| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,427.20 |
$9,284 |
5.2× |
| Abdomen 1 View (74018) |
$272.80 |
$341 |
3.0× |
| Abdomen 2 views (74019) |
$335.20 |
$419 |
3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,569.60 |
$1,962 |
3.8× |
| Ankle 2 views (73600) |
$303.20 |
$379 |
3.4× |
| Arthrogram hip (73525) |
$1,032.80 |
$1,291 |
2.9× |
| Arthrogram Wrist (73115) |
$775.20 |
$969 |
2.2× |
| Basic radiation dosimetry calculation (77300) |
$778.40 |
$973 |
5.6× |
| Bone age studies (77072) |
$184.80 |
$231 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$2,059.20 |
$2,574 |
5.0× |
| Bone Imaging Limited Area (78300) |
$1,328 |
$1,660 |
3.2× |
| Bone Imaging Whole Body (78306) |
$2,059.20 |
$2,574 |
5.0× |
| Bone survey infant (77076) |
$424.80 |
$531 |
3.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,952.80 |
$7,441 |
4.0× |
| Cat Scan Follow-Up Study (76380) |
$963.20 |
$1,204 |
10.7× |
| Chest 1 view (71045) |
$265.60 |
$332 |
3.0× |
| Chest 2 views (71046) |
$300.08 |
$375.10 |
3.3× |
| Chest 3 views (71047) |
$280 |
$350 |
3.1× |
| Chest 4 or more views (71048) |
$356.80 |
$446 |
3.3× |
| Clavicle complete (73000) |
$328.80 |
$411 |
3.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,896.36 |
$3,620.45 |
26.8× |
| Continuing medical physics consltj pr wk (77336) |
$987.20 |
$1,234 |
7.1× |
| Contrast X-Ray Bladder (74430) |
$552 |
$690 |
1.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,074.40 |
$1,343 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,371.20 |
$5,464 |
12.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,623.76 |
$4,529.70 |
14.7× |
| CT abdomen w contrast (74160) |
$2,987.20 |
$3,734 |
16.5× |
| CT abdomen w wo contrast (74170) |
$3,484.80 |
$4,356 |
19.2× |
| CT abdomen w/o contrast (74150) |
$2,472.80 |
$3,091 |
22.9× |
| CT Angio Abdomen and Pelvis (74174) |
$4,371.20 |
$5,464 |
12.1× |
| CT Angio Chest (71275) |
$2,789.71 |
$3,487.13 |
15.4× |
| CT Angio Head (70496) |
$3,183.20 |
$3,979 |
17.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,401.60 |
$3,002 |
13.3× |
| CT Angio Neck (70498) |
$3,183.20 |
$3,979 |
17.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,422.40 |
$3,028 |
13.4× |
| CT cervical spine w/ contrast (72126) |
$2,288 |
$2,860 |
6.4× |
| CT cervical spine w/o contrast (72125) |
$2,072.40 |
$2,590.50 |
19.2× |
| CT cervical spine w/wo cont (72127) |
$2,362.40 |
$2,953 |
13.0× |
| CT chest w contrast (71260) |
$2,778.40 |
$3,473 |
15.3× |
| CT chest w/wo contrast (71270) |
$3,056 |
$3,820 |
16.9× |
| CT head/brain with contrast (70460) |
$1,870.40 |
$2,338 |
10.3× |
| CT head/brain without and with contrast (70470) |
$2,056.80 |
$2,571 |
11.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$231.20 |
$289 |
2.6× |
| CT iac w contrast (70481) |
$2,497.60 |
$3,122 |
13.8× |
| CT l-spine w&w/o contrast (72133) |
$2,712 |
$3,390 |
15.0× |
| CT lower ext w/o (73700) |
$1,972.80 |
$2,466 |
18.3× |
| CT lower extremity w/contrast material (73701) |
$2,279.20 |
$2,849 |
12.6× |
| CT lumbar spine w contrast (72132) |
$2,185.60 |
$2,732 |
6.1× |
| CT lumbar spine w/o contrast (72131) |
$1,854.40 |
$2,318 |
17.2× |
| CT maxillofacial w contrast (70487) |
$2,497.60 |
$3,122 |
13.8× |
| CT maxillofacial wo contrast (70486) |
$2,285.60 |
$2,857 |
21.2× |
| CT neck tissue combo (70492) |
$2,675.20 |
$3,344 |
14.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,745.60 |
$3,432 |
15.2× |
| CT orbits w/o contrast (70480) |
$2,448.80 |
$3,061 |
22.7× |
| CT pelvis w&w/o contrast (72194) |
$2,484 |
$3,105 |
13.7× |
| CT pelvis w/o contrast (72192) |
$1,992.80 |
$2,491 |
18.5× |
| CT scan of leg combo (73702) |
$2,388.80 |
$2,986 |
13.2× |
| CT scans face/jaw combo (70488) |
$2,745.60 |
$3,432 |
15.2× |
| CT soft tissue neck w contrast (70491) |
$2,282.40 |
$2,853 |
12.6× |
| CT soft tissue neck w/o contrast (70490) |
$2,047.20 |
$2,559 |
19.0× |
| CT thoracic spine w contrast (72129) |
$2,464.80 |
$3,081 |
13.6× |
| CT thoracic spine w/o contrast (72128) |
$2,296.80 |
$2,871 |
21.3× |
| CT thoracic spine w/wo cont (72130) |
$2,641.60 |
$3,302 |
14.6× |
| CT thorax w/o contrast (71250) |
$2,372.80 |
$2,966 |
22.0× |
| CT unlisted procedure (76497) |
$147.20 |
$184 |
1.6× |
| CT upper ext wo (73200) |
$1,750.40 |
$2,188 |
16.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,377.60 |
$2,972 |
13.1× |
| CT upper extremity with contrast (73201) |
$2,063.20 |
$2,579 |
5.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,770.40 |
$4,713 |
20.8× |
| Cta Abdomen (74175) |
$3,770.40 |
$4,713 |
20.8× |
| CTA pelvis (72191) |
$2,588.80 |
$3,236 |
14.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$114.40 |
$143 |
1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$219.20 |
$274 |
2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$462.40 |
$578 |
4.3× |
| Dxa Bone Density Axial (77080) |
$481.60 |
$602 |
4.5× |
| Echo exam of fetal heart (76825) |
$1,477.60 |
$1,847 |
2.6× |
| Echo exam uterus (76831) |
$656 |
$820 |
2.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$981.60 |
$1,227 |
4.0× |
| Esophagram (74220) |
$618.40 |
$773 |
3.4× |
| Fetal Biophys Profile W/Nst (76818) |
$811.20 |
$1,014 |
7.5× |
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines |
$313.60–$676.24 |
$392–$845.30 |
varies |
| Fluoroscopy up to 1 hr (76000) |
$500 |
$625 |
2.0× |
| Foot 2 views (73620) |
$288.80 |
$361 |
3.2× |
| Forearm 2 views (73090) |
$323.20 |
$404 |
3.6× |
| Gastric emptying imaging study (78264) |
$1,775.20 |
$2,219 |
4.3× |
| Gated Heart Planar Single (78472) |
$1,818.40 |
$2,273 |
4.4× |
| Hand 2 views (73120) |
$283.20 |
$354 |
2.6× |
| Hepatobil Syst Image W/Drug (78227) |
$1,646.40 |
$2,058 |
2.9× |
| Hepatobiliary System Imaging (78226) |
$1,646.40 |
$2,058 |
4.0× |
| Ht Musc Image Planar Mult (78454) |
$2,446.40 |
$3,058 |
1.8× |
| Ht Muscle Image Spect Sing (78451) |
$2,838.40 |
$3,548 |
2.1× |
| Hysterosalpingogram (74740) |
$976 |
$1,220 |
4.0× |
| Image fusion (77399) |
$640.80 |
$801 |
4.6× |
| Infusion Ivp (74410) |
$863.20 |
$1,079 |
4.8× |
| Joint Survey Single View (77077) |
$198.40 |
$248 |
1.8× |
| K Flow/Funct Image W/Drug (78708) |
$1,577.60 |
$1,972 |
2.8× |
| Knee 3 Views (73562) |
$310.40 |
$388 |
3.5× |
| Liver & Spleen Imaging Static Only (78215) |
$1,328.80 |
$1,661 |
3.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,854.40 |
$2,318 |
3.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,950.40 |
$2,438 |
3.5× |
| Lymph System Imaging (78195) |
$1,213.60 |
$1,517 |
2.2× |
| Magnetic Image Jaw Joint (70336) |
$2,796 |
$3,495 |
11.4× |
| Meckels Divert Exam (78290) |
$1,430.40 |
$1,788 |
3.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,862.40 |
$4,828 |
10.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,791.20 |
$4,739 |
10.5× |
| MRA head w/o contrast (70544) |
$2,796.80 |
$3,496 |
11.4× |
| MRA head with contrast (70545) |
$2,761.60 |
$3,452 |
7.7× |
| MRA neck w contrast (70548) |
$2,885.60 |
$3,607 |
8.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,791.20 |
$4,739 |
10.5× |
| MRA neck w/o contrast (70547) |
$2,520 |
$3,150 |
10.2× |
| MRI abdomen w contrast (74182) |
$3,106.40 |
$3,883 |
8.6× |
| MRI abdomen w/o contrast (74181) |
$2,619.20 |
$3,274 |
10.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,039.20 |
$3,799 |
3.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,600.80 |
$4,501 |
10.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,330.40 |
$4,163 |
4.1× |
| MRI cervical spine w contrast (72142) |
$3,990.40 |
$4,988 |
11.1× |
| MRI cervical spine w/o cont (72141) |
$3,444 |
$4,305 |
14.0× |
| MRI chest w/o contrast (71550) |
$2,652.80 |
$3,316 |
10.8× |
| MRI chest wo w contrast (71552) |
$3,630.40 |
$4,538 |
10.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,541.60 |
$4,427 |
9.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,798.40 |
$3,498 |
11.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,632.80 |
$5,791 |
12.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,362.40 |
$4,203 |
13.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,860 |
$4,825 |
10.7× |
| MRI pelvis w/o & w contrast (72197) |
$3,841.73 |
$4,802.16 |
10.7× |
| MRI pelvis w/o contrast (72195) |
$2,604.80 |
$3,256 |
10.6× |
| MRI thoracic spine w/o contrast (72146) |
$3,441.60 |
$4,302 |
14.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,777.60 |
$3,472 |
11.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,697.60 |
$4,622 |
10.3× |
| MRI, abdomen, combo (74183) |
$3,967.92 |
$4,959.90 |
11.0× |
| MRI, dorsal spine combo (72157) |
$4,724.80 |
$5,906 |
13.1× |
| MRI, dorsal spine contrast (72147) |
$3,636.80 |
$4,546 |
10.1× |
| MRI, joint upper extrem (73221) |
$3,016.44 |
$3,770.55 |
12.2× |
| MRI, joint upper extrem combo (73223) |
$3,858.40 |
$4,823 |
10.7× |
| MRI, lumbar spine combo (72158) |
$4,224.80 |
$5,281 |
11.7× |
| Myelogram Lumbar (72265) |
$1,541.60 |
$1,927 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,340.48 |
$4,175.60 |
2.5× |
| Neck soft tissue (70360) |
$340 |
$425 |
3.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,828.80 |
$11,036 |
6.2× |
| Ob us nuchal meas 1 gest (76813) |
$489.60 |
$612 |
4.5× |
| Optic foramina (70190) |
$254.40 |
$318 |
2.8× |
| Panoramic X-ray of jaws (70355) |
$295.20 |
$369 |
3.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,716 |
$2,145 |
3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,464.80 |
$1,831 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$280.80 |
$351 |
2.6× |
| Pet Image W/Ct Lmtd (78814) |
$5,569.60 |
$6,962 |
3.8× |
| PET image w/CT, full body (78816) |
$6,666.40 |
$8,333 |
4.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$6,522.60 |
$8,153.25 |
4.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,185.60 |
$1,482 |
2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$330.40 |
$413 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$598.40 |
$748 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$353.60 |
$442 |
3.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$235.20 |
$294 |
2.6× |
| Radex elbow complete minimum 3 views (73080) |
$368.80 |
$461 |
4.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$412.80 |
$516 |
3.8× |
| Radex fingr minimum 2 views (73140) |
$277.60 |
$347 |
3.1× |
| Radex foot complete minimum 3 views (73630) |
$345.60 |
$432 |
3.8× |
| Radex Hand Minimum 3 Views (73130) |
$330.40 |
$413 |
3.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$264 |
$330 |
2.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$369.60 |
$462 |
3.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$184 |
$230 |
2.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$333.60 |
$417 |
3.7× |
| Radex shoulder complete minimum 2 views (73030) |
$283.20 |
$354 |
3.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$266.40 |
$333 |
3.0× |
| Radex Spine 1 View Specify Level (72020) |
$224 |
$280 |
2.5× |
| Radex Sternum Minimum 2 Views (71120) |
$236.80 |
$296 |
2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$394.40 |
$493 |
4.4× |
| Radex Toe Minimum 2 Views (73660) |
$270.40 |
$338 |
3.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$258.40 |
$323 |
2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$350.40 |
$438 |
3.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$537.60 |
$672 |
5.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$26,032 |
$32,540 |
3.4× |
| Radiation treatment delivery level 1 (77402) |
$752.80 |
$941 |
7.1× |
| Radiation treatment delivery level 2 (77407) |
$2,852.80 |
$3,566 |
7.2× |
| Radiation treatment delivery level 3 (77412) |
$4,083.20 |
$5,104 |
7.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$392 |
$490 |
3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$380.80 |
$476 |
3.5× |
| Radiologic exam colon double contrast study (74280) |
$1,114.40 |
$1,393 |
6.2× |
| Radiologic exam colon single contrast study (74270) |
$868 |
$1,085 |
4.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$199.20 |
$249 |
1.1× |
| Radiologic exam knee complete 4/more views (73564) |
$387.20 |
$484 |
3.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$276.80 |
$346 |
2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$750.40 |
$938 |
4.1× |
| Radiologic exam swallow function contrast study (74230) |
$491.20 |
$614 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$899.20 |
$1,124 |
5.0× |
| Radiologic examination femur 1 view (73551) |
$281.60 |
$352 |
3.1× |
| Radiologic examination femur minimum 2 views (73552) |
$321.60 |
$402 |
3.6× |
| Radiologic examination knee 1/2 views (73560) |
$304.80 |
$381 |
3.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$465.60 |
$582 |
4.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$349.60 |
$437 |
3.9× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$343.20 |
$429 |
0.6× |
| Ribs bilateral 3 views (71110) |
$478.40 |
$598 |
4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,039.20 |
$2,549 |
3.6× |
| Scapula (73010) |
$298.40 |
$373 |
2.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$110.40 |
$138 |
4.7× |
| Sella turcica (70240) |
$188.80 |
$236 |
2.1× |
| Shoulder 1 view (73020) |
$222.40 |
$278 |
2.5× |
| Shoulder Arthrography (73040) |
$1,056.80 |
$1,321 |
2.9× |
| Sialogram (70390) |
$708.80 |
$886 |
2.9× |
| Skull less than 4 views (70250) |
$391.20 |
$489 |
3.6× |
| Special dosimetry (77331) |
$985.60 |
$1,232 |
7.1× |
| Special Physics Consult (77370) |
$1,398.40 |
$1,748 |
10.1× |
| Special teletherapy port plan (77321) |
$2,856 |
$3,570 |
7.4× |
| Special treatment procedure (77470) |
$3,699.20 |
$4,624 |
6.5× |
| Stereotactic Body Radiation Delivery (77373) |
$11,344.80 |
$14,181 |
6.1× |
| Sternoclavicular joints (71130) |
$321.60 |
$402 |
3.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$6,175.20 |
$7,719 |
16.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$3,511.20 |
$4,389 |
9.1× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$572 |
$715 |
2.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,647.20 |
$3,309 |
6.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,047.20 |
$2,559 |
5.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,281.60 |
$1,602 |
9.2× |
| Thoracic spine 2 views (72070) |
$349.60 |
$437 |
3.2× |
| Thoracic spine 3 views (72072) |
$266.40 |
$333 |
2.5× |
| Thoracolumbar 2 views (72080) |
$371.20 |
$464 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$928.80 |
$1,161 |
2.3× |
| Thyroid Uptake Measurement (78012) |
$801.60 |
$1,002 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,380 |
$1,725 |
3.3× |
| Tx Devices Design & Construction Complex (77334) |
$1,766.40 |
$2,208 |
4.6× |
| Tx devices design & construction intermediate (77333) |
$953.60 |
$1,192 |
6.9× |
| Tx devices design & construction simple (77332) |
$768 |
$960 |
5.5× |
| Ultrasound Breast Limited (76642) |
$516 |
$645 |
5.7× |
| Ultrasound Exam Aaa Screen (76706) |
$618.40 |
$773 |
5.7× |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
$753.28–$824.80 |
$941.60–$1,031 |
varies |
Umbilical-artery Doppler (OB) (76820)
range across 2 matching MRF lines |
$369.60–$516 |
$462–$645 |
varies |
| Unlisted Dx Radiographic Procedure (76499) |
$951.20 |
$1,189 |
10.6× |
| Unlisted us procedure (76999) |
$326.40 |
$408 |
3.6× |
| Upper gi w/o kub (74240) |
$924 |
$1,155 |
5.1× |
| Urethrocystogram voiding (74455) |
$908 |
$1,135 |
3.7× |
| Urethrocystography retrograde (74450) |
$832 |
$1,040 |
3.4× |
| Us breast unilateral complete (76641) |
$704.80 |
$881 |
6.5× |
| Us chest (76604) |
$412.80 |
$516 |
3.8× |
| Us complete joint (76881) |
$662.40 |
$828 |
6.1× |
| Us exam, pelvic, limited (76857) |
$574.40 |
$718 |
5.3× |
| Us head (76506) |
$533.60 |
$667 |
4.9× |
| Us kidney transplant (76776) |
$746.40 |
$933 |
6.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$577.60 |
$722 |
5.4× |
| Us ob detailed single fetus (76811) |
$916 |
$1,145 |
3.7× |
| Us ob limited 1 or more fetuses (76815) |
$537.60 |
$672 |
5.0× |
| Us ob transvaginal (76817) |
$763.20 |
$954 |
7.1× |
| Us pelvic non ob complete (76856) |
$767.20 |
$959 |
7.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$748 |
$935 |
6.9× |
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines |
$310.40–$500 |
$388–$625 |
varies |
| Us retroperitoneal complete (76770) |
$905.60 |
$1,132 |
8.4× |
| Us retroperitoneal limited (76775) |
$618.40 |
$773 |
5.7× |
| Us scrotum and contents (76870) |
$733.60 |
$917 |
6.8× |
| Us spinal canal and contents (76800) |
$604 |
$755 |
5.6× |
| Us thyroid (76536) |
$700.80 |
$876 |
6.5× |
| Venography extremity unilateral rs&i (75820) |
$1,112 |
$1,390 |
0.7× |
| Wrist 2 views (73100) |
$296.80 |
$371 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$349.60 |
$437 |
3.9× |
| X-ray antegrade pyelogram tube (74425) |
$804 |
$1,005 |
2.2× |
| X-Ray Bend Only L-S Spine (72120) |
$171.20 |
$214 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$251.20 |
$314 |
2.8× |
| X-Ray Exam Breast Specimen (76098) |
$335.20 |
$419 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$306.40 |
$383 |
3.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$440.80 |
$551 |
4.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$417.60 |
$522 |
3.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$236.80 |
$296 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$290.40 |
$363 |
3.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$407.20 |
$509 |
3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$420.80 |
$526 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$472.80 |
$591 |
4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$505.60 |
$632 |
4.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$468.80 |
$586 |
4.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$283.20 |
$354 |
3.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$573.60 |
$717 |
5.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$298.40 |
$373 |
2.8× |
| X-ray eye for foreign body (70030) |
$262.40 |
$328 |
2.9× |
| X-ray humerus (73060) |
$272 |
$340 |
3.0× |
| X-ray IV pyelogram (ivp) (74400) |
$981.60 |
$1,227 |
5.4× |
| X-ray IV pyelogram+tomography (74415) |
$1,168.80 |
$1,461 |
6.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$264.80 |
$331 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$232 |
$290 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$288.80 |
$361 |
2.7× |
| X-ray nose-rectum child f.b. (76010) |
$272.80 |
$341 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$591.20 |
$739 |
5.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$314.40 |
$393 |
2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$283.20 |
$354 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$476 |
$595 |
5.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$552 |
$690 |
5.1× |
| X-ray thoracic spine 4 vw (72074) |
$649.60 |
$812 |
6.0× |
| X-Ray Tmj Unilat (70328) |
$252 |
$315 |
2.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$851.20 |
$1,064 |
2.4× |
| X-Rays Bone Length Studies (77073) |
$496.80 |
$621 |
4.6× |
| X-Rays Bone Survey Complete (77075) |
$767.20 |
$959 |
7.1× |
| Xr c-spine 4 or 5 views (72050) |
$437.60 |
$547 |
4.1× |
| Xr facial bones less than 3 views (70140) |
$270.40 |
$338 |
3.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$148 |
$185 |
1.4× |
| Xr orbits complete 4 views (70200) |
$389.60 |
$487 |
3.6× |
| Xr Tomogram Single Plane (76100) |
$562.40 |
$703 |
5.2× |