| Abdomen 2 views (74019) |
$154.88 |
$176 |
1.4× |
| Acute gi blood loss imaging (78278) |
$1,996.72 |
$2,269 |
4.8× |
| Ankle 2 views (73600) |
$139.92 |
$159 |
1.6× |
| Arthrogram hip (73525) |
$577.28 |
$656 |
1.6× |
| Arthrogram shoulder (73040) |
$858.88 |
$976 |
2.4× |
| Arthrogram wrist (73115) |
$579.92 |
$659 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$528.88 |
$601 |
1.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,128.16 |
$1,282 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$685.96 |
$779.50 |
1.7× |
| Bone age studies (77072) |
$110 |
$125 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$1,456.40 |
$1,655 |
3.5× |
| Bone survey complete (77075) |
$345.84 |
$393 |
3.2× |
| Bone survey infant (77076) |
$169.84 |
$193 |
1.6× |
| Bowel imaging (78290) |
$669.68 |
$761 |
1.6× |
| Brain Imaging Vascular Flow Only (78610) |
$543.84 |
$618 |
1.0× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$731.28 |
$831 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$153.56 |
$174.50 |
1.7× |
| Chest 1 view (71045) |
$140.80 |
$160 |
1.6× |
| Chest xray 3 views (71047) |
$334.40 |
$380 |
3.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$296.12 |
$336.50 |
1.6× |
| Clavicle complete (73000) |
$125.40 |
$142.50 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$238.92 |
$271.50 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,395.68 |
$1,586 |
3.9× |
| CT abdomen and pelvis without contrast (74176) |
$895.40 |
$1,017.50 |
3.6× |
| CT abdomen w contrast (74160) |
$605.88 |
$688.50 |
3.3× |
| CT abdomen w wo contrast (74170) |
$764.72 |
$869 |
4.2× |
| CT abdomen w/o contrast (74150) |
$422.84 |
$480.50 |
3.9× |
| CT angio lwr extr w/o&w/dye (73706) |
$642.84 |
$730.50 |
3.6× |
| CT angiography upper extremity lt (73206) |
$637.12 |
$724 |
3.5× |
| CT c-spine w/o contrast (72125) |
$495 |
$562.50 |
4.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,108.80 |
$1,260 |
6.1× |
| CT chest w contrast (71260) |
$623.92 |
$709 |
3.4× |
| CT chest w/wo contrast (71270) |
$756.36 |
$859.50 |
4.2× |
| CT head/brain with contrast (70460) |
$621.72 |
$706.50 |
3.4× |
| CT head/brain without and with contrast (70470) |
$768.68 |
$873.50 |
4.2× |
| CT iac w contrast (70481) |
$621.72 |
$706.50 |
3.4× |
| CT limited/localized follow up study (76380) |
$505.12 |
$574 |
5.6× |
| CT lower ext w/o (73700) |
$495 |
$562.50 |
4.6× |
| CT lower extremity w wo contrast (73702) |
$754.16 |
$857 |
4.2× |
| CT lower extremity w/contrast material (73701) |
$623.48 |
$708.50 |
3.4× |
| CT lumbar spine w/contrast (72132) |
$856.68 |
$973.50 |
2.4× |
| CT lumbar spine w/o contrast (72131) |
$495 |
$562.50 |
4.6× |
| CT maxillofacial w contrast (70487) |
$621.72 |
$706.50 |
3.4× |
| CT maxillofacial w/wo contrast (70488) |
$768.24 |
$873 |
4.2× |
| CT maxillofacial wo contrast (70486) |
$487.08 |
$553.50 |
4.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$768.24 |
$873 |
4.2× |
| CT orbits w/o contrast (70480) |
$512.16 |
$582 |
4.7× |
| CT pelvis w/o contrast (72192) |
$438.68 |
$498.50 |
4.1× |
| CT pelvis w/wo contrast (72194) |
$765.60 |
$870 |
4.2× |
| CT scan of arm combo (73202) |
$2,024 |
$2,300 |
11.2× |
| CT soft tissue neck w contrast (70491) |
$636.68 |
$723.50 |
3.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$788.92 |
$896.50 |
4.4× |
| CT soft tissue neck w/o contrast (70490) |
$512.16 |
$582 |
4.7× |
| CT thoracic spine w/contrast (72129) |
$1,108.80 |
$1,260 |
6.1× |
| CT thoracic spine w/o contrast (72128) |
$495 |
$562.50 |
4.6× |
| CT thoracic spine w/wo contrast (72130) |
$1,108.80 |
$1,260 |
6.1× |
| CT thorax w/o contrast (71250) |
$499.84 |
$568 |
4.6× |
| CT unlisted procedure (76497) |
$1,496.88 |
$1,701 |
16.7× |
| CT upper ext wo (73200) |
$376.64 |
$428 |
3.5× |
| CT upper extremity with contrast (73201) |
$983.40 |
$1,117.50 |
2.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$889.68 |
$1,011 |
4.9× |
| Cta Abdomen (74175) |
$1,060.40 |
$1,205 |
5.9× |
| CTA abdomen pelvis (74174) |
$1,045.44 |
$1,188 |
2.9× |
| CTA chest (71275) |
$768.68 |
$873.50 |
4.2× |
| Cta Head (70496) |
$697.84 |
$793 |
3.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,291.84 |
$1,468 |
3.6× |
| Cta Neck (70498) |
$697.84 |
$793 |
3.9× |
| Cta Pelvis (72191) |
$637.12 |
$724 |
3.5× |
| Cystography minimum 3 views rs&i (74430) |
$768.24 |
$873 |
2.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$206.80 |
$235 |
1.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$340.56 |
$387 |
3.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$212.96 |
$242 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$248.16 |
$282 |
2.8× |
| Esophagus (74220) |
$273.68 |
$311 |
1.5× |
| Facial bones min 3 views (70150) |
$184.80 |
$210 |
1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$329.12 |
$374 |
3.1× |
| Fluoroscopy up to 1 hr (76000) |
$306.68 |
$348.50 |
1.2× |
| Foot 2 views (73620) |
$174.24 |
$198 |
1.9× |
| Forearm 2 views (73090) |
$126.28 |
$143.50 |
1.4× |
| Hand 2 views (73120) |
$139.48 |
$158.50 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$959.20 |
$1,090 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$762.52 |
$866.50 |
1.8× |
| Hysterosalpingogram (74740) |
$423.28 |
$481 |
1.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$149.60 |
$170 |
1.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,698.40 |
$1,930 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,698.40 |
$1,930 |
3.0× |
| Knee 3 views (73562) |
$285.12 |
$324 |
3.2× |
| Liver & spleen imaging static only (78215) |
$1,038.40 |
$1,180 |
2.5× |
| Lymphoscintigraphy (78195) |
$1,566.40 |
$1,780 |
2.8× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,348.60 |
$1,532.50 |
1.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,219.36 |
$2,522 |
6.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,382.92 |
$1,571.50 |
3.8× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$91.96 |
$104.50 |
1.0× |
| MRA head w & w/o contrast (70546) |
$2,002 |
$2,275 |
5.6× |
| MRA head w/o contrast (70544) |
$778.36 |
$884.50 |
3.2× |
| MRA head with contrast (70545) |
$1,732.72 |
$1,969 |
4.8× |
| MRA neck w contrast (70548) |
$1,732.72 |
$1,969 |
4.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,021.24 |
$1,160.50 |
2.8× |
| MRA neck w/o contrast (70547) |
$1,414.16 |
$1,607 |
5.7× |
| MRI abdomen w contrast (74182) |
$2,219.36 |
$2,522 |
6.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,429.56 |
$1,624.50 |
4.0× |
| MRI abdomen w/o contrast (74181) |
$793.76 |
$902 |
3.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,636.80 |
$1,860 |
2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,888.92 |
$2,146.50 |
5.2× |
| MRI c-spine with contrast (72142) |
$1,194.16 |
$1,357 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$836.44 |
$950.50 |
3.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,420 |
$2,750 |
6.7× |
| MRI chest w/o contrast (71550) |
$1,414.16 |
$1,607 |
5.7× |
| MRI chest with contrast (71551) |
$2,068 |
$2,350 |
2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,206.04 |
$1,370.50 |
3.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,382.92 |
$1,571.50 |
3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$916.52 |
$1,041.50 |
3.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$783.64 |
$890.50 |
3.2× |
| MRI orbit face neck w contrast (70542) |
$2,219.36 |
$2,522 |
6.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,393.48 |
$1,583.50 |
3.9× |
| MRI pelvis w/contrast (72196) |
$1,212.64 |
$1,378 |
3.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,385.56 |
$1,574.50 |
3.8× |
| MRI pelvis w/o contrast (72195) |
$794.20 |
$902.50 |
3.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,391.28 |
$1,581 |
3.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,216.60 |
$1,382.50 |
3.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,391.28 |
$1,581 |
3.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,164.80 |
$2,460 |
6.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,391.28 |
$1,581 |
3.9× |
| MRI temporomandibular joint (70336) |
$794.64 |
$903 |
3.2× |
| MRI thoracic spine w/o contrast (72146) |
$836.44 |
$950.50 |
3.4× |
| MRI up ext w/o contrast (73218) |
$894.96 |
$1,017 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$894.96 |
$1,017 |
3.6× |
| MRI, joint upper extrem combo (73223) |
$1,457.28 |
$1,656 |
4.0× |
| Myelogram Cervical (72240) |
$880 |
$1,000 |
1.1× |
| Myelogram Lumbar (72265) |
$880 |
$1,000 |
1.1× |
| Myelogram thoracic (72255) |
$1,100 |
$1,250 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,902.12 |
$2,161.50 |
1.4× |
| Myocardial spect single study at rest or stress (78451) |
$1,447.60 |
$1,645 |
1.1× |
| Neck soft tissue (70360) |
$131.56 |
$149.50 |
1.5× |
| Nm gastric emptying study (78264) |
$822.80 |
$935 |
2.0× |
| Osseous survey limited (77074) |
$557.04 |
$633 |
5.2× |
| Parathyroid Planar Imaging (78070) |
$1,672 |
$1,900 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$142.12 |
$161.50 |
1.3× |
| PET image w/CT, skull-thigh (78815) |
$5,216.64 |
$5,928 |
3.5× |
| PET imaging for CT attenuation whole body (78816) |
$5,104 |
$5,800 |
3.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,015.52 |
$1,154 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$836 |
$950 |
1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$879.12 |
$999 |
1.6× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$139.48 |
$158.50 |
1.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$119.24 |
$135.50 |
1.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$145.20 |
$165 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$161.48 |
$183.50 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$275.44 |
$313 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$123.64 |
$140.50 |
1.4× |
| Radex Foot Compl Minimum 3 Views (73630) |
$139.48 |
$158.50 |
1.6× |
| Radex Hand Minimum 3 Views (73130) |
$137.28 |
$156 |
1.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$308.88 |
$351 |
3.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$227.92 |
$259 |
2.1× |
| Radex Humerus Minimum 2 Views (73060) |
$139.48 |
$158.50 |
1.6× |
| Radex Kne 1/2 Views (73560) |
$142.56 |
$162 |
1.6× |
| Radex Kne Compl 4/More Views (73564) |
$170.72 |
$194 |
1.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$162.36 |
$184.50 |
1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$133.32 |
$151.50 |
1.5× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$183.92 |
$209 |
1.7× |
| Radex Sho Compl Minimum 2 Views (73030) |
$146.96 |
$167 |
1.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$109.56 |
$124.50 |
1.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$295.68 |
$336 |
2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$176.44 |
$200.50 |
2.0× |
| Radex Toe Minimum 2 Views (73660) |
$115.72 |
$131.50 |
1.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$189.20 |
$215 |
1.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$143 |
$162.50 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$125.40 |
$142.50 |
1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$341.44 |
$388 |
3.2× |
| Radiologic exam chest 2 views (71046) |
$163.68 |
$186 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$373.56 |
$424.50 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$361.24 |
$410.50 |
2.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$336.60 |
$382.50 |
1.9× |
| Radiologic examination femur 1 view (73551) |
$139.92 |
$159 |
1.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$126.72 |
$144 |
1.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$136.40 |
$155 |
1.5× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$189.64 |
$215.50 |
1.8× |
| Radiological examination surgical specimen (76098) |
$513.04 |
$583 |
0.9× |
| Ribs bilateral 3 views (71110) |
$193.60 |
$220 |
1.8× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,020.80 |
$1,160 |
2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,735.36 |
$1,972 |
4.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,210.88 |
$1,376 |
2.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$168.08 |
$191 |
0.1× |
| Sacroiliac Joints < 3 Views (72200) |
$136.84 |
$155.50 |
1.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$768.24 |
$873 |
3.1× |
| Scapula (73010) |
$142.12 |
$161.50 |
1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$132 |
$150 |
5.6× |
| Shoulder 1 view (73020) |
$131.56 |
$149.50 |
1.5× |
| Sialogram (70390) |
$499.84 |
$568 |
2.0× |
| Small bowel series (74250) |
$848.32 |
$964 |
4.7× |
| Speech evaluation complex (70371) |
$445.28 |
$506 |
1.8× |
| Spine thoracic 3 views (72072) |
$168.08 |
$191 |
1.6× |
| Testicular Imaging With Vascular Flow (78761) |
$792 |
$900 |
1.9× |
| Thoracolumbar 2 views (72080) |
$148.28 |
$168.50 |
1.7× |
| Thyroid imaging w/blood flow (78013) |
$541.20 |
$615 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$548.24 |
$623 |
1.3× |
| Ultrasound breast complete (76641) |
$277.20 |
$315 |
2.6× |
| Ultrasound Exam Aaa Screen (76706) |
$254.32 |
$289 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$349.80 |
$397.50 |
3.2× |
| Umbilical-artery Doppler (OB) (76820) |
$213.40 |
$242.50 |
2.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$1,687.84 |
$1,918 |
18.8× |
| Urethrocystogram voiding (74455) |
$835.12 |
$949 |
3.4× |
| Us breast unilateral limited (76642) |
$236.28 |
$268.50 |
2.6× |
| Us chest (76604) |
$278.52 |
$316.50 |
2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$238.04 |
$270.50 |
2.2× |
| Us ob limited (76815) |
$268.40 |
$305 |
2.5× |
| Us ob transvaginal (76817) |
$286 |
$325 |
2.7× |
| Us pelvic non ob complete (76856) |
$304.04 |
$345.50 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$223.08 |
$253.50 |
2.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$316.80 |
$360 |
2.9× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$325.16 |
$369.50 |
3.0× |
| Us retroperitoneal complete (76770) |
$301.84 |
$343 |
2.8× |
| Us retroperitoneal limited (76775) |
$268.40 |
$305 |
2.5× |
| Us scrotum and contents (76870) |
$302.28 |
$343.50 |
2.8× |
| Us soft tissue head/neck (76536) |
$290.84 |
$330.50 |
2.7× |
| Us spinal canal and contents (76800) |
$316.80 |
$360 |
2.9× |
| Us,transplanted kidney, real time/ doppler (76776) |
$344.96 |
$392 |
3.2× |
| Venogram extremity bilateral (75822) |
$2,295.04 |
$2,608 |
1.4× |
| Venogram Extremity Unilateral (75820) |
$1,425.60 |
$1,620 |
0.9× |
| Wrist 2 views (73100) |
$135.52 |
$154 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$212.52 |
$241.50 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$146.52 |
$166.50 |
1.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$886.16 |
$1,007 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$126.28 |
$143.50 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$178.64 |
$203 |
2.0× |
| X-ray exam of femur 2/> (73552) |
$146.96 |
$167 |
1.6× |
| X-ray eye for foreign body (70030) |
$141.24 |
$160.50 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$154.44 |
$175.50 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$149.16 |
$169.50 |
1.7× |
| X-ray leg, infant (73592) |
$108.24 |
$123 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$154.88 |
$176 |
1.4× |
| X-ray nose-rectum child f.b. (76010) |
$134.20 |
$152.50 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$201.96 |
$229.50 |
1.9× |
| X-ray retrograde pyelogram (74420) |
$871.20 |
$990 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$137.72 |
$156.50 |
1.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$172.48 |
$196 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$215.16 |
$244.50 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$135.96 |
$154.50 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$156.64 |
$178 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$233.64 |
$265.50 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$144.32 |
$164 |
1.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$145.20 |
$165 |
1.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$269.28 |
$306 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$148.28 |
$168.50 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$157.08 |
$178.50 |
1.5× |
| Xr bone length studies (77073) |
$179.08 |
$203.50 |
1.7× |
| Xr c-spine 4 or 5 views (72050) |
$194.04 |
$220.50 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$249.92 |
$284 |
2.3× |
| Xr chest 4+ views (71048) |
$374 |
$425 |
3.5× |
| Xr urogram antegrade (74425) |
$979.44 |
$1,113 |
2.7× |