| Abdomen 2 views (74019) |
$114.89 |
$229.77 |
1.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$487.50 |
$975 |
1.4× |
| Ankle 2 views (73600) |
$54.08 |
$108.15 |
0.7× |
| Arthrogram hip (73525) |
$171.27 |
$342.54 |
0.6× |
| Arthrogram shoulder (73040) |
$180.50 |
$361 |
0.6× |
| Arthrography knee lt (73580) |
$203.33 |
$406.65 |
0.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$400 |
$800 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$585 |
$1,170 |
1.7× |
| Bone age studies (77072) |
$148.90 |
$297.80 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$605 |
$1,210 |
1.7× |
| Bone survey complete (77075) |
$187.46 |
$374.92 |
2.0× |
| Cervical spine 2 or 3 views (72040) |
$78.10 |
$156.19 |
1.0× |
| Chest 1 view (71045) |
$69.70 |
$139.40 |
0.9× |
| Chest 3 views (71047) |
$80.34 |
$160.68 |
1.1× |
| Clavicle complete (73000) |
$57.31 |
$114.62 |
0.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$145.86 |
$291.72 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,718 |
$3,435.98 |
5.6× |
| CT abdomen and pelvis without contrast (74176) |
$854.82 |
$1,709.64 |
4.1× |
| CT abdomen w contrast (74160) |
$589.16 |
$1,178.32 |
3.8× |
| CT abdomen w wo contrast (74170) |
$776.62 |
$1,553.24 |
5.1× |
| CT abdomen w/o contrast (74150) |
$535.60 |
$1,071.20 |
5.8× |
| CT angiography upper extremity lt (73206) |
$845 |
$1,690 |
5.5× |
| CT c-spine w/o contrast (72125) |
$746.76 |
$1,493.52 |
8.2× |
| CT cervical spine with contrast (72126) |
$629.91 |
$1,259.82 |
2.1× |
| CT chest w/wo contrast (71270) |
$696.28 |
$1,392.56 |
4.5× |
| CT chest with contrast (71260) |
$880.80 |
$1,761.59 |
5.7× |
| CT head/brain with contrast (70460) |
$508.82 |
$1,017.64 |
3.3× |
| CT head/brain without and with contrast (70470) |
$589.16 |
$1,178.32 |
3.8× |
| CT iac w contrast (70481) |
$589.16 |
$1,178.32 |
3.8× |
| CT lower ext w/o (73700) |
$374.92 |
$749.84 |
4.1× |
| CT lower extremity w wo contrast (73702) |
$482.04 |
$964.08 |
3.1× |
| CT lower extremity with contrast (73701) |
$428.48 |
$856.96 |
2.8× |
| CT lumbar spine w/o contrast (72131) |
$727.62 |
$1,455.23 |
7.9× |
| CT lumbar spine with contrast (72132) |
$617.55 |
$1,235.10 |
2.0× |
| CT maxillofacial w contrast (70487) |
$535.60 |
$1,071.20 |
3.5× |
| CT maxillofacial w/o contrast (70486) |
$438.34 |
$876.68 |
4.8× |
| CT maxillofacial w/wo contrast (70488) |
$642.72 |
$1,285.44 |
4.2× |
| CT neck soft tissue w contrast (70491) |
$447.76 |
$895.52 |
2.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$656.62 |
$1,313.25 |
4.3× |
| CT orbits w/o contrast (70480) |
$488.53 |
$977.06 |
5.3× |
| CT pelvis w & w/o contrast (72194) |
$637.37 |
$1,274.73 |
4.1× |
| CT pelvis w/o contrast (72192) |
$455.26 |
$910.52 |
5.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$669.50 |
$1,339 |
4.4× |
| CT soft tissue neck w/o contrast (70490) |
$482.04 |
$964.08 |
5.3× |
| CT thoracic spine w/contrast (72129) |
$624.08 |
$1,248.16 |
4.1× |
| CT thoracic spine w/o contrast (72128) |
$765.91 |
$1,531.82 |
8.4× |
| CT thoracic spine w/wo contrast (72130) |
$723.23 |
$1,446.46 |
4.7× |
| CT thorax w/o contrast (71250) |
$535.60 |
$1,071.20 |
5.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$482.04 |
$964.08 |
3.1× |
| CT upper extremity w/o contrast rt (73200) |
$374.92 |
$749.84 |
4.1× |
| CT upper extremity with contrast (73201) |
$428.48 |
$856.96 |
1.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,088.84 |
$4,177.68 |
13.6× |
| Cta Abdomen (74175) |
$1,277.72 |
$2,555.43 |
8.3× |
| CTA abdomen pelvis (74174) |
$1,813.56 |
$3,627.11 |
5.9× |
| CTA chest (71275) |
$1,377.11 |
$2,754.22 |
9.0× |
| Cta Head (70496) |
$977.47 |
$1,954.94 |
6.4× |
| Cta Neck (70498) |
$1,071.20 |
$2,142.40 |
7.0× |
| Cta Pelvis (72191) |
$1,071.20 |
$2,142.40 |
7.0× |
| Cystography minimum 3 views rs&i (74430) |
$147.83 |
$295.66 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$147.29 |
$294.58 |
1.6× |
| Esophagus (74220) |
$196.81 |
$393.62 |
1.3× |
| Fluoroscopy up to 1 hr (76000) |
$133.90 |
$267.80 |
0.6× |
| Foot 2 views (73620) |
$53.05 |
$106.09 |
0.7× |
| Forearm 2 views (73090) |
$48.74 |
$97.48 |
0.6× |
| Hand 2 views (73120) |
$53.09 |
$106.17 |
0.6× |
| Hand 3 views (73130) |
$43.44 |
$86.88 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$547.50 |
$1,095 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$515 |
$1,030 |
1.5× |
| Ht muscle image spect sing (78451) |
$535 |
$1,070 |
0.5× |
| Humerus Min 2 Views Left (73060) |
$53.56 |
$107.12 |
0.7× |
| Hysterosalpingogram (74740) |
$228.17 |
$456.34 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$580 |
$1,160 |
1.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$578.75 |
$1,157.50 |
1.2× |
| Knee 3 views (73562) |
$62.58 |
$125.14 |
0.8× |
| Lymphoscintigraphy (78195) |
$500 |
$1,000 |
1.1× |
| Meckels Diverticulum (78290) |
$410 |
$820 |
1.2× |
| MRA head w/o contrast (70544) |
$940.23 |
$1,880.46 |
4.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,326.37 |
$2,652.74 |
4.3× |
| MRA neck w/o contrast (70547) |
$940.23 |
$1,880.46 |
4.5× |
| MRI abdomen w contrast (74182) |
$1,305.90 |
$2,611.79 |
4.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,500.98 |
$3,001.94 |
4.9× |
| MRI abdomen w/o contrast (74181) |
$1,135.09 |
$2,270.18 |
5.4× |
| MRI c-spine with contrast (72142) |
$1,453.32 |
$2,906.63 |
4.8× |
| MRI cervical spine w/o contrast (72141) |
$1,453.32 |
$2,906.63 |
7.0× |
| MRI chest w/o & w/contrast material (71552) |
$1,779.92 |
$3,559.84 |
5.8× |
| MRI chest w/o contrast (71550) |
$1,289.76 |
$2,579.52 |
6.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$700 |
$1,400 |
2.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$826.87 |
$1,653.74 |
4.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,161.07 |
$2,322.13 |
5.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,536.63 |
$3,073.26 |
5.0× |
| MRI pelvis w contrast (72196) |
$1,196.16 |
$2,392.31 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,435.15 |
$2,870.29 |
4.7× |
| MRI pelvis w/o contrast (72195) |
$1,039.71 |
$2,079.42 |
5.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,044.12 |
$2,088.23 |
3.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,113.59 |
$2,227.17 |
3.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,403.12 |
$2,806.23 |
4.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,453.62 |
$2,907.24 |
4.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,530 |
$3,059.99 |
5.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,108.70 |
$2,217.39 |
5.3× |
| MRI tmj (70336) |
$730.73 |
$1,461.45 |
3.5× |
| MRI upper ext joint w/o contrast (73221) |
$809.85 |
$1,619.70 |
3.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$996.59 |
$1,993.18 |
3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$705.67 |
$1,411.34 |
3.4× |
| Myelogram Lumbar (72265) |
$423.93 |
$847.85 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,894.75 |
$3,789.50 |
1.7× |
| Neck soft tissue (70360) |
$50.89 |
$101.77 |
0.7× |
| Nm gastric emptying study (78264) |
$512.50 |
$1,025 |
1.5× |
| Parathyrd planar w/wo subtrj (78071) |
$500 |
$1,000 |
1.4× |
| Parathyroid imaging (78070) |
$400 |
$800 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$64.28 |
$128.55 |
0.7× |
| Pr heart first pass single,planar (78481) |
$337.50 |
$675 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,140.98 |
$2,281.96 |
3.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$405 |
$810 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$512.50 |
$1,025 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$239 |
$478 |
0.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$128.55 |
$257.09 |
1.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$101.77 |
$203.53 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$83.02 |
$166.04 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$43.44 |
$86.88 |
0.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$80.43 |
$160.85 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$182.11 |
$364.22 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$160.68 |
$321.36 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$150 |
$300 |
1.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$53 |
$106 |
0.7× |
| Radiological examination surgical specimen (76098) |
$53.56 |
$107.12 |
0.1× |
| Scanogram (77073) |
$85.70 |
$171.40 |
0.9× |
| Scapula complete (73010) |
$58.92 |
$117.84 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$107.25 |
$214.50 |
4.6× |
| Small bowel series (74250) |
$214.24 |
$428.48 |
1.4× |
| Spine thoracic 3 views (72072) |
$111.83 |
$223.65 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$375 |
$750 |
1.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$775 |
$1,550 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$155.33 |
$310.65 |
1.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$20 |
$40 |
0.3× |
| Unlisted Ultrasound Procedure (76999) |
$132.50 |
$265 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$227.63 |
$455.26 |
1.1× |
| Urethrocystography voiding (74455) |
$160.68 |
$321.36 |
0.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$195.50 |
$390.99 |
1.3× |
| Us abdl aorta screen aaa (76706) |
$187.50 |
$375 |
2.0× |
| Us breast unilateral complete (76641) |
$126 |
$252 |
1.4× |
| Us breast unilateral limited (76642) |
$200.20 |
$400.40 |
2.6× |
| Us chest (76604) |
$166.04 |
$332.08 |
1.8× |
| Us kidney transplant (76776) |
$199.25 |
$398.49 |
2.2× |
| Us ob transvaginal (76817) |
$169.25 |
$338.50 |
1.8× |
| Us pelvic non ob complete (76856) |
$201.74 |
$403.48 |
2.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$160.68 |
$321.36 |
1.8× |
| Us pregnancy ltd (76815) |
$129.62 |
$259.24 |
1.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$160.68 |
$321.36 |
1.8× |
| Us retroperitoneal complete (76770) |
$187.46 |
$374.92 |
2.0× |
| Us retroperitoneal limited (76775) |
$241.56 |
$483.11 |
2.6× |
| Us scrotum and contents (76870) |
$160.68 |
$321.36 |
1.8× |
| Us soft tissue head/neck (76536) |
$169.20 |
$338.40 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$144.08 |
$288.16 |
1.6× |
| Venogram extremity bilateral (75822) |
$329.40 |
$658.79 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$214.24 |
$428.48 |
0.2× |
| Wrist 2 views (73100) |
$54.08 |
$108.15 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$126.41 |
$252.81 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$57.31 |
$114.62 |
0.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$43.44 |
$86.88 |
0.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$230.31 |
$460.62 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$56.65 |
$113.30 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$65.08 |
$130.15 |
0.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$87.50 |
$175 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$91.92 |
$183.83 |
1.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$147.29 |
$294.58 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$78.20 |
$156.40 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$58.10 |
$116.20 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$45 |
$89.99 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$77.67 |
$155.33 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$78.10 |
$156.19 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$107.12 |
$214.24 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$48.21 |
$96.41 |
0.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$56.24 |
$112.48 |
0.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$99.09 |
$198.18 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$157.13 |
$314.25 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$87.12 |
$174.24 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$109.80 |
$219.60 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$80.34 |
$160.68 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$70.17 |
$140.33 |
0.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$88.08 |
$176.16 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$99.09 |
$198.18 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$57.87 |
$115.73 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$99.09 |
$198.18 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$50.89 |
$101.77 |
0.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$48.21 |
$96.41 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$49.28 |
$98.56 |
0.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$64.81 |
$129.62 |
0.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$40.17 |
$80.34 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$89.11 |
$178.22 |
1.2× |
| Xr arthrogram ankle (73615) |
$168.53 |
$337.05 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$103.38 |
$206.75 |
1.1× |
| Xr finger(s) 2+ views (73140) |
$37.50 |
$74.99 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$139.40 |
$278.79 |
1.5× |
| Xr tibia/fibula 2 views (73590) |
$58.10 |
$116.20 |
0.8× |
| Xr tmj bilateral (70330) |
$96.41 |
$192.82 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$68.94 |
$137.87 |
0.9× |