| Abdomen 2 views (74019) |
$205.28 |
$410.55 |
2.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$472.50 |
$945 |
1.3× |
| Ankle 2 views (73600) |
$132.30 |
$264.60 |
1.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$198.45 |
$396.90 |
0.6× |
| Arthrogram shoulder (73040) |
$441 |
$882 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$367.50 |
$735 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$724.50 |
$1,449 |
2.1× |
| Bone age studies (77072) |
$99.23 |
$198.45 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$787.50 |
$1,575 |
2.2× |
| Bone survey complete (77075) |
$330.75 |
$661.50 |
3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,155 |
$2,310 |
3.8× |
| Cervical spine 2 or 3 views (72040) |
$215.25 |
$430.50 |
2.8× |
| Chest 1 view (71045) |
$55.13 |
$110.25 |
0.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$181.65 |
$363.30 |
1.2× |
| Clavicle complete (73000) |
$135.45 |
$270.90 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$177.45 |
$354.90 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,323 |
$2,646 |
4.3× |
| CT abdomen and pelvis without contrast (74176) |
$945 |
$1,890 |
4.5× |
| CT abdomen w contrast (74160) |
$1,244.25 |
$2,488.50 |
8.1× |
| CT abdomen w wo contrast (74170) |
$1,323 |
$2,646 |
8.6× |
| CT abdomen w/o contrast (74150) |
$866.25 |
$1,732.50 |
9.5× |
| CT angio hrt w/3d image (75574) |
$438.38 |
$876.75 |
1.4× |
| CT c-spine w/o contrast (72125) |
$882 |
$1,764 |
9.6× |
| CT chest w/wo contrast (71270) |
$1,080 |
$2,160 |
7.0× |
| CT chest with contrast (71260) |
$1,005 |
$2,010 |
6.5× |
| CT head/brain with contrast (70460) |
$756 |
$1,512 |
4.9× |
| CT head/brain without and with contrast (70470) |
$1,197 |
$2,394 |
7.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$270.38 |
$540.75 |
0.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$200 |
$400 |
2.6× |
| CT iac w contrast (70481) |
$1,944.56 |
$3,889.12 |
12.7× |
| CT limited/localized follow up study (76380) |
$346.50 |
$693 |
4.5× |
| CT lower ext w/o (73700) |
$1,181.25 |
$2,362.50 |
12.9× |
| CT lower extremity w wo contrast (73702) |
$1,789.50 |
$3,578.99 |
11.6× |
| CT lower extremity with contrast (73701) |
$1,102.50 |
$2,205 |
7.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,134 |
$2,268 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$945 |
$1,890 |
10.3× |
| CT maxillofacial w contrast (70487) |
$1,008 |
$2,016 |
6.6× |
| CT maxillofacial w/o contrast (70486) |
$850.50 |
$1,701 |
9.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,071 |
$2,142 |
7.0× |
| CT neck soft tissue w contrast (70491) |
$1,008 |
$2,016 |
6.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,045.59 |
$4,091.17 |
13.3× |
| CT orbits w/o contrast (70480) |
$945 |
$1,890 |
10.3× |
| CT pelvis w & w/o contrast (72194) |
$1,323 |
$2,646 |
8.6× |
| CT pelvis w/o contrast (72192) |
$945 |
$1,890 |
10.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,134 |
$2,268 |
7.4× |
| CT soft tissue neck w/o contrast (70490) |
$882 |
$1,764 |
9.6× |
| CT thoracic spine w/o contrast (72128) |
$882 |
$1,764 |
9.6× |
| CT thorax w/o contrast (71250) |
$845.62 |
$1,691.25 |
9.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,181.25 |
$2,362.50 |
7.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,220.62 |
$2,441.25 |
13.3× |
| CT upper extremity with contrast (73201) |
$1,286.25 |
$2,572.50 |
4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,724.10 |
$3,448.20 |
11.2× |
| Cta Abdomen (74175) |
$1,134 |
$2,268 |
7.4× |
| CTA abdomen pelvis (74174) |
$1,071 |
$2,142 |
3.5× |
| CTA chest (71275) |
$1,102.50 |
$2,205 |
7.2× |
| Cta Head (70496) |
$1,512 |
$3,024 |
9.8× |
| Cta Neck (70498) |
$882 |
$1,764 |
5.7× |
| Cystography minimum 3 views rs&i (74430) |
$231.53 |
$463.05 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$231.53 |
$463.05 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$135.45 |
$270.90 |
1.8× |
| Dxa bone density study axial skeleton (77085) |
$135.98 |
$271.95 |
1.5× |
| Echoencephalography real time imaging (76506) |
$264.60 |
$529.20 |
2.9× |
| Esophagus (74220) |
$281.40 |
$562.80 |
1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$215.25 |
$430.50 |
2.3× |
| Fluoroscopy up to 1 hr (76000) |
$179.03 |
$358.05 |
0.9× |
| Foot 2 views (73620) |
$149.10 |
$298.20 |
2.0× |
| Forearm 2 views (73090) |
$139.13 |
$278.25 |
1.8× |
| Gated Heart Planar Single (78472) |
$499 |
$998 |
1.4× |
| Hand 2 views (73120) |
$149.10 |
$298.20 |
1.6× |
| Hand 3 views (73130) |
$165.38 |
$330.75 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$819 |
$1,638 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$819 |
$1,638 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$149.10 |
$298.20 |
2.0× |
| Hysterosalpingogram (74740) |
$446.25 |
$892.50 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$567 |
$1,134 |
1.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$567 |
$1,134 |
1.2× |
| Knee 3 views (73562) |
$132.30 |
$264.60 |
1.7× |
| Liver & spleen imaging static only (78215) |
$395 |
$790 |
1.1× |
| Liver imaging static only (78201) |
$315 |
$630 |
0.7× |
| Lung perf&ventilat diferentl (78598) |
$724.50 |
$1,449 |
1.5× |
| Lymphoscintigraphy (78195) |
$577.50 |
$1,155 |
1.2× |
| Meckels Diverticulum (78290) |
$409.50 |
$819 |
1.2× |
| MRA head w & w/o contrast (70546) |
$945 |
$1,890 |
3.1× |
| MRA head w/o contrast (70544) |
$735 |
$1,470 |
3.5× |
| MRA neck w contrast (70548) |
$740 |
$1,480 |
2.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$945 |
$1,890 |
3.1× |
| MRA neck w/o contrast (70547) |
$735 |
$1,470 |
3.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,124.55 |
$2,249.10 |
3.7× |
| MRI abdomen w/o contrast (74181) |
$992.25 |
$1,984.50 |
4.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,025.33 |
$2,050.65 |
1.5× |
| MRI breast w/o contrast bilateral (77047) |
$1,155 |
$2,310 |
5.5× |
| MRI c-spine with contrast (72142) |
$992 |
$1,984 |
3.2× |
| MRI cardiac w/o contrast (75557) |
$1,155 |
$2,310 |
5.5× |
| MRI cervical spine w/o contrast (72141) |
$819 |
$1,638 |
3.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,190.70 |
$2,381.40 |
3.9× |
| MRI chest w/o contrast (71550) |
$859.95 |
$1,719.90 |
4.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$992.25 |
$1,984.50 |
4.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$945 |
$1,890 |
4.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,662.81 |
$3,325.62 |
5.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,090.70 |
$2,181.39 |
3.6× |
| MRI pelvis w contrast (72196) |
$1,058.40 |
$2,116.80 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,256.85 |
$2,513.70 |
4.1× |
| MRI pelvis w/o contrast (72195) |
$992.25 |
$1,984.50 |
4.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,102.50 |
$2,205 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,190.70 |
$2,381.40 |
3.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,071 |
$2,142 |
3.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,190.70 |
$2,381.40 |
3.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,389.15 |
$2,778.30 |
4.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,190.70 |
$2,381.40 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,256.85 |
$2,513.70 |
4.1× |
| MRI thoracic spine w/o contrast (72146) |
$992.25 |
$1,984.50 |
4.7× |
| MRI tmj (70336) |
$1,190.70 |
$2,381.40 |
5.7× |
| MRI upper ext joint w/o contrast (73221) |
$992.25 |
$1,984.50 |
4.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,190.70 |
$2,381.40 |
3.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,058.40 |
$2,116.80 |
5.1× |
| Myocardial Spect Multiple Studies (78452) |
$1,386 |
$2,772 |
1.2× |
| Neck soft tissue (70360) |
$129.15 |
$258.30 |
1.7× |
| Nm gastric emptying study (78264) |
$499 |
$998 |
1.4× |
| Nm red cell sequestration (78140) |
$682.50 |
$1,365 |
1.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$198.45 |
$396.90 |
2.2× |
| Parathyroid imaging (78070) |
$472.50 |
$945 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$139.13 |
$278.25 |
1.5× |
| PET image w/CT, skull-thigh (78815) |
$1,446 |
$2,892 |
1.2× |
| PET imaging CT for attenuation limited area (78814) |
$1,446 |
$2,892 |
1.2× |
| PET imaging for CT attenuation whole body (78816) |
$1,446 |
$2,892 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,190.70 |
$2,381.40 |
3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$488 |
$976 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$198.45 |
$396.90 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$198.45 |
$396.90 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$80.98 |
$161.95 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$41.45 |
$82.90 |
0.5× |
| Radiologic exam colon single contrast study (74270) |
$363.83 |
$727.65 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$281.40 |
$562.80 |
1.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$198.45 |
$396.90 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$165.38 |
$330.75 |
2.2× |
| Radiological examination surgical specimen (76098) |
$137.55 |
$275.10 |
0.3× |
| Ribs bilateral 3 views (71110) |
$297.68 |
$595.35 |
3.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,111.50 |
$2,223 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$79.28 |
$158.55 |
0.9× |
| Scanogram (77073) |
$186.38 |
$372.75 |
2.0× |
| Scapula complete (73010) |
$181.65 |
$363.30 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$41 |
$82 |
1.8× |
| Small bowel series (74250) |
$297.68 |
$595.35 |
1.9× |
| Spine thoracic 3 views (72072) |
$215.25 |
$430.50 |
2.3× |
| Thoracolumbar 2 views (72080) |
$59.33 |
$118.65 |
0.8× |
| Thyroid uptake measurement (78012) |
$882 |
$1,764 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$347.55 |
$695.10 |
3.8× |
| Umbilical-artery Doppler (OB) (76820) |
$132.30 |
$264.60 |
1.4× |
| Unlisted Ultrasound Procedure (76999) |
$152.25 |
$304.50 |
2.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$547.50 |
$1,095 |
1.6× |
| Urethrocystography retrograde rs&i (74450) |
$261.45 |
$522.90 |
1.3× |
| Urethrocystography voiding (74455) |
$313.95 |
$627.90 |
1.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$317.63 |
$635.25 |
2.1× |
| Us abdl aorta screen aaa (76706) |
$264.60 |
$529.20 |
2.9× |
| Us breast unilateral limited (76642) |
$264.60 |
$529.20 |
3.5× |
| Us chest (76604) |
$264.60 |
$529.20 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$264.60 |
$529.20 |
2.9× |
| Us kidney transplant (76776) |
$396.90 |
$793.80 |
4.3× |
| Us ob transvaginal (76817) |
$137.03 |
$274.05 |
1.5× |
| Us pelvic non ob complete (76856) |
$463.05 |
$926.10 |
5.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$215.25 |
$430.50 |
2.3× |
| Us pregnancy ltd (76815) |
$173 |
$346 |
1.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$290.59 |
$581.18 |
3.2× |
| Us retroperitoneal complete (76770) |
$396.90 |
$793.80 |
4.3× |
| Us scrotum and contents (76870) |
$347.55 |
$695.10 |
3.8× |
| Us soft tissue head/neck (76536) |
$264.60 |
$529.20 |
2.9× |
| Us xtr non-vasc lmtd (76882) |
$264.60 |
$529.20 |
2.9× |
| Wrist 2 views (73100) |
$149.10 |
$298.20 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$231.53 |
$463.05 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$231.53 |
$463.05 |
3.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$165.38 |
$330.75 |
2.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$512.40 |
$1,024.80 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$132.30 |
$264.60 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$149.10 |
$298.20 |
2.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$247.80 |
$495.60 |
2.7× |
| X-ray exam hip uni 1 view (73501) |
$79.28 |
$158.55 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$165.38 |
$330.75 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$198.45 |
$396.90 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$165.38 |
$330.75 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$129.15 |
$258.30 |
1.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$215.25 |
$430.50 |
2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$132.30 |
$264.60 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$111.30 |
$222.60 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$231.53 |
$463.05 |
2.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$363.83 |
$727.65 |
4.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$181.65 |
$363.30 |
2.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$57.75 |
$115.50 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$231.53 |
$463.05 |
2.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$215.25 |
$430.50 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$215.25 |
$430.50 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$297.68 |
$595.35 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$247.80 |
$495.60 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$149.10 |
$298.20 |
2.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$181.65 |
$363.30 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$247.80 |
$495.60 |
3.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$181.65 |
$363.30 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$261.45 |
$522.90 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$181.65 |
$363.30 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$135.45 |
$270.90 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$132.30 |
$264.60 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$165.38 |
$330.75 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$119.18 |
$238.35 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$181.65 |
$363.30 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$347.55 |
$695.10 |
3.8× |
| Xr chest 4+ views (71048) |
$45.57 |
$91.13 |
0.5× |
| Xr finger(s) 2+ views (73140) |
$135.45 |
$270.90 |
1.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$132.30 |
$264.60 |
1.4× |
| Xr shoulder 1 view (73020) |
$132.30 |
$264.60 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$281.40 |
$562.80 |
3.1× |
| Xr tibia/fibula 2 views (73590) |
$205.28 |
$410.55 |
2.7× |
| Xr tmj bilateral (70330) |
$198.45 |
$396.90 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$102.38 |
$204.75 |
1.3× |