| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,286.20 |
$5,477 |
2.5× |
| Abdomen 1 View (74018) |
$259.20 |
$432 |
3.1× |
| Abdomen 2 views (74019) |
$312 |
$520 |
3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$354.60 |
$591 |
0.9× |
| Angio pulmonary bilat (75743) |
$2,917.80 |
$4,863 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$2,250 |
$3,750 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,956.60 |
$3,261 |
0.6× |
| Ankle 2 views (73600) |
$194.40 |
$324 |
2.3× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$1,830 |
$3,050 |
0.3× |
| Arthrogram ankle (73615) |
$321.60 |
$536 |
1.0× |
| Arthrogram hip (73525) |
$374.40 |
$624 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$339 |
$565 |
2.6× |
| Bone age studies (77072) |
$72.60 |
$121 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$1,203.60 |
$2,006 |
3.1× |
| Bone Imaging Limited Area (78300) |
$1,045.80 |
$1,743 |
2.7× |
| Bone Imaging Whole Body (78306) |
$1,432.80 |
$2,388 |
3.7× |
| Bone survey infant (77076) |
$304.20 |
$507 |
3.0× |
| Brain Image W/Flow < 4 Views (78601) |
$554.40 |
$924 |
1.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,948.80 |
$3,248 |
5.8× |
| Cat Scan Follow-Up Study (76380) |
$582 |
$970 |
7.0× |
| Chest 1 view (71045) |
$180 |
$300 |
2.1× |
| Chest 2 views (71046) |
$277.20 |
$462 |
3.3× |
| Chest 3 views (71047) |
$111.60 |
$186 |
1.3× |
| Chest 4 or more views (71048) |
$360 |
$600 |
3.6× |
| Clavicle complete (73000) |
$228.60 |
$381 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,018.20 |
$1,697 |
10.1× |
| Continuing medical physics consltj pr wk (77336) |
$271.80 |
$453 |
2.1× |
| Contrast Exam Abdominl Aorta (75625) |
$1,842 |
$3,070 |
0.6× |
| Contrast X-Ray Bladder (74430) |
$302.40 |
$504 |
0.9× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$159.60 |
$266 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,174.20 |
$6,957 |
12.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,604.80 |
$6,008 |
15.7× |
| CT abdomen w contrast (74160) |
$2,106 |
$3,510 |
12.5× |
| CT abdomen w wo contrast (74170) |
$2,149.20 |
$3,582 |
12.7× |
| CT abdomen w/o contrast (74150) |
$1,805.40 |
$3,009 |
17.9× |
| CT Angio Abdomen and Pelvis (74174) |
$2,892.60 |
$4,821 |
8.6× |
| CT Angio Chest (71275) |
$2,396.40 |
$3,994 |
14.2× |
| CT Angio Head (70496) |
$1,458 |
$2,430 |
8.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,044.60 |
$1,741 |
6.2× |
| CT Angio Neck (70498) |
$1,402.20 |
$2,337 |
8.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$862.20 |
$1,437 |
5.1× |
| CT cervical spine w/ contrast (72126) |
$1,536.60 |
$2,561 |
4.6× |
| CT cervical spine w/o contrast (72125) |
$1,291.20 |
$2,152 |
12.8× |
| CT cervical spine w/wo cont (72127) |
$1,536.60 |
$2,561 |
9.1× |
| CT chest w contrast (71260) |
$1,479 |
$2,465 |
8.8× |
| CT chest w/wo contrast (71270) |
$1,713 |
$2,855 |
10.1× |
| CT head/brain with contrast (70460) |
$1,309.80 |
$2,183 |
7.8× |
| CT head/brain without and with contrast (70470) |
$1,378.20 |
$2,297 |
8.2× |
| CT iac w contrast (70481) |
$1,387.20 |
$2,312 |
8.2× |
| CT l-spine w&w/o contrast (72133) |
$1,684.80 |
$2,808 |
10.0× |
| CT lower ext w/o (73700) |
$1,159.80 |
$1,933 |
11.5× |
| CT lower extremity w/contrast material (73701) |
$1,183.20 |
$1,972 |
7.0× |
| CT lumbar spine w contrast (72132) |
$1,669.80 |
$2,783 |
5.0× |
| CT lumbar spine w/o contrast (72131) |
$1,464.60 |
$2,441 |
14.6× |
| CT maxillofacial w contrast (70487) |
$1,509 |
$2,515 |
8.9× |
| CT maxillofacial wo contrast (70486) |
$1,289.40 |
$2,149 |
12.8× |
| CT neck tissue combo (70492) |
$1,509 |
$2,515 |
8.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,552.20 |
$2,587 |
9.2× |
| CT orbits w/o contrast (70480) |
$1,373.40 |
$2,289 |
13.7× |
| CT pelvis w&w/o contrast (72194) |
$1,269 |
$2,115 |
7.5× |
| CT pelvis w/o contrast (72192) |
$1,103.40 |
$1,839 |
11.0× |
| CT scan of leg combo (73702) |
$1,426.80 |
$2,378 |
8.5× |
| CT scans face/jaw combo (70488) |
$1,509 |
$2,515 |
8.9× |
| CT soft tissue neck w contrast (70491) |
$1,494 |
$2,490 |
8.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,180.20 |
$1,967 |
11.7× |
| CT thoracic spine w contrast (72129) |
$972.60 |
$1,621 |
5.8× |
| CT thoracic spine w/o contrast (72128) |
$846 |
$1,410 |
8.4× |
| CT thorax w/o contrast (71250) |
$1,232.40 |
$2,054 |
12.3× |
| CT upper ext wo (73200) |
$655.20 |
$1,092 |
6.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$694.80 |
$1,158 |
4.1× |
| CT upper extremity with contrast (73201) |
$694.80 |
$1,158 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,698 |
$2,830 |
10.1× |
| Cta Abdomen (74175) |
$1,533 |
$2,555 |
9.1× |
| CTA pelvis (72191) |
$1,494.60 |
$2,491 |
8.9× |
| Dilation ureters/urethra rs&i (74485) |
$504 |
$840 |
0.3× |
| Echo Guide For Artery Repair (76936) |
$358.80 |
$598 |
1.7× |
| Esophagram (74220) |
$435.60 |
$726 |
2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$323.40 |
$539 |
3.2× |
| Fluoroscopy up to 1 hr (76000) |
$460.80 |
$768 |
2.0× |
| Follow-Up Angiography (75898) |
$589.20 |
$982 |
0.2× |
| Foot 2 views (73620) |
$200.40 |
$334 |
2.4× |
| Forearm 2 views (73090) |
$309 |
$515 |
3.7× |
| Gastric emptying imaging study (78264) |
$1,470 |
$2,450 |
3.8× |
| Gated Heart Planar Single (78472) |
$662.40 |
$1,104 |
1.7× |
| Hand 2 views (73120) |
$163.80 |
$273 |
1.6× |
| Hepatobil Syst Image W/Drug (78227) |
$1,468.20 |
$2,447 |
2.8× |
| Hepatobiliary System Imaging (78226) |
$1,468.20 |
$2,447 |
3.8× |
| Ht Muscle Image Spect Sing (78451) |
$2,026.80 |
$3,378 |
1.6× |
| Hysterosalpingogram (74740) |
$142.20 |
$237 |
0.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$611.40 |
$1,019 |
7.3× |
| K Flow/Funct Image W/Drug (78708) |
$1,425 |
$2,375 |
2.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,282.80 |
$2,138 |
2.5× |
| Kidney Imaging Morphol (78700) |
$513 |
$855 |
1.3× |
| Knee 3 Views (73562) |
$406.20 |
$677 |
4.9× |
| Leveen/Shunt Patency Exam (78291) |
$563.40 |
$939 |
1.5× |
| Liver & Spleen Imaging Static Only (78215) |
$693 |
$1,155 |
1.8× |
| Lung Perf&Ventilat Diferentl (78598) |
$869.40 |
$1,449 |
1.7× |
| Lung perfusion differential (78597) |
$671.40 |
$1,119 |
1.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,690.20 |
$2,817 |
3.2× |
| Lung Ventilation Imaging (78579) |
$744.60 |
$1,241 |
1.9× |
| Lymph System Imaging (78195) |
$384.60 |
$641 |
0.7× |
| Magnetic Image Jaw Joint (70336) |
$1,834.80 |
$3,058 |
8.0× |
| Meckels Divert Exam (78290) |
$563.40 |
$939 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$508.20 |
$847 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$35.40 |
$59 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$133.20 |
$222 |
1.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$350.40 |
$584 |
1.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,705.60 |
$6,176 |
11.0× |
| MRA head w/o contrast (70544) |
$1,881 |
$3,135 |
8.2× |
| MRA head with contrast (70545) |
$3,291.60 |
$5,486 |
9.8× |
| MRA neck w contrast (70548) |
$1,923.60 |
$3,206 |
5.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,923.60 |
$3,206 |
5.7× |
| MRA neck w/o contrast (70547) |
$1,731 |
$2,885 |
7.5× |
| MRI abdomen w contrast (74182) |
$2,987.40 |
$4,979 |
8.9× |
| MRI abdomen w/o contrast (74181) |
$2,838 |
$4,730 |
12.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,390.40 |
$3,984 |
3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,390.40 |
$3,984 |
7.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,252.40 |
$3,754 |
3.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,782 |
$2,970 |
7.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,752 |
$2,920 |
7.6× |
| MRI cardiac w/o contrast (75557) |
$1,822.80 |
$3,038 |
7.9× |
| MRI cervical spine w contrast (72142) |
$2,453.40 |
$4,089 |
7.3× |
| MRI cervical spine w/o cont (72141) |
$2,336.40 |
$3,894 |
10.2× |
| MRI chest w/o contrast (71550) |
$1,775.40 |
$2,959 |
7.7× |
| MRI chest with contrast (71551) |
$1,948.80 |
$3,248 |
2.6× |
| MRI chest wo w contrast (71552) |
$1,948.80 |
$3,248 |
5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,572.80 |
$4,288 |
7.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,598.60 |
$4,331 |
7.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,520.60 |
$4,201 |
11.0× |
| MRI lumbar spine w contrast (72149) |
$2,112.60 |
$3,521 |
6.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,476.80 |
$4,128 |
7.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,849.20 |
$3,082 |
8.1× |
| MRI orbit face neck w contrast (70542) |
$2,464.80 |
$4,108 |
7.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,464.80 |
$4,108 |
7.3× |
| MRI pelvis w contrast (72196) |
$2,733.60 |
$4,556 |
8.1× |
| MRI pelvis w/o & w contrast (72197) |
$2,733.60 |
$4,556 |
8.1× |
| MRI pelvis w/o contrast (72195) |
$2,596.80 |
$4,328 |
11.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,042.40 |
$3,404 |
8.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,941 |
$3,235 |
5.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,073 |
$3,455 |
9.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,205.60 |
$3,676 |
6.6× |
| MRI, abdomen, combo (74183) |
$2,987.40 |
$4,979 |
8.9× |
| MRI, dorsal spine combo (72157) |
$2,164.80 |
$3,608 |
6.4× |
| MRI, dorsal spine contrast (72147) |
$2,144.40 |
$3,574 |
6.4× |
| MRI, joint upper extrem (73221) |
$2,230.20 |
$3,717 |
9.7× |
| MRI, joint upper extrem combo (73223) |
$2,274.60 |
$3,791 |
6.8× |
| MRI, lumbar spine combo (72158) |
$2,276.40 |
$3,794 |
6.8× |
| Myelogram Lumbar (72265) |
$888 |
$1,480 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,895 |
$4,825 |
2.3× |
| Neck soft tissue (70360) |
$250.20 |
$417 |
3.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,163 |
$8,605 |
3.9× |
| Panoramic X-ray of jaws (70355) |
$296.40 |
$494 |
3.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$710.40 |
$1,184 |
1.4× |
| Parathyroid Planar Imaging (78070) |
$725.40 |
$1,209 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$260.40 |
$434 |
2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,550.80 |
$5,918 |
2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$744.60 |
$1,241 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$439.80 |
$733 |
4.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$119.40 |
$199 |
0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$313.80 |
$523 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$216.60 |
$361 |
2.6× |
| Radex elbow complete minimum 3 views (73080) |
$329.40 |
$549 |
3.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$263.40 |
$439 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$217.20 |
$362 |
2.6× |
| Radex foot complete minimum 3 views (73630) |
$277.80 |
$463 |
3.3× |
| Radex Hand Minimum 3 Views (73130) |
$282 |
$470 |
3.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$94.80 |
$158 |
1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$244.20 |
$407 |
2.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$322.20 |
$537 |
3.8× |
| Radex shoulder complete minimum 2 views (73030) |
$304.20 |
$507 |
3.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$169.20 |
$282 |
2.0× |
| Radex Spine 1 View Specify Level (72020) |
$150.60 |
$251 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$196.20 |
$327 |
2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$155.40 |
$259 |
1.9× |
| Radex Toe Minimum 2 Views (73660) |
$211.80 |
$353 |
2.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$118.80 |
$198 |
1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$290.40 |
$484 |
3.5× |
| Radiation treatment delivery level 1 (77402) |
$217.20 |
$362 |
2.2× |
| Radiation treatment delivery level 3 (77412) |
$491.40 |
$819 |
0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$303.60 |
$506 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$272.40 |
$454 |
2.7× |
| Radiologic exam colon double contrast study (74280) |
$480.60 |
$801 |
2.8× |
| Radiologic exam colon single contrast study (74270) |
$351 |
$585 |
2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$438 |
$730 |
2.6× |
| Radiologic exam knee complete 4/more views (73564) |
$328.80 |
$548 |
3.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$135.60 |
$226 |
1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$427.80 |
$713 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$181.20 |
$302 |
1.1× |
| Radiologic exam teeth complete full mouth (70320) |
$269.40 |
$449 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$267 |
$445 |
1.6× |
| Radiologic examination femur minimum 2 views (73552) |
$209.40 |
$349 |
2.5× |
| Radiologic examination knee 1/2 views (73560) |
$252 |
$420 |
3.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$322.20 |
$537 |
3.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$267.60 |
$446 |
3.2× |
| Ribs bilateral 3 views (71110) |
$378.60 |
$631 |
3.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$395.40 |
$659 |
1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,281.60 |
$2,136 |
2.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,797.60 |
$2,996 |
3.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$996 |
$1,660 |
1.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,658.40 |
$2,764 |
1.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,658.40 |
$2,764 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$292.20 |
$487 |
1.3× |
| Scapula (73010) |
$199.80 |
$333 |
2.0× |
| Shoulder Arthrography (73040) |
$479.40 |
$799 |
1.4× |
| Skull less than 4 views (70250) |
$248.40 |
$414 |
2.5× |
| Special dosimetry (77331) |
$319.20 |
$532 |
2.5× |
| Special Physics Consult (77370) |
$187.20 |
$312 |
1.4× |
| Special teletherapy port plan (77321) |
$712.20 |
$1,187 |
2.0× |
| Stereotactic Body Radiation Delivery (77373) |
$1,216.80 |
$2,028 |
0.7× |
| Sternoclavicular joints (71130) |
$114 |
$190 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$520.80 |
$868 |
1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$213 |
$355 |
0.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,281.60 |
$2,136 |
3.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$821.40 |
$1,369 |
6.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$301.80 |
$503 |
1.8× |
| Thoracic spine 2 views (72070) |
$350.40 |
$584 |
3.5× |
| Thoracic spine 3 views (72072) |
$154.20 |
$257 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$481.80 |
$803 |
1.3× |
| Thyroid Met Imaging Body (78018) |
$891.60 |
$1,486 |
1.7× |
| Thyroid Uptake Measurement (78012) |
$329.40 |
$549 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$678.60 |
$1,131 |
1.8× |
| Tx Devices Design & Construction Complex (77334) |
$945 |
$1,575 |
2.6× |
| Tx devices design & construction simple (77332) |
$359.40 |
$599 |
2.8× |
| Ultrasound Breast Limited (76642) |
$272.40 |
$454 |
3.3× |
| Ultrasound Exam Aaa Screen (76706) |
$124.20 |
$207 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$657.60 |
$1,096 |
6.5× |
| Unlisted magnetic resonance procedure (76498) |
$500.40 |
$834 |
6.0× |
| Unlisted us procedure (76999) |
$430.80 |
$718 |
5.1× |
| Upper gi w/o kub (74240) |
$553.20 |
$922 |
3.3× |
| Urethrocystogram voiding (74455) |
$379.80 |
$633 |
1.7× |
| Urethrocystography retrograde (74450) |
$319.20 |
$532 |
1.4× |
| Us chest (76604) |
$263.40 |
$439 |
2.6× |
| Us exam, pelvic, limited (76857) |
$351 |
$585 |
3.5× |
| Us head (76506) |
$409.80 |
$683 |
4.1× |
| Us kidney transplant (76776) |
$250.20 |
$417 |
2.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$414.60 |
$691 |
4.1× |
| Us ob limited 1 or more fetuses (76815) |
$417.60 |
$696 |
4.2× |
| Us ob transvaginal (76817) |
$605.40 |
$1,009 |
6.0× |
| Us pelvic non ob complete (76856) |
$638.40 |
$1,064 |
6.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$614.40 |
$1,024 |
6.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$205.80 |
$343 |
2.0× |
| Us retroperitoneal complete (76770) |
$581.40 |
$969 |
5.8× |
| Us retroperitoneal limited (76775) |
$244.20 |
$407 |
2.4× |
| Us scrotum and contents (76870) |
$550.20 |
$917 |
5.5× |
| Us spinal canal and contents (76800) |
$423.60 |
$706 |
4.2× |
| Us thyroid (76536) |
$544.80 |
$908 |
5.4× |
| Vein X-Ray Chest (75827) |
$1,863 |
$3,105 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$1,863 |
$3,105 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$1,219.20 |
$2,032 |
0.8× |
| Wrist 2 views (73100) |
$165.60 |
$276 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$232.20 |
$387 |
2.8× |
| X-ray antegrade pyelogram tube (74425) |
$437.40 |
$729 |
1.3× |
| X-Ray Aorta Leg Arteries (75630) |
$1,842 |
$3,070 |
0.6× |
| X-Ray Bend Only L-S Spine (72120) |
$423.60 |
$706 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$168 |
$280 |
2.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$133.80 |
$223 |
1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$156 |
$260 |
1.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$118.80 |
$198 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$182.40 |
$304 |
2.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$147.60 |
$246 |
1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$270 |
$450 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$270 |
$450 |
2.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$477 |
$795 |
4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$388.20 |
$647 |
4.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$667.80 |
$1,113 |
6.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$350.40 |
$584 |
3.5× |
| X-ray humerus (73060) |
$154.80 |
$258 |
1.8× |
| X-ray IV pyelogram (ivp) (74400) |
$1,144.80 |
$1,908 |
6.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$243.60 |
$406 |
2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$333.60 |
$556 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$378.60 |
$631 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$153 |
$255 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$174 |
$290 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$412.80 |
$688 |
4.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$335.40 |
$559 |
3.3× |
| X-ray thoracic spine 4 vw (72074) |
$388.80 |
$648 |
3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$729.60 |
$1,216 |
2.2× |
| X-Rays Bone Survey Complete (77075) |
$608.40 |
$1,014 |
6.0× |
| Xr c-spine 4 or 5 views (72050) |
$667.80 |
$1,113 |
6.6× |
| Xr facial bones less than 3 views (70140) |
$181.80 |
$303 |
2.2× |
| Xr orbits complete 4 views (70200) |
$303.60 |
$506 |
3.0× |