| Abdomen 1 View (74018) |
$256.50 |
$342 |
3.1× |
| Abdomen 2 views (74019) |
$442.50 |
$590 |
4.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,626 |
$2,168 |
4.3× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$632.25 |
$843 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$4,122.75 |
$5,497 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$3,324 |
$4,432 |
1.1× |
| Ankle 2 views (73600) |
$398.25 |
$531 |
4.8× |
| Aortography thoracic serialography rs&i (75605) |
$4,972.50 |
$6,630 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$3,186 |
$4,248 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$4,369.50 |
$5,826 |
0.8× |
| Artery X-Rays Spine (75705) |
$2,771.25 |
$3,695 |
0.5× |
| Arthrogram hip (73525) |
$1,169.25 |
$1,559 |
3.5× |
| Arthrogram Wrist (73115) |
$417.75 |
$557 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$877.50 |
$1,170 |
6.9× |
| Bone age studies (77072) |
$327 |
$436 |
3.3× |
| Bone Imaging 3 Phase (78315) |
$2,654.25 |
$3,539 |
7.0× |
| Bone Imaging Whole Body (78306) |
$1,601.25 |
$2,135 |
4.2× |
| Bone survey infant (77076) |
$216 |
$288 |
2.2× |
| Brain Flow Imaging Only (78610) |
$407.25 |
$543 |
0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,298.25 |
$5,731 |
3.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,339 |
$4,452 |
10.1× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$4,399.50 |
$5,866 |
5.9× |
| Cat Scan Follow-Up Study (76380) |
$728.25 |
$971 |
8.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,124.25 |
$1,499 |
2.2× |
| Cerebrospinal Fluid Scan (78630) |
$1,859.25 |
$2,479 |
3.6× |
| Chest 1 view (71045) |
$321 |
$428 |
3.9× |
| Chest 2 views (71046) |
$375.75 |
$501 |
4.6× |
| Chest 3 views (71047) |
$329.25 |
$439 |
4.0× |
| Chest 4 or more views (71048) |
$450.75 |
$601 |
4.6× |
| Clavicle complete (73000) |
$281.25 |
$375 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$138.75 |
$185 |
1.4× |
| Contrast Exam Abdominl Aorta (75625) |
$4,356 |
$5,808 |
1.5× |
| Contrast X-Ray Bladder (74430) |
$738.75 |
$985 |
2.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$919.50 |
$1,226 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,399.25 |
$3,199 |
7.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,222.25 |
$2,963 |
9.8× |
| CT abdomen w contrast (74160) |
$1,711.50 |
$2,282 |
10.3× |
| CT abdomen w wo contrast (74170) |
$1,899 |
$2,532 |
11.4× |
| CT abdomen w/o contrast (74150) |
$1,506.75 |
$2,009 |
15.2× |
| CT Angio Abdomen and Pelvis (74174) |
$2,834.25 |
$3,779 |
8.6× |
| CT Angio Chest (71275) |
$2,384.25 |
$3,179 |
14.4× |
| CT Angio Head (70496) |
$1,951.50 |
$2,602 |
11.8× |
| CT angio hrt w/3d image (75574) |
$2,464.50 |
$3,286 |
7.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,212.50 |
$2,950 |
13.3× |
| CT Angio Neck (70498) |
$1,781.25 |
$2,375 |
10.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,781.25 |
$2,375 |
10.7× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$599.25 |
$799 |
3.6× |
| CT cervical spine w/ contrast (72126) |
$1,719.75 |
$2,293 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,556.25 |
$2,075 |
15.7× |
| CT chest w contrast (71260) |
$1,697.25 |
$2,263 |
10.2× |
| CT chest w/wo contrast (71270) |
$2,292.75 |
$3,057 |
13.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$2,472 |
$3,296 |
25.0× |
| CT head/brain with contrast (70460) |
$1,619.25 |
$2,159 |
9.8× |
| CT head/brain without and with contrast (70470) |
$1,781.25 |
$2,375 |
10.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,303.75 |
$4,405 |
10.0× |
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines |
$81–$2,629.50 |
$108–$3,506 |
varies |
| CT hrt w/3d image congen (75573) |
$2,772 |
$3,696 |
8.4× |
| CT iac w contrast (70481) |
$1,689 |
$2,252 |
10.2× |
| CT l-spine w&w/o contrast (72133) |
$2,060.25 |
$2,747 |
12.4× |
| CT lower ext w/o (73700) |
$1,471.50 |
$1,962 |
14.9× |
| CT lower extremity w/contrast material (73701) |
$1,619.25 |
$2,159 |
9.8× |
| CT lumbar spine w contrast (72132) |
$1,894.50 |
$2,526 |
5.7× |
| CT lumbar spine w/o contrast (72131) |
$1,668.75 |
$2,225 |
16.9× |
| CT maxillofacial w contrast (70487) |
$1,619.25 |
$2,159 |
9.8× |
| CT maxillofacial wo contrast (70486) |
$1,471.50 |
$1,962 |
14.9× |
| CT neck tissue combo (70492) |
$1,781.25 |
$2,375 |
10.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,781.25 |
$2,375 |
10.7× |
| CT orbits w/o contrast (70480) |
$1,471.50 |
$1,962 |
14.9× |
| CT pelvis w&w/o contrast (72194) |
$2,050.50 |
$2,734 |
12.4× |
| CT pelvis w/o contrast (72192) |
$1,471.50 |
$1,962 |
14.9× |
| CT scan of leg combo (73702) |
$1,781.25 |
$2,375 |
10.7× |
| CT scans face/jaw combo (70488) |
$1,781.25 |
$2,375 |
10.7× |
| CT soft tissue neck w contrast (70491) |
$1,739.25 |
$2,319 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,471.50 |
$1,962 |
14.9× |
| CT thoracic spine w contrast (72129) |
$1,619.25 |
$2,159 |
9.8× |
| CT thoracic spine w/o contrast (72128) |
$1,473.75 |
$1,965 |
14.9× |
| CT thoracic spine w/wo cont (72130) |
$2,060.25 |
$2,747 |
12.4× |
| CT thorax w/o contrast (71250) |
$1,471.50 |
$1,962 |
14.9× |
| CT unlisted procedure (76497) |
$1,518 |
$2,024 |
18.4× |
| CT upper ext wo (73200) |
$1,518.75 |
$2,025 |
15.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,424.75 |
$3,233 |
14.6× |
| CT upper extremity with contrast (73201) |
$1,764 |
$2,352 |
5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,851.50 |
$3,802 |
17.2× |
| Cta Abdomen (74175) |
$2,404.50 |
$3,206 |
14.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,781.25 |
$2,375 |
5.4× |
| CTA pelvis (72191) |
$2,262 |
$3,016 |
13.6× |
| Discography Cerv/Thor Spine (72285) |
$1,564.50 |
$2,086 |
0.8× |
| Diskography lumbar (72295) |
$2,690.25 |
$3,587 |
1.5× |
| Dxa Bone Density Axial (77080) |
$420 |
$560 |
4.2× |
| Dxa bone density study (77085) |
$786.75 |
$1,049 |
8.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$385.50 |
$514 |
4.7× |
| Echo exam uterus (76831) |
$634.50 |
$846 |
2.8× |
| Echograp Trans R Pros Study (76873) |
$964.50 |
$1,286 |
9.8× |
| Esophagram (74220) |
$570 |
$760 |
3.4× |
| Fetal Biophys Profile W/Nst (76818) |
$872.25 |
$1,163 |
8.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$734.25 |
$979 |
7.4× |
| Fluoroscopy up to 1 hr (76000) |
$513 |
$684 |
2.3× |
| Follow-Up Angiography (75898) |
$2,403.75 |
$3,205 |
0.8× |
| Foot 2 views (73620) |
$398.25 |
$531 |
4.8× |
| Forearm 2 views (73090) |
$360.75 |
$481 |
4.4× |
| Gastric emptying imaging study (78264) |
$1,014 |
$1,352 |
2.7× |
| Gastroesophageal Reflux Exam (78262) |
$1,139.25 |
$1,519 |
3.0× |
| Gated Heart Planar Single (78472) |
$1,920 |
$2,560 |
5.1× |
| Hand 2 views (73120) |
$370.50 |
$494 |
3.7× |
| Heart Image (Pet) Multiple (78492) |
$4,901.25 |
$6,535 |
3.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,792.25 |
$3,723 |
0.9× |
| Hepatobil Syst Image W/Drug (78227) |
$2,082.75 |
$2,777 |
4.1× |
| Hepatobiliary System Imaging (78226) |
$1,753.50 |
$2,338 |
4.6× |
| Ht Musc Image Planar Mult (78454) |
$5,357.25 |
$7,143 |
4.4× |
| Ht Muscle Image Spect Sing (78451) |
$3,696.75 |
$4,929 |
3.0× |
| Hysterosalpingogram (74740) |
$915.75 |
$1,221 |
4.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$310.50 |
$414 |
3.8× |
| Infant hip ultrasound, limited static exam (76886) |
$295.50 |
$394 |
3.6× |
| Joint Survey Single View (77077) |
$343.50 |
$458 |
3.5× |
| K Flow/Funct Image W/Drug (78708) |
$1,410.75 |
$1,881 |
2.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,392 |
$1,856 |
2.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$1,131 |
$1,508 |
3.0× |
| Kidney Imaging Morphol (78700) |
$1,176.75 |
$1,569 |
3.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,312.50 |
$1,750 |
3.5× |
| Knee 3 Views (73562) |
$276.75 |
$369 |
3.4× |
| Liver & Spleen Imaging Static Only (78215) |
$895.50 |
$1,194 |
2.4× |
| Liver imaging static only (78201) |
$1,241.25 |
$1,655 |
2.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,059.50 |
$2,746 |
4.0× |
| Lung perfusion differential (78597) |
$1,438.50 |
$1,918 |
3.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,296.50 |
$3,062 |
4.5× |
| Lung Ventilation Imaging (78579) |
$383.25 |
$511 |
1.0× |
| Lymph System Imaging (78195) |
$1,681.50 |
$2,242 |
3.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$1,464.75 |
$1,953 |
0.5× |
| Magnetic Image Jaw Joint (70336) |
$2,332.50 |
$3,110 |
10.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$2,185.50 |
$2,914 |
13.2× |
| Meckels Divert Exam (78290) |
$1,365.75 |
$1,821 |
3.6× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$621 |
$828 |
1.8× |
| Mr safety determination physician/other qhp (76016) |
$85.50 |
$114 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$24 |
$32 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$90 |
$120 |
1.0× |
| Mr safety implt pos&/immoblj (76019) |
$58.50 |
$78 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$235.50 |
$314 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,575.50 |
$3,434 |
7.8× |
| MRA head w/o contrast (70544) |
$1,806.75 |
$2,409 |
8.0× |
| MRA head with contrast (70545) |
$2,504.25 |
$3,339 |
7.6× |
| MRA neck w contrast (70548) |
$2,504.25 |
$3,339 |
7.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,575.50 |
$3,434 |
7.8× |
| MRA neck w/o contrast (70547) |
$1,806.75 |
$2,409 |
8.0× |
| MRI abdomen w contrast (74182) |
$2,143.50 |
$2,858 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$1,993.50 |
$2,658 |
8.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,987.50 |
$2,650 |
2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,292 |
$3,056 |
6.9× |
MRI any jt upper extremity w/contrast matrl (73222)
range across 2 matching MRF lines |
$1,987.50–$2,561.25 |
$2,650–$3,415 |
varies |
| MRI cardiac w/o cont stress (75559) |
$4,815.75 |
$6,421 |
9.3× |
| MRI cardiac w/o contrast (75557) |
$2,697 |
$3,596 |
11.9× |
| MRI cervical spine w contrast (72142) |
$3,132 |
$4,176 |
9.5× |
| MRI cervical spine w/o cont (72141) |
$1,914 |
$2,552 |
8.5× |
| MRI chest w/o contrast (71550) |
$2,279.25 |
$3,039 |
10.1× |
| MRI chest with contrast (71551) |
$2,294.25 |
$3,059 |
3.1× |
| MRI chest wo w contrast (71552) |
$3,137.25 |
$4,183 |
9.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,987.50 |
$2,650 |
6.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,292 |
$3,056 |
6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,854.75 |
$2,473 |
8.2× |
| MRI lumbar spine w contrast (72149) |
$2,661.75 |
$3,549 |
8.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,259 |
$3,012 |
6.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,806.75 |
$2,409 |
8.0× |
| MRI orbit face neck w contrast (70542) |
$2,421 |
$3,228 |
7.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,472 |
$3,296 |
7.5× |
| MRI pelvis w contrast (72196) |
$2,070 |
$2,760 |
6.3× |
| MRI pelvis w/o & w contrast (72197) |
$2,259 |
$3,012 |
6.8× |
| MRI pelvis w/o contrast (72195) |
$1,937.25 |
$2,583 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,977 |
$2,636 |
8.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,463 |
$3,284 |
7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,005.50 |
$2,674 |
8.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,832 |
$3,776 |
8.6× |
| MRI, abdomen, combo (74183) |
$2,292.75 |
$3,057 |
6.9× |
| MRI, dorsal spine combo (72157) |
$2,259 |
$3,012 |
6.8× |
| MRI, dorsal spine contrast (72147) |
$3,169.50 |
$4,226 |
9.6× |
| MRI, joint upper extrem (73221) |
$1,854.75 |
$2,473 |
8.2× |
| MRI, joint upper extrem combo (73223) |
$2,643.75 |
$3,525 |
8.0× |
| MRI, lumbar spine combo (72158) |
$2,259 |
$3,012 |
6.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,958.50 |
$5,278 |
3.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,654 |
$4,872 |
3.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,438.50 |
$5,918 |
3.6× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$1,804.50 |
$2,406 |
1.3× |
| N-invas est c ffr sw aly CTA (75580) |
$971.25 |
$1,295 |
1.2× |
| Neck soft tissue (70360) |
$314.25 |
$419 |
3.8× |
| Nm csf leak detection (78650) |
$1,319.25 |
$1,759 |
1.1× |
| Nm myocard infarct spect (78469) |
$807.75 |
$1,077 |
1.6× |
Nuclear Rx Oral Admin (79005)
range across 2 matching MRF lines |
$231–$1,123.50 |
$308–$1,498 |
varies |
| Ophthalmic us dx quantitative a-scan only (76511) |
$102 |
$136 |
1.0× |
| Optic foramina (70190) |
$353.25 |
$471 |
4.3× |
| Panoramic X-ray of jaws (70355) |
$274.50 |
$366 |
3.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,989.75 |
$2,653 |
3.9× |
| Parathyroid Planar Imaging (78070) |
$1,467.75 |
$1,957 |
3.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,949.25 |
$2,599 |
5.2× |
| Pelvis 1 or 2 views (72170) |
$201.75 |
$269 |
2.0× |
| Pet Image W/Ct Lmtd (78814) |
$4,327.50 |
$5,770 |
3.2× |
| PET image w/CT, full body (78816) |
$4,586.25 |
$6,115 |
3.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,365.75 |
$5,821 |
3.2× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$4,245 |
$5,660 |
3.5× |
| Pet Myocardial Sngl Study (78491) |
$4,556.25 |
$6,075 |
3.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,590.75 |
$2,121 |
4.2× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$972 |
$1,296 |
1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$655.50 |
$874 |
6.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$759 |
$1,012 |
1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$441.75 |
$589 |
5.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$387.75 |
$517 |
4.7× |
| Radex elbow complete minimum 3 views (73080) |
$441.75 |
$589 |
5.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$551.25 |
$735 |
5.6× |
| Radex fingr minimum 2 views (73140) |
$310.50 |
$414 |
3.8× |
| Radex foot complete minimum 3 views (73630) |
$507 |
$676 |
6.2× |
| Radex Hand Minimum 3 Views (73130) |
$375.75 |
$501 |
4.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$329.25 |
$439 |
4.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$465.75 |
$621 |
4.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$470.25 |
$627 |
5.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$303.75 |
$405 |
3.7× |
| Radex shoulder complete minimum 2 views (73030) |
$444 |
$592 |
5.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$343.50 |
$458 |
4.2× |
| Radex Spine 1 View Specify Level (72020) |
$327 |
$436 |
4.0× |
| Radex Sternum Minimum 2 Views (71120) |
$382.50 |
$510 |
4.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$631.50 |
$842 |
7.7× |
| Radex Toe Minimum 2 Views (73660) |
$281.25 |
$375 |
3.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$318.75 |
$425 |
3.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$470.25 |
$627 |
5.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$295.50 |
$394 |
3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$491.25 |
$655 |
5.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$449.25 |
$599 |
4.5× |
| Radiologic exam colon double contrast study (74280) |
$896.25 |
$1,195 |
5.4× |
| Radiologic exam colon single contrast study (74270) |
$886.50 |
$1,182 |
5.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$454.50 |
$606 |
2.7× |
| Radiologic exam knee complete 4/more views (73564) |
$467.25 |
$623 |
4.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$453.75 |
$605 |
4.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$630.75 |
$841 |
3.8× |
| Radiologic exam swallow function contrast study (74230) |
$559.50 |
$746 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$690 |
$920 |
4.2× |
| Radiologic examination femur 1 view (73551) |
$396 |
$528 |
4.8× |
| Radiologic examination femur minimum 2 views (73552) |
$414 |
$552 |
5.0× |
| Radiologic examination knee 1/2 views (73560) |
$267.75 |
$357 |
3.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$464.25 |
$619 |
4.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$436.50 |
$582 |
5.3× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
$231 |
$308 |
1.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,622.25 |
$2,163 |
7.3× |
| Ribs bilateral 3 views (71110) |
$551.25 |
$735 |
5.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,988.75 |
$3,985 |
5.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,283 |
$3,044 |
4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,106 |
$2,808 |
4.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,340 |
$3,120 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$1,216.50 |
$1,622 |
5.5× |
| Salivary Gland Imaging (78230) |
$541.50 |
$722 |
1.4× |
| Scapula (73010) |
$323.25 |
$431 |
3.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$74.25 |
$99 |
3.2× |
| Shoulder 1 view (73020) |
$263.25 |
$351 |
3.2× |
| Shoulder Arthrography (73040) |
$911.25 |
$1,215 |
2.8× |
| Skull less than 4 views (70250) |
$481.50 |
$642 |
4.9× |
| Speech evaluation, complex (70371) |
$927 |
$1,236 |
4.1× |
| Spleen Imaging (78185) |
$390.75 |
$521 |
1.0× |
| Sternoclavicular joints (71130) |
$393 |
$524 |
4.8× |
| Superior sagittal sinus venogram (75870) |
$2,236.50 |
$2,982 |
0.7× |
| Testicular Imaging W/Flow (78761) |
$1,047 |
$1,396 |
2.8× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$208.50 |
$278 |
1.3× |
| Thoracic spine 2 views (72070) |
$267.75 |
$357 |
2.7× |
| Thoracic spine 3 views (72072) |
$515.25 |
$687 |
5.2× |
| Thoracolumbar 2 views (72080) |
$348 |
$464 |
4.2× |
| Thyroid Met Imaging Body (78018) |
$2,013.75 |
$2,685 |
3.9× |
| Thyroid Uptake Measurement (78012) |
$737.25 |
$983 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,389.75 |
$1,853 |
3.7× |
| Ultrasound Breast Limited (76642) |
$423 |
$564 |
5.1× |
| Ultrasound elastography first target lesion (76982) |
$189 |
$252 |
1.9× |
| Ultrasound Elastography Parenchyma (76981) |
$126 |
$168 |
1.3× |
| Ultrasound Exam Aaa Screen (76706) |
$378.75 |
$505 |
3.8× |
| Ultrasound, abdomen limited (76705) |
$671.25 |
$895 |
6.8× |
| Unlisted magnetic resonance procedure (76498) |
$1,535.25 |
$2,047 |
18.6× |
Unlisted us procedure (76999)
range across 2 matching MRF lines |
$442.50–$462 |
$590–$616 |
varies |
| Upper gi w/o kub (74240) |
$570 |
$760 |
3.4× |
| Ureteral Reflux Study (78740) |
$1,251.75 |
$1,669 |
3.3× |
| Urethrocystogram voiding (74455) |
$707.25 |
$943 |
3.1× |
| Urethrocystography retrograde (74450) |
$699.75 |
$933 |
3.1× |
| Us breast unilateral complete (76641) |
$678.75 |
$905 |
6.9× |
| Us chest (76604) |
$582 |
$776 |
5.9× |
| Us complete joint (76881) |
$783.75 |
$1,045 |
7.9× |
| Us exam, pelvic, limited (76857) |
$577.50 |
$770 |
5.8× |
| Us head (76506) |
$443.25 |
$591 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$419.25 |
$559 |
4.2× |
| Us ob detailed single fetus (76811) |
$925.50 |
$1,234 |
4.1× |
| Us ob limited 1 or more fetuses (76815) |
$645 |
$860 |
6.5× |
| Us ob transvaginal (76817) |
$754.50 |
$1,006 |
7.6× |
| Us pelvic non ob complete (76856) |
$762 |
$1,016 |
7.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$747 |
$996 |
7.6× |
| Us retroperitoneal complete (76770) |
$729 |
$972 |
7.4× |
| Us retroperitoneal limited (76775) |
$543 |
$724 |
5.5× |
| Us scrotum and contents (76870) |
$693.75 |
$925 |
7.0× |
| Us spinal canal and contents (76800) |
$998.25 |
$1,331 |
10.1× |
| Us thyroid (76536) |
$764.25 |
$1,019 |
7.7× |
| Vascular Flow Imaging (78445) |
$806.25 |
$1,075 |
2.1× |
| Vein X-Ray Chest (75827) |
$2,816.25 |
$3,755 |
1.9× |
| Venogram Sinus/Jugular (75860) |
$1,979.25 |
$2,639 |
0.7× |
| Venography Adrenal Unilateral (75840) |
$1,992.75 |
$2,657 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,258 |
$4,344 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$2,285.25 |
$3,047 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$1,528.50 |
$2,038 |
1.0× |
| Venography Renal Bilateral (75833) |
$2,859.75 |
$3,813 |
1.0× |
| Venography Renal Unilateral (75831) |
$2,542.50 |
$3,390 |
0.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,047.75 |
$1,397 |
2.8× |
| Vertebral fracture assessment via dxa (77086) |
$712.50 |
$950 |
8.7× |
| Wrist 2 views (73100) |
$277.50 |
$370 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$444 |
$592 |
5.4× |
| X-ray antegrade pyelogram tube (74425) |
$822.75 |
$1,097 |
2.5× |
| X-Ray Aorta Leg Arteries (75630) |
$4,245 |
$5,660 |
1.4× |
| X-Ray Bend Only L-S Spine (72120) |
$420 |
$560 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$290.25 |
$387 |
3.5× |
X-Ray Exam Breast Specimen (76098)
range across 2 matching MRF lines |
$344.25–$400.50 |
$459–$534 |
varies |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$267 |
$356 |
3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$281.25 |
$375 |
2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$295.50 |
$394 |
3.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$270 |
$360 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$436.50 |
$582 |
5.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$513.75 |
$685 |
5.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$423 |
$564 |
4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$449.25 |
$599 |
4.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$607.50 |
$810 |
6.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$645 |
$860 |
6.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$384.75 |
$513 |
4.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$603.75 |
$805 |
6.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$473.25 |
$631 |
4.8× |
| X-ray humerus (73060) |
$285 |
$380 |
3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$326.25 |
$435 |
4.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$276 |
$368 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$390 |
$520 |
3.9× |
| X-ray nose-rectum child f.b. (76010) |
$387.75 |
$517 |
4.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$600.75 |
$801 |
6.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$528.75 |
$705 |
5.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$281.25 |
$375 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$374.25 |
$499 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$666 |
$888 |
6.7× |
| X-ray thoracic spine 4 vw (72074) |
$538.50 |
$718 |
5.4× |
| X-Ray Tmj Unilat (70328) |
$331.50 |
$442 |
4.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$839.25 |
$1,119 |
2.5× |
| X-Rays Bone Length Studies (77073) |
$366 |
$488 |
3.7× |
| X-Rays Bone Survey Complete (77075) |
$743.25 |
$991 |
7.5× |
| Xr c-spine 4 or 5 views (72050) |
$590.25 |
$787 |
6.0× |
| Xr facial bones less than 3 views (70140) |
$507 |
$676 |
6.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$333 |
$444 |
3.4× |
| Xr orbits complete 4 views (70200) |
$569.25 |
$759 |
5.8× |