Abdomen 1 View (74018)
range across 4 matching MRF lines |
— |
$388.50–$474 |
— |
| Abdomen 2 views (74019) |
— |
$516 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$1,024.50 |
— |
| Ankle 2 views (73600) |
— |
$456.50 |
— |
| Bone age studies (77072) |
— |
$232.50 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$2,568 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,781 |
— |
| Bone Imaging Whole Body (78306) |
— |
$3,082.50 |
— |
| Bone survey infant (77076) |
— |
$605.50 |
— |
| Chest 1 view (71045) |
— |
$418.50 |
— |
| Chest 2 views (71046) |
— |
$482.50 |
— |
| Chest 3 views (71047) |
— |
$560.50 |
— |
| Chest 4 or more views (71048) |
— |
$701.50 |
— |
| Cholecystography Oral Contrast (74290) |
— |
$74 |
— |
| Clavicle complete (73000) |
— |
$477 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$654 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$903 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$6,200 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$4,446 |
— |
| CT abdomen w contrast (74160) |
— |
$3,764.50 |
— |
| CT abdomen w wo contrast (74170) |
— |
$3,992.50 |
— |
| CT abdomen w/o contrast (74150) |
— |
$2,584.50 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$5,771.50 |
— |
| CT Angio Chest (71275) |
— |
$3,784.50 |
— |
| CT Angio Head (70496) |
— |
$4,436.50 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$3,828 |
— |
| CT Angio Neck (70498) |
— |
$3,756.50 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$1,808 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$3,075 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$2,754.50 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$3,616.50 |
— |
| CT chest w contrast (71260) |
— |
$3,521 |
— |
| CT chest w/wo contrast (71270) |
— |
$3,443 |
— |
| CT head/brain with contrast (70460) |
— |
$3,290.50 |
— |
| CT head/brain without and with contrast (70470) |
— |
$3,632 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$268.50 |
— |
CT iac w contrast (70481)
range across 4 matching MRF lines |
— |
$3,199–$3,469 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$3,360 |
— |
| CT lower ext w/o (73700) |
— |
$3,002 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$3,840.50 |
— |
| CT lumbar spine w contrast (72132) |
— |
$3,762 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$3,188.50 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,320.50 |
— |
CT maxillofacial wo contrast (70486)
range across 4 matching MRF lines |
— |
$2,224–$2,422 |
— |
| CT neck tissue combo (70492) |
— |
$3,546 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$4,430.50 |
— |
CT orbits w/o contrast (70480)
range across 4 matching MRF lines |
— |
$2,999–$3,105 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$3,790 |
— |
| CT pelvis w/o contrast (72192) |
— |
$2,799 |
— |
| CT scan of leg combo (73702) |
— |
$3,798 |
— |
| CT scans face/jaw combo (70488) |
— |
$3,442 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$3,129 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$2,685.50 |
— |
| CT thoracic spine w contrast (72129) |
— |
$2,998 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$3,135 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$897.50 |
— |
| CT thorax w/o contrast (71250) |
— |
$2,312.50 |
— |
| CT upper ext wo (73200) |
— |
$2,488 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$897.50 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,982.50 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$4,042 |
— |
| Cta Abdomen (74175) |
— |
$3,652 |
— |
| Dxa Bone Density Axial (77080) |
— |
$480 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$299.50 |
— |
| Esophagram (74220) |
— |
$764.50 |
— |
| Foot 2 views (73620) |
— |
$417.50 |
— |
| Forearm 2 views (73090) |
— |
$450 |
— |
| Gastric emptying imaging study (78264) |
— |
$2,039.50 |
— |
| Hand 2 views (73120) |
— |
$392 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$2,689.50 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$3,358 |
— |
| Hysterosalpingogram (74740) |
— |
$1,267 |
— |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
— |
$1,298.50 |
— |
| Knee 3 Views (73562) |
— |
$472 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$1,244 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$1,896.50 |
— |
| Lung Ventilation Imaging (78579) |
— |
$1,387 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$3,770.50 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$5,443 |
— |
| MRA head w/o contrast (70544) |
— |
$2,937 |
— |
| MRA head with contrast (70545) |
— |
$4,412 |
— |
| MRA neck w contrast (70548) |
— |
$4,259 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$4,759.50 |
— |
| MRA neck w/o contrast (70547) |
— |
$3,064 |
— |
| MRI abdomen w contrast (74182) |
— |
$1,710 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$4,503.50 |
— |
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 4 matching MRF lines |
— |
$612.50–$4,328 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$4,523 |
— |
| MRI cervical spine w contrast (72142) |
— |
$4,592.50 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$3,214.50 |
— |
MRI chest w/o contrast (71550)
range across 4 matching MRF lines |
— |
$3,498.50–$4,472 |
— |
| MRI chest with contrast (71551) |
— |
$3,230 |
— |
MRI chest wo w contrast (71552)
range across 4 matching MRF lines |
— |
$4,148–$6,591.50 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$6,425.50 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$3,675 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$3,337 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$4,666 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$5,513.50 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$4,966.50 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$5,194 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$6,821.50 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$3,560.50 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$3,567 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$1,942 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$4,472 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$6,591.50 |
— |
| MRI, abdomen, combo (74183) |
— |
$5,207.50 |
— |
| MRI, dorsal spine combo (72157) |
— |
$5,912 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$3,510 |
— |
| MRI, joint upper extrem (73221) |
— |
$2,558.50 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$5,512.50 |
— |
| MRI, lumbar spine combo (72158) |
— |
$4,658.50 |
— |
| Myelogram cervical (72240) |
— |
$2,319 |
— |
| Myelogram Lumbar (72265) |
— |
$2,319 |
— |
| Myelography thoracic (72255) |
— |
$2,319 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$3,013.50 |
— |
| Neck soft tissue (70360) |
— |
$592 |
— |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
— |
$483.50 |
— |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
— |
$483.50 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$424.50 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,250.50 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$821.50 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$400 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$544 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$460 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$546 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$625.50 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$368 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$489.50 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$543 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$408 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$641.50 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$446 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$476 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$512.50 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$135 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$327 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$312.50 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$348.50 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$542 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$443.50 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,245 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,004 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$654.50 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$960.50 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$772.50 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,148 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$602 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$462.50 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$1,076 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$491.50 |
— |
| Ribs bilateral 3 views (71110) |
— |
$899.50 |
— |
| Scapula (73010) |
— |
$311.50 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$121.50 |
— |
| Shoulder 1 view (73020) |
— |
$432 |
— |
| Skull less than 4 views (70250) |
— |
$438 |
— |
| Sternoclavicular joints (71130) |
— |
$241 |
— |
| Thoracic spine 2 views (72070) |
— |
$582 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$988.50 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$373 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$1,921 |
— |
Ultrasound Exam Aaa Screen (76706)
range across 4 matching MRF lines |
— |
$1,231.50–$1,444 |
— |
Ultrasound, abdomen limited (76705)
range across 6 matching MRF lines |
— |
$442–$1,007 |
— |
| Unlisted respiratory px dx nuclear medicine (78599) |
— |
$256 |
— |
| Unlisted us procedure (76999) |
— |
$872 |
— |
| Us breast unilateral complete (76641) |
— |
$720.50 |
— |
| Us chest (76604) |
— |
$442 |
— |
| Us complete joint (76881) |
— |
$1,004 |
— |
| Us exam, pelvic, limited (76857) |
— |
$768.50 |
— |
| Us head (76506) |
— |
$710 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$536.50 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$636.50 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,177 |
— |
| Us retroperitoneal complete (76770) |
— |
$468 |
— |
| Us retroperitoneal limited (76775) |
— |
$984 |
— |
| Us scrotum and contents (76870) |
— |
$1,169.50 |
— |
| Us thyroid (76536) |
— |
$958.50 |
— |
| Us transrectal (76872) |
— |
$1,537 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$184.50 |
— |
| Wrist 2 views (73100) |
— |
$414.50 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$401 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$377.50 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$241 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$474 |
— |
X-Ray Exam Hip Uni 1 View (73501)
range across 4 matching MRF lines |
— |
$144–$657 |
— |
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 4 matching MRF lines |
— |
$217–$403 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$607 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$622.50 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$687.50 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$515 |
— |
X-Ray Exam Neck Spine 6/>Vws (72052)
range across 4 matching MRF lines |
— |
$1,048–$1,102.50 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$624.50 |
— |
X-ray eye for foreign body (70030)
range across 4 matching MRF lines |
— |
$162–$382.50 |
— |
| X-ray humerus (73060) |
— |
$361.50 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,436 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$104 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$665 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$453.50 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$1,026.50 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$645 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$615.50 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$869 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$865.50 |
— |
| X-Ray Stress View (77071) |
— |
$142.50 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$909 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$745 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$1,847 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$888.50 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$299.50 |
— |
| XR Mastoids < 3 Views Bilateral (70120) |
— |
$329 |
— |
| Xr orbits complete 4 views (70200) |
— |
$611 |
— |