| Abdomen 1 View (74018) |
$62.80 |
$314 |
0.7× |
| Abdomen 2 views (74019) |
$83.40 |
$417 |
0.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$470 |
$2,474 |
1.2× |
| Angio pulmonary bilat (75743) |
$1,121.40 |
$5,607 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,107.60 |
$5,538 |
0.3× |
| Ankle 2 views (73600) |
$67 |
$335 |
0.8× |
Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,303 |
$6,515 |
0.2× |
| Bone age studies (77072) |
$39 |
$195 |
0.4× |
| Bone Imaging Whole Body (78306) |
$470 |
$1,894 |
1.2× |
| Cat Scan Follow-Up Study (76380) |
$450 |
$828 |
5.1× |
| Chest 1 view (71045) |
$51.40 |
$257 |
0.6× |
| Chest 2 views (71046) |
$74.80 |
$374 |
0.9× |
| Clavicle complete (73000) |
$72 |
$360 |
0.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$194.80 |
$974 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,063.80 |
$5,319 |
3.0× |
| CT abdomen and pelvis without contrast (74176) |
$668.80 |
$3,344 |
2.8× |
| CT abdomen w contrast (74160) |
$450 |
$2,410 |
2.6× |
| CT abdomen w wo contrast (74170) |
$550 |
$2,614 |
3.1× |
| CT abdomen w/o contrast (74150) |
$450 |
$1,671 |
4.3× |
| CT Angio Abdomen and Pelvis (74174) |
$608.20 |
$3,041 |
1.7× |
| CT Angio Chest (71275) |
$450 |
$2,195 |
2.6× |
| CT Angio Head (70496) |
$210 |
$1,940 |
1.2× |
| CT angio hrt w/3d image (75574) |
$421.60 |
$2,108 |
1.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$210 |
$3,249 |
1.2× |
| CT Angio Neck (70498) |
$450 |
$1,919 |
2.6× |
| CT cervical spine w/o contrast (72125) |
$450 |
$1,638 |
4.3× |
| CT chest w contrast (71260) |
$450 |
$2,340 |
2.6× |
| CT chest w/wo contrast (71270) |
$450 |
$2,543 |
2.6× |
| CT head/brain with contrast (70460) |
$468 |
$2,340 |
2.7× |
| CT head/brain without and with contrast (70470) |
$450 |
$2,543 |
2.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$143.80 |
$719 |
1.6× |
| CT lower ext w/o (73700) |
$450 |
$1,530 |
4.3× |
| CT lower extremity w/contrast material (73701) |
$210 |
$2,377 |
1.2× |
| CT lumbar spine w/o contrast (72131) |
$450 |
$1,638 |
4.3× |
| CT maxillofacial w contrast (70487) |
$450 |
$2,377 |
2.6× |
| CT maxillofacial wo contrast (70486) |
$450 |
$1,638 |
4.3× |
| CT orbits w/o contrast (70480) |
$450 |
$1,530 |
4.3× |
| CT pelvis w&w/o contrast (72194) |
$550 |
$2,704 |
3.1× |
| CT pelvis w/o contrast (72192) |
$450 |
$1,671 |
4.3× |
| CT soft tissue neck w contrast (70491) |
$450 |
$2,591 |
2.6× |
| CT soft tissue neck w/o contrast (70490) |
$450 |
$1,754 |
4.3× |
| CT thoracic spine w contrast (72129) |
$450 |
$2,377 |
2.6× |
| CT thoracic spine w/o contrast (72128) |
$450 |
$1,530 |
4.3× |
| CT thorax w/o contrast (71250) |
$450 |
$1,524 |
4.3× |
| CT upper ext wo (73200) |
$130 |
$1,530 |
1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$450 |
$2,178 |
2.6× |
| Cta Abdomen (74175) |
$450 |
$2,215 |
2.6× |
| Dxa Bone Density Axial (77080) |
$130 |
$549 |
1.2× |
| Esophagram (74220) |
$210 |
$695 |
1.2× |
| Foot 2 views (73620) |
$67 |
$335 |
0.8× |
| Forearm 2 views (73090) |
$70 |
$350 |
0.8× |
| Gastric emptying imaging study (78264) |
$470 |
$1,962 |
1.2× |
| Hand 2 views (73120) |
$62.80 |
$314 |
0.6× |
| Hepatobil Syst Image W/Drug (78227) |
$497.80 |
$2,489 |
0.9× |
| Hysterosalpingogram (74740) |
$280 |
$2,053 |
1.2× |
Knee 3 Views (73562) range across 3 matching MRF lines |
$77–$78.86 |
$385–$394.28 |
varies |
| Lung Ventilat&Perfus Imaging (78582) |
$712.80 |
$3,564 |
1.3× |
| MRA head w/o contrast (70544) |
$600 |
$1,603 |
2.5× |
| MRA head with contrast (70545) |
$600 |
$2,310 |
1.7× |
| MRA neck w/o contrast (70547) |
$600 |
$1,603 |
2.5× |
| MRI abdomen w/o contrast (74181) |
$600 |
$2,189 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$700 |
$3,112 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$920 |
$2,858 |
1.2× |
| MRI cervical spine w/o cont (72141) |
$500 |
$2,021 |
2.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$700 |
$3,112 |
2.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$500 |
$2,155 |
2.1× |
| MRI lumbar spine w contrast (72149) |
$600 |
$2,858 |
1.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$700 |
$3,112 |
2.0× |
| MRI pelvis w/o & w contrast (72197) |
$700 |
$3,239 |
2.0× |
| MRI pelvis w/o contrast (72195) |
$500 |
$2,323 |
2.1× |
| MRI thoracic spine w/o contrast (72146) |
$500 |
$2,021 |
2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$500 |
$2,155 |
2.1× |
| MRI, abdomen, combo (74183) |
$700 |
$3,239 |
2.0× |
| MRI, joint upper extrem (73221) |
$500 |
$2,155 |
2.1× |
| MRI, lumbar spine combo (72158) |
$700 |
$3,112 |
2.0× |
| Neck soft tissue (70360) |
$67 |
$335 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$62.80 |
$314 |
0.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$74.80 |
$374 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$630 |
$941 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$74.80 |
$374 |
0.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$57.40 |
$287 |
0.7× |
| Radex elbow complete minimum 3 views (73080) |
$74.80 |
$374 |
0.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$109.60 |
$548 |
1.0× |
| Radex fingr minimum 2 views (73140) |
$62.80 |
$314 |
0.7× |
| Radex foot complete minimum 3 views (73630) |
$74.80 |
$374 |
0.9× |
| Radex Hand Minimum 3 Views (73130) |
$72 |
$360 |
0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$72.40 |
$362 |
0.8× |
Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$87.60–$88.66 |
$438–$443.28 |
varies |
| Radex Spine 1 View Specify Level (72020) |
$67 |
$335 |
0.8× |
| Radex Toe Minimum 2 Views (73660) |
$70 |
$350 |
0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$74.80 |
$374 |
0.9× |
| Radiologic exam knee complete 4/more views (73564) |
$94.80 |
$474 |
0.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$210 |
$941 |
1.2× |
| Radiologic exam swallow function contrast study (74230) |
$210 |
$1,371 |
1.2× |
| Radiologic examination femur minimum 2 views (73552) |
$74.80 |
$374 |
0.9× |
Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$70–$75.75 |
$350–$378.77 |
varies |
Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$70–$98 |
$350–$490 |
varies |
| Scapula (73010) |
$70 |
$350 |
0.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$29.80 |
$149 |
1.3× |
| Shoulder 1 view (73020) |
$64.20 |
$321 |
0.7× |
| Shoulder Arthrography (73040) |
$440 |
$1,365 |
1.3× |
| Thoracic spine 2 views (72070) |
$83.80 |
$419 |
0.8× |
| Thoracic spine 3 views (72072) |
$139 |
$695 |
1.3× |
| Ultrasound Breast Limited (76642) |
$58.60 |
$293 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$150 |
$850 |
1.4× |
| Us breast unilateral complete (76641) |
$102 |
$510 |
1.0× |
| Us chest (76604) |
$130 |
$521 |
1.2× |
| Us complete joint (76881) |
$168.60 |
$843 |
1.6× |
| Us ob limited 1 or more fetuses (76815) |
$129.60 |
$648 |
1.2× |
| Us ob transvaginal (76817) |
$170 |
$850 |
1.6× |
| Us pelvic non ob complete (76856) |
$150 |
$908 |
1.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$150 |
$850 |
1.4× |
| Us retroperitoneal complete (76770) |
$150 |
$918 |
1.4× |
| Us scrotum and contents (76870) |
$150 |
$1,056 |
1.4× |
| Us thyroid (76536) |
$150 |
$1,010 |
1.4× |
| Wrist 2 views (73100) |
$67 |
$335 |
0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$72 |
$360 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$62.80 |
$314 |
0.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$105.40 |
$527 |
1.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$59.60 |
$298 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$74.80 |
$374 |
0.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$117.40 |
$587 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$87.60 |
$438 |
0.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$80.20 |
$401 |
0.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$90.20 |
$451 |
0.9× |
| X-ray humerus (73060) |
$70 |
$350 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$62.80 |
$314 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$105.40 |
$527 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$122.80 |
$614 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$72.40 |
$362 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$72 |
$360 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$109.60 |
$548 |
1.0× |
| Xr c-spine 4 or 5 views (72050) |
$139 |
$695 |
1.3× |