| Abdomen 2 views (74019) |
$271.50 |
$271.50 |
2.2× |
| Acute gi blood loss imaging (78278) |
$599 |
$599 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$4,231 |
$4,231 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,650 |
$3,650 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,231 |
$4,231 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,231 |
$4,231 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,231 |
$4,231 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$7,960 |
$7,960 |
1.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,759 |
$2,759 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,156 |
$2,156 |
0.6× |
| Ankle 2 views (73600) |
$260 |
$260 |
2.5× |
| Aortogram thoracic (75605) |
$4,231 |
$4,231 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,759 |
$2,759 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$4,231 |
$4,231 |
1.1× |
| Arthrogram ankle (73615) |
$670 |
$670 |
1.6× |
| Arthrogram elbow (73085) |
$274 |
$274 |
0.7× |
| Arthrogram hip (73525) |
$695 |
$695 |
1.7× |
| Arthrogram knee (73580) |
$470 |
$470 |
1.1× |
| Arthrogram shoulder (73040) |
$750 |
$750 |
1.8× |
| Arthrogram wrist (73115) |
$730 |
$730 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$682 |
$682 |
1.4× |
| Bone age studies (77072) |
$127 |
$127 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$772 |
$772 |
1.6× |
| Bone survey complete (77075) |
$209 |
$209 |
1.7× |
| Bone survey infant (77076) |
$210 |
$210 |
1.7× |
| Bowel imaging (78290) |
$670 |
$670 |
1.4× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$600 |
$600 |
1.3× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$660 |
$660 |
1.4× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$956 |
$956 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$956 |
$956 |
2.3× |
| Cervical spine 2 or 3 views (72040) |
$247 |
$247 |
2.4× |
| Chest 1 view (71045) |
$625 |
$625 |
6.0× |
| Chest xray 3 views (71047) |
$230 |
$230 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$452 |
$452 |
2.2× |
| Clavicle complete (73000) |
$288 |
$288 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$850 |
$850 |
6.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,825 |
$3,825 |
9.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,085 |
$3,085 |
10.8× |
| CT abdomen w contrast (74160) |
$2,467 |
$2,467 |
11.7× |
| CT abdomen w wo contrast (74170) |
$2,467 |
$2,467 |
11.7× |
| CT abdomen w/o contrast (74150) |
$2,138 |
$2,138 |
17.1× |
| CT angio hrt w/3d image (75574) |
$600 |
$600 |
1.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$915 |
$915 |
4.4× |
| CT angiography upper extremity lt (73206) |
$607 |
$607 |
2.9× |
| CT c-spine w/contrast (72126) |
$842 |
$842 |
2.0× |
| CT c-spine w/o contrast (72125) |
$1,973 |
$1,973 |
15.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,020 |
$1,020 |
4.9× |
| CT chest w contrast (71260) |
$2,138 |
$2,138 |
10.2× |
| CT chest w/wo contrast (71270) |
$1,343 |
$1,343 |
6.4× |
| CT colonography screening (74263) |
$400 |
$400 |
1.4× |
| CT colonography w/dye (74262) |
$675 |
$675 |
3.2× |
| CT head/brain with contrast (70460) |
$902 |
$902 |
4.3× |
| CT head/brain without and with contrast (70470) |
$1,898 |
$1,898 |
9.0× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$68 |
$68 |
0.7× |
| CT iac w contrast (70481) |
$685 |
$685 |
3.3× |
| CT limited/localized follow up study (76380) |
$153 |
$153 |
1.5× |
| CT lower ext w/o (73700) |
$1,973 |
$1,973 |
15.7× |
| CT lower extremity w/contrast material (73701) |
$937 |
$937 |
4.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,020 |
$1,020 |
4.9× |
| CT lumbar spine w/contrast (72132) |
$842 |
$842 |
2.0× |
| CT lumbar spine w/o contrast (72131) |
$937 |
$937 |
7.5× |
| CT maxillofacial w contrast (70487) |
$929 |
$929 |
4.4× |
| CT maxillofacial w/wo contrast (70488) |
$868 |
$868 |
4.1× |
| CT maxillofacial wo contrast (70486) |
$1,809 |
$1,809 |
14.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$810 |
$810 |
3.9× |
| CT orbits w/o contrast (70480) |
$807 |
$807 |
6.4× |
| CT pelvis w/o contrast (72192) |
$1,973 |
$1,973 |
15.7× |
| CT pelvis w/wo contrast (72194) |
$2,467 |
$2,467 |
11.7× |
| CT scan of arm combo (73202) |
$875 |
$875 |
4.2× |
| CT soft tissue neck w contrast (70491) |
$2,138 |
$2,138 |
10.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,133 |
$1,133 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$807 |
$807 |
6.4× |
| CT thoracic spine w/contrast (72129) |
$842 |
$842 |
4.0× |
| CT thoracic spine w/o contrast (72128) |
$721 |
$721 |
5.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,020 |
$1,020 |
4.9× |
| CT thorax w/o contrast (71250) |
$1,661 |
$1,661 |
13.3× |
| CT unlisted procedure (76497) |
$4,746 |
$4,746 |
45.5× |
| CT upper ext wo (73200) |
$806 |
$806 |
6.4× |
| CT upper extremity with contrast (73201) |
$937 |
$937 |
2.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$850 |
$850 |
4.0× |
| Cta Abdomen (74175) |
$890 |
$890 |
4.2× |
| CTA abdomen pelvis (74174) |
$2,900 |
$2,900 |
6.9× |
| CTA chest (71275) |
$2,625 |
$2,625 |
12.5× |
| Cta Head (70496) |
$825 |
$825 |
3.9× |
| Cta Neck (70498) |
$850 |
$850 |
4.0× |
| Cta Pelvis (72191) |
$789 |
$789 |
3.8× |
| Cystography minimum 3 views rs&i (74430) |
$310 |
$310 |
0.7× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$786 |
$786 |
0.3× |
| Diskogram cervical (72285) |
$2,957 |
$2,957 |
1.3× |
| Diskography lumbar (72295) |
$2,342 |
$2,342 |
1.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$209 |
$209 |
1.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$845 |
$845 |
6.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$220 |
$220 |
2.1× |
| Dxa bone density study axial skeleton (77085) |
$845 |
$845 |
6.7× |
| Esophagus (74220) |
$1,350 |
$1,350 |
6.4× |
| Facial bones min 3 views (70150) |
$382 |
$382 |
3.0× |
| Fetal biophysical profile non-stress testing (76818) |
$255 |
$255 |
2.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$840 |
$840 |
6.7× |
| Fluoroscopy up to 1 hr (76000) |
$370 |
$370 |
1.3× |
| Foot 2 views (73620) |
$113 |
$113 |
1.1× |
| Forearm 2 views (73090) |
$279 |
$279 |
2.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$640 |
$640 |
1.3× |
| Hand 2 views (73120) |
$278 |
$278 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$440 |
$440 |
0.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$780 |
$780 |
1.6× |
| Hysterosalpingogram (74740) |
$675 |
$675 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$722 |
$722 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$798 |
$798 |
1.2× |
| Knee 3 views (73562) |
$700 |
$700 |
6.7× |
| Liver & spleen imaging static only (78215) |
$550 |
$550 |
1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$484 |
$484 |
1.0× |
| Lung perf&ventilat diferentl (78598) |
$475 |
$475 |
0.7× |
| Lung perfusion differential (78597) |
$304 |
$304 |
0.6× |
| Lymphoscintigraphy (78195) |
$682 |
$682 |
1.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,467 |
$2,467 |
2.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,392 |
$1,392 |
3.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,404 |
$2,404 |
5.7× |
| Mammary ductogram or galactogram single (77053) |
$396.50 |
$396.50 |
1.4× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$370 |
$370 |
3.5× |
| Mr safety determination physician/other qhp (76016) |
$132 |
$132 |
1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$38 |
$38 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$138 |
$138 |
1.2× |
| Mr safety implt pos&/immoblj (76019) |
$89 |
$89 |
1.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$363 |
$363 |
1.3× |
| MRA head w & w/o contrast (70546) |
$2,530 |
$2,530 |
6.1× |
| MRA head w/o contrast (70544) |
$2,960 |
$2,960 |
10.4× |
| MRA head with contrast (70545) |
$1,392 |
$1,392 |
3.3× |
| MRA neck w contrast (70548) |
$1,392 |
$1,392 |
3.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,289 |
$3,289 |
7.9× |
| MRA neck w/o contrast (70547) |
$2,960 |
$2,960 |
10.4× |
| MRI abdomen w contrast (74182) |
$1,512 |
$1,512 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,767 |
$3,767 |
9.0× |
| MRI abdomen w/o contrast (74181) |
$2,294 |
$2,294 |
8.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,467 |
$2,467 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,125 |
$3,125 |
7.5× |
| MRI breast w/o contrast bilateral (77047) |
$2,795 |
$2,795 |
9.8× |
| MRI c-spine with contrast (72142) |
$2,016 |
$2,016 |
4.8× |
| MRI cardiac w/o cont stress (75559) |
$956 |
$956 |
1.5× |
| MRI cardiac w/o contrast (75557) |
$956 |
$956 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$2,867 |
$2,867 |
10.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,530 |
$2,530 |
6.1× |
| MRI chest w/o contrast (71550) |
$1,603 |
$1,603 |
5.6× |
| MRI chest with contrast (71551) |
$1,708 |
$1,708 |
1.8× |
| MRI fetal sngl/1st gestation (74712) |
$410 |
$410 |
1.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,500 |
$2,500 |
6.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,404 |
$2,404 |
5.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,603 |
$1,603 |
5.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,518 |
$1,518 |
5.3× |
| MRI orbit face neck w contrast (70542) |
$1,708 |
$1,708 |
4.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,371 |
$3,371 |
8.1× |
| MRI pelvis w/contrast (72196) |
$1,328 |
$1,328 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,289 |
$3,289 |
7.9× |
| MRI pelvis w/o contrast (72195) |
$2,338 |
$2,338 |
8.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,478 |
$3,478 |
8.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,993 |
$1,993 |
4.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,453 |
$3,453 |
8.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,015 |
$2,015 |
4.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,478 |
$3,478 |
8.3× |
| MRI temporomandibular joint (70336) |
$1,603 |
$1,603 |
5.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,867 |
$2,867 |
10.0× |
| MRI up ext w/o contrast (73218) |
$1,576 |
$1,576 |
5.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,603 |
$1,603 |
5.6× |
| MRI, joint upper extrem combo (73223) |
$3,125 |
$3,125 |
7.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,800 |
$1,800 |
1.2× |
| Myocardial spect single study at rest or stress (78451) |
$7,425 |
$7,425 |
4.8× |
| N-invas est c ffr sw aly CTA (75580) |
$1,715 |
$1,715 |
1.7× |
| Neck soft tissue (70360) |
$288 |
$288 |
2.8× |
| Nm adrenal scan (78075) |
$2,067 |
$2,067 |
1.3× |
| Nm csf leak detection (78650) |
$223 |
$223 |
0.1× |
| Nm gastric emptying study (78264) |
$2,900 |
$2,900 |
6.1× |
| Nm kidney scan w/flow (78701) |
$650 |
$650 |
1.4× |
| Nm red cell sequestration (78140) |
$601 |
$601 |
1.3× |
| Nuclear Rx Oral Admin (79005) |
$527 |
$527 |
1.9× |
| Ob us nuchal meas 1 gest (76813) |
$182 |
$182 |
1.5× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) |
$265 |
$265 |
2.1× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$108 |
$108 |
3.1× |
| Parathyroid Planar Imaging (78070) |
$2,900 |
$2,900 |
6.1× |
| Pelvis 1 or 2 views (72170) |
$840 |
$840 |
6.7× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$2,575 |
$2,575 |
1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$580 |
$580 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$475 |
$475 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$190 |
$190 |
0.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$321 |
$321 |
3.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$263 |
$263 |
2.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$283 |
$283 |
2.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$321 |
$321 |
3.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$580 |
$580 |
4.6× |
| Radex fingr minimum 2 views (73140) |
$279 |
$279 |
2.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$400 |
$400 |
3.8× |
| Radex Hand Minimum 3 Views (73130) |
$312 |
$312 |
3.0× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$321 |
$321 |
3.1× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$197 |
$197 |
1.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$800 |
$800 |
6.4× |
| Radex Humerus Minimum 2 Views (73060) |
$279 |
$279 |
2.7× |
| Radex Kne 1/2 Views (73560) |
$625 |
$625 |
6.0× |
| Radex Kne Compl 4/More Views (73564) |
$288 |
$288 |
2.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$358 |
$358 |
2.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$329 |
$329 |
3.2× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$269 |
$269 |
2.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$625 |
$625 |
6.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$370 |
$370 |
3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$190 |
$190 |
1.8× |
| Radex Toe Minimum 2 Views (73660) |
$270 |
$270 |
2.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$206 |
$206 |
1.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$294 |
$294 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$400 |
$400 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$197 |
$197 |
1.6× |
| Radiologic exam chest 2 views (71046) |
$625 |
$625 |
6.0× |
| Radiologic exam colon single contrast study (74270) |
$699 |
$699 |
3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,385 |
$1,385 |
6.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,385 |
$1,385 |
6.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$288 |
$288 |
1.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$298 |
$298 |
2.9× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$222 |
$222 |
1.8× |
| Radiological examination surgical specimen (76098) |
$675 |
$675 |
1.0× |
| Ribs bilateral 3 views (71110) |
$90 |
$90 |
0.7× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$590 |
$590 |
1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,100 |
$1,100 |
1.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$647 |
$647 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,172 |
$1,172 |
1.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$791 |
$791 |
2.8× |
| Scapula (73010) |
$206 |
$206 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$185 |
$185 |
7.9× |
| Shoulder 1 view (73020) |
$90 |
$90 |
0.9× |
| Sialogram (70390) |
$223 |
$223 |
0.8× |
| Small bowel series (74250) |
$288 |
$288 |
1.4× |
| Spine thoracic 3 views (72072) |
$140 |
$140 |
1.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$576 |
$576 |
0.9× |
| Thyroid imaging w/blood flow (78013) |
$576 |
$576 |
1.2× |
| Thyroid uptake measurement (78012) |
$206 |
$206 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$570 |
$570 |
1.2× |
| Ultrasound Exam Aaa Screen (76706) |
$840 |
$840 |
6.7× |
| Ultrasound, abdomen limited (76705) |
$550 |
$550 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$209 |
$209 |
1.7× |
| Unlisted ultrasound procedure (76999) |
$4,870.60 |
$4,870.60 |
46.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$310 |
$310 |
28.0× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$599 |
$599 |
6.3× |
| Urethrocystogram voiding (74455) |
$410 |
$410 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$544 |
$544 |
1.9× |
| Us breast unilateral limited (76642) |
$780 |
$780 |
7.5× |
| Us chest (76604) |
$596 |
$596 |
4.8× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$248 |
$248 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$580 |
$580 |
4.6× |
| Us elastography parenchyma (76981) |
$414 |
$414 |
3.3× |
| Us encephalogram (76506) |
$284 |
$284 |
2.3× |
| Us hips infant static (76886) |
$214 |
$214 |
2.1× |
| Us infant hips w manipulation (76885) |
$275 |
$275 |
2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$165 |
$165 |
1.3× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$189 |
$189 |
1.5× |
| Us ob detailed single fetus (76811) |
$410 |
$410 |
1.4× |
| Us ob limited (76815) |
$840 |
$840 |
6.7× |
| Us ob transvaginal (76817) |
$840 |
$840 |
6.7× |
| Us pelvic non ob complete (76856) |
$798 |
$798 |
6.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$275 |
$275 |
2.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$845 |
$845 |
6.7× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$840 |
$840 |
6.7× |
| Us retroperitoneal complete (76770) |
$658 |
$658 |
5.3× |
| Us retroperitoneal limited (76775) |
$291 |
$291 |
2.3× |
| Us scrotum and contents (76870) |
$576 |
$576 |
4.6× |
| Us soft tissue head/neck (76536) |
$802 |
$802 |
6.4× |
| Us spinal canal and contents (76800) |
$268 |
$268 |
2.1× |
| Us transrectal (76872) |
$412 |
$412 |
3.3× |
| Us, eye b-scan (76512) |
$451 |
$451 |
3.6× |
| Us,transplanted kidney, real time/ doppler (76776) |
$268 |
$268 |
2.1× |
| Venogram extremity bilateral (75822) |
$2,446 |
$2,446 |
1.3× |
| Venogram Extremity Unilateral (75820) |
$600 |
$600 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,840 |
$1,840 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$920 |
$920 |
0.5× |
| Venography Renal Bilateral (75833) |
$4,231 |
$4,231 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$4,231 |
$4,231 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$110 |
$110 |
1.1× |
| Wrist 2 views (73100) |
$273 |
$273 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$121 |
$121 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$736 |
$736 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$247 |
$247 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$625 |
$625 |
6.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$197 |
$197 |
1.6× |
| X-ray exam of femur 2/> (73552) |
$296 |
$296 |
2.8× |
| X-ray eye for foreign body (70030) |
$120 |
$120 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$329 |
$329 |
3.2× |
| X-ray leg, infant (73592) |
$190 |
$190 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$840 |
$840 |
6.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$210 |
$210 |
1.7× |
| X-ray nose-rectum child f.b. (76010) |
$247 |
$247 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$164 |
$164 |
1.3× |
| X-ray retrograde pyelogram (74420) |
$301 |
$301 |
0.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$288 |
$288 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$390 |
$390 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$288 |
$288 |
2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$115 |
$115 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$247 |
$247 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$195 |
$195 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$288 |
$288 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$288 |
$288 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$247 |
$247 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$206 |
$206 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$206 |
$206 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$319 |
$319 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$150 |
$150 |
1.2× |
| Xr bone length studies (77073) |
$210 |
$210 |
1.7× |
| Xr c-spine 4 or 5 views (72050) |
$621.48 |
$621.48 |
5.0× |
| Xr c-spine 6 or more views (72052) |
$850 |
$850 |
6.8× |
| Xr chest 4+ views (71048) |
$230 |
$230 |
1.8× |
| Xr urogram antegrade (74425) |
$258 |
$258 |
0.6× |