| Acute gi blood loss imaging (78278) |
$1,500.40 |
$2,308.31 |
3.6× |
| Ankle 2 views (73600) |
$255.42 |
$392.97 |
2.8× |
| Brain imaging, minimum 4 static views; with vascular flow Age Under 21 (78606) |
$1,305.16 |
$2,007.94 |
2.3× |
| Clavicle complete (73000) |
$291.98 |
$449.20 |
3.2× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$2,007.20 |
$3,088 |
5.5× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$859.95 |
$1,323 |
4.6× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,706.13 |
$2,624.83 |
9.2× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,646.65 |
$2,533.32 |
8.9× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,105.59 |
$1,700.92 |
6.0× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,820.96 |
$2,801.49 |
9.8× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$1,159.71 |
$1,784.18 |
6.3× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,033.42 |
$1,589.89 |
5.6× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$1,352.09 |
$2,080.14 |
7.3× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$931.46 |
$1,433.03 |
8.4× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$1,469.98 |
$2,261.51 |
7.9× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,163.01 |
$1,789.25 |
6.3× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$940.31 |
$1,446.64 |
8.5× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,103.03 |
$1,696.97 |
6.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$859.93 |
$1,322.97 |
7.8× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$931.52 |
$1,433.11 |
5.0× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$1,736.38 |
$2,671.36 |
9.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,905.28 |
$4,469.67 |
7.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,358.62 |
$3,628.66 |
9.4× |
| CT abdomen w & w/o contrast (74170) |
$1,232.59 |
$1,896.30 |
6.7× |
| CT abdomen w/contrast (74160) |
$1,362.30 |
$2,095.85 |
7.4× |
| CT abdomen w/o contrast (74150) |
$1,043.69 |
$1,605.68 |
9.5× |
| CT angio hrt w/3d image (75574) |
$1,778.80 |
$2,736.63 |
4.8× |
| CT cervical spine w/contrast (72126) |
$1,234.67 |
$1,899.50 |
3.4× |
| CT cervical spine w/o contrast (72125) |
$1,193.25 |
$1,835.78 |
10.8× |
| CT chest w/contrast (71260) |
$1,217.11 |
$1,872.49 |
6.6× |
| CT extremity upper w & w/o contrast (73202) |
$1,024.92 |
$1,576.81 |
5.5× |
| CT extremity upper w/o contrast (73200) |
$992.35 |
$1,526.70 |
9.0× |
| CT head/brain with contrast (70460) |
$1,031.60 |
$1,587.08 |
5.6× |
| CT head/brain without and with contrast (70470) |
$1,266.12 |
$1,947.88 |
6.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$176.76 |
$271.95 |
1.9× |
| CT l-spine w/contrast (72132) |
$857.08 |
$1,318.59 |
2.3× |
| CT lower extremity w/dye (73701) |
$1,003.13 |
$1,543.28 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$990.53 |
$1,523.90 |
9.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,257.82 |
$1,935.11 |
6.8× |
| CT neck w/contrast (70491) |
$1,002.11 |
$1,541.72 |
5.4× |
| CT neck w/o contrast (70490) |
$834.80 |
$1,284.31 |
7.6× |
| CT pelvis w & w/o contrast (72194) |
$1,479.55 |
$2,276.24 |
8.0× |
| CT pelvis w/o contrast (72192) |
$1,099.73 |
$1,691.90 |
10.0× |
| CT thoracic spine w/contrast (72129) |
$1,266.17 |
$1,947.96 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$1,205.26 |
$1,854.25 |
10.9× |
| CT thorax lung cancer scr c- (71271) |
$1,051.23 |
$1,617.29 |
9.5× |
| CT thorax w/o contrast (71250) |
$943.50 |
$1,451.55 |
8.6× |
| CT upper extremity w/dye (73201) |
$991.64 |
$1,525.60 |
2.7× |
| CTA head w contrast (70496) |
$931.52 |
$1,433.11 |
5.0× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$315.78 |
$485.82 |
2.9× |
| Dxa bone density study axial skeleton (77085) |
$204.75 |
$315 |
1.9× |
| Dxa bone density/peripheral (77081) |
$193.81 |
$298.18 |
2.1× |
| Fetal biophys profile w/o nst (76819) |
$510.47 |
$785.34 |
4.6× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$624.50 |
$960.78 |
2.5× |
| Gated heart planar single (78472) |
$2,086.55 |
$3,210.09 |
4.9× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,543.32 |
$2,374.34 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,018.32 |
$1,566.65 |
2.4× |
| Ht muscle image spect sing (78451) |
$2,761.15 |
$4,247.93 |
2.0× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$922.51 |
$1,419.25 |
2.2× |
| Kidney imaging morphol - nm kidney cortex (78700) |
$1,042.15 |
$1,603.31 |
2.5× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,953.37 |
$3,005.19 |
3.4× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,410.85 |
$2,170.55 |
2.5× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,885.44 |
$2,900.68 |
3.3× |
| Liver and spleen imaging (78215) |
$1,076.76 |
$1,656.56 |
2.6× |
| Lung perfusion imaging (78580) |
$1,206.19 |
$1,855.68 |
2.9× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$2,370.02 |
$3,646.19 |
6.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,561.70 |
$2,402.62 |
4.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,321.20 |
$2,032.63 |
5.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$2,761.58 |
$4,248.59 |
7.5× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$1,347.95 |
$2,073.77 |
5.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$1,487.53 |
$2,288.52 |
4.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,529.87 |
$2,353.66 |
4.2× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$1,426.91 |
$2,195.26 |
3.9× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$1,496.30 |
$2,302.01 |
4.1× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,485.93 |
$2,286.06 |
4.0× |
| Mandible min 4v (70110) |
$300.29 |
$461.99 |
2.7× |
| MRA head w/o contrast (70544) |
$1,191.08 |
$1,832.44 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,128.61 |
$1,736.33 |
4.5× |
| MRI abdomen w/contrast (74182) |
$1,399.62 |
$2,153.27 |
3.8× |
| MRI abdomen w/o contrast (74181) |
$1,271.10 |
$1,955.55 |
5.1× |
| MRI abdomen w/wo contrast (74183) |
$1,528.13 |
$2,350.97 |
4.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,323.32 |
$2,035.88 |
1.6× |
| MRI breast c- bilateral (77047) |
$1,244.25 |
$1,914.24 |
4.9× |
| MRI breast without contrast material unilateral (77046) |
$1,012.96 |
$1,558.40 |
4.0× |
| MRI c-spine w&w/o cont (72156) |
$1,707.43 |
$2,626.82 |
4.6× |
| MRI chest w/o contrast (71550) |
$1,004.18 |
$1,544.90 |
4.0× |
| MRI chest w/wo contrast (71552) |
$1,509.42 |
$2,322.20 |
4.1× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,370.02 |
$3,646.19 |
6.4× |
| MRI joint upr extrem w/dye (73222) |
$1,783.58 |
$2,743.97 |
2.2× |
| MRI joint upr extrem w/o dye (73221) |
$1,179.78 |
$1,815.05 |
4.7× |
| MRI lumbar spine w/contrast (72149) |
$1,487.68 |
$2,288.74 |
4.0× |
| MRI lumbar spine w/wo contrast (72158) |
$1,697.96 |
$2,612.26 |
4.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,669.64 |
$2,568.69 |
4.5× |
| MRI pelvis w & w/o contrast (72197) |
$1,913.48 |
$2,943.83 |
5.2× |
| MRI pelvis w/o contrast (72195) |
$1,067.33 |
$1,642.06 |
4.2× |
| MRI spine cervical w/o contrast (72141) |
$1,258.34 |
$1,935.91 |
5.0× |
| MRI t-spine w&w/o cont (72157) |
$2,678.37 |
$4,120.57 |
7.3× |
| MRI thoracic spine w/o contrst (72146) |
$1,006.14 |
$1,547.91 |
4.0× |
| MRI tmj (70336) |
$1,048.25 |
$1,612.70 |
4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,177.91 |
$1,812.18 |
4.7× |
| Myocardial spect multiple studies (78452) |
$3,307.22 |
$5,088.04 |
2.4× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$1,700.79 |
$2,616.60 |
1.9× |
| Nm bone 3 phase (78315) |
$1,432.39 |
$2,203.68 |
3.4× |
| Nm bone imaging whole body (78306) |
$1,364.88 |
$2,099.82 |
3.2× |
| Nm gastric emptying (78264) |
$1,552.21 |
$2,388.02 |
3.7× |
| Nm lung ventilation imaging (78579) |
$1,231.76 |
$1,895.03 |
2.9× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,105.35 |
$1,700.55 |
2.6× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$830.89 |
$1,278.30 |
2.0× |
| Nuclear medicine study of brain, 4 static views or more (78605) |
$1,028.61 |
$1,582.48 |
1.8× |
| Ob us limited fetus(s) (76815) |
$338.91 |
$521.40 |
3.1× |
| Parathyroid planar imaging (78070) |
$823.19 |
$1,266.45 |
2.0× |
| Pulmonary ventilation & perfusion imaging (78582) |
$2,814.18 |
$4,329.52 |
4.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$407.14 |
$626.38 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$232.83 |
$358.21 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$208.18 |
$320.28 |
1.9× |
| Radex hip unilateral with pelvis 1 view (73501) |
$215.79 |
$331.99 |
2.4× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$257.11 |
$395.56 |
2.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$303.07 |
$466.27 |
2.7× |
| Radex spine cervical 2 or 3 views (72040) |
$238.49 |
$366.91 |
2.6× |
| Radex spine cervical 4 or 5 views (72050) |
$348.71 |
$536.48 |
3.2× |
| Radex spine cervical 6 or more views (72052) |
$508.65 |
$782.55 |
4.6× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$265.44 |
$408.37 |
2.9× |
| Radiologic exam chest 3 views (71047) |
$278.47 |
$428.43 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$715.03 |
$1,100.05 |
3.9× |
| Radiologic exam esophagus single contrast study (74220) |
$510.90 |
$786 |
2.8× |
| Radiologic exam small int single contrast study (74250) |
$558.32 |
$858.96 |
3.0× |
| Radiologic exam swallow function contrast study (74230) |
$480.08 |
$738.59 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$575.46 |
$885.33 |
3.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$599.69 |
$922.61 |
3.2× |
| Radiologic examination femur 1 view (73551) |
$258.53 |
$397.74 |
2.8× |
| Radiologic examination femur minimum 2 views (73552) |
$272.48 |
$419.21 |
3.0× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$215.72 |
$331.89 |
2.3× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$294.13 |
$452.51 |
3.2× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$384.24 |
$591.14 |
3.5× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$243.26 |
$374.26 |
2.6× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$268.33 |
$412.82 |
2.9× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$271.18 |
$417.21 |
3.0× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$258.37 |
$397.50 |
2.8× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$224.10 |
$344.78 |
2.4× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$329.77 |
$507.35 |
3.0× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$280.76 |
$431.94 |
3.1× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$325.65 |
$501 |
3.5× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$389.42 |
$599.12 |
3.5× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$292.46 |
$449.94 |
2.7× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$275.92 |
$424.50 |
3.0× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$217.74 |
$334.99 |
2.4× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$321.36 |
$494.40 |
2.9× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$285.07 |
$438.57 |
2.6× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$348.03 |
$535.44 |
3.2× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$512.06 |
$787.79 |
4.6× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$335.52 |
$516.19 |
3.0× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$241 |
$370.78 |
2.6× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$237.26 |
$365.04 |
2.6× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$187.48 |
$288.44 |
2.0× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$227.31 |
$349.72 |
2.5× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$235.31 |
$362.02 |
2.6× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$276.74 |
$425.76 |
2.5× |
| Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) |
$1,327.33 |
$2,042.05 |
5.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,114.38 |
$1,714.44 |
2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,374.73 |
$2,114.98 |
3.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,871.49 |
$4,417.68 |
5.0× |
| Scapula complete (73010) |
$271.30 |
$417.39 |
2.5× |
| Screening digital breast tomosynthesis bi (77063) |
$31.53 |
$48.51 |
— |
| Thyroid imaging with vascular flow (78013) |
$720.85 |
$1,109.01 |
1.7× |
| Thyroid met imaging body (78018) |
$1,885.65 |
$2,901.01 |
3.3× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$930.18 |
$1,431.05 |
2.2× |
| Ultrasound breast limited (76642) |
$264.71 |
$407.26 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$442.87 |
$681.35 |
4.0× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$386.54 |
$594.69 |
3.5× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$427.91 |
$658.33 |
3.9× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$650.26 |
$1,000.41 |
2.6× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$442.10 |
$680.16 |
4.0× |
| Unlisted magnetic resonance procedure (eg, diagnostic, interventional) Age Under 21 (76498) |
$1,529.80 |
$2,353.54 |
16.7× |
| Us abdominal aorta real time screen study aaa (76706) |
$385.97 |
$593.81 |
3.5× |
| Us breast uni real time with image complete (76641) |
$295.91 |
$455.25 |
2.7× |
| Us chest (76604) |
$356.69 |
$548.76 |
3.2× |
| Us compl joint r-t w/image documentation (76881) |
$362.64 |
$557.91 |
3.3× |
| Us encephalogram (76506) |
$500.90 |
$770.63 |
4.5× |
| Us exam, pelvic, limited (76857) |
$354.44 |
$545.30 |
3.2× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$278.72 |
$428.81 |
3.0× |
| US OB Follow-Up/Repeat (76816) |
$335.79 |
$516.60 |
3.0× |
| Us ob transvaginal (76817) |
$400.76 |
$616.56 |
3.6× |
| Us retroperitoneal complete (76770) |
$490.31 |
$754.33 |
4.4× |
| Us retroperitoneal ltd (76775) |
$465.66 |
$716.40 |
4.2× |
| Us scrotum (76870) |
$478.56 |
$736.25 |
4.3× |
| Us soft tissue head/neck (76536) |
$473.83 |
$728.97 |
4.3× |
| Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) |
$150.15 |
$231 |
1.6× |
| X-ray exam hips bi 3-4 views (73522) |
$352.54 |
$542.38 |
3.2× |
| X-ray exam of finger(s) (73140) |
$210.38 |
$323.67 |
2.3× |
| X-ray exam of knee 1 or 2 (73560) |
$251.43 |
$386.82 |
2.7× |
| X-ray exam ribs bil 3 views (71110) |
$278.47 |
$428.43 |
2.5× |
| X-ray exam ribs uni 2 views (71100) |
$264.14 |
$406.38 |
2.9× |
| X-ray heel (73650) |
$297.15 |
$457.16 |
3.2× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$286.19 |
$440.30 |
2.6× |
| Xr abdomen 1 view (74018) |
$227.12 |
$349.43 |
2.5× |
| Xr abdomen 2 views (74019) |
$276.37 |
$425.19 |
2.5× |
| Xr arthrogram ankle (73615) |
$792.01 |
$1,218.49 |
2.2× |
| Xr arthrogram knee (73580) |
$839.87 |
$1,292.12 |
2.3× |
| Xr bone age studies (77072) |
$299.94 |
$461.46 |
2.7× |
| Xr bone length study (77073) |
$312.56 |
$480.87 |
2.8× |
| Xr bone survey infant (77076) |
$496.90 |
$764.47 |
4.5× |
| Xr chest 1 view (71045) |
$235.48 |
$362.28 |
2.6× |
| Xr chest 2 views (71046) |
$246.88 |
$379.82 |
2.7× |
| Xr eye foreign body (70030) |
$286.62 |
$440.96 |
3.1× |
| Xr facial bones 3+ views (70150) |
$356.33 |
$548.21 |
3.2× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$233.40 |
$359.08 |
2.5× |
| Xr forearm 2 views (73090) |
$249.91 |
$384.49 |
2.7× |
| Xr hand 2v (73120) |
$268.14 |
$412.53 |
2.4× |
| Xr neck soft tissue (70360) |
$216.39 |
$332.91 |
2.4× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$279.31 |
$429.71 |
3.0× |
| Xr osseous survey complete (77075) |
$569.48 |
$876.13 |
5.2× |
| Xr pelvis 1-2 views (72170) |
$252.38 |
$388.28 |
2.3× |
| Xr pelvis min 3 view (72190) |
$337.54 |
$519.30 |
3.1× |
| Xr sacrum/coccyx 2+ views (72220) |
$288.94 |
$444.53 |
3.1× |
| Xr shoulder 1 view (73020) |
$163.28 |
$251.21 |
1.8× |
| Xr sinuses 3+ views (70220) |
$328.51 |
$505.41 |
3.6× |
| Xr skull min 4 view (70260) |
$441.87 |
$679.80 |
4.0× |
| Xr spine 1 view (72020) |
$207.19 |
$318.76 |
2.3× |
| Xr spine thoracic 3v (72072) |
$326.87 |
$502.88 |
3.0× |
| Xr sternum 2+ views (71120) |
$295.11 |
$454.02 |
3.2× |
| Xr surgical specimen (76098) |
$661.41 |
$1,017.56 |
1.1× |
| Xr t-spine 2 views (72070) |
$259.56 |
$399.33 |
2.4× |
| Xr tibia/fibula 2 views (73590) |
$242.08 |
$372.44 |
2.6× |
| Xr tmj bilateral (70330) |
$256.83 |
$395.13 |
2.8× |
| Xr tmj unilateral (70328) |
$174.68 |
$268.74 |
1.9× |
| Xr wrist 2 views (73100) |
$215.38 |
$331.36 |
2.3× |