| Abdomen 2 views (74019) |
$601.50 |
$802 |
4.8× |
| Bone age studies (77072) |
$409.50 |
$546 |
3.3× |
| Bone survey complete (77075) |
$2,343.75 |
$3,125 |
18.7× |
| Cervical spine 2 or 3 views (72040) |
$491.25 |
$655 |
4.7× |
| Chest 1 view (71045) |
$421.50 |
$562 |
4.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,006.50 |
$1,342 |
8.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,138.25 |
$6,851 |
12.3× |
| CT abdomen and pelvis without contrast (74176) |
$3,581.25 |
$4,775 |
12.5× |
| CT abdomen w contrast (74160) |
$2,421.75 |
$3,229 |
11.5× |
| CT abdomen w wo contrast (74170) |
$2,982 |
$3,976 |
14.2× |
| CT abdomen w/o contrast (74150) |
$1,987.50 |
$2,650 |
15.9× |
| CT angio hrt w/3d image (75574) |
$3,105 |
$4,140 |
7.4× |
| CT c-spine w/o contrast (72125) |
$2,046.75 |
$2,729 |
16.3× |
| CT chest w contrast (71260) |
$2,441.25 |
$3,255 |
11.6× |
| CT chest w/wo contrast (71270) |
$2,972.25 |
$3,963 |
14.1× |
| CT head/brain with contrast (70460) |
$2,007.75 |
$2,677 |
9.6× |
| CT head/brain without and with contrast (70470) |
$2,481.75 |
$3,309 |
11.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$682.50 |
$910 |
1.6× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$392.25 |
$523 |
3.8× |
| CT iac w contrast (70481) |
$2,254.50 |
$3,006 |
10.7× |
| CT lumbar spine w/o contrast (72131) |
$2,046.75 |
$2,729 |
16.3× |
| CT maxillofacial w contrast (70487) |
$2,146.50 |
$2,862 |
10.2× |
| CT maxillofacial wo contrast (70486) |
$1,812 |
$2,416 |
14.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,589 |
$3,452 |
12.3× |
| CT orbits w/o contrast (70480) |
$1,944 |
$2,592 |
15.5× |
| CT pelvis w/o contrast (72192) |
$2,022 |
$2,696 |
16.1× |
| CT soft tissue neck w contrast (70491) |
$2,157.75 |
$2,877 |
10.3× |
| CT thoracic spine w/o contrast (72128) |
$2,046.75 |
$2,729 |
16.3× |
| CT thorax w/o contrast (71250) |
$2,046.75 |
$2,729 |
16.3× |
| CT unlisted procedure (76497) |
$2,665.50 |
$3,554 |
25.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$4,302 |
$5,736 |
20.5× |
| Cta Abdomen (74175) |
$2,817.75 |
$3,757 |
13.4× |
| CTA abdomen pelvis (74174) |
$4,003.50 |
$5,338 |
9.6× |
| CTA chest (71275) |
$2,304.75 |
$3,073 |
11.0× |
| Cta Head (70496) |
$2,571.75 |
$3,429 |
12.2× |
| Cta Neck (70498) |
$2,577 |
$3,436 |
12.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$374.25 |
$499 |
3.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$369.75 |
$493 |
3.5× |
| Facial bones min 3 views (70150) |
$837.75 |
$1,117 |
6.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$566.25 |
$755 |
4.5× |
| Knee 3 views (73562) |
$414 |
$552 |
4.0× |
| MRA head w/o contrast (70544) |
$2,093.25 |
$2,791 |
7.3× |
| MRA neck w contrast (70548) |
$2,343 |
$3,124 |
5.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,756.25 |
$3,675 |
6.6× |
| MRA neck w/o contrast (70547) |
$2,092.50 |
$2,790 |
7.3× |
| MRI abdomen w contrast (74182) |
$2,331.75 |
$3,109 |
5.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,032.25 |
$4,043 |
7.3× |
| MRI abdomen w/o contrast (74181) |
$2,054.25 |
$2,739 |
7.2× |
| MRI breast w/o contrast bilateral (77047) |
$3,069 |
$4,092 |
10.7× |
| MRI cervical spine w/o contrast (72141) |
$2,144.25 |
$2,859 |
7.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,925.75 |
$3,901 |
7.0× |
| MRI chest w/o contrast (71550) |
$2,211 |
$2,948 |
7.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,101.50 |
$2,802 |
7.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,046 |
$2,728 |
7.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,500.50 |
$3,334 |
6.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,820.75 |
$3,761 |
6.7× |
| MRI pelvis w/o contrast (72195) |
$1,941.75 |
$2,589 |
6.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,712.75 |
$3,617 |
6.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,466 |
$3,288 |
5.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,712.75 |
$3,617 |
6.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,712.75 |
$3,617 |
6.5× |
| MRI temporomandibular joint (70336) |
$1,716.75 |
$2,289 |
6.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,144.25 |
$2,859 |
7.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,150.25 |
$2,867 |
7.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,094.38 |
$2,792.50 |
1.3× |
| N-invas est c ffr sw aly CTA (75580) |
$5,081.25 |
$6,775 |
4.9× |
| Neck soft tissue (70360) |
$357 |
$476 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$391.50 |
$522 |
3.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$461.25 |
$615 |
4.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$441.75 |
$589 |
4.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$520.50 |
$694 |
4.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$564.75 |
$753 |
4.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$370.50 |
$494 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$430.50 |
$574 |
4.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$444.75 |
$593 |
3.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$596.25 |
$795 |
4.8× |
| Radex Humerus Minimum 2 Views (73060) |
$423.75 |
$565 |
4.1× |
| Radex Kne Compl 4/More Views (73564) |
$334.50 |
$446 |
2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$415.50 |
$554 |
4.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$438.75 |
$585 |
4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$998.25 |
$1,331 |
9.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$443.25 |
$591 |
4.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$411.75 |
$549 |
3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$393.75 |
$525 |
3.1× |
| Radiologic exam chest 2 views (71046) |
$574.50 |
$766 |
5.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$791.25 |
$1,055 |
3.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,687.50 |
$2,250 |
8.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$383.25 |
$511 |
3.7× |
| Ribs bilateral 3 views (71110) |
$731.25 |
$975 |
5.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$487.12 |
$649.50 |
1.7× |
| Scapula (73010) |
$429.75 |
$573 |
3.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$157.50 |
$210 |
6.7× |
| Spine thoracic 3 views (72072) |
$378.75 |
$505 |
3.0× |
| Ultrasound Exam Aaa Screen (76706) |
$295.50 |
$394 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$304.50 |
$406 |
2.4× |
| Umbilical-artery Doppler (OB) (76820) |
$540.75 |
$721 |
4.3× |
| Us breast unilateral limited (76642) |
$609.75 |
$813 |
5.8× |
| Us chest (76604) |
$333.38 |
$444.50 |
2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$246.75 |
$329 |
2.0× |
| Us ob limited (76815) |
$325.12 |
$433.50 |
2.6× |
| Us ob transvaginal (76817) |
$240 |
$320 |
1.9× |
| Us pelvic non ob complete (76856) |
$654.38 |
$872.50 |
5.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$337.88 |
$450.50 |
2.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$441.38 |
$588.50 |
3.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$288.38 |
$384.50 |
2.3× |
| Us retroperitoneal complete (76770) |
$688.88 |
$918.50 |
5.5× |
| Us retroperitoneal limited (76775) |
$528 |
$704 |
4.2× |
| Us scrotum and contents (76870) |
$671.62 |
$895.50 |
5.4× |
| Us soft tissue head/neck (76536) |
$366.75 |
$489 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$412.50 |
$550 |
4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$480.75 |
$641 |
3.8× |
| X-ray exam of femur 2/> (73552) |
$228 |
$304 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$525 |
$700 |
4.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$936 |
$1,248 |
7.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$747 |
$996 |
6.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$792 |
$1,056 |
6.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$468.75 |
$625 |
3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$423.75 |
$565 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$591 |
$788 |
5.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$500.25 |
$667 |
4.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$489.75 |
$653 |
4.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$567 |
$756 |
4.5× |
| Xr bone length studies (77073) |
$364.50 |
$486 |
2.9× |
| Xr c-spine 4 or 5 views (72050) |
$834.75 |
$1,113 |
6.7× |
| Xr c-spine 6 or more views (72052) |
$1,068.75 |
$1,425 |
8.5× |