| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$4,453.19 |
— |
| Abdomen 2 views (74019) |
— |
$233.50 |
— |
| Acute gastrointestinal blood loss imaging (78278) |
— |
$872 |
— |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
— |
$1,205.38 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$7,595 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$3,038 |
— |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
— |
$1,045.86 |
— |
| Angiography pulmonary bilateral slctv rs&i (75743) |
— |
$1,267.16 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$2,978.97 |
— |
| Angiography Spinal Selective Rs&I (75705) |
— |
$991.90 |
— |
| Angiography visceral slctv/supraslctv rs&i (75726) |
— |
$6,225 |
— |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
— |
$688.33 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$1,140.61 |
— |
| Ankle 2 views (73600) |
— |
$297.42 |
— |
| Antegrade urography radiological supvj & interpj (74425) |
— |
$386.45 |
— |
| Aortogram thoracic (75605) |
— |
$5,236 |
— |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
— |
$1,165.81 |
— |
| Aortography abdominal serialography rs&i (75625) |
— |
$3,038 |
— |
| Artery X-Rays Adrenal Gland (75731) |
— |
$1,074.65 |
— |
| Arthrogram elbow (73085) |
— |
$410.49 |
— |
| Arthrogram hip (73525) |
— |
$615 |
— |
| Arthrogram shoulder (73040) |
— |
$1,928.02 |
— |
| Arthrogram wrist (73115) |
— |
$380.46 |
— |
| Arthrography knee lt (73580) |
— |
$404.80 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$507.44 |
— |
| Bone &/Joint Imaging Limited Area (78300) |
— |
$745.60 |
— |
| Bone &/joint imaging whole body (78306) |
— |
$1,278.29 |
— |
| Bone age studies (77072) |
— |
$711 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$1,210.81 |
— |
| Bone Marrow Imaging Limited Area (78102) |
— |
$1,594.04 |
— |
| Bone survey complete (77075) |
— |
$383.29 |
— |
| Brain imaging < 4 static views w vascular flow (78601) |
— |
$854.29 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$1,024.90 |
— |
| Cervical spine 2 or 3 views (72040) |
— |
$1,139 |
— |
| Chest 1 view (71045) |
— |
$247.80 |
— |
| Chest 3 views (71047) |
— |
$229.62 |
— |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
— |
$468.06 |
— |
| Clavicle complete (73000) |
— |
$830 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$662.07 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$773.75 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$2,154.72 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$1,275 |
— |
| CT abdomen w contrast (74160) |
— |
$1,689.45 |
— |
| CT abdomen w wo contrast (74170) |
— |
$1,906.91 |
— |
| CT abdomen w/o contrast (74150) |
— |
$1,128.19 |
— |
| CT angiography upper extremity lt (73206) |
— |
$5,090 |
— |
| CT c-spine w/o contrast (72125) |
— |
$3,672 |
— |
| CT cervical spine w&w/o contrast (72127) |
— |
$5,010 |
— |
| CT cervical spine with contrast (72126) |
— |
$4,420 |
— |
| CT chest w/wo contrast (71270) |
— |
$1,954.29 |
— |
| CT chest with contrast (71260) |
— |
$4,839 |
— |
| CT head/brain with contrast (70460) |
— |
$1,755.11 |
— |
| CT head/brain without and with contrast (70470) |
— |
$1,959.79 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$132.50 |
— |
| CT iac w contrast (70481) |
— |
$1,782.51 |
— |
| CT limited/localized follow up study (76380) |
— |
$589.70 |
— |
| CT lower ext w/o (73700) |
— |
$2,775 |
— |
| CT lower extremity w wo contrast (73702) |
— |
$2,077.07 |
— |
| CT lower extremity with contrast (73701) |
— |
$2,264.96 |
— |
| CT lumbar spine w & w/o contrast (72133) |
— |
$1,995.90 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$3,291 |
— |
| CT lumbar spine with contrast (72132) |
— |
$1,673.99 |
— |
| CT maxillofacial w contrast (70487) |
— |
$1,792.44 |
— |
| CT maxillofacial w/o contrast (70486) |
— |
$1,775 |
— |
| CT maxillofacial w/wo contrast (70488) |
— |
$1,978.37 |
— |
| CT neck soft tissue w contrast (70491) |
— |
$1,730.92 |
— |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
— |
$1,949.06 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,116.96 |
— |
| CT pelvis w & w/o contrast (72194) |
— |
$1,906.08 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,155.48 |
— |
| CT soft tissue neck w/o & w/contrast material (70492) |
— |
$1,892.28 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,141.27 |
— |
| CT thoracic spine w/contrast (72129) |
— |
$1,737.57 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$3,613 |
— |
| CT thoracic spine w/wo contrast (72130) |
— |
$1,320.58 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,115.66 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$1,730.90 |
— |
| CT upper extremity w/o contrast rt (73200) |
— |
$2,965 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,165.98 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$2,003.44 |
— |
| Cta Abdomen (74175) |
— |
$2,001.32 |
— |
| CTA abdomen pelvis (74174) |
— |
$2,035.79 |
— |
| CTA chest (71275) |
— |
$2,055.22 |
— |
| Cta Head (70496) |
— |
$1,158.38 |
— |
| CTA lwr ext w&w/o contrast (73706) |
— |
$2,040.57 |
— |
| Cta Neck (70498) |
— |
$1,156.53 |
— |
| Cta Pelvis (72191) |
— |
$2,009.20 |
— |
| Cystography minimum 3 views rs&i (74430) |
— |
$962.62 |
— |
| Diskogram cervical (72285) |
— |
$551.73 |
— |
| Diskography lumbar (72295) |
— |
$649.48 |
— |
| Dxa bone density study 1/> sites axial skel (77080) |
— |
$630.37 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$166.72 |
— |
| Echoencephalography real time imaging (76506) |
— |
$331.90 |
— |
| Esophagus (74220) |
— |
$454.85 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$500.43 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$290.77 |
— |
| Foot 2 views (73620) |
— |
$976.50 |
— |
| Forearm 2 views (73090) |
— |
$1,191.50 |
— |
| Gated Heart Planar Single (78472) |
— |
$1,549.48 |
— |
| Hand 2 views (73120) |
— |
$645 |
— |
| Hand 3 views (73130) |
— |
$975 |
— |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
— |
$3,384.41 |
— |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
— |
$3,384.41 |
— |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
— |
$3,384.41 |
— |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
— |
$1,096.24 |
— |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
— |
$1,028.41 |
— |
| Hepatobiliary syst imaging including gallbladder (78226) |
— |
$1,028.41 |
— |
| Ht muscle image spect sing (78451) |
— |
$2,939.16 |
— |
| Humerus Min 2 Views Left (73060) |
— |
$1,242.50 |
— |
| Hysterosalpingogram (74740) |
— |
$1,732 |
— |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
— |
$1,155.79 |
— |
| Kidney img morphology vascular flow 1 w/rx (78708) |
— |
$1,159.69 |
— |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
— |
$1,414.07 |
— |
| Knee 3 views (73562) |
— |
$1,084 |
— |
| Liver & spleen imaging static only (78215) |
— |
$882.33 |
— |
| Lung perf&ventilat diferentl (78598) |
— |
$1,109.05 |
— |
| Lung perfusion differential (78597) |
— |
$709.37 |
— |
| Lung Ventilation Imaging (78579) |
— |
$709.37 |
— |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
— |
$1,010.18 |
— |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
— |
$5,183.99 |
— |
| Lymphoscintigraphy (78195) |
— |
$1,146.07 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$906.96 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$906.96 |
— |
| Meckels Diverticulum (78290) |
— |
$732.75 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$1,610.96 |
— |
| MRA head w & w/o contrast (70546) |
— |
$2,825.80 |
— |
| MRA head w/o contrast (70544) |
— |
$2,093.57 |
— |
| MRA head with contrast (70545) |
— |
$3,261.41 |
— |
| MRA neck w contrast (70548) |
— |
$1,469.24 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$3,039.87 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,060.16 |
— |
| MRI abdomen w/o & w/contrast material (74183) |
— |
$2,922.42 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$2,078.87 |
— |
| MRI any jnt lwr ext with con lt (73722) |
— |
$3,765 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$4,115 |
— |
| MRI breast w/o contrast bilateral (77047) |
— |
$4,722 |
— |
| MRI breast w/o contrast unilat (77046) |
— |
$1,436.27 |
— |
| MRI c-spine with contrast (72142) |
— |
$2,787.82 |
— |
| MRI cervical spine w/o contrast (72141) |
— |
$2,015.11 |
— |
| MRI chest w/o & w/contrast material (71552) |
— |
$2,850.57 |
— |
| MRI chest w/o contrast (71550) |
— |
$2,363.02 |
— |
| MRI chest with contrast (71551) |
— |
$2,203.35 |
— |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
— |
$3,492.54 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$1,380.79 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$2,550.21 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$1,988.01 |
— |
| MRI orbit/face/neck w&w/o cont (70543) |
— |
$2,899.35 |
— |
| MRI orbit/face/neck w/contrast (70542) |
— |
$2,101.13 |
— |
| MRI pelvis w contrast (72196) |
— |
$1,945.17 |
— |
| MRI pelvis w/o & w/contrast material (72197) |
— |
$2,908.79 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$2,029.78 |
— |
| MRI scan of arm joint before and after contrast (73223) |
— |
$5,138 |
— |
| MRI scan of leg joint before and after contrast (73723) |
— |
$5,602 |
— |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
— |
$2,981.21 |
— |
| MRI spinal canal lumbar w/contrast material (72149) |
— |
$2,646.99 |
— |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
— |
$2,973.19 |
— |
| MRI spinal canal thoracic w/contrast matrl (72147) |
— |
$2,410.84 |
— |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
— |
$3,017.10 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$2,020.24 |
— |
| MRI tmj (70336) |
— |
$1,788.04 |
— |
| MRI upper ext joint w/o contrast (73221) |
— |
$3,895 |
— |
| MRI upper extrem other than jt w/o & w/contras (73220) |
— |
$2,942.94 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$2,531.60 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$2,939.16 |
— |
| Neck soft tissue (70360) |
— |
$237.51 |
— |
| Nm adrenal scan (78075) |
— |
$4,791.47 |
— |
| Nm cisternogram (78630) |
— |
$1,953.98 |
— |
| Nm csf leak detection (78650) |
— |
$640.42 |
— |
| Nm gastric emptying study (78264) |
— |
$931.14 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$4,485.33 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$829.75 |
— |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
— |
$331.90 |
— |
| Orthopantogram (70355) |
— |
$473 |
— |
| Osseous survey infant (77076) |
— |
$399.61 |
— |
| Osseous survey limited (77074) |
— |
$375.13 |
— |
| Parathyroid imaging (78070) |
— |
$923.97 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$632 |
— |
| Peritoneogram rs&i (74190) |
— |
$503.13 |
— |
| PET image w/CT, skull-thigh (78815) |
— |
$6,470.26 |
— |
| PET imaging for CT attenuation whole body (78816) |
— |
$6,554.44 |
— |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
— |
$3,708.07 |
— |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
— |
$2,974.47 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$732.13 |
— |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
— |
$1,109.05 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$442.95 |
— |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
— |
$308.52 |
— |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
— |
$1,156 |
— |
| Radex hips bilateral with pelvis 2 views (73521) |
— |
$873 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$1,032.72 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$18,263.65 |
— |
| Radiation treatment delivery 1 mev >= complex (77412) |
— |
$729.45 |
— |
| Radiation treatment delivery 1 mev >= simple (77402) |
— |
$421.47 |
— |
| Radiation tx delivery 1 mev >= intermediate (77407) |
— |
$421.47 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$910 |
— |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
— |
$246.16 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$242.40 |
— |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
— |
$213.74 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$467.69 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$683.66 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,199 |
— |
| Radiologic exam upr gi trc single contrast study (74240) |
— |
$473.84 |
— |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
— |
$304.70 |
— |
| Radiological examination surgical specimen (76098) |
— |
$657.50 |
— |
| Review by radiologist of adrenal gland vein image (75840) |
— |
$1,020.67 |
— |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
— |
$1,051.86 |
— |
| Ribs bilateral 3 views (71110) |
— |
$234.05 |
— |
| Rp loclzj tum plnr whole body single day imaging (78802) |
— |
$1,232.14 |
— |
| Rp loclzj tum spect 1 area single day imaging (78803) |
— |
$725.73 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$797.02 |
— |
| Scanogram (77073) |
— |
$226.39 |
— |
| Scapula complete (73010) |
— |
$1,027.50 |
— |
| Screening digital breast tomosynthesis (77063) |
— |
$240 |
— |
| Sialogram (70390) |
— |
$476.08 |
— |
| Simulation intermediate (77285) |
— |
$662.83 |
— |
| Small bowel series (74250) |
— |
$478.58 |
— |
| Spec medical radj physics consltj (77370) |
— |
$477.98 |
— |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
— |
$1,120.96 |
— |
| Special dosimetry (77331) |
— |
$444.09 |
— |
| Special treatment procedure (77470) |
— |
$2,413.95 |
— |
| Spine thoracic 3 views (72072) |
— |
$938 |
— |
| Stereotactic body radiation delivery (77373) |
— |
$12,755.47 |
— |
| Superior sagittal sinus venogram (75870) |
— |
$991.90 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$418.40 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$429.94 |
— |
| Temporomandble Jt Arthrography Rs&I (70332) |
— |
$421.11 |
— |
| Ther rad simulaj-aided field setting complex (77290) |
— |
$1,217.75 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$462.56 |
— |
| Thoracolumbar 2 views (72080) |
— |
$297.11 |
— |
| Thyroid carcinoma metastases img whole body (78018) |
— |
$962.97 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,652 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$2,390 |
— |
| Tmj unilateral (70328) |
— |
$186.70 |
— |
| Treatment device intermediate (77333) |
— |
$910.95 |
— |
| Treatment devices simple (77332) |
— |
$883.53 |
— |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
— |
$1,381.35 |
— |
| Tx devices design & construction complex (77334) |
— |
$940.43 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$514.20 |
— |
| Unlisted Diagnostic Radiographic Procedure (76499) |
— |
$110.28 |
— |
| Unlisted fluoroscopic procedure (76496) |
— |
$559 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$2,164.59 |
— |
| Unlisted Ultrasound Procedure (76999) |
— |
$321.38 |
— |
| Upper Extremity Infant (73092) |
— |
$306.98 |
— |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
— |
$759.63 |
— |
| Urethrocystography retrograde rs&i (74450) |
— |
$1,466 |
— |
| Urethrocystography voiding (74455) |
— |
$1,412 |
— |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
— |
$938.51 |
— |
| Us abdl aorta screen aaa (76706) |
— |
$395.87 |
— |
| Us breast unilateral complete (76641) |
— |
$1,094 |
— |
| Us breast unilateral limited (76642) |
— |
$969 |
— |
| Us chest (76604) |
— |
$330.73 |
— |
| Us compl joint r-t w/image documentation (76881) |
— |
$627.98 |
— |
| Us guided compression repair (76936) |
— |
$995.75 |
— |
| Us infant hips dynamic (76885) |
— |
$1,531 |
— |
| Us kidney transplant (76776) |
— |
$530.10 |
— |
| Us ob transvaginal (76817) |
— |
$1,672 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,711 |
— |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
— |
$318.92 |
— |
| Us pregnancy ltd (76815) |
— |
$339.67 |
— |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
— |
$865 |
— |
| Us retroperitoneal complete (76770) |
— |
$513.27 |
— |
| Us retroperitoneal limited (76775) |
— |
$440.58 |
— |
| Us scrotum and contents (76870) |
— |
$516.82 |
— |
| Us soft tissue head/neck (76536) |
— |
$495.30 |
— |
| Us spinal canal and contents (76800) |
— |
$528.59 |
— |
| Us transrectal (76872) |
— |
$1,954 |
— |
| Us xtr non-vasc lmtd (76882) |
— |
$698 |
— |
| Us, eye b-scan (76512) |
— |
$437.08 |
— |
| Venogram extremity bilateral (75822) |
— |
$3,460.30 |
— |
| Venogram orbital (75880) |
— |
$462.97 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$3,038 |
— |
| Venography caval superior serialography rs&i (75827) |
— |
$1,526 |
— |
| Venography epidural rs&i (75872) |
— |
$991.90 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$3,348.25 |
— |
| Venography renal unilateral selective rs&i (75831) |
— |
$1,211.38 |
— |
| Venography venous sinus/jugular cath rs&i (75860) |
— |
$1,074.65 |
— |
| Venous sampling thru cath w/wo angiography rs& (75893) |
— |
$1,033.87 |
— |
| Wrist 2 views (73100) |
— |
$1,205 |
— |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
— |
$407.39 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$225.55 |
— |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
— |
$304.74 |
— |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
— |
$802.63 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$855 |
— |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
— |
$1,120 |
— |
| X-ray exam entire spi 4/5 vw (72083) |
— |
$1,032.72 |
— |
| X-ray exam hip uni 1 view (73501) |
— |
$296.54 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$299.32 |
— |
| X-ray exam hip uni 4/> views (73503) |
— |
$506.91 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$485.65 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$999.71 |
— |
| X-ray exam of femur 1 (73551) |
— |
$385.66 |
— |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
— |
$237.75 |
— |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
— |
$962 |
— |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
— |
$301.98 |
— |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
— |
$247.08 |
— |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
— |
$1,141.50 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$225.55 |
— |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
— |
$865 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$226.39 |
— |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
— |
$282.72 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$949 |
— |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
— |
$378.05 |
— |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
— |
$327.30 |
— |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
— |
$242.11 |
— |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
— |
$248.02 |
— |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
— |
$232.56 |
— |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
— |
$234.32 |
— |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
— |
$349.02 |
— |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
— |
$971.17 |
— |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
— |
$297 |
— |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
— |
$1,057 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$395.50 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$225.97 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$235.43 |
— |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
— |
$1,219 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$1,050 |
— |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
— |
$866 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$1,175 |
— |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
— |
$239.80 |
— |
| X-Ray Spine One View - Xr Spine (72020) |
— |
$602 |
— |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
— |
$204.52 |
— |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
— |
$238.30 |
— |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
— |
$681 |
— |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
— |
$1,342 |
— |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
— |
$770 |
— |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
— |
$1,205 |
— |
| Xr c-spine 6 or more views (72052) |
— |
$1,540 |
— |
| Xr chest 4+ views (71048) |
— |
$231.40 |
— |
| Xr finger(s) 2+ views (73140) |
— |
$505 |
— |
| Xr shoulder 1 view (73020) |
— |
$302.02 |
— |
| Xr spine cervical 4 or 5 views (72050) |
— |
$1,364 |
— |
| Xr tibia/fibula 2 views (73590) |
— |
$1,270 |
— |
| Xr tmj bilateral (70330) |
— |
$942 |
— |
| Xray knee 1 or 2 views rt (73560) |
— |
$293.22 |
— |