 |
$316.62 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$260.04 |
$433.40 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$271 |
$451.68 |
2.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$394.90 |
$658.17 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$173.56 |
$289.28 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$317.90 |
$529.83 |
3.4× |
| Xr c-spine 6 or more views (72052) |
$721.66 |
$1,202.78 |
6.5× |
| Xr finger(s) 2+ views (73140) |
$200.36 |
$333.94 |
2.2× |
| Xr shoulder 1 view (73020) |
$179.66 |
$299.42 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$566.37 |
$943.95 |
5.1× |
| Xr tibia/fibula 2 views (73590) |
$298.41 |
$497.35 |
3.2× |
| Xray knee 1 or 2 views rt (73560) |
$217.42 |
$362.36 |
2.3× |