| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$4,919 |
— |
| Abdomen 1 View (74018) |
— |
$210 |
— |
| Abdomen 2 views (74019) |
— |
$210 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$2,206 |
— |
| Adrenal Cortex & Medulla Img (78075) |
— |
$1,281 |
— |
| Angio pulmonary bilat (75743) |
— |
$10,444 |
— |
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines |
— |
$6,420–$7,242 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$9,426 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$10,763 |
— |
| Ankle 2 views (73600) |
— |
$208 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$9,426 |
— |
| Aortography thoracic w/o serialography rs&i (75600) |
— |
$7,570 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$10,089 |
— |
| Arthrogram ankle (73615) |
— |
$906 |
— |
Arthrogram hip (73525)
range across 3 matching MRF lines |
— |
$1,090–$1,247 |
— |
| Arthrogram Wrist (73115) |
— |
$906 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$501 |
— |
Bone age studies (77072)
range across 2 matching MRF lines |
— |
$332–$339 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$2,177 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,632 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$1,632 |
— |
| Bone Imaging Whole Body (78306) |
— |
$1,910 |
— |
Bone survey infant (77076)
range across 3 matching MRF lines |
— |
$288–$339 |
— |
| Cardiac Shunt Detection (78428) |
— |
$1,795 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$1,934 |
— |
| Chest 1 view (71045) |
— |
$143 |
— |
| Chest 2 views (71046) |
— |
$147 |
— |
| Chest 3 views (71047) |
— |
$258 |
— |
| Chest 4 or more views (71048) |
— |
$258 |
— |
| Clavicle complete (73000) |
— |
$208 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$536 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$692 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$9,426 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$761 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$906 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$906 |
— |
| Contrast Xray Throat/Cerv Esopha (74210) |
— |
$403 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$1,949 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$1,193 |
— |
| CT abdomen w contrast (74160) |
— |
$2,057 |
— |
| CT abdomen w wo contrast (74170) |
— |
$2,437 |
— |
| CT abdomen w/o contrast (74150) |
— |
$1,574 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$2,052 |
— |
| CT Angio Chest (71275) |
— |
$1,697 |
— |
| CT Angio Head (70496) |
— |
$2,425 |
— |
| CT angio hrt w/3d image (75574) |
— |
$3,012 |
— |
| CT Angio Neck (70498) |
— |
$2,425 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$2,322 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$2,057 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$1,193 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$2,385 |
— |
| CT chest w contrast (71260) |
— |
$1,441 |
— |
| CT chest w/wo contrast (71270) |
— |
$2,489 |
— |
| CT head/brain with contrast (70460) |
— |
$2,057 |
— |
| CT head/brain without and with contrast (70470) |
— |
$2,437 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$1,314 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$467 |
— |
| CT hrt w/3d image congen (75573) |
— |
$1,868 |
— |
| CT iac w contrast (70481) |
— |
$1,971 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$2,489 |
— |
| CT lower ext w/o (73700) |
— |
$1,104 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$1,971 |
— |
| CT lumbar spine w contrast (72132) |
— |
$1,971 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$1,193 |
— |
| CT maxillofacial w contrast (70487) |
— |
$2,057 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$1,028 |
— |
| CT neck tissue combo (70492) |
— |
$2,437 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$2,437 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,574 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$2,437 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,703 |
— |
| CT scan of leg combo (73702) |
— |
$2,437 |
— |
| CT scans face/jaw combo (70488) |
— |
$2,437 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$2,057 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,574 |
— |
| CT thoracic spine w contrast (72129) |
— |
$2,057 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$1,703 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$2,489 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,193 |
— |
| CT upper ext wo (73200) |
— |
$1,574 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$2,437 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,057 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$2,425 |
— |
| Cta Abdomen (74175) |
— |
$2,425 |
— |
| CTA pelvis (72191) |
— |
$2,425 |
— |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) |
— |
$1,795 |
— |
| Diskography lumbar (72295) |
— |
$3,024 |
— |
| Doppler Echo Fetal Spectral Display Complete (76827) |
— |
$375 |
— |
| Dxa Bone Density Axial (77080) |
— |
$341 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$210 |
— |
| Esophageal Motility Study (78258) |
— |
$1,544 |
— |
| Esophagram (74220) |
— |
$513 |
— |
Fetal Biophys Profile W/Nst (76818)
range across 3 matching MRF lines |
— |
$372–$480 |
— |
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 3 matching MRF lines |
— |
$161–$578 |
— |
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines |
— |
$588–$654 |
— |
| Foot 2 views (73620) |
— |
$208 |
— |
| Forearm 2 views (73090) |
— |
$208 |
— |
| Gastric emptying imaging study (78264) |
— |
$2,175 |
— |
| Gastroesophageal Reflux Exam (78262) |
— |
$1,544 |
— |
| Gated Heart Planar Single (78472) |
— |
$1,876 |
— |
| Hand 2 views (73120) |
— |
$339 |
— |
| Heart Image (Pet) Multiple (78492) |
— |
$2,842 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$1,860 |
— |
Ht Musc Image Planar Mult (78454)
range across 2 matching MRF lines |
— |
$1,005–$3,079 |
— |
Ht Muscle Image Spect Sing (78451)
range across 3 matching MRF lines |
— |
$1,005–$1,834 |
— |
| Hysterosalpingogram (74740) |
— |
$877 |
— |
Infant hip ultrasound with hip movement (dynamic) (76885)
range across 2 matching MRF lines |
— |
$526–$537 |
— |
| Infusion Ivp (74410) |
— |
$730 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$1,808 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$1,532 |
— |
| Knee 3 Views (73562) |
— |
$167 |
— |
| Leveen/Shunt Patency Exam (78291) |
— |
$1,544 |
— |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
— |
$1,783 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$2,171 |
— |
Lymph System Imaging (78195)
range across 2 matching MRF lines |
— |
$2,188–$2,312 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$2,347 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$753 |
— |
| Meckels Divert Exam (78290) |
— |
$2,184 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$2,257 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$2,392 |
— |
| MRA head w/o contrast (70544) |
— |
$1,797 |
— |
| MRA neck w contrast (70548) |
— |
$2,752 |
— |
| MRA neck w/o contrast (70547) |
— |
$1,797 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$2,568 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$2,636 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$3,564 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$2,579 |
— |
| MRI bone marrow blood supply (77084) |
— |
$2,341 |
— |
| MRI cervical spine w contrast (72142) |
— |
$2,752 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$1,797 |
— |
| MRI chest w/o contrast (71550) |
— |
$2,460 |
— |
| MRI chest wo w contrast (71552) |
— |
$4,266 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$1,392 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$1,392 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$2,636 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$4,453 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$2,568 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$2,636 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$3,720 |
— |
| MRI pelvis w contrast (72196) |
— |
$2,636 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$4,453 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$2,568 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$2,568 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$1,856 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$1,856 |
— |
| MRI, abdomen, combo (74183) |
— |
$3,720 |
— |
| MRI, dorsal spine combo (72157) |
— |
$4,453 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$2,636 |
— |
| MRI, joint upper extrem (73221) |
— |
$1,797 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$4,266 |
— |
| MRI, lumbar spine combo (72158) |
— |
$4,453 |
— |
| Myelogram cervical (72240) |
— |
$2,389 |
— |
Myelogram Lumbar (72265)
range across 2 matching MRF lines |
— |
$2,253–$2,389 |
— |
| Myelography thoracic (72255) |
— |
$2,389 |
— |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
— |
$2,842 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$2,654 |
— |
| N-invas est c ffr sw aly CTA (75580) |
— |
$4,429 |
— |
| Neck soft tissue (70360) |
— |
$208 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$12,925 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$275 |
— |
| Ob us nuchal meas 1 gest (76813) |
— |
$167 |
— |
| Optic foramina (70190) |
— |
$203 |
— |
| Parathyroid imaging w/tomographic spect & CT (78072) |
— |
$2,893 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$1,908 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$339 |
— |
| Peritoneogram Rs&I (74190) |
— |
$880 |
— |
| Pet Image Skull-Thigh (78812) |
— |
$9,519 |
— |
| Pet Image W/Ct Lmtd (78814) |
— |
$3,567 |
— |
| PET image w/CT, full body (78816) |
— |
$10,645 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$10,813 |
— |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
— |
$3,260 |
— |
| Pet Myocardial Sngl Study (78491) |
— |
$2,842 |
— |
| PET whole body (78813) |
— |
$9,519 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,484 |
— |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
— |
$1,410 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$339 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$383 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$208 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$208 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$208 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$339 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$208 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$146 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$208 |
— |
| Radex lower extremity infant minimum 2 views (73592) |
— |
$208 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$253 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$339 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$208 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$208 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$210 |
— |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
— |
$754 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$208 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$208 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$208 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$208 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$339 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$208 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$1,270 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$2,303 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$2,187 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$339 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$210 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$998 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$712 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$339 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$339 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$513 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$566 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$570 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$210 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$210 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$208 |
— |
Radiologic Examination Osseous Survey Limited (77074)
range across 2 matching MRF lines |
— |
$332–$339 |
— |
| Radiologic Examination Salivary Gland Calculus (70380) |
— |
$227 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$208 |
— |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
— |
$341 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$1,633 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$4,790 |
— |
| Salivary Gland Imaging (78230) |
— |
$1,544 |
— |
| Scapula (73010) |
— |
$208 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$33.60 |
— |
| Sella turcica (70240) |
— |
$203 |
— |
| Shoulder 1 view (73020) |
— |
$208 |
— |
| Shoulder Arthrography (73040) |
— |
$1,187 |
— |
| Sialogram (70390) |
— |
$503 |
— |
| Skull less than 4 views (70250) |
— |
$339 |
— |
| Special dosimetry (77331) |
— |
$501 |
— |
| Special Physics Consult (77370) |
— |
$1,077 |
— |
| Special teletherapy port plan (77321) |
— |
$1,323 |
— |
| Special treatment procedure (77470) |
— |
$2,129 |
— |
| Spleen Imaging (78185) |
— |
$1,632 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$10,490 |
— |
| Sternoclavicular joints (71130) |
— |
$208 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$1,323 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$1,323 |
— |
| Testicular Imaging W/Flow (78761) |
— |
$1,532 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$3,607 |
— |
Ther rad simulaj-aided field setting simple (77280)
range across 2 matching MRF lines |
— |
$2,088–$3,541 |
— |
| Thoracic spine 2 views (72070) |
— |
$227 |
— |
| Thoracic spine 3 views (72072) |
— |
$339 |
— |
| Thoracolumbar 2 views (72080) |
— |
$227 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$1,758 |
— |
Thyroid Uptake Measurement (78012)
range across 2 matching MRF lines |
— |
$692–$1,122 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$1,122 |
— |
| Tx Devices Design & Construction Complex (77334) |
— |
$1,323 |
— |
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines |
— |
$519–$702 |
— |
Tx devices design & construction simple (77332)
range across 2 matching MRF lines |
— |
$313–$501 |
— |
| Ultrasound Breast Limited (76642) |
— |
$300 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$486 |
— |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
— |
$396–$404 |
— |
Umbilical-artery Doppler (OB) (76820)
range across 2 matching MRF lines |
— |
$322–$328 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$2,347 |
— |
| Upper gi w/o kub (74240) |
— |
$513 |
— |
Ureteral Reflux Study (78740)
range across 2 matching MRF lines |
— |
$1,530–$1,532 |
— |
| Urethrocystogram voiding (74455) |
— |
$730 |
— |
| Urethrocystography retrograde (74450) |
— |
$730 |
— |
| Us breast unilateral complete (76641) |
— |
$396 |
— |
Us chest (76604)
range across 3 matching MRF lines |
— |
$332–$366 |
— |
Us complete joint (76881)
range across 2 matching MRF lines |
— |
$340–$347 |
— |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines |
— |
$567–$578 |
— |
Us ob detailed single fetus (76811)
range across 2 matching MRF lines |
— |
$842–$859 |
— |
Us ob limited 1 or more fetuses (76815)
range across 3 matching MRF lines |
— |
$336–$368 |
— |
Us ob transvaginal (76817)
range across 2 matching MRF lines |
— |
$567–$578 |
— |
Us pelvic non ob complete (76856)
range across 3 matching MRF lines |
— |
$480–$523 |
— |
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines |
— |
$567–$578 |
— |
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines |
— |
$290–$317 |
— |
Us retroperitoneal complete (76770)
range across 2 matching MRF lines |
— |
$396–$404 |
— |
| Us retroperitoneal limited (76775) |
— |
$554 |
— |
Us scrotum and contents (76870)
range across 3 matching MRF lines |
— |
$386–$578 |
— |
Us spinal canal and contents (76800)
range across 2 matching MRF lines |
— |
$567–$578 |
— |
| Us thyroid (76536) |
— |
$578 |
— |
Us transrectal (76872)
range across 3 matching MRF lines |
— |
$543–$890 |
— |
| Vein X-Ray Chest (75827) |
— |
$5,047 |
— |
Venography caval inferior serialography rs&i (75825)
range across 2 matching MRF lines |
— |
$3,889–$10,763 |
— |
Venography extremity bilateral rs&i (75822)
range across 2 matching MRF lines |
— |
$1,857–$1,962 |
— |
Venography extremity unilateral rs&i (75820)
range across 3 matching MRF lines |
— |
$1,857–$5,217 |
— |
| Wrist 2 views (73100) |
— |
$208 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$208 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$9,426 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$208 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$208 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$196 |
— |
X-Ray Exam Entire Spi 2/3 Vw (72082)
range across 2 matching MRF lines |
— |
$328–$357 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$357 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$208 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$210 |
— |
X-Ray Exam Hips Bi 3-4 Views (73522)
range across 3 matching MRF lines |
— |
$234–$370 |
— |
X-Ray Exam Hips Bi 5/> Views (73523)
range across 2 matching MRF lines |
— |
$219–$238 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$339 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$339 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$339 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$339 |
— |
| X-ray eye for foreign body (70030) |
— |
$203 |
— |
| X-ray humerus (73060) |
— |
$208 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$730 |
— |
| X-ray IV pyelogram+tomography (74415) |
— |
$761 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$208 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$339 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$282 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$339 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$339 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$208 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$208 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$339 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$1,292 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$265 |
— |
X-Rays Bone Survey Complete (77075)
range across 2 matching MRF lines |
— |
$487–$497 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$339 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$210 |
— |
| Xr orbits complete 4 views (70200) |
— |
$265 |
— |
| Xr Tomogram Single Plane (76100) |
— |
$379 |
— |