| Abdomen 2 views (74019) |
$68 |
$282 |
0.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$261 |
$1,086 |
0.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$719 |
$2,996 |
0.3× |
| Angiography extremity bilateral rs&i (75716) |
$1,228 |
$5,117 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,228 |
$5,117 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$655 |
$2,730 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$655 |
$2,730 |
0.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$1,130 |
$4,710 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$655 |
$2,730 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$655 |
$2,730 |
0.2× |
| Ankle 2 views (73600) |
$64 |
$265 |
0.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$81 |
$338 |
0.3× |
| Aortogram thoracic (75605) |
$1,074 |
$4,476 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,018 |
$4,242 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,018 |
$4,242 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$655 |
$2,730 |
0.2× |
| Artery X-Rays Adrenal Gland (75731) |
$560 |
$2,333 |
0.2× |
| Arthrogram elbow (73085) |
$180 |
$751 |
0.6× |
| Arthrogram hip (73525) |
$164 |
$682 |
0.5× |
| Arthrogram shoulder (73040) |
$180 |
$751 |
0.6× |
| Arthrogram wrist (73115) |
$196 |
$816 |
0.6× |
| Arthrography knee lt (73580) |
$196 |
$816 |
0.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$204 |
$849 |
0.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$360 |
$1,500 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$360 |
$1,500 |
1.0× |
| Bone age studies (77072) |
$64 |
$268 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$377 |
$1,570 |
1.1× |
| Bone survey complete (77075) |
$158 |
$658 |
1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,208 |
$5,034 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$129 |
$539 |
1.7× |
| Chest 1 view (71045) |
$52 |
$217 |
0.7× |
| Chest 3 views (71047) |
$178 |
$742.50 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$59 |
$246 |
0.4× |
| Clavicle complete (73000) |
$48 |
$201 |
0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$56 |
$235 |
0.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$59 |
$246 |
0.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,569 |
$6,538 |
5.0× |
| CT abdomen and pelvis without contrast (74176) |
$891 |
$1,866 |
4.2× |
| CT abdomen w contrast (74160) |
$792 |
$3,301 |
5.0× |
| CT abdomen w wo contrast (74170) |
$828 |
$3,452 |
5.3× |
| CT abdomen w/o contrast (74150) |
$254.50 |
$1,060.50 |
2.7× |
| CT angio hrt w/3d image (75574) |
$556 |
$2,317 |
1.8× |
| CT angiography upper extremity lt (73206) |
$1,044 |
$4,352 |
6.6× |
| CT c-spine w/o contrast (72125) |
$524 |
$2,183 |
5.6× |
| CT cervical spine w&w/o contrast (72127) |
$818 |
$3,410 |
5.2× |
| CT cervical spine with contrast (72126) |
$786 |
$3,275 |
2.5× |
| CT chest w/wo contrast (71270) |
$726 |
$3,024 |
4.6× |
| CT chest with contrast (71260) |
$688 |
$2,866 |
4.4× |
| CT head/brain with contrast (70460) |
$630 |
$2,625 |
4.0× |
| CT head/brain without and with contrast (70470) |
$655 |
$2,729 |
4.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$30 |
$126 |
0.4× |
| CT iac w contrast (70481) |
$556 |
$2,315 |
3.5× |
| CT limited/localized follow up study (76380) |
$56 |
$235 |
0.7× |
| CT lower ext w/o (73700) |
$390 |
$1,627 |
4.2× |
| CT lower extremity w wo contrast (73702) |
$697 |
$2,903 |
4.4× |
| CT lower extremity with contrast (73701) |
$621 |
$2,589 |
3.9× |
| CT lumbar spine w & w/o contrast (72133) |
$799 |
$3,329 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$489 |
$2,039 |
5.2× |
| CT lumbar spine with contrast (72132) |
$723 |
$3,012 |
2.3× |
| CT maxillofacial w contrast (70487) |
$642 |
$2,675 |
4.1× |
| CT maxillofacial w/o contrast (70486) |
$408 |
$1,699 |
4.4× |
| CT maxillofacial w/wo contrast (70488) |
$710 |
$2,958 |
4.5× |
| CT neck soft tissue w contrast (70491) |
$688 |
$2,866 |
4.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$713 |
$2,969 |
4.5× |
| CT orbits w/o contrast (70480) |
$388 |
$1,616 |
4.1× |
| CT pelvis w & w/o contrast (72194) |
$741 |
$3,087 |
4.7× |
| CT pelvis w/o contrast (72192) |
$408 |
$1,699 |
4.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$708 |
$2,950 |
4.5× |
| CT soft tissue neck w/o contrast (70490) |
$474 |
$1,975 |
5.1× |
| CT thoracic spine w/contrast (72129) |
$705 |
$2,936 |
4.5× |
| CT thoracic spine w/o contrast (72128) |
$489 |
$2,039 |
5.2× |
| CT thoracic spine w/wo contrast (72130) |
$781 |
$3,254 |
5.0× |
| CT thorax w/o contrast (71250) |
$484 |
$2,016 |
5.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$702 |
$2,924 |
4.5× |
| CT upper extremity w/o contrast rt (73200) |
$395 |
$1,647 |
4.2× |
| CT upper extremity with contrast (73201) |
$395 |
$1,647 |
1.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,873.50 |
$7,806.50 |
11.9× |
| Cta Abdomen (74175) |
$1,171 |
$4,879 |
7.4× |
| CTA abdomen pelvis (74174) |
$2,254 |
$9,393 |
7.2× |
| CTA chest (71275) |
$1,068 |
$4,451 |
6.8× |
| Cta Head (70496) |
$973 |
$4,055 |
6.2× |
| CTA lwr ext w&w/o contrast (73706) |
$1,044 |
$4,352 |
6.6× |
| Cta Neck (70498) |
$973 |
$4,055 |
6.2× |
| Cta Pelvis (72191) |
$1,084 |
$4,515 |
6.9× |
| Cystography minimum 3 views rs&i (74430) |
$150 |
$626 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$121 |
$504 |
1.3× |
| Echo exam of eye (76529) |
$73 |
$304 |
0.9× |
| Esophagus (74220) |
$59 |
$246 |
0.4× |
| Fetal biophysical profile non-stress testing (76818) |
$243 |
$1,012 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$107 |
$444 |
0.5× |
| Foot 2 views (73620) |
$48 |
$201 |
0.6× |
| Forearm 2 views (73090) |
$69 |
$287 |
0.9× |
| Gated Heart Planar Single (78472) |
$263 |
$1,097 |
0.7× |
| Hand 2 views (73120) |
$39 |
$162 |
0.4× |
| Hand 3 views (73130) |
$56 |
$235 |
0.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$655 |
$2,730 |
0.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$395 |
$1,647 |
0.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$306 |
$1,276 |
0.9× |
| Ht muscle image spect sing (78451) |
$435 |
$1,812 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$76 |
$318 |
1.0× |
| Hysterosalpingogram (74740) |
$221 |
$920 |
1.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$28 |
$117 |
0.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$306 |
$1,274 |
0.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$740 |
$3,084 |
1.5× |
| Knee 3 views (73562) |
$78 |
$325 |
1.0× |
| Liver & spleen imaging static only (78215) |
$226 |
$941 |
0.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$226 |
$941 |
0.6× |
| Lung perfusion differential (78597) |
$117 |
$487 |
0.3× |
| Lung Ventilation Imaging (78579) |
$198 |
$825 |
0.6× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$655 |
$2,730 |
0.2× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$127 |
$531 |
0.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$327 |
$1,364 |
0.2× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$655 |
$2,730 |
0.2× |
| Lymphoscintigraphy (78195) |
$175 |
$730 |
0.4× |
| Mammary ductogram or galactogram multiple (77054) |
$200 |
$834 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$168 |
$701 |
0.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$85 |
$355 |
1.1× |
| Meckels Diverticulum (78290) |
$261 |
$1,086 |
0.7× |
| Mr safety determination physician/other qhp (76016) |
$49 |
$203 |
0.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$33 |
$137 |
0.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$13 |
$56 |
0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$51 |
$212 |
0.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$133 |
$556 |
0.6× |
| MRA head w/o contrast (70544) |
$822 |
$3,427 |
3.8× |
| MRA head with contrast (70545) |
$1,076 |
$4,483 |
3.4× |
| MRA neck w contrast (70548) |
$1,076 |
$4,483 |
3.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,344 |
$5,598 |
4.3× |
| MRA neck w/o contrast (70547) |
$822 |
$3,427 |
3.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,494 |
$6,224 |
4.8× |
| MRI abdomen w/o contrast (74181) |
$1,003 |
$4,181 |
4.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,216 |
$5,068 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,216 |
$5,068 |
1.7× |
| MRI c-spine with contrast (72142) |
$1,313 |
$5,472 |
4.2× |
| MRI cervical spine w/o contrast (72141) |
$1,025 |
$4,272 |
4.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,621 |
$6,755 |
5.2× |
| MRI chest w/o contrast (71550) |
$1,003 |
$4,181 |
4.7× |
| MRI chest with contrast (71551) |
$1,013 |
$4,222 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,216 |
$5,068 |
3.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,216 |
$5,068 |
3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$956 |
$3,984 |
4.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,029 |
$4,289 |
4.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,329 |
$5,536 |
4.2× |
| MRI orbit/face/neck w/contrast (70542) |
$892 |
$3,715 |
2.9× |
| MRI pelvis w contrast (72196) |
$1,003 |
$4,181 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,597 |
$6,656 |
5.1× |
| MRI pelvis w/o contrast (72195) |
$1,003 |
$4,181 |
4.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,476 |
$6,151 |
4.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,476 |
$6,151 |
4.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,622 |
$6,758 |
5.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,216 |
$5,068 |
3.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,709 |
$7,119 |
5.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,230 |
$5,124 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,621 |
$6,755 |
5.2× |
| MRI thoracic spine w/o contrast (72146) |
$944 |
$3,932 |
4.4× |
| MRI tmj (70336) |
$787 |
$1,665 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$956 |
$3,984 |
4.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,476 |
$6,151 |
4.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$956 |
$3,984 |
4.5× |
| Myocardial Spect Multiple Studies (78452) |
$677 |
$2,820 |
0.6× |
| Neck soft tissue (70360) |
$37 |
$153 |
0.5× |
| Nm gastric emptying study (78264) |
$207 |
$864 |
0.6× |
| Nm gastroesophageal reflux study (78262) |
$193 |
$806 |
0.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$113 |
$470 |
1.2× |
| Osseous survey infant (77076) |
$102 |
$425 |
1.1× |
| Osseous survey limited (77074) |
$89 |
$371 |
0.9× |
| Parathyroid imaging (78070) |
$227 |
$945 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$64 |
$265 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$1,233 |
$5,138 |
1.0× |
| PET imaging CT for attenuation limited area (78814) |
$1,474 |
$6,141 |
1.1× |
| PET imaging for CT attenuation whole body (78816) |
$1,354 |
$5,640 |
1.1× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$2 |
$9 |
0.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,476 |
$6,151 |
4.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$394 |
$1,643 |
1.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$303 |
$1,263 |
0.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$111 |
$461 |
0.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$89.50 |
$372 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$59 |
$245 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$60 |
$252 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$53 |
$221 |
0.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$139 |
$578 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$116 |
$484 |
0.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$64 |
$266 |
0.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$121 |
$503 |
0.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$139 |
$580 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$69 |
$287 |
0.9× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$47 |
$194 |
0.6× |
| Radiological examination surgical specimen (76098) |
$234 |
$975 |
0.5× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$2 |
$9 |
0.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$655 |
$2,730 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$655 |
$2,730 |
0.2× |
| Ribs bilateral 3 views (71110) |
$138 |
$576 |
1.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$349 |
$1,456 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$292 |
$1,217 |
0.6× |
| Sacroiliac Joints < 3 Views (72200) |
$48 |
$201 |
0.5× |
| Scanogram (77073) |
$101 |
$422.50 |
1.1× |
| Scapula complete (73010) |
$55 |
$230 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$71 |
$297 |
3.0× |
| Sella turcica (70240) |
$24 |
$101 |
0.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$29 |
$121 |
0.3× |
| Sialogram (70390) |
$89 |
$369 |
0.4× |
| Small bowel series (74250) |
$64 |
$268 |
0.4× |
| Spine thoracic 3 views (72072) |
$83 |
$344 |
0.9× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$255 |
$1,061 |
1.2× |
| Testicular Imaging With Vascular Flow (78761) |
$220 |
$917 |
0.6× |
| Therapeutic Enema (74283) |
$116 |
$484 |
0.7× |
| Thoracolumbar 2 views (72080) |
$64 |
$265 |
0.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$222 |
$924 |
0.6× |
| Thyroid uptake measurement (78012) |
$303 |
$1,261.50 |
0.8× |
| Tmj unilateral (70328) |
$34 |
$143 |
0.4× |
| Tomogram (76100) |
$226 |
$943 |
2.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$86 |
$357 |
0.2× |
| Ultrasound elastography first target lesion (76982) |
$35 |
$146 |
0.4× |
| Ultrasound, abdomen limited (76705) |
$91 |
$378 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$67 |
$279.50 |
0.9× |
| Upper Extremity Infant (73092) |
$28 |
$117 |
0.3× |
| Urethrocystography retrograde rs&i (74450) |
$150 |
$326.50 |
0.7× |
| Urethrocystography voiding (74455) |
$150 |
$626 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$228 |
$949 |
1.4× |
| Us breast unilateral complete (76641) |
$132 |
$551 |
1.4× |
| Us breast unilateral limited (76642) |
$132 |
$551 |
1.7× |
| Us chest (76604) |
$143 |
$595 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$54 |
$225 |
0.6× |
| Us elastography parenchyma (76981) |
$70 |
$292 |
0.7× |
| Us guided compression repair (76936) |
$65 |
$271 |
0.3× |
| Us infant hips dynamic (76885) |
$69 |
$289 |
0.9× |
| Us infant hips limited static (76886) |
$69 |
$289 |
0.9× |
| Us ob transvaginal (76817) |
$125 |
$519 |
1.3× |
| Us pelvic non ob complete (76856) |
$120 |
$499 |
1.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$120 |
$499 |
1.3× |
| Us pregnancy ltd (76815) |
$125 |
$519 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$113 |
$470 |
1.2× |
| Us retroperitoneal complete (76770) |
$121 |
$506 |
1.3× |
| Us retroperitoneal limited (76775) |
$103 |
$430 |
1.1× |
| Us scrotum and contents (76870) |
$168 |
$702 |
1.8× |
| Us soft tissue head/neck (76536) |
$99 |
$414 |
1.1× |
| Us transrectal prostate volume (76873) |
$171 |
$712 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$132 |
$551 |
1.4× |
| Venogram extremity bilateral (75822) |
$296 |
$1,233 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$941.50 |
$3,923.50 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$327 |
$1,364 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$327 |
$1,364 |
0.2× |
| Venography Renal Bilateral (75833) |
$655 |
$2,730 |
0.2× |
| Venography renal unilateral selective rs&i (75831) |
$941.50 |
$3,923.50 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$655 |
$2,730 |
0.2× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$1,130 |
$4,710 |
0.2× |
| Wrist 2 views (73100) |
$69 |
$287 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$104 |
$434 |
1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$68 |
$282 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$76 |
$315 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$133 |
$555 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$64 |
$265 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$85 |
$355 |
1.1× |
| X-ray exam hip uni 1 view (73501) |
$78 |
$325 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$105 |
$438 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$126 |
$525 |
1.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$139 |
$580 |
0.9× |
| X-ray eye for foreign body (70030) |
$62 |
$257 |
0.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$83 |
$344 |
0.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$48 |
$199 |
0.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$64 |
$265 |
0.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$408 |
$1,700 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$37 |
$155 |
0.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$34 |
$143 |
0.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$108 |
$451 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$78 |
$325 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$28 |
$117 |
0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$93 |
$387 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$148 |
$617 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$93 |
$387 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$55 |
$229 |
0.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$107 |
$444 |
1.4× |
| X-ray of voice box or throat (70370) |
$32 |
$134 |
0.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$83 |
$344 |
0.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$95 |
$394 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$162 |
$677 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$55 |
$230 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$138 |
$576 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$190 |
$791 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$80 |
$334 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$80 |
$334 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$64 |
$268 |
0.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$95 |
$395 |
1.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$83 |
$344 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$95 |
$395 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$64 |
$265 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$48 |
$201 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$139 |
$578 |
1.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$139 |
$578 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$64 |
$265 |
0.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$111 |
$462 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$29 |
$122 |
0.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$85 |
$355 |
1.1× |
| Xr arthrogram ankle (73615) |
$196 |
$816 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$167 |
$694 |
1.8× |
| Xr chest 4+ views (71048) |
$209 |
$870.50 |
2.2× |
| Xr Cholecystography Oral Contrast (74290) |
$108 |
$448 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$42 |
$177 |
0.5× |
| Xr internal auditory meati complete (70134) |
$111 |
$461 |
0.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$34 |
$143 |
0.4× |
| Xr shoulder 1 view (73020) |
$48 |
$201 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$148 |
$617 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$42 |
$177 |
0.5× |
| Xr tmj bilateral (70330) |
$60 |
$252 |
0.8× |
| Xray knee 1 or 2 views rt (73560) |
$64 |
$265 |
0.8× |