| Abdomen 2 views (74019) |
$554 |
$554 |
5.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$774.50 |
$774.50 |
2.1× |
| Angiography extremity bilateral rs&i (75716) |
$2,270 |
$2,270 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,270 |
$2,270 |
0.8× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,783 |
$1,783 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$491 |
$491 |
0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,736 |
$4,736 |
1.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,696 |
$5,696 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$785.50 |
$785.50 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,065 |
$1,065 |
0.4× |
| Ankle 2 views (73600) |
$350 |
$350 |
4.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$438 |
$438 |
1.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,801.50 |
$1,801.50 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,845.50 |
$1,845.50 |
0.6× |
| Arthrogram elbow (73085) |
$653 |
$653 |
2.1× |
| Arthrogram hip (73525) |
$653 |
$653 |
2.1× |
| Arthrogram shoulder (73040) |
$653 |
$653 |
2.1× |
| Arthrogram wrist (73115) |
$653 |
$653 |
2.1× |
| Arthrography knee lt (73580) |
$536 |
$536 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$734.50 |
$734.50 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$734.50 |
$734.50 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$1,060 |
$1,060 |
2.9× |
| Bone age studies (77072) |
$554 |
$554 |
5.8× |
| Bone Imaging 3 Phase (78315) |
$1,069.50 |
$1,069.50 |
3.0× |
| Bone survey complete (77075) |
$319.50 |
$319.50 |
3.4× |
| Brain image w/flow 4 + views (78606) |
$943.50 |
$943.50 |
1.9× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$395 |
$395 |
35.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,961 |
$4,961 |
15.7× |
| Cervical spine 2 or 3 views (72040) |
$472 |
$472 |
6.0× |
| Chest 1 view (71045) |
$311 |
$311 |
3.9× |
| Chest 3 views (71047) |
$336 |
$336 |
4.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$378 |
$378 |
2.4× |
| Clavicle complete (73000) |
$328 |
$328 |
4.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,060 |
$1,060 |
11.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,779.50 |
$4,779.50 |
15.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,817 |
$2,817 |
13.0× |
| CT abdomen w contrast (74160) |
$2,057 |
$2,057 |
12.9× |
| CT abdomen w wo contrast (74170) |
$1,612.50 |
$1,612.50 |
10.1× |
| CT abdomen w/o contrast (74150) |
$1,872 |
$1,872 |
19.8× |
| CT angio hrt w/3d image (75574) |
$1,538 |
$1,538 |
4.9× |
| CT angiography upper extremity lt (73206) |
$1,901 |
$1,901 |
12.0× |
| CT c-spine w/o contrast (72125) |
$2,417 |
$2,417 |
25.5× |
| CT cervical spine w&w/o contrast (72127) |
$2,841 |
$2,841 |
17.9× |
| CT cervical spine with contrast (72126) |
$1,401 |
$1,401 |
4.4× |
| CT chest w/wo contrast (71270) |
$1,566.50 |
$1,566.50 |
9.9× |
| CT chest with contrast (71260) |
$2,041 |
$2,041 |
12.8× |
| CT head/brain with contrast (70460) |
$1,811.50 |
$1,811.50 |
11.4× |
| CT head/brain without and with contrast (70470) |
$2,679 |
$2,679 |
16.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$156 |
$156 |
2.0× |
| CT hrt w/3d image congen (75573) |
$1,538 |
$1,538 |
4.9× |
| CT iac w contrast (70481) |
$1,159 |
$1,159 |
7.3× |
| CT limited/localized follow up study (76380) |
$941 |
$941 |
11.9× |
| CT lower ext w/o (73700) |
$1,635 |
$1,635 |
17.3× |
| CT lower extremity w wo contrast (73702) |
$1,844 |
$1,844 |
11.6× |
| CT lower extremity with contrast (73701) |
$1,844 |
$1,844 |
11.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,841 |
$2,841 |
17.9× |
| CT lumbar spine w/o contrast (72131) |
$1,052 |
$1,052 |
11.1× |
| CT lumbar spine with contrast (72132) |
$2,368 |
$2,368 |
7.5× |
| CT maxillofacial w contrast (70487) |
$2,779 |
$2,779 |
17.5× |
| CT maxillofacial w/o contrast (70486) |
$2,321 |
$2,321 |
24.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,313 |
$2,313 |
14.6× |
| CT neck soft tissue w contrast (70491) |
$2,500 |
$2,500 |
15.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,551 |
$2,551 |
16.1× |
| CT orbits w/o contrast (70480) |
$2,083 |
$2,083 |
22.0× |
| CT pelvis w & w/o contrast (72194) |
$2,677 |
$2,677 |
16.8× |
| CT pelvis w/o contrast (72192) |
$1,711 |
$1,711 |
18.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,877 |
$1,877 |
11.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,093.50 |
$1,093.50 |
11.5× |
| CT thoracic spine w/contrast (72129) |
$1,305.50 |
$1,305.50 |
8.2× |
| CT thoracic spine w/o contrast (72128) |
$1,082 |
$1,082 |
11.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,567 |
$1,567 |
9.9× |
| CT thorax w/o contrast (71250) |
$1,753 |
$1,753 |
18.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,967 |
$2,967 |
18.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,748 |
$1,748 |
18.5× |
| CT upper extremity with contrast (73201) |
$2,333 |
$2,333 |
7.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,671 |
$2,671 |
16.8× |
| Cta Abdomen (74175) |
$2,768 |
$2,768 |
17.4× |
| CTA abdomen pelvis (74174) |
$2,209.30 |
$2,209.30 |
7.0× |
| CTA chest (71275) |
$2,361 |
$2,361 |
14.9× |
| Cta Head (70496) |
$2,710 |
$2,710 |
17.1× |
| CTA lwr ext w&w/o contrast (73706) |
$1,901 |
$1,901 |
12.0× |
| Cta Neck (70498) |
$2,351 |
$2,351 |
14.8× |
| Cta Pelvis (72191) |
$2,223 |
$2,223 |
14.0× |
| Cystography minimum 3 views rs&i (74430) |
$409 |
$409 |
1.3× |
| Diskography lumbar (72295) |
$1,986 |
$1,986 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$539 |
$539 |
5.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$38 |
$38 |
0.5× |
| Echoencephalography real time imaging (76506) |
$629 |
$629 |
6.6× |
| Esophagus (74220) |
$307.50 |
$307.50 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$474 |
$474 |
5.0× |
| Fluoroscopy up to 1 hr (76000) |
$619 |
$619 |
2.9× |
| Foot 2 views (73620) |
$339 |
$339 |
4.3× |
| Forearm 2 views (73090) |
$351 |
$351 |
4.5× |
| Gated Heart Planar Single (78472) |
$1,096.50 |
$1,096.50 |
3.0× |
| Hand 2 views (73120) |
$309 |
$309 |
3.3× |
| Hand 3 views (73130) |
$309 |
$309 |
3.9× |
| Heart Infarct Image (78466) |
$124 |
$124 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,909 |
$1,909 |
3.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,909 |
$1,909 |
5.3× |
| Ht muscle image spect sing (78451) |
$2,802.50 |
$2,802.50 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$376 |
$376 |
4.8× |
| Hysterosalpingogram (74740) |
$476 |
$476 |
2.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$327 |
$327 |
3.5× |
| Kidney imaging morphology (78700) |
$102 |
$102 |
0.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$959 |
$959 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$963 |
$963 |
2.0× |
| Knee 3 views (73562) |
$375 |
$375 |
4.8× |
| Liver & spleen imaging static only (78215) |
$740 |
$740 |
2.0× |
| Liver imaging static only (78201) |
$730.50 |
$730.50 |
1.5× |
| Lung perf&ventilat diferentl (78598) |
$1,756 |
$1,756 |
3.6× |
| Lung Ventilation Imaging (78579) |
$884 |
$884 |
2.4× |
| Lymphoscintigraphy (78195) |
$1,691 |
$1,691 |
3.4× |
| Mammary ductogram or galactogram multiple (77054) |
$597.50 |
$597.50 |
2.8× |
| Mammary ductogram or galactogram single (77053) |
$597.50 |
$597.50 |
2.8× |
| Meckels Diverticulum (78290) |
$743.50 |
$743.50 |
2.1× |
| Mr safety determination physician/other qhp (76016) |
$176 |
$176 |
2.2× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$119 |
$119 |
2.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$49 |
$49 |
1.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$183.50 |
$183.50 |
2.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$483 |
$483 |
2.2× |
| MRA head w & w/o contrast (70546) |
$686 |
$686 |
2.2× |
| MRA head w/o contrast (70544) |
$3,157 |
$3,157 |
14.6× |
| MRA neck w contrast (70548) |
$3,473 |
$3,473 |
11.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,699 |
$3,699 |
11.7× |
| MRA neck w/o contrast (70547) |
$2,866 |
$2,866 |
13.3× |
| MRI abdomen w contrast (74182) |
$3,157 |
$3,157 |
10.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,384 |
$3,384 |
10.7× |
| MRI abdomen w/o contrast (74181) |
$2,605 |
$2,605 |
12.0× |
| MRI any jnt lwr ext with con lt (73722) |
$3,787 |
$3,787 |
5.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,652 |
$3,652 |
5.1× |
| MRI breast w/o contrast bilateral (77047) |
$4,222 |
$4,222 |
19.5× |
| MRI breast w/o contrast unilat (77046) |
$3,377 |
$3,377 |
15.6× |
| MRI c-spine with contrast (72142) |
$3,946 |
$3,946 |
12.5× |
| MRI cardiac w/o contrast (75557) |
$2,834 |
$2,834 |
13.1× |
| MRI cervical spine w/o contrast (72141) |
$3,630 |
$3,630 |
16.8× |
| MRI chest w/o & w/contrast material (71552) |
$4,961 |
$4,961 |
15.7× |
| MRI chest w/o contrast (71550) |
$2,834 |
$2,834 |
13.1× |
| MRI chest with contrast (71551) |
$3,626 |
$3,626 |
5.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,652 |
$3,652 |
11.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,473 |
$3,473 |
11.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,453 |
$3,453 |
16.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,944 |
$2,944 |
13.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,157 |
$3,157 |
10.0× |
| MRI orbit/face/neck w/contrast (70542) |
$3,258 |
$3,258 |
10.3× |
| MRI pelvis w contrast (72196) |
$2,960 |
$2,960 |
9.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,157 |
$3,157 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$2,677 |
$2,677 |
12.4× |
| MRI scan of arm joint before and after contrast (73223) |
$3,946 |
$3,946 |
12.5× |
| MRI scan of leg joint before and after contrast (73723) |
$4,073 |
$4,073 |
12.9× |
| MRI spectroscopy (76390) |
$460.50 |
$460.50 |
5.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,419 |
$4,419 |
14.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,946 |
$3,946 |
12.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,419 |
$4,419 |
14.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,226 |
$3,226 |
10.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,419 |
$4,419 |
14.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,944 |
$2,944 |
13.6× |
| MRI tmj (70336) |
$3,265 |
$3,265 |
15.1× |
| MRI upper ext joint w/o contrast (73221) |
$3,402 |
$3,402 |
15.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,946 |
$3,946 |
12.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,465 |
$2,465 |
11.4× |
| Myelogram Cervical (72240) |
$166 |
$166 |
0.2× |
| Myelogram Lumbar (72265) |
$146 |
$146 |
0.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,469 |
$3,469 |
3.0× |
| Neck soft tissue (70360) |
$336 |
$336 |
4.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$613 |
$613 |
1.7× |
| Nm cisternogram (78630) |
$166 |
$166 |
0.3× |
| Nm gastric emptying study (78264) |
$1,027.50 |
$1,027.50 |
2.8× |
| Nm gastroesophageal reflux study (78262) |
$1,027 |
$1,027 |
2.8× |
| Nm peritoneal-venous shunt patency (78291) |
$747.50 |
$747.50 |
2.1× |
| Nm whole blood volume (78122) |
$2,127.50 |
$2,127.50 |
4.3× |
| Nuclear medicine of heart pumping function (78473) |
$779.50 |
$779.50 |
2.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$524 |
$524 |
5.5× |
| Osseous survey infant (77076) |
$475 |
$475 |
5.0× |
| Parathyrd planar w/wo subtrj (78071) |
$1,357 |
$1,357 |
3.7× |
| Parathyroid imaging (78070) |
$729 |
$729 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$355 |
$355 |
3.7× |
| Platelet survival study (78191) |
$681.50 |
$681.50 |
1.9× |
| Pr csf ventriculography (78635) |
$939.50 |
$939.50 |
1.9× |
| Pr heart first pass single,planar (78481) |
$704 |
$704 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,094 |
$4,094 |
13.0× |
| Pr red cell survival study (78130) |
$739.50 |
$739.50 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$940 |
$940 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,756 |
$1,756 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$160.50 |
$160.50 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$418 |
$418 |
5.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$448 |
$448 |
4.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$352 |
$352 |
3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$485 |
$485 |
5.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$340 |
$340 |
4.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$388 |
$388 |
4.9× |
| Radiologic exam colon single contrast study (74270) |
$562 |
$562 |
3.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$715 |
$715 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$540 |
$540 |
3.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$378 |
$378 |
4.8× |
| Radiological examination surgical specimen (76098) |
$948 |
$948 |
1.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$72 |
$72 |
0.2× |
| Ribs bilateral 3 views (71110) |
$563 |
$563 |
5.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$663.90 |
$663.90 |
1.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,240.68 |
$1,240.68 |
2.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,294.35 |
$2,294.35 |
4.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,294.35 |
$2,294.35 |
2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,667 |
$2,667 |
2.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,387 |
$2,387 |
2.0× |
| Scanogram (77073) |
$297.50 |
$297.50 |
3.1× |
| Scapula complete (73010) |
$371 |
$371 |
3.9× |
| Screening digital breast tomosynthesis (77063) |
$60 |
$60 |
2.6× |
| Sialogram (70390) |
$525 |
$525 |
2.4× |
| Small bowel series (74250) |
$340.50 |
$340.50 |
2.1× |
| Spine thoracic 3 views (72072) |
$482 |
$482 |
5.1× |
| Spleen imaging only (78185) |
$729 |
$729 |
2.0× |
| Testicular Imaging With Vascular Flow (78761) |
$953 |
$953 |
2.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$711.50 |
$711.50 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,218 |
$1,218 |
3.4× |
| Thyroid uptake measurement (78012) |
$706.96 |
$706.96 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,610 |
$1,610 |
4.4× |
| Tomogram (76100) |
$432 |
$432 |
4.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,618 |
$2,618 |
5.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$653.50 |
$653.50 |
1.8× |
| Ultrasound elastography first target lesion (76982) |
$192 |
$192 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$283 |
$283 |
3.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$280 |
$280 |
3.6× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$904.50 |
$904.50 |
2.5× |
| Unlisted Ultrasound Procedure (76999) |
$359 |
$359 |
4.6× |
| Upper Extremity Infant (73092) |
$351 |
$351 |
3.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$581 |
$581 |
1.6× |
| Urethrocystography retrograde rs&i (74450) |
$415 |
$415 |
1.9× |
| Urethrocystography voiding (74455) |
$477.50 |
$477.50 |
2.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$433.50 |
$433.50 |
2.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$661.50 |
$661.50 |
4.2× |
| Us abdl aorta screen aaa (76706) |
$882 |
$882 |
9.3× |
| Us breast unilateral complete (76641) |
$525 |
$525 |
5.5× |
| Us breast unilateral limited (76642) |
$525 |
$525 |
6.7× |
| Us chest (76604) |
$233 |
$233 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$541 |
$541 |
5.7× |
| Us elastography parenchyma (76981) |
$192 |
$192 |
2.0× |
| Us guided compression repair (76936) |
$524 |
$524 |
2.7× |
| Us infant hips dynamic (76885) |
$301 |
$301 |
3.8× |
| Us ob transvaginal (76817) |
$583.32 |
$583.32 |
6.2× |
| Us pelvic non ob complete (76856) |
$886 |
$886 |
9.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$524 |
$524 |
5.5× |
| Us pregnancy ltd (76815) |
$374 |
$374 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$634 |
$634 |
6.7× |
| Us retroperitoneal complete (76770) |
$200 |
$200 |
2.1× |
| Us retroperitoneal limited (76775) |
$192 |
$192 |
2.0× |
| Us scrotum and contents (76870) |
$886 |
$886 |
9.4× |
| Us soft tissue head/neck (76536) |
$539 |
$539 |
5.7× |
| Us spinal canal and contents (76800) |
$629 |
$629 |
6.6× |
| Us transrectal (76872) |
$498.50 |
$498.50 |
5.3× |
| Us xtr non-vasc lmtd (76882) |
$353 |
$353 |
3.7× |
| Vasogram (74440) |
$308.50 |
$308.50 |
1.4× |
| Venogram extremity bilateral (75822) |
$456 |
$456 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,069 |
$1,069 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$392 |
$392 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$813 |
$813 |
0.6× |
| Venography Renal Bilateral (75833) |
$405 |
$405 |
0.1× |
| Venography renal unilateral selective rs&i (75831) |
$4,732.50 |
$4,732.50 |
1.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,143.50 |
$1,143.50 |
0.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,741.50 |
$4,741.50 |
0.9× |
| Wrist 2 views (73100) |
$330 |
$330 |
4.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$636 |
$636 |
6.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$597 |
$597 |
7.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$350 |
$350 |
4.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$664.50 |
$664.50 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$227.50 |
$227.50 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$288 |
$288 |
3.7× |
| X-ray exam hip uni 1 view (73501) |
$572 |
$572 |
7.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$327 |
$327 |
4.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$442 |
$442 |
4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$442 |
$442 |
4.7× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$627 |
$627 |
3.9× |
| X-ray eye for foreign body (70030) |
$126 |
$126 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$352 |
$352 |
3.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$352 |
$352 |
4.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$345 |
$345 |
4.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$316 |
$316 |
4.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$606 |
$606 |
3.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$475 |
$475 |
5.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$327 |
$327 |
4.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$460 |
$460 |
4.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$406 |
$406 |
5.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$466 |
$466 |
4.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$527 |
$527 |
5.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$438.50 |
$438.50 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$458 |
$458 |
5.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$585 |
$585 |
6.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$399 |
$399 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$285 |
$285 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$391 |
$391 |
5.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$419 |
$419 |
5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$352 |
$352 |
4.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$352 |
$352 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$569 |
$569 |
6.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$470 |
$470 |
5.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$123.50 |
$123.50 |
1.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$341 |
$341 |
4.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$452 |
$452 |
5.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$452 |
$452 |
4.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$275 |
$275 |
3.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$309 |
$309 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$554 |
$554 |
5.8× |
| Xr chest 4+ views (71048) |
$311 |
$311 |
3.3× |
| Xr Cholecystography Oral Contrast (74290) |
$100.50 |
$100.50 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$279 |
$279 |
3.5× |
| Xr shoulder 1 view (73020) |
$181 |
$181 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$513 |
$513 |
5.4× |
| Xr tibia/fibula 2 views (73590) |
$395 |
$395 |
5.0× |
| Xr tmj bilateral (70330) |
$373 |
$373 |
4.7× |
| Xray knee 1 or 2 views rt (73560) |
$351 |
$351 |
4.5× |