Diagnostic radiology · New York

Diagnostic radiology commercial reimbursement in New York

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

Diagnostic radiology in New York

49 codes · 129 sampled providers
Index vs national
83
17% below
Rank among states
48 of 51
1 = highest
Codes above national
0 of 49
median code at 83%
Providers
129
sampled

What the data shows

1

Diagnostic radiology ranks 48th of 51 states in New York with an index of 83 (100 = the specialty's national median), across 49 codes and 129 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in New York, 0 pay above the national median and 49 below; the typical code sits at 83% of the national median.

3

Largest premium over the national median: CPT 72141 (Mri neck spine w/o dye) at 95%; largest discount: CPT 93000 (Electrocardiogram complete) at 75%.

4

Measured against Medicare, New York diagnostic radiology rates have a median of 131% 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 YorkNationalGapProv.
72141
Mri neck spine w/o dye
$370$390-5%128
72148
Mri lumbar spine w/o dye
$370$392-6%128
70551
Mri brain stem w/o dye
$370$402-8%128
99212
Office o/p est sf 10 min
$46$50-8%129
74177
Ct abd & pelvis w/contrast
$409$448-9%128

Lowest vs national

CodeNew YorkNationalGapProv.
93000
Electrocardiogram complete
$19$25-25%127
72158
Mri lumbar spine w/o & w/dye
$447$593-25%128
70553
Mri brain stem w/o & w/dye
$453$600-24%128
71046
X-ray exam chest 2 views
$34$45-24%128
72125
Ct neck spine w/o dye
$191$249-23%128

All diagnostic radiology codes in New York

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeNew YorkNationalGap% of MedicareProvidersTINsLevel
CPT 72141
Mri neck spine w/o dye
$370$390-5%194%128410
CPT 72148
Mri lumbar spine w/o dye
$370$392-5%193%128410
CPT 70551
Mri brain stem w/o dye
$370$402-8%190%128409
CPT 99212
Office o/p est sf 10 min
$46$50-8%78%129422
CPT 74177
Ct abd & pelvis w/contrast
$409$448-9%136%128406
CPT 73721
Mri jnt of lwr extre w/o dye
$370$407-9%181%128410
CPT 73221
Mri joint upr extrem w/o dye
$370$407-9%181%128409
CPT 76536
Us exam of head and neck
$140$154-9%129%128415
CPT 99203
Office o/p new low 30 min
$108$121-10%92%129421
CPT 99215
Office o/p est hi 40 min
$162$182-11%84%128421
CPT 99204
Office o/p new mod 45 min
$166$187-11%94%128420
CPT 99213
Office o/p est low 20 min
$77$88-12%81%128419
CPT 99214
Office o/p est mod 30 min
$113$128-12%83%128420
CPT 76641
Ultrasound breast complete
$128$145-12%127%128423
CPT 74178
Ct abd&plv wo cntr flwd cntr
$457$520-12%135%128405
CPT 99205
Office o/p new hi 60 min
$214$244-12%90%128419
CPT 77080
Dxa bone density axial
$58$66-13%147%124404
CPT 37243
Vasc embolize/occlude organ
$746$858-13%155%116364
CPT 76642
Ultrasound breast limited
$104$120-13%125%128423
CPT 71271
Ct thorax lung cancer scr c-
$179$208-14%131%129407
CPT 93971
Extremity study
$148$172-14%127%129417
CPT 93970
Extremity study
$232$270-14%126%129414
CPT 74174
Cta abd&plvs w/contrast
$508$601-16%134%128403
CPT 74176
Ct abd & pelvis w/o contrast
$242$287-16%132%128407
CPT 71275
Ct angiography chest
$385$462-17%137%128405
CPT 77066
Dx mammo incl cad bi
$188$225-17%120%129419
CPT 70498
Ct angiography neck
$382$459-17%139%128402
CPT 93880
Extracranial bilat study
$230$277-17%122%128411
CPT 77067
Scr mammo bi incl cad
$151$182-17%120%128414
CPT 20610
Drain/inj joint/bursa w/o us
$69$83-17%100%129425
CPT 77065
Dx mammo incl cad uni
$148$179-17%119%128414
CPT 70496
Ct angiography head
$378$457-17%138%128403
CPT 77049
Mri breast c-+ w/cad bi
$459$558-18%135%129408
CPT 76705
Echo exam of abdomen
$102$126-19%118%128408
CPT 76700
Us exam abdom complete
$135$168-19%119%128408
CPT 71045
X-ray exam chest 1 view
$26$33-20%104%128419
CPT 70450
Ct head/brain w/o dye
$154$194-21%145%128405
CPT 76770
Us exam abdo back wall comp
$126$158-21%118%128408
CPT 71260
Ct thorax dx c+
$247$312-21%148%128404
CPT 73502
X-ray exam hip uni 2-3 views
$49$61-21%100%128423
CPT 71250
Ct thorax dx c-
$195$250-22%147%128405
CPT 74183
Mri abd w/o cntr flwd cntr
$493$634-22%147%128408
CPT 72131
Ct lumbar spine w/o dye
$193$248-22%148%128404
CPT 72197
Mri pelvis w/o & w/dye
$491$634-23%147%128408
CPT 72125
Ct neck spine w/o dye
$191$249-23%146%128404
CPT 71046
X-ray exam chest 2 views
$34$45-24%103%128424
CPT 70553
Mri brain stem w/o & w/dye
$453$600-25%143%128410
CPT 72158
Mri lumbar spine w/o & w/dye
$447$593-25%140%128409
CPT 93000
Electrocardiogram complete
$19$25-25%122%127404

Frequently asked questions

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

New York ranks 48th of 51 states with an index of 83; 0 of 49 codes are above the national median.

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

CPT 72141 (Mri neck spine w/o dye), at 95% 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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