| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$1,502 |
$7,509 |
1.0× |
| Acute gi blood loss imaging (78278) |
$787 |
$3,935 |
1.9× |
| Angio extremity unilateral (75710) |
$1,476 |
$7,378 |
0.4× |
| Angio pulmonary unilateral (75741) |
$644 |
$3,218 |
0.2× |
| Angiogram extremity bilateral (75716) |
$1,891 |
$9,455 |
0.6× |
Angiogram pelvic (75736)
likely a partial charge, not the full procedure |
$1,073 |
$5,365 |
0.2× |
| Angiography internal mammary rs&i (75756) |
$206 |
$1,028 |
0.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$639.50 |
$3,196 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,321 |
$6,603 |
0.2× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$206 |
$1,028 |
0.1× |
| Ankle 2 views (73600) |
$154 |
$769 |
1.7× |
| Barium enema (74270) |
$434 |
$2,168 |
2.4× |
| Basic dosimetry (77300) |
$196 |
$980 |
1.4× |
| Bilat selctv renal venogram (75833) |
$1,059 |
$5,293 |
0.3× |
| Bone age studies (77072) |
$118 |
$590 |
1.1× |
| Bone survey complete (77075) |
$314 |
$1,569 |
2.9× |
| Bowel imaging (78290) |
$763 |
$3,816 |
1.8× |
| Brain image w/flow 4 + views (78606) |
$620 |
$3,101 |
1.1× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$1,509 |
$7,547 |
4.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$283 |
$1,416 |
1.5× |
| Clavicle complete (73000) |
$148 |
$742 |
1.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,138.50 |
$5,693 |
6.2× |
| Continuing medical physics consltj pr wk (77336) |
$154 |
$768 |
1.1× |
| Contrast exam abdominl aorta (75625) |
$1,610 |
$8,050 |
0.5× |
| Contrast exam thoracic aorta (75605) |
$4,414 |
$22,071 |
0.8× |
| CT - st neck w&wo contr (70492) |
$1,075 |
$5,374 |
5.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,778 |
$13,892 |
7.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,008 |
$10,039 |
8.1× |
| CT abdomen w wo contrast (74170) |
$2,227 |
$11,134 |
12.2× |
| CT abdomen w/contrast (74160) |
$1,207 |
$6,036 |
6.6× |
| CT abdomen w/o contrast (74150) |
$1,019 |
$5,096 |
9.3× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$1,113 |
$5,567 |
3.1× |
| CT angio abdom w/o & w/dye (74175) |
$2,227 |
$11,134 |
12.2× |
| CT angio abdominal arteries (75635) |
$1,424 |
$7,118 |
7.8× |
| CT angio hrt w/3d image (75574) |
$311 |
$1,554 |
0.9× |
| CT angiograph pelv w/o&w/dye (72191) |
$2,230 |
$11,150 |
12.2× |
| CT cervical spine w/contrast (72126) |
$1,223 |
$6,113 |
3.4× |
| CT cervical spine w/o contrast (72125) |
$1,154 |
$5,768 |
10.6× |
| CT chest w/contrast (71260) |
$1,167 |
$5,835 |
6.4× |
| CT extremity upper w & w/o contrast (73202) |
$1,546 |
$7,731 |
8.4× |
| CT head/brain with contrast (70460) |
$662.50 |
$3,314.50 |
3.6× |
| CT head/brain without and with contrast (70470) |
$1,822 |
$9,109 |
9.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$149 |
$745 |
1.6× |
| CT limited/localized follow up study (76380) |
$72 |
$361 |
0.8× |
| CT lower ext w/wo contrast (73702) |
$1,546 |
$7,731 |
8.4× |
| CT lower extremity w contrast (73701) |
$791 |
$3,956 |
4.3× |
| CT lower extremity w/o contrast unilateral (73700) |
$804 |
$4,019 |
7.4× |
| CT lumbar spine w/contrast (72132) |
$1,278 |
$6,392 |
3.5× |
| CT lumbar spine w/o contrast (72131) |
$1,008 |
$5,042 |
9.2× |
| CT lumbar spine w/o then w/ con (72133) |
$2,287 |
$11,433 |
12.5× |
| CT maxillofacial area w/o contrast (70486) |
$921 |
$4,606 |
8.4× |
| CT maxillofacial w/contrast (70487) |
$1,218.50 |
$6,091 |
6.7× |
| CT maxillofacial w/o then w/ con (70488) |
$2,104 |
$10,520 |
11.5× |
| CT orbit sella ear w/o con (70480) |
$1,005 |
$5,024 |
9.2× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$2,165 |
$10,826 |
11.8× |
| CT pelvis w & w/o contrast (72194) |
$2,230 |
$11,150 |
12.2× |
| CT pelvis w/o contrast (72192) |
$987 |
$4,937 |
9.0× |
| CT soft tissue neck w/contrast (70491) |
$1,168 |
$5,840 |
6.4× |
| CT soft tissue neck w/o contrast (70490) |
$836 |
$4,181 |
7.7× |
| CT spine cervical w/wo contrast (72127) |
$2,376 |
$11,880 |
13.0× |
| CT thoracic spine w/contrast (72129) |
$1,277 |
$6,384 |
7.0× |
| CT thoracic spine w/o contrast (72128) |
$929 |
$4,643 |
8.5× |
| CT thorax w/o contrast (71250) |
$950 |
$4,751 |
8.7× |
| CT thorax w/o then w/ contrast (71270) |
$2,475 |
$12,374 |
13.5× |
| CT upper extremity w/dye (73201) |
$1,156 |
$5,780 |
3.2× |
| CT upper extremity w/o contrast rt (73200) |
$832 |
$4,158 |
7.6× |
| CTA chest w/wo contrast (71275) |
$1,294 |
$6,470 |
7.1× |
| CTA head w contrast (70496) |
$1,252 |
$6,259 |
6.8× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$524 |
$2,619 |
2.9× |
| Cta Neck (70498) |
$1,230 |
$6,148 |
6.7× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$773 |
$3,867 |
4.2× |
| Dilation ureters/urethra rs&i (74485) |
$332.50 |
$1,663 |
0.2× |
| Doppler echo fetal spectral display complete (76827) |
$235 |
$1,177 |
2.2× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$235 |
$1,177 |
2.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$235 |
$1,177 |
0.9× |
| Esophogram (74220) |
$281 |
$1,404 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$335 |
$1,674 |
3.1× |
| Fetal biophysical profile w/o nst (76819) |
$177 |
$886 |
1.6× |
| Fetal echo complete (76825) |
$494 |
$2,471 |
0.9× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$269 |
$1,343 |
1.1× |
| Gastric emptying study (78264) |
$1,312 |
$6,559 |
3.1× |
| Gated heart planar single (78472) |
$1,192 |
$5,961 |
2.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$635 |
$3,174 |
0.2× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$968 |
$4,839 |
0.3× |
| Hepatobil syst image w/drug (78227) |
$1,119 |
$5,594 |
2.0× |
| Hepatobiliary system imaging (78226) |
$1,312 |
$6,559 |
3.1× |
| Humerus min 2 views (73060) |
$182 |
$911 |
2.0× |
| Hysterosalpingography (74740) |
$465 |
$2,326 |
1.9× |
| Image fusion (77399) |
$131 |
$654 |
0.9× |
| Imrt planning (77301) |
$1,534 |
$7,670 |
1.1× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$586 |
$2,928 |
1.4× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$1,338 |
$6,688 |
1.8× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$284 |
$1,419 |
0.7× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$206 |
$1,032 |
0.5× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$925 |
$4,627 |
1.6× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,073 |
$5,365 |
1.9× |
| Lung ventilat&perfus imaging (78582) |
$655 |
$3,274 |
1.2× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$2,146 |
$10,732 |
5.9× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$2,027 |
$10,136 |
5.6× |
| Mlc device(s) for imrt (77338) |
$112 |
$560 |
0.3× |
| MRA head w & w/o contrast (70546) |
$2,035 |
$10,176 |
5.6× |
| MRA head w/o contrast (70544) |
$1,209 |
$6,044 |
4.9× |
| MRA neck w/o contrast (70547) |
$898 |
$4,489 |
3.6× |
| MRA neck w/wo contrast (70549) |
$1,810 |
$9,050 |
5.0× |
| MRI abdomen w/contrast (74182) |
$1,048 |
$5,238 |
2.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,663 |
$8,316 |
4.6× |
| MRI abdomen w/o contrast (74181) |
$1,237 |
$6,184 |
5.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,431 |
$7,155 |
1.7× |
| MRI cervical spine w/o contrast (72141) |
$1,261.50 |
$6,307.50 |
5.1× |
| MRI cervical spine with contrast (72142) |
$1,451 |
$7,255 |
4.0× |
| MRI chest w & w/o contrast (71552) |
$1,810 |
$9,050 |
5.0× |
| MRI chest w/o contrast (71550) |
$926 |
$4,628 |
3.7× |
| MRI fetal sngl/1st gestation (74712) |
$176 |
$880 |
0.7× |
| MRI joint upper ext w/contrast (73222) |
$1,431 |
$7,155 |
1.7× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,146 |
$10,732 |
5.9× |
| MRI joint upr extrem w/o dye (73221) |
$1,311 |
$6,554 |
5.3× |
| Mri Lower Extremity W/O Dye (73718) |
$1,375 |
$6,875 |
5.5× |
| MRI lumbar spine with contrast (72149) |
$1,507 |
$7,536 |
4.1× |
| MRI lumbar w/wo contrast (72158) |
$1,986 |
$9,931 |
5.5× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$1,201.50 |
$6,007.50 |
3.3× |
| MRI orbit/face/neck w/o contrast (70540) |
$760.50 |
$3,801.50 |
3.1× |
| MRI pelvis w/ contrast (72196) |
$1,263 |
$6,317 |
3.5× |
| MRI pelvis w/o contrast (72195) |
$1,172.50 |
$5,863 |
4.7× |
| MRI pelvis w/wo contrast (72197) |
$1,824 |
$9,118 |
5.0× |
| MRI spine cervical wo/w contrast (72156) |
$1,652.50 |
$8,264 |
4.5× |
| MRI spine thoracic w/contrast (72147) |
$1,452 |
$7,262 |
4.0× |
| MRI thoracic spine w wo contrast (72157) |
$1,986 |
$9,931 |
5.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,126 |
$5,629.50 |
4.5× |
| MRI tmj (70336) |
$516 |
$2,578 |
2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,375 |
$6,875 |
5.5× |
| Mri Upper Extremity W/Dye (73219) |
$1,443 |
$7,217 |
4.0× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$2,027 |
$10,136 |
5.6× |
| Nm bone 3 phase (78315) |
$596 |
$2,981 |
1.4× |
| Nm bone imaging whole body (78306) |
$763 |
$3,816 |
1.8× |
| Nm heart perfusion spect stress rest (78452) |
$1,550 |
$7,751 |
1.1× |
| Nm lymph system (78195) |
$966 |
$4,829 |
1.7× |
| Nose to rectum for fb child (76010) |
$119 |
$595 |
1.3× |
| Ob us < 14 wks single fetus (76801) |
$217 |
$1,083 |
2.0× |
| Oral radiopharm rx (79005) |
$1,550 |
$7,751 |
6.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$429 |
$2,147 |
1.0× |
| Peritoneal-venous shunt patency test (78291) |
$406 |
$2,028 |
1.0× |
| Peritoneogram rs&i (74190) |
$405 |
$2,024 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$820 |
$4,098 |
0.2× |
| Pulmonary perfusion imaging particulate (78580) |
$505 |
$2,524 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$210 |
$1,051 |
0.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$259 |
$1,296 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$432 |
$2,159 |
4.0× |
| Radex hip unilateral with pelvis 1 view (73501) |
$151 |
$756 |
1.7× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$227 |
$1,136 |
2.5× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$303 |
$1,513 |
2.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$454 |
$2,269 |
4.2× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$605 |
$3,026 |
5.5× |
| Radex spine cervical 2 or 3 views (72040) |
$215 |
$1,073 |
2.4× |
| Radex spine cervical 4 or 5 views (72050) |
$266 |
$1,332 |
2.4× |
| Radex spine cervical 6 or more views (72052) |
$267 |
$1,337 |
2.4× |
Radiation delivery stereotactic cranial linear (77372)
unusually low: confirm this is the full procedure |
$2,423 |
$12,115 |
0.3× |
| Radiation tx delivery lvl 1 (77402) |
$164 |
$820 |
1.5× |
| Radiation tx delivery lvl 3 (77412) |
$257 |
$1,283 |
0.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$328 |
$1,641 |
1.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$335 |
$1,673 |
1.8× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$166 |
$829 |
1.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$248 |
$1,241 |
2.7× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$258 |
$1,289 |
2.4× |
| Renal cyst study (74470) |
$650 |
$3,250 |
1.1× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$3,027.50 |
$15,138.50 |
5.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,789.50 |
$13,947 |
4.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,286 |
$6,430 |
2.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$248 |
$1,242 |
1.0× |
Selective spinal angiogram (75705)
likely a partial charge, not the full procedure |
$1,321 |
$6,603 |
0.2× |
| Shoulder arthrogram (73040) |
$502 |
$2,511 |
1.4× |
| Simulation complex (77290) |
$565 |
$2,823 |
1.4× |
| Simulation simple (77280) |
$264 |
$1,319 |
1.9× |
| Small bowel series (74250) |
$307 |
$1,534 |
1.7× |
| Special physics consult (77370) |
$219 |
$1,094 |
1.6× |
| Special treatment procedure (77470) |
$151 |
$754 |
0.3× |
| Splenoportography (75810) |
$635 |
$3,174 |
0.2× |
| Stereotactic body radiation delivery (77373) |
$1,176 |
$5,880 |
0.6× |
| Therapeutic enema barium or air (74283) |
$227 |
$1,134 |
1.2× |
| Thyroid met imaging body (78018) |
$596 |
$2,981 |
1.1× |
| Treatment device intermediate (77333) |
$120 |
$602 |
0.9× |
| Treatment devices complex (77334) |
$284 |
$1,420.50 |
0.7× |
| Treatment devices simple (77332) |
$106 |
$528 |
0.8× |
| Ultrasound breast limited (76642) |
$168 |
$838 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$351 |
$1,754 |
3.2× |
| Unlisted fluoroscopic procedure (76496) |
$70 |
$350 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$453 |
$2,267 |
1.8× |
| Urethrocystography voiding (74455) |
$402 |
$2,009 |
1.6× |
| Urography antegrade (74425) |
$234 |
$1,169 |
0.6× |
| Us abdominal aorta real time screen study aaa (76706) |
$835 |
$4,174 |
7.6× |
| Us breast uni real time with image complete (76641) |
$194 |
$968 |
1.8× |
| Us chest (76604) |
$182 |
$911 |
1.7× |
| Us compl joint r-t w/image documentation (76881) |
$72 |
$358 |
0.7× |
| Us elastography parenchyma (76981) |
$316 |
$1,581 |
2.9× |
| Us encephalogram (76506) |
$149 |
$747 |
1.4× |
| Us guided compression repair (76936) |
$104 |
$519 |
0.5× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$320 |
$1,601 |
3.5× |
| Us kidney transplanted (76776) |
$85 |
$427 |
0.8× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$121 |
$605 |
1.1× |
| Us ob detailed single fetus (76811) |
$321 |
$1,606 |
1.3× |
| Us ob followup per fetus (76816) |
$121 |
$605 |
1.1× |
| Us ob limited 1 or more fetuses (76815) |
$237 |
$1,187 |
2.2× |
| Us obstetric transvaginal (76817) |
$267 |
$1,336 |
2.4× |
| Us pelvic limited or f/u non-ob (76857) |
$151 |
$754 |
1.4× |
| Us pelvis complete (76856) |
$340 |
$1,700.50 |
3.1× |
| Us retroperitoneal complete (76770) |
$317 |
$1,586 |
2.9× |
| Us retroperitoneal limited (76775) |
$147 |
$736 |
1.3× |
| Us scrotum (76870) |
$250 |
$1,252 |
2.3× |
| Us soft tissue head/neck (76536) |
$274 |
$1,370 |
2.5× |
| Us spinal canal (76800) |
$160 |
$802 |
1.5× |
| Us unlstd proc (76999) |
$159 |
$796 |
1.7× |
| Vein X-ray liver w/hemodynam (75885) |
$911 |
$4,553 |
0.3× |
| Venogram extremity bilateral (75822) |
$476 |
$2,380.50 |
0.3× |
| Venogram ivc w serialography (75825) |
$635 |
$3,174 |
0.2× |
| Venogram svc w serialography (75827) |
$733 |
$3,663 |
0.4× |
| Venography ext unilateral (75820) |
$269 |
$1,343 |
0.2× |
| Venography renal unilateral selective rs&i (75831) |
$818 |
$4,089 |
0.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$228 |
$1,139 |
0.1× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$635 |
$3,174 |
0.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$110 |
$548 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$186 |
$930 |
2.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$558 |
$2,788 |
3.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$167 |
$834 |
1.8× |
| X-ray exam hips bi 3-4 views (73522) |
$546 |
$2,728 |
5.0× |
| X-ray exam of finger(s) (73140) |
$144 |
$721 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$134.50 |
$672.50 |
1.5× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$159 |
$797 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$184 |
$918 |
2.0× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$156 |
$782 |
1.4× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$180 |
$898 |
2.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$146 |
$731 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$171 |
$856 |
1.9× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$180 |
$899 |
2.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$180 |
$899 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$207 |
$1,034 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$295 |
$1,476 |
2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$110 |
$552 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$186 |
$931 |
2.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$194 |
$970 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$212 |
$1,058 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$167 |
$837 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$163 |
$815 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$40 |
$200 |
0.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$132 |
$659 |
1.5× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$152 |
$762 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$191 |
$953 |
2.1× |
| Xr abdomen 1 view (74018) |
$158 |
$792 |
1.7× |
| Xr abdomen 2 views (74019) |
$163 |
$814.50 |
1.5× |
| Xr arthrogram hip (73525) |
$157 |
$784 |
0.4× |
| Xr bone survey infant (77076) |
$135 |
$675 |
1.2× |
| Xr bone survey limited (77074) |
$62 |
$312 |
0.6× |
| Xr chest 1 view (71045) |
$138 |
$691 |
1.5× |
| Xr chest 2 views (71046) |
$146 |
$731 |
1.6× |
| Xr chest 3 views (71047) |
$212 |
$1,058 |
2.3× |
| Xr cystogram 3+ views (74430) |
$325 |
$1,626 |
0.9× |
| Xr eye foreign body (70030) |
$92 |
$459 |
1.0× |
| Xr facial bones 3 views (70150) |
$228 |
$1,138 |
2.1× |
| Xr lower extremity 2 views infant (73592) |
$134 |
$671 |
1.5× |
| Xr mandible 4 views (70110) |
$224 |
$1,119 |
2.1× |
| Xr nasal bones (70160) |
$178 |
$892 |
2.0× |
| Xr pelvis 3 views (72190) |
$122 |
$609 |
1.1× |
| Xr spine 1 view (72020) |
$157 |
$784 |
1.7× |
| Xr sternum 2 views (71120) |
$163 |
$817 |
1.8× |
| Xr surgical specimen (76098) |
$305 |
$1,526 |
0.5× |
| Xr upper extremity 2 views infant (73092) |
$114.50 |
$574 |
1.0× |
| Xray elbow 2 views (73070) |
$165 |
$827 |
1.8× |
| Xray forearm 2 views (73090) |
$171 |
$853 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$186 |
$931 |
2.0× |
| Xray neck soft tissue (70360) |
$162 |
$812 |
1.8× |
| Xray orbits complete min 4 views (70200) |
$210 |
$1,048 |
1.9× |
| Xray pelvis 1 or 2 views (72170) |
$176 |
$882 |
1.6× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$222 |
$1,112 |
2.0× |
| Xray scapula complete (73010) |
$177 |
$886 |
1.6× |
| Xray shoulder 1 view (73020) |
$142 |
$712 |
1.6× |
| Xray sinuses paranasal <3 views (70210) |
$177 |
$887 |
1.9× |
| Xray spine thoracic 2 views (72070) |
$115 |
$577 |
1.1× |
| Xray spine thoracic 3 views (72072) |
$125 |
$625 |
1.1× |
| Xray tibia-fibula 2 views bil (73590) |
$180 |
$899 |
2.0× |
| Xray tmj's bilateral open-clsc (70330) |
$193 |
$963 |
2.1× |