| Abdomen 2 views (74019) |
$484 |
$484 |
4.5× |
| Ankle 2 views (73600) |
$314 |
$314 |
3.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,408 |
$1,408 |
3.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,778 |
$1,778 |
4.3× |
| Bone &/joint imaging whole body (78306) |
$2,329 |
$2,329 |
5.6× |
| Bone Imaging 3 Phase (78315) |
$2,742 |
$2,742 |
6.6× |
| Bone survey complete (77075) |
$1,025 |
$1,025 |
9.4× |
| Cervical spine 2 or 3 views (72040) |
$423 |
$423 |
4.7× |
| Chest 1 view (71045) |
$325 |
$325 |
3.6× |
| Chest 3 views (71047) |
$506 |
$506 |
5.6× |
| Clavicle complete (73000) |
$342 |
$342 |
3.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,069 |
$2,069 |
19.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,430 |
$6,430 |
17.7× |
| CT abdomen and pelvis without contrast (74176) |
$4,919 |
$4,919 |
19.9× |
| CT abdomen w contrast (74160) |
$3,285 |
$3,285 |
18.0× |
| CT abdomen w wo contrast (74170) |
$3,643 |
$3,643 |
20.0× |
| CT abdomen w/o contrast (74150) |
$2,812 |
$2,812 |
25.9× |
| CT angiography upper extremity lt (73206) |
$1,198 |
$1,198 |
6.6× |
| CT c-spine w/o contrast (72125) |
$2,832 |
$2,832 |
26.1× |
| CT cervical spine w&w/o contrast (72127) |
$3,882 |
$3,882 |
21.3× |
| CT cervical spine with contrast (72126) |
$3,375 |
$3,375 |
9.3× |
| CT chest w/wo contrast (71270) |
$3,760 |
$3,760 |
20.6× |
| CT chest with contrast (71260) |
$3,121 |
$3,121 |
17.1× |
| CT head/brain with contrast (70460) |
$2,778 |
$2,778 |
15.3× |
| CT head/brain without and with contrast (70470) |
$3,110 |
$3,110 |
17.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$182 |
$182 |
2.0× |
| CT iac w contrast (70481) |
$3,182 |
$3,182 |
17.5× |
| CT lower ext w/o (73700) |
$2,646 |
$2,646 |
24.4× |
| CT lower extremity w wo contrast (73702) |
$3,478 |
$3,478 |
19.1× |
| CT lower extremity with contrast (73701) |
$2,982 |
$2,982 |
16.4× |
| CT lumbar spine w & w/o contrast (72133) |
$3,601 |
$3,601 |
19.8× |
| CT lumbar spine w/o contrast (72131) |
$2,750 |
$2,750 |
25.3× |
| CT lumbar spine with contrast (72132) |
$3,106 |
$3,106 |
8.6× |
| CT maxillofacial w contrast (70487) |
$2,597 |
$2,597 |
14.3× |
| CT maxillofacial w/o contrast (70486) |
$2,279 |
$2,279 |
21.0× |
| CT maxillofacial w/wo contrast (70488) |
$3,298 |
$3,298 |
18.1× |
| CT neck soft tissue w contrast (70491) |
$2,994 |
$2,994 |
16.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,339 |
$3,339 |
18.3× |
| CT orbits w/o contrast (70480) |
$2,888 |
$2,888 |
26.6× |
| CT pelvis w & w/o contrast (72194) |
$3,842 |
$3,842 |
21.1× |
| CT pelvis w/o contrast (72192) |
$2,859 |
$2,859 |
26.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,236 |
$3,236 |
17.8× |
| CT soft tissue neck w/o contrast (70490) |
$2,657 |
$2,657 |
24.5× |
| CT thoracic spine w/contrast (72129) |
$3,166 |
$3,166 |
17.4× |
| CT thoracic spine w/o contrast (72128) |
$2,917 |
$2,917 |
26.9× |
| CT thoracic spine w/wo contrast (72130) |
$3,135 |
$3,135 |
17.2× |
| CT thorax w/o contrast (71250) |
$2,725 |
$2,725 |
25.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,809 |
$3,809 |
20.9× |
| CT upper extremity w/o contrast rt (73200) |
$2,619 |
$2,619 |
24.1× |
| CT upper extremity with contrast (73201) |
$2,717 |
$2,717 |
7.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,195 |
$4,195 |
23.0× |
| Cta Abdomen (74175) |
$4,094 |
$4,094 |
22.5× |
| CTA abdomen pelvis (74174) |
$6,586 |
$6,586 |
18.2× |
| CTA chest (71275) |
$3,936 |
$3,936 |
21.6× |
| Cta Head (70496) |
$3,667 |
$3,667 |
20.1× |
| Cta Neck (70498) |
$2,351.50 |
$2,351.50 |
12.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$588 |
$588 |
5.4× |
| Fetal biophysical profile non-stress testing (76818) |
$778 |
$778 |
7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$616 |
$616 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$757 |
$757 |
3.1× |
| Foot 2 views (73620) |
$303 |
$303 |
3.4× |
| Forearm 2 views (73090) |
$354 |
$354 |
3.9× |
| Hand 2 views (73120) |
$305 |
$305 |
2.8× |
| Hand 3 views (73130) |
$376 |
$376 |
4.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,371 |
$2,371 |
4.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,162 |
$2,162 |
5.2× |
| Humerus Min 2 Views Left (73060) |
$383 |
$383 |
4.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,969 |
$1,969 |
3.5× |
| Knee 3 views (73562) |
$456 |
$456 |
5.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,901 |
$1,901 |
4.6× |
| Liver imaging w/vascular flow (78202) |
$1,901 |
$1,901 |
3.4× |
| MRA head w & w/o contrast (70546) |
$4,354 |
$4,354 |
12.0× |
| MRA head w/o contrast (70544) |
$3,995 |
$3,995 |
16.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,574 |
$4,574 |
12.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,829 |
$4,829 |
13.3× |
| MRI abdomen w/o contrast (74181) |
$4,084 |
$4,084 |
16.5× |
| MRI c-spine with contrast (72142) |
$4,604 |
$4,604 |
12.7× |
| MRI cervical spine w/o contrast (72141) |
$3,979 |
$3,979 |
16.1× |
| MRI chest w/o & w/contrast material (71552) |
$5,443 |
$5,443 |
15.0× |
| MRI chest w/o contrast (71550) |
$4,816 |
$4,816 |
19.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,382 |
$3,382 |
13.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,290 |
$4,290 |
17.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,668 |
$4,668 |
12.9× |
| MRI pelvis w contrast (72196) |
$4,646 |
$4,646 |
12.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,118 |
$5,118 |
14.1× |
| MRI pelvis w/o contrast (72195) |
$4,042 |
$4,042 |
16.3× |
| MRI scan of arm joint before and after contrast (73223) |
$4,724 |
$4,724 |
13.0× |
| MRI scan of leg joint before and after contrast (73723) |
$4,389 |
$4,389 |
12.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,396 |
$5,396 |
14.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,626 |
$4,626 |
12.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,073 |
$5,073 |
14.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,788 |
$4,788 |
13.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,529 |
$5,529 |
15.3× |
| MRI thoracic spine w/o contrast (72146) |
$4,360 |
$4,360 |
17.6× |
| MRI tmj (70336) |
$4,839 |
$4,839 |
19.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,978 |
$2,978 |
12.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,293 |
$4,293 |
11.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,245 |
$3,245 |
13.1× |
| Myocardial Spect Multiple Studies (78452) |
$5,097 |
$5,097 |
3.8× |
| Neck soft tissue (70360) |
$389 |
$389 |
4.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$497 |
$497 |
4.6× |
| Parathyrd planar w/wo subtrj (78071) |
$1,857 |
$1,857 |
4.5× |
| Pelvis 1 or 2 views (72170) |
$405 |
$405 |
3.7× |
| PET image w/CT, skull-thigh (78815) |
$10,012 |
$10,012 |
6.7× |
| PET imaging for CT attenuation whole body (78816) |
$10,692 |
$10,692 |
7.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,177 |
$4,177 |
11.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,557 |
$1,557 |
3.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,968 |
$2,968 |
5.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$652 |
$652 |
6.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$601 |
$601 |
5.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$553 |
$553 |
5.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$376 |
$376 |
4.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$415 |
$415 |
4.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$401 |
$401 |
4.4× |
| Ribs bilateral 3 views (71110) |
$573 |
$573 |
5.3× |
| Sacroiliac Joints < 3 Views (72200) |
$427 |
$427 |
3.9× |
| Scapula complete (73010) |
$387 |
$387 |
3.6× |
| Screening digital breast tomosynthesis (77063) |
$67 |
$67 |
2.9× |
| Spine thoracic 3 views (72072) |
$657 |
$657 |
6.1× |
| Ultrasound scan to determine eye length and lens power (76519) |
$127 |
$127 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$860 |
$860 |
7.9× |
| Upper Extremity Infant (73092) |
$299 |
$299 |
2.8× |
| Us abdl aorta screen aaa (76706) |
$728 |
$728 |
6.7× |
| Us breast unilateral complete (76641) |
$711 |
$711 |
6.5× |
| Us breast unilateral limited (76642) |
$490 |
$490 |
5.4× |
| Us chest (76604) |
$699 |
$699 |
6.4× |
| Us compl joint r-t w/image documentation (76881) |
$791 |
$791 |
7.3× |
| Us ob transvaginal (76817) |
$691 |
$691 |
6.4× |
| Us pelvic non ob complete (76856) |
$1,002 |
$1,002 |
9.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$610 |
$610 |
5.6× |
| Us pregnancy ltd (76815) |
$575 |
$575 |
5.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$845 |
$845 |
7.8× |
| Us retroperitoneal complete (76770) |
$1,017 |
$1,017 |
9.4× |
| Us retroperitoneal limited (76775) |
$696 |
$696 |
6.4× |
| Us scrotum and contents (76870) |
$791 |
$791 |
7.3× |
| Us soft tissue head/neck (76536) |
$761 |
$761 |
7.0× |
| Us xtr non-vasc lmtd (76882) |
$632 |
$632 |
5.8× |
| Wrist 2 views (73100) |
$309 |
$309 |
3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$670 |
$670 |
6.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$375 |
$375 |
4.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$389 |
$389 |
4.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$334 |
$334 |
3.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$412 |
$412 |
4.6× |
| X-ray exam hip uni 1 view (73501) |
$325 |
$325 |
3.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$431 |
$431 |
4.8× |
| X-ray exam hip uni 4/> views (73503) |
$526 |
$526 |
4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$718 |
$718 |
6.6× |
| X-ray exam of femur 1 (73551) |
$362 |
$362 |
4.0× |
| X-ray eye for foreign body (70030) |
$309 |
$309 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$551 |
$551 |
5.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$358 |
$358 |
4.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$552 |
$552 |
6.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$307 |
$307 |
3.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$373 |
$373 |
4.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$480 |
$480 |
4.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$317 |
$317 |
3.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$275 |
$275 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$524 |
$524 |
4.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$782 |
$782 |
7.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$417 |
$417 |
4.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$393 |
$393 |
4.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$488 |
$488 |
4.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$406 |
$406 |
4.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$496 |
$496 |
4.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$617 |
$617 |
5.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$434 |
$434 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$402 |
$402 |
4.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$422 |
$422 |
4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$541 |
$541 |
6.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$349 |
$349 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$573 |
$573 |
5.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$379 |
$379 |
3.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$385 |
$385 |
4.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$453 |
$453 |
4.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$297 |
$297 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$379 |
$379 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$721 |
$721 |
6.6× |
| Xr chest 4+ views (71048) |
$342 |
$342 |
3.2× |
| Xr finger(s) 2+ views (73140) |
$292 |
$292 |
3.2× |
| Xr shoulder 1 view (73020) |
$292 |
$292 |
3.2× |
| Xr spine cervical 4 or 5 views (72050) |
$623 |
$623 |
5.7× |
| Xr tibia/fibula 2 views (73590) |
$375 |
$375 |
4.1× |
| Xray knee 1 or 2 views rt (73560) |
$383 |
$383 |
4.2× |