| Abdomen 2 views (74019) |
$143.65 |
$268 |
1.3× |
| Acute gi blood loss imaging (78278) |
$1,017.90 |
$1,885 |
2.4× |
| Ankle 2 views (73600) |
$121.67 |
$227 |
1.3× |
| Arthrogram ankle (73615) |
$446.57 |
$786 |
1.2× |
| Arthrogram elbow (73085) |
$452.82 |
$797 |
1.2× |
| Arthrogram hip (73525) |
$428.39 |
$754 |
1.2× |
| Arthrogram knee (73580) |
$401.11 |
$706 |
1.1× |
| Arthrogram shoulder (73040) |
$451.68 |
$795 |
1.2× |
| Arthrogram wrist (73115) |
$193.17 |
$340 |
0.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$885.60 |
$1,640 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,062.72 |
$1,968 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,165.86 |
$2,159 |
2.8× |
| Bone age studies (77072) |
$176.88 |
$330 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,340.82 |
$2,483 |
3.2× |
| Bone survey complete (77075) |
$282.47 |
$527 |
2.6× |
| Bone survey infant (77076) |
$345.18 |
$644 |
3.1× |
| Bowel imaging (78290) |
$914.76 |
$1,694 |
2.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$511.92 |
$948 |
0.9× |
| Brain Imaging Vascular Flow Only (78610) |
$260.82 |
$483 |
0.5× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$307.26 |
$569 |
0.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$844.56 |
$1,564 |
2.0× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,240.38 |
$2,297 |
2.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$738.72 |
$1,368 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$226.19 |
$422 |
2.5× |
| Chest 1 view (71045) |
$158.51 |
$333 |
1.7× |
| Chest xray 3 views (71047) |
$250.85 |
$527 |
2.7× |
| Cholecystography, oral contrast Non-Facility (74290) |
$233.16 |
$435 |
1.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$160.80 |
$300 |
0.9× |
| Clavicle complete (73000) |
$212.79 |
$397 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$599.76 |
$1,224 |
5.4× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$168.07 |
$343 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,552.90 |
$5,210 |
6.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,701.77 |
$3,473 |
6.8× |
| CT abdomen w contrast (74160) |
$1,396.50 |
$2,850 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,675.80 |
$3,420 |
9.1× |
| CT abdomen w/o contrast (74150) |
$1,117.20 |
$2,280 |
10.1× |
| CT angio lwr extr w/o&w/dye (73706) |
$964.81 |
$1,969 |
5.2× |
| CT angiography upper extremity lt (73206) |
$925.61 |
$1,889 |
5.0× |
| CT c-spine w/contrast (72126) |
$989.80 |
$2,020 |
2.7× |
| CT c-spine w/o contrast (72125) |
$791.84 |
$1,616 |
7.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,187.76 |
$2,424 |
6.4× |
| CT chest w contrast (71260) |
$1,445.01 |
$2,949 |
7.8× |
| CT chest w/wo contrast (71270) |
$1,734.11 |
$3,539 |
9.4× |
| CT head/brain with contrast (70460) |
$583.80 |
$1,390 |
3.2× |
| CT head/brain without and with contrast (70470) |
$700.56 |
$1,668 |
3.8× |
| CT iac w contrast (70481) |
$720.30 |
$1,715 |
3.9× |
| CT limited/localized follow up study (76380) |
$422.01 |
$1,063 |
4.6× |
| CT lower ext w/o (73700) |
$612.50 |
$1,250 |
5.6× |
| CT lower extremity w wo contrast (73702) |
$918.75 |
$1,875 |
5.0× |
| CT lower extremity w/contrast material (73701) |
$765.87 |
$1,563 |
4.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,495.97 |
$3,053 |
8.1× |
| CT lumbar spine w/contrast (72132) |
$1,246.56 |
$2,544 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$997.15 |
$2,035 |
9.0× |
| CT maxillofacial w contrast (70487) |
$629.58 |
$1,499 |
3.4× |
| CT maxillofacial w/wo contrast (70488) |
$755.58 |
$1,799 |
4.1× |
| CT maxillofacial wo contrast (70486) |
$503.58 |
$1,199 |
4.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$864.36 |
$2,058 |
4.7× |
| CT orbits w/o contrast (70480) |
$576.24 |
$1,372 |
5.2× |
| CT pelvis w/o contrast (72192) |
$1,308.30 |
$2,670 |
11.9× |
| CT pelvis w/wo contrast (72194) |
$1,962.45 |
$4,005 |
10.6× |
| CT scan of arm combo (73202) |
$881.51 |
$1,799 |
4.8× |
| CT soft tissue neck w contrast (70491) |
$754.74 |
$1,797 |
4.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$905.52 |
$2,156 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$603.54 |
$1,437 |
5.5× |
| CT thoracic spine w/contrast (72129) |
$1,036.35 |
$2,115 |
5.6× |
| CT thoracic spine w/o contrast (72128) |
$829.08 |
$1,692 |
7.5× |
| CT thoracic spine w/wo contrast (72130) |
$1,243.62 |
$2,538 |
6.7× |
| CT thorax w/o contrast (71250) |
$1,155.91 |
$2,359 |
10.5× |
| CT upper ext wo (73200) |
$587.51 |
$1,199 |
5.3× |
| CT upper extremity with contrast (73201) |
$734.51 |
$1,499 |
2.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,656.28 |
$4,172 |
8.9× |
| Cta Abdomen (74175) |
$1,759.59 |
$3,591 |
9.5× |
| CTA abdomen pelvis (74174) |
$2,680.79 |
$5,471 |
7.3× |
| CTA chest (71275) |
$1,820.84 |
$3,716 |
9.8× |
| Cta Head (70496) |
$735.84 |
$1,752 |
4.0× |
| Cta Neck (70498) |
$950.88 |
$2,264 |
5.1× |
| Cta Pelvis (72191) |
$2,060.94 |
$4,206 |
11.1× |
| Cystography minimum 3 views rs&i (74430) |
$211.18 |
$394 |
0.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$569.57 |
$816 |
5.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$338.75 |
$632 |
3.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$221.90 |
$414 |
2.4× |
| Dxa bone density study axial skeleton (77085) |
$352.69 |
$658 |
3.2× |
| Esophageal motility (78258) |
$523.80 |
$970 |
1.2× |
| Esophagus (74220) |
$275.50 |
$514 |
1.5× |
| Facial bones min 3 views (70150) |
$229.41 |
$428 |
2.1× |
| Fetal biophysical profile non-stress testing (76818) |
$535.37 |
$767 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$422.29 |
$605 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$360.19 |
$672 |
1.4× |
| Foot 2 views (73620) |
$101.30 |
$189 |
1.1× |
| Forearm 2 views (73090) |
$108.81 |
$203 |
1.2× |
| Hand 2 views (73120) |
$185.99 |
$347 |
1.7× |
| Heart first pass single,planar (78481) |
$339.12 |
$628 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,252.26 |
$2,319 |
2.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$498.42 |
$923 |
1.2× |
| Hysterosalpingogram (74740) |
$428.80 |
$800 |
1.7× |
| Kidney imaging morphology (78700) |
$324.54 |
$601 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$505.98 |
$937 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$385.56 |
$714 |
0.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$801.90 |
$1,485 |
1.4× |
| Knee 3 views (73562) |
$166.16 |
$310 |
1.8× |
| Liver & spleen imaging static only (78215) |
$565.38 |
$1,047 |
1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$490.32 |
$908 |
1.2× |
| Liver imaging static only (78201) |
$414.18 |
$767 |
0.7× |
| Liver imaging w/vascular flow (78202) |
$606.96 |
$1,124 |
1.1× |
| Lymphoscintigraphy (78195) |
$911.52 |
$1,688 |
1.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,166.15 |
$2,323 |
1.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,123.98 |
$2,239 |
3.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,348.87 |
$2,687 |
3.7× |
| Mammary ductogram or galactogram multiple (77054) |
$287.30 |
$536 |
1.1× |
| Mammary ductogram or galactogram single (77053) |
$242.81 |
$453 |
1.0× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$137.75 |
$257 |
1.5× |
| Mr safety determination physician/other qhp (76016) |
$57.89 |
$108 |
0.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$20.37 |
$38 |
0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$101.84 |
$190 |
1.0× |
| Mr safety implt pos&/immoblj (76019) |
$155.44 |
$290 |
2.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$241.74 |
$451 |
1.0× |
| MRA head w & w/o contrast (70546) |
$1,527.66 |
$3,105 |
4.1× |
| MRA head w/o contrast (70544) |
$1,018.44 |
$2,070 |
4.0× |
| MRA head with contrast (70545) |
$1,273.30 |
$2,588 |
3.5× |
| MRA neck w contrast (70548) |
$2,055.58 |
$4,178 |
5.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,466.40 |
$5,013 |
6.7× |
| MRA neck w/o contrast (70547) |
$1,644.26 |
$3,342 |
6.5× |
| MRI abdomen w contrast (74182) |
$1,788.12 |
$3,562 |
4.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,145.55 |
$4,274 |
5.8× |
| MRI abdomen w/o contrast (74181) |
$1,430.20 |
$2,849 |
5.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,929.19 |
$3,843 |
2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,314.72 |
$4,611 |
6.3× |
| MRI bone marrow blood supply (77084) |
$1,331.81 |
$2,653 |
5.3× |
| MRI breast w/o contrast bilateral (77047) |
$897.07 |
$1,787 |
3.6× |
| MRI breast wo contrast unilateral (77046) |
$759.02 |
$1,512 |
3.0× |
| MRI c-spine with contrast (72142) |
$1,414.55 |
$2,674 |
3.8× |
| MRI cervical spine w/o contrast (72141) |
$1,131.53 |
$2,139 |
4.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,620.46 |
$3,228 |
4.4× |
| MRI chest w/o contrast (71550) |
$1,080.30 |
$2,152 |
4.3× |
| MRI chest with contrast (71551) |
$1,350.38 |
$2,690 |
1.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$931.21 |
$1,855 |
2.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,117.45 |
$2,226 |
3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$744.97 |
$1,484 |
3.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,651.41 |
$3,110 |
6.6× |
| MRI orbit face neck w contrast (70542) |
$2,064.53 |
$3,888 |
5.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,477.12 |
$4,665 |
6.7× |
| MRI pelvis w/contrast (72196) |
$1,337.83 |
$2,665 |
3.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,605.40 |
$3,198 |
4.4× |
| MRI pelvis w/o contrast (72195) |
$1,070.26 |
$2,132 |
4.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,697.56 |
$3,209 |
4.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,438.69 |
$4,610 |
6.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,926.43 |
$5,532 |
7.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,425.65 |
$2,695 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,710.79 |
$3,234 |
4.6× |
| MRI temporomandibular joint (70336) |
$696.27 |
$1,387 |
2.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,140.52 |
$2,156 |
4.5× |
| MRI up ext w/o contrast (73218) |
$899.08 |
$1,791 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$932.72 |
$1,858 |
3.7× |
| MRI, joint upper extrem combo (73223) |
$1,399.07 |
$2,787 |
3.8× |
| Myelogram Cervical (72240) |
$1,123.99 |
$2,097 |
1.4× |
| Myelogram Lumbar (72265) |
$1,418.79 |
$2,647 |
1.7× |
| Myelogram thoracic (72255) |
$1,120.24 |
$2,090 |
1.4× |
| Myelography 2 or more regions (72270) |
$888.69 |
$1,658 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,220.02 |
$5,963 |
2.4× |
| Myocardial spect single study at rest or stress (78451) |
$1,851.66 |
$3,429 |
1.4× |
| Neck soft tissue (70360) |
$186.53 |
$348 |
2.0× |
| Nm cardiac blood pool multiple (78473) |
$1,496.88 |
$2,772 |
3.5× |
| Nm cisternogram (78630) |
$467.10 |
$865 |
0.8× |
| Nm csf leak detection (78650) |
$757.08 |
$1,402 |
0.6× |
| Nm gastric emptying study (78264) |
$1,038.42 |
$1,923 |
2.5× |
| Nm gastroesophageal reflux study (78262) |
$716.58 |
$1,327 |
1.7× |
| Nm kidney scan w/flow (78701) |
$415.80 |
$770 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$448.20 |
$830 |
1.1× |
| Noncardiac Vascular Flow Imaging (78445) |
$342.36 |
$634 |
0.8× |
| Nonvascular shunt X-ray (75809) |
$224.58 |
$419 |
2.0× |
| Ob us nuchal meas 1 gest (76813) |
$457.89 |
$656 |
4.1× |
| Osseous survey limited (77074) |
$265.32 |
$495 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$483.30 |
$895 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$199.93 |
$373 |
1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$609.12 |
$1,128 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$586.44 |
$1,086 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$235.30 |
$439 |
0.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$130.78 |
$244 |
1.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$120.06 |
$224 |
1.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$128.10 |
$239 |
1.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$233.70 |
$436 |
2.1× |
| Radex fingr minimum 2 views (73140) |
$157.05 |
$293 |
1.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$216.01 |
$403 |
2.4× |
| Radex Hand Minimum 3 Views (73130) |
$227.26 |
$424 |
2.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$104.52 |
$195 |
1.1× |
| Radex Humerus Minimum 2 Views (73060) |
$181.70 |
$339 |
2.0× |
| Radex Kne 1/2 Views (73560) |
$136.68 |
$255 |
1.5× |
| Radex Kne Compl 4/More Views (73564) |
$280.33 |
$523 |
2.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$202.61 |
$378 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$152.22 |
$284 |
1.7× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$222.44 |
$415 |
2.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$245.49 |
$458 |
2.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$183.85 |
$343 |
2.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$313.56 |
$585 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$307.13 |
$573 |
3.3× |
| Radex Toe Minimum 2 Views (73660) |
$131.32 |
$245 |
1.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$116.85 |
$218 |
1.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$213.33 |
$398 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$99.16 |
$185 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$157.58 |
$294 |
1.4× |
| Radiologic exam chest 2 views (71046) |
$201.35 |
$423 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$243.88 |
$455 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$643.20 |
$1,200 |
3.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$602.46 |
$1,124 |
3.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$121.14 |
$226 |
1.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$266.39 |
$497 |
2.4× |
| Radiological examination surgical specimen (76098) |
$92.73 |
$173 |
0.2× |
| Ribs bilateral 3 views (71110) |
$281.40 |
$525 |
2.6× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$396.36 |
$734 |
0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$525.42 |
$973 |
1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,165.32 |
$2,158 |
2.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$665.28 |
$1,232 |
1.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$806.22 |
$1,493 |
1.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$793.26 |
$1,469 |
0.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$871.02 |
$1,613 |
0.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$871.02 |
$1,613 |
0.6× |
| Sacroiliac Joints < 3 Views (72200) |
$179.02 |
$334 |
1.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$547.23 |
$784 |
2.2× |
| Scapula (73010) |
$148.47 |
$277 |
1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$37.93 |
$58 |
1.6× |
| Shoulder 1 view (73020) |
$106.13 |
$198 |
1.2× |
| Small bowel series (74250) |
$212.79 |
$397 |
1.1× |
| Speech evaluation complex (70371) |
$423.98 |
$791 |
1.7× |
| Spine thoracic 3 views (72072) |
$296.41 |
$553 |
2.7× |
| Testicular Imaging With Vascular Flow (78761) |
$404.46 |
$749 |
1.0× |
| Thoracolumbar 2 views (72080) |
$149.54 |
$279 |
1.6× |
| Thyroid imaging w/blood flow (78013) |
$420.66 |
$779 |
1.0× |
| Thyroid uptake measurement (78012) |
$265.68 |
$492 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$545.40 |
$1,010 |
1.3× |
| Tmj unilateral (70328) |
$117.38 |
$219 |
1.3× |
| Ultrasound breast complete (76641) |
$442.53 |
$634 |
4.0× |
| Ultrasound Exam Aaa Screen (76706) |
$240.11 |
$344 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$557.70 |
$799 |
5.1× |
| Umbilical-artery Doppler (OB) (76820) |
$282.69 |
$405 |
2.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$28.08 |
$52 |
2.5× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$228.42 |
$423 |
2.4× |
| Ureteral reflux study (78740) |
$447.12 |
$828 |
1.1× |
| Urethrocystogram voiding (74455) |
$462.03 |
$862 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$404.68 |
$755 |
1.6× |
| Us breast unilateral limited (76642) |
$362.96 |
$520 |
4.0× |
| Us chest (76604) |
$298.05 |
$427 |
2.7× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$345.51 |
$495 |
1.5× |
| Us encephalogram (76506) |
$429.97 |
$616 |
3.9× |
| Us hips infant static (76886) |
$164.03 |
$235 |
1.8× |
| Us infant hips w manipulation (76885) |
$270.82 |
$388 |
2.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$365.75 |
$524 |
3.3× |
| Us ob detailed single fetus (76811) |
$598.88 |
$858 |
2.4× |
| Us ob limited (76815) |
$427.18 |
$612 |
3.9× |
| Us ob transvaginal (76817) |
$490 |
$702 |
4.4× |
| Us pelvic non ob complete (76856) |
$662.40 |
$949 |
6.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$582.83 |
$835 |
5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$651.23 |
$933 |
5.9× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$506.05 |
$725 |
4.6× |
| Us retroperitoneal complete (76770) |
$683.34 |
$979 |
6.2× |
| Us retroperitoneal limited (76775) |
$355.28 |
$509 |
3.2× |
| Us scrotum and contents (76870) |
$613.54 |
$879 |
5.6× |
| Us soft tissue head/neck (76536) |
$582.13 |
$834 |
5.3× |
| Us spinal canal and contents (76800) |
$249.19 |
$357 |
2.3× |
| Us transrectal (76872) |
$313.40 |
$449 |
2.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$369.94 |
$530 |
3.4× |
| Venogram extremity bilateral (75822) |
$486.15 |
$907 |
0.3× |
| Venogram Extremity Unilateral (75820) |
$323.74 |
$604 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$117.38 |
$219 |
1.3× |
| Wrist 2 views (73100) |
$101.30 |
$189 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$225.12 |
$420 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$152.76 |
$285 |
1.7× |
| X-ray b.e. reductn intuss (74283) |
$523.14 |
$976 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$417.54 |
$779 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$113.63 |
$212 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$248.70 |
$464 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$288.90 |
$539 |
2.6× |
| X-ray exam of femur 2/> (73552) |
$197.78 |
$369 |
2.2× |
| X-ray eye for foreign body (70030) |
$108.81 |
$203 |
1.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$134.54 |
$251 |
1.5× |
| X-ray IV pyelogram (ivp) (74400) |
$504.38 |
$941 |
2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$108.81 |
$203 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$248.17 |
$463 |
2.7× |
| X-ray leg, infant (73592) |
$109.34 |
$204 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$319.99 |
$597 |
2.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$511.88 |
$955 |
4.6× |
| X-ray nose-rectum child f.b. (76010) |
$89.51 |
$167 |
1.0× |
| X-ray optic foramen (70190) |
$165.09 |
$308 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$212.79 |
$397 |
1.9× |
| X-ray retrograde pyelogram (74420) |
$393.42 |
$734 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$236.91 |
$442 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$267.46 |
$499 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$336.61 |
$628 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$251.92 |
$470 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$151.15 |
$282 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$170.98 |
$319 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$231.02 |
$431 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$157.58 |
$294 |
1.4× |
| X-Ray Small Bowel Enteroclysis (74251) |
$1,277.82 |
$2,384 |
6.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$159.19 |
$297 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$191.35 |
$357 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$162.94 |
$304 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$278.72 |
$520 |
2.5× |
| Xr bone length studies (77073) |
$272.82 |
$509 |
2.5× |
| Xr c-spine 4 or 5 views (72050) |
$310.34 |
$579 |
2.8× |
| Xr c-spine 6 or more views (72052) |
$368.77 |
$688 |
3.3× |
| Xr chest 4+ views (71048) |
$274.65 |
$577 |
2.5× |
| Xr urogram antegrade (74425) |
$462.57 |
$863 |
1.3× |