| Abdomen 2 views (74019) |
$412 |
$412 |
3.3× |
| Ankle 2 views (73600) |
$364 |
$364 |
3.5× |
| Arthrogram elbow (73085) |
$1,472 |
$1,472 |
3.5× |
| Arthrogram wrist (73115) |
$1,541 |
$1,541 |
3.7× |
| Bone &/joint imaging whole body (78306) |
$2,364 |
$2,364 |
4.9× |
| Bone age studies (77072) |
$289 |
$289 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$2,725 |
$2,725 |
5.7× |
| Bone survey complete (77075) |
$1,106 |
$1,106 |
8.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,572 |
$1,572 |
3.3× |
| Cervical spine 2 or 3 views (72040) |
$440 |
$440 |
4.2× |
| Chest 1 view (71045) |
$285 |
$285 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$714 |
$714 |
3.4× |
| Clavicle complete (73000) |
$360 |
$360 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$677 |
$677 |
5.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,140 |
$3,140 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,278 |
$1,278 |
4.5× |
| CT abdomen w wo contrast (74170) |
$2,475 |
$2,475 |
11.8× |
| CT abdomen w/o contrast (74150) |
$1,022 |
$1,022 |
8.2× |
| CT angiography upper extremity lt (73206) |
$2,726 |
$2,726 |
13.0× |
| CT c-spine w/o contrast (72125) |
$1,045 |
$1,045 |
8.3× |
| CT cervical spine with contrast (72126) |
$1,410 |
$1,410 |
3.4× |
| CT chest w/wo contrast (71270) |
$1,756 |
$1,756 |
8.4× |
| CT head/brain with contrast (70460) |
$1,201 |
$1,201 |
5.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$350 |
$350 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$1,037 |
$1,037 |
8.3× |
| CT lumbar spine with contrast (72132) |
$1,410 |
$1,410 |
3.4× |
| CT maxillofacial w contrast (70487) |
$1,255 |
$1,255 |
6.0× |
| CT maxillofacial w/o contrast (70486) |
$1,099 |
$1,099 |
8.8× |
| CT orbits w/o contrast (70480) |
$1,239 |
$1,239 |
9.9× |
| CT pelvis w/o contrast (72192) |
$1,033 |
$1,033 |
8.2× |
| CT thoracic spine w/contrast (72129) |
$1,422 |
$1,422 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$1,041 |
$1,041 |
8.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,760 |
$1,760 |
8.4× |
| CT thorax w/o contrast (71250) |
$1,689.90 |
$1,689.90 |
13.5× |
| CT unlisted procedure (76497) |
$99 |
$99 |
0.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,473 |
$1,473 |
11.8× |
| CT upper extremity with contrast (73201) |
$1,881 |
$1,881 |
4.5× |
| CTA abdomen pelvis (74174) |
$3,465 |
$3,465 |
8.3× |
| CTA lwr ext w&w/o contrast (73706) |
$2,987 |
$2,987 |
14.2× |
| Cta Neck (70498) |
$2,405 |
$2,405 |
11.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$258 |
$258 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$195 |
$195 |
1.9× |
| Esophagus (74220) |
$714 |
$714 |
3.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$222 |
$222 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$486.40 |
$486.40 |
1.7× |
| Foot 2 views (73620) |
$317 |
$317 |
3.0× |
| Forearm 2 views (73090) |
$325 |
$325 |
3.1× |
| Hand 2 views (73120) |
$348 |
$348 |
2.8× |
| Hand 3 views (73130) |
$406 |
$406 |
3.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,639 |
$3,639 |
5.6× |
| Ht muscle image spect sing (78451) |
$2,519 |
$2,519 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$360 |
$360 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,705 |
$1,705 |
2.6× |
| Knee 3 views (73562) |
$453 |
$453 |
4.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$43 |
$43 |
1.2× |
| MRA head w & w/o contrast (70546) |
$3,006 |
$3,006 |
7.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,027 |
$3,027 |
7.2× |
| MRA neck w/o contrast (70547) |
$1,860 |
$1,860 |
6.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,826 |
$2,826 |
6.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,868 |
$2,868 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,861 |
$2,861 |
3.0× |
| MRI breast w/o contrast bilateral (77047) |
$1,720 |
$1,720 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$4,430 |
$4,430 |
10.6× |
| MRI chest w/o contrast (71550) |
$3,245 |
$3,245 |
11.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,909 |
$1,909 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,944 |
$1,944 |
6.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,843 |
$2,843 |
6.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,819 |
$2,819 |
6.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,462 |
$3,462 |
8.3× |
| MRI scan of leg joint before and after contrast (73723) |
$3,452 |
$3,452 |
8.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,539 |
$2,539 |
6.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,546 |
$2,546 |
6.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,622 |
$1,622 |
5.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,738 |
$3,738 |
8.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,882 |
$2,882 |
10.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,638 |
$3,638 |
2.3× |
| Neck soft tissue (70360) |
$352 |
$352 |
3.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$329 |
$329 |
2.6× |
| Osseous survey infant (77076) |
$1,187 |
$1,187 |
9.5× |
| Parathyrd planar w/spect&CT (78072) |
$3,384 |
$3,384 |
5.2× |
| Pelvis 1 or 2 views (72170) |
$309 |
$309 |
2.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,840 |
$2,840 |
6.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,585 |
$2,585 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$105.10 |
$105.10 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$783 |
$783 |
6.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$459 |
$459 |
3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$486 |
$486 |
3.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$332 |
$332 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$477 |
$477 |
3.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$374 |
$374 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$714 |
$714 |
3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$905 |
$905 |
4.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$714 |
$714 |
3.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$714 |
$714 |
3.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$394 |
$394 |
3.8× |
| Radiological examination surgical specimen (76098) |
$630.42 |
$630.42 |
1.0× |
| Ribs bilateral 3 views (71110) |
$489 |
$489 |
3.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,869 |
$3,869 |
2.5× |
| Sacroiliac Joints < 3 Views (72200) |
$367 |
$367 |
2.9× |
| Scapula complete (73010) |
$262 |
$262 |
2.1× |
| Screening digital breast tomosynthesis (77063) |
$114 |
$114 |
4.9× |
| Small bowel series (74250) |
$714 |
$714 |
3.4× |
| Spine thoracic 3 views (72072) |
$436 |
$436 |
3.5× |
| Thoracolumbar 2 views (72080) |
$386 |
$386 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$284 |
$284 |
2.3× |
| Unlisted Ultrasound Procedure (76999) |
$596.85 |
$596.85 |
5.7× |
| Upper Extremity Infant (73092) |
$352 |
$352 |
2.8× |
| Us abdl aorta screen aaa (76706) |
$378 |
$378 |
3.0× |
| Us breast unilateral complete (76641) |
$446.88 |
$446.88 |
3.6× |
| Us breast unilateral limited (76642) |
$342.38 |
$342.38 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$163 |
$163 |
1.3× |
| Us elastography parenchyma (76981) |
$357 |
$357 |
2.8× |
| Us kidney transplant (76776) |
$542 |
$542 |
4.3× |
| Us ob transvaginal (76817) |
$272 |
$272 |
2.2× |
| Us pelvic non ob complete (76856) |
$348 |
$348 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$129.64 |
$129.64 |
1.0× |
| Us pregnancy ltd (76815) |
$239 |
$239 |
1.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$336 |
$336 |
2.7× |
| Us retroperitoneal complete (76770) |
$351 |
$351 |
2.8× |
| Us retroperitoneal limited (76775) |
$138 |
$138 |
1.1× |
| Us scrotum and contents (76870) |
$337 |
$337 |
2.7× |
| Us soft tissue head/neck (76536) |
$406 |
$406 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$151 |
$151 |
1.2× |
| Us, eye b-scan (76512) |
$129.64 |
$129.64 |
1.0× |
| Wrist 2 views (73100) |
$379 |
$379 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$554 |
$554 |
4.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$410 |
$410 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$325 |
$325 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$360 |
$360 |
3.5× |
| X-ray exam hip uni 1 view (73501) |
$359 |
$359 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$522 |
$522 |
5.0× |
| X-ray exam hip uni 4/> views (73503) |
$656 |
$656 |
5.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$597 |
$597 |
4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$686 |
$686 |
5.5× |
| X-ray exam of femur 1 (73551) |
$329 |
$329 |
3.2× |
| X-ray eye for foreign body (70030) |
$359 |
$359 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$528 |
$528 |
4.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$383 |
$383 |
3.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$321 |
$321 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$514 |
$514 |
4.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$352 |
$352 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$444 |
$444 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$694 |
$694 |
5.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$455 |
$455 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$426 |
$426 |
4.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$332 |
$332 |
3.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$539 |
$539 |
4.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$466 |
$466 |
3.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$409 |
$409 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$470 |
$470 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$585 |
$585 |
4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$436 |
$436 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$360 |
$360 |
3.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$383 |
$383 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$420 |
$420 |
4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$500 |
$500 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$398 |
$398 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$274 |
$274 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$463 |
$463 |
4.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$374 |
$374 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$363 |
$363 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$497 |
$497 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$326 |
$326 |
3.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$453 |
$453 |
4.3× |
| Xr c-spine 6 or more views (72052) |
$694 |
$694 |
5.5× |
| Xr finger(s) 2+ views (73140) |
$419 |
$419 |
4.0× |
| Xr shoulder 1 view (73020) |
$240 |
$240 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$590 |
$590 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$352 |
$352 |
3.4× |
| Xr tmj bilateral (70330) |
$599 |
$599 |
5.7× |
| Xray knee 1 or 2 views rt (73560) |
$300 |
$300 |
2.9× |