| Abdomen 2 views (74019) |
$339 |
$339 |
2.9× |
| Acute gi blood loss imaging (78278) |
$1,524 |
$1,524 |
3.4× |
| Ankle 2 views (73600) |
$560 |
$560 |
5.8× |
| Arthrogram ankle (73615) |
$898 |
$898 |
2.3× |
| Arthrogram elbow (73085) |
$882.50 |
$882.50 |
2.3× |
| Arthrogram hip (73525) |
$892 |
$892 |
2.3× |
| Arthrogram knee (73580) |
$1,595 |
$1,595 |
4.1× |
| Arthrogram shoulder (73040) |
$1,595 |
$1,595 |
4.1× |
| Arthrogram wrist (73115) |
$459 |
$459 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$978.50 |
$978.50 |
2.2× |
| Bone age studies (77072) |
$245 |
$245 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$985 |
$985 |
2.2× |
| Bone survey complete (77075) |
$325.50 |
$325.50 |
2.8× |
| Bone survey infant (77076) |
$219 |
$219 |
1.9× |
| Bowel imaging (78290) |
$791 |
$791 |
1.8× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,695 |
$1,695 |
3.8× |
| Cervical spine 2 or 3 views (72040) |
$268 |
$268 |
2.8× |
| Chest 1 view (71045) |
$208.50 |
$208.50 |
2.1× |
| Chest xray 3 views (71047) |
$495 |
$495 |
5.1× |
| Cholecystography, oral contrast Non-Facility (74290) |
$567 |
$567 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$290 |
$290 |
1.5× |
| Clavicle complete (73000) |
$237.50 |
$237.50 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$4,269 |
$4,269 |
36.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$525 |
$525 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,453.50 |
$2,453.50 |
6.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,649.50 |
$1,649.50 |
6.2× |
| CT abdomen w contrast (74160) |
$1,493 |
$1,493 |
7.6× |
| CT abdomen w wo contrast (74170) |
$1,571.50 |
$1,571.50 |
8.0× |
| CT abdomen w/o contrast (74150) |
$764.50 |
$764.50 |
6.6× |
| CT angio hrt w/3d image (75574) |
$2,557 |
$2,557 |
6.6× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,256.50 |
$1,256.50 |
6.4× |
| CT angiography upper extremity lt (73206) |
$1,827.50 |
$1,827.50 |
9.3× |
| CT c-spine w/contrast (72126) |
$1,112 |
$1,112 |
2.9× |
| CT c-spine w/o contrast (72125) |
$641.50 |
$641.50 |
5.5× |
| CT cervical spine w&w/o contrast (72127) |
$2,373 |
$2,373 |
12.1× |
| CT chest w contrast (71260) |
$1,657.50 |
$1,657.50 |
8.5× |
| CT chest w/wo contrast (71270) |
$1,998.50 |
$1,998.50 |
10.2× |
| CT head/brain with contrast (70460) |
$1,400 |
$1,400 |
7.2× |
| CT head/brain without and with contrast (70470) |
$1,713.50 |
$1,713.50 |
8.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,951 |
$2,951 |
7.6× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$357 |
$357 |
3.7× |
| CT hrt w/3d image congen (75573) |
$3,670 |
$3,670 |
9.4× |
| CT iac w contrast (70481) |
$1,607.50 |
$1,607.50 |
8.2× |
| CT limited/localized follow up study (76380) |
$877 |
$877 |
9.0× |
| CT lower ext w/o (73700) |
$557.50 |
$557.50 |
4.8× |
| CT lower extremity w wo contrast (73702) |
$2,011 |
$2,011 |
10.3× |
| CT lower extremity w/contrast material (73701) |
$1,078.50 |
$1,078.50 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,314 |
$1,314 |
6.7× |
| CT lumbar spine w/contrast (72132) |
$1,259 |
$1,259 |
3.2× |
| CT lumbar spine w/o contrast (72131) |
$613 |
$613 |
5.3× |
| CT maxillofacial w contrast (70487) |
$1,736 |
$1,736 |
8.9× |
| CT maxillofacial w/wo contrast (70488) |
$3,465 |
$3,465 |
17.7× |
| CT maxillofacial wo contrast (70486) |
$73 |
$73 |
0.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,793.50 |
$1,793.50 |
9.2× |
| CT orbits w/o contrast (70480) |
$902.50 |
$902.50 |
7.7× |
| CT pelvis w/o contrast (72192) |
$881.50 |
$881.50 |
7.6× |
| CT pelvis w/wo contrast (72194) |
$1,149 |
$1,149 |
5.9× |
| CT scan of arm combo (73202) |
$1,123 |
$1,123 |
5.7× |
| CT soft tissue neck w contrast (70491) |
$1,679 |
$1,679 |
8.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,271 |
$3,271 |
16.7× |
| CT soft tissue neck w/o contrast (70490) |
$923.50 |
$923.50 |
7.9× |
| CT thoracic spine w/contrast (72129) |
$1,317 |
$1,317 |
6.7× |
| CT thoracic spine w/o contrast (72128) |
$634 |
$634 |
5.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,240.50 |
$1,240.50 |
6.3× |
| CT thorax w/o contrast (71250) |
$759.50 |
$759.50 |
6.5× |
| CT upper ext wo (73200) |
$799 |
$799 |
6.9× |
| CT upper extremity with contrast (73201) |
$1,498.50 |
$1,498.50 |
3.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,529 |
$1,529 |
7.8× |
| Cta Abdomen (74175) |
$2,006.50 |
$2,006.50 |
10.3× |
| CTA abdomen pelvis (74174) |
$2,150.50 |
$2,150.50 |
5.5× |
| CTA chest (71275) |
$1,920 |
$1,920 |
9.8× |
| Cta Head (70496) |
$1,988.50 |
$1,988.50 |
10.2× |
| Cta Neck (70498) |
$1,991 |
$1,991 |
10.2× |
| Cta Pelvis (72191) |
$1,135 |
$1,135 |
5.8× |
| Cystography minimum 3 views rs&i (74430) |
$817.50 |
$817.50 |
2.1× |
| Diskogram cervical (72285) |
$11,449 |
$11,449 |
5.3× |
| Diskography lumbar (72295) |
$11,449 |
$11,449 |
5.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$240 |
$240 |
2.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$260 |
$260 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$84 |
$84 |
0.9× |
| Dxa bone density study axial skeleton (77085) |
$233 |
$233 |
2.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$672 |
$672 |
2.5× |
| Esophagus (74220) |
$301 |
$301 |
1.5× |
| Facial bones min 3 views (70150) |
$324.50 |
$324.50 |
2.8× |
| Fetal biophysical profile non-stress testing (76818) |
$542 |
$542 |
4.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$525 |
$525 |
4.5× |
| Fetal Echo (76825) |
$1,889 |
$1,889 |
3.1× |
| Fluoroscopy up to 1 hr (76000) |
$540 |
$540 |
2.0× |
| Foot 2 views (73620) |
$493 |
$493 |
5.1× |
| Forearm 2 views (73090) |
$493 |
$493 |
5.1× |
| Hand 2 views (73120) |
$453 |
$453 |
3.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$990 |
$990 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$793 |
$793 |
1.8× |
| Hysterosalpingogram (74740) |
$814 |
$814 |
3.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$28 |
$28 |
0.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,310.50 |
$1,310.50 |
2.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,060.50 |
$1,060.50 |
1.8× |
| Knee 3 views (73562) |
$222.50 |
$222.50 |
2.3× |
| Lymphoscintigraphy (78195) |
$946.50 |
$946.50 |
1.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,702.50 |
$1,702.50 |
1.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$3,271 |
$3,271 |
8.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,352 |
$2,352 |
6.0× |
| Mammary ductogram or galactogram multiple (77054) |
$2,135 |
$2,135 |
8.0× |
| Mammary ductogram or galactogram single (77053) |
$2,135 |
$2,135 |
8.0× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$346 |
$346 |
3.6× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$2,047 |
$2,047 |
4.9× |
| MRA head w & w/o contrast (70546) |
$3,248 |
$3,248 |
8.4× |
| MRA head w/o contrast (70544) |
$1,495.50 |
$1,495.50 |
5.6× |
| MRA head with contrast (70545) |
$2,067 |
$2,067 |
5.3× |
| MRA neck w contrast (70548) |
$4,631 |
$4,631 |
11.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,429 |
$2,429 |
6.2× |
| MRA neck w/o contrast (70547) |
$1,340.50 |
$1,340.50 |
5.0× |
| MRI abdomen w contrast (74182) |
$3,786 |
$3,786 |
9.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,538 |
$2,538 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$1,419.50 |
$1,419.50 |
5.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,781 |
$1,781 |
2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,533 |
$2,533 |
6.5× |
| MRI bone marrow blood supply (77084) |
$1,168.50 |
$1,168.50 |
4.4× |
| MRI breast w/o contrast bilateral (77047) |
$1,481 |
$1,481 |
5.6× |
| MRI breast wo contrast unilateral (77046) |
$2,967 |
$2,967 |
11.2× |
| MRI c-spine with contrast (72142) |
$1,717.50 |
$1,717.50 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$1,192 |
$1,192 |
4.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,385.50 |
$2,385.50 |
6.1× |
| MRI chest w/o contrast (71550) |
$1,419.50 |
$1,419.50 |
5.3× |
| MRI chest with contrast (71551) |
$4,048 |
$4,048 |
4.6× |
| MRI fetal sngl/1st gestation (74712) |
$1,245 |
$1,245 |
4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,985 |
$1,985 |
5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,580 |
$1,580 |
4.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$853.50 |
$853.50 |
3.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,691.50 |
$1,691.50 |
6.4× |
| MRI orbit face neck w contrast (70542) |
$3,618 |
$3,618 |
9.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,107 |
$2,107 |
5.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,952.50 |
$1,952.50 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,171.50 |
$1,171.50 |
4.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,048 |
$2,048 |
5.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,245 |
$2,245 |
5.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,066.50 |
$2,066.50 |
5.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,701 |
$1,701 |
4.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,145 |
$2,145 |
5.5× |
| MRI temporomandibular joint (70336) |
$1,759 |
$1,759 |
6.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,234 |
$1,234 |
4.6× |
| MRI up ext w/o contrast (73218) |
$1,407 |
$1,407 |
5.3× |
| MRI upper ext joint w/o contrast (73221) |
$769.50 |
$769.50 |
2.9× |
| MRI, joint upper extrem combo (73223) |
$1,934.50 |
$1,934.50 |
5.0× |
| Myelogram Cervical (72240) |
$1,676.50 |
$1,676.50 |
1.9× |
| Myelogram Lumbar (72265) |
$1,672 |
$1,672 |
1.9× |
| Myelogram thoracic (72255) |
$1,678 |
$1,678 |
1.9× |
| Myelography 2 or more regions (72270) |
$3,506 |
$3,506 |
4.0× |
| Myocardial Spect Multiple Studies (78452) |
$829 |
$829 |
0.6× |
| Myocardial spect single study at rest or stress (78451) |
$1,524 |
$1,524 |
1.1× |
| Neck soft tissue (70360) |
$253.50 |
$253.50 |
2.6× |
| Nm bone marrow wb (78104) |
$66 |
$66 |
0.1× |
| Nm gastric emptying study (78264) |
$794.50 |
$794.50 |
1.8× |
| Nonvascular shunt X-ray (75809) |
$458 |
$458 |
3.9× |
| Ob us nuchal meas 1 gest (76813) |
$261 |
$261 |
2.2× |
| Osseous survey limited (77074) |
$256 |
$256 |
2.2× |
| Parathyroid Planar Imaging (78070) |
$795.50 |
$795.50 |
1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$888 |
$888 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$243.50 |
$243.50 |
2.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,524 |
$1,524 |
3.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,195.50 |
$1,195.50 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,190 |
$2,190 |
3.6× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$370 |
$370 |
3.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$153 |
$153 |
1.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$250.50 |
$250.50 |
2.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$143 |
$143 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$397 |
$397 |
3.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$458.50 |
$458.50 |
3.9× |
| Radex fingr minimum 2 views (73140) |
$139 |
$139 |
1.4× |
| Radex Foot Compl Minimum 3 Views (73630) |
$265.50 |
$265.50 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$312 |
$312 |
3.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$182.50 |
$182.50 |
1.9× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$296 |
$296 |
2.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$296 |
$296 |
2.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$462.50 |
$462.50 |
4.0× |
| Radex Humerus Minimum 2 Views (73060) |
$342 |
$342 |
3.5× |
| Radex Kne 1/2 Views (73560) |
$164.50 |
$164.50 |
1.7× |
| Radex Kne Compl 4/More Views (73564) |
$280 |
$280 |
2.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$408.50 |
$408.50 |
3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$226 |
$226 |
2.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$256 |
$256 |
2.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$301 |
$301 |
3.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$247 |
$247 |
2.5× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$215.50 |
$215.50 |
1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$179 |
$179 |
1.8× |
| Radex Toe Minimum 2 Views (73660) |
$244 |
$244 |
2.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$285 |
$285 |
2.4× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$256.50 |
$256.50 |
2.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$897 |
$897 |
7.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$247 |
$247 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$378.50 |
$378.50 |
3.2× |
| Radiologic exam chest 2 views (71046) |
$266 |
$266 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$130.50 |
$130.50 |
0.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$642 |
$642 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$335.50 |
$335.50 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$352 |
$352 |
1.8× |
| Radiologic examination femur 1 view (73551) |
$188.50 |
$188.50 |
1.9× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$278 |
$278 |
2.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$480 |
$480 |
4.9× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$458 |
$458 |
3.9× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$278 |
$278 |
2.4× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$279 |
$279 |
2.9× |
| Radiological examination surgical specimen (76098) |
$1,862 |
$1,862 |
3.1× |
| Ribs bilateral 3 views (71110) |
$295.50 |
$295.50 |
2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,835.50 |
$2,835.50 |
4.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,432 |
$1,432 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$458 |
$458 |
3.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$731 |
$731 |
2.7× |
| Scapula (73010) |
$173 |
$173 |
1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$74.50 |
$74.50 |
3.2× |
| Sella turcica (70240) |
$278 |
$278 |
2.9× |
| Shoulder 1 view (73020) |
$156 |
$156 |
1.6× |
| Sialogram (70390) |
$872 |
$872 |
3.3× |
| Small bowel series (74250) |
$259 |
$259 |
1.3× |
| Speech evaluation complex (70371) |
$458 |
$458 |
1.7× |
| Spine thoracic 3 views (72072) |
$271 |
$271 |
2.3× |
| Thoracolumbar 2 views (72080) |
$157.50 |
$157.50 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$859 |
$859 |
1.9× |
| Tmj unilateral (70328) |
$278 |
$278 |
2.9× |
| Ultrasound breast complete (76641) |
$195.50 |
$195.50 |
1.7× |
| Ultrasound Exam Aaa Screen (76706) |
$116 |
$116 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$512.50 |
$512.50 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$366 |
$366 |
3.1× |
| Unlisted ultrasound procedure (76999) |
$518 |
$518 |
5.3× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$19 |
$19 |
1.7× |
| Urethrocystogram voiding (74455) |
$839 |
$839 |
3.2× |
| Urethrocystography retrograde rs&i (74450) |
$773 |
$773 |
2.9× |
| Us breast unilateral limited (76642) |
$322.50 |
$322.50 |
3.3× |
| Us chest (76604) |
$377.50 |
$377.50 |
3.2× |
| Us compl joint r-t w/image documentation (76881) |
$440.50 |
$440.50 |
3.8× |
| Us encephalogram (76506) |
$474.50 |
$474.50 |
4.1× |
| Us hips infant static (76886) |
$367.50 |
$367.50 |
3.8× |
| Us infant hips w manipulation (76885) |
$240.50 |
$240.50 |
2.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$166 |
$166 |
1.4× |
| Us ob detailed single fetus (76811) |
$783 |
$783 |
2.9× |
| Us ob limited (76815) |
$423.50 |
$423.50 |
3.6× |
| Us ob transvaginal (76817) |
$551.50 |
$551.50 |
4.7× |
| Us pelvic non ob complete (76856) |
$576.50 |
$576.50 |
4.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$388 |
$388 |
3.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$554 |
$554 |
4.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$376.50 |
$376.50 |
3.2× |
| Us retroperitoneal complete (76770) |
$427 |
$427 |
3.7× |
| Us retroperitoneal limited (76775) |
$471 |
$471 |
4.0× |
| Us scrotum and contents (76870) |
$573 |
$573 |
4.9× |
| Us soft tissue head/neck (76536) |
$541.50 |
$541.50 |
4.6× |
| Us spinal canal and contents (76800) |
$313 |
$313 |
2.7× |
| Us transrectal (76872) |
$381 |
$381 |
3.3× |
| Us,transplanted kidney, real time/ doppler (76776) |
$698 |
$698 |
6.0× |
| Venogram extremity bilateral (75822) |
$3,028 |
$3,028 |
1.7× |
| Venogram Extremity Unilateral (75820) |
$3,028 |
$3,028 |
1.7× |
| Wrist 2 views (73100) |
$475 |
$475 |
4.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$386 |
$386 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$276 |
$276 |
2.8× |
| X-ray b.e. reductn intuss (74283) |
$285 |
$285 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$229 |
$229 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$426 |
$426 |
4.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$207 |
$207 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$225.50 |
$225.50 |
1.9× |
| X-ray exam of femur 2/> (73552) |
$184 |
$184 |
1.9× |
| X-ray eye for foreign body (70030) |
$278 |
$278 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$391 |
$391 |
4.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,400 |
$1,400 |
7.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$246.50 |
$246.50 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$147 |
$147 |
1.5× |
| X-ray leg, infant (73592) |
$196.50 |
$196.50 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$215.50 |
$215.50 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$238.50 |
$238.50 |
2.0× |
| X-ray nose-rectum child f.b. (76010) |
$224 |
$224 |
2.3× |
| X-ray optic foramen (70190) |
$278 |
$278 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$279.50 |
$279.50 |
2.4× |
| X-ray retrograde pyelogram (74420) |
$1,517 |
$1,517 |
3.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$170 |
$170 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$295 |
$295 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$261.50 |
$261.50 |
2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$237.50 |
$237.50 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$217 |
$217 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$292.50 |
$292.50 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$358.50 |
$358.50 |
3.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$282 |
$282 |
2.4× |
| X-Ray Small Bowel Enteroclysis (74251) |
$809 |
$809 |
4.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$231 |
$231 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$158 |
$158 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$185.50 |
$185.50 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$159 |
$159 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$328 |
$328 |
2.8× |
| Xr bone length studies (77073) |
$202 |
$202 |
1.7× |
| Xr c-spine 4 or 5 views (72050) |
$311 |
$311 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$683 |
$683 |
5.9× |
| Xr chest 4+ views (71048) |
$783 |
$783 |
6.7× |
| Xr urogram antegrade (74425) |
$1,595 |
$1,595 |
4.1× |