| Abdomen 2 views (74019) |
$189 |
$252 |
1.8× |
| Acute gi blood loss imaging (78278) |
$1,185.75 |
$1,581 |
3.0× |
| Angiography extremity unilateral rs&i (75710) |
$1,914.75 |
$2,553 |
0.6× |
| Ankle 2 views (73600) |
$150.75 |
$201 |
1.8× |
| Arthrogram ankle (73615) |
$675.75 |
$901 |
2.0× |
| Arthrogram elbow (73085) |
$411.75 |
$549 |
1.2× |
| Arthrogram hip (73525) |
$675.75 |
$901 |
2.0× |
| Arthrogram knee (73580) |
$465.75 |
$621 |
1.4× |
| Arthrogram shoulder (73040) |
$1,227 |
$1,636 |
3.6× |
| Arthrogram wrist (73115) |
$434.25 |
$579 |
1.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,254.38 |
$1,672.50 |
3.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$996.75 |
$1,329 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,272 |
$1,696 |
3.2× |
| Bone age studies (77072) |
$203.25 |
$271 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,272 |
$1,696 |
3.2× |
| Bone survey complete (77075) |
$203.25 |
$271 |
2.0× |
| Bone survey infant (77076) |
$203.25 |
$271 |
2.0× |
| Bowel imaging (78290) |
$683.25 |
$911 |
1.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$816 |
$1,088 |
2.1× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$895.12 |
$1,193.50 |
2.3× |
| Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or… (78483) |
$1,342.50 |
$1,790 |
2.5× |
| Cervical spine 2 or 3 views (72040) |
$142.50 |
$190 |
1.7× |
| Chest 1 view (71045) |
$192.75 |
$257 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$253.12 |
$337.50 |
1.5× |
| Clavicle complete (73000) |
$148.12 |
$197.50 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$159 |
$212 |
1.5× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$258 |
$344 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,965.38 |
$2,620.50 |
5.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,473.75 |
$1,965 |
6.3× |
| CT abdomen w contrast (74160) |
$1,204.50 |
$1,606 |
7.0× |
| CT abdomen w wo contrast (74170) |
$1,180.50 |
$1,574 |
6.8× |
| CT abdomen w/o contrast (74150) |
$946.50 |
$1,262 |
9.2× |
| CT angio hrt w/3d image (75574) |
$527.25 |
$703 |
1.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,204.50 |
$1,606 |
7.0× |
| CT angiography upper extremity lt (73206) |
$1,808.25 |
$2,411 |
10.4× |
| CT c-spine w/contrast (72126) |
$2,645.25 |
$3,527 |
7.7× |
| CT c-spine w/o contrast (72125) |
$915.75 |
$1,221 |
8.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,228.50 |
$1,638 |
7.1× |
| CT chest w contrast (71260) |
$1,143.38 |
$1,524.50 |
6.6× |
| CT chest w/wo contrast (71270) |
$1,204.50 |
$1,606 |
7.0× |
| CT head/brain with contrast (70460) |
$886.88 |
$1,182.50 |
5.1× |
| CT head/brain without and with contrast (70470) |
$886.88 |
$1,182.50 |
5.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$527.25 |
$703 |
1.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$81.75 |
$109 |
1.0× |
| CT hrt w/3d image congen (75573) |
$527.25 |
$703 |
1.5× |
| CT iac w contrast (70481) |
$886.88 |
$1,182.50 |
5.1× |
| CT limited/localized follow up study (76380) |
$546.75 |
$729 |
6.4× |
| CT lower ext w/o (73700) |
$946.50 |
$1,262 |
9.2× |
| CT lower extremity w wo contrast (73702) |
$1,204.50 |
$1,606 |
7.0× |
| CT lower extremity w/contrast material (73701) |
$1,204.50 |
$1,606 |
7.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,228.50 |
$1,638 |
7.1× |
| CT lumbar spine w/contrast (72132) |
$2,593.50 |
$3,458 |
7.5× |
| CT lumbar spine w/o contrast (72131) |
$946.50 |
$1,262 |
9.2× |
| CT maxillofacial w contrast (70487) |
$886.88 |
$1,182.50 |
5.1× |
| CT maxillofacial w/wo contrast (70488) |
$904.50 |
$1,206 |
5.2× |
| CT maxillofacial wo contrast (70486) |
$661.88 |
$882.50 |
6.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$904.50 |
$1,206 |
5.2× |
| CT orbits w/o contrast (70480) |
$697.12 |
$929.50 |
6.7× |
| CT pelvis w/o contrast (72192) |
$946.50 |
$1,262 |
9.2× |
| CT pelvis w/wo contrast (72194) |
$1,204.50 |
$1,606 |
7.0× |
| CT scan of arm combo (73202) |
$1,204.50 |
$1,606 |
7.0× |
| CT soft tissue neck w contrast (70491) |
$872.25 |
$1,163 |
5.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,228.50 |
$1,638 |
7.1× |
| CT soft tissue neck w/o contrast (70490) |
$946.50 |
$1,262 |
9.2× |
| CT thoracic spine w/contrast (72129) |
$1,228.50 |
$1,638 |
7.1× |
| CT thoracic spine w/o contrast (72128) |
$946.50 |
$1,262 |
9.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,228.50 |
$1,638 |
7.1× |
| CT thorax w/o contrast (71250) |
$897.75 |
$1,197 |
8.7× |
| CT upper ext wo (73200) |
$946.50 |
$1,262 |
9.2× |
| CT upper extremity with contrast (73201) |
$2,593.50 |
$3,458 |
7.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$919.88 |
$1,226.50 |
5.3× |
| Cta Abdomen (74175) |
$1,180.50 |
$1,574 |
6.8× |
| CTA abdomen pelvis (74174) |
$1,980 |
$2,640 |
5.7× |
| CTA chest (71275) |
$1,166.25 |
$1,555 |
6.7× |
| Cta Head (70496) |
$842.62 |
$1,123.50 |
4.9× |
| Cta Neck (70498) |
$1,183.50 |
$1,578 |
6.8× |
| Cta Pelvis (72191) |
$1,228.50 |
$1,638 |
7.1× |
| Cystography minimum 3 views rs&i (74430) |
$544.88 |
$726.50 |
1.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$203.25 |
$271 |
2.0× |
| Esophageal motility (78258) |
$519 |
$692 |
1.3× |
| Esophagus (74220) |
$258 |
$344 |
1.5× |
| Facial bones min 3 views (70150) |
$203.25 |
$271 |
2.0× |
| Fetal biophysical profile non-stress testing (76818) |
$223.50 |
$298 |
2.2× |
| Fluoroscopy up to 1 hr (76000) |
$419.25 |
$559 |
1.8× |
| Foot 2 views (73620) |
$150.75 |
$201 |
1.8× |
| Forearm 2 views (73090) |
$150.75 |
$201 |
1.8× |
| Hand 2 views (73120) |
$247.88 |
$330.50 |
2.4× |
| Heart Infarct Image (78466) |
$668.25 |
$891 |
1.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,534.50 |
$2,046 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,272 |
$1,696 |
3.2× |
| Hysterosalpingogram (74740) |
$427.50 |
$570 |
1.8× |
| Kidney imaging morphology (78700) |
$424.50 |
$566 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,370.62 |
$1,827.50 |
2.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,566.75 |
$2,089 |
2.9× |
| Knee 3 views (73562) |
$174.38 |
$232.50 |
2.0× |
| Lung perf&ventilat diferentl (78598) |
$1,140 |
$1,520 |
2.1× |
| Lung perfusion differential (78597) |
$388.50 |
$518 |
1.0× |
| Lymphoscintigraphy (78195) |
$1,002.38 |
$1,336.50 |
1.9× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,357 |
$4,476 |
4.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,088 |
$2,784 |
6.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,637.62 |
$2,183.50 |
4.8× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$150.75 |
$201 |
1.8× |
| MRA head w & w/o contrast (70546) |
$1,670.25 |
$2,227 |
4.8× |
| MRA head w/o contrast (70544) |
$1,192.88 |
$1,590.50 |
5.1× |
| MRA head with contrast (70545) |
$2,194.12 |
$2,925.50 |
6.4× |
| MRA neck w contrast (70548) |
$1,637.62 |
$2,183.50 |
4.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,046.38 |
$2,728.50 |
5.9× |
| MRA neck w/o contrast (70547) |
$1,192.88 |
$1,590.50 |
5.1× |
| MRI abdomen w contrast (74182) |
$1,670.25 |
$2,227 |
4.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,637.62 |
$2,183.50 |
4.8× |
| MRI abdomen w/o contrast (74181) |
$1,260.38 |
$1,680.50 |
5.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,291 |
$4,388 |
4.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,670.25 |
$2,227 |
4.8× |
| MRI c-spine with contrast (72142) |
$1,532.25 |
$2,043 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$1,154.62 |
$1,539.50 |
4.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,637.62 |
$2,183.50 |
4.8× |
| MRI chest w/o contrast (71550) |
$1,285.50 |
$1,714 |
5.5× |
| MRI chest with contrast (71551) |
$3,357 |
$4,476 |
4.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,670.25 |
$2,227 |
4.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,637.62 |
$2,183.50 |
4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,260.38 |
$1,680.50 |
5.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,285.50 |
$1,714 |
5.5× |
| MRI orbit face neck w contrast (70542) |
$1,670.25 |
$2,227 |
4.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,670.25 |
$2,227 |
4.8× |
| MRI pelvis w/contrast (72196) |
$1,670.25 |
$2,227 |
4.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,637.62 |
$2,183.50 |
4.8× |
| MRI pelvis w/o contrast (72195) |
$1,260.38 |
$1,680.50 |
5.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,502.25 |
$2,003 |
4.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,532.25 |
$2,043 |
4.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,502.25 |
$2,003 |
4.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,532.25 |
$2,043 |
4.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,502.25 |
$2,003 |
4.4× |
| MRI temporomandibular joint (70336) |
$1,260.38 |
$1,680.50 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,154.62 |
$1,539.50 |
4.9× |
| MRI up ext w/o contrast (73218) |
$1,285.50 |
$1,714 |
5.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,569 |
$2,092 |
6.7× |
| MRI, joint upper extrem combo (73223) |
$1,637.62 |
$2,183.50 |
4.8× |
| Myelogram Cervical (72240) |
$1,118.25 |
$1,491 |
1.4× |
| Myelography 2 or more regions (72270) |
$1,118.25 |
$1,491 |
1.4× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$621.75 |
$829 |
1.2× |
| Myocardial infarct spect (78469) |
$2,162.25 |
$2,883 |
4.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$670.50 |
$894 |
0.5× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$1,198.50 |
$1,598 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,245.38 |
$5,660.50 |
3.3× |
| Myocardial spect single study at rest or stress (78451) |
$2,895.75 |
$3,861 |
2.3× |
| Neck soft tissue (70360) |
$148.12 |
$197.50 |
1.7× |
| Nm cardiac blood pool multiple (78473) |
$1,360.50 |
$1,814 |
3.4× |
| Nm gastric emptying study (78264) |
$1,247.25 |
$1,663 |
3.2× |
| Nm kidney scan w/flow (78701) |
$468.75 |
$625 |
1.2× |
| Nonvascular shunt X-ray (75809) |
$156.75 |
$209 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$315.75 |
$421 |
1.4× |
| Ob us nuchal meas 1 gest (76813) |
$253.50 |
$338 |
2.5× |
| Osseous survey limited (77074) |
$203.25 |
$271 |
2.0× |
| Parathyroid Planar Imaging (78070) |
$1,219.50 |
$1,626 |
3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,248.75 |
$1,665 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$192.75 |
$257 |
1.9× |
| Peritoneogram after injection (74190) |
$897 |
$1,196 |
1.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,617.75 |
$2,157 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$615.75 |
$821 |
1.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$177.38 |
$236.50 |
2.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$150.75 |
$201 |
1.8× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$174.38 |
$232.50 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$203.25 |
$271 |
2.0× |
| Radex fingr minimum 2 views (73140) |
$142.50 |
$190 |
1.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$177.38 |
$236.50 |
2.1× |
| Radex Hand Minimum 3 Views (73130) |
$174.38 |
$232.50 |
2.0× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$148.12 |
$197.50 |
1.7× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$253.50 |
$338 |
2.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$292.50 |
$390 |
2.8× |
| Radex Humerus Minimum 2 Views (73060) |
$174.38 |
$232.50 |
2.0× |
| Radex Kne 1/2 Views (73560) |
$174.38 |
$232.50 |
2.0× |
| Radex Kne Compl 4/More Views (73564) |
$235.12 |
$313.50 |
2.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$199.50 |
$266 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$148.12 |
$197.50 |
1.7× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$199.50 |
$266 |
1.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$174.38 |
$232.50 |
2.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$148.12 |
$197.50 |
1.7× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$199.50 |
$266 |
1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$225.75 |
$301 |
2.6× |
| Radex Toe Minimum 2 Views (73660) |
$150.75 |
$201 |
1.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$297.38 |
$396.50 |
2.9× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$174.38 |
$232.50 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$148.50 |
$198 |
1.7× |
| Radiologic exam chest 2 views (71046) |
$189 |
$252 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$253.12 |
$337.50 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$293.62 |
$391.50 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$253.12 |
$337.50 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$206.25 |
$275 |
2.4× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$203.25 |
$271 |
2.0× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$203.25 |
$271 |
2.0× |
| Radiological examination surgical specimen (76098) |
$1,014 |
$1,352 |
1.9× |
| Ribs bilateral 3 views (71110) |
$395.62 |
$527.50 |
3.8× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$648.75 |
$865 |
1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$553.50 |
$738 |
1.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,149 |
$5,532 |
7.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$4,133.25 |
$5,511 |
7.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,005 |
$1,340 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$203.25 |
$271 |
2.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$534.75 |
$713 |
2.3× |
| Scapula (73010) |
$199.50 |
$266 |
1.9× |
| Sella turcica (70240) |
$150.75 |
$201 |
1.8× |
| Shoulder 1 view (73020) |
$150.75 |
$201 |
1.8× |
| Small bowel series (74250) |
$258 |
$344 |
1.5× |
| Spine thoracic 3 views (72072) |
$199.50 |
$266 |
1.9× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$427.50 |
$570 |
1.8× |
| Thoracolumbar 2 views (72080) |
$148.12 |
$197.50 |
1.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$897.75 |
$1,197 |
1.7× |
| Thyroid uptake measurement (78012) |
$578.62 |
$771.50 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,219.50 |
$1,626 |
3.1× |
| Tmj unilateral (70328) |
$150.75 |
$201 |
1.8× |
| Ultrasound breast complete (76641) |
$253.50 |
$338 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$235.50 |
$314 |
2.3× |
| Umbilical-artery Doppler (OB) (76820) |
$248.62 |
$331.50 |
2.4× |
| Urethrocystogram voiding (74455) |
$419.25 |
$559 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$419.25 |
$559 |
1.8× |
| Us chest (76604) |
$248.62 |
$331.50 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$294.75 |
$393 |
2.9× |
| Us encephalogram (76506) |
$248.62 |
$331.50 |
2.4× |
| Us hips infant static (76886) |
$187.50 |
$250 |
2.2× |
| Us infant hips w manipulation (76885) |
$187.50 |
$250 |
2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$250.50 |
$334 |
2.4× |
| Us ob detailed single fetus (76811) |
$429 |
$572 |
1.8× |
| Us ob limited (76815) |
$248.62 |
$331.50 |
2.4× |
| Us ob transvaginal (76817) |
$243.75 |
$325 |
2.4× |
| Us pelvic non ob complete (76856) |
$444.38 |
$592.50 |
4.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$248.62 |
$331.50 |
2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$249.75 |
$333 |
2.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$223.50 |
$298 |
2.2× |
| Us retroperitoneal complete (76770) |
$235.50 |
$314 |
2.3× |
| Us retroperitoneal limited (76775) |
$248.62 |
$331.50 |
2.4× |
| Us scrotum and contents (76870) |
$271.50 |
$362 |
2.6× |
| Us soft tissue head/neck (76536) |
$235.50 |
$314 |
2.3× |
| Us spinal canal and contents (76800) |
$253.50 |
$338 |
2.5× |
| Venogram Extremity Unilateral (75820) |
$2,152.50 |
$2,870 |
1.4× |
| Wrist 2 views (73100) |
$142.50 |
$190 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$189 |
$252 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$225.75 |
$301 |
2.6× |
| X-ray b.e. reductn intuss (74283) |
$258 |
$344 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$258 |
$344 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$150.75 |
$201 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$154.12 |
$205.50 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$298.12 |
$397.50 |
2.9× |
| X-ray exam of femur 2/> (73552) |
$174.38 |
$232.50 |
2.0× |
| X-ray eye for foreign body (70030) |
$148.12 |
$197.50 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$150.75 |
$201 |
1.8× |
| X-ray IV pyelogram (ivp) (74400) |
$258 |
$344 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$150.75 |
$201 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$221.62 |
$295.50 |
2.6× |
| X-ray leg, infant (73592) |
$150.75 |
$201 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$189 |
$252 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$206.25 |
$275 |
2.0× |
| X-ray nose-rectum child f.b. (76010) |
$148.12 |
$197.50 |
1.7× |
| X-ray optic foramen (70190) |
$150.75 |
$201 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$203.25 |
$271 |
2.0× |
| X-ray retrograde pyelogram (74420) |
$555.75 |
$741 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$195 |
$260 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$250.12 |
$333.50 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$403.50 |
$538 |
3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$199.50 |
$266 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$148.12 |
$197.50 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$150.75 |
$201 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$203.25 |
$271 |
2.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$203.25 |
$271 |
2.0× |
| X-Ray Small Bowel Enteroclysis (74251) |
$258 |
$344 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$150.75 |
$201 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$198.75 |
$265 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$198.75 |
$265 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$199.50 |
$266 |
1.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$203.25 |
$271 |
2.0× |
| Xr bone length studies (77073) |
$199.50 |
$266 |
1.9× |
| Xr c-spine 4 or 5 views (72050) |
$199.50 |
$266 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$203.25 |
$271 |
2.0× |
| Xr chest 4+ views (71048) |
$240.75 |
$321 |
2.3× |
| Xr urogram antegrade (74425) |
$555.75 |
$741 |
1.6× |