| Abdomen 2 views (74019) |
$555 |
$555 |
5.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,234 |
$2,234 |
5.4× |
| Ankle 2 views (73600) |
$397 |
$397 |
4.4× |
| Arthrogram wrist (73115) |
$1,236 |
$1,236 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$2,614 |
$2,614 |
6.3× |
| Bone age studies (77072) |
$360 |
$360 |
3.3× |
| Bone Imaging 3 Phase (78315) |
$2,973 |
$2,973 |
7.2× |
| Bone survey complete (77075) |
$1,332 |
$1,332 |
12.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,153 |
$2,153 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$463 |
$463 |
5.1× |
| Chest 1 view (71045) |
$352 |
$352 |
3.9× |
| Chest 3 views (71047) |
$667 |
$667 |
7.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$825 |
$825 |
4.5× |
| Clavicle complete (73000) |
$423 |
$423 |
4.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,226 |
$1,226 |
11.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,515 |
$6,515 |
18.0× |
| CT abdomen and pelvis without contrast (74176) |
$4,727 |
$4,727 |
19.1× |
| CT abdomen w contrast (74160) |
$3,344 |
$3,344 |
18.4× |
| CT abdomen w wo contrast (74170) |
$4,182 |
$4,182 |
23.0× |
| CT abdomen w/o contrast (74150) |
$2,799 |
$2,799 |
25.8× |
| CT angiography upper extremity lt (73206) |
$3,977 |
$3,977 |
21.8× |
| CT c-spine w/o contrast (72125) |
$3,401 |
$3,401 |
31.3× |
| CT cervical spine w&w/o contrast (72127) |
$3,333 |
$3,333 |
18.3× |
| CT cervical spine with contrast (72126) |
$3,749 |
$3,749 |
10.3× |
| CT chest w/wo contrast (71270) |
$3,931 |
$3,931 |
21.6× |
| CT chest with contrast (71260) |
$3,137 |
$3,137 |
17.2× |
| CT head/brain with contrast (70460) |
$3,291 |
$3,291 |
18.1× |
| CT head/brain without and with contrast (70470) |
$3,358 |
$3,358 |
18.4× |
| CT iac w contrast (70481) |
$4,026 |
$4,026 |
22.1× |
| CT limited/localized follow up study (76380) |
$1,260 |
$1,260 |
13.9× |
| CT lower ext w/o (73700) |
$2,346 |
$2,346 |
21.6× |
| CT lower extremity w wo contrast (73702) |
$3,577 |
$3,577 |
19.6× |
| CT lower extremity with contrast (73701) |
$3,354 |
$3,354 |
18.4× |
| CT lumbar spine w & w/o contrast (72133) |
$4,396 |
$4,396 |
24.1× |
| CT lumbar spine w/o contrast (72131) |
$3,364 |
$3,364 |
31.0× |
| CT lumbar spine with contrast (72132) |
$4,941 |
$4,941 |
13.6× |
| CT maxillofacial w contrast (70487) |
$3,374 |
$3,374 |
18.5× |
| CT maxillofacial w/o contrast (70486) |
$2,694 |
$2,694 |
24.8× |
| CT maxillofacial w/wo contrast (70488) |
$3,225 |
$3,225 |
17.7× |
| CT neck soft tissue w contrast (70491) |
$3,189 |
$3,189 |
17.5× |
| CT orbits w/o contrast (70480) |
$3,094 |
$3,094 |
28.5× |
| CT pelvis w & w/o contrast (72194) |
$3,989 |
$3,989 |
21.9× |
| CT pelvis w/o contrast (72192) |
$3,196 |
$3,196 |
29.4× |
| CT soft tissue neck w/o contrast (70490) |
$3,058 |
$3,058 |
28.2× |
| CT thoracic spine w/contrast (72129) |
$3,496 |
$3,496 |
19.2× |
| CT thoracic spine w/o contrast (72128) |
$3,311 |
$3,311 |
30.5× |
| CT thoracic spine w/wo contrast (72130) |
$3,370 |
$3,370 |
18.5× |
| CT thorax w/o contrast (71250) |
$3,291 |
$3,291 |
30.3× |
| CT upper extremity w/o contrast rt (73200) |
$2,350 |
$2,350 |
21.6× |
| CT upper extremity with contrast (73201) |
$2,985 |
$2,985 |
8.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,139 |
$4,139 |
22.7× |
| Cta Abdomen (74175) |
$4,535 |
$4,535 |
24.9× |
| CTA abdomen pelvis (74174) |
$8,211 |
$8,211 |
22.7× |
| CTA chest (71275) |
$3,800 |
$3,800 |
20.9× |
| Cta Head (70496) |
$3,601 |
$3,601 |
19.8× |
| CTA lwr ext w&w/o contrast (73706) |
$4,611 |
$4,611 |
25.3× |
| Cta Neck (70498) |
$3,494 |
$3,494 |
19.2× |
| Cta Pelvis (72191) |
$4,555 |
$4,555 |
25.0× |
| Cystography minimum 3 views rs&i (74430) |
$1,911 |
$1,911 |
5.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$768 |
$768 |
7.1× |
| Esophagus (74220) |
$962 |
$962 |
5.3× |
| Fetal biophysical profile non-stress testing (76818) |
$1,179 |
$1,179 |
10.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$688 |
$688 |
6.3× |
| Fluoroscopy up to 1 hr (76000) |
$813 |
$813 |
3.3× |
| Foot 2 views (73620) |
$356 |
$356 |
3.9× |
| Forearm 2 views (73090) |
$405 |
$405 |
4.5× |
| Gated Heart Planar Single (78472) |
$2,219 |
$2,219 |
5.3× |
| Hand 2 views (73120) |
$408 |
$408 |
3.8× |
| Hand 3 views (73130) |
$466 |
$466 |
5.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,787 |
$2,787 |
4.9× |
| Ht muscle image spect sing (78451) |
$3,999 |
$3,999 |
3.0× |
| Humerus Min 2 Views Left (73060) |
$483 |
$483 |
5.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,118 |
$2,118 |
3.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,220 |
$2,220 |
3.9× |
| Knee 3 views (73562) |
$534 |
$534 |
5.9× |
| Lung perf&ventilat diferentl (78598) |
$2,341 |
$2,341 |
4.2× |
| Lymphoscintigraphy (78195) |
$2,669 |
$2,669 |
4.7× |
| Meckels Diverticulum (78290) |
$2,524 |
$2,524 |
6.1× |
| Mr safety determination physician/other qhp (76016) |
$92 |
$92 |
1.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$62 |
$62 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$26 |
$26 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$96 |
$96 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$251 |
$251 |
1.0× |
| MRA head w & w/o contrast (70546) |
$6,538 |
$6,538 |
18.0× |
| MRA head w/o contrast (70544) |
$4,876 |
$4,876 |
19.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,462 |
$5,462 |
15.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,754 |
$5,754 |
15.9× |
| MRI abdomen w/o contrast (74181) |
$4,579 |
$4,579 |
18.5× |
| MRI any jnt lwr ext with con lt (73722) |
$4,646 |
$4,646 |
5.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,955 |
$4,955 |
6.1× |
| MRI c-spine with contrast (72142) |
$5,602 |
$5,602 |
15.5× |
| MRI cervical spine w/o contrast (72141) |
$3,983 |
$3,983 |
16.1× |
| MRI chest w/o & w/contrast material (71552) |
$4,352 |
$4,352 |
12.0× |
| MRI chest w/o contrast (71550) |
$4,689 |
$4,689 |
18.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,738 |
$3,738 |
15.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,521 |
$5,521 |
15.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,766 |
$4,766 |
13.2× |
| MRI pelvis w/o contrast (72195) |
$4,620 |
$4,620 |
18.6× |
| MRI scan of arm joint before and after contrast (73223) |
$5,869 |
$5,869 |
16.2× |
| MRI scan of leg joint before and after contrast (73723) |
$5,128 |
$5,128 |
14.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,908 |
$5,908 |
16.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,093 |
$5,093 |
14.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,928 |
$5,928 |
16.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,701 |
$5,701 |
15.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,139 |
$6,139 |
16.9× |
| MRI thoracic spine w/o contrast (72146) |
$4,888 |
$4,888 |
19.7× |
| MRI upper ext joint w/o contrast (73221) |
$3,742 |
$3,742 |
15.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$5,363 |
$5,363 |
14.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,871 |
$3,871 |
15.6× |
| Myelogram Lumbar (72265) |
$1,624 |
$1,624 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$6,402 |
$6,402 |
4.8× |
| Neck soft tissue (70360) |
$430 |
$430 |
4.8× |
| Nm gastric emptying study (78264) |
$2,521 |
$2,521 |
6.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$514 |
$514 |
4.7× |
| Osseous survey infant (77076) |
$757 |
$757 |
7.0× |
| Osseous survey limited (77074) |
$1,063 |
$1,063 |
9.8× |
| Parathyrd planar w/wo subtrj (78071) |
$2,026 |
$2,026 |
4.9× |
| Parathyroid imaging (78070) |
$1,814 |
$1,814 |
4.4× |
| Pelvis 1 or 2 views (72170) |
$434 |
$434 |
4.0× |
| PET image w/CT, skull-thigh (78815) |
$8,400 |
$8,400 |
5.7× |
| PET imaging CT for attenuation limited area (78814) |
$7,782 |
$7,782 |
5.2× |
| PET imaging for CT attenuation whole body (78816) |
$9,137 |
$9,137 |
6.2× |
| PET imaging limited area chest head/neck (78811) |
$2,184 |
$2,184 |
1.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,908 |
$4,908 |
13.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,759 |
$1,759 |
4.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,144 |
$3,144 |
5.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$419 |
$419 |
4.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$863 |
$863 |
7.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$627 |
$627 |
5.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$679 |
$679 |
6.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$612 |
$612 |
5.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$434 |
$434 |
4.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$569 |
$569 |
5.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$455 |
$455 |
5.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,140 |
$1,140 |
6.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$991 |
$991 |
5.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$463 |
$463 |
5.1× |
| Radiological examination surgical specimen (76098) |
$345 |
$345 |
0.6× |
| Ribs bilateral 3 views (71110) |
$649 |
$649 |
6.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,838 |
$3,838 |
6.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,086 |
$4,086 |
3.0× |
| Sacroiliac Joints < 3 Views (72200) |
$450 |
$450 |
4.1× |
| Scanogram (77073) |
$416 |
$416 |
3.8× |
| Scapula complete (73010) |
$464 |
$464 |
4.3× |
| Screening digital breast tomosynthesis (77063) |
$110 |
$110 |
4.7× |
| Small bowel series (74250) |
$865 |
$865 |
4.7× |
| Spine thoracic 3 views (72072) |
$632 |
$632 |
5.8× |
| Thoracolumbar 2 views (72080) |
$428 |
$428 |
4.7× |
| Ultrasound scan to determine eye length and lens power (76519) |
$304 |
$304 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$855 |
$855 |
7.9× |
| Unlisted magnetic resonance procedure (76498) |
$3,514 |
$3,514 |
38.9× |
| Unlisted Ultrasound Procedure (76999) |
$809 |
$809 |
9.0× |
| Upper Extremity Infant (73092) |
$409 |
$409 |
3.8× |
| Urethrocystography voiding (74455) |
$1,386 |
$1,386 |
5.6× |
| Us abdl aorta screen aaa (76706) |
$776 |
$776 |
7.1× |
| Us breast unilateral complete (76641) |
$802 |
$802 |
7.4× |
| Us breast unilateral limited (76642) |
$626 |
$626 |
6.9× |
| Us chest (76604) |
$741 |
$741 |
6.8× |
| Us compl joint r-t w/image documentation (76881) |
$490 |
$490 |
4.5× |
| Us kidney transplant (76776) |
$951 |
$951 |
8.8× |
| Us ob transvaginal (76817) |
$823 |
$823 |
7.6× |
| Us pelvic non ob complete (76856) |
$1,114 |
$1,114 |
10.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$712 |
$712 |
6.6× |
| Us pregnancy ltd (76815) |
$696 |
$696 |
6.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,020 |
$1,020 |
9.4× |
| Us retroperitoneal complete (76770) |
$1,103 |
$1,103 |
10.2× |
| Us retroperitoneal limited (76775) |
$623 |
$623 |
5.7× |
| Us scrotum and contents (76870) |
$954 |
$954 |
8.8× |
| Us soft tissue head/neck (76536) |
$859 |
$859 |
7.9× |
| Us transrectal (76872) |
$854 |
$854 |
7.9× |
| Us transrectal prostate volume (76873) |
$795 |
$795 |
7.3× |
| Us xtr non-vasc lmtd (76882) |
$393 |
$393 |
3.6× |
| Us, eye b-scan (76512) |
$378 |
$378 |
3.5× |
| Wrist 2 views (73100) |
$395 |
$395 |
4.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$704 |
$704 |
6.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$414 |
$414 |
4.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$472 |
$472 |
5.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$402 |
$402 |
4.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$455 |
$455 |
5.0× |
| X-ray exam hip uni 1 view (73501) |
$374 |
$374 |
4.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$400 |
$400 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$594 |
$594 |
5.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$572 |
$572 |
5.3× |
| X-ray exam of femur 1 (73551) |
$396 |
$396 |
4.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$638 |
$638 |
5.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$466 |
$466 |
5.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$374 |
$374 |
4.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$575 |
$575 |
5.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$387 |
$387 |
4.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$390 |
$390 |
4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$604 |
$604 |
5.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$911 |
$911 |
8.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$686 |
$686 |
6.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$482 |
$482 |
5.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$602 |
$602 |
5.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$587 |
$587 |
5.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,806 |
$1,806 |
5.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$414 |
$414 |
4.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$557 |
$557 |
5.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$506 |
$506 |
4.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$404 |
$404 |
4.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$481 |
$481 |
5.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$432 |
$432 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$760 |
$760 |
7.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$492 |
$492 |
4.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$419 |
$419 |
4.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$429 |
$429 |
4.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$479 |
$479 |
4.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$357 |
$357 |
4.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$473 |
$473 |
5.2× |
| Xr c-spine 6 or more views (72052) |
$817 |
$817 |
7.5× |
| Xr finger(s) 2+ views (73140) |
$349 |
$349 |
3.9× |
| Xr shoulder 1 view (73020) |
$344 |
$344 |
3.8× |
| Xr spine cervical 4 or 5 views (72050) |
$648 |
$648 |
6.0× |
| Xr tibia/fibula 2 views (73590) |
$446 |
$446 |
4.9× |
| Xray knee 1 or 2 views rt (73560) |
$462 |
$462 |
5.1× |