| Abdomen 1 View (74018) |
$575.90 |
$886 |
6.3× |
| Abdomen 2 views (74019) |
$640.25 |
$985 |
5.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,450.80 |
$2,232 |
3.5× |
| Ankle 2 views (73600) |
$413.40 |
$636 |
4.5× |
| Arthrogram ankle (73615) |
$612.30 |
$942 |
1.7× |
| Arthrogram hip (73525) |
$1,058.85 |
$1,629 |
2.9× |
| Arthrogram Wrist (73115) |
$941.20 |
$1,448 |
2.6× |
| Bone age studies (77072) |
$416.65 |
$641 |
3.8× |
| Bone Imaging 3 Phase (78315) |
$2,737.80 |
$4,212 |
6.6× |
| Bone Imaging Limited Area (78300) |
$1,818.70 |
$2,798 |
4.4× |
| Bone Imaging Multiple Areas (78305) |
$1,515.80 |
$2,332 |
3.6× |
| Bone Imaging Whole Body (78306) |
$2,538.25 |
$3,905 |
6.1× |
| Bone marrow imaging limited area (78102) |
$911.95 |
$1,403 |
2.2× |
| Bone marrow imaging; multiple areas (78103) |
$1,026.35 |
$1,579 |
2.5× |
| Bone marrow imaging; whole body (78104) |
$1,148.55 |
$1,767 |
2.8× |
| Bone survey infant (77076) |
$620.75 |
$955 |
5.7× |
| Brain Flow Imaging Only (78610) |
$1,419.60 |
$2,184 |
2.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,797.90 |
$2,766 |
3.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$2,303.60 |
$3,544 |
5.5× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$3,541.85 |
$5,449 |
6.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,132 |
$3,280 |
5.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,132 |
$3,280 |
2.6× |
| Cardiac Shunt Detection (78428) |
$1,977.95 |
$3,043 |
4.7× |
| Cat Scan Follow-Up Study (76380) |
$1,225.90 |
$1,886 |
13.5× |
| Cerebrospinal Fluid Scan (78630) |
$1,679.60 |
$2,584 |
3.0× |
| Chest 1 view (71045) |
$418.60 |
$644 |
4.6× |
| Chest 2 views (71046) |
$497.25 |
$765 |
5.5× |
| Chest 3 views (71047) |
$681.85 |
$1,049 |
7.5× |
| Chest 4 or more views (71048) |
$905.45 |
$1,393 |
8.3× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$328.90 |
$506 |
3.0× |
| Cholecystography Oral Contrast (74290) |
$581.10 |
$894 |
3.2× |
| Clavicle complete (73000) |
$562.25 |
$865 |
6.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$427.70 |
$658 |
3.9× |
| Contrast X-Ray Bladder (74430) |
$818.35 |
$1,259 |
2.2× |
| Contrast X-Ray Of Elbow (73085) |
$800.15 |
$1,231 |
2.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,218.10 |
$1,874 |
3.3× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$392.60 |
$604 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,971.90 |
$10,726 |
19.1× |
| CT abdomen and pelvis without contrast (74176) |
$5,537.35 |
$8,519 |
22.2× |
| CT abdomen w contrast (74160) |
$3,341.65 |
$5,141 |
18.2× |
| CT abdomen w wo contrast (74170) |
$3,948.75 |
$6,075 |
21.6× |
| CT abdomen w/o contrast (74150) |
$3,194.75 |
$4,915 |
29.3× |
| CT Angio Abdomen and Pelvis (74174) |
$5,921.50 |
$9,110 |
16.3× |
| CT Angio Chest (71275) |
$4,726.15 |
$7,271 |
25.8× |
| CT Angio Head (70496) |
$2,639.65 |
$4,061 |
14.4× |
| CT angio hrt w/3d image (75574) |
$2,103.40 |
$3,236 |
5.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,766.10 |
$5,794 |
20.6× |
| CT Angio Neck (70498) |
$5,887.70 |
$9,058 |
32.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,065.40 |
$4,716 |
16.7× |
| CT bone density (77078) |
$1,216.80 |
$1,872 |
13.4× |
| CT cervical spine w/ contrast (72126) |
$3,245.45 |
$4,993 |
8.9× |
| CT cervical spine w/o contrast (72125) |
$3,395.60 |
$5,224 |
31.1× |
| CT cervical spine w/wo cont (72127) |
$4,158.70 |
$6,398 |
22.7× |
| CT chest w contrast (71260) |
$3,599.05 |
$5,537 |
19.6× |
| CT chest w/wo contrast (71270) |
$3,785.60 |
$5,824 |
20.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,175.20 |
$1,808 |
6.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$770.90 |
$1,186 |
7.1× |
| CT head/brain with contrast (70460) |
$3,426.80 |
$5,272 |
18.7× |
| CT head/brain without and with contrast (70470) |
$4,335.50 |
$6,670 |
23.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,513.20 |
$2,328 |
4.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,262.95 |
$1,943 |
13.9× |
| CT hrt w/3d image congen (75573) |
$1,217.45 |
$1,873 |
3.3× |
| CT iac w contrast (70481) |
$3,848.65 |
$5,921 |
21.0× |
| CT l-spine w&w/o contrast (72133) |
$4,265.30 |
$6,562 |
23.3× |
| CT lower ext w/o (73700) |
$2,312.05 |
$3,557 |
21.2× |
| CT lower extremity w/contrast material (73701) |
$2,622.10 |
$4,034 |
14.3× |
| CT lumbar spine w contrast (72132) |
$3,625.70 |
$5,578 |
10.0× |
| CT lumbar spine w/o contrast (72131) |
$3,282.50 |
$5,050 |
30.1× |
| CT maxillofacial w contrast (70487) |
$3,521.70 |
$5,418 |
19.2× |
| CT maxillofacial wo contrast (70486) |
$2,984.15 |
$4,591 |
27.3× |
| CT neck tissue combo (70492) |
$3,839.55 |
$5,907 |
21.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$4,727.45 |
$7,273 |
25.8× |
| CT orbits w/o contrast (70480) |
$3,557.45 |
$5,473 |
32.6× |
| CT pelvis w&w/o contrast (72194) |
$3,695.90 |
$5,686 |
20.2× |
| CT pelvis w/o contrast (72192) |
$3,043.95 |
$4,683 |
27.9× |
| CT scan of leg combo (73702) |
$2,962.05 |
$4,557 |
16.2× |
| CT scans face/jaw combo (70488) |
$3,688.10 |
$5,674 |
20.1× |
| CT soft tissue neck w contrast (70491) |
$3,583.45 |
$5,513 |
19.6× |
| CT soft tissue neck w/o contrast (70490) |
$3,123.90 |
$4,806 |
28.6× |
| CT thoracic spine w contrast (72129) |
$3,103.75 |
$4,775 |
16.9× |
| CT thoracic spine w/o contrast (72128) |
$3,012.75 |
$4,635 |
27.6× |
| CT thoracic spine w/wo cont (72130) |
$3,543.80 |
$5,452 |
19.3× |
| CT thorax w/o contrast (71250) |
$2,913.95 |
$4,483 |
26.7× |
| CT unlisted procedure (76497) |
$2,415.40 |
$3,716 |
26.6× |
| CT upper ext wo (73200) |
$2,354.30 |
$3,622 |
21.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,011.45 |
$4,633 |
16.4× |
| CT upper extremity with contrast (73201) |
$2,701.40 |
$4,156 |
7.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,499.90 |
$3,846 |
13.6× |
| Cta Abdomen (74175) |
$2,372.50 |
$3,650 |
13.0× |
| CTA pelvis (72191) |
$2,387.45 |
$3,673 |
13.0× |
Discography Cerv/Thor Spine (72285)
range across 2 matching MRF lines |
$3,021.85–$3,250 |
$4,649–$5,000 |
varies |
Diskography lumbar (72295)
range across 2 matching MRF lines |
$3,021.85–$3,412.50 |
$4,649–$5,250 |
varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$791.05 |
$1,217 |
7.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$564.85 |
$869 |
5.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$588.25 |
$905 |
5.4× |
| Dxa Bone Density Axial (77080) |
$546 |
$840 |
5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$493.35 |
$759 |
5.4× |
| Echo exam of fetal heart (76825) |
$1,569.10 |
$2,414 |
2.7× |
| Echo exam uterus (76831) |
$1,237.60 |
$1,904 |
5.0× |
| Echo Guide For Artery Repair (76936) |
$1,672.45 |
$2,573 |
7.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$524.55 |
$807 |
2.1× |
| Esophageal Motility Study (78258) |
$1,059.50 |
$1,630 |
2.5× |
| Esophagram (74220) |
$824.85 |
$1,269 |
4.5× |
| Fetal Biophys Profile W/Nst (76818) |
$1,025.05 |
$1,577 |
9.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$732.55 |
$1,127 |
6.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$3,249.35 |
$4,999 |
13.0× |
| Fluoroscopy up to 1 hr (76000) |
$873.60 |
$1,344 |
3.5× |
| Foot 2 views (73620) |
$434.85 |
$669 |
4.8× |
| Forearm 2 views (73090) |
$560.30 |
$862 |
6.2× |
| Gastric emptying imaging study (78264) |
$1,968.20 |
$3,028 |
4.7× |
| Gastroesophageal Reflux Exam (78262) |
$1,103.05 |
$1,697 |
2.6× |
| Gated Heart Planar Single (78472) |
$2,178.80 |
$3,352 |
5.2× |
| Gated Heart, Multiple (78473) |
$2,194.40 |
$3,376 |
5.3× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$2,379 |
$3,660 |
4.2× |
| Hand 2 views (73120) |
$404.95 |
$623 |
3.7× |
| Heart first pass single,planar (78481) |
$1,648.40 |
$2,536 |
2.9× |
| Hepatobil Syst Image W/Drug (78227) |
$2,037.75 |
$3,135 |
3.6× |
| Hepatobiliary System Imaging (78226) |
$2,037.75 |
$3,135 |
4.9× |
Ht Musc Image Planar Mult (78454)
range across 2 matching MRF lines |
$2,156.70–$4,065.75 |
$3,318–$6,255 |
varies |
Ht Muscle Image Spect Sing (78451)
range across 2 matching MRF lines |
$2,388.10–$4,313.40 |
$3,674–$6,636 |
varies |
| Hysterosalpingogram (74740) |
$1,124.50 |
$1,730 |
4.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,032.85 |
$1,589 |
11.4× |
| Infant hip ultrasound, limited static exam (76886) |
$616.20 |
$948 |
6.8× |
| Joint Survey Single View (77077) |
$1,365.65 |
$2,101 |
12.5× |
| K Flow/Funct Image Multiple (78709) |
$4,563 |
$7,020 |
8.0× |
| K Flow/Funct Image W/Drug (78708) |
$2,234.05 |
$3,437 |
3.9× |
| K Flow/Funct Image W/O Drug (78707) |
$1,928.55 |
$2,967 |
3.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$1,064.05 |
$1,637 |
2.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,344.20 |
$2,068 |
3.2× |
| Knee 3 Views (73562) |
$562.90 |
$866 |
6.2× |
| Leveen/Shunt Patency Exam (78291) |
$1,760.20 |
$2,708 |
4.2× |
| Liver & Spleen Imaging Static Only (78215) |
$2,200.90 |
$3,386 |
5.3× |
| Liver imaging static only (78201) |
$2,002.65 |
$3,081 |
3.5× |
| Lung Perf&Ventilat Diferentl (78598) |
$5,587.40 |
$8,596 |
9.9× |
| Lung perfusion differential (78597) |
$3,835.65 |
$5,901 |
9.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$3,835.65 |
$5,901 |
6.8× |
| Lung Ventilation Imaging (78579) |
$1,736.80 |
$2,672 |
4.2× |
| Lymph System Imaging (78195) |
$1,790.75 |
$2,755 |
3.2× |
| Magnetic Image Jaw Joint (70336) |
$3,744.65 |
$5,761 |
15.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$1,678.95 |
$2,583 |
9.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$1,558.05 |
$2,397 |
2.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$2,226.90 |
$3,426 |
12.2× |
| Magnetic Resonance Elastography (76391) |
$752.70 |
$1,158 |
3.0× |
| Mammary ductogram or galactogram multiple (77054) |
$776.75 |
$1,195 |
3.1× |
| Mammary ductogram or galactogram single (77053) |
$744.25 |
$1,145 |
3.0× |
| Meckels Divert Exam (78290) |
$1,742 |
$2,680 |
4.2× |
| Mr safety determination physician/other qhp (76016) |
$242.45 |
$373 |
2.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$67.60 |
$104 |
2.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$252.85 |
$389 |
2.5× |
| Mr safety implt pos&/immoblj (76019) |
$163.80 |
$252 |
2.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$666.25 |
$1,025 |
2.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,244.50 |
$6,530 |
11.7× |
| MRA head w/o contrast (70544) |
$2,825.55 |
$4,347 |
11.3× |
| MRA head with contrast (70545) |
$3,395.60 |
$5,224 |
9.3× |
| MRA neck w contrast (70548) |
$2,213.25 |
$3,405 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,765.10 |
$4,254 |
7.6× |
| MRA neck w/o contrast (70547) |
$1,846.65 |
$2,841 |
7.4× |
| MRI abdomen w contrast (74182) |
$3,765.45 |
$5,793 |
10.3× |
| MRI abdomen w/o contrast (74181) |
$3,647.80 |
$5,612 |
14.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,427.80 |
$6,812 |
5.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,699.20 |
$8,768 |
15.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,842.80 |
$5,912 |
4.7× |
| MRI bone marrow blood supply (77084) |
$893.10 |
$1,374 |
3.6× |
| MRI brain functional w/o physician admnistration (70554) |
$1,558.05 |
$2,397 |
6.3× |
| MRI brain functional w/physician admnistration (70555) |
$1,558.05 |
$2,397 |
6.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,578.25 |
$5,505 |
14.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$2,733.25 |
$4,205 |
11.0× |
| MRI cardiac w/o cont stress (75559) |
$1,392.95 |
$2,143 |
2.4× |
| MRI cardiac w/o contrast (75557) |
$1,392.95 |
$2,143 |
5.6× |
| MRI cervical spine w contrast (72142) |
$3,950.70 |
$6,078 |
10.8× |
| MRI cervical spine w/o cont (72141) |
$3,811.60 |
$5,864 |
15.3× |
| MRI chest w/o contrast (71550) |
$3,596.45 |
$5,533 |
14.4× |
| MRI chest with contrast (71551) |
$3,656.90 |
$5,626 |
4.5× |
| MRI chest wo w contrast (71552) |
$4,551.30 |
$7,002 |
12.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,081.65 |
$4,741 |
8.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,580.20 |
$5,508 |
9.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,958.15 |
$4,551 |
11.9× |
| MRI lumbar spine w contrast (72149) |
$4,028.70 |
$6,198 |
11.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,778.80 |
$7,352 |
13.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,413.15 |
$5,251 |
13.7× |
| MRI orbit face neck w contrast (70542) |
$3,835 |
$5,900 |
10.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,258.80 |
$6,552 |
11.7× |
| MRI pelvis w contrast (72196) |
$3,424.20 |
$5,268 |
9.4× |
| MRI pelvis w/o & w contrast (72197) |
$3,604.25 |
$5,545 |
9.9× |
| MRI pelvis w/o contrast (72195) |
$3,249.35 |
$4,999 |
13.0× |
| MRI spectroscopy (76390) |
$2,882.75 |
$4,435 |
31.7× |
| MRI thoracic spine w/o contrast (72146) |
$3,775.20 |
$5,808 |
15.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,191.50 |
$4,910 |
8.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,775.50 |
$4,270 |
11.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,708.25 |
$5,705 |
10.2× |
| MRI, abdomen, combo (74183) |
$4,013.75 |
$6,175 |
11.0× |
| MRI, dorsal spine combo (72157) |
$4,832.10 |
$7,434 |
13.3× |
| MRI, dorsal spine contrast (72147) |
$4,122.95 |
$6,343 |
11.3× |
| MRI, joint upper extrem (73221) |
$3,305.25 |
$5,085 |
13.3× |
| MRI, joint upper extrem combo (73223) |
$4,485 |
$6,900 |
12.3× |
| MRI, lumbar spine combo (72158) |
$4,846.40 |
$7,456 |
13.3× |
| Myelogram cervical (72240) |
$2,490.15 |
$3,831 |
3.0× |
| Myelogram Lumbar (72265) |
$2,450.50 |
$3,770 |
3.0× |
| Myelography thoracic (72255) |
$1,922.70 |
$2,958 |
2.3× |
| Myelograpy 2/more regions rs&i (72270) |
$2,815.80 |
$4,332 |
3.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$940.55 |
$1,447 |
2.3× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$1,238.90 |
$1,906 |
2.2× |
Myocardial Perfusion Planar 1 Study Rest/Stress (78453)
range across 2 matching MRF lines |
$1,448.20–$3,357.25 |
$2,228–$5,165 |
varies |
Myocardial Spect Multiple Studies (78452)
range across 2 matching MRF lines |
$4,613.70–$6,571.50 |
$7,098–$10,110 |
varies |
| N-invas est c ffr sw aly CTA (75580) |
$2,885.35 |
$4,439 |
3.2× |
| Neck soft tissue (70360) |
$596.70 |
$918 |
6.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,082.90 |
$1,666 |
2.6× |
| Nm myocard infarct spect (78469) |
$1,682.85 |
$2,589 |
3.0× |
| Nm whole blood volume (78122) |
$704.60 |
$1,084 |
1.2× |
| Nonvascular Shunt X-Ray (75809) |
$497.90 |
$766 |
4.6× |
| Nuclear Rx Oral Admin (79005) |
$3,308.50 |
$5,090 |
13.6× |
| Ob us nuchal meas 1 gest (76813) |
$447.85 |
$689 |
4.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,429.70 |
$3,738 |
4.3× |
| Parathyroid Planar Imaging (78070) |
$1,995.50 |
$3,070 |
4.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,694.55 |
$2,607 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$650.65 |
$1,001 |
6.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,567.25 |
$8,565 |
3.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,084.55 |
$3,207 |
5.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$761.15 |
$1,171 |
7.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,289.60 |
$1,984 |
2.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$599.30 |
$922 |
6.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$492.70 |
$758 |
5.4× |
| Radex elbow complete minimum 3 views (73080) |
$598 |
$920 |
6.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$815.10 |
$1,254 |
7.5× |
| Radex fingr minimum 2 views (73140) |
$472.55 |
$727 |
5.2× |
| Radex foot complete minimum 3 views (73630) |
$600.60 |
$924 |
6.6× |
| Radex Hand Minimum 3 Views (73130) |
$580.45 |
$893 |
6.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$163.15 |
$251 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$644.80 |
$992 |
7.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$736.45 |
$1,133 |
8.1× |
| Radex shoulder complete minimum 2 views (73030) |
$644.80 |
$992 |
7.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$372.45 |
$573 |
4.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,199.25 |
$1,845 |
6.5× |
| Radex Spine 1 View Specify Level (72020) |
$484.90 |
$746 |
5.3× |
| Radex Sternum Minimum 2 Views (71120) |
$627.90 |
$966 |
6.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$806 |
$1,240 |
8.9× |
| Radex Toe Minimum 2 Views (73660) |
$456.95 |
$703 |
5.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$372.45 |
$573 |
3.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$640.25 |
$985 |
7.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$827.45 |
$1,273 |
7.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$849.55 |
$1,307 |
7.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$674.70 |
$1,038 |
6.2× |
| Radiologic exam colon double contrast study (74280) |
$1,702.35 |
$2,619 |
9.3× |
| Radiologic exam colon single contrast study (74270) |
$1,249.30 |
$1,922 |
6.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$824.85 |
$1,269 |
4.5× |
| Radiologic exam knee complete 4/more views (73564) |
$662.35 |
$1,019 |
6.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$839.15 |
$1,291 |
7.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,032.20 |
$1,588 |
5.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,274 |
$1,960 |
7.0× |
| Radiologic examination femur 1 view (73551) |
$504.40 |
$776 |
5.6× |
| Radiologic examination femur minimum 2 views (73552) |
$627.90 |
$966 |
6.9× |
| Radiologic examination knee 1/2 views (73560) |
$460.85 |
$709 |
5.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$818.35 |
$1,259 |
7.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$583.05 |
$897 |
6.4× |
| Radiopharm Dacryocystography (78660) |
$813.15 |
$1,251 |
1.9× |
| Ribs bilateral 3 views (71110) |
$908.05 |
$1,397 |
8.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,539.85 |
$2,369 |
3.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,309.45 |
$3,553 |
5.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,043 |
$6,220 |
7.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$4,043 |
$6,220 |
7.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$4,182.75 |
$6,435 |
7.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,152.20 |
$6,388 |
3.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,708.60 |
$7,244 |
3.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$4,152.20 |
$6,388 |
3.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$342.55 |
$527 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$3,006.90 |
$4,626 |
12.3× |
| Salivary Gland Imaging Serial Images (78231) |
$1,112.80 |
$1,712 |
2.7× |
| Scapula (73010) |
$611.65 |
$941 |
5.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$162.50 |
$250 |
7.0× |
| Shoulder 1 view (73020) |
$438.75 |
$675 |
4.8× |
| Shoulder Arthrography (73040) |
$1,155.05 |
$1,777 |
3.2× |
| Skull less than 4 views (70250) |
$549.25 |
$845 |
5.0× |
| Spleen Imaging (78185) |
$1,203.80 |
$1,852 |
2.9× |
| Sternoclavicular joints (71130) |
$316.55 |
$487 |
3.5× |
| Tbs technical calculation only (77091) |
$253.50 |
$390 |
2.8× |
| Testicular Imaging W/Flow (78761) |
$2,331.55 |
$3,587 |
5.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,702.35 |
$2,619 |
9.3× |
| Thoracic spine 2 views (72070) |
$724.75 |
$1,115 |
6.6× |
| Thoracic spine 3 views (72072) |
$739.05 |
$1,137 |
6.8× |
| Thoracolumbar 2 views (72080) |
$193.70 |
$298 |
2.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$1,028.30 |
$1,582 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,219.40 |
$1,876 |
2.9× |
| Thyroid Met Imaging Body (78018) |
$1,985.75 |
$3,055 |
3.5× |
| Thyroid Uptake Measurement (78012) |
$770.25 |
$1,185 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,890.85 |
$2,909 |
4.5× |
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines |
$286–$573.30 |
$440–$882 |
varies |
| Ultrasound elastography first target lesion (76982) |
$404.30 |
$622 |
3.7× |
| Ultrasound Elastography Parenchyma (76981) |
$404.30 |
$622 |
3.7× |
| Ultrasound Exam Aaa Screen (76706) |
$494 |
$760 |
4.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$724.75 |
$1,115 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$1,167.40 |
$1,796 |
10.7× |
| Umbilical-artery Doppler (OB) (76820) |
$588.25 |
$905 |
5.4× |
| Unlisted magnetic resonance procedure (76498) |
$202.80 |
$312 |
2.2× |
| Upper gi w/o kub (74240) |
$1,180.40 |
$1,816 |
6.4× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$272.35 |
$419 |
24.6× |
| Ureteral Reflux Study (78740) |
$1,423.50 |
$2,190 |
3.4× |
| Urethrocystogram voiding (74455) |
$1,046.50 |
$1,610 |
4.2× |
| Urethrocystography retrograde (74450) |
$1,104.35 |
$1,699 |
4.4× |
Us breast unilateral complete (76641)
range across 2 matching MRF lines |
$358.15–$716.30 |
$551–$1,102 |
varies |
| Us chest (76604) |
$705.25 |
$1,085 |
6.5× |
| Us complete joint (76881) |
$391.30 |
$602 |
3.6× |
| Us exam, pelvic, limited (76857) |
$1,123.85 |
$1,729 |
10.3× |
| Us head (76506) |
$936.65 |
$1,441 |
8.6× |
| Us kidney transplant (76776) |
$494 |
$760 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$252.20 |
$388 |
2.3× |
| Us ob detailed single fetus (76811) |
$922.35 |
$1,419 |
3.7× |
| Us ob limited 1 or more fetuses (76815) |
$588.25 |
$905 |
5.4× |
| Us ob transvaginal (76817) |
$1,086.80 |
$1,672 |
10.0× |
| Us pelvic non ob complete (76856) |
$1,264.25 |
$1,945 |
11.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$748.15 |
$1,151 |
6.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$732.55 |
$1,127 |
6.7× |
| Us retroperitoneal complete (76770) |
$1,302.60 |
$2,004 |
11.9× |
| Us retroperitoneal limited (76775) |
$1,166.10 |
$1,794 |
10.7× |
| Us scrotum and contents (76870) |
$869.05 |
$1,337 |
8.0× |
| Us thyroid (76536) |
$718.25 |
$1,105 |
6.6× |
| Us transrectal (76872) |
$1,300 |
$2,000 |
11.9× |
| Vascular Flow Imaging (78445) |
$1,276.60 |
$1,964 |
3.1× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,759.55 |
$2,707 |
4.2× |
| Wrist 2 views (73100) |
$437.45 |
$673 |
4.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$379.60 |
$584 |
4.2× |
| X-Ray Bend Only L-S Spine (72120) |
$456.95 |
$703 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$438.75 |
$675 |
4.8× |
X-Ray Exam Breast Specimen (76098)
range across 2 matching MRF lines |
$31.20–$641.55 |
$48–$987 |
varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$433.55 |
$667 |
4.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$827.45 |
$1,273 |
7.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$414.70 |
$638 |
4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$666.90 |
$1,026 |
7.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$895.05 |
$1,377 |
8.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$828.75 |
$1,275 |
7.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,334.45 |
$2,053 |
12.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,898.65 |
$2,921 |
17.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$1,235.65 |
$1,901 |
11.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$663 |
$1,020 |
7.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$994.50 |
$1,530 |
9.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$821.60 |
$1,264 |
7.5× |
| X-ray eye for foreign body (70030) |
$408.20 |
$628 |
4.5× |
| X-ray humerus (73060) |
$581.10 |
$894 |
6.4× |
| X-ray IV pyelogram (ivp) (74400) |
$1,416.35 |
$2,179 |
7.7× |
| X-ray IV pyelogram+tomography (74415) |
$1,518.40 |
$2,336 |
8.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$624 |
$960 |
6.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$691.60 |
$1,064 |
6.3× |
| X-ray nose-rectum child f.b. (76010) |
$332.15 |
$511 |
3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$881.40 |
$1,356 |
8.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$765.70 |
$1,178 |
7.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$652.60 |
$1,004 |
7.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$905.45 |
$1,393 |
10.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$910 |
$1,400 |
8.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,134.25 |
$1,745 |
3.1× |
| X-Rays Bone Length Studies (77073) |
$631.80 |
$972 |
5.8× |
| X-Rays Bone Survey Complete (77075) |
$1,233.70 |
$1,898 |
11.3× |
| Xr c-spine 4 or 5 views (72050) |
$880.10 |
$1,354 |
8.1× |
| Xr facial bones less than 3 views (70140) |
$501.80 |
$772 |
5.5× |
| Xr orbits complete 4 views (70200) |
$919.75 |
$1,415 |
8.4× |
| Xr Tomogram Single Plane (76100) |
$1,197.30 |
$1,842 |
11.0× |