| Abdomen 2 views (74019) |
$825.18 |
$2,062.96 |
8.1× |
| Acute gi blood loss imaging (78278) |
$1,294.95 |
$3,237.38 |
3.3× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$1,201.99 |
$3,004.97 |
1.0× |
| Angio Adrenal Bilat Select (75733) |
$8,470.19 |
$21,175.48 |
2.7× |
| Angiography extremity unilateral rs&i (75710) |
$8,470.19 |
$21,175.48 |
2.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$8,470.19 |
$21,175.48 |
1.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,470.19 |
$21,175.48 |
2.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,470.19 |
$21,175.48 |
2.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$8,470.19 |
$21,175.48 |
1.6× |
| Ankle 2 views (73600) |
$210.39 |
$525.97 |
2.5× |
| Aortogram thoracic (75605) |
$8,470.19 |
$21,175.48 |
1.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$8,470.19 |
$21,175.48 |
2.7× |
| Aortography abdominal serialography rs&i (75625) |
$8,470.19 |
$21,175.48 |
2.7× |
| Artery X-Rays Adrenal Gland (75731) |
$8,470.19 |
$21,175.48 |
2.7× |
| Arthrogram ankle (73615) |
$1,139.20 |
$2,848 |
3.3× |
| Arthrogram elbow (73085) |
$1,139.20 |
$2,848 |
3.3× |
| Arthrogram hip (73525) |
$1,190.46 |
$2,976.16 |
3.5× |
| Arthrogram knee (73580) |
$1,190.46 |
$2,976.16 |
3.5× |
| Arthrogram shoulder (73040) |
$1,190.46 |
$2,976.16 |
3.5× |
| Arthrogram wrist (73115) |
$1,139.20 |
$2,848 |
3.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,078.08 |
$2,695.19 |
2.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,069.10 |
$2,672.76 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$1,078.08 |
$2,695.19 |
2.8× |
| Bone age studies (77072) |
$301.72 |
$754.31 |
3.0× |
| Bone Imaging 3 Phase (78315) |
$1,161.82 |
$2,904.53 |
3.0× |
| Bone survey complete (77075) |
$686.62 |
$1,716.56 |
6.7× |
| Bone survey infant (77076) |
$307.42 |
$768.56 |
3.0× |
| Brain Imaging Vascular Flow Only (78610) |
$998.12 |
$2,495.31 |
1.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,675.78 |
$4,189.44 |
4.3× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$3,189.27 |
$7,973.17 |
4.2× |
| Cervical spine 2 or 3 views (72040) |
$362.89 |
$907.23 |
4.3× |
| Chest 1 view (71045) |
$193.26 |
$483.14 |
2.3× |
| Chest xray 3 views (71047) |
$454.20 |
$1,135.51 |
5.3× |
| Cholecystography, oral contrast Non-Facility (74290) |
$74.20 |
$185.50 |
0.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$466.44 |
$1,166.10 |
2.7× |
| Clavicle complete (73000) |
$337.60 |
$844.01 |
4.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$815.35 |
$2,038.38 |
8.0× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$63.20 |
$158 |
0.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,022.92 |
$7,557.30 |
8.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,103.89 |
$5,259.72 |
9.0× |
| CT abdomen w contrast (74160) |
$1,698.35 |
$4,245.88 |
9.9× |
| CT abdomen w wo contrast (74170) |
$1,638.90 |
$4,097.26 |
9.6× |
| CT abdomen w/o contrast (74150) |
$1,167.04 |
$2,917.59 |
11.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,715.73 |
$4,289.32 |
10.0× |
| CT angiography upper extremity lt (73206) |
$1,715.73 |
$4,289.32 |
10.0× |
| CT c-spine w/contrast (72126) |
$1,677.40 |
$4,193.50 |
4.9× |
| CT c-spine w/o contrast (72125) |
$1,404.23 |
$3,510.57 |
13.8× |
| CT cervical spine w&w/o contrast (72127) |
$2,098.18 |
$5,245.45 |
12.3× |
| CT chest w contrast (71260) |
$1,752.88 |
$4,382.21 |
10.2× |
| CT chest w/wo contrast (71270) |
$2,098.18 |
$5,245.45 |
12.3× |
| CT head/brain with contrast (70460) |
$1,407.48 |
$3,518.71 |
8.2× |
| CT head/brain without and with contrast (70470) |
$1,677.40 |
$4,193.50 |
9.8× |
| CT iac w contrast (70481) |
$1,407.48 |
$3,518.71 |
8.2× |
| CT limited/localized follow up study (76380) |
$546.36 |
$1,365.90 |
6.4× |
| CT lower ext w/o (73700) |
$1,179.16 |
$2,947.90 |
11.6× |
| CT lower extremity w wo contrast (73702) |
$1,759.77 |
$4,399.43 |
10.3× |
| CT lower extremity w/contrast material (73701) |
$1,407.48 |
$3,518.71 |
8.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,098.18 |
$5,245.45 |
12.3× |
| CT lumbar spine w/contrast (72132) |
$1,677.40 |
$4,193.50 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$1,404.23 |
$3,510.57 |
13.8× |
| CT maxillofacial w contrast (70487) |
$1,407.48 |
$3,518.71 |
8.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,677.40 |
$4,193.50 |
9.8× |
| CT maxillofacial wo contrast (70486) |
$1,052.46 |
$2,631.16 |
10.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,677.40 |
$4,193.50 |
9.8× |
| CT orbits w/o contrast (70480) |
$1,175.12 |
$2,937.82 |
11.5× |
| CT pelvis w/o contrast (72192) |
$1,141.67 |
$2,854.17 |
11.2× |
| CT pelvis w/wo contrast (72194) |
$2,015.82 |
$5,039.56 |
11.8× |
| CT scan of arm combo (73202) |
$1,759.77 |
$4,399.43 |
10.3× |
| CT soft tissue neck w contrast (70491) |
$1,407.48 |
$3,518.71 |
8.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,677.40 |
$4,193.50 |
9.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,124.52 |
$2,811.31 |
11.0× |
| CT thoracic spine w/contrast (72129) |
$1,677.40 |
$4,193.50 |
9.8× |
| CT thoracic spine w/o contrast (72128) |
$1,404.23 |
$3,510.57 |
13.8× |
| CT thoracic spine w/wo contrast (72130) |
$2,098.18 |
$5,245.45 |
12.3× |
| CT thorax w/o contrast (71250) |
$1,404.23 |
$3,510.57 |
13.8× |
| CT upper ext wo (73200) |
$1,179.16 |
$2,947.90 |
11.6× |
| CT upper extremity with contrast (73201) |
$1,407.48 |
$3,518.71 |
4.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,949.76 |
$4,874.41 |
11.4× |
| Cta Abdomen (74175) |
$1,949.76 |
$4,874.41 |
11.4× |
| CTA chest (71275) |
$2,028.05 |
$5,070.13 |
11.9× |
| Cta Head (70496) |
$1,668.44 |
$4,171.11 |
9.7× |
| Cta Neck (70498) |
$1,668.44 |
$4,171.11 |
9.7× |
| Cta Pelvis (72191) |
$1,949.76 |
$4,874.41 |
11.4× |
| Cystography minimum 3 views rs&i (74430) |
$746.96 |
$1,867.40 |
2.2× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$960.61 |
$2,401.52 |
4.1× |
| Diskogram cervical (72285) |
$6,490.26 |
$16,225.65 |
3.4× |
| Diskography lumbar (72295) |
$6,490.26 |
$16,225.65 |
3.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$804.86 |
$2,012.16 |
7.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$181.85 |
$454.62 |
2.1× |
| Esophagus (74220) |
$349.01 |
$872.53 |
2.0× |
| Facial bones min 3 views (70150) |
$415.06 |
$1,037.66 |
4.1× |
| Fetal biophysical profile non-stress testing (76818) |
$1,294.95 |
$3,237.38 |
12.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,176.72 |
$2,941.79 |
11.5× |
| Fluoroscopy up to 1 hr (76000) |
$358.81 |
$897.02 |
1.5× |
| Foot 2 views (73620) |
$219.36 |
$548.41 |
2.6× |
| Forearm 2 views (73090) |
$199.10 |
$497.75 |
2.3× |
| Gastric mucosa imaging (78261) |
$1,134.31 |
$2,835.77 |
2.9× |
| Hand 2 views (73120) |
$251.98 |
$629.94 |
2.5× |
| Heart first pass single,planar (78481) |
$1,209.34 |
$3,023.34 |
2.3× |
| Heart Infarct Image (78466) |
$1,209.34 |
$3,023.34 |
3.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,503.70 |
$3,759.26 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,503.70 |
$3,759.26 |
3.9× |
| Hysterosalpingogram (74740) |
$960.61 |
$2,401.52 |
4.1× |
| Interstitial radiation source applic complex (77778) |
$3,411.89 |
$8,529.73 |
5.0× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$709.46 |
$1,773.66 |
1.8× |
| Kidney imaging morphology (78700) |
$1,352.38 |
$3,380.93 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,433.60 |
$3,583.99 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,294.14 |
$3,235.34 |
2.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,458.04 |
$3,645.09 |
2.8× |
| Knee 3 views (73562) |
$454.20 |
$1,135.51 |
5.3× |
| Liver & spleen imaging static only (78215) |
$1,192.20 |
$2,980.51 |
3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,277.84 |
$3,194.59 |
3.3× |
| Liver imaging static only (78201) |
$1,409.11 |
$3,522.78 |
2.7× |
| Liver imaging w/vascular flow (78202) |
$1,192.20 |
$2,980.51 |
2.3× |
| Lung perf&ventilat diferentl (78598) |
$1,285.98 |
$3,214.94 |
2.4× |
| Lung perfusion differential (78597) |
$912.51 |
$2,281.27 |
2.3× |
| Lung ventilation imaging (78579) |
$822.80 |
$2,057 |
2.1× |
| Lymphoscintigraphy (78195) |
$1,038.08 |
$2,595.21 |
2.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,097.94 |
$7,744.85 |
4.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$3,263.47 |
$8,158.68 |
9.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,691.84 |
$6,729.59 |
7.9× |
| Mammary ductogram or galactogram single (77053) |
$960.61 |
$2,401.52 |
4.1× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$234.03 |
$585.08 |
2.8× |
| MRA head w & w/o contrast (70546) |
$5,404.88 |
$13,512.19 |
15.9× |
| MRA head w/o contrast (70544) |
$2,761.97 |
$6,904.93 |
11.9× |
| MRA head with contrast (70545) |
$2,761.97 |
$6,904.93 |
8.1× |
| MRA neck w contrast (70548) |
$2,761.97 |
$6,904.93 |
8.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,404.88 |
$13,512.19 |
15.9× |
| MRA neck w/o contrast (70547) |
$2,761.97 |
$6,904.93 |
11.9× |
| MRI abdomen w contrast (74182) |
$3,105.27 |
$7,763.17 |
9.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,745.74 |
$14,364.34 |
16.9× |
| MRI abdomen w/o contrast (74181) |
$2,691.84 |
$6,729.59 |
11.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,097.94 |
$7,744.85 |
4.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,731.07 |
$14,327.67 |
16.8× |
| MRI breast w/o contrast bilateral (77047) |
$6,048.27 |
$15,120.67 |
26.0× |
| MRI breast wo contrast unilateral (77046) |
$4,458.94 |
$11,147.35 |
19.2× |
| MRI c-spine with contrast (72142) |
$3,225.96 |
$8,064.90 |
9.5× |
| MRI cardiac w/o contrast (75557) |
$2,691.84 |
$6,729.59 |
11.6× |
| MRI cervical spine w/o contrast (72141) |
$2,691.84 |
$6,729.59 |
11.6× |
| MRI chest w/o & w/contrast material (71552) |
$5,700.89 |
$14,252.22 |
16.7× |
| MRI chest w/o contrast (71550) |
$2,691.84 |
$6,729.59 |
11.6× |
| MRI chest with contrast (71551) |
$3,105.27 |
$7,763.17 |
4.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,097.94 |
$7,744.85 |
9.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,836.18 |
$7,090.46 |
8.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,580.92 |
$6,452.31 |
11.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,691.84 |
$6,729.59 |
11.6× |
| MRI orbit face neck w contrast (70542) |
$3,097.94 |
$7,744.85 |
9.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,731.07 |
$14,327.67 |
16.8× |
| MRI pelvis w/contrast (72196) |
$2,691.84 |
$6,729.59 |
7.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,745.74 |
$14,364.34 |
16.9× |
| MRI pelvis w/o contrast (72195) |
$2,594.80 |
$6,487.01 |
11.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,975.69 |
$14,939.23 |
17.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,225.96 |
$8,064.90 |
9.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,379.84 |
$10,949.61 |
12.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,225.96 |
$8,064.90 |
9.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,384.24 |
$15,960.59 |
18.8× |
| MRI temporomandibular joint (70336) |
$2,691.84 |
$6,729.59 |
11.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,986.22 |
$7,465.55 |
12.8× |
| MRI up ext w/o contrast (73218) |
$2,722.02 |
$6,805.04 |
11.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,963.81 |
$7,409.53 |
12.7× |
| MRI, joint upper extrem combo (73223) |
$5,731.07 |
$14,327.67 |
16.8× |
| Myelogram Cervical (72240) |
$2,006.85 |
$5,017.12 |
2.6× |
| Myelogram Lumbar (72265) |
$2,006.85 |
$5,017.12 |
2.6× |
| Myelogram thoracic (72255) |
$2,006.85 |
$5,017.12 |
2.6× |
| Myelography 2 or more regions (72270) |
$2,006.85 |
$5,017.12 |
2.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,730.16 |
$6,825.41 |
2.2× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$2,730.16 |
$6,825.41 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,757.88 |
$6,894.71 |
2.2× |
| Myocardial spect single study at rest or stress (78451) |
$2,730.16 |
$6,825.41 |
2.2× |
| Neck soft tissue (70360) |
$267.47 |
$668.68 |
3.2× |
| Nm cardiac blood pool multiple (78473) |
$1,814.41 |
$4,536.02 |
4.7× |
| Nm cisternogram (78630) |
$2,492.86 |
$6,232.16 |
4.7× |
| Nm csf leak detection (78650) |
$2,492.86 |
$6,232.16 |
2.0× |
| Nm gastric emptying study (78264) |
$1,209.34 |
$3,023.34 |
3.1× |
| Nm gastroesophageal reflux study (78262) |
$1,324.31 |
$3,310.78 |
3.4× |
| Nm kidney scan w/flow (78701) |
$1,294.14 |
$3,235.34 |
3.3× |
| Noncardiac Vascular Flow Imaging (78445) |
$629.54 |
$1,573.84 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$1,232.16 |
$3,080.40 |
5.4× |
| Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) |
$995.68 |
$2,489.19 |
9.8× |
| Osseous survey limited (77074) |
$547.99 |
$1,369.97 |
5.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,166.12 |
$2,915.29 |
2.2× |
| Parathyroid Planar Imaging (78070) |
$897.82 |
$2,244.54 |
2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,100.88 |
$2,752.20 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$217.74 |
$544.34 |
2.1× |
| PET image w/CT, skull-thigh (78815) |
$4,266.50 |
$10,666.24 |
3.1× |
| PET imaging CT for attenuation limited area (78814) |
$4,266.50 |
$10,666.24 |
3.1× |
| PET imaging for CT attenuation whole body (78816) |
$4,266.50 |
$10,666.24 |
3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$975.30 |
$2,438.25 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,285.98 |
$3,214.94 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$960.61 |
$2,401.52 |
1.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$337.60 |
$844.01 |
4.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$240.57 |
$601.43 |
2.8× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$337.60 |
$844.01 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$307.42 |
$768.56 |
3.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$323.55 |
$808.87 |
3.2× |
| Radex fingr minimum 2 views (73140) |
$211.20 |
$528.01 |
2.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$308.25 |
$770.62 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$273.19 |
$682.97 |
3.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$206.22 |
$515.55 |
2.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$273.19 |
$682.97 |
2.7× |
| Radex Humerus Minimum 2 Views (73060) |
$267.47 |
$668.68 |
3.2× |
| Radex Kne 1/2 Views (73560) |
$210.39 |
$525.97 |
2.5× |
| Radex Kne Compl 4/More Views (73564) |
$419.96 |
$1,049.91 |
4.1× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$450.95 |
$1,127.37 |
4.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$278.07 |
$695.18 |
3.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$273.19 |
$682.97 |
2.7× |
| Radex Sho Compl Minimum 2 Views (73030) |
$337.60 |
$844.01 |
4.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$240.57 |
$601.43 |
2.8× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$182.66 |
$456.65 |
1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$468.08 |
$1,170.19 |
5.5× |
| Radex Toe Minimum 2 Views (73660) |
$226.70 |
$566.76 |
2.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$220.18 |
$550.44 |
2.2× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$273.19 |
$682.97 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$246.21 |
$615.52 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$825.18 |
$2,062.96 |
8.1× |
| Radiologic exam chest 2 views (71046) |
$335.16 |
$837.90 |
3.9× |
| Radiologic exam colon single contrast study (74270) |
$412.62 |
$1,031.56 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$380.42 |
$951.06 |
2.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$419.61 |
$1,049.02 |
2.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$253.61 |
$634.03 |
3.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$337.60 |
$844.01 |
4.0× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$309.07 |
$772.67 |
0.6× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$459.92 |
$1,149.80 |
4.5× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$392.84 |
$982.10 |
3.9× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$358.81 |
$897.02 |
4.2× |
| Radiological examination surgical specimen (76098) |
$1,726.32 |
$4,315.81 |
3.2× |
| Renal Cyst Study (74470) |
$960.61 |
$2,401.52 |
1.8× |
| Ribs bilateral 3 views (71110) |
$375.92 |
$939.81 |
3.7× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,035.68 |
$2,589.20 |
2.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,626.97 |
$4,067.43 |
4.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,995.76 |
$9,989.39 |
7.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,455.84 |
$6,139.60 |
4.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,812.36 |
$4,530.91 |
3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,853.30 |
$7,133.24 |
2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,853.30 |
$7,133.24 |
2.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,853.30 |
$7,133.24 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$228.33 |
$570.83 |
2.2× |
| Scapula (73010) |
$337.60 |
$844.01 |
3.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$64.24 |
$160.62 |
2.7× |
| Sella turcica (70240) |
$228.33 |
$570.83 |
2.7× |
| Shoulder 1 view (73020) |
$197.35 |
$493.38 |
2.3× |
| Sialogram (70390) |
$960.61 |
$2,401.52 |
4.1× |
| Small bowel series (74250) |
$362.66 |
$906.63 |
2.1× |
| Special dosimetry (77331) |
$437.90 |
$1,094.75 |
3.3× |
| Spine thoracic 3 views (72072) |
$353.09 |
$882.73 |
3.5× |
| Spleen imaging only (78185) |
$1,038.08 |
$2,595.21 |
2.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$144.40 |
$361 |
1.5× |
| Testicular Imaging With Vascular Flow (78761) |
$1,384.65 |
$3,461.63 |
3.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,072.33 |
$2,680.83 |
2.9× |
| Thoracolumbar 2 views (72080) |
$280.52 |
$701.29 |
3.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,137.57 |
$2,843.93 |
2.1× |
| Thyroid imaging w/blood flow (78013) |
$827.69 |
$2,069.23 |
2.1× |
| Thyroid uptake measurement (78012) |
$424.75 |
$1,061.87 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$889.67 |
$2,224.18 |
2.3× |
| Tmj unilateral (70328) |
$332.72 |
$831.80 |
3.9× |
| Tomogram (76100) |
$377.56 |
$943.90 |
3.7× |
| Treatment devices simple (77332) |
$813.84 |
$2,034.60 |
6.2× |
| Ultrasound breast complete (76641) |
$1,123.71 |
$2,809.27 |
11.0× |
| Ultrasound Exam Aaa Screen (76706) |
$481.12 |
$1,202.81 |
4.7× |
| Ultrasound, abdomen limited (76705) |
$713.44 |
$1,783.61 |
7.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$601.38 |
$1,503.46 |
7.1× |
| Unlisted ultrasound procedure (76999) |
$313.14 |
$782.86 |
3.7× |
| Ureteral reflux study (78740) |
$1,294.14 |
$3,235.34 |
3.3× |
| Urethrocystogram voiding (74455) |
$746.96 |
$1,867.40 |
3.2× |
| Urethrocystography retrograde rs&i (74450) |
$746.96 |
$1,867.40 |
3.2× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$746.96 |
$1,867.40 |
4.4× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$746.96 |
$1,867.40 |
4.4× |
| Us breast unilateral limited (76642) |
$561.85 |
$1,404.62 |
6.6× |
| Us chest (76604) |
$1,105.24 |
$2,763.10 |
10.8× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$534.13 |
$1,335.32 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$1,166.92 |
$2,917.31 |
11.4× |
| Us encephalogram (76506) |
$1,340.62 |
$3,351.56 |
13.1× |
| Us ob detailed single fetus (76811) |
$106 |
$265 |
0.5× |
| Us ob limited (76815) |
$1,153.07 |
$2,882.67 |
11.3× |
| Us ob transvaginal (76817) |
$494.99 |
$1,237.47 |
4.9× |
| Us pelvic non ob complete (76856) |
$1,353.67 |
$3,384.17 |
13.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$757.27 |
$1,893.18 |
7.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$481.12 |
$1,202.81 |
4.7× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$313.14 |
$782.86 |
3.1× |
| Us retroperitoneal complete (76770) |
$733.27 |
$1,833.18 |
7.2× |
| Us retroperitoneal limited (76775) |
$741.25 |
$1,853.13 |
7.3× |
| Us scrotum and contents (76870) |
$1,385.47 |
$3,463.67 |
13.6× |
| Us soft tissue head/neck (76536) |
$949.19 |
$2,372.98 |
9.3× |
| Us spinal canal and contents (76800) |
$600.18 |
$1,500.46 |
5.9× |
| Us transrectal (76872) |
$1,701.06 |
$4,252.64 |
16.7× |
| Us, eye b-scan (76512) |
$1,144.10 |
$2,860.25 |
11.2× |
| Venogram extremity bilateral (75822) |
$2,677.98 |
$6,694.95 |
1.7× |
| Venogram Extremity Unilateral (75820) |
$2,677.98 |
$6,694.95 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$8,470.19 |
$21,175.48 |
2.7× |
| Venography caval superior serialography rs&i (75827) |
$2,677.98 |
$6,694.95 |
1.7× |
| Venous sampling by catheter (75893) |
$8,470.19 |
$21,175.48 |
1.6× |
| Wrist 2 views (73100) |
$251.98 |
$629.94 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$429.75 |
$1,074.37 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$264.21 |
$660.53 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$470.06 |
$1,175.14 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$280.52 |
$701.29 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$228.33 |
$570.83 |
2.7× |
| X-ray exam of femur 2/> (73552) |
$239.76 |
$599.39 |
2.8× |
| X-ray eye for foreign body (70030) |
$263.40 |
$658.50 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$217.74 |
$544.34 |
2.6× |
| X-ray IV pyelogram (ivp) (74400) |
$822.80 |
$2,057 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$280.52 |
$701.29 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$255.23 |
$638.08 |
3.0× |
| X-ray leg, infant (73592) |
$217.74 |
$544.34 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$366.96 |
$917.41 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$653.18 |
$1,632.95 |
6.4× |
| X-ray nose-rectum child f.b. (76010) |
$336.79 |
$841.97 |
4.0× |
| X-ray optic foramen (70190) |
$255.23 |
$638.08 |
3.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$400.39 |
$1,000.98 |
3.9× |
| X-ray retrograde pyelogram (74420) |
$746.96 |
$1,867.40 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$329.44 |
$823.60 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$401.22 |
$1,003.04 |
3.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$507.22 |
$1,268.05 |
5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$384.09 |
$960.22 |
3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$335.16 |
$837.90 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$255.99 |
$639.98 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$494.18 |
$1,235.45 |
4.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$245.31 |
$613.28 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$182.66 |
$456.65 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$260.14 |
$650.35 |
3.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$375.12 |
$937.79 |
4.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$332.72 |
$831.80 |
3.3× |
| Xr bone length studies (77073) |
$328.63 |
$821.58 |
3.2× |
| Xr c-spine 4 or 5 views (72050) |
$412.62 |
$1,031.56 |
4.0× |
| Xr c-spine 6 or more views (72052) |
$591.21 |
$1,478.03 |
5.8× |
| Xr chest 4+ views (71048) |
$495.08 |
$1,237.71 |
4.9× |
| Xr urogram antegrade (74425) |
$746.96 |
$1,867.40 |
2.2× |