| Abdomen 2 views (74019) |
$320.15 |
$337 |
2.9× |
| Ankle 2 views (73600) |
$461.70 |
$486 |
5.1× |
| Arthrogram elbow (73085) |
$888.25 |
$935 |
2.5× |
| Arthrogram hip (73525) |
$1,081.10 |
$1,138 |
3.0× |
| Arthrogram shoulder (73040) |
$1,014.60 |
$1,068 |
2.8× |
| Arthrogram wrist (73115) |
$601.35 |
$633 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$885.40 |
$932 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,436.40 |
$1,512 |
3.5× |
| Bone &/joint imaging whole body (78306) |
$1,748.95 |
$1,841 |
4.2× |
| Bone age studies (77072) |
$205.20 |
$216 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,842.05 |
$1,939 |
4.4× |
| Bone survey complete (77075) |
$827.45 |
$871 |
7.6× |
| Cervical spine 2 or 3 views (72040) |
$318.25 |
$335 |
3.5× |
| Chest 1 view (71045) |
$156.75 |
$165 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,481.05 |
$1,559 |
8.1× |
| Clavicle complete (73000) |
$281.20 |
$296 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$237.50 |
$250 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,148.05 |
$5,419 |
14.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,580.20 |
$2,716 |
10.4× |
| CT abdomen w contrast (74160) |
$3,404.80 |
$3,584 |
18.7× |
| CT abdomen w wo contrast (74170) |
$3,880.75 |
$4,085 |
21.3× |
| CT abdomen w/o contrast (74150) |
$1,881.95 |
$1,981 |
17.3× |
| CT c-spine w/o contrast (72125) |
$2,643.85 |
$2,783 |
24.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,603.95 |
$2,741 |
14.3× |
| CT cervical spine with contrast (72126) |
$3,197.70 |
$3,366 |
8.8× |
| CT chest w/wo contrast (71270) |
$3,319.30 |
$3,494 |
18.2× |
| CT chest with contrast (71260) |
$2,835.75 |
$2,985 |
15.6× |
| CT head/brain with contrast (70460) |
$1,992.15 |
$2,097 |
10.9× |
| CT head/brain without and with contrast (70470) |
$2,700.85 |
$2,843 |
14.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,498.15 |
$1,577 |
16.6× |
| CT iac w contrast (70481) |
$2,150.80 |
$2,264 |
11.8× |
| CT lower ext w/o (73700) |
$2,738.85 |
$2,883 |
25.2× |
| CT lower extremity w wo contrast (73702) |
$2,304.70 |
$2,426 |
12.7× |
| CT lower extremity with contrast (73701) |
$2,206.85 |
$2,323 |
12.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,241.05 |
$2,359 |
12.3× |
| CT lumbar spine w/o contrast (72131) |
$2,639.10 |
$2,778 |
24.3× |
| CT lumbar spine with contrast (72132) |
$3,364.90 |
$3,542 |
9.3× |
| CT maxillofacial w contrast (70487) |
$2,304.70 |
$2,426 |
12.7× |
| CT maxillofacial w/o contrast (70486) |
$2,152.70 |
$2,266 |
19.8× |
| CT maxillofacial w/wo contrast (70488) |
$2,694.20 |
$2,836 |
14.8× |
| CT neck soft tissue w contrast (70491) |
$2,829.10 |
$2,978 |
15.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,268.60 |
$2,388 |
12.5× |
| CT orbits w/o contrast (70480) |
$2,252.45 |
$2,371 |
20.7× |
| CT pelvis w & w/o contrast (72194) |
$2,314.20 |
$2,436 |
12.7× |
| CT pelvis w/o contrast (72192) |
$1,910.45 |
$2,011 |
17.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,292.70 |
$3,466 |
18.1× |
| CT soft tissue neck w/o contrast (70490) |
$2,288.55 |
$2,409 |
21.1× |
| CT thoracic spine w/contrast (72129) |
$2,337 |
$2,460 |
12.8× |
| CT thoracic spine w/o contrast (72128) |
$2,654.30 |
$2,794 |
24.5× |
| CT thoracic spine w/wo contrast (72130) |
$3,188.20 |
$3,356 |
17.5× |
| CT thorax w/o contrast (71250) |
$2,184.05 |
$2,299 |
20.1× |
| CT unlisted procedure (76497) |
$1,538.05 |
$1,619 |
17.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,130.85 |
$2,243 |
11.7× |
| CT upper extremity w/o contrast rt (73200) |
$2,632.45 |
$2,771 |
24.2× |
| CT upper extremity with contrast (73201) |
$2,071.95 |
$2,181 |
5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$6,158.85 |
$6,483 |
33.8× |
| Cta Abdomen (74175) |
$4,327.25 |
$4,555 |
23.8× |
| CTA abdomen pelvis (74174) |
$4,881.10 |
$5,138 |
13.5× |
| CTA chest (71275) |
$4,213.25 |
$4,435 |
23.1× |
| Cta Head (70496) |
$4,101.15 |
$4,317 |
22.5× |
| CTA lwr ext w&w/o contrast (73706) |
$4,872.55 |
$5,129 |
26.8× |
| Cta Neck (70498) |
$4,126.80 |
$4,344 |
22.7× |
| Cta Pelvis (72191) |
$4,140.10 |
$4,358 |
22.7× |
| Cystography minimum 3 views rs&i (74430) |
$462.65 |
$487 |
1.3× |
| Esophagus (74220) |
$950.95 |
$1,001 |
5.2× |
| Fetal biophysical profile non-stress testing (76818) |
$641.25 |
$675 |
5.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$345.80 |
$364 |
3.2× |
| Fluoroscopy up to 1 hr (76000) |
$577.60 |
$608 |
2.3× |
| Foot 2 views (73620) |
$399 |
$420 |
4.4× |
| Forearm 2 views (73090) |
$251.75 |
$265 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,113.40 |
$1,172 |
2.7× |
| Hand 2 views (73120) |
$430.35 |
$453 |
4.0× |
| Hand 3 views (73130) |
$501.60 |
$528 |
5.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,339.85 |
$2,463 |
5.6× |
| Humerus Min 2 Views Left (73060) |
$298.30 |
$314 |
3.3× |
| Hysterosalpingogram (74740) |
$706.80 |
$744 |
2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,143.80 |
$1,204 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$765.70 |
$806 |
1.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,489.60 |
$1,568 |
2.6× |
| Knee 3 views (73562) |
$571.42 |
$601.50 |
6.3× |
| Liver & spleen imaging static only (78215) |
$1,328.10 |
$1,398 |
3.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$701.10 |
$738 |
7.8× |
| Meckels Diverticulum (78290) |
$1,106.75 |
$1,165 |
2.7× |
| MRA head w & w/o contrast (70546) |
$4,724.35 |
$4,973 |
13.0× |
| MRA head w/o contrast (70544) |
$3,638.50 |
$3,830 |
14.7× |
| MRA neck w contrast (70548) |
$3,265.15 |
$3,437 |
9.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,667.70 |
$5,966 |
15.6× |
| MRA neck w/o contrast (70547) |
$2,774.95 |
$2,921 |
11.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,353.85 |
$4,583 |
12.0× |
| MRI abdomen w/o contrast (74181) |
$3,285.10 |
$3,458 |
13.3× |
| MRI any jnt lwr ext with con lt (73722) |
$4,116.35 |
$4,333 |
5.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,131.55 |
$4,349 |
5.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,103.90 |
$1,162 |
4.5× |
| MRI breast w/o contrast unilat (77046) |
$1,075.40 |
$1,132 |
4.3× |
| MRI c-spine with contrast (72142) |
$3,098.90 |
$3,262 |
8.6× |
| MRI cervical spine w/o contrast (72141) |
$2,141.30 |
$2,254 |
8.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,932.65 |
$3,087 |
8.1× |
| MRI chest w/o contrast (71550) |
$2,766.40 |
$2,912 |
11.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,465.60 |
$3,648 |
14.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,554.90 |
$3,742 |
14.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,053.65 |
$4,267 |
11.2× |
| MRI pelvis w contrast (72196) |
$2,932.65 |
$3,087 |
8.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,297.80 |
$4,524 |
11.9× |
| MRI pelvis w/o contrast (72195) |
$3,406.70 |
$3,586 |
13.8× |
| MRI scan of arm joint before and after contrast (73223) |
$3,241.40 |
$3,412 |
8.9× |
| MRI scan of leg joint before and after contrast (73723) |
$5,029.30 |
$5,294 |
13.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,824.70 |
$4,026 |
10.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,098.90 |
$3,262 |
8.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,807.60 |
$4,008 |
10.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,098.90 |
$3,262 |
8.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,833.25 |
$4,035 |
10.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,145.10 |
$2,258 |
8.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,432 |
$2,560 |
9.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,911.75 |
$3,065 |
8.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,290.45 |
$2,411 |
9.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,626.75 |
$2,765 |
2.0× |
| Neck soft tissue (70360) |
$350.55 |
$369 |
3.9× |
| Nm gastric emptying study (78264) |
$2,861.40 |
$3,012 |
6.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$681.15 |
$717 |
6.3× |
| Osseous survey infant (77076) |
$485.45 |
$511 |
4.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,838.25 |
$1,935 |
4.4× |
| Pelvis 1 or 2 views (72170) |
$330.60 |
$348 |
3.0× |
| PET image w/CT, skull-thigh (78815) |
$6,247.20 |
$6,576 |
4.2× |
| PET imaging for CT attenuation whole body (78816) |
$6,005.90 |
$6,322 |
4.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,731.25 |
$2,875 |
7.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,982.65 |
$2,087 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$391.40 |
$412 |
3.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$343.90 |
$362 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$256.50 |
$270 |
2.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$275.50 |
$290 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$1,607.40 |
$1,692 |
8.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,021.25 |
$1,075 |
5.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,261.60 |
$1,328 |
6.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,070.65 |
$1,127 |
5.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$380 |
$400 |
4.2× |
| Radiological examination surgical specimen (76098) |
$748.60 |
$788 |
1.3× |
| Ribs bilateral 3 views (71110) |
$343.90 |
$362 |
3.2× |
| Sacroiliac Joints < 3 Views (72200) |
$342.95 |
$361 |
3.2× |
| Scapula complete (73010) |
$355.30 |
$374 |
3.3× |
| Screening digital breast tomosynthesis (77063) |
$90.25 |
$95 |
3.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$574.75 |
$605 |
5.3× |
| Small bowel series (74250) |
$1,095.35 |
$1,153 |
6.0× |
| Thoracolumbar 2 views (72080) |
$312.55 |
$329 |
3.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$664.05 |
$699 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$931.95 |
$981 |
8.6× |
| Unlisted Ultrasound Procedure (76999) |
$489.25 |
$515 |
5.4× |
| Urethrocystography voiding (74455) |
$581.40 |
$612 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$625.10 |
$658 |
5.8× |
| Us breast unilateral complete (76641) |
$672.60 |
$708 |
6.2× |
| Us breast unilateral limited (76642) |
$661.20 |
$696 |
7.3× |
| Us chest (76604) |
$510.15 |
$537 |
4.7× |
| Us compl joint r-t w/image documentation (76881) |
$115.90 |
$122 |
1.1× |
| Us infant hips dynamic (76885) |
$449.35 |
$473 |
5.0× |
| Us kidney transplant (76776) |
$437 |
$460 |
4.0× |
| Us ob transvaginal (76817) |
$612.75 |
$645 |
5.6× |
| Us pelvic non ob complete (76856) |
$855 |
$900 |
7.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$485.45 |
$511 |
4.5× |
| Us pregnancy ltd (76815) |
$608.95 |
$641 |
5.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$993.70 |
$1,046 |
9.2× |
| Us retroperitoneal complete (76770) |
$711.55 |
$749 |
6.6× |
| Us retroperitoneal limited (76775) |
$281.20 |
$296 |
2.6× |
| Us scrotum and contents (76870) |
$766.65 |
$807 |
7.1× |
| Us soft tissue head/neck (76536) |
$837.90 |
$882 |
7.7× |
| Us transrectal (76872) |
$564.30 |
$594 |
5.2× |
| Us xtr non-vasc lmtd (76882) |
$714.40 |
$752 |
6.6× |
| Wrist 2 views (73100) |
$494.48 |
$520.50 |
5.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$463.60 |
$488 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$268.85 |
$283 |
3.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$494.48 |
$520.50 |
5.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,387.35 |
$2,513 |
13.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$416.10 |
$438 |
4.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$329.65 |
$347 |
3.6× |
| X-ray exam hip uni 1 view (73501) |
$309.70 |
$326 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$455.05 |
$479 |
5.0× |
| X-ray eye for foreign body (70030) |
$218.50 |
$230 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$400.90 |
$422 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$456 |
$480 |
5.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$277.40 |
$292 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$618.45 |
$651 |
5.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$343.90 |
$362 |
3.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$643.15 |
$677 |
5.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$415.15 |
$437 |
3.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$329.65 |
$347 |
3.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$379.05 |
$399 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$436.05 |
$459 |
4.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,352.80 |
$1,424 |
3.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$318.25 |
$335 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$354.35 |
$373 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$292.60 |
$308 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$298.30 |
$314 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$325.85 |
$343 |
3.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$211.85 |
$223 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$243.20 |
$256 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$197.60 |
$208 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$292.60 |
$308 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$281.20 |
$296 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$329.65 |
$347 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$310.65 |
$327 |
3.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$380.95 |
$401 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$602.30 |
$634 |
5.5× |
| Xr finger(s) 2+ views (73140) |
$364.80 |
$384 |
4.0× |
| Xr shoulder 1 view (73020) |
$334.88 |
$352.50 |
3.7× |
| Xr spine cervical 4 or 5 views (72050) |
$436.05 |
$459 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$437.48 |
$460.50 |
4.8× |
| Xray knee 1 or 2 views rt (73560) |
$329.65 |
$347 |
3.6× |