| Abdomen 2 views (74019) |
$249.50 |
$499 |
2.2× |
| Ankle 2 views (73600) |
$202.50 |
$405 |
2.2× |
| Arthrogram elbow (73085) |
$668.25 |
$1,336.50 |
1.8× |
| Arthrogram hip (73525) |
$537.50 |
$1,075 |
1.4× |
| Arthrogram shoulder (73040) |
$542.50 |
$1,085 |
1.5× |
| Arthrogram wrist (73115) |
$743.25 |
$1,486.50 |
2.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,039.50 |
$2,079 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$1,325.75 |
$2,651.50 |
3.1× |
| Bone age studies (77072) |
$197.75 |
$395.50 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,515.50 |
$3,031 |
3.6× |
| Bone survey complete (77075) |
$871.50 |
$1,743 |
7.8× |
| Bone survey infant (77076) |
$372 |
$744 |
3.3× |
| Bowel imaging (78290) |
$1,554 |
$3,108 |
3.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,340.50 |
$2,681 |
3.1× |
| Cervical spine 2 or 3 views (72040) |
$257.75 |
$515.50 |
2.8× |
| Chest 1 view (71045) |
$256.50 |
$513 |
2.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$519.25 |
$1,038.50 |
2.8× |
| Clavicle complete (73000) |
$319 |
$638 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,369.50 |
$2,739 |
12.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,070 |
$6,140 |
8.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,365.25 |
$4,730.50 |
9.3× |
| CT abdomen w contrast (74160) |
$1,586.75 |
$3,173.50 |
8.5× |
| CT abdomen w wo contrast (74170) |
$2,201.25 |
$4,402.50 |
11.8× |
| CT abdomen w/o contrast (74150) |
$1,408.75 |
$2,817.50 |
12.6× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,725.50 |
$3,451 |
9.2× |
| CT angiography upper extremity lt (73206) |
$1,725.50 |
$3,451 |
9.2× |
| CT c-spine w/contrast (72126) |
$1,535.50 |
$3,071 |
4.1× |
| CT c-spine w/o contrast (72125) |
$1,322.25 |
$2,644.50 |
11.8× |
| CT cervical spine w&w/o contrast (72127) |
$2,053.50 |
$4,107 |
11.0× |
| CT chest w contrast (71260) |
$1,044.50 |
$2,089 |
5.6× |
| CT chest w/wo contrast (71270) |
$1,644 |
$3,288 |
8.8× |
| CT head/brain with contrast (70460) |
$1,364.75 |
$2,729.50 |
7.3× |
| CT head/brain without and with contrast (70470) |
$2,053.50 |
$4,107 |
11.0× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$250 |
$500 |
2.7× |
| CT iac w contrast (70481) |
$2,020.25 |
$4,040.50 |
10.8× |
| CT limited/localized follow up study (76380) |
$768 |
$1,536 |
8.3× |
| CT lower ext w/o (73700) |
$1,105.50 |
$2,211 |
9.9× |
| CT lower extremity w wo contrast (73702) |
$1,826 |
$3,652 |
9.7× |
| CT lower extremity w/contrast material (73701) |
$1,290.50 |
$2,581 |
6.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,053.50 |
$4,107 |
11.0× |
| CT lumbar spine w/contrast (72132) |
$1,535.50 |
$3,071 |
4.1× |
| CT lumbar spine w/o contrast (72131) |
$1,322.25 |
$2,644.50 |
11.8× |
| CT maxillofacial w contrast (70487) |
$1,931.50 |
$3,863 |
10.3× |
| CT maxillofacial w/wo contrast (70488) |
$2,298.50 |
$4,597 |
12.3× |
| CT maxillofacial wo contrast (70486) |
$1,755.25 |
$3,510.50 |
15.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,354.50 |
$4,709 |
12.6× |
| CT orbits w/o contrast (70480) |
$1,798 |
$3,596 |
16.1× |
| CT pelvis w/o contrast (72192) |
$1,322.25 |
$2,644.50 |
11.8× |
| CT pelvis w/wo contrast (72194) |
$2,053.50 |
$4,107 |
11.0× |
| CT scan of arm combo (73202) |
$1,826 |
$3,652 |
9.7× |
| CT soft tissue neck w contrast (70491) |
$1,536 |
$3,072 |
8.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,053.50 |
$4,107 |
11.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,359.25 |
$2,718.50 |
12.2× |
| CT thoracic spine w/contrast (72129) |
$1,535.50 |
$3,071 |
8.2× |
| CT thoracic spine w/o contrast (72128) |
$1,322.25 |
$2,644.50 |
11.8× |
| CT thoracic spine w/wo contrast (72130) |
$2,053.50 |
$4,107 |
11.0× |
| CT thorax w/o contrast (71250) |
$955.25 |
$1,910.50 |
8.6× |
| CT upper ext wo (73200) |
$1,114.75 |
$2,229.50 |
10.0× |
| CT upper extremity with contrast (73201) |
$1,290.50 |
$2,581 |
3.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,168.25 |
$6,336.50 |
16.9× |
| Cta Abdomen (74175) |
$1,636 |
$3,272 |
8.7× |
| CTA abdomen pelvis (74174) |
$2,601 |
$5,202 |
7.0× |
| CTA chest (71275) |
$1,459 |
$2,918 |
7.8× |
| Cta Head (70496) |
$2,020.25 |
$4,040.50 |
10.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,069.50 |
$4,139 |
5.6× |
| Cta Neck (70498) |
$2,020.25 |
$4,040.50 |
10.8× |
| Cta Pelvis (72191) |
$1,494.50 |
$2,989 |
8.0× |
| Cystography minimum 3 views rs&i (74430) |
$338 |
$676 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$668 |
$1,336 |
6.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$668 |
$1,336 |
6.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$290 |
$580 |
2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$149.50 |
$299 |
1.6× |
| Dxa bone density study axial skeleton (77085) |
$377.50 |
$755 |
3.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$631.50 |
$1,263 |
2.5× |
| Esophagus (74220) |
$377.25 |
$754.50 |
2.0× |
| Facial bones min 3 views (70150) |
$241.50 |
$483 |
2.2× |
| Fetal biophysical profile non-stress testing (76818) |
$448 |
$896 |
4.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$524.50 |
$1,049 |
4.7× |
| Fetal Echo (76825) |
$988.50 |
$1,977 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$205 |
$410 |
0.8× |
| Foot 2 views (73620) |
$289.25 |
$578.50 |
3.1× |
| Forearm 2 views (73090) |
$202.50 |
$405 |
2.2× |
| Hand 2 views (73120) |
$202.50 |
$405 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,049.50 |
$4,099 |
3.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,540.50 |
$3,081 |
3.6× |
| Hysterosalpingogram (74740) |
$399 |
$798 |
1.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$160.50 |
$321 |
1.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,134.50 |
$2,269 |
2.0× |
| Knee 3 views (73562) |
$366.75 |
$733.50 |
3.9× |
| Liver & spleen imaging static only (78215) |
$896.50 |
$1,793 |
2.1× |
| Lymphoscintigraphy (78195) |
$1,564 |
$3,128 |
2.7× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,473 |
$2,946 |
1.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,597.50 |
$3,195 |
4.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,312 |
$4,624 |
6.2× |
| MRA head w & w/o contrast (70546) |
$2,074.50 |
$4,149 |
5.6× |
| MRA head w/o contrast (70544) |
$1,533.50 |
$3,067 |
6.0× |
| MRA head with contrast (70545) |
$1,816 |
$3,632 |
4.9× |
| MRA neck w contrast (70548) |
$1,704.50 |
$3,409 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,994.25 |
$3,988.50 |
5.4× |
| MRA neck w/o contrast (70547) |
$1,533.50 |
$3,067 |
6.0× |
| MRI abdomen w contrast (74182) |
$1,385.50 |
$2,771 |
3.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,312 |
$4,624 |
6.2× |
| MRI abdomen w/o contrast (74181) |
$1,095.75 |
$2,191.50 |
4.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,493 |
$2,986 |
1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,349.25 |
$4,698.50 |
6.3× |
| MRI bone marrow blood supply (77084) |
$1,633.50 |
$3,267 |
6.4× |
| MRI breast w/o contrast bilateral (77047) |
$894 |
$1,788 |
3.5× |
| MRI breast wo contrast unilateral (77046) |
$899.50 |
$1,799 |
3.5× |
| MRI c-spine with contrast (72142) |
$1,345 |
$2,690 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$1,095.75 |
$2,191.50 |
4.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,074.50 |
$4,149 |
5.6× |
| MRI chest w/o contrast (71550) |
$1,571 |
$3,142 |
6.2× |
| MRI chest with contrast (71551) |
$1,851 |
$3,702 |
2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,313 |
$2,626 |
3.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,296.50 |
$4,593 |
6.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,095.75 |
$2,191.50 |
4.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,633.50 |
$3,267 |
6.4× |
| MRI orbit face neck w contrast (70542) |
$1,633.50 |
$3,267 |
4.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,074.50 |
$4,149 |
5.6× |
| MRI pelvis w/contrast (72196) |
$1,299.50 |
$2,599 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,312 |
$4,624 |
6.2× |
| MRI pelvis w/o contrast (72195) |
$1,095.75 |
$2,191.50 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,825.50 |
$3,651 |
4.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,404 |
$2,808 |
3.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,825.50 |
$3,651 |
4.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,167.50 |
$2,335 |
3.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,825.50 |
$3,651 |
4.9× |
| MRI temporomandibular joint (70336) |
$2,450.25 |
$4,900.50 |
9.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,095.75 |
$2,191.50 |
4.3× |
| MRI up ext w/o contrast (73218) |
$1,129 |
$2,258 |
4.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,122.50 |
$2,245 |
4.4× |
| MRI, joint upper extrem combo (73223) |
$2,368.50 |
$4,737 |
6.4× |
| Myelogram Cervical (72240) |
$720.50 |
$1,441 |
0.9× |
| Myelogram Lumbar (72265) |
$721 |
$1,442 |
0.9× |
| Myelogram thoracic (72255) |
$720.50 |
$1,441 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,253 |
$4,506 |
1.6× |
| Myocardial spect single study at rest or stress (78451) |
$1,390.50 |
$2,781 |
1.0× |
| Neck soft tissue (70360) |
$216.75 |
$433.50 |
2.3× |
| Nm gastric emptying study (78264) |
$1,510.25 |
$3,020.50 |
3.5× |
| Nm kidney scan w/flow (78701) |
$1,015 |
$2,030 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$1,360.50 |
$2,721 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$216.75 |
$433.50 |
1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,059.50 |
$2,119 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,446.25 |
$2,892.50 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$354.50 |
$709 |
0.6× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$366.75 |
$733.50 |
3.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$202.50 |
$405 |
2.2× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$366.75 |
$733.50 |
3.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$269 |
$538 |
2.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$385 |
$770 |
3.4× |
| Radex fingr minimum 2 views (73140) |
$154 |
$308 |
1.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$367 |
$734 |
3.9× |
| Radex Hand Minimum 3 Views (73130) |
$366.75 |
$733.50 |
3.9× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$216.75 |
$433.50 |
2.3× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$504 |
$1,008 |
4.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$505.25 |
$1,010.50 |
4.5× |
| Radex Humerus Minimum 2 Views (73060) |
$253.50 |
$507 |
2.7× |
| Radex Kne 1/2 Views (73560) |
$315.75 |
$631.50 |
3.4× |
| Radex Kne Compl 4/More Views (73564) |
$398 |
$796 |
3.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$264 |
$528 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$221.50 |
$443 |
2.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$330 |
$660 |
3.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$315.75 |
$631.50 |
3.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$138 |
$276 |
1.5× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$371.50 |
$743 |
3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$365 |
$730 |
3.9× |
| Radex Toe Minimum 2 Views (73660) |
$145.50 |
$291 |
1.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$380.25 |
$760.50 |
3.4× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$361.75 |
$723.50 |
3.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$207.50 |
$415 |
2.2× |
| Radiologic exam chest 2 views (71046) |
$289.50 |
$579 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$651.50 |
$1,303 |
3.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$502.75 |
$1,005.50 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$568.25 |
$1,136.50 |
3.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$438.25 |
$876.50 |
2.3× |
| Radiologic examination femur 1 view (73551) |
$278.25 |
$556.50 |
3.0× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$139.50 |
$279 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$366.75 |
$733.50 |
3.9× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$196.50 |
$393 |
0.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$316.50 |
$633 |
2.8× |
| Radiological examination surgical specimen (76098) |
$137 |
$274 |
0.2× |
| Ribs bilateral 3 views (71110) |
$365 |
$730 |
3.3× |
| Sacroiliac Joints < 3 Views (72200) |
$209 |
$418 |
1.9× |
| Scapula (73010) |
$214 |
$428 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$126 |
$252 |
5.4× |
| Sella turcica (70240) |
$134.50 |
$269 |
1.4× |
| Shoulder 1 view (73020) |
$144.50 |
$289 |
1.6× |
| Small bowel series (74250) |
$460.50 |
$921 |
2.5× |
| Spine thoracic 3 views (72072) |
$362.75 |
$725.50 |
3.2× |
| Thoracolumbar 2 views (72080) |
$304.50 |
$609 |
3.3× |
| Thyroid imaging w/blood flow (78013) |
$907 |
$1,814 |
2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,109.50 |
$2,219 |
2.6× |
| Tmj unilateral (70328) |
$182.50 |
$365 |
2.0× |
| Ultrasound elastography first target lesion (76982) |
$335.50 |
$671 |
3.0× |
| Ultrasound Exam Aaa Screen (76706) |
$432 |
$864 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$317 |
$634 |
2.8× |
| Umbilical-artery Doppler (OB) (76820) |
$479 |
$958 |
4.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$180.50 |
$361 |
1.9× |
| Unlisted ultrasound procedure (76999) |
$476 |
$952 |
5.1× |
| Urethrocystogram voiding (74455) |
$411 |
$822 |
1.6× |
| Us breast unilateral limited (76642) |
$277.50 |
$555 |
3.0× |
| Us chest (76604) |
$444.75 |
$889.50 |
4.0× |
| Us compl joint r-t w/image documentation (76881) |
$293.50 |
$587 |
2.6× |
| Us elastography parenchyma (76981) |
$415.75 |
$831.50 |
3.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$396.75 |
$793.50 |
3.6× |
| Us ob limited (76815) |
$266 |
$532 |
2.4× |
| Us ob transvaginal (76817) |
$293.75 |
$587.50 |
2.6× |
| Us pelvic non ob complete (76856) |
$465.75 |
$931.50 |
4.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$120 |
$240 |
1.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$366 |
$732 |
3.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$448 |
$896 |
4.0× |
| Us retroperitoneal complete (76770) |
$380.75 |
$761.50 |
3.4× |
| Us retroperitoneal limited (76775) |
$161 |
$322 |
1.4× |
| Us scrotum and contents (76870) |
$369.50 |
$739 |
3.3× |
| Us soft tissue head/neck (76536) |
$437.25 |
$874.50 |
3.9× |
| Us spinal canal and contents (76800) |
$432.50 |
$865 |
3.9× |
| Venogram extremity bilateral (75822) |
$630 |
$1,260 |
0.4× |
| Venogram Extremity Unilateral (75820) |
$394 |
$788 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$169 |
$338 |
1.8× |
| Wrist 2 views (73100) |
$202.50 |
$405 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$290.50 |
$581 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$249 |
$498 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,162.50 |
$2,325 |
6.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$294.25 |
$588.50 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$237.75 |
$475.50 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$504 |
$1,008 |
4.5× |
| X-ray exam of femur 2/> (73552) |
$366.75 |
$733.50 |
3.9× |
| X-ray eye for foreign body (70030) |
$428 |
$856 |
4.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$192.75 |
$385.50 |
2.1× |
| X-ray IV pyelogram (ivp) (74400) |
$672 |
$1,344 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$136.25 |
$272.50 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$207.50 |
$415 |
2.2× |
| X-ray leg, infant (73592) |
$380.25 |
$760.50 |
4.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$297.25 |
$594.50 |
2.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$427 |
$854 |
3.8× |
| X-ray nose-rectum child f.b. (76010) |
$156.75 |
$313.50 |
1.7× |
| X-ray optic foramen (70190) |
$182.50 |
$365 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$270.50 |
$541 |
2.4× |
| X-ray retrograde pyelogram (74420) |
$591.50 |
$1,183 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$233.25 |
$466.50 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$368.50 |
$737 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$499 |
$998 |
4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$241.50 |
$483 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$241.50 |
$483 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$227 |
$454 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$289.50 |
$579 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$134.75 |
$269.50 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$153.75 |
$307.50 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$377.50 |
$755 |
4.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$241.50 |
$483 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$297.25 |
$594.50 |
2.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$362.75 |
$725.50 |
3.2× |
| Xr bone length studies (77073) |
$290.50 |
$581 |
2.6× |
| Xr c-spine 4 or 5 views (72050) |
$282.50 |
$565 |
2.5× |
| Xr c-spine 6 or more views (72052) |
$363.25 |
$726.50 |
3.3× |
| Xr chest 4+ views (71048) |
$377.50 |
$755 |
3.4× |
| Xr urogram antegrade (74425) |
$1,952.50 |
$3,905 |
5.2× |