| Abdomen 1 View (74018) |
$126 |
$180 |
1.5× |
| Abdomen 2 views (74019) |
$167 |
$238 |
1.6× |
| Ankle 2 views (73600) |
$111 |
$158 |
1.3× |
| Bone age studies (77072) |
$151 |
$216 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$702 |
$1,003 |
1.8× |
| Bone Imaging Limited Area (78300) |
$552 |
$789 |
1.4× |
| Bone Imaging Whole Body (78306) |
$1,161 |
$1,659 |
2.9× |
| Chest 2 views (71046) |
$160 |
$228 |
1.9× |
| Chest 3 views (71047) |
$228 |
$326 |
2.6× |
| Clavicle complete (73000) |
$151 |
$216 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$262 |
$374 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,186 |
$4,552 |
9.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,012 |
$2,875 |
8.5× |
| CT abdomen w contrast (74160) |
$1,654 |
$2,363 |
9.5× |
| CT abdomen w wo contrast (74170) |
$1,944 |
$2,777 |
11.2× |
| CT abdomen w/o contrast (74150) |
$1,256 |
$1,794 |
12.1× |
| CT Angio Abdomen and Pelvis (74174) |
$3,234 |
$4,620 |
9.4× |
| CT Angio Chest (71275) |
$2,072 |
$2,960 |
11.9× |
| CT Angio Head (70496) |
$1,093 |
$1,562 |
6.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,933 |
$2,762 |
11.1× |
| CT Angio Neck (70498) |
$663 |
$947 |
3.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,933 |
$2,762 |
11.1× |
| CT cervical spine w/o contrast (72125) |
$1,316 |
$1,880 |
12.7× |
| CT chest w contrast (71260) |
$1,305 |
$1,864 |
7.5× |
| CT chest w/wo contrast (71270) |
$1,617 |
$2,310 |
9.3× |
| CT head/brain with contrast (70460) |
$1,293 |
$1,847 |
7.4× |
| CT head/brain without and with contrast (70470) |
$1,782 |
$2,545 |
10.3× |
| CT iac w contrast (70481) |
$1,611 |
$2,301 |
9.3× |
| CT lower ext w/o (73700) |
$867 |
$1,239 |
8.4× |
| CT lower extremity w/contrast material (73701) |
$1,261 |
$1,801 |
7.3× |
| CT lumbar spine w/o contrast (72131) |
$1,847 |
$2,638 |
17.8× |
| CT maxillofacial w contrast (70487) |
$1,187 |
$1,695 |
6.8× |
| CT maxillofacial wo contrast (70486) |
$942 |
$1,346 |
9.1× |
| CT neck tissue combo (70492) |
$1,471 |
$2,102 |
8.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,812 |
$2,588 |
10.4× |
| CT orbits w/o contrast (70480) |
$1,186 |
$1,694 |
11.5× |
| CT pelvis w&w/o contrast (72194) |
$2,295 |
$3,279 |
13.2× |
| CT pelvis w/o contrast (72192) |
$970 |
$1,386 |
9.4× |
| CT scan of leg combo (73702) |
$2,040 |
$2,914 |
11.7× |
| CT scans face/jaw combo (70488) |
$1,464 |
$2,091 |
8.4× |
| CT soft tissue neck w contrast (70491) |
$1,014 |
$1,449 |
5.8× |
| CT soft tissue neck w/o contrast (70490) |
$792 |
$1,132 |
7.7× |
| CT thoracic spine w/o contrast (72128) |
$1,397 |
$1,995 |
13.5× |
| CT thorax w/o contrast (71250) |
$1,029 |
$1,470 |
9.9× |
| CT upper ext wo (73200) |
$988 |
$1,411 |
9.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,915 |
$2,736 |
11.0× |
| CT upper extremity with contrast (73201) |
$1,915 |
$2,736 |
5.5× |
| Cta Abdomen (74175) |
$2,205 |
$3,150 |
12.7× |
| CTA pelvis (72191) |
$1,934 |
$2,763 |
11.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$332 |
$474 |
3.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$431 |
$616 |
4.2× |
| Fluoroscopy up to 1 hr (76000) |
$221 |
$315 |
0.9× |
| Foot 2 views (73620) |
$137 |
$195 |
1.6× |
| Forearm 2 views (73090) |
$146 |
$208 |
1.7× |
| Gastric emptying imaging study (78264) |
$847 |
$1,210 |
2.1× |
| Hand 2 views (73120) |
$141 |
$202 |
1.4× |
| Hepatobil Syst Image W/Drug (78227) |
$853 |
$1,218 |
1.6× |
| Hepatobiliary System Imaging (78226) |
$1,238 |
$1,768 |
3.1× |
| Knee 3 Views (73562) |
$193 |
$275 |
2.2× |
| Liver & Spleen Imaging Static Only (78215) |
$573 |
$818 |
1.4× |
| Lung Ventilat&Perfus Imaging (78582) |
$890 |
$1,272 |
1.7× |
| Lung Ventilation Imaging (78579) |
$678 |
$969 |
1.7× |
| Meckels Divert Exam (78290) |
$1,089 |
$1,556 |
2.8× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,612 |
$5,160 |
10.5× |
| MRA head w/o contrast (70544) |
$2,415 |
$3,450 |
10.2× |
| MRA head with contrast (70545) |
$2,799 |
$3,999 |
8.1× |
| MRA neck w/o contrast (70547) |
$2,415 |
$3,450 |
10.2× |
| MRI abdomen w contrast (74182) |
$2,497 |
$3,567 |
7.2× |
| MRI abdomen w/o contrast (74181) |
$2,316 |
$3,308 |
9.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,497 |
$3,567 |
3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,798 |
$3,997 |
8.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,497 |
$3,567 |
3.2× |
| MRI cervical spine w contrast (72142) |
$2,497 |
$3,567 |
7.2× |
| MRI cervical spine w/o cont (72141) |
$2,316 |
$3,308 |
9.8× |
| MRI chest w/o contrast (71550) |
$2,316 |
$3,308 |
9.8× |
| MRI chest with contrast (71551) |
$2,497 |
$3,567 |
3.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,497 |
$3,567 |
7.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,798 |
$3,997 |
8.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,316 |
$3,308 |
9.8× |
| MRI lumbar spine w contrast (72149) |
$2,497 |
$3,567 |
7.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,798 |
$3,997 |
8.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,316 |
$3,308 |
9.8× |
| MRI orbit face neck w contrast (70542) |
$2,497 |
$3,567 |
7.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,958 |
$4,226 |
8.6× |
| MRI pelvis w contrast (72196) |
$2,497 |
$3,567 |
7.2× |
| MRI pelvis w/o & w contrast (72197) |
$2,798 |
$3,997 |
8.1× |
| MRI pelvis w/o contrast (72195) |
$2,316 |
$3,308 |
9.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,316 |
$3,308 |
9.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,248 |
$3,212 |
6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,995 |
$2,850 |
8.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,798 |
$3,997 |
8.1× |
| MRI, abdomen, combo (74183) |
$2,798 |
$3,997 |
8.1× |
| MRI, dorsal spine combo (72157) |
$2,798 |
$3,997 |
8.1× |
| MRI, dorsal spine contrast (72147) |
$2,497 |
$3,567 |
7.2× |
| MRI, joint upper extrem (73221) |
$2,316 |
$3,308 |
9.8× |
| MRI, joint upper extrem combo (73223) |
$2,798 |
$3,997 |
8.1× |
| MRI, lumbar spine combo (72158) |
$2,798 |
$3,997 |
8.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,463 |
$4,947 |
2.7× |
| Neck soft tissue (70360) |
$153 |
$218 |
1.8× |
| Nm red cell survival study (78130) |
$27 |
$39 |
0.1× |
Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$143–$156 |
$204–$223 |
varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$260 |
$371 |
2.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$174 |
$248 |
2.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$155 |
$222 |
1.8× |
| Radex elbow complete minimum 3 views (73080) |
$199 |
$284 |
2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$245 |
$350 |
2.4× |
| Radex fingr minimum 2 views (73140) |
$134 |
$191 |
1.6× |
| Radex foot complete minimum 3 views (73630) |
$162 |
$231 |
1.9× |
| Radex Hand Minimum 3 Views (73130) |
$162 |
$232 |
1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$220 |
$314 |
2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$155 |
$221 |
1.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$145 |
$207 |
1.7× |
| Radex shoulder complete minimum 2 views (73030) |
$158 |
$225 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$176 |
$252 |
2.0× |
| Radex Toe Minimum 2 Views (73660) |
$137 |
$195 |
1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$160 |
$229 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$182 |
$260 |
1.8× |
| Radiologic exam knee complete 4/more views (73564) |
$274 |
$391 |
2.6× |
| Radiologic examination femur minimum 2 views (73552) |
$156 |
$223 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$156 |
$223 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$153 |
$218 |
1.8× |
| Scapula (73010) |
$158 |
$225 |
1.5× |
| Shoulder 1 view (73020) |
$111 |
$159 |
1.3× |
| Skull less than 4 views (70250) |
$261 |
$373 |
2.5× |
| Thoracic spine 2 views (72070) |
$174 |
$249 |
1.7× |
| Thoracic spine 3 views (72072) |
$216 |
$309 |
2.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$773 |
$1,104 |
2.0× |
| Thyroid Uptake Measurement (78012) |
$773 |
$1,104 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$286 |
$409 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$272 |
$389 |
2.6× |
| Us breast unilateral complete (76641) |
$342 |
$488 |
3.3× |
| Us complete joint (76881) |
$383 |
$547 |
3.7× |
| Us exam, pelvic, limited (76857) |
$204 |
$291 |
2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$176 |
$252 |
1.7× |
| Us ob transvaginal (76817) |
$310 |
$443 |
3.0× |
| Us pelvic non ob complete (76856) |
$333 |
$476 |
3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$395 |
$564 |
3.8× |
| Us retroperitoneal complete (76770) |
$361 |
$515 |
3.5× |
| Us scrotum and contents (76870) |
$329 |
$470 |
3.2× |
| Us thyroid (76536) |
$307 |
$438 |
3.0× |
| Wrist 2 views (73100) |
$121 |
$173 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$202 |
$288 |
2.3× |
| X-Ray Bend Only L-S Spine (72120) |
$228 |
$326 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$106 |
$151 |
1.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$146 |
$209 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$169 |
$242 |
2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$183 |
$262 |
1.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$302 |
$431 |
2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$169 |
$242 |
2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$300 |
$428 |
2.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$251 |
$359 |
2.4× |
| X-ray humerus (73060) |
$159 |
$227 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$128 |
$183 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$178 |
$254 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$204 |
$291 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$165 |
$235 |
1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$224 |
$320 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$358 |
$512 |
3.5× |
| X-Rays Bone Survey Complete (77075) |
$197 |
$282 |
1.9× |
| Xr c-spine 4 or 5 views (72050) |
$261 |
$373 |
2.5× |