| Abdomen 2 views (74019) |
$196 |
$280 |
2.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,096 |
$1,566 |
3.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,748 |
$5,354 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$2,502 |
$3,574 |
0.9× |
| Ankle 2 views (73600) |
$195 |
$279 |
2.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,502 |
$3,574 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,066 |
$2,951 |
0.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$751 |
$1,073 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$960 |
$1,372 |
2.6× |
| Bone age studies (77072) |
$176 |
$251 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,072 |
$1,531 |
2.9× |
| Bone survey complete (77075) |
$420 |
$600 |
4.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,748 |
$2,497 |
1.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$557 |
$795 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$144.50 |
$243.50 |
1.8× |
| Chest 1 view (71045) |
$188 |
$269 |
2.3× |
| Chest 3 views (71047) |
$223 |
$318 |
2.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$439 |
$627 |
2.7× |
| Clavicle complete (73000) |
$206 |
$318 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,107 |
$1,581 |
11.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,954 |
$2,792 |
6.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,425 |
$2,036 |
6.5× |
| CT abdomen w contrast (74160) |
$980 |
$1,400 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,343 |
$1,919 |
8.3× |
| CT abdomen w/o contrast (74150) |
$980 |
$1,400 |
10.2× |
| CT angiography upper extremity lt (73206) |
$1,161 |
$1,658 |
7.2× |
| CT c-spine w/o contrast (72125) |
$1,107 |
$1,581 |
11.5× |
| CT cervical spine w&w/o contrast (72127) |
$1,650 |
$2,357 |
10.2× |
| CT cervical spine with contrast (72126) |
$1,107 |
$1,581 |
3.4× |
| CT chest w/wo contrast (71270) |
$1,650 |
$2,357 |
10.2× |
| CT chest with contrast (71260) |
$1,107 |
$1,581 |
6.8× |
| CT head/brain with contrast (70460) |
$1,107 |
$1,581 |
6.8× |
| CT head/brain without and with contrast (70470) |
$1,650 |
$2,357 |
10.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$70 |
$100 |
0.9× |
| CT iac w contrast (70481) |
$888 |
$1,268 |
5.5× |
| CT lower ext w/o (73700) |
$931 |
$1,330 |
9.7× |
| CT lower extremity with contrast (73701) |
$924 |
$1,320 |
5.7× |
| CT lumbar spine w/o contrast (72131) |
$1,107 |
$1,581 |
11.5× |
| CT lumbar spine with contrast (72132) |
$1,107 |
$1,581 |
3.4× |
| CT maxillofacial w contrast (70487) |
$1,063 |
$1,518 |
6.6× |
| CT maxillofacial w/o contrast (70486) |
$1,063 |
$1,518 |
11.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,767 |
$2,524 |
10.9× |
| CT neck soft tissue w contrast (70491) |
$885 |
$1,264 |
5.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$993 |
$1,419 |
6.1× |
| CT orbits w/o contrast (70480) |
$888 |
$1,268 |
9.2× |
| CT pelvis w & w/o contrast (72194) |
$1,343 |
$1,919 |
8.3× |
| CT pelvis w/o contrast (72192) |
$980 |
$1,400 |
10.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,324 |
$1,892 |
8.2× |
| CT soft tissue neck w/o contrast (70490) |
$885 |
$1,264 |
9.2× |
| CT thoracic spine w/contrast (72129) |
$1,107 |
$1,581 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$1,107 |
$1,581 |
11.5× |
| CT thorax w/o contrast (71250) |
$1,107 |
$1,581 |
11.5× |
| CT upper extremity w/o contrast rt (73200) |
$931 |
$1,330 |
9.7× |
| CT upper extremity with contrast (73201) |
$1,161 |
$1,658 |
3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,161 |
$1,658 |
7.2× |
| Cta Abdomen (74175) |
$1,650 |
$2,357 |
10.2× |
| CTA abdomen pelvis (74174) |
$1,650 |
$2,357 |
5.1× |
| CTA chest (71275) |
$1,650 |
$2,357 |
10.2× |
| Cta Head (70496) |
$1,650 |
$2,357 |
10.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,650 |
$2,357 |
5.1× |
| CTA lwr ext w&w/o contrast (73706) |
$1,161 |
$1,658 |
7.2× |
| Cta Neck (70498) |
$1,324 |
$1,892 |
8.2× |
| Cta Pelvis (72191) |
$1,126 |
$1,608 |
7.0× |
| Cystography minimum 3 views rs&i (74430) |
$376 |
$537 |
1.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$252 |
$360 |
2.6× |
| Echoencephalography real time imaging (76506) |
$517 |
$738 |
5.4× |
| Fetal biophysical profile non-stress testing (76818) |
$258 |
$368 |
2.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$258 |
$368 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$509 |
$727 |
2.3× |
| Foot 2 views (73620) |
$195 |
$314 |
2.4× |
| Forearm 2 views (73090) |
$206 |
$323 |
2.6× |
| Hand 2 views (73120) |
$195 |
$279 |
2.0× |
| Hand 3 views (73130) |
$213 |
$331 |
2.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,096 |
$1,566 |
2.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$825 |
$1,179 |
2.2× |
| Humerus Min 2 Views Left (73060) |
$227 |
$324 |
2.8× |
| Hysterosalpingogram (74740) |
$509 |
$727 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,338 |
$1,912 |
2.7× |
| Knee 3 views (73562) |
$227 |
$356 |
2.8× |
| Lymphoscintigraphy (78195) |
$535 |
$764 |
1.1× |
| Meckels Diverticulum (78290) |
$761 |
$1,087 |
2.1× |
| MRA head w/o contrast (70544) |
$1,697 |
$2,424 |
7.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,759 |
$5,370 |
11.7× |
| MRA neck w/o contrast (70547) |
$1,697 |
$2,424 |
7.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,759 |
$5,370 |
11.7× |
| MRI abdomen w/o contrast (74181) |
$1,528 |
$2,183 |
6.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,035 |
$2,907 |
2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,374 |
$3,391 |
3.3× |
| MRI breast w/o contrast bilateral (77047) |
$774 |
$1,105 |
3.5× |
| MRI c-spine with contrast (72142) |
$2,035 |
$2,907 |
6.3× |
| MRI cervical spine w/o contrast (72141) |
$2,035 |
$2,907 |
9.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,036 |
$2,908 |
6.3× |
| MRI chest w/o contrast (71550) |
$1,697 |
$2,424 |
7.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,697 |
$2,424 |
7.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,697 |
$2,424 |
7.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,759 |
$5,370 |
11.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,557 |
$5,081 |
11.1× |
| MRI pelvis w/o contrast (72195) |
$1,528 |
$2,183 |
6.9× |
| MRI scan of arm joint before and after contrast (73223) |
$1,697 |
$2,424 |
5.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,697 |
$2,424 |
5.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,759 |
$5,370 |
11.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,035 |
$2,907 |
6.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,385 |
$4,835 |
10.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,035 |
$2,907 |
6.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,385 |
$4,835 |
10.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,035 |
$2,907 |
9.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,035 |
$2,907 |
9.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,035 |
$2,907 |
6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,035 |
$2,907 |
9.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,638 |
$3,768 |
2.2× |
| Neck soft tissue (70360) |
$168 |
$240 |
2.1× |
| Nm cisternogram (78630) |
$568 |
$812 |
1.1× |
| Nm gastric emptying study (78264) |
$927 |
$1,325 |
2.5× |
| Osseous survey infant (77076) |
$244 |
$348 |
2.5× |
| Parathyrd planar w/wo subtrj (78071) |
$402 |
$574 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$206 |
$294 |
2.1× |
| PET image w/CT, skull-thigh (78815) |
$1,748 |
$2,497 |
1.3× |
| PET imaging for CT attenuation whole body (78816) |
$1,748 |
$2,497 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,697 |
$2,424 |
5.3× |
| Pr red cell survival study (78130) |
$142 |
$203 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$858 |
$1,226 |
2.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,263 |
$1,804 |
2.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$158 |
$225 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$195 |
$279 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$189 |
$270 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$186 |
$266 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$239 |
$341 |
2.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$188 |
$269 |
2.3× |
| Radiologic exam colon single contrast study (74270) |
$1,072 |
$1,531 |
6.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$462 |
$660 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$892.50 |
$1,275 |
5.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$415 |
$593 |
2.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$227 |
$386 |
2.8× |
| Radiological examination surgical specimen (76098) |
$193 |
$276 |
0.4× |
| Ribs bilateral 3 views (71110) |
$308 |
$440 |
3.2× |
| Scanogram (77073) |
$377 |
$539 |
3.9× |
| Scapula complete (73010) |
$206 |
$294 |
2.1× |
| Screening digital breast tomosynthesis (77063) |
$34 |
$48 |
1.5× |
| Small bowel series (74250) |
$534 |
$763 |
3.3× |
| Spine thoracic 3 views (72072) |
$245 |
$350 |
2.5× |
| Thoracolumbar 2 views (72080) |
$138 |
$235 |
1.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,356 |
$1,937 |
2.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$601 |
$858 |
1.6× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$111 |
$159 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$270 |
$386 |
2.8× |
| Upper Extremity Infant (73092) |
$148 |
$211 |
1.5× |
| Urethrocystography voiding (74455) |
$4 |
$6 |
0.0× |
| Us abdl aorta screen aaa (76706) |
$270 |
$386 |
2.8× |
| Us breast unilateral complete (76641) |
$226 |
$323 |
2.3× |
| Us breast unilateral limited (76642) |
$187 |
$267 |
2.3× |
| Us chest (76604) |
$132 |
$188 |
1.4× |
| Us elastography parenchyma (76981) |
$109 |
$155 |
1.1× |
| Us ob transvaginal (76817) |
$449 |
$642 |
4.7× |
| Us pelvic non ob complete (76856) |
$291 |
$416 |
3.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$200 |
$286 |
2.1× |
| Us pregnancy ltd (76815) |
$270 |
$386 |
2.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$399 |
$570 |
4.1× |
| Us retroperitoneal complete (76770) |
$373 |
$533 |
3.9× |
| Us retroperitoneal limited (76775) |
$373 |
$533 |
3.9× |
| Us scrotum and contents (76870) |
$242 |
$346 |
2.5× |
| Us soft tissue head/neck (76536) |
$517 |
$958 |
5.4× |
| Us xtr non-vasc lmtd (76882) |
$159 |
$298 |
1.7× |
| Wrist 2 views (73100) |
$195 |
$279 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$292 |
$417 |
3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$199.50 |
$411 |
2.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$213 |
$332 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$206 |
$294 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$227 |
$352 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$141 |
$225 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$172 |
$293 |
2.1× |
| X-ray exam hip uni 4/> views (73503) |
$175 |
$250 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$263 |
$376 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$308 |
$440 |
3.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$245 |
$350 |
3.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$213 |
$304 |
2.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$188 |
$269 |
2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$378.50 |
$540.50 |
4.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$364 |
$520 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$170 |
$243 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$164 |
$234 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$158 |
$263 |
1.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$704 |
$1,006 |
7.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$206 |
$294 |
2.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$176 |
$251 |
2.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$308 |
$440 |
3.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$198 |
$283 |
2.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$767 |
$1,096 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$227 |
$324 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$137 |
$196 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$355 |
$507 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$186 |
$266 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$136.50 |
$227 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$227 |
$350 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$308 |
$440 |
3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$352 |
$503 |
3.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$245 |
$350 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$232 |
$331 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$257 |
$367 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$118.50 |
$204.50 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$168 |
$240 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$213 |
$336 |
2.7× |
| Xr chest 4+ views (71048) |
$258 |
$368 |
2.7× |
| Xr finger(s) 2+ views (73140) |
$168 |
$240 |
2.1× |
| Xr shoulder 1 view (73020) |
$188 |
$269 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$211 |
$351.50 |
2.2× |
| Xr tibia/fibula 2 views (73590) |
$206 |
$317 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$206 |
$320 |
2.6× |