| Abdomen 2 views (74019) |
$192.82 |
$311 |
1.7× |
| Acute gi blood loss imaging (78278) |
$2,201 |
$3,550 |
5.2× |
| Ankle 2 views (73600) |
$234.67 |
$378.50 |
2.5× |
| Arthrogram ankle (73615) |
$943.64 |
$1,522 |
2.5× |
| Arthrogram elbow (73085) |
$763.84 |
$1,232 |
2.1× |
| Arthrogram hip (73525) |
$946.12 |
$1,526 |
2.5× |
| Arthrogram knee (73580) |
$1,070.12 |
$1,726 |
2.9× |
| Arthrogram shoulder (73040) |
$937.44 |
$1,512 |
2.5× |
| Arthrogram wrist (73115) |
$978.98 |
$1,579 |
2.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,457 |
$2,350 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$1,891 |
$3,050 |
4.4× |
| Bone age studies (77072) |
$173.60 |
$280 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$2,170 |
$3,500 |
5.1× |
| Bone survey complete (77075) |
$458.80 |
$740 |
4.1× |
| Bone survey infant (77076) |
$458.80 |
$740 |
4.1× |
| Bowel imaging (78290) |
$2,170 |
$3,500 |
5.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,871.28 |
$6,244 |
2.5× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,508.46 |
$2,433 |
3.5× |
| Cervical spine 2 or 3 views (72040) |
$186.93 |
$301.50 |
2.0× |
| Chest 1 view (71045) |
$204.60 |
$330 |
2.2× |
| Chest xray 3 views (71047) |
$191.89 |
$309.50 |
2.1× |
| Cholecystography, oral contrast Non-Facility (74290) |
$620 |
$1,000 |
3.3× |
| Clavicle complete (73000) |
$197.47 |
$318.50 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,178 |
$1,900 |
10.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$585.90 |
$945 |
3.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,604 |
$4,200 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,244.40 |
$3,620 |
8.8× |
| CT abdomen w contrast (74160) |
$1,488 |
$2,400 |
7.9× |
| CT abdomen w wo contrast (74170) |
$1,922 |
$3,100 |
10.3× |
| CT abdomen w/o contrast (74150) |
$1,054 |
$1,700 |
9.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,922 |
$3,100 |
10.3× |
| CT angiography upper extremity lt (73206) |
$1,364 |
$2,200 |
7.3× |
| CT c-spine w/contrast (72126) |
$1,519 |
$2,450 |
4.1× |
| CT c-spine w/o contrast (72125) |
$1,426 |
$2,300 |
12.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,612 |
$2,600 |
8.6× |
| CT chest w contrast (71260) |
$1,333 |
$2,150 |
7.1× |
| CT chest w/wo contrast (71270) |
$1,426 |
$2,300 |
7.6× |
| CT head/brain with contrast (70460) |
$1,100.50 |
$1,775 |
5.9× |
| CT head/brain without and with contrast (70470) |
$1,193.50 |
$1,925 |
6.4× |
| CT iac w contrast (70481) |
$1,333 |
$2,150 |
7.1× |
| CT limited/localized follow up study (76380) |
$868 |
$1,400 |
9.3× |
| CT lower ext w/o (73700) |
$1,283.40 |
$2,070 |
11.5× |
| CT lower extremity w wo contrast (73702) |
$1,655.40 |
$2,670 |
8.8× |
| CT lower extremity w/contrast material (73701) |
$1,531.40 |
$2,470 |
8.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,426 |
$2,300 |
7.6× |
| CT lumbar spine w/contrast (72132) |
$1,333 |
$2,150 |
3.6× |
| CT lumbar spine w/o contrast (72131) |
$1,116 |
$1,800 |
10.0× |
| CT maxillofacial w contrast (70487) |
$1,333 |
$2,150 |
7.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,426 |
$2,300 |
7.6× |
| CT maxillofacial wo contrast (70486) |
$1,240 |
$2,000 |
11.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,426 |
$2,300 |
7.6× |
| CT orbits w/o contrast (70480) |
$1,240 |
$2,000 |
11.1× |
| CT pelvis w/o contrast (72192) |
$1,178 |
$1,900 |
10.6× |
| CT pelvis w/wo contrast (72194) |
$1,953 |
$3,150 |
10.4× |
| CT scan of arm combo (73202) |
$1,599.60 |
$2,580 |
8.5× |
| CT soft tissue neck w contrast (70491) |
$1,333 |
$2,150 |
7.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,426 |
$2,300 |
7.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,240 |
$2,000 |
11.1× |
| CT thoracic spine w/contrast (72129) |
$1,333 |
$2,150 |
7.1× |
| CT thoracic spine w/o contrast (72128) |
$1,240 |
$2,000 |
11.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,426 |
$2,300 |
7.6× |
| CT thorax w/o contrast (71250) |
$1,240 |
$2,000 |
11.1× |
| CT upper ext wo (73200) |
$1,041.60 |
$1,680 |
9.3× |
| CT upper extremity with contrast (73201) |
$1,413.60 |
$2,280 |
3.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,418 |
$3,900 |
12.9× |
| Cta Abdomen (74175) |
$1,860 |
$3,000 |
9.9× |
| CTA abdomen pelvis (74174) |
$2,356 |
$3,800 |
6.3× |
| CTA chest (71275) |
$1,760.80 |
$2,840 |
9.4× |
| Cta Head (70496) |
$1,553.72 |
$2,506 |
8.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,768.24 |
$2,852 |
4.7× |
| Cta Neck (70498) |
$1,553.72 |
$2,506 |
8.3× |
| Cta Pelvis (72191) |
$1,581 |
$2,550 |
8.4× |
| Cystography minimum 3 views rs&i (74430) |
$378.20 |
$610 |
1.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$489.18 |
$789 |
4.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$393.70 |
$635 |
3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$167.40 |
$270 |
1.8× |
| Dxa bone density study axial skeleton (77085) |
$399.90 |
$645 |
3.6× |
| Esophagus (74220) |
$433.69 |
$699.50 |
2.3× |
| Facial bones min 3 views (70150) |
$229.09 |
$369.50 |
2.1× |
| Fetal biophysical profile non-stress testing (76818) |
$389.98 |
$629 |
3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$403 |
$650 |
3.6× |
| Fetal Echo (76825) |
$874.20 |
$1,410 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$372 |
$600 |
1.5× |
| Foot 2 views (73620) |
$197.47 |
$318.50 |
2.1× |
| Forearm 2 views (73090) |
$189.41 |
$305.50 |
2.0× |
| Hand 2 views (73120) |
$193.75 |
$312.50 |
1.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,883 |
$4,650 |
5.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,108 |
$3,400 |
4.9× |
| Hysterosalpingogram (74740) |
$682 |
$1,100 |
2.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,364 |
$2,200 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,426 |
$2,300 |
2.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,232 |
$3,600 |
3.8× |
| Knee 3 views (73562) |
$234.67 |
$378.50 |
2.5× |
| Lung perfusion differential (78597) |
$1,240 |
$2,000 |
2.9× |
| Lung ventilation imaging (78579) |
$1,364 |
$2,200 |
3.2× |
| Lymphoscintigraphy (78195) |
$2,170 |
$3,500 |
3.7× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,312.60 |
$3,730 |
2.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,337.40 |
$3,770 |
6.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,957.40 |
$4,770 |
7.9× |
| MRA head w & w/o contrast (70546) |
$2,480 |
$4,000 |
6.7× |
| MRA head w/o contrast (70544) |
$1,147 |
$1,850 |
4.5× |
| MRA head with contrast (70545) |
$2,015 |
$3,250 |
5.4× |
| MRA neck w contrast (70548) |
$2,015 |
$3,250 |
5.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,480 |
$4,000 |
6.7× |
| MRA neck w/o contrast (70547) |
$1,147 |
$1,850 |
4.5× |
| MRI abdomen w contrast (74182) |
$2,325 |
$3,750 |
6.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,604 |
$4,200 |
7.0× |
| MRI abdomen w/o contrast (74181) |
$1,376.40 |
$2,220 |
5.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,356 |
$3,800 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,728 |
$4,400 |
7.3× |
| MRI c-spine with contrast (72142) |
$2,294 |
$3,700 |
6.2× |
| MRI cervical spine w/o contrast (72141) |
$1,376.40 |
$2,220 |
5.4× |
| MRI chest w/o & w/contrast material (71552) |
$3,224 |
$5,200 |
8.7× |
| MRI chest w/o contrast (71550) |
$1,491.10 |
$2,405 |
5.9× |
| MRI chest with contrast (71551) |
$2,821 |
$4,550 |
3.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,356 |
$3,800 |
6.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,728 |
$4,400 |
7.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,422.28 |
$2,294 |
5.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,147 |
$1,850 |
4.5× |
| MRI orbit face neck w contrast (70542) |
$2,015 |
$3,250 |
5.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,480 |
$4,000 |
6.7× |
| MRI pelvis w/contrast (72196) |
$2,015 |
$3,250 |
5.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,170 |
$3,500 |
5.8× |
| MRI pelvis w/o contrast (72195) |
$1,240 |
$2,000 |
4.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,480 |
$4,000 |
6.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,294 |
$3,700 |
6.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,666 |
$4,300 |
7.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,294 |
$3,700 |
6.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,480 |
$4,000 |
6.7× |
| MRI temporomandibular joint (70336) |
$1,743.44 |
$2,812 |
6.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,376.40 |
$2,220 |
5.4× |
| MRI up ext w/o contrast (73218) |
$1,408.64 |
$2,272 |
5.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,390.35 |
$2,242.50 |
5.5× |
| MRI, joint upper extrem combo (73223) |
$2,746.60 |
$4,430 |
7.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,914 |
$4,700 |
2.1× |
| Myocardial spect single study at rest or stress (78451) |
$2,277.88 |
$3,674 |
1.6× |
| Neck soft tissue (70360) |
$148.18 |
$239 |
1.6× |
| Nm gastric emptying study (78264) |
$2,139 |
$3,450 |
5.0× |
| Nm peritoneal-venous shunt patency (78291) |
$1,612 |
$2,600 |
3.8× |
| Nonvascular shunt X-ray (75809) |
$589 |
$950 |
5.3× |
| Ophthalmic biometry by ultrasound echography, A-scan; Non-Facility (76516) |
$157.17 |
$253.50 |
1.4× |
| Osseous survey limited (77074) |
$275.28 |
$444 |
2.5× |
| Parathyroid Planar Imaging (78070) |
$1,860 |
$3,000 |
4.4× |
| Pelvis 1 or 2 views (72170) |
$192.82 |
$311 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$3,871.28 |
$6,244 |
2.5× |
| PET imaging CT for attenuation limited area (78814) |
$3,871.28 |
$6,244 |
2.5× |
| PET imaging for CT attenuation whole body (78816) |
$3,871.28 |
$6,244 |
2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,232 |
$3,600 |
5.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,046 |
$3,300 |
3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$293.88 |
$474 |
0.5× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$245.52 |
$396 |
2.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$205.53 |
$331.50 |
2.2× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$245.52 |
$396 |
2.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$196.54 |
$317 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$360.22 |
$581 |
3.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$401.45 |
$647.50 |
3.6× |
| Radex fingr minimum 2 views (73140) |
$200.57 |
$323.50 |
2.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$224.13 |
$361.50 |
2.4× |
| Radex Hand Minimum 3 Views (73130) |
$256.06 |
$413 |
2.8× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$164.30 |
$265 |
1.8× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$275.28 |
$444 |
2.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$225.37 |
$363.50 |
2.0× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$327.36 |
$528 |
2.9× |
| Radex Humerus Minimum 2 Views (73060) |
$197.47 |
$318.50 |
2.1× |
| Radex Kne 1/2 Views (73560) |
$202.74 |
$327 |
2.2× |
| Radex Kne Compl 4/More Views (73564) |
$272.18 |
$439 |
2.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$209.25 |
$337.50 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$194.06 |
$313 |
2.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$219.48 |
$354 |
2.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$208.01 |
$335.50 |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$157.17 |
$253.50 |
1.7× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$196.54 |
$317 |
1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$274.97 |
$443.50 |
3.0× |
| Radex Toe Minimum 2 Views (73660) |
$137.64 |
$222 |
1.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$197.47 |
$318.50 |
1.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$245.83 |
$396.50 |
2.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$512.74 |
$827 |
4.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$183.52 |
$296 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$261.64 |
$422 |
2.3× |
| Radiologic exam chest 2 views (71046) |
$186.62 |
$301 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$868 |
$1,400 |
4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$651 |
$1,050 |
3.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$837 |
$1,350 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$682 |
$1,100 |
3.6× |
| Radiologic examination femur 1 view (73551) |
$153.76 |
$248 |
1.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$199.64 |
$322 |
2.1× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$303.49 |
$489.50 |
2.7× |
| Radiological examination surgical specimen (76098) |
$229.40 |
$370 |
0.4× |
| Ribs bilateral 3 views (71110) |
$248 |
$400 |
2.2× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,643 |
$2,650 |
3.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,015 |
$3,250 |
3.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,418 |
$3,900 |
4.2× |
| Sacroiliac Joints < 3 Views (72200) |
$174.53 |
$281.50 |
1.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$682 |
$1,100 |
2.7× |
| Scapula (73010) |
$133.30 |
$215 |
1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$186 |
$300 |
8.0× |
| Sella turcica (70240) |
$157.17 |
$253.50 |
1.7× |
| Shoulder 1 view (73020) |
$124 |
$200 |
1.3× |
| Small bowel series (74250) |
$713 |
$1,150 |
3.8× |
| Spine thoracic 3 views (72072) |
$186.93 |
$301.50 |
1.7× |
| Thoracolumbar 2 views (72080) |
$161.51 |
$260.50 |
1.7× |
| Thyroid imaging w/blood flow (78013) |
$1,302 |
$2,100 |
3.1× |
| Ultrasound breast complete (76641) |
$558 |
$900 |
5.0× |
| Ultrasound Exam Aaa Screen (76706) |
$682 |
$1,100 |
6.1× |
| Ultrasound, abdomen limited (76705) |
$496 |
$800 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$283.96 |
$458 |
2.5× |
| Urethrocystogram voiding (74455) |
$725.40 |
$1,170 |
2.8× |
| Urethrocystography retrograde rs&i (74450) |
$1,798 |
$2,900 |
7.1× |
| Us breast unilateral limited (76642) |
$434 |
$700 |
4.7× |
| Us chest (76604) |
$373.86 |
$603 |
3.3× |
| Us encephalogram (76506) |
$899 |
$1,450 |
8.1× |
| Us infant hips w manipulation (76885) |
$651 |
$1,050 |
7.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$329.84 |
$532 |
3.0× |
| Us ob detailed single fetus (76811) |
$961 |
$1,550 |
3.8× |
| Us ob limited (76815) |
$682 |
$1,100 |
6.1× |
| Us ob transvaginal (76817) |
$496 |
$800 |
4.4× |
| Us pelvic non ob complete (76856) |
$620 |
$1,000 |
5.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$312.48 |
$504 |
2.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$589 |
$950 |
5.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$558 |
$900 |
5.0× |
| Us retroperitoneal complete (76770) |
$620 |
$1,000 |
5.6× |
| Us retroperitoneal limited (76775) |
$434 |
$700 |
3.9× |
| Us scrotum and contents (76870) |
$589 |
$950 |
5.3× |
| Us soft tissue head/neck (76536) |
$682 |
$1,100 |
6.1× |
| Us spinal canal and contents (76800) |
$713 |
$1,150 |
6.4× |
| Us transrectal (76872) |
$868 |
$1,400 |
7.8× |
| Us, eye b-scan (76512) |
$164.92 |
$266 |
1.5× |
| Vertebral fracture assessment via dxa (77086) |
$189.72 |
$306 |
2.0× |
| Wrist 2 views (73100) |
$210.80 |
$340 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$252.96 |
$408 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$137.64 |
$222 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,333 |
$2,150 |
7.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$181.35 |
$292.50 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$211.11 |
$340.50 |
2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$294.81 |
$475.50 |
2.6× |
| X-ray exam of femur 2/> (73552) |
$197.47 |
$318.50 |
2.1× |
| X-ray eye for foreign body (70030) |
$155 |
$250 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$146.32 |
$236 |
1.6× |
| X-ray IV pyelogram (ivp) (74400) |
$930 |
$1,500 |
5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$194.06 |
$313 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$204.29 |
$329.50 |
2.2× |
| X-ray leg, infant (73592) |
$232.19 |
$374.50 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$190.03 |
$306.50 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$309.69 |
$499.50 |
2.8× |
| X-ray nose-rectum child f.b. (76010) |
$133.30 |
$215 |
1.4× |
| X-ray optic foramen (70190) |
$178.87 |
$288.50 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$248.93 |
$401.50 |
2.2× |
| X-ray retrograde pyelogram (74420) |
$693.78 |
$1,119 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$170.19 |
$274.50 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$227.23 |
$366.50 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$275.28 |
$444 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$185.38 |
$299 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$169.88 |
$274 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$178.87 |
$288.50 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$205.22 |
$331 |
1.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$176.70 |
$285 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$111.60 |
$180 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$202.74 |
$327 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$159.34 |
$257 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$150.66 |
$243 |
1.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$261.95 |
$422.50 |
2.3× |
| Xr bone length studies (77073) |
$493.52 |
$796 |
4.4× |
| Xr c-spine 4 or 5 views (72050) |
$261.95 |
$422.50 |
2.3× |
| Xr c-spine 6 or more views (72052) |
$312.17 |
$503.50 |
2.8× |
| Xr chest 4+ views (71048) |
$205.22 |
$331 |
1.8× |
| Xr urogram antegrade (74425) |
$930 |
$1,500 |
2.5× |