| Abdomen 2 views (74019) |
$256.20 |
$427 |
2.5× |
| Ankle 2 views (73600) |
$207 |
$345 |
2.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$353.40 |
$589 |
1.0× |
| Arthrogram elbow (73085) |
$595.20 |
$992 |
1.8× |
| Bone age studies (77072) |
$178.80 |
$298 |
1.8× |
| Bone survey complete (77075) |
$369.60 |
$616 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$309 |
$515 |
3.7× |
| Chest 1 view (71045) |
$216.60 |
$361 |
2.6× |
| Chest 3 views (71047) |
$309 |
$515 |
3.7× |
| Clavicle complete (73000) |
$216.60 |
$361 |
2.6× |
| Cystography minimum 3 views rs&i (74430) |
$309 |
$515 |
0.9× |
| Dxa bone density study axial skeleton (77085) |
$163.20 |
$272 |
1.6× |
| Esophagus (74220) |
$317.40 |
$529 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$526.20 |
$877 |
2.3× |
| Foot 2 views (73620) |
$207 |
$345 |
2.5× |
| Forearm 2 views (73090) |
$183.90 |
$306.50 |
2.2× |
| Hand 2 views (73120) |
$183.90 |
$306.50 |
1.8× |
| Hand 3 views (73130) |
$309 |
$515 |
3.7× |
| Humerus Min 2 Views Left (73060) |
$183.90 |
$306.50 |
2.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$216.60 |
$361 |
2.1× |
| Knee 3 views (73562) |
$309 |
$515 |
3.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$143.40 |
$239 |
1.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,275.80 |
$3,793 |
1.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,510.60 |
$5,851 |
1.6× |
| Neck soft tissue (70360) |
$216.60 |
$361 |
2.6× |
| Osseous survey infant (77076) |
$256.20 |
$427 |
2.5× |
| Osseous survey limited (77074) |
$199.80 |
$333 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$256.20 |
$427 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$404.40 |
$674 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$204.60 |
$341 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$234 |
$390 |
2.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$256.20 |
$427 |
2.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$309 |
$515 |
3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$354 |
$590 |
3.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$328.20 |
$547 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$216.60 |
$361 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$309 |
$515 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$256.20 |
$427 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$523.20 |
$872 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$317.40 |
$529 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$386.40 |
$644 |
2.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$358.20 |
$597 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$256.20 |
$427 |
3.0× |
| Radiological examination surgical specimen (76098) |
$498.60 |
$831 |
0.9× |
| Ribs bilateral 3 views (71110) |
$309 |
$515 |
3.0× |
| Sacroiliac Joints < 3 Views (72200) |
$308.70 |
$514.50 |
3.0× |
| Scanogram (77073) |
$207.60 |
$346 |
2.0× |
| Scapula complete (73010) |
$309 |
$515 |
3.0× |
| Sella turcica (70240) |
$145.20 |
$242 |
1.7× |
| Small bowel series (74250) |
$386.40 |
$644 |
2.3× |
| Spine thoracic 3 views (72072) |
$309 |
$515 |
3.0× |
| Therapeutic Enema (74283) |
$349.20 |
$582 |
2.1× |
| Thoracolumbar 2 views (72080) |
$256.20 |
$427 |
3.0× |
| Tmj unilateral (70328) |
$256.80 |
$428 |
3.0× |
| Tomogram (76100) |
$242.40 |
$404 |
2.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$130.20 |
$217 |
1.5× |
| Unlisted Ultrasound Procedure (76999) |
$158.40 |
$264 |
1.9× |
| Upper Extremity Infant (73092) |
$256.20 |
$427 |
2.5× |
| Urethrocystography retrograde rs&i (74450) |
$409.20 |
$682 |
1.8× |
| Urethrocystography voiding (74455) |
$484.20 |
$807 |
2.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$402 |
$670 |
2.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$504 |
$840 |
3.0× |
| Vasogram (74440) |
$260.40 |
$434 |
1.1× |
| Wrist 2 views (73100) |
$148.80 |
$248 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$358.20 |
$597 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$309 |
$515 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$309 |
$515 |
3.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$678 |
$1,130 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$183.90 |
$306.50 |
2.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$309 |
$515 |
3.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$258 |
$430 |
2.5× |
| X-ray exam hip uni 1 view (73501) |
$216.60 |
$361 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$275.40 |
$459 |
3.3× |
| X-ray exam hip uni 4/> views (73503) |
$328.20 |
$547 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$328.20 |
$547 |
3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$355.20 |
$592 |
3.5× |
| X-ray exam of femur 1 (73551) |
$172.20 |
$287 |
2.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$655.80 |
$1,093 |
3.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$309 |
$515 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$256.20 |
$427 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$309 |
$515 |
3.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,420.20 |
$2,367 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$256.20 |
$427 |
3.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$437.40 |
$729 |
2.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$328.20 |
$547 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$328.20 |
$547 |
3.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$256.20 |
$427 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$309 |
$515 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$429.60 |
$716 |
4.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$328.20 |
$547 |
3.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$309 |
$515 |
3.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$199.20 |
$332 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$328.20 |
$547 |
3.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$309 |
$515 |
3.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$490.20 |
$817 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$216.60 |
$361 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$256.20 |
$427 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$309 |
$515 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$309 |
$515 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$256.20 |
$427 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$256.20 |
$427 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$309 |
$515 |
3.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$215.40 |
$359 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$328.20 |
$547 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$309 |
$515 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$216.60 |
$361 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$309 |
$515 |
3.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$256.20 |
$427 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$256.20 |
$427 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$328.20 |
$547 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$216.60 |
$361 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$309 |
$515 |
3.7× |
| Xr c-spine 6 or more views (72052) |
$410.40 |
$684 |
4.0× |
| Xr chest 4+ views (71048) |
$328.20 |
$547 |
3.2× |
| Xr Cholecystography Oral Contrast (74290) |
$245.40 |
$409 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$216.60 |
$361 |
2.6× |
| Xr shoulder 1 view (73020) |
$216.60 |
$361 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$328.20 |
$547 |
3.2× |
| Xr tibia/fibula 2 views (73590) |
$183.90 |
$306.50 |
2.2× |
| Xr tmj bilateral (70330) |
$246.60 |
$411 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$235.80 |
$393 |
2.8× |