| Abdomen 2 views (74019) |
$130 |
$153 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,369 |
$1,611 |
3.3× |
| Ankle 2 views (73600) |
$122 |
$143 |
1.4× |
| Arthrogram elbow (73085) |
$272 |
$320 |
0.8× |
| Arthrogram hip (73525) |
$617 |
$726 |
1.7× |
| Arthrogram shoulder (73040) |
$587 |
$691 |
1.6× |
| Arthrogram wrist (73115) |
$349 |
$410 |
1.0× |
| Arthrography knee lt (73580) |
$307 |
$361 |
0.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$870 |
$1,023 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,235 |
$1,453 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,719 |
$2,022 |
4.1× |
| Bone age studies (77072) |
$86 |
$101 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$1,956 |
$2,301 |
4.7× |
| Bone survey complete (77075) |
$815 |
$959 |
7.5× |
| Cervical spine 2 or 3 views (72040) |
$245.50 |
$289 |
2.7× |
| Chest 1 view (71045) |
$110 |
$129 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$499 |
$587 |
2.7× |
| Clavicle complete (73000) |
$121 |
$142 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,035 |
$1,218 |
9.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,185 |
$4,924 |
11.6× |
| CT abdomen and pelvis without contrast (74176) |
$3,754 |
$4,416 |
15.2× |
| CT abdomen w contrast (74160) |
$2,434 |
$2,863 |
13.4× |
| CT abdomen w wo contrast (74170) |
$2,905 |
$3,418 |
15.9× |
| CT abdomen w/o contrast (74150) |
$2,149 |
$2,528 |
19.8× |
| CT c-spine w/o contrast (72125) |
$2,335 |
$2,747 |
21.5× |
| CT cervical spine w&w/o contrast (72127) |
$1,709 |
$2,011 |
9.4× |
| CT cervical spine with contrast (72126) |
$1,846 |
$2,172 |
5.1× |
| CT chest w/wo contrast (71270) |
$2,661 |
$3,131 |
14.6× |
| CT chest with contrast (71260) |
$2,191 |
$2,578 |
12.0× |
| CT head/brain with contrast (70460) |
$2,051 |
$2,413 |
11.3× |
| CT head/brain without and with contrast (70470) |
$2,349 |
$2,763 |
12.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$134 |
$158 |
1.5× |
| CT iac w contrast (70481) |
$2,230 |
$2,623 |
12.2× |
| CT lower ext w/o (73700) |
$1,956 |
$2,301 |
18.0× |
| CT lower extremity w wo contrast (73702) |
$2,474 |
$2,911 |
13.6× |
| CT lower extremity with contrast (73701) |
$2,134 |
$2,510 |
11.7× |
| CT lumbar spine w & w/o contrast (72133) |
$2,488 |
$2,927 |
13.7× |
| CT lumbar spine w/o contrast (72131) |
$2,190 |
$2,576 |
20.2× |
| CT lumbar spine with contrast (72132) |
$2,700 |
$3,177 |
7.5× |
| CT maxillofacial w contrast (70487) |
$1,977 |
$2,326 |
10.9× |
| CT maxillofacial w/o contrast (70486) |
$1,705 |
$2,006 |
15.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,257 |
$2,655 |
12.4× |
| CT neck soft tissue w contrast (70491) |
$2,274 |
$2,675 |
12.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,290 |
$2,694 |
12.6× |
| CT orbits w/o contrast (70480) |
$2,033 |
$2,392 |
18.7× |
| CT pelvis w & w/o contrast (72194) |
$2,632 |
$3,097 |
14.5× |
| CT pelvis w/o contrast (72192) |
$2,112 |
$2,485 |
19.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,455 |
$2,888 |
13.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,933 |
$2,274 |
17.8× |
| CT thoracic spine w/contrast (72129) |
$2,213 |
$2,603 |
12.1× |
| CT thoracic spine w/o contrast (72128) |
$2,193 |
$2,580 |
20.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,010 |
$1,188 |
5.5× |
| CT thorax w/o contrast (71250) |
$2,270 |
$2,671 |
20.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,049 |
$2,410 |
11.2× |
| CT upper extremity w/o contrast rt (73200) |
$2,075 |
$2,441 |
19.1× |
| CT upper extremity with contrast (73201) |
$2,083 |
$2,451 |
5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,325 |
$2,735 |
12.8× |
| Cta Abdomen (74175) |
$2,850 |
$3,353 |
15.6× |
| CTA abdomen pelvis (74174) |
$4,216 |
$4,960 |
11.6× |
| CTA chest (71275) |
$2,778 |
$3,268 |
15.3× |
| Cta Head (70496) |
$2,220 |
$2,612 |
12.2× |
| Cta Neck (70498) |
$2,197 |
$2,585 |
12.1× |
| Cta Pelvis (72191) |
$1,204 |
$1,416 |
6.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$470 |
$553 |
4.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$258 |
$304 |
2.9× |
| Dxa bone density study axial skeleton (77085) |
$269 |
$317 |
2.5× |
| Esophagus (74220) |
$650 |
$765 |
3.6× |
| Fetal biophysical profile non-stress testing (76818) |
$277 |
$326 |
2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$450 |
$529 |
4.1× |
| Fluoroscopy up to 1 hr (76000) |
$650 |
$765 |
2.6× |
| Foot 2 views (73620) |
$122 |
$144 |
1.4× |
| Forearm 2 views (73090) |
$122 |
$144 |
1.4× |
| Gated Heart Planar Single (78472) |
$1,487 |
$1,749 |
3.6× |
| Hand 2 views (73120) |
$119 |
$140 |
1.1× |
| Hand 3 views (73130) |
$128 |
$150 |
1.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,712 |
$2,014 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,333 |
$1,568 |
3.2× |
| Ht muscle image spect sing (78451) |
$3,152 |
$3,708 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$174 |
$205 |
1.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,437 |
$1,691 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,633 |
$1,921 |
2.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,473 |
$1,733 |
2.6× |
| Knee 3 views (73562) |
$149 |
$175 |
1.6× |
| Liver & spleen imaging static only (78215) |
$1,504 |
$1,769 |
3.6× |
| Liver imaging w/vascular flow (78202) |
$1,504 |
$1,769 |
2.7× |
| Lung Ventilation Imaging (78579) |
$524 |
$616 |
1.3× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$2 |
$2 |
0.0× |
| Lymphoscintigraphy (78195) |
$1,944 |
$2,287 |
3.4× |
| Meckels Diverticulum (78290) |
$1,153 |
$1,357 |
2.8× |
| MRA head w & w/o contrast (70546) |
$3,159.50 |
$3,717 |
8.7× |
| MRA head w/o contrast (70544) |
$2,348 |
$2,762 |
9.5× |
| MRA head with contrast (70545) |
$2,396.50 |
$2,819.50 |
6.6× |
| MRA neck w contrast (70548) |
$3,103 |
$3,651 |
8.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,634 |
$4,275 |
10.0× |
| MRA neck w/o contrast (70547) |
$3,003 |
$3,533 |
12.1× |
| MRI abdomen w contrast (74182) |
$2,709 |
$3,187 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,830 |
$4,506 |
10.6× |
| MRI abdomen w/o contrast (74181) |
$3,296 |
$3,878 |
13.3× |
| MRI any jnt lwr ext with con lt (73722) |
$2,739 |
$3,222 |
3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,955 |
$3,476 |
3.6× |
| MRI c-spine with contrast (72142) |
$3,119 |
$3,669 |
8.6× |
| MRI cervical spine w/o contrast (72141) |
$3,154 |
$3,710 |
12.7× |
| MRI chest w/o & w/contrast material (71552) |
$2,917 |
$3,432 |
8.1× |
| MRI chest w/o contrast (71550) |
$2,904 |
$3,416 |
11.7× |
| MRI chest with contrast (71551) |
$1,234 |
$1,452 |
1.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,494 |
$1,758 |
4.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,380 |
$1,624 |
3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,733 |
$3,215 |
11.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,940 |
$3,459 |
11.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,257 |
$3,832 |
9.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,044 |
$2,405 |
5.6× |
| MRI pelvis w contrast (72196) |
$3,103 |
$3,651 |
8.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,681 |
$4,330 |
10.2× |
| MRI pelvis w/o contrast (72195) |
$2,941 |
$3,460 |
11.9× |
| MRI scan of arm joint before and after contrast (73223) |
$3,784 |
$4,452 |
10.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,080 |
$3,623.50 |
8.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,802 |
$4,473 |
10.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,097 |
$3,644 |
8.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,669 |
$4,317 |
10.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,294 |
$3,875 |
9.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,795 |
$4,465 |
10.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,159 |
$3,716 |
12.8× |
| MRI tmj (70336) |
$2,312 |
$2,720 |
9.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,412 |
$2,838 |
9.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,153 |
$3,709 |
8.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,541 |
$2,989 |
10.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,712 |
$4,367 |
2.8× |
| Neck soft tissue (70360) |
$94 |
$110 |
1.0× |
| Nm gastric emptying study (78264) |
$1,708 |
$2,009 |
4.1× |
| Nuclear medicine study of kidney and blood flow (78701) |
$467 |
$549 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$950 |
$1,118 |
2.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$333 |
$392 |
3.1× |
| Osseous survey infant (77076) |
$598 |
$703 |
5.5× |
| Parathyrd planar w/spect&CT (78072) |
$1,841 |
$2,166 |
3.3× |
| Parathyrd planar w/wo subtrj (78071) |
$949 |
$1,117 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$164 |
$193 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,027.50 |
$3,561.50 |
8.4× |
| Pr red cell survival study (78130) |
$3 |
$3 |
0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,092 |
$1,285 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,203 |
$2,592 |
3.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$421 |
$495 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$243 |
$286 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$356 |
$419 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$147 |
$173 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$502 |
$590 |
4.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$128 |
$151 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$637 |
$749 |
3.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$737 |
$867 |
4.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$629 |
$740 |
3.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$139 |
$163 |
1.5× |
| Radiological examination surgical specimen (76098) |
$184 |
$217 |
0.3× |
| Ribs bilateral 3 views (71110) |
$116 |
$137 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$349 |
$410 |
3.2× |
| Scapula complete (73010) |
$146 |
$172 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$77 |
$91 |
3.3× |
| Small bowel series (74250) |
$712 |
$838 |
3.9× |
| Spine thoracic 3 views (72072) |
$120 |
$141 |
1.1× |
| Therapeutic Enema (74283) |
$1,051 |
$1,236 |
5.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$541 |
$637 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$649 |
$764 |
1.6× |
| Tmj unilateral (70328) |
$276 |
$325 |
3.1× |
| Ultrasound, abdomen limited (76705) |
$643 |
$756 |
5.9× |
| Upper Extremity Infant (73092) |
$128 |
$151 |
1.2× |
| Urethrocystography voiding (74455) |
$434 |
$511 |
1.8× |
| Us abdl aorta screen aaa (76706) |
$458 |
$539 |
4.2× |
| Us breast unilateral complete (76641) |
$484 |
$569 |
4.5× |
| Us breast unilateral limited (76642) |
$318 |
$374 |
3.5× |
| Us chest (76604) |
$480 |
$564.50 |
4.4× |
| Us compl joint r-t w/image documentation (76881) |
$486 |
$572 |
4.5× |
| Us guided compression repair (76936) |
$885 |
$1,041 |
3.9× |
| Us kidney transplant (76776) |
$580 |
$682 |
5.3× |
| Us ob transvaginal (76817) |
$525 |
$618 |
4.8× |
| Us pelvic non ob complete (76856) |
$731 |
$860 |
6.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$368 |
$433 |
3.4× |
| Us pregnancy ltd (76815) |
$406 |
$478 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$648 |
$762 |
6.0× |
| Us retroperitoneal complete (76770) |
$726 |
$854 |
6.7× |
| Us retroperitoneal limited (76775) |
$583 |
$686 |
5.4× |
| Us scrotum and contents (76870) |
$630 |
$741 |
5.8× |
| Us soft tissue head/neck (76536) |
$559 |
$658 |
5.1× |
| Us transrectal (76872) |
$636 |
$748 |
5.9× |
| Us transrectal prostate volume (76873) |
$432 |
$508 |
4.0× |
| Us xtr non-vasc lmtd (76882) |
$550.50 |
$647.50 |
5.1× |
| Wrist 2 views (73100) |
$110 |
$129 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$111 |
$130 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$138 |
$162 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$130 |
$153 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$842 |
$990 |
4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$124 |
$146 |
1.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$124 |
$146 |
1.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$186 |
$219 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$173 |
$203.50 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$284 |
$334 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$578 |
$680 |
5.3× |
| X-ray eye for foreign body (70030) |
$242 |
$285 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$173 |
$204 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$154 |
$181 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$130 |
$153 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$119 |
$140 |
1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$121 |
$142 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$135.50 |
$159.50 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$94 |
$110 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$150 |
$176 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$185 |
$218 |
1.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$313 |
$368 |
2.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$124 |
$146 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$249 |
$293 |
2.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$289 |
$340 |
2.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$395 |
$465 |
3.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$140.50 |
$165.50 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$187 |
$220 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$513 |
$603 |
4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$349 |
$410 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$160 |
$188 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$155 |
$182 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$160 |
$188 |
1.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$115 |
$135 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$224 |
$263 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$159 |
$187 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$119 |
$140 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$270 |
$318 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$160 |
$188 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$155 |
$182 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$436 |
$513 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$118 |
$139 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$128 |
$150 |
1.4× |
| Xr arthrogram ankle (73615) |
$196 |
$230 |
0.5× |
| Xr c-spine 6 or more views (72052) |
$166 |
$195 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$99 |
$116 |
1.1× |
| Xr shoulder 1 view (73020) |
$130 |
$153 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$174 |
$205 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$133 |
$157 |
1.5× |
| Xr tmj bilateral (70330) |
$393 |
$462 |
4.3× |
| Xray knee 1 or 2 views rt (73560) |
$122 |
$144 |
1.4× |