| Abdomen 2 views (74019) |
$400.40 |
$616 |
4.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$982.80 |
$1,512 |
2.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,824.25 |
$4,345 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,547.35 |
$3,919 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$2,016.30 |
$3,102 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,482.70 |
$5,358 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,350.10 |
$5,154 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,317.25 |
$3,565 |
0.8× |
| Angiography Spinal Selective Rs&I (75705) |
$3,054.35 |
$4,699 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,073.20 |
$4,728 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,170 |
$1,800 |
0.4× |
| Ankle 2 views (73600) |
$250.25 |
$385 |
3.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$697.45 |
$1,073 |
2.1× |
| Aortogram thoracic (75605) |
$2,917.85 |
$4,489 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,473.60 |
$5,344 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$1,972.75 |
$3,035 |
0.7× |
| Arthrogram elbow (73085) |
$518.70 |
$798 |
1.6× |
| Arthrogram hip (73525) |
$560.95 |
$863 |
1.7× |
| Arthrogram shoulder (73040) |
$626.60 |
$964 |
1.9× |
| Arthrogram wrist (73115) |
$434.20 |
$668 |
1.3× |
| Arthrography knee lt (73580) |
$521.30 |
$802 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$548.60 |
$844 |
4.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$927.88 |
$1,427.50 |
2.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,152.45 |
$1,773 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$1,560.98 |
$2,401.50 |
4.2× |
| Bone age studies (77072) |
$168.35 |
$259 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,677.98 |
$2,581.50 |
4.5× |
| Bone Marrow Imaging Limited Area (78102) |
$655.85 |
$1,009 |
1.8× |
| Bone survey complete (77075) |
$451.10 |
$694 |
4.6× |
| Brain image w/flow 4 + views (78606) |
$1,214.20 |
$1,868 |
2.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$880.75 |
$1,355 |
1.7× |
| Brain Imaging Vascular Flow Only (78610) |
$794.30 |
$1,222 |
1.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,848.60 |
$2,844 |
5.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$811.85 |
$1,249 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$163.80 |
$252 |
2.0× |
| Chest 1 view (71045) |
$239.20 |
$368 |
2.9× |
| Chest 3 views (71047) |
$341.90 |
$526 |
4.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$583.05 |
$897 |
3.6× |
| Cineradiography/videoradiography (76120) |
$458.90 |
$706 |
4.7× |
| Clavicle complete (73000) |
$217.75 |
$335 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$432.25 |
$665 |
4.4× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$389.35 |
$599 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,730.05 |
$7,277 |
14.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,369.60 |
$5,184 |
15.1× |
| CT abdomen w contrast (74160) |
$1,925.95 |
$2,963 |
11.8× |
| CT abdomen w wo contrast (74170) |
$2,221.05 |
$3,417 |
13.6× |
| CT abdomen w/o contrast (74150) |
$1,526.20 |
$2,348 |
15.6× |
| CT angio hrt w/3d image (75574) |
$2,149.55 |
$3,307 |
6.6× |
| CT angiography upper extremity lt (73206) |
$1,927.90 |
$2,966 |
11.8× |
| CT c-spine w/o contrast (72125) |
$1,428.70 |
$2,198 |
14.6× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$911.30 |
$1,402 |
5.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,515.80 |
$2,332 |
9.3× |
| CT cervical spine with contrast (72126) |
$1,433.90 |
$2,206 |
4.4× |
| CT chest w/wo contrast (71270) |
$2,318.55 |
$3,567 |
14.2× |
| CT chest with contrast (71260) |
$2,091.70 |
$3,218 |
12.8× |
| CT colonography screening (74263) |
$637.65 |
$981 |
2.9× |
| CT colonography w/dye (74262) |
$1,539.85 |
$2,369 |
9.4× |
| CT colonography w/o cntrst (74261) |
$1,373.45 |
$2,113 |
14.1× |
| CT head/brain with contrast (70460) |
$1,936.35 |
$2,979 |
11.8× |
| CT head/brain without and with contrast (70470) |
$2,325.70 |
$3,578 |
14.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,327.30 |
$2,042 |
4.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$32.50 |
$50 |
0.4× |
| CT hrt w/3d image congen (75573) |
$1,113.45 |
$1,713 |
3.4× |
| CT iac w contrast (70481) |
$1,495 |
$2,300 |
9.1× |
| CT limited/localized follow up study (76380) |
$664.30 |
$1,022 |
8.2× |
| CT lower ext w/o (73700) |
$1,593.15 |
$2,451 |
16.3× |
| CT lower extremity w wo contrast (73702) |
$2,021.50 |
$3,110 |
12.3× |
| CT lower extremity with contrast (73701) |
$1,691.30 |
$2,602 |
10.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,755 |
$2,700 |
10.7× |
| CT lumbar spine w/o contrast (72131) |
$1,496.30 |
$2,302 |
15.3× |
| CT lumbar spine with contrast (72132) |
$1,666.60 |
$2,564 |
5.1× |
| CT maxillofacial w contrast (70487) |
$1,422.20 |
$2,188 |
8.7× |
| CT maxillofacial w/o contrast (70486) |
$1,191.45 |
$1,833 |
12.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,740.05 |
$2,677 |
10.6× |
| CT neck soft tissue w contrast (70491) |
$1,994.85 |
$3,069 |
12.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,708.85 |
$2,629 |
10.4× |
| CT orbits w/o contrast (70480) |
$1,452.10 |
$2,234 |
14.9× |
| CT pelvis w & w/o contrast (72194) |
$1,730.95 |
$2,663 |
10.6× |
| CT pelvis w/o contrast (72192) |
$1,396.20 |
$2,148 |
14.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$315.90 |
$486 |
3.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,070.90 |
$3,186 |
12.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,539.85 |
$2,369 |
15.8× |
| CT thoracic spine w/contrast (72129) |
$1,893.45 |
$2,913 |
11.6× |
| CT thoracic spine w/o contrast (72128) |
$1,933.10 |
$2,974 |
19.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,925.95 |
$2,963 |
11.8× |
| CT thorax w/o contrast (71250) |
$1,690 |
$2,600 |
17.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,844.05 |
$2,837 |
11.3× |
| CT upper extremity w/o contrast rt (73200) |
$1,708.20 |
$2,628 |
17.5× |
| CT upper extremity with contrast (73201) |
$1,808.95 |
$2,783 |
5.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,044.25 |
$3,145 |
12.5× |
| Cta Abdomen (74175) |
$1,840.15 |
$2,831 |
11.2× |
| CTA abdomen pelvis (74174) |
$4,192.50 |
$6,450 |
12.9× |
| CTA chest (71275) |
$2,373.15 |
$3,651 |
14.5× |
| Cta Head (70496) |
$2,234.05 |
$3,437 |
13.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,819.70 |
$4,338 |
8.7× |
| CTA lwr ext w&w/o contrast (73706) |
$2,162.55 |
$3,327 |
13.2× |
| Cta Neck (70498) |
$2,248.35 |
$3,459 |
13.7× |
| Cta Pelvis (72191) |
$1,568.45 |
$2,413 |
9.6× |
| Cystography minimum 3 views rs&i (74430) |
$529.10 |
$814 |
1.6× |
| Dacryocystography (70170) |
$447.85 |
$689 |
2.0× |
| Diskogram cervical (72285) |
$1,950 |
$3,000 |
1.1× |
| Diskography lumbar (72295) |
$1,950 |
$3,000 |
1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$313.30 |
$482 |
3.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$313.30 |
$482 |
3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$185.90 |
$286 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$306.80 |
$472 |
3.1× |
| Echoencephalography real time imaging (76506) |
$491.40 |
$756 |
5.0× |
| Esophagus (74220) |
$623.35 |
$959 |
3.8× |
| Fetal biophysical profile non-stress testing (76818) |
$571.35 |
$879 |
5.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$423.80 |
$652 |
4.3× |
| Fluoroscopy up to 1 hr (76000) |
$449.80 |
$692 |
2.0× |
| Foot 2 views (73620) |
$167.05 |
$257 |
2.1× |
| Forearm 2 views (73090) |
$239.85 |
$369 |
3.0× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$176.15 |
$271 |
0.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,708.85 |
$2,629 |
3.4× |
| Gated Heart Planar Single (78472) |
$1,582.75 |
$2,435 |
4.2× |
| Hand 2 views (73120) |
$189.15 |
$291 |
1.9× |
| Hand 3 views (73130) |
$245.05 |
$377 |
3.0× |
| Heart Infarct Image (78466) |
$817.05 |
$1,257 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,465.34 |
$2,254.36 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,661.72 |
$2,556.50 |
4.5× |
| Ht muscle image spect sing (78451) |
$2,108.92 |
$3,244.50 |
1.7× |
| Humerus Min 2 Views Left (73060) |
$323.70 |
$498 |
4.0× |
| Hysterosalpingogram (74740) |
$603.20 |
$928 |
2.7× |
| Interstitial radiation source applic complex (77778) |
$2,772.25 |
$4,265 |
4.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$241.15 |
$371 |
2.5× |
| Kidney imaging morphology (78700) |
$852.80 |
$1,312 |
2.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,157.32 |
$1,780.50 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,507.68 |
$2,319.50 |
3.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,624.56 |
$2,499.32 |
3.2× |
| Knee 3 views (73562) |
$265.85 |
$409 |
3.3× |
| Liver & spleen imaging static only (78215) |
$1,069.90 |
$1,646 |
2.9× |
| Liver imaging static only (78201) |
$934.70 |
$1,438 |
1.8× |
| Liver imaging w/vascular flow (78202) |
$924.30 |
$1,422 |
1.8× |
| Lung perf&ventilat diferentl (78598) |
$1,046.50 |
$1,610 |
2.1× |
| Lung perfusion differential (78597) |
$2,281.66 |
$3,510.25 |
6.1× |
| Lung Ventilation Imaging (78579) |
$842.40 |
$1,296 |
2.3× |
| Lymphoscintigraphy (78195) |
$8,516.14 |
$13,101.74 |
16.8× |
| Mammary ductogram or galactogram multiple (77054) |
$458.25 |
$705 |
2.1× |
| Mammary ductogram or galactogram single (77053) |
$443.30 |
$682 |
2.0× |
| Meckels Diverticulum (78290) |
$807.30 |
$1,242 |
2.2× |
| MRA head w & w/o contrast (70546) |
$1,954.55 |
$3,007 |
6.0× |
| MRA head w/o contrast (70544) |
$1,242.80 |
$1,912 |
5.6× |
| MRA head with contrast (70545) |
$1,573.65 |
$2,421 |
4.8× |
| MRA neck w contrast (70548) |
$1,669.20 |
$2,568 |
5.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,985.75 |
$3,055 |
6.1× |
| MRA neck w/o contrast (70547) |
$1,402.05 |
$2,157 |
6.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,133.65 |
$4,821 |
9.6× |
| MRI abdomen w/o contrast (74181) |
$2,590.25 |
$3,985 |
11.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,347.80 |
$3,612 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,081.95 |
$3,203 |
2.8× |
| MRI bone marrow blood supply (77084) |
$1,097.85 |
$1,689 |
4.9× |
| MRI breast w/o contrast bilateral (77047) |
$2,405 |
$3,700 |
10.8× |
| MRI breast w/o contrast unilat (77046) |
$1,842.75 |
$2,835 |
8.3× |
| MRI c-spine with contrast (72142) |
$2,163.20 |
$3,328 |
6.6× |
| MRI cardiac w/o contrast (75557) |
$1,519.05 |
$2,337 |
6.8× |
| MRI cervical spine w/o contrast (72141) |
$1,859.65 |
$2,861 |
8.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,852.20 |
$4,388 |
8.8× |
| MRI chest w/o contrast (71550) |
$1,287 |
$1,980 |
5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,184.65 |
$3,361 |
6.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,096.90 |
$3,226 |
9.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,431.95 |
$2,203 |
6.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,580.50 |
$3,970 |
7.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,729.65 |
$2,661 |
5.3× |
| MRI pelvis w contrast (72196) |
$2,247.05 |
$3,457 |
6.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,461.55 |
$3,787 |
7.6× |
| MRI pelvis w/o contrast (72195) |
$1,773.20 |
$2,728 |
8.0× |
| MRI scan of arm joint before and after contrast (73223) |
$2,993.25 |
$4,605 |
9.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,414.10 |
$3,714 |
7.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,473.60 |
$5,344 |
10.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,005.90 |
$3,086 |
6.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,459.95 |
$5,323 |
10.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,704 |
$4,160 |
8.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,552.25 |
$5,465 |
10.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,523.95 |
$3,883 |
11.3× |
| MRI tmj (70336) |
$1,578.20 |
$2,428 |
7.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,665.30 |
$2,562 |
7.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,112.50 |
$3,250 |
6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,374.10 |
$2,114 |
6.2× |
| Myelogram Cervical (72240) |
$1,159.60 |
$1,784 |
1.6× |
| Myelogram Lumbar (72265) |
$1,232.40 |
$1,896 |
1.7× |
| Myelogram thoracic (72255) |
$1,022.45 |
$1,573 |
1.4× |
| Myelography 2 or more regions (72270) |
$1,197.30 |
$1,842 |
1.6× |
| Myocardial infarct spect (78469) |
$797.88 |
$1,227.50 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$3,842.44 |
$5,911.45 |
3.2× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,577.95 |
$7,043 |
3.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,363.75 |
$5,175 |
2.5× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,701.75 |
$5,695 |
1.8× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$7,019.35 |
$10,799 |
3.4× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$5,291 |
$8,140 |
3.7× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,961.40 |
$4,556 |
3.7× |
| Neck soft tissue (70360) |
$276.90 |
$426 |
3.4× |
| Nm adrenal scan (78075) |
$1,573.65 |
$2,421 |
1.3× |
| Nm bone marrow multiple (78103) |
$813.15 |
$1,251 |
2.2× |
| Nm bone marrow wb (78104) |
$846.30 |
$1,302 |
2.3× |
| Nm cisternogram (78630) |
$1,408.55 |
$2,167 |
2.8× |
| Nm gastric emptying study (78264) |
$1,393.28 |
$2,143.50 |
3.7× |
| Nm gastroesophageal reflux study (78262) |
$1,072.50 |
$1,650 |
2.9× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,269.15 |
$3,491 |
1.9× |
| Nuclear medicine of heart pumping function (78473) |
$1,644.50 |
$2,530 |
4.4× |
| Nuclear medicine study of endocrine organs (78099) |
$6,502.22 |
$10,003.40 |
17.4× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,396.55 |
$3,687 |
2.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$941.20 |
$1,448 |
2.5× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$741.65 |
$1,141 |
2.0× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,289.60 |
$1,984 |
3.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$787.15 |
$1,211 |
2.1× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$840.45 |
$1,293 |
1.7× |
| Nuclear Rx Oral Admin (79005) |
$1,572.02 |
$2,418.50 |
7.2× |
| Nuclr Rx Interstit Colloid (79300) |
$372.45 |
$573 |
1.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$277.55 |
$427 |
2.8× |
| Orthopantogram (70355) |
$258.05 |
$397 |
3.2× |
| Osseous survey infant (77076) |
$331.50 |
$510 |
3.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,223.30 |
$1,882 |
2.4× |
| Parathyrd planar w/wo subtrj (78071) |
$1,402.70 |
$2,158 |
3.8× |
| Parathyroid imaging (78070) |
$1,173.90 |
$1,806 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$276.25 |
$425 |
2.8× |
| PET image w/CT, skull-thigh (78815) |
$4,645.22 |
$7,146.50 |
3.5× |
| PET imaging for CT attenuation whole body (78816) |
$4,700.15 |
$7,231 |
3.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,481.05 |
$3,817 |
7.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,644.20 |
$4,068 |
0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,424.80 |
$2,192 |
3.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,460.55 |
$2,247 |
2.9× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,852.50 |
$2,850 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$514.15 |
$791 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$227.50 |
$350 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$419.90 |
$646 |
4.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$241.15 |
$371 |
2.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$259.35 |
$399 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$711.10 |
$1,094 |
7.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$332.80 |
$512 |
3.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$317.20 |
$488 |
3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$449.15 |
$691 |
4.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$295.10 |
$454 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$830.70 |
$1,278 |
5.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,003.60 |
$1,544 |
6.1× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$176.15 |
$271 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$601.90 |
$926 |
3.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$597.35 |
$919 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$326.30 |
$502 |
4.0× |
| Radiological examination surgical specimen (76098) |
$332.15 |
$511 |
0.7× |
| Radiopharm Dacryocystography (78660) |
$644.80 |
$992 |
1.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,891.20 |
$4,448 |
1.0× |
| Ribs bilateral 3 views (71110) |
$362.70 |
$558 |
3.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,067.95 |
$1,643 |
2.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,739.40 |
$2,676 |
3.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,490.78 |
$2,293.50 |
2.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,681.25 |
$4,125 |
2.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,232.48 |
$6,511.50 |
3.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,568.18 |
$5,489.50 |
3.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$532.35 |
$819 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$658.45 |
$1,013 |
3.0× |
| Sacroiliac Joints < 3 Views (72200) |
$247 |
$380 |
2.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$385.45 |
$593 |
1.7× |
| Scanogram (77073) |
$176.80 |
$272 |
1.8× |
| Scapula complete (73010) |
$237.90 |
$366 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$64.35 |
$99 |
2.8× |
| Sialogram (70390) |
$579.15 |
$891 |
2.6× |
| Small bowel series (74250) |
$564.85 |
$869 |
3.5× |
| Speech evaluation complex (70371) |
$568.10 |
$874 |
2.6× |
| Spine thoracic 3 views (72072) |
$297.05 |
$457 |
3.0× |
| Spleen imaging only (78185) |
$579.80 |
$892 |
1.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$463.45 |
$713 |
2.1× |
| Testicular Imaging With Vascular Flow (78761) |
$755.95 |
$1,163 |
2.0× |
| Thoracolumbar 2 views (72080) |
$245.70 |
$378 |
3.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,817.40 |
$2,796 |
3.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$698.75 |
$1,075 |
1.9× |
| Thyroid uptake measurement (78012) |
$579.80 |
$892 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,168.38 |
$1,797.50 |
3.1× |
| Tmj unilateral (70328) |
$156.65 |
$241 |
1.9× |
| Tomogram (76100) |
$606.45 |
$933 |
6.2× |
| Treatment devices simple (77332) |
$494.65 |
$761 |
3.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,174.25 |
$3,345 |
4.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$748.80 |
$1,152 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$601.90 |
$926 |
6.2× |
| Umbilical-artery Doppler (OB) (76820) |
$280.15 |
$431 |
2.9× |
| Unlisted Ultrasound Procedure (76999) |
$131.95 |
$203 |
1.6× |
| Upper Extremity Infant (73092) |
$147.55 |
$227 |
1.5× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$778.70 |
$1,198 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$623.35 |
$959 |
2.8× |
| Urethrocystography voiding (74455) |
$708.50 |
$1,090 |
3.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$768.95 |
$1,183 |
4.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,065.35 |
$1,639 |
6.5× |
| Us abdl aorta screen aaa (76706) |
$276.90 |
$426 |
2.8× |
| Us breast unilateral complete (76641) |
$351 |
$540 |
3.6× |
| Us breast unilateral limited (76642) |
$264.55 |
$407 |
3.3× |
| Us chest (76604) |
$457.60 |
$704 |
4.7× |
| Us compl joint r-t w/image documentation (76881) |
$424.45 |
$653 |
4.3× |
| Us elastography parenchyma (76981) |
$252.85 |
$389 |
2.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$341.25 |
$525 |
3.5× |
| Us guided compression repair (76936) |
$633.75 |
$975 |
3.1× |
| Us infant hips dynamic (76885) |
$340.60 |
$524 |
4.2× |
| Us infant hips limited static (76886) |
$352.30 |
$542 |
4.3× |
| Us kidney transplant (76776) |
$453.05 |
$697 |
4.6× |
| Us ob detailed single fetus (76811) |
$629.20 |
$968 |
2.8× |
| Us ob transvaginal (76817) |
$350.35 |
$539 |
3.6× |
| Us pelvic non ob complete (76856) |
$506.35 |
$779 |
5.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$274.95 |
$423 |
2.8× |
| Us pregnancy ltd (76815) |
$351 |
$540 |
3.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$408.85 |
$629 |
4.2× |
| Us retroperitoneal complete (76770) |
$686.40 |
$1,056 |
7.0× |
| Us retroperitoneal limited (76775) |
$501.15 |
$771 |
5.1× |
| Us scrotum and contents (76870) |
$629.85 |
$969 |
6.5× |
| Us soft tissue head/neck (76536) |
$450.45 |
$693 |
4.6× |
| Us spinal canal and contents (76800) |
$329.55 |
$507 |
3.4× |
| Us transrectal prostate volume (76873) |
$561.60 |
$864 |
5.8× |
| Us xtr non-vasc lmtd (76882) |
$525.20 |
$808 |
5.4× |
| Vascular flow imaging (78445) |
$650 |
$1,000 |
1.7× |
| Venogram extremity bilateral (75822) |
$1,381.25 |
$2,125 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,187.90 |
$3,366 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,457.95 |
$2,243 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,062.75 |
$1,635 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,838.20 |
$2,828 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,143.70 |
$3,298 |
0.7× |
| Wrist 2 views (73100) |
$232.05 |
$357 |
2.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$562.90 |
$866 |
5.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$180.70 |
$278 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$281.45 |
$433 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$798.20 |
$1,228 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$197.28 |
$303.50 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$243.10 |
$374 |
3.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$560.95 |
$863 |
5.7× |
| X-ray exam hip uni 1 view (73501) |
$192.40 |
$296 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$294.45 |
$453 |
3.6× |
| X-ray exam hip uni 4/> views (73503) |
$371.80 |
$572 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$364.65 |
$561 |
3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$381.55 |
$587 |
3.9× |
| X-ray exam of femur 1 (73551) |
$168.35 |
$259 |
2.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$791.70 |
$1,218 |
4.8× |
| X-ray eye for foreign body (70030) |
$243.75 |
$375 |
3.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$306.15 |
$471 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$175.50 |
$270 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$265.20 |
$408 |
3.3× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,576.90 |
$2,426 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$208 |
$320 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$174.85 |
$269 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$332.15 |
$511 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$160.55 |
$247 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$172.25 |
$265 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$276.25 |
$425 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$411.45 |
$633 |
4.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$364 |
$560 |
3.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$248.30 |
$382 |
3.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$193.05 |
$297 |
2.4× |
| X-ray of voice box or throat (70370) |
$270.40 |
$416 |
3.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$278.20 |
$428 |
2.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$285.35 |
$439 |
2.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,030.25 |
$1,585 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$239.85 |
$369 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$314.60 |
$484 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$331.50 |
$510 |
3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$261.95 |
$403 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$254.80 |
$392 |
3.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$257.40 |
$396 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$276.90 |
$426 |
3.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$221.65 |
$341 |
2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$362.70 |
$558 |
3.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$349.05 |
$537 |
3.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$228.80 |
$352 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$237.90 |
$366 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$230.10 |
$354 |
2.8× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$89.70 |
$138 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$257.40 |
$396 |
2.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$313.95 |
$483 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$247.65 |
$381 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$265.20 |
$408 |
3.3× |
| Xr arthrogram ankle (73615) |
$674.70 |
$1,038 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$397.80 |
$612 |
4.1× |
| Xr chest 4+ views (71048) |
$389.35 |
$599 |
4.0× |
| Xr finger(s) 2+ views (73140) |
$183.30 |
$282 |
2.3× |
| Xr shoulder 1 view (73020) |
$206.05 |
$317 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$374.40 |
$576 |
3.8× |
| Xr tibia/fibula 2 views (73590) |
$339.30 |
$522 |
4.2× |
| Xr tmj bilateral (70330) |
$230.75 |
$355 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$230.75 |
$355 |
2.8× |