| Abdomen 2 views (74019) |
$450 |
$450 |
4.2× |
| Ankle 2 views (73600) |
$286 |
$286 |
3.2× |
| Bone &/joint imaging whole body (78306) |
$1,937 |
$1,937 |
4.7× |
| Bone Imaging 3 Phase (78315) |
$1,525 |
$1,525 |
3.7× |
| Cervical spine 2 or 3 views (72040) |
$361 |
$361 |
4.0× |
| Chest 1 view (71045) |
$328 |
$328 |
3.7× |
| Clavicle complete (73000) |
$247 |
$247 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,158 |
$2,158 |
20.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,348 |
$4,348 |
12.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,938 |
$3,938 |
16.0× |
| CT abdomen w contrast (74160) |
$2,494 |
$2,494 |
13.8× |
| CT abdomen w wo contrast (74170) |
$3,049 |
$3,049 |
16.8× |
| CT abdomen w/o contrast (74150) |
$2,063 |
$2,063 |
19.1× |
| CT c-spine w/o contrast (72125) |
$2,218 |
$2,218 |
20.6× |
| CT chest w contrast (71260) |
$2,613 |
$2,613 |
14.4× |
| CT chest w/wo contrast (71270) |
$3,155 |
$3,155 |
17.4× |
| CT head/brain with contrast (70460) |
$2,126 |
$2,126 |
11.7× |
| CT head/brain without and with contrast (70470) |
$2,611 |
$2,611 |
14.4× |
| CT lower ext w/o (73700) |
$1,834 |
$1,834 |
17.0× |
| CT lower extremity w/contrast material (73701) |
$3,719 |
$3,719 |
20.5× |
| CT lumbar spine w/contrast (72132) |
$2,836 |
$2,836 |
7.9× |
| CT lumbar spine w/o contrast (72131) |
$2,218 |
$2,218 |
20.6× |
| CT maxillofacial w contrast (70487) |
$2,248 |
$2,248 |
12.4× |
| CT maxillofacial wo contrast (70486) |
$1,773 |
$1,773 |
16.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,653 |
$2,653 |
14.7× |
| CT orbits w/o contrast (70480) |
$1,439 |
$1,439 |
13.3× |
| CT pelvis w/o contrast (72192) |
$2,155 |
$2,155 |
20.0× |
| CT soft tissue neck w contrast (70491) |
$2,126 |
$2,126 |
11.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,773 |
$1,773 |
16.4× |
| CT thoracic spine w/contrast (72129) |
$2,836 |
$2,836 |
15.7× |
| CT thoracic spine w/o contrast (72128) |
$2,224 |
$2,224 |
20.6× |
| CT thorax w/o contrast (71250) |
$2,094 |
$2,094 |
19.4× |
| CT upper ext wo (73200) |
$1,544 |
$1,544 |
14.3× |
| CT upper extremity with contrast (73201) |
$3,719 |
$3,719 |
10.3× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$6,270 |
$6,270 |
34.6× |
| CTA abdomen pelvis (74174) |
$4,305 |
$4,305 |
12.0× |
| CTA chest (71275) |
$2,613 |
$2,613 |
14.4× |
| Cta Head (70496) |
$2,921 |
$2,921 |
16.1× |
| Cta Neck (70498) |
$2,533 |
$2,533 |
14.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$146 |
$146 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$592 |
$592 |
5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$592 |
$592 |
6.6× |
| Esophagus (74220) |
$595 |
$595 |
3.3× |
| Facial bones min 3 views (70150) |
$435 |
$435 |
4.0× |
| Fetal biophysical profile non-stress testing (76818) |
$945 |
$945 |
8.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$945 |
$945 |
8.8× |
| Fluoroscopy up to 1 hr (76000) |
$480 |
$480 |
1.9× |
| Foot 2 views (73620) |
$286 |
$286 |
3.2× |
| Forearm 2 views (73090) |
$253 |
$253 |
2.8× |
| Hand 2 views (73120) |
$205 |
$205 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,556 |
$2,556 |
4.6× |
| Knee 3 views (73562) |
$325 |
$325 |
3.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$4,220 |
$4,220 |
5.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,413 |
$4,413 |
12.3× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$221 |
$221 |
2.5× |
| MRA head w & w/o contrast (70546) |
$5,211 |
$5,211 |
14.5× |
| MRA head w/o contrast (70544) |
$3,097 |
$3,097 |
12.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,521 |
$3,521 |
9.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,932 |
$4,932 |
13.7× |
| MRI abdomen w/o contrast (74181) |
$4,413 |
$4,413 |
17.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,220 |
$4,220 |
5.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,413 |
$4,413 |
12.3× |
| MRI cervical spine w/o contrast (72141) |
$2,992 |
$2,992 |
12.1× |
| MRI chest w/o contrast (71550) |
$4,413 |
$4,413 |
17.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,413 |
$4,413 |
12.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,025 |
$4,025 |
16.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,507 |
$2,507 |
10.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,849 |
$3,849 |
10.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,933 |
$3,933 |
10.9× |
| MRI pelvis w/o contrast (72195) |
$3,334 |
$3,334 |
13.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,806 |
$3,806 |
10.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,806 |
$3,806 |
10.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,651 |
$3,651 |
10.1× |
| MRI temporomandibular joint (70336) |
$2,507 |
$2,507 |
10.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,992 |
$2,992 |
12.1× |
| MRI up ext w/o contrast (73218) |
$4,025 |
$4,025 |
16.3× |
| MRI upper ext joint w/o contrast (73221) |
$3,487 |
$3,487 |
14.2× |
| MRI, joint upper extrem combo (73223) |
$4,413 |
$4,413 |
12.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,408 |
$3,408 |
2.6× |
| Myocardial spect single study at rest or stress (78451) |
$593 |
$593 |
0.4× |
| Neck soft tissue (70360) |
$289 |
$289 |
3.2× |
| Ob us nuchal meas 1 gest (76813) |
$213 |
$213 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$278 |
$278 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,896 |
$1,896 |
3.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$318 |
$318 |
3.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$182 |
$182 |
2.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$310 |
$310 |
3.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$284 |
$284 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$488 |
$488 |
4.5× |
| Radex fingr minimum 2 views (73140) |
$261 |
$261 |
2.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$318 |
$318 |
3.5× |
| Radex Hand Minimum 3 Views (73130) |
$318 |
$318 |
3.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$228 |
$228 |
2.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$406 |
$406 |
3.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$473 |
$473 |
4.4× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$564 |
$564 |
5.2× |
| Radex Humerus Minimum 2 Views (73060) |
$253 |
$253 |
2.8× |
| Radex Kne 1/2 Views (73560) |
$289 |
$289 |
3.2× |
| Radex Kne Compl 4/More Views (73564) |
$419 |
$419 |
3.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$433 |
$433 |
4.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$435 |
$435 |
4.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$317 |
$317 |
2.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$361 |
$361 |
4.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$232 |
$232 |
2.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$415 |
$415 |
3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$487 |
$487 |
5.4× |
| Radex Toe Minimum 2 Views (73660) |
$253 |
$253 |
2.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$318 |
$318 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$330 |
$330 |
3.7× |
| Radiologic exam chest 2 views (71046) |
$407 |
$407 |
4.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$595 |
$595 |
3.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$305 |
$305 |
3.4× |
| Ribs bilateral 3 views (71110) |
$335 |
$335 |
3.1× |
| Scapula (73010) |
$269 |
$269 |
2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$85 |
$85 |
3.6× |
| Small bowel series (74250) |
$596 |
$596 |
3.3× |
| Spine thoracic 3 views (72072) |
$402 |
$402 |
3.7× |
| Ultrasound Exam Aaa Screen (76706) |
$706 |
$706 |
6.5× |
| Ultrasound, abdomen limited (76705) |
$706 |
$706 |
6.5× |
| Umbilical-artery Doppler (OB) (76820) |
$62 |
$62 |
0.6× |
| Us breast unilateral limited (76642) |
$220 |
$220 |
2.4× |
| Us chest (76604) |
$580 |
$580 |
5.4× |
| Us compl joint r-t w/image documentation (76881) |
$628 |
$628 |
5.8× |
| Us hips infant static (76886) |
$1,098 |
$1,098 |
12.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$628 |
$628 |
5.8× |
| Us ob detailed single fetus (76811) |
$1,942 |
$1,942 |
7.9× |
| Us ob limited (76815) |
$595 |
$595 |
5.5× |
| Us ob transvaginal (76817) |
$488 |
$488 |
4.5× |
| Us pelvic non ob complete (76856) |
$803 |
$803 |
7.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$657 |
$657 |
6.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$643 |
$643 |
6.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$304 |
$304 |
2.8× |
| Us retroperitoneal complete (76770) |
$770 |
$770 |
7.1× |
| Us retroperitoneal limited (76775) |
$706 |
$706 |
6.5× |
| Us scrotum and contents (76870) |
$619 |
$619 |
5.7× |
| Us soft tissue head/neck (76536) |
$643 |
$643 |
6.0× |
| Wrist 2 views (73100) |
$236 |
$236 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$488 |
$488 |
4.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$437 |
$437 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$226 |
$226 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$434.50 |
$434.50 |
4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$308 |
$308 |
2.9× |
| X-ray exam of femur 2/> (73552) |
$289 |
$289 |
3.2× |
| X-ray eye for foreign body (70030) |
$346 |
$346 |
3.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$428 |
$428 |
4.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$534 |
$534 |
4.9× |
| X-ray nose-rectum child f.b. (76010) |
$225 |
$225 |
2.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$357 |
$357 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$325 |
$325 |
3.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$335 |
$335 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$407 |
$407 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$382 |
$382 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$332 |
$332 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$369 |
$369 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$258 |
$258 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$284 |
$284 |
3.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$412 |
$412 |
4.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$305 |
$305 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$415 |
$415 |
3.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$503 |
$503 |
4.7× |
| Xr c-spine 4 or 5 views (72050) |
$421 |
$421 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$623 |
$623 |
5.8× |