| Abdomen 2 views (74019) |
$397 |
$422 |
3.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,635 |
$1,739 |
3.9× |
| Angiography extremity unilateral rs&i (75710) |
$1,415 |
$1,505 |
0.4× |
| Ankle 2 views (73600) |
$279 |
$297 |
3.1× |
| Arthrogram shoulder (73040) |
$849 |
$903 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,598 |
$1,700 |
3.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$957 |
$1,018 |
2.3× |
| Bone &/joint imaging whole body (78306) |
$1,879 |
$1,999 |
4.5× |
| Bone age studies (77072) |
$237 |
$252 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$2,149 |
$2,286 |
5.2× |
| Bone survey complete (77075) |
$902 |
$960 |
8.3× |
| Cervical spine 2 or 3 views (72040) |
$367.50 |
$391 |
4.1× |
| Chest 1 view (71045) |
$288 |
$306 |
3.2× |
| Chest 3 views (71047) |
$419 |
$446 |
4.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$318 |
$338 |
1.7× |
| Clavicle complete (73000) |
$278 |
$296 |
3.1× |
| Corpora cavernosography (74445) |
$353 |
$376 |
3.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,855 |
$5,165 |
13.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,401 |
$3,618 |
13.7× |
| CT abdomen w contrast (74160) |
$2,695 |
$2,867 |
14.8× |
| CT abdomen w wo contrast (74170) |
$3,412 |
$3,630 |
18.7× |
| CT abdomen w/o contrast (74150) |
$2,304 |
$2,451 |
21.2× |
| CT angiography upper extremity lt (73206) |
$2,624 |
$2,791 |
14.4× |
| CT c-spine w/o contrast (72125) |
$2,451 |
$2,607 |
22.6× |
| CT cervical spine with contrast (72126) |
$2,624 |
$2,791 |
7.2× |
| CT chest w/wo contrast (71270) |
$2,947 |
$3,135 |
16.2× |
| CT chest with contrast (71260) |
$2,650 |
$2,819 |
14.5× |
| CT head/brain with contrast (70460) |
$2,249 |
$2,393 |
12.3× |
| CT head/brain without and with contrast (70470) |
$2,421 |
$2,576 |
13.3× |
| CT iac w contrast (70481) |
$2,716 |
$2,889 |
14.9× |
| CT limited/localized follow up study (76380) |
$1,371 |
$1,459 |
15.2× |
| CT lower ext w/o (73700) |
$2,092 |
$2,226 |
19.3× |
| CT lower extremity w wo contrast (73702) |
$2,341 |
$2,490 |
12.9× |
| CT lower extremity with contrast (73701) |
$2,247 |
$2,390 |
12.3× |
| CT lumbar spine w & w/o contrast (72133) |
$3,059 |
$3,254 |
16.8× |
| CT lumbar spine w/o contrast (72131) |
$2,278 |
$2,423 |
21.0× |
| CT lumbar spine with contrast (72132) |
$2,634 |
$2,802 |
7.3× |
| CT maxillofacial w contrast (70487) |
$2,186 |
$2,325 |
12.0× |
| CT maxillofacial w/o contrast (70486) |
$1,954 |
$2,079 |
18.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,379 |
$2,531 |
13.1× |
| CT neck soft tissue w contrast (70491) |
$2,538 |
$2,700 |
13.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,433 |
$2,588 |
13.4× |
| CT orbits w/o contrast (70480) |
$2,121.50 |
$2,257 |
19.5× |
| CT pelvis w & w/o contrast (72194) |
$2,713 |
$2,886 |
14.9× |
| CT pelvis w/o contrast (72192) |
$2,231 |
$2,373 |
20.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,573 |
$2,737 |
14.1× |
| CT soft tissue neck w/o contrast (70490) |
$2,247 |
$2,390 |
20.7× |
| CT thoracic spine w/contrast (72129) |
$2,592 |
$2,757 |
14.2× |
| CT thoracic spine w/o contrast (72128) |
$2,486 |
$2,645 |
22.9× |
| CT thorax w/o contrast (71250) |
$2,157 |
$2,295 |
19.9× |
| CT upper extremity w/o contrast rt (73200) |
$2,065 |
$2,197 |
19.0× |
| CT upper extremity with contrast (73201) |
$2,124 |
$2,260 |
5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,579 |
$3,807 |
19.6× |
| Cta Abdomen (74175) |
$3,137 |
$3,337 |
17.2× |
| CTA abdomen pelvis (74174) |
$4,959 |
$5,275 |
13.7× |
| CTA chest (71275) |
$3,180 |
$3,383 |
17.5× |
| Cta Head (70496) |
$2,917 |
$3,103 |
16.0× |
| Cta Neck (70498) |
$2,975 |
$3,165 |
16.3× |
| Cta Pelvis (72191) |
$3,092 |
$3,289 |
17.0× |
| Cystography minimum 3 views rs&i (74430) |
$601 |
$639 |
1.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$635 |
$676 |
5.8× |
| Fetal biophysical profile non-stress testing (76818) |
$551 |
$586 |
5.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$524 |
$557 |
4.8× |
| Fluoroscopy up to 1 hr (76000) |
$688 |
$732 |
2.8× |
| Foot 2 views (73620) |
$267 |
$284 |
3.0× |
| Forearm 2 views (73090) |
$318 |
$338 |
3.5× |
| Gated Heart Planar Single (78472) |
$1,904 |
$2,025 |
4.6× |
| Hand 2 views (73120) |
$256 |
$272 |
2.4× |
| Hand 3 views (73130) |
$348 |
$370 |
3.9× |
| Heart Infarct Image (78466) |
$1,832 |
$1,949 |
4.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,926 |
$2,049 |
3.4× |
| Ht muscle image spect sing (78451) |
$4,055 |
$4,314 |
3.0× |
| Humerus Min 2 Views Left (73060) |
$350 |
$372 |
3.9× |
| Kidney imaging morphology (78700) |
$1,892 |
$2,013 |
4.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,591 |
$1,693 |
2.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,644 |
$1,749 |
2.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,794 |
$1,908 |
3.2× |
| Knee 3 views (73562) |
$436 |
$464 |
4.8× |
| Liver & spleen imaging static only (78215) |
$1,572 |
$1,672 |
3.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,035 |
$2,165 |
4.9× |
| Lung Ventilation Imaging (78579) |
$1,843 |
$1,961 |
4.4× |
| Lymphoscintigraphy (78195) |
$1,688 |
$1,796 |
3.0× |
| Meckels Diverticulum (78290) |
$1,978 |
$2,104 |
4.8× |
| MRA head w & w/o contrast (70546) |
$3,781 |
$4,022 |
10.4× |
| MRA head w/o contrast (70544) |
$3,354 |
$3,568 |
13.5× |
| MRA head with contrast (70545) |
$3,391 |
$3,607 |
9.4× |
| MRA neck w contrast (70548) |
$3,345 |
$3,559 |
9.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,576 |
$3,804 |
9.9× |
| MRA neck w/o contrast (70547) |
$3,657 |
$3,890 |
14.8× |
| MRI abdomen w contrast (74182) |
$3,354 |
$3,568 |
9.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,756 |
$3,996 |
10.4× |
| MRI abdomen w/o contrast (74181) |
$3,211 |
$3,416 |
13.0× |
| MRI any jnt lwr ext with con lt (73722) |
$3,165 |
$3,367 |
3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,695 |
$2,867 |
3.3× |
| MRI c-spine with contrast (72142) |
$3,301 |
$3,512 |
9.1× |
| MRI cervical spine w/o contrast (72141) |
$3,063 |
$3,258 |
12.4× |
| MRI chest w/o & w/contrast material (71552) |
$4,692 |
$4,991 |
13.0× |
| MRI chest w/o contrast (71550) |
$3,807 |
$4,050 |
15.4× |
| MRI chest with contrast (71551) |
$3,844 |
$4,089 |
4.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,795 |
$2,973 |
7.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,964 |
$3,153 |
8.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,812 |
$2,991 |
11.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,530 |
$3,755 |
14.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,751 |
$3,990 |
10.4× |
| MRI orbit/face/neck w/contrast (70542) |
$4,122 |
$4,385 |
11.4× |
| MRI pelvis w contrast (72196) |
$3,296 |
$3,506 |
9.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,995 |
$4,250 |
11.0× |
| MRI pelvis w/o contrast (72195) |
$3,139 |
$3,339 |
12.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,559 |
$3,786 |
9.8× |
| MRI scan of leg joint before and after contrast (73723) |
$3,641 |
$3,873 |
10.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,520 |
$4,809 |
12.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,225 |
$3,431 |
8.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,520 |
$4,809 |
12.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,983 |
$4,237 |
11.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,520 |
$4,809 |
12.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,627 |
$3,859 |
14.6× |
| MRI tmj (70336) |
$3,435 |
$3,654 |
13.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,462 |
$2,619 |
9.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,073 |
$3,269 |
8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,568 |
$2,732 |
10.4× |
| Myelogram Lumbar (72265) |
$1,504 |
$1,600 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,278 |
$4,551 |
3.2× |
| Neck soft tissue (70360) |
$328 |
$349 |
3.6× |
| Nm gastric emptying study (78264) |
$1,799 |
$1,914 |
4.3× |
| Parathyroid imaging (78070) |
$1,504 |
$1,600 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$295 |
$314 |
2.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,063 |
$3,258 |
8.5× |
| Pr red cell survival study (78130) |
$89 |
$95 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$964 |
$1,025 |
2.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,320 |
$2,468 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$508 |
$540 |
4.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$537 |
$571 |
4.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$547 |
$582 |
5.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$367 |
$390 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$386 |
$411 |
4.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$979 |
$1,042 |
5.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$354 |
$377 |
3.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$137 |
$146 |
0.3× |
| Ribs bilateral 3 views (71110) |
$456.50 |
$486 |
4.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,362 |
$2,513 |
5.7× |
| Sacroiliac Joints < 3 Views (72200) |
$360 |
$383 |
3.3× |
| Scanogram (77073) |
$340 |
$362 |
3.1× |
| Scapula complete (73010) |
$328 |
$349 |
3.0× |
| Spine thoracic 3 views (72072) |
$491 |
$522 |
4.5× |
| Testicular Imaging With Vascular Flow (78761) |
$1,226 |
$1,304 |
3.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,288 |
$1,370 |
3.1× |
| Tmj unilateral (70328) |
$547 |
$582 |
6.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,490 |
$1,585 |
3.6× |
| Ultrasound scan to determine eye length and lens power (76519) |
$246 |
$262 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$732 |
$779 |
6.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$676 |
$719 |
7.5× |
| Unlisted magnetic resonance procedure (76498) |
$4,692 |
$4,991 |
51.9× |
| Unlisted Ultrasound Procedure (76999) |
$614 |
$653 |
6.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$2,522 |
$2,683 |
6.1× |
| Urethrocystography retrograde rs&i (74450) |
$664 |
$706 |
2.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$901 |
$959 |
4.9× |
| Us abdl aorta screen aaa (76706) |
$524 |
$557 |
4.8× |
| Us breast unilateral complete (76641) |
$598 |
$636 |
5.5× |
| Us ob detailed single fetus (76811) |
$890 |
$947 |
3.6× |
| Us ob transvaginal (76817) |
$529 |
$563 |
4.9× |
| Us pelvic non ob complete (76856) |
$776 |
$826 |
7.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$474 |
$504 |
4.4× |
| Us pregnancy ltd (76815) |
$513 |
$546 |
4.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$685 |
$729 |
6.3× |
| Us retroperitoneal complete (76770) |
$805 |
$856 |
7.4× |
| Us retroperitoneal limited (76775) |
$629 |
$669 |
5.8× |
| Us scrotum and contents (76870) |
$623 |
$663 |
5.7× |
| Us soft tissue head/neck (76536) |
$585 |
$622 |
5.4× |
| Us transrectal (76872) |
$667 |
$710 |
6.1× |
| Us xtr non-vasc lmtd (76882) |
$609 |
$648 |
5.6× |
| Venography extremity unilateral rs&i (75820) |
$708 |
$753 |
0.4× |
| Wrist 2 views (73100) |
$269 |
$286 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$608 |
$647 |
5.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$327 |
$347.50 |
3.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$361 |
$384 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$301 |
$320 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$304 |
$323 |
3.4× |
| X-ray exam hip uni 1 view (73501) |
$280 |
$298 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$361 |
$384 |
4.0× |
| X-ray eye for foreign body (70030) |
$267 |
$284 |
3.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$444 |
$472 |
4.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$348 |
$370 |
3.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$242 |
$257 |
2.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$430 |
$457 |
4.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$242 |
$257 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$431 |
$458 |
4.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$505 |
$537 |
4.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$442 |
$470 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$334 |
$355 |
3.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$298 |
$317 |
3.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$445 |
$473 |
4.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$784 |
$834 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$332 |
$353 |
3.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$33 |
$35 |
0.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$353 |
$375 |
3.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$327 |
$348 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$409 |
$435 |
4.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$304 |
$323 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$500 |
$532 |
4.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$335 |
$356 |
3.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$296 |
$315 |
3.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$295 |
$314 |
3.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$415 |
$441 |
4.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$384 |
$408.50 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$236 |
$251 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$348 |
$370 |
3.9× |
| Xr finger(s) 2+ views (73140) |
$259 |
$275 |
2.9× |
| Xr shoulder 1 view (73020) |
$224 |
$238 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$500 |
$532 |
4.6× |
| Xr tibia/fibula 2 views (73590) |
$333 |
$354 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$284 |
$302 |
3.1× |