| Acute gi blood loss imaging (78278) |
$1,293.06 |
$1,786 |
3.2× |
| Ankle 2 views (73600) |
$200.60 |
$265 |
2.3× |
| Clavicle complete (73000) |
$267.98 |
$354 |
3.0× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$2,298.70 |
$3,346 |
6.4× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$1,475.68 |
$2,148 |
8.2× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,926.62 |
$2,987 |
10.8× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,643.99 |
$2,393 |
9.2× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,773.83 |
$2,582 |
9.9× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,673.78 |
$2,595 |
9.3× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$3,228.21 |
$4,699 |
18.0× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$2,449.84 |
$3,566 |
13.7× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Age Under 21 (77078) |
$446.55 |
$650 |
5.0× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$3,052.34 |
$4,443 |
17.0× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,125.99 |
$1,639 |
10.5× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$1,689.33 |
$2,459 |
9.4× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$3,221.34 |
$4,689 |
18.0× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,980.15 |
$3,070 |
11.0× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,584.12 |
$2,456 |
14.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,971.77 |
$3,057 |
11.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,577.03 |
$2,445 |
14.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,365.86 |
$3,668 |
13.2× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,593.80 |
$2,471 |
8.9× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$3,246.08 |
$4,725 |
18.1× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$1,565.67 |
$2,279 |
8.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,188.78 |
$3,186 |
6.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,459.19 |
$2,124 |
6.0× |
| CT abdomen w & w/o contrast (74170) |
$1,404.92 |
$2,045 |
7.8× |
| CT abdomen w/contrast (74160) |
$1,170.65 |
$1,704 |
6.5× |
| CT abdomen w/o contrast (74150) |
$936.38 |
$1,363 |
8.8× |
| CT cervical spine w/contrast (72126) |
$2,543.96 |
$3,703 |
7.1× |
| CT cervical spine w/o contrast (72125) |
$2,034.89 |
$2,962 |
19.1× |
| CT chest w/contrast (71260) |
$1,304.61 |
$1,899 |
7.3× |
| CT extremity upper w & w/o contrast (73202) |
$2,333.05 |
$3,396 |
13.0× |
| CT extremity upper w/o contrast (73200) |
$1,555.37 |
$2,264 |
14.6× |
| CT head/brain with contrast (70460) |
$1,208.73 |
$1,874 |
6.7× |
| CT head/brain without and with contrast (70470) |
$1,450.61 |
$2,249 |
8.1× |
| CT l-spine w/contrast (72132) |
$2,684.80 |
$3,908 |
7.5× |
| CT limited/localized follow up study (76380) |
$640.48 |
$993 |
7.2× |
| CT lower extremity w/dye (73701) |
$1,407.66 |
$2,049 |
7.9× |
| CT lumbar spine w/o contrast (72131) |
$2,147.56 |
$3,126 |
20.1× |
| CT maxillofacial w/wo contrast (70488) |
$2,376.18 |
$3,684 |
13.3× |
| CT neck w/contrast (70491) |
$1,328.06 |
$2,059 |
7.4× |
| CT neck w/o contrast (70490) |
$1,062.32 |
$1,647 |
9.9× |
| CT pelvis w & w/o contrast (72194) |
$3,074.33 |
$4,475 |
17.2× |
| CT pelvis w/o contrast (72192) |
$2,049.32 |
$2,983 |
19.2× |
| CT thoracic spine w/contrast (72129) |
$2,705.41 |
$3,938 |
15.1× |
| CT thoracic spine w/o contrast (72128) |
$2,164.05 |
$3,150 |
20.3× |
| CT thorax lung cancer scr c- (71271) |
$377.16 |
$549 |
3.5× |
| CT thorax w/o contrast (71250) |
$1,043.55 |
$1,519 |
9.8× |
| CT upper extremity w/dye (73201) |
$1,944.21 |
$2,830 |
5.5× |
| CTA head w contrast (70496) |
$1,523.49 |
$2,362 |
8.5× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$408.02 |
$539 |
1.1× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete Age Under 21 (76827) |
$439.62 |
$510 |
4.1× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$343.68 |
$454 |
3.2× |
| Dxa bone density study axial skeleton (77085) |
$383.80 |
$507 |
3.6× |
| Dxa bone density/peripheral (77081) |
$358.06 |
$473 |
4.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76825) |
$930.96 |
$1,080 |
1.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$428.41 |
$497 |
1.8× |
| Fetal biophys profile w/o nst (76819) |
$673.22 |
$781 |
6.3× |
| Fetal biophysical profile non-stress testing (76818) |
$730.98 |
$848 |
6.8× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$567.75 |
$750 |
2.3× |
| Gastroesophageal reflux study (78262) |
$887.62 |
$1,226 |
2.2× |
| Gated heart planar single (78472) |
$1,375.60 |
$1,900 |
3.4× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,875.88 |
$2,591 |
3.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,369.81 |
$1,892 |
3.4× |
| Ht muscle image spect sing (78451) |
$2,986.50 |
$4,125 |
2.3× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$1,228.63 |
$1,697 |
3.0× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$758.03 |
$1,047 |
1.4× |
| Liver and spleen imaging (78215) |
$1,045.46 |
$1,444 |
2.6× |
| Lung perf&ventilat diferentl (78598) |
$1,125.10 |
$1,554 |
2.0× |
| Lung perfusion imaging (78580) |
$833.32 |
$1,151 |
2.0× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$2,728.18 |
$3,585 |
7.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,690.94 |
$2,222 |
4.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,352.30 |
$1,777 |
5.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$2,028.83 |
$2,666 |
5.7× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$2,834.64 |
$3,720 |
8.0× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$2,267.71 |
$2,976 |
9.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$2,206.90 |
$2,900 |
6.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,648.28 |
$3,480 |
7.4× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$1,700.66 |
$2,649 |
4.8× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$2,040.92 |
$3,179 |
5.7× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$3,538.06 |
$5,511 |
9.9× |
| Mandible min 4v (70110) |
$376.23 |
$497 |
3.5× |
| Mr safety determination physician/other qhp (76016) |
$100.68 |
$133 |
1.1× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$236.94 |
$313 |
3.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$28.77 |
$38 |
1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$155.18 |
$205 |
1.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$368.66 |
$487 |
1.5× |
| MRA head w/o contrast (70544) |
$1,360.40 |
$2,119 |
5.6× |
| MRA neck w/ contrast (70548) |
$2,948.71 |
$4,593 |
8.3× |
| MRA neck w/o contrast (70547) |
$2,358.71 |
$3,674 |
9.7× |
| MRI abdomen w/contrast (74182) |
$3,028.78 |
$3,980 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$2,423.02 |
$3,184 |
9.9× |
| MRI abdomen w/wo contrast (74183) |
$3,634.54 |
$4,776 |
10.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,273.87 |
$2,988 |
2.8× |
| MRI c-spine w&w/o cont (72156) |
$1,762.91 |
$2,604 |
4.9× |
| MRI cervical spine w/contrast (72142) |
$1,469.09 |
$2,170 |
4.1× |
| MRI chest w/contrast (71551) |
$2,745.69 |
$3,608 |
3.4× |
| MRI chest w/o contrast (71550) |
$2,196.25 |
$2,886 |
9.0× |
| MRI chest w/wo contrast (71552) |
$3,294.37 |
$4,329 |
9.2× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,168.09 |
$2,849 |
6.1× |
| MRI joint upr extrem w/dye (73222) |
$1,806.61 |
$2,374 |
2.3× |
| MRI joint upr extrem w/o dye (73221) |
$1,445.14 |
$1,899 |
5.9× |
| MRI lumbar spine w/contrast (72149) |
$1,469.09 |
$2,170 |
4.1× |
| MRI lumbar spine w/wo contrast (72158) |
$1,762.91 |
$2,604 |
4.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,401.57 |
$4,464 |
9.5× |
| MRI pelvis w & w/o contrast (72197) |
$2,359.86 |
$3,101 |
6.6× |
| MRI pelvis w/contrast (72196) |
$1,966.42 |
$2,584 |
5.5× |
| MRI pelvis w/o contrast (72195) |
$1,572.99 |
$2,067 |
6.5× |
| MRI spine cervical w/o contrast (72141) |
$1,175.27 |
$1,736 |
4.8× |
| MRI t-spine w&w/o cont (72157) |
$1,762.91 |
$2,604 |
4.9× |
| MRI thoracic spine w/contrast (72147) |
$1,469.09 |
$2,170 |
4.1× |
| MRI thoracic spine w/o contrst (72146) |
$1,175.27 |
$1,736 |
4.8× |
| MRI tmj (70336) |
$2,356.82 |
$3,097 |
9.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,765.52 |
$2,320 |
7.2× |
| Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first… (78453) |
$1,961.32 |
$2,709 |
1.5× |
| Myocardial spect multiple studies (78452) |
$3,858.20 |
$5,329 |
2.9× |
| Nm bone 3 phase (78315) |
$2,007.65 |
$2,773 |
4.9× |
| Nm bone imaging whole body (78306) |
$1,746.29 |
$2,412 |
4.3× |
| Nm gastric emptying (78264) |
$1,555.15 |
$2,148 |
3.8× |
| Nm lung ventilation imaging (78579) |
$590.78 |
$816 |
1.4× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$812.33 |
$1,122 |
2.0× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$964.37 |
$1,332 |
2.4× |
| Ob us limited fetus(s) (76815) |
$460.31 |
$534 |
4.3× |
| Parathyroid planar imaging (78070) |
$833.32 |
$1,151 |
2.0× |
| Pulmonary ventilation & perfusion imaging (78582) |
$1,319.13 |
$1,822 |
2.4× |
| Quant differential pulm perfusion w/wo imaging (78597) |
$687.80 |
$950 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$541.26 |
$715 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$262.68 |
$347 |
3.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$376.99 |
$498 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$428.46 |
$566 |
4.0× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$444.36 |
$587 |
4.2× |
| Radex hip unilateral with pelvis 1 view (73501) |
$167.30 |
$221 |
1.9× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$314.16 |
$415 |
3.5× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$392.88 |
$519 |
3.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$206.66 |
$273 |
1.9× |
| Radex spine cervical 2 or 3 views (72040) |
$355.79 |
$470 |
4.0× |
| Radex spine cervical 4 or 5 views (72050) |
$489.78 |
$647 |
4.6× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$198.33 |
$262 |
2.2× |
| Radiologic exam abdomen 3+ views (74021) |
$322.48 |
$426 |
3.0× |
| Radiologic exam chest 3 views (71047) |
$342.72 |
$476 |
3.9× |
| Radiologic exam chest 4+ views (71048) |
$387.36 |
$538 |
3.6× |
| Radiologic exam colon double contrast study (74280) |
$766.84 |
$1,013 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$691.14 |
$913 |
3.9× |
| Radiologic exam esophagus single contrast study (74220) |
$330.81 |
$437 |
1.8× |
| Radiologic exam small int single contrast study (74250) |
$456.47 |
$603 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$465.56 |
$615 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$669.19 |
$884 |
3.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$504.16 |
$666 |
2.8× |
| Radiologic examination femur 1 view (73551) |
$140.80 |
$186 |
1.6× |
| Radiologic examination femur minimum 2 views (73552) |
$208.93 |
$276 |
2.3× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$102.95 |
$136 |
1.2× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$356.55 |
$471 |
4.0× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$373.20 |
$493 |
3.5× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$295.23 |
$390 |
3.3× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$364.12 |
$481 |
4.1× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$296.74 |
$392 |
3.3× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$336.11 |
$444 |
3.8× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$269.49 |
$356 |
3.0× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$398.18 |
$526 |
4.5× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$442.85 |
$585 |
4.1× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$355.79 |
$470 |
4.0× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$248.30 |
$328 |
2.3× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$260.41 |
$344 |
2.9× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$424.68 |
$561 |
4.0× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$337.62 |
$446 |
3.2× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$783.69 |
$918 |
2.2× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$336.11 |
$444 |
3.8× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Age Under 21 (76100) |
$373.20 |
$493 |
3.5× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$209.69 |
$277 |
2.4× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$311.13 |
$411 |
2.9× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$283.88 |
$375 |
2.7× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$555.64 |
$734 |
5.2× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$644.96 |
$852 |
6.0× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$445.12 |
$588 |
4.2× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$334.59 |
$442 |
3.8× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$285.39 |
$377 |
3.2× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$324 |
$428 |
3.6× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$140.80 |
$186 |
1.6× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$278.58 |
$368 |
3.1× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$194.55 |
$257 |
2.2× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$266.46 |
$352 |
2.5× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$1,188.08 |
$1,641 |
2.1× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$609.38 |
$805 |
2.5× |
| Scapula complete (73010) |
$202.88 |
$268 |
1.9× |
| Screening digital breast tomosynthesis bi (77063) |
$39.15 |
$49 |
— |
| Thyroid imaging with vascular flow (78013) |
$703.73 |
$972 |
1.7× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$957.85 |
$1,323 |
2.3× |
| Ultrasound breast limited (76642) |
$500.82 |
$581 |
5.6× |
| Ultrasound, abdomen limited (76705) |
$768.04 |
$891 |
7.2× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$505.13 |
$586 |
4.7× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$900.79 |
$1,045 |
8.4× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$769.77 |
$893 |
7.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$1,167.29 |
$1,542 |
6.5× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Age Under 21 (74415) |
$1,054.50 |
$1,393 |
5.9× |
| Us abdominal aorta real time screen study aaa (76706) |
$331.01 |
$384 |
3.1× |
| Us breast uni real time with image complete (76641) |
$610.30 |
$708 |
5.7× |
| Us chest (76604) |
$512.03 |
$594 |
4.8× |
| Us compl joint r-t w/image documentation (76881) |
$783.56 |
$909 |
7.3× |
| Us encephalogram (76506) |
$447.38 |
$519 |
4.2× |
| Us exam, pelvic, limited (76857) |
$660.29 |
$766 |
6.2× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$248.26 |
$288 |
2.8× |
| US OB Follow-Up/Repeat (76816) |
$468.07 |
$543 |
4.4× |
| Us ob transvaginal (76817) |
$593.92 |
$689 |
5.6× |
| Us retroperitoneal complete (76770) |
$885.27 |
$1,027 |
8.3× |
| Us retroperitoneal ltd (76775) |
$290.49 |
$337 |
2.7× |
| Us scrotum (76870) |
$829.24 |
$962 |
7.8× |
| Us soft tissue head/neck (76536) |
$802.52 |
$931 |
7.5× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$597.27 |
$789 |
0.4× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$510.98 |
$675 |
0.3× |
| X-ray exam hips bi 3-4 views (73522) |
$336.86 |
$445 |
3.2× |
| X-ray exam of finger(s) (73140) |
$198.33 |
$262 |
2.2× |
| X-ray exam of knee 1 or 2 (73560) |
$238.46 |
$315 |
2.7× |
| X-ray exam ribs bil 3 views (71110) |
$345.95 |
$457 |
3.2× |
| X-ray exam ribs uni 2 views (71100) |
$297.50 |
$393 |
3.3× |
| X-ray heel (73650) |
$177.14 |
$234 |
2.0× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$398.18 |
$526 |
3.7× |
| Xr abdomen 1 view (74018) |
$170.32 |
$225 |
1.9× |
| Xr abdomen 2 views (74019) |
$308.10 |
$407 |
2.9× |
| Xr arthrogram hip (73525) |
$825.52 |
$967 |
2.3× |
| Xr arthrogram knee (73580) |
$476.36 |
$558 |
1.3× |
| Xr arthrogram wrist (73115) |
$583.92 |
$684 |
1.6× |
| Xr bone age studies (77072) |
$181.68 |
$240 |
1.7× |
| Xr bone length study (77073) |
$430.73 |
$569 |
4.0× |
| Xr bone survey ltd (77074) |
$247.54 |
$327 |
2.3× |
| Xr chest 1 view (71045) |
$158.40 |
$220 |
1.8× |
| Xr chest 2 views (71046) |
$332.64 |
$462 |
3.7× |
| Xr eye foreign body (70030) |
$127.18 |
$168 |
1.4× |
| Xr facial bones 3+ views (70150) |
$346.71 |
$458 |
3.2× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$234.67 |
$310 |
2.6× |
| Xr forearm 2 views (73090) |
$243.75 |
$322 |
2.7× |
| Xr hand 2v (73120) |
$173.35 |
$229 |
1.6× |
| Xr hysterosalpingogram (74740) |
$400.45 |
$529 |
1.6× |
| Xr joint survey 1 view (77077) |
$146.86 |
$194 |
1.4× |
| Xr myelogram c-spine (72240) |
$1,641.93 |
$2,169 |
2.1× |
| Xr myelogram l-spine (72265) |
$1,664.64 |
$2,199 |
2.1× |
| Xr myelogram t-spine (72255) |
$1,308.85 |
$1,729 |
1.6× |
| Xr neck soft tissue (70360) |
$235.43 |
$311 |
2.6× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$290.69 |
$384 |
3.3× |
| Xr osseous survey complete (77075) |
$373.20 |
$493 |
3.5× |
| Xr pelvis 1-2 views (72170) |
$186.98 |
$247 |
1.8× |
| Xr pelvis min 3 view (72190) |
$280.09 |
$370 |
2.6× |
| Xr sacrum/coccyx 2+ views (72220) |
$240.73 |
$318 |
2.7× |
| Xr shoulder 1 view (73020) |
$243.75 |
$322 |
2.7× |
| Xr sinuses 3+ views (70220) |
$329.30 |
$435 |
3.7× |
| Xr skull min 4 view (70260) |
$357.30 |
$472 |
3.3× |
| Xr spine 1 view (72020) |
$249.81 |
$330 |
2.8× |
| Xr spine thoracic 3v (72072) |
$386.83 |
$511 |
3.6× |
| Xr sternum 2+ views (71120) |
$175.62 |
$232 |
2.0× |
| Xr surgical specimen (76098) |
$195.31 |
$258 |
0.3× |
| Xr t-spine 2 views (72070) |
$373.20 |
$493 |
3.5× |
| Xr tibia/fibula 2 views (73590) |
$201.36 |
$266 |
2.3× |
| Xr tmj bilateral (70330) |
$295.23 |
$390 |
3.3× |
| Xr wrist 2 views (73100) |
$234.67 |
$310 |
2.6× |