| Abdomen 2 views (74019) |
$294.30 |
$327 |
2.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,715.40 |
$1,906 |
4.1× |
| Ankle 2 views (73600) |
$261 |
$290 |
2.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$890.10 |
$989 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,309.50 |
$1,455 |
3.2× |
| Bone &/joint imaging whole body (78306) |
$1,961.10 |
$2,179 |
4.7× |
| Bone Imaging 3 Phase (78315) |
$2,034 |
$2,260 |
4.9× |
| Bone survey complete (77075) |
$928.80 |
$1,032 |
8.6× |
| Cervical spine 2 or 3 views (72040) |
$355.50 |
$395 |
3.9× |
| Chest 1 view (71045) |
$273.60 |
$304 |
3.0× |
| Chest 3 views (71047) |
$431.10 |
$479 |
4.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$555.30 |
$617 |
3.0× |
| Clavicle complete (73000) |
$282.60 |
$314 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$306.90 |
$341 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,211.90 |
$5,791 |
14.4× |
| CT abdomen and pelvis without contrast (74176) |
$4,521.60 |
$5,024 |
18.2× |
| CT abdomen w contrast (74160) |
$2,870.10 |
$3,189 |
15.8× |
| CT abdomen w wo contrast (74170) |
$3,067.20 |
$3,408 |
16.8× |
| CT abdomen w/o contrast (74150) |
$2,436.30 |
$2,707 |
22.4× |
| CT angiography upper extremity lt (73206) |
$3,252.60 |
$3,614 |
17.9× |
| CT c-spine w/o contrast (72125) |
$2,601 |
$2,890 |
24.0× |
| CT cervical spine with contrast (72126) |
$2,549.70 |
$2,833 |
7.0× |
| CT chest w/wo contrast (71270) |
$2,936.70 |
$3,263 |
16.1× |
| CT chest with contrast (71260) |
$2,767.50 |
$3,075 |
15.2× |
| CT head/brain with contrast (70460) |
$2,185.20 |
$2,428 |
12.0× |
| CT head/brain without and with contrast (70470) |
$2,601 |
$2,890 |
14.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$203.40 |
$226 |
2.3× |
| CT iac w contrast (70481) |
$2,567.70 |
$2,853 |
14.1× |
| CT limited/localized follow up study (76380) |
$1,157.40 |
$1,286 |
12.8× |
| CT lower ext w/o (73700) |
$2,266.20 |
$2,518 |
20.9× |
| CT lower extremity w wo contrast (73702) |
$2,672.10 |
$2,969 |
14.7× |
| CT lower extremity with contrast (73701) |
$2,185.20 |
$2,428 |
12.0× |
| CT lumbar spine w & w/o contrast (72133) |
$2,925 |
$3,250 |
16.1× |
| CT lumbar spine w/o contrast (72131) |
$2,601 |
$2,890 |
24.0× |
| CT lumbar spine with contrast (72132) |
$2,842.20 |
$3,158 |
7.8× |
| CT maxillofacial w contrast (70487) |
$2,421 |
$2,690 |
13.3× |
| CT maxillofacial w/o contrast (70486) |
$1,927.80 |
$2,142 |
17.8× |
| CT maxillofacial w/wo contrast (70488) |
$2,686.50 |
$2,985 |
14.7× |
| CT neck soft tissue w contrast (70491) |
$2,430.90 |
$2,701 |
13.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,570.40 |
$2,856 |
14.1× |
| CT orbits w/o contrast (70480) |
$2,127.60 |
$2,364 |
19.6× |
| CT pelvis w & w/o contrast (72194) |
$2,902.50 |
$3,225 |
15.9× |
| CT pelvis w/o contrast (72192) |
$2,330.10 |
$2,589 |
21.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,570.40 |
$2,856 |
14.1× |
| CT soft tissue neck w/o contrast (70490) |
$2,185.20 |
$2,428 |
20.1× |
| CT thoracic spine w/contrast (72129) |
$2,434.50 |
$2,705 |
13.4× |
| CT thoracic spine w/o contrast (72128) |
$2,601 |
$2,890 |
24.0× |
| CT thoracic spine w/wo contrast (72130) |
$3,077.10 |
$3,419 |
16.9× |
| CT thorax w/o contrast (71250) |
$2,601 |
$2,890 |
24.0× |
| CT upper extremity w/o contrast rt (73200) |
$2,266.20 |
$2,518 |
20.9× |
| CT upper extremity with contrast (73201) |
$2,185.20 |
$2,428 |
6.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,374.10 |
$3,749 |
18.5× |
| Cta Abdomen (74175) |
$3,437.10 |
$3,819 |
18.9× |
| CTA abdomen pelvis (74174) |
$3,778.20 |
$4,198 |
10.4× |
| CTA chest (71275) |
$3,451.50 |
$3,835 |
18.9× |
| Cta Head (70496) |
$3,166.20 |
$3,518 |
17.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,587.50 |
$2,875 |
14.2× |
| Cta Neck (70498) |
$3,391.20 |
$3,768 |
18.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$505.80 |
$562 |
4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$235.80 |
$262 |
2.6× |
| Dxa bone density study axial skeleton (77085) |
$524.70 |
$583 |
4.8× |
| Esophagus (74220) |
$611.10 |
$679 |
3.4× |
| Fetal biophysical profile non-stress testing (76818) |
$467.10 |
$519 |
4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$490.50 |
$545 |
4.5× |
| Fluoroscopy up to 1 hr (76000) |
$642.60 |
$714 |
2.6× |
| Foot 2 views (73620) |
$269.10 |
$299 |
3.0× |
| Forearm 2 views (73090) |
$294.30 |
$327 |
3.3× |
| Gated Heart Planar Single (78472) |
$1,891.80 |
$2,102 |
4.6× |
| Hand 2 views (73120) |
$249.30 |
$277 |
2.3× |
| Hand 3 views (73130) |
$344.70 |
$383 |
3.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,998 |
$2,220 |
3.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,891.80 |
$2,102 |
4.6× |
| Ht muscle image spect sing (78451) |
$3,239.10 |
$3,599 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$322.20 |
$358 |
3.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,370.70 |
$1,523 |
2.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,568.70 |
$1,743 |
2.8× |
| Knee 3 views (73562) |
$443.70 |
$493 |
4.9× |
| Liver & spleen imaging static only (78215) |
$1,682.10 |
$1,869 |
4.1× |
| Meckels Diverticulum (78290) |
$1,339.20 |
$1,488 |
3.2× |
| MRA head w/o contrast (70544) |
$3,778.20 |
$4,198 |
15.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,980.70 |
$4,423 |
11.0× |
| MRA neck w/o contrast (70547) |
$3,093.30 |
$3,437 |
12.5× |
| MRI abdomen w contrast (74182) |
$3,679.20 |
$4,088 |
10.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,383 |
$4,870 |
12.1× |
| MRI abdomen w/o contrast (74181) |
$3,980.70 |
$4,423 |
16.1× |
| MRI any jnt lwr ext with con lt (73722) |
$3,664.80 |
$4,072 |
4.5× |
| MRI breast w/o contrast bilateral (77047) |
$2,224.80 |
$2,472 |
9.0× |
| MRI c-spine with contrast (72142) |
$3,601.80 |
$4,002 |
9.9× |
| MRI cervical spine w/o contrast (72141) |
$3,573.90 |
$3,971 |
14.4× |
| MRI chest w/o & w/contrast material (71552) |
$4,060.80 |
$4,512 |
11.2× |
| MRI chest w/o contrast (71550) |
$3,601.80 |
$4,002 |
14.5× |
| MRI chest with contrast (71551) |
$3,829.50 |
$4,255 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,970 |
$3,300 |
12.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,372.30 |
$3,747 |
13.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,182.30 |
$4,647 |
11.5× |
| MRI pelvis w contrast (72196) |
$3,601.80 |
$4,002 |
9.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,829.50 |
$4,255 |
10.6× |
| MRI pelvis w/o contrast (72195) |
$3,372.30 |
$3,747 |
13.6× |
| MRI scan of arm joint before and after contrast (73223) |
$3,374.10 |
$3,749 |
9.3× |
| MRI scan of leg joint before and after contrast (73723) |
$3,374.10 |
$3,749 |
9.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,980.70 |
$4,423 |
11.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,601.80 |
$4,002 |
9.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,980.70 |
$4,423 |
11.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,601.80 |
$4,002 |
9.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,980.70 |
$4,423 |
11.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,573.90 |
$3,971 |
14.4× |
| MRI tmj (70336) |
$2,453.40 |
$2,726 |
9.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,970 |
$3,300 |
12.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,374.10 |
$3,749 |
9.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,970 |
$3,300 |
12.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,586.40 |
$5,096 |
3.4× |
| Neck soft tissue (70360) |
$328.50 |
$365 |
3.6× |
| Nm gastric emptying study (78264) |
$1,703.70 |
$1,893 |
4.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$344.70 |
$383 |
3.2× |
| Osseous survey infant (77076) |
$522.90 |
$581 |
4.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,563.30 |
$1,737 |
3.8× |
| Parathyroid imaging (78070) |
$1,355.40 |
$1,506 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$302.40 |
$336 |
2.8× |
| PET image w/CT, skull-thigh (78815) |
$6,539.40 |
$7,266 |
4.4× |
| PET imaging for CT attenuation whole body (78816) |
$8,528.40 |
$9,476 |
5.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,914.20 |
$3,238 |
8.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,217.70 |
$1,353 |
2.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,662.30 |
$1,847 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$465.30 |
$517 |
4.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$413.10 |
$459 |
3.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$305.10 |
$339 |
3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$294.30 |
$327 |
2.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$403.20 |
$448 |
4.5× |
| Radiologic exam colon single contrast study (74270) |
$696.60 |
$774 |
3.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$596.70 |
$663 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$353.70 |
$393 |
3.9× |
| Ribs bilateral 3 views (71110) |
$418.50 |
$465 |
3.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,052 |
$2,280 |
3.6× |
| Scapula complete (73010) |
$354.60 |
$394 |
3.3× |
| Screening digital breast tomosynthesis (77063) |
$91.80 |
$102 |
3.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$715.50 |
$795 |
6.6× |
| Small bowel series (74250) |
$640.80 |
$712 |
3.5× |
| Spine thoracic 3 views (72072) |
$461.70 |
$513 |
4.3× |
| Testicular Imaging With Vascular Flow (78761) |
$1,616.40 |
$1,796 |
3.9× |
| Thoracolumbar 2 views (72080) |
$338.40 |
$376 |
3.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,390.50 |
$1,545 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$675 |
$750 |
6.2× |
| Upper Extremity Infant (73092) |
$225 |
$250 |
2.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$849.60 |
$944 |
4.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,249.20 |
$1,388 |
6.9× |
| Us abdl aorta screen aaa (76706) |
$583.20 |
$648 |
5.4× |
| Us breast unilateral complete (76641) |
$486 |
$540 |
4.5× |
| Us breast unilateral limited (76642) |
$486 |
$540 |
5.4× |
| Us chest (76604) |
$529.20 |
$588 |
4.9× |
| Us kidney transplant (76776) |
$858.60 |
$954 |
7.9× |
| Us ob transvaginal (76817) |
$502.20 |
$558 |
4.6× |
| Us pelvic non ob complete (76856) |
$819 |
$910 |
7.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$252 |
$280 |
2.3× |
| Us pregnancy ltd (76815) |
$423.90 |
$471 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$727.20 |
$808 |
6.7× |
| Us retroperitoneal complete (76770) |
$813.60 |
$904 |
7.5× |
| Us retroperitoneal limited (76775) |
$640.80 |
$712 |
5.9× |
| Us scrotum and contents (76870) |
$772.20 |
$858 |
7.1× |
| Us soft tissue head/neck (76536) |
$604.80 |
$672 |
5.6× |
| Us transrectal (76872) |
$737.10 |
$819 |
6.8× |
| Us xtr non-vasc lmtd (76882) |
$329.40 |
$366 |
3.0× |
| Vertebral fracture assessment via dxa (77086) |
$246.60 |
$274 |
2.7× |
| Wrist 2 views (73100) |
$230.40 |
$256 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$552.60 |
$614 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$291.60 |
$324 |
3.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$333 |
$370 |
3.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$979.20 |
$1,088 |
5.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$266.40 |
$296 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$326.70 |
$363 |
3.6× |
| X-ray exam hip uni 1 view (73501) |
$215.10 |
$239 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$354.60 |
$394 |
3.9× |
| X-ray exam hip uni 4/> views (73503) |
$415.80 |
$462 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$522.90 |
$581 |
4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$582.30 |
$647 |
5.4× |
| X-ray exam of femur 1 (73551) |
$294.30 |
$327 |
3.3× |
| X-ray eye for foreign body (70030) |
$262.80 |
$292 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$444.60 |
$494 |
4.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$277.20 |
$308 |
3.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$349.20 |
$388 |
3.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$227.70 |
$253 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$389.70 |
$433 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$234.90 |
$261 |
2.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$232.20 |
$258 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$468 |
$520 |
4.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$477 |
$530 |
4.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$473.40 |
$526 |
4.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$352.80 |
$392 |
3.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$300.60 |
$334 |
3.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$406.80 |
$452 |
3.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$437.40 |
$486 |
4.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$437.40 |
$486 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$590.40 |
$656 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$338.40 |
$376 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$390.60 |
$434 |
4.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$380.70 |
$423 |
4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$352.80 |
$392 |
3.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$328.50 |
$365 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$442.80 |
$492 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$290.70 |
$323 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$246.60 |
$274 |
2.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$351 |
$390 |
3.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$358.20 |
$398 |
4.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$381.60 |
$424 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$237.60 |
$264 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$336.60 |
$374 |
3.7× |
| Xr c-spine 6 or more views (72052) |
$677.70 |
$753 |
6.2× |
| Xr chest 4+ views (71048) |
$459 |
$510 |
4.2× |
| Xr finger(s) 2+ views (73140) |
$230.40 |
$256 |
2.5× |
| Xr shoulder 1 view (73020) |
$226.80 |
$252 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$513 |
$570 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$321.30 |
$357 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$342.90 |
$381 |
3.8× |