| Abdomen 2 views (74019) |
$120.68 |
$120.68 |
1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$458 |
$458 |
0.2× |
| Angiography extremity bilateral rs&i (75716) |
$471 |
$471 |
0.2× |
| Angiography extremity unilateral rs&i (75710) |
$395 |
$395 |
0.1× |
| Angiography internal mammary rs&i (75756) |
$411 |
$411 |
0.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$389 |
$389 |
0.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$428 |
$428 |
0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$368 |
$368 |
0.1× |
| Angiography Spinal Selective Rs&I (75705) |
$565 |
$565 |
0.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$369 |
$369 |
0.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$203 |
$203 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$380 |
$380 |
0.1× |
| Ankle 2 views (73600) |
$65 |
$65 |
0.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$43 |
$43 |
0.1× |
| Aortogram thoracic (75605) |
$344 |
$344 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$417 |
$417 |
0.2× |
| Aortography abdominal serialography rs&i (75625) |
$343 |
$343 |
0.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$464 |
$464 |
0.2× |
| Artery X-Rays Adrenal Gland (75731) |
$409 |
$409 |
0.2× |
| Arthrogram elbow (73085) |
$231 |
$231 |
0.8× |
| Arthrogram hip (73525) |
$255 |
$255 |
0.8× |
| Arthrogram shoulder (73040) |
$238 |
$238 |
0.8× |
| Arthrogram wrist (73115) |
$251 |
$251 |
0.8× |
| Arthrography knee lt (73580) |
$285 |
$285 |
0.9× |
| Bone age studies (77072) |
$112.36 |
$112.36 |
1.2× |
| Bone survey complete (77075) |
$267 |
$267 |
3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$975 |
$975 |
3.2× |
| Cervical spine 2 or 3 views (72040) |
$82 |
$82 |
1.1× |
| Chest 1 view (71045) |
$84.55 |
$84.55 |
1.1× |
| Chest 3 views (71047) |
$123.02 |
$123.02 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$209 |
$209 |
1.4× |
| Cineradiography/videoradiography (76120) |
$208 |
$208 |
2.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$348 |
$348 |
0.5× |
| Clavicle complete (73000) |
$66 |
$66 |
0.9× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$178 |
$178 |
1.2× |
| Corpora cavernosography (74445) |
$138 |
$138 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,215.50 |
$2,215.50 |
7.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,037 |
$2,037 |
9.9× |
| CT abdomen w contrast (74160) |
$953.69 |
$953.69 |
6.3× |
| CT abdomen w wo contrast (74170) |
$1,136.82 |
$1,136.82 |
7.5× |
| CT abdomen w/o contrast (74150) |
$915 |
$915 |
10.2× |
| CT angio hrt w/3d image (75574) |
$944 |
$944 |
3.1× |
| CT c-spine w/o contrast (72125) |
$909.46 |
$909.46 |
10.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,142.32 |
$1,142.32 |
7.6× |
| CT cervical spine with contrast (72126) |
$961.19 |
$961.19 |
3.2× |
| CT chest w/wo contrast (71270) |
$1,135.82 |
$1,135.82 |
7.5× |
| CT chest with contrast (71260) |
$951.69 |
$951.69 |
6.3× |
| CT colonography w/dye (74262) |
$1,181 |
$1,181 |
7.8× |
| CT colonography w/o cntrst (74261) |
$1,077 |
$1,077 |
11.9× |
| CT head/brain with contrast (70460) |
$955.19 |
$955.19 |
6.3× |
| CT head/brain without and with contrast (70470) |
$984.50 |
$984.50 |
6.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$648 |
$648 |
2.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$237 |
$237 |
3.2× |
| CT hrt w/3d image congen (75573) |
$892 |
$892 |
3.0× |
| CT iac w contrast (70481) |
$795.55 |
$795.55 |
5.3× |
| CT lower ext w/o (73700) |
$1,217 |
$1,217 |
13.5× |
| CT lower extremity with contrast (73701) |
$736.50 |
$736.50 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$943.19 |
$943.19 |
10.5× |
| CT maxillofacial w contrast (70487) |
$870.50 |
$870.50 |
5.8× |
| CT maxillofacial w/o contrast (70486) |
$845 |
$845 |
9.4× |
| CT neck soft tissue w contrast (70491) |
$939.50 |
$939.50 |
6.2× |
| CT orbits w/o contrast (70480) |
$648.64 |
$648.64 |
7.2× |
| CT pelvis w & w/o contrast (72194) |
$1,137.32 |
$1,137.32 |
7.5× |
| CT pelvis w/o contrast (72192) |
$909 |
$909 |
10.1× |
| CT soft tissue neck w/o contrast (70490) |
$764.50 |
$764.50 |
8.5× |
| CT thoracic spine w/o contrast (72128) |
$943.19 |
$943.19 |
10.5× |
| CT thorax w/o contrast (71250) |
$913.50 |
$913.50 |
10.1× |
| CT upper extremity w/o contrast rt (73200) |
$121 |
$121 |
1.3× |
| CT upper extremity with contrast (73201) |
$736.50 |
$736.50 |
2.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$603 |
$603 |
4.0× |
| Cta Abdomen (74175) |
$1,056 |
$1,056 |
7.0× |
| CTA abdomen pelvis (74174) |
$769.50 |
$769.50 |
2.6× |
| CTA chest (71275) |
$1,014 |
$1,014 |
6.7× |
| Cta Head (70496) |
$1,052 |
$1,052 |
7.0× |
| Cta Neck (70498) |
$821.05 |
$821.05 |
5.4× |
| Cta Pelvis (72191) |
$638 |
$638 |
4.2× |
| Cystography minimum 3 views rs&i (74430) |
$94 |
$94 |
0.3× |
| Dacryocystography (70170) |
$37 |
$37 |
0.2× |
| Diskography lumbar (72295) |
$228 |
$228 |
0.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$247.23 |
$247.23 |
2.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$209.51 |
$209.51 |
2.8× |
| Esophagus (74220) |
$211.37 |
$211.37 |
1.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$153.48 |
$153.48 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$113 |
$113 |
0.5× |
| Foot 2 views (73620) |
$62 |
$62 |
0.8× |
| Forearm 2 views (73090) |
$64 |
$64 |
0.9× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$119 |
$119 |
0.6× |
| Hand 2 views (73120) |
$63 |
$63 |
0.7× |
| Hand 3 views (73130) |
$75 |
$75 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$354 |
$354 |
0.1× |
| Humerus Min 2 Views Left (73060) |
$66 |
$66 |
0.9× |
| Hysterosalpingogram (74740) |
$175 |
$175 |
0.9× |
| Knee 3 views (73562) |
$84 |
$84 |
1.1× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$144 |
$144 |
0.1× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$105 |
$105 |
0.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$144 |
$144 |
0.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$100 |
$100 |
0.0× |
| Mammary ductogram or galactogram multiple (77054) |
$181 |
$181 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$134 |
$134 |
0.7× |
| MRA head w & w/o contrast (70546) |
$2,418.50 |
$2,418.50 |
8.0× |
| MRA head w/o contrast (70544) |
$1,468.50 |
$1,468.50 |
7.1× |
| MRA head with contrast (70545) |
$1,881 |
$1,881 |
6.3× |
| MRA neck w contrast (70548) |
$1,881 |
$1,881 |
6.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,418.50 |
$2,418.50 |
8.0× |
| MRA neck w/o contrast (70547) |
$1,469 |
$1,469 |
7.1× |
| MRI abdomen w contrast (74182) |
$1,912 |
$1,912 |
6.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,426.50 |
$2,426.50 |
8.1× |
| MRI abdomen w/o contrast (74181) |
$1,490 |
$1,490 |
7.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,892.50 |
$1,892.50 |
2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,892 |
$1,892 |
2.8× |
| MRI c-spine with contrast (72142) |
$1,927 |
$1,927 |
6.4× |
| MRI cardiac w/o cont stress (75559) |
$1,004 |
$1,004 |
2.1× |
| MRI cardiac w/o contrast (75557) |
$744 |
$744 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$1,489 |
$1,489 |
7.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,445.50 |
$2,445.50 |
8.1× |
| MRI chest w/o contrast (71550) |
$1,503.50 |
$1,503.50 |
7.3× |
| MRI chest with contrast (71551) |
$1,912 |
$1,912 |
2.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,879 |
$1,879 |
6.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,904.50 |
$1,904.50 |
6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,476.50 |
$1,476.50 |
7.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,492.50 |
$1,492.50 |
7.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,421.50 |
$2,421.50 |
8.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,904.50 |
$1,904.50 |
6.3× |
| MRI pelvis w contrast (72196) |
$1,914 |
$1,914 |
6.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,426.50 |
$2,426.50 |
8.1× |
| MRI pelvis w/o contrast (72195) |
$1,483 |
$1,483 |
7.2× |
| MRI scan of arm joint before and after contrast (73223) |
$2,456 |
$2,456 |
8.2× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,149 |
$1,149 |
1.7× |
| MRI scan of leg joint before and after contrast (73723) |
$4,600 |
$4,600 |
15.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,480 |
$2,480 |
8.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,718.50 |
$1,718.50 |
5.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,471.50 |
$2,471.50 |
8.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,926 |
$1,926 |
6.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,428.50 |
$2,428.50 |
8.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,489 |
$1,489 |
7.2× |
| MRI tmj (70336) |
$725 |
$725 |
3.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,478 |
$1,478 |
7.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,422 |
$2,422 |
8.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,476.50 |
$1,476.50 |
7.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,927.42 |
$1,927.42 |
1.7× |
| Neck soft tissue (70360) |
$66 |
$66 |
0.9× |
| Orthopantogram (70355) |
$48 |
$48 |
0.6× |
| Osseous survey infant (77076) |
$267 |
$267 |
3.0× |
| Osseous survey limited (77074) |
$318.12 |
$318.12 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$71.50 |
$71.50 |
0.8× |
| Perineogram (74775) |
$76 |
$76 |
0.4× |
| Peritoneogram rs&i (74190) |
$58 |
$58 |
0.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,421.50 |
$2,421.50 |
8.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$386 |
$386 |
0.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$384 |
$384 |
0.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$139 |
$139 |
0.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$493.19 |
$493.19 |
5.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$173.84 |
$173.84 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$132 |
$132 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$91 |
$91 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$112.36 |
$112.36 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$114.86 |
$114.86 |
1.5× |
| Radiologic exam colon single contrast study (74270) |
$354.64 |
$354.64 |
2.3× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$86 |
$86 |
0.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$293 |
$293 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$262 |
$262 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$110.86 |
$110.86 |
1.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$86 |
$86 |
1.1× |
| Radiological examination surgical specimen (76098) |
$43 |
$43 |
0.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$367 |
$367 |
0.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$352 |
$352 |
0.1× |
| Ribs bilateral 3 views (71110) |
$77 |
$77 |
0.9× |
| Sacroiliac Joints < 3 Views (72200) |
$100.39 |
$100.39 |
1.1× |
| Scapula complete (73010) |
$73 |
$73 |
0.8× |
| Sella turcica (70240) |
$70 |
$70 |
0.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$249 |
$249 |
2.8× |
| Sialogram (70390) |
$227 |
$227 |
1.1× |
| Small bowel series (74250) |
$298.64 |
$298.64 |
2.0× |
| Speech evaluation complex (70371) |
$213 |
$213 |
1.0× |
| Spine thoracic 3 views (72072) |
$85 |
$85 |
0.9× |
| Splenoportograpy rs&i (75810) |
$141 |
$141 |
0.1× |
| Superior sagittal sinus venogram (75870) |
$356 |
$356 |
0.1× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$189 |
$189 |
0.9× |
| Therapeutic Enema (74283) |
$473 |
$473 |
3.1× |
| Thoracolumbar 2 views (72080) |
$83 |
$83 |
1.1× |
| Tmj unilateral (70328) |
$72 |
$72 |
1.0× |
| Tomogram (76100) |
$228 |
$228 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$274 |
$274 |
3.0× |
| Upper Extremity Infant (73092) |
$111.50 |
$111.50 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$41 |
$41 |
0.2× |
| Urethrocystography voiding (74455) |
$544.80 |
$544.80 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$578.80 |
$578.80 |
3.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$311 |
$311 |
2.1× |
| Us breast unilateral complete (76641) |
$142.50 |
$142.50 |
1.6× |
| Us breast unilateral limited (76642) |
$213 |
$213 |
2.8× |
| Us chest (76604) |
$271.50 |
$271.50 |
3.0× |
| Us ob transvaginal (76817) |
$286.50 |
$286.50 |
3.2× |
| Us pelvic non ob complete (76856) |
$280.50 |
$280.50 |
3.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$260.25 |
$260.25 |
2.9× |
| Us pregnancy ltd (76815) |
$183.91 |
$183.91 |
2.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$293.50 |
$293.50 |
3.3× |
| Us retroperitoneal complete (76770) |
$333.08 |
$333.08 |
3.7× |
| Us retroperitoneal limited (76775) |
$162.12 |
$162.12 |
1.8× |
| Us scrotum and contents (76870) |
$277.50 |
$277.50 |
3.1× |
| Us soft tissue head/neck (76536) |
$272.50 |
$272.50 |
3.0× |
| Us xtr non-vasc lmtd (76882) |
$183 |
$183 |
2.0× |
| Vasogram (74440) |
$185 |
$185 |
0.9× |
| Venogram extremity bilateral (75822) |
$352 |
$352 |
0.3× |
| Venogram orbital (75880) |
$304 |
$304 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$332 |
$332 |
0.1× |
| Venography caval superior serialography rs&i (75827) |
$336 |
$336 |
0.2× |
| Venography epidural rs&i (75872) |
$342 |
$342 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$280 |
$280 |
0.2× |
| Venography Renal Bilateral (75833) |
$409 |
$409 |
0.2× |
| Venography renal unilateral selective rs&i (75831) |
$355 |
$355 |
0.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$348 |
$348 |
0.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$283 |
$283 |
0.1× |
| Wrist 2 views (73100) |
$115 |
$115 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$189.50 |
$189.50 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$90 |
$90 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$159 |
$159 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$460.86 |
$460.86 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$111.50 |
$111.50 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$76 |
$76 |
1.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$269.45 |
$269.45 |
3.0× |
| X-ray exam hip uni 1 view (73501) |
$110.86 |
$110.86 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$114.86 |
$114.86 |
1.5× |
| X-ray exam hip uni 4/> views (73503) |
$118.36 |
$118.36 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$178.34 |
$178.34 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$179.34 |
$179.34 |
2.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$924 |
$924 |
6.1× |
| X-ray eye for foreign body (70030) |
$67 |
$67 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$97 |
$97 |
1.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$69 |
$69 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$71 |
$71 |
0.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$218 |
$218 |
0.1× |
| X-ray head for orthodontia (70350) |
$49 |
$49 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$64 |
$64 |
0.9× |
| X-ray IV pyelogram+drip infusn (74410) |
$251 |
$251 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$79 |
$79 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$128.50 |
$128.50 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$119.50 |
$119.50 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$64 |
$64 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$82 |
$82 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$146 |
$146 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$92 |
$92 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$77 |
$77 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$62 |
$62 |
0.8× |
| X-ray of voice box or throat (70370) |
$181 |
$181 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$100 |
$100 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$97 |
$97 |
1.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$65 |
$65 |
0.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$44 |
$44 |
0.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$177.06 |
$177.06 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$267 |
$267 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$135.62 |
$135.62 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$110.86 |
$110.86 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$70 |
$70 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$72 |
$72 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$70 |
$70 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$109 |
$109 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$63.50 |
$63.50 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$53 |
$53 |
0.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$247.23 |
$247.23 |
3.3× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$34 |
$34 |
0.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$77 |
$77 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$101 |
$101 |
1.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$69 |
$69 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$85 |
$85 |
1.1× |
| Xr arthrogram ankle (73615) |
$233 |
$233 |
0.8× |
| Xr c-spine 6 or more views (72052) |
$142 |
$142 |
1.6× |
| Xr Cholecystography Oral Contrast (74290) |
$158 |
$158 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$75 |
$75 |
1.0× |
| Xr internal auditory meati complete (70134) |
$126 |
$126 |
0.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$82 |
$82 |
0.9× |
| Xr myelogram posterior fossa (70010) |
$154 |
$154 |
0.5× |
| Xr optic foramina (70190) |
$83 |
$83 |
1.1× |
| Xr shoulder 1 view (73020) |
$106.50 |
$106.50 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$214.58 |
$214.58 |
2.4× |
| Xr tibia/fibula 2 views (73590) |
$63 |
$63 |
0.8× |
| Xr tmj bilateral (70330) |
$111 |
$111 |
1.5× |
| Xray knee 1 or 2 views rt (73560) |
$114.50 |
$114.50 |
1.5× |