| Abdomen 2 views (74019) |
$524.63 |
$699.50 |
4.5× |
| Ankle 2 views (73600) |
$389.25 |
$519 |
4.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,191.73 |
$2,922.30 |
4.9× |
| Bone &/joint imaging whole body (78306) |
$2,779.80 |
$3,706.40 |
6.2× |
| Bone age studies (77072) |
$290.18 |
$386.90 |
2.5× |
| Bone survey complete (77075) |
$777.75 |
$1,037 |
6.7× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,244.98 |
$2,993.30 |
5.0× |
| Cervical spine 2 or 3 views (72040) |
$535.13 |
$713.50 |
5.5× |
| Chest 1 view (71045) |
$395.78 |
$527.70 |
4.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$733.88 |
$978.50 |
3.8× |
| Clavicle complete (73000) |
$361.88 |
$482.50 |
3.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$750 |
$1,000 |
6.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,641 |
$6,188 |
11.9× |
| CT abdomen and pelvis without contrast (74176) |
$3,313.58 |
$4,418.10 |
12.5× |
| CT abdomen w contrast (74160) |
$2,202.53 |
$2,936.70 |
11.3× |
| CT abdomen w wo contrast (74170) |
$2,841.23 |
$3,788.30 |
14.5× |
| CT abdomen w/o contrast (74150) |
$2,092.73 |
$2,790.30 |
18.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,909.83 |
$5,213.10 |
20.0× |
| CT angiography upper extremity lt (73206) |
$2,482.20 |
$3,309.60 |
12.7× |
| CT c-spine w/contrast (72126) |
$2,556.08 |
$3,408.10 |
6.6× |
| CT c-spine w/o contrast (72125) |
$2,457 |
$3,276 |
21.1× |
| CT chest w contrast (71260) |
$2,694.75 |
$3,593 |
13.8× |
| CT chest w/wo contrast (71270) |
$2,324.33 |
$3,099.10 |
11.9× |
| CT head/brain with contrast (70460) |
$2,311.88 |
$3,082.50 |
11.8× |
| CT head/brain without and with contrast (70470) |
$2,614.28 |
$3,485.70 |
13.4× |
| CT iac w contrast (70481) |
$2,311.88 |
$3,082.50 |
11.8× |
| CT limited/localized follow up study (76380) |
$595.28 |
$793.70 |
6.1× |
| CT lower ext w/o (73700) |
$1,826.10 |
$2,434.80 |
15.7× |
| CT lower extremity w wo contrast (73702) |
$2,445.68 |
$3,260.90 |
12.5× |
| CT lower extremity w/contrast material (73701) |
$2,516.63 |
$3,355.50 |
12.9× |
| CT lumbar spine w/contrast (72132) |
$2,886.08 |
$3,848.10 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$2,768.25 |
$3,691 |
23.8× |
| CT maxillofacial w contrast (70487) |
$2,543.40 |
$3,391.20 |
13.0× |
| CT maxillofacial wo contrast (70486) |
$1,881.83 |
$2,509.10 |
16.2× |
| CT orbits w/o contrast (70480) |
$2,088.90 |
$2,785.20 |
17.9× |
| CT pelvis w/o contrast (72192) |
$2,254.35 |
$3,005.80 |
19.4× |
| CT pelvis w/wo contrast (72194) |
$2,614.28 |
$3,485.70 |
13.4× |
| CT soft tissue neck w contrast (70491) |
$2,928 |
$3,904 |
15.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,517.60 |
$3,356.80 |
12.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,930.43 |
$2,573.90 |
16.6× |
| CT thoracic spine w/contrast (72129) |
$2,404.43 |
$3,205.90 |
12.3× |
| CT thoracic spine w/o contrast (72128) |
$2,525.18 |
$3,366.90 |
21.7× |
| CT thorax w/o contrast (71250) |
$2,210.10 |
$2,946.80 |
19.0× |
| CT upper ext wo (73200) |
$1,888.95 |
$2,518.60 |
16.2× |
| CT upper extremity with contrast (73201) |
$2,394.53 |
$3,192.70 |
6.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,367.95 |
$4,490.60 |
17.2× |
| CTA abdomen pelvis (74174) |
$5,443.80 |
$7,258.40 |
14.0× |
| CTA chest (71275) |
$4,120.50 |
$5,494 |
21.1× |
| Cta Head (70496) |
$4,617.75 |
$6,157 |
23.6× |
| Cta Neck (70498) |
$4,106.85 |
$5,475.80 |
21.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$526.58 |
$702.10 |
4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$240.23 |
$320.30 |
2.5× |
| Esophagus (74220) |
$664.05 |
$885.40 |
3.4× |
| Facial bones min 3 views (70150) |
$649.35 |
$865.80 |
5.6× |
| Fetal biophysical profile non-stress testing (76818) |
$442.20 |
$589.60 |
3.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$629.03 |
$838.70 |
5.4× |
| Fluoroscopy up to 1 hr (76000) |
$656.26 |
$875.01 |
2.5× |
| Foot 2 views (73620) |
$397.05 |
$529.40 |
4.1× |
| Forearm 2 views (73090) |
$361.88 |
$482.50 |
3.7× |
| Hand 2 views (73120) |
$449.10 |
$598.80 |
3.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,705.13 |
$2,273.50 |
3.8× |
| Knee 3 views (73562) |
$486.98 |
$649.30 |
5.0× |
| Lymphoscintigraphy (78195) |
$1,891.13 |
$2,521.50 |
3.1× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,475.65 |
$4,634.20 |
4.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,613.18 |
$6,150.90 |
11.9× |
| MRA head w & w/o contrast (70546) |
$3,849.83 |
$5,133.10 |
9.9× |
| MRA head w/o contrast (70544) |
$2,903.25 |
$3,871 |
10.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,323.08 |
$5,764.10 |
11.1× |
| MRA neck w/o contrast (70547) |
$2,556.53 |
$3,408.70 |
9.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,831.20 |
$6,441.60 |
12.4× |
| MRI abdomen w/o contrast (74181) |
$2,881.50 |
$3,842 |
10.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,391.43 |
$4,521.90 |
3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,507.80 |
$6,010.40 |
11.6× |
| MRI cervical spine w/o contrast (72141) |
$2,611.05 |
$3,481.40 |
9.8× |
| MRI chest w/o & w/contrast material (71552) |
$4,831.20 |
$6,441.60 |
12.4× |
| MRI chest w/o contrast (71550) |
$3,117.08 |
$4,156.10 |
11.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,613.18 |
$6,150.90 |
11.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,883.60 |
$3,844.80 |
10.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,613.18 |
$6,150.90 |
11.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,831.20 |
$6,441.60 |
12.4× |
| MRI pelvis w/o contrast (72195) |
$3,132 |
$4,176 |
11.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,689.48 |
$4,919.30 |
9.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,833.33 |
$5,111.10 |
9.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,002.08 |
$5,336.10 |
10.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,464.93 |
$4,619.90 |
8.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,943.23 |
$3,924.30 |
11.1× |
| MRI up ext w/o contrast (73218) |
$2,883.60 |
$3,844.80 |
10.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,883.60 |
$3,844.80 |
10.8× |
| MRI, joint upper extrem combo (73223) |
$4,613.18 |
$6,150.90 |
11.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,729.50 |
$6,306 |
3.3× |
| Neck soft tissue (70360) |
$278.25 |
$371 |
2.9× |
| Nm gastric emptying study (78264) |
$1,873.58 |
$2,498.10 |
4.2× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) |
$210.82 |
$281.10 |
1.8× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$37.09 |
$49.45 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$474.08 |
$632.10 |
4.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$512.85 |
$683.80 |
5.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$370.73 |
$494.30 |
3.8× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$397.05 |
$529.40 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$710.55 |
$947.40 |
6.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$511.65 |
$682.20 |
4.4× |
| Radex fingr minimum 2 views (73140) |
$366.15 |
$488.20 |
3.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$463.50 |
$618 |
4.8× |
| Radex Hand Minimum 3 Views (73130) |
$523.05 |
$697.40 |
5.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$364.95 |
$486.60 |
3.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$771.53 |
$1,028.70 |
6.6× |
| Radex Humerus Minimum 2 Views (73060) |
$361.88 |
$482.50 |
3.7× |
| Radex Kne 1/2 Views (73560) |
$426.75 |
$569 |
4.4× |
| Radex Kne Compl 4/More Views (73564) |
$520.65 |
$694.20 |
4.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$600.45 |
$800.60 |
5.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$397.05 |
$529.40 |
4.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$1,176.53 |
$1,568.70 |
10.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$535.13 |
$713.50 |
5.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$312.45 |
$416.60 |
3.2× |
| Radex Toe Minimum 2 Views (73660) |
$361.88 |
$482.50 |
3.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$523.05 |
$697.40 |
5.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$710.55 |
$947.40 |
6.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$464.70 |
$619.60 |
4.8× |
| Radiologic exam chest 2 views (71046) |
$462.08 |
$616.10 |
4.8× |
| Radiologic exam colon single contrast study (74270) |
$779.55 |
$1,039.40 |
4.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$847.73 |
$1,130.30 |
4.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$439.43 |
$585.90 |
4.5× |
| Radiological examination surgical specimen (76098) |
$505.20 |
$673.60 |
0.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,829.15 |
$3,772.20 |
4.7× |
| Scapula (73010) |
$366.45 |
$488.60 |
3.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$86.62 |
$115.50 |
3.7× |
| Shoulder 1 view (73020) |
$361.88 |
$482.50 |
3.7× |
| Small bowel series (74250) |
$894 |
$1,192 |
4.6× |
| Spine thoracic 3 views (72072) |
$588.15 |
$784.20 |
5.0× |
| Thoracolumbar 2 views (72080) |
$535.13 |
$713.50 |
5.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,266.75 |
$1,689 |
2.8× |
| Ultrasound Exam Aaa Screen (76706) |
$614.93 |
$819.90 |
5.3× |
| Ultrasound, abdomen limited (76705) |
$777 |
$1,036 |
6.7× |
| Umbilical-artery Doppler (OB) (76820) |
$289.32 |
$385.75 |
2.5× |
| Us breast unilateral limited (76642) |
$513.38 |
$684.50 |
5.3× |
| Us chest (76604) |
$1,150.65 |
$1,534.20 |
9.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$959.33 |
$1,279.10 |
8.2× |
| Us ob detailed single fetus (76811) |
$792 |
$1,056 |
3.0× |
| Us ob limited (76815) |
$747.68 |
$996.90 |
6.4× |
| Us ob transvaginal (76817) |
$543.60 |
$724.80 |
4.7× |
| Us pelvic non ob complete (76856) |
$834.15 |
$1,112.20 |
7.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$593.18 |
$790.90 |
5.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$661.50 |
$882 |
5.7× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$747.68 |
$996.90 |
6.4× |
| Us retroperitoneal complete (76770) |
$1,130.25 |
$1,507 |
9.7× |
| Us retroperitoneal limited (76775) |
$777 |
$1,036 |
6.7× |
| Us scrotum and contents (76870) |
$692.93 |
$923.90 |
5.9× |
| Us soft tissue head/neck (76536) |
$733.88 |
$978.50 |
6.3× |
| Wrist 2 views (73100) |
$361.88 |
$482.50 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$522.23 |
$696.30 |
4.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,104.68 |
$1,472.90 |
5.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$404.03 |
$538.70 |
4.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$510 |
$680 |
5.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,176.53 |
$1,568.70 |
10.1× |
| X-ray exam of femur 2/> (73552) |
$535.13 |
$713.50 |
5.5× |
| X-ray eye for foreign body (70030) |
$878.85 |
$1,171.80 |
9.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$702.98 |
$937.30 |
7.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$489.75 |
$653 |
4.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$806.03 |
$1,074.70 |
6.9× |
| X-ray nose-rectum child f.b. (76010) |
$218.40 |
$291.20 |
2.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$535.13 |
$713.50 |
5.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$535.13 |
$713.50 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$637.73 |
$850.30 |
5.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$535.13 |
$713.50 |
5.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$649.35 |
$865.80 |
6.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$721.50 |
$962 |
6.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$423.90 |
$565.20 |
3.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$532.88 |
$710.50 |
5.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$535.13 |
$713.50 |
5.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$569.70 |
$759.60 |
4.9× |
| Xr bone length studies (77073) |
$369.23 |
$492.30 |
3.2× |
| Xr c-spine 4 or 5 views (72050) |
$721.50 |
$962 |
6.2× |
| Xr c-spine 6 or more views (72052) |
$810.75 |
$1,081 |
7.0× |