| Abdomen 1 View (74018) |
$202 |
$311 |
2.3× |
| Abdomen 2 views (74019) |
$372 |
$572 |
3.5× |
| Angio pulmonary bilat (75743) |
$8,102 |
$12,464 |
2.6× |
| Angiography extremity bilateral rs&i (75716) |
$8,102 |
$12,464 |
2.6× |
| Angiography extremity unilateral rs&i (75710) |
$8,102 |
$12,464 |
2.6× |
| Ankle 2 views (73600) |
$202 |
$311 |
2.3× |
| Arthrogram ankle (73615) |
$1,483 |
$2,282 |
4.2× |
| Arthrogram hip (73525) |
$1,483 |
$2,282 |
4.2× |
| Arthrogram Wrist (73115) |
$822 |
$1,264 |
2.3× |
| Bone age studies (77072) |
$372 |
$572 |
3.5× |
| Bone Imaging 3 Phase (78315) |
$1,136 |
$1,747 |
2.8× |
| Bone Imaging Limited Area (78300) |
$1,136 |
$1,747 |
2.8× |
| Bone Imaging Multiple Areas (78305) |
$1,136 |
$1,747 |
2.8× |
| Bone Imaging Whole Body (78306) |
$1,136 |
$1,747 |
2.8× |
| Bone marrow imaging limited area (78102) |
$1,226 |
$1,886 |
3.1× |
| Bone marrow imaging; multiple areas (78103) |
$1,226 |
$1,886 |
3.1× |
| Bone marrow imaging; whole body (78104) |
$1,226 |
$1,886 |
3.1× |
| Bone survey infant (77076) |
$372 |
$572 |
3.5× |
Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$875–$1,136 |
$1,346–$1,747 |
varies |
| Cat Scan Follow-Up Study (76380) |
$761 |
$1,170 |
8.7× |
| Chest 1 view (71045) |
$202 |
$311 |
2.3× |
| Chest 2 views (71046) |
$202 |
$311 |
2.3× |
| Chest 3 views (71047) |
$202 |
$311 |
2.3× |
| Chest 4 or more views (71048) |
$372 |
$572 |
3.5× |
| Cholecystography Oral Contrast (74290) |
$822 |
$1,264 |
4.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$2,211 |
$3,402 |
2.8× |
| Clavicle complete (73000) |
$202 |
$311 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$865 |
$1,330 |
8.2× |
| Contrast X-Ray Bladder (74430) |
$822 |
$1,264 |
2.3× |
| Contrast X-Ray Of Elbow (73085) |
$1,483 |
$2,282 |
4.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,483 |
$2,282 |
4.2× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$822 |
$1,264 |
4.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,440 |
$3,754 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,539 |
$2,368 |
6.4× |
| CT abdomen w contrast (74160) |
$1,565 |
$2,408 |
8.9× |
| CT abdomen w wo contrast (74170) |
$1,752 |
$2,696 |
9.9× |
| CT abdomen w/o contrast (74150) |
$865 |
$1,330 |
8.2× |
| CT Angio Chest (71275) |
$1,832 |
$2,818 |
10.4× |
CT Angio Head (70496) range across 3 matching MRF lines |
$822–$1,832 |
$1,264–$2,818 |
varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,832 |
$2,818 |
10.4× |
| CT Angio Neck (70498) |
$1,832 |
$2,818 |
10.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,832 |
$2,818 |
10.4× |
| CT bone density (77078) |
$761 |
$1,170 |
8.7× |
| CT cervical spine w/ contrast (72126) |
$1,565 |
$2,408 |
4.5× |
| CT cervical spine w/o contrast (72125) |
$865 |
$1,330 |
8.2× |
| CT cervical spine w/wo cont (72127) |
$1,752 |
$2,696 |
9.9× |
| CT chest w contrast (71260) |
$1,565 |
$2,408 |
8.9× |
| CT chest w/wo contrast (71270) |
$1,752 |
$2,696 |
9.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,565 |
$2,408 |
8.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$865 |
$1,330 |
8.2× |
| CT head/brain with contrast (70460) |
$1,565 |
$2,408 |
8.9× |
| CT head/brain without and with contrast (70470) |
$1,752 |
$2,696 |
9.9× |
| CT iac w contrast (70481) |
$1,565 |
$2,408 |
8.9× |
| CT l-spine w&w/o contrast (72133) |
$1,752 |
$2,696 |
9.9× |
| CT lower ext w/o (73700) |
$865 |
$1,330 |
8.2× |
CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,565–$1,832 |
$2,408–$2,818 |
varies |
| CT lumbar spine w contrast (72132) |
$1,565 |
$2,408 |
4.5× |
| CT lumbar spine w/o contrast (72131) |
$865 |
$1,330 |
8.2× |
| CT maxillofacial w contrast (70487) |
$1,565 |
$2,408 |
8.9× |
| CT maxillofacial wo contrast (70486) |
$865 |
$1,330 |
8.2× |
| CT neck tissue combo (70492) |
$1,752 |
$2,696 |
9.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,752 |
$2,696 |
9.9× |
| CT orbits w/o contrast (70480) |
$865 |
$1,330 |
8.2× |
| CT pelvis w&w/o contrast (72194) |
$1,752 |
$2,696 |
9.9× |
| CT pelvis w/o contrast (72192) |
$865 |
$1,330 |
8.2× |
| CT scan of leg combo (73702) |
$1,752 |
$2,696 |
9.9× |
| CT scans face/jaw combo (70488) |
$1,752 |
$2,696 |
9.9× |
| CT soft tissue neck w contrast (70491) |
$1,565 |
$2,408 |
8.9× |
| CT soft tissue neck w/o contrast (70490) |
$865 |
$1,330 |
8.2× |
| CT thoracic spine w contrast (72129) |
$1,565 |
$2,408 |
8.9× |
| CT thoracic spine w/o contrast (72128) |
$865 |
$1,330 |
8.2× |
| CT thoracic spine w/wo cont (72130) |
$1,752 |
$2,696 |
9.9× |
| CT thorax w/o contrast (71250) |
$865 |
$1,330 |
8.2× |
| CT upper ext wo (73200) |
$865 |
$1,330 |
8.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,752 |
$2,696 |
9.9× |
| CT upper extremity with contrast (73201) |
$1,565 |
$2,408 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,552 |
$2,388 |
8.8× |
| Cta Abdomen (74175) |
$1,832 |
$2,818 |
10.4× |
| CTA pelvis (72191) |
$1,832 |
$2,818 |
10.4× |
| Dilation ureters/urethra rs&i (74485) |
$5,511 |
$8,478 |
2.6× |
| Discography Cerv/Thor Spine (72285) |
$5,234 |
$8,053 |
2.7× |
| Diskography lumbar (72295) |
$5,234 |
$8,053 |
2.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$372 |
$572 |
3.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$372 |
$572 |
3.5× |
| Dxa Bone Density Axial (77080) |
$372 |
$572 |
3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$202 |
$311 |
2.3× |
| Echo Guide For Artery Repair (76936) |
$809 |
$1,244 |
3.7× |
| Echograp Trans R Pros Study (76873) |
$372 |
$572 |
3.5× |
| Esophagram (74220) |
$822 |
$1,264 |
4.7× |
| Fetal Biophys Profile W/Nst (76818) |
$372 |
$572 |
3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$372 |
$572 |
3.5× |
| Fluoroscopy up to 1 hr (76000) |
$755 |
$1,162 |
3.1× |
| Foot 2 views (73620) |
$202 |
$311 |
2.3× |
| Forearm 2 views (73090) |
$202 |
$311 |
2.3× |
| Gastric emptying imaging study (78264) |
$1,136 |
$1,747 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,136 |
$1,747 |
2.8× |
| GI Endoscopic US S&I (76975) |
$755 |
$1,162 |
3.1× |
| Hand 2 views (73120) |
$372 |
$572 |
3.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$8,102 |
$12,464 |
2.6× |
| Hepatobil Syst Image W/Drug (78227) |
$1,472 |
$2,265 |
2.7× |
| Hepatobiliary System Imaging (78226) |
$1,136 |
$1,747 |
2.8× |
| Hysterosalpingogram (74740) |
$755 |
$1,162 |
3.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$202 |
$311 |
2.3× |
| Infant hip ultrasound, limited static exam (76886) |
$202 |
$311 |
2.3× |
| Infusion Ivp (74410) |
$822 |
$1,264 |
4.7× |
| K Flow/Funct Image Multiple (78709) |
$1,472 |
$2,265 |
2.7× |
| K Flow/Funct Image W/Drug (78708) |
$1,472 |
$2,265 |
2.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,472 |
$2,265 |
2.7× |
Knee 3 Views (73562) range across 3 matching MRF lines |
$259–$618 |
$399–$950 |
varies |
| Liver & Spleen Imaging Static Only (78215) |
$1,136 |
$1,747 |
2.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,472 |
$2,265 |
2.7× |
| Magnetic Image Jaw Joint (70336) |
$755 |
$1,162 |
3.1× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$755 |
$1,162 |
1.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$822 |
$1,264 |
4.7× |
| Mammary ductogram or galactogram multiple (77054) |
$755 |
$1,162 |
3.1× |
| Mammary ductogram or galactogram single (77053) |
$755 |
$1,162 |
3.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,483 |
$2,282 |
4.2× |
| MRA head w/o contrast (70544) |
$755 |
$1,162 |
3.1× |
| MRA head with contrast (70545) |
$822 |
$1,264 |
2.3× |
| MRA neck w contrast (70548) |
$822 |
$1,264 |
2.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,483 |
$2,282 |
4.2× |
| MRA neck w/o contrast (70547) |
$755 |
$1,162 |
3.1× |
| MRI abdomen w contrast (74182) |
$1,483 |
$2,282 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$755 |
$1,162 |
3.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,211 |
$3,402 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,483 |
$2,282 |
4.2× |
MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$759–$2,211 |
$1,168–$3,402 |
varies |
| MRI bone marrow blood supply (77084) |
$755 |
$1,162 |
3.1× |
| MRI brain functional w/o physician admnistration (70554) |
$755 |
$1,162 |
3.1× |
| MRI brain functional w/physician admnistration (70555) |
$755 |
$1,162 |
3.1× |
| MRI cervical spine w contrast (72142) |
$1,483 |
$2,282 |
4.2× |
| MRI cervical spine w/o cont (72141) |
$755 |
$1,162 |
3.1× |
| MRI chest w/o contrast (71550) |
$755 |
$1,162 |
3.1× |
| MRI chest with contrast (71551) |
$2,211 |
$3,402 |
2.8× |
| MRI chest wo w contrast (71552) |
$1,483 |
$2,282 |
4.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$822 |
$1,264 |
2.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,483 |
$2,282 |
4.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$755 |
$1,162 |
3.1× |
| MRI lumbar spine w contrast (72149) |
$1,483 |
$2,282 |
4.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,483 |
$2,282 |
4.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$755 |
$1,162 |
3.1× |
| MRI orbit face neck w contrast (70542) |
$1,483 |
$2,282 |
4.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,483 |
$2,282 |
4.2× |
| MRI pelvis w contrast (72196) |
$1,483 |
$2,282 |
4.2× |
| MRI pelvis w/o & w contrast (72197) |
$1,483 |
$2,282 |
4.2× |
| MRI pelvis w/o contrast (72195) |
$755 |
$1,162 |
3.1× |
| MRI thoracic spine w/o contrast (72146) |
$755 |
$1,162 |
3.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,483 |
$2,282 |
4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$755 |
$1,162 |
3.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,483 |
$2,282 |
4.2× |
| MRI, abdomen, combo (74183) |
$1,483 |
$2,282 |
4.2× |
| MRI, dorsal spine combo (72157) |
$1,483 |
$2,282 |
4.2× |
| MRI, dorsal spine contrast (72147) |
$1,483 |
$2,282 |
4.2× |
| MRI, joint upper extrem (73221) |
$755 |
$1,162 |
3.1× |
| MRI, joint upper extrem combo (73223) |
$1,483 |
$2,282 |
4.2× |
| MRI, lumbar spine combo (72158) |
$1,483 |
$2,282 |
4.2× |
| Myelogram cervical (72240) |
$2,211 |
$3,402 |
2.8× |
| Myelogram Lumbar (72265) |
$2,211 |
$3,402 |
2.8× |
| Myelography thoracic (72255) |
$2,211 |
$3,402 |
2.8× |
| Myelograpy 2/more regions rs&i (72270) |
$2,211 |
$3,402 |
2.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$4,135 |
$6,361 |
3.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,908 |
$6,013 |
3.0× |
| Neck soft tissue (70360) |
$202 |
$311 |
2.3× |
| Nm red cell survival study (78130) |
$33 |
$50 |
0.1× |
| Optic foramina (70190) |
$202 |
$311 |
2.3× |
| Panoramic X-ray of jaws (70355) |
$202 |
$311 |
2.3× |
| Parathyroid Planar Imaging (78070) |
$1,136 |
$1,747 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$372 |
$572 |
3.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$372 |
$572 |
3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$755 |
$1,162 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$202 |
$311 |
2.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$202 |
$311 |
2.3× |
| Radex elbow complete minimum 3 views (73080) |
$202 |
$311 |
2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$372 |
$572 |
3.5× |
| Radex fingr minimum 2 views (73140) |
$202 |
$311 |
2.3× |
| Radex foot complete minimum 3 views (73630) |
$202 |
$311 |
2.3× |
Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$202–$372 |
$311–$572 |
varies |
| Radex lower extremity infant minimum 2 views (73592) |
$202 |
$311 |
2.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$372 |
$572 |
3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$202 |
$311 |
2.3× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$202 |
$311 |
2.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$202 |
$311 |
2.3× |
Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$202–$618 |
$311–$950 |
varies |
| Radex Sinuses Paransl < 3 Views (70210) |
$202 |
$311 |
2.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$372 |
$572 |
2.1× |
| Radex Spine 1 View Specify Level (72020) |
$202 |
$311 |
2.3× |
| Radex Sternum Minimum 2 Views (71120) |
$202 |
$311 |
2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$202 |
$311 |
2.3× |
| Radex Toe Minimum 2 Views (73660) |
$202 |
$311 |
2.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$372 |
$572 |
3.5× |
Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$202–$259 |
$311–$399 |
varies |
| Radiolog exam mandible compl minimum 4 views (70110) |
$372 |
$572 |
3.5× |
| Radiologic exam colon double contrast study (74280) |
$822 |
$1,264 |
4.7× |
| Radiologic exam colon single contrast study (74270) |
$822 |
$1,264 |
4.7× |
| Radiologic exam knee complete 4/more views (73564) |
$372 |
$572 |
3.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$372 |
$572 |
3.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$372 |
$572 |
2.1× |
| Radiologic exam swallow function contrast study (74230) |
$372 |
$572 |
2.1× |
| Radiologic exam teeth complete full mouth (70320) |
$755 |
$1,162 |
3.1× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$755 |
$1,162 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$822 |
$1,264 |
4.7× |
| Radiologic examination femur 1 view (73551) |
$202 |
$311 |
2.3× |
| Radiologic examination femur minimum 2 views (73552) |
$202 |
$311 |
2.3× |
| Radiologic examination knee 1/2 views (73560) |
$202 |
$311 |
2.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$372 |
$572 |
3.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$202 |
$311 |
2.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$202 |
$311 |
2.3× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$755 |
$1,162 |
1.4× |
Radiologic examination, teeth; single view Non-Facility (70300) range across 2 matching MRF lines |
$81–$202 |
$125–$311 |
varies |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$7 |
$10 |
0.0× |
| Renal Cyst Study (74470) |
$755 |
$1,162 |
1.4× |
| Ribs bilateral 3 views (71110) |
$372 |
$572 |
3.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,226 |
$1,886 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,226 |
$1,886 |
3.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$4,245 |
$6,530 |
7.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,122 |
$3,264 |
3.9× |
| Scapula (73010) |
$372 |
$572 |
3.5× |
| Sella turcica (70240) |
$202 |
$311 |
2.3× |
| Shoulder 1 view (73020) |
$202 |
$311 |
2.3× |
| Shoulder Arthrography (73040) |
$1,483 |
$2,282 |
4.2× |
| Sialogram (70390) |
$755 |
$1,162 |
3.1× |
| Skull less than 4 views (70250) |
$372 |
$572 |
3.5× |
| Speech evaluation, complex (70371) |
$755 |
$1,162 |
3.1× |
| Sternoclavicular joints (71130) |
$202 |
$311 |
2.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$755 |
$1,162 |
3.1× |
| Thoracic spine 2 views (72070) |
$372 |
$572 |
3.5× |
| Thoracic spine 3 views (72072) |
$372 |
$572 |
3.5× |
| Thoracolumbar 2 views (72080) |
$202 |
$311 |
2.3× |
| Thyroid Met Imaging Body (78018) |
$1,472 |
$2,265 |
2.7× |
| Thyroid Uptake Measurement (78012) |
$1,136 |
$1,747 |
2.8× |
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 3 matching MRF lines |
$159–$1,136 |
$245–$1,747 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$372 |
$572 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$372 |
$572 |
3.5× |
| Unlisted Dx Radiographic Procedure (76499) |
$202 |
$311 |
2.3× |
| Unlisted us procedure (76999) |
$202 |
$311 |
2.3× |
| Upper gi w/o kub (74240) |
$822 |
$1,264 |
4.7× |
| Urethrocystogram voiding (74455) |
$755 |
$1,162 |
3.1× |
| Urethrocystography retrograde (74450) |
$755 |
$1,162 |
3.1× |
| Us bone density measurement (76977) |
$372 |
$572 |
3.5× |
| Us breast unilateral complete (76641) |
$372 |
$572 |
3.5× |
| Us chest (76604) |
$372 |
$572 |
3.5× |
| Us complete joint (76881) |
$372 |
$572 |
3.5× |
| Us exam, pelvic, limited (76857) |
$372 |
$572 |
3.5× |
| Us head (76506) |
$372 |
$572 |
3.5× |
| Us kidney transplant (76776) |
$372 |
$572 |
3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$372 |
$572 |
3.5× |
| Us ob detailed single fetus (76811) |
$372 |
$572 |
1.6× |
| Us ob limited 1 or more fetuses (76815) |
$372 |
$572 |
3.5× |
| Us ob transvaginal (76817) |
$372 |
$572 |
3.5× |
| Us pelvic non ob complete (76856) |
$372 |
$572 |
3.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$372 |
$572 |
3.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$372 |
$572 |
3.5× |
| Us retroperitoneal complete (76770) |
$372 |
$572 |
3.5× |
| Us retroperitoneal limited (76775) |
$372 |
$572 |
3.5× |
| Us scrotum and contents (76870) |
$372 |
$572 |
3.5× |
| Us spinal canal and contents (76800) |
$372 |
$572 |
3.5× |
| Us thyroid (76536) |
$372 |
$572 |
3.5× |
| Us transrectal (76872) |
$372 |
$572 |
3.5× |
| Vasogram (74440) |
$755 |
$1,162 |
3.1× |
| Venography caval inferior serialography rs&i (75825) |
$8,102 |
$12,464 |
2.6× |
| Venography extremity unilateral rs&i (75820) |
$1,991 |
$3,063 |
1.3× |
| Vertebral fracture assessment via dxa (77086) |
$202 |
$311 |
2.3× |
| Wrist 2 views (73100) |
$202 |
$311 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$202 |
$311 |
2.3× |
| X-Ray Aorta Leg Arteries (75630) |
$9,682 |
$14,895 |
3.1× |
| X-Ray Bend Only L-S Spine (72120) |
$372 |
$572 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$202 |
$311 |
2.3× |
| X-Ray Exam Breast Specimen (76098) |
$1,581 |
$2,433 |
2.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$202 |
$311 |
2.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$372 |
$572 |
3.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$372 |
$572 |
3.5× |
X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$202–$259 |
$311–$399 |
varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$202 |
$311 |
2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$372 |
$572 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$354 |
$545 |
3.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$372 |
$572 |
3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$202 |
$311 |
2.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$372 |
$572 |
3.5× |
X-Ray Exam Unilat Ribs/Chest (71101) range across 6 matching MRF lines |
$12–$372 |
$19–$572 |
varies |
| X-ray eye for foreign body (70030) |
$202 |
$311 |
2.3× |
| X-ray humerus (73060) |
$202 |
$311 |
2.3× |
| X-ray IV pyelogram (ivp) (74400) |
$822 |
$1,264 |
4.7× |
| X-ray IV pyelogram+tomography (74415) |
$822 |
$1,264 |
4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$202 |
$311 |
2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$202 |
$311 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$372 |
$572 |
3.5× |
| X-ray nose-rectum child f.b. (76010) |
$202 |
$311 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$372 |
$572 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$372 |
$572 |
3.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$372 |
$572 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$202 |
$311 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$202 |
$311 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$372 |
$572 |
3.5× |
| X-Ray Stress View (77071) |
$202 |
$311 |
2.3× |
| X-ray thoracic spine 4 vw (72074) |
$372 |
$572 |
3.5× |
| X-Ray Tmj Unilat (70328) |
$202 |
$311 |
2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,483 |
$2,282 |
4.2× |
| X-Rays Bone Length Studies (77073) |
$372 |
$572 |
3.5× |
| X-Rays Bone Survey Complete (77075) |
$372 |
$572 |
3.5× |
| Xr c-spine 4 or 5 views (72050) |
$372 |
$572 |
3.5× |
| Xr facial bones less than 3 views (70140) |
$202 |
$311 |
2.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$372 |
$572 |
3.5× |
| Xr myelogram posterior fossa (70010) |
$1,483 |
$2,282 |
4.2× |
| Xr orbits complete 4 views (70200) |
$372 |
$572 |
3.5× |
| Xr Tomogram Single Plane (76100) |
$372 |
$572 |
3.5× |