| Abdomen 2 views (74019) |
$49.95 |
$277.50 |
0.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$405.27 |
$2,251.50 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$4,064.90 |
$22,582.75 |
1.4× |
| Ankle 2 views (73600) |
$186.66 |
$1,037 |
2.4× |
| Arthrogram elbow (73085) |
$248.81 |
$1,382.25 |
0.8× |
| Arthrogram hip (73525) |
$446.99 |
$2,483.25 |
1.4× |
| Arthrogram shoulder (73040) |
$540.86 |
$3,004.75 |
1.7× |
| Arthrogram wrist (73115) |
$446.99 |
$2,483.25 |
1.4× |
| Arthrography knee lt (73580) |
$446.99 |
$2,483.25 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$166.50 |
$925 |
0.5× |
| Bone &/joint imaging whole body (78306) |
$1,281.33 |
$7,118.50 |
3.6× |
| Bone age studies (77072) |
$138.56 |
$769.75 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$1,339.92 |
$7,444 |
3.8× |
| Bone survey complete (77075) |
$646.43 |
$3,591.25 |
7.0× |
| Cervical spine 2 or 3 views (72040) |
$338.85 |
$1,882.50 |
4.4× |
| Chest 1 view (71045) |
$188.73 |
$1,048.50 |
2.4× |
| Chest 3 views (71047) |
$190.22 |
$1,056.75 |
2.5× |
| Clavicle complete (73000) |
$310.95 |
$1,727.50 |
4.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$49.95 |
$277.50 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,681.91 |
$14,899.50 |
8.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,377.31 |
$13,207.25 |
11.2× |
| CT abdomen w contrast (74160) |
$1,596.47 |
$8,869.25 |
10.2× |
| CT abdomen w wo contrast (74170) |
$1,982.79 |
$11,015.50 |
12.7× |
| CT abdomen w/o contrast (74150) |
$1,404.18 |
$7,801 |
15.1× |
| CT angiography upper extremity lt (73206) |
$1,640.97 |
$9,116.50 |
10.5× |
| CT c-spine w/o contrast (72125) |
$1,368.90 |
$7,605 |
14.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,949.63 |
$10,831.25 |
12.5× |
| CT cervical spine with contrast (72126) |
$1,795.73 |
$9,976.25 |
5.8× |
| CT chest w/wo contrast (71270) |
$1,896.08 |
$10,533.75 |
12.2× |
| CT chest with contrast (71260) |
$1,624.41 |
$9,024.50 |
10.4× |
| CT head/brain with contrast (70460) |
$1,642.68 |
$9,126 |
10.5× |
| CT head/brain without and with contrast (70470) |
$1,804.73 |
$10,026.25 |
11.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$82.71 |
$459.50 |
1.1× |
| CT iac w contrast (70481) |
$102.24 |
$568 |
0.7× |
| CT limited/localized follow up study (76380) |
$15.81 |
$87.83 |
0.2× |
| CT lower ext w/o (73700) |
$1,368.90 |
$7,605 |
14.7× |
| CT lower extremity w wo contrast (73702) |
$1,090.08 |
$6,056 |
7.0× |
| CT lower extremity with contrast (73701) |
$1,836.23 |
$10,201.25 |
11.8× |
| CT lumbar spine w & w/o contrast (72133) |
$1,991.61 |
$11,064.50 |
12.8× |
| CT lumbar spine w/o contrast (72131) |
$1,375.20 |
$7,640 |
14.8× |
| CT lumbar spine with contrast (72132) |
$1,788.17 |
$9,934.25 |
5.8× |
| CT maxillofacial w contrast (70487) |
$1,311.98 |
$7,288.75 |
8.4× |
| CT maxillofacial w/o contrast (70486) |
$1,349.37 |
$7,496.50 |
14.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,685.70 |
$9,365 |
10.8× |
| CT neck soft tissue w contrast (70491) |
$1,592.91 |
$8,849.50 |
10.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,784.39 |
$9,913.25 |
11.5× |
| CT orbits w/o contrast (70480) |
$1,223.60 |
$6,797.75 |
13.2× |
| CT pelvis w & w/o contrast (72194) |
$1,783.98 |
$9,911 |
11.5× |
| CT pelvis w/o contrast (72192) |
$1,317.65 |
$7,320.25 |
14.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,721.61 |
$9,564.50 |
11.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,451.61 |
$8,064.50 |
15.6× |
| CT thoracic spine w/contrast (72129) |
$1,748.70 |
$9,715 |
11.2× |
| CT thoracic spine w/o contrast (72128) |
$1,399.77 |
$7,776.50 |
15.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,949.63 |
$10,831.25 |
12.5× |
| CT thorax w/o contrast (71250) |
$1,335.74 |
$7,420.75 |
14.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,440.05 |
$8,000.25 |
15.5× |
| CT upper extremity with contrast (73201) |
$1,090.08 |
$6,056 |
3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,690.73 |
$14,948.50 |
17.3× |
| Cta Abdomen (74175) |
$1,739.88 |
$9,666 |
11.2× |
| CTA abdomen pelvis (74174) |
$2,172.15 |
$12,067.50 |
7.0× |
| CTA chest (71275) |
$1,370.97 |
$7,616.50 |
8.8× |
| Cta Head (70496) |
$1,609.70 |
$8,942.75 |
10.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,381.84 |
$18,788 |
10.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,972.31 |
$10,957.25 |
12.7× |
| Cta Neck (70498) |
$1,772.01 |
$9,844.50 |
11.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$179.51 |
$997.25 |
1.9× |
| Echoencephalography real time imaging (76506) |
$494.42 |
$2,746.75 |
5.3× |
| Esophagus (74220) |
$242.51 |
$1,347.25 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$467.15 |
$2,595.25 |
5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$521.10 |
$2,895 |
5.6× |
| Fluoroscopy up to 1 hr (76000) |
$300.02 |
$1,666.75 |
1.4× |
| Foot 2 views (73620) |
$281.12 |
$1,561.75 |
3.6× |
| Forearm 2 views (73090) |
$243.14 |
$1,350.75 |
3.1× |
| Gated Heart Planar Single (78472) |
$1,249.43 |
$6,941.25 |
3.5× |
| Hand 2 views (73120) |
$189.59 |
$1,053.25 |
2.0× |
| Hand 3 views (73130) |
$330.03 |
$1,833.50 |
4.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,259.28 |
$6,996 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,224.63 |
$6,803.50 |
3.4× |
| Ht muscle image spect sing (78451) |
$2,289.74 |
$12,720.75 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$251.51 |
$1,397.25 |
3.3× |
| Hysterosalpingogram (74740) |
$772.61 |
$4,292.25 |
3.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,252.17 |
$6,956.50 |
2.6× |
| Knee 3 views (73562) |
$297.72 |
$1,654 |
3.9× |
| Liver & spleen imaging static only (78215) |
$797 |
$4,427.75 |
2.2× |
| Lymphoscintigraphy (78195) |
$997.07 |
$5,539.25 |
2.1× |
| MRA head w/o contrast (70544) |
$1,353.15 |
$7,517.50 |
6.4× |
| MRA neck w/o contrast (70547) |
$865.44 |
$4,808 |
4.1× |
| MRI abdomen w contrast (74182) |
$1,295.60 |
$7,197.75 |
4.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,936.40 |
$10,757.75 |
6.2× |
| MRI abdomen w/o contrast (74181) |
$1,666.40 |
$9,257.75 |
7.9× |
| MRI any jnt lwr ext with con lt (73722) |
$1,110.76 |
$6,170.88 |
1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,153.49 |
$6,408.25 |
1.7× |
| MRI c-spine with contrast (72142) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI cervical spine w/o contrast (72141) |
$903.65 |
$5,020.25 |
4.3× |
| MRI chest w/o contrast (71550) |
$415.94 |
$2,310.75 |
2.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$450.77 |
$2,504.25 |
1.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,862.28 |
$10,346 |
8.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$865.44 |
$4,808 |
4.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI pelvis w contrast (72196) |
$363.83 |
$2,021.25 |
1.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,660.32 |
$9,224 |
5.4× |
| MRI pelvis w/o contrast (72195) |
$865.44 |
$4,808 |
4.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,709 |
$15,050 |
8.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,465.47 |
$8,141.50 |
6.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,153.49 |
$6,408.25 |
5.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,153.49 |
$6,408.25 |
3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$946.69 |
$5,259.38 |
4.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,349.99 |
$13,055.50 |
2.0× |
| Neck soft tissue (70360) |
$260.33 |
$1,446.25 |
3.4× |
| Nm gastric emptying study (78264) |
$1,160.82 |
$6,449 |
3.3× |
| Nuclear Rx Oral Admin (79005) |
$1,286.37 |
$7,146.50 |
6.2× |
| Parathyroid imaging (78070) |
$836.24 |
$4,645.75 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$227.16 |
$1,262 |
2.4× |
| PET image w/CT, skull-thigh (78815) |
$6,317.46 |
$35,097 |
5.0× |
| PET imaging for CT attenuation whole body (78816) |
$6,317.46 |
$35,097 |
5.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,853.87 |
$10,299.25 |
6.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$961.56 |
$5,342 |
2.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,836.23 |
$10,201.25 |
3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$288.27 |
$1,601.50 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$60.48 |
$336 |
0.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$100.35 |
$557.50 |
1.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$100.35 |
$557.50 |
1.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$192.11 |
$1,067.25 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$304.83 |
$1,693.50 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$243.14 |
$1,350.75 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$348.93 |
$1,938.50 |
3.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$239.36 |
$1,329.75 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$703.13 |
$3,906.25 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$687.83 |
$3,821.25 |
4.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$305.06 |
$1,694.75 |
3.9× |
| Radiological examination surgical specimen (76098) |
$87.98 |
$488.75 |
0.2× |
| Ribs bilateral 3 views (71110) |
$470.93 |
$2,616.25 |
5.1× |
| Sacroiliac Joints < 3 Views (72200) |
$199.44 |
$1,108 |
2.1× |
| Scapula complete (73010) |
$281.75 |
$1,565.25 |
3.0× |
| Screening digital breast tomosynthesis (77063) |
$20.39 |
$113.25 |
0.9× |
| Small bowel series (74250) |
$538.97 |
$2,994.25 |
3.5× |
| Speech evaluation complex (70371) |
$159.57 |
$886.50 |
0.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$480.15 |
$2,667.50 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$911.39 |
$5,063.25 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$718.88 |
$3,993.75 |
7.7× |
| Urethrocystography voiding (74455) |
$456.03 |
$2,533.50 |
2.2× |
| Us breast unilateral complete (76641) |
$396.81 |
$2,204.50 |
4.3× |
| Us breast unilateral limited (76642) |
$339.93 |
$1,888.50 |
4.4× |
| Us chest (76604) |
$112.73 |
$626.25 |
1.2× |
| Us compl joint r-t w/image documentation (76881) |
$144.45 |
$802.50 |
1.6× |
| Us ob transvaginal (76817) |
$456.44 |
$2,535.75 |
4.9× |
| Us pelvic non ob complete (76856) |
$598.59 |
$3,325.50 |
6.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$530.33 |
$2,946.25 |
5.7× |
| Us pregnancy ltd (76815) |
$382.10 |
$2,122.75 |
4.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$424.31 |
$2,357.25 |
4.6× |
| Us retroperitoneal complete (76770) |
$697.23 |
$3,873.50 |
7.5× |
| Us retroperitoneal limited (76775) |
$530.78 |
$2,948.75 |
5.7× |
| Us scrotum and contents (76870) |
$572.54 |
$3,180.75 |
6.2× |
| Us soft tissue head/neck (76536) |
$581.76 |
$3,232 |
6.3× |
| Us spinal canal and contents (76800) |
$450.14 |
$2,500.75 |
4.8× |
| Us xtr non-vasc lmtd (76882) |
$89.46 |
$497 |
1.0× |
| Wrist 2 views (73100) |
$191.88 |
$1,066 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$422.24 |
$2,345.75 |
4.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$225.72 |
$1,254 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$310.10 |
$1,722.75 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$336.33 |
$1,868.50 |
4.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$270.86 |
$1,504.75 |
3.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$192.11 |
$1,067.25 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$60.48 |
$336 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$60.48 |
$336 |
0.8× |
| X-ray exam hip uni 4/> views (73503) |
$100.35 |
$557.50 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$100.35 |
$557.50 |
1.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$192.11 |
$1,067.25 |
2.1× |
| X-ray exam of femur 1 (73551) |
$60.48 |
$336 |
0.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$409.82 |
$2,276.75 |
4.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$286.38 |
$1,591 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$284.49 |
$1,580.50 |
3.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$317.88 |
$1,766 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$278.42 |
$1,546.75 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$190.22 |
$1,056.75 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$204.30 |
$1,135 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$407.52 |
$2,264 |
4.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$440.46 |
$2,447 |
4.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$314.73 |
$1,748.50 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$286.38 |
$1,591 |
3.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$191.70 |
$1,065 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$566.64 |
$3,148 |
7.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$541.49 |
$3,008.25 |
5.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$443.84 |
$2,465.75 |
4.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$270.41 |
$1,502.25 |
3.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$282.20 |
$1,567.75 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$316.62 |
$1,759 |
4.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$265.82 |
$1,476.75 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$475.11 |
$2,639.50 |
5.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$240.80 |
$1,337.75 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$194.63 |
$1,081.25 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$256.77 |
$1,426.50 |
3.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$373.91 |
$2,077.25 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$202.19 |
$1,123.25 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$322.47 |
$1,791.50 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$445.50 |
$2,475 |
4.8× |
| Xr chest 4+ views (71048) |
$193.59 |
$1,075.50 |
2.1× |
| Xr finger(s) 2+ views (73140) |
$227.61 |
$1,264.50 |
2.9× |
| Xr shoulder 1 view (73020) |
$231.35 |
$1,285.25 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$393.66 |
$2,187 |
4.2× |
| Xr tibia/fibula 2 views (73590) |
$283.64 |
$1,575.75 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$301.28 |
$1,673.75 |
3.9× |