| Abdomen 2 views (74019) |
$387.20 |
$484 |
3.6× |
| Acute gi blood loss imaging (78278) |
$1,561.60 |
$1,952 |
3.8× |
| Ankle 2 views (73600) |
$220 |
$275 |
2.4× |
| Arthrogram ankle (73615) |
$1,014.40 |
$1,268 |
2.8× |
| Arthrogram elbow (73085) |
$936.80 |
$1,171 |
2.6× |
| Arthrogram hip (73525) |
$1,008 |
$1,260 |
2.8× |
| Arthrogram knee (73580) |
$1,044 |
$1,305 |
2.9× |
| Arthrogram shoulder (73040) |
$1,044.80 |
$1,306 |
2.9× |
| Arthrogram wrist (73115) |
$898.40 |
$1,123 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,234.40 |
$1,543 |
3.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,576 |
$1,970 |
3.8× |
| Bone &/joint imaging whole body (78306) |
$1,197.60 |
$1,497 |
2.9× |
| Bone age studies (77072) |
$189.60 |
$237 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,506.40 |
$1,883 |
3.7× |
| Bone survey complete (77075) |
$770.40 |
$963 |
7.1× |
| Bone survey infant (77076) |
$484.80 |
$606 |
4.5× |
| Bowel imaging (78290) |
$1,369.60 |
$1,712 |
3.3× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,063.20 |
$1,329 |
2.6× |
| Cephalogram, orthodontic Non-Facility (70350) |
$90.40 |
$113 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$334.40 |
$418 |
3.7× |
| Chest 1 view (71045) |
$296.80 |
$371 |
3.3× |
| Chest xray 3 views (71047) |
$354.40 |
$443 |
3.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$791.20 |
$989 |
4.4× |
| Clavicle complete (73000) |
$278.40 |
$348 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$481.60 |
$602 |
4.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,408.80 |
$5,511 |
12.2× |
| CT abdomen and pelvis without contrast (74176) |
$3,016 |
$3,770 |
12.2× |
| CT abdomen w contrast (74160) |
$2,375.20 |
$2,969 |
13.1× |
| CT abdomen w wo contrast (74170) |
$2,724 |
$3,405 |
15.0× |
| CT abdomen w/o contrast (74150) |
$1,888.80 |
$2,361 |
17.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,542.40 |
$3,178 |
14.0× |
| CT angiography upper extremity lt (73206) |
$2,307.20 |
$2,884 |
12.7× |
| CT c-spine w/contrast (72126) |
$2,521.60 |
$3,152 |
7.0× |
| CT c-spine w/o contrast (72125) |
$1,961.60 |
$2,452 |
18.2× |
| CT chest w contrast (71260) |
$2,200 |
$2,750 |
12.2× |
| CT chest w/wo contrast (71270) |
$2,654.40 |
$3,318 |
14.7× |
| CT head/brain with contrast (70460) |
$1,966.40 |
$2,458 |
10.9× |
| CT head/brain without and with contrast (70470) |
$2,371.20 |
$2,964 |
13.1× |
| CT iac w contrast (70481) |
$2,194.40 |
$2,743 |
12.1× |
| CT lower ext w/o (73700) |
$1,724.80 |
$2,156 |
16.0× |
| CT lower extremity w wo contrast (73702) |
$2,496 |
$3,120 |
13.8× |
| CT lower extremity w/contrast material (73701) |
$2,092 |
$2,615 |
11.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,896.80 |
$3,621 |
16.0× |
| CT lumbar spine w/contrast (72132) |
$2,419.20 |
$3,024 |
6.7× |
| CT lumbar spine w/o contrast (72131) |
$2,286.40 |
$2,858 |
21.2× |
| CT maxillofacial w contrast (70487) |
$2,156 |
$2,695 |
11.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,638.40 |
$3,298 |
14.6× |
| CT maxillofacial wo contrast (70486) |
$1,729.60 |
$2,162 |
16.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,578.40 |
$3,223 |
14.2× |
| CT orbits w/o contrast (70480) |
$1,815.20 |
$2,269 |
16.8× |
| CT pelvis w/o contrast (72192) |
$1,737.60 |
$2,172 |
16.1× |
| CT pelvis w/wo contrast (72194) |
$2,576 |
$3,220 |
14.2× |
| CT scan of arm combo (73202) |
$2,300 |
$2,875 |
12.7× |
| CT soft tissue neck w contrast (70491) |
$2,135.20 |
$2,669 |
11.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,729.60 |
$3,412 |
15.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,784 |
$2,230 |
16.5× |
| CT thoracic spine w/contrast (72129) |
$2,295.20 |
$2,869 |
12.7× |
| CT thoracic spine w/o contrast (72128) |
$2,012 |
$2,515 |
18.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,660 |
$3,325 |
14.7× |
| CT thorax w/o contrast (71250) |
$1,746.40 |
$2,183 |
16.2× |
| CT upper ext wo (73200) |
$1,731.20 |
$2,164 |
16.0× |
| CT upper extremity with contrast (73201) |
$2,082.40 |
$2,603 |
5.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,102.40 |
$3,878 |
17.1× |
| Cta Abdomen (74175) |
$2,851.20 |
$3,564 |
15.7× |
| CTA abdomen pelvis (74174) |
$4,101.60 |
$5,127 |
11.4× |
| CTA chest (71275) |
$2,650.40 |
$3,313 |
14.6× |
| Cta Head (70496) |
$2,634.40 |
$3,293 |
14.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,600 |
$4,500 |
10.0× |
| Cta Neck (70498) |
$3,146.40 |
$3,933 |
17.4× |
| Cta Pelvis (72191) |
$2,414.40 |
$3,018 |
13.3× |
| Cystography minimum 3 views rs&i (74430) |
$793.60 |
$992 |
2.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$466.40 |
$583 |
4.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$432 |
$540 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$117.60 |
$147 |
1.3× |
| Esophagus (74220) |
$537.60 |
$672 |
3.0× |
| Facial bones min 3 views (70150) |
$368.80 |
$461 |
3.4× |
| Fetal biophysical profile non-stress testing (76818) |
$823.20 |
$1,029 |
7.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$624 |
$780 |
5.8× |
| Fetal Echo (76825) |
$1,267.20 |
$1,584 |
2.2× |
| Fluoroscopy up to 1 hr (76000) |
$516.80 |
$646 |
2.1× |
| Foot 2 views (73620) |
$224.80 |
$281 |
2.5× |
| Forearm 2 views (73090) |
$240 |
$300 |
2.7× |
| Gastric mucosa imaging (78261) |
$1,266.40 |
$1,583 |
3.1× |
| Hand 2 views (73120) |
$267.20 |
$334 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,594.40 |
$1,993 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,771.20 |
$2,214 |
4.3× |
| Hysterosalpingogram (74740) |
$642.40 |
$803 |
2.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$220.80 |
$276 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,880 |
$2,350 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,958.40 |
$2,448 |
3.5× |
| Knee 3 views (73562) |
$391.20 |
$489 |
4.4× |
| Liver & spleen imaging static only (78215) |
$1,480.80 |
$1,851 |
3.6× |
| Lymphoscintigraphy (78195) |
$1,548 |
$1,935 |
2.8× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,169.60 |
$3,962 |
3.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,429.60 |
$4,287 |
9.5× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$264.80 |
$331 |
2.9× |
| MRA head w & w/o contrast (70546) |
$3,588.80 |
$4,486 |
10.0× |
| MRA head w/o contrast (70544) |
$2,655.20 |
$3,319 |
10.8× |
| MRA head with contrast (70545) |
$2,924.80 |
$3,656 |
8.1× |
| MRA neck w contrast (70548) |
$2,965.60 |
$3,707 |
8.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,713.60 |
$4,642 |
10.3× |
| MRA neck w/o contrast (70547) |
$2,529.60 |
$3,162 |
10.3× |
| MRI abdomen w contrast (74182) |
$3,252 |
$4,065 |
9.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,297.60 |
$5,372 |
11.9× |
| MRI abdomen w/o contrast (74181) |
$3,114.40 |
$3,893 |
12.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,146.40 |
$3,933 |
3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,605.60 |
$4,507 |
10.0× |
| MRI c-spine with contrast (72142) |
$3,180 |
$3,975 |
8.8× |
| MRI cervical spine w/o contrast (72141) |
$2,757.60 |
$3,447 |
11.2× |
| MRI chest w/o & w/contrast material (71552) |
$3,820 |
$4,775 |
10.6× |
| MRI chest w/o contrast (71550) |
$2,708 |
$3,385 |
11.0× |
| MRI chest with contrast (71551) |
$2,497.60 |
$3,122 |
3.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,935.20 |
$3,669 |
8.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,600 |
$4,500 |
10.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,612.80 |
$3,266 |
10.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,835.20 |
$3,544 |
11.5× |
| MRI orbit face neck w contrast (70542) |
$3,347.20 |
$4,184 |
9.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,772 |
$4,715 |
10.5× |
| MRI pelvis w/contrast (72196) |
$3,708 |
$4,635 |
10.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,714.40 |
$4,643 |
10.3× |
| MRI pelvis w/o contrast (72195) |
$2,677.60 |
$3,347 |
10.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,868.80 |
$4,836 |
10.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,382.40 |
$4,228 |
9.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,103.20 |
$5,129 |
11.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,304 |
$4,130 |
9.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,863.20 |
$4,829 |
10.7× |
| MRI temporomandibular joint (70336) |
$2,698.40 |
$3,373 |
11.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,707.20 |
$3,384 |
11.0× |
| MRI up ext w/o contrast (73218) |
$2,481.60 |
$3,102 |
10.1× |
| MRI upper ext joint w/o contrast (73221) |
$2,656.80 |
$3,321 |
10.8× |
| MRI, joint upper extrem combo (73223) |
$3,592 |
$4,490 |
10.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,927.20 |
$3,659 |
2.2× |
| Myocardial spect single study at rest or stress (78451) |
$1,594.40 |
$1,993 |
1.2× |
| Neck soft tissue (70360) |
$220 |
$275 |
2.4× |
| Nm csf leak detection (78650) |
$1,880.80 |
$2,351 |
1.4× |
| Nm gastric emptying study (78264) |
$1,374.40 |
$1,718 |
3.3× |
| Nuclear Rx Oral Admin (79005) |
$1,547.20 |
$1,934 |
6.4× |
| Orthopantogram (70355) |
$370.40 |
$463 |
4.1× |
| Osseous survey limited (77074) |
$578.40 |
$723 |
5.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,664.80 |
$2,081 |
3.0× |
| Parathyroid Planar Imaging (78070) |
$955.20 |
$1,194 |
2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,419.20 |
$1,774 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$313.60 |
$392 |
2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,460 |
$1,825 |
3.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,937.60 |
$2,422 |
3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$764 |
$955 |
1.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$351.20 |
$439 |
3.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$220 |
$275 |
2.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$267.20 |
$334 |
3.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$281.60 |
$352 |
3.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$342.40 |
$428 |
3.2× |
| Radex fingr minimum 2 views (73140) |
$220 |
$275 |
2.4× |
| Radex Foot Compl Minimum 3 Views (73630) |
$313.60 |
$392 |
3.5× |
| Radex Hand Minimum 3 Views (73130) |
$324.80 |
$406 |
3.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$255.20 |
$319 |
2.8× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$473.60 |
$592 |
4.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$432 |
$540 |
4.0× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$663.20 |
$829 |
6.1× |
| Radex Humerus Minimum 2 Views (73060) |
$313.60 |
$392 |
3.5× |
| Radex Kne 1/2 Views (73560) |
$323.20 |
$404 |
3.6× |
| Radex Kne Compl 4/More Views (73564) |
$487.20 |
$609 |
4.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$328.80 |
$411 |
3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$325.60 |
$407 |
3.6× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$334.40 |
$418 |
3.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$324.80 |
$406 |
3.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$344 |
$430 |
3.8× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$407.20 |
$509 |
3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$442.40 |
$553 |
4.9× |
| Radex Toe Minimum 2 Views (73660) |
$220 |
$275 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$164.80 |
$206 |
1.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$313.60 |
$392 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$619.20 |
$774 |
5.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$313.60 |
$392 |
3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$377.60 |
$472 |
3.5× |
| Radiologic exam chest 2 views (71046) |
$326.40 |
$408 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$839.20 |
$1,049 |
4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$586.40 |
$733 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$811.20 |
$1,014 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$591.20 |
$739 |
3.3× |
| Radiologic examination femur 1 view (73551) |
$212.80 |
$266 |
2.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$273.60 |
$342 |
3.0× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$283.20 |
$354 |
2.6× |
| Radiologic examination, teeth; complete, full mouth Non-Facility (70320) |
$163.20 |
$204 |
0.7× |
| Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) |
$60.80 |
$76 |
0.2× |
| Radiological examination surgical specimen (76098) |
$464.80 |
$581 |
0.8× |
| Ribs bilateral 3 views (71110) |
$554.40 |
$693 |
5.1× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,390.40 |
$1,738 |
3.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,052.80 |
$2,566 |
5.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,800 |
$3,500 |
5.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,634.40 |
$3,293 |
4.7× |
| Sacroiliac Joints < 3 Views (72200) |
$94.40 |
$118 |
0.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$376.80 |
$471 |
1.5× |
| Scapula (73010) |
$313.60 |
$392 |
2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$84 |
$105 |
3.6× |
| Shoulder 1 view (73020) |
$220 |
$275 |
2.4× |
| Small bowel series (74250) |
$545.60 |
$682 |
3.0× |
| Spine thoracic 3 views (72072) |
$366.40 |
$458 |
3.4× |
| Thoracolumbar 2 views (72080) |
$248.80 |
$311 |
2.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$820 |
$1,025 |
2.0× |
| Tmj unilateral (70328) |
$372 |
$465 |
4.1× |
| Ultrasound breast complete (76641) |
$480 |
$600 |
4.4× |
| Ultrasound Exam Aaa Screen (76706) |
$491.20 |
$614 |
4.6× |
| Ultrasound, abdomen limited (76705) |
$664.80 |
$831 |
6.2× |
| Umbilical-artery Doppler (OB) (76820) |
$511.20 |
$639 |
4.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$213.20 |
$266.50 |
2.4× |
| Ureteral reflux study (78740) |
$1,333.60 |
$1,667 |
3.2× |
| Urethrocystogram voiding (74455) |
$722.40 |
$903 |
2.9× |
| Urethrocystography retrograde rs&i (74450) |
$785.60 |
$982 |
3.2× |
| Us breast unilateral limited (76642) |
$496.80 |
$621 |
5.5× |
| Us chest (76604) |
$542.40 |
$678 |
5.0× |
| Us compl joint r-t w/image documentation (76881) |
$696 |
$870 |
6.5× |
| Us elastography parenchyma (76981) |
$241.60 |
$302 |
2.2× |
| Us encephalogram (76506) |
$481.60 |
$602 |
4.5× |
| Us hips infant static (76886) |
$620.80 |
$776 |
6.9× |
| Us infant hips w manipulation (76885) |
$453.60 |
$567 |
5.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$412.80 |
$516 |
3.8× |
| Us ob detailed single fetus (76811) |
$988.80 |
$1,236 |
4.0× |
| Us ob limited (76815) |
$508.80 |
$636 |
4.7× |
| Us ob transvaginal (76817) |
$387.20 |
$484 |
3.6× |
| Us pelvic non ob complete (76856) |
$650.40 |
$813 |
6.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$418.40 |
$523 |
3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$418.40 |
$523 |
3.9× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$524.80 |
$656 |
4.9× |
| Us retroperitoneal complete (76770) |
$776.80 |
$971 |
7.2× |
| Us retroperitoneal limited (76775) |
$629.60 |
$787 |
5.8× |
| Us scrotum and contents (76870) |
$579.20 |
$724 |
5.4× |
| Us soft tissue head/neck (76536) |
$507.20 |
$634 |
4.7× |
| Us spinal canal and contents (76800) |
$521.60 |
$652 |
4.8× |
| Us transrectal (76872) |
$656 |
$820 |
6.1× |
| Us,transplanted kidney, real time/ doppler (76776) |
$658.40 |
$823 |
6.1× |
| Wrist 2 views (73100) |
$262.40 |
$328 |
2.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$524 |
$655 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$304 |
$380 |
3.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,146.40 |
$1,433 |
6.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$220 |
$275 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$315.20 |
$394 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$520 |
$650 |
4.8× |
| X-ray exam of femur 2/> (73552) |
$305.60 |
$382 |
3.4× |
| X-ray eye for foreign body (70030) |
$262.40 |
$328 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$253.60 |
$317 |
2.8× |
| X-ray IV pyelogram (ivp) (74400) |
$929.60 |
$1,162 |
5.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$334.40 |
$418 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$220 |
$275 |
2.4× |
| X-ray leg, infant (73592) |
$184.80 |
$231 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$412 |
$515 |
3.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$440 |
$550 |
4.1× |
| X-ray nose-rectum child f.b. (76010) |
$276 |
$345 |
3.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$481.60 |
$602 |
4.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$313.60 |
$392 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$437.60 |
$547 |
4.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$577.60 |
$722 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$334.40 |
$418 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$313.60 |
$392 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$351.20 |
$439 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$464.80 |
$581 |
4.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$313.60 |
$392 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$352 |
$440 |
3.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$340.80 |
$426 |
3.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$291.20 |
$364 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$334.40 |
$418 |
3.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$516.80 |
$646 |
4.8× |
| Xr bone length studies (77073) |
$368.80 |
$461 |
3.4× |
| Xr c-spine 4 or 5 views (72050) |
$508 |
$635 |
4.7× |
| Xr c-spine 6 or more views (72052) |
$651.20 |
$814 |
6.0× |
| Xr chest 4+ views (71048) |
$501.60 |
$627 |
4.6× |