| Abdomen 2 views (74019) |
$618.88 |
$1,547.20 |
6.1× |
| Acute gi blood loss imaging (78278) |
$876.48 |
$2,191.19 |
2.2× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$960.33 |
$2,400.82 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$1,337.90 |
$3,344.74 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,337.90 |
$3,344.74 |
0.4× |
| Ankle 2 views (73600) |
$337.99 |
$844.98 |
4.0× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,008.32 |
$5,020.80 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,609.20 |
$4,023 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$2,008.32 |
$5,020.80 |
0.7× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$1,398.10 |
$3,495.26 |
0.5× |
| Arthrogram hip (73525) |
$1,063 |
$2,657.48 |
3.1× |
| Arthrogram knee (73580) |
$838.63 |
$2,096.58 |
2.5× |
| Arthrogram shoulder (73040) |
$761.34 |
$1,903.36 |
2.2× |
| Arthrogram wrist (73115) |
$784.98 |
$1,962.47 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,640.34 |
$4,100.85 |
4.2× |
| Bone &/joint imaging whole body (78306) |
$2,621.44 |
$6,553.59 |
6.7× |
| Bone age studies (77072) |
$282.62 |
$706.56 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$2,386.11 |
$5,965.28 |
6.1× |
| Bone survey complete (77075) |
$1,124.71 |
$2,811.77 |
11.0× |
| Bone survey infant (77076) |
$311.46 |
$778.65 |
3.1× |
| Bowel imaging (78290) |
$1,716.48 |
$4,291.19 |
4.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$855.36 |
$2,138.40 |
1.6× |
| Brain Imaging Vascular Flow Only (78610) |
$656.36 |
$1,640.92 |
1.2× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$964.94 |
$2,412.35 |
1.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,445.97 |
$3,614.92 |
3.7× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,173.74 |
$2,934.33 |
3.0× |
| Cervical spine 2 or 3 views (72040) |
$605.61 |
$1,514.02 |
7.1× |
| Chest 1 view (71045) |
$325.30 |
$813.25 |
3.8× |
| Chest xray 3 views (71047) |
$337.99 |
$844.98 |
4.0× |
| Cholecystography, oral contrast Non-Facility (74290) |
$996.09 |
$2,490.22 |
5.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$298.77 |
$746.92 |
1.7× |
| Clavicle complete (73000) |
$459.70 |
$1,149.23 |
5.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$432.58 |
$1,081.45 |
4.2× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$737.70 |
$1,844.24 |
8.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,891.99 |
$19,729.98 |
23.2× |
| CT abdomen and pelvis without contrast (74176) |
$6,349.70 |
$15,874.24 |
27.3× |
| CT abdomen w contrast (74160) |
$3,581.76 |
$8,954.40 |
20.9× |
| CT abdomen w wo contrast (74170) |
$3,955.52 |
$9,888.78 |
23.1× |
| CT abdomen w/o contrast (74150) |
$3,205.13 |
$8,012.82 |
31.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,772.95 |
$4,432.37 |
10.4× |
| CT angiography upper extremity lt (73206) |
$1,699.76 |
$4,249.38 |
9.9× |
| CT c-spine w/contrast (72126) |
$3,581.76 |
$8,954.40 |
10.5× |
| CT c-spine w/o contrast (72125) |
$2,960.58 |
$7,401.44 |
29.0× |
| CT cervical spine w&w/o contrast (72127) |
$3,868.42 |
$9,671.04 |
22.6× |
| CT chest w contrast (71260) |
$3,362.02 |
$8,405.03 |
19.6× |
| CT chest w/wo contrast (71270) |
$3,755.95 |
$9,389.87 |
21.9× |
| CT head/brain with contrast (70460) |
$3,251.27 |
$8,128.18 |
19.0× |
| CT head/brain without and with contrast (70470) |
$3,721.92 |
$9,304.78 |
21.7× |
| CT iac w contrast (70481) |
$1,995.06 |
$4,987.65 |
11.7× |
| CT limited/localized follow up study (76380) |
$651.76 |
$1,629.38 |
7.7× |
| CT lower ext w/o (73700) |
$2,796.78 |
$6,991.94 |
27.4× |
| CT lower extremity w wo contrast (73702) |
$3,189.55 |
$7,973.88 |
18.6× |
| CT lower extremity w/contrast material (73701) |
$2,949.04 |
$7,372.61 |
17.2× |
| CT lumbar spine w & w/o contrast (72133) |
$4,560.54 |
$11,401.36 |
26.6× |
| CT lumbar spine w/contrast (72132) |
$4,190.84 |
$10,477.08 |
12.3× |
| CT lumbar spine w/o contrast (72131) |
$3,493.52 |
$8,733.78 |
34.3× |
| CT maxillofacial w contrast (70487) |
$2,744.28 |
$6,860.72 |
16.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,448.98 |
$6,122.44 |
14.3× |
| CT maxillofacial wo contrast (70486) |
$2,621.44 |
$6,553.59 |
25.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,725.90 |
$6,814.75 |
15.9× |
| CT orbits w/o contrast (70480) |
$1,640.34 |
$4,100.85 |
16.1× |
| CT pelvis w/o contrast (72192) |
$3,148.03 |
$7,870.08 |
30.9× |
| CT pelvis w/wo contrast (72194) |
$3,941.66 |
$9,854.17 |
23.0× |
| CT scan of arm combo (73202) |
$2,539.53 |
$6,348.82 |
14.8× |
| CT soft tissue neck w contrast (70491) |
$3,205.13 |
$8,012.82 |
18.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,287.16 |
$10,717.90 |
25.1× |
| CT soft tissue neck w/o contrast (70490) |
$3,013.07 |
$7,532.66 |
29.5× |
| CT thoracic spine w/contrast (72129) |
$3,435.84 |
$8,589.60 |
20.1× |
| CT thoracic spine w/o contrast (72128) |
$2,960.58 |
$7,401.44 |
29.0× |
| CT thoracic spine w/wo contrast (72130) |
$3,868.42 |
$9,671.04 |
22.6× |
| CT thorax w/o contrast (71250) |
$3,103.04 |
$7,757.60 |
30.4× |
| CT upper ext wo (73200) |
$2,287.48 |
$5,718.71 |
22.4× |
| CT upper extremity with contrast (73201) |
$2,461.09 |
$6,152.72 |
7.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,699.76 |
$4,249.38 |
9.9× |
| Cta Abdomen (74175) |
$3,124.38 |
$7,810.94 |
18.3× |
| CTA abdomen pelvis (74174) |
$2,943.28 |
$7,358.18 |
8.6× |
| CTA chest (71275) |
$3,044.21 |
$7,610.52 |
17.8× |
| Cta Head (70496) |
$2,917.89 |
$7,294.74 |
17.0× |
| Cta Neck (70498) |
$2,625.47 |
$6,281.03 |
15.3× |
| Cta Pelvis (72191) |
$3,148.03 |
$7,870.08 |
18.4× |
| Cystography minimum 3 views rs&i (74430) |
$741.73 |
$1,854.33 |
2.2× |
| Diskogram cervical (72285) |
$1,372.66 |
$3,431.66 |
0.7× |
| Diskography lumbar (72295) |
$1,302.02 |
$3,255.04 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$999.55 |
$2,498.88 |
9.8× |
| Esophageal motility (78258) |
$982.82 |
$2,457.06 |
2.5× |
| Esophagus (74220) |
$540.44 |
$1,351.09 |
3.2× |
| Facial bones min 3 views (70150) |
$524.89 |
$1,312.22 |
5.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$840.94 |
$2,102.34 |
8.2× |
| Fluoroscopy up to 1 hr (76000) |
$674.24 |
$1,685.62 |
2.9× |
| Foot 2 views (73620) |
$351.26 |
$878.14 |
4.1× |
| Forearm 2 views (73090) |
$436.04 |
$1,090.10 |
5.1× |
| Hand 2 views (73120) |
$351.26 |
$878.14 |
3.4× |
| Heart first pass single,planar (78481) |
$3,062.66 |
$7,656.66 |
5.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,856.63 |
$4,641.58 |
3.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,610.35 |
$4,025.88 |
4.1× |
| Hysterosalpingogram (74740) |
$1,372.14 |
$3,430.36 |
5.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$294.73 |
$736.83 |
2.9× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$692.70 |
$1,731.76 |
1.8× |
| Kidney imaging morphology (78700) |
$1,370.42 |
$3,426.04 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,453.47 |
$3,633.68 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,026.20 |
$5,065.51 |
3.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,670.92 |
$4,177.28 |
3.2× |
| Knee 3 views (73562) |
$621.76 |
$1,554.40 |
7.3× |
| Liver & spleen imaging static only (78215) |
$2,109.26 |
$5,273.14 |
5.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,650.72 |
$4,126.81 |
4.2× |
| Liver imaging static only (78201) |
$1,749.94 |
$4,374.83 |
3.3× |
| Liver imaging w/vascular flow (78202) |
$1,022.62 |
$2,556.55 |
1.9× |
| Lung perf&ventilat diferentl (78598) |
$1,071.65 |
$2,679.12 |
2.0× |
| Lung ventilation imaging (78579) |
$1,571.14 |
$3,927.83 |
4.0× |
| Lymphoscintigraphy (78195) |
$801.35 |
$2,003.37 |
1.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,637.14 |
$9,092.84 |
4.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$3,941.09 |
$9,852.73 |
11.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,645.78 |
$9,114.46 |
10.7× |
| Mammary ductogram or galactogram single (77053) |
$263.28 |
$658.19 |
1.1× |
| Mr safety determination physician/other qhp (76016) |
$31.35 |
$78.38 |
0.4× |
| Mr safety implt pos&/immoblj (76019) |
$31.35 |
$78.38 |
0.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$31.35 |
$78.38 |
0.1× |
| MRA head w/o contrast (70544) |
$4,408.28 |
$11,020.70 |
18.9× |
| MRA neck w contrast (70548) |
$5,068.68 |
$12,671.71 |
14.9× |
| MRA neck w/o contrast (70547) |
$4,408.28 |
$11,020.70 |
18.9× |
| MRI abdomen w contrast (74182) |
$4,538.62 |
$11,346.57 |
13.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,216.92 |
$13,042.29 |
15.3× |
| MRI abdomen w/o contrast (74181) |
$3,945.71 |
$9,864.26 |
16.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$5,216.92 |
$13,042.29 |
6.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,170.19 |
$12,925.48 |
15.2× |
| MRI breast w/o contrast bilateral (77047) |
$4,741.08 |
$11,852.70 |
20.4× |
| MRI breast wo contrast unilateral (77046) |
$3,797.48 |
$9,493.69 |
16.3× |
| MRI c-spine with contrast (72142) |
$4,629.18 |
$11,572.94 |
13.6× |
| MRI cardiac w/o contrast (75557) |
$3,408.73 |
$8,521.82 |
14.6× |
| MRI cervical spine w/o contrast (72141) |
$3,653.26 |
$9,133.16 |
15.7× |
| MRI chest w/o & w/contrast material (71552) |
$5,275.16 |
$13,187.91 |
15.5× |
| MRI chest w/o contrast (71550) |
$2,563.76 |
$6,409.40 |
11.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,110.78 |
$12,776.96 |
15.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,933.02 |
$9,832.54 |
16.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,736.79 |
$6,841.97 |
11.8× |
| MRI orbit face neck w contrast (70542) |
$2,778.31 |
$6,945.78 |
8.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,452.69 |
$11,131.72 |
13.1× |
| MRI pelvis w/contrast (72196) |
$4,317.72 |
$10,794.30 |
12.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,618.22 |
$11,545.56 |
13.6× |
| MRI pelvis w/o contrast (72195) |
$4,016.07 |
$10,040.18 |
17.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,471.85 |
$13,679.62 |
16.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,701.28 |
$11,753.19 |
13.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,473.58 |
$13,683.95 |
16.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,558.82 |
$11,397.04 |
13.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,069.26 |
$12,673.14 |
14.9× |
| MRI temporomandibular joint (70336) |
$2,201.54 |
$5,503.85 |
9.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,553.92 |
$8,884.79 |
15.3× |
| MRI up ext w/o contrast (73218) |
$3,941.09 |
$9,852.73 |
16.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,553.92 |
$8,884.79 |
15.3× |
| Myelogram Cervical (72240) |
$1,190.46 |
$2,976.15 |
1.6× |
| Myelogram Lumbar (72265) |
$1,287.36 |
$3,218.39 |
1.7× |
| Myelogram thoracic (72255) |
$1,688.22 |
$4,220.54 |
2.2× |
| Myelography 2 or more regions (72270) |
$1,983.52 |
$4,958.80 |
2.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,118.87 |
$5,297.18 |
1.7× |
| Myocardial spect single study at rest or stress (78451) |
$2,930.78 |
$7,326.95 |
2.3× |
| Neck soft tissue (70360) |
$438.34 |
$1,095.86 |
5.2× |
| Nm cardiac blood pool multiple (78473) |
$2,424.17 |
$6,060.44 |
6.2× |
| Nm cisternogram (78630) |
$842.08 |
$2,105.22 |
1.6× |
| Nm csf leak detection (78650) |
$774.60 |
$1,936.52 |
0.6× |
| Nm gastric emptying study (78264) |
$1,533.64 |
$3,834.10 |
3.9× |
| Nm kidney scan w/flow (78701) |
$1,699.41 |
$4,248.53 |
4.4× |
| Nm red cell sequestration (78140) |
$3,042.48 |
$7,606.20 |
7.8× |
| Noncardiac Vascular Flow Imaging (78445) |
$689.82 |
$1,724.56 |
1.8× |
| Nuclear Rx Oral Admin (79005) |
$906.02 |
$2,265.06 |
4.0× |
| Parathyroid Planar Imaging (78070) |
$578.50 |
$1,446.26 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$282.62 |
$706.56 |
2.8× |
| PET image w/CT, skull-thigh (78815) |
$2,886.77 |
$7,216.92 |
2.1× |
| PET imaging for CT attenuation whole body (78816) |
$2,886.77 |
$7,216.92 |
2.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,900.47 |
$4,751.18 |
4.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,102.46 |
$7,756.16 |
5.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$711.16 |
$1,777.91 |
1.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$471.80 |
$1,179.50 |
5.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$445.27 |
$1,113.18 |
5.2× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$498.33 |
$1,245.83 |
5.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,499.04 |
$3,747.59 |
14.7× |
| Radex fingr minimum 2 views (73140) |
$411.24 |
$1,028.10 |
4.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$474.10 |
$1,185.27 |
5.6× |
| Radex Hand Minimum 3 Views (73130) |
$462 |
$1,154.98 |
5.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$243.40 |
$608.50 |
2.9× |
| Radex Humerus Minimum 2 Views (73060) |
$469.50 |
$1,173.74 |
5.5× |
| Radex Kne 1/2 Views (73560) |
$422.78 |
$1,056.94 |
5.0× |
| Radex Kne Compl 4/More Views (73564) |
$511.60 |
$1,279 |
5.0× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$621.76 |
$1,554.40 |
6.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$511.60 |
$1,279 |
6.0× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$486.80 |
$1,216.98 |
4.8× |
| Radex Sho Compl Minimum 2 Views (73030) |
$527.10 |
$1,317.75 |
6.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$358.18 |
$895.44 |
4.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$519.67 |
$1,299.18 |
5.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$605.61 |
$1,514.02 |
7.1× |
| Radex Toe Minimum 2 Views (73660) |
$406.63 |
$1,016.56 |
4.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$233.59 |
$583.98 |
2.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$486.80 |
$1,216.98 |
5.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$526.60 |
$1,316.49 |
6.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$294.73 |
$736.83 |
2.9× |
| Radiologic exam chest 2 views (71046) |
$491.98 |
$1,229.96 |
5.8× |
| Radiologic exam colon single contrast study (74270) |
$1,124.13 |
$2,810.33 |
6.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,103.95 |
$2,759.88 |
6.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,185.27 |
$2,963.17 |
6.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$422.78 |
$1,056.94 |
5.0× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$471.80 |
$1,179.50 |
0.9× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$835.75 |
$2,089.36 |
8.2× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$692.12 |
$1,730.32 |
6.8× |
| Radiological examination surgical specimen (76098) |
$323.44 |
$808.59 |
0.6× |
| Renal Cyst Study (74470) |
$532.94 |
$1,332.36 |
1.0× |
| Ribs bilateral 3 views (71110) |
$400.07 |
$1,000.18 |
3.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,131.06 |
$2,827.64 |
2.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,034.28 |
$5,085.70 |
3.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,975.69 |
$4,939.23 |
3.7× |
| Sacroiliac Joints < 3 Views (72200) |
$454.24 |
$1,135.61 |
4.5× |
| Scapula (73010) |
$550.82 |
$1,377.05 |
5.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$100.94 |
$252.34 |
4.3× |
| Sella turcica (70240) |
$505.83 |
$1,264.58 |
6.0× |
| Shoulder 1 view (73020) |
$374.33 |
$935.82 |
4.4× |
| Small bowel series (74250) |
$516.78 |
$1,291.96 |
3.0× |
| Spine thoracic 3 views (72072) |
$621.76 |
$1,554.40 |
6.1× |
| Testicular Imaging With Vascular Flow (78761) |
$744.01 |
$1,860.02 |
1.9× |
| Thoracolumbar 2 views (72080) |
$389.32 |
$973.30 |
4.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,459.24 |
$3,648.08 |
2.8× |
| Thyroid imaging w/blood flow (78013) |
$1,218.14 |
$3,045.36 |
3.1× |
| Thyroid uptake measurement (78012) |
$854.20 |
$2,135.51 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$923.42 |
$2,308.53 |
2.4× |
| Tmj unilateral (70328) |
$364.52 |
$911.30 |
4.3× |
| Tomogram (76100) |
$657.52 |
$1,643.80 |
6.4× |
| Ultrasound breast complete (76641) |
$578.15 |
$1,445.37 |
5.7× |
| Ultrasound elastography first target lesion (76982) |
$212.25 |
$530.63 |
2.1× |
| Ultrasound Exam Aaa Screen (76706) |
$88.82 |
$222.06 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$948.23 |
$2,370.57 |
9.3× |
| Umbilical-artery Doppler (OB) (76820) |
$242.25 |
$605.62 |
2.4× |
| Ureteral reflux study (78740) |
$294.73 |
$736.83 |
0.8× |
| Urethrocystogram voiding (74455) |
$613.11 |
$1,532.78 |
2.6× |
| Urethrocystography retrograde rs&i (74450) |
$1,210.65 |
$3,026.62 |
5.2× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$1,257.36 |
$3,143.41 |
7.3× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,918.34 |
$4,795.86 |
11.2× |
| Us breast unilateral limited (76642) |
$554.28 |
$1,385.70 |
6.5× |
| Us chest (76604) |
$672.52 |
$1,681.29 |
6.6× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$1,009.36 |
$2,523.38 |
4.8× |
| Us compl joint r-t w/image documentation (76881) |
$755.58 |
$1,888.93 |
7.4× |
| Us elastography parenchyma (76981) |
$272.81 |
$682.03 |
2.7× |
| Us encephalogram (76506) |
$396.82 |
$992.05 |
3.9× |
| Us infant hips w manipulation (76885) |
$794.80 |
$1,986.98 |
9.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$726.73 |
$1,816.82 |
7.1× |
| Us ob limited (76815) |
$640.80 |
$1,602 |
6.3× |
| Us ob transvaginal (76817) |
$278 |
$695.01 |
2.7× |
| Us pelvic non ob complete (76856) |
$1,110.29 |
$2,775.72 |
10.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,062.48 |
$2,656.19 |
10.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,110.29 |
$2,775.72 |
10.9× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$536.40 |
$1,341 |
5.3× |
| Us retroperitoneal complete (76770) |
$1,542.66 |
$3,856.66 |
15.1× |
| Us retroperitoneal limited (76775) |
$971.28 |
$2,428.22 |
9.5× |
| Us scrotum and contents (76870) |
$925.72 |
$2,314.30 |
9.1× |
| Us soft tissue head/neck (76536) |
$813.83 |
$2,034.58 |
8.0× |
| Us spinal canal and contents (76800) |
$647.72 |
$1,619.29 |
6.4× |
| Us transrectal (76872) |
$682.90 |
$1,707.25 |
6.7× |
| Us, eye b-scan (76512) |
$918.22 |
$2,295.55 |
9.0× |
| Vasogram (74440) |
$459.70 |
$1,149.23 |
2.0× |
| Venogram extremity bilateral (75822) |
$1,124.71 |
$2,811.77 |
0.7× |
| Venogram Extremity Unilateral (75820) |
$809.21 |
$2,023.02 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$3,186.88 |
$7,967.20 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$2,299.60 |
$5,748.98 |
1.5× |
| Venous thrombosis imaging, venogram; unilateral Non-Facility (78457) |
$918.22 |
$2,295.55 |
1.7× |
| Wrist 2 views (73100) |
$343.18 |
$857.96 |
4.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$689.82 |
$1,724.56 |
6.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$588.31 |
$1,470.78 |
6.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,426.94 |
$3,567.35 |
8.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$346.06 |
$865.16 |
4.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$81.90 |
$204.74 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$501.22 |
$1,253.04 |
4.9× |
| X-ray exam of femur 2/> (73552) |
$65.75 |
$164.38 |
0.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$468.92 |
$1,172.29 |
5.5× |
| X-ray IV pyelogram (ivp) (74400) |
$1,763.20 |
$4,407.99 |
10.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$425.08 |
$1,062.70 |
5.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$343.18 |
$857.96 |
4.0× |
| X-ray leg, infant (73592) |
$233.59 |
$583.98 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$581.38 |
$1,453.47 |
5.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$771.14 |
$1,927.86 |
7.6× |
| X-ray nose-rectum child f.b. (76010) |
$188.60 |
$471.52 |
2.2× |
| X-ray optic foramen (70190) |
$319.53 |
$798.83 |
3.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$698.48 |
$1,746.18 |
6.8× |
| X-ray retrograde pyelogram (74420) |
$1,150.08 |
$2,875.22 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$259.54 |
$648.87 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$325.30 |
$813.25 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$851.32 |
$2,128.29 |
8.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$516.78 |
$1,291.96 |
5.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$523.71 |
$1,309.28 |
6.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$732.50 |
$1,831.26 |
8.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$822.48 |
$2,056.20 |
8.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$517.94 |
$1,294.86 |
5.1× |
| X-Ray Small Bowel Enteroclysis (74251) |
$712.32 |
$1,780.78 |
4.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$392.21 |
$980.52 |
4.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$445.27 |
$1,113.18 |
5.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$445.27 |
$1,113.18 |
5.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$519.67 |
$1,299.18 |
5.1× |
| Xr bone length studies (77073) |
$294.73 |
$736.83 |
2.9× |
| Xr c-spine 4 or 5 views (72050) |
$821.90 |
$2,054.75 |
8.1× |
| Xr c-spine 6 or more views (72052) |
$873.81 |
$2,184.53 |
8.6× |
| Xr chest 4+ views (71048) |
$209.38 |
$523.43 |
2.1× |
| Xr urogram antegrade (74425) |
$474.10 |
$1,185.27 |
1.4× |