| Abdomen 2 views (74019) |
$320.40 |
$534 |
3.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,004.40 |
$1,674 |
2.7× |
| Ankle 2 views (73600) |
$218.40 |
$364 |
2.7× |
| Arthrogram hip (73525) |
$626.40 |
$1,044 |
1.9× |
| Arthrogram shoulder (73040) |
$433.80 |
$723 |
1.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,117.20 |
$1,862 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,342.20 |
$2,237 |
3.6× |
| Bone age studies (77072) |
$237.60 |
$396 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$1,239.60 |
$2,066 |
3.3× |
| Bone survey complete (77075) |
$1,247.40 |
$2,079 |
12.7× |
| Cervical spine 2 or 3 views (72040) |
$268.20 |
$447 |
3.3× |
| Chest 1 view (71045) |
$221.40 |
$369 |
2.7× |
| Chest 3 views (71047) |
$294 |
$490 |
3.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$570 |
$950 |
3.5× |
| Clavicle complete (73000) |
$237.60 |
$396 |
2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,892.40 |
$3,154 |
19.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,283.60 |
$8,806 |
16.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,452.40 |
$5,754 |
15.4× |
| CT abdomen w contrast (74160) |
$2,016.60 |
$3,361 |
12.3× |
| CT abdomen w wo contrast (74170) |
$2,410.20 |
$4,017 |
14.6× |
| CT abdomen w/o contrast (74150) |
$1,636.80 |
$2,728 |
16.7× |
| CT angio hrt w/3d image (75574) |
$235.20 |
$392 |
0.7× |
| CT angiography upper extremity lt (73206) |
$3,091.20 |
$5,152 |
18.8× |
| CT c-spine w/o contrast (72125) |
$2,103.60 |
$3,506 |
21.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,874.60 |
$4,791 |
17.5× |
| CT cervical spine with contrast (72126) |
$2,428.20 |
$4,047 |
7.4× |
| CT chest w/wo contrast (71270) |
$3,096 |
$5,160 |
18.8× |
| CT chest with contrast (71260) |
$2,587.80 |
$4,313 |
15.7× |
| CT head/brain with contrast (70460) |
$1,683.60 |
$2,806 |
10.2× |
| CT head/brain without and with contrast (70470) |
$2,391.60 |
$3,986 |
14.5× |
| CT lower ext w/o (73700) |
$1,560 |
$2,600 |
15.9× |
| CT lower extremity w wo contrast (73702) |
$2,241 |
$3,735 |
13.6× |
| CT lower extremity with contrast (73701) |
$1,970.40 |
$3,284 |
12.0× |
| CT lumbar spine w/o contrast (72131) |
$1,992.60 |
$3,321 |
20.3× |
| CT lumbar spine with contrast (72132) |
$2,428.20 |
$4,047 |
7.4× |
| CT maxillofacial w contrast (70487) |
$1,970.40 |
$3,284 |
12.0× |
| CT maxillofacial w/o contrast (70486) |
$1,560 |
$2,600 |
15.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,241 |
$3,735 |
13.6× |
| CT neck soft tissue w contrast (70491) |
$1,970.40 |
$3,284 |
12.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,241 |
$3,735 |
13.6× |
| CT orbits w/o contrast (70480) |
$1,560 |
$2,600 |
15.9× |
| CT pelvis w & w/o contrast (72194) |
$2,874.60 |
$4,791 |
17.5× |
| CT pelvis w/o contrast (72192) |
$1,815 |
$3,025 |
18.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,241 |
$3,735 |
13.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,560 |
$2,600 |
15.9× |
| CT thoracic spine w/contrast (72129) |
$2,428.20 |
$4,047 |
14.8× |
| CT thoracic spine w/o contrast (72128) |
$2,145 |
$3,575 |
21.9× |
| CT thoracic spine w/wo contrast (72130) |
$2,874.60 |
$4,791 |
17.5× |
| CT thorax w/o contrast (71250) |
$1,892.40 |
$3,154 |
19.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,241 |
$3,735 |
13.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,560 |
$2,600 |
15.9× |
| CT upper extremity with contrast (73201) |
$1,970.40 |
$3,284 |
6.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,241 |
$3,735 |
13.6× |
| Cta Abdomen (74175) |
$2,241 |
$3,735 |
13.6× |
| CTA abdomen pelvis (74174) |
$5,170.80 |
$8,618 |
15.8× |
| CTA chest (71275) |
$2,874.60 |
$4,791 |
17.5× |
| Cta Head (70496) |
$2,241 |
$3,735 |
13.6× |
| CTA lwr ext w&w/o contrast (73706) |
$3,361.80 |
$5,603 |
20.4× |
| Cta Neck (70498) |
$2,241 |
$3,735 |
13.6× |
| Cta Pelvis (72191) |
$2,928.60 |
$4,881 |
17.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$559.80 |
$933 |
5.7× |
| Dxa bone density study axial skeleton (77085) |
$279.60 |
$466 |
2.9× |
| Echoencephalography real time imaging (76506) |
$805.80 |
$1,343 |
8.2× |
| Esophagus (74220) |
$567 |
$945 |
3.4× |
| Fetal biophysical profile non-stress testing (76818) |
$975 |
$1,625 |
9.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$153.60 |
$256 |
1.6× |
| Fluoroscopy up to 1 hr (76000) |
$387.60 |
$646 |
1.7× |
| Foot 2 views (73620) |
$216.60 |
$361 |
2.7× |
| Forearm 2 views (73090) |
$228 |
$380 |
2.8× |
| Hand 2 views (73120) |
$199.80 |
$333 |
2.0× |
| Hand 3 views (73130) |
$238.80 |
$398 |
2.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,342.20 |
$2,237 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$696 |
$1,160 |
1.9× |
| Ht muscle image spect sing (78451) |
$1,915.80 |
$3,193 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$237.60 |
$396 |
2.9× |
| Hysterosalpingogram (74740) |
$477 |
$795 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,471.20 |
$2,452 |
2.9× |
| Knee 3 views (73562) |
$480 |
$800 |
5.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$188.40 |
$314 |
2.3× |
| MRA head w & w/o contrast (70546) |
$2,887.80 |
$4,813 |
8.8× |
| MRA head w/o contrast (70544) |
$2,887.80 |
$4,813 |
12.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,887.80 |
$4,813 |
8.8× |
| MRA neck w/o contrast (70547) |
$2,887.80 |
$4,813 |
12.9× |
| MRI abdomen w contrast (74182) |
$2,628 |
$4,380 |
8.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,950.80 |
$4,918 |
9.0× |
| MRI abdomen w/o contrast (74181) |
$2,773.80 |
$4,623 |
12.4× |
| MRI any jnt lwr ext with con lt (73722) |
$3,325.20 |
$5,542 |
4.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,325.20 |
$5,542 |
4.5× |
| MRI c-spine with contrast (72142) |
$3,324 |
$5,540 |
10.2× |
| MRI cervical spine w/o contrast (72141) |
$3,325.20 |
$5,542 |
14.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,325.20 |
$5,542 |
10.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,249.40 |
$3,749 |
10.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,873.40 |
$4,789 |
12.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,314.80 |
$8,858 |
16.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,325.20 |
$5,542 |
10.2× |
| MRI pelvis w/o contrast (72195) |
$3,325.20 |
$5,542 |
14.9× |
| MRI scan of arm joint before and after contrast (73223) |
$3,325.20 |
$5,542 |
10.2× |
| MRI scan of leg joint before and after contrast (73723) |
$3,325.20 |
$5,542 |
10.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,052 |
$8,420 |
15.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,469.20 |
$5,782 |
10.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,153.80 |
$6,923 |
12.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,324 |
$5,540 |
10.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,052 |
$8,420 |
15.4× |
| MRI thoracic spine w/o contrast (72146) |
$3,325.20 |
$5,542 |
14.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,325.20 |
$5,542 |
14.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,325.20 |
$5,542 |
10.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,397.60 |
$3,996 |
10.7× |
| Myelogram Lumbar (72265) |
$114 |
$190 |
0.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,490 |
$4,150 |
2.0× |
| Neck soft tissue (70360) |
$218.40 |
$364 |
2.7× |
| Nm gastric emptying study (78264) |
$1,369.80 |
$2,283 |
3.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$904.80 |
$1,508 |
9.2× |
| Parathyroid imaging (78070) |
$805.80 |
$1,343 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$237.60 |
$396 |
2.4× |
| PET image w/CT, skull-thigh (78815) |
$4,928.40 |
$8,214 |
3.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,325.20 |
$5,542 |
10.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$697.20 |
$1,162 |
1.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,425 |
$2,375 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$484.20 |
$807 |
4.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$461.40 |
$769 |
4.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$672.60 |
$1,121 |
6.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$387.60 |
$646 |
4.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$237.60 |
$396 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$325.20 |
$542 |
3.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$261 |
$435 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$862.20 |
$1,437 |
5.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,225.20 |
$2,042 |
7.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,149 |
$1,915 |
7.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$473.40 |
$789 |
5.8× |
| Radiological examination surgical specimen (76098) |
$768 |
$1,280 |
1.5× |
| Ribs bilateral 3 views (71110) |
$468.60 |
$781 |
4.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$373.80 |
$623 |
0.7× |
| Sacroiliac Joints < 3 Views (72200) |
$237.60 |
$396 |
2.4× |
| Scapula complete (73010) |
$237.60 |
$396 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$40.20 |
$67 |
1.7× |
| Small bowel series (74250) |
$457.20 |
$762 |
2.8× |
| Spine thoracic 3 views (72072) |
$363 |
$605 |
3.7× |
| Thoracolumbar 2 views (72080) |
$321.60 |
$536 |
3.9× |
| Thyroid uptake measurement (78012) |
$323.40 |
$539 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$918.60 |
$1,531 |
2.4× |
| Tmj unilateral (70328) |
$237.60 |
$396 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$579 |
$965 |
5.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$113.40 |
$189 |
1.4× |
| Upper Extremity Infant (73092) |
$174.60 |
$291 |
1.8× |
| Urethrocystography voiding (74455) |
$334.80 |
$558 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$452.40 |
$754 |
4.6× |
| Us breast unilateral complete (76641) |
$403.80 |
$673 |
4.1× |
| Us breast unilateral limited (76642) |
$201.60 |
$336 |
2.5× |
| Us chest (76604) |
$958.20 |
$1,597 |
9.8× |
| Us compl joint r-t w/image documentation (76881) |
$255 |
$425 |
2.6× |
| Us infant hips dynamic (76885) |
$733.20 |
$1,222 |
9.0× |
| Us kidney transplant (76776) |
$578.40 |
$964 |
5.9× |
| Us ob transvaginal (76817) |
$448.20 |
$747 |
4.6× |
| Us pelvic non ob complete (76856) |
$799.20 |
$1,332 |
8.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$179.40 |
$299 |
1.8× |
| Us pregnancy ltd (76815) |
$720 |
$1,200 |
7.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$904.80 |
$1,508 |
9.2× |
| Us retroperitoneal complete (76770) |
$508.20 |
$847 |
5.2× |
| Us retroperitoneal limited (76775) |
$452.40 |
$754 |
4.6× |
| Us scrotum and contents (76870) |
$904.80 |
$1,508 |
9.2× |
| Us soft tissue head/neck (76536) |
$720 |
$1,200 |
7.3× |
| Us spinal canal and contents (76800) |
$432 |
$720 |
4.4× |
| Us transrectal (76872) |
$904.80 |
$1,508 |
9.2× |
| Us transrectal prostate volume (76873) |
$192 |
$320 |
2.0× |
| Us xtr non-vasc lmtd (76882) |
$166.20 |
$277 |
1.7× |
| Wrist 2 views (73100) |
$216.60 |
$361 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$549.60 |
$916 |
5.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$315.60 |
$526 |
3.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$261 |
$435 |
3.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$937.80 |
$1,563 |
5.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$203.40 |
$339 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$268.20 |
$447 |
3.3× |
| X-ray exam hip uni 1 view (73501) |
$231.60 |
$386 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$235.80 |
$393 |
2.9× |
| X-ray exam hip uni 4/> views (73503) |
$246 |
$410 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$457.20 |
$762 |
4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$34.80 |
$58 |
0.4× |
| X-ray exam of femur 1 (73551) |
$118.20 |
$197 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$348 |
$580 |
3.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$237.60 |
$396 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$246 |
$410 |
3.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$228 |
$380 |
2.8× |
| X-ray IV pyelogram+drip infusn (74410) |
$739.80 |
$1,233 |
4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$237.60 |
$396 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$292.20 |
$487 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$414 |
$690 |
5.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$216.60 |
$361 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$274.20 |
$457 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$668.40 |
$1,114 |
6.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$376.20 |
$627 |
3.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$237.60 |
$396 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$396 |
$660 |
4.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$309 |
$515 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$307.20 |
$512 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$373.20 |
$622 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$533.40 |
$889 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$343.80 |
$573 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$268.20 |
$447 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$237.60 |
$396 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$385.80 |
$643 |
4.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$124.20 |
$207 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$387.60 |
$646 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$237.60 |
$396 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$237.60 |
$396 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$315.60 |
$526 |
3.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$237.60 |
$396 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$321.60 |
$536 |
3.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$455.40 |
$759 |
4.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$180.60 |
$301 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$264 |
$440 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$468.60 |
$781 |
4.8× |
| Xr chest 4+ views (71048) |
$274.20 |
$457 |
2.8× |
| Xr finger(s) 2+ views (73140) |
$199.20 |
$332 |
2.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$468.60 |
$781 |
4.8× |
| Xr shoulder 1 view (73020) |
$207 |
$345 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$349.80 |
$583 |
3.6× |
| Xr tibia/fibula 2 views (73590) |
$246 |
$410 |
3.0× |
| Xr tmj bilateral (70330) |
$387.60 |
$646 |
4.7× |
| Xray knee 1 or 2 views rt (73560) |
$224.40 |
$374 |
2.7× |