| Abdomen 2 views (74019) |
$367.50 |
$367.50 |
3.8× |
| Ankle 2 views (73600) |
$278.25 |
$278.25 |
3.5× |
| Bone &/joint imaging whole body (78306) |
$1,302 |
$1,302 |
3.5× |
| Bone age studies (77072) |
$288.75 |
$288.75 |
3.0× |
| Bone Imaging 3 Phase (78315) |
$1,359.75 |
$1,359.75 |
3.7× |
| Cervical spine 2 or 3 views (72040) |
$357 |
$357 |
4.5× |
| Chest 1 view (71045) |
$252 |
$252 |
3.1× |
| Chest 3 views (71047) |
$336 |
$336 |
4.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$649.15 |
$649.15 |
4.0× |
| Clavicle complete (73000) |
$299.25 |
$299.25 |
3.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$630 |
$630 |
6.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,467.50 |
$2,467.50 |
7.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,879.50 |
$1,879.50 |
8.6× |
| CT abdomen w contrast (74160) |
$1,968.75 |
$1,968.75 |
12.2× |
| CT abdomen w wo contrast (74170) |
$2,310 |
$2,310 |
14.3× |
| CT abdomen w/o contrast (74150) |
$1,837.50 |
$1,837.50 |
19.1× |
| CT c-spine w/o contrast (72125) |
$1,758.75 |
$1,758.75 |
18.3× |
| CT cervical spine with contrast (72126) |
$1,916.25 |
$1,916.25 |
6.0× |
| CT chest w/wo contrast (71270) |
$2,231.25 |
$2,231.25 |
13.8× |
| CT chest with contrast (71260) |
$1,916.25 |
$1,916.25 |
11.9× |
| CT head/brain with contrast (70460) |
$1,732.50 |
$1,732.50 |
10.7× |
| CT head/brain without and with contrast (70470) |
$2,073.75 |
$2,073.75 |
12.9× |
| CT iac w contrast (70481) |
$1,837.50 |
$1,837.50 |
11.4× |
| CT lower ext w/o (73700) |
$1,575 |
$1,575 |
16.4× |
| CT lower extremity w wo contrast (73702) |
$2,100 |
$2,100 |
13.0× |
| CT lower extremity with contrast (73701) |
$1,706.25 |
$1,706.25 |
10.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,362.50 |
$2,362.50 |
14.6× |
| CT lumbar spine w/o contrast (72131) |
$1,758.75 |
$1,758.75 |
18.3× |
| CT lumbar spine with contrast (72132) |
$1,916.25 |
$1,916.25 |
6.0× |
| CT maxillofacial w contrast (70487) |
$1,758.75 |
$1,758.75 |
10.9× |
| CT maxillofacial w/o contrast (70486) |
$1,669.50 |
$1,669.50 |
17.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,047.50 |
$2,047.50 |
12.7× |
| CT neck soft tissue w contrast (70491) |
$1,837.50 |
$1,837.50 |
11.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,047.50 |
$2,047.50 |
12.7× |
| CT orbits w/o contrast (70480) |
$1,758.75 |
$1,758.75 |
18.3× |
| CT pelvis w & w/o contrast (72194) |
$2,205 |
$2,205 |
13.7× |
| CT pelvis w/o contrast (72192) |
$1,837.50 |
$1,837.50 |
19.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,073.75 |
$2,073.75 |
12.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,716.75 |
$1,716.75 |
17.9× |
| CT thoracic spine w/contrast (72129) |
$1,916.25 |
$1,916.25 |
11.9× |
| CT thoracic spine w/o contrast (72128) |
$1,706.25 |
$1,706.25 |
17.7× |
| CT thorax w/o contrast (71250) |
$1,779.75 |
$1,779.75 |
18.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,073.75 |
$2,073.75 |
12.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,575 |
$1,575 |
16.4× |
| CT upper extremity with contrast (73201) |
$1,680 |
$1,680 |
5.2× |
| CTA chest (71275) |
$2,378.25 |
$2,378.25 |
14.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$472.50 |
$472.50 |
4.9× |
| Echoencephalography real time imaging (76506) |
$661.50 |
$661.50 |
6.9× |
| Fetal biophysical profile non-stress testing (76818) |
$577.50 |
$577.50 |
6.0× |
| Fluoroscopy up to 1 hr (76000) |
$535.50 |
$535.50 |
2.4× |
| Foot 2 views (73620) |
$278.25 |
$278.25 |
3.5× |
| Forearm 2 views (73090) |
$299.25 |
$299.25 |
3.7× |
| Hand 2 views (73120) |
$283.50 |
$283.50 |
2.9× |
| Hand 3 views (73130) |
$330.75 |
$330.75 |
4.1× |
| Humerus Min 2 Views Left (73060) |
$304.50 |
$304.50 |
3.8× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$278.25 |
$278.25 |
2.9× |
| Knee 3 views (73562) |
$357 |
$357 |
4.5× |
| Mammary ductogram or galactogram single (77053) |
$36.75 |
$36.75 |
0.2× |
| MRA head w & w/o contrast (70546) |
$2,399.25 |
$2,399.25 |
7.5× |
| MRA head w/o contrast (70544) |
$1,837.50 |
$1,837.50 |
8.4× |
| MRA head with contrast (70545) |
$2,047.50 |
$2,047.50 |
6.4× |
| MRA neck w contrast (70548) |
$2,325.75 |
$2,325.75 |
7.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,625 |
$2,625 |
8.2× |
| MRA neck w/o contrast (70547) |
$1,837.50 |
$1,837.50 |
8.4× |
| MRI abdomen w contrast (74182) |
$2,415 |
$2,415 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,625 |
$2,625 |
8.2× |
| MRI abdomen w/o contrast (74181) |
$2,100 |
$2,100 |
9.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,415 |
$2,415 |
3.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,415 |
$2,415 |
3.3× |
| MRI bone marrow blood supply (77084) |
$2,341.50 |
$2,341.50 |
10.7× |
| MRI c-spine with contrast (72142) |
$2,415 |
$2,415 |
7.5× |
| MRI cervical spine w/o contrast (72141) |
$2,100 |
$2,100 |
9.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,625 |
$2,625 |
8.2× |
| MRI chest w/o contrast (71550) |
$1,995 |
$1,995 |
9.1× |
| MRI chest with contrast (71551) |
$2,357.25 |
$2,357.25 |
3.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,415 |
$2,415 |
7.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,415 |
$2,415 |
7.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,257.50 |
$2,257.50 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,890 |
$1,890 |
8.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,625 |
$2,625 |
8.2× |
| MRI orbit/face/neck w/contrast (70542) |
$2,362.50 |
$2,362.50 |
7.4× |
| MRI pelvis w contrast (72196) |
$2,415 |
$2,415 |
7.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,625 |
$2,625 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$2,100 |
$2,100 |
9.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,625 |
$2,625 |
8.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,625 |
$2,625 |
8.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,625 |
$2,625 |
8.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,415 |
$2,415 |
7.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,625 |
$2,625 |
8.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,415 |
$2,415 |
7.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,625 |
$2,625 |
8.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,100 |
$2,100 |
9.6× |
| MRI tmj (70336) |
$1,837.50 |
$1,837.50 |
8.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,100 |
$2,100 |
9.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,625 |
$2,625 |
8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,100 |
$2,100 |
9.6× |
| Neck soft tissue (70360) |
$283.50 |
$283.50 |
3.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$357 |
$357 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$278.25 |
$278.25 |
2.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,625 |
$2,625 |
8.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$123.90 |
$123.90 |
0.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$325.50 |
$325.50 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$417.38 |
$417.38 |
4.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$262.50 |
$262.50 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$278.25 |
$278.25 |
3.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$309.75 |
$309.75 |
3.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$320.25 |
$320.25 |
4.0× |
| Ribs bilateral 3 views (71110) |
$430.50 |
$430.50 |
4.5× |
| Scanogram (77073) |
$351.75 |
$351.75 |
3.7× |
| Scapula complete (73010) |
$309.75 |
$309.75 |
3.2× |
| Screening digital breast tomosynthesis (77063) |
$110.23 |
$110.23 |
4.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$263.13 |
$263.13 |
2.7× |
| Tmj unilateral (70328) |
$262.50 |
$262.50 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$560.44 |
$560.44 |
5.8× |
| Us abdl aorta screen aaa (76706) |
$640.50 |
$640.50 |
6.7× |
| Us breast unilateral complete (76641) |
$446.25 |
$446.25 |
4.6× |
| Us chest (76604) |
$472.50 |
$472.50 |
4.9× |
| Us compl joint r-t w/image documentation (76881) |
$420 |
$420 |
4.4× |
| Us ob transvaginal (76817) |
$472.50 |
$472.50 |
4.9× |
| Us pelvic non ob complete (76856) |
$656.25 |
$656.25 |
6.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$420 |
$420 |
4.4× |
| Us pregnancy ltd (76815) |
$157.80 |
$157.80 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$448.35 |
$448.35 |
4.7× |
| Us retroperitoneal complete (76770) |
$575.92 |
$575.92 |
6.0× |
| Us scrotum and contents (76870) |
$603.75 |
$603.75 |
6.3× |
| Us soft tissue head/neck (76536) |
$390.32 |
$390.32 |
4.1× |
| Us transrectal (76872) |
$577.50 |
$577.50 |
6.0× |
| Us xtr non-vasc lmtd (76882) |
$210 |
$210 |
2.2× |
| Vertebral fracture assessment via dxa (77086) |
$105 |
$105 |
1.3× |
| Wrist 2 views (73100) |
$273 |
$273 |
3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$488.25 |
$488.25 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$325.50 |
$325.50 |
4.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$330.75 |
$330.75 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$278.25 |
$278.25 |
3.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$278.25 |
$278.25 |
3.5× |
| X-ray exam hip uni 1 view (73501) |
$241.50 |
$241.50 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$315 |
$315 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$282.07 |
$282.07 |
2.9× |
| X-ray exam of femur 1 (73551) |
$225.75 |
$225.75 |
2.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$425.25 |
$425.25 |
4.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$294 |
$294 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$325.50 |
$325.50 |
4.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$278.25 |
$278.25 |
3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$283.50 |
$283.50 |
3.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$425.25 |
$425.25 |
4.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$273 |
$273 |
3.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$262.50 |
$262.50 |
3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$378 |
$378 |
3.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$320.25 |
$320.25 |
4.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$404.25 |
$404.25 |
4.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$325.50 |
$325.50 |
4.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$404.25 |
$404.25 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$525 |
$525 |
5.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$301.39 |
$301.39 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$325.50 |
$325.50 |
4.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$341.25 |
$341.25 |
4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$420 |
$420 |
5.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$488.25 |
$488.25 |
5.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$330.75 |
$330.75 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$283.50 |
$283.50 |
3.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$325.50 |
$325.50 |
4.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$265.12 |
$265.12 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$325.50 |
$325.50 |
4.1× |
| Xr c-spine 6 or more views (72052) |
$561.75 |
$561.75 |
5.8× |
| Xr chest 4+ views (71048) |
$393.75 |
$393.75 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$252 |
$252 |
3.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$236.25 |
$236.25 |
2.5× |
| Xr shoulder 1 view (73020) |
$252 |
$252 |
3.1× |
| Xr spine cervical 4 or 5 views (72050) |
$509.25 |
$509.25 |
5.3× |
| Xr tibia/fibula 2 views (73590) |
$315 |
$315 |
3.9× |
| Xr tmj bilateral (70330) |
$367.50 |
$367.50 |
4.6× |
| Xray knee 1 or 2 views rt (73560) |
$294 |
$294 |
3.7× |