| Abdomen 1 View (74018) |
$348.80 |
$436 |
3.9× |
| Abdomen 2 views (74019) |
$484 |
$605 |
4.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,589.60 |
$1,987 |
3.9× |
| Ankle 2 views (73600) |
$342.40 |
$428 |
3.9× |
| Arthrogram hip (73525) |
$1,044 |
$1,305 |
2.9× |
| Bone age studies (77072) |
$365.60 |
$457 |
3.4× |
| Bone Imaging 3 Phase (78315) |
$2,013.60 |
$2,517 |
4.9× |
| Bone Imaging Limited Area (78300) |
$1,344 |
$1,680 |
3.3× |
| Bone Imaging Multiple Areas (78305) |
$1,476.80 |
$1,846 |
3.6× |
| Bone Imaging Whole Body (78306) |
$1,969.60 |
$2,462 |
4.8× |
| Bone survey infant (77076) |
$582.40 |
$728 |
5.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,801.60 |
$2,252 |
3.2× |
| Cat Scan Follow-Up Study (76380) |
$957.60 |
$1,197 |
10.8× |
| Chest 1 view (71045) |
$306.40 |
$383 |
3.4× |
| Chest 2 views (71046) |
$369.60 |
$462 |
4.2× |
| Chest 3 views (71047) |
$411.20 |
$514 |
4.6× |
| Chest 4 or more views (71048) |
$489.60 |
$612 |
4.6× |
| Clavicle complete (73000) |
$363.20 |
$454 |
4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,072.80 |
$2,591 |
19.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,085.60 |
$1,357 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,994.40 |
$6,243 |
14.0× |
| CT abdomen and pelvis without contrast (74176) |
$4,107.20 |
$5,134 |
16.8× |
| CT abdomen w contrast (74160) |
$2,896.80 |
$3,621 |
16.2× |
| CT abdomen w wo contrast (74170) |
$2,796 |
$3,495 |
15.6× |
| CT abdomen w/o contrast (74150) |
$2,237.60 |
$2,797 |
20.9× |
| CT Angio Abdomen and Pelvis (74174) |
$3,775.20 |
$4,719 |
10.6× |
| CT Angio Chest (71275) |
$2,717.60 |
$3,397 |
15.2× |
| CT Angio Head (70496) |
$2,718.40 |
$3,398 |
15.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,516 |
$3,145 |
14.0× |
| CT Angio Neck (70498) |
$3,082.40 |
$3,853 |
17.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,472.80 |
$3,091 |
13.8× |
| CT cervical spine w/ contrast (72126) |
$2,424.80 |
$3,031 |
6.8× |
| CT cervical spine w/o contrast (72125) |
$2,290.40 |
$2,863 |
21.4× |
| CT cervical spine w/wo cont (72127) |
$2,748 |
$3,435 |
15.3× |
| CT chest w contrast (71260) |
$2,841.60 |
$3,552 |
15.9× |
| CT chest w/wo contrast (71270) |
$2,862.40 |
$3,578 |
16.0× |
| CT head/brain with contrast (70460) |
$2,522.40 |
$3,153 |
14.1× |
| CT head/brain without and with contrast (70470) |
$2,708.80 |
$3,386 |
15.1× |
| CT iac w contrast (70481) |
$2,397.60 |
$2,997 |
13.4× |
| CT l-spine w&w/o contrast (72133) |
$2,746.40 |
$3,433 |
15.3× |
| CT lower ext w/o (73700) |
$1,942.40 |
$2,428 |
18.2× |
| CT lower extremity w/contrast material (73701) |
$2,017.60 |
$2,522 |
11.3× |
| CT lumbar spine w contrast (72132) |
$2,445.60 |
$3,057 |
6.9× |
| CT lumbar spine w/o contrast (72131) |
$2,344.80 |
$2,931 |
22.0× |
| CT maxillofacial w contrast (70487) |
$2,392.80 |
$2,991 |
13.4× |
| CT maxillofacial wo contrast (70486) |
$1,952 |
$2,440 |
18.3× |
| CT neck tissue combo (70492) |
$2,680.80 |
$3,351 |
15.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,619.20 |
$3,274 |
14.6× |
| CT orbits w/o contrast (70480) |
$2,057.60 |
$2,572 |
19.3× |
| CT pelvis w&w/o contrast (72194) |
$2,626.40 |
$3,283 |
14.7× |
| CT pelvis w/o contrast (72192) |
$2,008.80 |
$2,511 |
18.8× |
| CT scan of leg combo (73702) |
$2,536.80 |
$3,171 |
14.2× |
| CT scans face/jaw combo (70488) |
$2,796.80 |
$3,496 |
15.6× |
| CT soft tissue neck w contrast (70491) |
$2,743.20 |
$3,429 |
15.3× |
| CT soft tissue neck w/o contrast (70490) |
$2,036.80 |
$2,546 |
19.1× |
| CT thoracic spine w contrast (72129) |
$2,530.40 |
$3,163 |
14.1× |
| CT thoracic spine w/o contrast (72128) |
$2,279.20 |
$2,849 |
21.3× |
| CT thoracic spine w/wo cont (72130) |
$2,957.60 |
$3,697 |
16.5× |
| CT thorax w/o contrast (71250) |
$2,307.20 |
$2,884 |
21.6× |
| CT upper ext wo (73200) |
$1,811.20 |
$2,264 |
17.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,494.40 |
$3,118 |
13.9× |
| CT upper extremity with contrast (73201) |
$2,087.20 |
$2,609 |
5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,172.80 |
$3,966 |
17.7× |
| Cta Abdomen (74175) |
$2,866.40 |
$3,583 |
16.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,008 |
$3,760 |
8.4× |
| CTA pelvis (72191) |
$2,510.40 |
$3,138 |
14.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$340 |
$425 |
3.2× |
| Dxa Bone Density Axial (77080) |
$594.40 |
$743 |
5.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$369.60 |
$462 |
4.2× |
| Echo exam uterus (76831) |
$908 |
$1,135 |
3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$709.60 |
$887 |
6.6× |
| Fluoroscopy up to 1 hr (76000) |
$598.40 |
$748 |
2.5× |
| Foot 2 views (73620) |
$340.80 |
$426 |
3.8× |
| Forearm 2 views (73090) |
$363.20 |
$454 |
4.1× |
| Gastric emptying imaging study (78264) |
$1,749.60 |
$2,187 |
4.3× |
| Gastroesophageal Reflux Exam (78262) |
$1,635.20 |
$2,044 |
4.0× |
| Gated Heart Planar Single (78472) |
$2,056 |
$2,570 |
5.0× |
| Hand 2 views (73120) |
$336 |
$420 |
3.1× |
| Hepatobil Syst Image W/Drug (78227) |
$2,114.40 |
$2,643 |
3.8× |
| Hepatobiliary System Imaging (78226) |
$1,758.40 |
$2,198 |
4.3× |
| Ht Muscle Image Spect Sing (78451) |
$3,606.40 |
$4,508 |
2.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$646.40 |
$808 |
7.3× |
| Joint Survey Single View (77077) |
$328.80 |
$411 |
3.1× |
| K Flow/Funct Image W/Drug (78708) |
$2,032.80 |
$2,541 |
3.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,811.20 |
$2,264 |
3.3× |
| Knee 3 Views (73562) |
$385.60 |
$482 |
4.3× |
| Leveen/Shunt Patency Exam (78291) |
$1,164.80 |
$1,456 |
2.9× |
| Liver & Spleen Imaging Static Only (78215) |
$1,669.60 |
$2,087 |
4.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,580 |
$1,975 |
2.8× |
| Magnetic Image Jaw Joint (70336) |
$2,715.20 |
$3,394 |
11.1× |
| Meckels Divert Exam (78290) |
$1,610.40 |
$2,013 |
3.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,762.40 |
$4,703 |
10.6× |
| MRA head w/o contrast (70544) |
$2,723.20 |
$3,404 |
11.2× |
| MRA head with contrast (70545) |
$3,040.80 |
$3,801 |
8.5× |
| MRA neck w contrast (70548) |
$2,912.80 |
$3,641 |
8.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,707.20 |
$4,634 |
10.4× |
| MRA neck w/o contrast (70547) |
$2,754.40 |
$3,443 |
11.3× |
| MRI abdomen w/o contrast (74181) |
$2,930.40 |
$3,663 |
12.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,064 |
$3,830 |
3.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,798.40 |
$4,748 |
10.7× |
| MRI cervical spine w contrast (72142) |
$3,335.20 |
$4,169 |
9.4× |
| MRI cervical spine w/o cont (72141) |
$3,078.40 |
$3,848 |
12.6× |
| MRI chest w/o contrast (71550) |
$2,746.40 |
$3,433 |
11.3× |
| MRI chest with contrast (71551) |
$3,175.20 |
$3,969 |
4.0× |
| MRI chest wo w contrast (71552) |
$3,997.60 |
$4,997 |
11.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,467.20 |
$4,334 |
9.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,632 |
$4,540 |
10.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,198.40 |
$3,998 |
13.1× |
| MRI lumbar spine w contrast (72149) |
$3,285.60 |
$4,107 |
9.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,184.80 |
$5,231 |
11.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,019.20 |
$3,774 |
12.4× |
| MRI orbit face neck w contrast (70542) |
$3,536 |
$4,420 |
9.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,215.20 |
$5,269 |
11.8× |
| MRI pelvis w contrast (72196) |
$3,920.80 |
$4,901 |
11.0× |
| MRI pelvis w/o & w contrast (72197) |
$3,984 |
$4,980 |
11.2× |
| MRI pelvis w/o contrast (72195) |
$2,895.20 |
$3,619 |
11.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,043.20 |
$3,804 |
12.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,067.20 |
$3,834 |
8.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,079.20 |
$3,849 |
12.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,728.80 |
$4,661 |
10.5× |
| MRI, abdomen, combo (74183) |
$3,828.80 |
$4,786 |
10.7× |
| MRI, dorsal spine combo (72157) |
$4,165.60 |
$5,207 |
11.7× |
| MRI, dorsal spine contrast (72147) |
$3,240 |
$4,050 |
9.1× |
| MRI, joint upper extrem (73221) |
$3,198.40 |
$3,998 |
13.1× |
| MRI, joint upper extrem combo (73223) |
$4,070.40 |
$5,088 |
11.4× |
| MRI, lumbar spine combo (72158) |
$4,159.20 |
$5,199 |
11.7× |
| Myocardial Spect Multiple Studies (78452) |
$4,322.40 |
$5,403 |
3.3× |
| Neck soft tissue (70360) |
$334.40 |
$418 |
3.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,109.60 |
$2,637 |
3.8× |
| Parathyroid Planar Imaging (78070) |
$1,483.20 |
$1,854 |
3.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,856.80 |
$2,321 |
4.5× |
| Pelvis 1 or 2 views (72170) |
$348 |
$435 |
3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,363.20 |
$1,704 |
3.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$628 |
$785 |
5.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$936 |
$1,170 |
1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$388 |
$485 |
4.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$363.20 |
$454 |
4.1× |
| Radex elbow complete minimum 3 views (73080) |
$420.80 |
$526 |
4.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$528 |
$660 |
4.9× |
| Radex fingr minimum 2 views (73140) |
$278.40 |
$348 |
3.1× |
| Radex foot complete minimum 3 views (73630) |
$384.80 |
$481 |
4.3× |
| Radex Hand Minimum 3 Views (73130) |
$363.20 |
$454 |
4.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$315.20 |
$394 |
3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$350.40 |
$438 |
3.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$368 |
$460 |
4.1× |
| Radex shoulder complete minimum 2 views (73030) |
$378.40 |
$473 |
4.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$328.80 |
$411 |
3.7× |
| Radex Spine 1 View Specify Level (72020) |
$348.80 |
$436 |
3.9× |
| Radex Sternum Minimum 2 Views (71120) |
$368.80 |
$461 |
4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$442.40 |
$553 |
5.0× |
| Radex Toe Minimum 2 Views (73660) |
$278.40 |
$348 |
3.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$397.60 |
$497 |
3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$363.20 |
$454 |
4.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$732.80 |
$916 |
6.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$478.40 |
$598 |
4.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$451.20 |
$564 |
4.2× |
| Radiologic exam knee complete 4/more views (73564) |
$485.60 |
$607 |
4.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$400.80 |
$501 |
3.8× |
| Radiologic exam swallow function contrast study (74230) |
$660.80 |
$826 |
3.7× |
| Radiologic examination femur 1 view (73551) |
$352.80 |
$441 |
4.0× |
| Radiologic examination femur minimum 2 views (73552) |
$369.60 |
$462 |
4.2× |
| Radiologic examination knee 1/2 views (73560) |
$331.20 |
$414 |
3.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$580.80 |
$726 |
5.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$363.20 |
$454 |
4.1× |
| Ribs bilateral 3 views (71110) |
$634.40 |
$793 |
5.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,736 |
$3,420 |
4.9× |
| Scapula (73010) |
$390.40 |
$488 |
3.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$92.80 |
$116 |
4.0× |
| Shoulder 1 view (73020) |
$282.40 |
$353 |
3.2× |
| Shoulder Arthrography (73040) |
$1,045.60 |
$1,307 |
2.9× |
| Skull less than 4 views (70250) |
$413.60 |
$517 |
3.9× |
| Thoracic spine 2 views (72070) |
$420.80 |
$526 |
3.9× |
| Thoracic spine 3 views (72072) |
$513.60 |
$642 |
4.8× |
| Thoracolumbar 2 views (72080) |
$436.80 |
$546 |
4.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$970.40 |
$1,213 |
2.4× |
| Thyroid Uptake Measurement (78012) |
$921.60 |
$1,152 |
2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,591.20 |
$1,989 |
3.9× |
| Ultrasound Breast Limited (76642) |
$552.80 |
$691 |
6.2× |
| Ultrasound Exam Aaa Screen (76706) |
$475.20 |
$594 |
4.4× |
| Ultrasound, abdomen limited (76705) |
$705.60 |
$882 |
6.6× |
| Umbilical-artery Doppler (OB) (76820) |
$424 |
$530 |
4.0× |
| Us breast unilateral complete (76641) |
$574.40 |
$718 |
5.4× |
| Us chest (76604) |
$547.20 |
$684 |
5.1× |
| Us complete joint (76881) |
$639.20 |
$799 |
6.0× |
| Us exam, pelvic, limited (76857) |
$687.20 |
$859 |
6.4× |
| Us head (76506) |
$576.80 |
$721 |
5.4× |
| Us kidney transplant (76776) |
$840.80 |
$1,051 |
7.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$595.20 |
$744 |
5.6× |
| Us ob detailed single fetus (76811) |
$1,038.40 |
$1,298 |
4.3× |
| Us ob limited 1 or more fetuses (76815) |
$576.80 |
$721 |
5.4× |
| Us ob transvaginal (76817) |
$758.40 |
$948 |
7.1× |
| Us pelvic non ob complete (76856) |
$986.40 |
$1,233 |
9.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$731.20 |
$914 |
6.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$565.60 |
$707 |
5.3× |
| Us retroperitoneal complete (76770) |
$934.40 |
$1,168 |
8.7× |
| Us retroperitoneal limited (76775) |
$660.80 |
$826 |
6.2× |
| Us scrotum and contents (76870) |
$717.60 |
$897 |
6.7× |
| Us thyroid (76536) |
$682.40 |
$853 |
6.4× |
| Vascular Flow Imaging (78445) |
$902.40 |
$1,128 |
2.2× |
| Wrist 2 views (73100) |
$332 |
$415 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$363.20 |
$454 |
4.1× |
| X-Ray Bend Only L-S Spine (72120) |
$437.60 |
$547 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$352.80 |
$441 |
4.0× |
| X-Ray Exam Breast Specimen (76098) |
$697.60 |
$872 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$389.60 |
$487 |
4.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$576 |
$720 |
5.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$301.60 |
$377 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$374.40 |
$468 |
4.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$461.60 |
$577 |
4.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$508.80 |
$636 |
4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$628.80 |
$786 |
5.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$639.20 |
$799 |
6.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$691.20 |
$864 |
6.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$436.80 |
$546 |
4.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$760 |
$950 |
7.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$592 |
$740 |
5.5× |
| X-ray eye for foreign body (70030) |
$319.20 |
$399 |
3.6× |
| X-ray humerus (73060) |
$363.20 |
$454 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$335.20 |
$419 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$311.20 |
$389 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$428.80 |
$536 |
4.0× |
| X-ray nose-rectum child f.b. (76010) |
$380.80 |
$476 |
4.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$697.60 |
$872 |
6.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$420.80 |
$526 |
3.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$319.20 |
$399 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$356 |
$445 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$488.80 |
$611 |
5.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$564.80 |
$706 |
5.3× |
| X-ray thoracic spine 4 vw (72074) |
$461.60 |
$577 |
4.3× |
| X-Ray Tmj Unilat (70328) |
$367.20 |
$459 |
4.1× |
| X-Rays Bone Length Studies (77073) |
$520 |
$650 |
4.9× |
| X-Rays Bone Survey Complete (77075) |
$956 |
$1,195 |
9.0× |
| Xr c-spine 4 or 5 views (72050) |
$582.40 |
$728 |
5.5× |
| Xr facial bones less than 3 views (70140) |
$339.20 |
$424 |
3.8× |
| Xr orbits complete 4 views (70200) |
$501.60 |
$627 |
4.7× |