Abdomen 1 View (74018)
range across 2 matching MRF lines |
$229.50–$274.50 |
$306–$366 |
varies |
| Abdomen 2 views (74019) |
$291.75 |
$389 |
2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,243.50 |
$1,658 |
2.8× |
| Angiography extremity bilateral rs&i (75716) |
$3,444 |
$4,592 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,290.25 |
$4,387 |
0.9× |
| Ankle 2 views (73600) |
$238.50 |
$318 |
2.5× |
| Arthrogram ankle (73615) |
$339.75 |
$453 |
0.9× |
| Arthrogram hip (73525) |
$1,034.25 |
$1,379 |
2.7× |
| Arthrogram Wrist (73115) |
$319.50 |
$426 |
0.8× |
| Bone age studies (77072) |
$100.50 |
$134 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$2,345.25 |
$3,127 |
5.3× |
| Bone Imaging Limited Area (78300) |
$1,312.50 |
$1,750 |
2.9× |
| Bone Imaging Multiple Areas (78305) |
$1,673.25 |
$2,231 |
3.8× |
| Bone Imaging Whole Body (78306) |
$1,622.25 |
$2,163 |
3.6× |
| Bone survey infant (77076) |
$155.25 |
$207 |
1.3× |
| Cat Scan Follow-Up Study (76380) |
$705 |
$940 |
7.3× |
Chest 1 view (71045)
range across 2 matching MRF lines |
$246.75–$296.25 |
$329–$395 |
varies |
| Chest 2 views (71046) |
$273 |
$364 |
2.8× |
| Chest 3 views (71047) |
$295.50 |
$394 |
3.0× |
| Chest 4 or more views (71048) |
$316.50 |
$422 |
2.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$334.50 |
$446 |
0.4× |
| Clavicle complete (73000) |
$255.75 |
$341 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,541.25 |
$2,055 |
13.2× |
| Contrast X-Ray Bladder (74430) |
$756.75 |
$1,009 |
1.9× |
| Contrast X-Ray Of Elbow (73085) |
$357.75 |
$477 |
0.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$398.25 |
$531 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,672.50 |
$6,230 |
12.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,644.50 |
$3,526 |
9.9× |
| CT abdomen w contrast (74160) |
$2,103 |
$2,804 |
10.8× |
| CT abdomen w wo contrast (74170) |
$2,556.75 |
$3,409 |
13.1× |
| CT abdomen w/o contrast (74150) |
$1,663.50 |
$2,218 |
14.3× |
| CT Angio Abdomen and Pelvis (74174) |
$3,335.25 |
$4,447 |
8.6× |
| CT Angio Chest (71275) |
$2,851.50 |
$3,802 |
14.6× |
| CT Angio Head (70496) |
$2,894.25 |
$3,859 |
14.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,997.75 |
$3,997 |
15.3× |
| CT Angio Neck (70498) |
$2,865.75 |
$3,821 |
14.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,851 |
$2,468 |
9.5× |
| CT bone density (77078) |
$397.50 |
$530 |
4.1× |
| CT cervical spine w/ contrast (72126) |
$2,499.75 |
$3,333 |
6.4× |
| CT cervical spine w/o contrast (72125) |
$2,025 |
$2,700 |
17.4× |
| CT cervical spine w/wo cont (72127) |
$3,166.50 |
$4,222 |
16.2× |
| CT chest w contrast (71260) |
$2,127.75 |
$2,837 |
10.9× |
| CT chest w/wo contrast (71270) |
$2,598.75 |
$3,465 |
13.3× |
| CT head/brain with contrast (70460) |
$1,619.25 |
$2,159 |
8.3× |
| CT head/brain without and with contrast (70470) |
$1,989 |
$2,652 |
10.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$150 |
$200 |
1.5× |
| CT iac w contrast (70481) |
$1,983.75 |
$2,645 |
10.1× |
| CT l-spine w&w/o contrast (72133) |
$2,621.25 |
$3,495 |
13.4× |
| CT lower ext w/o (73700) |
$1,682.25 |
$2,243 |
14.4× |
| CT lower extremity w/contrast material (73701) |
$1,984.50 |
$2,646 |
10.2× |
| CT lumbar spine w contrast (72132) |
$2,299.50 |
$3,066 |
5.9× |
| CT lumbar spine w/o contrast (72131) |
$2,160 |
$2,880 |
18.5× |
| CT maxillofacial w contrast (70487) |
$1,912.50 |
$2,550 |
9.8× |
| CT maxillofacial wo contrast (70486) |
$1,590.75 |
$2,121 |
13.7× |
| CT neck tissue combo (70492) |
$2,028 |
$2,704 |
10.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,751 |
$3,668 |
14.1× |
| CT orbits w/o contrast (70480) |
$1,719.75 |
$2,293 |
14.8× |
| CT pelvis w&w/o contrast (72194) |
$3,166.50 |
$4,222 |
16.2× |
| CT pelvis w/o contrast (72192) |
$1,842 |
$2,456 |
15.8× |
| CT scan of leg combo (73702) |
$1,763.25 |
$2,351 |
9.0× |
| CT scans face/jaw combo (70488) |
$2,248.50 |
$2,998 |
11.5× |
| CT soft tissue neck w contrast (70491) |
$1,911.75 |
$2,549 |
9.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,635.75 |
$2,181 |
14.0× |
| CT thoracic spine w contrast (72129) |
$2,679 |
$3,572 |
13.7× |
| CT thoracic spine w/o contrast (72128) |
$2,058 |
$2,744 |
17.7× |
| CT thoracic spine w/wo cont (72130) |
$2,940.75 |
$3,921 |
15.0× |
| CT thorax w/o contrast (71250) |
$1,716.75 |
$2,289 |
14.7× |
| CT upper ext wo (73200) |
$1,527 |
$2,036 |
13.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,763.25 |
$2,351 |
9.0× |
| CT upper extremity with contrast (73201) |
$1,763.25 |
$2,351 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,880 |
$3,840 |
14.7× |
| Cta Abdomen (74175) |
$2,996.25 |
$3,995 |
15.3× |
| CTA pelvis (72191) |
$3,785.25 |
$5,047 |
19.4× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$153 |
$204 |
0.6× |
| Dilation ureters/urethra rs&i (74485) |
$614.25 |
$819 |
0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$267.75 |
$357 |
2.3× |
| Dxa Bone Density Axial (77080) |
$361.50 |
$482 |
3.1× |
| Dxa bone density study (77085) |
$585.75 |
$781 |
5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$123.75 |
$165 |
1.3× |
| Echo exam of fetal heart (76825) |
$465.75 |
$621 |
0.8× |
| Echo exam uterus (76831) |
$427.50 |
$570 |
1.6× |
| Echograp Trans R Pros Study (76873) |
$475.50 |
$634 |
4.1× |
| Esophagram (74220) |
$455.25 |
$607 |
2.3× |
| Fetal Biophys Profile W/Nst (76818) |
$346.50 |
$462 |
3.0× |
| Fluoroscopy up to 1 hr (76000) |
$572.25 |
$763 |
2.2× |
| Foot 2 views (73620) |
$203.25 |
$271 |
2.1× |
| Forearm 2 views (73090) |
$255.75 |
$341 |
2.6× |
| Gastric emptying imaging study (78264) |
$1,621.50 |
$2,162 |
3.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,573.50 |
$2,098 |
3.5× |
| Gastroesophageal Reflux Exam (78262) |
$1,026 |
$1,368 |
2.3× |
| Gated Heart Planar Single (78472) |
$1,481.25 |
$1,975 |
3.3× |
| Hand 2 views (73120) |
$203.25 |
$271 |
1.7× |
| Hepatobil Syst Image W/Drug (78227) |
$1,868.25 |
$2,491 |
3.1× |
| Hepatobiliary System Imaging (78226) |
$1,828.50 |
$2,438 |
4.1× |
| Ht Musc Image Planar Mult (78454) |
$1,925.25 |
$2,567 |
1.3× |
| Ht Muscle Image Spect Sing (78451) |
$3,269.25 |
$4,359 |
2.3× |
| Infusion Ivp (74410) |
$545.25 |
$727 |
2.8× |
| Joint Survey Single View (77077) |
$328.50 |
$438 |
2.8× |
| K Flow/Funct Image Multiple (78709) |
$1,494 |
$1,992 |
2.5× |
| K Flow/Funct Image W/Drug (78708) |
$1,356.75 |
$1,809 |
2.2× |
| K Flow/Funct Image W/O Drug (78707) |
$1,749.75 |
$2,333 |
2.9× |
| Kidney Imaging Morphol (78700) |
$844.50 |
$1,126 |
1.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,281 |
$1,708 |
2.9× |
| Knee 3 Views (73562) |
$273 |
$364 |
2.8× |
| Liver & Spleen Imaging Static Only (78215) |
$1,110.75 |
$1,481 |
2.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,665.75 |
$2,221 |
3.7× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,540.50 |
$2,054 |
2.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,836 |
$2,448 |
3.0× |
| Lymph System Imaging (78195) |
$1,611.75 |
$2,149 |
2.7× |
| Magnetic Image Jaw Joint (70336) |
$1,908 |
$2,544 |
7.2× |
| Mammary ductogram or galactogram multiple (77054) |
$435.75 |
$581 |
1.6× |
| Mammary ductogram or galactogram single (77053) |
$383.25 |
$511 |
1.4× |
| Meckels Divert Exam (78290) |
$1,551.75 |
$2,069 |
3.5× |
| MRA head w/o contrast (70544) |
$2,274 |
$3,032 |
8.6× |
| MRA head with contrast (70545) |
$1,856.25 |
$2,475 |
4.8× |
| MRA neck w contrast (70548) |
$2,062.50 |
$2,750 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,508.50 |
$4,678 |
9.0× |
| MRA neck w/o contrast (70547) |
$2,265.75 |
$3,021 |
8.5× |
| MRI abdomen w contrast (74182) |
$2,208.75 |
$2,945 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$2,301 |
$3,068 |
8.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,059.25 |
$4,079 |
3.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,552.75 |
$4,737 |
9.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,503.50 |
$3,338 |
2.9× |
| MRI cervical spine w contrast (72142) |
$2,134.50 |
$2,846 |
5.5× |
| MRI cervical spine w/o cont (72141) |
$2,353.50 |
$3,138 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,671.50 |
$3,562 |
10.0× |
| MRI chest wo w contrast (71552) |
$3,257.25 |
$4,343 |
8.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,652 |
$3,536 |
6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,552.75 |
$4,737 |
9.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,210.25 |
$2,947 |
8.3× |
| MRI lumbar spine w contrast (72149) |
$2,820.75 |
$3,761 |
7.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,319.25 |
$5,759 |
11.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,204.25 |
$2,939 |
8.3× |
| MRI orbit face neck w contrast (70542) |
$2,327.25 |
$3,103 |
6.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,773.25 |
$5,031 |
9.7× |
| MRI pelvis w contrast (72196) |
$2,179.50 |
$2,906 |
5.6× |
| MRI pelvis w/o & w contrast (72197) |
$3,729 |
$4,972 |
9.6× |
| MRI pelvis w/o contrast (72195) |
$2,125.50 |
$2,834 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,397.75 |
$3,197 |
9.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,733.75 |
$3,645 |
7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,921.50 |
$2,562 |
7.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,610 |
$3,480 |
6.7× |
| MRI, abdomen, combo (74183) |
$3,517.50 |
$4,690 |
9.0× |
| MRI, dorsal spine combo (72157) |
$3,799.50 |
$5,066 |
9.8× |
| MRI, dorsal spine contrast (72147) |
$2,267.25 |
$3,023 |
5.8× |
| MRI, joint upper extrem (73221) |
$2,160 |
$2,880 |
8.1× |
| MRI, joint upper extrem combo (73223) |
$4,152.75 |
$5,537 |
10.7× |
| MRI, lumbar spine combo (72158) |
$3,782.25 |
$5,043 |
9.7× |
| Myocardial Spect Multiple Studies (78452) |
$4,110 |
$5,480 |
2.8× |
| Neck soft tissue (70360) |
$220.50 |
$294 |
2.3× |
| Parathyroid Planar Imaging (78070) |
$1,525.50 |
$2,034 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$246.75 |
$329 |
2.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$872.25 |
$1,163 |
2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$379.50 |
$506 |
3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$948 |
$1,264 |
1.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$273 |
$364 |
2.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$220.50 |
$294 |
2.3× |
| Radex elbow complete minimum 3 views (73080) |
$273 |
$364 |
2.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$317.25 |
$423 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$246.75 |
$329 |
2.5× |
| Radex foot complete minimum 3 views (73630) |
$264.75 |
$353 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$273 |
$364 |
2.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$170.25 |
$227 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$249 |
$332 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$264.75 |
$353 |
2.7× |
| Radex shoulder complete minimum 2 views (73030) |
$299.25 |
$399 |
3.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$187.50 |
$250 |
1.9× |
| Radex Spine 1 View Specify Level (72020) |
$222.75 |
$297 |
2.3× |
| Radex Sternum Minimum 2 Views (71120) |
$334.50 |
$446 |
3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$183.75 |
$245 |
1.9× |
| Radex Toe Minimum 2 Views (73660) |
$242.25 |
$323 |
2.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$99 |
$132 |
0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$273 |
$364 |
2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$327 |
$436 |
2.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$311.25 |
$415 |
2.7× |
| Radiologic exam colon double contrast study (74280) |
$862.50 |
$1,150 |
4.4× |
| Radiologic exam colon single contrast study (74270) |
$655.50 |
$874 |
3.4× |
| Radiologic exam knee complete 4/more views (73564) |
$317.25 |
$423 |
2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$347.25 |
$463 |
3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$605.25 |
$807 |
3.1× |
| Radiologic exam swallow function contrast study (74230) |
$467.25 |
$623 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$627 |
$836 |
3.2× |
| Radiologic examination femur 1 view (73551) |
$226.50 |
$302 |
2.3× |
| Radiologic examination femur minimum 2 views (73552) |
$273 |
$364 |
2.8× |
| Radiologic examination knee 1/2 views (73560) |
$220.50 |
$294 |
2.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$153.75 |
$205 |
1.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$112.50 |
$150 |
1.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$246.75 |
$329 |
2.5× |
| Ribs bilateral 3 views (71110) |
$288 |
$384 |
2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,585.50 |
$2,114 |
2.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,461.75 |
$1,949 |
2.4× |
| Scapula (73010) |
$273 |
$364 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$96.75 |
$129 |
4.1× |
| Shoulder 1 view (73020) |
$220.50 |
$294 |
2.3× |
| Shoulder Arthrography (73040) |
$730.50 |
$974 |
1.9× |
| Sialogram (70390) |
$357 |
$476 |
1.3× |
| Skull less than 4 views (70250) |
$246.75 |
$329 |
2.1× |
| Spleen Imaging (78185) |
$846.75 |
$1,129 |
1.9× |
| Sternoclavicular joints (71130) |
$273 |
$364 |
2.8× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$330 |
$440 |
1.2× |
| Thoracic spine 2 views (72070) |
$317.25 |
$423 |
2.7× |
| Thoracic spine 3 views (72072) |
$327 |
$436 |
2.8× |
| Thoracolumbar 2 views (72080) |
$299.25 |
$399 |
3.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,092 |
$1,456 |
2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,114.50 |
$1,486 |
2.5× |
| Ultrasound Breast Limited (76642) |
$315 |
$420 |
3.2× |
| Ultrasound Exam Aaa Screen (76706) |
$309 |
$412 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$578.25 |
$771 |
5.0× |
| Unlisted us procedure (76999) |
$471.75 |
$629 |
4.9× |
| Upper gi w/o kub (74240) |
$433.50 |
$578 |
2.2× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$249 |
$332 |
22.5× |
| Urethrocystogram voiding (74455) |
$972 |
$1,296 |
3.7× |
| Urethrocystography retrograde (74450) |
$741 |
$988 |
2.8× |
| Us breast unilateral complete (76641) |
$315 |
$420 |
2.7× |
| Us chest (76604) |
$488.25 |
$651 |
4.2× |
| Us complete joint (76881) |
$507 |
$676 |
4.4× |
| Us exam, pelvic, limited (76857) |
$375.75 |
$501 |
3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$444.75 |
$593 |
3.8× |
| Us ob limited 1 or more fetuses (76815) |
$159 |
$212 |
1.4× |
| Us ob transvaginal (76817) |
$596.25 |
$795 |
5.1× |
| Us pelvic non ob complete (76856) |
$625.50 |
$834 |
5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$750 |
$1,000 |
6.4× |
| Us retroperitoneal complete (76770) |
$611.25 |
$815 |
5.2× |
| Us scrotum and contents (76870) |
$672.75 |
$897 |
5.8× |
| Us thyroid (76536) |
$440.25 |
$587 |
3.8× |
| Us transrectal (76872) |
$510 |
$680 |
4.4× |
| Venography extremity bilateral rs&i (75822) |
$540 |
$720 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$1,543.50 |
$2,058 |
0.9× |
| Wrist 2 views (73100) |
$203.25 |
$271 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$430.50 |
$574 |
4.4× |
| X-ray antegrade pyelogram tube (74425) |
$279 |
$372 |
0.7× |
| X-Ray Aorta Leg Arteries (75630) |
$1,722 |
$2,296 |
0.5× |
| X-Ray Bend Only L-S Spine (72120) |
$316.50 |
$422 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$211.50 |
$282 |
2.2× |
| X-Ray Exam Breast Specimen (76098) |
$711 |
$948 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$344.25 |
$459 |
3.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$507.75 |
$677 |
4.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$174 |
$232 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$336 |
$448 |
3.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$267 |
$356 |
2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$368.25 |
$491 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$554.25 |
$739 |
4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$460.50 |
$614 |
4.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$573 |
$764 |
4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$291.75 |
$389 |
3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$485.25 |
$647 |
4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$319.50 |
$426 |
2.7× |
| X-ray eye for foreign body (70030) |
$246.75 |
$329 |
2.5× |
| X-ray humerus (73060) |
$246.75 |
$329 |
2.5× |
| X-ray IV pyelogram (ivp) (74400) |
$623.25 |
$831 |
3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$316.50 |
$422 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$238.50 |
$318 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$309 |
$412 |
2.7× |
| X-ray nose-rectum child f.b. (76010) |
$264.75 |
$353 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$497.25 |
$663 |
4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$317.25 |
$423 |
2.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$299.25 |
$399 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$291.75 |
$389 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$361.50 |
$482 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$351 |
$468 |
3.0× |
| X-Ray Stress View (77071) |
$78 |
$104 |
0.8× |
| X-ray thoracic spine 4 vw (72074) |
$171 |
$228 |
1.5× |
| X-Ray Tmj Unilat (70328) |
$127.50 |
$170 |
1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,047.75 |
$1,397 |
2.7× |
| X-Rays Bone Length Studies (77073) |
$459 |
$612 |
3.9× |
| X-Rays Bone Survey Complete (77075) |
$566.25 |
$755 |
4.9× |
| Xr c-spine 4 or 5 views (72050) |
$414 |
$552 |
3.6× |
| Xr facial bones less than 3 views (70140) |
$122.25 |
$163 |
1.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$99.75 |
$133 |
0.9× |
| Xr myelogram posterior fossa (70010) |
$449.25 |
$599 |
1.2× |
| Xr orbits complete 4 views (70200) |
$411.75 |
$549 |
3.5× |