| Abdomen 2 views (74019) |
$407 |
$428 |
3.7× |
| Ankle 2 views (73600) |
$282 |
$297 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,064 |
$1,120 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,987 |
$2,092 |
4.8× |
| Bone Imaging 3 Phase (78315) |
$2,316 |
$2,438 |
5.6× |
| Bone survey complete (77075) |
$937 |
$986 |
8.6× |
| Cervical spine 2 or 3 views (72040) |
$366 |
$385 |
4.1× |
| Chest 1 view (71045) |
$295 |
$311 |
3.3× |
| Chest 3 views (71047) |
$410 |
$432 |
4.5× |
| Clavicle complete (73000) |
$308 |
$324 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,231 |
$1,296 |
11.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,662 |
$5,960 |
15.6× |
| CT abdomen and pelvis without contrast (74176) |
$4,147 |
$4,365 |
16.7× |
| CT abdomen w contrast (74160) |
$2,826 |
$2,975 |
15.5× |
| CT abdomen w wo contrast (74170) |
$3,297 |
$3,471 |
18.1× |
| CT abdomen w/o contrast (74150) |
$2,484 |
$2,615 |
22.9× |
| CT angiography upper extremity lt (73206) |
$3,517 |
$3,702 |
19.3× |
| CT c-spine w/o contrast (72125) |
$2,576 |
$2,712 |
23.7× |
| CT cervical spine w&w/o contrast (72127) |
$2,932 |
$3,086 |
16.1× |
| CT cervical spine with contrast (72126) |
$2,932 |
$3,086 |
8.1× |
| CT chest w/wo contrast (71270) |
$3,215 |
$3,384 |
17.7× |
| CT chest with contrast (71260) |
$2,774 |
$2,920 |
15.2× |
| CT head/brain with contrast (70460) |
$2,481 |
$2,612 |
13.6× |
| CT head/brain without and with contrast (70470) |
$2,846 |
$2,996 |
15.6× |
| CT iac w contrast (70481) |
$2,804 |
$2,952 |
15.4× |
| CT limited/localized follow up study (76380) |
$675 |
$710 |
7.5× |
| CT lower ext w/o (73700) |
$2,387 |
$2,513 |
22.0× |
| CT lower extremity w wo contrast (73702) |
$3,120 |
$3,284 |
17.1× |
| CT lower extremity with contrast (73701) |
$2,702 |
$2,844 |
14.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,894 |
$3,046 |
15.9× |
| CT lumbar spine with contrast (72132) |
$2,879 |
$3,030 |
7.9× |
| CT maxillofacial w contrast (70487) |
$2,417 |
$2,544 |
13.3× |
| CT maxillofacial w/o contrast (70486) |
$2,038 |
$2,145 |
18.8× |
| CT maxillofacial w/wo contrast (70488) |
$2,658 |
$2,798 |
14.6× |
| CT neck soft tissue w contrast (70491) |
$2,599 |
$2,736 |
14.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,874 |
$3,025 |
15.8× |
| CT orbits w/o contrast (70480) |
$2,367 |
$2,492 |
21.8× |
| CT pelvis w & w/o contrast (72194) |
$3,093 |
$3,256 |
17.0× |
| CT pelvis w/o contrast (72192) |
$2,494 |
$2,625 |
23.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,919 |
$3,073 |
16.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,316 |
$2,438 |
21.3× |
| CT thoracic spine w/contrast (72129) |
$2,241 |
$2,359 |
12.3× |
| CT thoracic spine w/o contrast (72128) |
$2,552 |
$2,686 |
23.5× |
| CT thoracic spine w/wo contrast (72130) |
$3,071 |
$3,233 |
16.9× |
| CT thorax w/o contrast (71250) |
$2,487 |
$2,618 |
22.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,120 |
$3,284 |
17.1× |
| CT upper extremity w/o contrast rt (73200) |
$4,427 |
$4,660 |
40.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,645 |
$3,837 |
20.0× |
| Cta Abdomen (74175) |
$3,618 |
$3,808 |
19.9× |
| CTA abdomen pelvis (74174) |
$5,723 |
$6,024 |
15.8× |
| CTA chest (71275) |
$3,570 |
$3,758 |
19.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$6,384 |
$6,720 |
17.6× |
| CTA lwr ext w&w/o contrast (73706) |
$3,358 |
$3,535 |
18.4× |
| Cta Neck (70498) |
$3,180 |
$3,347 |
17.5× |
| Cta Pelvis (72191) |
$3,123 |
$3,287 |
17.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$542 |
$570 |
5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$302 |
$318 |
3.3× |
| Fetal biophysical profile non-stress testing (76818) |
$660 |
$695 |
6.1× |
| Foot 2 views (73620) |
$276 |
$290 |
3.1× |
| Forearm 2 views (73090) |
$310 |
$326 |
3.4× |
| Hand 2 views (73120) |
$285 |
$300 |
2.6× |
| Hand 3 views (73130) |
$351 |
$369 |
3.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,090 |
$2,200 |
3.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,873 |
$1,972 |
4.5× |
| Ht muscle image spect sing (78451) |
$4,114 |
$4,330 |
3.1× |
| Humerus Min 2 Views Left (73060) |
$335 |
$353 |
3.7× |
| Knee 3 views (73562) |
$393 |
$414 |
4.3× |
| MRA head w/o contrast (70544) |
$3,535 |
$3,721 |
14.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,054 |
$4,267 |
11.2× |
| MRA neck w/o contrast (70547) |
$3,219 |
$3,388 |
13.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,415 |
$4,647 |
12.2× |
| MRI abdomen w/o contrast (74181) |
$3,475 |
$3,658 |
14.0× |
| MRI any jnt lwr ext with con lt (73722) |
$3,486 |
$3,669 |
4.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,288 |
$3,461 |
4.0× |
| MRI c-spine with contrast (72142) |
$3,464 |
$3,646 |
9.6× |
| MRI cervical spine w/o contrast (72141) |
$3,632 |
$3,823 |
14.7× |
| MRI chest w/o & w/contrast material (71552) |
$4,006 |
$4,217 |
11.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,991 |
$3,148 |
8.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,991 |
$3,148 |
8.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,040 |
$3,200 |
12.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,274 |
$3,446 |
13.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,951 |
$4,159 |
10.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,329 |
$4,557 |
11.9× |
| MRI pelvis w/o contrast (72195) |
$3,253 |
$3,424 |
13.1× |
| MRI scan of arm joint before and after contrast (73223) |
$3,826 |
$4,027 |
10.6× |
| MRI scan of leg joint before and after contrast (73723) |
$3,745 |
$3,942 |
10.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,624 |
$4,867 |
12.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,106 |
$4,322 |
11.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,464 |
$4,699 |
12.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,601 |
$4,843 |
12.7× |
| MRI thoracic spine w/o contrast (72146) |
$3,733 |
$3,929 |
15.1× |
| MRI tmj (70336) |
$3,213 |
$3,382 |
13.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,754 |
$2,899 |
11.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,485 |
$3,668 |
9.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,965 |
$3,121 |
12.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,612 |
$4,855 |
3.4× |
| Neck soft tissue (70360) |
$332 |
$349 |
3.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$391 |
$412 |
3.6× |
| Osseous survey limited (77074) |
$756 |
$796 |
7.0× |
| Pelvis 1 or 2 views (72170) |
$341 |
$359 |
3.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,421 |
$3,601 |
9.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$298 |
$314 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$534 |
$562 |
4.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$503 |
$529 |
4.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$322 |
$339 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$371 |
$390 |
4.1× |
| Ribs bilateral 3 views (71110) |
$467 |
$492 |
4.3× |
| Scapula complete (73010) |
$400 |
$421 |
3.7× |
| Spine thoracic 3 views (72072) |
$532 |
$560 |
4.9× |
| Ultrasound, abdomen limited (76705) |
$684 |
$720 |
6.3× |
| Unlisted Ultrasound Procedure (76999) |
$516 |
$543 |
5.7× |
| Us abdl aorta screen aaa (76706) |
$622 |
$655 |
5.7× |
| Us breast unilateral complete (76641) |
$608 |
$640 |
5.6× |
| Us breast unilateral limited (76642) |
$441 |
$464 |
4.9× |
| Us chest (76604) |
$599 |
$631 |
5.5× |
| Us compl joint r-t w/image documentation (76881) |
$701 |
$738 |
6.5× |
| Us kidney transplant (76776) |
$865 |
$910 |
8.0× |
| Us ob transvaginal (76817) |
$571 |
$601 |
5.3× |
| Us pelvic non ob complete (76856) |
$860 |
$905 |
7.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$493 |
$519 |
4.5× |
| Us pregnancy ltd (76815) |
$479 |
$504 |
4.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$725 |
$763 |
6.7× |
| Us retroperitoneal complete (76770) |
$997 |
$1,049 |
9.2× |
| Us retroperitoneal limited (76775) |
$623 |
$656 |
5.7× |
| Us scrotum and contents (76870) |
$716 |
$754 |
6.6× |
| Us soft tissue head/neck (76536) |
$665 |
$700 |
6.1× |
| Us xtr non-vasc lmtd (76882) |
$584 |
$615 |
5.4× |
| Wrist 2 views (73100) |
$276 |
$291 |
3.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$557 |
$586 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$338 |
$356 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$347 |
$365 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$300 |
$316 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$348 |
$366 |
3.9× |
| X-ray exam hip uni 1 view (73501) |
$238 |
$251 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$362 |
$381 |
4.0× |
| X-ray exam of femur 1 (73551) |
$342 |
$360 |
3.8× |
| X-ray eye for foreign body (70030) |
$265 |
$279 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$461 |
$485 |
4.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$364 |
$383 |
4.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$258 |
$272 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$326 |
$343 |
3.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$403 |
$424 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$233 |
$245 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$455 |
$479 |
4.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$514 |
$541 |
4.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$352 |
$371 |
3.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$340 |
$358 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$430 |
$453 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$332 |
$349 |
3.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$368 |
$387 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$427 |
$449 |
4.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$286 |
$301 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$344 |
$362 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$327 |
$344 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$334 |
$352 |
3.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$387 |
$407 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$248 |
$261 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$333 |
$350 |
3.7× |
| Xr c-spine 6 or more views (72052) |
$675 |
$710 |
6.2× |
| Xr chest 4+ views (71048) |
$430 |
$453 |
4.0× |
| Xr finger(s) 2+ views (73140) |
$252 |
$265 |
2.8× |
| Xr shoulder 1 view (73020) |
$261 |
$275 |
2.9× |
| Xr spine cervical 4 or 5 views (72050) |
$515 |
$542 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$336 |
$354 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$343 |
$361 |
3.8× |