| Abdomen 2 views (74019) |
$98.53 |
$144.90 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$465.80 |
$685 |
1.3× |
| Ankle 2 views (73600) |
$81.40 |
$119.70 |
1.0× |
| Arthrogram shoulder (73040) |
$492.66 |
$724.50 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$535.67 |
$787.75 |
1.5× |
| Bone age studies (77072) |
$141.10 |
$207.50 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$442.51 |
$650.75 |
1.2× |
| Bone survey complete (77075) |
$141.10 |
$207.50 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$134.06 |
$197.15 |
1.7× |
| Chest 1 view (71045) |
$83.54 |
$122.85 |
1.1× |
| Chest 3 views (71047) |
$85.68 |
$126 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$134.06 |
$197.15 |
0.8× |
| Clavicle complete (73000) |
$98.53 |
$144.90 |
1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$523.91 |
$770.45 |
5.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,619.76 |
$2,382 |
5.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,082.56 |
$1,592 |
5.0× |
| CT abdomen w contrast (74160) |
$1,103.30 |
$1,622.50 |
6.9× |
| CT abdomen w wo contrast (74170) |
$1,103.30 |
$1,622.50 |
6.9× |
| CT abdomen w/o contrast (74150) |
$523.91 |
$770.45 |
5.5× |
| CT angio hrt w/3d image (75574) |
$1,435.48 |
$2,111 |
4.5× |
| CT angiography upper extremity lt (73206) |
$1,161.44 |
$1,708 |
7.3× |
| CT c-spine w/o contrast (72125) |
$634.20 |
$932.65 |
6.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,161.44 |
$1,708 |
7.3× |
| CT chest w/wo contrast (71270) |
$1,619.76 |
$2,382 |
10.2× |
| CT chest with contrast (71260) |
$1,103.30 |
$1,622.50 |
6.9× |
| CT head/brain with contrast (70460) |
$1,103.37 |
$1,622.60 |
6.9× |
| CT head/brain without and with contrast (70470) |
$1,335.52 |
$1,964 |
8.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$34 |
$50 |
0.4× |
| CT iac w contrast (70481) |
$1,161.44 |
$1,708 |
7.3× |
| CT lower ext w/o (73700) |
$523.91 |
$770.45 |
5.5× |
| CT lower extremity w wo contrast (73702) |
$1,161.44 |
$1,708 |
7.3× |
| CT lower extremity with contrast (73701) |
$1,103.13 |
$1,622.25 |
6.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,103.30 |
$1,622.50 |
6.9× |
| CT lumbar spine w/o contrast (72131) |
$634.20 |
$932.65 |
6.7× |
| CT lumbar spine with contrast (72132) |
$1,619.76 |
$2,382 |
5.1× |
| CT maxillofacial w contrast (70487) |
$1,335.52 |
$1,964 |
8.4× |
| CT maxillofacial w/o contrast (70486) |
$501.66 |
$737.72 |
5.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,161.44 |
$1,708 |
7.3× |
| CT neck soft tissue w contrast (70491) |
$1,103.30 |
$1,622.50 |
6.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,103.37 |
$1,622.60 |
6.9× |
| CT orbits w/o contrast (70480) |
$523.91 |
$770.45 |
5.5× |
| CT pelvis w & w/o contrast (72194) |
$1,103.30 |
$1,622.50 |
6.9× |
| CT pelvis w/o contrast (72192) |
$523.91 |
$770.45 |
5.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,103.30 |
$1,622.50 |
6.9× |
| CT soft tissue neck w/o contrast (70490) |
$523.94 |
$770.50 |
5.5× |
| CT thoracic spine w/contrast (72129) |
$1,161.44 |
$1,708 |
7.3× |
| CT thoracic spine w/o contrast (72128) |
$634.20 |
$932.65 |
6.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,161.44 |
$1,708 |
7.3× |
| CT thorax w/o contrast (71250) |
$523.94 |
$770.50 |
5.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,161.44 |
$1,708 |
7.3× |
| CT upper extremity w/o contrast rt (73200) |
$634.20 |
$932.65 |
6.7× |
| CT upper extremity with contrast (73201) |
$1,619.76 |
$2,382 |
5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,335.52 |
$1,964 |
8.4× |
| Cta Abdomen (74175) |
$1,161.44 |
$1,708 |
7.3× |
| CTA abdomen pelvis (74174) |
$1,960.88 |
$2,883.65 |
6.2× |
| CTA chest (71275) |
$1,335.52 |
$1,964 |
8.4× |
| Cta Head (70496) |
$1,103.30 |
$1,622.50 |
6.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,103.30 |
$1,622.50 |
6.9× |
| Cta Neck (70498) |
$1,103.30 |
$1,622.50 |
6.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$133.96 |
$197 |
1.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$85.68 |
$126 |
1.1× |
| Esophagus (74220) |
$141.78 |
$208.50 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$78.37 |
$115.25 |
0.4× |
| Foot 2 views (73620) |
$98.53 |
$144.90 |
1.2× |
| Forearm 2 views (73090) |
$81.40 |
$119.70 |
1.0× |
| Hand 2 views (73120) |
$162.28 |
$238.65 |
1.7× |
| Hand 3 views (73130) |
$170.10 |
$250.15 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$535.67 |
$787.75 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$442.51 |
$650.75 |
1.2× |
| Ht muscle image spect sing (78451) |
$1,553.12 |
$2,284 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$81.40 |
$119.70 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$587.52 |
$864 |
1.2× |
| Knee 3 views (73562) |
$102.44 |
$150.65 |
1.3× |
| Lymphoscintigraphy (78195) |
$442.51 |
$650.75 |
0.9× |
| Meckels Diverticulum (78290) |
$465.80 |
$685 |
1.3× |
| MRA head w/o contrast (70544) |
$881.28 |
$1,296 |
4.1× |
| MRA neck w/o contrast (70547) |
$728.04 |
$1,070.65 |
3.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,464.04 |
$2,153 |
4.6× |
| MRI abdomen w/o contrast (74181) |
$728.04 |
$1,070.65 |
3.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,272.96 |
$1,872 |
1.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,464.04 |
$2,153 |
2.1× |
| MRI c-spine with contrast (72142) |
$1,272.96 |
$1,872 |
4.0× |
| MRI cervical spine w/o contrast (72141) |
$881.28 |
$1,296 |
4.1× |
| MRI chest w/o & w/contrast material (71552) |
$728.04 |
$1,070.65 |
2.3× |
| MRI chest w/o contrast (71550) |
$766.36 |
$1,127 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$881.28 |
$1,296 |
4.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$766.36 |
$1,127 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,209.38 |
$1,778.50 |
3.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,464.04 |
$2,153 |
4.6× |
| MRI pelvis w/o contrast (72195) |
$881.28 |
$1,296 |
4.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,272.96 |
$1,872 |
4.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,209.21 |
$1,778.25 |
3.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,464.04 |
$2,153 |
4.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,272.96 |
$1,872 |
4.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,464.04 |
$2,153 |
4.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,209.38 |
$1,778.50 |
3.8× |
| MRI thoracic spine w/o contrast (72146) |
$728.04 |
$1,070.65 |
3.4× |
| MRI upper ext joint w/o contrast (73221) |
$881.28 |
$1,296 |
4.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,272.96 |
$1,872 |
4.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$747.20 |
$1,098.82 |
3.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,475.60 |
$2,170 |
1.3× |
| Neck soft tissue (70360) |
$98.53 |
$144.90 |
1.2× |
| Nm gastric emptying study (78264) |
$535.67 |
$787.75 |
1.5× |
| Parathyrd planar w/wo subtrj (78071) |
$465.80 |
$685 |
1.3× |
| Parathyroid imaging (78070) |
$454.16 |
$667.88 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$134.06 |
$197.15 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,241.17 |
$1,825.25 |
3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$436.05 |
$641.25 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$587.52 |
$864 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$162.28 |
$238.65 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$134.06 |
$197.15 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$98.53 |
$144.90 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$90.78 |
$133.50 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$134.06 |
$197.15 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$141.10 |
$207.50 |
0.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$141.10 |
$207.50 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$98.53 |
$144.90 |
1.2× |
| Radiological examination surgical specimen (76098) |
$142.12 |
$209 |
0.3× |
| Ribs bilateral 3 views (71110) |
$140.52 |
$206.65 |
1.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,553.12 |
$2,284 |
4.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$542.13 |
$797.25 |
1.1× |
| Scapula complete (73010) |
$92.10 |
$135.45 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$47.94 |
$70.50 |
2.1× |
| Small bowel series (74250) |
$134.06 |
$197.15 |
0.8× |
| Spine thoracic 3 views (72072) |
$162.28 |
$238.65 |
1.7× |
| Thoracolumbar 2 views (72080) |
$85.68 |
$126 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$535.67 |
$787.75 |
1.5× |
| Tmj unilateral (70328) |
$85.68 |
$126 |
1.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,514.36 |
$2,227 |
3.1× |
| Ultrasound, abdomen limited (76705) |
$119.51 |
$175.75 |
1.3× |
| Upper Extremity Infant (73092) |
$141.10 |
$207.50 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$269.28 |
$396 |
1.2× |
| Urethrocystography voiding (74455) |
$492.66 |
$724.50 |
2.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$269.28 |
$396 |
1.7× |
| Us abdl aorta screen aaa (76706) |
$193.46 |
$284.50 |
2.0× |
| Us breast unilateral complete (76641) |
$222.50 |
$327.20 |
2.3× |
| Us breast unilateral limited (76642) |
$146.64 |
$215.65 |
1.9× |
| Us chest (76604) |
$183.80 |
$270.30 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$306.85 |
$451.25 |
3.2× |
| Us ob transvaginal (76817) |
$371.45 |
$546.25 |
3.9× |
| Us pelvic non ob complete (76856) |
$306.85 |
$451.25 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$222.53 |
$327.25 |
2.3× |
| Us pregnancy ltd (76815) |
$123.73 |
$181.95 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$323 |
$475 |
3.4× |
| Us retroperitoneal complete (76770) |
$306.85 |
$451.25 |
3.2× |
| Us retroperitoneal limited (76775) |
$306.85 |
$451.25 |
3.2× |
| Us scrotum and contents (76870) |
$371.45 |
$546.25 |
3.9× |
| Us soft tissue head/neck (76536) |
$371.45 |
$546.25 |
3.9× |
| Us transrectal (76872) |
$306.85 |
$451.25 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$306.85 |
$451.25 |
3.2× |
| Wrist 2 views (73100) |
$81.40 |
$119.70 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$133.96 |
$197 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$85.68 |
$126 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$89.49 |
$131.60 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$269.28 |
$396 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$81.40 |
$119.70 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$88.50 |
$130.15 |
1.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$302.87 |
$445.40 |
3.2× |
| X-ray exam hip uni 1 view (73501) |
$81.40 |
$119.70 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$87.86 |
$129.20 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$134.06 |
$197.15 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$255.82 |
$376.20 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$162.28 |
$238.65 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$81.40 |
$119.70 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$89.49 |
$131.60 |
1.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$83.54 |
$122.85 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$98.60 |
$145 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$134.06 |
$197.15 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$85.68 |
$126 |
1.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$85.68 |
$126 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$119.90 |
$176.32 |
1.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$134.06 |
$197.15 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$81.40 |
$119.70 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$255.82 |
$376.20 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$134.06 |
$197.15 |
1.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$141.10 |
$207.50 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$98.53 |
$144.90 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$134.06 |
$197.15 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$178.30 |
$262.20 |
1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$162.28 |
$238.65 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$81.40 |
$119.70 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$106.35 |
$156.40 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$113.02 |
$166.20 |
1.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$98.60 |
$145 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$143.11 |
$210.45 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$134.06 |
$197.15 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$85.68 |
$126 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$85.68 |
$126 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$81.40 |
$119.70 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$101.66 |
$149.50 |
1.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$98.53 |
$144.90 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$106.35 |
$156.40 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$178.30 |
$262.20 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$98.53 |
$144.90 |
1.2× |
| Xr shoulder 1 view (73020) |
$83.54 |
$122.85 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$140.52 |
$206.65 |
1.5× |
| Xr tibia/fibula 2 views (73590) |
$81.40 |
$119.70 |
1.0× |
| Xr tmj bilateral (70330) |
$85.68 |
$126 |
1.1× |
| Xray knee 1 or 2 views rt (73560) |
$81.40 |
$119.70 |
1.0× |