| Abdomen 2 views (74019) |
$434 |
$434 |
4.0× |
| Ankle 2 views (73600) |
$301 |
$301 |
3.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,468 |
$1,468 |
3.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,468 |
$1,468 |
3.5× |
| Bone &/joint imaging whole body (78306) |
$1,993 |
$1,993 |
4.8× |
| Bone age studies (77072) |
$270 |
$270 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$2,331 |
$2,331 |
5.6× |
| Bone survey complete (77075) |
$960 |
$960 |
8.8× |
| Cervical spine 2 or 3 views (72040) |
$406 |
$406 |
4.5× |
| Chest 1 view (71045) |
$317 |
$317 |
3.5× |
| Chest 3 views (71047) |
$344 |
$344 |
3.8× |
| Clavicle complete (73000) |
$323 |
$323 |
3.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$500 |
$500 |
4.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,917 |
$5,917 |
16.3× |
| CT abdomen and pelvis without contrast (74176) |
$4,200 |
$4,200 |
17.0× |
| CT abdomen w contrast (74160) |
$2,853 |
$2,853 |
15.7× |
| CT abdomen w wo contrast (74170) |
$3,339 |
$3,339 |
18.3× |
| CT abdomen w/o contrast (74150) |
$2,697 |
$2,697 |
24.8× |
| CT c-spine w/o contrast (72125) |
$2,670 |
$2,670 |
24.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,704 |
$2,704 |
14.8× |
| CT chest w/wo contrast (71270) |
$3,198 |
$3,198 |
17.6× |
| CT chest with contrast (71260) |
$2,817 |
$2,817 |
15.5× |
| CT head/brain with contrast (70460) |
$2,544 |
$2,544 |
14.0× |
| CT head/brain without and with contrast (70470) |
$2,933 |
$2,933 |
16.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$150 |
$150 |
1.7× |
| CT iac w contrast (70481) |
$2,805 |
$2,805 |
15.4× |
| CT limited/localized follow up study (76380) |
$1,794 |
$1,794 |
19.9× |
| CT lower ext w/o (73700) |
$2,443 |
$2,443 |
22.5× |
| CT lower extremity w wo contrast (73702) |
$3,200 |
$3,200 |
17.6× |
| CT lower extremity with contrast (73701) |
$2,653 |
$2,653 |
14.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,891 |
$2,891 |
15.9× |
| CT lumbar spine w/o contrast (72131) |
$2,700 |
$2,700 |
24.9× |
| CT lumbar spine with contrast (72132) |
$2,872 |
$2,872 |
7.9× |
| CT maxillofacial w contrast (70487) |
$2,395 |
$2,395 |
13.1× |
| CT maxillofacial w/o contrast (70486) |
$2,062 |
$2,062 |
19.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,832 |
$2,832 |
15.5× |
| CT neck soft tissue w contrast (70491) |
$2,622 |
$2,622 |
14.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,713 |
$2,713 |
14.9× |
| CT orbits w/o contrast (70480) |
$2,415 |
$2,415 |
22.2× |
| CT pelvis w & w/o contrast (72194) |
$3,147 |
$3,147 |
17.3× |
| CT pelvis w/o contrast (72192) |
$2,529 |
$2,529 |
23.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,952 |
$2,952 |
16.2× |
| CT soft tissue neck w/o contrast (70490) |
$2,383 |
$2,383 |
22.0× |
| CT thoracic spine w/contrast (72129) |
$2,691 |
$2,691 |
14.8× |
| CT thoracic spine w/o contrast (72128) |
$2,643 |
$2,643 |
24.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,970 |
$2,970 |
16.3× |
| CT thorax w/o contrast (71250) |
$2,545 |
$2,545 |
23.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,019 |
$3,019 |
16.6× |
| CT upper extremity w/o contrast rt (73200) |
$2,311 |
$2,311 |
21.3× |
| CT upper extremity with contrast (73201) |
$2,597 |
$2,597 |
7.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,905 |
$3,905 |
21.4× |
| Cta Abdomen (74175) |
$3,631 |
$3,631 |
19.9× |
| CTA abdomen pelvis (74174) |
$6,229 |
$6,229 |
17.2× |
| CTA chest (71275) |
$3,736 |
$3,736 |
20.5× |
| Cta Head (70496) |
$3,337 |
$3,337 |
18.3× |
| Cta Neck (70498) |
$3,301 |
$3,301 |
18.1× |
| Cta Pelvis (72191) |
$3,077 |
$3,077 |
16.9× |
| Cystography minimum 3 views rs&i (74430) |
$790 |
$790 |
2.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$534 |
$534 |
4.9× |
| Esophagus (74220) |
$740 |
$740 |
4.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$540 |
$540 |
5.0× |
| Fluoroscopy up to 1 hr (76000) |
$750 |
$750 |
3.0× |
| Foot 2 views (73620) |
$286 |
$286 |
3.2× |
| Forearm 2 views (73090) |
$330 |
$330 |
3.7× |
| Gated Heart Planar Single (78472) |
$2,449 |
$2,449 |
5.9× |
| Hand 2 views (73120) |
$283 |
$283 |
2.6× |
| Hand 3 views (73130) |
$367 |
$367 |
4.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,130 |
$2,130 |
3.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,157 |
$2,157 |
5.2× |
| Ht muscle image spect sing (78451) |
$6,886 |
$6,886 |
5.1× |
| Humerus Min 2 Views Left (73060) |
$340 |
$340 |
3.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,930 |
$1,930 |
3.4× |
| Knee 3 views (73562) |
$403 |
$403 |
4.5× |
| Liver & spleen imaging static only (78215) |
$2,236 |
$2,236 |
5.4× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$177 |
$177 |
2.0× |
| Meckels Diverticulum (78290) |
$1,468 |
$1,468 |
3.5× |
| MRA head w/o contrast (70544) |
$3,675 |
$3,675 |
14.8× |
| MRA head with contrast (70545) |
$3,675 |
$3,675 |
10.1× |
| MRA neck w contrast (70548) |
$3,508 |
$3,508 |
9.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,149 |
$4,149 |
11.5× |
| MRA neck w/o contrast (70547) |
$3,460 |
$3,460 |
14.0× |
| MRI abdomen w contrast (74182) |
$4,264 |
$4,264 |
11.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,633 |
$4,633 |
12.8× |
| MRI abdomen w/o contrast (74181) |
$3,648 |
$3,648 |
14.7× |
| MRI any jnt lwr ext with con lt (73722) |
$3,650 |
$3,650 |
4.5× |
| MRI c-spine with contrast (72142) |
$3,750 |
$3,750 |
10.4× |
| MRI cardiac w/o contrast (75557) |
$5,408 |
$5,408 |
21.8× |
| MRI cervical spine w/o contrast (72141) |
$3,724 |
$3,724 |
15.0× |
| MRI chest w/o contrast (71550) |
$3,934 |
$3,934 |
15.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,018 |
$3,018 |
12.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,395 |
$3,395 |
13.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,996 |
$3,996 |
11.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,348 |
$4,348 |
12.0× |
| MRI pelvis w/o contrast (72195) |
$3,350 |
$3,350 |
13.5× |
| MRI scan of arm joint before and after contrast (73223) |
$4,250 |
$4,250 |
11.7× |
| MRI scan of leg joint before and after contrast (73723) |
$3,745 |
$3,745 |
10.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,694 |
$4,694 |
13.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,162 |
$4,162 |
11.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,597 |
$4,597 |
12.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,568 |
$3,568 |
9.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,661 |
$4,661 |
12.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,836 |
$3,836 |
15.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,764 |
$2,764 |
11.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,754 |
$3,754 |
10.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,188 |
$3,188 |
12.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,874 |
$4,874 |
3.6× |
| Neck soft tissue (70360) |
$357 |
$357 |
4.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,884 |
$1,884 |
4.5× |
| Osseous survey limited (77074) |
$676 |
$676 |
6.2× |
| Parathyroid imaging (78070) |
$1,468 |
$1,468 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$373 |
$373 |
3.4× |
| PET image w/CT, skull-thigh (78815) |
$7,076 |
$7,076 |
4.8× |
| PET imaging CT for attenuation limited area (78814) |
$6,344 |
$6,344 |
4.3× |
| PET imaging for CT attenuation whole body (78816) |
$8,697 |
$8,697 |
5.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,743 |
$3,743 |
10.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$332 |
$332 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$346 |
$346 |
3.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$652 |
$652 |
6.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$516 |
$516 |
4.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$315 |
$315 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$338 |
$338 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$488 |
$488 |
4.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$340 |
$340 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$590 |
$590 |
5.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$395 |
$395 |
4.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$377 |
$377 |
4.2× |
| Ribs bilateral 3 views (71110) |
$499 |
$499 |
4.6× |
| Sacroiliac Joints < 3 Views (72200) |
$415 |
$415 |
3.8× |
| Scapula complete (73010) |
$353 |
$353 |
3.3× |
| Screening digital breast tomosynthesis (77063) |
$100 |
$100 |
4.3× |
| Sella turcica (70240) |
$312 |
$312 |
3.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$817 |
$817 |
7.5× |
| Spine thoracic 3 views (72072) |
$571 |
$571 |
5.3× |
| Testicular Imaging With Vascular Flow (78761) |
$2,243 |
$2,243 |
5.4× |
| Thoracolumbar 2 views (72080) |
$370 |
$370 |
4.1× |
| Tomogram (76100) |
$640 |
$640 |
5.9× |
| Ultrasound, abdomen limited (76705) |
$757 |
$757 |
7.0× |
| Upper Extremity Infant (73092) |
$313 |
$313 |
2.9× |
| Urethrocystography retrograde rs&i (74450) |
$872 |
$872 |
3.5× |
| Urethrocystography voiding (74455) |
$754 |
$754 |
3.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,248 |
$1,248 |
6.9× |
| Us abdl aorta screen aaa (76706) |
$671 |
$671 |
6.2× |
| Us breast unilateral complete (76641) |
$623 |
$623 |
5.7× |
| Us breast unilateral limited (76642) |
$462 |
$462 |
5.1× |
| Us chest (76604) |
$671 |
$671 |
6.2× |
| Us ob transvaginal (76817) |
$681 |
$681 |
6.3× |
| Us pelvic non ob complete (76856) |
$861 |
$861 |
7.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$558 |
$558 |
5.1× |
| Us pregnancy ltd (76815) |
$503 |
$503 |
4.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$773 |
$773 |
7.1× |
| Us retroperitoneal complete (76770) |
$890 |
$890 |
8.2× |
| Us retroperitoneal limited (76775) |
$644 |
$644 |
5.9× |
| Us scrotum and contents (76870) |
$752 |
$752 |
6.9× |
| Us soft tissue head/neck (76536) |
$680 |
$680 |
6.3× |
| Us xtr non-vasc lmtd (76882) |
$606 |
$606 |
5.6× |
| Venography extremity unilateral rs&i (75820) |
$1,664 |
$1,664 |
1.0× |
| Wrist 2 views (73100) |
$283 |
$283 |
3.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$603 |
$603 |
5.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$343 |
$343 |
3.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$375 |
$375 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$319 |
$319 |
3.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$370 |
$370 |
4.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$582 |
$582 |
5.4× |
| X-ray exam hip uni 1 view (73501) |
$294 |
$294 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$375 |
$375 |
4.1× |
| X-ray exam hip uni 4/> views (73503) |
$463 |
$463 |
4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$640 |
$640 |
5.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$587 |
$587 |
5.4× |
| X-ray exam of femur 1 (73551) |
$354 |
$354 |
3.9× |
| X-ray eye for foreign body (70030) |
$290 |
$290 |
3.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$489 |
$489 |
4.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$381 |
$381 |
4.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$295 |
$295 |
3.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$347 |
$347 |
3.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$435 |
$435 |
4.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$255 |
$255 |
2.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$236 |
$236 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$504 |
$504 |
4.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$700 |
$700 |
6.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$546 |
$546 |
5.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$371 |
$371 |
4.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$353 |
$353 |
3.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$485 |
$485 |
4.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$492 |
$492 |
4.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,299 |
$1,299 |
3.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$385 |
$385 |
4.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$468 |
$468 |
4.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$585 |
$585 |
5.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$363 |
$363 |
4.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$387 |
$387 |
4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$467 |
$467 |
5.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$304 |
$304 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$479 |
$479 |
4.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$351 |
$351 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$330 |
$330 |
3.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$369 |
$369 |
4.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$415 |
$415 |
3.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$587 |
$587 |
5.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$261 |
$261 |
2.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$352 |
$352 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$706 |
$706 |
6.5× |
| Xr chest 4+ views (71048) |
$338 |
$338 |
3.1× |
| Xr finger(s) 2+ views (73140) |
$261 |
$261 |
2.9× |
| Xr optic foramina (70190) |
$312 |
$312 |
3.5× |
| Xr shoulder 1 view (73020) |
$288 |
$288 |
3.2× |
| Xr spine cervical 4 or 5 views (72050) |
$567 |
$567 |
5.2× |
| Xr tibia/fibula 2 views (73590) |
$353 |
$353 |
3.9× |
| Xr tmj bilateral (70330) |
$510 |
$510 |
5.6× |
| Xray knee 1 or 2 views rt (73560) |
$354 |
$354 |
3.9× |