| Abdomen 2 views (74019) |
$391 |
$782 |
3.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,827 |
$3,654 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$3,583 |
$7,166 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$4,886.50 |
$9,773 |
1.5× |
| Angiography internal mammary rs&i (75756) |
$1,749.50 |
$3,499 |
0.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,607.50 |
$7,215 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,998.50 |
$3,997 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,831.50 |
$3,663 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,246 |
$4,492 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,749.50 |
$3,499 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,104 |
$4,208 |
0.7× |
| Ankle 2 views (73600) |
$282.50 |
$565 |
3.2× |
| Aortogram thoracic (75605) |
$3,490 |
$6,980 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,583 |
$7,166 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$3,583 |
$7,166 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$1,749.50 |
$3,499 |
0.6× |
| Arthrogram hip (73525) |
$416 |
$832 |
1.2× |
| Arthrogram shoulder (73040) |
$416 |
$832 |
1.2× |
| Arthrogram wrist (73115) |
$375.50 |
$751 |
1.1× |
| Arthrography knee lt (73580) |
$526 |
$1,052 |
1.5× |
| Bone age studies (77072) |
$269 |
$538 |
2.6× |
| Bone survey complete (77075) |
$1,170.50 |
$2,341 |
11.1× |
| Cervical spine 2 or 3 views (72040) |
$420 |
$840 |
4.8× |
| Chest 1 view (71045) |
$300.50 |
$601 |
3.4× |
| Chest 3 views (71047) |
$348.50 |
$697 |
4.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$524.50 |
$1,049 |
3.0× |
| Clavicle complete (73000) |
$269 |
$538 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$170.50 |
$341 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,006 |
$10,012 |
14.3× |
| CT abdomen and pelvis without contrast (74176) |
$3,769.50 |
$7,539 |
15.7× |
| CT abdomen w contrast (74160) |
$2,273 |
$4,546 |
12.9× |
| CT abdomen w wo contrast (74170) |
$2,569 |
$5,138 |
14.6× |
| CT abdomen w/o contrast (74150) |
$1,977 |
$3,954 |
18.8× |
| CT angiography upper extremity lt (73206) |
$3,730.50 |
$7,461 |
21.2× |
| CT c-spine w/o contrast (72125) |
$2,112.50 |
$4,225 |
20.1× |
| CT cervical spine w&w/o contrast (72127) |
$2,745.50 |
$5,491 |
15.6× |
| CT cervical spine with contrast (72126) |
$2,429 |
$4,858 |
6.9× |
| CT chest w/wo contrast (71270) |
$2,547.50 |
$5,095 |
14.5× |
| CT chest with contrast (71260) |
$2,252.50 |
$4,505 |
12.8× |
| CT head/brain with contrast (70460) |
$2,057.50 |
$4,115 |
11.7× |
| CT head/brain without and with contrast (70470) |
$2,325.50 |
$4,651 |
13.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$129 |
$258 |
1.5× |
| CT iac w contrast (70481) |
$2,049.50 |
$4,099 |
11.6× |
| CT limited/localized follow up study (76380) |
$1,422.50 |
$2,845 |
16.3× |
| CT lower ext w/o (73700) |
$1,819.50 |
$3,639 |
17.3× |
| CT lower extremity w wo contrast (73702) |
$2,365 |
$4,730 |
13.4× |
| CT lower extremity with contrast (73701) |
$2,092.50 |
$4,185 |
11.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,943 |
$5,886 |
16.7× |
| CT lumbar spine w/o contrast (72131) |
$2,263 |
$4,526 |
21.5× |
| CT lumbar spine with contrast (72132) |
$2,602 |
$5,204 |
7.4× |
| CT maxillofacial w contrast (70487) |
$1,952.50 |
$3,905 |
11.1× |
| CT maxillofacial w/o contrast (70486) |
$1,698.50 |
$3,397 |
16.2× |
| CT maxillofacial w/wo contrast (70488) |
$2,208 |
$4,416 |
12.5× |
| CT neck soft tissue w contrast (70491) |
$2,257 |
$4,514 |
12.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,316.50 |
$4,633 |
13.1× |
| CT orbits w/o contrast (70480) |
$1,782 |
$3,564 |
17.0× |
| CT pelvis w & w/o contrast (72194) |
$2,545 |
$5,090 |
14.4× |
| CT pelvis w/o contrast (72192) |
$1,958 |
$3,916 |
18.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,552 |
$5,104 |
14.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,962.50 |
$3,925 |
18.7× |
| CT thoracic spine w/contrast (72129) |
$2,577 |
$5,154 |
14.6× |
| CT thoracic spine w/o contrast (72128) |
$2,240.50 |
$4,481 |
21.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,912.50 |
$5,825 |
16.5× |
| CT thorax w/o contrast (71250) |
$1,959.50 |
$3,919 |
18.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,177 |
$4,354 |
12.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,675 |
$3,350 |
15.9× |
| CT upper extremity with contrast (73201) |
$1,925.50 |
$3,851 |
5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,431 |
$4,862 |
13.8× |
| Cta Abdomen (74175) |
$3,111.50 |
$6,223 |
17.7× |
| CTA abdomen pelvis (74174) |
$4,607.50 |
$9,215 |
13.1× |
| CTA chest (71275) |
$2,835.50 |
$5,671 |
16.1× |
| Cta Head (70496) |
$2,824.50 |
$5,649 |
16.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,783 |
$3,566 |
5.1× |
| CTA lwr ext w&w/o contrast (73706) |
$3,210 |
$6,420 |
18.2× |
| Cta Neck (70498) |
$2,883 |
$5,766 |
16.4× |
| Cta Pelvis (72191) |
$2,808.50 |
$5,617 |
15.9× |
| Cystography minimum 3 views rs&i (74430) |
$536 |
$1,072 |
1.5× |
| Diskography lumbar (72295) |
$1,718 |
$3,436 |
0.9× |
| Esophagus (74220) |
$442.50 |
$885 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$216.50 |
$433 |
0.9× |
| Foot 2 views (73620) |
$243 |
$486 |
2.8× |
| Forearm 2 views (73090) |
$324 |
$648 |
3.7× |
| Hand 2 views (73120) |
$277 |
$554 |
2.6× |
| Hand 3 views (73130) |
$283.50 |
$567 |
3.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,083 |
$6,166 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$283.50 |
$567 |
3.2× |
| Knee 3 views (73562) |
$204 |
$408 |
2.3× |
| MRA head w & w/o contrast (70546) |
$2,644 |
$5,288 |
7.5× |
| MRA head w/o contrast (70544) |
$1,977.50 |
$3,955 |
8.3× |
| MRA head with contrast (70545) |
$2,273.50 |
$4,547 |
6.5× |
| MRA neck w contrast (70548) |
$2,338.50 |
$4,677 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,644 |
$5,288 |
7.5× |
| MRA neck w/o contrast (70547) |
$2,034 |
$4,068 |
8.5× |
| MRI abdomen w contrast (74182) |
$2,625 |
$5,250 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,967 |
$5,934 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$2,282.50 |
$4,565 |
9.5× |
| MRI any jnt lwr ext with con lt (73722) |
$2,805.50 |
$5,611 |
3.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,751.50 |
$5,503 |
3.5× |
| MRI c-spine with contrast (72142) |
$2,783 |
$5,566 |
7.9× |
| MRI cervical spine w/o contrast (72141) |
$2,419 |
$4,838 |
10.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,723.50 |
$5,447 |
7.8× |
| MRI chest w/o contrast (71550) |
$2,095 |
$4,190 |
8.7× |
| MRI chest with contrast (71551) |
$2,408.50 |
$4,817 |
3.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,192 |
$4,384 |
6.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,645.50 |
$5,291 |
7.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,300.50 |
$4,601 |
9.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,091 |
$4,182 |
8.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,717.50 |
$5,435 |
7.8× |
| MRI orbit/face/neck w/contrast (70542) |
$2,404 |
$4,808 |
6.9× |
| MRI pelvis w contrast (72196) |
$2,337.50 |
$4,675 |
6.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,642 |
$5,284 |
7.5× |
| MRI pelvis w/o contrast (72195) |
$2,032.50 |
$4,065 |
8.5× |
| MRI scan of arm joint before and after contrast (73223) |
$3,110 |
$6,220 |
8.9× |
| MRI scan of leg joint before and after contrast (73723) |
$3,171.50 |
$6,343 |
9.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,146 |
$6,292 |
9.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,824 |
$5,648 |
8.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,191.50 |
$6,383 |
9.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,652.50 |
$5,305 |
7.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,998 |
$5,996 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,307 |
$4,614 |
9.6× |
| MRI tmj (70336) |
$1,890 |
$3,780 |
7.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,392 |
$4,784 |
10.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,478.50 |
$4,957 |
7.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,906 |
$3,812 |
8.0× |
| Neck soft tissue (70360) |
$187 |
$374 |
2.1× |
| Osseous survey infant (77076) |
$629.50 |
$1,259 |
6.0× |
| Osseous survey limited (77074) |
$1,203.50 |
$2,407 |
11.5× |
| Pelvis 1 or 2 views (72170) |
$334 |
$668 |
3.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,753.50 |
$5,507 |
7.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,895 |
$3,790 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,895 |
$3,790 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$467 |
$934 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$501.50 |
$1,003 |
4.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$303.50 |
$607 |
3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$478.50 |
$957 |
4.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$324.50 |
$649 |
3.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$442.50 |
$885 |
2.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$707.50 |
$1,415 |
4.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$707.50 |
$1,415 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$355.50 |
$711 |
4.1× |
| Radiological examination surgical specimen (76098) |
$434.50 |
$869 |
0.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,749.50 |
$3,499 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,468.50 |
$6,937 |
1.1× |
| Ribs bilateral 3 views (71110) |
$493.50 |
$987 |
4.7× |
| Scanogram (77073) |
$491 |
$982 |
4.7× |
| Scapula complete (73010) |
$263.50 |
$527 |
2.5× |
| Small bowel series (74250) |
$584 |
$1,168 |
3.3× |
| Spine thoracic 3 views (72072) |
$467 |
$934 |
4.4× |
| Splenoportograpy rs&i (75810) |
$1,749.50 |
$3,499 |
0.6× |
| Superior sagittal sinus venogram (75870) |
$1,749.50 |
$3,499 |
0.6× |
| Therapeutic Enema (74283) |
$981.50 |
$1,963 |
5.6× |
| Thoracolumbar 2 views (72080) |
$373 |
$746 |
4.3× |
| Ultrasound, abdomen limited (76705) |
$506.50 |
$1,013 |
4.8× |
| Upper Extremity Infant (73092) |
$324 |
$648 |
3.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$756.50 |
$1,513 |
4.3× |
| Us abdl aorta screen aaa (76706) |
$506.50 |
$1,013 |
4.8× |
| Us breast unilateral limited (76642) |
$180 |
$360 |
2.1× |
| Us chest (76604) |
$188 |
$376 |
1.8× |
| Us ob transvaginal (76817) |
$414.50 |
$829 |
3.9× |
| Us pelvic non ob complete (76856) |
$629.50 |
$1,259 |
6.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$330.50 |
$661 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$531.50 |
$1,063 |
5.1× |
| Us retroperitoneal complete (76770) |
$708 |
$1,416 |
6.7× |
| Us retroperitoneal limited (76775) |
$549.50 |
$1,099 |
5.2× |
| Us scrotum and contents (76870) |
$573.50 |
$1,147 |
5.5× |
| Us soft tissue head/neck (76536) |
$497 |
$994 |
4.7× |
| Us xtr non-vasc lmtd (76882) |
$506.50 |
$1,013 |
4.8× |
| Venogram extremity bilateral (75822) |
$1,441.50 |
$2,883 |
0.9× |
| Venogram orbital (75880) |
$629.50 |
$1,259 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,066 |
$6,132 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,749.50 |
$3,499 |
1.1× |
| Venography epidural rs&i (75872) |
$1,746.50 |
$3,493 |
2.8× |
| Venography extremity unilateral rs&i (75820) |
$1,163 |
$2,326 |
0.7× |
| Venography Renal Bilateral (75833) |
$1,917 |
$3,834 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$2,583.50 |
$5,167 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,810.50 |
$3,621 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,738.50 |
$7,477 |
0.7× |
| Wrist 2 views (73100) |
$318.50 |
$637 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$478.50 |
$957 |
4.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$351.50 |
$703 |
4.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$377.50 |
$755 |
4.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$814 |
$1,628 |
4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$324 |
$648 |
3.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$154.50 |
$309 |
1.8× |
| X-ray exam hip uni 1 view (73501) |
$250.50 |
$501 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$418 |
$836 |
4.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$442 |
$884 |
4.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$353 |
$706 |
4.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$324 |
$648 |
3.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$258.50 |
$517 |
3.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$242.50 |
$485 |
2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$204 |
$408 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$410 |
$820 |
4.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$373 |
$746 |
3.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$467 |
$934 |
4.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$283.50 |
$567 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$60.50 |
$121 |
0.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$574 |
$1,148 |
5.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$334.50 |
$669 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$300.50 |
$601 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$589.50 |
$1,179 |
5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$353 |
$706 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$353 |
$706 |
4.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$339.50 |
$679 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$422 |
$844 |
4.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$501.50 |
$1,003 |
4.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$251 |
$502 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$373 |
$746 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$258.50 |
$517 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$311 |
$622 |
3.6× |
| Xr arthrogram ankle (73615) |
$452 |
$904 |
1.3× |
| Xr chest 4+ views (71048) |
$373 |
$746 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$214 |
$428 |
2.4× |
| Xr shoulder 1 view (73020) |
$324 |
$648 |
3.7× |
| Xr spine cervical 4 or 5 views (72050) |
$706 |
$1,412 |
6.7× |
| Xr tibia/fibula 2 views (73590) |
$410 |
$820 |
4.7× |
| Xray knee 1 or 2 views rt (73560) |
$135 |
$270 |
1.5× |