| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,745.50 |
$11,350 |
2.7× |
| Abdomen 2 views (74019) |
$199.65 |
$605 |
1.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$627 |
$1,900 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,537.70 |
$7,690 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,239.05 |
$6,785 |
0.7× |
| Ankle 2 views (73600) |
$135.30 |
$410 |
1.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$399.30 |
$1,210 |
1.1× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,772 |
$8,400 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,451.90 |
$7,430 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$1,656.60 |
$5,020 |
0.5× |
| Arthrogram hip (73525) |
$425.70 |
$1,290 |
1.2× |
| Arthrogram shoulder (73040) |
$435.60 |
$1,320 |
1.2× |
| Arthrogram wrist (73115) |
$366.30 |
$1,110 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$531.30 |
$1,610 |
3.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$521.40 |
$1,580 |
1.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$745.80 |
$2,260 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$836.55 |
$2,535 |
2.1× |
| Bone age studies (77072) |
$168.30 |
$510 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$828.30 |
$2,510 |
2.1× |
| Bone Marrow Imaging Limited Area (78102) |
$603.90 |
$1,830 |
1.5× |
| Bone survey complete (77075) |
$386.10 |
$1,170 |
3.7× |
| Brain image w/flow 4 + views (78606) |
$854.70 |
$2,590 |
1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,973.40 |
$5,980 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$211.20 |
$640 |
2.4× |
| Chest 1 view (71045) |
$82.83 |
$251 |
0.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$306.90 |
$930 |
1.7× |
| Clavicle complete (73000) |
$151.80 |
$460 |
1.7× |
| Continuing medical physics consltj pr wk (77336) |
$498.30 |
$1,510 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,072.40 |
$6,280 |
5.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,313.40 |
$3,980 |
5.5× |
| CT abdomen w contrast (74160) |
$1,009.80 |
$3,060 |
5.7× |
| CT abdomen w wo contrast (74170) |
$1,069.20 |
$3,240 |
6.1× |
| CT abdomen w/o contrast (74150) |
$803.55 |
$2,435 |
7.7× |
| CT angio hrt w/3d image (75574) |
$693 |
$2,100 |
2.0× |
| CT angiography upper extremity lt (73206) |
$983.40 |
$2,980 |
5.6× |
| CT c-spine w/o contrast (72125) |
$943.80 |
$2,860 |
9.0× |
| CT cervical spine with contrast (72126) |
$1,004.85 |
$3,045 |
2.9× |
| CT chest w/wo contrast (71270) |
$952.05 |
$2,885 |
5.4× |
| CT chest with contrast (71260) |
$993.30 |
$3,010 |
5.7× |
| CT head/brain with contrast (70460) |
$864.60 |
$2,620 |
4.9× |
| CT head/brain without and with contrast (70470) |
$1,013.10 |
$3,070 |
5.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$653.40 |
$1,980 |
1.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$198 |
$600 |
2.3× |
| CT iac w contrast (70481) |
$795.30 |
$2,410 |
4.5× |
| CT limited/localized follow up study (76380) |
$316.80 |
$960 |
3.6× |
| CT lower ext w/o (73700) |
$782.10 |
$2,370 |
7.5× |
| CT lower extremity w wo contrast (73702) |
$986.70 |
$2,990 |
5.6× |
| CT lower extremity with contrast (73701) |
$957 |
$2,900 |
5.4× |
| CT lumbar spine w & w/o contrast (72133) |
$891 |
$2,700 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$730.95 |
$2,215 |
7.0× |
| CT lumbar spine with contrast (72132) |
$902.55 |
$2,735 |
2.6× |
| CT maxillofacial w contrast (70487) |
$881.10 |
$2,670 |
5.0× |
| CT maxillofacial w/o contrast (70486) |
$651.75 |
$1,975 |
6.2× |
| CT maxillofacial w/wo contrast (70488) |
$966.90 |
$2,930 |
5.5× |
| CT neck soft tissue w contrast (70491) |
$877.80 |
$2,660 |
5.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$998.25 |
$3,025 |
5.7× |
| CT orbits w/o contrast (70480) |
$653.40 |
$1,980 |
6.2× |
| CT pelvis w & w/o contrast (72194) |
$1,059.30 |
$3,210 |
6.0× |
| CT pelvis w/o contrast (72192) |
$735.90 |
$2,230 |
7.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$879.45 |
$2,665 |
5.0× |
| CT soft tissue neck w/o contrast (70490) |
$699.60 |
$2,120 |
6.7× |
| CT thoracic spine w/contrast (72129) |
$735.90 |
$2,230 |
4.2× |
| CT thoracic spine w/o contrast (72128) |
$810.15 |
$2,455 |
7.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,023 |
$3,100 |
5.8× |
| CT thorax w/o contrast (71250) |
$884.40 |
$2,680 |
8.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,026.30 |
$3,110 |
5.8× |
| CT upper extremity w/o contrast rt (73200) |
$796.95 |
$2,415 |
7.6× |
| CT upper extremity with contrast (73201) |
$983.40 |
$2,980 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,204.50 |
$3,650 |
6.9× |
| Cta Abdomen (74175) |
$1,184.70 |
$3,590 |
6.7× |
| CTA abdomen pelvis (74174) |
$1,580.70 |
$4,790 |
4.5× |
| CTA chest (71275) |
$1,188 |
$3,600 |
6.8× |
| Cta Head (70496) |
$1,029.60 |
$3,120 |
5.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,620.30 |
$4,910 |
4.6× |
| CTA lwr ext w&w/o contrast (73706) |
$994.95 |
$3,015 |
5.7× |
| Cta Neck (70498) |
$1,128.60 |
$3,420 |
6.4× |
| Cta Pelvis (72191) |
$1,082.40 |
$3,280 |
6.2× |
| Cystography minimum 3 views rs&i (74430) |
$392.70 |
$1,190 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$174.90 |
$530 |
1.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$191.40 |
$580 |
1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$148.50 |
$450 |
1.7× |
| Echoencephalography real time imaging (76506) |
$287.10 |
$870 |
2.7× |
| Esophagus (74220) |
$280.50 |
$850 |
1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$221.10 |
$670 |
2.1× |
| Fluoroscopy up to 1 hr (76000) |
$141.57 |
$429 |
0.6× |
| Foot 2 views (73620) |
$120.45 |
$365 |
1.4× |
| Forearm 2 views (73090) |
$118.80 |
$360 |
1.4× |
| Gated Heart Planar Single (78472) |
$772.20 |
$2,340 |
1.9× |
| Hand 2 views (73120) |
$168.30 |
$510 |
1.6× |
| Hand 3 views (73130) |
$32.34 |
$98 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$793.65 |
$2,405 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$699.60 |
$2,120 |
1.7× |
| Ht muscle image spect sing (78451) |
$1,310.10 |
$3,970 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$16.17 |
$49 |
0.2× |
| Hysterosalpingogram (74740) |
$498.30 |
$1,510 |
2.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$138.60 |
$420 |
1.3× |
| Kidney imaging morphology (78700) |
$630.30 |
$1,910 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,018.05 |
$3,085 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$785.40 |
$2,380 |
1.4× |
| Knee 3 views (73562) |
$34.98 |
$106 |
0.4× |
| Lung perf&ventilat diferentl (78598) |
$772.20 |
$2,340 |
1.4× |
| Lymphoscintigraphy (78195) |
$714.45 |
$2,165 |
1.3× |
| Mammary ductogram or galactogram multiple (77054) |
$273.90 |
$830 |
1.1× |
| Mammary ductogram or galactogram single (77053) |
$224.40 |
$680 |
0.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$15.51 |
$47 |
0.2× |
| Meckels Diverticulum (78290) |
$759 |
$2,300 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,592.25 |
$4,825 |
4.2× |
| Mr safety determination physician/other qhp (76016) |
$89.10 |
$270 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$26.40 |
$80 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$85.80 |
$260 |
0.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$239.25 |
$725 |
1.0× |
| MRA head w & w/o contrast (70546) |
$1,452 |
$4,400 |
4.2× |
| MRA head w/o contrast (70544) |
$1,026.30 |
$3,110 |
4.3× |
| MRA head with contrast (70545) |
$1,056 |
$3,200 |
3.0× |
| MRA neck w contrast (70548) |
$1,138.50 |
$3,450 |
3.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,367.85 |
$4,145 |
3.9× |
| MRA neck w/o contrast (70547) |
$904.20 |
$2,740 |
3.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,009.70 |
$6,090 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,184.70 |
$3,590 |
5.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,141.80 |
$3,460 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,090.65 |
$3,305 |
1.4× |
| MRI breast w/o contrast bilateral (77047) |
$902.55 |
$2,735 |
3.8× |
| MRI breast w/o contrast unilat (77046) |
$666.60 |
$2,020 |
2.8× |
| MRI cervical spine w/o contrast (72141) |
$1,221 |
$3,700 |
5.1× |
| MRI chest w/o & w/contrast material (71552) |
$1,438.80 |
$4,360 |
4.1× |
| MRI chest w/o contrast (71550) |
$953.70 |
$2,890 |
4.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,057.65 |
$3,205 |
4.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,029.60 |
$3,120 |
4.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,560.90 |
$4,730 |
4.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,729.20 |
$5,240 |
4.9× |
| MRI pelvis w/o contrast (72195) |
$1,148.40 |
$3,480 |
4.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,742.40 |
$5,280 |
5.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,659.90 |
$5,030 |
4.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,663.20 |
$5,040 |
4.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,768.80 |
$5,360 |
5.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,780.35 |
$5,395 |
5.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,141.80 |
$3,460 |
4.8× |
| MRI tmj (70336) |
$795.30 |
$2,410 |
3.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,107.15 |
$3,355 |
4.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,508.10 |
$4,570 |
4.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,095.60 |
$3,320 |
4.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,181.30 |
$6,610 |
1.7× |
| Neck soft tissue (70360) |
$158.40 |
$480 |
1.8× |
| Nm cisternogram (78630) |
$729.30 |
$2,210 |
1.3× |
| Nm gastric emptying study (78264) |
$862.95 |
$2,615 |
2.2× |
| Nm peritoneal-venous shunt patency (78291) |
$432.30 |
$1,310 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,557.30 |
$13,810 |
3.3× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,894.20 |
$5,740 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$696.30 |
$2,110 |
3.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$193.05 |
$585 |
1.8× |
| Orthopantogram (70355) |
$132 |
$400 |
1.5× |
| Osseous survey infant (77076) |
$165 |
$500 |
1.6× |
| Osseous survey limited (77074) |
$326.70 |
$990 |
3.1× |
| Parathyrd planar w/wo subtrj (78071) |
$706.20 |
$2,140 |
1.8× |
| Parathyroid imaging (78070) |
$577.50 |
$1,750 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$148.50 |
$450 |
1.4× |
| PET image w/CT, skull-thigh (78815) |
$2,722.50 |
$8,250 |
1.9× |
| PET imaging CT for attenuation limited area (78814) |
$2,560.80 |
$7,760 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$2,415.60 |
$7,320 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,567.50 |
$4,750 |
4.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$495 |
$1,500 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$726 |
$2,200 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$412.50 |
$1,250 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$95.70 |
$290 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$108.08 |
$327.50 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$101.48 |
$307.50 |
1.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$10,984.05 |
$33,285 |
1.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,150.05 |
$3,485 |
2.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,314.06 |
$3,982 |
12.9× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,481.70 |
$4,490 |
3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$201.30 |
$610 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$89.43 |
$271 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$201.30 |
$610 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$168.30 |
$510 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$369.60 |
$1,120 |
2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$313.50 |
$950 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$425.70 |
$1,290 |
2.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$397.65 |
$1,205 |
2.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$33 |
$100 |
0.4× |
| Radiological examination surgical specimen (76098) |
$247.50 |
$750 |
0.5× |
| Ribs bilateral 3 views (71110) |
$178.20 |
$540 |
1.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$943.80 |
$2,860 |
1.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,362.90 |
$4,130 |
2.5× |
| Rp Therapy Intravenous Administration (79101) |
$409.20 |
$1,240 |
1.7× |
| Sacroiliac Joints < 3 Views (72200) |
$15.18 |
$46 |
0.1× |
| Scanogram (77073) |
$87.12 |
$264 |
0.8× |
| Scapula complete (73010) |
$136.95 |
$415 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$31.35 |
$95 |
1.3× |
| Small bowel series (74250) |
$339.90 |
$1,030 |
1.9× |
| Spec medical radj physics consltj (77370) |
$618.75 |
$1,875 |
4.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$983.40 |
$2,980 |
2.6× |
| Special treatment procedure (77470) |
$1,597.20 |
$4,840 |
2.9× |
| Spine thoracic 3 views (72072) |
$211.20 |
$640 |
2.0× |
| Stereotactic body radiation delivery (77373) |
$5,841 |
$17,700 |
3.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,262.25 |
$3,825 |
3.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$752.40 |
$2,280 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,447.05 |
$4,385 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$688.05 |
$2,085 |
5.1× |
| Thoracolumbar 2 views (72080) |
$17.49 |
$53 |
0.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$963.60 |
$2,920 |
1.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$425.70 |
$1,290 |
1.1× |
| Thyroid uptake measurement (78012) |
$349.80 |
$1,060 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$574.20 |
$1,740 |
1.4× |
| Tomogram (76100) |
$237.60 |
$720 |
2.3× |
| Treatment device intermediate (77333) |
$544.50 |
$1,650 |
4.0× |
| Treatment devices simple (77332) |
$336.60 |
$1,020 |
2.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,399.20 |
$4,240 |
2.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$485.10 |
$1,470 |
1.2× |
| Tx devices design & construction complex (77334) |
$859.65 |
$2,605 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$287.10 |
$870 |
2.7× |
| Umbilical-artery Doppler (OB) (76820) |
$193.05 |
$585 |
1.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$323.40 |
$980 |
3.7× |
| Upper Extremity Infant (73092) |
$181.50 |
$550 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$442.20 |
$1,340 |
1.8× |
| Urethrocystography voiding (74455) |
$455.40 |
$1,380 |
1.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$468.60 |
$1,420 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$176.55 |
$535 |
1.7× |
| Us breast unilateral complete (76641) |
$254.10 |
$770 |
2.4× |
| Us breast unilateral limited (76642) |
$305.25 |
$925 |
3.5× |
| Us chest (76604) |
$244.20 |
$740 |
2.3× |
| Us compl joint r-t w/image documentation (76881) |
$290.40 |
$880 |
2.8× |
| Us elastography parenchyma (76981) |
$165 |
$500 |
1.6× |
| Us guided compression repair (76936) |
$323.40 |
$980 |
1.5× |
| Us infant hips dynamic (76885) |
$252.45 |
$765 |
2.9× |
| Us kidney transplant (76776) |
$339.90 |
$1,030 |
3.2× |
| Us ob transvaginal (76817) |
$320.10 |
$970 |
3.1× |
| Us pelvic non ob complete (76856) |
$399.30 |
$1,210 |
3.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$224.40 |
$680 |
2.1× |
| Us pregnancy ltd (76815) |
$283.80 |
$860 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$259.05 |
$785 |
2.5× |
| Us retroperitoneal complete (76770) |
$349.80 |
$1,060 |
3.3× |
| Us retroperitoneal limited (76775) |
$221.10 |
$670 |
2.1× |
| Us scrotum and contents (76870) |
$313.50 |
$950 |
3.0× |
| Us soft tissue head/neck (76536) |
$346.50 |
$1,050 |
3.3× |
| Us spinal canal and contents (76800) |
$252.45 |
$765 |
2.4× |
| Us transrectal (76872) |
$320.10 |
$970 |
3.1× |
| Us xtr non-vasc lmtd (76882) |
$202.95 |
$615 |
1.9× |
| Venogram extremity bilateral (75822) |
$958.65 |
$2,905 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,600.50 |
$4,850 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$716.10 |
$2,170 |
0.5× |
| Venography Renal Bilateral (75833) |
$1,329.90 |
$4,030 |
0.4× |
| Wrist 2 views (73100) |
$146.85 |
$445 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$295.35 |
$895 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$198 |
$600 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$115.50 |
$350 |
1.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$415.80 |
$1,260 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$171.60 |
$520 |
2.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$111.21 |
$337 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$130.35 |
$395 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$151.80 |
$460 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$109.89 |
$333 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$153.78 |
$466 |
1.5× |
| X-ray eye for foreign body (70030) |
$105.60 |
$320 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$189.75 |
$575 |
1.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$127.05 |
$385 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$138.60 |
$420 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$53.46 |
$162 |
0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$151.80 |
$460 |
1.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$146.19 |
$443 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$21.78 |
$66 |
0.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$151.80 |
$460 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$129.20 |
$391.50 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$336.60 |
$1,020 |
3.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$20.46 |
$62 |
0.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$211.20 |
$640 |
2.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$161.70 |
$490 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$194.70 |
$590 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$168.30 |
$510 |
1.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$584.10 |
$1,770 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$130.35 |
$395 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$183.15 |
$555 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$259.05 |
$785 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$174.90 |
$530 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$194.70 |
$590 |
2.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$132 |
$400 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$207.90 |
$630 |
2.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$138.60 |
$420 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$255.75 |
$775 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$174.90 |
$530 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$161.70 |
$490 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$141.90 |
$430 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$141.90 |
$430 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$184.80 |
$560 |
1.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$105.60 |
$320 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$96.03 |
$291 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$208.89 |
$633 |
2.0× |
| Xr finger(s) 2+ views (73140) |
$60.39 |
$183 |
0.7× |
| Xr shoulder 1 view (73020) |
$128.70 |
$390 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$191.40 |
$580 |
1.8× |
| Xr tibia/fibula 2 views (73590) |
$151.80 |
$460 |
1.7× |
| Xr tmj bilateral (70330) |
$196.35 |
$595 |
2.3× |
| Xray knee 1 or 2 views rt (73560) |
$83.82 |
$254 |
1.0× |