| Abdomen 1 View (74018) |
$199.50 |
$266 |
2.5× |
| Abdomen 2 views (74019) |
$199.50 |
$266 |
2.1× |
| Ankle 2 views (73600) |
$154.50 |
$206 |
1.9× |
| Bone age studies (77072) |
$223.50 |
$298 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$517.50 |
$690 |
1.4× |
| Bone Imaging Limited Area (78300) |
$510 |
$680 |
1.4× |
| Bone Imaging Whole Body (78306) |
$594.75 |
$793 |
1.6× |
| Chest 1 view (71045) |
$181.43 |
$241.90 |
2.3× |
| Chest 2 views (71046) |
$223.30 |
$297.74 |
2.8× |
| Clavicle complete (73000) |
$170.25 |
$227 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$656.67 |
$875.57 |
6.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$657 |
$876 |
2.0× |
CT abdomen and pelvis without contrast (74176)
range across 2 matching MRF lines |
$656.62–$657 |
$875.50–$876 |
varies |
| CT abdomen w contrast (74160) |
$657 |
$876 |
4.1× |
| CT abdomen w wo contrast (74170) |
$657 |
$876 |
4.1× |
| CT Angio Abdomen and Pelvis (74174) |
$2,078.25 |
$2,771 |
6.5× |
| CT Angio Chest (71275) |
$1,388.57 |
$1,851.43 |
8.6× |
| CT Angio Head (70496) |
$1,467.75 |
$1,957 |
9.1× |
| CT Angio Neck (70498) |
$1,467.75 |
$1,957 |
9.1× |
| CT cervical spine w/o contrast (72125) |
$657 |
$876 |
6.8× |
| CT chest w contrast (71260) |
$657 |
$876 |
4.1× |
| CT head/brain with contrast (70460) |
$657 |
$876 |
4.1× |
| CT head/brain without and with contrast (70470) |
$657 |
$876 |
4.1× |
| CT lower ext w/o (73700) |
$657 |
$876 |
6.8× |
| CT lower extremity w/contrast material (73701) |
$657 |
$876 |
4.1× |
| CT lumbar spine w/o contrast (72131) |
$657 |
$876 |
6.8× |
| CT maxillofacial wo contrast (70486) |
$657 |
$876 |
6.8× |
| CT orbits w/o contrast (70480) |
$657 |
$876 |
6.8× |
| CT pelvis w/o contrast (72192) |
$657 |
$876 |
6.8× |
| CT soft tissue neck w contrast (70491) |
$657 |
$876 |
4.1× |
| CT soft tissue neck w/o contrast (70490) |
$657 |
$876 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$657 |
$876 |
6.8× |
CT thorax w/o contrast (71250)
range across 2 matching MRF lines |
$656.43–$657 |
$875.24–$876 |
varies |
| CT upper ext wo (73200) |
$657 |
$876 |
6.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,510.50 |
$2,014 |
9.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$657 |
$876 |
2.0× |
| Dxa Bone Density Axial (77080) |
$293.11 |
$390.81 |
3.0× |
| Foot 2 views (73620) |
$140.25 |
$187 |
1.8× |
| Forearm 2 views (73090) |
$184.50 |
$246 |
2.3× |
| Gastric emptying imaging study (78264) |
$402 |
$536 |
1.1× |
| Hand 2 views (73120) |
$154.50 |
$206 |
1.6× |
| Hepatobil Syst Image W/Drug (78227) |
$786.75 |
$1,049 |
1.6× |
| Knee 3 Views (73562) |
$222 |
$296 |
2.8× |
| MRI abdomen w/o contrast (74181) |
$772.50 |
$1,030 |
3.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$772.50 |
$1,030 |
2.4× |
| MRI cervical spine w/o cont (72141) |
$772.50 |
$1,030 |
3.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$772.50 |
$1,030 |
2.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$772.50 |
$1,030 |
3.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$772.50 |
$1,030 |
2.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$772.50 |
$1,030 |
2.4× |
| MRI pelvis w/o contrast (72195) |
$772.50 |
$1,030 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$772.50 |
$1,030 |
3.5× |
| MRI, abdomen, combo (74183) |
$767.50 |
$1,023.33 |
2.4× |
| MRI, dorsal spine combo (72157) |
$772.50 |
$1,030 |
2.4× |
| MRI, joint upper extrem (73221) |
$772.50 |
$1,030 |
3.5× |
| MRI, joint upper extrem combo (73223) |
$772.50 |
$1,030 |
2.4× |
| MRI, lumbar spine combo (72158) |
$772.50 |
$1,030 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,178.75 |
$2,905 |
1.8× |
| Neck soft tissue (70360) |
$183.75 |
$245 |
2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,120.50 |
$1,494 |
3.0× |
| Pelvis 1 or 2 views (72170) |
$185.25 |
$247 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$389.89 |
$519.86 |
4.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$207 |
$276 |
2.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$169.50 |
$226 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$225 |
$300 |
2.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$281.25 |
$375 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$157.50 |
$210 |
2.0× |
Radex foot complete minimum 3 views (73630)
range across 2 matching MRF lines |
$200.11–$200.25 |
$266.81–$267 |
varies |
| Radex Hand Minimum 3 Views (73130) |
$202.50 |
$270 |
2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$210 |
$280 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$198.75 |
$265 |
2.5× |
| Radex shoulder complete minimum 2 views (73030) |
$208.50 |
$278 |
2.6× |
| Radex Toe Minimum 2 Views (73660) |
$159.75 |
$213 |
2.0× |
Radex Wrist Complete Minimum 3 Views (73110)
range across 2 matching MRF lines |
$211.93–$212.25 |
$282.58–$283 |
varies |
| Radiologic exam knee complete 4/more views (73564) |
$321 |
$428 |
3.3× |
| Radiologic exam swallow function contrast study (74230) |
$463.50 |
$618 |
2.9× |
| Radiologic examination femur 1 view (73551) |
$123.75 |
$165 |
1.5× |
| Radiologic examination femur minimum 2 views (73552) |
$147 |
$196 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$159.75 |
$213 |
2.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$210.75 |
$281 |
2.6× |
| Ribs bilateral 3 views (71110) |
$197.25 |
$263 |
2.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,228.50 |
$1,638 |
2.5× |
| Scapula (73010) |
$174 |
$232 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$114.72 |
$152.96 |
4.9× |
| Thoracic spine 2 views (72070) |
$197.25 |
$263 |
2.1× |
| Thoracic spine 3 views (72072) |
$299.25 |
$399 |
3.1× |
| Thoracolumbar 2 views (72080) |
$282 |
$376 |
3.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$629.25 |
$839 |
1.7× |
| Ultrasound Breast Limited (76642) |
$140.25 |
$187 |
1.8× |
| Ultrasound Exam Aaa Screen (76706) |
$225 |
$300 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$174 |
$232 |
1.8× |
| Us chest (76604) |
$165.75 |
$221 |
1.7× |
| Us exam, pelvic, limited (76857) |
$153 |
$204 |
1.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$174 |
$232 |
1.8× |
| Us pelvic non ob complete (76856) |
$183 |
$244 |
1.9× |
| Us retroperitoneal complete (76770) |
$225 |
$300 |
2.3× |
| Us retroperitoneal limited (76775) |
$174 |
$232 |
1.8× |
| Us scrotum and contents (76870) |
$183 |
$244 |
1.9× |
| Us thyroid (76536) |
$714 |
$952 |
7.4× |
| Wrist 2 views (73100) |
$141.75 |
$189 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$168.75 |
$225 |
2.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$258 |
$344 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$257.25 |
$343 |
3.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$180.75 |
$241 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$225 |
$300 |
2.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$237.53 |
$316.70 |
3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$297.75 |
$397 |
3.1× |
| X-ray humerus (73060) |
$204 |
$272 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$258.75 |
$345 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$363 |
$484 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$216 |
$288 |
2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$208.50 |
$278 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$212.25 |
$283 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$285.75 |
$381 |
3.6× |
| X-Rays Bone Survey Complete (77075) |
$749.25 |
$999 |
7.8× |
| Xr c-spine 4 or 5 views (72050) |
$339.75 |
$453 |
3.5× |
| Xr facial bones less than 3 views (70140) |
$266.25 |
$355 |
3.3× |