| Abdomen 1 View (74018) |
$204.50 |
$409 |
2.6× |
| Abdomen 2 views (74019) |
$223 |
$446 |
2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$727.50 |
$1,455 |
2.0× |
| Angio internal mammary (75756) |
$1,376 |
$2,752 |
0.5× |
| Angio pulmonary bilat (75743) |
$3,576.50 |
$7,153 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$3,243 |
$6,486 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$1,996.50 |
$3,993 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,167.50 |
$6,335 |
1.1× |
| Ankle 2 views (73600) |
$151 |
$302 |
1.9× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$1,826.50 |
$3,653 |
0.4× |
| Artery X-Rays Abdomen (75726) |
$4,844 |
$9,688 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$3,576.50 |
$7,153 |
0.7× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$1,677.50 |
$3,355 |
0.3× |
| Arthrogram ankle (73615) |
$543.50 |
$1,087 |
1.7× |
| Arthrogram hip (73525) |
$510 |
$1,020 |
1.6× |
| Arthrogram Wrist (73115) |
$429 |
$858 |
1.4× |
| Bone age studies (77072) |
$200.50 |
$401 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,245 |
$2,490 |
3.4× |
| Bone Imaging Limited Area (78300) |
$1,068 |
$2,136 |
3.0× |
| Bone Imaging Multiple Areas (78305) |
$1,068 |
$2,136 |
3.0× |
| Bone Imaging Whole Body (78306) |
$1,106.50 |
$2,213 |
3.1× |
| Bone survey infant (77076) |
$185 |
$370 |
2.0× |
| Brain Image W/Flow < 4 Views (78601) |
$618 |
$1,236 |
1.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$743 |
$1,486 |
1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,437 |
$4,874 |
1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,819 |
$3,638 |
5.8× |
| Cat Scan Follow-Up Study (76380) |
$468.50 |
$937 |
5.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$727.50 |
$1,455 |
1.5× |
| Cerebrospinal Fluid Scan (78630) |
$893.50 |
$1,787 |
1.8× |
| Chest 1 view (71045) |
$192 |
$384 |
2.4× |
| Chest 2 views (71046) |
$223.50 |
$447 |
2.8× |
| Chest 3 views (71047) |
$246 |
$492 |
3.1× |
| Chest 4 or more views (71048) |
$255.50 |
$511 |
2.7× |
| Clavicle complete (73000) |
$187.50 |
$375 |
2.4× |
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271)
range across 2 matching MRF lines |
$207.50–$338.50 |
$415–$677 |
varies |
| Contrast Exam Abdominl Aorta (75625) |
$2,276.50 |
$4,553 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$483 |
$966 |
1.5× |
| Contrast X-Ray Of Elbow (73085) |
$654 |
$1,308 |
2.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$576 |
$1,152 |
1.8× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$310.50 |
$621 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,874.50 |
$3,749 |
5.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,594.50 |
$3,189 |
7.4× |
| CT abdomen w contrast (74160) |
$1,488 |
$2,976 |
9.4× |
| CT abdomen w wo contrast (74170) |
$1,594.50 |
$3,189 |
10.0× |
| CT abdomen w/o contrast (74150) |
$1,227.50 |
$2,455 |
13.0× |
| CT Angio Abdomen and Pelvis (74174) |
$1,848.50 |
$3,697 |
5.9× |
| CT Angio Chest (71275) |
$1,669 |
$3,338 |
10.5× |
| CT Angio Head (70496) |
$1,570.50 |
$3,141 |
9.9× |
| CT angio hrt w/3d image (75574) |
$1,044 |
$2,088 |
3.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,143.50 |
$4,287 |
13.5× |
| CT Angio Neck (70498) |
$1,663.50 |
$3,327 |
10.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,499 |
$2,998 |
9.4× |
| CT cervical spine w/ contrast (72126) |
$6,110 |
$12,220 |
19.3× |
| CT cervical spine w/o contrast (72125) |
$1,315 |
$2,630 |
13.9× |
| CT cervical spine w/wo cont (72127) |
$3,126.50 |
$6,253 |
19.7× |
| CT chest w contrast (71260) |
$1,373 |
$2,746 |
8.6× |
| CT chest w/wo contrast (71270) |
$1,544 |
$3,088 |
9.7× |
| CT colonography screening (74263) |
$768 |
$1,536 |
3.6× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$909 |
$1,818 |
5.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$532.50 |
$1,065 |
5.6× |
| CT head/brain with contrast (70460) |
$1,217 |
$2,434 |
7.7× |
| CT head/brain without and with contrast (70470) |
$1,341.50 |
$2,683 |
8.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$437 |
$874 |
1.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$50 |
$100 |
0.6× |
| CT hrt w/3d image congen (75573) |
$1,033.50 |
$2,067 |
3.3× |
| CT iac w contrast (70481) |
$1,162 |
$2,324 |
7.3× |
| CT l-spine w&w/o contrast (72133) |
$2,347 |
$4,694 |
14.8× |
| CT lower ext w/o (73700) |
$1,227.50 |
$2,455 |
13.0× |
| CT lower extremity w/contrast material (73701) |
$2,113 |
$4,226 |
13.3× |
| CT lumbar spine w contrast (72132) |
$5,144.50 |
$10,289 |
16.3× |
| CT lumbar spine w/o contrast (72131) |
$1,495 |
$2,990 |
15.8× |
| CT maxillofacial w contrast (70487) |
$2,186 |
$4,372 |
13.8× |
| CT maxillofacial wo contrast (70486) |
$937 |
$1,874 |
9.9× |
| CT neck tissue combo (70492) |
$2,465.50 |
$4,931 |
15.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,268 |
$2,536 |
8.0× |
| CT orbits w/o contrast (70480) |
$1,133 |
$2,266 |
12.0× |
| CT pelvis w&w/o contrast (72194) |
$1,602 |
$3,204 |
10.1× |
| CT pelvis w/o contrast (72192) |
$1,195.50 |
$2,391 |
12.6× |
| CT scan of leg combo (73702) |
$2,131 |
$4,262 |
13.4× |
| CT scans face/jaw combo (70488) |
$2,351 |
$4,702 |
14.8× |
| CT soft tissue neck w contrast (70491) |
$2,216 |
$4,432 |
14.0× |
| CT soft tissue neck w/o contrast (70490) |
$967.50 |
$1,935 |
10.2× |
| CT thoracic spine w contrast (72129) |
$2,577 |
$5,154 |
16.2× |
| CT thoracic spine w/o contrast (72128) |
$1,313.50 |
$2,627 |
13.9× |
| CT thoracic spine w/wo cont (72130) |
$2,534 |
$5,068 |
16.0× |
| CT thorax w/o contrast (71250) |
$1,284 |
$2,568 |
13.6× |
| CT upper ext wo (73200) |
$1,136 |
$2,272 |
12.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,247.50 |
$4,495 |
14.2× |
| CT upper extremity with contrast (73201) |
$3,427.50 |
$6,855 |
10.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,737 |
$3,474 |
10.9× |
| Cta Abdomen (74175) |
$1,590 |
$3,180 |
10.0× |
| CTA pelvis (72191) |
$1,757.50 |
$3,515 |
11.1× |
| Dilation ureters/urethra rs&i (74485) |
$2,974.50 |
$5,949 |
1.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$322.50 |
$645 |
3.4× |
| Dxa Bone Density Axial (77080) |
$306 |
$612 |
3.2× |
| Dxa bone density study (77085) |
$453 |
$906 |
4.8× |
| Echo exam uterus (76831) |
$395 |
$790 |
1.8× |
| Echo Guide For Artery Repair (76936) |
$344.50 |
$689 |
1.8× |
| Echograp Trans R Pros Study (76873) |
$422 |
$844 |
4.5× |
| Esophagram (74220) |
$300.50 |
$601 |
1.9× |
| Fetal Biophys Profile W/Nst (76818) |
$518 |
$1,036 |
5.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$356 |
$712 |
3.8× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$366 |
$732 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$328 |
$656 |
1.5× |
| Follow-Up Angiography (75898) |
$1,992 |
$3,984 |
0.7× |
| Foot 2 views (73620) |
$129.50 |
$259 |
1.6× |
| Forearm 2 views (73090) |
$154 |
$308 |
2.0× |
| Gastric emptying imaging study (78264) |
$909 |
$1,818 |
2.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$814 |
$1,628 |
2.2× |
| Gastric Mucosa Imaging (78261) |
$347.50 |
$695 |
1.0× |
| Gastroesophageal Reflux Exam (78262) |
$1,000.50 |
$2,001 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,214 |
$2,428 |
3.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$892 |
$1,784 |
1.8× |
| Hand 2 views (73120) |
$129 |
$258 |
1.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,868 |
$7,736 |
1.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,045.50 |
$6,091 |
1.1× |
| Hepatobil Syst Image W/Drug (78227) |
$1,067 |
$2,134 |
2.2× |
| Hepatobiliary System Imaging (78226) |
$892 |
$1,784 |
2.5× |
| Ht Muscle Image Spect Sing (78451) |
$1,655.50 |
$3,311 |
1.4× |
| Hysterosalpingogram (74740) |
$695 |
$1,390 |
3.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$127.50 |
$255 |
1.6× |
| Infusion Ivp (74410) |
$617 |
$1,234 |
3.9× |
| Joint Survey Single View (77077) |
$111.50 |
$223 |
1.2× |
| K Flow/Funct Image Multiple (78709) |
$1,375.50 |
$2,751 |
2.8× |
| K Flow/Funct Image W/Drug (78708) |
$1,302 |
$2,604 |
2.6× |
| K Flow/Funct Image W/O Drug (78707) |
$1,249.50 |
$2,499 |
2.5× |
| Knee 3 Views (73562) |
$168 |
$336 |
2.1× |
| Leveen/Shunt Patency Exam (78291) |
$788.50 |
$1,577 |
2.2× |
| Liver & Spleen Imaging Static Only (78215) |
$640.50 |
$1,281 |
1.8× |
| Liver imaging static only (78201) |
$2,163.50 |
$4,327 |
4.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,238 |
$2,476 |
2.5× |
| Lung perfusion differential (78597) |
$938 |
$1,876 |
2.6× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,241.50 |
$2,483 |
2.5× |
| Lung Ventilation Imaging (78579) |
$771.50 |
$1,543 |
2.1× |
| Lymph System Imaging (78195) |
$727.50 |
$1,455 |
1.5× |
| Magnetic Image Jaw Joint (70336) |
$1,620 |
$3,240 |
7.5× |
| Magnetic Resonance Elastography (76391) |
$284.50 |
$569 |
1.3× |
| Mammary ductogram or galactogram multiple (77054) |
$482 |
$964 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$463.50 |
$927 |
2.1× |
| Meckels Divert Exam (78290) |
$536 |
$1,072 |
1.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$94.50 |
$189 |
0.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,292 |
$2,584 |
4.1× |
| MRA head w/o contrast (70544) |
$1,558 |
$3,116 |
7.2× |
| MRA head with contrast (70545) |
$963 |
$1,926 |
3.0× |
| MRA neck w contrast (70548) |
$1,650.50 |
$3,301 |
5.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,840 |
$3,680 |
5.8× |
| MRA neck w/o contrast (70547) |
$1,798.50 |
$3,597 |
8.3× |
| MRI abdomen w contrast (74182) |
$1,620 |
$3,240 |
5.1× |
| MRI abdomen w/o contrast (74181) |
$1,500 |
$3,000 |
6.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,514.50 |
$3,029 |
2.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,857.50 |
$3,715 |
5.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,306 |
$8,612 |
6.1× |
| MRI bone marrow blood supply (77084) |
$1,636.50 |
$3,273 |
7.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,695 |
$3,390 |
7.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$847.50 |
$1,695 |
3.9× |
| MRI cardiac w/o contrast (75557) |
$1,419.50 |
$2,839 |
6.6× |
| MRI cervical spine w contrast (72142) |
$1,792 |
$3,584 |
5.7× |
MRI cervical spine w/o cont (72141)
range across 2 matching MRF lines |
$273–$1,740 |
$546–$3,480 |
varies |
| MRI chest w/o contrast (71550) |
$1,620 |
$3,240 |
7.5× |
| MRI chest with contrast (71551) |
$2,746.50 |
$5,493 |
3.9× |
| MRI chest wo w contrast (71552) |
$3,397 |
$6,794 |
10.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,792 |
$3,584 |
5.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,168 |
$4,336 |
6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,620 |
$3,240 |
7.5× |
| MRI lumbar spine w contrast (72149) |
$1,792 |
$3,584 |
5.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,372 |
$4,744 |
7.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,620 |
$3,240 |
7.5× |
| MRI orbit face neck w contrast (70542) |
$2,085 |
$4,170 |
6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,839.50 |
$5,679 |
9.0× |
| MRI pelvis w contrast (72196) |
$1,896 |
$3,792 |
6.0× |
| MRI pelvis w/o & w contrast (72197) |
$2,247 |
$4,494 |
7.1× |
| MRI pelvis w/o contrast (72195) |
$1,620 |
$3,240 |
7.5× |
| MRI spectroscopy (76390) |
$689.50 |
$1,379 |
8.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,620 |
$3,240 |
7.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,792 |
$3,584 |
5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,620 |
$3,240 |
7.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,168 |
$4,336 |
6.9× |
| MRI, abdomen, combo (74183) |
$2,168 |
$4,336 |
6.9× |
| MRI, dorsal spine combo (72157) |
$2,168 |
$4,336 |
6.9× |
| MRI, dorsal spine contrast (72147) |
$1,792 |
$3,584 |
5.7× |
| MRI, joint upper extrem (73221) |
$1,548.50 |
$3,097 |
7.2× |
| MRI, joint upper extrem combo (73223) |
$2,617 |
$5,234 |
8.3× |
| MRI, lumbar spine combo (72158) |
$2,330.50 |
$4,661 |
7.4× |
| Myelogram cervical (72240) |
$1,448.50 |
$2,897 |
2.0× |
| Myelogram Lumbar (72265) |
$1,448.50 |
$2,897 |
2.0× |
| Myelography thoracic (72255) |
$1,213.50 |
$2,427 |
1.7× |
| Myelograpy 2/more regions rs&i (72270) |
$1,601.50 |
$3,203 |
2.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,611 |
$11,222 |
4.8× |
| Myocardial Spect Multiple Studies (78452) |
$2,057.50 |
$4,115 |
1.8× |
| Neck soft tissue (70360) |
$167 |
$334 |
2.1× |
| Nm csf leak detection (78650) |
$857.50 |
$1,715 |
0.7× |
| Nm myocard infarct spect (78469) |
$2,046 |
$4,092 |
4.2× |
| Nonvascular Shunt X-Ray (75809) |
$168 |
$336 |
1.8× |
| Nuclear Rx Oral Admin (79005) |
$823.50 |
$1,647 |
3.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$221.50 |
$443 |
2.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$345 |
$690 |
3.6× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$62 |
$124 |
2.4× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$165 |
$330 |
1.7× |
| Optic foramina (70190) |
$87 |
$174 |
1.1× |
| Panoramic X-ray of jaws (70355) |
$158.50 |
$317 |
2.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,260 |
$2,520 |
2.6× |
| Parathyroid Planar Imaging (78070) |
$786.50 |
$1,573 |
2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,066 |
$2,132 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$149.50 |
$299 |
1.6× |
| Pet Image Skull-Thigh (78812) |
$3,984 |
$7,968 |
3.1× |
| Pet Image W/Ct Lmtd (78814) |
$2,456 |
$4,912 |
1.9× |
| PET image w/CT, full body (78816) |
$4,622 |
$9,244 |
3.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,456 |
$4,912 |
1.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,683.50 |
$5,367 |
2.3× |
| PET whole body (78813) |
$3,984 |
$7,968 |
3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$536 |
$1,072 |
1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$314 |
$628 |
3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$709 |
$1,418 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$164.50 |
$329 |
2.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$137 |
$274 |
1.7× |
| Radex elbow complete minimum 3 views (73080) |
$201.50 |
$403 |
2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$209.50 |
$419 |
2.2× |
| Radex fingr minimum 2 views (73140) |
$130.50 |
$261 |
1.7× |
| Radex foot complete minimum 3 views (73630) |
$155 |
$310 |
2.0× |
| Radex Hand Minimum 3 Views (73130) |
$159 |
$318 |
2.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$199 |
$398 |
2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$159 |
$318 |
2.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$178 |
$356 |
2.3× |
| Radex shoulder complete minimum 2 views (73030) |
$223.50 |
$447 |
2.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$186.50 |
$373 |
2.4× |
| Radex Spine 1 View Specify Level (72020) |
$143.50 |
$287 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$171.50 |
$343 |
2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$195 |
$390 |
2.5× |
| Radex Toe Minimum 2 Views (73660) |
$137 |
$274 |
1.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$200.50 |
$401 |
2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$155 |
$310 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$219.50 |
$439 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$314 |
$628 |
3.3× |
| Radiologic exam colon double contrast study (74280) |
$512 |
$1,024 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$494 |
$988 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$299.50 |
$599 |
1.9× |
| Radiologic exam knee complete 4/more views (73564) |
$199.50 |
$399 |
2.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$223 |
$446 |
2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$390 |
$780 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$382 |
$764 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$468 |
$936 |
2.9× |
| Radiologic examination femur 1 view (73551) |
$89 |
$178 |
1.1× |
| Radiologic examination femur minimum 2 views (73552) |
$181.50 |
$363 |
2.3× |
| Radiologic examination knee 1/2 views (73560) |
$149.50 |
$299 |
1.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$367.50 |
$735 |
3.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$159 |
$318 |
2.0× |
| Ribs bilateral 3 views (71110) |
$233.50 |
$467 |
2.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,027 |
$2,054 |
2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,068 |
$2,136 |
3.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,160.50 |
$4,321 |
4.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,593 |
$3,186 |
3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,797 |
$3,594 |
3.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,068 |
$2,136 |
0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,068 |
$2,136 |
0.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,027 |
$2,054 |
0.9× |
| Scapula (73010) |
$168 |
$336 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$39.50 |
$79 |
1.7× |
| Sella turcica (70240) |
$31.50 |
$63 |
0.4× |
| Shoulder 1 view (73020) |
$172.50 |
$345 |
2.2× |
| Shoulder Arthrography (73040) |
$524 |
$1,048 |
1.7× |
| Sialogram (70390) |
$466 |
$932 |
2.2× |
| Skull less than 4 views (70250) |
$159 |
$318 |
1.7× |
| Sternoclavicular joints (71130) |
$87 |
$174 |
1.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$375.50 |
$751 |
2.4× |
| Thoracic spine 2 views (72070) |
$191 |
$382 |
2.0× |
| Thoracic spine 3 views (72072) |
$207.50 |
$415 |
2.2× |
| Thoracolumbar 2 views (72080) |
$242.50 |
$485 |
3.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$483.50 |
$967 |
1.3× |
| Thyroid Met Imaging Body (78018) |
$727.50 |
$1,455 |
1.5× |
| Thyroid Uptake Measurement (78012) |
$483.50 |
$967 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$643.50 |
$1,287 |
1.8× |
| Ultrasound Breast Limited (76642) |
$220 |
$440 |
2.8× |
| Ultrasound elastography first target lesion (76982) |
$143 |
$286 |
1.5× |
| Ultrasound Elastography Parenchyma (76981) |
$148.50 |
$297 |
1.6× |
| Ultrasound Exam Aaa Screen (76706) |
$197.50 |
$395 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$417.50 |
$835 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$273 |
$546 |
2.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$162.50 |
$325 |
2.1× |
| Unlisted magnetic resonance procedure (76498) |
$620 |
$1,240 |
7.9× |
| Upper gi w/o kub (74240) |
$570 |
$1,140 |
3.6× |
| Urethrocystogram voiding (74455) |
$475.50 |
$951 |
2.2× |
| Urethrocystography retrograde (74450) |
$520 |
$1,040 |
2.4× |
| Us breast unilateral complete (76641) |
$220 |
$440 |
2.3× |
| Us chest (76604) |
$437 |
$874 |
4.6× |
| Us complete joint (76881) |
$336 |
$672 |
3.5× |
| Us exam, pelvic, limited (76857) |
$285.50 |
$571 |
3.0× |
| Us head (76506) |
$368 |
$736 |
3.9× |
| Us kidney transplant (76776) |
$462 |
$924 |
4.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$190 |
$380 |
2.0× |
| Us ob detailed single fetus (76811) |
$532 |
$1,064 |
2.5× |
| Us ob limited 1 or more fetuses (76815) |
$209 |
$418 |
2.2× |
| Us ob transvaginal (76817) |
$357 |
$714 |
3.8× |
| Us pelvic non ob complete (76856) |
$488 |
$976 |
5.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$387 |
$774 |
4.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$586.50 |
$1,173 |
6.2× |
| Us retroperitoneal complete (76770) |
$488 |
$976 |
5.2× |
| Us retroperitoneal limited (76775) |
$434 |
$868 |
4.6× |
| Us scrotum and contents (76870) |
$446 |
$892 |
4.7× |
| Us spinal canal and contents (76800) |
$294 |
$588 |
3.1× |
| Us thyroid (76536) |
$439.50 |
$879 |
4.6× |
| Us transrectal (76872) |
$418.50 |
$837 |
4.4× |
| Vascular Flow Imaging (78445) |
$505.50 |
$1,011 |
1.4× |
| Vein X-Ray Chest (75827) |
$1,240 |
$2,480 |
0.9× |
| Venogram Sinus/Jugular (75860) |
$1,240 |
$2,480 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$3,576.50 |
$7,153 |
1.3× |
| Venography extremity bilateral rs&i (75822) |
$1,268 |
$2,536 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$960.50 |
$1,921 |
0.7× |
| Venography Renal Bilateral (75833) |
$1,989.50 |
$3,979 |
0.7× |
| Venography Renal Unilateral (75831) |
$1,567.50 |
$3,135 |
0.5× |
| Venous sampling by catheter (75893) |
$3,576.50 |
$7,153 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$109 |
$218 |
1.4× |
| Wrist 2 views (73100) |
$146.50 |
$293 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$119.50 |
$239 |
1.5× |
| X-ray antegrade pyelogram tube (74425) |
$475.50 |
$951 |
1.5× |
| X-Ray Aorta Leg Arteries (75630) |
$3,576.50 |
$7,153 |
1.3× |
| X-Ray Bend Only L-S Spine (72120) |
$289.50 |
$579 |
3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$161.50 |
$323 |
2.0× |
| X-Ray Exam Breast Specimen (76098) |
$640 |
$1,280 |
1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$89 |
$178 |
1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$151 |
$302 |
1.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$271 |
$542 |
2.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$115.50 |
$231 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$149 |
$298 |
1.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$149 |
$298 |
1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$147 |
$294 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$243 |
$486 |
2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$282 |
$564 |
3.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$334.50 |
$669 |
3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$200.50 |
$401 |
2.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$365 |
$730 |
3.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$286.50 |
$573 |
3.0× |
| X-ray eye for foreign body (70030) |
$176.50 |
$353 |
2.2× |
| X-ray head for orthodontia (70350) |
$131 |
$262 |
1.7× |
| X-ray humerus (73060) |
$159 |
$318 |
2.0× |
| X-ray IV pyelogram (ivp) (74400) |
$502.50 |
$1,005 |
3.2× |
| X-ray IV pyelogram+tomography (74415) |
$724.50 |
$1,449 |
4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$143.50 |
$287 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$141.50 |
$283 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$229 |
$458 |
2.4× |
| X-ray nose-rectum child f.b. (76010) |
$233.50 |
$467 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$358 |
$716 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$195 |
$390 |
2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$107 |
$214 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$159 |
$318 |
2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$219.50 |
$439 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$262.50 |
$525 |
2.8× |
| X-ray thoracic spine 4 vw (72074) |
$261 |
$522 |
2.8× |
| X-Ray Tmj Unilat (70328) |
$72.50 |
$145 |
0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$475.50 |
$951 |
1.5× |
| X-Rays Bone Length Studies (77073) |
$146 |
$292 |
1.5× |
| X-Rays Bone Survey Complete (77075) |
$441.50 |
$883 |
4.7× |
| Xr c-spine 4 or 5 views (72050) |
$280 |
$560 |
3.0× |
| Xr facial bones less than 3 views (70140) |
$150.50 |
$301 |
1.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$120.50 |
$241 |
1.3× |
| Xr orbits complete 4 views (70200) |
$205.50 |
$411 |
2.2× |
| Xr Tomogram Single Plane (76100) |
$436.50 |
$873 |
4.6× |