| Abdomen 2 views (74019) |
$46.50 |
$155 |
0.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$456.30 |
$1,521 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$2,253.30 |
$7,511 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,203.90 |
$4,013 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,253.30 |
$7,511 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,151.90 |
$7,173 |
0.4× |
| Ankle 2 views (73600) |
$42.90 |
$143 |
0.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$189.60 |
$632 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,151.90 |
$7,173 |
0.8× |
| Arthrogram elbow (73085) |
$262.80 |
$876 |
0.9× |
| Arthrogram hip (73525) |
$265.80 |
$886 |
0.9× |
| Arthrogram shoulder (73040) |
$295.80 |
$986 |
1.0× |
| Arthrogram wrist (73115) |
$255.60 |
$852 |
0.8× |
| Arthrography knee lt (73580) |
$346.50 |
$1,155 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$339 |
$1,130 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$393.90 |
$1,313 |
1.1× |
| Bone age studies (77072) |
$67.65 |
$225.50 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$435.90 |
$1,453 |
1.3× |
| Bone Marrow Imaging Limited Area (78102) |
$353.70 |
$1,179 |
1.0× |
| Bone survey complete (77075) |
$170.10 |
$567 |
1.9× |
| Cervical spine 2 or 3 views (72040) |
$29.10 |
$97 |
0.4× |
| Chest 1 view (71045) |
$87 |
$290 |
1.2× |
| Chest 3 views (71047) |
$109.95 |
$366.50 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$205.50 |
$685 |
1.4× |
| Clavicle complete (73000) |
$55.80 |
$186 |
0.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$45.60 |
$152 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$879 |
$2,930 |
2.9× |
| CT abdomen and pelvis without contrast (74176) |
$654 |
$2,180 |
3.2× |
| CT abdomen w contrast (74160) |
$862.20 |
$2,874 |
5.7× |
| CT abdomen w wo contrast (74170) |
$1,028.40 |
$3,428 |
6.8× |
| CT abdomen w/o contrast (74150) |
$532.95 |
$1,776.50 |
5.9× |
| CT angio hrt w/3d image (75574) |
$235.65 |
$785.50 |
0.8× |
| CT angiography upper extremity lt (73206) |
$365.10 |
$1,217 |
2.4× |
| CT c-spine w/o contrast (72125) |
$777.60 |
$2,592 |
8.6× |
| CT cervical spine w&w/o contrast (72127) |
$495.30 |
$1,651 |
3.3× |
| CT cervical spine with contrast (72126) |
$389.70 |
$1,299 |
1.3× |
| CT chest w/wo contrast (71270) |
$1,053 |
$3,510 |
7.0× |
| CT chest with contrast (71260) |
$777.60 |
$2,592 |
5.1× |
| CT colonography w/o cntrst (74261) |
$282 |
$940 |
3.1× |
| CT head/brain with contrast (70460) |
$322.80 |
$1,076 |
2.1× |
| CT head/brain without and with contrast (70470) |
$890.70 |
$2,969 |
5.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$37.50 |
$125 |
0.5× |
| CT iac w contrast (70481) |
$785.70 |
$2,619 |
5.2× |
| CT limited/localized follow up study (76380) |
$761.10 |
$2,537 |
10.1× |
| CT lower ext w/o (73700) |
$656.40 |
$2,188 |
7.3× |
| CT lower extremity w wo contrast (73702) |
$909.60 |
$3,032 |
6.0× |
| CT lower extremity with contrast (73701) |
$777.60 |
$2,592 |
5.1× |
| CT lumbar spine w & w/o contrast (72133) |
$366.60 |
$1,222 |
2.4× |
| CT lumbar spine w/o contrast (72131) |
$777.60 |
$2,592 |
8.6× |
| CT lumbar spine with contrast (72132) |
$459.60 |
$1,532 |
1.5× |
| CT maxillofacial w contrast (70487) |
$688.50 |
$2,295 |
4.6× |
| CT maxillofacial w/o contrast (70486) |
$559.80 |
$1,866 |
6.2× |
| CT maxillofacial w/wo contrast (70488) |
$856.80 |
$2,856 |
5.7× |
| CT neck soft tissue w contrast (70491) |
$688.50 |
$2,295 |
4.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$915.30 |
$3,051 |
6.1× |
| CT orbits w/o contrast (70480) |
$697.20 |
$2,324 |
7.7× |
| CT pelvis w & w/o contrast (72194) |
$1,004.40 |
$3,348 |
6.6× |
| CT pelvis w/o contrast (72192) |
$761.10 |
$2,537 |
8.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$915.30 |
$3,051 |
6.1× |
| CT soft tissue neck w/o contrast (70490) |
$697.20 |
$2,324 |
7.7× |
| CT thoracic spine w/contrast (72129) |
$550.35 |
$1,834.50 |
3.6× |
| CT thoracic spine w/o contrast (72128) |
$777.60 |
$2,592 |
8.6× |
| CT thoracic spine w/wo contrast (72130) |
$500.40 |
$1,668 |
3.3× |
| CT thorax w/o contrast (71250) |
$777.60 |
$2,592 |
8.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$915.30 |
$3,051 |
6.1× |
| CT upper extremity w/o contrast rt (73200) |
$656.40 |
$2,188 |
7.3× |
| CT upper extremity with contrast (73201) |
$777.60 |
$2,592 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,953.60 |
$6,512 |
12.9× |
| Cta Abdomen (74175) |
$1,210.80 |
$4,036 |
8.0× |
| CTA abdomen pelvis (74174) |
$404.25 |
$1,347.50 |
1.3× |
| CTA chest (71275) |
$1,444.50 |
$4,815 |
9.6× |
| Cta Head (70496) |
$653.70 |
$2,179 |
4.3× |
| CTA lwr ext w&w/o contrast (73706) |
$366.60 |
$1,222 |
2.4× |
| Cta Neck (70498) |
$653.70 |
$2,179 |
4.3× |
| Cta Pelvis (72191) |
$461.10 |
$1,537 |
3.0× |
| Cystography minimum 3 views rs&i (74430) |
$189.60 |
$632 |
0.6× |
| Diskogram cervical (72285) |
$1,797.90 |
$5,993 |
1.1× |
| Diskography lumbar (72295) |
$2,059.50 |
$6,865 |
1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$31.50 |
$105 |
0.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$319.80 |
$1,066 |
3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$68.10 |
$227 |
0.9× |
| Dxa bone density study axial skeleton (77085) |
$95.10 |
$317 |
1.1× |
| Echo exam of fetal heart (76825) |
$616.80 |
$2,056 |
1.3× |
| Echoencephalography real time imaging (76506) |
$180 |
$600 |
2.0× |
| Esophagus (74220) |
$155.10 |
$517 |
1.0× |
| Fetal biophysical profile non-stress testing (76818) |
$289.50 |
$965 |
3.2× |
| Fluoroscopy up to 1 hr (76000) |
$132.30 |
$441 |
0.6× |
| Foot 2 views (73620) |
$44.40 |
$148 |
0.6× |
| Forearm 2 views (73090) |
$43.20 |
$144 |
0.6× |
| Gated Heart Planar Single (78472) |
$496.20 |
$1,654 |
1.4× |
| Hand 2 views (73120) |
$53.70 |
$179 |
0.6× |
| Hand 3 views (73130) |
$58.20 |
$194 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$356.70 |
$1,189 |
0.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$356.70 |
$1,189 |
1.0× |
| Ht muscle image spect sing (78451) |
$817.20 |
$2,724 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$45.60 |
$152 |
0.6× |
| Hysterosalpingogram (74740) |
$247.50 |
$825 |
1.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$95.70 |
$319 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$430.80 |
$1,436 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$345.60 |
$1,152 |
0.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$345.60 |
$1,152 |
0.7× |
| Liver & spleen imaging static only (78215) |
$285.30 |
$951 |
0.8× |
| Lung perfusion differential (78597) |
$119.10 |
$397 |
0.3× |
| Lung Ventilation Imaging (78579) |
$327 |
$1,090 |
0.9× |
| Lymphoscintigraphy (78195) |
$276.30 |
$921 |
0.6× |
| Mammary ductogram or galactogram multiple (77054) |
$247.50 |
$825 |
1.2× |
| Mammary ductogram or galactogram single (77053) |
$247.50 |
$825 |
1.2× |
| Meckels Diverticulum (78290) |
$293.10 |
$977 |
0.9× |
| MRA head w & w/o contrast (70546) |
$1,039.50 |
$3,465 |
3.5× |
| MRA head w/o contrast (70544) |
$1,002.30 |
$3,341 |
4.9× |
| MRA neck w contrast (70548) |
$1,020 |
$3,400 |
3.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,020 |
$3,400 |
3.4× |
| MRA neck w/o contrast (70547) |
$1,002.30 |
$3,341 |
4.9× |
| MRI abdomen w contrast (74182) |
$782.70 |
$2,609 |
2.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$850.50 |
$2,835 |
2.8× |
| MRI abdomen w/o contrast (74181) |
$770.85 |
$2,569.50 |
3.7× |
| MRI any jnt lwr ext with con lt (73722) |
$603.90 |
$2,013 |
0.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$676.95 |
$2,256.50 |
1.0× |
| MRI c-spine with contrast (72142) |
$1,182.60 |
$3,942 |
3.9× |
| MRI cervical spine w/o contrast (72141) |
$861.30 |
$2,871 |
4.2× |
| MRI chest w/o & w/contrast material (71552) |
$850.50 |
$2,835 |
2.8× |
| MRI chest w/o contrast (71550) |
$680.40 |
$2,268 |
3.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$309.90 |
$1,033 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$849 |
$2,830 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$742.20 |
$2,474 |
3.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$849 |
$2,830 |
4.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$761.70 |
$2,539 |
2.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,182.60 |
$3,942 |
3.9× |
| MRI pelvis w contrast (72196) |
$850.20 |
$2,834 |
2.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$850.20 |
$2,834 |
2.8× |
| MRI pelvis w/o contrast (72195) |
$833.70 |
$2,779 |
4.1× |
| MRI scan of arm joint before and after contrast (73223) |
$668.40 |
$2,228 |
2.2× |
| MRI scan of leg joint before and after contrast (73723) |
$849 |
$2,830 |
2.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,612.80 |
$5,376 |
5.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,182.60 |
$3,942 |
3.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,614.90 |
$5,383 |
5.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,182.60 |
$3,942 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,606.50 |
$5,355 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$849 |
$2,830 |
4.1× |
| MRI tmj (70336) |
$813.60 |
$2,712 |
4.0× |
| MRI upper ext joint w/o contrast (73221) |
$690 |
$2,300 |
3.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$849 |
$2,830 |
2.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$849 |
$2,830 |
4.1× |
| Myelogram Cervical (72240) |
$489.90 |
$1,633 |
0.7× |
| Myelogram Lumbar (72265) |
$621.60 |
$2,072 |
0.9× |
| Myelogram thoracic (72255) |
$486 |
$1,620 |
0.7× |
| Myelography 2 or more regions (72270) |
$522.60 |
$1,742 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$897.90 |
$2,993 |
0.8× |
| Neck soft tissue (70360) |
$50.40 |
$168 |
0.7× |
| Nm gastric emptying study (78264) |
$377.70 |
$1,259 |
1.1× |
| Nm gastroesophageal reflux study (78262) |
$279.30 |
$931 |
0.8× |
| Nuclear medicine study of digestive tracts (78299) |
$317.70 |
$1,059 |
0.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$345.60 |
$1,152 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$402.90 |
$1,343 |
2.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$182.10 |
$607 |
2.0× |
| Osseous survey infant (77076) |
$86.10 |
$287 |
1.0× |
| Osseous survey limited (77074) |
$125.40 |
$418 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$298.50 |
$995 |
0.9× |
| Parathyroid imaging (78070) |
$370.95 |
$1,236.50 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$37.50 |
$125 |
0.4× |
| Peritoneogram rs&i (74190) |
$251.70 |
$839 |
0.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$849 |
$2,830 |
2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$327 |
$1,090 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$470.70 |
$1,569 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$247.50 |
$825 |
0.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$37.50 |
$125 |
0.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$98.10 |
$327 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$74.70 |
$249 |
0.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$16.20 |
$54 |
0.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$101.40 |
$338 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$63.75 |
$212.50 |
0.8× |
| Radiologic exam colon single contrast study (74270) |
$206.10 |
$687 |
1.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$155.10 |
$517 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$260.40 |
$868 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$191.10 |
$637 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$64.50 |
$215 |
0.9× |
| Radiological examination surgical specimen (76098) |
$325.20 |
$1,084 |
0.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$412.20 |
$1,374 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$796.65 |
$2,655.50 |
1.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$796.65 |
$2,655.50 |
1.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,082.40 |
$3,608 |
1.0× |
| Scanogram (77073) |
$79.20 |
$264 |
0.9× |
| Scapula complete (73010) |
$59.70 |
$199 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$17.70 |
$59 |
0.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$127.50 |
$425 |
1.4× |
| Small bowel series (74250) |
$155.10 |
$517 |
1.0× |
| Spine thoracic 3 views (72072) |
$56.85 |
$189.50 |
0.6× |
| Testicular Imaging With Vascular Flow (78761) |
$345.60 |
$1,152 |
1.0× |
| Thoracolumbar 2 views (72080) |
$43.20 |
$144 |
0.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$680.10 |
$2,267 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$341.40 |
$1,138 |
1.0× |
| Thyroid uptake measurement (78012) |
$119.10 |
$397 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$202.20 |
$674 |
0.6× |
| Tomogram (76100) |
$162.90 |
$543 |
1.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,082.40 |
$3,608 |
2.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$381.15 |
$1,270.50 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$174.90 |
$583 |
1.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$28.20 |
$94 |
0.4× |
| Unlisted Ultrasound Procedure (76999) |
$141.30 |
$471 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$189.60 |
$632 |
0.9× |
| Urethrocystography voiding (74455) |
$189.60 |
$632 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$189.60 |
$632 |
1.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$282 |
$940 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$84 |
$280 |
0.9× |
| Us breast unilateral complete (76641) |
$141.30 |
$471 |
1.6× |
| Us breast unilateral limited (76642) |
$76.80 |
$256 |
1.0× |
| Us chest (76604) |
$198 |
$660 |
2.2× |
| Us compl joint r-t w/image documentation (76881) |
$175.20 |
$584 |
1.9× |
| Us infant hips dynamic (76885) |
$183.90 |
$613 |
2.5× |
| Us kidney transplant (76776) |
$115.20 |
$384 |
1.3× |
| Us ob transvaginal (76817) |
$86.40 |
$288 |
1.0× |
| Us pelvic non ob complete (76856) |
$194.10 |
$647 |
2.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$85.80 |
$286 |
1.0× |
| Us pregnancy ltd (76815) |
$163.80 |
$546 |
1.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$199.80 |
$666 |
2.2× |
| Us retroperitoneal complete (76770) |
$228.60 |
$762 |
2.5× |
| Us retroperitoneal limited (76775) |
$228.60 |
$762 |
2.5× |
| Us scrotum and contents (76870) |
$186.90 |
$623 |
2.1× |
| Us soft tissue head/neck (76536) |
$169.80 |
$566 |
1.9× |
| Us transrectal (76872) |
$127.80 |
$426 |
1.4× |
| Us xtr non-vasc lmtd (76882) |
$85.80 |
$286 |
1.0× |
| Us, eye b-scan (76512) |
$91.20 |
$304 |
1.0× |
| Venogram extremity bilateral (75822) |
$772.80 |
$2,576 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,550.60 |
$8,502 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$915.30 |
$3,051 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$772.80 |
$2,576 |
0.6× |
| Wrist 2 views (73100) |
$58.20 |
$194 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$91.20 |
$304 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$74.70 |
$249 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$62.10 |
$207 |
0.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$279.30 |
$931 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$58.20 |
$194 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$62.70 |
$209 |
0.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$22.50 |
$75 |
0.2× |
| X-ray exam hip uni 1 view (73501) |
$58.20 |
$194 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$29.10 |
$97 |
0.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$45.75 |
$152.50 |
0.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$87.90 |
$293 |
1.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$155.10 |
$517 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$106.80 |
$356 |
1.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$81.90 |
$273 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$63 |
$210 |
0.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$991.80 |
$3,306 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$41.70 |
$139 |
0.6× |
| X-ray IV pyelogram+drip infusn (74410) |
$189.60 |
$632 |
1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$62.10 |
$207 |
0.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$79.50 |
$265 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$58.35 |
$194.50 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$37.50 |
$125 |
0.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$126 |
$420 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$59.70 |
$199 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$93 |
$310 |
1.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$76.20 |
$254 |
0.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$316.20 |
$1,054 |
0.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$209.40 |
$698 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$79.05 |
$263.50 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$97.05 |
$323.50 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$71.10 |
$237 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$37.20 |
$124 |
0.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$46.05 |
$153.50 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$51.15 |
$170.50 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$41.85 |
$139.50 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$106.80 |
$356 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$74.70 |
$249 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$76.80 |
$256 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$76.80 |
$256 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$72 |
$240 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$55.20 |
$184 |
0.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$29.25 |
$97.50 |
0.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$62.70 |
$209 |
0.8× |
| Xr arthrogram ankle (73615) |
$324.30 |
$1,081 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$76.35 |
$254.50 |
0.8× |
| Xr chest 4+ views (71048) |
$101.40 |
$338 |
1.1× |
| Xr finger(s) 2+ views (73140) |
$31.05 |
$103.50 |
0.4× |
| Xr optic foramina (70190) |
$74.70 |
$249 |
1.0× |
| Xr shoulder 1 view (73020) |
$52.80 |
$176 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$62.55 |
$208.50 |
0.7× |
| Xr tibia/fibula 2 views (73590) |
$43.20 |
$144 |
0.6× |
| Xr tmj bilateral (70330) |
$89.10 |
$297 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$38.10 |
$127 |
0.5× |