| Abdomen 2 views (74019) |
$56.85 |
$189.50 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$83.70 |
$279 |
0.0× |
| Ankle 2 views (73600) |
$50.70 |
$169 |
0.6× |
| Bone age studies (77072) |
$9 |
$30 |
0.1× |
| Bone Imaging 3 Phase (78315) |
$461.70 |
$1,539 |
1.3× |
| Bone survey complete (77075) |
$99 |
$330 |
1.0× |
| Brain image w/flow 4 + views (78606) |
$378.90 |
$1,263 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$58.95 |
$196.50 |
0.7× |
| Chest 1 view (71045) |
$50.70 |
$169 |
0.6× |
| Chest 3 views (71047) |
$59.40 |
$198 |
0.8× |
| Clavicle complete (73000) |
$44.70 |
$149 |
0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$264.15 |
$880.50 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$450.45 |
$1,501.50 |
1.4× |
| CT abdomen and pelvis without contrast (74176) |
$636.60 |
$2,122 |
2.9× |
| CT abdomen w contrast (74160) |
$245.10 |
$817 |
1.5× |
| CT abdomen w wo contrast (74170) |
$343.05 |
$1,143.50 |
2.2× |
| CT abdomen w/o contrast (74150) |
$212.40 |
$708 |
2.2× |
| CT angiography upper extremity lt (73206) |
$714.75 |
$2,382.50 |
4.5× |
| CT c-spine w/o contrast (72125) |
$208.35 |
$694.50 |
2.2× |
| CT cervical spine w&w/o contrast (72127) |
$412.88 |
$1,376.25 |
2.6× |
| CT cervical spine with contrast (72126) |
$427.50 |
$1,425 |
1.4× |
| CT chest w/wo contrast (71270) |
$660.30 |
$2,201 |
4.2× |
| CT chest with contrast (71260) |
$427.50 |
$1,425 |
2.7× |
| CT head/brain with contrast (70460) |
$427.50 |
$1,425 |
2.7× |
| CT head/brain without and with contrast (70470) |
$653.10 |
$2,177 |
4.1× |
| CT iac w contrast (70481) |
$231 |
$770 |
1.5× |
| CT lower ext w/o (73700) |
$368.70 |
$1,229 |
3.9× |
| CT lower extremity w wo contrast (73702) |
$653.10 |
$2,177 |
4.1× |
| CT lower extremity with contrast (73701) |
$427.50 |
$1,425 |
2.7× |
| CT lumbar spine w & w/o contrast (72133) |
$401.70 |
$1,339 |
2.5× |
| CT lumbar spine w/o contrast (72131) |
$391.80 |
$1,306 |
4.1× |
| CT lumbar spine with contrast (72132) |
$346.43 |
$1,154.78 |
1.1× |
| CT maxillofacial w contrast (70487) |
$427.50 |
$1,425 |
2.7× |
| CT maxillofacial w/o contrast (70486) |
$171.90 |
$573 |
1.8× |
| CT maxillofacial w/wo contrast (70488) |
$660.30 |
$2,201 |
4.2× |
| CT neck soft tissue w contrast (70491) |
$427.50 |
$1,425 |
2.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$368.70 |
$1,229 |
2.3× |
| CT orbits w/o contrast (70480) |
$208.80 |
$696 |
2.2× |
| CT pelvis w & w/o contrast (72194) |
$540 |
$1,800 |
3.4× |
| CT pelvis w/o contrast (72192) |
$302.70 |
$1,009 |
3.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$660.30 |
$2,201 |
4.2× |
| CT soft tissue neck w/o contrast (70490) |
$310.80 |
$1,036 |
3.3× |
| CT thoracic spine w/contrast (72129) |
$242.85 |
$809.50 |
1.5× |
| CT thoracic spine w/o contrast (72128) |
$207.75 |
$692.50 |
2.2× |
| CT thoracic spine w/wo contrast (72130) |
$764.10 |
$2,547 |
4.8× |
| CT thorax w/o contrast (71250) |
$368.70 |
$1,229 |
3.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$653.10 |
$2,177 |
4.1× |
| CT upper extremity w/o contrast rt (73200) |
$368.70 |
$1,229 |
3.9× |
| CT upper extremity with contrast (73201) |
$427.50 |
$1,425 |
1.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$594 |
$1,980 |
3.7× |
| Cta Abdomen (74175) |
$660 |
$2,200 |
4.2× |
| CTA abdomen pelvis (74174) |
$660 |
$2,200 |
2.1× |
| CTA chest (71275) |
$462 |
$1,540 |
2.9× |
| Cta Head (70496) |
$660 |
$2,200 |
4.2× |
| CTA lwr ext w&w/o contrast (73706) |
$604.50 |
$2,015 |
3.8× |
| Cta Neck (70498) |
$594 |
$1,980 |
3.7× |
| Cta Pelvis (72191) |
$660 |
$2,200 |
4.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$66 |
$220 |
0.7× |
| Fetal biophysical profile non-stress testing (76818) |
$178.50 |
$595 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$57.75 |
$192.50 |
0.3× |
| Foot 2 views (73620) |
$50.70 |
$169 |
0.6× |
| Forearm 2 views (73090) |
$45.30 |
$151 |
0.6× |
| Hand 2 views (73120) |
$45.30 |
$151 |
0.5× |
| Hand 3 views (73130) |
$50.70 |
$169 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$42 |
$140 |
0.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$34.80 |
$116 |
0.1× |
| Humerus Min 2 Views Left (73060) |
$45.30 |
$151 |
0.6× |
| Kidney imaging morphology (78700) |
$231 |
$770 |
0.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$183.60 |
$612 |
0.4× |
| Knee 3 views (73562) |
$57.90 |
$193 |
0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$395.70 |
$1,319 |
1.1× |
| Neck soft tissue (70360) |
$45.30 |
$151 |
0.6× |
| Nm gastric emptying study (78264) |
$384.90 |
$1,283 |
1.1× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$164.70 |
$549 |
0.5× |
| Osseous survey infant (77076) |
$99.30 |
$331 |
1.0× |
| Parathyroid imaging (78070) |
$289.20 |
$964 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$36 |
$120 |
0.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$178.50 |
$595 |
0.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$104.70 |
$349 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$41.40 |
$138 |
0.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$99 |
$330 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$31.20 |
$104 |
0.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$55.35 |
$184.50 |
0.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$41.86 |
$139.55 |
0.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$59.40 |
$198 |
0.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$171.60 |
$572 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$50.70 |
$169 |
0.6× |
| Ribs bilateral 3 views (71110) |
$40.80 |
$136 |
0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$376.65 |
$1,255.50 |
1.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$435 |
$1,450 |
0.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$471.60 |
$1,572 |
1.0× |
| Sacroiliac Joints < 3 Views (72200) |
$44.70 |
$149 |
0.5× |
| Scanogram (77073) |
$84.60 |
$282 |
0.9× |
| Scapula complete (73010) |
$45.30 |
$151 |
0.5× |
| Screening digital breast tomosynthesis (77063) |
$30.22 |
$100.75 |
1.3× |
| Sella turcica (70240) |
$45.30 |
$151 |
0.6× |
| Small bowel series (74250) |
$171.60 |
$572 |
1.1× |
| Spine thoracic 3 views (72072) |
$46.80 |
$156 |
0.5× |
| Testicular Imaging With Vascular Flow (78761) |
$293.10 |
$977 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$328.80 |
$1,096 |
0.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$219.90 |
$733 |
0.6× |
| Thyroid uptake measurement (78012) |
$286.80 |
$956 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$112.65 |
$375.50 |
0.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$326.10 |
$1,087 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$178.50 |
$595 |
1.9× |
| Unlisted Ultrasound Procedure (76999) |
$95.10 |
$317 |
1.2× |
| Upper Extremity Infant (73092) |
$38.10 |
$127 |
0.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$191.10 |
$637 |
1.2× |
| Us abdl aorta screen aaa (76706) |
$26.40 |
$88 |
0.3× |
| Us breast unilateral complete (76641) |
$86.70 |
$289 |
0.9× |
| Us breast unilateral limited (76642) |
$33 |
$110 |
0.4× |
| Us chest (76604) |
$27.60 |
$92 |
0.3× |
| Us compl joint r-t w/image documentation (76881) |
$66 |
$220 |
0.7× |
| Us ob detailed single fetus (76811) |
$144.30 |
$481 |
0.7× |
| Us ob transvaginal (76817) |
$106.65 |
$355.50 |
1.1× |
| Us pelvic non ob complete (76856) |
$134.40 |
$448 |
1.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$23.10 |
$77 |
0.2× |
| Us pregnancy ltd (76815) |
$144.30 |
$481 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$181.50 |
$605 |
1.9× |
| Us retroperitoneal complete (76770) |
$178.50 |
$595 |
1.9× |
| Us retroperitoneal limited (76775) |
$123.30 |
$411 |
1.3× |
| Us scrotum and contents (76870) |
$178.50 |
$595 |
1.9× |
| Us soft tissue head/neck (76536) |
$178.50 |
$595 |
1.9× |
| Us transrectal (76872) |
$178.50 |
$595 |
1.9× |
| Us xtr non-vasc lmtd (76882) |
$178.50 |
$595 |
1.9× |
| Venogram extremity bilateral (75822) |
$68.70 |
$229 |
0.0× |
| Wrist 2 views (73100) |
$50.70 |
$169 |
0.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$165 |
$550 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$54.15 |
$180.50 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$45.30 |
$151 |
0.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$45.30 |
$151 |
0.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$45.30 |
$151 |
0.6× |
| X-ray exam hip uni 1 view (73501) |
$44.70 |
$149 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$44.70 |
$149 |
0.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$82.50 |
$275 |
0.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$82.50 |
$275 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$38.10 |
$127 |
0.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$63.60 |
$212 |
0.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$45.30 |
$151 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$38.10 |
$127 |
0.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$50.70 |
$169 |
0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$53.70 |
$179 |
0.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$38.10 |
$127 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$52.95 |
$176.50 |
0.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$57 |
$190 |
0.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$82.50 |
$275 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$36 |
$120 |
0.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$66 |
$220 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$36.45 |
$121.50 |
0.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$24.90 |
$83 |
0.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$55.20 |
$184 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$59.40 |
$198 |
0.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$27.60 |
$92 |
0.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$37.20 |
$124 |
0.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$45.30 |
$151 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$28.50 |
$95 |
0.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$46.80 |
$156 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$46.80 |
$156 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$95.40 |
$318 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$66 |
$220 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$55.20 |
$184 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$46.80 |
$156 |
0.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$31.80 |
$106 |
0.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$45.30 |
$151 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$67.05 |
$223.50 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$45.30 |
$151 |
0.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$128.10 |
$427 |
1.4× |
| Xr shoulder 1 view (73020) |
$45.30 |
$151 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$59.70 |
$199 |
0.6× |
| Xr tibia/fibula 2 views (73590) |
$45.30 |
$151 |
0.6× |
| Xr tmj bilateral (70330) |
$50.70 |
$169 |
0.6× |
| Xray knee 1 or 2 views rt (73560) |
$33 |
$110 |
0.4× |