| Abdomen 1 View (74018) |
$255.60 |
$426 |
2.9× |
| Abdomen 2 views (74019) |
$330 |
$550 |
3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$796.80 |
$1,328 |
2.0× |
| Angio pulmonary bilat (75743) |
$4,053 |
$6,755 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$3,856.20 |
$6,427 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,856.20 |
$6,427 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,744.80 |
$2,908 |
0.5× |
| Ankle 2 views (73600) |
$267 |
$445 |
3.0× |
| Aortography thoracic serialography rs&i (75605) |
$8,047.20 |
$13,412 |
1.4× |
| Artery X-Rays Abdomen (75726) |
$7,081.20 |
$11,802 |
1.3× |
| Artery X-Rays Pelvis (75736) |
$8,218.80 |
$13,698 |
1.5× |
| Arthrogram ankle (73615) |
$802.80 |
$1,338 |
2.3× |
| Arthrogram hip (73525) |
$646.80 |
$1,078 |
1.8× |
| Arthrogram Wrist (73115) |
$807 |
$1,345 |
2.3× |
| Bone age studies (77072) |
$207.60 |
$346 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,498.20 |
$2,497 |
3.7× |
| Bone Imaging Limited Area (78300) |
$1,070.40 |
$1,784 |
2.6× |
| Bone Imaging Whole Body (78306) |
$1,581.60 |
$2,636 |
3.9× |
| Bone marrow imaging limited area (78102) |
$1,118.40 |
$1,864 |
2.8× |
| Bone survey infant (77076) |
$183.60 |
$306 |
1.7× |
| Brain Image W/Flow < 4 Views (78601) |
$814.20 |
$1,357 |
2.0× |
| Cat Scan Follow-Up Study (76380) |
$953.40 |
$1,589 |
10.8× |
| Chest 1 view (71045) |
$160.80 |
$268 |
1.8× |
| Chest 2 views (71046) |
$224.40 |
$374 |
2.5× |
| Chest 3 views (71047) |
$252 |
$420 |
2.9× |
| Chest 4 or more views (71048) |
$199.20 |
$332 |
1.9× |
| Clavicle complete (73000) |
$255 |
$425 |
2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,621.20 |
$2,702 |
15.3× |
| Contrast Exam Abdominl Aorta (75625) |
$4,434.60 |
$7,391 |
1.4× |
| Contrast X-Ray Bladder (74430) |
$452.40 |
$754 |
1.3× |
| Contrast X-Ray Of Elbow (73085) |
$718.80 |
$1,198 |
2.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$802.80 |
$1,338 |
2.3× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$358.80 |
$598 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,449 |
$7,415 |
12.6× |
| CT abdomen and pelvis without contrast (74176) |
$3,213 |
$5,355 |
13.3× |
| CT abdomen w contrast (74160) |
$1,904.40 |
$3,174 |
10.7× |
| CT abdomen w wo contrast (74170) |
$2,254.80 |
$3,758 |
12.7× |
| CT abdomen w/o contrast (74150) |
$1,496.40 |
$2,494 |
14.1× |
| CT Angio Abdomen and Pelvis (74174) |
$4,416.60 |
$7,361 |
12.5× |
| CT Angio Chest (71275) |
$2,324.40 |
$3,874 |
13.1× |
| CT Angio Head (70496) |
$2,512.80 |
$4,188 |
14.1× |
| CT angio hrt w/3d image (75574) |
$2,485.20 |
$4,142 |
7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,956.20 |
$4,927 |
16.6× |
| CT Angio Neck (70498) |
$2,382.60 |
$3,971 |
13.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,879.40 |
$4,799 |
16.2× |
| CT cervical spine w/ contrast (72126) |
$2,170.80 |
$3,618 |
6.1× |
| CT cervical spine w/o contrast (72125) |
$1,723.20 |
$2,872 |
16.3× |
| CT cervical spine w/wo cont (72127) |
$2,222.40 |
$3,704 |
12.5× |
| CT chest w contrast (71260) |
$1,755 |
$2,925 |
9.9× |
| CT chest w/wo contrast (71270) |
$2,064 |
$3,440 |
11.6× |
| CT head/brain with contrast (70460) |
$1,600.80 |
$2,668 |
9.0× |
| CT head/brain without and with contrast (70470) |
$1,958.40 |
$3,264 |
11.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$148.80 |
$248 |
1.7× |
| CT iac w contrast (70481) |
$1,765.20 |
$2,942 |
9.9× |
| CT l-spine w&w/o contrast (72133) |
$2,233.80 |
$3,723 |
12.6× |
| CT lower ext w/o (73700) |
$1,506.60 |
$2,511 |
14.2× |
| CT lower extremity w/contrast material (73701) |
$1,938.60 |
$3,231 |
10.9× |
| CT lumbar spine w contrast (72132) |
$1,913.40 |
$3,189 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$1,573.20 |
$2,622 |
14.9× |
| CT maxillofacial w contrast (70487) |
$1,857.60 |
$3,096 |
10.5× |
| CT maxillofacial wo contrast (70486) |
$1,521.60 |
$2,536 |
14.4× |
| CT neck tissue combo (70492) |
$2,107.20 |
$3,512 |
11.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,969.20 |
$3,282 |
11.1× |
| CT orbits w/o contrast (70480) |
$1,470 |
$2,450 |
13.9× |
| CT pelvis w&w/o contrast (72194) |
$1,842.60 |
$3,071 |
10.4× |
| CT pelvis w/o contrast (72192) |
$1,375.20 |
$2,292 |
13.0× |
| CT scan of leg combo (73702) |
$2,541 |
$4,235 |
14.3× |
| CT scans face/jaw combo (70488) |
$2,101.20 |
$3,502 |
11.8× |
| CT soft tissue neck w contrast (70491) |
$1,849.20 |
$3,082 |
10.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,550.40 |
$2,584 |
14.6× |
| CT thoracic spine w contrast (72129) |
$1,637.40 |
$2,729 |
9.2× |
| CT thoracic spine w/o contrast (72128) |
$1,345.20 |
$2,242 |
12.7× |
| CT thoracic spine w/wo cont (72130) |
$1,910.40 |
$3,184 |
10.8× |
| CT thorax w/o contrast (71250) |
$1,398.60 |
$2,331 |
13.2× |
| CT upper ext wo (73200) |
$1,760.40 |
$2,934 |
16.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,605.80 |
$4,343 |
14.7× |
| CT upper extremity with contrast (73201) |
$2,413.20 |
$4,022 |
6.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,437.20 |
$4,062 |
13.7× |
| Cta Abdomen (74175) |
$2,435.40 |
$4,059 |
13.7× |
| CTA pelvis (72191) |
$2,457.60 |
$4,096 |
13.8× |
| Diskography lumbar (72295) |
$2,748 |
$4,580 |
1.4× |
| Dxa Bone Density Axial (77080) |
$546.60 |
$911 |
5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$174 |
$290 |
2.0× |
| Echo Guide For Artery Repair (76936) |
$622.20 |
$1,037 |
2.8× |
| Esophagram (74220) |
$469.20 |
$782 |
2.6× |
| Fetal Biophys Profile W/Nst (76818) |
$382.20 |
$637 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$570.60 |
$951 |
5.4× |
| Fluoroscopy up to 1 hr (76000) |
$855.60 |
$1,426 |
3.5× |
| Foot 2 views (73620) |
$318 |
$530 |
3.6× |
| Forearm 2 views (73090) |
$227.40 |
$379 |
2.6× |
| Gastric emptying imaging study (78264) |
$1,347 |
$2,245 |
3.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,176 |
$1,960 |
2.9× |
| Gated Heart Planar Single (78472) |
$1,344.60 |
$2,241 |
3.3× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,293.60 |
$2,156 |
2.4× |
| Hand 2 views (73120) |
$258.60 |
$431 |
2.4× |
| Hepatobil Syst Image W/Drug (78227) |
$1,639.80 |
$2,733 |
3.0× |
| Hepatobiliary System Imaging (78226) |
$1,426.80 |
$2,378 |
3.5× |
| Ht Muscle Image Spect Sing (78451) |
$2,325.60 |
$3,876 |
1.8× |
| Hysterosalpingogram (74740) |
$801.60 |
$1,336 |
3.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$336 |
$560 |
3.8× |
| Infant hip ultrasound, limited static exam (76886) |
$244.80 |
$408 |
2.8× |
| K Flow/Funct Image W/Drug (78708) |
$1,813.20 |
$3,022 |
3.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,323.60 |
$2,206 |
2.4× |
| Knee 3 Views (73562) |
$222.60 |
$371 |
2.5× |
| Liver & Spleen Imaging Static Only (78215) |
$1,464.60 |
$2,441 |
3.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,393.20 |
$2,322 |
2.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,491.60 |
$2,486 |
2.7× |
| Lung Ventilation Imaging (78579) |
$776.40 |
$1,294 |
1.9× |
| Lymph System Imaging (78195) |
$1,614 |
$2,690 |
2.9× |
| Magnetic Image Jaw Joint (70336) |
$1,687.80 |
$2,813 |
7.0× |
| Meckels Divert Exam (78290) |
$1,044.60 |
$1,741 |
2.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,767.80 |
$4,613 |
7.8× |
| MRA head w/o contrast (70544) |
$2,080.80 |
$3,468 |
8.6× |
| MRA head with contrast (70545) |
$2,202.60 |
$3,671 |
6.2× |
| MRA neck w contrast (70548) |
$2,159.40 |
$3,599 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,999.40 |
$4,999 |
8.5× |
| MRA neck w/o contrast (70547) |
$1,947 |
$3,245 |
8.1× |
| MRI abdomen w contrast (74182) |
$2,700.60 |
$4,501 |
7.6× |
| MRI abdomen w/o contrast (74181) |
$2,553.60 |
$4,256 |
10.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,227.20 |
$3,712 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,094.80 |
$5,158 |
8.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,445.60 |
$4,076 |
3.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,974.60 |
$3,291 |
8.2× |
| MRI cervical spine w contrast (72142) |
$2,481 |
$4,135 |
7.0× |
| MRI cervical spine w/o cont (72141) |
$2,414.40 |
$4,024 |
10.0× |
| MRI chest w/o contrast (71550) |
$2,612.40 |
$4,354 |
10.8× |
| MRI chest wo w contrast (71552) |
$3,073.20 |
$5,122 |
8.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,335.20 |
$3,892 |
6.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,199.20 |
$5,332 |
9.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,224.80 |
$3,708 |
9.2× |
| MRI lumbar spine w contrast (72149) |
$2,430.60 |
$4,051 |
6.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,062.40 |
$5,104 |
8.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,514 |
$4,190 |
10.4× |
| MRI orbit face neck w contrast (70542) |
$2,815.20 |
$4,692 |
8.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,351.60 |
$5,586 |
9.5× |
| MRI pelvis w contrast (72196) |
$3,072 |
$5,120 |
8.7× |
| MRI pelvis w/o & w contrast (72197) |
$3,232.80 |
$5,388 |
9.2× |
| MRI pelvis w/o contrast (72195) |
$2,075.40 |
$3,459 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,109.60 |
$3,516 |
8.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,162.40 |
$3,604 |
9.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,094.80 |
$5,158 |
8.8× |
| MRI, abdomen, combo (74183) |
$3,140.40 |
$5,234 |
8.9× |
| MRI, dorsal spine combo (72157) |
$2,947.20 |
$4,912 |
8.3× |
| MRI, dorsal spine contrast (72147) |
$2,564.40 |
$4,274 |
7.3× |
| MRI, joint upper extrem (73221) |
$2,083.80 |
$3,473 |
8.6× |
| MRI, joint upper extrem combo (73223) |
$2,819.40 |
$4,699 |
8.0× |
| MRI, lumbar spine combo (72158) |
$3,272.40 |
$5,454 |
9.3× |
| Myelogram cervical (72240) |
$2,502 |
$4,170 |
3.2× |
| Myelogram Lumbar (72265) |
$2,977.20 |
$4,962 |
3.8× |
| Myelography thoracic (72255) |
$1,838.40 |
$3,064 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,906.40 |
$4,844 |
2.2× |
| N-invas est c ffr sw aly CTA (75580) |
$2,319 |
$3,865 |
2.7× |
| Neck soft tissue (70360) |
$217.20 |
$362 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$880.20 |
$1,467 |
3.7× |
| Parathyroid Planar Imaging (78070) |
$896.40 |
$1,494 |
2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,269 |
$2,115 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$204.60 |
$341 |
1.9× |
| PET image w/CT, full body (78816) |
$3,690 |
$6,150 |
2.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,894.60 |
$6,491 |
2.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$955.20 |
$1,592 |
2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$451.20 |
$752 |
4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$623.40 |
$1,039 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$277.80 |
$463 |
3.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$240.60 |
$401 |
2.7× |
| Radex elbow complete minimum 3 views (73080) |
$265.20 |
$442 |
3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$360.60 |
$601 |
3.4× |
| Radex fingr minimum 2 views (73140) |
$165.60 |
$276 |
1.9× |
| Radex foot complete minimum 3 views (73630) |
$277.80 |
$463 |
3.2× |
| Radex Hand Minimum 3 Views (73130) |
$236.40 |
$394 |
2.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$130.80 |
$218 |
1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$236.40 |
$394 |
2.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$289.80 |
$483 |
3.3× |
| Radex shoulder complete minimum 2 views (73030) |
$277.20 |
$462 |
3.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$312.60 |
$521 |
3.5× |
| Radex Spine 1 View Specify Level (72020) |
$265.20 |
$442 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$231 |
$385 |
2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$247.20 |
$412 |
2.8× |
| Radex Toe Minimum 2 Views (73660) |
$194.40 |
$324 |
2.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$178.80 |
$298 |
1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$208.20 |
$347 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$618.60 |
$1,031 |
5.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$327 |
$545 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$324 |
$540 |
3.1× |
| Radiologic exam colon double contrast study (74280) |
$1,035.60 |
$1,726 |
5.8× |
| Radiologic exam colon single contrast study (74270) |
$643.20 |
$1,072 |
3.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$471 |
$785 |
2.7× |
| Radiologic exam knee complete 4/more views (73564) |
$289.20 |
$482 |
2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$324.60 |
$541 |
3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$605.40 |
$1,009 |
3.4× |
| Radiologic exam swallow function contrast study (74230) |
$244.20 |
$407 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$357.60 |
$596 |
2.0× |
| Radiologic examination femur 1 view (73551) |
$137.40 |
$229 |
1.6× |
| Radiologic examination femur minimum 2 views (73552) |
$259.20 |
$432 |
2.9× |
| Radiologic examination knee 1/2 views (73560) |
$256.20 |
$427 |
2.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$160.80 |
$268 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$212.40 |
$354 |
2.4× |
| Ribs bilateral 3 views (71110) |
$647.40 |
$1,079 |
6.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$672 |
$1,120 |
1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,660.40 |
$4,434 |
4.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,324.40 |
$3,874 |
4.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,860.60 |
$3,101 |
3.4× |
| Scapula (73010) |
$229.20 |
$382 |
2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$83.40 |
$139 |
3.6× |
| Shoulder 1 view (73020) |
$275.40 |
$459 |
3.1× |
| Shoulder Arthrography (73040) |
$1,422 |
$2,370 |
4.0× |
| Skull less than 4 views (70250) |
$300.60 |
$501 |
2.8× |
| Sternoclavicular joints (71130) |
$231 |
$385 |
2.6× |
| Superior sagittal sinus venogram (75870) |
$1,974 |
$3,290 |
0.6× |
| Thoracic spine 2 views (72070) |
$262.20 |
$437 |
2.5× |
| Thoracic spine 3 views (72072) |
$196.20 |
$327 |
1.9× |
| Thoracolumbar 2 views (72080) |
$338.40 |
$564 |
3.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$635.40 |
$1,059 |
1.6× |
| Thyroid Met Imaging Body (78018) |
$2,622.60 |
$4,371 |
4.8× |
| Thyroid Uptake Measurement (78012) |
$483 |
$805 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,039.80 |
$1,733 |
2.6× |
| Ultrasound Breast Limited (76642) |
$295.20 |
$492 |
3.3× |
| Ultrasound Exam Aaa Screen (76706) |
$394.20 |
$657 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$561.60 |
$936 |
5.3× |
| Umbilical-artery Doppler (OB) (76820) |
$252 |
$420 |
2.4× |
| Unlisted us procedure (76999) |
$384.60 |
$641 |
4.4× |
| Upper gi w/o kub (74240) |
$375.60 |
$626 |
2.1× |
| Urethrocystogram voiding (74455) |
$707.40 |
$1,179 |
2.9× |
| Urethrocystography retrograde (74450) |
$707.40 |
$1,179 |
2.9× |
| Us breast unilateral complete (76641) |
$275.40 |
$459 |
2.6× |
| Us chest (76604) |
$344.40 |
$574 |
3.3× |
| Us complete joint (76881) |
$706.80 |
$1,178 |
6.7× |
| Us exam, pelvic, limited (76857) |
$493.80 |
$823 |
4.7× |
| Us kidney transplant (76776) |
$739.20 |
$1,232 |
7.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$458.40 |
$764 |
4.3× |
| Us ob detailed single fetus (76811) |
$576.60 |
$961 |
2.4× |
| Us ob limited 1 or more fetuses (76815) |
$382.20 |
$637 |
3.6× |
| Us ob transvaginal (76817) |
$501 |
$835 |
4.7× |
| Us pelvic non ob complete (76856) |
$622.20 |
$1,037 |
5.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$454.80 |
$758 |
4.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$256.20 |
$427 |
2.4× |
| Us retroperitoneal complete (76770) |
$645.60 |
$1,076 |
6.1× |
| Us retroperitoneal limited (76775) |
$470.40 |
$784 |
4.4× |
| Us scrotum and contents (76870) |
$557.40 |
$929 |
5.3× |
| Us spinal canal and contents (76800) |
$128.40 |
$214 |
1.2× |
| Us thyroid (76536) |
$536.40 |
$894 |
5.1× |
| Vein X-Ray Chest (75827) |
$2,471.40 |
$4,119 |
1.6× |
| Venogram Sinus/Jugular (75860) |
$4,386 |
$7,310 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$3,002.40 |
$5,004 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,185 |
$1,975 |
0.7× |
| Wrist 2 views (73100) |
$225 |
$375 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$313.20 |
$522 |
3.6× |
| X-ray antegrade pyelogram tube (74425) |
$850.20 |
$1,417 |
2.4× |
| X-Ray Aorta Leg Arteries (75630) |
$5,499 |
$9,165 |
1.7× |
| X-Ray Bend Only L-S Spine (72120) |
$349.20 |
$582 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$243.60 |
$406 |
2.8× |
| X-Ray Exam Breast Specimen (76098) |
$895.80 |
$1,493 |
1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$370.20 |
$617 |
4.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$487.20 |
$812 |
4.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$516.60 |
$861 |
4.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$280.20 |
$467 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$296.40 |
$494 |
3.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$454.80 |
$758 |
4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$441.60 |
$736 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$647.40 |
$1,079 |
6.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$525 |
$875 |
5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$297.60 |
$496 |
3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$557.40 |
$929 |
5.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$350.40 |
$584 |
3.3× |
| X-ray eye for foreign body (70030) |
$194.40 |
$324 |
2.2× |
| X-ray humerus (73060) |
$264 |
$440 |
3.0× |
| X-ray IV pyelogram (ivp) (74400) |
$875.40 |
$1,459 |
4.9× |
| X-ray IV pyelogram+tomography (74415) |
$1,041.60 |
$1,736 |
5.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$235.80 |
$393 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$189.60 |
$316 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$295.20 |
$492 |
2.8× |
| X-ray nose-rectum child f.b. (76010) |
$101.40 |
$169 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$351 |
$585 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$221.40 |
$369 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$221.40 |
$369 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$355.20 |
$592 |
4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$402.60 |
$671 |
3.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,132.20 |
$1,887 |
3.2× |
| X-Rays Bone Length Studies (77073) |
$449.40 |
$749 |
4.2× |
| X-Rays Bone Survey Complete (77075) |
$556.20 |
$927 |
5.3× |
| Xr c-spine 4 or 5 views (72050) |
$396 |
$660 |
3.7× |
| Xr facial bones less than 3 views (70140) |
$288.60 |
$481 |
3.3× |
| Xr orbits complete 4 views (70200) |
$300 |
$500 |
2.8× |