| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,545 |
$2,060 |
1.2× |
| Abdomen 2 views (74019) |
$240.75 |
$321 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$642.75 |
$857 |
1.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,317.50 |
$3,090 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$3,213.75 |
$4,285 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$1,815 |
$2,420 |
0.6× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,317.50 |
$3,090 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,621.50 |
$2,162 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,213.75 |
$4,285 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,285.50 |
$1,714 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,262.25 |
$1,683 |
0.4× |
| Ankle 2 views (73600) |
$118.50 |
$158 |
1.4× |
| Aortogram thoracic (75605) |
$3,213.75 |
$4,285 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,213.75 |
$4,285 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$3,213.75 |
$4,285 |
1.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,008.50 |
$2,678 |
0.7× |
| Arthrogram elbow (73085) |
$636 |
$848 |
1.9× |
| Arthrogram hip (73525) |
$522 |
$696 |
1.6× |
| Arthrogram shoulder (73040) |
$522 |
$696 |
1.6× |
| Arthrogram wrist (73115) |
$1,701 |
$2,268 |
5.1× |
| Arthrography knee lt (73580) |
$636 |
$848 |
1.9× |
| Basic radiation dosimetry calculation (77300) |
$386.25 |
$515 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$578.25 |
$771 |
1.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$600 |
$800 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$819.75 |
$1,093 |
2.1× |
| Bone age studies (77072) |
$118.50 |
$158 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$494.25 |
$659 |
1.3× |
| Bone survey complete (77075) |
$415.50 |
$554 |
4.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$702 |
$936 |
1.8× |
| Brain Imaging Vascular Flow Only (78610) |
$286.50 |
$382 |
0.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,200.25 |
$4,267 |
9.5× |
| Cervical spine 2 or 3 views (72040) |
$129 |
$172 |
1.5× |
| Chest 1 view (71045) |
$103.50 |
$138 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$177.75 |
$237 |
1.1× |
| Clavicle complete (73000) |
$149.25 |
$199 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$231.75 |
$309 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$226.50 |
$302 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,092.50 |
$2,790 |
6.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,216.62 |
$2,955.50 |
9.7× |
| CT abdomen w contrast (74160) |
$1,175.25 |
$1,567 |
7.0× |
| CT abdomen w wo contrast (74170) |
$1,229.25 |
$1,639 |
7.3× |
| CT abdomen w/o contrast (74150) |
$1,025.62 |
$1,367.50 |
10.2× |
| CT angio hrt w/3d image (75574) |
$610.50 |
$814 |
1.8× |
| CT angiography upper extremity lt (73206) |
$575.25 |
$767 |
3.4× |
| CT c-spine w/o contrast (72125) |
$1,101 |
$1,468 |
10.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,130.25 |
$1,507 |
6.7× |
| CT cervical spine with contrast (72126) |
$1,113 |
$1,484 |
3.3× |
| CT chest w/wo contrast (71270) |
$1,229.62 |
$1,639.50 |
7.3× |
| CT chest with contrast (71260) |
$1,182.38 |
$1,576.50 |
7.0× |
| CT head/brain with contrast (70460) |
$841.50 |
$1,122 |
5.0× |
| CT head/brain without and with contrast (70470) |
$1,006.88 |
$1,342.50 |
6.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$122.25 |
$163 |
1.5× |
| CT iac w contrast (70481) |
$887.25 |
$1,183 |
5.3× |
| CT lower ext w/o (73700) |
$1,482 |
$1,976 |
14.7× |
| CT lower extremity w wo contrast (73702) |
$1,017.75 |
$1,357 |
6.0× |
| CT lower extremity with contrast (73701) |
$1,021.50 |
$1,362 |
6.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,130.25 |
$1,507 |
6.7× |
| CT lumbar spine w/o contrast (72131) |
$1,046.62 |
$1,395.50 |
10.4× |
| CT lumbar spine with contrast (72132) |
$1,066.50 |
$1,422 |
3.2× |
| CT maxillofacial w contrast (70487) |
$841.50 |
$1,122 |
5.0× |
| CT maxillofacial w/o contrast (70486) |
$701.25 |
$935 |
7.0× |
| CT maxillofacial w/wo contrast (70488) |
$939 |
$1,252 |
5.6× |
| CT neck soft tissue w contrast (70491) |
$957.38 |
$1,276.50 |
5.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$939.75 |
$1,253 |
5.6× |
| CT orbits w/o contrast (70480) |
$813.56 |
$1,084.75 |
8.1× |
| CT pelvis w & w/o contrast (72194) |
$1,182 |
$1,576 |
7.0× |
| CT pelvis w/o contrast (72192) |
$1,025.62 |
$1,367.50 |
10.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$983.62 |
$1,311.50 |
5.8× |
| CT soft tissue neck w/o contrast (70490) |
$872.25 |
$1,163 |
8.7× |
| CT thoracic spine w/contrast (72129) |
$968.79 |
$1,291.72 |
5.7× |
| CT thoracic spine w/o contrast (72128) |
$785.62 |
$1,047.50 |
7.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,066.50 |
$1,422 |
6.3× |
| CT thorax w/o contrast (71250) |
$1,117.50 |
$1,490 |
11.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,190.62 |
$1,587.50 |
7.1× |
| CT upper extremity w/o contrast rt (73200) |
$940.50 |
$1,254 |
9.4× |
| CT upper extremity with contrast (73201) |
$1,184.25 |
$1,579 |
3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$695.25 |
$927 |
4.1× |
| Cta Abdomen (74175) |
$695.25 |
$927 |
4.1× |
| CTA abdomen pelvis (74174) |
$695.25 |
$927 |
2.1× |
| CTA chest (71275) |
$695.25 |
$927 |
4.1× |
| Cta Head (70496) |
$530.25 |
$707 |
3.1× |
| CTA lwr ext w&w/o contrast (73706) |
$695.25 |
$927 |
4.1× |
| Cta Neck (70498) |
$640.50 |
$854 |
3.8× |
| Cta Pelvis (72191) |
$695.25 |
$927 |
4.1× |
| Cystography minimum 3 views rs&i (74430) |
$329.25 |
$439 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$235.50 |
$314 |
2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$102 |
$136 |
1.2× |
| Echoencephalography real time imaging (76506) |
$254.25 |
$339 |
2.5× |
| Esophagus (74220) |
$134.25 |
$179 |
0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$265.88 |
$354.50 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$201 |
$268 |
0.9× |
| Foot 2 views (73620) |
$118.50 |
$158 |
1.4× |
| Forearm 2 views (73090) |
$162.75 |
$217 |
1.9× |
| Gated Heart Planar Single (78472) |
$628.50 |
$838 |
1.6× |
| Hand 2 views (73120) |
$56.25 |
$75 |
0.6× |
| Hand 3 views (73130) |
$207 |
$276 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$698.25 |
$931 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$679.50 |
$906 |
1.8× |
| Ht muscle image spect sing (78451) |
$1,687.50 |
$2,250 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$141.75 |
$189 |
1.7× |
| Hysterosalpingogram (74740) |
$357.75 |
$477 |
1.6× |
| Image fusion (77399) |
$450 |
$600 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$749.25 |
$999 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$783 |
$1,044 |
1.5× |
| Knee 3 views (73562) |
$162.75 |
$217 |
1.9× |
| Liver & spleen imaging static only (78215) |
$614.25 |
$819 |
1.6× |
| Lymphoscintigraphy (78195) |
$402 |
$536 |
0.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$131.62 |
$175.50 |
1.6× |
| Meckels Diverticulum (78290) |
$570.75 |
$761 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,158.75 |
$1,545 |
3.2× |
| MRA head w & w/o contrast (70546) |
$1,584 |
$2,112 |
4.7× |
| MRA head w/o contrast (70544) |
$2,196 |
$2,928 |
9.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,288.62 |
$3,051.50 |
6.8× |
| MRA neck w/o contrast (70547) |
$2,196 |
$2,928 |
9.6× |
| MRI abdomen w contrast (74182) |
$917.25 |
$1,223 |
2.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,107.12 |
$2,809.50 |
6.3× |
| MRI abdomen w/o contrast (74181) |
$1,785.38 |
$2,380.50 |
7.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,446 |
$1,928 |
1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,220.38 |
$2,960.50 |
2.9× |
| MRI c-spine with contrast (72142) |
$2,177.62 |
$2,903.50 |
6.5× |
| MRI cardiac w/o contrast (75557) |
$2,450.25 |
$3,267 |
10.7× |
| MRI cervical spine w/o contrast (72141) |
$2,450.25 |
$3,267 |
10.7× |
| MRI chest w/o & w/contrast material (71552) |
$888.75 |
$1,185 |
2.6× |
| MRI chest w/o contrast (71550) |
$1,637.62 |
$2,183.50 |
7.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,639.88 |
$2,186.50 |
4.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$807 |
$1,076 |
2.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,853.62 |
$2,471.50 |
8.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,429.82 |
$1,906.42 |
6.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,381.25 |
$3,175 |
7.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,473 |
$1,964 |
4.4× |
| MRI pelvis w contrast (72196) |
$2,251.50 |
$3,002 |
6.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,401.88 |
$3,202.50 |
7.2× |
| MRI pelvis w/o contrast (72195) |
$1,853.62 |
$2,471.50 |
8.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,341.12 |
$3,121.50 |
7.0× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,450.25 |
$3,267 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,682.62 |
$2,243.50 |
5.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,295 |
$3,060 |
6.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,137.50 |
$2,850 |
6.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,362.50 |
$3,150 |
7.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,137.50 |
$2,850 |
6.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,362.50 |
$3,150 |
7.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,782 |
$2,376 |
7.8× |
| MRI tmj (70336) |
$2,450.25 |
$3,267 |
10.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,611.12 |
$3,481.50 |
11.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,590.50 |
$3,454 |
7.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,771.88 |
$2,362.50 |
7.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,993.25 |
$3,991 |
2.4× |
| Neck soft tissue (70360) |
$103.50 |
$138 |
1.2× |
| Nm cisternogram (78630) |
$856.50 |
$1,142 |
1.6× |
| Nm gastric emptying study (78264) |
$577.50 |
$770 |
1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,703.75 |
$3,605 |
2.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,807.50 |
$2,410 |
1.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$227.62 |
$303.50 |
2.3× |
| Osseous survey infant (77076) |
$204 |
$272 |
2.0× |
| Osseous survey limited (77074) |
$323.25 |
$431 |
3.2× |
| Parathyroid imaging (78070) |
$430.50 |
$574 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$118.50 |
$158 |
1.2× |
| Peritoneogram rs&i (74190) |
$891 |
$1,188 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$3,615 |
$4,820 |
2.6× |
| PET imaging CT for attenuation limited area (78814) |
$3,615 |
$4,820 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$3,615 |
$4,820 |
2.6× |
| PET whole body (78813) |
$3,213.75 |
$4,285 |
2.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,992.88 |
$3,990.50 |
8.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$948.75 |
$1,265 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$988.50 |
$1,318 |
1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$357 |
$476 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$138.75 |
$185 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$135 |
$180 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$207 |
$276 |
2.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$93.75 |
$125 |
0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$135 |
$180 |
1.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$423 |
$564 |
0.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$220.50 |
$294 |
2.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$423 |
$564 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$129 |
$172 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$103.50 |
$138 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$180 |
$240 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$120.75 |
$161 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$202.50 |
$270 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$234 |
$312 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$224.25 |
$299 |
1.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$172.12 |
$229.50 |
2.1× |
| Ribs bilateral 3 views (71110) |
$144.75 |
$193 |
1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$723 |
$964 |
1.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$723 |
$964 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$193.50 |
$258 |
1.9× |
| Scanogram (77073) |
$154.50 |
$206 |
1.5× |
| Scapula complete (73010) |
$118.50 |
$158 |
1.2× |
| Screening digital breast tomosynthesis (77063) |
$62.25 |
$83 |
2.7× |
| Simulation intermediate (77285) |
$695.25 |
$927 |
1.9× |
| Small bowel series (74250) |
$191.25 |
$255 |
1.1× |
| Spec medical radj physics consltj (77370) |
$226.50 |
$302 |
1.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$386.25 |
$515 |
1.1× |
| Special dosimetry (77331) |
$226.50 |
$302 |
1.8× |
| Special treatment procedure (77470) |
$618 |
$824 |
1.2× |
| Spine thoracic 3 views (72072) |
$135 |
$180 |
1.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$220.50 |
$294 |
2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$695.25 |
$927 |
1.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$598.50 |
$798 |
1.7× |
| Testicular Imaging With Vascular Flow (78761) |
$632.25 |
$843 |
1.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$772.50 |
$1,030 |
2.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$618 |
$824 |
4.8× |
| Thoracolumbar 2 views (72080) |
$135 |
$180 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$415.88 |
$554.50 |
1.1× |
| Tmj unilateral (70328) |
$150 |
$200 |
1.8× |
| Treatment device intermediate (77333) |
$540.75 |
$721 |
4.2× |
| Treatment devices simple (77332) |
$386.25 |
$515 |
3.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,125 |
$5,500 |
7.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$692.25 |
$923 |
1.8× |
| Tx devices design & construction complex (77334) |
$695.25 |
$927 |
1.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$432.75 |
$577 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$314.62 |
$419.50 |
3.1× |
| Umbilical-artery Doppler (OB) (76820) |
$160.50 |
$214 |
1.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$482.62 |
$643.50 |
5.8× |
| Urethrocystography voiding (74455) |
$329.25 |
$439 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$329.25 |
$439 |
2.0× |
| Us abdl aorta screen aaa (76706) |
$345.75 |
$461 |
3.4× |
| Us breast unilateral complete (76641) |
$157.50 |
$210 |
1.6× |
| Us breast unilateral limited (76642) |
$233.62 |
$311.50 |
2.8× |
| Us chest (76604) |
$246.75 |
$329 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$266.62 |
$355.50 |
2.7× |
| Us elastography parenchyma (76981) |
$247.50 |
$330 |
2.5× |
| Us infant hips dynamic (76885) |
$184.50 |
$246 |
2.2× |
| Us ob transvaginal (76817) |
$197.62 |
$263.50 |
2.0× |
| Us pelvic non ob complete (76856) |
$324 |
$432 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$203.25 |
$271 |
2.0× |
| Us pregnancy ltd (76815) |
$307.50 |
$410 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$207.75 |
$277 |
2.1× |
| Us retroperitoneal complete (76770) |
$312 |
$416 |
3.1× |
| Us retroperitoneal limited (76775) |
$192.75 |
$257 |
1.9× |
| Us scrotum and contents (76870) |
$280.12 |
$373.50 |
2.8× |
| Us soft tissue head/neck (76536) |
$277.50 |
$370 |
2.8× |
| Us spinal canal and contents (76800) |
$243 |
$324 |
2.4× |
| Us transrectal (76872) |
$238.50 |
$318 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$261.75 |
$349 |
2.6× |
| Venogram extremity bilateral (75822) |
$984 |
$1,312 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,621.50 |
$2,162 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$1,125 |
$1,500 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$642.75 |
$857 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,719.75 |
$6,293 |
1.6× |
| Wrist 2 views (73100) |
$120 |
$160 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$225 |
$300 |
2.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$162.75 |
$217 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$137.25 |
$183 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$118.50 |
$158 |
1.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$165 |
$220 |
1.6× |
| X-ray exam hip uni 1 view (73501) |
$162.75 |
$217 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$119.25 |
$159 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$208.50 |
$278 |
2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$507 |
$676 |
5.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$164.25 |
$219 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$171.38 |
$228.50 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$162.75 |
$217 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$162.75 |
$217 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$197.25 |
$263 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$131.25 |
$175 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$147.75 |
$197 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$184.88 |
$246.50 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$231.75 |
$309 |
2.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$118.50 |
$158 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$118.50 |
$158 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$118.50 |
$158 |
1.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$141 |
$188 |
1.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$458.62 |
$611.50 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$118.50 |
$158 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$162 |
$216 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$203.25 |
$271 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$118.50 |
$158 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$118.50 |
$158 |
1.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$169.50 |
$226 |
2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$129 |
$172 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$194.25 |
$259 |
1.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$118.50 |
$158 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$118.50 |
$158 |
1.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$77.25 |
$103 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$118.50 |
$158 |
1.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$135 |
$180 |
1.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$190.50 |
$254 |
1.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$162.75 |
$217 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$137.25 |
$183 |
1.6× |
| Xr arthrogram ankle (73615) |
$522 |
$696 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$231.75 |
$309 |
2.3× |
| Xr chest 4+ views (71048) |
$140.25 |
$187 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$118.50 |
$158 |
1.4× |
| Xr shoulder 1 view (73020) |
$116.25 |
$155 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$181.50 |
$242 |
1.8× |
| Xr tibia/fibula 2 views (73590) |
$134.62 |
$179.50 |
1.6× |
| Xr tmj bilateral (70330) |
$177.75 |
$237 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$118.50 |
$158 |
1.4× |