| Abdomen 1 View (74018) |
$170.66 |
$322 |
1.9× |
| Ankle 2 views (73600) |
$135.15 |
$255 |
1.5× |
| Bone age studies (77072) |
$146.28 |
$276 |
1.4× |
| Bone survey infant (77076) |
$162.18 |
$306 |
1.5× |
| Cat Scan Follow-Up Study (76380) |
$516.22 |
$974 |
5.9× |
| Chest 1 view (71045) |
$115.54 |
$218 |
1.3× |
| Chest 2 views (71046) |
$171.19 |
$323 |
1.9× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$198.22 |
$374 |
1.9× |
| Clavicle complete (73000) |
$144.69 |
$273 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$595.72 |
$1,124 |
5.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$25.97 |
$49 |
0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$251.75 |
$475 |
2.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$322.77 |
$609 |
3.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$332.31 |
$627 |
3.1× |
| Dxa Bone Density Axial (77080) |
$173.84 |
$328 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$134.62 |
$254 |
1.5× |
| Echo exam of fetal heart (76825) |
$389.55 |
$735 |
0.7× |
| Echo Guide For Artery Repair (76936) |
$594.13 |
$1,121 |
2.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$312.17 |
$589 |
1.3× |
| Echograp Trans R Pros Study (76873) |
$348.21 |
$657 |
3.3× |
| Esophagram (74220) |
$156.88 |
$296 |
0.9× |
| Fetal Biophys Profile W/Nst (76818) |
$367.29 |
$693 |
3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$367.29 |
$693 |
3.5× |
| Fluoroscopy up to 1 hr (76000) |
$161.12 |
$304 |
0.7× |
| Foot 2 views (73620) |
$148.93 |
$281 |
1.7× |
| Forearm 2 views (73090) |
$144.69 |
$273 |
1.6× |
| Hand 2 views (73120) |
$139.92 |
$264 |
1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$249.10 |
$470 |
2.8× |
| Infant hip ultrasound, limited static exam (76886) |
$367.29 |
$693 |
4.2× |
| Joint Survey Single View (77077) |
$156.88 |
$296 |
1.5× |
| Knee 3 Views (73562) |
$152.64 |
$288 |
1.7× |
| Mammary ductogram or galactogram single (77053) |
$174.37 |
$329 |
0.7× |
| Mr safety determination physician/other qhp (76016) |
$163.24 |
$308 |
1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$45.58 |
$86 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$170.13 |
$321 |
1.8× |
| Mr safety implt pos&/immoblj (76019) |
$110.24 |
$208 |
1.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$448.38 |
$846 |
1.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$649.78 |
$1,226 |
2.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$633.88 |
$1,196 |
2.6× |
| Neck soft tissue (70360) |
$138.86 |
$262 |
1.6× |
| Ob us nuchal meas 1 gest (76813) |
$322.77 |
$609 |
3.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$226.31 |
$427 |
2.1× |
| Panoramic X-ray of jaws (70355) |
$123.49 |
$233 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$130.91 |
$247 |
1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$182.85 |
$345 |
1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$158.47 |
$299 |
1.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$135.15 |
$255 |
1.5× |
| Radex elbow complete minimum 3 views (73080) |
$158.47 |
$299 |
1.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$158.47 |
$299 |
1.5× |
| Radex fingr minimum 2 views (73140) |
$155.82 |
$294 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$170.66 |
$322 |
1.9× |
| Radex Hand Minimum 3 Views (73130) |
$171.19 |
$323 |
1.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$156.88 |
$296 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$158.47 |
$299 |
1.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$158.47 |
$299 |
1.8× |
| Radex shoulder complete minimum 2 views (73030) |
$158.47 |
$299 |
1.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$147.87 |
$279 |
1.7× |
| Radex Spine 1 View Specify Level (72020) |
$125.61 |
$237 |
1.4× |
| Radex Sternum Minimum 2 Views (71120) |
$147.87 |
$279 |
1.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$156.88 |
$296 |
1.8× |
| Radex Toe Minimum 2 Views (73660) |
$138.86 |
$262 |
1.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$152.64 |
$288 |
1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$158.47 |
$299 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$161.12 |
$304 |
1.5× |
| Radiologic exam knee complete 4/more views (73564) |
$156.88 |
$296 |
1.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$158.47 |
$299 |
1.5× |
| Radiologic exam swallow function contrast study (74230) |
$166.42 |
$314 |
0.9× |
| Radiologic examination femur 1 view (73551) |
$155.82 |
$294 |
1.8× |
| Radiologic examination femur minimum 2 views (73552) |
$182.85 |
$345 |
2.1× |
| Radiologic examination knee 1/2 views (73560) |
$147.87 |
$279 |
1.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$161.12 |
$304 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$158.47 |
$299 |
1.8× |
| Ribs bilateral 3 views (71110) |
$177.55 |
$335 |
1.7× |
| Scapula (73010) |
$146.81 |
$277 |
1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$21.73 |
$41 |
0.9× |
| Shoulder 1 view (73020) |
$146.81 |
$277 |
1.7× |
| Skull less than 4 views (70250) |
$147.87 |
$279 |
1.4× |
| Sternoclavicular joints (71130) |
$156.88 |
$296 |
1.8× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$112.36 |
$212 |
1.3× |
| Tbs technical calculation only (77091) |
$112.36 |
$212 |
1.3× |
| Thoracic spine 2 views (72070) |
$135.15 |
$255 |
1.3× |
| Thoracic spine 3 views (72072) |
$161.12 |
$304 |
1.5× |
| Thoracolumbar 2 views (72080) |
$138.86 |
$262 |
1.6× |
| Ultrasound Breast Limited (76642) |
$510.39 |
$963 |
5.8× |
| Ultrasound Exam Aaa Screen (76706) |
$351.92 |
$664 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$374.71 |
$707 |
3.5× |
| Umbilical-artery Doppler (OB) (76820) |
$331.25 |
$625 |
3.1× |
| Unlisted Dx Radiographic Procedure (76499) |
$123.49 |
$233 |
1.4× |
| Us breast unilateral complete (76641) |
$534.24 |
$1,008 |
5.0× |
| Us chest (76604) |
$347.15 |
$655 |
3.3× |
| Us complete joint (76881) |
$367.29 |
$693 |
3.5× |
| Us exam, pelvic, limited (76857) |
$334.43 |
$631 |
3.2× |
| Us head (76506) |
$282.49 |
$533 |
2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$286.73 |
$541 |
2.7× |
| Us ob detailed single fetus (76811) |
$404.92 |
$764 |
1.7× |
| Us ob limited 1 or more fetuses (76815) |
$367.29 |
$693 |
3.5× |
| Us ob transvaginal (76817) |
$371 |
$700 |
3.5× |
| Us pelvic non ob complete (76856) |
$371 |
$700 |
3.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$367.29 |
$693 |
3.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$469.58 |
$886 |
4.4× |
| Us retroperitoneal complete (76770) |
$510.39 |
$963 |
4.8× |
| Us retroperitoneal limited (76775) |
$469.58 |
$886 |
4.4× |
| Us scrotum and contents (76870) |
$385.84 |
$728 |
3.6× |
| Us spinal canal and contents (76800) |
$367.29 |
$693 |
3.5× |
| Us thyroid (76536) |
$510.39 |
$963 |
4.8× |
| Us transrectal (76872) |
$350.86 |
$662 |
3.3× |
| Vertebral fracture assessment via dxa (77086) |
$137.80 |
$260 |
1.6× |
| Wrist 2 views (73100) |
$135.15 |
$255 |
1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$147.87 |
$279 |
1.7× |
| X-Ray Bend Only L-S Spine (72120) |
$156.88 |
$296 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$138.86 |
$262 |
1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$171.19 |
$323 |
1.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$131.44 |
$248 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$182.32 |
$344 |
2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$175.96 |
$332 |
1.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$171.19 |
$323 |
1.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$156.88 |
$296 |
1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$166.42 |
$314 |
1.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$158.47 |
$299 |
1.5× |
| X-ray eye for foreign body (70030) |
$140.98 |
$266 |
1.6× |
| X-ray humerus (73060) |
$147.87 |
$279 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$119.25 |
$225 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$138.86 |
$262 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$155.29 |
$293 |
1.5× |
| X-ray nose-rectum child f.b. (76010) |
$156.88 |
$296 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$177.55 |
$335 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$156.88 |
$296 |
1.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$112.89 |
$213 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$156.88 |
$296 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$156.88 |
$296 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$156.88 |
$296 |
1.5× |
| X-ray thoracic spine 4 vw (72074) |
$163.24 |
$308 |
1.5× |
| X-Rays Bone Length Studies (77073) |
$83.74 |
$158 |
0.8× |
| Xr c-spine 4 or 5 views (72050) |
$162.18 |
$306 |
1.5× |
| Xr facial bones less than 3 views (70140) |
$147.87 |
$279 |
1.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$75.26 |
$142 |
0.7× |
| Xr orbits complete 4 views (70200) |
$158.47 |
$299 |
1.5× |