| Abdomen 1 View (74018) |
$170.40 |
$284 |
2.0× |
| Abdomen 2 views (74019) |
$221.40 |
$369 |
2.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$735 |
$1,225 |
1.9× |
| Ankle 2 views (73600) |
$234.60 |
$391 |
2.8× |
| Arthrogram ankle (73615) |
$370.20 |
$617 |
1.1× |
| Arthrogram hip (73525) |
$370.20 |
$617 |
1.1× |
| Arthrogram Wrist (73115) |
$370.20 |
$617 |
1.1× |
| Bone age studies (77072) |
$192 |
$320 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,240.20 |
$2,067 |
3.2× |
| Bone Imaging Limited Area (78300) |
$772.80 |
$1,288 |
2.0× |
| Bone Imaging Multiple Areas (78305) |
$741 |
$1,235 |
1.9× |
| Bone Imaging Whole Body (78306) |
$1,610.40 |
$2,684 |
4.2× |
| Bone survey infant (77076) |
$301.20 |
$502 |
3.0× |
| Brain Image W/Flow < 4 Views (78601) |
$535.20 |
$892 |
1.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$610.20 |
$1,017 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,658 |
$4,430 |
1.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$948.60 |
$1,581 |
2.5× |
| Cat Scan Follow-Up Study (76380) |
$390 |
$650 |
4.7× |
| Chest 1 view (71045) |
$126 |
$210 |
1.5× |
| Chest 2 views (71046) |
$140.40 |
$234 |
1.7× |
| Chest 3 views (71047) |
$165.60 |
$276 |
2.0× |
| Chest 4 or more views (71048) |
$244.80 |
$408 |
2.4× |
| Clavicle complete (73000) |
$205.20 |
$342 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$184.80 |
$308 |
1.8× |
| Contrast X-Ray Bladder (74430) |
$333.60 |
$556 |
1.0× |
| Contrast X-Ray Of Elbow (73085) |
$370.20 |
$617 |
1.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$298.80 |
$498 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,624 |
$6,040 |
10.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,526 |
$4,210 |
11.0× |
| CT abdomen w contrast (74160) |
$1,349.40 |
$2,249 |
8.0× |
| CT abdomen w wo contrast (74170) |
$1,578.60 |
$2,631 |
9.4× |
| CT abdomen w/o contrast (74150) |
$1,120.20 |
$1,867 |
11.2× |
| CT Angio Abdomen and Pelvis (74174) |
$1,890.60 |
$3,151 |
5.6× |
| CT Angio Chest (71275) |
$1,567.20 |
$2,612 |
9.3× |
| CT Angio Head (70496) |
$1,218.60 |
$2,031 |
7.2× |
| CT angio hrt w/3d image (75574) |
$1,578 |
$2,630 |
4.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,435.80 |
$2,393 |
8.5× |
| CT Angio Neck (70498) |
$1,218.60 |
$2,031 |
7.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,282.20 |
$2,137 |
7.6× |
| CT cervical spine w/ contrast (72126) |
$1,402.20 |
$2,337 |
4.2× |
| CT cervical spine w/o contrast (72125) |
$1,263 |
$2,105 |
12.6× |
| CT cervical spine w/wo cont (72127) |
$1,642.20 |
$2,737 |
9.8× |
| CT chest w contrast (71260) |
$998.40 |
$1,664 |
5.9× |
| CT head/brain with contrast (70460) |
$792 |
$1,320 |
4.7× |
| CT head/brain without and with contrast (70470) |
$931.20 |
$1,552 |
5.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$522.60 |
$871 |
1.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$962.40 |
$1,604 |
11.5× |
| CT iac w contrast (70481) |
$1,173 |
$1,955 |
7.0× |
| CT l-spine w&w/o contrast (72133) |
$950.40 |
$1,584 |
5.6× |
| CT lower ext w/o (73700) |
$780.60 |
$1,301 |
7.8× |
| CT lower extremity w/contrast material (73701) |
$921 |
$1,535 |
5.5× |
| CT lumbar spine w contrast (72132) |
$1,116 |
$1,860 |
3.3× |
| CT lumbar spine w/o contrast (72131) |
$1,033.20 |
$1,722 |
10.3× |
| CT maxillofacial w contrast (70487) |
$939 |
$1,565 |
5.6× |
| CT maxillofacial wo contrast (70486) |
$846 |
$1,410 |
8.4× |
| CT neck tissue combo (70492) |
$1,556.40 |
$2,594 |
9.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,389.60 |
$2,316 |
8.3× |
| CT orbits w/o contrast (70480) |
$1,138.80 |
$1,898 |
11.4× |
| CT pelvis w&w/o contrast (72194) |
$1,024.80 |
$1,708 |
6.1× |
| CT pelvis w/o contrast (72192) |
$678.60 |
$1,131 |
6.8× |
| CT scan of leg combo (73702) |
$1,374 |
$2,290 |
8.2× |
| CT scans face/jaw combo (70488) |
$1,074.60 |
$1,791 |
6.4× |
| CT soft tissue neck w contrast (70491) |
$1,556.40 |
$2,594 |
9.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,261.20 |
$2,102 |
12.6× |
| CT thoracic spine w contrast (72129) |
$892.80 |
$1,488 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$744 |
$1,240 |
7.4× |
| CT thoracic spine w/wo cont (72130) |
$1,465.80 |
$2,443 |
8.7× |
| CT thorax w/o contrast (71250) |
$846 |
$1,410 |
8.4× |
| CT upper ext wo (73200) |
$722.40 |
$1,204 |
7.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$931.80 |
$1,553 |
5.5× |
| CT upper extremity with contrast (73201) |
$917.40 |
$1,529 |
2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,450.20 |
$2,417 |
8.6× |
| Cta Abdomen (74175) |
$1,323.60 |
$2,206 |
7.9× |
| CTA pelvis (72191) |
$1,435.80 |
$2,393 |
8.5× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$577.80 |
$963 |
2.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$189 |
$315 |
1.9× |
| Dxa Bone Density Axial (77080) |
$169.20 |
$282 |
1.7× |
| Echo exam uterus (76831) |
$214.80 |
$358 |
0.9× |
| Echo Guide For Artery Repair (76936) |
$747 |
$1,245 |
3.6× |
| Esophagram (74220) |
$293.40 |
$489 |
1.7× |
| Fetal Biophys Profile W/Nst (76818) |
$300.60 |
$501 |
3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$300.60 |
$501 |
3.0× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,682.40 |
$2,804 |
7.3× |
| Fluoroscopy up to 1 hr (76000) |
$202.80 |
$338 |
0.9× |
| Foot 2 views (73620) |
$189 |
$315 |
2.3× |
| Forearm 2 views (73090) |
$196.80 |
$328 |
2.4× |
| Gastric emptying imaging study (78264) |
$706.80 |
$1,178 |
1.8× |
| Gastroesophageal Reflux Exam (78262) |
$828.60 |
$1,381 |
2.2× |
| Gated Heart Planar Single (78472) |
$977.40 |
$1,629 |
2.5× |
| Hand 2 views (73120) |
$256.80 |
$428 |
2.6× |
| Heart first pass single,planar (78481) |
$792 |
$1,320 |
1.5× |
| Hepatobil Syst Image W/Drug (78227) |
$1,587 |
$2,645 |
3.0× |
| Hepatobiliary System Imaging (78226) |
$1,253.40 |
$2,089 |
3.3× |
| Ht Musc Image Planar Mult (78454) |
$2,602.80 |
$4,338 |
2.1× |
| Ht Muscle Image Spect Sing (78451) |
$2,044.80 |
$3,408 |
1.6× |
| Hysterosalpingogram (74740) |
$393.60 |
$656 |
1.7× |
| Joint Survey Single View (77077) |
$333.60 |
$556 |
3.3× |
| K Flow/Funct Image W/Drug (78708) |
$941.40 |
$1,569 |
1.8× |
| K Flow/Funct Image W/O Drug (78707) |
$915.60 |
$1,526 |
1.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$760.20 |
$1,267 |
2.0× |
| Knee 3 Views (73562) |
$276.60 |
$461 |
3.3× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$651 |
$1,085 |
1.7× |
| Liver & Spleen Imaging Static Only (78215) |
$639.60 |
$1,066 |
1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,320.60 |
$2,201 |
3.4× |
| Liver imaging static only (78201) |
$501.60 |
$836 |
1.0× |
| Lung Perf&Ventilat Diferentl (78598) |
$806.40 |
$1,344 |
1.5× |
| Lung perfusion differential (78597) |
$811.20 |
$1,352 |
2.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$449.40 |
$749 |
0.9× |
| Lung Ventilation Imaging (78579) |
$445.80 |
$743 |
1.2× |
| Lymph System Imaging (78195) |
$714 |
$1,190 |
1.4× |
| Mammary ductogram or galactogram multiple (77054) |
$379.20 |
$632 |
1.7× |
| Mammary ductogram or galactogram single (77053) |
$344.40 |
$574 |
1.5× |
| Meckels Divert Exam (78290) |
$544.20 |
$907 |
1.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,125.20 |
$3,542 |
6.3× |
| MRA head w/o contrast (70544) |
$1,507.20 |
$2,512 |
6.6× |
| MRA head with contrast (70545) |
$1,778.40 |
$2,964 |
5.3× |
| MRA neck w contrast (70548) |
$1,662.60 |
$2,771 |
5.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,714.20 |
$2,857 |
5.1× |
| MRA neck w/o contrast (70547) |
$1,508.40 |
$2,514 |
6.6× |
| MRI abdomen w contrast (74182) |
$2,341.20 |
$3,902 |
7.0× |
| MRI abdomen w/o contrast (74181) |
$2,010 |
$3,350 |
8.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,110.80 |
$3,518 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,164.20 |
$3,607 |
6.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,957.20 |
$3,262 |
2.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,562.40 |
$2,604 |
6.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,292.40 |
$2,154 |
5.6× |
| MRI cervical spine w contrast (72142) |
$1,566 |
$2,610 |
4.7× |
| MRI cervical spine w/o cont (72141) |
$1,666.20 |
$2,777 |
7.3× |
| MRI chest w/o contrast (71550) |
$1,612.80 |
$2,688 |
7.0× |
| MRI chest with contrast (71551) |
$1,794 |
$2,990 |
2.4× |
| MRI chest wo w contrast (71552) |
$1,950.60 |
$3,251 |
5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,491.60 |
$2,486 |
4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,133.60 |
$3,556 |
6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,734.60 |
$2,891 |
7.6× |
| MRI lumbar spine w contrast (72149) |
$2,010 |
$3,350 |
6.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,166 |
$3,610 |
6.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,399.20 |
$2,332 |
6.1× |
| MRI orbit face neck w contrast (70542) |
$1,503.60 |
$2,506 |
4.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,747.80 |
$2,913 |
5.2× |
| MRI pelvis w contrast (72196) |
$1,657.20 |
$2,762 |
5.0× |
| MRI pelvis w/o & w contrast (72197) |
$2,436.60 |
$4,061 |
7.3× |
| MRI pelvis w/o contrast (72195) |
$1,900.80 |
$3,168 |
8.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,597.80 |
$2,663 |
7.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,616.40 |
$2,694 |
4.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,569.60 |
$2,616 |
6.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,836.60 |
$3,061 |
5.5× |
| MRI, abdomen, combo (74183) |
$2,544.60 |
$4,241 |
7.6× |
| MRI, dorsal spine combo (72157) |
$1,997.40 |
$3,329 |
6.0× |
| MRI, dorsal spine contrast (72147) |
$1,837.80 |
$3,063 |
5.5× |
| MRI, joint upper extrem (73221) |
$1,795.80 |
$2,993 |
7.8× |
| MRI, joint upper extrem combo (73223) |
$2,173.20 |
$3,622 |
6.5× |
| MRI, lumbar spine combo (72158) |
$2,214.60 |
$3,691 |
6.6× |
| Myelogram cervical (72240) |
$726.60 |
$1,211 |
1.0× |
| Myelogram Lumbar (72265) |
$843.60 |
$1,406 |
1.1× |
| Myelography thoracic (72255) |
$767.40 |
$1,279 |
1.0× |
| Myelograpy 2/more regions rs&i (72270) |
$1,135.20 |
$1,892 |
1.5× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$685.20 |
$1,142 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$3,098.40 |
$5,164 |
2.5× |
| Neck soft tissue (70360) |
$129 |
$215 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$456 |
$760 |
2.0× |
| Ob us nuchal meas 1 gest (76813) |
$342.60 |
$571 |
3.4× |
| Parathyroid Planar Imaging (78070) |
$581.40 |
$969 |
1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,156.20 |
$1,927 |
3.0× |
| Pelvis 1 or 2 views (72170) |
$117.60 |
$196 |
1.2× |
| Pet Image W/Ct Lmtd (78814) |
$4,202.40 |
$7,004 |
3.1× |
| PET image w/CT, full body (78816) |
$3,786 |
$6,310 |
2.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,786 |
$6,310 |
2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$401.40 |
$669 |
1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$283.80 |
$473 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$272.40 |
$454 |
0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$276 |
$460 |
3.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$163.80 |
$273 |
2.0× |
| Radex elbow complete minimum 3 views (73080) |
$214.80 |
$358 |
2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$240.60 |
$401 |
2.4× |
| Radex fingr minimum 2 views (73140) |
$184.20 |
$307 |
2.2× |
| Radex foot complete minimum 3 views (73630) |
$222 |
$370 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$288.60 |
$481 |
3.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$172.20 |
$287 |
2.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$214.80 |
$358 |
2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$184.20 |
$307 |
2.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$224.40 |
$374 |
2.7× |
| Radex shoulder complete minimum 2 views (73030) |
$320.40 |
$534 |
3.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$125.40 |
$209 |
1.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$296.40 |
$494 |
1.8× |
| Radex Spine 1 View Specify Level (72020) |
$147 |
$245 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$169.20 |
$282 |
2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$228.60 |
$381 |
2.7× |
| Radex Toe Minimum 2 Views (73660) |
$176.40 |
$294 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$153.60 |
$256 |
1.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$256.80 |
$428 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$204 |
$340 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$244.20 |
$407 |
2.4× |
| Radiologic exam colon double contrast study (74280) |
$475.20 |
$792 |
2.8× |
| Radiologic exam colon single contrast study (74270) |
$360.60 |
$601 |
2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$426.60 |
$711 |
2.5× |
| Radiologic exam knee complete 4/more views (73564) |
$333.60 |
$556 |
3.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$133.80 |
$223 |
1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$321.60 |
$536 |
1.9× |
| Radiologic exam swallow function contrast study (74230) |
$286.80 |
$478 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$537 |
$895 |
3.2× |
| Radiologic examination femur 1 view (73551) |
$148.20 |
$247 |
1.8× |
| Radiologic examination femur minimum 2 views (73552) |
$154.20 |
$257 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$183.60 |
$306 |
2.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$281.40 |
$469 |
2.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$235.80 |
$393 |
2.8× |
| Ribs bilateral 3 views (71110) |
$320.40 |
$534 |
3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$713.40 |
$1,189 |
1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$676.80 |
$1,128 |
1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,203.80 |
$3,673 |
4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,027.20 |
$1,712 |
2.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,206 |
$2,010 |
2.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,573.80 |
$2,623 |
1.3× |
| Scapula (73010) |
$201.60 |
$336 |
2.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$114.60 |
$191 |
4.9× |
| Shoulder 1 view (73020) |
$249.60 |
$416 |
3.0× |
| Shoulder Arthrography (73040) |
$331.20 |
$552 |
1.0× |
| Skull less than 4 views (70250) |
$160.20 |
$267 |
1.6× |
| Sternoclavicular joints (71130) |
$174 |
$290 |
2.1× |
| Testicular Imaging W/Flow (78761) |
$714.60 |
$1,191 |
1.9× |
| Thoracic spine 2 views (72070) |
$195.60 |
$326 |
2.0× |
| Thoracic spine 3 views (72072) |
$279.60 |
$466 |
2.8× |
| Thoracolumbar 2 views (72080) |
$126 |
$210 |
1.5× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
$713.40 |
$1,189 |
1.9× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$603.60 |
$1,006 |
1.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$418.20 |
$697 |
1.1× |
| Thyroid Met Imaging Body (78018) |
$915.60 |
$1,526 |
1.8× |
| Thyroid Uptake Measurement (78012) |
$231.60 |
$386 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$495 |
$825 |
1.3× |
| Ultrasound Breast Limited (76642) |
$312 |
$520 |
3.7× |
| Ultrasound Exam Aaa Screen (76706) |
$163.20 |
$272 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$482.40 |
$804 |
4.8× |
| Umbilical-artery Doppler (OB) (76820) |
$257.40 |
$429 |
2.6× |
| Unlisted magnetic resonance procedure (76498) |
$1,057.20 |
$1,762 |
12.7× |
| Unlisted us procedure (76999) |
$130.80 |
$218 |
1.6× |
| Upper gi w/o kub (74240) |
$537 |
$895 |
3.2× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$159 |
$265 |
14.4× |
| Urethrocystogram voiding (74455) |
$365.40 |
$609 |
1.6× |
| Urethrocystography retrograde (74450) |
$371.40 |
$619 |
1.6× |
| Us breast unilateral complete (76641) |
$333.60 |
$556 |
3.3× |
| Us chest (76604) |
$214.80 |
$358 |
2.1× |
| Us complete joint (76881) |
$511.20 |
$852 |
5.1× |
| Us exam, pelvic, limited (76857) |
$134.40 |
$224 |
1.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$266.40 |
$444 |
2.7× |
| Us ob detailed single fetus (76811) |
$473.40 |
$789 |
2.1× |
| Us ob limited 1 or more fetuses (76815) |
$200.40 |
$334 |
2.0× |
| Us ob transvaginal (76817) |
$364.20 |
$607 |
3.6× |
| Us pelvic non ob complete (76856) |
$639 |
$1,065 |
6.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$393.60 |
$656 |
3.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$258.60 |
$431 |
2.6× |
| Us retroperitoneal complete (76770) |
$472.20 |
$787 |
4.7× |
| Us scrotum and contents (76870) |
$458.40 |
$764 |
4.6× |
| Us spinal canal and contents (76800) |
$231 |
$385 |
2.3× |
| Us thyroid (76536) |
$505.20 |
$842 |
5.0× |
| Venography extremity bilateral rs&i (75822) |
$1,458 |
$2,430 |
1.0× |
| Wrist 2 views (73100) |
$184.80 |
$308 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$159 |
$265 |
1.9× |
| X-ray antegrade pyelogram tube (74425) |
$342.60 |
$571 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$484.80 |
$808 |
4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$191.40 |
$319 |
2.3× |
| X-Ray Exam Breast Specimen (76098) |
$212.40 |
$354 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$88.80 |
$148 |
1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$142.80 |
$238 |
1.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$117.60 |
$196 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$138.60 |
$231 |
1.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$210.60 |
$351 |
2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$188.40 |
$314 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$201 |
$335 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$224.40 |
$374 |
2.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$532.80 |
$888 |
5.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$227.40 |
$379 |
2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$433.80 |
$723 |
4.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$320.40 |
$534 |
3.2× |
| X-ray eye for foreign body (70030) |
$118.80 |
$198 |
1.4× |
| X-ray humerus (73060) |
$147.60 |
$246 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$133.20 |
$222 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$166.80 |
$278 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$266.40 |
$444 |
2.7× |
| X-ray nose-rectum child f.b. (76010) |
$106.20 |
$177 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$365.40 |
$609 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$249.60 |
$416 |
2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$176.40 |
$294 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$294 |
$490 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$220.20 |
$367 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$234 |
$390 |
2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$474 |
$790 |
1.4× |
| X-Rays Bone Length Studies (77073) |
$222.60 |
$371 |
2.2× |
| X-Rays Bone Survey Complete (77075) |
$367.80 |
$613 |
3.7× |
| Xr c-spine 4 or 5 views (72050) |
$355.20 |
$592 |
3.5× |
| Xr facial bones less than 3 views (70140) |
$123 |
$205 |
1.5× |
| Xr orbits complete 4 views (70200) |
$200.40 |
$334 |
2.0× |