| Abdomen 2 views (74019) |
$74 |
$74 |
0.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$3,250 |
$3,250 |
7.8× |
| Ankle 2 views (73600) |
$72 |
$72 |
0.8× |
| Arthrogram hip (73525) |
$956 |
$956 |
2.6× |
| Arthrogram shoulder (73040) |
$1,048 |
$1,048 |
2.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,479 |
$1,479 |
3.6× |
| Bone &/joint imaging whole body (78306) |
$2,224 |
$2,224 |
5.4× |
| Bone age studies (77072) |
$66 |
$66 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$2,690 |
$2,690 |
6.5× |
| Bone survey complete (77075) |
$1,151 |
$1,151 |
10.6× |
| Cervical spine 2 or 3 views (72040) |
$56 |
$56 |
0.6× |
| Chest 1 view (71045) |
$60 |
$60 |
0.7× |
| Chest 3 views (71047) |
$426 |
$426 |
4.7× |
| Clavicle complete (73000) |
$82 |
$82 |
0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,573 |
$1,573 |
14.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,506 |
$6,506 |
18.0× |
| CT abdomen and pelvis without contrast (74176) |
$4,127 |
$4,127 |
16.7× |
| CT abdomen w contrast (74160) |
$3,409 |
$3,409 |
18.7× |
| CT abdomen w wo contrast (74170) |
$3,968 |
$3,968 |
21.8× |
| CT abdomen w/o contrast (74150) |
$2,558 |
$2,558 |
23.6× |
| CT angiography upper extremity lt (73206) |
$2,979 |
$2,979 |
16.4× |
| CT c-spine w/o contrast (72125) |
$2,663 |
$2,663 |
24.5× |
| CT cervical spine with contrast (72126) |
$3,469 |
$3,469 |
9.6× |
| CT chest w/wo contrast (71270) |
$3,673 |
$3,673 |
20.2× |
| CT chest with contrast (71260) |
$3,300 |
$3,300 |
18.1× |
| CT head/brain with contrast (70460) |
$2,789 |
$2,789 |
15.3× |
| CT head/brain without and with contrast (70470) |
$3,161 |
$3,161 |
17.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$178 |
$178 |
2.0× |
| CT iac w contrast (70481) |
$3,120.50 |
$3,120.50 |
17.1× |
| CT lower ext w/o (73700) |
$2,286 |
$2,286 |
21.1× |
| CT lower extremity w wo contrast (73702) |
$3,464 |
$3,464 |
19.0× |
| CT lower extremity with contrast (73701) |
$3,123 |
$3,123 |
17.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,504 |
$3,504 |
19.2× |
| CT lumbar spine w/o contrast (72131) |
$2,609 |
$2,609 |
24.0× |
| CT lumbar spine with contrast (72132) |
$3,483 |
$3,483 |
9.6× |
| CT maxillofacial w contrast (70487) |
$2,830 |
$2,830 |
15.5× |
| CT maxillofacial w/o contrast (70486) |
$2,085 |
$2,085 |
19.2× |
| CT maxillofacial w/wo contrast (70488) |
$3,121 |
$3,121 |
17.1× |
| CT neck soft tissue w contrast (70491) |
$3,198 |
$3,198 |
17.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,216.50 |
$3,216.50 |
17.7× |
| CT orbits w/o contrast (70480) |
$2,776 |
$2,776 |
25.6× |
| CT pelvis w & w/o contrast (72194) |
$3,704 |
$3,704 |
20.3× |
| CT pelvis w/o contrast (72192) |
$2,432 |
$2,432 |
22.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,587 |
$3,587 |
19.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,426 |
$2,426 |
22.3× |
| CT thoracic spine w/contrast (72129) |
$3,706 |
$3,706 |
20.3× |
| CT thoracic spine w/o contrast (72128) |
$2,587 |
$2,587 |
23.8× |
| CT thoracic spine w/wo contrast (72130) |
$3,634 |
$3,634 |
20.0× |
| CT thorax w/o contrast (71250) |
$2,515 |
$2,515 |
23.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,639 |
$3,639 |
20.0× |
| CT upper extremity w/o contrast rt (73200) |
$2,178 |
$2,178 |
20.1× |
| CT upper extremity with contrast (73201) |
$2,935 |
$2,935 |
8.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,075 |
$4,075 |
22.4× |
| Cta Abdomen (74175) |
$3,600 |
$3,600 |
19.8× |
| CTA abdomen pelvis (74174) |
$6,310 |
$6,310 |
17.4× |
| CTA chest (71275) |
$4,008 |
$4,008 |
22.0× |
| Cta Head (70496) |
$3,374 |
$3,374 |
18.5× |
| Cta Neck (70498) |
$3,661 |
$3,661 |
20.1× |
| Cta Pelvis (72191) |
$2,696 |
$2,696 |
14.8× |
| Cystography minimum 3 views rs&i (74430) |
$837 |
$837 |
2.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$562 |
$562 |
5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$314 |
$314 |
3.5× |
| Echoencephalography real time imaging (76506) |
$862 |
$862 |
7.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,359 |
$1,359 |
12.5× |
| Fluoroscopy up to 1 hr (76000) |
$505.50 |
$505.50 |
2.0× |
| Foot 2 views (73620) |
$71 |
$71 |
0.8× |
| Forearm 2 views (73090) |
$64 |
$64 |
0.7× |
| Gated Heart Planar Single (78472) |
$2,294 |
$2,294 |
5.5× |
| Hand 2 views (73120) |
$63 |
$63 |
0.6× |
| Hand 3 views (73130) |
$75 |
$75 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,916 |
$2,916 |
5.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,099 |
$2,099 |
5.1× |
| Ht muscle image spect sing (78451) |
$4,999 |
$4,999 |
3.7× |
| Humerus Min 2 Views Left (73060) |
$66 |
$66 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,757 |
$1,757 |
3.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,222 |
$2,222 |
3.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,962 |
$2,962 |
5.3× |
| Knee 3 views (73562) |
$94 |
$94 |
1.0× |
| Liver & spleen imaging static only (78215) |
$1,565 |
$1,565 |
3.8× |
| Lung perf&ventilat diferentl (78598) |
$2,888 |
$2,888 |
5.1× |
| Lymphoscintigraphy (78195) |
$2,478 |
$2,478 |
4.4× |
| MRA head w & w/o contrast (70546) |
$2,894 |
$2,894 |
8.0× |
| MRA head w/o contrast (70544) |
$3,821 |
$3,821 |
15.4× |
| MRA head with contrast (70545) |
$4,476 |
$4,476 |
12.4× |
| MRA neck w contrast (70548) |
$4,658 |
$4,658 |
12.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,086 |
$5,086 |
14.0× |
| MRA neck w/o contrast (70547) |
$3,948 |
$3,948 |
15.9× |
| MRI abdomen w contrast (74182) |
$4,403 |
$4,403 |
12.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,351 |
$5,351 |
14.8× |
| MRI abdomen w/o contrast (74181) |
$3,887 |
$3,887 |
15.7× |
| MRI any jnt lwr ext with con lt (73722) |
$4,259 |
$4,259 |
5.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,368 |
$3,368 |
4.1× |
| MRI breast w/o contrast unilat (77046) |
$3,366 |
$3,366 |
13.6× |
| MRI c-spine with contrast (72142) |
$4,124 |
$4,124 |
11.4× |
| MRI cervical spine w/o contrast (72141) |
$3,804 |
$3,804 |
15.4× |
| MRI chest w/o & w/contrast material (71552) |
$4,762 |
$4,762 |
13.1× |
| MRI chest w/o contrast (71550) |
$4,590 |
$4,590 |
18.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,998 |
$2,998 |
12.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,020 |
$3,020 |
12.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,268 |
$5,268 |
14.5× |
| MRI orbit/face/neck w/contrast (70542) |
$3,803 |
$3,803 |
10.5× |
| MRI pelvis w contrast (72196) |
$4,286 |
$4,286 |
11.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,653 |
$4,653 |
12.8× |
| MRI pelvis w/o contrast (72195) |
$3,648 |
$3,648 |
14.7× |
| MRI scan of arm joint before and after contrast (73223) |
$4,766 |
$4,766 |
13.2× |
| MRI scan of leg joint before and after contrast (73723) |
$4,442 |
$4,442 |
12.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,061 |
$5,061 |
14.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,868 |
$3,868 |
10.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,825 |
$4,825 |
13.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,830 |
$4,830 |
13.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,125 |
$5,125 |
14.1× |
| MRI thoracic spine w/o contrast (72146) |
$3,999 |
$3,999 |
16.1× |
| MRI tmj (70336) |
$2,764 |
$2,764 |
11.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,735 |
$2,735 |
11.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,286 |
$4,286 |
11.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,077 |
$3,077 |
12.4× |
| Myocardial Spect Multiple Studies (78452) |
$5,069 |
$5,069 |
3.8× |
| Neck soft tissue (70360) |
$358 |
$358 |
4.0× |
| Nm gastric emptying study (78264) |
$2,373 |
$2,373 |
5.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$525 |
$525 |
4.8× |
| Parathyroid imaging (78070) |
$1,597 |
$1,597 |
3.8× |
| Pelvis 1 or 2 views (72170) |
$72 |
$72 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,403 |
$4,403 |
12.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,725 |
$2,725 |
4.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$347 |
$347 |
3.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$902 |
$902 |
8.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$92 |
$92 |
0.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$485 |
$485 |
4.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,127 |
$1,127 |
10.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$106 |
$106 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$50 |
$50 |
0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$490 |
$490 |
4.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$58 |
$58 |
0.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$73 |
$73 |
0.8× |
| Radiological examination surgical specimen (76098) |
$210 |
$210 |
0.4× |
| Ribs bilateral 3 views (71110) |
$82 |
$82 |
0.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,323 |
$2,323 |
4.1× |
| Sacroiliac Joints < 3 Views (72200) |
$68 |
$68 |
0.6× |
| Scanogram (77073) |
$345 |
$345 |
3.2× |
| Scapula complete (73010) |
$60 |
$60 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$55 |
$55 |
2.4× |
| Small bowel series (74250) |
$934 |
$934 |
5.1× |
| Spine thoracic 3 views (72072) |
$65 |
$65 |
0.6× |
| Thoracolumbar 2 views (72080) |
$84 |
$84 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$851 |
$851 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$806 |
$806 |
7.4× |
| Umbilical-artery Doppler (OB) (76820) |
$336 |
$336 |
3.1× |
| Upper Extremity Infant (73092) |
$407 |
$407 |
3.7× |
| Urethrocystography retrograde rs&i (74450) |
$1,021 |
$1,021 |
4.1× |
| Urethrocystography voiding (74455) |
$972 |
$972 |
3.9× |
| Us abdl aorta screen aaa (76706) |
$664 |
$664 |
6.1× |
| Us breast unilateral complete (76641) |
$691 |
$691 |
6.4× |
| Us breast unilateral limited (76642) |
$453 |
$453 |
5.0× |
| Us chest (76604) |
$754 |
$754 |
6.9× |
| Us infant hips limited static (76886) |
$931 |
$931 |
10.3× |
| Us kidney transplant (76776) |
$1,024 |
$1,024 |
9.4× |
| Us ob transvaginal (76817) |
$702 |
$702 |
6.5× |
| Us pelvic non ob complete (76856) |
$887 |
$887 |
8.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$681.50 |
$681.50 |
6.3× |
| Us pregnancy ltd (76815) |
$578 |
$578 |
5.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$897 |
$897 |
8.3× |
| Us retroperitoneal complete (76770) |
$948 |
$948 |
8.7× |
| Us retroperitoneal limited (76775) |
$782 |
$782 |
7.2× |
| Us scrotum and contents (76870) |
$838 |
$838 |
7.7× |
| Us soft tissue head/neck (76536) |
$799 |
$799 |
7.4× |
| Us xtr non-vasc lmtd (76882) |
$722 |
$722 |
6.7× |
| Wrist 2 views (73100) |
$60 |
$60 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$662 |
$662 |
6.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$260 |
$260 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$75 |
$75 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$70 |
$70 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$77 |
$77 |
0.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,127 |
$1,127 |
10.4× |
| X-ray exam hip uni 1 view (73501) |
$64 |
$64 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$97 |
$97 |
1.1× |
| X-ray exam hip uni 4/> views (73503) |
$726 |
$726 |
6.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$656 |
$656 |
6.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,001 |
$1,001 |
9.2× |
| X-ray exam of femur 1 (73551) |
$328 |
$328 |
3.6× |
| X-ray eye for foreign body (70030) |
$291 |
$291 |
3.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$525 |
$525 |
4.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$320 |
$320 |
3.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$82 |
$82 |
0.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$63 |
$63 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$438 |
$438 |
4.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$415 |
$415 |
4.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$65 |
$65 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$74 |
$74 |
0.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$693 |
$693 |
7.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$540 |
$540 |
5.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$481 |
$481 |
4.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,032 |
$1,032 |
2.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$69 |
$69 |
0.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$75 |
$75 |
0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$98 |
$98 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$75 |
$75 |
0.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$65 |
$65 |
0.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$514 |
$514 |
5.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$368 |
$368 |
4.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$99 |
$99 |
0.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$460 |
$460 |
4.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$424 |
$424 |
4.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$329 |
$329 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$67 |
$67 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$54 |
$54 |
0.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$64 |
$64 |
0.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$83 |
$83 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$723 |
$723 |
6.7× |
| Xr chest 4+ views (71048) |
$566 |
$566 |
5.2× |
| Xr finger(s) 2+ views (73140) |
$87 |
$87 |
1.0× |
| Xr shoulder 1 view (73020) |
$50 |
$50 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$171 |
$171 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$65 |
$65 |
0.7× |
| Xray knee 1 or 2 views rt (73560) |
$71 |
$71 |
0.8× |