| Abdomen 2 views (74019) |
$191.70 |
$1,065 |
2.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$725.04 |
$4,028 |
2.0× |
| Acute venous thrombus image (78456) |
$925.38 |
$5,141 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$2,787.30 |
$15,485 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,226.86 |
$17,927 |
1.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,787.30 |
$15,485 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,787.30 |
$15,485 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,787.30 |
$15,485 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$5,652 |
$31,400 |
1.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,652 |
$31,400 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,035.72 |
$5,754 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$894.78 |
$4,971 |
0.3× |
| Ankle 2 views (73600) |
$214.74 |
$1,193 |
2.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$323.46 |
$1,797 |
1.0× |
| Aortogram thoracic (75605) |
$2,787.30 |
$15,485 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,787.30 |
$15,485 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$2,787.30 |
$15,485 |
1.0× |
| Arthrogram elbow (73085) |
$637.74 |
$3,543 |
2.1× |
| Arthrogram hip (73525) |
$637.74 |
$3,543 |
2.1× |
| Arthrogram shoulder (73040) |
$637.74 |
$3,543 |
2.1× |
| Arthrogram wrist (73115) |
$683.82 |
$3,799 |
2.2× |
| Arthrography knee lt (73580) |
$637.74 |
$3,543 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$789.12 |
$4,384 |
2.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$660.42 |
$3,669 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,111.50 |
$6,175 |
3.1× |
| Bone age studies (77072) |
$142.92 |
$794 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$1,413.90 |
$7,855 |
4.0× |
| Bone Marrow Imaging Limited Area (78102) |
$981.36 |
$5,452 |
2.8× |
| Bone survey complete (77075) |
$165.24 |
$918 |
1.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$671.22 |
$3,729 |
1.9× |
| Cervical spine 2 or 3 views (72040) |
$217.62 |
$1,209 |
2.8× |
| Chest 1 view (71045) |
$159.30 |
$885 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$415.08 |
$2,306 |
2.7× |
| Clavicle complete (73000) |
$214.74 |
$1,193 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,794.86 |
$15,527 |
9.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,329.56 |
$12,942 |
11.0× |
| CT abdomen w contrast (74160) |
$1,407.06 |
$7,817 |
9.0× |
| CT abdomen w wo contrast (74170) |
$1,622.34 |
$9,013 |
10.4× |
| CT abdomen w/o contrast (74150) |
$1,407.06 |
$7,817 |
15.2× |
| CT angio hrt w/3d image (75574) |
$1,407.06 |
$7,817 |
4.5× |
| CT angiography upper extremity lt (73206) |
$1,898.19 |
$10,545.50 |
12.2× |
| CT c-spine w/o contrast (72125) |
$1,214.10 |
$6,745 |
13.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,214.10 |
$6,745 |
7.8× |
| CT cervical spine with contrast (72126) |
$1,214.10 |
$6,745 |
3.9× |
| CT chest w/wo contrast (71270) |
$1,622.34 |
$9,013 |
10.4× |
| CT chest with contrast (71260) |
$1,407.06 |
$7,817 |
9.0× |
| CT head/brain with contrast (70460) |
$1,365.30 |
$7,585 |
8.8× |
| CT head/brain without and with contrast (70470) |
$1,584.36 |
$8,802 |
10.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,407.06 |
$7,817 |
4.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$113.40 |
$630 |
1.5× |
| CT hrt w/3d image congen (75573) |
$1,407.06 |
$7,817 |
4.5× |
| CT iac w contrast (70481) |
$704.88 |
$3,916 |
4.5× |
| CT limited/localized follow up study (76380) |
$163.26 |
$907 |
2.1× |
| CT lower ext w/o (73700) |
$1,692.81 |
$9,404.50 |
18.2× |
| CT lower extremity w wo contrast (73702) |
$2,022.75 |
$11,237.50 |
13.0× |
| CT lower extremity with contrast (73701) |
$1,692.81 |
$9,404.50 |
10.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,431.90 |
$7,955 |
9.2× |
| CT lumbar spine w/o contrast (72131) |
$1,431.90 |
$7,955 |
15.4× |
| CT lumbar spine with contrast (72132) |
$1,214.10 |
$6,745 |
3.9× |
| CT maxillofacial w contrast (70487) |
$1,129.68 |
$6,276 |
7.3× |
| CT maxillofacial w/o contrast (70486) |
$1,129.68 |
$6,276 |
12.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,349.64 |
$7,498 |
8.7× |
| CT neck soft tissue w contrast (70491) |
$1,129.68 |
$6,276 |
7.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$894.78 |
$4,971 |
5.7× |
| CT orbits w/o contrast (70480) |
$675.36 |
$3,752 |
7.3× |
| CT pelvis w & w/o contrast (72194) |
$1,171.26 |
$6,507 |
7.5× |
| CT pelvis w/o contrast (72192) |
$924.12 |
$5,134 |
10.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,349.64 |
$7,498 |
8.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,129.68 |
$6,276 |
12.2× |
| CT thoracic spine w/contrast (72129) |
$1,300.50 |
$7,225 |
8.3× |
| CT thoracic spine w/o contrast (72128) |
$1,300.50 |
$7,225 |
14.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,300.50 |
$7,225 |
8.3× |
| CT thorax w/o contrast (71250) |
$1,407.06 |
$7,817 |
15.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,898.19 |
$10,545.50 |
12.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,569.33 |
$8,718.50 |
16.9× |
| CT upper extremity with contrast (73201) |
$1,569.33 |
$8,718.50 |
5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,765.88 |
$15,366 |
17.8× |
| Cta Abdomen (74175) |
$1,622.34 |
$9,013 |
10.4× |
| CTA abdomen pelvis (74174) |
$2,765.88 |
$15,366 |
8.9× |
| CTA chest (71275) |
$1,622.34 |
$9,013 |
10.4× |
| Cta Head (70496) |
$1,584.36 |
$8,802 |
10.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,934 |
$16,300 |
9.5× |
| CTA lwr ext w&w/o contrast (73706) |
$2,375.46 |
$13,197 |
15.2× |
| Cta Neck (70498) |
$1,349.64 |
$7,498 |
8.7× |
| Cta Pelvis (72191) |
$1,141.92 |
$6,344 |
7.3× |
| Cystography minimum 3 views rs&i (74430) |
$323.46 |
$1,797 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$403.02 |
$2,239 |
4.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$403.02 |
$2,239 |
5.2× |
| Echoencephalography real time imaging (76506) |
$425.52 |
$2,364 |
4.6× |
| Esophagus (74220) |
$323.46 |
$1,797 |
2.1× |
| Fetal biophysical profile non-stress testing (76818) |
$650.34 |
$3,613 |
7.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$650.34 |
$3,613 |
7.0× |
| Fluoroscopy up to 1 hr (76000) |
$197.10 |
$1,095 |
0.9× |
| Foot 2 views (73620) |
$171.36 |
$952 |
2.2× |
| Forearm 2 views (73090) |
$214.74 |
$1,193 |
2.8× |
| Gated Heart Planar Single (78472) |
$835.56 |
$4,642 |
2.4× |
| Hand 2 views (73120) |
$214.74 |
$1,193 |
2.3× |
| Hand 3 views (73130) |
$236.88 |
$1,316 |
3.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,226.86 |
$17,927 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$911.52 |
$5,064 |
1.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$911.52 |
$5,064 |
2.6× |
| Ht muscle image spect sing (78451) |
$1,445.04 |
$8,028 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$214.74 |
$1,193 |
2.8× |
| Hysterosalpingogram (74740) |
$398.70 |
$2,215 |
1.9× |
| Interstitial radiation source applic complex (77778) |
$9,717.30 |
$53,985 |
15.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,106.28 |
$6,146 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,111.50 |
$6,175 |
2.3× |
| Knee 3 views (73562) |
$235.26 |
$1,307 |
3.0× |
| Liver & spleen imaging static only (78215) |
$744.30 |
$4,135 |
2.1× |
| Lung perf&ventilat diferentl (78598) |
$1,352.70 |
$7,515 |
2.8× |
| Lung perfusion differential (78597) |
$747 |
$4,150 |
2.1× |
| Lung Ventilation Imaging (78579) |
$747 |
$4,150 |
2.1× |
| Lymphoscintigraphy (78195) |
$959.40 |
$5,330 |
2.0× |
| Mammary ductogram or galactogram multiple (77054) |
$398.70 |
$2,215 |
1.9× |
| Mammary ductogram or galactogram single (77053) |
$398.70 |
$2,215 |
1.9× |
| Meckels Diverticulum (78290) |
$807.48 |
$4,486 |
2.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$9 |
$50 |
0.4× |
| MRA head w & w/o contrast (70546) |
$1,443.78 |
$8,021 |
4.7× |
| MRA head w/o contrast (70544) |
$1,102.68 |
$6,126 |
5.2× |
| MRA head with contrast (70545) |
$1,130.04 |
$6,278 |
3.6× |
| MRA neck w contrast (70548) |
$1,130.04 |
$6,278 |
3.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,443.78 |
$8,021 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,031.76 |
$5,732 |
4.9× |
| MRI abdomen w contrast (74182) |
$1,237.86 |
$6,877 |
4.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,443.78 |
$8,021 |
4.7× |
| MRI abdomen w/o contrast (74181) |
$1,031.76 |
$5,732 |
4.9× |
| MRI any jnt lwr ext with con lt (73722) |
$1,695.51 |
$9,419.50 |
2.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,130.04 |
$6,278 |
1.6× |
| MRI breast w/o contrast bilateral (77047) |
$159.84 |
$888 |
0.8× |
| MRI breast w/o contrast unilat (77046) |
$159.84 |
$888 |
0.8× |
| MRI c-spine with contrast (72142) |
$1,130.04 |
$6,278 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$1,584.36 |
$8,802 |
7.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,443.78 |
$8,021 |
4.7× |
| MRI chest w/o contrast (71550) |
$1,031.76 |
$5,732 |
4.9× |
| MRI chest with contrast (71551) |
$1,130.04 |
$6,278 |
1.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,130.04 |
$6,278 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,695.51 |
$9,419.50 |
5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,126.52 |
$11,814 |
10.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,031.76 |
$5,732 |
4.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,443.78 |
$8,021 |
4.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,130.04 |
$6,278 |
3.6× |
| MRI pelvis w contrast (72196) |
$1,130.04 |
$6,278 |
3.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,443.78 |
$8,021 |
4.7× |
| MRI pelvis w/o contrast (72195) |
$1,031.76 |
$5,732 |
4.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,165.40 |
$12,030 |
7.0× |
| MRI scan of leg joint before and after contrast (73723) |
$2,165.40 |
$12,030 |
7.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,443.78 |
$8,021 |
4.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,130.04 |
$6,278 |
3.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,971.62 |
$16,509 |
9.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,130.04 |
$6,278 |
3.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,443.78 |
$8,021 |
4.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,584.36 |
$8,802 |
7.5× |
| MRI tmj (70336) |
$1,031.76 |
$5,732 |
4.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,030.85 |
$11,282.50 |
9.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,443.78 |
$8,021 |
4.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,547.64 |
$8,598 |
7.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,149.46 |
$17,497 |
2.7× |
| Neck soft tissue (70360) |
$102.78 |
$571 |
1.3× |
| Nm cisternogram (78630) |
$2,326.32 |
$12,924 |
4.8× |
| Nm gastric emptying study (78264) |
$1,007.10 |
$5,595 |
2.8× |
| Nm gastroesophageal reflux study (78262) |
$1,066.50 |
$5,925 |
3.0× |
| Nuclear Rx Oral Admin (79005) |
$945.90 |
$5,255 |
4.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$361.08 |
$2,006 |
3.9× |
| Osseous survey infant (77076) |
$136.80 |
$760 |
1.5× |
| Osseous survey limited (77074) |
$145.44 |
$808 |
1.6× |
| Parathyrd planar w/spect&CT (78072) |
$925.38 |
$5,141 |
1.9× |
| Parathyrd planar w/wo subtrj (78071) |
$925.38 |
$5,141 |
2.6× |
| Parathyroid imaging (78070) |
$548.28 |
$3,046 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$158.04 |
$878 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,165.40 |
$12,030 |
7.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,226.86 |
$17,927 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,035.72 |
$5,754 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$747 |
$4,150 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,352.70 |
$7,515 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$434.16 |
$2,412 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$196.38 |
$1,091 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$196.38 |
$1,091 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$180.18 |
$1,001 |
1.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$392.94 |
$2,183 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$131.58 |
$731 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$172.62 |
$959 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$191.70 |
$1,065 |
2.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$182.16 |
$1,012 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$353.16 |
$1,962 |
2.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$150.12 |
$834 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$365.04 |
$2,028 |
2.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$150.12 |
$834 |
1.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$214.74 |
$1,193 |
2.8× |
| Radiological examination surgical specimen (76098) |
$502.74 |
$2,793 |
1.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,226.86 |
$17,927 |
1.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,226.86 |
$17,927 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$842.94 |
$4,683 |
2.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$908.10 |
$5,045 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$72.90 |
$405 |
0.8× |
| Scanogram (77073) |
$311.13 |
$1,728.50 |
3.4× |
| Scapula complete (73010) |
$214.74 |
$1,193 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$23.76 |
$132 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$114.48 |
$636 |
1.2× |
| Small bowel series (74250) |
$225.54 |
$1,253 |
1.4× |
| Testicular Imaging With Vascular Flow (78761) |
$867.06 |
$4,817 |
2.4× |
| Thoracolumbar 2 views (72080) |
$189.36 |
$1,052 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,057.86 |
$5,877 |
2.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$603.18 |
$3,351 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$446.04 |
$2,478 |
1.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,326.32 |
$12,924 |
4.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$839.34 |
$4,663 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$367.74 |
$2,043 |
4.0× |
| Umbilical-artery Doppler (OB) (76820) |
$100.62 |
$559 |
1.1× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$72.90 |
$405 |
0.9× |
| Unlisted fluoroscopic procedure (76496) |
$63.36 |
$352 |
0.8× |
| Unlisted Ultrasound Procedure (76999) |
$113.76 |
$632 |
1.5× |
| Upper Extremity Infant (73092) |
$171.45 |
$952.50 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$323.46 |
$1,797 |
1.5× |
| Urethrocystography voiding (74455) |
$323.46 |
$1,797 |
1.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$331.02 |
$1,839 |
2.1× |
| Us abdl aorta screen aaa (76706) |
$146.70 |
$815 |
1.6× |
| Us breast unilateral complete (76641) |
$566.64 |
$3,148 |
6.1× |
| Us breast unilateral limited (76642) |
$566.64 |
$3,148 |
7.3× |
| Us chest (76604) |
$437.22 |
$2,429 |
4.7× |
| Us compl joint r-t w/image documentation (76881) |
$439.38 |
$2,441 |
4.7× |
| Us guided compression repair (76936) |
$959.04 |
$5,328 |
5.0× |
| Us infant hips dynamic (76885) |
$267.48 |
$1,486 |
3.5× |
| Us infant hips limited static (76886) |
$267.48 |
$1,486 |
3.5× |
| Us ob detailed single fetus (76811) |
$964.08 |
$5,356 |
4.5× |
| Us ob transvaginal (76817) |
$498.78 |
$2,771 |
5.4× |
| Us pelvic non ob complete (76856) |
$593.46 |
$3,297 |
6.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$400.86 |
$2,227 |
4.3× |
| Us pregnancy ltd (76815) |
$208.44 |
$1,158 |
2.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$564.12 |
$3,134 |
6.1× |
| Us retroperitoneal complete (76770) |
$437.22 |
$2,429 |
4.7× |
| Us retroperitoneal limited (76775) |
$437.22 |
$2,429 |
4.7× |
| Us scrotum and contents (76870) |
$648.36 |
$3,602 |
7.0× |
| Us soft tissue head/neck (76536) |
$564.12 |
$3,134 |
6.1× |
| Us spinal canal and contents (76800) |
$161.10 |
$895 |
1.7× |
| Us transrectal prostate volume (76873) |
$394.02 |
$2,189 |
4.2× |
| Us xtr non-vasc lmtd (76882) |
$421.65 |
$2,342.50 |
4.5× |
| Venogram extremity bilateral (75822) |
$942.66 |
$5,237 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,226.86 |
$17,927 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$1,035.72 |
$5,754 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$1,035.72 |
$5,754 |
0.7× |
| Venography Renal Bilateral (75833) |
$3,226.86 |
$17,927 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$3,226.86 |
$17,927 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,035.72 |
$5,754 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$72.90 |
$405 |
0.9× |
| Wrist 2 views (73100) |
$214.74 |
$1,193 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$351 |
$1,950 |
3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$142.92 |
$794 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$214.74 |
$1,193 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$383.04 |
$2,128 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$214.74 |
$1,193 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$236.88 |
$1,316 |
3.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$392.94 |
$2,183 |
4.2× |
| X-ray exam hip uni 1 view (73501) |
$113.76 |
$632 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$180.18 |
$1,001 |
2.3× |
| X-ray exam hip uni 4/> views (73503) |
$270.36 |
$1,502 |
2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$180.18 |
$1,001 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$360.54 |
$2,003 |
3.9× |
| X-ray exam of femur 1 (73551) |
$142.92 |
$794 |
1.8× |
| X-ray eye for foreign body (70030) |
$108.45 |
$602.50 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$222.48 |
$1,236 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$72.90 |
$405 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$214.74 |
$1,193 |
2.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,508.94 |
$8,383 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$214.74 |
$1,193 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$142.92 |
$794 |
1.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$176.94 |
$983 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$189.36 |
$1,052 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$194.04 |
$1,078 |
2.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$159.30 |
$885 |
2.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$172.62 |
$959 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$189.36 |
$1,052 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$323.46 |
$1,797 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$72.90 |
$405 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$182.16 |
$1,012 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$224.46 |
$1,247 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$189.36 |
$1,052 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$149.04 |
$828 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$257.94 |
$1,433 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$182.70 |
$1,015 |
2.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$75.96 |
$422 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$192.42 |
$1,069 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$163.26 |
$907 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$189.36 |
$1,052 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$131.58 |
$731 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$138.24 |
$768 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$189.36 |
$1,052 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$129.15 |
$717.50 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$235.26 |
$1,307 |
3.0× |
| Xr arthrogram ankle (73615) |
$404.82 |
$2,249 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$229.32 |
$1,274 |
2.5× |
| Xr chest 4+ views (71048) |
$224.46 |
$1,247 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$126 |
$700 |
1.6× |
| Xr shoulder 1 view (73020) |
$214.74 |
$1,193 |
2.8× |
| Xr spine cervical 4 or 5 views (72050) |
$238.32 |
$1,324 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$214.74 |
$1,193 |
2.8× |
| Xr tmj bilateral (70330) |
$230.58 |
$1,281 |
3.0× |
| Xray knee 1 or 2 views rt (73560) |
$214.74 |
$1,193 |
2.8× |