| Abdomen 2 views (74019) |
$294.91 |
$421.30 |
2.8× |
| Ankle 2 views (73600) |
$319.55 |
$456.50 |
3.7× |
| Bone age studies (77072) |
$253.33 |
$361.90 |
2.4× |
| Bone survey complete (77075) |
$1,603.14 |
$2,290.20 |
15.3× |
| Cervical spine 2 or 3 views (72040) |
$362.67 |
$518.10 |
4.1× |
| Chest 1 view (71045) |
$279.51 |
$399.30 |
3.2× |
| Chest 3 views (71047) |
$306.46 |
$437.80 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$744.59 |
$1,063.70 |
4.2× |
| Clavicle complete (73000) |
$446.60 |
$638 |
5.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,600.29 |
$3,714.70 |
24.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,681.14 |
$3,830.20 |
7.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,814.89 |
$2,592.70 |
7.6× |
| CT abdomen w contrast (74160) |
$3,393.39 |
$4,847.70 |
19.3× |
| CT abdomen w wo contrast (74170) |
$4,125.66 |
$5,893.80 |
23.4× |
| CT abdomen w/o contrast (74150) |
$2,775.85 |
$3,965.50 |
26.4× |
| CT c-spine w/o contrast (72125) |
$1,067.99 |
$1,525.70 |
10.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,107.49 |
$3,010.70 |
12.0× |
| CT cervical spine with contrast (72126) |
$3,967.04 |
$5,667.20 |
11.3× |
| CT chest w/wo contrast (71270) |
$2,905.21 |
$4,150.30 |
16.5× |
| CT chest with contrast (71260) |
$1,421.42 |
$2,030.60 |
8.1× |
| CT head/brain with contrast (70460) |
$1,426.81 |
$2,038.30 |
8.1× |
| CT head/brain without and with contrast (70470) |
$1,789.48 |
$2,556.40 |
10.2× |
| CT iac w contrast (70481) |
$1,862.63 |
$2,660.90 |
10.6× |
| CT limited/localized follow up study (76380) |
$291.06 |
$415.80 |
3.3× |
| CT lower ext w/o (73700) |
$1,727.50 |
$2,467.85 |
16.4× |
| CT lower extremity w wo contrast (73702) |
$1,874.95 |
$2,678.50 |
10.6× |
| CT lower extremity with contrast (73701) |
$1,727.50 |
$2,467.85 |
9.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,107.49 |
$3,010.70 |
12.0× |
| CT lumbar spine w/o contrast (72131) |
$1,106.49 |
$1,580.70 |
10.5× |
| CT lumbar spine with contrast (72132) |
$3,927 |
$5,610 |
11.2× |
| CT maxillofacial w contrast (70487) |
$1,807.19 |
$2,581.70 |
10.3× |
| CT maxillofacial w/o contrast (70486) |
$1,166.55 |
$1,666.50 |
11.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,898.05 |
$2,711.50 |
10.8× |
| CT neck soft tissue w contrast (70491) |
$3,168.55 |
$4,526.50 |
18.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,259.18 |
$3,227.40 |
12.8× |
| CT orbits w/o contrast (70480) |
$2,921.38 |
$4,173.40 |
27.8× |
| CT pelvis w & w/o contrast (72194) |
$1,920.38 |
$2,743.40 |
10.9× |
| CT pelvis w/o contrast (72192) |
$1,292.83 |
$1,846.90 |
12.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,614.92 |
$3,735.60 |
14.8× |
| CT soft tissue neck w/o contrast (70490) |
$2,259.18 |
$3,227.40 |
21.5× |
| CT thoracic spine w/contrast (72129) |
$3,330.25 |
$4,757.50 |
18.9× |
| CT thoracic spine w/o contrast (72128) |
$1,292.83 |
$1,846.90 |
12.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,107.49 |
$3,010.70 |
12.0× |
| CT thorax w/o contrast (71250) |
$1,737.89 |
$2,482.70 |
16.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,892.66 |
$2,703.80 |
10.7× |
| CT upper extremity w/o contrast rt (73200) |
$2,417.03 |
$3,452.90 |
23.0× |
| CT upper extremity with contrast (73201) |
$1,837.99 |
$2,625.70 |
5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,104.64 |
$4,435.20 |
17.6× |
| Cta Abdomen (74175) |
$3,532.76 |
$5,046.80 |
20.0× |
| CTA abdomen pelvis (74174) |
$6,859.16 |
$9,798.80 |
19.6× |
| CTA chest (71275) |
$2,373.91 |
$3,391.30 |
13.5× |
| Cta Head (70496) |
$2,875.18 |
$4,107.40 |
16.3× |
| CTA lwr ext w&w/o contrast (73706) |
$508.97 |
$727.10 |
2.9× |
| Cta Neck (70498) |
$2,942.17 |
$4,203.10 |
16.7× |
| Cta Pelvis (72191) |
$2,656.50 |
$3,795 |
15.1× |
| Esophagus (74220) |
$1,064.14 |
$1,520.20 |
6.0× |
| Fetal biophysical profile non-stress testing (76818) |
$590.59 |
$843.70 |
5.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$488.18 |
$697.40 |
4.6× |
| Fluoroscopy up to 1 hr (76000) |
$696.85 |
$995.50 |
2.9× |
| Foot 2 views (73620) |
$296.45 |
$423.50 |
3.4× |
| Forearm 2 views (73090) |
$362.67 |
$518.10 |
4.1× |
| Hand 2 views (73120) |
$328.79 |
$469.70 |
3.1× |
| Hand 3 views (73130) |
$362.67 |
$518.10 |
4.1× |
| Humerus Min 2 Views Left (73060) |
$362.67 |
$518.10 |
4.1× |
| Knee 3 views (73562) |
$383.46 |
$547.80 |
4.4× |
| MRA head w & w/o contrast (70546) |
$2,869.02 |
$4,098.60 |
8.2× |
| MRA head w/o contrast (70544) |
$2,753.52 |
$3,933.60 |
11.5× |
| MRA head with contrast (70545) |
$2,869.02 |
$4,098.60 |
8.2× |
| MRA neck w contrast (70548) |
$2,464 |
$3,520 |
7.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,898.28 |
$4,140.40 |
8.3× |
| MRA neck w/o contrast (70547) |
$2,361.59 |
$3,373.70 |
9.9× |
| MRI abdomen w contrast (74182) |
$2,695 |
$3,850 |
7.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,630.01 |
$6,614.30 |
13.2× |
| MRI abdomen w/o contrast (74181) |
$3,374.91 |
$4,821.30 |
14.1× |
| MRI any jnt lwr ext with con lt (73722) |
$2,750.44 |
$3,929.20 |
3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,708.32 |
$5,297.60 |
4.7× |
| MRI c-spine with contrast (72142) |
$2,986.06 |
$4,265.80 |
8.5× |
| MRI cervical spine w/o contrast (72141) |
$2,869.02 |
$4,098.60 |
12.0× |
| MRI chest w/o & w/contrast material (71552) |
$1,061.06 |
$1,515.80 |
3.0× |
| MRI chest w/o contrast (71550) |
$540.54 |
$772.20 |
2.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,596.44 |
$3,709.20 |
7.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,597.21 |
$3,710.30 |
7.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,032.26 |
$4,331.80 |
12.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$5,775.77 |
$8,251.10 |
24.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,775.77 |
$8,251.10 |
16.5× |
| MRI orbit/face/neck w/contrast (70542) |
$2,909.83 |
$4,156.90 |
8.3× |
| MRI pelvis w contrast (72196) |
$2,403.17 |
$3,433.10 |
6.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,031.95 |
$7,188.50 |
14.4× |
| MRI pelvis w/o contrast (72195) |
$3,445.75 |
$4,922.50 |
14.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,869.02 |
$4,098.60 |
8.2× |
| MRI scan of leg joint before and after contrast (73723) |
$3,427.27 |
$4,896.10 |
9.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,376.91 |
$7,681.30 |
15.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,179.33 |
$4,541.90 |
9.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,596.90 |
$6,567 |
13.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,403.17 |
$3,433.10 |
6.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,881.26 |
$8,401.80 |
16.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,432.97 |
$2,047.10 |
6.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,517.67 |
$2,168.10 |
6.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,400.09 |
$3,428.70 |
6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,400.09 |
$3,428.70 |
10.0× |
| Neck soft tissue (70360) |
$279.51 |
$399.30 |
3.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$287.98 |
$411.40 |
2.7× |
| Osseous survey infant (77076) |
$245.63 |
$350.90 |
2.3× |
| Osseous survey limited (77074) |
$603.68 |
$862.40 |
5.7× |
| Pelvis 1 or 2 views (72170) |
$328.79 |
$469.70 |
3.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,769.15 |
$5,384.50 |
10.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$870.87 |
$1,244.10 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$579.04 |
$827.20 |
6.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$536.69 |
$766.70 |
5.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$355.74 |
$508.20 |
3.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$379.61 |
$542.30 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$279.51 |
$399.30 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$435.82 |
$622.60 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$306.46 |
$437.80 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$1,132.67 |
$1,618.10 |
6.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$974.05 |
$1,391.50 |
5.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$337.26 |
$481.80 |
3.9× |
| Ribs bilateral 3 views (71110) |
$454.30 |
$649 |
4.3× |
| Scanogram (77073) |
$409.26 |
$584.65 |
3.9× |
| Scapula complete (73010) |
$279.51 |
$399.30 |
2.7× |
| Screening digital breast tomosynthesis (77063) |
$127.18 |
$181.68 |
5.4× |
| Sella turcica (70240) |
$279.51 |
$399.30 |
3.2× |
| Small bowel series (74250) |
$1,281.28 |
$1,830.40 |
7.3× |
| Spine thoracic 3 views (72072) |
$528.22 |
$754.60 |
5.0× |
| Thoracolumbar 2 views (72080) |
$279.51 |
$399.30 |
3.2× |
| Tmj unilateral (70328) |
$305.69 |
$436.70 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$647.96 |
$925.65 |
6.2× |
| Umbilical-artery Doppler (OB) (76820) |
$238.70 |
$341 |
2.3× |
| Urethrocystography voiding (74455) |
$1,002.54 |
$1,432.20 |
4.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$2,951.41 |
$4,216.30 |
16.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,481.48 |
$2,116.40 |
8.4× |
| Us breast unilateral complete (76641) |
$385.56 |
$550.80 |
3.7× |
| Us breast unilateral limited (76642) |
$427.35 |
$610.50 |
4.9× |
| Us chest (76604) |
$488.18 |
$697.40 |
4.6× |
| Us compl joint r-t w/image documentation (76881) |
$823.90 |
$1,177 |
7.8× |
| Us ob detailed single fetus (76811) |
$636.02 |
$908.60 |
2.7× |
| Us ob transvaginal (76817) |
$378.07 |
$540.10 |
3.6× |
| Us pelvic non ob complete (76856) |
$826.98 |
$1,181.40 |
7.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$238.70 |
$341 |
2.3× |
| Us pregnancy ltd (76815) |
$348.81 |
$498.30 |
3.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$378.07 |
$540.10 |
3.6× |
| Us retroperitoneal complete (76770) |
$826.98 |
$1,181.40 |
7.9× |
| Us retroperitoneal limited (76775) |
$826.98 |
$1,181.40 |
7.9× |
| Us scrotum and contents (76870) |
$1,141.91 |
$1,631.30 |
10.9× |
| Us soft tissue head/neck (76536) |
$636.79 |
$909.70 |
6.1× |
| Us spinal canal and contents (76800) |
$293.37 |
$419.10 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$335.75 |
$479.64 |
3.2× |
| Wrist 2 views (73100) |
$202.51 |
$289.30 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$639.87 |
$914.10 |
6.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$245.63 |
$350.90 |
2.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$374.22 |
$534.60 |
4.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,553.09 |
$2,218.70 |
8.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$328.79 |
$469.70 |
3.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$362.67 |
$518.10 |
4.1× |
| X-ray exam hip uni 1 view (73501) |
$207.13 |
$295.90 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$420.42 |
$600.60 |
4.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$343.42 |
$490.60 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$279.51 |
$399.30 |
3.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$362.67 |
$518.10 |
4.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$279.51 |
$399.30 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$279.51 |
$399.30 |
3.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$544.39 |
$777.70 |
5.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$302.61 |
$432.30 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$362.67 |
$518.10 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$947.87 |
$1,354.10 |
9.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$279.51 |
$399.30 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$279.51 |
$399.30 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$286.44 |
$409.20 |
2.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,002.54 |
$1,432.20 |
2.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$309.54 |
$442.20 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$362.67 |
$518.10 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$462 |
$660 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$362.67 |
$518.10 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$561.33 |
$801.90 |
6.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$374.22 |
$534.60 |
4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$299.53 |
$427.90 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$488.18 |
$697.40 |
4.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$245.63 |
$350.90 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$279.51 |
$399.30 |
3.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$264.11 |
$377.30 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$279.51 |
$399.30 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$362.67 |
$518.10 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$378.07 |
$540.10 |
4.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$213.29 |
$304.70 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$1,699.39 |
$2,427.70 |
16.2× |
| Xr chest 4+ views (71048) |
$306.46 |
$437.80 |
2.9× |
| Xr finger(s) 2+ views (73140) |
$233.31 |
$333.30 |
2.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$279.51 |
$399.30 |
2.7× |
| Xr optic foramina (70190) |
$279.51 |
$399.30 |
3.2× |
| Xr shoulder 1 view (73020) |
$279.51 |
$399.30 |
3.2× |
| Xr spine cervical 4 or 5 views (72050) |
$635.25 |
$907.50 |
6.0× |
| Xr tibia/fibula 2 views (73590) |
$337.26 |
$481.80 |
3.9× |
| Xr tmj bilateral (70330) |
$604.45 |
$863.50 |
6.9× |
| Xray knee 1 or 2 views rt (73560) |
$302.61 |
$432.30 |
3.5× |