| Abdomen 1 View (74018) |
$177 |
$295 |
2.1× |
| Abdomen 2 views (74019) |
$382.20 |
$637 |
3.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,100 |
$3,500 |
5.6× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$1,345.80 |
$2,243 |
1.1× |
| Angio internal mammary (75756) |
$2,974.20 |
$4,957 |
1.0× |
| Angio pulmonary bilat (75743) |
$6,676.80 |
$11,128 |
2.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,044 |
$6,740 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$7,327.20 |
$12,212 |
2.5× |
| Angiography extremity unilateral rs&i (75710) |
$7,327.20 |
$12,212 |
2.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,199.20 |
$5,332 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,974.20 |
$4,957 |
1.0× |
| Ankle 2 views (73600) |
$582 |
$970 |
7.1× |
| Aortography thoracic serialography rs&i (75605) |
$6,982.20 |
$11,637 |
1.3× |
| Artery X-Rays Abdomen (75726) |
$6,982.20 |
$11,637 |
1.3× |
| Artery X-Rays Adrenal Gland (75731) |
$2,157.60 |
$3,596 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$6,982.20 |
$11,637 |
1.3× |
| Artery X-Rays Spine (75705) |
$7,709.40 |
$12,849 |
1.5× |
| Arthrogram ankle (73615) |
$2,466.60 |
$4,111 |
7.5× |
| Arthrogram hip (73525) |
$2,466.60 |
$4,111 |
7.5× |
| Arthrogram Wrist (73115) |
$2,466.60 |
$4,111 |
7.5× |
| Bone age studies (77072) |
$582 |
$970 |
5.9× |
| Bone Imaging 3 Phase (78315) |
$2,217 |
$3,695 |
5.9× |
| Bone Imaging Limited Area (78300) |
$2,216.40 |
$3,694 |
5.9× |
| Bone Imaging Multiple Areas (78305) |
$2,217 |
$3,695 |
5.9× |
| Bone Imaging Whole Body (78306) |
$2,217 |
$3,695 |
5.9× |
| Bone marrow imaging limited area (78102) |
$2,206.20 |
$3,677 |
5.8× |
| Bone survey infant (77076) |
$1,008 |
$1,680 |
10.2× |
| Brain Image W/Flow < 4 Views (78601) |
$2,748 |
$4,580 |
7.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$809.40 |
$1,349 |
1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,664 |
$9,440 |
4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,375.60 |
$5,626 |
10.2× |
| Cardiac Shunt Detection (78428) |
$2,928 |
$4,880 |
7.7× |
| Cat Scan Follow-Up Study (76380) |
$1,106.40 |
$1,844 |
13.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,939.80 |
$3,233 |
3.8× |
| Cerebrospinal Fluid Scan (78630) |
$1,939.80 |
$3,233 |
3.8× |
| Chest 1 view (71045) |
$666 |
$1,110 |
8.1× |
| Chest 2 views (71046) |
$666 |
$1,110 |
8.1× |
| Chest 3 views (71047) |
$733.80 |
$1,223 |
8.9× |
| Chest 4 or more views (71048) |
$770.40 |
$1,284 |
7.8× |
| Cholecystography Oral Contrast (74290) |
$785.40 |
$1,309 |
4.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$872.40 |
$1,454 |
1.2× |
| Clavicle complete (73000) |
$582 |
$970 |
7.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$104.40 |
$174 |
1.1× |
| Contrast Exam Abdominl Aorta (75625) |
$7,327.20 |
$12,212 |
2.5× |
| Contrast X-Ray Bladder (74430) |
$1,416 |
$2,360 |
4.3× |
| Contrast X-Ray Of Elbow (73085) |
$2,466.60 |
$4,111 |
7.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$2,466.60 |
$4,111 |
7.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,334.40 |
$7,224 |
13.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,277.20 |
$5,462 |
14.5× |
| CT abdomen w contrast (74160) |
$2,511.60 |
$4,186 |
15.1× |
| CT abdomen w wo contrast (74170) |
$2,889.60 |
$4,816 |
17.4× |
| CT abdomen w/o contrast (74150) |
$2,184.60 |
$3,641 |
22.1× |
| CT Angio Abdomen and Pelvis (74174) |
$7,242.60 |
$12,071 |
21.9× |
| CT Angio Chest (71275) |
$3,621 |
$6,035 |
21.8× |
| CT Angio Head (70496) |
$3,177.60 |
$5,296 |
19.1× |
| CT angio hrt w/3d image (75574) |
$1,150.80 |
$1,918 |
3.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,621 |
$6,035 |
21.8× |
| CT Angio Neck (70498) |
$3,177.60 |
$5,296 |
19.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,621 |
$6,035 |
21.8× |
| CT cervical spine w/ contrast (72126) |
$2,511.60 |
$4,186 |
7.6× |
| CT cervical spine w/o contrast (72125) |
$2,184.60 |
$3,641 |
22.1× |
| CT cervical spine w/wo cont (72127) |
$2,889.60 |
$4,816 |
17.4× |
| CT chest w contrast (71260) |
$2,511.60 |
$4,186 |
15.1× |
| CT chest w/wo contrast (71270) |
$2,889.60 |
$4,816 |
17.4× |
| CT head/brain with contrast (70460) |
$2,204.40 |
$3,674 |
13.3× |
| CT head/brain without and with contrast (70470) |
$2,533.80 |
$4,223 |
15.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,010.40 |
$1,684 |
3.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,150.80 |
$1,918 |
14.0× |
| CT iac w contrast (70481) |
$2,204.40 |
$3,674 |
13.3× |
| CT l-spine w&w/o contrast (72133) |
$2,889.60 |
$4,816 |
17.4× |
| CT lower ext w/o (73700) |
$2,184.60 |
$3,641 |
22.1× |
| CT lower extremity w/contrast material (73701) |
$2,511.60 |
$4,186 |
15.1× |
| CT lumbar spine w contrast (72132) |
$2,511.60 |
$4,186 |
7.6× |
| CT lumbar spine w/o contrast (72131) |
$2,184.60 |
$3,641 |
22.1× |
| CT maxillofacial w contrast (70487) |
$2,204.40 |
$3,674 |
13.3× |
| CT maxillofacial wo contrast (70486) |
$1,916.40 |
$3,194 |
19.4× |
| CT neck tissue combo (70492) |
$2,533.80 |
$4,223 |
15.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,533.80 |
$4,223 |
15.3× |
| CT orbits w/o contrast (70480) |
$1,916.40 |
$3,194 |
19.4× |
| CT pelvis w&w/o contrast (72194) |
$2,889.60 |
$4,816 |
17.4× |
| CT pelvis w/o contrast (72192) |
$2,184.60 |
$3,641 |
22.1× |
| CT scan of leg combo (73702) |
$2,889.60 |
$4,816 |
17.4× |
| CT scans face/jaw combo (70488) |
$2,533.80 |
$4,223 |
15.3× |
| CT soft tissue neck w contrast (70491) |
$2,204.40 |
$3,674 |
13.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,916.40 |
$3,194 |
19.4× |
| CT thoracic spine w contrast (72129) |
$2,511.60 |
$4,186 |
15.1× |
| CT thoracic spine w/o contrast (72128) |
$2,184.60 |
$3,641 |
22.1× |
| CT thoracic spine w/wo cont (72130) |
$2,889.60 |
$4,816 |
17.4× |
| CT thorax w/o contrast (71250) |
$2,184.60 |
$3,641 |
22.1× |
| CT upper ext wo (73200) |
$2,184.60 |
$3,641 |
22.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,889.60 |
$4,816 |
17.4× |
| CT upper extremity with contrast (73201) |
$2,511.60 |
$4,186 |
7.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,621 |
$6,035 |
21.8× |
| Cta Abdomen (74175) |
$3,621 |
$6,035 |
21.8× |
| CTA pelvis (72191) |
$3,621 |
$6,035 |
21.8× |
| Dilation ureters/urethra rs&i (74485) |
$1,273.20 |
$2,122 |
0.6× |
| Discography Cerv/Thor Spine (72285) |
$4,474.20 |
$7,457 |
2.4× |
| Diskography lumbar (72295) |
$4,474.20 |
$7,457 |
2.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$185.40 |
$309 |
1.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$185.40 |
$309 |
1.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,673.40 |
$2,789 |
16.9× |
| Dxa Bone Density Axial (77080) |
$582 |
$970 |
5.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$390 |
$650 |
4.7× |
| Echo exam of fetal heart (76825) |
$687 |
$1,145 |
1.3× |
| Echo exam uterus (76831) |
$1,022.40 |
$1,704 |
4.5× |
| Echo Guide For Artery Repair (76936) |
$831.60 |
$1,386 |
4.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$502.20 |
$837 |
2.2× |
| Echograp Trans R Pros Study (76873) |
$1,335 |
$2,225 |
13.5× |
| Esophagram (74220) |
$785.40 |
$1,309 |
4.7× |
| Fetal Biophys Profile W/Nst (76818) |
$185.40 |
$309 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$185.40 |
$309 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$488.40 |
$814 |
2.2× |
| Follow-Up Angiography (75898) |
$4,468.20 |
$7,447 |
1.5× |
| Foot 2 views (73620) |
$582 |
$970 |
7.1× |
| Forearm 2 views (73090) |
$582 |
$970 |
7.1× |
| Gastric emptying imaging study (78264) |
$2,100 |
$3,500 |
5.6× |
| Gastric Mucosa Imaging (78261) |
$2,100 |
$3,500 |
5.6× |
| Gastroesophageal Reflux Exam (78262) |
$2,100 |
$3,500 |
5.6× |
| Gated Heart Planar Single (78472) |
$2,440.80 |
$4,068 |
6.5× |
| Gated Heart, Multiple (78473) |
$2,592 |
$4,320 |
6.9× |
| GI Endoscopic US S&I (76975) |
$568.20 |
$947 |
2.5× |
| Hand 2 views (73120) |
$582 |
$970 |
5.9× |
| Heart first pass single,planar (78481) |
$2,440.80 |
$4,068 |
4.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$7,506 |
$12,510 |
2.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,197.40 |
$5,329 |
1.1× |
| Hepatobil Syst Image W/Drug (78227) |
$2,418.60 |
$4,031 |
4.7× |
| Hepatobiliary System Imaging (78226) |
$2,418.60 |
$4,031 |
6.4× |
| Ht Musc Image Planar Mult (78454) |
$3,717.60 |
$6,196 |
3.0× |
| Ht Muscle Image Spect Sing (78451) |
$2,440.80 |
$4,068 |
2.0× |
| Hysterosalpingogram (74740) |
$1,698 |
$2,830 |
7.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$785.40 |
$1,309 |
9.5× |
| Infant hip ultrasound, limited static exam (76886) |
$265.20 |
$442 |
3.2× |
| K Flow/Funct Image Multiple (78709) |
$2,217 |
$3,695 |
4.3× |
| K Flow/Funct Image W/Drug (78708) |
$2,082.60 |
$3,471 |
4.1× |
| K Flow/Funct Image W/O Drug (78707) |
$661.80 |
$1,103 |
1.3× |
| Kidney Imaging Morphol (78700) |
$510.60 |
$851 |
1.4× |
| Knee 3 Views (73562) |
$610.80 |
$1,018 |
7.4× |
| Leveen/Shunt Patency Exam (78291) |
$606.60 |
$1,011 |
1.6× |
| Liver & Spleen Imaging Static Only (78215) |
$2,418.60 |
$4,031 |
6.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,418.60 |
$4,031 |
6.4× |
| Liver imaging static only (78201) |
$1,473.60 |
$2,456 |
2.9× |
| Liver imaging w/vascular flow (78202) |
$1,473.60 |
$2,456 |
2.9× |
| Lung perfusion differential (78597) |
$2,943.60 |
$4,906 |
7.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,943.60 |
$4,906 |
5.7× |
| Lung Ventilation Imaging (78579) |
$1,770.60 |
$2,951 |
4.7× |
| Lymph System Imaging (78195) |
$2,206.20 |
$3,677 |
4.3× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,270.20 |
$2,117 |
0.9× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$1,270.20 |
$2,117 |
2.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,208.60 |
$3,681 |
0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$4,803.60 |
$8,006 |
1.6× |
| Magnetic Image Jaw Joint (70336) |
$3,009 |
$5,015 |
13.3× |
| Mammary ductogram or galactogram single (77053) |
$1,146.60 |
$1,911 |
5.1× |
| Meckels Divert Exam (78290) |
$2,100 |
$3,500 |
5.6× |
| Mr safety determination physician/other qhp (76016) |
$132 |
$220 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$36.60 |
$61 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$137.40 |
$229 |
1.5× |
| Mr safety implt pos&/immoblj (76019) |
$89.40 |
$149 |
1.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$362.40 |
$604 |
1.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,140 |
$6,900 |
12.5× |
| MRA head w/o contrast (70544) |
$3,130.20 |
$5,217 |
13.9× |
| MRA head with contrast (70545) |
$3,600.60 |
$6,001 |
10.9× |
| MRA neck w contrast (70548) |
$3,600.60 |
$6,001 |
10.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,140 |
$6,900 |
12.5× |
| MRA neck w/o contrast (70547) |
$3,130.20 |
$5,217 |
13.9× |
| MRI abdomen w contrast (74182) |
$3,611.40 |
$6,019 |
10.9× |
| MRI abdomen w/o contrast (74181) |
$3,140.40 |
$5,234 |
13.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,611.40 |
$6,019 |
4.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,153.20 |
$6,922 |
12.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,611.40 |
$6,019 |
4.9× |
| MRI brain functional w/o physician admnistration (70554) |
$1,956 |
$3,260 |
8.7× |
| MRI Breast W/O Contrast Bilateral (77047) |
$5,440.80 |
$9,068 |
24.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$2,365.80 |
$3,943 |
10.5× |
| MRI cardiac w/o contrast (75557) |
$3,140.40 |
$5,234 |
13.9× |
| MRI cervical spine w contrast (72142) |
$3,611.40 |
$6,019 |
10.9× |
| MRI cervical spine w/o cont (72141) |
$3,140.40 |
$5,234 |
13.9× |
| MRI chest w/o contrast (71550) |
$3,140.40 |
$5,234 |
13.9× |
| MRI chest with contrast (71551) |
$3,611.40 |
$6,019 |
4.9× |
| MRI chest wo w contrast (71552) |
$4,153.20 |
$6,922 |
12.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,611.40 |
$6,019 |
10.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,153.20 |
$6,922 |
12.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,140.40 |
$5,234 |
13.9× |
| MRI lumbar spine w contrast (72149) |
$3,611.40 |
$6,019 |
10.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,153.20 |
$6,922 |
12.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,130.20 |
$5,217 |
13.9× |
| MRI orbit face neck w contrast (70542) |
$3,600.60 |
$6,001 |
10.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,140 |
$6,900 |
12.5× |
| MRI pelvis w contrast (72196) |
$3,611.40 |
$6,019 |
10.9× |
| MRI pelvis w/o & w contrast (72197) |
$4,153.20 |
$6,922 |
12.6× |
| MRI pelvis w/o contrast (72195) |
$3,140.40 |
$5,234 |
13.9× |
| MRI spectroscopy (76390) |
$1,004.40 |
$1,674 |
12.2× |
| MRI thoracic spine w/o contrast (72146) |
$3,140.40 |
$5,234 |
13.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,611.40 |
$6,019 |
10.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,140.40 |
$5,234 |
13.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,153.20 |
$6,922 |
12.6× |
| MRI, abdomen, combo (74183) |
$4,152.60 |
$6,921 |
12.6× |
| MRI, dorsal spine combo (72157) |
$4,153.20 |
$6,922 |
12.6× |
| MRI, dorsal spine contrast (72147) |
$3,611.40 |
$6,019 |
10.9× |
| MRI, joint upper extrem (73221) |
$3,140.40 |
$5,234 |
13.9× |
| MRI, joint upper extrem combo (73223) |
$4,153.20 |
$6,922 |
12.6× |
| MRI, lumbar spine combo (72158) |
$4,153.20 |
$6,922 |
12.6× |
| Myelogram cervical (72240) |
$2,485.80 |
$4,143 |
3.4× |
| Myelogram Lumbar (72265) |
$1,072.20 |
$1,787 |
1.4× |
| Myelography thoracic (72255) |
$2,485.80 |
$4,143 |
3.4× |
| Myelograpy 2/more regions rs&i (72270) |
$1,072.20 |
$1,787 |
1.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$639.60 |
$1,066 |
1.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,717.60 |
$6,196 |
3.0× |
| Myocardial Spect Multiple Studies (78452) |
$5,400.60 |
$9,001 |
4.4× |
| Neck soft tissue (70360) |
$382.20 |
$637 |
4.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$315 |
$525 |
0.8× |
| Nm myocard infarct spect (78469) |
$2,440.80 |
$4,068 |
4.8× |
| Nonvascular Shunt X-Ray (75809) |
$919.80 |
$1,533 |
9.3× |
| Nuclear Rx Intra-Arterial (79445) |
$1,140.60 |
$1,901 |
5.2× |
| Nuclear Rx Oral Admin (79005) |
$9,173.40 |
$15,289 |
41.6× |
| Ob us nuchal meas 1 gest (76813) |
$1,673.40 |
$2,789 |
16.9× |
| Optic foramina (70190) |
$582 |
$970 |
7.1× |
| Panoramic X-ray of jaws (70355) |
$534 |
$890 |
6.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,741.80 |
$2,903 |
3.4× |
| Parathyroid Planar Imaging (78070) |
$1,180.80 |
$1,968 |
3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,473.60 |
$2,456 |
3.9× |
| Pelvis 1 or 2 views (72170) |
$582 |
$970 |
5.9× |
| Peritoneogram Rs&I (74190) |
$1,319.40 |
$2,199 |
2.6× |
| Pet Image Skull-Thigh (78812) |
$5,664 |
$9,440 |
4.2× |
| Pet Image W/Ct Lmtd (78814) |
$5,664 |
$9,440 |
4.2× |
| PET image w/CT, full body (78816) |
$5,664 |
$9,440 |
4.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,664 |
$9,440 |
4.2× |
| PET whole body (78813) |
$5,664 |
$9,440 |
4.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$7,506 |
$12,510 |
2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,770.60 |
$2,951 |
4.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$662.40 |
$1,104 |
6.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$919.80 |
$1,533 |
1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$610.80 |
$1,018 |
7.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$582 |
$970 |
7.1× |
| Radex elbow complete minimum 3 views (73080) |
$582 |
$970 |
7.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$610.80 |
$1,018 |
6.2× |
| Radex fingr minimum 2 views (73140) |
$582 |
$970 |
7.1× |
| Radex foot complete minimum 3 views (73630) |
$610.80 |
$1,018 |
7.4× |
| Radex Hand Minimum 3 Views (73130) |
$610.80 |
$1,018 |
7.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$582 |
$970 |
7.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$582 |
$970 |
5.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$582 |
$970 |
7.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$582 |
$970 |
7.1× |
| Radex shoulder complete minimum 2 views (73030) |
$610.80 |
$1,018 |
7.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$582 |
$970 |
7.1× |
| Radex Spine 1 View Specify Level (72020) |
$582 |
$970 |
7.1× |
| Radex Sternum Minimum 2 Views (71120) |
$582 |
$970 |
7.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$571.20 |
$952 |
6.9× |
| Radex Toe Minimum 2 Views (73660) |
$582 |
$970 |
7.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$582 |
$970 |
5.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$610.80 |
$1,018 |
7.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,008 |
$1,680 |
10.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$582 |
$970 |
5.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$662.40 |
$1,104 |
6.7× |
| Radiologic exam colon double contrast study (74280) |
$1,210.20 |
$2,017 |
7.3× |
| Radiologic exam colon single contrast study (74270) |
$785.40 |
$1,309 |
4.7× |
| Radiologic exam knee complete 4/more views (73564) |
$610.80 |
$1,018 |
6.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$610.80 |
$1,018 |
6.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$785.40 |
$1,309 |
4.7× |
| Radiologic exam swallow function contrast study (74230) |
$785.40 |
$1,309 |
4.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$785.40 |
$1,309 |
4.7× |
| Radiologic examination femur 1 view (73551) |
$371.40 |
$619 |
4.5× |
| Radiologic examination femur minimum 2 views (73552) |
$582 |
$970 |
7.1× |
| Radiologic examination knee 1/2 views (73560) |
$582 |
$970 |
7.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$990.60 |
$1,651 |
10.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$582 |
$970 |
7.1× |
| Radiopharm Dacryocystography (78660) |
$1,939.80 |
$3,233 |
5.1× |
| Renal Cyst Study (74470) |
$409.80 |
$683 |
0.8× |
| Ribs bilateral 3 views (71110) |
$642 |
$1,070 |
6.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$2,389.20 |
$3,982 |
6.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,389.80 |
$3,983 |
6.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$6,014.40 |
$10,024 |
11.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,389.80 |
$3,983 |
4.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,389.80 |
$3,983 |
4.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,749.20 |
$4,582 |
2.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,834.80 |
$3,058 |
8.3× |
| Rp Therapy Intravenous Administration (79101) |
$8,206.80 |
$13,678 |
37.2× |
| Scapula (73010) |
$582 |
$970 |
5.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$24 |
$40 |
1.0× |
| Sella turcica (70240) |
$642 |
$1,070 |
7.8× |
| Shoulder 1 view (73020) |
$582 |
$970 |
7.1× |
| Shoulder Arthrography (73040) |
$1,195.20 |
$1,992 |
3.6× |
| Sialogram (70390) |
$919.80 |
$1,533 |
4.1× |
| Skull less than 4 views (70250) |
$582 |
$970 |
5.9× |
| Sternoclavicular joints (71130) |
$610.80 |
$1,018 |
7.4× |
| Superior sagittal sinus venogram (75870) |
$2,319.60 |
$3,866 |
0.8× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$1,195.20 |
$1,992 |
5.3× |
| Testicular Imaging W/Flow (78761) |
$2,082.60 |
$3,471 |
5.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$861 |
$1,435 |
5.2× |
| Thoracic spine 2 views (72070) |
$582 |
$970 |
5.9× |
| Thoracic spine 3 views (72072) |
$610.80 |
$1,018 |
6.2× |
| Thoracolumbar 2 views (72080) |
$582 |
$970 |
7.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$521.40 |
$869 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,528.80 |
$2,548 |
4.0× |
| Thyroid Met Imaging Body (78018) |
$1,496.40 |
$2,494 |
2.9× |
| Thyroid Uptake Measurement (78012) |
$939.60 |
$1,566 |
2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,741.80 |
$2,903 |
4.6× |
| Ultrasound Breast Limited (76642) |
$1,066.80 |
$1,778 |
13.0× |
| Ultrasound elastography first target lesion (76982) |
$796.20 |
$1,327 |
8.0× |
| Ultrasound Elastography Parenchyma (76981) |
$796.20 |
$1,327 |
8.0× |
| Ultrasound Exam Aaa Screen (76706) |
$419.40 |
$699 |
4.2× |
| Ultrasound, abdomen limited (76705) |
$972.60 |
$1,621 |
9.8× |
| Umbilical-artery Doppler (OB) (76820) |
$1,673.40 |
$2,789 |
16.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$207.60 |
$346 |
2.5× |
| Unlisted us procedure (76999) |
$786 |
$1,310 |
9.5× |
| Upper gi w/o kub (74240) |
$998.40 |
$1,664 |
6.0× |
| Ureteral Reflux Study (78740) |
$2,082.60 |
$3,471 |
5.5× |
| Urethrocystogram voiding (74455) |
$1,416 |
$2,360 |
6.3× |
| Urethrocystography retrograde (74450) |
$1,416 |
$2,360 |
6.3× |
| Us breast unilateral complete (76641) |
$1,093.20 |
$1,822 |
11.1× |
| Us chest (76604) |
$1,140.60 |
$1,901 |
11.5× |
| Us complete joint (76881) |
$933.60 |
$1,556 |
9.4× |
| Us exam, pelvic, limited (76857) |
$1,196.40 |
$1,994 |
12.1× |
| Us head (76506) |
$760.80 |
$1,268 |
7.7× |
| Us kidney transplant (76776) |
$972.60 |
$1,621 |
9.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$933.60 |
$1,556 |
9.4× |
| Us ob detailed single fetus (76811) |
$231.60 |
$386 |
1.0× |
| Us ob limited 1 or more fetuses (76815) |
$498.60 |
$831 |
5.0× |
| Us ob transvaginal (76817) |
$498.60 |
$831 |
5.0× |
| Us pelvic non ob complete (76856) |
$1,508.40 |
$2,514 |
15.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$185.40 |
$309 |
1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$112.20 |
$187 |
1.1× |
| Us retroperitoneal complete (76770) |
$1,701 |
$2,835 |
17.2× |
| Us retroperitoneal limited (76775) |
$1,489.80 |
$2,483 |
15.1× |
| Us scrotum and contents (76870) |
$796.20 |
$1,327 |
8.0× |
| Us spinal canal and contents (76800) |
$915 |
$1,525 |
9.3× |
| Us thyroid (76536) |
$1,251 |
$2,085 |
12.6× |
| Us transrectal (76872) |
$975.60 |
$1,626 |
9.9× |
| Vein X-Ray Chest (75827) |
$3,197.40 |
$5,329 |
2.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,197.40 |
$5,329 |
1.1× |
| Vein X-Ray Skull Epidural (75872) |
$3,197.40 |
$5,329 |
5.4× |
| Vein X-Ray Spleen/Liver (75810) |
$3,197.40 |
$5,329 |
1.1× |
| Venogram Sinus/Jugular (75860) |
$2,319.60 |
$3,866 |
0.8× |
| Venography Adrenal Unilateral (75840) |
$7,506 |
$12,510 |
2.5× |
| Venography caval inferior serialography rs&i (75825) |
$3,197.40 |
$5,329 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$3,258.60 |
$5,431 |
2.2× |
| Venography extremity unilateral rs&i (75820) |
$2,319.60 |
$3,866 |
1.6× |
| Venography Orbital Rs&I (75880) |
$2,319.60 |
$3,866 |
3.9× |
| Venography Renal Bilateral (75833) |
$2,974.20 |
$4,957 |
1.0× |
| Venography Renal Unilateral (75831) |
$3,197.40 |
$5,329 |
1.1× |
| Venous sampling by catheter (75893) |
$8,287.80 |
$13,813 |
1.6× |
| Wrist 2 views (73100) |
$582 |
$970 |
7.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$582 |
$970 |
7.1× |
| X-ray antegrade pyelogram tube (74425) |
$618 |
$1,030 |
1.9× |
| X-Ray Aorta Leg Arteries (75630) |
$7,327.20 |
$12,212 |
2.5× |
| X-Ray Bend Only L-S Spine (72120) |
$582 |
$970 |
5.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$582 |
$970 |
7.1× |
| X-Ray Exam Breast Specimen (76098) |
$438 |
$730 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$582 |
$970 |
7.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$610.80 |
$1,018 |
6.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$1,008 |
$1,680 |
10.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$523.80 |
$873 |
6.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$610.80 |
$1,018 |
7.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$699 |
$1,165 |
7.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$610.80 |
$1,018 |
6.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,163.40 |
$1,939 |
11.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,163.40 |
$1,939 |
11.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$1,008 |
$1,680 |
10.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$610.80 |
$1,018 |
7.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$1,059 |
$1,765 |
10.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$610.80 |
$1,018 |
6.2× |
| X-ray eye for foreign body (70030) |
$382.20 |
$637 |
4.6× |
| X-ray humerus (73060) |
$582 |
$970 |
7.1× |
| X-ray IV pyelogram (ivp) (74400) |
$1,416 |
$2,360 |
8.5× |
| X-ray IV pyelogram+tomography (74415) |
$1,416 |
$2,360 |
8.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$514.80 |
$858 |
6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$642 |
$1,070 |
7.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$610.80 |
$1,018 |
6.2× |
| X-ray nose-rectum child f.b. (76010) |
$382.20 |
$637 |
4.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$908.40 |
$1,514 |
9.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$582 |
$970 |
5.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$582 |
$970 |
7.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$610.80 |
$1,018 |
7.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,008 |
$1,680 |
10.2× |
| X-ray thoracic spine 4 vw (72074) |
$610.80 |
$1,018 |
6.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,416 |
$2,360 |
4.3× |
| X-Rays Bone Length Studies (77073) |
$582 |
$970 |
5.9× |
| X-Rays Bone Survey Complete (77075) |
$1,008 |
$1,680 |
10.2× |
| Xr c-spine 4 or 5 views (72050) |
$1,008 |
$1,680 |
10.2× |
| Xr facial bones less than 3 views (70140) |
$582 |
$970 |
7.1× |
| Xr orbits complete 4 views (70200) |
$642 |
$1,070 |
6.5× |
| Xr Tomogram Single Plane (76100) |
$919.80 |
$1,533 |
9.3× |