| Abdomen 2 views (74019) |
$439.20 |
$732 |
4.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,119.60 |
$1,866 |
3.0× |
| Ankle 2 views (73600) |
$305.40 |
$509 |
3.7× |
| Arthrogram shoulder (73040) |
$709.20 |
$1,182 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,458.60 |
$2,431 |
3.9× |
| Bone &/joint imaging whole body (78306) |
$1,750.20 |
$2,917 |
4.7× |
| Bone age studies (77072) |
$332.40 |
$554 |
3.4× |
| Bone Imaging 3 Phase (78315) |
$1,192.20 |
$1,987 |
3.2× |
| Bone survey complete (77075) |
$1,138.80 |
$1,898 |
11.6× |
| Cervical spine 2 or 3 views (72040) |
$379.80 |
$633 |
4.7× |
| Chest 1 view (71045) |
$250.20 |
$417 |
3.1× |
| Chest 3 views (71047) |
$332.40 |
$554 |
4.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$439.20 |
$732 |
2.7× |
| Clavicle complete (73000) |
$332.40 |
$554 |
4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,073 |
$3,455 |
21.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,546.40 |
$9,244 |
16.9× |
| CT abdomen and pelvis without contrast (74176) |
$3,785.40 |
$6,309 |
16.9× |
| CT abdomen w contrast (74160) |
$2,214.60 |
$3,691 |
13.5× |
| CT abdomen w wo contrast (74170) |
$2,644.20 |
$4,407 |
16.1× |
| CT abdomen w/o contrast (74150) |
$1,794 |
$2,990 |
18.3× |
| CT angiography upper extremity lt (73206) |
$2,345.40 |
$3,909 |
14.3× |
| CT c-spine w/o contrast (72125) |
$2,874.60 |
$4,791 |
29.3× |
| CT cervical spine with contrast (72126) |
$2,881.80 |
$4,803 |
8.8× |
| CT chest w/wo contrast (71270) |
$3,396 |
$5,660 |
20.6× |
| CT chest with contrast (71260) |
$2,839.20 |
$4,732 |
17.3× |
| CT head/brain with contrast (70460) |
$1,848 |
$3,080 |
11.2× |
| CT head/brain without and with contrast (70470) |
$2,624.40 |
$4,374 |
15.9× |
| CT iac w contrast (70481) |
$2,696.40 |
$4,494 |
16.4× |
| CT lower ext w/o (73700) |
$2,133.60 |
$3,556 |
21.8× |
| CT lower extremity with contrast (73701) |
$2,344.20 |
$3,907 |
14.2× |
| CT lumbar spine w & w/o contrast (72133) |
$3,409.80 |
$5,683 |
20.7× |
| CT lumbar spine w/o contrast (72131) |
$2,725.20 |
$4,542 |
27.8× |
| CT lumbar spine with contrast (72132) |
$2,876.40 |
$4,794 |
8.8× |
| CT maxillofacial w contrast (70487) |
$1,735.20 |
$2,892 |
10.5× |
| CT maxillofacial w/o contrast (70486) |
$2,133.60 |
$3,556 |
21.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,966.80 |
$3,278 |
12.0× |
| CT neck soft tissue w contrast (70491) |
$2,696.40 |
$4,494 |
16.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,966.80 |
$3,278 |
12.0× |
| CT orbits w/o contrast (70480) |
$2,133.60 |
$3,556 |
21.8× |
| CT pelvis w/o contrast (72192) |
$1,989.60 |
$3,316 |
20.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,058.20 |
$5,097 |
18.6× |
| CT soft tissue neck w/o contrast (70490) |
$2,133.60 |
$3,556 |
21.8× |
| CT thoracic spine w/o contrast (72128) |
$2,931 |
$4,885 |
29.9× |
| CT thoracic spine w/wo contrast (72130) |
$3,920.40 |
$6,534 |
23.8× |
| CT thorax w/o contrast (71250) |
$2,073 |
$3,455 |
21.1× |
| CT upper extremity w/o contrast rt (73200) |
$2,133.60 |
$3,556 |
21.8× |
| CT upper extremity with contrast (73201) |
$2,343 |
$3,905 |
7.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,450.60 |
$5,751 |
21.0× |
| Cta Abdomen (74175) |
$2,345.40 |
$3,909 |
14.3× |
| CTA abdomen pelvis (74174) |
$5,409.60 |
$9,016 |
16.5× |
| CTA chest (71275) |
$3,010.20 |
$5,017 |
18.3× |
| Cta Head (70496) |
$2,345.40 |
$3,909 |
14.3× |
| CTA lwr ext w&w/o contrast (73706) |
$3,518.40 |
$5,864 |
21.4× |
| Cta Neck (70498) |
$2,457 |
$4,095 |
14.9× |
| Cystography minimum 3 views rs&i (74430) |
$294.60 |
$491 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$682.20 |
$1,137 |
7.0× |
| Esophagus (74220) |
$351 |
$585 |
2.1× |
| Fluoroscopy up to 1 hr (76000) |
$470.40 |
$784 |
2.1× |
| Foot 2 views (73620) |
$302.40 |
$504 |
3.7× |
| Forearm 2 views (73090) |
$325.20 |
$542 |
4.0× |
| Gated Heart Planar Single (78472) |
$583.80 |
$973 |
1.6× |
| Hand 2 views (73120) |
$394.20 |
$657 |
4.0× |
| Hand 3 views (73130) |
$337.80 |
$563 |
4.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,750.20 |
$2,917 |
3.4× |
| Ht muscle image spect sing (78451) |
$2,099.40 |
$3,499 |
1.7× |
| Humerus Min 2 Views Left (73060) |
$332.40 |
$554 |
4.1× |
| Knee 3 views (73562) |
$454.20 |
$757 |
5.6× |
| Lymphoscintigraphy (78195) |
$385.20 |
$642 |
0.8× |
| Meckels Diverticulum (78290) |
$1,297.80 |
$2,163 |
3.5× |
| MRA head w & w/o contrast (70546) |
$3,322.20 |
$5,537 |
10.1× |
| MRA head w/o contrast (70544) |
$3,322.20 |
$5,537 |
14.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,322.20 |
$5,537 |
10.1× |
| MRA neck w/o contrast (70547) |
$3,322.20 |
$5,537 |
14.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,188.40 |
$5,314 |
9.7× |
| MRI abdomen w/o contrast (74181) |
$3,188.40 |
$5,314 |
14.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,829.20 |
$6,382 |
5.2× |
| MRI cervical spine w/o contrast (72141) |
$4,480.80 |
$7,468 |
20.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,388.20 |
$5,647 |
15.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,892.80 |
$6,488 |
17.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$6,114.60 |
$10,191 |
18.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,892.80 |
$6,488 |
11.9× |
| MRI pelvis w/o contrast (72195) |
$3,892.80 |
$6,488 |
17.4× |
| MRI scan of arm joint before and after contrast (73223) |
$3,823.20 |
$6,372 |
11.7× |
| MRI scan of leg joint before and after contrast (73723) |
$3,823.20 |
$6,372 |
11.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,679.80 |
$11,133 |
20.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,747 |
$6,245 |
11.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,486.20 |
$7,477 |
13.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,819.60 |
$6,366 |
11.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,808.60 |
$9,681 |
17.7× |
| MRI thoracic spine w/o contrast (72146) |
$3,892.80 |
$6,488 |
17.4× |
| MRI upper ext joint w/o contrast (73221) |
$3,829.20 |
$6,382 |
17.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,823.20 |
$6,372 |
11.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,755.80 |
$4,593 |
12.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,611.80 |
$4,353 |
2.2× |
| Neck soft tissue (70360) |
$305.40 |
$509 |
3.7× |
| Nm gastric emptying study (78264) |
$1,550.40 |
$2,584 |
4.1× |
| Osseous survey infant (77076) |
$383.40 |
$639 |
3.9× |
| Pelvis 1 or 2 views (72170) |
$332.40 |
$554 |
3.4× |
| PET image w/CT, skull-thigh (78815) |
$5,165.40 |
$8,609 |
3.8× |
| PET imaging for CT attenuation whole body (78816) |
$5,165.40 |
$8,609 |
3.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,829.20 |
$6,382 |
11.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$956.40 |
$1,594 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,016 |
$3,360 |
4.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$744 |
$1,240 |
7.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$652.50 |
$1,087.50 |
6.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$946.80 |
$1,578 |
9.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$549.60 |
$916 |
5.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$332.40 |
$554 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$294.60 |
$491 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$904.20 |
$1,507 |
5.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,225.20 |
$2,042 |
7.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,149 |
$1,915 |
7.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$332.40 |
$554 |
4.1× |
| Ribs bilateral 3 views (71110) |
$667.20 |
$1,112 |
6.8× |
| Sacroiliac Joints < 3 Views (72200) |
$285.60 |
$476 |
2.9× |
| Scapula complete (73010) |
$332.40 |
$554 |
3.4× |
| Screening digital breast tomosynthesis (77063) |
$40.20 |
$67 |
1.7× |
| Spine thoracic 3 views (72072) |
$511.20 |
$852 |
5.2× |
| Thoracolumbar 2 views (72080) |
$454.80 |
$758 |
5.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$871.80 |
$1,453 |
2.3× |
| Tmj unilateral (70328) |
$223.80 |
$373 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$743.40 |
$1,239 |
7.6× |
| Upper Extremity Infant (73092) |
$249 |
$415 |
2.5× |
| Us abdl aorta screen aaa (76706) |
$464.40 |
$774 |
4.7× |
| Us breast unilateral complete (76641) |
$516.60 |
$861 |
5.3× |
| Us breast unilateral limited (76642) |
$259.80 |
$433 |
3.2× |
| Us chest (76604) |
$792 |
$1,320 |
8.1× |
| Us compl joint r-t w/image documentation (76881) |
$261 |
$435 |
2.7× |
| Us infant hips dynamic (76885) |
$753.60 |
$1,256 |
9.2× |
| Us kidney transplant (76776) |
$289.20 |
$482 |
2.9× |
| Us ob transvaginal (76817) |
$934.20 |
$1,557 |
9.5× |
| Us pelvic non ob complete (76856) |
$1,023.60 |
$1,706 |
10.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$666.60 |
$1,111 |
6.8× |
| Us pregnancy ltd (76815) |
$744 |
$1,240 |
7.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$871.80 |
$1,453 |
8.9× |
| Us retroperitoneal complete (76770) |
$654 |
$1,090 |
6.7× |
| Us retroperitoneal limited (76775) |
$289.20 |
$482 |
2.9× |
| Us scrotum and contents (76870) |
$1,164.60 |
$1,941 |
11.9× |
| Us soft tissue head/neck (76536) |
$102.60 |
$171 |
1.0× |
| Us transrectal prostate volume (76873) |
$192 |
$320 |
2.0× |
| Us xtr non-vasc lmtd (76882) |
$169.20 |
$282 |
1.7× |
| Wrist 2 views (73100) |
$302.40 |
$504 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$740.40 |
$1,234 |
7.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$383.40 |
$639 |
4.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$363 |
$605 |
4.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$983.40 |
$1,639 |
6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$215.40 |
$359 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$382.20 |
$637 |
4.7× |
| X-ray exam hip uni 1 view (73501) |
$243 |
$405 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$253.20 |
$422 |
3.1× |
| X-ray exam hip uni 4/> views (73503) |
$263.40 |
$439 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$648 |
$1,080 |
6.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$34.80 |
$58 |
0.4× |
| X-ray exam of femur 1 (73551) |
$163.20 |
$272 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$493.20 |
$822 |
5.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$249 |
$415 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$343.80 |
$573 |
4.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$325.20 |
$542 |
4.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$124.20 |
$207 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$454.20 |
$757 |
4.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$500.40 |
$834 |
6.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$223.80 |
$373 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$388.80 |
$648 |
4.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$761.40 |
$1,269 |
7.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$337.80 |
$563 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$332.40 |
$554 |
4.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$396 |
$660 |
4.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$377.40 |
$629 |
3.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$433.20 |
$722 |
5.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$527.40 |
$879 |
5.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$758.40 |
$1,264 |
7.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$490.80 |
$818 |
5.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$379.80 |
$633 |
4.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$332.40 |
$554 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$546.60 |
$911 |
6.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$292.20 |
$487 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$541.20 |
$902 |
5.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$330.60 |
$551 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$292.20 |
$487 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$332.40 |
$554 |
4.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$454.80 |
$758 |
4.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$553.80 |
$923 |
5.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$252.60 |
$421 |
3.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$374.40 |
$624 |
4.6× |
| Xr c-spine 6 or more views (72052) |
$537 |
$895 |
5.5× |
| Xr chest 4+ views (71048) |
$388.80 |
$648 |
4.0× |
| Xr finger(s) 2+ views (73140) |
$268.20 |
$447 |
3.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$569.40 |
$949 |
5.8× |
| Xr shoulder 1 view (73020) |
$292.20 |
$487 |
3.6× |
| Xr spine cervical 4 or 5 views (72050) |
$494.40 |
$824 |
5.0× |
| Xr tibia/fibula 2 views (73590) |
$343.80 |
$573 |
4.2× |
| Xr tmj bilateral (70330) |
$476.40 |
$794 |
5.8× |
| Xray knee 1 or 2 views rt (73560) |
$320.40 |
$534 |
3.9× |