| Abdomen 1 View (74018) |
$280.20 |
$467 |
3.2× |
| Abdomen 2 views (74019) |
$352.80 |
$588 |
3.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$813.60 |
$1,356 |
2.0× |
| Angio pulmonary bilat (75743) |
$2,929.80 |
$4,883 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$3,000.60 |
$5,001 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,875.80 |
$4,793 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,875.80 |
$4,793 |
0.9× |
| Ankle 2 views (73600) |
$266.40 |
$444 |
3.1× |
| Aortography thoracic serialography rs&i (75605) |
$4,693.80 |
$7,823 |
0.8× |
| Artery X-Rays Abdomen (75726) |
$3,912.60 |
$6,521 |
0.7× |
| Bone age studies (77072) |
$159.60 |
$266 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$1,728.60 |
$2,881 |
4.3× |
| Bone Imaging Limited Area (78300) |
$597.60 |
$996 |
1.5× |
| Bone Imaging Whole Body (78306) |
$1,500.60 |
$2,501 |
3.7× |
| Bone survey infant (77076) |
$215.40 |
$359 |
2.1× |
| Chest 1 view (71045) |
$141.60 |
$236 |
1.6× |
| Chest 2 views (71046) |
$294.60 |
$491 |
3.4× |
| Chest 3 views (71047) |
$327 |
$545 |
3.8× |
| Chest 4 or more views (71048) |
$346.20 |
$577 |
3.3× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$397.20 |
$662 |
3.8× |
| Clavicle complete (73000) |
$283.80 |
$473 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$995.40 |
$1,659 |
9.5× |
| Contrast Exam Abdominl Aorta (75625) |
$2,875.80 |
$4,793 |
0.9× |
| Contrast X-Ray Bladder (74430) |
$417.60 |
$696 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,156 |
$5,260 |
9.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,948.20 |
$3,247 |
8.2× |
| CT abdomen w contrast (74160) |
$1,221.60 |
$2,036 |
7.0× |
| CT abdomen w wo contrast (74170) |
$1,371.60 |
$2,286 |
7.8× |
| CT abdomen w/o contrast (74150) |
$1,062 |
$1,770 |
10.1× |
| CT Angio Abdomen and Pelvis (74174) |
$2,041.20 |
$3,402 |
5.8× |
| CT Angio Chest (71275) |
$1,654.80 |
$2,758 |
9.4× |
| CT Angio Head (70496) |
$1,592.40 |
$2,654 |
9.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,426.80 |
$2,378 |
8.1× |
| CT Angio Neck (70498) |
$1,961.40 |
$3,269 |
11.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,462.80 |
$2,438 |
8.3× |
| CT cervical spine w/ contrast (72126) |
$1,153.80 |
$1,923 |
3.3× |
| CT cervical spine w/o contrast (72125) |
$1,010.40 |
$1,684 |
9.6× |
| CT cervical spine w/wo cont (72127) |
$1,262.40 |
$2,104 |
7.2× |
| CT chest w contrast (71260) |
$1,285.80 |
$2,143 |
7.3× |
| CT chest w/wo contrast (71270) |
$1,576.20 |
$2,627 |
9.0× |
| CT head/brain with contrast (70460) |
$1,052.40 |
$1,754 |
6.0× |
| CT head/brain without and with contrast (70470) |
$1,516.80 |
$2,528 |
8.6× |
| CT iac w contrast (70481) |
$1,618.80 |
$2,698 |
9.2× |
| CT l-spine w&w/o contrast (72133) |
$1,516.20 |
$2,527 |
8.6× |
| CT lower ext w/o (73700) |
$804 |
$1,340 |
7.7× |
| CT lower extremity w/contrast material (73701) |
$1,027.80 |
$1,713 |
5.9× |
| CT lumbar spine w contrast (72132) |
$1,306.20 |
$2,177 |
3.7× |
| CT lumbar spine w/o contrast (72131) |
$973.80 |
$1,623 |
9.3× |
| CT maxillofacial w contrast (70487) |
$1,354.20 |
$2,257 |
7.7× |
| CT maxillofacial wo contrast (70486) |
$1,197 |
$1,995 |
11.4× |
| CT neck tissue combo (70492) |
$1,867.80 |
$3,113 |
10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,784.40 |
$2,974 |
10.2× |
| CT orbits w/o contrast (70480) |
$1,323.60 |
$2,206 |
12.6× |
| CT pelvis w&w/o contrast (72194) |
$1,622.40 |
$2,704 |
9.2× |
| CT pelvis w/o contrast (72192) |
$720 |
$1,200 |
6.9× |
| CT scan of leg combo (73702) |
$1,239.60 |
$2,066 |
7.1× |
| CT scans face/jaw combo (70488) |
$1,407.60 |
$2,346 |
8.0× |
| CT soft tissue neck w contrast (70491) |
$1,380.60 |
$2,301 |
7.9× |
| CT soft tissue neck w/o contrast (70490) |
$784.20 |
$1,307 |
7.5× |
| CT thoracic spine w contrast (72129) |
$1,201.20 |
$2,002 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$893.40 |
$1,489 |
8.5× |
| CT thoracic spine w/wo cont (72130) |
$1,374.60 |
$2,291 |
7.8× |
| CT thorax w/o contrast (71250) |
$914.40 |
$1,524 |
8.7× |
| CT upper ext wo (73200) |
$895.20 |
$1,492 |
8.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,211.40 |
$2,019 |
6.9× |
| CT upper extremity with contrast (73201) |
$1,064.40 |
$1,774 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,438.80 |
$2,398 |
8.2× |
| Cta Abdomen (74175) |
$1,508.40 |
$2,514 |
8.6× |
| CTA pelvis (72191) |
$1,703.40 |
$2,839 |
9.7× |
| Dxa Bone Density Axial (77080) |
$321 |
$535 |
3.1× |
| Dxa bone density study (77085) |
$201 |
$335 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$144 |
$240 |
1.7× |
| Esophagram (74220) |
$478.80 |
$798 |
2.7× |
| Fetal Biophys Profile W/Nst (76818) |
$521.40 |
$869 |
5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$630 |
$1,050 |
6.0× |
| Fluoroscopy up to 1 hr (76000) |
$288.60 |
$481 |
1.2× |
| Foot 2 views (73620) |
$297 |
$495 |
3.4× |
| Forearm 2 views (73090) |
$313.20 |
$522 |
3.6× |
| Gastric emptying imaging study (78264) |
$1,471.20 |
$2,452 |
3.7× |
| Gated Heart Planar Single (78472) |
$1,410.60 |
$2,351 |
3.5× |
| Gated Heart, Multiple (78473) |
$1,714.80 |
$2,858 |
4.3× |
| Hand 2 views (73120) |
$263.40 |
$439 |
2.5× |
| Hepatobil Syst Image W/Drug (78227) |
$1,975.20 |
$3,292 |
3.6× |
| Hepatobiliary System Imaging (78226) |
$1,698.60 |
$2,831 |
4.2× |
| Ht Muscle Image Spect Sing (78451) |
$2,592.60 |
$4,321 |
2.0× |
| Hysterosalpingogram (74740) |
$411 |
$685 |
1.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$440.40 |
$734 |
5.1× |
| Infant hip ultrasound, limited static exam (76886) |
$291.60 |
$486 |
3.3× |
| K Flow/Funct Image Multiple (78709) |
$1,518.60 |
$2,531 |
2.8× |
| K Flow/Funct Image W/Drug (78708) |
$1,455.60 |
$2,426 |
2.7× |
| K Flow/Funct Image W/O Drug (78707) |
$814.80 |
$1,358 |
1.5× |
Knee 3 Views (73562) range across 6 matching MRF lines |
$394.80–$789.60 |
$658–$1,316 |
varies |
| Liver & Spleen Imaging Static Only (78215) |
$465.60 |
$776 |
1.2× |
| Lung perfusion differential (78597) |
$498.60 |
$831 |
1.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$912 |
$1,520 |
1.7× |
| Lung Ventilation Imaging (78579) |
$448.20 |
$747 |
1.1× |
| Magnetic Image Jaw Joint (70336) |
$1,486.80 |
$2,478 |
6.2× |
| Meckels Divert Exam (78290) |
$787.20 |
$1,312 |
2.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,631.60 |
$4,386 |
7.5× |
| MRA head w/o contrast (70544) |
$2,025.60 |
$3,376 |
8.5× |
| MRA head with contrast (70545) |
$2,143.20 |
$3,572 |
6.1× |
| MRA neck w contrast (70548) |
$1,888.20 |
$3,147 |
5.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,280 |
$3,800 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,496.40 |
$2,494 |
6.3× |
| MRI abdomen w contrast (74182) |
$1,779.60 |
$2,966 |
5.1× |
| MRI abdomen w/o contrast (74181) |
$1,694.40 |
$2,824 |
7.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,990.80 |
$3,318 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,024.40 |
$3,374 |
5.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,755.80 |
$4,593 |
3.5× |
| MRI cervical spine w contrast (72142) |
$2,438.40 |
$4,064 |
7.0× |
| MRI cervical spine w/o cont (72141) |
$2,217 |
$3,695 |
9.3× |
| MRI chest w/o contrast (71550) |
$1,390.20 |
$2,317 |
5.8× |
| MRI chest wo w contrast (71552) |
$2,137.80 |
$3,563 |
6.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,783.80 |
$2,973 |
5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,195.40 |
$3,659 |
6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,776 |
$2,960 |
7.4× |
| MRI lumbar spine w contrast (72149) |
$2,704.20 |
$4,507 |
7.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,560.20 |
$4,267 |
7.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,485 |
$2,475 |
6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,720.40 |
$4,534 |
7.8× |
| MRI pelvis w contrast (72196) |
$1,700.40 |
$2,834 |
4.9× |
| MRI pelvis w/o & w contrast (72197) |
$1,912.80 |
$3,188 |
5.5× |
| MRI pelvis w/o contrast (72195) |
$1,453.80 |
$2,423 |
6.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,473.60 |
$2,456 |
6.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,962.60 |
$3,271 |
8.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,485.80 |
$4,143 |
7.1× |
| MRI, abdomen, combo (74183) |
$2,425.80 |
$4,043 |
6.9× |
| MRI, dorsal spine combo (72157) |
$1,923.60 |
$3,206 |
5.5× |
| MRI, dorsal spine contrast (72147) |
$1,831.80 |
$3,053 |
5.2× |
| MRI, joint upper extrem (73221) |
$2,226.60 |
$3,711 |
9.3× |
| MRI, joint upper extrem combo (73223) |
$2,920.80 |
$4,868 |
8.4× |
| MRI, lumbar spine combo (72158) |
$2,839.20 |
$4,732 |
8.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,325.60 |
$3,876 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,294.20 |
$7,157 |
3.3× |
| Neck soft tissue (70360) |
$269.40 |
$449 |
3.1× |
| Nuclear Rx Oral Admin (79005) |
$755.40 |
$1,259 |
3.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$858 |
$1,430 |
1.6× |
| Parathyroid Planar Imaging (78070) |
$448.20 |
$747 |
1.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$780 |
$1,300 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$213 |
$355 |
2.0× |
| Pet Image W/Ct Lmtd (78814) |
$3,606 |
$6,010 |
2.5× |
| PET image w/CT, full body (78816) |
$4,598.40 |
$7,664 |
3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,571.40 |
$7,619 |
3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,523.40 |
$2,539 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$679.20 |
$1,132 |
1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$432.60 |
$721 |
4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$599.40 |
$999 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$349.80 |
$583 |
4.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$217.20 |
$362 |
2.5× |
| Radex elbow complete minimum 3 views (73080) |
$335.40 |
$559 |
3.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$381 |
$635 |
3.6× |
| Radex fingr minimum 2 views (73140) |
$243 |
$405 |
2.8× |
| Radex foot complete minimum 3 views (73630) |
$345 |
$575 |
4.0× |
| Radex Hand Minimum 3 Views (73130) |
$322.80 |
$538 |
3.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$175.80 |
$293 |
2.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$201 |
$335 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$281.40 |
$469 |
3.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$294.60 |
$491 |
3.4× |
| Radex shoulder complete minimum 2 views (73030) |
$352.20 |
$587 |
4.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$169.20 |
$282 |
1.9× |
| Radex Spine 1 View Specify Level (72020) |
$164.40 |
$274 |
1.9× |
| Radex Sternum Minimum 2 Views (71120) |
$285.60 |
$476 |
3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$329.40 |
$549 |
3.8× |
| Radex Toe Minimum 2 Views (73660) |
$227.40 |
$379 |
2.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$309 |
$515 |
3.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$326.40 |
$544 |
3.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$560.40 |
$934 |
5.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$366 |
$610 |
3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$414.60 |
$691 |
4.0× |
| Radiologic exam colon double contrast study (74280) |
$537.60 |
$896 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$422.40 |
$704 |
2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$529.20 |
$882 |
3.0× |
| Radiologic exam knee complete 4/more views (73564) |
$429 |
$715 |
4.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$317.40 |
$529 |
3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$311.40 |
$519 |
1.8× |
| Radiologic exam swallow function contrast study (74230) |
$327.60 |
$546 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$727.20 |
$1,212 |
4.1× |
| Radiologic examination femur 1 view (73551) |
$176.40 |
$294 |
2.0× |
| Radiologic examination femur minimum 2 views (73552) |
$253.20 |
$422 |
2.9× |
| Radiologic examination knee 1/2 views (73560) |
$324.60 |
$541 |
3.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$223.80 |
$373 |
2.6× |
| Ribs bilateral 3 views (71110) |
$458.40 |
$764 |
4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,541.40 |
$2,569 |
2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,671.20 |
$4,452 |
2.1× |
| Scapula (73010) |
$324.60 |
$541 |
3.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$30 |
$50 |
1.3× |
| Shoulder 1 view (73020) |
$138 |
$230 |
1.6× |
| Skull less than 4 views (70250) |
$223.80 |
$373 |
2.1× |
| Thoracic spine 2 views (72070) |
$315.60 |
$526 |
3.0× |
| Thoracic spine 3 views (72072) |
$379.80 |
$633 |
3.6× |
| Thoracolumbar 2 views (72080) |
$261 |
$435 |
3.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$448.20 |
$747 |
1.1× |
| Thyroid Met Imaging Body (78018) |
$1,034.40 |
$1,724 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,077 |
$1,795 |
2.7× |
Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$468–$936 |
$780–$1,560 |
varies |
| Ultrasound Elastography Parenchyma (76981) |
$754.80 |
$1,258 |
7.2× |
| Ultrasound Exam Aaa Screen (76706) |
$246.60 |
$411 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$782.40 |
$1,304 |
7.5× |
| Umbilical-artery Doppler (OB) (76820) |
$337.20 |
$562 |
3.2× |
| Upper gi w/o kub (74240) |
$637.20 |
$1,062 |
3.6× |
| Urethrocystogram voiding (74455) |
$329.40 |
$549 |
1.4× |
| Urethrocystography retrograde (74450) |
$403.20 |
$672 |
1.7× |
Us breast unilateral complete (76641) range across 4 matching MRF lines |
$683.40–$1,366.80 |
$1,139–$2,278 |
varies |
| Us chest (76604) |
$514.80 |
$858 |
4.9× |
| Us complete joint (76881) |
$552.60 |
$921 |
5.3× |
| Us exam, pelvic, limited (76857) |
$450.60 |
$751 |
4.3× |
| Us head (76506) |
$289.80 |
$483 |
2.8× |
| Us kidney transplant (76776) |
$553.80 |
$923 |
5.3× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 7 matching MRF lines |
$514.80–$1,029.60 |
$858–$1,716 |
varies |
| Us ob detailed single fetus (76811) |
$1,036.20 |
$1,727 |
4.3× |
| Us ob limited 1 or more fetuses (76815) |
$450.60 |
$751 |
4.3× |
| Us ob transvaginal (76817) |
$567 |
$945 |
5.4× |
| Us pelvic non ob complete (76856) |
$770.40 |
$1,284 |
7.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$611.40 |
$1,019 |
5.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$532.20 |
$887 |
5.1× |
| Us retroperitoneal complete (76770) |
$796.80 |
$1,328 |
7.6× |
| Us retroperitoneal limited (76775) |
$440.40 |
$734 |
4.2× |
| Us scrotum and contents (76870) |
$772.20 |
$1,287 |
7.4× |
| Us spinal canal and contents (76800) |
$403.20 |
$672 |
3.9× |
| Us thyroid (76536) |
$637.80 |
$1,063 |
6.1× |
| Vein X-Ray Chest (75827) |
$1,638.60 |
$2,731 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,436.40 |
$2,394 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,608.60 |
$2,681 |
0.5× |
| Venography extremity bilateral rs&i (75822) |
$1,443.60 |
$2,406 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,352.40 |
$2,254 |
0.9× |
| Wrist 2 views (73100) |
$306.60 |
$511 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$220.20 |
$367 |
2.5× |
| X-Ray Aorta Leg Arteries (75630) |
$3,099.60 |
$5,166 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$342.60 |
$571 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$205.20 |
$342 |
2.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$478.80 |
$798 |
5.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$502.20 |
$837 |
4.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$525 |
$875 |
5.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$184.20 |
$307 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$340.80 |
$568 |
3.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$381.60 |
$636 |
3.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$415.80 |
$693 |
4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$439.20 |
$732 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$465.60 |
$776 |
4.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$622.80 |
$1,038 |
5.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$360 |
$600 |
4.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$769.20 |
$1,282 |
7.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$388.20 |
$647 |
3.7× |
| X-ray eye for foreign body (70030) |
$186.60 |
$311 |
2.1× |
| X-ray humerus (73060) |
$229.80 |
$383 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$100.80 |
$168 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$296.40 |
$494 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$362.40 |
$604 |
3.5× |
| X-ray nose-rectum child f.b. (76010) |
$223.20 |
$372 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$522.60 |
$871 |
5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$374.40 |
$624 |
3.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$247.80 |
$413 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$327 |
$545 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$355.20 |
$592 |
4.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$287.40 |
$479 |
2.7× |
| X-Ray Tmj Unilat (70328) |
$100.80 |
$168 |
1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$583.20 |
$972 |
1.7× |
| X-Rays Bone Length Studies (77073) |
$360.60 |
$601 |
3.4× |
| X-Rays Bone Survey Complete (77075) |
$511.80 |
$853 |
4.9× |
| Xr c-spine 4 or 5 views (72050) |
$488.40 |
$814 |
4.7× |
| Xr facial bones less than 3 views (70140) |
$232.80 |
$388 |
2.7× |
| Xr orbits complete 4 views (70200) |
$442.80 |
$738 |
4.2× |