| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,915.50 |
$6,385 |
1.1× |
| Abdomen 1 View (74018) |
— |
$187.40 |
— |
| Abdomen 2 views (74019) |
— |
$204 |
— |
| Ankle 2 views (73600) |
$18 |
$60 |
0.2× |
| Arthrogram hip (73525) |
$180.69 |
$602.30 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$199.50 |
$665 |
1.2× |
| Bone age studies (77072) |
$177.71 |
$592.35 |
1.4× |
| Bone survey infant (77076) |
$167.70 |
$559 |
1.3× |
| Brachytx isodose complex (77318) |
$699 |
$2,330 |
1.5× |
| Brachytx isodose intermed (77317) |
$622.50 |
$2,075 |
1.3× |
| Brachytx Isodose Plan Simple (77316) |
$579 |
$1,930 |
1.2× |
| Cat Scan Follow-Up Study (76380) |
$718.11 |
$2,393.70 |
6.6× |
| Chest 1 view (71045) |
$82.97 |
$276.55 |
0.8× |
| Chest 2 views (71046) |
$65.28 |
$217.60 |
0.6× |
| Chest 3 views (71047) |
$45 |
$150 |
0.4× |
| Chest 4 or more views (71048) |
$91.61 |
$305.35 |
0.7× |
| Cholecystography Oral Contrast (74290) |
— |
$343.40 |
— |
| Clavicle complete (73000) |
$64.49 |
$214.95 |
0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$164.97 |
$549.89 |
1.3× |
| Continuing medical physics consltj pr wk (77336) |
$211.50 |
$705 |
1.3× |
| Contrast X-Ray Bladder (74430) |
$113.75 |
$379.16 |
0.3× |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$3,640.80 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$2,744.20 |
— |
| CT abdomen w contrast (74160) |
— |
$1,615.10 |
— |
| CT abdomen w wo contrast (74170) |
— |
$1,936.15 |
— |
| CT abdomen w/o contrast (74150) |
— |
$1,420.70 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$2,576 |
— |
| CT Angio Chest (71275) |
$805.50 |
$2,685 |
3.7× |
| CT Angio Head (70496) |
$819.66 |
$2,732.20 |
3.7× |
| CT angio hrt w/3d image (75574) |
$798.60 |
$2,662 |
1.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$553.50 |
$1,845 |
2.5× |
| CT Angio Neck (70498) |
$874.05 |
$2,913.50 |
4.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$642.75 |
$2,142.50 |
2.9× |
| CT cervical spine w/ contrast (72126) |
$514.80 |
$1,716 |
1.2× |
| CT cervical spine w/o contrast (72125) |
$457.80 |
$1,526 |
3.5× |
| CT cervical spine w/wo cont (72127) |
$610.98 |
$2,036.60 |
2.8× |
| CT chest w contrast (71260) |
$528.60 |
$1,762 |
2.4× |
| CT chest w/wo contrast (71270) |
$654.30 |
$2,181 |
3.0× |
| CT colonography screening (74263) |
— |
$1,838 |
— |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
— |
$1,307 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$1,351 |
— |
| CT head/brain with contrast (70460) |
$526.46 |
$1,754.85 |
2.4× |
| CT head/brain without and with contrast (70470) |
$636 |
$2,120 |
2.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$259.50 |
$865 |
0.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$25.50 |
$85 |
0.2× |
| CT hrt w/3d image congen (75573) |
$277.50 |
$925 |
0.6× |
| CT iac w contrast (70481) |
$477.65 |
$1,592.15 |
2.2× |
| CT l-spine w&w/o contrast (72133) |
$610.98 |
$2,036.60 |
2.8× |
| CT lower ext w/o (73700) |
$374.40 |
$1,248 |
2.9× |
| CT lower extremity w/contrast material (73701) |
$448.49 |
$1,494.95 |
2.0× |
| CT lumbar spine w contrast (72132) |
$508.44 |
$1,694.80 |
1.2× |
| CT lumbar spine w/o contrast (72131) |
$442.59 |
$1,475.30 |
3.4× |
| CT maxillofacial w contrast (70487) |
$434.73 |
$1,449.10 |
2.0× |
| CT maxillofacial wo contrast (70486) |
$429.17 |
$1,430.55 |
3.3× |
| CT neck tissue combo (70492) |
$535.64 |
$1,785.45 |
2.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$535.64 |
$1,785.45 |
2.4× |
| CT orbits w/o contrast (70480) |
$415.08 |
$1,383.60 |
3.2× |
| CT pelvis w&w/o contrast (72194) |
$511.40 |
$1,704.65 |
2.3× |
| CT pelvis w/o contrast (72192) |
$397.05 |
$1,323.50 |
3.0× |
| CT scan of leg combo (73702) |
$547.50 |
$1,825 |
2.5× |
| CT scans face/jaw combo (70488) |
$521.55 |
$1,738.50 |
2.4× |
| CT soft tissue neck w contrast (70491) |
$535.20 |
$1,784 |
2.4× |
| CT soft tissue neck w/o contrast (70490) |
$476.01 |
$1,586.70 |
3.6× |
| CT thoracic spine w contrast (72129) |
$508.44 |
$1,694.80 |
2.3× |
| CT thoracic spine w/o contrast (72128) |
$442.59 |
$1,475.30 |
3.4× |
| CT thoracic spine w/wo cont (72130) |
$610.98 |
$2,036.60 |
2.8× |
| CT thorax w/o contrast (71250) |
$478.20 |
$1,594 |
3.7× |
| CT upper ext wo (73200) |
$394.44 |
$1,314.80 |
3.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$586.20 |
$1,954 |
2.7× |
| CT upper extremity with contrast (73201) |
$435.39 |
$1,451.30 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,275.36 |
$4,251.20 |
5.8× |
| Cta Abdomen (74175) |
— |
$3,117.70 |
— |
| CTA pelvis (72191) |
$912.71 |
$3,042.35 |
4.2× |
| Dilation ureters/urethra rs&i (74485) |
$304.68 |
$1,015.60 |
0.1× |
| Dxa Bone Density Axial (77080) |
$267.60 |
$892 |
2.1× |
| Dxa bone density study (77085) |
$249 |
$830 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$62.40 |
$208 |
0.6× |
| Echo exam uterus (76831) |
$188.70 |
$629 |
0.6× |
| Echo Guide For Artery Repair (76936) |
$543.90 |
$1,813 |
2.0× |
| Echograp Trans R Pros Study (76873) |
$244.80 |
$816 |
1.9× |
| Esophagram (74220) |
— |
$382.70 |
— |
| Fetal Biophys Profile W/Nst (76818) |
$120.60 |
$402 |
0.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$86.40 |
$288 |
0.7× |
| Fluoroscopy up to 1 hr (76000) |
$108.60 |
$362 |
0.4× |
| Foot 2 views (73620) |
$16.50 |
$55 |
0.2× |
| Forearm 2 views (73090) |
$63.32 |
$211.05 |
0.6× |
| Hand 2 views (73120) |
$56.33 |
$187.75 |
0.4× |
| Hysterosalpingogram (74740) |
$145.50 |
$485 |
0.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$159.60 |
$532 |
1.5× |
| Infant hip ultrasound, limited static exam (76886) |
$159.60 |
$532 |
1.5× |
| Infusion Ivp (74410) |
$193.80 |
$646 |
0.9× |
| Interstitial radiation source applic complex (77778) |
$899.40 |
$2,998 |
1.0× |
| Knee 3 Views (73562) |
$35.70 |
$119 |
0.3× |
| Magnetic Image Jaw Joint (70336) |
$697.50 |
$2,325 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$167.09 |
$556.95 |
0.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$706.50 |
$2,355 |
1.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,471.50 |
$4,905 |
3.4× |
| MRA head w/o contrast (70544) |
$1,085.40 |
$3,618 |
3.6× |
| MRA head with contrast (70545) |
$1,150.80 |
$3,836 |
2.6× |
| MRA neck w contrast (70548) |
$1,147.80 |
$3,826 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,471.50 |
$4,905 |
3.4× |
| MRA neck w/o contrast (70547) |
$1,004.40 |
$3,348 |
3.4× |
| MRI abdomen w contrast (74182) |
— |
$2,920 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$2,518 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
$845.40 |
$2,818 |
0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,296.90 |
$4,323 |
3.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$858 |
$2,860 |
0.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$530.40 |
$1,768 |
1.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$517.20 |
$1,724 |
1.7× |
| MRI cervical spine w contrast (72142) |
$821.70 |
$2,739 |
1.9× |
| MRI cervical spine w/o cont (72141) |
$819.60 |
$2,732 |
2.8× |
| MRI chest w/o contrast (71550) |
$808.50 |
$2,695 |
2.7× |
| MRI chest with contrast (71551) |
$679.80 |
$2,266 |
0.7× |
| MRI chest wo w contrast (71552) |
$1,307.10 |
$4,357 |
3.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$774.60 |
$2,582 |
1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,320 |
$4,400 |
3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$958.50 |
$3,195 |
3.2× |
| MRI lumbar spine w contrast (72149) |
$840.30 |
$2,801 |
1.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,138.50 |
$3,795 |
2.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,135.80 |
$3,786 |
3.8× |
| MRI orbit face neck w contrast (70542) |
$1,318.20 |
$4,394 |
3.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,756.50 |
$5,855 |
4.0× |
| MRI pelvis w contrast (72196) |
$780.30 |
$2,601 |
1.8× |
| MRI pelvis w/o & w contrast (72197) |
$1,149.60 |
$3,832 |
2.6× |
| MRI pelvis w/o contrast (72195) |
$817.80 |
$2,726 |
2.7× |
| MRI thoracic spine w/o contrast (72146) |
$869.70 |
$2,899 |
2.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$784.20 |
$2,614 |
1.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$688.80 |
$2,296 |
2.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$990.90 |
$3,303 |
2.3× |
| MRI, abdomen, combo (74183) |
— |
$4,055 |
— |
| MRI, dorsal spine combo (72157) |
$1,199.40 |
$3,998 |
2.8× |
| MRI, dorsal spine contrast (72147) |
$805.20 |
$2,684 |
1.8× |
| MRI, joint upper extrem (73221) |
$805.98 |
$2,686.60 |
2.7× |
| MRI, joint upper extrem combo (73223) |
$1,111.80 |
$3,706 |
2.6× |
| MRI, lumbar spine combo (72158) |
$1,197.60 |
$3,992 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$199.50 |
$665 |
0.1× |
| Neck soft tissue (70360) |
$62.91 |
$209.70 |
0.6× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$541.50 |
$1,805 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,671.50 |
$8,905 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$348 |
$1,160 |
1.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$171.30 |
$571 |
1.3× |
| Optic foramina (70190) |
$91.61 |
$305.35 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$65.40 |
$218 |
0.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$335.50 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$149.21 |
$497.38 |
0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$62.76 |
$209.20 |
0.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$16.50 |
$55 |
0.2× |
| Radex elbow complete minimum 3 views (73080) |
$51.30 |
$171 |
0.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$99.08 |
$330.25 |
0.8× |
| Radex fingr minimum 2 views (73140) |
$42.72 |
$142.40 |
0.4× |
| Radex foot complete minimum 3 views (73630) |
$65.28 |
$217.60 |
0.6× |
| Radex Hand Minimum 3 Views (73130) |
$62.76 |
$209.20 |
0.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$41.40 |
$138 |
0.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$94.76 |
$315.85 |
0.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$58.59 |
$195.30 |
0.5× |
| Radex shoulder complete minimum 2 views (73030) |
$58.20 |
$194 |
0.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$55.85 |
$186.15 |
0.5× |
| Radex Spine 1 View Specify Level (72020) |
$15 |
$50 |
0.1× |
| Radex Sternum Minimum 2 Views (71120) |
$59.78 |
$199.25 |
0.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$120.32 |
$401.05 |
1.1× |
| Radex Toe Minimum 2 Views (73660) |
$16.50 |
$55 |
0.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$41.40 |
$138 |
0.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$24 |
$80 |
0.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$158.45 |
$528.15 |
1.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$9,688.50 |
$32,295 |
1.1× |
| Radiation treatment delivery level 1 (77402) |
$132 |
$440 |
1.0× |
| Radiation treatment delivery level 2 (77407) |
$316.50 |
$1,055 |
0.7× |
| Radiation treatment delivery level 3 (77412) |
$316.50 |
$1,055 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$84.93 |
$283.10 |
0.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$111.19 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$786.25 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$600.20 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$699 |
— |
| Radiologic exam knee complete 4/more views (73564) |
$84.60 |
$282 |
0.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$79.43 |
$264.75 |
0.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$425.90 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$269 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$530 |
— |
| Radiologic examination femur 1 view (73551) |
$16.50 |
$55 |
0.2× |
| Radiologic examination femur minimum 2 views (73552) |
$19.80 |
$66 |
0.2× |
| Radiologic examination knee 1/2 views (73560) |
$58.22 |
$194.05 |
0.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$18 |
$60 |
0.2× |
| Rp Therapy Intravenous Administration (79101) |
$352.50 |
$1,175 |
1.2× |
| Scapula (73010) |
$65.03 |
$216.75 |
0.5× |
| Sella turcica (70240) |
$55.85 |
$186.15 |
0.5× |
| Shoulder 1 view (73020) |
$13.50 |
$45 |
0.1× |
| Sialogram (70390) |
$159 |
$530 |
0.5× |
| Skull less than 4 views (70250) |
$66.06 |
$220.20 |
0.5× |
| Special dosimetry (77331) |
$198 |
$660 |
1.2× |
| Special Physics Consult (77370) |
$243 |
$810 |
1.4× |
| Special treatment procedure (77470) |
$781.50 |
$2,605 |
1.1× |
| Stereotactic Body Radiation Delivery (77373) |
$2,647.50 |
$8,825 |
1.2× |
| Sternoclavicular joints (71130) |
$71.96 |
$239.85 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$603 |
$2,010 |
1.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$523.50 |
$1,745 |
1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$878.10 |
$2,927 |
1.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$687 |
$2,290 |
1.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$310.50 |
$1,035 |
1.9× |
| Thoracic spine 3 views (72072) |
$77.85 |
$259.50 |
0.6× |
| Thoracolumbar 2 views (72080) |
$75.50 |
$251.65 |
0.7× |
| Tx Devices Design & Construction Complex (77334) |
$262.94 |
$876.45 |
0.6× |
| Tx devices design & construction intermediate (77333) |
$237 |
$790 |
1.4× |
| Tx devices design & construction simple (77332) |
$184.50 |
$615 |
1.1× |
| Ultrasound Breast Limited (76642) |
$142.50 |
$475 |
1.3× |
| Ultrasound Exam Aaa Screen (76706) |
$98.70 |
$329 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$88.20 |
$294 |
0.7× |
| Umbilical-artery Doppler (OB) (76820) |
$73.20 |
$244 |
0.6× |
| Unlisted Dx Radiographic Procedure (76499) |
$100.65 |
$335.50 |
0.9× |
| Upper gi w/o kub (74240) |
— |
$804 |
— |
| Urethrocystogram voiding (74455) |
$216.30 |
$721 |
0.7× |
| Urethrocystography retrograde (74450) |
$146.70 |
$489 |
0.5× |
| Us breast unilateral complete (76641) |
$62.10 |
$207 |
0.5× |
| Us chest (76604) |
$100.91 |
$336.35 |
0.8× |
| Us complete joint (76881) |
$163.80 |
$546 |
1.3× |
| Us exam, pelvic, limited (76857) |
$104.10 |
$347 |
0.8× |
| Us head (76506) |
$87.90 |
$293 |
0.7× |
| Us kidney transplant (76776) |
$120 |
$400 |
0.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$33.67 |
$112.24 |
0.3× |
| Us ob detailed single fetus (76811) |
$174.95 |
$583.15 |
0.6× |
| Us ob limited 1 or more fetuses (76815) |
$102.30 |
$341 |
0.8× |
| Us ob transvaginal (76817) |
$104.10 |
$347 |
0.8× |
| Us pelvic non ob complete (76856) |
$123.60 |
$412 |
0.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$145.50 |
$485 |
1.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$66 |
$220 |
0.5× |
| Us retroperitoneal complete (76770) |
$152.34 |
$507.80 |
1.2× |
| Us retroperitoneal limited (76775) |
$82.20 |
$274 |
0.6× |
| Us scrotum and contents (76870) |
$181.50 |
$605 |
1.4× |
| Us spinal canal and contents (76800) |
$178.80 |
$596 |
1.4× |
| Us thyroid (76536) |
$121.88 |
$406.25 |
0.9× |
| Us transrectal (76872) |
$177.90 |
$593 |
1.4× |
| Venography extremity bilateral rs&i (75822) |
$289.56 |
$965.20 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$192.41 |
$641.35 |
0.1× |
| Vertebral fracture assessment via dxa (77086) |
$72.90 |
$243 |
0.7× |
| Wrist 2 views (73100) |
$19.50 |
$65 |
0.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$70.77 |
$235.90 |
0.7× |
| X-Ray Bend Only L-S Spine (72120) |
$52.20 |
$174 |
0.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$16.50 |
$55 |
0.2× |
| X-Ray Exam Breast Specimen (76098) |
$55.05 |
$183.50 |
0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$77.70 |
$259 |
0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$125.10 |
$417 |
1.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$119.70 |
$399 |
0.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$19.50 |
$65 |
0.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$27 |
$90 |
0.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$58.80 |
$196 |
0.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$148 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$484.85 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$355 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
$76.50 |
$255 |
0.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$89.22 |
$297.40 |
0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$129.74 |
$432.45 |
1.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$83.55 |
$278.50 |
0.6× |
| X-ray humerus (73060) |
$18 |
$60 |
0.2× |
| X-ray IV pyelogram (ivp) (74400) |
$54.10 |
$180.34 |
0.2× |
| X-ray IV pyelogram+tomography (74415) |
$217.50 |
$725 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$50.72 |
$169.05 |
0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$22.50 |
$75 |
0.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$68.42 |
$228.05 |
0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$128.18 |
$427.25 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$78.24 |
$260.80 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$67.23 |
$224.10 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$103.02 |
$343.40 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$110.49 |
$368.30 |
0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$147 |
$490 |
0.3× |
| X-Rays Bone Survey Complete (77075) |
$139.50 |
$465 |
1.1× |
| Xr c-spine 4 or 5 views (72050) |
$24 |
$80 |
0.2× |
| Xr facial bones less than 3 views (70140) |
$72.35 |
$241.15 |
0.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$45.62 |
$152.05 |
0.3× |
| Xr Tomogram Single Plane (76100) |
$128.96 |
$429.85 |
1.0× |