| Abdomen 2 views (74019) |
$891.20 |
$2,228 |
6.8× |
| Acute gi blood loss imaging (78278) |
$2,913.40 |
$7,283.50 |
5.9× |
| Angio Adrenal Bilat Select (75733) |
$4,075.60 |
$10,189 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,709.40 |
$9,273.50 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,904.60 |
$7,261.50 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$1,983.60 |
$4,959 |
0.5× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$3,132.40 |
$7,831 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,132.40 |
$7,831 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,507.60 |
$6,269 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$4,784.40 |
$11,961 |
0.7× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$3,026.80 |
$7,567 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,382.80 |
$3,457 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,043.60 |
$2,609 |
0.3× |
| Ankle 2 views (73600) |
$504 |
$1,260 |
4.7× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$3,048.20 |
$7,620.50 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,715.60 |
$6,789 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$3,616.20 |
$9,040.50 |
0.9× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$2,464.80 |
$6,162 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$3,132.40 |
$7,831 |
0.8× |
| Arthrogram ankle (73615) |
$1,672.80 |
$4,182 |
3.9× |
| Arthrogram elbow (73085) |
$1,714.60 |
$4,286.50 |
3.9× |
| Arthrogram hip (73525) |
$1,622.80 |
$4,057 |
3.7× |
| Arthrogram knee (73580) |
$2,053.20 |
$5,133 |
4.7× |
| Arthrogram shoulder (73040) |
$1,655.20 |
$4,138 |
3.8× |
| Arthrogram wrist (73115) |
$1,320.20 |
$3,300.50 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,657.20 |
$4,143 |
3.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,837.60 |
$4,594 |
3.7× |
| Bone &/joint imaging whole body (78306) |
$3,370.40 |
$8,426 |
6.8× |
| Bone age studies (77072) |
$562.80 |
$1,407 |
4.3× |
| Bone Imaging 3 Phase (78315) |
$3,497.60 |
$8,744 |
7.0× |
| Bone Marrow Imaging Limited Area (78102) |
$984.40 |
$2,461 |
2.0× |
| Bone survey complete (77075) |
$1,264.40 |
$3,161 |
9.7× |
| Bone survey infant (77076) |
$672.40 |
$1,681 |
5.2× |
| Bowel imaging (78290) |
$1,792.80 |
$4,482 |
3.6× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$1,638.40 |
$4,096 |
3.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,138 |
$5,345 |
3.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$12,963.20 |
$32,408 |
7.3× |
| Brain Imaging Vascular Flow Only (78610) |
$2,470 |
$6,175 |
3.7× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$1,638.40 |
$4,096 |
2.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,213.60 |
$5,534 |
4.4× |
| Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or… (78483) |
$4,308.80 |
$10,772 |
6.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,905.60 |
$9,764 |
9.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,530.80 |
$3,827 |
2.3× |
| Cervical spine 2 or 3 views (72040) |
$453.20 |
$1,133 |
4.2× |
| Chest 1 view (71045) |
$690.40 |
$1,726 |
6.4× |
| Chest xray 3 views (71047) |
$515.40 |
$1,288.50 |
4.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,073.80 |
$2,684.50 |
4.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$2,368 |
$5,920 |
2.4× |
| Clavicle complete (73000) |
$552.40 |
$1,381 |
5.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$329.20 |
$823 |
2.5× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$821.60 |
$2,054 |
3.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$9,204 |
$23,010 |
21.2× |
| CT abdomen and pelvis without contrast (74176) |
$6,830.40 |
$17,076 |
23.0× |
| CT abdomen w contrast (74160) |
$3,686.60 |
$9,216.50 |
16.9× |
| CT abdomen w wo contrast (74170) |
$4,487 |
$11,217.50 |
20.6× |
| CT abdomen w/o contrast (74150) |
$3,142.20 |
$7,855.50 |
24.1× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,511.20 |
$8,778 |
16.1× |
| CT angiography upper extremity lt (73206) |
$3,678.40 |
$9,196 |
16.8× |
| CT c-spine w/contrast (72126) |
$4,583.60 |
$11,459 |
10.6× |
| CT c-spine w/o contrast (72125) |
$3,279.80 |
$8,199.50 |
25.2× |
| CT cervical spine w&w/o contrast (72127) |
$4,165.40 |
$10,413.50 |
19.1× |
| CT chest w contrast (71260) |
$3,741 |
$9,352.50 |
17.1× |
| CT chest w/wo contrast (71270) |
$5,423.60 |
$13,559 |
24.8× |
| CT head/brain with contrast (70460) |
$3,924.40 |
$9,811 |
18.0× |
| CT head/brain without and with contrast (70470) |
$3,816.40 |
$9,541 |
17.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$418 |
$1,045 |
3.9× |
| CT iac w contrast (70481) |
$2,843.20 |
$7,108 |
13.0× |
| CT limited/localized follow up study (76380) |
$1,548.40 |
$3,871 |
14.3× |
| CT lower ext w/o (73700) |
$3,272.40 |
$8,181 |
25.1× |
| CT lower extremity w wo contrast (73702) |
$3,477.80 |
$8,694.50 |
15.9× |
| CT lower extremity w/contrast material (73701) |
$3,678.80 |
$9,197 |
16.8× |
| CT lumbar spine w & w/o contrast (72133) |
$5,623.20 |
$14,058 |
25.8× |
| CT lumbar spine w/contrast (72132) |
$5,206.80 |
$13,017 |
12.0× |
| CT lumbar spine w/o contrast (72131) |
$3,516.40 |
$8,791 |
27.0× |
| CT maxillofacial w contrast (70487) |
$2,930 |
$7,325 |
13.4× |
| CT maxillofacial w/wo contrast (70488) |
$3,538 |
$8,845 |
16.2× |
| CT maxillofacial wo contrast (70486) |
$2,930.60 |
$7,326.50 |
22.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,465.60 |
$8,664 |
15.9× |
| CT orbits w/o contrast (70480) |
$3,190.40 |
$7,976 |
24.5× |
| CT pelvis w/o contrast (72192) |
$3,200 |
$8,000 |
24.6× |
| CT pelvis w/wo contrast (72194) |
$4,655.20 |
$11,638 |
21.3× |
| CT scan of arm combo (73202) |
$3,498.60 |
$8,746.50 |
16.0× |
| CT soft tissue neck w contrast (70491) |
$3,136.60 |
$7,841.50 |
14.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,257.60 |
$10,644 |
19.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,656.60 |
$6,641.50 |
20.4× |
| CT thoracic spine w/contrast (72129) |
$4,995.60 |
$12,489 |
22.9× |
| CT thoracic spine w/o contrast (72128) |
$3,576.60 |
$8,941.50 |
27.5× |
| CT thoracic spine w/wo contrast (72130) |
$5,248.40 |
$13,121 |
24.0× |
| CT thorax w/o contrast (71250) |
$3,323.20 |
$8,308 |
25.5× |
| CT upper ext wo (73200) |
$3,029.60 |
$7,574 |
23.3× |
| CT upper extremity with contrast (73201) |
$3,298.80 |
$8,247 |
7.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,345 |
$8,362.50 |
15.3× |
| Cta Abdomen (74175) |
$3,673.20 |
$9,183 |
16.8× |
| CTA abdomen pelvis (74174) |
$7,350.40 |
$18,376 |
16.9× |
| CTA chest (71275) |
$3,733.20 |
$9,333 |
17.1× |
| Cta Head (70496) |
$3,233.20 |
$8,083 |
14.8× |
| Cta Neck (70498) |
$3,233.20 |
$8,083 |
14.8× |
| Cta Pelvis (72191) |
$3,506 |
$8,765 |
16.1× |
| Cystography minimum 3 views rs&i (74430) |
$851.80 |
$2,129.50 |
2.0× |
| Diskogram cervical (72285) |
$5,963.60 |
$14,909 |
2.5× |
| Diskography lumbar (72295) |
$5,690.40 |
$14,226 |
2.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$2,024.40 |
$5,061 |
15.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$1,335.80 |
$3,339.50 |
12.3× |
| Dxa bone density study axial skeleton (77085) |
$250 |
$625 |
1.9× |
| Esophagus (74220) |
$863.20 |
$2,158 |
4.0× |
| Facial bones min 3 views (70150) |
$566.40 |
$1,416 |
4.4× |
| Fetal biophysical profile non-stress testing (76818) |
$942.20 |
$2,355.50 |
7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$453.40 |
$1,133.50 |
3.5× |
| Fluoroscopy up to 1 hr (76000) |
$959.20 |
$2,398 |
3.2× |
| Foot 2 views (73620) |
$498.80 |
$1,247 |
4.6× |
| Forearm 2 views (73090) |
$500 |
$1,250 |
4.6× |
| Hand 2 views (73120) |
$450.40 |
$1,126 |
3.5× |
| Heart first pass single,planar (78481) |
$2,524.80 |
$6,312 |
3.7× |
| Heart Infarct Image (78466) |
$1,268.80 |
$3,172 |
2.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,352.60 |
$5,881.50 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,295.20 |
$5,738 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,395.60 |
$5,989 |
3.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,289.20 |
$5,723 |
4.6× |
| Hysterosalpingogram (74740) |
$997.60 |
$2,494 |
3.4× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$920.40 |
$2,301 |
1.8× |
| Kidney imaging morphology (78700) |
$1,393.60 |
$3,484 |
2.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,054 |
$5,135 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,697.60 |
$6,744 |
4.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,084.80 |
$7,712 |
4.6× |
| Knee 3 views (73562) |
$597.20 |
$1,493 |
5.5× |
| Liver & spleen imaging static only (78215) |
$1,946.40 |
$4,866 |
3.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,688.40 |
$4,221 |
3.4× |
| Liver imaging static only (78201) |
$1,134.40 |
$2,836 |
1.7× |
| Liver imaging w/vascular flow (78202) |
$1,384.40 |
$3,461 |
2.0× |
| Lung perf&ventilat diferentl (78598) |
$2,783.20 |
$6,958 |
4.1× |
| Lung perfusion differential (78597) |
$1,627.20 |
$4,068 |
3.3× |
| Lung ventilation imaging (78579) |
$1,627.20 |
$4,068 |
3.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,050.80 |
$7,627 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,613.20 |
$6,533 |
0.7× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$3,132.40 |
$7,831 |
1.6× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$2,464.40 |
$6,161 |
3.2× |
| Lymphoscintigraphy (78195) |
$2,010 |
$5,025 |
3.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$4,846.80 |
$12,117 |
5.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$4,032.80 |
$10,082 |
9.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,478 |
$11,195 |
10.3× |
| Mammary ductogram or galactogram multiple (77054) |
$3,010 |
$7,525 |
10.1× |
| Mammary ductogram or galactogram single (77053) |
$2,027.20 |
$5,068 |
6.8× |
| MRA head w & w/o contrast (70546) |
$4,972.40 |
$12,431 |
11.5× |
| MRA head w/o contrast (70544) |
$4,981.60 |
$12,454 |
16.8× |
| MRA head with contrast (70545) |
$3,970 |
$9,925 |
9.1× |
| MRA neck w contrast (70548) |
$5,068 |
$12,670 |
11.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,469.60 |
$13,674 |
12.6× |
| MRA neck w/o contrast (70547) |
$4,981.60 |
$12,454 |
16.8× |
| MRI abdomen w contrast (74182) |
$3,480 |
$8,700 |
8.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,496.40 |
$11,241 |
10.4× |
| MRI abdomen w/o contrast (74181) |
$4,670.80 |
$11,677 |
15.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,653.20 |
$11,633 |
4.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,878.80 |
$12,197 |
11.2× |
| MRI bone marrow blood supply (77084) |
$3,758.40 |
$9,396 |
12.7× |
| MRI breast wo contrast unilateral (77046) |
$1,171.60 |
$2,929 |
3.9× |
| MRI c-spine with contrast (72142) |
$4,382.40 |
$10,956 |
10.1× |
| MRI cardiac w/o contrast (75557) |
$3,045.60 |
$7,614 |
10.3× |
| MRI cervical spine w/o contrast (72141) |
$4,591.20 |
$11,478 |
15.5× |
| MRI chest w/o & w/contrast material (71552) |
$5,351.20 |
$13,378 |
12.3× |
| MRI chest w/o contrast (71550) |
$3,741.80 |
$9,354.50 |
12.6× |
| MRI chest with contrast (71551) |
$3,758.40 |
$9,396 |
3.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,337.60 |
$10,844 |
10.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,641.60 |
$11,604 |
10.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,943.60 |
$9,859 |
13.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,218.80 |
$10,547 |
14.2× |
| MRI orbit face neck w contrast (70542) |
$4,510 |
$11,275 |
10.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,665.60 |
$11,664 |
10.7× |
| MRI pelvis w/contrast (72196) |
$3,758.40 |
$9,396 |
8.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,833.20 |
$12,083 |
11.1× |
| MRI pelvis w/o contrast (72195) |
$4,517.40 |
$11,293.50 |
15.2× |
| MRI spectroscopy (76390) |
$3,279.20 |
$8,198 |
30.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,510.80 |
$16,277 |
15.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,699.80 |
$11,749.50 |
10.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,987.80 |
$14,969.50 |
13.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,798 |
$11,995 |
11.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,780.20 |
$14,450.50 |
13.3× |
| MRI temporomandibular joint (70336) |
$3,758.40 |
$9,396 |
12.7× |
| MRI thoracic spine w/o contrast (72146) |
$4,796.40 |
$11,991 |
16.1× |
| MRI up ext w/o contrast (73218) |
$4,328.80 |
$10,822 |
14.6× |
| MRI upper ext joint w/o contrast (73221) |
$4,337.20 |
$10,843 |
14.6× |
| MRI, joint upper extrem combo (73223) |
$5,288.80 |
$13,222 |
12.2× |
| Myelogram Cervical (72240) |
$1,756.40 |
$4,391 |
1.8× |
| Myelogram Lumbar (72265) |
$1,428.80 |
$3,572 |
1.5× |
| Myelogram thoracic (72255) |
$1,699.20 |
$4,248 |
1.7× |
| Myelography 2 or more regions (72270) |
$2,787.60 |
$6,969 |
2.9× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$1,769.20 |
$4,423 |
2.6× |
| Myocardial infarct spect (78469) |
$2,539.20 |
$6,348 |
3.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$970.80 |
$2,427 |
0.6× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$2,289.20 |
$5,723 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$7,353.20 |
$18,383 |
4.6× |
| Myocardial spect single study at rest or stress (78451) |
$3,760.80 |
$9,402 |
2.3× |
| Neck soft tissue (70360) |
$546 |
$1,365 |
5.0× |
| Nm adrenal scan (78075) |
$2,640.80 |
$6,602 |
1.6× |
| Nm bone marrow wb (78104) |
$1,921.60 |
$4,804 |
3.9× |
| Nm cardiac blood pool multiple (78473) |
$4,464.40 |
$11,161 |
9.0× |
| Nm cisternogram (78630) |
$2,060.40 |
$5,151 |
3.0× |
| Nm csf leak detection (78650) |
$2,223.20 |
$5,558 |
1.4× |
| Nm gastric emptying study (78264) |
$2,812 |
$7,030 |
5.7× |
| Nm gastroesophageal reflux study (78262) |
$2,036.80 |
$5,092 |
4.1× |
| Nm kidney scan w/flow (78701) |
$1,765 |
$4,412.50 |
3.5× |
| Nm peritoneal-venous shunt patency (78291) |
$1,267.20 |
$3,168 |
2.5× |
| Noncardiac Vascular Flow Imaging (78445) |
$920.40 |
$2,301 |
1.8× |
| Nonvascular shunt X-ray (75809) |
$346.80 |
$867 |
2.7× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,988.80 |
$4,972 |
4.0× |
| Ob us nuchal meas 1 gest (76813) |
$513.20 |
$1,283 |
3.9× |
| Orthopantogram (70355) |
$528 |
$1,320 |
4.9× |
| Osseous survey limited (77074) |
$830.80 |
$2,077 |
6.4× |
| Parathyrd planar w/spect&CT (78072) |
$665.60 |
$1,664 |
1.0× |
| Parathyroid Planar Imaging (78070) |
$898.40 |
$2,246 |
1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$665.60 |
$1,664 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$356 |
$890 |
2.7× |
| Perineogram (74775) |
$895.60 |
$2,239 |
3.0× |
| Peritoneogram after injection (74190) |
$2,266.40 |
$5,666 |
3.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,295.20 |
$5,738 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,295.20 |
$5,738 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,391 |
$5,977.50 |
4.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,061.60 |
$7,654 |
4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$783.60 |
$1,959 |
1.2× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$431 |
$1,077.50 |
4.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$385.80 |
$964.50 |
3.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$640.40 |
$1,601 |
5.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$558 |
$1,395 |
4.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$894.80 |
$2,237 |
6.9× |
| Radex fingr minimum 2 views (73140) |
$438.80 |
$1,097 |
4.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$416.60 |
$1,041.50 |
3.8× |
| Radex Hand Minimum 3 Views (73130) |
$414.40 |
$1,036 |
3.8× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$368.80 |
$922 |
3.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$538.40 |
$1,346 |
4.1× |
| Radex Humerus Minimum 2 Views (73060) |
$565.60 |
$1,414 |
5.2× |
| Radex Kne 1/2 Views (73560) |
$427 |
$1,067.50 |
3.9× |
| Radex Kne Compl 4/More Views (73564) |
$486 |
$1,215 |
3.7× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$813.60 |
$2,034 |
6.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$522 |
$1,305 |
4.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$436.20 |
$1,090.50 |
3.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$477 |
$1,192.50 |
4.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$746.80 |
$1,867 |
6.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$501.60 |
$1,254 |
3.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$706.20 |
$1,765.50 |
6.5× |
| Radex Toe Minimum 2 Views (73660) |
$452 |
$1,130 |
4.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$481.20 |
$1,203 |
3.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$426.20 |
$1,065.50 |
3.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,012.80 |
$2,532 |
7.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$365 |
$912.50 |
3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$728.60 |
$1,821.50 |
5.6× |
| Radiologic exam chest 2 views (71046) |
$622 |
$1,555 |
5.7× |
| Radiologic exam colon single contrast study (74270) |
$1,345 |
$3,362.50 |
6.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$735.20 |
$1,838 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,862.80 |
$4,657 |
8.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$2,174.60 |
$5,436.50 |
10.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$516.40 |
$1,291 |
4.8× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$695.20 |
$1,738 |
5.3× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$468 |
$1,170 |
3.6× |
| Radiologic examination, teeth; complete, full mouth Non-Facility (70320) |
$638.40 |
$1,596 |
2.1× |
| Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) |
$392 |
$980 |
1.3× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$938.80 |
$2,347 |
8.7× |
| Radiological examination surgical specimen (76098) |
$310.80 |
$777 |
0.5× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,956 |
$4,890 |
6.7× |
| Renal Cyst Study (74470) |
$732 |
$1,830 |
1.1× |
| Ribs bilateral 3 views (71110) |
$678.80 |
$1,697 |
5.2× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,663.20 |
$4,158 |
3.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,088.80 |
$5,222 |
4.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,876 |
$9,690 |
5.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,675.60 |
$6,689 |
4.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,899.80 |
$7,249.50 |
4.3× |
| Sacroiliac Joints < 3 Views (72200) |
$343 |
$857.50 |
2.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,114 |
$2,785 |
3.8× |
| Salivary gland imaging (78230) |
$1,086.80 |
$2,717 |
2.2× |
| Scapula (73010) |
$814.40 |
$2,036 |
6.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$111.20 |
$278 |
4.8× |
| Sella turcica (70240) |
$392 |
$980 |
3.6× |
| Shoulder 1 view (73020) |
$444 |
$1,110 |
4.1× |
| Sialogram (70390) |
$1,327.60 |
$3,319 |
4.5× |
| Small bowel series (74250) |
$1,411.20 |
$3,528 |
6.5× |
| Speech evaluation complex (70371) |
$1,672.80 |
$4,182 |
5.6× |
| Spine thoracic 3 views (72072) |
$743.80 |
$1,859.50 |
5.7× |
| Splenoportograpy rs&i (75810) |
$1,837.60 |
$4,594 |
0.5× |
| Superior sagittal sinus venogram (75870) |
$2,295.20 |
$5,738 |
0.6× |
| Testicular Imaging With Vascular Flow (78761) |
$1,534.80 |
$3,837 |
3.1× |
| Thoracolumbar 2 views (72080) |
$426.20 |
$1,065.50 |
3.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,453.20 |
$6,133 |
3.6× |
| Thyroid imaging w/blood flow (78013) |
$1,337.20 |
$3,343 |
2.7× |
| Thyroid uptake measurement (78012) |
$501.60 |
$1,254 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,881 |
$4,702.50 |
3.8× |
| Tmj unilateral (70328) |
$441.80 |
$1,104.50 |
4.1× |
| Tomogram (76100) |
$936.80 |
$2,342 |
7.2× |
| Ultrasound breast complete (76641) |
$797.20 |
$1,993 |
6.1× |
| Ultrasound elastography first target lesion (76982) |
$1,182.80 |
$2,957 |
9.1× |
| Ultrasound Exam Aaa Screen (76706) |
$364.80 |
$912 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$1,266.80 |
$3,167 |
9.7× |
| Umbilical-artery Doppler (OB) (76820) |
$262.40 |
$656 |
2.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$51.20 |
$128 |
0.5× |
| Unlisted ultrasound procedure (76999) |
$194.80 |
$487 |
1.8× |
| Ureteral reflux study (78740) |
$1,086.80 |
$2,717 |
2.2× |
| Urethrocystogram voiding (74455) |
$1,251.60 |
$3,129 |
4.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,126.60 |
$2,816.50 |
3.8× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$1,057.60 |
$2,644 |
4.8× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,563.60 |
$3,909 |
7.2× |
| Us breast unilateral limited (76642) |
$686.80 |
$1,717 |
6.3× |
| Us chest (76604) |
$833.20 |
$2,083 |
6.4× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$2,110 |
$5,275 |
7.9× |
| Us compl joint r-t w/image documentation (76881) |
$1,076.40 |
$2,691 |
8.3× |
| Us elastography parenchyma (76981) |
$1,301.20 |
$3,253 |
10.0× |
| Us encephalogram (76506) |
$831.40 |
$2,078.50 |
6.4× |
| Us hips infant static (76886) |
$1,043.60 |
$2,609 |
9.6× |
| Us infant hips w manipulation (76885) |
$1,271.60 |
$3,179 |
11.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$920.80 |
$2,302 |
7.1× |
| Us ob detailed single fetus (76811) |
$630.80 |
$1,577 |
2.1× |
| Us ob limited (76815) |
$948.80 |
$2,372 |
7.3× |
| Us ob transvaginal (76817) |
$299.60 |
$749 |
2.3× |
| Us pelvic non ob complete (76856) |
$1,509.60 |
$3,774 |
11.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,356.40 |
$3,391 |
10.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$458 |
$1,145 |
3.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$657.20 |
$1,643 |
5.0× |
| Us retroperitoneal complete (76770) |
$1,419.60 |
$3,549 |
10.9× |
| Us retroperitoneal limited (76775) |
$1,379.60 |
$3,449 |
10.6× |
| Us scrotum and contents (76870) |
$1,206.20 |
$3,015.50 |
9.3× |
| Us soft tissue head/neck (76536) |
$836 |
$2,090 |
6.4× |
| Us spinal canal and contents (76800) |
$1,190.20 |
$2,975.50 |
9.1× |
| Us transrectal (76872) |
$1,368.40 |
$3,421 |
10.5× |
| Us, eye b-scan (76512) |
$878 |
$2,195 |
6.7× |
| Us,transplanted kidney, real time/ doppler (76776) |
$659.60 |
$1,649 |
5.1× |
| Venogram adrenal unilat (75840) |
$2,295.20 |
$5,738 |
0.6× |
| Venogram extremity bilateral (75822) |
$1,876.20 |
$4,690.50 |
1.0× |
| Venogram Extremity Unilateral (75820) |
$1,276.80 |
$3,192 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,141.40 |
$7,853.50 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$2,488.20 |
$6,220.50 |
1.3× |
| Venography Renal Bilateral (75833) |
$2,295.20 |
$5,738 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$2,125.60 |
$5,314 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,295.20 |
$5,738 |
0.6× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,295.20 |
$5,738 |
0.3× |
| Wrist 2 views (73100) |
$598.40 |
$1,496 |
5.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,173.20 |
$2,933 |
9.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$525.20 |
$1,313 |
4.8× |
| X-ray b.e. reductn intuss (74283) |
$579.60 |
$1,449 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,765.80 |
$4,414.50 |
8.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$619.20 |
$1,548 |
5.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$792.80 |
$1,982 |
7.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$552 |
$1,380 |
4.2× |
| X-ray exam of femur 2/> (73552) |
$478.80 |
$1,197 |
4.4× |
| X-ray eye for foreign body (70030) |
$522 |
$1,305 |
4.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$543.20 |
$1,358 |
5.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,599.20 |
$3,998 |
7.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$674.40 |
$1,686 |
6.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$316.20 |
$790.50 |
2.9× |
| X-ray leg, infant (73592) |
$481.20 |
$1,203 |
4.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$470.60 |
$1,176.50 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$861.60 |
$2,154 |
6.6× |
| X-ray nose-rectum child f.b. (76010) |
$467.20 |
$1,168 |
4.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$649.40 |
$1,623.50 |
5.0× |
| X-ray retrograde pyelogram (74420) |
$1,718 |
$4,295 |
4.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$471 |
$1,177.50 |
4.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$786 |
$1,965 |
6.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$772.20 |
$1,930.50 |
5.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$443.60 |
$1,109 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$414.20 |
$1,035.50 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$579.80 |
$1,449.50 |
5.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$956.80 |
$2,392 |
7.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$398.60 |
$996.50 |
3.1× |
| X-Ray Small Bowel Enteroclysis (74251) |
$1,895.20 |
$4,738 |
8.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$517.20 |
$1,293 |
4.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$521.40 |
$1,303.50 |
4.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$532.40 |
$1,331 |
4.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$644.80 |
$1,612 |
5.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$954 |
$2,385 |
7.3× |
| Xr bone length studies (77073) |
$565.60 |
$1,414 |
4.3× |
| Xr c-spine 4 or 5 views (72050) |
$630.60 |
$1,576.50 |
4.8× |
| Xr c-spine 6 or more views (72052) |
$790.20 |
$1,975.50 |
6.1× |
| Xr chest 4+ views (71048) |
$845.20 |
$2,113 |
6.5× |
| Xr urogram antegrade (74425) |
$1,114.40 |
$2,786 |
2.6× |