| Abdomen 2 views (74019) |
$310.05 |
$477 |
3.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,248 |
$1,920 |
3.6× |
| Ankle 2 views (73600) |
$140.40 |
$216 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$914.55 |
$1,407 |
2.6× |
| Bone age studies (77072) |
$224.25 |
$345 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$798.20 |
$1,228 |
2.3× |
| Bone survey complete (77075) |
$595.40 |
$916 |
6.5× |
| Cervical spine 2 or 3 views (72040) |
$111.15 |
$171 |
1.5× |
| Chest 1 view (71045) |
$165.75 |
— |
2.2× |
| Chest 3 views (71047) |
$164.45 |
$253 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$303.55 |
$467 |
2.0× |
| Clavicle complete (73000) |
$172.90 |
$266 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$276.90 |
$426 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,440.10 |
$3,754 |
8.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,111.20 |
— |
10.1× |
| CT abdomen w contrast (74160) |
$1,402.70 |
$2,158 |
9.1× |
| CT abdomen w wo contrast (74170) |
$1,483.30 |
$2,282 |
9.6× |
| CT abdomen w/o contrast (74150) |
$998.40 |
$1,536 |
10.9× |
| CT angiography upper extremity lt (73206) |
$1,111.50 |
$1,710 |
7.2× |
| CT c-spine w/o contrast (72125) |
$1,268.80 |
$1,952 |
13.8× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$96.85 |
$149 |
0.6× |
| CT cervical spine with contrast (72126) |
$1,296.10 |
$1,994 |
4.2× |
| CT chest w/wo contrast (71270) |
$1,773.85 |
$2,729 |
11.5× |
| CT chest with contrast (71260) |
$923 |
$1,420 |
6.0× |
| CT head/brain with contrast (70460) |
$1,385.15 |
$2,131 |
9.0× |
| CT head/brain without and with contrast (70470) |
$1,920.75 |
$2,955 |
12.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$716.30 |
$1,102 |
2.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$109.20 |
$168 |
1.4× |
| CT iac w contrast (70481) |
$1,197.30 |
$1,842 |
7.8× |
| CT lower ext w/o (73700) |
$869.70 |
$1,338 |
9.5× |
| CT lower extremity w wo contrast (73702) |
$1,401.40 |
$2,156 |
9.1× |
| CT lower extremity with contrast (73701) |
$1,369.55 |
$2,107 |
8.9× |
| CT lumbar spine w & w/o contrast (72133) |
$502.45 |
$773 |
3.3× |
| CT lumbar spine w/o contrast (72131) |
$982.80 |
$1,512 |
10.7× |
| CT lumbar spine with contrast (72132) |
$2,122.90 |
$3,266 |
6.9× |
| CT maxillofacial w contrast (70487) |
$849.55 |
$1,307 |
5.5× |
| CT maxillofacial w/o contrast (70486) |
$786.50 |
$1,210 |
8.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,825.20 |
$2,808 |
11.9× |
| CT neck soft tissue w contrast (70491) |
$1,197.30 |
$1,842 |
7.8× |
| CT orbits w/o contrast (70480) |
$1,382.55 |
$2,127 |
15.1× |
| CT pelvis w & w/o contrast (72194) |
$2,110.55 |
$3,247 |
13.7× |
| CT pelvis w/o contrast (72192) |
$968.50 |
$1,490 |
10.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,220.05 |
$1,877 |
7.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,067.30 |
$1,642 |
11.6× |
| CT thoracic spine w/o contrast (72128) |
$1,318.20 |
$2,028 |
14.4× |
| CT thorax w/o contrast (71250) |
$850.85 |
$1,309 |
9.3× |
| CT upper extremity w/o contrast rt (73200) |
$849.55 |
$1,307 |
9.3× |
| CT upper extremity with contrast (73201) |
$1,677 |
$2,580 |
5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,011.45 |
$4,633 |
19.6× |
| Cta Abdomen (74175) |
$2,620.15 |
$4,031 |
17.0× |
| CTA abdomen pelvis (74174) |
$2,516.15 |
$3,871 |
8.2× |
| CTA chest (71275) |
$1,394.90 |
$2,146 |
9.1× |
| Cta Head (70496) |
$2,340.65 |
$3,601 |
15.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$96.85 |
$149 |
0.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,656.85 |
$2,549 |
10.8× |
| Cta Neck (70498) |
$2,348.45 |
$3,613 |
15.3× |
| Cystography minimum 3 views rs&i (74430) |
$735.15 |
$1,131 |
2.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$304.85 |
— |
3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$162.50 |
$250 |
2.1× |
| Esophagus (74220) |
$379.60 |
$584 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$334.10 |
$514 |
3.6× |
| Fluoroscopy up to 1 hr (76000) |
$307.45 |
$473 |
1.5× |
| Foot 2 views (73620) |
$73.45 |
$113 |
1.0× |
| Forearm 2 views (73090) |
$144.30 |
$222 |
1.9× |
| Gated Heart Planar Single (78472) |
$1,475.50 |
$2,270 |
4.2× |
| Hand 2 views (73120) |
$258.70 |
$398 |
2.8× |
| Hand 3 views (73130) |
$266.50 |
$410 |
3.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,042.60 |
$1,604 |
2.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$727.35 |
$1,119 |
2.1× |
| Ht muscle image spect sing (78451) |
$1,060.15 |
$1,631 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$135.85 |
$209 |
1.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$928.85 |
$1,429 |
2.0× |
| Knee 3 views (73562) |
$153.40 |
$236 |
2.0× |
| MRA head w/o contrast (70544) |
$1,885 |
— |
9.0× |
| MRA neck w/o contrast (70547) |
$1,023.75 |
$1,575 |
4.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,155.70 |
$1,778 |
3.8× |
| MRI abdomen w/o contrast (74181) |
$936.65 |
$1,441 |
4.5× |
| MRI breast w/o contrast bilateral (77047) |
$468 |
$720 |
2.2× |
| MRI c-spine with contrast (72142) |
$1,324.05 |
$2,037 |
4.3× |
| MRI cervical spine w/o contrast (72141) |
$936.65 |
$1,441 |
4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,807.65 |
$2,781 |
8.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,950.35 |
$4,539 |
9.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,834 |
$4,360 |
9.3× |
| MRI pelvis w/o contrast (72195) |
$1,309.10 |
$2,014 |
6.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,653.95 |
$4,083 |
8.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,329.25 |
$2,045 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,349.10 |
$3,614 |
7.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,248.65 |
$1,921 |
4.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,196.35 |
$3,379 |
7.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,639 |
$4,060 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$936.65 |
$1,441 |
4.5× |
| MRI upper ext joint w/o contrast (73221) |
$936.65 |
$1,441 |
4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$936.65 |
$1,441 |
4.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,748.20 |
$4,228 |
2.4× |
| Neck soft tissue (70360) |
$103.35 |
$159 |
1.4× |
| Nm gastric emptying study (78264) |
$893.75 |
$1,375 |
2.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$249.60 |
$384 |
2.7× |
| Parathyrd planar w/wo subtrj (78071) |
$1,285.70 |
$1,978 |
3.7× |
| Parathyroid imaging (78070) |
$646.10 |
$994 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$85.80 |
$132 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,553.20 |
$3,928 |
8.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$798.20 |
$1,228 |
2.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,006.85 |
$1,549 |
2.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$253.50 |
$390 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$190.45 |
$293 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$182.65 |
$281 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$174.85 |
$269 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$276.25 |
$425 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$202.80 |
— |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$619.45 |
$953 |
4.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$276.25 |
$425 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$586.95 |
$903 |
3.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$531.05 |
$817 |
3.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$213.20 |
$328 |
2.8× |
| Ribs bilateral 3 views (71110) |
$323.05 |
$497 |
3.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,647.75 |
$2,535 |
3.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,050.40 |
$1,616 |
2.2× |
| Sacroiliac Joints < 3 Views (72200) |
$254.15 |
$391 |
2.8× |
| Scapula complete (73010) |
$163.15 |
$251 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$39.65 |
$61 |
1.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$196.95 |
$303 |
2.1× |
| Small bowel series (74250) |
$181.35 |
$279 |
1.2× |
| Spine thoracic 3 views (72072) |
$369.85 |
$569 |
4.0× |
| Tbs Technical Calculation Only (77091) |
$177.45 |
$273 |
2.3× |
| Thoracolumbar 2 views (72080) |
$280.15 |
$431 |
3.7× |
| Thyroid uptake measurement (78012) |
$807.30 |
$1,242 |
2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$720.85 |
$1,109 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$295.75 |
$455 |
3.2× |
| Upper Extremity Infant (73092) |
$128.05 |
$197 |
1.4× |
| Urethrocystography voiding (74455) |
$575.90 |
$886 |
2.8× |
| Us abdl aorta screen aaa (76706) |
$356.20 |
$548 |
3.9× |
| Us breast unilateral complete (76641) |
$222.95 |
$343 |
2.4× |
| Us breast unilateral limited (76642) |
$236.60 |
$364 |
3.1× |
| Us chest (76604) |
$202.80 |
$312 |
2.2× |
| Us compl joint r-t w/image documentation (76881) |
$198.25 |
$305 |
2.2× |
| Us ob transvaginal (76817) |
$246.35 |
$379 |
2.7× |
| Us pelvic non ob complete (76856) |
$225.55 |
$347 |
2.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$157.30 |
$242 |
1.7× |
| Us pregnancy ltd (76815) |
$325 |
$500 |
3.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$338 |
$520 |
3.7× |
| Us retroperitoneal complete (76770) |
$620.75 |
$955 |
6.8× |
| Us retroperitoneal limited (76775) |
$609.70 |
$938 |
6.7× |
| Us scrotum and contents (76870) |
$244.40 |
$376 |
2.7× |
| Us soft tissue head/neck (76536) |
$291.20 |
$448 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$195.65 |
$301 |
2.1× |
| Wrist 2 views (73100) |
$108.55 |
$167 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$342.55 |
$527 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$180.05 |
$277 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$214.82 |
— |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$598.65 |
$921 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$156.65 |
$241 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$159.25 |
$245 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$86.45 |
$133 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$182.65 |
$281 |
2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$210.60 |
$324 |
2.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$225.55 |
$347 |
2.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$118.30 |
$182 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$101.40 |
$156 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$200.85 |
$309 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$169.65 |
$261 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$378.30 |
$582 |
4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$176.80 |
$272 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$156 |
$240 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$228.15 |
$351 |
2.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$217.75 |
$335 |
2.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$151.45 |
$233 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$135.85 |
$209 |
1.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$83.85 |
$129 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$274.30 |
$422 |
3.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$222.95 |
$343 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$283.40 |
$436 |
3.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$283.40 |
$436 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$338.65 |
$521 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$312.65 |
$481 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$147.55 |
$227 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$314.92 |
— |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$135.85 |
$209 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$265.20 |
$408 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$265.85 |
$409 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$239.85 |
$369 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$127.40 |
$196 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$91.65 |
$141 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$175.50 |
$270 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$207.35 |
$319 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$91.65 |
— |
1.2× |
| Xr shoulder 1 view (73020) |
$205.40 |
$316 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$159.90 |
$246 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$363.35 |
— |
4.8× |
| Xr tmj bilateral (70330) |
$176.80 |
$272 |
2.3× |
| Xray knee 1 or 2 views rt (73560) |
$107.25 |
$165 |
1.4× |