| Abdomen 2 views (74019) |
$104 |
$1,335.04 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$399 |
$2,215 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,156 |
$5,857.94 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,156 |
$7,812 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,156 |
$8,745.31 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,562 |
$10,965 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,156 |
$8,083 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,156 |
$2,915.10 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$5,562 |
$6,432.90 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,562 |
$14,160 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,156 |
$4,712.18 |
1.0× |
| Ankle 2 views (73600) |
$86 |
$1,563.16 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$348 |
$1,840.60 |
1.0× |
| Aortogram thoracic (75605) |
$5,562 |
$8,083 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,156 |
$8,083 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,156 |
$8,745.31 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,156 |
$2,915.10 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$3,156 |
$2,915.10 |
1.0× |
| Arthrogram elbow (73085) |
$348 |
$1,651.55 |
1.0× |
| Arthrogram hip (73525) |
$348 |
$1,758.56 |
1.0× |
| Arthrogram shoulder (73040) |
$348 |
$1,758.56 |
1.0× |
| Arthrogram wrist (73115) |
$348 |
$2,944.78 |
1.0× |
| Arthrography knee lt (73580) |
$348 |
$2,453 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$399 |
$1,885.98 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$399 |
$3,993.68 |
1.0× |
| Bone age studies (77072) |
$104 |
$502.73 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$399 |
$1,885.98 |
1.0× |
| Bone survey complete (77075) |
$104 |
$1,259 |
1.0× |
| Brain image w/flow 4 + views (78606) |
$542 |
$2,786.25 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,429 |
$7,147.50 |
1.0× |
| Brain Imaging Vascular Flow Only (78610) |
$542 |
$1,482.95 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$348 |
$1,970.50 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$86 |
$1,152.33 |
1.0× |
| Chest 1 view (71045) |
$86 |
$719 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$175 |
$1,300 |
1.0× |
| Clavicle complete (73000) |
$86 |
$415.52 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$348 |
$7,478.91 |
1.0× |
| CT abdomen and pelvis without contrast (74176) |
$238 |
$5,400 |
1.0× |
| CT abdomen w contrast (74160) |
$175 |
$3,568.96 |
1.0× |
| CT abdomen w wo contrast (74170) |
$175 |
$3,755.45 |
1.0× |
| CT abdomen w/o contrast (74150) |
$104 |
$2,696.30 |
1.0× |
| CT angio hrt w/3d image (75574) |
$348 |
$3,398.19 |
1.0× |
| CT angiography upper extremity lt (73206) |
$175 |
$3,568.96 |
1.0× |
| CT c-spine w/o contrast (72125) |
$104 |
$3,500 |
1.0× |
| CT cervical spine w&w/o contrast (72127) |
$175 |
$3,568.96 |
1.0× |
| CT cervical spine with contrast (72126) |
$348 |
$7,478.91 |
1.0× |
| CT chest w/wo contrast (71270) |
$175 |
$3,591.95 |
1.0× |
| CT chest with contrast (71260) |
$175 |
$3,568.96 |
1.0× |
| CT head/brain with contrast (70460) |
$175 |
$3,568.96 |
1.0× |
| CT head/brain without and with contrast (70470) |
$175 |
$3,568.96 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$86 |
$672.54 |
1.0× |
| CT iac w contrast (70481) |
$175 |
$3,568.96 |
1.0× |
| CT limited/localized follow up study (76380) |
$86 |
$1,174.16 |
1.0× |
| CT lower ext w/o (73700) |
$104 |
$2,440.70 |
1.0× |
| CT lower extremity w wo contrast (73702) |
$175 |
$4,151.70 |
1.0× |
| CT lower extremity with contrast (73701) |
$175 |
$3,698.25 |
1.0× |
| CT lumbar spine w & w/o contrast (72133) |
$175 |
$3,568.96 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$104 |
$3,400 |
1.0× |
| CT lumbar spine with contrast (72132) |
$348 |
$1,758.56 |
1.0× |
| CT maxillofacial w contrast (70487) |
$175 |
$3,568.96 |
1.0× |
| CT maxillofacial w/o contrast (70486) |
$104 |
$2,600 |
1.0× |
| CT maxillofacial w/wo contrast (70488) |
$175 |
$3,568.96 |
1.0× |
| CT neck soft tissue w contrast (70491) |
$175 |
$3,568.96 |
1.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$175 |
$3,568.96 |
1.0× |
| CT orbits w/o contrast (70480) |
$104 |
$2,195.20 |
1.0× |
| CT pelvis w & w/o contrast (72194) |
$175 |
$3,568.96 |
1.0× |
| CT pelvis w/o contrast (72192) |
$104 |
$2,551.10 |
1.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$175 |
$3,568.96 |
1.0× |
| CT soft tissue neck w/o contrast (70490) |
$104 |
$2,443.55 |
1.0× |
| CT thoracic spine w/contrast (72129) |
$175 |
$3,568.96 |
1.0× |
| CT thoracic spine w/o contrast (72128) |
$104 |
$3,300 |
1.0× |
| CT thoracic spine w/wo contrast (72130) |
$175 |
$3,568.96 |
1.0× |
| CT thorax w/o contrast (71250) |
$104 |
$2,563.95 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$175 |
$3,568.96 |
1.0× |
| CT upper extremity w/o contrast rt (73200) |
$104 |
$2,358.70 |
1.0× |
| CT upper extremity with contrast (73201) |
$348 |
$4,419 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$175 |
$3,877.10 |
1.0× |
| Cta Abdomen (74175) |
$175 |
$3,688.90 |
1.0× |
| CTA abdomen pelvis (74174) |
$348 |
$5,917.60 |
1.0× |
| CTA chest (71275) |
$175 |
$5,000 |
1.0× |
| Cta Head (70496) |
$175 |
$3,568.96 |
1.0× |
| CTA lwr ext w&w/o contrast (73706) |
$175 |
$3,568.96 |
1.0× |
| Cta Neck (70498) |
$175 |
$3,568.96 |
1.0× |
| Cta Pelvis (72191) |
$175 |
$3,568.96 |
1.0× |
| Cystography minimum 3 views rs&i (74430) |
$348 |
$1,758.56 |
1.0× |
| Diskography lumbar (72295) |
$1,952 |
$5,297.36 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$104 |
$1,439.73 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$86 |
$415.52 |
1.0× |
| Echoencephalography real time imaging (76506) |
$104 |
$502.73 |
1.0× |
| Esophagus (74220) |
$175 |
$840.17 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$104 |
$1,352 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$238 |
$1,848 |
1.0× |
| Foot 2 views (73620) |
$86 |
$1,563.16 |
1.0× |
| Forearm 2 views (73090) |
$86 |
$1,563.16 |
1.0× |
| Gated Heart Planar Single (78472) |
$399 |
$2,747.80 |
1.0× |
| Hand 2 views (73120) |
$104 |
$1,775.40 |
1.0× |
| Hand 3 views (73130) |
$86 |
$1,563.16 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,156 |
$2,915.10 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$542 |
$2,471.59 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$399 |
$1,885.98 |
1.0× |
| Ht muscle image spect sing (78451) |
$1,294 |
$5,923.68 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$86 |
$415.52 |
1.0× |
| Hysterosalpingogram (74740) |
$238 |
$1,120.49 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$542 |
$3,149 |
1.0× |
| Knee 3 views (73562) |
$86 |
$1,024 |
1.0× |
| Liver imaging static only (78201) |
$542 |
$2,353.05 |
1.0× |
| Liver imaging w/vascular flow (78202) |
$542 |
$2,326 |
1.0× |
| Lung Ventilation Imaging (78579) |
$399 |
$2,180.01 |
1.0× |
| Lymphoscintigraphy (78195) |
$542 |
$2,471.59 |
1.0× |
| Meckels Diverticulum (78290) |
$399 |
$2,326 |
1.0× |
| Mr elastography (76391) |
$238 |
$1,167.35 |
1.0× |
| MRA head w & w/o contrast (70546) |
$348 |
$1,758.56 |
1.0× |
| MRA head w/o contrast (70544) |
$238 |
$4,564.32 |
1.0× |
| MRA head with contrast (70545) |
$348 |
$1,758.56 |
1.0× |
| MRA neck w contrast (70548) |
$348 |
$3,304.50 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$348 |
$1,758.56 |
1.0× |
| MRA neck w/o contrast (70547) |
$238 |
$4,564.32 |
1.0× |
| MRI abdomen w contrast (74182) |
$348 |
$7,478.91 |
1.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$348 |
$7,478.91 |
1.0× |
| MRI abdomen w/o contrast (74181) |
$238 |
$4,564.32 |
1.0× |
| MRI any jnt lwr ext with con lt (73722) |
$783 |
$3,661.29 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$783 |
$3,661.29 |
1.0× |
| MRI breast w/o contrast bilateral (77047) |
$238 |
$2,721.10 |
1.0× |
| MRI c-spine with contrast (72142) |
$348 |
$7,478.91 |
1.0× |
| MRI cardiac w/o cont stress (75559) |
$546 |
$2,522.66 |
1.0× |
| MRI cardiac w/o contrast (75557) |
$238 |
$3,217.75 |
1.0× |
| MRI cervical spine w/o contrast (72141) |
$238 |
$4,564.32 |
1.0× |
| MRI chest w/o & w/contrast material (71552) |
$348 |
$7,478.91 |
1.0× |
| MRI chest w/o contrast (71550) |
$238 |
$4,564.32 |
1.0× |
| MRI chest with contrast (71551) |
$783 |
$4,042 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$348 |
$1,758.56 |
1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$238 |
$4,564.32 |
1.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$348 |
$7,478.91 |
1.0× |
| MRI pelvis w contrast (72196) |
$348 |
$5,739.02 |
1.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$348 |
$7,478.91 |
1.0× |
| MRI pelvis w/o contrast (72195) |
$238 |
$4,040 |
1.0× |
| MRI scan of arm joint before and after contrast (73223) |
$348 |
$1,758.56 |
1.0× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$783 |
$2,928.75 |
1.0× |
| MRI scan of leg joint before and after contrast (73723) |
$348 |
$1,758.56 |
1.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$348 |
$7,478.91 |
1.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$348 |
$4,984.30 |
1.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$348 |
$7,478.91 |
1.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$348 |
$5,200.95 |
1.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$348 |
$7,478.91 |
1.0× |
| MRI thoracic spine w/o contrast (72146) |
$238 |
$4,564.32 |
1.0× |
| MRI upper ext joint w/o contrast (73221) |
$238 |
$4,564.32 |
1.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$348 |
$7,478.91 |
1.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$238 |
$4,040 |
1.0× |
| Myelogram Cervical (72240) |
$783 |
$3,031.90 |
1.0× |
| Myelogram Lumbar (72265) |
$783 |
$3,661.29 |
1.0× |
| Myelogram thoracic (72255) |
$783 |
$2,196.77 |
1.0× |
| Myelography 2 or more regions (72270) |
$783 |
$3,941.45 |
1.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,294 |
$3,895.87 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,294 |
$6,355.93 |
1.0× |
| Neck soft tissue (70360) |
$86 |
$415.52 |
1.0× |
| Nm cisternogram (78630) |
$542 |
$2,701.45 |
1.0× |
| Nm gastric emptying study (78264) |
$399 |
$3,374.97 |
1.0× |
| Nm red cell sequestration (78140) |
$399 |
$1,885.98 |
1.0× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,429 |
$7,147.50 |
1.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,294 |
$4,704.15 |
1.0× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$1,429 |
$7,153.84 |
1.0× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,429 |
$4,292.30 |
1.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,294 |
$3,618.55 |
1.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$399 |
$2,023.25 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$233 |
$2,390 |
1.0× |
| Osseous survey limited (77074) |
$104 |
$1,919.51 |
1.0× |
| Parathyroid imaging (78070) |
$399 |
$1,885.98 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$104 |
$755 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$1,429 |
$7,153.84 |
1.0× |
| PET imaging for CT attenuation whole body (78816) |
$1,429 |
$7,153.84 |
1.0× |
| PET imaging limited area chest head/neck (78811) |
$1,294 |
$5,714.24 |
1.0× |
| PET whole body (78813) |
$1,429 |
$7,153.84 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$348 |
$1,758.56 |
1.0× |
| Pr sono bone density measure,peripheral (76977) |
$104 |
$585.05 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,156 |
$15,185 |
1.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,156 |
$3,961.90 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$399 |
$2,215 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$542 |
$2,471.59 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$546 |
$504.53 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$104 |
$502.73 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$86 |
$734 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$104 |
$544.85 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$86 |
$997.58 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$175 |
$974 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$175 |
$880 |
1.0× |
| Radiological examination surgical specimen (76098) |
$546 |
$2,522.66 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,156 |
$2,915.10 |
1.0× |
| Ribs bilateral 3 views (71110) |
$104 |
$1,185 |
1.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$542 |
$6,493.12 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$542 |
$5,237.29 |
1.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$233 |
$2,499.80 |
1.0× |
| Scanogram (77073) |
$104 |
$502.73 |
1.0× |
| Scapula complete (73010) |
$104 |
$502.73 |
1.0× |
| Small bowel series (74250) |
$175 |
$840.17 |
1.0× |
| Splenoportograpy rs&i (75810) |
$3,156 |
$4,896.30 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$542 |
$3,821.11 |
1.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$542 |
$5,943.70 |
1.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$399 |
$1,960.40 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$104 |
$1,406.55 |
1.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$86 |
$281.05 |
1.0× |
| Unlisted fluoroscopic procedure (76496) |
$86 |
$942.69 |
1.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$399 |
$2,023.25 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$238 |
$1,120.49 |
1.0× |
| Urethrocystography voiding (74455) |
$238 |
$1,120.49 |
1.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$175 |
$840.17 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$104 |
$523.75 |
1.0× |
| Us breast unilateral complete (76641) |
$104 |
$976.80 |
1.0× |
| Us breast unilateral limited (76642) |
$86 |
$962.75 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$104 |
$502.73 |
1.0× |
| Us guided compression repair (76936) |
$215 |
$1,435.28 |
1.0× |
| Us ob transvaginal (76817) |
$104 |
$502.73 |
1.0× |
| Us pelvic non ob complete (76856) |
$104 |
$502.73 |
1.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$104 |
$502.73 |
1.0× |
| Us pregnancy ltd (76815) |
$104 |
$502.73 |
1.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$104 |
$502.73 |
1.0× |
| Us retroperitoneal complete (76770) |
$104 |
$1,495 |
1.0× |
| Us retroperitoneal limited (76775) |
$104 |
$1,376.01 |
1.0× |
| Us scrotum and contents (76870) |
$104 |
$502.73 |
1.0× |
| Us soft tissue head/neck (76536) |
$104 |
$2,195.20 |
1.0× |
| Us xtr non-vasc lmtd (76882) |
$104 |
$875.02 |
1.0× |
| Vascular flow imaging (78445) |
$399 |
$1,245.25 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,573 |
$3,499 |
1.0× |
| Venogram orbital (75880) |
$627 |
$3,120 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,156 |
$8,083 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,573 |
$1,464.68 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,573 |
$2,594 |
1.0× |
| Venography Renal Bilateral (75833) |
$3,156 |
$2,915.10 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$3,156 |
$8,083 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,156 |
$14,575.50 |
1.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,562 |
$8,083 |
1.0× |
| Wrist 2 views (73100) |
$86 |
$415.52 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$104 |
$502.73 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$86 |
$1,042.86 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$86 |
$1,563.16 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$175 |
$840.17 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$86 |
$795 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$86 |
$415.52 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$86 |
$751 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$104 |
$502.73 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$104 |
$502.73 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$86 |
$415.52 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$86 |
$1,563.16 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,089 |
$6,021.60 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$86 |
$415.52 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$86 |
$415.52 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$104 |
$502.73 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$104 |
$1,138.42 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$104 |
$1,813.90 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$104 |
$502.73 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$86 |
$415.52 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$86 |
$415.52 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$104 |
$502.73 |
1.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$104 |
$502.73 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$348 |
$1,758.56 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$86 |
$415.52 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$104 |
$502.73 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$104 |
$502.73 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$86 |
$415.52 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$86 |
$1,563.16 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$86 |
$1,410.78 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$104 |
$502.73 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$104 |
$502.73 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$86 |
$654.25 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$86 |
$658 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$86 |
$415.52 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$104 |
$502.73 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$104 |
$502.73 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$86 |
$415.52 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$86 |
$1,563.16 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$104 |
$502.73 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$86 |
$1,563.16 |
1.0× |
| Xr optic foramina (70190) |
$86 |
$415.52 |
1.0× |
| Xr shoulder 1 view (73020) |
$86 |
$415.52 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$104 |
$502.73 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$86 |
$1,563.16 |
1.0× |
| Xr tmj bilateral (70330) |
$86 |
$682 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$86 |
$1,545.76 |
1.0× |