Diagnostic radiology · West Virginia

Diagnostic radiology commercial reimbursement in West Virginia

How West Virginia diagnostic radiology rates compare with the national market.

Diagnostic radiology in West Virginia

49 codes · 118 sampled providers
Index vs national
101
1% above
Rank among states
22 of 51
1 = highest
Codes above national
25 of 49
median code at 101%
Providers
118
sampled

What the data shows

1

Diagnostic radiology ranks 22nd of 51 states in West Virginia with an index of 101 (100 = the specialty's national median), across 49 codes and 118 sampled providers.

2

Of the 49 diagnostic radiology codes with enough data in West Virginia, 25 pay above the national median and 24 below; the typical code sits at 101% of the national median.

3

Largest premium over the national median: CPT 73502 (X-ray exam hip uni 2-3 views) at 114%; largest discount: CPT 93880 (Extracranial bilat study) at 86%.

4

Measured against Medicare, West Virginia diagnostic radiology rates have a median of 152% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeWest VirgiNationalGapProv.
73502
X-ray exam hip uni 2-3 views
$70$61+14%117
71045
X-ray exam chest 1 view
$37$33+13%116
74174
Cta abd&plvs w/contrast
$666$601+11%117
71271
Ct thorax lung cancer scr c-
$227$208+9%117
70450
Ct head/brain w/o dye
$211$194+9%117

Lowest vs national

CodeWest VirgiNationalGapProv.
93880
Extracranial bilat study
$237$277-14%117
99215
Office o/p est hi 40 min
$159$182-13%118
99213
Office o/p est low 20 min
$77$88-12%118
99205
Office o/p new hi 60 min
$218$244-11%117
99214
Office o/p est mod 30 min
$114$128-11%118

All diagnostic radiology codes in West Virginia

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeWest VirginiNationalGap% of MedicareProvidersTINsLevel
CPT 73502
X-ray exam hip uni 2-3 views
$70$61+14%144%117215
CPT 71045
X-ray exam chest 1 view
$37$33+13%146%116209
CPT 74174
Cta abd&plvs w/contrast
$666$601+11%176%117215
CPT 71271
Ct thorax lung cancer scr c-
$227$208+9%167%117218
CPT 70450
Ct head/brain w/o dye
$211$194+9%198%117216
CPT 77049
Mri breast c-+ w/cad bi
$601$558+8%177%117215
CPT 71046
X-ray exam chest 2 views
$48$45+7%146%117214
CPT 77080
Dxa bone density axial
$71$66+7%180%117216
CPT 70496
Ct angiography head
$483$457+6%176%117217
CPT 71275
Ct angiography chest
$487$462+6%174%117217
CPT 70498
Ct angiography neck
$483$459+5%176%117216
CPT 76641
Ultrasound breast complete
$151$145+4%151%117214
CPT 77066
Dx mammo incl cad bi
$235$225+4%149%117219
CPT 72131
Ct lumbar spine w/o dye
$257$248+4%198%117216
CPT 72125
Ct neck spine w/o dye
$257$249+3%197%117217
CPT 74176
Ct abd & pelvis w/o contrast
$297$287+3%162%117216
CPT 71250
Ct thorax dx c-
$257$250+3%194%117216
CPT 20610
Drain/inj joint/bursa w/o us
$85$83+2%123%118224
CPT 76700
Us exam abdom complete
$171$168+2%150%117217
CPT 76536
Us exam of head and neck
$158$154+2%145%117217
CPT 77065
Dx mammo incl cad uni
$182$179+2%147%117213
CPT 74177
Ct abd & pelvis w/contrast
$457$448+2%152%117216
CPT 76642
Ultrasound breast limited
$122$120+2%147%117214
CPT 77067
Scr mammo bi incl cad
$185$182+2%146%117216
CPT 76770
Us exam abdo back wall comp
$160$158+1%150%117217
CPT 76705
Echo exam of abdomen
$126$126+0%146%117217
CPT 70551
Mri brain stem w/o dye
$402$402-0%206%117216
CPT 74178
Ct abd&plv wo cntr flwd cntr
$515$520-1%152%117215
CPT 72141
Mri neck spine w/o dye
$383$390-2%201%117215
CPT 72148
Mri lumbar spine w/o dye
$385$392-2%201%117216
CPT 71260
Ct thorax dx c+
$306$312-2%183%117217
CPT 73221
Mri joint upr extrem w/o dye
$399$407-2%195%117215
CPT 73721
Mri jnt of lwr extre w/o dye
$397$407-2%194%117215
CPT 93970
Extremity study
$263$270-3%143%117220
CPT 70553
Mri brain stem w/o & w/dye
$579$600-4%183%117216
CPT 72158
Mri lumbar spine w/o & w/dye
$564$593-5%177%117214
CPT 93000
Electrocardiogram complete
$23$25-6%152%116204
CPT 74183
Mri abd w/o cntr flwd cntr
$594$634-6%177%117216
CPT 72197
Mri pelvis w/o & w/dye
$591$634-7%177%114214
CPT 99203
Office o/p new low 30 min
$112$121-7%95%118218
CPT 99212
Office o/p est sf 10 min
$46$50-8%78%118220
CPT 37243
Vasc embolize/occlude organ
$787$858-8%163%117216
CPT 93971
Extremity study
$156$172-9%135%117221
CPT 99204
Office o/p new mod 45 min
$167$187-11%94%118218
CPT 99214
Office o/p est mod 30 min
$114$128-11%84%118218
CPT 99205
Office o/p new hi 60 min
$218$244-11%92%117217
CPT 99213
Office o/p est low 20 min
$77$88-12%81%118218
CPT 99215
Office o/p est hi 40 min
$159$182-13%82%118218
CPT 93880
Extracranial bilat study
$237$277-14%126%117217

Frequently asked questions

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

West Virginia ranks 22nd of 51 states with an index of 101; 25 of 49 codes are above the national median.

Which diagnostic radiology code has the biggest premium in West Virginia?

CPT 73502 (X-ray exam hip uni 2-3 views), at 114% 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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