| Abdomen 1 View (74018) |
$270.40 |
$416 |
3.2× |
| Abdomen 2 views (74019) |
$408.20 |
$628 |
4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,612 |
$2,480 |
4.1× |
| Adrenal Cortex & Medulla Img (78075) |
$5,550.35 |
$8,539 |
4.4× |
| Ankle 2 views (73600) |
$399.75 |
$615 |
4.7× |
| Arthrogram hip (73525) |
$1,263.60 |
$1,944 |
3.7× |
| Bone age studies (77072) |
$222.95 |
$343 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$2,095.60 |
$3,224 |
5.3× |
| Bone Imaging Limited Area (78300) |
$1,151.80 |
$1,772 |
2.9× |
| Bone Imaging Multiple Areas (78305) |
$1,595.75 |
$2,455 |
4.1× |
| Bone Imaging Whole Body (78306) |
$1,820 |
$2,800 |
4.6× |
| Bone marrow imaging; whole body (78104) |
$1,496.95 |
$2,303 |
3.8× |
| Bone survey infant (77076) |
$373.10 |
$574 |
3.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,710.25 |
$8,785 |
4.1× |
| Cat Scan Follow-Up Study (76380) |
$360.10 |
$554 |
4.2× |
| Cerebrospinal Fluid Scan (78630) |
$4,925.70 |
$7,578 |
9.2× |
| Chest 1 view (71045) |
$298.35 |
$459 |
3.5× |
| Chest 2 views (71046) |
$440.70 |
$678 |
5.2× |
| Chest 3 views (71047) |
$573.95 |
$883 |
6.7× |
| Chest 4 or more views (71048) |
$659.10 |
$1,014 |
6.4× |
| Clavicle complete (73000) |
$217.75 |
$335 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$571.35 |
$879 |
5.6× |
| Contrast X-Ray Bladder (74430) |
$655.20 |
$1,008 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,921.40 |
$2,956 |
5.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,315.60 |
$2,024 |
5.6× |
| CT abdomen w contrast (74160) |
$1,122.55 |
$1,727 |
6.5× |
| CT abdomen w wo contrast (74170) |
$1,264.90 |
$1,946 |
7.4× |
| CT abdomen w/o contrast (74150) |
$571.35 |
$879 |
5.6× |
| CT Angio Abdomen and Pelvis (74174) |
$1,760.20 |
$2,708 |
5.1× |
| CT Angio Chest (71275) |
$1,317.55 |
$2,027 |
7.7× |
| CT Angio Head (70496) |
$1,317.55 |
$2,027 |
7.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,317.55 |
$2,027 |
7.7× |
| CT Angio Neck (70498) |
$1,317.55 |
$2,027 |
7.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,317.55 |
$2,027 |
7.7× |
| CT cervical spine w/ contrast (72126) |
$1,122.55 |
$1,727 |
3.3× |
| CT cervical spine w/o contrast (72125) |
$571.35 |
$879 |
5.6× |
| CT chest w contrast (71260) |
$1,122.55 |
$1,727 |
6.5× |
| CT chest w/wo contrast (71270) |
$1,264.90 |
$1,946 |
7.4× |
| CT head/brain with contrast (70460) |
$1,122.55 |
$1,727 |
6.5× |
| CT head/brain without and with contrast (70470) |
$1,264.90 |
$1,946 |
7.4× |
| CT iac w contrast (70481) |
$1,122.55 |
$1,727 |
6.5× |
| CT l-spine w&w/o contrast (72133) |
$1,264.90 |
$1,946 |
7.4× |
| CT lower ext w/o (73700) |
$571.35 |
$879 |
5.6× |
| CT lower extremity w/contrast material (73701) |
$1,122.55 |
$1,727 |
6.5× |
| CT lumbar spine w contrast (72132) |
$1,122.55 |
$1,727 |
3.3× |
| CT lumbar spine w/o contrast (72131) |
$571.35 |
$879 |
5.6× |
| CT maxillofacial w contrast (70487) |
$1,122.55 |
$1,727 |
6.5× |
| CT maxillofacial wo contrast (70486) |
$571.35 |
$879 |
5.6× |
| CT neck tissue combo (70492) |
$1,264.90 |
$1,946 |
7.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,264.90 |
$1,946 |
7.4× |
| CT orbits w/o contrast (70480) |
$571.35 |
$879 |
5.6× |
| CT pelvis w/o contrast (72192) |
$571.35 |
$879 |
5.6× |
| CT scan of leg combo (73702) |
$1,264.90 |
$1,946 |
7.4× |
| CT soft tissue neck w contrast (70491) |
$1,122.55 |
$1,727 |
6.5× |
| CT soft tissue neck w/o contrast (70490) |
$571.35 |
$879 |
5.6× |
| CT thoracic spine w contrast (72129) |
$1,122.55 |
$1,727 |
6.5× |
| CT thoracic spine w/o contrast (72128) |
$571.35 |
$879 |
5.6× |
| CT thorax w/o contrast (71250) |
$571.35 |
$879 |
5.6× |
| CT unlisted procedure (76497) |
$460.20 |
$708 |
5.4× |
| CT upper ext wo (73200) |
$571.35 |
$879 |
5.6× |
| CT upper extremity with contrast (73201) |
$1,122.55 |
$1,727 |
3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,317.55 |
$2,027 |
7.7× |
| Cta Abdomen (74175) |
$1,317.55 |
$2,027 |
7.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,219.40 |
$1,876 |
3.6× |
| CTA pelvis (72191) |
$1,317.55 |
$2,027 |
7.7× |
| Diskography lumbar (72295) |
$4,180.80 |
$6,432 |
2.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$173.55 |
$267 |
1.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$173.55 |
$267 |
1.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$167.05 |
$257 |
1.6× |
| Dxa Bone Density Axial (77080) |
$360.10 |
$554 |
3.5× |
| Dxa bone density study (77085) |
$646.75 |
$995 |
6.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$373.10 |
$574 |
4.4× |
| Echo exam of fetal heart (76825) |
$1,648.40 |
$2,536 |
3.1× |
| Echo exam uterus (76831) |
$577.85 |
$889 |
2.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$348.40 |
$536 |
1.5× |
| Esophagram (74220) |
$562.25 |
$865 |
3.3× |
| Fetal Biophys Profile W/Nst (76818) |
$595.40 |
$916 |
5.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$595.40 |
$916 |
5.8× |
| Fluoroscopy up to 1 hr (76000) |
$790.40 |
$1,216 |
3.4× |
| Foot 2 views (73620) |
$399.75 |
$615 |
4.7× |
| Forearm 2 views (73090) |
$399.75 |
$615 |
4.7× |
| Gastric emptying imaging study (78264) |
$1,573.65 |
$2,421 |
4.0× |
| Gated Heart Planar Single (78472) |
$1,761.50 |
$2,710 |
4.5× |
| Hand 2 views (73120) |
$399.75 |
$615 |
3.9× |
| Hepatobil Syst Image W/Drug (78227) |
$1,985.75 |
$3,055 |
3.7× |
| Hepatobiliary System Imaging (78226) |
$1,655.55 |
$2,547 |
4.2× |
| Ht Muscle Image Spect Sing (78451) |
$3,578.90 |
$5,506 |
2.8× |
| Hysterosalpingogram (74740) |
$822.90 |
$1,266 |
3.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$463.45 |
$713 |
5.4× |
| Infant hip ultrasound, limited static exam (76886) |
$463.45 |
$713 |
5.4× |
| K Flow/Funct Image W/Drug (78708) |
$2,249.65 |
$3,461 |
4.2× |
| K Flow/Funct Image W/O Drug (78707) |
$1,769.95 |
$2,723 |
3.3× |
| Knee 3 Views (73562) |
$524.55 |
$807 |
6.1× |
| Liver & Spleen Imaging Static Only (78215) |
$1,249.95 |
$1,923 |
3.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,583.75 |
$3,975 |
4.9× |
| Lymph System Imaging (78195) |
$2,767.70 |
$4,258 |
5.2× |
| Magnetic Image Jaw Joint (70336) |
$941.85 |
$1,449 |
4.0× |
| Mr safety determination physician/other qhp (76016) |
$180.70 |
$278 |
2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$50.70 |
$78 |
1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$188.50 |
$290 |
2.0× |
| Mr safety implt pos&/immoblj (76019) |
$121.55 |
$187 |
2.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$495.95 |
$763 |
2.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,573.65 |
$2,421 |
4.6× |
| MRA head w/o contrast (70544) |
$941.85 |
$1,449 |
4.0× |
| MRA head with contrast (70545) |
$1,363.05 |
$2,097 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,573.65 |
$2,421 |
4.6× |
| MRA neck w/o contrast (70547) |
$941.85 |
$1,449 |
4.0× |
| MRI abdomen w contrast (74182) |
$1,363.05 |
$2,097 |
4.0× |
| MRI abdomen w/o contrast (74181) |
$941.85 |
$1,449 |
4.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,363.05 |
$2,097 |
1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,573.65 |
$2,421 |
4.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,363.05 |
$2,097 |
1.8× |
| MRI cervical spine w contrast (72142) |
$1,363.05 |
$2,097 |
4.0× |
| MRI cervical spine w/o cont (72141) |
$941.85 |
$1,449 |
4.0× |
| MRI chest w/o contrast (71550) |
$941.85 |
$1,449 |
4.0× |
| MRI chest wo w contrast (71552) |
$1,573.65 |
$2,421 |
4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,363.05 |
$2,097 |
4.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,573.65 |
$2,421 |
4.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$941.85 |
$1,449 |
4.0× |
| MRI lumbar spine w contrast (72149) |
$1,363.05 |
$2,097 |
4.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,573.65 |
$2,421 |
4.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$941.85 |
$1,449 |
4.0× |
| MRI orbit face neck w contrast (70542) |
$1,363.05 |
$2,097 |
4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,573.65 |
$2,421 |
4.6× |
| MRI pelvis w/o & w contrast (72197) |
$1,573.65 |
$2,421 |
4.6× |
| MRI pelvis w/o contrast (72195) |
$941.85 |
$1,449 |
4.0× |
| MRI thoracic spine w/o contrast (72146) |
$941.85 |
$1,449 |
4.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,363.05 |
$2,097 |
4.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$941.85 |
$1,449 |
4.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,573.65 |
$2,421 |
4.6× |
| MRI, abdomen, combo (74183) |
$1,573.65 |
$2,421 |
4.6× |
| MRI, dorsal spine combo (72157) |
$1,573.65 |
$2,421 |
4.6× |
| MRI, dorsal spine contrast (72147) |
$1,363.05 |
$2,097 |
4.0× |
| MRI, joint upper extrem (73221) |
$941.85 |
$1,449 |
4.0× |
| MRI, joint upper extrem combo (73223) |
$1,573.65 |
$2,421 |
4.6× |
| MRI, lumbar spine combo (72158) |
$1,573.65 |
$2,421 |
4.6× |
| Myocardial Spect Multiple Studies (78452) |
$6,427.20 |
$9,888 |
5.1× |
| Neck soft tissue (70360) |
$217.75 |
$335 |
2.6× |
| Ob us nuchal meas 1 gest (76813) |
$463.45 |
$713 |
4.5× |
| Parathyroid Planar Imaging (78070) |
$1,673.10 |
$2,574 |
4.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$3,116.75 |
$4,795 |
7.9× |
| Pelvis 1 or 2 views (72170) |
$399.75 |
$615 |
3.9× |
| Peritoneogram Rs&I (74190) |
$1,132.95 |
$1,743 |
2.1× |
| PET image w/CT, full body (78816) |
$7,328.10 |
$11,274 |
5.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,328.10 |
$11,274 |
5.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,448.85 |
$2,229 |
3.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$556.40 |
$856 |
5.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,122.55 |
$1,727 |
2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$562.25 |
$865 |
6.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$524.55 |
$807 |
6.1× |
| Radex elbow complete minimum 3 views (73080) |
$562.25 |
$865 |
6.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$562.25 |
$865 |
5.5× |
| Radex fingr minimum 2 views (73140) |
$267.15 |
$411 |
3.1× |
| Radex foot complete minimum 3 views (73630) |
$562.25 |
$865 |
6.6× |
| Radex Hand Minimum 3 Views (73130) |
$562.25 |
$865 |
6.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$524.55 |
$807 |
6.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$562.25 |
$865 |
5.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$524.55 |
$807 |
6.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$399.75 |
$615 |
4.7× |
| Radex shoulder complete minimum 2 views (73030) |
$524.55 |
$807 |
6.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$399.75 |
$615 |
4.7× |
| Radex Spine 1 View Specify Level (72020) |
$270.40 |
$416 |
3.2× |
| Radex Sternum Minimum 2 Views (71120) |
$524.55 |
$807 |
6.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$460.85 |
$709 |
5.4× |
| Radex Toe Minimum 2 Views (73660) |
$267.15 |
$411 |
3.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$524.55 |
$807 |
5.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$562.25 |
$865 |
6.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$598 |
$920 |
5.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$477.75 |
$735 |
4.7× |
| Radiologic exam colon double contrast study (74280) |
$726.05 |
$1,117 |
4.2× |
| Radiologic exam colon single contrast study (74270) |
$532.35 |
$819 |
3.1× |
| Radiologic exam knee complete 4/more views (73564) |
$598 |
$920 |
5.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$562.25 |
$865 |
5.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$554.45 |
$853 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$887.90 |
$1,366 |
5.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$629.85 |
$969 |
3.7× |
| Radiologic examination femur 1 view (73551) |
$228.80 |
$352 |
2.7× |
| Radiologic examination femur minimum 2 views (73552) |
$440.05 |
$677 |
5.2× |
| Radiologic examination knee 1/2 views (73560) |
$399.75 |
$615 |
4.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$539.50 |
$830 |
5.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$440.05 |
$677 |
5.2× |
| Ribs bilateral 3 views (71110) |
$524.55 |
$807 |
5.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$3,395.60 |
$5,224 |
8.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,395.60 |
$5,224 |
8.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,431.05 |
$6,817 |
8.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,818.40 |
$4,336 |
5.3× |
| Scapula (73010) |
$217.75 |
$335 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$46.15 |
$71 |
2.0× |
| Shoulder 1 view (73020) |
$270.40 |
$416 |
3.2× |
| Shoulder Arthrography (73040) |
$1,263.60 |
$1,944 |
3.7× |
| Skull less than 4 views (70250) |
$399.75 |
$615 |
3.9× |
| Sternoclavicular joints (71130) |
$562.25 |
$865 |
6.6× |
| Thoracic spine 2 views (72070) |
$399.75 |
$615 |
3.9× |
| Thoracic spine 3 views (72072) |
$524.55 |
$807 |
5.1× |
| Thoracolumbar 2 views (72080) |
$399.75 |
$615 |
4.7× |
| Thyroid Uptake Measurement (78012) |
$766.35 |
$1,179 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,734.85 |
$2,669 |
4.4× |
| Ultrasound Breast Limited (76642) |
$536.90 |
$826 |
6.3× |
| Ultrasound Exam Aaa Screen (76706) |
$315.25 |
$485 |
3.1× |
| Ultrasound, abdomen limited (76705) |
$926.25 |
$1,425 |
9.0× |
| Umbilical-artery Doppler (OB) (76820) |
$147.55 |
$227 |
1.4× |
| Upper gi w/o kub (74240) |
$622.70 |
$958 |
3.6× |
| Urethrocystogram voiding (74455) |
$630.50 |
$970 |
2.7× |
| Us chest (76604) |
$693.55 |
$1,067 |
6.8× |
| Us complete joint (76881) |
$558.35 |
$859 |
5.4× |
| Us exam, pelvic, limited (76857) |
$583.05 |
$897 |
5.7× |
| Us head (76506) |
$576.55 |
$887 |
5.6× |
| Us kidney transplant (76776) |
$926.25 |
$1,425 |
9.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$463.45 |
$713 |
4.5× |
| Us ob detailed single fetus (76811) |
$557.70 |
$858 |
2.4× |
| Us ob limited 1 or more fetuses (76815) |
$389.35 |
$599 |
3.8× |
| Us ob transvaginal (76817) |
$406.25 |
$625 |
4.0× |
| Us pelvic non ob complete (76856) |
$1,053.65 |
$1,621 |
10.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$543.40 |
$836 |
5.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$306.80 |
$472 |
3.0× |
| Us retroperitoneal complete (76770) |
$926.25 |
$1,425 |
9.0× |
| Us retroperitoneal limited (76775) |
$926.25 |
$1,425 |
9.0× |
| Us scrotum and contents (76870) |
$966.55 |
$1,487 |
9.4× |
| Us spinal canal and contents (76800) |
$669.50 |
$1,030 |
6.5× |
| Us thyroid (76536) |
$718.90 |
$1,106 |
7.0× |
| Us transrectal (76872) |
$780 |
$1,200 |
7.6× |
| Vein X-Ray Chest (75827) |
$1,802.45 |
$2,773 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$5,203.90 |
$8,006 |
1.7× |
| Venography extremity bilateral rs&i (75822) |
$1,802.45 |
$2,773 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$1,802.45 |
$2,773 |
1.2× |
| Venography Renal Unilateral (75831) |
$3,673.15 |
$5,651 |
1.2× |
| Vertebral fracture assessment via dxa (77086) |
$194.35 |
$299 |
2.3× |
| Wrist 2 views (73100) |
$399.75 |
$615 |
4.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$554.45 |
$853 |
6.5× |
| X-Ray Bend Only L-S Spine (72120) |
$769.60 |
$1,184 |
7.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$399.75 |
$615 |
4.7× |
| X-Ray Exam Breast Specimen (76098) |
$1,604.20 |
$2,468 |
3.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$270.40 |
$416 |
3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$399.75 |
$615 |
3.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$270.40 |
$416 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$471.90 |
$726 |
5.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$627.25 |
$965 |
6.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$471.90 |
$726 |
4.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$627.25 |
$965 |
6.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$772.85 |
$1,189 |
7.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$774.15 |
$1,191 |
7.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$524.55 |
$807 |
6.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$614.90 |
$946 |
6.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$524.55 |
$807 |
5.1× |
| X-ray eye for foreign body (70030) |
$355.55 |
$547 |
4.2× |
| X-ray humerus (73060) |
$524.55 |
$807 |
6.1× |
| X-ray IV pyelogram (ivp) (74400) |
$752.70 |
$1,158 |
4.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$399.75 |
$615 |
4.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$528.45 |
$813 |
6.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$524.55 |
$807 |
5.1× |
| X-ray nose-rectum child f.b. (76010) |
$325 |
$500 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$598 |
$920 |
5.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$562.25 |
$865 |
5.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$399.75 |
$615 |
3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$524.55 |
$807 |
6.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$562.25 |
$865 |
6.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$598 |
$920 |
5.8× |
| X-Ray Stress View (77071) |
$399.75 |
$615 |
4.7× |
| X-ray thoracic spine 4 vw (72074) |
$598 |
$920 |
5.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$957.45 |
$1,473 |
2.8× |
| X-Rays Bone Length Studies (77073) |
$390.65 |
$601 |
3.8× |
| X-Rays Bone Survey Complete (77075) |
$698.75 |
$1,075 |
6.8× |
| Xr c-spine 4 or 5 views (72050) |
$598 |
$920 |
5.8× |
| Xr facial bones less than 3 views (70140) |
$524.55 |
$807 |
6.1× |
| Xr orbits complete 4 views (70200) |
$598 |
$920 |
5.8× |