| Abdomen 1 View (74018) |
$222.50 |
$445 |
2.5× |
| Abdomen 2 views (74019) |
$408.50 |
$817 |
3.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$670.50 |
$1,341 |
1.6× |
| Ankle 2 views (73600) |
$122.50 |
$245 |
1.4× |
Arthrogram hip (73525)
range across 4 matching MRF lines |
$122–$466 |
$244–$932 |
varies |
Arthrogram Wrist (73115)
range across 4 matching MRF lines |
$34–$580.50 |
$68–$1,161 |
varies |
| Bone age studies (77072) |
$398 |
$796 |
3.7× |
| Bone Imaging 3 Phase (78315) |
$945 |
$1,890 |
2.3× |
| Bone Imaging Limited Area (78300) |
$410.50 |
$821 |
1.0× |
| Bone Imaging Whole Body (78306) |
$818.50 |
$1,637 |
2.0× |
| Bone marrow imaging limited area (78102) |
$435.50 |
$871 |
1.1× |
| Bone marrow imaging; multiple areas (78103) |
$735.50 |
$1,471 |
1.8× |
| Bone survey infant (77076) |
$190 |
$380 |
1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$535 |
$1,070 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,383 |
$6,766 |
2.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,697.50 |
$5,395 |
7.6× |
| Cat Scan Follow-Up Study (76380) |
$718 |
$1,436 |
8.1× |
| Chest 1 view (71045) |
$164 |
$328 |
1.8× |
| Chest 2 views (71046) |
$232.50 |
$465 |
2.6× |
| Chest 4 or more views (71048) |
$174.50 |
$349 |
1.6× |
| Clavicle complete (73000) |
$194 |
$388 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,579 |
$3,158 |
14.8× |
| Contrast X-Ray Bladder (74430) |
$399 |
$798 |
1.1× |
| Contrast X-Ray Of Elbow (73085) |
$446 |
$892 |
1.3× |
Contrast X-Ray Of Knee Joint (73580)
range across 4 matching MRF lines |
$38–$446 |
$76–$892 |
varies |
| Contrast Xray Throat/Cerv Esopha (74210) |
$178 |
$356 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,881 |
$5,762 |
8.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,818 |
$3,636 |
7.5× |
| CT abdomen w contrast (74160) |
$1,317.50 |
$2,635 |
7.4× |
| CT abdomen w wo contrast (74170) |
$1,549 |
$3,098 |
8.6× |
| CT abdomen w/o contrast (74150) |
$1,241 |
$2,482 |
11.6× |
| CT Angio Abdomen and Pelvis (74174) |
$2,565 |
$5,130 |
7.2× |
| CT Angio Chest (71275) |
$1,938.50 |
$3,877 |
10.8× |
| CT Angio Head (70496) |
$1,813.50 |
$3,627 |
10.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,596 |
$3,192 |
8.9× |
| CT Angio Neck (70498) |
$1,864.50 |
$3,729 |
10.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,530 |
$3,060 |
8.5× |
| CT bone density (77078) |
$446 |
$892 |
5.0× |
| CT cervical spine w/ contrast (72126) |
$1,720.50 |
$3,441 |
4.8× |
| CT cervical spine w/o contrast (72125) |
$1,643.50 |
$3,287 |
15.4× |
| CT cervical spine w/wo cont (72127) |
$1,952.50 |
$3,905 |
10.9× |
| CT chest w contrast (71260) |
$1,730.50 |
$3,461 |
9.7× |
| CT chest w/wo contrast (71270) |
$1,961.50 |
$3,923 |
10.9× |
| CT head/brain with contrast (70460) |
$1,308.50 |
$2,617 |
7.3× |
| CT head/brain without and with contrast (70470) |
$1,618 |
$3,236 |
9.0× |
| CT iac w contrast (70481) |
$1,501.50 |
$3,003 |
8.4× |
| CT l-spine w&w/o contrast (72133) |
$1,847 |
$3,694 |
10.3× |
| CT lower ext w/o (73700) |
$1,629 |
$3,258 |
15.3× |
| CT lower extremity w/contrast material (73701) |
$1,706.50 |
$3,413 |
9.5× |
| CT lumbar spine w contrast (72132) |
$1,617 |
$3,234 |
4.5× |
| CT lumbar spine w/o contrast (72131) |
$1,540 |
$3,080 |
14.4× |
| CT maxillofacial w contrast (70487) |
$1,303 |
$2,606 |
7.3× |
| CT maxillofacial wo contrast (70486) |
$1,225.50 |
$2,451 |
11.5× |
| CT neck tissue combo (70492) |
$2,131 |
$4,262 |
11.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,595 |
$3,190 |
8.9× |
| CT orbits w/o contrast (70480) |
$1,424 |
$2,848 |
13.3× |
| CT pelvis w&w/o contrast (72194) |
$1,808 |
$3,616 |
10.1× |
| CT pelvis w/o contrast (72192) |
$1,498.50 |
$2,997 |
14.0× |
| CT scan of leg combo (73702) |
$1,937 |
$3,874 |
10.8× |
| CT scans face/jaw combo (70488) |
$1,534 |
$3,068 |
8.6× |
| CT soft tissue neck w contrast (70491) |
$1,899.50 |
$3,799 |
10.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,823.50 |
$3,647 |
17.1× |
| CT thoracic spine w contrast (72129) |
$1,720.50 |
$3,441 |
9.6× |
| CT thoracic spine w/o contrast (72128) |
$1,644 |
$3,288 |
15.4× |
| CT thoracic spine w/wo cont (72130) |
$1,952.50 |
$3,905 |
10.9× |
| CT thorax w/o contrast (71250) |
$1,653.50 |
$3,307 |
15.5× |
| CT upper ext wo (73200) |
$1,566 |
$3,132 |
14.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,874 |
$3,748 |
10.5× |
| CT upper extremity with contrast (73201) |
$1,643.50 |
$3,287 |
4.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,368.50 |
$4,737 |
13.2× |
| Cta Abdomen (74175) |
$1,957 |
$3,914 |
10.9× |
| CTA pelvis (72191) |
$1,796 |
$3,592 |
10.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$303 |
$606 |
2.8× |
| Dxa Bone Density Axial (77080) |
$366 |
$732 |
3.4× |
| Dxa bone density study (77085) |
$249.50 |
$499 |
2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$86.50 |
$173 |
1.0× |
| Echo exam uterus (76831) |
$511 |
$1,022 |
2.1× |
Esophagram (74220)
range across 2 matching MRF lines |
$35.50–$413 |
$71–$826 |
varies |
| Fetal Biophys Profile W/Nst (76818) |
$734 |
$1,468 |
6.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$369 |
$738 |
3.5× |
| Fluoroscopy up to 1 hr (76000) |
$619 |
$1,238 |
2.5× |
| Foot 2 views (73620) |
$257.50 |
$515 |
2.9× |
| Forearm 2 views (73090) |
$257.50 |
$515 |
2.9× |
| Gastric emptying imaging study (78264) |
$1,153.50 |
$2,307 |
2.8× |
| Gated Heart Planar Single (78472) |
$731.50 |
$1,463 |
1.8× |
| Hand 2 views (73120) |
$257.50 |
$515 |
2.4× |
| Hepatobil Syst Image W/Drug (78227) |
$1,259 |
$2,518 |
2.3× |
| Hepatobiliary System Imaging (78226) |
$1,259 |
$2,518 |
3.1× |
| Ht Muscle Image Spect Sing (78451) |
$2,195.50 |
$4,391 |
1.7× |
| Hysterosalpingogram (74740) |
$281 |
$562 |
1.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$217.50 |
$435 |
2.4× |
| Infant hip ultrasound, limited static exam (76886) |
$303 |
$606 |
3.4× |
| Joint Survey Single View (77077) |
$128 |
$256 |
1.2× |
| K Flow/Funct Image Multiple (78709) |
$616 |
$1,232 |
1.1× |
| K Flow/Funct Image W/Drug (78708) |
$616 |
$1,232 |
1.1× |
| K Flow/Funct Image W/O Drug (78707) |
$643 |
$1,286 |
1.2× |
| Knee 3 Views (73562) |
$261.50 |
$523 |
2.9× |
| Liver & Spleen Imaging Static Only (78215) |
$406.50 |
$813 |
1.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$998.50 |
$1,997 |
1.8× |
| Lymph System Imaging (78195) |
$690 |
$1,380 |
1.2× |
| Magnetic Image Jaw Joint (70336) |
$1,619.50 |
$3,239 |
6.6× |
| Meckels Divert Exam (78290) |
$421.50 |
$843 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,929 |
$5,858 |
8.2× |
| MRA head w/o contrast (70544) |
$2,157 |
$4,314 |
8.8× |
| MRA head with contrast (70545) |
$2,312.50 |
$4,625 |
6.5× |
| MRA neck w contrast (70548) |
$2,312.50 |
$4,625 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,929 |
$5,858 |
8.2× |
| MRA neck w/o contrast (70547) |
$2,157 |
$4,314 |
8.8× |
| MRI abdomen w contrast (74182) |
$2,312.50 |
$4,625 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$2,157 |
$4,314 |
8.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,042 |
$4,084 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,659 |
$5,318 |
7.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,582.50 |
$5,165 |
3.2× |
| MRI cardiac w/o contrast (75557) |
$1,926.50 |
$3,853 |
7.9× |
| MRI cervical spine w contrast (72142) |
$2,236 |
$4,472 |
6.3× |
| MRI cervical spine w/o cont (72141) |
$2,081.50 |
$4,163 |
8.5× |
| MRI chest w/o contrast (71550) |
$2,157 |
$4,314 |
8.8× |
| MRI chest with contrast (71551) |
$2,312.50 |
$4,625 |
2.9× |
| MRI chest wo w contrast (71552) |
$2,929 |
$5,858 |
8.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,889 |
$3,778 |
5.3× |
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 2 matching MRF lines |
$2,625.50–$2,628 |
$5,251–$5,256 |
varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,735 |
$3,470 |
7.1× |
| MRI lumbar spine w contrast (72149) |
$2,929 |
$5,858 |
8.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,773.50 |
$5,547 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,157 |
$4,314 |
8.8× |
| MRI orbit face neck w contrast (70542) |
$2,312.50 |
$4,625 |
6.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,082.50 |
$6,165 |
8.6× |
| MRI pelvis w contrast (72196) |
$2,929 |
$5,858 |
8.2× |
| MRI pelvis w/o & w contrast (72197) |
$3,545 |
$7,090 |
9.9× |
| MRI pelvis w/o contrast (72195) |
$2,773.50 |
$5,547 |
11.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,773.50 |
$5,547 |
11.4× |
MRI upper extremity oth than jt w/contr matrl (73219)
range across 2 matching MRF lines |
$1,889–$1,908.50 |
$3,778–$3,817 |
varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,735 |
$3,470 |
7.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,504 |
$5,008 |
7.0× |
| MRI, abdomen, combo (74183) |
$2,929 |
$5,858 |
8.2× |
| MRI, dorsal spine combo (72157) |
$3,545 |
$7,090 |
9.9× |
| MRI, dorsal spine contrast (72147) |
$2,929 |
$5,858 |
8.2× |
| MRI, joint upper extrem (73221) |
$2,428 |
$4,856 |
10.0× |
| MRI, joint upper extrem combo (73223) |
$3,198.50 |
$6,397 |
9.0× |
| MRI, lumbar spine combo (72158) |
$3,545 |
$7,090 |
9.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,290.50 |
$4,581 |
1.7× |
| Neck soft tissue (70360) |
$185 |
$370 |
2.1× |
| Nonvascular Shunt X-Ray (75809) |
$288.50 |
$577 |
2.7× |
| Ob us nuchal meas 1 gest (76813) |
$280 |
$560 |
2.6× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$51.50 |
$103 |
0.5× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$8.50 |
$17 |
0.3× |
| Parathyroid Planar Imaging (78070) |
$1,291 |
$2,582 |
3.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,291 |
$2,582 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$215.50 |
$431 |
2.0× |
| PET image w/CT, full body (78816) |
$3,383 |
$6,766 |
2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,383 |
$6,766 |
2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$479.50 |
$959 |
1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$288.50 |
$577 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$215 |
$430 |
0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$420 |
$840 |
4.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$122.50 |
$245 |
1.4× |
| Radex elbow complete minimum 3 views (73080) |
$257.50 |
$515 |
2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$186 |
$372 |
1.7× |
| Radex fingr minimum 2 views (73140) |
$208 |
$416 |
2.3× |
| Radex foot complete minimum 3 views (73630) |
$257.50 |
$515 |
2.9× |
| Radex Hand Minimum 3 Views (73130) |
$257.50 |
$515 |
2.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$162.50 |
$325 |
1.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$154 |
$308 |
1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$186 |
$372 |
2.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$306.50 |
$613 |
3.4× |
| Radex shoulder complete minimum 2 views (73030) |
$257.50 |
$515 |
2.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$162 |
$324 |
1.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$445 |
$890 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$315.50 |
$631 |
3.5× |
| Radex Sternum Minimum 2 Views (71120) |
$182.50 |
$365 |
2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$190 |
$380 |
2.1× |
| Radex Toe Minimum 2 Views (73660) |
$122.50 |
$245 |
1.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$162.50 |
$325 |
1.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$257.50 |
$515 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$148 |
$296 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$190 |
$380 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$408.50 |
$817 |
3.8× |
| Radiologic exam colon double contrast study (74280) |
$626 |
$1,252 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$781 |
$1,562 |
4.4× |
Radiologic Exam Esophagus Double Contrast Study (74221)
range across 2 matching MRF lines |
$41.50–$413 |
$83–$826 |
varies |
| Radiologic exam knee complete 4/more views (73564) |
$261.50 |
$523 |
2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$120 |
$240 |
1.1× |
Radiologic Exam Small Int Single Contrast Study (74250)
range across 3 matching MRF lines |
$48–$231 |
$96–$462 |
varies |
Radiologic exam swallow function contrast study (74230)
range across 2 matching MRF lines |
$31.50–$388.50 |
$63–$777 |
varies |
Radiologic exam upr gi trc double contrast study (74246)
range across 2 matching MRF lines |
$53–$621 |
$106–$1,242 |
varies |
| Radiologic examination femur 1 view (73551) |
$117.50 |
$235 |
1.3× |
| Radiologic examination femur minimum 2 views (73552) |
$148 |
$296 |
1.7× |
| Radiologic examination knee 1/2 views (73560) |
$261.50 |
$523 |
2.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$390 |
$780 |
3.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$257.50 |
$515 |
2.9× |
| Ribs bilateral 3 views (71110) |
$399 |
$798 |
3.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$681 |
$1,362 |
1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$581 |
$1,162 |
1.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,401.50 |
$2,803 |
2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,623.50 |
$3,247 |
2.9× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 3 matching MRF lines |
$722–$1,401.50 |
$1,444–$2,803 |
varies |
| Scapula (73010) |
$194 |
$388 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$27 |
$54 |
1.2× |
| Shoulder 1 view (73020) |
$151.50 |
$303 |
1.7× |
Shoulder Arthrography (73040)
range across 4 matching MRF lines |
$33.50–$547 |
$67–$1,094 |
varies |
| Skull less than 4 views (70250) |
$154 |
$308 |
1.4× |
| Sternoclavicular joints (71130) |
$88.50 |
$177 |
1.0× |
| Testicular Imaging W/Flow (78761) |
$441 |
$882 |
1.1× |
| Thoracic spine 2 views (72070) |
$231 |
$462 |
2.2× |
| Thoracic spine 3 views (72072) |
$305.50 |
$611 |
2.9× |
| Thoracolumbar 2 views (72080) |
$148 |
$296 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$351 |
$702 |
0.9× |
| Thyroid Met Imaging Body (78018) |
$872 |
$1,744 |
1.6× |
| Thyroid Uptake Measurement (78012) |
$162.50 |
$325 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$800 |
$1,600 |
2.0× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$346.50–$520 |
$693–$1,040 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$379.50 |
$759 |
3.6× |
| Ultrasound, abdomen limited (76705) |
$663 |
$1,326 |
6.2× |
| Umbilical-artery Doppler (OB) (76820) |
$309 |
$618 |
2.9× |
| Unlisted us procedure (76999) |
$276.50 |
$553 |
3.1× |
Upper gi w/o kub (74240)
range across 4 matching MRF lines |
$48–$369.50 |
$96–$739 |
varies |
| Urethrocystogram voiding (74455) |
$445 |
$890 |
1.8× |
| Urethrocystography retrograde (74450) |
$445 |
$890 |
1.8× |
Us breast unilateral complete (76641)
range across 3 matching MRF lines |
$346.50–$520 |
$693–$1,040 |
varies |
| Us chest (76604) |
$271.50 |
$543 |
2.5× |
| Us complete joint (76881) |
$285.50 |
$571 |
2.7× |
| Us exam, pelvic, limited (76857) |
$281 |
$562 |
2.6× |
| Us kidney transplant (76776) |
$637 |
$1,274 |
6.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$273.50 |
$547 |
2.6× |
| Us ob detailed single fetus (76811) |
$358 |
$716 |
1.5× |
| Us ob limited 1 or more fetuses (76815) |
$273 |
$546 |
2.6× |
| Us ob transvaginal (76817) |
$273 |
$546 |
2.6× |
| Us pelvic non ob complete (76856) |
$663 |
$1,326 |
6.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$307.50 |
$615 |
2.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$254.50 |
$509 |
2.4× |
| Us retroperitoneal complete (76770) |
$471.50 |
$943 |
4.4× |
Us retroperitoneal limited (76775)
range across 4 matching MRF lines |
$631–$946.50 |
$1,262–$1,893 |
varies |
| Us scrotum and contents (76870) |
$617.50 |
$1,235 |
5.8× |
| Us spinal canal and contents (76800) |
$261.50 |
$523 |
2.4× |
| Us thyroid (76536) |
$480.50 |
$961 |
4.5× |
| Us transrectal (76872) |
$486.50 |
$973 |
4.6× |
| Vertebral fracture assessment via dxa (77086) |
$90.50 |
$181 |
1.0× |
| Wrist 2 views (73100) |
$257.50 |
$515 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$171 |
$342 |
1.9× |
| X-ray antegrade pyelogram tube (74425) |
$898.50 |
$1,797 |
2.5× |
| X-Ray Bend Only L-S Spine (72120) |
$79.50 |
$159 |
0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$122.50 |
$245 |
1.4× |
| X-Ray Exam Breast Specimen (76098) |
$12 |
$24 |
0.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$279 |
$558 |
3.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$148 |
$296 |
1.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$148 |
$296 |
1.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$148 |
$296 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$148 |
$296 |
1.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$148 |
$296 |
1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$148 |
$296 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$148 |
$296 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$148 |
$296 |
1.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$356 |
$712 |
3.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$357 |
$714 |
4.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$405.50 |
$811 |
3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$368.50 |
$737 |
3.5× |
| X-ray eye for foreign body (70030) |
$103 |
$206 |
1.2× |
| X-ray humerus (73060) |
$247.50 |
$495 |
2.8× |
| X-ray IV pyelogram (ivp) (74400) |
$560 |
$1,120 |
3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$168.50 |
$337 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$270 |
$540 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$314 |
$628 |
2.9× |
| X-ray nose-rectum child f.b. (76010) |
$66.50 |
$133 |
0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$473 |
$946 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$403.50 |
$807 |
3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$294.50 |
$589 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$199 |
$398 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$267.50 |
$535 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$213.50 |
$427 |
2.0× |
| X-ray thoracic spine 4 vw (72074) |
$331.50 |
$663 |
3.1× |
| X-Ray Tmj Unilat (70328) |
$168.50 |
$337 |
1.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$394 |
$788 |
1.1× |
| X-Rays Bone Length Studies (77073) |
$181.50 |
$363 |
1.7× |
| X-Rays Bone Survey Complete (77075) |
$495 |
$990 |
4.6× |
| Xr c-spine 4 or 5 views (72050) |
$384 |
$768 |
3.6× |
| Xr facial bones less than 3 views (70140) |
$162 |
$324 |
1.8× |
| Xr orbits complete 4 views (70200) |
$179 |
$358 |
1.7× |