| Abdomen 2 views (74019) |
$568.50 |
$568.50 |
5.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,228 |
$1,228 |
3.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,624.75 |
$3,624.75 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$6,796 |
$6,796 |
2.2× |
| Angiography extremity unilateral rs&i (75710) |
$4,641 |
$4,641 |
1.5× |
| Angiography internal mammary rs&i (75756) |
$3,038 |
$3,038 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,236 |
$5,236 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,798 |
$3,798 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,038 |
$3,038 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$11,737 |
$11,737 |
2.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$8,219 |
$8,219 |
1.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,038 |
$3,038 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,038 |
$3,038 |
1.0× |
| Ankle 2 views (73600) |
$350 |
$350 |
4.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$852 |
$852 |
2.5× |
| Aortogram thoracic (75605) |
$5,236 |
$5,236 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,777 |
$3,777 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,754 |
$3,754 |
1.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,038 |
$3,038 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$3,038 |
$3,038 |
1.0× |
| Arthrogram elbow (73085) |
$888 |
$888 |
2.6× |
| Arthrogram hip (73525) |
$964 |
$964 |
2.9× |
| Arthrogram shoulder (73040) |
$983 |
$983 |
2.9× |
| Arthrogram wrist (73115) |
$839 |
$839 |
2.5× |
| Arthrography knee lt (73580) |
$987 |
$987 |
2.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,662 |
$1,662 |
4.3× |
| Bone &/joint imaging whole body (78306) |
$2,208 |
$2,208 |
5.7× |
| Bone age studies (77072) |
$278.50 |
$278.50 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$2,405 |
$2,405 |
6.2× |
| Bone survey complete (77075) |
$973.50 |
$973.50 |
9.7× |
| Brain image w/flow 4 + views (78606) |
$986.36 |
$986.36 |
1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,000 |
$6,000 |
4.4× |
| Brain Imaging Vascular Flow Only (78610) |
$515 |
$515 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$641 |
$641 |
7.6× |
| Chest 1 view (71045) |
$281.50 |
$281.50 |
3.4× |
| Chest 3 views (71047) |
$467.50 |
$467.50 |
5.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$494.50 |
$494.50 |
2.9× |
| Clavicle complete (73000) |
$432 |
$432 |
5.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,004 |
$2,004 |
19.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,394 |
$5,394 |
16.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,900 |
$3,900 |
17.0× |
| CT abdomen w contrast (74160) |
$3,190 |
$3,190 |
18.9× |
| CT abdomen w wo contrast (74170) |
$3,422 |
$3,422 |
20.3× |
| CT abdomen w/o contrast (74150) |
$2,535 |
$2,535 |
25.2× |
| CT angiography upper extremity lt (73206) |
$3,012 |
$3,012 |
17.8× |
| CT c-spine w/o contrast (72125) |
$2,100 |
$2,100 |
20.9× |
| CT cervical spine w&w/o contrast (72127) |
$3,415 |
$3,415 |
20.2× |
| CT cervical spine with contrast (72126) |
$3,171 |
$3,171 |
9.4× |
| CT chest w/wo contrast (71270) |
$3,418 |
$3,418 |
20.2× |
| CT chest with contrast (71260) |
$2,810 |
$2,810 |
16.6× |
| CT head/brain with contrast (70460) |
$2,368 |
$2,368 |
14.0× |
| CT head/brain without and with contrast (70470) |
$2,987 |
$2,987 |
17.7× |
| CT iac w contrast (70481) |
$2,694 |
$2,694 |
15.9× |
| CT limited/localized follow up study (76380) |
$998 |
$998 |
11.9× |
| CT lower ext w/o (73700) |
$2,406 |
$2,406 |
23.9× |
| CT lower extremity w wo contrast (73702) |
$3,123 |
$3,123 |
18.5× |
| CT lower extremity with contrast (73701) |
$2,948 |
$2,948 |
17.5× |
| CT lumbar spine w & w/o contrast (72133) |
$3,417 |
$3,417 |
20.2× |
| CT lumbar spine w/o contrast (72131) |
$2,321 |
$2,321 |
23.1× |
| CT lumbar spine with contrast (72132) |
$3,044 |
$3,044 |
9.1× |
| CT maxillofacial w contrast (70487) |
$2,725 |
$2,725 |
16.1× |
| CT maxillofacial w/o contrast (70486) |
$2,137 |
$2,137 |
21.2× |
| CT maxillofacial w/wo contrast (70488) |
$3,222 |
$3,222 |
19.1× |
| CT neck soft tissue w contrast (70491) |
$2,762 |
$2,762 |
16.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,963 |
$2,963 |
17.5× |
| CT orbits w/o contrast (70480) |
$2,191 |
$2,191 |
21.8× |
| CT pelvis w & w/o contrast (72194) |
$2,993 |
$2,993 |
17.7× |
| CT pelvis w/o contrast (72192) |
$2,053 |
$2,053 |
20.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,143 |
$3,143 |
18.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,917 |
$1,917 |
19.0× |
| CT thoracic spine w/contrast (72129) |
$2,781 |
$2,781 |
16.5× |
| CT thoracic spine w/o contrast (72128) |
$1,955 |
$1,955 |
19.4× |
| CT thoracic spine w/wo contrast (72130) |
$3,855 |
$3,855 |
22.8× |
| CT thorax w/o contrast (71250) |
$2,050 |
$2,050 |
20.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,771 |
$2,771 |
16.4× |
| CT upper extremity w/o contrast rt (73200) |
$2,500 |
$2,500 |
24.8× |
| CT upper extremity with contrast (73201) |
$2,976 |
$2,976 |
8.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,940 |
$2,940 |
17.4× |
| Cta Abdomen (74175) |
$3,230 |
$3,230 |
19.1× |
| CTA abdomen pelvis (74174) |
$4,400 |
$4,400 |
13.1× |
| CTA chest (71275) |
$3,100 |
$3,100 |
18.4× |
| Cta Head (70496) |
$2,500 |
$2,500 |
14.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,000 |
$1,000 |
3.0× |
| CTA lwr ext w&w/o contrast (73706) |
$2,958 |
$2,958 |
17.5× |
| Cta Neck (70498) |
$2,300 |
$2,300 |
13.6× |
| Cta Pelvis (72191) |
$3,355 |
$3,355 |
19.9× |
| Cystography minimum 3 views rs&i (74430) |
$673 |
$673 |
2.0× |
| Diskogram cervical (72285) |
$2,003.76 |
$2,003.76 |
1.1× |
| Diskography lumbar (72295) |
$1,840 |
$1,840 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$656.10 |
$656.10 |
6.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$636 |
$636 |
6.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$87 |
$87 |
1.0× |
| Dxa bone density study axial skeleton (77085) |
$459 |
$459 |
4.6× |
| Echo exam of fetal heart (76825) |
$526 |
$526 |
1.0× |
| Echoencephalography real time imaging (76506) |
$679 |
$679 |
6.7× |
| Esophagus (74220) |
$611 |
$611 |
3.6× |
| Fetal biophysical profile non-stress testing (76818) |
$524 |
$524 |
5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$540 |
$540 |
5.4× |
| Fluoroscopy up to 1 hr (76000) |
$678 |
$678 |
3.0× |
| Foot 2 views (73620) |
$396 |
$396 |
4.7× |
| Forearm 2 views (73090) |
$516 |
$516 |
6.2× |
| Gated Heart Planar Single (78472) |
$1,759 |
$1,759 |
4.6× |
| Hand 2 views (73120) |
$378 |
$378 |
3.8× |
| Hand 3 views (73130) |
$563 |
$563 |
6.7× |
| Heart Infarct Image (78466) |
$596 |
$596 |
1.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,207 |
$2,207 |
4.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,173 |
$2,173 |
5.6× |
| Ht muscle image spect sing (78451) |
$2,979 |
$2,979 |
2.4× |
| Humerus Min 2 Views Left (73060) |
$397 |
$397 |
4.7× |
| Hysterosalpingogram (74740) |
$599 |
$599 |
2.6× |
| Kidney imaging morphology (78700) |
$732.78 |
$732.78 |
1.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,804 |
$1,804 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,339 |
$2,339 |
4.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,984 |
$2,984 |
5.7× |
| Knee 3 views (73562) |
$689 |
$689 |
8.2× |
| Liver & spleen imaging static only (78215) |
$1,512 |
$1,512 |
3.9× |
| Liver imaging w/vascular flow (78202) |
$882 |
$882 |
1.7× |
| Lung perfusion differential (78597) |
$876 |
$876 |
2.3× |
| Lung Ventilation Imaging (78579) |
$888 |
$888 |
2.3× |
| Lymphoscintigraphy (78195) |
$1,700 |
$1,700 |
3.3× |
| Mammary ductogram or galactogram multiple (77054) |
$569.25 |
$569.25 |
2.5× |
| Mammary ductogram or galactogram single (77053) |
$1,305 |
$1,305 |
5.7× |
| Meckels Diverticulum (78290) |
$1,183 |
$1,183 |
3.1× |
| MRA head w & w/o contrast (70546) |
$5,463 |
$5,463 |
16.3× |
| MRA head w/o contrast (70544) |
$3,244 |
$3,244 |
14.1× |
| MRA head with contrast (70545) |
$3,202.13 |
$3,202.13 |
9.5× |
| MRA neck w contrast (70548) |
$2,910 |
$2,910 |
8.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,137 |
$4,137 |
12.3× |
| MRA neck w/o contrast (70547) |
$3,072 |
$3,072 |
13.4× |
| MRI abdomen w contrast (74182) |
$4,716 |
$4,716 |
14.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,959 |
$4,959 |
14.8× |
| MRI abdomen w/o contrast (74181) |
$3,835 |
$3,835 |
16.7× |
| MRI any jnt lwr ext with con lt (73722) |
$3,802 |
$3,802 |
5.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,230 |
$4,230 |
5.6× |
| MRI breast w/o contrast bilateral (77047) |
$2,781 |
$2,781 |
12.1× |
| MRI breast w/o contrast unilat (77046) |
$589 |
$589 |
2.6× |
| MRI c-spine with contrast (72142) |
$4,398 |
$4,398 |
13.1× |
| MRI cervical spine w/o contrast (72141) |
$3,632 |
$3,632 |
15.8× |
| MRI chest w/o & w/contrast material (71552) |
$4,857 |
$4,857 |
14.5× |
| MRI chest w/o contrast (71550) |
$3,344 |
$3,344 |
14.6× |
| MRI chest with contrast (71551) |
$3,588.35 |
$3,588.35 |
4.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,524 |
$3,524 |
10.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,746 |
$3,746 |
11.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,472 |
$3,472 |
15.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,066.53 |
$3,066.53 |
13.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,005 |
$5,005 |
14.9× |
| MRI orbit/face/neck w/contrast (70542) |
$3,847 |
$3,847 |
11.4× |
| MRI pelvis w contrast (72196) |
$3,625 |
$3,625 |
10.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,995 |
$4,995 |
14.9× |
| MRI pelvis w/o contrast (72195) |
$3,600 |
$3,600 |
15.7× |
| MRI scan of arm joint before and after contrast (73223) |
$4,745 |
$4,745 |
14.1× |
| MRI scan of leg joint before and after contrast (73723) |
$4,743 |
$4,743 |
14.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,920 |
$4,920 |
14.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,188 |
$4,188 |
12.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,900 |
$4,900 |
14.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,248 |
$4,248 |
12.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,742 |
$4,742 |
14.1× |
| MRI thoracic spine w/o contrast (72146) |
$3,403 |
$3,403 |
14.8× |
| MRI tmj (70336) |
$3,315 |
$3,315 |
14.4× |
| MRI upper ext joint w/o contrast (73221) |
$3,081 |
$3,081 |
13.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,659 |
$4,659 |
13.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,270 |
$3,270 |
14.2× |
| Myelogram Cervical (72240) |
$1,162.31 |
$1,162.31 |
1.5× |
| Myelogram Lumbar (72265) |
$1,760 |
$1,760 |
2.3× |
| Myelogram thoracic (72255) |
$1,097.10 |
$1,097.10 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,199.57 |
$1,199.57 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,877 |
$4,877 |
3.9× |
| Neck soft tissue (70360) |
$413 |
$413 |
4.9× |
| Nm cisternogram (78630) |
$1,540 |
$1,540 |
2.9× |
| Nm gastric emptying study (78264) |
$2,315 |
$2,315 |
6.0× |
| Nm gastroesophageal reflux study (78262) |
$1,109.52 |
$1,109.52 |
2.9× |
| Nuclear medicine of heart pumping function (78473) |
$3,263 |
$3,263 |
8.5× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$3,622.50 |
$3,622.50 |
2.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,203.52 |
$2,203.52 |
1.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,340.33 |
$1,340.33 |
3.5× |
| Nuclear Rx Oral Admin (79005) |
$1,381 |
$1,381 |
6.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$388 |
$388 |
3.9× |
| Osseous survey infant (77076) |
$272.50 |
$272.50 |
2.7× |
| Osseous survey limited (77074) |
$469 |
$469 |
4.7× |
| Parathyrd planar w/wo subtrj (78071) |
$656 |
$656 |
1.7× |
| Parathyroid imaging (78070) |
$1,469 |
$1,469 |
3.8× |
| Pelvis 1 or 2 views (72170) |
$448 |
$448 |
4.4× |
| Perineogram (74775) |
$284.63 |
$284.63 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$5,507 |
$5,507 |
4.0× |
| PET imaging CT for attenuation limited area (78814) |
$7,943 |
$7,943 |
5.8× |
| PET imaging for CT attenuation whole body (78816) |
$6,678 |
$6,678 |
4.8× |
| PET imaging limited area chest head/neck (78811) |
$3,105 |
$3,105 |
2.5× |
| PET whole body (78813) |
$3,829.50 |
$3,829.50 |
2.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,767 |
$4,767 |
14.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,263 |
$1,263 |
3.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,484 |
$1,484 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$788 |
$788 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$445 |
$445 |
4.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$244 |
$244 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$629 |
$629 |
6.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$400 |
$400 |
4.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$637 |
$637 |
6.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$382.50 |
$382.50 |
4.6× |
| Radiologic exam colon single contrast study (74270) |
$841 |
$841 |
5.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$464 |
$464 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$811.78 |
$811.78 |
4.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$668.50 |
$668.50 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$483 |
$483 |
5.8× |
| Radiological examination surgical specimen (76098) |
$658 |
$658 |
1.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,038 |
$3,038 |
1.0× |
| Ribs bilateral 3 views (71110) |
$601.50 |
$601.50 |
6.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,492 |
$1,492 |
3.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,213 |
$3,213 |
6.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,804 |
$1,804 |
3.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$750 |
$750 |
3.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,098 |
$1,098 |
4.9× |
| Sacroiliac Joints < 3 Views (72200) |
$313 |
$313 |
3.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,424 |
$1,424 |
6.2× |
| Scanogram (77073) |
$619 |
$619 |
6.1× |
| Scapula complete (73010) |
$424 |
$424 |
4.2× |
| Screening digital breast tomosynthesis (77063) |
$39.44 |
$39.44 |
1.7× |
| Sella turcica (70240) |
$125 |
$125 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$213.50 |
$213.50 |
2.1× |
| Sialogram (70390) |
$633 |
$633 |
2.8× |
| Small bowel series (74250) |
$819.50 |
$819.50 |
4.9× |
| Speech evaluation complex (70371) |
$810.41 |
$810.41 |
3.5× |
| Spine thoracic 3 views (72072) |
$492 |
$492 |
4.9× |
| Testicular Imaging With Vascular Flow (78761) |
$527.85 |
$527.85 |
1.4× |
| Therapeutic Enema (74283) |
$488.34 |
$488.34 |
2.9× |
| Thoracolumbar 2 views (72080) |
$512.50 |
$512.50 |
6.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,274 |
$2,274 |
4.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$979 |
$979 |
2.5× |
| Thyroid uptake measurement (78012) |
$475 |
$475 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,253 |
$1,253 |
3.3× |
| Tmj unilateral (70328) |
$148 |
$148 |
1.8× |
| Tomogram (76100) |
$478.17 |
$478.17 |
4.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,534.72 |
$2,534.72 |
4.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,154 |
$1,154 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$950 |
$950 |
9.4× |
| Unlisted magnetic resonance procedure (76498) |
$822 |
$822 |
9.8× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$864 |
$864 |
2.2× |
| Upper Extremity Infant (73092) |
$173 |
$173 |
1.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$850.77 |
$850.77 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$616 |
$616 |
2.7× |
| Urethrocystography voiding (74455) |
$847 |
$847 |
3.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$2,241 |
$2,241 |
13.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$491.63 |
$491.63 |
2.9× |
| Us abdl aorta screen aaa (76706) |
$450 |
$450 |
4.5× |
| Us breast unilateral complete (76641) |
$392.96 |
$392.96 |
3.9× |
| Us breast unilateral limited (76642) |
$262.76 |
$262.76 |
3.1× |
| Us chest (76604) |
$558 |
$558 |
5.5× |
| Us compl joint r-t w/image documentation (76881) |
$732 |
$732 |
7.3× |
| Us guided compression repair (76936) |
$424 |
$424 |
2.0× |
| Us infant hips dynamic (76885) |
$559 |
$559 |
6.7× |
| Us infant hips limited static (76886) |
$474 |
$474 |
5.7× |
| Us kidney transplant (76776) |
$864 |
$864 |
8.6× |
| Us ob transvaginal (76817) |
$702 |
$702 |
7.0× |
| Us pelvic non ob complete (76856) |
$1,144 |
$1,144 |
11.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$700 |
$700 |
7.0× |
| Us pregnancy ltd (76815) |
$574 |
$574 |
5.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$745 |
$745 |
7.4× |
| Us retroperitoneal complete (76770) |
$1,084 |
$1,084 |
10.8× |
| Us retroperitoneal limited (76775) |
$688 |
$688 |
6.8× |
| Us scrotum and contents (76870) |
$933 |
$933 |
9.3× |
| Us soft tissue head/neck (76536) |
$905 |
$905 |
9.0× |
| Us spinal canal and contents (76800) |
$327 |
$327 |
3.2× |
| Us transrectal (76872) |
$1,300 |
$1,300 |
12.9× |
| Us transrectal prostate volume (76873) |
$549.59 |
$549.59 |
5.5× |
| Us xtr non-vasc lmtd (76882) |
$510 |
$510 |
5.1× |
| Vascular flow imaging (78445) |
$558.90 |
$558.90 |
1.5× |
| Venogram extremity bilateral (75822) |
$1,977 |
$1,977 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$5,563 |
$5,563 |
1.8× |
| Venography caval superior serialography rs&i (75827) |
$2,872 |
$2,872 |
1.9× |
| Venography epidural rs&i (75872) |
$2,161.08 |
$2,161.08 |
3.6× |
| Venography extremity unilateral rs&i (75820) |
$1,672 |
$1,672 |
1.1× |
| Venography Renal Bilateral (75833) |
$8,243 |
$8,243 |
2.7× |
| Venography renal unilateral selective rs&i (75831) |
$7,041 |
$7,041 |
2.3× |
| Vertebral fracture assessment via dxa (77086) |
$125 |
$125 |
1.5× |
| Wrist 2 views (73100) |
$387.50 |
$387.50 |
4.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$765.50 |
$765.50 |
7.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$312.50 |
$312.50 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$549 |
$549 |
6.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$996 |
$996 |
5.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$391 |
$391 |
4.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$587 |
$587 |
7.0× |
| X-ray exam hip uni 1 view (73501) |
$283 |
$283 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$362 |
$362 |
4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$471.50 |
$471.50 |
4.7× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,123 |
$1,123 |
6.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$544 |
$544 |
5.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$565 |
$565 |
6.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,941 |
$1,941 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$415 |
$415 |
5.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$690 |
$690 |
6.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$366 |
$366 |
4.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$258 |
$258 |
3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$588 |
$588 |
5.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$858 |
$858 |
8.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$448 |
$448 |
4.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$376 |
$376 |
4.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$162 |
$162 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$475 |
$475 |
4.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$419.66 |
$419.66 |
4.2× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$526 |
$526 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,366.93 |
$1,366.93 |
4.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$452 |
$452 |
5.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$628 |
$628 |
6.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$775 |
$775 |
7.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$415 |
$415 |
4.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$444 |
$444 |
5.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$582 |
$582 |
6.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$550 |
$550 |
6.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$267 |
$267 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$679 |
$679 |
6.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$517 |
$517 |
5.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$389 |
$389 |
4.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$237 |
$237 |
2.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$438 |
$438 |
5.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$528 |
$528 |
5.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$338 |
$338 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$337.50 |
$337.50 |
4.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$589 |
$589 |
7.0× |
| Xr arthrogram ankle (73615) |
$608 |
$608 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$948 |
$948 |
9.4× |
| Xr chest 4+ views (71048) |
$652 |
$652 |
6.5× |
| Xr Cholecystography Oral Contrast (74290) |
$331.99 |
$331.99 |
2.0× |
| Xr finger(s) 2+ views (73140) |
$395 |
$395 |
4.7× |
| Xr internal auditory meati complete (70134) |
$575 |
$575 |
1.1× |
| Xr shoulder 1 view (73020) |
$378 |
$378 |
4.5× |
| Xr spine cervical 4 or 5 views (72050) |
$898.50 |
$898.50 |
8.9× |
| Xr tibia/fibula 2 views (73590) |
$392 |
$392 |
4.7× |
| Xr tmj bilateral (70330) |
$387.50 |
$387.50 |
4.6× |
| Xray knee 1 or 2 views rt (73560) |
$521 |
$521 |
6.2× |