| Abdomen 1 View (74018) |
$399.20 |
$499 |
4.4× |
| Abdomen 2 views (74019) |
$428.80 |
$536 |
4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,804 |
$2,255 |
4.4× |
| Ankle 2 views (73600) |
$359.20 |
$449 |
4.0× |
| Bone Imaging 3 Phase (78315) |
$2,340 |
$2,925 |
5.7× |
| Bone Imaging Limited Area (78300) |
$1,363.20 |
$1,704 |
3.3× |
| Bone Imaging Whole Body (78306) |
$2,111.20 |
$2,639 |
5.1× |
| Bone survey infant (77076) |
$577.60 |
$722 |
5.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,024 |
$2,530 |
3.6× |
| Chest 1 view (71045) |
$348.80 |
$436 |
3.9× |
| Chest 2 views (71046) |
$392 |
$490 |
4.4× |
| Chest 3 views (71047) |
$425.60 |
$532 |
4.7× |
| Chest 4 or more views (71048) |
$536.80 |
$671 |
5.0× |
| Clavicle complete (73000) |
$409.60 |
$512 |
4.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,184.80 |
$6,481 |
14.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,684.80 |
$4,606 |
15.0× |
| CT abdomen w contrast (74160) |
$2,974.40 |
$3,718 |
16.4× |
| CT abdomen w wo contrast (74170) |
$3,090.40 |
$3,863 |
17.1× |
| CT abdomen w/o contrast (74150) |
$2,217.60 |
$2,772 |
20.6× |
| CT Angio Abdomen and Pelvis (74174) |
$4,878.40 |
$6,098 |
13.5× |
| CT Angio Chest (71275) |
$3,137.60 |
$3,922 |
17.3× |
| CT Angio Head (70496) |
$3,079.20 |
$3,849 |
17.0× |
| CT Angio Neck (70498) |
$3,079.20 |
$3,849 |
17.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,912.80 |
$3,641 |
16.1× |
| CT cervical spine w/ contrast (72126) |
$2,680 |
$3,350 |
7.4× |
| CT cervical spine w/o contrast (72125) |
$2,520.80 |
$3,151 |
23.4× |
| CT chest w contrast (71260) |
$2,926.40 |
$3,658 |
16.2× |
| CT chest w/wo contrast (71270) |
$3,352.80 |
$4,191 |
18.5× |
| CT head/brain with contrast (70460) |
$2,567.20 |
$3,209 |
14.2× |
| CT head/brain without and with contrast (70470) |
$2,741.60 |
$3,427 |
15.1× |
| CT iac w contrast (70481) |
$2,754.40 |
$3,443 |
15.2× |
| CT l-spine w&w/o contrast (72133) |
$3,119.20 |
$3,899 |
17.2× |
| CT lower ext w/o (73700) |
$2,174.40 |
$2,718 |
20.2× |
| CT lower extremity w/contrast material (73701) |
$2,661.60 |
$3,327 |
14.7× |
| CT lumbar spine w contrast (72132) |
$2,580 |
$3,225 |
7.2× |
| CT lumbar spine w/o contrast (72131) |
$2,563.20 |
$3,204 |
23.8× |
| CT maxillofacial w contrast (70487) |
$2,620 |
$3,275 |
14.5× |
| CT maxillofacial wo contrast (70486) |
$2,173.60 |
$2,717 |
20.1× |
| CT neck tissue combo (70492) |
$2,672.80 |
$3,341 |
14.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,067.20 |
$3,834 |
16.9× |
| CT orbits w/o contrast (70480) |
$2,228.80 |
$2,786 |
20.7× |
| CT pelvis w&w/o contrast (72194) |
$2,752.80 |
$3,441 |
15.2× |
| CT pelvis w/o contrast (72192) |
$2,067.20 |
$2,584 |
19.2× |
| CT scans face/jaw combo (70488) |
$3,030.40 |
$3,788 |
16.7× |
| CT soft tissue neck w contrast (70491) |
$2,624 |
$3,280 |
14.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,184.80 |
$2,731 |
20.2× |
| CT thoracic spine w contrast (72129) |
$2,742.40 |
$3,428 |
15.1× |
| CT thoracic spine w/o contrast (72128) |
$2,563.20 |
$3,204 |
23.8× |
| CT thoracic spine w/wo cont (72130) |
$3,082.40 |
$3,853 |
17.0× |
| CT thorax w/o contrast (71250) |
$2,233.60 |
$2,792 |
20.7× |
| CT upper ext wo (73200) |
$2,173.60 |
$2,717 |
20.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,778.40 |
$3,473 |
15.3× |
| CT upper extremity with contrast (73201) |
$2,061.60 |
$2,577 |
5.7× |
| Cta Abdomen (74175) |
$3,293.60 |
$4,117 |
18.2× |
| Dxa Bone Density Axial (77080) |
$579.20 |
$724 |
5.4× |
| Foot 2 views (73620) |
$358.40 |
$448 |
4.0× |
| Forearm 2 views (73090) |
$398.40 |
$498 |
4.4× |
| Gastric emptying imaging study (78264) |
$1,974.40 |
$2,468 |
4.8× |
| Gated Heart Planar Single (78472) |
$2,163.20 |
$2,704 |
5.2× |
| Hand 2 views (73120) |
$363.20 |
$454 |
3.4× |
| Hepatobil Syst Image W/Drug (78227) |
$2,141.60 |
$2,677 |
3.8× |
| Hepatobiliary System Imaging (78226) |
$1,965.60 |
$2,457 |
4.8× |
| Ht Musc Image Planar Mult (78454) |
$2,621.60 |
$3,277 |
2.0× |
| Ht Muscle Image Spect Sing (78451) |
$3,215.20 |
$4,019 |
2.4× |
| Joint Survey Single View (77077) |
$341.60 |
$427 |
3.2× |
| K Flow/Funct Image W/Drug (78708) |
$2,394.40 |
$2,993 |
4.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,999.20 |
$2,499 |
3.6× |
| Knee 3 Views (73562) |
$401.60 |
$502 |
4.5× |
| Liver & Spleen Imaging Static Only (78215) |
$1,677.60 |
$2,097 |
4.1× |
| Liver imaging static only (78201) |
$1,812.80 |
$2,266 |
3.2× |
| Meckels Divert Exam (78290) |
$1,572 |
$1,965 |
3.8× |
| MRA head w/o contrast (70544) |
$2,948.80 |
$3,686 |
12.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,956.80 |
$4,946 |
11.0× |
| MRA neck w/o contrast (70547) |
$2,517.60 |
$3,147 |
10.2× |
| MRI abdomen w contrast (74182) |
$3,451.20 |
$4,314 |
9.6× |
| MRI abdomen w/o contrast (74181) |
$3,148 |
$3,935 |
12.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,003.20 |
$5,004 |
11.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,758.40 |
$4,698 |
4.6× |
| MRI cervical spine w/o cont (72141) |
$3,368.80 |
$4,211 |
13.7× |
| MRI chest w/o contrast (71550) |
$3,032 |
$3,790 |
12.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,173.60 |
$5,217 |
11.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,968.80 |
$3,711 |
12.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,790.40 |
$5,988 |
13.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,490.40 |
$4,363 |
14.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,750.40 |
$5,938 |
13.2× |
| MRI pelvis w contrast (72196) |
$4,084 |
$5,105 |
11.3× |
| MRI pelvis w/o & w contrast (72197) |
$4,302.40 |
$5,378 |
11.9× |
| MRI pelvis w/o contrast (72195) |
$3,203.20 |
$4,004 |
13.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,419.20 |
$4,274 |
13.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,924.80 |
$3,656 |
11.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,123.20 |
$5,154 |
11.5× |
| MRI, abdomen, combo (74183) |
$4,281.60 |
$5,352 |
11.9× |
| MRI, dorsal spine combo (72157) |
$4,491.20 |
$5,614 |
12.5× |
| MRI, joint upper extrem (73221) |
$3,020.80 |
$3,776 |
12.3× |
| MRI, joint upper extrem combo (73223) |
$4,244.80 |
$5,306 |
11.8× |
| MRI, lumbar spine combo (72158) |
$4,488 |
$5,610 |
12.5× |
| Myocardial Spect Multiple Studies (78452) |
$4,525.60 |
$5,657 |
3.4× |
| Neck soft tissue (70360) |
$384.80 |
$481 |
4.3× |
| Optic foramina (70190) |
$365.60 |
$457 |
4.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,914.40 |
$2,393 |
3.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,430.40 |
$1,788 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$391.20 |
$489 |
3.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,472.80 |
$1,841 |
3.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$472 |
$590 |
5.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$380 |
$475 |
4.2× |
| Radex elbow complete minimum 3 views (73080) |
$455.20 |
$569 |
5.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$607.20 |
$759 |
5.6× |
| Radex fingr minimum 2 views (73140) |
$348.80 |
$436 |
3.9× |
| Radex foot complete minimum 3 views (73630) |
$465.60 |
$582 |
5.2× |
| Radex Hand Minimum 3 Views (73130) |
$438.40 |
$548 |
4.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$326.40 |
$408 |
3.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$430.40 |
$538 |
4.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$449.60 |
$562 |
5.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$410.40 |
$513 |
4.6× |
| Radex shoulder complete minimum 2 views (73030) |
$448 |
$560 |
5.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$364 |
$455 |
4.1× |
| Radex Spine 1 View Specify Level (72020) |
$396 |
$495 |
4.4× |
| Radex Sternum Minimum 2 Views (71120) |
$432 |
$540 |
4.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$434.40 |
$543 |
4.8× |
| Radex Toe Minimum 2 Views (73660) |
$337.60 |
$422 |
3.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$342.40 |
$428 |
3.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$436 |
$545 |
4.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$805.60 |
$1,007 |
7.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$528.80 |
$661 |
4.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$329.60 |
$412 |
3.1× |
| Radiologic exam knee complete 4/more views (73564) |
$584 |
$730 |
5.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$214.40 |
$268 |
2.0× |
| Radiologic examination femur 1 view (73551) |
$385.60 |
$482 |
4.3× |
| Radiologic examination femur minimum 2 views (73552) |
$564.80 |
$706 |
6.3× |
| Radiologic examination knee 1/2 views (73560) |
$384 |
$480 |
4.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$644 |
$805 |
6.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$447.20 |
$559 |
5.0× |
| Ribs bilateral 3 views (71110) |
$677.60 |
$847 |
6.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,892.80 |
$3,616 |
5.2× |
| Scapula (73010) |
$424 |
$530 |
3.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$132 |
$165 |
5.6× |
| Sella turcica (70240) |
$244 |
$305 |
2.7× |
| Shoulder 1 view (73020) |
$348 |
$435 |
3.9× |
| Skull less than 4 views (70250) |
$436 |
$545 |
4.0× |
| Sternoclavicular joints (71130) |
$354.40 |
$443 |
3.9× |
| Thoracic spine 2 views (72070) |
$464 |
$580 |
4.3× |
| Thoracic spine 3 views (72072) |
$598.40 |
$748 |
5.5× |
| Thoracolumbar 2 views (72080) |
$443.20 |
$554 |
4.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,136.80 |
$1,421 |
2.8× |
| Thyroid Uptake Measurement (78012) |
$1,031.20 |
$1,289 |
2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,484 |
$1,855 |
3.6× |
| Ultrasound Exam Aaa Screen (76706) |
$585.60 |
$732 |
5.4× |
| Ultrasound, abdomen limited (76705) |
$778.40 |
$973 |
7.2× |
| Us chest (76604) |
$686.40 |
$858 |
6.4× |
| Us complete joint (76881) |
$616 |
$770 |
5.7× |
| Us exam, pelvic, limited (76857) |
$716 |
$895 |
6.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$627.20 |
$784 |
5.8× |
| Us ob detailed single fetus (76811) |
$1,182.40 |
$1,478 |
4.8× |
| Us ob limited 1 or more fetuses (76815) |
$602.40 |
$753 |
5.6× |
| Us ob transvaginal (76817) |
$829.60 |
$1,037 |
7.7× |
| Us pelvic non ob complete (76856) |
$1,015.20 |
$1,269 |
9.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$856 |
$1,070 |
7.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$549.60 |
$687 |
5.1× |
| Us retroperitoneal complete (76770) |
$1,035.20 |
$1,294 |
9.6× |
| Us retroperitoneal limited (76775) |
$734.40 |
$918 |
6.8× |
| Us scrotum and contents (76870) |
$843.20 |
$1,054 |
7.8× |
| Us thyroid (76536) |
$817.60 |
$1,022 |
7.6× |
| Wrist 2 views (73100) |
$340 |
$425 |
3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$420 |
$525 |
4.7× |
| X-Ray Bend Only L-S Spine (72120) |
$542.40 |
$678 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$380 |
$475 |
4.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$448.80 |
$561 |
5.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$634.40 |
$793 |
5.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$686.40 |
$858 |
6.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$303.20 |
$379 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$376 |
$470 |
4.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$544.80 |
$681 |
5.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$533.60 |
$667 |
4.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$668.80 |
$836 |
6.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$796 |
$995 |
7.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$730.40 |
$913 |
6.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$492 |
$615 |
5.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$514.40 |
$643 |
4.8× |
| X-ray eye for foreign body (70030) |
$339.20 |
$424 |
3.8× |
| X-ray humerus (73060) |
$410.40 |
$513 |
4.6× |
| X-ray IV pyelogram (ivp) (74400) |
$1,144 |
$1,430 |
6.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$380.80 |
$476 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$484.80 |
$606 |
5.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$542.40 |
$678 |
5.0× |
| X-ray nose-rectum child f.b. (76010) |
$379.20 |
$474 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$687.20 |
$859 |
6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$440.80 |
$551 |
4.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$348 |
$435 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$442.40 |
$553 |
4.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$560.80 |
$701 |
6.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$612 |
$765 |
5.7× |
| X-Ray Stress View (77071) |
$211.20 |
$264 |
2.4× |
| X-ray thoracic spine 4 vw (72074) |
$630.40 |
$788 |
5.8× |
| X-Ray Tmj Unilat (70328) |
$381.60 |
$477 |
4.2× |
| X-Rays Bone Length Studies (77073) |
$552 |
$690 |
5.1× |
| X-Rays Bone Survey Complete (77075) |
$1,103.20 |
$1,379 |
10.2× |
| Xr c-spine 4 or 5 views (72050) |
$682.40 |
$853 |
6.3× |
| Xr facial bones less than 3 views (70140) |
$379.20 |
$474 |
4.2× |
| Xr orbits complete 4 views (70200) |
$544.80 |
$681 |
5.0× |