| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,880.50 |
$3,761 |
1.4× |
| Abdomen 2 views (74019) |
$108.50 |
$217 |
1.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$558 |
$1,116 |
1.4× |
| Ankle 2 views (73600) |
$181 |
$362 |
2.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$172 |
$344 |
0.5× |
| Arthrogram hip (73525) |
$232.50 |
$465 |
0.7× |
| Arthrogram shoulder (73040) |
$309 |
$618 |
0.9× |
| Arthrogram wrist (73115) |
$173.50 |
$347 |
0.5× |
| Basic radiation dosimetry calculation (77300) |
$320.50 |
$641 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$332 |
$664 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$597 |
$1,194 |
1.5× |
| Bone age studies (77072) |
$132.50 |
$265 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$608.50 |
$1,217 |
1.5× |
| Bone survey complete (77075) |
$236 |
$472 |
2.3× |
| Brachytx isodose complex (77318) |
$1,000 |
$2,000 |
2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,391.50 |
$8,783 |
3.1× |
| Brain Imaging Vascular Flow Only (78610) |
$279 |
$558 |
0.5× |
| Cervical spine 2 or 3 views (72040) |
$100 |
$200 |
1.2× |
| Chest 1 view (71045) |
$78 |
$156 |
0.9× |
| Chest 3 views (71047) |
$118.50 |
$237 |
1.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$164.50 |
$329 |
1.0× |
| Clavicle complete (73000) |
$115.50 |
$231 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$95 |
$190 |
0.9× |
| Continuing medical physics consltj pr wk (77336) |
$242 |
$484 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,927.50 |
$3,855 |
5.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,394 |
$2,788 |
5.9× |
| CT abdomen w contrast (74160) |
$889 |
$1,778 |
5.2× |
| CT abdomen w wo contrast (74170) |
$1,072 |
$2,144 |
6.2× |
| CT abdomen w/o contrast (74150) |
$760 |
$1,520 |
7.4× |
| CT angiography upper extremity lt (73206) |
$1,104 |
$2,208 |
6.4× |
| CT c-spine w/o contrast (72125) |
$800.50 |
$1,601 |
7.8× |
| CT cervical spine w&w/o contrast (72127) |
$834 |
$1,668 |
4.8× |
| CT cervical spine with contrast (72126) |
$694 |
$1,388 |
2.0× |
| CT chest w/wo contrast (71270) |
$1,056.50 |
$2,113 |
6.1× |
| CT chest with contrast (71260) |
$883.50 |
$1,767 |
5.1× |
| CT head/brain with contrast (70460) |
$721 |
$1,442 |
4.2× |
| CT head/brain without and with contrast (70470) |
$1,060 |
$2,120 |
6.1× |
| CT iac w contrast (70481) |
$738 |
$1,476 |
4.3× |
| CT limited/localized follow up study (76380) |
$558 |
$1,116 |
6.5× |
| CT lower ext w/o (73700) |
$542.50 |
$1,085 |
5.3× |
| CT lower extremity w wo contrast (73702) |
$728 |
$1,456 |
4.2× |
| CT lower extremity with contrast (73701) |
$638.50 |
$1,277 |
3.7× |
| CT lumbar spine w & w/o contrast (72133) |
$834 |
$1,668 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$716.50 |
$1,433 |
7.0× |
| CT lumbar spine with contrast (72132) |
$694 |
$1,388 |
2.0× |
| CT maxillofacial w contrast (70487) |
$771 |
$1,542 |
4.5× |
| CT maxillofacial w/o contrast (70486) |
$704.50 |
$1,409 |
6.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,052 |
$2,104 |
6.1× |
| CT neck soft tissue w contrast (70491) |
$809 |
$1,618 |
4.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$869.50 |
$1,739 |
5.0× |
| CT orbits w/o contrast (70480) |
$743 |
$1,486 |
7.2× |
| CT pelvis w & w/o contrast (72194) |
$924 |
$1,848 |
5.4× |
| CT pelvis w/o contrast (72192) |
$634 |
$1,268 |
6.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$893 |
$1,786 |
5.2× |
| CT soft tissue neck w/o contrast (70490) |
$701.50 |
$1,403 |
6.8× |
| CT thoracic spine w/contrast (72129) |
$694.50 |
$1,389 |
4.0× |
| CT thoracic spine w/o contrast (72128) |
$800.50 |
$1,601 |
7.8× |
| CT thoracic spine w/wo contrast (72130) |
$834 |
$1,668 |
4.8× |
| CT thorax w/o contrast (71250) |
$738.50 |
$1,477 |
7.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$701.50 |
$1,403 |
4.1× |
| CT upper extremity w/o contrast rt (73200) |
$597 |
$1,194 |
5.8× |
| CT upper extremity with contrast (73201) |
$617.50 |
$1,235 |
1.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,049 |
$4,098 |
11.9× |
| Cta Abdomen (74175) |
$1,441 |
$2,882 |
8.3× |
| CTA abdomen pelvis (74174) |
$1,372.50 |
$2,745 |
4.0× |
| CTA chest (71275) |
$1,436.50 |
$2,873 |
8.3× |
| Cta Head (70496) |
$1,108.50 |
$2,217 |
6.4× |
| CTA lwr ext w&w/o contrast (73706) |
$1,041.50 |
$2,083 |
6.0× |
| Cta Neck (70498) |
$1,427 |
$2,854 |
8.3× |
| Cta Pelvis (72191) |
$1,345 |
$2,690 |
7.8× |
| Cystography minimum 3 views rs&i (74430) |
$190 |
$380 |
0.6× |
| Diskography lumbar (72295) |
$3,515.50 |
$7,031 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$289.50 |
$579 |
2.8× |
| Esophagus (74220) |
$189 |
$378 |
1.1× |
| Fetal biophysical profile non-stress testing (76818) |
$225.50 |
$451 |
2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$248.50 |
$497 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$190 |
$380 |
0.8× |
| Foot 2 views (73620) |
$181 |
$362 |
2.1× |
| Forearm 2 views (73090) |
$101.50 |
$203 |
1.2× |
| Functional MRI brain by tech (70554) |
$1,434.50 |
$2,869 |
6.1× |
| Gated Heart Planar Single (78472) |
$540 |
$1,080 |
1.4× |
| Hand 2 views (73120) |
$181 |
$362 |
1.8× |
| Hand 3 views (73130) |
$86 |
$172 |
1.0× |
| Heart infarct image w ef (78468) |
$406 |
$812 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$805.50 |
$1,611 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$674 |
$1,348 |
1.7× |
| Ht muscle image spect sing (78451) |
$1,728 |
$3,456 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$110.50 |
$221 |
1.3× |
| Hysterosalpingogram (74740) |
$200.50 |
$401 |
0.9× |
| Interstitial radiation source applic complex (77778) |
$2,023.50 |
$4,047 |
3.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$627.50 |
$1,255 |
1.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$720.50 |
$1,441 |
1.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,012.50 |
$4,025 |
3.8× |
| Knee 3 views (73562) |
$116.50 |
$233 |
1.4× |
| Liver & spleen imaging static only (78215) |
$671 |
$1,342 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$887 |
$1,774 |
1.7× |
| Lung perfusion differential (78597) |
$469 |
$938 |
1.2× |
| Lung Ventilation Imaging (78579) |
$443 |
$886 |
1.1× |
| Lymphoscintigraphy (78195) |
$605 |
$1,210 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$506.50 |
$1,013 |
1.4× |
| MRA head w & w/o contrast (70546) |
$1,478 |
$2,956 |
4.3× |
| MRA head w/o contrast (70544) |
$1,048.50 |
$2,097 |
4.5× |
| MRA head with contrast (70545) |
$1,173.50 |
$2,347 |
3.4× |
| MRA neck w contrast (70548) |
$1,173.50 |
$2,347 |
3.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,408 |
$2,816 |
4.1× |
| MRA neck w/o contrast (70547) |
$1,048.50 |
$2,097 |
4.5× |
| MRI abdomen w contrast (74182) |
$2,496 |
$4,992 |
7.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,859.50 |
$3,719 |
5.4× |
| MRI abdomen w/o contrast (74181) |
$1,438.50 |
$2,877 |
6.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,108.50 |
$2,217 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,438 |
$2,876 |
1.9× |
| MRI breast w/o contrast bilateral (77047) |
$2,298 |
$4,596 |
9.8× |
| MRI c-spine with contrast (72142) |
$1,186.50 |
$2,373 |
3.5× |
| MRI cervical spine w/o contrast (72141) |
$1,084.50 |
$2,169 |
4.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,100 |
$4,200 |
6.1× |
| MRI chest w/o contrast (71550) |
$1,449.50 |
$2,899 |
6.2× |
| MRI chest with contrast (71551) |
$2,179.10 |
$4,358.19 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$930 |
$1,860 |
4.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,232.50 |
$2,465 |
5.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,714.50 |
$3,429 |
5.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,581.50 |
$3,163 |
4.6× |
| MRI pelvis w contrast (72196) |
$1,214 |
$2,428 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,530.50 |
$3,061 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$1,108.50 |
$2,217 |
4.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,436.50 |
$2,873 |
4.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,356.50 |
$2,713 |
4.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,580.50 |
$3,161 |
4.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,229 |
$2,458 |
3.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,550 |
$3,100 |
4.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,295 |
$2,590 |
3.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,630 |
$3,260 |
4.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,240.50 |
$2,481 |
5.3× |
| MRI tmj (70336) |
$930 |
$1,860 |
4.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,230 |
$2,460 |
5.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,131.50 |
$2,263 |
3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$894.50 |
$1,789 |
3.8× |
| Myocardial Spect Multiple Studies (78452) |
$1,796 |
$3,592 |
1.4× |
| Neck soft tissue (70360) |
$94 |
$188 |
1.1× |
| Nm gastric emptying study (78264) |
$548.50 |
$1,097 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,454.50 |
$8,909 |
3.3× |
| Nuclear Rx Oral Admin (79005) |
$568.50 |
$1,137 |
2.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$151.50 |
$303 |
1.5× |
| Osseous survey infant (77076) |
$89 |
$178 |
0.9× |
| Osseous survey limited (77074) |
$556.50 |
$1,113 |
5.4× |
| Parathyrd planar w/wo subtrj (78071) |
$256.50 |
$513 |
0.7× |
| Parathyroid imaging (78070) |
$753.50 |
$1,507 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$126 |
$252 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$3,736.50 |
$7,473 |
2.7× |
| PET imaging CT for attenuation limited area (78814) |
$3,736.50 |
$7,473 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$3,736.50 |
$7,473 |
2.7× |
| Pr heart first pass single,planar (78481) |
$498.50 |
$997 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,334.50 |
$2,669 |
3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$508 |
$1,016 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$848.50 |
$1,697 |
1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$135.50 |
$271 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$97 |
$194 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$99.50 |
$199 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$135.50 |
$271 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$95 |
$190 |
0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$284.50 |
$569 |
2.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$366 |
$732 |
0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$157.50 |
$315 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$89.50 |
$179 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$103 |
$206 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$162 |
$324 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$260 |
$520 |
1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$266 |
$532 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$245 |
$490 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$232.50 |
$465 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$115.50 |
$231 |
1.3× |
| Radiological examination surgical specimen (76098) |
$129.50 |
$259 |
0.2× |
| Ribs bilateral 3 views (71110) |
$139.50 |
$279 |
1.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,220 |
$2,440 |
2.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$535 |
$1,070 |
1.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,998 |
$3,996 |
1.6× |
| Sacroiliac Joints < 3 Views (72200) |
$199 |
$398 |
1.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$291 |
$582 |
1.2× |
| Scanogram (77073) |
$98.50 |
$197 |
1.0× |
| Scapula complete (73010) |
$124.50 |
$249 |
1.2× |
| Screening digital breast tomosynthesis (77063) |
$61.50 |
$123 |
2.6× |
| Sella turcica (70240) |
$62.50 |
$125 |
0.7× |
| Sialogram (70390) |
$152.50 |
$305 |
0.6× |
| Small bowel series (74250) |
$221.50 |
$443 |
1.3× |
| Spec medical radj physics consltj (77370) |
$381 |
$762 |
2.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$505 |
$1,010 |
1.4× |
| Special dosimetry (77331) |
$275.50 |
$551 |
2.1× |
| Special treatment procedure (77470) |
$688 |
$1,376 |
1.3× |
| Spine thoracic 3 views (72072) |
$140.50 |
$281 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,750.50 |
$3,501 |
4.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,491 |
$2,982 |
4.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$794.50 |
$1,589 |
6.0× |
| Thoracolumbar 2 views (72080) |
$83 |
$166 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$347.50 |
$695 |
0.9× |
| Thyroid uptake measurement (78012) |
$159 |
$318 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$427 |
$854 |
1.1× |
| Treatment devices simple (77332) |
$356.50 |
$713 |
2.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,008.50 |
$4,017 |
3.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$332.50 |
$665 |
0.8× |
| Tx devices design & construction complex (77334) |
$564 |
$1,128 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$244.50 |
$489 |
2.4× |
| Umbilical-artery Doppler (OB) (76820) |
$167 |
$334 |
1.6× |
| Unlisted Ultrasound Procedure (76999) |
$177.50 |
$355 |
2.1× |
| Upper Extremity Infant (73092) |
$91 |
$182 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$231 |
$462 |
1.0× |
| Urethrocystography voiding (74455) |
$209.50 |
$419 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$368.50 |
$737 |
2.1× |
| Us abdl aorta screen aaa (76706) |
$230.50 |
$461 |
2.2× |
| Us breast unilateral complete (76641) |
$213.50 |
$427 |
2.1× |
| Us breast unilateral limited (76642) |
$213.50 |
$427 |
2.5× |
| Us chest (76604) |
$231.50 |
$463 |
2.3× |
| Us compl joint r-t w/image documentation (76881) |
$128.50 |
$257 |
1.2× |
| Us kidney transplant (76776) |
$402.50 |
$805 |
3.9× |
| Us ob transvaginal (76817) |
$202.50 |
$405 |
2.0× |
| Us pelvic non ob complete (76856) |
$233.50 |
$467 |
2.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$177.50 |
$355 |
1.7× |
| Us pregnancy ltd (76815) |
$174 |
$348 |
1.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$256 |
$512 |
2.5× |
| Us retroperitoneal complete (76770) |
$440.50 |
$881 |
4.3× |
| Us retroperitoneal limited (76775) |
$262 |
$524 |
2.5× |
| Us scrotum and contents (76870) |
$244 |
$488 |
2.4× |
| Us soft tissue head/neck (76536) |
$258.50 |
$517 |
2.5× |
| Us spinal canal and contents (76800) |
$240 |
$480 |
2.3× |
| Us transrectal prostate volume (76873) |
$244.50 |
$489 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$97 |
$194 |
0.9× |
| Us, eye b-scan (76512) |
$234.50 |
$469 |
2.3× |
| Venography extremity unilateral rs&i (75820) |
$244 |
$488 |
0.2× |
| Wrist 2 views (73100) |
$181 |
$362 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$134.50 |
$269 |
1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$78 |
$156 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$115.50 |
$231 |
1.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$348.50 |
$697 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$105 |
$210 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$118 |
$236 |
1.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$93 |
$186 |
0.9× |
| X-ray exam hip uni 1 view (73501) |
$97 |
$194 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$112.50 |
$225 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$276 |
$552 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$552 |
$1,104 |
5.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$284.50 |
$569 |
2.8× |
| X-ray exam of femur 1 (73551) |
$97 |
$194 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$163 |
$326 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$155 |
$310 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$115.50 |
$231 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$83.50 |
$167 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$94 |
$188 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$125 |
$250 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$434 |
$868 |
5.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$104.50 |
$209 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$121.50 |
$243 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$208.50 |
$417 |
2.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$150.50 |
$301 |
1.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$132.50 |
$265 |
1.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$162.50 |
$325 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$132.50 |
$265 |
1.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$159 |
$318 |
1.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$220 |
$440 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$143 |
$286 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$170.50 |
$341 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$207.50 |
$415 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$153 |
$306 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$126.50 |
$253 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$132.50 |
$265 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$154 |
$308 |
1.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$65 |
$130 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$176.50 |
$353 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$107.50 |
$215 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$85 |
$170 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$92.50 |
$185 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$132 |
$264 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$120.50 |
$241 |
1.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$357 |
$714 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$72.50 |
$145 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$99.50 |
$199 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$197 |
$394 |
1.9× |
| Xr chest 4+ views (71048) |
$127.50 |
$255 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$89 |
$178 |
1.0× |
| Xr optic foramina (70190) |
$84 |
$168 |
1.0× |
| Xr shoulder 1 view (73020) |
$81 |
$162 |
0.9× |
| Xr spine cervical 4 or 5 views (72050) |
$171.50 |
$343 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$105 |
$210 |
1.2× |
| Xr tmj bilateral (70330) |
$135 |
$270 |
1.6× |
| Xray knee 1 or 2 views rt (73560) |
$93.50 |
$187 |
1.1× |