| Abdomen 2 views (74019) |
$306.15 |
$471 |
3.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,200.55 |
$1,847 |
3.1× |
| Ankle 2 views (73600) |
$250.90 |
$386 |
3.0× |
| Arthrogram hip (73525) |
$672.75 |
$1,035 |
2.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$965.25 |
$1,485 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,573 |
$2,420 |
4.1× |
| Bone age studies (77072) |
$268.45 |
$413 |
2.7× |
| Bone Imaging 3 Phase (78315) |
$1,676.35 |
$2,579 |
4.4× |
| Bone survey complete (77075) |
$833.30 |
$1,282 |
8.3× |
| Cervical spine 2 or 3 views (72040) |
$365.95 |
$563 |
4.4× |
| Chest 1 view (71045) |
$184.60 |
$284 |
2.2× |
| Chest 3 views (71047) |
$287.30 |
$442 |
3.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$540.80 |
$832 |
3.2× |
| Clavicle complete (73000) |
$217.10 |
$334 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$447.20 |
$688 |
4.4× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$302.90 |
$466 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,138.50 |
$3,290 |
6.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,599 |
$2,460 |
7.0× |
| CT abdomen w contrast (74160) |
$1,933.10 |
$2,974 |
11.5× |
| CT abdomen w wo contrast (74170) |
$2,187.90 |
$3,366 |
13.0× |
| CT abdomen w/o contrast (74150) |
$1,675.70 |
$2,578 |
16.7× |
| CT c-spine w/o contrast (72125) |
$1,807.65 |
$2,781 |
18.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,202.20 |
$3,388 |
13.1× |
| CT cervical spine with contrast (72126) |
$1,868.10 |
$2,874 |
5.6× |
| CT chest w/wo contrast (71270) |
$2,462.20 |
$3,788 |
14.6× |
| CT chest with contrast (71260) |
$2,008.50 |
$3,090 |
11.9× |
| CT head/brain with contrast (70460) |
$1,880.45 |
$2,893 |
11.1× |
| CT head/brain without and with contrast (70470) |
$2,320.50 |
$3,570 |
13.8× |
| CT iac w contrast (70481) |
$2,241.85 |
$3,449 |
13.3× |
| CT lower ext w/o (73700) |
$1,585.35 |
$2,439 |
15.8× |
| CT lower extremity w wo contrast (73702) |
$1,829.75 |
$2,815 |
10.8× |
| CT lower extremity with contrast (73701) |
$1,781.65 |
$2,741 |
10.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,507.05 |
$3,857 |
14.9× |
| CT lumbar spine w/o contrast (72131) |
$1,825.85 |
$2,809 |
18.2× |
| CT lumbar spine with contrast (72132) |
$2,113.15 |
$3,251 |
6.3× |
| CT maxillofacial w contrast (70487) |
$1,965.60 |
$3,024 |
11.7× |
| CT maxillofacial w/o contrast (70486) |
$1,194.05 |
$1,837 |
11.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,115.10 |
$3,254 |
12.5× |
| CT neck soft tissue w contrast (70491) |
$1,756.30 |
$2,702 |
10.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,323.75 |
$3,575 |
13.8× |
| CT orbits w/o contrast (70480) |
$1,683.50 |
$2,590 |
16.7× |
| CT pelvis w & w/o contrast (72194) |
$2,182.70 |
$3,358 |
12.9× |
| CT pelvis w/o contrast (72192) |
$1,822.60 |
$2,804 |
18.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,167.10 |
$3,334 |
12.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,327.95 |
$2,043 |
13.2× |
| CT thoracic spine w/contrast (72129) |
$1,878.50 |
$2,890 |
11.1× |
| CT thoracic spine w/o contrast (72128) |
$1,816.75 |
$2,795 |
18.1× |
| CT thoracic spine w/wo contrast (72130) |
$2,306.85 |
$3,549 |
13.7× |
| CT thorax w/o contrast (71250) |
$1,695.20 |
$2,608 |
16.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,860.62 |
$2,862.50 |
11.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,621.10 |
$2,494 |
16.1× |
| CT upper extremity with contrast (73201) |
$1,619.80 |
$2,492 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,538.60 |
$5,444 |
21.0× |
| Cta Abdomen (74175) |
$2,643.55 |
$4,067 |
15.7× |
| CTA abdomen pelvis (74174) |
$3,175.90 |
$4,886 |
9.5× |
| CTA chest (71275) |
$1,899.30 |
$2,922 |
11.3× |
| Cta Head (70496) |
$2,059.85 |
$3,169 |
12.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,027.35 |
$3,119 |
6.0× |
| Cta Neck (70498) |
$2,049.45 |
$3,153 |
12.1× |
| Cystography minimum 3 views rs&i (74430) |
$681.85 |
$1,049 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$258.70 |
$398 |
2.6× |
| Esophagus (74220) |
$525.85 |
$809 |
3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$458.25 |
$705 |
4.6× |
| Fluoroscopy up to 1 hr (76000) |
$448.50 |
$690 |
2.0× |
| Foot 2 views (73620) |
$261.95 |
$403 |
3.1× |
| Forearm 2 views (73090) |
$284.05 |
$437 |
3.4× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,463.15 |
$2,251 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,632.15 |
$2,511 |
4.2× |
| Hand 2 views (73120) |
$251.55 |
$387 |
2.5× |
| Hand 3 views (73130) |
$274.30 |
$422 |
3.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,729.65 |
$2,661 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,288.95 |
$1,983 |
3.4× |
| Humerus Min 2 Views Left (73060) |
$248.30 |
$382 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,586 |
$2,440 |
3.0× |
| Knee 3 views (73562) |
$280.80 |
$432 |
3.4× |
| Lung Ventilation Imaging (78579) |
$795.60 |
$1,224 |
2.1× |
| MRA head w & w/o contrast (70546) |
$2,113.15 |
$3,251 |
6.3× |
| MRA head w/o contrast (70544) |
$2,252.25 |
$3,465 |
9.8× |
| MRA head with contrast (70545) |
$2,496.65 |
$3,841 |
7.4× |
| MRA neck w contrast (70548) |
$2,476.50 |
$3,810 |
7.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,932.15 |
$4,511 |
8.7× |
| MRA neck w/o contrast (70547) |
$2,293.85 |
$3,529 |
10.0× |
| MRI abdomen w contrast (74182) |
$2,644.85 |
$4,069 |
7.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,443.70 |
$5,298 |
10.3× |
| MRI abdomen w/o contrast (74181) |
$2,451.80 |
$3,772 |
10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,419.95 |
$3,723 |
3.2× |
| MRI c-spine with contrast (72142) |
$2,531.10 |
$3,894 |
7.5× |
| MRI cervical spine w/o contrast (72141) |
$2,379 |
$3,660 |
10.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,775.50 |
$4,270 |
8.3× |
| MRI chest w/o contrast (71550) |
$2,143.70 |
$3,298 |
9.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,996.15 |
$3,071 |
5.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,137.20 |
$3,288 |
9.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,092.35 |
$3,219 |
9.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,414.75 |
$3,715 |
7.2× |
| MRI orbit/face/neck w/contrast (70542) |
$2,213.25 |
$3,405 |
6.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,344.25 |
$5,145 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$2,414.10 |
$3,714 |
10.5× |
| MRI scan of arm joint before and after contrast (73223) |
$2,821.65 |
$4,341 |
8.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,915.90 |
$4,486 |
8.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,479.45 |
$5,353 |
10.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,539.55 |
$3,907 |
7.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,455.40 |
$5,316 |
10.3× |
| 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) |
$3,430.70 |
$5,278 |
10.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,398.50 |
$3,690 |
10.5× |
| MRI tmj (70336) |
$1,787.50 |
$2,750 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,282.80 |
$3,512 |
9.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,735.85 |
$4,209 |
8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,057.90 |
$3,166 |
9.0× |
| Neck soft tissue (70360) |
$221 |
$340 |
2.6× |
| Nm gastric emptying study (78264) |
$1,285.70 |
$1,978 |
3.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,105 |
$1,700 |
2.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$333.45 |
$513 |
3.3× |
| Osseous survey infant (77076) |
$349.70 |
$538 |
3.5× |
| Parathyroid imaging (78070) |
$1,052.35 |
$1,619 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$260.65 |
$401 |
2.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,925.65 |
$4,501 |
8.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,077.05 |
$1,657 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,311.70 |
$2,018 |
2.5× |
| 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) |
$442 |
$680 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$421.20 |
$648 |
4.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$267.15 |
$411 |
2.7× |
| 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) |
$357.50 |
$550 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$243.75 |
$375 |
2.9× |
| 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) |
$216.45 |
$333 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$606.45 |
$933 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$711.10 |
$1,094 |
4.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$243.10 |
$374 |
2.9× |
| Ribs bilateral 3 views (71110) |
$391.30 |
$602 |
3.9× |
| Scapula complete (73010) |
$241.80 |
$372 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$60.45 |
$93 |
2.6× |
| Sella turcica (70240) |
$117.65 |
$181 |
1.4× |
| Small bowel series (74250) |
$491.40 |
$756 |
2.9× |
| Spine thoracic 3 views (72072) |
$384.80 |
$592 |
3.8× |
| Thoracolumbar 2 views (72080) |
$317.20 |
$488 |
3.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$698.75 |
$1,075 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,037.40 |
$1,596 |
2.7× |
| Tmj unilateral (70328) |
$206.05 |
$317 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$510.90 |
$786 |
5.1× |
| Upper Extremity Infant (73092) |
$161.85 |
$249 |
1.6× |
| Urethrocystography voiding (74455) |
$622.05 |
$957 |
2.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$761.15 |
$1,171 |
4.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$748.15 |
$1,151 |
4.4× |
| Us abdl aorta screen aaa (76706) |
$406.90 |
$626 |
4.0× |
| Us breast unilateral limited (76642) |
$333.45 |
$513 |
4.0× |
| Us chest (76604) |
$459.55 |
$707 |
4.6× |
| Us compl joint r-t w/image documentation (76881) |
$786.50 |
$1,210 |
7.8× |
| Us ob transvaginal (76817) |
$467.35 |
$719 |
4.6× |
| Us pelvic non ob complete (76856) |
$594.75 |
$915 |
5.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$438.10 |
$674 |
4.4× |
| Us pregnancy ltd (76815) |
$421.85 |
$649 |
4.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$490.10 |
$754 |
4.9× |
| Us retroperitoneal complete (76770) |
$663.65 |
$1,021 |
6.6× |
| Us retroperitoneal limited (76775) |
$499.20 |
$768 |
5.0× |
| Us scrotum and contents (76870) |
$596.05 |
$917 |
5.9× |
| Us soft tissue head/neck (76536) |
$533 |
$820 |
5.3× |
| Us xtr non-vasc lmtd (76882) |
$445.25 |
$685 |
4.4× |
| Wrist 2 views (73100) |
$273.65 |
$421 |
3.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$406.90 |
$626 |
4.0× |
| 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) |
$274.30 |
$422 |
3.3× |
| 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) |
$243.75 |
$375 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$265.20 |
$408 |
3.2× |
| X-ray exam hip uni 1 view (73501) |
$175.50 |
$270 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$286 |
$440 |
3.4× |
| X-ray exam hip uni 4/> views (73503) |
$387.40 |
$596 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$523.25 |
$805 |
5.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$577.85 |
$889 |
5.7× |
| X-ray exam of femur 1 (73551) |
$229.45 |
$353 |
2.7× |
| X-ray eye for foreign body (70030) |
$242.45 |
$373 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$300.30 |
$462 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$216.45 |
$333 |
2.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$295.10 |
$454 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$213.85 |
$329 |
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) |
$319.15 |
$491 |
3.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$619.45 |
$953 |
6.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$345.15 |
$531 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$271.70 |
$418 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$222.30 |
$342 |
2.7× |
| X-ray of voice box or throat (70370) |
$271.05 |
$417 |
3.2× |
| 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) |
$208 |
$320 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$243.75 |
$375 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$442.65 |
$681 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$266.50 |
$410 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$268.45 |
$413 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$331.50 |
$510 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$337.35 |
$519 |
4.0× |
| 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) |
$382.20 |
$588 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$294.45 |
$453 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$301.60 |
$464 |
3.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$226.20 |
$348 |
2.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$243.75 |
$375 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$341.25 |
$525 |
3.4× |
| 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) |
$208 |
$320 |
2.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$317.20 |
$488 |
3.8× |
| Xr c-spine 6 or more views (72052) |
$469.95 |
$723 |
4.7× |
| Xr chest 4+ views (71048) |
$365.95 |
$563 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$233.35 |
$359 |
2.8× |
| Xr shoulder 1 view (73020) |
$210.60 |
$324 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$434.85 |
$669 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$310.05 |
$477 |
3.7× |
| Xr tmj bilateral (70330) |
$308.75 |
$475 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$243.10 |
$374 |
2.9× |