Imaging prices at Adena Pike Medical Center
Waverly, OH · every code in this section with a posted price and a Medicare benchmark.
317 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $5,755.97 | $11,511.94 | 4.4× |
| Abdomen 1 View (74018) | $154.09 | $308.18 | 1.9× |
| Abdomen 2 views (74019) | $186.10 | $372.19 | 1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,235.36 | $2,470.71 | 3.3× |
| Angio pulmonary bilat (75743) | $6,609.69 | $13,219.37 | 2.2× |
| Angiography extremity bilateral rs&i (75716) | $5,783.53 | $11,567.06 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $5,783.53 | $11,567.06 | 1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,859.54 | $11,719.07 | 2.0× |
| Ankle 2 views (73600) | $154.09 | $308.18 | 1.9× |
| Aortography thoracic serialography rs&i (75605) | $3,103.13 | $6,206.26 | 0.6× |
| Artery X-Rays Abdomen (75726) | $3,258.29 | $6,516.57 | 0.6× |
| Artery X-Rays Pelvis (75736) | $3,103.13 | $6,206.26 | 0.6× |
| Arthrogram ankle (73615) | $608.28 | $1,216.56 | 1.8× |
| Arthrogram hip (73525) | $624.98 | $1,249.96 | 1.9× |
| Arthrogram Wrist (73115) | $624.98 | $1,249.96 | 1.9× |
| Basic radiation dosimetry calculation (77300) | $656.67 | $1,313.34 | 5.2× |
| Bone age studies (77072) | $186.10 | $372.19 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,324.31 | $2,648.61 | 3.5× |
| Bone Imaging Limited Area (78300) | $1,324.31 | $2,648.61 | 3.5× |
| Bone Imaging Whole Body (78306) | $1,324.31 | $2,648.61 | 3.5× |
| Bone marrow imaging; whole body (78104) | $1,379.24 | $2,758.47 | 3.6× |
| Bone survey infant (77076) | $186.10 | $372.19 | 1.9× |
| Brachytx isodose intermed (77317) | $958.13 | $1,916.25 | 2.7× |
| Brachytx Isodose Plan Simple (77316) | $937.13 | $1,874.25 | 2.6× |
| Brain Flow Imaging Only (78610) | $440.15 | $880.30 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $882.88 | $1,765.75 | 1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,759.18 | $5,518.36 | 2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,484.53 | $2,969.05 | 4.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,052 | $2,103.99 | 1.4× |
| Cat Scan Follow-Up Study (76380) | $380.95 | $761.89 | 4.6× |
| Chest 1 view (71045) | $173.44 | $346.87 | 2.1× |
| Chest 2 views (71046) | $173.44 | $346.87 | 2.1× |
| Chest 3 views (71047) | $173.44 | $346.87 | 2.1× |
| Chest 4 or more views (71048) | $173.37 | $346.73 | 1.8× |
| Clavicle complete (73000) | $176.76 | $353.51 | 2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $223.78 | $447.55 | 2.3× |
| Continuing medical physics consltj pr wk (77336) | $656.67 | $1,313.34 | 5.2× |
| Contrast Exam Abdominl Aorta (75625) | $5,783.53 | $11,567.06 | 1.9× |
| Contrast X-Ray Bladder (74430) | $624.98 | $1,249.96 | 1.9× |
| Contrast X-Ray Of Elbow (73085) | $624.98 | $1,249.96 | 1.9× |
| Contrast X-Ray Of Knee Joint (73580) | $624.98 | $1,249.96 | 1.9× |
| CT abdomen and pelvis without and with contrast (74178) | $2,390.47 | $4,780.93 | 7.2× |
| CT abdomen and pelvis without contrast (74176) | $1,526.80 | $3,053.60 | 6.8× |
| CT abdomen w contrast (74160) | $1,008.12 | $2,016.23 | 6.1× |
| CT abdomen w wo contrast (74170) | $1,195.23 | $2,390.46 | 7.2× |
| CT abdomen w/o contrast (74150) | $764.32 | $1,528.63 | 7.7× |
| CT Angio Abdomen and Pelvis (74174) | $2,016.23 | $4,032.46 | 6.1× |
| CT Angio Chest (71275) | $1,198.89 | $2,397.77 | 7.2× |
| CT Angio Head (70496) | $1,198.89 | $2,397.77 | 7.2× |
| CT angio hrt w/3d image (75574) | $1,969.30 | $3,938.59 | 6.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,198.89 | $2,397.77 | 7.2× |
| CT Angio Neck (70498) | $1,198.89 | $2,397.77 | 7.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,198.89 | $2,397.77 | 7.2× |
| CT cervical spine w/ contrast (72126) | $1,211.47 | $2,422.94 | 3.7× |
| CT cervical spine w/o contrast (72125) | $764.32 | $1,528.63 | 7.7× |
| CT cervical spine w/wo cont (72127) | $1,464.25 | $2,928.50 | 8.8× |
| CT chest w contrast (71260) | $1,008.12 | $2,016.23 | 6.1× |
| CT chest w/wo contrast (71270) | $1,195.23 | $2,390.46 | 7.2× |
| CT head/brain with contrast (70460) | $1,008.12 | $2,016.23 | 6.1× |
| CT head/brain without and with contrast (70470) | $1,195.23 | $2,390.46 | 7.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,418.31 | $2,836.61 | 4.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $177.98 | $355.95 | 2.2× |
| CT iac w contrast (70481) | $1,008.12 | $2,016.23 | 6.1× |
| CT l-spine w&w/o contrast (72133) | $1,452.44 | $2,904.88 | 8.8× |
| CT lower ext w/o (73700) | $1,528.63 | $3,057.25 | 15.5× |
| CT lower extremity w/contrast material (73701) | $2,016.23 | $4,032.45 | 12.2× |
| CT lumbar spine w contrast (72132) | $1,178.78 | $2,357.55 | 3.6× |
| CT lumbar spine w/o contrast (72131) | $764.32 | $1,528.63 | 7.7× |
| CT maxillofacial w contrast (70487) | $1,150 | $2,300 | 6.9× |
| CT maxillofacial wo contrast (70486) | $764.75 | $1,529.50 | 7.7× |
| CT neck tissue combo (70492) | $1,195.23 | $2,390.46 | 7.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,195.23 | $2,390.46 | 7.2× |
| CT orbits w/o contrast (70480) | $764.32 | $1,528.63 | 7.7× |
| CT pelvis w&w/o contrast (72194) | $1,195.23 | $2,390.46 | 7.2× |
| CT pelvis w/o contrast (72192) | $764.32 | $1,528.63 | 7.7× |
| CT scan of leg combo (73702) | $1,195.23 | $2,390.46 | 7.2× |
| CT scans face/jaw combo (70488) | $1,265 | $2,530 | 7.6× |
| CT soft tissue neck w contrast (70491) | $1,008.12 | $2,016.23 | 6.1× |
| CT soft tissue neck w/o contrast (70490) | $764.32 | $1,528.63 | 7.7× |
| CT thoracic spine w contrast (72129) | $1,196.59 | $2,393.17 | 7.2× |
| CT thoracic spine w/o contrast (72128) | $764.32 | $1,528.63 | 7.7× |
| CT thoracic spine w/wo cont (72130) | $1,509.49 | $3,018.97 | 9.1× |
| CT thorax w/o contrast (71250) | $764.32 | $1,528.63 | 7.7× |
| CT upper ext wo (73200) | $1,529.50 | $3,059 | 15.5× |
| CT upper extremity w/o & w/contrast material (73202) | $1,006.25 | $2,012.50 | 6.1× |
| CT upper extremity with contrast (73201) | $1,897.50 | $3,795 | 5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,198.89 | $2,397.77 | 7.2× |
| Cta Abdomen (74175) | $1,198.89 | $2,397.77 | 7.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $623.76 | $1,247.51 | 1.9× |
| CTA pelvis (72191) | $1,198.89 | $2,397.77 | 7.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $81.17 | $162.34 | 0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $125.42 | $250.84 | 1.3× |
| Dxa Bone Density Axial (77080) | $291.95 | $583.90 | 3.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $154.09 | $308.18 | 1.9× |
| Echo exam uterus (76831) | $126.79 | $253.58 | 0.6× |
| Esophagram (74220) | $262.09 | $524.17 | 1.6× |
| Fetal Biophys Profile W/Nst (76818) | $207.08 | $414.16 | 2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $186.10 | $372.19 | 1.9× |
| Fluoroscopy up to 1 hr (76000) | $423.01 | $846.02 | 1.9× |
| Foot 2 views (73620) | $154.09 | $308.18 | 1.9× |
| Forearm 2 views (73090) | $176.76 | $353.51 | 2.1× |
| Gastric emptying imaging study (78264) | $1,337.47 | $2,674.93 | 3.5× |
| Gated Heart Planar Single (78472) | $1,058.50 | $2,117 | 2.8× |
| Gated Heart, Multiple (78473) | $1,395 | $2,790 | 3.7× |
| Hand 2 views (73120) | $372.19 | $744.38 | 3.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $4,625.14 | $9,250.28 | 7.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,084.54 | $8,169.08 | 6.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,712.91 | $3,425.82 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,508.13 | $11,016.25 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,479.80 | $2,959.59 | 2.9× |
| Hepatobiliary System Imaging (78226) | $969.25 | $1,938.50 | 2.6× |
| Ht Muscle Image Spect Sing (78451) | $2,284.59 | $4,569.18 | 1.9× |
| Hysterosalpingogram (74740) | $541.85 | $1,083.69 | 2.4× |
| K Flow/Funct Image Multiple (78709) | $1,375 | $2,750 | 2.7× |
| K Flow/Funct Image W/Drug (78708) | $1,366 | $2,732 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,156.50 | $2,313 | 2.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $409.50 | $819 | 1.1× |
| Knee 3 Views (73562) | $353.51 | $707.02 | 4.3× |
| Liver & Spleen Imaging Static Only (78215) | $1,581.90 | $3,163.80 | 4.2× |
| Lung Perf&Ventilat Diferentl (78598) | $1,724.23 | $3,448.46 | 3.4× |
| Lung Ventilat&Perfus Imaging (78582) | $2,133.44 | $4,266.87 | 4.2× |
| Lung Ventilation Imaging (78579) | $1,414.04 | $2,828.08 | 3.7× |
| Lymph System Imaging (78195) | $1,321.22 | $2,642.43 | 2.6× |
| Magnetic Image Jaw Joint (70336) | $1,058.10 | $2,116.20 | 4.7× |
| Meckels Divert Exam (78290) | $703.21 | $1,406.41 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $672.66 | $1,345.31 | 1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $42.86 | $85.72 | 1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $160.64 | $321.27 | 1.8× |
| Mra Head W/O & W/Contrast Material (70546) | $1,460.50 | $2,921 | 4.4× |
| MRA head w/o contrast (70544) | $1,061.45 | $2,122.90 | 4.7× |
| MRA head with contrast (70545) | $1,249.77 | $2,499.53 | 3.8× |
| MRA neck w contrast (70548) | $1,116.94 | $2,233.88 | 3.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,293.75 | $2,587.50 | 3.9× |
| MRA neck w/o contrast (70547) | $1,017.75 | $2,035.50 | 4.5× |
| MRI abdomen w contrast (74182) | $1,529.50 | $3,059 | 4.6× |
| MRI abdomen w/o contrast (74181) | $1,158.63 | $2,317.25 | 5.1× |
| MRI any jt lower extrem w/contrast material (73722) | $1,382.61 | $2,765.21 | 1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,875 | $5,750 | 8.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,382.61 | $2,765.21 | 1.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $546.86 | $1,093.72 | 2.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $332.07 | $664.13 | 1.5× |
| MRI cardiac w/o contrast (75557) | $1,511.57 | $3,023.13 | 6.7× |
| MRI cervical spine w contrast (72142) | $1,156.04 | $2,312.08 | 3.5× |
| MRI cervical spine w/o cont (72141) | $1,150.96 | $2,301.92 | 5.1× |
| MRI chest w/o contrast (71550) | $848.70 | $1,697.40 | 3.8× |
| MRI chest with contrast (71551) | $1,462.29 | $2,924.57 | 2.0× |
| MRI chest wo w contrast (71552) | $1,603.68 | $3,207.35 | 4.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,509.38 | $3,018.75 | 4.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,047.50 | $6,095 | 9.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,265.50 | $4,531 | 10.0× |
| MRI lumbar spine w contrast (72149) | $1,293.75 | $2,587.50 | 3.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,487.75 | $2,975.49 | 4.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,165.79 | $2,331.57 | 5.2× |
| MRI orbit face neck w contrast (70542) | $1,482.82 | $2,965.64 | 4.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,422.29 | $2,844.57 | 4.3× |
| MRI pelvis w contrast (72196) | $1,358.44 | $2,716.88 | 4.1× |
| MRI pelvis w/o & w contrast (72197) | $1,523.75 | $3,047.50 | 4.6× |
| MRI pelvis w/o contrast (72195) | $1,143.10 | $2,286.20 | 5.1× |
| MRI thoracic spine w/o contrast (72146) | $1,155.64 | $2,311.27 | 5.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,437.50 | $2,875 | 4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,058 | $2,116 | 4.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,725 | $3,450 | 5.2× |
| MRI, abdomen, combo (74183) | $1,575.50 | $3,151 | 4.8× |
| MRI, dorsal spine combo (72157) | $1,482.46 | $2,964.92 | 4.5× |
| MRI, dorsal spine contrast (72147) | $1,192.55 | $2,385.10 | 3.6× |
| MRI, joint upper extrem (73221) | $1,094.12 | $2,188.24 | 4.8× |
| MRI, joint upper extrem combo (73223) | $1,511.03 | $3,022.06 | 4.6× |
| MRI, lumbar spine combo (72158) | $1,466.25 | $2,932.50 | 4.4× |
| Myocardial Spect Multiple Studies (78452) | $3,215.63 | $6,431.25 | 2.6× |
| Neck soft tissue (70360) | $154.09 | $308.18 | 1.9× |
| Nonvascular Shunt X-Ray (75809) | $310.85 | $621.69 | 3.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,755.97 | $11,511.94 | 4.4× |
| Nuclear Rx Intra-Arterial (79445) | $951.46 | $1,902.92 | 4.3× |
| Nuclear Rx Oral Admin (79005) | $1,224.52 | $2,449.04 | 5.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $186.10 | $372.19 | 1.9× |
| Parathyroid Planar Imaging (78070) | $1,366.08 | $2,732.15 | 3.6× |
| Pelvis 1 or 2 views (72170) | $186.10 | $372.19 | 1.9× |
| Pet Image W/Ct Lmtd (78814) | $2,552.54 | $5,105.07 | 1.9× |
| PET image w/CT, full body (78816) | $3,475 | $6,950 | 2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,375 | $6,750 | 2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,147.17 | $2,294.34 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $224.30 | $448.59 | 2.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $353.51 | $707.02 | 4.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $176.76 | $353.51 | 2.1× |
| Radex elbow complete minimum 3 views (73080) | $176.76 | $353.51 | 2.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $186.10 | $372.19 | 1.9× |
| Radex fingr minimum 2 views (73140) | $353.51 | $707.02 | 4.3× |
| Radex foot complete minimum 3 views (73630) | $353.51 | $707.02 | 4.3× |
| Radex Hand Minimum 3 Views (73130) | $353.51 | $707.02 | 4.3× |
| Radex lower extremity infant minimum 2 views (73592) | $353.51 | $707.02 | 4.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $176.76 | $353.51 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $176.76 | $353.51 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) | $176.76 | $353.51 | 2.1× |
| Radex shoulder complete minimum 2 views (73030) | $353.51 | $707.02 | 4.3× |
| Radex Spine 1 View Specify Level (72020) | $176.76 | $353.51 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $176.76 | $353.51 | 2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $176.76 | $353.51 | 2.1× |
| Radex Toe Minimum 2 Views (73660) | $176.76 | $353.51 | 2.1× |
| Radex upper extremity infant minimum 2 views (73092) | $186.10 | $372.19 | 1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $353.51 | $707.02 | 4.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $13,633.59 | $27,267.18 | 2.0× |
| Radiation treatment delivery level 1 (77402) | $512.45 | $1,024.89 | 5.3× |
| Radiation treatment delivery level 2 (77407) | $1,993.60 | $3,987.20 | 5.5× |
| Radiation treatment delivery level 3 (77412) | $2,193.97 | $4,387.93 | 4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $186.10 | $372.19 | 1.9× |
| Radiologic exam colon double contrast study (74280) | $405.93 | $811.85 | 2.4× |
| Radiologic exam colon single contrast study (74270) | $311.54 | $623.07 | 1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $366.68 | $733.36 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) | $187.12 | $374.23 | 1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $215.10 | $430.19 | 2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $311.54 | $623.07 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $311.54 | $623.07 | 1.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $311.54 | $623.07 | 1.9× |
| Radiologic examination femur minimum 2 views (73552) | $176.76 | $353.51 | 2.1× |
| Radiologic examination knee 1/2 views (73560) | $353.51 | $707.02 | 4.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $176.76 | $353.51 | 2.1× |
| Ribs bilateral 3 views (71110) | $186.10 | $372.19 | 1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $501 | $1,002 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,005 | $4,010 | 3.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,284.59 | $4,569.18 | 4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,284.59 | $4,569.18 | 4.4× |
| Rp Therapy Intravenous Administration (79101) | $514.41 | $1,028.82 | 2.3× |
| Scapula (73010) | $186.10 | $372.19 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $42.30 | $84.59 | 1.8× |
| Shoulder 1 view (73020) | $154.09 | $308.18 | 1.9× |
| Shoulder Arthrography (73040) | $624.98 | $1,249.96 | 1.9× |
| Sialogram (70390) | $347.59 | $695.18 | 1.5× |
| Skull less than 4 views (70250) | $186.10 | $372.19 | 1.9× |
| Special dosimetry (77331) | $577.97 | $1,155.93 | 4.5× |
| Special Physics Consult (77370) | $656.67 | $1,313.34 | 5.2× |
| Special teletherapy port plan (77321) | $1,658.69 | $3,317.37 | 4.7× |
| Special treatment procedure (77470) | $2,454.56 | $4,909.11 | 4.7× |
| Stereotactic Body Radiation Delivery (77373) | $5,548.76 | $11,097.51 | 3.3× |
| Sternoclavicular joints (71130) | $176.76 | $353.51 | 2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,658.69 | $3,317.37 | 4.7× |
| Testicular Imaging W/Flow (78761) | $389.33 | $778.66 | 1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,658.69 | $3,317.37 | 4.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,280.31 | $2,560.62 | 3.6× |
| Ther rad simulaj-aided field setting simple (77280) | $656.67 | $1,313.34 | 5.2× |
| Thoracic spine 2 views (72070) | $186.10 | $372.19 | 1.9× |
| Thoracic spine 3 views (72072) | $218.50 | $437 | 2.2× |
| Thoracolumbar 2 views (72080) | $170.20 | $340.40 | 2.1× |
| Thyroid Met Imaging Body (78018) | $1,350.61 | $2,701.21 | 2.6× |
| Thyroid Uptake Measurement (78012) | $243.06 | $486.12 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $919.74 | $1,839.48 | 2.4× |
| Tx Devices Design & Construction Complex (77334) | $1,228.33 | $2,456.66 | 3.5× |
| Tx devices design & construction intermediate (77333) | $1,169.84 | $2,339.68 | 9.2× |
| Tx devices design & construction simple (77332) | $1,228.33 | $2,456.66 | 9.7× |
| Ultrasound Breast Limited (76642) | $318.85 | $637.70 | 3.9× |
| Ultrasound Elastography Parenchyma (76981) | $207.08 | $414.15 | 2.1× |
| Ultrasound Exam Aaa Screen (76706) | $186.10 | $372.19 | 1.9× |
| Ultrasound, abdomen limited (76705) | $409.20 | $818.40 | 4.1× |
| Umbilical-artery Doppler (OB) (76820) | $186.10 | $372.19 | 1.9× |
| Upper gi w/o kub (74240) | $311.54 | $623.07 | 1.9× |
| Ureteral Reflux Study (78740) | $353.77 | $707.54 | 0.9× |
| Urethrocystogram voiding (74455) | $442.50 | $884.99 | 2.0× |
| Urethrocystography retrograde (74450) | $442.50 | $884.99 | 2.0× |
| Us breast unilateral complete (76641) | $638.83 | $1,277.66 | 6.5× |
| Us chest (76604) | $260.72 | $521.43 | 2.6× |
| Us complete joint (76881) | $409.20 | $818.40 | 4.1× |
| Us exam, pelvic, limited (76857) | $249.78 | $499.56 | 2.5× |
| Us head (76506) | $260.72 | $521.43 | 2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $268.47 | $536.93 | 2.7× |
| Us ob limited 1 or more fetuses (76815) | $177.50 | $355 | 1.8× |
| Us ob transvaginal (76817) | $177.50 | $355 | 1.8× |
| Us pelvic non ob complete (76856) | $409.20 | $818.40 | 4.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $177.50 | $355 | 1.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $177.50 | $355 | 1.8× |
| Us retroperitoneal complete (76770) | $371.92 | $743.83 | 3.8× |
| Us retroperitoneal limited (76775) | $347.49 | $694.97 | 3.5× |
| Us scrotum and contents (76870) | $409.20 | $818.40 | 4.1× |
| Us spinal canal and contents (76800) | $409.20 | $818.40 | 4.1× |
| Us thyroid (76536) | $409.20 | $818.40 | 4.1× |
| Us transrectal (76872) | $328.06 | $656.11 | 3.3× |
| Vein X-Ray Chest (75827) | $2,718.52 | $5,437.04 | 1.8× |
| Venography caval inferior serialography rs&i (75825) | $5,508.13 | $11,016.25 | 1.8× |
| Venography extremity bilateral rs&i (75822) | $2,670.38 | $5,340.76 | 1.8× |
| Venography extremity unilateral rs&i (75820) | $2,718.52 | $5,437.04 | 1.8× |
| Venography Renal Unilateral (75831) | $5,508.13 | $11,016.25 | 1.8× |
| Wrist 2 views (73100) | $154.09 | $308.18 | 1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $176.76 | $353.51 | 2.1× |
| X-ray antegrade pyelogram tube (74425) | $442.50 | $884.99 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) | $5,783.53 | $11,567.06 | 1.9× |
| X-Ray Bend Only L-S Spine (72120) | $304.14 | $608.28 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $154.09 | $308.18 | 1.9× |
| X-Ray Exam Breast Specimen (76098) | $959.53 | $1,919.05 | 1.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $176.76 | $353.51 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $186.10 | $372.19 | 1.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $154.09 | $308.18 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $176.76 | $353.51 | 2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $287.50 | $575 | 2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $330.63 | $661.25 | 3.3× |
| X-Ray Exam L-S Spine Bending (72114) | $304.14 | $608.28 | 3.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $176.76 | $353.51 | 2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $304.14 | $608.28 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $186.10 | $372.19 | 1.9× |
| X-ray eye for foreign body (70030) | $154.09 | $308.18 | 1.9× |
| X-ray humerus (73060) | $176.76 | $353.51 | 2.1× |
| X-ray IV pyelogram (ivp) (74400) | $442.50 | $884.99 | 2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $64.98 | $129.95 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $154.09 | $308.18 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $186.10 | $372.19 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $154.09 | $308.18 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $304.14 | $608.28 | 3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $457.13 | $914.25 | 4.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $176.76 | $353.51 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $176.76 | $353.51 | 2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $176.76 | $353.51 | 2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $304.14 | $608.28 | 3.1× |
| X-ray thoracic spine 4 vw (72074) | $261.63 | $523.25 | 2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $624.98 | $1,249.96 | 1.9× |
| X-Rays Bone Length Studies (77073) | $186.10 | $372.19 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $304.14 | $608.28 | 3.1× |
| Xr c-spine 4 or 5 views (72050) | $304.14 | $608.28 | 3.1× |
| Xr facial bones less than 3 views (70140) | $176.76 | $353.51 | 2.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $174.23 | $348.45 | 1.8× |
| Xr orbits complete 4 views (70200) | $186.10 | $372.19 | 1.9× |