| Abdomen 2 views (74019) |
$162.60 |
$271 |
1.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$297 |
$495 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$3,343.80 |
$5,573 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,343.80 |
$5,573 |
1.1× |
| Ankle 2 views (73600) |
$368.40 |
$614 |
4.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$156 |
$260 |
0.5× |
| Aortogram thoracic (75605) |
$4,158 |
$6,930 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,343.80 |
$5,573 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$3,343.80 |
$5,573 |
1.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,363 |
$5,605 |
1.1× |
| Arthrogram elbow (73085) |
$355.20 |
$592 |
1.1× |
| Arthrogram hip (73525) |
$442.80 |
$738 |
1.3× |
| Arthrogram wrist (73115) |
$451.80 |
$753 |
1.4× |
| Arthrography knee lt (73580) |
$315 |
$525 |
0.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,192.20 |
$1,987 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$1,569 |
$2,615 |
4.1× |
| Bone age studies (77072) |
$134.40 |
$224 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$1,788.60 |
$2,981 |
4.7× |
| Bone survey complete (77075) |
$389.40 |
$649 |
3.9× |
| Brain imaging < 4 static views w vascular flow (78601) |
$403.80 |
$673 |
1.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$323.40 |
$539 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,518 |
$2,530 |
4.6× |
| Cervical spine 2 or 3 views (72040) |
$430.20 |
$717 |
5.2× |
| Chest 1 view (71045) |
$151.80 |
$253 |
1.8× |
| Chest 3 views (71047) |
$297.60 |
$496 |
3.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$176.40 |
$294 |
1.1× |
| Clavicle complete (73000) |
$388.80 |
$648 |
4.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$120 |
$200 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,232.40 |
$7,054 |
12.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,397 |
$3,995 |
10.5× |
| CT abdomen w contrast (74160) |
$2,259.60 |
$3,766 |
13.5× |
| CT abdomen w wo contrast (74170) |
$2,575.80 |
$4,293 |
15.4× |
| CT abdomen w/o contrast (74150) |
$1,468.80 |
$2,448 |
14.7× |
| CT angio hrt w/3d image (75574) |
$1,633.80 |
$2,723 |
4.9× |
| CT angiography upper extremity lt (73206) |
$898.80 |
$1,498 |
5.4× |
| CT c-spine w/o contrast (72125) |
$1,891.20 |
$3,152 |
18.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,779.80 |
$4,633 |
16.6× |
| CT cervical spine with contrast (72126) |
$2,344.80 |
$3,908 |
7.0× |
| CT chest w/wo contrast (71270) |
$1,927.20 |
$3,212 |
11.5× |
| CT chest with contrast (71260) |
$1,606.20 |
$2,677 |
9.6× |
| CT head/brain with contrast (70460) |
$2,245.20 |
$3,742 |
13.4× |
| CT head/brain without and with contrast (70470) |
$2,627.40 |
$4,379 |
15.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,633.80 |
$2,723 |
4.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,389 |
$2,315 |
16.7× |
| CT hrt w/3d image congen (75573) |
$1,633.80 |
$2,723 |
4.9× |
| CT iac w contrast (70481) |
$1,521 |
$2,535 |
9.1× |
| CT limited/localized follow up study (76380) |
$79.20 |
$132 |
1.0× |
| CT lower ext w/o (73700) |
$1,081.80 |
$1,803 |
10.8× |
| CT lower extremity w wo contrast (73702) |
$1,655.40 |
$2,759 |
9.9× |
| CT lower extremity with contrast (73701) |
$1,363.20 |
$2,272 |
8.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,258.40 |
$3,764 |
13.5× |
| CT lumbar spine w/o contrast (72131) |
$1,505.40 |
$2,509 |
15.1× |
| CT lumbar spine with contrast (72132) |
$1,912.20 |
$3,187 |
5.7× |
| CT maxillofacial w contrast (70487) |
$1,760.40 |
$2,934 |
10.5× |
| CT maxillofacial w/o contrast (70486) |
$1,467 |
$2,445 |
14.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,156.40 |
$3,594 |
12.9× |
| CT neck soft tissue w contrast (70491) |
$2,032.20 |
$3,387 |
12.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,661.40 |
$2,769 |
9.9× |
| CT orbits w/o contrast (70480) |
$1,278 |
$2,130 |
12.8× |
| CT pelvis w & w/o contrast (72194) |
$901.80 |
$1,503 |
5.4× |
| CT pelvis w/o contrast (72192) |
$501 |
$835 |
5.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,458.80 |
$4,098 |
14.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,686.60 |
$2,811 |
16.9× |
| CT thoracic spine w/contrast (72129) |
$1,557.60 |
$2,596 |
9.3× |
| CT thoracic spine w/o contrast (72128) |
$731.40 |
$1,219 |
7.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,557.60 |
$2,596 |
9.3× |
| CT thorax w/o contrast (71250) |
$1,333.20 |
$2,222 |
13.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,784.60 |
$4,641 |
16.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,796.40 |
$2,994 |
18.0× |
| CT upper extremity with contrast (73201) |
$2,227.20 |
$3,712 |
6.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$527.40 |
$879 |
3.1× |
| Cta Abdomen (74175) |
$1,205.40 |
$2,009 |
7.2× |
| CTA abdomen pelvis (74174) |
$1,525.80 |
$2,543 |
4.6× |
| CTA chest (71275) |
$2,387.40 |
$3,979 |
14.2× |
| Cta Head (70496) |
$2,398.80 |
$3,998 |
14.3× |
| CTA lwr ext w&w/o contrast (73706) |
$813 |
$1,355 |
4.8× |
| Cta Neck (70498) |
$1,639.20 |
$2,732 |
9.8× |
| Cta Pelvis (72191) |
$1,133.40 |
$1,889 |
6.8× |
| Cystography minimum 3 views rs&i (74430) |
$156 |
$260 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$443.40 |
$739 |
4.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$231 |
$385 |
2.8× |
| Echoencephalography real time imaging (76506) |
$133.20 |
$222 |
1.3× |
| Esophagus (74220) |
$459 |
$765 |
2.7× |
| Fetal biophysical profile non-stress testing (76818) |
$227.40 |
$379 |
2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$165.60 |
$276 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$474 |
$790 |
2.1× |
| Foot 2 views (73620) |
$323.40 |
$539 |
3.9× |
| Forearm 2 views (73090) |
$408.60 |
$681 |
4.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$978 |
$1,630 |
1.9× |
| Gated Heart Planar Single (78472) |
$1,200.60 |
$2,001 |
3.1× |
| Hand 2 views (73120) |
$359.40 |
$599 |
3.6× |
| Hand 3 views (73130) |
$403.80 |
$673 |
4.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,269.80 |
$3,783 |
4.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,656.60 |
$2,761 |
4.3× |
| Ht muscle image spect sing (78451) |
$3,392.40 |
$5,654 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$294 |
$490 |
3.5× |
| Hysterosalpingogram (74740) |
$422.40 |
$704 |
1.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$122.40 |
$204 |
1.2× |
| Kidney imaging morphology (78700) |
$1,204.20 |
$2,007 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,618.20 |
$2,697 |
3.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,216.20 |
$2,027 |
2.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,554.80 |
$4,258 |
4.9× |
| Knee 3 views (73562) |
$387.60 |
$646 |
4.7× |
| Liver & spleen imaging static only (78215) |
$795.60 |
$1,326 |
2.1× |
| Lung perf&ventilat diferentl (78598) |
$309 |
$515 |
0.6× |
| Lung perfusion differential (78597) |
$201 |
$335 |
0.5× |
| Lung Ventilation Imaging (78579) |
$482.40 |
$804 |
1.3× |
| Lymphoscintigraphy (78195) |
$876.60 |
$1,461 |
1.7× |
| Meckels Diverticulum (78290) |
$196.80 |
$328 |
0.5× |
| MRA head w & w/o contrast (70546) |
$1,849.20 |
$3,082 |
5.5× |
| MRA head w/o contrast (70544) |
$994.20 |
$1,657 |
4.4× |
| MRA head with contrast (70545) |
$1,024.20 |
$1,707 |
3.1× |
| MRA neck w contrast (70548) |
$1,401.60 |
$2,336 |
4.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,056.20 |
$3,427 |
6.2× |
| MRA neck w/o contrast (70547) |
$1,335 |
$2,225 |
5.9× |
| MRI abdomen w contrast (74182) |
$3,910.20 |
$6,517 |
11.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,910.20 |
$6,517 |
11.7× |
| MRI abdomen w/o contrast (74181) |
$2,111.40 |
$3,519 |
9.3× |
| MRI any jnt lwr ext with con lt (73722) |
$8,023.80 |
$13,373 |
10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$7,704.60 |
$12,841 |
10.3× |
| MRI breast w/o contrast bilateral (77047) |
$844.80 |
$1,408 |
3.7× |
| MRI c-spine with contrast (72142) |
$5,466 |
$9,110 |
16.4× |
| MRI cardiac w/o contrast (75557) |
$238.20 |
$397 |
1.0× |
| MRI cervical spine w/o contrast (72141) |
$2,938.80 |
$4,898 |
12.9× |
| MRI chest w/o & w/contrast material (71552) |
$2,409.60 |
$4,016 |
7.2× |
| MRI chest w/o contrast (71550) |
$1,687.80 |
$2,813 |
7.4× |
| MRI chest with contrast (71551) |
$1,881 |
$3,135 |
2.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,755.80 |
$4,593 |
8.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,736.40 |
$2,894 |
5.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,705.20 |
$2,842 |
7.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,140 |
$1,900 |
5.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,111.40 |
$3,519 |
6.3× |
| MRI orbit/face/neck w/contrast (70542) |
$2,111.40 |
$3,519 |
6.3× |
| MRI pelvis w contrast (72196) |
$3,922.20 |
$6,537 |
11.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,922.20 |
$6,537 |
11.8× |
| MRI pelvis w/o contrast (72195) |
$2,118 |
$3,530 |
9.3× |
| MRI scan of arm joint before and after contrast (73223) |
$5,154.60 |
$8,591 |
15.5× |
| MRI scan of leg joint before and after contrast (73723) |
$5,368.20 |
$8,947 |
16.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,466 |
$9,110 |
16.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,040 |
$8,400 |
15.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,040 |
$8,400 |
15.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,371.40 |
$5,619 |
10.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,371.40 |
$5,619 |
10.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,820.40 |
$3,034 |
8.0× |
| MRI tmj (70336) |
$931.80 |
$1,553 |
4.1× |
| MRI upper ext joint w/o contrast (73221) |
$2,771.40 |
$4,619 |
12.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,755.80 |
$4,593 |
8.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,488 |
$2,480 |
6.5× |
| Myelogram Cervical (72240) |
$481.80 |
$803 |
0.6× |
| Myelogram Lumbar (72265) |
$828.60 |
$1,381 |
1.1× |
| Myelogram thoracic (72255) |
$365.40 |
$609 |
0.5× |
| Myocardial Spect Multiple Studies (78452) |
$4,087.80 |
$6,813 |
3.3× |
| Neck soft tissue (70360) |
$289.20 |
$482 |
3.5× |
| Nm cisternogram (78630) |
$454.80 |
$758 |
0.9× |
| Nm gastric emptying study (78264) |
$1,462.20 |
$2,437 |
3.8× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$4,349.40 |
$7,249 |
3.2× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$978 |
$1,630 |
2.6× |
| Nuclear Rx Oral Admin (79005) |
$1,336.80 |
$2,228 |
6.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$508.20 |
$847 |
5.1× |
| Osseous survey infant (77076) |
$427.80 |
$713 |
4.3× |
| Osseous survey limited (77074) |
$288 |
$480 |
2.9× |
| Parathyrd planar w/wo subtrj (78071) |
$537 |
$895 |
1.4× |
| Parathyroid imaging (78070) |
$385.20 |
$642 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$214.80 |
$358 |
2.1× |
| PET image w/CT, skull-thigh (78815) |
$4,296 |
$7,160 |
3.1× |
| PET imaging CT for attenuation limited area (78814) |
$4,768.20 |
$7,947 |
3.5× |
| PET imaging for CT attenuation whole body (78816) |
$4,296 |
$7,160 |
3.1× |
| PET imaging limited area chest head/neck (78811) |
$2,558.40 |
$4,264 |
2.1× |
| PET whole body (78813) |
$4,221.60 |
$7,036 |
3.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,157.20 |
$5,262 |
9.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$612 |
$1,020 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$861.60 |
$1,436 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$192.60 |
$321 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$253.20 |
$422 |
3.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$408.60 |
$681 |
4.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$310.20 |
$517 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$289.80 |
$483 |
2.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$253.80 |
$423 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$350.40 |
$584 |
3.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$232.20 |
$387 |
2.8× |
| Radiologic exam colon single contrast study (74270) |
$590.40 |
$984 |
3.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$452.40 |
$754 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$728.40 |
$1,214 |
4.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$333 |
$555 |
2.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$225 |
$375 |
2.7× |
| Radiological examination surgical specimen (76098) |
$745.80 |
$1,243 |
1.4× |
| Ribs bilateral 3 views (71110) |
$382.20 |
$637 |
3.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,023.80 |
$3,373 |
3.9× |
| Scanogram (77073) |
$52.20 |
$87 |
0.5× |
| Scapula complete (73010) |
$238.80 |
$398 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$69.60 |
$116 |
3.0× |
| Sialogram (70390) |
$192.60 |
$321 |
0.8× |
| Small bowel series (74250) |
$469.20 |
$782 |
2.8× |
| Spine thoracic 3 views (72072) |
$221.40 |
$369 |
2.2× |
| Therapeutic Enema (74283) |
$232.80 |
$388 |
1.4× |
| Thoracolumbar 2 views (72080) |
$70.80 |
$118 |
0.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,303.20 |
$2,172 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$899.40 |
$1,499 |
2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,124.40 |
$1,874 |
2.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,011.60 |
$1,686 |
1.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$963.60 |
$1,606 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$730.80 |
$1,218 |
7.3× |
| Umbilical-artery Doppler (OB) (76820) |
$268.80 |
$448 |
2.7× |
| Upper Extremity Infant (73092) |
$122.40 |
$204 |
1.2× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$252.60 |
$421 |
0.7× |
| Urethrocystography retrograde rs&i (74450) |
$156 |
$260 |
0.7× |
| Urethrocystography voiding (74455) |
$190.20 |
$317 |
0.8× |
| Us abdl aorta screen aaa (76706) |
$143.40 |
$239 |
1.4× |
| Us breast unilateral complete (76641) |
$696 |
$1,160 |
7.0× |
| Us breast unilateral limited (76642) |
$570.60 |
$951 |
6.9× |
| Us chest (76604) |
$424.80 |
$708 |
4.3× |
| Us compl joint r-t w/image documentation (76881) |
$546.60 |
$911 |
5.5× |
| Us infant hips dynamic (76885) |
$124.80 |
$208 |
1.5× |
| Us infant hips limited static (76886) |
$91.20 |
$152 |
1.1× |
| Us kidney transplant (76776) |
$133.20 |
$222 |
1.3× |
| Us ob detailed single fetus (76811) |
$385.20 |
$642 |
1.7× |
| Us ob transvaginal (76817) |
$416.40 |
$694 |
4.2× |
| Us pelvic non ob complete (76856) |
$817.80 |
$1,363 |
8.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$515.40 |
$859 |
5.2× |
| Us pregnancy ltd (76815) |
$375 |
$625 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$440.40 |
$734 |
4.4× |
| Us retroperitoneal complete (76770) |
$736.80 |
$1,228 |
7.4× |
| Us retroperitoneal limited (76775) |
$375.60 |
$626 |
3.8× |
| Us scrotum and contents (76870) |
$632.40 |
$1,054 |
6.3× |
| Us soft tissue head/neck (76536) |
$627 |
$1,045 |
6.3× |
| Us spinal canal and contents (76800) |
$132 |
$220 |
1.3× |
| Us xtr non-vasc lmtd (76882) |
$248.40 |
$414 |
2.5× |
| Venogram extremity bilateral (75822) |
$1,452 |
$2,420 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,022.20 |
$5,037 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$561 |
$935 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$2,142.60 |
$3,571 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$328.20 |
$547 |
3.9× |
| Wrist 2 views (73100) |
$382.20 |
$637 |
4.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$487.20 |
$812 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$159 |
$265 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$391.80 |
$653 |
4.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$831.60 |
$1,386 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$339.60 |
$566 |
4.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$394.80 |
$658 |
4.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$494.40 |
$824 |
4.9× |
| X-ray exam hip uni 1 view (73501) |
$247.20 |
$412 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$271.80 |
$453 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$402.60 |
$671 |
4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$465 |
$775 |
4.7× |
| X-ray exam of femur 1 (73551) |
$240.60 |
$401 |
2.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$469.20 |
$782 |
2.8× |
| X-ray eye for foreign body (70030) |
$70.80 |
$118 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$206.40 |
$344 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$146.40 |
$244 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$363.60 |
$606 |
4.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$222 |
$370 |
2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$52.20 |
$87 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$430.20 |
$717 |
4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$283.80 |
$473 |
3.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$70.80 |
$118 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$415.80 |
$693 |
4.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$856.20 |
$1,427 |
8.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$565.20 |
$942 |
5.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$373.20 |
$622 |
4.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$147.60 |
$246 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$129.60 |
$216 |
1.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$255.60 |
$426 |
2.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$156 |
$260 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$318.60 |
$531 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$293.40 |
$489 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$449.40 |
$749 |
4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$403.20 |
$672 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$348 |
$580 |
4.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$415.80 |
$693 |
5.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$200.40 |
$334 |
2.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$157.80 |
$263 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$316.80 |
$528 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$247.80 |
$413 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$70.80 |
$118 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$131.40 |
$219 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$107.40 |
$179 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$173.40 |
$289 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$97.20 |
$162 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$424.80 |
$708 |
5.1× |
| Xr c-spine 6 or more views (72052) |
$730.80 |
$1,218 |
7.3× |
| Xr chest 4+ views (71048) |
$318.60 |
$531 |
3.2× |
| Xr finger(s) 2+ views (73140) |
$185.40 |
$309 |
2.2× |
| Xr shoulder 1 view (73020) |
$324 |
$540 |
3.9× |
| Xr spine cervical 4 or 5 views (72050) |
$589.20 |
$982 |
5.9× |
| Xr tibia/fibula 2 views (73590) |
$381 |
$635 |
4.6× |
| Xr tmj bilateral (70330) |
$34.80 |
$58 |
0.4× |
| Xray knee 1 or 2 views rt (73560) |
$340.20 |
$567 |
4.1× |