| Abdomen 2 views (74019) |
$402.66 |
$541.50 |
3.7× |
| Ankle 2 views (73600) |
$207.72 |
$279.34 |
2.3× |
| Bone age studies (77072) |
$296.40 |
$398.60 |
2.7× |
| Bone survey complete (77075) |
$907.49 |
$1,220.40 |
8.4× |
| Bone survey infant (77076) |
$278.48 |
$374.50 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$426.53 |
$573.60 |
4.7× |
| Chest 1 view (71045) |
$314.32 |
$422.70 |
3.5× |
| Clavicle complete (73000) |
$346.96 |
$466.60 |
3.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,003.86 |
$1,350 |
9.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,555.14 |
$6,125.80 |
12.7× |
| CT abdomen and pelvis without contrast (74176) |
$3,190.79 |
$4,291 |
13.0× |
| CT abdomen w contrast (74160) |
$1,935.89 |
$2,603.40 |
10.7× |
| CT abdomen w wo contrast (74170) |
$2,521.47 |
$3,390.90 |
13.9× |
| CT abdomen w/o contrast (74150) |
$1,560.30 |
$2,098.30 |
14.5× |
| CT c-spine w/contrast (72126) |
$2,291.48 |
$3,081.60 |
6.4× |
| CT c-spine w/o contrast (72125) |
$2,045.64 |
$2,751 |
19.0× |
| CT chest w contrast (71260) |
$1,885.92 |
$2,536.20 |
10.4× |
| CT head/brain with contrast (70460) |
$1,897.67 |
$2,552 |
10.5× |
| CT head/brain without and with contrast (70470) |
$2,121.27 |
$2,852.70 |
11.7× |
| CT iac w contrast (70481) |
$1,554.72 |
$2,090.80 |
8.6× |
| CT lower ext w/o (73700) |
$1,777.50 |
$2,390.40 |
16.5× |
| CT lower extremity w/contrast material (73701) |
$1,301.30 |
$1,750 |
7.2× |
| CT lumbar spine w/contrast (72132) |
$4,284.70 |
$5,762.10 |
11.9× |
| CT lumbar spine w/o contrast (72131) |
$2,127.59 |
$2,861.20 |
19.7× |
| CT maxillofacial w contrast (70487) |
$1,864.28 |
$2,507.10 |
10.3× |
| CT maxillofacial wo contrast (70486) |
$1,745.68 |
$2,347.60 |
16.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,727.38 |
$2,323 |
9.5× |
| CT orbits w/o contrast (70480) |
$1,197.49 |
$1,610.40 |
11.1× |
| CT pelvis w/o contrast (72192) |
$1,475.15 |
$1,983.80 |
13.7× |
| CT pelvis w/wo contrast (72194) |
$1,923.10 |
$2,586.20 |
10.6× |
| CT soft tissue neck w contrast (70491) |
$2,142.76 |
$2,881.60 |
11.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,335.13 |
$1,795.50 |
7.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,612.05 |
$2,167.90 |
14.9× |
| CT thoracic spine w/contrast (72129) |
$4,309.16 |
$5,795 |
23.8× |
| CT thoracic spine w/o contrast (72128) |
$2,114.05 |
$2,843 |
19.6× |
| CT thorax w/o contrast (71250) |
$1,341.56 |
$1,804.15 |
12.4× |
| CT upper ext wo (73200) |
$1,273.04 |
$1,712 |
11.8× |
| CT upper extremity with contrast (73201) |
$1,301.30 |
$1,750 |
3.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,286.86 |
$4,420.20 |
18.2× |
| Cta Abdomen (74175) |
$2,189.68 |
$2,944.70 |
12.1× |
| CTA chest (71275) |
$2,450.57 |
$3,295.55 |
13.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,821.22 |
$3,794 |
7.8× |
| Cta Neck (70498) |
$2,812.26 |
$3,781.95 |
15.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$604.70 |
$813.20 |
5.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$158.39 |
$213 |
1.8× |
| Dxa bone density study axial skeleton (77085) |
$158.39 |
$213 |
1.5× |
| Facial bones min 3 views (70150) |
$377.60 |
$507.80 |
3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$504.50 |
$678.45 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$357.02 |
$480.12 |
1.4× |
| Foot 2 views (73620) |
$240.33 |
$323.20 |
2.7× |
| Forearm 2 views (73090) |
$272.98 |
$367.10 |
3.0× |
| Hand 2 views (73120) |
$229.18 |
$308.20 |
2.1× |
| Knee 3 views (73562) |
$362.06 |
$486.90 |
4.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,809.47 |
$3,778.20 |
3.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,832.52 |
$3,809.20 |
7.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,165.95 |
$4,257.60 |
8.8× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$161.36 |
$217 |
1.8× |
| MRA head w & w/o contrast (70546) |
$2,678.22 |
$3,601.70 |
7.4× |
| MRA head w/o contrast (70544) |
$2,227.83 |
$2,996 |
9.0× |
| MRA head with contrast (70545) |
$1,592.49 |
$2,141.60 |
4.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,979.90 |
$5,352.20 |
11.1× |
| MRA neck w/o contrast (70547) |
$2,381.45 |
$3,202.60 |
9.7× |
| MRI abdomen w contrast (74182) |
$2,608.55 |
$3,508 |
7.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,803.22 |
$5,114.60 |
10.6× |
| MRI abdomen w/o contrast (74181) |
$1,877.37 |
$2,524.70 |
7.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,705.22 |
$3,638 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,341.74 |
$4,494 |
9.3× |
| MRI c-spine with contrast (72142) |
$2,760.17 |
$3,711.90 |
7.7× |
| MRI cervical spine w/o contrast (72141) |
$2,505.56 |
$3,369.50 |
10.2× |
| MRI chest w/o & w/contrast material (71552) |
$3,786.56 |
$5,092.20 |
10.5× |
| MRI chest w/o contrast (71550) |
$1,894.10 |
$2,547.20 |
7.7× |
| MRI chest with contrast (71551) |
$3,413.35 |
$4,590.30 |
4.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,989.58 |
$2,675.60 |
5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,023.48 |
$4,066 |
8.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,894.10 |
$2,547.20 |
7.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,894.10 |
$2,547.20 |
7.7× |
| MRI orbit face neck w contrast (70542) |
$2,906.14 |
$3,908.20 |
8.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,142.83 |
$4,226.50 |
8.7× |
| MRI pelvis w/contrast (72196) |
$2,526.23 |
$3,397.30 |
7.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,560.58 |
$4,788.30 |
9.9× |
| MRI pelvis w/o contrast (72195) |
$2,100.52 |
$2,824.80 |
8.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,455.58 |
$4,647.10 |
9.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,692.13 |
$3,620.40 |
7.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,935.35 |
$5,292.30 |
10.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,746.64 |
$3,693.70 |
7.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,566.16 |
$4,795.80 |
9.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,248.57 |
$3,023.90 |
9.1× |
| MRI up ext w/o contrast (73218) |
$2,526.23 |
$3,397.30 |
10.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,575.53 |
$3,463.60 |
10.5× |
| MRI, joint upper extrem combo (73223) |
$3,451.57 |
$4,641.70 |
9.6× |
| Neck soft tissue (70360) |
$240.33 |
$323.20 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$310.30 |
$417.30 |
2.9× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$311.94 |
$419.50 |
3.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$240.33 |
$323.20 |
2.7× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$420.13 |
$565 |
4.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$627 |
$843.20 |
7.0× |
| Radex fingr minimum 2 views (73140) |
$254.61 |
$342.40 |
2.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$391.73 |
$526.80 |
4.4× |
| Radex Hand Minimum 3 Views (73130) |
$294.39 |
$395.90 |
3.3× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$437.61 |
$588.50 |
4.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$585.66 |
$787.60 |
5.4× |
| Radex Humerus Minimum 2 Views (73060) |
$342.13 |
$460.10 |
3.8× |
| Radex Kne 1/2 Views (73560) |
$280.93 |
$377.80 |
3.1× |
| Radex Kne Compl 4/More Views (73564) |
$496.36 |
$667.50 |
4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$241.89 |
$325.30 |
2.7× |
| Radex Sho Compl Minimum 2 Views (73030) |
$463.52 |
$623.35 |
5.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$331.05 |
$445.20 |
3.7× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$225.24 |
$302.90 |
2.1× |
| Radex Toe Minimum 2 Views (73660) |
$264.20 |
$355.30 |
2.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$337.82 |
$454.30 |
3.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$323.09 |
$434.50 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$336.63 |
$452.70 |
3.7× |
| Radiologic exam chest 2 views (71046) |
$321.46 |
$432.30 |
3.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$356.22 |
$479.05 |
4.0× |
| Sacroiliac Joints < 3 Views (72200) |
$265.76 |
$357.40 |
2.5× |
| Scapula (73010) |
$333.43 |
$448.40 |
3.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$253.87 |
$341.40 |
10.9× |
| Spine thoracic 3 views (72072) |
$488.55 |
$657 |
4.5× |
| Ultrasound Exam Aaa Screen (76706) |
$541.86 |
$728.70 |
5.0× |
| Ultrasound, abdomen limited (76705) |
$743.97 |
$1,000.50 |
6.9× |
| Us breast unilateral limited (76642) |
$561.79 |
$755.50 |
6.3× |
| Us chest (76604) |
$597.56 |
$803.60 |
5.5× |
| Us encephalogram (76506) |
$449.58 |
$604.60 |
4.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$282.42 |
$379.80 |
2.6× |
| Us ob detailed single fetus (76811) |
$542.68 |
$729.80 |
2.2× |
| Us ob limited (76815) |
$540.30 |
$726.60 |
5.0× |
| Us ob transvaginal (76817) |
$434.49 |
$584.30 |
4.0× |
| Us pelvic non ob complete (76856) |
$674.74 |
$907.40 |
6.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$533.09 |
$716.90 |
4.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$519.63 |
$698.80 |
4.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$635.78 |
$855 |
5.9× |
| Us retroperitoneal complete (76770) |
$955.23 |
$1,284.60 |
8.9× |
| Us retroperitoneal limited (76775) |
$650.87 |
$875.30 |
6.0× |
| Us scrotum and contents (76870) |
$659.65 |
$887.10 |
6.1× |
| Us soft tissue head/neck (76536) |
$729.62 |
$981.20 |
6.8× |
| Wrist 2 views (73100) |
$294.84 |
$396.50 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$238.70 |
$321 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$240.33 |
$323.20 |
2.7× |
| X-ray exam of femur 2/> (73552) |
$293.65 |
$394.90 |
3.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$363.62 |
$489 |
4.0× |
| X-ray leg, infant (73592) |
$337.82 |
$454.30 |
3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$424.89 |
$571.40 |
3.9× |
| X-ray nose-rectum child f.b. (76010) |
$260.63 |
$350.50 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$377.60 |
$507.80 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$511.67 |
$688.10 |
4.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$683.52 |
$919.20 |
6.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$356.48 |
$479.40 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$331.05 |
$445.20 |
3.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$384.37 |
$516.90 |
3.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$325.47 |
$437.70 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$329.41 |
$443 |
3.7× |
| Xr c-spine 4 or 5 views (72050) |
$522.75 |
$703 |
4.8× |
| Xr c-spine 6 or more views (72052) |
$433.70 |
$583.25 |
4.0× |
| Xr chest 4+ views (71048) |
$390.32 |
$524.90 |
3.6× |