| Abdomen 2 views (74019) |
$178.10 |
$274 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$194.02 |
$298.50 |
2.2× |
| Chest 1 view (71045) |
$116.68 |
$179.50 |
1.3× |
| Clavicle complete (73000) |
$250.25 |
$385 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$847.92 |
$1,304.50 |
7.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,751.80 |
$5,772 |
10.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,066.05 |
$4,717 |
12.5× |
| CT abdomen w/o contrast (74150) |
$1,481.35 |
$2,279 |
13.7× |
| CT c-spine w/o contrast (72125) |
$1,758.90 |
$2,706 |
16.3× |
| CT chest w contrast (71260) |
$1,103.70 |
$1,698 |
6.1× |
| CT head/brain without and with contrast (70470) |
$1,951.95 |
$3,003 |
10.8× |
| CT lower ext w/o (73700) |
$1,481.35 |
$2,279 |
13.7× |
| CT lower extremity w/contrast material (73701) |
$1,699.75 |
$2,615 |
9.4× |
| CT lumbar spine w/o contrast (72131) |
$1,883.70 |
$2,898 |
17.5× |
| CT maxillofacial w contrast (70487) |
$1,699.75 |
$2,615 |
9.4× |
| CT maxillofacial wo contrast (70486) |
$1,387.10 |
$2,134 |
12.9× |
| CT pelvis w/o contrast (72192) |
$1,467.05 |
$2,257 |
13.6× |
| CT soft tissue neck w contrast (70491) |
$1,849.25 |
$2,845 |
10.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,481.35 |
$2,279 |
13.7× |
| CT thoracic spine w/o contrast (72128) |
$1,748.50 |
$2,690 |
16.2× |
| CT thorax w/o contrast (71250) |
$1,606.15 |
$2,471 |
14.9× |
| CT upper ext wo (73200) |
$727.68 |
$1,119.50 |
6.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,104.05 |
$3,237 |
11.6× |
| CTA abdomen pelvis (74174) |
$3,751.15 |
$5,771 |
10.4× |
| CTA chest (71275) |
$2,128.10 |
$3,274 |
11.8× |
| Cta Head (70496) |
$2,112.50 |
$3,250 |
11.7× |
| Cta Neck (70498) |
$2,409.55 |
$3,707 |
13.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$79.95 |
$123 |
0.7× |
| Facial bones min 3 views (70150) |
$201.82 |
$310.50 |
1.9× |
| Foot 2 views (73620) |
$177.45 |
$273 |
2.0× |
| Forearm 2 views (73090) |
$143 |
$220 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,103.05 |
$1,697 |
2.7× |
| Knee 3 views (73562) |
$166.08 |
$255.50 |
1.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,364.02 |
$2,098.50 |
3.8× |
| MRA head w/o contrast (70544) |
$1,089.72 |
$1,676.50 |
4.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,366.95 |
$2,103 |
3.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,451.45 |
$2,233 |
4.0× |
| MRI cervical spine w/o contrast (72141) |
$2,175.55 |
$3,347 |
8.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,334.12 |
$2,052.50 |
3.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,270.42 |
$1,954.50 |
5.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,372.48 |
$2,111.50 |
3.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,407.90 |
$2,166 |
3.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,393.30 |
$3,682 |
6.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,025.40 |
$3,116 |
5.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,046.55 |
$4,687 |
8.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,002 |
$3,080 |
8.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,254.50 |
$1,930 |
5.1× |
| Myocardial Spect Multiple Studies (78452) |
$2,958.15 |
$4,551 |
2.2× |
| Neck soft tissue (70360) |
$142.35 |
$219 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$141.05 |
$217 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,682.85 |
$2,589 |
3.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$153.72 |
$236.50 |
1.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$131.30 |
$202 |
1.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$137.15 |
$211 |
1.5× |
| Radex fingr minimum 2 views (73140) |
$116.68 |
$179.50 |
1.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$157.62 |
$242.50 |
1.8× |
| Radex Hand Minimum 3 Views (73130) |
$159.58 |
$245.50 |
1.8× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$484.25 |
$745 |
4.5× |
| Radex Humerus Minimum 2 Views (73060) |
$153.40 |
$236 |
1.7× |
| Radex Kne 1/2 Views (73560) |
$159.58 |
$245.50 |
1.8× |
| Radex Kne Compl 4/More Views (73564) |
$205.08 |
$315.50 |
1.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$203.45 |
$313 |
1.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$162.50 |
$250 |
1.8× |
| Radex Toe Minimum 2 Views (73660) |
$136.50 |
$210 |
1.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$159.90 |
$246 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$138.78 |
$213.50 |
1.5× |
| Radiologic exam chest 2 views (71046) |
$163.48 |
$251.50 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$137.15 |
$211 |
1.5× |
| Ribs bilateral 3 views (71110) |
$213.85 |
$329 |
2.0× |
| Scapula (73010) |
$273 |
$420 |
2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$72.48 |
$111.50 |
3.1× |
| Shoulder 1 view (73020) |
$226.85 |
$349 |
2.5× |
| Spine thoracic 3 views (72072) |
$188.18 |
$289.50 |
1.7× |
| Ultrasound breast complete (76641) |
$622.70 |
$958 |
5.8× |
| Ultrasound Exam Aaa Screen (76706) |
$447.20 |
$688 |
4.1× |
| Ultrasound, abdomen limited (76705) |
$221 |
$340 |
2.0× |
| Us breast unilateral limited (76642) |
$436.15 |
$671 |
4.9× |
| Us chest (76604) |
$145.92 |
$224.50 |
1.4× |
| Us compl joint r-t w/image documentation (76881) |
$346.12 |
$532.50 |
3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$574.60 |
$884 |
5.3× |
| Us pelvic non ob complete (76856) |
$637.65 |
$981 |
5.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$333.45 |
$513 |
3.1× |
| Us retroperitoneal complete (76770) |
$614.90 |
$946 |
5.7× |
| Us retroperitoneal limited (76775) |
$413.40 |
$636 |
3.8× |
| Us scrotum and contents (76870) |
$317.85 |
$489 |
2.9× |
| Us soft tissue head/neck (76536) |
$389.68 |
$599.50 |
3.6× |
| Us transrectal (76872) |
$407.22 |
$626.50 |
3.8× |
| Wrist 2 views (73100) |
$116.02 |
$178.50 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$242.45 |
$373 |
2.7× |
| X-ray exam of femur 2/> (73552) |
$183.95 |
$283 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$192.40 |
$296 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$152.10 |
$234 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$219.70 |
$338 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$171.60 |
$264 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$160.88 |
$247.50 |
1.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$262.60 |
$404 |
2.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$146.25 |
$225 |
1.4× |
| Xr c-spine 4 or 5 views (72050) |
$217.75 |
$335 |
2.0× |