| Abdomen 2 views (74019) |
$159.80 |
$188 |
1.4× |
| Ankle 2 views (73600) |
$116.45 |
$137 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$195.92 |
$230.50 |
2.0× |
| Chest 1 view (71045) |
$152.15 |
$179 |
1.6× |
| Clavicle complete (73000) |
$181.05 |
$213 |
1.9× |
| CT thorax w/o contrast (71250) |
$98.60 |
$116 |
0.8× |
| CTA chest (71275) |
$166.60 |
$196 |
0.9× |
| Facial bones min 3 views (70150) |
$172.98 |
$203.50 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$285.18 |
$335.50 |
2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$255 |
$300 |
2.2× |
| Foot 2 views (73620) |
$148.75 |
$175 |
1.5× |
| Forearm 2 views (73090) |
$124.95 |
$147 |
1.3× |
| Hand 2 views (73120) |
$139.82 |
$164.50 |
1.2× |
| Knee 3 views (73562) |
$138.12 |
$162.50 |
1.4× |
| Neck soft tissue (70360) |
$168.72 |
$198.50 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$160.22 |
$188.50 |
1.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$134.30 |
$158 |
1.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$123.25 |
$145 |
1.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$134.72 |
$158.50 |
1.4× |
| Radex fingr minimum 2 views (73140) |
$123.25 |
$145 |
1.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$132.60 |
$156 |
1.4× |
| Radex Hand Minimum 3 Views (73130) |
$133.45 |
$157 |
1.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$114.32 |
$134.50 |
1.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$157.25 |
$185 |
1.3× |
| Radex Humerus Minimum 2 Views (73060) |
$162.35 |
$191 |
1.7× |
| Radex Kne 1/2 Views (73560) |
$150.88 |
$177.50 |
1.6× |
| Radex Kne Compl 4/More Views (73564) |
$164.48 |
$193.50 |
1.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$154.70 |
$182 |
1.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$132.18 |
$155.50 |
1.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$178.08 |
$209.50 |
1.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$135.58 |
$159.50 |
1.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$98.60 |
$116 |
1.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$149.18 |
$175.50 |
1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$135.15 |
$159 |
1.4× |
| Radex Toe Minimum 2 Views (73660) |
$123.25 |
$145 |
1.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$239.70 |
$282 |
2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$154.70 |
$182 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$151.72 |
$178.50 |
1.3× |
| Radiologic exam chest 2 views (71046) |
$176.80 |
$208 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$126.65 |
$149 |
1.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$117.30 |
$138 |
1.0× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$169.15 |
$199 |
1.5× |
| Ribs bilateral 3 views (71110) |
$340 |
$400 |
2.9× |
| Sacroiliac Joints < 3 Views (72200) |
$109.22 |
$128.50 |
0.9× |
| Scapula (73010) |
$193.80 |
$228 |
1.7× |
| Shoulder 1 view (73020) |
$110.08 |
$129.50 |
1.1× |
| Spine thoracic 3 views (72072) |
$238.42 |
$280.50 |
2.0× |
| Thoracolumbar 2 views (72080) |
$249.05 |
$293 |
2.6× |
| Tmj unilateral (70328) |
$89.68 |
$105.50 |
0.9× |
| Ultrasound breast complete (76641) |
$260.52 |
$306.50 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$400.35 |
$471 |
3.4× |
| Unlisted ultrasound procedure (76999) |
$226.95 |
$267 |
2.3× |
| Us breast unilateral limited (76642) |
$246.50 |
$290 |
2.5× |
| Us chest (76604) |
$260.10 |
$306 |
2.2× |
| Us compl joint r-t w/image documentation (76881) |
$520.20 |
$612 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$486.20 |
$572 |
4.2× |
| Us ob detailed single fetus (76811) |
$367.20 |
$432 |
1.4× |
| Us ob limited (76815) |
$251.18 |
$295.50 |
2.2× |
| Us ob transvaginal (76817) |
$272.42 |
$320.50 |
2.3× |
| Us pelvic non ob complete (76856) |
$408.85 |
$481 |
3.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$279.22 |
$328.50 |
2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$293.25 |
$345 |
2.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$259.25 |
$305 |
2.2× |
| Us retroperitoneal complete (76770) |
$441.15 |
$519 |
3.8× |
| Us retroperitoneal limited (76775) |
$382.50 |
$450 |
3.3× |
| Us scrotum and contents (76870) |
$340.85 |
$401 |
2.9× |
| Us soft tissue head/neck (76536) |
$422.45 |
$497 |
3.6× |
| Us,transplanted kidney, real time/ doppler (76776) |
$334.05 |
$393 |
2.9× |
| Wrist 2 views (73100) |
$239.70 |
$282 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$269.45 |
$317 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$119.42 |
$140.50 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$170.85 |
$201 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$130.48 |
$153.50 |
1.3× |
| X-ray exam of femur 2/> (73552) |
$165.75 |
$195 |
1.7× |
| X-ray eye for foreign body (70030) |
$107.52 |
$126.50 |
1.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$117.30 |
$138 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$107.52 |
$126.50 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$195.92 |
$230.50 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$214.20 |
$252 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$155.12 |
$182.50 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$164.05 |
$193 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$215.05 |
$253 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$197.62 |
$232.50 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$185.30 |
$218 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$186.15 |
$219 |
1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$129.20 |
$152 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$170.85 |
$201 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$141.95 |
$167 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$207.82 |
$244.50 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$131.75 |
$155 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$159.80 |
$188 |
1.4× |
| Xr c-spine 4 or 5 views (72050) |
$245.65 |
$289 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$274.55 |
$323 |
2.4× |