| Abdomen 2 views (74019) |
$53.36 |
$91 |
0.6× |
| Ankle 2 views (73600) |
$43.98 |
$66.50 |
0.6× |
| Bone age studies (77072) |
$52.57 |
$71.12 |
0.6× |
| Bone survey complete (77075) |
$60.53 |
$173.50 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$45.10 |
$79 |
0.6× |
| Chest 1 view (71045) |
$80.36 |
$93.25 |
1.1× |
| Chest 3 views (71047) |
$46.22 |
$96.38 |
0.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$92.76 |
$213.24 |
0.6× |
| Clavicle complete (73000) |
$43.98 |
$68.62 |
0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$71.86 |
$62.50 |
0.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$205.35 |
$1,144.12 |
0.7× |
| CT abdomen and pelvis without contrast (74176) |
$148.29 |
$899.25 |
0.7× |
| CT abdomen w contrast (74160) |
$108.88 |
$501.62 |
0.7× |
| CT abdomen w wo contrast (74170) |
$111.62 |
$591.75 |
0.7× |
| CT abdomen w/o contrast (74150) |
$74.40 |
$447.50 |
0.8× |
| CT c-spine w/o contrast (72125) |
$70.40 |
$456.38 |
0.8× |
| CT cervical spine w&w/o contrast (72127) |
$108.74 |
$676.25 |
0.7× |
| CT chest w/wo contrast (71270) |
$108.40 |
$327 |
0.7× |
| CT chest with contrast (71260) |
$106.61 |
$604.38 |
0.7× |
| CT head/brain with contrast (70460) |
$105.82 |
$444.25 |
0.7× |
| CT head/brain without and with contrast (70470) |
$108.88 |
$656.96 |
0.7× |
| CT iac w contrast (70481) |
$105.82 |
$459.62 |
0.7× |
| CT lower ext w/o (73700) |
$70.40 |
$412.38 |
0.8× |
| CT lower extremity w wo contrast (73702) |
$107.62 |
$622.25 |
0.7× |
| CT lower extremity with contrast (73701) |
$106.46 |
$456.38 |
0.7× |
| CT lumbar spine w & w/o contrast (72133) |
$108.88 |
$598.50 |
0.7× |
| CT lumbar spine w/o contrast (72131) |
$70.40 |
$456.38 |
0.8× |
| CT lumbar spine with contrast (72132) |
$187.84 |
$539 |
0.6× |
| CT maxillofacial w contrast (70487) |
$105.82 |
$455 |
0.7× |
| CT maxillofacial w/o contrast (70486) |
$67.20 |
$405.62 |
0.7× |
| CT maxillofacial w/wo contrast (70488) |
$108.88 |
$535.25 |
0.7× |
| CT neck soft tissue w contrast (70491) |
$111.29 |
$459.62 |
0.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$108.74 |
$594.25 |
0.7× |
| CT orbits w/o contrast (70480) |
$76.48 |
$415.12 |
0.8× |
| CT pelvis w & w/o contrast (72194) |
$107.76 |
$579.88 |
0.7× |
| CT pelvis w/o contrast (72192) |
$72.03 |
$451.62 |
0.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$116.26 |
$536.62 |
0.8× |
| CT soft tissue neck w/o contrast (70490) |
$76.48 |
$415.12 |
0.8× |
| CT thoracic spine w/contrast (72129) |
$107.76 |
$300.05 |
0.7× |
| CT thoracic spine w/o contrast (72128) |
$70.40 |
$456.38 |
0.8× |
| CT thorax w/o contrast (71250) |
$71.86 |
$255.38 |
0.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$107.62 |
$622.25 |
0.7× |
| CT upper extremity w/o contrast rt (73200) |
$70.40 |
$412.38 |
0.8× |
| CT upper extremity with contrast (73201) |
$186.56 |
$456.38 |
0.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$133.27 |
$575.50 |
0.9× |
| Cta Abdomen (74175) |
$120.67 |
$358.42 |
0.8× |
| CTA abdomen pelvis (74174) |
$209.22 |
$471.41 |
0.7× |
| CTA chest (71275) |
$120.81 |
$575 |
0.8× |
| Cta Head (70496) |
$119.28 |
$358.42 |
0.8× |
| Cta Neck (70498) |
$119.28 |
$358.18 |
0.8× |
| Cystography minimum 3 views rs&i (74430) |
$322.14 |
$200.23 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$52.74 |
$178.88 |
0.6× |
| Esophagus (74220) |
$94.22 |
$204.10 |
0.6× |
| Fetal biophysical profile non-stress testing (76818) |
$72.10 |
$189.12 |
0.8× |
| Fluoroscopy up to 1 hr (76000) |
$117.41 |
$169.10 |
0.6× |
| Foot 2 views (73620) |
$43.84 |
$66.50 |
0.6× |
| Forearm 2 views (73090) |
$43.84 |
$68.62 |
0.6× |
| Hand 2 views (73120) |
$52.06 |
$93.47 |
0.6× |
| Hand 3 views (73130) |
$44.30 |
$72.62 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$43.98 |
$67.88 |
0.6× |
| Hysterosalpingogram (74740) |
$118.60 |
$678.56 |
0.6× |
| Knee 3 views (73562) |
$44.60 |
$71.75 |
0.6× |
| MRA head w & w/o contrast (70546) |
$193.44 |
$1,484.25 |
0.6× |
| MRA head w/o contrast (70544) |
$136.46 |
$812.12 |
0.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$200.49 |
$1,484.25 |
0.7× |
| MRA neck w/o contrast (70547) |
$136.46 |
$812.12 |
0.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$209.51 |
$1,677.12 |
0.7× |
| MRI abdomen w/o contrast (74181) |
$141.93 |
$832.25 |
0.7× |
| MRI any jnt lwr ext with con lt (73722) |
$397.78 |
$1,011.62 |
0.6× |
| MRI c-spine with contrast (72142) |
$200.54 |
$979.88 |
0.7× |
| MRI cervical spine w/o contrast (72141) |
$142.68 |
$839.62 |
0.7× |
| MRI chest w/o & w/contrast material (71552) |
$99.12 |
$196.90 |
0.3× |
| MRI chest w/o contrast (71550) |
$63.54 |
$275 |
0.3× |
| MRI chest with contrast (71551) |
$723.85 |
$1,456 |
1.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$196.50 |
$1,011.62 |
0.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$139.82 |
$829.25 |
0.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$139.68 |
$829.25 |
0.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$208.26 |
$1,672.62 |
0.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$209.51 |
$1,677.12 |
0.7× |
| MRI pelvis w/o contrast (72195) |
$142.07 |
$832.25 |
0.7× |
| MRI scan of arm joint before and after contrast (73223) |
$208.55 |
$1,673 |
0.7× |
| MRI scan of leg joint before and after contrast (73723) |
$208.40 |
$1,672.62 |
0.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$211.42 |
$1,697.12 |
0.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$200.30 |
$979.88 |
0.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$211.42 |
$1,697.12 |
0.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$200.30 |
$979.88 |
0.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$211.42 |
$1,697.12 |
0.7× |
| MRI thoracic spine w/o contrast (72146) |
$142.68 |
$916.88 |
0.7× |
| MRI tmj (70336) |
$142.12 |
$839.62 |
0.7× |
| MRI upper ext joint w/o contrast (73221) |
$140.26 |
$829.25 |
0.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$208.55 |
$1,673 |
0.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$140.12 |
$829.25 |
0.7× |
| Neck soft tissue (70360) |
$44.32 |
$65.25 |
0.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$67.66 |
$165 |
0.8× |
| Osseous survey infant (77076) |
$63.71 |
$98.50 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$52.24 |
$94.84 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$208.40 |
$1,673 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$23 |
$126.50 |
0.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$46.18 |
$73.64 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$55.39 |
$141 |
0.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$10.14 |
$65.50 |
0.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$55.89 |
$114.50 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$53.84 |
$87.38 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$44.32 |
$73.62 |
0.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$9.56 |
$54.50 |
0.1× |
| Radiologic exam colon single contrast study (74270) |
$103.76 |
$187.75 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$100.90 |
$185.75 |
0.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$98.96 |
$233.48 |
0.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$44.32 |
$68.50 |
0.6× |
| Radiological examination surgical specimen (76098) |
$13.96 |
$41.25 |
0.0× |
| Ribs bilateral 3 views (71110) |
$54.64 |
$100.38 |
0.6× |
| Scapula complete (73010) |
$52.52 |
$72 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$36.56 |
$61.36 |
1.6× |
| Sella turcica (70240) |
$8.61 |
$52 |
0.1× |
| Small bowel series (74250) |
$98.82 |
$154.56 |
0.7× |
| Spine thoracic 3 views (72072) |
$53.22 |
$86.50 |
0.6× |
| Thoracolumbar 2 views (72080) |
$44.94 |
$82.50 |
0.6× |
| Tomogram (76100) |
$25.82 |
$134.25 |
0.3× |
| Ultrasound, abdomen limited (76705) |
$26.15 |
$190.50 |
0.3× |
| Unlisted Ultrasound Procedure (76999) |
$80.36 |
$154.38 |
1.1× |
| Upper Extremity Infant (73092) |
$51.92 |
$66.50 |
0.6× |
| Urethrocystography voiding (74455) |
$117.62 |
$137.25 |
0.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$91.81 |
$217.36 |
0.6× |
| Us abdl aorta screen aaa (76706) |
$60.51 |
$153 |
0.7× |
| Us breast unilateral complete (76641) |
$64.36 |
$268.80 |
0.7× |
| Us breast unilateral limited (76642) |
$55.14 |
$121.51 |
0.7× |
| Us infant hips limited static (76886) |
$53.86 |
$154 |
0.7× |
| Us ob detailed single fetus (76811) |
$153.26 |
$257.50 |
0.7× |
| Us ob transvaginal (76817) |
$33.71 |
$203.50 |
0.4× |
| Us pelvic non ob complete (76856) |
$30.84 |
$203.50 |
0.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$22.57 |
$156 |
0.3× |
| Us pregnancy ltd (76815) |
$62.88 |
$174.25 |
0.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$70.40 |
$252 |
0.8× |
| Us retroperitoneal complete (76770) |
$32.51 |
$156 |
0.4× |
| Us retroperitoneal limited (76775) |
$61.18 |
$190.50 |
0.7× |
| Us scrotum and contents (76870) |
$62.42 |
$171.62 |
0.7× |
| Us soft tissue head/neck (76536) |
$60.84 |
$175.50 |
0.7× |
| Us xtr non-vasc lmtd (76882) |
$30.56 |
$124.25 |
0.3× |
| Venogram extremity bilateral (75822) |
$64.25 |
$200.75 |
0.0× |
| Venography extremity unilateral rs&i (75820) |
$45.82 |
$164.25 |
0.0× |
| Wrist 2 views (73100) |
$44.12 |
$66.50 |
0.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$55.42 |
$107.62 |
0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$44.60 |
$79.88 |
0.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$44.15 |
$72.88 |
0.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$108.57 |
$260.12 |
0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$43.98 |
$67 |
0.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$44.15 |
$69.12 |
0.6× |
| X-ray exam hip uni 1 view (73501) |
$44.46 |
$67.88 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$45.25 |
$50.75 |
0.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$54.92 |
$92 |
0.6× |
| X-ray exam of femur 1 (73551) |
$43.98 |
$68.91 |
0.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$106.64 |
$225.60 |
0.7× |
| X-ray eye for foreign body (70030) |
$8.27 |
$46.50 |
0.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$54.14 |
$97.88 |
0.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$44 |
$72.62 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$43.84 |
$65.25 |
0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$44.46 |
$64 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$53.48 |
$81.25 |
0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$44.12 |
$67.88 |
0.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$43.84 |
$66.50 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$53.34 |
$81.88 |
0.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$55.08 |
$127.62 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$44.15 |
$72 |
0.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$7.98 |
$47.75 |
0.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$54.48 |
$101.75 |
0.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$172.86 |
$175 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$45.10 |
$77.75 |
0.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$54.29 |
$93.75 |
0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$55.42 |
$116.50 |
0.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$53.22 |
$76.50 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$44.15 |
$69.12 |
0.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$44.46 |
$70.50 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$45.10 |
$47.50 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$12.43 |
$83.75 |
0.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$52.40 |
$85.25 |
0.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$43.84 |
$65.75 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$45.10 |
$84.50 |
0.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$44.65 |
$79.25 |
0.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$52.88 |
$81.88 |
0.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$43.20 |
$56.50 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$44.30 |
$69.12 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$55.08 |
$125.62 |
0.6× |
| Xr chest 4+ views (71048) |
$55.24 |
$105.12 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$43.34 |
$56.50 |
0.6× |
| Xr shoulder 1 view (73020) |
$43.67 |
$53 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$54.44 |
$113.88 |
0.6× |
| Xr tibia/fibula 2 views (73590) |
$43.84 |
$69.75 |
0.6× |
| Xr tmj bilateral (70330) |
$45.58 |
$97.12 |
0.6× |
| Xray knee 1 or 2 views rt (73560) |
$43.98 |
$69.75 |
0.6× |