| Abdomen 2 views (74019) |
$288 |
$411 |
3.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,114.50 |
$1,592 |
3.0× |
| Angiography extremity unilateral rs&i (75710) |
$108 |
$154 |
0.0× |
| Ankle 2 views (73600) |
$158 |
$225.50 |
2.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$333.50 |
$476.50 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$155 |
$222 |
0.1× |
| Arthrogram elbow (73085) |
$585 |
$835 |
1.8× |
| Arthrogram hip (73525) |
$762 |
$1,088 |
2.4× |
| Arthrogram shoulder (73040) |
$433 |
$618.50 |
1.3× |
| Arthrogram wrist (73115) |
$694 |
$992 |
2.2× |
| Arthrography knee lt (73580) |
$973 |
$1,390 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$698.50 |
$997.50 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,012.50 |
$1,446 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$891.50 |
$1,273.50 |
2.4× |
| Bone age studies (77072) |
$202 |
$288 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$833.50 |
$1,190.50 |
2.3× |
| Bone Marrow Imaging Limited Area (78102) |
$612 |
$874 |
1.7× |
| Bone survey complete (77075) |
$641 |
$916 |
6.7× |
| Brain image w/flow 4 + views (78606) |
$818 |
$1,169 |
1.6× |
| Brain Imaging Minimum 4 Static Views (78605) |
$597 |
$853 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$63 |
$90 |
0.8× |
| Chest 1 view (71045) |
$56 |
$80 |
0.7× |
| Chest 3 views (71047) |
$277 |
$395 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$371.50 |
$531 |
2.3× |
| Clavicle complete (73000) |
$222.50 |
$318.50 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,381 |
$4,830 |
10.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,352 |
$3,360 |
10.7× |
| CT abdomen w contrast (74160) |
$911.50 |
$1,302 |
5.7× |
| CT abdomen w wo contrast (74170) |
$972.50 |
$1,389 |
6.0× |
| CT abdomen w/o contrast (74150) |
$802.50 |
$1,146.50 |
8.3× |
| CT angiography upper extremity lt (73206) |
$1,079 |
$1,541.50 |
6.7× |
| CT c-spine w/o contrast (72125) |
$722.50 |
$1,032 |
7.5× |
| CT cervical spine w&w/o contrast (72127) |
$1,147.50 |
$1,639.50 |
7.1× |
| CT cervical spine with contrast (72126) |
$831 |
$1,187 |
2.6× |
| CT chest w/wo contrast (71270) |
$888.50 |
$1,269.50 |
5.5× |
| CT chest with contrast (71260) |
$831 |
$1,187 |
5.2× |
| CT head/brain with contrast (70460) |
$823.50 |
$1,177 |
5.1× |
| CT head/brain without and with contrast (70470) |
$998 |
$1,425.50 |
6.2× |
| CT iac w contrast (70481) |
$933.50 |
$1,333.50 |
5.8× |
| CT limited/localized follow up study (76380) |
$552 |
$788 |
6.9× |
| CT lower ext w/o (73700) |
$1,357 |
$1,939 |
14.1× |
| CT lower extremity w wo contrast (73702) |
$1,662 |
$2,374 |
10.3× |
| CT lower extremity with contrast (73701) |
$1,530 |
$2,185 |
9.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,008.50 |
$1,441 |
6.3× |
| CT lumbar spine w/o contrast (72131) |
$830.50 |
$1,186.50 |
8.6× |
| CT lumbar spine with contrast (72132) |
$965 |
$1,379 |
3.0× |
| CT maxillofacial w contrast (70487) |
$897.50 |
$1,282 |
5.6× |
| CT maxillofacial w/o contrast (70486) |
$813.50 |
$1,161.50 |
8.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,739 |
$3,913 |
17.0× |
| CT neck soft tissue w contrast (70491) |
$991.50 |
$1,416.50 |
6.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,337 |
$1,910 |
8.3× |
| CT orbits w/o contrast (70480) |
$601.50 |
$859 |
6.3× |
| CT pelvis w & w/o contrast (72194) |
$837.50 |
$1,196.50 |
5.2× |
| CT pelvis w/o contrast (72192) |
$776 |
$1,109 |
8.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,886.50 |
$2,695 |
11.7× |
| CT soft tissue neck w/o contrast (70490) |
$901.50 |
$1,287.50 |
9.4× |
| CT thoracic spine w/contrast (72129) |
$801 |
$1,144.50 |
5.0× |
| CT thoracic spine w/o contrast (72128) |
$754.50 |
$1,077.50 |
7.8× |
| CT thoracic spine w/wo contrast (72130) |
$845 |
$1,207 |
5.2× |
| CT thorax w/o contrast (71250) |
$745.50 |
$1,064.50 |
7.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,330 |
$1,900 |
8.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,208 |
$1,725 |
12.6× |
| CT upper extremity with contrast (73201) |
$1,250 |
$1,785 |
3.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,149.50 |
$1,642 |
7.1× |
| Cta Abdomen (74175) |
$1,048 |
$1,497 |
6.5× |
| CTA abdomen pelvis (74174) |
$3,021 |
$4,316 |
9.4× |
| CTA chest (71275) |
$1,260 |
$1,799.50 |
7.8× |
| Cta Head (70496) |
$1,409.50 |
$2,013 |
8.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,375 |
$1,964 |
8.5× |
| Cta Neck (70498) |
$1,248.50 |
$1,783 |
7.7× |
| Cta Pelvis (72191) |
$1,032 |
$1,474 |
6.4× |
| Cystography minimum 3 views rs&i (74430) |
$359.50 |
$514 |
1.1× |
| Diskogram cervical (72285) |
$399 |
$570 |
0.2× |
| Diskography lumbar (72295) |
$2,787 |
$3,981 |
1.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$202 |
$288 |
2.1× |
| Echoencephalography real time imaging (76506) |
$289 |
$412.50 |
3.0× |
| Esophagus (74220) |
$253.50 |
$362.50 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$100 |
$143 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$323.50 |
$462 |
3.4× |
| Fluoroscopy up to 1 hr (76000) |
$266 |
$380 |
1.2× |
| Foot 2 views (73620) |
$244 |
$349 |
3.0× |
| Forearm 2 views (73090) |
$71 |
$102 |
0.9× |
| Gated Heart Planar Single (78472) |
$938.50 |
$1,340.50 |
2.6× |
| Hand 2 views (73120) |
$49 |
$70 |
0.5× |
| Hand 3 views (73130) |
$53 |
$75 |
0.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,506 |
$2,151 |
4.1× |
| Ht muscle image spect sing (78451) |
$3,402 |
$4,860 |
2.9× |
| Humerus Min 2 Views Left (73060) |
$56 |
$80 |
0.7× |
| Hysterosalpingogram (74740) |
$199.50 |
$285 |
0.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$88 |
$125 |
0.9× |
| Kidney imaging morphology (78700) |
$613 |
$875 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$917.50 |
$1,310.50 |
1.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,286.50 |
$1,837.50 |
2.6× |
| Knee 3 views (73562) |
$74 |
$105 |
0.9× |
| Liver & spleen imaging static only (78215) |
$544.50 |
$777.50 |
1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$627.50 |
$896 |
1.7× |
| Liver imaging w/vascular flow (78202) |
$776 |
$1,108 |
1.6× |
| Lung perf&ventilat diferentl (78598) |
$1,290 |
$1,843 |
2.6× |
| Lung perfusion differential (78597) |
$710 |
$1,014 |
1.9× |
| Lung Ventilation Imaging (78579) |
$1,419 |
$2,027 |
3.9× |
| Lymphoscintigraphy (78195) |
$911.50 |
$1,302 |
1.8× |
| Mammary ductogram or galactogram multiple (77054) |
$203 |
$290 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$203 |
$290 |
0.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$107 |
$153 |
1.3× |
| Meckels Diverticulum (78290) |
$541 |
$772.50 |
1.5× |
| MRA head w & w/o contrast (70546) |
$1,648 |
$2,354 |
5.1× |
| MRA head w/o contrast (70544) |
$1,211 |
$1,730 |
5.5× |
| MRA head with contrast (70545) |
$1,320 |
$1,885 |
4.1× |
| MRA neck w contrast (70548) |
$1,982 |
$2,832 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,566 |
$3,666 |
8.0× |
| MRA neck w/o contrast (70547) |
$815 |
$1,164 |
3.7× |
| MRI abdomen w contrast (74182) |
$2,213 |
$3,161 |
6.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,109 |
$4,441 |
9.7× |
| MRI abdomen w/o contrast (74181) |
$1,106 |
$1,580 |
5.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,348 |
$3,354 |
3.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,096 |
$2,994 |
2.9× |
| MRI c-spine with contrast (72142) |
$1,352 |
$1,931.50 |
4.2× |
| MRI cervical spine w/o contrast (72141) |
$1,010 |
$1,442.50 |
4.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,027 |
$2,896 |
6.3× |
| MRI chest w/o contrast (71550) |
$543.50 |
$776.50 |
2.5× |
| MRI chest with contrast (71551) |
$1,546 |
$2,208 |
2.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,948 |
$2,783 |
6.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,069 |
$2,956 |
6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$741 |
$1,059 |
3.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$802.50 |
$1,146.50 |
3.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,027 |
$2,896 |
6.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,735 |
$2,479 |
5.4× |
| MRI pelvis w contrast (72196) |
$1,098 |
$1,568.50 |
3.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,552 |
$3,646 |
8.0× |
| MRI pelvis w/o contrast (72195) |
$1,402 |
$2,003 |
6.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,608 |
$3,726 |
8.1× |
| MRI scan of leg joint before and after contrast (73723) |
$3,084 |
$4,405 |
9.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,758 |
$2,511 |
5.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,689.50 |
$2,414 |
5.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,758.50 |
$2,512 |
5.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,172.50 |
$1,675.50 |
3.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,535.50 |
$2,194 |
4.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,042 |
$1,488.50 |
4.7× |
| MRI tmj (70336) |
$1,703.50 |
$2,433.50 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,863 |
$2,662 |
8.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,596 |
$3,709 |
8.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,495 |
$2,135 |
6.8× |
| Myelogram Cervical (72240) |
$178 |
$254 |
0.2× |
| Myelogram thoracic (72255) |
$151 |
$215 |
0.2× |
| Myelography 2 or more regions (72270) |
$200 |
$286 |
0.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,043 |
$4,347 |
2.6× |
| Neck soft tissue (70360) |
$132 |
$188.50 |
1.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$550 |
$786 |
1.5× |
| Nm bone marrow multiple (78103) |
$664 |
$949 |
1.8× |
| Nm bone marrow wb (78104) |
$402 |
$574 |
1.1× |
| Nm cisternogram (78630) |
$980 |
$1,400 |
2.0× |
| Nm gastric emptying study (78264) |
$1,071 |
$1,529.50 |
2.9× |
| Nm whole blood volume (78122) |
$4 |
$6 |
0.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,378 |
$1,968 |
1.2× |
| Nuclear medicine of heart pumping function (78473) |
$787.50 |
$1,125 |
2.1× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,065 |
$1,521 |
2.9× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$645 |
$921 |
1.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$479 |
$684 |
1.3× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$708 |
$1,011 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$1,075 |
$1,535 |
5.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$258 |
$368 |
2.7× |
| Osseous survey infant (77076) |
$173 |
$247 |
1.8× |
| Osseous survey limited (77074) |
$494 |
$706 |
5.1× |
| Parathyrd planar w/spect&CT (78072) |
$2,275 |
$3,250 |
4.6× |
| Parathyrd planar w/wo subtrj (78071) |
$669 |
$956 |
1.8× |
| Parathyroid imaging (78070) |
$797 |
$1,138.50 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$56 |
$80 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$5,509 |
$7,870 |
4.2× |
| PET imaging for CT attenuation whole body (78816) |
$5,614 |
$8,020 |
4.3× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$7 |
$10 |
0.0× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$2 |
$3 |
0.0× |
| Platelet survival study (78191) |
$26 |
$37 |
0.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,661 |
$3,801 |
8.3× |
| Pr red cell survival study (78130) |
$31 |
$44 |
0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$794 |
$1,134 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,540 |
$2,200 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$403 |
$575 |
0.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$323.50 |
$462 |
3.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$218 |
$311 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$173 |
$247 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$202 |
$289 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$274 |
$392 |
3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$498 |
$712 |
5.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$235 |
$336 |
2.9× |
| Radiologic exam colon single contrast study (74270) |
$652 |
$931 |
4.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$521 |
$744 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$694 |
$991.50 |
4.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$597 |
$853 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$56 |
$80 |
0.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$134 |
$191 |
1.7× |
| Radiological examination surgical specimen (76098) |
$706 |
$1,008 |
1.4× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$15 |
$12.50 |
0.0× |
| Ribs bilateral 3 views (71110) |
$62.50 |
$89 |
0.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$788 |
$1,125 |
2.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,113 |
$1,590 |
2.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,888.50 |
$2,697.50 |
3.8× |
| Sacroiliac Joints < 3 Views (72200) |
$53 |
$75 |
0.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$526 |
$752 |
2.4× |
| Salivary gland function study (78232) |
$629 |
$899 |
1.7× |
| Salivary gland imaging (78230) |
$629 |
$899 |
1.7× |
| Salivary gland imaging serial images (78231) |
$629 |
$899 |
1.7× |
| Scanogram (77073) |
$234 |
$334 |
2.4× |
| Scapula complete (73010) |
$171 |
$244 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$55 |
$78 |
2.4× |
| Sella turcica (70240) |
$118 |
$168 |
1.5× |
| Sialogram (70390) |
$365 |
$522 |
1.7× |
| Small bowel series (74250) |
$410 |
$586 |
2.5× |
| Spine thoracic 3 views (72072) |
$55 |
$79 |
0.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$725 |
$1,035 |
3.3× |
| Testicular Imaging With Vascular Flow (78761) |
$591 |
$844 |
1.6× |
| Therapeutic Enema (74283) |
$902 |
$1,288 |
5.6× |
| Thoracolumbar 2 views (72080) |
$67 |
$95 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,087.50 |
$1,553.50 |
2.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$343 |
$490 |
0.9× |
| Thyroid uptake measurement (78012) |
$305 |
$435 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$550 |
$786 |
1.5× |
| Tmj unilateral (70328) |
$132 |
$188 |
1.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$747.50 |
$1,067.50 |
2.0× |
| Ultrasound elastography first target lesion (76982) |
$80 |
$114 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$308 |
$440.50 |
3.2× |
| Umbilical-artery Doppler (OB) (76820) |
$145 |
$207 |
1.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$502 |
$717.50 |
6.3× |
| Upper Extremity Infant (73092) |
$194 |
$277 |
2.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$793 |
$1,133 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$336.50 |
$481 |
1.5× |
| Urethrocystography voiding (74455) |
$417 |
$596 |
1.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$417.50 |
$596.50 |
2.6× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$62 |
$88 |
0.4× |
| Us abdl aorta screen aaa (76706) |
$322 |
$460 |
3.3× |
| Us breast unilateral limited (76642) |
$375 |
$535 |
4.7× |
| Us chest (76604) |
$282.50 |
$403.50 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$588 |
$840 |
6.1× |
| Us elastography parenchyma (76981) |
$80 |
$114 |
0.8× |
| Us guided compression repair (76936) |
$444 |
$634 |
2.2× |
| Us infant hips dynamic (76885) |
$337 |
$481 |
4.2× |
| Us kidney transplant (76776) |
$106 |
$152 |
1.1× |
| Us ob detailed single fetus (76811) |
$382 |
$545.50 |
1.7× |
| Us ob transvaginal (76817) |
$348.50 |
$498 |
3.6× |
| Us pelvic non ob complete (76856) |
$425.50 |
$607.50 |
4.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$247.50 |
$353 |
2.6× |
| Us pregnancy ltd (76815) |
$246.50 |
$351.50 |
2.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$414 |
$591.50 |
4.3× |
| Us retroperitoneal complete (76770) |
$363.50 |
$519 |
3.8× |
| Us retroperitoneal limited (76775) |
$127 |
$182 |
1.3× |
| Us scrotum and contents (76870) |
$413 |
$590 |
4.3× |
| Us soft tissue head/neck (76536) |
$364 |
$520 |
3.8× |
| Us spinal canal and contents (76800) |
$294.50 |
$420.50 |
3.1× |
| Us xtr non-vasc lmtd (76882) |
$556 |
$794 |
5.8× |
| Vascular flow imaging (78445) |
$535 |
$764 |
1.5× |
| Vasogram (74440) |
$454 |
$648 |
2.1× |
| Venography caval inferior serialography rs&i (75825) |
$223 |
$319 |
0.1× |
| Venography caval superior serialography rs&i (75827) |
$726 |
$1,037 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$143 |
$204 |
0.1× |
| Wrist 2 views (73100) |
$244 |
$348 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$27 |
$39 |
0.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$59 |
$85 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$63 |
$90 |
0.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$444.50 |
$635 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$56 |
$80 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$53 |
$76 |
0.7× |
| X-ray exam hip uni 1 view (73501) |
$42 |
$60 |
0.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$167 |
$238 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$88 |
$125 |
0.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$109 |
$155 |
1.1× |
| X-ray exam of femur 1 (73551) |
$248 |
$355 |
3.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$526 |
$751 |
3.3× |
| X-ray eye for foreign body (70030) |
$154 |
$220 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$208 |
$296.50 |
2.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$246 |
$351 |
3.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$63 |
$90 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$234 |
$334.50 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$257.50 |
$368 |
3.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$95 |
$135 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$70 |
$100 |
0.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$117 |
$167 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$67 |
$95 |
0.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$271.50 |
$388 |
2.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$174 |
$248.50 |
1.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$75 |
$106.50 |
0.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$75 |
$107.50 |
0.9× |
| X-ray of voice box or throat (70370) |
$176 |
$252 |
2.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$212.50 |
$303.50 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$84 |
$120 |
0.9× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$1,317 |
$1,881.50 |
2.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$727 |
$1,039 |
2.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$59 |
$85 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$57 |
$82 |
0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$72 |
$103 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$187.50 |
$267.50 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$56 |
$80 |
0.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$63 |
$90 |
0.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$163.50 |
$233.50 |
2.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$107.50 |
$153 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$275 |
$392.50 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$207 |
$296 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$148 |
$211.50 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$129 |
$184 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$93 |
$132.50 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$67 |
$95 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$214 |
$305 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$59 |
$85 |
0.7× |
| Xr arthrogram ankle (73615) |
$869 |
$1,241 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$273 |
$390 |
2.8× |
| Xr chest 4+ views (71048) |
$306 |
$436.50 |
3.2× |
| Xr Cholecystography Oral Contrast (74290) |
$25 |
$35 |
0.2× |
| Xr finger(s) 2+ views (73140) |
$60 |
$86 |
0.7× |
| Xr internal auditory meati complete (70134) |
$169 |
$241 |
0.3× |
| Xr optic foramina (70190) |
$457 |
$653 |
5.7× |
| Xr shoulder 1 view (73020) |
$39 |
$55 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$74 |
$105 |
0.8× |
| Xr tibia/fibula 2 views (73590) |
$59 |
$85 |
0.7× |
| Xr tmj bilateral (70330) |
$225 |
$321 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$67 |
$95 |
0.8× |