| Abdomen 2 views (74019) |
$390 |
$390 |
3.1× |
| Acute gi blood loss imaging (78278) |
$1,560 |
$1,560 |
3.3× |
| Angiography extremity unilateral rs&i (75710) |
$8,715 |
$8,715 |
2.3× |
| Ankle 2 views (73600) |
$284 |
$284 |
2.7× |
| Arthrogram ankle (73615) |
$1,067 |
$1,067 |
2.6× |
| Arthrogram elbow (73085) |
$1,067 |
$1,067 |
2.6× |
| Arthrogram hip (73525) |
$1,120.50 |
$1,120.50 |
2.7× |
| Arthrogram knee (73580) |
$1,067 |
$1,067 |
2.6× |
| Arthrogram shoulder (73040) |
$1,067 |
$1,067 |
2.6× |
| Arthrogram wrist (73115) |
$1,067 |
$1,067 |
2.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,323 |
$1,323 |
2.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,323 |
$1,323 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$1,560 |
$1,560 |
3.3× |
| Bone age studies (77072) |
$288 |
$288 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$1,489 |
$1,489 |
3.1× |
| Bone survey complete (77075) |
$713 |
$713 |
5.7× |
| Bone survey infant (77076) |
$441 |
$441 |
3.5× |
| Bowel imaging (78290) |
$1,074 |
$1,074 |
2.2× |
| Brain Imaging Vascular Flow Only (78610) |
$1,595 |
$1,595 |
2.5× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,220 |
$2,220 |
4.6× |
| Cervical spine 2 or 3 views (72040) |
$441 |
$441 |
4.2× |
| Chest 1 view (71045) |
$17,467.62 |
$17,467.62 |
167.5× |
| Chest xray 3 views (71047) |
$432 |
$432 |
4.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$660 |
$660 |
3.1× |
| Clavicle complete (73000) |
$284 |
$284 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$447 |
$447 |
3.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,021 |
$5,021 |
12.0× |
| CT abdomen and pelvis without contrast (74176) |
$4,692 |
$4,692 |
16.4× |
| CT abdomen w contrast (74160) |
$2,805 |
$2,805 |
13.3× |
| CT abdomen w wo contrast (74170) |
$2,843 |
$2,843 |
13.5× |
| CT abdomen w/o contrast (74150) |
$2,386 |
$2,386 |
19.0× |
| CT angio hrt w/3d image (75574) |
$1,573 |
$1,573 |
3.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,301 |
$2,301 |
10.9× |
| CT angiography upper extremity lt (73206) |
$1,824 |
$1,824 |
8.7× |
| CT c-spine w/contrast (72126) |
$2,351 |
$2,351 |
5.6× |
| CT c-spine w/o contrast (72125) |
$2,351 |
$2,351 |
18.8× |
| CT cere prfu aly c+wo CT/CTA (70473) |
$2,091 |
$2,091 |
9.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,711 |
$2,711 |
12.9× |
| CT chest w contrast (71260) |
$6,927.91 |
$6,927.91 |
33.0× |
| CT chest w/wo contrast (71270) |
$2,742 |
$2,742 |
13.0× |
| CT colonography screening (74263) |
$4,005 |
$4,005 |
14.0× |
| CT colonography w/o cntrst (74261) |
$1,325 |
$1,325 |
10.6× |
| CT head/brain with contrast (70460) |
$2,763 |
$2,763 |
13.1× |
| CT head/brain without and with contrast (70470) |
$2,932 |
$2,932 |
13.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,207 |
$1,207 |
2.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$61 |
$61 |
0.6× |
| CT iac w contrast (70481) |
$1,973 |
$1,973 |
9.4× |
| CT limited/localized follow up study (76380) |
$1,077 |
$1,077 |
10.3× |
| CT lower ext w/o (73700) |
$1,973 |
$1,973 |
15.7× |
| CT lower extremity w wo contrast (73702) |
$2,254 |
$2,254 |
10.7× |
| CT lower extremity w/contrast material (73701) |
$1,982 |
$1,982 |
9.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,676.50 |
$2,676.50 |
12.7× |
| CT lumbar spine w/contrast (72132) |
$2,658 |
$2,658 |
6.4× |
| CT lumbar spine w/o contrast (72131) |
$2,386 |
$2,386 |
19.0× |
| CT maxillofacial w contrast (70487) |
$2,055 |
$2,055 |
9.8× |
| CT maxillofacial w/wo contrast (70488) |
$3,135 |
$3,135 |
14.9× |
| CT maxillofacial wo contrast (70486) |
$1,971 |
$1,971 |
15.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,218 |
$2,218 |
10.6× |
| CT orbits w/o contrast (70480) |
$1,699 |
$1,699 |
13.6× |
| CT pelvis w/o contrast (72192) |
$2,371 |
$2,371 |
18.9× |
| CT pelvis w/wo contrast (72194) |
$2,770 |
$2,770 |
13.2× |
| CT scan of arm combo (73202) |
$2,151.50 |
$2,151.50 |
10.2× |
| CT soft tissue neck w contrast (70491) |
$2,799 |
$2,799 |
13.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,264 |
$2,264 |
10.8× |
| CT soft tissue neck w/o contrast (70490) |
$2,724.50 |
$2,724.50 |
21.7× |
| CT thoracic spine w/contrast (72129) |
$2,351 |
$2,351 |
11.2× |
| CT thoracic spine w/o contrast (72128) |
$2,297 |
$2,297 |
18.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,561 |
$2,561 |
12.2× |
| CT thorax w/o contrast (71250) |
$2,211 |
$2,211 |
17.6× |
| CT upper ext wo (73200) |
$1,967 |
$1,967 |
15.7× |
| CT upper extremity with contrast (73201) |
$1,976 |
$1,976 |
4.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,718 |
$2,718 |
12.9× |
| Cta Abdomen (74175) |
$2,089.50 |
$2,089.50 |
9.9× |
| CTA abdomen pelvis (74174) |
$6,045.56 |
$6,045.56 |
14.5× |
| CTA chest (71275) |
$3,128.38 |
$3,128.38 |
14.9× |
| Cta Head (70496) |
$2,247 |
$2,247 |
10.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,091 |
$2,091 |
5.0× |
| Cta Neck (70498) |
$2,091 |
$2,091 |
9.9× |
| Cta Pelvis (72191) |
$2,002.50 |
$2,002.50 |
9.5× |
| Cystography minimum 3 views rs&i (74430) |
$879 |
$879 |
2.1× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$4,290 |
$4,290 |
1.7× |
| Diskography lumbar (72295) |
$9,041 |
$9,041 |
3.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$537 |
$537 |
4.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$537 |
$537 |
4.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,085 |
$1,085 |
8.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$462 |
$462 |
4.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,177 |
$1,177 |
4.1× |
| Esophagus (74220) |
$642 |
$642 |
3.1× |
| Facial bones min 3 views (70150) |
$514 |
$514 |
4.1× |
| Fetal biophysical profile non-stress testing (76818) |
$580 |
$580 |
4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$460 |
$460 |
3.7× |
| Fetal Echo (76825) |
$1,177 |
$1,177 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$632 |
$632 |
2.2× |
| Foot 2 views (73620) |
$353 |
$353 |
3.4× |
| Forearm 2 views (73090) |
$639.50 |
$639.50 |
6.1× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,230 |
$1,230 |
2.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,595 |
$1,595 |
2.5× |
| Hand 2 views (73120) |
$365 |
$365 |
2.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,936 |
$1,936 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,936 |
$1,936 |
4.0× |
| Hysterosalpingogram (74740) |
$1,043 |
$1,043 |
3.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$356 |
$356 |
2.8× |
| Kidney imaging morphology (78700) |
$2,908 |
$2,908 |
6.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,981.50 |
$1,981.50 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,622 |
$1,622 |
2.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,622 |
$1,622 |
2.5× |
| Knee 3 views (73562) |
$805.50 |
$805.50 |
7.7× |
| Liver & spleen imaging static only (78215) |
$1,237 |
$1,237 |
2.6× |
| Lung perf&ventilat diferentl (78598) |
$2,352 |
$2,352 |
3.6× |
| Lung perfusion differential (78597) |
$1,456 |
$1,456 |
3.0× |
| Lung ventilation imaging (78579) |
$1,474 |
$1,474 |
3.1× |
| Lymphoscintigraphy (78195) |
$26,121.82 |
$26,121.82 |
40.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,400 |
$3,400 |
8.1× |
| Magnetic Resonance Elastography (76391) |
$924 |
$924 |
3.2× |
| Mammary ductogram or galactogram single (77053) |
$1,069 |
$1,069 |
3.7× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$199 |
$199 |
1.9× |
| Mr safety determination physician/other qhp (76016) |
$266 |
$266 |
2.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$300 |
$300 |
8.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$722.50 |
$722.50 |
6.3× |
| Mr safety implt pos&/immoblj (76019) |
$249 |
$249 |
3.5× |
| MRA head w & w/o contrast (70546) |
$5,424 |
$5,424 |
13.0× |
| MRA head w/o contrast (70544) |
$2,754 |
$2,754 |
9.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,424 |
$5,424 |
13.0× |
| MRA neck w/o contrast (70547) |
$2,754 |
$2,754 |
9.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,506 |
$4,506 |
10.8× |
| MRI abdomen w/o contrast (74181) |
$3,400 |
$3,400 |
11.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$6,051 |
$6,051 |
14.5× |
| MRI breast w/o contrast bilateral (77047) |
$4,494 |
$4,494 |
15.7× |
| MRI cervical spine w/o contrast (72141) |
$3,774 |
$3,774 |
13.2× |
| MRI chest w/o contrast (71550) |
$3,400 |
$3,400 |
11.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,400 |
$3,400 |
8.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,724 |
$2,724 |
9.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,400 |
$3,400 |
11.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,400 |
$3,400 |
8.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,094 |
$6,094 |
14.6× |
| MRI pelvis w/o contrast (72195) |
$2,732 |
$2,732 |
9.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,079 |
$4,079 |
9.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,079 |
$4,079 |
9.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,608 |
$3,608 |
8.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,079 |
$4,079 |
9.8× |
| MRI thoracic spine w/o contrast (72146) |
$3,774 |
$3,774 |
13.2× |
| MRI up ext w/o contrast (73218) |
$2,724 |
$2,724 |
9.5× |
| MRI upper ext joint w/o contrast (73221) |
$3,400 |
$3,400 |
11.9× |
| MRI, joint upper extrem combo (73223) |
$6,051 |
$6,051 |
14.5× |
| Musculoskeletal Nuclear Exam (78399) |
$1,355 |
$1,355 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,222 |
$4,222 |
2.7× |
| Myocardial spect single study at rest or stress (78451) |
$3,182 |
$3,182 |
2.1× |
| N-invas est c ffr sw aly CTA (75580) |
$3,021 |
$3,021 |
2.9× |
| Neck soft tissue (70360) |
$292 |
$292 |
2.8× |
| Nm cardiac blood pool multiple (78473) |
$1,819 |
$1,819 |
3.8× |
| Nm cisternogram (78630) |
$2,138 |
$2,138 |
3.3× |
| Nm gastric emptying study (78264) |
$1,320 |
$1,320 |
2.8× |
| Nuclear Rx Oral Admin (79005) |
$1,391 |
$1,391 |
5.0× |
| Ob us nuchal meas 1 gest (76813) |
$477 |
$477 |
3.8× |
| Osseous survey limited (77074) |
$403 |
$403 |
3.2× |
| Parathyrd planar w/spect&CT (78072) |
$1,934 |
$1,934 |
3.0× |
| Parathyroid Planar Imaging (78070) |
$1,096 |
$1,096 |
2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$3,232 |
$3,232 |
6.7× |
| Pelvis 1 or 2 views (72170) |
$426 |
$426 |
3.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,622 |
$1,622 |
3.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,806 |
$1,806 |
2.8× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,561 |
$1,561 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,197 |
$1,197 |
1.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$319 |
$319 |
3.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$423 |
$423 |
4.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$288 |
$288 |
2.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$423 |
$423 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$470 |
$470 |
3.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$841 |
$841 |
6.7× |
| Radex fingr minimum 2 views (73140) |
$284 |
$284 |
2.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$357 |
$357 |
3.4× |
| Radex Hand Minimum 3 Views (73130) |
$319 |
$319 |
3.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$64,167.71 |
$64,167.71 |
615.3× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$441 |
$441 |
3.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$441 |
$441 |
3.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$728 |
$728 |
5.8× |
| Radex Humerus Minimum 2 Views (73060) |
$284 |
$284 |
2.7× |
| Radex Kne 1/2 Views (73560) |
$30,259.20 |
$30,259.20 |
290.1× |
| Radex Kne Compl 4/More Views (73564) |
$470 |
$470 |
3.8× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$514 |
$514 |
4.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$333 |
$333 |
3.2× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$426 |
$426 |
3.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$846 |
$846 |
8.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$406 |
$406 |
3.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$512 |
$512 |
4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$403 |
$403 |
3.9× |
| Radex Toe Minimum 2 Views (73660) |
$284 |
$284 |
2.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$365 |
$365 |
2.9× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$710.50 |
$710.50 |
6.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$841 |
$841 |
6.7× |
| Radiation treatment delivery level 1 (77402) |
$5,470 |
$5,470 |
44.7× |
| Radiation treatment delivery level 2 (77407) |
$6,860 |
$6,860 |
14.8× |
| Radiation treatment delivery level 3 (77412) |
$6,927 |
$6,927 |
10.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$369 |
$369 |
3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$406 |
$406 |
3.2× |
| Radiologic exam chest 2 views (71046) |
$1,921.50 |
$1,921.50 |
18.4× |
| Radiologic exam colon single contrast study (74270) |
$948.50 |
$948.50 |
4.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$642 |
$642 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$622.50 |
$622.50 |
3.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$652.50 |
$652.50 |
3.1× |
| Radiologic examination femur 1 view (73551) |
$200 |
$200 |
1.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$652 |
$652 |
6.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$441 |
$441 |
3.5× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$348 |
$348 |
2.8× |
| Radiological examination surgical specimen (76098) |
$24,705.66 |
$24,705.66 |
37.7× |
| Ribs bilateral 3 views (71110) |
$510 |
$510 |
4.1× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,463 |
$1,463 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,806 |
$1,806 |
3.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,909 |
$3,909 |
6.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,063 |
$2,063 |
3.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,745.50 |
$2,745.50 |
4.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,219 |
$3,219 |
2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,345 |
$7,345 |
4.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,219 |
$3,219 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$365 |
$365 |
2.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$626 |
$626 |
2.2× |
| Scapula (73010) |
$284 |
$284 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$102 |
$102 |
4.4× |
| Shoulder 1 view (73020) |
$274 |
$274 |
2.6× |
| Sialogram (70390) |
$948 |
$948 |
3.3× |
| Small bowel series (74250) |
$590 |
$590 |
2.8× |
| Spine thoracic 3 views (72072) |
$483 |
$483 |
3.9× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$281 |
$281 |
2.7× |
| Tbs technical calculation only (77091) |
$309 |
$309 |
3.0× |
| Thoracolumbar 2 views (72080) |
$328 |
$328 |
3.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,402 |
$1,402 |
2.2× |
| Thyroid imaging w/blood flow (78013) |
$765 |
$765 |
1.6× |
| Thyroid uptake measurement (78012) |
$1,491 |
$1,491 |
3.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,029 |
$1,029 |
2.1× |
| Tmj unilateral (70328) |
$270 |
$270 |
2.6× |
| Ultrasound breast complete (76641) |
$690 |
$690 |
5.5× |
| Ultrasound Exam Aaa Screen (76706) |
$420 |
$420 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$1,446 |
$1,446 |
11.5× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$568 |
$568 |
1.2× |
| Urethrocystogram voiding (74455) |
$853 |
$853 |
3.0× |
| Urethrocystography retrograde rs&i (74450) |
$1,093 |
$1,093 |
3.8× |
| Us breast unilateral limited (76642) |
$1,144.50 |
$1,144.50 |
11.0× |
| Us chest (76604) |
$621 |
$621 |
5.0× |
| Us compl joint r-t w/image documentation (76881) |
$592 |
$592 |
4.7× |
| Us elastography parenchyma (76981) |
$375 |
$375 |
3.0× |
| Us hips infant static (76886) |
$475 |
$475 |
4.6× |
| Us infant hips w manipulation (76885) |
$488 |
$488 |
4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$883 |
$883 |
7.0× |
| Us ob detailed single fetus (76811) |
$1,237 |
$1,237 |
4.3× |
| Us ob limited (76815) |
$1,053 |
$1,053 |
8.4× |
| Us ob transvaginal (76817) |
$597 |
$597 |
4.8× |
| Us pelvic non ob complete (76856) |
$2,129.50 |
$2,129.50 |
17.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$578 |
$578 |
4.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$633 |
$633 |
5.1× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$355 |
$355 |
2.8× |
| Us retroperitoneal complete (76770) |
$1,233 |
$1,233 |
9.8× |
| Us retroperitoneal limited (76775) |
$643 |
$643 |
5.1× |
| Us scrotum and contents (76870) |
$1,237 |
$1,237 |
9.9× |
| Us soft tissue head/neck (76536) |
$566 |
$566 |
4.5× |
| Us spinal canal and contents (76800) |
$483 |
$483 |
3.9× |
| Us transrectal (76872) |
$537 |
$537 |
4.3× |
| Us, eye b-scan (76512) |
$802 |
$802 |
6.4× |
| Venogram extremity bilateral (75822) |
$2,712 |
$2,712 |
1.4× |
| Venogram Extremity Unilateral (75820) |
$2,878 |
$2,878 |
1.5× |
| Wrist 2 views (73100) |
$315 |
$315 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$421 |
$421 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$284 |
$284 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,021.50 |
$1,021.50 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$284 |
$284 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$698.50 |
$698.50 |
6.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$453 |
$453 |
3.6× |
| X-ray exam of femur 2/> (73552) |
$299 |
$299 |
2.9× |
| X-ray eye for foreign body (70030) |
$256 |
$256 |
2.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$284 |
$284 |
2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$423 |
$423 |
4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$284 |
$284 |
2.7× |
| X-ray leg, infant (73592) |
$293 |
$293 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$512 |
$512 |
4.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$724 |
$724 |
5.8× |
| X-ray nose-rectum child f.b. (76010) |
$354 |
$354 |
3.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$510 |
$510 |
4.1× |
| X-ray retrograde pyelogram (74420) |
$1,013 |
$1,013 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$365 |
$365 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$438 |
$438 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$527 |
$527 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$487 |
$487 |
3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$319 |
$319 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$581 |
$581 |
5.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$530 |
$530 |
4.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$426 |
$426 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$296 |
$296 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$284 |
$284 |
2.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$284 |
$284 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$467 |
$467 |
3.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$483 |
$483 |
3.9× |
| Xr bone length studies (77073) |
$582 |
$582 |
4.6× |
| Xr c-spine 4 or 5 views (72050) |
$483 |
$483 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$780 |
$780 |
6.2× |
| Xr chest 4+ views (71048) |
$462 |
$462 |
3.7× |
| Xr urogram antegrade (74425) |
$977 |
$977 |
2.3× |