| 3-D radiotherapy plan dose-volume histograms (77295) |
$921.80 |
$4,190 |
0.7× |
| Abdomen 2 views (74019) |
$95.04 |
$432 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$487.96 |
$2,218 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$1,354.10 |
$6,155 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,354.10 |
$6,155 |
0.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,251.04 |
$10,232 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,354.10 |
$6,155 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,592.48 |
$11,784 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$351.56 |
$1,598 |
0.1× |
| Ankle 2 views (73600) |
$78.10 |
$355 |
1.0× |
| Aortogram thoracic (75605) |
$2,251.04 |
$10,232 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,354.10 |
$6,155 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$1,354.10 |
$6,155 |
0.5× |
| Arthrogram elbow (73085) |
$248.16 |
$1,128 |
0.8× |
| Arthrogram shoulder (73040) |
$223.08 |
$1,014 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$226.16 |
$1,028 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$344.08 |
$1,564 |
1.0× |
| Bone age studies (77072) |
$78.32 |
$356 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$344.30 |
$1,565 |
1.0× |
| Bone survey complete (77075) |
$189.64 |
$862 |
2.0× |
| Brain image w/flow 4 + views (78606) |
$183.04 |
$832 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$79.20 |
$360 |
1.0× |
| Chest 1 view (71045) |
$79.20 |
$360 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$102.74 |
$467 |
0.7× |
| Clavicle complete (73000) |
$79.20 |
$360 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$243.98 |
$1,109 |
2.6× |
| Continuing medical physics consltj pr wk (77336) |
$312.40 |
$1,420 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,204.72 |
$5,476 |
3.9× |
| CT abdomen and pelvis without contrast (74176) |
$777.92 |
$3,536 |
3.7× |
| CT abdomen w contrast (74160) |
$286.88 |
$1,304 |
1.8× |
| CT abdomen w wo contrast (74170) |
$358.82 |
$1,631 |
2.3× |
| CT abdomen w/o contrast (74150) |
$239.14 |
$1,087 |
2.6× |
| CT angiography upper extremity lt (73206) |
$338.14 |
$1,537 |
2.2× |
| CT c-spine w/o contrast (72125) |
$179.30 |
$815 |
1.9× |
| CT cervical spine w&w/o contrast (72127) |
$286.88 |
$1,304 |
1.8× |
| CT cervical spine with contrast (72126) |
$239.14 |
$1,087 |
0.8× |
| CT chest w/wo contrast (71270) |
$358.82 |
$1,631 |
2.3× |
| CT chest with contrast (71260) |
$286.88 |
$1,304 |
1.8× |
| CT head/brain with contrast (70460) |
$440.44 |
$2,002 |
2.8× |
| CT head/brain without and with contrast (70470) |
$581.68 |
$2,644 |
3.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$59.18 |
$269 |
0.8× |
| CT iac w contrast (70481) |
$445.94 |
$2,027 |
2.9× |
| CT limited/localized follow up study (76380) |
$203.72 |
$926 |
2.6× |
| CT lower ext w/o (73700) |
$381.26 |
$1,733 |
4.1× |
| CT lower extremity w wo contrast (73702) |
$626.78 |
$2,849 |
4.0× |
| CT lower extremity with contrast (73701) |
$475.20 |
$2,160 |
3.1× |
| CT lumbar spine w & w/o contrast (72133) |
$286.88 |
$1,304 |
1.8× |
| CT lumbar spine w/o contrast (72131) |
$207.68 |
$944 |
2.2× |
| CT lumbar spine with contrast (72132) |
$239.14 |
$1,087 |
0.8× |
| CT maxillofacial w contrast (70487) |
$445.94 |
$2,027 |
2.9× |
| CT maxillofacial w/o contrast (70486) |
$371.14 |
$1,687 |
4.0× |
| CT maxillofacial w/wo contrast (70488) |
$588.72 |
$2,676 |
3.8× |
| CT neck soft tissue w contrast (70491) |
$519.64 |
$2,362 |
3.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$615.12 |
$2,796 |
3.9× |
| CT orbits w/o contrast (70480) |
$371.14 |
$1,687 |
4.0× |
| CT pelvis w/o contrast (72192) |
$239.47 |
$1,088.50 |
2.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$656.48 |
$2,984 |
4.2× |
| CT soft tissue neck w/o contrast (70490) |
$454.30 |
$2,065 |
4.9× |
| CT thoracic spine w/contrast (72129) |
$239.14 |
$1,087 |
1.5× |
| CT thoracic spine w/o contrast (72128) |
$178.64 |
$812 |
1.9× |
| CT thoracic spine w/wo contrast (72130) |
$286.88 |
$1,304 |
1.8× |
| CT thorax w/o contrast (71250) |
$239.14 |
$1,087 |
2.6× |
| CT upper extremity w/o contrast rt (73200) |
$377.74 |
$1,717 |
4.1× |
| CT upper extremity with contrast (73201) |
$470.80 |
$2,140 |
1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$622.38 |
$2,829 |
4.0× |
| Cta Abdomen (74175) |
$622.38 |
$2,829 |
4.0× |
| CTA abdomen pelvis (74174) |
$795.74 |
$3,617 |
2.6× |
| CTA chest (71275) |
$369.38 |
$1,679 |
2.4× |
| Cta Head (70496) |
$525.14 |
$2,387 |
3.4× |
| CTA lwr ext w&w/o contrast (73706) |
$502.04 |
$2,282 |
3.2× |
| Cta Neck (70498) |
$564.96 |
$2,568 |
3.6× |
| Cta Pelvis (72191) |
$282.92 |
$1,286 |
1.8× |
| Cystography minimum 3 views rs&i (74430) |
$137.50 |
$625 |
0.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$79.20 |
$360 |
0.9× |
| Echoencephalography real time imaging (76506) |
$69.52 |
$316 |
0.7× |
| Esophagus (74220) |
$79.20 |
$360 |
0.5× |
| Fetal biophysical profile non-stress testing (76818) |
$136.84 |
$622 |
1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$166.76 |
$758 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$115.50 |
$525 |
0.5× |
| Foot 2 views (73620) |
$78.76 |
$358 |
1.0× |
| Forearm 2 views (73090) |
$78.98 |
$359 |
1.0× |
| Gated Heart Planar Single (78472) |
$236.28 |
$1,074 |
0.7× |
| Hand 2 views (73120) |
$76.23 |
$346.50 |
0.8× |
| Hand 3 views (73130) |
$75.46 |
$343 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$344.30 |
$1,565 |
0.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$219.34 |
$997 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$78.76 |
$358 |
1.0× |
| Hysterosalpingogram (74740) |
$176.88 |
$804 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$328.46 |
$1,493 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$373.12 |
$1,696 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$618.42 |
$2,811 |
1.3× |
| Knee 3 views (73562) |
$78.76 |
$358 |
1.0× |
| Liver & spleen imaging static only (78215) |
$219.34 |
$997 |
0.6× |
| Liver imaging static only (78201) |
$181.94 |
$827 |
0.4× |
| Lymphoscintigraphy (78195) |
$253 |
$1,150 |
0.5× |
| Meckels Diverticulum (78290) |
$300.08 |
$1,364 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$197.12 |
$896 |
0.6× |
| MRA head w & w/o contrast (70546) |
$444.18 |
$2,019 |
1.4× |
| MRA head w/o contrast (70544) |
$252.78 |
$1,149 |
1.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$418 |
$1,900 |
1.3× |
| MRA neck w/o contrast (70547) |
$313.50 |
$1,425 |
1.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$444.18 |
$2,019 |
1.4× |
| MRI abdomen w/o contrast (74181) |
$313.50 |
$1,425 |
1.5× |
| MRI any jnt lwr ext with con lt (73722) |
$444.18 |
$2,019 |
0.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$444.18 |
$2,019 |
0.6× |
| MRI breast w/o contrast bilateral (77047) |
$300.52 |
$1,366 |
1.4× |
| MRI c-spine with contrast (72142) |
$310.86 |
$1,413 |
1.0× |
| MRI cervical spine w/o contrast (72141) |
$263.12 |
$1,196 |
1.2× |
| MRI chest w/o & w/contrast material (71552) |
$444.18 |
$2,019 |
1.4× |
| MRI chest w/o contrast (71550) |
$313.50 |
$1,425 |
1.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$377.96 |
$1,718 |
1.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$313.50 |
$1,425 |
1.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$457.38 |
$2,079 |
1.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$354.42 |
$1,611 |
1.1× |
| MRI pelvis w/o contrast (72195) |
$313.50 |
$1,425 |
1.5× |
| MRI scan of arm joint before and after contrast (73223) |
$444.18 |
$2,019 |
1.4× |
| MRI scan of leg joint before and after contrast (73723) |
$444.18 |
$2,019 |
1.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$358.82 |
$1,631 |
1.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$310.86 |
$1,413 |
1.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$358.82 |
$1,631 |
1.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$358.82 |
$1,631 |
1.2× |
| MRI thoracic spine w/o contrast (72146) |
$263.12 |
$1,196 |
1.2× |
| MRI tmj (70336) |
$252.78 |
$1,149 |
1.2× |
| MRI upper ext joint w/o contrast (73221) |
$282.26 |
$1,283 |
1.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$444.18 |
$2,019 |
1.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$313.50 |
$1,425 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$473.22 |
$2,151 |
0.4× |
| Neck soft tissue (70360) |
$79.20 |
$360 |
1.0× |
| Nm gastric emptying study (78264) |
$290.84 |
$1,322 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,030.26 |
$4,683 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$188.32 |
$856 |
0.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$135.30 |
$615 |
1.5× |
| Osseous survey infant (77076) |
$110.66 |
$503 |
1.2× |
| Parathyrd planar w/wo subtrj (78071) |
$208.12 |
$946 |
0.6× |
| Parathyroid imaging (78070) |
$138.82 |
$631 |
0.4× |
| Pelvis 1 or 2 views (72170) |
$79.20 |
$360 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$1,801.80 |
$8,190 |
1.4× |
| PET imaging for CT attenuation whole body (78816) |
$1,801.80 |
$8,190 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$444.18 |
$2,019 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$240.46 |
$1,093 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$443.08 |
$2,014 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$307.12 |
$1,396 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$79.20 |
$360 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$137.94 |
$627 |
1.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$66.88 |
$304 |
0.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$68.86 |
$313 |
0.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$160.16 |
$728 |
1.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$242.44 |
$1,102 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$63.80 |
$290 |
0.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$79.20 |
$360 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$78.54 |
$357 |
0.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$77.44 |
$352 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$107.58 |
$489 |
0.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$254.32 |
$1,156 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$98.12 |
$446 |
1.3× |
| Radiological examination surgical specimen (76098) |
$302.50 |
$1,375 |
0.6× |
| Ribs bilateral 3 views (71110) |
$79.20 |
$360 |
0.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$653.18 |
$2,969 |
1.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$621.06 |
$2,823 |
3.0× |
| Rp Therapy Intravenous Administration (79101) |
$227.48 |
$1,034 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$65.12 |
$296 |
0.7× |
| Scanogram (77073) |
$80.96 |
$368 |
0.9× |
| Scapula complete (73010) |
$79.20 |
$360 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$70.40 |
$320 |
3.0× |
| Simulation intermediate (77285) |
$234.74 |
$1,067 |
0.7× |
| Small bowel series (74250) |
$86.24 |
$392 |
0.6× |
| Spec medical radj physics consltj (77370) |
$110.22 |
$501 |
0.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$212.74 |
$967 |
0.6× |
| Special treatment procedure (77470) |
$928.18 |
$4,219 |
1.9× |
| Spine thoracic 3 views (72072) |
$57.20 |
$260 |
0.6× |
| Stereotactic body radiation delivery (77373) |
$1,893.76 |
$8,608 |
1.2× |
| Tbs Technical Calculation Only (77091) |
$98.12 |
$446 |
1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$197.12 |
$896 |
0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$212.74 |
$967 |
0.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$485.54 |
$2,207 |
1.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$295.02 |
$1,341 |
2.5× |
| Thoracolumbar 2 views (72080) |
$92.40 |
$420 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$211.20 |
$960 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$150.48 |
$684 |
0.4× |
| Tmj unilateral (70328) |
$33.88 |
$154 |
0.4× |
| Tomogram (76100) |
$161.26 |
$733 |
1.7× |
| Treatment device intermediate (77333) |
$281.16 |
$1,278 |
2.4× |
| Treatment devices simple (77332) |
$281.16 |
$1,278 |
2.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$666.16 |
$3,028 |
1.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$616.22 |
$2,801 |
1.7× |
| Tx devices design & construction complex (77334) |
$213.84 |
$972 |
0.6× |
| Ultrasound, abdomen limited (76705) |
$130.02 |
$591 |
1.4× |
| Upper Extremity Infant (73092) |
$79.20 |
$360 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$137.50 |
$625 |
0.6× |
| Urethrocystography voiding (74455) |
$137.50 |
$625 |
0.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$167.20 |
$760 |
1.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$231.44 |
$1,052 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$67.98 |
$309 |
0.7× |
| Us breast unilateral complete (76641) |
$73.26 |
$333 |
0.8× |
| Us breast unilateral limited (76642) |
$59.18 |
$269 |
0.8× |
| Us chest (76604) |
$70.18 |
$319 |
0.8× |
| Us compl joint r-t w/image documentation (76881) |
$105.60 |
$480 |
1.1× |
| Us elastography parenchyma (76981) |
$69.52 |
$316 |
0.7× |
| Us guided compression repair (76936) |
$88.22 |
$401 |
0.5× |
| Us infant hips dynamic (76885) |
$57.20 |
$260 |
0.7× |
| Us infant hips limited static (76886) |
$47.08 |
$214 |
0.6× |
| Us ob detailed single fetus (76811) |
$321.64 |
$1,462 |
1.5× |
| Us ob transvaginal (76817) |
$135.30 |
$615 |
1.5× |
| Us pelvic non ob complete (76856) |
$175.34 |
$797 |
1.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$70.84 |
$322 |
0.8× |
| Us pregnancy ltd (76815) |
$135.30 |
$615 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$135.30 |
$615 |
1.5× |
| Us retroperitoneal complete (76770) |
$90.64 |
$412 |
1.0× |
| Us retroperitoneal limited (76775) |
$134.64 |
$612 |
1.5× |
| Us scrotum and contents (76870) |
$86.68 |
$394 |
0.9× |
| Us soft tissue head/neck (76536) |
$76.12 |
$346 |
0.8× |
| Us spinal canal and contents (76800) |
$72.16 |
$328 |
0.8× |
| Us transrectal (76872) |
$70.84 |
$322 |
0.8× |
| Us xtr non-vasc lmtd (76882) |
$105.60 |
$480 |
1.1× |
| Us, eye b-scan (76512) |
$36.74 |
$167 |
0.4× |
| Venogram extremity bilateral (75822) |
$447.26 |
$2,033 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$499.84 |
$2,272 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$447.26 |
$2,033 |
0.3× |
| Wrist 2 views (73100) |
$76.34 |
$347 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$79.20 |
$360 |
0.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$57.42 |
$261 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$75.68 |
$344 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$144.98 |
$659 |
0.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$77.55 |
$352.50 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$74.80 |
$340 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$79.20 |
$360 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$78.76 |
$358 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$125.18 |
$569 |
1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$115.06 |
$523 |
1.2× |
| X-ray exam of femur 1 (73551) |
$78.54 |
$357 |
1.0× |
| X-ray eye for foreign body (70030) |
$98.12 |
$446 |
1.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$79.20 |
$360 |
0.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$79.20 |
$360 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$78.76 |
$358 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$456.94 |
$2,077 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$79.20 |
$360 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$18.26 |
$83 |
0.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$79.20 |
$360 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$98.12 |
$446 |
1.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$79.20 |
$360 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$77.88 |
$354 |
0.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$113.74 |
$517 |
1.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$79.20 |
$360 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$79.20 |
$360 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$52.36 |
$238 |
0.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$49.94 |
$227 |
0.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$79.20 |
$360 |
0.9× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$307.12 |
$1,396 |
0.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$258.06 |
$1,173 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$79.20 |
$360 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$79.20 |
$360 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$113.52 |
$516 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$53.90 |
$245 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$76.34 |
$347 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$73.92 |
$336 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$79.20 |
$360 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$79.20 |
$360 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$82.06 |
$373 |
0.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$77.66 |
$353 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$79.20 |
$360 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$79.20 |
$360 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$75.46 |
$343 |
0.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$79.20 |
$360 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$79.20 |
$360 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$79.20 |
$360 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$35.42 |
$161 |
0.4× |
| Xr finger(s) 2+ views (73140) |
$79.20 |
$360 |
1.0× |
| Xr shoulder 1 view (73020) |
$79.20 |
$360 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$117.70 |
$535 |
1.3× |
| Xr tibia/fibula 2 views (73590) |
$78.76 |
$358 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$79.20 |
$360 |
1.0× |