| Abdomen 2 views (74019) |
$159 |
$318 |
1.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$618 |
$1,236 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,517 |
$5,034 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,450 |
$4,900 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$852 |
$1,704 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,517 |
$5,034 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,662 |
$5,324 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,517 |
$5,034 |
0.8× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,549 |
$5,098 |
0.5× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,517 |
$5,034 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$416 |
$832 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$933 |
$1,866 |
0.3× |
| Ankle 2 views (73600) |
$89.50 |
$179 |
1.1× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,517 |
$5,034 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,517 |
$5,034 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,517 |
$5,034 |
0.8× |
| Arthrogram elbow (73085) |
$337 |
$674 |
1.0× |
| Arthrogram hip (73525) |
$337 |
$674 |
1.0× |
| Arthrogram shoulder (73040) |
$337 |
$674 |
1.0× |
| Arthrogram wrist (73115) |
$337 |
$674 |
1.0× |
| Arthrography knee lt (73580) |
$337 |
$674 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$688 |
$1,376 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$764.50 |
$1,529 |
2.0× |
| Bone age studies (77072) |
$84 |
$168 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$618 |
$1,236 |
1.6× |
| Bone survey complete (77075) |
$140 |
$280 |
1.4× |
| Brain image w/flow 4 + views (78606) |
$632.50 |
$1,265 |
1.2× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$24 |
$48 |
2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$458.50 |
$917 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$105.50 |
$211 |
1.3× |
| Chest 1 view (71045) |
$207 |
$414 |
2.5× |
| Chest 3 views (71047) |
$289.50 |
$579 |
3.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$325.50 |
$651 |
1.9× |
| Cineradiography/videoradiography (76120) |
$95.50 |
$191 |
0.9× |
| Clavicle complete (73000) |
$105.50 |
$211 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$54.50 |
$109 |
0.5× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$229.50 |
$459 |
1.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,327 |
$2,654 |
3.9× |
| CT abdomen and pelvis without contrast (74176) |
$903 |
$1,806 |
3.9× |
| CT abdomen w contrast (74160) |
$663.50 |
$1,327 |
3.9× |
| CT abdomen w wo contrast (74170) |
$797.50 |
$1,595 |
4.7× |
| CT abdomen w/o contrast (74150) |
$394.50 |
$789 |
3.9× |
| CT angio hrt w/3d image (75574) |
$604 |
$1,208 |
1.8× |
| CT angiography upper extremity lt (73206) |
$803.50 |
$1,607 |
4.7× |
| CT c-spine w/o contrast (72125) |
$402.50 |
$805 |
4.0× |
| CT cervical spine w&w/o contrast (72127) |
$730.50 |
$1,461 |
4.3× |
| CT cervical spine with contrast (72126) |
$609 |
$1,218 |
1.8× |
| CT chest w/wo contrast (71270) |
$665.50 |
$1,331 |
3.9× |
| CT chest with contrast (71260) |
$567 |
$1,134 |
3.3× |
| CT colonography w/dye (74262) |
$529 |
$1,058 |
3.1× |
| CT colonography w/o cntrst (74261) |
$347.50 |
$695 |
3.4× |
| CT head/brain with contrast (70460) |
$487.50 |
$975 |
2.9× |
| CT head/brain without and with contrast (70470) |
$548 |
$1,096 |
3.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$513 |
$1,026 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$65 |
$130 |
0.8× |
| CT hrt w/3d image congen (75573) |
$483.50 |
$967 |
1.4× |
| CT iac w contrast (70481) |
$487.50 |
$975 |
2.9× |
| CT limited/localized follow up study (76380) |
$212 |
$424 |
2.5× |
| CT lower ext w/o (73700) |
$438 |
$876 |
4.3× |
| CT lower extremity w wo contrast (73702) |
$1,010.50 |
$2,021 |
6.0× |
| CT lower extremity with contrast (73701) |
$531 |
$1,062 |
3.1× |
| CT lumbar spine w & w/o contrast (72133) |
$795 |
$1,590 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$438 |
$876 |
4.3× |
| CT lumbar spine with contrast (72132) |
$662 |
$1,324 |
2.0× |
| CT maxillofacial w contrast (70487) |
$487.50 |
$975 |
2.9× |
| CT maxillofacial w/o contrast (70486) |
$402.50 |
$805 |
4.0× |
| CT maxillofacial w/wo contrast (70488) |
$548 |
$1,096 |
3.2× |
| CT neck soft tissue w contrast (70491) |
$610 |
$1,220 |
3.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$616 |
$1,232 |
3.6× |
| CT orbits w/o contrast (70480) |
$321.50 |
$643 |
3.2× |
| CT pelvis w & w/o contrast (72194) |
$752 |
$1,504 |
4.4× |
| CT pelvis w/o contrast (72192) |
$441 |
$882 |
4.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$722 |
$1,444 |
4.3× |
| CT soft tissue neck w/o contrast (70490) |
$321.50 |
$643 |
3.2× |
| CT thoracic spine w/contrast (72129) |
$662 |
$1,324 |
3.9× |
| CT thoracic spine w/o contrast (72128) |
$438 |
$876 |
4.3× |
| CT thoracic spine w/wo contrast (72130) |
$795 |
$1,590 |
4.7× |
| CT thorax w/o contrast (71250) |
$394.50 |
$789 |
3.9× |
| CT unlisted procedure (76497) |
$586 |
$1,172 |
7.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$678 |
$1,356 |
4.0× |
| CT upper extremity w/o contrast rt (73200) |
$438 |
$876 |
4.3× |
| CT upper extremity with contrast (73201) |
$531 |
$1,062 |
1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$610 |
$1,220 |
3.6× |
| Cta Abdomen (74175) |
$863 |
$1,726 |
5.1× |
| CTA abdomen pelvis (74174) |
$863 |
$1,726 |
2.6× |
| CTA chest (71275) |
$1,034 |
$2,068 |
6.1× |
| Cta Head (70496) |
$617.50 |
$1,235 |
3.6× |
| CTA lwr ext w&w/o contrast (73706) |
$732 |
$1,464 |
4.3× |
| Cta Neck (70498) |
$791 |
$1,582 |
4.7× |
| Cta Pelvis (72191) |
$848 |
$1,696 |
5.0× |
| Cystography minimum 3 views rs&i (74430) |
$510 |
$1,020 |
1.5× |
| Diskogram cervical (72285) |
$2,869 |
$5,738 |
1.5× |
| Diskography lumbar (72295) |
$2,869 |
$5,738 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$129 |
$258 |
1.3× |
| Esophagus (74220) |
$325.50 |
$651 |
1.9× |
| Fetal biophysical profile non-stress testing (76818) |
$176.50 |
$353 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$134.50 |
$269 |
0.6× |
| Foot 2 views (73620) |
$105.50 |
$211 |
1.3× |
| Forearm 2 views (73090) |
$105.50 |
$211 |
1.3× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$57 |
$114 |
0.2× |
| Gated Heart Planar Single (78472) |
$857.50 |
$1,715 |
2.2× |
| Hand 2 views (73120) |
$105.50 |
$211 |
1.0× |
| Hand 3 views (73130) |
$105.50 |
$211 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$762.50 |
$1,525 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$762.50 |
$1,525 |
2.0× |
| Ht muscle image spect sing (78451) |
$1,704.50 |
$3,409 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$105.50 |
$211 |
1.3× |
| Hysterosalpingogram (74740) |
$591 |
$1,182 |
2.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$725.50 |
$1,451 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$725.50 |
$1,451 |
1.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$725.50 |
$1,451 |
1.4× |
| Knee 3 views (73562) |
$113.50 |
$227 |
1.3× |
| Liver & spleen imaging static only (78215) |
$647.50 |
$1,295 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$719 |
$1,438 |
1.4× |
| Lung Ventilation Imaging (78579) |
$564.50 |
$1,129 |
1.5× |
| Lymphoscintigraphy (78195) |
$618 |
$1,236 |
1.2× |
| Mammary ductogram or galactogram multiple (77054) |
$289.50 |
$579 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$248 |
$496 |
1.1× |
| Meckels Diverticulum (78290) |
$618 |
$1,236 |
1.6× |
| Mr safety determination physician/other qhp (76016) |
$25 |
$50 |
0.3× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$25 |
$50 |
0.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$25 |
$50 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$25 |
$50 |
0.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$25 |
$50 |
0.1× |
| MRA head w & w/o contrast (70546) |
$1,211 |
$2,422 |
3.6× |
| MRA head w/o contrast (70544) |
$1,511 |
$3,022 |
6.6× |
| MRA neck w contrast (70548) |
$1,772 |
$3,544 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,260 |
$8,520 |
12.6× |
| MRA neck w/o contrast (70547) |
$1,288.50 |
$2,577 |
5.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,525 |
$3,050 |
4.5× |
| MRI abdomen w/o contrast (74181) |
$1,253.50 |
$2,507 |
5.4× |
| MRI any jnt lwr ext with con lt (73722) |
$3,914.50 |
$7,829 |
5.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,370.50 |
$2,741 |
1.8× |
| MRI c-spine with contrast (72142) |
$646.50 |
$1,293 |
1.9× |
| MRI cardiac w/o contrast (75557) |
$298 |
$596 |
1.3× |
| MRI cervical spine w/o contrast (72141) |
$540 |
$1,080 |
2.3× |
| MRI chest w/o & w/contrast material (71552) |
$1,525 |
$3,050 |
4.5× |
| MRI chest w/o contrast (71550) |
$1,003 |
$2,006 |
4.3× |
| MRI chest with contrast (71551) |
$1,203.50 |
$2,407 |
1.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,251.50 |
$6,503 |
9.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,253.50 |
$2,507 |
5.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,208.50 |
$2,417 |
5.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,298.50 |
$4,597 |
6.8× |
| MRI pelvis w contrast (72196) |
$1,203.50 |
$2,407 |
3.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,525 |
$3,050 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$1,003 |
$2,006 |
4.3× |
| MRI scan of arm joint before and after contrast (73223) |
$1,525 |
$3,050 |
4.5× |
| MRI scan of leg joint before and after contrast (73723) |
$4,880 |
$9,760 |
14.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$820.50 |
$1,641 |
2.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,202.50 |
$2,405 |
3.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,525 |
$3,050 |
4.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,202.50 |
$2,405 |
3.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,525 |
$3,050 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,003 |
$2,006 |
4.3× |
| MRI tmj (70336) |
$1,003 |
$2,006 |
4.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,253.50 |
$2,507 |
5.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,525 |
$3,050 |
4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,003 |
$2,006 |
4.3× |
| Myelogram Cervical (72240) |
$606 |
$1,212 |
0.8× |
| Myelogram Lumbar (72265) |
$606 |
$1,212 |
0.8× |
| Myelogram thoracic (72255) |
$606 |
$1,212 |
0.8× |
| Myelography 2 or more regions (72270) |
$606 |
$1,212 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$2,130.50 |
$4,261 |
1.7× |
| Neck soft tissue (70360) |
$167.50 |
$335 |
2.0× |
| Nm cisternogram (78630) |
$1,316.50 |
$2,633 |
2.5× |
| Nm gastric emptying study (78264) |
$686 |
$1,372 |
1.8× |
| Nm peritoneal-venous shunt patency (78291) |
$618 |
$1,236 |
1.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,704.50 |
$3,409 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$478.50 |
$957 |
2.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$120.50 |
$241 |
1.2× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$304 |
$608 |
3.0× |
| Osseous survey infant (77076) |
$140 |
$280 |
1.4× |
| Osseous survey limited (77074) |
$140 |
$280 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$1,749.50 |
$3,499 |
4.5× |
| Parathyroid imaging (78070) |
$490 |
$980 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$117 |
$234 |
1.2× |
| Peritoneogram rs&i (74190) |
$345 |
$690 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,525 |
$3,050 |
4.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,517 |
$5,034 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$494 |
$988 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$719 |
$1,438 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$591 |
$1,182 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$219 |
$438 |
2.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$219 |
$438 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$152.50 |
$305 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$134 |
$268 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$191 |
$382 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$248 |
$496 |
2.9× |
| Radiologic exam colon single contrast study (74270) |
$260.50 |
$521 |
1.5× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$173 |
$346 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$325.50 |
$651 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$325.50 |
$651 |
1.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$219 |
$438 |
2.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$71.50 |
$143 |
0.8× |
| Radiological examination surgical specimen (76098) |
$496 |
$992 |
0.9× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,549 |
$5,098 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,517 |
$5,034 |
0.8× |
| Ribs bilateral 3 views (71110) |
$140 |
$280 |
1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,196 |
$2,392 |
3.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,017 |
$2,034 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,407 |
$6,814 |
6.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,465 |
$2,930 |
1.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$280 |
$560 |
1.2× |
| Salivary gland imaging serial images (78231) |
$445.50 |
$891 |
1.2× |
| Scapula complete (73010) |
$89.50 |
$179 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$358 |
$716 |
15.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$204.50 |
$409 |
2.0× |
| Sialogram (70390) |
$591 |
$1,182 |
2.6× |
| Small bowel series (74250) |
$260.50 |
$521 |
1.5× |
| Special treatment procedure (77470) |
$2,058 |
$4,116 |
3.9× |
| Spine thoracic 3 views (72072) |
$105.50 |
$211 |
1.0× |
| Testicular Imaging With Vascular Flow (78761) |
$725.50 |
$1,451 |
1.9× |
| Thoracolumbar 2 views (72080) |
$585.50 |
$1,171 |
7.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$649.50 |
$1,299 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$353 |
$706 |
0.9× |
| Thyroid uptake measurement (78012) |
$288 |
$576 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$507 |
$1,014 |
1.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,196 |
$2,392 |
2.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,196 |
$2,392 |
3.1× |
| Ultrasound scan to determine eye length and lens power (76519) |
$306.50 |
$613 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$220 |
$440 |
2.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$52.50 |
$105 |
0.6× |
| Unlisted fluoroscopic procedure (76496) |
$160 |
$320 |
1.9× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$521 |
$1,042 |
1.3× |
| Upper Extremity Infant (73092) |
$84 |
$168 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$510 |
$1,020 |
2.2× |
| Urethrocystography voiding (74455) |
$510 |
$1,020 |
2.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$510 |
$1,020 |
3.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$510 |
$1,020 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$267.50 |
$535 |
2.6× |
| Us breast unilateral complete (76641) |
$240.50 |
$481 |
2.4× |
| Us breast unilateral limited (76642) |
$240.50 |
$481 |
2.9× |
| Us chest (76604) |
$113.50 |
$227 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$126.50 |
$253 |
1.3× |
| Us kidney transplant (76776) |
$176.50 |
$353 |
1.7× |
| Us ob transvaginal (76817) |
$141.50 |
$283 |
1.4× |
| Us pelvic non ob complete (76856) |
$220 |
$440 |
2.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$224.50 |
$449 |
2.2× |
| Us pregnancy ltd (76815) |
$120.50 |
$241 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$220 |
$440 |
2.2× |
| Us retroperitoneal complete (76770) |
$333.50 |
$667 |
3.3× |
| Us retroperitoneal limited (76775) |
$173 |
$346 |
1.7× |
| Us scrotum and contents (76870) |
$351 |
$702 |
3.5× |
| Us soft tissue head/neck (76536) |
$220 |
$440 |
2.2× |
| Us spinal canal and contents (76800) |
$176.50 |
$353 |
1.7× |
| Us xtr non-vasc lmtd (76882) |
$111 |
$222 |
1.1× |
| Venogram extremity bilateral (75822) |
$933 |
$1,866 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,517 |
$5,034 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$933 |
$1,866 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$933 |
$1,866 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,549 |
$5,098 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,549 |
$5,098 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$933 |
$1,866 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,517 |
$5,034 |
0.5× |
| Wrist 2 views (73100) |
$105.50 |
$211 |
1.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$199.50 |
$399 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$84 |
$168 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$105.50 |
$211 |
1.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$529 |
$1,058 |
3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$105.50 |
$211 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$105.50 |
$211 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$133 |
$266 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$133 |
$266 |
1.6× |
| X-ray exam hip uni 4/> views (73503) |
$176.50 |
$353 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$219 |
$438 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$101 |
$202 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$84 |
$168 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$114.50 |
$229 |
1.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$3,407 |
$6,814 |
1.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$105.50 |
$211 |
1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$89.50 |
$179 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$120.50 |
$241 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$101 |
$202 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$84 |
$168 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$105.50 |
$211 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$175 |
$350 |
1.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$140 |
$280 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$105.50 |
$211 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$84 |
$168 |
0.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$117.50 |
$235 |
1.2× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$654.50 |
$1,309 |
1.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$510 |
$1,020 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$140 |
$280 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$105.50 |
$211 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$140 |
$280 |
1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$105.50 |
$211 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$105.50 |
$211 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$105.50 |
$211 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$89.50 |
$179 |
1.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$84 |
$168 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$140 |
$280 |
1.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$84 |
$168 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$84 |
$168 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$84 |
$168 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$84 |
$168 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$105.50 |
$211 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$105.50 |
$211 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$105.50 |
$211 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$175 |
$350 |
1.7× |
| Xr chest 4+ views (71048) |
$344.50 |
$689 |
3.4× |
| Xr finger(s) 2+ views (73140) |
$105.50 |
$211 |
1.3× |
| Xr shoulder 1 view (73020) |
$84 |
$168 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$175 |
$350 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$105.50 |
$211 |
1.3× |
| Xr tmj bilateral (70330) |
$84 |
$168 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$105.50 |
$211 |
1.3× |