| Abdomen 2 views (74019) |
$280.50 |
$374 |
2.6× |
| Ankle 2 views (73600) |
$213 |
$284 |
2.4× |
| Arthrogram hip (73525) |
$784.50 |
$1,046 |
2.2× |
| Arthrogram shoulder (73040) |
$755.62 |
$1,007.50 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$789 |
$1,052 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,059 |
$1,412 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,661.25 |
$2,215 |
4.0× |
| Bone Imaging 3 Phase (78315) |
$1,960.50 |
$2,614 |
4.7× |
| Cervical spine 2 or 3 views (72040) |
$318.75 |
$425 |
3.5× |
| Chest 1 view (71045) |
$244.50 |
$326 |
2.7× |
| Chest 3 views (71047) |
$323.62 |
$431.50 |
3.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$624 |
$832 |
3.4× |
| Clavicle complete (73000) |
$272.25 |
$363 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,236 |
$1,648 |
11.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,606.50 |
$6,142 |
12.7× |
| CT abdomen and pelvis without contrast (74176) |
$3,451.50 |
$4,602 |
13.9× |
| CT abdomen w contrast (74160) |
$2,373 |
$3,164 |
13.0× |
| CT abdomen w wo contrast (74170) |
$2,868 |
$3,824 |
15.7× |
| CT abdomen w/o contrast (74150) |
$2,031.75 |
$2,709 |
18.7× |
| CT c-spine w/o contrast (72125) |
$2,244 |
$2,992 |
20.7× |
| CT cervical spine w&w/o contrast (72127) |
$2,455.50 |
$3,274 |
13.5× |
| CT chest w/wo contrast (71270) |
$2,293.50 |
$3,058 |
12.6× |
| CT chest with contrast (71260) |
$2,373 |
$3,164 |
13.0× |
| CT head/brain with contrast (70460) |
$2,231.25 |
$2,975 |
12.3× |
| CT head/brain without and with contrast (70470) |
$2,265 |
$3,020 |
12.4× |
| CT iac w contrast (70481) |
$2,182.50 |
$2,910 |
12.0× |
| CT lower ext w/o (73700) |
$2,042.25 |
$2,723 |
18.8× |
| CT lower extremity w wo contrast (73702) |
$2,531.25 |
$3,375 |
13.9× |
| CT lower extremity with contrast (73701) |
$2,331.75 |
$3,109 |
12.8× |
| CT lumbar spine w/o contrast (72131) |
$2,082.75 |
$2,777 |
19.2× |
| CT lumbar spine with contrast (72132) |
$2,184 |
$2,912 |
6.0× |
| CT maxillofacial w contrast (70487) |
$2,096.25 |
$2,795 |
11.5× |
| CT maxillofacial w/o contrast (70486) |
$1,671.75 |
$2,229 |
15.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,279.25 |
$3,039 |
12.5× |
| CT neck soft tissue w contrast (70491) |
$2,147.25 |
$2,863 |
11.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,271.75 |
$3,029 |
12.5× |
| CT orbits w/o contrast (70480) |
$2,094 |
$2,792 |
19.3× |
| CT pelvis w & w/o contrast (72194) |
$2,213.25 |
$2,951 |
12.2× |
| CT pelvis w/o contrast (72192) |
$2,103 |
$2,804 |
19.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,469 |
$3,292 |
13.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,317.75 |
$1,757 |
12.1× |
| CT thoracic spine w/contrast (72129) |
$2,265.75 |
$3,021 |
12.4× |
| CT thoracic spine w/o contrast (72128) |
$2,261.25 |
$3,015 |
20.8× |
| CT thorax w/o contrast (71250) |
$2,103 |
$2,804 |
19.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,900.50 |
$2,534 |
17.5× |
| CT upper extremity with contrast (73201) |
$2,331.75 |
$3,109 |
6.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,805.75 |
$3,741 |
15.4× |
| Cta Abdomen (74175) |
$2,760 |
$3,680 |
15.2× |
| CTA abdomen pelvis (74174) |
$4,749 |
$6,332 |
13.1× |
| CTA chest (71275) |
$3,107.25 |
$4,143 |
17.1× |
| Cta Head (70496) |
$2,676.75 |
$3,569 |
14.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,882.50 |
$6,510 |
13.5× |
| Cta Neck (70498) |
$2,676.75 |
$3,569 |
14.7× |
| Cystography minimum 3 views rs&i (74430) |
$471 |
$628 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$420.75 |
$561 |
3.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$228 |
$304 |
2.5× |
| Dxa bone density study axial skeleton (77085) |
$581.25 |
$775 |
5.4× |
| Esophagus (74220) |
$532.50 |
$710 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$624 |
$832 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$579.75 |
$773 |
2.3× |
| Foot 2 views (73620) |
$246 |
$328 |
2.7× |
| Forearm 2 views (73090) |
$260.25 |
$347 |
2.9× |
| Gated Heart Planar Single (78472) |
$1,520.25 |
$2,027 |
3.7× |
| Hand 2 views (73120) |
$211.50 |
$282 |
1.9× |
| Hand 3 views (73130) |
$294.75 |
$393 |
3.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,722.75 |
$2,297 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,008 |
$1,344 |
2.4× |
| Ht muscle image spect sing (78451) |
$3,071.25 |
$4,095 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$290.25 |
$387 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,158.75 |
$1,545 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,493.25 |
$1,991 |
2.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,610.25 |
$2,147 |
2.9× |
| Knee 3 views (73562) |
$312.75 |
$417 |
3.5× |
| Lung perf&ventilat diferentl (78598) |
$1,889.25 |
$2,519 |
3.4× |
| MRA head w & w/o contrast (70546) |
$3,318.75 |
$4,425 |
9.2× |
| MRA head w/o contrast (70544) |
$3,039.75 |
$4,053 |
12.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,863.50 |
$3,818 |
7.9× |
| MRA neck w/o contrast (70547) |
$2,812.50 |
$3,750 |
11.4× |
| MRI abdomen w contrast (74182) |
$3,133.50 |
$4,178 |
8.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,676.50 |
$4,902 |
10.1× |
| MRI abdomen w/o contrast (74181) |
$3,190.50 |
$4,254 |
12.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,572.50 |
$3,430 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,393.25 |
$3,191 |
2.9× |
| MRI bone marrow blood supply (77084) |
$2,088.75 |
$2,785 |
8.4× |
| MRI c-spine with contrast (72142) |
$3,559.50 |
$4,746 |
9.8× |
| MRI cervical spine w/o contrast (72141) |
$3,074.25 |
$4,099 |
12.4× |
| MRI chest w/o & w/contrast material (71552) |
$3,318.75 |
$4,425 |
9.2× |
| MRI chest w/o contrast (71550) |
$3,069.75 |
$4,093 |
12.4× |
| MRI chest with contrast (71551) |
$3,264.75 |
$4,353 |
4.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,373 |
$3,164 |
6.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,334.75 |
$3,113 |
9.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,976 |
$3,968 |
12.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,324 |
$4,432 |
9.2× |
| MRI pelvis w contrast (72196) |
$2,613.75 |
$3,485 |
7.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,264.75 |
$4,353 |
9.0× |
| MRI pelvis w/o contrast (72195) |
$2,960.25 |
$3,947 |
11.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,389.12 |
$3,185.50 |
6.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,845.50 |
$3,794 |
7.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,903.75 |
$5,205 |
10.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,496 |
$3,328 |
6.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,670.50 |
$4,894 |
10.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,069.75 |
$4,093 |
8.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,147.50 |
$5,530 |
11.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,921.25 |
$3,895 |
11.8× |
| MRI tmj (70336) |
$2,088.75 |
$2,785 |
8.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,319.75 |
$3,093 |
9.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,849.25 |
$3,799 |
7.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,286.75 |
$3,049 |
9.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,716.25 |
$4,955 |
2.8× |
| Neck soft tissue (70360) |
$291 |
$388 |
3.2× |
| Nm gastric emptying study (78264) |
$1,722.75 |
$2,297 |
4.2× |
| Osseous survey limited (77074) |
$602.25 |
$803 |
5.5× |
| Parathyroid imaging (78070) |
$1,147.50 |
$1,530 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$264 |
$352 |
2.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,660.25 |
$3,547 |
7.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,931.25 |
$2,575 |
3.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$261 |
$348 |
2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$329.25 |
$439 |
3.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$429.75 |
$573 |
4.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$250.50 |
$334 |
2.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$347.25 |
$463 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$274.50 |
$366 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$359.25 |
$479 |
3.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$316.50 |
$422 |
3.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$302.25 |
$403 |
3.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$230.25 |
$307 |
2.5× |
| Ribs bilateral 3 views (71110) |
$385.50 |
$514 |
3.6× |
| Scapula complete (73010) |
$304.12 |
$405.50 |
2.8× |
| Screening digital breast tomosynthesis (77063) |
$90.75 |
$121 |
3.9× |
| Spine thoracic 3 views (72072) |
$387.75 |
$517 |
3.6× |
| Thoracolumbar 2 views (72080) |
$286.50 |
$382 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$613.50 |
$818 |
5.7× |
| Unlisted Ultrasound Procedure (76999) |
$321 |
$428 |
3.6× |
| Upper Extremity Infant (73092) |
$189.75 |
$253 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$543.75 |
$725 |
2.2× |
| Us abdl aorta screen aaa (76706) |
$519 |
$692 |
4.8× |
| Us breast unilateral complete (76641) |
$429.75 |
$573 |
4.0× |
| Us breast unilateral limited (76642) |
$326.25 |
$435 |
3.6× |
| Us chest (76604) |
$672.75 |
$897 |
6.2× |
| Us compl joint r-t w/image documentation (76881) |
$676.50 |
$902 |
6.2× |
| Us infant hips dynamic (76885) |
$478.50 |
$638 |
5.3× |
| Us ob detailed single fetus (76811) |
$673.50 |
$898 |
2.7× |
| Us ob transvaginal (76817) |
$429.75 |
$573 |
4.0× |
| Us pelvic non ob complete (76856) |
$717.75 |
$957 |
6.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$324.75 |
$433 |
3.0× |
| Us pregnancy ltd (76815) |
$416.25 |
$555 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$572.25 |
$763 |
5.3× |
| Us retroperitoneal complete (76770) |
$765 |
$1,020 |
7.0× |
| Us retroperitoneal limited (76775) |
$549.75 |
$733 |
5.1× |
| Us scrotum and contents (76870) |
$615.75 |
$821 |
5.7× |
| Us soft tissue head/neck (76536) |
$543.75 |
$725 |
5.0× |
| Us transrectal (76872) |
$494.25 |
$659 |
4.6× |
| Us xtr non-vasc lmtd (76882) |
$545.25 |
$727 |
5.0× |
| Wrist 2 views (73100) |
$211.88 |
$282.50 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$359.25 |
$479 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$264 |
$352 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$307.50 |
$410 |
3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$250.50 |
$334 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$296.25 |
$395 |
3.3× |
| X-ray exam hip uni 1 view (73501) |
$235.50 |
$314 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$303.75 |
$405 |
3.4× |
| X-ray exam of femur 1 (73551) |
$241.50 |
$322 |
2.7× |
| X-ray eye for foreign body (70030) |
$216.75 |
$289 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$366 |
$488 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$255.75 |
$341 |
2.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$318.75 |
$425 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$190.50 |
$254 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$299.25 |
$399 |
3.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$336 |
$448 |
3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$234 |
$312 |
2.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$190.50 |
$254 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$429.75 |
$573 |
4.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$417.75 |
$557 |
3.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$303 |
$404 |
3.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$337.50 |
$450 |
3.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$656.25 |
$875 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$291 |
$388 |
3.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$359.25 |
$479 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$313.50 |
$418 |
2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$350.25 |
$467 |
3.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$326.62 |
$435.50 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$372.75 |
$497 |
4.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$248.25 |
$331 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$255.75 |
$341 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$219 |
$292 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$265.50 |
$354 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$290.25 |
$387 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$331.50 |
$442 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$220.12 |
$293.50 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$294.38 |
$392.50 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$209.25 |
$279 |
2.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$222 |
$296 |
2.0× |
| Xr shoulder 1 view (73020) |
$207.75 |
$277 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$444 |
$592 |
4.1× |
| Xr tibia/fibula 2 views (73590) |
$282 |
$376 |
3.1× |
| Xr tmj bilateral (70330) |
$355.50 |
$474 |
3.9× |
| Xray knee 1 or 2 views rt (73560) |
$291 |
$388 |
3.2× |