| Acute gi blood loss imaging (78278) |
$943.35 |
$1,655 |
2.3× |
| Ankle 2 views (73600) |
$223.72 |
$392.50 |
2.5× |
| Clavicle complete (73000) |
$251.37 |
$441 |
2.8× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$4,008.24 |
$7,032 |
11.2× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$2,255.49 |
$3,957 |
12.6× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$2,262.62 |
$3,969.50 |
12.6× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,887.84 |
$3,312 |
10.5× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$2,273.16 |
$3,988 |
12.7× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,897.53 |
$3,329 |
10.6× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,876.79 |
$5,047 |
16.1× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,962.51 |
$3,443 |
11.0× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Age Under 21 (77078) |
$482.22 |
$846 |
5.4× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$2,803.26 |
$4,918 |
15.6× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,444.95 |
$2,535 |
13.5× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$3,559.08 |
$6,244 |
19.9× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$2,972.55 |
$5,215 |
16.6× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,737.08 |
$3,047.50 |
9.7× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,266.82 |
$2,222.50 |
11.9× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,781.82 |
$3,126 |
9.9× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,352.04 |
$2,372 |
12.7× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,020.94 |
$3,545.50 |
11.3× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$2,003.55 |
$3,515 |
11.2× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$2,595.21 |
$4,553 |
14.5× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$2,109.86 |
$3,701.50 |
11.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,034.96 |
$5,324.50 |
8.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,931.51 |
$5,143 |
12.0× |
| CT abdomen w & w/o contrast (74170) |
$2,142.34 |
$3,758.50 |
12.0× |
| CT abdomen w/contrast (74160) |
$1,784.67 |
$3,131 |
10.0× |
| CT abdomen w/o contrast (74150) |
$1,583.46 |
$2,778 |
14.8× |
| CT angio hrt w/3d image (75574) |
$1,224.93 |
$2,149 |
3.4× |
| CT cervical spine w/contrast (72126) |
$2,040.32 |
$3,579.50 |
5.7× |
| CT cervical spine w/o contrast (72125) |
$1,723.96 |
$3,024.50 |
16.1× |
| CT chest w/contrast (71260) |
$1,708.58 |
$2,997.50 |
9.5× |
| CT extremity upper w & w/o contrast (73202) |
$2,754.81 |
$4,833 |
15.4× |
| CT extremity upper w/o contrast (73200) |
$1,385.38 |
$2,430.50 |
13.0× |
| CT head/brain with contrast (70460) |
$1,421.86 |
$2,494.50 |
7.9× |
| CT head/brain without and with contrast (70470) |
$1,959.94 |
$3,438.50 |
10.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$107.73 |
$189 |
1.2× |
| CT l-spine w/contrast (72132) |
$1,942.84 |
$3,408.50 |
5.5× |
| CT lower extremity w/dye (73701) |
$1,543.56 |
$2,708 |
8.6× |
| CT lumbar spine w/o contrast (72131) |
$1,728.81 |
$3,033 |
16.2× |
| CT maxillofacial w/wo contrast (70488) |
$2,361.80 |
$4,143.50 |
13.2× |
| CT neck w/contrast (70491) |
$1,687.48 |
$2,960.50 |
9.4× |
| CT neck w/o contrast (70490) |
$1,534.44 |
$2,692 |
14.4× |
| CT pelvis w & w/o contrast (72194) |
$2,251.50 |
$3,950 |
12.6× |
| CT pelvis w/o contrast (72192) |
$1,490.26 |
$2,614.50 |
14.0× |
| CT thoracic spine w/contrast (72129) |
$2,156.31 |
$3,783 |
12.0× |
| CT thoracic spine w/o contrast (72128) |
$2,106.72 |
$3,696 |
19.7× |
| CT thorax lung cancer scr c- (71271) |
$172.71 |
$303 |
1.6× |
| CT thorax w/o contrast (71250) |
$1,410.18 |
$2,474 |
13.2× |
| CT upper extremity w/dye (73201) |
$1,809.46 |
$3,174.50 |
5.1× |
| CTA head w contrast (70496) |
$1,767 |
$3,100 |
9.9× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$385.89 |
$677 |
1.1× |
| Discography, cervical or thoracic, radiological supervision and interpretation Age Under 21 (72285) |
$110.58 |
$194 |
0.1× |
| Diskography lumbar s&i (72295) |
$78.09 |
$137 |
0.0× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$309.80 |
$543.50 |
2.9× |
| Fetal biophys profile w/o nst (76819) |
$545.49 |
$957 |
5.1× |
| Fetal biophysical profile non-stress testing (76818) |
$369.36 |
$648 |
3.5× |
| Gated heart planar single (78472) |
$1,654.14 |
$2,902 |
4.0× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$895.18 |
$1,570.50 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$788.88 |
$1,384 |
1.9× |
| Ht muscle image spect sing (78451) |
$5,527.86 |
$9,698 |
4.2× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$691.41 |
$1,213 |
1.7× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$939.93 |
$1,649 |
1.7× |
| Liver and spleen imaging; with vascular flow Age Under 21 (78216) |
$1,106.37 |
$1,941 |
2.7× |
| Lung perfusion imaging (78580) |
$833.06 |
$1,461.50 |
2.0× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$2,346.69 |
$4,117 |
6.6× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$2,218.44 |
$3,892 |
6.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,595.43 |
$2,799 |
6.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$2,475.51 |
$4,343 |
6.9× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$1,863.33 |
$3,269 |
5.2× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$1,541.28 |
$2,704 |
6.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,340.42 |
$4,106 |
6.6× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$2,447.58 |
$4,294 |
6.9× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$2,743.41 |
$4,813 |
7.7× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$2,666.74 |
$4,678.50 |
7.5× |
| Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation Age Under 21 (77054) |
$718.20 |
$1,260 |
2.9× |
| Mammary ductogram single (77053) |
$538.65 |
$945 |
2.2× |
| Mandible min 4v (70110) |
$255.93 |
$449 |
2.4× |
| MRA head w/o contrast (70544) |
$1,663.26 |
$2,918 |
6.8× |
| MRA neck w/ contrast (70548) |
$2,458.41 |
$4,313 |
6.9× |
| MRA neck w/o contrast (70547) |
$1,858.77 |
$3,261 |
7.6× |
| MRI abdomen w/contrast (74182) |
$2,976.54 |
$5,222 |
8.4× |
| MRI abdomen w/o contrast (74181) |
$2,232.98 |
$3,917.50 |
9.2× |
| MRI abdomen w/wo contrast (74183) |
$2,922.10 |
$5,126.50 |
8.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,355.24 |
$4,132 |
2.9× |
| MRI c-spine w&w/o cont (72156) |
$2,467.82 |
$4,329.50 |
6.9× |
| MRI cervical spine w/contrast (72142) |
$2,536.50 |
$4,450 |
7.1× |
| MRI chest w/o contrast (71550) |
$1,742.49 |
$3,057 |
7.1× |
| MRI chest w/wo contrast (71552) |
$2,197.64 |
$3,855.50 |
6.2× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,118.12 |
$3,716 |
5.9× |
| MRI joint upr extrem w/dye (73222) |
$1,698.03 |
$2,979 |
2.1× |
| MRI joint upr extrem w/o dye (73221) |
$1,716.27 |
$3,011 |
7.0× |
| MRI lumbar spine w/contrast (72149) |
$2,661.90 |
$4,670 |
7.5× |
| MRI lumbar spine w/wo contrast (72158) |
$2,611.17 |
$4,581 |
7.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,300.24 |
$4,035.50 |
6.5× |
| MRI pelvis w & w/o contrast (72197) |
$2,497.46 |
$4,381.50 |
7.0× |
| MRI pelvis w/contrast (72196) |
$2,534.79 |
$4,447 |
7.1× |
| MRI pelvis w/o contrast (72195) |
$1,861.90 |
$3,266.50 |
7.6× |
| MRI spine cervical w/o contrast (72141) |
$1,863.33 |
$3,269 |
7.6× |
| MRI t-spine w&w/o cont (72157) |
$2,956.30 |
$5,186.50 |
8.3× |
| MRI thoracic spine w/contrast (72147) |
$2,716.62 |
$4,766 |
7.6× |
| MRI thoracic spine w/o contrst (72146) |
$1,813.17 |
$3,181 |
7.4× |
| MRI tmj (70336) |
$1,452.36 |
$2,548 |
6.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,540.42 |
$2,702.50 |
6.3× |
| Myocardial spect multiple studies (78452) |
$3,336.78 |
$5,854 |
2.5× |
| Nm bone 3 phase (78315) |
$1,760.73 |
$3,089 |
4.3× |
| Nm bone imaging whole body (78306) |
$1,610.25 |
$2,825 |
3.9× |
| Nm gastric emptying (78264) |
$1,121.76 |
$1,968 |
2.7× |
| Nm lymph system (78195) |
$1,099.82 |
$1,929.50 |
2.0× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,557.81 |
$2,733 |
3.8× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$1,700.88 |
$2,984 |
4.2× |
| Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume… (78494) |
$978.12 |
$1,716 |
2.4× |
| Nuclear medicine study of stomach lining (78261) |
$719.34 |
$1,262 |
1.8× |
| Ob us limited fetus(s) (76815) |
$438.90 |
$770 |
4.1× |
| Ob us nuchal meas 1 gest (76813) |
$538.08 |
$944 |
5.0× |
| Optic foramina (70190) |
$127.11 |
$223 |
1.4× |
| Parathyrd planar w/spect&CT (78072) |
$743 |
$1,303.50 |
1.3× |
| Parathyroid planar imaging (78070) |
$1,165.94 |
$2,045.50 |
2.9× |
| Pulmonary ventilation & perfusion imaging (78582) |
$1,387.95 |
$2,435 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$410.40 |
$720 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$148.77 |
$261 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$324.04 |
$568.50 |
3.0× |
| Radex hip unilateral with pelvis 1 view (73501) |
$230.28 |
$404 |
2.6× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$249.09 |
$437 |
2.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$375.92 |
$659.50 |
3.5× |
| Radex spine cervical 2 or 3 views (72040) |
$296.40 |
$520 |
3.3× |
| Radex spine cervical 4 or 5 views (72050) |
$381.33 |
$669 |
3.6× |
| Radex spine cervical 6 or more views (72052) |
$513.28 |
$900.50 |
4.8× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$260.20 |
$456.50 |
2.9× |
| Radiologic exam abdomen 3+ views (74021) |
$282.15 |
$495 |
2.6× |
| Radiologic exam chest 4+ views (71048) |
$346.56 |
$608 |
3.2× |
| Radiologic exam colon double contrast study (74280) |
$732.16 |
$1,284.50 |
4.1× |
| Radiologic exam colon single contrast study (74270) |
$529.53 |
$929 |
3.0× |
| Radiologic exam esophagus single contrast study (74220) |
$472.82 |
$829.50 |
2.6× |
| Radiologic exam small int single contrast study (74250) |
$473.10 |
$830 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$731.02 |
$1,282.50 |
4.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$549.48 |
$964 |
3.1× |
| Radiologic examination femur minimum 2 views (73552) |
$265.62 |
$466 |
3.0× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$446.60 |
$783.50 |
5.0× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$300.96 |
$528 |
3.4× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$412.40 |
$723.50 |
3.9× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$213.18 |
$374 |
2.4× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$281.01 |
$493 |
3.2× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$277.02 |
$486 |
3.1× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$251.94 |
$442 |
2.8× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$263.91 |
$463 |
3.0× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$344.85 |
$605 |
3.9× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$339.44 |
$595.50 |
3.2× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$219.45 |
$385 |
2.5× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$310.65 |
$545 |
3.5× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$440.32 |
$772.50 |
4.1× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$344.28 |
$604 |
3.2× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$764.08 |
$1,340.50 |
2.1× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$285 |
$500 |
3.2× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$216.03 |
$379 |
2.4× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$283.86 |
$498 |
2.7× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$338.86 |
$594.50 |
3.2× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$328.89 |
$577 |
3.1× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$427.22 |
$749.50 |
4.0× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$271.04 |
$475.50 |
3.0× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$288.42 |
$506 |
3.2× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$206.06 |
$361.50 |
2.3× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$176.13 |
$309 |
2.0× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$410.40 |
$720 |
3.8× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$203.49 |
$357 |
2.3× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$186.39 |
$327 |
2.1× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$242.82 |
$426 |
2.3× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$1,342.92 |
$2,356 |
2.4× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$607.05 |
$1,065 |
2.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$573.42 |
$1,006 |
1.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$808.26 |
$1,418 |
1.5× |
| Rp loclzj tum spect 2 areas (78831) |
$1,764.72 |
$3,096 |
1.3× |
| Rp loclzj tum spect w/CT 1 (78830) |
$2,180.25 |
$3,825 |
1.6× |
| Rp loclzj tum spect w/CT 2 (78832) |
$2,287.98 |
$4,014 |
1.6× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$454.58 |
$797.50 |
1.9× |
| Scapula complete (73010) |
$307.23 |
$539 |
2.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$35.91 |
$63 |
0.3× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$621.87 |
$1,091 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$572.28 |
$1,004 |
5.4× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$211.47 |
$371 |
2.0× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$555.18 |
$974 |
5.2× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$912.57 |
$1,601 |
3.7× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$540.93 |
$949 |
5.1× |
| Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) Age Under 21 (76873) |
$124.26 |
$218 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$315.21 |
$553 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$830.49 |
$1,457 |
4.6× |
| Us breast uni real time with image complete (76641) |
$358.82 |
$629.50 |
3.4× |
| Us chest (76604) |
$456 |
$800 |
4.3× |
| Us compl joint r-t w/image documentation (76881) |
$343.14 |
$602 |
3.2× |
| Us exam, pelvic, limited (76857) |
$342.57 |
$601 |
3.2× |
| US OB Follow-Up/Repeat (76816) |
$398.14 |
$698.50 |
3.7× |
| Us ob transvaginal (76817) |
$488.49 |
$857 |
4.6× |
| Us retroperitoneal complete (76770) |
$630.70 |
$1,106.50 |
5.9× |
| Us retroperitoneal ltd (76775) |
$406.12 |
$712.50 |
3.8× |
| Us scrotum (76870) |
$497.61 |
$873 |
4.7× |
| Us soft tissue head/neck (76536) |
$534.09 |
$937 |
5.0× |
| Us spinal canal (76800) |
$319.77 |
$561 |
3.0× |
| Us transrectal (76872) |
$62.70 |
$110 |
0.6× |
| Venous thrombosis imaging - nm extremity veins thrombosis right (78457) |
$1,085.28 |
$1,904 |
2.0× |
| X-ray exam of finger(s) (73140) |
$186.96 |
$328 |
2.1× |
| X-ray exam of knee 1 or 2 (73560) |
$241.96 |
$424.50 |
2.7× |
| X-ray exam ribs bil 3 views (71110) |
$360.24 |
$632 |
3.4× |
| X-ray exam ribs uni 2 views (71100) |
$241.40 |
$423.50 |
2.7× |
| X-ray heel (73650) |
$214.89 |
$377 |
2.4× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$275.60 |
$483.50 |
2.6× |
| Xr abdomen 1 view (74018) |
$351.12 |
$616 |
3.9× |
| Xr abdomen 2 views (74019) |
$277.59 |
$487 |
2.6× |
| Xr arthrogram ankle (73615) |
$438.90 |
$770 |
1.2× |
| Xr arthrogram hip (73525) |
$664.05 |
$1,165 |
1.9× |
| Xr arthrogram knee (73580) |
$524.97 |
$921 |
1.5× |
| Xr arthrogram wrist (73115) |
$484.50 |
$850 |
1.4× |
| Xr bone age studies (77072) |
$234.84 |
$412 |
2.2× |
| Xr bone length study (77073) |
$246.81 |
$433 |
2.3× |
| Xr bone survey infant (77076) |
$229.71 |
$403 |
2.2× |
| Xr bone survey ltd (77074) |
$372.21 |
$653 |
3.5× |
| Xr chest 1 view (71045) |
$192.94 |
$338.50 |
2.2× |
| Xr chest 2 views (71046) |
$262.20 |
$460 |
2.9× |
| Xr eye foreign body (70030) |
$252.51 |
$443 |
2.8× |
| Xr facial bones 3+ views (70150) |
$423.51 |
$743 |
4.0× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$205.48 |
$360.50 |
2.3× |
| Xr forearm 2 views (73090) |
$239.68 |
$420.50 |
2.7× |
| Xr hand 2v (73120) |
$243.68 |
$427.50 |
2.3× |
| Xr hysterosalpingogram (74740) |
$817.10 |
$1,433.50 |
3.4× |
| Xr joint survey 1 view (77077) |
$242.82 |
$426 |
2.3× |
| Xr neck soft tissue (70360) |
$260.49 |
$457 |
2.9× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$336.87 |
$591 |
3.8× |
| Xr osseous survey complete (77075) |
$581.40 |
$1,020 |
5.4× |
| Xr pelvis 1-2 views (72170) |
$249.09 |
$437 |
2.3× |
| Xr pelvis min 3 view (72190) |
$320.34 |
$562 |
3.0× |
| Xr sacrum/coccyx 2+ views (72220) |
$268.47 |
$471 |
3.0× |
| Xr shoulder 1 view (73020) |
$190.10 |
$333.50 |
2.1× |
| Xr sinuses 3+ views (70220) |
$372.78 |
$654 |
4.2× |
| Xr skull min 4 view (70260) |
$518.13 |
$909 |
4.9× |
| Xr spine 1 view (72020) |
$167.01 |
$293 |
1.9× |
| Xr spine thoracic 3v (72072) |
$368.22 |
$646 |
3.4× |
| Xr sternum 2+ views (71120) |
$354.82 |
$622.50 |
4.0× |
| Xr surgical specimen (76098) |
$416.67 |
$731 |
0.7× |
| Xr t-spine 2 views (72070) |
$285 |
$500 |
2.7× |
| Xr tibia/fibula 2 views (73590) |
$267.33 |
$469 |
3.0× |
| Xr tmj unilateral (70328) |
$171.57 |
$301 |
1.9× |
| Xr wrist 2 views (73100) |
$210.90 |
$370 |
2.4× |