| Abdomen 1 View (74018) |
$334 |
$334 |
4.0× |
| Abdomen 2 views (74019) |
$383 |
$383 |
3.8× |
| Ankle 2 views (73600) |
$279 |
$279 |
3.3× |
| Bone age studies (77072) |
$284 |
$284 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,861 |
$1,861 |
4.8× |
| Bone Imaging Whole Body (78306) |
$1,861 |
$1,861 |
4.8× |
| Bone survey infant (77076) |
$459 |
$459 |
4.6× |
| Chest 1 view (71045) |
$306 |
$306 |
3.7× |
| Chest 2 views (71046) |
$389 |
$389 |
4.6× |
| Clavicle complete (73000) |
$314 |
$314 |
3.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$528 |
$528 |
5.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,194 |
$5,194 |
15.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,492 |
$4,492 |
19.6× |
| CT abdomen w contrast (74160) |
$2,581 |
$2,581 |
15.3× |
| CT abdomen w wo contrast (74170) |
$2,651 |
$2,651 |
15.7× |
| CT abdomen w/o contrast (74150) |
$2,581 |
$2,581 |
25.7× |
| CT Angio Abdomen and Pelvis (74174) |
$4,129 |
$4,129 |
12.3× |
| CT Angio Chest (71275) |
$3,115 |
$3,115 |
18.5× |
| CT Angio Head (70496) |
$2,722 |
$2,722 |
16.1× |
| CT Angio Neck (70498) |
$2,819 |
$2,819 |
16.7× |
| CT cervical spine w/o contrast (72125) |
$2,528 |
$2,528 |
25.2× |
| CT chest w contrast (71260) |
$1,840 |
$1,840 |
10.9× |
| CT chest w/wo contrast (71270) |
$2,133 |
$2,133 |
12.6× |
| CT iac w contrast (70481) |
$2,581 |
$2,581 |
15.3× |
| CT lower ext w/o (73700) |
$2,247 |
$2,247 |
22.4× |
| CT lower extremity w/contrast material (73701) |
$2,247 |
$2,247 |
13.3× |
| CT lumbar spine w/o contrast (72131) |
$2,528 |
$2,528 |
25.2× |
| CT maxillofacial w contrast (70487) |
$2,457 |
$2,457 |
14.6× |
| CT maxillofacial wo contrast (70486) |
$2,457 |
$2,457 |
24.4× |
| CT orbits w/o contrast (70480) |
$2,581 |
$2,581 |
25.7× |
| CT pelvis w/o contrast (72192) |
$2,386 |
$2,386 |
23.7× |
| CT soft tissue neck w contrast (70491) |
$2,581 |
$2,581 |
15.3× |
| CT thoracic spine w/o contrast (72128) |
$2,528 |
$2,528 |
25.2× |
| CT thorax w/o contrast (71250) |
$1,840 |
$1,840 |
18.3× |
| CT upper ext wo (73200) |
$2,316 |
$2,316 |
23.0× |
| CT upper extremity with contrast (73201) |
$2,316 |
$2,316 |
6.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,441 |
$3,441 |
20.4× |
| Cta Abdomen (74175) |
$2,963 |
$2,963 |
17.6× |
| Dxa Bone Density Axial (77080) |
$651 |
$651 |
6.5× |
| Fetal Biophys Profile W/Nst (76818) |
$1,205 |
$1,205 |
12.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$947 |
$947 |
9.4× |
| Fluoroscopy up to 1 hr (76000) |
$563 |
$563 |
2.5× |
| Foot 2 views (73620) |
$304 |
$304 |
3.6× |
| Forearm 2 views (73090) |
$300 |
$300 |
3.6× |
| Gastric emptying imaging study (78264) |
$1,502 |
$1,502 |
3.9× |
| Hand 2 views (73120) |
$255 |
$255 |
2.5× |
| Hepatobil Syst Image W/Drug (78227) |
$3,489 |
$3,489 |
6.7× |
| Ht Muscle Image Spect Sing (78451) |
$3,300 |
$3,300 |
2.7× |
| Knee 3 Views (73562) |
$366 |
$366 |
4.4× |
| Lung Ventilat&Perfus Imaging (78582) |
$3,090 |
$3,090 |
5.9× |
| MRA head w/o contrast (70544) |
$3,229 |
$3,229 |
14.1× |
| MRA neck w contrast (70548) |
$3,186 |
$3,186 |
9.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,132 |
$4,132 |
12.3× |
| MRA neck w/o contrast (70547) |
$2,911 |
$2,911 |
12.7× |
| MRI abdomen w/o contrast (74181) |
$4,422 |
$4,422 |
19.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,056 |
$3,056 |
4.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,757 |
$3,757 |
11.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,056 |
$3,056 |
4.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,097 |
$3,097 |
13.5× |
| MRI cervical spine w/o cont (72141) |
$3,370 |
$3,370 |
14.7× |
| MRI chest wo w contrast (71552) |
$4,320 |
$4,320 |
12.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,056 |
$3,056 |
9.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,140 |
$4,140 |
12.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,056 |
$3,056 |
13.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,350 |
$2,350 |
7.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,249 |
$4,249 |
12.7× |
| MRI pelvis w/o & w contrast (72197) |
$4,320 |
$4,320 |
12.9× |
| MRI pelvis w/o contrast (72195) |
$3,056 |
$3,056 |
13.3× |
| MRI thoracic spine w/o contrast (72146) |
$3,370 |
$3,370 |
14.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,056 |
$3,056 |
13.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,039 |
$4,039 |
12.0× |
| MRI, abdomen, combo (74183) |
$4,844 |
$4,844 |
14.4× |
| MRI, dorsal spine combo (72157) |
$4,757 |
$4,757 |
14.2× |
| MRI, joint upper extrem (73221) |
$3,056 |
$3,056 |
13.3× |
| MRI, joint upper extrem combo (73223) |
$3,757 |
$3,757 |
11.2× |
| MRI, lumbar spine combo (72158) |
$4,444 |
$4,444 |
13.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,650 |
$3,650 |
2.9× |
| Neck soft tissue (70360) |
$325 |
$325 |
3.9× |
| Parathyroid Planar Imaging (78070) |
$2,386 |
$2,386 |
6.2× |
| Pelvis 1 or 2 views (72170) |
$338 |
$338 |
3.4× |
| PET image w/CT, full body (78816) |
$12,500 |
$12,500 |
9.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$11,582 |
$11,582 |
8.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$325 |
$325 |
3.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$317 |
$317 |
3.8× |
| Radex elbow complete minimum 3 views (73080) |
$351 |
$351 |
4.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$508 |
$508 |
5.1× |
| Radex fingr minimum 2 views (73140) |
$276 |
$276 |
3.3× |
| Radex foot complete minimum 3 views (73630) |
$328 |
$328 |
3.9× |
| Radex Hand Minimum 3 Views (73130) |
$329 |
$329 |
3.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$317 |
$317 |
3.8× |
| Radex shoulder complete minimum 2 views (73030) |
$376 |
$376 |
4.5× |
| Radex Spine 1 View Specify Level (72020) |
$284 |
$284 |
3.4× |
| Radex Sternum Minimum 2 Views (71120) |
$286 |
$286 |
3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$615 |
$615 |
7.4× |
| Radex Toe Minimum 2 Views (73660) |
$261 |
$261 |
3.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$324 |
$324 |
3.9× |
| Radiologic exam knee complete 4/more views (73564) |
$389 |
$389 |
3.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$467 |
$467 |
2.8× |
| Radiologic examination femur 1 view (73551) |
$456 |
$456 |
5.5× |
| Radiologic examination femur minimum 2 views (73552) |
$494 |
$494 |
5.9× |
| Radiologic examination knee 1/2 views (73560) |
$310 |
$310 |
3.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$338 |
$338 |
4.0× |
| Ribs bilateral 3 views (71110) |
$544 |
$544 |
5.4× |
| Scapula (73010) |
$324 |
$324 |
3.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$86 |
$86 |
3.7× |
| Shoulder 1 view (73020) |
$214 |
$214 |
2.6× |
| Skull less than 4 views (70250) |
$280 |
$280 |
2.8× |
| Thoracic spine 2 views (72070) |
$428 |
$428 |
4.3× |
| Thoracic spine 3 views (72072) |
$494 |
$494 |
4.9× |
| Thoracolumbar 2 views (72080) |
$428 |
$428 |
5.1× |
Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$703–$1,056 |
$703–$1,056 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$845 |
$845 |
8.4× |
| Ultrasound, abdomen limited (76705) |
$773 |
$773 |
7.7× |
| Umbilical-artery Doppler (OB) (76820) |
$215 |
$215 |
2.1× |
Us breast unilateral complete (76641) range across 2 matching MRF lines |
$771–$1,126 |
$771–$1,126 |
varies |
| Us chest (76604) |
$963 |
$963 |
9.6× |
| Us complete joint (76881) |
$845 |
$845 |
8.4× |
Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$594–$734 |
$594–$734 |
varies |
| Us head (76506) |
$548 |
$548 |
5.5× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$809–$810 |
$809–$810 |
varies |
| Us ob limited 1 or more fetuses (76815) |
$950 |
$950 |
9.5× |
| Us ob transvaginal (76817) |
$753 |
$753 |
7.5× |
| Us pelvic non ob complete (76856) |
$845 |
$845 |
8.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$950 |
$950 |
9.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$703 |
$703 |
7.0× |
| Us retroperitoneal complete (76770) |
$963 |
$963 |
9.6× |
Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$658–$685 |
$658–$685 |
varies |
| Us scrotum and contents (76870) |
$800 |
$800 |
8.0× |
| Us thyroid (76536) |
$703 |
$703 |
7.0× |
| Wrist 2 views (73100) |
$286 |
$286 |
3.4× |
| X-Ray Bend Only L-S Spine (72120) |
$563 |
$563 |
5.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$313 |
$313 |
3.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$284 |
$284 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$494 |
$494 |
5.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$773 |
$773 |
7.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$845 |
$845 |
8.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$845 |
$845 |
8.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$633 |
$633 |
6.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$396 |
$396 |
4.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$528 |
$528 |
5.3× |
X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$247–$264 |
$247–$264 |
varies |
| X-ray eye for foreign body (70030) |
$284 |
$284 |
3.4× |
| X-ray humerus (73060) |
$325 |
$325 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$319 |
$319 |
3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$559 |
$559 |
5.6× |
| X-ray nose-rectum child f.b. (76010) |
$286 |
$286 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$545 |
$545 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$319 |
$319 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$353 |
$353 |
4.2× |
| X-Rays Bone Survey Complete (77075) |
$972 |
$972 |
9.7× |
| Xr c-spine 4 or 5 views (72050) |
$494 |
$494 |
4.9× |
| Xr facial bones less than 3 views (70140) |
$286 |
$286 |
3.4× |
| Xr orbits complete 4 views (70200) |
$459 |
$459 |
4.6× |