| Abdomen 2 views (74019) |
$153.99 |
$384.97 |
1.3× |
| Ankle 2 views (73600) |
$112.44 |
$281.11 |
1.2× |
| Arthrogram shoulder (73040) |
$507.50 |
$1,268.74 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$829.35 |
$2,073.38 |
1.9× |
| Bone age studies (77072) |
$87.66 |
$219.16 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$696.86 |
$1,742.16 |
1.6× |
| Bowel imaging (78290) |
$558.11 |
$1,395.27 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$141.09 |
$352.72 |
1.5× |
| Chest 1 view (71045) |
$147.54 |
$368.84 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$508.50 |
$1,271.25 |
2.6× |
| Clavicle complete (73000) |
$86.66 |
$216.65 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,541.39 |
$3,853.48 |
4.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,630.20 |
$4,075.51 |
6.1× |
| CT abdomen w contrast (74160) |
$1,157.80 |
$2,894.50 |
5.9× |
| CT abdomen w wo contrast (74170) |
$1,416.63 |
$3,541.58 |
7.2× |
| CT abdomen w/o contrast (74150) |
$959.99 |
$2,399.98 |
8.2× |
| CT c-spine w/o contrast (72125) |
$983.34 |
$2,458.34 |
8.4× |
| CT chest w contrast (71260) |
$1,149.63 |
$2,874.08 |
5.9× |
| CT chest w/wo contrast (71270) |
$1,416.63 |
$3,541.58 |
7.2× |
| CT head/brain with contrast (70460) |
$1,046.82 |
$2,617.06 |
5.4× |
| CT head/brain without and with contrast (70470) |
$1,219.25 |
$3,048.12 |
6.2× |
| CT lower ext w/o (73700) |
$557.78 |
$1,394.44 |
4.8× |
| CT lower extremity w/contrast material (73701) |
$1,299.46 |
$3,248.65 |
6.6× |
| CT lumbar spine w/o contrast (72131) |
$983.48 |
$2,458.70 |
8.4× |
| CT maxillofacial w contrast (70487) |
$953.58 |
$2,383.96 |
4.9× |
| CT maxillofacial wo contrast (70486) |
$712.61 |
$1,781.53 |
6.1× |
| CT orbits w/o contrast (70480) |
$878.19 |
$2,195.47 |
7.5× |
| CT pelvis w/o contrast (72192) |
$955.41 |
$2,388.52 |
8.2× |
| CT soft tissue neck w contrast (70491) |
$1,209.08 |
$3,022.70 |
6.2× |
| CT soft tissue neck w/o contrast (70490) |
$966.01 |
$2,415.02 |
8.3× |
| CT thoracic spine w/o contrast (72128) |
$983.48 |
$2,458.70 |
8.4× |
| CT thorax w/o contrast (71250) |
$989.35 |
$2,473.37 |
8.5× |
| CT upper ext wo (73200) |
$892.95 |
$2,232.38 |
7.7× |
| CTA abdomen pelvis (74174) |
$1,800.77 |
$4,501.93 |
4.6× |
| CTA chest (71275) |
$1,573.19 |
$3,932.97 |
8.0× |
| Cta Head (70496) |
$1,405.46 |
$3,513.64 |
7.2× |
| Cta Neck (70498) |
$1,535.81 |
$3,839.52 |
7.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$340.90 |
$852.26 |
2.9× |
| Esophagus (74220) |
$483.43 |
$1,208.58 |
2.5× |
| Facial bones min 3 views (70150) |
$154.70 |
$386.75 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$435.16 |
$1,087.91 |
3.7× |
| Fluoroscopy up to 1 hr (76000) |
$433.87 |
$1,084.68 |
1.6× |
| Foot 2 views (73620) |
$71.04 |
$177.61 |
0.7× |
| Forearm 2 views (73090) |
$75.34 |
$188.36 |
0.8× |
| Hand 2 views (73120) |
$66.90 |
$167.24 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$861.87 |
$2,154.67 |
1.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$839.81 |
$2,099.53 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$997.66 |
$2,494.14 |
1.6× |
| Knee 3 views (73562) |
$137.79 |
$344.48 |
1.4× |
| Lung perf&ventilat diferentl (78598) |
$1,197.33 |
$2,993.32 |
2.0× |
| Lymphoscintigraphy (78195) |
$620.94 |
$1,552.34 |
1.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,261.88 |
$3,154.69 |
1.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,472.33 |
$3,680.83 |
3.8× |
| MRA head w/o contrast (70544) |
$860.35 |
$2,150.88 |
3.2× |
| MRA neck w contrast (70548) |
$1,312.36 |
$3,280.89 |
3.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,392.02 |
$3,480.06 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,191.50 |
$2,978.75 |
3.1× |
| MRI abdomen w/o contrast (74181) |
$841.25 |
$2,103.12 |
3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,136.24 |
$2,840.60 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$1,195.22 |
$2,988.04 |
4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,542.16 |
$3,855.39 |
4.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$892.36 |
$2,230.91 |
3.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,331.85 |
$3,329.62 |
3.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,191.50 |
$2,978.75 |
3.1× |
| MRI pelvis w/o contrast (72195) |
$841.25 |
$2,103.12 |
3.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,426.79 |
$3,566.98 |
3.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,296.86 |
$3,242.15 |
3.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,472.33 |
$3,680.83 |
3.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,472.33 |
$3,680.83 |
3.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,156.66 |
$2,891.64 |
4.4× |
| MRI up ext w/o contrast (73218) |
$1,121.81 |
$2,804.53 |
4.2× |
| MRI upper ext joint w/o contrast (73221) |
$981.60 |
$2,454 |
3.7× |
| MRI, joint upper extrem combo (73223) |
$1,472.33 |
$3,680.83 |
3.8× |
| Myocardial Spect Multiple Studies (78452) |
$1,980.70 |
$4,951.75 |
1.4× |
| Myocardial spect single study at rest or stress (78451) |
$1,380.10 |
$3,450.26 |
1.0× |
| Neck soft tissue (70360) |
$109.87 |
$274.67 |
1.1× |
| Nm gastric emptying study (78264) |
$895.10 |
$2,237.75 |
2.0× |
| Parathyroid Planar Imaging (78070) |
$421.98 |
$1,054.94 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$102.27 |
$255.68 |
0.9× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$118.89 |
$297.22 |
1.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$115.02 |
$287.56 |
1.2× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$131.78 |
$329.45 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$125.33 |
$313.32 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$146.62 |
$366.56 |
1.3× |
| Radex fingr minimum 2 views (73140) |
$62.88 |
$157.21 |
0.6× |
| Radex Foot Compl Minimum 3 Views (73630) |
$95.69 |
$239.22 |
1.0× |
| Radex Hand Minimum 3 Views (73130) |
$79.36 |
$198.39 |
0.8× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$87.38 |
$218.45 |
0.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$308.12 |
$770.29 |
2.6× |
| Radex Humerus Minimum 2 Views (73060) |
$91.53 |
$228.83 |
0.9× |
| Radex Kne 1/2 Views (73560) |
$112.44 |
$281.11 |
1.2× |
| Radex Kne Compl 4/More Views (73564) |
$220.59 |
$551.47 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$141.38 |
$353.44 |
1.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$130.63 |
$326.57 |
1.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$53.26 |
$133.14 |
0.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$186.64 |
$466.60 |
1.9× |
| Radex Toe Minimum 2 Views (73660) |
$79.36 |
$198.39 |
0.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$81.94 |
$204.84 |
0.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$120.47 |
$301.18 |
1.2× |
| Radiologic exam chest 2 views (71046) |
$191.80 |
$479.50 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$498.04 |
$1,245.10 |
2.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$140.37 |
$350.93 |
1.4× |
| Radiological examination surgical specimen (76098) |
$128.34 |
$320.86 |
0.2× |
| Ribs bilateral 3 views (71110) |
$173.04 |
$432.60 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$556.47 |
$1,391.18 |
0.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$940.34 |
$2,350.85 |
0.7× |
| Scapula (73010) |
$113.45 |
$283.62 |
1.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$22.78 |
$56.95 |
1.0× |
| Shoulder 1 view (73020) |
$78.50 |
$196.25 |
0.8× |
| Small bowel series (74250) |
$513.36 |
$1,283.40 |
2.6× |
| Spine thoracic 3 views (72072) |
$182.34 |
$455.85 |
1.6× |
| Thoracolumbar 2 views (72080) |
$183.34 |
$458.36 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$645.72 |
$1,614.31 |
1.4× |
| Ultrasound breast complete (76641) |
$229.48 |
$573.70 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$372.99 |
$932.47 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$332.60 |
$831.50 |
2.9× |
| Us breast unilateral limited (76642) |
$89.82 |
$224.55 |
0.9× |
| Us chest (76604) |
$304.82 |
$762.04 |
2.6× |
| Us compl joint r-t w/image documentation (76881) |
$375.29 |
$938.22 |
3.2× |
| Us encephalogram (76506) |
$393.88 |
$984.69 |
3.4× |
| Us infant hips w manipulation (76885) |
$228.04 |
$570.10 |
2.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$232.76 |
$581.91 |
2.0× |
| Us ob limited (76815) |
$330.03 |
$825.07 |
2.8× |
| Us ob transvaginal (76817) |
$267.71 |
$669.28 |
2.3× |
| Us pelvic non ob complete (76856) |
$320.28 |
$800.69 |
2.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$127.54 |
$318.84 |
1.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$370.99 |
$927.48 |
3.2× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$256.97 |
$642.43 |
2.2× |
| Us retroperitoneal complete (76770) |
$533.28 |
$1,333.20 |
4.6× |
| Us retroperitoneal limited (76775) |
$372.99 |
$932.47 |
3.2× |
| Us scrotum and contents (76870) |
$375.29 |
$938.22 |
3.2× |
| Us soft tissue head/neck (76536) |
$309.39 |
$773.48 |
2.7× |
| Us spinal canal and contents (76800) |
$397.20 |
$993 |
3.4× |
| Wrist 2 views (73100) |
$75.34 |
$188.36 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$211.34 |
$528.35 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$74.92 |
$187.29 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$154.13 |
$385.32 |
1.6× |
| X-ray exam of femur 2/> (73552) |
$127.91 |
$319.78 |
1.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$107.55 |
$268.88 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$126.62 |
$316.55 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$133.64 |
$334.09 |
1.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$292.59 |
$731.48 |
2.5× |
| X-ray nose-rectum child f.b. (76010) |
$230.90 |
$577.26 |
2.4× |
| X-ray retrograde pyelogram (74420) |
$670.35 |
$1,675.88 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$133.07 |
$332.67 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$186.21 |
$465.52 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$220.07 |
$550.17 |
1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$169.74 |
$424.35 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$131.78 |
$329.45 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$99.84 |
$249.60 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$99.84 |
$249.60 |
0.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$114.30 |
$285.76 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$143.24 |
$358.09 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$126.62 |
$316.55 |
1.1× |
| Xr c-spine 4 or 5 views (72050) |
$174.32 |
$435.81 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$259.92 |
$649.79 |
2.2× |