| Ankle 2 views (73600) |
$39.60 |
$110 |
0.5× |
| Cervical spine 2 or 3 views (72040) |
$46.80 |
$130 |
0.5× |
| Chest 1 view (71045) |
$40.68 |
$113 |
0.5× |
| Chest 3 views (71047) |
$63 |
$175 |
0.7× |
| Clavicle complete (73000) |
$63 |
$175 |
0.7× |
| CT lumbar spine w/o contrast (72131) |
$267.30 |
$742.50 |
2.5× |
| Diskogram cervical (72285) |
$2,334.60 |
$6,485 |
1.2× |
| Diskography lumbar (72295) |
$2,334.60 |
$6,485 |
1.2× |
| Foot 2 views (73620) |
$46.80 |
$130 |
0.5× |
| Forearm 2 views (73090) |
$30.60 |
$85 |
0.4× |
| Hand 2 views (73120) |
$45 |
$125 |
0.4× |
| Hand 3 views (73130) |
$63 |
$175 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$50.40 |
$140 |
0.6× |
| Knee 3 views (73562) |
$57.60 |
$160 |
0.7× |
| Neck soft tissue (70360) |
$63 |
$175 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$63 |
$175 |
0.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$320.81 |
$891.14 |
0.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$63 |
$175 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$63 |
$175 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$63 |
$175 |
0.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$68.40 |
$190 |
0.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$117 |
$325 |
1.3× |
| Scanogram (77073) |
$115.20 |
$320 |
1.1× |
| Scapula complete (73010) |
$63 |
$175 |
0.6× |
| Spine thoracic 3 views (72072) |
$63 |
$175 |
0.6× |
| Thoracolumbar 2 views (72080) |
$45 |
$125 |
0.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$189 |
$525 |
1.1× |
| Us breast unilateral complete (76641) |
$203.40 |
$565 |
1.9× |
| Wrist 2 views (73100) |
$63 |
$175 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$106.20 |
$295 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$63 |
$175 |
0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$48.60 |
$135 |
0.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$63 |
$175 |
0.7× |
| X-ray exam hip uni 1 view (73501) |
$54.90 |
$152.50 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$63 |
$175 |
0.7× |
| X-ray exam hip uni 4/> views (73503) |
$58.90 |
$163.60 |
0.6× |
| X-ray exam of femur 1 (73551) |
$57.60 |
$160 |
0.7× |
| X-ray eye for foreign body (70030) |
$63 |
$175 |
0.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$63 |
$175 |
0.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$63 |
$175 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$52.20 |
$145 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$63 |
$175 |
0.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$63 |
$175 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$63 |
$175 |
0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$63 |
$175 |
0.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$63 |
$175 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$145.80 |
$405 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$106.20 |
$295 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$63 |
$175 |
0.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$63 |
$175 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$63 |
$175 |
0.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$700.56 |
$1,946 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$63 |
$175 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$63 |
$175 |
0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$63 |
$175 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$63 |
$175 |
0.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$52.20 |
$145 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$63 |
$175 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$63 |
$175 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$81 |
$225 |
0.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$52.20 |
$145 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$79.20 |
$220 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$63 |
$175 |
0.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$63 |
$175 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$52.20 |
$145 |
0.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$63 |
$175 |
0.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$45 |
$125 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$52.20 |
$145 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$79.20 |
$220 |
0.8× |
| Xr finger(s) 2+ views (73140) |
$23.40 |
$65 |
0.3× |
| Xr shoulder 1 view (73020) |
$41.40 |
$115 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$106.20 |
$295 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$52.20 |
$145 |
0.6× |
| Xr tmj bilateral (70330) |
$63 |
$175 |
0.7× |
| Xray knee 1 or 2 views rt (73560) |
$52.20 |
$145 |
0.6× |