| Abdomen 1 View (74018) |
$271 |
$430 |
3.3× |
| Abdomen 2 views (74019) |
$217 |
$344 |
2.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$740 |
$1,173 |
2.0× |
| Angiography extremity bilateral rs&i (75716) |
$5,815 |
$9,214 |
2.0× |
| Angiography extremity unilateral rs&i (75710) |
$5,815 |
$9,214 |
2.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,701 |
$9,034 |
1.9× |
| Ankle 2 views (73600) |
$322 |
$511 |
4.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$5,701 |
$9,034 |
1.9× |
| Arthrogram hip (73525) |
$466 |
$739 |
1.4× |
| Arthrogram Wrist (73115) |
$286 |
$453 |
0.9× |
| Bone age studies (77072) |
$190 |
$302 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$854 |
$1,353 |
2.3× |
| Bone Imaging Limited Area (78300) |
$689 |
$1,092 |
1.9× |
| Bone Imaging Whole Body (78306) |
$854 |
$1,353 |
2.3× |
| Bone marrow imaging; whole body (78104) |
$854 |
$1,353 |
2.3× |
| Bone survey infant (77076) |
$190 |
$302 |
2.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$889 |
$1,409 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,761 |
$4,375 |
2.1× |
| Cardiac Shunt Detection (78428) |
$679 |
$1,075 |
1.8× |
| Cerebrospinal Fluid Scan (78630) |
$946 |
$1,500 |
1.9× |
| Chest 1 view (71045) |
$186 |
$295 |
2.3× |
| Chest 2 views (71046) |
$246 |
$390 |
3.0× |
| Chest 3 views (71047) |
$278 |
$440 |
3.4× |
| Chest 4 or more views (71048) |
$324 |
$513 |
3.3× |
| Clavicle complete (73000) |
$185 |
$294 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$150 |
$238 |
1.5× |
| Contrast Exam Abdominl Aorta (75625) |
$5,838 |
$9,251 |
2.0× |
| Contrast X-Ray Bladder (74430) |
$430 |
$682 |
1.3× |
| Contrast X-Ray Of Elbow (73085) |
$533 |
$845 |
1.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$329 |
$521 |
1.0× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$456 |
$722 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,119 |
$4,943 |
9.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,498 |
$2,373 |
6.8× |
| CT abdomen w contrast (74160) |
$1,447 |
$2,293 |
8.9× |
| CT abdomen w wo contrast (74170) |
$1,808 |
$2,865 |
11.1× |
| CT abdomen w/o contrast (74150) |
$1,158 |
$1,834 |
11.9× |
| CT Angio Abdomen and Pelvis (74174) |
$1,384 |
$2,193 |
4.3× |
| CT Angio Chest (71275) |
$1,384 |
$2,448 |
8.5× |
| CT Angio Head (70496) |
$1,091 |
$1,729 |
6.7× |
| CT angio hrt w/3d image (75574) |
$322 |
$2,500 |
1.0× |
| CT Angio Neck (70498) |
$1,091 |
$1,729 |
6.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$660 |
$1,046 |
4.0× |
| CT cervical spine w/ contrast (72126) |
$1,620 |
$2,567 |
5.0× |
| CT cervical spine w/o contrast (72125) |
$1,364 |
$2,162 |
14.0× |
| CT cervical spine w/wo cont (72127) |
$1,996 |
$3,162 |
12.2× |
| CT chest w contrast (71260) |
$1,631 |
$2,584 |
10.0× |
| CT chest w/wo contrast (71270) |
$1,680 |
$2,663 |
10.3× |
| CT colonography screening (74263) |
$431 |
$663 |
1.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$2,679 |
$4,245 |
27.6× |
| CT head/brain with contrast (70460) |
$1,581 |
$2,505 |
9.7× |
| CT head/brain without and with contrast (70470) |
$1,724 |
$2,733 |
10.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$150 |
$231 |
1.9× |
| CT iac w contrast (70481) |
$970 |
$1,537 |
5.9× |
| CT l-spine w&w/o contrast (72133) |
$1,815 |
$2,877 |
11.1× |
| CT lower ext w/o (73700) |
$1,266 |
$2,005 |
13.0× |
| CT lower extremity w/contrast material (73701) |
$1,581 |
$2,506 |
9.7× |
| CT lumbar spine w contrast (72132) |
$1,482 |
$2,348 |
4.6× |
| CT lumbar spine w/o contrast (72131) |
$1,354 |
$2,145 |
13.9× |
| CT maxillofacial w contrast (70487) |
$1,580 |
$2,504 |
9.7× |
| CT maxillofacial wo contrast (70486) |
$1,227 |
$1,944 |
12.6× |
| CT neck tissue combo (70492) |
$1,628 |
$2,579 |
10.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,212 |
$1,921 |
7.4× |
| CT orbits w/o contrast (70480) |
$970 |
$1,537 |
10.0× |
| CT pelvis w&w/o contrast (72194) |
$1,680 |
$2,663 |
10.3× |
| CT pelvis w/o contrast (72192) |
$998 |
$1,582 |
10.3× |
| CT scan of leg combo (73702) |
$1,977 |
$3,132 |
12.1× |
| CT scans face/jaw combo (70488) |
$1,655 |
$2,622 |
10.1× |
| CT soft tissue neck w contrast (70491) |
$1,415 |
$2,242 |
8.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,150 |
$1,822 |
11.8× |
| CT thoracic spine w contrast (72129) |
$1,133 |
$1,795 |
6.9× |
| CT thoracic spine w/o contrast (72128) |
$1,089 |
$1,726 |
11.2× |
| CT thoracic spine w/wo cont (72130) |
$1,482 |
$2,348 |
9.1× |
| CT thorax w/o contrast (71250) |
$1,038 |
$1,645 |
10.7× |
| CT upper ext wo (73200) |
$1,266 |
$2,005 |
13.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,977 |
$3,132 |
12.1× |
| CT upper extremity with contrast (73201) |
$1,581 |
$2,506 |
4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,003 |
$1,589 |
6.1× |
| Cta Abdomen (74175) |
$894 |
$1,416 |
5.5× |
| Diskography lumbar (72295) |
$1,980 |
$3,137 |
1.1× |
| Dxa Bone Density Axial (77080) |
$496 |
$786 |
5.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$476 |
$755 |
5.9× |
| Esophagram (74220) |
$363 |
$576 |
2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$401 |
$636 |
4.1× |
| Fluoroscopy up to 1 hr (76000) |
$467 |
$741 |
2.1× |
| Follow-Up Angiography (75898) |
$5,701 |
$9,034 |
1.9× |
| Foot 2 views (73620) |
$244 |
$387 |
3.0× |
| Forearm 2 views (73090) |
$213 |
$337 |
2.6× |
| Gastric emptying imaging study (78264) |
$1,838 |
$2,912 |
4.9× |
| Gated Heart, Multiple (78473) |
$1,190 |
$1,885 |
3.2× |
| Hand 2 views (73120) |
$292 |
$462 |
3.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,350 |
$2,139 |
2.7× |
| Hepatobiliary System Imaging (78226) |
$956 |
$1,515 |
2.6× |
| Ht Musc Image Planar Mult (78454) |
$1,310 |
$2,075 |
1.1× |
| Ht Muscle Image Spect Sing (78451) |
$1,455 |
$2,306 |
1.2× |
| Hysterosalpingogram (74740) |
$482 |
$763 |
2.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$315 |
$499 |
3.9× |
| K Flow/Funct Image Multiple (78709) |
$499 |
$790 |
1.0× |
| K Flow/Funct Image W/Drug (78708) |
$889 |
$1,409 |
1.8× |
| K Flow/Funct Image W/O Drug (78707) |
$828 |
$1,312 |
1.6× |
| Kidney Imaging Morphol (78700) |
$679 |
$1,075 |
1.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$679 |
$1,075 |
1.8× |
| Knee 3 Views (73562) |
$271 |
$430 |
3.3× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$920 |
$1,457 |
2.5× |
| Leveen/Shunt Patency Exam (78291) |
$679 |
$1,075 |
1.8× |
| Liver & Spleen Imaging Static Only (78215) |
$439 |
$695 |
1.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,326 |
$2,101 |
2.6× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,377 |
$2,183 |
2.7× |
| Lung Ventilation Imaging (78579) |
$689 |
$1,092 |
1.9× |
| Lymph System Imaging (78195) |
$956 |
$1,515 |
1.9× |
| Magnetic Image Jaw Joint (70336) |
$2,600 |
$4,120 |
11.7× |
| Meckels Divert Exam (78290) |
$956 |
$1,515 |
2.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,041 |
$4,819 |
9.4× |
| MRA head w/o contrast (70544) |
$1,947 |
$3,085 |
8.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,923 |
$3,047 |
5.9× |
| MRI abdomen w contrast (74182) |
$4,030 |
$6,386 |
12.4× |
| MRI abdomen w/o contrast (74181) |
$2,600 |
$4,120 |
11.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,470 |
$5,498 |
4.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,337 |
$6,872 |
13.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,760 |
$4,373 |
3.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,050 |
$3,249 |
9.2× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,977 |
$3,132 |
8.9× |
| MRI cervical spine w contrast (72142) |
$2,600 |
$4,120 |
8.0× |
| MRI cervical spine w/o cont (72141) |
$2,434 |
$3,857 |
11.0× |
| MRI chest w/o contrast (71550) |
$2,283 |
$3,617 |
10.3× |
| MRI chest wo w contrast (71552) |
$2,742 |
$4,345 |
8.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,557 |
$4,052 |
7.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,320 |
$3,676 |
10.5× |
| MRI lumbar spine w contrast (72149) |
$2,724 |
$4,317 |
8.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,160 |
$5,007 |
9.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,672 |
$2,649 |
7.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,612 |
$4,139 |
8.0× |
| MRI pelvis w/o & w contrast (72197) |
$2,800 |
$4,436 |
8.6× |
| MRI pelvis w/o contrast (72195) |
$2,213 |
$3,507 |
10.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,363 |
$3,744 |
10.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,760 |
$4,373 |
8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,600 |
$4,120 |
11.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,776 |
$4,398 |
8.6× |
| MRI, abdomen, combo (74183) |
$5,038 |
$7,983 |
15.5× |
| MRI, dorsal spine combo (72157) |
$2,541 |
$4,026 |
7.8× |
| MRI, dorsal spine contrast (72147) |
$2,452 |
$3,885 |
7.6× |
| MRI, joint upper extrem (73221) |
$2,600 |
$4,120 |
11.7× |
| MRI, joint upper extrem combo (73223) |
$2,776 |
$4,398 |
8.6× |
| MRI, lumbar spine combo (72158) |
$2,909 |
$4,610 |
9.0× |
| Myelogram Lumbar (72265) |
$885 |
$1,403 |
1.2× |
| Myelograpy 2/more regions rs&i (72270) |
$978 |
$1,550 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,517 |
$5,573 |
2.9× |
| Neck soft tissue (70360) |
$264 |
$418 |
3.3× |
| Nonvascular Shunt X-Ray (75809) |
$331 |
$524 |
3.4× |
| Nuclear Rx Oral Admin (79005) |
$466 |
$739 |
2.1× |
| Parathyroid Planar Imaging (78070) |
$976 |
$1,546 |
2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$679 |
$1,075 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$190 |
$302 |
2.0× |
| Pet Image W/Ct Lmtd (78814) |
$3,108 |
$4,924 |
2.3× |
| PET image w/CT, full body (78816) |
$3,726 |
$5,904 |
2.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,121 |
$7,291 |
3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$689 |
$1,092 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$297 |
$471 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$857 |
$1,358 |
1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$349 |
$553 |
4.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$207 |
$329 |
2.6× |
| Radex elbow complete minimum 3 views (73080) |
$271 |
$430 |
3.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$283 |
$448 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$213 |
$337 |
2.6× |
| Radex foot complete minimum 3 views (73630) |
$350 |
$554 |
4.3× |
| Radex Hand Minimum 3 Views (73130) |
$332 |
$525 |
4.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$244 |
$387 |
3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$257 |
$408 |
2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$261 |
$414 |
3.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$223 |
$353 |
2.8× |
| Radex shoulder complete minimum 2 views (73030) |
$348 |
$552 |
4.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$178 |
$282 |
2.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$771 |
$1,222 |
4.7× |
| Radex Spine 1 View Specify Level (72020) |
$190 |
$302 |
2.3× |
| Radex Sternum Minimum 2 Views (71120) |
$194 |
$308 |
2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$244 |
$387 |
3.0× |
| Radex Toe Minimum 2 Views (73660) |
$218 |
$345 |
2.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$244 |
$387 |
2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$264 |
$418 |
3.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$351 |
$556 |
3.6× |
| Radiologic exam colon double contrast study (74280) |
$302 |
$479 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$445 |
$705 |
2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$725 |
$1,149 |
4.4× |
| Radiologic exam knee complete 4/more views (73564) |
$297 |
$471 |
3.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$452 |
$716 |
4.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$499 |
$791 |
3.1× |
| Radiologic exam swallow function contrast study (74230) |
$363 |
$576 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$493 |
$781 |
3.0× |
| Radiologic examination femur minimum 2 views (73552) |
$207 |
$329 |
2.6× |
| Radiologic examination knee 1/2 views (73560) |
$206 |
$327 |
2.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$213 |
$337 |
2.6× |
| Ribs bilateral 3 views (71110) |
$271 |
$430 |
2.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,171 |
$1,856 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$679 |
$1,075 |
1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,171 |
$1,856 |
2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,340 |
$3,708 |
4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$718 |
$1,137 |
1.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,246 |
$3,560 |
1.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,246 |
$3,560 |
1.9× |
| Scapula (73010) |
$190 |
$302 |
2.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$77 |
$123 |
3.3× |
| Shoulder 1 view (73020) |
$172 |
$272 |
2.1× |
| Shoulder Arthrography (73040) |
$533 |
$845 |
1.6× |
| Sialogram (70390) |
$265 |
$420 |
1.2× |
| Skull less than 4 views (70250) |
$183 |
$289 |
1.9× |
| Sternoclavicular joints (71130) |
$163 |
$258 |
2.0× |
| Testicular Imaging W/Flow (78761) |
$679 |
$1,075 |
1.8× |
| Thoracic spine 2 views (72070) |
$90 |
$142 |
0.9× |
| Thoracic spine 3 views (72072) |
$311 |
$493 |
3.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$994 |
$1,575 |
2.7× |
| Thyroid Met Imaging Body (78018) |
$868 |
$1,375 |
1.7× |
| Thyroid Uptake Measurement (78012) |
$679 |
$1,075 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$900 |
$1,426 |
2.4× |
| Ultrasound Breast Limited (76642) |
$169 |
$268 |
2.1× |
| Ultrasound Exam Aaa Screen (76706) |
$179 |
$284 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$413 |
$655 |
4.2× |
| Unlisted us procedure (76999) |
$228 |
$361 |
2.8× |
| Upper gi w/o kub (74240) |
$426 |
$676 |
2.6× |
| Ureteral Reflux Study (78740) |
$679 |
$1,075 |
1.8× |
| Urethrocystogram voiding (74455) |
$458 |
$726 |
2.1× |
| Urethrocystography retrograde (74450) |
$248 |
$392 |
1.1× |
| Us breast unilateral complete (76641) |
$485 |
$768 |
5.0× |
| Us chest (76604) |
$203 |
$321 |
2.1× |
| Us complete joint (76881) |
$503 |
$797 |
5.2× |
| Us exam, pelvic, limited (76857) |
$254 |
$402 |
2.6× |
| Us head (76506) |
$419 |
$664 |
4.3× |
| Us kidney transplant (76776) |
$539 |
$854 |
5.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$203 |
$321 |
2.1× |
| Us ob detailed single fetus (76811) |
$1,029 |
$1,630 |
4.6× |
| Us ob limited 1 or more fetuses (76815) |
$282 |
$447 |
2.9× |
| Us ob transvaginal (76817) |
$455 |
$721 |
4.7× |
| Us pelvic non ob complete (76856) |
$588 |
$932 |
6.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$549 |
$869 |
5.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$400 |
$633 |
4.1× |
| Us retroperitoneal complete (76770) |
$731 |
$1,159 |
7.5× |
| Us scrotum and contents (76870) |
$573 |
$907 |
5.9× |
| Us spinal canal and contents (76800) |
$415 |
$658 |
4.3× |
| Us thyroid (76536) |
$539 |
$854 |
5.5× |
| Venography caval inferior serialography rs&i (75825) |
$5,342 |
$8,465 |
1.8× |
| Venography extremity bilateral rs&i (75822) |
$2,801 |
$4,438 |
1.9× |
| Venography extremity unilateral rs&i (75820) |
$2,857 |
$4,527 |
2.0× |
| Vertebral fracture assessment via dxa (77086) |
$146 |
$232 |
1.8× |
| Wrist 2 views (73100) |
$231 |
$367 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$267 |
$422 |
3.3× |
| X-ray antegrade pyelogram tube (74425) |
$320 |
$507 |
1.0× |
| X-Ray Aorta Leg Arteries (75630) |
$5,838 |
$9,251 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$190 |
$302 |
2.3× |
| X-Ray Exam Breast Specimen (76098) |
$613 |
$971 |
1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$109 |
$172 |
1.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$183 |
$289 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$237 |
$375 |
2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$325 |
$515 |
3.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$351 |
$556 |
3.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$264 |
$418 |
3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$365 |
$578 |
3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$223 |
$353 |
2.3× |
| X-ray humerus (73060) |
$203 |
$322 |
2.5× |
| X-ray IV pyelogram (ivp) (74400) |
$458 |
$726 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$192 |
$304 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$264 |
$418 |
2.7× |
| X-ray nose-rectum child f.b. (76010) |
$244 |
$387 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$343 |
$544 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$307 |
$487 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$251 |
$398 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$288 |
$456 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$330 |
$523 |
3.4× |
| X-Ray Stress View (77071) |
$158 |
$242 |
2.0× |
| X-Rays Bone Length Studies (77073) |
$413 |
$655 |
4.2× |
| X-Rays Bone Survey Complete (77075) |
$471 |
$747 |
4.8× |
| Xr c-spine 4 or 5 views (72050) |
$358 |
$567 |
3.7× |
| Xr facial bones less than 3 views (70140) |
$148 |
$235 |
1.8× |
| Xr orbits complete 4 views (70200) |
$244 |
$387 |
2.5× |