| Abdomen 1 View (74018) |
$204 |
$227 |
2.3× |
| Abdomen 2 views (74019) |
$241 |
$268 |
2.3× |
| Ankle 2 views (73600) |
$193 |
$214 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$1,607 |
$1,785 |
3.9× |
| Bone Imaging Limited Area (78300) |
$1,006 |
$1,118 |
2.5× |
| Bone Imaging Multiple Areas (78305) |
$1,212 |
$1,347 |
3.0× |
| Bone Imaging Whole Body (78306) |
$1,393 |
$1,548 |
3.4× |
| Cat Scan Follow-Up Study (76380) |
$930 |
$1,033 |
10.5× |
| Chest 1 view (71045) |
$185 |
$206 |
2.1× |
| Chest 2 views (71046) |
$241 |
$268 |
2.7× |
| Chest 3 views (71047) |
$299 |
$332 |
3.4× |
| Chest 4 or more views (71048) |
$162 |
$180 |
1.5× |
| Clavicle complete (73000) |
$204 |
$227 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$266 |
$295 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,157 |
$3,508 |
8.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,715 |
$1,905 |
7.0× |
| CT abdomen w contrast (74160) |
$1,509 |
$1,677 |
8.4× |
| CT abdomen w wo contrast (74170) |
$2,210 |
$2,456 |
12.3× |
| CT abdomen w/o contrast (74150) |
$1,246 |
$1,384 |
11.7× |
| CT Angio Abdomen and Pelvis (74174) |
$3,095 |
$3,439 |
8.7× |
| CT Angio Chest (71275) |
$2,195 |
$2,439 |
12.2× |
| CT Angio Head (70496) |
$2,152 |
$2,391 |
12.0× |
| CT Angio Neck (70498) |
$2,148 |
$2,387 |
12.0× |
| CT cervical spine w/ contrast (72126) |
$1,557 |
$1,730 |
4.4× |
| CT cervical spine w/o contrast (72125) |
$1,377 |
$1,530 |
12.9× |
| CT chest w contrast (71260) |
$1,557 |
$1,730 |
8.7× |
| CT chest w/wo contrast (71270) |
$2,060 |
$2,289 |
11.5× |
| CT head/brain with contrast (70460) |
$1,244 |
$1,382 |
6.9× |
| CT head/brain without and with contrast (70470) |
$1,557 |
$1,730 |
8.7× |
| CT iac w contrast (70481) |
$1,745 |
$1,939 |
9.7× |
| CT lower ext w/o (73700) |
$1,247 |
$1,386 |
11.7× |
| CT lower extremity w/contrast material (73701) |
$1,418 |
$1,576 |
7.9× |
| CT lumbar spine w contrast (72132) |
$1,557 |
$1,730 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$1,377 |
$1,530 |
12.9× |
| CT maxillofacial w contrast (70487) |
$1,253 |
$1,392 |
7.0× |
| CT maxillofacial wo contrast (70486) |
$1,185 |
$1,317 |
11.1× |
| CT neck tissue combo (70492) |
$1,733 |
$1,925 |
9.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,931 |
$2,146 |
10.8× |
| CT orbits w/o contrast (70480) |
$1,427 |
$1,585 |
13.4× |
| CT pelvis w&w/o contrast (72194) |
$1,869 |
$2,077 |
10.4× |
| CT pelvis w/o contrast (72192) |
$1,377 |
$1,530 |
12.9× |
| CT scan of leg combo (73702) |
$1,799 |
$1,999 |
10.0× |
| CT scans face/jaw combo (70488) |
$1,645 |
$1,828 |
9.2× |
| CT soft tissue neck w contrast (70491) |
$1,402 |
$1,558 |
7.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,237 |
$1,374 |
11.6× |
| CT thoracic spine w contrast (72129) |
$1,557 |
$1,730 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$1,377 |
$1,530 |
12.9× |
| CT thorax w/o contrast (71250) |
$1,302 |
$1,447 |
12.2× |
| CT upper ext wo (73200) |
$1,316 |
$1,462 |
12.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,827 |
$2,030 |
10.2× |
| CT upper extremity with contrast (73201) |
$1,577 |
$1,752 |
4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,345 |
$3,717 |
18.7× |
| Cta Abdomen (74175) |
$1,870 |
$2,078 |
10.4× |
| Dxa Bone Density Axial (77080) |
$188 |
$209 |
1.8× |
| Foot 2 views (73620) |
$193 |
$214 |
2.2× |
| Forearm 2 views (73090) |
$204 |
$227 |
2.3× |
| Hand 2 views (73120) |
$193 |
$214 |
1.8× |
| Hepatobil Syst Image W/Drug (78227) |
$2,146 |
$2,384 |
3.9× |
| Hepatobiliary System Imaging (78226) |
$1,575 |
$1,750 |
3.9× |
| Ht Muscle Image Spect Sing (78451) |
$2,778 |
$3,087 |
2.1× |
| Joint Survey Single View (77077) |
$116 |
$129 |
1.1× |
| Knee 3 Views (73562) |
$225 |
$250 |
2.5× |
| Magnetic Image Jaw Joint (70336) |
$2,097 |
$2,330 |
8.6× |
| MRA head w/o contrast (70544) |
$2,809 |
$3,121 |
11.5× |
| MRA neck w contrast (70548) |
$2,985 |
$3,317 |
8.4× |
| MRI abdomen w/o contrast (74181) |
$2,195 |
$2,439 |
9.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,425 |
$3,806 |
9.6× |
| MRI cervical spine w contrast (72142) |
$2,462 |
$2,735 |
6.9× |
| MRI cervical spine w/o cont (72141) |
$1,953 |
$2,170 |
8.0× |
| MRI chest w/o contrast (71550) |
$2,896 |
$3,218 |
11.9× |
| MRI chest wo w contrast (71552) |
$3,914 |
$4,349 |
11.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,432 |
$3,813 |
9.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,510 |
$2,789 |
10.3× |
| MRI lumbar spine w contrast (72149) |
$2,563 |
$2,848 |
7.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,246 |
$3,607 |
9.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,152 |
$2,391 |
8.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,391 |
$3,768 |
9.5× |
| MRI pelvis w contrast (72196) |
$2,210 |
$2,455 |
6.2× |
| MRI pelvis w/o & w contrast (72197) |
$3,413 |
$3,792 |
9.6× |
| MRI pelvis w/o contrast (72195) |
$2,552 |
$2,836 |
10.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,074 |
$2,304 |
8.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,047 |
$3,385 |
8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,859 |
$3,177 |
11.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,710 |
$4,122 |
10.4× |
| MRI, abdomen, combo (74183) |
$3,421 |
$3,801 |
9.6× |
| MRI, dorsal spine combo (72157) |
$3,031 |
$3,368 |
8.5× |
| MRI, dorsal spine contrast (72147) |
$1,975 |
$2,194 |
5.5× |
| MRI, joint upper extrem (73221) |
$2,094 |
$2,327 |
8.6× |
| MRI, joint upper extrem combo (73223) |
$3,435 |
$3,817 |
9.6× |
| MRI, lumbar spine combo (72158) |
$3,240 |
$3,600 |
9.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,512 |
$3,902 |
2.7× |
| Neck soft tissue (70360) |
$166 |
$184 |
1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$418 |
$464 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$204 |
$227 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$288 |
$320 |
2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$208 |
$231 |
2.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$185 |
$206 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$225 |
$250 |
2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$304 |
$338 |
2.8× |
| Radex fingr minimum 2 views (73140) |
$166 |
$184 |
1.9× |
| Radex foot complete minimum 3 views (73630) |
$208 |
$231 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$208 |
$231 |
2.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$193 |
$214 |
2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$232 |
$258 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$277 |
$308 |
3.1× |
| Radex shoulder complete minimum 2 views (73030) |
$225 |
$250 |
2.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$241 |
$268 |
2.7× |
| Radex Spine 1 View Specify Level (72020) |
$166 |
$184 |
1.9× |
| Radex Sternum Minimum 2 Views (71120) |
$253 |
$281 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$189 |
$210 |
2.1× |
| Radex Toe Minimum 2 Views (73660) |
$166 |
$184 |
1.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$193 |
$214 |
1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$208 |
$231 |
2.3× |
| Radiologic exam knee complete 4/more views (73564) |
$269 |
$299 |
2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$260 |
$289 |
2.4× |
| Radiologic examination femur 1 view (73551) |
$219 |
$243 |
2.5× |
| Radiologic examination femur minimum 2 views (73552) |
$225 |
$250 |
2.5× |
| Radiologic examination knee 1/2 views (73560) |
$204 |
$227 |
2.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$204 |
$227 |
2.3× |
| Ribs bilateral 3 views (71110) |
$329 |
$366 |
3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,378 |
$1,531 |
2.5× |
| Scapula (73010) |
$204 |
$227 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$134 |
$149 |
5.7× |
| Shoulder 1 view (73020) |
$185 |
$206 |
2.1× |
| Skull less than 4 views (70250) |
$241 |
$268 |
2.3× |
| Thoracic spine 2 views (72070) |
$253 |
$281 |
2.4× |
| Thoracic spine 3 views (72072) |
$289 |
$321 |
2.7× |
| Thoracolumbar 2 views (72080) |
$260 |
$289 |
2.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$952 |
$1,058 |
2.3× |
| Ultrasound Breast Limited (76642) |
$327 |
$363 |
3.7× |
| Ultrasound Exam Aaa Screen (76706) |
$446 |
$495 |
4.2× |
| Ultrasound, abdomen limited (76705) |
$371 |
$412 |
3.5× |
| Us breast unilateral complete (76641) |
$392 |
$436 |
3.7× |
| Us chest (76604) |
$340 |
$378 |
3.2× |
| Us complete joint (76881) |
$401 |
$445 |
3.8× |
| Us exam, pelvic, limited (76857) |
$199 |
$221 |
1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$178 |
$198 |
1.7× |
| Us ob limited 1 or more fetuses (76815) |
$339 |
$377 |
3.2× |
| Us ob transvaginal (76817) |
$329 |
$366 |
3.1× |
| Us pelvic non ob complete (76856) |
$433 |
$481 |
4.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$423 |
$470 |
4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$401 |
$445 |
3.8× |
| Us retroperitoneal complete (76770) |
$473 |
$525 |
4.4× |
| Us retroperitoneal limited (76775) |
$412 |
$458 |
3.9× |
| Us scrotum and contents (76870) |
$441 |
$490 |
4.1× |
| Us thyroid (76536) |
$491 |
$545 |
4.6× |
| Wrist 2 views (73100) |
$193 |
$214 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$260 |
$289 |
2.9× |
| X-Ray Bend Only L-S Spine (72120) |
$163 |
$181 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$204 |
$227 |
2.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$178 |
$198 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$240 |
$267 |
2.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$240 |
$267 |
2.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$250 |
$278 |
2.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$233 |
$259 |
2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$439 |
$488 |
4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$374 |
$415 |
3.5× |
| X-ray eye for foreign body (70030) |
$232 |
$258 |
2.6× |
| X-ray humerus (73060) |
$225 |
$250 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$232 |
$258 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$173 |
$192 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$260 |
$289 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$506 |
$562 |
4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$241 |
$268 |
2.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$232 |
$258 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$233 |
$259 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$304 |
$338 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$383 |
$425 |
3.6× |
| X-ray thoracic spine 4 vw (72074) |
$141 |
$157 |
1.3× |
| X-Ray Tmj Unilat (70328) |
$113 |
$126 |
1.3× |
| X-Rays Bone Survey Complete (77075) |
$385 |
$428 |
3.6× |
| Xr c-spine 4 or 5 views (72050) |
$345 |
$383 |
3.2× |
| Xr facial bones less than 3 views (70140) |
$241 |
$268 |
2.7× |
| Xr orbits complete 4 views (70200) |
$153 |
$170 |
1.4× |