| Abdomen 2 views (74019) |
$614.40 |
$2,048 |
6.0× |
| Ankle 2 views (73600) |
$174 |
$580 |
2.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,402.50 |
$4,675 |
3.6× |
| Bone &/joint imaging whole body (78306) |
$1,692 |
$5,640 |
4.3× |
| Bone Imaging 3 Phase (78315) |
$804 |
$2,680 |
2.1× |
| Bone survey complete (77075) |
$586.50 |
$1,955 |
5.8× |
| Bone survey infant (77076) |
$335.10 |
$1,117 |
3.3× |
| Cervical spine 2 or 3 views (72040) |
$614.40 |
$2,048 |
7.2× |
| Chest 1 view (71045) |
$473.10 |
$1,577 |
5.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$318.30 |
$1,061 |
1.9× |
| Clavicle complete (73000) |
$832.50 |
$2,775 |
9.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,916.20 |
$23,054 |
20.3× |
| CT abdomen and pelvis without contrast (74176) |
$4,967.70 |
$16,559 |
21.3× |
| CT abdomen w contrast (74160) |
$861.90 |
$2,873 |
5.0× |
| CT abdomen w wo contrast (74170) |
$3,578.40 |
$11,928 |
20.9× |
| CT abdomen w/o contrast (74150) |
$2,631.60 |
$8,772 |
25.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,453.80 |
$4,846 |
8.5× |
| CT c-spine w/o contrast (72125) |
$2,016.90 |
$6,723 |
19.8× |
| CT cervical spine w&w/o contrast (72127) |
$4,165.80 |
$13,886 |
24.3× |
| CT chest w contrast (71260) |
$2,930.70 |
$9,769 |
17.1× |
| CT chest w/wo contrast (71270) |
$5,418.60 |
$18,062 |
31.7× |
| CT head/brain without and with contrast (70470) |
$3,602.70 |
$12,009 |
21.1× |
| CT iac w contrast (70481) |
$408 |
$1,360 |
2.4× |
| CT lower ext w/o (73700) |
$2,165.70 |
$7,219 |
21.2× |
| CT lower extremity w wo contrast (73702) |
$983.10 |
$3,277 |
5.7× |
| CT lower extremity w/contrast material (73701) |
$2,656.20 |
$8,854 |
15.5× |
| CT lumbar spine w & w/o contrast (72133) |
$517.50 |
$1,725 |
3.0× |
| CT lumbar spine w/o contrast (72131) |
$4,352.40 |
$14,508 |
42.7× |
| CT maxillofacial w contrast (70487) |
$758.10 |
$2,527 |
4.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,388.70 |
$4,629 |
8.1× |
| CT maxillofacial wo contrast (70486) |
$1,874.40 |
$6,248 |
18.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,016 |
$6,720 |
11.8× |
| CT orbits w/o contrast (70480) |
$1,582.80 |
$5,276 |
15.5× |
| CT pelvis w/o contrast (72192) |
$2,336.70 |
$7,789 |
22.9× |
| CT scan of arm combo (73202) |
$495.90 |
$1,653 |
2.9× |
| CT soft tissue neck w contrast (70491) |
$3,633.90 |
$12,113 |
21.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$5,454.90 |
$18,183 |
31.9× |
| CT soft tissue neck w/o contrast (70490) |
$2,708.10 |
$9,027 |
26.6× |
| CT thoracic spine w/contrast (72129) |
$824.10 |
$2,747 |
4.8× |
| CT thoracic spine w/o contrast (72128) |
$3,485.40 |
$11,618 |
34.2× |
| CT thoracic spine w/wo contrast (72130) |
$595.50 |
$1,985 |
3.5× |
| CT thorax w/o contrast (71250) |
$3,984.30 |
$13,281 |
39.1× |
| CT upper ext wo (73200) |
$2,502 |
$8,340 |
24.5× |
| CT upper extremity with contrast (73201) |
$2,828.10 |
$9,427 |
8.3× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,826.60 |
$9,422 |
16.5× |
| Cta Abdomen (74175) |
$4,437.30 |
$14,791 |
25.9× |
| CTA abdomen pelvis (74174) |
$8,874.90 |
$29,583 |
26.1× |
| CTA chest (71275) |
$4,437.30 |
$14,791 |
25.9× |
| Cta Head (70496) |
$4,436.10 |
$14,787 |
25.9× |
| Cta Neck (70498) |
$4,436.10 |
$14,787 |
25.9× |
| Cta Pelvis (72191) |
$847.50 |
$2,825 |
5.0× |
| Esophagus (74220) |
$556.50 |
$1,855 |
3.3× |
| Facial bones min 3 views (70150) |
$298.50 |
$995 |
2.9× |
| Fluoroscopy up to 1 hr (76000) |
$384.90 |
$1,283 |
1.7× |
| Foot 2 views (73620) |
$202.50 |
$675 |
2.4× |
| Forearm 2 views (73090) |
$422.10 |
$1,407 |
5.0× |
| Hand 2 views (73120) |
$259.50 |
$865 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,567.70 |
$8,559 |
4.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,567.70 |
$8,559 |
6.6× |
| Knee 3 views (73562) |
$423.30 |
$1,411 |
5.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,361.40 |
$4,538 |
4.0× |
| Mr safety determination physician/other qhp (76016) |
$83.10 |
$277 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$23.10 |
$77 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$86.70 |
$289 |
0.9× |
| Mr safety implt pos&/immoblj (76019) |
$56.10 |
$187 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$228.30 |
$761 |
1.0× |
| MRA head w/o contrast (70544) |
$4,781.70 |
$15,939 |
20.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,354.20 |
$14,514 |
12.8× |
| MRA neck w/o contrast (70547) |
$376.50 |
$1,255 |
1.6× |
| MRI abdomen w contrast (74182) |
$1,434.90 |
$4,783 |
4.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,792.80 |
$15,976 |
14.1× |
| MRI abdomen w/o contrast (74181) |
$2,122.50 |
$7,075 |
9.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,217.10 |
$4,057 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$4,669.20 |
$15,564 |
20.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$9,555.90 |
$31,853 |
28.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,511.40 |
$15,038 |
19.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$6,997.20 |
$23,324 |
20.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,499.90 |
$18,333 |
16.2× |
| MRI pelvis w/o contrast (72195) |
$797.70 |
$2,659 |
3.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$687 |
$2,290 |
2.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$778.50 |
$2,595 |
2.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,545.60 |
$15,152 |
13.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$880.20 |
$2,934 |
2.6× |
| MRI thoracic spine w/o contrast (72146) |
$5,499.90 |
$18,333 |
23.6× |
| MRI up ext w/o contrast (73218) |
$5,499.90 |
$18,333 |
23.6× |
| MRI upper ext joint w/o contrast (73221) |
$5,499.90 |
$18,333 |
23.6× |
| Myocardial Spect Multiple Studies (78452) |
$3,625.80 |
$12,086 |
2.9× |
| Myocardial spect single study at rest or stress (78451) |
$1,200.30 |
$4,001 |
1.0× |
| Neck soft tissue (70360) |
$646.50 |
$2,155 |
7.6× |
| Nm gastric emptying study (78264) |
$496.20 |
$1,654 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$456.90 |
$1,523 |
4.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$293.10 |
$977 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,477.70 |
$8,259 |
4.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$591.30 |
$1,971 |
7.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$541.20 |
$1,804 |
6.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$687 |
$2,290 |
8.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$138.60 |
$462 |
1.4× |
| Radex fingr minimum 2 views (73140) |
$456.90 |
$1,523 |
5.4× |
| Radex Foot Compl Minimum 3 Views (73630) |
$591.30 |
$1,971 |
7.0× |
| Radex Hand Minimum 3 Views (73130) |
$591.30 |
$1,971 |
7.0× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$463.50 |
$1,545 |
5.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$266.10 |
$887 |
2.6× |
| Radex Humerus Minimum 2 Views (73060) |
$832.50 |
$2,775 |
9.8× |
| Radex Kne 1/2 Views (73560) |
$464.40 |
$1,548 |
5.5× |
| Radex Kne Compl 4/More Views (73564) |
$1,032.30 |
$3,441 |
10.1× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$111.60 |
$372 |
1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$614.40 |
$2,048 |
7.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$613.20 |
$2,044 |
7.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$264.60 |
$882 |
3.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$51 |
$170 |
0.5× |
| Radex Toe Minimum 2 Views (73660) |
$456.90 |
$1,523 |
5.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$402 |
$1,340 |
3.9× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$562.50 |
$1,875 |
6.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$422.10 |
$1,407 |
5.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$582.90 |
$1,943 |
5.7× |
| Radiologic exam chest 2 views (71046) |
$473.10 |
$1,577 |
5.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$220.20 |
$734 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$730.20 |
$2,434 |
4.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$447.30 |
$1,491 |
2.6× |
| Radiologic examination femur 1 view (73551) |
$272.10 |
$907 |
3.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$422.10 |
$1,407 |
5.0× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$270 |
$900 |
2.6× |
| Ribs bilateral 3 views (71110) |
$300 |
$1,000 |
2.9× |
| Scapula (73010) |
$289.50 |
$965 |
2.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$67.20 |
$224 |
2.9× |
| Shoulder 1 view (73020) |
$422.10 |
$1,407 |
5.0× |
| Small bowel series (74250) |
$619.80 |
$2,066 |
3.6× |
| Spine thoracic 3 views (72072) |
$614.40 |
$2,048 |
6.0× |
| Thoracolumbar 2 views (72080) |
$47.70 |
$159 |
0.6× |
| Tmj unilateral (70328) |
$90.60 |
$302 |
1.1× |
| Ultrasound breast complete (76641) |
$627 |
$2,090 |
6.1× |
| Ultrasound Exam Aaa Screen (76706) |
$750.30 |
$2,501 |
7.4× |
| Ultrasound, abdomen limited (76705) |
$1,334.40 |
$4,448 |
13.1× |
| Us breast unilateral limited (76642) |
$627 |
$2,090 |
7.4× |
| Us chest (76604) |
$313.20 |
$1,044 |
3.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$372.90 |
$1,243 |
3.7× |
| Us ob detailed single fetus (76811) |
$2,347.50 |
$7,825 |
10.1× |
| Us ob limited (76815) |
$1,334.40 |
$4,448 |
13.1× |
| Us ob transvaginal (76817) |
$886.80 |
$2,956 |
8.7× |
| Us pelvic non ob complete (76856) |
$1,334.40 |
$4,448 |
13.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$886.50 |
$2,955 |
8.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,334.40 |
$4,448 |
13.1× |
| Us retroperitoneal complete (76770) |
$1,334.40 |
$4,448 |
13.1× |
| Us scrotum and contents (76870) |
$1,334.40 |
$4,448 |
13.1× |
| Us soft tissue head/neck (76536) |
$879.60 |
$2,932 |
8.6× |
| Us spinal canal and contents (76800) |
$482.10 |
$1,607 |
4.7× |
| Wrist 2 views (73100) |
$509.70 |
$1,699 |
6.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$553.20 |
$1,844 |
5.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$313.20 |
$1,044 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$438 |
$1,460 |
5.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$636.60 |
$2,122 |
7.5× |
| X-ray exam of femur 2/> (73552) |
$614.40 |
$2,048 |
7.2× |
| X-ray eye for foreign body (70030) |
$289.80 |
$966 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$625.80 |
$2,086 |
7.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$90.60 |
$302 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$37.50 |
$125 |
0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$614.40 |
$2,048 |
6.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$390.30 |
$1,301 |
3.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$424.50 |
$1,415 |
5.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$928.20 |
$3,094 |
9.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,230.30 |
$4,101 |
12.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$614.40 |
$2,048 |
7.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$790.80 |
$2,636 |
9.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$285.90 |
$953 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$221.10 |
$737 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$614.40 |
$2,048 |
6.0× |
| Xr c-spine 4 or 5 views (72050) |
$830.40 |
$2,768 |
8.1× |
| Xr c-spine 6 or more views (72052) |
$790.80 |
$2,636 |
7.8× |