| Abdomen 2 views (74019) |
$96.54 |
$137.92 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$451.50 |
$645 |
1.3× |
| Bone age studies (77072) |
$58.24 |
$83.19 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$451.50 |
$645 |
1.3× |
| Bone survey complete (77075) |
$131.03 |
$187.18 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$88.20 |
$126 |
1.2× |
| Chest 1 view (71045) |
$42.86 |
$61.22 |
0.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$224.70 |
$321 |
1.5× |
| Clavicle complete (73000) |
$91.70 |
$131 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,773.80 |
$2,534 |
5.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,137.50 |
$1,625 |
5.5× |
| CT abdomen w contrast (74160) |
$686 |
$980 |
4.5× |
| CT abdomen w wo contrast (74170) |
$868 |
$1,240 |
5.7× |
| CT abdomen w/o contrast (74150) |
$572.60 |
$818 |
6.4× |
| CT c-spine w/o contrast (72125) |
$704.90 |
$1,007 |
7.8× |
| CT cervical spine w&w/o contrast (72127) |
$252.48 |
$360.68 |
1.7× |
| CT cervical spine with contrast (72126) |
$450.80 |
$644 |
1.5× |
| CT chest w/wo contrast (71270) |
$252.48 |
$360.68 |
1.7× |
| CT chest with contrast (71260) |
$252.48 |
$360.68 |
1.7× |
| CT head/brain with contrast (70460) |
$957.60 |
$1,368 |
6.3× |
| CT head/brain without and with contrast (70470) |
$1,138.90 |
$1,627 |
7.5× |
| CT iac w contrast (70481) |
$507.80 |
$725.43 |
3.4× |
| CT lower ext w/o (73700) |
$489.30 |
$699 |
5.4× |
| CT lower extremity w wo contrast (73702) |
$1,018.50 |
$1,455 |
6.7× |
| CT lower extremity with contrast (73701) |
$720.30 |
$1,029 |
4.8× |
| CT lumbar spine w & w/o contrast (72133) |
$905.80 |
$1,294 |
6.0× |
| CT lumbar spine w/o contrast (72131) |
$723.80 |
$1,034 |
8.0× |
| CT lumbar spine with contrast (72132) |
$804.30 |
$1,149 |
2.7× |
| CT maxillofacial w contrast (70487) |
$646.10 |
$923 |
4.3× |
| CT maxillofacial w/o contrast (70486) |
$564.20 |
$806 |
6.3× |
| CT maxillofacial w/wo contrast (70488) |
$555.12 |
$793.02 |
3.7× |
| CT neck soft tissue w contrast (70491) |
$723.80 |
$1,034 |
4.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$580.60 |
$829.43 |
3.8× |
| CT orbits w/o contrast (70480) |
$360.28 |
$514.69 |
4.0× |
| CT pelvis w & w/o contrast (72194) |
$905.80 |
$1,294 |
6.0× |
| CT pelvis w/o contrast (72192) |
$564.90 |
$807 |
6.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$847 |
$1,210 |
5.6× |
| CT soft tissue neck w/o contrast (70490) |
$564.90 |
$807 |
6.3× |
| CT thoracic spine w/contrast (72129) |
$252.48 |
$360.68 |
1.7× |
| CT thoracic spine w/o contrast (72128) |
$905.80 |
$1,294 |
10.0× |
| CT thoracic spine w/wo contrast (72130) |
$252.48 |
$360.68 |
1.7× |
| CT thorax w/o contrast (71250) |
$468.30 |
$669 |
5.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$870.45 |
$1,243.50 |
5.8× |
| CT upper extremity w/o contrast rt (73200) |
$729.05 |
$1,041.50 |
8.1× |
| CT upper extremity with contrast (73201) |
$851.55 |
$1,216.50 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$252.48 |
$360.68 |
1.7× |
| Cta Abdomen (74175) |
$1,367.80 |
$1,954 |
9.0× |
| CTA abdomen pelvis (74174) |
$482.60 |
$689.43 |
1.6× |
| CTA chest (71275) |
$1,505 |
$2,150 |
10.0× |
| Cta Head (70496) |
$373.10 |
$533 |
2.5× |
| Cta Neck (70498) |
$373.10 |
$533 |
2.5× |
| Cta Pelvis (72191) |
$1,367.80 |
$1,954 |
9.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$61.95 |
$88.50 |
0.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$53.55 |
$76.50 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$189 |
$270 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$189 |
$270 |
2.5× |
| Dxa bone density study axial skeleton (77085) |
$160.30 |
$229 |
1.8× |
| Esophagus (74220) |
$174.30 |
$249 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$31.50 |
$45 |
0.2× |
| Foot 2 views (73620) |
$88.20 |
$126 |
1.2× |
| Forearm 2 views (73090) |
$93.80 |
$134 |
1.3× |
| Hand 3 views (73130) |
$137.55 |
$196.50 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$753.58 |
$1,076.54 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$451.50 |
$645 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$121.45 |
$173.50 |
1.6× |
| Kidney imaging morphology (78700) |
$451.50 |
$645 |
1.3× |
| Knee 3 views (73562) |
$99.77 |
$142.53 |
1.3× |
| Lung Ventilation Imaging (78579) |
$451.50 |
$645 |
1.3× |
| MRA head w/o contrast (70544) |
$1,031.80 |
$1,474 |
5.0× |
| MRA neck w contrast (70548) |
$1,171.80 |
$1,674 |
3.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,273.30 |
$1,819 |
4.2× |
| MRA neck w/o contrast (70547) |
$322.70 |
$461 |
1.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,321.25 |
$1,887.50 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$1,339.80 |
$1,914 |
6.5× |
| MRI any jnt lwr ext with con lt (73722) |
$956.90 |
$1,367 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$956.90 |
$1,367 |
1.4× |
| MRI cervical spine w/o contrast (72141) |
$919.10 |
$1,313 |
4.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$799.05 |
$1,141.50 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$799.05 |
$1,141.50 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$609 |
$870 |
3.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$639.80 |
$914 |
3.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,253 |
$1,790 |
4.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,491 |
$2,130 |
5.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,483.30 |
$2,119 |
4.9× |
| MRI pelvis w/o contrast (72195) |
$1,217.30 |
$1,739 |
5.9× |
| MRI scan of arm joint before and after contrast (73223) |
$1,157.10 |
$1,653 |
3.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,183 |
$1,690 |
3.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,484 |
$2,120 |
4.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,351 |
$1,930 |
4.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,483.30 |
$2,119 |
4.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,379 |
$1,970 |
4.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,483.30 |
$2,119 |
4.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,323 |
$1,890 |
6.4× |
| MRI tmj (70336) |
$1,203.30 |
$1,719 |
5.8× |
| MRI upper ext joint w/o contrast (73221) |
$609 |
$870 |
3.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,157.10 |
$1,653 |
3.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$609 |
$870 |
3.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,827.67 |
$2,610.96 |
1.6× |
| Neck soft tissue (70360) |
$78.75 |
$112.50 |
1.0× |
| Nm gastric emptying study (78264) |
$451.50 |
$645 |
1.3× |
| Nm red cell sequestration (78140) |
$451.50 |
$645 |
1.3× |
| Osseous survey infant (77076) |
$118.23 |
$168.90 |
1.3× |
| Parathyroid imaging (78070) |
$451.50 |
$645 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$78.05 |
$111.50 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,157.10 |
$1,653 |
3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$451.50 |
$645 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$753.58 |
$1,076.54 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$225.05 |
$321.50 |
2.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$132.50 |
$189.28 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$143.85 |
$205.50 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$62.86 |
$89.79 |
0.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$59.88 |
$85.55 |
0.8× |
| Radiologic exam colon single contrast study (74270) |
$210.70 |
$301 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$214.90 |
$307 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$93.80 |
$134 |
1.3× |
| Ribs bilateral 3 views (71110) |
$92.75 |
$132.50 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,827.67 |
$2,610.96 |
3.9× |
| Scapula complete (73010) |
$70.35 |
$100.50 |
0.8× |
| Screening digital breast tomosynthesis (77063) |
$30.80 |
$44 |
1.3× |
| Small bowel series (74250) |
$241.50 |
$345 |
1.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$451.50 |
$645 |
1.3× |
| Thyroid uptake measurement (78012) |
$451.50 |
$645 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$451.50 |
$645 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$123.38 |
$176.25 |
1.4× |
| Unlisted Ultrasound Procedure (76999) |
$121.21 |
$173.16 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$34.29 |
$48.98 |
0.4× |
| Us breast unilateral complete (76641) |
$170.10 |
$243 |
1.9× |
| Us breast unilateral limited (76642) |
$160.70 |
$229.58 |
2.1× |
| Us chest (76604) |
$174.30 |
$249 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$99.31 |
$141.87 |
1.1× |
| Us ob transvaginal (76817) |
$231.70 |
$331 |
2.6× |
| Us pelvic non ob complete (76856) |
$193.20 |
$276 |
2.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$112.40 |
$160.57 |
1.2× |
| Us pregnancy ltd (76815) |
$141.60 |
$202.28 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$130.90 |
$187 |
1.5× |
| Us retroperitoneal complete (76770) |
$149.80 |
$214 |
1.7× |
| Us retroperitoneal limited (76775) |
$139.30 |
$199 |
1.5× |
| Us scrotum and contents (76870) |
$193.20 |
$276 |
2.1× |
| Us soft tissue head/neck (76536) |
$197.40 |
$282 |
2.2× |
| Us xtr non-vasc lmtd (76882) |
$95.84 |
$136.92 |
1.1× |
| Wrist 2 views (73100) |
$88.20 |
$126 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$93.80 |
$134 |
1.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$212.80 |
$304 |
1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$121.45 |
$173.50 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$51.49 |
$73.56 |
0.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$101.85 |
$145.50 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$94.50 |
$135 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$88.20 |
$126 |
1.2× |
| X-ray IV pyelogram+drip infusn (74410) |
$582.40 |
$832 |
3.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$86.10 |
$123 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$113.75 |
$162.50 |
1.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$85.05 |
$121.50 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$160.30 |
$229 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$78.05 |
$111.50 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$136.85 |
$195.50 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$157.50 |
$225 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$91.35 |
$130.50 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$93.80 |
$134 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$83.30 |
$119 |
1.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$60.20 |
$86 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$134.75 |
$192.50 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$71.75 |
$102.50 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$66.50 |
$95 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$23.25 |
$33.22 |
0.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$90.65 |
$129.50 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$81.90 |
$117 |
1.1× |
| Xr finger(s) 2+ views (73140) |
$81.90 |
$117 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$120.75 |
$172.50 |
1.3× |
| Xr tibia/fibula 2 views (73590) |
$103.60 |
$148 |
1.4× |
| Xr tmj bilateral (70330) |
$154.70 |
$221 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$103.60 |
$148 |
1.4× |