| Abdomen 2 views (74019) |
$490.50 |
$654 |
4.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$9,040.50 |
$12,054 |
2.9× |
| Angiography extremity bilateral rs&i (75716) |
$9,492.75 |
$12,657 |
3.0× |
| Angiography extremity unilateral rs&i (75710) |
$9,492.75 |
$12,657 |
3.0× |
| Angiography internal mammary rs&i (75756) |
$11,116.50 |
$14,822 |
3.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$9,040.50 |
$12,054 |
1.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$11,116.50 |
$14,822 |
3.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$9,584.25 |
$12,779 |
3.0× |
| Angiography Spinal Selective Rs&I (75705) |
$9,492.75 |
$12,657 |
1.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,492.75 |
$12,657 |
1.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,333.25 |
$3,111 |
0.7× |
| Ankle 2 views (73600) |
$484.50 |
$646 |
5.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,268.25 |
$1,691 |
3.6× |
| Aortogram thoracic (75605) |
$9,040.50 |
$12,054 |
1.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$9,492.75 |
$12,657 |
3.0× |
| Aortography abdominal serialography rs&i (75625) |
$9,492.75 |
$12,657 |
3.0× |
| Artery X-Rays Adrenal Gland (75731) |
$9,584.25 |
$12,779 |
3.0× |
| Arthrogram elbow (73085) |
$1,700.25 |
$2,267 |
4.9× |
| Arthrogram hip (73525) |
$1,573.50 |
$2,098 |
4.5× |
| Arthrogram shoulder (73040) |
$1,654.50 |
$2,206 |
4.7× |
| Arthrogram wrist (73115) |
$1,146 |
$1,528 |
3.3× |
| Arthrography knee lt (73580) |
$1,769.25 |
$2,359 |
5.0× |
| Basic radiation dosimetry calculation (77300) |
$320.25 |
$427 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,010 |
$2,680 |
5.0× |
| Bone &/joint imaging whole body (78306) |
$2,552.25 |
$3,403 |
6.4× |
| Bone age studies (77072) |
$662.25 |
$883 |
6.3× |
| Bone Imaging 3 Phase (78315) |
$3,038.25 |
$4,051 |
7.6× |
| Bone Marrow Imaging Limited Area (78102) |
$1,057.50 |
$1,410 |
2.6× |
| Bone survey complete (77075) |
$960.75 |
$1,281 |
9.1× |
| Brain image w/flow 4 + views (78606) |
$3,816.75 |
$5,089 |
7.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$8,711.62 |
$11,615.50 |
6.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,125 |
$1,500 |
3.2× |
| Cardiac shunt detection (78428) |
$1,072.12 |
$1,429.50 |
2.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,134.75 |
$1,513 |
2.1× |
| Cervical spine 2 or 3 views (72040) |
$554.25 |
$739 |
6.3× |
| Chest 1 view (71045) |
$420 |
$560 |
4.8× |
| Chest 3 views (71047) |
$618 |
$824 |
7.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$489 |
$652 |
2.8× |
| Clavicle complete (73000) |
$493.50 |
$658 |
5.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$261 |
$348 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$9,751.88 |
$13,002.50 |
27.8× |
| CT abdomen and pelvis without contrast (74176) |
$7,071.75 |
$9,429 |
29.5× |
| CT abdomen w contrast (74160) |
$3,518.25 |
$4,691 |
20.0× |
| CT abdomen w wo contrast (74170) |
$4,843.88 |
$6,458.50 |
27.5× |
| CT abdomen w/o contrast (74150) |
$3,514.50 |
$4,686 |
33.5× |
| CT angio hrt w/3d image (75574) |
$1,105.50 |
$1,474 |
3.2× |
| CT angiography upper extremity lt (73206) |
$5,199 |
$6,932 |
29.5× |
| CT c-spine w/o contrast (72125) |
$3,558.75 |
$4,745 |
33.9× |
| CT cervical spine w&w/o contrast (72127) |
$4,968 |
$6,624 |
28.2× |
| CT cervical spine with contrast (72126) |
$4,112.25 |
$5,483 |
11.7× |
| CT chest w/wo contrast (71270) |
$4,786.50 |
$6,382 |
27.2× |
| CT chest with contrast (71260) |
$3,962.25 |
$5,283 |
22.5× |
| CT head/brain with contrast (70460) |
$3,558.75 |
$4,745 |
20.2× |
| CT head/brain without and with contrast (70470) |
$4,112.25 |
$5,483 |
23.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,105.50 |
$1,474 |
3.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$144 |
$192 |
1.6× |
| CT hrt w/3d image congen (75573) |
$1,282.50 |
$1,710 |
3.7× |
| CT iac w contrast (70481) |
$3,552.75 |
$4,737 |
20.2× |
| CT limited/localized follow up study (76380) |
$1,081.50 |
$1,442 |
12.4× |
| CT lower ext w/o (73700) |
$3,131.25 |
$4,175 |
29.8× |
| CT lower extremity w wo contrast (73702) |
$4,042.50 |
$5,390 |
22.9× |
| CT lower extremity with contrast (73701) |
$3,500.25 |
$4,667 |
19.9× |
| CT lumbar spine w & w/o contrast (72133) |
$4,611 |
$6,148 |
26.2× |
| CT lumbar spine w/o contrast (72131) |
$3,303.75 |
$4,405 |
31.5× |
| CT lumbar spine with contrast (72132) |
$3,816 |
$5,088 |
10.9× |
| CT maxillofacial w contrast (70487) |
$3,552.75 |
$4,737 |
20.2× |
| CT maxillofacial w/o contrast (70486) |
$3,177 |
$4,236 |
30.3× |
| CT maxillofacial w/wo contrast (70488) |
$4,103.25 |
$5,471 |
23.3× |
| CT neck soft tissue w contrast (70491) |
$3,462 |
$4,616 |
19.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$4,103.25 |
$5,471 |
23.3× |
| CT orbits w/o contrast (70480) |
$3,177 |
$4,236 |
30.3× |
| CT pelvis w & w/o contrast (72194) |
$4,968 |
$6,624 |
28.2× |
| CT pelvis w/o contrast (72192) |
$3,558.75 |
$4,745 |
33.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,507.50 |
$6,010 |
25.6× |
| CT soft tissue neck w/o contrast (70490) |
$3,007.50 |
$4,010 |
28.6× |
| CT thoracic spine w/contrast (72129) |
$3,558.75 |
$4,745 |
20.2× |
| CT thoracic spine w/o contrast (72128) |
$3,011.25 |
$4,015 |
28.7× |
| CT thoracic spine w/wo contrast (72130) |
$4,112.25 |
$5,483 |
23.3× |
| CT thorax w/o contrast (71250) |
$3,387.75 |
$4,517 |
32.3× |
| CT unlisted procedure (76497) |
$862.50 |
$1,150 |
9.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,888.75 |
$5,185 |
22.1× |
| CT upper extremity w/o contrast rt (73200) |
$3,013.50 |
$4,018 |
28.7× |
| CT upper extremity with contrast (73201) |
$3,369 |
$4,492 |
9.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$7,013.25 |
$9,351 |
39.8× |
| Cta Abdomen (74175) |
$5,427 |
$7,236 |
30.8× |
| CTA abdomen pelvis (74174) |
$11,920.88 |
$15,894.50 |
34.0× |
| CTA chest (71275) |
$5,043 |
$6,724 |
28.6× |
| Cta Head (70496) |
$5,069.25 |
$6,759 |
28.8× |
| CTA lwr ext w&w/o contrast (73706) |
$5,404.50 |
$7,206 |
30.7× |
| Cta Neck (70498) |
$5,193 |
$6,924 |
29.5× |
| Cta Pelvis (72191) |
$5,103 |
$6,804 |
29.0× |
| Cystography minimum 3 views rs&i (74430) |
$1,065 |
$1,420 |
3.0× |
| Diskogram cervical (72285) |
$9,265.50 |
$12,354 |
4.7× |
| Diskography lumbar (72295) |
$9,265.50 |
$12,354 |
4.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$696 |
$928 |
6.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$757.50 |
$1,010 |
8.7× |
| Echoencephalography real time imaging (76506) |
$1,053.75 |
$1,405 |
10.0× |
| Esophagus (74220) |
$906.75 |
$1,209 |
5.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,027.50 |
$1,370 |
9.8× |
| Fluoroscopy up to 1 hr (76000) |
$702 |
$936 |
2.9× |
| Foot 2 views (73620) |
$481.50 |
$642 |
5.5× |
| Forearm 2 views (73090) |
$493.50 |
$658 |
5.6× |
| Gastric mucosa imaging (78261) |
$1,022.25 |
$1,363 |
2.5× |
| Gated Heart Planar Single (78472) |
$2,626.50 |
$3,502 |
6.5× |
| Hand 2 views (73120) |
$473.25 |
$631 |
4.5× |
| Hand 3 views (73130) |
$507 |
$676 |
5.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$9,584.25 |
$12,779 |
3.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,969.50 |
$2,626 |
3.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,603.50 |
$2,138 |
4.0× |
| Ht muscle image spect sing (78451) |
$3,968.25 |
$5,291 |
3.1× |
| Humerus Min 2 Views Left (73060) |
$534.75 |
$713 |
6.1× |
| Hysterosalpingogram (74740) |
$6,683.25 |
$8,911 |
27.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,330.25 |
$3,107 |
4.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,760 |
$3,680 |
5.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,301.50 |
$4,402 |
6.1× |
| Knee 3 views (73562) |
$572.25 |
$763 |
6.5× |
| Liver & spleen imaging static only (78215) |
$2,463 |
$3,284 |
6.1× |
| Lung perf&ventilat diferentl (78598) |
$1,580.25 |
$2,107 |
2.9× |
| Lung perfusion differential (78597) |
$1,134.75 |
$1,513 |
2.8× |
| Lung Ventilation Imaging (78579) |
$1,192.50 |
$1,590 |
3.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$9,041.25 |
$12,055 |
2.9× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,683 |
$2,244 |
2.7× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$2,223 |
$2,964 |
1.4× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,223 |
$2,964 |
0.7× |
| Lymphoscintigraphy (78195) |
$2,076 |
$2,768 |
3.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$362.25 |
$483 |
4.1× |
| Meckels Diverticulum (78290) |
$2,405.25 |
$3,207 |
6.0× |
| MRA head w & w/o contrast (70546) |
$5,820.75 |
$7,761 |
16.6× |
| MRA head w/o contrast (70544) |
$3,147.75 |
$4,197 |
13.1× |
| MRA head with contrast (70545) |
$4,046.25 |
$5,395 |
11.5× |
| MRA neck w contrast (70548) |
$4,046.25 |
$5,395 |
11.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,584.25 |
$8,779 |
18.8× |
| MRA neck w/o contrast (70547) |
$3,785.25 |
$5,047 |
15.8× |
| MRI abdomen w contrast (74182) |
$3,972.75 |
$5,297 |
11.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$6,459 |
$8,612 |
18.4× |
| MRI abdomen w/o contrast (74181) |
$3,455.25 |
$4,607 |
14.4× |
| MRI any jnt lwr ext with con lt (73722) |
$4,400.25 |
$5,867 |
5.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,526.25 |
$6,035 |
5.7× |
| MRI bone marrow blood supply (77084) |
$739.50 |
$986 |
3.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,104 |
$1,472 |
4.6× |
| MRI breast w/o contrast unilat (77046) |
$516 |
$688 |
2.2× |
| MRI c-spine with contrast (72142) |
$4,144.50 |
$5,526 |
11.8× |
| MRI cardiac w/o contrast (75557) |
$687.75 |
$917 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$3,873.75 |
$5,165 |
16.2× |
| MRI chest w/o & w/contrast material (71552) |
$6,804 |
$9,072 |
19.4× |
| MRI chest w/o contrast (71550) |
$2,661.75 |
$3,549 |
11.1× |
| MRI chest with contrast (71551) |
$3,612 |
$4,816 |
4.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,999.75 |
$5,333 |
11.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,281 |
$5,708 |
12.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,918 |
$5,224 |
16.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,392.25 |
$4,523 |
14.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$6,255.75 |
$8,341 |
17.9× |
| MRI orbit/face/neck w/contrast (70542) |
$3,957.75 |
$5,277 |
11.3× |
| MRI pelvis w contrast (72196) |
$3,833.25 |
$5,111 |
10.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,395.25 |
$8,527 |
18.2× |
| MRI pelvis w/o contrast (72195) |
$3,462 |
$4,616 |
14.4× |
| MRI scan of arm joint before and after contrast (73223) |
$6,369 |
$8,492 |
18.2× |
| MRI scan of leg joint before and after contrast (73723) |
$6,459.75 |
$8,613 |
18.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,675 |
$8,900 |
19.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,611 |
$6,148 |
13.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,660 |
$8,880 |
19.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,009.50 |
$5,346 |
11.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,610.50 |
$8,814 |
18.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,574.50 |
$4,766 |
14.9× |
| MRI tmj (70336) |
$3,404.25 |
$4,539 |
14.2× |
| MRI upper ext joint w/o contrast (73221) |
$3,865.50 |
$5,154 |
16.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$6,369 |
$8,492 |
18.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,865.50 |
$5,154 |
16.1× |
| Myelogram Cervical (72240) |
$3,065.25 |
$4,087 |
3.9× |
| Myelogram Lumbar (72265) |
$2,770.50 |
$3,694 |
3.5× |
| Myelogram thoracic (72255) |
$2,333.25 |
$3,111 |
3.0× |
| Myelography 2 or more regions (72270) |
$3,111.75 |
$4,149 |
4.0× |
| Myocardial Spect Multiple Studies (78452) |
$3,744.38 |
$4,992.50 |
2.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,471.25 |
$3,295 |
2.9× |
| Neck soft tissue (70360) |
$484.50 |
$646 |
5.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$741.75 |
$989 |
1.8× |
| Nm bone marrow wb (78104) |
$1,134.75 |
$1,513 |
2.8× |
| Nm cisternogram (78630) |
$2,492.25 |
$3,323 |
4.6× |
| Nm gastric emptying study (78264) |
$2,497.50 |
$3,330 |
6.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$2,137.50 |
$2,850 |
5.3× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$2,128.50 |
$2,838 |
5.3× |
| Nuclear Rx Oral Admin (79005) |
$2,046 |
$2,728 |
8.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$492 |
$656 |
4.7× |
| Osseous survey infant (77076) |
$583.50 |
$778 |
5.6× |
| Osseous survey limited (77074) |
$626.25 |
$835 |
6.0× |
| Parathyrd planar w/spect&CT (78072) |
$1,211.25 |
$1,615 |
2.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,211.25 |
$1,615 |
3.0× |
| Parathyroid imaging (78070) |
$1,211.25 |
$1,615 |
3.0× |
| Pelvis 1 or 2 views (72170) |
$488.25 |
$651 |
4.6× |
| Peritoneogram rs&i (74190) |
$1,185.75 |
$1,581 |
2.2× |
| PET image w/CT, skull-thigh (78815) |
$9,060 |
$12,080 |
6.3× |
| PET imaging CT for attenuation limited area (78814) |
$3,695.25 |
$4,927 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$9,060 |
$12,080 |
6.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$6,456 |
$8,608 |
18.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$9,040.50 |
$12,054 |
2.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$7,534.50 |
$10,046 |
2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,489.50 |
$1,986 |
3.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,726.50 |
$2,302 |
3.2× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,319.25 |
$1,759 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,261.50 |
$1,682 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$219.75 |
$293 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$362.25 |
$483 |
3.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$705 |
$940 |
6.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$606.75 |
$809 |
5.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$477.75 |
$637 |
5.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$517.50 |
$690 |
5.9× |
| Radiologic exam colon single contrast study (74270) |
$1,221 |
$1,628 |
6.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,554.75 |
$2,073 |
8.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$893.25 |
$1,191 |
5.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$219.75 |
$293 |
2.5× |
| Radiological examination surgical specimen (76098) |
$1,683 |
$2,244 |
3.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$9,040.50 |
$12,054 |
2.9× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$9,040.50 |
$12,054 |
2.9× |
| Ribs bilateral 3 views (71110) |
$645.75 |
$861 |
6.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,320.50 |
$3,094 |
5.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,236.50 |
$2,982 |
4.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,744.75 |
$4,993 |
6.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,104.75 |
$1,473 |
4.7× |
| Rp Therapy Intravenous Administration (79101) |
$2,046 |
$2,728 |
8.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$764.25 |
$1,019 |
3.2× |
| Scanogram (77073) |
$404.25 |
$539 |
3.8× |
| Scapula complete (73010) |
$477.75 |
$637 |
4.5× |
| Screening digital breast tomosynthesis (77063) |
$81 |
$108 |
3.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,114.50 |
$1,486 |
10.6× |
| Spine thoracic 3 views (72072) |
$639.75 |
$853 |
6.1× |
| Spleen imaging only (78185) |
$1,134.75 |
$1,513 |
2.8× |
| Splenoportograpy rs&i (75810) |
$9,040.50 |
$12,054 |
2.9× |
| Superior sagittal sinus venogram (75870) |
$2,627.25 |
$3,503 |
0.8× |
| Therapeutic Enema (74283) |
$673.50 |
$898 |
3.8× |
| Thoracolumbar 2 views (72080) |
$601.50 |
$802 |
6.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,535 |
$3,380 |
4.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,192.50 |
$1,590 |
3.0× |
| Thyroid uptake measurement (78012) |
$1,192.50 |
$1,590 |
3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,192.50 |
$1,590 |
3.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,744.75 |
$4,993 |
6.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,279.50 |
$1,706 |
3.2× |
| Ultrasound elastography first target lesion (76982) |
$292.50 |
$390 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$981 |
$1,308 |
9.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$312 |
$416 |
3.6× |
| Unlisted fluoroscopic procedure (76496) |
$419.25 |
$559 |
4.8× |
| Unlisted magnetic resonance procedure (76498) |
$2,374.50 |
$3,166 |
27.2× |
| Unlisted Ultrasound Procedure (76999) |
$582.75 |
$777 |
6.7× |
| Upper Extremity Infant (73092) |
$387 |
$516 |
3.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,729.50 |
$2,306 |
4.3× |
| Urethrocystography retrograde rs&i (74450) |
$1,338 |
$1,784 |
5.6× |
| Urethrocystography voiding (74455) |
$1,274.25 |
$1,699 |
5.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,702.50 |
$2,270 |
9.7× |
| Us abdl aorta screen aaa (76706) |
$505.50 |
$674 |
4.8× |
| Us breast unilateral complete (76641) |
$345.75 |
$461 |
3.3× |
| Us breast unilateral limited (76642) |
$345.75 |
$461 |
4.0× |
| Us chest (76604) |
$627 |
$836 |
6.0× |
| Us elastography parenchyma (76981) |
$292.50 |
$390 |
2.8× |
| Us infant hips dynamic (76885) |
$1,027.50 |
$1,370 |
11.8× |
| Us infant hips limited static (76886) |
$764.25 |
$1,019 |
8.7× |
| Us kidney transplant (76776) |
$946.50 |
$1,262 |
9.0× |
| Us ob transvaginal (76817) |
$761.25 |
$1,015 |
7.2× |
| Us pelvic non ob complete (76856) |
$986.25 |
$1,315 |
9.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$555 |
$740 |
5.3× |
| Us pregnancy ltd (76815) |
$606.75 |
$809 |
5.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$894.75 |
$1,193 |
8.5× |
| Us retroperitoneal complete (76770) |
$1,053.75 |
$1,405 |
10.0× |
| Us scrotum and contents (76870) |
$376.50 |
$502 |
3.6× |
| Us soft tissue head/neck (76536) |
$937.50 |
$1,250 |
8.9× |
| Us spinal canal and contents (76800) |
$1,053.75 |
$1,405 |
10.0× |
| Us transrectal (76872) |
$852.75 |
$1,137 |
8.1× |
| Us xtr non-vasc lmtd (76882) |
$376.50 |
$502 |
3.6× |
| Venogram extremity bilateral (75822) |
$2,748.75 |
$3,665 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$9,492.75 |
$12,657 |
3.0× |
| Venography caval superior serialography rs&i (75827) |
$3,048.75 |
$4,065 |
1.9× |
| Venography epidural rs&i (75872) |
$9,040.50 |
$12,054 |
14.3× |
| Venography extremity unilateral rs&i (75820) |
$2,627.25 |
$3,503 |
1.7× |
| Venography Renal Bilateral (75833) |
$9,584.25 |
$12,779 |
3.0× |
| Venography renal unilateral selective rs&i (75831) |
$9,584.25 |
$12,779 |
3.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$9,040.50 |
$12,054 |
2.9× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$9,040.50 |
$12,054 |
1.6× |
| Vertebral fracture assessment via dxa (77086) |
$219 |
$292 |
2.5× |
| Wrist 2 views (73100) |
$437.25 |
$583 |
5.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$726 |
$968 |
6.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$617.62 |
$823.50 |
7.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$517.50 |
$690 |
5.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,647 |
$2,196 |
9.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$484.50 |
$646 |
5.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$534.75 |
$713 |
6.1× |
| X-ray exam hip uni 1 view (73501) |
$219.75 |
$293 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$219.75 |
$293 |
2.5× |
| X-ray exam of femur 1 (73551) |
$219.75 |
$293 |
2.5× |
| X-ray eye for foreign body (70030) |
$476.25 |
$635 |
5.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$699 |
$932 |
6.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$544.50 |
$726 |
6.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$492.75 |
$657 |
5.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$6,520.50 |
$8,694 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$470.25 |
$627 |
5.4× |
| X-ray IV pyelogram+drip infusn (74410) |
$1,428 |
$1,904 |
8.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$566.25 |
$755 |
6.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$575.25 |
$767 |
5.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$696 |
$928 |
8.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$600.75 |
$801 |
5.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,028.25 |
$1,371 |
9.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$658.50 |
$878 |
6.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$484.50 |
$646 |
5.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$690 |
$920 |
7.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$741.75 |
$989 |
7.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$531.75 |
$709 |
5.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$1,246.12 |
$1,661.50 |
2.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,572.75 |
$2,097 |
4.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$441 |
$588 |
5.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$579.75 |
$773 |
5.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$726 |
$968 |
6.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$438.75 |
$585 |
4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$461.25 |
$615 |
5.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$547.50 |
$730 |
6.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$666 |
$888 |
7.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$336.75 |
$449 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$854.25 |
$1,139 |
8.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$601.50 |
$802 |
5.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$382.50 |
$510 |
4.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$500.25 |
$667 |
5.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$513 |
$684 |
5.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$582.75 |
$777 |
5.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$406.50 |
$542 |
4.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$507 |
$676 |
5.8× |
| Xr arthrogram ankle (73615) |
$1,526.25 |
$2,035 |
4.4× |
| Xr c-spine 6 or more views (72052) |
$970.88 |
$1,294.50 |
9.2× |
| Xr chest 4+ views (71048) |
$671.25 |
$895 |
6.4× |
| Xr Cholecystography Oral Contrast (74290) |
$450.75 |
$601 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$408.75 |
$545 |
4.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$461.25 |
$615 |
4.4× |
| Xr optic foramina (70190) |
$267.75 |
$357 |
3.1× |
| Xr shoulder 1 view (73020) |
$444 |
$592 |
5.1× |
| Xr spine cervical 4 or 5 views (72050) |
$804 |
$1,072 |
7.7× |
| Xr tibia/fibula 2 views (73590) |
$513 |
$684 |
5.9× |
| Xr tmj bilateral (70330) |
$513.75 |
$685 |
5.9× |
| Xray knee 1 or 2 views rt (73560) |
$551.25 |
$735 |
6.3× |