| Abdomen 2 views (74019) |
$300.96 |
$501.60 |
2.9× |
| Ankle 2 views (73600) |
$247.80 |
$413 |
2.8× |
| Cervical spine 2 or 3 views (72040) |
$276.24 |
$460.40 |
3.2× |
| Chest 1 view (71045) |
$156.96 |
$261.60 |
1.8× |
| Chest 3 views (71047) |
$134.10 |
$223.50 |
1.5× |
| Clavicle complete (73000) |
$176.10 |
$293.50 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$268.20 |
$447 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,151.80 |
$5,253 |
9.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,588.26 |
$2,647.10 |
6.6× |
| CT abdomen w contrast (74160) |
$1,042.56 |
$1,737.60 |
5.9× |
| CT abdomen w wo contrast (74170) |
$1,087.68 |
$1,812.80 |
6.2× |
| CT abdomen w/o contrast (74150) |
$1,449.18 |
$2,415.30 |
13.8× |
| CT angiography upper extremity lt (73206) |
$1,514.16 |
$2,523.60 |
8.6× |
| CT c-spine w/o contrast (72125) |
$1,114.20 |
$1,857 |
10.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,035.72 |
$1,726.20 |
5.9× |
| CT cervical spine with contrast (72126) |
$1,114.20 |
$1,857 |
3.2× |
| CT chest w/wo contrast (71270) |
$2,892.24 |
$4,820.40 |
16.4× |
| CT chest with contrast (71260) |
$1,297.80 |
$2,163 |
7.4× |
| CT head/brain with contrast (70460) |
$982.62 |
$1,637.70 |
5.6× |
| CT head/brain without and with contrast (70470) |
$1,056.12 |
$1,760.20 |
6.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$303.90 |
$506.50 |
3.5× |
| CT iac w contrast (70481) |
$849.12 |
$1,415.20 |
4.8× |
| CT lower ext w/o (73700) |
$1,115.46 |
$1,859.10 |
10.6× |
| CT lower extremity w wo contrast (73702) |
$1,221.45 |
$2,035.75 |
6.9× |
| CT lower extremity with contrast (73701) |
$1,115.46 |
$1,859.10 |
6.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,048.74 |
$1,747.90 |
6.0× |
| CT lumbar spine w/o contrast (72131) |
$1,270.56 |
$2,117.60 |
12.1× |
| CT lumbar spine with contrast (72132) |
$1,322.52 |
$2,204.20 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,126.56 |
$1,877.60 |
6.4× |
| CT maxillofacial w/o contrast (70486) |
$946.14 |
$1,576.90 |
9.0× |
| CT maxillofacial w/wo contrast (70488) |
$981.96 |
$1,636.60 |
5.6× |
| CT neck soft tissue w contrast (70491) |
$916.44 |
$1,527.40 |
5.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$943.02 |
$1,571.70 |
5.4× |
| CT orbits w/o contrast (70480) |
$869.52 |
$1,449.20 |
8.3× |
| CT pelvis w & w/o contrast (72194) |
$949.86 |
$1,583.10 |
5.4× |
| CT pelvis w/o contrast (72192) |
$862.68 |
$1,437.80 |
8.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,869.42 |
$3,115.70 |
10.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,145.76 |
$1,909.60 |
10.9× |
| CT thoracic spine w/contrast (72129) |
$1,004.82 |
$1,674.70 |
5.7× |
| CT thoracic spine w/o contrast (72128) |
$1,195.80 |
$1,993 |
11.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,016.58 |
$1,694.30 |
5.8× |
| CT thorax w/o contrast (71250) |
$957.90 |
$1,596.50 |
9.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,096.62 |
$1,827.70 |
6.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,154.73 |
$1,924.55 |
11.0× |
| CT upper extremity with contrast (73201) |
$1,031.13 |
$1,718.55 |
2.9× |
| Cta Abdomen (74175) |
$1,835.64 |
$3,059.40 |
10.4× |
| CTA abdomen pelvis (74174) |
$3,938.88 |
$6,564.80 |
11.2× |
| CTA chest (71275) |
$1,578.36 |
$2,630.60 |
9.0× |
| Cta Head (70496) |
$2,045.58 |
$3,409.30 |
11.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,698.72 |
$2,831.20 |
9.6× |
| Cta Neck (70498) |
$1,865.70 |
$3,109.50 |
10.6× |
| Cta Pelvis (72191) |
$1,404.48 |
$2,340.80 |
8.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$213.18 |
$355.30 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$213.18 |
$355.30 |
2.4× |
| Esophagus (74220) |
$280.56 |
$467.60 |
1.6× |
| Foot 2 views (73620) |
$156.30 |
$260.50 |
1.8× |
| Forearm 2 views (73090) |
$252.72 |
$421.20 |
2.9× |
| Hand 2 views (73120) |
$166.20 |
$277 |
1.6× |
| Hand 3 views (73130) |
$249.66 |
$416.10 |
2.9× |
| Humerus Min 2 Views Left (73060) |
$205.74 |
$342.90 |
2.4× |
| Knee 3 views (73562) |
$229.86 |
$383.10 |
2.6× |
| MRA head w/o contrast (70544) |
$830.58 |
$1,384.30 |
3.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,393.56 |
$2,322.60 |
4.0× |
| MRA neck w/o contrast (70547) |
$829.32 |
$1,382.20 |
3.5× |
| MRI abdomen w contrast (74182) |
$1,274.88 |
$2,124.80 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,274.88 |
$2,124.80 |
3.6× |
| MRI abdomen w/o contrast (74181) |
$1,095.06 |
$1,825.10 |
4.6× |
| MRI any jnt lwr ext with con lt (73722) |
$990 |
$1,650 |
1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$990 |
$1,650 |
1.3× |
| MRI c-spine with contrast (72142) |
$1,082.10 |
$1,803.50 |
3.1× |
| MRI cervical spine w/o contrast (72141) |
$1,199.52 |
$1,999.20 |
5.0× |
| MRI chest w/o & w/contrast material (71552) |
$957.24 |
$1,595.40 |
2.7× |
| MRI chest w/o contrast (71550) |
$500.58 |
$834.30 |
2.1× |
| MRI chest with contrast (71551) |
$792.24 |
$1,320.40 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$990 |
$1,650 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$990 |
$1,650 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,090.74 |
$1,817.90 |
4.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$881.88 |
$1,469.80 |
3.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,232.28 |
$2,053.80 |
3.5× |
| MRI orbit/face/neck w/contrast (70542) |
$947.34 |
$1,578.90 |
2.7× |
| MRI pelvis w contrast (72196) |
$1,057.98 |
$1,763.30 |
3.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,242.78 |
$2,071.30 |
3.5× |
| MRI pelvis w/o contrast (72195) |
$829.32 |
$1,382.20 |
3.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,121.04 |
$1,868.40 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,121.04 |
$1,868.40 |
3.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,278.60 |
$2,131 |
3.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,082.10 |
$1,803.50 |
3.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,278.60 |
$2,131 |
3.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,082.10 |
$1,803.50 |
3.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,213.08 |
$2,021.80 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,199.52 |
$1,999.20 |
5.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,090.74 |
$1,817.90 |
4.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,176.66 |
$1,961.10 |
3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,090.74 |
$1,817.90 |
4.6× |
| Neck soft tissue (70360) |
$192.18 |
$320.30 |
2.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$358.44 |
$597.40 |
3.4× |
| Osseous survey infant (77076) |
$91.44 |
$152.40 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$157.56 |
$262.60 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,176.66 |
$1,961.10 |
3.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,771.14 |
$2,951.90 |
3.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$158.16 |
$263.60 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$147.66 |
$246.10 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$95.76 |
$159.60 |
0.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$164.34 |
$273.90 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$287.34 |
$478.90 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$152.64 |
$254.40 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$178.56 |
$297.60 |
2.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$243.48 |
$405.80 |
2.8× |
| Ribs bilateral 3 views (71110) |
$368.94 |
$614.90 |
3.5× |
| Scapula complete (73010) |
$194.64 |
$324.40 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$26.52 |
$44.20 |
1.1× |
| Small bowel series (74250) |
$550.02 |
$916.70 |
3.1× |
| Spine thoracic 3 views (72072) |
$252.72 |
$421.20 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$494.40 |
$824 |
4.7× |
| Unlisted Ultrasound Procedure (76999) |
$247.20 |
$412 |
2.8× |
| Upper Extremity Infant (73092) |
$140.88 |
$234.80 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$266.34 |
$443.90 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$434.40 |
$724 |
4.1× |
| Us breast unilateral complete (76641) |
$553.08 |
$921.80 |
5.3× |
| Us breast unilateral limited (76642) |
$344.82 |
$574.70 |
3.9× |
| Us chest (76604) |
$278.70 |
$464.50 |
2.7× |
| Us ob detailed single fetus (76811) |
$474.60 |
$791 |
2.0× |
| Us ob transvaginal (76817) |
$510.42 |
$850.70 |
4.9× |
| Us pelvic non ob complete (76856) |
$729.84 |
$1,216.40 |
6.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$228 |
$380 |
2.2× |
| Us pregnancy ltd (76815) |
$213.18 |
$355.30 |
2.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$567.30 |
$945.50 |
5.4× |
| Us retroperitoneal complete (76770) |
$411.54 |
$685.90 |
3.9× |
| Us scrotum and contents (76870) |
$475.20 |
$792 |
4.5× |
| Us soft tissue head/neck (76536) |
$448.02 |
$746.70 |
4.3× |
| Us transrectal (76872) |
$569.16 |
$948.60 |
5.4× |
| Us xtr non-vasc lmtd (76882) |
$425.76 |
$709.60 |
4.1× |
| Wrist 2 views (73100) |
$196.20 |
$327 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$327.54 |
$545.90 |
3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$82.14 |
$136.90 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$259.56 |
$432.60 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$301.26 |
$502.10 |
3.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$192.18 |
$320.30 |
2.2× |
| X-ray exam hip uni 1 view (73501) |
$181.02 |
$301.70 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$161.28 |
$268.80 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$432.60 |
$721 |
4.1× |
| X-ray exam of femur 1 (73551) |
$61.14 |
$101.90 |
0.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$217.50 |
$362.50 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$134.10 |
$223.50 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$179.22 |
$298.70 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$142.74 |
$237.90 |
1.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$411.54 |
$685.90 |
3.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$98.88 |
$164.80 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$192.18 |
$320.30 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$284.28 |
$473.80 |
2.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$187.20 |
$312 |
2.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$71.64 |
$119.40 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$164.34 |
$273.90 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$233.58 |
$389.30 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$244.08 |
$406.80 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$295.38 |
$492.30 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$198.96 |
$331.60 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$279.90 |
$466.50 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$263.22 |
$438.70 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$226.14 |
$376.90 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$278.70 |
$464.50 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$175.50 |
$292.50 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$126.06 |
$210.10 |
1.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$82.14 |
$136.90 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$88.32 |
$147.20 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$333.06 |
$555.10 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$190.92 |
$318.20 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$184.40 |
$307.34 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$354.06 |
$590.10 |
3.4× |
| Xr chest 4+ views (71048) |
$192.18 |
$320.30 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$218.10 |
$363.50 |
2.5× |
| Xr shoulder 1 view (73020) |
$162.48 |
$270.80 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$383.76 |
$639.60 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$208.86 |
$348.10 |
2.4× |
| Xr tmj bilateral (70330) |
$140.88 |
$234.80 |
1.6× |
| Xray knee 1 or 2 views rt (73560) |
$156.96 |
$261.60 |
1.8× |