| Abdomen 1 View (74018) |
$336 |
$840 |
3.7× |
| Abdomen 2 views (74019) |
$438.40 |
$1,096 |
4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$812.40 |
$2,031 |
1.9× |
| Angio internal mammary (75756) |
$1,494.80 |
$3,737 |
0.5× |
| Angio pulmonary bilat (75743) |
$1,046 |
$2,615 |
0.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,568 |
$8,920 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$2,098 |
$5,245 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,930.40 |
$4,826 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,616.80 |
$4,042 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,598.40 |
$3,996 |
0.5× |
| Ankle 2 views (73600) |
$330.40 |
$826 |
3.6× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,579.60 |
$6,449 |
0.4× |
| Artery X-Rays Abdomen (75726) |
$3,668 |
$9,170 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$2,099.20 |
$5,248 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$4,468.40 |
$11,171 |
0.8× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$2,445.20 |
$6,113 |
0.4× |
| Arthrogram ankle (73615) |
$1,900 |
$4,750 |
5.2× |
| Arthrogram hip (73525) |
$346 |
$865 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$132.80 |
$332 |
0.9× |
| Bone age studies (77072) |
$401.60 |
$1,004 |
3.7× |
| Bone Imaging 3 Phase (78315) |
$2,015.60 |
$5,039 |
4.8× |
| Bone Imaging Limited Area (78300) |
$1,378 |
$3,445 |
3.3× |
| Bone Imaging Multiple Areas (78305) |
$1,786 |
$4,465 |
4.3× |
| Bone Imaging Whole Body (78306) |
$1,907.20 |
$4,768 |
4.6× |
| Bone marrow imaging limited area (78102) |
$720.40 |
$1,801 |
1.7× |
| Bone marrow imaging; whole body (78104) |
$740 |
$1,850 |
1.8× |
| Bone survey infant (77076) |
$543.60 |
$1,359 |
5.0× |
| Brain Flow Imaging Only (78610) |
$873.60 |
$2,184 |
1.5× |
| Brain Image W/Flow < 4 Views (78601) |
$367.20 |
$918 |
0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,187.20 |
$2,968 |
2.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$367.20 |
$918 |
0.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,283.60 |
$3,209 |
3.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$864 |
$2,160 |
1.5× |
| Cerebrospinal Fluid Scan (78630) |
$920.40 |
$2,301 |
1.6× |
| Chest 1 view (71045) |
$226 |
$565 |
2.5× |
| Chest 2 views (71046) |
$157.20 |
$393 |
1.7× |
| Chest 3 views (71047) |
$146.80 |
$367 |
1.6× |
| Chest 4 or more views (71048) |
$157.20 |
$393 |
1.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$926.80 |
$2,317 |
1.1× |
| Clavicle complete (73000) |
$325.60 |
$814 |
3.6× |
| Contrast Exam Abdominl Aorta (75625) |
$2,028 |
$5,070 |
0.6× |
| Contrast X-Ray Bladder (74430) |
$439.20 |
$1,098 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,629.20 |
$11,573 |
12.7× |
| CT abdomen and pelvis without contrast (74176) |
$3,126 |
$7,815 |
12.5× |
| CT abdomen w contrast (74160) |
$3,235.20 |
$8,088 |
17.7× |
| CT abdomen w wo contrast (74170) |
$3,338.80 |
$8,347 |
18.2× |
| CT abdomen w/o contrast (74150) |
$2,129.20 |
$5,323 |
19.5× |
| CT Angio Abdomen and Pelvis (74174) |
$4,179.60 |
$10,449 |
11.5× |
| CT Angio Chest (71275) |
$2,036.80 |
$5,092 |
11.1× |
| CT Angio Head (70496) |
$1,215.20 |
$3,038 |
6.6× |
CT angio hrt w/3d image (75574)
range across 2 matching MRF lines |
$1,254.80–$1,328.40 |
$3,137–$3,321 |
varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,948.80 |
$4,872 |
10.6× |
| CT Angio Neck (70498) |
$1,215.20 |
$3,038 |
6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,754 |
$4,385 |
9.6× |
| CT cervical spine w/ contrast (72126) |
$3,292.40 |
$8,231 |
9.0× |
| CT cervical spine w/o contrast (72125) |
$1,952.40 |
$4,881 |
17.9× |
| CT cervical spine w/wo cont (72127) |
$4,435.20 |
$11,088 |
24.2× |
| CT chest w contrast (71260) |
$3,094.40 |
$7,736 |
16.9× |
| CT chest w/wo contrast (71270) |
$3,107.60 |
$7,769 |
17.0× |
| CT head/brain with contrast (70460) |
$1,796 |
$4,490 |
9.8× |
| CT head/brain without and with contrast (70470) |
$1,971.60 |
$4,929 |
10.8× |
CT heart contrast eval cardiac structure&morph (75572)
range across 2 matching MRF lines |
$1,355.20–$1,434.80 |
$3,388–$3,587 |
varies |
| CT heart no contrast quant eval coronry calcium (75571) |
$268.80 |
$672 |
3.0× |
CT hrt w/3d image congen (75573)
range across 2 matching MRF lines |
$1,099.20–$1,163.60 |
$2,748–$2,909 |
varies |
| CT iac w contrast (70481) |
$2,329.20 |
$5,823 |
12.7× |
| CT l-spine w&w/o contrast (72133) |
$6,108 |
$15,270 |
33.3× |
| CT lower ext w/o (73700) |
$2,023.20 |
$5,058 |
18.5× |
| CT lower extremity w/contrast material (73701) |
$3,000.80 |
$7,502 |
16.4× |
| CT lumbar spine w contrast (72132) |
$3,772.40 |
$9,431 |
10.4× |
| CT lumbar spine w/o contrast (72131) |
$2,036 |
$5,090 |
18.6× |
| CT maxillofacial w contrast (70487) |
$1,680.40 |
$4,201 |
9.2× |
| CT maxillofacial wo contrast (70486) |
$1,368.80 |
$3,422 |
12.5× |
| CT neck tissue combo (70492) |
$2,101.20 |
$5,253 |
11.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,869.20 |
$7,173 |
15.7× |
| CT orbits w/o contrast (70480) |
$2,060.40 |
$5,151 |
18.9× |
| CT pelvis w&w/o contrast (72194) |
$4,450.40 |
$11,126 |
24.3× |
| CT pelvis w/o contrast (72192) |
$2,329.60 |
$5,824 |
21.3× |
| CT scan of leg combo (73702) |
$3,028 |
$7,570 |
16.5× |
| CT scans face/jaw combo (70488) |
$2,100 |
$5,250 |
11.5× |
| CT soft tissue neck w contrast (70491) |
$1,868.40 |
$4,671 |
10.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,542.40 |
$3,856 |
14.1× |
| CT thoracic spine w contrast (72129) |
$4,587.60 |
$11,469 |
25.0× |
| CT thoracic spine w/o contrast (72128) |
$3,058.40 |
$7,646 |
28.0× |
| CT thoracic spine w/wo cont (72130) |
$6,230.40 |
$15,576 |
34.0× |
| CT thorax w/o contrast (71250) |
$1,956.80 |
$4,892 |
17.9× |
| CT upper ext wo (73200) |
$1,996.40 |
$4,991 |
18.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,502 |
$8,755 |
19.1× |
| CT upper extremity with contrast (73201) |
$2,918.80 |
$7,297 |
8.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,916.80 |
$7,292 |
15.9× |
| Cta Abdomen (74175) |
$2,094 |
$5,235 |
11.4× |
| CTA pelvis (72191) |
$2,083.60 |
$5,209 |
11.4× |
| Dilation ureters/urethra rs&i (74485) |
$1,151.60 |
$2,879 |
0.5× |
| Discography Cerv/Thor Spine (72285) |
$1,033.60 |
$2,584 |
0.5× |
| Diskography lumbar (72295) |
$1,439.60 |
$3,599 |
0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$249.60 |
$624 |
2.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$353.20 |
$883 |
3.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$158.40 |
$396 |
1.5× |
| Echo exam of fetal heart (76825) |
$716.40 |
$1,791 |
1.3× |
| Echo Guide For Artery Repair (76936) |
$411.20 |
$1,028 |
1.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$606.80 |
$1,517 |
2.4× |
| Esophagram (74220) |
$436 |
$1,090 |
2.4× |
| Fetal Biophys Profile W/Nst (76818) |
$998.40 |
$2,496 |
9.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$500.40 |
$1,251 |
4.6× |
| Fluoroscopy up to 1 hr (76000) |
$466.80 |
$1,167 |
1.9× |
| Follow-Up Angiography (75898) |
$1,589.60 |
$3,974 |
0.5× |
| Foot 2 views (73620) |
$338 |
$845 |
3.7× |
| Forearm 2 views (73090) |
$450.40 |
$1,126 |
5.0× |
| Gastric emptying imaging study (78264) |
$388.80 |
$972 |
0.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$898 |
$2,245 |
2.2× |
| Gated Heart Planar Single (78472) |
$1,247.20 |
$3,118 |
3.0× |
| Gated Heart, Multiple (78473) |
$1,260 |
$3,150 |
3.0× |
| Hand 2 views (73120) |
$308 |
$770 |
2.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,007.20 |
$7,518 |
0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,446.40 |
$6,116 |
0.7× |
| Hepatobil Syst Image W/Drug (78227) |
$1,206 |
$3,015 |
2.1× |
| Hepatobiliary System Imaging (78226) |
$680 |
$1,700 |
1.6× |
| Ht Muscle Image Spect Sing (78451) |
$1,823.60 |
$4,559 |
1.3× |
| Hysterosalpingogram (74740) |
$416 |
$1,040 |
1.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$664 |
$1,660 |
7.3× |
| Infant hip ultrasound, limited static exam (76886) |
$99.20 |
$248 |
1.1× |
| Interstitial radiation source applic complex (77778) |
$2,083.20 |
$5,208 |
2.9× |
| K Flow/Funct Image Multiple (78709) |
$1,580.40 |
$3,951 |
2.8× |
| K Flow/Funct Image W/Drug (78708) |
$1,556.80 |
$3,892 |
2.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,449.20 |
$3,623 |
2.6× |
| Kidney Imaging Morphol (78700) |
$1,148.80 |
$2,872 |
2.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,033.20 |
$2,583 |
2.5× |
| Knee 3 Views (73562) |
$449.20 |
$1,123 |
4.9× |
| Leveen/Shunt Patency Exam (78291) |
$367.20 |
$918 |
0.9× |
| Liver & Spleen Imaging Static Only (78215) |
$788.80 |
$1,972 |
1.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$777.60 |
$1,944 |
1.9× |
| Liver imaging w/vascular flow (78202) |
$476.40 |
$1,191 |
0.8× |
| Lung Perf&Ventilat Diferentl (78598) |
$473.60 |
$1,184 |
0.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$954.40 |
$2,386 |
1.7× |
| Lymph System Imaging (78195) |
$834 |
$2,085 |
1.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,501.60 |
$8,754 |
1.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$3,501.60 |
$8,754 |
1.1× |
| Meckels Divert Exam (78290) |
$1,030.80 |
$2,577 |
2.5× |
| Mr safety determination physician/other qhp (76016) |
$93.20 |
$233 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$26 |
$65 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$96.80 |
$242 |
1.0× |
| Mr safety implt pos&/immoblj (76019) |
$63.20 |
$158 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$255.60 |
$639 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,156 |
$5,390 |
5.9× |
| MRA head w/o contrast (70544) |
$1,627.60 |
$4,069 |
6.5× |
| MRA neck w contrast (70548) |
$1,894.40 |
$4,736 |
5.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,373.60 |
$5,934 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,701.60 |
$4,254 |
6.8× |
| MRI abdomen w contrast (74182) |
$2,893.20 |
$7,233 |
7.9× |
| MRI abdomen w/o contrast (74181) |
$2,075.20 |
$5,188 |
8.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,771.60 |
$6,929 |
3.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,791.20 |
$6,978 |
7.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,066.80 |
$5,167 |
2.5× |
| MRI cardiac w/o contrast (75557) |
$994.80 |
$2,487 |
4.0× |
| MRI cervical spine w contrast (72142) |
$1,858 |
$4,645 |
5.1× |
| MRI cervical spine w/o cont (72141) |
$1,835.20 |
$4,588 |
7.4× |
| MRI chest w/o contrast (71550) |
$2,034.80 |
$5,087 |
8.2× |
| MRI chest wo w contrast (71552) |
$2,206.80 |
$5,517 |
6.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,440.80 |
$6,102 |
6.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,162.40 |
$7,906 |
8.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,866 |
$4,665 |
7.5× |
| MRI lumbar spine w contrast (72149) |
$2,186 |
$5,465 |
6.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,980.40 |
$7,451 |
8.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,636 |
$4,090 |
6.6× |
| MRI orbit face neck w contrast (70542) |
$1,813.60 |
$4,534 |
5.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,396.40 |
$5,991 |
6.6× |
| MRI pelvis w contrast (72196) |
$1,468.80 |
$3,672 |
4.0× |
| MRI pelvis w/o & w contrast (72197) |
$2,073.20 |
$5,183 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,178 |
$2,945 |
4.7× |
| MRI spectroscopy (76390) |
$992.40 |
$2,481 |
10.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,816.40 |
$4,541 |
7.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,816.40 |
$4,541 |
7.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,964.40 |
$7,411 |
8.1× |
| MRI, abdomen, combo (74183) |
$3,679.60 |
$9,199 |
10.1× |
| MRI, dorsal spine combo (72157) |
$2,632.40 |
$6,581 |
7.2× |
| MRI, dorsal spine contrast (72147) |
$2,508 |
$6,270 |
6.9× |
| MRI, joint upper extrem (73221) |
$1,969.60 |
$4,924 |
7.9× |
| MRI, joint upper extrem combo (73223) |
$2,362.40 |
$5,906 |
6.5× |
| MRI, lumbar spine combo (72158) |
$2,632.40 |
$6,581 |
7.2× |
| Myelogram Lumbar (72265) |
$926.80 |
$2,317 |
1.1× |
| Myelograpy 2/more regions rs&i (72270) |
$1,090 |
$2,725 |
1.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$367.20 |
$918 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,515.20 |
$6,288 |
1.9× |
| N-invas est c ffr sw aly CTA (75580) |
$1,796 |
$4,490 |
2.0× |
| Neck soft tissue (70360) |
$376.40 |
$941 |
4.1× |
| Nm myocard infarct spect (78469) |
$722.40 |
$1,806 |
1.3× |
| Nonvascular Shunt X-Ray (75809) |
$601.60 |
$1,504 |
5.5× |
| Nuclear Rx Intra-Arterial (79445) |
$512 |
$1,280 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$2,383.60 |
$5,959 |
9.8× |
| Ob us nuchal meas 1 gest (76813) |
$254.40 |
$636 |
2.3× |
| Parathyroid Planar Imaging (78070) |
$1,281.60 |
$3,204 |
3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,365.60 |
$3,414 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$341.20 |
$853 |
3.1× |
| Peritoneogram Rs&I (74190) |
$271.20 |
$678 |
0.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$858.40 |
$2,146 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$841.20 |
$2,103 |
2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$616.40 |
$1,541 |
5.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$375.20 |
$938 |
0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$293.60 |
$734 |
3.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$472 |
$1,180 |
5.2× |
| Radex elbow complete minimum 3 views (73080) |
$512.80 |
$1,282 |
5.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$752.40 |
$1,881 |
6.9× |
| Radex fingr minimum 2 views (73140) |
$288.80 |
$722 |
3.2× |
| Radex foot complete minimum 3 views (73630) |
$569.60 |
$1,424 |
6.3× |
| Radex Hand Minimum 3 Views (73130) |
$505.20 |
$1,263 |
5.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$535.20 |
$1,338 |
5.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$423.60 |
$1,059 |
4.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$490.80 |
$1,227 |
5.4× |
| Radex shoulder complete minimum 2 views (73030) |
$530 |
$1,325 |
5.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$503.60 |
$1,259 |
5.5× |
| Radex Spine 1 View Specify Level (72020) |
$312 |
$780 |
3.4× |
| Radex Sternum Minimum 2 Views (71120) |
$530 |
$1,325 |
5.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$419.60 |
$1,049 |
4.6× |
| Radex Toe Minimum 2 Views (73660) |
$330.80 |
$827 |
3.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$406 |
$1,015 |
3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$520 |
$1,300 |
5.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$503.60 |
$1,259 |
4.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$451.60 |
$1,129 |
4.1× |
| Radiologic exam colon double contrast study (74280) |
$554 |
$1,385 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$444.80 |
$1,112 |
2.4× |
| Radiologic exam knee complete 4/more views (73564) |
$511.60 |
$1,279 |
4.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$373.20 |
$933 |
3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$515.60 |
$1,289 |
2.8× |
| Radiologic exam swallow function contrast study (74230) |
$426.40 |
$1,066 |
2.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$531.20 |
$1,328 |
2.9× |
| Radiologic examination femur minimum 2 views (73552) |
$354 |
$885 |
3.9× |
| Radiologic examination knee 1/2 views (73560) |
$341.20 |
$853 |
3.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$409.20 |
$1,023 |
4.5× |
| Renal Cyst Study (74470) |
$591.20 |
$1,478 |
1.0× |
| Ribs bilateral 3 views (71110) |
$418.80 |
$1,047 |
3.8× |
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines |
$1,173.20–$1,242 |
$2,933–$3,105 |
varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,109.20 |
$2,773 |
2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,844.80 |
$7,112 |
5.0× |
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802)
range across 2 matching MRF lines |
$2,762–$2,924 |
$6,905–$7,310 |
varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,768.40 |
$4,421 |
3.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,289.60 |
$5,724 |
1.7× |
| Rp Therapy Intravenous Administration (79101) |
$481.60 |
$1,204 |
2.0× |
| Scapula (73010) |
$482.40 |
$1,206 |
4.4× |
| Shoulder 1 view (73020) |
$244.40 |
$611 |
2.7× |
| Skull less than 4 views (70250) |
$392.80 |
$982 |
3.6× |
| Superior sagittal sinus venogram (75870) |
$1,580.40 |
$3,951 |
0.5× |
| Testicular Imaging W/Flow (78761) |
$682.40 |
$1,706 |
1.6× |
| Thoracic spine 2 views (72070) |
$578.80 |
$1,447 |
5.3× |
| Thoracic spine 3 views (72072) |
$610.40 |
$1,526 |
5.6× |
| Thoracolumbar 2 views (72080) |
$312 |
$780 |
3.4× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
$367.20 |
$918 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$388.80 |
$972 |
0.9× |
| Thyroid Met Imaging Body (78018) |
$1,630.40 |
$4,076 |
2.9× |
| Thyroid Uptake Measurement (78012) |
$502.40 |
$1,256 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,308.80 |
$3,272 |
3.1× |
| Ultrasound Breast Limited (76642) |
$312 |
$780 |
3.4× |
| Ultrasound Exam Aaa Screen (76706) |
$264.40 |
$661 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$817.60 |
$2,044 |
7.5× |
| Umbilical-artery Doppler (OB) (76820) |
$158.40 |
$396 |
1.5× |
| Unlisted Dx Radiographic Procedure (76499) |
$556.40 |
$1,391 |
6.1× |
| Upper gi w/o kub (74240) |
$412.40 |
$1,031 |
2.3× |
| Urethrocystogram voiding (74455) |
$625.60 |
$1,564 |
2.5× |
| Us breast unilateral complete (76641) |
$430 |
$1,075 |
3.9× |
| Us chest (76604) |
$438 |
$1,095 |
4.0× |
| Us exam, pelvic, limited (76857) |
$358.40 |
$896 |
3.3× |
| Us head (76506) |
$914.80 |
$2,287 |
8.4× |
| Us kidney transplant (76776) |
$589.20 |
$1,473 |
5.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$386.80 |
$967 |
3.5× |
| Us ob detailed single fetus (76811) |
$664.80 |
$1,662 |
2.7× |
| Us ob limited 1 or more fetuses (76815) |
$438.80 |
$1,097 |
4.0× |
| Us ob transvaginal (76817) |
$522.40 |
$1,306 |
4.8× |
| Us pelvic non ob complete (76856) |
$1,264.40 |
$3,161 |
11.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$866.40 |
$2,166 |
7.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$564.40 |
$1,411 |
5.2× |
| Us retroperitoneal complete (76770) |
$629.60 |
$1,574 |
5.8× |
Us retroperitoneal limited (76775)
range across 2 matching MRF lines |
$477.60–$505.60 |
$1,194–$1,264 |
varies |
| Us scrotum and contents (76870) |
$978.40 |
$2,446 |
9.0× |
| Us spinal canal and contents (76800) |
$770.80 |
$1,927 |
7.1× |
| Us thyroid (76536) |
$800.80 |
$2,002 |
7.3× |
| Vein X-Ray Chest (75827) |
$1,235.60 |
$3,089 |
0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,032.80 |
$5,082 |
0.6× |
| Vein X-Ray Skull Epidural (75872) |
$5,916.80 |
$14,792 |
9.0× |
| Vein X-Ray Spleen/Liver (75810) |
$2,094 |
$5,235 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$630.40 |
$1,576 |
0.2× |
| Venography Adrenal Unilateral (75840) |
$5,916.80 |
$14,792 |
1.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,042.80 |
$5,107 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$1,338 |
$3,345 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$782 |
$1,955 |
0.5× |
| Venography Orbital Rs&I (75880) |
$5,916.80 |
$14,792 |
9.0× |
| Venography Renal Bilateral (75833) |
$2,820 |
$7,050 |
0.9× |
| Venography Renal Unilateral (75831) |
$1,733.20 |
$4,333 |
0.5× |
| Venous sampling by catheter (75893) |
$5,916.80 |
$14,792 |
1.0× |
| Wrist 2 views (73100) |
$341.20 |
$853 |
3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$391.20 |
$978 |
4.3× |
| X-ray antegrade pyelogram tube (74425) |
$490.40 |
$1,226 |
1.3× |
| X-Ray Aorta Leg Arteries (75630) |
$2,091.20 |
$5,228 |
0.6× |
| X-Ray Bend Only L-S Spine (72120) |
$504 |
$1,260 |
4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$358.40 |
$896 |
3.9× |
| X-Ray Exam Breast Specimen (76098) |
$187.20 |
$468 |
0.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$216.80 |
$542 |
2.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$208.40 |
$521 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$286.80 |
$717 |
3.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$332.80 |
$832 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$375.20 |
$938 |
3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$550.40 |
$1,376 |
5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$538.80 |
$1,347 |
5.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$780.80 |
$1,952 |
7.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$613.20 |
$1,533 |
5.6× |
| X-ray eye for foreign body (70030) |
$172.80 |
$432 |
1.9× |
| X-ray humerus (73060) |
$353.20 |
$883 |
3.9× |
| X-ray IV pyelogram (ivp) (74400) |
$921.20 |
$2,303 |
5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$314.40 |
$786 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$318 |
$795 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$476 |
$1,190 |
4.4× |
| X-ray nose-rectum child f.b. (76010) |
$208 |
$520 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$758 |
$1,895 |
6.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$192 |
$480 |
1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$203.20 |
$508 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$495.20 |
$1,238 |
5.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$633.20 |
$1,583 |
7.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$910.40 |
$2,276 |
8.3× |
| X-ray thoracic spine 4 vw (72074) |
$623.60 |
$1,559 |
5.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$699.20 |
$1,748 |
1.9× |
| X-Rays Bone Survey Complete (77075) |
$548.80 |
$1,372 |
5.0× |
| Xr c-spine 4 or 5 views (72050) |
$702.80 |
$1,757 |
6.4× |
| Xr facial bones less than 3 views (70140) |
$722 |
$1,805 |
7.9× |
| Xr orbits complete 4 views (70200) |
$780.80 |
$1,952 |
7.2× |
| Xr Tomogram Single Plane (76100) |
$249.60 |
$624 |
2.3× |