| Acute gastrointestinal blood loss imaging (78278) |
$1,997.40 |
$4,993.50 |
5.0× |
| Ankle 2 views (73600) |
$233 |
$582.50 |
2.7× |
| Arthrogram hip (73525) |
$1,686.80 |
$4,217 |
4.9× |
| Arthrogram shoulder (73040) |
$823.20 |
$2,058 |
2.4× |
| Arthrography knee lt (73580) |
$1,772.40 |
$4,431 |
5.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$920.60 |
$2,301.50 |
2.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,371.60 |
$3,429 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$1,813.40 |
$4,533.50 |
4.6× |
| Bone age studies (77072) |
$369.20 |
$923 |
3.5× |
| Bone Imaging 3 Phase (78315) |
$1,813.40 |
$4,533.50 |
4.6× |
| Bone survey complete (77075) |
$640.80 |
$1,602 |
6.2× |
| Cervical spine 2 or 3 views (72040) |
$325.80 |
$814.50 |
3.8× |
| Chest 1 view (71045) |
$265.60 |
$664 |
3.1× |
| Chest 3 views (71047) |
$310.40 |
$776 |
3.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$386.40 |
$966 |
2.2× |
| Clavicle complete (73000) |
$224.20 |
$560.50 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$620.40 |
$1,551 |
6.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,882 |
$12,205 |
14.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,589.80 |
$8,974.50 |
15.1× |
| CT abdomen w contrast (74160) |
$3,018.40 |
$7,546 |
17.3× |
| CT abdomen w wo contrast (74170) |
$3,273 |
$8,182.50 |
18.8× |
| CT abdomen w/o contrast (74150) |
$2,603.40 |
$6,508.50 |
25.0× |
| CT angiography upper extremity lt (73206) |
$2,569.60 |
$6,424 |
14.7× |
| CT c-spine w/o contrast (72125) |
$2,757.20 |
$6,893 |
26.5× |
| CT cervical spine with contrast (72126) |
$2,192 |
$5,480 |
6.3× |
| CT chest w/wo contrast (71270) |
$2,753.80 |
$6,884.50 |
15.8× |
| CT chest with contrast (71260) |
$2,587.60 |
$6,469 |
14.8× |
| CT head/brain with contrast (70460) |
$1,796.20 |
$4,490.50 |
10.3× |
| CT head/brain without and with contrast (70470) |
$2,016.20 |
$5,040.50 |
11.6× |
| CT iac w contrast (70481) |
$1,778.60 |
$4,446.50 |
10.2× |
| CT lower ext w/o (73700) |
$2,238.40 |
$5,596 |
21.5× |
| CT lower extremity w wo contrast (73702) |
$2,374.80 |
$5,937 |
13.6× |
| CT lower extremity with contrast (73701) |
$2,238.40 |
$5,596 |
12.8× |
| CT lumbar spine w & w/o contrast (72133) |
$3,160.60 |
$7,901.50 |
18.1× |
| CT lumbar spine w/o contrast (72131) |
$3,273 |
$8,182.50 |
31.5× |
| CT lumbar spine with contrast (72132) |
$3,273 |
$8,182.50 |
9.4× |
| CT maxillofacial w contrast (70487) |
$2,657.40 |
$6,643.50 |
15.2× |
| CT maxillofacial w/o contrast (70486) |
$2,445.20 |
$6,113 |
23.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,801.20 |
$7,003 |
16.0× |
| CT neck soft tissue w contrast (70491) |
$1,796.20 |
$4,490.50 |
10.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,469.80 |
$3,674.50 |
8.4× |
| CT orbits w/o contrast (70480) |
$1,213.60 |
$3,034 |
11.7× |
| CT pelvis w & w/o contrast (72194) |
$3,273 |
$8,182.50 |
18.8× |
| CT pelvis w/o contrast (72192) |
$2,603.40 |
$6,508.50 |
25.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,016.20 |
$5,040.50 |
11.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,625.80 |
$4,064.50 |
15.6× |
| CT thoracic spine w/o contrast (72128) |
$3,273 |
$8,182.50 |
31.5× |
| CT thorax w/o contrast (71250) |
$2,162 |
$5,405 |
20.8× |
| CT upper extremity w/o contrast rt (73200) |
$2,116.80 |
$5,292 |
20.3× |
| CT upper extremity with contrast (73201) |
$2,238.40 |
$5,596 |
6.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,055.20 |
$7,638 |
17.5× |
| Cta Abdomen (74175) |
$3,666.40 |
$9,166 |
21.0× |
| CTA abdomen pelvis (74174) |
$5,620.20 |
$14,050.50 |
16.2× |
| CTA chest (71275) |
$2,935.20 |
$7,338 |
16.8× |
| Cta Head (70496) |
$2,164.60 |
$5,411.50 |
12.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,569.60 |
$6,424 |
14.7× |
| Cta Neck (70498) |
$2,320.40 |
$5,801 |
13.3× |
| Cta Pelvis (72191) |
$3,209 |
$8,022.50 |
18.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$539 |
$1,347.50 |
5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$242.60 |
$606.50 |
2.8× |
| Echoencephalography real time imaging (76506) |
$418.60 |
$1,046.50 |
4.0× |
| Esophagus (74220) |
$479.60 |
$1,199 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$450.20 |
$1,125.50 |
1.9× |
| Foot 2 views (73620) |
$224.20 |
$560.50 |
2.6× |
| Forearm 2 views (73090) |
$235.80 |
$589.50 |
2.7× |
| Gated Heart Planar Single (78472) |
$1,799.20 |
$4,498 |
4.5× |
| Hand 2 views (73120) |
$237.60 |
$594 |
2.3× |
| Hand 3 views (73130) |
$235.80 |
$589.50 |
2.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,932.60 |
$4,831.50 |
3.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,932.60 |
$4,831.50 |
4.9× |
| Ht muscle image spect sing (78451) |
$3,694.40 |
$9,236 |
2.9× |
| Humerus Min 2 Views Left (73060) |
$300.20 |
$750.50 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,623.20 |
$4,058 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,623.20 |
$4,058 |
3.0× |
| Knee 3 views (73562) |
$278.40 |
$696 |
3.2× |
| Liver & spleen imaging static only (78215) |
$1,195.60 |
$2,989 |
3.0× |
| Lymphoscintigraphy (78195) |
$2,179.20 |
$5,448 |
4.0× |
| Meckels Diverticulum (78290) |
$1,902.40 |
$4,756 |
4.8× |
| MRA head w & w/o contrast (70546) |
$3,006 |
$7,515 |
8.7× |
| MRA head w/o contrast (70544) |
$1,649.20 |
$4,123 |
6.9× |
| MRA neck w contrast (70548) |
$1,595.20 |
$3,988 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,598 |
$6,495 |
7.5× |
| MRA neck w/o contrast (70547) |
$1,762.40 |
$4,406 |
7.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,249.60 |
$8,124 |
9.4× |
| MRI abdomen w/o contrast (74181) |
$2,373.60 |
$5,934 |
10.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,334.40 |
$5,836 |
3.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,217.20 |
$5,543 |
2.8× |
| MRI c-spine with contrast (72142) |
$2,261 |
$5,652.50 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$2,373.60 |
$5,934 |
10.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,268.60 |
$5,671.50 |
6.5× |
| MRI chest w/o contrast (71550) |
$2,373.60 |
$5,934 |
10.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,373.60 |
$5,934 |
10.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,690.40 |
$4,226 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,318.20 |
$8,295.50 |
9.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,943.80 |
$4,859.50 |
5.6× |
| MRI pelvis w contrast (72196) |
$1,483.60 |
$3,709 |
4.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,868 |
$7,170 |
8.3× |
| MRI pelvis w/o contrast (72195) |
$2,373.60 |
$5,934 |
10.0× |
| MRI scan of arm joint before and after contrast (73223) |
$2,271.20 |
$5,678 |
6.5× |
| MRI scan of leg joint before and after contrast (73723) |
$2,477.20 |
$6,193 |
7.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,373.60 |
$5,934 |
6.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,259.40 |
$5,648.50 |
6.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,068.20 |
$7,670.50 |
8.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,068.20 |
$7,670.50 |
8.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,373.60 |
$5,934 |
10.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,271.20 |
$5,678 |
9.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,373.60 |
$5,934 |
6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,191 |
$2,977.50 |
5.0× |
| Myelogram Lumbar (72265) |
$1,561 |
$3,902.50 |
2.0× |
| Myelography 2 or more regions (72270) |
$2,517.20 |
$6,293 |
3.2× |
| Myocardial Spect Multiple Studies (78452) |
$5,308.60 |
$13,271.50 |
4.1× |
| Neck soft tissue (70360) |
$213.60 |
$534 |
2.5× |
| Nm gastric emptying study (78264) |
$2,810.80 |
$7,027 |
7.1× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$4,854 |
$12,135 |
3.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$672.20 |
$1,680.50 |
6.5× |
| Osseous survey infant (77076) |
$492 |
$1,230 |
4.7× |
| Pelvis 1 or 2 views (72170) |
$257.20 |
$643 |
2.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,373.60 |
$5,934 |
6.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,084.20 |
$5,210.50 |
3.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$242.60 |
$606.50 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$398.40 |
$996 |
3.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$362 |
$905 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$756.60 |
$1,891.50 |
7.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$479.60 |
$1,199 |
4.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$222.80 |
$557 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$316.60 |
$791.50 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$272.60 |
$681.50 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$748.80 |
$1,872 |
4.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$823.20 |
$2,058 |
4.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$737.40 |
$1,843.50 |
4.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$242.60 |
$606.50 |
2.8× |
| Radiological examination surgical specimen (76098) |
$785.60 |
$1,964 |
1.4× |
| Ribs bilateral 3 views (71110) |
$386.40 |
$966 |
3.7× |
| Scanogram (77073) |
$338.20 |
$845.50 |
3.3× |
| Scapula complete (73010) |
$300.20 |
$750.50 |
2.9× |
| Screening digital breast tomosynthesis (77063) |
$94.60 |
$236.50 |
4.0× |
| Small bowel series (74250) |
$386.40 |
$966 |
2.2× |
| Thoracolumbar 2 views (72080) |
$325.80 |
$814.50 |
3.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,173.40 |
$2,933.50 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$560.40 |
$1,401 |
5.4× |
| Unlisted magnetic resonance procedure (76498) |
$205.40 |
$513.50 |
2.4× |
| Upper Extremity Infant (73092) |
$237.60 |
$594 |
2.3× |
| Urethrocystography retrograde rs&i (74450) |
$300.20 |
$750.50 |
1.3× |
| Us abdl aorta screen aaa (76706) |
$365 |
$912.50 |
3.5× |
| Us breast unilateral complete (76641) |
$475.40 |
$1,188.50 |
4.6× |
| Us chest (76604) |
$985.80 |
$2,464.50 |
9.5× |
| Us compl joint r-t w/image documentation (76881) |
$696.80 |
$1,742 |
6.7× |
| Us ob transvaginal (76817) |
$646.80 |
$1,617 |
6.2× |
| Us pelvic non ob complete (76856) |
$979.40 |
$2,448.50 |
9.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$475.40 |
$1,188.50 |
4.6× |
| Us pregnancy ltd (76815) |
$609.20 |
$1,523 |
5.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$964.80 |
$2,412 |
9.3× |
| Us retroperitoneal complete (76770) |
$701.20 |
$1,753 |
6.7× |
| Us scrotum and contents (76870) |
$985.80 |
$2,464.50 |
9.5× |
| Us soft tissue head/neck (76536) |
$928.80 |
$2,322 |
8.9× |
| Us spinal canal and contents (76800) |
$643.40 |
$1,608.50 |
6.2× |
| Us xtr non-vasc lmtd (76882) |
$458.60 |
$1,146.50 |
4.4× |
| Wrist 2 views (73100) |
$235.80 |
$589.50 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$569 |
$1,422.50 |
5.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$327.40 |
$818.50 |
3.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$277.20 |
$693 |
3.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$931.40 |
$2,328.50 |
5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$235.80 |
$589.50 |
2.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$281.40 |
$703.50 |
3.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$756.60 |
$1,891.50 |
7.3× |
| X-ray exam hip uni 1 view (73501) |
$242.60 |
$606.50 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$242.60 |
$606.50 |
2.8× |
| X-ray exam hip uni 4/> views (73503) |
$398.40 |
$996 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$398.40 |
$996 |
3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$756.60 |
$1,891.50 |
7.3× |
| X-ray exam of femur 1 (73551) |
$242.60 |
$606.50 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$454.80 |
$1,137 |
4.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$254.60 |
$636.50 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$281.40 |
$703.50 |
3.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$224.20 |
$560.50 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$315.60 |
$789 |
3.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$160.40 |
$401 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$325.80 |
$814.50 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$624.20 |
$1,560.50 |
6.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$531 |
$1,327.50 |
5.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$327.40 |
$818.50 |
3.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$263.40 |
$658.50 |
3.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$301.40 |
$753.50 |
2.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$334.40 |
$836 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$327.40 |
$818.50 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$541 |
$1,352.50 |
5.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$640.80 |
$1,602 |
6.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$270.20 |
$675.50 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$325.80 |
$814.50 |
3.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$300.20 |
$750.50 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$479.60 |
$1,199 |
5.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$263 |
$657.50 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$479.60 |
$1,199 |
4.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$315.60 |
$789 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$197 |
$492.50 |
2.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$363.40 |
$908.50 |
4.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$355.40 |
$888.50 |
4.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$325.80 |
$814.50 |
3.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$410.60 |
$1,026.50 |
3.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$191.60 |
$479 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$281.40 |
$703.50 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$531 |
$1,327.50 |
5.1× |
| Xr chest 4+ views (71048) |
$332 |
$830 |
3.2× |
| Xr Cholecystography Oral Contrast (74290) |
$450.20 |
$1,125.50 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$174.40 |
$436 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$467.80 |
$1,169.50 |
4.5× |
| Xr tibia/fibula 2 views (73590) |
$233 |
$582.50 |
2.7× |
| Xr tmj bilateral (70330) |
$386.40 |
$966 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$235.80 |
$589.50 |
2.7× |