| Abdomen 1 View (74018) |
$284.25 |
$379 |
3.5× |
| Abdomen 2 views (74019) |
$489 |
$652 |
4.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,023.50 |
$2,698 |
5.4× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$873.75 |
$1,165 |
0.7× |
| Angio internal mammary (75756) |
$4,255.50 |
$5,674 |
1.4× |
| Angio pulmonary bilat (75743) |
$5,836.50 |
$7,782 |
2.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$5,043 |
$6,724 |
1.7× |
| Angiography extremity bilateral rs&i (75716) |
$4,206 |
$5,608 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$3,650.25 |
$4,867 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,931.25 |
$6,575 |
1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,405 |
$4,540 |
1.1× |
| Ankle 2 views (73600) |
$361.50 |
$482 |
4.4× |
| Aortography thoracic serialography rs&i (75605) |
$5,378.25 |
$7,171 |
1.0× |
| Artery X-Rays Abdomen (75726) |
$4,294.50 |
$5,726 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$4,035 |
$5,380 |
1.4× |
| Artery X-Rays Pelvis (75736) |
$4,725.75 |
$6,301 |
0.9× |
| Artery X-Rays Spine (75705) |
$4,294.50 |
$5,726 |
0.8× |
| Arthrogram hip (73525) |
$1,455 |
$1,940 |
4.4× |
| Arthrogram Wrist (73115) |
$417.75 |
$557 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$949.50 |
$1,266 |
7.5× |
| Bone age studies (77072) |
$367.50 |
$490 |
3.7× |
| Bone Imaging 3 Phase (78315) |
$2,543.25 |
$3,391 |
6.7× |
| Bone Imaging Whole Body (78306) |
$2,499.75 |
$3,333 |
6.6× |
| Bone survey infant (77076) |
$403.50 |
$538 |
4.1× |
| Brain Flow Imaging Only (78610) |
$456.75 |
$609 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,834.50 |
$6,446 |
3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,945.25 |
$3,927 |
8.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$3,879.75 |
$5,173 |
5.2× |
| Cat Scan Follow-Up Study (76380) |
$642.75 |
$857 |
7.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,215.75 |
$1,621 |
2.4× |
| Cerebrospinal Fluid Scan (78630) |
$2,313.75 |
$3,085 |
4.5× |
| Chest 1 view (71045) |
$292.50 |
$390 |
3.6× |
| Chest 2 views (71046) |
$366 |
$488 |
4.4× |
| Chest 3 views (71047) |
$500.25 |
$667 |
6.1× |
| Chest 4 or more views (71048) |
$507 |
$676 |
5.1× |
| Clavicle complete (73000) |
$364.50 |
$486 |
4.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$187.50 |
$250 |
1.9× |
| Contrast Exam Abdominl Aorta (75625) |
$4,711.50 |
$6,282 |
1.6× |
| Contrast X-Ray Bladder (74430) |
$919.50 |
$1,226 |
2.8× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,143.75 |
$1,525 |
3.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,605.50 |
$3,474 |
7.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,418.75 |
$3,225 |
10.7× |
| CT abdomen w contrast (74160) |
$1,962.75 |
$2,617 |
11.8× |
| CT abdomen w wo contrast (74170) |
$2,049 |
$2,732 |
12.3× |
| CT abdomen w/o contrast (74150) |
$1,722 |
$2,296 |
17.4× |
| CT Angio Abdomen and Pelvis (74174) |
$2,605.50 |
$3,474 |
7.9× |
| CT Angio Chest (71275) |
$2,150.25 |
$2,867 |
13.0× |
| CT Angio Head (70496) |
$2,237.25 |
$2,983 |
13.5× |
| CT angio hrt w/3d image (75574) |
$2,243.25 |
$2,991 |
6.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,807.50 |
$2,410 |
10.9× |
| CT Angio Neck (70498) |
$1,987.50 |
$2,650 |
12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,652.25 |
$2,203 |
10.0× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$633 |
$844 |
3.8× |
| CT cervical spine w/ contrast (72126) |
$1,732.50 |
$2,310 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,568.25 |
$2,091 |
15.9× |
| CT chest w contrast (71260) |
$1,747.50 |
$2,330 |
10.5× |
| CT chest w/wo contrast (71270) |
$1,829.25 |
$2,439 |
11.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$2,139 |
$2,852 |
21.6× |
| CT head/brain with contrast (70460) |
$1,496.25 |
$1,995 |
9.0× |
| CT head/brain without and with contrast (70470) |
$1,629 |
$2,172 |
9.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,883 |
$3,844 |
8.7× |
CT heart no contrast quant eval coronry calcium (75571)
range across 3 matching MRF lines |
$97.50–$2,051.25 |
$130–$2,735 |
varies |
| CT hrt w/3d image congen (75573) |
$2,418.75 |
$3,225 |
7.3× |
| CT iac w contrast (70481) |
$1,487.25 |
$1,983 |
9.0× |
| CT l-spine w&w/o contrast (72133) |
$1,817.25 |
$2,423 |
11.0× |
| CT lower ext w/o (73700) |
$1,372.50 |
$1,830 |
13.9× |
| CT lower extremity w/contrast material (73701) |
$1,553.25 |
$2,071 |
9.4× |
| CT lumbar spine w contrast (72132) |
$1,829.25 |
$2,439 |
5.5× |
| CT lumbar spine w/o contrast (72131) |
$1,734.75 |
$2,313 |
17.5× |
| CT maxillofacial w contrast (70487) |
$1,519.50 |
$2,026 |
9.2× |
| CT maxillofacial wo contrast (70486) |
$1,303.50 |
$1,738 |
13.2× |
| CT neck tissue combo (70492) |
$1,752.75 |
$2,337 |
10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,661.25 |
$2,215 |
10.0× |
| CT orbits w/o contrast (70480) |
$1,400.25 |
$1,867 |
14.2× |
| CT pelvis w&w/o contrast (72194) |
$1,881 |
$2,508 |
11.3× |
| CT pelvis w/o contrast (72192) |
$1,392.75 |
$1,857 |
14.1× |
| CT scan of leg combo (73702) |
$1,618.50 |
$2,158 |
9.8× |
| CT scans face/jaw combo (70488) |
$1,576.50 |
$2,102 |
9.5× |
| CT soft tissue neck w contrast (70491) |
$1,730.25 |
$2,307 |
10.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,389.75 |
$1,853 |
14.1× |
| CT thoracic spine w contrast (72129) |
$1,732.50 |
$2,310 |
10.4× |
| CT thoracic spine w/o contrast (72128) |
$1,464 |
$1,952 |
14.8× |
| CT thoracic spine w/wo cont (72130) |
$1,817.25 |
$2,423 |
11.0× |
| CT thorax w/o contrast (71250) |
$1,519.50 |
$2,026 |
15.4× |
| CT unlisted procedure (76497) |
$1,578.75 |
$2,105 |
19.2× |
| CT upper ext wo (73200) |
$1,473.75 |
$1,965 |
14.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,224.50 |
$2,966 |
13.4× |
| CT upper extremity with contrast (73201) |
$1,614.75 |
$2,153 |
4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,718.75 |
$3,625 |
16.4× |
| Cta Abdomen (74175) |
$2,422.50 |
$3,230 |
14.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,237.25 |
$2,983 |
6.8× |
| CTA pelvis (72191) |
$2,418.75 |
$3,225 |
14.6× |
| Dilation ureters/urethra rs&i (74485) |
$1,712.25 |
$2,283 |
0.9× |
| Discography Cerv/Thor Spine (72285) |
$2,691 |
$3,588 |
1.5× |
| Diskography lumbar (72295) |
$2,909.25 |
$3,879 |
1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$300.75 |
$401 |
3.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$576.75 |
$769 |
5.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$645.75 |
$861 |
6.5× |
| Dxa Bone Density Axial (77080) |
$483 |
$644 |
4.9× |
| Dxa bone density study (77085) |
$591.75 |
$789 |
6.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$417 |
$556 |
5.1× |
| Echo exam of fetal heart (76825) |
$644.25 |
$859 |
1.2× |
| Echo exam uterus (76831) |
$825.75 |
$1,101 |
3.7× |
| Echo Guide For Artery Repair (76936) |
$1,386 |
$1,848 |
6.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$480.75 |
$641 |
2.1× |
| Esophagram (74220) |
$792.75 |
$1,057 |
4.8× |
| Fetal Biophys Profile W/Nst (76818) |
$831.75 |
$1,109 |
8.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$535.50 |
$714 |
5.4× |
| Fluoroscopy up to 1 hr (76000) |
$818.25 |
$1,091 |
3.6× |
| Follow-Up Angiography (75898) |
$2,599.50 |
$3,466 |
0.9× |
| Foot 2 views (73620) |
$333 |
$444 |
4.0× |
| Forearm 2 views (73090) |
$394.50 |
$526 |
4.8× |
| Gastric emptying imaging study (78264) |
$1,431.75 |
$1,909 |
3.8× |
| Gastroesophageal Reflux Exam (78262) |
$1,232.25 |
$1,643 |
3.3× |
| Gated Heart Planar Single (78472) |
$1,746 |
$2,328 |
4.6× |
| Hand 2 views (73120) |
$426.75 |
$569 |
4.3× |
| Heart Image (Pet) Multiple (78492) |
$5,301 |
$7,068 |
3.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,859.50 |
$5,146 |
1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,135.75 |
$4,181 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$2,326.50 |
$3,102 |
4.5× |
| Hepatobiliary System Imaging (78226) |
$1,494 |
$1,992 |
4.0× |
| Ht Musc Image Planar Mult (78454) |
$5,794.50 |
$7,726 |
4.7× |
| Ht Muscle Image Spect Sing (78451) |
$4,367.25 |
$5,823 |
3.6× |
| Hysterosalpingogram (74740) |
$1,139.25 |
$1,519 |
5.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$382.50 |
$510 |
4.6× |
| Infant hip ultrasound, limited static exam (76886) |
$311.25 |
$415 |
3.8× |
| Joint Survey Single View (77077) |
$393.75 |
$525 |
4.0× |
| K Flow/Funct Image W/Drug (78708) |
$1,674.75 |
$2,233 |
3.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,584.75 |
$2,113 |
3.1× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$1,133.25 |
$1,511 |
3.0× |
| Kidney Imaging Morphol (78700) |
$1,238.25 |
$1,651 |
3.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,419.75 |
$1,893 |
3.8× |
| Knee 3 Views (73562) |
$420.75 |
$561 |
5.1× |
| Liver & Spleen Imaging Static Only (78215) |
$1,856.25 |
$2,475 |
4.9× |
| Liver imaging static only (78201) |
$1,241.25 |
$1,655 |
2.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,580 |
$3,440 |
5.0× |
| Lung perfusion differential (78597) |
$1,789.50 |
$2,386 |
4.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,622 |
$3,496 |
5.1× |
| Lung Ventilation Imaging (78579) |
$478.50 |
$638 |
1.3× |
| Lymph System Imaging (78195) |
$2,091.75 |
$2,789 |
4.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$2,379 |
$3,172 |
1.6× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,379 |
$3,172 |
4.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,489.25 |
$3,319 |
0.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,489.25 |
$3,319 |
0.8× |
| Magnetic Image Jaw Joint (70336) |
$1,860 |
$2,480 |
8.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$2,608.50 |
$3,478 |
15.7× |
| Mammary ductogram or galactogram multiple (77054) |
$634.50 |
$846 |
2.8× |
| Mammary ductogram or galactogram single (77053) |
$515.25 |
$687 |
2.3× |
| Meckels Divert Exam (78290) |
$1,699.50 |
$2,266 |
4.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$621 |
$828 |
1.8× |
| Mr safety determination physician/other qhp (76016) |
$102.75 |
$137 |
1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$30 |
$40 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$108 |
$144 |
1.2× |
| Mr safety implt pos&/immoblj (76019) |
$70.50 |
$94 |
1.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$283.50 |
$378 |
1.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,229 |
$2,972 |
6.8× |
| MRA head w/o contrast (70544) |
$1,779.75 |
$2,373 |
7.9× |
| MRA head with contrast (70545) |
$1,998 |
$2,664 |
6.1× |
| MRA neck w contrast (70548) |
$1,998 |
$2,664 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,229 |
$2,972 |
6.8× |
| MRA neck w/o contrast (70547) |
$1,779.75 |
$2,373 |
7.9× |
| MRI abdomen w contrast (74182) |
$2,457.75 |
$3,277 |
7.4× |
| MRI abdomen w/o contrast (74181) |
$2,285.25 |
$3,047 |
10.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,259 |
$3,012 |
3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,628.75 |
$3,505 |
8.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,259 |
$3,012 |
3.0× |
| MRI brain functional w/o physician admnistration (70554) |
$1,157.25 |
$1,543 |
5.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$262.50 |
$350 |
1.2× |
| MRI cardiac w/o cont stress (75559) |
$4,247.25 |
$5,663 |
8.2× |
| MRI cardiac w/o contrast (75557) |
$2,379 |
$3,172 |
10.5× |
| MRI cervical spine w contrast (72142) |
$2,373.75 |
$3,165 |
7.2× |
| MRI cervical spine w/o cont (72141) |
$2,194.50 |
$2,926 |
9.7× |
| MRI chest w/o contrast (71550) |
$1,818 |
$2,424 |
8.1× |
| MRI chest with contrast (71551) |
$2,105.25 |
$2,807 |
2.8× |
| MRI chest wo w contrast (71552) |
$2,877.75 |
$3,837 |
8.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,259 |
$3,012 |
6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,628.75 |
$3,505 |
8.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,127 |
$2,836 |
9.4× |
| MRI lumbar spine w contrast (72149) |
$2,441.25 |
$3,255 |
7.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,590.50 |
$3,454 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,883.25 |
$2,511 |
8.3× |
| MRI orbit face neck w contrast (70542) |
$2,776.50 |
$3,702 |
8.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,181 |
$2,908 |
6.6× |
| MRI pelvis w contrast (72196) |
$2,373.75 |
$3,165 |
7.2× |
| MRI pelvis w/o & w contrast (72197) |
$2,590.50 |
$3,454 |
7.8× |
| MRI pelvis w/o contrast (72195) |
$2,221.50 |
$2,962 |
9.8× |
| MRI spectroscopy (76390) |
$1,610.25 |
$2,147 |
19.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,265.75 |
$3,021 |
10.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,550.75 |
$3,401 |
7.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,127 |
$2,836 |
9.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,628.75 |
$3,505 |
8.0× |
| MRI, abdomen, combo (74183) |
$2,629.50 |
$3,506 |
8.0× |
| MRI, dorsal spine combo (72157) |
$2,590.50 |
$3,454 |
7.8× |
| MRI, dorsal spine contrast (72147) |
$2,441.25 |
$3,255 |
7.4× |
| MRI, joint upper extrem (73221) |
$2,127 |
$2,836 |
9.4× |
| MRI, joint upper extrem combo (73223) |
$2,628.75 |
$3,505 |
8.0× |
| MRI, lumbar spine combo (72158) |
$2,590.50 |
$3,454 |
7.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,680.75 |
$6,241 |
3.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,952.50 |
$5,270 |
3.2× |
| Myocardial Spect Multiple Studies (78452) |
$5,417.25 |
$7,223 |
4.4× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$2,251.50 |
$3,002 |
1.6× |
| N-invas est c ffr sw aly CTA (75580) |
$2,020.50 |
$2,694 |
2.5× |
| Neck soft tissue (70360) |
$350.25 |
$467 |
4.3× |
| Nm csf leak detection (78650) |
$1,645.50 |
$2,194 |
1.3× |
| Nm myocard infarct spect (78469) |
$1,006.50 |
$1,342 |
2.0× |
| Nonvascular Shunt X-Ray (75809) |
$539.25 |
$719 |
5.5× |
| Nuclear Rx Intra-Arterial (79445) |
$1,467 |
$1,956 |
6.6× |
Nuclear Rx Oral Admin (79005)
range across 2 matching MRF lines |
$288.75–$1,642.50 |
$385–$2,190 |
varies |
| Ob us nuchal meas 1 gest (76813) |
$596.25 |
$795 |
6.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$404.25 |
$539 |
4.1× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$127.50 |
$170 |
1.3× |
| Optic foramina (70190) |
$426.75 |
$569 |
5.2× |
| Panoramic X-ray of jaws (70355) |
$270 |
$360 |
3.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,445 |
$3,260 |
4.8× |
| Parathyroid Planar Imaging (78070) |
$1,436.25 |
$1,915 |
3.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,424.75 |
$3,233 |
6.4× |
| Pelvis 1 or 2 views (72170) |
$300 |
$400 |
3.0× |
| Perineogram (74775) |
$284.25 |
$379 |
1.3× |
| Pet Image W/Ct Lmtd (78814) |
$4,680.75 |
$6,241 |
3.5× |
| PET image w/CT, full body (78816) |
$4,915.50 |
$6,554 |
3.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,854.75 |
$6,473 |
3.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$4,590.75 |
$6,121 |
3.7× |
| Pet Myocardial Sngl Study (78491) |
$4,928.25 |
$6,571 |
3.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,413.25 |
$4,551 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,789.50 |
$2,386 |
4.7× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$2,019.75 |
$2,693 |
2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$471.75 |
$629 |
4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$944.25 |
$1,259 |
1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$396.75 |
$529 |
4.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$385.50 |
$514 |
4.7× |
| Radex elbow complete minimum 3 views (73080) |
$462 |
$616 |
5.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$663 |
$884 |
6.7× |
| Radex fingr minimum 2 views (73140) |
$387 |
$516 |
4.7× |
| Radex foot complete minimum 3 views (73630) |
$420 |
$560 |
5.1× |
| Radex Hand Minimum 3 Views (73130) |
$431.25 |
$575 |
5.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$375.75 |
$501 |
4.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$524.25 |
$699 |
5.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$367.50 |
$490 |
4.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$448.50 |
$598 |
5.4× |
| Radex shoulder complete minimum 2 views (73030) |
$461.25 |
$615 |
5.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$444.75 |
$593 |
5.4× |
| Radex Spine 1 View Specify Level (72020) |
$360 |
$480 |
4.4× |
| Radex Sternum Minimum 2 Views (71120) |
$521.25 |
$695 |
6.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$636 |
$848 |
7.7× |
| Radex Toe Minimum 2 Views (73660) |
$375.75 |
$501 |
4.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$299.25 |
$399 |
3.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$461.25 |
$615 |
5.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$341.25 |
$455 |
3.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$421.50 |
$562 |
4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$502.50 |
$670 |
5.1× |
| Radiologic exam colon double contrast study (74280) |
$966 |
$1,288 |
5.8× |
| Radiologic exam colon single contrast study (74270) |
$814.50 |
$1,086 |
4.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$759 |
$1,012 |
4.6× |
| Radiologic exam knee complete 4/more views (73564) |
$508.50 |
$678 |
5.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$355.50 |
$474 |
3.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$709.50 |
$946 |
4.3× |
| Radiologic exam swallow function contrast study (74230) |
$719.25 |
$959 |
4.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$813 |
$1,084 |
4.9× |
| Radiologic examination femur 1 view (73551) |
$295.50 |
$394 |
3.6× |
| Radiologic examination femur minimum 2 views (73552) |
$300.75 |
$401 |
3.7× |
| Radiologic examination knee 1/2 views (73560) |
$283.50 |
$378 |
3.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$619.50 |
$826 |
6.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$372.75 |
$497 |
4.5× |
| Radiopharm Dacryocystography (78660) |
$951.75 |
$1,269 |
2.5× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
$288.75 |
$385 |
1.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,755 |
$2,340 |
8.0× |
| Ribs bilateral 3 views (71110) |
$492.75 |
$657 |
5.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,232.50 |
$4,310 |
6.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,841 |
$3,788 |
5.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,619 |
$3,492 |
5.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,531.25 |
$3,375 |
2.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$2,648.25 |
$3,531 |
12.0× |
| Rp Therapy Intravenous Administration (79101) |
$1,315.50 |
$1,754 |
6.0× |
| Salivary Gland Imaging (78230) |
$585 |
$780 |
1.5× |
| Scapula (73010) |
$255 |
$340 |
2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$81.75 |
$109 |
3.5× |
| Shoulder 1 view (73020) |
$244.50 |
$326 |
3.0× |
| Shoulder Arthrography (73040) |
$1,134 |
$1,512 |
3.4× |
| Skull less than 4 views (70250) |
$377.25 |
$503 |
3.8× |
| Speech evaluation, complex (70371) |
$1,077 |
$1,436 |
4.8× |
| Spleen Imaging (78185) |
$469.50 |
$626 |
1.2× |
| Sternoclavicular joints (71130) |
$527.25 |
$703 |
6.4× |
| Superior sagittal sinus venogram (75870) |
$2,489.25 |
$3,319 |
0.8× |
| Testicular Imaging W/Flow (78761) |
$1,209.75 |
$1,613 |
3.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$208.50 |
$278 |
1.3× |
| Thoracic spine 2 views (72070) |
$388.50 |
$518 |
3.9× |
| Thoracic spine 3 views (72072) |
$606 |
$808 |
6.1× |
| Thoracolumbar 2 views (72080) |
$408 |
$544 |
5.0× |
| Thyroid Met Imaging Body (78018) |
$2,506.50 |
$3,342 |
4.9× |
| Thyroid Uptake Measurement (78012) |
$856.50 |
$1,142 |
2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,419 |
$1,892 |
3.8× |
| Ultrasound Breast Limited (76642) |
$478.50 |
$638 |
5.8× |
| Ultrasound elastography first target lesion (76982) |
$252 |
$336 |
2.5× |
| Ultrasound Elastography Parenchyma (76981) |
$284.25 |
$379 |
2.9× |
| Ultrasound Exam Aaa Screen (76706) |
$473.25 |
$631 |
4.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$303 |
$404 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$753 |
$1,004 |
7.6× |
| Umbilical-artery Doppler (OB) (76820) |
$561 |
$748 |
5.7× |
| Unlisted Dx Radiographic Procedure (76499) |
$564.75 |
$753 |
6.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,616.25 |
$2,155 |
19.6× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$680.25 |
$907 |
1.8× |
Unlisted us procedure (76999)
range across 2 matching MRF lines |
$460.50–$532.50 |
$614–$710 |
varies |
| Upper gi w/o kub (74240) |
$709.50 |
$946 |
4.3× |
| Ureteral Reflux Study (78740) |
$1,353.75 |
$1,805 |
3.6× |
| Urethrocystogram voiding (74455) |
$880.50 |
$1,174 |
3.9× |
| Urethrocystography retrograde (74450) |
$810.75 |
$1,081 |
3.6× |
| Us breast unilateral complete (76641) |
$510 |
$680 |
5.2× |
| Us chest (76604) |
$695.25 |
$927 |
7.0× |
| Us complete joint (76881) |
$808.50 |
$1,078 |
8.2× |
| Us exam, pelvic, limited (76857) |
$567 |
$756 |
5.7× |
| Us head (76506) |
$463.50 |
$618 |
4.7× |
| Us kidney transplant (76776) |
$967.50 |
$1,290 |
9.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$542.25 |
$723 |
5.5× |
| Us ob detailed single fetus (76811) |
$915.75 |
$1,221 |
4.1× |
| Us ob limited 1 or more fetuses (76815) |
$548.25 |
$731 |
5.5× |
| Us ob transvaginal (76817) |
$765.75 |
$1,021 |
7.7× |
| Us pelvic non ob complete (76856) |
$919.50 |
$1,226 |
9.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$801.75 |
$1,069 |
8.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$450.75 |
$601 |
4.6× |
| Us retroperitoneal complete (76770) |
$972.75 |
$1,297 |
9.8× |
| Us retroperitoneal limited (76775) |
$718.50 |
$958 |
7.3× |
| Us scrotum and contents (76870) |
$735.75 |
$981 |
7.4× |
| Us spinal canal and contents (76800) |
$352.50 |
$470 |
3.6× |
| Us thyroid (76536) |
$885.75 |
$1,181 |
9.0× |
| Us transrectal (76872) |
$954.75 |
$1,273 |
9.7× |
| Vascular Flow Imaging (78445) |
$914.25 |
$1,219 |
2.4× |
| Vein X-Ray Chest (75827) |
$4,438.50 |
$5,918 |
3.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,489.25 |
$3,319 |
0.8× |
| Vein X-Ray Skull Epidural (75872) |
$1,424.25 |
$1,899 |
2.4× |
| Vein X-Ray Spleen/Liver (75810) |
$3,682.50 |
$4,910 |
1.2× |
| Venogram Sinus/Jugular (75860) |
$2,489.25 |
$3,319 |
0.8× |
| Venography Adrenal Unilateral (75840) |
$2,489.25 |
$3,319 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$4,438.50 |
$5,918 |
1.5× |
| Venography extremity bilateral rs&i (75822) |
$2,472 |
$3,296 |
1.7× |
| Venography extremity unilateral rs&i (75820) |
$1,653.75 |
$2,205 |
1.1× |
| Venography Orbital Rs&I (75880) |
$2,040 |
$2,720 |
3.4× |
| Venography Renal Bilateral (75833) |
$3,386.25 |
$4,515 |
1.1× |
| Venography Renal Unilateral (75831) |
$2,750.25 |
$3,667 |
0.9× |
| Venous sampling by catheter (75893) |
$4,294.50 |
$5,726 |
0.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,103.25 |
$1,471 |
2.9× |
| Vertebral fracture assessment via dxa (77086) |
$771 |
$1,028 |
9.4× |
| Wrist 2 views (73100) |
$355.50 |
$474 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$525.75 |
$701 |
6.4× |
| X-ray antegrade pyelogram tube (74425) |
$808.50 |
$1,078 |
2.4× |
| X-Ray Aorta Leg Arteries (75630) |
$5,568.75 |
$7,425 |
1.9× |
| X-Ray Bend Only L-S Spine (72120) |
$408 |
$544 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$379.50 |
$506 |
4.6× |
| X-Ray Exam Breast Specimen (76098) |
$432.75 |
$577 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$367.50 |
$490 |
4.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$378 |
$504 |
3.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$381.75 |
$509 |
3.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$265.50 |
$354 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$436.50 |
$582 |
5.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$531 |
$708 |
5.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$342.75 |
$457 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$475.50 |
$634 |
4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$683.25 |
$911 |
6.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$702.75 |
$937 |
7.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$432.75 |
$577 |
5.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$781.50 |
$1,042 |
7.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$471.75 |
$629 |
4.8× |
| X-ray humerus (73060) |
$363.75 |
$485 |
4.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$319.50 |
$426 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$388.50 |
$518 |
4.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$439.50 |
$586 |
4.4× |
| X-ray nose-rectum child f.b. (76010) |
$367.50 |
$490 |
4.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$524.25 |
$699 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$542.25 |
$723 |
5.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$297 |
$396 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$629.25 |
$839 |
7.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$749.25 |
$999 |
7.6× |
| X-ray thoracic spine 4 vw (72074) |
$616.50 |
$822 |
6.2× |
| X-Ray Tmj Unilat (70328) |
$429 |
$572 |
5.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$810.75 |
$1,081 |
2.5× |
| X-Rays Bone Length Studies (77073) |
$287.25 |
$383 |
2.9× |
| X-Rays Bone Survey Complete (77075) |
$963.75 |
$1,285 |
9.7× |
| Xr c-spine 4 or 5 views (72050) |
$663.75 |
$885 |
6.7× |
| Xr facial bones less than 3 views (70140) |
$570 |
$760 |
6.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$374.25 |
$499 |
3.8× |
| Xr orbits complete 4 views (70200) |
$674.25 |
$899 |
6.8× |
| Xr Tomogram Single Plane (76100) |
$1,032.75 |
$1,377 |
10.4× |