| Abdomen 2 views (74019) |
$219.20 |
$548 |
2.3× |
| Ankle 2 views (73600) |
$145.60 |
$364 |
1.8× |
| Bone age studies (77072) |
$165.20 |
$413 |
1.7× |
| Bone survey complete (77075) |
$588.80 |
$1,472 |
6.1× |
| Cervical spine 2 or 3 views (72040) |
$252.40 |
$631 |
3.2× |
| Chest 1 view (71045) |
$149.20 |
$373 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$212.40 |
$531 |
1.3× |
| Clavicle complete (73000) |
$167.60 |
$419 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$562 |
$1,405 |
5.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,462 |
$6,155 |
7.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,987.60 |
$4,969 |
9.1× |
| CT abdomen w contrast (74160) |
$1,203.60 |
$3,009 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,330 |
$3,325 |
8.2× |
| CT abdomen w/o contrast (74150) |
$982.80 |
$2,457 |
10.2× |
| CT angiography upper extremity lt (73206) |
$944.80 |
$2,362 |
5.9× |
| CT c-spine w/o contrast (72125) |
$1,264 |
$3,160 |
13.1× |
| CT cervical spine with contrast (72126) |
$1,307.20 |
$3,268 |
4.1× |
| CT chest w/wo contrast (71270) |
$1,100 |
$2,750 |
6.8× |
| CT chest with contrast (71260) |
$944 |
$2,360 |
5.9× |
| CT head/brain with contrast (70460) |
$1,145.60 |
$2,864 |
7.1× |
| CT head/brain without and with contrast (70470) |
$1,248 |
$3,120 |
7.7× |
| CT iac w contrast (70481) |
$887.20 |
$2,218 |
5.5× |
| CT limited/localized follow up study (76380) |
$556 |
$1,390 |
6.9× |
| CT lower ext w/o (73700) |
$894.40 |
$2,236 |
9.3× |
| CT lower extremity w wo contrast (73702) |
$1,008 |
$2,520 |
6.2× |
| CT lower extremity with contrast (73701) |
$1,018 |
$2,545 |
6.3× |
| CT lumbar spine w/o contrast (72131) |
$1,204.40 |
$3,011 |
12.5× |
| CT lumbar spine with contrast (72132) |
$1,321.20 |
$3,303 |
4.1× |
| CT maxillofacial w contrast (70487) |
$644.80 |
$1,612 |
4.0× |
| CT maxillofacial w/o contrast (70486) |
$740.40 |
$1,851 |
7.7× |
| CT maxillofacial w/wo contrast (70488) |
$972.40 |
$2,431 |
6.0× |
| CT neck soft tissue w contrast (70491) |
$1,136.80 |
$2,842 |
7.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,001.60 |
$2,504 |
6.2× |
| CT orbits w/o contrast (70480) |
$941.60 |
$2,354 |
9.8× |
| CT pelvis w & w/o contrast (72194) |
$1,338.80 |
$3,347 |
8.3× |
| CT pelvis w/o contrast (72192) |
$1,145.60 |
$2,864 |
11.9× |
| CT soft tissue neck w/o contrast (70490) |
$773.60 |
$1,934 |
8.0× |
| CT thoracic spine w/contrast (72129) |
$1,261.60 |
$3,154 |
7.8× |
| CT thoracic spine w/o contrast (72128) |
$1,330 |
$3,325 |
13.8× |
| CT thorax w/o contrast (71250) |
$850.40 |
$2,126 |
8.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,087.60 |
$2,719 |
6.7× |
| CT upper extremity w/o contrast rt (73200) |
$809.20 |
$2,023 |
8.4× |
| CT upper extremity with contrast (73201) |
$1,038.40 |
$2,596 |
3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$836.40 |
$2,091 |
5.2× |
| Cta Abdomen (74175) |
$812.40 |
$2,031 |
5.0× |
| CTA abdomen pelvis (74174) |
$2,528 |
$6,320 |
7.9× |
| CTA chest (71275) |
$898.40 |
$2,246 |
5.6× |
| Cta Head (70496) |
$959.20 |
$2,398 |
5.9× |
| CTA lwr ext w&w/o contrast (73706) |
$916.40 |
$2,291 |
5.7× |
| Cta Neck (70498) |
$906 |
$2,265 |
5.6× |
| Cta Pelvis (72191) |
$677.20 |
$1,693 |
4.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$140.40 |
$351 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$127.60 |
$319 |
1.6× |
| Esophagus (74220) |
$252.40 |
$631 |
1.6× |
| Fluoroscopy up to 1 hr (76000) |
$81.20 |
$203 |
0.4× |
| Foot 2 views (73620) |
$145.60 |
$364 |
1.8× |
| Forearm 2 views (73090) |
$145.60 |
$364 |
1.8× |
| Hand 2 views (73120) |
$145.60 |
$364 |
1.5× |
| Hand 3 views (73130) |
$178.80 |
$447 |
2.2× |
| Ht muscle image spect sing (78451) |
$837.20 |
$2,093 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$228 |
$570 |
2.8× |
| Hysterosalpingogram (74740) |
$402 |
$1,005 |
1.8× |
| Knee 3 views (73562) |
$190 |
$475 |
2.4× |
| MRA head w & w/o contrast (70546) |
$1,852.40 |
$4,631 |
5.8× |
| MRA head w/o contrast (70544) |
$1,383.20 |
$3,458 |
6.3× |
| MRA head with contrast (70545) |
$1,595.60 |
$3,989 |
5.0× |
| MRA neck w contrast (70548) |
$1,595.60 |
$3,989 |
5.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,791.60 |
$4,479 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,342.40 |
$3,356 |
6.1× |
| MRI abdomen w contrast (74182) |
$1,382 |
$3,455 |
4.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,475.20 |
$6,188 |
7.7× |
| MRI abdomen w/o contrast (74181) |
$1,402 |
$3,505 |
6.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,341.20 |
$3,353 |
1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,732 |
$4,330 |
2.4× |
| MRI c-spine with contrast (72142) |
$1,549.60 |
$3,874 |
4.8× |
| MRI cervical spine w/o contrast (72141) |
$1,402 |
$3,505 |
6.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,250 |
$5,625 |
7.0× |
| MRI chest w/o contrast (71550) |
$901.20 |
$2,253 |
4.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,469.20 |
$3,673 |
4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,513.60 |
$3,784 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,610.80 |
$4,027 |
7.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,908 |
$4,770 |
5.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,475.20 |
$6,188 |
7.7× |
| MRI pelvis w/o contrast (72195) |
$1,694.40 |
$4,236 |
7.7× |
| MRI scan of arm joint before and after contrast (73223) |
$2,403.20 |
$6,008 |
7.5× |
| MRI scan of leg joint before and after contrast (73723) |
$2,403.20 |
$6,008 |
7.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,849.20 |
$7,123 |
8.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,117.60 |
$5,294 |
6.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,849.20 |
$7,123 |
8.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,722.80 |
$4,307 |
5.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,402 |
$3,505 |
6.4× |
| MRI tmj (70336) |
$968.80 |
$2,422 |
4.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,402 |
$3,505 |
6.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,475.20 |
$6,188 |
7.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,402 |
$3,505 |
6.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,341.20 |
$3,353 |
1.1× |
| Neck soft tissue (70360) |
$183.20 |
$458 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$252.40 |
$631 |
2.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,403.20 |
$6,008 |
7.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$237.20 |
$593 |
3.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$141.60 |
$354 |
1.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$371.20 |
$928 |
3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$248.80 |
$622 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$176 |
$440 |
2.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$219.20 |
$548 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$441.60 |
$1,104 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$416 |
$1,040 |
2.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$246 |
$615 |
3.1× |
| Ribs bilateral 3 views (71110) |
$154 |
$385 |
1.6× |
| Sacroiliac Joints < 3 Views (72200) |
$188.80 |
$472 |
2.0× |
| Scapula complete (73010) |
$183.20 |
$458 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$43.20 |
$108 |
1.8× |
| Spine thoracic 3 views (72072) |
$271.20 |
$678 |
2.8× |
| Tbs Technical Calculation Only (77091) |
$64.80 |
$162 |
0.8× |
| Thoracolumbar 2 views (72080) |
$256.40 |
$641 |
3.2× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$64.80 |
$162 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$452.80 |
$1,132 |
4.7× |
| Upper Extremity Infant (73092) |
$228 |
$570 |
2.4× |
| Us abdl aorta screen aaa (76706) |
$325.20 |
$813 |
3.4× |
| Us breast unilateral limited (76642) |
$290.80 |
$727 |
3.6× |
| Us chest (76604) |
$255.20 |
$638 |
2.7× |
| Us compl joint r-t w/image documentation (76881) |
$280.40 |
$701 |
2.9× |
| Us ob transvaginal (76817) |
$96 |
$240 |
1.0× |
| Us pelvic non ob complete (76856) |
$564.40 |
$1,411 |
5.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$396 |
$990 |
4.1× |
| Us pregnancy ltd (76815) |
$121.80 |
$304.50 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$462.40 |
$1,156 |
4.8× |
| Us retroperitoneal complete (76770) |
$593.20 |
$1,483 |
6.2× |
| Us retroperitoneal limited (76775) |
$335.20 |
$838 |
3.5× |
| Us scrotum and contents (76870) |
$340 |
$850 |
3.5× |
| Us soft tissue head/neck (76536) |
$337.20 |
$843 |
3.5× |
| Us xtr non-vasc lmtd (76882) |
$280.40 |
$701 |
2.9× |
| Wrist 2 views (73100) |
$145.60 |
$364 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$271.20 |
$678 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$230.40 |
$576 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$165.20 |
$413 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$684.40 |
$1,711 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$176 |
$440 |
2.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$228 |
$570 |
2.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$534 |
$1,335 |
5.6× |
| X-ray exam hip uni 1 view (73501) |
$192.80 |
$482 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$246 |
$615 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$383.20 |
$958 |
4.0× |
| X-ray eye for foreign body (70030) |
$149.20 |
$373 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$294 |
$735 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$192.40 |
$481 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$165.20 |
$413 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$145.60 |
$364 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$206 |
$515 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$183.20 |
$458 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$212.40 |
$531 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$184 |
$460 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$271.20 |
$678 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$312.40 |
$781 |
3.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$182.80 |
$457 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$191.60 |
$479 |
2.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$90.80 |
$227 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$234.40 |
$586 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$219.20 |
$548 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$230.40 |
$576 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$370.40 |
$926 |
3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$271.20 |
$678 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$252.40 |
$631 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$228 |
$570 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$282 |
$705 |
3.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$228 |
$570 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$252.40 |
$631 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$245.60 |
$614 |
3.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$126.40 |
$316 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$219.20 |
$548 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$230.40 |
$576 |
2.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$145.60 |
$364 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$165.20 |
$413 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$378 |
$945 |
3.9× |
| Xr finger(s) 2+ views (73140) |
$167.60 |
$419 |
2.1× |
| Xr shoulder 1 view (73020) |
$145.60 |
$364 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$378 |
$945 |
3.9× |
| Xr tibia/fibula 2 views (73590) |
$194.40 |
$486 |
2.4× |
| Xr tmj bilateral (70330) |
$248.80 |
$622 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$143.20 |
$358 |
1.8× |