| Abdomen 2 views (74019) |
$278.20 |
$428 |
2.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$941.65 |
$1,448.69 |
2.3× |
| Acute venous thrombus image (78456) |
$1,130.12 |
$1,738.64 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$5,404.02 |
$8,313.87 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$5,265.65 |
$8,101 |
1.7× |
| Angiography internal mammary rs&i (75756) |
$4,490.07 |
$6,907.80 |
1.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,149.90 |
$4,846 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,107.18 |
$1,703.36 |
0.3× |
| Ankle 2 views (73600) |
$159.25 |
$245 |
1.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$588.90 |
$906 |
1.7× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,812.04 |
$2,787.75 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,542.38 |
$4,379.70 |
1.7× |
| Aortography abdominal serialography rs&i (75625) |
$5,265.65 |
$8,101 |
1.7× |
| Arthrogram elbow (73085) |
$595.71 |
$916.48 |
1.7× |
| Arthrogram hip (73525) |
$786.28 |
$1,209.66 |
2.2× |
| Arthrogram shoulder (73040) |
$806.20 |
$1,240.31 |
2.3× |
| Arthrogram wrist (73115) |
$595.71 |
$916.48 |
1.7× |
| Arthrography knee lt (73580) |
$806.20 |
$1,240.31 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$588.35 |
$905.15 |
1.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$689.40 |
$1,060.61 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$1,186.90 |
$1,826 |
3.0× |
| Bone age studies (77072) |
$153.40 |
$236 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$1,998.10 |
$3,074 |
5.0× |
| Bone survey complete (77075) |
$566.80 |
$872 |
5.4× |
| Brain image w/flow 4 + views (78606) |
$1,158.78 |
$1,782.74 |
2.1× |
| Brain imaging < 4 static views (78600) |
$434.99 |
$669.22 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$724.51 |
$1,114.63 |
1.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$941.65 |
$1,448.69 |
1.7× |
| Brain Imaging Vascular Flow Only (78610) |
$434.99 |
$669.22 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$287.30 |
$442 |
3.3× |
| Chest 1 view (71045) |
$161.85 |
$249 |
1.9× |
| Chest 3 views (71047) |
$293.49 |
$451.52 |
3.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$227.50 |
$350 |
1.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$988.94 |
$1,521.45 |
1.3× |
| Clavicle complete (73000) |
$198.90 |
$306 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,261.10 |
$8,094 |
15.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,520.40 |
$5,416 |
14.7× |
| CT abdomen w contrast (74160) |
$2,167.75 |
$3,335 |
12.3× |
| CT abdomen w wo contrast (74170) |
$2,692.30 |
$4,142 |
15.3× |
| CT abdomen w/o contrast (74150) |
$1,518.40 |
$2,336 |
14.5× |
| CT angio hrt w/3d image (75574) |
$1,994.85 |
$3,069 |
5.7× |
| CT angiography upper extremity lt (73206) |
$1,704.95 |
$2,623 |
9.7× |
| CT c-spine w/o contrast (72125) |
$2,081.95 |
$3,203 |
19.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,584.70 |
$2,438 |
9.0× |
| CT cervical spine with contrast (72126) |
$1,407.25 |
$2,165 |
4.0× |
| CT chest w/wo contrast (71270) |
$2,322.45 |
$3,573 |
13.2× |
| CT chest with contrast (71260) |
$1,642.55 |
$2,527 |
9.3× |
| CT head/brain with contrast (70460) |
$976.95 |
$1,503 |
5.5× |
| CT head/brain without and with contrast (70470) |
$1,597.05 |
$2,457 |
9.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,723.80 |
$2,652 |
4.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$135.85 |
$209 |
1.6× |
| CT iac w contrast (70481) |
$2,234.70 |
$3,438 |
12.7× |
| CT limited/localized follow up study (76380) |
$717.34 |
$1,103.60 |
8.2× |
| CT lower ext w/o (73700) |
$1,453.40 |
$2,236 |
13.8× |
| CT lower extremity w wo contrast (73702) |
$1,789.45 |
$2,753 |
10.2× |
| CT lower extremity with contrast (73701) |
$1,651.65 |
$2,541 |
9.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,144.35 |
$3,299 |
12.2× |
| CT lumbar spine w/o contrast (72131) |
$1,264.25 |
$1,945 |
12.0× |
| CT lumbar spine with contrast (72132) |
$1,407.25 |
$2,165 |
4.0× |
| CT maxillofacial w contrast (70487) |
$2,303.60 |
$3,544 |
13.1× |
| CT maxillofacial w/o contrast (70486) |
$1,913.60 |
$2,944 |
18.2× |
| CT maxillofacial w/wo contrast (70488) |
$2,580.34 |
$3,969.76 |
14.6× |
| CT neck soft tissue w contrast (70491) |
$1,904.50 |
$2,930 |
10.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,789.45 |
$2,753 |
10.2× |
| CT orbits w/o contrast (70480) |
$2,156.05 |
$3,317 |
20.5× |
| CT pelvis w & w/o contrast (72194) |
$2,441.40 |
$3,756 |
13.9× |
| CT pelvis w/o contrast (72192) |
$1,890.85 |
$2,909 |
18.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,445.95 |
$3,763 |
13.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,264.25 |
$1,945 |
12.0× |
| CT thoracic spine w/contrast (72129) |
$1,584.70 |
$2,438 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$1,407.25 |
$2,165 |
13.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,711.45 |
$2,633 |
9.7× |
| CT thorax w/o contrast (71250) |
$1,476.80 |
$2,272 |
14.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,789.45 |
$2,753 |
10.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,593.80 |
$2,452 |
15.2× |
| CT upper extremity with contrast (73201) |
$2,464.15 |
$3,791 |
7.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,704.95 |
$2,623 |
9.7× |
| Cta Abdomen (74175) |
$1,704.95 |
$2,623 |
9.7× |
| CTA abdomen pelvis (74174) |
$3,427.45 |
$5,273 |
9.8× |
| CTA chest (71275) |
$1,714.05 |
$2,637 |
9.7× |
| Cta Head (70496) |
$1,714.05 |
$2,637 |
9.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,704.95 |
$2,623 |
9.7× |
| Cta Neck (70498) |
$1,714.05 |
$2,637 |
9.7× |
| Cta Pelvis (72191) |
$1,794.43 |
$2,760.66 |
10.2× |
| Cystography minimum 3 views rs&i (74430) |
$268.45 |
$413 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$400.40 |
$616 |
3.8× |
| Echoencephalography real time imaging (76506) |
$500.50 |
$770 |
4.8× |
| Esophagus (74220) |
$307.45 |
$473 |
1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$807.30 |
$1,242 |
7.7× |
| Fluoroscopy up to 1 hr (76000) |
$206.05 |
$317 |
0.9× |
| Foot 2 views (73620) |
$167.70 |
$258 |
1.9× |
| Forearm 2 views (73090) |
$190.45 |
$293 |
2.2× |
| Gated Heart Planar Single (78472) |
$1,070.55 |
$1,647 |
2.7× |
| Hand 2 views (73120) |
$167.05 |
$257 |
1.6× |
| Hand 3 views (73130) |
$198.25 |
$305 |
2.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,770 |
$5,800 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,539.20 |
$2,368 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,245.40 |
$1,916 |
3.1× |
| Ht muscle image spect sing (78451) |
$1,651.32 |
$2,540.50 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$180.05 |
$277 |
2.1× |
| Hysterosalpingogram (74740) |
$534.95 |
$823 |
2.2× |
| Kidney imaging morphology (78700) |
$434.99 |
$669.22 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$796.89 |
$1,225.98 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,117.35 |
$1,719 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,014.03 |
$1,560.04 |
1.9× |
| Knee 3 views (73562) |
$196.95 |
$303 |
2.3× |
| Liver & spleen imaging static only (78215) |
$936.65 |
$1,441 |
2.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,231.17 |
$1,894.10 |
3.1× |
| Liver imaging static only (78201) |
$724.51 |
$1,114.63 |
1.3× |
| Liver imaging w/vascular flow (78202) |
$1,014.03 |
$1,560.04 |
1.9× |
| Lung perfusion differential (78597) |
$652.98 |
$1,004.58 |
1.6× |
| Lymphoscintigraphy (78195) |
$975 |
$1,500 |
1.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$125.45 |
$193 |
1.4× |
| Meckels Diverticulum (78290) |
$1,274.16 |
$1,960.25 |
3.2× |
| MRA head w & w/o contrast (70546) |
$2,753.28 |
$4,235.81 |
7.9× |
| MRA head w/o contrast (70544) |
$1,827.15 |
$2,811 |
7.6× |
| MRA head with contrast (70545) |
$1,966.42 |
$3,025.26 |
5.6× |
| MRA neck w contrast (70548) |
$1,966.42 |
$3,025.26 |
5.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,973.75 |
$4,575 |
8.5× |
| MRA neck w/o contrast (70547) |
$1,884.35 |
$2,899 |
7.9× |
| MRI abdomen w contrast (74182) |
$3,639.03 |
$5,598.50 |
10.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,013.75 |
$6,175 |
11.5× |
| MRI abdomen w/o contrast (74181) |
$3,584.10 |
$5,514 |
15.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,023.03 |
$3,112.36 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,499.59 |
$3,845.52 |
3.2× |
| MRI breast w/o contrast bilateral (77047) |
$338 |
$520 |
1.4× |
| MRI breast w/o contrast unilat (77046) |
$355.55 |
$547 |
1.5× |
| MRI c-spine with contrast (72142) |
$2,030.92 |
$3,124.49 |
5.8× |
| MRI cervical spine w/o contrast (72141) |
$1,435.85 |
$2,209 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$3,992.30 |
$6,142 |
11.4× |
| MRI chest w/o contrast (71550) |
$3,276.41 |
$5,040.63 |
13.7× |
| MRI chest with contrast (71551) |
$3,639.03 |
$5,598.50 |
4.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,023.03 |
$3,112.36 |
5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,023.03 |
$3,112.36 |
5.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,315.95 |
$3,563 |
9.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,242.50 |
$3,450 |
9.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,539.25 |
$5,445 |
10.1× |
| MRI orbit/face/neck w/contrast (70542) |
$2,527.20 |
$3,888 |
7.2× |
| MRI pelvis w contrast (72196) |
$2,665.85 |
$4,101.30 |
7.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,911.70 |
$6,018 |
11.2× |
| MRI pelvis w/o contrast (72195) |
$2,322.45 |
$3,573 |
9.7× |
| MRI scan of arm joint before and after contrast (73223) |
$2,670.20 |
$4,108 |
7.6× |
| MRI scan of leg joint before and after contrast (73723) |
$3,612.70 |
$5,558 |
10.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,856.75 |
$4,395 |
8.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,929.85 |
$2,969 |
5.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,978.30 |
$4,582 |
8.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,030.92 |
$3,124.49 |
5.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,700.75 |
$4,155 |
7.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,913.60 |
$2,944 |
8.0× |
| MRI tmj (70336) |
$884.65 |
$1,361 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,202.85 |
$3,389 |
9.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,035.50 |
$4,670 |
8.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,358.85 |
$3,629 |
9.8× |
| Myelogram Cervical (72240) |
$1,348.95 |
$2,075.30 |
1.7× |
| Myelogram Lumbar (72265) |
$738.86 |
$1,136.70 |
0.9× |
| Myelogram thoracic (72255) |
$1,348.95 |
$2,075.30 |
1.7× |
| Myelography 2 or more regions (72270) |
$1,062.12 |
$1,634.03 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,812.85 |
$2,789 |
1.4× |
| Neck soft tissue (70360) |
$167.70 |
$258 |
1.9× |
| Nm adrenal scan (78075) |
$1,984.71 |
$3,053.40 |
1.5× |
| Nm gastric emptying study (78264) |
$1,239.55 |
$1,907 |
3.1× |
| Nm gastroesophageal reflux study (78262) |
$1,231.17 |
$1,894.10 |
3.1× |
| Nuclear medicine of heart pumping function (78473) |
$111.56 |
$171.63 |
0.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$579.75 |
$891.92 |
1.4× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$652.13 |
$1,003.28 |
1.6× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$724.51 |
$1,114.63 |
1.8× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$507.37 |
$780.57 |
0.9× |
| Nuclear Rx Oral Admin (79005) |
$864.50 |
$1,330 |
3.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$372.45 |
$573 |
3.5× |
| Osseous survey limited (77074) |
$346.85 |
$533.61 |
3.3× |
| Parathyrd planar w/wo subtrj (78071) |
$602.41 |
$926.79 |
1.5× |
| Parathyroid imaging (78070) |
$1,283.75 |
$1,975 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$180.05 |
$277 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,670.20 |
$4,108 |
7.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$551.20 |
$848 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$941.65 |
$1,448.69 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$412.10 |
$634 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$339.30 |
$522 |
3.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$246.35 |
$379 |
2.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$213.20 |
$328 |
2.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$208.54 |
$320.83 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$185.90 |
$286 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$218.40 |
$336 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$275.60 |
$424 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$284.05 |
$437 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$498.55 |
$767 |
2.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$685.10 |
$1,054 |
3.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$428.35 |
$659 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$98.80 |
$152 |
1.1× |
| Radiological examination surgical specimen (76098) |
$316.55 |
$487 |
0.6× |
| Review by radiologist of adrenal gland vein image (75840) |
$4,215.12 |
$6,484.80 |
1.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,225 |
$6,500 |
1.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,158.78 |
$1,782.74 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,599.88 |
$2,461.36 |
2.9× |
| Sacroiliac Joints < 3 Views (72200) |
$183.95 |
$283 |
1.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$487.85 |
$750.54 |
2.0× |
| Salivary gland imaging (78230) |
$869.26 |
$1,337.33 |
2.2× |
| Salivary gland imaging serial images (78231) |
$1,158.78 |
$1,782.74 |
2.9× |
| Scanogram (77073) |
$210.60 |
$324 |
2.0× |
| Scapula complete (73010) |
$175.50 |
$270 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$41.60 |
$64 |
1.8× |
| Sella turcica (70240) |
$116.10 |
$178.61 |
1.3× |
| Small bowel series (74250) |
$498.55 |
$767 |
2.8× |
| Spine thoracic 3 views (72072) |
$273.65 |
$421 |
2.6× |
| Superior sagittal sinus venogram (75870) |
$1,237.35 |
$1,903.62 |
0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$363.60 |
$559.38 |
1.5× |
| Testicular Imaging With Vascular Flow (78761) |
$724.51 |
$1,114.63 |
1.8× |
| Thoracolumbar 2 views (72080) |
$313.89 |
$482.90 |
3.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,014.03 |
$1,560.04 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$507.37 |
$780.57 |
1.3× |
| Thyroid uptake measurement (78012) |
$685.81 |
$1,055.09 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,210.95 |
$1,863 |
3.0× |
| Tmj unilateral (70328) |
$90.35 |
$139 |
1.0× |
| Tomogram (76100) |
$394.15 |
$606.38 |
3.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$652.13 |
$1,003.28 |
1.6× |
| Ultrasound elastography first target lesion (76982) |
$451.41 |
$694.47 |
4.3× |
| Ultrasound, abdomen limited (76705) |
$642.20 |
$988 |
6.1× |
| Unlisted Ultrasound Procedure (76999) |
$124.53 |
$191.58 |
1.4× |
| Urethrocystography voiding (74455) |
$451.10 |
$694 |
1.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$631.35 |
$971.30 |
3.6× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$754.60 |
$1,160.93 |
4.3× |
| Us abdl aorta screen aaa (76706) |
$516.10 |
$794 |
4.9× |
| Us breast unilateral complete (76641) |
$403.65 |
$621 |
3.8× |
| Us breast unilateral limited (76642) |
$367.90 |
$566 |
4.2× |
| Us chest (76604) |
$237.25 |
$365 |
2.3× |
| Us compl joint r-t w/image documentation (76881) |
$514.80 |
$792 |
4.9× |
| Us elastography parenchyma (76981) |
$451.41 |
$694.47 |
4.3× |
| Us guided compression repair (76936) |
$378.38 |
$582.12 |
1.7× |
| Us infant hips limited static (76886) |
$456.30 |
$702 |
5.2× |
| Us kidney transplant (76776) |
$536.90 |
$826 |
5.1× |
| Us ob transvaginal (76817) |
$685.10 |
$1,054 |
6.5× |
| Us pelvic non ob complete (76856) |
$392.98 |
$604.59 |
3.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$445.64 |
$685.61 |
4.2× |
| Us pregnancy ltd (76815) |
$392 |
$603.07 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$271.72 |
$418.02 |
2.6× |
| Us retroperitoneal complete (76770) |
$474.50 |
$730 |
4.5× |
| Us retroperitoneal limited (76775) |
$529.66 |
$814.85 |
5.0× |
| Us scrotum and contents (76870) |
$807.30 |
$1,242 |
7.7× |
| Us soft tissue head/neck (76536) |
$599.30 |
$922 |
5.7× |
| Us spinal canal and contents (76800) |
$260 |
$400 |
2.5× |
| Us transrectal (76872) |
$399.10 |
$614 |
3.8× |
| Us xtr non-vasc lmtd (76882) |
$343.85 |
$529 |
3.3× |
| Vascular flow imaging (78445) |
$574.29 |
$883.53 |
1.4× |
| Venogram extremity bilateral (75822) |
$705.38 |
$1,085.21 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$4,964.04 |
$7,636.98 |
1.6× |
| Venography caval superior serialography rs&i (75827) |
$1,175.85 |
$1,809 |
0.7× |
| Venography epidural rs&i (75872) |
$1,425.20 |
$2,192.61 |
2.3× |
| Venography extremity unilateral rs&i (75820) |
$903.06 |
$1,389.32 |
0.6× |
| Venography Renal Bilateral (75833) |
$4,917.64 |
$7,565.60 |
1.6× |
| Venography renal unilateral selective rs&i (75831) |
$3,855.42 |
$5,931.42 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,833 |
$2,820 |
0.6× |
| Wrist 2 views (73100) |
$183.30 |
$282 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$516.10 |
$794 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$61.10 |
$94 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$222.95 |
$343 |
2.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$716.95 |
$1,103 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$204.75 |
$315 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$246.35 |
$379 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$196.30 |
$302 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$161.85 |
$249 |
1.9× |
| X-ray exam of femur 1 (73551) |
$94.59 |
$145.53 |
1.1× |
| X-ray eye for foreign body (70030) |
$140.46 |
$216.09 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$141.70 |
$218 |
1.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$124.15 |
$191 |
1.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$211.90 |
$326 |
2.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$139.93 |
$215.28 |
1.6× |
| X-ray IV pyelogram+drip infusn (74410) |
$368.35 |
$566.69 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$227.50 |
$350 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$257.40 |
$396 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$137.80 |
$212 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$294.53 |
$453.13 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$354.25 |
$545 |
3.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$173.43 |
$266.81 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$175.50 |
$270 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$162.68 |
$250.27 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$235.30 |
$362 |
2.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$592.15 |
$911 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$241.80 |
$372 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$244.40 |
$376 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$328.25 |
$505 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$206.70 |
$318 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$181.35 |
$279 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$224.25 |
$345 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$319.15 |
$491 |
3.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$254.15 |
$391 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$358.15 |
$551 |
3.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$225.55 |
$347 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$156.65 |
$241 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$226.20 |
$348 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$205.14 |
$315.61 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$300.30 |
$462 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$275.60 |
$424 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$183.95 |
$283 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$193.05 |
$297 |
2.2× |
| Xr arthrogram ankle (73615) |
$595.71 |
$916.48 |
1.7× |
| Xr c-spine 6 or more views (72052) |
$321.75 |
$495 |
3.1× |
| Xr chest 4+ views (71048) |
$318.74 |
$490.37 |
3.0× |
| Xr finger(s) 2+ views (73140) |
$152.10 |
$234 |
1.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$167.70 |
$258 |
1.6× |
| Xr optic foramina (70190) |
$124.70 |
$191.84 |
1.4× |
| Xr shoulder 1 view (73020) |
$185.25 |
$285 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$267.80 |
$412 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$212.55 |
$327 |
2.4× |
| Xr tmj bilateral (70330) |
$118.95 |
$183 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$163.80 |
$252 |
1.9× |