| Abdomen 2 views (74019) |
$215.46 |
$567 |
2.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$999.40 |
$2,630 |
2.5× |
| Angiography extremity bilateral rs&i (75716) |
$1,458.82 |
$3,839 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,508.22 |
$3,969 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$2,222.24 |
$5,848 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,326.52 |
$8,754 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,502.52 |
$3,954 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,504.80 |
$3,960 |
0.5× |
| Angiography Spinal Selective Rs&I (75705) |
$3,326.52 |
$8,754 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,326.52 |
$8,754 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,072.14 |
$5,453 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,314.80 |
$3,460 |
0.4× |
| Ankle 2 views (73600) |
$235.22 |
$619 |
2.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$211.66 |
$557 |
0.6× |
| Aortogram thoracic (75605) |
$3,326.52 |
$8,754 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,519.24 |
$3,998 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$1,464.90 |
$3,855 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,502.52 |
$3,954 |
0.5× |
| Arthrogram elbow (73085) |
$370.88 |
$976 |
1.0× |
| Arthrogram hip (73525) |
$275.50 |
$725 |
0.8× |
| Arthrogram shoulder (73040) |
$338.20 |
$890 |
1.0× |
| Arthrogram wrist (73115) |
$370.88 |
$976 |
1.0× |
| Arthrography knee lt (73580) |
$324.14 |
$853 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$574.94 |
$1,513 |
4.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,003.20 |
$2,640 |
2.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$950.76 |
$2,502 |
2.3× |
| Bone &/joint imaging whole body (78306) |
$1,350.52 |
$3,554 |
3.3× |
| Bone age studies (77072) |
$137.94 |
$363 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$1,327.34 |
$3,493 |
3.3× |
| Bone survey complete (77075) |
$253.46 |
$667 |
2.4× |
| Brain image w/flow 4 + views (78606) |
$688.94 |
$1,813 |
1.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$688.94 |
$1,813 |
1.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,371.99 |
$3,610.50 |
3.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,361.16 |
$3,582 |
3.9× |
| Cardiac shunt detection (78428) |
$494 |
$1,300 |
1.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$647.14 |
$1,703 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$235.22 |
$619 |
2.7× |
| Chest 1 view (71045) |
$131.48 |
$346 |
1.5× |
| Chest 3 views (71047) |
$197.60 |
$520 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$281.58 |
$741 |
1.6× |
| Cisternography Positive Contrast Rs&I (70015) |
$521.74 |
$1,373 |
0.7× |
| Clavicle complete (73000) |
$177.08 |
$466 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$235.60 |
$620 |
2.2× |
| Corpora cavernosography (74445) |
$825.74 |
$2,173 |
7.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,533.84 |
$6,668 |
7.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,915.58 |
$5,041 |
7.9× |
| CT abdomen w contrast (74160) |
$1,212.96 |
$3,192 |
6.8× |
| CT abdomen w wo contrast (74170) |
$1,227.78 |
$3,231 |
6.9× |
| CT abdomen w/o contrast (74150) |
$898.32 |
$2,364 |
8.5× |
| CT angio hrt w/3d image (75574) |
$872.29 |
$2,295.50 |
2.5× |
| CT angiography upper extremity lt (73206) |
$1,076.16 |
$2,832 |
6.1× |
| CT c-spine w/o contrast (72125) |
$1,038.54 |
$2,733 |
9.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,117.20 |
$2,940 |
6.3× |
| CT cervical spine with contrast (72126) |
$1,103.52 |
$2,904 |
3.1× |
| CT chest w/wo contrast (71270) |
$1,117.58 |
$2,941 |
6.3× |
| CT chest with contrast (71260) |
$1,049.18 |
$2,761 |
5.9× |
| CT head/brain with contrast (70460) |
$994.84 |
$2,618 |
5.6× |
| CT head/brain without and with contrast (70470) |
$1,094.02 |
$2,879 |
6.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$541.50 |
$1,425 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$235.60 |
$620 |
2.7× |
| CT hrt w/3d image congen (75573) |
$912 |
$2,400 |
2.6× |
| CT iac w contrast (70481) |
$1,343.68 |
$3,536 |
7.6× |
| CT limited/localized follow up study (76380) |
$334.02 |
$879 |
3.8× |
| CT lower ext w/o (73700) |
$931.76 |
$2,452 |
8.8× |
| CT lower extremity w wo contrast (73702) |
$960.26 |
$2,527 |
5.4× |
| CT lower extremity with contrast (73701) |
$952.28 |
$2,506 |
5.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,135.06 |
$2,987 |
6.4× |
| CT lumbar spine w/o contrast (72131) |
$1,087.94 |
$2,863 |
10.3× |
| CT lumbar spine with contrast (72132) |
$1,108.84 |
$2,918 |
3.1× |
| CT maxillofacial w contrast (70487) |
$1,178.76 |
$3,102 |
6.6× |
| CT maxillofacial w/o contrast (70486) |
$1,014.22 |
$2,669 |
9.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,272.62 |
$3,349 |
7.2× |
| CT neck soft tissue w contrast (70491) |
$1,069.32 |
$2,814 |
6.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,451.60 |
$3,820 |
8.2× |
| CT orbits w/o contrast (70480) |
$1,155.96 |
$3,042 |
10.9× |
| CT pelvis w & w/o contrast (72194) |
$1,263.50 |
$3,325 |
7.1× |
| CT pelvis w/o contrast (72192) |
$1,018.40 |
$2,680 |
9.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,083.76 |
$2,852 |
6.1× |
| CT soft tissue neck w/o contrast (70490) |
$915.04 |
$2,408 |
8.6× |
| CT thoracic spine w/contrast (72129) |
$1,091.36 |
$2,872 |
6.1× |
| CT thoracic spine w/o contrast (72128) |
$1,087.18 |
$2,861 |
10.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,119.86 |
$2,947 |
6.3× |
| CT thorax w/o contrast (71250) |
$791.16 |
$2,082 |
7.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,095.54 |
$2,883 |
6.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,010.04 |
$2,658 |
9.5× |
| CT upper extremity with contrast (73201) |
$1,065.90 |
$2,805 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,180.66 |
$3,107 |
6.6× |
| Cta Abdomen (74175) |
$1,154.06 |
$3,037 |
6.5× |
| CTA abdomen pelvis (74174) |
$2,218.82 |
$5,839 |
6.3× |
| CTA chest (71275) |
$1,124.04 |
$2,958 |
6.3× |
| Cta Head (70496) |
$1,372.18 |
$3,611 |
7.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,076.16 |
$2,832 |
6.1× |
| Cta Neck (70498) |
$1,359.64 |
$3,578 |
7.6× |
| Cta Pelvis (72191) |
$1,221.70 |
$3,215 |
6.9× |
| Cystography minimum 3 views rs&i (74430) |
$213.94 |
$563 |
0.6× |
| Diskogram cervical (72285) |
$954.56 |
$2,512 |
0.5× |
| Diskography lumbar (72295) |
$954.56 |
$2,512 |
0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$218.12 |
$574 |
2.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$238.26 |
$627 |
2.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$85.88 |
$226 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$558.60 |
$1,470 |
5.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$179.36 |
$472 |
2.0× |
| Echo exam of fetal heart (76825) |
$342 |
$900 |
0.6× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$186.58 |
$491 |
0.8× |
| Echoencephalography real time imaging (76506) |
$586.72 |
$1,544 |
5.5× |
| Esophagus (74220) |
$302.48 |
$796 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$85.88 |
$226 |
0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$85.88 |
$226 |
0.8× |
| Fluoroscopy up to 1 hr (76000) |
$304.76 |
$802 |
1.3× |
| Foot 2 views (73620) |
$137.94 |
$363 |
1.6× |
| Forearm 2 views (73090) |
$149.34 |
$393 |
1.7× |
| Gated Heart Planar Single (78472) |
$912.57 |
$2,401.50 |
2.3× |
| Hand 2 views (73120) |
$163.97 |
$431.50 |
1.5× |
| Hand 3 views (73130) |
$165.30 |
$435 |
1.9× |
| Heart Infarct Image (78466) |
$631.94 |
$1,663 |
1.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,470.98 |
$3,871 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$487.54 |
$1,283 |
1.2× |
| Ht muscle image spect sing (78451) |
$1,424.62 |
$3,749 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$184.30 |
$485 |
2.1× |
| Hysterosalpingogram (74740) |
$553.28 |
$1,456 |
2.3× |
| Interstitial radiation source applic complex (77778) |
$3,765.80 |
$9,910 |
5.3× |
| Kidney imaging morphology (78700) |
$1,435.64 |
$3,778 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$538.46 |
$1,417 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,247.92 |
$3,284 |
2.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,399.54 |
$3,683 |
2.5× |
| Knee 3 views (73562) |
$226.48 |
$596 |
2.6× |
| Liver & spleen imaging static only (78215) |
$1,053.74 |
$2,773 |
2.6× |
| Liver imaging static only (78201) |
$1,053.74 |
$2,773 |
1.9× |
| Lung perf&ventilat diferentl (78598) |
$393.30 |
$1,035 |
0.7× |
| Lung perfusion differential (78597) |
$321.10 |
$845 |
0.8× |
| Lung Ventilation Imaging (78579) |
$891.48 |
$2,346 |
2.2× |
| Lymphoscintigraphy (78195) |
$437.76 |
$1,152 |
0.8× |
| Meckels Diverticulum (78290) |
$739.10 |
$1,945 |
1.8× |
| Mr safety determination physician/other qhp (76016) |
$90.44 |
$238 |
1.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$61.18 |
$161 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$25.46 |
$67 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$94.24 |
$248 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$248.14 |
$653 |
1.0× |
| MRA head w & w/o contrast (70546) |
$1,326.96 |
$3,492 |
3.8× |
| MRA head w/o contrast (70544) |
$1,326.96 |
$3,492 |
5.5× |
| MRA neck w contrast (70548) |
$1,616.90 |
$4,255 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,805.38 |
$4,751 |
5.1× |
| MRA neck w/o contrast (70547) |
$1,326.96 |
$3,492 |
5.5× |
| MRI abdomen w contrast (74182) |
$1,752.94 |
$4,613 |
5.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,058.46 |
$5,417 |
5.8× |
| MRI abdomen w/o contrast (74181) |
$1,513.54 |
$3,983 |
6.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,607.02 |
$4,229 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,840.34 |
$4,843 |
2.3× |
| MRI bone marrow blood supply (77084) |
$1,231.20 |
$3,240 |
5.1× |
| MRI breast w/o contrast bilateral (77047) |
$828.02 |
$2,179 |
3.4× |
| MRI breast w/o contrast unilat (77046) |
$439.28 |
$1,156 |
1.8× |
| MRI c-spine with contrast (72142) |
$1,752.94 |
$4,613 |
5.0× |
| MRI cardiac w/o contrast (75557) |
$1,437.54 |
$3,783 |
5.9× |
| MRI cervical spine w/o contrast (72141) |
$1,513.54 |
$3,983 |
6.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,058.46 |
$5,417 |
5.8× |
| MRI chest w/o contrast (71550) |
$1,513.54 |
$3,983 |
6.3× |
| MRI chest with contrast (71551) |
$1,752.56 |
$4,612 |
2.2× |
| MRI fetal sngl/1st gestation (74712) |
$1,513.54 |
$3,983 |
6.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,708.86 |
$4,497 |
4.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,607.02 |
$4,229 |
4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,629.44 |
$4,288 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,513.54 |
$3,983 |
6.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,058.46 |
$5,417 |
5.8× |
| MRI orbit/face/neck w/contrast (70542) |
$1,752.94 |
$4,613 |
5.0× |
| MRI pelvis w contrast (72196) |
$1,427.66 |
$3,757 |
4.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,805.38 |
$4,751 |
5.1× |
| MRI pelvis w/o contrast (72195) |
$1,326.96 |
$3,492 |
5.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,840.34 |
$4,843 |
5.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,840.34 |
$4,843 |
5.2× |
| MRI spectroscopy (76390) |
$1,676.18 |
$4,411 |
19.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,058.46 |
$5,417 |
5.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,752.94 |
$4,613 |
5.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,058.46 |
$5,417 |
5.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,752.94 |
$4,613 |
5.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,058.46 |
$5,417 |
5.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,513.54 |
$3,983 |
6.3× |
| MRI tmj (70336) |
$1,326.96 |
$3,492 |
5.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,629.44 |
$4,288 |
6.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,840.34 |
$4,843 |
5.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,629.44 |
$4,288 |
6.7× |
| Myocardial infarct spect (78469) |
$1,180.66 |
$3,107 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$2,288.36 |
$6,022 |
1.7× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,477.25 |
$3,887.50 |
1.7× |
| Neck soft tissue (70360) |
$125.02 |
$329 |
1.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$341.24 |
$898 |
0.8× |
| Nm bone marrow multiple (78103) |
$322.62 |
$849 |
0.8× |
| Nm bone marrow wb (78104) |
$379.24 |
$998 |
0.9× |
| Nm cisternogram (78630) |
$1,262.74 |
$3,323 |
2.3× |
| Nm csf leak detection (78650) |
$839.04 |
$2,208 |
0.6× |
| Nm gastric emptying study (78264) |
$999.40 |
$2,630 |
2.5× |
| Nm gastroesophageal reflux study (78262) |
$999.02 |
$2,629 |
2.5× |
| Nm peritoneal-venous shunt patency (78291) |
$799.52 |
$2,104 |
2.0× |
| Nuclear Rx Oral Admin (79005) |
$1,366.10 |
$3,595 |
5.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$370.88 |
$976 |
3.5× |
| Osseous survey infant (77076) |
$191.90 |
$505 |
1.8× |
| Osseous survey limited (77074) |
$253.46 |
$667 |
2.4× |
| Parathyrd planar w/wo subtrj (78071) |
$600.40 |
$1,580 |
1.5× |
| Parathyroid imaging (78070) |
$529.72 |
$1,394 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$155.04 |
$408 |
1.5× |
| Peritoneogram rs&i (74190) |
$238.64 |
$628 |
0.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,840.34 |
$4,843 |
5.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$858.04 |
$2,258 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,336.84 |
$3,518 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$264.86 |
$697 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$215.46 |
$567 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$277.40 |
$730 |
2.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$331.36 |
$872 |
3.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$440.42 |
$1,159 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$242.06 |
$637 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$165.30 |
$435 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$265.62 |
$699 |
2.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$175.94 |
$463 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$356.06 |
$937 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$627.38 |
$1,651 |
3.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$627.38 |
$1,651 |
3.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$203.30 |
$535 |
2.3× |
| Radiological examination surgical specimen (76098) |
$369.74 |
$973 |
0.7× |
| Ribs bilateral 3 views (71110) |
$272.46 |
$717 |
2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$970.14 |
$2,553 |
2.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,132.78 |
$2,981 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,221.32 |
$3,214 |
2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,223.22 |
$3,219 |
0.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$992.18 |
$2,611 |
0.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$172.90 |
$455 |
0.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$177.08 |
$466 |
0.7× |
| Scanogram (77073) |
$148.58 |
$391 |
1.4× |
| Scapula complete (73010) |
$159.22 |
$419 |
1.5× |
| Screening digital breast tomosynthesis (77063) |
$148.96 |
$392 |
6.4× |
| Sella turcica (70240) |
$61.18 |
$161 |
0.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$474.24 |
$1,248 |
4.5× |
| Sialogram (70390) |
$224.20 |
$590 |
0.9× |
| Small bowel series (74250) |
$413.06 |
$1,087 |
2.3× |
| Spec medical radj physics consltj (77370) |
$284.24 |
$748 |
2.1× |
| Special dosimetry (77331) |
$155.80 |
$410 |
1.1× |
| Special treatment procedure (77470) |
$441.94 |
$1,163 |
0.8× |
| Spine thoracic 3 views (72072) |
$308.94 |
$813 |
2.9× |
| Superior sagittal sinus venogram (75870) |
$1,434.12 |
$3,774 |
0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$378.86 |
$997 |
1.6× |
| Testicular Imaging With Vascular Flow (78761) |
$525.16 |
$1,382 |
1.3× |
| Therapeutic Enema (74283) |
$576.46 |
$1,517 |
3.2× |
| Thoracolumbar 2 views (72080) |
$207.10 |
$545 |
2.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,473.26 |
$3,877 |
2.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$555.56 |
$1,462 |
1.4× |
| Thyroid uptake measurement (78012) |
$464.36 |
$1,222 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$606.86 |
$1,597 |
1.5× |
| Tomogram (76100) |
$311.22 |
$819 |
2.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,000.92 |
$2,634 |
1.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$667.28 |
$1,756 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$441.94 |
$1,163 |
4.2× |
| Umbilical-artery Doppler (OB) (76820) |
$85.88 |
$226 |
0.8× |
| Upper Extremity Infant (73092) |
$150.86 |
$397 |
1.4× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,230.06 |
$3,237 |
3.0× |
| Urethrocystography retrograde rs&i (74450) |
$265.24 |
$698 |
1.1× |
| Urethrocystography voiding (74455) |
$143.64 |
$378 |
0.6× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$537.70 |
$1,415 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$83.22 |
$219 |
0.8× |
| Us breast unilateral complete (76641) |
$376.58 |
$991 |
3.6× |
| Us breast unilateral limited (76642) |
$286.90 |
$755 |
3.3× |
| Us chest (76604) |
$331.17 |
$871.50 |
3.1× |
| Us compl joint r-t w/image documentation (76881) |
$390.26 |
$1,027 |
3.7× |
| Us infant hips dynamic (76885) |
$481.84 |
$1,268 |
5.5× |
| Us kidney transplant (76776) |
$463.98 |
$1,221 |
4.4× |
| Us ob detailed single fetus (76811) |
$248.52 |
$654 |
1.0× |
| Us ob transvaginal (76817) |
$383.42 |
$1,009 |
3.6× |
| Us pelvic non ob complete (76856) |
$352.26 |
$927 |
3.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$193.80 |
$510 |
1.8× |
| Us pregnancy ltd (76815) |
$283.10 |
$745 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$383.42 |
$1,009 |
3.6× |
| Us retroperitoneal complete (76770) |
$435.10 |
$1,145 |
4.1× |
| Us retroperitoneal limited (76775) |
$279.68 |
$736 |
2.6× |
| Us scrotum and contents (76870) |
$353.40 |
$930 |
3.3× |
| Us soft tissue head/neck (76536) |
$353.40 |
$930 |
3.3× |
| Us spinal canal and contents (76800) |
$476.52 |
$1,254 |
4.5× |
| Us transrectal prostate volume (76873) |
$174.04 |
$458 |
1.6× |
| Us xtr non-vasc lmtd (76882) |
$416.10 |
$1,095 |
3.9× |
| Us, eye b-scan (76512) |
$87.02 |
$229 |
0.8× |
| Venogram extremity bilateral (75822) |
$655.12 |
$1,724 |
0.4× |
| Venogram orbital (75880) |
$956.08 |
$2,516 |
1.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,553.44 |
$4,088 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$942.40 |
$2,480 |
0.6× |
| Venography epidural rs&i (75872) |
$956.08 |
$2,516 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$595.08 |
$1,566 |
0.4× |
| Venography Renal Bilateral (75833) |
$1,347.86 |
$3,547 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$2,321.80 |
$6,110 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,434.12 |
$3,774 |
0.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,326.52 |
$8,754 |
0.6× |
| Wrist 2 views (73100) |
$180.12 |
$474 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$270.56 |
$712 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$158.84 |
$418 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$272.84 |
$718 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$665.38 |
$1,751 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$179.74 |
$473 |
2.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$194.56 |
$512 |
2.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$339.72 |
$894 |
3.2× |
| X-ray exam hip uni 1 view (73501) |
$191.90 |
$505 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$211.66 |
$557 |
2.4× |
| X-ray exam of femur 1 (73551) |
$182.78 |
$481 |
2.1× |
| X-ray eye for foreign body (70030) |
$78.28 |
$206 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$257.26 |
$677 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$164.16 |
$432 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$253.84 |
$668 |
2.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,144.94 |
$3,013 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$145.92 |
$384 |
1.7× |
| X-ray IV pyelogram+drip infusn (74410) |
$368.98 |
$971 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$165.30 |
$435 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$263.34 |
$693 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$113.24 |
$298 |
1.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$117.04 |
$308 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$220.02 |
$579 |
2.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$526.30 |
$1,385 |
5.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$225.34 |
$593 |
2.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$153.52 |
$404 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$92.34 |
$243 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$212.04 |
$558 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$242.82 |
$639 |
2.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$265.24 |
$698 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$232.18 |
$611 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$246.24 |
$648 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$348.46 |
$917 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$148.58 |
$391 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$152 |
$400 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$190.38 |
$501 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$249.28 |
$656 |
2.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$201.78 |
$531 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$305.14 |
$803 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$179.36 |
$472 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$263.72 |
$694 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$218.12 |
$574 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$177.08 |
$466 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$195.32 |
$514 |
1.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$339.72 |
$894 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$119.70 |
$315 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$218.12 |
$574 |
2.5× |
| Xr arthrogram ankle (73615) |
$302.10 |
$795 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$469.30 |
$1,235 |
4.4× |
| Xr chest 4+ views (71048) |
$219.26 |
$577 |
2.1× |
| Xr finger(s) 2+ views (73140) |
$104.50 |
$275 |
1.2× |
| Xr internal auditory meati complete (70134) |
$411.54 |
$1,083 |
0.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$137.56 |
$362 |
1.3× |
| Xr optic foramina (70190) |
$140.98 |
$371 |
1.6× |
| Xr shoulder 1 view (73020) |
$310.46 |
$817 |
3.5× |
| Xr spine cervical 4 or 5 views (72050) |
$293.74 |
$773 |
2.8× |
| Xr tibia/fibula 2 views (73590) |
$143.64 |
$378 |
1.6× |
| Xr tmj bilateral (70330) |
$115.14 |
$303 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$188.48 |
$496 |
2.1× |