| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$8,066 |
— |
| Abdomen 1 View (74018) |
— |
$585 |
— |
| Abdomen 2 views (74019) |
— |
$696 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$1,152 |
— |
| Angio internal mammary (75756) |
— |
$1,032 |
— |
| Angio pulmonary bilat (75743) |
— |
$4,023 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$3,786 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$3,786 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$4,023 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$723 |
— |
| Ankle 2 views (73600) |
— |
$292 |
— |
| Aortography thoracic w/o serialography rs&i (75600) |
— |
$3,292 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$3,786 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$4,023 |
— |
| Arthrogram ankle (73615) |
— |
$1,324 |
— |
Arthrogram hip (73525)
range across 4 matching MRF lines |
— |
$963–$1,155 |
— |
| Arthrogram Wrist (73115) |
— |
$1,588 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$650 |
— |
| Bone age studies (77072) |
— |
$519 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$3,038 |
— |
| Bone Imaging Limited Area (78300) |
— |
$2,749 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$2,583 |
— |
| Bone Imaging Whole Body (78306) |
— |
$2,717 |
— |
| Bone survey infant (77076) |
— |
$509 |
— |
| Brachytx isodose complex (77318) |
— |
$2,317 |
— |
| Brachytx isodose intermed (77317) |
— |
$1,733 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$1,101 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$888 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$7,029 |
— |
| Cardiac MRI w/w/o contrast & further seq (75561) |
— |
$3,800 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$1,157 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$1,643 |
— |
| Chest 1 view (71045) |
— |
$319 |
— |
| Chest 2 views (71046) |
— |
$501 |
— |
| Chest 3 views (71047) |
— |
$536 |
— |
| Chest 4 or more views (71048) |
— |
$813 |
— |
| Clavicle complete (73000) |
— |
$621 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$500 |
— |
Continuing medical physics consltj pr wk (77336)
range across 2 matching MRF lines |
— |
$885–$1,061 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$3,786 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$642 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$960 |
— |
Contrast X-Ray Of Knee Joint (73580)
range across 2 matching MRF lines |
— |
$1,070–$1,283 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$6,006 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$2,673 |
— |
| CT abdomen w contrast (74160) |
— |
$3,184 |
— |
| CT abdomen w wo contrast (74170) |
— |
$3,297 |
— |
| CT abdomen w/o contrast (74150) |
— |
$1,320 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$4,574 |
— |
| CT Angio Chest (71275) |
— |
$2,719 |
— |
CT Angio Head (70496)
range across 2 matching MRF lines |
— |
$2,179–$2,804 |
— |
| CT angio hrt w/3d image (75574) |
— |
$2,619 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$2,011 |
— |
| CT Angio Neck (70498) |
— |
$2,325 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$2,009 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$2,828 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$2,655 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$3,161 |
— |
| CT chest w contrast (71260) |
— |
$2,857 |
— |
| CT chest w/wo contrast (71270) |
— |
$3,211 |
— |
| CT colonography screening (74263) |
— |
$1,505 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$1,990 |
— |
| CT head/brain with contrast (70460) |
— |
$2,547 |
— |
| CT head/brain without and with contrast (70470) |
— |
$2,804 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$90 |
— |
| CT iac w contrast (70481) |
— |
$2,230 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$2,834 |
— |
| CT lower ext w/o (73700) |
— |
$1,644 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$2,168 |
— |
| CT lumbar spine w contrast (72132) |
— |
$2,608 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$2,067 |
— |
| CT maxillofacial w contrast (70487) |
— |
$2,307 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$1,934 |
— |
| CT neck tissue combo (70492) |
— |
$2,188 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$2,664 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,657 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$3,377 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,650 |
— |
| CT scan of leg combo (73702) |
— |
$2,518 |
— |
| CT scans face/jaw combo (70488) |
— |
$2,664 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$2,310 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,646 |
— |
| CT thoracic spine w contrast (72129) |
— |
$2,647 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$2,293 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$2,855 |
— |
| CT thorax w/o contrast (71250) |
— |
$2,121 |
— |
| CT upper ext wo (73200) |
— |
$1,405 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$2,832 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,552 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$2,246 |
— |
| Cta Abdomen (74175) |
— |
$2,447 |
— |
| CTA pelvis (72191) |
— |
$2,787 |
— |
| Dilation ureters/urethra rs&i (74485) |
— |
$2,673 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
— |
$950 |
— |
Dxa Bone Density Axial (77080)
range across 2 matching MRF lines |
— |
$413–$923 |
— |
| Echo exam uterus (76831) |
— |
$1,134 |
— |
| Esophagram (74220) |
— |
$821 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$1,168 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$1,343 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$988 |
— |
| Foot 2 views (73620) |
— |
$200 |
— |
| Forearm 2 views (73090) |
— |
$574 |
— |
| Gastric emptying imaging study (78264) |
— |
$2,824 |
— |
| Gastroesophageal Reflux Exam (78262) |
— |
$1,034 |
— |
| Gated Heart Planar Single (78472) |
— |
$3,096 |
— |
| Hand 2 views (73120) |
— |
$290 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
— |
$4,079 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
— |
$4,079 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
— |
$4,079 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$2,908 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$2,908 |
— |
| Ht Musc Image Planar Mult (78454) |
— |
$2,022 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$4,500 |
— |
| Hysterosalpingogram (74740) |
— |
$1,304 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$1,145 |
— |
| Infant hip ultrasound, limited static exam (76886) |
— |
$923 |
— |
| K Flow/Funct Image Multiple (78709) |
— |
$1,586 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$1,569 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$1,569 |
— |
| Kidney Imaging Morphol (78700) |
— |
$1,211 |
— |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
— |
$1,149 |
— |
| Knee 3 Views (73562) |
— |
$780 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$1,517 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$2,881 |
— |
| Lung perfusion differential (78597) |
— |
$1,393 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$1,930 |
— |
| Lung Ventilation Imaging (78579) |
— |
$1,489 |
— |
| Lymph System Imaging (78195) |
— |
$2,520 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$1,305 |
— |
| Meckels Divert Exam (78290) |
— |
$1,203 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$2,486 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$2,152 |
— |
| MRA head w/o contrast (70544) |
— |
$1,879 |
— |
| MRA head with contrast (70545) |
— |
$1,833 |
— |
| MRA neck w contrast (70548) |
— |
$2,016 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$2,153 |
— |
| MRA neck w/o contrast (70547) |
— |
$1,879 |
— |
| MRI abdomen w contrast (74182) |
— |
$1,493 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$1,375 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$1,830 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$1,831 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$1,663 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$1,162 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$2,661 |
— |
| MRI cervical spine w contrast (72142) |
— |
$1,967 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$1,808 |
— |
| MRI chest w/o contrast (71550) |
— |
$1,336 |
— |
| MRI chest wo w contrast (71552) |
— |
$1,570 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$1,833 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$1,969 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$1,695 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$2,247 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$2,123 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$1,879 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$2,537 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$2,153 |
— |
| MRI pelvis w contrast (72196) |
— |
$1,493 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$1,525 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$1,292 |
— |
| MRI spectroscopy (76390) |
— |
$500 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$1,782 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$1,663 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$1,542 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$1,792 |
— |
| MRI, abdomen, combo (74183) |
— |
$1,608 |
— |
| MRI, dorsal spine combo (72157) |
— |
$1,747 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$1,629 |
— |
MRI, joint upper extrem (73221)
range across 3 matching MRF lines |
— |
$1,539–$3,078 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$1,792 |
— |
| MRI, lumbar spine combo (72158) |
— |
$2,410 |
— |
| Myelogram cervical (72240) |
— |
$2,396 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$5,209 |
— |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
— |
$7,029 |
— |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
— |
$10,641 |
— |
| Neck soft tissue (70360) |
— |
$526 |
— |
| Nonvascular Shunt X-Ray (75809) |
— |
$917 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$9,321 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$2,126 |
— |
| Panoramic X-ray of jaws (70355) |
— |
$621 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$1,642 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$565 |
— |
| PET image w/CT, full body (78816) |
— |
$10,328 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$10,328 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,930 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$1,037 |
— |
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines |
— |
$396–$475 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$667 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$532 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$675 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$720 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$526 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$639 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$688 |
— |
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines |
— |
$380–$455 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$524 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$626 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$627 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$679 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$578 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$494 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$676 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$842 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$467 |
— |
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines |
— |
$384–$461 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$642 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$960 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$26,846 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$643 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$641 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$1,111 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$800 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$696 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,104 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,104 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$1,145 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$977 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$573 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$1,295 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$813 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,435 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$398 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$685 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$378 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$1,171 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$685 |
— |
| Ribs bilateral 3 views (71110) |
— |
$696 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$889 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$889 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$4,448 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$1,613 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$4,449 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$4,449 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$1,985 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$724 |
— |
| Scapula (73010) |
— |
$829 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$191 |
— |
| Shoulder 1 view (73020) |
— |
$373 |
— |
| Shoulder Arthrography (73040) |
— |
$1,574 |
— |
Skull less than 4 views (70250)
range across 2 matching MRF lines |
— |
$597–$712 |
— |
| Special dosimetry (77331) |
— |
$591 |
— |
| Special Physics Consult (77370) |
— |
$1,332 |
— |
| Special teletherapy port plan (77321) |
— |
$1,478 |
— |
| Special treatment procedure (77470) |
— |
$1,718 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$17,326 |
— |
| Sternoclavicular joints (71130) |
— |
$276 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$4,016 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$2,151 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$2,193 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$1,586 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$1,196 |
— |
| Thoracic spine 2 views (72070) |
— |
$574 |
— |
| Thoracic spine 3 views (72072) |
— |
$875 |
— |
| Thoracolumbar 2 views (72080) |
— |
$447 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$3,039 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$979 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$2,849 |
— |
Tx Devices Design & Construction Complex (77334)
range across 3 matching MRF lines |
— |
$824–$1,734 |
— |
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines |
— |
$648–$923 |
— |
| Tx devices design & construction simple (77332) |
— |
$524 |
— |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
— |
$607–$1,214 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$854 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$854 |
— |
Ultrasound, abdomen limited (76705)
range across 4 matching MRF lines |
— |
$494–$854 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$1,140 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$1,292 |
— |
| Upper gi w/o kub (74240) |
— |
$1,159 |
— |
| Urethrocystogram voiding (74455) |
— |
$574 |
— |
| Urethrocystography retrograde (74450) |
— |
$574 |
— |
Us breast unilateral complete (76641)
range across 3 matching MRF lines |
— |
$1,193–$2,385 |
— |
Us chest (76604)
range across 4 matching MRF lines |
— |
$555–$765 |
— |
| Us exam, pelvic, limited (76857) |
— |
$621 |
— |
| Us head (76506) |
— |
$800 |
— |
| Us kidney transplant (76776) |
— |
$1,155 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$768 |
— |
| Us ob detailed single fetus (76811) |
— |
$1,693 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$1,140 |
— |
| Us ob transvaginal (76817) |
— |
$1,311 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,700 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$1,389 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$626 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,151 |
— |
Us retroperitoneal limited (76775)
range across 3 matching MRF lines |
— |
$401–$552 |
— |
| Us scrotum and contents (76870) |
— |
$1,298 |
— |
| Us spinal canal and contents (76800) |
— |
$768 |
— |
| Us thyroid (76536) |
— |
$1,305 |
— |
| Us transrectal (76872) |
— |
$1,524 |
— |
| Vein X-Ray Chest (75827) |
— |
$1,621 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$3,466 |
— |
Venography extremity bilateral rs&i (75822)
range across 2 matching MRF lines |
— |
$1,118–$1,341 |
— |
Venography extremity unilateral rs&i (75820)
range across 2 matching MRF lines |
— |
$790–$948 |
— |
| Venography Renal Unilateral (75831) |
— |
$3,466 |
— |
| Wrist 2 views (73100) |
— |
$392 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$362 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$1,113 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$3,786 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$1,310 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$213 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$691 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$568 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$954 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$923 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$476 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$715 |
— |
X-Ray Exam Hip Uni 4/> Views (73503)
range across 2 matching MRF lines |
— |
$728–$874 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$952 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$1,030 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$1,071 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$1,567 |
— |
X-Ray Exam Neck Spine 2-3 Vw (72040)
range across 2 matching MRF lines |
— |
$575–$775 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$1,193 |
— |
X-Ray Exam Unilat Ribs/Chest (71101)
range across 3 matching MRF lines |
— |
$580–$696 |
— |
| X-ray eye for foreign body (70030) |
— |
$363 |
— |
| X-ray humerus (73060) |
— |
$649 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$423 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$1,048 |
— |
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100)
range across 2 matching MRF lines |
— |
$551–$910 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$278 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$875 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$729 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$685 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$578 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$765 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$957 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$890 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$512 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$345 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$1,193 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$681 |
— |
Xr orbits complete 4 views (70200)
range across 3 matching MRF lines |
— |
$690–$828 |
— |