| Bone &/joint imaging whole body (78306) |
$578.39 |
$1,652.55 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$578.39 |
$1,652.55 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$105.72 |
$302.06 |
1.2× |
| Chest 1 view (71045) |
$105.72 |
$302.06 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$210.43 |
$601.24 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,217.02 |
$3,477.20 |
3.5× |
| CT abdomen and pelvis without contrast (74176) |
$813.48 |
$2,324.22 |
3.4× |
| CT abdomen w contrast (74160) |
$591.65 |
$1,690.42 |
3.4× |
| CT abdomen w wo contrast (74170) |
$777.80 |
$2,222.29 |
4.4× |
| CT abdomen w/o contrast (74150) |
$457.74 |
$1,307.84 |
4.4× |
| CT angio hrt w/3d image (75574) |
$732.94 |
$2,094.10 |
2.1× |
| CT chest w/wo contrast (71270) |
$777.80 |
$2,222.29 |
4.4× |
| CT chest with contrast (71260) |
$662.64 |
$1,893.27 |
3.8× |
| CT lower ext w/o (73700) |
$457.74 |
$1,307.84 |
4.4× |
| CT thorax w/o contrast (71250) |
$457.74 |
$1,307.84 |
4.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$694.47 |
$1,984.19 |
3.9× |
| CT upper extremity w/o contrast rt (73200) |
$457.74 |
$1,307.84 |
4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$701.13 |
$2,003.23 |
4.0× |
| CTA abdomen pelvis (74174) |
$954.25 |
$2,726.44 |
2.7× |
| Cta Head (70496) |
$785.27 |
$2,243.62 |
4.5× |
| Cta Neck (70498) |
$785.27 |
$2,243.62 |
4.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$183.39 |
$523.96 |
1.7× |
| Esophagus (74220) |
$187.89 |
$536.82 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$240.86 |
$688.16 |
2.3× |
| Fluoroscopy up to 1 hr (76000) |
$180.20 |
$514.86 |
0.8× |
| Hand 3 views (73130) |
$105.72 |
$302.06 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$692.80 |
$1,979.44 |
1.3× |
| Knee 3 views (73562) |
$105.72 |
$302.06 |
1.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,253.90 |
$3,582.57 |
3.6× |
| MRI abdomen w/o contrast (74181) |
$732.29 |
$2,092.27 |
3.1× |
| MRI cervical spine w/o contrast (72141) |
$820.17 |
$2,343.34 |
3.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$820.17 |
$2,343.34 |
3.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,119.55 |
$3,198.72 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,119.55 |
$3,198.72 |
3.2× |
| MRI pelvis w/o contrast (72195) |
$732.29 |
$2,092.27 |
3.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$559.78 |
$1,599.36 |
1.6× |
| MRI thoracic spine w/o contrast (72146) |
$820.17 |
$2,343.34 |
3.4× |
| MRI upper ext joint w/o contrast (73221) |
$820.17 |
$2,343.34 |
3.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,313.26 |
$3,752.16 |
3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$732.29 |
$2,092.27 |
3.1× |
| Myocardial Spect Multiple Studies (78452) |
$1,609.24 |
$4,597.82 |
1.2× |
| Nm gastric emptying study (78264) |
$576.42 |
$1,646.90 |
1.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$153.14 |
$437.54 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$94.40 |
$269.70 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,119.55 |
$3,198.72 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$176.01 |
$502.89 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$105.72 |
$302.06 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$105.72 |
$302.06 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$94.40 |
$269.70 |
1.1× |
| Screening digital breast tomosynthesis (77063) |
$64.80 |
$185.15 |
2.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$986.70 |
$2,819.14 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$275.24 |
$786.39 |
2.6× |
| Us breast unilateral complete (76641) |
$174.56 |
$498.75 |
1.7× |
| Us ob transvaginal (76817) |
$153.14 |
$437.54 |
1.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$151.39 |
$432.54 |
1.4× |
| Us retroperitoneal complete (76770) |
$245.75 |
$702.13 |
2.3× |
| Us soft tissue head/neck (76536) |
$275.24 |
$786.39 |
2.6× |
| Us xtr non-vasc lmtd (76882) |
$147.48 |
$421.36 |
1.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$94.40 |
$269.70 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$94.40 |
$269.70 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$105.72 |
$302.06 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$94.40 |
$269.70 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$105.72 |
$302.06 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$105.72 |
$302.06 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$94.40 |
$269.70 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$105.72 |
$302.06 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$94.40 |
$269.70 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$105.77 |
$302.19 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$94.40 |
$269.70 |
1.1× |
| Xray knee 1 or 2 views rt (73560) |
$94.40 |
$269.70 |
1.1× |