| Abdomen 2 views (74019) |
$152 |
$475 |
1.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$501.76 |
$1,568 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$3,414.40 |
$10,670 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,414.40 |
$10,670 |
1.2× |
| Angiography internal mammary rs&i (75756) |
$484.48 |
$1,514 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,414.40 |
$10,670 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,414.40 |
$10,670 |
1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,414.40 |
$10,670 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$255.36 |
$798 |
0.1× |
| Ankle 2 views (73600) |
$63.84 |
$199.50 |
0.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$441.60 |
$1,380 |
1.3× |
| Aortogram thoracic (75605) |
$3,414.40 |
$10,670 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,414.40 |
$10,670 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,414.40 |
$10,670 |
1.2× |
| Arthrogram elbow (73085) |
$145.28 |
$454 |
0.4× |
| Arthrogram hip (73525) |
$149.44 |
$467 |
0.5× |
| Arthrogram shoulder (73040) |
$240.48 |
$751.50 |
0.7× |
| Arthrogram wrist (73115) |
$165.76 |
$518 |
0.5× |
| Arthrography knee lt (73580) |
$293.28 |
$916.50 |
0.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$273.60 |
$855 |
0.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$309.44 |
$967 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$403.20 |
$1,260 |
1.1× |
| Bone age studies (77072) |
$38.72 |
$121 |
0.4× |
| Bone Imaging 3 Phase (78315) |
$535.04 |
$1,672 |
1.4× |
| Bone survey complete (77075) |
$152 |
$475 |
1.5× |
| Brain image w/flow 4 + views (78606) |
$456 |
$1,425 |
0.9× |
| Brain imaging < 4 static views w vascular flow (78601) |
$333.76 |
$1,043 |
0.9× |
| Brain Imaging Vascular Flow Only (78610) |
$269.44 |
$842 |
0.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$478.08 |
$1,494 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$78.72 |
$246 |
1.0× |
| Chest 1 view (71045) |
$79.68 |
$249 |
1.0× |
| Chest 3 views (71047) |
$79.68 |
$249 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$136.32 |
$426 |
0.8× |
| Clavicle complete (73000) |
$64.32 |
$201 |
0.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$105.28 |
$329 |
1.1× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$144.32 |
$451 |
0.9× |
| Corpora cavernosography (74445) |
$155.84 |
$487 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$635.20 |
$1,985 |
1.9× |
| CT abdomen and pelvis without contrast (74176) |
$318.72 |
$996 |
1.4× |
| CT abdomen w contrast (74160) |
$495.04 |
$1,547 |
3.0× |
| CT abdomen w wo contrast (74170) |
$597.12 |
$1,866 |
3.6× |
| CT abdomen w/o contrast (74150) |
$366.40 |
$1,145 |
3.7× |
| CT angio hrt w/3d image (75574) |
$549.12 |
$1,716 |
1.7× |
| CT angiography upper extremity lt (73206) |
$632.64 |
$1,977 |
3.8× |
| CT c-spine w/o contrast (72125) |
$361.92 |
$1,131 |
3.7× |
| CT cervical spine w&w/o contrast (72127) |
$558.08 |
$1,744 |
3.4× |
| CT cervical spine with contrast (72126) |
$459.84 |
$1,437 |
1.4× |
| CT chest w/wo contrast (71270) |
$384.64 |
$1,202 |
2.3× |
| CT chest with contrast (71260) |
$341.44 |
$1,067 |
2.1× |
| CT head/brain with contrast (70460) |
$341.44 |
$1,067 |
2.1× |
| CT head/brain without and with contrast (70470) |
$384.64 |
$1,202 |
2.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$109.12 |
$341 |
1.3× |
| CT iac w contrast (70481) |
$341.44 |
$1,067 |
2.1× |
| CT lower ext w/o (73700) |
$542.88 |
$1,696.50 |
5.5× |
| CT lower extremity w wo contrast (73702) |
$856.80 |
$2,677.50 |
5.2× |
| CT lower extremity with contrast (73701) |
$672 |
$2,100 |
4.1× |
| CT lumbar spine w & w/o contrast (72133) |
$558.08 |
$1,744 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$361.92 |
$1,131 |
3.7× |
| CT lumbar spine with contrast (72132) |
$459.84 |
$1,437 |
1.4× |
| CT maxillofacial w contrast (70487) |
$341.44 |
$1,067 |
2.1× |
| CT maxillofacial w/o contrast (70486) |
$173.44 |
$542 |
1.8× |
| CT maxillofacial w/wo contrast (70488) |
$384.64 |
$1,202 |
2.3× |
| CT neck soft tissue w contrast (70491) |
$341.44 |
$1,067 |
2.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$384.64 |
$1,202 |
2.3× |
| CT orbits w/o contrast (70480) |
$173.44 |
$542 |
1.8× |
| CT pelvis w & w/o contrast (72194) |
$559.36 |
$1,748 |
3.4× |
| CT pelvis w/o contrast (72192) |
$361.28 |
$1,129 |
3.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$384.64 |
$1,202 |
2.3× |
| CT soft tissue neck w/o contrast (70490) |
$173.44 |
$542 |
1.8× |
| CT thoracic spine w/contrast (72129) |
$461.12 |
$1,441 |
2.8× |
| CT thoracic spine w/o contrast (72128) |
$361.92 |
$1,131 |
3.7× |
| CT thoracic spine w/wo contrast (72130) |
$558.40 |
$1,745 |
3.4× |
| CT thorax w/o contrast (71250) |
$173.44 |
$542 |
1.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$852.48 |
$2,664 |
5.2× |
| CT upper extremity w/o contrast rt (73200) |
$664.80 |
$2,077.50 |
6.8× |
| CT upper extremity with contrast (73201) |
$665.76 |
$2,080.50 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$676.80 |
$2,115 |
4.1× |
| Cta Abdomen (74175) |
$640.96 |
$2,003 |
3.9× |
| CTA abdomen pelvis (74174) |
$822.40 |
$2,570 |
2.5× |
| CTA chest (71275) |
$400.32 |
$1,251 |
2.4× |
| Cta Head (70496) |
$400.32 |
$1,251 |
2.4× |
| CTA lwr ext w&w/o contrast (73706) |
$960 |
$3,000 |
5.8× |
| Cta Neck (70498) |
$400.32 |
$1,251 |
2.4× |
| Cta Pelvis (72191) |
$633.92 |
$1,981 |
3.9× |
| Cystography minimum 3 views rs&i (74430) |
$90.56 |
$283 |
0.3× |
| Diskogram cervical (72285) |
$1,028.48 |
$3,214 |
0.6× |
| Diskography lumbar (72295) |
$1,028.48 |
$3,214 |
0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$143.36 |
$448 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$143.68 |
$449 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$79.36 |
$248 |
1.0× |
| Dxa bone density study axial skeleton (77085) |
$136.96 |
$428 |
1.4× |
| Echoencephalography real time imaging (76506) |
$146.56 |
$458 |
1.5× |
| Esophagus (74220) |
$134.08 |
$419 |
0.8× |
| Fluoroscopy up to 1 hr (76000) |
$115.52 |
$361 |
0.5× |
| Foot 2 views (73620) |
$61.44 |
$192 |
0.8× |
| Forearm 2 views (73090) |
$63.36 |
$198 |
0.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$564.80 |
$1,765 |
1.1× |
| Gated Heart Planar Single (78472) |
$352.32 |
$1,101 |
0.9× |
| Hand 2 views (73120) |
$61.92 |
$193.50 |
0.6× |
| Hand 3 views (73130) |
$71.52 |
$223.50 |
0.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,414.40 |
$10,670 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$498.88 |
$1,559 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$498.88 |
$1,559 |
1.3× |
| Ht muscle image spect sing (78451) |
$683.84 |
$2,137 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$43.84 |
$137 |
0.5× |
| Hysterosalpingogram (74740) |
$117.76 |
$368 |
0.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$146.56 |
$458 |
1.5× |
| Kidney imaging morphology (78700) |
$252.80 |
$790 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$387.52 |
$1,211 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$251.20 |
$785 |
0.5× |
| Knee 3 views (73562) |
$82.56 |
$258 |
1.0× |
| Liver & spleen imaging static only (78215) |
$298.24 |
$932 |
0.8× |
| Lung perfusion differential (78597) |
$279.36 |
$873 |
0.7× |
| Lymphoscintigraphy (78195) |
$539.84 |
$1,687 |
1.1× |
| Meckels Diverticulum (78290) |
$477.76 |
$1,493 |
1.3× |
| Mr elastography (76391) |
$295.36 |
$923 |
1.3× |
| MRA head w & w/o contrast (70546) |
$1,115.84 |
$3,487 |
3.4× |
| MRA head w/o contrast (70544) |
$404.16 |
$1,263 |
1.8× |
| MRA head with contrast (70545) |
$734.08 |
$2,294 |
2.2× |
| MRA neck w contrast (70548) |
$1,095.04 |
$3,422 |
3.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$675.84 |
$2,112 |
2.1× |
| MRA neck w/o contrast (70547) |
$404.16 |
$1,263 |
1.8× |
| MRI abdomen w contrast (74182) |
$471.36 |
$1,473 |
1.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$675.84 |
$2,112 |
2.1× |
| MRI abdomen w/o contrast (74181) |
$613.76 |
$1,918 |
2.7× |
| MRI any jnt lwr ext with con lt (73722) |
$845.76 |
$2,643 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$877.44 |
$2,742 |
1.2× |
| MRI breast w/o contrast bilateral (77047) |
$247.68 |
$774 |
1.1× |
| MRI breast w/o contrast unilat (77046) |
$203.20 |
$635 |
0.9× |
| MRI c-spine with contrast (72142) |
$1,095.04 |
$3,422 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$404.16 |
$1,263 |
1.8× |
| MRI chest w/o & w/contrast material (71552) |
$471.36 |
$1,473 |
1.4× |
| MRI chest w/o contrast (71550) |
$404.16 |
$1,263 |
1.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$773.76 |
$2,418 |
2.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,642.56 |
$5,133 |
5.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$606.24 |
$1,894.50 |
2.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$404.16 |
$1,263 |
1.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$675.84 |
$2,112 |
2.1× |
| MRI orbit/face/neck w/contrast (70542) |
$584.96 |
$1,828 |
1.8× |
| MRI pelvis w contrast (72196) |
$418.88 |
$1,309 |
1.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$954.24 |
$2,982 |
2.9× |
| MRI pelvis w/o contrast (72195) |
$404.16 |
$1,263 |
1.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,419.36 |
$4,435.50 |
4.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,419.36 |
$4,435.50 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$977.92 |
$3,056 |
3.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$563.52 |
$1,761 |
1.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$675.84 |
$2,112 |
2.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,095.04 |
$3,422 |
3.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$977.92 |
$3,056 |
3.0× |
| MRI thoracic spine w/o contrast (72146) |
$624.64 |
$1,952 |
2.8× |
| MRI upper ext joint w/o contrast (73221) |
$608.32 |
$1,901 |
2.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$675.84 |
$2,112 |
2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$606.24 |
$1,894.50 |
2.7× |
| Myelogram Cervical (72240) |
$214.72 |
$671 |
0.3× |
| Myelogram Lumbar (72265) |
$838.72 |
$2,621 |
1.1× |
| Myelogram thoracic (72255) |
$838.72 |
$2,621 |
1.1× |
| Myelography 2 or more regions (72270) |
$318.40 |
$995 |
0.4× |
| Myocardial Spect Multiple Studies (78452) |
$711.36 |
$2,223 |
0.6× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,847.04 |
$5,772 |
1.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,847.04 |
$5,772 |
1.4× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,880.64 |
$9,002 |
1.4× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$3,520.64 |
$11,002 |
1.7× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$3,520.64 |
$11,002 |
2.5× |
| Neck soft tissue (70360) |
$78.72 |
$246 |
1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$452.48 |
$1,414 |
1.2× |
| Nm cisternogram (78630) |
$519.36 |
$1,623 |
1.0× |
| Nm gastric emptying study (78264) |
$410.24 |
$1,282 |
1.1× |
| Nm gastroesophageal reflux study (78262) |
$346.56 |
$1,083 |
0.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$307.20 |
$960 |
0.8× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$425.92 |
$1,331 |
1.1× |
| Nuclear Rx Oral Admin (79005) |
$249.28 |
$779 |
1.1× |
| Osseous survey limited (77074) |
$104 |
$325 |
1.1× |
| Parathyrd planar w/wo subtrj (78071) |
$482.88 |
$1,509 |
1.3× |
| Parathyroid imaging (78070) |
$280.32 |
$876 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$42.24 |
$132 |
0.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$675.84 |
$2,112 |
2.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,414.40 |
$10,670 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$466.56 |
$1,458 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$318.72 |
$996 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$455.36 |
$1,423 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$441.60 |
$1,380 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$77.76 |
$243 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$128.96 |
$403 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$128.96 |
$403 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$83.52 |
$261 |
0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$245.76 |
$768 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$124.80 |
$390 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$79.68 |
$249 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$152 |
$475 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$79.68 |
$249 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$179.84 |
$562 |
1.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$233.28 |
$729 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$178.88 |
$559 |
1.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$144.32 |
$451 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$116.64 |
$364.50 |
1.4× |
| Radiological examination surgical specimen (76098) |
$441.60 |
$1,380 |
0.9× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,547.20 |
$11,085 |
1.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,414.40 |
$10,670 |
1.2× |
| Ribs bilateral 3 views (71110) |
$124.80 |
$390 |
1.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$549.12 |
$1,716 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$46.72 |
$146 |
0.5× |
| Scanogram (77073) |
$61.44 |
$192 |
0.6× |
| Scapula complete (73010) |
$68.64 |
$214.50 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$16 |
$50 |
0.7× |
| Sella turcica (70240) |
$44.48 |
$139 |
0.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$145.28 |
$454 |
1.5× |
| Small bowel series (74250) |
$164.16 |
$513 |
1.0× |
| Spine thoracic 3 views (72072) |
$124.80 |
$390 |
1.3× |
| Superior sagittal sinus venogram (75870) |
$441.28 |
$1,379 |
0.1× |
| Tbs Technical Calculation Only (77091) |
$52.48 |
$164 |
0.6× |
| Testicular Imaging With Vascular Flow (78761) |
$331.84 |
$1,037 |
0.9× |
| Thoracolumbar 2 views (72080) |
$79.36 |
$248 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$508.80 |
$1,590 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$245.76 |
$768 |
0.7× |
| Thyroid uptake measurement (78012) |
$497.60 |
$1,555 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$288.64 |
$902 |
0.8× |
| Tmj unilateral (70328) |
$79.68 |
$249 |
1.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$482.56 |
$1,508 |
1.3× |
| Ultrasound elastography first target lesion (76982) |
$144.32 |
$451 |
1.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$258.24 |
$807 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$126.40 |
$395 |
1.3× |
| Upper Extremity Infant (73092) |
$68.16 |
$213 |
0.7× |
| Urethrocystography retrograde rs&i (74450) |
$111.36 |
$348 |
0.5× |
| Urethrocystography voiding (74455) |
$148.48 |
$464 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$166.40 |
$520 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$144.32 |
$451 |
1.5× |
| Us breast unilateral complete (76641) |
$204.96 |
$640.50 |
2.1× |
| Us breast unilateral limited (76642) |
$181.92 |
$568.50 |
2.2× |
| Us chest (76604) |
$136.64 |
$427 |
1.4× |
| Us compl joint r-t w/image documentation (76881) |
$176 |
$550 |
1.8× |
| Us elastography parenchyma (76981) |
$144.32 |
$451 |
1.5× |
| Us infant hips dynamic (76885) |
$117.76 |
$368 |
1.4× |
| Us infant hips limited static (76886) |
$79.36 |
$248 |
1.0× |
| Us kidney transplant (76776) |
$337.28 |
$1,054 |
3.4× |
| Us ob transvaginal (76817) |
$127.68 |
$399 |
1.3× |
| Us pelvic non ob complete (76856) |
$147.52 |
$461 |
1.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$138.88 |
$434 |
1.4× |
| Us pregnancy ltd (76815) |
$196.48 |
$614 |
2.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$143.68 |
$449 |
1.5× |
| Us retroperitoneal complete (76770) |
$160.64 |
$502 |
1.6× |
| Us retroperitoneal limited (76775) |
$140.16 |
$438 |
1.4× |
| Us scrotum and contents (76870) |
$149.44 |
$467 |
1.5× |
| Us soft tissue head/neck (76536) |
$180.16 |
$563 |
1.8× |
| Us transrectal (76872) |
$353.28 |
$1,104 |
3.6× |
| Us xtr non-vasc lmtd (76882) |
$44.48 |
$139 |
0.5× |
| Venogram extremity bilateral (75822) |
$251.20 |
$785 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$3,414.40 |
$10,670 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$1,115.36 |
$3,485.50 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$213.76 |
$668 |
0.1× |
| Venography Renal Bilateral (75833) |
$3,414.40 |
$10,670 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$3,414.40 |
$10,670 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,414.40 |
$10,670 |
1.2× |
| Vertebral fracture assessment via dxa (77086) |
$41.28 |
$129 |
0.5× |
| Wrist 2 views (73100) |
$68.64 |
$214.50 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$71.68 |
$224 |
0.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$57.28 |
$179 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$72.96 |
$228 |
0.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$282.24 |
$882 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$63.84 |
$199.50 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$76.80 |
$240 |
0.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$245.76 |
$768 |
2.5× |
| X-ray exam hip uni 1 view (73501) |
$77.76 |
$243 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$77.76 |
$243 |
1.0× |
| X-ray exam hip uni 4/> views (73503) |
$128.96 |
$403 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$128.96 |
$403 |
1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$245.76 |
$768 |
2.5× |
| X-ray exam of femur 1 (73551) |
$77.76 |
$243 |
1.0× |
| X-ray eye for foreign body (70030) |
$118.08 |
$369 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$124.80 |
$390 |
1.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$78.72 |
$246 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$71.04 |
$222 |
0.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$63.36 |
$198 |
0.8× |
| X-ray IV pyelogram+drip infusn (74410) |
$171.52 |
$536 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$78.72 |
$246 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$94.56 |
$295.50 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$50.88 |
$159 |
0.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$69.60 |
$217.50 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$78.72 |
$246 |
0.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$124.80 |
$390 |
1.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$124.80 |
$390 |
1.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$78.72 |
$246 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$240.96 |
$753 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$66.24 |
$207 |
0.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$64.32 |
$201 |
0.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$584 |
$1,825 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$78.72 |
$246 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$124.80 |
$390 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$124.80 |
$390 |
1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$52.16 |
$163 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$43.84 |
$137 |
0.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$72.96 |
$228 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$78.72 |
$246 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$78.72 |
$246 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$124.80 |
$390 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$78.72 |
$246 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$35.84 |
$112 |
0.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$78.72 |
$246 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$78.72 |
$246 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$78.72 |
$246 |
0.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$128.64 |
$402 |
1.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$43.84 |
$137 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$82.08 |
$256.50 |
1.0× |
| Xr arthrogram ankle (73615) |
$154.56 |
$483 |
0.5× |
| Xr c-spine 6 or more views (72052) |
$124.80 |
$390 |
1.3× |
| Xr chest 4+ views (71048) |
$152 |
$475 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$47.04 |
$147 |
0.6× |
| Xr internal auditory meati complete (70134) |
$68.80 |
$215 |
0.1× |
| Xr shoulder 1 view (73020) |
$57.60 |
$180 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$124.80 |
$390 |
1.3× |
| Xr tibia/fibula 2 views (73590) |
$61.92 |
$193.50 |
0.8× |
| Xr tmj bilateral (70330) |
$78.72 |
$246 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$69.12 |
$216 |
0.8× |