3-D radiotherapy plan dose-volume histograms (77295)
range across 2 matching MRF lines |
$878.50–$2,222.50 |
$1,255–$3,175 |
varies |
| Abdomen 1 View (74018) |
$128.10 |
$183 |
1.5× |
| Abdomen 2 views (74019) |
$187.60 |
$268 |
1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$596.40 |
$852 |
1.5× |
| Angio internal mammary (75756) |
$4,018.70 |
$5,741 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$7,555.80 |
$10,794 |
2.4× |
| Angiography extremity unilateral rs&i (75710) |
$2,303 |
$3,290 |
0.7× |
| Ankle 2 views (73600) |
$151.20 |
$216 |
1.8× |
| Artery X-Rays Pelvis (75736) |
$6,372.10 |
$9,103 |
1.2× |
| Arthrogram hip (73525) |
$612.50 |
$875 |
1.8× |
| Arthrogram Wrist (73115) |
$509.60 |
$728 |
1.5× |
Basic radiation dosimetry calculation (77300)
range across 2 matching MRF lines |
$141.40–$561.40 |
$202–$802 |
varies |
| Bone age studies (77072) |
$160.30 |
$229 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$1,019.20 |
$1,456 |
2.6× |
| Bone Imaging Limited Area (78300) |
$599.90 |
$857 |
1.5× |
| Bone Imaging Whole Body (78306) |
$954.80 |
$1,364 |
2.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,142.40 |
$1,632 |
2.9× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$1,313.90 |
$1,877 |
2.4× |
| Chest 1 view (71045) |
$219.80 |
$314 |
2.6× |
| Chest 2 views (71046) |
$227.50 |
$325 |
2.6× |
| Chest 3 views (71047) |
$234.50 |
$335 |
2.7× |
| Chest 4 or more views (71048) |
$326.20 |
$466 |
3.2× |
| Clavicle complete (73000) |
$211.40 |
$302 |
2.5× |
| Continuing medical physics consltj pr wk (77336) |
$519.40 |
$742 |
3.9× |
| Contrast Exam Abdominl Aorta (75625) |
$7,555.80 |
$10,794 |
2.4× |
| Contrast X-Ray Bladder (74430) |
$469 |
$670 |
1.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$542.50 |
$775 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,246.80 |
$8,924 |
18.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,235 |
$6,050 |
17.9× |
| CT abdomen w contrast (74160) |
$2,108.40 |
$3,012 |
12.1× |
| CT abdomen w wo contrast (74170) |
$2,544.50 |
$3,635 |
14.7× |
| CT abdomen w/o contrast (74150) |
$1,820 |
$2,600 |
17.6× |
| CT Angio Abdomen and Pelvis (74174) |
$6,435.10 |
$9,193 |
18.6× |
| CT Angio Chest (71275) |
$4,103.40 |
$5,862 |
23.6× |
| CT Angio Head (70496) |
$1,596 |
$2,280 |
9.2× |
| CT angio hrt w/3d image (75574) |
$1,040.20 |
$1,486 |
3.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,989.30 |
$5,699 |
23.0× |
| CT Angio Neck (70498) |
$2,358.30 |
$3,369 |
13.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,383.90 |
$1,977 |
8.0× |
| CT cervical spine w/ contrast (72126) |
$1,991.50 |
$2,845 |
5.8× |
| CT cervical spine w/o contrast (72125) |
$1,483.30 |
$2,119 |
14.3× |
| CT cervical spine w/wo cont (72127) |
$2,837.10 |
$4,053 |
16.3× |
| CT chest w contrast (71260) |
$1,794.10 |
$2,563 |
10.3× |
| CT chest w/wo contrast (71270) |
$2,579.50 |
$3,685 |
14.9× |
| CT head/brain with contrast (70460) |
$962.50 |
$1,375 |
5.5× |
| CT head/brain without and with contrast (70470) |
$1,171.10 |
$1,673 |
6.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,073.10 |
$1,533 |
3.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$83.30 |
$119 |
1.0× |
| CT hrt w/3d image congen (75573) |
$1,087.80 |
$1,554 |
3.1× |
| CT iac w contrast (70481) |
$1,045.80 |
$1,494 |
6.0× |
| CT l-spine w&w/o contrast (72133) |
$3,455.20 |
$4,936 |
19.9× |
| CT lower ext w/o (73700) |
$1,364.30 |
$1,949 |
13.2× |
| CT lower extremity w/contrast material (73701) |
$2,524.90 |
$3,607 |
14.5× |
| CT lumbar spine w contrast (72132) |
$2,450 |
$3,500 |
7.1× |
| CT lumbar spine w/o contrast (72131) |
$1,824.20 |
$2,606 |
17.6× |
| CT maxillofacial w contrast (70487) |
$1,027.60 |
$1,468 |
5.9× |
| CT maxillofacial wo contrast (70486) |
$714 |
$1,020 |
6.9× |
| CT neck tissue combo (70492) |
$1,498 |
$2,140 |
8.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,174.60 |
$1,678 |
6.8× |
| CT orbits w/o contrast (70480) |
$687.40 |
$982 |
6.6× |
| CT pelvis w&w/o contrast (72194) |
$2,248.40 |
$3,212 |
12.9× |
| CT pelvis w/o contrast (72192) |
$1,633.10 |
$2,333 |
15.8× |
| CT scan of leg combo (73702) |
$3,058.30 |
$4,369 |
17.6× |
| CT scans face/jaw combo (70488) |
$1,356.60 |
$1,938 |
7.8× |
| CT soft tissue neck w contrast (70491) |
$1,202.60 |
$1,718 |
6.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,076.60 |
$1,538 |
10.4× |
| CT thoracic spine w contrast (72129) |
$1,128.40 |
$1,612 |
6.5× |
| CT thoracic spine w/o contrast (72128) |
$740.60 |
$1,058 |
7.2× |
| CT thoracic spine w/wo cont (72130) |
$1,264.90 |
$1,807 |
7.3× |
| CT thorax w/o contrast (71250) |
$1,541.40 |
$2,202 |
14.9× |
| CT upper ext wo (73200) |
$778.40 |
$1,112 |
7.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,330 |
$1,900 |
7.7× |
| CT upper extremity with contrast (73201) |
$1,184.40 |
$1,692 |
3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,495.40 |
$6,422 |
25.9× |
| Cta Abdomen (74175) |
$4,095 |
$5,850 |
23.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$427 |
$610 |
4.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$427 |
$610 |
4.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$311.50 |
$445 |
3.0× |
| Dxa Bone Density Axial (77080) |
$340.20 |
$486 |
3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$116.20 |
$166 |
1.3× |
| Echo exam of fetal heart (76825) |
$2,775.50 |
$3,965 |
5.1× |
| Echo exam uterus (76831) |
$722.40 |
$1,032 |
3.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$2,100 |
$3,000 |
8.9× |
| Esophageal Motility Study (78258) |
$871.50 |
$1,245 |
2.2× |
| Esophagram (74220) |
$302.40 |
$432 |
1.7× |
| Fetal Biophys Profile W/Nst (76818) |
$699.30 |
$999 |
6.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$149.10 |
$213 |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$482.30 |
$689 |
2.0× |
| Foot 2 views (73620) |
$209.30 |
$299 |
2.4× |
| Forearm 2 views (73090) |
$188.30 |
$269 |
2.2× |
| Gastric emptying imaging study (78264) |
$631.40 |
$902 |
1.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,171.10 |
$1,673 |
3.0× |
| Gated Heart Planar Single (78472) |
$1,142.40 |
$1,632 |
2.9× |
| Hand 2 views (73120) |
$150.50 |
$215 |
1.5× |
| Heart first pass single,planar (78481) |
$1,142.40 |
$1,632 |
2.1× |
| Hepatobil Syst Image W/Drug (78227) |
$1,330.70 |
$1,901 |
2.5× |
| Hepatobiliary System Imaging (78226) |
$824.60 |
$1,178 |
2.1× |
| Ht Musc Image Planar Mult (78454) |
$3,329.90 |
$4,757 |
2.6× |
| Ht Muscle Image Spect Sing (78451) |
$2,895.20 |
$4,136 |
2.3× |
| Hysterosalpingogram (74740) |
$567.70 |
$811 |
2.4× |
| K Flow/Funct Image W/Drug (78708) |
$833.70 |
$1,191 |
1.6× |
| K Flow/Funct Image W/O Drug (78707) |
$379.40 |
$542 |
0.7× |
| Knee 3 Views (73562) |
$194.60 |
$278 |
2.3× |
| Liver & Spleen Imaging Static Only (78215) |
$919.80 |
$1,314 |
2.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,016.40 |
$1,452 |
1.9× |
| Lymph System Imaging (78195) |
$318.50 |
$455 |
0.6× |
| Meckels Divert Exam (78290) |
$723.10 |
$1,033 |
1.8× |
Mlc imrt design & construction per imrt plan (77338)
range across 2 matching MRF lines |
$762.30–$1,073.80 |
$1,089–$1,534 |
varies |
| Mr safety determination physician/other qhp (76016) |
$121.10 |
$173 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$33.60 |
$48 |
1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$126 |
$180 |
1.3× |
| Mr safety implt pos&/immoblj (76019) |
$81.90 |
$117 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$331.10 |
$473 |
1.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,640.10 |
$2,343 |
4.7× |
| MRA head w/o contrast (70544) |
$1,071 |
$1,530 |
4.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,640.10 |
$2,343 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,305.50 |
$1,865 |
5.5× |
| MRI abdomen w contrast (74182) |
$1,584.10 |
$2,263 |
4.6× |
| MRI abdomen w/o contrast (74181) |
$1,421 |
$2,030 |
6.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,932 |
$2,760 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,947.40 |
$2,782 |
5.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,418.20 |
$2,026 |
1.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$158.20 |
$226 |
0.7× |
| MRI cervical spine w contrast (72142) |
$1,813.70 |
$2,591 |
5.3× |
| MRI cervical spine w/o cont (72141) |
$1,540.70 |
$2,201 |
6.5× |
| MRI chest w/o contrast (71550) |
$1,071 |
$1,530 |
4.5× |
| MRI chest wo w contrast (71552) |
$1,640.10 |
$2,343 |
4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,418.20 |
$2,026 |
4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,790.60 |
$2,558 |
5.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,169 |
$1,670 |
4.9× |
| MRI lumbar spine w contrast (72149) |
$1,868.30 |
$2,669 |
5.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,086.70 |
$2,981 |
6.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,177.40 |
$1,682 |
5.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,491.30 |
$3,559 |
7.2× |
| MRI pelvis w/o & w contrast (72197) |
$3,826.90 |
$5,467 |
11.1× |
| MRI pelvis w/o contrast (72195) |
$1,899.80 |
$2,714 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,544.20 |
$2,206 |
6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,134 |
$1,620 |
4.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,937.60 |
$2,768 |
5.6× |
| MRI, abdomen, combo (74183) |
$1,992.20 |
$2,846 |
5.8× |
| MRI, dorsal spine combo (72157) |
$3,226.30 |
$4,609 |
9.3× |
| MRI, joint upper extrem (73221) |
$1,169 |
$1,670 |
4.9× |
| MRI, joint upper extrem combo (73223) |
$1,790.60 |
$2,558 |
5.2× |
| MRI, lumbar spine combo (72158) |
$2,167.20 |
$3,096 |
6.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,895.20 |
$4,136 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,438.50 |
$2,055 |
1.1× |
| Neck soft tissue (70360) |
$211.40 |
$302 |
2.5× |
Ntsty modul radthx pln dose-vol histos (77301)
range across 2 matching MRF lines |
$2,962.40–$3,014.20 |
$4,232–$4,306 |
varies |
| Ob us nuchal meas 1 gest (76813) |
$445.20 |
$636 |
4.3× |
| Panoramic X-ray of jaws (70355) |
$182.70 |
$261 |
2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,271.50 |
$3,245 |
5.7× |
| Pelvis 1 or 2 views (72170) |
$160.30 |
$229 |
1.5× |
| PET image w/CT, full body (78816) |
$4,475.80 |
$6,394 |
3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,475.80 |
$6,394 |
3.2× |
| PET whole body (78813) |
$5,061 |
$7,230 |
3.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$518.70 |
$741 |
1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$296.80 |
$424 |
2.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$188.30 |
$269 |
2.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$184.80 |
$264 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$305.20 |
$436 |
3.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$274.40 |
$392 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$183.40 |
$262 |
2.1× |
| Radex foot complete minimum 3 views (73630) |
$240.80 |
$344 |
2.8× |
| Radex Hand Minimum 3 Views (73130) |
$202.30 |
$289 |
2.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$242.90 |
$347 |
2.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$291.20 |
$416 |
2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$221.20 |
$316 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$176.40 |
$252 |
2.0× |
| Radex shoulder complete minimum 2 views (73030) |
$189 |
$270 |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$163.10 |
$233 |
1.9× |
| Radex Spine 1 View Specify Level (72020) |
$171.50 |
$245 |
2.0× |
| Radex Sternum Minimum 2 Views (71120) |
$195.30 |
$279 |
2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$240.80 |
$344 |
2.8× |
| Radex Toe Minimum 2 Views (73660) |
$179.20 |
$256 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$166.60 |
$238 |
1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$200.20 |
$286 |
2.3× |
| Radiation treatment delivery level 1 (77402) |
$375.90 |
$537 |
3.7× |
| Radiation treatment delivery level 2 (77407) |
$398.30 |
$569 |
1.0× |
| Radiation treatment delivery level 3 (77412) |
$508.90 |
$727 |
0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$309.40 |
$442 |
3.0× |
| Radiologic exam colon double contrast study (74280) |
$744.80 |
$1,064 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$569.80 |
$814 |
3.3× |
| Radiologic exam knee complete 4/more views (73564) |
$249.90 |
$357 |
2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$220.50 |
$315 |
2.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$360.50 |
$515 |
2.1× |
| Radiologic exam swallow function contrast study (74230) |
$385 |
$550 |
2.2× |
| Radiologic exam teeth complete full mouth (70320) |
$182 |
$260 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$511.70 |
$731 |
2.9× |
| Radiologic examination femur minimum 2 views (73552) |
$153.30 |
$219 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$151.20 |
$216 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$166.60 |
$238 |
1.9× |
| Ribs bilateral 3 views (71110) |
$213.50 |
$305 |
2.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,563.10 |
$2,233 |
2.9× |
| Scapula (73010) |
$178.50 |
$255 |
1.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$85.40 |
$122 |
3.7× |
| Shoulder 1 view (73020) |
$147.70 |
$211 |
1.7× |
| Shoulder Arthrography (73040) |
$585.90 |
$837 |
1.7× |
| Skull less than 4 views (70250) |
$243.60 |
$348 |
2.4× |
Special teletherapy port plan (77321)
range across 2 matching MRF lines |
$345.80–$1,176 |
$494–$1,680 |
varies |
Special treatment procedure (77470)
range across 2 matching MRF lines |
$910.70–$2,054.50 |
$1,301–$2,935 |
varies |
| Stereotactic Body Radiation Delivery (77373) |
$7,214.90 |
$10,307 |
4.1× |
| Sternoclavicular joints (71130) |
$224.70 |
$321 |
2.6× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$334.60 |
$478 |
3.9× |
Telethx isodose pln cplx w/basic dosimetry (77307)
range across 2 matching MRF lines |
$471.10–$1,681.40 |
$673–$2,402 |
varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,837.50 |
$2,625 |
5.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,287.30 |
$1,839 |
3.5× |
Ther rad simulaj-aided field setting simple (77280)
range across 2 matching MRF lines |
$431.90–$982.10 |
$617–$1,403 |
varies |
| Thoracic spine 2 views (72070) |
$238 |
$340 |
2.3× |
| Thoracic spine 3 views (72072) |
$341.60 |
$488 |
3.3× |
| Thoracolumbar 2 views (72080) |
$248.50 |
$355 |
2.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$170.80 |
$244 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$210.70 |
$301 |
0.5× |
| Tx Devices Design & Construction Complex (77334) |
$994.70 |
$1,421 |
2.7× |
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines |
$196.70–$569.10 |
$281–$813 |
varies |
Tx devices design & construction simple (77332)
range across 2 matching MRF lines |
$134.40–$498.40 |
$192–$712 |
varies |
| Ultrasound Breast Limited (76642) |
$371 |
$530 |
4.3× |
| Ultrasound Exam Aaa Screen (76706) |
$98 |
$140 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$382.90 |
$547 |
3.7× |
| Umbilical-artery Doppler (OB) (76820) |
$311.50 |
$445 |
3.0× |
| Unlisted Dx Radiographic Procedure (76499) |
$228.20 |
$326 |
2.6× |
| Upper gi w/o kub (74240) |
$340.20 |
$486 |
2.0× |
| Urethrocystogram voiding (74455) |
$312.90 |
$447 |
1.3× |
| Urethrocystography retrograde (74450) |
$354.20 |
$506 |
1.5× |
| Us breast unilateral complete (76641) |
$427.70 |
$611 |
4.1× |
| Us chest (76604) |
$271.60 |
$388 |
2.6× |
| Us complete joint (76881) |
$427 |
$610 |
4.1× |
| Us exam, pelvic, limited (76857) |
$236.60 |
$338 |
2.3× |
| Us head (76506) |
$137.90 |
$197 |
1.3× |
| Us kidney transplant (76776) |
$409.50 |
$585 |
4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$414.40 |
$592 |
4.0× |
| Us ob detailed single fetus (76811) |
$722.40 |
$1,032 |
3.1× |
| Us ob limited 1 or more fetuses (76815) |
$205.80 |
$294 |
2.0× |
| Us ob transvaginal (76817) |
$337.40 |
$482 |
3.3× |
| Us pelvic non ob complete (76856) |
$455 |
$650 |
4.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$394.80 |
$564 |
3.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$427 |
$610 |
4.1× |
| Us retroperitoneal complete (76770) |
$552.30 |
$789 |
5.3× |
| Us retroperitoneal limited (76775) |
$479.50 |
$685 |
4.6× |
| Us scrotum and contents (76870) |
$417.90 |
$597 |
4.0× |
| Us spinal canal and contents (76800) |
$245.70 |
$351 |
2.4× |
| Us thyroid (76536) |
$460.60 |
$658 |
4.5× |
Us transrectal (76872)
range across 2 matching MRF lines |
$394.80–$414.40 |
$564–$592 |
varies |
| Venography extremity unilateral rs&i (75820) |
$2,672.60 |
$3,818 |
1.7× |
| Wrist 2 views (73100) |
$149.10 |
$213 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$273 |
$390 |
3.2× |
| X-ray antegrade pyelogram tube (74425) |
$701.40 |
$1,002 |
2.0× |
| X-Ray Aorta Leg Arteries (75630) |
$7,555.80 |
$10,794 |
2.4× |
| X-Ray Bend Only L-S Spine (72120) |
$240.80 |
$344 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$158.20 |
$226 |
1.8× |
| X-Ray Exam Breast Specimen (76098) |
$356.30 |
$509 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$290.50 |
$415 |
3.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$140.70 |
$201 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$256.20 |
$366 |
3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$337.40 |
$482 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$337.40 |
$482 |
3.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$616 |
$880 |
6.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$246.40 |
$352 |
2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$455 |
$650 |
4.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$354.90 |
$507 |
3.4× |
| X-ray humerus (73060) |
$214.90 |
$307 |
2.5× |
| X-ray IV pyelogram (ivp) (74400) |
$504.70 |
$721 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$252.70 |
$361 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$262.50 |
$375 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$168 |
$240 |
1.6× |
| X-ray nose-rectum child f.b. (76010) |
$162.40 |
$232 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$254.10 |
$363 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$247.80 |
$354 |
2.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$125.30 |
$179 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$235.90 |
$337 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$263.20 |
$376 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$273 |
$390 |
2.6× |
| X-ray thoracic spine 4 vw (72074) |
$429.10 |
$613 |
4.1× |
| X-Ray Tmj Unilat (70328) |
$209.30 |
$299 |
2.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$546 |
$780 |
1.6× |
| X-Rays Bone Length Studies (77073) |
$379.40 |
$542 |
3.7× |
| X-Rays Bone Survey Complete (77075) |
$486.50 |
$695 |
4.7× |
| Xr c-spine 4 or 5 views (72050) |
$359.80 |
$514 |
3.5× |
| Xr facial bones less than 3 views (70140) |
$223.30 |
$319 |
2.6× |
| Xr orbits complete 4 views (70200) |
$310.10 |
$443 |
3.0× |