| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,146.84 |
$2,703 |
0.8× |
| Abdomen 2 views (74019) |
$437.44 |
$1,031 |
4.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,016.58 |
$2,396 |
2.6× |
| Ankle 2 views (73600) |
$344.95 |
$813 |
4.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$423.86 |
$999 |
1.2× |
| Arthrogram hip (73525) |
$649.58 |
$1,531 |
1.9× |
| Arthrogram shoulder (73040) |
$571.51 |
$1,347 |
1.7× |
| Arthrography knee lt (73580) |
$353.01 |
$832 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$136.62 |
$322 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,209.21 |
$2,850 |
3.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,641.12 |
$3,868 |
4.2× |
| Bone &/joint imaging whole body (78306) |
$2,159.60 |
$5,090 |
5.5× |
| Bone age studies (77072) |
$247.79 |
$584 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$2,202.45 |
$5,191 |
5.6× |
| Bone survey complete (77075) |
$358.52 |
$845 |
3.5× |
| Brain image w/flow 4 + views (78606) |
$584.24 |
$1,377 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$537.14 |
$1,266 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,770.56 |
$6,530 |
2.0× |
| Cervical spine 2 or 3 views (72040) |
$470.96 |
$1,110 |
5.5× |
| Chest 1 view (71045) |
$246.94 |
$582 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$615.64 |
$1,451 |
3.6× |
| Clavicle complete (73000) |
$332.22 |
$783 |
3.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$961 |
$2,265 |
9.3× |
| Continuing medical physics consltj pr wk (77336) |
$168.87 |
$398 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,332.70 |
$5,498 |
6.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,638.15 |
$3,861 |
7.0× |
| CT abdomen w contrast (74160) |
$831.60 |
$1,960 |
4.8× |
| CT abdomen w wo contrast (74170) |
$1,006.40 |
$2,372 |
5.8× |
| CT abdomen w/o contrast (74150) |
$840.08 |
$1,980 |
8.2× |
| CT angiography upper extremity lt (73206) |
$793.41 |
$1,870 |
4.6× |
| CT c-spine w/o contrast (72125) |
$1,269.03 |
$2,991 |
12.3× |
| CT cervical spine with contrast (72126) |
$1,573.66 |
$3,709 |
4.6× |
| CT chest w/wo contrast (71270) |
$1,143.87 |
$2,696 |
6.6× |
| CT chest with contrast (71260) |
$961 |
$2,265 |
5.6× |
| CT head/brain with contrast (70460) |
$725.53 |
$1,710 |
4.2× |
| CT head/brain without and with contrast (70470) |
$1,267.33 |
$2,987 |
7.3× |
| CT iac w contrast (70481) |
$1,104.83 |
$2,604 |
6.4× |
| CT lower ext w/o (73700) |
$791.71 |
$1,866 |
7.7× |
| CT lower extremity w wo contrast (73702) |
$918.57 |
$2,165 |
5.3× |
| CT lower extremity with contrast (73701) |
$867.02 |
$2,043.50 |
5.0× |
| CT lumbar spine w/o contrast (72131) |
$1,280.06 |
$3,017 |
12.4× |
| CT lumbar spine with contrast (72132) |
$1,433.65 |
$3,379 |
4.2× |
| CT maxillofacial w contrast (70487) |
$1,279.21 |
$3,015 |
7.4× |
| CT maxillofacial w/o contrast (70486) |
$1,266.48 |
$2,985 |
12.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,127.32 |
$2,657 |
6.5× |
| CT neck soft tissue w contrast (70491) |
$829.05 |
$1,954 |
4.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,325.46 |
$3,124 |
7.7× |
| CT orbits w/o contrast (70480) |
$1,104.83 |
$2,604 |
10.7× |
| CT pelvis w & w/o contrast (72194) |
$865.96 |
$2,041 |
5.0× |
| CT pelvis w/o contrast (72192) |
$963.12 |
$2,270 |
9.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,044.58 |
$2,462 |
6.0× |
| CT soft tissue neck w/o contrast (70490) |
$829.05 |
$1,954 |
8.0× |
| CT thoracic spine w/contrast (72129) |
$1,147.26 |
$2,704 |
6.6× |
| CT thoracic spine w/o contrast (72128) |
$1,260.97 |
$2,972 |
12.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,026.34 |
$2,419 |
5.9× |
| CT thorax w/o contrast (71250) |
$961 |
$2,265 |
9.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$841.35 |
$1,983 |
4.9× |
| CT upper extremity w/o contrast rt (73200) |
$758.20 |
$1,787 |
7.4× |
| CT upper extremity with contrast (73201) |
$765.83 |
$1,805 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$731.04 |
$1,723 |
4.2× |
| Cta Abdomen (74175) |
$1,790.47 |
$4,220 |
10.4× |
| CTA abdomen pelvis (74174) |
$1,529.96 |
$3,606 |
4.5× |
| CTA chest (71275) |
$734.86 |
$1,732 |
4.3× |
| Cta Head (70496) |
$1,047.13 |
$2,468 |
6.1× |
| CTA lwr ext w&w/o contrast (73706) |
$579.15 |
$1,365 |
3.4× |
| Cta Neck (70498) |
$1,277.51 |
$3,011 |
7.4× |
| Cta Pelvis (72191) |
$857.48 |
$2,021 |
5.0× |
| Cystography minimum 3 views rs&i (74430) |
$282.15 |
$665 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$394.16 |
$929 |
3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$459.08 |
$1,082 |
5.4× |
| Echoencephalography real time imaging (76506) |
$304.21 |
$717 |
3.0× |
| Esophagus (74220) |
$451.86 |
$1,065 |
2.6× |
| Fetal biophysical profile non-stress testing (76818) |
$660.61 |
$1,557 |
6.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$125.59 |
$296 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$561.75 |
$1,324 |
2.4× |
| Foot 2 views (73620) |
$312.28 |
$736 |
3.6× |
| Forearm 2 views (73090) |
$302.94 |
$714 |
3.5× |
| Gated Heart Planar Single (78472) |
$923.66 |
$2,177 |
2.3× |
| Hand 2 views (73120) |
$256.70 |
$605 |
2.5× |
| Hand 3 views (73130) |
$383.13 |
$903 |
4.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,051.83 |
$4,836 |
3.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,292.79 |
$3,047 |
3.3× |
| Ht muscle image spect sing (78451) |
$1,469.29 |
$3,463 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$433.62 |
$1,022 |
5.1× |
| Hysterosalpingogram (74740) |
$544.36 |
$1,283 |
2.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,258.85 |
$2,967 |
1.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$885.48 |
$2,087 |
1.6× |
| Intracavitary radiation source applic simple (77761) |
$649.15 |
$1,530 |
1.2× |
| Kidney imaging morphology (78700) |
$1,065.37 |
$2,511 |
2.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$918.15 |
$2,164 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$917.72 |
$2,163 |
1.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$629.21 |
$1,483 |
1.2× |
| Knee 3 views (73562) |
$324.16 |
$764 |
3.8× |
| Liver & spleen imaging static only (78215) |
$659.76 |
$1,555 |
1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$749.29 |
$1,766 |
1.9× |
| Lung perfusion differential (78597) |
$2,088.74 |
$4,923 |
5.3× |
| Lung Ventilation Imaging (78579) |
$1,146.41 |
$2,702 |
2.9× |
| Lymphoscintigraphy (78195) |
$637.27 |
$1,502 |
1.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$83.59 |
$197 |
1.0× |
| Meckels Diverticulum (78290) |
$669.94 |
$1,579 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,037.80 |
$2,446 |
2.8× |
| Mr safety determination physician/other qhp (76016) |
$94.62 |
$223 |
1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$26.31 |
$62 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$98.86 |
$233 |
1.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$259.66 |
$612 |
1.1× |
| MRA head w & w/o contrast (70546) |
$1,258 |
$2,965 |
3.7× |
| MRA head w/o contrast (70544) |
$2,062.43 |
$4,861 |
8.8× |
| MRA head with contrast (70545) |
$1,691.19 |
$3,986 |
4.9× |
| MRA neck w contrast (70548) |
$1,781.98 |
$4,200 |
5.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,163.41 |
$5,099 |
6.3× |
| MRA neck w/o contrast (70547) |
$1,599.54 |
$3,770 |
6.8× |
| MRI abdomen w contrast (74182) |
$940.21 |
$2,216 |
2.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,089.16 |
$4,924 |
6.1× |
| MRI abdomen w/o contrast (74181) |
$1,566.87 |
$3,693 |
6.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,096.35 |
$2,584 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,249.51 |
$2,945 |
1.6× |
| MRI breast w/o contrast bilateral (77047) |
$577.45 |
$1,361 |
2.5× |
| MRI c-spine with contrast (72142) |
$1,987.76 |
$4,685 |
5.8× |
| MRI cervical spine w/o contrast (72141) |
$1,461.65 |
$3,445 |
6.2× |
| MRI chest w/o & w/contrast material (71552) |
$703.89 |
$1,659 |
2.0× |
| MRI chest w/o contrast (71550) |
$581.69 |
$1,371 |
2.5× |
| MRI chest with contrast (71551) |
$640.67 |
$1,510 |
0.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,601.67 |
$3,775 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,079.80 |
$2,545 |
4.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,458.68 |
$3,438 |
6.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,084.07 |
$4,912 |
6.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,804.05 |
$4,252 |
5.2× |
| MRI pelvis w/o contrast (72195) |
$1,262.67 |
$2,976 |
5.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,981.40 |
$4,670 |
5.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,090.01 |
$4,926 |
6.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,090.01 |
$4,926 |
6.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,728.10 |
$4,073 |
5.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,902.48 |
$4,484 |
5.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,806.17 |
$4,257 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,263.09 |
$2,977 |
5.4× |
| MRI tmj (70336) |
$1,361.95 |
$3,210 |
5.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,262.24 |
$2,975 |
5.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,856.23 |
$4,375 |
5.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,262.67 |
$2,976 |
5.4× |
| Myelogram Lumbar (72265) |
$1,047.55 |
$2,469 |
1.4× |
| Myelogram thoracic (72255) |
$1,047.55 |
$2,469 |
1.4× |
| Myelography 2 or more regions (72270) |
$713.65 |
$1,682 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,766.77 |
$8,878 |
3.0× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,056.46 |
$2,490 |
1.2× |
| Neck soft tissue (70360) |
$335.61 |
$791 |
3.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$641.09 |
$1,511 |
1.7× |
| Nm gastric emptying study (78264) |
$1,142.59 |
$2,693 |
2.9× |
| Nm gastroesophageal reflux study (78262) |
$929.60 |
$2,191 |
2.4× |
| Nm peritoneal-venous shunt patency (78291) |
$1,091.68 |
$2,573 |
2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,599.57 |
$6,127 |
1.9× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,393.77 |
$3,285 |
1.1× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,130.29 |
$2,664 |
0.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,316.12 |
$3,102 |
3.3× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$900.75 |
$2,123 |
1.7× |
| Nuclear Rx Oral Admin (79005) |
$852.81 |
$2,010 |
3.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$184.99 |
$436 |
1.8× |
| Osseous survey infant (77076) |
$227.84 |
$537 |
2.2× |
| Osseous survey limited (77074) |
$334.76 |
$789 |
3.3× |
| Parathyroid imaging (78070) |
$526.54 |
$1,241 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$414.53 |
$977 |
4.0× |
| Perineogram (74775) |
$231.24 |
$545 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$3,753.62 |
$8,847 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$2,965.30 |
$6,989 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,799.38 |
$4,241 |
5.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$943.18 |
$2,223 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$596.97 |
$1,407 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$352.58 |
$831 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$219.78 |
$518 |
2.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$168.02 |
$396 |
1.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$249.06 |
$587 |
2.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$8,096.98 |
$19,084 |
1.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$581.69 |
$1,371 |
1.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$438.29 |
$1,033 |
4.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$472.65 |
$1,114 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$345.80 |
$815 |
3.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$383.98 |
$905 |
4.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$187.96 |
$443 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$303.79 |
$716 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$610.12 |
$1,438 |
3.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$924.09 |
$2,178 |
5.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$437.86 |
$1,032 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$385.68 |
$909 |
4.5× |
| Radiological examination surgical specimen (76098) |
$279.18 |
$658 |
0.5× |
| Ribs bilateral 3 views (71110) |
$319.49 |
$753 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$596.12 |
$1,405 |
1.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,157.05 |
$5,084 |
4.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,208.57 |
$2,848.50 |
2.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$575.75 |
$1,357 |
0.5× |
| Sacroiliac Joints < 3 Views (72200) |
$222.75 |
$525 |
2.2× |
| Salivary gland imaging (78230) |
$369.13 |
$870 |
0.9× |
| Scanogram (77073) |
$202.39 |
$477 |
2.0× |
| Scapula complete (73010) |
$313.97 |
$740 |
3.0× |
| Screening digital breast tomosynthesis (77063) |
$58.98 |
$139 |
2.5× |
| Simulation intermediate (77285) |
$612.24 |
$1,443 |
1.7× |
| Small bowel series (74250) |
$582.97 |
$1,374 |
3.4× |
| Spec medical radj physics consltj (77370) |
$263.48 |
$621 |
2.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$197.72 |
$466 |
0.5× |
| Special dosimetry (77331) |
$125.59 |
$296 |
0.9× |
| Special treatment procedure (77470) |
$402.65 |
$949 |
0.7× |
| Spine thoracic 3 views (72072) |
$487.08 |
$1,148 |
4.7× |
| Spleen imaging only (78185) |
$659.76 |
$1,555 |
1.7× |
| Stereotactic body radiation delivery (77373) |
$1,735.95 |
$4,091.50 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$303.79 |
$716 |
0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$275.36 |
$649 |
0.7× |
| Testicular Imaging With Vascular Flow (78761) |
$465.87 |
$1,098 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$816.32 |
$1,924 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$400.10 |
$943 |
3.0× |
| Therapeutic Enema (74283) |
$529.08 |
$1,247 |
3.1× |
| Thoracolumbar 2 views (72080) |
$189.23 |
$446 |
2.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$907.54 |
$2,139 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$525.69 |
$1,239 |
1.3× |
| Thyroid uptake measurement (78012) |
$852.81 |
$2,010 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$367.86 |
$867 |
0.9× |
| Tmj unilateral (70328) |
$142.56 |
$336 |
1.7× |
| Tomogram (76100) |
$513.81 |
$1,211 |
5.0× |
| Treatment device intermediate (77333) |
$128.56 |
$303 |
1.0× |
| Treatment devices simple (77332) |
$176.93 |
$417 |
1.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,558.81 |
$3,674 |
2.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,713.25 |
$4,038 |
4.3× |
| Tx devices design & construction complex (77334) |
$401.80 |
$947 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$656.79 |
$1,548 |
6.4× |
| Upper Extremity Infant (73092) |
$179.90 |
$424 |
1.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$414.95 |
$978 |
1.1× |
| Urethrocystography voiding (74455) |
$574.91 |
$1,355 |
2.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$580.42 |
$1,368 |
3.4× |
| Us abdl aorta screen aaa (76706) |
$336.04 |
$792 |
3.3× |
| Us breast unilateral complete (76641) |
$512.12 |
$1,207 |
5.0× |
| Us breast unilateral limited (76642) |
$455.26 |
$1,073 |
5.3× |
| Us chest (76604) |
$302.09 |
$712 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$776.01 |
$1,829 |
7.5× |
| Us infant hips dynamic (76885) |
$263.91 |
$622 |
3.1× |
| Us ob transvaginal (76817) |
$543.08 |
$1,280 |
5.3× |
| Us pelvic non ob complete (76856) |
$622 |
$1,466 |
6.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$609.27 |
$1,436 |
5.9× |
| Us pregnancy ltd (76815) |
$195.60 |
$461 |
1.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$383.98 |
$905 |
3.7× |
| Us retroperitoneal complete (76770) |
$1,193.08 |
$2,812 |
11.6× |
| Us retroperitoneal limited (76775) |
$345.79 |
$815 |
3.4× |
| Us scrotum and contents (76870) |
$638.12 |
$1,504 |
6.2× |
| Us soft tissue head/neck (76536) |
$631.34 |
$1,488 |
6.1× |
| Us spinal canal and contents (76800) |
$539.27 |
$1,271 |
5.2× |
| Us transrectal (76872) |
$1,798.96 |
$4,240 |
17.5× |
| Us xtr non-vasc lmtd (76882) |
$368.50 |
$868.50 |
3.6× |
| Venography extremity unilateral rs&i (75820) |
$775.17 |
$1,827 |
0.5× |
| Wrist 2 views (73100) |
$343.67 |
$810 |
4.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$663.58 |
$1,564 |
6.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$383.13 |
$903 |
4.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$683.52 |
$1,611 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$390.34 |
$920 |
4.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$433.62 |
$1,022 |
5.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$283 |
$667 |
2.7× |
| X-ray exam hip uni 1 view (73501) |
$164.63 |
$388 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$274.30 |
$646.50 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$706.01 |
$1,664 |
6.9× |
| X-ray eye for foreign body (70030) |
$134.08 |
$316 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$309.94 |
$730.50 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$156.56 |
$369 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$383.13 |
$903 |
4.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$266.45 |
$628 |
3.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$552.42 |
$1,302 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$160.81 |
$379 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$426.62 |
$1,005.50 |
4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$205.36 |
$484 |
2.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$228.27 |
$538 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$451.02 |
$1,063 |
4.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$695.40 |
$1,639 |
6.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$619.88 |
$1,461 |
6.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$299.55 |
$706 |
3.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$247.79 |
$584 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$179.05 |
$422 |
1.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$356.83 |
$841 |
3.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$362.34 |
$854 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$495.57 |
$1,168 |
5.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$596.97 |
$1,407 |
5.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$471.59 |
$1,111.50 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$360.64 |
$850 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$377.62 |
$890 |
4.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$488.99 |
$1,152.50 |
5.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$350.67 |
$826.50 |
4.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$176.72 |
$416.50 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$487.08 |
$1,148 |
4.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$299.34 |
$705.50 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$263.06 |
$620 |
3.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$245.66 |
$579 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$341.13 |
$804 |
3.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$409.01 |
$964 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$332.22 |
$783 |
3.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$377.62 |
$890 |
4.4× |
| Xr c-spine 6 or more views (72052) |
$614.79 |
$1,449 |
6.0× |
| Xr chest 4+ views (71048) |
$145.96 |
$344 |
1.4× |
| Xr Cholecystography Oral Contrast (74290) |
$308.46 |
$727 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$332.22 |
$783 |
3.9× |
| Xr shoulder 1 view (73020) |
$348.34 |
$821 |
4.1× |
| Xr spine cervical 4 or 5 views (72050) |
$654.67 |
$1,543 |
6.4× |
| Xr tibia/fibula 2 views (73590) |
$357.67 |
$843 |
4.2× |
| Xr tmj bilateral (70330) |
$211.30 |
$498 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$301.03 |
$709.50 |
3.5× |