| Abdomen 2 views (74019) |
$175.66 |
$905.39 |
1.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$666.12 |
$3,433.58 |
1.7× |
| Acute venous thrombus image (78456) |
$804.28 |
$4,145.73 |
0.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,427.31 |
$22,821.12 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$4,427.31 |
$22,821.12 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$4,427.31 |
$22,821.12 |
1.4× |
| Angiography internal mammary rs&i (75756) |
$1,445.56 |
$7,451.30 |
0.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,427.31 |
$22,821.12 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,427.31 |
$22,821.12 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,427.31 |
$22,821.12 |
1.4× |
| Angiography Spinal Selective Rs&I (75705) |
$4,914.37 |
$25,331.75 |
0.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,753.62 |
$24,503.15 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$900.38 |
$4,641.09 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,546.75 |
$7,972.89 |
0.5× |
| Ankle 2 views (73600) |
$151.95 |
$783.20 |
1.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$264.80 |
$1,364.92 |
0.8× |
| Aortogram thoracic (75605) |
$4,427.31 |
$22,821.12 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,427.31 |
$22,821.12 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$4,126.41 |
$21,270.10 |
1.3× |
| Artery X-Rays Adrenal Gland (75731) |
$4,427.31 |
$22,821.12 |
1.4× |
| Arthrogram elbow (73085) |
$369.47 |
$1,904.43 |
1.1× |
| Arthrogram hip (73525) |
$600.93 |
$3,097.52 |
1.8× |
| Arthrogram shoulder (73040) |
$600.93 |
$3,097.52 |
1.8× |
| Arthrogram wrist (73115) |
$600.93 |
$3,097.52 |
1.8× |
| Arthrography knee lt (73580) |
$600.93 |
$3,097.52 |
1.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$673.49 |
$3,471.56 |
1.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$673.49 |
$3,471.56 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$673.49 |
$3,471.56 |
1.7× |
| Bone age studies (77072) |
$175.66 |
$905.39 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$673.49 |
$3,471.56 |
1.7× |
| Bone survey complete (77075) |
$168.78 |
$869.97 |
1.6× |
| Brain imaging < 4 static views w vascular flow (78601) |
$512.09 |
$2,639.57 |
1.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$580.53 |
$2,992.36 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$101.48 |
$523.04 |
1.2× |
| Chest 1 view (71045) |
$101.48 |
$523.04 |
1.2× |
| Chest 3 views (71047) |
$101.48 |
$523.04 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$199.27 |
$1,027.10 |
1.2× |
| Cineradiography/videoradiography (76120) |
$82.63 |
$425.90 |
0.8× |
| Clavicle complete (73000) |
$151.95 |
$783.20 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,626.71 |
$13,539.70 |
7.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,870.72 |
$9,642.82 |
8.0× |
| CT abdomen w contrast (74160) |
$819.13 |
$4,222.29 |
4.8× |
| CT abdomen w wo contrast (74170) |
$913.16 |
$4,706.95 |
5.3× |
| CT abdomen w/o contrast (74150) |
$643.90 |
$3,319.01 |
6.3× |
| CT angio hrt w/3d image (75574) |
$1,052.56 |
$5,425.49 |
3.1× |
| CT angiography upper extremity lt (73206) |
$2,214.98 |
$11,417.36 |
12.9× |
| CT c-spine w/o contrast (72125) |
$726.90 |
$3,746.88 |
7.1× |
| CT cervical spine w&w/o contrast (72127) |
$879.83 |
$4,535.15 |
5.1× |
| CT cervical spine with contrast (72126) |
$869.79 |
$4,483.42 |
2.5× |
| CT chest w/wo contrast (71270) |
$889.45 |
$4,584.74 |
5.2× |
| CT chest with contrast (71260) |
$752.57 |
$3,879.18 |
4.4× |
| CT head/brain with contrast (70460) |
$1,420.83 |
$7,323.84 |
8.3× |
| CT head/brain without and with contrast (70470) |
$1,574.11 |
$8,113.94 |
9.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,186.61 |
$6,116.52 |
3.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$440.58 |
$2,270.99 |
5.2× |
| CT hrt w/3d image congen (75573) |
$1,052.56 |
$5,425.49 |
3.1× |
| CT iac w contrast (70481) |
$693.35 |
$3,573.92 |
4.0× |
| CT limited/localized follow up study (76380) |
$51.80 |
$266.97 |
0.6× |
| CT lower ext w/o (73700) |
$1,124.42 |
$5,795.90 |
11.0× |
| CT lower extremity w wo contrast (73702) |
$1,833.02 |
$9,448.48 |
10.6× |
| CT lower extremity with contrast (73701) |
$1,634.82 |
$8,426.84 |
9.5× |
| CT lumbar spine w & w/o contrast (72133) |
$934.09 |
$4,814.87 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$781.60 |
$4,028.84 |
7.6× |
| CT lumbar spine with contrast (72132) |
$1,291.77 |
$6,658.57 |
3.8× |
| CT maxillofacial w contrast (70487) |
$671.61 |
$3,461.88 |
3.9× |
| CT maxillofacial w/o contrast (70486) |
$602.42 |
$3,105.21 |
5.9× |
| CT maxillofacial w/wo contrast (70488) |
$842.61 |
$4,343.31 |
4.9× |
| CT neck soft tissue w contrast (70491) |
$728.60 |
$3,755.64 |
4.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$862.78 |
$4,447.29 |
5.0× |
| CT orbits w/o contrast (70480) |
$587.32 |
$3,027.37 |
5.7× |
| CT pelvis w & w/o contrast (72194) |
$876.45 |
$4,517.72 |
5.1× |
| CT pelvis w/o contrast (72192) |
$669.85 |
$3,452.80 |
6.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$842.92 |
$4,344.90 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$638.53 |
$3,291.35 |
6.2× |
| CT thoracic spine w/contrast (72129) |
$758.62 |
$3,910.38 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$712.80 |
$3,674.16 |
6.9× |
| CT thoracic spine w/wo contrast (72130) |
$948.87 |
$4,891.04 |
5.5× |
| CT thorax w/o contrast (71250) |
$622.95 |
$3,211.02 |
6.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,431.09 |
$7,376.69 |
8.3× |
| CT upper extremity w/o contrast rt (73200) |
$1,107.20 |
$5,707.14 |
10.8× |
| CT upper extremity with contrast (73201) |
$1,595.16 |
$8,222.47 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,476.84 |
$7,612.51 |
8.6× |
| Cta Abdomen (74175) |
$1,476.84 |
$7,612.51 |
8.6× |
| CTA abdomen pelvis (74174) |
$2,953.56 |
$15,224.48 |
8.6× |
| CTA chest (71275) |
$1,476.84 |
$7,612.51 |
8.6× |
| Cta Head (70496) |
$1,476.80 |
$7,612.28 |
8.6× |
| CTA lwr ext w&w/o contrast (73706) |
$2,214.98 |
$11,417.36 |
12.9× |
| Cta Neck (70498) |
$1,476.80 |
$7,612.28 |
8.6× |
| Cta Pelvis (72191) |
$1,476.84 |
$7,612.51 |
8.6× |
| Cystography minimum 3 views rs&i (74430) |
$394.32 |
$2,032.54 |
1.2× |
| Diskography lumbar (72295) |
$1,190.54 |
$6,136.74 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$162.99 |
$840.09 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$72.04 |
$371.27 |
0.8× |
| Echoencephalography real time imaging (76506) |
$170.36 |
$878.08 |
1.7× |
| Esophagus (74220) |
$373.84 |
$1,926.95 |
2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$266.56 |
$1,373.99 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$189.64 |
$977.46 |
0.8× |
| Foot 2 views (73620) |
$151.95 |
$783.20 |
1.8× |
| Forearm 2 views (73090) |
$151.95 |
$783.20 |
1.8× |
| Gated Heart Planar Single (78472) |
$855.93 |
$4,411.94 |
2.2× |
| Hand 2 views (73120) |
$189.04 |
$974.38 |
1.8× |
| Hand 3 views (73130) |
$151.95 |
$783.20 |
1.8× |
| Heart Infarct Image (78466) |
$855.93 |
$4,411.94 |
2.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,409.62 |
$7,266.05 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$753.41 |
$3,883.53 |
1.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$753.41 |
$3,883.53 |
1.9× |
| Ht muscle image spect sing (78451) |
$2,279.12 |
$11,747.98 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$151.95 |
$783.20 |
1.8× |
| Hysterosalpingogram (74740) |
$452.15 |
$2,330.61 |
1.9× |
| Interstitial radiation source applic complex (77778) |
$1,412.51 |
$7,280.91 |
2.1× |
| Kidney imaging morphology (78700) |
$255.92 |
$1,319.13 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$901.66 |
$4,647.67 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$901.66 |
$4,647.67 |
1.7× |
| Knee 3 views (73562) |
$151.95 |
$783.20 |
1.8× |
| Liver & spleen imaging static only (78215) |
$753.40 |
$3,883.47 |
1.9× |
| Lung perf&ventilat diferentl (78598) |
$1,427.95 |
$7,360.53 |
2.7× |
| Lung perfusion differential (78597) |
$333.19 |
$1,717.42 |
0.8× |
| Lung Ventilation Imaging (78579) |
$580.08 |
$2,990.05 |
1.5× |
| Lymphoscintigraphy (78195) |
$719.76 |
$3,710.05 |
1.4× |
| Mammary ductogram or galactogram multiple (77054) |
$678.22 |
$3,495.93 |
2.9× |
| Mammary ductogram or galactogram single (77053) |
$452.15 |
$2,330.61 |
1.9× |
| Meckels Diverticulum (78290) |
$666.12 |
$3,433.58 |
1.7× |
| MRA head w & w/o contrast (70546) |
$2,813.27 |
$14,501.35 |
8.2× |
| MRA head w/o contrast (70544) |
$780.12 |
$4,021.18 |
3.3× |
| MRA head with contrast (70545) |
$2,231.79 |
$11,504.01 |
6.5× |
| MRA neck w contrast (70548) |
$2,231.79 |
$11,504.01 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,813.27 |
$14,501.35 |
8.2× |
| MRA neck w/o contrast (70547) |
$806.26 |
$4,155.92 |
3.4× |
| MRI abdomen w contrast (74182) |
$2,231.79 |
$11,504.01 |
6.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,116.80 |
$5,756.64 |
3.3× |
| MRI abdomen w/o contrast (74181) |
$846.32 |
$4,362.44 |
3.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,636.75 |
$13,591.45 |
3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,164.49 |
$6,002.45 |
1.5× |
| MRI breast w/o contrast bilateral (77047) |
$165.54 |
$853.27 |
0.7× |
| MRI breast w/o contrast unilat (77046) |
$165.54 |
$853.27 |
0.7× |
| MRI c-spine with contrast (72142) |
$2,231.79 |
$11,504.01 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$899.39 |
$4,635.97 |
3.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,009.23 |
$5,202.19 |
2.9× |
| MRI chest w/o contrast (71550) |
$689.18 |
$3,552.44 |
2.9× |
| MRI chest with contrast (71551) |
$2,231.79 |
$11,504.01 |
2.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$829.56 |
$4,276.02 |
2.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,696.09 |
$13,897.32 |
7.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,199.40 |
$11,337.08 |
9.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$830.44 |
$4,280.59 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,057.03 |
$5,448.57 |
3.1× |
| MRI orbit/face/neck w/contrast (70542) |
$2,231.79 |
$11,504.01 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,231.79 |
$11,504.01 |
6.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,125.83 |
$5,803.21 |
3.3× |
| MRI pelvis w/o contrast (72195) |
$788.18 |
$4,062.75 |
3.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,183.74 |
$6,101.72 |
3.5× |
| MRI scan of leg joint before and after contrast (73723) |
$969.54 |
$4,997.56 |
2.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,158.63 |
$5,972.27 |
3.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$971.10 |
$5,005.63 |
2.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,207.71 |
$6,225.24 |
3.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$910.95 |
$4,695.57 |
2.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,207.39 |
$6,223.63 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$880.12 |
$4,536.67 |
3.8× |
| MRI tmj (70336) |
$1,817.51 |
$9,368.56 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,205.35 |
$11,367.72 |
9.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$902.22 |
$4,650.56 |
2.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,190.46 |
$11,291 |
9.4× |
| Myelogram Cervical (72240) |
$540.56 |
$2,786.34 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,279.12 |
$11,747.98 |
1.8× |
| Neck soft tissue (70360) |
$101.48 |
$523.04 |
1.2× |
| Nm cisternogram (78630) |
$1,503.65 |
$7,750.71 |
2.8× |
| Nm gastric emptying study (78264) |
$666.12 |
$3,433.58 |
1.7× |
| Nm gastroesophageal reflux study (78262) |
$666.12 |
$3,433.58 |
1.7× |
| Nm peritoneal-venous shunt patency (78291) |
$666.12 |
$3,433.58 |
1.7× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,168.70 |
$11,178.82 |
1.5× |
| Nuclear medicine study of kidney and blood flow (78701) |
$901.66 |
$4,647.67 |
2.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$280.84 |
$1,447.56 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$589.89 |
$3,040.64 |
2.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$170.36 |
$878.08 |
1.7× |
| Orthopantogram (70355) |
$101.48 |
$523.04 |
1.2× |
| Osseous survey infant (77076) |
$168.78 |
$869.97 |
1.6× |
| Osseous survey limited (77074) |
$168.78 |
$869.97 |
1.6× |
| Parathyrd planar w/spect&CT (78072) |
$839.50 |
$4,327.29 |
1.6× |
| Parathyrd planar w/wo subtrj (78071) |
$839.50 |
$4,327.29 |
2.1× |
| Parathyroid imaging (78070) |
$608.12 |
$3,134.61 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$175.66 |
$905.39 |
1.7× |
| Peritoneogram rs&i (74190) |
$369.23 |
$1,903.22 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$2,168.70 |
$11,178.82 |
1.5× |
| PET imaging CT for attenuation limited area (78814) |
$2,168.70 |
$11,178.82 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$2,168.70 |
$11,178.82 |
1.5× |
| PET whole body (78813) |
$2,168.70 |
$11,178.82 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$997.59 |
$5,142.14 |
2.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,976.19 |
$10,186.48 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$579.90 |
$2,989.14 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$890.06 |
$4,587.91 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$231.34 |
$1,192.40 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$70.26 |
$362.09 |
0.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$175.66 |
$905.39 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$157.75 |
$813.08 |
1.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$101.48 |
$523.04 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$140.50 |
$724.18 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$175.66 |
$905.39 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$101.48 |
$523.04 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$175.66 |
$905.39 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$101.48 |
$523.04 |
1.2× |
| Radiologic exam colon single contrast study (74270) |
$373.84 |
$1,926.95 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$326.48 |
$1,682.82 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$347.88 |
$1,793.13 |
2.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$151.95 |
$783.20 |
1.8× |
| Radiological examination surgical specimen (76098) |
$369.23 |
$1,903.22 |
0.7× |
| Review by radiologist of adrenal gland vein image (75840) |
$4,427.31 |
$22,821.12 |
1.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,409.62 |
$7,266.05 |
0.5× |
| Ribs bilateral 3 views (71110) |
$101.48 |
$523.04 |
1.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,545.17 |
$7,964.76 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$939.40 |
$4,842.20 |
1.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$170.64 |
$879.55 |
0.7× |
| Scanogram (77073) |
$175.66 |
$905.39 |
1.7× |
| Scapula complete (73010) |
$189.04 |
$974.38 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$15.86 |
$81.69 |
0.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$73.96 |
$381.17 |
0.7× |
| Small bowel series (74250) |
$199.27 |
$1,027.10 |
1.2× |
| Spine thoracic 3 views (72072) |
$175.66 |
$905.39 |
1.7× |
| Testicular Imaging With Vascular Flow (78761) |
$901.66 |
$4,647.67 |
2.3× |
| Therapeutic Enema (74283) |
$199.27 |
$1,027.10 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$819.65 |
$4,224.95 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$373.27 |
$1,924 |
1.0× |
| Thyroid uptake measurement (78012) |
$321.75 |
$1,658.47 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$608.12 |
$3,134.61 |
1.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,750.71 |
$14,178.85 |
5.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,778.93 |
$9,169.67 |
4.5× |
| Ultrasound elastography first target lesion (76982) |
$100.30 |
$516.96 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$176.25 |
$908.48 |
1.7× |
| Unlisted Ultrasound Procedure (76999) |
$170.36 |
$878.08 |
2.0× |
| Upper Extremity Infant (73092) |
$189.04 |
$974.38 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$280.48 |
$1,445.71 |
1.2× |
| Urethrocystography voiding (74455) |
$394.32 |
$2,032.54 |
1.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$394.32 |
$2,032.54 |
2.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$394.32 |
$2,032.54 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$106.06 |
$546.66 |
1.0× |
| Us breast unilateral complete (76641) |
$220.62 |
$1,137.19 |
2.1× |
| Us breast unilateral limited (76642) |
$220.62 |
$1,137.19 |
2.6× |
| Us chest (76604) |
$128.15 |
$660.52 |
1.2× |
| Us compl joint r-t w/image documentation (76881) |
$207.23 |
$1,068.16 |
2.0× |
| Us elastography parenchyma (76981) |
$100.30 |
$516.96 |
1.0× |
| Us guided compression repair (76936) |
$383.96 |
$1,979.14 |
1.8× |
| Us infant hips dynamic (76885) |
$104.11 |
$536.58 |
1.2× |
| Us ob detailed single fetus (76811) |
$417.97 |
$2,154.44 |
1.8× |
| Us ob transvaginal (76817) |
$170.36 |
$878.08 |
1.7× |
| Us pelvic non ob complete (76856) |
$266.56 |
$1,373.99 |
2.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$170.36 |
$878.08 |
1.7× |
| Us pregnancy ltd (76815) |
$170.36 |
$878.08 |
1.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$266.56 |
$1,373.99 |
2.6× |
| Us retroperitoneal complete (76770) |
$266.56 |
$1,373.99 |
2.6× |
| Us retroperitoneal limited (76775) |
$266.56 |
$1,373.99 |
2.6× |
| Us scrotum and contents (76870) |
$266.56 |
$1,373.99 |
2.6× |
| Us soft tissue head/neck (76536) |
$266.56 |
$1,373.99 |
2.6× |
| Us spinal canal and contents (76800) |
$266.56 |
$1,373.99 |
2.6× |
| Us transrectal (76872) |
$129.66 |
$668.32 |
1.3× |
| Us xtr non-vasc lmtd (76882) |
$140.59 |
$724.66 |
1.4× |
| Vascular flow imaging (78445) |
$512.09 |
$2,639.57 |
1.3× |
| Venogram extremity bilateral (75822) |
$1,546.75 |
$7,972.89 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$4,427.31 |
$22,821.12 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$1,546.75 |
$7,972.89 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,546.75 |
$7,972.89 |
1.0× |
| Venography Renal Bilateral (75833) |
$4,427.31 |
$22,821.12 |
1.4× |
| Venography renal unilateral selective rs&i (75831) |
$4,427.31 |
$22,821.12 |
1.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,939.42 |
$9,996.98 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,427.31 |
$22,821.12 |
0.8× |
| Wrist 2 views (73100) |
$74.66 |
$384.79 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$175.66 |
$905.39 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$151.95 |
$783.20 |
1.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$323.34 |
$1,666.67 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$151.95 |
$783.20 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$151.95 |
$783.20 |
1.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$140.50 |
$724.18 |
1.4× |
| X-ray exam hip uni 1 view (73501) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$94.71 |
$488.17 |
1.1× |
| X-ray exam hip uni 4/> views (73503) |
$142.07 |
$732.26 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$157.75 |
$813.08 |
1.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$315.49 |
$1,626.19 |
3.1× |
| X-ray exam of femur 1 (73551) |
$91.89 |
$473.59 |
1.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$323.34 |
$1,666.67 |
1.9× |
| X-ray eye for foreign body (70030) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$175.62 |
$905.20 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$151.95 |
$783.20 |
1.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,311.78 |
$6,761.70 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$151.95 |
$783.20 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$189.04 |
$974.38 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$54.86 |
$282.72 |
0.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$151.95 |
$783.20 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$175.66 |
$905.39 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$168.78 |
$869.97 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$168.78 |
$869.97 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$84.12 |
$433.58 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$175.66 |
$905.39 |
1.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$175.62 |
$905.20 |
1.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$675.04 |
$3,479.55 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$175.66 |
$905.39 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$168.78 |
$869.97 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$175.66 |
$905.39 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$151.95 |
$783.20 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$168.78 |
$869.97 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$175.66 |
$905.39 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$101.48 |
$523.04 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$175.66 |
$905.39 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$73.38 |
$378.16 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$151.95 |
$783.20 |
1.8× |
| Xr arthrogram ankle (73615) |
$369.47 |
$1,904.43 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$168.95 |
$870.82 |
1.6× |
| Xr chest 4+ views (71048) |
$175.66 |
$905.39 |
1.7× |
| Xr Cholecystography Oral Contrast (74290) |
$199.27 |
$1,027.10 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$73.38 |
$378.16 |
0.9× |
| Xr shoulder 1 view (73020) |
$151.95 |
$783.20 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$168.95 |
$870.82 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$151.95 |
$783.20 |
1.8× |
| Xr tmj bilateral (70330) |
$101.48 |
$523.04 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$151.95 |
$783.20 |
1.8× |