| Abdomen 2 views (74019) |
$237.10 |
$408.80 |
2.0× |
| Ankle 2 views (73600) |
$253.37 |
$436.85 |
2.5× |
| Arthrogram shoulder (73040) |
$298.66 |
$514.93 |
0.7× |
| Bone age studies (77072) |
$69.12 |
$119.16 |
0.6× |
| Bone survey complete (77075) |
$268.15 |
$462.33 |
2.2× |
| Bone survey infant (77076) |
$212.61 |
$366.57 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$226.56 |
$390.62 |
2.2× |
| Chest 1 view (71045) |
$195.80 |
$337.59 |
1.9× |
| Chest xray 3 views (71047) |
$180.99 |
$312.06 |
1.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$293.61 |
$506.22 |
1.4× |
| Clavicle complete (73000) |
$266.13 |
$458.84 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$184.50 |
$318.11 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,389.07 |
$4,119.08 |
5.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,559.53 |
$2,688.85 |
5.6× |
| CT abdomen w contrast (74160) |
$1,174.66 |
$2,025.28 |
5.8× |
| CT abdomen w wo contrast (74170) |
$1,360.68 |
$2,346 |
6.7× |
| CT abdomen w/o contrast (74150) |
$911.12 |
$1,570.90 |
7.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,981.88 |
$3,417.03 |
9.7× |
| CT angiography upper extremity lt (73206) |
$1,108.69 |
$1,911.54 |
5.4× |
| CT c-spine w/contrast (72126) |
$1,029.42 |
$1,774.86 |
2.5× |
| CT c-spine w/o contrast (72125) |
$851.24 |
$1,467.66 |
7.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,150 |
$1,982.77 |
5.6× |
| CT chest w contrast (71260) |
$1,182.36 |
$2,038.55 |
5.8× |
| CT chest w/wo contrast (71270) |
$1,349.56 |
$2,326.82 |
6.6× |
| CT head/brain with contrast (70460) |
$1,019.96 |
$1,758.56 |
5.0× |
| CT head/brain without and with contrast (70470) |
$1,283.76 |
$2,213.37 |
6.3× |
| CT iac w contrast (70481) |
$889.48 |
$1,533.60 |
4.4× |
| CT lower ext w/o (73700) |
$1,162.19 |
$2,003.77 |
9.6× |
| CT lower extremity w wo contrast (73702) |
$1,710.65 |
$2,949.39 |
8.4× |
| CT lower extremity w/contrast material (73701) |
$1,518.92 |
$2,618.82 |
7.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,150 |
$1,982.77 |
5.6× |
| CT lumbar spine w/contrast (72132) |
$1,029.42 |
$1,774.86 |
2.5× |
| CT lumbar spine w/o contrast (72131) |
$851.24 |
$1,467.66 |
7.0× |
| CT maxillofacial w contrast (70487) |
$921.58 |
$1,588.94 |
4.5× |
| CT maxillofacial w/wo contrast (70488) |
$975.87 |
$1,682.53 |
4.8× |
| CT maxillofacial wo contrast (70486) |
$768.72 |
$1,325.38 |
6.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$944.54 |
$1,628.52 |
4.6× |
| CT orbits w/o contrast (70480) |
$715.92 |
$1,234.33 |
5.9× |
| CT pelvis w/o contrast (72192) |
$906.80 |
$1,563.44 |
7.5× |
| CT pelvis w/wo contrast (72194) |
$1,348.74 |
$2,325.40 |
6.6× |
| CT scan of arm combo (73202) |
$954 |
$1,644.83 |
4.7× |
| CT soft tissue neck w contrast (70491) |
$1,169.06 |
$2,015.62 |
5.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,291.64 |
$2,226.96 |
6.3× |
| CT soft tissue neck w/o contrast (70490) |
$753.66 |
$1,299.40 |
6.2× |
| CT thoracic spine w/contrast (72129) |
$1,029.42 |
$1,774.86 |
5.1× |
| CT thoracic spine w/o contrast (72128) |
$851.24 |
$1,467.66 |
7.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,150 |
$1,982.77 |
5.6× |
| CT thorax w/o contrast (71250) |
$908.08 |
$1,565.66 |
7.5× |
| CT upper ext wo (73200) |
$804.60 |
$1,387.25 |
6.6× |
| CT upper extremity with contrast (73201) |
$864.02 |
$1,489.70 |
2.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,077.56 |
$1,857.86 |
5.3× |
| Cta Abdomen (74175) |
$1,189.25 |
$2,050.43 |
5.8× |
| CTA abdomen pelvis (74174) |
$1,620.70 |
$2,794.31 |
4.0× |
| CTA chest (71275) |
$1,512.90 |
$2,608.46 |
7.4× |
| Cta Head (70496) |
$1,158.88 |
$1,998.06 |
5.7× |
| Cta Neck (70498) |
$1,158.88 |
$1,998.06 |
5.7× |
| Cta Pelvis (72191) |
$1,171.62 |
$2,020.03 |
5.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$131.80 |
$227.26 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$295.46 |
$509.40 |
2.4× |
| Facial bones min 3 views (70150) |
$286.50 |
$493.98 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$192.95 |
$332.67 |
0.7× |
| Foot 2 views (73620) |
$293.64 |
$506.27 |
2.9× |
| Forearm 2 views (73090) |
$282.90 |
$487.75 |
2.8× |
| Hand 2 views (73120) |
$133.10 |
$229.49 |
1.1× |
| Knee 3 views (73562) |
$325.75 |
$561.63 |
3.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,723.88 |
$2,972.20 |
1.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,310.28 |
$2,259.10 |
3.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,903.91 |
$5,006.74 |
7.2× |
| MRA head w & w/o contrast (70546) |
$1,969.11 |
$3,395.02 |
4.9× |
| MRA head w/o contrast (70544) |
$1,204.22 |
$2,076.26 |
4.3× |
| MRA head with contrast (70545) |
$1,245.53 |
$2,147.47 |
3.1× |
| MRA neck w contrast (70548) |
$1,245.53 |
$2,147.47 |
3.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,969.32 |
$3,395.38 |
4.9× |
| MRA neck w/o contrast (70547) |
$1,204.22 |
$2,076.26 |
4.3× |
| MRI abdomen w contrast (74182) |
$1,501.35 |
$2,588.54 |
3.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,967.52 |
$3,392.28 |
4.9× |
| MRI abdomen w/o contrast (74181) |
$1,284.82 |
$2,215.22 |
4.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,373.66 |
$2,368.36 |
1.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,865.08 |
$3,215.64 |
4.6× |
| MRI bone marrow blood supply (77084) |
$1,741.29 |
$3,002.23 |
6.3× |
| MRI c-spine with contrast (72142) |
$2,190.76 |
$3,777.17 |
5.4× |
| MRI cervical spine w/o contrast (72141) |
$1,823.54 |
$3,144.04 |
6.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,788.62 |
$3,083.84 |
4.4× |
| MRI chest w/o contrast (71550) |
$1,221.86 |
$2,106.65 |
4.4× |
| MRI chest with contrast (71551) |
$1,364.83 |
$2,353.16 |
1.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,309.24 |
$2,257.32 |
3.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,799.61 |
$3,102.78 |
4.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,205.77 |
$2,078.91 |
4.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,291.68 |
$2,227.02 |
4.7× |
| MRI orbit face neck w contrast (70542) |
$1,409.92 |
$2,430.88 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,873.78 |
$3,230.65 |
4.6× |
| MRI pelvis w/contrast (72196) |
$1,598.52 |
$2,756.07 |
3.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,889.32 |
$3,257.44 |
4.7× |
| MRI pelvis w/o contrast (72195) |
$1,284.82 |
$2,215.22 |
4.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,388.58 |
$4,118.26 |
5.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,124 |
$3,662.07 |
5.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,537.19 |
$4,374.46 |
6.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,137 |
$3,684.48 |
5.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,863.02 |
$3,212.10 |
4.6× |
| MRI temporomandibular joint (70336) |
$318.13 |
$548.50 |
1.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,823.79 |
$3,144.46 |
6.6× |
| MRI up ext w/o contrast (73218) |
$1,205.77 |
$2,078.91 |
4.4× |
| MRI upper ext joint w/o contrast (73221) |
$654.52 |
$1,128.48 |
2.4× |
| MRI, joint upper extrem combo (73223) |
$1,873.78 |
$3,230.65 |
4.6× |
| Neck soft tissue (70360) |
$191.94 |
$330.94 |
1.9× |
| Osseous survey limited (77074) |
$275.06 |
$474.24 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$154.20 |
$265.86 |
1.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$383.87 |
$661.85 |
3.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$266.13 |
$458.84 |
2.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$332.88 |
$573.93 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$263.34 |
$454.02 |
2.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$286.20 |
$493.46 |
2.4× |
| Radex fingr minimum 2 views (73140) |
$201.32 |
$347.11 |
2.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$292.13 |
$503.67 |
2.9× |
| Radex Hand Minimum 3 Views (73130) |
$308.94 |
$532.65 |
3.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$150.42 |
$259.35 |
1.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$294.36 |
$507.52 |
2.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$82.30 |
$141.90 |
0.7× |
| Radex Humerus Minimum 2 Views (73060) |
$307.38 |
$529.97 |
3.0× |
| Radex Kne 1/2 Views (73560) |
$202.39 |
$348.94 |
2.0× |
| Radex Kne Compl 4/More Views (73564) |
$405.73 |
$699.53 |
3.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$285.41 |
$492.08 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$227.92 |
$392.96 |
2.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$34.84 |
$60.08 |
0.3× |
| Radex Sho Compl Minimum 2 Views (73030) |
$349.19 |
$602.06 |
3.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$96.74 |
$166.80 |
1.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$130.09 |
$224.30 |
1.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$113.40 |
$195.52 |
1.1× |
| Radex Toe Minimum 2 Views (73660) |
$241.04 |
$415.59 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$81.62 |
$140.72 |
0.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$369.12 |
$636.41 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$173.35 |
$298.88 |
1.7× |
| Radiologic exam chest 2 views (71046) |
$227.28 |
$391.88 |
2.2× |
| Radiologic examination femur 1 view (73551) |
$81.36 |
$140.27 |
0.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$349.19 |
$602.06 |
3.5× |
| Ribs bilateral 3 views (71110) |
$280.64 |
$483.86 |
2.3× |
| Scapula (73010) |
$251.37 |
$433.39 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$58.24 |
$100.41 |
2.5× |
| Shoulder 1 view (73020) |
$270.66 |
$466.65 |
2.7× |
| Small bowel series (74250) |
$329.06 |
$567.35 |
1.6× |
| Spine thoracic 3 views (72072) |
$276.27 |
$476.32 |
2.3× |
| Thoracolumbar 2 views (72080) |
$215.84 |
$372.14 |
2.1× |
| Ultrasound Exam Aaa Screen (76706) |
$288.40 |
$497.23 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$334.54 |
$576.80 |
2.8× |
| Umbilical-artery Doppler (OB) (76820) |
$87.42 |
$150.72 |
0.7× |
| Us breast unilateral limited (76642) |
$157.62 |
$271.76 |
1.6× |
| Us chest (76604) |
$218.73 |
$377.12 |
1.8× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$241.30 |
$416.03 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$256.32 |
$441.92 |
2.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$190.34 |
$328.18 |
1.6× |
| Us ob limited (76815) |
$319.74 |
$551.27 |
2.6× |
| Us ob transvaginal (76817) |
$315.82 |
$544.52 |
2.6× |
| Us pelvic non ob complete (76856) |
$401.51 |
$692.26 |
3.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$392.57 |
$676.85 |
3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$285.20 |
$491.73 |
2.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$89.20 |
$153.79 |
0.7× |
| Us retroperitoneal complete (76770) |
$120.27 |
$207.36 |
1.0× |
| Us retroperitoneal limited (76775) |
$76.80 |
$132.42 |
0.6× |
| Us scrotum and contents (76870) |
$371.42 |
$640.38 |
3.1× |
| Us soft tissue head/neck (76536) |
$337.46 |
$581.82 |
2.8× |
| Us, eye b-scan (76512) |
$43.16 |
$74.41 |
0.4× |
| Wrist 2 views (73100) |
$236 |
$406.90 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$293.09 |
$505.33 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$169.31 |
$291.92 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$266.13 |
$458.84 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$86 |
$148.27 |
0.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$143.38 |
$247.21 |
1.2× |
| X-ray exam of femur 2/> (73552) |
$97.12 |
$167.45 |
1.0× |
| X-ray eye for foreign body (70030) |
$98.38 |
$169.63 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$64.34 |
$110.94 |
0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$86.94 |
$149.89 |
0.9× |
| X-ray leg, infant (73592) |
$47.40 |
$81.71 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$253.58 |
$437.21 |
2.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$317.30 |
$547.08 |
2.6× |
| X-ray nose-rectum child f.b. (76010) |
$76.50 |
$131.89 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$271.18 |
$467.54 |
2.2× |
| X-ray retrograde pyelogram (74420) |
$349.72 |
$602.96 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$179.88 |
$310.14 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$250.32 |
$431.58 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$318.08 |
$548.41 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$224.31 |
$386.74 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$232.49 |
$400.84 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$326.17 |
$562.36 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$268.64 |
$463.16 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$150.38 |
$259.26 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$152.18 |
$262.38 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$164.35 |
$283.36 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$178.44 |
$307.64 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$214.48 |
$369.80 |
1.8× |
| Xr bone length studies (77073) |
$31.53 |
$54.37 |
0.3× |
| Xr c-spine 4 or 5 views (72050) |
$594.91 |
$1,025.70 |
4.9× |
| Xr c-spine 6 or more views (72052) |
$324.50 |
$559.48 |
2.7× |
| Xr chest 4+ views (71048) |
$328.56 |
$566.48 |
2.7× |