| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$7,322.85 |
— |
| Abdomen 1 View (74018) |
— |
$223.80 |
— |
| Abdomen 2 views (74019) |
— |
$363.30 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$941.31 |
— |
| Ankle 2 views (73600) |
— |
$268.20 |
— |
| Arthrogram hip (73525) |
— |
$930.34 |
— |
| Arthrogram Wrist (73115) |
— |
$581.33 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$718.95 |
— |
| Bone age studies (77072) |
— |
$168.30 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$971 |
— |
| Bone Imaging Limited Area (78300) |
— |
$590.40 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$725.89 |
— |
| Bone Imaging Whole Body (78306) |
— |
$824.60 |
— |
| Bone survey infant (77076) |
— |
$256.39 |
— |
| Brachytx isodose complex (77318) |
— |
$896.45 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$823.58 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$766.31 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$1,285.80 |
— |
| Chest 1 view (71045) |
— |
$299.10 |
— |
| Chest 2 views (71046) |
— |
$330.95 |
— |
| Chest 3 views (71047) |
— |
$373.30 |
— |
| Chest 4 or more views (71048) |
— |
$432.24 |
— |
| Clavicle complete (73000) |
— |
$270.70 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$297 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$782.70 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$7,062.58 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$675.89 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$1,297.87 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$3,237.20 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$2,091.30 |
— |
| CT abdomen w contrast (74160) |
— |
$1,272.10 |
— |
| CT abdomen w wo contrast (74170) |
— |
$1,512 |
— |
| CT abdomen w/o contrast (74150) |
— |
$973.95 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$3,247.15 |
— |
| CT Angio Chest (71275) |
— |
$3,523.80 |
— |
| CT Angio Head (70496) |
— |
$2,346.95 |
— |
| CT angio hrt w/3d image (75574) |
— |
$3,552 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$2,066.10 |
— |
| CT Angio Neck (70498) |
— |
$3,497 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$1,800.19 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$1,961.95 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$1,940.70 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$2,128.60 |
— |
| CT chest w contrast (71260) |
— |
$2,245.90 |
— |
| CT chest w/wo contrast (71270) |
— |
$2,286.70 |
— |
| CT head/brain with contrast (70460) |
— |
$1,584.65 |
— |
| CT head/brain without and with contrast (70470) |
— |
$1,690.35 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$3,552 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$1,257.06 |
— |
| CT iac w contrast (70481) |
— |
$1,428.25 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$1,987.06 |
— |
| CT lower ext w/o (73700) |
— |
$1,676.90 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$1,882.20 |
— |
| CT lumbar spine w contrast (72132) |
— |
$1,964 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$1,842.35 |
— |
| CT maxillofacial w contrast (70487) |
— |
$1,805.25 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$1,566.20 |
— |
| CT neck tissue combo (70492) |
— |
$2,340.85 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$1,704.19 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,202.40 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$1,490.42 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,424.55 |
— |
| CT scan of leg combo (73702) |
— |
$2,066.08 |
— |
| CT scans face/jaw combo (70488) |
— |
$1,877.08 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$2,261.45 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,320.35 |
— |
| CT thoracic spine w contrast (72129) |
— |
$1,581.36 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$1,384.85 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$1,909.06 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,945.20 |
— |
| CT unlisted procedure (76497) |
— |
$2,262.95 |
— |
| CT upper ext wo (73200) |
— |
$1,193.90 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$1,645.06 |
— |
| CT upper extremity with contrast (73201) |
— |
$1,416.90 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$2,081.65 |
— |
| Cta Abdomen (74175) |
— |
$2,274.70 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
— |
$368.59 |
— |
| Dxa Bone Density Axial (77080) |
— |
$392.60 |
— |
| Dxa bone density study (77085) |
— |
$283.39 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$131.96 |
— |
| Echo exam uterus (76831) |
— |
$847.30 |
— |
| Echograp Trans R Pros Study (76873) |
— |
$1,351.87 |
— |
| Esophagram (74220) |
— |
$453.85 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$1,055 |
— |
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines |
— |
$775.08–$930.10 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$783 |
— |
Foot 2 views (73620)
range across 2 matching MRF lines |
— |
$193.25–$193.26 |
— |
Forearm 2 views (73090)
range across 2 matching MRF lines |
— |
$268.18–$268.20 |
— |
| Gastric emptying imaging study (78264) |
— |
$815.95 |
— |
| Gated Heart Planar Single (78472) |
— |
$1,036 |
— |
| Hand 2 views (73120) |
— |
$206.65 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$808.20 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$671 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$2,126.59 |
— |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) |
— |
$1,735.40 |
— |
| Hysterosalpingogram (74740) |
— |
$675.89 |
— |
| Image fusion (77399) |
— |
$943.15 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$752.04 |
— |
| Infusion Ivp (74410) |
— |
$944.64 |
— |
| K Flow/Funct Image Multiple (78709) |
— |
$968.86 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$874 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$766.31 |
— |
| Kidney Imaging Morphol (78700) |
— |
$590.40 |
— |
| Knee 3 Views (73562) |
— |
$374.50 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$590.40 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$796.51 |
— |
| Lung perfusion differential (78597) |
— |
$590.40 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$796.51 |
— |
| Lung Ventilation Imaging (78579) |
— |
$590.40 |
— |
| Lymph System Imaging (78195) |
— |
$766.31 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$2,209.80 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
— |
$2,681.50 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
— |
$2,245.71 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
— |
$3,467.78 |
— |
| Meckels Divert Exam (78290) |
— |
$602.30 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$1,969.80 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$1,917.58 |
— |
| MRA head w/o contrast (70544) |
— |
$1,398.55 |
— |
| MRA head with contrast (70545) |
— |
$1,523.29 |
— |
| MRA neck w contrast (70548) |
— |
$2,090.30 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$2,142.26 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,012.95 |
— |
| MRI abdomen w contrast (74182) |
— |
$2,577.60 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$2,334.25 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$2,611.60 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$2,650.90 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$2,401.15 |
— |
| MRI cervical spine w contrast (72142) |
— |
$2,718.82 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$1,969.90 |
— |
| MRI chest w/o contrast (71550) |
— |
$2,049.89 |
— |
MRI chest wo w contrast (71552)
range across 2 matching MRF lines |
— |
$2,182.05–$2,182.06 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$2,139.12 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$2,819.60 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$2,072.70 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$2,789.76 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$3,058.50 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$1,390.42 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$2,052.38 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$2,987.65 |
— |
| MRI pelvis w contrast (72196) |
— |
$2,400 |
— |
MRI pelvis w/o & w contrast (72197)
range across 2 matching MRF lines |
— |
$3,058.50–$3,058.51 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$2,121.55 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$1,553.95 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$1,818.10 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$2,806.35 |
— |
MRI, abdomen, combo (74183)
range across 2 matching MRF lines |
— |
$3,058.50–$3,058.51 |
— |
| MRI, dorsal spine combo (72157) |
— |
$3,226.40 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$3,018.82 |
— |
| MRI, joint upper extrem (73221) |
— |
$2,203.15 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$2,851 |
— |
| MRI, lumbar spine combo (72158) |
— |
$3,058.50 |
— |
| Myelogram cervical (72240) |
— |
$1,350.19 |
— |
| Myelogram Lumbar (72265) |
— |
$1,350.19 |
— |
| Myelography thoracic (72255) |
— |
$1,350.19 |
— |
| Myelograpy 2/more regions rs&i (72270) |
— |
$1,350.19 |
— |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
— |
$590.40 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$3,087.65 |
— |
| Neck soft tissue (70360) |
— |
$214.60 |
— |
| Nm myocard infarct spect (78469) |
— |
$1,239.54 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$9,945.15 |
— |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
— |
$299.93 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$590.40 |
— |
| Parathyroid planar imaging w/wo subtraction (78071) |
— |
$1,441.70 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$288.40 |
— |
| PET image w/CT, full body (78816) |
— |
$5,740.49 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$5,672.24 |
— |
| PET whole body (78813) |
— |
$5,562.56 |
— |
| Proton trmt simple w/comp (77522) |
— |
$3,826.55 |
— |
| Proton tx delivery complex (77525) |
— |
$4,630.10 |
— |
| Proton tx delivery intermediate (77523) |
— |
$4,209.20 |
— |
| Proton tx delivery simple w/o compensation (77520) |
— |
$1,735.40 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$590.40 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$387.10 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$1,345.39 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$326.45 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$245.05 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$358.85 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$382.32 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$264.95 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$342 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$391.25 |
— |
| Radex lower extremity infant minimum 2 views (73592) |
— |
$255.65 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$408.05 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$264.85 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$278.60 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$337.25 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$335.76 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$214.60 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$326.55 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$426.29 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$248.20 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$255.65 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$340.95 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$328.13 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$33,803.76 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$1,336.78 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$1,531.72 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$1,738.30 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$313.06 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$364.48 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,116.62 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$863.40 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$396.20 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$359.85 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$635.04 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$652.45 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$467.80 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$199.30 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$233.25 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$273.80 |
— |
Radiologic examination tibia & fibula 2 views (73590)
range across 2 matching MRF lines |
— |
$266.33–$266.35 |
— |
| Ribs bilateral 3 views (71110) |
— |
$441.25 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$590.40 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$638.24 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$2,016.07 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$2,016.07 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$2,770.56 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$3,049.60 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$2,238.72 |
— |
| Scapula (73010) |
— |
$270.70 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$124.80 |
— |
| Sella turcica (70240) |
— |
$222.53 |
— |
| Shoulder 1 view (73020) |
— |
$245.05 |
— |
| Shoulder Arthrography (73040) |
— |
$955.75 |
— |
| Skull less than 4 views (70250) |
— |
$335.75 |
— |
| Special dosimetry (77331) |
— |
$420.20 |
— |
| Special Physics Consult (77370) |
— |
$1,289.23 |
— |
| Special teletherapy port plan (77321) |
— |
$1,630.30 |
— |
| Special treatment procedure (77470) |
— |
$2,045.10 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$8,793.88 |
— |
| Sternoclavicular joints (71130) |
— |
$355.39 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$896.45 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$823.58 |
— |
| Testicular Imaging W/Flow (78761) |
— |
$630.08 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$2,807.70 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$2,464.10 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$1,533.50 |
— |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
— |
$363.60 |
— |
| Thoracic spine 2 views (72070) |
— |
$375.05 |
— |
| Thoracic spine 3 views (72072) |
— |
$538.45 |
— |
| Thoracolumbar 2 views (72080) |
— |
$322 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$590.40 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$996.77 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$590.40 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$641.80 |
— |
| Tx Devices Design & Construction Complex (77334) |
— |
$1,289.25 |
— |
| Tx devices design & construction intermediate (77333) |
— |
$1,207.40 |
— |
| Tx devices design & construction simple (77332) |
— |
$887.84 |
— |
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines |
— |
$427.10–$455.65 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$561.05 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$320.65 |
— |
Unlisted magnetic resonance procedure (76498)
range across 4 matching MRF lines |
— |
$785.23–$4,800 |
— |
| Upper gi w/o kub (74240) |
— |
$709.15 |
— |
| Ureteral Reflux Study (78740) |
— |
$590.40 |
— |
| Urethrocystogram voiding (74455) |
— |
$801.20 |
— |
| Urethrocystography retrograde (74450) |
— |
$675.89 |
— |
Us breast unilateral complete (76641)
range across 2 matching MRF lines |
— |
$700.25–$899.21 |
— |
Us chest (76604)
range across 2 matching MRF lines |
— |
$798–$798.02 |
— |
| Us complete joint (76881) |
— |
$632.35 |
— |
| Us exam, pelvic, limited (76857) |
— |
$408.15 |
— |
| Us head (76506) |
— |
$790.13 |
— |
| Us kidney transplant (76776) |
— |
$1,079.02 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$546.85 |
— |
| Us ob detailed single fetus (76811) |
— |
$1,358.35 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$309.60 |
— |
| Us ob transvaginal (76817) |
— |
$402.50 |
— |
| Us pelvic non ob complete (76856) |
— |
$735.20 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$371.50 |
— |
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines |
— |
$258–$398.15 |
— |
| Us retroperitoneal complete (76770) |
— |
$609.05 |
— |
| Us retroperitoneal limited (76775) |
— |
$519.45 |
— |
| Us scrotum and contents (76870) |
— |
$735.20 |
— |
| Us spinal canal and contents (76800) |
— |
$742.46 |
— |
| Us thyroid (76536) |
— |
$808.70 |
— |
| Us transrectal (76872) |
— |
$864.50 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$175.97 |
— |
Wrist 2 views (73100)
range across 2 matching MRF lines |
— |
$251.09–$251.10 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$251.82 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$1,345.39 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$306.12 |
— |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 2 matching MRF lines |
— |
$239.45–$239.47 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$1,011.35 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$158.35 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$263.04 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$287 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$330.90 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$366.08 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$599.05 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$603.60 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$675.51 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$637.73 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$287.65 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$538.46 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$411.30 |
— |
| X-ray eye for foreign body (70030) |
— |
$214.60 |
— |
X-ray humerus (73060)
range across 2 matching MRF lines |
— |
$351.98–$352 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$811.78 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$264.85 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$291.55 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$300.10 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$250.85 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$494.26 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$313.05 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$274.70 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$293.40 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$397.73 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$445.82 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$586.90 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$241.15 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$507.87 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$376.60 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$313.06 |
— |
| Xr orbits complete 4 views (70200) |
— |
$411.22 |
— |