| Abdomen 1 View (74018) |
$360 |
$450 |
4.2× |
| Abdomen 2 views (74019) |
$408 |
$510 |
3.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$708 |
$885 |
1.8× |
| Ankle 2 views (73600) |
$163.20 |
$204 |
1.9× |
| Arthrogram ankle (73615) |
$868 |
$1,085 |
2.5× |
| Arthrogram hip (73525) |
$1,300 |
$1,625 |
3.7× |
| Arthrogram Wrist (73115) |
$324 |
$405 |
0.9× |
| Bone age studies (77072) |
$140.80 |
$176 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,025.60 |
$1,282 |
2.6× |
| Bone Imaging Limited Area (78300) |
$399.20 |
$499 |
1.0× |
| Bone Imaging Multiple Areas (78305) |
$932.80 |
$1,166 |
2.3× |
| Bone Imaging Whole Body (78306) |
$1,092 |
$1,365 |
2.7× |
| Bone marrow imaging limited area (78102) |
$504.80 |
$631 |
1.3× |
| Bone marrow imaging; multiple areas (78103) |
$687.20 |
$859 |
1.7× |
| Bone marrow imaging; whole body (78104) |
$752 |
$940 |
1.9× |
| Bone survey infant (77076) |
$560 |
$700 |
5.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$821.60 |
$1,027 |
1.5× |
| Cat Scan Follow-Up Study (76380) |
$920 |
$1,150 |
10.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,616 |
$2,020 |
3.0× |
| Chest 1 view (71045) |
$440 |
$550 |
5.1× |
| Chest 2 views (71046) |
$440 |
$550 |
5.1× |
| Chest 3 views (71047) |
$220 |
$275 |
2.5× |
| Chest 4 or more views (71048) |
$208.80 |
$261 |
2.0× |
| Cholecystography Oral Contrast (74290) |
$236 |
$295 |
1.4× |
| Clavicle complete (73000) |
$138.40 |
$173 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$979.20 |
$1,224 |
9.4× |
| Contrast X-Ray Bladder (74430) |
$292.80 |
$366 |
0.8× |
| Contrast X-Ray Of Elbow (73085) |
$300 |
$375 |
0.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$420.80 |
$526 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,120 |
$7,650 |
17.6× |
| CT abdomen and pelvis without contrast (74176) |
$4,161.60 |
$5,202 |
17.5× |
| CT abdomen w contrast (74160) |
$2,284 |
$2,855 |
13.1× |
| CT abdomen w wo contrast (74170) |
$3,672 |
$4,590 |
21.0× |
| CT abdomen w/o contrast (74150) |
$1,736.80 |
$2,171 |
16.7× |
| CT Angio Abdomen and Pelvis (74174) |
$5,712 |
$7,140 |
16.4× |
| CT Angio Chest (71275) |
$2,856 |
$3,570 |
16.4× |
| CT Angio Head (70496) |
$2,856 |
$3,570 |
16.4× |
| CT angio hrt w/3d image (75574) |
$2,448 |
$3,060 |
7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,040 |
$2,550 |
11.7× |
| CT Angio Neck (70498) |
$2,856 |
$3,570 |
16.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,872.80 |
$2,341 |
10.7× |
| CT bone density (77078) |
$958.40 |
$1,198 |
11.1× |
| CT cervical spine w/ contrast (72126) |
$2,175.20 |
$2,719 |
6.3× |
| CT cervical spine w/o contrast (72125) |
$3,900.80 |
$4,876 |
37.5× |
| CT cervical spine w/wo cont (72127) |
$1,820.80 |
$2,276 |
10.4× |
| CT chest w contrast (71260) |
$2,856 |
$3,570 |
16.4× |
| CT chest w/wo contrast (71270) |
$2,544.80 |
$3,181 |
14.6× |
| CT head/brain with contrast (70460) |
$2,322.40 |
$2,903 |
13.3× |
| CT head/brain without and with contrast (70470) |
$2,448 |
$3,060 |
14.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$131.20 |
$164 |
1.5× |
| CT iac w contrast (70481) |
$1,993.60 |
$2,492 |
11.4× |
| CT l-spine w&w/o contrast (72133) |
$2,185.60 |
$2,732 |
12.5× |
| CT lower ext w/o (73700) |
$1,951.20 |
$2,439 |
18.7× |
| CT lower extremity w/contrast material (73701) |
$2,448 |
$3,060 |
14.0× |
| CT lumbar spine w contrast (72132) |
$2,175.20 |
$2,719 |
6.3× |
| CT lumbar spine w/o contrast (72131) |
$2,856 |
$3,570 |
27.4× |
| CT maxillofacial w contrast (70487) |
$2,448 |
$3,060 |
14.0× |
| CT maxillofacial wo contrast (70486) |
$2,448 |
$3,060 |
23.5× |
| CT neck tissue combo (70492) |
$2,329.60 |
$2,912 |
13.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,939.20 |
$2,424 |
11.1× |
| CT orbits w/o contrast (70480) |
$1,949.60 |
$2,437 |
18.7× |
| CT pelvis w&w/o contrast (72194) |
$2,500 |
$3,125 |
14.3× |
| CT pelvis w/o contrast (72192) |
$2,002.40 |
$2,503 |
19.2× |
| CT scan of leg combo (73702) |
$1,467.20 |
$1,834 |
8.4× |
| CT scans face/jaw combo (70488) |
$1,861.60 |
$2,327 |
10.7× |
| CT soft tissue neck w contrast (70491) |
$2,856 |
$3,570 |
16.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,951.20 |
$2,439 |
18.7× |
| CT thoracic spine w contrast (72129) |
$1,576 |
$1,970 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$2,856 |
$3,570 |
27.4× |
| CT thoracic spine w/wo cont (72130) |
$1,462.40 |
$1,828 |
8.4× |
| CT thorax w/o contrast (71250) |
$2,856 |
$3,570 |
27.4× |
| CT upper ext wo (73200) |
$1,951.20 |
$2,439 |
18.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,462.40 |
$1,828 |
8.4× |
| CT upper extremity with contrast (73201) |
$1,890.40 |
$2,363 |
5.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,448 |
$3,060 |
14.0× |
| Cta Abdomen (74175) |
$2,794.40 |
$3,493 |
16.0× |
| CTA pelvis (72191) |
$1,705.60 |
$2,132 |
9.8× |
| Discography Cerv/Thor Spine (72285) |
$468.80 |
$586 |
0.2× |
| Diskography lumbar (72295) |
$468.80 |
$586 |
0.2× |
| Dxa Bone Density Axial (77080) |
$600 |
$750 |
5.8× |
| Dxa bone density study (77085) |
$600 |
$750 |
5.8× |
| Echo exam uterus (76831) |
$322.40 |
$403 |
1.4× |
| Esophagram (74220) |
$571.20 |
$714 |
3.3× |
| Fetal Biophys Profile W/Nst (76818) |
$366.40 |
$458 |
3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$720 |
$900 |
6.9× |
| Fluoroscopy up to 1 hr (76000) |
$612 |
$765 |
2.6× |
| Foot 2 views (73620) |
$174.40 |
$218 |
2.0× |
| Forearm 2 views (73090) |
$169.60 |
$212 |
2.0× |
| Gastric emptying imaging study (78264) |
$1,760 |
$2,200 |
4.4× |
| Gastroesophageal Reflux Exam (78262) |
$594.40 |
$743 |
1.5× |
| Gated Heart Planar Single (78472) |
$846.40 |
$1,058 |
2.1× |
| Gated Heart, Multiple (78473) |
$1,084.80 |
$1,356 |
2.7× |
| Hand 2 views (73120) |
$168 |
$210 |
1.6× |
| Hepatobil Syst Image W/Drug (78227) |
$2,400 |
$3,000 |
4.4× |
| Hepatobiliary System Imaging (78226) |
$1,036 |
$1,295 |
2.6× |
| Ht Musc Image Planar Mult (78454) |
$1,059.20 |
$1,324 |
0.8× |
| Ht Muscle Image Spect Sing (78451) |
$1,687.20 |
$2,109 |
1.3× |
| Hysterosalpingogram (74740) |
$228.80 |
$286 |
1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$740 |
$925 |
8.5× |
| Infusion Ivp (74410) |
$470.40 |
$588 |
2.7× |
| K Flow/Funct Image Multiple (78709) |
$1,199.20 |
$1,499 |
2.2× |
| K Flow/Funct Image W/Drug (78708) |
$704.80 |
$881 |
1.3× |
| K Flow/Funct Image W/O Drug (78707) |
$720.80 |
$901 |
1.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$393.60 |
$492 |
1.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$440 |
$550 |
1.1× |
| Knee 3 Views (73562) |
$240 |
$300 |
2.8× |
| Liver & Spleen Imaging Static Only (78215) |
$511.20 |
$639 |
1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$560.80 |
$701 |
1.4× |
| Liver imaging static only (78201) |
$511.20 |
$639 |
0.9× |
| Liver imaging w/vascular flow (78202) |
$619.20 |
$774 |
1.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,184 |
$1,480 |
2.2× |
| Lung Ventilation Imaging (78579) |
$698.40 |
$873 |
1.8× |
| Lymph System Imaging (78195) |
$555.20 |
$694 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$1,311.20 |
$1,639 |
5.5× |
| Mammary ductogram or galactogram multiple (77054) |
$673.60 |
$842 |
2.8× |
| Mammary ductogram or galactogram single (77053) |
$673.60 |
$842 |
2.8× |
| Meckels Divert Exam (78290) |
$464 |
$580 |
1.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,938.40 |
$2,423 |
5.6× |
| MRA head w/o contrast (70544) |
$3,344 |
$4,180 |
14.1× |
| MRA head with contrast (70545) |
$1,952 |
$2,440 |
5.6× |
| MRA neck w contrast (70548) |
$2,590.40 |
$3,238 |
7.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,012 |
$5,015 |
11.6× |
| MRA neck w/o contrast (70547) |
$3,264 |
$4,080 |
13.7× |
| MRI abdomen w contrast (74182) |
$1,988 |
$2,485 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$3,277.60 |
$4,097 |
13.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,544.80 |
$1,931 |
2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,666.40 |
$3,333 |
7.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,344 |
$4,180 |
4.3× |
| MRI bone marrow blood supply (77084) |
$1,282.40 |
$1,603 |
5.4× |
| MRI cervical spine w contrast (72142) |
$1,600.80 |
$2,001 |
4.6× |
| MRI cervical spine w/o cont (72141) |
$3,672 |
$4,590 |
15.5× |
| MRI chest w/o contrast (71550) |
$1,406.40 |
$1,758 |
5.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,719.20 |
$3,399 |
7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,856 |
$3,570 |
8.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,264 |
$4,080 |
13.7× |
| MRI lumbar spine w contrast (72149) |
$2,093.60 |
$2,617 |
6.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,012 |
$5,015 |
11.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,631.20 |
$2,039 |
6.9× |
| MRI orbit face neck w contrast (70542) |
$1,816.80 |
$2,271 |
5.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,012 |
$5,015 |
11.6× |
| MRI pelvis w contrast (72196) |
$1,742.40 |
$2,178 |
5.0× |
| MRI pelvis w/o & w contrast (72197) |
$3,483.20 |
$4,354 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$3,344 |
$4,180 |
14.1× |
| MRI thoracic spine w/o contrast (72146) |
$3,672 |
$4,590 |
15.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,272 |
$1,590 |
3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,264 |
$4,080 |
13.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,920 |
$2,400 |
5.5× |
| MRI, abdomen, combo (74183) |
$4,012 |
$5,015 |
11.6× |
| MRI, dorsal spine combo (72157) |
$4,681.60 |
$5,852 |
13.5× |
| MRI, dorsal spine contrast (72147) |
$1,700 |
$2,125 |
4.9× |
| MRI, joint upper extrem (73221) |
$3,672 |
$4,590 |
15.5× |
| MRI, joint upper extrem combo (73223) |
$3,672 |
$4,590 |
10.6× |
| MRI, lumbar spine combo (72158) |
$4,896 |
$6,120 |
14.1× |
| Myelogram cervical (72240) |
$576 |
$720 |
0.7× |
| Myelogram Lumbar (72265) |
$525.60 |
$657 |
0.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$464 |
$580 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$5,280 |
$6,600 |
4.1× |
| Neck soft tissue (70360) |
$134.40 |
$168 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$722.40 |
$903 |
3.1× |
| Optic foramina (70190) |
$140.80 |
$176 |
1.6× |
| Parathyroid Planar Imaging (78070) |
$471.20 |
$589 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$408 |
$510 |
3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$771.20 |
$964 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$160 |
$200 |
1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$186.40 |
$233 |
0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$382.40 |
$478 |
4.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$160 |
$200 |
1.8× |
| Radex elbow complete minimum 3 views (73080) |
$408 |
$510 |
4.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$218.40 |
$273 |
2.1× |
| Radex fingr minimum 2 views (73140) |
$326.40 |
$408 |
3.8× |
| Radex foot complete minimum 3 views (73630) |
$440 |
$550 |
5.1× |
| Radex Hand Minimum 3 Views (73130) |
$408 |
$510 |
4.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$94.40 |
$118 |
1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$187.20 |
$234 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$164.80 |
$206 |
1.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$279.20 |
$349 |
3.2× |
| Radex shoulder complete minimum 2 views (73030) |
$440 |
$550 |
5.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$117.60 |
$147 |
1.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$173.60 |
$217 |
1.0× |
| Radex Spine 1 View Specify Level (72020) |
$134.40 |
$168 |
1.6× |
| Radex Sternum Minimum 2 Views (71120) |
$153.60 |
$192 |
1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$188.80 |
$236 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$148.80 |
$186 |
1.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$94.40 |
$118 |
0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$408 |
$510 |
4.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$187.20 |
$234 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$187.20 |
$234 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$232.80 |
$291 |
2.2× |
| Radiologic exam colon double contrast study (74280) |
$520.80 |
$651 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$381.60 |
$477 |
2.2× |
| Radiologic exam knee complete 4/more views (73564) |
$281.60 |
$352 |
2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$200 |
$250 |
1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$357.60 |
$447 |
2.0× |
| Radiologic exam swallow function contrast study (74230) |
$354.40 |
$443 |
2.0× |
| Radiologic examination femur 1 view (73551) |
$112.80 |
$141 |
1.3× |
| Radiologic examination femur minimum 2 views (73552) |
$156 |
$195 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$157.60 |
$197 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$173.60 |
$217 |
2.0× |
| Ribs bilateral 3 views (71110) |
$290.40 |
$363 |
2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$767.20 |
$959 |
1.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$889.60 |
$1,112 |
1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,028.80 |
$1,286 |
1.9× |
| Salivary Gland Imaging (78230) |
$508 |
$635 |
1.3× |
| Salivary Gland Imaging Serial Images (78231) |
$597.60 |
$747 |
1.5× |
| Scapula (73010) |
$156.80 |
$196 |
1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$129.60 |
$162 |
5.5× |
| Shoulder 1 view (73020) |
$172 |
$215 |
2.0× |
| Shoulder Arthrography (73040) |
$332 |
$415 |
1.0× |
| Skull less than 4 views (70250) |
$146.40 |
$183 |
1.4× |
| Sternoclavicular joints (71130) |
$198.40 |
$248 |
2.3× |
| Testicular Imaging W/Flow (78761) |
$472 |
$590 |
1.2× |
| Thoracic spine 2 views (72070) |
$202.40 |
$253 |
1.9× |
| Thoracolumbar 2 views (72080) |
$176.80 |
$221 |
2.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$628 |
$785 |
1.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$458.40 |
$573 |
1.2× |
| Thyroid Met Imaging Body (78018) |
$876 |
$1,095 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$543.20 |
$679 |
1.4× |
| Ultrasound Breast Limited (76642) |
$332.80 |
$416 |
3.8× |
| Ultrasound Elastography Parenchyma (76981) |
$336 |
$420 |
3.2× |
| Ultrasound Exam Aaa Screen (76706) |
$740 |
$925 |
7.1× |
| Ultrasound, abdomen limited (76705) |
$740 |
$925 |
7.1× |
| Umbilical-artery Doppler (OB) (76820) |
$720 |
$900 |
6.9× |
| Upper gi w/o kub (74240) |
$452.80 |
$566 |
2.6× |
| Urethrocystogram voiding (74455) |
$253.60 |
$317 |
1.1× |
| Urethrocystography retrograde (74450) |
$236.80 |
$296 |
1.0× |
| Us breast unilateral complete (76641) |
$720 |
$900 |
6.9× |
| Us chest (76604) |
$740 |
$925 |
7.1× |
| Us complete joint (76881) |
$347.20 |
$434 |
3.3× |
| Us exam, pelvic, limited (76857) |
$335.20 |
$419 |
3.2× |
| Us head (76506) |
$193.60 |
$242 |
1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$740 |
$925 |
7.1× |
| Us ob detailed single fetus (76811) |
$517.60 |
$647 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$720 |
$900 |
6.9× |
| Us ob transvaginal (76817) |
$740 |
$925 |
7.1× |
| Us pelvic non ob complete (76856) |
$1,019.20 |
$1,274 |
9.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$740 |
$925 |
7.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$740 |
$925 |
7.1× |
| Us retroperitoneal complete (76770) |
$740 |
$925 |
7.1× |
| Us retroperitoneal limited (76775) |
$189.60 |
$237 |
1.8× |
| Us scrotum and contents (76870) |
$740 |
$925 |
7.1× |
| Us spinal canal and contents (76800) |
$252 |
$315 |
2.4× |
| Us thyroid (76536) |
$740 |
$925 |
7.1× |
| Us transrectal (76872) |
$720 |
$900 |
6.9× |
| Vascular Flow Imaging (78445) |
$416.80 |
$521 |
1.0× |
| Venography extremity bilateral rs&i (75822) |
$539.20 |
$674 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$508 |
$635 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$160 |
$200 |
1.8× |
| Wrist 2 views (73100) |
$109.60 |
$137 |
1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$310.40 |
$388 |
3.6× |
| X-ray antegrade pyelogram tube (74425) |
$374.40 |
$468 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$172 |
$215 |
2.0× |
| X-Ray Exam Breast Specimen (76098) |
$885.60 |
$1,107 |
1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$205.60 |
$257 |
2.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$239.20 |
$299 |
2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$187.20 |
$234 |
1.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$102.40 |
$128 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$326.40 |
$408 |
3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$189.60 |
$237 |
1.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$325.60 |
$407 |
3.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$138.40 |
$173 |
1.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$292.80 |
$366 |
2.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$220.80 |
$276 |
2.1× |
| X-ray eye for foreign body (70030) |
$130.40 |
$163 |
1.5× |
| X-ray humerus (73060) |
$122.40 |
$153 |
1.4× |
| X-ray IV pyelogram (ivp) (74400) |
$396 |
$495 |
2.3× |
| X-ray IV pyelogram+tomography (74415) |
$556.80 |
$696 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$128.80 |
$161 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$146.40 |
$183 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$440 |
$550 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$256.80 |
$321 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$138.40 |
$173 |
1.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$112 |
$140 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$172 |
$215 |
2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$251.20 |
$314 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$283.20 |
$354 |
2.7× |
| X-Ray Stress View (77071) |
$172 |
$215 |
2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$489.60 |
$612 |
1.4× |
| X-Rays Bone Length Studies (77073) |
$165.60 |
$207 |
1.6× |
| X-Rays Bone Survey Complete (77075) |
$536 |
$670 |
5.1× |
| Xr c-spine 4 or 5 views (72050) |
$360.80 |
$451 |
3.5× |
| Xr facial bones less than 3 views (70140) |
$126.40 |
$158 |
1.5× |
| Xr orbits complete 4 views (70200) |
$231.20 |
$289 |
2.2× |
| Xr Tomogram Single Plane (76100) |
$120.80 |
$151 |
1.2× |