| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,596.10 |
$3,994 |
1.6× |
| Abdomen 2 views (74019) |
$170.30 |
$262 |
1.4× |
| Acute gi blood loss imaging (78278) |
$553.15 |
$851 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$5,590.77 |
— |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$2,915.25 |
$4,485 |
0.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,006.95 |
$7,703 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,639 |
$4,060 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,639 |
$4,060 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,006.95 |
$7,703 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,914.60 |
$4,484 |
0.8× |
| Ankle 2 views (73600) |
$134.55 |
$207 |
1.3× |
| Aortogram thoracic (75605) |
$5,006.95 |
$7,703 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,915.25 |
$4,485 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,915.25 |
$4,485 |
0.8× |
| Arthrogram elbow (73085) |
$560.30 |
$862 |
1.3× |
| Arthrogram hip (73525) |
$536.25 |
$825 |
1.3× |
| Arthrogram knee (73580) |
$536.25 |
$825 |
1.3× |
| Arthrogram shoulder (73040) |
$592.80 |
$912 |
1.4× |
| Basic dosimetry (77300) |
$217.75 |
$335 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$512.20 |
$788 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$640.90 |
$986 |
1.3× |
| Bone age studies (77072) |
$126.10 |
$194 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$649.35 |
$999 |
1.4× |
| Bone survey complete (77075) |
$100.75 |
$155 |
0.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$498.55 |
$767 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$214.50 |
$330 |
2.1× |
| Chest 1 view (71045) |
$7,236.84 |
— |
69.4× |
| Chest xray 3 views (71047) |
$196.95 |
$303 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$235.95 |
$363 |
1.1× |
| Cineradiography/videoradiography (76120) |
$168.35 |
$259 |
1.3× |
| Clavicle complete (73000) |
$150.80 |
$232 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$98.15 |
$151 |
0.8× |
| Continuing medical physics consltj pr wk (77336) |
$11,682.45 |
— |
72.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,027 |
$1,580 |
2.5× |
| CT abdomen and pelvis without contrast (74176) |
$599.30 |
— |
2.1× |
| CT abdomen w contrast (74160) |
$871 |
$1,340 |
4.1× |
| CT abdomen w wo contrast (74170) |
$1,262.30 |
$1,942 |
6.0× |
| CT abdomen w/o contrast (74150) |
$661.05 |
$1,017 |
5.3× |
| CT angio hrt w/3d image (75574) |
$707.85 |
$1,089 |
1.7× |
| CT angio lwr extr w/o&w/dye (73706) |
$981.17 |
— |
4.7× |
| CT angiography upper extremity lt (73206) |
$955.50 |
$1,470 |
4.5× |
| CT c-spine w/contrast (72126) |
$1,027 |
$1,580 |
2.5× |
| CT c-spine w/o contrast (72125) |
$926.90 |
$1,426 |
7.4× |
| CT chest w contrast (71260) |
$1,756.62 |
— |
8.4× |
| CT chest w/wo contrast (71270) |
$161.20 |
$248 |
0.8× |
| CT head/brain with contrast (70460) |
$960.70 |
$1,478 |
4.6× |
| CT head/brain without and with contrast (70470) |
$1,033.50 |
$1,590 |
4.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$584.35 |
$899 |
1.4× |
| CT iac w contrast (70481) |
$808.60 |
$1,244 |
3.8× |
| CT limited/localized follow up study (76380) |
$246.35 |
$379 |
2.4× |
| CT lower ext w/o (73700) |
$759.20 |
— |
6.1× |
| CT lower extremity w wo contrast (73702) |
$1,060.80 |
$1,632 |
5.0× |
| CT lower extremity w/contrast material (73701) |
$1,191.77 |
— |
5.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,085.50 |
$1,670 |
5.2× |
| CT lumbar spine w/contrast (72132) |
$985.40 |
$1,516 |
2.4× |
| CT lumbar spine w/o contrast (72131) |
$871 |
$1,340 |
7.0× |
| CT maxillofacial w contrast (70487) |
$869.70 |
$1,338 |
4.1× |
| CT maxillofacial w/wo contrast (70488) |
$954.85 |
$1,469 |
4.5× |
| CT maxillofacial wo contrast (70486) |
$742.95 |
$1,143 |
5.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$161.20 |
$248 |
0.8× |
| CT orbits w/o contrast (70480) |
$743.60 |
— |
5.9× |
| CT pelvis w/o contrast (72192) |
$835.90 |
$1,286 |
6.7× |
| CT scan of arm combo (73202) |
$165.10 |
$254 |
0.8× |
| CT soft tissue neck w contrast (70491) |
$882.70 |
$1,358 |
4.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,033.50 |
$1,590 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$620.75 |
$955 |
5.0× |
| CT thoracic spine w/contrast (72129) |
$982.15 |
$1,511 |
4.7× |
| CT thoracic spine w/o contrast (72128) |
$900.90 |
$1,386 |
7.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,080.95 |
$1,663 |
5.1× |
| CT thorax w/o contrast (71250) |
$649.35 |
$999 |
5.2× |
| CT upper ext wo (73200) |
$758.55 |
$1,167 |
6.1× |
| CT upper extremity with contrast (73201) |
$959.72 |
— |
2.3× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$958.10 |
$1,474 |
4.6× |
| Cta Abdomen (74175) |
$871 |
$1,340 |
4.1× |
| CTA abdomen pelvis (74174) |
$1,008.15 |
$1,551 |
2.4× |
| CTA chest (71275) |
$958.10 |
$1,474 |
4.6× |
| Cta Head (70496) |
$1,846.32 |
— |
8.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,757.60 |
$2,704 |
4.2× |
| Cta Neck (70498) |
$1,846.32 |
— |
8.8× |
| Cta Pelvis (72191) |
$1,287.65 |
$1,981 |
6.1× |
| Cystography minimum 3 views rs&i (74430) |
$425.75 |
$655 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$275.60 |
$424 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$96.20 |
$148 |
0.9× |
| Esophagus (74220) |
$267.15 |
$411 |
1.3× |
| Facial bones min 3 views (70150) |
$228.80 |
$352 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$1,349.12 |
— |
4.7× |
| Foot 2 views (73620) |
$156.65 |
$241 |
1.5× |
| Forearm 2 views (73090) |
$181.35 |
$279 |
1.7× |
| Hand 2 views (73120) |
$130 |
$200 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$614.25 |
$945 |
0.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$549.90 |
$846 |
1.1× |
| Hysterosalpingogram (74740) |
$502.45 |
$773 |
1.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$696.15 |
$1,071 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$872.95 |
$1,343 |
1.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$498.55 |
$767 |
0.8× |
| Knee 3 views (73562) |
$187.20 |
$288 |
1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$549.90 |
$846 |
1.1× |
| Liver imaging w/vascular flow (78202) |
$1,101.75 |
$1,695 |
1.7× |
| Lymphoscintigraphy (78195) |
$550.55 |
$847 |
0.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$562.25 |
$865 |
1.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,251.90 |
$1,926 |
3.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$10,158.20 |
— |
22.6× |
| MRA head w & w/o contrast (70546) |
$1,654.25 |
$2,545 |
4.0× |
| MRA head w/o contrast (70544) |
$863.20 |
$1,328 |
3.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,235 |
$1,900 |
3.0× |
| MRA neck w/o contrast (70547) |
$923.65 |
$1,421 |
3.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,255.80 |
$1,932 |
3.0× |
| MRI abdomen w/o contrast (74181) |
$875.55 |
$1,347 |
3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,847.30 |
$2,842 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$1,286.35 |
$1,979 |
4.5× |
| MRI chest w/o & w/contrast material (71552) |
$330.85 |
$509 |
0.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,277.25 |
$1,965 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$854.10 |
$1,314 |
3.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,052.70 |
$3,158 |
4.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,847.30 |
$2,842 |
4.4× |
| MRI pelvis w/o contrast (72195) |
$1,021.80 |
$1,572 |
3.6× |
| MRI spectroscopy (76390) |
$81.25 |
$125 |
0.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,975.35 |
$3,039 |
4.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,774.50 |
$2,730 |
4.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,977.95 |
$3,043 |
4.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,630.20 |
$2,508 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,975.35 |
$3,039 |
4.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,286.35 |
$1,979 |
4.5× |
| MRI up ext w/o contrast (73218) |
$216.45 |
$333 |
0.8× |
| MRI upper ext joint w/o contrast (73221) |
$931.45 |
$1,433 |
3.3× |
| MRI, joint upper extrem combo (73223) |
$1,847.30 |
$2,842 |
4.4× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78433) |
$1,807 |
$2,780 |
0.7× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$2,083.90 |
$3,206 |
0.8× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$3,541.85 |
$5,449 |
2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,245.40 |
$1,916 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$1,379.30 |
$2,122 |
0.9× |
| Myocardial spect single study at rest or stress (78451) |
$1,366.30 |
$2,102 |
0.9× |
| Neck soft tissue (70360) |
$143.65 |
$221 |
1.4× |
| Nm cardiac blood pool multiple (78473) |
$529.10 |
$814 |
1.1× |
| Nm gastric emptying study (78264) |
$582.40 |
$896 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,553.20 |
$3,928 |
1.5× |
| Osseous survey limited (77074) |
$228.80 |
$352 |
1.8× |
| Parathyrd planar w/spect&CT (78072) |
$1,108.25 |
$1,705 |
1.7× |
| Parathyroid Planar Imaging (78070) |
$388.05 |
$597 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$17,607.09 |
— |
140.5× |
| PET image w/CT, skull-thigh (78815) |
$2,744.95 |
$4,223 |
1.6× |
| PET imaging CT for attenuation limited area (78814) |
$2,677.35 |
$4,119 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$512.20 |
$788 |
1.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$653.90 |
$1,006 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$522.60 |
$804 |
0.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$234.32 |
— |
2.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$145.60 |
$224 |
1.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$775.12 |
— |
7.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$107.90 |
$166 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$208.65 |
$321 |
1.7× |
| Radex fingr minimum 2 views (73140) |
$174.85 |
— |
1.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$246.02 |
— |
2.4× |
| Radex Hand Minimum 3 Views (73130) |
$416.32 |
— |
4.0× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$107.25 |
$165 |
1.0× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$98.15 |
$151 |
0.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$172.90 |
$266 |
1.4× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$313.95 |
$483 |
2.5× |
| Radex Humerus Minimum 2 Views (73060) |
$172.90 |
— |
1.7× |
| Radex Kne 1/2 Views (73560) |
$418.28 |
— |
4.0× |
| Radex Kne Compl 4/More Views (73564) |
$250.90 |
$386 |
2.0× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$256.10 |
$394 |
2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$196.95 |
$303 |
1.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$226.85 |
$349 |
1.8× |
| Radex Sho Compl Minimum 2 Views (73030) |
$233.68 |
— |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$154.70 |
$238 |
1.5× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$251.55 |
$387 |
2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$150.15 |
$231 |
1.4× |
| Radex Toe Minimum 2 Views (73660) |
$152.10 |
$234 |
1.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$131.95 |
$203 |
1.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$205.40 |
— |
2.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,078.50 |
$10,890 |
0.8× |
| Radiation treatment delivery level 1 (77402) |
$258.70 |
$398 |
2.1× |
| Radiation treatment delivery level 2 (77407) |
$917.15 |
$1,411 |
2.0× |
| Radiation treatment delivery level 3 (77412) |
$426.40 |
$656 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$161.20 |
— |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$186.55 |
$287 |
1.5× |
| Radiologic exam chest 2 views (71046) |
$179.40 |
— |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$350.35 |
$539 |
1.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$173.55 |
$267 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$358.15 |
$551 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$340.60 |
$524 |
1.6× |
| Radiologic examination femur 1 view (73551) |
$109.20 |
$168 |
1.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$182.65 |
$281 |
1.8× |
| Radiological examination surgical specimen (76098) |
$475.80 |
$732 |
0.7× |
| Ribs bilateral 3 views (71110) |
$236.60 |
$364 |
1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,712.10 |
$2,634 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,175.85 |
$1,809 |
1.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,175.85 |
$1,809 |
1.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,211.60 |
$1,864 |
0.8× |
| Sacroiliac Joints < 3 Views (72200) |
$142.35 |
$219 |
1.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$341.90 |
$526 |
1.2× |
| Scapula (73010) |
$154.70 |
$238 |
1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$133.25 |
$205 |
5.7× |
| Shoulder 1 view (73020) |
$133.25 |
$205 |
1.3× |
| Small bowel series (74250) |
$362.70 |
$558 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$521.30 |
$802 |
1.2× |
| Special dosimetry (77331) |
$258.70 |
$398 |
1.6× |
| Special Physics Consult (77370) |
$346.45 |
$533 |
2.2× |
| Special treatment procedure (77470) |
$759.20 |
$1,168 |
1.1× |
| Spine thoracic 3 views (72072) |
$225.55 |
$347 |
1.8× |
| Stereotactic Body Radiation Delivery (77373) |
$2,974.40 |
$4,576 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$338 |
$520 |
0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$292.50 |
$450 |
0.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$737.10 |
$1,134 |
1.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$358.80 |
$552 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$456.30 |
$702 |
1.0× |
| Tmj unilateral (70328) |
$98.80 |
$152 |
0.9× |
| Treatment device complex (77334) |
$417.95 |
$643 |
0.9× |
| Treatment device intermediate (77333) |
$379.60 |
$584 |
2.4× |
| Treatment devices simple (77332) |
$356.85 |
$549 |
2.2× |
| Ultrasound breast complete (76641) |
$169.65 |
$261 |
1.4× |
| Ultrasound Exam Aaa Screen (76706) |
$163.80 |
$252 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$439.40 |
$676 |
3.5× |
| Urethrocystogram voiding (74455) |
$425.75 |
$655 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$425.75 |
$655 |
1.5× |
| Us breast unilateral limited (76642) |
$140.40 |
$216 |
1.3× |
| Us chest (76604) |
$234.65 |
$361 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$238.55 |
$367 |
1.9× |
| Us elastography parenchyma (76981) |
$122.20 |
$188 |
1.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$180.05 |
$277 |
1.4× |
| Us ob limited (76815) |
$214.50 |
$330 |
1.7× |
| Us ob transvaginal (76817) |
$588.25 |
$905 |
4.7× |
| Us pelvic non ob complete (76856) |
$523.25 |
$805 |
4.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$217.75 |
$335 |
1.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$237.90 |
$366 |
1.9× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$280.80 |
$432 |
2.2× |
| Us retroperitoneal complete (76770) |
$305.50 |
$470 |
2.4× |
| Us retroperitoneal limited (76775) |
$213.20 |
$328 |
1.7× |
| Us scrotum and contents (76870) |
$449.80 |
$692 |
3.6× |
| Us soft tissue head/neck (76536) |
$267.15 |
$411 |
2.1× |
| Us spinal canal and contents (76800) |
$531.70 |
$818 |
4.2× |
| Us transrectal (76872) |
$285.35 |
$439 |
2.3× |
| Us, eye b-scan (76512) |
$214.50 |
$330 |
1.7× |
| Venogram extremity bilateral (75822) |
$2,157.35 |
$3,319 |
1.1× |
| Venogram Extremity Unilateral (75820) |
$1,438.45 |
$2,213 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$3,691.35 |
$5,679 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,491.75 |
$2,295 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,915.25 |
$4,485 |
0.8× |
| Wrist 2 views (73100) |
$156 |
$240 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$235.95 |
$363 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$162.50 |
$250 |
1.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$428.35 |
$659 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$167.70 |
— |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$141.05 |
— |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$230.10 |
$354 |
1.8× |
| X-ray exam of femur 2/> (73552) |
$132.60 |
$204 |
1.3× |
| X-ray eye for foreign body (70030) |
$147.55 |
$227 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$192.40 |
$296 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$188.50 |
$290 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$104 |
$160 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$247.65 |
$381 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$347.75 |
$535 |
2.8× |
| X-ray nose-rectum child f.b. (76010) |
$96.20 |
$148 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$214.50 |
$330 |
1.7× |
| X-ray retrograde pyelogram (74420) |
$475.80 |
$732 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$166.40 |
$256 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$259.35 |
— |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$273.65 |
$421 |
2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$195 |
$300 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$187.20 |
$288 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$258.70 |
$398 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$243.75 |
$375 |
1.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$156.65 |
$241 |
1.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$12,136.49 |
— |
116.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$217.10 |
$334 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$169.65 |
$261 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$214.50 |
$330 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$268.45 |
$413 |
2.1× |
| Xr c-spine 4 or 5 views (72050) |
$269.10 |
$414 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$358.15 |
$551 |
2.9× |
| Xr urogram antegrade (74425) |
$475.80 |
$732 |
1.1× |