| Abdomen 2 views (74019) |
— |
$524.90 |
— |
| Acute gastrointestinal blood loss imaging (78278) |
— |
$5,005.15 |
— |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
— |
$4,317.90 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$4,054.35 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$3,895.05 |
— |
| Angiography internal mammary rs&i (75756) |
— |
$7,599.45 |
— |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
— |
$12,001.70 |
— |
| Angiography pulmonary bilateral slctv rs&i (75743) |
— |
$9,817.20 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$6,544.80 |
— |
| Angiography Spinal Selective Rs&I (75705) |
— |
$12,633.40 |
— |
| Angiography visceral slctv/supraslctv rs&i (75726) |
— |
$7,603.35 |
— |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
— |
$3,332.10 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$3,286.40 |
— |
| Ankle 2 views (73600) |
— |
$376.95 |
— |
| Antegrade urography radiological supvj & interpj (74425) |
— |
$1,687.50 |
— |
| Aortogram thoracic (75605) |
— |
$12,633.40 |
— |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
— |
$7,979.45 |
— |
| Aortography abdominal serialography rs&i (75625) |
— |
$7,599.45 |
— |
| Artery X-Rays Adrenal Gland (75731) |
— |
$3,286.40 |
— |
| Arthrogram hip (73525) |
— |
$1,396.30 |
— |
| Arthrogram shoulder (73040) |
— |
$1,450.10 |
— |
| Arthrogram wrist (73115) |
— |
$1,516.45 |
— |
| Arthrography knee lt (73580) |
— |
$1,816.30 |
— |
| Bone &/Joint Imaging Limited Area (78300) |
— |
$2,428.95 |
— |
| Bone &/joint imaging whole body (78306) |
— |
$6,799.50 |
— |
| Bone age studies (77072) |
— |
$693 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$5,483.25 |
— |
| Bone survey complete (77075) |
— |
$3,092.95 |
— |
| Brain image w/flow 4 + views (78606) |
— |
$4,774.30 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$9,378.95 |
— |
| Cervical spine 2 or 3 views (72040) |
— |
$376.95 |
— |
| Chest 1 view (71045) |
— |
$417.85 |
— |
| Chest 3 views (71047) |
— |
$566.80 |
— |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
— |
$920.15 |
— |
| Clavicle complete (73000) |
— |
$445.75 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$887.75 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$1,581.20 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$8,983.15 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$4,308.05 |
— |
| CT abdomen w contrast (74160) |
— |
$3,889.25 |
— |
| CT abdomen w wo contrast (74170) |
— |
$4,663.65 |
— |
| CT abdomen w/o contrast (74150) |
— |
$3,379.45 |
— |
| CT angio hrt w/3d image (75574) |
— |
$2,809.85 |
— |
| CT angiography upper extremity lt (73206) |
— |
$2,141.25 |
— |
| CT c-spine w/o contrast (72125) |
— |
$2,489.40 |
— |
| CT cervical spine w&w/o contrast (72127) |
— |
$3,062.25 |
— |
| CT cervical spine with contrast (72126) |
— |
$2,905.20 |
— |
| CT chest w/wo contrast (71270) |
— |
$3,253.65 |
— |
| CT chest with contrast (71260) |
— |
$3,190.65 |
— |
| CT head/brain with contrast (70460) |
— |
$2,380.25 |
— |
| CT head/brain without and with contrast (70470) |
— |
$3,313.65 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$3,062.90 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$887.90 |
— |
| CT iac w contrast (70481) |
— |
$1,849.45 |
— |
| CT limited/localized follow up study (76380) |
— |
$966.40 |
— |
| CT lower ext w/o (73700) |
— |
$1,147.45 |
— |
| CT lower extremity w wo contrast (73702) |
— |
$2,600 |
— |
| CT lower extremity with contrast (73701) |
— |
$2,457.15 |
— |
| CT lumbar spine w & w/o contrast (72133) |
— |
$2,326.55 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$1,338.20 |
— |
| CT lumbar spine with contrast (72132) |
— |
$1,916.90 |
— |
| CT maxillofacial w contrast (70487) |
— |
$2,361.95 |
— |
| CT maxillofacial w/o contrast (70486) |
— |
$1,796.20 |
— |
| CT maxillofacial w/wo contrast (70488) |
— |
$2,467.95 |
— |
| CT neck soft tissue w contrast (70491) |
— |
$2,139.20 |
— |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
— |
$2,069.05 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,832.90 |
— |
| CT pelvis w & w/o contrast (72194) |
— |
$2,841.10 |
— |
| CT pelvis w/o contrast (72192) |
— |
$2,468.45 |
— |
| CT soft tissue neck w/o & w/contrast material (70492) |
— |
$2,917.40 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,288 |
— |
| CT thoracic spine w/contrast (72129) |
— |
$2,176.85 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$2,077.45 |
— |
| CT thoracic spine w/wo contrast (72130) |
— |
$2,284.60 |
— |
| CT thorax w/o contrast (71250) |
— |
$2,777.10 |
— |
| CT unlisted procedure (76497) |
— |
$4,420.40 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$2,101.85 |
— |
| CT upper extremity w/o contrast rt (73200) |
— |
$1,734.35 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,001.95 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$2,116.80 |
— |
| Cta Abdomen (74175) |
— |
$3,768.05 |
— |
| CTA abdomen pelvis (74174) |
— |
$6,822.80 |
— |
| CTA chest (71275) |
— |
$3,754.60 |
— |
| Cta Head (70496) |
— |
$3,191.20 |
— |
| CTA lwr ext w&w/o contrast (73706) |
— |
$2,371.15 |
— |
| Cta Neck (70498) |
— |
$3,191.20 |
— |
| Cta Pelvis (72191) |
— |
$2,420.50 |
— |
| Cystography minimum 3 views rs&i (74430) |
— |
$737.85 |
— |
| Diskogram cervical (72285) |
— |
$4,781.45 |
— |
| Diskography lumbar (72295) |
— |
$5,033.10 |
— |
| Echoencephalography real time imaging (76506) |
— |
$2,254.70 |
— |
| Esophagus (74220) |
— |
$904.55 |
— |
| Fetal biophysical profile non-stress testing (76818) |
— |
$2,295.75 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$1,678.20 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$1,788.25 |
— |
| Foot 2 views (73620) |
— |
$372.75 |
— |
| Forearm 2 views (73090) |
— |
$376.95 |
— |
| Gated Heart Planar Single (78472) |
— |
$3,490.05 |
— |
| Hand 2 views (73120) |
— |
$359.60 |
— |
| Hand 3 views (73130) |
— |
$461.95 |
— |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
— |
$5,256.40 |
— |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
— |
$6,645.10 |
— |
| Hepatobiliary syst imaging including gallbladder (78226) |
— |
$4,619.40 |
— |
| Ht muscle image spect sing (78451) |
— |
$5,076.05 |
— |
| Humerus Min 2 Views Left (73060) |
— |
$376.95 |
— |
| Hyperthermia ntrstl prb 5/< (77610) |
— |
$1,804.80 |
— |
| Hysterosalpingogram (74740) |
— |
$798.75 |
— |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
— |
$2,314.25 |
— |
| Kidney img morphology vascular flow 1 w/rx (78708) |
— |
$2,461.35 |
— |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
— |
$3,020.35 |
— |
| Knee 3 views (73562) |
— |
$479.70 |
— |
| Liver & spleen imaging static only (78215) |
— |
$2,225.60 |
— |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
— |
$2,233.90 |
— |
| Liver imaging w/vascular flow (78202) |
— |
$2,947.75 |
— |
| Lung perfusion differential (78597) |
— |
$2,401.80 |
— |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
— |
$3,287.75 |
— |
| Lymphoscintigraphy (78195) |
— |
$4,167.60 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$1,706.50 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$1,251.15 |
— |
| Meckels Diverticulum (78290) |
— |
$3,224.65 |
— |
| MRA head w & w/o contrast (70546) |
— |
$5,301.80 |
— |
| MRA head w/o contrast (70544) |
— |
$3,248.75 |
— |
| MRA neck w contrast (70548) |
— |
$3,701.15 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$5,045.50 |
— |
| MRA neck w/o contrast (70547) |
— |
$3,248.75 |
— |
| MRI abdomen w contrast (74182) |
— |
$1,867.90 |
— |
| MRI abdomen w/o & w/contrast material (74183) |
— |
$4,410.35 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$1,746.20 |
— |
| MRI any jnt lwr ext with con lt (73722) |
— |
$2,915.75 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$2,915.75 |
— |
| MRI bone marrow blood supply (77084) |
— |
$3,534.65 |
— |
| MRI breast w/o contrast bilateral (77047) |
— |
$3,435.15 |
— |
| MRI breast w/o contrast unilat (77046) |
— |
$2,558.70 |
— |
| MRI c-spine with contrast (72142) |
— |
$3,280.25 |
— |
| MRI cervical spine w/o contrast (72141) |
— |
$3,094.95 |
— |
| MRI chest w/o & w/contrast material (71552) |
— |
$2,604.70 |
— |
| MRI chest w/o contrast (71550) |
— |
$1,705.80 |
— |
| MRI chest with contrast (71551) |
— |
$1,909.15 |
— |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
— |
$2,499.20 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$1,941.25 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$1,779 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$2,321.05 |
— |
| MRI orbit/face/neck w&w/o cont (70543) |
— |
$4,666.90 |
— |
| MRI orbit/face/neck w/contrast (70542) |
— |
$2,502.30 |
— |
| MRI pelvis w contrast (72196) |
— |
$3,189.10 |
— |
| MRI pelvis w/o & w/contrast material (72197) |
— |
$4,776.60 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$3,084.75 |
— |
| MRI scan of arm joint before and after contrast (73223) |
— |
$4,208.15 |
— |
| MRI scan of leg joint before and after contrast (73723) |
— |
$4,777.45 |
— |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
— |
$4,410.35 |
— |
| MRI spinal canal lumbar w/contrast material (72149) |
— |
$3,359.55 |
— |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
— |
$4,410.35 |
— |
| MRI spinal canal thoracic w/contrast matrl (72147) |
— |
$3,359.55 |
— |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
— |
$5,177.80 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$3,284.80 |
— |
| MRI tmj (70336) |
— |
$1,325.55 |
— |
| MRI upper ext joint w/o contrast (73221) |
— |
$2,757.15 |
— |
| MRI upper extrem other than jt w/o & w/contras (73220) |
— |
$4,208.15 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$2,360.35 |
— |
| Myelogram thoracic (72255) |
— |
$2,066.30 |
— |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
— |
$9,239.05 |
— |
| Myocardial infarct spect (78469) |
— |
$6,414.60 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$8,731.05 |
— |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
— |
$4,996.60 |
— |
| Neck soft tissue (70360) |
— |
$361.05 |
— |
| Nm adrenal scan (78075) |
— |
$13,881.15 |
— |
| Nm cisternogram (78630) |
— |
$4,914.45 |
— |
| Nm gastric emptying study (78264) |
— |
$4,979.50 |
— |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
— |
$9,822.60 |
— |
| Nuclear medicine study from skull base to mid-thigh (78812) |
— |
$7,853.40 |
— |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
— |
$8,821.75 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$1,939.75 |
— |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
— |
$1,292.50 |
— |
| Osseous survey infant (77076) |
— |
$3,232.95 |
— |
| Osseous survey limited (77074) |
— |
$2,088.90 |
— |
| Parathyrd planar w/spect&CT (78072) |
— |
$3,849.90 |
— |
| Parathyrd planar w/wo subtrj (78071) |
— |
$2,270.15 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$507.70 |
— |
| Peritoneogram rs&i (74190) |
— |
$607.40 |
— |
| PET image w/CT, skull-thigh (78815) |
— |
$9,989.95 |
— |
| PET imaging CT for attenuation limited area (78814) |
— |
$8,054.75 |
— |
| PET imaging for CT attenuation whole body (78816) |
— |
$10,289.90 |
— |
| PET imaging limited area chest head/neck (78811) |
— |
$7,511 |
— |
| PET whole body (78813) |
— |
$8,054.75 |
— |
| Pr MRI brain w/ dye (70558) |
— |
$3,359.55 |
— |
| Pr MRI brain w/o & w/ dye (70559) |
— |
$4,410.35 |
— |
| Pr MRI brain w/o dye (70557) |
— |
$3,177.25 |
— |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
— |
$4,777.45 |
— |
| Proton trmt simple w/comp (77522) |
— |
$3,979.60 |
— |
| Proton tx delivery complex (77525) |
— |
$4,815.30 |
— |
| Proton tx delivery intermediate (77523) |
— |
$4,377.55 |
— |
| Proton tx delivery simple w/o compensation (77520) |
— |
$1,804.80 |
— |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
— |
$3,286.40 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$3,320.20 |
— |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
— |
$5,208 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$816.75 |
— |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
— |
$476 |
— |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
— |
$780.40 |
— |
| Radex hips bilateral with pelvis 2 views (73521) |
— |
$663.60 |
— |
| Radex mastoids compl minimum 3 views pr side (70130) |
— |
$762.60 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$530.50 |
— |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
— |
$376.95 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$537.40 |
— |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
— |
$557.70 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$2,088.90 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,566.95 |
— |
| Radiologic exam upr gi trc single contrast study (74240) |
— |
$1,488.60 |
— |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
— |
$376.95 |
— |
| Radiological examination surgical specimen (76098) |
— |
$1,878.55 |
— |
| Review by radiologist of adrenal gland vein image (75840) |
— |
$7,599.45 |
— |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
— |
$5,310.95 |
— |
| Ribs bilateral 3 views (71110) |
— |
$780 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$2,687.85 |
— |
| Rp loclzj tum spect 1 area single day imaging (78803) |
— |
$3,596.15 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$6,769.10 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$7,450.90 |
— |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
— |
$6,546.80 |
— |
| Rp therapy intra-arterial particulate admn (79445) |
— |
$1,569.55 |
— |
| Sacroiliac Joints < 3 Views (72200) |
— |
$278.98 |
— |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
— |
$2,243.55 |
— |
| Scanogram (77073) |
— |
$1,271.50 |
— |
| Scapula complete (73010) |
— |
$423.70 |
— |
| Screening digital breast tomosynthesis (77063) |
— |
$38.65 |
— |
| Sialogram (70390) |
— |
$1,978.42 |
— |
| Small bowel series (74250) |
— |
$1,567.65 |
— |
| Spine thoracic 3 views (72072) |
— |
$547.75 |
— |
| Splenoportograpy rs&i (75810) |
— |
$5,837.90 |
— |
| Superior sagittal sinus venogram (75870) |
— |
$3,286.40 |
— |
| Thoracolumbar 2 views (72080) |
— |
$516.55 |
— |
| Thyroid carcinoma metastases img whole body (78018) |
— |
$4,756.80 |
— |
| Thyroid uptake measurement (78012) |
— |
$914.95 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$1,897.85 |
— |
| Tmj unilateral (70328) |
— |
$415.55 |
— |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
— |
$22,543.05 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$1,468.75 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$790.80 |
— |
| Unlisted fluoroscopic procedure (76496) |
— |
$1,029.25 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$5,107.35 |
— |
| Upper Extremity Infant (73092) |
— |
$374.35 |
— |
| Urethrocystography retrograde rs&i (74450) |
— |
$905.60 |
— |
| Urethrocystography voiding (74455) |
— |
$967.25 |
— |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
— |
$1,036.35 |
— |
| Us abdl aorta screen aaa (76706) |
— |
$539.30 |
— |
| Us breast unilateral complete (76641) |
— |
$1,131.92 |
— |
| Us breast unilateral limited (76642) |
— |
$745.28 |
— |
| Us chest (76604) |
— |
$1,153.55 |
— |
| Us compl joint r-t w/image documentation (76881) |
— |
$858.75 |
— |
| Us kidney transplant (76776) |
— |
$2,306.95 |
— |
| Us ob detailed single fetus (76811) |
— |
$2,718.95 |
— |
| Us ob transvaginal (76817) |
— |
$1,468.75 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,958.20 |
— |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
— |
$1,444.35 |
— |
| Us pregnancy ltd (76815) |
— |
$1,395.30 |
— |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
— |
$1,468.75 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,529.95 |
— |
| Us retroperitoneal limited (76775) |
— |
$1,444.35 |
— |
| Us scrotum and contents (76870) |
— |
$1,468.75 |
— |
| Us soft tissue head/neck (76536) |
— |
$1,468.75 |
— |
| Us spinal canal and contents (76800) |
— |
$2,395.65 |
— |
| Us xtr non-vasc lmtd (76882) |
— |
$942.20 |
— |
| Us, eye b-scan (76512) |
— |
$862.85 |
— |
| Venogram extremity bilateral (75822) |
— |
$1,944.65 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$6,950.70 |
— |
| Venography caval superior serialography rs&i (75827) |
— |
$2,425.75 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$1,778.20 |
— |
| Venography Renal Bilateral (75833) |
— |
$9,817.20 |
— |
| Venography renal unilateral selective rs&i (75831) |
— |
$6,544.80 |
— |
| Venography venous sinus/jugular cath rs&i (75860) |
— |
$7,124.50 |
— |
| Venous sampling thru cath w/wo angiography rs& (75893) |
— |
$12,633.40 |
— |
| Wrist 2 views (73100) |
— |
$359.60 |
— |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
— |
$739.70 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$337.15 |
— |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
— |
$452.30 |
— |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
— |
$2,890.60 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$359.60 |
— |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
— |
$461.95 |
— |
| X-ray exam entire spi 4/5 vw (72083) |
— |
$834.10 |
— |
| X-ray exam hip uni 1 view (73501) |
— |
$530.60 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$540.70 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$750.75 |
— |
| X-ray exam of femur 1 (73551) |
— |
$372.75 |
— |
| X-ray eye for foreign body (70030) |
— |
$383.90 |
— |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
— |
$571.80 |
— |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
— |
$406 |
— |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
— |
$479.70 |
— |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
— |
$6,618.25 |
— |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
— |
$378 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$459.05 |
— |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
— |
$672.80 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$430.55 |
— |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
— |
$433.25 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$557.15 |
— |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
— |
$621.20 |
— |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
— |
$564.95 |
— |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
— |
$445.80 |
— |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
— |
$361.05 |
— |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
— |
$585.05 |
— |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
— |
$661.80 |
— |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
— |
$2,159.65 |
— |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
— |
$1,656.40 |
— |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
— |
$657.50 |
— |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
— |
$741.05 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$806 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$464.20 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$387.60 |
— |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
— |
$376.95 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$526.15 |
— |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
— |
$419.25 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$814.90 |
— |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
— |
$891.10 |
— |
| X-Ray Spine One View - Xr Spine (72020) |
— |
$358.80 |
— |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
— |
$500.35 |
— |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
— |
$423.70 |
— |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
— |
$507.70 |
— |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
— |
$593.15 |
— |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
— |
$325.40 |
— |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
— |
$461.95 |
— |
| Xr c-spine 6 or more views (72052) |
— |
$804.35 |
— |
| Xr chest 4+ views (71048) |
— |
$582.40 |
— |
| Xr finger(s) 2+ views (73140) |
— |
$376.95 |
— |
| XR Mastoids < 3 Views Bilateral (70120) |
— |
$486.30 |
— |
| Xr shoulder 1 view (73020) |
— |
$369.30 |
— |
| Xr spine cervical 4 or 5 views (72050) |
— |
$508.20 |
— |
| Xr tibia/fibula 2 views (73590) |
— |
$376.95 |
— |
| Xr tmj bilateral (70330) |
— |
$650.65 |
— |
| Xray knee 1 or 2 views rt (73560) |
— |
$409.25 |
— |