| Acute gastrointestinal blood loss imaging (78278) |
$1,620.45 |
$2,700.75 |
4.6× |
| Ankle 2 views (73600) |
$96 |
$160 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$161.85 |
$269.75 |
0.5× |
| Arthrogram hip (73525) |
$310.50 |
$517.50 |
1.0× |
| Arthrogram shoulder (73040) |
$279.45 |
$465.75 |
0.9× |
| Arthrogram wrist (73115) |
$199.50 |
$332.50 |
0.7× |
| Arthrography knee lt (73580) |
$360 |
$600 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$268.88 |
$448.12 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$723 |
$1,205 |
2.1× |
| Bone age studies (77072) |
$178.72 |
$297.88 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$650.85 |
$1,084.75 |
1.9× |
| Bone survey complete (77075) |
$168 |
$280 |
1.8× |
| Brain image w/flow 4 + views (78606) |
$675.45 |
$1,125.75 |
1.4× |
| Brain imaging < 4 static views (78600) |
$671.85 |
$1,119.75 |
1.9× |
| Brain Imaging Vascular Flow Only (78610) |
$901.80 |
$1,503 |
1.9× |
| Cervical spine 2 or 3 views (72040) |
$96.30 |
$160.50 |
1.3× |
| Chest 1 view (71045) |
$79.80 |
$133 |
1.0× |
| Chest 3 views (71047) |
$68.25 |
$113.75 |
0.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$143.67 |
$239.45 |
0.9× |
| Clavicle complete (73000) |
$95.85 |
$159.75 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$224.40 |
$374 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,019.40 |
$1,699 |
3.3× |
| CT abdomen and pelvis without contrast (74176) |
$865.65 |
$1,442.75 |
4.1× |
| CT abdomen w contrast (74160) |
$568.80 |
$948 |
3.7× |
| CT abdomen w wo contrast (74170) |
$784.95 |
$1,308.25 |
5.1× |
| CT abdomen w/o contrast (74150) |
$549.60 |
$916 |
6.0× |
| CT angiography upper extremity lt (73206) |
$855.15 |
$1,425.25 |
5.6× |
| CT c-spine w/o contrast (72125) |
$840 |
$1,400 |
9.2× |
| CT cervical spine w&w/o contrast (72127) |
$568.88 |
$948.12 |
3.7× |
| CT cervical spine with contrast (72126) |
$470.70 |
$784.50 |
1.5× |
| CT chest w/wo contrast (71270) |
$460.80 |
$768 |
3.0× |
| CT chest with contrast (71260) |
$655.20 |
$1,092 |
4.3× |
| CT head/brain with contrast (70460) |
$855.15 |
$1,425.25 |
5.6× |
| CT head/brain without and with contrast (70470) |
$1,140.15 |
$1,900.25 |
7.4× |
| CT iac w contrast (70481) |
$662.92 |
$1,104.88 |
4.3× |
| CT limited/localized follow up study (76380) |
$568.80 |
$948 |
7.5× |
| CT lower ext w/o (73700) |
$331.80 |
$553 |
3.6× |
| CT lower extremity w wo contrast (73702) |
$1,140.15 |
$1,900.25 |
7.4× |
| CT lower extremity with contrast (73701) |
$431.55 |
$719.25 |
2.8× |
| CT lumbar spine w & w/o contrast (72133) |
$855.15 |
$1,425.25 |
5.6× |
| CT lumbar spine w/o contrast (72131) |
$447.60 |
$746 |
4.9× |
| CT lumbar spine with contrast (72132) |
$708.60 |
$1,181 |
2.3× |
| CT maxillofacial w contrast (70487) |
$482.18 |
$803.62 |
3.1× |
| CT maxillofacial w/o contrast (70486) |
$600 |
$1,000 |
6.5× |
| CT maxillofacial w/wo contrast (70488) |
$303.60 |
$506 |
2.0× |
| CT neck soft tissue w contrast (70491) |
$855.15 |
$1,425.25 |
5.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$392.40 |
$654 |
2.6× |
| CT orbits w/o contrast (70480) |
$497.40 |
$829 |
5.4× |
| CT pelvis w & w/o contrast (72194) |
$660.98 |
$1,101.62 |
4.3× |
| CT pelvis w/o contrast (72192) |
$398.40 |
$664 |
4.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$175.72 |
$292.88 |
2.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$784.95 |
$1,308.25 |
5.1× |
| CT soft tissue neck w/o contrast (70490) |
$399 |
$665 |
4.4× |
| CT thoracic spine w/contrast (72129) |
$662.92 |
$1,104.88 |
4.3× |
| CT thoracic spine w/o contrast (72128) |
$559.20 |
$932 |
6.1× |
| CT thoracic spine w/wo contrast (72130) |
$855.15 |
$1,425.25 |
5.6× |
| CT thorax w/o contrast (71250) |
$398.40 |
$664 |
4.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$863.25 |
$1,438.75 |
5.6× |
| CT upper extremity w/o contrast rt (73200) |
$392.40 |
$654 |
4.3× |
| CT upper extremity with contrast (73201) |
$470.70 |
$784.50 |
1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$397.65 |
$662.75 |
2.6× |
| Cta Abdomen (74175) |
$470.70 |
$784.50 |
3.1× |
| CTA abdomen pelvis (74174) |
$447.60 |
$746 |
1.5× |
| CTA chest (71275) |
$651.38 |
$1,085.62 |
4.2× |
| Cta Head (70496) |
$396.90 |
$661.50 |
2.6× |
| CTA lwr ext w&w/o contrast (73706) |
$855.15 |
$1,425.25 |
5.6× |
| Cta Neck (70498) |
$317.40 |
$529 |
2.1× |
| Cta Pelvis (72191) |
$549.98 |
$916.62 |
3.6× |
| Cystography minimum 3 views rs&i (74430) |
$302.18 |
$503.62 |
1.0× |
| Esophagus (74220) |
$216 |
$360 |
1.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$154.65 |
$257.75 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$274.35 |
$457.25 |
1.3× |
| Foot 2 views (73620) |
$96.30 |
$160.50 |
1.3× |
| Forearm 2 views (73090) |
$96.30 |
$160.50 |
1.3× |
| Gated Heart Planar Single (78472) |
$830.10 |
$1,383.50 |
2.4× |
| Hand 2 views (73120) |
$75.15 |
$125.25 |
0.8× |
| Hand 3 views (73130) |
$88.05 |
$146.75 |
1.2× |
| Heart Infarct Image (78466) |
$292.88 |
$488.12 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$703.65 |
$1,172.75 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$895.95 |
$1,493.25 |
2.6× |
| Ht muscle image spect sing (78451) |
$182.62 |
$304.38 |
0.2× |
| Humerus Min 2 Views Left (73060) |
$114.08 |
$190.12 |
1.5× |
| Hysterosalpingogram (74740) |
$204.38 |
$340.62 |
1.0× |
| Kidney imaging morphology (78700) |
$836.18 |
$1,393.62 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,463.85 |
$2,439.75 |
3.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$473.55 |
$789.25 |
1.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$794.02 |
$1,323.38 |
1.7× |
| Knee 3 views (73562) |
$115.50 |
$192.50 |
1.5× |
| Liver & spleen imaging static only (78215) |
$788.70 |
$1,314.50 |
2.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$866.10 |
$1,443.50 |
2.5× |
| Lung perf&ventilat diferentl (78598) |
$851.40 |
$1,419 |
1.8× |
| Lung perfusion differential (78597) |
$1,418.55 |
$2,364.25 |
4.0× |
| Lung Ventilation Imaging (78579) |
$788.70 |
$1,314.50 |
2.3× |
| Lymphoscintigraphy (78195) |
$514.65 |
$857.75 |
1.1× |
| Meckels Diverticulum (78290) |
$265.88 |
$443.12 |
0.8× |
| MRA head w & w/o contrast (70546) |
$768.60 |
$1,281 |
2.5× |
| MRA head w/o contrast (70544) |
$692.57 |
$1,154.28 |
3.3× |
| MRA neck w contrast (70548) |
$579.52 |
$965.88 |
1.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$479.10 |
$798.50 |
1.6× |
| MRA neck w/o contrast (70547) |
$369.15 |
$615.25 |
1.8× |
| MRI abdomen w contrast (74182) |
$997.65 |
$1,662.75 |
3.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$828.90 |
$1,381.50 |
2.7× |
| MRI abdomen w/o contrast (74181) |
$997.65 |
$1,662.75 |
4.8× |
| MRI any jnt lwr ext with con lt (73722) |
$997.65 |
$1,662.75 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$997.65 |
$1,662.75 |
1.5× |
| MRI bone marrow blood supply (77084) |
$735.22 |
$1,225.38 |
3.5× |
| MRI c-spine with contrast (72142) |
$607.42 |
$1,012.38 |
2.0× |
| MRI cervical spine w/o contrast (72141) |
$438.60 |
$731 |
2.1× |
| MRI chest w/o & w/contrast material (71552) |
$1,282.80 |
$2,138 |
4.2× |
| MRI chest w/o contrast (71550) |
$997.65 |
$1,662.75 |
4.8× |
| MRI chest with contrast (71551) |
$594.82 |
$991.38 |
0.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$997.65 |
$1,662.75 |
3.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$576.90 |
$961.50 |
2.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$997.65 |
$1,662.75 |
4.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,282.80 |
$2,138 |
4.2× |
| MRI orbit/face/neck w/contrast (70542) |
$606.82 |
$1,011.38 |
2.0× |
| MRI pelvis w contrast (72196) |
$594.52 |
$990.88 |
1.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$550.80 |
$918 |
1.8× |
| MRI pelvis w/o contrast (72195) |
$396.45 |
$660.75 |
1.9× |
| MRI scan of arm joint before and after contrast (73223) |
$779.40 |
$1,299 |
2.5× |
| MRI scan of leg joint before and after contrast (73723) |
$708.60 |
$1,181 |
2.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$568.80 |
$948 |
1.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$455.10 |
$758.50 |
1.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$774 |
$1,290 |
2.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$606.82 |
$1,011.38 |
2.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$568.80 |
$948 |
1.9× |
| MRI thoracic spine w/o contrast (72146) |
$515.92 |
$859.88 |
2.5× |
| MRI tmj (70336) |
$787.28 |
$1,312.12 |
3.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,193.10 |
$1,988.50 |
5.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$708.60 |
$1,181 |
2.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$576.90 |
$961.50 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$972.90 |
$1,621.50 |
0.9× |
| Neck soft tissue (70360) |
$96.30 |
$160.50 |
1.3× |
| Nm cisternogram (78630) |
$1,176.30 |
$1,960.50 |
2.5× |
| Nm gastric emptying study (78264) |
$650.78 |
$1,084.62 |
1.9× |
| Nm gastroesophageal reflux study (78262) |
$758.85 |
$1,264.75 |
2.2× |
| Nm red cell sequestration (78140) |
$371.62 |
$619.38 |
1.1× |
| Nuclear medicine of heart pumping function (78473) |
$1,146.60 |
$1,911 |
3.3× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$931.95 |
$1,553.25 |
2.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$494.25 |
$823.75 |
0.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$371.62 |
$619.38 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$468.15 |
$780.25 |
1.3× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$387.98 |
$646.62 |
0.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$153.30 |
$255.50 |
1.7× |
| Osseous survey infant (77076) |
$158.40 |
$264 |
1.7× |
| Parathyroid imaging (78070) |
$542.70 |
$904.50 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$80.40 |
$134 |
0.9× |
| Pr heart first pass single,planar (78481) |
$901.80 |
$1,503 |
1.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$850.20 |
$1,417 |
2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$453.45 |
$755.75 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$847.65 |
$1,412.75 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$198.98 |
$331.62 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$48 |
$80 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$220.80 |
$368 |
2.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$168.60 |
$281 |
1.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$132.90 |
$221.50 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$177 |
$295 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$83.06 |
$138.42 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$81 |
$135 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$96.30 |
$160.50 |
1.3× |
| Radiologic exam colon single contrast study (74270) |
$392.40 |
$654 |
2.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$360.75 |
$601.25 |
2.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$96.30 |
$160.50 |
1.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$116.40 |
$194 |
1.5× |
| Radiological examination surgical specimen (76098) |
$39.60 |
$66 |
0.1× |
| Ribs bilateral 3 views (71110) |
$111.93 |
$186.56 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$812.70 |
$1,354.50 |
2.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,074.75 |
$1,791.25 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$104.70 |
$174.50 |
1.1× |
| Scanogram (77073) |
$188.85 |
$314.75 |
2.1× |
| Scapula complete (73010) |
$177.60 |
$296 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$83.73 |
$139.56 |
3.6× |
| Sella turcica (70240) |
$68.02 |
$113.38 |
0.9× |
| Sialogram (70390) |
$112.50 |
$187.50 |
0.5× |
| Small bowel series (74250) |
$177.60 |
$296 |
1.2× |
| Spine thoracic 3 views (72072) |
$152.85 |
$254.75 |
1.7× |
| Spleen imaging only (78185) |
$513.90 |
$856.50 |
1.5× |
| Testicular Imaging With Vascular Flow (78761) |
$596.25 |
$993.75 |
1.7× |
| Thoracolumbar 2 views (72080) |
$84.87 |
$141.45 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$686.70 |
$1,144.50 |
2.0× |
| Thyroid uptake measurement (78012) |
$300.75 |
$501.25 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$661.65 |
$1,102.75 |
1.9× |
| Tomogram (76100) |
$245.40 |
$409 |
2.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$691.20 |
$1,152 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$324.70 |
$541.18 |
3.5× |
| Unlisted cardiovascular procedure, diagnostic nuclear medicine UNSCHEDULED (78499) |
$669.90 |
$1,116.50 |
1.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$125.85 |
$209.75 |
1.7× |
| Unlisted Ultrasound Procedure (76999) |
$250.80 |
$418 |
3.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,033.20 |
$1,722 |
2.9× |
| Urethrocystography retrograde rs&i (74450) |
$163.65 |
$272.75 |
0.8× |
| Urethrocystography voiding (74455) |
$172.92 |
$288.20 |
0.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$294.48 |
$490.80 |
1.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$261.15 |
$435.25 |
1.7× |
| Us abdl aorta screen aaa (76706) |
$257.02 |
$428.38 |
2.8× |
| Us breast unilateral complete (76641) |
$284.40 |
$474 |
3.1× |
| Us chest (76604) |
$334.50 |
$557.50 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$177.60 |
$296 |
1.9× |
| Us ob transvaginal (76817) |
$346.50 |
$577.50 |
3.8× |
| Us pelvic non ob complete (76856) |
$435.38 |
$725.62 |
4.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$272.02 |
$453.38 |
3.0× |
| Us pregnancy ltd (76815) |
$177.60 |
$296 |
1.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$128.40 |
$214 |
1.4× |
| Us retroperitoneal complete (76770) |
$567.90 |
$946.50 |
6.2× |
| Us retroperitoneal limited (76775) |
$310.95 |
$518.25 |
3.4× |
| Us scrotum and contents (76870) |
$411.15 |
$685.25 |
4.5× |
| Us soft tissue head/neck (76536) |
$293.10 |
$488.50 |
3.2× |
| Us transrectal (76872) |
$206.78 |
$344.62 |
2.3× |
| Us xtr non-vasc lmtd (76882) |
$205.28 |
$342.12 |
2.2× |
| Venogram extremity bilateral (75822) |
$441.68 |
$736.12 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$388.65 |
$647.75 |
0.3× |
| Wrist 2 views (73100) |
$96.30 |
$160.50 |
1.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$172.88 |
$288.12 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$131.85 |
$219.75 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$115.50 |
$192.50 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$350.02 |
$583.38 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$96.30 |
$160.50 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$96.30 |
$160.50 |
1.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$284.84 |
$474.73 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$96.30 |
$160.50 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$96.30 |
$160.50 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$232.95 |
$388.25 |
2.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$177.60 |
$296 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$98.10 |
$163.50 |
1.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$96.30 |
$160.50 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$96.30 |
$160.50 |
1.3× |
| X-ray IV pyelogram+drip infusn (74410) |
$174 |
$290 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$70.35 |
$117.25 |
0.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$177.60 |
$296 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$162.60 |
$271 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$117.30 |
$195.50 |
1.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$96.30 |
$160.50 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$173.40 |
$289 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$257.98 |
$429.98 |
2.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$162.09 |
$270.15 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$64.95 |
$108.25 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$96 |
$160 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$177.60 |
$296 |
1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$104.70 |
$174.50 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$96.30 |
$160.50 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$126 |
$210 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$152.70 |
$254.50 |
2.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$103.50 |
$172.50 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$114 |
$190 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$174 |
$290 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$99.60 |
$166 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$115.50 |
$192.50 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$96.30 |
$160.50 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$173.40 |
$289 |
1.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$108.60 |
$181 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$96.30 |
$160.50 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$96.30 |
$160.50 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$144.60 |
$241 |
1.6× |
| Xr chest 4+ views (71048) |
$193.80 |
$323 |
2.1× |
| Xr Cholecystography Oral Contrast (74290) |
$226.20 |
$377 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$94.72 |
$157.88 |
1.2× |
| Xr internal auditory meati complete (70134) |
$111.82 |
$186.38 |
0.2× |
| Xr optic foramina (70190) |
$86.25 |
$143.75 |
1.1× |
| Xr shoulder 1 view (73020) |
$96.30 |
$160.50 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$79.42 |
$132.38 |
0.9× |
| Xr tibia/fibula 2 views (73590) |
$96.30 |
$160.50 |
1.3× |
| Xr tmj bilateral (70330) |
$109.20 |
$182 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$96.30 |
$160.50 |
1.3× |