| Abdomen 2 views (74019) |
$214.74 |
$383.45 |
2.0× |
| Acute gi blood loss imaging (78278) |
$2,296.34 |
$4,100.60 |
5.6× |
| Ankle 2 views (73600) |
$204.57 |
$365.30 |
2.3× |
| Arthrogram elbow (73085) |
$811.38 |
$1,448.90 |
2.3× |
| Arthrogram hip (73525) |
$343.56 |
$613.50 |
1.0× |
| Arthrogram knee (73580) |
$343.56 |
$613.50 |
1.0× |
| Arthrogram shoulder (73040) |
$343.56 |
$613.50 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$765.41 |
$1,366.80 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,148.22 |
$2,050.40 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$768.71 |
$1,372.70 |
1.9× |
| Bone age studies (77072) |
$171.81 |
$306.80 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$960.96 |
$1,716 |
2.3× |
| Bone survey complete (77075) |
$257.66 |
$460.10 |
2.4× |
| Bone survey infant (77076) |
$343.56 |
$613.50 |
3.2× |
| Bowel imaging (78290) |
$765.41 |
$1,366.80 |
1.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,148.22 |
$2,050.40 |
2.8× |
| Cervical spine 2 or 3 views (72040) |
$214.74 |
$383.45 |
2.4× |
| Chest 1 view (71045) |
$214.74 |
$383.45 |
2.4× |
| Chest xray 3 views (71047) |
$171.81 |
$306.80 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$257.66 |
$460.10 |
1.4× |
| Clavicle complete (73000) |
$214.74 |
$383.45 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$794.70 |
$1,419.10 |
7.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,986.77 |
$3,547.80 |
5.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,192.13 |
$2,128.80 |
4.8× |
| CT abdomen w contrast (74160) |
$1,192.13 |
$2,128.80 |
6.6× |
| CT abdomen w wo contrast (74170) |
$1,589.34 |
$2,838.10 |
8.8× |
| CT abdomen w/o contrast (74150) |
$695.36 |
$1,241.70 |
6.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,986.77 |
$3,547.80 |
11.0× |
| CT angiography upper extremity lt (73206) |
$1,589.34 |
$2,838.10 |
8.8× |
| CT c-spine w/contrast (72126) |
$1,192.13 |
$2,128.80 |
3.3× |
| CT c-spine w/o contrast (72125) |
$794.70 |
$1,419.10 |
7.4× |
| CT chest w contrast (71260) |
$596.06 |
$1,064.40 |
3.3× |
| CT chest w/wo contrast (71270) |
$794.75 |
$1,419.20 |
4.4× |
| CT head/brain with contrast (70460) |
$1,192.13 |
$2,128.80 |
6.6× |
| CT head/brain without and with contrast (70470) |
$1,589.34 |
$2,838.10 |
8.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$794.70 |
$1,419.10 |
8.8× |
| CT iac w contrast (70481) |
$1,192.13 |
$2,128.80 |
6.6× |
| CT lower ext w/o (73700) |
$1,324.51 |
$2,365.20 |
12.3× |
| CT lower extremity w wo contrast (73702) |
$2,119.26 |
$3,784.40 |
11.7× |
| CT lower extremity w/contrast material (73701) |
$1,721.78 |
$3,074.60 |
9.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,589.34 |
$2,838.10 |
8.8× |
| CT lumbar spine w/contrast (72132) |
$1,192.13 |
$2,128.80 |
3.3× |
| CT lumbar spine w/o contrast (72131) |
$794.70 |
$1,419.10 |
7.4× |
| CT maxillofacial w contrast (70487) |
$1,192.13 |
$2,128.80 |
6.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,589.34 |
$2,838.10 |
8.8× |
| CT maxillofacial wo contrast (70486) |
$1,475.63 |
$2,635.05 |
13.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,589.34 |
$2,838.10 |
8.8× |
| CT orbits w/o contrast (70480) |
$794.70 |
$1,419.10 |
7.4× |
| CT pelvis w/o contrast (72192) |
$1,192.13 |
$2,128.80 |
11.0× |
| CT pelvis w/wo contrast (72194) |
$1,589.34 |
$2,838.10 |
8.8× |
| CT scan of arm combo (73202) |
$1,986.77 |
$3,547.80 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$794.70 |
$1,419.10 |
4.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,192.13 |
$2,128.80 |
6.6× |
| CT soft tissue neck w/o contrast (70490) |
$529.76 |
$946 |
4.9× |
| CT thoracic spine w/contrast (72129) |
$1,192.13 |
$2,128.80 |
6.6× |
| CT thoracic spine w/o contrast (72128) |
$794.70 |
$1,419.10 |
7.4× |
| CT thorax w/o contrast (71250) |
$430.44 |
$768.65 |
4.0× |
| CT upper ext wo (73200) |
$1,192.13 |
$2,128.80 |
11.0× |
| CT upper extremity with contrast (73201) |
$1,589.34 |
$2,838.10 |
4.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,589.34 |
$2,838.10 |
8.8× |
| Cta Abdomen (74175) |
$1,589.34 |
$2,838.10 |
8.8× |
| CTA abdomen pelvis (74174) |
$2,781.41 |
$4,966.80 |
7.7× |
| CTA chest (71275) |
$794.70 |
$1,419.10 |
4.4× |
| Cta Head (70496) |
$1,589.34 |
$2,838.10 |
8.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,849.46 |
$3,302.60 |
5.1× |
| Cta Neck (70498) |
$1,192.13 |
$2,128.80 |
6.6× |
| Cta Pelvis (72191) |
$1,192.13 |
$2,128.80 |
6.6× |
| Cystography minimum 3 views rs&i (74430) |
$1,832.15 |
$3,271.70 |
5.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$141.68 |
$253 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$176.85 |
$315.80 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$114.58 |
$204.60 |
1.3× |
| Esophagus (74220) |
$257.66 |
$460.10 |
1.4× |
| Facial bones min 3 views (70150) |
$171.81 |
$306.80 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$425.21 |
$759.30 |
3.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$425.21 |
$759.30 |
3.9× |
| Fetal Echo (76825) |
$141.68 |
$253 |
0.3× |
| Fluoroscopy up to 1 hr (76000) |
$1,540.50 |
$2,750.90 |
6.3× |
| Foot 2 views (73620) |
$182.54 |
$325.95 |
2.0× |
| Forearm 2 views (73090) |
$171.81 |
$306.80 |
1.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$2,208.53 |
$3,943.80 |
5.4× |
| Hand 2 views (73120) |
$171.81 |
$306.80 |
1.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,537.59 |
$2,745.70 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,345.29 |
$2,402.30 |
3.3× |
| Hysterosalpingogram (74740) |
$257.66 |
$460.10 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,148.22 |
$2,050.40 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,153.21 |
$2,059.30 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$960.96 |
$1,716 |
1.7× |
| Knee 3 views (73562) |
$204.66 |
$365.45 |
2.3× |
| Liver & spleen imaging static only (78215) |
$694.96 |
$1,241 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$768.82 |
$1,372.90 |
1.4× |
| Lung ventilation imaging (78579) |
$576.69 |
$1,029.80 |
1.4× |
| Lymphoscintigraphy (78195) |
$1,921.98 |
$3,432.10 |
3.4× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,825.93 |
$5,046.30 |
3.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,229.63 |
$5,767.20 |
9.0× |
| Magnetic Resonance Elastography (76391) |
$2,140.15 |
$3,821.70 |
8.7× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$171.81 |
$306.80 |
1.9× |
| MRA head w & w/o contrast (70546) |
$2,422.17 |
$4,325.30 |
6.7× |
| MRA head w/o contrast (70544) |
$1,614.76 |
$2,883.50 |
6.6× |
| MRA head with contrast (70545) |
$2,018.46 |
$3,604.40 |
5.6× |
| MRA neck w contrast (70548) |
$1,614.76 |
$2,883.50 |
4.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,018.46 |
$3,604.40 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,211.06 |
$2,162.60 |
4.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,027.75 |
$5,406.70 |
8.4× |
| MRI abdomen w/o contrast (74181) |
$2,422.17 |
$4,325.30 |
9.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,633.28 |
$6,488 |
4.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,825.93 |
$5,046.30 |
7.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,009.29 |
$1,802.30 |
4.1× |
| MRI c-spine with contrast (72142) |
$1,614.76 |
$2,883.50 |
4.5× |
| MRI cervical spine w/o contrast (72141) |
$1,059.69 |
$1,892.30 |
4.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,624.10 |
$4,685.90 |
7.3× |
| MRI chest w/o contrast (71550) |
$1,816.70 |
$3,244.10 |
7.4× |
| MRI chest with contrast (71551) |
$2,220.34 |
$3,964.90 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,614.20 |
$2,882.50 |
4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,027.75 |
$5,406.70 |
8.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,422.17 |
$4,325.30 |
9.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,614.76 |
$2,883.50 |
6.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,229.63 |
$5,767.20 |
9.0× |
| MRI pelvis w/contrast (72196) |
$2,329.04 |
$4,159 |
6.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,825.93 |
$5,046.30 |
7.8× |
| MRI pelvis w/o contrast (72195) |
$2,018.46 |
$3,604.40 |
8.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,822.46 |
$3,254.40 |
5.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,614.76 |
$2,883.50 |
4.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,018.46 |
$3,604.40 |
5.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,614.76 |
$2,883.50 |
4.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,766.18 |
$3,153.90 |
4.9× |
| MRI temporomandibular joint (70336) |
$1,816.70 |
$3,244.10 |
7.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,059.69 |
$1,892.30 |
4.3× |
| MRI up ext w/o contrast (73218) |
$2,422.17 |
$4,325.30 |
9.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,018.46 |
$3,604.40 |
8.2× |
| MRI, joint upper extrem combo (73223) |
$2,825.93 |
$5,046.30 |
7.8× |
| Myelogram Cervical (72240) |
$343.56 |
$613.50 |
0.4× |
| Myelogram Lumbar (72265) |
$343.56 |
$613.50 |
0.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,679.15 |
$4,784.20 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,306.30 |
$4,118.40 |
1.7× |
| Myocardial spect single study at rest or stress (78451) |
$2,296.34 |
$4,100.60 |
1.7× |
| Neck soft tissue (70360) |
$214.74 |
$383.45 |
2.4× |
| Nm gastric emptying study (78264) |
$1,729.78 |
$3,088.90 |
4.2× |
| Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) |
$237.94 |
$424.90 |
2.2× |
| Orthopantogram (70355) |
$257.66 |
$460.10 |
2.9× |
| Parathyroid Planar Imaging (78070) |
$2,306.30 |
$4,118.40 |
5.6× |
| Pelvis 1 or 2 views (72170) |
$214.74 |
$383.45 |
2.0× |
| PET image w/CT, skull-thigh (78815) |
$2,813.33 |
$5,023.80 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$2,813.33 |
$5,023.80 |
1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$574.17 |
$1,025.30 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$768.71 |
$1,372.70 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$257.66 |
$460.10 |
0.5× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$204.57 |
$365.30 |
2.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$149.83 |
$267.55 |
1.7× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$171.81 |
$306.80 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$257.66 |
$460.10 |
2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$311.92 |
$557 |
2.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$339.02 |
$605.40 |
3.1× |
| Radex fingr minimum 2 views (73140) |
$214.74 |
$383.45 |
2.4× |
| Radex Foot Compl Minimum 3 Views (73630) |
$204.57 |
$365.30 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$171.81 |
$306.80 |
1.9× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$429.55 |
$767.05 |
4.8× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$440.38 |
$786.40 |
4.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$354.37 |
$632.80 |
3.3× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$307.89 |
$549.80 |
2.9× |
| Radex Humerus Minimum 2 Views (73060) |
$171.81 |
$306.80 |
1.9× |
| Radex Kne 1/2 Views (73560) |
$204.57 |
$365.30 |
2.3× |
| Radex Kne Compl 4/More Views (73564) |
$163.69 |
$292.30 |
1.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$171.81 |
$306.80 |
1.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$171.81 |
$306.80 |
1.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$171.81 |
$306.80 |
1.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$204.57 |
$365.30 |
2.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$171.81 |
$306.80 |
1.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$171.81 |
$306.80 |
1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$171.81 |
$306.80 |
1.9× |
| Radex Toe Minimum 2 Views (73660) |
$214.74 |
$383.45 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$171.81 |
$306.80 |
1.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$214.74 |
$383.45 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$393.34 |
$702.40 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$171.81 |
$306.80 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$171.81 |
$306.80 |
1.6× |
| Radiologic exam chest 2 views (71046) |
$204.57 |
$365.30 |
2.3× |
| Radiologic exam colon single contrast study (74270) |
$343.56 |
$613.50 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$257.66 |
$460.10 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$257.66 |
$460.10 |
1.4× |
| Radiologic examination femur 1 view (73551) |
$214.82 |
$383.60 |
2.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$171.81 |
$306.80 |
1.9× |
| Radiological examination surgical specimen (76098) |
$85.96 |
$153.50 |
0.2× |
| Ribs bilateral 3 views (71110) |
$171.81 |
$306.80 |
1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,184.55 |
$5,686.70 |
5.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,041.20 |
$3,645 |
3.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$956.82 |
$1,708.60 |
1.7× |
| Sacroiliac Joints < 3 Views (72200) |
$170.58 |
$304.60 |
1.6× |
| Scapula (73010) |
$171.81 |
$306.80 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$24.48 |
$43.70 |
1.0× |
| Shoulder 1 view (73020) |
$204.57 |
$365.30 |
2.3× |
| Small bowel series (74250) |
$515.42 |
$920.40 |
2.8× |
| Spine thoracic 3 views (72072) |
$171.81 |
$306.80 |
1.6× |
| Thoracolumbar 2 views (72080) |
$171.81 |
$306.80 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$768.71 |
$1,372.70 |
1.9× |
| Tmj unilateral (70328) |
$171.81 |
$306.80 |
1.9× |
| Tomogram (76100) |
$257.66 |
$460.10 |
2.4× |
| Ultrasound breast complete (76641) |
$409.36 |
$731 |
3.8× |
| Ultrasound elastography first target lesion (76982) |
$283.53 |
$506.30 |
2.6× |
| Ultrasound Exam Aaa Screen (76706) |
$336.39 |
$600.70 |
3.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$310.30 |
$554.10 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$295.34 |
$527.40 |
2.7× |
| Umbilical-artery Doppler (OB) (76820) |
$141.68 |
$253 |
1.3× |
| Unlisted magnetic resonance procedure (76498) |
$2,422.17 |
$4,325.30 |
27.0× |
| Unlisted ultrasound procedure (76999) |
$425.21 |
$759.30 |
4.7× |
| Ureteral reflux study (78740) |
$765.41 |
$1,366.80 |
1.9× |
| Urethrocystogram voiding (74455) |
$515.42 |
$920.40 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$343.56 |
$613.50 |
1.4× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$343.56 |
$613.50 |
1.9× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$343.56 |
$613.50 |
1.9× |
| Us breast unilateral limited (76642) |
$314.78 |
$562.10 |
3.5× |
| Us chest (76604) |
$248.02 |
$442.90 |
2.3× |
| Us compl joint r-t w/image documentation (76881) |
$425.21 |
$759.30 |
3.9× |
| Us elastography parenchyma (76981) |
$283.53 |
$506.30 |
2.6× |
| Us encephalogram (76506) |
$283.53 |
$506.30 |
2.6× |
| Us hips infant static (76886) |
$425.21 |
$759.30 |
4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$283.53 |
$506.30 |
2.6× |
| Us ob detailed single fetus (76811) |
$425.21 |
$759.30 |
1.7× |
| Us ob limited (76815) |
$423.53 |
$756.30 |
3.9× |
| Us ob transvaginal (76817) |
$283.53 |
$506.30 |
2.6× |
| Us pelvic non ob complete (76856) |
$378.03 |
$675.05 |
3.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$283.53 |
$506.30 |
2.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$382.70 |
$683.40 |
3.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$423.70 |
$756.60 |
3.9× |
| Us retroperitoneal complete (76770) |
$283.53 |
$506.30 |
2.6× |
| Us retroperitoneal limited (76775) |
$441.20 |
$787.85 |
4.1× |
| Us scrotum and contents (76870) |
$580.42 |
$1,036.45 |
5.4× |
| Us soft tissue head/neck (76536) |
$380.50 |
$679.45 |
3.5× |
| Us spinal canal and contents (76800) |
$425.21 |
$759.30 |
3.9× |
| Wrist 2 views (73100) |
$214.74 |
$383.45 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$171.81 |
$306.80 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$343.56 |
$613.50 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$343.73 |
$613.80 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$461.78 |
$824.60 |
4.3× |
| X-ray exam of femur 2/> (73552) |
$171.81 |
$306.80 |
1.9× |
| X-ray eye for foreign body (70030) |
$175 |
$312.50 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$171.81 |
$306.80 |
1.9× |
| X-ray IV pyelogram (ivp) (74400) |
$257.66 |
$460.10 |
1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$171.81 |
$306.80 |
1.9× |
| X-ray leg, infant (73592) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$204.57 |
$365.30 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$171.81 |
$306.80 |
1.6× |
| X-ray nose-rectum child f.b. (76010) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$112.73 |
$201.30 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$171.81 |
$306.80 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$171.81 |
$306.80 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$171.81 |
$306.80 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$171.81 |
$306.80 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$214.74 |
$383.45 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$214.74 |
$383.45 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$171.81 |
$306.80 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$214.74 |
$383.45 |
2.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$171.81 |
$306.80 |
1.6× |
| Xr bone length studies (77073) |
$257.66 |
$460.10 |
2.4× |
| Xr c-spine 4 or 5 views (72050) |
$171.81 |
$306.80 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$257.66 |
$460.10 |
2.4× |