| Abdomen 2 views (74019) |
$439.40 |
$845 |
3.7× |
| Acute gi blood loss imaging (78278) |
$1,101.36 |
$2,118 |
2.4× |
| Angiography extremity bilateral rs&i (75716) |
$6,384.56 |
$12,278 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$6,384.56 |
$12,278 |
1.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$16,386.24 |
$31,512 |
2.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,048.72 |
$7,786 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$11,291.28 |
$21,714 |
1.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$10,924.68 |
$21,009 |
1.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,517.32 |
$4,841 |
0.7× |
| Ankle 2 views (73600) |
$206.96 |
$398 |
2.1× |
| Aortogram thoracic (75605) |
$10,924.68 |
$21,009 |
1.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$6,384.56 |
$12,278 |
1.8× |
| Aortography abdominal serialography rs&i (75625) |
$6,384.56 |
$12,278 |
1.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,101.36 |
$2,118 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$1,101.36 |
$2,118 |
2.4× |
| Bone age studies (77072) |
$397.28 |
$764 |
3.3× |
| Bone Imaging 3 Phase (78315) |
$1,101.36 |
$2,118 |
2.4× |
| Bone survey complete (77075) |
$397.28 |
$764 |
3.3× |
| Bone survey infant (77076) |
$397.28 |
$764 |
3.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,351.48 |
$2,599 |
2.2× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,101.36 |
$2,118 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$184.60 |
$355 |
1.8× |
| Chest 1 view (71045) |
$236.60 |
$455 |
2.4× |
| Chest xray 3 views (71047) |
$236.60 |
$455 |
2.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$392.60 |
$755 |
1.9× |
| Clavicle complete (73000) |
$310.44 |
$597 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$235.56 |
$453 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,175.68 |
$4,184 |
5.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,116.96 |
$2,148 |
4.1× |
| CT abdomen w contrast (74160) |
$1,698.32 |
$3,266 |
8.4× |
| CT abdomen w wo contrast (74170) |
$1,728.48 |
$3,324 |
8.6× |
| CT abdomen w/o contrast (74150) |
$1,396.72 |
$2,686 |
11.6× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,214.68 |
$4,259 |
11.0× |
| CT angiography upper extremity lt (73206) |
$1,698.32 |
$3,266 |
8.4× |
| CT c-spine w/contrast (72126) |
$1,215.76 |
$2,338 |
3.0× |
| CT c-spine w/o contrast (72125) |
$1,004.12 |
$1,931 |
8.4× |
| CT chest w contrast (71260) |
$1,698.32 |
$3,266 |
8.4× |
| CT chest w/wo contrast (71270) |
$1,836.64 |
$3,532 |
9.1× |
| CT head/brain with contrast (70460) |
$1,218.36 |
$2,343 |
6.0× |
| CT head/brain without and with contrast (70470) |
$1,353.04 |
$2,602 |
6.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$743.08 |
$1,429 |
1.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$187.72 |
$361 |
1.9× |
| CT iac w contrast (70481) |
$1,218.36 |
$2,343 |
6.0× |
| CT limited/localized follow up study (76380) |
$648.96 |
$1,248 |
6.5× |
| CT lower ext w/o (73700) |
$1,350.96 |
$2,598 |
11.2× |
| CT lower extremity w/contrast material (73701) |
$1,711.32 |
$3,291 |
8.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,834.04 |
$3,527 |
9.1× |
| CT lumbar spine w/contrast (72132) |
$1,670.76 |
$3,213 |
4.2× |
| CT lumbar spine w/o contrast (72131) |
$1,215.76 |
$2,338 |
10.1× |
| CT maxillofacial w contrast (70487) |
$1,218.36 |
$2,343 |
6.0× |
| CT maxillofacial wo contrast (70486) |
$986.70 |
$1,897.50 |
8.2× |
| CT orbits w/o contrast (70480) |
$807.04 |
$1,552 |
6.7× |
| CT pelvis w/o contrast (72192) |
$1,691.56 |
$3,253 |
14.1× |
| CT pelvis w/wo contrast (72194) |
$2,201.68 |
$4,234 |
10.9× |
| CT scan of arm combo (73202) |
$1,857.44 |
$3,572 |
9.2× |
| CT soft tissue neck w contrast (70491) |
$1,218.36 |
$2,343 |
6.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,353.04 |
$2,602 |
6.7× |
| CT soft tissue neck w/o contrast (70490) |
$884 |
$1,700 |
7.4× |
| CT thoracic spine w/contrast (72129) |
$1,474.72 |
$2,836 |
7.3× |
| CT thoracic spine w/o contrast (72128) |
$1,215.76 |
$2,338 |
10.1× |
| CT thorax w/o contrast (71250) |
$1,305.72 |
$2,511 |
10.9× |
| CT upper ext wo (73200) |
$1,623.44 |
$3,122 |
13.5× |
| CT upper extremity with contrast (73201) |
$1,694.16 |
$3,258 |
4.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,568.84 |
$3,017 |
7.8× |
| Cta Abdomen (74175) |
$1,750.32 |
$3,366 |
8.7× |
| CTA abdomen pelvis (74174) |
$2,512.64 |
$4,832 |
6.3× |
| CTA chest (71275) |
$1,379.56 |
$2,653 |
6.8× |
| Cta Head (70496) |
$1,316.64 |
$2,532 |
6.5× |
| Cta Neck (70498) |
$1,301.56 |
$2,503 |
6.5× |
| Cta Pelvis (72191) |
$2,604.68 |
$5,009 |
12.9× |
| Cystography minimum 3 views rs&i (74430) |
$935.48 |
$1,799 |
2.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$221 |
$425 |
1.8× |
| Esophagus (74220) |
$935.48 |
$1,799 |
4.6× |
| Facial bones min 3 views (70150) |
$397.28 |
$764 |
3.3× |
| Fetal biophysical profile non-stress testing (76818) |
$1,362.40 |
$2,620 |
11.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$485.16 |
$933 |
4.0× |
| Fluoroscopy up to 1 hr (76000) |
$304.72 |
$586 |
1.1× |
| Foot 2 views (73620) |
$310.44 |
$597 |
3.1× |
| Forearm 2 views (73090) |
$206.96 |
$398 |
2.1× |
| Hand 2 views (73120) |
$397.28 |
$764 |
3.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,788.60 |
$13,055 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,351.48 |
$2,599 |
2.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,049.36 |
$2,018 |
2.3× |
| Interstitial radiation source applic complex (77778) |
$3,629.60 |
$6,980 |
4.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$354.64 |
$682 |
2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,427.40 |
$2,745 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,427.40 |
$2,745 |
2.3× |
| Knee 3 views (73562) |
$310.44 |
$597 |
3.1× |
| Liver & spleen imaging static only (78215) |
$883.48 |
$1,699 |
1.9× |
| Liver imaging static only (78201) |
$3,787.68 |
$7,284 |
6.1× |
| Lung perfusion differential (78597) |
$1,175.20 |
$2,260 |
2.6× |
| Lung ventilation imaging (78579) |
$794.04 |
$1,527 |
1.7× |
| Lymphoscintigraphy (78195) |
$1,427.40 |
$2,745 |
2.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,014.44 |
$5,797 |
3.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,016.56 |
$3,878 |
5.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,159.04 |
$4,152 |
5.4× |
| Mr safety determination physician/other qhp (76016) |
$173.68 |
$334 |
1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$48.36 |
$93 |
1.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$181.48 |
$349 |
1.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$477.88 |
$919 |
1.7× |
| MRA head w & w/o contrast (70546) |
$1,512.16 |
$2,908 |
3.8× |
| MRA head w/o contrast (70544) |
$812.76 |
$1,563 |
3.0× |
| MRA head with contrast (70545) |
$837.72 |
$1,611 |
2.1× |
| MRA neck w contrast (70548) |
$902.72 |
$1,736 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,512.16 |
$2,908 |
3.8× |
| MRA neck w/o contrast (70547) |
$812.76 |
$1,563 |
3.0× |
| MRI abdomen w contrast (74182) |
$743.08 |
$1,429 |
1.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,016.56 |
$3,878 |
5.0× |
| MRI abdomen w/o contrast (74181) |
$1,083.68 |
$2,084 |
3.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,014.44 |
$5,797 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,156.40 |
$6,070 |
7.9× |
| MRI c-spine with contrast (72142) |
$983.32 |
$1,891 |
2.5× |
| MRI cervical spine w/o contrast (72141) |
$812.76 |
$1,563 |
3.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,016.56 |
$3,878 |
5.0× |
| MRI chest w/o contrast (71550) |
$998.40 |
$1,920 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$782.60 |
$1,505 |
2.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,047.28 |
$2,014 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$806.60 |
$1,551.15 |
2.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$812.76 |
$1,563 |
3.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,512.16 |
$2,908 |
3.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,016.56 |
$3,878 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,083.68 |
$2,084 |
3.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,512.16 |
$2,908 |
3.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,016.56 |
$3,878 |
5.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,215.72 |
$4,261 |
5.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,800.24 |
$3,462 |
4.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,016.56 |
$3,878 |
5.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,083.68 |
$2,084 |
3.9× |
| MRI up ext w/o contrast (73218) |
$1,083.68 |
$2,084 |
3.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,083.68 |
$2,084 |
3.9× |
| MRI, joint upper extrem combo (73223) |
$3,156.40 |
$6,070 |
7.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,787.68 |
$7,284 |
2.5× |
| Myocardial spect single study at rest or stress (78451) |
$3,787.68 |
$7,284 |
2.5× |
| Neck soft tissue (70360) |
$204.36 |
$393 |
2.0× |
| Nm cisternogram (78630) |
$1,215.76 |
$2,338 |
1.9× |
| Nm gastric emptying study (78264) |
$1,101.36 |
$2,118 |
2.4× |
| Nuclear Rx Oral Admin (79005) |
$703.56 |
$1,353 |
2.6× |
| Osseous survey limited (77074) |
$354.64 |
$682 |
2.9× |
| Parathyrd planar w/spect&CT (78072) |
$1,351.48 |
$2,599 |
2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,240.20 |
$2,385 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$397.28 |
$764 |
3.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,427.40 |
$2,745 |
2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$810.16 |
$1,558 |
1.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$310.44 |
$597 |
3.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$310.44 |
$597 |
3.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$300.56 |
$578 |
3.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$397.28 |
$764 |
3.3× |
| Radex fingr minimum 2 views (73140) |
$206.96 |
$398 |
2.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$310.44 |
$597 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$310.44 |
$597 |
3.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$143.52 |
$276 |
1.4× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$354.64 |
$682 |
2.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$354.64 |
$682 |
2.9× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$553.28 |
$1,064 |
4.6× |
| Radex Humerus Minimum 2 Views (73060) |
$206.96 |
$398 |
2.1× |
| Radex Kne 1/2 Views (73560) |
$310.44 |
$597 |
3.1× |
| Radex Kne Compl 4/More Views (73564) |
$707.47 |
$1,360.52 |
5.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$397.28 |
$764 |
3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$206.96 |
$398 |
2.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$421.20 |
$810 |
3.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$310.44 |
$597 |
3.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$206.96 |
$398 |
2.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$395.72 |
$761 |
3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$206.96 |
$398 |
2.1× |
| Radex Toe Minimum 2 Views (73660) |
$206.96 |
$398 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$354.64 |
$682 |
2.9× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$310.44 |
$597 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$293.80 |
$565 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$563.16 |
$1,083 |
4.7× |
| Radiologic exam chest 2 views (71046) |
$236.60 |
$455 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$935.48 |
$1,799 |
4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$973.96 |
$1,873 |
4.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$955.76 |
$1,838 |
4.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$935.48 |
$1,799 |
4.6× |
| Radiologic examination femur 1 view (73551) |
$184.60 |
$355 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$276.64 |
$532 |
2.8× |
| Ribs bilateral 3 views (71110) |
$354.64 |
$682 |
2.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$880.88 |
$1,694 |
1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,860.52 |
$5,501 |
4.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,860.52 |
$5,501 |
4.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,860.52 |
$5,501 |
4.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,195.92 |
$6,146 |
1.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,860.52 |
$5,501 |
1.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$642.20 |
$1,235 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$703.56 |
$1,353 |
2.6× |
| Sacroiliac Joints < 3 Views (72200) |
$354.64 |
$682 |
2.9× |
| Scapula (73010) |
$397.28 |
$764 |
3.3× |
| Shoulder 1 view (73020) |
$206.96 |
$398 |
2.1× |
| Small bowel series (74250) |
$439.40 |
$845 |
2.2× |
| Spine thoracic 3 views (72072) |
$421.20 |
$810 |
3.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,466.92 |
$2,821 |
3.4× |
| Thoracolumbar 2 views (72080) |
$206.96 |
$398 |
2.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,427.40 |
$2,745 |
2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,049.36 |
$2,018 |
2.3× |
| Tmj unilateral (70328) |
$206.96 |
$398 |
2.1× |
| Treatment devices simple (77332) |
$637.52 |
$1,226 |
4.1× |
| Ultrasound breast complete (76641) |
$689.52 |
$1,326 |
5.7× |
| Ultrasound Exam Aaa Screen (76706) |
$485.16 |
$933 |
4.0× |
| Ultrasound, abdomen limited (76705) |
$508.04 |
$977 |
4.2× |
| Umbilical-artery Doppler (OB) (76820) |
$288.60 |
$555 |
2.4× |
| Unlisted ultrasound procedure (76999) |
$252.72 |
$486 |
2.5× |
| Urethrocystogram voiding (74455) |
$907.92 |
$1,746 |
3.3× |
| Urethrocystography retrograde rs&i (74450) |
$907.92 |
$1,746 |
3.3× |
| Us breast unilateral limited (76642) |
$383.50 |
$737.50 |
3.8× |
| Us chest (76604) |
$453.44 |
$872 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$485.16 |
$933 |
4.0× |
| Us encephalogram (76506) |
$543.40 |
$1,045 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$485.16 |
$933 |
4.0× |
| Us ob limited (76815) |
$508.04 |
$977 |
4.2× |
| Us ob transvaginal (76817) |
$485.16 |
$933 |
4.0× |
| Us pelvic non ob complete (76856) |
$543.40 |
$1,045 |
4.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$453.44 |
$872 |
3.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$543.40 |
$1,045 |
4.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$543.40 |
$1,045 |
4.5× |
| Us retroperitoneal complete (76770) |
$543.40 |
$1,045 |
4.5× |
| Us retroperitoneal limited (76775) |
$508.04 |
$977 |
4.2× |
| Us scrotum and contents (76870) |
$543.40 |
$1,045 |
4.5× |
| Us soft tissue head/neck (76536) |
$508.04 |
$977 |
4.2× |
| Us spinal canal and contents (76800) |
$543.40 |
$1,045 |
4.5× |
| Us, eye b-scan (76512) |
$234.26 |
$450.50 |
1.9× |
| Us,transplanted kidney, real time/ doppler (76776) |
$543.40 |
$1,045 |
4.5× |
| Venogram extremity bilateral (75822) |
$2,517.32 |
$4,841 |
1.4× |
| Venogram Extremity Unilateral (75820) |
$1,568.84 |
$3,017 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$6,384.56 |
$12,278 |
1.8× |
| Venography caval superior serialography rs&i (75827) |
$1,568.84 |
$3,017 |
0.9× |
| Venography Renal Bilateral (75833) |
$6,788.60 |
$13,055 |
1.9× |
| Venography renal unilateral selective rs&i (75831) |
$6,788.60 |
$13,055 |
1.9× |
| Venography venous sinus/jugular cath rs&i (75860) |
$6,501.04 |
$12,502 |
1.8× |
| Wrist 2 views (73100) |
$184.60 |
$355 |
1.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$439.40 |
$845 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$206.96 |
$398 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$935.48 |
$1,799 |
4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$276.64 |
$532 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$184.60 |
$355 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$531.44 |
$1,022 |
4.4× |
| X-ray exam of femur 2/> (73552) |
$184.60 |
$355 |
1.8× |
| X-ray eye for foreign body (70030) |
$204.36 |
$393 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$206.96 |
$398 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$206.96 |
$398 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$184.60 |
$355 |
1.8× |
| X-ray leg, infant (73592) |
$184.60 |
$355 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$397.28 |
$764 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$481 |
$925 |
4.0× |
| X-ray nose-rectum child f.b. (76010) |
$204.36 |
$393 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$397.28 |
$764 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$206.96 |
$398 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$397.28 |
$764 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$397.28 |
$764 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$397.28 |
$764 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$206.96 |
$398 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$206.96 |
$398 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$397.28 |
$764 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$397.28 |
$764 |
3.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$206.96 |
$398 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$184.60 |
$355 |
1.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$206.96 |
$398 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$397.28 |
$764 |
3.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$450.84 |
$867 |
3.7× |
| Xr bone length studies (77073) |
$397.28 |
$764 |
3.3× |
| Xr c-spine 4 or 5 views (72050) |
$397.28 |
$764 |
3.3× |
| Xr c-spine 6 or more views (72052) |
$397.28 |
$764 |
3.3× |
| Xr chest 4+ views (71048) |
$452.92 |
$871 |
3.8× |
| Xr urogram antegrade (74425) |
$1,341.08 |
$2,579 |
3.3× |