| Abdomen 2 views (74019) |
$203.46 |
$508.64 |
1.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$666.70 |
$1,666.74 |
1.6× |
| Ankle 2 views (73600) |
$255.60 |
$639.01 |
2.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$678.84 |
$1,697.10 |
1.8× |
| Arthrogram hip (73525) |
$659.50 |
$1,648.74 |
1.8× |
| Arthrogram shoulder (73040) |
$597.12 |
$1,492.78 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$698.16 |
$1,745.40 |
1.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$679.67 |
$1,699.16 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$790.96 |
$1,977.40 |
1.9× |
| Bone age studies (77072) |
$171.74 |
$429.33 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$901.36 |
$2,253.40 |
2.1× |
| Bone Marrow Imaging Limited Area (78102) |
$534.36 |
$1,335.90 |
1.3× |
| Bone survey complete (77075) |
$400.59 |
$1,001.46 |
3.6× |
| Brain image w/flow 4 + views (78606) |
$611.46 |
$1,528.65 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$544.10 |
$1,360.24 |
1.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$617.50 |
$1,543.74 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$280.87 |
$702.16 |
3.1× |
| Chest 1 view (71045) |
$213.32 |
$533.29 |
2.3× |
| Chest 3 views (71047) |
$240.82 |
$602.03 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$459.75 |
$1,149.36 |
2.5× |
| Clavicle complete (73000) |
$254.92 |
$637.28 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$256.25 |
$640.61 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,470.81 |
$6,177.01 |
6.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,482.49 |
$3,706.21 |
5.9× |
| CT abdomen w contrast (74160) |
$2,255.22 |
$5,638.04 |
12.2× |
| CT abdomen w wo contrast (74170) |
$2,347.28 |
$5,868.18 |
12.7× |
| CT abdomen w/o contrast (74150) |
$1,439.65 |
$3,599.11 |
13.1× |
| CT angio hrt w/3d image (75574) |
$2,335.07 |
$5,837.66 |
6.3× |
| CT angiography upper extremity lt (73206) |
$2,673.62 |
$6,684.04 |
14.4× |
| CT c-spine w/o contrast (72125) |
$1,533.77 |
$3,834.41 |
13.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,618.84 |
$6,547.09 |
14.2× |
| CT cervical spine with contrast (72126) |
$2,333.29 |
$5,833.21 |
6.3× |
| CT chest w/wo contrast (71270) |
$1,879.61 |
$4,699.01 |
10.2× |
| CT chest with contrast (71260) |
$2,333.29 |
$5,833.21 |
12.6× |
| CT head/brain with contrast (70460) |
$1,637.63 |
$4,094.06 |
8.9× |
| CT head/brain without and with contrast (70470) |
$1,838.04 |
$4,595.08 |
9.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,279.96 |
$3,199.89 |
3.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$465.68 |
$1,164.20 |
5.1× |
| CT iac w contrast (70481) |
$1,637.63 |
$4,094.06 |
8.9× |
| CT limited/localized follow up study (76380) |
$1,533.77 |
$3,834.41 |
16.7× |
| CT lower ext w/o (73700) |
$1,763.84 |
$4,409.57 |
16.0× |
| CT lower extremity w wo contrast (73702) |
$1,238.65 |
$3,096.61 |
6.7× |
| CT lower extremity with contrast (73701) |
$2,150.66 |
$5,376.64 |
11.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,618.84 |
$6,547.09 |
14.2× |
| CT lumbar spine w/o contrast (72131) |
$1,533.77 |
$3,834.41 |
13.9× |
| CT lumbar spine with contrast (72132) |
$2,333.29 |
$5,833.21 |
6.3× |
| CT maxillofacial w contrast (70487) |
$1,637.63 |
$4,094.06 |
8.9× |
| CT maxillofacial w/o contrast (70486) |
$1,076.48 |
$2,691.20 |
9.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,318.94 |
$3,297.34 |
7.1× |
| CT neck soft tissue w contrast (70491) |
$1,637.63 |
$4,094.06 |
8.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,642.20 |
$4,105.48 |
8.9× |
| CT orbits w/o contrast (70480) |
$1,076.48 |
$2,691.20 |
9.8× |
| CT pelvis w & w/o contrast (72194) |
$2,618.84 |
$6,547.09 |
14.2× |
| CT pelvis w/o contrast (72192) |
$1,458.74 |
$3,646.83 |
13.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,838.04 |
$4,595.08 |
9.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,076.48 |
$2,691.20 |
9.8× |
| CT thoracic spine w/contrast (72129) |
$2,462.64 |
$6,156.60 |
13.3× |
| CT thoracic spine w/o contrast (72128) |
$1,533.77 |
$3,834.41 |
13.9× |
| CT thoracic spine w/wo contrast (72130) |
$2,618.84 |
$6,547.09 |
14.2× |
| CT thorax w/o contrast (71250) |
$1,533.77 |
$3,834.41 |
13.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,781.22 |
$6,953.04 |
15.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,763.84 |
$4,409.57 |
16.0× |
| CT upper extremity with contrast (73201) |
$2,683.28 |
$6,708.20 |
7.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,673.62 |
$6,684.04 |
14.4× |
| Cta Abdomen (74175) |
$2,673.62 |
$6,684.04 |
14.4× |
| CTA abdomen pelvis (74174) |
$5,347.22 |
$13,368.03 |
14.5× |
| CTA chest (71275) |
$2,673.62 |
$6,684.04 |
14.4× |
| Cta Head (70496) |
$1,876.49 |
$4,691.22 |
10.1× |
| CTA lwr ext w&w/o contrast (73706) |
$3,074.66 |
$7,686.63 |
16.6× |
| Cta Neck (70498) |
$1,876.49 |
$4,691.22 |
10.1× |
| Cta Pelvis (72191) |
$2,673.62 |
$6,684.04 |
14.4× |
| Cystography minimum 3 views rs&i (74430) |
$720.91 |
$1,802.26 |
2.0× |
| Diskography lumbar (72295) |
$969.08 |
$2,422.68 |
0.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$362.52 |
$906.29 |
3.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$411.20 |
$1,027.98 |
3.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$344.08 |
$860.20 |
3.7× |
| Dxa bone density study axial skeleton (77085) |
$494.94 |
$1,237.34 |
4.5× |
| Echoencephalography real time imaging (76506) |
$547.78 |
$1,369.44 |
5.0× |
| Esophagus (74220) |
$459.75 |
$1,149.36 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$167.79 |
$419.47 |
1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$548.95 |
$1,372.36 |
5.0× |
| Fluoroscopy up to 1 hr (76000) |
$237.17 |
$592.91 |
0.9× |
| Foot 2 views (73620) |
$255.60 |
$639.01 |
2.8× |
| Forearm 2 views (73090) |
$255.60 |
$639.01 |
2.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$970.43 |
$2,426.07 |
1.7× |
| Gated Heart Planar Single (78472) |
$1,110.64 |
$2,776.58 |
2.6× |
| Hand 2 views (73120) |
$255.60 |
$639.01 |
2.3× |
| Hand 3 views (73130) |
$255.60 |
$639.01 |
2.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$978.59 |
$2,446.46 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$889.63 |
$2,224.06 |
2.1× |
| Ht muscle image spect sing (78451) |
$2,224.92 |
$5,562.28 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$222.27 |
$555.67 |
2.4× |
| Hysterosalpingogram (74740) |
$502.29 |
$1,255.71 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,009.63 |
$2,524.06 |
1.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$892.30 |
$2,230.74 |
1.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$552.24 |
$1,380.58 |
1.0× |
| Knee 3 views (73562) |
$255.60 |
$639.01 |
2.8× |
| Liver & spleen imaging static only (78215) |
$600.55 |
$1,501.37 |
1.4× |
| Liver imaging static only (78201) |
$696.47 |
$1,741.17 |
1.2× |
| Lung perf&ventilat diferentl (78598) |
$1,080.47 |
$2,701.16 |
1.9× |
| Lung perfusion differential (78597) |
$954.70 |
$2,386.75 |
2.3× |
| Lung Ventilation Imaging (78579) |
$675.44 |
$1,688.59 |
1.6× |
| Lymphoscintigraphy (78195) |
$646.95 |
$1,617.37 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$536.85 |
$1,342.11 |
2.1× |
| Mammary ductogram or galactogram single (77053) |
$466.92 |
$1,167.28 |
1.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$165.63 |
$414.07 |
1.8× |
| Meckels Diverticulum (78290) |
$646.95 |
$1,617.37 |
1.5× |
| Mr safety determination physician/other qhp (76016) |
$551.20 |
$1,378 |
6.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$551.20 |
$1,378 |
8.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$551.20 |
$1,378 |
18.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$551.20 |
$1,378 |
5.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$551.20 |
$1,378 |
2.2× |
| MRA head w & w/o contrast (70546) |
$3,329.81 |
$8,324.52 |
9.0× |
| MRA head w/o contrast (70544) |
$2,647.03 |
$6,617.57 |
10.5× |
| MRA head with contrast (70545) |
$2,343.21 |
$5,858.01 |
6.4× |
| MRA neck w contrast (70548) |
$2,939.34 |
$7,348.33 |
8.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,235.99 |
$8,089.96 |
8.8× |
| MRA neck w/o contrast (70547) |
$1,675.84 |
$4,189.59 |
6.7× |
| MRI abdomen w contrast (74182) |
$2,742.54 |
$6,856.33 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,019.34 |
$7,548.34 |
8.2× |
| MRI abdomen w/o contrast (74181) |
$2,469.82 |
$6,174.55 |
9.8× |
| MRI any jnt lwr ext with con lt (73722) |
$4,113.80 |
$10,284.50 |
5.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,113.80 |
$10,284.50 |
5.0× |
| MRI breast w/o contrast bilateral (77047) |
$2,589.93 |
$6,474.82 |
10.3× |
| MRI breast w/o contrast unilat (77046) |
$458.86 |
$1,147.14 |
1.8× |
| MRI c-spine with contrast (72142) |
$2,443.84 |
$6,109.59 |
6.6× |
| MRI cervical spine w/o contrast (72141) |
$2,469.82 |
$6,174.55 |
9.8× |
| MRI chest w/o & w/contrast material (71552) |
$3,019.34 |
$7,548.34 |
8.2× |
| MRI chest w/o contrast (71550) |
$2,469.82 |
$6,174.55 |
9.8× |
| MRI chest with contrast (71551) |
$2,742.54 |
$6,856.33 |
3.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$646.42 |
$1,616.03 |
1.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,952.77 |
$7,381.91 |
8.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,704.73 |
$9,261.82 |
14.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,277.06 |
$5,692.65 |
9.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,628.45 |
$6,571.12 |
7.1× |
| MRI orbit/face/neck w/contrast (70542) |
$2,343.21 |
$5,858.01 |
6.4× |
| MRI pelvis w contrast (72196) |
$2,742.54 |
$6,856.33 |
7.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,019.34 |
$7,548.34 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$2,469.82 |
$6,174.55 |
9.8× |
| MRI scan of arm joint before and after contrast (73223) |
$4,529.01 |
$11,322.51 |
12.3× |
| MRI scan of leg joint before and after contrast (73723) |
$4,529.01 |
$11,322.51 |
12.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,019.34 |
$7,548.34 |
8.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,742.54 |
$6,856.33 |
7.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,019.34 |
$7,548.34 |
8.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,186.34 |
$5,465.85 |
5.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,019.34 |
$7,548.34 |
8.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,469.82 |
$6,174.55 |
9.8× |
| MRI tmj (70336) |
$3,704.73 |
$9,261.82 |
14.7× |
| MRI upper ext joint w/o contrast (73221) |
$3,317.77 |
$8,294.42 |
13.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,495.72 |
$11,239.30 |
12.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,704.73 |
$9,261.82 |
14.7× |
| Myelogram Cervical (72240) |
$686.58 |
$1,716.44 |
0.8× |
| Myelogram Lumbar (72265) |
$686.58 |
$1,716.44 |
0.8× |
| Myelogram thoracic (72255) |
$686.58 |
$1,716.44 |
0.8× |
| Myelography 2 or more regions (72270) |
$762.49 |
$1,906.21 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$1,959.52 |
$4,898.79 |
1.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$6,749.14 |
$16,872.83 |
7.5× |
| Neck soft tissue (70360) |
$268.81 |
$672.02 |
2.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$388.61 |
$971.52 |
0.9× |
| Nm cisternogram (78630) |
$659.74 |
$1,649.33 |
1.2× |
| Nm csf leak detection (78650) |
$728.66 |
$1,821.63 |
0.5× |
| Nm gastric emptying study (78264) |
$646.95 |
$1,617.37 |
1.5× |
| Nm peritoneal-venous shunt patency (78291) |
$680.64 |
$1,701.59 |
1.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$540.29 |
$1,350.71 |
1.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$776.35 |
$1,940.86 |
1.8× |
| Nuclear Rx Oral Admin (79005) |
$1,144.14 |
$2,860.34 |
4.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$340.33 |
$850.81 |
3.1× |
| Osseous survey infant (77076) |
$286.26 |
$715.63 |
2.6× |
| Parathyrd planar w/spect&CT (78072) |
$1,805.51 |
$4,513.77 |
3.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,978.59 |
$4,946.47 |
4.7× |
| Parathyroid imaging (78070) |
$513.08 |
$1,282.69 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$222.27 |
$555.67 |
2.0× |
| Peritoneogram rs&i (74190) |
$511.56 |
$1,278.89 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,495.72 |
$11,239.30 |
12.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$596.82 |
$1,492.05 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$954.70 |
$2,386.75 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$462.68 |
$1,156.69 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$185.23 |
$463.06 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$222.27 |
$555.67 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$426.54 |
$1,066.35 |
3.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$245.81 |
$614.51 |
2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$438.52 |
$1,096.28 |
4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$391.19 |
$977.96 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$212.53 |
$531.32 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$212.53 |
$531.32 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$197.50 |
$493.73 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$459.75 |
$1,149.36 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$449.25 |
$1,123.12 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$459.75 |
$1,149.36 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$413.77 |
$1,034.42 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$237.56 |
$593.90 |
2.6× |
| Radiological examination surgical specimen (76098) |
$423.08 |
$1,057.69 |
0.7× |
| Ribs bilateral 3 views (71110) |
$333.41 |
$833.52 |
3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,111.41 |
$2,778.51 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,672 |
$4,179.98 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,136.67 |
$2,841.67 |
2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,500.41 |
$3,751.01 |
1.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,650.44 |
$4,126.09 |
1.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,250.34 |
$3,125.84 |
0.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$724.26 |
$1,810.65 |
2.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,183.08 |
$2,957.70 |
4.8× |
| Rp Therapy Intravenous Administration (79101) |
$712.75 |
$1,781.86 |
2.9× |
| Sacroiliac Joints < 3 Views (72200) |
$222.27 |
$555.67 |
2.0× |
| Scanogram (77073) |
$149.96 |
$374.90 |
1.4× |
| Scapula complete (73010) |
$255.60 |
$639.01 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$16 |
$40 |
0.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$465.48 |
$1,163.70 |
4.2× |
| Sialogram (70390) |
$722.87 |
$1,807.17 |
2.9× |
| Small bowel series (74250) |
$569.61 |
$1,424.02 |
3.1× |
| Spine thoracic 3 views (72072) |
$222.27 |
$555.67 |
2.0× |
| Testicular Imaging With Vascular Flow (78761) |
$480.17 |
$1,200.42 |
1.1× |
| Thoracolumbar 2 views (72080) |
$222.27 |
$555.67 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,128.90 |
$2,822.23 |
2.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$645.76 |
$1,614.40 |
1.5× |
| Thyroid uptake measurement (78012) |
$282.74 |
$706.83 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$724.33 |
$1,810.82 |
1.7× |
| Tmj unilateral (70328) |
$146.70 |
$366.73 |
1.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,680.59 |
$4,201.46 |
2.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$841.98 |
$2,104.94 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$548.80 |
$1,371.99 |
5.0× |
| Umbilical-artery Doppler (OB) (76820) |
$362.52 |
$906.29 |
3.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$3,717.26 |
$9,293.15 |
40.5× |
| Upper Extremity Infant (73092) |
$255.07 |
$637.66 |
2.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$555.94 |
$1,389.83 |
1.3× |
| Urethrocystography retrograde rs&i (74450) |
$720.91 |
$1,802.26 |
2.9× |
| Urethrocystography voiding (74455) |
$720.91 |
$1,802.26 |
2.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$720.91 |
$1,802.26 |
3.9× |
| Us abdl aorta screen aaa (76706) |
$215.35 |
$538.37 |
2.0× |
| Us breast unilateral complete (76641) |
$394.41 |
$986.02 |
3.6× |
| Us breast unilateral limited (76642) |
$593.30 |
$1,483.24 |
6.5× |
| Us chest (76604) |
$547.78 |
$1,369.44 |
5.0× |
| Us compl joint r-t w/image documentation (76881) |
$497.72 |
$1,244.30 |
4.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$345 |
$862.49 |
3.1× |
| Us kidney transplant (76776) |
$604.34 |
$1,510.84 |
5.5× |
| Us ob detailed single fetus (76811) |
$521.80 |
$1,304.49 |
2.1× |
| Us ob transvaginal (76817) |
$462.36 |
$1,155.89 |
4.2× |
| Us pelvic non ob complete (76856) |
$714.44 |
$1,786.08 |
6.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$340.33 |
$850.81 |
3.1× |
| Us pregnancy ltd (76815) |
$340.33 |
$850.81 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$340.33 |
$850.81 |
3.1× |
| Us retroperitoneal complete (76770) |
$631.70 |
$1,579.25 |
5.7× |
| Us retroperitoneal limited (76775) |
$548.95 |
$1,372.36 |
5.0× |
| Us scrotum and contents (76870) |
$548.95 |
$1,372.36 |
5.0× |
| Us soft tissue head/neck (76536) |
$685.30 |
$1,713.24 |
6.2× |
| Us xtr non-vasc lmtd (76882) |
$355.47 |
$888.66 |
3.2× |
| Us, eye b-scan (76512) |
$710.19 |
$1,775.46 |
6.4× |
| Venogram extremity bilateral (75822) |
$966.77 |
$2,416.91 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$768.35 |
$1,920.87 |
0.5× |
| Wrist 2 views (73100) |
$255.60 |
$639.01 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$374.64 |
$936.59 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$440.92 |
$1,102.30 |
4.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$255.60 |
$639.01 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$672.02 |
$1,680.03 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$219.08 |
$547.68 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$255.60 |
$639.01 |
2.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$308.74 |
$771.84 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$222.27 |
$555.67 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$277.84 |
$694.58 |
3.0× |
| X-ray exam hip uni 4/> views (73503) |
$325.99 |
$814.97 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$302.99 |
$757.46 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$614.21 |
$1,535.52 |
5.6× |
| X-ray exam of femur 1 (73551) |
$171.50 |
$428.74 |
1.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$354.10 |
$885.24 |
1.9× |
| X-ray eye for foreign body (70030) |
$258.48 |
$646.20 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$222.27 |
$555.67 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$205.82 |
$514.55 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$255.60 |
$639.01 |
2.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$255.60 |
$639.01 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$222.27 |
$555.67 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$369.36 |
$923.40 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$333.41 |
$833.52 |
3.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$308.16 |
$770.40 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$309.53 |
$773.82 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$384.89 |
$962.22 |
3.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$348.64 |
$871.58 |
3.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$222.27 |
$555.67 |
2.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$246.61 |
$616.51 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$334.47 |
$836.16 |
3.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$222.27 |
$555.67 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$720.91 |
$1,802.26 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$266.07 |
$665.17 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$222.27 |
$555.67 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$488.99 |
$1,222.46 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$222.27 |
$555.67 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$222.27 |
$555.67 |
2.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$255.60 |
$639.01 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$222.27 |
$555.67 |
2.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$222.27 |
$555.67 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$391.19 |
$977.96 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$222.27 |
$555.67 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$222.27 |
$555.67 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$222.27 |
$555.67 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$208.01 |
$520.02 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$222.27 |
$555.67 |
2.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$372.07 |
$930.17 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$255.60 |
$639.01 |
2.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$255.60 |
$639.01 |
2.8× |
| Xr c-spine 6 or more views (72052) |
$341.78 |
$854.43 |
3.1× |
| Xr chest 4+ views (71048) |
$336.18 |
$840.43 |
3.0× |
| Xr Cholecystography Oral Contrast (74290) |
$429.53 |
$1,073.82 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$250.06 |
$625.12 |
2.7× |
| Xr shoulder 1 view (73020) |
$175.20 |
$437.98 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$325.99 |
$814.97 |
3.0× |
| Xr tibia/fibula 2 views (73590) |
$255.60 |
$639.01 |
2.8× |
| Xr tmj bilateral (70330) |
$202.06 |
$505.14 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$237.08 |
$592.68 |
2.6× |