| Abdomen 2 views (74019) |
$293.15 |
$451 |
2.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,036.75 |
$1,595 |
2.6× |
| Ankle 2 views (73600) |
$194.35 |
$299 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$979.55 |
$1,507 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$1,346.48 |
$2,071.50 |
3.4× |
| Bone age studies (77072) |
$275.60 |
$424 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,342.25 |
$2,065 |
3.4× |
| Bone survey complete (77075) |
$711.10 |
$1,094 |
6.8× |
| Brain image w/flow 4 + views (78606) |
$1,213.55 |
$1,867 |
2.2× |
| Brain Imaging Minimum 4 Static Views (78605) |
$848.25 |
$1,305 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$309.40 |
$476 |
3.5× |
| Chest 1 view (71045) |
$166.40 |
$256 |
1.9× |
| Chest 3 views (71047) |
$271.05 |
$417 |
3.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$431.60 |
$664 |
2.5× |
| Clavicle complete (73000) |
$239.20 |
$368 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$830.05 |
$1,277 |
7.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,906.50 |
$6,010 |
11.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,574.65 |
$3,961 |
10.8× |
| CT abdomen w contrast (74160) |
$1,954.55 |
$3,007 |
11.1× |
| CT abdomen w wo contrast (74170) |
$2,377.05 |
$3,657 |
13.5× |
| CT abdomen w/o contrast (74150) |
$1,504.10 |
$2,314 |
14.4× |
| CT angiography upper extremity lt (73206) |
$2,114.45 |
$3,253 |
12.0× |
| CT c-spine w/o contrast (72125) |
$1,623.05 |
$2,497 |
15.5× |
| CT cervical spine with contrast (72126) |
$2,101.45 |
$3,233 |
6.0× |
| CT chest w/wo contrast (71270) |
$1,977.95 |
$3,043 |
11.3× |
| CT chest with contrast (71260) |
$1,900.60 |
$2,924 |
10.8× |
| CT head/brain with contrast (70460) |
$1,543.10 |
$2,374 |
8.8× |
| CT head/brain without and with contrast (70470) |
$1,918.80 |
$2,952 |
10.9× |
| CT iac w contrast (70481) |
$1,661.40 |
$2,556 |
9.5× |
| CT limited/localized follow up study (76380) |
$695.50 |
$1,070 |
8.0× |
| CT lower ext w/o (73700) |
$1,278.55 |
$1,967 |
12.2× |
| CT lower extremity w wo contrast (73702) |
$1,737.45 |
$2,673 |
9.9× |
| CT lower extremity with contrast (73701) |
$1,540.50 |
$2,370 |
8.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,050.75 |
$3,155 |
11.7× |
| CT lumbar spine w/o contrast (72131) |
$1,656.85 |
$2,549 |
15.8× |
| CT lumbar spine with contrast (72132) |
$2,191.15 |
$3,371 |
6.3× |
| CT maxillofacial w contrast (70487) |
$1,697.15 |
$2,611 |
9.7× |
| CT maxillofacial w/o contrast (70486) |
$1,321.12 |
$2,032.50 |
12.6× |
| CT maxillofacial w/wo contrast (70488) |
$2,224.30 |
$3,422 |
12.7× |
| CT neck soft tissue w contrast (70491) |
$1,789.45 |
$2,753 |
10.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,010.45 |
$3,093 |
11.4× |
| CT orbits w/o contrast (70480) |
$1,472.90 |
$2,266 |
14.1× |
| CT pelvis w & w/o contrast (72194) |
$2,172.30 |
$3,342 |
12.4× |
| CT pelvis w/o contrast (72192) |
$1,574.30 |
$2,422 |
15.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,014.35 |
$3,099 |
11.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,469.65 |
$2,261 |
14.0× |
| CT thoracic spine w/contrast (72129) |
$2,143.70 |
$3,298 |
12.2× |
| CT thoracic spine w/o contrast (72128) |
$1,688.05 |
$2,597 |
16.1× |
| CT thorax w/o contrast (71250) |
$1,584.05 |
$2,437 |
15.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,262.95 |
$1,943 |
12.1× |
| CT upper extremity with contrast (73201) |
$1,417.65 |
$2,181 |
4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,710.50 |
$4,170 |
15.4× |
| Cta Abdomen (74175) |
$2,399.80 |
$3,692 |
13.7× |
| CTA abdomen pelvis (74174) |
$3,262.35 |
$5,019 |
9.3× |
| CTA chest (71275) |
$2,351.05 |
$3,617 |
13.4× |
| Cta Head (70496) |
$2,006.55 |
$3,087 |
11.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,670.85 |
$4,109 |
7.6× |
| CTA lwr ext w&w/o contrast (73706) |
$2,310.10 |
$3,554 |
13.1× |
| Cta Neck (70498) |
$2,006.55 |
$3,087 |
11.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$352.95 |
$543 |
3.4× |
| Esophagus (74220) |
$436.15 |
$671 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$577.20 |
$888 |
5.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$433.55 |
$667 |
4.1× |
| Fluoroscopy up to 1 hr (76000) |
$550.55 |
$847 |
2.3× |
| Foot 2 views (73620) |
$220.35 |
$339 |
2.5× |
| Forearm 2 views (73090) |
$229.45 |
$353 |
2.6× |
| Gated Heart Planar Single (78472) |
$929.50 |
$1,430 |
2.3× |
| Hand 2 views (73120) |
$201.50 |
$310 |
1.9× |
| Hand 3 views (73130) |
$260 |
$400 |
3.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,581.40 |
$2,432.92 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,768.70 |
$2,721.08 |
4.4× |
| Ht muscle image spect sing (78451) |
$2,072.20 |
$3,188 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$250.90 |
$386 |
2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,467.70 |
$2,258 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,508.65 |
$2,321 |
2.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,370.85 |
$2,109 |
2.5× |
| Knee 3 views (73562) |
$273.65 |
$421 |
3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,002.30 |
$1,542 |
2.5× |
| Lung perfusion differential (78597) |
$1,216.80 |
$1,872 |
3.0× |
| MRA head w/o contrast (70544) |
$1,721.20 |
$2,648 |
7.2× |
| MRA neck w contrast (70548) |
$2,411.50 |
$3,710 |
6.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,900.30 |
$4,462 |
8.3× |
| MRA neck w/o contrast (70547) |
$1,894.10 |
$2,914 |
7.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,897.05 |
$4,457 |
8.3× |
| MRI abdomen w/o contrast (74181) |
$2,085.85 |
$3,209 |
8.7× |
| MRI c-spine with contrast (72142) |
$2,593.50 |
$3,990 |
7.4× |
| MRI cervical spine w/o contrast (72141) |
$2,003.30 |
$3,082 |
8.4× |
| MRI chest w/o contrast (71550) |
$1,921.40 |
$2,956 |
8.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,161.90 |
$3,326 |
6.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,867.45 |
$2,873 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,009.15 |
$3,091 |
8.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,635.10 |
$4,054 |
7.5× |
| MRI pelvis w contrast (72196) |
$2,293.20 |
$3,528 |
6.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,603.25 |
$4,005 |
7.4× |
| MRI pelvis w/o contrast (72195) |
$1,879.15 |
$2,891 |
7.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,853.50 |
$4,390 |
8.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,624.05 |
$4,037 |
7.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,496 |
$3,840 |
7.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,652.65 |
$4,081 |
7.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,496 |
$3,840 |
7.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,941.25 |
$4,525 |
8.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,496 |
$3,840 |
7.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,996.15 |
$3,071 |
8.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,065.05 |
$3,177 |
8.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,361.45 |
$3,633 |
6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,920.10 |
$2,954 |
8.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,750.15 |
$4,231 |
2.1× |
| Neck soft tissue (70360) |
$227.50 |
$350 |
2.6× |
| Nm gastric emptying study (78264) |
$1,187.55 |
$1,827 |
3.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$373.10 |
$574 |
3.6× |
| Osseous survey infant (77076) |
$403 |
$620 |
3.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,440.40 |
$2,216 |
3.6× |
| Parathyroid imaging (78070) |
$751.40 |
$1,156 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$213.85 |
$329 |
2.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,587.65 |
$3,981 |
7.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$783.25 |
$1,205 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,586 |
$2,440 |
2.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$279.50 |
$430 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$328.25 |
$505 |
3.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$328.90 |
$506 |
3.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$259.35 |
$399 |
2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$644.80 |
$992 |
6.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$347.10 |
$534 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$206.70 |
$318 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$386.75 |
$595 |
3.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$208 |
$320 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$771.55 |
$1,187 |
4.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$258.05 |
$397 |
3.0× |
| Ribs bilateral 3 views (71110) |
$354.90 |
$546 |
3.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,638.65 |
$2,521 |
3.0× |
| Scapula complete (73010) |
$280.80 |
$432 |
2.7× |
| Screening digital breast tomosynthesis (77063) |
$68.90 |
$106 |
2.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$351.65 |
$541 |
3.4× |
| Small bowel series (74250) |
$583.05 |
$897 |
3.3× |
| Speech evaluation complex (70371) |
$570.70 |
$878 |
2.4× |
| Spine thoracic 3 views (72072) |
$331.50 |
$510 |
3.2× |
| Thoracolumbar 2 views (72080) |
$305.50 |
$470 |
3.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$592.80 |
$912 |
1.5× |
| Tmj unilateral (70328) |
$196.30 |
$302 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$493.35 |
$759 |
4.7× |
| Upper Extremity Infant (73092) |
$176.15 |
$271 |
1.7× |
| Urethrocystography voiding (74455) |
$702 |
$1,080 |
2.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$878.15 |
$1,351 |
5.0× |
| Us breast unilateral complete (76641) |
$364 |
$560 |
3.5× |
| Us breast unilateral limited (76642) |
$286 |
$440 |
3.3× |
| Us chest (76604) |
$441.68 |
$679.50 |
4.2× |
| Us compl joint r-t w/image documentation (76881) |
$517.40 |
$796 |
4.9× |
| Us ob transvaginal (76817) |
$411.45 |
$633 |
3.9× |
| Us pelvic non ob complete (76856) |
$649.35 |
$999 |
6.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$436.15 |
$671 |
4.2× |
| Us pregnancy ltd (76815) |
$358.80 |
$552 |
3.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$526.50 |
$810 |
5.0× |
| Us retroperitoneal complete (76770) |
$679.25 |
$1,045 |
6.5× |
| Us retroperitoneal limited (76775) |
$483.60 |
$744 |
4.6× |
| Us scrotum and contents (76870) |
$580.45 |
$893 |
5.5× |
| Us soft tissue head/neck (76536) |
$564.85 |
$869 |
5.4× |
| Us xtr non-vasc lmtd (76882) |
$363.35 |
$559 |
3.5× |
| Vascular flow imaging (78445) |
$683.15 |
$1,051 |
1.7× |
| Wrist 2 views (73100) |
$205.40 |
$316 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$371.80 |
$572 |
3.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$256.10 |
$394 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$288.60 |
$444 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$878.15 |
$1,351 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$213.20 |
$328 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$292.50 |
$450 |
3.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$482.95 |
$743 |
4.6× |
| X-ray exam hip uni 1 view (73501) |
$181.35 |
$279 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$237.90 |
$366 |
2.7× |
| X-ray exam hip uni 4/> views (73503) |
$271.05 |
$417 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$419.90 |
$646 |
4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$495.95 |
$763 |
4.7× |
| X-ray exam of femur 1 (73551) |
$196.95 |
$303 |
2.3× |
| X-ray eye for foreign body (70030) |
$143.65 |
$221 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$312.65 |
$481 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$210.60 |
$324 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$273.65 |
$421 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$184.60 |
$284 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$252.20 |
$388 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$353.60 |
$544 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$245.05 |
$377 |
2.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$178.10 |
$274 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$275.60 |
$424 |
2.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$581.10 |
$894 |
5.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$363.35 |
$559 |
3.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$258.70 |
$398 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$226.85 |
$349 |
2.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$349.05 |
$537 |
3.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$318.50 |
$490 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$235.30 |
$362 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$273.65 |
$421 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$417.30 |
$642 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$273.65 |
$421 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$262.60 |
$404 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$263.25 |
$405 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$339.30 |
$522 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$377 |
$580 |
3.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$235.30 |
$362 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$180.05 |
$277 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$258.05 |
$397 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$269.10 |
$414 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$261.95 |
$403 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$371.80 |
$572 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$198.90 |
$306 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$250.90 |
$386 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$490.75 |
$755 |
4.7× |
| Xr chest 4+ views (71048) |
$325 |
$500 |
3.1× |
| Xr finger(s) 2+ views (73140) |
$205.40 |
$316 |
2.4× |
| Xr shoulder 1 view (73020) |
$186.55 |
$287 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$414.05 |
$637 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$241.80 |
$372 |
2.8× |
| Xr tmj bilateral (70330) |
$335.40 |
$516 |
3.8× |
| Xray knee 1 or 2 views rt (73560) |
$209.95 |
$323 |
2.4× |