| Abdomen 1 View (74018) |
$86 |
$734 |
1.0× |
| Abdomen 2 views (74019) |
$104 |
$1,335.04 |
1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$399 |
$2,215 |
1.0× |
| Angio pulmonary bilat (75743) |
$3,156 |
$8,083 |
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 pulmonary unilateral slctv rs&i (75741) |
$3,156 |
$2,915.10 |
1.0× |
| Ankle 2 views (73600) |
$86 |
$1,563.16 |
1.0× |
| Aortography thoracic serialography rs&i (75605) |
$5,562 |
$8,083 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,156 |
$2,915.10 |
1.0× |
| Artery X-Rays Abdomen (75726) |
$5,562 |
$14,160 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$3,156 |
$2,915.10 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$5,562 |
$10,965 |
1.0× |
| Artery X-Rays Spine (75705) |
$5,562 |
$6,432.90 |
1.0× |
| Arthrogram hip (73525) |
$348 |
$1,758.56 |
1.0× |
| Arthrogram Wrist (73115) |
$348 |
$2,944.78 |
1.0× |
| Bone age studies (77072) |
$104 |
$502.73 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$399 |
$1,885.98 |
1.0× |
| Bone Imaging Limited Area (78300) |
$399 |
$1,885.98 |
1.0× |
| Bone Imaging Whole Body (78306) |
$399 |
$3,993.68 |
1.0× |
| Brain Flow Imaging Only (78610) |
$542 |
$1,482.95 |
1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$542 |
$2,786.25 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,429 |
$7,147.50 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$348 |
$1,970.50 |
1.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$783 |
$2,928.75 |
1.0× |
| Cat Scan Follow-Up Study (76380) |
$86 |
$1,174.16 |
1.0× |
| Cerebrospinal Fluid Scan (78630) |
$542 |
$2,701.45 |
1.0× |
| Chest 1 view (71045) |
$86 |
$719 |
1.0× |
| Chest 2 views (71046) |
$86 |
$997.58 |
1.0× |
| Clavicle complete (73000) |
$86 |
$415.52 |
1.0× |
| Contrast Exam Abdominl Aorta (75625) |
$3,156 |
$8,745.31 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$348 |
$1,758.56 |
1.0× |
| Contrast X-Ray Of Elbow (73085) |
$348 |
$1,651.55 |
1.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$348 |
$2,453 |
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 Abdomen and Pelvis (74174) |
$348 |
$5,917.60 |
1.0× |
| CT Angio Chest (71275) |
$175 |
$5,000 |
1.0× |
| CT Angio Head (70496) |
$175 |
$3,568.96 |
1.0× |
| CT angio hrt w/3d image (75574) |
$348 |
$3,398.19 |
1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$175 |
$3,568.96 |
1.0× |
| CT Angio Neck (70498) |
$175 |
$3,568.96 |
1.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$175 |
$3,568.96 |
1.0× |
| CT cervical spine w/ contrast (72126) |
$348 |
$7,478.91 |
1.0× |
| CT cervical spine w/o contrast (72125) |
$104 |
$3,500 |
1.0× |
| CT cervical spine w/wo cont (72127) |
$175 |
$3,568.96 |
1.0× |
| CT chest w contrast (71260) |
$175 |
$3,568.96 |
1.0× |
| CT chest w/wo contrast (71270) |
$175 |
$3,591.95 |
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 l-spine w&w/o contrast (72133) |
$175 |
$3,568.96 |
1.0× |
| CT lower ext w/o (73700) |
$104 |
$2,440.70 |
1.0× |
| CT lower extremity w/contrast material (73701) |
$175 |
$3,698.25 |
1.0× |
| CT lumbar spine w contrast (72132) |
$348 |
$1,758.56 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$104 |
$3,400 |
1.0× |
| CT maxillofacial w contrast (70487) |
$175 |
$3,568.96 |
1.0× |
| CT maxillofacial wo contrast (70486) |
$104 |
$2,600 |
1.0× |
| CT neck tissue combo (70492) |
$175 |
$3,568.96 |
1.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (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 scan of leg combo (73702) |
$175 |
$4,151.70 |
1.0× |
| CT scans face/jaw combo (70488) |
$175 |
$3,568.96 |
1.0× |
| CT soft tissue neck w contrast (70491) |
$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 cont (72130) |
$175 |
$3,568.96 |
1.0× |
| CT thorax w/o contrast (71250) |
$104 |
$2,563.95 |
1.0× |
| CT upper ext wo (73200) |
$104 |
$2,358.70 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$175 |
$3,568.96 |
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 pelvis (72191) |
$175 |
$3,568.96 |
1.0× |
| Dilation ureters/urethra rs&i (74485) |
$2,089 |
$6,021.60 |
1.0× |
| Diskography lumbar (72295) |
$1,952 |
$5,297.36 |
1.0× |
| Dxa Bone Density Axial (77080) |
$104 |
$1,439.73 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$86 |
$415.52 |
1.0× |
| Echo Guide For Artery Repair (76936) |
$215 |
$1,435.28 |
1.0× |
| Esophagram (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× |
| Follow-Up Angiography (75898) |
$3,156 |
$4,712.18 |
1.0× |
| Foot 2 views (73620) |
$86 |
$1,563.16 |
1.0× |
| Forearm 2 views (73090) |
$86 |
$1,563.16 |
1.0× |
| Gastric emptying imaging study (78264) |
$399 |
$3,374.97 |
1.0× |
| Gated Heart Planar Single (78472) |
$399 |
$2,747.80 |
1.0× |
| Hand 2 views (73120) |
$104 |
$1,775.40 |
1.0× |
| Heart Image (Pet) Multiple (78492) |
$1,429 |
$7,147.50 |
1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,156 |
$2,915.10 |
1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,156 |
$2,915.10 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$542 |
$2,471.59 |
1.0× |
| Hepatobiliary System Imaging (78226) |
$399 |
$1,885.98 |
1.0× |
| Ht Musc Image Planar Mult (78454) |
$1,294 |
$4,704.15 |
1.0× |
| Ht Muscle Image Spect Sing (78451) |
$1,294 |
$5,923.68 |
1.0× |
| Hysterosalpingogram (74740) |
$238 |
$1,120.49 |
1.0× |
| K Flow/Funct Image W/Drug (78708) |
$542 |
$3,149 |
1.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$399 |
$2,023.25 |
1.0× |
| Knee 3 Views (73562) |
$86 |
$1,024 |
1.0× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$399 |
$1,885.98 |
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 Ventilat&Perfus Imaging (78582) |
$542 |
$2,471.59 |
1.0× |
| Lung Ventilation Imaging (78579) |
$399 |
$2,180.01 |
1.0× |
| Lymph System Imaging (78195) |
$542 |
$2,471.59 |
1.0× |
| Magnetic Resonance Elastography (76391) |
$238 |
$1,167.35 |
1.0× |
| Meckels Divert Exam (78290) |
$399 |
$2,326 |
1.0× |
| Mra Head W/O & W/Contrast Material (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 contrast (74181) |
$238 |
$4,564.32 |
1.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$783 |
$3,661.29 |
1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$348 |
$1,758.56 |
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 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 contrast (72142) |
$348 |
$7,478.91 |
1.0× |
| MRI cervical spine w/o cont (72141) |
$238 |
$4,564.32 |
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 chest wo w contrast (71552) |
$348 |
$7,478.91 |
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 & w/contr matr (73720) |
$348 |
$1,758.56 |
1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$238 |
$4,564.32 |
1.0× |
| MRI lumbar spine w contrast (72149) |
$348 |
$4,984.30 |
1.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$348 |
$7,478.91 |
1.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$348 |
$7,478.91 |
1.0× |
| MRI pelvis w contrast (72196) |
$348 |
$5,739.02 |
1.0× |
| MRI pelvis w/o & w contrast (72197) |
$348 |
$7,478.91 |
1.0× |
| MRI pelvis w/o contrast (72195) |
$238 |
$4,040 |
1.0× |
| MRI thoracic spine w/o contrast (72146) |
$238 |
$4,564.32 |
1.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$238 |
$4,040 |
1.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$348 |
$7,478.91 |
1.0× |
| MRI, abdomen, combo (74183) |
$348 |
$7,478.91 |
1.0× |
| MRI, dorsal spine combo (72157) |
$348 |
$7,478.91 |
1.0× |
| MRI, dorsal spine contrast (72147) |
$348 |
$5,200.95 |
1.0× |
| MRI, joint upper extrem (73221) |
$238 |
$4,564.32 |
1.0× |
| MRI, joint upper extrem combo (73223) |
$348 |
$1,758.56 |
1.0× |
| MRI, lumbar spine combo (72158) |
$348 |
$7,478.91 |
1.0× |
| Myelogram cervical (72240) |
$783 |
$3,031.90 |
1.0× |
| Myelogram Lumbar (72265) |
$783 |
$3,661.29 |
1.0× |
| Myelography thoracic (72255) |
$783 |
$2,196.77 |
1.0× |
| Myelograpy 2/more regions rs&i (72270) |
$783 |
$3,941.45 |
1.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,294 |
$3,895.87 |
1.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,294 |
$3,618.55 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,294 |
$6,355.93 |
1.0× |
| Neck soft tissue (70360) |
$86 |
$415.52 |
1.0× |
| Nuclear Rx Intra-Arterial (79445) |
$233 |
$2,499.80 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$233 |
$2,390 |
1.0× |
| Optic foramina (70190) |
$86 |
$415.52 |
1.0× |
| Parathyroid Planar Imaging (78070) |
$399 |
$1,885.98 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$104 |
$755 |
1.0× |
| Pet Image Skull-Thigh (78812) |
$1,429 |
$7,153.84 |
1.0× |
| PET image w/CT, full body (78816) |
$1,429 |
$7,153.84 |
1.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,429 |
$7,153.84 |
1.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,294 |
$5,714.24 |
1.0× |
| Pet Myocardial Sngl Study (78491) |
$1,429 |
$4,292.30 |
1.0× |
| PET whole body (78813) |
$1,429 |
$7,153.84 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,156 |
$15,185 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$399 |
$2,215 |
1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$104 |
$502.73 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$546 |
$504.53 |
1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$86 |
$1,563.16 |
1.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$86 |
$415.52 |
1.0× |
| Radex elbow complete minimum 3 views (73080) |
$86 |
$415.52 |
1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$104 |
$502.73 |
1.0× |
| Radex fingr minimum 2 views (73140) |
$86 |
$1,563.16 |
1.0× |
| Radex foot complete minimum 3 views (73630) |
$86 |
$1,563.16 |
1.0× |
| Radex Hand Minimum 3 Views (73130) |
$86 |
$1,563.16 |
1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$86 |
$415.52 |
1.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$86 |
$415.52 |
1.0× |
| Radex shoulder complete minimum 2 views (73030) |
$86 |
$1,563.16 |
1.0× |
| Radex Spine 1 View Specify Level (72020) |
$86 |
$654.25 |
1.0× |
| Radex Sternum Minimum 2 Views (71120) |
$86 |
$415.52 |
1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$86 |
$682 |
1.0× |
| Radex Toe Minimum 2 Views (73660) |
$86 |
$415.52 |
1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$86 |
$1,563.16 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$104 |
$502.73 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$104 |
$544.85 |
1.0× |
| Radiologic exam colon double contrast study (74280) |
$175 |
$840.17 |
1.0× |
| Radiologic exam knee complete 4/more views (73564) |
$104 |
$502.73 |
1.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$104 |
$502.73 |
1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$175 |
$840.17 |
1.0× |
| Radiologic exam swallow function contrast study (74230) |
$175 |
$1,300 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$175 |
$974 |
1.0× |
| Radiologic examination knee 1/2 views (73560) |
$86 |
$1,545.76 |
1.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$104 |
$1,919.51 |
1.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$86 |
$1,563.16 |
1.0× |
| Ribs bilateral 3 views (71110) |
$104 |
$1,185 |
1.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$399 |
$1,960.40 |
1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$542 |
$5,943.70 |
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× |
| Scapula (73010) |
$104 |
$502.73 |
1.0× |
| Shoulder 1 view (73020) |
$86 |
$415.52 |
1.0× |
| Shoulder Arthrography (73040) |
$348 |
$1,758.56 |
1.0× |
| Skull less than 4 views (70250) |
$104 |
$502.73 |
1.0× |
| Sternoclavicular joints (71130) |
$86 |
$658 |
1.0× |
| Thoracic spine 2 views (72070) |
$104 |
$502.73 |
1.0× |
| Thyroid Met Imaging Body (78018) |
$542 |
$3,821.11 |
1.0× |
| Ultrasound Breast Limited (76642) |
$86 |
$962.75 |
1.0× |
| Ultrasound Exam Aaa Screen (76706) |
$104 |
$523.75 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$104 |
$1,406.55 |
1.0× |
| Unlisted Dx Radiographic Procedure (76499) |
$86 |
$281.05 |
1.0× |
| Unlisted fluoroscopic procedure (76496) |
$86 |
$942.69 |
1.0× |
| Upper gi w/o kub (74240) |
$175 |
$880 |
1.0× |
| Ureteral Reflux Study (78740) |
$399 |
$2,023.25 |
1.0× |
| Urethrocystogram voiding (74455) |
$238 |
$1,120.49 |
1.0× |
| Urethrocystography retrograde (74450) |
$238 |
$1,120.49 |
1.0× |
| Us bone density measurement (76977) |
$104 |
$585.05 |
1.0× |
| Us breast unilateral complete (76641) |
$104 |
$976.80 |
1.0× |
| Us complete joint (76881) |
$104 |
$502.73 |
1.0× |
| Us exam, pelvic, limited (76857) |
$104 |
$502.73 |
1.0× |
| Us head (76506) |
$104 |
$502.73 |
1.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$104 |
$875.02 |
1.0× |
| Us ob limited 1 or more fetuses (76815) |
$104 |
$502.73 |
1.0× |
| Us ob transvaginal (76817) |
$104 |
$502.73 |
1.0× |
| Us pelvic non ob complete (76856) |
$104 |
$502.73 |
1.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (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 thyroid (76536) |
$104 |
$2,195.20 |
1.0× |
| Vascular Flow Imaging (78445) |
$399 |
$1,245.25 |
1.0× |
| Vein X-Ray Chest (75827) |
$1,573 |
$1,464.68 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,156 |
$3,961.90 |
1.0× |
| Vein X-Ray Spleen/Liver (75810) |
$3,156 |
$4,896.30 |
1.0× |
| Venogram Sinus/Jugular (75860) |
$3,156 |
$14,575.50 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,156 |
$8,083 |
1.0× |
| Venography extremity bilateral rs&i (75822) |
$1,573 |
$3,499 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,573 |
$2,594 |
1.0× |
| Venography Orbital Rs&I (75880) |
$627 |
$3,120 |
1.0× |
| Venography Renal Bilateral (75833) |
$3,156 |
$2,915.10 |
1.0× |
| Venography Renal Unilateral (75831) |
$3,156 |
$8,083 |
1.0× |
| Venous sampling by catheter (75893) |
$5,562 |
$8,083 |
1.0× |
| Wrist 2 views (73100) |
$86 |
$415.52 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$86 |
$1,042.86 |
1.0× |
| X-ray antegrade pyelogram tube (74425) |
$348 |
$1,840.60 |
1.0× |
| X-Ray Aorta Leg Arteries (75630) |
$3,156 |
$8,083 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$104 |
$502.73 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$86 |
$795 |
1.0× |
| X-Ray Exam Breast Specimen (76098) |
$546 |
$2,522.66 |
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 Exam L-S Spine Bending (72114) |
$104 |
$1,813.90 |
1.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$86 |
$1,152.33 |
1.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$104 |
$502.73 |
1.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$104 |
$502.73 |
1.0× |
| X-ray humerus (73060) |
$86 |
$415.52 |
1.0× |
| X-ray IV pyelogram (ivp) (74400) |
$175 |
$840.17 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$86 |
$415.52 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$104 |
$1,138.42 |
1.0× |
| X-ray nose-rectum child f.b. (76010) |
$86 |
$415.52 |
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 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 thoracic spine 4 vw (72074) |
$104 |
$502.73 |
1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$348 |
$1,758.56 |
1.0× |
| X-Rays Bone Length Studies (77073) |
$104 |
$502.73 |
1.0× |
| X-Rays Bone Survey Complete (77075) |
$104 |
$1,259 |
1.0× |
| Xr c-spine 4 or 5 views (72050) |
$104 |
$502.73 |
1.0× |
| Xr facial bones less than 3 views (70140) |
$86 |
$415.52 |
1.0× |
| Xr orbits complete 4 views (70200) |
$104 |
$502.73 |
1.0× |