| Abdomen 2 views (74019) |
$409.36 |
$731 |
4.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$544.32 |
$972 |
1.4× |
| Ankle 2 views (73600) |
$302.40 |
$540 |
3.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$470.96 |
$841 |
1.4× |
| Arthrogram elbow (73085) |
$644.56 |
$1,151 |
1.9× |
| Arthrogram hip (73525) |
$429.52 |
$767 |
1.3× |
| Arthrogram shoulder (73040) |
$743.68 |
$1,328 |
2.2× |
| Arthrogram wrist (73115) |
$411.04 |
$734 |
1.2× |
| Arthrography knee lt (73580) |
$644.56 |
$1,151 |
1.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$682.08 |
$1,218 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$3,855.60 |
$6,885 |
10.1× |
| Bone age studies (77072) |
$75.04 |
$134 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$4,536 |
$8,100 |
11.9× |
| Bone survey complete (77075) |
$346.08 |
$618 |
3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,429.36 |
$11,481 |
4.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,561.20 |
$8,145 |
13.7× |
| Cervical spine 2 or 3 views (72040) |
$504 |
$900 |
6.1× |
| Chest 1 view (71045) |
$123.20 |
$220 |
1.5× |
| Chest 3 views (71047) |
$286.72 |
$512 |
3.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$579.60 |
$1,035 |
3.5× |
| Clavicle complete (73000) |
$262.08 |
$468 |
3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$678.72 |
$1,212 |
6.8× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$152.32 |
$272 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,176.80 |
$11,030 |
18.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,591.44 |
$8,199 |
20.1× |
| CT abdomen w contrast (74160) |
$2,473.52 |
$4,417 |
14.8× |
| CT abdomen w wo contrast (74170) |
$4,056.64 |
$7,244 |
24.2× |
| CT abdomen w/o contrast (74150) |
$2,248.40 |
$4,015 |
22.5× |
| CT angiography upper extremity lt (73206) |
$714.56 |
$1,276 |
4.3× |
| CT c-spine w/o contrast (72125) |
$2,133.60 |
$3,810 |
21.4× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$271.04 |
$484 |
1.6× |
| CT cervical spine w&w/o contrast (72127) |
$3,200.40 |
$5,715 |
19.1× |
| CT cervical spine with contrast (72126) |
$2,666.72 |
$4,762 |
8.0× |
| CT chest w/wo contrast (71270) |
$2,469.04 |
$4,409 |
14.7× |
| CT chest with contrast (71260) |
$2,244.48 |
$4,008 |
13.4× |
| CT colonography screening (74263) |
$2,408 |
$4,300 |
10.6× |
| CT colonography w/o cntrst (74261) |
$1,015.28 |
$1,813 |
10.2× |
| CT head/brain with contrast (70460) |
$1,925.28 |
$3,438 |
11.5× |
| CT head/brain without and with contrast (70470) |
$2,213.68 |
$3,953 |
13.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,009.68 |
$1,803 |
3.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$616 |
$1,100 |
7.4× |
| CT iac w contrast (70481) |
$2,011.52 |
$3,592 |
12.0× |
| CT limited/localized follow up study (76380) |
$378.56 |
$676 |
4.6× |
| CT lower ext w/o (73700) |
$806.40 |
$1,440 |
8.1× |
| CT lower extremity w wo contrast (73702) |
$1,937.04 |
$3,459 |
11.6× |
| CT lower extremity with contrast (73701) |
$978.32 |
$1,747 |
5.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,706.48 |
$4,833 |
16.1× |
| CT lumbar spine w/o contrast (72131) |
$1,965.04 |
$3,509 |
19.7× |
| CT lumbar spine with contrast (72132) |
$1,978.48 |
$3,533 |
5.9× |
| CT maxillofacial w contrast (70487) |
$2,681.84 |
$4,789 |
16.0× |
| CT maxillofacial w/o contrast (70486) |
$2,135.84 |
$3,814 |
21.4× |
| CT maxillofacial w/wo contrast (70488) |
$3,096.80 |
$5,530 |
18.5× |
| CT neck soft tissue w contrast (70491) |
$2,484.72 |
$4,437 |
14.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,402 |
$6,075 |
20.3× |
| CT orbits w/o contrast (70480) |
$1,606.64 |
$2,869 |
16.1× |
| CT pelvis w & w/o contrast (72194) |
$2,383.92 |
$4,257 |
14.2× |
| CT pelvis w/o contrast (72192) |
$1,872.08 |
$3,343 |
18.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$246.96 |
$441 |
3.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,800.56 |
$5,001 |
16.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,167.20 |
$3,870 |
21.7× |
| CT thoracic spine w/contrast (72129) |
$1,396.08 |
$2,493 |
8.3× |
| CT thoracic spine w/o contrast (72128) |
$1,193.36 |
$2,131 |
11.9× |
| CT thoracic spine w/wo contrast (72130) |
$1,692.88 |
$3,023 |
10.1× |
| CT thorax w/o contrast (71250) |
$1,788.08 |
$3,193 |
17.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,103.36 |
$3,756 |
12.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,746.64 |
$3,119 |
17.5× |
| CT upper extremity with contrast (73201) |
$1,786.96 |
$3,191 |
5.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,616.88 |
$4,673 |
15.6× |
| Cta Abdomen (74175) |
$2,149.28 |
$3,838 |
12.8× |
| CTA abdomen pelvis (74174) |
$4,898.32 |
$8,747 |
14.7× |
| CTA chest (71275) |
$2,925.44 |
$5,224 |
17.4× |
| Cta Head (70496) |
$1,032.08 |
$1,843 |
6.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$621.04 |
$1,109 |
1.9× |
| CTA lwr ext w&w/o contrast (73706) |
$714.56 |
$1,276 |
4.3× |
| Cta Neck (70498) |
$1,976.24 |
$3,529 |
11.8× |
| Cystography minimum 3 views rs&i (74430) |
$490.56 |
$876 |
1.5× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$245.84 |
$439 |
2.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$545.44 |
$974 |
5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$86.24 |
$154 |
1.0× |
| Dxa bone density study axial skeleton (77085) |
$142.24 |
$254 |
1.4× |
| Echo exam of fetal heart (76825) |
$498.40 |
$890 |
1.0× |
| Echoencephalography real time imaging (76506) |
$146.72 |
$262 |
1.5× |
| Esophagus (74220) |
$579.60 |
$1,035 |
3.5× |
| Fetal biophysical profile non-stress testing (76818) |
$1,286.88 |
$2,298 |
12.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$524.72 |
$937 |
5.3× |
| Fluoroscopy up to 1 hr (76000) |
$826.56 |
$1,476 |
3.6× |
| Foot 2 views (73620) |
$238.28 |
$425.50 |
2.9× |
| Forearm 2 views (73090) |
$394.24 |
$704 |
4.7× |
| Gated Heart Planar Single (78472) |
$486.08 |
$868 |
1.3× |
| Hand 2 views (73120) |
$311.36 |
$556 |
3.1× |
| Hand 3 views (73130) |
$385.84 |
$689 |
4.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,917.76 |
$6,996 |
7.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,817.92 |
$5,032 |
7.4× |
| Ht muscle image spect sing (78451) |
$736.40 |
$1,315 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$197.68 |
$353 |
2.4× |
| Hysterosalpingogram (74740) |
$619.36 |
$1,106 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,800.72 |
$6,787 |
7.3× |
| Knee 3 views (73562) |
$382.48 |
$683 |
4.6× |
| Liver & spleen imaging static only (78215) |
$3,001.60 |
$5,360 |
7.9× |
| Liver imaging static only (78201) |
$1,561.84 |
$2,789 |
3.0× |
| Mammary ductogram or galactogram multiple (77054) |
$291.76 |
$521 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$259.28 |
$463 |
1.1× |
| Mr safety determination physician/other qhp (76016) |
$133.28 |
$238 |
1.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$90.16 |
$161 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$37.52 |
$67 |
1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$138.88 |
$248 |
1.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$365.68 |
$653 |
1.6× |
| MRA head w & w/o contrast (70546) |
$3,501.68 |
$6,253 |
10.5× |
| MRA head w/o contrast (70544) |
$3,172.96 |
$5,666 |
13.9× |
| MRA head with contrast (70545) |
$3,186.40 |
$5,690 |
9.6× |
| MRA neck w contrast (70548) |
$2,689.68 |
$4,803 |
8.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,056.08 |
$7,243 |
12.2× |
| MRA neck w/o contrast (70547) |
$1,193.92 |
$2,132 |
5.2× |
| MRI abdomen w contrast (74182) |
$3,792.88 |
$6,773 |
11.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,011.28 |
$7,163 |
12.0× |
| MRI abdomen w/o contrast (74181) |
$3,604.72 |
$6,437 |
15.8× |
| MRI any jnt lwr ext with con lt (73722) |
$5,103.28 |
$9,113 |
6.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,768.96 |
$8,516 |
6.4× |
| MRI c-spine with contrast (72142) |
$3,601.36 |
$6,431 |
10.8× |
| MRI cardiac w/o cont stress (75559) |
$4,672.08 |
$8,343 |
8.9× |
| MRI cardiac w/o contrast (75557) |
$4,449.76 |
$7,946 |
19.5× |
| MRI cervical spine w/o contrast (72141) |
$3,433.92 |
$6,132 |
15.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,072 |
$3,700 |
6.2× |
| MRI chest w/o contrast (71550) |
$1,165.92 |
$2,082 |
5.1× |
| MRI chest with contrast (71551) |
$1,748.88 |
$3,123 |
2.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,163.44 |
$5,649 |
9.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,434.32 |
$4,347 |
7.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,410.24 |
$4,304 |
10.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,034.32 |
$1,847 |
4.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,671.36 |
$6,556 |
11.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,820.72 |
$5,037 |
8.5× |
| MRI pelvis w contrast (72196) |
$2,870.56 |
$5,126 |
8.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,896.48 |
$6,958 |
11.7× |
| MRI pelvis w/o contrast (72195) |
$1,748.32 |
$3,122 |
7.7× |
| MRI scan of arm joint before and after contrast (73223) |
$5,635.84 |
$10,064 |
16.9× |
| MRI scan of leg joint before and after contrast (73723) |
$6,728.40 |
$12,015 |
20.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,780.56 |
$6,751 |
11.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,624.88 |
$6,473 |
10.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,275.60 |
$7,635 |
12.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,675.28 |
$6,563 |
11.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,306.40 |
$7,690 |
12.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,552.64 |
$6,344 |
15.6× |
| MRI tmj (70336) |
$2,074.80 |
$3,705 |
9.1× |
| MRI upper ext joint w/o contrast (73221) |
$3,091.76 |
$5,521 |
13.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,528.56 |
$6,301 |
10.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,707.04 |
$4,834 |
11.9× |
| Myocardial Spect Multiple Studies (78452) |
$7,250.88 |
$12,948 |
5.9× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$5,103.84 |
$9,114 |
2.4× |
| Neck soft tissue (70360) |
$383.60 |
$685 |
4.6× |
| Nm gastric emptying study (78264) |
$1,025.92 |
$1,832 |
2.7× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$6,322.96 |
$11,291 |
5.1× |
| Nuclear medicine of heart pumping function (78473) |
$563.36 |
$1,006 |
1.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,465.12 |
$4,402 |
2.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$78.96 |
$141 |
0.8× |
| Osseous survey infant (77076) |
$92.96 |
$166 |
0.9× |
| Osseous survey limited (77074) |
$218.40 |
$390 |
2.2× |
| Parathyrd planar w/wo subtrj (78071) |
$589.12 |
$1,052 |
1.5× |
| Parathyroid imaging (78070) |
$407.68 |
$728 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$330.40 |
$590 |
3.3× |
| PET image w/CT, skull-thigh (78815) |
$3,469.76 |
$6,196 |
2.5× |
| PET imaging for CT attenuation whole body (78816) |
$7,249.20 |
$12,945 |
5.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,924.32 |
$5,222 |
8.8× |
| Pr sono bone density measure,peripheral (76977) |
$160.72 |
$287 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$418.88 |
$748 |
1.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$664.72 |
$1,187 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$623.84 |
$1,114 |
1.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$357.84 |
$639 |
4.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$718.48 |
$1,283 |
7.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$395.36 |
$706 |
4.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$233.52 |
$417 |
2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$979.44 |
$1,749 |
9.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$246.96 |
$441 |
2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$317.52 |
$567 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$456.96 |
$816 |
4.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$184.24 |
$329 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$870.80 |
$1,555 |
5.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$596.40 |
$1,065 |
3.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$906.08 |
$1,618 |
5.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$873.04 |
$1,559 |
5.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$372.96 |
$666 |
4.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$96.88 |
$173 |
1.2× |
| Radiological examination surgical specimen (76098) |
$563.92 |
$1,007 |
1.1× |
| Ribs bilateral 3 views (71110) |
$340.48 |
$608 |
3.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,330.88 |
$5,948 |
6.4× |
| Sacroiliac Joints < 3 Views (72200) |
$388.08 |
$693 |
3.9× |
| Scanogram (77073) |
$84.56 |
$151 |
0.8× |
| Scapula complete (73010) |
$319.76 |
$571 |
3.2× |
| Screening digital breast tomosynthesis (77063) |
$63.28 |
$113 |
2.7× |
| Sella turcica (70240) |
$110.88 |
$198 |
1.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$79.52 |
$142 |
0.8× |
| Sialogram (70390) |
$448.56 |
$801 |
2.0× |
| Small bowel series (74250) |
$423.92 |
$757 |
2.5× |
| Speech evaluation complex (70371) |
$196.56 |
$351 |
0.9× |
| Spine thoracic 3 views (72072) |
$494.48 |
$883 |
4.9× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$517.44 |
$924 |
2.3× |
| Therapeutic Enema (74283) |
$439.04 |
$784 |
2.6× |
| Thoracolumbar 2 views (72080) |
$201.04 |
$359 |
2.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$378 |
$675 |
1.0× |
| Thyroid uptake measurement (78012) |
$302.40 |
$540 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$397.04 |
$709 |
1.0× |
| Tmj unilateral (70328) |
$73.36 |
$131 |
0.9× |
| Tomogram (76100) |
$442.96 |
$791 |
4.4× |
| Ultrasound elastography first target lesion (76982) |
$186.48 |
$333 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$1,261.68 |
$2,253 |
12.6× |
| Umbilical-artery Doppler (OB) (76820) |
$771.68 |
$1,378 |
7.7× |
| Unlisted Ultrasound Procedure (76999) |
$512.40 |
$915 |
6.2× |
| Upper Extremity Infant (73092) |
$131.04 |
$234 |
1.3× |
| Urethrocystography retrograde rs&i (74450) |
$356.16 |
$636 |
1.6× |
| Urethrocystography voiding (74455) |
$402.08 |
$718 |
1.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$735.28 |
$1,313 |
4.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$767.20 |
$1,370 |
4.6× |
| Us abdl aorta screen aaa (76706) |
$88.48 |
$158 |
0.9× |
| Us breast unilateral complete (76641) |
$1,030.96 |
$1,841 |
10.3× |
| Us breast unilateral limited (76642) |
$987.28 |
$1,763 |
11.9× |
| Us chest (76604) |
$1,034.88 |
$1,848 |
10.4× |
| Us compl joint r-t w/image documentation (76881) |
$183.12 |
$327 |
1.8× |
| Us elastography parenchyma (76981) |
$185.92 |
$332 |
1.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$1,378.72 |
$2,462 |
13.8× |
| Us kidney transplant (76776) |
$130.48 |
$233 |
1.3× |
| Us ob detailed single fetus (76811) |
$277.76 |
$496 |
1.2× |
| Us ob transvaginal (76817) |
$813.68 |
$1,453 |
8.1× |
| Us pelvic non ob complete (76856) |
$2,371.60 |
$4,235 |
23.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$606.48 |
$1,083 |
6.1× |
| Us pregnancy ltd (76815) |
$222.32 |
$397 |
2.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$262.64 |
$469 |
2.6× |
| Us retroperitoneal complete (76770) |
$2,051.84 |
$3,664 |
20.5× |
| Us retroperitoneal limited (76775) |
$195.44 |
$349 |
2.0× |
| Us scrotum and contents (76870) |
$541.52 |
$967 |
5.4× |
| Us soft tissue head/neck (76536) |
$1,356.88 |
$2,423 |
13.6× |
| Us spinal canal and contents (76800) |
$119.28 |
$213 |
1.2× |
| Us xtr non-vasc lmtd (76882) |
$205.52 |
$367 |
2.1× |
| Venogram extremity bilateral (75822) |
$2,420.32 |
$4,322 |
1.6× |
| Venography extremity unilateral rs&i (75820) |
$1,210.16 |
$2,161 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$146.72 |
$262 |
1.8× |
| Wrist 2 views (73100) |
$324.80 |
$580 |
3.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$559.44 |
$999 |
5.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$93.52 |
$167 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$502.32 |
$897 |
6.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,741.60 |
$3,110 |
10.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$146.72 |
$262 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$380.80 |
$680 |
4.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$848.40 |
$1,515 |
8.5× |
| X-ray exam hip uni 1 view (73501) |
$54.32 |
$97 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$306.32 |
$547 |
3.7× |
| X-ray exam hip uni 4/> views (73503) |
$359.52 |
$642 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$845.04 |
$1,509 |
8.5× |
| X-ray exam of femur 1 (73551) |
$109.76 |
$196 |
1.3× |
| X-ray eye for foreign body (70030) |
$131.04 |
$234 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$283.92 |
$507 |
2.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$242.48 |
$433 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$491.12 |
$877 |
5.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$160.72 |
$287 |
1.9× |
| X-ray IV pyelogram+drip infusn (74410) |
$658 |
$1,175 |
3.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$197.12 |
$352 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$607.04 |
$1,084 |
6.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$228.48 |
$408 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$142.24 |
$254 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$475.44 |
$849 |
4.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$726.32 |
$1,297 |
7.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$693.28 |
$1,238 |
6.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$224.56 |
$401 |
2.7× |
| X-ray of voice box or throat (70370) |
$138.32 |
$247 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$319.20 |
$570 |
3.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$413.84 |
$739 |
4.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$778.96 |
$1,391 |
2.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$318.64 |
$569 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$561.12 |
$1,002 |
5.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$716.24 |
$1,279 |
7.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$654.64 |
$1,169 |
6.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$380.80 |
$680 |
4.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$397.04 |
$709 |
4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$907.76 |
$1,621 |
10.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$245.28 |
$438 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$384.16 |
$686 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$179.20 |
$320 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$248.64 |
$444 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$131.60 |
$235 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$93.52 |
$167 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$439.04 |
$784 |
4.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$546 |
$975 |
5.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$271.04 |
$484 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$455.28 |
$813 |
5.5× |
| Xr arthrogram ankle (73615) |
$644.56 |
$1,151 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$875.28 |
$1,563 |
8.8× |
| Xr chest 4+ views (71048) |
$339.92 |
$607 |
3.4× |
| Xr Cholecystography Oral Contrast (74290) |
$204.96 |
$366 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$249.76 |
$446 |
3.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$99.12 |
$177 |
1.0× |
| Xr shoulder 1 view (73020) |
$109.76 |
$196 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$667.52 |
$1,192 |
6.7× |
| Xr tibia/fibula 2 views (73590) |
$299.04 |
$534 |
3.6× |
| Xr tmj bilateral (70330) |
$109.76 |
$196 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$232.40 |
$415 |
2.8× |