| Abdomen 1 View (74018) |
$249 |
$415 |
3.0× |
| Abdomen 2 views (74019) |
$191.40 |
$319 |
1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,179.60 |
$1,966 |
3.1× |
| Angiography extremity bilateral rs&i (75716) |
$5,731.80 |
$9,553 |
1.9× |
| Angiography extremity unilateral rs&i (75710) |
$5,731.80 |
$9,553 |
1.9× |
| Ankle 2 views (73600) |
$190.80 |
$318 |
2.3× |
| Artery X-Rays Pelvis (75736) |
$8,514 |
$14,190 |
1.6× |
| Arthrogram hip (73525) |
$2,263.20 |
$3,772 |
6.9× |
| Bone age studies (77072) |
$97.20 |
$162 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$1,725.60 |
$2,876 |
4.6× |
| Bone Imaging Limited Area (78300) |
$1,122 |
$1,870 |
3.0× |
| Bone Imaging Whole Body (78306) |
$1,144.80 |
$1,908 |
3.0× |
| Bone marrow imaging limited area (78102) |
$1,347.60 |
$2,246 |
3.6× |
| Bone survey infant (77076) |
$733.20 |
$1,222 |
7.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,705 |
$11,175 |
5.0× |
| Cat Scan Follow-Up Study (76380) |
$366 |
$610 |
4.4× |
| Chest 1 view (71045) |
$102.60 |
$171 |
1.2× |
| Chest 2 views (71046) |
$133.20 |
$222 |
1.6× |
| Chest 3 views (71047) |
$93 |
$155 |
1.1× |
| Chest 4 or more views (71048) |
$105.60 |
$176 |
1.1× |
| Clavicle complete (73000) |
$250.20 |
$417 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$229.20 |
$382 |
2.3× |
| Contrast Exam Abdominl Aorta (75625) |
$4,643.40 |
$7,739 |
1.6× |
| Contrast X-Ray Bladder (74430) |
$273.60 |
$456 |
0.8× |
| Contrast X-Ray Of Knee Joint (73580) |
$2,350.80 |
$3,918 |
7.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,092.80 |
$3,488 |
6.3× |
| CT abdomen and pelvis without contrast (74176) |
$3,154.80 |
$5,258 |
14.0× |
| CT abdomen w contrast (74160) |
$1,269.60 |
$2,116 |
7.7× |
| CT abdomen w wo contrast (74170) |
$1,101.60 |
$1,836 |
6.6× |
| CT abdomen w/o contrast (74150) |
$1,126.20 |
$1,877 |
11.4× |
| CT Angio Abdomen and Pelvis (74174) |
$3,333.60 |
$5,556 |
10.1× |
| CT Angio Chest (71275) |
$972.60 |
$1,621 |
5.9× |
| CT Angio Head (70496) |
$1,137.60 |
$1,896 |
6.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,324.20 |
$2,207 |
8.0× |
| CT Angio Neck (70498) |
$1,137.60 |
$1,896 |
6.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,324.20 |
$2,207 |
8.0× |
| CT cervical spine w/ contrast (72126) |
$1,025.40 |
$1,709 |
3.1× |
| CT cervical spine w/o contrast (72125) |
$624.60 |
$1,041 |
6.3× |
| CT cervical spine w/wo cont (72127) |
$3,664.20 |
$6,107 |
22.1× |
| CT chest w contrast (71260) |
$1,951.20 |
$3,252 |
11.8× |
| CT chest w/wo contrast (71270) |
$1,412.40 |
$2,354 |
8.5× |
| CT head/brain with contrast (70460) |
$843 |
$1,405 |
5.1× |
| CT head/brain without and with contrast (70470) |
$678.60 |
$1,131 |
4.1× |
| CT iac w contrast (70481) |
$529.20 |
$882 |
3.2× |
| CT l-spine w&w/o contrast (72133) |
$1,475.40 |
$2,459 |
8.9× |
| CT lower ext w/o (73700) |
$720 |
$1,200 |
7.3× |
| CT lower extremity w/contrast material (73701) |
$1,239.60 |
$2,066 |
7.5× |
| CT lumbar spine w contrast (72132) |
$1,282.80 |
$2,138 |
3.9× |
| CT lumbar spine w/o contrast (72131) |
$780 |
$1,300 |
7.9× |
| CT maxillofacial w contrast (70487) |
$728.40 |
$1,214 |
4.4× |
| CT maxillofacial wo contrast (70486) |
$499.20 |
$832 |
5.0× |
| CT neck tissue combo (70492) |
$1,373.40 |
$2,289 |
8.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,161.60 |
$1,936 |
7.0× |
| CT orbits w/o contrast (70480) |
$496.20 |
$827 |
5.0× |
| CT pelvis w&w/o contrast (72194) |
$1,489.80 |
$2,483 |
9.0× |
| CT pelvis w/o contrast (72192) |
$789 |
$1,315 |
8.0× |
| CT scan of leg combo (73702) |
$1,770.60 |
$2,951 |
10.7× |
| CT scans face/jaw combo (70488) |
$1,432.80 |
$2,388 |
8.6× |
| CT soft tissue neck w contrast (70491) |
$1,150.80 |
$1,918 |
6.9× |
| CT soft tissue neck w/o contrast (70490) |
$610.20 |
$1,017 |
6.2× |
| CT thoracic spine w contrast (72129) |
$981.60 |
$1,636 |
5.9× |
| CT thoracic spine w/o contrast (72128) |
$595.80 |
$993 |
6.0× |
| CT thoracic spine w/wo cont (72130) |
$1,126.80 |
$1,878 |
6.8× |
| CT thorax w/o contrast (71250) |
$679.80 |
$1,133 |
6.9× |
| CT upper ext wo (73200) |
$381.60 |
$636 |
3.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,857.60 |
$3,096 |
11.2× |
| CT upper extremity with contrast (73201) |
$1,108.20 |
$1,847 |
3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$972.60 |
$1,621 |
5.9× |
| Cta Abdomen (74175) |
$1,389 |
$2,315 |
8.4× |
| CTA pelvis (72191) |
$1,389 |
$2,315 |
8.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$185.40 |
$309 |
1.9× |
| Dxa Bone Density Axial (77080) |
$233.40 |
$389 |
2.4× |
| Dxa bone density study (77085) |
$461.40 |
$769 |
4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$266.40 |
$444 |
3.2× |
| Esophagram (74220) |
$448.20 |
$747 |
2.7× |
| Fetal Biophys Profile W/Nst (76818) |
$1,006.80 |
$1,678 |
10.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$468.60 |
$781 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$327 |
$545 |
1.4× |
| Foot 2 views (73620) |
$235.80 |
$393 |
2.9× |
| Forearm 2 views (73090) |
$153 |
$255 |
1.9× |
| Gastric emptying imaging study (78264) |
$756.60 |
$1,261 |
2.0× |
| Gated Heart Planar Single (78472) |
$1,623.60 |
$2,706 |
4.3× |
| Hand 2 views (73120) |
$128.40 |
$214 |
1.3× |
| Hepatobil Syst Image W/Drug (78227) |
$2,672.40 |
$4,454 |
5.2× |
| Hepatobiliary System Imaging (78226) |
$1,336.20 |
$2,227 |
3.5× |
| Ht Muscle Image Spect Sing (78451) |
$6,259.80 |
$10,433 |
5.1× |
| Hysterosalpingogram (74740) |
$648 |
$1,080 |
2.9× |
| K Flow/Funct Image Multiple (78709) |
$2,448 |
$4,080 |
4.8× |
| K Flow/Funct Image W/Drug (78708) |
$1,702.80 |
$2,838 |
3.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,339.20 |
$2,232 |
2.6× |
| Knee 3 Views (73562) |
$379.20 |
$632 |
4.6× |
| Liver & Spleen Imaging Static Only (78215) |
$1,090.80 |
$1,818 |
2.9× |
| Liver imaging w/vascular flow (78202) |
$939 |
$1,565 |
1.8× |
| Lung perfusion differential (78597) |
$4,194.60 |
$6,991 |
11.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,600.20 |
$2,667 |
3.1× |
| Lung Ventilation Imaging (78579) |
$2,285.40 |
$3,809 |
6.0× |
| Lymph System Imaging (78195) |
$1,297.20 |
$2,162 |
2.5× |
| Magnetic Image Jaw Joint (70336) |
$2,158.80 |
$3,598 |
9.6× |
| Meckels Divert Exam (78290) |
$921.60 |
$1,536 |
2.4× |
| Mr safety determination physician/other qhp (76016) |
$138.60 |
$231 |
1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$38.40 |
$64 |
1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$144 |
$240 |
1.6× |
| Mr safety implt pos&/immoblj (76019) |
$93.60 |
$156 |
1.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$380.40 |
$634 |
1.7× |
| MRI abdomen w contrast (74182) |
$2,523 |
$4,205 |
7.6× |
| MRI abdomen w/o contrast (74181) |
$1,648.80 |
$2,748 |
7.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,796.20 |
$6,327 |
5.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,545.80 |
$4,243 |
7.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,375 |
$5,625 |
4.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$4,783.80 |
$7,973 |
21.2× |
| MRI chest w/o contrast (71550) |
$1,297.20 |
$2,162 |
5.7× |
| MRI chest wo w contrast (71552) |
$3,531 |
$5,885 |
10.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,873.40 |
$4,789 |
8.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,314.20 |
$3,857 |
7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,749.60 |
$2,916 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,930.80 |
$3,218 |
8.6× |
| MRI orbit face neck w contrast (70542) |
$2,219.40 |
$3,699 |
6.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,553.60 |
$4,256 |
7.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,978.40 |
$4,964 |
9.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,110.40 |
$5,184 |
13.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,110 |
$6,850 |
12.5× |
| MRI, abdomen, combo (74183) |
$1,760.40 |
$2,934 |
5.3× |
| MRI, joint upper extrem (73221) |
$807.60 |
$1,346 |
3.6× |
| MRI, joint upper extrem combo (73223) |
$2,846.40 |
$4,744 |
8.6× |
| Myelogram cervical (72240) |
$1,132.80 |
$1,888 |
1.5× |
| Myelogram Lumbar (72265) |
$1,132.80 |
$1,888 |
1.5× |
| Myelography thoracic (72255) |
$1,132.80 |
$1,888 |
1.5× |
| Myelograpy 2/more regions rs&i (72270) |
$1,132.80 |
$1,888 |
1.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$6,705 |
$11,175 |
5.5× |
| Myocardial Spect Multiple Studies (78452) |
$6,186.60 |
$10,311 |
5.1× |
| Neck soft tissue (70360) |
$220.80 |
$368 |
2.7× |
| Nonvascular Shunt X-Ray (75809) |
$709.80 |
$1,183 |
7.2× |
| Nuclear Rx Oral Admin (79005) |
$1,169.40 |
$1,949 |
5.3× |
| Parathyroid Planar Imaging (78070) |
$733.20 |
$1,222 |
1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,350.60 |
$2,251 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$249 |
$415 |
2.5× |
| Pet Image Skull-Thigh (78812) |
$5,035.20 |
$8,392 |
3.7× |
| Pet Image W/Ct Lmtd (78814) |
$5,035.20 |
$8,392 |
3.7× |
| PET image w/CT, full body (78816) |
$3,524.40 |
$5,874 |
2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,524.40 |
$5,874 |
2.6× |
| PET whole body (78813) |
$5,035.20 |
$8,392 |
3.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,318.80 |
$2,198 |
3.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$299.40 |
$499 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$385.20 |
$642 |
0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$429 |
$715 |
5.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$255.60 |
$426 |
3.1× |
| Radex elbow complete minimum 3 views (73080) |
$203.40 |
$339 |
2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$388.20 |
$647 |
3.9× |
| Radex fingr minimum 2 views (73140) |
$135 |
$225 |
1.6× |
| Radex foot complete minimum 3 views (73630) |
$448.80 |
$748 |
5.5× |
| Radex Hand Minimum 3 Views (73130) |
$325.80 |
$543 |
4.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$364.80 |
$608 |
4.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$288.60 |
$481 |
3.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$360 |
$600 |
4.4× |
| Radex shoulder complete minimum 2 views (73030) |
$233.40 |
$389 |
2.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$205.20 |
$342 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$305.40 |
$509 |
3.7× |
| Radex Sternum Minimum 2 Views (71120) |
$275.40 |
$459 |
3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$411 |
$685 |
5.0× |
| Radex Toe Minimum 2 Views (73660) |
$193.80 |
$323 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$382.80 |
$638 |
3.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$343.20 |
$572 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$373.20 |
$622 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$427.80 |
$713 |
4.3× |
| Radiologic exam colon double contrast study (74280) |
$894 |
$1,490 |
5.4× |
| Radiologic exam colon single contrast study (74270) |
$615.60 |
$1,026 |
3.7× |
| Radiologic exam knee complete 4/more views (73564) |
$333 |
$555 |
3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$530.40 |
$884 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$570 |
$950 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$653.40 |
$1,089 |
3.9× |
| Radiologic examination femur 1 view (73551) |
$233.40 |
$389 |
2.8× |
| Radiologic examination femur minimum 2 views (73552) |
$184.80 |
$308 |
2.2× |
| Radiologic examination knee 1/2 views (73560) |
$141.60 |
$236 |
1.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$192 |
$320 |
2.3× |
| Ribs bilateral 3 views (71110) |
$436.80 |
$728 |
4.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,063.80 |
$1,773 |
2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$958.20 |
$1,597 |
2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,366.20 |
$2,277 |
2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,737.60 |
$2,896 |
3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,122 |
$1,870 |
0.9× |
| Rp Therapy Intravenous Administration (79101) |
$855 |
$1,425 |
3.9× |
| Scapula (73010) |
$243 |
$405 |
2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$21.60 |
$36 |
0.9× |
| Shoulder 1 view (73020) |
$163.80 |
$273 |
2.0× |
| Shoulder Arthrography (73040) |
$725.40 |
$1,209 |
2.2× |
| Sialogram (70390) |
$448.20 |
$747 |
2.0× |
| Skull less than 4 views (70250) |
$243 |
$405 |
2.5× |
| Sternoclavicular joints (71130) |
$331.80 |
$553 |
4.0× |
| Testicular Imaging W/Flow (78761) |
$1,040.40 |
$1,734 |
2.8× |
| Thoracic spine 2 views (72070) |
$339.60 |
$566 |
3.4× |
| Thoracic spine 3 views (72072) |
$302.40 |
$504 |
3.1× |
| Thoracolumbar 2 views (72080) |
$339.60 |
$566 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,162.20 |
$1,937 |
3.1× |
| Thyroid Uptake Measurement (78012) |
$1,162.20 |
$1,937 |
3.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,189.20 |
$1,982 |
3.1× |
| Ultrasound Breast Limited (76642) |
$164.40 |
$274 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$422.40 |
$704 |
4.3× |
| Ultrasound, abdomen limited (76705) |
$1,223.40 |
$2,039 |
12.4× |
| Umbilical-artery Doppler (OB) (76820) |
$208.80 |
$348 |
2.1× |
| Unlisted Dx Radiographic Procedure (76499) |
$259.20 |
$432 |
3.1× |
| Unlisted us procedure (76999) |
$679.20 |
$1,132 |
8.2× |
| Upper gi w/o kub (74240) |
$658.20 |
$1,097 |
4.0× |
| Urethrocystogram voiding (74455) |
$336.60 |
$561 |
1.5× |
| Urethrocystography retrograde (74450) |
$336.60 |
$561 |
1.5× |
| Us breast unilateral complete (76641) |
$102.60 |
$171 |
1.0× |
| Us chest (76604) |
$525 |
$875 |
5.3× |
| Us complete joint (76881) |
$550.20 |
$917 |
5.6× |
| Us exam, pelvic, limited (76857) |
$247.80 |
$413 |
2.5× |
| Us head (76506) |
$639 |
$1,065 |
6.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$664.80 |
$1,108 |
6.7× |
| Us ob detailed single fetus (76811) |
$885.60 |
$1,476 |
3.9× |
| Us ob limited 1 or more fetuses (76815) |
$313.80 |
$523 |
3.2× |
| Us ob transvaginal (76817) |
$762.60 |
$1,271 |
7.7× |
| Us pelvic non ob complete (76856) |
$316.80 |
$528 |
3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$767.40 |
$1,279 |
7.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$448.80 |
$748 |
4.5× |
| Us retroperitoneal complete (76770) |
$615 |
$1,025 |
6.2× |
| Us retroperitoneal limited (76775) |
$570.60 |
$951 |
5.8× |
| Us scrotum and contents (76870) |
$882 |
$1,470 |
8.9× |
| Us spinal canal and contents (76800) |
$767.40 |
$1,279 |
7.8× |
| Us thyroid (76536) |
$804 |
$1,340 |
8.1× |
| Us transrectal (76872) |
$651 |
$1,085 |
6.6× |
| Vein X-Ray Chest (75827) |
$3,378 |
$5,630 |
2.3× |
| Venography caval inferior serialography rs&i (75825) |
$3,870.60 |
$6,451 |
1.3× |
| Venography extremity bilateral rs&i (75822) |
$6,398.40 |
$10,664 |
4.3× |
| Venography extremity unilateral rs&i (75820) |
$3,199.20 |
$5,332 |
2.1× |
| Wrist 2 views (73100) |
$243 |
$405 |
3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$293.40 |
$489 |
3.6× |
| X-Ray Aorta Leg Arteries (75630) |
$5,487.60 |
$9,146 |
1.8× |
| X-Ray Bend Only L-S Spine (72120) |
$290.40 |
$484 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$223.80 |
$373 |
2.7× |
| X-Ray Exam Breast Specimen (76098) |
$379.80 |
$633 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$210 |
$350 |
2.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$287.40 |
$479 |
2.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$189 |
$315 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$200.40 |
$334 |
2.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$378.60 |
$631 |
3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$220.80 |
$368 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$325.80 |
$543 |
3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$378.60 |
$631 |
3.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$616.20 |
$1,027 |
6.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$162.60 |
$271 |
2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$609.60 |
$1,016 |
6.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$339 |
$565 |
3.4× |
| X-ray eye for foreign body (70030) |
$226.20 |
$377 |
2.7× |
| X-ray humerus (73060) |
$213.60 |
$356 |
2.6× |
| X-ray IV pyelogram (ivp) (74400) |
$741 |
$1,235 |
4.5× |
| X-ray IV pyelogram+tomography (74415) |
$726 |
$1,210 |
4.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$273.60 |
$456 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$252.60 |
$421 |
3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$225.60 |
$376 |
2.3× |
| X-ray nose-rectum child f.b. (76010) |
$186 |
$310 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$568.80 |
$948 |
5.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$202.80 |
$338 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$289.20 |
$482 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$447.60 |
$746 |
5.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$487.80 |
$813 |
4.9× |
| X-ray thoracic spine 4 vw (72074) |
$612.60 |
$1,021 |
6.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$452.40 |
$754 |
1.4× |
| X-Rays Bone Length Studies (77073) |
$315 |
$525 |
3.2× |
| X-Rays Bone Survey Complete (77075) |
$733.20 |
$1,222 |
7.4× |
| Xr c-spine 4 or 5 views (72050) |
$325.20 |
$542 |
3.3× |
| Xr facial bones less than 3 views (70140) |
$214.20 |
$357 |
2.6× |
| Xr orbits complete 4 views (70200) |
$365.40 |
$609 |
3.7× |
| Xr Tomogram Single Plane (76100) |
$223.80 |
$373 |
2.3× |