| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,046.15 |
$3,583.70 |
2.2× |
| Acute gi blood loss imaging (78278) |
$1,356.28 |
$1,595.62 |
3.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,478.60 |
$2,916 |
0.8× |
| Angiography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75716) |
$2,297.55 |
$2,703 |
0.7× |
| Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) |
$2,192.58 |
$2,579.50 |
0.7× |
| Ankle 2 views (73600) |
$286.28 |
$336.80 |
3.2× |
| Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision… (75630) |
$1,676.62 |
$1,972.50 |
0.5× |
| Aortography, abdominal, by serialography, radiological supervision and interpretation Age Under 21 (75625) |
$1,671.95 |
$1,967 |
0.5× |
Aortography, thoracic, by serialography, radiological supervision and interpretation Age Under 21 (75605)
unusually low — confirm this is the full procedure |
$2,598.02 |
$3,056.50 |
0.5× |
| Basic radiation dosimetry calculation (77300) |
$229.30 |
$269.76 |
1.7× |
| Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or… (78481) |
$765.85 |
$901 |
1.4× |
| Cephalogram, orthodontic Age Under 21 (70350) |
$107.94 |
$127 |
1.2× |
| Clavicle complete (73000) |
$204.01 |
$240.01 |
2.3× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$3,291.73 |
$3,872.62 |
9.2× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$2,776.02 |
$3,265.91 |
15.5× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$2,126.46 |
$2,501.72 |
11.9× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$2,134.90 |
$2,511.65 |
11.9× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,919.75 |
$3,435 |
16.3× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$2,444.90 |
$2,876.35 |
13.6× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$3,815.92 |
$4,489.32 |
21.3× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,233.54 |
$1,451.22 |
11.5× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$2,913.89 |
$3,428.10 |
16.3× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$3,008.15 |
$3,539 |
16.8× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$2,433.58 |
$2,863.04 |
13.6× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,362.41 |
$1,602.84 |
12.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$2,010.42 |
$2,365.20 |
11.2× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,134.55 |
$1,334.77 |
10.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,806.69 |
$3,301.99 |
15.7× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$2,347.48 |
$2,761.74 |
13.1× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$2,903.60 |
$3,416 |
16.2× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$2,102.68 |
$2,473.74 |
11.7× |
| Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose… (77336) |
$533.92 |
$628.14 |
3.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,074.64 |
$3,617.22 |
8.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,646.59 |
$3,113.63 |
10.9× |
| CT abdomen w & w/o contrast (74170) |
$2,278.91 |
$2,681.07 |
12.7× |
| CT abdomen w/contrast (74160) |
$1,453.71 |
$1,710.25 |
8.1× |
| CT abdomen w/o contrast (74150) |
$1,570.80 |
$1,848 |
14.7× |
| CT cervical spine w/contrast (72126) |
$1,725.07 |
$2,029.49 |
4.8× |
| CT cervical spine w/o contrast (72125) |
$1,247.34 |
$1,467.46 |
11.7× |
| CT chest w/contrast (71260) |
$1,342.46 |
$1,579.37 |
7.5× |
| CT extremity upper w & w/o contrast (73202) |
$2,079.10 |
$2,446 |
11.6× |
| CT extremity upper w/o contrast (73200) |
$1,116.17 |
$1,313.14 |
10.5× |
| CT head/brain with contrast (70460) |
$1,339.36 |
$1,575.72 |
7.5× |
| CT head/brain without and with contrast (70470) |
$2,267.34 |
$2,667.46 |
12.7× |
| CT heart c+ cardiac strux&morph cgen hrt ds (75573) |
$264.44 |
$311.11 |
0.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$384.79 |
$452.69 |
4.3× |
| CT l-spine w/contrast (72132) |
$1,453.71 |
$1,710.25 |
4.1× |
| CT limited/localized follow up study (76380) |
$733.55 |
$863 |
8.3× |
| CT lower extremity w/dye (73701) |
$1,744.46 |
$2,052.30 |
9.7× |
| CT lumbar spine w/o contrast (72131) |
$1,383.13 |
$1,627.21 |
12.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,109 |
$2,481.18 |
11.8× |
| CT neck w/contrast (70491) |
$2,330.84 |
$2,742.16 |
13.0× |
| CT neck w/o contrast (70490) |
$1,134.55 |
$1,334.77 |
10.6× |
| CT pelvis w & w/o contrast (72194) |
$2,081.32 |
$2,448.61 |
11.6× |
| CT thoracic spine w/contrast (72129) |
$1,563.03 |
$1,838.86 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$1,247.35 |
$1,467.47 |
11.7× |
| CT thorax lung cancer scr c- (71271) |
$210.19 |
$247.28 |
2.0× |
| CT thorax w/o contrast (71250) |
$1,577.21 |
$1,855.54 |
14.8× |
| CT upper extremity w/dye (73201) |
$1,673.56 |
$1,968.89 |
4.7× |
| CTA h&n c+ w/noncontrast img (70471) |
$3,291.73 |
$3,872.62 |
9.2× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$454.76 |
$535.01 |
1.3× |
| Doppler fetal mid cerebral artery (76821) |
$323 |
$380 |
3.0× |
| Dxa bone density study axial skeleton (77085) |
$361.73 |
$425.57 |
3.4× |
| Dxa bone density/peripheral (77081) |
$821.13 |
$966.03 |
9.2× |
| Fetal biophys profile w/o nst (76819) |
$623.05 |
$733 |
5.8× |
| Fetal biophysical profile non-stress testing (76818) |
$180.20 |
$212 |
1.7× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$272.72 |
$320.85 |
1.1× |
| Gated heart planar single (78472) |
$1,769.68 |
$2,081.98 |
4.3× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,615.01 |
$1,900.01 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,579.61 |
$1,858.37 |
3.9× |
| Ht muscle image spect sing (78451) |
$1,006.15 |
$1,183.70 |
0.8× |
| Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial… (77301) |
$2,932.99 |
$3,450.58 |
2.1× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$780.30 |
$918 |
1.9× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$803.68 |
$945.50 |
2.1× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$800.70 |
$942 |
2.1× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,187.03 |
$1,396.50 |
2.1× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,420.35 |
$1,671 |
2.6× |
| Liver and spleen imaging (78215) |
$1,427.66 |
$1,679.60 |
3.5× |
| Lung perf&ventilat diferentl (78598) |
$1,503.57 |
$1,768.90 |
2.7× |
| Lung perfusion imaging (78580) |
$875.50 |
$1,030 |
2.1× |
| Mandible min 4v (70110) |
$294.79 |
$346.81 |
2.8× |
| Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per… (77338) |
$1,010.12 |
$1,188.38 |
2.6× |
| Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first… (78453) |
$2,327.30 |
$2,738 |
1.8× |
| Myocardial spect multiple studies (78452) |
$1,443.56 |
$1,698.30 |
1.1× |
| Nm adrenal imaging (78075) |
$2,646.05 |
$3,113 |
2.0× |
| Nm bone 3 phase (78315) |
$1,414.59 |
$1,664.22 |
3.5× |
| Nm bone imaging whole body (78306) |
$1,041 |
$1,224.70 |
2.5× |
| Nm gastric emptying (78264) |
$1,420.59 |
$1,671.28 |
3.5× |
| Nm lymph system (78195) |
$1,358.78 |
$1,598.56 |
2.4× |
| Nm myocard infarct spect (78469) |
$1,948.20 |
$2,292 |
3.5× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,081.20 |
$1,272 |
2.6× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$1,442.45 |
$1,697 |
3.5× |
| Ob us limited fetus(s) (76815) |
$212.74 |
$250.28 |
2.0× |
| Ob us nuchal meas 1 gest (76813) |
$498.10 |
$586 |
4.7× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$77.35 |
$91 |
0.7× |
| Optic foramina (70190) |
$213.35 |
$251 |
2.4× |
| Panoramic X-ray of jaws (70355) |
$118.15 |
$139 |
1.3× |
| Parathyroid planar imaging (78070) |
$1,169.86 |
$1,376.30 |
2.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,367.65 |
$1,609 |
3.3× |
| Pulmonary ventilation & perfusion imaging (78582) |
$1,305.73 |
$1,536.15 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$421.60 |
$496 |
0.8× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$252.32 |
$296.85 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$352.80 |
$415.05 |
3.3× |
| Radex hip unilateral with pelvis 1 view (73501) |
$142.38 |
$167.50 |
1.6× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$209.01 |
$245.90 |
2.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$233.02 |
$274.14 |
2.2× |
| Radex spine cervical 2 or 3 views (72040) |
$265.60 |
$312.48 |
3.0× |
| Radex spine cervical 4 or 5 views (72050) |
$334.07 |
$393.02 |
3.1× |
| Radex spine cervical 6 or more views (72052) |
$336.72 |
$396.14 |
3.2× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$167.03 |
$196.50 |
1.9× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77372) |
$20,262.30 |
$23,838 |
2.7× |
| Radiation tx delivery lvl 1 (77402) |
$619.65 |
$729 |
5.9× |
| Radiation tx delivery lvl 2 (77407) |
$833 |
$980 |
2.1× |
| Radiation tx delivery lvl 3 (77412) |
$678.14 |
$797.81 |
1.2× |
| Radiologic exam abdomen 3+ views (74021) |
$79.90 |
$94 |
0.7× |
| Radiologic exam colon double contrast study (74280) |
$615.32 |
$723.90 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$477.11 |
$561.31 |
2.7× |
| Radiologic exam esophagus single contrast study (74220) |
$543.50 |
$639.41 |
3.0× |
| Radiologic exam small int single contrast study (74250) |
$730.27 |
$859.14 |
4.1× |
| Radiologic exam swallow function contrast study (74230) |
$465.64 |
$547.81 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$828.22 |
$974.38 |
4.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$689.98 |
$811.74 |
3.9× |
| Radiologic examination femur minimum 2 views (73552) |
$146.74 |
$172.64 |
1.7× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$273.26 |
$321.48 |
3.1× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$196.22 |
$230.86 |
2.2× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$386.67 |
$454.90 |
3.6× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$152.14 |
$178.99 |
1.7× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$209 |
$245.88 |
2.4× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$290.70 |
$342 |
3.3× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$203.82 |
$239.79 |
2.3× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$223.88 |
$263.38 |
2.5× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$189.29 |
$222.70 |
1.8× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$188.15 |
$221.35 |
2.1× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$347.65 |
$409 |
3.3× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$346.76 |
$407.95 |
3.9× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$369.98 |
$435.27 |
3.5× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$159.41 |
$187.54 |
1.5× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$229.62 |
$270.14 |
2.1× |
| Radiologic examination, salivary gland for calculus Age Under 21 (70380) |
$200.60 |
$236 |
2.3× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$547.40 |
$644 |
1.5× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$185.03 |
$217.68 |
2.1× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$175.95 |
$207 |
2.0× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$193.12 |
$227.20 |
1.8× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$258 |
$303.52 |
2.4× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$348.64 |
$410.16 |
3.3× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$506.35 |
$595.71 |
4.7× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$182.08 |
$214.20 |
2.0× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$203.58 |
$239.50 |
2.3× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$257.38 |
$302.80 |
2.9× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$126.58 |
$148.92 |
1.4× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$254.71 |
$299.66 |
2.4× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$155.12 |
$182.50 |
1.7× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$145.08 |
$170.68 |
1.6× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$212.37 |
$249.85 |
2.0× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$1,624.35 |
$1,911 |
2.9× |
| Radiopharmaceutical therapy, by intravenous administration Age Under 21 (79101) |
$607.38 |
$714.57 |
2.5× |
| Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) |
$843.20 |
$992 |
3.5× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$639.68 |
$752.57 |
2.6× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$2,524.25 |
$2,969.70 |
4.6× |
| Rp loclzj tum spect 2 areas (78831) |
$2,657.10 |
$3,126 |
2.0× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$495.55 |
$583 |
2.0× |
| Scapula complete (73010) |
$163.54 |
$192.40 |
1.5× |
| Screening digital breast tomosynthesis bi (77063) |
$75.96 |
$89.36 |
— |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$550.80 |
$648 |
5.2× |
| Simulation intermediate (77285) |
$760.32 |
$894.50 |
2.0× |
| Special dosimetry (77331) |
$198.46 |
$233.48 |
1.4× |
| Special physics consult (77370) |
$559.14 |
$657.81 |
4.1× |
| Special teletherapy port plan (77321) |
$406.30 |
$478 |
1.1× |
| Special treatment procedure (77470) |
$1,298.06 |
$1,527.14 |
2.3× |
| Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance,… (77373) |
$6,528 |
$7,680 |
3.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$805.14 |
$947.22 |
2.1× |
| Thyroid met imaging body (78018) |
$620.50 |
$730 |
1.1× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,723.32 |
$2,027.44 |
4.2× |
| Tr simulation simple (77280) |
$590.65 |
$694.88 |
4.3× |
| Treatment device complex (77334) |
$746.02 |
$877.68 |
2.0× |
| Treatment device intermediate (77333) |
$494.42 |
$581.68 |
3.6× |
| Treatment device simple (77332) |
$258.82 |
$304.50 |
1.9× |
| Ultrasound breast limited (76642) |
$238 |
$280 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$297.34 |
$349.81 |
2.8× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$534.42 |
$628.73 |
5.0× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$604.59 |
$711.28 |
5.7× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$528.80 |
$622.12 |
2.2× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$382.58 |
$450.10 |
3.6× |
| Umbilical-artery Doppler (OB) (76820) |
$309.82 |
$364.50 |
2.9× |
| Unlisted CT procedure (76497) |
$859.35 |
$1,011 |
9.7× |
| Urethrocystography retrograde rs&i (74450) |
$1,050.39 |
$1,235.75 |
4.3× |
| Us abdominal aorta real time screen study aaa (76706) |
$310.70 |
$365.53 |
2.9× |
| Us breast uni real time with image complete (76641) |
$617.36 |
$726.30 |
5.8× |
| Us chest (76604) |
$222.18 |
$261.38 |
2.1× |
| Us exam, pelvic, limited (76857) |
$240.81 |
$283.30 |
2.3× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$610.30 |
$718 |
6.9× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$473.45 |
$557 |
5.3× |
| US OB Follow-Up/Repeat (76816) |
$335.95 |
$395.24 |
3.1× |
| Us ob transvaginal (76817) |
$385.79 |
$453.87 |
3.6× |
| Us retroperitoneal complete (76770) |
$525.91 |
$618.72 |
4.9× |
| Us retroperitoneal ltd (76775) |
$370.48 |
$435.86 |
3.5× |
| Us scrotum (76870) |
$414.20 |
$487.30 |
3.9× |
| Us soft tissue head/neck (76536) |
$324.98 |
$382.34 |
3.0× |
| Us transrectal (76872) |
$124.41 |
$146.37 |
1.2× |
| Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) |
$237.15 |
$279 |
2.7× |
| Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) |
$1,751.85 |
$2,061 |
0.5× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$599.25 |
$705 |
0.4× |
| X-ray exam hips bi 3-4 views (73522) |
$321.56 |
$378.30 |
3.0× |
| X-ray exam of finger(s) (73140) |
$152.48 |
$179.38 |
1.7× |
| X-ray exam of knee 1 or 2 (73560) |
$157.35 |
$185.12 |
1.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$205.54 |
$241.81 |
1.1× |
| X-ray exam ribs bil 3 views (71110) |
$374.53 |
$440.62 |
3.5× |
| X-ray exam ribs uni 2 views (71100) |
$190.67 |
$224.32 |
2.1× |
| X-ray heel (73650) |
$139.96 |
$164.66 |
1.6× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$349.51 |
$411.19 |
3.3× |
| X-ray retrograde pyelogram (74420) |
$792.64 |
$932.52 |
2.2× |
| Xr abdomen 1 view (74018) |
$159.62 |
$187.78 |
1.8× |
| Xr abdomen 2 views (74019) |
$202.95 |
$238.76 |
1.9× |
| Xr arthrogram ankle (73615) |
$464.10 |
$546 |
1.3× |
| Xr arthrogram hip (73525) |
$605.35 |
$712.18 |
1.7× |
| Xr arthrogram knee (73580) |
$538.82 |
$633.90 |
1.5× |
| Xr arthrogram wrist (73115) |
$545.70 |
$642 |
1.5× |
| Xr bone age studies (77072) |
$289.36 |
$340.42 |
2.7× |
| Xr bone length study (77073) |
$140.25 |
$165 |
1.3× |
| Xr bone survey infant (77076) |
$461.89 |
$543.40 |
4.3× |
| Xr bone survey ltd (77074) |
$384.20 |
$452 |
3.6× |
| Xr chest 1 view (71045) |
$44.20 |
$52 |
0.5× |
| Xr chest 2 views (71046) |
$86.70 |
$102 |
1.0× |
| Xr eye foreign body (70030) |
$170.94 |
$201.10 |
1.9× |
| Xr facial bones 3+ views (70150) |
$323 |
$380 |
3.0× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$176.71 |
$207.90 |
2.0× |
| Xr forearm 2 views (73090) |
$212.50 |
$250 |
2.4× |
| Xr hand 2v (73120) |
$140.50 |
$165.30 |
1.3× |
| Xr hysterosalpingogram (74740) |
$910.30 |
$1,070.94 |
3.7× |
| Xr joint survey 1 view (77077) |
$284.75 |
$335 |
2.7× |
| Xr neck soft tissue (70360) |
$301.56 |
$354.78 |
3.4× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$173.72 |
$204.38 |
2.0× |
| Xr osseous survey complete (77075) |
$554.11 |
$651.89 |
5.2× |
| Xr pelvis 1-2 views (72170) |
$165.04 |
$194.16 |
1.5× |
| Xr pelvis min 3 view (72190) |
$195.91 |
$230.48 |
1.8× |
| Xr sacrum/coccyx 2+ views (72220) |
$184.26 |
$216.77 |
2.1× |
| Xr sella turcica (70240) |
$161.50 |
$190 |
1.8× |
| Xr shoulder 1 view (73020) |
$123.15 |
$144.88 |
1.4× |
| Xr sinuses 3+ views (70220) |
$352.75 |
$415 |
4.0× |
| Xr skull min 4 view (70260) |
$445.40 |
$524 |
4.2× |
| Xr spine 1 view (72020) |
$194.30 |
$228.59 |
2.2× |
| Xr spine thoracic 3v (72072) |
$175.07 |
$205.96 |
1.6× |
| Xr sternum 2+ views (71120) |
$170.82 |
$200.96 |
1.9× |
| Xr stress view joint (77071) |
$141.95 |
$167 |
1.6× |
| Xr surgical specimen (76098) |
$232.91 |
$274.01 |
0.4× |
| Xr t-spine 2 views (72070) |
$214.40 |
$252.24 |
2.0× |
| Xr tibia/fibula 2 views (73590) |
$157.86 |
$185.72 |
1.8× |
| Xr tmj bilateral (70330) |
$275.40 |
$324 |
3.1× |
| Xr wrist 2 views (73100) |
$190.14 |
$223.70 |
2.1× |