| Abdomen 2 views (74019) |
$57.20 |
$286 |
0.6× |
| Ankle 2 views (73600) |
$56 |
$280 |
0.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$259.20 |
$1,296 |
0.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$297.20 |
$1,486 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$361.80 |
$1,809 |
1.0× |
| Bone age studies (77072) |
$71.80 |
$359 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$380.80 |
$1,904 |
1.0× |
| Bone survey complete (77075) |
$141.20 |
$706 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$79.20 |
$396 |
1.0× |
| Chest 1 view (71045) |
$52.40 |
$262 |
0.7× |
| Chest 3 views (71047) |
$67 |
$335 |
0.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$169.40 |
$847 |
1.1× |
| Clavicle complete (73000) |
$61.80 |
$309 |
0.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$336 |
$336 |
3.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$605.80 |
$3,029 |
1.9× |
| CT abdomen and pelvis without contrast (74176) |
$504.80 |
$2,524 |
2.3× |
| CT abdomen w contrast (74160) |
$275 |
$1,375 |
1.7× |
| CT abdomen w wo contrast (74170) |
$330 |
$1,650 |
2.0× |
| CT abdomen w/o contrast (74150) |
$275 |
$1,375 |
2.9× |
| CT angiography upper extremity lt (73206) |
$154.80 |
$774 |
1.0× |
| CT c-spine w/o contrast (72125) |
$358.80 |
$1,794 |
3.7× |
| CT cervical spine w&w/o contrast (72127) |
$373.20 |
$1,866 |
2.3× |
| CT cervical spine with contrast (72126) |
$373.20 |
$1,866 |
1.2× |
| CT chest w/wo contrast (71270) |
$382.60 |
$1,913 |
2.4× |
| CT chest with contrast (71260) |
$318.80 |
$1,594 |
2.0× |
| CT head/brain with contrast (70460) |
$311.20 |
$1,556 |
1.9× |
| CT head/brain without and with contrast (70470) |
$373.40 |
$1,867 |
2.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$35 |
$35 |
0.4× |
| CT iac w contrast (70481) |
$269.20 |
$1,346 |
1.7× |
| CT lower ext w/o (73700) |
$238.80 |
$1,194 |
2.5× |
| CT lower extremity w wo contrast (73702) |
$286.60 |
$1,433 |
1.8× |
| CT lower extremity with contrast (73701) |
$238.80 |
$1,194 |
1.5× |
| CT lumbar spine w & w/o contrast (72133) |
$470.40 |
$2,352 |
2.9× |
| CT lumbar spine w/o contrast (72131) |
$392 |
$1,960 |
4.1× |
| CT lumbar spine with contrast (72132) |
$392 |
$1,960 |
1.2× |
| CT maxillofacial w contrast (70487) |
$334.60 |
$1,673 |
2.1× |
| CT maxillofacial w/o contrast (70486) |
$334.60 |
$1,673 |
3.5× |
| CT maxillofacial w/wo contrast (70488) |
$401.60 |
$2,008 |
2.5× |
| CT neck soft tissue w contrast (70491) |
$273.80 |
$1,369 |
1.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$297.40 |
$1,487 |
1.8× |
| CT orbits w/o contrast (70480) |
$269.20 |
$1,346 |
2.8× |
| CT pelvis w & w/o contrast (72194) |
$294.20 |
$1,471 |
1.8× |
| CT pelvis w/o contrast (72192) |
$302.60 |
$1,513 |
3.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$328.60 |
$1,643 |
2.0× |
| CT soft tissue neck w/o contrast (70490) |
$273.80 |
$1,369 |
2.8× |
| CT thoracic spine w/contrast (72129) |
$369.60 |
$1,848 |
2.3× |
| CT thoracic spine w/o contrast (72128) |
$369.60 |
$1,848 |
3.8× |
| CT thoracic spine w/wo contrast (72130) |
$443.60 |
$2,218 |
2.7× |
| CT thorax w/o contrast (71250) |
$318.80 |
$1,594 |
3.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$247.60 |
$1,238 |
1.5× |
| CT upper extremity w/o contrast rt (73200) |
$172 |
$860 |
1.8× |
| CT upper extremity with contrast (73201) |
$172 |
$860 |
0.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$546.20 |
$2,731 |
3.4× |
| Cta Abdomen (74175) |
$395.80 |
$1,979 |
2.5× |
| CTA abdomen pelvis (74174) |
$613.40 |
$3,067 |
1.9× |
| CTA chest (71275) |
$490.60 |
$2,453 |
3.0× |
| Cta Head (70496) |
$489.20 |
$2,446 |
3.0× |
| CTA lwr ext w&w/o contrast (73706) |
$154.80 |
$774 |
1.0× |
| Cta Neck (70498) |
$434.80 |
$2,174 |
2.7× |
| Cta Pelvis (72191) |
$357.60 |
$1,788 |
2.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$78.60 |
$393 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$111.60 |
$558 |
1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$68.40 |
$342 |
0.9× |
| Echoencephalography real time imaging (76506) |
$155 |
$775 |
1.6× |
| Esophagus (74220) |
$133 |
$665 |
0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$87.80 |
$439 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$68 |
$340 |
0.3× |
| Foot 2 views (73620) |
$55.60 |
$278 |
0.7× |
| Forearm 2 views (73090) |
$58.80 |
$294 |
0.7× |
| Hand 2 views (73120) |
$71.80 |
$359 |
0.7× |
| Hand 3 views (73130) |
$65.60 |
$328 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$298.60 |
$1,493 |
0.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$232 |
$1,160 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$70 |
$350 |
0.9× |
| Hysterosalpingogram (74740) |
$178.80 |
$894 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$329.80 |
$1,649 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$398.20 |
$1,991 |
0.8× |
| Knee 3 views (73562) |
$72.80 |
$364 |
0.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$1,957.53 |
$9,787.67 |
24.5× |
| MRA head w & w/o contrast (70546) |
$652 |
$3,260 |
2.0× |
| MRA head w/o contrast (70544) |
$543.40 |
$2,717 |
2.5× |
| MRA head with contrast (70545) |
$528.40 |
$2,642 |
1.6× |
| MRA neck w contrast (70548) |
$557.80 |
$2,789 |
1.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$669.20 |
$3,346 |
2.1× |
| MRA neck w/o contrast (70547) |
$557.80 |
$2,789 |
2.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$473.60 |
$2,368 |
1.5× |
| MRI abdomen w/o contrast (74181) |
$394.60 |
$1,973 |
1.8× |
| MRI any jnt lwr ext with con lt (73722) |
$539.80 |
$2,699 |
0.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$538.40 |
$2,692 |
0.7× |
| MRI breast w/o contrast bilateral (77047) |
$297.20 |
$1,486 |
1.4× |
| MRI c-spine with contrast (72142) |
$529.20 |
$2,646 |
1.6× |
| MRI cervical spine w/o contrast (72141) |
$531.60 |
$2,658 |
2.4× |
| MRI chest w/o & w/contrast material (71552) |
$576.60 |
$2,883 |
1.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$569.20 |
$2,846 |
1.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$380.80 |
$1,904 |
1.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$391.60 |
$1,958 |
1.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$516.20 |
$2,581 |
2.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$571.20 |
$2,856 |
1.8× |
| MRI orbit/face/neck w/contrast (70542) |
$516.20 |
$2,581 |
1.6× |
| MRI pelvis w contrast (72196) |
$222.80 |
$1,114 |
0.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$361.40 |
$1,807 |
1.1× |
| MRI pelvis w/o contrast (72195) |
$305.80 |
$1,529 |
1.4× |
| MRI scan of arm joint before and after contrast (73223) |
$646 |
$3,230 |
2.0× |
| MRI scan of leg joint before and after contrast (73723) |
$647.80 |
$3,239 |
2.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$638 |
$3,190 |
2.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$446.20 |
$2,231 |
1.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$593 |
$2,965 |
1.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$518 |
$2,590 |
1.6× |
| MRI thoracic spine w/o contrast (72146) |
$431.60 |
$2,158 |
2.0× |
| MRI upper ext joint w/o contrast (73221) |
$538.40 |
$2,692 |
2.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$459.80 |
$2,299 |
1.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$574.80 |
$2,874 |
2.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,054.20 |
$5,271 |
0.9× |
| Neck soft tissue (70360) |
$43.20 |
$216 |
0.5× |
| Nm gastric emptying study (78264) |
$354.80 |
$1,774 |
1.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$78.60 |
$393 |
0.8× |
| Osseous survey infant (77076) |
$56.40 |
$282 |
0.6× |
| Parathyrd planar w/wo subtrj (78071) |
$252.60 |
$1,263 |
0.7× |
| Parathyroid imaging (78070) |
$314.80 |
$1,574 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$78.60 |
$393 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$470 |
$2,350 |
1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$277 |
$1,385 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$45.80 |
$229 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$100.80 |
$504 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$119.20 |
$596 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$90.40 |
$452 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$53 |
$265 |
0.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$78 |
$390 |
0.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$70.80 |
$354 |
0.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$235.40 |
$1,177 |
1.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$95.40 |
$477 |
0.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$56.40 |
$282 |
0.7× |
| Radiological examination surgical specimen (76098) |
$193 |
$965 |
0.4× |
| Ribs bilateral 3 views (71110) |
$128.40 |
$642 |
1.3× |
| Scapula complete (73010) |
$68 |
$340 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$13.80 |
$69 |
0.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$65.40 |
$327 |
0.7× |
| Small bowel series (74250) |
$148.80 |
$744 |
0.9× |
| Spine thoracic 3 views (72072) |
$91.40 |
$457 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$245.60 |
$1,228 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$132.80 |
$664 |
1.4× |
| Umbilical-artery Doppler (OB) (76820) |
$78.60 |
$393 |
0.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$100 |
$100 |
1.2× |
| Upper Extremity Infant (73092) |
$52.40 |
$262 |
0.5× |
| Us abdl aorta screen aaa (76706) |
$76.20 |
$339 |
0.8× |
| Us breast unilateral complete (76641) |
$91.60 |
$458 |
1.0× |
| Us breast unilateral limited (76642) |
$109.60 |
$548 |
1.4× |
| Us chest (76604) |
$69 |
$345 |
0.7× |
| Us compl joint r-t w/image documentation (76881) |
$189.60 |
$948 |
2.0× |
| Us elastography parenchyma (76981) |
$78.60 |
$393 |
0.8× |
| Us infant hips dynamic (76885) |
$111 |
$555 |
1.4× |
| Us infant hips limited static (76886) |
$89 |
$445 |
1.1× |
| Us ob transvaginal (76817) |
$78.60 |
$393 |
0.8× |
| Us pelvic non ob complete (76856) |
$164.40 |
$822 |
1.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$62 |
$310 |
0.6× |
| Us pregnancy ltd (76815) |
$81 |
$405 |
0.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$84.60 |
$423 |
0.9× |
| Us retroperitoneal complete (76770) |
$129.60 |
$648 |
1.3× |
| Us retroperitoneal limited (76775) |
$110.80 |
$554 |
1.2× |
| Us scrotum and contents (76870) |
$114 |
$570 |
1.2× |
| Us soft tissue head/neck (76536) |
$177.40 |
$887 |
1.8× |
| Us spinal canal and contents (76800) |
$84.20 |
$421 |
0.9× |
| Us xtr non-vasc lmtd (76882) |
$110 |
$550 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$39 |
$195 |
0.5× |
| Wrist 2 views (73100) |
$54.40 |
$272 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$68.40 |
$342 |
0.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$55.60 |
$278 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$67 |
$335 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$58.40 |
$292 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$65.20 |
$326 |
0.8× |
| X-ray exam hip uni 1 view (73501) |
$48.80 |
$244 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$59.60 |
$298 |
0.7× |
| X-ray exam hip uni 4/> views (73503) |
$68.40 |
$342 |
0.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$100.80 |
$504 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$141.80 |
$709 |
1.5× |
| X-ray exam of femur 1 (73551) |
$48.60 |
$243 |
0.6× |
| X-ray eye for foreign body (70030) |
$86.20 |
$431 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$70.80 |
$354 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$65.60 |
$328 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$49.20 |
$246 |
0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$65.20 |
$326 |
0.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$77.40 |
$387 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$57 |
$285 |
0.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$51.60 |
$258 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$80.80 |
$404 |
0.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$119.40 |
$597 |
1.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$91.60 |
$458 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$38.60 |
$193 |
0.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$90.20 |
$451 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$70.80 |
$354 |
0.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$64.20 |
$321 |
0.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$70.80 |
$354 |
0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$141.60 |
$708 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$78.60 |
$393 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$42.40 |
$212 |
0.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$79.80 |
$399 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$67.60 |
$338 |
0.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$49.20 |
$246 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$76.40 |
$382 |
0.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$71.80 |
$359 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$44.60 |
$223 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$64.20 |
$321 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$64.40 |
$322 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$78.60 |
$393 |
0.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$89 |
$445 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$51.60 |
$258 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$65.80 |
$329 |
0.8× |
| Xr c-spine 6 or more views (72052) |
$108.80 |
$544 |
1.1× |
| Xr chest 4+ views (71048) |
$55.60 |
$278 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$46.60 |
$233 |
0.6× |
| Xr shoulder 1 view (73020) |
$52.20 |
$261 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$93.40 |
$467 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$58.80 |
$294 |
0.7× |
| Xr tmj bilateral (70330) |
$74.80 |
$374 |
0.9× |
| Xray knee 1 or 2 views rt (73560) |
$58.40 |
$292 |
0.7× |