| Abdomen 2 views (74019) |
$130 |
$518 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$486 |
$1,943 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,252 |
$5,007 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$1,126 |
$4,504 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,126 |
$4,504 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,715 |
$6,860 |
0.5× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,887 |
$7,548 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$742 |
$2,966 |
0.2× |
| Ankle 2 views (73600) |
$169 |
$675.50 |
1.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$208 |
$831 |
0.6× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,279 |
$5,117 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,311 |
$5,242 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$988 |
$3,953 |
0.3× |
| Artery X-Rays Adrenal Gland (75731) |
$1,252 |
$5,007 |
0.4× |
| Arthrogram hip (73525) |
$367 |
$1,468 |
1.0× |
| Arthrogram shoulder (73040) |
$516 |
$2,064 |
1.5× |
| Arthrogram wrist (73115) |
$453 |
$1,812 |
1.3× |
| Arthrography knee lt (73580) |
$413 |
$1,651 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$488 |
$1,952 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$486 |
$1,943 |
1.2× |
| Bone age studies (77072) |
$81 |
$323 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$486 |
$1,943 |
1.2× |
| Bone survey complete (77075) |
$130 |
$518 |
1.2× |
| Brain imaging < 4 static views (78600) |
$272 |
$1,087 |
0.7× |
| Brain imaging < 4 static views w vascular flow (78601) |
$472 |
$1,886 |
1.2× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$20 |
$81 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$107 |
$428 |
1.2× |
| Chest 1 view (71045) |
$93 |
$370 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$125 |
$499 |
0.7× |
| Clavicle complete (73000) |
$163 |
$651.50 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$113 |
$453 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$453 |
$1,812 |
1.3× |
| CT abdomen and pelvis without contrast (74176) |
$289 |
$1,155 |
1.2× |
| CT abdomen w contrast (74160) |
$217 |
$866 |
1.2× |
| CT abdomen w wo contrast (74170) |
$217 |
$866 |
1.2× |
| CT abdomen w/o contrast (74150) |
$130 |
$518 |
1.2× |
| CT angio hrt w/3d image (75574) |
$661 |
$2,642 |
1.9× |
| CT angiography upper extremity lt (73206) |
$556.50 |
$2,225.50 |
3.2× |
| CT c-spine w/o contrast (72125) |
$130 |
$518 |
1.2× |
| CT cervical spine w&w/o contrast (72127) |
$217 |
$866 |
1.2× |
| CT cervical spine with contrast (72126) |
$453 |
$1,812 |
1.3× |
| CT chest w/wo contrast (71270) |
$217 |
$866 |
1.2× |
| CT chest with contrast (71260) |
$217 |
$866 |
1.2× |
| CT head/brain with contrast (70460) |
$217 |
$866 |
1.2× |
| CT head/brain without and with contrast (70470) |
$217 |
$866 |
1.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$661 |
$2,642 |
1.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$123 |
$491 |
1.4× |
| CT hrt w/3d image congen (75573) |
$661 |
$2,642 |
1.9× |
| CT iac w contrast (70481) |
$217 |
$866 |
1.2× |
| CT limited/localized follow up study (76380) |
$107 |
$428 |
1.2× |
| CT lower ext w/o (73700) |
$294.50 |
$1,176 |
2.8× |
| CT lower extremity w wo contrast (73702) |
$543.50 |
$2,173.50 |
3.1× |
| CT lower extremity with contrast (73701) |
$457.50 |
$1,829 |
2.6× |
| CT lumbar spine w & w/o contrast (72133) |
$217 |
$866 |
1.2× |
| CT lumbar spine w/o contrast (72131) |
$130 |
$518 |
1.2× |
| CT lumbar spine with contrast (72132) |
$453 |
$1,812 |
1.3× |
| CT maxillofacial w contrast (70487) |
$217 |
$866 |
1.2× |
| CT maxillofacial w/o contrast (70486) |
$130 |
$518 |
1.2× |
| CT maxillofacial w/wo contrast (70488) |
$217 |
$866 |
1.2× |
| CT neck soft tissue w contrast (70491) |
$217 |
$866 |
1.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$217 |
$866 |
1.2× |
| CT orbits w/o contrast (70480) |
$130 |
$518 |
1.2× |
| CT pelvis w & w/o contrast (72194) |
$217 |
$866 |
1.2× |
| CT pelvis w/o contrast (72192) |
$130 |
$518 |
1.2× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$122 |
$486 |
1.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$217 |
$866 |
1.2× |
| CT soft tissue neck w/o contrast (70490) |
$130 |
$518 |
1.2× |
| CT thoracic spine w/contrast (72129) |
$217 |
$866 |
1.2× |
| CT thoracic spine w/o contrast (72128) |
$130 |
$518 |
1.2× |
| CT thoracic spine w/wo contrast (72130) |
$217 |
$866 |
1.2× |
| CT thorax w/o contrast (71250) |
$130 |
$518 |
1.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$543.50 |
$2,173.50 |
3.1× |
| CT upper extremity w/o contrast rt (73200) |
$294.50 |
$1,176 |
2.8× |
| CT upper extremity with contrast (73201) |
$575.50 |
$2,302 |
1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$217 |
$866 |
1.2× |
| Cta Abdomen (74175) |
$217 |
$866 |
1.2× |
| CTA abdomen pelvis (74174) |
$453 |
$1,812 |
1.3× |
| CTA chest (71275) |
$217 |
$866 |
1.2× |
| Cta Head (70496) |
$217 |
$866 |
1.2× |
| CTA lwr ext w&w/o contrast (73706) |
$556.50 |
$2,225.50 |
3.2× |
| Cta Neck (70498) |
$217 |
$866 |
1.2× |
| Cta Pelvis (72191) |
$217 |
$866 |
1.2× |
| Cystography minimum 3 views rs&i (74430) |
$292 |
$1,167 |
0.8× |
| Diskogram cervical (72285) |
$1,289 |
$5,156 |
0.7× |
| Diskography lumbar (72295) |
$1,289 |
$5,156 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$130 |
$518 |
1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$104 |
$414 |
1.2× |
| Echoencephalography real time imaging (76506) |
$89 |
$354 |
0.8× |
| Esophagus (74220) |
$217 |
$866 |
1.2× |
| Fetal biophysical profile non-stress testing (76818) |
$177 |
$709 |
1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$130 |
$518 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$279 |
$1,114 |
1.2× |
| Foot 2 views (73620) |
$126 |
$503 |
1.4× |
| Forearm 2 views (73090) |
$153.50 |
$613 |
1.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$325 |
$1,298 |
0.6× |
| Gated Heart Planar Single (78472) |
$486 |
$1,943 |
1.2× |
| Hand 2 views (73120) |
$194 |
$775.50 |
1.8× |
| Hand 3 views (73130) |
$186 |
$744 |
2.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$637 |
$2,547 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$486 |
$1,943 |
1.2× |
| Ht muscle image spect sing (78451) |
$1,329 |
$5,316 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$160 |
$640.50 |
1.8× |
| Hysterosalpingogram (74740) |
$289 |
$1,155 |
1.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$118 |
$472 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$637 |
$2,547 |
1.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$575 |
$2,300 |
1.1× |
| Knee 3 views (73562) |
$107 |
$428 |
1.2× |
| Liver & spleen imaging static only (78215) |
$379 |
$1,517 |
0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$379 |
$1,517 |
0.9× |
| Lung perf&ventilat diferentl (78598) |
$329 |
$1,315 |
0.6× |
| Lung perfusion differential (78597) |
$216 |
$864 |
0.5× |
| Lung Ventilation Imaging (78579) |
$481 |
$1,925 |
1.2× |
| Lymphoscintigraphy (78195) |
$272 |
$1,088 |
0.5× |
| Mammary ductogram or galactogram single (77053) |
$584 |
$2,336 |
2.4× |
| Meckels Diverticulum (78290) |
$486 |
$1,943 |
1.2× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$158 |
$633 |
0.4× |
| MRA head w & w/o contrast (70546) |
$453 |
$1,812 |
1.3× |
| MRA head w/o contrast (70544) |
$289 |
$1,155 |
1.2× |
| MRA head with contrast (70545) |
$453 |
$1,812 |
1.3× |
| MRA neck w contrast (70548) |
$1,028 |
$4,112 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$453 |
$1,812 |
1.3× |
| MRA neck w/o contrast (70547) |
$289 |
$1,155 |
1.2× |
| MRI abdomen w contrast (74182) |
$659.50 |
$2,638 |
1.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$453 |
$1,812 |
1.3× |
| MRI abdomen w/o contrast (74181) |
$289 |
$1,155 |
1.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,347 |
$5,388.50 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,299.50 |
$5,197.50 |
1.7× |
| MRI breast w/o contrast bilateral (77047) |
$289 |
$1,155 |
1.2× |
| MRI breast w/o contrast unilat (77046) |
$186.50 |
$744.50 |
0.8× |
| MRI c-spine with contrast (72142) |
$453 |
$1,812 |
1.3× |
| MRI cervical spine w/o contrast (72141) |
$289 |
$1,155 |
1.2× |
| MRI chest w/o & w/contrast material (71552) |
$453 |
$1,812 |
1.3× |
| MRI chest w/o contrast (71550) |
$289 |
$1,155 |
1.2× |
| MRI chest with contrast (71551) |
$805.50 |
$3,223 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$453 |
$1,812 |
1.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,054.50 |
$4,217 |
3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$761 |
$3,043 |
3.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$289 |
$1,155 |
1.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$453 |
$1,812 |
1.3× |
| MRI orbit/face/neck w/contrast (70542) |
$453 |
$1,812 |
1.3× |
| MRI pelvis w contrast (72196) |
$453 |
$1,812 |
1.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$453 |
$1,812 |
1.3× |
| MRI pelvis w/o contrast (72195) |
$289 |
$1,155 |
1.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,227 |
$4,908.50 |
3.5× |
| MRI scan of leg joint before and after contrast (73723) |
$1,227 |
$4,908.50 |
3.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$453 |
$1,812 |
1.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$453 |
$1,812 |
1.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$453 |
$1,812 |
1.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$453 |
$1,812 |
1.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$453 |
$1,812 |
1.3× |
| MRI thoracic spine w/o contrast (72146) |
$289 |
$1,155 |
1.2× |
| MRI tmj (70336) |
$289 |
$584 |
1.2× |
| MRI upper ext joint w/o contrast (73221) |
$810 |
$3,240 |
3.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,116 |
$4,463.50 |
3.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$761 |
$3,043 |
3.2× |
| Myelogram Cervical (72240) |
$573 |
$2,293 |
0.7× |
| Myelogram Lumbar (72265) |
$573 |
$2,293 |
0.7× |
| Myelogram thoracic (72255) |
$573 |
$2,293 |
0.7× |
| Myelography 2 or more regions (72270) |
$573 |
$2,293 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,329 |
$5,316 |
1.0× |
| Neck soft tissue (70360) |
$107 |
$428 |
1.2× |
| Nm cisternogram (78630) |
$472 |
$1,888 |
0.9× |
| Nm gastric emptying study (78264) |
$486 |
$1,943 |
1.2× |
| Nm gastroesophageal reflux study (78262) |
$573 |
$2,291 |
1.4× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,329 |
$5,316 |
1.0× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$245 |
$978 |
0.6× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$341 |
$1,362 |
0.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$119 |
$475 |
1.1× |
| Osseous survey infant (77076) |
$130 |
$518 |
1.2× |
| Osseous survey limited (77074) |
$130 |
$518 |
1.2× |
| Parathyroid imaging (78070) |
$420 |
$1,680 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$107 |
$429 |
1.0× |
| Peritoneogram rs&i (74190) |
$686 |
$2,742 |
1.2× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$3 |
$7.50 |
0.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,102 |
$4,408 |
3.1× |
| Pr red cell survival study (78130) |
$15 |
$60 |
0.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,348 |
$5,391 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$481 |
$1,925 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$339 |
$1,356 |
0.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$338 |
$1,350 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$107 |
$428 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$130 |
$518 |
1.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$100 |
$400 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$102 |
$406 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$130 |
$518 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$130 |
$518 |
1.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$107 |
$428 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$130 |
$518 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$93 |
$373 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$217 |
$866 |
1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$217 |
$866 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$217 |
$866 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$99 |
$397 |
1.1× |
| Radiological examination surgical specimen (76098) |
$202 |
$806 |
0.4× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
— |
$2 |
— |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$3 |
$7 |
0.0× |
| Ribs bilateral 3 views (71110) |
$130 |
$518 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$486 |
$1,943 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$560.50 |
$2,242.50 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$761 |
$3,042 |
1.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,272 |
$5,088 |
1.0× |
| Sacroiliac Joints < 3 Views (72200) |
$126 |
$502 |
1.2× |
| Scanogram (77073) |
$130 |
$518 |
1.2× |
| Scapula complete (73010) |
$142.50 |
$568 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$36 |
$142 |
1.5× |
| Sella turcica (70240) |
$107 |
$428 |
1.2× |
| Sialogram (70390) |
$158 |
$633 |
0.7× |
| Small bowel series (74250) |
$217 |
$866 |
1.2× |
| Spine thoracic 3 views (72072) |
$130 |
$518 |
1.2× |
| Testicular Imaging With Vascular Flow (78761) |
$343 |
$1,370 |
0.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$396 |
$1,582 |
0.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$170 |
$681 |
0.4× |
| Thyroid uptake measurement (78012) |
$185 |
$741 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$259 |
$1,035 |
0.6× |
| Tomogram (76100) |
$131 |
$525 |
1.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,197 |
$4,786 |
2.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$396 |
$1,582 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$130 |
$518 |
1.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$85 |
$340 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$53 |
$213 |
0.6× |
| Upper Extremity Infant (73092) |
$130.50 |
$521 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$243 |
$972 |
1.0× |
| Urethrocystography voiding (74455) |
$289 |
$1,155 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$217 |
$866 |
1.2× |
| Us abdl aorta screen aaa (76706) |
$130 |
$518 |
1.2× |
| Us breast unilateral complete (76641) |
$130 |
$518 |
1.2× |
| Us breast unilateral limited (76642) |
$107 |
$428 |
1.2× |
| Us chest (76604) |
$76 |
$303 |
0.7× |
| Us compl joint r-t w/image documentation (76881) |
$130 |
$518 |
1.2× |
| Us guided compression repair (76936) |
$168 |
$673 |
0.8× |
| Us infant hips dynamic (76885) |
$67 |
$268 |
0.8× |
| Us ob detailed single fetus (76811) |
$191 |
$763 |
0.8× |
| Us ob transvaginal (76817) |
$210.50 |
$841 |
2.0× |
| Us pelvic non ob complete (76856) |
$130 |
$518 |
1.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$134 |
$534 |
1.3× |
| Us pregnancy ltd (76815) |
$130 |
$518 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$130 |
$518 |
1.2× |
| Us retroperitoneal complete (76770) |
$130 |
$518 |
1.2× |
| Us retroperitoneal limited (76775) |
$130 |
$518 |
1.2× |
| Us scrotum and contents (76870) |
$255.50 |
$1,021 |
2.4× |
| Us soft tissue head/neck (76536) |
$130 |
$518 |
1.2× |
| Us spinal canal and contents (76800) |
$82 |
$327 |
0.8× |
| Us transrectal (76872) |
$169 |
$675 |
1.6× |
| Us xtr non-vasc lmtd (76882) |
$130 |
$518 |
1.2× |
| Venogram extremity bilateral (75822) |
$530 |
$2,121 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$742 |
$2,966 |
0.2× |
| Venography caval superior serialography rs&i (75827) |
$487 |
$1,947 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$440 |
$1,759 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$1,260 |
$5,039 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$742 |
$2,966 |
0.2× |
| Wrist 2 views (73100) |
$176.50 |
$706.50 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$130 |
$518 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$102 |
$406 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$171 |
$683 |
2.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$217 |
$866 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$154 |
$615 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$158.50 |
$633.50 |
1.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$130 |
$518 |
1.2× |
| X-ray exam hip uni 1 view (73501) |
$99 |
$397 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$100 |
$400 |
1.1× |
| X-ray exam hip uni 4/> views (73503) |
$141.50 |
$564.50 |
1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$130 |
$518 |
1.2× |
| X-ray exam of femur 1 (73551) |
$99 |
$397 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$130 |
$518 |
1.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$107 |
$428 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$179 |
$715 |
2.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$139.50 |
$557 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$107 |
$428 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$229 |
$915.50 |
2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$107 |
$428 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$107 |
$428 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$130 |
$518 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$130 |
$518 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$107 |
$428 |
1.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$47 |
$189 |
0.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$130 |
$518 |
1.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$130 |
$518 |
1.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$314 |
$1,254 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$140.50 |
$561.50 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$130 |
$518 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$130 |
$518 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$130 |
$518 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$107 |
$428 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$179 |
$716.50 |
2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$107 |
$428 |
1.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$107 |
$428 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$130 |
$518 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$130 |
$518 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$107 |
$428 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$107 |
$428 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$107 |
$428 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$130 |
$518 |
1.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$130 |
$518 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$142 |
$568 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$256 |
$1,022 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$130 |
$518 |
1.2× |
| Xr Cholecystography Oral Contrast (74290) |
$153 |
$613 |
0.9× |
| Xr finger(s) 2+ views (73140) |
$133.50 |
$534.50 |
1.5× |
| Xr shoulder 1 view (73020) |
$176.50 |
$706 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$130 |
$518 |
1.2× |
| Xr tibia/fibula 2 views (73590) |
$107 |
$428 |
1.2× |
| Xr tmj bilateral (70330) |
$81 |
$323 |
0.9× |
| Xray knee 1 or 2 views rt (73560) |
$127.50 |
$510 |
1.5× |