| 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× |
| Antegrade urography radiological supvj & interpj (74425) |
$342.60 |
$571 |
1.0× |
| Arthrogram elbow (73085) |
$370.20 |
$617 |
1.1× |
| Arthrogram hip (73525) |
$370.20 |
$617 |
1.1× |
| Arthrogram shoulder (73040) |
$331.20 |
$552 |
1.0× |
| Arthrogram wrist (73115) |
$370.20 |
$617 |
1.1× |
| Arthrography knee lt (73580) |
$298.80 |
$498 |
0.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$772.80 |
$1,288 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$741 |
$1,235 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,610.40 |
$2,684 |
4.2× |
| Bone age studies (77072) |
$192 |
$320 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,240.20 |
$2,067 |
3.2× |
| Bone survey complete (77075) |
$367.80 |
$613 |
3.7× |
| Brain imaging < 4 static views w vascular flow (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× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$159 |
$265 |
14.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$948.60 |
$1,581 |
2.5× |
| Cervical spine 2 or 3 views (72040) |
$227.40 |
$379 |
2.7× |
| Chest 1 view (71045) |
$126 |
$210 |
1.5× |
| Chest 3 views (71047) |
$165.60 |
$276 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$286.80 |
$478 |
1.7× |
| Clavicle complete (73000) |
$205.20 |
$342 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$184.80 |
$308 |
1.8× |
| 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 hrt w/3d image (75574) |
$1,578 |
$2,630 |
4.7× |
| CT angiography upper extremity lt (73206) |
$1,282.20 |
$2,137 |
7.6× |
| CT c-spine w/o contrast (72125) |
$1,263 |
$2,105 |
12.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,642.20 |
$2,737 |
9.8× |
| CT cervical spine with contrast (72126) |
$1,402.20 |
$2,337 |
4.2× |
| CT chest with 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 limited/localized follow up study (76380) |
$390 |
$650 |
4.7× |
| CT lower ext w/o (73700) |
$780.60 |
$1,301 |
7.8× |
| CT lower extremity w wo contrast (73702) |
$1,374 |
$2,290 |
8.2× |
| CT lower extremity with contrast (73701) |
$921 |
$1,535 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$950.40 |
$1,584 |
5.6× |
| CT lumbar spine w/o contrast (72131) |
$1,033.20 |
$1,722 |
10.3× |
| CT lumbar spine with contrast (72132) |
$1,116 |
$1,860 |
3.3× |
| CT maxillofacial w contrast (70487) |
$939 |
$1,565 |
5.6× |
| CT maxillofacial w/o contrast (70486) |
$846 |
$1,410 |
8.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,074.60 |
$1,791 |
6.4× |
| CT neck soft tissue w contrast (70491) |
$1,556.40 |
$2,594 |
9.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) |
$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 contrast (72130) |
$1,465.80 |
$2,443 |
8.7× |
| CT thorax w/o contrast (71250) |
$846 |
$1,410 |
8.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$931.80 |
$1,553 |
5.5× |
| CT upper extremity w/o contrast rt (73200) |
$722.40 |
$1,204 |
7.2× |
| 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 abdomen pelvis (74174) |
$1,890.60 |
$3,151 |
5.6× |
| CTA chest (71275) |
$1,567.20 |
$2,612 |
9.3× |
| Cta Head (70496) |
$1,218.60 |
$2,031 |
7.2× |
| CTA lwr ext w&w/o contrast (73706) |
$1,435.80 |
$2,393 |
8.5× |
| Cta Neck (70498) |
$1,218.60 |
$2,031 |
7.2× |
| Cta Pelvis (72191) |
$1,435.80 |
$2,393 |
8.5× |
| Cystography minimum 3 views rs&i (74430) |
$333.60 |
$556 |
1.0× |
| Dacryocystography (70170) |
$577.80 |
$963 |
2.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$189 |
$315 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$169.20 |
$282 |
1.7× |
| Esophagus (74220) |
$293.40 |
$489 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$300.60 |
$501 |
3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$300.60 |
$501 |
3.0× |
| 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× |
| Gated Heart Planar Single (78472) |
$977.40 |
$1,629 |
2.5× |
| Hand 2 views (73120) |
$256.80 |
$428 |
2.6× |
| Hand 3 views (73130) |
$288.60 |
$481 |
3.5× |
| Heart Infarct Image (78466) |
$685.20 |
$1,142 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,587 |
$2,645 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,253.40 |
$2,089 |
3.3× |
| Ht muscle image spect sing (78451) |
$2,044.80 |
$3,408 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$147.60 |
$246 |
1.8× |
| Hysterosalpingogram (74740) |
$393.60 |
$656 |
1.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$333.60 |
$556 |
3.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$915.60 |
$1,526 |
1.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$941.40 |
$1,569 |
1.8× |
| Knee 3 views (73562) |
$276.60 |
$461 |
3.3× |
| 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 Ventilation Imaging (78579) |
$445.80 |
$743 |
1.2× |
| Lymphoscintigraphy (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 Diverticulum (78290) |
$544.20 |
$907 |
1.4× |
| MRA head w & w/o contrast (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 & w/contrast material (74183) |
$2,544.60 |
$4,241 |
7.6× |
| MRI abdomen w/o contrast (74181) |
$2,010 |
$3,350 |
8.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,110.80 |
$3,518 |
2.8× |
| 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 w/o contrast unilat (77046) |
$1,292.40 |
$2,154 |
5.6× |
| MRI c-spine with contrast (72142) |
$1,566 |
$2,610 |
4.7× |
| MRI cervical spine w/o contrast (72141) |
$1,666.20 |
$2,777 |
7.3× |
| MRI chest w/o & w/contrast material (71552) |
$1,950.60 |
$3,251 |
5.8× |
| 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 fetal sngl/1st gestation (74712) |
$1,682.40 |
$2,804 |
7.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,616.40 |
$2,694 |
4.8× |
| 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 contr matrl (73718) |
$1,734.60 |
$2,891 |
7.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,399.20 |
$2,332 |
6.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,747.80 |
$2,913 |
5.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,503.60 |
$2,506 |
4.5× |
| MRI pelvis w contrast (72196) |
$1,657.20 |
$2,762 |
5.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,436.60 |
$4,061 |
7.3× |
| MRI pelvis w/o contrast (72195) |
$1,900.80 |
$3,168 |
8.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,173.20 |
$3,622 |
6.5× |
| MRI scan of leg joint before and after contrast (73723) |
$2,164.20 |
$3,607 |
6.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,166 |
$3,610 |
6.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,010 |
$3,350 |
6.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,214.60 |
$3,691 |
6.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,837.80 |
$3,063 |
5.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,997.40 |
$3,329 |
6.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,597.80 |
$2,663 |
7.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,795.80 |
$2,993 |
7.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,836.60 |
$3,061 |
5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,569.60 |
$2,616 |
6.9× |
| Myelogram Cervical (72240) |
$726.60 |
$1,211 |
1.0× |
| Myelogram Lumbar (72265) |
$843.60 |
$1,406 |
1.1× |
| Myelogram thoracic (72255) |
$767.40 |
$1,279 |
1.0× |
| Myelography 2 or more regions (72270) |
$1,135.20 |
$1,892 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,098.40 |
$5,164 |
2.5× |
| Neck soft tissue (70360) |
$129 |
$215 |
1.5× |
| Nm gastric emptying study (78264) |
$706.80 |
$1,178 |
1.8× |
| Nm gastroesophageal reflux study (78262) |
$828.60 |
$1,381 |
2.2× |
| Nm red cell sequestration (78140) |
$651 |
$1,085 |
1.7× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,602.80 |
$4,338 |
2.1× |
| Nuclear medicine study of kidney and blood flow (78701) |
$760.20 |
$1,267 |
2.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$603.60 |
$1,006 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$456 |
$760 |
2.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$258.60 |
$431 |
2.6× |
| Osseous survey infant (77076) |
$301.20 |
$502 |
3.0× |
| Osseous survey limited (77074) |
$281.40 |
$469 |
2.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,156.20 |
$1,927 |
3.0× |
| Parathyroid imaging (78070) |
$581.40 |
$969 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$117.60 |
$196 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$3,786 |
$6,310 |
2.8× |
| PET imaging CT for attenuation limited area (78814) |
$4,202.40 |
$7,004 |
3.1× |
| PET imaging for CT attenuation whole body (78816) |
$3,786 |
$6,310 |
2.8× |
| Pr heart first pass single,planar (78481) |
$792 |
$1,320 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,133.60 |
$3,556 |
6.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$401.40 |
$669 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$449.40 |
$749 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$272.40 |
$454 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$88.80 |
$148 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$142.80 |
$238 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$188.40 |
$314 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$214.80 |
$358 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$204 |
$340 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$170.40 |
$284 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$244.20 |
$407 |
2.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$140.40 |
$234 |
1.7× |
| 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 upr gi trc double contrast study (74246) |
$537 |
$895 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$537 |
$895 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$154.20 |
$257 |
1.8× |
| Radiological examination surgical specimen (76098) |
$212.40 |
$354 |
0.4× |
| Ribs bilateral 3 views (71110) |
$320.40 |
$534 |
3.2× |
| 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 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× |
| Sacroiliac Joints < 3 Views (72200) |
$176.40 |
$294 |
1.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$214.80 |
$358 |
0.9× |
| Scanogram (77073) |
$222.60 |
$371 |
2.2× |
| Scapula complete (73010) |
$201.60 |
$336 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$114.60 |
$191 |
4.9× |
| Small bowel series (74250) |
$321.60 |
$536 |
1.9× |
| Spine thoracic 3 views (72072) |
$279.60 |
$466 |
2.8× |
| Testicular Imaging With Vascular Flow (78761) |
$714.60 |
$1,191 |
1.9× |
| Thoracolumbar 2 views (72080) |
$126 |
$210 |
1.5× |
| Thyroid carcinoma metastases img addl study (78016) |
$713.40 |
$1,189 |
1.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$915.60 |
$1,526 |
1.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$418.20 |
$697 |
1.1× |
| Thyroid uptake measurement (78012) |
$231.60 |
$386 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$495 |
$825 |
1.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,203.80 |
$3,673 |
4.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$713.40 |
$1,189 |
1.9× |
| 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 Ultrasound Procedure (76999) |
$130.80 |
$218 |
1.6× |
| Upper Extremity Infant (73092) |
$153.60 |
$256 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$371.40 |
$619 |
1.6× |
| Urethrocystography voiding (74455) |
$365.40 |
$609 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$163.20 |
$272 |
1.6× |
| Us breast unilateral complete (76641) |
$333.60 |
$556 |
3.3× |
| Us breast unilateral limited (76642) |
$312 |
$520 |
3.7× |
| Us chest (76604) |
$214.80 |
$358 |
2.1× |
| Us compl joint r-t w/image documentation (76881) |
$511.20 |
$852 |
5.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$342.60 |
$571 |
3.4× |
| Us guided compression repair (76936) |
$747 |
$1,245 |
3.6× |
| Us ob detailed single fetus (76811) |
$473.40 |
$789 |
2.1× |
| Us ob transvaginal (76817) |
$364.20 |
$607 |
3.6× |
| Us pelvic non ob complete (76856) |
$639 |
$1,065 |
6.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$134.40 |
$224 |
1.3× |
| Us pregnancy ltd (76815) |
$200.40 |
$334 |
2.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$393.60 |
$656 |
3.9× |
| Us retroperitoneal complete (76770) |
$472.20 |
$787 |
4.7× |
| Us scrotum and contents (76870) |
$458.40 |
$764 |
4.6× |
| Us soft tissue head/neck (76536) |
$505.20 |
$842 |
5.0× |
| Us spinal canal and contents (76800) |
$231 |
$385 |
2.3× |
| Us xtr non-vasc lmtd (76882) |
$266.40 |
$444 |
2.7× |
| Venogram extremity bilateral (75822) |
$1,458 |
$2,430 |
1.0× |
| Wrist 2 views (73100) |
$184.80 |
$308 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$283.80 |
$473 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$159 |
$265 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$276 |
$460 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$475.20 |
$792 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$191.40 |
$319 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$214.80 |
$358 |
2.6× |
| 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 3-4 Views (73522) |
$201 |
$335 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$224.40 |
$374 |
2.2× |
| X-ray exam of femur 1 (73551) |
$148.20 |
$247 |
1.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$296.40 |
$494 |
1.8× |
| X-ray eye for foreign body (70030) |
$118.80 |
$198 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$240.60 |
$401 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$123 |
$205 |
1.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$222 |
$370 |
2.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$163.80 |
$273 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$133.20 |
$222 |
1.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$333.60 |
$556 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$166.80 |
$278 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$172.20 |
$287 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$266.40 |
$444 |
2.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$532.80 |
$888 |
5.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$484.80 |
$808 |
4.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$184.20 |
$307 |
2.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$106.20 |
$177 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$200.40 |
$334 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$133.80 |
$223 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$474 |
$790 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$224.40 |
$374 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$320.40 |
$534 |
3.2× |
| 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 Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$294 |
$490 |
3.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$320.40 |
$534 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$220.20 |
$367 |
2.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$125.40 |
$209 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$234 |
$390 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$160.20 |
$267 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$147 |
$245 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$174 |
$290 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$169.20 |
$282 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$195.60 |
$326 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$176.40 |
$294 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$256.80 |
$428 |
3.1× |
| Xr arthrogram ankle (73615) |
$370.20 |
$617 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$433.80 |
$723 |
4.3× |
| Xr chest 4+ views (71048) |
$244.80 |
$408 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$184.20 |
$307 |
2.2× |
| Xr shoulder 1 view (73020) |
$249.60 |
$416 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$355.20 |
$592 |
3.5× |
| Xr tibia/fibula 2 views (73590) |
$235.80 |
$393 |
2.8× |
| Xr tmj bilateral (70330) |
$228.60 |
$381 |
2.7× |
| Xray knee 1 or 2 views rt (73560) |
$183.60 |
$306 |
2.2× |