| Abdomen 2 views (74019) |
$179.08 |
$179.08 |
1.9× |
| Ankle 2 views (73600) |
$222.45 |
$222.45 |
2.8× |
| Arthrogram shoulder (73040) |
$462 |
$462 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$713 |
$713 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$930 |
$930 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$429 |
$429 |
1.2× |
| Bone age studies (77072) |
$118.80 |
$118.80 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$1,538 |
$1,538 |
4.2× |
| Bone survey complete (77075) |
$462 |
$462 |
4.9× |
| Brain imaging < 4 static views (78600) |
$480 |
$480 |
1.3× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,892 |
$1,892 |
5.2× |
| Cervical spine 2 or 3 views (72040) |
$258.49 |
$258.49 |
3.3× |
| Chest 1 view (71045) |
$132 |
$132 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$250 |
$250 |
1.6× |
| Clavicle complete (73000) |
$118.80 |
$118.80 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,453 |
$1,453 |
15.3× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$237.60 |
$237.60 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,000 |
$3,000 |
9.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,800 |
$1,800 |
8.3× |
| CT abdomen w contrast (74160) |
$1,615.73 |
$1,615.73 |
10.2× |
| CT abdomen w wo contrast (74170) |
$1,782 |
$1,782 |
11.2× |
| CT abdomen w/o contrast (74150) |
$1,396.13 |
$1,396.13 |
14.7× |
| CT c-spine w/o contrast (72125) |
$1,415.40 |
$1,415.40 |
15.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,484.62 |
$1,484.62 |
9.3× |
| CT cervical spine with contrast (72126) |
$850 |
$850 |
2.7× |
| CT chest w/wo contrast (71270) |
$2,549.93 |
$2,549.93 |
16.1× |
| CT chest with contrast (71260) |
$1,534.13 |
$1,534.13 |
9.7× |
| CT head/brain with contrast (70460) |
$850 |
$850 |
5.4× |
| CT head/brain without and with contrast (70470) |
$1,577.68 |
$1,577.68 |
9.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$110 |
$110 |
1.4× |
| CT iac w contrast (70481) |
$850 |
$850 |
5.4× |
| CT lower ext w/o (73700) |
$1,510.60 |
$1,510.60 |
16.0× |
| CT lower extremity w wo contrast (73702) |
$900 |
$900 |
5.7× |
| CT lower extremity with contrast (73701) |
$850 |
$850 |
5.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,004.59 |
$2,004.59 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$1,776.29 |
$1,776.29 |
18.8× |
| CT lumbar spine with contrast (72132) |
$850 |
$850 |
2.7× |
| CT maxillofacial w contrast (70487) |
$850 |
$850 |
5.4× |
| CT maxillofacial w/o contrast (70486) |
$1,403.42 |
$1,403.42 |
14.8× |
| CT maxillofacial w/wo contrast (70488) |
$900 |
$900 |
5.7× |
| CT neck soft tissue w contrast (70491) |
$1,294.65 |
$1,294.65 |
8.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,000 |
$1,000 |
6.3× |
| CT orbits w/o contrast (70480) |
$800 |
$800 |
8.5× |
| CT pelvis w & w/o contrast (72194) |
$1,745.10 |
$1,745.10 |
11.0× |
| CT pelvis w/o contrast (72192) |
$1,382.18 |
$1,382.18 |
14.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$900 |
$900 |
5.7× |
| CT soft tissue neck w/o contrast (70490) |
$800 |
$800 |
8.5× |
| CT thoracic spine w/contrast (72129) |
$850 |
$850 |
5.4× |
| CT thoracic spine w/o contrast (72128) |
$1,230.30 |
$1,230.30 |
13.0× |
| CT thoracic spine w/wo contrast (72130) |
$900 |
$900 |
5.7× |
| CT thorax w/o contrast (71250) |
$1,453.01 |
$1,453.01 |
15.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$900 |
$900 |
5.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,341.05 |
$1,341.05 |
14.2× |
| CT upper extremity with contrast (73201) |
$850 |
$850 |
2.7× |
| Cta Abdomen (74175) |
$460 |
$460 |
2.9× |
| CTA abdomen pelvis (74174) |
$1,534.13 |
$1,534.13 |
4.9× |
| CTA chest (71275) |
$1,534.13 |
$1,534.13 |
9.7× |
| Cta Head (70496) |
$460 |
$460 |
2.9× |
| CTA lwr ext w&w/o contrast (73706) |
$630 |
$630 |
4.0× |
| Cta Neck (70498) |
$460 |
$460 |
2.9× |
| Cystography minimum 3 views rs&i (74430) |
$290.40 |
$290.40 |
0.9× |
| Esophagus (74220) |
$343.20 |
$343.20 |
2.2× |
| Fluoroscopy up to 1 hr (76000) |
$337.32 |
$337.32 |
1.6× |
| Foot 2 views (73620) |
$240.98 |
$240.98 |
3.1× |
| Forearm 2 views (73090) |
$201.93 |
$201.93 |
2.6× |
| Gated Heart Planar Single (78472) |
$437 |
$437 |
1.2× |
| Hand 2 views (73120) |
$229.14 |
$229.14 |
2.4× |
| Hand 3 views (73130) |
$212.37 |
$212.37 |
2.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$400 |
$400 |
0.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,184 |
$1,184 |
3.3× |
| Humerus Min 2 Views Left (73060) |
$196.79 |
$196.79 |
2.5× |
| Kidney imaging morphology (78700) |
$340 |
$340 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$933 |
$933 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,186 |
$1,186 |
2.4× |
| Knee 3 views (73562) |
$158.40 |
$158.40 |
2.0× |
| Liver & spleen imaging static only (78215) |
$411 |
$411 |
1.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$4,000 |
$4,000 |
1.4× |
| MRA head w & w/o contrast (70546) |
$2,626.80 |
$2,626.80 |
8.3× |
| MRA head w/o contrast (70544) |
$2,164.80 |
$2,164.80 |
10.0× |
| MRA head with contrast (70545) |
$2,389.20 |
$2,389.20 |
7.6× |
| MRA neck w contrast (70548) |
$2,172 |
$2,172 |
6.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,626.80 |
$2,626.80 |
8.3× |
| MRA neck w/o contrast (70547) |
$2,164.80 |
$2,164.80 |
10.0× |
| MRI abdomen w contrast (74182) |
$2,172 |
$2,172 |
6.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,388 |
$2,388 |
7.6× |
| MRI abdomen w/o contrast (74181) |
$1,968 |
$1,968 |
9.1× |
| MRI any jnt lwr ext with con lt (73722) |
$2,172 |
$2,172 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,112 |
$2,112 |
3.0× |
| MRI c-spine with contrast (72142) |
$2,172 |
$2,172 |
6.9× |
| MRI cervical spine w/o contrast (72141) |
$1,968 |
$1,968 |
9.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,388 |
$2,388 |
7.6× |
| MRI chest w/o contrast (71550) |
$1,968 |
$1,968 |
9.1× |
| MRI chest with contrast (71551) |
$2,172 |
$2,172 |
3.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,172 |
$2,172 |
6.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,172 |
$2,172 |
6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,968 |
$1,968 |
9.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,782.40 |
$1,782.40 |
8.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,626.80 |
$2,626.80 |
8.3× |
| MRI orbit/face/neck w/contrast (70542) |
$2,389.20 |
$2,389.20 |
7.6× |
| MRI pelvis w contrast (72196) |
$2,172 |
$2,172 |
6.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,388 |
$2,388 |
7.6× |
| MRI pelvis w/o contrast (72195) |
$1,968 |
$1,968 |
9.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,388 |
$2,388 |
7.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,388 |
$2,388 |
7.6× |
| MRI spectroscopy (76390) |
$2,388 |
$2,388 |
30.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,388 |
$2,388 |
7.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,172 |
$2,172 |
6.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,388 |
$2,388 |
7.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,172 |
$2,172 |
6.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,388 |
$2,388 |
7.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,968 |
$1,968 |
9.1× |
| MRI tmj (70336) |
$2,164.80 |
$2,164.80 |
10.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,968 |
$1,968 |
9.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,388 |
$2,388 |
7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,968 |
$1,968 |
9.1× |
| Myocardial Spect Multiple Studies (78452) |
$1,500 |
$1,500 |
1.3× |
| Neck soft tissue (70360) |
$195.35 |
$195.35 |
2.5× |
| Nm gastric emptying study (78264) |
$1,030 |
$1,030 |
2.8× |
| Nuclear medicine of heart pumping function (78473) |
$1,656 |
$1,656 |
4.6× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$622 |
$622 |
1.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$340 |
$340 |
0.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$158.40 |
$158.40 |
1.7× |
| Osseous survey limited (77074) |
$303.60 |
$303.60 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$193.41 |
$193.41 |
2.0× |
| Pr heart first pass single,planar (78481) |
$413 |
$413 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,388 |
$2,388 |
7.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$231 |
$231 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$311.62 |
$311.62 |
3.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$264 |
$264 |
2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$284.40 |
$284.40 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$208.98 |
$208.98 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$171.60 |
$171.60 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$203.47 |
$203.47 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$437.58 |
$437.58 |
2.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$432.72 |
$432.72 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$561.15 |
$561.15 |
3.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$210.19 |
$210.19 |
2.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$171.60 |
$171.60 |
2.2× |
| Ribs bilateral 3 views (71110) |
$198 |
$198 |
2.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$528 |
$528 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$145.20 |
$145.20 |
1.5× |
| Scapula complete (73010) |
$145.20 |
$145.20 |
1.5× |
| Screening digital breast tomosynthesis (77063) |
$20 |
$20 |
0.9× |
| Sella turcica (70240) |
$145.20 |
$145.20 |
1.8× |
| Sialogram (70390) |
$382.80 |
$382.80 |
1.8× |
| Small bowel series (74250) |
$277.20 |
$277.20 |
1.7× |
| Speech evaluation complex (70371) |
$198 |
$198 |
0.9× |
| Spine thoracic 3 views (72072) |
$295.25 |
$295.25 |
3.1× |
| Therapeutic Enema (74283) |
$462 |
$462 |
2.9× |
| Thoracolumbar 2 views (72080) |
$298.58 |
$298.58 |
3.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$783 |
$783 |
2.2× |
| Thyroid uptake measurement (78012) |
$783 |
$783 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$400 |
$400 |
1.1× |
| Tmj unilateral (70328) |
$158.40 |
$158.40 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$534.80 |
$534.80 |
5.6× |
| Unlisted Ultrasound Procedure (76999) |
$250.80 |
$250.80 |
3.2× |
| Upper Extremity Infant (73092) |
$118.80 |
$118.80 |
1.3× |
| Urethrocystography voiding (74455) |
$303.60 |
$303.60 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$462 |
$462 |
2.9× |
| Us abdl aorta screen aaa (76706) |
$422.40 |
$422.40 |
4.5× |
| Us breast unilateral complete (76641) |
$365 |
$365 |
3.9× |
| Us breast unilateral limited (76642) |
$320 |
$320 |
4.1× |
| Us elastography parenchyma (76981) |
$534.80 |
$534.80 |
5.6× |
| Us ob transvaginal (76817) |
$385 |
$385 |
4.1× |
| Us pelvic non ob complete (76856) |
$500.63 |
$500.63 |
5.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$171.60 |
$171.60 |
1.8× |
| Us pregnancy ltd (76815) |
$158.40 |
$158.40 |
1.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$440 |
$440 |
4.6× |
| Us retroperitoneal complete (76770) |
$290.40 |
$290.40 |
3.1× |
| Us scrotum and contents (76870) |
$527.49 |
$527.49 |
5.6× |
| Us soft tissue head/neck (76536) |
$394.29 |
$394.29 |
4.2× |
| Us xtr non-vasc lmtd (76882) |
$158.40 |
$158.40 |
1.7× |
| Venography extremity unilateral rs&i (75820) |
$602 |
$602 |
0.4× |
| Wrist 2 views (73100) |
$220.88 |
$220.88 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$356.96 |
$356.96 |
3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$211.20 |
$211.20 |
2.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$215.60 |
$215.60 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$336.60 |
$336.60 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$200.43 |
$200.43 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$205.12 |
$205.12 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$118.80 |
$118.80 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$188.17 |
$188.17 |
2.4× |
| X-ray exam of femur 1 (73551) |
$210.19 |
$210.19 |
2.7× |
| X-ray eye for foreign body (70030) |
$145.20 |
$145.20 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$356.90 |
$356.90 |
3.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$158.40 |
$158.40 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$225.05 |
$225.05 |
2.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$118.80 |
$118.80 |
1.5× |
| X-ray IV pyelogram+drip infusn (74410) |
$336 |
$336 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$145.20 |
$145.20 |
1.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$275.21 |
$275.21 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$118.80 |
$118.80 |
1.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$158.40 |
$158.40 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$280.04 |
$280.04 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$330 |
$330 |
3.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$145.20 |
$145.20 |
1.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$92.40 |
$92.40 |
1.2× |
| X-ray of voice box or throat (70370) |
$237.60 |
$237.60 |
3.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$237.60 |
$237.60 |
2.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$198 |
$198 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$245.30 |
$245.30 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$270.13 |
$270.13 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$303.60 |
$303.60 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$198 |
$198 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$196.73 |
$196.73 |
2.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$236.55 |
$236.55 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$291.94 |
$291.94 |
3.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$118.80 |
$118.80 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$237.60 |
$237.60 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$132 |
$132 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$164.86 |
$164.86 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$158.40 |
$158.40 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$237.60 |
$237.60 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$262.40 |
$262.40 |
2.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$303.60 |
$303.60 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$209.67 |
$209.67 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$208.86 |
$208.86 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$413.46 |
$413.46 |
4.4× |
| Xr chest 4+ views (71048) |
$264 |
$264 |
2.8× |
| Xr Cholecystography Oral Contrast (74290) |
$237.60 |
$237.60 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$183.65 |
$183.65 |
2.3× |
| Xr internal auditory meati complete (70134) |
$211.20 |
$211.20 |
0.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$158.40 |
$158.40 |
1.7× |
| Xr shoulder 1 view (73020) |
$105.60 |
$105.60 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$463.07 |
$463.07 |
4.9× |
| Xr tibia/fibula 2 views (73590) |
$210.38 |
$210.38 |
2.7× |
| Xr tmj bilateral (70330) |
$303.60 |
$303.60 |
3.9× |
| Xray knee 1 or 2 views rt (73560) |
$213.84 |
$213.84 |
2.7× |