| Abdomen 2 views (74019) |
$173.40 |
$266.77 |
1.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$752.05 |
$1,157 |
1.9× |
| Ankle 2 views (73600) |
$140.26 |
$215.78 |
1.6× |
| Arthrogram hip (73525) |
$653.76 |
$1,005.80 |
1.9× |
| Arthrogram shoulder (73040) |
$653.76 |
$1,005.80 |
1.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$514.80 |
$792 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$743.60 |
$1,144 |
1.9× |
| Bone age studies (77072) |
$220.27 |
$338.87 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$818.35 |
$1,259 |
2.0× |
| Bone survey complete (77075) |
$619.29 |
$952.75 |
5.9× |
| Cervical spine 2 or 3 views (72040) |
$147.96 |
$227.63 |
1.7× |
| Chest 1 view (71045) |
$176.75 |
$271.92 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$519.35 |
$799 |
2.9× |
| Clavicle complete (73000) |
$112.48 |
$173.04 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$224.25 |
$345 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,969.20 |
$4,568 |
8.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,451.80 |
$3,772 |
10.2× |
| CT abdomen w contrast (74160) |
$1,366.95 |
$2,103 |
7.8× |
| CT abdomen w wo contrast (74170) |
$1,834.30 |
$2,822 |
10.4× |
| CT abdomen w/o contrast (74150) |
$950.95 |
$1,463 |
9.1× |
| CT angiography upper extremity lt (73206) |
$1,249.95 |
$1,923 |
7.1× |
| CT c-spine w/o contrast (72125) |
$1,208.35 |
$1,859 |
11.5× |
| CT cervical spine w&w/o contrast (72127) |
$2,296.45 |
$3,533 |
13.0× |
| CT cervical spine with contrast (72126) |
$1,346.80 |
$2,072 |
3.8× |
| CT chest w/wo contrast (71270) |
$2,286.05 |
$3,517 |
13.0× |
| CT chest with contrast (71260) |
$2,135.90 |
$3,286 |
12.1× |
| CT head/brain with contrast (70460) |
$1,978.60 |
$3,044 |
11.2× |
| CT head/brain without and with contrast (70470) |
$2,058.55 |
$3,167 |
11.7× |
| CT iac w contrast (70481) |
$1,175.85 |
$1,809 |
6.7× |
| CT lower ext w/o (73700) |
$1,218.75 |
$1,875 |
11.6× |
| CT lower extremity w wo contrast (73702) |
$1,490.45 |
$2,293 |
8.5× |
| CT lower extremity with contrast (73701) |
$1,315.60 |
$2,024 |
7.5× |
| CT lumbar spine w & w/o contrast (72133) |
$2,276.30 |
$3,502 |
12.9× |
| CT lumbar spine w/o contrast (72131) |
$1,260.35 |
$1,939 |
12.0× |
| CT lumbar spine with contrast (72132) |
$1,346.80 |
$2,072 |
3.8× |
| CT maxillofacial w contrast (70487) |
$956.15 |
$1,471 |
5.4× |
| CT maxillofacial w/o contrast (70486) |
$834.60 |
$1,284 |
7.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,221.16 |
$1,878.70 |
6.9× |
| CT neck soft tissue w contrast (70491) |
$1,376.05 |
$2,117 |
7.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,303.25 |
$2,005 |
7.4× |
| CT orbits w/o contrast (70480) |
$1,064.05 |
$1,637 |
10.1× |
| CT pelvis w & w/o contrast (72194) |
$1,433.90 |
$2,206 |
8.1× |
| CT pelvis w/o contrast (72192) |
$1,001 |
$1,540 |
9.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,597.05 |
$2,457 |
9.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,111.50 |
$1,710 |
10.6× |
| CT thoracic spine w/contrast (72129) |
$1,160.25 |
$1,785 |
6.6× |
| CT thoracic spine w/o contrast (72128) |
$1,144 |
$1,760 |
10.9× |
| CT thoracic spine w/wo contrast (72130) |
$1,177.15 |
$1,811 |
6.7× |
| CT thorax w/o contrast (71250) |
$1,667.25 |
$2,565 |
15.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,950 |
$3,000 |
11.1× |
| CT upper extremity w/o contrast rt (73200) |
$987.35 |
$1,519 |
9.4× |
| CT upper extremity with contrast (73201) |
$1,734.20 |
$2,668 |
4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,317.55 |
$2,027 |
7.5× |
| Cta Abdomen (74175) |
$1,389.05 |
$2,137 |
7.9× |
| CTA abdomen pelvis (74174) |
$2,055.30 |
$3,162 |
5.9× |
| CTA chest (71275) |
$1,471.60 |
$2,264 |
8.4× |
| Cta Head (70496) |
$1,277.25 |
$1,965 |
7.2× |
| CTA lwr ext w&w/o contrast (73706) |
$1,336.40 |
$2,056 |
7.6× |
| Cta Neck (70498) |
$1,261.65 |
$1,941 |
7.2× |
| Cta Pelvis (72191) |
$1,405.30 |
$2,162 |
8.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$236.33 |
$363.59 |
2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$169.65 |
$261 |
1.9× |
| Esophagus (74220) |
$309.31 |
$475.86 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$344.79 |
$530.45 |
1.4× |
| Foot 2 views (73620) |
$146.28 |
$225.06 |
1.7× |
| Forearm 2 views (73090) |
$158 |
$243.08 |
1.8× |
| Hand 2 views (73120) |
$135.58 |
$208.58 |
1.3× |
| Hand 3 views (73130) |
$216.58 |
$333.20 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$750.10 |
$1,154 |
1.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$750.10 |
$1,154 |
1.9× |
| Ht muscle image spect sing (78451) |
$1,841.45 |
$2,833 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$155.66 |
$239.48 |
1.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$752.05 |
$1,157 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,474.20 |
$2,268 |
2.7× |
| Knee 3 views (73562) |
$275.94 |
$424.52 |
3.2× |
| Liver & spleen imaging static only (78215) |
$1,313.65 |
$2,021 |
3.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,756.30 |
$2,702 |
4.4× |
| Lung perf&ventilat diferentl (78598) |
$846.95 |
$1,303 |
1.6× |
| Lung perfusion differential (78597) |
$846.95 |
$1,303 |
2.1× |
| Lung Ventilation Imaging (78579) |
$846.95 |
$1,303 |
2.1× |
| MRA head w & w/o contrast (70546) |
$1,414.14 |
$2,175.60 |
4.0× |
| MRA head w/o contrast (70544) |
$630.63 |
$970.20 |
2.6× |
| MRA head with contrast (70545) |
$1,205.98 |
$1,855.35 |
3.4× |
| MRA neck w contrast (70548) |
$1,476.93 |
$2,272.20 |
4.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,657.79 |
$2,550.45 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,447.58 |
$2,227.05 |
6.0× |
| MRI abdomen w contrast (74182) |
$1,414.14 |
$2,175.60 |
4.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,552.01 |
$2,387.70 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$1,360.91 |
$2,093.70 |
5.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,552.01 |
$2,387.70 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,540.50 |
$2,370 |
2.0× |
| MRI c-spine with contrast (72142) |
$1,447.58 |
$2,227.05 |
4.1× |
| MRI cervical spine w/o contrast (72141) |
$1,414.14 |
$2,175.60 |
5.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,754.03 |
$2,698.50 |
5.0× |
| MRI chest w/o contrast (71550) |
$1,043.54 |
$1,605.45 |
4.4× |
| MRI chest with contrast (71551) |
$1,694.65 |
$2,607.15 |
2.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,554.74 |
$2,391.90 |
4.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,476.93 |
$2,272.20 |
4.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,447.58 |
$2,227.05 |
6.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,205.98 |
$1,855.35 |
5.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,447.58 |
$2,227.05 |
4.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,414.14 |
$2,175.60 |
4.0× |
| MRI pelvis w contrast (72196) |
$1,205.98 |
$1,855.35 |
3.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,414.14 |
$2,175.60 |
4.0× |
| MRI pelvis w/o contrast (72195) |
$1,125.44 |
$1,731.45 |
4.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,414.14 |
$2,175.60 |
4.0× |
| MRI scan of leg joint before and after contrast (73723) |
$2,077.53 |
$3,196.20 |
5.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,552.01 |
$2,387.70 |
4.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,617.20 |
$2,488 |
4.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,087.80 |
$3,212 |
6.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,414.14 |
$2,175.60 |
4.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,478.10 |
$2,274 |
4.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,375.24 |
$2,115.75 |
5.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,205.98 |
$1,855.35 |
5.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,728.77 |
$2,659.65 |
4.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,544.50 |
$2,376.15 |
6.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,405 |
$3,700 |
1.8× |
| Neck soft tissue (70360) |
$175.41 |
$269.86 |
2.0× |
| Nm gastric emptying study (78264) |
$1,321.45 |
$2,033 |
3.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$231.40 |
$356 |
2.2× |
| Osseous survey limited (77074) |
$411.74 |
$633.45 |
3.9× |
| Parathyroid imaging (78070) |
$618.80 |
$952 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$120.51 |
$185.40 |
1.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,633.22 |
$2,512.65 |
4.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$846.95 |
$1,303 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$846.95 |
$1,303 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$220.27 |
$338.87 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$302.90 |
$466 |
2.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$127.21 |
$195.70 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$164.03 |
$252.35 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$144.61 |
$222.48 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$182.77 |
$281.19 |
2.1× |
| Radiologic exam colon single contrast study (74270) |
$322.70 |
$496.46 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$413.08 |
$635.51 |
2.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$388.31 |
$597.40 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$181.44 |
$279.13 |
2.1× |
| Radiological examination surgical specimen (76098) |
$1,068.60 |
$1,644 |
1.9× |
| Ribs bilateral 3 views (71110) |
$217.75 |
$335 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$122.52 |
$188.49 |
1.2× |
| Scapula complete (73010) |
$159.34 |
$245.14 |
1.5× |
| Screening digital breast tomosynthesis (77063) |
$80.07 |
$123.19 |
3.4× |
| Small bowel series (74250) |
$405.72 |
$624.18 |
2.3× |
| Tbs Technical Calculation Only (77091) |
$171.60 |
$264 |
2.0× |
| Thyroid uptake measurement (78012) |
$560.30 |
$862 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,302.60 |
$2,004 |
3.2× |
| Tmj unilateral (70328) |
$90.38 |
$139.05 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$358.45 |
$551.46 |
3.4× |
| Upper Extremity Infant (73092) |
$158 |
$243.08 |
1.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$413.08 |
$635.51 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$358.45 |
$551.46 |
3.4× |
| Us breast unilateral complete (76641) |
$354.90 |
$546 |
3.4× |
| Us breast unilateral limited (76642) |
$204.75 |
$315 |
2.3× |
| Us chest (76604) |
$357.79 |
$550.45 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$357.79 |
$550.45 |
3.4× |
| Us ob transvaginal (76817) |
$321.69 |
$494.90 |
3.1× |
| Us pelvic non ob complete (76856) |
$523.25 |
$805 |
5.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$490.75 |
$755 |
4.7× |
| Us pregnancy ltd (76815) |
$357.14 |
$549.44 |
3.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$365.01 |
$561.56 |
3.5× |
| Us retroperitoneal complete (76770) |
$397.18 |
$611.05 |
3.8× |
| Us retroperitoneal limited (76775) |
$358.45 |
$551.46 |
3.4× |
| Us scrotum and contents (76870) |
$255.38 |
$392.89 |
2.4× |
| Us soft tissue head/neck (76536) |
$288.86 |
$444.40 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$120.14 |
$184.83 |
1.1× |
| Wrist 2 views (73100) |
$156.33 |
$240.50 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$228.30 |
$351.23 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$243.70 |
$374.92 |
2.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$233.32 |
$358.96 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$527.15 |
$811 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$158 |
$243.08 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$185.12 |
$284.80 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$83.69 |
$128.75 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$108.46 |
$166.86 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$203.53 |
$313.12 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$117.16 |
$180.25 |
1.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$211.56 |
$325.48 |
2.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$155.66 |
$239.48 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$117.16 |
$180.25 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$357.85 |
$550.54 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$220.27 |
$338.87 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$130.55 |
$200.85 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$147.96 |
$227.63 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$482.71 |
$742.63 |
4.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$137.25 |
$211.15 |
1.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$174.74 |
$268.83 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$206.70 |
$318 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$131.89 |
$202.91 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$159.25 |
$245 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$187.85 |
$289 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$267.80 |
$412 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$153.99 |
$236.90 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$152.65 |
$234.84 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$195.16 |
$300.24 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$203.53 |
$313.12 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$117.16 |
$180.25 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$193.49 |
$297.67 |
1.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$117.16 |
$180.25 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$147.96 |
$227.63 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$257.09 |
$395.52 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$115.15 |
$177.16 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$147.96 |
$227.63 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$168.71 |
$259.56 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$211.56 |
$325.48 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$165.37 |
$254.41 |
1.6× |
| Xr chest 4+ views (71048) |
$196.16 |
$301.79 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$97.75 |
$150.38 |
1.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$111.81 |
$172.01 |
1.1× |
| Xr optic foramina (70190) |
$171.60 |
$264 |
2.0× |
| Xr shoulder 1 view (73020) |
$179.76 |
$276.56 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$171.06 |
$263.16 |
2.0× |
| Xr tmj bilateral (70330) |
$215.58 |
$331.66 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$165.36 |
$254.41 |
1.9× |