| Abdomen 2 views (74019) |
$156.65 |
$602.50 |
1.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$240.89 |
$926.50 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$547.43 |
$2,105.50 |
0.2× |
| Angiography extremity unilateral rs&i (75710) |
$469.04 |
$1,804 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$625.17 |
$2,404.50 |
0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$625.17 |
$2,404.50 |
0.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$625.17 |
$2,404.50 |
0.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$282.75 |
$1,087.50 |
0.1× |
| Ankle 2 views (73600) |
$106.92 |
$411.25 |
1.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$253.63 |
$975.50 |
0.8× |
| Aortogram thoracic (75605) |
$625.17 |
$2,404.50 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$772.72 |
$2,972 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$625.17 |
$2,404.50 |
0.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$328.25 |
$1,262.50 |
0.1× |
| Arthrogram elbow (73085) |
$367.51 |
$1,413.50 |
1.2× |
| Arthrogram hip (73525) |
$268.19 |
$1,031.50 |
0.9× |
| Arthrogram shoulder (73040) |
$512.59 |
$1,971.50 |
1.7× |
| Arthrogram wrist (73115) |
$224.64 |
$864 |
0.7× |
| Arthrography knee lt (73580) |
$423.54 |
$1,629 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$18.59 |
$71.50 |
0.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$103.09 |
$396.50 |
0.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$579.28 |
$2,228 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$623.48 |
$2,398 |
1.8× |
| Bone age studies (77072) |
$114.14 |
$439 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$381.03 |
$1,465.50 |
1.1× |
| Bone Marrow Imaging Limited Area (78102) |
$353.60 |
$1,360 |
1.0× |
| Bone survey complete (77075) |
$175.24 |
$674 |
1.9× |
| Brain Imaging Vascular Flow Only (78610) |
$330.33 |
$1,270.50 |
0.7× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$172.51 |
$663.50 |
15.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$305.63 |
$1,175.50 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$98.80 |
$380 |
1.3× |
| Chest 1 view (71045) |
$85.54 |
$329 |
1.1× |
| Chest 3 views (71047) |
$167.05 |
$642.50 |
2.2× |
| Clavicle complete (73000) |
$87.62 |
$337 |
1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$52.53 |
$202.04 |
0.6× |
| Continuing medical physics consltj pr wk (77336) |
$37.70 |
$145 |
0.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,954.68 |
$7,518 |
6.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,186.25 |
$4,562.50 |
5.7× |
| CT abdomen w contrast (74160) |
$645.32 |
$2,482 |
4.2× |
| CT abdomen w wo contrast (74170) |
$913.51 |
$3,513.50 |
6.0× |
| CT abdomen w/o contrast (74150) |
$588.77 |
$2,264.50 |
6.5× |
| CT angio hrt w/3d image (75574) |
$471.12 |
$1,812 |
1.6× |
| CT angiography upper extremity lt (73206) |
$1,048.97 |
$4,034.50 |
6.9× |
| CT c-spine w/o contrast (72125) |
$710.45 |
$2,732.50 |
7.8× |
| CT cervical spine with contrast (72126) |
$835.64 |
$3,214 |
2.8× |
| CT chest w/wo contrast (71270) |
$1,164.80 |
$4,480 |
7.7× |
| CT chest with contrast (71260) |
$962.39 |
$3,701.50 |
6.3× |
| CT head/brain with contrast (70460) |
$817.31 |
$3,143.50 |
5.4× |
| CT head/brain without and with contrast (70470) |
$1,021.67 |
$3,929.50 |
6.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$13 |
$50 |
0.2× |
| CT iac w contrast (70481) |
$654.68 |
$2,518 |
4.3× |
| CT limited/localized follow up study (76380) |
$465.53 |
$1,790.50 |
6.2× |
| CT lower ext w/o (73700) |
$783.25 |
$3,012.50 |
8.7× |
| CT lower extremity w wo contrast (73702) |
$769.47 |
$2,959.50 |
5.1× |
| CT lower extremity with contrast (73701) |
$680.81 |
$2,618.50 |
4.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,006.07 |
$3,869.50 |
6.6× |
| CT lumbar spine w/o contrast (72131) |
$880.23 |
$3,385.50 |
9.7× |
| CT lumbar spine with contrast (72132) |
$1,006.07 |
$3,869.50 |
3.3× |
| CT maxillofacial w contrast (70487) |
$772.72 |
$2,972 |
5.1× |
| CT maxillofacial w/o contrast (70486) |
$570.96 |
$2,196 |
6.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,021.67 |
$3,929.50 |
6.7× |
| CT neck soft tissue w contrast (70491) |
$888.29 |
$3,416.50 |
5.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$785.98 |
$3,023 |
5.2× |
| CT orbits w/o contrast (70480) |
$654.68 |
$2,518 |
7.2× |
| CT pelvis w & w/o contrast (72194) |
$1,041.30 |
$4,005 |
6.9× |
| CT pelvis w/o contrast (72192) |
$344.62 |
$1,325.44 |
3.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$817.05 |
$3,142.50 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$540.28 |
$2,078 |
6.0× |
| CT thoracic spine w/contrast (72129) |
$835.64 |
$3,214 |
5.5× |
| CT thoracic spine w/o contrast (72128) |
$931.06 |
$3,581 |
10.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,012.70 |
$3,895 |
6.7× |
| CT thorax w/o contrast (71250) |
$901.94 |
$3,469 |
10.0× |
| CT unlisted procedure (76497) |
$43.81 |
$168.50 |
0.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$404.17 |
$1,554.50 |
2.7× |
| CT upper extremity w/o contrast rt (73200) |
$412.36 |
$1,586 |
4.6× |
| CT upper extremity with contrast (73201) |
$358.02 |
$1,377 |
1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,198.60 |
$4,610 |
7.9× |
| Cta Abdomen (74175) |
$1,378.52 |
$5,302 |
9.1× |
| CTA abdomen pelvis (74174) |
$551.72 |
$2,122 |
1.8× |
| CTA chest (71275) |
$1,019.20 |
$3,920 |
6.7× |
| Cta Head (70496) |
$1,019.20 |
$3,920 |
6.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,048.97 |
$4,034.50 |
6.9× |
| Cta Neck (70498) |
$575.51 |
$2,213.50 |
3.8× |
| Cta Pelvis (72191) |
$1,198.60 |
$4,610 |
7.9× |
| Cystography minimum 3 views rs&i (74430) |
$644.93 |
$2,480.50 |
2.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$63.05 |
$242.50 |
0.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$28.34 |
$109 |
0.4× |
| Echoencephalography real time imaging (76506) |
$286 |
$1,100 |
3.2× |
| Esophagus (74220) |
$103.09 |
$396.50 |
0.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$214.89 |
$826.50 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$205.79 |
$791.50 |
1.0× |
| Foot 2 views (73620) |
$68.06 |
$261.75 |
0.9× |
| Forearm 2 views (73090) |
$104.78 |
$403 |
1.4× |
| Gated Heart Planar Single (78472) |
$353.34 |
$1,359 |
1.0× |
| Hand 2 views (73120) |
$87.75 |
$337.50 |
1.0× |
| Hand 3 views (73130) |
$104.13 |
$400.50 |
1.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$631.74 |
$2,429.75 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$647.27 |
$2,489.50 |
1.9× |
| Ht muscle image spect sing (78451) |
$733.33 |
$2,820.50 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$104.13 |
$400.50 |
1.4× |
| Hysterosalpingogram (74740) |
$222.82 |
$857 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$344.30 |
$1,324.25 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$513.89 |
$1,976.50 |
1.1× |
| Knee 3 views (73562) |
$120.77 |
$464.50 |
1.6× |
| Liver & spleen imaging static only (78215) |
$693.81 |
$2,668.50 |
2.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$386.36 |
$1,486 |
1.1× |
| Liver imaging static only (78201) |
$386.36 |
$1,486 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$381.03 |
$1,465.50 |
0.8× |
| Lung perf&ventilat diferentl (78598) |
$278.33 |
$1,070.50 |
0.6× |
| Lung perfusion differential (78597) |
$278.33 |
$1,070.50 |
0.8× |
| Lung Ventilation Imaging (78579) |
$172.51 |
$663.50 |
0.5× |
| Lymphoscintigraphy (78195) |
$623.48 |
$2,398 |
1.3× |
| Meckels Diverticulum (78290) |
$387.14 |
$1,489 |
1.1× |
| MRA head w & w/o contrast (70546) |
$1,404.39 |
$5,401.50 |
4.6× |
| MRA head w/o contrast (70544) |
$736.06 |
$2,831 |
3.6× |
| MRA head with contrast (70545) |
$908.96 |
$3,496 |
3.0× |
| MRA neck w contrast (70548) |
$1,044.94 |
$4,019 |
3.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,614.60 |
$6,210 |
5.3× |
| MRA neck w/o contrast (70547) |
$772.59 |
$2,971.50 |
3.7× |
| MRI abdomen w contrast (74182) |
$664.04 |
$2,554 |
2.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,017.77 |
$3,914.50 |
3.4× |
| MRI abdomen w/o contrast (74181) |
$564.72 |
$2,172 |
2.7× |
| MRI any jnt lwr ext with con lt (73722) |
$879.19 |
$3,381.50 |
1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$572.65 |
$2,202.50 |
0.8× |
| MRI c-spine with contrast (72142) |
$1,070.81 |
$4,118.50 |
3.5× |
| MRI cervical spine w/o contrast (72141) |
$1,231.49 |
$4,736.50 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$885.30 |
$3,405 |
2.9× |
| MRI chest w/o contrast (71550) |
$564.72 |
$2,172 |
2.7× |
| MRI chest with contrast (71551) |
$664.04 |
$2,554 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,119.50 |
$4,305.75 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,198.60 |
$4,610 |
4.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,275.82 |
$4,907 |
6.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$447.20 |
$1,720 |
2.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,404.39 |
$5,401.50 |
4.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,053.26 |
$4,051 |
3.5× |
| MRI pelvis w contrast (72196) |
$772.59 |
$2,971.50 |
2.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,614.60 |
$6,210 |
5.3× |
| MRI pelvis w/o contrast (72195) |
$764.53 |
$2,940.50 |
3.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,614.60 |
$6,210 |
5.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,614.60 |
$6,210 |
5.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,641.25 |
$6,312.50 |
5.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$917.80 |
$3,530 |
3.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,641.25 |
$6,312.50 |
5.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,070.81 |
$4,118.50 |
3.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,641.25 |
$6,312.50 |
5.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,231.49 |
$4,736.50 |
6.0× |
| MRI tmj (70336) |
$379.73 |
$1,460.50 |
1.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,044.94 |
$4,019 |
5.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,427.40 |
$5,490 |
4.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,041.30 |
$4,005 |
5.0× |
| Myelogram Cervical (72240) |
$414.70 |
$1,595 |
0.6× |
| Myelogram Lumbar (72265) |
$476.97 |
$1,834.50 |
0.7× |
| Myelogram thoracic (72255) |
$414.70 |
$1,595 |
0.6× |
| Myelography 2 or more regions (72270) |
$977.21 |
$3,758.50 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$777.40 |
$2,990 |
0.7× |
| Neck soft tissue (70360) |
$98.41 |
$378.50 |
1.3× |
| Nm bone marrow multiple (78103) |
$353.60 |
$1,360 |
1.0× |
| Nm bone marrow wb (78104) |
$353.60 |
$1,360 |
1.0× |
| Nm cisternogram (78630) |
$423.15 |
$1,627.50 |
0.9× |
| Nm gastric emptying study (78264) |
$325.84 |
$1,253.25 |
0.9× |
| Nm gastroesophageal reflux study (78262) |
$305.63 |
$1,175.50 |
0.9× |
| Nm whole blood volume (78122) |
$693.81 |
$2,668.50 |
1.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,149.46 |
$4,421 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$567.58 |
$2,183 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$101.14 |
$389 |
1.1× |
| Osseous survey infant (77076) |
$147.94 |
$569 |
1.6× |
| Osseous survey limited (77074) |
$86.32 |
$332 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$340.28 |
$1,308.75 |
1.0× |
| Parathyroid imaging (78070) |
$353.08 |
$1,358 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$131.04 |
$504 |
1.4× |
| Pr heart first pass single,planar (78481) |
$295.23 |
$1,135.50 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,275.82 |
$4,907 |
4.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$157.82 |
$607 |
0.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$524.68 |
$2,018 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$212.94 |
$819 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$188.11 |
$723.50 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$348.92 |
$1,342 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$154.57 |
$594.50 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$268.19 |
$1,031.50 |
3.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$50.83 |
$195.50 |
0.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$33.54 |
$129 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$123.89 |
$476.50 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$145.60 |
$560 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$156.65 |
$602.50 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$134.16 |
$516 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$163.41 |
$628.50 |
1.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$189.54 |
$729 |
1.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$315.77 |
$1,214.50 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$187.07 |
$719.50 |
2.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$127.40 |
$490 |
1.7× |
| Radiological examination surgical specimen (76098) |
$445.25 |
$1,712.50 |
0.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$693.81 |
$2,668.50 |
2.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$261.56 |
$1,006 |
0.1× |
| Ribs bilateral 3 views (71110) |
$201.89 |
$776.50 |
2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$574.73 |
$2,210.50 |
1.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$212.55 |
$817.50 |
0.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,323.14 |
$5,089 |
2.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,323.14 |
$5,089 |
1.2× |
| Sacroiliac Joints < 3 Views (72200) |
$52.52 |
$202 |
0.6× |
| Salivary gland function study (78232) |
$153.40 |
$590 |
0.4× |
| Salivary gland imaging (78230) |
$327.47 |
$1,259.50 |
0.9× |
| Scanogram (77073) |
$106.47 |
$409.50 |
1.2× |
| Scapula complete (73010) |
$109.72 |
$422 |
1.2× |
| Sella turcica (70240) |
$32.24 |
$124 |
0.4× |
| Sialogram (70390) |
$300.43 |
$1,155.50 |
1.5× |
| Small bowel series (74250) |
$339.56 |
$1,306 |
2.2× |
| Special dosimetry (77331) |
$7.41 |
$28.50 |
0.1× |
| Spine thoracic 3 views (72072) |
$126.49 |
$486.50 |
1.4× |
| Spleen imaging only (78185) |
$353.60 |
$1,360 |
1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$23.53 |
$90.50 |
0.1× |
| Testicular Imaging With Vascular Flow (78761) |
$353.08 |
$1,358 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$119.73 |
$460.50 |
0.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$54.34 |
$209 |
0.5× |
| Thoracolumbar 2 views (72080) |
$175.24 |
$674 |
2.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$164.84 |
$634 |
0.5× |
| Thyroid uptake measurement (78012) |
$117.52 |
$452 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$248.04 |
$954 |
0.7× |
| Tmj unilateral (70328) |
$106.86 |
$411 |
1.4× |
| Tomogram (76100) |
$231.01 |
$888.50 |
2.6× |
| Tx devices design & construction complex (77334) |
$45.11 |
$173.50 |
0.1× |
| Ultrasound, abdomen limited (76705) |
$70.20 |
$270 |
0.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$154.96 |
$596 |
2.1× |
| Upper Extremity Infant (73092) |
$142.22 |
$547 |
1.6× |
| Urethrocystography retrograde rs&i (74450) |
$92.95 |
$357.50 |
0.4× |
| Urethrocystography voiding (74455) |
$352.17 |
$1,354.50 |
1.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$283.27 |
$1,089.50 |
1.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$342.16 |
$1,316 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$116.61 |
$448.50 |
1.3× |
| Us breast unilateral complete (76641) |
$156.39 |
$601.50 |
1.7× |
| Us breast unilateral limited (76642) |
$152.68 |
$587.25 |
2.0× |
| Us chest (76604) |
$99.97 |
$384.50 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$191.88 |
$738 |
2.1× |
| Us infant hips dynamic (76885) |
$99.97 |
$384.50 |
1.3× |
| Us infant hips limited static (76886) |
$99.97 |
$384.50 |
1.3× |
| Us kidney transplant (76776) |
$177.71 |
$683.50 |
2.0× |
| Us ob detailed single fetus (76811) |
$271.31 |
$1,043.50 |
1.3× |
| Us ob transvaginal (76817) |
$107.64 |
$414 |
1.2× |
| Us pelvic non ob complete (76856) |
$165.23 |
$635.50 |
1.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$191.88 |
$738 |
2.1× |
| Us pregnancy ltd (76815) |
$34.58 |
$133 |
0.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$210.21 |
$808.50 |
2.3× |
| Us retroperitoneal complete (76770) |
$312.65 |
$1,202.50 |
3.5× |
| Us retroperitoneal limited (76775) |
$105.69 |
$406.50 |
1.2× |
| Us scrotum and contents (76870) |
$143 |
$550 |
1.6× |
| Us soft tissue head/neck (76536) |
$235.50 |
$905.75 |
2.6× |
| Us transrectal (76872) |
$258.57 |
$994.50 |
2.9× |
| Us xtr non-vasc lmtd (76882) |
$99.97 |
$384.50 |
1.1× |
| Venogram extremity bilateral (75822) |
$266.76 |
$1,026 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$1,323.60 |
$5,090.75 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$346.58 |
$1,333 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$203.71 |
$783.50 |
0.1× |
| Wrist 2 views (73100) |
$81.38 |
$313 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$166.14 |
$639 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$96.33 |
$370.50 |
1.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$209.95 |
$807.50 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$164.19 |
$631.50 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$98.22 |
$377.75 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$100.75 |
$387.50 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$96.98 |
$373 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$105.56 |
$406 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$104.78 |
$403 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$199.68 |
$768 |
2.2× |
| X-ray exam of femur 1 (73551) |
$115.57 |
$444.50 |
1.5× |
| X-ray eye for foreign body (70030) |
$171.34 |
$659 |
2.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$122.72 |
$472 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$144.04 |
$554 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$107.64 |
$414 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$92.43 |
$355.50 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$109.72 |
$422 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$128.18 |
$493 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$180.57 |
$694.50 |
2.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$123.50 |
$475 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$123.89 |
$476.50 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$176.41 |
$678.50 |
1.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$81.12 |
$312 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$101.79 |
$391.50 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$52.52 |
$202 |
0.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$128.83 |
$495.50 |
1.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$124.67 |
$479.50 |
1.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$130.91 |
$503.50 |
0.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$137.15 |
$527.50 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$149.50 |
$575 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$256.36 |
$986 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$71.89 |
$276.50 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$75.92 |
$292 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$131.50 |
$505.75 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$203.71 |
$783.50 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$90.09 |
$346.50 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$222.95 |
$857.50 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$99.19 |
$381.50 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$100.75 |
$387.50 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$142.22 |
$547 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$102.18 |
$393 |
1.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$94.90 |
$365 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$134.42 |
$517 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$92.43 |
$355.50 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$172.12 |
$662 |
2.3× |
| Xr arthrogram ankle (73615) |
$547.43 |
$2,105.50 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$283.14 |
$1,089 |
3.1× |
| Xr chest 4+ views (71048) |
$167.05 |
$642.50 |
1.8× |
| Xr Cholecystography Oral Contrast (74290) |
$171.86 |
$661 |
1.1× |
| Xr finger(s) 2+ views (73140) |
$76.57 |
$294.50 |
1.0× |
| Xr internal auditory meati complete (70134) |
$81.12 |
$312 |
0.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$81.12 |
$312 |
0.9× |
| Xr optic foramina (70190) |
$52.52 |
$202 |
0.7× |
| Xr shoulder 1 view (73020) |
$108.03 |
$415.50 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$187.46 |
$721 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$97.50 |
$375 |
1.3× |
| Xr tmj bilateral (70330) |
$166.79 |
$641.50 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$106.47 |
$409.50 |
1.4× |