| Abdomen 2 views (74019) |
$151.53 |
$473.53 |
1.5× |
| Ankle 2 views (73600) |
$69.24 |
$216.37 |
0.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$215.23 |
$672.59 |
0.6× |
| Bone &/joint imaging whole body (78306) |
$426.11 |
$1,331.58 |
1.1× |
| Bone age studies (77072) |
$149.55 |
$467.35 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$511.57 |
$1,598.65 |
1.3× |
| Bone survey infant (77076) |
$282.49 |
$882.78 |
2.8× |
| Cervical spine 2 or 3 views (72040) |
$94.96 |
$296.74 |
1.1× |
| Chest 1 view (71045) |
$102.08 |
$318.99 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$240.15 |
$750.48 |
1.4× |
| Clavicle complete (73000) |
$108.01 |
$337.54 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$340.84 |
$1,065.14 |
3.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,897.90 |
$5,930.93 |
5.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,381.98 |
$4,318.69 |
6.0× |
| CT abdomen w contrast (74160) |
$762.80 |
$2,383.75 |
4.5× |
| CT abdomen w/o contrast (74150) |
$646.08 |
$2,019.01 |
6.4× |
| CT angio hrt w/3d image (75574) |
$1,660.12 |
$5,187.86 |
5.0× |
| CT angiography upper extremity lt (73206) |
$987.13 |
$3,084.78 |
5.9× |
| CT c-spine w/o contrast (72125) |
$830.06 |
$2,593.94 |
8.3× |
| CT chest w contrast (71260) |
$785.35 |
$2,454.22 |
4.7× |
| CT head/brain with contrast (70460) |
$762.40 |
$2,382.51 |
4.5× |
| CT head/brain without and with contrast (70470) |
$987.13 |
$3,084.78 |
5.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$44.71 |
$139.71 |
0.5× |
| CT iac w contrast (70481) |
$762.80 |
$2,383.75 |
4.5× |
| CT lower ext w/o (73700) |
$646.08 |
$2,019.01 |
6.4× |
| CT lower extremity w wo contrast (73702) |
$762.80 |
$2,383.75 |
4.5× |
| CT lower extremity w/contrast material (73701) |
$646.08 |
$2,019.01 |
3.8× |
| CT lumbar spine w/contrast (72132) |
$897.32 |
$2,804.12 |
2.7× |
| CT lumbar spine w/o contrast (72131) |
$830.06 |
$2,593.94 |
8.3× |
| CT maxillofacial w contrast (70487) |
$762.80 |
$2,383.75 |
4.5× |
| CT maxillofacial w/wo contrast (70488) |
$987.13 |
$3,084.78 |
5.9× |
| CT maxillofacial wo contrast (70486) |
$646.08 |
$2,019.01 |
6.4× |
| CT orbits w/o contrast (70480) |
$646.08 |
$2,019.01 |
6.4× |
| CT pelvis w/o contrast (72192) |
$740.64 |
$2,314.51 |
7.4× |
| CT soft tissue neck w contrast (70491) |
$762.80 |
$2,383.75 |
4.5× |
| CT soft tissue neck w/o contrast (70490) |
$646.08 |
$2,019.01 |
6.4× |
| CT thoracic spine w/o contrast (72128) |
$830.06 |
$2,593.94 |
8.3× |
| CT thorax w/o contrast (71250) |
$646.08 |
$2,019.01 |
6.4× |
| CT upper ext wo (73200) |
$646.08 |
$2,019.01 |
6.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,256.56 |
$3,926.76 |
7.5× |
| Cta Abdomen (74175) |
$1,121.64 |
$3,505.14 |
6.7× |
| CTA abdomen pelvis (74174) |
$2,108.77 |
$6,589.92 |
6.3× |
| CTA chest (71275) |
$1,076.94 |
$3,365.44 |
6.4× |
| Cta Head (70496) |
$1,076.94 |
$3,365.44 |
6.4× |
| Cta Neck (70498) |
$1,076.94 |
$3,365.44 |
6.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$185.95 |
$581.10 |
1.9× |
| Esophagus (74220) |
$202.57 |
$633.03 |
1.2× |
| Facial bones min 3 views (70150) |
$187.93 |
$587.28 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$315.33 |
$985.40 |
1.4× |
| Foot 2 views (73620) |
$69.24 |
$216.37 |
0.8× |
| Forearm 2 views (73090) |
$115.13 |
$359.79 |
1.4× |
| Hand 2 views (73120) |
$115.13 |
$359.79 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$546.38 |
$1,707.45 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$441.54 |
$1,379.80 |
1.2× |
| Knee 3 views (73562) |
$145.99 |
$456.22 |
1.7× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,341.63 |
$4,192.58 |
1.8× |
| MRA head w & w/o contrast (70546) |
$1,121.64 |
$3,505.14 |
3.4× |
| MRA head w/o contrast (70544) |
$718.09 |
$2,244.04 |
3.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,494.34 |
$4,669.82 |
4.5× |
| MRI abdomen w/o contrast (74181) |
$1,211.46 |
$3,785.81 |
5.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,494.34 |
$4,669.82 |
4.5× |
| MRI c-spine with contrast (72142) |
$1,341.63 |
$4,192.58 |
4.0× |
| MRI cervical spine w/o contrast (72141) |
$1,211.46 |
$3,785.81 |
5.3× |
| MRI chest w/o & w/contrast material (71552) |
$1,301.27 |
$4,066.47 |
3.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,352.90 |
$4,227.82 |
4.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,211.46 |
$3,785.81 |
5.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$852.61 |
$2,664.41 |
3.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,301.27 |
$4,066.47 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,494.34 |
$4,669.82 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$1,211.46 |
$3,785.81 |
5.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,494.34 |
$4,669.82 |
4.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,341.63 |
$4,192.58 |
4.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,494.34 |
$4,669.82 |
4.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,494.34 |
$4,669.82 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,211.46 |
$3,785.81 |
5.3× |
| MRI up ext w/o contrast (73218) |
$1,211.46 |
$3,785.81 |
5.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,857.55 |
$5,804.83 |
8.1× |
| MRI, joint upper extrem combo (73223) |
$1,494.34 |
$4,669.82 |
4.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,842.91 |
$5,759.08 |
1.5× |
| Neck soft tissue (70360) |
$135.31 |
$422.84 |
1.6× |
| Nm gastric emptying study (78264) |
$374.67 |
$1,170.85 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$433.23 |
$1,353.84 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$84.27 |
$263.35 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$1,187.32 |
$3,710.39 |
0.9× |
| PET imaging for CT attenuation whole body (78816) |
$1,187.32 |
$3,710.39 |
0.9× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$129.37 |
$404.29 |
1.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$108.01 |
$337.54 |
1.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$131.35 |
$410.47 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$167.56 |
$523.60 |
2.0× |
| Radex fingr minimum 2 views (73140) |
$107.62 |
$336.30 |
1.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$151.53 |
$473.53 |
1.8× |
| Radex Hand Minimum 3 Views (73130) |
$116.32 |
$363.50 |
1.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$184.18 |
$575.54 |
1.8× |
| Radex Humerus Minimum 2 Views (73060) |
$129.37 |
$404.29 |
1.5× |
| Radex Kne 1/2 Views (73560) |
$84.47 |
$263.97 |
1.0× |
| Radex Kne Compl 4/More Views (73564) |
$183.97 |
$574.92 |
1.8× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$169.73 |
$530.41 |
1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$115.13 |
$359.79 |
1.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$127.80 |
$399.36 |
1.5× |
| Radex Toe Minimum 2 Views (73660) |
$107.62 |
$336.30 |
1.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$131.35 |
$410.47 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$100.10 |
$312.81 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$202.17 |
$631.79 |
2.0× |
| Radiologic exam chest 2 views (71046) |
$182.39 |
$569.97 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$313.35 |
$979.22 |
1.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$127.80 |
$399.36 |
1.5× |
| Ribs bilateral 3 views (71110) |
$183.18 |
$572.44 |
1.8× |
| Scapula (73010) |
$127.80 |
$399.36 |
1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$25.72 |
$80.37 |
1.1× |
| Shoulder 1 view (73020) |
$69.24 |
$216.37 |
0.8× |
| Small bowel series (74250) |
$251.63 |
$786.34 |
1.5× |
| Spine thoracic 3 views (72072) |
$169.73 |
$530.41 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$313.75 |
$980.46 |
0.8× |
| Ultrasound breast complete (76641) |
$254.40 |
$795 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$146.39 |
$457.46 |
1.5× |
| Us breast unilateral limited (76642) |
$94.96 |
$296.74 |
1.1× |
| Us chest (76604) |
$148.36 |
$463.64 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$155.88 |
$487.13 |
1.6× |
| Us elastography parenchyma (76981) |
$97.81 |
$305.66 |
1.0× |
| Us ob limited (76815) |
$166.56 |
$520.51 |
1.7× |
| Us ob transvaginal (76817) |
$265.48 |
$829.61 |
2.6× |
| Us pelvic non ob complete (76856) |
$271.81 |
$849.40 |
2.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$94.56 |
$295.50 |
0.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$280.91 |
$877.83 |
2.8× |
| Us retroperitoneal complete (76770) |
$371.91 |
$1,162.21 |
3.7× |
| Us retroperitoneal limited (76775) |
$367.16 |
$1,147.37 |
3.7× |
| Us scrotum and contents (76870) |
$189.91 |
$593.46 |
1.9× |
| Us soft tissue head/neck (76536) |
$215.62 |
$673.83 |
2.2× |
| Wrist 2 views (73100) |
$69.24 |
$216.37 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$176.85 |
$552.66 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$127.80 |
$399.36 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$116.52 |
$364.11 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$160.23 |
$500.73 |
1.9× |
| X-ray exam of femur 2/> (73552) |
$127.80 |
$399.36 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$100.10 |
$312.81 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$96.54 |
$301.68 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$211.67 |
$661.46 |
2.1× |
| X-ray retrograde pyelogram (74420) |
$424.52 |
$1,326.64 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$125.42 |
$391.94 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$142.43 |
$445.09 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$198.61 |
$620.66 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$187.93 |
$587.28 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$125.82 |
$393.18 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$213.25 |
$666.41 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$113.16 |
$353.61 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$69.24 |
$216.37 |
0.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$125.82 |
$393.18 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$127.80 |
$399.36 |
1.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$169.73 |
$530.41 |
1.7× |
| Xr c-spine 4 or 5 views (72050) |
$189.51 |
$592.23 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$223.93 |
$699.79 |
2.2× |