| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,173.95 |
$4,883 |
2.3× |
| Abdomen 1 View (74018) |
$142.35 |
$219 |
1.6× |
| Abdomen 2 views (74019) |
$163.80 |
$252 |
1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,004.25 |
$1,545 |
2.5× |
| Angiography extremity bilateral rs&i (75716) |
$3,054.35 |
$4,699 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,054.35 |
$4,699 |
1.0× |
| Ankle 2 views (73600) |
$113.75 |
$175 |
1.3× |
| Artery X-Rays Abdomen (75726) |
$3,610.10 |
$5,554 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$6,540.95 |
$10,063 |
1.2× |
| Arthrogram hip (73525) |
$544.70 |
$838 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$532.35 |
$819 |
3.9× |
| Bone age studies (77072) |
$156 |
$240 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$1,954.55 |
$3,007 |
4.9× |
| Bone Imaging Limited Area (78300) |
$728.65 |
$1,121 |
1.8× |
| Bone Imaging Multiple Areas (78305) |
$822.90 |
$1,266 |
2.0× |
| Bone Imaging Whole Body (78306) |
$1,396.85 |
$2,149 |
3.5× |
| Bone survey infant (77076) |
$219.70 |
$338 |
2.1× |
| Brain Flow Imaging Only (78610) |
$1,292.20 |
$1,988 |
2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,459.95 |
$5,323 |
2.4× |
| Cat Scan Follow-Up Study (76380) |
$300.30 |
$462 |
3.4× |
| Cerebrospinal Fluid Scan (78630) |
$1,617.20 |
$2,488 |
3.0× |
| Chest 1 view (71045) |
$146.90 |
$226 |
1.7× |
| Chest 2 views (71046) |
$152.10 |
$234 |
1.7× |
| Chest 3 views (71047) |
$159.90 |
$246 |
1.8× |
| Chest 4 or more views (71048) |
$198.25 |
$305 |
1.9× |
| Clavicle complete (73000) |
$198.25 |
$305 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,068.60 |
$1,644 |
10.1× |
| Continuing medical physics consltj pr wk (77336) |
$559 |
$860 |
4.1× |
| Contrast Exam Abdominl Aorta (75625) |
$3,054.35 |
$4,699 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$631.80 |
$972 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,183.40 |
$6,436 |
11.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,385.50 |
$3,670 |
9.9× |
| CT abdomen w contrast (74160) |
$1,447.55 |
$2,227 |
8.2× |
| CT abdomen w wo contrast (74170) |
$1,725.75 |
$2,655 |
9.8× |
| CT abdomen w/o contrast (74150) |
$1,196 |
$1,840 |
11.4× |
| CT Angio Abdomen and Pelvis (74174) |
$3,250 |
$5,000 |
9.2× |
| CT Angio Chest (71275) |
$1,642.55 |
$2,527 |
9.3× |
| CT Angio Head (70496) |
$1,751.75 |
$2,695 |
9.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,387.75 |
$2,135 |
7.9× |
| CT Angio Neck (70498) |
$1,751.75 |
$2,695 |
9.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,387.75 |
$2,135 |
7.9× |
| CT cervical spine w/ contrast (72126) |
$1,820.65 |
$2,801 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,481.35 |
$2,279 |
14.1× |
| CT cervical spine w/wo cont (72127) |
$2,599.35 |
$3,999 |
14.7× |
| CT chest w contrast (71260) |
$1,445.60 |
$2,224 |
8.2× |
| CT chest w/wo contrast (71270) |
$2,457.65 |
$3,781 |
13.9× |
| CT head/brain with contrast (70460) |
$1,136.20 |
$1,748 |
6.4× |
| CT head/brain without and with contrast (70470) |
$1,301.95 |
$2,003 |
7.4× |
| CT iac w contrast (70481) |
$1,420.90 |
$2,186 |
8.0× |
| CT l-spine w&w/o contrast (72133) |
$1,516.45 |
$2,333 |
8.6× |
| CT lower ext w/o (73700) |
$911.95 |
$1,403 |
8.7× |
| CT lower extremity w/contrast material (73701) |
$1,032.85 |
$1,589 |
5.8× |
| CT lumbar spine w contrast (72132) |
$1,654.90 |
$2,546 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$1,518.40 |
$2,336 |
14.4× |
| CT maxillofacial w contrast (70487) |
$1,492.40 |
$2,296 |
8.4× |
| CT maxillofacial wo contrast (70486) |
$1,067.95 |
$1,643 |
10.1× |
| CT neck tissue combo (70492) |
$1,301.95 |
$2,003 |
7.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,583.40 |
$2,436 |
9.0× |
| CT orbits w/o contrast (70480) |
$1,369.55 |
$2,107 |
13.0× |
| CT pelvis w&w/o contrast (72194) |
$2,460.25 |
$3,785 |
13.9× |
| CT pelvis w/o contrast (72192) |
$1,192.10 |
$1,834 |
11.3× |
| CT scan of leg combo (73702) |
$1,114.10 |
$1,714 |
6.3× |
| CT scans face/jaw combo (70488) |
$1,583.40 |
$2,436 |
9.0× |
| CT soft tissue neck w contrast (70491) |
$1,136.20 |
$1,748 |
6.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,002.95 |
$1,543 |
9.5× |
| CT thoracic spine w contrast (72129) |
$1,654.90 |
$2,546 |
9.4× |
| CT thoracic spine w/o contrast (72128) |
$1,518.40 |
$2,336 |
14.4× |
| CT thorax w/o contrast (71250) |
$1,068.60 |
$1,644 |
10.1× |
| CT unlisted procedure (76497) |
$264.55 |
$407 |
3.0× |
| CT upper ext wo (73200) |
$911.95 |
$1,403 |
8.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,114.10 |
$1,714 |
6.3× |
| CT upper extremity with contrast (73201) |
$1,032.85 |
$1,589 |
2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,457.65 |
$3,781 |
13.9× |
| Cta Abdomen (74175) |
$1,862.90 |
$2,866 |
10.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$793.65 |
$1,221 |
2.3× |
| CTA pelvis (72191) |
$1,390.35 |
$2,139 |
7.9× |
| Dxa Bone Density Axial (77080) |
$550.55 |
$847 |
5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$415.35 |
$639 |
4.7× |
| Esophagram (74220) |
$254.15 |
$391 |
1.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$522.60 |
$804 |
5.0× |
| Fluoroscopy up to 1 hr (76000) |
$371.15 |
$571 |
1.5× |
| Foot 2 views (73620) |
$120.90 |
$186 |
1.4× |
| Forearm 2 views (73090) |
$187.20 |
$288 |
2.1× |
| Gastric emptying imaging study (78264) |
$982.15 |
$1,511 |
2.4× |
| Gated Heart Planar Single (78472) |
$1,214.20 |
$1,868 |
3.0× |
| Hand 2 views (73120) |
$120.90 |
$186 |
1.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,037.15 |
$6,211 |
1.3× |
| Hepatobil Syst Image W/Drug (78227) |
$971.10 |
$1,494 |
1.8× |
| Hepatobiliary System Imaging (78226) |
$923.65 |
$1,421 |
2.3× |
| Ht Muscle Image Spect Sing (78451) |
$2,295.80 |
$3,532 |
1.8× |
| Hysterosalpingogram (74740) |
$609.05 |
$937 |
2.5× |
| Image fusion (77399) |
$1,082.90 |
$1,666 |
8.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$559 |
$860 |
6.4× |
| Infant hip ultrasound, limited static exam (76886) |
$559 |
$860 |
6.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,412.45 |
$2,173 |
2.6× |
| K Flow/Funct Image W/O Drug (78707) |
$1,113.45 |
$1,713 |
2.0× |
| Knee 3 Views (73562) |
$209.30 |
$322 |
2.4× |
| Liver & Spleen Imaging Static Only (78215) |
$1,017.90 |
$1,566 |
2.5× |
| Lung perfusion differential (78597) |
$729.95 |
$1,123 |
1.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,227.20 |
$1,888 |
2.2× |
| Lymph System Imaging (78195) |
$1,077.70 |
$1,658 |
2.0× |
| Magnetic Image Jaw Joint (70336) |
$1,643.20 |
$2,528 |
6.8× |
| Mammary ductogram or galactogram single (77053) |
$384.15 |
$591 |
1.6× |
| Meckels Divert Exam (78290) |
$741 |
$1,140 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,151.80 |
$1,772 |
3.1× |
| Mr safety determination physician/other qhp (76016) |
$145.60 |
$224 |
1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$40.30 |
$62 |
1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$152.75 |
$235 |
1.6× |
| Mr safety implt pos&/immoblj (76019) |
$99.45 |
$153 |
1.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$401.05 |
$617 |
1.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,939.60 |
$2,984 |
5.5× |
| MRA head w/o contrast (70544) |
$1,405.30 |
$2,162 |
5.8× |
| MRA neck w contrast (70548) |
$1,912.30 |
$2,942 |
5.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,939.60 |
$2,984 |
5.5× |
| MRA neck w/o contrast (70547) |
$1,477.45 |
$2,273 |
6.1× |
| MRI abdomen w contrast (74182) |
$1,766.70 |
$2,718 |
5.0× |
| MRI abdomen w/o contrast (74181) |
$1,667.25 |
$2,565 |
6.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,832.35 |
$2,819 |
2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,260.05 |
$3,477 |
6.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,842.10 |
$2,834 |
2.3× |
| MRI cervical spine w contrast (72142) |
$1,846.65 |
$2,841 |
5.3× |
| MRI cervical spine w/o cont (72141) |
$1,648.40 |
$2,536 |
6.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,957.80 |
$3,012 |
5.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,504.75 |
$2,315 |
6.3× |
| MRI lumbar spine w contrast (72149) |
$1,912.30 |
$2,942 |
5.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,019.90 |
$4,646 |
8.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,643.20 |
$2,528 |
6.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,111.55 |
$4,787 |
8.9× |
| MRI pelvis w contrast (72196) |
$1,766.70 |
$2,718 |
5.0× |
| MRI pelvis w/o & w contrast (72197) |
$2,367.95 |
$3,643 |
6.7× |
| MRI pelvis w/o contrast (72195) |
$1,643.20 |
$2,528 |
6.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,667.25 |
$2,565 |
6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,504.75 |
$2,315 |
6.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,957.80 |
$3,012 |
5.6× |
| MRI, abdomen, combo (74183) |
$2,308.15 |
$3,551 |
6.6× |
| MRI, dorsal spine combo (72157) |
$2,989.35 |
$4,599 |
8.5× |
| MRI, dorsal spine contrast (72147) |
$1,912.30 |
$2,942 |
5.4× |
| MRI, joint upper extrem (73221) |
$1,643.20 |
$2,528 |
6.8× |
| MRI, joint upper extrem combo (73223) |
$2,260.05 |
$3,477 |
6.4× |
| MRI, lumbar spine combo (72158) |
$2,989.35 |
$4,599 |
8.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,819.40 |
$5,876 |
2.9× |
| Neck soft tissue (70360) |
$146.90 |
$226 |
1.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,528.55 |
$6,967 |
3.2× |
| Nuclear Rx Oral Admin (79005) |
$1,131.65 |
$1,741 |
4.8× |
| Parathyroid Planar Imaging (78070) |
$737.75 |
$1,135 |
1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,415.70 |
$2,178 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$204.75 |
$315 |
1.9× |
| PET image w/CT, full body (78816) |
$3,459.30 |
$5,322 |
2.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,459.30 |
$5,322 |
2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$729.95 |
$1,123 |
1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$250.25 |
$385 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$411.45 |
$633 |
0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$214.50 |
$330 |
2.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$120.90 |
$186 |
1.4× |
| Radex elbow complete minimum 3 views (73080) |
$223.60 |
$344 |
2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$146.90 |
$226 |
1.4× |
| Radex fingr minimum 2 views (73140) |
$120.90 |
$186 |
1.4× |
| Radex foot complete minimum 3 views (73630) |
$239.85 |
$369 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$219.05 |
$337 |
2.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$174.20 |
$268 |
2.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$247.65 |
$381 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$234 |
$360 |
2.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$221 |
$340 |
2.5× |
| Radex shoulder complete minimum 2 views (73030) |
$239.85 |
$369 |
2.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$135.20 |
$208 |
1.5× |
| Radex Spine 1 View Specify Level (72020) |
$107.90 |
$166 |
1.2× |
| Radex Sternum Minimum 2 Views (71120) |
$120.90 |
$186 |
1.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$135.20 |
$208 |
1.5× |
| Radex Toe Minimum 2 Views (73660) |
$120.90 |
$186 |
1.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$174.20 |
$268 |
1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$219.05 |
$337 |
2.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$19,181.50 |
$29,510 |
2.6× |
| Radiation treatment delivery level 1 (77402) |
$1,648.40 |
$2,536 |
16.0× |
| Radiation treatment delivery level 2 (77407) |
$2,060.50 |
$3,170 |
5.3× |
| Radiation treatment delivery level 3 (77412) |
$2,472.60 |
$3,804 |
4.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$258.70 |
$398 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$193.05 |
$297 |
1.8× |
| Radiologic exam colon double contrast study (74280) |
$492.05 |
$757 |
2.8× |
| Radiologic exam colon single contrast study (74270) |
$438.10 |
$674 |
2.5× |
| Radiologic exam knee complete 4/more views (73564) |
$266.50 |
$410 |
2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$258.70 |
$398 |
2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$226.85 |
$349 |
1.3× |
| Radiologic exam swallow function contrast study (74230) |
$284.70 |
$438 |
1.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$435.50 |
$670 |
2.5× |
| Radiologic examination femur 1 view (73551) |
$174.20 |
$268 |
2.0× |
| Radiologic examination femur minimum 2 views (73552) |
$232.05 |
$357 |
2.6× |
| Radiologic examination knee 1/2 views (73560) |
$120.90 |
$186 |
1.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$267.15 |
$411 |
2.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$205.40 |
$316 |
2.3× |
| Ribs bilateral 3 views (71110) |
$187.20 |
$288 |
1.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,164.15 |
$1,791 |
2.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,164.15 |
$1,791 |
2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,380.30 |
$3,662 |
4.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,589.90 |
$2,446 |
2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,371.85 |
$3,649 |
4.3× |
| Scapula (73010) |
$120.90 |
$186 |
1.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$47.45 |
$73 |
2.0× |
| Shoulder 1 view (73020) |
$109.85 |
$169 |
1.3× |
| Skull less than 4 views (70250) |
$139.75 |
$215 |
1.3× |
| Special dosimetry (77331) |
$973.05 |
$1,497 |
7.2× |
| Special Physics Consult (77370) |
$1,082.90 |
$1,666 |
8.0× |
| Special teletherapy port plan (77321) |
$1,337.05 |
$2,057 |
3.5× |
| Special treatment procedure (77470) |
$3,586.70 |
$5,518 |
6.4× |
| Stereotactic Body Radiation Delivery (77373) |
$7,192.25 |
$11,065 |
4.0× |
| Sternoclavicular joints (71130) |
$159.90 |
$246 |
1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,279.85 |
$1,969 |
3.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$514.15 |
$791 |
1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,463.15 |
$2,251 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$689 |
$1,060 |
5.1× |
| Thoracic spine 2 views (72070) |
$265.20 |
$408 |
2.5× |
| Thoracic spine 3 views (72072) |
$323.05 |
$497 |
3.1× |
| Thoracolumbar 2 views (72080) |
$195.65 |
$301 |
2.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$657.15 |
$1,011 |
1.6× |
| Thyroid Uptake Measurement (78012) |
$532.35 |
$819 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$751.40 |
$1,156 |
1.9× |
| Tx Devices Design & Construction Complex (77334) |
$1,099.15 |
$1,691 |
2.9× |
| Tx devices design & construction intermediate (77333) |
$637 |
$980 |
4.7× |
| Tx devices design & construction simple (77332) |
$497.90 |
$766 |
3.7× |
| Ultrasound Breast Limited (76642) |
$384.80 |
$592 |
4.4× |
| Ultrasound Elastography Parenchyma (76981) |
$286.65 |
$441 |
2.7× |
| Ultrasound Exam Aaa Screen (76706) |
$284.05 |
$437 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$430.30 |
$662 |
4.1× |
| Unlisted magnetic resonance procedure (76498) |
$1,068.60 |
$1,644 |
12.2× |
| Upper gi w/o kub (74240) |
$391.30 |
$602 |
2.2× |
| Urethrocystogram voiding (74455) |
$352.95 |
$543 |
1.5× |
| Urethrocystography retrograde (74450) |
$352.95 |
$543 |
1.5× |
| Us breast unilateral complete (76641) |
$406.25 |
$625 |
3.9× |
| Us chest (76604) |
$399.75 |
$615 |
3.8× |
| Us complete joint (76881) |
$303.55 |
$467 |
2.9× |
| Us exam, pelvic, limited (76857) |
$299.65 |
$461 |
2.8× |
| Us head (76506) |
$664.30 |
$1,022 |
6.3× |
| Us kidney transplant (76776) |
$286.65 |
$441 |
2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$196.30 |
$302 |
1.9× |
| Us ob detailed single fetus (76811) |
$705.25 |
$1,085 |
2.9× |
| Us ob limited 1 or more fetuses (76815) |
$552.50 |
$850 |
5.2× |
| Us ob transvaginal (76817) |
$406.25 |
$625 |
3.9× |
| Us pelvic non ob complete (76856) |
$531.70 |
$818 |
5.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$705.25 |
$1,085 |
6.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$163.15 |
$251 |
1.5× |
| Us retroperitoneal complete (76770) |
$688.35 |
$1,059 |
6.5× |
| Us retroperitoneal limited (76775) |
$397.15 |
$611 |
3.8× |
| Us scrotum and contents (76870) |
$602.55 |
$927 |
5.7× |
| Us spinal canal and contents (76800) |
$323.05 |
$497 |
3.1× |
| Us thyroid (76536) |
$416 |
$640 |
3.9× |
| Us transrectal (76872) |
$703.95 |
$1,083 |
6.7× |
| Venography caval inferior serialography rs&i (75825) |
$4,238.65 |
$6,521 |
1.3× |
| Venography extremity bilateral rs&i (75822) |
$2,026.05 |
$3,117 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,634.75 |
$2,515 |
1.0× |
| Wrist 2 views (73100) |
$165.75 |
$255 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$135.20 |
$208 |
1.5× |
| X-Ray Aorta Leg Arteries (75630) |
$3,054.35 |
$4,699 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$247.65 |
$381 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$109.85 |
$169 |
1.3× |
| X-Ray Exam Breast Specimen (76098) |
$651.95 |
$1,003 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$174.20 |
$268 |
2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$290.55 |
$447 |
2.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$109.85 |
$169 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$266.50 |
$410 |
3.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$312.65 |
$481 |
3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$266.50 |
$410 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$312.65 |
$481 |
3.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$374.40 |
$576 |
3.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$313.30 |
$482 |
3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$135.20 |
$208 |
1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$410.15 |
$631 |
3.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$274.30 |
$422 |
2.6× |
| X-ray eye for foreign body (70030) |
$213.20 |
$328 |
2.4× |
| X-ray humerus (73060) |
$206.05 |
$317 |
2.3× |
| X-ray IV pyelogram (ivp) (74400) |
$528.45 |
$813 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$120.90 |
$186 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$209.30 |
$322 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$274.30 |
$422 |
2.6× |
| X-ray nose-rectum child f.b. (76010) |
$87.10 |
$134 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$208 |
$320 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$258.70 |
$398 |
2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$120.90 |
$186 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$214.50 |
$330 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$272.35 |
$419 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$328.25 |
$505 |
3.1× |
| X-Ray Stress View (77071) |
$120.90 |
$186 |
1.4× |
| X-ray thoracic spine 4 vw (72074) |
$393.90 |
$606 |
3.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$447.85 |
$689 |
1.3× |
| X-Rays Bone Length Studies (77073) |
$163.15 |
$251 |
1.5× |
| X-Rays Bone Survey Complete (77075) |
$267.15 |
$411 |
2.5× |
| Xr c-spine 4 or 5 views (72050) |
$342.55 |
$527 |
3.3× |
| Xr facial bones less than 3 views (70140) |
$135.20 |
$208 |
1.5× |
| Xr orbits complete 4 views (70200) |
$146.90 |
$226 |
1.4× |