Diagnostic radiology · Illinois

Diagnostic radiology commercial reimbursement in Illinois

How Illinois diagnostic radiology rates compare with the national market.

Diagnostic radiology in Illinois

49 codes · 126 sampled providers
Index vs national
84
16% below
Rank among states
47 of 51
1 = highest
Codes above national
2 of 49
median code at 84%
Providers
126
sampled

What the data shows

1

Diagnostic radiology ranks 47th of 51 states in Illinois with an index of 84 (100 = the specialty's national median), across 49 codes and 126 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in Illinois, 2 pay above the national median and 47 below; the typical code sits at 84% of the national median.

3

Largest premium over the national median: CPT 93000 (Electrocardiogram complete) at 116%; largest discount: CPT 72148 (Mri lumbar spine w/o dye) at 79%.

4

Measured against Medicare, Illinois diagnostic radiology rates have a median of 132% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeIllinoisNationalGapProv.
93000
Electrocardiogram complete
$29$25+16%122
37243
Vasc embolize/occlude organ
$991$858+16%122
20610
Drain/inj joint/bursa w/o us
$78$83-6%124
99215
Office o/p est hi 40 min
$168$182-7%123
99212
Office o/p est sf 10 min
$47$50-8%123

Lowest vs national

CodeIllinoisNationalGapProv.
72148
Mri lumbar spine w/o dye
$312$392-20%124
70551
Mri brain stem w/o dye
$323$402-20%123
71045
X-ray exam chest 1 view
$26$33-19%125
72131
Ct lumbar spine w/o dye
$200$248-19%124
72141
Mri neck spine w/o dye
$315$390-19%122

All diagnostic radiology codes in Illinois

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeIllinoisNationalGap% of MedicareProvidersTINsLevel
CPT 93000
Electrocardiogram complete
$29$25+16%188%122561
CPT 37243
Vasc embolize/occlude organ
$991$858+15%205%122566
CPT 20610
Drain/inj joint/bursa w/o us
$78$83-6%113%124589
CPT 99215
Office o/p est hi 40 min
$168$182-7%88%123581
CPT 99212
Office o/p est sf 10 min
$47$50-8%78%123582
CPT 74178
Ct abd&plv wo cntr flwd cntr
$475$520-9%141%124574
CPT 99213
Office o/p est low 20 min
$80$88-9%84%123581
CPT 99214
Office o/p est mod 30 min
$116$128-9%86%123584
CPT 99203
Office o/p new low 30 min
$109$121-9%93%123581
CPT 74174
Cta abd&plvs w/contrast
$543$601-10%143%122566
CPT 99204
Office o/p new mod 45 min
$167$187-10%94%123584
CPT 99205
Office o/p new hi 60 min
$219$244-10%92%123581
CPT 74176
Ct abd & pelvis w/o contrast
$256$287-11%140%124574
CPT 74177
Ct abd & pelvis w/contrast
$397$448-11%132%124573
CPT 93971
Extremity study
$152$172-12%131%124590
CPT 70496
Ct angiography head
$399$457-13%146%123572
CPT 71275
Ct angiography chest
$403$462-13%144%124577
CPT 77080
Dxa bone density axial
$58$66-13%147%124575
CPT 70498
Ct angiography neck
$399$459-13%146%123570
CPT 76770
Us exam abdo back wall comp
$136$158-14%128%124581
CPT 76705
Echo exam of abdomen
$108$126-14%125%125584
CPT 77049
Mri breast c-+ w/cad bi
$475$558-15%140%122573
CPT 70450
Ct head/brain w/o dye
$165$194-15%154%124571
CPT 74183
Mri abd w/o cntr flwd cntr
$534$634-16%159%123578
CPT 77067
Scr mammo bi incl cad
$153$182-16%121%124580
CPT 76700
Us exam abdom complete
$141$168-16%124%124580
CPT 76641
Ultrasound breast complete
$122$145-16%122%122575
CPT 70553
Mri brain stem w/o & w/dye
$505$600-16%159%124579
CPT 77065
Dx mammo incl cad uni
$150$179-16%121%124575
CPT 71250
Ct thorax dx c-
$209$250-16%158%124577
CPT 76642
Ultrasound breast limited
$100$120-17%120%124579
CPT 71046
X-ray exam chest 2 views
$38$45-17%114%124582
CPT 71260
Ct thorax dx c+
$260$312-17%156%124575
CPT 77066
Dx mammo incl cad bi
$188$225-17%120%123585
CPT 71271
Ct thorax lung cancer scr c-
$172$208-17%127%123575
CPT 72197
Mri pelvis w/o & w/dye
$524$634-17%157%123576
CPT 72158
Mri lumbar spine w/o & w/dye
$490$593-17%154%122578
CPT 73502
X-ray exam hip uni 2-3 views
$51$61-18%104%122576
CPT 76536
Us exam of head and neck
$127$154-18%117%124586
CPT 72125
Ct neck spine w/o dye
$204$249-18%156%123568
CPT 73721
Mri jnt of lwr extre w/o dye
$333$407-18%163%123577
CPT 93880
Extracranial bilat study
$226$277-19%119%124579
CPT 73221
Mri joint upr extrem w/o dye
$332$407-19%162%123576
CPT 93970
Extremity study
$220$270-19%120%124586
CPT 72141
Mri neck spine w/o dye
$315$390-19%165%122574
CPT 72131
Ct lumbar spine w/o dye
$200$248-19%154%124571
CPT 71045
X-ray exam chest 1 view
$26$33-19%104%125575
CPT 70551
Mri brain stem w/o dye
$323$402-20%165%123572
CPT 72148
Mri lumbar spine w/o dye
$312$392-21%163%124579

Frequently asked questions

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

Illinois ranks 47th of 51 states with an index of 84; 2 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in Illinois?

CPT 93000 (Electrocardiogram complete), at 116% 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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