| Abdomen 1 View (74018) |
$213 |
$355 |
2.6× |
| Abdomen 2 views (74019) |
$264.60 |
$441 |
2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,049.40 |
$1,749 |
2.7× |
| Angio internal mammary (75756) |
$4,043.40 |
$6,739 |
1.3× |
| Angio pulmonary bilat (75743) |
$4,043.40 |
$6,739 |
1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,043.40 |
$6,739 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$4,098.60 |
$6,831 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$4,098.60 |
$6,831 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,043.40 |
$6,739 |
1.3× |
| Ankle 2 views (73600) |
$220.80 |
$368 |
2.6× |
| Aortography thoracic serialography rs&i (75605) |
$6,736.20 |
$11,227 |
1.3× |
| Artery X-Rays Abdomen (75726) |
$7,709.40 |
$12,849 |
1.4× |
| Artery X-Rays Adrenal Gland (75731) |
$4,043.40 |
$6,739 |
1.3× |
| Artery X-Rays Pelvis (75736) |
$7,709.40 |
$12,849 |
1.4× |
| Artery X-Rays Spine (75705) |
$6,736.20 |
$11,227 |
1.3× |
| Arthrogram ankle (73615) |
$520.20 |
$867 |
1.6× |
| Arthrogram hip (73525) |
$692.40 |
$1,154 |
2.1× |
| Arthrogram Wrist (73115) |
$560.40 |
$934 |
1.7× |
| Bone age studies (77072) |
$216.60 |
$361 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$1,342.20 |
$2,237 |
3.5× |
| Bone Imaging Whole Body (78306) |
$1,249.80 |
$2,083 |
3.3× |
| Bone marrow imaging limited area (78102) |
$784.80 |
$1,308 |
2.0× |
| Bone marrow imaging; multiple areas (78103) |
$821.40 |
$1,369 |
2.1× |
| Brain Flow Imaging Only (78610) |
$691.20 |
$1,152 |
1.3× |
| Brain Image W/Flow < 4 Views (78601) |
$532.20 |
$887 |
1.4× |
| Brain imaging < 4 static views (78600) |
$532.20 |
$887 |
1.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,203 |
$2,005 |
3.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$691.20 |
$1,152 |
1.3× |
| Cerebrospinal Fluid Scan (78630) |
$1,217.40 |
$2,029 |
2.3× |
| Chest 1 view (71045) |
$198.60 |
$331 |
2.4× |
| Chest 2 views (71046) |
$231.60 |
$386 |
2.8× |
| Clavicle complete (73000) |
$225.60 |
$376 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$160.20 |
$267 |
1.6× |
| Contrast Exam Abdominl Aorta (75625) |
$4,468.20 |
$7,447 |
1.5× |
| Contrast X-Ray Bladder (74430) |
$520.20 |
$867 |
1.6× |
| Contrast X-Ray Of Elbow (73085) |
$520.20 |
$867 |
1.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$687 |
$1,145 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,940 |
$4,900 |
8.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,085.60 |
$3,476 |
9.1× |
| CT abdomen w contrast (74160) |
$1,536 |
$2,560 |
9.1× |
| CT abdomen w wo contrast (74170) |
$1,810.80 |
$3,018 |
10.8× |
| CT abdomen w/o contrast (74150) |
$1,246.80 |
$2,078 |
12.4× |
| CT Angio Abdomen and Pelvis (74174) |
$2,598.60 |
$4,331 |
7.8× |
| CT Angio Chest (71275) |
$1,833.60 |
$3,056 |
10.9× |
| CT Angio Head (70496) |
$1,770.60 |
$2,951 |
10.5× |
CT angio hrt w/3d image (75574)
range across 2 matching MRF lines |
$1,418.40–$1,627.20 |
$2,364–$2,712 |
varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,777.80 |
$2,963 |
10.6× |
| CT Angio Neck (70498) |
$1,747.20 |
$2,912 |
10.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,613.40 |
$2,689 |
9.6× |
| CT cervical spine w/ contrast (72126) |
$1,500 |
$2,500 |
4.5× |
| CT cervical spine w/o contrast (72125) |
$1,364.40 |
$2,274 |
13.6× |
| CT cervical spine w/wo cont (72127) |
$1,859.40 |
$3,099 |
11.0× |
| CT chest w contrast (71260) |
$1,538.40 |
$2,564 |
9.1× |
| CT chest w/wo contrast (71270) |
$1,817.40 |
$3,029 |
10.8× |
| CT head/brain with contrast (70460) |
$1,308.60 |
$2,181 |
7.8× |
| CT head/brain without and with contrast (70470) |
$1,591.80 |
$2,653 |
9.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,132.80 |
$1,888 |
3.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$79.20 |
$132 |
0.9× |
| CT hrt w/3d image congen (75573) |
$1,390.80 |
$2,318 |
4.2× |
| CT iac w contrast (70481) |
$1,434 |
$2,390 |
8.5× |
| CT l-spine w&w/o contrast (72133) |
$1,909.80 |
$3,183 |
11.3× |
| CT lower ext w/o (73700) |
$1,181.40 |
$1,969 |
11.8× |
| CT lower extremity w/contrast material (73701) |
$1,396.20 |
$2,327 |
8.3× |
| CT lumbar spine w contrast (72132) |
$1,570.80 |
$2,618 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$1,353 |
$2,255 |
13.5× |
| CT maxillofacial w contrast (70487) |
$1,438.80 |
$2,398 |
8.6× |
| CT maxillofacial wo contrast (70486) |
$1,164.60 |
$1,941 |
11.6× |
| CT neck tissue combo (70492) |
$1,624.80 |
$2,708 |
9.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,541.40 |
$2,569 |
9.2× |
| CT orbits w/o contrast (70480) |
$1,197.60 |
$1,996 |
11.9× |
| CT pelvis w&w/o contrast (72194) |
$1,707 |
$2,845 |
10.1× |
| CT pelvis w/o contrast (72192) |
$1,234.80 |
$2,058 |
12.3× |
| CT scan of leg combo (73702) |
$1,638 |
$2,730 |
9.7× |
| CT scans face/jaw combo (70488) |
$1,643.40 |
$2,739 |
9.8× |
| CT soft tissue neck w contrast (70491) |
$1,462.20 |
$2,437 |
8.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,173 |
$1,955 |
11.7× |
| CT thoracic spine w contrast (72129) |
$1,486.80 |
$2,478 |
8.8× |
| CT thoracic spine w/o contrast (72128) |
$1,317.60 |
$2,196 |
13.1× |
| CT thoracic spine w/wo cont (72130) |
$1,770.60 |
$2,951 |
10.5× |
| CT thorax w/o contrast (71250) |
$1,217.40 |
$2,029 |
12.1× |
| CT upper ext wo (73200) |
$1,171.20 |
$1,952 |
11.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,645.80 |
$2,743 |
9.8× |
| CT upper extremity with contrast (73201) |
$1,361.40 |
$2,269 |
4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,827 |
$3,045 |
10.9× |
| Cta Abdomen (74175) |
$1,782 |
$2,970 |
10.6× |
| Dilation ureters/urethra rs&i (74485) |
$2,529 |
$4,215 |
1.3× |
| Dxa Bone Density Axial (77080) |
$338.40 |
$564 |
3.4× |
| Echo exam uterus (76831) |
$421.20 |
$702 |
1.8× |
| Esophagram (74220) |
$415.20 |
$692 |
2.5× |
| Fetal Biophys Profile W/Nst (76818) |
$481.20 |
$802 |
4.8× |
| Fluoroscopy up to 1 hr (76000) |
$438 |
$730 |
1.9× |
| Follow-Up Angiography (75898) |
$4,043.40 |
$6,739 |
1.3× |
| Foot 2 views (73620) |
$218.40 |
$364 |
2.6× |
| Forearm 2 views (73090) |
$238.20 |
$397 |
2.9× |
| Gastric emptying imaging study (78264) |
$1,191.60 |
$1,986 |
3.1× |
| Hand 2 views (73120) |
$241.20 |
$402 |
2.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,043.40 |
$6,739 |
1.3× |
| Hepatobil Syst Image W/Drug (78227) |
$1,342.80 |
$2,238 |
2.6× |
| Hepatobiliary System Imaging (78226) |
$1,171.80 |
$1,953 |
3.1× |
| Ht Muscle Image Spect Sing (78451) |
$2,175.60 |
$3,626 |
1.8× |
| Hysterosalpingogram (74740) |
$91.13 |
$151.88 |
0.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$114 |
$190 |
1.4× |
| Joint Survey Single View (77077) |
$227.40 |
$379 |
2.3× |
| K Flow/Funct Image Multiple (78709) |
$1,945.20 |
$3,242 |
3.7× |
| K Flow/Funct Image W/Drug (78708) |
$1,223.40 |
$2,039 |
2.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,198.20 |
$1,997 |
2.3× |
| Knee 3 Views (73562) |
$278.40 |
$464 |
3.3× |
| Liver & Spleen Imaging Static Only (78215) |
$1,002.60 |
$1,671 |
2.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$691.20 |
$1,152 |
1.3× |
| Lung perfusion differential (78597) |
$532.20 |
$887 |
1.4× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,306.80 |
$2,178 |
2.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,043.40 |
$6,739 |
1.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$4,043.40 |
$6,739 |
1.3× |
| Magnetic Image Jaw Joint (70336) |
$1,588.80 |
$2,648 |
6.9× |
| Mammary ductogram or galactogram single (77053) |
$435.60 |
$726 |
1.9× |
| MRA head w/o contrast (70544) |
$1,740 |
$2,900 |
7.6× |
| MRA head with contrast (70545) |
$1,948.80 |
$3,248 |
5.8× |
| MRA neck w contrast (70548) |
$1,860 |
$3,100 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,638 |
$2,730 |
7.2× |
| MRI abdomen w contrast (74182) |
$2,208.60 |
$3,681 |
6.6× |
| MRI abdomen w/o contrast (74181) |
$1,823.40 |
$3,039 |
8.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,913.40 |
$3,189 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,470.80 |
$4,118 |
7.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,048.40 |
$3,414 |
2.7× |
| MRI cervical spine w contrast (72142) |
$2,143.20 |
$3,572 |
6.4× |
| MRI cervical spine w/o cont (72141) |
$1,880.40 |
$3,134 |
8.2× |
| MRI chest w/o contrast (71550) |
$1,659 |
$2,765 |
7.2× |
| MRI chest wo w contrast (71552) |
$2,489.40 |
$4,149 |
7.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,076.60 |
$3,461 |
6.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,377.20 |
$3,962 |
7.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,736.40 |
$2,894 |
7.6× |
| MRI lumbar spine w contrast (72149) |
$2,047.20 |
$3,412 |
6.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,655.60 |
$4,426 |
7.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,696.20 |
$2,827 |
7.4× |
| MRI orbit face neck w contrast (70542) |
$2,143.20 |
$3,572 |
6.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,490 |
$4,150 |
7.4× |
| MRI pelvis w/o & w contrast (72197) |
$2,549.40 |
$4,249 |
7.6× |
| MRI pelvis w/o contrast (72195) |
$1,746.60 |
$2,911 |
7.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,868.40 |
$3,114 |
8.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,925.40 |
$3,209 |
5.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,757.40 |
$2,929 |
7.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,382.60 |
$3,971 |
7.1× |
| MRI, abdomen, combo (74183) |
$2,539.20 |
$4,232 |
7.6× |
| MRI, dorsal spine combo (72157) |
$2,610 |
$4,350 |
7.8× |
| MRI, dorsal spine contrast (72147) |
$2,204.40 |
$3,674 |
6.6× |
| MRI, joint upper extrem (73221) |
$1,812 |
$3,020 |
7.9× |
| MRI, joint upper extrem combo (73223) |
$2,424.60 |
$4,041 |
7.2× |
| MRI, lumbar spine combo (72158) |
$2,668.80 |
$4,448 |
8.0× |
| Myelogram cervical (72240) |
$1,010.40 |
$1,684 |
1.3× |
| Myelogram Lumbar (72265) |
$1,010.40 |
$1,684 |
1.3× |
| Myelography thoracic (72255) |
$1,010.40 |
$1,684 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,970 |
$4,950 |
2.4× |
| Neck soft tissue (70360) |
$224.40 |
$374 |
2.7× |
| Nonvascular Shunt X-Ray (75809) |
$355.20 |
$592 |
3.5× |
| Nuclear medicine study of endocrine organs (78099) |
$532.20 |
$887 |
1.4× |
| Ob us nuchal meas 1 gest (76813) |
$331.20 |
$552 |
3.3× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$237.60 |
$396 |
2.4× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$356.40 |
$594 |
3.6× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$105 |
$175 |
0.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$270 |
$450 |
2.7× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$49.20 |
$82 |
1.8× |
| Optic foramina (70190) |
$114 |
$190 |
1.4× |
| Panoramic X-ray of jaws (70355) |
$183.60 |
$306 |
2.2× |
| Parathyroid Planar Imaging (78070) |
$978.60 |
$1,631 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$235.80 |
$393 |
2.4× |
| Pet Image W/Ct Lmtd (78814) |
$2,049 |
$3,415 |
1.5× |
| PET image w/CT, full body (78816) |
$2,049 |
$3,415 |
1.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,049 |
$3,415 |
1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$904.20 |
$1,507 |
2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$366 |
$610 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$682.80 |
$1,138 |
1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$264 |
$440 |
3.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$290.40 |
$484 |
3.5× |
| Radex elbow complete minimum 3 views (73080) |
$261.60 |
$436 |
3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$302.40 |
$504 |
3.0× |
| Radex fingr minimum 2 views (73140) |
$198 |
$330 |
2.4× |
| Radex foot complete minimum 3 views (73630) |
$262.80 |
$438 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$265.20 |
$442 |
3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$246 |
$410 |
2.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$244.80 |
$408 |
2.9× |
| Radex shoulder complete minimum 2 views (73030) |
$266.40 |
$444 |
3.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$176.40 |
$294 |
2.1× |
| Radex Spine 1 View Specify Level (72020) |
$213 |
$355 |
2.6× |
| Radex Sternum Minimum 2 Views (71120) |
$237.60 |
$396 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$275.40 |
$459 |
3.3× |
| Radex Toe Minimum 2 Views (73660) |
$195.60 |
$326 |
2.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$153.60 |
$256 |
1.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$256.20 |
$427 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$296.40 |
$494 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$309.60 |
$516 |
3.1× |
| Radiologic exam colon double contrast study (74280) |
$690.60 |
$1,151 |
4.1× |
| Radiologic exam colon single contrast study (74270) |
$559.80 |
$933 |
3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$382.80 |
$638 |
2.3× |
| Radiologic exam knee complete 4/more views (73564) |
$327.60 |
$546 |
3.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$277.80 |
$463 |
2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$495 |
$825 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$531.60 |
$886 |
3.2× |
| Radiologic examination femur minimum 2 views (73552) |
$228.60 |
$381 |
2.7× |
| Radiologic examination knee 1/2 views (73560) |
$231 |
$385 |
2.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$369.60 |
$616 |
3.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$114 |
$190 |
1.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$247.80 |
$413 |
3.0× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$682.80 |
$1,138 |
1.3× |
| Renal Cyst Study (74470) |
$682.80 |
$1,138 |
1.3× |
| Ribs bilateral 3 views (71110) |
$153.60 |
$256 |
1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,846.20 |
$3,077 |
3.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,846.20 |
$3,077 |
3.5× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 3 matching MRF lines |
$1,826.40–$1,846.20 |
$3,044–$3,077 |
varies |
| Scapula (73010) |
$240 |
$400 |
2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$59.40 |
$99 |
2.5× |
| Shoulder 1 view (73020) |
$196.80 |
$328 |
2.4× |
| Shoulder Arthrography (73040) |
$520.20 |
$867 |
1.6× |
| Sialogram (70390) |
$325.20 |
$542 |
1.4× |
| Skull less than 4 views (70250) |
$256.20 |
$427 |
2.6× |
| Spleen Imaging (78185) |
$532.20 |
$887 |
1.4× |
| Sternoclavicular joints (71130) |
$213 |
$355 |
2.6× |
| Thoracic spine 3 views (72072) |
$309 |
$515 |
3.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$532.20 |
$887 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$882 |
$1,470 |
2.3× |
| Ultrasound Breast Limited (76642) |
$295.80 |
$493 |
3.5× |
| Ultrasound Exam Aaa Screen (76706) |
$296.40 |
$494 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$505.80 |
$843 |
5.0× |
| Umbilical-artery Doppler (OB) (76820) |
$267 |
$445 |
2.7× |
| Upper gi w/o kub (74240) |
$518.40 |
$864 |
3.1× |
| Urethrocystogram voiding (74455) |
$615 |
$1,025 |
2.7× |
| Urethrocystography retrograde (74450) |
$541.20 |
$902 |
2.4× |
| Us breast unilateral complete (76641) |
$391.80 |
$653 |
3.9× |
| Us chest (76604) |
$372.60 |
$621 |
3.7× |
| Us complete joint (76881) |
$435 |
$725 |
4.3× |
| Us exam, pelvic, limited (76857) |
$352.80 |
$588 |
3.5× |
| Us head (76506) |
$153.60 |
$256 |
1.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$308.40 |
$514 |
3.1× |
| Us ob detailed single fetus (76811) |
$545.40 |
$909 |
2.4× |
| Us ob limited 1 or more fetuses (76815) |
$344.40 |
$574 |
3.4× |
| Us ob transvaginal (76817) |
$392.40 |
$654 |
3.9× |
| Us pelvic non ob complete (76856) |
$559.20 |
$932 |
5.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$456 |
$760 |
4.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$326.40 |
$544 |
3.3× |
| Us retroperitoneal complete (76770) |
$549 |
$915 |
5.5× |
| Us retroperitoneal limited (76775) |
$434.40 |
$724 |
4.3× |
| Us scrotum and contents (76870) |
$520.20 |
$867 |
5.2× |
| Us thyroid (76536) |
$490.80 |
$818 |
4.9× |
| Us transrectal (76872) |
$419.40 |
$699 |
4.2× |
| Vein X-Ray Chest (75827) |
$1,986.60 |
$3,311 |
1.3× |
| Vein X-Ray Spleen/Liver (75810) |
$4,043.40 |
$6,739 |
1.3× |
| Venogram Sinus/Jugular (75860) |
$1,860 |
$3,100 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$4,043.40 |
$6,739 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$4,468.20 |
$7,447 |
1.5× |
| Venography extremity bilateral rs&i (75822) |
$1,986.60 |
$3,311 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$2,231.40 |
$3,719 |
1.5× |
| Venography Orbital Rs&I (75880) |
$763.80 |
$1,273 |
1.3× |
| Venography Renal Bilateral (75833) |
$4,043.40 |
$6,739 |
1.3× |
| Venography Renal Unilateral (75831) |
$4,043.40 |
$6,739 |
1.3× |
| Venous sampling by catheter (75893) |
$6,736.20 |
$11,227 |
1.3× |
| Venous thrombosis imaging (78457) |
$691.20 |
$1,152 |
1.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$532.20 |
$887 |
1.4× |
| Wrist 2 views (73100) |
$221.40 |
$369 |
2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$330.60 |
$551 |
4.0× |
| X-ray antegrade pyelogram tube (74425) |
$558.60 |
$931 |
1.7× |
| X-Ray Aorta Leg Arteries (75630) |
$4,468.20 |
$7,447 |
1.5× |
| X-Ray Bend Only L-S Spine (72120) |
$294 |
$490 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$218.40 |
$364 |
2.6× |
| X-Ray Exam Breast Specimen (76098) |
$682.80 |
$1,138 |
1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$114 |
$190 |
1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$292.80 |
$488 |
2.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$189 |
$315 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$237 |
$395 |
2.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$304.20 |
$507 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$325.80 |
$543 |
3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$153.60 |
$256 |
1.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$453 |
$755 |
4.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$264.60 |
$441 |
3.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$423 |
$705 |
4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$310.80 |
$518 |
3.1× |
| X-ray eye for foreign body (70030) |
$192.60 |
$321 |
2.3× |
| X-ray humerus (73060) |
$235.20 |
$392 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$297 |
$495 |
3.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$294 |
$490 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$395.40 |
$659 |
3.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$153.60 |
$256 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$244.20 |
$407 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$283.80 |
$473 |
3.4× |
| X-ray thoracic spine 4 vw (72074) |
$325.80 |
$543 |
3.2× |
| X-Ray Tmj Unilat (70328) |
$198 |
$330 |
2.4× |
| X-Rays Bone Survey Complete (77075) |
$523.20 |
$872 |
5.2× |
| Xr c-spine 4 or 5 views (72050) |
$369 |
$615 |
3.7× |
| Xr orbits complete 4 views (70200) |
$298.20 |
$497 |
3.0× |