| Abdomen 2 views (74019) |
$92.75 |
$185.50 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$586.50 |
$1,173 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$8,284 |
$16,568 |
2.6× |
| Angiography extremity unilateral rs&i (75710) |
$8,284 |
$16,568 |
2.6× |
| Angiography internal mammary rs&i (75756) |
$2,937.50 |
$5,875 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$8,284 |
$16,568 |
1.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,284 |
$16,568 |
2.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,284 |
$16,568 |
2.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$8,284 |
$16,568 |
1.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,737 |
$3,474 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,937.50 |
$5,875 |
0.9× |
| Ankle 2 views (73600) |
$161.50 |
$323 |
1.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$408 |
$816 |
1.2× |
| Aortogram thoracic (75605) |
$8,284 |
$16,568 |
1.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$8,284 |
$16,568 |
2.6× |
| Aortography abdominal serialography rs&i (75625) |
$8,284 |
$16,568 |
2.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$8,284 |
$16,568 |
2.6× |
| Arthrogram elbow (73085) |
$575.50 |
$1,151 |
1.6× |
| Arthrogram hip (73525) |
$419.25 |
$838.50 |
1.2× |
| Arthrogram shoulder (73040) |
$408.25 |
$816.50 |
1.2× |
| Arthrogram wrist (73115) |
$347.25 |
$694.50 |
1.0× |
| Arthrography knee lt (73580) |
$407.50 |
$815 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$550.25 |
$1,100.50 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$563.25 |
$1,126.50 |
1.4× |
| Bone age studies (77072) |
$91.25 |
$182.50 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$593 |
$1,186 |
1.5× |
| Bone survey complete (77075) |
$186.25 |
$372.50 |
1.8× |
| Brain image w/flow 4 + views (78606) |
$1,043 |
$2,086 |
1.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$427 |
$854 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$93.75 |
$187.50 |
1.1× |
| Chest 1 view (71045) |
$90.25 |
$180.50 |
1.0× |
| Chest 3 views (71047) |
$95.75 |
$191.50 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$78 |
$156 |
0.4× |
| Clavicle complete (73000) |
$90.25 |
$180.50 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$517.75 |
$1,035.50 |
4.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,125 |
$2,250 |
3.2× |
| CT abdomen and pelvis without contrast (74176) |
$729.25 |
$1,458.50 |
3.0× |
| CT abdomen w contrast (74160) |
$736.25 |
$1,472.50 |
4.2× |
| CT abdomen w wo contrast (74170) |
$864 |
$1,728 |
4.9× |
| CT abdomen w/o contrast (74150) |
$556.75 |
$1,113.50 |
5.3× |
| CT angio hrt w/3d image (75574) |
$783 |
$1,566 |
2.2× |
| CT angiography upper extremity lt (73206) |
$817.50 |
$1,635 |
4.6× |
| CT c-spine w/o contrast (72125) |
$521.25 |
$1,042.50 |
5.0× |
| CT cervical spine w&w/o contrast (72127) |
$829 |
$1,658 |
4.7× |
| CT cervical spine with contrast (72126) |
$692.50 |
$1,385 |
2.0× |
| CT chest w/wo contrast (71270) |
$836.25 |
$1,672.50 |
4.7× |
| CT chest with contrast (71260) |
$694.25 |
$1,388.50 |
3.9× |
| CT head/brain with contrast (70460) |
$691.25 |
$1,382.50 |
3.9× |
| CT head/brain without and with contrast (70470) |
$818.25 |
$1,636.50 |
4.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,045.50 |
$2,091 |
3.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$88.50 |
$177 |
1.0× |
| CT hrt w/3d image congen (75573) |
$1,378 |
$2,756 |
3.9× |
| CT iac w contrast (70481) |
$701.25 |
$1,402.50 |
4.0× |
| CT lower ext w/o (73700) |
$520.50 |
$1,041 |
5.0× |
| CT lower extremity w wo contrast (73702) |
$811.50 |
$1,623 |
4.6× |
| CT lower extremity with contrast (73701) |
$688.25 |
$1,376.50 |
3.9× |
| CT lumbar spine w & w/o contrast (72133) |
$820.50 |
$1,641 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$523.50 |
$1,047 |
5.0× |
| CT lumbar spine with contrast (72132) |
$691.25 |
$1,382.50 |
2.0× |
| CT maxillofacial w contrast (70487) |
$695 |
$1,390 |
3.9× |
| CT maxillofacial w/o contrast (70486) |
$521.50 |
$1,043 |
5.0× |
| CT maxillofacial w/wo contrast (70488) |
$827.75 |
$1,655.50 |
4.7× |
| CT neck soft tissue w contrast (70491) |
$701.50 |
$1,403 |
4.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$775 |
$1,550 |
4.4× |
| CT orbits w/o contrast (70480) |
$541 |
$1,082 |
5.2× |
| CT pelvis w & w/o contrast (72194) |
$811.50 |
$1,623 |
4.6× |
| CT pelvis w/o contrast (72192) |
$520.25 |
$1,040.50 |
5.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$844 |
$1,688 |
4.8× |
| CT soft tissue neck w/o contrast (70490) |
$531 |
$1,062 |
5.1× |
| CT thoracic spine w/contrast (72129) |
$691.25 |
$1,382.50 |
3.9× |
| CT thoracic spine w/o contrast (72128) |
$520.50 |
$1,041 |
5.0× |
| CT thoracic spine w/wo contrast (72130) |
$820.75 |
$1,641.50 |
4.7× |
| CT thorax w/o contrast (71250) |
$926 |
$1,852 |
8.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$814.25 |
$1,628.50 |
4.6× |
| CT upper extremity w/o contrast rt (73200) |
$523 |
$1,046 |
5.0× |
| CT upper extremity with contrast (73201) |
$706.25 |
$1,412.50 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$846.75 |
$1,693.50 |
4.8× |
| Cta Abdomen (74175) |
$859.75 |
$1,719.50 |
4.9× |
| CTA abdomen pelvis (74174) |
$911.75 |
$1,823.50 |
2.6× |
| CTA chest (71275) |
$846.75 |
$1,693.50 |
4.8× |
| Cta Head (70496) |
$817.75 |
$1,635.50 |
4.6× |
| CTA lwr ext w&w/o contrast (73706) |
$822.75 |
$1,645.50 |
4.7× |
| Cta Neck (70498) |
$846.75 |
$1,693.50 |
4.8× |
| Cta Pelvis (72191) |
$820.75 |
$1,641.50 |
4.7× |
| Cystography minimum 3 views rs&i (74430) |
$668.50 |
$1,337 |
1.9× |
| Diskography lumbar (72295) |
$2,614 |
$2,692 |
1.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$267.50 |
$535 |
2.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$207.25 |
$414.50 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$199 |
$398 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$215.75 |
$431.50 |
2.1× |
| Echo exam of fetal heart (76825) |
$417 |
$834 |
0.8× |
| Echoencephalography real time imaging (76506) |
$185.25 |
$370.50 |
1.8× |
| Esophagus (74220) |
$186.75 |
$373.50 |
1.1× |
| Fetal biophysical profile non-stress testing (76818) |
$575.50 |
$1,151 |
5.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$265 |
$530 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$368 |
$736 |
1.5× |
| Foot 2 views (73620) |
$161.50 |
$323 |
1.8× |
| Forearm 2 views (73090) |
$90 |
$180 |
1.0× |
| Gated Heart Planar Single (78472) |
$599 |
$1,198 |
1.5× |
| Hand 2 views (73120) |
$161.50 |
$323 |
1.5× |
| Hand 3 views (73130) |
$161.50 |
$323 |
1.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$7,655 |
$15,310 |
2.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$610.25 |
$1,220.50 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$593.50 |
$1,187 |
1.5× |
| Ht muscle image spect sing (78451) |
$1,002.50 |
$2,005 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$90.25 |
$180.50 |
1.0× |
| Hysterosalpingogram (74740) |
$417.25 |
$834.50 |
1.7× |
| Kidney imaging morphology (78700) |
$348 |
$696 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$514.25 |
$1,028.50 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$517.25 |
$1,034.50 |
0.9× |
| Knee 3 views (73562) |
$161.50 |
$323 |
1.8× |
| Liver & spleen imaging static only (78215) |
$568 |
$1,136 |
1.4× |
| Lung perf&ventilat diferentl (78598) |
$1,143.50 |
$2,287 |
2.1× |
| Lung perfusion differential (78597) |
$746 |
$1,492 |
1.9× |
| Lymphoscintigraphy (78195) |
$583.50 |
$1,167 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$288 |
$576 |
1.2× |
| Mammary ductogram or galactogram single (77053) |
$285.50 |
$571 |
1.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$159.50 |
$319 |
1.8× |
| Meckels Diverticulum (78290) |
$526 |
$1,052 |
1.3× |
| MRA head w & w/o contrast (70546) |
$1,213 |
$2,426 |
3.5× |
| MRA head w/o contrast (70544) |
$1,475.50 |
$2,951 |
6.2× |
| MRA head with contrast (70545) |
$948.25 |
$1,896.50 |
2.7× |
| MRA neck w contrast (70548) |
$931 |
$1,862 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,213 |
$2,426 |
3.5× |
| MRA neck w/o contrast (70547) |
$813.75 |
$1,627.50 |
3.4× |
| MRI abdomen w contrast (74182) |
$996.50 |
$1,993 |
2.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,270.75 |
$2,541.50 |
3.6× |
| MRI abdomen w/o contrast (74181) |
$867.75 |
$1,735.50 |
3.6× |
| MRI any jnt lwr ext with con lt (73722) |
$957.50 |
$1,915 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$963.25 |
$1,926.50 |
1.2× |
| MRI breast w/o contrast bilateral (77047) |
$1,789 |
$3,578 |
7.5× |
| MRI breast w/o contrast unilat (77046) |
$1,494.25 |
$2,988.50 |
6.2× |
| MRI c-spine with contrast (72142) |
$957.50 |
$1,915 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$832.75 |
$1,665.50 |
3.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,255.75 |
$2,511.50 |
3.6× |
| MRI chest w/o contrast (71550) |
$840.75 |
$1,681.50 |
3.5× |
| MRI chest with contrast (71551) |
$1,707 |
$3,414 |
2.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$944.50 |
$1,889 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$943.25 |
$1,886.50 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$812.50 |
$1,625 |
3.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$834 |
$1,668 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,242.75 |
$2,485.50 |
3.5× |
| MRI orbit/face/neck w/contrast (70542) |
$956.25 |
$1,912.50 |
2.7× |
| MRI pelvis w contrast (72196) |
$964 |
$1,928 |
2.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,249.25 |
$2,498.50 |
3.6× |
| MRI pelvis w/o contrast (72195) |
$835.25 |
$1,670.50 |
3.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,249.25 |
$2,498.50 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,236.25 |
$2,472.50 |
3.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,255.75 |
$2,511.50 |
3.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$958 |
$1,916 |
2.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,261.25 |
$2,522.50 |
3.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$957.25 |
$1,914.50 |
2.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,268.75 |
$2,537.50 |
3.6× |
| MRI thoracic spine w/o contrast (72146) |
$832.75 |
$1,665.50 |
3.5× |
| MRI tmj (70336) |
$784.75 |
$1,569.50 |
3.3× |
| MRI upper ext joint w/o contrast (73221) |
$839.25 |
$1,678.50 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,249.25 |
$2,498.50 |
3.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$822.25 |
$1,644.50 |
3.4× |
| Myelogram Cervical (72240) |
$1,077.25 |
$2,154.50 |
1.4× |
| Myelogram Lumbar (72265) |
$2,044 |
$4,088 |
2.6× |
| Myelogram thoracic (72255) |
$1,080.50 |
$2,161 |
1.4× |
| Myelography 2 or more regions (72270) |
$1,085.75 |
$2,171.50 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,432.50 |
$2,865 |
1.1× |
| Neck soft tissue (70360) |
$90.25 |
$180.50 |
1.0× |
| Nm adrenal scan (78075) |
$1,421 |
$2,842 |
1.1× |
| Nm gastric emptying study (78264) |
$527.75 |
$1,055.50 |
1.3× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,657 |
$5,314 |
2.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$710 |
$1,420 |
1.8× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$1,945 |
$3,890 |
3.6× |
| Nuclear Rx Oral Admin (79005) |
$275.75 |
$551.50 |
1.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$266.50 |
$533 |
2.5× |
| Osseous survey infant (77076) |
$171 |
$342 |
1.6× |
| Osseous survey limited (77074) |
$178.75 |
$357.50 |
1.7× |
| Parathyrd planar w/wo subtrj (78071) |
$554 |
$1,108 |
1.4× |
| Parathyroid imaging (78070) |
$388.75 |
$777.50 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$90.50 |
$181 |
0.9× |
| Perineogram (74775) |
$720.50 |
$1,441 |
3.0× |
| Peritoneogram rs&i (74190) |
$665 |
$1,330 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$1,068.25 |
$2,136.50 |
0.7× |
| PET imaging CT for attenuation limited area (78814) |
$1,047.75 |
$2,095.50 |
0.7× |
| PET imaging for CT attenuation whole body (78816) |
$1,145.50 |
$2,291 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,232.50 |
$2,465 |
3.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,445.50 |
$8,891 |
1.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,717 |
$5,434 |
0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$382 |
$764 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$744 |
$1,488 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$214 |
$428 |
0.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$76 |
$152 |
0.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$106.75 |
$213.50 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$94.25 |
$188.50 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$161.50 |
$323 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$107.75 |
$215.50 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$92.50 |
$185 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$244 |
$488 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$221 |
$442 |
1.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$195.50 |
$391 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$90.75 |
$181.50 |
1.0× |
| Radiological examination surgical specimen (76098) |
$712 |
$1,424 |
1.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$7,655 |
$15,310 |
2.4× |
| Ribs bilateral 3 views (71110) |
$152.75 |
$305.50 |
1.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$617 |
$1,234 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$932.25 |
$1,864.50 |
1.7× |
| Sacroiliac Joints < 3 Views (72200) |
$93.75 |
$187.50 |
0.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$238.75 |
$477.50 |
1.0× |
| Scanogram (77073) |
$174.75 |
$349.50 |
1.7× |
| Scapula complete (73010) |
$90.25 |
$180.50 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$33.50 |
$67 |
1.4× |
| Sella turcica (70240) |
$92 |
$184 |
1.1× |
| Small bowel series (74250) |
$185.75 |
$371.50 |
1.1× |
| Spine thoracic 3 views (72072) |
$93.75 |
$187.50 |
0.9× |
| Testicular Imaging With Vascular Flow (78761) |
$683.50 |
$1,367 |
1.7× |
| Thoracolumbar 2 views (72080) |
$66 |
$132 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$656 |
$1,312 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$619 |
$1,238 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$401.75 |
$803.50 |
1.0× |
| Tomogram (76100) |
$329 |
$658 |
3.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$357.25 |
$714.50 |
0.9× |
| Ultrasound elastography first target lesion (76982) |
$318 |
$636 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$204 |
$408 |
1.9× |
| Umbilical-artery Doppler (OB) (76820) |
$191 |
$382 |
1.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$104 |
$208 |
1.2× |
| Unlisted fluoroscopic procedure (76496) |
$154 |
$308 |
1.8× |
| Upper Extremity Infant (73092) |
$82.25 |
$164.50 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$725 |
$1,450 |
3.0× |
| Urethrocystography voiding (74455) |
$309 |
$618 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$320.75 |
$641.50 |
1.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$326 |
$652 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$132 |
$264 |
1.3× |
| Us breast unilateral complete (76641) |
$195.25 |
$390.50 |
1.9× |
| Us breast unilateral limited (76642) |
$178.25 |
$356.50 |
2.0× |
| Us chest (76604) |
$224.75 |
$449.50 |
2.1× |
| Us compl joint r-t w/image documentation (76881) |
$234.75 |
$469.50 |
2.2× |
| Us elastography parenchyma (76981) |
$191.50 |
$383 |
1.8× |
| Us fetal nuchal translucency 1st gestation (76813) |
$266.50 |
$533 |
2.5× |
| Us guided compression repair (76936) |
$252.50 |
$505 |
1.2× |
| Us infant hips dynamic (76885) |
$161 |
$322 |
1.8× |
| Us infant hips limited static (76886) |
$157.25 |
$314.50 |
1.8× |
| Us kidney transplant (76776) |
$200.25 |
$400.50 |
1.9× |
| Us ob detailed single fetus (76811) |
$570 |
$1,140 |
2.4× |
| Us ob transvaginal (76817) |
$345.50 |
$691 |
3.3× |
| Us pelvic non ob complete (76856) |
$223.25 |
$446.50 |
2.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$161 |
$322 |
1.5× |
| Us pregnancy ltd (76815) |
$266.50 |
$533 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$388.50 |
$777 |
3.7× |
| Us retroperitoneal complete (76770) |
$242.75 |
$485.50 |
2.3× |
| Us retroperitoneal limited (76775) |
$205 |
$410 |
2.0× |
| Us scrotum and contents (76870) |
$213.50 |
$427 |
2.0× |
| Us soft tissue head/neck (76536) |
$210 |
$420 |
2.0× |
| Us spinal canal and contents (76800) |
$250.75 |
$501.50 |
2.4× |
| Us transrectal prostate volume (76873) |
$156 |
$312 |
1.5× |
| Us xtr non-vasc lmtd (76882) |
$92.50 |
$185 |
0.9× |
| Venogram extremity bilateral (75822) |
$2,937.50 |
$5,875 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$8,284 |
$16,568 |
2.6× |
| Venography caval superior serialography rs&i (75827) |
$2,937.50 |
$5,875 |
1.9× |
| Venography extremity unilateral rs&i (75820) |
$2,937.50 |
$5,875 |
1.9× |
| Venography Renal Bilateral (75833) |
$8,284 |
$16,568 |
2.6× |
| Venography renal unilateral selective rs&i (75831) |
$8,284 |
$16,568 |
2.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,937.50 |
$5,875 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$80.25 |
$160.50 |
0.9× |
| Wrist 2 views (73100) |
$161.50 |
$323 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$97.25 |
$194.50 |
0.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$92.25 |
$184.50 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$91 |
$182 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$360.25 |
$720.50 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$89.50 |
$179 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$90.75 |
$181.50 |
1.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$121.25 |
$242.50 |
1.2× |
| X-ray exam hip uni 1 view (73501) |
$90 |
$180 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$92.50 |
$185 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$152.75 |
$305.50 |
1.5× |
| X-ray exam of femur 1 (73551) |
$89.50 |
$179 |
1.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$343.50 |
$687 |
1.9× |
| X-ray eye for foreign body (70030) |
$91.25 |
$182.50 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$95.75 |
$191.50 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$91 |
$182 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,138.50 |
$2,277 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$90.25 |
$180.50 |
1.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$326 |
$652 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$92.50 |
$185 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$95 |
$190 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$92.75 |
$185.50 |
1.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$62.75 |
$125.50 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$93.75 |
$187.50 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$161.25 |
$322.50 |
1.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$148.75 |
$297.50 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$91.25 |
$182.50 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$91.50 |
$183 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$96.50 |
$193 |
0.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$93.75 |
$187.50 |
0.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$383 |
$766 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$93.75 |
$187.50 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$95.25 |
$190.50 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$154.50 |
$309 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$93.75 |
$187.50 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$91.25 |
$182.50 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$91.75 |
$183.50 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$106.75 |
$213.50 |
1.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$90 |
$180 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$154.25 |
$308.50 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$93.25 |
$186.50 |
0.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$89.50 |
$179 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$93.75 |
$187.50 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$92 |
$184 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$93.50 |
$187 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$97.75 |
$195.50 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$88.75 |
$177.50 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$91 |
$182 |
1.0× |
| Xr arthrogram ankle (73615) |
$396.75 |
$793.50 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$158.75 |
$317.50 |
1.5× |
| Xr chest 4+ views (71048) |
$99 |
$198 |
0.9× |
| Xr Cholecystography Oral Contrast (74290) |
$319.50 |
$639 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$88.75 |
$177.50 |
1.0× |
| Xr optic foramina (70190) |
$93.50 |
$187 |
1.1× |
| Xr shoulder 1 view (73020) |
$89 |
$178 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$154.50 |
$309 |
1.5× |
| Xr tibia/fibula 2 views (73590) |
$90 |
$180 |
1.0× |
| Xr tmj bilateral (70330) |
$113.25 |
$226.50 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$90.25 |
$180.50 |
1.0× |