| Abdomen 2 views (74019) |
$523.88 |
$828 |
4.9× |
| Ankle 2 views (73600) |
$283.45 |
$448 |
3.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,198.97 |
$1,895 |
2.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,418.51 |
$2,242 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$1,418.51 |
$2,242 |
3.4× |
| Bone age studies (77072) |
$275.86 |
$436 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,576.69 |
$2,492 |
3.8× |
| Bone survey complete (77075) |
$953.48 |
$1,507 |
8.8× |
| Bone survey infant (77076) |
$448.58 |
$709 |
4.2× |
| Bowel imaging (78290) |
$1,371.69 |
$2,168 |
3.3× |
| Cervical spine 2 or 3 views (72040) |
$508.69 |
$804 |
5.7× |
| Chest 1 view (71045) |
$213.85 |
$338 |
2.4× |
| Chest xray 3 views (71047) |
$555.51 |
$878 |
6.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$398.60 |
$630 |
2.2× |
| Clavicle complete (73000) |
$378.99 |
$599 |
4.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$976.89 |
$1,544 |
9.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,867.01 |
$5,509 |
5.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,190.04 |
$4,706 |
4.8× |
| CT abdomen w contrast (74160) |
$891.77 |
$2,926 |
4.9× |
| CT abdomen w wo contrast (74170) |
$891.77 |
$3,142 |
4.9× |
| CT abdomen w/o contrast (74150) |
$533.43 |
$2,712 |
4.9× |
| CT c-spine w/o contrast (72125) |
$533.43 |
$2,712 |
4.9× |
| CT chest w contrast (71260) |
$891.77 |
$2,712 |
4.9× |
| CT chest w/wo contrast (71270) |
$891.77 |
$2,926 |
4.9× |
| CT head/brain with contrast (70460) |
$891.77 |
$2,712 |
4.9× |
| CT head/brain without and with contrast (70470) |
$891.77 |
$2,926 |
4.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$63.27 |
$100 |
0.7× |
| CT iac w contrast (70481) |
$891.77 |
$2,767 |
4.9× |
| CT lower ext w/o (73700) |
$533.43 |
$2,496 |
4.9× |
| CT lower extremity w wo contrast (73702) |
$891.77 |
$2,926 |
4.9× |
| CT lower extremity w/contrast material (73701) |
$891.77 |
$2,712 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$533.43 |
$2,712 |
4.9× |
| CT maxillofacial w contrast (70487) |
$891.77 |
$2,926 |
4.9× |
| CT maxillofacial wo contrast (70486) |
$533.43 |
$2,712 |
4.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$891.77 |
$2,926 |
4.9× |
| CT orbits w/o contrast (70480) |
$533.43 |
$2,712 |
4.9× |
| CT pelvis w/o contrast (72192) |
$533.43 |
$2,496 |
4.9× |
| CT pelvis w/wo contrast (72194) |
$891.77 |
$2,355.50 |
4.9× |
| CT scan of arm combo (73202) |
$891.77 |
$2,926 |
4.9× |
| CT soft tissue neck w contrast (70491) |
$891.77 |
$2,926 |
4.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$891.77 |
$2,926 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$533.43 |
$2,712 |
4.9× |
| CT thoracic spine w/o contrast (72128) |
$533.43 |
$2,712 |
4.9× |
| CT thorax w/o contrast (71250) |
$533.43 |
$2,020 |
4.9× |
| CT upper ext wo (73200) |
$533.43 |
$2,496 |
4.9× |
| CT upper extremity with contrast (73201) |
$1,867.01 |
$2,712 |
5.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,513.42 |
$2,392 |
8.4× |
| Cta Abdomen (74175) |
$891.77 |
$2,712 |
4.9× |
| CTA abdomen pelvis (74174) |
$1,867.01 |
$4,557 |
5.2× |
| CTA chest (71275) |
$891.77 |
$2,857 |
4.9× |
| Cta Head (70496) |
$891.77 |
$1,430 |
4.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,731.70 |
$2,737 |
4.8× |
| Cta Neck (70498) |
$891.77 |
$1,307 |
4.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$539.69 |
$853 |
5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$201.83 |
$319 |
2.2× |
| Facial bones min 3 views (70150) |
$523.88 |
$828 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$300.53 |
$475 |
2.8× |
| Fluoroscopy up to 1 hr (76000) |
$384.05 |
$607 |
1.6× |
| Foot 2 views (73620) |
$206.26 |
$326 |
2.3× |
| Forearm 2 views (73090) |
$190.44 |
$301 |
2.1× |
| Hand 2 views (73120) |
$195.50 |
$309 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,044.59 |
$1,651 |
1.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,093.94 |
$1,729 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,130.63 |
$1,787 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,387.51 |
$2,193 |
2.5× |
| Knee 3 views (73562) |
$404.30 |
$639 |
4.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,341.32 |
$2,120 |
3.3× |
| Liver imaging w/vascular flow (78202) |
$1,304.63 |
$2,062 |
2.3× |
| Lung ventilation imaging (78579) |
$1,204.03 |
$1,903 |
2.9× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,721.90 |
$4,635 |
4.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,867.01 |
$5,235 |
5.2× |
| MRA head w/o contrast (70544) |
$1,190.04 |
$4,864 |
4.8× |
| MRA head with contrast (70545) |
$1,867.01 |
$2,568 |
5.2× |
| MRA neck w contrast (70548) |
$1,867.01 |
$4,864 |
5.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,867.01 |
$5,045 |
5.2× |
| MRA neck w/o contrast (70547) |
$1,190.04 |
$4,864 |
4.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,867.01 |
$5,349 |
5.2× |
| MRI abdomen w/o contrast (74181) |
$1,190.04 |
$4,379 |
4.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,867.01 |
$5,235 |
5.2× |
| MRI c-spine with contrast (72142) |
$1,867.01 |
$4,864 |
5.2× |
| MRI cervical spine w/o contrast (72141) |
$1,190.04 |
$4,379 |
4.8× |
| MRI chest w/o contrast (71550) |
$1,190.04 |
$4,379 |
4.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,867.01 |
$4,635 |
5.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,867.01 |
$5,235 |
5.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,190.04 |
$3,889 |
4.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,190.04 |
$4,379 |
4.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,867.01 |
$5,349 |
5.2× |
| MRI pelvis w/contrast (72196) |
$1,867.01 |
$4,864 |
5.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,867.01 |
$5,349 |
5.2× |
| MRI pelvis w/o contrast (72195) |
$1,190.04 |
$4,379 |
4.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,867.01 |
$5,349 |
5.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,867.01 |
$4,864 |
5.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,867.01 |
$5,349 |
5.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,867.01 |
$4,864 |
5.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,867.01 |
$5,349 |
5.2× |
| MRI temporomandibular joint (70336) |
$1,190.04 |
$4,864 |
4.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,190.04 |
$4,379 |
4.8× |
| MRI up ext w/o contrast (73218) |
$1,190.04 |
$3,889 |
4.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,190.04 |
$3,889 |
4.8× |
| MRI, joint upper extrem combo (73223) |
$1,867.01 |
$5,235 |
5.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,965.48 |
$3,693 |
2.2× |
| Myocardial spect single study at rest or stress (78451) |
$542.22 |
$857 |
0.4× |
| Neck soft tissue (70360) |
$313.19 |
$495 |
3.5× |
| Osseous survey limited (77074) |
$575.12 |
$909 |
5.3× |
| Parathyroid Planar Imaging (78070) |
$632.70 |
$1,000 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$236 |
$373 |
2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,277.42 |
$2,019 |
3.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,129.37 |
$1,785 |
2.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$206.26 |
$326 |
2.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$347.98 |
$550 |
3.9× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$428.34 |
$677 |
4.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$239.16 |
$378 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$151.85 |
$240 |
1.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$206.26 |
$326 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$195.50 |
$309 |
2.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$275.86 |
$436 |
3.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$455.54 |
$720 |
4.2× |
| Radex Humerus Minimum 2 Views (73060) |
$404.30 |
$639 |
4.5× |
| Radex Kne 1/2 Views (73560) |
$170.83 |
$270 |
1.9× |
| Radex Kne Compl 4/More Views (73564) |
$466.93 |
$738 |
4.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$431.18 |
$681.50 |
4.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$487.81 |
$771 |
5.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$451.12 |
$713 |
4.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$265.10 |
$419 |
3.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$141.72 |
$224 |
1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$530.20 |
$838 |
5.9× |
| Radex Toe Minimum 2 Views (73660) |
$254.98 |
$403 |
2.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$121.48 |
$192 |
1.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$195.50 |
$309 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$378.99 |
$599 |
4.2× |
| Radiologic exam chest 2 views (71046) |
$299.52 |
$373 |
3.3× |
| Radiologic examination femur 1 view (73551) |
$136.03 |
$215 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$215.75 |
$341 |
2.4× |
| Ribs bilateral 3 views (71110) |
$499.83 |
$790 |
4.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,469.76 |
$2,323 |
2.6× |
| Sacroiliac Joints < 3 Views (72200) |
$347.98 |
$550 |
3.2× |
| Scapula (73010) |
$357.48 |
$565 |
3.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$242.51 |
$302 |
10.4× |
| Shoulder 1 view (73020) |
$233.47 |
$369 |
2.6× |
| Spine thoracic 3 views (72072) |
$558.04 |
$882 |
5.2× |
| Thoracolumbar 2 views (72080) |
$275.86 |
$436 |
3.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,180.62 |
$1,866 |
2.9× |
| Tmj unilateral (70328) |
$423.91 |
$670 |
4.7× |
| Ultrasound Exam Aaa Screen (76706) |
$472.63 |
$747 |
4.4× |
| Ultrasound, abdomen limited (76705) |
$790.88 |
$1,250 |
7.3× |
| Umbilical-artery Doppler (OB) (76820) |
$139.19 |
$220 |
1.3× |
| Us breast unilateral limited (76642) |
$206.26 |
$326 |
2.3× |
| Us chest (76604) |
$285.98 |
$452 |
2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$403.03 |
$637 |
3.7× |
| Us ob limited (76815) |
$425.17 |
$672 |
3.9× |
| Us ob transvaginal (76817) |
$477.69 |
$755 |
4.4× |
| Us pelvic non ob complete (76856) |
$477.69 |
$755 |
4.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$396.70 |
$627 |
3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$629.54 |
$995 |
5.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$425.17 |
$672 |
3.9× |
| Us retroperitoneal complete (76770) |
$772.53 |
$1,221 |
7.2× |
| Us retroperitoneal limited (76775) |
$461.24 |
$729 |
4.3× |
| Us scrotum and contents (76870) |
$477.69 |
$755 |
4.4× |
| Us soft tissue head/neck (76536) |
$650.42 |
$1,028 |
6.0× |
| Us spinal canal and contents (76800) |
$388.48 |
$614 |
3.6× |
| Wrist 2 views (73100) |
$195.50 |
$309 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$156.28 |
$247 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$378.99 |
$599 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$195.50 |
$309 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$218.91 |
$346 |
2.4× |
| X-ray exam of femur 2/> (73552) |
$215.75 |
$341 |
2.4× |
| X-ray eye for foreign body (70030) |
$172.73 |
$273 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$373.93 |
$591 |
4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$349.25 |
$552 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$197.40 |
$289 |
2.2× |
| X-ray leg, infant (73592) |
$215.75 |
$341 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$224.61 |
$355 |
2.1× |
| X-ray nose-rectum child f.b. (76010) |
$404.30 |
$639 |
4.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$515.02 |
$814 |
4.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$378.99 |
$599 |
4.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$463.77 |
$733 |
4.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$662.44 |
$1,047 |
6.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$199.30 |
$315 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$404.30 |
$639 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$663.07 |
$1,048 |
6.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$499.83 |
$790 |
4.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$313.19 |
$495 |
3.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$404.30 |
$639 |
4.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$423.91 |
$670 |
4.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$239.16 |
$378 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$640.93 |
$1,013 |
5.9× |
| Xr c-spine 4 or 5 views (72050) |
$616.88 |
$975 |
5.7× |
| Xr c-spine 6 or more views (72052) |
$783.92 |
$1,239 |
7.3× |