| Abdomen 2 views (74019) |
$310.70 |
$478 |
3.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$973.70 |
$1,498 |
2.4× |
| Ankle 2 views (73600) |
$269.75 |
$415 |
3.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$588.25 |
$905 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$846.95 |
$1,303 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$986.70 |
$1,518 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,300.65 |
$2,001 |
3.2× |
| Bone age studies (77072) |
$266.50 |
$410 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,470.30 |
$2,262 |
3.7× |
| Bone survey complete (77075) |
$686.40 |
$1,056 |
6.6× |
| Cervical spine 2 or 3 views (72040) |
$194.02 |
$298.50 |
2.2× |
| Chest 1 view (71045) |
$158.60 |
$244 |
1.8× |
| Chest 3 views (71047) |
$195 |
$300 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$490.75 |
$755 |
2.8× |
| Clavicle complete (73000) |
$274.95 |
$423 |
3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$801.45 |
$1,233 |
7.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,098.20 |
$3,228 |
6.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,407.58 |
$2,165.50 |
5.9× |
| CT abdomen w contrast (74160) |
$964.92 |
$1,484.50 |
5.5× |
| CT abdomen w wo contrast (74170) |
$1,872.65 |
$2,881 |
10.7× |
| CT abdomen w/o contrast (74150) |
$838.50 |
$1,290 |
8.0× |
| CT c-spine w/o contrast (72125) |
$776.42 |
$1,194.50 |
7.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,321.78 |
$2,033.50 |
7.5× |
| CT cervical spine with contrast (72126) |
$1,156.02 |
$1,778.50 |
3.3× |
| CT chest w/wo contrast (71270) |
$979.55 |
$1,507 |
5.6× |
| CT chest with contrast (71260) |
$862.55 |
$1,327 |
4.9× |
| CT head/brain with contrast (70460) |
$875.88 |
$1,347.50 |
5.0× |
| CT head/brain without and with contrast (70470) |
$1,048.12 |
$1,612.50 |
6.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$84.50 |
$130 |
1.0× |
| CT iac w contrast (70481) |
$966.55 |
$1,487 |
5.5× |
| CT limited/localized follow up study (76380) |
$713.05 |
$1,097 |
8.2× |
| CT lower ext w/o (73700) |
$1,296.75 |
$1,995 |
12.4× |
| CT lower extremity w wo contrast (73702) |
$1,817.40 |
$2,796 |
10.3× |
| CT lower extremity with contrast (73701) |
$1,426.75 |
$2,195 |
8.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,081.60 |
$1,664 |
6.2× |
| CT lumbar spine w/o contrast (72131) |
$807.95 |
$1,243 |
7.7× |
| CT lumbar spine with contrast (72132) |
$1,004.90 |
$1,546 |
2.9× |
| CT maxillofacial w contrast (70487) |
$861.25 |
$1,325 |
4.9× |
| CT maxillofacial w/o contrast (70486) |
$1,134.25 |
$1,745 |
10.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,024.72 |
$1,576.50 |
5.8× |
| CT neck soft tissue w contrast (70491) |
$836.22 |
$1,286.50 |
4.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,107.92 |
$1,704.50 |
6.3× |
| CT orbits w/o contrast (70480) |
$773.18 |
$1,189.50 |
7.4× |
| CT pelvis w & w/o contrast (72194) |
$1,139.45 |
$1,753 |
6.5× |
| CT pelvis w/o contrast (72192) |
$849.55 |
$1,307 |
8.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,005.22 |
$1,546.50 |
5.7× |
| CT soft tissue neck w/o contrast (70490) |
$684.12 |
$1,052.50 |
6.5× |
| CT thoracic spine w/contrast (72129) |
$1,832.35 |
$2,819 |
10.4× |
| CT thoracic spine w/o contrast (72128) |
$732.22 |
$1,126.50 |
7.0× |
| CT thoracic spine w/wo contrast (72130) |
$2,401.75 |
$3,695 |
13.7× |
| CT thorax w/o contrast (71250) |
$679.90 |
$1,046 |
6.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,652.95 |
$2,543 |
9.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,274.65 |
$1,961 |
12.2× |
| CT upper extremity with contrast (73201) |
$896.02 |
$1,378.50 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,181.70 |
$1,818 |
6.7× |
| Cta Abdomen (74175) |
$2,208.05 |
$3,397 |
12.6× |
| CTA abdomen pelvis (74174) |
$1,953.25 |
$3,005 |
5.6× |
| CTA chest (71275) |
$900.58 |
$1,385.50 |
5.1× |
| Cta Head (70496) |
$1,134.90 |
$1,746 |
6.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,854.45 |
$2,853 |
5.3× |
| Cta Neck (70498) |
$1,135.55 |
$1,747 |
6.5× |
| Cta Pelvis (72191) |
$529.75 |
$815 |
3.0× |
| Cystography minimum 3 views rs&i (74430) |
$607.75 |
$935 |
1.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$376.35 |
$579 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$202.80 |
$312 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$392.60 |
$604 |
3.7× |
| Esophagus (74220) |
$433.55 |
$667 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$488.15 |
$751 |
2.0× |
| Foot 2 views (73620) |
$259.35 |
$399 |
3.0× |
| Forearm 2 views (73090) |
$245.05 |
$377 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,350.05 |
$2,077 |
3.4× |
| Hand 2 views (73120) |
$277.55 |
$427 |
2.7× |
| Hand 3 views (73130) |
$251.55 |
$387 |
2.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,443 |
$2,220 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,333.15 |
$2,051 |
3.3× |
| Ht muscle image spect sing (78451) |
$2,185.95 |
$3,363 |
1.7× |
| Humerus Min 2 Views Left (73060) |
$253.50 |
$390 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$261.95 |
$403 |
2.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,195.35 |
$1,839 |
2.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,636.38 |
$2,517.50 |
3.0× |
| Knee 3 views (73562) |
$180.38 |
$277.50 |
2.1× |
| Lung perfusion differential (78597) |
$1,277.25 |
$1,965 |
3.2× |
| Lymphoscintigraphy (78195) |
$1,201.20 |
$1,848 |
2.2× |
| Meckels Diverticulum (78290) |
$848.25 |
$1,305 |
2.1× |
| MRA head w & w/o contrast (70546) |
$2,770.30 |
$4,262 |
7.9× |
| MRA head w/o contrast (70544) |
$2,038.40 |
$3,136 |
8.5× |
| MRA head with contrast (70545) |
$2,283.45 |
$3,513 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,712.45 |
$4,173 |
7.8× |
| MRA neck w/o contrast (70547) |
$2,154.75 |
$3,315 |
9.0× |
| MRI abdomen w contrast (74182) |
$2,651.35 |
$4,079 |
7.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,664.05 |
$5,637 |
10.5× |
| MRI abdomen w/o contrast (74181) |
$2,271.10 |
$3,494 |
9.5× |
| MRI any jnt lwr ext with con lt (73722) |
$2,406.30 |
$3,702 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,483 |
$3,820 |
3.2× |
| MRI c-spine with contrast (72142) |
$2,643.55 |
$4,067 |
7.6× |
| MRI cervical spine w/o contrast (72141) |
$2,042.95 |
$3,143 |
8.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,809.30 |
$4,322 |
8.0× |
| MRI chest w/o contrast (71550) |
$1,979.25 |
$3,045 |
8.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,518.40 |
$2,336 |
4.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,076.10 |
$3,194 |
8.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,097.55 |
$3,227 |
8.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,808.98 |
$4,321.50 |
8.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,446.60 |
$3,764 |
7.0× |
| MRI pelvis w contrast (72196) |
$2,051.40 |
$3,156 |
5.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,850.25 |
$4,385 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$2,146.30 |
$3,302 |
9.0× |
| MRI scan of arm joint before and after contrast (73223) |
$2,843.10 |
$4,374 |
8.1× |
| MRI scan of leg joint before and after contrast (73723) |
$2,650.70 |
$4,078 |
7.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,674.75 |
$4,115 |
7.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,702.05 |
$4,157 |
7.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,631.85 |
$4,049 |
7.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,110.25 |
$4,785 |
8.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,937.65 |
$2,981 |
8.1× |
| MRI tmj (70336) |
$1,413.10 |
$2,174 |
5.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,996.15 |
$3,071 |
8.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,460.25 |
$3,785 |
7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,979.25 |
$3,045 |
8.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,986.12 |
$6,132.50 |
3.1× |
| Neck soft tissue (70360) |
$143 |
$220 |
1.6× |
| Nm gastric emptying study (78264) |
$1,173.25 |
$1,805 |
2.9× |
| Osseous survey infant (77076) |
$262.92 |
$404.50 |
2.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,445.60 |
$2,224 |
3.6× |
| Parathyroid imaging (78070) |
$910 |
$1,400 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$139.75 |
$215 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,600.65 |
$4,001 |
7.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,052.35 |
$1,619 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$741 |
$1,140 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$287.95 |
$443 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$361.40 |
$556 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$393.25 |
$605 |
3.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$239.85 |
$369 |
2.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$203.12 |
$312.50 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$236.60 |
$364 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$360.75 |
$555 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$176.15 |
$271 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$585 |
$900 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$582.08 |
$895.50 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$656.50 |
$1,010 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$261.30 |
$402 |
3.0× |
| Radiological examination surgical specimen (76098) |
$380.25 |
$585 |
0.7× |
| Ribs bilateral 3 views (71110) |
$385.45 |
$593 |
3.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,692.60 |
$2,604 |
3.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,390.08 |
$5,215.50 |
2.6× |
| Sacroiliac Joints < 3 Views (72200) |
$242.45 |
$373 |
2.3× |
| Scanogram (77073) |
$265.85 |
$409 |
2.5× |
| Scapula complete (73010) |
$286 |
$440 |
2.7× |
| Screening digital breast tomosynthesis (77063) |
$105.95 |
$163 |
4.5× |
| Small bowel series (74250) |
$517.40 |
$796 |
2.9× |
| Spine thoracic 3 views (72072) |
$204.10 |
$314 |
1.9× |
| Thoracolumbar 2 views (72080) |
$286.65 |
$441 |
3.3× |
| Tmj unilateral (70328) |
$153.40 |
$236 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$337.35 |
$519 |
3.2× |
| Unlisted Ultrasound Procedure (76999) |
$260.65 |
$401 |
3.0× |
| Upper Extremity Infant (73092) |
$166.40 |
$256 |
1.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$685.75 |
$1,055 |
3.9× |
| Us abdl aorta screen aaa (76706) |
$308.10 |
$474 |
2.9× |
| Us breast unilateral complete (76641) |
$466.05 |
$717 |
4.5× |
| Us breast unilateral limited (76642) |
$396.50 |
$610 |
4.5× |
| Us chest (76604) |
$506.35 |
$779 |
4.8× |
| Us compl joint r-t w/image documentation (76881) |
$475.80 |
$732 |
4.5× |
| Us kidney transplant (76776) |
$648.70 |
$998 |
6.2× |
| Us ob transvaginal (76817) |
$527.80 |
$812 |
5.0× |
| Us pelvic non ob complete (76856) |
$355.22 |
$546.50 |
3.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$267.80 |
$412 |
2.6× |
| Us pregnancy ltd (76815) |
$299 |
$460 |
2.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$351.65 |
$541 |
3.4× |
| Us retroperitoneal complete (76770) |
$414.05 |
$637 |
4.0× |
| Us retroperitoneal limited (76775) |
$333.45 |
$513 |
3.2× |
| Us scrotum and contents (76870) |
$722.80 |
$1,112 |
6.9× |
| Us soft tissue head/neck (76536) |
$346.78 |
$533.50 |
3.3× |
| Us xtr non-vasc lmtd (76882) |
$378.30 |
$582 |
3.6× |
| Vertebral fracture assessment via dxa (77086) |
$174.85 |
$269 |
2.0× |
| Wrist 2 views (73100) |
$243.75 |
$375 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$259.68 |
$399.50 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$310.05 |
$477 |
3.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$255.45 |
$393 |
2.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$759.85 |
$1,169 |
4.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$235.95 |
$363 |
2.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$323.05 |
$497 |
3.7× |
| X-ray exam hip uni 1 view (73501) |
$226.85 |
$349 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$158.92 |
$244.50 |
1.8× |
| X-ray exam hip uni 4/> views (73503) |
$352.95 |
$543 |
3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$421.20 |
$648 |
4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$533 |
$820 |
5.1× |
| X-ray eye for foreign body (70030) |
$219.05 |
$337 |
2.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$199.22 |
$306.50 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$252.20 |
$388 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$235.30 |
$362 |
2.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$176.48 |
$271.50 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$273 |
$420 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$218.72 |
$336.50 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$263.25 |
$405 |
3.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$175.50 |
$270 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$171.92 |
$264.50 |
1.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$322.72 |
$496.50 |
3.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$350.35 |
$539 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$144.62 |
$222.50 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$213.20 |
$328 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$377.65 |
$581 |
3.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$171.28 |
$263.50 |
1.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$634.40 |
$976 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$171.60 |
$264 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$364.65 |
$561 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$506.35 |
$779 |
4.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$311.35 |
$479 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$168.35 |
$259 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$317.20 |
$488 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$330.85 |
$509 |
3.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$202.80 |
$312 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$241.15 |
$371 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$173.88 |
$267.50 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$245.70 |
$378 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$281.45 |
$433 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$296.40 |
$456 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$182.98 |
$281.50 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$429 |
$660 |
4.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$213.85 |
$329 |
2.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$219.05 |
$337 |
2.5× |
| Xr c-spine 6 or more views (72052) |
$582.40 |
$896 |
5.6× |
| Xr chest 4+ views (71048) |
$317.20 |
$488 |
3.0× |
| Xr finger(s) 2+ views (73140) |
$232.05 |
$357 |
2.7× |
| Xr shoulder 1 view (73020) |
$217.75 |
$335 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$247.65 |
$381 |
2.4× |
| Xr tibia/fibula 2 views (73590) |
$280.80 |
$432 |
3.2× |
| Xr tmj bilateral (70330) |
$364.65 |
$561 |
4.2× |
| Xray knee 1 or 2 views rt (73560) |
$156 |
$240 |
1.8× |