| Abdomen 2 views (74019) |
$381.60 |
$477 |
3.4× |
| Ankle 2 views (73600) |
$141 |
$176.25 |
1.5× |
| Bone age studies (77072) |
$135.40 |
$169.25 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$389.60 |
$487 |
4.1× |
| Chest 1 view (71045) |
$277.60 |
$347 |
2.9× |
| Chest xray 3 views (71047) |
$291.20 |
$364 |
3.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,017.20 |
$1,271.50 |
5.4× |
| Clavicle complete (73000) |
$182.20 |
$227.75 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$875.20 |
$1,094 |
7.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,519.60 |
$4,399.50 |
9.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,939.80 |
$2,424.75 |
7.5× |
| CT abdomen w contrast (74160) |
$1,664.80 |
$2,081 |
8.8× |
| CT abdomen w wo contrast (74170) |
$1,988.40 |
$2,485.50 |
10.5× |
| CT abdomen w/o contrast (74150) |
$1,097.60 |
$1,372 |
9.7× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,109.20 |
$2,636.50 |
11.1× |
| CT c-spine w/o contrast (72125) |
$1,364.60 |
$1,705.75 |
12.1× |
| CT chest w contrast (71260) |
$2,161.40 |
$2,701.75 |
11.4× |
| CT chest w/wo contrast (71270) |
$2,073.60 |
$2,592 |
10.9× |
| CT head/brain with contrast (70460) |
$1,158 |
$1,447.50 |
6.1× |
| CT head/brain without and with contrast (70470) |
$1,512.80 |
$1,891 |
8.0× |
| CT iac w contrast (70481) |
$1,684.40 |
$2,105.50 |
8.9× |
| CT lower ext w/o (73700) |
$1,301 |
$1,626.25 |
11.5× |
| CT lower extremity w/contrast material (73701) |
$1,358.20 |
$1,697.75 |
7.2× |
| CT lumbar spine w/contrast (72132) |
$1,905 |
$2,381.25 |
5.0× |
| CT lumbar spine w/o contrast (72131) |
$1,468.60 |
$1,835.75 |
13.0× |
| CT maxillofacial w contrast (70487) |
$1,427.20 |
$1,784 |
7.5× |
| CT maxillofacial wo contrast (70486) |
$859.40 |
$1,074.25 |
7.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,089.20 |
$2,611.50 |
11.0× |
| CT orbits w/o contrast (70480) |
$1,385.80 |
$1,732.25 |
12.2× |
| CT pelvis w/o contrast (72192) |
$1,177 |
$1,471.25 |
10.4× |
| CT pelvis w/wo contrast (72194) |
$2,070 |
$2,587.50 |
10.9× |
| CT soft tissue neck w contrast (70491) |
$1,802.20 |
$2,252.75 |
9.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,729.20 |
$2,161.50 |
9.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,140 |
$1,425 |
10.1× |
| CT thoracic spine w/contrast (72129) |
$1,499.20 |
$1,874 |
7.9× |
| CT thoracic spine w/o contrast (72128) |
$1,383.40 |
$1,729.25 |
12.2× |
| CT thorax w/o contrast (71250) |
$1,434.40 |
$1,793 |
12.7× |
| CT upper ext wo (73200) |
$1,346.80 |
$1,683.50 |
11.9× |
| CT upper extremity with contrast (73201) |
$1,504.60 |
$1,880.75 |
4.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,588 |
$3,235 |
13.6× |
| Cta Abdomen (74175) |
$2,197.40 |
$2,746.75 |
11.6× |
| CTA abdomen pelvis (74174) |
$2,588 |
$3,235 |
6.9× |
| CTA chest (71275) |
$2,199.60 |
$2,749.50 |
11.6× |
| Cta Head (70496) |
$2,321 |
$2,901.25 |
12.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,280 |
$2,850 |
6.0× |
| Cta Neck (70498) |
$2,239.60 |
$2,799.50 |
11.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$657 |
$821.25 |
5.8× |
| Facial bones min 3 views (70150) |
$186.20 |
$232.75 |
1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$638.80 |
$798.50 |
5.6× |
| Fluoroscopy up to 1 hr (76000) |
$491.80 |
$614.75 |
1.9× |
| Foot 2 views (73620) |
$162.50 |
$203.12 |
1.7× |
| Forearm 2 views (73090) |
$230.80 |
$288.50 |
2.4× |
| Hand 2 views (73120) |
$150.20 |
$187.75 |
1.3× |
| Knee 3 views (73562) |
$380.40 |
$475.50 |
4.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,360.60 |
$5,450.75 |
11.5× |
| MRA head w & w/o contrast (70546) |
$5,366.20 |
$6,707.75 |
14.2× |
| MRA head w/o contrast (70544) |
$2,812.60 |
$3,515.75 |
10.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,841 |
$6,051.25 |
12.8× |
| MRA neck w/o contrast (70547) |
$2,648.80 |
$3,311 |
10.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,719.60 |
$5,899.50 |
12.5× |
| MRI abdomen w/o contrast (74181) |
$2,358.40 |
$2,948 |
9.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,441 |
$4,301.25 |
4.1× |
| MRI cervical spine w/o contrast (72141) |
$2,558.60 |
$3,198.25 |
9.9× |
| MRI chest w/o & w/contrast material (71552) |
$4,890.20 |
$6,112.75 |
12.9× |
| MRI chest with contrast (71551) |
$3,014.60 |
$3,768.25 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,175.40 |
$3,969.25 |
8.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,467.60 |
$5,584.50 |
11.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,887.20 |
$3,609 |
11.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,755.60 |
$3,444.50 |
10.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,467.60 |
$5,584.50 |
11.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,731.60 |
$5,914.50 |
12.5× |
| MRI pelvis w/o contrast (72195) |
$2,909.40 |
$3,636.75 |
11.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,182.60 |
$5,228.25 |
11.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,112.60 |
$3,890.75 |
8.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,196.60 |
$5,245.75 |
11.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,025.40 |
$3,781.75 |
8.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,202.80 |
$5,253.50 |
11.1× |
| MRI temporomandibular joint (70336) |
$2,802.20 |
$3,502.75 |
10.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,761.40 |
$3,451.75 |
10.7× |
| MRI up ext w/o contrast (73218) |
$2,849.80 |
$3,562.25 |
11.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,584 |
$3,230 |
10.0× |
| Neck soft tissue (70360) |
$157 |
$196.25 |
1.7× |
| Nonvascular shunt X-ray (75809) |
$311.60 |
$389.50 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$249.20 |
$311.50 |
2.2× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$257.10 |
$321.38 |
2.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$150.20 |
$187.75 |
1.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$353 |
$441.25 |
3.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$226.60 |
$283.25 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$195 |
$243.75 |
1.7× |
| Radex fingr minimum 2 views (73140) |
$303 |
$378.75 |
3.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$227 |
$283.75 |
2.4× |
| Radex Hand Minimum 3 Views (73130) |
$333.60 |
$417 |
3.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$487.40 |
$609.25 |
5.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$881.60 |
$1,102 |
7.8× |
| Radex Humerus Minimum 2 Views (73060) |
$205.80 |
$257.25 |
2.2× |
| Radex Kne 1/2 Views (73560) |
$310.20 |
$387.75 |
3.3× |
| Radex Kne Compl 4/More Views (73564) |
$442.60 |
$553.25 |
3.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$162.20 |
$202.75 |
1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$146.20 |
$182.75 |
1.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$303 |
$378.75 |
3.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$175 |
$218.75 |
1.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$325.60 |
$407 |
2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$250.20 |
$312.75 |
2.7× |
| Radex Toe Minimum 2 Views (73660) |
$148.20 |
$185.25 |
1.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$162.20 |
$202.75 |
1.4× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$401.60 |
$502 |
4.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$200.80 |
$251 |
2.1× |
| Radiologic exam chest 2 views (71046) |
$238.50 |
$298.12 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$584.80 |
$731 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$506.40 |
$633 |
2.7× |
| Radiologic examination femur 1 view (73551) |
$159.40 |
$199.25 |
1.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$303 |
$378.75 |
3.2× |
| Ribs bilateral 3 views (71110) |
$311.60 |
$389.50 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$180.40 |
$225.50 |
1.6× |
| Scapula (73010) |
$292.40 |
$365.50 |
2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$38.20 |
$47.75 |
1.6× |
| Shoulder 1 view (73020) |
$218 |
$272.50 |
2.3× |
| Spine thoracic 3 views (72072) |
$389.60 |
$487 |
3.4× |
| Thoracolumbar 2 views (72080) |
$200.20 |
$250.25 |
2.1× |
| Tmj unilateral (70328) |
$147.20 |
$184 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$500 |
$625 |
4.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$402.40 |
$503 |
3.6× |
| Us ob limited (76815) |
$425.80 |
$532.25 |
3.8× |
| Us ob transvaginal (76817) |
$479.80 |
$599.75 |
4.2× |
| Us pelvic non ob complete (76856) |
$577.80 |
$722.25 |
5.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$578.60 |
$723.25 |
5.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$586.80 |
$733.50 |
5.2× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$331.60 |
$414.50 |
2.9× |
| Us retroperitoneal complete (76770) |
$640.80 |
$801 |
5.7× |
| Us retroperitoneal limited (76775) |
$481 |
$601.25 |
4.2× |
| Us scrotum and contents (76870) |
$811.40 |
$1,014.25 |
7.2× |
| Us soft tissue head/neck (76536) |
$591.40 |
$739.25 |
5.2× |
| Wrist 2 views (73100) |
$421.80 |
$527.25 |
4.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$294.60 |
$368.25 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$232.20 |
$290.25 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$88.20 |
$110.25 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$567 |
$708.75 |
6.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$263.32 |
$329.14 |
2.3× |
| X-ray exam of femur 2/> (73552) |
$230.80 |
$288.50 |
2.4× |
| X-ray eye for foreign body (70030) |
$283.60 |
$354.50 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$157 |
$196.25 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$163 |
$203.75 |
1.7× |
| X-ray leg, infant (73592) |
$162.20 |
$202.75 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$252.90 |
$316.12 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$677.80 |
$847.25 |
6.0× |
| X-ray nose-rectum child f.b. (76010) |
$173.60 |
$217 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$264 |
$330 |
2.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$303 |
$378.75 |
3.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$366.60 |
$458.25 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$334.60 |
$418.25 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$237.40 |
$296.75 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$264 |
$330 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$290.40 |
$363 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$274.40 |
$343 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$168.10 |
$210.12 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$277.60 |
$347 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$238.60 |
$298.25 |
2.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$222.40 |
$278 |
2.0× |
| Xr bone length studies (77073) |
$186.20 |
$232.75 |
1.6× |
| Xr c-spine 4 or 5 views (72050) |
$524.60 |
$655.75 |
4.6× |
| Xr c-spine 6 or more views (72052) |
$373 |
$466.25 |
3.3× |