| Abdomen 2 views (74019) |
$92.84 |
$109.40 |
1.0× |
| Ankle 2 views (73600) |
$77.28 |
$109.40 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$309.81 |
$797.37 |
1.0× |
| Arthrogram hip (73525) |
$309.81 |
$686.76 |
1.0× |
| Arthrogram shoulder (73040) |
$309.81 |
$854.70 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$77.28 |
$109.40 |
1.0× |
| Chest 1 view (71045) |
$77.28 |
$109.40 |
1.0× |
| Clavicle complete (73000) |
$77.28 |
$109.40 |
1.0× |
| Cystography minimum 3 views rs&i (74430) |
$309.81 |
$797.37 |
1.0× |
| Diskogram cervical (72285) |
$1,734.07 |
$1,701.71 |
1.0× |
| Diskography lumbar (72295) |
$1,734.07 |
$1,701.71 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$211.88 |
$1,002.79 |
1.0× |
| Foot 2 views (73620) |
$77.28 |
$109.40 |
1.0× |
| Forearm 2 views (73090) |
$77.28 |
$109.40 |
1.0× |
| Hand 2 views (73120) |
$92.84 |
$109.40 |
1.0× |
| Hand 3 views (73130) |
$77.28 |
$109.40 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$77.28 |
$109.40 |
1.0× |
| Hysterosalpingogram (74740) |
$211.88 |
$729.31 |
1.0× |
| Interstitial radiation source applic complex (77778) |
$618.49 |
$1,221.58 |
1.0× |
| Knee 3 views (73562) |
$77.28 |
$109.40 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$92.84 |
$109.40 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$485.23 |
$451.87 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$92.84 |
$109.40 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$77.28 |
$109.40 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$92.84 |
$109.40 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$77.28 |
$109.40 |
1.0× |
| Radiological examination surgical specimen (76098) |
$485.23 |
$170.17 |
1.0× |
| Sacroiliac Joints < 3 Views (72200) |
$92.84 |
$109.40 |
1.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$211.88 |
$638.14 |
1.0× |
| Scapula complete (73010) |
$92.84 |
$109.40 |
1.0× |
| Spec medical radj physics consltj (77370) |
$119.36 |
$663.32 |
1.0× |
| Special dosimetry (77331) |
$119.36 |
$369.29 |
1.0× |
| Special treatment procedure (77470) |
$490.67 |
$1,603.77 |
1.0× |
| Spine thoracic 3 views (72072) |
$92.84 |
$254.44 |
1.0× |
| Thoracolumbar 2 views (72080) |
$77.28 |
$109.40 |
1.0× |
| Tomogram (76100) |
$92.84 |
$652 |
1.0× |
| Unlisted fluoroscopic procedure (76496) |
$77.28 |
$600 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$211.88 |
$364.65 |
1.0× |
| Urethrocystography voiding (74455) |
$211.88 |
$696.51 |
1.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$155.76 |
$797.37 |
1.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$155.76 |
$797.37 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$92.84 |
$347.89 |
1.0× |
| Us transrectal (76872) |
$92.84 |
$820.47 |
1.0× |
| Us transrectal prostate volume (76873) |
$92.84 |
$613.83 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,397.89 |
$1,762.49 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,397.89 |
$1,033.19 |
1.0× |
| Wrist 2 views (73100) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$77.28 |
$114.70 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$77.28 |
$109.40 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$77.28 |
$120 |
1.0× |
| X-ray eye for foreign body (70030) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$92.84 |
$109.40 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$92.84 |
$109.40 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$77.28 |
$145.87 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$92.84 |
$109.40 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$92.84 |
$182.33 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$92.84 |
$109.40 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$309.81 |
$797.37 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$92.84 |
$109.40 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$92.84 |
$371.29 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$92.84 |
$170.17 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$92.84 |
$109.40 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$92.84 |
$121.55 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$77.28 |
$109.40 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$77.28 |
$109.40 |
1.0× |
| Xr arthrogram ankle (73615) |
$309.81 |
$668.54 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$92.84 |
$164.09 |
1.0× |
| Xr chest 4+ views (71048) |
$92.84 |
$109.40 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$77.28 |
$145.87 |
1.0× |
| Xr optic foramina (70190) |
$77.28 |
$109.40 |
1.0× |
| Xr shoulder 1 view (73020) |
$77.28 |
$109.40 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$92.84 |
$164.09 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$77.28 |
$109.40 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$77.28 |
$109.40 |
1.0× |