| Acute gi blood loss imaging (78278) |
$1,766 |
$1,766 |
4.2× |
| Ankle 2 views (73600) |
$373 |
$373 |
4.1× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$1,427 |
$1,427 |
3.4× |
| Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or… (78481) |
$524 |
$524 |
0.9× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$1,524.50 |
$1,524.50 |
3.6× |
| Clavicle complete (73000) |
$409 |
$409 |
4.5× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$2,847 |
$2,847 |
7.7× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$2,123 |
$2,123 |
11.5× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$2,582 |
$2,582 |
14.0× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$2,798 |
$2,798 |
15.1× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$2,086 |
$2,086 |
11.3× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$2,609 |
$2,609 |
14.1× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,086 |
$2,086 |
11.3× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$2,006 |
$2,006 |
10.8× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$2,221 |
$2,221 |
12.0× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,730 |
$1,730 |
15.7× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$2,359 |
$2,359 |
12.7× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$2,266 |
$2,266 |
12.2× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$3,070 |
$3,070 |
16.6× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,658 |
$1,658 |
15.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$2,701 |
$2,701 |
14.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$2,496 |
$2,496 |
22.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,781 |
$2,781 |
15.0× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$2,890 |
$2,890 |
15.6× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$2,395 |
$2,395 |
12.9× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$3,078 |
$3,078 |
16.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,718 |
$5,718 |
15.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,788 |
$3,788 |
15.0× |
| CT abdomen w & w/o contrast (74170) |
$2,995 |
$2,995 |
16.2× |
| CT abdomen w/contrast (74160) |
$2,661 |
$2,661 |
14.4× |
| CT abdomen w/o contrast (74150) |
$1,958 |
$1,958 |
17.8× |
| CT angio hrt w/3d image (75574) |
$2,229 |
$2,229 |
6.1× |
| CT cervical spine w/contrast (72126) |
$2,116 |
$2,116 |
5.7× |
| CT cervical spine w/o contrast (72125) |
$1,502.50 |
$1,502.50 |
13.6× |
| CT chest w/contrast (71260) |
$2,927 |
$2,927 |
15.8× |
| CT extremity upper w & w/o contrast (73202) |
$2,583 |
$2,583 |
14.0× |
| CT extremity upper w/o contrast (73200) |
$1,730 |
$1,730 |
15.7× |
| CT head/brain with contrast (70460) |
$3,617 |
$3,617 |
19.5× |
| CT head/brain without and with contrast (70470) |
$3,477 |
$3,477 |
18.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$177 |
$177 |
1.9× |
| CT l-spine w/contrast (72132) |
$1,976 |
$1,976 |
5.4× |
| CT lower extremity w/dye (73701) |
$2,209 |
$2,209 |
11.9× |
| CT lumbar spine w/o contrast (72131) |
$1,502.50 |
$1,502.50 |
13.6× |
| CT maxillofacial w/wo contrast (70488) |
$3,573 |
$3,573 |
19.3× |
| CT neck w/contrast (70491) |
$2,875 |
$2,875 |
15.5× |
| CT neck w/o contrast (70490) |
$2,875 |
$2,875 |
26.1× |
| CT pelvis w & w/o contrast (72194) |
$2,921 |
$2,921 |
15.8× |
| CT pelvis w/o contrast (72192) |
$1,834 |
$1,834 |
16.6× |
| CT thoracic spine w/contrast (72129) |
$1,976 |
$1,976 |
10.7× |
| CT thoracic spine w/o contrast (72128) |
$1,502.50 |
$1,502.50 |
13.6× |
| CT thorax lung cancer scr c- (71271) |
$179 |
$179 |
1.6× |
| CT thorax w/o contrast (71250) |
$1,834 |
$1,834 |
16.6× |
| CT upper extremity w/dye (73201) |
$2,209 |
$2,209 |
6.0× |
| CTA h&n c+ w/noncontrast img (70471) |
$6,007 |
$6,007 |
16.3× |
| CTA head w contrast (70496) |
$3,398 |
$3,398 |
18.4× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$1,325 |
$1,325 |
3.6× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$628 |
$628 |
5.7× |
| Dxa bone density study axial skeleton (77085) |
$440 |
$440 |
4.0× |
| Dxa bone density/peripheral (77081) |
$367 |
$367 |
4.0× |
| Echo exam of eye thickness (76514) |
$93 |
$93 |
3.0× |
| Fetal biophysical profile non-stress testing (76818) |
$1,215 |
$1,215 |
11.0× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$1,162.50 |
$1,162.50 |
4.6× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$2,251 |
$2,251 |
3.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,642 |
$1,642 |
3.9× |
| Ht muscle image spect sing (78451) |
$1,809 |
$1,809 |
1.3× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$2,777 |
$2,777 |
6.6× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$1,512 |
$1,512 |
3.6× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$964 |
$964 |
1.7× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,390 |
$1,390 |
2.4× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,607 |
$1,607 |
2.8× |
| Liver imaging (78201) |
$444 |
$444 |
0.8× |
| Lung perfusion imaging (78580) |
$1,200 |
$1,200 |
2.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$4,918 |
$4,918 |
13.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$4,272 |
$4,272 |
11.6× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$4,065 |
$4,065 |
16.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$4,986 |
$4,986 |
13.5× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$4,189 |
$4,189 |
11.4× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$3,784 |
$3,784 |
15.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$4,271 |
$4,271 |
11.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$5,034 |
$5,034 |
13.7× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$4,041 |
$4,041 |
11.0× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$4,173 |
$4,173 |
11.3× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$4,383 |
$4,383 |
11.9× |
| Mandible min 4v (70110) |
$495 |
$495 |
4.5× |
| MRA head w/o contrast (70544) |
$3,886 |
$3,886 |
15.4× |
| MRA neck w/ contrast (70548) |
$4,188 |
$4,188 |
11.4× |
| MRA neck w/o contrast (70547) |
$3,886 |
$3,886 |
15.4× |
| MRI abdomen w/contrast (74182) |
$4,696 |
$4,696 |
12.8× |
| MRI abdomen w/o contrast (74181) |
$3,453 |
$3,453 |
13.7× |
| MRI abdomen w/wo contrast (74183) |
$4,919 |
$4,919 |
13.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,516 |
$4,516 |
5.5× |
| MRI breast c- bilateral (77047) |
$3,312 |
$3,312 |
13.2× |
| MRI breast without contrast material unilateral (77046) |
$3,312 |
$3,312 |
13.2× |
| MRI c-spine w&w/o cont (72156) |
$4,110 |
$4,110 |
11.2× |
| MRI cervical spine w/contrast (72142) |
$4,000 |
$4,000 |
10.9× |
| MRI chest w/contrast (71551) |
$4,442 |
$4,442 |
5.4× |
| MRI chest w/o contrast (71550) |
$3,420 |
$3,420 |
13.6× |
| MRI chest w/wo contrast (71552) |
$4,968 |
$4,968 |
13.5× |
| MRI joint upr extr w/o&w/dye (73223) |
$4,695 |
$4,695 |
12.8× |
| MRI joint upr extrem w/dye (73222) |
$4,516 |
$4,516 |
5.5× |
| MRI joint upr extrem w/o dye (73221) |
$4,122 |
$4,122 |
16.4× |
| MRI lumbar spine w/contrast (72149) |
$4,149 |
$4,149 |
11.3× |
| MRI lumbar spine w/wo contrast (72158) |
$4,110 |
$4,110 |
11.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,638 |
$4,638 |
12.6× |
| MRI pelvis w & w/o contrast (72197) |
$4,919 |
$4,919 |
13.4× |
| MRI pelvis w/contrast (72196) |
$4,075 |
$4,075 |
11.1× |
| MRI pelvis w/o contrast (72195) |
$4,065 |
$4,065 |
16.2× |
| MRI spine cervical w/o contrast (72141) |
$3,386 |
$3,386 |
13.5× |
| MRI t-spine w&w/o cont (72157) |
$4,110 |
$4,110 |
11.2× |
| MRI thoracic spine w/contrast (72147) |
$4,025 |
$4,025 |
10.9× |
| MRI thoracic spine w/o contrst (72146) |
$3,537 |
$3,537 |
14.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,065 |
$4,065 |
16.2× |
| Myocardial spect multiple studies (78452) |
$1,727.50 |
$1,727.50 |
1.3× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$5,700 |
$5,700 |
6.3× |
| Nm bone 3 phase (78315) |
$2,289 |
$2,289 |
5.4× |
| Nm bone imaging whole body (78306) |
$1,863 |
$1,863 |
4.4× |
| Nm bone marrow ltd (78102) |
$1,643 |
$1,643 |
3.9× |
| Nm gastric emptying (78264) |
$1,242 |
$1,242 |
2.9× |
| Nm lung ventilation imaging (78579) |
$1,200 |
$1,200 |
2.8× |
| Nm lymph system (78195) |
$2,299 |
$2,299 |
4.0× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,649 |
$1,649 |
3.9× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$1,632 |
$1,632 |
3.9× |
| Ob us limited fetus(s) (76815) |
$859 |
$859 |
7.8× |
| Parathyrd planar w/spect&CT (78072) |
$1,848 |
$1,848 |
3.2× |
| Parathyroid planar imaging (78070) |
$651 |
$651 |
1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,583 |
$1,583 |
3.8× |
| Pulmonary ventilation & perfusion imaging (78582) |
$2,530 |
$2,530 |
4.4× |
| Quan&char c athrosclrtc plaq (75577) |
$1,259 |
$1,259 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$770 |
$770 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$569 |
$569 |
6.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$579 |
$579 |
5.3× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$394 |
$394 |
4.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$410 |
$410 |
3.7× |
| Radex spine cervical 2 or 3 views (72040) |
$493 |
$493 |
5.4× |
| Radex spine cervical 4 or 5 views (72050) |
$886 |
$886 |
8.0× |
| Radex spine cervical 6 or more views (72052) |
$688 |
$688 |
6.2× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$606 |
$606 |
6.6× |
| Radiologic exam abdomen 3+ views (74021) |
$737 |
$737 |
6.7× |
| Radiologic exam chest 3 views (71047) |
$378 |
$378 |
4.1× |
| Radiologic exam chest 4+ views (71048) |
$393 |
$393 |
3.6× |
| Radiologic exam colon double contrast study (74280) |
$1,314 |
$1,314 |
7.1× |
| Radiologic exam colon single contrast study (74270) |
$946 |
$946 |
5.1× |
| Radiologic exam esophagus single contrast study (74220) |
$858 |
$858 |
4.6× |
| Radiologic exam small int single contrast study (74250) |
$980 |
$980 |
5.3× |
| Radiologic exam swallow function contrast study (74230) |
$1,944 |
$1,944 |
10.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,318 |
$1,318 |
7.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,127.50 |
$1,127.50 |
6.1× |
| Radiologic examination femur 1 view (73551) |
$485 |
$485 |
5.3× |
| Radiologic examination femur minimum 2 views (73552) |
$509 |
$509 |
5.5× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$501 |
$501 |
5.5× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$451 |
$451 |
4.9× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$400 |
$400 |
4.4× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$451 |
$451 |
4.9× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$379 |
$379 |
4.1× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$451 |
$451 |
4.9× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$445 |
$445 |
4.8× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$974 |
$974 |
10.6× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$519 |
$519 |
4.7× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$213 |
$213 |
2.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$355 |
$355 |
3.2× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$529 |
$529 |
5.8× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$757 |
$757 |
6.9× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$521 |
$521 |
4.7× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$553 |
$553 |
5.0× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$1,289 |
$1,289 |
3.5× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$506 |
$506 |
5.5× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$162 |
$162 |
1.8× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$523 |
$523 |
4.7× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$573 |
$573 |
5.2× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$601 |
$601 |
5.4× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$708 |
$708 |
6.4× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$451 |
$451 |
4.9× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$457 |
$457 |
5.0× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$496 |
$496 |
5.4× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$588 |
$588 |
5.3× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$447 |
$447 |
4.9× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$390 |
$390 |
4.2× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$2,488 |
$2,488 |
4.3× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$1,326 |
$1,326 |
5.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,197 |
$1,197 |
2.8× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$3,262 |
$3,262 |
5.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,346 |
$1,346 |
2.3× |
| Rp loclzj tum spect w/CT 1 (78830) |
$2,092 |
$2,092 |
1.5× |
| Scapula complete (73010) |
$526.50 |
$526.50 |
4.8× |
| Thyroid imaging with vascular flow (78013) |
$666 |
$666 |
1.6× |
| Thyroid uptake single/multiple quant measurement (78012) |
$1,386 |
$1,386 |
3.3× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,540 |
$1,540 |
3.7× |
| Ultrasound breast limited (76642) |
$436 |
$436 |
4.7× |
| Ultrasound, abdomen limited (76705) |
$803 |
$803 |
7.3× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$613 |
$613 |
5.6× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$907 |
$907 |
8.2× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$1,154 |
$1,154 |
10.5× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$995 |
$995 |
9.0× |
| Unlisted CT procedure (76497) |
$300 |
$300 |
3.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$1,318 |
$1,318 |
7.1× |
| Us abdominal aorta real time screen study aaa (76706) |
$883 |
$883 |
8.0× |
| Us breast uni real time with image complete (76641) |
$499 |
$499 |
4.5× |
| Us chest (76604) |
$803 |
$803 |
7.3× |
| Us compl joint r-t w/image documentation (76881) |
$946 |
$946 |
8.6× |
| Us encephalogram (76506) |
$803 |
$803 |
7.3× |
| Us exam, pelvic, limited (76857) |
$612 |
$612 |
5.5× |
| Us guided compression repair (76936) |
$931 |
$931 |
4.1× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$985 |
$985 |
10.7× |
| US OB Follow-Up/Repeat (76816) |
$628 |
$628 |
5.7× |
| Us ob transvaginal (76817) |
$944 |
$944 |
8.6× |
| Us retroperitoneal complete (76770) |
$1,003 |
$1,003 |
9.1× |
| Us retroperitoneal ltd (76775) |
$810 |
$810 |
7.3× |
| Us scrotum (76870) |
$822 |
$822 |
7.5× |
| Us soft tissue head/neck (76536) |
$803 |
$803 |
7.3× |
| Us spinal canal (76800) |
$883 |
$883 |
8.0× |
| Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) |
$189 |
$189 |
2.1× |
| Vertebral fracture assessment via dxa (77086) |
$426 |
$426 |
4.6× |
| X-ray exam of finger(s) (73140) |
$355 |
$355 |
3.9× |
| X-ray exam of knee 1 or 2 (73560) |
$366 |
$366 |
4.0× |
| X-ray exam ribs bil 3 views (71110) |
$732 |
$732 |
6.6× |
| X-ray exam ribs uni 2 views (71100) |
$462 |
$462 |
5.0× |
| X-ray heel (73650) |
$373 |
$373 |
4.1× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$609 |
$609 |
5.5× |
| Xr abdomen 1 view (74018) |
$415 |
$415 |
4.5× |
| Xr abdomen 2 views (74019) |
$615 |
$615 |
5.6× |
| Xr arthrogram ankle (73615) |
$1,507 |
$1,507 |
4.1× |
| Xr arthrogram elbow (73085) |
$1,507 |
$1,507 |
4.1× |
| Xr arthrogram hip (73525) |
$1,504 |
$1,504 |
4.1× |
| Xr arthrogram knee (73580) |
$1,457 |
$1,457 |
4.0× |
| Xr arthrogram wrist (73115) |
$615 |
$615 |
1.7× |
| Xr bone age studies (77072) |
$384 |
$384 |
3.5× |
| Xr bone length study (77073) |
$588 |
$588 |
5.3× |
| Xr bone survey infant (77076) |
$617 |
$617 |
5.6× |
| Xr chest 1 view (71045) |
$309 |
$309 |
3.4× |
| Xr chest 2 views (71046) |
$382.50 |
$382.50 |
4.2× |
| Xr facial bones 3+ views (70150) |
$586 |
$586 |
5.3× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$374 |
$374 |
4.1× |
| Xr forearm 2 views (73090) |
$415 |
$415 |
4.5× |
| Xr hand 2v (73120) |
$415 |
$415 |
3.8× |
| Xr hysterosalpingogram (74740) |
$1,514 |
$1,514 |
6.0× |
| Xr neck soft tissue (70360) |
$379 |
$379 |
4.1× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$402 |
$402 |
4.4× |
| Xr osseous survey complete (77075) |
$959 |
$959 |
8.7× |
| Xr pelvis 1-2 views (72170) |
$525 |
$525 |
4.8× |
| Xr pelvis min 3 view (72190) |
$737 |
$737 |
6.7× |
| Xr sacrum/coccyx 2+ views (72220) |
$542 |
$542 |
5.9× |
| Xr shoulder 1 view (73020) |
$388 |
$388 |
4.2× |
| Xr sialogram (70390) |
$1,336 |
$1,336 |
5.3× |
| Xr sinuses 3+ views (70220) |
$515 |
$515 |
5.6× |
| Xr skull min 4 view (70260) |
$656 |
$656 |
5.9× |
| Xr spine 1 view (72020) |
$361 |
$361 |
3.9× |
| Xr sternum 2+ views (71120) |
$604 |
$604 |
6.6× |
| Xr surgical specimen (76098) |
$269 |
$269 |
0.5× |
| Xr t-spine 2 views (72070) |
$584 |
$584 |
5.3× |
| Xr tibia/fibula 2 views (73590) |
$431 |
$431 |
4.7× |
| Xr tmj bilateral (70330) |
$544 |
$544 |
5.9× |
| Xr wrist 2 views (73100) |
$399 |
$399 |
4.3× |