| 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× |
| Antegrade urography radiological supvj & interpj (74425) |
$414 |
$414 |
1.2× |
| Arthrogram hip (73525) |
$489 |
$577 |
1.4× |
| Arthrogram shoulder (73040) |
$561 |
$662 |
1.6× |
| Arthrography knee lt (73580) |
$583 |
$688 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$628 |
$741 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$860 |
$1,015 |
2.1× |
| Bone age studies (77072) |
$239 |
$283 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$1,286 |
$1,518 |
3.2× |
| Bone survey complete (77075) |
$2,183 |
$2,575 |
20.8× |
| Brain imaging < 4 static views (78600) |
$1,195 |
$1,411 |
3.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,229 |
$1,449 |
3.1× |
| Cervical spine 2 or 3 views (72040) |
$410 |
$485 |
4.7× |
| Chest 1 view (71045) |
$288 |
$314 |
3.3× |
| Chest 3 views (71047) |
$294 |
$348 |
3.4× |
| Clavicle complete (73000) |
$344 |
$406 |
3.9× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (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 angiography upper extremity lt (73206) |
$2,934 |
$3,462 |
16.7× |
| CT c-spine w/o contrast (72125) |
$1,788 |
$2,109 |
17.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,266 |
$1,494 |
7.2× |
| CT cervical spine with contrast (72126) |
$2,035 |
$2,402 |
5.8× |
| CT chest w/wo contrast (71270) |
$2,351 |
$2,775 |
13.4× |
| CT chest with contrast (71260) |
$1,991 |
$2,349 |
11.3× |
| 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 limited/localized follow up study (76380) |
$1,063 |
$1,254 |
12.2× |
| CT lower ext w/o (73700) |
$1,454 |
$1,716 |
13.9× |
| CT lower extremity w wo contrast (73702) |
$1,356 |
$1,601 |
7.7× |
| CT lower extremity with contrast (73701) |
$1,642 |
$1,938 |
9.3× |
| CT lumbar spine w & w/o contrast (72133) |
$2,263 |
$2,670 |
12.9× |
| 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 w/o contrast (70486) |
$1,682 |
$1,985 |
16.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,929 |
$2,276 |
11.0× |
| CT neck soft tissue w contrast (70491) |
$1,903 |
$2,245 |
10.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (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 for measuring calcium and other minerals in bone (77078) |
$408 |
$481 |
4.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,263 |
$2,670 |
12.9× |
| 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 contrast (72130) |
$2,291 |
$2,703 |
13.0× |
| CT thorax w/o contrast (71250) |
$1,788 |
$2,109 |
17.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,454 |
$1,716 |
8.3× |
| CT upper extremity w/o contrast rt (73200) |
$1,454 |
$110 |
13.9× |
| 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 chest (71275) |
$3,278 |
$3,868 |
18.7× |
| Cta Head (70496) |
$3,278 |
$3,868 |
18.7× |
| CTA lwr ext w&w/o contrast (73706) |
$3,278 |
$3,868 |
18.7× |
| Cta Neck (70498) |
$3,278 |
$3,868 |
18.7× |
| Cta Pelvis (72191) |
$3,104 |
$3,662 |
17.7× |
| Cystography minimum 3 views rs&i (74430) |
$407 |
$184 |
1.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$408 |
$481 |
3.9× |
| Echoencephalography real time imaging (76506) |
$628 |
$741 |
6.0× |
| Esophagus (74220) |
$393 |
$465 |
2.2× |
| Fetal biophysical profile non-stress testing (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× |
| Gated Heart Planar Single (78472) |
$774 |
$914 |
1.9× |
| Hand 2 views (73120) |
$332 |
$392 |
3.2× |
| Hand 3 views (73130) |
$344 |
$406 |
3.9× |
| Heart Infarct Image (78466) |
$774 |
$914 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,452 |
$1,714 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,373 |
$1,621 |
3.4× |
| Humerus Min 2 Views Left (73060) |
$344 |
$406 |
3.9× |
| Hysterosalpingogram (74740) |
$231 |
$231 |
1.0× |
| Kidney imaging morphology (78700) |
$949 |
$1,120 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,193 |
$1,409 |
2.2× |
| Knee 3 views (73562) |
$405 |
$478 |
4.6× |
| 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 & w/contrast material (74183) |
$3,101 |
$3,659 |
8.9× |
| MRI abdomen w/o contrast (74181) |
$2,648 |
$3,124 |
11.1× |
| MRI any jnt lwr ext with con lt (73722) |
$3,642 |
$4,227 |
4.6× |
| MRI c-spine with contrast (72142) |
$2,881 |
$3,399 |
8.2× |
| MRI cervical spine w/o contrast (72141) |
$2,743 |
$3,237 |
11.5× |
| MRI chest w/o & w/contrast material (71552) |
$3,014 |
$3,557 |
8.6× |
| MRI chest w/o contrast (71550) |
$2,222 |
$2,621 |
9.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,601 |
$3,069 |
10.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,684 |
$3,166 |
11.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,641 |
$3,116 |
7.6× |
| MRI pelvis w contrast (72196) |
$2,270 |
$2,679 |
6.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,571 |
$3,034 |
7.4× |
| MRI pelvis w/o contrast (72195) |
$2,270 |
$2,679 |
9.5× |
| MRI scan of arm joint before and after contrast (73223) |
$3,848 |
$4,540 |
11.0× |
| MRI scan of leg joint before and after contrast (73723) |
$3,826 |
$4,443 |
10.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,297 |
$3,890 |
9.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,747 |
$3,241 |
7.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,202 |
$3,777 |
9.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,372 |
$2,799 |
6.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,582 |
$3,047 |
7.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,477 |
$2,923 |
10.4× |
| MRI tmj (70336) |
$2,058 |
$2,428 |
8.6× |
| MRI upper ext joint w/o contrast (73221) |
$3,366 |
$3,971 |
14.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,289 |
$2,700 |
6.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,845 |
$2,177 |
7.7× |
| Myelography 2 or more regions (72270) |
$944 |
$944 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,472 |
$2,917 |
1.9× |
| Neck soft tissue (70360) |
$390 |
$461 |
4.5× |
| Nm gastric emptying study (78264) |
$1,455 |
$1,717 |
3.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,025 |
$1,209 |
2.6× |
| Osseous survey limited (77074) |
$916 |
$1,081 |
8.7× |
| Parathyroid imaging (78070) |
$1,085 |
$1,280 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$344 |
$406 |
3.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,100 |
$3,658 |
8.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,922 |
$2,267 |
4.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,583 |
$3,048 |
4.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,199 |
$1,199 |
2.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$436 |
$515 |
4.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$374 |
$443 |
3.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$430 |
$509 |
4.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$326 |
$385 |
3.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$344 |
$406 |
3.9× |
| Radiologic exam colon single contrast study (74270) |
$574 |
$678 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$567 |
$669 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$390 |
$461 |
4.5× |
| Radiological examination surgical specimen (76098) |
$96 |
$114 |
0.2× |
| Sacroiliac Joints < 3 Views (72200) |
$294 |
$348 |
2.8× |
| Scapula complete (73010) |
$344 |
$406 |
3.3× |
| Sella turcica (70240) |
$270 |
$270 |
3.1× |
| Sialogram (70390) |
$591 |
$591 |
2.5× |
| Small bowel series (74250) |
$616 |
$727 |
3.5× |
| Spine thoracic 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 Extremity Infant (73092) |
$312 |
$369 |
3.0× |
| Urethrocystography voiding (74455) |
$535 |
$632 |
2.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$748 |
$882 |
4.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$850 |
$1,004 |
4.8× |
| Us breast unilateral complete (76641) |
$431 |
$510 |
4.1× |
| Us chest (76604) |
$638 |
$753 |
6.1× |
| Us pelvic non ob complete (76856) |
$718 |
$848 |
6.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (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 soft tissue head/neck (76536) |
$598 |
$706 |
5.7× |
| Us transrectal (76872) |
$591 |
$698 |
5.6× |
| Us xtr non-vasc lmtd (76882) |
$550 |
$649 |
5.3× |
| Venography caval superior serialography rs&i (75827) |
$596 |
$704 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$590 |
$697 |
0.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$512 |
$605 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$410 |
$485 |
4.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$359 |
$424 |
4.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$618 |
$729 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$344 |
$406 |
3.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$401 |
$473 |
4.6× |
| 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 Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$468 |
$552 |
4.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$355 |
$419 |
4.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$327 |
$386 |
3.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$233 |
$233 |
2.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$204 |
$241 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$469 |
$553 |
4.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$371 |
$438 |
4.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$390 |
$461 |
3.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$193 |
$193 |
1.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$227 |
$227 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$424 |
$500 |
4.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$427 |
$406 |
4.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$344 |
$406 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$462 |
$545 |
5.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$223 |
$263 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$469 |
$553 |
4.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$344 |
$406 |
3.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$285 |
$336 |
3.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$266 |
$314 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$332 |
$392 |
3.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$333 |
$394 |
3.8× |
| Xr c-spine 6 or more views (72052) |
$531 |
$627 |
5.1× |
| Xr chest 4+ views (71048) |
$326 |
$385 |
3.1× |
| Xr Cholecystography Oral Contrast (74290) |
$263 |
$263 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$332 |
$392 |
3.8× |
| Xr shoulder 1 view (73020) |
$230 |
$272 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$342 |
$404 |
3.9× |
| Xr tmj bilateral (70330) |
$365 |
$431 |
4.2× |
| Xray knee 1 or 2 views rt (73560) |
$332 |
$392 |
3.8× |