| Ankle 2 views (73600) |
$222.40 |
$556 |
2.7× |
| Arthrogram ankle (73615) |
$183.50 |
$458.75 |
0.5× |
| Arthrogram hip (73525) |
$214 |
$535 |
0.6× |
| Arthrogram shoulder (73040) |
$121.80 |
$304.50 |
0.4× |
| Arthrogram wrist (73115) |
$245.20 |
$613 |
0.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$855.20 |
$2,138 |
2.2× |
| Bone age studies (77072) |
$222.40 |
$556 |
2.2× |
| Bowel imaging (78290) |
$169.70 |
$424.25 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$80.20 |
$200.50 |
1.0× |
| Chest xray 3 views (71047) |
$126 |
$315 |
1.5× |
| Cholecystography, oral contrast Non-Facility (74290) |
$171.60 |
$429 |
1.0× |
| Clavicle complete (73000) |
$33.60 |
$84 |
0.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$104 |
$260 |
1.2× |
| CT limited/localized follow up study (76380) |
$200 |
$500 |
2.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$245.60 |
$614 |
2.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$222.40 |
$556 |
2.2× |
| Facial bones min 3 views (70150) |
$222.40 |
$556 |
2.2× |
| Fluoroscopy up to 1 hr (76000) |
$130 |
$325 |
0.6× |
| Forearm 2 views (73090) |
$33.60 |
$84 |
0.4× |
| Hand 2 views (73120) |
$222.40 |
$556 |
2.2× |
| Hysterosalpingogram (74740) |
$790.40 |
$1,976 |
3.5× |
| Kidney imaging morphology (78700) |
$1,123.20 |
$2,808 |
2.9× |
| Knee 3 views (73562) |
$222.40 |
$556 |
2.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$50 |
$125 |
1.8× |
| Nonvascular shunt X-ray (75809) |
$173.60 |
$434 |
1.7× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$390 |
$975 |
1.0× |
| Ob us nuchal meas 1 gest (76813) |
$180 |
$450 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$222.40 |
$556 |
2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$118.25 |
$295.62 |
0.2× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$222.40 |
$556 |
2.7× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$36.80 |
$92 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$134 |
$335 |
1.6× |
| Radex Hand Minimum 3 Views (73130) |
$35 |
$87.50 |
0.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$134 |
$335 |
1.6× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$214 |
$535 |
2.1× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$214 |
$535 |
2.1× |
| Radex Kne 1/2 Views (73560) |
$39.90 |
$99.75 |
0.5× |
| Radex Kne Compl 4/More Views (73564) |
$153.20 |
$383 |
1.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$222.40 |
$556 |
2.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$37.20 |
$93 |
0.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$157.60 |
$394 |
1.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$222.40 |
$556 |
2.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$222.40 |
$556 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$354 |
$885 |
2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$227.20 |
$568 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$354 |
$885 |
2.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$354 |
$885 |
2.1× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$197.20 |
$493 |
2.4× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$222.40 |
$556 |
2.2× |
| Radiological examination surgical specimen (76098) |
$63 |
$157.50 |
0.1× |
| Ribs bilateral 3 views (71110) |
$222.40 |
$556 |
2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$53.60 |
$134 |
2.3× |
| Sella turcica (70240) |
$100.40 |
$251 |
1.2× |
| Sialogram (70390) |
$330 |
$825 |
1.4× |
| Small bowel series (74250) |
$303.60 |
$759 |
1.8× |
| Spine thoracic 3 views (72072) |
$142.70 |
$356.75 |
1.4× |
| Tomogram (76100) |
$300 |
$750 |
3.0× |
| Ultrasound breast complete (76641) |
$163.60 |
$409 |
1.6× |
| Ultrasound Exam Aaa Screen (76706) |
$163.60 |
$409 |
1.6× |
| Umbilical-artery Doppler (OB) (76820) |
$187.60 |
$469 |
1.9× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$131.70 |
$329.25 |
1.4× |
| Us chest (76604) |
$89.52 |
$223.81 |
0.9× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$658.40 |
$1,646 |
3.2× |
| Us elastography parenchyma (76981) |
$216.80 |
$542 |
2.2× |
| Us hips infant static (76886) |
$187.60 |
$469 |
2.2× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$187.60 |
$469 |
1.9× |
| Venogram Extremity Unilateral (75820) |
$271.20 |
$678 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$158 |
$395 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$222.40 |
$556 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$142 |
$355 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$155.99 |
$389.97 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$134 |
$335 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$214 |
$535 |
2.1× |
| X-ray exam of femur 2/> (73552) |
$134 |
$335 |
1.6× |
| X-ray eye for foreign body (70030) |
$28.14 |
$70.35 |
0.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$128.40 |
$321 |
1.5× |
| X-ray leg, infant (73592) |
$222.40 |
$556 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$222.40 |
$556 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$135.75 |
$339.38 |
1.4× |
| X-ray nose-rectum child f.b. (76010) |
$52.50 |
$131.25 |
0.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$138.10 |
$345.25 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$81.20 |
$203 |
0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$222.40 |
$556 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$222.40 |
$556 |
2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$142.50 |
$356.25 |
1.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$222.40 |
$556 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$100.40 |
$251 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$222.40 |
$556 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$174.80 |
$437 |
1.7× |
| Xr bone length studies (77073) |
$222.40 |
$556 |
2.2× |
| Xr c-spine 4 or 5 views (72050) |
$163.70 |
$409.25 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$222.40 |
$556 |
2.2× |
| Xr chest 4+ views (71048) |
$143.20 |
$358 |
1.4× |