Imaging prices at Vandalia Health Mon Marion Neighborhood Hospital

White Hall, WV · every code in this section with a posted price and a Medicare benchmark.

331 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $5,178.82 $10,357.64 3.9×
Abdomen 2 views (74019) $402.50 $804.99 4.0×
Acute gi blood loss imaging (78278) $1,520.92 $3,041.83 4.0×
Angiography extremity bilateral rs&i (75716) $11,962.22 $23,826.37 3.9×
Angiography extremity unilateral rs&i (75710) $11,913.18 $23,826.37 3.9×
Angiography internal mammary rs&i (75756) $11,529.76 $23,059.52 3.8×
Angiography pelvic slctv/supraslctv rs&i (75736) $20,487.83 $40,975.66 3.8×
Angiography pulmonary bilateral slctv rs&i (75743) $11,953.52 $23,907.04 3.9×
Angiography pulmonary unilateral slctv rs&i (75741) $11,944.77 $23,889.54 3.9×
Angiography visceral slctv/supraslctv rs&i (75726) $20,509.75 $41,019.50 3.8×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $11,940.75 $23,881.50 3.9×
Ankle 2 views (73600) $333.26 $666.53 4.0×
Aortogram thoracic (75605) $20,488.62 $40,977.24 3.8×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $11,962.92 $23,925.83 3.9×
Aortography abdominal serialography rs&i (75625) $11,949.54 $23,899.08 3.9×
Arthrogram hip (73525) $1,208.32 $2,416.64 3.6×
Arthrogram shoulder (73040) $1,351.72 $2,703.45 4.0×
Basic dosimetry (77300) $502.53 $1,005.06 3.9×
Bone &/Joint Imaging Limited Area (78300) $1,520.92 $3,041.83 4.0×
Bone &/joint imaging whole body (78306) $1,520.92 $3,041.83 4.0×
Bone age studies (77072) $407.26 $814.52 4.1×
Bone Imaging 3 Phase (78315) $1,520.92 $3,041.83 4.0×
Bone survey infant (77076) $419.99 $839.98 4.2×
Bowel imaging (78290) $1,520.92 $3,041.83 4.0×
Brachytx isodose complex (77318) $1,385.56 $2,771.13 3.9×
Brachytx isodose intermed (77317) $1,385.56 $2,771.13 3.9×
Brachytx isodose pln smpl w/dosimetry cal (77316) $1,423.66 $2,847.31 4.0×
Brain Imaging Pet Metabolic Evaluation (78608) $5,520.72 $11,041.44 4.0×
Brain Imaging Vascular Flow Only (78610) $2,037.34 $4,074.67 3.9×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $1,544.72 $3,089.43 4.0×
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) $2,990.35 $5,980.70 4.0×
Cardiac MRI w/w/o contrast & further seq (75561) $739.47 $1,478.94 2.2×
Cardiac shunt detection (78428) $1,520.92 $3,041.83 4.0×
Cervical spine 2 or 3 views (72040) $338.88 $677.76 4.1×
Chest 1 view (71045) $333.26 $666.53 4.0×
Chest xray 3 views (71047) $333.26 $666.53 4.0×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $673.80 $1,347.60 4.0×
Clavicle complete (73000) $333.26 $666.53 4.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $402.50 $804.99 4.0×
Continuing medical physics consltj pr wk (77336) $544.78 $1,089.55 4.2×
CT abdomen and pelvis without and with contrast (74178) $1,351.72 $2,703.45 4.0×
CT abdomen and pelvis without contrast (74176) $914.90 $1,829.81 4.0×
CT abdomen w contrast (74160) $673.80 $1,347.60 4.0×
CT abdomen w wo contrast (74170) $673.80 $1,347.60 4.0×
CT abdomen w/o contrast (74150) $402.50 $804.99 4.0×
CT angio hrt w/3d image (75574) $734.77 $1,469.54 2.2×
CT angio lwr extr w/o&w/dye (73706) $673.80 $1,347.60 4.0×
CT angiography upper extremity lt (73206) $381.33 $762.66 2.3×
CT c-spine w/contrast (72126) $1,351.72 $2,703.45 4.0×
CT c-spine w/o contrast (72125) $402.50 $804.99 4.0×
CT cervical spine w&w/o contrast (72127) $673.80 $1,347.60 4.0×
CT chest w contrast (71260) $673.80 $1,347.60 4.0×
CT chest w/wo contrast (71270) $673.80 $1,347.60 4.0×
CT head/brain with contrast (70460) $673.80 $1,347.60 4.0×
CT head/brain without and with contrast (70470) $673.80 $1,347.60 4.0×
CT heart contrast eval cardiac structure&morph (75572) $718.73 $1,437.46 2.1×
CT heart w/o contrast quant eval coronary calcium (75571) $333.26 $666.53 4.0×
CT hrt w/3d image congen (75573) $1,351.72 $2,703.45 4.0×
CT iac w contrast (70481) $673.80 $1,347.60 4.0×
CT limited/localized follow up study (76380) $333.26 $666.53 4.0×
CT lower ext w/o (73700) $402.50 $804.99 4.0×
CT lower extremity w wo contrast (73702) $673.80 $1,347.60 4.0×
CT lower extremity w/contrast material (73701) $673.80 $1,347.60 4.0×
CT lumbar spine w & w/o contrast (72133) $673.80 $1,347.60 4.0×
CT lumbar spine w/contrast (72132) $1,351.72 $2,703.45 4.0×
CT lumbar spine w/o contrast (72131) $402.50 $804.99 4.0×
CT maxillofacial w contrast (70487) $673.80 $1,347.60 4.0×
CT maxillofacial w/wo contrast (70488) $673.80 $1,347.60 4.0×
CT maxillofacial wo contrast (70486) $402.50 $804.99 4.0×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $673.80 $1,347.60 4.0×
CT orbits w/o contrast (70480) $402.50 $804.99 4.0×
CT pelvis w/o contrast (72192) $402.50 $804.99 4.0×
CT pelvis w/wo contrast (72194) $673.80 $1,347.60 4.0×
CT scan of arm combo (73202) $1,012.76 $2,025.52 6.0×
CT soft tissue neck w contrast (70491) $673.80 $1,347.60 4.0×
CT soft tissue neck w/o & w/contrast material (70492) $673.80 $1,347.60 4.0×
CT soft tissue neck w/o contrast (70490) $402.50 $804.99 4.0×
CT thoracic spine w/contrast (72129) $673.80 $1,347.60 4.0×
CT thoracic spine w/o contrast (72128) $402.50 $804.99 4.0×
CT thoracic spine w/wo contrast (72130) $673.80 $1,347.60 4.0×
CT thorax w/o contrast (71250) $402.50 $804.99 4.0×
CT upper ext wo (73200) $538.15 $1,076.30 5.4×
CT upper extremity with contrast (73201) $877.11 $1,754.22 2.6×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $673.80 $1,347.60 4.0×
Cta Abdomen (74175) $673.80 $1,347.60 4.0×
CTA abdomen pelvis (74174) $1,351.72 $2,703.45 4.0×
CTA chest (71275) $673.80 $1,347.60 4.0×
Cta Head (70496) $673.80 $1,347.60 4.0×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,558.50 $3,117 4.7×
Cta Neck (70498) $673.80 $1,347.60 4.0×
Cta Pelvis (72191) $673.80 $1,347.60 4.0×
Cystography minimum 3 views rs&i (74430) $1,351.72 $2,703.45 4.0×
Dxa bone density study 1/> sites axial skel (77080) $402.50 $804.99 4.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $338.21 $676.42 4.1×
Dxa bone density study axial skeleton (77085) $409.87 $819.74 4.1×
Esophagus (74220) $673.80 $1,347.60 4.0×
Facial bones min 3 views (70150) $408.99 $817.98 4.1×
Fetal biophysical profile non-stress testing (76818) $402.50 $804.99 4.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $402.50 $804.99 4.0×
Fluoroscopy up to 1 hr (76000) $914.90 $1,829.81 4.0×
Foot 2 views (73620) $333.26 $666.53 4.0×
Forearm 2 views (73090) $333.26 $666.53 4.0×
Hand 2 views (73120) $402.50 $804.99 4.0×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $2,626.04 $5,252.09 3.9×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $2,626.04 $5,252.09 3.9×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $2,772.06 $5,544.12 4.1×
Heart Infarct Image (78466) $1,520.92 $3,041.83 4.0×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $2,037.34 $4,074.67 3.9×
Hepatobiliary syst imaging including gallbladder (78226) $1,520.92 $3,041.83 4.0×
Hysterosalpingogram (74740) $466.97 $933.94 2.0×
Image fusion (77399) $475.76 $951.52 3.7×
Interstitial radiation source applic complex (77778) $2,864.33 $5,728.66 4.3×
Intracavitary Radiation Source Applic Complex (77763) $2,861.46 $5,722.92 4.3×
Intracavitary Radiation Source Applic Intermed (77762) $2,346.14 $4,692.28 4.4×
Intracavitary Radiation Source Applic Simple (77761) $2,294.16 $4,588.31 4.3×
Kidney img morphology vascular flow 1 w/rx (78708) $2,066.46 $4,132.92 4.0×
Knee 3 views (73562) $333.26 $666.53 4.0×
Liver & spleen imaging static only (78215) $1,520.92 $3,041.83 4.0×
Lung perf&ventilat diferentl (78598) $2,057.46 $4,114.92 4.0×
Lung perfusion differential (78597) $1,520.92 $3,041.83 4.0×
Lymphoscintigraphy (78195) $2,037.34 $4,074.67 3.9×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $2,990.35 $5,980.70 4.0×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $1,351.72 $2,703.45 4.0×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $1,351.72 $2,703.45 4.0×
Mammary ductogram or galactogram multiple (77054) $914.90 $1,829.81 4.0×
Mammary ductogram or galactogram single (77053) $914.90 $1,829.81 4.0×
Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) $333.26 $666.53 4.0×
Mlc imrt design & construction per imrt plan (77338) $1,385.56 $2,771.13 3.9×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $92.70 $185.39 3.3×
Mr safety implt electronics prepj supvj phys/qhp (76018) $347.42 $694.84 3.8×
MRA head w & w/o contrast (70546) $1,351.72 $2,703.45 4.0×
MRA head w/o contrast (70544) $914.90 $1,829.81 4.0×
MRA head with contrast (70545) $1,351.72 $2,703.45 4.0×
MRA neck w contrast (70548) $1,351.72 $2,703.45 4.0×
Mra Neck W/O &W/Contrast Material (70549) $1,351.72 $2,703.45 4.0×
MRA neck w/o contrast (70547) $914.90 $1,829.81 4.0×
MRI abdomen w contrast (74182) $1,351.72 $2,703.45 4.0×
MRI abdomen w/o & w/contrast material (74183) $1,351.72 $2,703.45 4.0×
MRI abdomen w/o contrast (74181) $914.90 $1,829.81 4.0×
MRI any jt lower extrem w/contrast material (73722) $2,990.35 $5,980.70 4.0×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,351.72 $2,703.45 4.0×
MRI bone marrow blood supply (77084) $914.90 $1,829.81 4.0×
MRI breast w/o contrast bilateral (77047) $914.90 $1,829.81 4.0×
MRI breast wo contrast unilateral (77046) $914.90 $1,829.81 4.0×
MRI c-spine with contrast (72142) $1,351.72 $2,703.45 4.0×
MRI cardiac w/o cont stress (75559) $142.32 $284.64 0.3×
MRI cardiac w/o contrast (75557) $114.90 $229.80 0.5×
MRI cervical spine w/o contrast (72141) $914.90 $1,829.81 4.0×
MRI chest w/o & w/contrast material (71552) $1,351.72 $2,703.45 4.0×
MRI chest w/o contrast (71550) $914.90 $1,829.81 4.0×
MRI chest with contrast (71551) $2,990.35 $5,980.70 4.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,351.72 $2,703.45 4.0×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,351.72 $2,703.45 4.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $914.90 $1,829.81 4.0×
MRI orbit face &/neck w/o contrast (70540) $914.90 $1,829.81 4.0×
MRI orbit face neck w contrast (70542) $1,351.72 $2,703.45 4.0×
MRI orbit/face/neck w&w/o cont (70543) $1,351.72 $2,703.45 4.0×
MRI pelvis w/contrast (72196) $1,351.72 $2,703.45 4.0×
MRI pelvis w/o & w/contrast material (72197) $1,351.72 $2,703.45 4.0×
MRI pelvis w/o contrast (72195) $914.90 $1,829.81 4.0×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,351.72 $2,703.45 4.0×
MRI spinal canal lumbar w/contrast material (72149) $1,351.72 $2,703.45 4.0×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,351.72 $2,703.45 4.0×
MRI spinal canal thoracic w/contrast matrl (72147) $1,351.72 $2,703.45 4.0×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,351.72 $2,703.45 4.0×
MRI temporomandibular joint (70336) $951.50 $1,903 4.2×
MRI thoracic spine w/o contrast (72146) $914.90 $1,829.81 4.0×
MRI up ext w/o contrast (73218) $914.90 $1,829.81 4.0×
MRI upper ext joint w/o contrast (73221) $914.90 $1,829.81 4.0×
MRI, joint upper extrem combo (73223) $1,351.72 $2,703.45 4.0×
Myocardial Imaging Pet Metabolic Evaluation (78459) $4,941.20 $9,882.40 4.0×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $2,056.71 $4,113.42 3.9×
Myocardial Spect Multiple Studies (78452) $4,980.46 $9,960.92 4.0×
Myocardial spect single study at rest or stress (78451) $4,974.48 $9,948.96 4.0×
N-invas est c ffr sw aly CTA (75580) $3,850.79 $7,701.58 4.7×
Neck soft tissue (70360) $337.84 $675.68 4.0×
Nm adrenal scan (78075) $4,941.20 $9,882.40 4.0×
Nm gastric emptying study (78264) $1,520.92 $3,041.83 4.0×
Nm gastroesophageal reflux study (78262) $1,520.92 $3,041.83 4.0×
Nm peritoneal-venous shunt patency (78291) $1,520.92 $3,041.83 4.0×
Ntsty modul radthx pln dose-vol histos (77301) $5,178.82 $10,357.64 3.9×
Nuclear Rx Oral Admin (79005) $848.32 $1,696.65 3.8×
Ob us nuchal meas 1 gest (76813) $402.50 $804.99 4.0×
Osseous survey limited (77074) $413.41 $826.82 4.1×
Parathyroid Planar Imaging (78070) $1,520.92 $3,041.83 4.0×
Parathyroid planar imaging w/wo subtraction (78071) $1,520.92 $3,041.83 4.0×
Pelvis 1 or 2 views (72170) $406.90 $813.79 4.1×
Perineogram (74775) $914.90 $1,829.81 4.0×
Peritoneogram after injection (74190) $2,075.30 $4,150.59 4.0×
PET image w/CT, skull-thigh (78815) $5,520.72 $11,041.44 4.0×
PET imaging CT for attenuation limited area (78814) $5,520.72 $11,041.44 4.0×
PET imaging for CT attenuation whole body (78816) $5,520.72 $11,041.44 4.0×
Pulmonary Perfusion Imaging Particulate (78580) $1,520.92 $3,041.83 4.0×
Pulmonary Ventilation & Perfusion Imaging (78582) $2,037.34 $4,074.67 3.9×
Quan&charac c atherosclerotc plaq asses sev c ds (75577) $2,904.66 $5,809.32 3.3×
Radex abscess/fistula/sinus tract rs&i (76080) $2,075.30 $4,150.59 4.0×
Radex Ankle Compl Minimum 3 Views (73610) $333.26 $666.53 4.0×
Radex Calcaneus Minimum 2 Views (73650) $337.33 $674.66 4.0×
Radex Elbw Compl Minimum 3 Views (73080) $333.26 $666.53 4.0×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $339.76 $679.52 4.1×
Radex fingr minimum 2 views (73140) $336.78 $673.57 4.0×
Radex Foot Compl Minimum 3 Views (73630) $333.26 $666.53 4.0×
Radex Hand Minimum 3 Views (73130) $333.26 $666.53 4.0×
Radex Hip Unilateral With Pelvis 1 View (73501) $338 $676 4.0×
Radex Hips Bilateral With Pelvis 2 Views (73521) $408.11 $816.22 4.1×
Radex Humerus Minimum 2 Views (73060) $333.26 $666.53 4.0×
Radex Kne 1/2 Views (73560) $333.26 $666.53 4.0×
Radex Kne Compl 4/More Views (73564) $402.50 $804.99 4.0×
Radex Mndbl Compl Minimum 4 Views (70110) $408.65 $817.30 4.1×
Radex Nasal Bones Complete Minimum 3 Views (70160) $337.51 $675.02 4.0×
Radex Pelvis Compl Minimum 3 Views (72190) $408.80 $817.61 4.1×
Radex Sho Compl Minimum 2 Views (73030) $333.26 $666.53 4.0×
Radex Sinuses Paransl < 3 Views (70210) $337.66 $675.33 4.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $339.24 $678.48 4.1×
Radex Toe Minimum 2 Views (73660) $336.64 $673.27 4.0×
Radex upper extremity infant minimum 2 views (73092) $406.56 $813.12 4.1×
Radex Wrst Compl Minimum 3 Views (73110) $333.26 $666.53 4.0×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $402.50 $804.99 4.0×
Radiation Delivery Stereotactic Cranial Cobalt (77371) $28,934.15 $57,868.30 4.1×
Radiation Delivery Stereotactic Cranial Linear (77372) $29,380.89 $58,761.78 4.2×
Radiation treatment delivery level 1 (77402) $414.46 $828.91 4.2×
Radiation treatment delivery level 2 (77407) $995.37 $1,990.74 2.7×
Radiation treatment delivery level 3 (77412) $995.37 $1,990.74 1.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $333.26 $666.53 4.0×
Radiologic exam chest 2 views (71046) $333.26 $666.53 4.0×
Radiologic Exam Esophagus Double Contrast Study (74221) $673.80 $1,347.60 4.0×
Radiologic exam upr gi trc double contrast study (74246) $673.80 $1,347.60 4.0×
Radiologic exam upr gi trc single contrast study (74240) $673.80 $1,347.60 4.0×
Radiologic examination tibia & fibula 2 views (73590) $333.26 $666.53 4.0×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $2,084.16 $4,168.33 4.0×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $410.98 $821.97 4.1×
Radiological examination surgical specimen (76098) $2,075.30 $4,150.59 4.0×
Ribs bilateral 3 views (71110) $402.50 $804.99 4.0×
Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) $1,520.92 $3,041.83 4.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $4,941.20 $9,882.40 9.5×
Rp loclzj tum plnr whole body single day imaging (78802) $4,941.20 $9,882.40 9.5×
Rp loclzj tum spect 1 area single day imaging (78803) $4,941.20 $9,882.40 9.5×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $5,520.72 $11,041.44 4.0×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $4,941.20 $9,882.40 4.0×
Rp Therapy Intravenous Administration (79101) $848.32 $1,696.65 3.8×
Saline Infus Sonohysterography W/Color Doppler (76831) $914.90 $1,829.81 4.0×
Scapula (73010) $402.50 $804.99 4.0×
Screening Digital Breast Tomosynthesis Bi (77063) $103.66 $207.32 4.4×
Sella turcica (70240) $338.03 $676.06 4.0×
Shoulder 1 view (73020) $337.15 $674.30 4.0×
Simulation intermediate (77285) $1,385.56 $2,771.13 3.9×
Small bowel series (74250) $673.80 $1,347.60 4.0×
Spec telethx port pln parts hemibdy tot bdy (77321) $1,385.56 $2,771.13 3.9×
Special dosimetry (77331) $502.53 $1,005.06 3.9×
Special Physics Consult (77370) $571.36 $1,142.72 4.4×
Special treatment procedure (77470) $2,189.49 $4,378.98 4.1×
Spine thoracic 3 views (72072) $408.14 $816.28 4.1×
Stereotactic Body Radiation Delivery (77373) $7,112.84 $14,225.68 4.1×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,385.56 $2,771.13 3.9×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,385.56 $2,771.13 3.9×
Ther rad simulaj-aided field setting complex (77290) $1,385.56 $2,771.13 3.9×
Ther rad simulaj-aided field setting simple (77280) $502.53 $1,005.06 3.9×
Thyroid imaging w/blood flow (78013) $1,520.92 $3,041.83 4.0×
Thyroid uptake measurement (78012) $1,520.92 $3,041.83 4.0×
Treatment device complex (77334) $1,385.56 $2,771.13 3.9×
Treatment device intermediate (77333) $502.53 $1,005.06 3.9×
Treatment devices simple (77332) $450.42 $900.84 3.5×
Ultrasound breast complete (76641) $402.50 $804.99 4.0×
Ultrasound Exam Aaa Screen (76706) $402.50 $804.99 4.0×
Ultrasound, abdomen limited (76705) $402.50 $804.99 4.0×
Umbilical-artery Doppler (OB) (76820) $402.50 $804.99 4.0×
Unlisted procedure, therapeutic radiology clinical treatment planning 2nd-5th Sessions (77299) $502.53 $1,005.06 3.9×
Unlisted ultrasound procedure (76999) $333.26 $666.53 4.0×
Ureteral reflux study (78740) $1,520.92 $3,041.83 4.0×
Urethrocystogram voiding (74455) $914.90 $1,829.81 4.0×
Urethrocystography retrograde rs&i (74450) $914.90 $1,829.81 4.0×
Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) $673.80 $1,347.60 4.0×
Us breast unilateral limited (76642) $333.26 $666.53 4.0×
Us chest (76604) $402.50 $804.99 4.0×
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) $1,178.64 $2,357.28 5.7×
Us compl joint r-t w/image documentation (76881) $425 $850 4.2×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $402.50 $804.99 4.0×
Us ob limited (76815) $402.50 $804.99 4.0×
Us ob transvaginal (76817) $402.50 $804.99 4.0×
Us pelvic non ob complete (76856) $402.50 $804.99 4.0×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $402.50 $804.99 4.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $402.50 $804.99 4.0×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $402.50 $804.99 4.0×
Us retroperitoneal complete (76770) $402.50 $804.99 4.0×
Us retroperitoneal limited (76775) $402.50 $804.99 4.0×
Us scrotum and contents (76870) $402.50 $804.99 4.0×
Us soft tissue head/neck (76536) $402.50 $804.99 4.0×
Us spinal canal and contents (76800) $402.50 $804.99 4.0×
Us transrectal (76872) $402.50 $804.99 4.0×
Us, eye b-scan (76512) $402.50 $804.99 4.0×
Us,transplanted kidney, real time/ doppler (76776) $421.23 $842.46 4.2×
Venogram extremity bilateral (75822) $5,916.12 $11,832.24 3.9×
Venogram Extremity Unilateral (75820) $5,879.72 $11,759.45 3.9×
Venography caval inferior serialography rs&i (75825) $11,941.66 $23,883.31 3.9×
Venography caval superior serialography rs&i (75827) $5,908.26 $11,816.53 3.9×
Venography renal unilateral selective rs&i (75831) $11,939.78 $23,879.56 3.9×
Venous sampling by catheter (75893) $20,473.85 $40,947.70 3.8×
Wrist 2 views (73100) $333.26 $666.53 4.0×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $402.50 $804.99 4.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $338 $676 4.0×
X-ray b.e. reductn intuss (74283) $673.80 $1,347.60 4.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $333.26 $666.53 4.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $333.26 $666.53 4.0×
X-ray exam of femur 2/> (73552) $333.26 $666.53 4.0×
X-ray eye for foreign body (70030) $337.69 $675.38 4.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $337.84 $675.68 4.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $333.26 $666.53 4.0×
X-ray leg, infant (73592) $337.33 $674.66 4.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $402.50 $804.99 4.0×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $402.50 $804.99 4.0×
X-ray nose-rectum child f.b. (76010) $333.26 $666.53 4.0×
X-ray optic foramen (70190) $338.85 $677.70 4.1×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $409.50 $819.01 4.1×
X-ray retrograde pyelogram (74420) $1,351.72 $2,703.45 4.0×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $333.26 $666.53 4.0×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $402.50 $804.99 4.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $402.50 $804.99 4.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $408.14 $816.28 4.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $337.66 $675.33 4.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $338.72 $677.44 4.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $409.50 $819.01 4.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $407.07 $814.14 4.1×
X-Ray Spine One View - Xr Spine (72020) $333.26 $666.53 4.0×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $333.26 $666.53 4.0×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $333.26 $666.53 4.0×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $407.60 $815.19 4.1×
Xr bone length studies (77073) $409.38 $818.77 4.1×
Xr c-spine 4 or 5 views (72050) $409.17 $818.34 4.1×
Xr c-spine 6 or more views (72052) $410.11 $820.22 4.1×
Xr chest 4+ views (71048) $402.50 $804.99 4.0×
Xr urogram antegrade (74425) $1,351.72 $2,703.45 4.0×