| Abdomen 2 views (74019) |
$229.77 |
$621 |
2.0× |
| Acute gi blood loss imaging (78278) |
$1,387.13 |
$3,749 |
3.2× |
| Angiography extremity bilateral rs&i (75716) |
$3,789.54 |
$10,242 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$2,819.03 |
$7,619 |
0.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,065.08 |
$8,284 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,266.73 |
$8,829 |
0.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,199.76 |
$8,648 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,347.76 |
$9,048 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,177.08 |
$5,884 |
0.6× |
| Ankle 2 views (73600) |
$210.53 |
$569 |
2.2× |
| Aortogram thoracic (75605) |
$5,150.40 |
$13,920 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,729.71 |
$12,783 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$3,367.37 |
$9,101 |
1.0× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$4,729.71 |
$12,783 |
1.4× |
| Arthrogram hip (73525) |
$851.37 |
$2,301 |
2.2× |
| Arthrogram knee (73580) |
$369.63 |
$999 |
1.0× |
| Arthrogram shoulder (73040) |
$138.38 |
$374 |
0.4× |
| Arthrogram wrist (73115) |
$464.35 |
$1,255 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$1,312.02 |
$3,546 |
3.0× |
| Bone age studies (77072) |
$293.41 |
$793 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,464.46 |
$3,958 |
3.4× |
| Bone survey complete (77075) |
$616.42 |
$1,666 |
5.4× |
| Bone survey infant (77076) |
$448.07 |
$1,211 |
3.9× |
| Bowel imaging (78290) |
$1,067.82 |
$2,886 |
2.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,376.77 |
$3,721 |
2.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,561.62 |
$9,626 |
2.3× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$657.86 |
$1,778 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$213.12 |
$576 |
2.2× |
| Chest 1 view (71045) |
$117.66 |
$318 |
1.2× |
| Chest xray 3 views (71047) |
$186.85 |
$505 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$324.49 |
$877 |
1.7× |
| Cineradiography/videoradiography (76120) |
$321.53 |
$869 |
2.8× |
| Clavicle complete (73000) |
$184.26 |
$498 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$522.44 |
$1,412 |
4.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,789.32 |
$4,836 |
4.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,192.51 |
$3,223 |
4.6× |
| CT abdomen w contrast (74160) |
$801.79 |
$2,167 |
4.2× |
| CT abdomen w wo contrast (74170) |
$962 |
$2,600 |
5.0× |
| CT abdomen w/o contrast (74150) |
$708.18 |
$1,914 |
6.2× |
| CT angio hrt w/3d image (75574) |
$997.89 |
$2,697 |
2.6× |
| CT angio lwr extr w/o&w/dye (73706) |
$704.48 |
$1,904 |
3.7× |
| CT angiography upper extremity lt (73206) |
$716.69 |
$1,937 |
3.7× |
| CT c-spine w/contrast (72126) |
$788.10 |
$2,130 |
2.1× |
| CT c-spine w/o contrast (72125) |
$644.54 |
$1,742 |
5.6× |
| CT chest w contrast (71260) |
$775.15 |
$2,095 |
4.0× |
| CT chest w/wo contrast (71270) |
$799.20 |
$2,160 |
4.2× |
| CT colonography screening (74263) |
$1,079.29 |
$2,917 |
4.1× |
| CT colonography w/dye (74262) |
$770.71 |
$2,083 |
4.0× |
| CT colonography w/o cntrst (74261) |
$462.50 |
$1,250 |
4.0× |
| CT head/brain with contrast (70460) |
$708.18 |
$1,914 |
3.7× |
| CT head/brain without and with contrast (70470) |
$765.53 |
$2,069 |
4.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$737.78 |
$1,994 |
1.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$144.67 |
$391 |
1.5× |
| CT hrt w/3d image congen (75573) |
$737.78 |
$1,994 |
1.9× |
| CT iac w contrast (70481) |
$650.46 |
$1,758 |
3.4× |
| CT limited/localized follow up study (76380) |
$293.78 |
$794 |
3.1× |
| CT lower ext w/o (73700) |
$612.35 |
$1,655 |
5.4× |
| CT lower extremity w wo contrast (73702) |
$894.29 |
$2,417 |
4.7× |
| CT lower extremity w/contrast material (73701) |
$711.14 |
$1,922 |
3.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,074.48 |
$2,904 |
5.6× |
| CT lumbar spine w/contrast (72132) |
$798.83 |
$2,159 |
2.1× |
| CT lumbar spine w/o contrast (72131) |
$653.42 |
$1,766 |
5.7× |
| CT maxillofacial w contrast (70487) |
$555 |
$1,500 |
2.9× |
| CT maxillofacial w/wo contrast (70488) |
$656.38 |
$1,774 |
3.4× |
| CT maxillofacial wo contrast (70486) |
$508.01 |
$1,373 |
4.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$854.33 |
$2,309 |
4.5× |
| CT orbits w/o contrast (70480) |
$362.23 |
$979 |
3.2× |
| CT pelvis w/o contrast (72192) |
$729.27 |
$1,971 |
6.4× |
| CT pelvis w/wo contrast (72194) |
$1,423.39 |
$3,847 |
7.4× |
| CT scan of arm combo (73202) |
$899.47 |
$2,431 |
4.7× |
| CT soft tissue neck w contrast (70491) |
$634.18 |
$1,714 |
3.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$795.87 |
$2,151 |
4.2× |
| CT soft tissue neck w/o contrast (70490) |
$510.97 |
$1,381 |
4.5× |
| CT thoracic spine w/contrast (72129) |
$798.83 |
$2,159 |
4.2× |
| CT thoracic spine w/o contrast (72128) |
$653.42 |
$1,766 |
5.7× |
| CT thorax w/o contrast (71250) |
$321.34 |
$868.50 |
2.8× |
| CT upper ext wo (73200) |
$747.77 |
$2,021 |
6.5× |
| CT upper extremity with contrast (73201) |
$817.33 |
$2,209 |
2.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$992.71 |
$2,683 |
5.2× |
| Cta Abdomen (74175) |
$923.15 |
$2,495 |
4.8× |
| CTA abdomen pelvis (74174) |
$1,196.95 |
$3,235 |
3.1× |
| CTA chest (71275) |
$735.56 |
$1,988 |
3.8× |
| Cta Head (70496) |
$703.74 |
$1,902 |
3.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,652.79 |
$4,467 |
4.3× |
| Cta Neck (70498) |
$949.05 |
$2,565 |
5.0× |
| Cystography minimum 3 views rs&i (74430) |
$166.50 |
$450 |
0.4× |
| Diskography lumbar (72295) |
$391.09 |
$1,057 |
0.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$300.44 |
$812 |
2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$255.30 |
$690 |
2.7× |
| Dxa bone density study axial skeleton (77085) |
$328.93 |
$889 |
2.9× |
| Esophagus (74220) |
$406.63 |
$1,099 |
2.1× |
| Facial bones min 3 views (70150) |
$261.22 |
$706 |
2.3× |
| Fetal biophysical profile non-stress testing (76818) |
$640.84 |
$1,732 |
5.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$606.06 |
$1,638 |
5.3× |
| Fluoroscopy up to 1 hr (76000) |
$421.80 |
$1,140 |
1.6× |
| Foot 2 views (73620) |
$156.14 |
$422 |
1.6× |
| Forearm 2 views (73090) |
$191.66 |
$518 |
2.0× |
| Hand 2 views (73120) |
$361.86 |
$978 |
3.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,839.60 |
$13,080 |
1.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,622.08 |
$4,384 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,282.05 |
$3,465 |
2.9× |
| Hysterosalpingogram (74740) |
$383.69 |
$1,037 |
1.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$264.55 |
$715 |
2.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,134.79 |
$3,067 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,396.38 |
$3,774 |
2.4× |
| Knee 3 views (73562) |
$211.27 |
$571 |
2.2× |
| Liver & spleen imaging static only (78215) |
$999 |
$2,700 |
2.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$999 |
$2,700 |
2.3× |
| Lung perf&ventilat diferentl (78598) |
$1,286.86 |
$3,478 |
2.2× |
| Lung perfusion differential (78597) |
$1,556.22 |
$4,206 |
3.6× |
| Lymphoscintigraphy (78195) |
$1,137.38 |
$3,074 |
1.9× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,179.19 |
$3,187 |
1.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,644.28 |
$4,444 |
4.3× |
| Magnetic Resonance Elastography (76391) |
$594.22 |
$1,606 |
2.3× |
| MRA head w & w/o contrast (70546) |
$1,373.07 |
$3,711 |
3.6× |
| MRA head w/o contrast (70544) |
$727.05 |
$1,965 |
2.8× |
| MRA head with contrast (70545) |
$853.96 |
$2,308 |
2.2× |
| MRA neck w contrast (70548) |
$742.96 |
$2,008 |
1.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,373.07 |
$3,711 |
3.6× |
| MRA neck w/o contrast (70547) |
$727.05 |
$1,965 |
2.8× |
| MRI abdomen w contrast (74182) |
$1,156.25 |
$3,125 |
3.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,648.72 |
$4,456 |
4.3× |
| MRI abdomen w/o contrast (74181) |
$1,149.59 |
$3,107 |
4.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,549.93 |
$4,189 |
1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,704.96 |
$4,608 |
4.5× |
| MRI breast w/o contrast bilateral (77047) |
$408.11 |
$1,103 |
1.6× |
| MRI c-spine with contrast (72142) |
$940.17 |
$2,541 |
2.5× |
| MRI cervical spine w/o contrast (72141) |
$598.66 |
$1,618 |
2.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,171.53 |
$5,869 |
5.7× |
| MRI chest w/o contrast (71550) |
$830.65 |
$2,245 |
3.2× |
| MRI chest with contrast (71551) |
$1,045.62 |
$2,826 |
1.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,407.48 |
$3,804 |
3.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,654.64 |
$4,472 |
4.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,151.44 |
$3,112 |
4.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$727.05 |
$1,965 |
2.8× |
| MRI orbit face neck w contrast (70542) |
$830.28 |
$2,244 |
2.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,005.29 |
$2,717 |
2.6× |
| MRI pelvis w/contrast (72196) |
$1,405.63 |
$3,799 |
3.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,644.28 |
$4,444 |
4.3× |
| MRI pelvis w/o contrast (72195) |
$1,149.96 |
$3,108 |
4.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,058.20 |
$2,860 |
2.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,524.77 |
$4,121 |
4.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,677.21 |
$4,533 |
4.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,198.43 |
$3,239 |
3.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,367.15 |
$3,695 |
3.6× |
| MRI temporomandibular joint (70336) |
$936.84 |
$2,532 |
3.6× |
| MRI thoracic spine w/o contrast (72146) |
$772.93 |
$2,089 |
3.0× |
| MRI up ext w/o contrast (73218) |
$938.32 |
$2,536 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$867.65 |
$2,345 |
3.3× |
| MRI, joint upper extrem combo (73223) |
$1,517.74 |
$4,102 |
4.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,207.79 |
$5,967 |
1.6× |
| Myocardial spect single study at rest or stress (78451) |
$1,633.55 |
$4,415 |
1.2× |
| Neck soft tissue (70360) |
$187.22 |
$506 |
2.0× |
| Nm gastric emptying study (78264) |
$1,366.41 |
$3,693 |
3.1× |
| Nuclear Rx Oral Admin (79005) |
$697.82 |
$1,886 |
2.7× |
| Parathyroid Planar Imaging (78070) |
$1,393.79 |
$3,767 |
3.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,393.79 |
$3,767 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$171.68 |
$464 |
1.5× |
| PET image w/CT, skull-thigh (78815) |
$3,764.38 |
$10,174 |
2.4× |
| PET imaging for CT attenuation whole body (78816) |
$3,803.23 |
$10,279 |
2.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,057.20 |
$5,560 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,312.02 |
$3,546 |
3.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,267.99 |
$3,427 |
2.1× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$997.89 |
$2,697 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$418.84 |
$1,132 |
0.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$239.76 |
$648 |
2.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$197.95 |
$535 |
2.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$178.71 |
$483 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$186.85 |
$505 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$320.42 |
$866 |
2.8× |
| Radex fingr minimum 2 views (73140) |
$194.62 |
$526 |
2.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$207.94 |
$562 |
2.2× |
| Radex Hand Minimum 3 Views (73130) |
$361.86 |
$978 |
3.8× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$194.62 |
$526 |
2.0× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$293.41 |
$793 |
2.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$344.47 |
$931 |
3.0× |
| Radex Humerus Minimum 2 Views (73060) |
$171.68 |
$464 |
1.8× |
| Radex Kne 1/2 Views (73560) |
$189.44 |
$512 |
2.0× |
| Radex Kne Compl 4/More Views (73564) |
$305.62 |
$826 |
2.7× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$284.53 |
$769 |
2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$209.05 |
$565 |
2.2× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$215.34 |
$582 |
1.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$233.84 |
$632 |
2.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$133.20 |
$360 |
1.4× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$320.42 |
$866 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$297.48 |
$804 |
3.1× |
| Radex Toe Minimum 2 Views (73660) |
$173.53 |
$469 |
1.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$299.70 |
$810 |
2.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$246.42 |
$666 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$223.11 |
$603 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$261.22 |
$706 |
2.3× |
| Radiologic exam chest 2 views (71046) |
$183.15 |
$495 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$468.05 |
$1,265 |
2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$431.42 |
$1,166 |
2.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$535.02 |
$1,446 |
2.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$452.14 |
$1,222 |
2.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$416.25 |
$1,125 |
4.4× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$259 |
$700 |
2.3× |
| Radiological examination surgical specimen (76098) |
$566.47 |
$1,531 |
0.9× |
| Ribs bilateral 3 views (71110) |
$375.18 |
$1,014 |
3.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,325.82 |
$6,286 |
3.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,759.72 |
$4,756 |
3.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,242.20 |
$6,060 |
3.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,398.34 |
$6,482 |
1.7× |
| Sacroiliac Joints < 3 Views (72200) |
$285.64 |
$772 |
2.5× |
| Scapula (73010) |
$200.54 |
$542 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$55.50 |
$150 |
2.4× |
| Shoulder 1 view (73020) |
$189.07 |
$511 |
2.0× |
| Small bowel series (74250) |
$672.29 |
$1,817 |
3.5× |
| Spine thoracic 3 views (72072) |
$277.87 |
$751 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,185.85 |
$3,205 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,013.80 |
$2,740 |
2.3× |
| Tmj unilateral (70328) |
$208.31 |
$563 |
2.2× |
| Ultrasound breast complete (76641) |
$296.74 |
$802 |
2.6× |
| Ultrasound Exam Aaa Screen (76706) |
$727.79 |
$1,967 |
6.4× |
| Ultrasound, abdomen limited (76705) |
$508.01 |
$1,373 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$208.68 |
$564 |
1.8× |
| Unlisted magnetic resonance procedure (76498) |
$3,043.25 |
$8,225 |
32.0× |
| Urethrocystogram voiding (74455) |
$509.12 |
$1,376 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$592.37 |
$1,601 |
2.3× |
| Us breast unilateral limited (76642) |
$296.74 |
$802 |
3.1× |
| Us chest (76604) |
$291.93 |
$789 |
2.6× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$597.55 |
$1,615 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$387.02 |
$1,046 |
3.4× |
| Us elastography parenchyma (76981) |
$489.88 |
$1,324 |
4.3× |
| Us encephalogram (76506) |
$488.77 |
$1,321 |
4.3× |
| Us hips infant static (76886) |
$318.94 |
$862 |
3.4× |
| Us infant hips w manipulation (76885) |
$338.18 |
$914 |
3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$374.44 |
$1,012 |
3.3× |
| Us ob limited (76815) |
$333.37 |
$901 |
2.9× |
| Us ob transvaginal (76817) |
$434.38 |
$1,174 |
3.8× |
| Us pelvic non ob complete (76856) |
$374.44 |
$1,012 |
3.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$374.44 |
$1,012 |
3.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$348.17 |
$941 |
3.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$433.64 |
$1,172 |
3.8× |
| Us retroperitoneal complete (76770) |
$727.79 |
$1,967 |
6.4× |
| Us retroperitoneal limited (76775) |
$485.44 |
$1,312 |
4.3× |
| Us scrotum and contents (76870) |
$374.44 |
$1,012 |
3.3× |
| Us soft tissue head/neck (76536) |
$374.44 |
$1,012 |
3.3× |
| Us spinal canal and contents (76800) |
$323.75 |
$875 |
2.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$410.33 |
$1,109 |
3.6× |
| Venogram extremity bilateral (75822) |
$2,778.33 |
$7,509 |
1.6× |
| Venogram Extremity Unilateral (75820) |
$1,622.45 |
$4,385 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,367.37 |
$9,101 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$2,823.10 |
$7,630 |
1.6× |
| Venography renal unilateral selective rs&i (75831) |
$4,812.59 |
$13,007 |
1.4× |
| Venous sampling by catheter (75893) |
$6,990.04 |
$18,892 |
1.1× |
| Wrist 2 views (73100) |
$246.42 |
$666 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$361.86 |
$978 |
3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$207.94 |
$562 |
2.2× |
| X-ray b.e. reductn intuss (74283) |
$793.28 |
$2,144 |
4.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$743.70 |
$2,010 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$156.14 |
$422 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$250.12 |
$676 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$306.73 |
$829 |
2.7× |
| X-ray exam of femur 2/> (73552) |
$586.82 |
$1,586 |
6.2× |
| X-ray eye for foreign body (70030) |
$148.74 |
$402 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$210.53 |
$569 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$186.11 |
$503 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$211.27 |
$571 |
2.2× |
| X-ray leg, infant (73592) |
$189.81 |
$513 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$277.87 |
$751 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$502.09 |
$1,357 |
4.4× |
| X-ray nose-rectum child f.b. (76010) |
$138.01 |
$373 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$319.68 |
$864 |
2.8× |
| X-ray retrograde pyelogram (74420) |
$909.46 |
$2,458 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$207.57 |
$561 |
2.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$296.74 |
$802 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$409.59 |
$1,107 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$324.49 |
$877 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$205.72 |
$556 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$320.05 |
$865 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$375.18 |
$1,014 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$219.41 |
$593 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$191.66 |
$518 |
2.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$195.73 |
$529 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$224.96 |
$608 |
2.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$218.30 |
$590 |
1.9× |
| Xr bone length studies (77073) |
$293.41 |
$793 |
2.6× |
| Xr c-spine 4 or 5 views (72050) |
$357.42 |
$966 |
3.1× |
| Xr c-spine 6 or more views (72052) |
$389.24 |
$1,052 |
3.4× |
| Xr urogram antegrade (74425) |
$2,620.34 |
$7,082 |
6.9× |