| Abdomen 2 views (74019) |
$414.40 |
$414.40 |
3.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,096.30 |
$1,096.30 |
2.7× |
| Angiography extremity bilateral rs&i (75716) |
$4,409 |
$4,409 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$2,597.70 |
$2,597.70 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,537.45 |
$4,537.45 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,344 |
$6,344 |
2.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,883 |
$5,883 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$6,344 |
$6,344 |
2.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$6,344 |
$6,344 |
2.0× |
| Ankle 2 views (73600) |
$294.50 |
$294.50 |
3.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$993.20 |
$993.20 |
2.8× |
| Aortogram thoracic (75605) |
$11,180 |
$11,180 |
2.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,639.20 |
$1,639.20 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$2,730.90 |
$2,730.90 |
0.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,406 |
$1,406 |
3.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,239.80 |
$1,239.80 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$939.10 |
$939.10 |
2.3× |
| Bone age studies (77072) |
$210 |
$210 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,063.45 |
$1,063.45 |
2.6× |
| Bone survey complete (77075) |
$384.30 |
$384.30 |
3.7× |
| Cervical spine 2 or 3 views (72040) |
$165.25 |
$165.25 |
1.9× |
| Chest 1 view (71045) |
$224.60 |
$224.60 |
2.6× |
| Chest 3 views (71047) |
$224.60 |
$224.60 |
2.6× |
| Clavicle complete (73000) |
$306 |
$306 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,347.20 |
$1,347.20 |
12.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,216.54 |
$1,216.54 |
3.5× |
| CT abdomen and pelvis without contrast (74176) |
$775.17 |
$775.17 |
3.2× |
| CT abdomen w contrast (74160) |
$2,299.70 |
$2,299.70 |
13.1× |
| CT abdomen w wo contrast (74170) |
$2,585.55 |
$2,585.55 |
14.7× |
| CT abdomen w/o contrast (74150) |
$2,112.70 |
$2,112.70 |
20.1× |
| CT angio hrt w/3d image (75574) |
$3,136.26 |
$3,136.26 |
8.9× |
| CT angiography upper extremity lt (73206) |
$2,648.60 |
$2,648.60 |
15.0× |
| CT c-spine w/o contrast (72125) |
$2,062.40 |
$2,062.40 |
19.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,648.60 |
$2,648.60 |
15.0× |
| CT cervical spine with contrast (72126) |
$2,436.80 |
$2,436.80 |
7.0× |
| CT chest w/wo contrast (71270) |
$614.30 |
$614.30 |
3.5× |
| CT chest with contrast (71260) |
$2,258.60 |
$2,258.60 |
12.8× |
| CT colonography w/dye (74262) |
$1,407.60 |
$1,407.60 |
8.0× |
| CT colonography w/o cntrst (74261) |
$823.10 |
$823.10 |
7.8× |
| CT head/brain with contrast (70460) |
$2,204.80 |
$2,204.80 |
12.5× |
| CT head/brain without and with contrast (70470) |
$2,648.60 |
$2,648.60 |
15.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,602.60 |
$2,602.60 |
7.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$129.75 |
$129.75 |
1.5× |
| CT hrt w/3d image congen (75573) |
$2,666.10 |
$2,666.10 |
7.6× |
| CT iac w contrast (70481) |
$2,258.60 |
$2,258.60 |
12.8× |
| CT limited/localized follow up study (76380) |
$811.50 |
$811.50 |
9.3× |
| CT lower ext w/o (73700) |
$2,112.70 |
$2,112.70 |
20.1× |
| CT lower extremity w wo contrast (73702) |
$2,648.60 |
$2,648.60 |
15.0× |
| CT lower extremity with contrast (73701) |
$2,258.60 |
$2,258.60 |
12.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,648.60 |
$2,648.60 |
15.0× |
| CT lumbar spine w/o contrast (72131) |
$2,062.40 |
$2,062.40 |
19.6× |
| CT lumbar spine with contrast (72132) |
$2,436.80 |
$2,436.80 |
7.0× |
| CT maxillofacial w contrast (70487) |
$2,258.60 |
$2,258.60 |
12.8× |
| CT maxillofacial w/o contrast (70486) |
$1,522.25 |
$1,522.25 |
14.5× |
| CT maxillofacial w/wo contrast (70488) |
$604.10 |
$604.10 |
3.4× |
| CT neck soft tissue w contrast (70491) |
$2,204.80 |
$2,204.80 |
12.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,648.60 |
$2,648.60 |
15.0× |
| CT orbits w/o contrast (70480) |
$1,559.40 |
$1,559.40 |
14.8× |
| CT pelvis w & w/o contrast (72194) |
$2,648.60 |
$2,648.60 |
15.0× |
| CT pelvis w/o contrast (72192) |
$2,062.40 |
$2,062.40 |
19.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,062.40 |
$2,062.40 |
11.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,559.40 |
$1,559.40 |
14.8× |
| CT thoracic spine w/contrast (72129) |
$2,436.80 |
$2,436.80 |
13.8× |
| CT thoracic spine w/o contrast (72128) |
$2,062.40 |
$2,062.40 |
19.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,648.60 |
$2,648.60 |
15.0× |
| CT thorax w/o contrast (71250) |
$1,559.40 |
$1,559.40 |
14.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,950.65 |
$1,950.65 |
11.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,485.10 |
$1,485.10 |
14.1× |
| CT upper extremity with contrast (73201) |
$3,168.50 |
$3,168.50 |
9.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,860.50 |
$2,860.50 |
16.2× |
| Cta Abdomen (74175) |
$2,601.45 |
$2,601.45 |
14.8× |
| CTA abdomen pelvis (74174) |
$5,201.75 |
$5,201.75 |
14.8× |
| CTA chest (71275) |
$2,379.15 |
$2,379.15 |
13.5× |
| Cta Head (70496) |
$2,601.45 |
$2,601.45 |
14.8× |
| CTA lwr ext w&w/o contrast (73706) |
$2,664.90 |
$2,664.90 |
15.1× |
| Cta Neck (70498) |
$2,601.45 |
$2,601.45 |
14.8× |
| Cystography minimum 3 views rs&i (74430) |
$675.80 |
$675.80 |
1.9× |
| Diskogram cervical (72285) |
$11,210.40 |
$11,210.40 |
5.7× |
| Diskography lumbar (72295) |
$11,210.40 |
$11,210.40 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$547.95 |
$547.95 |
2.3× |
| Foot 2 views (73620) |
$294.50 |
$294.50 |
3.4× |
| Forearm 2 views (73090) |
$214.75 |
$214.75 |
2.5× |
| Hand 2 views (73120) |
$168.10 |
$168.10 |
1.6× |
| Hand 3 views (73130) |
$220.80 |
$220.80 |
2.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,356.10 |
$1,356.10 |
3.4× |
| Ht muscle image spect sing (78451) |
$2,762.10 |
$2,762.10 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$225.40 |
$225.40 |
2.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,091 |
$1,091 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,091 |
$1,091 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,164.50 |
$2,164.50 |
4.0× |
| Knee 3 views (73562) |
$216.90 |
$216.90 |
2.5× |
| Liver & spleen imaging static only (78215) |
$1,356 |
$1,356 |
3.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,490 |
$1,490 |
3.7× |
| Lymphoscintigraphy (78195) |
$1,326.70 |
$1,326.70 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$3,410.50 |
$3,410.50 |
2.6× |
| Neck soft tissue (70360) |
$145.40 |
$145.40 |
1.7× |
| Nm gastric emptying study (78264) |
$919.20 |
$919.20 |
2.3× |
| Nm red cell sequestration (78140) |
$846.30 |
$846.30 |
2.1× |
| Nuclear medicine of heart pumping function (78473) |
$1,808.20 |
$1,808.20 |
4.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,462.50 |
$1,462.50 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$167.85 |
$167.85 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$938 |
$938 |
2.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,464.50 |
$1,464.50 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$555.70 |
$555.70 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$246.60 |
$246.60 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$407.50 |
$407.50 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$368 |
$368 |
3.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$218.80 |
$218.80 |
2.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$356.30 |
$356.30 |
3.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$210 |
$210 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$219.25 |
$219.25 |
2.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$219.25 |
$219.25 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$582.30 |
$582.30 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$582.30 |
$582.30 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$582.30 |
$582.30 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$369.30 |
$369.30 |
4.2× |
| Ribs bilateral 3 views (71110) |
$335.70 |
$335.70 |
3.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,381.30 |
$2,381.30 |
4.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,381.30 |
$2,381.30 |
4.4× |
| Sacroiliac Joints < 3 Views (72200) |
$167.85 |
$167.85 |
1.6× |
| Scapula complete (73010) |
$210 |
$210 |
2.0× |
| Sella turcica (70240) |
$175 |
$175 |
2.0× |
| Small bowel series (74250) |
$429.60 |
$429.60 |
2.4× |
| Spine thoracic 3 views (72072) |
$356.30 |
$356.30 |
3.4× |
| Tmj unilateral (70328) |
$175 |
$175 |
2.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,422.80 |
$1,422.80 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$399.40 |
$399.40 |
3.8× |
| Upper Extremity Infant (73092) |
$210 |
$210 |
2.0× |
| Urethrocystography voiding (74455) |
$701 |
$701 |
2.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$758.30 |
$758.30 |
4.3× |
| Us chest (76604) |
$299.50 |
$299.50 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$355 |
$355 |
3.4× |
| Us guided compression repair (76936) |
$869.40 |
$869.40 |
4.0× |
| Us pelvic non ob complete (76856) |
$441.10 |
$441.10 |
4.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$359.35 |
$359.35 |
3.4× |
| Us retroperitoneal complete (76770) |
$532.30 |
$532.30 |
5.1× |
| Us retroperitoneal limited (76775) |
$443.85 |
$443.85 |
4.2× |
| Us scrotum and contents (76870) |
$487.10 |
$487.10 |
4.6× |
| Us soft tissue head/neck (76536) |
$356.30 |
$356.30 |
3.4× |
| Us transrectal (76872) |
$328.90 |
$328.90 |
3.1× |
| Venogram extremity bilateral (75822) |
$5,105.27 |
$5,105.27 |
3.2× |
| Venography caval inferior serialography rs&i (75825) |
$4,415.30 |
$4,415.30 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$2,511 |
$2,511 |
1.6× |
| Venography extremity unilateral rs&i (75820) |
$4,864.95 |
$4,864.95 |
3.1× |
| Venography Renal Bilateral (75833) |
$6,344 |
$6,344 |
2.0× |
| Venography renal unilateral selective rs&i (75831) |
$9,526.10 |
$9,526.10 |
3.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$11,180 |
$11,180 |
2.0× |
| Wrist 2 views (73100) |
$151.75 |
$151.75 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$335.70 |
$335.70 |
3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$339.30 |
$339.30 |
3.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$196.25 |
$196.25 |
2.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$582.30 |
$582.30 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$161 |
$161 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$221.95 |
$221.95 |
2.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$777.90 |
$777.90 |
7.4× |
| X-ray exam hip uni 1 view (73501) |
$204.95 |
$204.95 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$270.45 |
$270.45 |
3.1× |
| X-ray exam of femur 1 (73551) |
$369.30 |
$369.30 |
4.2× |
| X-ray eye for foreign body (70030) |
$306 |
$306 |
3.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$210 |
$210 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$175 |
$175 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$217.55 |
$217.55 |
2.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$306 |
$306 |
3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$306 |
$306 |
3.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$368 |
$368 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$306 |
$306 |
3.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$306 |
$306 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$187.70 |
$187.70 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$356.30 |
$356.30 |
3.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$335.70 |
$335.70 |
3.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$150.35 |
$150.35 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$210 |
$210 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$217.70 |
$217.70 |
2.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$993.20 |
$993.20 |
2.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$156.30 |
$156.30 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$353.64 |
$353.64 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$356.30 |
$356.30 |
3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$210 |
$210 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$159.90 |
$159.90 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$280.45 |
$280.45 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$198 |
$198 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$175 |
$175 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$240.80 |
$240.80 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$190.10 |
$190.10 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$217.70 |
$217.70 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$177.10 |
$177.10 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$175 |
$175 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$210 |
$210 |
2.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$217.70 |
$217.70 |
2.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$140.20 |
$140.20 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$128.50 |
$128.50 |
1.5× |
| Xr chest 4+ views (71048) |
$414.40 |
$414.40 |
3.9× |
| Xr finger(s) 2+ views (73140) |
$289.38 |
$289.38 |
3.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$210 |
$210 |
2.0× |
| Xr optic foramina (70190) |
$175 |
$175 |
2.0× |
| Xr shoulder 1 view (73020) |
$120.40 |
$120.40 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$321.70 |
$321.70 |
3.1× |
| Xr tibia/fibula 2 views (73590) |
$306 |
$306 |
3.5× |
| Xr tmj bilateral (70330) |
$205 |
$205 |
2.3× |
| Xray knee 1 or 2 views rt (73560) |
$280.45 |
$280.45 |
3.2× |