| Abdomen 2 views (74019) |
$317.10 |
$453 |
2.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$507.50 |
$725 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$1,259.30 |
$1,799 |
3.0× |
| Bone age studies (77072) |
$294.70 |
$421 |
2.7× |
| Bone Imaging 3 Phase (78315) |
$1,362.20 |
$1,946 |
3.2× |
| Bone survey complete (77075) |
$189 |
$270 |
1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,899.10 |
$2,713 |
5.2× |
| Cervical spine 2 or 3 views (72040) |
$191.10 |
$273 |
2.1× |
| Chest 1 view (71045) |
$186.90 |
$267 |
2.0× |
| Chest 3 views (71047) |
$193.20 |
$276 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$515.90 |
$737 |
2.8× |
| Clavicle complete (73000) |
$175.70 |
$251 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$639.80 |
$914 |
5.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,806 |
$2,580 |
4.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,295.70 |
$1,851 |
5.1× |
| CT abdomen w contrast (74160) |
$1,247.40 |
$1,782 |
6.7× |
| CT abdomen w wo contrast (74170) |
$1,465.80 |
$2,094 |
7.9× |
| CT abdomen w/o contrast (74150) |
$842.10 |
$1,203 |
7.6× |
| CT angio hrt w/3d image (75574) |
$1,806 |
$2,580 |
4.9× |
| CT angiography upper extremity lt (73206) |
$1,263.50 |
$1,805 |
6.8× |
| CT c-spine w/o contrast (72125) |
$830.20 |
$1,186 |
7.5× |
| CT cervical spine w&w/o contrast (72127) |
$1,052.80 |
$1,504 |
5.7× |
| CT cervical spine with contrast (72126) |
$845.60 |
$1,208 |
2.3× |
| CT chest w/wo contrast (71270) |
$1,616.30 |
$2,309 |
8.7× |
| CT chest with contrast (71260) |
$1,477.70 |
$2,111 |
8.0× |
| CT head/brain with contrast (70460) |
$1,153.60 |
$1,648 |
6.2× |
| CT head/brain without and with contrast (70470) |
$1,255.80 |
$1,794 |
6.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,437.10 |
$2,053 |
3.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$51.80 |
$74 |
0.6× |
| CT hrt w/3d image congen (75573) |
$648.20 |
$926 |
1.8× |
| CT iac w contrast (70481) |
$1,153.60 |
$1,648 |
6.2× |
| CT lower ext w/o (73700) |
$814.10 |
$1,163 |
7.4× |
| CT lower extremity with contrast (73701) |
$911.40 |
$1,302 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$805.70 |
$1,151 |
7.3× |
| CT lumbar spine with contrast (72132) |
$996.10 |
$1,423 |
2.7× |
| CT maxillofacial w contrast (70487) |
$1,215.20 |
$1,736 |
6.6× |
| CT maxillofacial w/o contrast (70486) |
$1,133.30 |
$1,619 |
10.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,080.80 |
$1,544 |
5.8× |
| CT neck soft tissue w contrast (70491) |
$1,231.30 |
$1,759 |
6.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,133.30 |
$1,619 |
6.1× |
| CT orbits w/o contrast (70480) |
$809.20 |
$1,156 |
7.3× |
| CT pelvis w & w/o contrast (72194) |
$1,060.50 |
$1,515 |
5.7× |
| CT pelvis w/o contrast (72192) |
$728.70 |
$1,041 |
6.6× |
| CT soft tissue neck w/o contrast (70490) |
$830.20 |
$1,186 |
7.5× |
| CT thoracic spine w/contrast (72129) |
$1,000.30 |
$1,429 |
5.4× |
| CT thoracic spine w/o contrast (72128) |
$805.70 |
$1,151 |
7.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,052.80 |
$1,504 |
5.7× |
| CT thorax w/o contrast (71250) |
$1,434.30 |
$2,049 |
13.0× |
| CT upper extremity w/o contrast rt (73200) |
$814.10 |
$1,163 |
7.4× |
| CT upper extremity with contrast (73201) |
$1,069.60 |
$1,528 |
2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,278.90 |
$1,827 |
6.9× |
| Cta Abdomen (74175) |
$1,486.80 |
$2,124 |
8.0× |
| CTA abdomen pelvis (74174) |
$1,778 |
$2,540 |
4.8× |
| CTA chest (71275) |
$2,105.60 |
$3,008 |
11.4× |
| Cta Head (70496) |
$1,960 |
$2,800 |
10.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,237.60 |
$1,768 |
6.7× |
| Cta Neck (70498) |
$2,331.70 |
$3,331 |
12.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$501.20 |
$716 |
4.5× |
| Dxa bone density study axial skeleton (77085) |
$501.20 |
$716 |
4.5× |
| Esophagus (74220) |
$527.80 |
$754 |
2.9× |
| Fluoroscopy up to 1 hr (76000) |
$604.10 |
$863 |
2.4× |
| Forearm 2 views (73090) |
$186.90 |
$267 |
2.0× |
| Gated Heart Planar Single (78472) |
$1,241.80 |
$1,774 |
2.9× |
| Hand 3 views (73130) |
$186.90 |
$267 |
2.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,775.20 |
$2,536 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$627.90 |
$897 |
1.5× |
| Ht muscle image spect sing (78451) |
$2,905.70 |
$4,151 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$186.90 |
$267 |
2.0× |
| Knee 3 views (73562) |
$195.30 |
$279 |
2.1× |
| Lung perf&ventilat diferentl (78598) |
$1,873.90 |
$2,677 |
3.3× |
| Lung perfusion differential (78597) |
$998.20 |
$1,426 |
2.4× |
| Lung Ventilation Imaging (78579) |
$784.70 |
$1,121 |
1.9× |
| Mr elastography (76391) |
$1,365 |
$1,950 |
5.4× |
| Mr safety determination physician/other qhp (76016) |
$156.80 |
$224 |
1.7× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$105.70 |
$151 |
1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$43.40 |
$62 |
1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$163.10 |
$233 |
1.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$429.80 |
$614 |
1.7× |
| MRA head w & w/o contrast (70546) |
$2,715.30 |
$3,879 |
7.4× |
| MRA head w/o contrast (70544) |
$1,791.30 |
$2,559 |
7.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,719.50 |
$3,885 |
7.4× |
| MRA neck w/o contrast (70547) |
$1,753.50 |
$2,505 |
7.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,114.70 |
$3,021 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,384.60 |
$1,978 |
5.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,596 |
$2,280 |
1.9× |
| MRI bone marrow blood supply (77084) |
$1,675.10 |
$2,393 |
6.7× |
| MRI c-spine with contrast (72142) |
$1,737.40 |
$2,482 |
4.7× |
| MRI cardiac w/o contrast (75557) |
$1,197.70 |
$1,711 |
4.8× |
| MRI cervical spine w/o contrast (72141) |
$1,380.40 |
$1,972 |
5.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,524.20 |
$3,606 |
6.9× |
| MRI chest w/o contrast (71550) |
$1,845.20 |
$2,636 |
7.3× |
| MRI chest with contrast (71551) |
$2,014.60 |
$2,878 |
2.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,724.10 |
$2,463 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,604.40 |
$2,292 |
6.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,592.50 |
$2,275 |
6.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,093.70 |
$2,991 |
5.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,708 |
$2,440 |
4.6× |
| MRI pelvis w contrast (72196) |
$1,733.20 |
$2,476 |
4.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,109.80 |
$3,014 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,617 |
$2,310 |
6.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,957.20 |
$2,796 |
5.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,487.80 |
$3,554 |
3.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,953 |
$2,790 |
5.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,960.70 |
$2,801 |
5.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,729 |
$2,470 |
4.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,960.70 |
$2,801 |
5.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,496.60 |
$2,138 |
4.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,845.20 |
$2,636 |
5.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,384.60 |
$1,978 |
5.5× |
| MRI tmj (70336) |
$1,355.90 |
$1,937 |
5.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,521.80 |
$2,174 |
6.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,126.60 |
$3,038 |
5.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,646.40 |
$2,352 |
6.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,384.50 |
$4,835 |
2.5× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$3,173.10 |
$4,533 |
2.1× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$6,076.70 |
$8,681 |
2.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,592.10 |
$3,703 |
2.9× |
| Neck soft tissue (70360) |
$186.90 |
$267 |
2.0× |
| Nm gastric emptying study (78264) |
$1,526.70 |
$2,181 |
3.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,686.60 |
$3,838 |
2.0× |
| Osseous survey limited (77074) |
$374.50 |
$535 |
3.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,022 |
$1,460 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$321.30 |
$459 |
2.9× |
| PET image w/CT, skull-thigh (78815) |
$4,834.20 |
$6,906 |
3.2× |
| PET imaging for CT attenuation whole body (78816) |
$4,834.20 |
$6,906 |
3.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,118.90 |
$3,027 |
5.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,241.80 |
$1,774 |
2.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,736.70 |
$2,481 |
3.0× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$3,066.70 |
$4,381 |
3.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$163.10 |
$233 |
1.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$329 |
$470 |
3.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$206.50 |
$295 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$282.80 |
$404 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$186.90 |
$267 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$191.10 |
$273 |
2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$588.70 |
$841 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$527.10 |
$753 |
2.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$592.20 |
$846 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$347.90 |
$497 |
3.8× |
| Ribs bilateral 3 views (71110) |
$317.10 |
$453 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,452.50 |
$2,075 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,307.40 |
$7,582 |
3.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,629.20 |
$3,756 |
1.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$746.90 |
$1,067 |
3.0× |
| Rp Therapy Intravenous Administration (79101) |
$581.70 |
$831 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$312.90 |
$447 |
2.8× |
| Scapula complete (73010) |
$186.90 |
$267 |
1.7× |
| Small bowel series (74250) |
$489.30 |
$699 |
2.6× |
| Tbs Technical Calculation Only (77091) |
$163.10 |
$233 |
1.8× |
| Therapeutic Enema (74283) |
$315 |
$450 |
1.7× |
| Thoracolumbar 2 views (72080) |
$200.20 |
$286 |
2.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,040.20 |
$1,486 |
2.5× |
| Tmj unilateral (70328) |
$154 |
$220 |
1.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,484.30 |
$3,549 |
4.3× |
| Ultrasound, abdomen limited (76705) |
$473.20 |
$676 |
4.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$501.20 |
$716 |
5.5× |
| Upper Extremity Infant (73092) |
$187.60 |
$268 |
1.7× |
| Us abdl aorta screen aaa (76706) |
$473.20 |
$676 |
4.3× |
| Us chest (76604) |
$412.30 |
$589 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$238 |
$340 |
2.2× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$189 |
$270 |
1.7× |
| Us retroperitoneal complete (76770) |
$435.40 |
$622 |
3.9× |
| Us retroperitoneal limited (76775) |
$435.40 |
$622 |
3.9× |
| Us soft tissue head/neck (76536) |
$435.40 |
$622 |
3.9× |
| Us xtr non-vasc lmtd (76882) |
$280 |
$400 |
2.5× |
| Vertebral fracture assessment via dxa (77086) |
$309.40 |
$442 |
3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$319.20 |
$456 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$133.70 |
$191 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$186.90 |
$267 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$186.90 |
$267 |
2.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$186.90 |
$267 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$206.50 |
$295 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$333.90 |
$477 |
3.0× |
| X-ray eye for foreign body (70030) |
$179.90 |
$257 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$282.80 |
$404 |
2.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$186.90 |
$267 |
2.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$183.40 |
$262 |
2.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$336 |
$480 |
3.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$155.40 |
$222 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$321.30 |
$459 |
2.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$145.60 |
$208 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$168.70 |
$241 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$324.80 |
$464 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$408.10 |
$583 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$333.90 |
$477 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$312.90 |
$447 |
3.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$191.10 |
$273 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$294.70 |
$421 |
3.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$183.40 |
$262 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$294.70 |
$421 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$163.10 |
$233 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$133.70 |
$191 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$191.10 |
$273 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$317.10 |
$453 |
2.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$183.40 |
$262 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$186.90 |
$267 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$362.60 |
$518 |
3.3× |
| Xr chest 4+ views (71048) |
$207.90 |
$297 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$191.10 |
$273 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$347.90 |
$497 |
3.2× |
| Xr tibia/fibula 2 views (73590) |
$186.90 |
$267 |
2.0× |
| Xr tmj bilateral (70330) |
$218.40 |
$312 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$183.40 |
$262 |
2.0× |