Diagnostic radiology · New Jersey

Diagnostic radiology commercial reimbursement in New Jersey

How New Jersey diagnostic radiology rates compare with the national market.

Diagnostic radiology in New Jersey

49 codes · 126 sampled providers
Index vs national
102
2% above
Rank among states
21 of 51
1 = highest
Codes above national
33 of 49
median code at 102%
Providers
126
sampled

What the data shows

1

Diagnostic radiology ranks 21st of 51 states in New Jersey with an index of 102 (100 = the specialty's national median), across 49 codes and 126 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in New Jersey, 33 pay above the national median and 16 below; the typical code sits at 102% of the national median.

3

Largest premium over the national median: CPT 77080 (Dxa bone density axial) at 113%; largest discount: CPT 99213 (Office o/p est low 20 min) at 84%.

4

Measured against Medicare, New Jersey diagnostic radiology rates have a median of 156% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeNew JerseyNationalGapProv.
77080
Dxa bone density axial
$75$66+13%126
93971
Extremity study
$189$172+10%126
74183
Mri abd w/o cntr flwd cntr
$683$634+8%126
71275
Ct angiography chest
$497$462+8%126
72158
Mri lumbar spine w/o & w/dye
$638$593+8%126

Lowest vs national

CodeNew JerseyNationalGapProv.
99213
Office o/p est low 20 min
$74$88-16%125
99215
Office o/p est hi 40 min
$153$182-16%124
99214
Office o/p est mod 30 min
$110$128-14%124
99205
Office o/p new hi 60 min
$213$244-13%125
71045
X-ray exam chest 1 view
$29$33-12%125

All diagnostic radiology codes in New Jersey

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNew JerseyNationalGap% of MedicareProvidersTINsLevel
CPT 77080
Dxa bone density axial
$75$66+13%190%126434
CPT 93971
Extremity study
$189$172+10%162%126446
CPT 74183
Mri abd w/o cntr flwd cntr
$683$634+8%203%126444
CPT 71275
Ct angiography chest
$497$462+8%177%126428
CPT 72158
Mri lumbar spine w/o & w/dye
$638$593+8%200%126444
CPT 72197
Mri pelvis w/o & w/dye
$682$634+8%204%126443
CPT 70496
Ct angiography head
$491$457+7%179%126430
CPT 70498
Ct angiography neck
$491$459+7%179%126429
CPT 70553
Mri brain stem w/o & w/dye
$636$600+6%201%126444
CPT 71260
Ct thorax dx c+
$329$312+5%197%126429
CPT 74178
Ct abd&plv wo cntr flwd cntr
$546$520+5%161%126433
CPT 77067
Scr mammo bi incl cad
$190$182+5%151%125439
CPT 74174
Cta abd&plvs w/contrast
$628$601+4%166%126430
CPT 74177
Ct abd & pelvis w/contrast
$468$448+4%156%126434
CPT 74176
Ct abd & pelvis w/o contrast
$299$287+4%164%126434
CPT 71250
Ct thorax dx c-
$260$250+4%196%126426
CPT 72141
Mri neck spine w/o dye
$402$390+3%211%126444
CPT 77066
Dx mammo incl cad bi
$232$225+3%148%125447
CPT 73721
Mri jnt of lwr extre w/o dye
$418$407+3%205%126444
CPT 73221
Mri joint upr extrem w/o dye
$418$407+3%204%126443
CPT 72125
Ct neck spine w/o dye
$255$249+3%196%126424
CPT 72148
Mri lumbar spine w/o dye
$402$392+3%210%126444
CPT 72131
Ct lumbar spine w/o dye
$254$248+2%196%126429
CPT 77065
Dx mammo incl cad uni
$182$179+2%147%125440
CPT 76641
Ultrasound breast complete
$148$145+2%148%126447
CPT 93970
Extremity study
$275$270+2%149%126447
CPT 70450
Ct head/brain w/o dye
$198$194+2%185%126433
CPT 93880
Extracranial bilat study
$280$277+1%148%126438
CPT 77049
Mri breast c-+ w/cad bi
$563$558+1%166%125447
CPT 76642
Ultrasound breast limited
$121$120+1%145%126441
CPT 76770
Us exam abdo back wall comp
$159$158+1%150%126433
CPT 70551
Mri brain stem w/o dye
$404$402+0%207%126445
CPT 71271
Ct thorax lung cancer scr c-
$208$208+0%153%125437
CPT 76700
Us exam abdom complete
$168$168-0%147%126440
CPT 76705
Echo exam of abdomen
$125$126-1%145%126436
CPT 20610
Drain/inj joint/bursa w/o us
$79$83-5%115%126455
CPT 99212
Office o/p est sf 10 min
$48$50-5%80%124446
CPT 99203
Office o/p new low 30 min
$114$121-6%97%125441
CPT 93000
Electrocardiogram complete
$23$25-6%153%121428
CPT 73502
X-ray exam hip uni 2-3 views
$57$61-7%118%126447
CPT 71046
X-ray exam chest 2 views
$41$45-8%125%125447
CPT 37243
Vasc embolize/occlude organ
$788$858-8%163%126442
CPT 99204
Office o/p new mod 45 min
$168$187-10%95%125439
CPT 76536
Us exam of head and neck
$137$154-11%126%126442
CPT 71045
X-ray exam chest 1 view
$29$33-12%114%125444
CPT 99205
Office o/p new hi 60 min
$213$244-13%90%125443
CPT 99214
Office o/p est mod 30 min
$110$128-14%81%124437
CPT 99215
Office o/p est hi 40 min
$153$182-16%80%124439
CPT 99213
Office o/p est low 20 min
$74$88-16%78%125444

Frequently asked questions

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

New Jersey ranks 21st of 51 states with an index of 102; 33 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in New Jersey?

CPT 77080 (Dxa bone density axial), at 113% 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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