| Abdomen 2 views (74019) |
$563.40 |
$626 |
5.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,381.40 |
$2,646 |
5.7× |
| Ankle 2 views (73600) |
$500.40 |
$556 |
5.5× |
| Arthrogram shoulder (73040) |
$1,802.70 |
$2,003 |
5.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,620 |
$1,800 |
3.9× |
| Bone &/joint imaging whole body (78306) |
$2,340 |
$2,600 |
5.6× |
| Bone age studies (77072) |
$188.10 |
$209 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$2,819.70 |
$3,133 |
6.8× |
| Bone survey complete (77075) |
$1,037.70 |
$1,153 |
9.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,885.90 |
$7,651 |
4.6× |
| Cervical spine 2 or 3 views (72040) |
$477.90 |
$531 |
5.3× |
| Chest 1 view (71045) |
$292.50 |
$325 |
3.2× |
| Chest 3 views (71047) |
$554.40 |
$616 |
6.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$841.50 |
$935 |
4.6× |
| Clavicle complete (73000) |
$424.80 |
$472 |
4.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,593.90 |
$1,771 |
14.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,810.40 |
$6,456 |
16.0× |
| CT abdomen and pelvis without contrast (74176) |
$4,250.70 |
$4,723 |
17.2× |
| CT abdomen w contrast (74160) |
$4,119.30 |
$4,577 |
22.6× |
| CT abdomen w wo contrast (74170) |
$4,669.20 |
$5,188 |
25.6× |
| CT abdomen w/o contrast (74150) |
$3,003.30 |
$3,337 |
27.7× |
| CT angiography upper extremity lt (73206) |
$2,900.70 |
$3,223 |
15.9× |
| CT c-spine w/o contrast (72125) |
$3,190.50 |
$3,545 |
29.4× |
| CT cervical spine w&w/o contrast (72127) |
$4,394.70 |
$4,883 |
24.1× |
| CT cervical spine with contrast (72126) |
$4,157.10 |
$4,619 |
11.5× |
| CT chest w/wo contrast (71270) |
$4,394.70 |
$4,883 |
24.1× |
| CT chest with contrast (71260) |
$4,157.10 |
$4,619 |
22.8× |
| CT head/brain with contrast (70460) |
$3,681 |
$4,090 |
20.2× |
| CT head/brain without and with contrast (70470) |
$3,919.50 |
$4,355 |
21.5× |
| CT iac w contrast (70481) |
$3,919.50 |
$4,355 |
21.5× |
| CT lower ext w/o (73700) |
$2,715.30 |
$3,017 |
25.0× |
| CT lower extremity w wo contrast (73702) |
$3,919.50 |
$4,355 |
21.5× |
| CT lower extremity with contrast (73701) |
$3,681 |
$4,090 |
20.2× |
| CT lumbar spine w & w/o contrast (72133) |
$4,394.70 |
$4,883 |
24.1× |
| CT lumbar spine w/o contrast (72131) |
$3,190.50 |
$3,545 |
29.4× |
| CT lumbar spine with contrast (72132) |
$4,157.10 |
$4,619 |
11.5× |
| CT maxillofacial w contrast (70487) |
$3,206.70 |
$3,563 |
17.6× |
| CT maxillofacial w/o contrast (70486) |
$2,242.80 |
$2,492 |
20.7× |
| CT maxillofacial w/wo contrast (70488) |
$3,442.50 |
$3,825 |
18.9× |
| CT neck soft tissue w contrast (70491) |
$3,681 |
$4,090 |
20.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$4,157.10 |
$4,619 |
22.8× |
| CT orbits w/o contrast (70480) |
$2,952.90 |
$3,281 |
27.2× |
| CT pelvis w & w/o contrast (72194) |
$4,286.70 |
$4,763 |
23.5× |
| CT pelvis w/o contrast (72192) |
$2,811.60 |
$3,124 |
25.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,919.50 |
$4,355 |
21.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,715.30 |
$3,017 |
25.0× |
| CT thoracic spine w/contrast (72129) |
$4,157.10 |
$4,619 |
22.8× |
| CT thoracic spine w/o contrast (72128) |
$3,190.50 |
$3,545 |
29.4× |
| CT thoracic spine w/wo contrast (72130) |
$4,394.70 |
$4,883 |
24.1× |
| CT thorax w/o contrast (71250) |
$2,581.65 |
$2,868.50 |
23.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,919.50 |
$4,355 |
21.5× |
| CT upper extremity w/o contrast rt (73200) |
$2,715.30 |
$3,017 |
25.0× |
| CT upper extremity with contrast (73201) |
$3,681 |
$4,090 |
10.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,682.80 |
$4,092 |
20.2× |
| Cta Abdomen (74175) |
$5,238 |
$5,820 |
28.8× |
| CTA abdomen pelvis (74174) |
$5,840.10 |
$6,489 |
16.1× |
| CTA chest (71275) |
$4,725.90 |
$5,251 |
25.9× |
| Cta Head (70496) |
$3,919.50 |
$4,355 |
21.5× |
| CTA lwr ext w&w/o contrast (73706) |
$2,617.20 |
$2,908 |
14.4× |
| Cta Neck (70498) |
$3,919.50 |
$4,355 |
21.5× |
| Cta Pelvis (72191) |
$4,919.40 |
$5,466 |
27.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$355.95 |
$395.50 |
3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$530.10 |
$589 |
4.9× |
| Fluoroscopy up to 1 hr (76000) |
$886.50 |
$985 |
3.6× |
| Foot 2 views (73620) |
$378.90 |
$421 |
4.2× |
| Forearm 2 views (73090) |
$423 |
$470 |
4.7× |
| Gated Heart Planar Single (78472) |
$2,592 |
$2,880 |
6.2× |
| Hand 2 views (73120) |
$472.50 |
$525 |
4.4× |
| Hand 3 views (73130) |
$479.70 |
$533 |
5.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,530.80 |
$2,812 |
4.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,241 |
$2,490 |
5.4× |
| Ht muscle image spect sing (78451) |
$5,407.20 |
$6,008 |
4.0× |
| Humerus Min 2 Views Left (73060) |
$458.10 |
$509 |
5.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,127.60 |
$2,364 |
3.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,127.60 |
$2,364 |
3.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,340 |
$2,600 |
4.2× |
| Knee 3 views (73562) |
$405 |
$450 |
4.5× |
| Liver & spleen imaging static only (78215) |
$2,550.60 |
$2,834 |
6.1× |
| Lung Ventilation Imaging (78579) |
$1,723.50 |
$1,915 |
4.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$370.80 |
$412 |
4.1× |
| Meckels Diverticulum (78290) |
$2,273.40 |
$2,526 |
5.5× |
| MRA head w & w/o contrast (70546) |
$3,893.40 |
$4,326 |
10.7× |
| MRA head w/o contrast (70544) |
$3,522.60 |
$3,914 |
14.2× |
| MRA head with contrast (70545) |
$3,708 |
$4,120 |
10.2× |
| MRA neck w contrast (70548) |
$3,940.20 |
$4,378 |
10.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,356.90 |
$4,841 |
12.0× |
| MRA neck w/o contrast (70547) |
$3,522.60 |
$3,914 |
14.2× |
| MRI abdomen w contrast (74182) |
$4,078.80 |
$4,532 |
11.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,449.60 |
$4,944 |
12.3× |
| MRI abdomen w/o contrast (74181) |
$3,708 |
$4,120 |
15.0× |
| MRI any jnt lwr ext with con lt (73722) |
$3,244.50 |
$3,605 |
4.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,476.70 |
$3,863 |
4.3× |
| MRI c-spine with contrast (72142) |
$3,893.40 |
$4,326 |
10.7× |
| MRI cervical spine w/o contrast (72141) |
$3,615.30 |
$4,017 |
14.6× |
| MRI chest w/o & w/contrast material (71552) |
$3,800.70 |
$4,223 |
10.5× |
| MRI chest w/o contrast (71550) |
$4,242.60 |
$4,714 |
17.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,429.90 |
$3,811 |
9.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,244.50 |
$3,605 |
9.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,966.40 |
$3,296 |
12.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,151.80 |
$3,502 |
12.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,800.70 |
$4,223 |
10.5× |
| MRI orbit/face/neck w/contrast (70542) |
$3,429.90 |
$3,811 |
9.5× |
| MRI pelvis w contrast (72196) |
$3,708 |
$4,120 |
10.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,264.20 |
$4,738 |
11.8× |
| MRI pelvis w/o contrast (72195) |
$3,151.80 |
$3,502 |
12.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,986.10 |
$4,429 |
11.0× |
| MRI scan of leg joint before and after contrast (73723) |
$3,708 |
$4,120 |
10.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,542.30 |
$5,047 |
12.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,893.40 |
$4,326 |
10.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,171.50 |
$4,635 |
11.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,893.40 |
$4,326 |
10.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,542.30 |
$5,047 |
12.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,615.30 |
$4,017 |
14.6× |
| MRI tmj (70336) |
$4,146.30 |
$4,607 |
16.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,688.30 |
$2,987 |
10.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,893.40 |
$4,326 |
10.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,966.40 |
$3,296 |
12.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,999.50 |
$5,555 |
3.7× |
| Neck soft tissue (70360) |
$458.10 |
$509 |
5.1× |
| Nm gastric emptying study (78264) |
$2,706.30 |
$3,007 |
6.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$682.20 |
$758 |
6.3× |
| Osseous survey limited (77074) |
$945 |
$1,050 |
8.7× |
| Parathyroid imaging (78070) |
$1,723.50 |
$1,915 |
4.2× |
| Pelvis 1 or 2 views (72170) |
$419.40 |
$466 |
3.9× |
| PET image w/CT, skull-thigh (78815) |
$6,885.90 |
$7,651 |
4.6× |
| PET imaging for CT attenuation whole body (78816) |
$7,939.80 |
$8,822 |
5.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,522.60 |
$3,914 |
9.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,850.40 |
$2,056 |
4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,817.90 |
$3,131 |
5.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$668.70 |
$743 |
6.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$647.10 |
$719 |
6.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$593.10 |
$659 |
5.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$448.20 |
$498 |
5.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$400.50 |
$445 |
4.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$675 |
$750 |
7.5× |
| Radiological examination surgical specimen (76098) |
$253.80 |
$282 |
0.4× |
| Ribs bilateral 3 views (71110) |
$793.80 |
$882 |
7.3× |
| Sacroiliac Joints < 3 Views (72200) |
$420.30 |
$467 |
3.9× |
| Scapula complete (73010) |
$458.10 |
$509 |
4.2× |
| Screening digital breast tomosynthesis (77063) |
$56.70 |
$63 |
2.4× |
| Small bowel series (74250) |
$1,037.70 |
$1,153 |
5.7× |
| Spine thoracic 3 views (72072) |
$660.60 |
$734 |
6.1× |
| Testicular Imaging With Vascular Flow (78761) |
$1,787.40 |
$1,986 |
4.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,281.60 |
$1,424 |
3.1× |
| Tmj unilateral (70328) |
$531.90 |
$591 |
5.9× |
| Ultrasound, abdomen limited (76705) |
$855.90 |
$951 |
7.9× |
| Unlisted Ultrasound Procedure (76999) |
$527.40 |
$586 |
5.8× |
| Upper Extremity Infant (73092) |
$405 |
$450 |
3.7× |
| Urethrocystography retrograde rs&i (74450) |
$1,067.40 |
$1,186 |
4.3× |
| Urethrocystography voiding (74455) |
$802.80 |
$892 |
3.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$3,248.10 |
$3,609 |
17.8× |
| Us abdl aorta screen aaa (76706) |
$828.90 |
$921 |
7.6× |
| Us breast unilateral complete (76641) |
$834.75 |
$927.50 |
7.7× |
| Us breast unilateral limited (76642) |
$458.10 |
$509 |
5.1× |
| Us chest (76604) |
$613.80 |
$682 |
5.7× |
| Us compl joint r-t w/image documentation (76881) |
$662.40 |
$736 |
6.1× |
| Us ob transvaginal (76817) |
$781.20 |
$868 |
7.2× |
| Us pelvic non ob complete (76856) |
$992.70 |
$1,103 |
9.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$589.50 |
$655 |
5.4× |
| Us pregnancy ltd (76815) |
$526.50 |
$585 |
4.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$828 |
$920 |
7.6× |
| Us retroperitoneal complete (76770) |
$1,074.60 |
$1,194 |
9.9× |
| Us scrotum and contents (76870) |
$900.90 |
$1,001 |
8.3× |
| Us soft tissue head/neck (76536) |
$841.50 |
$935 |
7.8× |
| Wrist 2 views (73100) |
$328.50 |
$365 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$763.20 |
$848 |
7.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$419.40 |
$466 |
4.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$460.80 |
$512 |
5.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$378.90 |
$421 |
4.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$470.70 |
$523 |
5.2× |
| X-ray exam hip uni 1 view (73501) |
$315.90 |
$351 |
3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$461.70 |
$513 |
5.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$642.60 |
$714 |
5.9× |
| X-ray eye for foreign body (70030) |
$387 |
$430 |
4.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$593.10 |
$659 |
5.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$479.70 |
$533 |
5.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$345.60 |
$384 |
3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$415.80 |
$462 |
4.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$679.50 |
$755 |
6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$337.50 |
$375 |
3.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$365.40 |
$406 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$613.80 |
$682 |
5.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$872.10 |
$969 |
8.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$488.70 |
$543 |
5.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$477.90 |
$531 |
5.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$632.70 |
$703 |
5.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$577.80 |
$642 |
6.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$792 |
$880 |
7.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$729.90 |
$811 |
6.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$506.70 |
$563 |
4.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$437.40 |
$486 |
4.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$530.10 |
$589 |
5.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$612.90 |
$681 |
6.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$360.90 |
$401 |
4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$577.80 |
$642 |
5.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$428.40 |
$476 |
3.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$367.20 |
$408 |
4.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$441.90 |
$491 |
4.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$470.70 |
$523 |
5.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$506.70 |
$563 |
4.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$324.90 |
$361 |
3.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$449.10 |
$499 |
5.0× |
| Xr c-spine 6 or more views (72052) |
$1,354.50 |
$1,505 |
12.5× |
| Xr finger(s) 2+ views (73140) |
$324.90 |
$361 |
3.6× |
| Xr shoulder 1 view (73020) |
$419.40 |
$466 |
4.6× |
| Xr spine cervical 4 or 5 views (72050) |
$706.50 |
$785 |
6.5× |
| Xr tibia/fibula 2 views (73590) |
$441.90 |
$491 |
4.9× |
| Xr tmj bilateral (70330) |
$558 |
$620 |
6.2× |
| Xray knee 1 or 2 views rt (73560) |
$597.60 |
$664 |
6.6× |