| Abdomen 1 View (74018) |
$357.60 |
$447 |
4.0× |
| Abdomen 2 views (74019) |
$437.60 |
$547 |
4.1× |
| Ankle 2 views (73600) |
$348 |
$435 |
3.9× |
| Bone age studies (77072) |
$432.80 |
$541 |
4.0× |
| Bone Imaging 3 Phase (78315) |
$1,639.20 |
$2,049 |
4.0× |
| Bone Imaging Limited Area (78300) |
$1,358.40 |
$1,698 |
3.3× |
| Bone Imaging Multiple Areas (78305) |
$1,450.40 |
$1,813 |
3.5× |
| Bone Imaging Whole Body (78306) |
$1,857.60 |
$2,322 |
4.5× |
| Bone survey infant (77076) |
$496 |
$620 |
4.6× |
| Cat Scan Follow-Up Study (76380) |
$992.80 |
$1,241 |
11.1× |
| Chest 1 view (71045) |
$307.20 |
$384 |
3.4× |
| Chest 2 views (71046) |
$386.40 |
$483 |
4.3× |
| Chest 3 views (71047) |
$457.60 |
$572 |
5.1× |
| Chest 4 or more views (71048) |
$584.80 |
$731 |
5.4× |
| Clavicle complete (73000) |
$365.60 |
$457 |
4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$542.40 |
$678 |
5.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,288.80 |
$5,361 |
11.9× |
| CT abdomen and pelvis without contrast (74176) |
$3,476 |
$4,345 |
14.1× |
| CT abdomen w contrast (74160) |
$2,364 |
$2,955 |
13.1× |
| CT abdomen w wo contrast (74170) |
$2,673.60 |
$3,342 |
14.8× |
| CT abdomen w/o contrast (74150) |
$1,928.80 |
$2,411 |
17.9× |
| CT Angio Abdomen and Pelvis (74174) |
$4,071.20 |
$5,089 |
11.3× |
| CT Angio Chest (71275) |
$2,758.40 |
$3,448 |
15.2× |
| CT Angio Head (70496) |
$2,606.40 |
$3,258 |
14.4× |
| CT Angio Neck (70498) |
$2,615.20 |
$3,269 |
14.4× |
| CT cervical spine w/ contrast (72126) |
$2,451.20 |
$3,064 |
6.8× |
| CT cervical spine w/o contrast (72125) |
$1,996.80 |
$2,496 |
18.5× |
| CT chest w contrast (71260) |
$2,296.80 |
$2,871 |
12.7× |
| CT chest w/wo contrast (71270) |
$2,644 |
$3,305 |
14.6× |
| CT head/brain with contrast (70460) |
$2,047.20 |
$2,559 |
11.3× |
| CT head/brain without and with contrast (70470) |
$2,363.20 |
$2,954 |
13.1× |
| CT iac w contrast (70481) |
$2,210.40 |
$2,763 |
12.2× |
| CT lower ext w/o (73700) |
$1,751.20 |
$2,189 |
16.2× |
| CT lower extremity w/contrast material (73701) |
$2,099.20 |
$2,624 |
11.6× |
| CT lumbar spine w contrast (72132) |
$2,434.40 |
$3,043 |
6.8× |
| CT lumbar spine w/o contrast (72131) |
$1,996.80 |
$2,496 |
18.5× |
| CT maxillofacial w contrast (70487) |
$2,211.20 |
$2,764 |
12.2× |
| CT maxillofacial wo contrast (70486) |
$1,876 |
$2,345 |
17.4× |
| CT neck tissue combo (70492) |
$2,640 |
$3,300 |
14.6× |
| CT orbits w/o contrast (70480) |
$1,824 |
$2,280 |
16.9× |
| CT pelvis w/o contrast (72192) |
$1,715.20 |
$2,144 |
15.9× |
| CT soft tissue neck w contrast (70491) |
$2,211.20 |
$2,764 |
12.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,799.20 |
$2,249 |
16.7× |
| CT thoracic spine w contrast (72129) |
$2,369.60 |
$2,962 |
13.1× |
| CT thoracic spine w/o contrast (72128) |
$1,924 |
$2,405 |
17.8× |
| CT thorax w/o contrast (71250) |
$1,964.80 |
$2,456 |
18.2× |
| CT upper ext wo (73200) |
$1,744.80 |
$2,181 |
16.2× |
| CT upper extremity with contrast (73201) |
$2,151.20 |
$2,689 |
6.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,056 |
$3,820 |
16.9× |
| Cta Abdomen (74175) |
$2,702.40 |
$3,378 |
14.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,000 |
$5,000 |
11.1× |
| Dxa Bone Density Axial (77080) |
$530.40 |
$663 |
4.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$284 |
$355 |
3.2× |
| Foot 2 views (73620) |
$371.20 |
$464 |
4.1× |
| Forearm 2 views (73090) |
$391.20 |
$489 |
4.4× |
| Gastric emptying imaging study (78264) |
$1,236 |
$1,545 |
3.0× |
| Hand 2 views (73120) |
$348.80 |
$436 |
3.2× |
| Hepatobil Syst Image W/Drug (78227) |
$1,854.40 |
$2,318 |
3.3× |
| Ht Muscle Image Spect Sing (78451) |
$2,913.60 |
$3,642 |
2.2× |
| Joint Survey Single View (77077) |
$332.80 |
$416 |
3.1× |
| Knee 3 Views (73562) |
$532.80 |
$666 |
5.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,065.60 |
$2,582 |
3.7× |
| Magnetic Image Jaw Joint (70336) |
$2,739.20 |
$3,424 |
11.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,830.40 |
$4,788 |
10.6× |
| MRA head w/o contrast (70544) |
$3,235.20 |
$4,044 |
13.1× |
| MRA head with contrast (70545) |
$3,181.60 |
$3,977 |
8.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,708 |
$4,635 |
10.3× |
| MRI abdomen w/o contrast (74181) |
$2,804.80 |
$3,506 |
11.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,164 |
$3,955 |
3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,810.40 |
$4,763 |
10.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,234.40 |
$4,043 |
4.0× |
| MRI cervical spine w contrast (72142) |
$3,477.60 |
$4,347 |
9.7× |
| MRI cervical spine w/o cont (72141) |
$2,959.20 |
$3,699 |
12.0× |
| MRI chest w/o contrast (71550) |
$2,727.20 |
$3,409 |
11.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,207.20 |
$4,009 |
8.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,701.60 |
$4,627 |
10.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,974.40 |
$3,718 |
12.1× |
| MRI lumbar spine w contrast (72149) |
$3,376.80 |
$4,221 |
9.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,034.40 |
$5,043 |
11.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,105.60 |
$3,882 |
12.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,011.20 |
$5,014 |
11.1× |
| MRI pelvis w/o & w contrast (72197) |
$3,837.60 |
$4,797 |
10.7× |
| MRI pelvis w/o contrast (72195) |
$2,744 |
$3,430 |
11.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,976 |
$3,720 |
12.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,265.60 |
$4,082 |
9.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,222.40 |
$4,028 |
13.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,688.80 |
$4,611 |
10.2× |
| MRI, abdomen, combo (74183) |
$3,850.40 |
$4,813 |
10.7× |
| MRI, dorsal spine combo (72157) |
$4,034.40 |
$5,043 |
11.2× |
| MRI, dorsal spine contrast (72147) |
$3,460.80 |
$4,326 |
9.6× |
| MRI, joint upper extrem (73221) |
$3,040.80 |
$3,801 |
12.3× |
| MRI, joint upper extrem combo (73223) |
$3,881.60 |
$4,852 |
10.8× |
| MRI, lumbar spine combo (72158) |
$4,034.40 |
$5,043 |
11.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,842.40 |
$4,803 |
2.9× |
| Neck soft tissue (70360) |
$328.80 |
$411 |
3.7× |
| Parathyroid Planar Imaging (78070) |
$1,509.60 |
$1,887 |
3.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,752.80 |
$2,191 |
4.2× |
| Pelvis 1 or 2 views (72170) |
$351.20 |
$439 |
3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,476 |
$1,845 |
3.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$706.40 |
$883 |
6.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$513.60 |
$642 |
5.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$408 |
$510 |
4.5× |
| Radex elbow complete minimum 3 views (73080) |
$437.60 |
$547 |
4.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$570.40 |
$713 |
5.3× |
| Radex fingr minimum 2 views (73140) |
$319.20 |
$399 |
3.6× |
| Radex foot complete minimum 3 views (73630) |
$438.40 |
$548 |
4.9× |
| Radex Hand Minimum 3 Views (73130) |
$505.60 |
$632 |
5.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$393.60 |
$492 |
4.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$404.80 |
$506 |
4.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$412.80 |
$516 |
4.6× |
| Radex shoulder complete minimum 2 views (73030) |
$530.40 |
$663 |
5.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$332.80 |
$416 |
3.7× |
| Radex Spine 1 View Specify Level (72020) |
$267.20 |
$334 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$365.60 |
$457 |
4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$415.20 |
$519 |
4.6× |
| Radex Toe Minimum 2 Views (73660) |
$322.40 |
$403 |
3.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$385.60 |
$482 |
3.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$510.40 |
$638 |
5.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$612 |
$765 |
5.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$496.80 |
$621 |
4.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$536 |
$670 |
5.0× |
| Radiologic exam knee complete 4/more views (73564) |
$640.80 |
$801 |
5.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$456.80 |
$571 |
4.2× |
| Radiologic examination femur 1 view (73551) |
$561.60 |
$702 |
6.3× |
| Radiologic examination femur minimum 2 views (73552) |
$556 |
$695 |
6.2× |
| Radiologic examination knee 1/2 views (73560) |
$446.40 |
$558 |
5.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$532.80 |
$666 |
5.9× |
| Ribs bilateral 3 views (71110) |
$604.80 |
$756 |
5.6× |
| Scapula (73010) |
$404 |
$505 |
3.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$93.60 |
$117 |
4.0× |
| Shoulder 1 view (73020) |
$303.20 |
$379 |
3.4× |
| Skull less than 4 views (70250) |
$410.40 |
$513 |
3.8× |
| Sternoclavicular joints (71130) |
$365.60 |
$457 |
4.1× |
| Thoracic spine 2 views (72070) |
$405.60 |
$507 |
3.8× |
| Thoracic spine 3 views (72072) |
$529.60 |
$662 |
4.9× |
| Thoracolumbar 2 views (72080) |
$385.60 |
$482 |
4.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$975.20 |
$1,219 |
2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,316.80 |
$1,646 |
3.2× |
| Ultrasound Exam Aaa Screen (76706) |
$488 |
$610 |
4.5× |
| Ultrasound, abdomen limited (76705) |
$743.20 |
$929 |
6.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$311.20 |
$389 |
3.5× |
| Unlisted us procedure (76999) |
$452.80 |
$566 |
5.0× |
| Us chest (76604) |
$393.60 |
$492 |
3.6× |
| Us exam, pelvic, limited (76857) |
$410.40 |
$513 |
3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$238.40 |
$298 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$344 |
$430 |
3.2× |
| Us ob transvaginal (76817) |
$371.20 |
$464 |
3.4× |
| Us pelvic non ob complete (76856) |
$772 |
$965 |
7.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$426.40 |
$533 |
4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$460.80 |
$576 |
4.3× |
| Us retroperitoneal complete (76770) |
$420.80 |
$526 |
3.9× |
| Us retroperitoneal limited (76775) |
$399.20 |
$499 |
3.7× |
| Us scrotum and contents (76870) |
$614.40 |
$768 |
5.7× |
| Us thyroid (76536) |
$426.40 |
$533 |
4.0× |
| Wrist 2 views (73100) |
$349.60 |
$437 |
3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$452.80 |
$566 |
5.0× |
| X-Ray Bend Only L-S Spine (72120) |
$392.80 |
$491 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$388.80 |
$486 |
4.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$319.20 |
$399 |
3.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$461.60 |
$577 |
4.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$621.60 |
$777 |
5.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$292.80 |
$366 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$350.40 |
$438 |
3.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$469.60 |
$587 |
4.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$506.40 |
$633 |
4.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$582.40 |
$728 |
5.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$639.20 |
$799 |
5.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$451.20 |
$564 |
5.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$503.20 |
$629 |
4.7× |
| X-ray eye for foreign body (70030) |
$324.80 |
$406 |
3.6× |
| X-ray humerus (73060) |
$532.80 |
$666 |
5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$356.80 |
$446 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$444 |
$555 |
4.1× |
| X-ray nose-rectum child f.b. (76010) |
$360 |
$450 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$641.60 |
$802 |
5.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$116 |
$145 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$404.80 |
$506 |
4.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$473.60 |
$592 |
5.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$771.20 |
$964 |
7.1× |
| X-Ray Tmj Unilat (70328) |
$287.20 |
$359 |
3.2× |
| X-Rays Bone Survey Complete (77075) |
$954.40 |
$1,193 |
8.8× |
| Xr c-spine 4 or 5 views (72050) |
$604 |
$755 |
5.6× |
| Xr facial bones less than 3 views (70140) |
$335.20 |
$419 |
3.7× |
| Xr orbits complete 4 views (70200) |
$472.80 |
$591 |
4.4× |