| Acute gi blood loss imaging (78278) |
$780.09 |
$917.75 |
1.9× |
| Ankle 2 views (73600) |
$150.58 |
$177.15 |
1.7× |
| Clavicle complete (73000) |
$143.56 |
$168.90 |
1.6× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$1,179.72 |
$1,387.90 |
3.3× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$391.34 |
$460.40 |
2.2× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$2,546.39 |
$2,995.75 |
14.2× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,461.20 |
$1,719.05 |
8.2× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,188.04 |
$1,397.70 |
6.6× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,314.57 |
$1,546.55 |
7.3× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$1,339.09 |
$1,575.40 |
7.5× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,234.03 |
$1,451.80 |
6.9× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$1,193.32 |
$1,403.90 |
6.7× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$676.78 |
$796.20 |
6.3× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$899.56 |
$1,058.30 |
5.0× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$2,255.31 |
$2,653.30 |
12.6× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$863.26 |
$1,015.60 |
4.8× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$743.76 |
$875 |
7.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$856.25 |
$1,007.35 |
4.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$787.95 |
$927 |
7.4× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$999.39 |
$1,175.75 |
5.6× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,019.54 |
$1,199.45 |
5.7× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$1,149.54 |
$1,352.40 |
6.4× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$1,144.28 |
$1,346.20 |
6.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,643.87 |
$4,286.90 |
10.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,497.81 |
$2,938.60 |
10.2× |
| CT abdomen w & w/o contrast (74170) |
$2,179.15 |
$2,563.70 |
12.2× |
| CT abdomen w/contrast (74160) |
$1,779.90 |
$2,094 |
9.9× |
| CT abdomen w/o contrast (74150) |
$1,481.38 |
$1,742.80 |
13.9× |
| CT cervical spine w/contrast (72126) |
$1,065.94 |
$1,254.05 |
3.0× |
| CT cervical spine w/o contrast (72125) |
$231.12 |
$271.90 |
2.2× |
| CT chest w/contrast (71260) |
$1,031.82 |
$1,213.90 |
5.8× |
| CT extremity upper w & w/o contrast (73202) |
$883.84 |
$1,039.80 |
4.9× |
| CT extremity upper w/o contrast (73200) |
$700.40 |
$824 |
6.6× |
| CT head/brain with contrast (70460) |
$977.08 |
$1,149.50 |
5.5× |
| CT head/brain without and with contrast (70470) |
$1,060.21 |
$1,247.30 |
5.9× |
| CT l-spine w/contrast (72132) |
$1,147.80 |
$1,350.35 |
3.2× |
| CT limited/localized follow up study (76380) |
$527.94 |
$621.10 |
5.9× |
| CT lower extremity w/dye (73701) |
$806.78 |
$949.15 |
4.5× |
| CT lumbar spine w/o contrast (72131) |
$850.98 |
$1,001.15 |
8.0× |
| CT maxillofacial w/wo contrast (70488) |
$976.61 |
$1,148.95 |
5.4× |
| CT neck w/contrast (70491) |
$930.67 |
$1,094.90 |
5.2× |
| CT neck w/o contrast (70490) |
$878.60 |
$1,033.65 |
8.2× |
| CT pelvis w & w/o contrast (72194) |
$1,038.79 |
$1,222.10 |
5.8× |
| CT pelvis w/o contrast (72192) |
$762.12 |
$896.60 |
7.1× |
| CT thoracic spine w/contrast (72129) |
$1,014.74 |
$1,193.80 |
5.7× |
| CT thoracic spine w/o contrast (72128) |
$853.62 |
$1,004.25 |
8.0× |
| CT thorax lung cancer scr c- (71271) |
$541.92 |
$637.55 |
5.1× |
| CT thorax w/o contrast (71250) |
$1,503.23 |
$1,768.50 |
14.1× |
| CT upper extremity w/dye (73201) |
$808.56 |
$951.25 |
2.3× |
| CTA head w contrast (70496) |
$1,316.74 |
$1,549.10 |
7.3× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$511.74 |
$602.05 |
1.4× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$234.64 |
$276.05 |
2.2× |
| Dxa bone density study axial skeleton (77085) |
$160.22 |
$188.50 |
1.5× |
| Dxa bone density/peripheral (77081) |
$121.72 |
$143.20 |
1.4× |
| Fetal biophys profile w/o nst (76819) |
$457.48 |
$538.20 |
4.3× |
| Fetal biophysical profile non-stress testing (76818) |
$457.48 |
$538.20 |
4.3× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$567.29 |
$667.40 |
2.3× |
| Gated heart planar single (78472) |
$988.90 |
$1,163.40 |
2.4× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$940.74 |
$1,106.75 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$542.86 |
$638.65 |
1.3× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$425.04 |
$500.05 |
1.0× |
| Kidney imaging morphology; with vascular flow Age Under 21 (78701) |
$332.27 |
$390.90 |
0.8× |
| Liver and spleen imaging (78215) |
$434.27 |
$510.90 |
1.1× |
| Lung perf&ventilat diferentl (78598) |
$233.75 |
$275 |
0.4× |
| Lung perfusion imaging (78580) |
$553.74 |
$651.45 |
1.4× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$1,486.61 |
$1,748.95 |
4.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$434.27 |
$510.90 |
1.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,180.18 |
$1,388.45 |
4.8× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$1,486.61 |
$1,748.95 |
4.2× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$1,749.26 |
$2,057.95 |
4.9× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$1,267.74 |
$1,491.45 |
5.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$434.27 |
$510.90 |
1.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,486.61 |
$1,748.95 |
4.2× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$1,705.48 |
$2,006.45 |
4.8× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$1,486.61 |
$1,748.95 |
4.2× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,486.61 |
$1,748.95 |
4.2× |
| Mandible min 4v (70110) |
$130.90 |
$154 |
1.2× |
| MRA head w/o contrast (70544) |
$1,267.74 |
$1,491.45 |
5.2× |
| MRA neck w/ contrast (70548) |
$1,705.48 |
$2,006.45 |
4.8× |
| MRA neck w/o contrast (70547) |
$1,399.06 |
$1,645.95 |
5.7× |
| MRI abdomen w/contrast (74182) |
$1,574.16 |
$1,851.95 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$1,442.84 |
$1,697.45 |
5.9× |
| MRI abdomen w/wo contrast (74183) |
$1,749.26 |
$2,057.95 |
4.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,486.61 |
$1,748.95 |
1.9× |
| MRI breast c- bilateral (77047) |
$1,399.06 |
$1,645.95 |
5.7× |
| MRI breast without contrast material unilateral (77046) |
$1,136.41 |
$1,336.95 |
4.7× |
| MRI c-spine w&w/o cont (72156) |
$434.27 |
$510.90 |
1.2× |
| MRI cervical spine w/contrast (72142) |
$434.27 |
$510.90 |
1.2× |
| MRI chest w/contrast (71551) |
$1,705.48 |
$2,006.45 |
2.1× |
| MRI chest w/o contrast (71550) |
$1,442.84 |
$1,697.45 |
5.9× |
| MRI chest w/wo contrast (71552) |
$1,880.58 |
$2,212.45 |
5.3× |
| MRI joint upr extr w/o&w/dye (73223) |
$1,486.61 |
$1,748.95 |
4.2× |
| MRI joint upr extrem w/dye (73222) |
$1,486.61 |
$1,748.95 |
1.9× |
| MRI joint upr extrem w/o dye (73221) |
$1,180.18 |
$1,388.45 |
4.8× |
| MRI lumbar spine w/contrast (72149) |
$434.27 |
$510.90 |
1.2× |
| MRI lumbar spine w/wo contrast (72158) |
$434.27 |
$510.90 |
1.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,880.58 |
$2,212.45 |
5.3× |
| MRI pelvis w & w/o contrast (72197) |
$434.27 |
$510.90 |
1.2× |
| MRI pelvis w/contrast (72196) |
$1,880.58 |
$2,212.45 |
5.3× |
| MRI pelvis w/o contrast (72195) |
$434.27 |
$510.90 |
1.8× |
| MRI spine cervical w/o contrast (72141) |
$434.27 |
$510.90 |
1.8× |
| MRI t-spine w&w/o cont (72157) |
$434.27 |
$510.90 |
1.2× |
| MRI thoracic spine w/contrast (72147) |
$434.27 |
$510.90 |
1.2× |
| MRI thoracic spine w/o contrst (72146) |
$434.27 |
$510.90 |
1.8× |
| MRI tmj (70336) |
$1,223.96 |
$1,439.95 |
5.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,180.18 |
$1,388.45 |
4.8× |
| Myocardial spect multiple studies (78452) |
$1,427.11 |
$1,678.95 |
1.1× |
| Nm bone 3 phase (78315) |
$838.32 |
$986.25 |
2.1× |
| Nm bone imaging whole body (78306) |
$762.12 |
$896.60 |
1.9× |
| Nm gastric emptying (78264) |
$553.74 |
$651.45 |
1.4× |
| Nm lymph system (78195) |
$828.24 |
$974.40 |
1.5× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$553.74 |
$651.45 |
1.4× |
| Ob us limited fetus(s) (76815) |
$92.82 |
$109.20 |
0.9× |
| Ob us nuchal meas 1 gest (76813) |
$470.99 |
$554.10 |
4.4× |
| Parathyroid planar imaging (78070) |
$819.91 |
$964.60 |
2.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$968.32 |
$1,139.20 |
2.4× |
| Pulmonary ventilation & perfusion imaging (78582) |
$777.88 |
$915.15 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$556.84 |
$655.10 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$91.50 |
$107.65 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$138.76 |
$163.25 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$225.85 |
$265.70 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$268.77 |
$316.20 |
2.5× |
| Radex hip unilateral with pelvis 1 view (73501) |
$141.82 |
$166.85 |
1.6× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$184.32 |
$216.85 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$104.21 |
$122.60 |
1.0× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$126.95 |
$149.35 |
1.2× |
| Radex spine cervical 2 or 3 views (72040) |
$204.90 |
$241.05 |
2.3× |
| Radex spine cervical 4 or 5 views (72050) |
$241.66 |
$284.30 |
2.3× |
| Radex spine cervical 6 or more views (72052) |
$301.62 |
$354.85 |
2.8× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$101.15 |
$119 |
1.1× |
| Radiologic exam abdomen 3+ views (74021) |
$242.98 |
$285.85 |
2.3× |
| Radiologic exam colon double contrast study (74280) |
$634.74 |
$746.75 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$563.85 |
$663.35 |
3.1× |
| Radiologic exam esophagus single contrast study (74220) |
$353.69 |
$416.10 |
2.0× |
| Radiologic exam small int single contrast study (74250) |
$580.04 |
$682.40 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$202.22 |
$237.90 |
1.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$692.96 |
$815.25 |
3.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$692.96 |
$815.25 |
3.9× |
| Radiologic examination femur 1 view (73551) |
$135.70 |
$159.65 |
1.5× |
| Radiologic examination femur minimum 2 views (73552) |
$166.34 |
$195.70 |
1.9× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$152.79 |
$179.75 |
1.7× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$172.89 |
$203.40 |
1.9× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$218.45 |
$257 |
2.0× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$151.90 |
$178.70 |
1.7× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$170.72 |
$200.85 |
1.9× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$120.40 |
$141.65 |
1.4× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$169.40 |
$199.30 |
1.9× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$169.88 |
$199.85 |
1.9× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$163.71 |
$192.60 |
1.8× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$221.51 |
$260.60 |
2.1× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$124.36 |
$146.30 |
1.4× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$205.32 |
$241.55 |
1.9× |
| Radiologic examination, mastoids; less than 3 views per side Age Under 21 (70120) |
$171.62 |
$201.90 |
1.6× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$161.12 |
$189.55 |
1.8× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$279.31 |
$328.60 |
2.6× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$208.80 |
$245.65 |
2.0× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$172.94 |
$203.45 |
1.6× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$629.04 |
$740.05 |
1.8× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$167.66 |
$197.25 |
1.9× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$158.06 |
$185.95 |
1.8× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$192.18 |
$226.10 |
1.8× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$191.30 |
$225.05 |
1.8× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$187.81 |
$220.95 |
1.8× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$368.18 |
$433.15 |
3.4× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$315.18 |
$370.80 |
3.0× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$164.18 |
$193.15 |
1.8× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$183.43 |
$215.80 |
2.1× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$165.50 |
$194.70 |
1.9× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$137.02 |
$161.20 |
1.5× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$220.20 |
$259.05 |
2.1× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$181.69 |
$213.75 |
2.0× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$138.30 |
$162.70 |
1.6× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$124.36 |
$146.30 |
1.2× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$1,557.97 |
$1,832.90 |
2.8× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$474.09 |
$557.75 |
1.9× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$448.25 |
$527.35 |
1.8× |
| Scapula complete (73010) |
$170.30 |
$200.35 |
1.6× |
| Screening digital breast tomosynthesis bi (77063) |
$125.68 |
$147.85 |
— |
| Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium… (74283) |
$969.64 |
$1,140.75 |
5.4× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$671.08 |
$789.50 |
1.6× |
| Ultrasound breast limited (76642) |
$517.40 |
$608.70 |
5.8× |
| Ultrasound, abdomen limited (76705) |
$305.15 |
$359 |
2.9× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$528.36 |
$621.60 |
4.9× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$372.56 |
$438.30 |
3.5× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$175.95 |
$207 |
1.6× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$274.04 |
$322.40 |
2.6× |
| Umbilical-artery Doppler (OB) (76820) |
$179.48 |
$211.15 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$605.84 |
$712.75 |
2.5× |
| Us abdominal aorta real time screen study aaa (76706) |
$291.08 |
$342.45 |
2.7× |
| Us breast uni real time with image complete (76641) |
$427.68 |
$503.15 |
4.0× |
| Us chest (76604) |
$553.74 |
$651.45 |
5.2× |
| Us compl joint r-t w/image documentation (76881) |
$528.36 |
$621.60 |
4.9× |
| Us elastography organ (76981) |
$305.15 |
$359 |
2.9× |
| Us encephalogram (76506) |
$281.95 |
$331.70 |
2.6× |
| Us exam, pelvic, limited (76857) |
$441.24 |
$519.10 |
4.1× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$283.64 |
$333.70 |
3.2× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$211.86 |
$249.25 |
2.4× |
| US OB Follow-Up/Repeat (76816) |
$321.30 |
$378 |
3.0× |
| Us ob transvaginal (76817) |
$221.51 |
$260.60 |
2.1× |
| Us retroperitoneal complete (76770) |
$413.66 |
$486.65 |
3.9× |
| Us retroperitoneal ltd (76775) |
$144.50 |
$170 |
1.4× |
| Us scrotum (76870) |
$274.04 |
$322.40 |
2.6× |
| Us soft tissue head/neck (76536) |
$353.30 |
$415.65 |
3.3× |
| Us spinal canal (76800) |
$464.06 |
$545.95 |
4.3× |
| Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) |
$2,524.08 |
$2,969.50 |
0.8× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$405.37 |
$476.90 |
0.3× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$746.82 |
$878.60 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$160.22 |
$188.50 |
1.8× |
| X-ray exam hips bi 3-4 views (73522) |
$112.08 |
$131.85 |
1.0× |
| X-ray exam of finger(s) (73140) |
$130.01 |
$152.95 |
1.5× |
| X-ray exam of knee 1 or 2 (73560) |
$174.68 |
$205.50 |
2.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,034.41 |
$1,216.95 |
5.8× |
| X-ray exam ribs bil 3 views (71110) |
$255.68 |
$300.80 |
2.4× |
| X-ray exam ribs uni 2 views (71100) |
$188.70 |
$222 |
2.1× |
| X-ray heel (73650) |
$117.77 |
$138.55 |
1.3× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$174.68 |
$205.50 |
1.6× |
| X-ray retrograde pyelogram (74420) |
$764.32 |
$899.20 |
2.1× |
| Xr abdomen 1 view (74018) |
$182.12 |
$214.25 |
2.0× |
| Xr abdomen 2 views (74019) |
$190.02 |
$223.55 |
1.8× |
| Xr arthrogram ankle (73615) |
$440.82 |
$518.60 |
1.2× |
| Xr arthrogram elbow (73085) |
$468.82 |
$551.55 |
1.3× |
| Xr arthrogram hip (73525) |
$547.23 |
$643.80 |
1.5× |
| Xr arthrogram knee (73580) |
$699.08 |
$822.45 |
2.0× |
| Xr arthrogram wrist (73115) |
$440.82 |
$518.60 |
1.2× |
| Xr bone age studies (77072) |
$402.74 |
$473.80 |
3.8× |
| Xr bone length study (77073) |
$298.99 |
$351.75 |
2.8× |
| Xr bone survey infant (77076) |
$180.80 |
$212.70 |
1.7× |
| Xr bone survey ltd (77074) |
$503.42 |
$592.25 |
4.7× |
| Xr chest 1 view (71045) |
$69.19 |
$81.40 |
0.8× |
| Xr chest 2 views (71046) |
$154.53 |
$181.80 |
1.7× |
| Xr eye foreign body (70030) |
$133.11 |
$156.60 |
1.5× |
| Xr facial bones 3+ views (70150) |
$98.09 |
$115.40 |
0.9× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$117.30 |
$138 |
1.3× |
| Xr forearm 2 views (73090) |
$148.84 |
$175.10 |
1.7× |
| Xr hand 2v (73120) |
$154.96 |
$182.30 |
1.5× |
| Xr hysterosalpingogram (74740) |
$598.87 |
$704.55 |
2.5× |
| Xr joint survey 1 view (77077) |
$239.02 |
$281.20 |
2.2× |
| Xr neck soft tissue (70360) |
$136.17 |
$160.20 |
1.5× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$200.05 |
$235.35 |
2.3× |
| Xr osseous survey complete (77075) |
$396.61 |
$466.60 |
3.7× |
| Xr pelvis 1-2 views (72170) |
$158.91 |
$186.95 |
1.5× |
| Xr pelvis min 3 view (72190) |
$155.85 |
$183.35 |
1.5× |
| Xr sacrum/coccyx 2+ views (72220) |
$170.30 |
$200.35 |
1.9× |
| Xr sella turcica (70240) |
$238.17 |
$280.20 |
2.7× |
| Xr shoulder 1 view (73020) |
$147.10 |
$173.05 |
1.7× |
| Xr sinuses 3+ views (70220) |
$161.12 |
$189.55 |
1.8× |
| Xr skull min 4 view (70260) |
$246.46 |
$289.95 |
2.3× |
| Xr spine 1 view (72020) |
$143.14 |
$168.40 |
1.6× |
| Xr spine thoracic 3v (72072) |
$177.74 |
$209.10 |
1.7× |
| Xr sternum 2+ views (71120) |
$177.74 |
$209.10 |
2.0× |
| Xr surgical specimen (76098) |
$167.66 |
$197.25 |
0.3× |
| Xr t-spine 2 views (72070) |
$170.30 |
$200.35 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$160.22 |
$188.50 |
1.8× |
| Xr tmj bilateral (70330) |
$276.25 |
$325 |
3.1× |
| Xr tmj unilateral (70328) |
$133.11 |
$156.60 |
1.5× |
| Xr wrist 2 views (73100) |
$138.76 |
$163.25 |
1.6× |