| Abdomen 2 views (74019) |
$324.35 |
$499 |
3.2× |
| Ankle 2 views (73600) |
$250.90 |
$386 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,573 |
$2,420 |
4.1× |
| Bone age studies (77072) |
$272.35 |
$419 |
2.7× |
| Bone survey complete (77075) |
$837.20 |
$1,288 |
8.3× |
| Cervical spine 2 or 3 views (72040) |
$369.85 |
$569 |
4.4× |
| Chest 1 view (71045) |
$222.95 |
$343 |
2.7× |
| Chest 3 views (71047) |
$291.20 |
$448 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$536.25 |
$825 |
3.2× |
| Clavicle complete (73000) |
$263.25 |
$405 |
3.1× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$302.90 |
$466 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,298.10 |
$5,074 |
9.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,038.40 |
$3,136 |
8.9× |
| CT abdomen w contrast (74160) |
$1,906.45 |
$2,933 |
11.3× |
| CT abdomen w wo contrast (74170) |
$2,158 |
$3,320 |
12.8× |
| CT abdomen w/o contrast (74150) |
$1,652.95 |
$2,543 |
16.4× |
| CT c-spine w/o contrast (72125) |
$1,532.70 |
$2,358 |
15.2× |
| CT cervical spine with contrast (72126) |
$1,834.95 |
$2,823 |
5.5× |
| CT chest w/wo contrast (71270) |
$2,197 |
$3,380 |
13.0× |
| CT chest with contrast (71260) |
$1,981.20 |
$3,048 |
11.7× |
| CT head/brain with contrast (70460) |
$1,880.45 |
$2,893 |
11.1× |
| CT head/brain without and with contrast (70470) |
$2,288 |
$3,520 |
13.6× |
| CT iac w contrast (70481) |
$2,206.75 |
$3,395 |
13.1× |
| CT lower ext w/o (73700) |
$1,564.55 |
$2,407 |
15.6× |
| CT lower extremity w wo contrast (73702) |
$1,829.75 |
$2,815 |
10.8× |
| CT lower extremity with contrast (73701) |
$1,809.60 |
$2,784 |
10.7× |
| CT lumbar spine w & w/o contrast (72133) |
$2,507.05 |
$3,857 |
14.9× |
| CT lumbar spine w/o contrast (72131) |
$1,556.75 |
$2,395 |
15.5× |
| CT lumbar spine with contrast (72132) |
$1,848.60 |
$2,844 |
5.5× |
| CT maxillofacial w contrast (70487) |
$1,938.95 |
$2,983 |
11.5× |
| CT maxillofacial w/o contrast (70486) |
$1,185.60 |
$1,824 |
11.8× |
| CT maxillofacial w/wo contrast (70488) |
$2,081.95 |
$3,203 |
12.3× |
| CT neck soft tissue w contrast (70491) |
$1,732.25 |
$2,665 |
10.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,291.25 |
$3,525 |
13.6× |
| CT orbits w/o contrast (70480) |
$1,661.40 |
$2,556 |
16.5× |
| CT pelvis w & w/o contrast (72194) |
$2,148.25 |
$3,305 |
12.7× |
| CT pelvis w/o contrast (72192) |
$1,797.90 |
$2,766 |
17.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,137.20 |
$3,288 |
12.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,311.05 |
$2,017 |
13.0× |
| CT thoracic spine w/contrast (72129) |
$1,788.80 |
$2,752 |
10.6× |
| CT thoracic spine w/o contrast (72128) |
$1,563.90 |
$2,406 |
15.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,275 |
$3,500 |
13.5× |
| CT thorax w/o contrast (71250) |
$1,673.10 |
$2,574 |
16.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,599.65 |
$2,461 |
15.9× |
| CT upper extremity with contrast (73201) |
$1,590.22 |
$2,446.50 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,486.60 |
$5,364 |
20.7× |
| Cta Abdomen (74175) |
$2,396.55 |
$3,687 |
14.2× |
| CTA abdomen pelvis (74174) |
$3,073.85 |
$4,729 |
9.2× |
| CTA chest (71275) |
$1,784.90 |
$2,746 |
10.6× |
| Cta Head (70496) |
$1,971.45 |
$3,033 |
11.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,027.35 |
$3,119 |
6.0× |
| CTA lwr ext w&w/o contrast (73706) |
$2,973.10 |
$4,574 |
17.6× |
| Cta Neck (70498) |
$1,881.75 |
$2,895 |
11.2× |
| Cta Pelvis (72191) |
$1,746.55 |
$2,687 |
10.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$258.70 |
$398 |
2.6× |
| Echoencephalography real time imaging (76506) |
$469.95 |
$723 |
4.7× |
| Esophagus (74220) |
$529.75 |
$815 |
3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$450.45 |
$693 |
4.5× |
| Fluoroscopy up to 1 hr (76000) |
$448.50 |
$690 |
2.0× |
| Foot 2 views (73620) |
$266.50 |
$410 |
3.2× |
| Forearm 2 views (73090) |
$287.95 |
$443 |
3.4× |
| Hand 2 views (73120) |
$251.55 |
$387 |
2.5× |
| Hand 3 views (73130) |
$294.45 |
$453 |
3.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,288.95 |
$1,983 |
3.4× |
| Humerus Min 2 Views Left (73060) |
$252.85 |
$389 |
3.0× |
| Knee 3 views (73562) |
$334.75 |
$515 |
4.0× |
| MRA head w/o contrast (70544) |
$2,221.05 |
$3,417 |
9.7× |
| MRA neck w contrast (70548) |
$2,476.50 |
$3,810 |
7.4× |
| MRA neck w/o contrast (70547) |
$2,297.75 |
$3,535 |
10.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,694.25 |
$4,145 |
8.0× |
| MRI abdomen w/o contrast (74181) |
$2,451.80 |
$3,772 |
10.7× |
| MRI any jnt lwr ext with con lt (73722) |
$2,113.15 |
$3,251 |
2.8× |
| MRI c-spine with contrast (72142) |
$2,531.10 |
$3,894 |
7.5× |
| MRI cervical spine w/o contrast (72141) |
$2,156.70 |
$3,318 |
9.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,899.30 |
$2,922 |
8.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,096.90 |
$3,226 |
9.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,358.20 |
$3,628 |
7.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,213.25 |
$3,405 |
6.6× |
| MRI pelvis w contrast (72196) |
$2,169.70 |
$3,338 |
6.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,159 |
$4,860 |
9.4× |
| MRI pelvis w/o contrast (72195) |
$1,934.40 |
$2,976 |
8.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,823.60 |
$4,344 |
8.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,947.75 |
$4,535 |
8.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,893.15 |
$4,451 |
8.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,499.25 |
$3,845 |
7.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,893.15 |
$4,451 |
8.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,645.50 |
$4,070 |
7.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,893.15 |
$4,451 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,156.70 |
$3,318 |
9.4× |
| MRI tmj (70336) |
$1,787.50 |
$2,750 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,250.95 |
$3,463 |
9.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,091.05 |
$3,217 |
6.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,853.15 |
$2,851 |
8.1× |
| Neck soft tissue (70360) |
$258.05 |
$397 |
3.1× |
| Osseous survey infant (77076) |
$353.60 |
$544 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$264.55 |
$407 |
2.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,139.15 |
$3,291 |
6.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$307.45 |
$473 |
3.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$446.55 |
$687 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$415.35 |
$639 |
4.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$662.35 |
$1,019 |
6.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$362.05 |
$557 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$260.65 |
$401 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$371.80 |
$572 |
3.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$274.95 |
$423 |
3.3× |
| Radiologic exam colon single contrast study (74270) |
$672.75 |
$1,035 |
4.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$606.45 |
$933 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$715 |
$1,100 |
4.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$306.15 |
$471 |
3.7× |
| Ribs bilateral 3 views (71110) |
$391.30 |
$602 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$226.20 |
$348 |
2.2× |
| Scapula complete (73010) |
$243.75 |
$375 |
2.4× |
| Small bowel series (74250) |
$491.40 |
$756 |
2.9× |
| Spine thoracic 3 views (72072) |
$389.35 |
$599 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$507 |
$780 |
5.0× |
| Upper Extremity Infant (73092) |
$161.85 |
$249 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$410.80 |
$632 |
4.1× |
| Us breast unilateral complete (76641) |
$419.90 |
$646 |
4.2× |
| Us breast unilateral limited (76642) |
$333.45 |
$513 |
4.0× |
| Us chest (76604) |
$420.55 |
$647 |
4.2× |
| Us compl joint r-t w/image documentation (76881) |
$575.90 |
$886 |
5.7× |
| Us ob transvaginal (76817) |
$464.10 |
$714 |
4.6× |
| Us pelvic non ob complete (76856) |
$588.90 |
$906 |
5.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$420.55 |
$647 |
4.2× |
| Us pregnancy ltd (76815) |
$421.85 |
$649 |
4.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$486.85 |
$749 |
4.8× |
| Us retroperitoneal complete (76770) |
$657.15 |
$1,011 |
6.5× |
| Us retroperitoneal limited (76775) |
$494.65 |
$761 |
4.9× |
| Us scrotum and contents (76870) |
$590.20 |
$908 |
5.9× |
| Us soft tissue head/neck (76536) |
$529.10 |
$814 |
5.3× |
| Us xtr non-vasc lmtd (76882) |
$354.25 |
$545 |
3.5× |
| Wrist 2 views (73100) |
$277.55 |
$427 |
3.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$480.35 |
$739 |
4.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$245.05 |
$377 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$296.40 |
$456 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$868.40 |
$1,336 |
5.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$247.65 |
$381 |
3.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$294.45 |
$453 |
3.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$529.10 |
$814 |
5.3× |
| X-ray exam hip uni 1 view (73501) |
$177.45 |
$273 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$289.90 |
$446 |
3.5× |
| X-ray exam hip uni 4/> views (73503) |
$387.40 |
$596 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$527.80 |
$812 |
5.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$577.85 |
$889 |
5.7× |
| X-ray exam of femur 1 (73551) |
$231.40 |
$356 |
2.8× |
| X-ray eye for foreign body (70030) |
$141.70 |
$218 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$304.20 |
$468 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$213.20 |
$328 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$299 |
$460 |
3.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$217.75 |
$335 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$274.30 |
$422 |
3.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$316.55 |
$487 |
3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$222.30 |
$342 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$188.50 |
$290 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$356.85 |
$549 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$564.85 |
$869 |
5.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$349.70 |
$538 |
3.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$275.60 |
$424 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$226.85 |
$349 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$318.50 |
$490 |
3.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$295.10 |
$454 |
2.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$250.90 |
$386 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$278.85 |
$429 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$447.20 |
$688 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$270.40 |
$416 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$291.20 |
$448 |
3.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$336.05 |
$517 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$341.25 |
$525 |
4.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$214.50 |
$330 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$386.10 |
$594 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$319.80 |
$492 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$301.60 |
$464 |
3.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$220.35 |
$339 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$247.65 |
$381 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$313.30 |
$482 |
3.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$400.40 |
$616 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$212.55 |
$327 |
2.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$321.75 |
$495 |
3.8× |
| Xr c-spine 6 or more views (72052) |
$474.50 |
$730 |
4.7× |
| Xr chest 4+ views (71048) |
$365.95 |
$563 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$237.25 |
$365 |
2.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$335.40 |
$516 |
3.3× |
| Xr shoulder 1 view (73020) |
$250.25 |
$385 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$432.90 |
$666 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$313.95 |
$483 |
3.8× |
| Xr tmj bilateral (70330) |
$308.75 |
$475 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$247 |
$380 |
3.0× |