| Abdomen 2 views (74019) |
$341.17 |
$426.46 |
3.1× |
| Ankle 2 views (73600) |
$261.22 |
$326.52 |
2.8× |
| Arthrogram hip (73525) |
$1,174.41 |
$1,468.01 |
3.2× |
| Arthrogram shoulder (73040) |
$1,148.17 |
$1,435.21 |
3.1× |
| Arthrography knee lt (73580) |
$1,300.72 |
$1,625.89 |
3.5× |
| Bone age studies (77072) |
$309.81 |
$387.26 |
2.8× |
| Bone survey complete (77075) |
$775.02 |
$968.78 |
7.0× |
| Cervical spine 2 or 3 views (72040) |
$308.38 |
$385.46 |
3.4× |
| Chest 1 view (71045) |
$242.76 |
$303.44 |
2.6× |
| Chest 3 views (71047) |
$392.02 |
$490.02 |
4.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,234.29 |
$1,542.86 |
6.7× |
| Clavicle complete (73000) |
$257.52 |
$321.90 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,782.66 |
$2,228.32 |
16.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,572.20 |
$3,215.25 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,324.43 |
$1,655.53 |
5.3× |
| CT abdomen w contrast (74160) |
$1,764.53 |
$2,205.66 |
9.5× |
| CT abdomen w wo contrast (74170) |
$2,006.84 |
$2,508.54 |
10.8× |
| CT abdomen w/o contrast (74150) |
$859.60 |
$1,074.50 |
7.8× |
| CT angiography upper extremity lt (73206) |
$2,294.47 |
$2,868.08 |
12.4× |
| CT c-spine w/o contrast (72125) |
$1,487.61 |
$1,859.51 |
13.5× |
| CT chest w/wo contrast (71270) |
$1,569.20 |
$1,961.50 |
8.5× |
| CT chest with contrast (71260) |
$1,284.87 |
$1,606.08 |
6.9× |
| CT head/brain with contrast (70460) |
$1,557.67 |
$1,947.08 |
8.4× |
| CT head/brain without and with contrast (70470) |
$1,826.34 |
$2,282.92 |
9.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$80 |
$100 |
0.9× |
| CT iac w contrast (70481) |
$2,140.35 |
$2,675.43 |
11.6× |
| CT lower ext w/o (73700) |
$1,480.20 |
$1,850.24 |
13.4× |
| CT lower extremity with contrast (73701) |
$1,851.89 |
$2,314.86 |
10.0× |
| CT lumbar spine w & w/o contrast (72133) |
$2,193.09 |
$2,741.36 |
11.9× |
| CT lumbar spine w/o contrast (72131) |
$1,480.20 |
$1,850.24 |
13.4× |
| CT lumbar spine with contrast (72132) |
$1,871.67 |
$2,339.58 |
5.1× |
| CT maxillofacial w contrast (70487) |
$1,595.58 |
$1,994.47 |
8.6× |
| CT maxillofacial w/o contrast (70486) |
$1,331.02 |
$1,663.77 |
12.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,946.67 |
$2,433.33 |
10.5× |
| CT neck soft tissue w contrast (70491) |
$1,935.13 |
$2,418.91 |
10.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,371.12 |
$2,963.89 |
12.8× |
| CT orbits w/o contrast (70480) |
$1,915.35 |
$2,394.18 |
17.4× |
| CT pelvis w & w/o contrast (72194) |
$2,607.64 |
$3,259.55 |
14.1× |
| CT pelvis w/o contrast (72192) |
$1,387.07 |
$1,733.83 |
12.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,338.97 |
$2,923.71 |
12.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,569.20 |
$1,961.50 |
14.2× |
| CT thoracic spine w/contrast (72129) |
$1,881.56 |
$2,351.95 |
10.2× |
| CT thoracic spine w/o contrast (72128) |
$1,487.61 |
$1,859.51 |
13.5× |
| CT thoracic spine w/wo contrast (72130) |
$815.10 |
$1,018.87 |
4.4× |
| CT thorax w/o contrast (71250) |
$962.62 |
$1,203.27 |
8.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,133.10 |
$3,916.37 |
16.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,710.14 |
$2,137.67 |
15.5× |
| CT upper extremity with contrast (73201) |
$2,129.64 |
$2,662.04 |
5.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,110.68 |
$2,638.34 |
11.4× |
| Cta Abdomen (74175) |
$2,236.77 |
$2,795.96 |
12.1× |
| CTA abdomen pelvis (74174) |
$3,036.20 |
$3,795.26 |
8.3× |
| CTA chest (71275) |
$2,038.15 |
$2,547.68 |
11.0× |
| Cta Head (70496) |
$2,010.13 |
$2,512.66 |
10.9× |
| CTA lwr ext w&w/o contrast (73706) |
$2,513.69 |
$3,142.11 |
13.6× |
| Cta Neck (70498) |
$2,006.84 |
$2,508.54 |
10.8× |
| Cta Pelvis (72191) |
$2,240.07 |
$2,800.08 |
12.1× |
| Cystography minimum 3 views rs&i (74430) |
$380.54 |
$475.67 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$375.62 |
$469.52 |
3.4× |
| Echoencephalography real time imaging (76506) |
$534.06 |
$667.57 |
4.8× |
| Esophagus (74220) |
$775.02 |
$968.78 |
4.2× |
| Fetal biophysical profile non-stress testing (76818) |
$586.80 |
$733.50 |
5.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$553.01 |
$691.26 |
5.0× |
| Fluoroscopy up to 1 hr (76000) |
$397.76 |
$497.20 |
1.6× |
| Foot 2 views (73620) |
$226.77 |
$283.46 |
2.5× |
| Forearm 2 views (73090) |
$233.74 |
$292.17 |
2.5× |
| Hand 2 views (73120) |
$247.27 |
$309.08 |
2.2× |
| Hand 3 views (73130) |
$289.92 |
$362.40 |
3.2× |
| Humerus Min 2 Views Left (73060) |
$257.52 |
$321.90 |
2.8× |
| Knee 3 views (73562) |
$327.64 |
$409.55 |
3.6× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$503.56 |
$629.44 |
5.5× |
| Mr elastography (76391) |
$2,226.06 |
$2,782.57 |
8.8× |
| MRA head w & w/o contrast (70546) |
$3,562.84 |
$4,453.55 |
9.7× |
| MRA head w/o contrast (70544) |
$2,151.88 |
$2,689.85 |
8.5× |
| MRA head with contrast (70545) |
$2,453.53 |
$3,066.91 |
6.7× |
| MRA neck w contrast (70548) |
$2,631.55 |
$3,289.43 |
7.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,734.28 |
$4,667.84 |
10.1× |
| MRA neck w/o contrast (70547) |
$2,357.92 |
$2,947.40 |
9.4× |
| MRI abdomen w contrast (74182) |
$3,368.35 |
$4,210.43 |
9.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,431.80 |
$4,289.75 |
9.3× |
| MRI abdomen w/o contrast (74181) |
$1,973.04 |
$2,466.30 |
7.8× |
| MRI any jnt lwr ext with con lt (73722) |
$3,217.52 |
$4,021.90 |
3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,211.76 |
$4,014.69 |
3.9× |
| MRI c-spine with contrast (72142) |
$3,018.08 |
$3,772.59 |
8.2× |
| MRI cervical spine w/o contrast (72141) |
$1,900.52 |
$2,375.64 |
7.6× |
| MRI chest w/o & w/contrast material (71552) |
$5,308.42 |
$6,635.52 |
14.4× |
| MRI chest w/o contrast (71550) |
$3,803.50 |
$4,754.37 |
15.1× |
| MRI chest with contrast (71551) |
$4,194.16 |
$5,242.69 |
5.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,427.68 |
$4,284.60 |
9.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,674.40 |
$3,343 |
7.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,260.68 |
$2,825.84 |
9.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,496.39 |
$3,120.48 |
9.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,416.15 |
$4,270.18 |
9.3× |
| MRI orbit/face/neck w/contrast (70542) |
$2,965.33 |
$3,706.66 |
8.1× |
| MRI pelvis w contrast (72196) |
$2,971.10 |
$3,713.87 |
8.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,736.75 |
$4,670.93 |
10.2× |
| MRI pelvis w/o contrast (72195) |
$2,334.03 |
$2,917.53 |
9.3× |
| MRI scan of arm joint before and after contrast (73223) |
$3,969.16 |
$4,961.44 |
10.8× |
| MRI scan of leg joint before and after contrast (73723) |
$3,963.39 |
$4,954.23 |
10.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,515.87 |
$4,394.83 |
9.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,970.28 |
$3,712.84 |
8.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,216.70 |
$4,020.87 |
8.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,747.76 |
$3,434.69 |
7.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,522.46 |
$4,403.07 |
9.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,900.52 |
$2,375.64 |
7.6× |
| MRI tmj (70336) |
$2,953.80 |
$3,692.24 |
11.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,015.08 |
$2,518.84 |
8.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,589.75 |
$5,737.18 |
12.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,102.14 |
$3,877.67 |
12.3× |
| Neck soft tissue (70360) |
$247.27 |
$309.08 |
2.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$721.15 |
$901.43 |
6.5× |
| Osseous survey infant (77076) |
$815.20 |
$1,019 |
7.4× |
| Pelvis 1 or 2 views (72170) |
$228.41 |
$285.50 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,734.28 |
$4,667.84 |
10.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$642.98 |
$803.72 |
5.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$378.90 |
$473.62 |
3.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$342.40 |
$428 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$233.33 |
$291.66 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$332.15 |
$415.18 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$310.01 |
$387.51 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$1,221.98 |
$1,527.48 |
6.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$869.74 |
$1,087.18 |
4.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,105.12 |
$1,381.39 |
6.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,144.89 |
$1,431.11 |
6.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$328.05 |
$410.06 |
3.6× |
| Ribs bilateral 3 views (71110) |
$408.42 |
$510.52 |
3.7× |
| Sacroiliac Joints < 3 Views (72200) |
$407.60 |
$509.50 |
3.7× |
| Scapula complete (73010) |
$177.15 |
$221.43 |
1.6× |
| Small bowel series (74250) |
$959.14 |
$1,198.92 |
5.2× |
| Spine thoracic 3 views (72072) |
$310.02 |
$387.52 |
2.8× |
| Therapeutic Enema (74283) |
$2,360.31 |
$2,950.38 |
12.8× |
| Thoracolumbar 2 views (72080) |
$221.44 |
$276.79 |
2.4× |
| Ultrasound elastography first target lesion (76982) |
$613.18 |
$766.47 |
5.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$2,089.25 |
$2,611.56 |
5.7× |
| Ultrasound, abdomen limited (76705) |
$489.56 |
$611.94 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$217.99 |
$272.48 |
2.0× |
| Unlisted Ultrasound Procedure (76999) |
$856.25 |
$1,070.31 |
9.3× |
| Upper Extremity Infant (73092) |
$248.91 |
$311.14 |
2.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,060.01 |
$1,325.01 |
5.7× |
| Us abdl aorta screen aaa (76706) |
$563.73 |
$704.66 |
5.1× |
| Us breast unilateral complete (76641) |
$683.24 |
$854.04 |
6.2× |
| Us breast unilateral limited (76642) |
$864.96 |
$1,081.20 |
9.4× |
| Us chest (76604) |
$321.43 |
$401.78 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$395.60 |
$494.50 |
3.6× |
| Us elastography parenchyma (76981) |
$689 |
$861.25 |
6.2× |
| Us kidney transplant (76776) |
$757.40 |
$946.75 |
6.9× |
| Us ob detailed single fetus (76811) |
$531.59 |
$664.48 |
2.1× |
| Us ob transvaginal (76817) |
$492.02 |
$615.03 |
4.5× |
| Us pelvic non ob complete (76856) |
$591.76 |
$739.68 |
5.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$230.36 |
$287.94 |
2.1× |
| Us pregnancy ltd (76815) |
$433.52 |
$541.88 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$479.66 |
$599.58 |
4.3× |
| Us retroperitoneal complete (76770) |
$606.58 |
$758.23 |
5.5× |
| Us retroperitoneal limited (76775) |
$196.16 |
$245.19 |
1.8× |
| Us scrotum and contents (76870) |
$570.32 |
$712.90 |
5.2× |
| Us soft tissue head/neck (76536) |
$652.74 |
$815.92 |
5.9× |
| Us spinal canal and contents (76800) |
$1,332.67 |
$1,665.83 |
12.1× |
| Us xtr non-vasc lmtd (76882) |
$286.81 |
$358.51 |
2.6× |
| Wrist 2 views (73100) |
$271.06 |
$338.82 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$384.64 |
$480.80 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$258.35 |
$322.93 |
2.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$289.92 |
$362.40 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$230.05 |
$287.56 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$252.19 |
$315.24 |
2.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$748.78 |
$935.97 |
6.8× |
| X-ray exam hip uni 1 view (73501) |
$301 |
$376.24 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$429.75 |
$537.18 |
4.7× |
| X-ray exam hip uni 4/> views (73503) |
$531.44 |
$664.30 |
4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$493.72 |
$617.14 |
4.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$561.79 |
$702.23 |
5.1× |
| X-ray exam of femur 1 (73551) |
$277.20 |
$346.50 |
3.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$3,840.63 |
$4,800.78 |
20.8× |
| X-ray eye for foreign body (70030) |
$253.83 |
$317.28 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$373.16 |
$466.44 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$253.42 |
$316.77 |
2.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$271.06 |
$338.82 |
3.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$228.41 |
$285.50 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$305.50 |
$381.87 |
3.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$362.91 |
$453.64 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$369.06 |
$461.32 |
4.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$248.91 |
$311.14 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$308.38 |
$385.46 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$493.72 |
$617.14 |
4.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$378.08 |
$472.60 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$303.86 |
$379.82 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$351.06 |
$438.82 |
3.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$376.44 |
$470.54 |
3.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$325.59 |
$406.98 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$337.89 |
$422.36 |
3.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$388.74 |
$485.92 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$486.34 |
$607.92 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$306.74 |
$383.42 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$297.71 |
$372.13 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$296.88 |
$371.10 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$294.84 |
$368.54 |
3.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$252.19 |
$315.24 |
2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$351.02 |
$438.77 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$289.92 |
$362.39 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$191.50 |
$239.38 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$296.48 |
$370.60 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$310.84 |
$388.54 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$252.19 |
$315.24 |
2.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$351.02 |
$438.76 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$235.79 |
$294.74 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$327.64 |
$409.55 |
3.6× |
| Xr c-spine 6 or more views (72052) |
$493.72 |
$617.14 |
4.5× |
| Xr Cholecystography Oral Contrast (74290) |
$708.59 |
$885.74 |
3.8× |
| Xr finger(s) 2+ views (73140) |
$305.50 |
$381.87 |
3.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$305.50 |
$381.87 |
2.8× |
| Xr shoulder 1 view (73020) |
$165.26 |
$206.57 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$415.80 |
$519.75 |
3.8× |
| Xr tibia/fibula 2 views (73590) |
$358.81 |
$448.50 |
3.9× |
| Xr tmj bilateral (70330) |
$433.03 |
$541.28 |
4.7× |
| Xray knee 1 or 2 views rt (73560) |
$278.02 |
$347.52 |
3.0× |