| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,673.20 |
$11,683 |
3.2× |
| Abdomen 2 views (74019) |
$258.80 |
$647 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,054 |
$2,635 |
2.5× |
| Angiography extremity bilateral rs&i (75716) |
$3,100.80 |
$7,752 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,837.60 |
$7,094 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,709.20 |
$9,273 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,156.40 |
$5,391 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$3,538.40 |
$8,846 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,403.20 |
$11,008 |
0.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,758 |
$4,395 |
0.5× |
| Ankle 2 views (73600) |
$209.76 |
$524.40 |
2.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$713.52 |
$1,783.80 |
1.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,644 |
$6,610 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,479.20 |
$6,198 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$416.40 |
$1,041 |
2.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$843.85 |
$2,109.61 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$1,212.40 |
$3,031 |
2.9× |
| Bone age studies (77072) |
$130.96 |
$327.40 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$1,353.60 |
$3,384 |
3.2× |
| Bone survey complete (77075) |
$589.48 |
$1,473.70 |
5.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,667.49 |
$11,668.72 |
3.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,113.84 |
$2,784.60 |
1.9× |
| Cervical spine 2 or 3 views (72040) |
$231.84 |
$579.60 |
2.5× |
| Chest 1 view (71045) |
$128 |
$320 |
1.4× |
| Chest 3 views (71047) |
$267.08 |
$667.70 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$406.80 |
$1,017 |
2.2× |
| Clavicle complete (73000) |
$222.48 |
$556.20 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$412 |
$1,030 |
3.7× |
| Continuing medical physics consltj pr wk (77336) |
$578.40 |
$1,446 |
4.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,322.40 |
$8,306 |
9.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,502.40 |
$6,256 |
9.9× |
| CT abdomen w contrast (74160) |
$1,733.60 |
$4,334 |
9.4× |
| CT abdomen w wo contrast (74170) |
$2,159.60 |
$5,399 |
11.7× |
| CT abdomen w/o contrast (74150) |
$1,526.80 |
$3,817 |
13.8× |
| CT angio hrt w/3d image (75574) |
$1,481.20 |
$3,703 |
4.0× |
| CT angiography upper extremity lt (73206) |
$1,463.20 |
$3,658 |
7.9× |
| CT c-spine w/o contrast (72125) |
$1,472.80 |
$3,682 |
13.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,299.55 |
$3,248.87 |
7.0× |
| CT cervical spine with contrast (72126) |
$1,652.80 |
$4,132 |
4.5× |
| CT chest w/wo contrast (71270) |
$1,703.20 |
$4,258 |
9.2× |
| CT chest with contrast (71260) |
$1,581.20 |
$3,953 |
8.5× |
| CT head/brain with contrast (70460) |
$1,378.40 |
$3,446 |
7.4× |
| CT head/brain without and with contrast (70470) |
$1,647.60 |
$4,119 |
8.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$254.92 |
$637.30 |
2.8× |
| CT iac w contrast (70481) |
$1,718 |
$4,295 |
9.3× |
| CT lower ext w/o (73700) |
$1,933.20 |
$4,833 |
17.5× |
| CT lower extremity w wo contrast (73702) |
$1,588 |
$3,970 |
8.6× |
| CT lower extremity with contrast (73701) |
$1,456 |
$3,640 |
7.9× |
| CT lumbar spine w/o contrast (72131) |
$1,514.80 |
$3,787 |
13.7× |
| CT lumbar spine with contrast (72132) |
$1,689.60 |
$4,224 |
4.6× |
| CT maxillofacial w contrast (70487) |
$1,587.20 |
$3,968 |
8.6× |
| CT maxillofacial w/o contrast (70486) |
$1,238.40 |
$3,096 |
11.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,299.55 |
$3,248.87 |
7.0× |
| CT neck soft tissue w contrast (70491) |
$1,524.80 |
$3,812 |
8.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,729.76 |
$4,324.40 |
9.3× |
| CT orbits w/o contrast (70480) |
$1,442.80 |
$3,607 |
13.1× |
| CT pelvis w & w/o contrast (72194) |
$1,806.56 |
$4,516.40 |
9.8× |
| CT pelvis w/o contrast (72192) |
$1,558.44 |
$3,896.10 |
14.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,687.60 |
$4,219 |
9.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,461.60 |
$3,654 |
13.3× |
| CT thoracic spine w/contrast (72129) |
$1,550.16 |
$3,875.40 |
8.4× |
| CT thoracic spine w/o contrast (72128) |
$1,527.20 |
$3,818 |
13.8× |
| CT thorax w/o contrast (71250) |
$1,411.20 |
$3,528 |
12.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,618 |
$4,045 |
8.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,182.40 |
$2,956 |
10.7× |
| CT upper extremity with contrast (73201) |
$1,480 |
$3,700 |
4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,165.20 |
$5,413 |
11.7× |
| Cta Abdomen (74175) |
$1,984.80 |
$4,962 |
10.7× |
| CTA abdomen pelvis (74174) |
$3,781.20 |
$9,453 |
10.3× |
| CTA chest (71275) |
$1,988 |
$4,970 |
10.7× |
| Cta Head (70496) |
$1,716.80 |
$4,292 |
9.3× |
| CTA lwr ext w&w/o contrast (73706) |
$2,003.60 |
$5,009 |
10.8× |
| Cta Neck (70498) |
$1,713.60 |
$4,284 |
9.3× |
| Cta Pelvis (72191) |
$1,983.60 |
$4,959 |
10.7× |
| Cystography minimum 3 views rs&i (74430) |
$613.92 |
$1,534.80 |
1.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$340.36 |
$850.90 |
3.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$119.17 |
$297.92 |
1.3× |
| Echoencephalography real time imaging (76506) |
$333.72 |
$834.30 |
3.0× |
| Esophagus (74220) |
$487.60 |
$1,219 |
2.6× |
| Fetal biophysical profile non-stress testing (76818) |
$335.20 |
$838 |
3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$366.80 |
$917 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$429.20 |
$1,073 |
1.7× |
| Foot 2 views (73620) |
$199.56 |
$498.90 |
2.2× |
| Forearm 2 views (73090) |
$223.76 |
$559.40 |
2.4× |
| Gated Heart Planar Single (78472) |
$1,214.71 |
$3,036.77 |
2.9× |
| Hand 2 views (73120) |
$194 |
$485 |
1.8× |
| Hand 3 views (73130) |
$241.64 |
$604.10 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,643.04 |
$4,107.60 |
2.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,050.80 |
$5,127 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,526.40 |
$3,816 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,352.60 |
$3,381.50 |
3.2× |
| Ht muscle image spect sing (78451) |
$2,741.51 |
$6,853.77 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$224.56 |
$561.40 |
2.4× |
| Hysterosalpingogram (74740) |
$464.52 |
$1,161.30 |
1.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$833.20 |
$2,083 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,264.80 |
$3,162 |
2.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,251.12 |
$3,127.80 |
2.2× |
| Knee 3 views (73562) |
$255.32 |
$638.30 |
2.8× |
| Liver & spleen imaging static only (78215) |
$836.20 |
$2,090.50 |
2.0× |
| Lung perf&ventilat diferentl (78598) |
$1,898.44 |
$4,746.10 |
3.3× |
| Lymphoscintigraphy (78195) |
$1,270.76 |
$3,176.90 |
2.2× |
| Mammary ductogram or galactogram multiple (77054) |
$96.26 |
$240.65 |
0.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,546.40 |
$3,866 |
3.9× |
| MRA head w & w/o contrast (70546) |
$2,773.60 |
$6,934 |
7.5× |
| MRA head w/o contrast (70544) |
$2,241.20 |
$5,603 |
8.9× |
| MRA head with contrast (70545) |
$2,372 |
$5,930 |
6.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,294.80 |
$8,237 |
9.0× |
| MRA neck w/o contrast (70547) |
$1,958 |
$4,895 |
7.8× |
| MRI abdomen w contrast (74182) |
$1,924 |
$4,810 |
5.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,519.60 |
$6,299 |
6.8× |
| MRI abdomen w/o contrast (74181) |
$1,740.40 |
$4,351 |
6.9× |
| MRI any jnt lwr ext with con lt (73722) |
$1,789.20 |
$4,473 |
2.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,700.40 |
$4,251 |
2.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,529.32 |
$3,823.30 |
6.1× |
| MRI c-spine with contrast (72142) |
$2,264.40 |
$5,661 |
6.2× |
| MRI cervical spine w/o contrast (72141) |
$1,960 |
$4,900 |
7.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,930 |
$7,325 |
8.0× |
| MRI chest w/o contrast (71550) |
$1,600 |
$4,000 |
6.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,710.47 |
$4,276.17 |
4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,025.36 |
$5,063.40 |
5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,563.20 |
$3,908 |
6.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,768.80 |
$4,422 |
7.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,724.40 |
$6,811 |
7.4× |
| MRI pelvis w contrast (72196) |
$2,330.84 |
$5,827.10 |
6.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,930 |
$7,325 |
8.0× |
| MRI pelvis w/o contrast (72195) |
$2,175.60 |
$5,439 |
8.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,982.40 |
$4,956 |
5.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,911.20 |
$4,778 |
5.2× |
| MRI spectroscopy (76390) |
$1,793.20 |
$4,483 |
19.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,552.40 |
$6,381 |
6.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,377.60 |
$5,944 |
6.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,672.80 |
$6,682 |
7.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,243.60 |
$5,609 |
6.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,648 |
$6,620 |
7.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,095.60 |
$5,239 |
8.3× |
| MRI tmj (70336) |
$1,985.76 |
$4,964.40 |
7.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,400.40 |
$3,501 |
5.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,386 |
$5,965 |
6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,563.20 |
$3,908 |
6.2× |
| Myelogram Cervical (72240) |
$1,580.12 |
$3,950.30 |
1.9× |
| Myelogram Lumbar (72265) |
$1,580.12 |
$3,950.30 |
1.9× |
| Myelogram thoracic (72255) |
$1,580.12 |
$3,950.30 |
1.9× |
| Myelography 2 or more regions (72270) |
$1,580.12 |
$3,950.30 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,175.84 |
$7,939.60 |
2.3× |
| Neck soft tissue (70360) |
$216.32 |
$540.80 |
2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$843.85 |
$2,109.61 |
2.0× |
| Nm gastric emptying study (78264) |
$1,263.52 |
$3,158.80 |
3.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,224 |
$10,560 |
2.9× |
| Nuclear Rx Oral Admin (79005) |
$1,253.16 |
$3,132.90 |
5.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$287.68 |
$719.20 |
2.6× |
| Osseous survey infant (77076) |
$186.20 |
$465.50 |
1.7× |
| Parathyrd planar w/spect&CT (78072) |
$589.68 |
$1,474.20 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$816.44 |
$2,041.10 |
1.9× |
| Parathyroid imaging (78070) |
$937.16 |
$2,342.90 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$199.52 |
$498.80 |
1.8× |
| PET image w/CT, skull-thigh (78815) |
$3,993.20 |
$9,983 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$4,608 |
$11,520 |
3.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,386 |
$5,965 |
6.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$914.40 |
$2,286 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,625.48 |
$4,063.70 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,035.42 |
$2,588.53 |
1.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$52.40 |
$131 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$381.28 |
$953.20 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$224 |
$560 |
2.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$212.68 |
$531.70 |
1.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$762.80 |
$1,907 |
1.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$433.04 |
$1,082.60 |
4.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,529.32 |
$3,823.30 |
3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$310.36 |
$775.90 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$205.28 |
$513.20 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$26.99 |
$67.47 |
0.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$204 |
$510 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$538.40 |
$1,346 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$555.76 |
$1,389.40 |
3.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$468 |
$1,170 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$205.20 |
$513 |
2.2× |
| Radiological examination surgical specimen (76098) |
$410.80 |
$1,027 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,740.80 |
$9,352 |
1.1× |
| Ribs bilateral 3 views (71110) |
$302.08 |
$755.20 |
2.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,414.40 |
$3,536 |
2.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,741.51 |
$6,853.77 |
2.0× |
| Rp Therapy Intravenous Administration (79101) |
$470.68 |
$1,176.68 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$180.80 |
$452 |
1.6× |
| Scanogram (77073) |
$228.72 |
$571.80 |
2.1× |
| Scapula complete (73010) |
$224.44 |
$561.10 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$117.88 |
$294.70 |
5.0× |
| Small bowel series (74250) |
$477.64 |
$1,194.10 |
2.6× |
| Spec medical radj physics consltj (77370) |
$573.20 |
$1,433 |
4.0× |
| Special dosimetry (77331) |
$554.80 |
$1,387 |
3.9× |
| Spine thoracic 3 views (72072) |
$268.80 |
$672 |
2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,124.80 |
$2,812 |
2.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,580.40 |
$3,951 |
4.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$874 |
$2,185 |
6.2× |
| Thoracolumbar 2 views (72080) |
$230 |
$575 |
2.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,272 |
$3,180 |
2.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$461.04 |
$1,152.60 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$881 |
$2,202.50 |
2.1× |
| Tomogram (76100) |
$366.12 |
$915.30 |
3.3× |
| Treatment device intermediate (77333) |
$451.42 |
$1,128.55 |
3.2× |
| Treatment devices simple (77332) |
$440.40 |
$1,101 |
3.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,443.88 |
$6,109.70 |
4.3× |
| Tx devices design & construction complex (77334) |
$944.40 |
$2,361 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$383 |
$957.50 |
3.5× |
| Umbilical-artery Doppler (OB) (76820) |
$188.60 |
$471.50 |
1.7× |
| Unlisted magnetic resonance procedure (76498) |
$2,664.56 |
$6,661.38 |
29.0× |
| Upper Extremity Infant (73092) |
$47.58 |
$118.95 |
0.4× |
| Urethrocystography retrograde rs&i (74450) |
$69.22 |
$173.05 |
0.3× |
| Urethrocystography voiding (74455) |
$722 |
$1,805 |
2.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$65.58 |
$163.95 |
0.4× |
| Us abdl aorta screen aaa (76706) |
$366.88 |
$917.20 |
3.3× |
| Us breast unilateral complete (76641) |
$447.28 |
$1,118.20 |
4.1× |
| Us breast unilateral limited (76642) |
$319.44 |
$798.60 |
3.5× |
| Us chest (76604) |
$420 |
$1,050 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$532.80 |
$1,332 |
4.8× |
| Us infant hips dynamic (76885) |
$259.92 |
$649.80 |
2.8× |
| Us infant hips limited static (76886) |
$281.76 |
$704.40 |
3.1× |
| Us kidney transplant (76776) |
$485.60 |
$1,214 |
4.4× |
| Us ob transvaginal (76817) |
$346.40 |
$866 |
3.1× |
| Us pelvic non ob complete (76856) |
$547.12 |
$1,367.80 |
5.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$325.74 |
$814.36 |
3.0× |
| Us pregnancy ltd (76815) |
$339.22 |
$848.05 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$376.08 |
$940.20 |
3.4× |
| Us retroperitoneal complete (76770) |
$572.24 |
$1,430.60 |
5.2× |
| Us retroperitoneal limited (76775) |
$366.64 |
$916.60 |
3.3× |
| Us scrotum and contents (76870) |
$444 |
$1,110 |
4.0× |
| Us soft tissue head/neck (76536) |
$445.16 |
$1,112.90 |
4.0× |
| Us spinal canal and contents (76800) |
$436.96 |
$1,092.40 |
4.0× |
| Us xtr non-vasc lmtd (76882) |
$254.28 |
$635.70 |
2.3× |
| Us, eye b-scan (76512) |
$335.20 |
$838 |
3.0× |
| Venogram extremity bilateral (75822) |
$1,576.24 |
$3,940.60 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,630.56 |
$6,576.40 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$1,676.40 |
$4,191 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,252.80 |
$3,132 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,630.56 |
$6,576.40 |
0.8× |
| Wrist 2 views (73100) |
$209.68 |
$524.20 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$372.12 |
$930.30 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$224.44 |
$561.10 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$234.12 |
$585.30 |
2.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$695.04 |
$1,737.60 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$210.24 |
$525.60 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$247.44 |
$618.60 |
2.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$418.88 |
$1,047.20 |
3.8× |
| X-ray exam hip uni 1 view (73501) |
$184.40 |
$461 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$210.40 |
$526 |
2.3× |
| X-ray exam hip uni 4/> views (73503) |
$274.44 |
$686.10 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$310.80 |
$777 |
2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$343.20 |
$858 |
3.1× |
| X-ray exam of femur 1 (73551) |
$170.48 |
$426.20 |
1.9× |
| X-ray eye for foreign body (70030) |
$170 |
$425 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$307.68 |
$769.20 |
2.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$232.16 |
$580.40 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$233.60 |
$584 |
2.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$225.24 |
$563.10 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$260 |
$650 |
2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$204.36 |
$510.90 |
2.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$125.08 |
$312.70 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$277.36 |
$693.40 |
2.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$436 |
$1,090 |
4.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$317.56 |
$793.90 |
2.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$222.48 |
$556.20 |
2.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$199.20 |
$498 |
2.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$303.92 |
$759.80 |
2.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$283.72 |
$709.30 |
2.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$652.33 |
$1,630.82 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$288.20 |
$720.50 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$340.56 |
$851.40 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$409.64 |
$1,024.10 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$270.52 |
$676.30 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$231.12 |
$577.80 |
2.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$245.44 |
$613.60 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$274.84 |
$687.10 |
3.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$191.36 |
$478.40 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$367.60 |
$919 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$229.20 |
$573 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$214.24 |
$535.60 |
2.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$173.16 |
$432.90 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$246.12 |
$615.30 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$241.60 |
$604 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$209.50 |
$523.75 |
1.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$201.40 |
$503.50 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$243.08 |
$607.70 |
2.6× |
| Xr c-spine 6 or more views (72052) |
$408.36 |
$1,020.90 |
3.7× |
| Xr finger(s) 2+ views (73140) |
$181.08 |
$452.70 |
2.0× |
| Xr shoulder 1 view (73020) |
$195.84 |
$489.60 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$294.24 |
$735.60 |
2.7× |
| Xr tibia/fibula 2 views (73590) |
$231.36 |
$578.40 |
2.5× |
| Xr tmj bilateral (70330) |
$309.48 |
$773.70 |
3.4× |
| Xray knee 1 or 2 views rt (73560) |
$213.80 |
$534.50 |
2.3× |