| Acute gi blood loss imaging (78278) |
$612.80 |
$1,532 |
1.5× |
| Angio extremity unilateral (75710) |
$2,478.80 |
$6,197 |
0.8× |
| Angio pulmonary unilateral (75741) |
$1,800 |
$4,500 |
0.5× |
| Angiogram extremity bilateral (75716) |
$2,412 |
$6,030 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,600.40 |
$9,001 |
1.1× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,539.20 |
$6,348 |
0.4× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$676.80 |
$1,692 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,149.60 |
$2,874 |
0.3× |
| Ankle 2 views (73600) |
$232 |
$580 |
2.6× |
| Barium enema (74270) |
$703.60 |
$1,759 |
3.8× |
| Bone age studies (77072) |
$284.80 |
$712 |
2.6× |
| Bone imaging limited area (78300) |
$688 |
$1,720 |
1.6× |
| Bowel imaging (78290) |
$558.40 |
$1,396 |
1.3× |
| Brain image w/flow 4 + views (78606) |
$573.60 |
$1,434 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$413.60 |
$1,034 |
2.3× |
| Cisternogram (78630) |
$887.20 |
$2,218 |
1.6× |
| Clavicle complete (73000) |
$234 |
$585 |
2.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,210.40 |
$3,026 |
6.6× |
| Contrast exam abdominl aorta (75625) |
$2,028 |
$5,070 |
0.6× |
Contrast exam thoracic aorta (75605)
unusually low: confirm this is the full procedure |
$2,506.80 |
$6,267 |
0.4× |
| CT - st neck w&wo contr (70492) |
$1,446.80 |
$3,617 |
7.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,815.20 |
$9,538 |
10.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,946.40 |
$7,366 |
11.8× |
| CT abdomen w wo contrast (74170) |
$2,247.60 |
$5,619 |
12.3× |
| CT abdomen w/contrast (74160) |
$1,794.80 |
$4,487 |
9.8× |
| CT abdomen w/o contrast (74150) |
$1,294 |
$3,235 |
11.9× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$1,880.40 |
$4,701 |
5.2× |
| CT angio abdom w/o & w/dye (74175) |
$1,403.20 |
$3,508 |
7.7× |
| CT angio abdominal arteries (75635) |
$1,262.80 |
$3,157 |
6.9× |
| CT angio hrt w/3d image (75574) |
$1,458.40 |
$3,646 |
4.0× |
| CT cervical spine w/contrast (72126) |
$1,119.20 |
$2,798 |
3.1× |
| CT cervical spine w/o contrast (72125) |
$1,438.40 |
$3,596 |
13.2× |
| CT chest w/contrast (71260) |
$1,725.20 |
$4,313 |
9.4× |
| CT extremity upper w & w/o contrast (73202) |
$1,130 |
$2,825 |
6.2× |
| CT head/brain with contrast (70460) |
$1,328 |
$3,320 |
7.3× |
| CT head/brain without and with contrast (70470) |
$1,593.60 |
$3,984 |
8.7× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$622.40 |
$1,556 |
6.8× |
| CT lower ext w/wo contrast (73702) |
$1,094.40 |
$2,736 |
6.0× |
| CT lower extremity w contrast (73701) |
$1,102 |
$2,755 |
6.0× |
| CT lower extremity w/o contrast unilateral (73700) |
$923.60 |
$2,309 |
8.5× |
| CT lumbar spine w/contrast (72132) |
$1,431.20 |
$3,578 |
3.9× |
| CT lumbar spine w/o contrast (72131) |
$1,481.60 |
$3,704 |
13.6× |
| CT lumbar spine w/o then w/ con (72133) |
$1,589.20 |
$3,973 |
8.7× |
| CT maxillofacial area w/o contrast (70486) |
$1,154 |
$2,885 |
10.6× |
| CT maxillofacial w/contrast (70487) |
$1,415.20 |
$3,538 |
7.7× |
| CT maxillofacial w/o then w/ con (70488) |
$1,083.20 |
$2,708 |
5.9× |
| CT orbit sella ear w/o con (70480) |
$1,081.60 |
$2,704 |
9.9× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$1,256 |
$3,140 |
6.9× |
| CT pelvis w & w/o contrast (72194) |
$2,171.60 |
$5,429 |
11.9× |
| CT pelvis w/o contrast (72192) |
$1,508 |
$3,770 |
13.8× |
| CT soft tissue neck w/contrast (70491) |
$1,400 |
$3,500 |
7.6× |
| CT soft tissue neck w/o contrast (70490) |
$908.40 |
$2,271 |
8.3× |
| CT spine cervical w/wo contrast (72127) |
$1,429.60 |
$3,574 |
7.8× |
| CT thoracic spine w/contrast (72129) |
$1,713.20 |
$4,283 |
9.4× |
| CT thoracic spine w/o contrast (72128) |
$1,644 |
$4,110 |
15.1× |
| CT thoracic spine w/o then w/ con (72130) |
$1,530.80 |
$3,827 |
8.4× |
| CT thorax lung cancer scr c- (71271) |
$217.20 |
$543 |
2.0× |
| CT thorax w/o contrast (71250) |
$1,345.20 |
$3,363 |
12.3× |
| CT thorax w/o then w/ contrast (71270) |
$2,147.20 |
$5,368 |
11.7× |
| CT upper extremity w/dye (73201) |
$1,229.20 |
$3,073 |
3.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,044 |
$2,610 |
9.6× |
| CTA chest w/wo contrast (71275) |
$1,771.60 |
$4,429 |
9.7× |
| CTA head w contrast (70496) |
$848 |
$2,120 |
4.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,859.20 |
$4,648 |
5.1× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$984.80 |
$2,462 |
5.4× |
| Cta Neck (70498) |
$1,011.20 |
$2,528 |
5.5× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$1,044 |
$2,610 |
5.7× |
| Dilation ureters/urethra rs&i (74485) |
$863.60 |
$2,159 |
0.4× |
| Esophogram (74220) |
$448.40 |
$1,121 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$420.40 |
$1,051 |
3.9× |
| Fetal biophysical profile w/o nst (76819) |
$370 |
$925 |
3.4× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$573.60 |
$1,434 |
2.3× |
| Gastric emptying study (78264) |
$1,462.80 |
$3,657 |
3.5× |
| Gated heart planar single (78472) |
$1,002.40 |
$2,506 |
2.4× |
| Hepatobil syst image w/drug (78227) |
$1,320.40 |
$3,301 |
2.3× |
| Hepatobiliary system imaging (78226) |
$994 |
$2,485 |
2.4× |
| Humerus min 2 views (73060) |
$260 |
$650 |
2.9× |
| Hysterosalpingography (74740) |
$1,120.40 |
$2,801 |
4.5× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$196.80 |
$492 |
0.5× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$827.60 |
$2,069 |
1.5× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,015.60 |
$2,539 |
1.8× |
| Liver & spleen; static only (78215) |
$1,052.40 |
$2,631 |
2.5× |
| Lung perf&ventilat diferentl (78598) |
$1,094.80 |
$2,737 |
1.9× |
| Lung ventilat&perfus imaging (78582) |
$1,020.40 |
$2,551 |
1.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$1,900.40 |
$4,751 |
5.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$1,655.20 |
$4,138 |
4.5× |
| Mr safety determination physician/other qhp (76016) |
$84 |
$210 |
0.9× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$56.80 |
$142 |
0.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$23.20 |
$58 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$87.60 |
$219 |
0.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$230.40 |
$576 |
0.9× |
| MRA head w & w/o contrast (70546) |
$1,797.60 |
$4,494 |
4.9× |
| MRA head w/contrast (70545) |
$1,263.20 |
$3,158 |
3.5× |
| MRA head w/o contrast (70544) |
$1,241.60 |
$3,104 |
5.0× |
| MRA neck w/o contrast (70547) |
$1,153.20 |
$2,883 |
4.6× |
| MRA neck w/wo contrast (70549) |
$1,607.20 |
$4,018 |
4.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,484.80 |
$3,712 |
4.1× |
| MRI abdomen w/o contrast (74181) |
$1,094.80 |
$2,737 |
4.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,668 |
$4,170 |
2.0× |
| MRI cervical spine w/o contrast (72141) |
$1,685.20 |
$4,213 |
6.8× |
| MRI chest w & w/o contrast (71552) |
$1,841.60 |
$4,604 |
5.1× |
| MRI chest w/o contrast (71550) |
$1,446.40 |
$3,616 |
5.8× |
| MRI joint upper ext w/contrast (73222) |
$1,231.20 |
$3,078 |
1.5× |
| MRI joint upr extr w/o&w/dye (73223) |
$1,957.60 |
$4,894 |
5.4× |
| MRI joint upr extrem w/o dye (73221) |
$1,541.20 |
$3,853 |
6.2× |
| Mri Lower Extremity W/O Dye (73718) |
$1,005.20 |
$2,513 |
4.0× |
| MRI lumbar w/wo contrast (72158) |
$1,968 |
$4,920 |
5.4× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$1,565.20 |
$3,913 |
4.3× |
| MRI orbit/face/neck w/o contrast (70540) |
$1,290.40 |
$3,226 |
5.2× |
| MRI pelvis w/o contrast (72195) |
$1,392.80 |
$3,482 |
5.6× |
| MRI pelvis w/wo contrast (72197) |
$1,584.80 |
$3,962 |
4.4× |
| MRI spine cervical wo/w contrast (72156) |
$1,728 |
$4,320 |
4.7× |
| MRI thoracic spine w wo contrast (72157) |
$1,814 |
$4,535 |
5.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,688.40 |
$4,221 |
6.8× |
| MRI tmj (70336) |
$1,213.60 |
$3,034 |
4.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,005.20 |
$2,513 |
4.0× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$1,336 |
$3,340 |
3.7× |
| Myelogram thoracic (72255) |
$1,349.60 |
$3,374 |
1.6× |
| Myelography lumbosacral (72265) |
$1,394.40 |
$3,486 |
1.7× |
| Myocardial spect single study at rest or stress (78451) |
$1,792.80 |
$4,482 |
1.3× |
| Nm bone 3 phase (78315) |
$1,438 |
$3,595 |
3.4× |
| Nm bone imaging whole body (78306) |
$1,386.40 |
$3,466 |
3.3× |
| Nm bone marrow scan limited (78102) |
$441.60 |
$1,104 |
1.1× |
| Nm heart perfusion spect stress rest (78452) |
$3,248.80 |
$8,122 |
2.4× |
| Nm lymph system (78195) |
$1,719.20 |
$4,298 |
3.0× |
| Nm thyroid imaging only (78013) |
$474 |
$1,185 |
1.1× |
| Nose to rectum for fb child (76010) |
$230 |
$575 |
2.5× |
| Ob us < 14 wks single fetus (76801) |
$640.80 |
$1,602 |
5.9× |
| Oral radiopharm rx (79005) |
$1,192.40 |
$2,981 |
4.9× |
| Parathyroid imaging (78070) |
$762.80 |
$1,907 |
1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$912 |
$2,280 |
2.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,604.40 |
$6,511 |
1.7× |
| PET imaging CT for attenuation limited area (78814) |
$1,464 |
$3,660 |
1.0× |
| PET imaging for CT attenuation whole body (78816) |
$3,580.80 |
$8,952 |
2.4× |
| Pulmonary perfusion imaging particulate (78580) |
$913.20 |
$2,283 |
2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$230.40 |
$576 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$542 |
$1,355 |
6.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$595.60 |
$1,489 |
5.5× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$643.60 |
$1,609 |
5.9× |
| Radex hip unilateral with pelvis 1 view (73501) |
$328.40 |
$821 |
3.6× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$334 |
$835 |
3.7× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$374 |
$935 |
3.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$639.60 |
$1,599 |
5.9× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$636.40 |
$1,591 |
5.8× |
| Radex spine cervical 2 or 3 views (72040) |
$340 |
$850 |
3.7× |
| Radex spine cervical 4 or 5 views (72050) |
$498 |
$1,245 |
4.6× |
| Radex spine cervical 6 or more views (72052) |
$564 |
$1,410 |
5.2× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$308 |
$770 |
3.4× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$232.80 |
$582 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$537.20 |
$1,343 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$426 |
$1,065 |
2.3× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$247.20 |
$618 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$252 |
$630 |
2.8× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$490.40 |
$1,226 |
4.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$543.60 |
$1,359 |
1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$794.80 |
$1,987 |
1.9× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$1,682.40 |
$4,206 |
3.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,157.20 |
$2,893 |
2.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,090 |
$2,725 |
1.9× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$33.60 |
$84 |
1.4× |
| Shoulder arthrogram (73040) |
$633.20 |
$1,583 |
1.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$253.20 |
$633 |
2.3× |
| Small bowel series (74250) |
$564.80 |
$1,412 |
3.1× |
| Thyroid met imaging body (78018) |
$1,372.80 |
$3,432 |
2.4× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$956.40 |
$2,391 |
2.3× |
| Ultrasound breast limited (76642) |
$319.60 |
$799 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$643.20 |
$1,608 |
5.9× |
| Urethrocystography retrograde rs&i (74450) |
$434.80 |
$1,087 |
1.7× |
| Urethrocystography voiding (74455) |
$1,100.40 |
$2,751 |
4.4× |
| Urography antegrade (74425) |
$396.40 |
$991 |
1.1× |
| Urography retrograde w/wo kub (74420) |
$688.80 |
$1,722 |
1.9× |
| Us abdominal aorta real time screen study aaa (76706) |
$399.60 |
$999 |
3.7× |
| Us breast uni real time with image complete (76641) |
$426.80 |
$1,067 |
3.9× |
| Us chest (76604) |
$304.40 |
$761 |
2.8× |
| Us encephalogram (76506) |
$179.20 |
$448 |
1.6× |
| Us guided compression repair (76936) |
$466 |
$1,165 |
2.1× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$570.40 |
$1,426 |
6.3× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$465.20 |
$1,163 |
4.3× |
| Us ob followup per fetus (76816) |
$347.60 |
$869 |
3.2× |
| Us ob limited 1 or more fetuses (76815) |
$299.20 |
$748 |
2.7× |
| Us obstetric transvaginal (76817) |
$564.40 |
$1,411 |
5.2× |
| Us pelvic limited or f/u non-ob (76857) |
$324.40 |
$811 |
3.0× |
| Us pelvis complete (76856) |
$773.60 |
$1,934 |
7.1× |
| Us retroperitoneal complete (76770) |
$440.80 |
$1,102 |
4.0× |
| Us retroperitoneal limited (76775) |
$634.80 |
$1,587 |
5.8× |
| Us scrotum (76870) |
$596.80 |
$1,492 |
5.5× |
| Us soft tissue head/neck (76536) |
$552.80 |
$1,382 |
5.1× |
| Us spinal canal (76800) |
$204.40 |
$511 |
1.9× |
| Vein X-ray liver w/hemodynam (75885) |
$2,164.80 |
$5,412 |
0.7× |
| Venogram extremity bilateral (75822) |
$1,606.40 |
$4,016 |
1.0× |
| Venogram ivc w serialography (75825) |
$1,678 |
$4,195 |
0.5× |
| Venogram svc w serialography (75827) |
$1,437.60 |
$3,594 |
0.9× |
| Venography ext unilateral (75820) |
$803.20 |
$2,008 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$2,374.40 |
$5,936 |
0.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$186 |
$465 |
2.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$332.80 |
$832 |
3.7× |
| X-ray aorta leg arteries (75630) |
$1,664.80 |
$4,162 |
0.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$599.20 |
$1,498 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$260 |
$650 |
2.9× |
| X-ray exam hips bi 3-4 views (73522) |
$537.20 |
$1,343 |
4.9× |
| X-ray exam of finger(s) (73140) |
$198 |
$495 |
2.2× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$242.40 |
$606 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$241.60 |
$604 |
2.7× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$212.80 |
$532 |
1.9× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$281.20 |
$703 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$234.80 |
$587 |
2.6× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$261.20 |
$653 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$289.60 |
$724 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$148.80 |
$372 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$381.60 |
$954 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$655.20 |
$1,638 |
6.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$296.40 |
$741 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$336.80 |
$842 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$298.80 |
$747 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$276 |
$690 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$289.20 |
$723 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$440 |
$1,100 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$477.60 |
$1,194 |
4.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$208.80 |
$522 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$125.60 |
$314 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$162.40 |
$406 |
1.8× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$249.60 |
$624 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$244.40 |
$611 |
2.7× |
| Xr abdomen 1 view (74018) |
$274.80 |
$687 |
3.0× |
| Xr abdomen 2 views (74019) |
$258.40 |
$646 |
2.4× |
| Xr abdomen 3 views (74021) |
$351.60 |
$879 |
3.2× |
| Xr bone density axial (77080) |
$390.80 |
$977 |
3.6× |
| Xr bone length study (77073) |
$203.20 |
$508 |
1.9× |
| Xr bone survey infant (77076) |
$252 |
$630 |
2.3× |
| Xr bone survey limited (77074) |
$331.60 |
$829 |
3.0× |
| Xr chest 1 view (71045) |
$218.40 |
$546 |
2.4× |
| Xr chest 2 views (71046) |
$307.60 |
$769 |
3.4× |
| Xr chest 3 views (71047) |
$294.80 |
$737 |
3.2× |
| Xr cystogram 3+ views (74430) |
$398.80 |
$997 |
1.1× |
| Xr eye foreign body (70030) |
$232.40 |
$581 |
2.6× |
| Xr facial bones 3 views (70150) |
$384.40 |
$961 |
3.5× |
| Xr lower extremity 2 views infant (73592) |
$124.80 |
$312 |
1.4× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$208.80 |
$522 |
1.9× |
| Xr mandible 4 views (70110) |
$380.80 |
$952 |
3.5× |
| Xr myelogram c-spine (72240) |
$1,394.40 |
$3,486 |
1.7× |
| Xr nasal bones (70160) |
$260 |
$650 |
2.9× |
| Xr spine 1 view (72020) |
$186 |
$465 |
2.0× |
| Xr sternum 2 views (71120) |
$331.60 |
$829 |
3.6× |
| Xr surgical specimen (76098) |
$410 |
$1,025 |
0.7× |
| Xr upper extremity 2 views infant (73092) |
$174.40 |
$436 |
1.6× |
| Xray elbow 2 views (73070) |
$212.80 |
$532 |
2.3× |
| Xray forearm 2 views (73090) |
$238.40 |
$596 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$269.20 |
$673 |
3.0× |
| Xray neck soft tissue (70360) |
$276 |
$690 |
3.0× |
| Xray orbits complete min 4 views (70200) |
$462.40 |
$1,156 |
4.2× |
| Xray pelvis 1 or 2 views (72170) |
$279.60 |
$699 |
2.6× |
| Xray ribs bilateral 3 views (71110) |
$340 |
$850 |
3.1× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$272 |
$680 |
2.5× |
| Xray scapula complete (73010) |
$295.60 |
$739 |
2.7× |
| Xray shoulder 1 view (73020) |
$273.20 |
$683 |
3.0× |
| Xray sinuses paranasal <3 views (70210) |
$189.60 |
$474 |
2.1× |
| Xray spine thoracic 2 views (72070) |
$377.20 |
$943 |
3.5× |
| Xray tibia-fibula 2 views bil (73590) |
$254 |
$635 |
2.8× |