| Ankle 2 views (73600) |
$242.10 |
$269 |
2.6× |
| Brain imaging, positron emission tomography (PET); metabolic evaluation Age Under 21 (78608) |
$5,061.60 |
$5,624 |
3.4× |
| Clavicle complete (73000) |
$253.80 |
$282 |
2.8× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$2,583 |
$2,870 |
7.0× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$1,579.50 |
$1,755 |
8.5× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,326.60 |
$1,474 |
7.2× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,985.40 |
$2,206 |
10.7× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,638 |
$1,820 |
8.9× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,883.70 |
$2,093 |
10.2× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$1,326.60 |
$1,474 |
7.2× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,562.40 |
$1,736 |
8.4× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$1,557 |
$1,730 |
8.4× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,228.50 |
$1,365 |
11.1× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$1,375.20 |
$1,528 |
7.4× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$1,588.50 |
$1,765 |
8.6× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,274.40 |
$1,416 |
6.9× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,127.70 |
$1,253 |
10.2× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,117.80 |
$1,242 |
6.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$910.80 |
$1,012 |
8.3× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$1,097.10 |
$1,219 |
5.9× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,469.70 |
$1,633 |
7.9× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$1,776.60 |
$1,974 |
9.6× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$1,712.70 |
$1,903 |
9.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,459.70 |
$2,733 |
6.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,867.50 |
$2,075 |
7.4× |
| CT abdomen w & w/o contrast (74170) |
$1,503.90 |
$1,671 |
8.1× |
| CT abdomen w/contrast (74160) |
$1,326.60 |
$1,474 |
7.2× |
| CT abdomen w/o contrast (74150) |
$1,127.70 |
$1,253 |
10.2× |
| CT angio hrt w/3d image (75574) |
$1,326.60 |
$1,474 |
3.6× |
| CT cervical spine w/contrast (72126) |
$1,521 |
$1,690 |
4.1× |
| CT cervical spine w/o contrast (72125) |
$1,710 |
$1,900 |
15.5× |
| CT chest w/contrast (71260) |
$1,557 |
$1,730 |
8.4× |
| CT extremity upper w/o contrast (73200) |
$942.30 |
$1,047 |
8.5× |
| CT head/brain with contrast (70460) |
$1,297.80 |
$1,442 |
7.0× |
| CT head/brain without and with contrast (70470) |
$1,493.10 |
$1,659 |
8.1× |
| CT heart c+ cardiac strux&morph cgen hrt ds (75573) |
$559.80 |
$622 |
1.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$532.80 |
$592 |
1.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$135 |
$150 |
1.5× |
| CT l-spine w/contrast (72132) |
$1,297.80 |
$1,442 |
3.5× |
| CT lower extremity w/dye (73701) |
$1,317.60 |
$1,464 |
7.1× |
| CT lumbar spine w/o contrast (72131) |
$980.10 |
$1,089 |
8.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,717.20 |
$1,908 |
9.3× |
| CT neck w/contrast (70491) |
$1,376.10 |
$1,529 |
7.4× |
| CT neck w/o contrast (70490) |
$1,222.20 |
$1,358 |
11.1× |
| CT pelvis w & w/o contrast (72194) |
$1,576.80 |
$1,752 |
8.5× |
| CT pelvis w/o contrast (72192) |
$1,064.70 |
$1,183 |
9.7× |
| CT thoracic spine w/contrast (72129) |
$1,487.70 |
$1,653 |
8.0× |
| CT thoracic spine w/o contrast (72128) |
$1,096.20 |
$1,218 |
9.9× |
| CT thorax lung cancer scr c- (71271) |
$252 |
$280 |
2.3× |
| CT thorax w/o contrast (71250) |
$910.80 |
$1,012 |
8.3× |
| CT upper extremity w/dye (73201) |
$1,275.30 |
$1,417 |
3.5× |
| CTA head w contrast (70496) |
$1,883.70 |
$2,093 |
10.2× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$1,233.90 |
$1,371 |
3.4× |
| Doppler fetal mid cerebral artery (76821) |
$275.40 |
$306 |
2.5× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$329.40 |
$366 |
3.0× |
| Dxa bone density/peripheral (77081) |
$210.60 |
$234 |
2.3× |
| Fetal biophys profile w/o nst (76819) |
$401.40 |
$446 |
3.6× |
| Fetal biophysical profile non-stress testing (76818) |
$498.60 |
$554 |
4.5× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$738.90 |
$821 |
2.9× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,314 |
$1,460 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$966.60 |
$1,074 |
2.3× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,532.70 |
$1,703 |
2.7× |
| Liver and spleen imaging (78215) |
$1,262.70 |
$1,403 |
3.0× |
| Lung perfusion imaging (78580) |
$1,224.90 |
$1,361 |
2.9× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$2,471.40 |
$2,746 |
6.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,360.80 |
$1,512 |
3.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$940.50 |
$1,045 |
3.7× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$1,565.10 |
$1,739 |
4.3× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$1,360.80 |
$1,512 |
3.7× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$940.50 |
$1,045 |
3.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$1,293.30 |
$1,437 |
3.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,565.10 |
$1,739 |
4.3× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$1,565.10 |
$1,739 |
4.3× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,565.10 |
$1,739 |
4.3× |
| Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation Age Under 21 (77054) |
$666 |
$740 |
2.6× |
| Mandible min 4v (70110) |
$328.50 |
$365 |
3.0× |
| MRA head w/o contrast (70544) |
$940.50 |
$1,045 |
3.7× |
| MRA neck w/ contrast (70548) |
$1,544.40 |
$1,716 |
4.2× |
| MRA neck w/o contrast (70547) |
$1,401.30 |
$1,557 |
5.6× |
| MRI abdomen w/contrast (74182) |
$1,536.30 |
$1,707 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$940.50 |
$1,045 |
3.7× |
| MRI abdomen w/wo contrast (74183) |
$1,565.10 |
$1,739 |
4.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,565.10 |
$1,739 |
1.9× |
| MRI breast c- bilateral (77047) |
$1,777.50 |
$1,975 |
7.1× |
| MRI c-spine w&w/o cont (72156) |
$1,565.10 |
$1,739 |
4.3× |
| MRI cervical spine w/contrast (72142) |
$1,533.60 |
$1,704 |
4.2× |
| MRI chest w/o contrast (71550) |
$1,149.30 |
$1,277 |
4.6× |
| MRI chest w/wo contrast (71552) |
$1,565.10 |
$1,739 |
4.3× |
| MRI joint upr extr w/o&w/dye (73223) |
$1,536.30 |
$1,707 |
4.2× |
| MRI joint upr extrem w/dye (73222) |
$1,271.70 |
$1,413 |
1.5× |
| MRI joint upr extrem w/o dye (73221) |
$925.20 |
$1,028 |
3.7× |
| MRI lumbar spine w/contrast (72149) |
$1,533.60 |
$1,704 |
4.2× |
| MRI lumbar spine w/wo contrast (72158) |
$1,565.10 |
$1,739 |
4.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,565.10 |
$1,739 |
4.3× |
| MRI pelvis w & w/o contrast (72197) |
$1,565.10 |
$1,739 |
4.3× |
| MRI pelvis w/contrast (72196) |
$1,246.50 |
$1,385 |
3.4× |
| MRI pelvis w/o contrast (72195) |
$940.50 |
$1,045 |
3.7× |
| MRI spine cervical w/o contrast (72141) |
$940.50 |
$1,045 |
3.7× |
| MRI t-spine w&w/o cont (72157) |
$1,565.10 |
$1,739 |
4.3× |
| MRI thoracic spine w/contrast (72147) |
$1,533.60 |
$1,704 |
4.2× |
| MRI thoracic spine w/o contrst (72146) |
$940.50 |
$1,045 |
3.7× |
| MRI tmj (70336) |
$788.40 |
$876 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$940.50 |
$1,045 |
3.7× |
| Myocardial spect multiple studies (78452) |
$3,581.10 |
$3,979 |
2.6× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$2,747.70 |
$3,053 |
3.0× |
| Nm bone 3 phase (78315) |
$1,844.10 |
$2,049 |
4.4× |
| Nm bone imaging whole body (78306) |
$1,656 |
$1,840 |
3.9× |
| Nm gastric emptying (78264) |
$1,595.70 |
$1,773 |
3.8× |
| Nm lymph system (78195) |
$2,035.80 |
$2,262 |
3.6× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,125.90 |
$1,251 |
2.7× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$1,538.10 |
$1,709 |
3.6× |
| Ob us limited fetus(s) (76815) |
$325.80 |
$362 |
3.0× |
| Ob us nuchal meas 1 gest (76813) |
$404.10 |
$449 |
3.7× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$325.80 |
$362 |
3.0× |
| Parathyrd planar w/spect&CT (78072) |
$1,512.90 |
$1,681 |
2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,071.90 |
$1,191 |
2.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,068.60 |
$7,854 |
4.7× |
| PET imaging for CT attenuation whole body (78816) |
$7,140.60 |
$7,934 |
4.7× |
| Pulmonary ventilation & perfusion imaging (78582) |
$2,126.70 |
$2,363 |
3.7× |
| Quant differential pulm perfusion w/wo imaging (78597) |
$1,182.60 |
$1,314 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$263.70 |
$293 |
2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$357.30 |
$397 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$379.80 |
$422 |
3.4× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$398.70 |
$443 |
3.6× |
| Radex hip unilateral with pelvis 1 view (73501) |
$210.60 |
$234 |
2.3× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$296.10 |
$329 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$326.70 |
$363 |
3.0× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$394.20 |
$438 |
3.6× |
| Radex spine cervical 2 or 3 views (72040) |
$322.20 |
$358 |
3.5× |
| Radex spine cervical 4 or 5 views (72050) |
$388.80 |
$432 |
3.5× |
| Radex spine cervical 6 or more views (72052) |
$513.90 |
$571 |
4.7× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$259.20 |
$288 |
2.8× |
| Radiologic exam chest 3 views (71047) |
$309.60 |
$344 |
3.4× |
| Radiologic exam chest 4+ views (71048) |
$331.20 |
$368 |
3.0× |
| Radiologic exam colon double contrast study (74280) |
$738.90 |
$821 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$647.10 |
$719 |
3.5× |
| Radiologic exam esophagus single contrast study (74220) |
$431.10 |
$479 |
2.3× |
| Radiologic exam small int single contrast study (74250) |
$536.40 |
$596 |
2.9× |
| Radiologic exam swallow function contrast study (74230) |
$532.80 |
$592 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$668.70 |
$743 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$532.80 |
$592 |
2.9× |
| Radiologic examination femur 1 view (73551) |
$242.10 |
$269 |
2.6× |
| Radiologic examination femur minimum 2 views (73552) |
$333.90 |
$371 |
3.6× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$252 |
$280 |
2.7× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$256.50 |
$285 |
2.8× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$470.70 |
$523 |
4.3× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$242.10 |
$269 |
2.6× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$276.30 |
$307 |
3.0× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$333 |
$370 |
3.6× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$279.90 |
$311 |
3.0× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$269.10 |
$299 |
2.9× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$259.20 |
$288 |
2.8× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$337.50 |
$375 |
3.1× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$210.60 |
$234 |
2.3× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$302.40 |
$336 |
3.3× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$418.50 |
$465 |
3.8× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$346.50 |
$385 |
3.1× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$292.50 |
$325 |
2.7× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$671.40 |
$746 |
1.8× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$337.50 |
$375 |
3.7× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$242.10 |
$269 |
2.6× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$260.10 |
$289 |
2.4× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$359.10 |
$399 |
3.3× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$414 |
$460 |
3.8× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$382.50 |
$425 |
3.5× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$498.60 |
$554 |
4.5× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$242.10 |
$269 |
2.6× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$290.70 |
$323 |
3.2× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$276.30 |
$307 |
3.0× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$210.60 |
$234 |
2.3× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$351.90 |
$391 |
3.2× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$264.60 |
$294 |
2.9× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$242.10 |
$269 |
2.6× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$332.10 |
$369 |
3.0× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$2,578.50 |
$2,865 |
4.5× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$513 |
$570 |
2.0× |
| Rp loclzj tum spect w/CT 1 (78830) |
$3,402 |
$3,780 |
2.5× |
| Scapula complete (73010) |
$295.20 |
$328 |
2.7× |
| Screening digital breast tomosynthesis bi (77063) |
$54.90 |
$61 |
— |
| Thyroid imaging with vascular flow (78013) |
$897.30 |
$997 |
2.1× |
| Thyroid met imaging body (78018) |
$1,532.70 |
$1,703 |
2.7× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$937.80 |
$1,042 |
2.2× |
| Ultrasound breast limited (76642) |
$206.10 |
$229 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$507.60 |
$564 |
4.6× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$359.10 |
$399 |
3.3× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$513 |
$570 |
4.7× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$776.70 |
$863 |
3.1× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$325.80 |
$362 |
3.0× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$948.60 |
$1,054 |
8.6× |
| Umbilical-artery Doppler (OB) (76820) |
$239.40 |
$266 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$690.30 |
$767 |
2.7× |
| Urography antegrade rs&i (74425) |
$1,153.80 |
$1,282 |
3.1× |
| Us abdominal aorta real time screen study aaa (76706) |
$513 |
$570 |
4.7× |
| Us breast uni real time with image complete (76641) |
$209.70 |
$233 |
1.9× |
| Us chest (76604) |
$507.60 |
$564 |
4.6× |
| Us compl joint r-t w/image documentation (76881) |
$445.50 |
$495 |
4.0× |
| Us elastography organ (76981) |
$288.90 |
$321 |
2.6× |
| Us encephalogram (76506) |
$513 |
$570 |
4.7× |
| Us exam, pelvic, limited (76857) |
$325.80 |
$362 |
3.0× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$513 |
$570 |
5.6× |
| US OB Follow-Up/Repeat (76816) |
$318.60 |
$354 |
2.9× |
| Us ob transvaginal (76817) |
$325.80 |
$362 |
3.0× |
| Us retroperitoneal complete (76770) |
$496.80 |
$552 |
4.5× |
| Us retroperitoneal ltd (76775) |
$445.50 |
$495 |
4.0× |
| Us scrotum (76870) |
$513 |
$570 |
4.7× |
| Us soft tissue head/neck (76536) |
$513 |
$570 |
4.7× |
| Us spinal canal (76800) |
$513 |
$570 |
4.7× |
| Us unlstd proc (76999) |
$210.47 |
$233.85 |
2.3× |
| Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) |
$179.20 |
$199.11 |
2.0× |
| Vertebral fracture assessment via dxa (77086) |
$225.90 |
$251 |
2.5× |
| X-ray exam hips bi 3-4 views (73522) |
$344.70 |
$383 |
3.1× |
| X-ray exam of finger(s) (73140) |
$242.10 |
$269 |
2.6× |
| X-ray exam of knee 1 or 2 (73560) |
$243.90 |
$271 |
2.7× |
| X-ray exam ribs bil 3 views (71110) |
$384.30 |
$427 |
3.5× |
| X-ray exam ribs uni 2 views (71100) |
$265.50 |
$295 |
2.9× |
| X-ray heel (73650) |
$242.10 |
$269 |
2.6× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$342.90 |
$381 |
3.1× |
| Xr abdomen 1 view (74018) |
$252.90 |
$281 |
2.8× |
| Xr abdomen 2 views (74019) |
$450.90 |
$501 |
4.1× |
| Xr arthrogram wrist (73115) |
$375.30 |
$417 |
1.0× |
| Xr bone age studies (77072) |
$283.50 |
$315 |
2.6× |
| Xr chest 1 view (71045) |
$273.60 |
$304 |
3.0× |
| Xr chest 2 views (71046) |
$294.30 |
$327 |
3.2× |
| Xr eye foreign body (70030) |
$347.40 |
$386 |
3.8× |
| Xr facial bones 3+ views (70150) |
$364.50 |
$405 |
3.3× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$242.10 |
$269 |
2.6× |
| Xr forearm 2 views (73090) |
$276.30 |
$307 |
3.0× |
| Xr hand 2v (73120) |
$230.40 |
$256 |
2.1× |
| Xr hysterosalpingogram (74740) |
$527.40 |
$586 |
2.1× |
| Xr neck soft tissue (70360) |
$248.40 |
$276 |
2.7× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$332.10 |
$369 |
3.6× |
| Xr osseous survey complete (77075) |
$627.30 |
$697 |
5.7× |
| Xr pelvis 1-2 views (72170) |
$324.90 |
$361 |
2.9× |
| Xr pelvis min 3 view (72190) |
$335.70 |
$373 |
3.0× |
| Xr sacrum/coccyx 2+ views (72220) |
$306 |
$340 |
3.3× |
| Xr shoulder 1 view (73020) |
$228.60 |
$254 |
2.5× |
| Xr sinuses 3+ views (70220) |
$252 |
$280 |
2.7× |
| Xr skull min 4 view (70260) |
$427.50 |
$475 |
3.9× |
| Xr spine 1 view (72020) |
$242.10 |
$269 |
2.6× |
| Xr spine thoracic 3v (72072) |
$433.80 |
$482 |
3.9× |
| Xr sternum 2+ views (71120) |
$247.50 |
$275 |
2.7× |
| Xr surgical specimen (76098) |
$991.80 |
$1,102 |
1.7× |
| Xr t-spine 2 views (72070) |
$352.80 |
$392 |
3.2× |
| Xr tibia/fibula 2 views (73590) |
$288.90 |
$321 |
3.1× |
| Xr tmj bilateral (70330) |
$231.30 |
$257 |
2.5× |
| Xr tmj unilateral (70328) |
$220.50 |
$245 |
2.4× |
| Xr wrist 2 views (73100) |
$221.40 |
$246 |
2.4× |