| Ankle 2 views (73600) |
$109.70 |
$219.39 |
1.2× |
| Barium enema (74270) |
$255.82 |
$511.64 |
1.4× |
| Bone age studies (77072) |
$75.39 |
$150.78 |
0.7× |
| Clavicle complete (73000) |
$149.28 |
$298.55 |
1.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$830.36 |
$1,660.72 |
4.5× |
| CT - st neck w&wo contr (70492) |
$850.28 |
$1,700.57 |
4.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$366.53 |
$733.05 |
1.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,347.50 |
$2,695 |
5.4× |
| CT abdomen w wo contrast (74170) |
$519.12 |
$1,038.24 |
2.8× |
| CT abdomen w/contrast (74160) |
$165.83 |
$331.66 |
0.9× |
| CT angio abdom w/o & w/dye (74175) |
$676.20 |
$1,352.39 |
3.7× |
| CT angio abdominal arteries (75635) |
$1,004.25 |
$2,008.50 |
5.5× |
| CT cervical spine w/o contrast (72125) |
$251.32 |
$502.64 |
2.3× |
| CT extremity upper w & w/o contrast (73202) |
$816.28 |
$1,632.55 |
4.5× |
| CT head/brain with contrast (70460) |
$897.13 |
$1,794.26 |
4.9× |
| CT head/brain without and with contrast (70470) |
$904.08 |
$1,808.16 |
4.9× |
| CT limited/localized follow up study (76380) |
$220.68 |
$441.36 |
2.4× |
| CT lower ext w/wo contrast (73702) |
$78.80 |
$157.59 |
0.4× |
| CT lower extremity w contrast (73701) |
$527.88 |
$1,055.75 |
2.9× |
| CT lower extremity w/o contrast unilateral (73700) |
$828.75 |
$1,657.50 |
7.6× |
| CT lumbar spine w/contrast (72132) |
$837.33 |
$1,674.66 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$142.66 |
$285.31 |
1.3× |
| CT maxillofacial area w/o contrast (70486) |
$261.54 |
$523.08 |
2.4× |
| CT maxillofacial w/contrast (70487) |
$710.45 |
$1,420.90 |
3.9× |
| CT maxillofacial w/o then w/ con (70488) |
$109.18 |
$218.36 |
0.6× |
| CT orbit sella ear w/o con (70480) |
$769.41 |
$1,538.82 |
7.0× |
| CT pelvis w & w/o contrast (72194) |
$487.45 |
$974.90 |
2.7× |
| CT pelvis w/o contrast (72192) |
$451.92 |
$903.82 |
4.1× |
| CT soft tissue neck w/contrast (70491) |
$776.62 |
$1,553.24 |
4.2× |
| CT soft tissue neck w/o contrast (70490) |
$267.28 |
$534.57 |
2.4× |
| CT thoracic spine w/contrast (72129) |
$502.13 |
$1,004.25 |
2.7× |
| CT thoracic spine w/o contrast (72128) |
$156.05 |
$312.09 |
1.4× |
| CT thorax lung cancer scr c- (71271) |
$1,339 |
$2,678 |
12.3× |
| CT thorax w/o then w/ contrast (71270) |
$919.18 |
$1,838.34 |
5.0× |
| CT upper extremity w/dye (73201) |
$554.14 |
$1,108.28 |
1.5× |
| CT upper extremity w/o contrast rt (73200) |
$566.50 |
$1,133 |
5.2× |
| CTA chest w/wo contrast (71275) |
$391.04 |
$782.08 |
2.1× |
| CTA head w contrast (70496) |
$916.10 |
$1,832.20 |
5.0× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$333.72 |
$667.44 |
1.8× |
| Cta Neck (70498) |
$676.20 |
$1,352.39 |
3.7× |
| Esophogram (74220) |
$46.12 |
$92.24 |
0.3× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$282.60 |
$565.18 |
1.1× |
| Humerus min 2 views (73060) |
$128.60 |
$257.18 |
1.4× |
| Ivp (74400) |
$23.18 |
$46.35 |
0.1× |
| Ob us < 14 wks single fetus (76801) |
$154.12 |
$308.23 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$64.38 |
$128.75 |
0.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$103.90 |
$207.78 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$84.64 |
$169.28 |
0.8× |
| Radex spine cervical 2 or 3 views (72040) |
$133.52 |
$267.02 |
1.5× |
| Radex spine cervical 6 or more views (72052) |
$212.51 |
$425.02 |
1.9× |
| Radiologic exam phrnx&/crv esoph contrast study (74210) |
$98.58 |
$197.14 |
0.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$297.41 |
$594.82 |
1.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$161.97 |
$323.94 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$136.13 |
$272.26 |
1.5× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$216.20 |
$432.38 |
2.0× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$12.50 |
$25 |
0.5× |
| Ultrasound, abdomen limited (76705) |
$227 |
$454 |
2.1× |
| Unlisted diagnostic radiographic procedure (76499) |
$3.61 |
$7.21 |
0.0× |
| Urethrocystography voiding (74455) |
$99.22 |
$198.42 |
0.4× |
| Us abdominal aorta real time screen study aaa (76706) |
$85.57 |
$171.14 |
0.8× |
| Us breast uni real time with image complete (76641) |
$253.28 |
$506.56 |
2.3× |
| Us chest (76604) |
$120.51 |
$241.02 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$185.81 |
$371.62 |
1.7× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$91.42 |
$182.82 |
1.0× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$55.10 |
$110.21 |
0.5× |
| Us ob detailed single fetus (76811) |
$161.46 |
$322.90 |
0.6× |
| Us ob limited 1 or more fetuses (76815) |
$93.12 |
$186.22 |
0.9× |
| Us obstetric transvaginal (76817) |
$224.79 |
$449.58 |
2.1× |
| Us pelvic limited or f/u non-ob (76857) |
$146.68 |
$293.34 |
1.3× |
| Us pelvis complete (76856) |
$250.18 |
$500.34 |
2.3× |
| Us retroperitoneal complete (76770) |
$362.62 |
$725.25 |
3.3× |
| Us retroperitoneal limited (76775) |
$168.40 |
$336.81 |
1.5× |
| Us scrotum (76870) |
$218.09 |
$436.18 |
2.0× |
| Us soft tissue head/neck (76536) |
$168.92 |
$337.84 |
1.5× |
| Us transrectal (76872) |
$391.50 |
$783 |
3.6× |
| Us unlstd proc (76999) |
$178.98 |
$357.94 |
2.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$152.50 |
$304.99 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$339.32 |
$678.64 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$163.59 |
$327.18 |
1.8× |
| X-ray exam of finger(s) (73140) |
$122.33 |
$244.66 |
1.3× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$108 |
$216 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$148.63 |
$297.26 |
1.6× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$97.43 |
$194.86 |
0.9× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$153.74 |
$307.49 |
1.7× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$172.52 |
$345.05 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$172.52 |
$345.05 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$91.14 |
$182.29 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$88.65 |
$177.30 |
0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$80.60 |
$161.20 |
0.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$63.45 |
$126.90 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$123.94 |
$247.89 |
1.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$69.20 |
$138.38 |
0.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$166.98 |
$333.96 |
1.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$89.38 |
$178.76 |
1.0× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$111.96 |
$223.92 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$141.24 |
$282.49 |
1.6× |
| Xr abdomen 1 view (74018) |
$109.25 |
$218.50 |
1.2× |
| Xr abdomen 2 views (74019) |
$135.94 |
$271.89 |
1.2× |
| Xr bone survey infant (77076) |
$267.90 |
$535.79 |
2.5× |
| Xr chest 1 view (71045) |
$102.55 |
$205.10 |
1.1× |
| Xr chest 2 views (71046) |
$32.70 |
$65.40 |
0.4× |
| Xr cystogram 3+ views (74430) |
$8.24 |
$16.48 |
0.0× |
| Xr eye foreign body (70030) |
$101.39 |
$202.78 |
1.1× |
| Xr mandible 4 views (70110) |
$136.06 |
$272.12 |
1.2× |
| Xr nasal bones (70160) |
$121 |
$242 |
1.3× |
| Xr sternum 2 views (71120) |
$88.03 |
$176.06 |
1.0× |
| Xray elbow 2 views (73070) |
$111.88 |
$223.76 |
1.2× |
| Xray forearm 2 views (73090) |
$134.80 |
$269.60 |
1.5× |
| Xray knee 1 or 2 views rt (73560) |
$113.18 |
$226.36 |
1.2× |
| Xray neck soft tissue (70360) |
$123.50 |
$247 |
1.4× |
| Xray orbits complete min 4 views (70200) |
$148.24 |
$296.48 |
1.4× |
| Xray pelvis 1 or 2 views (72170) |
$154.22 |
$308.42 |
1.4× |
| Xray ribs bilateral 3 views (71110) |
$82.15 |
$164.29 |
0.8× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$193.42 |
$386.82 |
1.8× |
| Xray scapula complete (73010) |
$164.60 |
$329.18 |
1.5× |
| Xray shoulder 1 view (73020) |
$63.24 |
$126.49 |
0.7× |
| Xray sinuses paranasal <3 views (70210) |
$133.03 |
$266.06 |
1.5× |
| Xray spine thoracic 3 views (72072) |
$132.26 |
$264.52 |
1.2× |
| Xray tmj's bilateral open-clsc (70330) |
$174.10 |
$348.19 |
1.9× |