| Abdomen 2 views (74019) |
$201 |
$335 |
2.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$897 |
$1,495 |
2.3× |
| Acute venous thrombus image (78456) |
$1,561.82 |
$2,603.04 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,220.20 |
$5,367 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$3,712.20 |
$6,187 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,373.20 |
$5,622 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$2,618.40 |
$4,364 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,373.20 |
$5,622 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,079.80 |
$5,133 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,300.40 |
$3,834 |
0.8× |
| Angiography Spinal Selective Rs&I (75705) |
$3,373.20 |
$5,622 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,712.20 |
$6,187 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,454.60 |
$4,091 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,964.40 |
$3,274 |
0.6× |
| Ankle 2 views (73600) |
$162 |
$270 |
1.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$312 |
$520 |
0.9× |
| Aortogram thoracic (75605) |
$5,979 |
$9,965 |
1.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,454 |
$4,090 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,318.40 |
$3,864 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$2,611.80 |
$4,353 |
0.9× |
| Arthrogram elbow (73085) |
$465.60 |
$776 |
1.4× |
| Arthrogram hip (73525) |
$384.60 |
$641 |
1.1× |
| Arthrogram shoulder (73040) |
$387.60 |
$646 |
1.1× |
| Arthrogram wrist (73115) |
$540 |
$900 |
1.6× |
| Arthrography knee lt (73580) |
$461.40 |
$769 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$603 |
$1,005 |
1.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$724.20 |
$1,207 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,193.40 |
$1,989 |
3.1× |
| Bone age studies (77072) |
$140.40 |
$234 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,206 |
$2,010 |
3.1× |
| Bone Marrow Imaging Limited Area (78102) |
$921 |
$1,535 |
2.4× |
| Bone survey complete (77075) |
$289.20 |
$482 |
2.9× |
| Brain image w/flow 4 + views (78606) |
$1,217.40 |
$2,029 |
2.3× |
| Brain imaging < 4 static views (78600) |
$540 |
$900 |
1.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,135.80 |
$1,893 |
2.9× |
| Brain Imaging Minimum 4 Static Views (78605) |
$873.60 |
$1,456 |
1.7× |
| Brain Imaging Vascular Flow Only (78610) |
$1,309.80 |
$2,183 |
2.5× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$26.40 |
$44 |
2.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$924 |
$1,540 |
2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,707 |
$2,845 |
5.0× |
| Cardiac shunt detection (78428) |
$979.80 |
$1,633 |
2.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,217.40 |
$2,029 |
2.3× |
| Cervical spine 2 or 3 views (72040) |
$241.80 |
$403 |
2.9× |
| Chest 1 view (71045) |
$169.80 |
$283 |
2.0× |
| Chest 3 views (71047) |
$241.80 |
$403 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$330.60 |
$551 |
1.9× |
| Cineradiography/videoradiography (76120) |
$225.60 |
$376 |
2.2× |
| Clavicle complete (73000) |
$169.80 |
$283 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$219.60 |
$366 |
2.2× |
| Corpora cavernosography (74445) |
$452.40 |
$754 |
4.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,782.20 |
$4,637 |
8.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,963.80 |
$3,273 |
8.5× |
| CT abdomen w contrast (74160) |
$1,377 |
$2,295 |
8.1× |
| CT abdomen w wo contrast (74170) |
$1,583.10 |
$2,638.50 |
9.3× |
| CT abdomen w/o contrast (74150) |
$1,065.60 |
$1,776 |
10.5× |
| CT angio hrt w/3d image (75574) |
$1,182.60 |
$1,971 |
3.5× |
| CT angiography upper extremity lt (73206) |
$1,649.40 |
$2,749 |
9.7× |
| CT c-spine w/o contrast (72125) |
$1,143 |
$1,905 |
11.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,639.20 |
$2,732 |
9.6× |
| CT cervical spine with contrast (72126) |
$1,441.20 |
$2,402 |
4.3× |
| CT chest w/wo contrast (71270) |
$1,653.60 |
$2,756 |
9.7× |
| CT chest with contrast (71260) |
$1,269 |
$2,115 |
7.5× |
| CT colonography screening (74263) |
$1,393.50 |
$2,322.50 |
6.0× |
| CT colonography w/o cntrst (74261) |
$1,284.60 |
$2,141 |
12.7× |
| CT head/brain with contrast (70460) |
$1,092 |
$1,820 |
6.4× |
| CT head/brain without and with contrast (70470) |
$1,254 |
$2,090 |
7.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$423.60 |
$706 |
1.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$115.39 |
$192.31 |
1.4× |
| CT hrt w/3d image congen (75573) |
$458.40 |
$764 |
1.4× |
| CT iac w contrast (70481) |
$1,227 |
$2,045 |
7.2× |
| CT limited/localized follow up study (76380) |
$305.40 |
$509 |
3.6× |
| CT lower ext w/o (73700) |
$996.60 |
$1,661 |
9.8× |
| CT lower extremity w wo contrast (73702) |
$1,488.60 |
$2,481 |
8.8× |
| CT lower extremity with contrast (73701) |
$1,304.40 |
$2,174 |
7.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,831.20 |
$3,052 |
10.8× |
| CT lumbar spine w/o contrast (72131) |
$1,185.60 |
$1,976 |
11.7× |
| CT lumbar spine with contrast (72132) |
$1,468.80 |
$2,448 |
4.3× |
| CT maxillofacial w contrast (70487) |
$1,074 |
$1,790 |
6.3× |
| CT maxillofacial w/o contrast (70486) |
$967.20 |
$1,612 |
9.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,475.40 |
$2,459 |
8.7× |
| CT neck soft tissue w contrast (70491) |
$1,275 |
$2,125 |
7.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,371.60 |
$2,286 |
8.1× |
| CT orbits w/o contrast (70480) |
$1,086 |
$1,810 |
10.7× |
| CT pelvis w & w/o contrast (72194) |
$1,292.40 |
$2,154 |
7.6× |
| CT pelvis w/o contrast (72192) |
$996 |
$1,660 |
9.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$294.60 |
$491 |
3.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,407.60 |
$2,346 |
8.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,036.20 |
$1,727 |
10.2× |
| CT thoracic spine w/contrast (72129) |
$1,441.20 |
$2,402 |
8.5× |
| CT thoracic spine w/o contrast (72128) |
$1,143 |
$1,905 |
11.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,539 |
$2,565 |
9.0× |
| CT thorax w/o contrast (71250) |
$884.10 |
$1,473.50 |
8.7× |
| CT unlisted procedure (76497) |
$313.20 |
$522 |
3.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,398 |
$2,330 |
8.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,143 |
$1,905 |
11.3× |
| CT upper extremity with contrast (73201) |
$1,284 |
$2,140 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,548.60 |
$2,581 |
9.1× |
| Cta Abdomen (74175) |
$1,430.40 |
$2,384 |
8.4× |
| CTA abdomen pelvis (74174) |
$2,282.40 |
$3,804 |
6.7× |
| CTA chest (71275) |
$1,882.80 |
$3,138 |
11.1× |
| Cta Head (70496) |
$1,671 |
$2,785 |
9.8× |
| CTA lwr ext w&w/o contrast (73706) |
$1,816.80 |
$3,028 |
10.7× |
| Cta Neck (70498) |
$1,687.80 |
$2,813 |
9.9× |
| Cta Pelvis (72191) |
$1,528.20 |
$2,547 |
9.0× |
| Cystography minimum 3 views rs&i (74430) |
$241.80 |
$403 |
0.7× |
| Dacryocystography (70170) |
$409.50 |
$682.50 |
1.8× |
| Diskogram cervical (72285) |
$2,264.40 |
$3,774 |
1.2× |
| Diskography lumbar (72295) |
$3,022.80 |
$5,038 |
1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$241.20 |
$402 |
2.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$523.20 |
$872 |
5.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$247.20 |
$412 |
2.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$198 |
$330 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$220.80 |
$368 |
2.6× |
| Dxa bone density study axial skeleton (77085) |
$128.40 |
$214 |
1.3× |
| Echo exam of fetal heart (76825) |
$1,455 |
$2,425 |
2.7× |
| Echoencephalography real time imaging (76506) |
$300.30 |
$500.50 |
3.0× |
| Esophagus (74220) |
$248.40 |
$414 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$493.80 |
$823 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$379.80 |
$633 |
3.7× |
| Fluoroscopy up to 1 hr (76000) |
$411 |
$685 |
1.8× |
| Foot 2 views (73620) |
$162 |
$270 |
1.9× |
| Forearm 2 views (73090) |
$155.10 |
$258.50 |
1.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$3,072.60 |
$5,121 |
5.8× |
| Gated Heart Planar Single (78472) |
$1,239.60 |
$2,066 |
3.2× |
| Hand 2 views (73120) |
$154.20 |
$257 |
1.5× |
| Hand 3 views (73130) |
$241.80 |
$403 |
2.9× |
| Heart Infarct Image (78466) |
$738.60 |
$1,231 |
1.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,023 |
$6,705 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,572.60 |
$2,621 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,544.40 |
$2,574 |
4.0× |
| Ht muscle image spect sing (78451) |
$1,850.40 |
$3,084 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$155.10 |
$258.50 |
1.8× |
| Hysterosalpingogram (74740) |
$514.20 |
$857 |
2.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$177 |
$295 |
1.7× |
| Kidney imaging morphology (78700) |
$821.40 |
$1,369 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,018.20 |
$1,697 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,138.20 |
$1,897 |
2.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,647 |
$2,745 |
3.1× |
| Knee 3 views (73562) |
$241.80 |
$403 |
2.9× |
| Liver & spleen imaging static only (78215) |
$762 |
$1,270 |
2.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$927.60 |
$1,546 |
2.4× |
| Liver imaging static only (78201) |
$1,085.40 |
$1,809 |
2.1× |
| Liver imaging w/vascular flow (78202) |
$1,551 |
$2,585 |
2.9× |
| Lung perf&ventilat diferentl (78598) |
$1,255.80 |
$2,093 |
2.4× |
| Lung perfusion differential (78597) |
$1,028.40 |
$1,714 |
2.7× |
| Lung Ventilation Imaging (78579) |
$1,080 |
$1,800 |
2.8× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,006.40 |
$3,344 |
0.7× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$723.60 |
$1,206 |
1.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$969.60 |
$1,616 |
0.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,964.40 |
$3,274 |
0.6× |
| Lymphoscintigraphy (78195) |
$1,498.20 |
$2,497 |
2.8× |
| Mammary ductogram or galactogram multiple (77054) |
$468.60 |
$781 |
2.0× |
| Mammary ductogram or galactogram single (77053) |
$292.20 |
$487 |
1.3× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$155.40 |
$259 |
1.8× |
| Meckels Diverticulum (78290) |
$736.80 |
$1,228 |
1.9× |
| Mr elastography (76391) |
$306.60 |
$511 |
1.3× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$137.10 |
$228.50 |
2.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$56.70 |
$94.50 |
2.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$211.80 |
$353 |
2.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$557.70 |
$929.50 |
2.4× |
| MRA head w & w/o contrast (70546) |
$2,106 |
$3,510 |
6.2× |
| MRA head w/o contrast (70544) |
$1,545.30 |
$2,575.50 |
6.7× |
| MRA head with contrast (70545) |
$1,866.30 |
$3,110.50 |
5.5× |
| MRA neck w contrast (70548) |
$2,184 |
$3,640 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,007.90 |
$3,346.50 |
5.9× |
| MRA neck w/o contrast (70547) |
$1,375.80 |
$2,293 |
5.9× |
| MRI abdomen w contrast (74182) |
$1,714.80 |
$2,858 |
5.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,339.70 |
$3,899.50 |
6.9× |
| MRI abdomen w/o contrast (74181) |
$1,250.40 |
$2,084 |
5.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,536 |
$2,560 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,691.10 |
$2,818.50 |
2.2× |
| MRI bone marrow blood supply (77084) |
$273 |
$455 |
1.2× |
| MRI breast w/o contrast bilateral (77047) |
$2,760 |
$4,600 |
11.9× |
| MRI breast w/o contrast unilat (77046) |
$2,160 |
$3,600 |
9.3× |
| MRI c-spine with contrast (72142) |
$1,510.20 |
$2,517 |
4.5× |
| MRI cardiac w/o cont stress (75559) |
$1,156.80 |
$1,928 |
2.2× |
| MRI cardiac w/o contrast (75557) |
$1,050 |
$1,750 |
4.5× |
| MRI cervical spine w/o contrast (72141) |
$1,386 |
$2,310 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$1,976.40 |
$3,294 |
5.8× |
| MRI chest w/o contrast (71550) |
$1,135.20 |
$1,892 |
4.9× |
| MRI chest with contrast (71551) |
$1,466.40 |
$2,444 |
1.9× |
| MRI fetal sngl/1st gestation (74712) |
$558 |
$930 |
2.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,624.20 |
$2,707 |
4.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,578 |
$2,630 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$997.50 |
$1,662.50 |
4.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,188.90 |
$1,981.50 |
5.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,963.20 |
$3,272 |
5.8× |
| MRI orbit/face/neck w/contrast (70542) |
$1,551 |
$2,585 |
4.6× |
| MRI pelvis w contrast (72196) |
$1,536.60 |
$2,561 |
4.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,152.20 |
$3,587 |
6.4× |
| MRI pelvis w/o contrast (72195) |
$1,174.80 |
$1,958 |
5.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,127 |
$3,545 |
6.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,800.60 |
$3,001 |
2.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,794.60 |
$2,991 |
5.3× |
| MRI spectroscopy (76390) |
$1,015.20 |
$1,692 |
12.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,798.50 |
$2,997.50 |
5.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,510.20 |
$2,517 |
4.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,798.50 |
$2,997.50 |
5.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,299.60 |
$2,166 |
3.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,798.50 |
$2,997.50 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,386 |
$2,310 |
6.0× |
| MRI tmj (70336) |
$1,273.20 |
$2,122 |
5.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,197.60 |
$1,996 |
5.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,793.70 |
$2,989.50 |
5.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,086 |
$1,810 |
4.7× |
| Myelogram Cervical (72240) |
$680.40 |
$1,134 |
0.9× |
| Myelogram Lumbar (72265) |
$1,072.20 |
$1,787 |
1.4× |
| Myelogram thoracic (72255) |
$1,629.60 |
$2,716 |
2.1× |
| Myelography 2 or more regions (72270) |
$766.20 |
$1,277 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$3,072.60 |
$5,121 |
2.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,225.40 |
$3,709 |
1.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,433.20 |
$5,722 |
1.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,129.60 |
$5,216 |
3.8× |
| Neck soft tissue (70360) |
$169.80 |
$283 |
2.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$319.56 |
$532.60 |
0.9× |
| Nm bone marrow multiple (78103) |
$1,237.20 |
$2,062 |
3.2× |
| Nm bone marrow wb (78104) |
$522 |
$870 |
1.3× |
| Nm cisternogram (78630) |
$1,144.20 |
$1,907 |
2.2× |
| Nm csf leak detection (78650) |
$1,561.82 |
$2,603.04 |
1.2× |
| Nm gastric emptying study (78264) |
$1,282.80 |
$2,138 |
3.3× |
| Nm gastroesophageal reflux study (78262) |
$580.20 |
$967 |
1.5× |
| Nm peritoneal-venous shunt patency (78291) |
$755.40 |
$1,259 |
1.9× |
| Nm red cell sequestration (78140) |
$1,021.80 |
$1,703 |
2.6× |
| Nm whole blood volume (78122) |
$1,322.40 |
$2,204 |
2.5× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,863.20 |
$4,772 |
2.3× |
| Nuclear medicine of heart pumping function (78473) |
$924 |
$1,540 |
2.4× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,001.60 |
$3,336 |
1.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,743.60 |
$2,906 |
4.5× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$763.80 |
$1,273 |
2.0× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,113.60 |
$1,856 |
2.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$540 |
$900 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$742.20 |
$1,237 |
3.3× |
| Nuclr Rx Interstit Colloid (79300) |
$556.20 |
$927 |
2.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$264.60 |
$441 |
2.6× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$340.20 |
$567 |
3.4× |
| Orthopantogram (70355) |
$295.50 |
$492.50 |
3.5× |
| Osseous survey infant (77076) |
$201 |
$335 |
2.0× |
| Osseous survey limited (77074) |
$156 |
$260 |
1.5× |
| Parathyrd planar w/spect&CT (78072) |
$3,328.20 |
$5,547 |
6.3× |
| Parathyrd planar w/wo subtrj (78071) |
$1,214.40 |
$2,024 |
3.1× |
| Parathyroid imaging (78070) |
$781.20 |
$1,302 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$201 |
$335 |
2.0× |
| Peritoneogram rs&i (74190) |
$378 |
$630 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,809 |
$3,015 |
5.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,612.40 |
$4,354 |
0.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,454.60 |
$4,091 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$755.40 |
$1,259 |
1.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,239.60 |
$2,066 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$439.20 |
$732 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$191.40 |
$319 |
2.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$216 |
$360 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$201 |
$335 |
2.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$275.40 |
$459 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$354 |
$590 |
3.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$292.50 |
$487.50 |
2.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$169.80 |
$283 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$241.80 |
$403 |
2.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$885.30 |
$1,475.50 |
10.5× |
| Radiologic exam colon single contrast study (74270) |
$408.60 |
$681 |
2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$248.40 |
$414 |
1.5× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$175.20 |
$292 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$301.80 |
$503 |
1.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$280.20 |
$467 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$201 |
$335 |
2.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$69 |
$115 |
0.8× |
| Radiological examination surgical specimen (76098) |
$390 |
$650 |
0.7× |
| Radiopharm Dacryocystography (78660) |
$408 |
$680 |
1.1× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$685.80 |
$1,143 |
3.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,079.20 |
$5,132 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,871.60 |
$4,786 |
0.9× |
| Ribs bilateral 3 views (71110) |
$241.80 |
$403 |
2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$922.20 |
$1,537 |
2.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,688.40 |
$2,814 |
3.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,263.60 |
$2,106 |
2.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,195.20 |
$1,992 |
1.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,317 |
$2,195 |
0.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,195.20 |
$1,992 |
1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$997.20 |
$1,662 |
4.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,013.40 |
$1,689 |
4.5× |
| Rp Therapy Intravenous Administration (79101) |
$917.40 |
$1,529 |
4.1× |
| Sacroiliac Joints < 3 Views (72200) |
$241.50 |
$402.50 |
2.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$348 |
$580 |
1.5× |
| Salivary gland imaging (78230) |
$490.43 |
$817.38 |
1.3× |
| Salivary gland imaging serial images (78231) |
$508.20 |
$847 |
1.3× |
| Scanogram (77073) |
$162.60 |
$271 |
1.6× |
| Scapula complete (73010) |
$241.80 |
$403 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$84.60 |
$141 |
3.6× |
| Sella turcica (70240) |
$129.30 |
$215.50 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$168.60 |
$281 |
1.7× |
| Sialogram (70390) |
$349.20 |
$582 |
1.5× |
| Small bowel series (74250) |
$301.80 |
$503 |
1.8× |
| Spine thoracic 3 views (72072) |
$241.80 |
$403 |
2.4× |
| Spleen imaging only (78185) |
$895.20 |
$1,492 |
2.3× |
| Splenoportograpy rs&i (75810) |
$3,079.80 |
$5,133 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$2,454.60 |
$4,091 |
0.8× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$560.40 |
$934 |
2.4× |
| Testicular Imaging With Vascular Flow (78761) |
$812.40 |
$1,354 |
2.1× |
| Therapeutic Enema (74283) |
$737.40 |
$1,229 |
4.3× |
| Thoracolumbar 2 views (72080) |
$201 |
$335 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,324.20 |
$2,207 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$577.80 |
$963 |
1.5× |
| Thyroid uptake measurement (78012) |
$408 |
$680 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$624 |
$1,040 |
1.6× |
| Tmj unilateral (70328) |
$229.20 |
$382 |
2.7× |
| Tomogram (76100) |
$189.60 |
$316 |
1.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,183.40 |
$3,639 |
4.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$745.80 |
$1,243 |
1.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$815.40 |
$1,359 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$415.80 |
$693 |
4.1× |
| Umbilical-artery Doppler (OB) (76820) |
$247.20 |
$412 |
2.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$532.80 |
$888 |
6.3× |
| Unlisted magnetic resonance procedure (76498) |
$78 |
$130 |
0.9× |
| Unlisted Ultrasound Procedure (76999) |
$168 |
$280 |
2.0× |
| Upper Extremity Infant (73092) |
$201 |
$335 |
2.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$823.80 |
$1,373 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$320.40 |
$534 |
1.4× |
| Urethrocystography voiding (74455) |
$379.20 |
$632 |
1.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$314.40 |
$524 |
1.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$394.20 |
$657 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$258 |
$430 |
2.5× |
| Us breast unilateral complete (76641) |
$274.50 |
$457.50 |
2.7× |
| Us breast unilateral limited (76642) |
$274.50 |
$457.50 |
3.3× |
| Us chest (76604) |
$222 |
$370 |
2.2× |
| Us compl joint r-t w/image documentation (76881) |
$328.20 |
$547 |
3.2× |
| Us elastography parenchyma (76981) |
$190.80 |
$318 |
1.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$318 |
$530 |
3.1× |
| Us guided compression repair (76936) |
$432.60 |
$721 |
2.1× |
| Us infant hips dynamic (76885) |
$240.60 |
$401 |
2.9× |
| Us infant hips limited static (76886) |
$240.60 |
$401 |
2.9× |
| Us kidney transplant (76776) |
$430.50 |
$717.50 |
4.2× |
| Us ob detailed single fetus (76811) |
$487.20 |
$812 |
2.1× |
| Us ob transvaginal (76817) |
$336 |
$560 |
3.3× |
| Us pelvic non ob complete (76856) |
$561.60 |
$936 |
5.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$270 |
$450 |
2.7× |
| Us pregnancy ltd (76815) |
$270.60 |
$451 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$396 |
$660 |
3.9× |
| Us retroperitoneal complete (76770) |
$489.60 |
$816 |
4.8× |
| Us retroperitoneal limited (76775) |
$300 |
$500 |
3.0× |
| Us scrotum and contents (76870) |
$449.40 |
$749 |
4.4× |
| Us soft tissue head/neck (76536) |
$397.20 |
$662 |
3.9× |
| Us spinal canal and contents (76800) |
$345.60 |
$576 |
3.4× |
| Us transrectal (76872) |
$498 |
$830 |
4.9× |
| Us transrectal prostate volume (76873) |
$1,196.40 |
$1,994 |
11.8× |
| Us xtr non-vasc lmtd (76882) |
$131.40 |
$219 |
1.3× |
| Venogram extremity bilateral (75822) |
$1,228.80 |
$2,048 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,539.80 |
$4,233 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$1,636.80 |
$2,728 |
1.1× |
| Venography epidural rs&i (75872) |
$1,159.80 |
$1,933 |
1.9× |
| Venography extremity unilateral rs&i (75820) |
$1,147.20 |
$1,912 |
0.8× |
| Venography Renal Bilateral (75833) |
$3,694.20 |
$6,157 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$3,226.20 |
$5,377 |
1.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,006.40 |
$3,344 |
0.7× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,942 |
$6,570 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$159.60 |
$266 |
1.9× |
| Wrist 2 views (73100) |
$136.80 |
$228 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$280.20 |
$467 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$241.80 |
$403 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$241.80 |
$403 |
2.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$531 |
$885 |
3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$155.10 |
$258.50 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$241.80 |
$403 |
2.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$240 |
$400 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$169.80 |
$283 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$222 |
$370 |
2.6× |
| X-ray exam hip uni 4/> views (73503) |
$256.80 |
$428 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$256.80 |
$428 |
2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$277.80 |
$463 |
2.7× |
| X-ray exam of femur 1 (73551) |
$136.80 |
$228 |
1.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$385.80 |
$643 |
2.3× |
| X-ray eye for foreign body (70030) |
$193.20 |
$322 |
2.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$275.40 |
$459 |
2.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$228.60 |
$381 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$241.80 |
$403 |
2.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,929 |
$3,215 |
1.0× |
| X-ray head for orthodontia (70350) |
$143.40 |
$239 |
1.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$201 |
$335 |
2.4× |
| X-ray IV pyelogram+drip infusn (74410) |
$475.20 |
$792 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$292.50 |
$487.50 |
3.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$256.80 |
$428 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$256.80 |
$428 |
3.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$201 |
$335 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$241.80 |
$403 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$335.40 |
$559 |
3.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$256.80 |
$428 |
2.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$275.40 |
$459 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$155.40 |
$259 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$292.50 |
$487.50 |
2.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$241.80 |
$403 |
2.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$781.20 |
$1,302 |
1.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$400.80 |
$668 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$177 |
$295 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$210 |
$350 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$267 |
$445 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$241.80 |
$403 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$201 |
$335 |
2.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$201 |
$335 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$275.40 |
$459 |
3.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$202.50 |
$337.50 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$292.50 |
$487.50 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$275.40 |
$459 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$169.80 |
$283 |
2.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$241.80 |
$403 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$201 |
$335 |
2.4× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$56.40 |
$94 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$201 |
$335 |
2.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$256.80 |
$428 |
2.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$235.20 |
$392 |
2.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$241.80 |
$403 |
2.9× |
| Xr arthrogram ankle (73615) |
$326.40 |
$544 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$321 |
$535 |
3.2× |
| Xr chest 4+ views (71048) |
$256.80 |
$428 |
2.5× |
| Xr Cholecystography Oral Contrast (74290) |
$266.40 |
$444 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$169.80 |
$283 |
2.0× |
| Xr internal auditory meati complete (70134) |
$409.80 |
$683 |
0.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$260.40 |
$434 |
2.6× |
| Xr myelogram posterior fossa (70010) |
$734.40 |
$1,224 |
2.2× |
| Xr optic foramina (70190) |
$121.20 |
$202 |
1.4× |
| Xr shoulder 1 view (73020) |
$169.80 |
$283 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$256.80 |
$428 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$168.90 |
$281.50 |
2.0× |
| Xr tmj bilateral (70330) |
$219.60 |
$366 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$184.80 |
$308 |
2.2× |