| Abdomen 2 views (74019) |
$129.96 |
$171 |
1.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$471.96 |
$621 |
1.3× |
| Ankle 2 views (73600) |
$65.36 |
$86 |
0.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$765.70 |
$1,007.50 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$965.20 |
$1,270 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,018.40 |
$1,340 |
2.7× |
| Bone age studies (77072) |
$140.98 |
$185.50 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$681.72 |
$897 |
1.8× |
| Bone survey complete (77075) |
$329.84 |
$434 |
3.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$874.76 |
$1,151 |
2.3× |
| Cervical spine 2 or 3 views (72040) |
$134.14 |
$176.50 |
1.6× |
| Chest 1 view (71045) |
$170.24 |
$224 |
2.1× |
| Chest 3 views (71047) |
$58.52 |
$77 |
0.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$611.04 |
$804 |
3.7× |
| Clavicle complete (73000) |
$189.24 |
$249 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$421.80 |
$555 |
4.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,015.84 |
$5,284 |
12.3× |
| CT abdomen and pelvis without contrast (74176) |
$3,256.60 |
$4,285 |
14.5× |
| CT abdomen w contrast (74160) |
$1,792.84 |
$2,359 |
10.9× |
| CT abdomen w wo contrast (74170) |
$2,372.72 |
$3,122 |
14.4× |
| CT abdomen w/o contrast (74150) |
$1,330 |
$1,750 |
13.6× |
| CT angio hrt w/3d image (75574) |
$2,189.56 |
$2,881 |
6.7× |
| CT angiography upper extremity lt (73206) |
$1,053.36 |
$1,386 |
6.4× |
| CT c-spine w/o contrast (72125) |
$1,566.36 |
$2,061 |
16.0× |
| CT chest w/wo contrast (71270) |
$1,919 |
$2,525 |
11.7× |
| CT chest with contrast (71260) |
$1,584.60 |
$2,085 |
9.6× |
| CT head/brain with contrast (70460) |
$1,596 |
$2,100 |
9.7× |
| CT head/brain without and with contrast (70470) |
$1,930.40 |
$2,540 |
11.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$436.24 |
$574 |
5.3× |
| CT lower ext w/o (73700) |
$1,443.24 |
$1,899 |
14.7× |
| CT lumbar spine w & w/o contrast (72133) |
$875.52 |
$1,152 |
5.3× |
| CT lumbar spine w/o contrast (72131) |
$1,727.48 |
$2,273 |
17.6× |
| CT lumbar spine with contrast (72132) |
$1,258.56 |
$1,656 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,102.76 |
$1,451 |
6.7× |
| CT maxillofacial w/o contrast (70486) |
$1,421.96 |
$1,871 |
14.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,213.72 |
$1,597 |
7.4× |
| CT neck soft tissue w contrast (70491) |
$1,529.12 |
$2,012 |
9.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$832.96 |
$1,096 |
5.1× |
| CT orbits w/o contrast (70480) |
$1,139.24 |
$1,499 |
11.6× |
| CT pelvis w & w/o contrast (72194) |
$2,254.92 |
$2,967 |
13.7× |
| CT pelvis w/o contrast (72192) |
$1,361.54 |
$1,791.50 |
13.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,031.48 |
$2,673 |
12.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,354.32 |
$1,782 |
13.8× |
| CT thoracic spine w/o contrast (72128) |
$1,710.76 |
$2,251 |
17.4× |
| CT thorax w/o contrast (71250) |
$1,838.44 |
$2,419 |
18.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,929.64 |
$2,539 |
11.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,443.24 |
$1,899 |
14.7× |
| CT upper extremity with contrast (73201) |
$1,573.20 |
$2,070 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,512.40 |
$1,990 |
9.2× |
| Cta Abdomen (74175) |
$1,240.32 |
$1,632 |
7.5× |
| CTA abdomen pelvis (74174) |
$3,256.60 |
$4,285 |
9.9× |
| CTA chest (71275) |
$1,567.12 |
$2,062 |
9.5× |
| Cta Head (70496) |
$1,599.04 |
$2,104 |
9.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,053.36 |
$1,386 |
6.4× |
| Cta Neck (70498) |
$1,240.32 |
$1,632 |
7.5× |
| Cta Pelvis (72191) |
$1,148.36 |
$1,511 |
7.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$362.52 |
$477 |
3.7× |
| Echoencephalography real time imaging (76506) |
$327.56 |
$431 |
3.3× |
| Esophagus (74220) |
$381.52 |
$502 |
2.3× |
| Fluoroscopy up to 1 hr (76000) |
$409.64 |
$539 |
1.8× |
| Foot 2 views (73620) |
$77.52 |
$102 |
0.9× |
| Forearm 2 views (73090) |
$149.72 |
$197 |
1.8× |
| Hand 2 views (73120) |
$56.24 |
$74 |
0.6× |
| Hand 3 views (73130) |
$161.50 |
$212.50 |
2.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$965.20 |
$1,270 |
1.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$965.20 |
$1,270 |
2.6× |
| Ht muscle image spect sing (78451) |
$1,288.96 |
$1,696 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$133 |
$175 |
1.6× |
| Kidney imaging morphology (78700) |
$860.32 |
$1,132 |
2.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$490.20 |
$645 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$540.36 |
$711 |
1.1× |
| Knee 3 views (73562) |
$125.02 |
$164.50 |
1.5× |
| Liver & spleen imaging static only (78215) |
$383.80 |
$505 |
1.0× |
| Liver imaging static only (78201) |
$826.88 |
$1,088 |
1.6× |
| Lung Ventilation Imaging (78579) |
$744.04 |
$979 |
2.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$56.24 |
$74 |
0.7× |
| Meckels Diverticulum (78290) |
$1,018.40 |
$1,340 |
2.7× |
| MRA head w/o contrast (70544) |
$2,041.36 |
$2,686 |
9.1× |
| MRA neck w/o contrast (70547) |
$2,041.36 |
$2,686 |
9.1× |
| MRI abdomen w contrast (74182) |
$2,293.68 |
$3,018 |
7.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,438.08 |
$3,208 |
7.4× |
| MRI abdomen w/o contrast (74181) |
$2,041.36 |
$2,686 |
9.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,361.92 |
$1,792 |
1.9× |
| MRI cervical spine w/o contrast (72141) |
$2,098.36 |
$2,761 |
9.4× |
| MRI chest w/o & w/contrast material (71552) |
$4,262.08 |
$5,608 |
13.0× |
| MRI chest w/o contrast (71550) |
$2,041.36 |
$2,686 |
9.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,594.86 |
$2,098.50 |
7.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,041.36 |
$2,686 |
9.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,262.08 |
$5,608 |
13.0× |
| MRI pelvis w contrast (72196) |
$2,232.88 |
$2,938 |
6.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,309.96 |
$5,671 |
13.2× |
| MRI pelvis w/o contrast (72195) |
$2,120.40 |
$2,790 |
9.5× |
| MRI scan of arm joint before and after contrast (73223) |
$3,329.94 |
$4,381.50 |
10.2× |
| MRI scan of leg joint before and after contrast (73723) |
$3,329.94 |
$4,381.50 |
10.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,424.72 |
$5,822 |
13.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,498.44 |
$5,919 |
13.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,391.28 |
$5,778 |
13.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,424.72 |
$5,822 |
13.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,318 |
$3,050 |
10.4× |
| MRI tmj (70336) |
$2,073.28 |
$2,728 |
9.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,594.86 |
$2,098.50 |
7.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,811.84 |
$2,384 |
5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$969.76 |
$1,276 |
4.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,226.80 |
$2,930 |
1.8× |
| Neck soft tissue (70360) |
$77.90 |
$102.50 |
1.0× |
| Nm gastric emptying study (78264) |
$1,018.40 |
$1,340 |
2.7× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$279.68 |
$368 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$292.22 |
$384.50 |
1.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$416.48 |
$548 |
4.2× |
| Osseous survey infant (77076) |
$194.94 |
$256.50 |
2.0× |
| Osseous survey limited (77074) |
$308.94 |
$406.50 |
3.1× |
| Parathyroid imaging (78070) |
$660.44 |
$869 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$85.12 |
$112 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,329.94 |
$4,381.50 |
10.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$510.34 |
$671.50 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$932.52 |
$1,227 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$142.12 |
$187 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$59.28 |
$78 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$164.16 |
$216 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$130.34 |
$171.50 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$173.28 |
$228 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$115.14 |
$151.50 |
1.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$130.72 |
$172 |
1.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$130.72 |
$172 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$389.88 |
$513 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$675.64 |
$889 |
4.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$387.22 |
$509.50 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$112.48 |
$148 |
1.4× |
| Radiological examination surgical specimen (76098) |
$33.06 |
$43.50 |
0.1× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$139.08 |
$183 |
0.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$225.72 |
$297 |
0.4× |
| Ribs bilateral 3 views (71110) |
$90.44 |
$119 |
0.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$570.76 |
$751 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$90.06 |
$118.50 |
0.9× |
| Scanogram (77073) |
$139.84 |
$184 |
1.4× |
| Scapula complete (73010) |
$151.62 |
$199.50 |
1.5× |
| Screening digital breast tomosynthesis (77063) |
$83.60 |
$110 |
3.6× |
| Sella turcica (70240) |
$49.40 |
$65 |
0.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$164.16 |
$216 |
1.7× |
| Small bowel series (74250) |
$383.80 |
$505 |
2.3× |
| Spine thoracic 3 views (72072) |
$135.66 |
$178.50 |
1.4× |
| Thoracolumbar 2 views (72080) |
$89.68 |
$118 |
1.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$865.26 |
$1,138.50 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$317.68 |
$418 |
0.8× |
| Thyroid uptake measurement (78012) |
$150.48 |
$198 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$361 |
$475 |
1.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,406.76 |
$1,851 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$398.62 |
$524.50 |
4.1× |
| Unlisted Ultrasound Procedure (76999) |
$139.08 |
$183 |
1.7× |
| Upper Extremity Infant (73092) |
$78.28 |
$103 |
0.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$531.24 |
$699 |
1.4× |
| Urethrocystography voiding (74455) |
$503.12 |
$662 |
2.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$327.94 |
$431.50 |
2.0× |
| Us abdl aorta screen aaa (76706) |
$166.44 |
$219 |
1.7× |
| Us breast unilateral complete (76641) |
$256.88 |
$338 |
2.6× |
| Us breast unilateral limited (76642) |
$211.28 |
$278 |
2.6× |
| Us chest (76604) |
$613.32 |
$807 |
6.3× |
| Us infant hips limited static (76886) |
$247.76 |
$326 |
3.0× |
| Us ob transvaginal (76817) |
$115.52 |
$152 |
1.2× |
| Us pelvic non ob complete (76856) |
$178.60 |
$235 |
1.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$366.32 |
$482 |
3.7× |
| Us pregnancy ltd (76815) |
$375.06 |
$493.50 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$746.32 |
$982 |
7.6× |
| Us retroperitoneal complete (76770) |
$620.92 |
$817 |
6.3× |
| Us retroperitoneal limited (76775) |
$203.68 |
$268 |
2.1× |
| Us scrotum and contents (76870) |
$613.32 |
$807 |
6.3× |
| Us soft tissue head/neck (76536) |
$369.74 |
$486.50 |
3.8× |
| Us spinal canal and contents (76800) |
$247.76 |
$326 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$69.92 |
$92 |
0.7× |
| Venogram extremity bilateral (75822) |
$297.16 |
$391 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$259.92 |
$342 |
0.2× |
| Wrist 2 views (73100) |
$69.92 |
$92 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$187.72 |
$247 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$155.42 |
$204.50 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$165.30 |
$217.50 |
2.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$671.08 |
$883 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$69.92 |
$92 |
0.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$123.88 |
$163 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$82.08 |
$108 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$74.10 |
$97.50 |
0.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$74.48 |
$98 |
0.8× |
| X-ray eye for foreign body (70030) |
$69.92 |
$92 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$114 |
$150 |
1.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$125.02 |
$164.50 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$152.38 |
$200.50 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$126.54 |
$166.50 |
1.5× |
| X-ray IV pyelogram+drip infusn (74410) |
$212.04 |
$279 |
1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$63.84 |
$84 |
0.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$50.16 |
$66 |
0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$94.24 |
$124 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$78.28 |
$103 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$114.76 |
$151 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$148.96 |
$196 |
1.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$133.76 |
$176 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$111.72 |
$147 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$109.44 |
$144 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$121.98 |
$160.50 |
1.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$129.96 |
$171 |
0.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$90.44 |
$119 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$137.94 |
$181.50 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$109.06 |
$143.50 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$99.94 |
$131.50 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$31.92 |
$42 |
0.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$102.98 |
$135.50 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$69.92 |
$92 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$253.84 |
$334 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$49.40 |
$65 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$89.68 |
$118 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$47.88 |
$63 |
0.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$85.88 |
$113 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$107.54 |
$141.50 |
1.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$69.92 |
$92 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$166.82 |
$219.50 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$149.72 |
$197 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$64.60 |
$85 |
0.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$88.54 |
$116.50 |
0.9× |
| Xr optic foramina (70190) |
$55.10 |
$72.50 |
0.7× |
| Xr shoulder 1 view (73020) |
$82.08 |
$108 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$169.86 |
$223.50 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$146.68 |
$193 |
1.8× |
| Xr tmj bilateral (70330) |
$112.48 |
$148 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$89.68 |
$118 |
1.1× |