| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$6,722 |
— |
| Abdomen 1 View (74018) |
— |
$490 |
— |
| Abdomen 2 views (74019) |
— |
$582 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$1,218 |
— |
| Angio internal mammary (75756) |
— |
$1,032 |
— |
| Angio pulmonary bilat (75743) |
— |
$3,353 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$3,712 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$3,712 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$4,023 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$602 |
— |
| Ankle 2 views (73600) |
— |
$244 |
— |
| Aortography thoracic w/o serialography rs&i (75600) |
— |
$3,292 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$3,712 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$3,944 |
— |
| Arthrogram ankle (73615) |
— |
$1,324 |
— |
| Arthrogram hip (73525) |
— |
$718 |
— |
| Arthrogram Wrist (73115) |
— |
$1,103 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$638 |
— |
| Bone age studies (77072) |
— |
$362 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$2,202 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,992 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$1,873 |
— |
| Bone Imaging Whole Body (78306) |
— |
$1,968 |
— |
| Bone survey infant (77076) |
— |
$427 |
— |
| Brachytx isodose complex (77318) |
— |
$1,931 |
— |
| Brachytx isodose intermed (77317) |
— |
$1,734 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$1,101 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$871 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$6,892 |
— |
| Cardiac MRI w/w/o contrast & further seq (75561) |
— |
$3,800 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$969 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$1,612 |
— |
| Chest 1 view (71045) |
— |
$304 |
— |
| Chest 2 views (71046) |
— |
$476 |
— |
| Chest 3 views (71047) |
— |
$447 |
— |
| Chest 4 or more views (71048) |
— |
$565 |
— |
| 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–$905 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$3,712 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$448 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$801 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$893 |
— |
CT abdomen and pelvis without and with contrast (74178)
range across 2 matching MRF lines |
— |
$5,030–$6,006 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$2,239 |
— |
| CT abdomen w contrast (74160) |
— |
$2,667 |
— |
| CT abdomen w wo contrast (74170) |
— |
$2,762 |
— |
| CT abdomen w/o contrast (74150) |
— |
$1,106 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$3,831 |
— |
| CT Angio Chest (71275) |
— |
$2,277 |
— |
CT Angio Head (70496)
range across 2 matching MRF lines |
— |
$1,825–$2,348 |
— |
| CT angio hrt w/3d image (75574) |
— |
$2,277 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$1,684 |
— |
| CT Angio Neck (70498) |
— |
$1,948 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$1,682 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$2,368 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$2,224 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$3,161 |
— |
| CT chest w contrast (71260) |
— |
$2,393 |
— |
| CT chest w/wo contrast (71270) |
— |
$2,689 |
— |
| CT colonography screening (74263) |
— |
$1,254 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$1,659 |
— |
| CT head/brain with contrast (70460) |
— |
$2,134 |
— |
| CT head/brain without and with contrast (70470) |
— |
$2,348 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$90 |
— |
| CT iac w contrast (70481) |
— |
$1,868 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$2,374 |
— |
| CT lower ext w/o (73700) |
— |
$1,377 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$1,815 |
— |
| CT lumbar spine w contrast (72132) |
— |
$2,184 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$1,731 |
— |
| CT maxillofacial w contrast (70487) |
— |
$1,932 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$1,620 |
— |
| CT neck tissue combo (70492) |
— |
$1,833 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$2,232 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,388 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$2,828 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,382 |
— |
| CT scan of leg combo (73702) |
— |
$2,099 |
— |
| CT scans face/jaw combo (70488) |
— |
$2,232 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$1,935 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,378 |
— |
| CT thoracic spine w contrast (72129) |
— |
$2,217 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$1,921 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$2,379 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,777 |
— |
| CT upper ext wo (73200) |
— |
$1,177 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$2,372 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,138 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$1,881 |
— |
| Cta Abdomen (74175) |
— |
$2,049 |
— |
| CTA pelvis (72191) |
— |
$2,334 |
— |
| Dilation ureters/urethra rs&i (74485) |
— |
$1,867 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
— |
$950 |
— |
Dxa Bone Density Axial (77080)
range across 2 matching MRF lines |
— |
$346–$773 |
— |
| Echo exam uterus (76831) |
— |
$793 |
— |
| Esophagram (74220) |
— |
$574 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$1,168 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$973 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$690 |
— |
| Foot 2 views (73620) |
— |
$167 |
— |
| Forearm 2 views (73090) |
— |
$481 |
— |
| Gastric emptying imaging study (78264) |
— |
$2,211 |
— |
| Gastroesophageal Reflux Exam (78262) |
— |
$972 |
— |
| Gated Heart Planar Single (78472) |
— |
$2,424 |
— |
| Hand 2 views (73120) |
— |
$243 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
— |
$3,547 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
— |
$3,547 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
— |
$3,547 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$2,107 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$2,107 |
— |
| Ht Musc Image Planar Mult (78454) |
— |
$2,510 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$4,767 |
— |
| Hysterosalpingogram (74740) |
— |
$911 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$831 |
— |
| Infant hip ultrasound, limited static exam (76886) |
— |
$644 |
— |
| K Flow/Funct Image Multiple (78709) |
— |
$1,149 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$1,138 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$1,138 |
— |
| Kidney Imaging Morphol (78700) |
— |
$1,211 |
— |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
— |
$999 |
— |
| Knee 3 Views (73562) |
— |
$653 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$1,187 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$2,505 |
— |
| Lung perfusion differential (78597) |
— |
$1,211 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$1,399 |
— |
| Lung Ventilation Imaging (78579) |
— |
$1,294 |
— |
| Lymph System Imaging (78195) |
— |
$1,973 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$1,305 |
— |
| Meckels Divert Exam (78290) |
— |
$1,274 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$1,803 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$2,912 |
— |
| MRA head w/o contrast (70544) |
— |
$2,542 |
— |
| MRA head with contrast (70545) |
— |
$2,479 |
— |
| MRA neck w contrast (70548) |
— |
$2,728 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$2,913 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,542 |
— |
| MRI abdomen w contrast (74182) |
— |
$2,019 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$1,861 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$2,476 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$2,477 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$2,251 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$1,572 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$2,661 |
— |
| MRI cervical spine w contrast (72142) |
— |
$2,661 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$2,446 |
— |
| MRI chest w/o contrast (71550) |
— |
$1,808 |
— |
| MRI chest wo w contrast (71552) |
— |
$2,124 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$1,833 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$2,665 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$2,293 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$3,041 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$2,873 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$2,542 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$2,537 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$2,913 |
— |
| MRI pelvis w contrast (72196) |
— |
$2,019 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$2,063 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$1,748 |
— |
| MRI spectroscopy (76390) |
— |
$500 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$2,410 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$2,251 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$2,086 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$2,424 |
— |
| MRI, abdomen, combo (74183) |
— |
$2,176 |
— |
| MRI, dorsal spine combo (72157) |
— |
$2,363 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$2,205 |
— |
MRI, joint upper extrem (73221)
range across 3 matching MRF lines |
— |
$2,082–$3,078 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$2,424 |
— |
| MRI, lumbar spine combo (72158) |
— |
$3,260 |
— |
| Myelogram cervical (72240) |
— |
$2,007 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$5,516 |
— |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
— |
$6,892 |
— |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
— |
$10,789 |
— |
| Neck soft tissue (70360) |
— |
$440 |
— |
| Nonvascular Shunt X-Ray (75809) |
— |
$641 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$7,768 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$1,663 |
— |
| Panoramic X-ray of jaws (70355) |
— |
$377 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$1,738 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$474 |
— |
PET image w/CT, full body (78816)
range across 4 matching MRF lines |
— |
$10,127–$10,328 |
— |
PET imaging CT attenuation skull base mid-thigh (78815)
range across 18 matching MRF lines |
— |
$8,607–$10,329 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,399 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$858 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$329 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$559 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$446 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$565 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$603 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$440 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$536 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$575 |
— |
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines |
— |
$318–$381 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$437 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$523 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$526 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$568 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$404 |
— |
Radex Spine 1 View Specify Level (72020)
range across 3 matching MRF lines |
— |
$344–$413 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$473 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$702 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$391 |
— |
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines |
— |
$321–$462 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$537 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$960 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$26,319 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$536 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$641 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$926 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$669 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$582 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$771 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$771 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$800 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$819 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$478 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$903 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$566 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,002 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$332 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$685 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$317 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$981 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$574 |
— |
| Ribs bilateral 3 views (71110) |
— |
$582 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$872 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$872 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$4,710 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$1,581 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$4,710 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$4,710 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$1,946 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$724 |
— |
| Scapula (73010) |
— |
$696 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$159 |
— |
| Shoulder 1 view (73020) |
— |
$313 |
— |
| Shoulder Arthrography (73040) |
— |
$1,100 |
— |
Skull less than 4 views (70250)
range across 2 matching MRF lines |
— |
$497–$596 |
— |
| Special dosimetry (77331) |
— |
$580 |
— |
| Special Physics Consult (77370) |
— |
$1,306 |
— |
| Special teletherapy port plan (77321) |
— |
$1,448 |
— |
| Special treatment procedure (77470) |
— |
$1,685 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$16,987 |
— |
| Sternoclavicular joints (71130) |
— |
$276 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$3,347 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$1,792 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$2,151 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$1,866 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$1,173 |
— |
| Thoracic spine 2 views (72070) |
— |
$481 |
— |
| Thoracic spine 3 views (72072) |
— |
$733 |
— |
| Thoracolumbar 2 views (72080) |
— |
$447 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$2,203 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$979 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$2,065 |
— |
Tx Devices Design & Construction Complex (77334)
range across 3 matching MRF lines |
— |
$824–$1,446 |
— |
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines |
— |
$648–$903 |
— |
| Tx devices design & construction simple (77332) |
— |
$513 |
— |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
— |
$607–$1,214 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$712 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$712 |
— |
Ultrasound, abdomen limited (76705)
range across 4 matching MRF lines |
— |
$429–$854 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$950 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$1,292 |
— |
| Upper gi w/o kub (74240) |
— |
$810 |
— |
| Urethrocystogram voiding (74455) |
— |
$401 |
— |
Urethrocystography retrograde (74450)
range across 2 matching MRF lines |
— |
$401–$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 |
— |
$482–$1,035 |
— |
| Us exam, pelvic, limited (76857) |
— |
$539 |
— |
| Us head (76506) |
— |
$558 |
— |
| Us kidney transplant (76776) |
— |
$718 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$768 |
— |
| Us ob detailed single fetus (76811) |
— |
$1,472 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$1,140 |
— |
| Us ob transvaginal (76817) |
— |
$1,311 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,256 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$857 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$544 |
— |
| Us retroperitoneal complete (76770) |
— |
$861 |
— |
Us retroperitoneal limited (76775)
range across 3 matching MRF lines |
— |
$348–$649 |
— |
| Us scrotum and contents (76870) |
— |
$959 |
— |
| Us spinal canal and contents (76800) |
— |
$641 |
— |
| Us thyroid (76536) |
— |
$1,305 |
— |
| Us transrectal (76872) |
— |
$1,104 |
— |
| Vein X-Ray Chest (75827) |
— |
$1,410 |
— |
Venography caval inferior serialography rs&i (75825)
range across 2 matching MRF lines |
— |
$2,512–$3,466 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$1,315 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$929 |
— |
| Venography Renal Unilateral (75831) |
— |
$3,466 |
— |
| Wrist 2 views (73100) |
— |
$329 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$302 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$778 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$3,712 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$1,310 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$178 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$483 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$474 |
— |
| 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) |
— |
$728 |
— |
| 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 |
— |
$483–$649 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$1,193 |
— |
X-Ray Exam Unilat Ribs/Chest (71101)
range across 3 matching MRF lines |
— |
$486–$696 |
— |
| X-ray eye for foreign body (70030) |
— |
$364 |
— |
| X-ray humerus (73060) |
— |
$544 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$294 |
— |
| 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 |
— |
$462–$761 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$234 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$729 |
— |
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202)
range across 3 matching MRF lines |
— |
$510–$729 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$574 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$484 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$535 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$957 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$745 |
— |
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines |
— |
$427–$512 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$289 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$998 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$570 |
— |
Xr orbits complete 4 views (70200)
range across 3 matching MRF lines |
— |
$579–$695 |
— |