| Abdomen 2 views (74019) |
$273.50 |
$547 |
2.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$573 |
$1,146 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$3,399 |
$6,798 |
1.1× |
| Ankle 2 views (73600) |
$82 |
$164 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$336 |
$672 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,972 |
$5,944 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$2,972 |
$5,944 |
1.0× |
| Arthrogram elbow (73085) |
$465.50 |
$931 |
1.4× |
| Arthrogram hip (73525) |
$242.75 |
$485.50 |
0.7× |
| Arthrogram shoulder (73040) |
$242 |
$484 |
0.7× |
| Arthrogram wrist (73115) |
$465.50 |
$931 |
1.4× |
| Arthrography knee lt (73580) |
$465.50 |
$931 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,006.50 |
$2,013 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$1,097.50 |
$2,195 |
2.9× |
| Bone age studies (77072) |
$114.50 |
$229 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$950 |
$1,900 |
2.5× |
| Bone Marrow Imaging Limited Area (78102) |
$461.50 |
$923 |
1.2× |
| Bone survey complete (77075) |
$260.75 |
$521.50 |
2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,441.50 |
$6,883 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$155 |
$310 |
1.9× |
| Chest 1 view (71045) |
$60.75 |
$121.50 |
0.7× |
| Chest 3 views (71047) |
$72.50 |
$145 |
0.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$222.25 |
$444.50 |
1.4× |
| Clavicle complete (73000) |
$98.50 |
$197 |
1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$188.75 |
$377.50 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,562 |
$3,124 |
4.8× |
| CT abdomen and pelvis without contrast (74176) |
$982.75 |
$1,965.50 |
4.4× |
| CT abdomen w contrast (74160) |
$551.50 |
$1,103 |
3.4× |
| CT abdomen w wo contrast (74170) |
$820.50 |
$1,641 |
5.0× |
| CT abdomen w/o contrast (74150) |
$439.50 |
$879 |
4.5× |
| CT angiography upper extremity lt (73206) |
$378 |
$756 |
2.3× |
| CT c-spine w/o contrast (72125) |
$439.50 |
$879 |
4.5× |
| CT cervical spine w&w/o contrast (72127) |
$820.50 |
$1,641 |
5.0× |
| CT cervical spine with contrast (72126) |
$551.50 |
$1,103 |
1.7× |
| CT chest w/wo contrast (71270) |
$820.50 |
$1,641 |
5.0× |
| CT chest with contrast (71260) |
$551.50 |
$1,103 |
3.4× |
| CT head/brain with contrast (70460) |
$551.50 |
$1,103 |
3.4× |
| CT head/brain without and with contrast (70470) |
$820.50 |
$1,641 |
5.0× |
| CT iac w contrast (70481) |
$551.50 |
$1,103 |
3.4× |
| CT lower ext w/o (73700) |
$439.50 |
$879 |
4.5× |
| CT lower extremity w wo contrast (73702) |
$820.50 |
$1,641 |
5.0× |
| CT lower extremity with contrast (73701) |
$551.50 |
$1,103 |
3.4× |
| CT lumbar spine w & w/o contrast (72133) |
$820.50 |
$1,641 |
5.0× |
| CT lumbar spine w/o contrast (72131) |
$439.50 |
$879 |
4.5× |
| CT lumbar spine with contrast (72132) |
$551.50 |
$1,103 |
1.7× |
| CT maxillofacial w contrast (70487) |
$551.50 |
$1,103 |
3.4× |
| CT maxillofacial w/o contrast (70486) |
$439 |
$878 |
4.5× |
| CT maxillofacial w/wo contrast (70488) |
$820.50 |
$1,641 |
5.0× |
| CT neck soft tissue w contrast (70491) |
$551.50 |
$1,103 |
3.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$820.50 |
$1,641 |
5.0× |
| CT orbits w/o contrast (70480) |
$439 |
$878 |
4.5× |
| CT pelvis w & w/o contrast (72194) |
$820.50 |
$1,641 |
5.0× |
| CT pelvis w/o contrast (72192) |
$439.50 |
$879 |
4.5× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$605 |
$1,210 |
7.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$820.50 |
$1,641 |
5.0× |
| CT soft tissue neck w/o contrast (70490) |
$439 |
$878 |
4.5× |
| CT thoracic spine w/contrast (72129) |
$551.50 |
$1,103 |
3.4× |
| CT thoracic spine w/o contrast (72128) |
$439.50 |
$879 |
4.5× |
| CT thoracic spine w/wo contrast (72130) |
$820.50 |
$1,641 |
5.0× |
| CT thorax w/o contrast (71250) |
$492.25 |
$984.50 |
5.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$820.50 |
$1,641 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$439.50 |
$879 |
4.5× |
| CT upper extremity with contrast (73201) |
$551.50 |
$1,103 |
1.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,435.50 |
$2,871 |
8.7× |
| Cta Abdomen (74175) |
$906 |
$1,812 |
5.5× |
| CTA abdomen pelvis (74174) |
$648.50 |
$1,297 |
2.0× |
| CTA chest (71275) |
$772 |
$1,544 |
4.7× |
| Cta Head (70496) |
$886 |
$1,772 |
5.4× |
| CTA lwr ext w&w/o contrast (73706) |
$379.50 |
$759 |
2.3× |
| Cta Neck (70498) |
$797.50 |
$1,595 |
4.8× |
| Cystography minimum 3 views rs&i (74430) |
$371 |
$384.50 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$162.50 |
$325 |
1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$67.50 |
$135 |
0.8× |
| Dxa bone density study axial skeleton (77085) |
$107 |
$214 |
1.1× |
| Echoencephalography real time imaging (76506) |
$308.50 |
$617 |
3.1× |
| Esophagus (74220) |
$120 |
$240 |
0.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$616.50 |
$1,233 |
6.3× |
| Fluoroscopy up to 1 hr (76000) |
$189 |
$378 |
0.8× |
| Foot 2 views (73620) |
$79.75 |
$159.50 |
1.0× |
| Forearm 2 views (73090) |
$109.50 |
$219 |
1.3× |
| Gated Heart Planar Single (78472) |
$878 |
$1,756 |
2.3× |
| Hand 2 views (73120) |
$111 |
$222 |
1.1× |
| Hand 3 views (73130) |
$121.25 |
$242.50 |
1.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,589 |
$3,178 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,317 |
$2,634 |
3.5× |
| Ht muscle image spect sing (78451) |
$1,663.50 |
$3,327 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$111 |
$222 |
1.4× |
| Hysterosalpingogram (74740) |
$669 |
$1,338 |
3.0× |
| Kidney funcj study non-img radioisotopic study (78725) |
$355.50 |
$711 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$703.50 |
$1,407 |
1.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,705 |
$3,410 |
3.3× |
| Knee 3 views (73562) |
$197 |
$394 |
2.4× |
| Liver & spleen imaging static only (78215) |
$706 |
$1,412 |
1.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,000 |
$2,000 |
2.7× |
| Lung perf&ventilat diferentl (78598) |
$584.50 |
$1,169 |
1.1× |
| Lung perfusion differential (78597) |
$374.50 |
$749 |
1.0× |
| Lung Ventilation Imaging (78579) |
$374.50 |
$749 |
1.0× |
| Lymphoscintigraphy (78195) |
$566 |
$1,132 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$334 |
$668 |
1.5× |
| Mammary ductogram or galactogram single (77053) |
$334 |
$668 |
1.5× |
| Meckels Diverticulum (78290) |
$405 |
$810 |
1.1× |
| MRA head w/o contrast (70544) |
$1,401 |
$2,802 |
6.3× |
| MRA neck w contrast (70548) |
$1,212.50 |
$2,425 |
3.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,512.50 |
$3,025 |
4.6× |
| MRA neck w/o contrast (70547) |
$1,401 |
$2,802 |
6.3× |
| MRI abdomen w contrast (74182) |
$1,212.50 |
$2,425 |
3.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,875.50 |
$3,751 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,401 |
$2,802 |
6.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,503.50 |
$3,007 |
2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,503.50 |
$3,007 |
2.0× |
| MRI c-spine with contrast (72142) |
$1,212.50 |
$2,425 |
3.7× |
| MRI cervical spine w/o contrast (72141) |
$1,401 |
$2,802 |
6.3× |
| MRI chest w/o & w/contrast material (71552) |
$1,751 |
$3,502 |
5.3× |
| MRI chest w/o contrast (71550) |
$968.50 |
$1,937 |
4.3× |
| MRI chest with contrast (71551) |
$1,096 |
$2,192 |
1.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,212.50 |
$2,425 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,212.50 |
$2,425 |
3.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,401 |
$2,802 |
6.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,130 |
$2,260 |
5.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,875.50 |
$3,751 |
5.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,212.50 |
$2,425 |
3.7× |
| MRI pelvis w contrast (72196) |
$1,212.50 |
$2,425 |
3.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,875.50 |
$3,751 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,401 |
$2,802 |
6.3× |
| MRI scan of arm joint before and after contrast (73223) |
$1,875.50 |
$3,751 |
5.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,875.50 |
$3,751 |
5.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,875.50 |
$3,751 |
5.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,212.50 |
$2,425 |
3.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,875.50 |
$3,751 |
5.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,212.50 |
$2,425 |
3.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,875.50 |
$3,751 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,401 |
$2,802 |
6.3× |
| MRI tmj (70336) |
$504 |
$1,008 |
2.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,401 |
$2,802 |
6.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,875.50 |
$3,751 |
5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,401 |
$2,802 |
6.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,233 |
$2,466 |
1.0× |
| Neck soft tissue (70360) |
$168.50 |
$337 |
2.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$449 |
$898 |
1.2× |
| Nm bone marrow wb (78104) |
$493.50 |
$987 |
1.3× |
| Nm gastric emptying study (78264) |
$517 |
$1,034 |
1.4× |
| Nm peritoneal-venous shunt patency (78291) |
$510.50 |
$1,021 |
1.4× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,325 |
$2,650 |
1.1× |
| Nuclear Rx Oral Admin (79005) |
$301.50 |
$603 |
1.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$147.50 |
$295 |
1.5× |
| Osseous survey infant (77076) |
$174 |
$348 |
1.8× |
| Osseous survey limited (77074) |
$257.25 |
$514.50 |
2.6× |
| Parathyroid imaging (78070) |
$457.50 |
$915 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$126.50 |
$253 |
1.3× |
| PET image w/CT, skull-thigh (78815) |
$2,606.50 |
$5,213 |
1.9× |
| PET imaging CT for attenuation limited area (78814) |
$2,606.50 |
$5,213 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$2,606.50 |
$5,213 |
1.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,875.50 |
$3,751 |
5.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$464.50 |
$929 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$725 |
$1,450 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$389 |
$778 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$124 |
$248 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$206 |
$412 |
2.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$162 |
$324 |
1.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$384.50 |
$769 |
3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$260.50 |
$521 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$168.50 |
$337 |
2.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$130 |
$260 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$164.75 |
$329.50 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$136 |
$272 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$323.75 |
$647.50 |
2.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$195 |
$390 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$136.50 |
$273 |
1.7× |
| Radiological examination surgical specimen (76098) |
$430.50 |
$861 |
0.8× |
| Ribs bilateral 3 views (71110) |
$121.75 |
$243.50 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$880.50 |
$1,761 |
2.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$880.50 |
$1,761 |
1.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,333.50 |
$2,667 |
2.6× |
| Scanogram (77073) |
$131.50 |
$263 |
1.3× |
| Scapula complete (73010) |
$99 |
$198 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$30.50 |
$61 |
1.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$212 |
$424 |
2.2× |
| Sialogram (70390) |
$227.50 |
$455 |
1.0× |
| Small bowel series (74250) |
$168 |
$336 |
1.0× |
| Spine thoracic 3 views (72072) |
$152 |
$304 |
1.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$951.50 |
$1,903 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$532 |
$1,064 |
1.4× |
| Thyroid uptake measurement (78012) |
$298.50 |
$597 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$906 |
$1,812 |
2.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,394 |
$2,788 |
2.7× |
| Ultrasound elastography first target lesion (76982) |
$123 |
$246 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$760.50 |
$1,521 |
7.8× |
| Umbilical-artery Doppler (OB) (76820) |
$122.50 |
$245 |
1.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$389 |
$778 |
4.8× |
| Unlisted Ultrasound Procedure (76999) |
$411 |
$822 |
5.0× |
| Upper Extremity Infant (73092) |
$71.75 |
$143.50 |
0.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$799 |
$1,598 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$203 |
$406 |
0.9× |
| Urethrocystography voiding (74455) |
$192.25 |
$384.50 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$336 |
$672 |
2.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$471 |
$942 |
2.9× |
| Us abdl aorta screen aaa (76706) |
$204 |
$408 |
2.1× |
| Us breast unilateral complete (76641) |
$261 |
$522 |
2.7× |
| Us breast unilateral limited (76642) |
$324 |
$648 |
4.0× |
| Us chest (76604) |
$335 |
$670 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$408.50 |
$817 |
4.2× |
| Us elastography parenchyma (76981) |
$123 |
$246 |
1.3× |
| Us infant hips dynamic (76885) |
$231 |
$462 |
2.8× |
| Us infant hips limited static (76886) |
$126.50 |
$253 |
1.5× |
| Us ob transvaginal (76817) |
$140.50 |
$281 |
1.4× |
| Us pelvic non ob complete (76856) |
$572.50 |
$1,145 |
5.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$299.50 |
$599 |
3.1× |
| Us pregnancy ltd (76815) |
$122.50 |
$245 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$122.50 |
$245 |
1.2× |
| Us retroperitoneal limited (76775) |
$305.50 |
$611 |
3.1× |
| Us scrotum and contents (76870) |
$690 |
$1,380 |
7.0× |
| Us soft tissue head/neck (76536) |
$659 |
$1,318 |
6.7× |
| Us spinal canal and contents (76800) |
$272 |
$544 |
2.8× |
| Us transrectal (76872) |
$266.50 |
$533 |
2.7× |
| Us transrectal prostate volume (76873) |
$341.50 |
$683 |
3.5× |
| Us xtr non-vasc lmtd (76882) |
$104.75 |
$209.50 |
1.1× |
| Venogram extremity bilateral (75822) |
$1,214.50 |
$2,429 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,972 |
$5,944 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,214.50 |
$2,429 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$78 |
$156 |
1.0× |
| Wrist 2 views (73100) |
$72.25 |
$144.50 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$173.25 |
$346.50 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$102 |
$204 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$121 |
$242 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$296.25 |
$592.50 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$80.25 |
$160.50 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$118.75 |
$237.50 |
1.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$384.50 |
$769 |
3.9× |
| X-ray exam hip uni 1 view (73501) |
$126.50 |
$253 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$136.50 |
$273 |
1.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$114.50 |
$229 |
1.2× |
| X-ray eye for foreign body (70030) |
$180.50 |
$361 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$144.75 |
$289.50 |
1.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$136.50 |
$273 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$197 |
$394 |
2.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$109 |
$218 |
1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$47.50 |
$95 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$134 |
$268 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$126.50 |
$253 |
1.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$87.75 |
$175.50 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$151.50 |
$303 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$320 |
$640 |
3.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$255 |
$510 |
2.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$114.50 |
$229 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$126.50 |
$253 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$145.25 |
$290.50 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$192 |
$384 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$471 |
$942 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$97.50 |
$195 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$183 |
$366 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$147 |
$294 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$122 |
$244 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$123.75 |
$247.50 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$113 |
$226 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$139 |
$278 |
1.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$74.75 |
$149.50 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$157.75 |
$315.50 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$147.25 |
$294.50 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$78 |
$156 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$126.50 |
$253 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$90 |
$180 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$118.25 |
$236.50 |
1.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$267 |
$534 |
2.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$66.75 |
$133.50 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$123.75 |
$247.50 |
1.5× |
| Xr arthrogram ankle (73615) |
$465.50 |
$931 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$305.50 |
$611 |
3.1× |
| Xr chest 4+ views (71048) |
$129.50 |
$259 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$72.25 |
$144.50 |
0.9× |
| Xr internal auditory meati complete (70134) |
$251 |
$502 |
0.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$47 |
$94 |
0.5× |
| Xr shoulder 1 view (73020) |
$65 |
$130 |
0.8× |
| Xr spine cervical 4 or 5 views (72050) |
$174.75 |
$349.50 |
1.8× |
| Xr tibia/fibula 2 views (73590) |
$111 |
$222 |
1.4× |
| Xr tmj bilateral (70330) |
$128.50 |
$257 |
1.6× |
| Xray knee 1 or 2 views rt (73560) |
$84.25 |
$168.50 |
1.0× |