| 3-D radiotherapy plan dose-volume histograms (77295) |
$387.50 |
$775 |
0.3× |
| Abdomen 2 views (74019) |
$56.50 |
$113 |
0.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$320.25 |
$640.50 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
— |
$186 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$166 |
— |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,077 |
$4,154 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,139 |
$4,278 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,000 |
$10,000 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,000 |
$6,000 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$175 |
— |
| Ankle 2 views (73600) |
$72.50 |
$145 |
0.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$233.25 |
$466.50 |
0.7× |
| Aortogram thoracic (75605) |
$4,250 |
$8,500 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
— |
$169 |
— |
| Aortography abdominal serialography rs&i (75625) |
— |
$184 |
— |
| Arthrogram hip (73525) |
$226.50 |
$453 |
0.6× |
| Arthrogram shoulder (73040) |
$239.75 |
$479.50 |
0.7× |
| Arthrogram wrist (73115) |
$241.25 |
$482.50 |
0.7× |
| Arthrography knee lt (73580) |
$226.75 |
$453.50 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$88 |
$176 |
0.7× |
| Bone &/joint imaging whole body (78306) |
$412.98 |
$825.95 |
1.0× |
| Bone age studies (77072) |
$69.25 |
$138.50 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$422.98 |
$845.95 |
1.1× |
| Bone survey complete (77075) |
$101.25 |
$202.50 |
1.0× |
| Brain image w/flow 4 + views (78606) |
$386.25 |
$772.50 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$72.50 |
$145 |
0.8× |
| Chest 1 view (71045) |
$52.50 |
$105 |
0.6× |
| Chest 3 views (71047) |
$55 |
$110 |
0.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$125 |
$250 |
0.7× |
| Clavicle complete (73000) |
$72.50 |
$145 |
0.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$127.25 |
$254.50 |
1.2× |
| Continuing medical physics consltj pr wk (77336) |
$213.40 |
$426.80 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$454.75 |
$909.50 |
1.3× |
| CT abdomen and pelvis without contrast (74176) |
$275.75 |
$551.50 |
1.2× |
| CT abdomen w contrast (74160) |
$248.38 |
$496.75 |
1.4× |
| CT abdomen w wo contrast (74170) |
$260.62 |
$521.25 |
1.5× |
| CT abdomen w/o contrast (74150) |
$147.60 |
$295.20 |
1.4× |
| CT angiography upper extremity lt (73206) |
$268.12 |
$536.25 |
1.5× |
| CT c-spine w/o contrast (72125) |
$144.85 |
$289.70 |
1.4× |
| CT cervical spine w&w/o contrast (72127) |
$232.88 |
$465.75 |
1.3× |
| CT cervical spine with contrast (72126) |
$378.25 |
$756.50 |
1.1× |
| CT chest w/wo contrast (71270) |
$231.88 |
$463.75 |
1.3× |
| CT chest with contrast (71260) |
$219.38 |
$438.75 |
1.2× |
| CT head/brain with contrast (70460) |
$206.88 |
$413.75 |
1.2× |
| CT head/brain without and with contrast (70470) |
$200.62 |
$401.25 |
1.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$81.25 |
$162.50 |
0.9× |
| CT iac w contrast (70481) |
$288.75 |
$577.50 |
1.6× |
| CT lower ext w/o (73700) |
$125.10 |
$250.20 |
1.2× |
| CT lower extremity w wo contrast (73702) |
$205 |
$410 |
1.2× |
| CT lower extremity with contrast (73701) |
$208.12 |
$416.25 |
1.2× |
| CT lumbar spine w & w/o contrast (72133) |
$218.12 |
$436.25 |
1.2× |
| CT lumbar spine w/o contrast (72131) |
$183.12 |
$366.25 |
1.7× |
| CT lumbar spine with contrast (72132) |
$366.25 |
$732.50 |
1.0× |
| CT maxillofacial w contrast (70487) |
$213.12 |
$426.25 |
1.2× |
| CT maxillofacial w/o contrast (70486) |
$172.70 |
$345.40 |
1.6× |
| CT maxillofacial w/wo contrast (70488) |
$219.38 |
$438.75 |
1.2× |
| CT neck soft tissue w contrast (70491) |
$213.12 |
$426.25 |
1.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$243.12 |
$486.25 |
1.4× |
| CT orbits w/o contrast (70480) |
$172.70 |
$345.40 |
1.6× |
| CT pelvis w & w/o contrast (72194) |
$244.38 |
$488.75 |
1.4× |
| CT pelvis w/o contrast (72192) |
$142.60 |
$285.20 |
1.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$233.88 |
$467.75 |
1.3× |
| CT soft tissue neck w/o contrast (70490) |
$142.60 |
$285.20 |
1.4× |
| CT thoracic spine w/contrast (72129) |
$218.12 |
$436.25 |
1.2× |
| CT thoracic spine w/o contrast (72128) |
$135.10 |
$270.20 |
1.3× |
| CT thoracic spine w/wo contrast (72130) |
$218.12 |
$436.25 |
1.2× |
| CT thorax w/o contrast (71250) |
$146.35 |
$292.70 |
1.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$243.12 |
$486.25 |
1.4× |
| CT upper extremity w/o contrast rt (73200) |
$148.85 |
$297.70 |
1.4× |
| CT upper extremity with contrast (73201) |
$383.75 |
$767.50 |
1.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$243.12 |
$486.25 |
1.4× |
| Cta Abdomen (74175) |
$268.12 |
$536.25 |
1.5× |
| CTA abdomen pelvis (74174) |
$426.25 |
$852.50 |
1.2× |
| CTA chest (71275) |
$268.12 |
$536.25 |
1.5× |
| Cta Head (70496) |
$255.62 |
$511.25 |
1.5× |
| CTA lwr ext w&w/o contrast (73706) |
$268.12 |
$536.25 |
1.5× |
| Cta Neck (70498) |
$231.88 |
$463.75 |
1.3× |
| Cta Pelvis (72191) |
$338.25 |
$676.50 |
1.9× |
| Cystography minimum 3 views rs&i (74430) |
— |
$31 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
$82.50 |
$165 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$74.75 |
$149.50 |
0.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$57 |
$114 |
0.7× |
| Echoencephalography real time imaging (76506) |
$80.68 |
$161.35 |
0.8× |
| Esophagus (74220) |
$118.75 |
$237.50 |
0.7× |
| Fetal biophysical profile non-stress testing (76818) |
$100.25 |
$200.50 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$101.25 |
$202.50 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
— |
$17 |
— |
| Foot 2 views (73620) |
$72.50 |
$145 |
0.8× |
| Forearm 2 views (73090) |
$57.58 |
$115.15 |
0.7× |
| Gated Heart Planar Single (78472) |
$228 |
$456 |
0.6× |
| Hand 2 views (73120) |
$87.50 |
$175 |
0.8× |
| Hand 3 views (73130) |
$72.50 |
$145 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$473 |
$946 |
0.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$448 |
$896 |
1.1× |
| Ht muscle image spect sing (78451) |
$247 |
$494 |
0.2× |
| Humerus Min 2 Views Left (73060) |
$72.50 |
$145 |
0.8× |
| Hysterosalpingogram (74740) |
$22 |
$44 |
0.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$79.75 |
$159.50 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$467.50 |
$935 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$457.75 |
$915.50 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$408.25 |
$816.50 |
0.8× |
| Knee 3 views (73562) |
$72.50 |
$145 |
0.8× |
| Lung perf&ventilat diferentl (78598) |
$286.50 |
$573 |
0.5× |
| Lung perfusion differential (78597) |
$216.25 |
$432.50 |
0.5× |
| Lymphoscintigraphy (78195) |
$363.75 |
$727.50 |
0.7× |
| Mammary ductogram or galactogram single (77053) |
$62.80 |
$125.60 |
0.3× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$34 |
$68 |
0.4× |
| Meckels Diverticulum (78290) |
$321.50 |
$643 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$397.50 |
$795 |
1.1× |
| MRA head w/o contrast (70544) |
$217.18 |
$434.35 |
0.9× |
| MRA neck w contrast (70548) |
$304.08 |
$608.15 |
0.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$350.32 |
$700.65 |
1.0× |
| MRA neck w/o contrast (70547) |
$215.92 |
$431.85 |
0.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$295.32 |
$590.65 |
0.8× |
| MRI abdomen w/o contrast (74181) |
$190.92 |
$381.85 |
0.8× |
| MRI any jnt lwr ext with con lt (73722) |
$280 |
$560 |
0.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$550.62 |
$1,101.25 |
0.7× |
| MRI c-spine with contrast (72142) |
$295.32 |
$590.65 |
0.8× |
| MRI cervical spine w/o contrast (72141) |
$197.18 |
$394.35 |
0.8× |
| MRI chest w/o & w/contrast material (71552) |
$411.58 |
$823.15 |
1.2× |
| MRI chest w/o contrast (71550) |
$272.18 |
$544.35 |
1.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$319.82 |
$639.65 |
0.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$256.85 |
$513.70 |
1.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$219.75 |
$439.50 |
0.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$307.82 |
$615.65 |
0.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$325.32 |
$650.65 |
0.9× |
| MRI pelvis w/o contrast (72195) |
$227.18 |
$454.35 |
1.0× |
| MRI scan of arm joint before and after contrast (73223) |
$403.15 |
$806.30 |
1.2× |
| MRI scan of leg joint before and after contrast (73723) |
$403.15 |
$806.30 |
1.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$307.82 |
$615.65 |
0.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$295.32 |
$590.65 |
0.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$320.32 |
$640.65 |
0.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$307.82 |
$615.65 |
0.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$307.82 |
$615.65 |
0.9× |
| MRI thoracic spine w/o contrast (72146) |
$190.92 |
$381.85 |
0.8× |
| MRI tmj (70336) |
$256.85 |
$513.70 |
1.1× |
| MRI upper ext joint w/o contrast (73221) |
$256.85 |
$513.70 |
1.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$403.15 |
$806.30 |
1.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$256.85 |
$513.70 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$271 |
$542 |
0.2× |
| Neck soft tissue (70360) |
$79.75 |
$159.50 |
0.9× |
| Nm gastric emptying study (78264) |
$422.98 |
$845.95 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,375 |
$2,750 |
1.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$91.75 |
$183.50 |
0.9× |
| Osseous survey infant (77076) |
$110.50 |
$221 |
1.1× |
| Osseous survey limited (77074) |
$112.25 |
$224.50 |
1.1× |
| Parathyroid imaging (78070) |
$393.50 |
$787 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$62.50 |
$125 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$647.75 |
$1,295.50 |
0.5× |
| PET imaging for CT attenuation whole body (78816) |
$648.25 |
$1,296.50 |
0.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$403.15 |
$806.30 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$368.50 |
$737 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$356.25 |
$712.50 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$270.25 |
$540.50 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$44.50 |
$89 |
0.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$75.50 |
$151 |
0.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$92.50 |
$185 |
0.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$84.75 |
$169.50 |
0.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$12,242.45 |
$24,484.90 |
1.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$422.40 |
$844.80 |
0.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$228 |
$456 |
2.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$263 |
$526 |
0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$78.38 |
$156.75 |
0.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$52 |
$104 |
0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$51.50 |
$103 |
0.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$62.50 |
$125 |
0.7× |
| Radiologic exam colon single contrast study (74270) |
$163.50 |
$327 |
0.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$101.75 |
$203.50 |
0.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$152.50 |
$305 |
0.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$145 |
$290 |
0.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$31 |
$62 |
0.4× |
| Radiological examination surgical specimen (76098) |
$235.45 |
$470.90 |
0.4× |
| Ribs bilateral 3 views (71110) |
$71.75 |
$143.50 |
0.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$775.25 |
$1,550.50 |
1.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$814 |
$1,628 |
1.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$497.50 |
$995 |
0.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$74 |
$148 |
0.3× |
| Scanogram (77073) |
$61 |
$122 |
0.6× |
| Scapula complete (73010) |
$105 |
$210 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$57.25 |
$114.50 |
2.4× |
| Simulation intermediate (77285) |
$212.50 |
$425 |
0.6× |
| Small bowel series (74250) |
$112.50 |
$225 |
0.6× |
| Spec medical radj physics consltj (77370) |
$213.40 |
$426.80 |
1.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$87.50 |
$175 |
0.2× |
| Special dosimetry (77331) |
$59.50 |
$119 |
0.4× |
| Special treatment procedure (77470) |
$138 |
$276 |
0.2× |
| Spine thoracic 3 views (72072) |
$105 |
$210 |
1.0× |
| Stereotactic body radiation delivery (77373) |
$1,260 |
$2,520 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$268 |
$536 |
0.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$347.50 |
$695 |
0.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$225 |
$450 |
1.7× |
| Therapeutic Enema (74283) |
$195 |
$390 |
1.1× |
| Thoracolumbar 2 views (72080) |
$50 |
$100 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$393 |
$786 |
1.0× |
| Tmj unilateral (70328) |
$54.88 |
$109.75 |
0.6× |
| Treatment device intermediate (77333) |
$213.40 |
$426.80 |
1.6× |
| Treatment devices simple (77332) |
$35.50 |
$71 |
0.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$864 |
$1,728 |
1.6× |
| Tx devices design & construction complex (77334) |
$184.25 |
$368.50 |
0.5× |
| Ultrasound, abdomen limited (76705) |
$86.35 |
$172.70 |
0.8× |
| Umbilical-artery Doppler (OB) (76820) |
$78.50 |
$157 |
0.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$79.75 |
$159.50 |
0.9× |
| Unlisted Ultrasound Procedure (76999) |
$55.75 |
$111.50 |
0.6× |
| Upper Extremity Infant (73092) |
$63.75 |
$127.50 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$63 |
$126 |
0.3× |
| Urethrocystography voiding (74455) |
$170.50 |
$341 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$154.50 |
$309 |
0.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$158.75 |
$317.50 |
0.9× |
| Us abdl aorta screen aaa (76706) |
$24.50 |
$49 |
0.2× |
| Us breast unilateral complete (76641) |
$80.75 |
$161.50 |
0.8× |
| Us breast unilateral limited (76642) |
$69.50 |
$139 |
0.8× |
| Us chest (76604) |
$64.92 |
$129.85 |
0.6× |
| Us compl joint r-t w/image documentation (76881) |
$48.50 |
$97 |
0.5× |
| Us infant hips dynamic (76885) |
$83.75 |
$167.50 |
1.0× |
| Us infant hips limited static (76886) |
$68.75 |
$137.50 |
0.8× |
| Us kidney transplant (76776) |
$100.68 |
$201.35 |
1.0× |
| Us ob transvaginal (76817) |
$84.25 |
$168.50 |
0.8× |
| Us pelvic non ob complete (76856) |
$86.35 |
$172.70 |
0.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$86 |
$172 |
0.8× |
| Us pregnancy ltd (76815) |
$53.25 |
$106.50 |
0.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$98.75 |
$197.50 |
0.9× |
| Us retroperitoneal complete (76770) |
$81.92 |
$163.85 |
0.8× |
| Us retroperitoneal limited (76775) |
$61.18 |
$122.35 |
0.6× |
| Us scrotum and contents (76870) |
$81.92 |
$163.85 |
0.8× |
| Us soft tissue head/neck (76536) |
$86.35 |
$172.70 |
0.8× |
| Us spinal canal and contents (76800) |
$101.75 |
$203.50 |
1.0× |
| Us transrectal (76872) |
$86 |
$172 |
0.8× |
| Us xtr non-vasc lmtd (76882) |
$41 |
$82 |
0.4× |
| Us, eye b-scan (76512) |
$62.90 |
$125.80 |
0.6× |
| Venogram extremity bilateral (75822) |
$723 |
$1,446 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,139 |
$4,278 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,500 |
$3,000 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
— |
$150 |
— |
| Wrist 2 views (73100) |
$86.50 |
$173 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$105 |
$210 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$76.12 |
$152.25 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$72.50 |
$145 |
0.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$192 |
$384 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$72.50 |
$145 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$72.50 |
$145 |
0.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$85.25 |
$170.50 |
0.8× |
| X-ray exam hip uni 1 view (73501) |
$29 |
$58 |
0.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$72.50 |
$145 |
0.8× |
| X-ray exam hip uni 4/> views (73503) |
$72.50 |
$145 |
0.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$92.50 |
$185 |
0.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$97.12 |
$194.25 |
0.9× |
| X-ray exam of femur 1 (73551) |
$41 |
$82 |
0.5× |
| X-ray eye for foreign body (70030) |
$49.75 |
$99.50 |
0.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$76.50 |
$153 |
0.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$86.50 |
$173 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$72.50 |
$145 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$72.50 |
$145 |
0.8× |
| X-ray IV pyelogram+drip infusn (74410) |
$152.50 |
$305 |
0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$58.25 |
$116.50 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$105 |
$210 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$87 |
$174 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$42 |
$84 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$68.75 |
$137.50 |
0.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$81.50 |
$163 |
0.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$61.50 |
$123 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$63.82 |
$127.65 |
0.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$45.62 |
$91.25 |
0.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$78.75 |
$157.50 |
0.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$76 |
$152 |
0.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$257.50 |
$515 |
0.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$86.50 |
$173 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$105 |
$210 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$105 |
$210 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$105 |
$210 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$54.25 |
$108.50 |
0.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$86.50 |
$173 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$57 |
$114 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$86.50 |
$173 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$74 |
$148 |
0.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$68.50 |
$137 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$51 |
$102 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$57 |
$114 |
0.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$58.82 |
$117.65 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$66.50 |
$133 |
0.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$76.50 |
$153 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$52.25 |
$104.50 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$86.50 |
$173 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$81.50 |
$163 |
0.8× |
| Xr finger(s) 2+ views (73140) |
$55 |
$110 |
0.6× |
| Xr shoulder 1 view (73020) |
$86.50 |
$173 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$73 |
$146 |
0.7× |
| Xr tibia/fibula 2 views (73590) |
$86.50 |
$173 |
1.0× |
| Xr tmj bilateral (70330) |
$66.32 |
$132.65 |
0.8× |
| Xray knee 1 or 2 views rt (73560) |
$72.50 |
$145 |
0.8× |