| Abdomen 1 View (74018) |
$326 |
$385 |
3.7× |
| Abdomen 2 views (74019) |
$370 |
$437 |
3.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,195 |
$1,411 |
3.0× |
| Ankle 2 views (73600) |
$309 |
$365 |
3.5× |
| Arthrogram hip (73525) |
$489 |
$577 |
1.4× |
| Bone age studies (77072) |
$239 |
$283 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$1,286 |
$1,518 |
3.2× |
| Bone Imaging Limited Area (78300) |
$628 |
$741 |
1.6× |
| Bone Imaging Whole Body (78306) |
$860 |
$1,015 |
2.1× |
| Brain Image W/Flow < 4 Views (78601) |
$1,229 |
$1,449 |
3.1× |
| Brain imaging < 4 static views (78600) |
$1,195 |
$1,411 |
3.0× |
| Cat Scan Follow-Up Study (76380) |
$1,063 |
$1,254 |
12.2× |
| Chest 1 view (71045) |
$288 |
$314 |
3.3× |
| Chest 2 views (71046) |
$344 |
$406 |
3.9× |
| Chest 3 views (71047) |
$294 |
$348 |
3.4× |
| Chest 4 or more views (71048) |
$326 |
$385 |
3.1× |
| Cholecystography Oral Contrast (74290) |
$263 |
$263 |
1.5× |
| Clavicle complete (73000) |
$344 |
$406 |
3.9× |
| Contrast X-Ray Bladder (74430) |
$407 |
$184 |
1.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$583 |
$688 |
1.7× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$371 |
$438 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,720 |
$5,569 |
13.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,742 |
$4,415 |
15.7× |
| CT abdomen w contrast (74160) |
$2,159 |
$2,548 |
12.3× |
| CT abdomen w wo contrast (74170) |
$2,371 |
$2,798 |
13.5× |
| CT abdomen w/o contrast (74150) |
$1,956 |
$2,308 |
18.7× |
| CT Angio Chest (71275) |
$3,278 |
$3,868 |
18.7× |
| CT Angio Head (70496) |
$3,278 |
$3,868 |
18.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,278 |
$3,868 |
18.7× |
| CT Angio Neck (70498) |
$3,278 |
$3,868 |
18.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,934 |
$3,462 |
16.7× |
| CT bone density (77078) |
$408 |
$481 |
4.7× |
| CT cervical spine w/ contrast (72126) |
$2,035 |
$2,402 |
5.8× |
| CT cervical spine w/o contrast (72125) |
$1,788 |
$2,109 |
17.1× |
| CT cervical spine w/wo cont (72127) |
$1,266 |
$1,494 |
7.2× |
| CT chest w contrast (71260) |
$1,991 |
$2,349 |
11.3× |
| CT chest w/wo contrast (71270) |
$2,351 |
$2,775 |
13.4× |
| CT head/brain with contrast (70460) |
$2,039 |
$2,406 |
11.6× |
| CT head/brain without and with contrast (70470) |
$2,263 |
$2,670 |
12.9× |
| CT iac w contrast (70481) |
$2,064 |
$2,435 |
11.7× |
| CT l-spine w&w/o contrast (72133) |
$2,263 |
$2,670 |
12.9× |
| CT lower ext w/o (73700) |
$1,454 |
$1,716 |
13.9× |
| CT lower extremity w/contrast material (73701) |
$1,642 |
$1,938 |
9.3× |
| CT lumbar spine w/o contrast (72131) |
$1,971 |
$2,524 |
18.8× |
| CT maxillofacial w contrast (70487) |
$1,812 |
$2,138 |
10.3× |
| CT maxillofacial wo contrast (70486) |
$1,682 |
$1,985 |
16.1× |
| CT neck tissue combo (70492) |
$2,263 |
$2,670 |
12.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,263 |
$2,670 |
12.9× |
| CT orbits w/o contrast (70480) |
$1,788 |
$2,109 |
17.1× |
| CT pelvis w&w/o contrast (72194) |
$2,351 |
$2,775 |
13.4× |
| CT pelvis w/o contrast (72192) |
$1,841 |
$2,172 |
17.6× |
| CT scan of leg combo (73702) |
$1,356 |
$1,601 |
7.7× |
| CT scans face/jaw combo (70488) |
$1,929 |
$2,276 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$1,903 |
$2,245 |
10.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,792 |
$2,115 |
17.1× |
| CT thoracic spine w contrast (72129) |
$2,139 |
$2,524 |
12.2× |
| CT thoracic spine w/o contrast (72128) |
$1,788 |
$2,109 |
17.1× |
| CT thoracic spine w/wo cont (72130) |
$2,291 |
$2,703 |
13.0× |
| CT thorax w/o contrast (71250) |
$1,788 |
$2,109 |
17.1× |
| CT upper ext wo (73200) |
$1,454 |
$110 |
13.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,454 |
$1,716 |
8.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,623 |
$4,274 |
20.6× |
| Cta Abdomen (74175) |
$3,104 |
$3,662 |
17.7× |
| CTA pelvis (72191) |
$3,104 |
$3,662 |
17.7× |
| Dxa Bone Density Axial (77080) |
$408 |
$481 |
3.9× |
| Esophagram (74220) |
$393 |
$465 |
2.2× |
| Fetal Biophys Profile W/Nst (76818) |
$845 |
$997 |
8.1× |
| Fluoroscopy up to 1 hr (76000) |
$208 |
$245 |
0.9× |
| Foot 2 views (73620) |
$308 |
$364 |
3.5× |
| Forearm 2 views (73090) |
$306 |
$361 |
3.5× |
| Gastric emptying imaging study (78264) |
$1,455 |
$1,717 |
3.6× |
| Gated Heart Planar Single (78472) |
$774 |
$914 |
1.9× |
| Hand 2 views (73120) |
$332 |
$392 |
3.2× |
| Hepatobil Syst Image W/Drug (78227) |
$1,452 |
$1,714 |
2.7× |
| Hepatobiliary System Imaging (78226) |
$1,373 |
$1,621 |
3.4× |
| Hysterosalpingogram (74740) |
$231 |
$231 |
1.0× |
| K Flow/Funct Image W/Drug (78708) |
$1,193 |
$1,409 |
2.2× |
| Kidney Imaging Morphol (78700) |
$949 |
$1,120 |
2.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,025 |
$1,209 |
2.6× |
| Knee 3 Views (73562) |
$405 |
$478 |
4.6× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,583 |
$3,048 |
4.7× |
| Magnetic Image Jaw Joint (70336) |
$2,058 |
$2,428 |
8.6× |
| MRA head w/o contrast (70544) |
$2,739 |
$3,231 |
11.5× |
| MRA neck w/o contrast (70547) |
$2,877 |
$3,394 |
12.0× |
| MRI abdomen w contrast (74182) |
$3,058 |
$3,608 |
8.8× |
| MRI abdomen w/o contrast (74181) |
$2,648 |
$3,124 |
11.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,642 |
$4,227 |
4.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,826 |
$4,443 |
10.9× |
| MRI cervical spine w contrast (72142) |
$2,881 |
$3,399 |
8.2× |
| MRI cervical spine w/o cont (72141) |
$2,743 |
$3,237 |
11.5× |
| MRI chest w/o contrast (71550) |
$2,222 |
$2,621 |
9.3× |
| MRI chest wo w contrast (71552) |
$3,014 |
$3,557 |
8.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,100 |
$3,658 |
8.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,601 |
$3,069 |
10.9× |
| MRI lumbar spine w contrast (72149) |
$2,747 |
$3,241 |
7.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,297 |
$3,890 |
9.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,684 |
$3,166 |
11.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,641 |
$3,116 |
7.6× |
| MRI pelvis w contrast (72196) |
$2,270 |
$2,679 |
6.5× |
| MRI pelvis w/o & w contrast (72197) |
$2,571 |
$3,034 |
7.4× |
| MRI pelvis w/o contrast (72195) |
$2,270 |
$2,679 |
9.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,477 |
$2,923 |
10.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,845 |
$2,177 |
7.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,289 |
$2,700 |
6.6× |
| MRI, abdomen, combo (74183) |
$3,101 |
$3,659 |
8.9× |
| MRI, dorsal spine combo (72157) |
$2,582 |
$3,047 |
7.4× |
| MRI, dorsal spine contrast (72147) |
$2,372 |
$2,799 |
6.8× |
| MRI, joint upper extrem (73221) |
$3,366 |
$3,971 |
14.1× |
| MRI, joint upper extrem combo (73223) |
$3,848 |
$4,540 |
11.0× |
| MRI, lumbar spine combo (72158) |
$3,202 |
$3,777 |
9.2× |
| Myelograpy 2/more regions rs&i (72270) |
$944 |
$944 |
1.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$774 |
$914 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,472 |
$2,917 |
1.9× |
| Neck soft tissue (70360) |
$390 |
$461 |
4.5× |
| Parathyroid Planar Imaging (78070) |
$1,085 |
$1,280 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$344 |
$406 |
3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,922 |
$2,267 |
4.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$512 |
$605 |
4.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,199 |
$1,199 |
2.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$359 |
$424 |
4.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$327 |
$386 |
3.8× |
| Radex elbow complete minimum 3 views (73080) |
$401 |
$473 |
4.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$468 |
$552 |
4.5× |
| Radex fingr minimum 2 views (73140) |
$332 |
$392 |
3.8× |
| Radex foot complete minimum 3 views (73630) |
$355 |
$419 |
4.1× |
| Radex Hand Minimum 3 Views (73130) |
$344 |
$406 |
3.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$204 |
$241 |
2.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$374 |
$443 |
3.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$371 |
$438 |
4.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$424 |
$500 |
4.9× |
| Radex shoulder complete minimum 2 views (73030) |
$344 |
$406 |
3.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$223 |
$263 |
2.6× |
| Radex Spine 1 View Specify Level (72020) |
$285 |
$336 |
3.3× |
| Radex Sternum Minimum 2 Views (71120) |
$266 |
$314 |
3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$365 |
$431 |
4.2× |
| Radex Toe Minimum 2 Views (73660) |
$332 |
$392 |
3.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$312 |
$369 |
3.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$333 |
$394 |
3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$430 |
$509 |
4.1× |
| Radiologic exam colon double contrast study (74280) |
$618 |
$729 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$574 |
$678 |
3.3× |
| Radiologic exam knee complete 4/more views (73564) |
$233 |
$233 |
2.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$193 |
$193 |
1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$616 |
$727 |
3.5× |
| Radiologic examination femur minimum 2 views (73552) |
$390 |
$461 |
4.5× |
| Radiologic examination knee 1/2 views (73560) |
$332 |
$392 |
3.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$916 |
$1,081 |
8.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$342 |
$404 |
3.9× |
| Scapula (73010) |
$344 |
$406 |
3.3× |
| Sella turcica (70240) |
$270 |
$270 |
3.1× |
| Shoulder 1 view (73020) |
$230 |
$272 |
2.6× |
| Shoulder Arthrography (73040) |
$561 |
$662 |
1.6× |
| Sialogram (70390) |
$591 |
$591 |
2.5× |
| Skull less than 4 views (70250) |
$344 |
$406 |
3.3× |
| Thoracic spine 3 views (72072) |
$424 |
$500 |
4.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,085 |
$1,280 |
2.7× |
| Thyroid Uptake Measurement (78012) |
$1,141 |
$1,347 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$831 |
$981 |
7.9× |
| Upper gi w/o kub (74240) |
$567 |
$669 |
3.2× |
| Urethrocystogram voiding (74455) |
$535 |
$632 |
2.2× |
| Us breast unilateral complete (76641) |
$431 |
$510 |
4.1× |
| Us chest (76604) |
$638 |
$753 |
6.1× |
| Us head (76506) |
$628 |
$741 |
6.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$550 |
$649 |
5.3× |
| Us pelvic non ob complete (76856) |
$718 |
$848 |
6.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$754 |
$890 |
7.2× |
| Us retroperitoneal complete (76770) |
$615 |
$726 |
5.9× |
| Us retroperitoneal limited (76775) |
$580 |
$685 |
5.5× |
| Us scrotum and contents (76870) |
$462 |
$545 |
4.4× |
| Us thyroid (76536) |
$598 |
$706 |
5.7× |
| Us transrectal (76872) |
$591 |
$698 |
5.6× |
| Vein X-Ray Chest (75827) |
$596 |
$704 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$590 |
$697 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$410 |
$485 |
4.7× |
| X-ray antegrade pyelogram tube (74425) |
$414 |
$414 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$344 |
$406 |
3.9× |
| X-Ray Exam Breast Specimen (76098) |
$96 |
$114 |
0.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$436 |
$515 |
4.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$326 |
$385 |
3.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$339 |
$401 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$599 |
$707 |
5.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$410 |
$485 |
4.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$531 |
$627 |
5.1× |
| X-ray humerus (73060) |
$344 |
$406 |
3.9× |
| X-ray IV pyelogram (ivp) (74400) |
$748 |
$882 |
4.3× |
| X-ray IV pyelogram+tomography (74415) |
$850 |
$1,004 |
4.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$469 |
$553 |
4.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$294 |
$348 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$427 |
$406 |
4.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$462 |
$545 |
5.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$469 |
$553 |
4.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$227 |
$227 |
0.6× |
| X-Rays Bone Survey Complete (77075) |
$2,183 |
$2,575 |
20.8× |
| Xr orbits complete 4 views (70200) |
$390 |
$461 |
3.7× |