| Abdomen 2 views (74019) |
$342 |
$428 |
3.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,258 |
$1,572 |
3.0× |
| Ankle 2 views (73600) |
$209 |
$261 |
2.3× |
| Arthrogram shoulder (73040) |
$791 |
$989 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,009 |
$1,261 |
2.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,279 |
$1,599 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$1,477 |
$1,846 |
3.6× |
| Bone age studies (77072) |
$199 |
$249 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,668 |
$2,085 |
4.0× |
| Bone survey complete (77075) |
$654 |
$818 |
6.0× |
| Brain image w/flow 4 + views (78606) |
$1,886 |
$2,358 |
3.3× |
| Brain Imaging Vascular Flow Only (78610) |
$1,154 |
$1,442 |
2.0× |
| Cervical spine 2 or 3 views (72040) |
$282 |
$352 |
3.1× |
| Chest 1 view (71045) |
$258 |
$323 |
2.9× |
| Chest 3 views (71047) |
$292 |
$365 |
3.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$510 |
$638 |
2.8× |
| Clavicle complete (73000) |
$261 |
$326 |
2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,946 |
$2,432 |
17.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,389 |
$5,807 |
14.9× |
| CT abdomen and pelvis without contrast (74176) |
$3,548 |
$4,435 |
14.3× |
| CT abdomen w contrast (74160) |
$2,160 |
$2,700 |
11.9× |
| CT abdomen w wo contrast (74170) |
$2,898 |
$3,622 |
15.9× |
| CT abdomen w/o contrast (74150) |
$2,192 |
$2,740 |
20.2× |
| CT c-spine w/o contrast (72125) |
$2,111 |
$2,639 |
19.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,182 |
$2,727 |
12.0× |
| CT cervical spine with contrast (72126) |
$2,364 |
$2,955 |
6.5× |
| CT chest w/wo contrast (71270) |
$2,530 |
$3,163 |
13.9× |
| CT chest with contrast (71260) |
$2,337 |
$2,921 |
12.8× |
| CT head/brain with contrast (70460) |
$2,249 |
$2,811 |
12.3× |
| CT head/brain without and with contrast (70470) |
$2,138 |
$2,673 |
11.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$125 |
$156 |
1.4× |
| CT iac w contrast (70481) |
$2,230 |
$2,788 |
12.2× |
| CT lower ext w/o (73700) |
$2,042 |
$2,552 |
18.8× |
| CT lower extremity w wo contrast (73702) |
$2,297 |
$2,871 |
12.6× |
| CT lower extremity with contrast (73701) |
$1,972 |
$2,465 |
10.8× |
| CT lumbar spine w/o contrast (72131) |
$2,003 |
$2,504 |
18.5× |
| CT lumbar spine with contrast (72132) |
$2,338 |
$2,923 |
6.5× |
| CT maxillofacial w contrast (70487) |
$1,939 |
$2,424 |
10.6× |
| CT maxillofacial w/o contrast (70486) |
$1,570 |
$1,963 |
14.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,015 |
$2,519 |
11.1× |
| CT neck soft tissue w contrast (70491) |
$2,067 |
$2,584 |
11.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,363 |
$2,954 |
13.0× |
| CT orbits w/o contrast (70480) |
$1,881 |
$2,351 |
17.3× |
| CT pelvis w & w/o contrast (72194) |
$2,628 |
$3,285 |
14.4× |
| CT pelvis w/o contrast (72192) |
$1,910 |
$2,387 |
17.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,492 |
$3,115 |
13.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,748 |
$2,185 |
16.1× |
| CT thoracic spine w/contrast (72129) |
$2,096 |
$2,620 |
11.5× |
| CT thoracic spine w/o contrast (72128) |
$1,936 |
$2,420 |
17.8× |
| CT thoracic spine w/wo contrast (72130) |
$2,105 |
$2,631 |
11.6× |
| CT thorax w/o contrast (71250) |
$2,001 |
$2,501 |
18.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,377 |
$2,971 |
13.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,884 |
$2,355 |
17.4× |
| CT upper extremity with contrast (73201) |
$1,904 |
$2,380 |
5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,500 |
$4,375 |
19.2× |
| Cta Abdomen (74175) |
$2,652 |
$3,315 |
14.6× |
| CTA abdomen pelvis (74174) |
$4,717 |
$5,896 |
13.0× |
| CTA chest (71275) |
$2,911 |
$3,639 |
16.0× |
| Cta Head (70496) |
$2,403 |
$3,004 |
13.2× |
| Cta Neck (70498) |
$2,631 |
$3,289 |
14.4× |
| Cta Pelvis (72191) |
$2,949 |
$3,686 |
16.2× |
| Cystography minimum 3 views rs&i (74430) |
$886 |
$1,107 |
2.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$390 |
$487 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$299 |
$374 |
3.3× |
| Esophagus (74220) |
$659 |
$824 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$397 |
$496 |
3.7× |
| Fluoroscopy up to 1 hr (76000) |
$562 |
$702 |
2.3× |
| Foot 2 views (73620) |
$200 |
$250 |
2.2× |
| Forearm 2 views (73090) |
$255 |
$319 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,651 |
$2,064 |
4.0× |
| Hand 2 views (73120) |
$188 |
$235 |
1.7× |
| Hand 3 views (73130) |
$258 |
$322 |
2.9× |
| Heart Infarct Image (78466) |
$1,257 |
$1,571 |
3.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,572 |
$1,965 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,385 |
$1,731 |
3.3× |
| Humerus Min 2 Views Left (73060) |
$262 |
$327 |
2.9× |
| Kidney imaging morphology (78700) |
$1,258 |
$1,572 |
3.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,194 |
$1,492 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,299 |
$1,624 |
2.3× |
| Knee 3 views (73562) |
$308 |
$385 |
3.4× |
| Liver & spleen imaging static only (78215) |
$1,292 |
$1,615 |
3.1× |
| Lung Ventilation Imaging (78579) |
$1,514 |
$1,893 |
3.6× |
| Meckels Diverticulum (78290) |
$1,218 |
$1,523 |
2.9× |
| MRA head w & w/o contrast (70546) |
$5,670 |
$7,088 |
15.7× |
| MRA head w/o contrast (70544) |
$2,585 |
$3,231 |
10.4× |
| MRA head with contrast (70545) |
$4,543 |
$5,679 |
12.5× |
| MRA neck w contrast (70548) |
$2,589 |
$3,236 |
7.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,102 |
$3,878 |
8.6× |
| MRA neck w/o contrast (70547) |
$2,117 |
$2,646 |
8.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,109 |
$5,136 |
11.3× |
| MRI abdomen w/o contrast (74181) |
$2,913 |
$3,641 |
11.8× |
| MRI any jnt lwr ext with con lt (73722) |
$3,097.50 |
$3,872 |
3.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,158 |
$3,948 |
3.9× |
| MRI c-spine with contrast (72142) |
$3,207 |
$4,009 |
8.9× |
| MRI cervical spine w/o contrast (72141) |
$2,846 |
$3,557 |
11.5× |
| MRI chest w/o & w/contrast material (71552) |
$3,345 |
$4,181 |
9.2× |
| MRI chest w/o contrast (71550) |
$2,974 |
$3,717 |
12.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,463 |
$3,079 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,295 |
$2,869 |
9.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,843 |
$3,554 |
11.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,964 |
$3,705 |
8.2× |
| MRI pelvis w contrast (72196) |
$2,751 |
$3,439 |
7.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,413 |
$4,266 |
9.4× |
| MRI pelvis w/o contrast (72195) |
$2,259 |
$2,824 |
9.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,880 |
$3,600 |
7.9× |
| MRI scan of leg joint before and after contrast (73723) |
$3,116 |
$3,895 |
8.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,849 |
$4,811 |
10.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,683 |
$3,354 |
7.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,346 |
$4,182 |
9.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,230 |
$4,038 |
8.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,368 |
$4,210 |
9.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,688 |
$3,360 |
10.8× |
| MRI tmj (70336) |
$1,804 |
$2,255 |
7.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,189 |
$2,736 |
8.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,778 |
$3,473 |
7.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,142 |
$2,677 |
8.6× |
| Neck soft tissue (70360) |
$284 |
$355 |
3.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$943 |
$1,179 |
2.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$355 |
$444 |
3.3× |
| Osseous survey infant (77076) |
$460 |
$575 |
4.2× |
| Osseous survey limited (77074) |
$593 |
$741 |
5.5× |
| Parathyroid imaging (78070) |
$1,012 |
$1,265 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$251 |
$314 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$5,143 |
$6,429 |
3.5× |
| PET imaging for CT attenuation whole body (78816) |
$5,016 |
$6,270 |
3.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,991 |
$3,739 |
8.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,174 |
$1,467 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,752 |
$2,190 |
3.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$252 |
$315 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$403 |
$504 |
3.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$432 |
$540 |
4.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$582 |
$727 |
5.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$362 |
$452 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$265 |
$331 |
2.9× |
| Radiologic exam colon single contrast study (74270) |
$669 |
$836 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$693 |
$866 |
3.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$489.50 |
$612 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$290 |
$362 |
3.2× |
| Ribs bilateral 3 views (71110) |
$361 |
$451 |
3.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,111 |
$2,639 |
3.7× |
| Sacroiliac Joints < 3 Views (72200) |
$375 |
$469 |
3.5× |
| Scanogram (77073) |
$352 |
$440 |
3.2× |
| Scapula complete (73010) |
$305 |
$381 |
2.8× |
| Small bowel series (74250) |
$587 |
$734 |
3.2× |
| Spine thoracic 3 views (72072) |
$508 |
$635 |
4.7× |
| Testicular Imaging With Vascular Flow (78761) |
$1,258 |
$1,572 |
3.0× |
| Thoracolumbar 2 views (72080) |
$296 |
$370 |
3.3× |
| Tmj unilateral (70328) |
$172 |
$215 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$622 |
$777 |
5.7× |
| Upper Extremity Infant (73092) |
$154 |
$193 |
1.4× |
| Urethrocystography voiding (74455) |
$668 |
$835 |
2.7× |
| Us breast unilateral complete (76641) |
$439 |
$549 |
4.0× |
| Us breast unilateral limited (76642) |
$356 |
$445 |
3.9× |
| Us chest (76604) |
$419 |
$524 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$444 |
$555 |
4.1× |
| Us ob transvaginal (76817) |
$504 |
$630 |
4.6× |
| Us pelvic non ob complete (76856) |
$648 |
$810 |
6.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$378 |
$472 |
3.5× |
| Us pregnancy ltd (76815) |
$398 |
$498 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$651 |
$814 |
6.0× |
| Us retroperitoneal complete (76770) |
$636 |
$795 |
5.9× |
| Us retroperitoneal limited (76775) |
$584 |
$730 |
5.4× |
| Us scrotum and contents (76870) |
$577 |
$721 |
5.3× |
| Us soft tissue head/neck (76536) |
$602 |
$752 |
5.5× |
| Us xtr non-vasc lmtd (76882) |
$484 |
$605 |
4.5× |
| Wrist 2 views (73100) |
$222 |
$277 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$498 |
$622 |
4.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$236 |
$295 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$272 |
$340 |
3.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$909 |
$1,136 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$219 |
$274 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$278 |
$348 |
3.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$485 |
$606 |
4.5× |
| X-ray exam hip uni 1 view (73501) |
$266 |
$333 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$413 |
$516 |
4.6× |
| X-ray exam hip uni 4/> views (73503) |
$270 |
$337 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$466 |
$583 |
4.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$501 |
$626 |
4.6× |
| X-ray exam of femur 1 (73551) |
$222 |
$278 |
2.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$343 |
$429 |
3.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$180 |
$225 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$284 |
$355 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$198 |
$247 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$344 |
$430 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$238 |
$297 |
2.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$171 |
$214 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$344 |
$430 |
3.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$594 |
$742 |
5.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$295 |
$369 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$286 |
$358 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$278 |
$348 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$363 |
$454 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$353 |
$441 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$282 |
$353 |
3.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$327 |
$409 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$211 |
$264 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$188 |
$235 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$406 |
$508 |
3.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$275 |
$344 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$201 |
$251 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$196 |
$245 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$232 |
$290 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$299 |
$374 |
2.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$201 |
$251 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$251 |
$314 |
2.8× |
| Xr c-spine 6 or more views (72052) |
$698 |
$872 |
6.4× |
| Xr finger(s) 2+ views (73140) |
$195 |
$244 |
2.2× |
| Xr shoulder 1 view (73020) |
$222 |
$277 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$443 |
$554 |
4.1× |
| Xr tibia/fibula 2 views (73590) |
$259 |
$324 |
2.9× |
| Xr tmj bilateral (70330) |
$298 |
$373 |
3.3× |
| Xray knee 1 or 2 views rt (73560) |
$246 |
$308 |
2.7× |