| Abdomen 2 views (74019) |
$275.40 |
$324 |
2.9× |
| Ankle 2 views (73600) |
$199.92 |
$235.20 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$406.30 |
$478 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$614.55 |
$723 |
1.7× |
| Bone age studies (77072) |
$190.74 |
$224.40 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$575.45 |
$677 |
1.6× |
| Bone survey complete (77075) |
$936.36 |
$1,101.60 |
9.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$770.10 |
$906 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$231.54 |
$272.40 |
2.9× |
| Chest 1 view (71045) |
$199.92 |
$235.20 |
2.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$442.34 |
$520.40 |
2.7× |
| Clavicle complete (73000) |
$196.86 |
$231.60 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$537.20 |
$632 |
5.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$552.50 |
$650 |
1.7× |
| CT abdomen and pelvis without contrast (74176) |
$515.10 |
$606 |
2.3× |
| CT abdomen w contrast (74160) |
$544 |
$640 |
3.4× |
| CT abdomen w wo contrast (74170) |
$552.50 |
$650 |
3.4× |
| CT abdomen w/o contrast (74150) |
$537.20 |
$632 |
5.6× |
| CT angiography upper extremity lt (73206) |
$1,251.63 |
$1,472.50 |
7.8× |
| CT c-spine w/o contrast (72125) |
$515.10 |
$606 |
5.4× |
| CT cervical spine w&w/o contrast (72127) |
$552.50 |
$650 |
3.4× |
| CT cervical spine with contrast (72126) |
$544 |
$640 |
1.7× |
| CT chest w/wo contrast (71270) |
$527 |
$620 |
3.3× |
| CT chest with contrast (71260) |
$518.50 |
$610 |
3.2× |
| CT head/brain with contrast (70460) |
$544 |
$640 |
3.4× |
| CT head/brain without and with contrast (70470) |
$537.20 |
$632 |
3.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$500.65 |
$589 |
6.3× |
| CT iac w contrast (70481) |
$544 |
$640 |
3.4× |
| CT lower ext w/o (73700) |
$515.10 |
$606 |
5.4× |
| CT lower extremity w wo contrast (73702) |
$527 |
$620 |
3.3× |
| CT lower extremity with contrast (73701) |
$518.50 |
$610 |
3.2× |
| CT lumbar spine w & w/o contrast (72133) |
$552.50 |
$650 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$537.20 |
$632 |
5.6× |
| CT lumbar spine with contrast (72132) |
$544 |
$640 |
1.7× |
| CT maxillofacial w contrast (70487) |
$544 |
$640 |
3.4× |
| CT maxillofacial w/o contrast (70486) |
$537.20 |
$632 |
5.6× |
| CT maxillofacial w/wo contrast (70488) |
$552.50 |
$650 |
3.4× |
| CT neck soft tissue w contrast (70491) |
$544 |
$640 |
3.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$552.50 |
$650 |
3.4× |
| CT orbits w/o contrast (70480) |
$537.20 |
$632 |
5.6× |
| CT pelvis w & w/o contrast (72194) |
$552.50 |
$650 |
3.4× |
| CT pelvis w/o contrast (72192) |
$537.20 |
$632 |
5.6× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$212.50 |
$250 |
2.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$552.50 |
$650 |
3.4× |
| CT soft tissue neck w/o contrast (70490) |
$537.20 |
$632 |
5.6× |
| CT thoracic spine w/contrast (72129) |
$544 |
$640 |
3.4× |
| CT thoracic spine w/o contrast (72128) |
$537.20 |
$632 |
5.6× |
| CT thoracic spine w/wo contrast (72130) |
$552.50 |
$650 |
3.4× |
| CT thorax w/o contrast (71250) |
$515.10 |
$606 |
5.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$527 |
$620 |
3.3× |
| CT upper extremity w/o contrast rt (73200) |
$537.20 |
$632 |
5.6× |
| CT upper extremity with contrast (73201) |
$518.50 |
$610 |
1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,417.38 |
$1,667.50 |
8.8× |
| Cta Abdomen (74175) |
$1,392.30 |
$1,638 |
8.6× |
| CTA abdomen pelvis (74174) |
$2,000.05 |
$2,353 |
6.2× |
| CTA chest (71275) |
$1,342.15 |
$1,579 |
8.3× |
| Cta Head (70496) |
$1,360 |
$1,600 |
8.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,762.50 |
$3,250 |
8.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,251.63 |
$1,472.50 |
7.8× |
| Cta Neck (70498) |
$1,360.85 |
$1,601 |
8.4× |
| Cystography minimum 3 views rs&i (74430) |
$592.62 |
$697.20 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$386.75 |
$455 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$62.90 |
$74 |
0.8× |
| Esophagus (74220) |
$419.22 |
$493.20 |
2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$232.05 |
$273 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$510 |
$600 |
2.3× |
| Foot 2 views (73620) |
$199.92 |
$235.20 |
2.5× |
| Forearm 2 views (73090) |
$230.52 |
$271.20 |
2.9× |
| Hand 2 views (73120) |
$199.92 |
$235.20 |
2.1× |
| Hand 3 views (73130) |
$230.52 |
$271.20 |
2.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$613.70 |
$722 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$613.70 |
$722 |
1.7× |
| Ht muscle image spect sing (78451) |
$1,185.75 |
$1,395 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$230.52 |
$271.20 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$190.40 |
$224 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$992.80 |
$1,168 |
2.0× |
| Knee 3 views (73562) |
$230.52 |
$271.20 |
2.9× |
| MRA head w & w/o contrast (70546) |
$777.75 |
$915 |
2.4× |
| MRA head w/o contrast (70544) |
$770.10 |
$906 |
3.5× |
| MRA neck w contrast (70548) |
$855.10 |
$1,006 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,005.55 |
$1,183 |
3.1× |
| MRA neck w/o contrast (70547) |
$770.10 |
$906 |
3.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$770.10 |
$906 |
2.4× |
| MRI abdomen w/o contrast (74181) |
$697 |
$820 |
3.2× |
| MRI any jnt lwr ext with con lt (73722) |
$722.50 |
$850 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$722.50 |
$850 |
1.0× |
| MRI breast w/o contrast bilateral (77047) |
$770.10 |
$906 |
3.5× |
| MRI c-spine with contrast (72142) |
$722.50 |
$850 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$697 |
$820 |
3.2× |
| MRI cervical spine w/o contrast (72141) |
$697 |
$820 |
3.2× |
| MRI chest w/o & w/contrast material (71552) |
$770.10 |
$906 |
2.4× |
| MRI chest w/o contrast (71550) |
$697 |
$820 |
3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$697 |
$820 |
3.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$697 |
$820 |
3.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$770.10 |
$906 |
2.4× |
| MRI pelvis w contrast (72196) |
$722.50 |
$850 |
2.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$770.10 |
$906 |
2.4× |
| MRI pelvis w/o contrast (72195) |
$697 |
$820 |
3.2× |
| MRI scan of arm joint before and after contrast (73223) |
$770.10 |
$906 |
2.4× |
| MRI scan of leg joint before and after contrast (73723) |
$770.10 |
$906 |
2.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$770.10 |
$906 |
2.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$722.50 |
$850 |
2.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$770.10 |
$906 |
2.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$722.50 |
$850 |
2.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$770.10 |
$906 |
2.4× |
| MRI thoracic spine w/o contrast (72146) |
$697 |
$820 |
3.2× |
| MRI tmj (70336) |
$697 |
$820 |
3.2× |
| MRI upper ext joint w/o contrast (73221) |
$697 |
$820 |
3.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$770.10 |
$906 |
2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$697 |
$820 |
3.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,552.10 |
$1,826 |
1.3× |
| Neck soft tissue (70360) |
$199.92 |
$235.20 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$199.92 |
$235.20 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$770.10 |
$906 |
2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$515.95 |
$607 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$739.50 |
$870 |
1.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$190.74 |
$224.40 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$193.80 |
$228 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$321.30 |
$378 |
3.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$380.46 |
$447.60 |
4.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$199.92 |
$235.20 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,864.48 |
$2,193.50 |
19.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$303.96 |
$357.60 |
3.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$702.78 |
$826.80 |
4.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$302.94 |
$356.40 |
3.8× |
| Scanogram (77073) |
$421.26 |
$495.60 |
4.4× |
| Scapula complete (73010) |
$231.54 |
$272.40 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$55.25 |
$65 |
2.4× |
| Small bowel series (74250) |
$571.20 |
$672 |
3.5× |
| Spine thoracic 3 views (72072) |
$357 |
$420 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$259.25 |
$305 |
2.7× |
| Unlisted Ultrasound Procedure (76999) |
$151.30 |
$178 |
1.9× |
| Urethrocystography voiding (74455) |
$653.82 |
$769.20 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$190.40 |
$224 |
2.0× |
| Us breast unilateral complete (76641) |
$204.85 |
$241 |
2.1× |
| Us breast unilateral limited (76642) |
$181.05 |
$213 |
2.3× |
| Us chest (76604) |
$249.90 |
$294 |
2.6× |
| Us compl joint r-t w/image documentation (76881) |
$181.05 |
$213 |
1.9× |
| Us ob transvaginal (76817) |
$176.80 |
$208 |
1.8× |
| Us pelvic non ob complete (76856) |
$274.55 |
$323 |
2.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$176.80 |
$208 |
1.8× |
| Us pregnancy ltd (76815) |
$165.75 |
$195 |
1.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$171.70 |
$202 |
1.8× |
| Us retroperitoneal complete (76770) |
$249.90 |
$294 |
2.6× |
| Us retroperitoneal limited (76775) |
$178.08 |
$209.50 |
1.9× |
| Us scrotum and contents (76870) |
$230.35 |
$271 |
2.4× |
| Us soft tissue head/neck (76536) |
$541.45 |
$637 |
5.6× |
| Us xtr non-vasc lmtd (76882) |
$190.40 |
$224 |
2.0× |
| Wrist 2 views (73100) |
$189.72 |
$223.20 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$357 |
$420 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$335.58 |
$394.80 |
4.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$230.52 |
$271.20 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$199.92 |
$235.20 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$230.52 |
$271.20 |
2.9× |
| X-ray exam hip uni 1 view (73501) |
$204 |
$240 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$311.10 |
$366 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$361.25 |
$425 |
3.8× |
| X-ray exam of femur 1 (73551) |
$204 |
$240 |
2.5× |
| X-ray eye for foreign body (70030) |
$109.65 |
$129 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$362.10 |
$426 |
3.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$232.56 |
$273.60 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$230.52 |
$271.20 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$199.92 |
$235.20 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$303.96 |
$357.60 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$154.70 |
$182 |
1.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$153 |
$180 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$330.48 |
$388.80 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$230.52 |
$271.20 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$362.10 |
$426 |
3.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$329.46 |
$387.60 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$395.76 |
$465.60 |
4.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$405.96 |
$477.60 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$484.50 |
$570 |
5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$231.54 |
$272.40 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$220.32 |
$259.20 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$292.74 |
$344.40 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$380.46 |
$447.60 |
4.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$157.08 |
$184.80 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$380.46 |
$447.60 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$231.54 |
$272.40 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$242.76 |
$285.60 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$288.66 |
$339.60 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$302.94 |
$356.40 |
3.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$355.98 |
$418.80 |
3.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$199.92 |
$235.20 |
2.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$231.54 |
$272.40 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$427.38 |
$502.80 |
4.4× |
| Xr finger(s) 2+ views (73140) |
$199.92 |
$235.20 |
2.5× |
| Xr optic foramina (70190) |
$227.46 |
$267.60 |
2.8× |
| Xr shoulder 1 view (73020) |
$199.92 |
$235.20 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$380.46 |
$447.60 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$231.54 |
$272.40 |
2.9× |
| Xr tmj bilateral (70330) |
$362.10 |
$426 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$199.92 |
$235.20 |
2.5× |