| Abdomen 2 views (74019) |
$245.70 |
$378 |
2.3× |
| Ankle 2 views (73600) |
$135.85 |
$209 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$1,117.68 |
$1,719.50 |
2.8× |
| Bone age studies (77072) |
$462.15 |
$711 |
4.4× |
| Bone Imaging 3 Phase (78315) |
$864.82 |
$1,330.50 |
2.2× |
| Bone survey complete (77075) |
$1,164.80 |
$1,792 |
11.1× |
| Cervical spine 2 or 3 views (72040) |
$273 |
$420 |
3.1× |
| Chest 1 view (71045) |
$117 |
$180 |
1.3× |
| Chest 3 views (71047) |
$141.05 |
$217 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$388.05 |
$597 |
2.2× |
| Clavicle complete (73000) |
$176.15 |
$271 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$237.90 |
$366 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,525.25 |
$3,885 |
7.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,148.25 |
$3,305 |
9.0× |
| CT abdomen w contrast (74160) |
$1,329.90 |
$2,046 |
7.6× |
| CT abdomen w wo contrast (74170) |
$2,148.25 |
$3,305 |
12.2× |
| CT abdomen w/o contrast (74150) |
$1,075.10 |
$1,654 |
10.3× |
| CT angio hrt w/3d image (75574) |
$2,257.45 |
$3,473 |
6.5× |
| CT c-spine w/o contrast (72125) |
$1,147.90 |
$1,766 |
11.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,413.75 |
$2,175 |
8.0× |
| CT cervical spine with contrast (72126) |
$1,329.90 |
$2,046 |
3.8× |
| CT chest w/wo contrast (71270) |
$1,313.65 |
$2,021 |
7.5× |
| CT chest with contrast (71260) |
$1,300.65 |
$2,001 |
7.4× |
| CT head/brain with contrast (70460) |
$1,329.90 |
$2,046 |
7.6× |
| CT head/brain without and with contrast (70470) |
$1,248 |
$1,920 |
7.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$171.60 |
$264 |
2.0× |
| CT iac w contrast (70481) |
$1,329.90 |
$2,046 |
7.6× |
| CT limited/localized follow up study (76380) |
$587.60 |
$904 |
6.7× |
| CT lower ext w/o (73700) |
$1,026.35 |
$1,579 |
9.8× |
| CT lower extremity w wo contrast (73702) |
$1,413.75 |
$2,175 |
8.0× |
| CT lower extremity with contrast (73701) |
$1,329.90 |
$2,046 |
7.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,361.10 |
$2,094 |
7.7× |
| CT lumbar spine w/o contrast (72131) |
$1,147.90 |
$1,766 |
11.0× |
| CT lumbar spine with contrast (72132) |
$1,329.90 |
$2,046 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,329.90 |
$2,046 |
7.6× |
| CT maxillofacial w/o contrast (70486) |
$1,075.10 |
$1,654 |
10.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,248 |
$1,920 |
7.1× |
| CT neck soft tissue w contrast (70491) |
$1,262.95 |
$1,943 |
7.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,403.35 |
$2,159 |
8.0× |
| CT orbits w/o contrast (70480) |
$1,065.35 |
$1,639 |
10.2× |
| CT pelvis w & w/o contrast (72194) |
$1,413.75 |
$2,175 |
8.0× |
| CT pelvis w/o contrast (72192) |
$1,168.70 |
$1,798 |
11.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,403.35 |
$2,159 |
8.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,147.90 |
$1,766 |
11.0× |
| CT thoracic spine w/contrast (72129) |
$1,329.90 |
$2,046 |
7.6× |
| CT thoracic spine w/o contrast (72128) |
$1,168.70 |
$1,798 |
11.2× |
| CT thorax w/o contrast (71250) |
$1,075.10 |
$1,654 |
10.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,413.75 |
$2,175 |
8.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,026.35 |
$1,579 |
9.8× |
| CT upper extremity with contrast (73201) |
$1,329.90 |
$2,046 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,328.95 |
$3,583 |
13.3× |
| Cta Abdomen (74175) |
$1,403.35 |
$2,159 |
8.0× |
| CTA abdomen pelvis (74174) |
$2,949.05 |
$4,537 |
8.4× |
| CTA chest (71275) |
$2,148.25 |
$3,305 |
12.2× |
| Cta Head (70496) |
$1,403.35 |
$2,159 |
8.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,060.50 |
$3,170 |
5.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,403.35 |
$2,159 |
8.0× |
| Cta Neck (70498) |
$1,403.35 |
$2,159 |
8.0× |
| Cta Pelvis (72191) |
$1,403.35 |
$2,159 |
8.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$295.10 |
$454 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$156 |
$240 |
1.8× |
| Esophagus (74220) |
$611 |
$940 |
3.5× |
| Fetal biophysical profile non-stress testing (76818) |
$350.35 |
$539 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$377 |
$580 |
1.6× |
| Foot 2 views (73620) |
$148.85 |
$229 |
1.7× |
| Forearm 2 views (73090) |
$176.15 |
$271 |
2.0× |
| Gated Heart Planar Single (78472) |
$789.75 |
$1,215 |
2.0× |
| Hand 2 views (73120) |
$137.80 |
$212 |
1.3× |
| Hand 3 views (73130) |
$176.15 |
$271 |
2.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,641 |
$2,524.62 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,067.30 |
$1,642 |
2.7× |
| Ht muscle image spect sing (78451) |
$451.10 |
$694 |
0.3× |
| Humerus Min 2 Views Left (73060) |
$176.15 |
$271 |
2.0× |
| Kidney funcj study non-img radioisotopic study (78725) |
$2,330.25 |
$3,585 |
5.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,036.10 |
$1,594 |
1.9× |
| Knee 3 views (73562) |
$176.15 |
$271 |
2.0× |
| Lymphoscintigraphy (78195) |
$1,589.25 |
$2,445 |
2.9× |
| MRA head w & w/o contrast (70546) |
$1,561.95 |
$2,403 |
4.5× |
| MRA head w/o contrast (70544) |
$1,337.70 |
$2,058 |
5.6× |
| MRA head with contrast (70545) |
$1,450.15 |
$2,231 |
4.1× |
| MRA neck w contrast (70548) |
$1,450.15 |
$2,231 |
4.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,561.95 |
$2,403 |
4.5× |
| MRA neck w/o contrast (70547) |
$1,337.70 |
$2,058 |
5.6× |
| MRI abdomen w contrast (74182) |
$1,450.15 |
$2,231 |
4.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,561.95 |
$2,403 |
4.5× |
| MRI abdomen w/o contrast (74181) |
$1,337.70 |
$2,058 |
5.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,450.15 |
$2,231 |
1.8× |
| MRI c-spine with contrast (72142) |
$1,450.15 |
$2,231 |
4.1× |
| MRI cervical spine w/o contrast (72141) |
$1,337.70 |
$2,058 |
5.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,561.95 |
$2,403 |
4.5× |
| MRI chest w/o contrast (71550) |
$1,337.70 |
$2,058 |
5.6× |
| MRI chest with contrast (71551) |
$1,450.15 |
$2,231 |
1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,337.70 |
$2,058 |
5.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,299.35 |
$1,999 |
5.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,561.95 |
$2,403 |
4.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,407.25 |
$2,165 |
4.0× |
| MRI pelvis w contrast (72196) |
$1,450.15 |
$2,231 |
4.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,561.95 |
$2,403 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$1,337.70 |
$2,058 |
5.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,487.20 |
$2,288 |
4.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,487.20 |
$2,288 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,561.95 |
$2,403 |
4.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,450.15 |
$2,231 |
4.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,561.95 |
$2,403 |
4.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,450.15 |
$2,231 |
4.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,561.95 |
$2,403 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,337.70 |
$2,058 |
5.6× |
| MRI tmj (70336) |
$1,337.70 |
$2,058 |
5.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,337.70 |
$2,058 |
5.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,561.95 |
$2,403 |
4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,337.70 |
$2,058 |
5.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,797.76 |
$4,304.25 |
2.2× |
| Neck soft tissue (70360) |
$179.40 |
$276 |
2.1× |
| Nm gastric emptying study (78264) |
$1,278.88 |
$1,967.50 |
3.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$311.35 |
$479 |
3.0× |
| Osseous survey infant (77076) |
$443.30 |
$682 |
4.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,309.10 |
$2,014 |
3.3× |
| Parathyroid imaging (78070) |
$445.90 |
$686 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$148.85 |
$229 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,487.20 |
$2,288 |
4.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$893.75 |
$1,375 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$854.75 |
$1,315 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$108.55 |
$167 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$304.20 |
$468 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$306.80 |
$472 |
2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$249.60 |
$384 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$170.30 |
$262 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$156 |
$240 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$525.20 |
$808 |
3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$646.10 |
$994 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$590.20 |
$908 |
3.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$579.15 |
$891 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$182.65 |
$281 |
2.1× |
| Ribs bilateral 3 views (71110) |
$306.80 |
$472 |
2.9× |
| Scanogram (77073) |
$462.15 |
$711 |
4.4× |
| Scapula complete (73010) |
$245.70 |
$378 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$57.20 |
$88 |
2.4× |
| Small bowel series (74250) |
$396.50 |
$610 |
2.3× |
| Spine thoracic 3 views (72072) |
$295.75 |
$455 |
2.8× |
| Thoracolumbar 2 views (72080) |
$415.35 |
$639 |
4.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$681.85 |
$1,049 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$474.50 |
$730 |
4.5× |
| Upper Extremity Infant (73092) |
$487.18 |
$749.50 |
4.7× |
| Us abdl aorta screen aaa (76706) |
$232.70 |
$358 |
2.2× |
| Us breast unilateral complete (76641) |
$429 |
$660 |
4.1× |
| Us breast unilateral limited (76642) |
$352.95 |
$543 |
4.0× |
| Us chest (76604) |
$414.05 |
$637 |
4.0× |
| Us compl joint r-t w/image documentation (76881) |
$368.55 |
$567 |
3.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$388.05 |
$597 |
3.7× |
| Us ob detailed single fetus (76811) |
$388.05 |
$597 |
1.6× |
| Us ob transvaginal (76817) |
$477.75 |
$735 |
4.6× |
| Us pelvic non ob complete (76856) |
$479.05 |
$737 |
4.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$256.10 |
$394 |
2.4× |
| Us pregnancy ltd (76815) |
$388.05 |
$597 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$274.30 |
$422 |
2.6× |
| Us retroperitoneal complete (76770) |
$474.50 |
$730 |
4.5× |
| Us retroperitoneal limited (76775) |
$230.10 |
$354 |
2.2× |
| Us scrotum and contents (76870) |
$474.50 |
$730 |
4.5× |
| Us soft tissue head/neck (76536) |
$373.75 |
$575 |
3.6× |
| Us xtr non-vasc lmtd (76882) |
$352.95 |
$543 |
3.4× |
| Wrist 2 views (73100) |
$126.10 |
$194 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$295.75 |
$455 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$268.45 |
$413 |
3.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$176.15 |
$271 |
2.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$773.50 |
$1,190 |
4.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$152.75 |
$235 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$213.20 |
$328 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$273 |
$420 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$232.70 |
$358 |
2.7× |
| X-ray eye for foreign body (70030) |
$444.60 |
$684 |
5.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$291.85 |
$449 |
2.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$176.15 |
$271 |
2.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$152.75 |
$235 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$191.10 |
$294 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$241.80 |
$372 |
2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$117 |
$180 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$223.60 |
$344 |
2.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$373.10 |
$574 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$249.60 |
$384 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$524.55 |
$807 |
5.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$217.75 |
$335 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$141.70 |
$218 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$280.80 |
$432 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$327.60 |
$504 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$202.80 |
$312 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$280.15 |
$431 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$195 |
$300 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$241.80 |
$372 |
2.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$152.75 |
$235 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$306.80 |
$472 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$229.45 |
$353 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$134.55 |
$207 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$183.30 |
$282 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$209.30 |
$322 |
2.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$249.60 |
$384 |
2.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$172.90 |
$266 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$176.15 |
$271 |
2.0× |
| Xr chest 4+ views (71048) |
$254.80 |
$392 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$182.65 |
$281 |
2.1× |
| Xr optic foramina (70190) |
$232.05 |
$357 |
2.7× |
| Xr shoulder 1 view (73020) |
$144.30 |
$222 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$330.20 |
$508 |
3.2× |
| Xr tibia/fibula 2 views (73590) |
$176.15 |
$271 |
2.0× |
| Xr tmj bilateral (70330) |
$280.80 |
$432 |
3.2× |
| Xray knee 1 or 2 views rt (73560) |
$152.75 |
$235 |
1.8× |