| Abdomen 2 views (74019) |
$789 |
$1,315 |
8.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,362 |
$2,270 |
3.6× |
| Angiography extremity bilateral rs&i (75716) |
$5,643.60 |
$9,406 |
1.9× |
| Angiography extremity unilateral rs&i (75710) |
$4,379.40 |
$7,299 |
1.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,319.80 |
$5,533 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$6,973.80 |
$11,623 |
2.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,844.80 |
$11,408 |
2.3× |
| Angiography Spinal Selective Rs&I (75705) |
$3,306 |
$5,510 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,319.80 |
$5,533 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,037 |
$3,395 |
0.7× |
| Ankle 2 views (73600) |
$594.60 |
$991 |
7.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$579.60 |
$966 |
1.8× |
| Aortogram thoracic (75605) |
$4,461 |
$7,435 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,643.60 |
$9,406 |
1.9× |
| Aortography abdominal serialography rs&i (75625) |
$3,019.80 |
$5,033 |
1.0× |
| Arthrogram elbow (73085) |
$807 |
$1,345 |
2.4× |
| Arthrogram hip (73525) |
$1,461 |
$2,435 |
4.4× |
| Arthrogram shoulder (73040) |
$792.60 |
$1,321 |
2.4× |
| Arthrogram wrist (73115) |
$1,023.60 |
$1,706 |
3.1× |
| Arthrography knee lt (73580) |
$1,109.40 |
$1,849 |
3.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,125 |
$1,875 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,625.40 |
$2,709 |
4.3× |
| Bone age studies (77072) |
$299.40 |
$499 |
3.0× |
| Bone Imaging 3 Phase (78315) |
$2,437.80 |
$4,063 |
6.4× |
| Bone Marrow Imaging Limited Area (78102) |
$1,232.40 |
$2,054 |
3.3× |
| Bone survey complete (77075) |
$2,505.60 |
$4,176 |
25.3× |
| Brain image w/flow 4 + views (78606) |
$1,357.20 |
$2,262 |
2.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,400.80 |
$5,668 |
2.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$836.40 |
$1,394 |
2.2× |
| Cervical spine 2 or 3 views (72040) |
$637.80 |
$1,063 |
7.7× |
| Chest 1 view (71045) |
$418.80 |
$698 |
5.1× |
| Chest 3 views (71047) |
$709.20 |
$1,182 |
8.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,031.40 |
$1,719 |
6.2× |
| Clavicle complete (73000) |
$600 |
$1,000 |
7.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$144 |
$240 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,394.40 |
$12,324 |
22.4× |
| CT abdomen and pelvis without contrast (74176) |
$6,001.20 |
$10,002 |
26.6× |
| CT abdomen w contrast (74160) |
$3,255.60 |
$5,426 |
19.6× |
| CT abdomen w wo contrast (74170) |
$3,690.60 |
$6,151 |
22.2× |
| CT abdomen w/o contrast (74150) |
$2,454.60 |
$4,091 |
24.8× |
| CT angio hrt w/3d image (75574) |
$936 |
$1,560 |
2.8× |
| CT angiography upper extremity lt (73206) |
$2,668.80 |
$4,448 |
16.1× |
| CT c-spine w/o contrast (72125) |
$3,592.80 |
$5,988 |
36.3× |
| CT cervical spine w&w/o contrast (72127) |
$4,485.60 |
$7,476 |
27.0× |
| CT cervical spine with contrast (72126) |
$3,630 |
$6,050 |
11.0× |
| CT chest w/wo contrast (71270) |
$3,679.20 |
$6,132 |
22.2× |
| CT chest with contrast (71260) |
$2,535.60 |
$4,226 |
15.3× |
| CT head/brain with contrast (70460) |
$3,903 |
$6,505 |
23.5× |
| CT head/brain without and with contrast (70470) |
$4,665 |
$7,775 |
28.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$966 |
$1,610 |
2.9× |
| CT hrt w/3d image congen (75573) |
$1,224 |
$2,040 |
3.7× |
| CT iac w contrast (70481) |
$4,909.20 |
$8,182 |
29.6× |
| CT limited/localized follow up study (76380) |
$937.20 |
$1,562 |
11.4× |
| CT lower ext w/o (73700) |
$2,782.50 |
$4,637.50 |
28.1× |
| CT lower extremity w wo contrast (73702) |
$2,368.20 |
$3,947 |
14.3× |
| CT lower extremity with contrast (73701) |
$2,234.40 |
$3,724 |
13.5× |
| CT lumbar spine w & w/o contrast (72133) |
$4,530 |
$7,550 |
27.3× |
| CT lumbar spine w/o contrast (72131) |
$4,108.80 |
$6,848 |
41.5× |
| CT lumbar spine with contrast (72132) |
$4,314 |
$7,190 |
13.1× |
| CT maxillofacial w contrast (70487) |
$2,873.40 |
$4,789 |
17.3× |
| CT maxillofacial w/o contrast (70486) |
$2,701.20 |
$4,502 |
27.3× |
| CT maxillofacial w/wo contrast (70488) |
$3,605.40 |
$6,009 |
21.7× |
| CT neck soft tissue w contrast (70491) |
$4,354.20 |
$7,257 |
26.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$5,824.20 |
$9,707 |
35.1× |
| CT orbits w/o contrast (70480) |
$3,808.80 |
$6,348 |
38.5× |
| CT pelvis w & w/o contrast (72194) |
$3,504 |
$5,840 |
21.1× |
| CT pelvis w/o contrast (72192) |
$2,454.60 |
$4,091 |
24.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,600.20 |
$7,667 |
27.7× |
| CT soft tissue neck w/o contrast (70490) |
$3,280.20 |
$5,467 |
33.1× |
| CT thoracic spine w/contrast (72129) |
$5,244.60 |
$8,741 |
31.6× |
| CT thoracic spine w/o contrast (72128) |
$5,042.40 |
$8,404 |
50.9× |
| CT thoracic spine w/wo contrast (72130) |
$5,506.80 |
$9,178 |
33.2× |
| CT thorax w/o contrast (71250) |
$1,971.60 |
$3,286 |
19.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,368.20 |
$3,947 |
14.3× |
| CT upper extremity w/o contrast rt (73200) |
$1,985.40 |
$3,309 |
20.1× |
| CT upper extremity with contrast (73201) |
$2,232 |
$3,720 |
6.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,089 |
$6,815 |
24.6× |
| Cta Abdomen (74175) |
$3,992.40 |
$6,654 |
24.0× |
| CTA abdomen pelvis (74174) |
$8,329.80 |
$13,883 |
25.2× |
| CTA chest (71275) |
$4,706.40 |
$7,844 |
28.3× |
| Cta Head (70496) |
$4,870.80 |
$8,118 |
29.3× |
| CTA lwr ext w&w/o contrast (73706) |
$2,486.40 |
$4,144 |
15.0× |
| Cta Neck (70498) |
$4,902.60 |
$8,171 |
29.5× |
| Cta Pelvis (72191) |
$3,680.40 |
$6,134 |
22.2× |
| Cystography minimum 3 views rs&i (74430) |
$778.20 |
$1,297 |
2.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$468.60 |
$781 |
4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$424.20 |
$707 |
5.1× |
| Echoencephalography real time imaging (76506) |
$926.40 |
$1,544 |
9.4× |
| Esophagus (74220) |
$627.60 |
$1,046 |
3.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$348 |
$580 |
3.5× |
| Fluoroscopy up to 1 hr (76000) |
$748.80 |
$1,248 |
3.3× |
| Foot 2 views (73620) |
$312.60 |
$521 |
3.8× |
| Forearm 2 views (73090) |
$382.20 |
$637 |
4.6× |
| Hand 2 views (73120) |
$312.60 |
$521 |
3.2× |
| Hand 3 views (73130) |
$628.20 |
$1,047 |
7.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,981.40 |
$4,969 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,796 |
$4,660 |
5.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,854.60 |
$3,091 |
4.9× |
| Ht muscle image spect sing (78451) |
$5,955 |
$9,925 |
4.9× |
| Humerus Min 2 Views Left (73060) |
$490.20 |
$817 |
5.9× |
| Hysterosalpingogram (74740) |
$913.20 |
$1,522 |
4.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$301.80 |
$503 |
3.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,698 |
$2,830 |
3.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,804.40 |
$4,674 |
5.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,944.80 |
$4,908 |
5.7× |
| Knee 3 views (73562) |
$595.20 |
$992 |
7.2× |
| Lung perfusion differential (78597) |
$1,214.40 |
$2,024 |
3.2× |
| Lung Ventilation Imaging (78579) |
$1,177.20 |
$1,962 |
3.1× |
| Lymphoscintigraphy (78195) |
$3,336.60 |
$5,561 |
6.5× |
| Mammary ductogram or galactogram multiple (77054) |
$432.60 |
$721 |
1.9× |
| Mammary ductogram or galactogram single (77053) |
$353.40 |
$589 |
1.6× |
| Meckels Diverticulum (78290) |
$844.80 |
$1,408 |
2.2× |
| Mr safety determination physician/other qhp (76016) |
$193.80 |
$323 |
2.4× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$315.60 |
$526 |
5.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$64.20 |
$107 |
2.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$206.40 |
$344 |
2.3× |
| MRA head w & w/o contrast (70546) |
$4,012.20 |
$6,687 |
12.1× |
| MRA head w/o contrast (70544) |
$2,461.80 |
$4,103 |
10.9× |
| MRA head with contrast (70545) |
$2,640 |
$4,400 |
8.0× |
| MRA neck w contrast (70548) |
$2,216.40 |
$3,694 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,686.80 |
$4,478 |
8.1× |
| MRA neck w/o contrast (70547) |
$2,014.20 |
$3,357 |
8.9× |
| MRI abdomen w contrast (74182) |
$3,310.20 |
$5,517 |
10.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,683 |
$7,805 |
14.2× |
| MRI abdomen w/o contrast (74181) |
$3,152.40 |
$5,254 |
14.0× |
| MRI any jnt lwr ext with con lt (73722) |
$4,123.20 |
$6,872 |
5.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,748.20 |
$6,247 |
5.1× |
| MRI breast w/o contrast bilateral (77047) |
$696.60 |
$1,161 |
3.1× |
| MRI breast w/o contrast unilat (77046) |
$633 |
$1,055 |
2.8× |
| MRI c-spine with contrast (72142) |
$4,045.80 |
$6,743 |
12.2× |
| MRI cervical spine w/o contrast (72141) |
$3,853.20 |
$6,422 |
17.1× |
| MRI chest w/o & w/contrast material (71552) |
$4,599 |
$7,665 |
13.9× |
| MRI chest w/o contrast (71550) |
$3,027.60 |
$5,046 |
13.4× |
| MRI fetal sngl/1st gestation (74712) |
$864 |
$1,440 |
3.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,091.20 |
$5,152 |
9.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,066.60 |
$5,111 |
13.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,027.60 |
$5,046 |
13.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,500.60 |
$7,501 |
13.6× |
| MRI orbit/face/neck w/contrast (70542) |
$3,574.80 |
$5,958 |
10.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,888.20 |
$8,147 |
14.8× |
| MRI pelvis w/o contrast (72195) |
$3,748.20 |
$6,247 |
16.6× |
| MRI scan of arm joint before and after contrast (73223) |
$4,683 |
$7,805 |
14.2× |
| MRI scan of leg joint before and after contrast (73723) |
$4,947.60 |
$8,246 |
15.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,248 |
$7,080 |
12.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,045.80 |
$6,743 |
12.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,248 |
$7,080 |
12.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,045.80 |
$6,743 |
12.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,248 |
$7,080 |
12.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,853.20 |
$6,422 |
17.1× |
| MRI upper ext joint w/o contrast (73221) |
$2,209.20 |
$3,682 |
9.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,502.40 |
$7,504 |
13.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,748.20 |
$6,247 |
16.6× |
| Myocardial Spect Multiple Studies (78452) |
$7,850.40 |
$13,084 |
6.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$3,451.20 |
$5,752 |
2.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,616.80 |
$6,028 |
2.7× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$5,943.60 |
$9,906 |
2.8× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$6,690 |
$11,150 |
3.2× |
| Neck soft tissue (70360) |
$358.80 |
$598 |
4.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$967.80 |
$1,613 |
2.6× |
| Nm gastric emptying study (78264) |
$1,863 |
$3,105 |
4.9× |
| Nm peritoneal-venous shunt patency (78291) |
$970.80 |
$1,618 |
2.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$712.80 |
$1,188 |
1.9× |
| Nuclear Rx Oral Admin (79005) |
$1,989.60 |
$3,316 |
9.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$484.80 |
$808 |
4.9× |
| Orthopantogram (70355) |
$717 |
$1,195 |
8.7× |
| Osseous survey infant (77076) |
$2,528.40 |
$4,214 |
25.5× |
| Parathyrd planar w/spect&CT (78072) |
$1,482.60 |
$2,471 |
2.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,471.80 |
$2,453 |
3.9× |
| Parathyroid imaging (78070) |
$1,368.60 |
$2,281 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$492 |
$820 |
5.0× |
| Peritoneogram rs&i (74190) |
$615.60 |
$1,026 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$5,529.60 |
$9,216 |
4.1× |
| PET imaging CT for attenuation limited area (78814) |
$3,796.20 |
$6,327 |
2.8× |
| PET imaging for CT attenuation whole body (78816) |
$5,571.60 |
$9,286 |
4.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,904.80 |
$6,508 |
11.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,219.20 |
$2,032 |
3.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,671.60 |
$2,786 |
3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$780.60 |
$1,301 |
1.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$211.80 |
$353 |
2.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$349.20 |
$582 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$349.20 |
$582 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$845.40 |
$1,409 |
8.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$630.60 |
$1,051 |
6.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$559.20 |
$932 |
6.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$920.40 |
$1,534 |
9.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$564 |
$940 |
6.8× |
| Radiologic exam colon single contrast study (74270) |
$1,112.40 |
$1,854 |
6.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$697.20 |
$1,162 |
4.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$874.80 |
$1,458 |
5.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$533.40 |
$889 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$268.20 |
$447 |
3.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,861.60 |
$6,436 |
1.3× |
| Ribs bilateral 3 views (71110) |
$682.20 |
$1,137 |
6.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,108.20 |
$1,847 |
2.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,258.80 |
$2,098 |
2.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,531.20 |
$2,552 |
3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,915.40 |
$4,859 |
2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,737.40 |
$6,229 |
2.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,896 |
$3,160 |
1.5× |
| Sacroiliac Joints < 3 Views (72200) |
$415.80 |
$693 |
4.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$830.40 |
$1,384 |
3.7× |
| Scanogram (77073) |
$478.80 |
$798 |
4.8× |
| Scapula complete (73010) |
$586.20 |
$977 |
5.9× |
| Screening digital breast tomosynthesis (77063) |
$18 |
$30 |
0.8× |
| Small bowel series (74250) |
$638.40 |
$1,064 |
3.8× |
| Spine thoracic 3 views (72072) |
$730.20 |
$1,217 |
7.4× |
| Thoracolumbar 2 views (72080) |
$661.80 |
$1,103 |
8.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,878 |
$3,130 |
3.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$782.40 |
$1,304 |
2.1× |
| Thyroid uptake measurement (78012) |
$700.20 |
$1,167 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,321.80 |
$2,203 |
3.5× |
| Tmj unilateral (70328) |
$217.20 |
$362 |
2.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,775 |
$4,625 |
5.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,038 |
$1,730 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$670.20 |
$1,117 |
6.8× |
| Umbilical-artery Doppler (OB) (76820) |
$262.20 |
$437 |
2.6× |
| Unlisted fluoroscopic procedure (76496) |
$339.60 |
$566 |
4.1× |
| Upper Extremity Infant (73092) |
$456.90 |
$761.50 |
4.6× |
| Urethrocystography retrograde rs&i (74450) |
$1,079.40 |
$1,799 |
4.8× |
| Urethrocystography voiding (74455) |
$1,019.40 |
$1,699 |
4.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,338.60 |
$2,231 |
8.1× |
| Us abdl aorta screen aaa (76706) |
$373.80 |
$623 |
3.8× |
| Us breast unilateral complete (76641) |
$329.40 |
$549 |
3.3× |
| Us breast unilateral limited (76642) |
$255.60 |
$426 |
3.1× |
| Us chest (76604) |
$816.60 |
$1,361 |
8.3× |
| Us compl joint r-t w/image documentation (76881) |
$1,311.60 |
$2,186 |
13.3× |
| Us guided compression repair (76936) |
$766.20 |
$1,277 |
3.7× |
| Us infant hips dynamic (76885) |
$831 |
$1,385 |
10.1× |
| Us kidney transplant (76776) |
$996.60 |
$1,661 |
10.1× |
| Us ob transvaginal (76817) |
$708.60 |
$1,181 |
7.2× |
| Us pelvic non ob complete (76856) |
$987.60 |
$1,646 |
10.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$630 |
$1,050 |
6.4× |
| Us pregnancy ltd (76815) |
$583.80 |
$973 |
5.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$766.80 |
$1,278 |
7.7× |
| Us retroperitoneal complete (76770) |
$938.40 |
$1,564 |
9.5× |
| Us retroperitoneal limited (76775) |
$868.20 |
$1,447 |
8.8× |
| Us scrotum and contents (76870) |
$1,065 |
$1,775 |
10.8× |
| Us soft tissue head/neck (76536) |
$1,095.60 |
$1,826 |
11.1× |
| Us spinal canal and contents (76800) |
$396.60 |
$661 |
4.0× |
| Us xtr non-vasc lmtd (76882) |
$1,212 |
$2,020 |
12.2× |
| Us, eye b-scan (76512) |
$328.20 |
$547 |
3.3× |
| Venogram extremity bilateral (75822) |
$1,486.80 |
$2,478 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,929.40 |
$6,549 |
1.3× |
| Venography caval superior serialography rs&i (75827) |
$4,205.40 |
$7,009 |
2.8× |
| Venography extremity unilateral rs&i (75820) |
$1,398 |
$2,330 |
0.9× |
| Venography Renal Bilateral (75833) |
$3,849.60 |
$6,416 |
1.3× |
| Venography renal unilateral selective rs&i (75831) |
$3,279.60 |
$5,466 |
1.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,306 |
$5,510 |
0.6× |
| Wrist 2 views (73100) |
$530.40 |
$884 |
6.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$949.20 |
$1,582 |
9.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$574.80 |
$958 |
7.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$700.20 |
$1,167 |
8.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,702.20 |
$2,837 |
10.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$561.60 |
$936 |
6.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$649.20 |
$1,082 |
7.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$667.20 |
$1,112 |
6.7× |
| X-ray exam hip uni 1 view (73501) |
$211.80 |
$353 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$326.40 |
$544 |
4.0× |
| X-ray exam hip uni 4/> views (73503) |
$349.20 |
$582 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$455.40 |
$759 |
4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$666.60 |
$1,111 |
6.7× |
| X-ray exam of femur 1 (73551) |
$211.80 |
$353 |
2.6× |
| X-ray eye for foreign body (70030) |
$310.20 |
$517 |
3.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$640.80 |
$1,068 |
6.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$535.80 |
$893 |
6.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$607.20 |
$1,012 |
7.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$357 |
$595 |
4.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$597.60 |
$996 |
7.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$675.60 |
$1,126 |
6.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$319.80 |
$533 |
3.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$456.90 |
$761.50 |
5.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$637.20 |
$1,062 |
6.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,102.80 |
$1,838 |
11.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$211.80 |
$353 |
2.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$622.20 |
$1,037 |
7.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$318 |
$530 |
3.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$738 |
$1,230 |
7.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$703.80 |
$1,173 |
7.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$680.40 |
$1,134 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,169.40 |
$1,949 |
3.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$383.40 |
$639 |
4.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$948.60 |
$1,581 |
9.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,194 |
$1,990 |
12.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$577.80 |
$963 |
5.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$586.20 |
$977 |
7.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$756.60 |
$1,261 |
9.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$543 |
$905 |
6.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$401.40 |
$669 |
4.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$651 |
$1,085 |
6.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$375.60 |
$626 |
3.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$438 |
$730 |
5.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$576.60 |
$961 |
7.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$549 |
$915 |
6.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$591 |
$985 |
6.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$775.80 |
$1,293 |
7.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$355.20 |
$592 |
4.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$673.20 |
$1,122 |
8.2× |
| Xr arthrogram ankle (73615) |
$880.80 |
$1,468 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$1,304.40 |
$2,174 |
13.2× |
| Xr chest 4+ views (71048) |
$757.80 |
$1,263 |
7.7× |
| Xr finger(s) 2+ views (73140) |
$483 |
$805 |
5.9× |
| Xr shoulder 1 view (73020) |
$463.20 |
$772 |
5.6× |
| Xr spine cervical 4 or 5 views (72050) |
$1,128.60 |
$1,881 |
11.4× |
| Xr tibia/fibula 2 views (73590) |
$476.40 |
$794 |
5.8× |
| Xr tmj bilateral (70330) |
$689.40 |
$1,149 |
8.4× |
| Xray knee 1 or 2 views rt (73560) |
$434.40 |
$724 |
5.3× |