| Abdomen 2 views (74019) |
$247.65 |
$381 |
2.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,146.60 |
$1,764 |
3.3× |
| Ankle 2 views (73600) |
$115.05 |
$177 |
1.5× |
| Arthrogram shoulder (73040) |
$910.65 |
$1,401 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,563.25 |
$2,405 |
4.5× |
| Bone age studies (77072) |
$195.65 |
$301 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,326 |
$2,040 |
3.8× |
| Bone survey complete (77075) |
$633.10 |
$974 |
6.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$768.95 |
$1,183 |
2.5× |
| Cervical spine 2 or 3 views (72040) |
$228.80 |
$352 |
3.0× |
| Chest 1 view (71045) |
$18,835.83 |
— |
247.0× |
| Chest 3 views (71047) |
$193.70 |
$298 |
2.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$232.05 |
$357 |
1.5× |
| Clavicle complete (73000) |
$127.40 |
$196 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$276.90 |
$426 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,376.70 |
$2,118 |
4.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,138.15 |
— |
5.4× |
| CT abdomen w contrast (74160) |
$1,386.45 |
$2,133 |
9.0× |
| CT abdomen w wo contrast (74170) |
$1,567.80 |
$2,412 |
10.2× |
| CT abdomen w/o contrast (74150) |
$1,341.60 |
$2,064 |
14.6× |
| CT angio hrt w/3d image (75574) |
$780 |
$1,200 |
2.6× |
| CT angiography upper extremity lt (73206) |
$378.30 |
$582 |
2.5× |
| CT c-spine w/o contrast (72125) |
$1,134.90 |
$1,746 |
12.4× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$96.85 |
$149 |
0.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,055.30 |
$3,162 |
13.4× |
| CT chest w/wo contrast (71270) |
$1,532.05 |
$2,357 |
10.0× |
| CT chest with contrast (71260) |
$1,370.20 |
$2,108 |
8.9× |
| CT head/brain with contrast (70460) |
$378.30 |
$582 |
2.5× |
| CT head/brain without and with contrast (70470) |
$1,509.30 |
$2,322 |
9.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$716.30 |
$1,102 |
2.3× |
| CT iac w contrast (70481) |
$1,328.60 |
$2,044 |
8.6× |
| CT lower ext w/o (73700) |
$1,105 |
$1,700 |
12.1× |
| CT lower extremity w wo contrast (73702) |
$1,523.60 |
$2,344 |
9.9× |
| CT lower extremity with contrast (73701) |
$1,457.95 |
$2,243 |
9.5× |
| CT lumbar spine w/o contrast (72131) |
$1,203.15 |
$1,851 |
13.1× |
| CT lumbar spine with contrast (72132) |
$1,347.45 |
$2,073 |
4.4× |
| CT maxillofacial w contrast (70487) |
$1,316.90 |
$2,026 |
8.6× |
| CT maxillofacial w/o contrast (70486) |
$1,236.95 |
$1,903 |
13.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,365.65 |
$2,101 |
8.9× |
| CT neck soft tissue w contrast (70491) |
$1,494.35 |
$2,299 |
9.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,404.65 |
$2,161 |
9.1× |
| CT orbits w/o contrast (70480) |
$1,237.60 |
$1,904 |
13.5× |
| CT pelvis w & w/o contrast (72194) |
$1,103.05 |
$1,697 |
7.2× |
| CT pelvis w/o contrast (72192) |
$1,357.20 |
$2,088 |
14.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,580.15 |
$2,431 |
10.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,393.60 |
$2,144 |
15.2× |
| CT thoracic spine w/contrast (72129) |
$400.40 |
$616 |
2.6× |
| CT thoracic spine w/o contrast (72128) |
$1,218.75 |
$1,875 |
13.3× |
| CT thorax w/o contrast (71250) |
$1,279.20 |
— |
14.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,291.55 |
$1,987 |
8.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,030.90 |
$1,586 |
11.3× |
| CT upper extremity with contrast (73201) |
$1,474.20 |
$2,268 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,574.30 |
$2,422 |
10.2× |
| Cta Abdomen (74175) |
$1,414.40 |
$2,176 |
9.2× |
| CTA abdomen pelvis (74174) |
$1,431.30 |
$2,202 |
4.7× |
| CTA chest (71275) |
$2,157.35 |
$3,319 |
14.0× |
| Cta Head (70496) |
$1,556.10 |
$2,394 |
10.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$96.85 |
$149 |
0.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,793.35 |
$2,759 |
11.7× |
| Cta Neck (70498) |
$1,472.25 |
$2,265 |
9.6× |
| Cta Pelvis (72191) |
$1,509.95 |
$2,323 |
9.8× |
| Cystography minimum 3 views rs&i (74430) |
$772.20 |
$1,188 |
2.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$372.45 |
$573 |
4.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$182.65 |
$281 |
2.4× |
| Dxa bone density study axial skeleton (77085) |
$247.65 |
$381 |
2.7× |
| Esophagus (74220) |
$417.95 |
$643 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$34,367.14 |
— |
164.4× |
| Foot 2 views (73620) |
$188.50 |
$290 |
2.5× |
| Forearm 2 views (73090) |
$120.90 |
$186 |
1.6× |
| Hand 2 views (73120) |
$220.35 |
$339 |
2.4× |
| Hand 3 views (73130) |
$170.95 |
$263 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$723.45 |
$1,113 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$723.45 |
$1,113 |
2.1× |
| Ht muscle image spect sing (78451) |
$2,037.10 |
$3,134 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$120.90 |
$186 |
1.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$219.70 |
$338 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,122.55 |
$1,727 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,309.10 |
$2,014 |
2.8× |
| Knee 3 views (73562) |
$313.30 |
$482 |
4.1× |
| MRA head w/o contrast (70544) |
$2,289.92 |
— |
11.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,525.25 |
$3,885 |
8.3× |
| MRA neck w/o contrast (70547) |
$1,693.25 |
$2,605 |
8.1× |
| MRI abdomen w contrast (74182) |
$768.95 |
$1,183 |
2.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,392 |
$3,680 |
7.8× |
| MRI abdomen w/o contrast (74181) |
$1,854.45 |
$2,853 |
8.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,571.70 |
$2,418 |
2.3× |
| MRI breast w/o contrast bilateral (77047) |
$468 |
$720 |
2.2× |
| MRI c-spine with contrast (72142) |
$2,770.30 |
$4,262 |
9.1× |
| MRI cardiac w/o contrast (75557) |
$700.70 |
$1,078 |
3.4× |
| MRI cervical spine w/o contrast (72141) |
$1,389.05 |
$2,137 |
6.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,022.15 |
$3,111 |
6.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,554.80 |
$2,392 |
7.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$522.60 |
$804 |
2.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,432.30 |
$3,742 |
8.0× |
| MRI orbit/face/neck w/contrast (70542) |
$768.95 |
$1,183 |
2.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,307.50 |
$3,550 |
7.5× |
| MRI pelvis w/o contrast (72195) |
$1,469.65 |
$2,261 |
7.0× |
| MRI scan of arm joint before and after contrast (73223) |
$2,018.25 |
$3,105 |
6.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,169.05 |
$3,337 |
7.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,510.95 |
$3,863 |
8.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,088.45 |
$3,213 |
6.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,217.80 |
$3,412 |
7.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,663.05 |
$4,097 |
8.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,877.20 |
$2,888 |
9.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,265.55 |
— |
6.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,437.15 |
$2,211 |
6.9× |
| Myelogram Lumbar (72265) |
$1,575.60 |
$2,424 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,037.10 |
$3,134 |
1.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,120 |
$4,800 |
4.1× |
| Neck soft tissue (70360) |
$163.80 |
$252 |
2.1× |
| Nm gastric emptying study (78264) |
$1,194.05 |
$1,837 |
3.4× |
| Parathyroid imaging (78070) |
$815.10 |
$1,254 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$154.05 |
$237 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,499.90 |
$3,846 |
8.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,244.75 |
$1,915 |
3.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$780.65 |
$1,201 |
1.6× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$3,120 |
$4,800 |
3.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$182 |
$280 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$237.25 |
$365 |
2.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$217.10 |
$334 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$247.65 |
$381 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$116.35 |
$179 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$247 |
$380 |
2.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$154.05 |
$237 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$622.70 |
$958 |
4.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$473.20 |
$728 |
3.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$131.95 |
$203 |
1.7× |
| Ribs bilateral 3 views (71110) |
$241.15 |
$371 |
2.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,783.30 |
$4,282 |
5.8× |
| Sacroiliac Joints < 3 Views (72200) |
$148.85 |
$229 |
1.6× |
| Scapula complete (73010) |
$117.65 |
$181 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$29.25 |
$45 |
1.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$415.35 |
$639 |
4.5× |
| Small bowel series (74250) |
$405.60 |
$624 |
2.6× |
| Spine thoracic 3 views (72072) |
$214.50 |
$330 |
2.3× |
| Tbs Technical Calculation Only (77091) |
$177.45 |
$273 |
2.3× |
| Thoracolumbar 2 views (72080) |
$292.50 |
$450 |
3.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$573.95 |
$883 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$354.25 |
$545 |
3.9× |
| Upper Extremity Infant (73092) |
$83.85 |
$129 |
0.9× |
| Us abdl aorta screen aaa (76706) |
$247.65 |
$381 |
2.7× |
| Us breast unilateral complete (76641) |
$267.80 |
$412 |
2.9× |
| Us breast unilateral limited (76642) |
$193.70 |
$298 |
2.5× |
| Us chest (76604) |
$224.90 |
$346 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$217.75 |
$335 |
2.4× |
| Us kidney transplant (76776) |
$482.30 |
$742 |
5.3× |
| Us ob transvaginal (76817) |
$295.75 |
$455 |
3.2× |
| Us pelvic non ob complete (76856) |
$520 |
$800 |
5.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$164.45 |
$253 |
1.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$351.65 |
$541 |
3.8× |
| Us retroperitoneal complete (76770) |
$556.40 |
$856 |
6.1× |
| Us retroperitoneal limited (76775) |
$276.90 |
$426 |
3.0× |
| Us scrotum and contents (76870) |
$520 |
$800 |
5.7× |
| Us soft tissue head/neck (76536) |
$471.25 |
$725 |
5.1× |
| Us xtr non-vasc lmtd (76882) |
$156.65 |
$241 |
1.7× |
| Wrist 2 views (73100) |
$115.05 |
$177 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$309.40 |
$476 |
3.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$163.80 |
$252 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$671.45 |
$1,033 |
4.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$182.65 |
$281 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$167.70 |
$258 |
2.2× |
| X-ray exam hip uni 1 view (73501) |
$192.40 |
$296 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$131.95 |
$203 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$228.15 |
$351 |
2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$248.30 |
$382 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$260 |
$400 |
2.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$182.65 |
$281 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$170.95 |
$263 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$132.60 |
$204 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$244.40 |
$376 |
3.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$317.20 |
$488 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$186.55 |
$287 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$208.65 |
$321 |
2.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$471.25 |
$725 |
5.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$204.10 |
$314 |
2.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$195 |
$300 |
2.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$85.80 |
$132 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$162.50 |
$250 |
1.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$196.30 |
$302 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$193.70 |
$298 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$220.35 |
$339 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$303.55 |
$467 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$311.35 |
$479 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$163.15 |
$251 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$122.85 |
$189 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$232.05 |
$357 |
3.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$194.35 |
$299 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$245.05 |
$377 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$224.25 |
$345 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$184.60 |
$284 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$163.15 |
$251 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$156 |
$240 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$90.35 |
$139 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$151.45 |
$233 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$319.15 |
$491 |
3.5× |
| Xr finger(s) 2+ views (73140) |
$141.70 |
$218 |
1.9× |
| Xr shoulder 1 view (73020) |
$73.45 |
$113 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$282.75 |
$435 |
3.1× |
| Xr tibia/fibula 2 views (73590) |
$107.25 |
$165 |
1.4× |
| Xr tmj bilateral (70330) |
$176.80 |
$272 |
2.3× |
| Xray knee 1 or 2 views rt (73560) |
$151.45 |
$233 |
2.0× |