| Abdomen 2 views (74019) |
$294 |
$294 |
2.8× |
| Ankle 2 views (73600) |
$192.25 |
$192.25 |
2.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$187.69 |
$187.69 |
0.5× |
| Bone age studies (77072) |
$128 |
$128 |
1.2× |
| Bone survey complete (77075) |
$118 |
$118 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$231 |
$231 |
2.6× |
| Chest 1 view (71045) |
$183.18 |
$183.18 |
2.1× |
| Chest 3 views (71047) |
$262 |
$262 |
3.0× |
| Clavicle complete (73000) |
$301 |
$301 |
3.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,005.50 |
$4,005.50 |
11.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,600 |
$3,600 |
15.0× |
| CT abdomen w contrast (74160) |
$1,990.75 |
$1,990.75 |
11.3× |
| CT abdomen w wo contrast (74170) |
$1,482.34 |
$1,482.34 |
8.4× |
| CT abdomen w/o contrast (74150) |
$1,900 |
$1,900 |
18.1× |
| CT angiography upper extremity lt (73206) |
$1,387.65 |
$1,387.65 |
7.9× |
| CT c-spine w/o contrast (72125) |
$3,342.50 |
$3,342.50 |
31.8× |
| CT cervical spine w&w/o contrast (72127) |
$2,537 |
$2,537 |
14.4× |
| CT cervical spine with contrast (72126) |
$2,205 |
$2,205 |
6.3× |
| CT chest w/wo contrast (71270) |
$2,135 |
$2,135 |
12.1× |
| CT chest with contrast (71260) |
$1,379 |
$1,379 |
7.8× |
| CT head/brain with contrast (70460) |
$1,851 |
$1,851 |
10.5× |
| CT head/brain without and with contrast (70470) |
$1,947 |
$1,947 |
11.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$4,102 |
$4,102 |
46.9× |
| CT iac w contrast (70481) |
$1,409 |
$1,409 |
8.0× |
| CT lower ext w/o (73700) |
$1,350 |
$1,350 |
12.9× |
| CT lower extremity w wo contrast (73702) |
$1,515 |
$1,515 |
8.6× |
| CT lower extremity with contrast (73701) |
$1,290 |
$1,290 |
7.3× |
| CT lumbar spine w & w/o contrast (72133) |
$2,037 |
$2,037 |
11.6× |
| CT lumbar spine w/o contrast (72131) |
$1,900 |
$1,900 |
18.1× |
| CT lumbar spine with contrast (72132) |
$1,772 |
$1,772 |
5.1× |
| CT maxillofacial w contrast (70487) |
$1,613.95 |
$1,613.95 |
9.2× |
| CT maxillofacial w/o contrast (70486) |
$1,863 |
$1,863 |
17.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,276.28 |
$1,276.28 |
7.2× |
| CT neck soft tissue w contrast (70491) |
$1,517.51 |
$1,517.51 |
8.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,114.50 |
$1,114.50 |
6.3× |
| CT orbits w/o contrast (70480) |
$2,373.34 |
$2,373.34 |
22.6× |
| CT pelvis w & w/o contrast (72194) |
$1,507 |
$1,507 |
8.6× |
| CT pelvis w/o contrast (72192) |
$2,343 |
$2,343 |
22.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,986.50 |
$1,986.50 |
11.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,779.18 |
$1,779.18 |
16.9× |
| CT thoracic spine w/contrast (72129) |
$1,882 |
$1,882 |
10.7× |
| CT thoracic spine w/o contrast (72128) |
$2,031.50 |
$2,031.50 |
19.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,892 |
$1,892 |
10.7× |
| CT thorax w/o contrast (71250) |
$1,797 |
$1,797 |
17.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,451 |
$1,451 |
8.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,898.50 |
$1,898.50 |
18.1× |
| CT upper extremity with contrast (73201) |
$1,161 |
$1,161 |
3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$100 |
$100 |
0.6× |
| Cta Abdomen (74175) |
$3,600 |
$3,600 |
20.4× |
| CTA abdomen pelvis (74174) |
$2,353 |
$2,353 |
6.7× |
| CTA chest (71275) |
$2,827.65 |
$2,827.65 |
16.0× |
| Cta Head (70496) |
$1,645.35 |
$1,645.35 |
9.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,379.44 |
$1,379.44 |
7.8× |
| Cta Neck (70498) |
$1,291 |
$1,291 |
7.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,048 |
$1,048 |
10.0× |
| Echoencephalography real time imaging (76506) |
$514 |
$514 |
4.9× |
| Esophagus (74220) |
$432.48 |
$432.48 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$597 |
$597 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$187.95 |
$187.95 |
0.8× |
| Foot 2 views (73620) |
$195.50 |
$195.50 |
2.2× |
| Forearm 2 views (73090) |
$260 |
$260 |
3.0× |
| Hand 2 views (73120) |
$155.50 |
$155.50 |
1.5× |
| Hand 3 views (73130) |
$212.94 |
$212.94 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$221 |
$221 |
2.5× |
| Knee 3 views (73562) |
$238.84 |
$238.84 |
2.7× |
| MRA head w/o contrast (70544) |
$2,723 |
$2,723 |
11.4× |
| MRA head with contrast (70545) |
$2,312 |
$2,312 |
6.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,995 |
$1,995 |
5.7× |
| MRA neck w/o contrast (70547) |
$2,659 |
$2,659 |
11.1× |
| MRI abdomen w contrast (74182) |
$2,161 |
$2,161 |
6.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,183 |
$2,183 |
6.2× |
| MRI abdomen w/o contrast (74181) |
$2,852 |
$2,852 |
11.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,438 |
$2,438 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,738.80 |
$1,738.80 |
2.2× |
| MRI c-spine with contrast (72142) |
$2,492 |
$2,492 |
7.1× |
| MRI cervical spine w/o contrast (72141) |
$2,100 |
$2,100 |
8.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,093 |
$2,093 |
6.0× |
| MRI chest w/o contrast (71550) |
$2,772 |
$2,772 |
11.6× |
| MRI chest with contrast (71551) |
$1,950.50 |
$1,950.50 |
2.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,575 |
$1,575 |
4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,787 |
$1,787 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,525 |
$2,525 |
10.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,246 |
$2,246 |
9.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,936.60 |
$1,936.60 |
5.5× |
| MRI orbit/face/neck w/contrast (70542) |
$2,177.18 |
$2,177.18 |
6.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,317 |
$3,317 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$4,362 |
$4,362 |
18.2× |
| MRI scan of arm joint before and after contrast (73223) |
$2,325 |
$2,325 |
6.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,627.50 |
$1,627.50 |
4.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,609.50 |
$2,609.50 |
7.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,287 |
$2,287 |
6.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,520 |
$3,520 |
10.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,232.36 |
$2,232.36 |
6.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,894 |
$3,894 |
11.1× |
| MRI thoracic spine w/o contrast (72146) |
$3,115 |
$3,115 |
13.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,092.25 |
$2,092.25 |
8.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,709 |
$1,709 |
4.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,841.25 |
$2,841.25 |
11.9× |
| Neck soft tissue (70360) |
$213 |
$213 |
2.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$222 |
$222 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$369.30 |
$369.30 |
3.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,782 |
$1,782 |
5.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$202 |
$202 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$155.50 |
$155.50 |
1.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$139.50 |
$139.50 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$207 |
$207 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$220.80 |
$220.80 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$194.50 |
$194.50 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$210.96 |
$210.96 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$262.50 |
$262.50 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$276 |
$276 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$184 |
$184 |
2.1× |
| Radiological examination surgical specimen (76098) |
$236.50 |
$236.50 |
0.4× |
| Ribs bilateral 3 views (71110) |
$149.10 |
$149.10 |
1.4× |
| Scanogram (77073) |
$1,690.50 |
$1,690.50 |
16.1× |
| Scapula complete (73010) |
$255 |
$255 |
2.4× |
| Sella turcica (70240) |
$330 |
$330 |
3.8× |
| Small bowel series (74250) |
$603.75 |
$603.75 |
3.4× |
| Spine thoracic 3 views (72072) |
$157 |
$157 |
1.5× |
| Tmj unilateral (70328) |
$201.75 |
$201.75 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$379.84 |
$379.84 |
3.6× |
| Unlisted Ultrasound Procedure (76999) |
$276.50 |
$276.50 |
3.2× |
| Upper Extremity Infant (73092) |
$90.04 |
$90.04 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$173 |
$173 |
1.0× |
| Us breast unilateral complete (76641) |
$337 |
$337 |
3.2× |
| Us breast unilateral limited (76642) |
$337 |
$337 |
3.9× |
| Us chest (76604) |
$387.56 |
$387.56 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$375.38 |
$375.38 |
3.6× |
| Us infant hips dynamic (76885) |
$327 |
$327 |
3.7× |
| Us kidney transplant (76776) |
$497 |
$497 |
4.7× |
| Us ob transvaginal (76817) |
$414 |
$414 |
3.9× |
| Us pelvic non ob complete (76856) |
$599.02 |
$599.02 |
5.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$427.50 |
$427.50 |
4.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$441 |
$441 |
4.2× |
| Us retroperitoneal complete (76770) |
$420.20 |
$420.20 |
4.0× |
| Us scrotum and contents (76870) |
$210 |
$210 |
2.0× |
| Us soft tissue head/neck (76536) |
$289.50 |
$289.50 |
2.8× |
| Us transrectal (76872) |
$530 |
$530 |
5.0× |
| Wrist 2 views (73100) |
$182 |
$182 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$390 |
$390 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$162 |
$162 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$197.55 |
$197.55 |
2.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$453.50 |
$453.50 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$201 |
$201 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$197 |
$197 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$143.75 |
$143.75 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$220.79 |
$220.79 |
2.5× |
| X-ray eye for foreign body (70030) |
$82 |
$82 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$136.50 |
$136.50 |
1.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$158.25 |
$158.25 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$221.75 |
$221.75 |
2.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$258.50 |
$258.50 |
3.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$488.50 |
$488.50 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$99 |
$99 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$455.27 |
$455.27 |
4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$445.50 |
$445.50 |
5.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$267 |
$267 |
3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$315.88 |
$315.88 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$496 |
$496 |
4.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$258 |
$258 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$661.50 |
$661.50 |
7.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$325.38 |
$325.38 |
3.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$144.50 |
$144.50 |
1.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$264.34 |
$264.34 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$197.75 |
$197.75 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$301 |
$301 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$319 |
$319 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$298 |
$298 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$210 |
$210 |
2.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$276.50 |
$276.50 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$140 |
$140 |
1.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$183 |
$183 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$155 |
$155 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$142.75 |
$142.75 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$308.50 |
$308.50 |
3.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$144 |
$144 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$660 |
$660 |
7.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$390.25 |
$390.25 |
3.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$177 |
$177 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$122.25 |
$122.25 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$203.48 |
$203.48 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$445 |
$445 |
4.2× |
| Xr chest 4+ views (71048) |
$170 |
$170 |
1.6× |
| Xr Cholecystography Oral Contrast (74290) |
$717.50 |
$717.50 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$173.50 |
$173.50 |
2.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$131.78 |
$131.78 |
1.3× |
| Xr shoulder 1 view (73020) |
$271.75 |
$271.75 |
3.1× |
| Xr spine cervical 4 or 5 views (72050) |
$131 |
$131 |
1.2× |
| Xr tibia/fibula 2 views (73590) |
$222.26 |
$222.26 |
2.5× |
| Xr tmj bilateral (70330) |
$328 |
$328 |
3.8× |
| Xray knee 1 or 2 views rt (73560) |
$221.55 |
$221.55 |
2.5× |