| Abdomen 2 views (74019) |
$317.40 |
$529 |
3.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,473.60 |
$2,456 |
4.0× |
| Ankle 2 views (73600) |
$211.20 |
$352 |
2.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$506.70 |
$844.50 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$874.20 |
$1,457 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$717 |
$1,195 |
2.0× |
| Bone age studies (77072) |
$181.80 |
$303 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$735.60 |
$1,226 |
2.0× |
| Bone survey complete (77075) |
$712.20 |
$1,187 |
7.4× |
| Cervical spine 2 or 3 views (72040) |
$310.20 |
$517 |
3.9× |
| Chest 1 view (71045) |
$188.40 |
$314 |
2.4× |
| Chest 3 views (71047) |
$316.80 |
$528 |
4.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$425.40 |
$709 |
2.6× |
| Clavicle complete (73000) |
$200.40 |
$334 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$408.60 |
$681 |
4.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,765.40 |
$4,609 |
8.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,305.80 |
$3,843 |
10.5× |
| CT abdomen w contrast (74160) |
$1,440.60 |
$2,401 |
8.9× |
| CT abdomen w wo contrast (74170) |
$1,737.60 |
$2,896 |
10.8× |
| CT abdomen w/o contrast (74150) |
$1,226.40 |
$2,044 |
12.8× |
| CT c-spine w/o contrast (72125) |
$1,265.40 |
$2,109 |
13.2× |
| CT chest w/wo contrast (71270) |
$1,626.60 |
$2,711 |
10.1× |
| CT chest with contrast (71260) |
$1,378.20 |
$2,297 |
8.5× |
| CT head/brain with contrast (70460) |
$1,322.40 |
$2,204 |
8.2× |
| CT head/brain without and with contrast (70470) |
$1,610.40 |
$2,684 |
10.0× |
| CT iac w contrast (70481) |
$1,186.80 |
$1,978 |
7.4× |
| CT lower ext w/o (73700) |
$1,170.90 |
$1,951.50 |
12.2× |
| CT lower extremity w wo contrast (73702) |
$1,935 |
$3,225 |
12.0× |
| CT lower extremity with contrast (73701) |
$1,332 |
$2,220 |
8.3× |
| CT lumbar spine w/o contrast (72131) |
$1,282.80 |
$2,138 |
13.3× |
| CT maxillofacial w contrast (70487) |
$1,329 |
$2,215 |
8.2× |
| CT maxillofacial w/o contrast (70486) |
$1,082.40 |
$1,804 |
11.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,587.60 |
$2,646 |
9.8× |
| CT neck soft tissue w contrast (70491) |
$1,348.80 |
$2,248 |
8.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,354.80 |
$2,258 |
8.4× |
| CT orbits w/o contrast (70480) |
$1,033.20 |
$1,722 |
10.7× |
| CT pelvis w & w/o contrast (72194) |
$1,636.80 |
$2,728 |
10.1× |
| CT pelvis w/o contrast (72192) |
$1,164 |
$1,940 |
12.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,549.20 |
$2,582 |
9.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,065 |
$1,775 |
11.1× |
| CT thoracic spine w/o contrast (72128) |
$1,227.60 |
$2,046 |
12.8× |
| CT thorax w/o contrast (71250) |
$1,119 |
$1,865 |
11.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,042.80 |
$1,738 |
10.8× |
| CT upper extremity with contrast (73201) |
$978.60 |
$1,631 |
3.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,657.80 |
$2,763 |
10.3× |
| Cta Abdomen (74175) |
$1,581 |
$2,635 |
9.8× |
| CTA abdomen pelvis (74174) |
$2,520.60 |
$4,201 |
7.9× |
| CTA chest (71275) |
$1,702.80 |
$2,838 |
10.6× |
| Cta Head (70496) |
$1,523.40 |
$2,539 |
9.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,060.60 |
$5,101 |
9.5× |
| CTA lwr ext w&w/o contrast (73706) |
$1,592.40 |
$2,654 |
9.9× |
| Cta Neck (70498) |
$1,591.20 |
$2,652 |
9.9× |
| Cta Pelvis (72191) |
$1,638.60 |
$2,731 |
10.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$264 |
$440 |
2.7× |
| Echoencephalography real time imaging (76506) |
$453.60 |
$756 |
4.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$339.60 |
$566 |
3.5× |
| Fluoroscopy up to 1 hr (76000) |
$388.20 |
$647 |
1.8× |
| Foot 2 views (73620) |
$205.20 |
$342 |
2.6× |
| Forearm 2 views (73090) |
$214.20 |
$357 |
2.7× |
| Gated Heart Planar Single (78472) |
$863.70 |
$1,439.50 |
2.3× |
| Hand 2 views (73120) |
$221.40 |
$369 |
2.3× |
| Hand 3 views (73130) |
$260.40 |
$434 |
3.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$856.50 |
$1,427.50 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$735 |
$1,225 |
2.0× |
| Ht muscle image spect sing (78451) |
$1,659 |
$2,765 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$240 |
$400 |
3.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,016.60 |
$3,361 |
4.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,021.20 |
$1,702 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$559.80 |
$933 |
1.1× |
| Knee 3 views (73562) |
$288 |
$480 |
3.6× |
| Meckels Diverticulum (78290) |
$1,210.80 |
$2,018 |
3.3× |
| MRA head w/o contrast (70544) |
$1,399.80 |
$2,333 |
6.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,815.60 |
$3,026 |
5.7× |
| MRA neck w/o contrast (70547) |
$1,492.20 |
$2,487 |
6.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,170.80 |
$3,618 |
6.8× |
| MRI abdomen w/o contrast (74181) |
$1,545.60 |
$2,576 |
7.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,876.80 |
$3,128 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,893 |
$3,155 |
2.6× |
| MRI c-spine with contrast (72142) |
$1,996.20 |
$3,327 |
6.2× |
| MRI cervical spine w/o contrast (72141) |
$1,795.80 |
$2,993 |
8.2× |
| MRI chest w/o & w/contrast material (71552) |
$3,546 |
$5,910 |
11.1× |
| MRI chest w/o contrast (71550) |
$1,431.60 |
$2,386 |
6.5× |
| MRI chest with contrast (71551) |
$2,028 |
$3,380 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,789.20 |
$2,982 |
8.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,435.80 |
$2,393 |
6.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,184.60 |
$3,641 |
6.8× |
| MRI pelvis w contrast (72196) |
$1,836.60 |
$3,061 |
5.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,192.40 |
$3,654 |
6.8× |
| MRI pelvis w/o contrast (72195) |
$1,560.60 |
$2,601 |
7.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,376.60 |
$3,961 |
7.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,214.60 |
$3,691 |
6.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,527.80 |
$4,213 |
7.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,974.60 |
$3,291 |
6.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,288.40 |
$3,814 |
7.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,886.40 |
$3,144 |
5.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,222.40 |
$3,704 |
6.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,793.40 |
$2,989 |
8.2× |
| MRI tmj (70336) |
$1,672.80 |
$2,788 |
7.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,637.40 |
$2,729 |
7.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,987.80 |
$3,313 |
6.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,466.40 |
$2,444 |
6.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,545.80 |
$4,243 |
2.1× |
| Neck soft tissue (70360) |
$222.60 |
$371 |
2.8× |
| Nm gastric emptying study (78264) |
$727.20 |
$1,212 |
2.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$309 |
$515 |
3.2× |
| Osseous survey infant (77076) |
$385.80 |
$643 |
4.0× |
| Osseous survey limited (77074) |
$529.80 |
$883 |
5.5× |
| Parathyroid imaging (78070) |
$567 |
$945 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$274.20 |
$457 |
2.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,151 |
$3,585 |
6.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$675.60 |
$1,126 |
1.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$297.60 |
$496 |
3.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$396 |
$660 |
4.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$336 |
$560 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$207.60 |
$346 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$261 |
$435 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$279 |
$465 |
3.5× |
| Radiological examination surgical specimen (76098) |
$339 |
$565 |
0.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,353.20 |
$3,922 |
4.7× |
| Scapula complete (73010) |
$260.40 |
$434 |
2.7× |
| Screening digital breast tomosynthesis (77063) |
$81.60 |
$136 |
3.5× |
| Small bowel series (74250) |
$639.60 |
$1,066 |
4.0× |
| Spine thoracic 3 views (72072) |
$381.60 |
$636 |
4.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$411.30 |
$685.50 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$556.50 |
$927.50 |
1.5× |
| Tmj unilateral (70328) |
$245.40 |
$409 |
3.1× |
| Ultrasound, abdomen limited (76705) |
$467.40 |
$779 |
4.9× |
| Upper Extremity Infant (73092) |
$106.80 |
$178 |
1.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$637.20 |
$1,062 |
4.0× |
| Us abdl aorta screen aaa (76706) |
$363 |
$605 |
3.8× |
| Us breast unilateral complete (76641) |
$346.20 |
$577 |
3.6× |
| Us breast unilateral limited (76642) |
$339 |
$565 |
4.2× |
| Us chest (76604) |
$493.20 |
$822 |
5.1× |
| Us compl joint r-t w/image documentation (76881) |
$415.80 |
$693 |
4.3× |
| Us infant hips dynamic (76885) |
$312 |
$520 |
3.9× |
| Us ob detailed single fetus (76811) |
$525.60 |
$876 |
2.4× |
| Us ob transvaginal (76817) |
$463.20 |
$772 |
4.8× |
| Us pelvic non ob complete (76856) |
$560.40 |
$934 |
5.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$352.20 |
$587 |
3.7× |
| Us pregnancy ltd (76815) |
$349.80 |
$583 |
3.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$583.80 |
$973 |
6.1× |
| Us retroperitoneal complete (76770) |
$636 |
$1,060 |
6.6× |
| Us scrotum and contents (76870) |
$510 |
$850 |
5.3× |
| Us soft tissue head/neck (76536) |
$580.80 |
$968 |
6.0× |
| Us xtr non-vasc lmtd (76882) |
$320.40 |
$534 |
3.3× |
| Wrist 2 views (73100) |
$201 |
$335 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$396.60 |
$661 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$306 |
$510 |
3.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$254.40 |
$424 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$196.20 |
$327 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$258.60 |
$431 |
3.2× |
| X-ray exam hip uni 1 view (73501) |
$199.20 |
$332 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$274.80 |
$458 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$277.80 |
$463 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$198 |
$330 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$238.20 |
$397 |
3.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$213.60 |
$356 |
2.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$356.10 |
$593.50 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$270.60 |
$451 |
3.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$183.60 |
$306 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$357.60 |
$596 |
3.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$487.20 |
$812 |
5.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$222.60 |
$371 |
2.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$231 |
$385 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$349.80 |
$583 |
3.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$259.80 |
$433 |
3.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$358.20 |
$597 |
3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$462 |
$770 |
4.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$242.40 |
$404 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$300 |
$500 |
3.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$262.80 |
$438 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$279.60 |
$466 |
3.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$232.20 |
$387 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$358.20 |
$597 |
3.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$280.20 |
$467 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$225.60 |
$376 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$348.60 |
$581 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$181.20 |
$302 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$232.20 |
$387 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$462 |
$770 |
4.8× |
| Xr chest 4+ views (71048) |
$300 |
$500 |
3.1× |
| Xr finger(s) 2+ views (73140) |
$184.20 |
$307 |
2.3× |
| Xr optic foramina (70190) |
$144.60 |
$241 |
1.8× |
| Xr shoulder 1 view (73020) |
$190.20 |
$317 |
2.4× |
| Xr spine cervical 4 or 5 views (72050) |
$422.40 |
$704 |
4.4× |
| Xr tibia/fibula 2 views (73590) |
$252.60 |
$421 |
3.2× |
| Xray knee 1 or 2 views rt (73560) |
$198.60 |
$331 |
2.5× |