Diagnostic radiology · California

Diagnostic radiology commercial reimbursement in California

How California diagnostic radiology rates compare with the national market.

Diagnostic radiology in California

49 codes · 107 sampled providers
Index vs national
100
0% below
Rank among states
24 of 51
1 = highest
Codes above national
24 of 49
median code at 100%
Providers
107
sampled

What the data shows

1

Diagnostic radiology ranks 24th of 51 states in California with an index of 100 (100 = the specialty's national median), across 49 codes and 107 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in California, 24 pay above the national median and 25 below; the typical code sits at 100% of the national median.

3

Largest premium over the national median: CPT 77080 (Dxa bone density axial) at 151%; largest discount: CPT 37243 (Vasc embolize/occlude organ) at 83%.

4

Measured against Medicare, California diagnostic radiology rates have a median of 148% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeCaliforniaNationalGapProv.
77080
Dxa bone density axial
$100$66+51%106
93000
Electrocardiogram complete
$30$25+21%107
72141
Mri neck spine w/o dye
$469$390+20%106
72148
Mri lumbar spine w/o dye
$470$392+20%106
70551
Mri brain stem w/o dye
$475$402+18%106

Lowest vs national

CodeCaliforniaNationalGapProv.
37243
Vasc embolize/occlude organ
$713$858-17%102
99215
Office o/p est hi 40 min
$153$182-16%107
99214
Office o/p est mod 30 min
$113$128-12%107
71271
Ct thorax lung cancer scr c-
$184$208-11%105
76536
Us exam of head and neck
$137$154-11%107

All diagnostic radiology codes in California

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeCaliforniaNationalGap% of MedicareProvidersTINsLevel
CPT 77080
Dxa bone density axial
$100$66+51%254%106560
CPT 93000
Electrocardiogram complete
$30$25+21%197%107555
CPT 72141
Mri neck spine w/o dye
$469$390+20%246%106559
CPT 72148
Mri lumbar spine w/o dye
$470$392+20%245%106564
CPT 70551
Mri brain stem w/o dye
$475$402+18%243%106565
CPT 73721
Mri jnt of lwr extre w/o dye
$475$407+17%232%106556
CPT 73221
Mri joint upr extrem w/o dye
$475$407+17%232%106562
CPT 72125
Ct neck spine w/o dye
$272$249+9%208%106559
CPT 72131
Ct lumbar spine w/o dye
$269$248+8%207%106558
CPT 71260
Ct thorax dx c+
$337$312+8%202%107558
CPT 70450
Ct head/brain w/o dye
$210$194+8%197%107561
CPT 71250
Ct thorax dx c-
$270$250+8%203%107562
CPT 70496
Ct angiography head
$489$457+7%179%106553
CPT 70498
Ct angiography neck
$491$459+7%179%106560
CPT 71275
Ct angiography chest
$489$462+6%174%107552
CPT 74174
Cta abd&plvs w/contrast
$621$601+3%164%107559
CPT 73502
X-ray exam hip uni 2-3 views
$63$61+3%130%107561
CPT 72158
Mri lumbar spine w/o & w/dye
$604$593+2%190%106560
CPT 74183
Mri abd w/o cntr flwd cntr
$643$634+1%191%106559
CPT 77049
Mri breast c-+ w/cad bi
$565$558+1%166%107561
CPT 72197
Mri pelvis w/o & w/dye
$641$634+1%192%106557
CPT 93970
Extremity study
$273$270+1%148%107560
CPT 70553
Mri brain stem w/o & w/dye
$604$600+1%190%106561
CPT 93971
Extremity study
$173$172+0%149%107565
CPT 20610
Drain/inj joint/bursa w/o us
$83$83-0%120%107572
CPT 99212
Office o/p est sf 10 min
$50$50-2%83%107564
CPT 74178
Ct abd&plv wo cntr flwd cntr
$501$520-4%148%107553
CPT 93880
Extracranial bilat study
$265$277-4%140%107562
CPT 99203
Office o/p new low 30 min
$115$121-4%98%107568
CPT 77066
Dx mammo incl cad bi
$215$225-5%137%107558
CPT 76641
Ultrasound breast complete
$138$145-5%138%107559
CPT 71046
X-ray exam chest 2 views
$43$45-5%129%107563
CPT 76705
Echo exam of abdomen
$119$126-5%138%107564
CPT 99213
Office o/p est low 20 min
$83$88-6%87%107568
CPT 76770
Us exam abdo back wall comp
$148$158-6%140%107560
CPT 76642
Ultrasound breast limited
$113$120-6%135%107557
CPT 77067
Scr mammo bi incl cad
$170$182-7%135%107563
CPT 76700
Us exam abdom complete
$157$168-7%137%107561
CPT 71045
X-ray exam chest 1 view
$31$33-7%120%105551
CPT 74177
Ct abd & pelvis w/contrast
$417$448-7%139%107559
CPT 77065
Dx mammo incl cad uni
$166$179-7%134%107567
CPT 99204
Office o/p new mod 45 min
$172$187-8%97%107571
CPT 74176
Ct abd & pelvis w/o contrast
$261$287-9%143%107559
CPT 99205
Office o/p new hi 60 min
$222$244-9%94%107567
CPT 76536
Us exam of head and neck
$137$154-11%126%107560
CPT 71271
Ct thorax lung cancer scr c-
$184$208-11%135%105553
CPT 99214
Office o/p est mod 30 min
$113$128-12%83%107567
CPT 99215
Office o/p est hi 40 min
$153$182-16%80%107565
CPT 37243
Vasc embolize/occlude organ
$713$858-17%148%102546

Frequently asked questions

How do California diagnostic radiology rates compare with the rest of the country?

California ranks 24th of 51 states with an index of 100; 24 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in California?

CPT 77080 (Dxa bone density axial), at 151% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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