| Abdomen 2 views (74019) |
$147.11 |
$313 |
1.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$321.01 |
$683 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$2,542.70 |
$5,410 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,542.70 |
$5,410 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$1,276.99 |
$2,717 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,383.37 |
$5,071 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$388.67 |
$826.95 |
0.1× |
| Ankle 2 views (73600) |
$87.42 |
$186 |
1.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$192.70 |
$410 |
0.6× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,489.43 |
$3,169 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,542.70 |
$5,410 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,542.70 |
$5,410 |
0.9× |
| Arthrogram elbow (73085) |
$464.83 |
$989 |
1.4× |
| Arthrogram hip (73525) |
$434.75 |
$925 |
1.3× |
| Arthrogram shoulder (73040) |
$348.27 |
$741 |
1.1× |
| Arthrogram wrist (73115) |
$237.35 |
$505 |
0.7× |
| Arthrography knee lt (73580) |
$683.14 |
$1,453.50 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$321.01 |
$683 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$321.01 |
$683 |
0.9× |
| Bone age studies (77072) |
$58.28 |
$124 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$321.01 |
$683 |
0.9× |
| Bone Marrow Imaging Limited Area (78102) |
$561.65 |
$1,195 |
1.5× |
| Bone survey complete (77075) |
$97.76 |
$208 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$70.97 |
$151 |
0.9× |
| Chest 1 view (71045) |
$77.08 |
$164 |
1.0× |
| Chest 3 views (71047) |
$77.08 |
$164 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$58.28 |
$124 |
0.4× |
| Clavicle complete (73000) |
$87.42 |
$186 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$101.99 |
$217 |
1.0× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$249.57 |
$531 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$433.34 |
$922 |
1.3× |
| CT abdomen and pelvis without contrast (74176) |
$251.45 |
$535 |
1.1× |
| CT abdomen w contrast (74160) |
$384.93 |
$819 |
2.4× |
| CT abdomen w wo contrast (74170) |
$432.40 |
$920 |
2.6× |
| CT abdomen w/o contrast (74150) |
$253.33 |
$539 |
2.6× |
| CT angiography upper extremity lt (73206) |
$387.28 |
$824 |
2.4× |
| CT c-spine w/o contrast (72125) |
$253.33 |
$539 |
2.6× |
| CT cervical spine w&w/o contrast (72127) |
$537.68 |
$1,144 |
3.3× |
| CT cervical spine with contrast (72126) |
$308.79 |
$657 |
1.0× |
| CT chest w/wo contrast (71270) |
$442.27 |
$941 |
2.7× |
| CT chest with contrast (71260) |
$384.93 |
$819 |
2.4× |
| CT head/brain with contrast (70460) |
$384.93 |
$819 |
2.4× |
| CT head/brain without and with contrast (70470) |
$432.40 |
$920 |
2.6× |
| CT iac w contrast (70481) |
$384.93 |
$819 |
2.4× |
| CT lower ext w/o (73700) |
$380 |
$808.50 |
3.9× |
| CT lower extremity w wo contrast (73702) |
$928.48 |
$1,975.50 |
5.7× |
| CT lower extremity with contrast (73701) |
$598.54 |
$1,273.50 |
3.7× |
| CT lumbar spine w/o contrast (72131) |
$253.33 |
$539 |
2.6× |
| CT lumbar spine with contrast (72132) |
$384.93 |
$819 |
1.2× |
| CT maxillofacial w contrast (70487) |
$399.03 |
$849 |
2.4× |
| CT maxillofacial w/o contrast (70486) |
$253.33 |
$539 |
2.6× |
| CT maxillofacial w/wo contrast (70488) |
$442.27 |
$941 |
2.7× |
| CT neck soft tissue w contrast (70491) |
$384.93 |
$819 |
2.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$432.40 |
$920 |
2.6× |
| CT orbits w/o contrast (70480) |
$253.33 |
$539 |
2.6× |
| CT pelvis w & w/o contrast (72194) |
$432.40 |
$920 |
2.6× |
| CT pelvis w/o contrast (72192) |
$253.33 |
$539 |
2.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$432.40 |
$920 |
2.6× |
| CT soft tissue neck w/o contrast (70490) |
$253.33 |
$539 |
2.6× |
| CT thoracic spine w/contrast (72129) |
$384.93 |
$819 |
2.4× |
| CT thoracic spine w/o contrast (72128) |
$253.33 |
$539 |
2.6× |
| CT thorax w/o contrast (71250) |
$253.33 |
$539 |
2.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$575.28 |
$1,224 |
3.5× |
| CT upper extremity w/o contrast rt (73200) |
$380 |
$808.50 |
3.9× |
| CT upper extremity with contrast (73201) |
$577.40 |
$1,228.50 |
1.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$441.33 |
$939 |
2.7× |
| Cta Abdomen (74175) |
$441.33 |
$939 |
2.7× |
| CTA abdomen pelvis (74174) |
$482.22 |
$1,026 |
1.5× |
| CTA chest (71275) |
$441.33 |
$939 |
2.7× |
| Cta Head (70496) |
$441.33 |
$939 |
2.7× |
| CTA lwr ext w&w/o contrast (73706) |
$662 |
$1,408.50 |
4.1× |
| Cta Neck (70498) |
$441.33 |
$939 |
2.7× |
| Cta Pelvis (72191) |
$441.33 |
$939 |
2.7× |
| Cystography minimum 3 views rs&i (74430) |
$222.78 |
$474 |
0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$138.65 |
$295 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$81.78 |
$174 |
0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$39.01 |
$83 |
0.5× |
| Dxa bone density study axial skeleton (77085) |
$117.50 |
$250 |
1.2× |
| Echoencephalography real time imaging (76506) |
$81.31 |
$173 |
0.8× |
| Esophagus (74220) |
$113.74 |
$242 |
0.7× |
| Fluoroscopy up to 1 hr (76000) |
$111.39 |
$237 |
0.5× |
| Foot 2 views (73620) |
$87.42 |
$186 |
1.1× |
| Forearm 2 views (73090) |
$87.42 |
$186 |
1.1× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$545.67 |
$1,161 |
1.1× |
| Gated Heart Planar Single (78472) |
$396.68 |
$844 |
1.1× |
| Hand 2 views (73120) |
$87.42 |
$186 |
0.9× |
| Hand 3 views (73130) |
$87.42 |
$186 |
1.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$860.57 |
$1,831 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$860.57 |
$1,831 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$860.57 |
$1,831 |
1.3× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$240.17 |
$511 |
0.7× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$240.17 |
$511 |
0.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$333.70 |
$710 |
0.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$333.70 |
$710 |
0.9× |
| Ht muscle image spect sing (78451) |
$764.22 |
$1,626 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$58.28 |
$124 |
0.7× |
| Hysterosalpingogram (74740) |
$272.60 |
$580 |
1.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$117.50 |
$250 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$421.59 |
$897 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$421.59 |
$897 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$321.95 |
$685 |
0.6× |
| Knee 3 views (73562) |
$87.42 |
$186 |
1.1× |
| Liver & spleen imaging static only (78215) |
$377.41 |
$803 |
1.0× |
| Lung perfusion differential (78597) |
$230.30 |
$490 |
0.6× |
| Lymphoscintigraphy (78195) |
$335.11 |
$713 |
0.7× |
| Meckels Diverticulum (78290) |
$411.25 |
$875 |
1.1× |
| Mr elastography (76391) |
$285.29 |
$607 |
1.3× |
| MRA head w/o contrast (70544) |
$453.08 |
$964 |
2.0× |
| MRA head with contrast (70545) |
$549.43 |
$1,169 |
1.7× |
| MRA neck w contrast (70548) |
$549.43 |
$1,169 |
1.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$694.19 |
$1,477 |
2.1× |
| MRA neck w/o contrast (70547) |
$453.08 |
$964 |
2.0× |
| MRI abdomen w contrast (74182) |
$1,052.80 |
$2,240 |
3.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$694.19 |
$1,477 |
2.1× |
| MRI abdomen w/o contrast (74181) |
$453.08 |
$964 |
2.0× |
| MRI any jnt lwr ext with con lt (73722) |
$824.14 |
$1,753.50 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$824.14 |
$1,753.50 |
1.1× |
| MRI c-spine with contrast (72142) |
$549.43 |
$1,169 |
1.7× |
| MRI cervical spine w/o contrast (72141) |
$453.08 |
$964 |
2.0× |
| MRI chest w/o & w/contrast material (71552) |
$694.19 |
$1,477 |
2.1× |
| MRI chest w/o contrast (71550) |
$453.08 |
$964 |
2.0× |
| MRI fetal sngl/1st gestation (74712) |
$337.93 |
$719 |
1.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$824.14 |
$1,753.50 |
2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$822.74 |
$1,750.50 |
2.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$679.62 |
$1,446 |
3.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$453.08 |
$964 |
2.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$694.19 |
$1,477 |
2.1× |
| MRI orbit/face/neck w/contrast (70542) |
$480.81 |
$1,023 |
1.5× |
| MRI pelvis w contrast (72196) |
$549.43 |
$1,169 |
1.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$694.19 |
$1,477 |
2.1× |
| MRI pelvis w/o contrast (72195) |
$453.08 |
$964 |
2.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,041.28 |
$2,215.50 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,041.28 |
$2,215.50 |
3.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$694.19 |
$1,477 |
2.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$549.43 |
$1,169 |
1.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$694.19 |
$1,477 |
2.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$480.81 |
$1,023 |
1.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$694.19 |
$1,477 |
2.1× |
| MRI thoracic spine w/o contrast (72146) |
$453.08 |
$964 |
2.0× |
| MRI tmj (70336) |
$362.84 |
$772 |
1.6× |
| MRI upper ext joint w/o contrast (73221) |
$679.62 |
$1,446 |
3.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$694.19 |
$1,477 |
2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$679.62 |
$1,446 |
3.1× |
| Myocardial Spect Multiple Studies (78452) |
$1,004.39 |
$2,137 |
0.8× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,784.12 |
$3,796 |
1.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,784.12 |
$3,796 |
1.3× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,781.93 |
$5,919 |
1.4× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$3,399.98 |
$7,234 |
1.7× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$3,399.98 |
$7,234 |
2.4× |
| Neck soft tissue (70360) |
$58.28 |
$124 |
0.7× |
| Nm gastric emptying study (78264) |
$321.01 |
$683 |
0.9× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$411.25 |
$875 |
1.1× |
| Nuclear Rx Oral Admin (79005) |
$282.94 |
$602 |
1.3× |
| Orthopantogram (70355) |
$58.28 |
$124 |
0.7× |
| Osseous survey limited (77074) |
$97.76 |
$208 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$411.25 |
$875 |
1.1× |
| Parathyroid imaging (78070) |
$288.11 |
$613 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$58.28 |
$124 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,032.82 |
$2,197.50 |
3.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$267.90 |
$570 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$360.02 |
$766 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$39.01 |
$83 |
0.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$75.20 |
$160 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$124.55 |
$265 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$124.55 |
$265 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$58.28 |
$124 |
0.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$237.35 |
$505 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$58.28 |
$124 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$77.08 |
$164 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$147.11 |
$313 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$77.08 |
$164 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$113.74 |
$242 |
0.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$225.60 |
$480 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$312.55 |
$665 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$113.74 |
$242 |
0.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$112.80 |
$240 |
1.4× |
| Radiological examination surgical specimen (76098) |
$489.74 |
$1,042 |
1.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,425.36 |
$7,288 |
1.2× |
| Ribs bilateral 3 views (71110) |
$58.28 |
$124 |
0.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,571.68 |
$3,344 |
3.1× |
| Sacroiliac Joints < 3 Views (72200) |
$58.28 |
$124 |
0.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$201.63 |
$429 |
0.9× |
| Scanogram (77073) |
$58.28 |
$124 |
0.6× |
| Scapula complete (73010) |
$87.42 |
$186 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$23.50 |
$50 |
1.0× |
| Sella turcica (70240) |
$58.28 |
$124 |
0.7× |
| Small bowel series (74250) |
$113.74 |
$242 |
0.7× |
| Spine thoracic 3 views (72072) |
$58.28 |
$124 |
0.6× |
| Tbs Technical Calculation Only (77091) |
$93.06 |
$198 |
1.1× |
| Testicular Imaging With Vascular Flow (78761) |
$543.79 |
$1,157 |
1.5× |
| Thoracolumbar 2 views (72080) |
$58.28 |
$124 |
0.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$376.47 |
$801 |
0.7× |
| Thyroid uptake measurement (78012) |
$124.40 |
$264.68 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$254.27 |
$541 |
0.7× |
| Tmj unilateral (70328) |
$76.61 |
$163 |
0.9× |
| Ultrasound elastography first target lesion (76982) |
$139.12 |
$296 |
1.4× |
| Ultrasound scan of cornea to determine thickness (76514) |
$48.88 |
$104 |
1.8× |
| Ultrasound scan to determine eye length and lens power (76519) |
$124.55 |
$265 |
1.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$249.57 |
$531 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$126.43 |
$269 |
1.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$75.20 |
$160 |
0.9× |
| Unlisted Ultrasound Procedure (76999) |
$81.31 |
$173 |
1.0× |
| Upper Extremity Infant (73092) |
$87.42 |
$186 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$318.66 |
$678 |
1.4× |
| Urethrocystography voiding (74455) |
$222.78 |
$474 |
1.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$222.78 |
$474 |
1.4× |
| Us abdl aorta screen aaa (76706) |
$139.12 |
$296 |
1.4× |
| Us breast unilateral complete (76641) |
$177.66 |
$378 |
1.8× |
| Us breast unilateral limited (76642) |
$177.66 |
$378 |
2.2× |
| Us chest (76604) |
$79.90 |
$170 |
0.8× |
| Us compl joint r-t w/image documentation (76881) |
$125.02 |
$266 |
1.3× |
| Us elastography parenchyma (76981) |
$139.12 |
$296 |
1.4× |
| Us kidney transplant (76776) |
$370.83 |
$789 |
3.8× |
| Us ob transvaginal (76817) |
$81.31 |
$173 |
0.8× |
| Us pelvic non ob complete (76856) |
$126.43 |
$269 |
1.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$81.31 |
$173 |
0.8× |
| Us pregnancy ltd (76815) |
$66.74 |
$142 |
0.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$126.43 |
$269 |
1.3× |
| Us retroperitoneal complete (76770) |
$126.43 |
$269 |
1.3× |
| Us retroperitoneal limited (76775) |
$126.43 |
$269 |
1.3× |
| Us scrotum and contents (76870) |
$126.43 |
$269 |
1.3× |
| Us soft tissue head/neck (76536) |
$126.43 |
$269 |
1.3× |
| Us spinal canal and contents (76800) |
$111.39 |
$237 |
1.1× |
| Us transrectal (76872) |
$126.43 |
$269 |
1.3× |
| Us transrectal prostate volume (76873) |
$141.47 |
$301 |
1.5× |
| Us xtr non-vasc lmtd (76882) |
$81.31 |
$173 |
0.8× |
| Venogram extremity bilateral (75822) |
$772.21 |
$1,643 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$3,360.97 |
$7,151 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$881.72 |
$1,876 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$772.21 |
$1,643 |
0.5× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$561.65 |
$1,195 |
0.1× |
| Vertebral fracture assessment via dxa (77086) |
$73.32 |
$156 |
0.9× |
| Wrist 2 views (73100) |
$87.42 |
$186 |
1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$58.28 |
$124 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$87.42 |
$186 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$183.77 |
$391 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$87.42 |
$186 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$87.42 |
$186 |
1.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$237.35 |
$505 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$75.20 |
$160 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$75.20 |
$160 |
0.9× |
| X-ray exam hip uni 4/> views (73503) |
$124.55 |
$265 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$124.55 |
$265 |
1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$237.35 |
$505 |
2.4× |
| X-ray exam of femur 1 (73551) |
$75.20 |
$160 |
0.9× |
| X-ray eye for foreign body (70030) |
$83.19 |
$177 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$58.28 |
$124 |
0.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$58.28 |
$124 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$87.42 |
$186 |
1.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$87.42 |
$186 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$58.28 |
$124 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$87.42 |
$186 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$58.28 |
$124 |
0.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$87.42 |
$186 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$58.28 |
$124 |
0.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$97.76 |
$208 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$112.33 |
$239 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$58.28 |
$124 |
0.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$237.35 |
$505 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$58.28 |
$124 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$58.28 |
$124 |
0.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$222.78 |
$474 |
0.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$58.28 |
$124 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$253.33 |
$539 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$117.50 |
$250 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$58.28 |
$124 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$58.28 |
$124 |
0.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$87.42 |
$186 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$58.28 |
$124 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$58.28 |
$124 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$97.76 |
$208 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$58.28 |
$124 |
0.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$58.28 |
$124 |
0.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$58.28 |
$124 |
0.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$58.28 |
$124 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$58.28 |
$124 |
0.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$58.28 |
$124 |
0.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$58.28 |
$124 |
0.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$87.42 |
$186 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$97.76 |
$208 |
1.0× |
| Xr chest 4+ views (71048) |
$147.11 |
$313 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$58.28 |
$124 |
0.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$144.76 |
$308 |
1.5× |
| Xr shoulder 1 view (73020) |
$87.42 |
$186 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$97.76 |
$208 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$87.42 |
$186 |
1.1× |
| Xr tmj bilateral (70330) |
$58.28 |
$124 |
0.7× |
| Xray knee 1 or 2 views rt (73560) |
$87.42 |
$186 |
1.1× |