| Abdomen 2 views (74019) |
$135.08 |
$307 |
1.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$381.48 |
$867 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$2,514.16 |
$5,714 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,514.16 |
$5,714 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$1,316.48 |
$2,992 |
0.5× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,022.24 |
$4,596 |
0.4× |
| Ankle 2 views (73600) |
$202.62 |
$460.50 |
2.6× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,022.24 |
$4,596 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,514.16 |
$5,714 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,514.16 |
$5,714 |
0.9× |
| Arthrogram elbow (73085) |
$967.56 |
$2,199 |
3.1× |
| Arthrogram hip (73525) |
$430.32 |
$978 |
1.4× |
| Arthrogram shoulder (73040) |
$967.56 |
$2,199 |
3.1× |
| Arthrogram wrist (73115) |
$645.48 |
$1,467 |
2.0× |
| Arthrography knee lt (73580) |
$483.78 |
$1,099.50 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$368.72 |
$838 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$368.72 |
$838 |
1.0× |
| Bone age studies (77072) |
$90.20 |
$205 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$374.88 |
$852 |
1.0× |
| Bone survey complete (77075) |
$153.12 |
$348 |
1.6× |
| Brain imaging < 4 static views (78600) |
$477.84 |
$1,086 |
1.3× |
| Brain imaging < 4 static views w vascular flow (78601) |
$477.84 |
$1,086 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$135.08 |
$307 |
1.7× |
| Chest 1 view (71045) |
$135.08 |
$307 |
1.7× |
| Chest 3 views (71047) |
$135.08 |
$307 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$271.48 |
$617 |
1.7× |
| Clavicle complete (73000) |
$202.62 |
$460.50 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$99.44 |
$226 |
1.1× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$256.96 |
$584 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$895.84 |
$2,036 |
2.8× |
| CT abdomen and pelvis without contrast (74176) |
$506 |
$1,150 |
2.3× |
| CT abdomen w contrast (74160) |
$536.80 |
$1,220 |
3.4× |
| CT abdomen w wo contrast (74170) |
$643.72 |
$1,463 |
4.1× |
| CT abdomen w/o contrast (74150) |
$398.64 |
$906 |
4.2× |
| CT angiography upper extremity lt (73206) |
$559.24 |
$1,271 |
3.5× |
| CT c-spine w/o contrast (72125) |
$398.64 |
$906 |
4.2× |
| CT cervical spine w&w/o contrast (72127) |
$643.72 |
$1,463 |
4.1× |
| CT cervical spine with contrast (72126) |
$541.20 |
$1,230 |
1.7× |
| CT chest w/wo contrast (71270) |
$643.72 |
$1,463 |
4.1× |
| CT chest with contrast (71260) |
$541.20 |
$1,230 |
3.4× |
| CT head/brain with contrast (70460) |
$444.40 |
$1,010 |
2.8× |
| CT head/brain without and with contrast (70470) |
$554.84 |
$1,261 |
3.5× |
| CT iac w contrast (70481) |
$444.40 |
$1,010 |
2.8× |
| CT limited/localized follow up study (76380) |
$201.08 |
$457 |
2.6× |
| CT lower ext w/o (73700) |
$582.12 |
$1,323 |
6.1× |
| CT lower extremity w wo contrast (73702) |
$873.18 |
$1,984.50 |
5.5× |
| CT lower extremity with contrast (73701) |
$695.64 |
$1,581 |
4.4× |
| CT lumbar spine w & w/o contrast (72133) |
$643.72 |
$1,463 |
4.1× |
| CT lumbar spine w/o contrast (72131) |
$398.64 |
$906 |
4.2× |
| CT lumbar spine with contrast (72132) |
$541.20 |
$1,230 |
1.7× |
| CT maxillofacial w contrast (70487) |
$444.40 |
$1,010 |
2.8× |
| CT maxillofacial w/o contrast (70486) |
$370.48 |
$842 |
3.9× |
| CT maxillofacial w/wo contrast (70488) |
$554.84 |
$1,261 |
3.5× |
| CT neck soft tissue w contrast (70491) |
$444.40 |
$1,010 |
2.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$554.84 |
$1,261 |
3.5× |
| CT orbits w/o contrast (70480) |
$370.48 |
$842 |
3.9× |
| CT pelvis w & w/o contrast (72194) |
$643.72 |
$1,463 |
4.1× |
| CT pelvis w/o contrast (72192) |
$398.64 |
$906 |
4.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$554.84 |
$1,261 |
3.5× |
| CT soft tissue neck w/o contrast (70490) |
$370.48 |
$842 |
3.9× |
| CT thoracic spine w/contrast (72129) |
$541.20 |
$1,230 |
3.4× |
| CT thoracic spine w/o contrast (72128) |
$398.64 |
$906 |
4.2× |
| CT thoracic spine w/wo contrast (72130) |
$643.72 |
$1,463 |
4.1× |
| CT thorax w/o contrast (71250) |
$398.64 |
$906 |
4.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$873.18 |
$1,984.50 |
5.5× |
| CT upper extremity w/o contrast rt (73200) |
$582.12 |
$1,323 |
6.1× |
| CT upper extremity with contrast (73201) |
$695.64 |
$1,581 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$629.64 |
$1,431 |
4.0× |
| Cta Abdomen (74175) |
$629.64 |
$1,431 |
4.0× |
| CTA abdomen pelvis (74174) |
$893.64 |
$2,031 |
2.8× |
| CTA chest (71275) |
$629.64 |
$1,431 |
4.0× |
| Cta Head (70496) |
$629.64 |
$1,431 |
4.0× |
| CTA lwr ext w&w/o contrast (73706) |
$944.46 |
$2,146.50 |
5.9× |
| Cta Neck (70498) |
$629.64 |
$1,431 |
4.0× |
| Cystography minimum 3 views rs&i (74430) |
$315.04 |
$716 |
1.0× |
| Diskography lumbar (72295) |
$2,247.96 |
$5,109 |
1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$132.66 |
$301.50 |
1.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$108.68 |
$247 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$148.28 |
$337 |
1.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$74.36 |
$169 |
0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$41.36 |
$94 |
0.5× |
| Dxa bone density study axial skeleton (77085) |
$74.36 |
$169 |
0.8× |
| Echo exam of fetal heart (76825) |
$108.68 |
$247 |
0.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$157.52 |
$358 |
0.7× |
| Echoencephalography real time imaging (76506) |
$149.16 |
$339 |
1.6× |
| Esophagus (74220) |
$271.48 |
$617 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$102.96 |
$234 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$146.96 |
$334 |
1.6× |
| Fluoroscopy up to 1 hr (76000) |
$163.68 |
$372 |
0.8× |
| Foot 2 views (73620) |
$202.62 |
$460.50 |
2.6× |
| Forearm 2 views (73090) |
$202.62 |
$460.50 |
2.6× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$734.80 |
$1,670 |
1.5× |
| Gated Heart Planar Single (78472) |
$433.40 |
$985 |
1.2× |
| Hand 2 views (73120) |
$202.62 |
$460.50 |
2.1× |
| Hand 3 views (73130) |
$202.62 |
$460.50 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$496.76 |
$1,129 |
0.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$905.08 |
$2,057 |
1.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,427.80 |
$3,245 |
2.3× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$631.40 |
$1,435 |
1.8× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$384.12 |
$873 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$792.44 |
$1,801 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$574.20 |
$1,305 |
1.6× |
| Ht muscle image spect sing (78451) |
$530.20 |
$1,205 |
0.5× |
| Humerus Min 2 Views Left (73060) |
$135.08 |
$307 |
1.7× |
| Hysterosalpingogram (74740) |
$425.48 |
$967 |
2.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$116.60 |
$265 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$350.24 |
$796 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$383.24 |
$871 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$383.24 |
$871 |
0.8× |
| Knee 3 views (73562) |
$202.62 |
$460.50 |
2.6× |
| Liver & spleen imaging static only (78215) |
$398.20 |
$905 |
1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$398.20 |
$905 |
1.1× |
| Lung Ventilation Imaging (78579) |
$296.56 |
$674 |
0.8× |
| Lymphoscintigraphy (78195) |
$361.68 |
$822 |
0.7× |
| Meckels Diverticulum (78290) |
$348.48 |
$792 |
1.0× |
| Mr elastography (76391) |
$385 |
$875 |
1.8× |
| MRA head w & w/o contrast (70546) |
$1,072.28 |
$2,437 |
3.4× |
| MRA head w/o contrast (70544) |
$739.64 |
$1,681 |
3.4× |
| MRA head with contrast (70545) |
$785.84 |
$1,786 |
2.5× |
| MRA neck w contrast (70548) |
$785.84 |
$1,786 |
2.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,072.28 |
$2,437 |
3.4× |
| MRA neck w/o contrast (70547) |
$739.64 |
$1,681 |
3.4× |
| MRI abdomen w contrast (74182) |
$785.84 |
$1,786 |
2.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,072.28 |
$2,437 |
3.4× |
| MRI abdomen w/o contrast (74181) |
$986.48 |
$2,242 |
4.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,178.76 |
$2,679 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,178.76 |
$2,679 |
1.7× |
| MRI bone marrow blood supply (77084) |
$642.84 |
$1,461 |
3.0× |
| MRI c-spine with contrast (72142) |
$785.84 |
$1,786 |
2.5× |
| MRI cervical spine w/o contrast (72141) |
$739.64 |
$1,681 |
3.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,072.28 |
$2,437 |
3.4× |
| MRI chest w/o contrast (71550) |
$739.64 |
$1,681 |
3.4× |
| MRI fetal sngl/1st gestation (74712) |
$457.60 |
$1,040 |
2.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,178.76 |
$2,679 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,178.76 |
$2,679 |
3.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,109.46 |
$2,521.50 |
5.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$739.64 |
$1,681 |
3.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,072.28 |
$2,437 |
3.4× |
| MRI orbit/face/neck w/contrast (70542) |
$785.84 |
$1,786 |
2.5× |
| MRI pelvis w contrast (72196) |
$785.84 |
$1,786 |
2.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,072.28 |
$2,437 |
3.4× |
| MRI pelvis w/o contrast (72195) |
$739.64 |
$1,681 |
3.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,608.42 |
$3,655.50 |
5.1× |
| MRI scan of leg joint before and after contrast (73723) |
$1,608.42 |
$3,655.50 |
5.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,072.28 |
$2,437 |
3.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$785.84 |
$1,786 |
2.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,072.28 |
$2,437 |
3.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$785.84 |
$1,786 |
2.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,072.28 |
$2,437 |
3.4× |
| MRI thoracic spine w/o contrast (72146) |
$739.64 |
$1,681 |
3.4× |
| MRI tmj (70336) |
$642.84 |
$1,461 |
3.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,109.46 |
$2,521.50 |
5.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,072.28 |
$2,437 |
3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,109.46 |
$2,521.50 |
5.1× |
| Myelogram Cervical (72240) |
$735.24 |
$1,671 |
1.0× |
| Myelogram Lumbar (72265) |
$639.76 |
$1,454 |
0.9× |
| Myelogram thoracic (72255) |
$678.04 |
$1,541 |
1.0× |
| Myocardial infarct spect (78469) |
$410.08 |
$932 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$841.28 |
$1,912 |
0.7× |
| Neck soft tissue (70360) |
$135.08 |
$307 |
1.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$259.60 |
$590 |
0.7× |
| Nm gastric emptying study (78264) |
$348.48 |
$792 |
1.0× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$555.72 |
$1,263 |
1.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$262.68 |
$597 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$64.24 |
$146 |
0.7× |
| Osseous survey limited (77074) |
$153.12 |
$348 |
1.6× |
| Parathyrd planar w/wo subtrj (78071) |
$425.92 |
$968 |
1.2× |
| Parathyroid imaging (78070) |
$324.72 |
$738 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$135.08 |
$307 |
1.4× |
| Peritoneogram rs&i (74190) |
$230.12 |
$523 |
0.5× |
| Pr heart first pass single,planar (78481) |
$410.08 |
$932 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,608.42 |
$3,655.50 |
5.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$306.24 |
$696 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$531.96 |
$1,209 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$209.44 |
$476 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$85.36 |
$194 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$154.88 |
$352 |
1.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$95.04 |
$216 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$135.08 |
$307 |
1.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$201.96 |
$459 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$135.08 |
$307 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$135.08 |
$307 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$135.08 |
$307 |
1.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$135.08 |
$307 |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$135.96 |
$309 |
0.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$220.88 |
$502 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$271.48 |
$617 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$271.48 |
$617 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$115.50 |
$262.50 |
1.5× |
| Radiological examination surgical specimen (76098) |
$230.12 |
$523 |
0.5× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,856.48 |
$6,492 |
1.0× |
| Ribs bilateral 3 views (71110) |
$135.08 |
$307 |
1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$382.36 |
$869 |
1.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$434.72 |
$988 |
0.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$999.24 |
$2,271 |
2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,539.56 |
$3,499 |
1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,746.36 |
$3,969 |
1.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,539.56 |
$3,499 |
1.3× |
| Sacroiliac Joints < 3 Views (72200) |
$135.08 |
$307 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$165.44 |
$376 |
0.8× |
| Scanogram (77073) |
$153.12 |
$348 |
1.6× |
| Scapula complete (73010) |
$202.62 |
$460.50 |
2.1× |
| Screening digital breast tomosynthesis (77063) |
$22 |
$50 |
0.9× |
| Sella turcica (70240) |
$135.08 |
$307 |
1.7× |
| Sialogram (70390) |
$313.72 |
$713 |
1.5× |
| Small bowel series (74250) |
$271.48 |
$617 |
1.7× |
| Speech evaluation complex (70371) |
$165.88 |
$377 |
0.8× |
| Testicular Imaging With Vascular Flow (78761) |
$337.92 |
$768 |
0.9× |
| Therapeutic Enema (74283) |
$185.24 |
$421 |
1.2× |
| Thoracolumbar 2 views (72080) |
$135.08 |
$307 |
1.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$425.92 |
$968 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$340.56 |
$774 |
0.9× |
| Thyroid uptake measurement (78012) |
$174.68 |
$397 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$388.52 |
$883 |
1.1× |
| Tmj unilateral (70328) |
$135.08 |
$307 |
1.7× |
| Tomogram (76100) |
$153.12 |
$348 |
1.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,008.48 |
$2,292 |
2.1× |
| Ultrasound elastography first target lesion (76982) |
$187.88 |
$427 |
2.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$336.60 |
$765 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$146.96 |
$334 |
1.6× |
| Umbilical-artery Doppler (OB) (76820) |
$148.28 |
$337 |
1.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$91.52 |
$208 |
1.2× |
| Unlisted Ultrasound Procedure (76999) |
$124.08 |
$282 |
1.6× |
| Upper Extremity Infant (73092) |
$202.62 |
$460.50 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$315.04 |
$716 |
1.5× |
| Urethrocystography voiding (74455) |
$315.04 |
$716 |
1.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$315.04 |
$716 |
2.0× |
| Us abdl aorta screen aaa (76706) |
$112.20 |
$255 |
1.2× |
| Us breast unilateral complete (76641) |
$137.94 |
$313.50 |
1.5× |
| Us breast unilateral limited (76642) |
$137.94 |
$313.50 |
1.8× |
| Us chest (76604) |
$146.96 |
$334 |
1.6× |
| Us compl joint r-t w/image documentation (76881) |
$170.28 |
$387 |
1.8× |
| Us elastography parenchyma (76981) |
$187.88 |
$427 |
2.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$151.36 |
$344 |
1.6× |
| Us infant hips dynamic (76885) |
$121.44 |
$276 |
1.5× |
| Us infant hips limited static (76886) |
$146.96 |
$334 |
1.9× |
| Us kidney transplant (76776) |
$155.32 |
$353 |
1.6× |
| Us ob detailed single fetus (76811) |
$299.20 |
$680 |
1.4× |
| Us ob transvaginal (76817) |
$146.96 |
$334 |
1.6× |
| Us pelvic non ob complete (76856) |
$146.96 |
$334 |
1.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$125.40 |
$285 |
1.3× |
| Us pregnancy ltd (76815) |
$112.20 |
$255 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$165.88 |
$377 |
1.8× |
| Us retroperitoneal complete (76770) |
$155.32 |
$353 |
1.6× |
| Us retroperitoneal limited (76775) |
$146.96 |
$334 |
1.6× |
| Us scrotum and contents (76870) |
$146.96 |
$334 |
1.6× |
| Us soft tissue head/neck (76536) |
$146.96 |
$334 |
1.6× |
| Us spinal canal and contents (76800) |
$146.96 |
$334 |
1.6× |
| Us transrectal (76872) |
$157.96 |
$359 |
1.7× |
| Us xtr non-vasc lmtd (76882) |
$20.24 |
$46 |
0.2× |
| Vascular flow imaging (78445) |
$192.72 |
$438 |
0.5× |
| Venogram extremity bilateral (75822) |
$505.56 |
$1,149 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,316.48 |
$2,992 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$1,316.48 |
$2,992 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$286.88 |
$652 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$90.20 |
$205 |
1.1× |
| Wrist 2 views (73100) |
$202.62 |
$460.50 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$229.68 |
$522 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$135.08 |
$307 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$202.62 |
$460.50 |
2.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$282.92 |
$643 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$202.62 |
$460.50 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$202.62 |
$460.50 |
2.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$168.08 |
$382 |
1.8× |
| X-ray exam hip uni 1 view (73501) |
$68.64 |
$156 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$100.76 |
$229 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$124.96 |
$284 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$113.08 |
$257 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$135.96 |
$309 |
1.4× |
| X-ray exam of femur 1 (73551) |
$65.12 |
$148 |
0.8× |
| X-ray eye for foreign body (70030) |
$202.62 |
$460.50 |
2.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$135.08 |
$307 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$135.08 |
$307 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$202.62 |
$460.50 |
2.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$202.62 |
$460.50 |
2.6× |
| X-ray IV pyelogram+drip infusn (74410) |
$315.04 |
$716 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$135.08 |
$307 |
1.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$202.62 |
$460.50 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$135.08 |
$307 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$202.62 |
$460.50 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$135.08 |
$307 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$229.68 |
$522 |
2.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$229.68 |
$522 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$135.08 |
$307 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$90.20 |
$205 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$135.08 |
$307 |
1.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$135.08 |
$307 |
1.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$315.04 |
$716 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$135.08 |
$307 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$135.08 |
$307 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$229.68 |
$522 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$135.08 |
$307 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$135.08 |
$307 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$202.62 |
$460.50 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$135.08 |
$307 |
1.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$135.08 |
$307 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$229.68 |
$522 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$135.08 |
$307 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$135.08 |
$307 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$135.08 |
$307 |
1.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$135.08 |
$307 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$135.08 |
$307 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$145.20 |
$330 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$135.08 |
$307 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$202.62 |
$460.50 |
2.6× |
| Xr arthrogram ankle (73615) |
$483.78 |
$1,099.50 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$229.68 |
$522 |
2.4× |
| Xr chest 4+ views (71048) |
$135.08 |
$307 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$135.08 |
$307 |
1.7× |
| Xr internal auditory meati complete (70134) |
$229.68 |
$522 |
0.5× |
| Xr shoulder 1 view (73020) |
$202.62 |
$460.50 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$229.68 |
$522 |
2.4× |
| Xr tibia/fibula 2 views (73590) |
$202.62 |
$460.50 |
2.6× |
| Xr tmj bilateral (70330) |
$135.08 |
$307 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$202.62 |
$460.50 |
2.6× |