| 3-D radiotherapy plan dose-volume histograms (77295) |
$672.70 |
$2,170 |
0.6× |
| Abdomen 2 views (74019) |
$34.12 |
$97.50 |
0.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$410.82 |
$1,325.21 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$835.64 |
$2,695.61 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$835.64 |
$2,695.61 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,896.20 |
$6,116.78 |
0.7× |
| Ankle 2 views (73600) |
$27.48 |
$78.50 |
0.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$44.72 |
$135.50 |
0.1× |
| Aortogram thoracic (75605) |
$392.37 |
$1,189 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$878.85 |
$2,835 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$878.85 |
$2,835 |
0.3× |
| Arthrogram elbow (73085) |
$199.26 |
$642.76 |
0.6× |
| Arthrogram hip (73525) |
$199.26 |
$642.76 |
0.6× |
| Arthrogram shoulder (73040) |
$299 |
$964.50 |
1.0× |
| Arthrogram wrist (73115) |
$261.28 |
$842.83 |
0.8× |
| Arthrography knee lt (73580) |
$298.96 |
$964.38 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$24.50 |
$70 |
0.2× |
| Bone &/joint imaging whole body (78306) |
$341.43 |
$1,101.40 |
1.0× |
| Bone age studies (77072) |
$30.76 |
$97 |
0.3× |
| Bone Imaging 3 Phase (78315) |
$371.17 |
$1,197.32 |
1.1× |
| Bone survey complete (77075) |
$203.02 |
$654.89 |
2.2× |
| Brain image w/flow 4 + views (78606) |
$371.17 |
$1,197.32 |
0.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$82.77 |
$267 |
0.2× |
| Cervical spine 2 or 3 views (72040) |
$21.68 |
$66 |
0.3× |
| Chest 1 view (71045) |
$18.55 |
$53 |
0.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$130.90 |
$422.26 |
0.8× |
| Clavicle complete (73000) |
$30.80 |
$88 |
0.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$220.68 |
$690.50 |
2.4× |
| Continuing medical physics consltj pr wk (77336) |
$81.20 |
$232 |
0.7× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$155.62 |
$502 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$716.10 |
$2,310 |
2.3× |
| CT abdomen and pelvis without contrast (74176) |
$415.01 |
$1,338.75 |
2.0× |
| CT abdomen w contrast (74160) |
$501.38 |
$1,617.37 |
3.2× |
| CT abdomen w wo contrast (74170) |
$597.76 |
$1,928.27 |
3.9× |
| CT abdomen w/o contrast (74150) |
$325.50 |
$1,050 |
3.5× |
| CT angiography upper extremity lt (73206) |
$501.38 |
$1,617.37 |
3.2× |
| CT c-spine w/o contrast (72125) |
$385.52 |
$1,243.62 |
4.2× |
| CT cervical spine w&w/o contrast (72127) |
$730.03 |
$2,354.94 |
4.7× |
| CT cervical spine with contrast (72126) |
$600.16 |
$1,935.99 |
1.9× |
| CT chest w/wo contrast (71270) |
$654.16 |
$2,110.19 |
4.2× |
| CT chest with contrast (71260) |
$596.40 |
$1,923.86 |
3.9× |
| CT head/brain with contrast (70460) |
$183.21 |
$591 |
1.2× |
| CT head/brain without and with contrast (70470) |
$614.51 |
$1,982.30 |
4.0× |
| CT iac w contrast (70481) |
$523.26 |
$1,687.93 |
3.4× |
| CT limited/localized follow up study (76380) |
$327.76 |
$1,057.30 |
4.3× |
| CT lower ext w/o (73700) |
$488.25 |
$1,575 |
5.3× |
| CT lower extremity w wo contrast (73702) |
$981.62 |
$3,166.50 |
6.3× |
| CT lower extremity with contrast (73701) |
$784.92 |
$2,532 |
5.1× |
| CT lumbar spine w & w/o contrast (72133) |
$730.03 |
$2,354.94 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$385.52 |
$1,243.62 |
4.2× |
| CT lumbar spine with contrast (72132) |
$600.16 |
$1,935.99 |
1.9× |
| CT maxillofacial w contrast (70487) |
$523.26 |
$1,687.93 |
3.4× |
| CT maxillofacial w/o contrast (70486) |
$281.75 |
$805 |
3.1× |
| CT maxillofacial w/wo contrast (70488) |
$261.95 |
$845 |
1.7× |
| CT neck soft tissue w contrast (70491) |
$523.26 |
$1,687.93 |
3.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$654.16 |
$2,110.19 |
4.2× |
| CT orbits w/o contrast (70480) |
$325.50 |
$1,050 |
3.5× |
| CT pelvis w & w/o contrast (72194) |
$614.51 |
$1,982.30 |
4.0× |
| CT pelvis w/o contrast (72192) |
$325.50 |
$1,050 |
3.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$654.16 |
$2,110.19 |
4.2× |
| CT soft tissue neck w/o contrast (70490) |
$325.50 |
$1,050 |
3.5× |
| CT thoracic spine w/contrast (72129) |
$600.16 |
$1,935.99 |
3.9× |
| CT thoracic spine w/o contrast (72128) |
$398.74 |
$1,286.25 |
4.3× |
| CT thoracic spine w/wo contrast (72130) |
$730.03 |
$2,354.94 |
4.7× |
| CT thorax w/o contrast (71250) |
$325.50 |
$1,050 |
3.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$239.01 |
$771 |
1.5× |
| CT upper extremity w/o contrast rt (73200) |
$235.55 |
$673 |
2.6× |
| CT upper extremity with contrast (73201) |
$270.64 |
$773.25 |
0.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$561.49 |
$1,811.25 |
3.6× |
| Cta Abdomen (74175) |
$496 |
$1,600 |
3.2× |
| CTA abdomen pelvis (74174) |
$534.75 |
$1,725 |
1.7× |
| CTA chest (71275) |
$501.38 |
$1,617.37 |
3.2× |
| Cta Head (70496) |
$501.38 |
$1,617.37 |
3.2× |
| CTA lwr ext w&w/o contrast (73706) |
$752.37 |
$2,427 |
4.9× |
| Cta Neck (70498) |
$501.38 |
$1,617.37 |
3.2× |
| Cta Pelvis (72191) |
$614.73 |
$1,983 |
4.0× |
| Cystography minimum 3 views rs&i (74430) |
$34.48 |
$98.50 |
0.1× |
| Diskogram cervical (72285) |
$1,316.40 |
$4,246.45 |
0.8× |
| Diskography lumbar (72295) |
$724.89 |
$2,338.35 |
0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$35.96 |
$116 |
0.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$48.67 |
$157 |
0.5× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$44.64 |
$144 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$193.79 |
$625.12 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$70.68 |
$228 |
0.9× |
| Dxa bone density study axial skeleton (77085) |
$43.01 |
$122.88 |
0.5× |
| Echo exam of eye (76529) |
$40.30 |
$130 |
0.5× |
| Echo exam of fetal heart (76825) |
$80.29 |
$259 |
0.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$43.05 |
$123 |
0.2× |
| Echoencephalography real time imaging (76506) |
$87.50 |
$250 |
0.9× |
| Esophagus (74220) |
$59.94 |
$179.50 |
0.4× |
| Fetal biophysical profile non-stress testing (76818) |
$49.60 |
$160 |
0.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$57.05 |
$163 |
0.6× |
| Fluoroscopy up to 1 hr (76000) |
$49 |
$140 |
0.2× |
| Foot 2 views (73620) |
$28.52 |
$81.50 |
0.4× |
| Forearm 2 views (73090) |
$23.62 |
$67.50 |
0.3× |
| Gated Heart Planar Single (78472) |
$204.75 |
$585 |
0.6× |
| Hand 2 views (73120) |
$25.38 |
$72.50 |
0.3× |
| Hand 3 views (73130) |
$27.48 |
$78.50 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$401.68 |
$1,295.73 |
0.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$401.68 |
$1,295.73 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$21 |
$60 |
0.3× |
| Hysterosalpingogram (74740) |
$164.39 |
$530.30 |
0.8× |
| Kidney funcj study non-img radioisotopic study (78725) |
$410.47 |
$1,324.10 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$426.25 |
$1,375 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$399.28 |
$1,288 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$477.80 |
$1,541.30 |
1.0× |
| Knee 3 views (73562) |
$30.62 |
$87.50 |
0.4× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$372.93 |
$1,203 |
0.1× |
| Lymphoscintigraphy (78195) |
$325.50 |
$1,050 |
0.7× |
| Meckels Diverticulum (78290) |
$217.71 |
$702.29 |
0.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$136.71 |
$441 |
0.4× |
| MRA head w & w/o contrast (70546) |
$779.59 |
$2,514.80 |
2.5× |
| MRA head w/o contrast (70544) |
$671.93 |
$2,167.52 |
3.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$981.24 |
$3,165.28 |
3.2× |
| MRA neck w/o contrast (70547) |
$551.97 |
$1,780.54 |
2.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$928.95 |
$2,996.60 |
3.0× |
| MRI abdomen w/o contrast (74181) |
$673.13 |
$2,171.40 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$800.75 |
$2,583.06 |
1.2× |
| MRI breast w/o contrast bilateral (77047) |
$1,463.82 |
$4,722.01 |
6.9× |
| MRI c-spine with contrast (72142) |
$363.32 |
$1,172 |
1.2× |
| MRI cervical spine w/o contrast (72141) |
$495.25 |
$1,415 |
2.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$767.32 |
$2,475.22 |
2.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$454.18 |
$1,385.50 |
2.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$681.92 |
$2,199.75 |
3.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$902.97 |
$2,912.81 |
2.9× |
| MRI pelvis w contrast (72196) |
$549.45 |
$1,665 |
1.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$781.98 |
$2,522.52 |
2.5× |
| MRI pelvis w/o contrast (72195) |
$566.32 |
$1,826.84 |
2.7× |
| MRI scan of arm joint before and after contrast (73223) |
$962.55 |
$3,105 |
3.1× |
| MRI scan of leg joint before and after contrast (73723) |
$963.94 |
$3,109.50 |
3.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$754.30 |
$2,433.22 |
2.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$359.29 |
$1,159 |
1.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$781.98 |
$2,522.52 |
2.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$685.60 |
$2,211.62 |
2.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$822.99 |
$2,654.82 |
2.7× |
| MRI thoracic spine w/o contrast (72146) |
$596.40 |
$1,923.86 |
2.8× |
| MRI tmj (70336) |
$226.61 |
$731 |
1.1× |
| MRI upper ext joint w/o contrast (73221) |
$442.59 |
$1,350.15 |
2.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$571.79 |
$1,844.48 |
1.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$714.66 |
$2,305.34 |
3.4× |
| Myocardial Spect Multiple Studies (78452) |
$75.25 |
$215 |
0.1× |
| Neck soft tissue (70360) |
$48.82 |
$157.50 |
0.6× |
| Nm gastric emptying study (78264) |
$337.67 |
$1,089.27 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$154.69 |
$499 |
0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$605.54 |
$1,953.37 |
0.5× |
| Nuclear Rx Oral Admin (79005) |
$89.56 |
$276 |
0.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$42 |
$120 |
0.5× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$28.21 |
$91 |
0.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$37.80 |
$116 |
0.4× |
| Orthopantogram (70355) |
$18.81 |
$57 |
0.2× |
| Osseous survey infant (77076) |
$86.13 |
$277.83 |
0.9× |
| Osseous survey limited (77074) |
$39.06 |
$126 |
0.4× |
| Parathyrd planar w/wo subtrj (78071) |
$499.10 |
$1,610 |
1.4× |
| Parathyroid imaging (78070) |
$255.44 |
$824 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$66.65 |
$214.99 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$614.17 |
$1,981.19 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$262.49 |
$846.75 |
0.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$30.38 |
$93.50 |
0.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$37.05 |
$115 |
0.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$38.50 |
$110 |
0.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$24.50 |
$70 |
0.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$32.90 |
$94 |
0.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$47.52 |
$144 |
0.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$46.20 |
$140 |
0.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$42.57 |
$129 |
0.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$34.48 |
$98.50 |
0.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$18.05 |
$55 |
0.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$92.28 |
$297.68 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$21.35 |
$62 |
0.3× |
| Radiologic exam colon single contrast study (74270) |
$160.29 |
$517.07 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$180.12 |
$581.02 |
1.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$180.12 |
$581.02 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$45.49 |
$143 |
0.6× |
| Radiological examination surgical specimen (76098) |
$329.51 |
$1,062.95 |
0.7× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$71.40 |
$204 |
0.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$897.16 |
$2,894.06 |
0.3× |
| Ribs bilateral 3 views (71110) |
$34.48 |
$98.50 |
0.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$533.17 |
$1,719.90 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$177.80 |
$508 |
0.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$383.62 |
$1,218.50 |
0.3× |
| Rp Therapy Intravenous Administration (79101) |
$115.50 |
$350 |
0.6× |
| Sacroiliac Joints < 3 Views (72200) |
$94.86 |
$306 |
1.0× |
| Scanogram (77073) |
$94.86 |
$306 |
1.0× |
| Scapula complete (73010) |
$20.77 |
$67 |
0.2× |
| Screening digital breast tomosynthesis (77063) |
$35.03 |
$106 |
1.5× |
| Simulation intermediate (77285) |
$134.23 |
$433 |
0.4× |
| Small bowel series (74250) |
$158.58 |
$511.56 |
1.0× |
| Spec medical radj physics consltj (77370) |
$95.20 |
$272 |
0.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$66.96 |
$216 |
0.2× |
| Special dosimetry (77331) |
$7.70 |
$22 |
0.1× |
| Special treatment procedure (77470) |
$188.79 |
$609 |
0.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$12.95 |
$37 |
0.1× |
| Tbs Technical Calculation Only (77091) |
$38.13 |
$123 |
0.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$141.36 |
$456 |
0.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$84.01 |
$271 |
0.7× |
| Therapeutic Enema (74283) |
$138.42 |
$446.51 |
0.9× |
| Thoracolumbar 2 views (72080) |
$92.28 |
$297.68 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$193.13 |
$623 |
0.4× |
| Thyroid uptake measurement (78012) |
$251.88 |
$812.53 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$201.50 |
$650 |
0.6× |
| Treatment device intermediate (77333) |
$33.60 |
$96 |
0.3× |
| Treatment devices simple (77332) |
$21.45 |
$65 |
0.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,138.01 |
$3,671 |
2.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$533.17 |
$1,719.90 |
1.5× |
| Tx devices design & construction complex (77334) |
$56.10 |
$170 |
0.2× |
| Ultrasound scan to determine eye length and lens power (76519) |
$30.07 |
$97 |
0.3× |
| Ultrasound, abdomen limited (76705) |
$43.05 |
$123 |
0.5× |
| Umbilical-artery Doppler (OB) (76820) |
$94.86 |
$306 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$38.68 |
$110.50 |
0.5× |
| Upper Extremity Infant (73092) |
$94.86 |
$306 |
1.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$51.15 |
$165 |
0.1× |
| Urethrocystography retrograde rs&i (74450) |
$42 |
$135.50 |
0.2× |
| Urethrocystography voiding (74455) |
$50.98 |
$154.50 |
0.2× |
| Us abdl aorta screen aaa (76706) |
$79.33 |
$252.66 |
0.9× |
| Us breast unilateral complete (76641) |
$77.50 |
$250 |
0.8× |
| Us breast unilateral limited (76642) |
$69.75 |
$225 |
0.9× |
| Us chest (76604) |
$49.83 |
$151 |
0.5× |
| Us compl joint r-t w/image documentation (76881) |
$26.25 |
$75 |
0.3× |
| Us elastography parenchyma (76981) |
$85.25 |
$275 |
0.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$45.57 |
$147 |
0.5× |
| Us guided compression repair (76936) |
$335.28 |
$1,081.55 |
1.8× |
| Us infant hips dynamic (76885) |
$62.89 |
$202.86 |
0.8× |
| Us infant hips limited static (76886) |
$58.90 |
$190 |
0.8× |
| Us ob detailed single fetus (76811) |
$95.55 |
$273 |
0.5× |
| Us ob transvaginal (76817) |
$52.15 |
$149 |
0.6× |
| Us pelvic non ob complete (76856) |
$52.85 |
$151 |
0.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$49 |
$140 |
0.5× |
| Us pregnancy ltd (76815) |
$54.25 |
$155 |
0.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$52.15 |
$149 |
0.6× |
| Us retroperitoneal complete (76770) |
$54.95 |
$157 |
0.6× |
| Us retroperitoneal limited (76775) |
$44.80 |
$128 |
0.5× |
| Us scrotum and contents (76870) |
$45.15 |
$129 |
0.5× |
| Us soft tissue head/neck (76536) |
$46.90 |
$134 |
0.5× |
| Us spinal canal and contents (76800) |
$104.93 |
$338.47 |
1.1× |
| Us transrectal (76872) |
$73.84 |
$238.18 |
0.8× |
| Us transrectal prostate volume (76873) |
$57.40 |
$164 |
0.6× |
| Us xtr non-vasc lmtd (76882) |
$44.80 |
$128 |
0.5× |
| Us, eye b-scan (76512) |
$37.82 |
$122 |
0.4× |
| Venogram extremity bilateral (75822) |
$750 |
$2,419.35 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$835.64 |
$2,695.61 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$325.50 |
$1,050 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$46.02 |
$144.50 |
0.6× |
| Wrist 2 views (73100) |
$22.58 |
$64.50 |
0.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$40.25 |
$115 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$87.15 |
$281.14 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$26.95 |
$77 |
0.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$203.36 |
$655.99 |
1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$27.12 |
$77.50 |
0.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$43.58 |
$124.50 |
0.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$27.30 |
$78 |
0.3× |
| X-ray exam hip uni 1 view (73501) |
$18.20 |
$52 |
0.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$43.06 |
$137.50 |
0.6× |
| X-ray exam hip uni 4/> views (73503) |
$39.35 |
$121 |
0.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$30.10 |
$86 |
0.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$35.35 |
$101 |
0.4× |
| X-ray exam of femur 1 (73551) |
$11.72 |
$33.50 |
0.2× |
| X-ray eye for foreign body (70030) |
$85.56 |
$276 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$106.29 |
$342.88 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$21.18 |
$60.50 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$23.28 |
$66.50 |
0.3× |
| X-ray IV pyelogram+drip infusn (74410) |
$366.38 |
$1,181.88 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$70.68 |
$228 |
0.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$33.25 |
$95 |
0.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$19.25 |
$55 |
0.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$59.98 |
$193.50 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$23.45 |
$67 |
0.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$152.09 |
$490.61 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$84.63 |
$273 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$20.82 |
$59.50 |
0.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$70.68 |
$228 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$114.15 |
$368.24 |
1.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$33.25 |
$95 |
0.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$67.32 |
$204 |
0.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$24.50 |
$70 |
0.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$18.55 |
$53 |
0.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$149.70 |
$482.90 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$92.28 |
$297.68 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$28.35 |
$81 |
0.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$34.30 |
$98 |
0.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$34.48 |
$98.50 |
0.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$20.30 |
$58 |
0.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$34.48 |
$98.50 |
0.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$72.80 |
$234.83 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$70.75 |
$228.22 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$18.15 |
$55 |
0.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$21.70 |
$62 |
0.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$24.15 |
$69 |
0.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$94.86 |
$306 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$15.05 |
$43 |
0.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$43.98 |
$138 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$38.50 |
$110 |
0.4× |
| Xr finger(s) 2+ views (73140) |
$28.70 |
$82 |
0.4× |
| Xr shoulder 1 view (73020) |
$69.28 |
$223.50 |
0.9× |
| Xr spine cervical 4 or 5 views (72050) |
$30.45 |
$87 |
0.3× |
| Xr tibia/fibula 2 views (73590) |
$28.88 |
$82.50 |
0.4× |
| Xr tmj bilateral (70330) |
$31.62 |
$102 |
0.4× |
| Xray knee 1 or 2 views rt (73560) |
$28.35 |
$81 |
0.4× |