| Abdomen 1 View (74018) |
$254.50 |
$509 |
3.0× |
| Abdomen 2 views (74019) |
$340 |
$680 |
3.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,083.50 |
$2,167 |
2.8× |
| Angio internal mammary (75756) |
$1,613 |
$3,226 |
0.5× |
| Angio pulmonary bilat (75743) |
$4,410 |
$8,820 |
1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,410 |
$8,820 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$4,699.50 |
$9,399 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$4,409.50 |
$8,819 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,409.50 |
$8,819 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,613 |
$3,226 |
0.5× |
| Ankle 2 views (73600) |
$243.50 |
$487 |
2.9× |
| Aortography thoracic serialography rs&i (75605) |
$4,699.50 |
$9,399 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$4,410 |
$8,820 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$4,409.50 |
$8,819 |
1.4× |
| Artery X-Rays Pelvis (75736) |
$4,410 |
$8,820 |
0.8× |
| Artery X-Rays Spine (75705) |
$4,431.50 |
$8,863 |
0.8× |
| Arthrogram ankle (73615) |
$614 |
$1,228 |
1.8× |
| Arthrogram hip (73525) |
$619 |
$1,238 |
1.8× |
| Arthrogram Wrist (73115) |
$625 |
$1,250 |
1.9× |
| Bone age studies (77072) |
$206 |
$412 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,704.50 |
$3,409 |
4.4× |
| Bone Imaging Limited Area (78300) |
$1,008.50 |
$2,017 |
2.6× |
| Bone Imaging Multiple Areas (78305) |
$1,045.50 |
$2,091 |
2.7× |
| Bone Imaging Whole Body (78306) |
$1,675 |
$3,350 |
4.3× |
| Bone survey infant (77076) |
$196 |
$392 |
1.9× |
| Brain Flow Imaging Only (78610) |
$825.50 |
$1,651 |
1.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$535.50 |
$1,071 |
1.0× |
| Cat Scan Follow-Up Study (76380) |
$1,259.50 |
$2,519 |
15.0× |
| Chest 1 view (71045) |
$207 |
$414 |
2.5× |
| Chest 2 views (71046) |
$248 |
$496 |
2.9× |
| Chest 3 views (71047) |
$289.50 |
$579 |
3.4× |
| Chest 4 or more views (71048) |
$344.50 |
$689 |
3.4× |
| Cholecystography Oral Contrast (74290) |
$110 |
$220 |
0.6× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$96.50 |
$193 |
1.0× |
| Clavicle complete (73000) |
$250.50 |
$501 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$45.50 |
$91 |
0.5× |
| Contrast Exam Abdominl Aorta (75625) |
$4,699.50 |
$9,399 |
1.5× |
| Contrast X-Ray Bladder (74430) |
$503.50 |
$1,007 |
1.5× |
| Contrast X-Ray Of Elbow (73085) |
$770 |
$1,540 |
2.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$614 |
$1,228 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,508.50 |
$7,017 |
10.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,769 |
$5,538 |
12.0× |
| CT abdomen w contrast (74160) |
$1,532.50 |
$3,065 |
9.0× |
| CT abdomen w wo contrast (74170) |
$1,941.50 |
$3,883 |
11.5× |
| CT abdomen w/o contrast (74150) |
$1,425 |
$2,850 |
14.1× |
| CT Angio Abdomen and Pelvis (74174) |
$2,346 |
$4,692 |
7.0× |
| CT Angio Chest (71275) |
$1,881.50 |
$3,763 |
11.1× |
| CT Angio Head (70496) |
$2,003 |
$4,006 |
11.8× |
| CT angio hrt w/3d image (75574) |
$1,354 |
$2,708 |
4.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,937 |
$3,874 |
11.4× |
| CT Angio Neck (70498) |
$2,018.50 |
$4,037 |
11.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,631.50 |
$3,263 |
9.6× |
| CT cervical spine w/ contrast (72126) |
$1,772 |
$3,544 |
5.3× |
| CT cervical spine w/o contrast (72125) |
$1,761 |
$3,522 |
17.4× |
| CT cervical spine w/wo cont (72127) |
$1,994 |
$3,988 |
11.8× |
| CT chest w contrast (71260) |
$1,716 |
$3,432 |
10.1× |
| CT chest w/wo contrast (71270) |
$1,863 |
$3,726 |
11.0× |
| CT head/brain with contrast (70460) |
$1,680.50 |
$3,361 |
9.9× |
| CT head/brain without and with contrast (70470) |
$1,967 |
$3,934 |
11.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$65 |
$130 |
0.8× |
| CT iac w contrast (70481) |
$1,795 |
$3,590 |
10.6× |
| CT l-spine w&w/o contrast (72133) |
$1,871 |
$3,742 |
11.0× |
| CT lower ext w/o (73700) |
$1,337.50 |
$2,675 |
13.2× |
| CT lower extremity w/contrast material (73701) |
$1,474 |
$2,948 |
8.7× |
| CT lumbar spine w contrast (72132) |
$1,637 |
$3,274 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$1,554.50 |
$3,109 |
15.4× |
| CT maxillofacial w contrast (70487) |
$1,683.50 |
$3,367 |
9.9× |
| CT maxillofacial wo contrast (70486) |
$1,464.50 |
$2,929 |
14.5× |
| CT neck tissue combo (70492) |
$1,987 |
$3,974 |
11.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,985 |
$3,970 |
11.7× |
| CT orbits w/o contrast (70480) |
$1,570.50 |
$3,141 |
15.5× |
| CT pelvis w&w/o contrast (72194) |
$1,836 |
$3,672 |
10.8× |
| CT pelvis w/o contrast (72192) |
$1,446.50 |
$2,893 |
14.3× |
| CT scan of leg combo (73702) |
$1,492 |
$2,984 |
8.8× |
| CT scans face/jaw combo (70488) |
$1,760 |
$3,520 |
10.4× |
| CT soft tissue neck w contrast (70491) |
$1,761.50 |
$3,523 |
10.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,511.50 |
$3,023 |
15.0× |
| CT thoracic spine w contrast (72129) |
$1,553.50 |
$3,107 |
9.2× |
| CT thoracic spine w/o contrast (72128) |
$1,425 |
$2,850 |
14.1× |
| CT thoracic spine w/wo cont (72130) |
$1,682.50 |
$3,365 |
9.9× |
| CT thorax w/o contrast (71250) |
$1,425 |
$2,850 |
14.1× |
| CT upper ext wo (73200) |
$1,322.50 |
$2,645 |
13.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,615 |
$3,230 |
9.5× |
| CT upper extremity with contrast (73201) |
$1,589.50 |
$3,179 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,163 |
$4,326 |
12.8× |
| Cta Abdomen (74175) |
$1,731 |
$3,462 |
10.2× |
| CTA pelvis (72191) |
$1,816.50 |
$3,633 |
10.7× |
| Dxa Bone Density Axial (77080) |
$405.50 |
$811 |
4.0× |
| Dxa bone density study (77085) |
$402 |
$804 |
4.0× |
| Echo exam uterus (76831) |
$377 |
$754 |
1.6× |
| Echo Guide For Artery Repair (76936) |
$448 |
$896 |
2.1× |
| Esophagram (74220) |
$408.50 |
$817 |
2.4× |
| Fetal Biophys Profile W/Nst (76818) |
$290 |
$580 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$418.50 |
$837 |
4.1× |
| Fluoroscopy up to 1 hr (76000) |
$417 |
$834 |
1.8× |
| Follow-Up Angiography (75898) |
$553 |
$1,106 |
0.2× |
| Foot 2 views (73620) |
$247 |
$494 |
2.9× |
| Forearm 2 views (73090) |
$257.50 |
$515 |
3.1× |
| Gastric emptying imaging study (78264) |
$1,420 |
$2,840 |
3.7× |
| Gated Heart Planar Single (78472) |
$1,514 |
$3,028 |
3.9× |
| Hand 2 views (73120) |
$239.50 |
$479 |
2.4× |
| Hepatobil Syst Image W/Drug (78227) |
$1,705.50 |
$3,411 |
3.2× |
| Hepatobiliary System Imaging (78226) |
$1,545 |
$3,090 |
4.0× |
| Ht Muscle Image Spect Sing (78451) |
$2,241 |
$4,482 |
1.8× |
| Hysterosalpingogram (74740) |
$562 |
$1,124 |
2.4× |
| Infant hip ultrasound, limited static exam (76886) |
$224.50 |
$449 |
2.7× |
| Joint Survey Single View (77077) |
$196 |
$392 |
1.9× |
| K Flow/Funct Image W/Drug (78708) |
$1,454 |
$2,908 |
2.8× |
| K Flow/Funct Image W/O Drug (78707) |
$1,378 |
$2,756 |
2.6× |
| Knee 3 Views (73562) |
$321 |
$642 |
3.8× |
| Liver & Spleen Imaging Static Only (78215) |
$1,104 |
$2,208 |
2.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,405.50 |
$2,811 |
2.7× |
| Lymph System Imaging (78195) |
$1,266 |
$2,532 |
2.4× |
| Magnetic Image Jaw Joint (70336) |
$1,758 |
$3,516 |
7.6× |
| Mammary ductogram or galactogram multiple (77054) |
$289.50 |
$579 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$248 |
$496 |
1.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,469 |
$2,938 |
4.4× |
| MRA head w/o contrast (70544) |
$1,801.50 |
$3,603 |
7.8× |
| MRA neck w contrast (70548) |
$1,801.50 |
$3,603 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$904.50 |
$1,809 |
2.7× |
| MRA neck w/o contrast (70547) |
$1,691 |
$3,382 |
7.3× |
| MRI abdomen w contrast (74182) |
$1,996 |
$3,992 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,863.50 |
$3,727 |
8.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,096 |
$4,192 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,429 |
$4,858 |
7.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,056.50 |
$4,113 |
2.7× |
| MRI cervical spine w contrast (72142) |
$2,434 |
$4,868 |
7.2× |
| MRI cervical spine w/o cont (72141) |
$2,100 |
$4,200 |
9.1× |
| MRI chest w/o contrast (71550) |
$1,878 |
$3,756 |
8.1× |
| MRI chest wo w contrast (71552) |
$2,197.50 |
$4,395 |
6.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,372 |
$4,744 |
7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,870 |
$3,740 |
8.1× |
| MRI lumbar spine w contrast (72149) |
$2,112.50 |
$4,225 |
6.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,553 |
$5,106 |
7.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,213.50 |
$4,427 |
9.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,530.50 |
$5,061 |
7.5× |
| MRI pelvis w/o & w contrast (72197) |
$2,525 |
$5,050 |
7.5× |
| MRI pelvis w/o contrast (72195) |
$1,749.50 |
$3,499 |
7.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,946 |
$3,892 |
8.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,880.50 |
$3,761 |
8.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,304.50 |
$4,609 |
6.8× |
| MRI, abdomen, combo (74183) |
$2,444.50 |
$4,889 |
7.2× |
| MRI, dorsal spine combo (72157) |
$2,442.50 |
$4,885 |
7.2× |
| MRI, dorsal spine contrast (72147) |
$2,074 |
$4,148 |
6.2× |
| MRI, joint upper extrem (73221) |
$2,015 |
$4,030 |
8.7× |
| MRI, joint upper extrem combo (73223) |
$2,324 |
$4,648 |
6.9× |
| MRI, lumbar spine combo (72158) |
$2,561.50 |
$5,123 |
7.6× |
| Myelogram cervical (72240) |
$1,143 |
$2,286 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,601.50 |
$7,203 |
2.9× |
| Neck soft tissue (70360) |
$259.50 |
$519 |
3.1× |
| Nonvascular Shunt X-Ray (75809) |
$350.50 |
$701 |
3.5× |
| Optic foramina (70190) |
$108 |
$216 |
1.3× |
| Parathyroid Planar Imaging (78070) |
$1,126 |
$2,252 |
2.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$850.50 |
$1,701 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$243 |
$486 |
2.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,037.50 |
$2,075 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$817.50 |
$1,635 |
2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$415.50 |
$831 |
4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$506 |
$1,012 |
1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$313.50 |
$627 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$249.50 |
$499 |
3.0× |
| Radex elbow complete minimum 3 views (73080) |
$282 |
$564 |
3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$345.50 |
$691 |
3.4× |
| Radex fingr minimum 2 views (73140) |
$222 |
$444 |
2.6× |
| Radex foot complete minimum 3 views (73630) |
$306 |
$612 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$288 |
$576 |
3.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$107.50 |
$215 |
1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$275 |
$550 |
3.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$262 |
$524 |
3.1× |
| Radex shoulder complete minimum 2 views (73030) |
$308.50 |
$617 |
3.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$217 |
$434 |
2.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$173.50 |
$347 |
1.0× |
| Radex Spine 1 View Specify Level (72020) |
$217 |
$434 |
2.6× |
| Radex Sternum Minimum 2 Views (71120) |
$268 |
$536 |
3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$293.50 |
$587 |
3.5× |
| Radex Toe Minimum 2 Views (73660) |
$213.50 |
$427 |
2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$283.50 |
$567 |
3.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$352 |
$704 |
3.5× |
| Radiologic exam colon double contrast study (74280) |
$780.50 |
$1,561 |
4.6× |
| Radiologic exam colon single contrast study (74270) |
$612.50 |
$1,225 |
3.6× |
| Radiologic exam knee complete 4/more views (73564) |
$374 |
$748 |
3.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$277 |
$554 |
2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$520.50 |
$1,041 |
3.1× |
| Radiologic exam swallow function contrast study (74230) |
$444 |
$888 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$410 |
$820 |
2.4× |
| Radiologic examination femur minimum 2 views (73552) |
$267 |
$534 |
3.2× |
| Radiologic examination knee 1/2 views (73560) |
$257.50 |
$515 |
3.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$363.50 |
$727 |
3.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$79.50 |
$159 |
0.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$267 |
$534 |
3.2× |
| Ribs bilateral 3 views (71110) |
$336 |
$672 |
3.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,767 |
$3,534 |
3.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$853 |
$1,706 |
1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,626.50 |
$3,253 |
3.1× |
| Salivary Gland Imaging Serial Images (78231) |
$385 |
$770 |
1.0× |
| Scapula (73010) |
$238.50 |
$477 |
2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$358.50 |
$717 |
15.3× |
| Shoulder 1 view (73020) |
$171 |
$342 |
2.0× |
| Shoulder Arthrography (73040) |
$667.50 |
$1,335 |
2.0× |
| Sialogram (70390) |
$525.50 |
$1,051 |
2.3× |
| Skull less than 4 views (70250) |
$263 |
$526 |
2.6× |
| Sternoclavicular joints (71130) |
$209.50 |
$419 |
2.5× |
| Thoracic spine 2 views (72070) |
$313 |
$626 |
3.1× |
| Thoracic spine 3 views (72072) |
$357.50 |
$715 |
3.5× |
| Thoracolumbar 2 views (72080) |
$267 |
$534 |
3.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$614.50 |
$1,229 |
1.6× |
| Thyroid Met Imaging Body (78018) |
$1,333 |
$2,666 |
2.5× |
| Thyroid Uptake Measurement (78012) |
$475 |
$950 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,083 |
$2,166 |
2.8× |
| Ultrasound Breast Limited (76642) |
$276.50 |
$553 |
3.3× |
| Ultrasound Exam Aaa Screen (76706) |
$452.50 |
$905 |
4.5× |
| Ultrasound, abdomen limited (76705) |
$657 |
$1,314 |
6.5× |
| Upper gi w/o kub (74240) |
$574.50 |
$1,149 |
3.4× |
| Urethrocystogram voiding (74455) |
$531 |
$1,062 |
2.3× |
| Urethrocystography retrograde (74450) |
$524.50 |
$1,049 |
2.3× |
| Us breast unilateral complete (76641) |
$367.50 |
$735 |
3.6× |
| Us chest (76604) |
$422.50 |
$845 |
4.2× |
| Us complete joint (76881) |
$110 |
$220 |
1.1× |
| Us exam, pelvic, limited (76857) |
$430.50 |
$861 |
4.3× |
| Us head (76506) |
$178 |
$356 |
1.8× |
| Us kidney transplant (76776) |
$202.50 |
$405 |
2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$417 |
$834 |
4.1× |
| Us ob limited 1 or more fetuses (76815) |
$391 |
$782 |
3.9× |
| Us ob transvaginal (76817) |
$486 |
$972 |
4.8× |
| Us pelvic non ob complete (76856) |
$619.50 |
$1,239 |
6.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$512 |
$1,024 |
5.1× |
| Us retroperitoneal complete (76770) |
$329 |
$658 |
3.3× |
| Us retroperitoneal limited (76775) |
$545 |
$1,090 |
5.4× |
| Us scrotum and contents (76870) |
$549 |
$1,098 |
5.4× |
| Us spinal canal and contents (76800) |
$337.50 |
$675 |
3.3× |
| Us thyroid (76536) |
$561 |
$1,122 |
5.6× |
| Vein X-Ray Chest (75827) |
$4,409.50 |
$8,819 |
2.9× |
| Vein X-Ray Spleen/Liver (75810) |
$4,409.50 |
$8,819 |
1.4× |
| Venogram Sinus/Jugular (75860) |
$1,613.50 |
$3,227 |
0.5× |
| Venography Adrenal Unilateral (75840) |
$4,409.50 |
$8,819 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$4,409.50 |
$8,819 |
1.4× |
| Venography extremity bilateral rs&i (75822) |
$1,744.50 |
$3,489 |
1.1× |
| Venography Renal Bilateral (75833) |
$4,409.50 |
$8,819 |
1.4× |
| Venography Renal Unilateral (75831) |
$4,409.50 |
$8,819 |
1.4× |
| Wrist 2 views (73100) |
$234.50 |
$469 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$296 |
$592 |
3.5× |
| X-ray antegrade pyelogram tube (74425) |
$508 |
$1,016 |
1.5× |
| X-Ray Aorta Leg Arteries (75630) |
$4,493 |
$8,986 |
1.5× |
| X-Ray Bend Only L-S Spine (72120) |
$387.50 |
$775 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$237.50 |
$475 |
2.8× |
| X-Ray Exam Breast Specimen (76098) |
$496 |
$992 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$337.50 |
$675 |
4.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$355 |
$710 |
3.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$190.50 |
$381 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$545.50 |
$1,091 |
6.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$574.50 |
$1,149 |
5.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$357 |
$714 |
3.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$512 |
$1,024 |
5.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$338.50 |
$677 |
4.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$487 |
$974 |
4.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$162 |
$324 |
1.6× |
| X-ray humerus (73060) |
$257.50 |
$515 |
3.1× |
| X-ray IV pyelogram (ivp) (74400) |
$744 |
$1,488 |
4.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$243 |
$486 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$239.50 |
$479 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$355 |
$710 |
3.5× |
| X-ray nose-rectum child f.b. (76010) |
$204 |
$408 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$240.50 |
$481 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$275 |
$550 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$268 |
$536 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$370.50 |
$741 |
4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$165.50 |
$331 |
1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$620.50 |
$1,241 |
1.8× |
| X-Rays Bone Length Studies (77073) |
$240.50 |
$481 |
2.4× |
| X-Rays Bone Survey Complete (77075) |
$591.50 |
$1,183 |
5.9× |
| Xr c-spine 4 or 5 views (72050) |
$421 |
$842 |
4.2× |
| Xr facial bones less than 3 views (70140) |
$224 |
$448 |
2.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$105.50 |
$211 |
1.0× |
| Xr orbits complete 4 views (70200) |
$313.50 |
$627 |
3.1× |
| Xr Tomogram Single Plane (76100) |
$406.50 |
$813 |
4.0× |