| 3-D radiotherapy plan dose-volume histograms (77295) |
$798.80 |
$3,994 |
0.6× |
Abdomen 1 View (74018)
range across 5 matching MRF lines |
$28.20–$42.40 |
$141–$212 |
varies |
| Abdomen 2 views (74019) |
$52 |
$260 |
0.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$302.20 |
$1,511 |
0.8× |
| Angio internal mammary (75756) |
$154 |
$770 |
0.0× |
| Angio pulmonary bilat (75743) |
$137.40 |
$687 |
0.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$160.80 |
$804 |
0.1× |
| Angiography extremity bilateral rs&i (75716) |
$558.20 |
$2,791 |
0.2× |
| Angiography extremity unilateral rs&i (75710) |
$140 |
$700 |
0.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$121 |
$605 |
0.0× |
| Ankle 2 views (73600) |
$30.20 |
$151 |
0.3× |
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure |
$158.20 |
$791 |
0.0× |
| Artery X-Rays Adrenal Gland (75731) |
$143 |
$715 |
0.0× |
Artery X-Rays Pelvis (75736)
range across 4 matching MRF lines |
$525.20–$1,375.80 |
$2,626–$6,879 |
varies |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$233.60 |
$1,168 |
0.0× |
| Arthrogram ankle (73615) |
$119.40 |
$597 |
0.3× |
| Arthrogram hip (73525) |
$120.40 |
$602 |
0.3× |
| Arthrogram Wrist (73115) |
$126 |
$630 |
0.4× |
| Bone age studies (77072) |
$24.20 |
$121 |
0.2× |
| Bone Imaging 3 Phase (78315) |
$300.40 |
$1,502 |
0.7× |
| Bone Imaging Whole Body (78306) |
$256.60 |
$1,283 |
0.6× |
| Bone survey infant (77076) |
$97.40 |
$487 |
0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$283.60 |
$1,418 |
0.5× |
| Brain Imaging Minimum 4 Static Views (78605) |
$176 |
$880 |
0.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$341 |
$1,705 |
1.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$406.40 |
$2,032 |
0.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$279.60 |
$1,398 |
0.5× |
| Cerebrospinal Fluid Scan (78630) |
$292.20 |
$1,461 |
0.5× |
Chest 1 view (71045)
range across 7 matching MRF lines |
$24–$36 |
$120–$180 |
varies |
Chest 2 views (71046)
range across 3 matching MRF lines |
$31.40–$47.60 |
$157–$238 |
varies |
| Clavicle complete (73000) |
$30.40 |
$152 |
0.3× |
| Contrast Exam Abdominl Aorta (75625) |
$117.80 |
$589 |
0.0× |
| Contrast X-Ray Bladder (74430) |
$38.60 |
$193 |
0.1× |
| Contrast X-Ray Of Elbow (73085) |
$93.20 |
$466 |
0.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$103.20 |
$516 |
0.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$325.80 |
$1,629 |
0.9× |
| CT abdomen and pelvis without contrast (74176) |
$175 |
$875 |
0.7× |
| CT abdomen w contrast (74160) |
$163 |
$815 |
0.9× |
| CT abdomen w wo contrast (74170) |
$163 |
$815 |
0.9× |
| CT abdomen w/o contrast (74150) |
$97.40 |
$487 |
0.9× |
| CT Angio Abdomen and Pelvis (74174) |
$2,078.40 |
$10,392 |
5.9× |
| CT Angio Chest (71275) |
$1,157.60 |
$5,788 |
6.6× |
| CT Angio Head (70496) |
$163 |
$815 |
0.9× |
| CT angio hrt w/3d image (75574) |
$963.40 |
$4,817 |
2.7× |
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 2 matching MRF lines |
$543.20–$1,090 |
$2,716–$5,450 |
varies |
| CT Angio Neck (70498) |
$954.20 |
$4,771 |
5.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$163 |
$815 |
0.9× |
| CT cervical spine w/ contrast (72126) |
$161.40 |
$807 |
0.5× |
| CT cervical spine w/o contrast (72125) |
$97.40 |
$487 |
0.9× |
| CT chest w contrast (71260) |
$422.60 |
$2,113 |
2.4× |
| CT chest w/wo contrast (71270) |
$163 |
$815 |
0.9× |
| CT head/brain with contrast (70460) |
$141.80 |
$709 |
0.8× |
| CT head/brain without and with contrast (70470) |
$163 |
$815 |
0.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$163 |
$815 |
0.5× |
| CT hrt w/3d image congen (75573) |
$163 |
$815 |
0.5× |
| CT iac w contrast (70481) |
$163 |
$815 |
0.9× |
| CT lower ext w/o (73700) |
$97.40 |
$487 |
0.9× |
| CT lower extremity w/contrast material (73701) |
$159.60 |
$798 |
0.9× |
| CT lumbar spine w contrast (72132) |
$161.60 |
$808 |
0.5× |
| CT lumbar spine w/o contrast (72131) |
$97.40 |
$487 |
0.9× |
| CT maxillofacial w contrast (70487) |
$145.60 |
$728 |
0.8× |
| CT maxillofacial wo contrast (70486) |
$97.40 |
$487 |
0.9× |
| CT neck tissue combo (70492) |
$163 |
$815 |
0.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$163 |
$815 |
0.9× |
| CT orbits w/o contrast (70480) |
$97.40 |
$487 |
0.9× |
| CT pelvis w&w/o contrast (72194) |
$163 |
$815 |
0.9× |
| CT pelvis w/o contrast (72192) |
$97.40 |
$487 |
0.9× |
| CT scan of leg combo (73702) |
$163 |
$815 |
0.9× |
| CT scans face/jaw combo (70488) |
$163 |
$815 |
0.9× |
| CT soft tissue neck w contrast (70491) |
$385.40 |
$1,927 |
2.2× |
| CT soft tissue neck w/o contrast (70490) |
$97.40 |
$487 |
0.9× |
| CT thoracic spine w contrast (72129) |
$162.60 |
$813 |
0.9× |
| CT thoracic spine w/o contrast (72128) |
$97.40 |
$487 |
0.9× |
| CT thoracic spine w/wo cont (72130) |
$163 |
$815 |
0.9× |
| CT thorax w/o contrast (71250) |
$97.40 |
$487 |
0.9× |
| CT unlisted procedure (76497) |
$80.60 |
$403 |
0.9× |
| CT upper ext wo (73200) |
$97.40 |
$487 |
0.9× |
| CT upper extremity with contrast (73201) |
$192.20 |
$961 |
0.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$818.80 |
$4,094 |
4.6× |
| Cta Abdomen (74175) |
$1,323.60 |
$6,618 |
7.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$45.40 |
$227 |
0.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$65.20 |
$326 |
0.6× |
| Echo exam of fetal heart (76825) |
$244 |
$1,220 |
0.4× |
| Echo Guide For Artery Repair (76936) |
$242.80 |
$1,214 |
1.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$146.20 |
$731 |
0.6× |
| Esophagram (74220) |
$90.80 |
$454 |
0.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$217.20 |
$1,086 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$39.80 |
$199 |
0.2× |
| Follow-Up Angiography (75898) |
$124.40 |
$622 |
0.0× |
| Foot 2 views (73620) |
$26.80 |
$134 |
0.3× |
| Forearm 2 views (73090) |
$27.40 |
$137 |
0.3× |
| Gastric emptying imaging study (78264) |
$286.60 |
$1,433 |
0.7× |
| Gastroesophageal Reflux Exam (78262) |
$214.60 |
$1,073 |
0.5× |
| Gated Heart, Multiple (78473) |
$251.20 |
$1,256 |
0.6× |
| Hand 2 views (73120) |
$29.60 |
$148 |
0.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$115 |
$575 |
0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$115.60 |
$578 |
0.0× |
| Hepatobil Syst Image W/Drug (78227) |
$379 |
$1,895 |
0.7× |
| Hepatobiliary System Imaging (78226) |
$282 |
$1,410 |
0.7× |
| Ht Muscle Image Spect Sing (78451) |
$293.80 |
$1,469 |
0.2× |
| Hysterosalpingogram (74740) |
$62.20 |
$311 |
0.3× |
| Infant hip ultrasound, limited static exam (76886) |
$80.60 |
$403 |
0.9× |
| Infusion Ivp (74410) |
$132.20 |
$661 |
0.8× |
| K Flow/Funct Image Multiple (78709) |
$321.60 |
$1,608 |
0.6× |
| K Flow/Funct Image W/Drug (78708) |
$161.60 |
$808 |
0.3× |
| K Flow/Funct Image W/O Drug (78707) |
$203.40 |
$1,017 |
0.4× |
| Kidney Imaging Morphol (78700) |
$149.60 |
$748 |
0.4× |
| Knee 3 Views (73562) |
$38.20 |
$191 |
0.4× |
| Leveen/Shunt Patency Exam (78291) |
$228.80 |
$1,144 |
0.6× |
| Liver & Spleen Imaging Static Only (78215) |
$171.60 |
$858 |
0.4× |
| Lung perfusion differential (78597) |
$175 |
$875 |
0.4× |
| Lung Ventilat&Perfus Imaging (78582) |
$288 |
$1,440 |
0.5× |
| Lymph System Imaging (78195) |
$307 |
$1,535 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$217.20 |
$1,086 |
0.9× |
| Meckels Divert Exam (78290) |
$286.40 |
$1,432 |
0.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$316.60 |
$1,583 |
0.9× |
| MRA head w/o contrast (70544) |
$206.80 |
$1,034 |
0.9× |
| MRA head with contrast (70545) |
$218 |
$1,090 |
0.6× |
| MRA neck w contrast (70548) |
$811.60 |
$4,058 |
2.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$331.40 |
$1,657 |
0.9× |
| MRA neck w/o contrast (70547) |
$728.80 |
$3,644 |
3.0× |
| MRI abdomen w contrast (74182) |
$290.20 |
$1,451 |
0.8× |
| MRI abdomen w/o contrast (74181) |
$187.80 |
$939 |
0.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$301 |
$1,505 |
0.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$341 |
$1,705 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$300.60 |
$1,503 |
0.4× |
| MRI brain functional w/o physician admnistration (70554) |
$217.20 |
$1,086 |
0.9× |
| MRI cardiac w/o contrast (75557) |
$217.20 |
$1,086 |
0.9× |
| MRI cervical spine w contrast (72142) |
$264.20 |
$1,321 |
0.8× |
| MRI cervical spine w/o cont (72141) |
$182.80 |
$914 |
0.8× |
| MRI chest w/o contrast (71550) |
$217.20 |
$1,086 |
0.9× |
| MRI chest with contrast (71551) |
$358.60 |
$1,793 |
0.5× |
| MRI chest wo w contrast (71552) |
$341 |
$1,705 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$252.40 |
$1,262 |
0.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$323.40 |
$1,617 |
0.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$214.20 |
$1,071 |
0.9× |
| MRI lumbar spine w contrast (72149) |
$259.60 |
$1,298 |
0.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$631.60 |
$3,158 |
1.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$217 |
$1,085 |
0.9× |
| MRI orbit face neck w contrast (70542) |
$257.40 |
$1,287 |
0.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$587.20 |
$2,936 |
1.7× |
| MRI pelvis w contrast (72196) |
$257.40 |
$1,287 |
0.7× |
| MRI pelvis w/o & w contrast (72197) |
$570.40 |
$2,852 |
1.6× |
| MRI pelvis w/o contrast (72195) |
$217.20 |
$1,086 |
0.9× |
| MRI spectroscopy (76390) |
$748.20 |
$3,741 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$182.60 |
$913 |
0.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$318 |
$1,590 |
0.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$217.20 |
$1,086 |
0.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$341 |
$1,705 |
1.0× |
| MRI, abdomen, combo (74183) |
$629.40 |
$3,147 |
1.8× |
| MRI, dorsal spine combo (72157) |
$616 |
$3,080 |
1.8× |
| MRI, dorsal spine contrast (72147) |
$261.80 |
$1,309 |
0.7× |
| MRI, joint upper extrem (73221) |
$194.60 |
$973 |
0.8× |
| MRI, joint upper extrem combo (73223) |
$341 |
$1,705 |
1.0× |
| MRI, lumbar spine combo (72158) |
$611.40 |
$3,057 |
1.7× |
| Myelogram cervical (72240) |
$104.40 |
$522 |
0.1× |
| Myelogram Lumbar (72265) |
$101.60 |
$508 |
0.1× |
| Myelography thoracic (72255) |
$100.40 |
$502 |
0.1× |
| Myelograpy 2/more regions rs&i (72270) |
$142.40 |
$712 |
0.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$162 |
$810 |
0.4× |
| Myocardial Spect Multiple Studies (78452) |
$407.60 |
$2,038 |
0.3× |
| Neck soft tissue (70360) |
$29.20 |
$146 |
0.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$144.20 |
$721 |
0.4× |
| Nm csf leak detection (78650) |
$235 |
$1,175 |
0.2× |
| Nm myocard infarct spect (78469) |
$79.40 |
$397 |
0.1× |
| Nm unlisted gi procedure (78299) |
$205.20 |
$1,026 |
0.5× |
| Nonvascular Shunt X-Ray (75809) |
$76.20 |
$381 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$125 |
$625 |
0.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$44.80 |
$224 |
0.4× |
| Optic foramina (70190) |
$35.20 |
$176 |
0.4× |
| Panoramic X-ray of jaws (70355) |
$17.20 |
$86 |
0.2× |
| Parathyroid Planar Imaging (78070) |
$254.60 |
$1,273 |
0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$304.20 |
$1,521 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$26.20 |
$131 |
0.2× |
| Peritoneogram Rs&I (74190) |
$75.40 |
$377 |
0.1× |
| Pet Image W/Ct Lmtd (78814) |
$1,386 |
$6,930 |
1.0× |
| PET image w/CT, full body (78816) |
$1,386 |
$6,930 |
1.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,386 |
$6,930 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$127.20 |
$636 |
0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$40 |
$200 |
0.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$46.60 |
$233 |
0.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$55.60 |
$278 |
0.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$34.20 |
$171 |
0.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$26.80 |
$134 |
0.3× |
| Radex elbow complete minimum 3 views (73080) |
$56 |
$280 |
0.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$44.20 |
$221 |
0.4× |
| Radex fingr minimum 2 views (73140) |
$35.80 |
$179 |
0.4× |
| Radex foot complete minimum 3 views (73630) |
$32 |
$160 |
0.4× |
| Radex Hand Minimum 3 Views (73130) |
$34.80 |
$174 |
0.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$35.20 |
$176 |
0.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$80.60 |
$403 |
0.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$34.20 |
$171 |
0.4× |
| Radex shoulder complete minimum 2 views (73030) |
$32.60 |
$163 |
0.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$30.20 |
$151 |
0.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$163 |
$815 |
0.9× |
| Radex Spine 1 View Specify Level (72020) |
$22.60 |
$113 |
0.3× |
| Radex Sternum Minimum 2 Views (71120) |
$31.40 |
$157 |
0.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$49.40 |
$247 |
0.6× |
| Radex Toe Minimum 2 Views (73660) |
$27.40 |
$137 |
0.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$38.60 |
$193 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$40.80 |
$204 |
0.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$40.20 |
$201 |
0.4× |
| Radiologic exam colon double contrast study (74280) |
$163 |
$815 |
0.9× |
| Radiologic exam colon single contrast study (74270) |
$143 |
$715 |
0.8× |
| Radiologic exam knee complete 4/more views (73564) |
$44.20 |
$221 |
0.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$113.40 |
$567 |
0.6× |
| Radiologic exam swallow function contrast study (74230) |
$116.20 |
$581 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$129.60 |
$648 |
0.7× |
| Radiologic examination femur 1 view (73551) |
$27.40 |
$137 |
0.3× |
| Radiologic examination femur minimum 2 views (73552) |
$33.20 |
$166 |
0.4× |
| Radiologic examination knee 1/2 views (73560) |
$32 |
$160 |
0.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$61 |
$305 |
0.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$29.60 |
$148 |
0.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$237.80 |
$1,189 |
0.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$560.60 |
$2,803 |
1.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$268.60 |
$1,343 |
0.5× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 5 matching MRF lines |
$330.60–$508.40 |
$1,653–$2,542 |
varies |
| Scapula (73010) |
$22.40 |
$112 |
0.2× |
| Shoulder 1 view (73020) |
$20.20 |
$101 |
0.2× |
| Shoulder Arthrography (73040) |
$122.80 |
$614 |
0.4× |
| Sialogram (70390) |
$107.80 |
$539 |
0.4× |
| Skull less than 4 views (70250) |
$33.60 |
$168 |
0.3× |
| Sternoclavicular joints (71130) |
$38.60 |
$193 |
0.4× |
| Superior sagittal sinus venogram (75870) |
$144.80 |
$724 |
0.0× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$77.20 |
$386 |
0.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$163 |
$815 |
0.9× |
| Thoracic spine 2 views (72070) |
$30.80 |
$154 |
0.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$159.80 |
$799 |
0.4× |
| Thyroid Met Imaging Body (78018) |
$270.60 |
$1,353 |
0.5× |
| Thyroid Uptake Measurement (78012) |
$75.60 |
$378 |
0.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$203 |
$1,015 |
0.5× |
| Ultrasound Breast Limited (76642) |
$79.20 |
$396 |
0.9× |
| Ultrasound elastography first target lesion (76982) |
$87 |
$435 |
0.8× |
| Ultrasound Elastography Parenchyma (76981) |
$97.40 |
$487 |
0.9× |
| Ultrasound Exam Aaa Screen (76706) |
$97.40 |
$487 |
0.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$163 |
$815 |
0.5× |
Ultrasound, abdomen limited (76705)
range across 5 matching MRF lines |
$81.20–$121.80 |
$406–$609 |
varies |
| Unlisted magnetic resonance procedure (76498) |
$80.60 |
$403 |
0.9× |
| Upper gi w/o kub (74240) |
$114.40 |
$572 |
0.6× |
| Ureteral Reflux Study (78740) |
$189.60 |
$948 |
0.5× |
| Urethrocystogram voiding (74455) |
$97 |
$485 |
0.4× |
| Urethrocystography retrograde (74450) |
$75.80 |
$379 |
0.3× |
| Us breast unilateral complete (76641) |
$95.80 |
$479 |
0.9× |
| Us chest (76604) |
$53.20 |
$266 |
0.5× |
| Us complete joint (76881) |
$89.60 |
$448 |
0.9× |
| Us exam, pelvic, limited (76857) |
$47.20 |
$236 |
0.4× |
| Us head (76506) |
$97.40 |
$487 |
0.9× |
| Us kidney transplant (76776) |
$97.40 |
$487 |
0.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$28.20 |
$141 |
0.3× |
| Us ob detailed single fetus (76811) |
$165.40 |
$827 |
0.7× |
| Us ob limited 1 or more fetuses (76815) |
$75.60 |
$378 |
0.7× |
| Us ob transvaginal (76817) |
$86.40 |
$432 |
0.8× |
| Us pelvic non ob complete (76856) |
$89.60 |
$448 |
0.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$97.40 |
$487 |
0.9× |
| Us retroperitoneal complete (76770) |
$104.80 |
$524 |
1.0× |
| Us scrotum and contents (76870) |
$93.20 |
$466 |
0.9× |
| Us spinal canal and contents (76800) |
$97.40 |
$487 |
0.9× |
| Us thyroid (76536) |
$97.40 |
$487 |
0.9× |
| Us transrectal (76872) |
$97.40 |
$487 |
0.9× |
| Vein X-Ray Chest (75827) |
$110.60 |
$553 |
0.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$128.20 |
$641 |
0.0× |
| Venogram Sinus/Jugular (75860) |
$117 |
$585 |
0.0× |
| Venography caval inferior serialography rs&i (75825) |
$106.40 |
$532 |
0.0× |
| Venography extremity bilateral rs&i (75822) |
$124.40 |
$622 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$100.40 |
$502 |
0.1× |
| Venography Orbital Rs&I (75880) |
$100.40 |
$502 |
0.2× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$98 |
$490 |
0.0× |
| Wrist 2 views (73100) |
$31.80 |
$159 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$27 |
$135 |
0.3× |
| X-ray antegrade pyelogram tube (74425) |
$126.60 |
$633 |
0.4× |
| X-Ray Aorta Leg Arteries (75630) |
$146.20 |
$731 |
0.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$27.40 |
$137 |
0.3× |
| X-Ray Exam Breast Specimen (76098) |
$39.80 |
$199 |
0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$39.80 |
$199 |
0.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$65.60 |
$328 |
0.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$74 |
$370 |
0.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$30.80 |
$154 |
0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$44.40 |
$222 |
0.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$56 |
$280 |
0.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$38.60 |
$193 |
0.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$50.40 |
$252 |
0.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$57.80 |
$289 |
0.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$57.20 |
$286 |
0.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$37 |
$185 |
0.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$39.40 |
$197 |
0.4× |
| X-ray humerus (73060) |
$29.80 |
$149 |
0.3× |
| X-ray IV pyelogram (ivp) (74400) |
$126 |
$630 |
0.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$36.40 |
$182 |
0.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$37.40 |
$187 |
0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$37.40 |
$187 |
0.4× |
| X-ray nose-rectum child f.b. (76010) |
$80.60 |
$403 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$49.20 |
$246 |
0.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$36.60 |
$183 |
0.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$30.40 |
$152 |
0.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$35.20 |
$176 |
0.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$41.60 |
$208 |
0.4× |
| X-ray thoracic spine 4 vw (72074) |
$41.60 |
$208 |
0.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$72.80 |
$364 |
0.2× |
| X-Rays Bone Length Studies (77073) |
$42.20 |
$211 |
0.4× |
| X-Rays Bone Survey Complete (77075) |
$93 |
$465 |
0.9× |
| Xr c-spine 4 or 5 views (72050) |
$50 |
$250 |
0.5× |
| Xr facial bones less than 3 views (70140) |
$29.80 |
$149 |
0.3× |
| Xr orbits complete 4 views (70200) |
$44.80 |
$224 |
0.4× |