| Abdomen 2 views (74019) |
$183.58 |
$305.96 |
1.8× |
| Ankle 2 views (73600) |
$126.59 |
$210.99 |
1.5× |
| Arthrogram hip (73525) |
$353.48 |
$589.14 |
1.1× |
| Arthrogram knee (73580) |
$413.20 |
$688.66 |
1.2× |
| Arthrogram shoulder (73040) |
$304.88 |
$508.13 |
0.9× |
| Bone age studies (77072) |
$157.52 |
$262.53 |
1.6× |
| Bone survey complete (77075) |
$218.77 |
$364.61 |
2.2× |
| Bone survey infant (77076) |
$498.80 |
$831.34 |
5.0× |
| Cervical spine 2 or 3 views (72040) |
$221.27 |
$368.78 |
2.7× |
| Chest 1 view (71045) |
$216.77 |
$361.28 |
2.6× |
| Chest xray 3 views (71047) |
$207.96 |
$346.60 |
2.5× |
| Clavicle complete (73000) |
$151.38 |
$252.31 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,621.69 |
$2,702.81 |
4.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,621.69 |
$2,702.81 |
7.1× |
| CT abdomen w contrast (74160) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT abdomen w wo contrast (74170) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT abdomen w/o contrast (74150) |
$1,621.69 |
$2,702.81 |
16.2× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,816.30 |
$3,027.16 |
10.8× |
| CT angiography upper extremity lt (73206) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT c-spine w/contrast (72126) |
$1,286.15 |
$2,143.58 |
3.8× |
| CT c-spine w/o contrast (72125) |
$976.57 |
$1,627.62 |
9.7× |
| CT chest w contrast (71260) |
$1,719 |
$2,864.98 |
10.2× |
| CT chest w/wo contrast (71270) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT head/brain with contrast (70460) |
$1,173.13 |
$1,955.22 |
7.0× |
| CT head/brain without and with contrast (70470) |
$1,173.13 |
$1,955.22 |
7.0× |
| CT iac w contrast (70481) |
$1,173.13 |
$1,955.22 |
7.0× |
| CT lower ext w/o (73700) |
$1,621.69 |
$2,702.81 |
16.2× |
| CT lower extremity w wo contrast (73702) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT lower extremity w/contrast material (73701) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT lumbar spine w/contrast (72132) |
$1,621.69 |
$2,702.81 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$1,621.69 |
$2,702.81 |
16.2× |
| CT maxillofacial w contrast (70487) |
$1,173.13 |
$1,955.22 |
7.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,173.13 |
$1,955.22 |
7.0× |
| CT maxillofacial wo contrast (70486) |
$976.57 |
$1,627.62 |
9.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,173.13 |
$1,955.22 |
7.0× |
| CT orbits w/o contrast (70480) |
$976.57 |
$1,627.62 |
9.7× |
| CT pelvis w/o contrast (72192) |
$1,621.69 |
$2,702.81 |
16.2× |
| CT pelvis w/wo contrast (72194) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT soft tissue neck w contrast (70491) |
$1,173.13 |
$1,955.22 |
7.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,173.13 |
$1,955.22 |
7.0× |
| CT soft tissue neck w/o contrast (70490) |
$976.57 |
$1,627.62 |
9.7× |
| CT thoracic spine w/contrast (72129) |
$1,621.69 |
$2,702.81 |
9.6× |
| CT thoracic spine w/o contrast (72128) |
$1,621.69 |
$2,702.81 |
16.2× |
| CT thorax w/o contrast (71250) |
$1,621.69 |
$2,702.81 |
16.2× |
| CT upper ext wo (73200) |
$1,621.69 |
$2,702.81 |
16.2× |
| CT upper extremity with contrast (73201) |
$1,621.69 |
$2,702.81 |
4.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,816.30 |
$3,027.16 |
10.8× |
| Cta Abdomen (74175) |
$1,816.30 |
$3,027.16 |
10.8× |
| CTA abdomen pelvis (74174) |
$1,681.76 |
$2,802.93 |
5.0× |
| CTA chest (71275) |
$1,621.69 |
$2,702.81 |
9.6× |
| Cta Head (70496) |
$1,173.13 |
$1,955.22 |
7.0× |
| Cta Neck (70498) |
$1,173.13 |
$1,955.22 |
7.0× |
| Cta Pelvis (72191) |
$1,815.40 |
$3,025.66 |
10.8× |
| Cystography minimum 3 views rs&i (74430) |
$199.10 |
$331.84 |
0.6× |
| Esophagus (74220) |
$283.41 |
$472.35 |
1.7× |
| Facial bones min 3 views (70150) |
$266.18 |
$443.64 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$302.81 |
$504.68 |
1.3× |
| Foot 2 views (73620) |
$153.17 |
$255.29 |
1.8× |
| Forearm 2 views (73090) |
$157.14 |
$261.91 |
1.9× |
| Functional MRI brain by tech (70554) |
$2,156.88 |
$3,594.80 |
9.4× |
| Hand 2 views (73120) |
$151.97 |
$253.29 |
1.5× |
| Knee 3 views (73562) |
$245.04 |
$408.40 |
2.9× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,124.36 |
$3,540.60 |
2.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,124.36 |
$3,540.60 |
6.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,124.36 |
$3,540.60 |
6.3× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$941.74 |
$1,569.57 |
2.6× |
| MRA head w/o contrast (70544) |
$1,787.35 |
$2,978.91 |
7.8× |
| MRA head with contrast (70545) |
$982.99 |
$1,638.32 |
2.9× |
| MRA neck w contrast (70548) |
$2,025.47 |
$3,375.79 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,054.28 |
$3,423.80 |
6.1× |
| MRA neck w/o contrast (70547) |
$1,787.35 |
$2,978.91 |
7.8× |
| MRI abdomen w contrast (74182) |
$1,935.65 |
$3,226.09 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,207.66 |
$2,012.77 |
3.6× |
| MRI abdomen w/o contrast (74181) |
$2,124.85 |
$3,541.42 |
9.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,124.36 |
$3,540.60 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,124.36 |
$3,540.60 |
6.3× |
| MRI c-spine with contrast (72142) |
$1,787.35 |
$2,978.91 |
5.3× |
| MRI cervical spine w/o contrast (72141) |
$2,155.37 |
$3,592.28 |
9.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,124.36 |
$3,540.60 |
6.3× |
| MRI chest w/o contrast (71550) |
$1,913.34 |
$3,188.90 |
8.4× |
| MRI chest with contrast (71551) |
$2,124.36 |
$3,540.60 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,124.36 |
$3,540.60 |
6.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,124.36 |
$3,540.60 |
6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,913.34 |
$3,188.90 |
8.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,744.78 |
$2,907.98 |
7.6× |
| MRI orbit face neck w contrast (70542) |
$2,025.47 |
$3,375.79 |
6.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,155.37 |
$3,592.28 |
6.4× |
| MRI pelvis w/contrast (72196) |
$2,124.36 |
$3,540.60 |
6.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,124.36 |
$3,540.60 |
6.3× |
| MRI pelvis w/o contrast (72195) |
$1,913.34 |
$3,188.90 |
8.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,155.37 |
$3,592.28 |
6.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,913.34 |
$3,188.90 |
5.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,124.36 |
$3,540.60 |
6.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,913.34 |
$3,188.90 |
5.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,124.36 |
$3,540.60 |
6.3× |
| MRI temporomandibular joint (70336) |
$1,913.34 |
$3,188.90 |
8.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,124.36 |
$3,540.60 |
9.3× |
| MRI up ext w/o contrast (73218) |
$1,913.34 |
$3,188.90 |
8.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,913.34 |
$3,188.90 |
8.4× |
| MRI, joint upper extrem combo (73223) |
$2,124.36 |
$3,540.60 |
6.3× |
| Neck soft tissue (70360) |
$200.74 |
$334.57 |
2.4× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) |
$99.17 |
$165.29 |
1.0× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter… (76510) |
$123.96 |
$206.58 |
1.0× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$18.64 |
$31.07 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$223.15 |
$371.92 |
2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$433.89 |
$723.15 |
0.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$224.70 |
$374.50 |
2.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$198.35 |
$330.58 |
2.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$198.35 |
$330.58 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$284.78 |
$474.64 |
2.8× |
| Radex fingr minimum 2 views (73140) |
$157.52 |
$262.53 |
1.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$140.24 |
$233.74 |
1.7× |
| Radex Hand Minimum 3 Views (73130) |
$216.67 |
$361.12 |
2.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$171.98 |
$286.64 |
2.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$242.17 |
$403.61 |
2.4× |
| Radex Humerus Minimum 2 Views (73060) |
$192.54 |
$320.92 |
2.3× |
| Radex Kne 1/2 Views (73560) |
$207.10 |
$345.16 |
2.5× |
| Radex Kne Compl 4/More Views (73564) |
$294.62 |
$491.03 |
2.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$259.55 |
$432.59 |
2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$207.10 |
$345.16 |
2.5× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$312.12 |
$520.20 |
3.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$207.10 |
$345.16 |
2.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$202.74 |
$337.90 |
2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$319.13 |
$531.89 |
3.8× |
| Radex Toe Minimum 2 Views (73660) |
$157.52 |
$262.53 |
1.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$157.52 |
$262.53 |
1.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$193.34 |
$322.22 |
2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$543.25 |
$905.42 |
5.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$187.86 |
$313.11 |
2.3× |
| Radiologic exam chest 2 views (71046) |
$189.46 |
$315.76 |
2.3× |
| Radiologic exam colon single contrast study (74270) |
$446.58 |
$744.30 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$265.15 |
$441.92 |
1.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$352.11 |
$586.85 |
2.1× |
| Radiologic examination femur 1 view (73551) |
$171.98 |
$286.64 |
2.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$198.35 |
$330.58 |
2.4× |
| Ribs bilateral 3 views (71110) |
$327.65 |
$546.08 |
3.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,501.50 |
$4,169.17 |
4.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,501.50 |
$4,169.17 |
4.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,837.67 |
$4,729.45 |
2.1× |
| Scapula (73010) |
$255.23 |
$425.39 |
2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$182.97 |
$304.95 |
7.8× |
| Sella turcica (70240) |
$145.75 |
$242.92 |
1.7× |
| Shoulder 1 view (73020) |
$159.57 |
$265.95 |
1.9× |
| Small bowel series (74250) |
$334.93 |
$558.21 |
2.0× |
| Spine thoracic 3 views (72072) |
$258.15 |
$430.25 |
2.6× |
| Thoracolumbar 2 views (72080) |
$258.15 |
$430.25 |
3.1× |
| Ultrasound Exam Aaa Screen (76706) |
$190.89 |
$318.15 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$604.46 |
$1,007.44 |
6.0× |
| Us breast unilateral limited (76642) |
$355.09 |
$591.82 |
4.3× |
| Us chest (76604) |
$381.79 |
$636.31 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$117.82 |
$196.37 |
1.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$611.83 |
$1,019.71 |
6.1× |
| Us ob limited (76815) |
$243.28 |
$405.46 |
2.4× |
| Us ob transvaginal (76817) |
$240.85 |
$401.42 |
2.4× |
| Us pelvic non ob complete (76856) |
$420.24 |
$700.40 |
4.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$421.97 |
$703.29 |
4.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$301.09 |
$501.81 |
3.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$278.22 |
$463.70 |
2.8× |
| Us retroperitoneal complete (76770) |
$366.23 |
$610.38 |
3.7× |
| Us retroperitoneal limited (76775) |
$535.92 |
$893.20 |
5.3× |
| Us scrotum and contents (76870) |
$366.23 |
$610.38 |
3.7× |
| Us soft tissue head/neck (76536) |
$431.20 |
$718.67 |
4.3× |
| Us transrectal (76872) |
$168.78 |
$281.30 |
1.7× |
| Us,transplanted kidney, real time/ doppler (76776) |
$346.58 |
$577.63 |
3.5× |
| Venogram extremity bilateral (75822) |
$299.20 |
$498.67 |
0.2× |
| Venogram Extremity Unilateral (75820) |
$148.31 |
$247.18 |
0.1× |
| Wrist 2 views (73100) |
$159.57 |
$265.95 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$329.75 |
$549.58 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$258.15 |
$430.25 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$463.75 |
$772.92 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$198.35 |
$330.58 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$92.22 |
$153.70 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$284.78 |
$474.64 |
2.8× |
| X-ray exam of femur 2/> (73552) |
$171.98 |
$286.64 |
2.1× |
| X-ray eye for foreign body (70030) |
$149.22 |
$248.70 |
1.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$235.10 |
$391.84 |
2.8× |
| X-ray IV pyelogram (ivp) (74400) |
$468.04 |
$780.07 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$145.75 |
$242.92 |
1.7× |
| X-ray leg, infant (73592) |
$171.28 |
$285.46 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$314.88 |
$524.80 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$536.54 |
$894.23 |
5.3× |
| X-ray optic foramen (70190) |
$456.36 |
$760.60 |
5.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$155.32 |
$258.87 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$169.15 |
$281.91 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$245.04 |
$408.40 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$325.25 |
$542.08 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$233.36 |
$388.93 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$255.23 |
$425.39 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$312.12 |
$520.20 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$331.07 |
$551.79 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$274.45 |
$457.42 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$184.03 |
$306.72 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$239.34 |
$398.90 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$258.15 |
$430.25 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$258.15 |
$430.25 |
2.6× |
| Xr bone length studies (77073) |
$299.99 |
$499.99 |
3.0× |
| Xr c-spine 4 or 5 views (72050) |
$385.04 |
$641.74 |
3.8× |
| Xr c-spine 6 or more views (72052) |
$402.54 |
$670.90 |
4.0× |
| Xr chest 4+ views (71048) |
$226.46 |
$377.44 |
2.3× |