| Abdomen 2 views (74019) |
$218.40 |
$273 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$583.20 |
$729 |
1.6× |
| Ankle 2 views (73600) |
$129.18 |
$161.48 |
1.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,348 |
$6,685 |
1.9× |
| Arthrogram hip (73525) |
$544.80 |
$681 |
1.7× |
| Arthrogram shoulder (73040) |
$273.60 |
$342 |
0.9× |
| Arthrography knee lt (73580) |
$544.80 |
$681 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$644.80 |
$806 |
1.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$520 |
$650 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$520 |
$650 |
1.4× |
| Bone age studies (77072) |
$104.80 |
$131 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$520 |
$650 |
1.4× |
| Bone survey complete (77075) |
$225.60 |
$282 |
2.4× |
| Brain image w/flow 4 + views (78606) |
$668.80 |
$836 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,762.40 |
$3,453 |
2.1× |
| Cervical spine 2 or 3 views (72040) |
$184.80 |
$231 |
2.3× |
| Chest 1 view (71045) |
$126.40 |
$158 |
1.6× |
| Chest 3 views (71047) |
$233.60 |
$292 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$244.80 |
$306 |
1.5× |
| Clavicle complete (73000) |
$129.32 |
$161.65 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,190.40 |
$1,488 |
12.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,476.80 |
$1,846 |
4.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,476.80 |
$1,846 |
6.8× |
| CT abdomen w contrast (74160) |
$1,476.80 |
$1,846 |
9.2× |
| CT abdomen w wo contrast (74170) |
$1,440 |
$1,800 |
9.0× |
| CT abdomen w/o contrast (74150) |
$1,060.80 |
$1,326 |
11.1× |
| CT angiography upper extremity lt (73206) |
$716.80 |
$896 |
4.5× |
| CT c-spine w/o contrast (72125) |
$1,125.60 |
$1,407 |
11.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,451.20 |
$1,814 |
9.0× |
| CT cervical spine with contrast (72126) |
$1,339.20 |
$1,674 |
4.2× |
| CT chest w/wo contrast (71270) |
$1,508.80 |
$1,886 |
9.4× |
| CT chest with contrast (71260) |
$1,297.60 |
$1,622 |
8.1× |
| CT head/brain with contrast (70460) |
$1,114.40 |
$1,393 |
6.9× |
| CT head/brain without and with contrast (70470) |
$1,238.40 |
$1,548 |
7.7× |
| CT iac w contrast (70481) |
$1,171.20 |
$1,464 |
7.3× |
| CT limited/localized follow up study (76380) |
$606.40 |
$758 |
7.6× |
| CT lower ext w/o (73700) |
$996.80 |
$1,246 |
10.4× |
| CT lower extremity w wo contrast (73702) |
$1,333.60 |
$1,667 |
8.3× |
| CT lower extremity with contrast (73701) |
$1,045.60 |
$1,307 |
6.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,451.20 |
$1,814 |
9.0× |
| CT lumbar spine w/o contrast (72131) |
$1,159.20 |
$1,449 |
12.1× |
| CT lumbar spine with contrast (72132) |
$1,340 |
$1,675 |
4.2× |
| CT maxillofacial w contrast (70487) |
$1,171.20 |
$1,464 |
7.3× |
| CT maxillofacial w/o contrast (70486) |
$1,139.20 |
$1,424 |
11.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,298.40 |
$1,623 |
8.1× |
| CT neck soft tissue w contrast (70491) |
$1,145.60 |
$1,432 |
7.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,338.40 |
$1,673 |
8.3× |
| CT orbits w/o contrast (70480) |
$1,114.40 |
$1,393 |
11.7× |
| CT pelvis w & w/o contrast (72194) |
$1,572 |
$1,965 |
9.8× |
| CT pelvis w/o contrast (72192) |
$1,132.80 |
$1,416 |
11.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,489.60 |
$1,862 |
9.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,145.60 |
$1,432 |
12.0× |
| CT thoracic spine w/contrast (72129) |
$1,427.20 |
$1,784 |
8.9× |
| CT thoracic spine w/o contrast (72128) |
$1,190.40 |
$1,488 |
12.5× |
| CT thoracic spine w/wo contrast (72130) |
$1,451.20 |
$1,814 |
9.0× |
| CT thorax w/o contrast (71250) |
$1,190.40 |
$1,488 |
12.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,204.80 |
$1,506 |
7.5× |
| CT upper extremity w/o contrast rt (73200) |
$992 |
$1,240 |
10.4× |
| CT upper extremity with contrast (73201) |
$1,096 |
$1,370 |
3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$716.80 |
$896 |
4.5× |
| Cta Abdomen (74175) |
$716.80 |
$896 |
4.5× |
| CTA abdomen pelvis (74174) |
$1,005.60 |
$1,257 |
3.2× |
| CTA chest (71275) |
$716.80 |
$896 |
4.5× |
| Cta Head (70496) |
$716.80 |
$896 |
4.5× |
| CTA lwr ext w&w/o contrast (73706) |
$716.80 |
$896 |
4.5× |
| Cta Neck (70498) |
$716.80 |
$896 |
4.5× |
| Cta Pelvis (72191) |
$716.80 |
$896 |
4.5× |
| Cystography minimum 3 views rs&i (74430) |
$312 |
$390 |
1.0× |
| Diskography lumbar (72295) |
$3,086.40 |
$3,858 |
1.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$133.60 |
$167 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$150.40 |
$188 |
1.6× |
| Echo exam of fetal heart (76825) |
$922.40 |
$1,153 |
1.8× |
| Echoencephalography real time imaging (76506) |
$519.20 |
$649 |
5.4× |
| Esophagus (74220) |
$238.40 |
$298 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$407.20 |
$509 |
4.3× |
| Fluoroscopy up to 1 hr (76000) |
$332 |
$415 |
1.5× |
| Foot 2 views (73620) |
$143.50 |
$179.38 |
1.8× |
| Forearm 2 views (73090) |
$152.80 |
$191 |
1.9× |
| Gated Heart Planar Single (78472) |
$857.60 |
$1,072 |
2.3× |
| Hand 2 views (73120) |
$142.60 |
$178.25 |
1.5× |
| Hand 3 views (73130) |
$149.60 |
$187 |
1.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$964.80 |
$1,206 |
2.6× |
| Ht muscle image spect sing (78451) |
$1,416.80 |
$1,771 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$149.60 |
$187 |
1.9× |
| Hysterosalpingogram (74740) |
$362.40 |
$453 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$713.20 |
$891.50 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$670.40 |
$838 |
1.4× |
| Knee 3 views (73562) |
$160.80 |
$201 |
2.0× |
| Liver & spleen imaging static only (78215) |
$668.80 |
$836 |
1.8× |
| Liver imaging static only (78201) |
$394.40 |
$493 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$2,537.60 |
$3,172 |
5.1× |
| Lung perfusion differential (78597) |
$735.20 |
$919 |
2.0× |
| Lung Ventilation Imaging (78579) |
$572.80 |
$716 |
1.6× |
| Lymphoscintigraphy (78195) |
$1,030.40 |
$1,288 |
2.1× |
| Mammary ductogram or galactogram multiple (77054) |
$525.60 |
$657 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$525.60 |
$657 |
2.4× |
| Meckels Diverticulum (78290) |
$513.60 |
$642 |
1.4× |
| MRA head w & w/o contrast (70546) |
$1,824 |
$2,280 |
5.7× |
| MRA head w/o contrast (70544) |
$1,375.20 |
$1,719 |
6.3× |
| MRA head with contrast (70545) |
$1,476 |
$1,845 |
4.6× |
| MRA neck w contrast (70548) |
$1,707.20 |
$2,134 |
5.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,667.20 |
$2,084 |
5.2× |
| MRA neck w/o contrast (70547) |
$1,316 |
$1,645 |
6.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,055.20 |
$2,569 |
6.4× |
| MRI abdomen w/o contrast (74181) |
$1,520 |
$1,900 |
7.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,502.40 |
$1,878 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,675.20 |
$2,094 |
2.3× |
| MRI c-spine with contrast (72142) |
$1,656 |
$2,070 |
5.2× |
| MRI cervical spine w/o contrast (72141) |
$1,591.20 |
$1,989 |
7.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,291.20 |
$2,864 |
7.2× |
| MRI chest w/o contrast (71550) |
$1,576 |
$1,970 |
7.2× |
| MRI chest with contrast (71551) |
$1,656 |
$2,070 |
2.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,465.60 |
$1,832 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,086.40 |
$2,608 |
9.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,080 |
$2,600 |
6.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,977.60 |
$2,472 |
6.2× |
| MRI pelvis w contrast (72196) |
$1,512.80 |
$1,891 |
4.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,133.60 |
$2,667 |
6.7× |
| MRI pelvis w/o contrast (72195) |
$1,436 |
$1,795 |
6.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,675.20 |
$2,094 |
5.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,988 |
$2,485 |
6.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,291.20 |
$2,864 |
7.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,675.20 |
$2,094 |
5.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,288 |
$2,860 |
7.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,637.60 |
$2,047 |
5.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,365.60 |
$2,957 |
7.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,569.60 |
$1,962 |
7.2× |
| MRI tmj (70336) |
$1,825.60 |
$2,282 |
8.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,548 |
$1,935 |
7.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,365.60 |
$1,707 |
4.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,325.60 |
$1,657 |
6.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,923.20 |
$2,404 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,416.80 |
$1,771 |
1.2× |
| Neck soft tissue (70360) |
$177.60 |
$222 |
2.2× |
| Nm gastric emptying study (78264) |
$513.60 |
$642 |
1.4× |
| Nm gastroesophageal reflux study (78262) |
$657.60 |
$822 |
1.8× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$5,968 |
$7,460 |
4.6× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,923.20 |
$2,404 |
1.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$476.80 |
$596 |
1.3× |
| Nuclear Rx Oral Admin (79005) |
$485.60 |
$607 |
2.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$236 |
$295 |
2.5× |
| Parathyroid imaging (78070) |
$465.60 |
$582 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$78.86 |
$98.58 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$2,441.60 |
$3,052 |
1.9× |
| PET imaging CT for attenuation limited area (78814) |
$2,441.60 |
$3,052 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$2,441.60 |
$3,052 |
1.9× |
| Pr heart first pass single,planar (78481) |
$571.20 |
$714 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,960.80 |
$2,451 |
6.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$668.80 |
$836 |
1.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$666.40 |
$833 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$218.40 |
$273 |
0.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$402.01 |
$502.51 |
4.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$178.67 |
$223.34 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$210.40 |
$263 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$218.40 |
$273 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$392.40 |
$490.50 |
4.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$168 |
$210 |
2.1× |
| Radiologic exam colon single contrast study (74270) |
$312 |
$390 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$376 |
$470 |
2.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$153.60 |
$192 |
1.9× |
| Radiological examination surgical specimen (76098) |
$128 |
$160 |
0.3× |
| Ribs bilateral 3 views (71110) |
$179.78 |
$224.72 |
1.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$936.80 |
$1,171 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,048.80 |
$1,311 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$184.80 |
$231 |
1.9× |
| Scanogram (77073) |
$606.40 |
$758 |
6.3× |
| Scapula complete (73010) |
$135.08 |
$168.86 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$94.40 |
$118 |
4.0× |
| Small bowel series (74250) |
$114.05 |
$142.56 |
0.7× |
| Spine thoracic 3 views (72072) |
$203.20 |
$254 |
2.1× |
| Spleen imaging only (78185) |
$668.80 |
$836 |
1.8× |
| Testicular Imaging With Vascular Flow (78761) |
$394.40 |
$493 |
1.1× |
| Thoracolumbar 2 views (72080) |
$177.60 |
$222 |
2.2× |
| Thyroid uptake measurement (78012) |
$279.20 |
$349 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$460 |
$575 |
1.3× |
| Tmj unilateral (70328) |
$153.60 |
$192 |
1.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,561.60 |
$1,952 |
3.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$589.60 |
$737 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$370 |
$462.50 |
3.9× |
| Upper Extremity Infant (73092) |
$184.80 |
$231 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$312 |
$390 |
1.4× |
| Urethrocystography voiding (74455) |
$336.80 |
$421 |
1.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$404.80 |
$506 |
2.5× |
| Us abdl aorta screen aaa (76706) |
$208 |
$260 |
2.2× |
| Us breast unilateral complete (76641) |
$232.80 |
$291 |
2.4× |
| Us breast unilateral limited (76642) |
$232.80 |
$291 |
2.9× |
| Us chest (76604) |
$136.80 |
$171 |
1.4× |
| Us compl joint r-t w/image documentation (76881) |
$272 |
$340 |
2.8× |
| Us guided compression repair (76936) |
$240.80 |
$301 |
1.2× |
| Us infant hips dynamic (76885) |
$475.20 |
$594 |
6.0× |
| Us infant hips limited static (76886) |
$475.20 |
$594 |
6.0× |
| Us kidney transplant (76776) |
$394.40 |
$493 |
4.1× |
| Us ob transvaginal (76817) |
$230.40 |
$288 |
2.4× |
| Us pelvic non ob complete (76856) |
$386.40 |
$483 |
4.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$386.40 |
$483 |
4.0× |
| Us pregnancy ltd (76815) |
$407.20 |
$509 |
4.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$230.40 |
$288 |
2.4× |
| Us retroperitoneal complete (76770) |
$394.40 |
$493 |
4.1× |
| Us retroperitoneal limited (76775) |
$394.40 |
$493 |
4.1× |
| Us scrotum and contents (76870) |
$536 |
$670 |
5.6× |
| Us soft tissue head/neck (76536) |
$443.20 |
$554 |
4.6× |
| Us spinal canal and contents (76800) |
$218.40 |
$273 |
2.3× |
| Us transrectal (76872) |
$404.80 |
$506 |
4.2× |
| Us xtr non-vasc lmtd (76882) |
$272 |
$340 |
2.8× |
| Venography extremity unilateral rs&i (75820) |
$198.40 |
$248 |
0.1× |
| Wrist 2 views (73100) |
$140 |
$175 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$169.60 |
$212 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$157.60 |
$197 |
2.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$336.80 |
$421 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$160.80 |
$201 |
2.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$203.20 |
$254 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$182.40 |
$228 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$182.40 |
$228 |
2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$456 |
$570 |
4.8× |
| X-ray eye for foreign body (70030) |
$104.80 |
$131 |
1.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$267.20 |
$334 |
2.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$176.91 |
$221.14 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$152.80 |
$191 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$160.80 |
$201 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$184.80 |
$231 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$117.86 |
$147.32 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$267.20 |
$334 |
2.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$184.80 |
$231 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$160.80 |
$201 |
2.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$218.40 |
$273 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$206.40 |
$258 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$191.02 |
$238.77 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$358.40 |
$448 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$165.60 |
$207 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$165.60 |
$207 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$159.20 |
$199 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$140.46 |
$175.57 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$161.60 |
$202 |
2.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$141.60 |
$177 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$278.40 |
$348 |
3.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$150.40 |
$188 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$241.60 |
$302 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$104.80 |
$131 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$133.60 |
$167 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$165.60 |
$207 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$172 |
$215 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$177.60 |
$222 |
1.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$182.40 |
$228 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$156 |
$195 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$248 |
$310 |
2.6× |
| Xr chest 4+ views (71048) |
$148.31 |
$185.39 |
1.6× |
| Xr Cholecystography Oral Contrast (74290) |
$210.40 |
$263 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$121.60 |
$152 |
1.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$210.40 |
$263 |
2.2× |
| Xr optic foramina (70190) |
$191.20 |
$239 |
2.4× |
| Xr shoulder 1 view (73020) |
$108 |
$135 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$196.80 |
$246 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$184.80 |
$231 |
2.3× |
| Xr tmj bilateral (70330) |
$164.42 |
$205.53 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$126.30 |
$157.87 |
1.6× |