| Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) |
$1,643.05 |
$1,933 |
0.5× |
| Ankle 2 views (73600) |
$111.35 |
$131 |
1.2× |
| Clavicle complete (73000) |
$206.55 |
$243 |
2.3× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$2,032.35 |
$2,391 |
5.5× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$1,505.35 |
$1,771 |
8.1× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,940.98 |
$2,283.50 |
10.5× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,577.60 |
$1,856 |
8.5× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,711.05 |
$2,013 |
9.2× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,676.20 |
$1,972 |
9.1× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$1,559.32 |
$1,834.50 |
8.4× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,534.68 |
$1,805.50 |
8.3× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$1,305.60 |
$1,536 |
7.1× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$980.05 |
$1,153 |
8.9× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$1,392.72 |
$1,638.50 |
7.5× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$1,406.32 |
$1,654.50 |
7.6× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,207.85 |
$1,421 |
6.5× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,001.72 |
$1,178.50 |
9.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,287.75 |
$1,515 |
7.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$994.08 |
$1,169.50 |
9.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$1,475.18 |
$1,735.50 |
8.0× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,457.32 |
$1,714.50 |
7.9× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$1,430.98 |
$1,683.50 |
7.7× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$1,459.45 |
$1,717 |
7.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,486.68 |
$2,925.50 |
6.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,674.08 |
$1,969.50 |
6.7× |
| CT abdomen w & w/o contrast (74170) |
$1,446.70 |
$1,702 |
7.8× |
| CT abdomen w/contrast (74160) |
$1,269.90 |
$1,494 |
6.9× |
| CT abdomen w/o contrast (74150) |
$991.95 |
$1,167 |
9.0× |
| CT angio hrt w/3d image (75574) |
$762.02 |
$896.50 |
2.1× |
| CT cervical spine w/contrast (72126) |
$1,194.68 |
$1,405.50 |
3.2× |
| CT cervical spine w/o contrast (72125) |
$1,089.28 |
$1,281.50 |
9.9× |
| CT chest w/contrast (71260) |
$1,235.05 |
$1,453 |
6.7× |
| CT extremity upper w & w/o contrast (73202) |
$1,252.90 |
$1,474 |
6.8× |
| CT extremity upper w/o contrast (73200) |
$998.32 |
$1,174.50 |
9.1× |
| CT head/brain with contrast (70460) |
$1,288.18 |
$1,515.50 |
7.0× |
| CT head/brain without and with contrast (70470) |
$1,459.88 |
$1,717.50 |
7.9× |
| CT heart c+ cardiac strux&morph cgen hrt ds (75573) |
$343.40 |
$404 |
0.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$376.12 |
$442.50 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$105.82 |
$124.50 |
1.2× |
| CT l-spine w/contrast (72132) |
$1,311.12 |
$1,542.50 |
3.6× |
| CT limited/localized follow up study (76380) |
$241.40 |
$284 |
2.6× |
| CT lower extremity w/dye (73701) |
$1,278.40 |
$1,504 |
6.9× |
| CT lumbar spine w/o contrast (72131) |
$1,069.30 |
$1,258 |
9.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,281.38 |
$1,507.50 |
6.9× |
| CT neck w/contrast (70491) |
$1,217.20 |
$1,432 |
6.6× |
| CT neck w/o contrast (70490) |
$999.18 |
$1,175.50 |
9.1× |
| CT pelvis w & w/o contrast (72194) |
$1,365.52 |
$1,606.50 |
7.4× |
| CT pelvis w/o contrast (72192) |
$999.18 |
$1,175.50 |
9.1× |
| CT thoracic spine w/contrast (72129) |
$1,133.05 |
$1,333 |
6.1× |
| CT thoracic spine w/o contrast (72128) |
$1,005.12 |
$1,182.50 |
9.1× |
| CT thorax lung cancer scr c- (71271) |
$375.70 |
$442 |
3.4× |
| CT thorax w/o contrast (71250) |
$958.38 |
$1,127.50 |
8.7× |
| CT upper extremity w/dye (73201) |
$1,105.85 |
$1,301 |
3.0× |
| CTA h&n c+ w/noncontrast img (70471) |
$2,402.95 |
$2,827 |
6.5× |
| CTA head w contrast (70496) |
$1,698.30 |
$1,998 |
9.2× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$572.90 |
$674 |
1.6× |
| Diskography lumbar s&i (72295) |
$1,605.65 |
$1,889 |
0.8× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$323 |
$380 |
2.9× |
| Dxa bone density/peripheral (77081) |
$174.68 |
$205.50 |
1.9× |
| Fetal biophys profile w/o nst (76819) |
$397.80 |
$468 |
3.6× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$345.95 |
$407 |
1.4× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$1,849.18 |
$2,175.50 |
5.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,429.28 |
$1,681.50 |
3.9× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,357.02 |
$1,596.50 |
5.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$2,005.15 |
$2,359 |
5.4× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$1,250.35 |
$1,471 |
3.4× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$1,130.50 |
$1,330 |
4.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$1,521.92 |
$1,790.50 |
4.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,865.75 |
$2,195 |
5.1× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$1,300.50 |
$1,530 |
3.5× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$1,802.42 |
$2,120.50 |
4.9× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,953.30 |
$2,298 |
5.3× |
| Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation Age Under 21 (77054) |
$159.80 |
$188 |
0.6× |
| Mammary ductogram single (77053) |
$151.30 |
$178 |
0.6× |
| Mandible min 4v (70110) |
$267.75 |
$315 |
2.4× |
| MRA head w/o contrast (70544) |
$1,168.32 |
$1,374.50 |
4.6× |
| MRA neck w/ contrast (70548) |
$1,379.12 |
$1,622.50 |
3.7× |
| MRA neck w/o contrast (70547) |
$1,143.68 |
$1,345.50 |
4.5× |
| MRI abdomen w/contrast (74182) |
$1,530.42 |
$1,800.50 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$1,300.92 |
$1,530.50 |
5.2× |
| MRI abdomen w/wo contrast (74183) |
$1,979.22 |
$2,328.50 |
5.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,496.85 |
$1,761 |
1.8× |
| MRI breast c- bilateral (77047) |
$606.05 |
$713 |
2.4× |
| MRI breast without contrast material unilateral (77046) |
$378.25 |
$445 |
1.5× |
| MRI c-spine w&w/o cont (72156) |
$2,071.88 |
$2,437.50 |
5.6× |
| MRI cervical spine w/contrast (72142) |
$1,621.80 |
$1,908 |
4.4× |
| MRI chest w/contrast (71551) |
$1,449.68 |
$1,705.50 |
1.8× |
| MRI chest w/o contrast (71550) |
$1,150.90 |
$1,354 |
4.6× |
| MRI chest w/wo contrast (71552) |
$2,231.68 |
$2,625.50 |
6.1× |
| MRI joint upr extr w/o&w/dye (73223) |
$1,861.08 |
$2,189.50 |
5.1× |
| MRI joint upr extrem w/dye (73222) |
$1,548.28 |
$1,821.50 |
1.9× |
| MRI joint upr extrem w/o dye (73221) |
$1,357.88 |
$1,597.50 |
5.4× |
| MRI lumbar spine w/contrast (72149) |
$1,712.32 |
$2,014.50 |
4.7× |
| MRI lumbar spine w/wo contrast (72158) |
$2,160.28 |
$2,541.50 |
5.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,980.50 |
$2,330 |
5.4× |
| MRI pelvis w & w/o contrast (72197) |
$2,221.48 |
$2,613.50 |
6.0× |
| MRI pelvis w/contrast (72196) |
$1,656.22 |
$1,948.50 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$1,311.98 |
$1,543.50 |
5.2× |
| MRI spine cervical w/o contrast (72141) |
$1,312.82 |
$1,544.50 |
5.2× |
| MRI t-spine w&w/o cont (72157) |
$2,110.12 |
$2,482.50 |
5.7× |
| MRI thoracic spine w/contrast (72147) |
$1,582.28 |
$1,861.50 |
4.3× |
| MRI thoracic spine w/o contrst (72146) |
$1,320.48 |
$1,553.50 |
5.2× |
| MRI tmj (70336) |
$824.08 |
$969.50 |
3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,324.30 |
$1,558 |
5.3× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$2,127.55 |
$2,503 |
2.3× |
| Ob us limited fetus(s) (76815) |
$352.75 |
$415 |
3.2× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Age Under 21 (76519) |
$508.30 |
$598 |
4.6× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$154.70 |
$182 |
1.4× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$181.48 |
$213.50 |
1.6× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter Age Under… (76510) |
$65.02 |
$76.50 |
0.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,748.50 |
$4,410 |
2.5× |
| PET imaging CT for attenuation limited area (78814) |
$2,739.55 |
$3,223 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$3,750.62 |
$4,412.50 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$635.80 |
$748 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$377.82 |
$444.50 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$402.90 |
$474 |
3.7× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$451.78 |
$531.50 |
4.1× |
| Radex hip unilateral with pelvis 1 view (73501) |
$103.70 |
$122 |
1.1× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$262.22 |
$308.50 |
2.9× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$73.52 |
$86.50 |
0.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$313.65 |
$369 |
2.8× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$74.80 |
$88 |
0.7× |
| Radex spine cervical 2 or 3 views (72040) |
$237.58 |
$279.50 |
2.6× |
| Radex spine cervical 4 or 5 views (72050) |
$325.98 |
$383.50 |
3.0× |
| Radex spine cervical 6 or more views (72052) |
$371.02 |
$436.50 |
3.4× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$242.25 |
$285 |
2.6× |
| Radiologic exam abdomen 3+ views (74021) |
$254.15 |
$299 |
2.3× |
| Radiologic exam colon double contrast study (74280) |
$645.15 |
$759 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$510.42 |
$600.50 |
2.8× |
| Radiologic exam esophagus single contrast study (74220) |
$398.65 |
$469 |
2.2× |
| Radiologic exam small int single contrast study (74250) |
$532.52 |
$626.50 |
2.9× |
| Radiologic exam swallow function contrast study (74230) |
$131.75 |
$155 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$563.98 |
$663.50 |
3.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$404.18 |
$475.50 |
2.2× |
| Radiologic examination femur minimum 2 views (73552) |
$233.75 |
$275 |
2.5× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$178.08 |
$209.50 |
1.9× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$219.30 |
$258 |
2.4× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$325.12 |
$382.50 |
2.9× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$204.85 |
$241 |
2.2× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$436.05 |
$513 |
4.8× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$167.88 |
$197.50 |
1.8× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$215.90 |
$254 |
2.4× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$218.45 |
$257 |
2.4× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$269.45 |
$317 |
2.9× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$292.40 |
$344 |
2.7× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$221.42 |
$260.50 |
2.4× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$498.95 |
$587 |
4.5× |
| Radiologic examination, mastoids; less than 3 views per side Age Under 21 (70120) |
$232.90 |
$274 |
2.1× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$210.38 |
$247.50 |
2.3× |
| Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s),… (74210) |
$396.10 |
$466 |
2.1× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$324.70 |
$382 |
2.9× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$260.52 |
$306.50 |
2.4× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$246.50 |
$290 |
2.2× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$504.05 |
$593 |
1.4× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$263.50 |
$310 |
2.9× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$152.58 |
$179.50 |
1.7× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$273.70 |
$322 |
2.5× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$304.72 |
$358.50 |
2.8× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$272.42 |
$320.50 |
2.5× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$420.75 |
$495 |
3.8× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$307.28 |
$361.50 |
2.8× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$222.70 |
$262 |
2.4× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$277.52 |
$326.50 |
3.0× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$228.22 |
$268.50 |
2.5× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$136.42 |
$160.50 |
1.5× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$250.32 |
$294.50 |
2.3× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Age Under 21 (70370) |
$246.92 |
$290.50 |
2.7× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$56.10 |
$66 |
0.6× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$188.70 |
$222 |
2.1× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$125.38 |
$147.50 |
1.1× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$553.35 |
$651 |
2.2× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$444.55 |
$523 |
1.8× |
| Scapula complete (73010) |
$248.62 |
$292.50 |
2.3× |
| Screening digital breast tomosynthesis bi (77063) |
$36.55 |
$43 |
— |
| Temporomandibular joint arthrography, radiological supervision and interpretation Age Under 21 (70332) |
$154.70 |
$182 |
0.6× |
| Ultrasound breast limited (76642) |
$237.58 |
$279.50 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$396.52 |
$466.50 |
3.6× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$241.40 |
$284 |
2.2× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$474.72 |
$558.50 |
4.3× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$216.75 |
$255 |
2.0× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$558.88 |
$657.50 |
5.1× |
| Umbilical-artery Doppler (OB) (76820) |
$290.70 |
$342 |
2.6× |
| Urethrocystography retrograde rs&i (74450) |
$130.05 |
$153 |
0.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$181.90 |
$214 |
1.0× |
| Us abdominal aorta real time screen study aaa (76706) |
$289.42 |
$340.50 |
2.6× |
| Us breast uni real time with image complete (76641) |
$139.40 |
$164 |
1.3× |
| Us chest (76604) |
$393.12 |
$462.50 |
3.6× |
| Us compl joint r-t w/image documentation (76881) |
$206.98 |
$243.50 |
1.9× |
| Us encephalogram (76506) |
$339.15 |
$399 |
3.1× |
| Us exam, pelvic, limited (76857) |
$387.18 |
$455.50 |
3.5× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$71.40 |
$84 |
0.8× |
| US OB Follow-Up/Repeat (76816) |
$404.18 |
$475.50 |
3.7× |
| Us ob transvaginal (76817) |
$253.30 |
$298 |
2.3× |
| Us retroperitoneal complete (76770) |
$443.70 |
$522 |
4.0× |
| Us retroperitoneal ltd (76775) |
$417.35 |
$491 |
3.8× |
| Us scrotum (76870) |
$449.65 |
$529 |
4.1× |
| Us soft tissue head/neck (76536) |
$462.40 |
$544 |
4.2× |
| Us spinal canal (76800) |
$170.42 |
$200.50 |
1.5× |
| Us transrectal (76872) |
$277.10 |
$326 |
2.5× |
| Us unlstd proc (76999) |
$554.20 |
$652 |
6.0× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$243.95 |
$287 |
0.1× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$367.20 |
$432 |
0.2× |
| X-ray exam hips bi 3-4 views (73522) |
$179.78 |
$211.50 |
1.6× |
| X-ray exam of finger(s) (73140) |
$204.42 |
$240.50 |
2.2× |
| X-ray exam of knee 1 or 2 (73560) |
$208.68 |
$245.50 |
2.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$299.62 |
$352.50 |
1.6× |
| X-ray exam ribs bil 3 views (71110) |
$281.78 |
$331.50 |
2.6× |
| X-ray exam ribs uni 2 views (71100) |
$254.58 |
$299.50 |
2.8× |
| X-ray heel (73650) |
$208.25 |
$245 |
2.3× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$246.92 |
$290.50 |
2.2× |
| X-ray retrograde pyelogram (74420) |
$117.30 |
$138 |
0.3× |
| Xr abdomen 1 view (74018) |
$209.10 |
$246 |
2.3× |
| Xr abdomen 2 views (74019) |
$249.90 |
$294 |
2.3× |
| Xr arthrogram ankle (73615) |
$534.65 |
$629 |
1.5× |
| Xr arthrogram elbow (73085) |
$439.45 |
$517 |
1.2× |
| Xr arthrogram hip (73525) |
$499.80 |
$588 |
1.4× |
| Xr arthrogram knee (73580) |
$575.02 |
$676.50 |
1.6× |
| Xr arthrogram wrist (73115) |
$550.38 |
$647.50 |
1.5× |
| Xr bone age studies (77072) |
$138.55 |
$163 |
1.3× |
| Xr bone length study (77073) |
$243.52 |
$286.50 |
2.2× |
| Xr bone survey infant (77076) |
$210.80 |
$248 |
1.9× |
| Xr bone survey ltd (77074) |
$765.42 |
$900.50 |
6.9× |
| Xr chest 1 view (71045) |
$56.10 |
$66 |
0.6× |
| Xr chest 2 views (71046) |
$197.20 |
$232 |
2.1× |
| Xr eye foreign body (70030) |
$181.90 |
$214 |
2.0× |
| Xr facial bones 3+ views (70150) |
$269.88 |
$317.50 |
2.4× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$204.42 |
$240.50 |
2.2× |
| Xr forearm 2 views (73090) |
$215.48 |
$253.50 |
2.3× |
| Xr hand 2v (73120) |
$221.85 |
$261 |
2.0× |
| Xr hysterosalpingogram (74740) |
$540.60 |
$636 |
2.1× |
| Xr joint survey 1 view (77077) |
$93.50 |
$110 |
0.8× |
| Xr myelogram l-spine (72265) |
$328.95 |
$387 |
0.4× |
| Xr neck soft tissue (70360) |
$198.05 |
$233 |
2.2× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$230.35 |
$271 |
2.5× |
| Xr osseous survey complete (77075) |
$1,026.38 |
$1,207.50 |
9.3× |
| Xr pelvis 1-2 views (72170) |
$238.42 |
$280.50 |
2.2× |
| Xr pelvis min 3 view (72190) |
$289.42 |
$340.50 |
2.6× |
| Xr sacrum/coccyx 2+ views (72220) |
$259.25 |
$305 |
2.8× |
| Xr sella turcica (70240) |
$47.60 |
$56 |
0.5× |
| Xr shoulder 1 view (73020) |
$56.10 |
$66 |
0.6× |
| Xr sialogram (70390) |
$275.82 |
$324.50 |
1.1× |
| Xr sinuses 3+ views (70220) |
$283.48 |
$333.50 |
3.1× |
| Xr skull min 4 view (70260) |
$425.85 |
$501 |
3.9× |
| Xr spine 1 view (72020) |
$195.08 |
$229.50 |
2.1× |
| Xr spine thoracic 3v (72072) |
$287.72 |
$338.50 |
2.6× |
| Xr sternum 2+ views (71120) |
$206.98 |
$243.50 |
2.3× |
| Xr surgical specimen (76098) |
$335.75 |
$395 |
0.6× |
| Xr t-spine 2 views (72070) |
$279.65 |
$329 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$221.85 |
$261 |
2.4× |
| Xr tmj bilateral (70330) |
$243.95 |
$287 |
2.7× |
| Xr tmj unilateral (70328) |
$208.68 |
$245.50 |
2.3× |
| Xr wrist 2 views (73100) |
$203.15 |
$239 |
2.2× |