| Abdomen 2 views (74019) |
$135.70 |
$163.50 |
1.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,476.03 |
$1,778.35 |
3.9× |
| Ankle 2 views (73600) |
$44.98 |
$54.20 |
0.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$794.89 |
$957.70 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,146.77 |
$1,381.65 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$1,294.51 |
$1,559.65 |
3.5× |
| Bone age studies (77072) |
$277.22 |
$334 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,464.87 |
$1,764.90 |
3.9× |
| Bone survey complete (77075) |
$210.47 |
$253.58 |
2.1× |
| Cervical spine 2 or 3 views (72040) |
$45.73 |
$55.10 |
0.6× |
| Chest 1 view (71045) |
$45.73 |
$55.10 |
0.6× |
| Chest 3 views (71047) |
$227.11 |
$273.62 |
2.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$460.61 |
$554.95 |
2.8× |
| Clavicle complete (73000) |
$91.40 |
$110.12 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$359.81 |
$433.50 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,722.60 |
$2,075.42 |
5.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,005.71 |
$1,211.70 |
4.5× |
| CT abdomen w contrast (74160) |
$798.42 |
$961.95 |
4.9× |
| CT abdomen w wo contrast (74170) |
$874.97 |
$1,054.18 |
5.3× |
| CT abdomen w/o contrast (74150) |
$764.58 |
$921.18 |
7.8× |
| CT c-spine w/o contrast (72125) |
$463.62 |
$558.58 |
4.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,633.32 |
$1,967.85 |
9.9× |
| CT chest w/wo contrast (71270) |
$872.16 |
$1,050.80 |
5.3× |
| CT chest with contrast (71260) |
$644.74 |
$776.80 |
3.9× |
| CT head/brain with contrast (70460) |
$643.15 |
$774.88 |
3.9× |
| CT head/brain without and with contrast (70470) |
$873.41 |
$1,052.30 |
5.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$41.50 |
$50 |
0.5× |
| CT iac w contrast (70481) |
$1,409.38 |
$1,698.05 |
8.6× |
| CT lower ext w/o (73700) |
$463.62 |
$558.58 |
4.7× |
| CT lower extremity w wo contrast (73702) |
$1,633.32 |
$1,967.85 |
9.9× |
| CT lower extremity with contrast (73701) |
$644.44 |
$776.42 |
3.9× |
| CT lumbar spine w & w/o contrast (72133) |
$873.41 |
$1,052.30 |
5.3× |
| CT lumbar spine w/o contrast (72131) |
$463.62 |
$558.58 |
4.7× |
| CT maxillofacial w contrast (70487) |
$643.15 |
$774.88 |
3.9× |
| CT maxillofacial w/o contrast (70486) |
$437.62 |
$527.25 |
4.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,633.32 |
$1,967.85 |
9.9× |
| CT neck soft tissue w contrast (70491) |
$654.54 |
$788.60 |
4.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,633.32 |
$1,967.85 |
9.9× |
| CT orbits w/o contrast (70480) |
$798.96 |
$962.60 |
8.1× |
| CT pelvis w & w/o contrast (72194) |
$1,633.32 |
$1,967.85 |
9.9× |
| CT pelvis w/o contrast (72192) |
$565.06 |
$680.80 |
5.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,633.32 |
$1,967.85 |
9.9× |
| CT soft tissue neck w/o contrast (70490) |
$456.86 |
$550.42 |
4.7× |
| CT thoracic spine w/o contrast (72128) |
$463.62 |
$558.58 |
4.7× |
| CT thorax w/o contrast (71250) |
$467.62 |
$563.40 |
4.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,633.32 |
$1,967.85 |
9.9× |
| CT upper extremity w/o contrast rt (73200) |
$463.62 |
$558.58 |
4.7× |
| CT upper extremity with contrast (73201) |
$644.44 |
$776.42 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,345.14 |
$1,620.65 |
8.2× |
| Cta Abdomen (74175) |
$753.35 |
$907.65 |
4.6× |
| CTA abdomen pelvis (74174) |
$1,345.14 |
$1,620.65 |
4.1× |
| CTA chest (71275) |
$914.41 |
$1,101.70 |
5.6× |
| Cta Head (70496) |
$1,345.14 |
$1,620.65 |
8.2× |
| CTA lwr ext w&w/o contrast (73706) |
$1,345.14 |
$1,620.65 |
8.2× |
| Cta Neck (70498) |
$750.74 |
$904.50 |
4.6× |
| Cta Pelvis (72191) |
$1,345.14 |
$1,620.65 |
8.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$151.91 |
$183.02 |
1.5× |
| Esophagus (74220) |
$278.47 |
$335.50 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$417.28 |
$502.75 |
1.9× |
| Foot 2 views (73620) |
$45.73 |
$55.10 |
0.6× |
| Forearm 2 views (73090) |
$44.98 |
$54.20 |
0.6× |
| Gated Heart Planar Single (78472) |
$863.08 |
$1,039.85 |
2.3× |
| Hand 2 views (73120) |
$45.73 |
$55.10 |
0.5× |
| Hand 3 views (73130) |
$147.26 |
$177.42 |
1.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,146.77 |
$1,381.65 |
3.1× |
| Ht muscle image spect sing (78451) |
$1,990.13 |
$2,397.75 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$91.40 |
$110.12 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,373.90 |
$1,655.30 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,423.91 |
$1,715.55 |
2.8× |
| Knee 3 views (73562) |
$114.70 |
$138.20 |
1.4× |
| Liver & spleen imaging static only (78215) |
$851.62 |
$1,026.05 |
2.3× |
| Meckels Diverticulum (78290) |
$953.84 |
$1,149.20 |
2.5× |
| MRA head w & w/o contrast (70546) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRA head w/o contrast (70544) |
$843.80 |
$1,016.62 |
3.8× |
| MRA head with contrast (70545) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRA neck w contrast (70548) |
$1,678.18 |
$2,021.90 |
5.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRA neck w/o contrast (70547) |
$1,580.36 |
$1,904.05 |
7.1× |
| MRI abdomen w contrast (74182) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,243.03 |
$1,497.62 |
3.8× |
| MRI abdomen w/o contrast (74181) |
$1,580.36 |
$1,904.05 |
7.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,678.18 |
$2,021.90 |
2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,678.18 |
$2,021.90 |
2.3× |
| MRI c-spine with contrast (72142) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRI cervical spine w/o contrast (72141) |
$856.38 |
$1,031.78 |
3.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRI chest w/o contrast (71550) |
$1,580.36 |
$1,904.05 |
7.1× |
| MRI chest with contrast (71551) |
$1,678.18 |
$2,021.90 |
2.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$850.40 |
$1,024.58 |
3.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,580.36 |
$1,904.05 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRI pelvis w contrast (72196) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRI pelvis w/o contrast (72195) |
$1,580.36 |
$1,904.05 |
7.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,241.39 |
$1,495.65 |
3.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,247.38 |
$1,502.88 |
3.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,678.18 |
$2,021.90 |
5.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRI thoracic spine w/o contrast (72146) |
$856.38 |
$1,031.78 |
3.8× |
| MRI tmj (70336) |
$1,372.11 |
$1,653.15 |
6.1× |
| MRI upper ext joint w/o contrast (73221) |
$850.96 |
$1,025.25 |
3.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,290.51 |
$2,759.65 |
7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$850.71 |
$1,024.95 |
3.8× |
| Myocardial Spect Multiple Studies (78452) |
$1,971.54 |
$2,375.35 |
1.6× |
| Neck soft tissue (70360) |
$71.80 |
$86.50 |
0.9× |
| Nm gastric emptying study (78264) |
$1,231.06 |
$1,483.20 |
3.3× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,990.13 |
$2,397.75 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$307.18 |
$370.10 |
3.1× |
| Osseous survey limited (77074) |
$265.14 |
$319.45 |
2.7× |
| Parathyroid imaging (78070) |
$458.82 |
$552.80 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$45.73 |
$55.10 |
0.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,241.12 |
$1,495.32 |
3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,056.09 |
$1,272.40 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$997.06 |
$1,201.28 |
2.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$78.39 |
$94.45 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$44.24 |
$53.30 |
0.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$191.02 |
$230.15 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$124.68 |
$150.22 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$31.04 |
$37.40 |
0.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$222.98 |
$268.65 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$333.95 |
$402.35 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$389.44 |
$469.20 |
2.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$397.40 |
$478.80 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$44.24 |
$53.30 |
0.5× |
| Ribs bilateral 3 views (71110) |
$361.63 |
$435.70 |
3.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,623.85 |
$1,956.45 |
3.2× |
| Sacroiliac Joints < 3 Views (72200) |
$278.47 |
$335.50 |
2.8× |
| Scapula complete (73010) |
$16.27 |
$19.60 |
0.2× |
| Screening digital breast tomosynthesis (77063) |
$58.14 |
$70.05 |
2.5× |
| Sella turcica (70240) |
$151.10 |
$182.05 |
1.9× |
| Small bowel series (74250) |
$250.62 |
$301.95 |
1.5× |
| Spine thoracic 3 views (72072) |
$93.98 |
$113.22 |
1.0× |
| Thyroid uptake measurement (78012) |
$737.95 |
$889.10 |
2.0× |
| Tmj unilateral (70328) |
$181.89 |
$219.15 |
2.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,206.31 |
$2,658.20 |
4.3× |
| Ultrasound, abdomen limited (76705) |
$462.60 |
$557.35 |
4.7× |
| Unlisted magnetic resonance procedure (76498) |
$1,372.11 |
$1,653.15 |
16.8× |
| Unlisted Ultrasound Procedure (76999) |
$259.62 |
$312.80 |
3.2× |
| Upper Extremity Infant (73092) |
$161.14 |
$194.15 |
1.6× |
| Urethrocystography voiding (74455) |
$534.77 |
$644.30 |
2.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$418.49 |
$504.20 |
2.5× |
| Us abdl aorta screen aaa (76706) |
$428.03 |
$515.70 |
4.4× |
| Us breast unilateral complete (76641) |
$190.36 |
$229.35 |
1.9× |
| Us breast unilateral limited (76642) |
$190.36 |
$229.35 |
2.3× |
| Us chest (76604) |
$208.25 |
$250.90 |
2.1× |
| Us ob transvaginal (76817) |
$299.67 |
$361.05 |
3.1× |
| Us pelvic non ob complete (76856) |
$450.36 |
$542.60 |
4.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$450.36 |
$542.60 |
4.6× |
| Us pregnancy ltd (76815) |
$306.02 |
$368.70 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$427.24 |
$514.75 |
4.4× |
| Us retroperitoneal complete (76770) |
$511.53 |
$616.30 |
5.2× |
| Us retroperitoneal limited (76775) |
$160 |
$192.78 |
1.6× |
| Us scrotum and contents (76870) |
$572.95 |
$690.30 |
5.8× |
| Us soft tissue head/neck (76536) |
$282.45 |
$340.30 |
2.9× |
| Us xtr non-vasc lmtd (76882) |
$213.44 |
$257.15 |
2.2× |
| Wrist 2 views (73100) |
$91.40 |
$110.12 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$186.98 |
$225.28 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$92.34 |
$111.25 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$45.73 |
$55.10 |
0.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$417.28 |
$502.75 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$45.73 |
$55.10 |
0.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$147.26 |
$177.42 |
1.8× |
| X-ray exam hip uni 1 view (73501) |
$44.24 |
$53.30 |
0.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$116.06 |
$139.82 |
1.4× |
| X-ray eye for foreign body (70030) |
$129.38 |
$155.88 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$109.22 |
$131.60 |
1.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$167.78 |
$202.15 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$146.94 |
$177.02 |
1.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$91.16 |
$109.82 |
1.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$484.68 |
$583.95 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$105.72 |
$127.38 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$149.74 |
$180.40 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$152.31 |
$183.50 |
1.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$147.66 |
$177.90 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$45.73 |
$55.10 |
0.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$77.77 |
$93.70 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$161.14 |
$194.15 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$124.08 |
$149.50 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$135.40 |
$163.12 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$170.90 |
$205.90 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$227.98 |
$274.68 |
2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$302.37 |
$364.30 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$91.78 |
$110.58 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$92.34 |
$111.25 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$107.32 |
$129.30 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$88.46 |
$106.58 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$124.08 |
$149.50 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$45.73 |
$55.10 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$106.95 |
$128.85 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$172.31 |
$207.60 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$167.78 |
$202.15 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$89.68 |
$108.05 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$45.73 |
$55.10 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$45.73 |
$55.10 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$347.56 |
$418.75 |
3.5× |
| Xr chest 4+ views (71048) |
$306.73 |
$369.55 |
3.1× |
| Xr Cholecystography Oral Contrast (74290) |
$250.62 |
$301.95 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$45.73 |
$55.10 |
0.6× |
| Xr shoulder 1 view (73020) |
$45.73 |
$55.10 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$151.50 |
$182.52 |
1.5× |
| Xr tibia/fibula 2 views (73590) |
$45.73 |
$55.10 |
0.6× |
| Xr tmj bilateral (70330) |
$227.25 |
$273.80 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$45.73 |
$55.10 |
0.6× |