| Abdomen 2 views (74019) |
$194.62 |
$259.50 |
2.0× |
| Angiography extremity bilateral rs&i (75716) |
$1,953 |
$2,604 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,936.88 |
$2,582.50 |
0.7× |
| Ankle 2 views (73600) |
$174 |
$232 |
2.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,946.62 |
$2,595.50 |
0.7× |
| Arthrogram hip (73525) |
$310.50 |
$414 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$241.50 |
$322 |
1.9× |
| Bone age studies (77072) |
$194.62 |
$259.50 |
2.0× |
| Bone survey complete (77075) |
$234.75 |
$313 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$174 |
$232 |
2.2× |
| Chest 1 view (71045) |
$174 |
$232 |
2.2× |
| Chest 3 views (71047) |
$212.25 |
$283 |
2.6× |
| Clavicle complete (73000) |
$174 |
$232 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$239.25 |
$319 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$803.25 |
$1,071 |
2.5× |
| CT abdomen and pelvis without contrast (74176) |
$543.75 |
$725 |
2.5× |
| CT abdomen w contrast (74160) |
$400.50 |
$534 |
2.5× |
| CT abdomen w wo contrast (74170) |
$400.50 |
$534 |
2.5× |
| CT abdomen w/o contrast (74150) |
$239.25 |
$319 |
2.5× |
| CT angiography upper extremity lt (73206) |
$400.50 |
$534 |
2.5× |
| CT c-spine w/o contrast (72125) |
$239.25 |
$319 |
2.5× |
| CT chest w/wo contrast (71270) |
$400.50 |
$534 |
2.5× |
| CT chest with contrast (71260) |
$400.50 |
$534 |
2.5× |
| CT head/brain with contrast (70460) |
$400.50 |
$534 |
2.5× |
| CT head/brain without and with contrast (70470) |
$400.50 |
$534 |
2.5× |
| CT lower ext w/o (73700) |
$239.25 |
$319 |
2.5× |
| CT lumbar spine w/o contrast (72131) |
$239.25 |
$319 |
2.5× |
| CT maxillofacial w/o contrast (70486) |
$239.25 |
$319 |
2.5× |
| CT maxillofacial w/wo contrast (70488) |
$400.50 |
$534 |
2.5× |
| CT neck soft tissue w contrast (70491) |
$400.50 |
$534 |
2.5× |
| CT orbits w/o contrast (70480) |
$239.25 |
$319 |
2.5× |
| CT pelvis w & w/o contrast (72194) |
$400.50 |
$534 |
2.5× |
| CT pelvis w/o contrast (72192) |
$239.25 |
$319 |
2.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$400.50 |
$534 |
2.5× |
| CT soft tissue neck w/o contrast (70490) |
$400.50 |
$534 |
4.1× |
| CT thoracic spine w/o contrast (72128) |
$239.25 |
$319 |
2.5× |
| CT thorax w/o contrast (71250) |
$239.25 |
$319 |
2.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$400.50 |
$534 |
2.5× |
| CT upper extremity w/o contrast rt (73200) |
$239.25 |
$319 |
2.5× |
| CT upper extremity with contrast (73201) |
$803.25 |
$1,071 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$400.50 |
$534 |
2.5× |
| Cta Abdomen (74175) |
$400.50 |
$534 |
2.5× |
| CTA abdomen pelvis (74174) |
$803.25 |
$1,071 |
2.5× |
| CTA chest (71275) |
$400.50 |
$534 |
2.5× |
| Cta Head (70496) |
$400.50 |
$534 |
2.5× |
| CTA lwr ext w&w/o contrast (73706) |
$400.50 |
$534 |
2.5× |
| Cta Neck (70498) |
$400.50 |
$534 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$239.25 |
$319 |
2.5× |
| Foot 2 views (73620) |
$174 |
$232 |
2.2× |
| Forearm 2 views (73090) |
$174 |
$232 |
2.2× |
| Hand 2 views (73120) |
$194.62 |
$259.50 |
2.0× |
| Hand 3 views (73130) |
$174 |
$232 |
2.2× |
| Humerus Min 2 Views Left (73060) |
$174 |
$232 |
2.2× |
| Neck soft tissue (70360) |
$174 |
$232 |
2.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$239.25 |
$319 |
2.5× |
| Osseous survey infant (77076) |
$244.12 |
$325.50 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$194.62 |
$259.50 |
2.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$261.38 |
$348.50 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$194.62 |
$259.50 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$194.62 |
$259.50 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$174 |
$232 |
2.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$174 |
$232 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$174 |
$232 |
2.2× |
| Ribs bilateral 3 views (71110) |
$194.62 |
$259.50 |
2.0× |
| Sacroiliac Joints < 3 Views (72200) |
$194.62 |
$259.50 |
2.0× |
| Scanogram (77073) |
$194.62 |
$259.50 |
2.0× |
| Scapula complete (73010) |
$194.62 |
$259.50 |
2.0× |
| Spine thoracic 3 views (72072) |
$194.62 |
$259.50 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,129.50 |
$1,506 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$239.25 |
$319 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$469.50 |
$626 |
2.9× |
| Us abdl aorta screen aaa (76706) |
$239.25 |
$319 |
2.5× |
| Us breast unilateral complete (76641) |
$239.25 |
$319 |
2.5× |
| Us breast unilateral limited (76642) |
$198 |
$264 |
2.5× |
| Us ob transvaginal (76817) |
$239.25 |
$319 |
2.5× |
| Us pelvic non ob complete (76856) |
$239.25 |
$319 |
2.5× |
| Us pregnancy ltd (76815) |
$239.25 |
$319 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$239.25 |
$319 |
2.5× |
| Us retroperitoneal complete (76770) |
$239.25 |
$319 |
2.5× |
| Us scrotum and contents (76870) |
$239.25 |
$319 |
2.5× |
| Us soft tissue head/neck (76536) |
$239.25 |
$319 |
2.5× |
| Us transrectal prostate volume (76873) |
$239.25 |
$319 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$239.25 |
$319 |
2.5× |
| Venogram extremity bilateral (75822) |
$1,020.38 |
$1,360.50 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$1,899.38 |
$2,532.50 |
0.6× |
| Wrist 2 views (73100) |
$174 |
$232 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$232.88 |
$310.50 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$174 |
$232 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$174 |
$232 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$174 |
$232 |
2.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$174 |
$232 |
2.2× |
| X-ray exam hip uni 1 view (73501) |
$174 |
$232 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$174 |
$232 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$194.62 |
$259.50 |
2.0× |
| X-ray exam of femur 1 (73551) |
$174 |
$232 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$194.62 |
$259.50 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$174 |
$232 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$174 |
$232 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$174 |
$232 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$194.62 |
$259.50 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$174 |
$232 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$194.62 |
$259.50 |
2.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$174 |
$232 |
2.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$194.62 |
$259.50 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$174 |
$232 |
2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$194.62 |
$259.50 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$174 |
$232 |
2.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$174 |
$232 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$174 |
$232 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$232.88 |
$310.50 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$194.62 |
$259.50 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$174 |
$232 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$174 |
$232 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$174 |
$232 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$194.62 |
$259.50 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$174 |
$232 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$198 |
$264 |
2.5× |
| Xr c-spine 6 or more views (72052) |
$232.88 |
$310.50 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$174 |
$232 |
2.2× |
| Xr shoulder 1 view (73020) |
$174 |
$232 |
2.2× |
| Xr tibia/fibula 2 views (73590) |
$174 |
$232 |
2.2× |
| Xr tmj bilateral (70330) |
$174 |
$232 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$174 |
$232 |
2.2× |