| Abdomen 2 views (74019) |
$422.40 |
$440 |
3.9× |
| Ankle 2 views (73600) |
$283.20 |
$295 |
3.1× |
| Arthrogram shoulder (73040) |
$902.40 |
$940 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,440 |
$1,500 |
3.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,440 |
$1,500 |
3.5× |
| Bone &/joint imaging whole body (78306) |
$1,958.40 |
$2,040 |
4.7× |
| Bone age studies (77072) |
$271.68 |
$283 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$2,366.40 |
$2,465 |
5.7× |
| Bone survey complete (77075) |
$998.40 |
$1,040 |
9.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,280 |
$5,500 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$385.92 |
$402 |
4.3× |
| Chest 1 view (71045) |
$302.40 |
$315 |
3.3× |
| Chest 3 views (71047) |
$369.60 |
$385 |
4.1× |
| Clavicle complete (73000) |
$313.92 |
$327 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,440 |
$1,500 |
13.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,616 |
$5,850 |
15.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,248 |
$4,425 |
17.1× |
| CT abdomen w contrast (74160) |
$2,784 |
$2,900 |
15.3× |
| CT abdomen w wo contrast (74170) |
$3,278.40 |
$3,415 |
18.0× |
| CT abdomen w/o contrast (74150) |
$2,524.80 |
$2,630 |
23.3× |
| CT angiography upper extremity lt (73206) |
$3,451.20 |
$3,595 |
18.9× |
| CT c-spine w/o contrast (72125) |
$2,601.60 |
$2,710 |
24.0× |
| CT cervical spine w&w/o contrast (72127) |
$3,072 |
$3,200 |
16.9× |
| CT cervical spine with contrast (72126) |
$2,832 |
$2,950 |
7.8× |
| CT chest w/wo contrast (71270) |
$3,187.20 |
$3,320 |
17.5× |
| CT chest with contrast (71260) |
$2,760 |
$2,875 |
15.2× |
| CT head/brain with contrast (70460) |
$2,390.40 |
$2,490 |
13.1× |
| CT head/brain without and with contrast (70470) |
$2,774.40 |
$2,890 |
15.2× |
| CT iac w contrast (70481) |
$2,841.60 |
$2,960 |
15.6× |
| CT lower ext w/o (73700) |
$2,352 |
$2,450 |
21.7× |
| CT lower extremity w wo contrast (73702) |
$3,139.20 |
$3,270 |
17.2× |
| CT lower extremity with contrast (73701) |
$2,721.60 |
$2,835 |
14.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,774.40 |
$2,890 |
15.2× |
| CT lumbar spine w/o contrast (72131) |
$2,534.40 |
$2,640 |
23.3× |
| CT lumbar spine with contrast (72132) |
$2,745.60 |
$2,860 |
7.6× |
| CT maxillofacial w contrast (70487) |
$2,395.20 |
$2,495 |
13.2× |
| CT maxillofacial w/o contrast (70486) |
$2,011.20 |
$2,095 |
18.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,630.40 |
$2,740 |
14.4× |
| CT neck soft tissue w contrast (70491) |
$2,577.60 |
$2,685 |
14.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,856 |
$2,975 |
15.7× |
| CT orbits w/o contrast (70480) |
$2,414.40 |
$2,515 |
22.2× |
| CT pelvis w & w/o contrast (72194) |
$3,144 |
$3,275 |
17.3× |
| CT pelvis w/o contrast (72192) |
$2,462.40 |
$2,565 |
22.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,961.60 |
$3,085 |
16.3× |
| CT soft tissue neck w/o contrast (70490) |
$2,313.60 |
$2,410 |
21.3× |
| CT thoracic spine w/contrast (72129) |
$2,587.20 |
$2,695 |
14.2× |
| CT thoracic spine w/o contrast (72128) |
$2,544 |
$2,650 |
23.4× |
| CT thoracic spine w/wo contrast (72130) |
$3,057.60 |
$3,185 |
16.8× |
| CT thorax w/o contrast (71250) |
$2,476.80 |
$2,580 |
22.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,072 |
$3,200 |
16.9× |
| CT upper extremity w/o contrast rt (73200) |
$2,280 |
$2,375 |
21.0× |
| CT upper extremity with contrast (73201) |
$2,505.60 |
$2,610 |
6.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,787.20 |
$3,945 |
20.8× |
| Cta Abdomen (74175) |
$3,542.40 |
$3,690 |
19.4× |
| CTA abdomen pelvis (74174) |
$5,200.80 |
$5,417.50 |
14.4× |
| CTA chest (71275) |
$3,504 |
$3,650 |
19.2× |
| Cta Head (70496) |
$3,244.80 |
$3,380 |
17.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,329.60 |
$4,510 |
12.0× |
| Cta Neck (70498) |
$3,240 |
$3,375 |
17.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$518.40 |
$540 |
4.8× |
| Fetal biophysical profile non-stress testing (76818) |
$648 |
$675 |
6.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$518.40 |
$540 |
4.8× |
| Foot 2 views (73620) |
$278.40 |
$290 |
3.1× |
| Forearm 2 views (73090) |
$312 |
$325 |
3.5× |
| Hand 2 views (73120) |
$278.40 |
$290 |
2.6× |
| Hand 3 views (73130) |
$350.40 |
$365 |
3.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,092.80 |
$2,180 |
3.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,054.40 |
$2,140 |
4.9× |
| Ht muscle image spect sing (78451) |
$2,328 |
$2,425 |
1.7× |
| Humerus Min 2 Views Left (73060) |
$336 |
$350 |
3.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,488 |
$1,550 |
2.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,804.80 |
$1,880 |
3.2× |
| Knee 3 views (73562) |
$388.80 |
$405 |
4.3× |
| Lung perf&ventilat diferentl (78598) |
$2,289.60 |
$2,385 |
4.1× |
| MRA head w & w/o contrast (70546) |
$3,849.60 |
$4,010 |
10.6× |
| MRA head w/o contrast (70544) |
$3,192 |
$3,325 |
12.9× |
| MRA head with contrast (70545) |
$3,360 |
$3,500 |
9.3× |
| MRA neck w contrast (70548) |
$3,470.40 |
$3,615 |
9.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,744 |
$3,900 |
10.3× |
| MRA neck w/o contrast (70547) |
$3,110.40 |
$3,240 |
12.6× |
| MRI abdomen w contrast (74182) |
$3,648 |
$3,800 |
10.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,984 |
$4,150 |
11.0× |
| MRI abdomen w/o contrast (74181) |
$3,470.40 |
$3,615 |
14.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,592 |
$2,700 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,168 |
$3,300 |
3.9× |
| MRI c-spine with contrast (72142) |
$3,360 |
$3,500 |
9.3× |
| MRI cervical spine w/o contrast (72141) |
$2,880 |
$3,000 |
11.6× |
| MRI chest w/o & w/contrast material (71552) |
$3,686.40 |
$3,840 |
10.2× |
| MRI chest w/o contrast (71550) |
$3,283.20 |
$3,420 |
13.3× |
| MRI chest with contrast (71551) |
$3,456 |
$3,600 |
4.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,072 |
$3,200 |
8.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,976 |
$3,100 |
8.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,832 |
$2,950 |
11.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,031.20 |
$3,157.50 |
12.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,840 |
$4,000 |
10.6× |
| MRI orbit/face/neck w/contrast (70542) |
$3,456 |
$3,600 |
9.5× |
| MRI pelvis w contrast (72196) |
$3,456 |
$3,600 |
9.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,032 |
$4,200 |
11.1× |
| MRI pelvis w/o contrast (72195) |
$3,129.60 |
$3,260 |
12.6× |
| MRI scan of arm joint before and after contrast (73223) |
$3,552 |
$3,700 |
9.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,832 |
$2,950 |
7.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,224 |
$4,400 |
11.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,360 |
$3,500 |
9.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,224 |
$4,400 |
11.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,360 |
$3,500 |
9.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,224 |
$4,400 |
11.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,880 |
$3,000 |
11.6× |
| MRI tmj (70336) |
$2,592 |
$2,700 |
10.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,592 |
$2,700 |
10.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,456 |
$3,600 |
9.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,880 |
$3,000 |
11.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,280 |
$5,500 |
3.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,592 |
$2,700 |
1.9× |
| Neck soft tissue (70360) |
$331.20 |
$345 |
3.7× |
| Nm gastric emptying study (78264) |
$2,040 |
$2,125 |
4.9× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$5,280 |
$5,500 |
3.6× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$5,280 |
$5,500 |
3.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$403.20 |
$420 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$350.40 |
$365 |
3.2× |
| PET image w/CT, skull-thigh (78815) |
$6,912 |
$7,200 |
4.7× |
| PET imaging for CT attenuation whole body (78816) |
$8,256 |
$8,600 |
5.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,312 |
$3,450 |
9.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,289.60 |
$2,385 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$577.92 |
$602 |
5.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$513.60 |
$535 |
4.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$350.40 |
$365 |
3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$513.60 |
$535 |
4.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$331.20 |
$345 |
3.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$369.60 |
$385 |
4.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$366.72 |
$382 |
4.1× |
| Ribs bilateral 3 views (71110) |
$462.72 |
$482 |
4.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,136 |
$2,225 |
3.8× |
| Sacroiliac Joints < 3 Views (72200) |
$409.92 |
$427 |
3.8× |
| Scapula complete (73010) |
$336 |
$350 |
3.1× |
| Screening digital breast tomosynthesis (77063) |
$86.40 |
$90 |
3.7× |
| Sella turcica (70240) |
$182.40 |
$190 |
2.0× |
| Spine thoracic 3 views (72072) |
$532.80 |
$555 |
4.9× |
| Thoracolumbar 2 views (72080) |
$360.96 |
$376 |
4.0× |
| Tmj unilateral (70328) |
$249.60 |
$260 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$739.20 |
$770 |
6.8× |
| Umbilical-artery Doppler (OB) (76820) |
$307.20 |
$320 |
2.8× |
| Unlisted fluoroscopic procedure (76496) |
$700.80 |
$730 |
7.8× |
| Upper Extremity Infant (73092) |
$266.88 |
$278 |
2.5× |
| Us abdl aorta screen aaa (76706) |
$648 |
$675 |
6.0× |
| Us breast unilateral complete (76641) |
$580.80 |
$605 |
5.4× |
| Us breast unilateral limited (76642) |
$441.60 |
$460 |
4.9× |
| Us chest (76604) |
$609.60 |
$635 |
5.6× |
| Us compl joint r-t w/image documentation (76881) |
$705.60 |
$735 |
6.5× |
| Us kidney transplant (76776) |
$859.20 |
$895 |
7.9× |
| Us ob transvaginal (76817) |
$619.20 |
$645 |
5.7× |
| Us pelvic non ob complete (76856) |
$840 |
$875 |
7.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$561.60 |
$585 |
5.2× |
| Us pregnancy ltd (76815) |
$487.20 |
$507.50 |
4.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$724.80 |
$755 |
6.7× |
| Us retroperitoneal complete (76770) |
$864 |
$900 |
8.0× |
| Us retroperitoneal limited (76775) |
$643.20 |
$670 |
5.9× |
| Us scrotum and contents (76870) |
$729.60 |
$760 |
6.7× |
| Us soft tissue head/neck (76536) |
$662.40 |
$690 |
6.1× |
| Us xtr non-vasc lmtd (76882) |
$595.20 |
$620 |
5.5× |
| Wrist 2 views (73100) |
$273.60 |
$285 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$561.60 |
$585 |
5.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$340.80 |
$355 |
3.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$355.20 |
$370 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$297.60 |
$310 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$357.12 |
$372 |
4.0× |
| X-ray exam hip uni 1 view (73501) |
$278.40 |
$290 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$364.80 |
$380 |
4.0× |
| X-ray eye for foreign body (70030) |
$288 |
$300 |
3.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$460.80 |
$480 |
4.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$312.96 |
$326 |
3.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$364.80 |
$380 |
4.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$266.40 |
$277.50 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$355.20 |
$370 |
3.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$417.60 |
$435 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$247.68 |
$258 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$307.20 |
$320 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$475.20 |
$495 |
4.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$672 |
$700 |
6.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$513.60 |
$535 |
4.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$355.20 |
$370 |
3.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$345.60 |
$360 |
3.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$460.80 |
$480 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$427.20 |
$445 |
3.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$364.80 |
$380 |
4.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$446.40 |
$465 |
4.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$571.20 |
$595 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$379.20 |
$395 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$341.76 |
$356 |
3.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$374.40 |
$390 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$432 |
$450 |
4.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$326.40 |
$340 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$475.20 |
$495 |
4.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$340.80 |
$355 |
3.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$331.20 |
$345 |
3.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$268.80 |
$280 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$350.40 |
$365 |
3.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$398.40 |
$415 |
3.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$576 |
$600 |
5.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$254.40 |
$265 |
2.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$345.60 |
$360 |
3.8× |
| Xr c-spine 6 or more views (72052) |
$672 |
$700 |
6.2× |
| Xr chest 4+ views (71048) |
$369.60 |
$385 |
3.4× |
| Xr finger(s) 2+ views (73140) |
$254.40 |
$265 |
2.8× |
| Xr internal auditory meati complete (70134) |
$172.80 |
$180 |
0.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$216 |
$225 |
2.0× |
| Xr optic foramina (70190) |
$153.60 |
$160 |
1.7× |
| Xr shoulder 1 view (73020) |
$271.68 |
$283 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$552 |
$575 |
5.1× |
| Xr tibia/fibula 2 views (73590) |
$336 |
$350 |
3.7× |
| Xr tmj bilateral (70330) |
$403.20 |
$420 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$350.40 |
$365 |
3.9× |