| Abdomen 2 views (74019) |
$133.60 |
$668 |
1.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$251.20 |
$1,256 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$925.20 |
$4,626 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$817.20 |
$4,086 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,081.40 |
$5,407 |
0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,081.40 |
$5,407 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,508.60 |
$7,543 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,081.40 |
$5,407 |
0.4× |
| Ankle 2 views (73600) |
$119.20 |
$596 |
1.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$241.80 |
$1,209 |
0.7× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,508.60 |
$7,543 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$872.20 |
$4,361 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$817.20 |
$4,086 |
0.3× |
| Arthrogram hip (73525) |
$187 |
$935 |
0.6× |
| Arthrogram shoulder (73040) |
$191.40 |
$957 |
0.6× |
| Arthrogram wrist (73115) |
$162.60 |
$813 |
0.5× |
| Arthrography knee lt (73580) |
$230.40 |
$1,152 |
0.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$194.40 |
$972 |
0.5× |
| Bone &/joint imaging whole body (78306) |
$254.40 |
$1,272 |
0.7× |
| Bone age studies (77072) |
$64.80 |
$324 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$288.60 |
$1,443 |
0.8× |
| Bone survey complete (77075) |
$178.80 |
$894 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$743.40 |
$3,717 |
0.5× |
| Brain Imaging Vascular Flow Only (78610) |
$204.60 |
$1,023 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$154.80 |
$774 |
1.8× |
| Chest 1 view (71045) |
$51.80 |
$259 |
0.6× |
| Chest 3 views (71047) |
$156.40 |
$782 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$137.40 |
$687 |
0.8× |
| Clavicle complete (73000) |
$142 |
$710 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$107.80 |
$539 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,651.60 |
$8,258 |
4.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,279.40 |
$6,397 |
5.6× |
| CT abdomen w contrast (74160) |
$505.40 |
$2,527 |
3.0× |
| CT abdomen w wo contrast (74170) |
$631.60 |
$3,158 |
3.7× |
| CT abdomen w/o contrast (74150) |
$404.20 |
$2,021 |
4.0× |
| CT angio hrt w/3d image (75574) |
$303.40 |
$1,517 |
0.9× |
| CT angiography upper extremity lt (73206) |
$158.80 |
$794 |
0.9× |
| CT c-spine w/o contrast (72125) |
$546.20 |
$2,731 |
5.4× |
| CT cervical spine w&w/o contrast (72127) |
$853.60 |
$4,268 |
5.1× |
| CT cervical spine with contrast (72126) |
$682.80 |
$3,414 |
2.0× |
| CT chest w/wo contrast (71270) |
$653.80 |
$3,269 |
3.9× |
| CT chest with contrast (71260) |
$523 |
$2,615 |
3.1× |
| CT head/brain with contrast (70460) |
$744 |
$3,720 |
4.4× |
| CT head/brain without and with contrast (70470) |
$831.60 |
$4,158 |
4.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$33.60 |
$168 |
0.4× |
| CT iac w contrast (70481) |
$508 |
$2,540 |
3.0× |
| CT limited/localized follow up study (76380) |
$162.20 |
$811 |
1.9× |
| CT lower ext w/o (73700) |
$873.90 |
$4,369.50 |
8.7× |
| CT lower extremity w wo contrast (73702) |
$1,015.40 |
$5,077 |
6.0× |
| CT lower extremity with contrast (73701) |
$976 |
$4,880 |
5.8× |
| CT lumbar spine w & w/o contrast (72133) |
$722 |
$3,610 |
4.3× |
| CT lumbar spine w/o contrast (72131) |
$462 |
$2,310 |
4.6× |
| CT lumbar spine with contrast (72132) |
$577.60 |
$2,888 |
1.7× |
| CT maxillofacial w contrast (70487) |
$906.60 |
$4,533 |
5.4× |
| CT maxillofacial w/o contrast (70486) |
$764.40 |
$3,822 |
7.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,146 |
$5,730 |
6.8× |
| CT neck soft tissue w contrast (70491) |
$935.20 |
$4,676 |
5.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$592.40 |
$2,962 |
3.5× |
| CT orbits w/o contrast (70480) |
$396.80 |
$1,984 |
3.9× |
| CT pelvis w & w/o contrast (72194) |
$586.80 |
$2,934 |
3.5× |
| CT pelvis w/o contrast (72192) |
$375.60 |
$1,878 |
3.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,089 |
$5,445 |
6.5× |
| CT soft tissue neck w/o contrast (70490) |
$808.20 |
$4,041 |
8.0× |
| CT thoracic spine w/contrast (72129) |
$479.20 |
$2,396 |
2.8× |
| CT thoracic spine w/o contrast (72128) |
$383.40 |
$1,917 |
3.8× |
| CT thoracic spine w/wo contrast (72130) |
$599 |
$2,995 |
3.6× |
| CT thorax w/o contrast (71250) |
$418.40 |
$2,092 |
4.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$597.40 |
$2,987 |
3.5× |
| CT upper extremity w/o contrast rt (73200) |
$382.20 |
$1,911 |
3.8× |
| CT upper extremity with contrast (73201) |
$478 |
$2,390 |
1.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$481.40 |
$2,407 |
2.9× |
| Cta Abdomen (74175) |
$514.40 |
$2,572 |
3.0× |
| CTA abdomen pelvis (74174) |
$650.20 |
$3,251 |
1.9× |
| CTA chest (71275) |
$858.80 |
$4,294 |
5.1× |
| Cta Head (70496) |
$510.60 |
$2,553 |
3.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$424.40 |
$2,122 |
1.3× |
| CTA lwr ext w&w/o contrast (73706) |
$642.60 |
$3,213 |
3.8× |
| Cta Neck (70498) |
$520.40 |
$2,602 |
3.1× |
| Cta Pelvis (72191) |
$442.80 |
$2,214 |
2.6× |
| Cystography minimum 3 views rs&i (74430) |
$190.80 |
$954 |
0.6× |
| Diskography lumbar (72295) |
$1,264.20 |
$6,321 |
0.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$51.20 |
$256 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$83.40 |
$417 |
0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$47.80 |
$239 |
0.6× |
| Echoencephalography real time imaging (76506) |
$131.40 |
$657 |
1.3× |
| Esophagus (74220) |
$245.60 |
$1,228 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$212 |
$1,060 |
2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$80.80 |
$404 |
0.8× |
| Fluoroscopy up to 1 hr (76000) |
$102.20 |
$511 |
0.4× |
| Foot 2 views (73620) |
$113.20 |
$566 |
1.4× |
| Forearm 2 views (73090) |
$140.70 |
$703.50 |
1.7× |
| Gated Heart Planar Single (78472) |
$193.80 |
$969 |
0.5× |
| Hand 2 views (73120) |
$129 |
$645 |
1.3× |
| Hand 3 views (73130) |
$221.70 |
$1,108.50 |
2.6× |
| Heart Infarct Image (78466) |
$156.40 |
$782 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$542.60 |
$2,713 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$278.60 |
$1,393 |
0.7× |
| Ht muscle image spect sing (78451) |
$536.60 |
$2,683 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$77.20 |
$386 |
0.9× |
| Hysterosalpingogram (74740) |
$252.60 |
$1,263 |
1.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$56.60 |
$283 |
0.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$340.80 |
$1,704 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$340.80 |
$1,704 |
0.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$452.20 |
$2,261 |
0.9× |
| Knee 3 views (73562) |
$95.20 |
$476 |
1.1× |
| Liver & spleen imaging static only (78215) |
$160.20 |
$801 |
0.4× |
| Lung perf&ventilat diferentl (78598) |
$408.80 |
$2,044 |
0.8× |
| Lung Ventilation Imaging (78579) |
$252.60 |
$1,263 |
0.7× |
| Lymphoscintigraphy (78195) |
$574.80 |
$2,874 |
1.1× |
| Meckels Diverticulum (78290) |
$144.80 |
$724 |
0.4× |
| MRA head w & w/o contrast (70546) |
$790.40 |
$3,952 |
2.4× |
| MRA head w/o contrast (70544) |
$505.80 |
$2,529 |
2.2× |
| MRA head with contrast (70545) |
$632.40 |
$3,162 |
1.9× |
| MRA neck w contrast (70548) |
$588 |
$2,940 |
1.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$705.80 |
$3,529 |
2.1× |
| MRA neck w/o contrast (70547) |
$470.40 |
$2,352 |
2.0× |
| MRI abdomen w contrast (74182) |
$723 |
$3,615 |
2.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$903.80 |
$4,519 |
2.7× |
| MRI abdomen w/o contrast (74181) |
$561.60 |
$2,808 |
2.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,081.60 |
$5,408 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,084.20 |
$5,421 |
1.4× |
| MRI c-spine with contrast (72142) |
$718 |
$3,590 |
2.1× |
| MRI cervical spine w/o contrast (72141) |
$574.20 |
$2,871 |
2.5× |
| MRI chest w/o & w/contrast material (71552) |
$505.60 |
$2,528 |
1.5× |
| MRI chest w/o contrast (71550) |
$323.60 |
$1,618 |
1.4× |
| MRI chest with contrast (71551) |
$404.40 |
$2,022 |
0.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$907.40 |
$4,537 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$532.20 |
$2,661 |
1.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$425.60 |
$2,128 |
1.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$656.60 |
$3,283 |
2.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,026 |
$5,130 |
3.1× |
| MRI orbit/face/neck w/contrast (70542) |
$820.80 |
$4,104 |
2.4× |
| MRI pelvis w contrast (72196) |
$580.60 |
$2,903 |
1.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$725.80 |
$3,629 |
2.2× |
| MRI pelvis w/o contrast (72195) |
$464.60 |
$2,323 |
2.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,355.40 |
$6,777 |
4.0× |
| MRI scan of leg joint before and after contrast (73723) |
$1,352 |
$6,760 |
4.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$897.60 |
$4,488 |
2.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,020 |
$5,100 |
3.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,108 |
$5,540 |
3.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$687.40 |
$3,437 |
2.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$859.20 |
$4,296 |
2.6× |
| MRI thoracic spine w/o contrast (72146) |
$549.80 |
$2,749 |
2.4× |
| MRI tmj (70336) |
$560.40 |
$2,802 |
2.4× |
| MRI upper ext joint w/o contrast (73221) |
$867.40 |
$4,337 |
3.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,134.20 |
$5,671 |
3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$726 |
$3,630 |
3.2× |
| Myocardial infarct spect (78469) |
$464 |
$2,320 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$627.40 |
$3,137 |
0.5× |
| Neck soft tissue (70360) |
$103.60 |
$518 |
1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$145.60 |
$728 |
0.4× |
| Nm bone marrow wb (78104) |
$366.40 |
$1,832 |
1.0× |
| Nm gastric emptying study (78264) |
$206.40 |
$1,032 |
0.5× |
| Nuclear medicine study of kidney and blood flow (78701) |
$232 |
$1,160 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$259.60 |
$1,298 |
1.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$84.20 |
$421 |
0.8× |
| Osseous survey infant (77076) |
$56.60 |
$283 |
0.6× |
| Osseous survey limited (77074) |
$104 |
$520 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$524.40 |
$2,622 |
1.4× |
| Parathyroid imaging (78070) |
$150.40 |
$752 |
0.4× |
| Pelvis 1 or 2 views (72170) |
$58.20 |
$291 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$816.40 |
$4,082 |
0.6× |
| PET imaging CT for attenuation limited area (78814) |
$736.60 |
$3,683 |
0.5× |
| PET imaging for CT attenuation whole body (78816) |
$826 |
$4,130 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$665.20 |
$3,326 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$313.60 |
$1,568 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$436.60 |
$2,183 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$216.40 |
$1,082 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$58.60 |
$293 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$173 |
$865 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$162.60 |
$813 |
1.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$98.60 |
$493 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$313 |
$1,565 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$180.60 |
$903 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$99.80 |
$499 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$154.60 |
$773 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$142.20 |
$711 |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$177.60 |
$888 |
1.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$454 |
$2,270 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$261.80 |
$1,309 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$159.70 |
$798.50 |
1.9× |
| Radiological examination surgical specimen (76098) |
$110.40 |
$552 |
0.2× |
| Ribs bilateral 3 views (71110) |
$98.80 |
$494 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$756.40 |
$3,782 |
1.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$756.40 |
$3,782 |
0.6× |
| Sacroiliac Joints < 3 Views (72200) |
$115.80 |
$579 |
1.2× |
| Scanogram (77073) |
$87 |
$435 |
0.9× |
| Scapula complete (73010) |
$118 |
$590 |
1.2× |
| Screening digital breast tomosynthesis (77063) |
$20 |
$100 |
0.9× |
| Small bowel series (74250) |
$146.60 |
$733 |
0.9× |
| Spine thoracic 3 views (72072) |
$104 |
$520 |
1.0× |
| Thoracolumbar 2 views (72080) |
$97 |
$485 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$377.20 |
$1,886 |
1.0× |
| Tmj unilateral (70328) |
$41.60 |
$208 |
0.5× |
| Ultrasound, abdomen limited (76705) |
$219.40 |
$1,097 |
2.2× |
| Umbilical-artery Doppler (OB) (76820) |
$53.40 |
$267 |
0.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$102.20 |
$511 |
1.2× |
| Unlisted Ultrasound Procedure (76999) |
$91.40 |
$457 |
1.1× |
| Upper Extremity Infant (73092) |
$117.20 |
$586 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$239.60 |
$1,198 |
1.0× |
| Urethrocystography voiding (74455) |
$164.80 |
$824 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$215.60 |
$1,078 |
1.3× |
| Us abdl aorta screen aaa (76706) |
$97.60 |
$488 |
1.0× |
| Us breast unilateral complete (76641) |
$234.30 |
$1,171.50 |
2.3× |
| Us breast unilateral limited (76642) |
$220.90 |
$1,104.50 |
2.6× |
| Us chest (76604) |
$87.60 |
$438 |
0.9× |
| Us compl joint r-t w/image documentation (76881) |
$130.20 |
$651 |
1.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$69 |
$345 |
0.7× |
| Us infant hips dynamic (76885) |
$62.60 |
$313 |
0.7× |
| Us kidney transplant (76776) |
$189.60 |
$948 |
1.9× |
| Us ob transvaginal (76817) |
$69.40 |
$347 |
0.7× |
| Us pelvic non ob complete (76856) |
$243.80 |
$1,219 |
2.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$135.40 |
$677 |
1.3× |
| Us pregnancy ltd (76815) |
$60.60 |
$303 |
0.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$185.80 |
$929 |
1.8× |
| Us retroperitoneal complete (76770) |
$91.60 |
$458 |
0.9× |
| Us retroperitoneal limited (76775) |
$80 |
$400 |
0.8× |
| Us scrotum and contents (76870) |
$226 |
$1,130 |
2.2× |
| Us soft tissue head/neck (76536) |
$218 |
$1,090 |
2.2× |
| Us spinal canal and contents (76800) |
$191.60 |
$958 |
1.9× |
| Us transrectal (76872) |
$75.80 |
$379 |
0.8× |
| Us xtr non-vasc lmtd (76882) |
$113.20 |
$566 |
1.1× |
| Venogram extremity bilateral (75822) |
$449.20 |
$2,246 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$817.20 |
$4,086 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$308.80 |
$1,544 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$277 |
$1,385 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,865.80 |
$9,329 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$26.20 |
$131 |
0.3× |
| Wrist 2 views (73100) |
$56.20 |
$281 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$176.40 |
$882 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$63.80 |
$319 |
0.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$144.30 |
$721.50 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$250.60 |
$1,253 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$97.80 |
$489 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$173.90 |
$869.50 |
2.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$269.20 |
$1,346 |
2.7× |
| X-ray exam hip uni 1 view (73501) |
$39.60 |
$198 |
0.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$46.80 |
$234 |
0.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$206.60 |
$1,033 |
2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$250.20 |
$1,251 |
2.5× |
| X-ray eye for foreign body (70030) |
$138.80 |
$694 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$192.20 |
$961 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$67 |
$335 |
0.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$164 |
$820 |
2.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$90.10 |
$450.50 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$101.60 |
$508 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$190.10 |
$950.50 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$86 |
$430 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$40.40 |
$202 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$194.60 |
$973 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$237.60 |
$1,188 |
2.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$204.40 |
$1,022 |
2.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$129.40 |
$647 |
1.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$47 |
$235 |
0.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$56.60 |
$283 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$67.60 |
$338 |
0.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$284.40 |
$1,422 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$86.60 |
$433 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$97.20 |
$486 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$183.80 |
$919 |
1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$137.60 |
$688 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$72.60 |
$363 |
0.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$143.10 |
$715.50 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$161.80 |
$809 |
1.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$34.80 |
$174 |
0.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$171.20 |
$856 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$136.20 |
$681 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$100.20 |
$501 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$72.20 |
$361 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$66 |
$330 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$99.20 |
$496 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$122.40 |
$612 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$76.60 |
$383 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$81.70 |
$408.50 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$225.20 |
$1,126 |
2.2× |
| Xr chest 4+ views (71048) |
$172 |
$860 |
1.7× |
| Xr Cholecystography Oral Contrast (74290) |
$156 |
$780 |
0.9× |
| Xr finger(s) 2+ views (73140) |
$60.40 |
$302 |
0.7× |
| Xr shoulder 1 view (73020) |
$133.70 |
$668.50 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$204.60 |
$1,023 |
2.0× |
| Xr tibia/fibula 2 views (73590) |
$128.50 |
$642.50 |
1.5× |
| Xr tmj bilateral (70330) |
$73 |
$365 |
0.9× |
| Xray knee 1 or 2 views rt (73560) |
$55.80 |
$279 |
0.7× |