| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,717 |
$5,434 |
2.1× |
| Abdomen 1 View (74018) |
$170.50 |
$341 |
2.1× |
| Abdomen 2 views (74019) |
$226.50 |
$453 |
2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$385 |
$770 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$1,135.50 |
$2,271 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$977 |
$1,954 |
0.3× |
| Ankle 2 views (73600) |
$170 |
$340 |
2.1× |
| Arthrogram hip (73525) |
$246 |
$492 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$184.50 |
$369 |
1.5× |
| Bone age studies (77072) |
$165.50 |
$331 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$938.50 |
$1,877 |
2.5× |
| Bone Imaging Limited Area (78300) |
$444.50 |
$889 |
1.2× |
| Bone Imaging Whole Body (78306) |
$967.50 |
$1,935 |
2.6× |
| Bone survey infant (77076) |
$252.50 |
$505 |
2.6× |
| Brachytx isodose complex (77318) |
$529.50 |
$1,059 |
1.5× |
| Brachytx isodose intermed (77317) |
$529.50 |
$1,059 |
1.5× |
| Brachytx Isodose Plan Simple (77316) |
$190 |
$380 |
0.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$740.50 |
$1,481 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,711 |
$7,422 |
2.7× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$849 |
$1,698 |
1.7× |
| Chest 1 view (71045) |
$138.50 |
$277 |
1.7× |
| Chest 2 views (71046) |
$199 |
$398 |
2.4× |
| Chest 3 views (71047) |
$199 |
$398 |
2.4× |
| Chest 4 or more views (71048) |
$199 |
$398 |
2.0× |
| Clavicle complete (73000) |
$170 |
$340 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$149 |
$298 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$240.50 |
$481 |
1.9× |
| Contrast Exam Abdominl Aorta (75625) |
$2,389 |
$4,778 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$304.50 |
$609 |
0.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$769.50 |
$1,539 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,275 |
$4,550 |
6.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,747.50 |
$3,495 |
7.7× |
| CT abdomen w contrast (74160) |
$1,523 |
$3,046 |
9.2× |
| CT abdomen w wo contrast (74170) |
$1,591.50 |
$3,183 |
9.6× |
| CT abdomen w/o contrast (74150) |
$1,038 |
$2,076 |
10.5× |
| CT Angio Abdomen and Pelvis (74174) |
$2,223.50 |
$4,447 |
6.7× |
| CT Angio Chest (71275) |
$1,561 |
$3,122 |
9.4× |
| CT Angio Head (70496) |
$1,561 |
$3,122 |
9.4× |
| CT angio hrt w/3d image (75574) |
$210.50 |
$421 |
0.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,561 |
$3,122 |
9.4× |
| CT Angio Neck (70498) |
$1,561 |
$3,122 |
9.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,561 |
$3,122 |
9.4× |
| CT cervical spine w/ contrast (72126) |
$1,538 |
$3,076 |
4.7× |
| CT cervical spine w/o contrast (72125) |
$1,463 |
$2,926 |
14.8× |
| CT cervical spine w/wo cont (72127) |
$1,836 |
$3,672 |
11.1× |
| CT chest w contrast (71260) |
$1,385.50 |
$2,771 |
8.3× |
| CT chest w/wo contrast (71270) |
$1,453.50 |
$2,907 |
8.8× |
| CT head/brain with contrast (70460) |
$1,400 |
$2,800 |
8.4× |
| CT head/brain without and with contrast (70470) |
$1,638.50 |
$3,277 |
9.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,394.50 |
$2,789 |
4.2× |
| CT hrt w/3d image congen (75573) |
$210.50 |
$421 |
0.6× |
| CT iac w contrast (70481) |
$1,674 |
$3,348 |
10.1× |
| CT lower ext w/o (73700) |
$780.50 |
$1,561 |
7.9× |
| CT lower extremity w/contrast material (73701) |
$874 |
$1,748 |
5.3× |
| CT lumbar spine w contrast (72132) |
$1,538 |
$3,076 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$1,463 |
$2,926 |
14.8× |
| CT maxillofacial w contrast (70487) |
$1,800 |
$3,600 |
10.8× |
| CT maxillofacial wo contrast (70486) |
$986.50 |
$1,973 |
10.0× |
| CT neck tissue combo (70492) |
$1,493 |
$2,986 |
9.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,492.50 |
$2,985 |
9.0× |
| CT orbits w/o contrast (70480) |
$1,246 |
$2,492 |
12.6× |
| CT pelvis w&w/o contrast (72194) |
$1,051 |
$2,102 |
6.3× |
| CT pelvis w/o contrast (72192) |
$826.50 |
$1,653 |
8.4× |
| CT scan of leg combo (73702) |
$1,006.50 |
$2,013 |
6.1× |
| CT scans face/jaw combo (70488) |
$2,257 |
$4,514 |
13.6× |
| CT soft tissue neck w contrast (70491) |
$1,241 |
$2,482 |
7.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,028 |
$2,056 |
10.4× |
| CT thoracic spine w contrast (72129) |
$1,538 |
$3,076 |
9.3× |
| CT thoracic spine w/o contrast (72128) |
$1,463 |
$2,926 |
14.8× |
| CT thorax w/o contrast (71250) |
$1,111.50 |
$2,223 |
11.2× |
| CT upper ext wo (73200) |
$1,246 |
$2,492 |
12.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,264 |
$2,528 |
7.6× |
CT upper extremity with contrast (73201)
range across 2 matching MRF lines |
$1,283.50–$1,322 |
$2,567–$2,644 |
varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,790 |
$3,580 |
10.8× |
| Cta Abdomen (74175) |
$1,561 |
$3,122 |
9.4× |
| CTA pelvis (72191) |
$1,561 |
$3,122 |
9.4× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$379.50 |
$759 |
1.7× |
| Discography Cerv/Thor Spine (72285) |
$360 |
$720 |
0.2× |
| Diskography lumbar (72295) |
$360 |
$720 |
0.2× |
| Echo Guide For Artery Repair (76936) |
$341 |
$682 |
1.7× |
| Echograp Trans R Pros Study (76873) |
$199 |
$398 |
2.0× |
| Esophagram (74220) |
$396.50 |
$793 |
2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$518 |
$1,036 |
5.2× |
| Fluoroscopy up to 1 hr (76000) |
$432 |
$864 |
1.9× |
| Follow-Up Angiography (75898) |
$456 |
$912 |
0.2× |
| Foot 2 views (73620) |
$170 |
$340 |
2.1× |
| Forearm 2 views (73090) |
$163.50 |
$327 |
2.0× |
| Gastric emptying imaging study (78264) |
$1,221 |
$2,442 |
3.2× |
| Gastroesophageal Reflux Exam (78262) |
$810 |
$1,620 |
2.1× |
| Gated Heart Planar Single (78472) |
$1,012 |
$2,024 |
2.7× |
| Hand 2 views (73120) |
$157 |
$314 |
1.6× |
| Heart Image (Pet) Multiple (78492) |
$3,711 |
$7,422 |
2.7× |
| Hepatobil Syst Image W/Drug (78227) |
$1,113 |
$2,226 |
2.2× |
| Hepatobiliary System Imaging (78226) |
$952 |
$1,904 |
2.5× |
| Ht Muscle Image Spect Sing (78451) |
$1,335.50 |
$2,671 |
1.1× |
| Hysterosalpingogram (74740) |
$292.50 |
$585 |
1.3× |
| Infant hip ultrasound, limited static exam (76886) |
$258.50 |
$517 |
3.1× |
| Infusion Ivp (74410) |
$339.50 |
$679 |
2.0× |
| Interstitial radiation source applic complex (77778) |
$1,475.50 |
$2,951 |
2.2× |
| Intracavitary Radiation Source Applic Complex (77763) |
$762.50 |
$1,525 |
1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$692.50 |
$1,385 |
1.3× |
| Intracavitary radiation source applic simple (77761) |
$620.50 |
$1,241 |
1.2× |
| Joint Survey Single View (77077) |
$224 |
$448 |
2.3× |
| K Flow/Funct Image W/Drug (78708) |
$784 |
$1,568 |
1.5× |
| K Flow/Funct Image W/O Drug (78707) |
$434 |
$868 |
0.8× |
| Knee 3 Views (73562) |
$224 |
$448 |
2.7× |
| Liver & Spleen Imaging Static Only (78215) |
$449 |
$898 |
1.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$341 |
$682 |
0.7× |
| Lung perfusion differential (78597) |
$341 |
$682 |
0.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$975.50 |
$1,951 |
1.9× |
| Lung Ventilation Imaging (78579) |
$341 |
$682 |
0.9× |
| Lymph System Imaging (78195) |
$896 |
$1,792 |
1.7× |
| Meckels Divert Exam (78290) |
$552.50 |
$1,105 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$490.50 |
$981 |
1.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,730.50 |
$3,461 |
5.2× |
| MRI lumbar spine w contrast (72149) |
$906 |
$1,812 |
2.7× |
| MRI pelvis w contrast (72196) |
$764.50 |
$1,529 |
2.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$846 |
$1,692 |
3.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,561 |
$3,122 |
4.7× |
| Myelogram cervical (72240) |
$717.50 |
$1,435 |
1.0× |
| Myelogram Lumbar (72265) |
$717.50 |
$1,435 |
1.0× |
| Myelography thoracic (72255) |
$855.50 |
$1,711 |
1.2× |
| Myelograpy 2/more regions rs&i (72270) |
$1,028 |
$2,056 |
1.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,711 |
$7,422 |
3.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,210 |
$4,420 |
1.8× |
| Neck soft tissue (70360) |
$177.50 |
$355 |
2.2× |
| Nm csf leak detection (78650) |
$854 |
$1,708 |
0.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,017.50 |
$6,035 |
2.3× |
| Nuclear Rx Oral Admin (79005) |
$976.50 |
$1,953 |
4.4× |
| Optic foramina (70190) |
$166.50 |
$333 |
2.0× |
| Parathyroid Planar Imaging (78070) |
$730 |
$1,460 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$167 |
$334 |
1.7× |
| Pet Image W/Ct Lmtd (78814) |
$2,928 |
$5,856 |
2.2× |
| PET image w/CT, full body (78816) |
$3,711 |
$7,422 |
2.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,711 |
$7,422 |
2.7× |
| Pet Myocardial Sngl Study (78491) |
$3,168 |
$6,336 |
2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$635 |
$1,270 |
1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$341.50 |
$683 |
3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$281 |
$562 |
0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$180.50 |
$361 |
2.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$192.50 |
$385 |
2.3× |
| Radex elbow complete minimum 3 views (73080) |
$176 |
$352 |
2.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$292.50 |
$585 |
3.0× |
| Radex fingr minimum 2 views (73140) |
$152.50 |
$305 |
1.9× |
| Radex foot complete minimum 3 views (73630) |
$232 |
$464 |
2.8× |
| Radex Hand Minimum 3 Views (73130) |
$175.50 |
$351 |
2.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$95.50 |
$191 |
1.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$232 |
$464 |
2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$175 |
$350 |
2.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$181.50 |
$363 |
2.2× |
| Radex shoulder complete minimum 2 views (73030) |
$176.50 |
$353 |
2.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$126 |
$252 |
1.5× |
| Radex Spine 1 View Specify Level (72020) |
$124.50 |
$249 |
1.5× |
| Radex Sternum Minimum 2 Views (71120) |
$223.50 |
$447 |
2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$268 |
$536 |
3.3× |
| Radex Toe Minimum 2 Views (73660) |
$155.50 |
$311 |
1.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$107 |
$214 |
1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$176 |
$352 |
2.1× |
| Radiation treatment delivery level 1 (77402) |
$169 |
$338 |
1.8× |
| Radiation treatment delivery level 2 (77407) |
$322.50 |
$645 |
0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$186 |
$372 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$158 |
$316 |
1.6× |
| Radiologic exam colon double contrast study (74280) |
$740.50 |
$1,481 |
4.5× |
| Radiologic exam colon single contrast study (74270) |
$570 |
$1,140 |
3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$272.50 |
$545 |
1.6× |
| Radiologic exam knee complete 4/more views (73564) |
$226.50 |
$453 |
2.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$208 |
$416 |
2.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$408.50 |
$817 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$147 |
$294 |
0.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$503 |
$1,006 |
3.0× |
| Radiologic examination femur 1 view (73551) |
$110.50 |
$221 |
1.3× |
Radiologic examination femur minimum 2 views (73552)
range across 2 matching MRF lines |
$170–$175 |
$340–$350 |
varies |
| Radiologic examination knee 1/2 views (73560) |
$168.50 |
$337 |
2.0× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$126 |
$252 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$171 |
$342 |
2.1× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$277.50 |
$555 |
0.5× |
| Ribs bilateral 3 views (71110) |
$204 |
$408 |
2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$831.50 |
$1,663 |
2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$838.50 |
$1,677 |
1.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$671.50 |
$1,343 |
1.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$765 |
$1,530 |
1.5× |
| Salivary Gland Imaging Serial Images (78231) |
$379.50 |
$759 |
1.0× |
| Scapula (73010) |
$99 |
$198 |
1.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$30.50 |
$61 |
1.3× |
| Sella turcica (70240) |
$101.50 |
$203 |
1.2× |
| Shoulder 1 view (73020) |
$107.50 |
$215 |
1.3× |
| Shoulder Arthrography (73040) |
$522 |
$1,044 |
1.6× |
| Skull less than 4 views (70250) |
$135 |
$270 |
1.4× |
| Special dosimetry (77331) |
$184.50 |
$369 |
1.5× |
| Special Physics Consult (77370) |
$184.50 |
$369 |
1.5× |
| Special teletherapy port plan (77321) |
$515 |
$1,030 |
1.5× |
| Special treatment procedure (77470) |
$860.50 |
$1,721 |
1.6× |
| Sternoclavicular joints (71130) |
$112 |
$224 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$381.50 |
$763 |
1.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$190 |
$380 |
0.5× |
| Testicular Imaging W/Flow (78761) |
$581.50 |
$1,163 |
1.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$837 |
$1,674 |
2.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$491 |
$982 |
1.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$457 |
$914 |
3.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$171 |
$342 |
1.0× |
| Thoracic spine 2 views (72070) |
$171.50 |
$343 |
1.7× |
| Thoracic spine 3 views (72072) |
$275.50 |
$551 |
2.8× |
Thyroid Imaging With Vascular Flow (78013)
range across 2 matching MRF lines |
$411–$536 |
$822–$1,072 |
varies |
| Thyroid Met Imaging Body (78018) |
$882.50 |
$1,765 |
1.7× |
| Thyroid Uptake Measurement (78012) |
$393 |
$786 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$603 |
$1,206 |
1.6× |
| Tx Devices Design & Construction Complex (77334) |
$425 |
$850 |
1.2× |
| Tx devices design & construction intermediate (77333) |
$374.50 |
$749 |
2.9× |
| Tx devices design & construction simple (77332) |
$340.50 |
$681 |
2.7× |
| Ultrasound Breast Limited (76642) |
$289.50 |
$579 |
3.5× |
| Ultrasound Exam Aaa Screen (76706) |
$175.50 |
$351 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$498 |
$996 |
5.0× |
| Umbilical-artery Doppler (OB) (76820) |
$356 |
$712 |
3.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$692.50 |
$1,385 |
7.2× |
Upper gi w/o kub (74240)
range across 2 matching MRF lines |
$427–$510 |
$854–$1,020 |
varies |
| Ureteral Reflux Study (78740) |
$548 |
$1,096 |
1.4× |
| Urethrocystogram voiding (74455) |
$193.50 |
$387 |
0.9× |
| Urethrocystography retrograde (74450) |
$267.50 |
$535 |
1.2× |
| Us breast unilateral complete (76641) |
$579 |
$1,158 |
5.9× |
| Us chest (76604) |
$289.50 |
$579 |
2.9× |
| Us complete joint (76881) |
$472.50 |
$945 |
4.8× |
| Us exam, pelvic, limited (76857) |
$195 |
$390 |
2.0× |
| Us head (76506) |
$370.50 |
$741 |
3.7× |
| Us kidney transplant (76776) |
$381.50 |
$763 |
3.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$426 |
$852 |
4.3× |
| Us ob limited 1 or more fetuses (76815) |
$448.50 |
$897 |
4.5× |
| Us ob transvaginal (76817) |
$483.50 |
$967 |
4.9× |
| Us pelvic non ob complete (76856) |
$460 |
$920 |
4.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$673 |
$1,346 |
6.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$307 |
$614 |
3.1× |
| Us retroperitoneal complete (76770) |
$455.50 |
$911 |
4.6× |
| Us retroperitoneal limited (76775) |
$341.50 |
$683 |
3.5× |
| Us scrotum and contents (76870) |
$520 |
$1,040 |
5.3× |
| Us thyroid (76536) |
$406 |
$812 |
4.1× |
| Venography Adrenal Unilateral (75840) |
$727 |
$1,454 |
0.2× |
| Venography extremity bilateral rs&i (75822) |
$719 |
$1,438 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$513.50 |
$1,027 |
0.3× |
| Venography Renal Unilateral (75831) |
$727 |
$1,454 |
0.2× |
| Wrist 2 views (73100) |
$160 |
$320 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$134 |
$268 |
1.6× |
| X-ray antegrade pyelogram tube (74425) |
$443.50 |
$887 |
1.3× |
| X-Ray Bend Only L-S Spine (72120) |
$259.50 |
$519 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$188 |
$376 |
2.3× |
| X-Ray Exam Breast Specimen (76098) |
$342.50 |
$685 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$114.50 |
$229 |
1.4× |
X-Ray Exam Entire Spi 2/3 Vw (72082)
range across 2 matching MRF lines |
$175–$292.50 |
$350–$585 |
varies |
| X-Ray Exam Hip Uni 1 View (73501) |
$109 |
$218 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$124.50 |
$249 |
1.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$147 |
$294 |
1.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$494.50 |
$989 |
5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$210.50 |
$421 |
2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$359.50 |
$719 |
3.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$220 |
$440 |
2.2× |
| X-ray eye for foreign body (70030) |
$146.50 |
$293 |
1.8× |
| X-ray humerus (73060) |
$198 |
$396 |
2.4× |
| X-ray IV pyelogram+tomography (74415) |
$432 |
$864 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$134 |
$268 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$181.50 |
$363 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$224.50 |
$449 |
2.3× |
| X-ray nose-rectum child f.b. (76010) |
$75.50 |
$151 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$313 |
$626 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$181 |
$362 |
1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$92.50 |
$185 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$211.50 |
$423 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$281 |
$562 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$281 |
$562 |
2.8× |
| X-ray thoracic spine 4 vw (72074) |
$235.50 |
$471 |
2.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$447 |
$894 |
1.4× |
| X-Rays Bone Length Studies (77073) |
$175 |
$350 |
1.8× |
| X-Rays Bone Survey Complete (77075) |
$406.50 |
$813 |
4.1× |
| Xr c-spine 4 or 5 views (72050) |
$310.50 |
$621 |
3.1× |
| Xr facial bones less than 3 views (70140) |
$140 |
$280 |
1.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$184 |
$368 |
1.9× |
| Xr orbits complete 4 views (70200) |
$204.50 |
$409 |
2.1× |