Imaging prices at UofL Health – Shelbyville Hospital

Shelbyville, KY · every code in this section with a posted price and a Medicare benchmark.

320 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $106.78 $281 1.1×
Acute gastrointestinal blood loss imaging (78278) $810.54 $2,133 2.1×
Angiography extremity bilateral rs&i (75716) $3,867.64 $10,178 1.3×
Angiography extremity unilateral rs&i (75710) $2,729.54 $7,183 0.9×
Ankle 2 views (73600) $147.06 $387 1.7×
Antegrade urography radiological supvj & interpj (74425) $562.78 $1,481 1.7×
Arthrogram hip (73525) $565.06 $1,487 1.7×
Arthrogram shoulder (73040) $584.82 $1,539 1.7×
Arthrography knee lt (73580) $584.06 $1,537 1.7×
Bone &/Joint Imaging Limited Area (78300) $852.34 $2,243 2.2×
Bone &/joint imaging whole body (78306) $1,041.58 $2,741 2.7×
Bone age studies (77072) $190.76 $502 1.9×
Bone Imaging 3 Phase (78315) $1,106.94 $2,913 2.9×
Bone Marrow Imaging Limited Area (78102) $428.64 $1,128 1.1×
Bone survey complete (77075) $206.34 $543 2.0×
Brain image w/flow 4 + views (78606) $849.68 $2,236 1.6×
Brain Imaging Pet Metabolic Evaluation (78608) $2,678.62 $7,049 1.9×
Cardiac MRI w/w/o contrast & further seq (75561) $1,512.40 $3,980 4.5×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $245.86 $647 0.5×
Cervical spine 2 or 3 views (72040) $267.52 $704 3.2×
Chest 1 view (71045) $137.56 $362 1.6×
Chest 3 views (71047) $164.92 $434 2.0×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $478.04 $1,258 2.8×
Clavicle complete (73000) $238.26 $627 2.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $446.12 $1,174 4.4×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $198.74 $523 1.2×
CT abdomen and pelvis without and with contrast (74178) $1,248.30 $3,285 3.7×
CT abdomen and pelvis without contrast (74176) $976.98 $2,571 4.2×
CT abdomen w contrast (74160) $473.86 $1,247 2.8×
CT abdomen w wo contrast (74170) $612.56 $1,612 3.6×
CT abdomen w/o contrast (74150) $418 $1,100 4.1×
CT angio hrt w/3d image (75574) $2,095.68 $5,514.94 6.2×
CT angiography upper extremity lt (73206) $1,124.80 $2,960 6.6×
CT c-spine w/o contrast (72125) $807.50 $2,125 8.0×
CT cervical spine w&w/o contrast (72127) $1,144.94 $3,013 6.7×
CT cervical spine with contrast (72126) $842.84 $2,218 2.5×
CT chest w/wo contrast (71270) $1,102 $2,900 6.5×
CT chest with contrast (71260) $763.80 $2,010 4.5×
CT colonography w/dye (74262) $1,972.58 $5,191 11.6×
CT colonography w/o cntrst (74261) $772.92 $2,034 7.6×
CT head/brain with contrast (70460) $705.66 $1,857 4.2×
CT head/brain without and with contrast (70470) $971.28 $2,556 5.7×
CT heart no contrast quant eval coronry calcium (75571) $127.68 $336 1.5×
CT hrt w/3d image congen (75573) $2,095.68 $5,514.94 6.2×
CT iac w contrast (70481) $815.86 $2,147 4.8×
CT limited/localized follow up study (76380) $567.72 $1,494 6.7×
CT lower ext w/o (73700) $713.83 $1,878.49 7.1×
CT lower extremity w wo contrast (73702) $1,426.52 $3,754 8.4×
CT lower extremity with contrast (73701) $862.60 $2,270 5.1×
CT lumbar spine w & w/o contrast (72133) $1,532.16 $4,032 9.0×
CT lumbar spine w/o contrast (72131) $773.68 $2,036 7.6×
CT lumbar spine with contrast (72132) $842.84 $2,218 2.5×
CT maxillofacial w contrast (70487) $747.84 $1,968 4.4×
CT maxillofacial w/o contrast (70486) $676.78 $1,781 6.7×
CT maxillofacial w/wo contrast (70488) $1,052.81 $2,770.55 6.2×
CT neck soft tissue w contrast (70491) $933.66 $2,457 5.5×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,696.32 $4,464 10.0×
CT orbits w/o contrast (70480) $759.24 $1,998 7.5×
CT pelvis w & w/o contrast (72194) $1,122.90 $2,955 6.6×
CT pelvis w/o contrast (72192) $620.92 $1,634 6.1×
CT scan for measuring calcium and other minerals in bone (77078) $240.66 $633.31 2.9×
CT soft tissue neck w/o & w/contrast material (70492) $968.62 $2,549 5.7×
CT soft tissue neck w/o contrast (70490) $690.84 $1,818 6.8×
CT thoracic spine w/contrast (72129) $1,078.06 $2,837 6.3×
CT thoracic spine w/o contrast (72128) $895.66 $2,357 8.9×
CT thoracic spine w/wo contrast (72130) $1,411.70 $3,715 8.3×
CT thorax w/o contrast (71250) $554.04 $1,458 5.5×
CT upper extremity w/o contrast rt (73200) $669.04 $1,760.65 6.6×
CT upper extremity with contrast (73201) $893 $2,350 2.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,549.26 $4,077 9.1×
Cta Abdomen (74175) $1,046.90 $2,755 6.2×
CTA abdomen pelvis (74174) $1,993.86 $5,247 5.9×
CTA chest (71275) $1,047.28 $2,756 6.2×
Cta Head (70496) $1,058.30 $2,785 6.2×
CTA lwr ext w&w/o contrast (73706) $1,349 $3,550 7.9×
Cta Neck (70498) $918.08 $2,416 5.4×
Cta Pelvis (72191) $1,354.70 $3,565 8.0×
Cystography minimum 3 views rs&i (74430) $462.46 $1,217 1.4×
Diskogram cervical (72285) $1,616.14 $4,253 0.9×
Diskography lumbar (72295) $1,372.56 $3,612 0.7×
Dxa bone density study 1/> sites axial skel (77080) $201.40 $530 2.0×
Echoencephalography real time imaging (76506) $254.98 $671 2.5×
Esophagus (74220) $346.56 $912 2.0×
Fluoroscopy up to 1 hr (76000) $198.74 $523 0.9×
Foot 2 views (73620) $153.14 $403 1.8×
Forearm 2 views (73090) $181.26 $477 2.2×
Functional MRI brain by phys/psych (70555) $1,182.18 $3,111 5.1×
Functional MRI brain by tech (70554) $1,092.50 $2,875 4.7×
Gated Heart Planar Single (78472) $735.68 $1,936 1.9×
Hand 2 views (73120) $172.52 $454 1.7×
Hand 3 views (73130) $202.16 $532 2.4×
Heart Infarct Image (78466) $748.60 $1,970 1.9×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,117.20 $2,940 2.1×
Hepatobiliary syst imaging including gallbladder (78226) $539.22 $1,419 1.4×
Ht muscle image spect sing (78451) $1,815.26 $4,777 1.4×
Humerus Min 2 Views Left (73060) $162.64 $428 1.9×
Hysterosalpingogram (74740) $290.89 $765.50 1.3×
Interstitial radiation source applic complex (77778) $1,960.04 $5,158 2.9×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $175.56 $462 1.7×
Kidney imaging morphology (78700) $577.60 $1,520 1.5×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $681.72 $1,794 1.3×
Kidney img morphology vascular flow 1 w/rx (78708) $605.34 $1,593 1.2×
Knee 3 views (73562) $379.62 $999 4.5×
Liver & spleen imaging static only (78215) $430.16 $1,132 1.1×
Liver & Spleen Imaging W/Vascular Flow (78216) $552.52 $1,454 1.4×
Liver imaging static only (78201) $926.06 $2,437 1.8×
Lung perf&ventilat diferentl (78598) $497.42 $1,309 0.9×
Lung perfusion differential (78597) $349.98 $921 0.9×
Lung Ventilation Imaging (78579) $708.70 $1,865 1.8×
Lymphoscintigraphy (78195) $702.62 $1,849 1.3×
Mammary ductogram or galactogram multiple (77054) $201.40 $530 0.9×
Mammary ductogram or galactogram single (77053) $371.26 $977 1.6×
Manual appl stress pfrmd phys/qhp joint films (77071) $65.36 $172 0.8×
Meckels Diverticulum (78290) $496.66 $1,307 1.3×
Mr safety determination physician/other qhp (76016) $140.98 $371 1.7×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $39.14 $103 1.4×
Mr safety implt electronics prepj supvj phys/qhp (76018) $147.06 $387 1.6×
Mr safety med physics xm customization plng&mntr (76017) $387.60 $1,020 1.7×
MRA head w & w/o contrast (70546) $2,160.68 $5,686 6.4×
MRA head w/o contrast (70544) $1,563.70 $4,115 6.8×
MRA head with contrast (70545) $2,052 $5,400 6.1×
MRA neck w contrast (70548) $1,421.20 $3,740 4.2×
Mra Neck W/O &W/Contrast Material (70549) $1,425 $3,750 4.2×
MRA neck w/o contrast (70547) $1,420.82 $3,739 6.2×
MRI abdomen w contrast (74182) $2,208.94 $5,813 6.5×
MRI abdomen w/o & w/contrast material (74183) $1,440.20 $3,790 4.3×
MRI abdomen w/o contrast (74181) $1,106.18 $2,911 4.8×
MRI any jnt lwr ext with con lt (73722) $1,035.50 $2,725 1.4×
MRI any jt upper extremity w/contrast matrl (73222) $1,101.24 $2,898 1.5×
MRI breast w/o contrast unilat (77046) $1,193.39 $3,140.50 5.2×
MRI c-spine with contrast (72142) $1,597.52 $4,204 4.7×
MRI cardiac w/o cont stress (75559) $1,949.62 $5,130.58 3.7×
MRI cardiac w/o contrast (75557) $965.96 $2,542 4.2×
MRI cervical spine w/o contrast (72141) $1,336.84 $3,518 5.8×
MRI chest w/o & w/contrast material (71552) $1,694.42 $4,459 5.0×
MRI chest w/o contrast (71550) $1,322.40 $3,480 5.7×
MRI chest with contrast (71551) $1,429.56 $3,762 1.9×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $1,616.52 $4,254 4.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $960.64 $2,528 2.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,161.28 $3,056 5.0×
MRI orbit face &/neck w/o contrast (70540) $1,449.32 $3,814 6.3×
MRI orbit/face/neck w&w/o cont (70543) $1,223.98 $3,221 3.6×
MRI orbit/face/neck w/contrast (70542) $2,208.94 $5,813 6.5×
MRI pelvis w contrast (72196) $1,944.84 $5,118 5.8×
MRI pelvis w/o & w/contrast material (72197) $1,253.62 $3,299 3.7×
MRI pelvis w/o contrast (72195) $1,683.30 $4,429.74 7.3×
MRI scan of arm joint before and after contrast (73223) $1,359.26 $3,577 4.0×
MRI scan of heart before and after contrast with stress imaging (75563) $1,281.64 $3,372.75 1.7×
MRI scan of leg joint before and after contrast (73723) $1,355.46 $3,567 4.0×
MRI spectroscopy (76390) $1,432.60 $3,770 17.0×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,425 $3,750 4.2×
MRI spinal canal lumbar w/contrast material (72149) $1,597.52 $4,204 4.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,336.84 $3,518 4.0×
MRI spinal canal thoracic w/contrast matrl (72147) $1,292 $3,400 3.8×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,425 $3,750 4.2×
MRI thoracic spine w/o contrast (72146) $1,336.84 $3,518 5.8×
MRI tmj (70336) $1,944.84 $5,118 8.4×
MRI upper ext joint w/o contrast (73221) $1,032.84 $2,718 4.5×
MRI upper extrem other than jt w/o & w/contras (73220) $1,506.51 $3,964.50 4.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $820.80 $2,160 3.6×
Myocardial Spect Multiple Studies (78452) $3,226.20 $8,490 2.6×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $869.82 $2,289 1.0×
Neck soft tissue (70360) $203.68 $536 2.4×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $372.02 $979 1.0×
Nm cisternogram (78630) $850.82 $2,239 1.6×
Nm csf leak detection (78650) $1,176.24 $3,095.37 0.9×
Nm gastric emptying study (78264) $1,061.72 $2,794 2.7×
Nm peritoneal-venous shunt patency (78291) $490.58 $1,291 1.3×
Nuclear medicine study of kidney and blood flow (78701) $513 $1,350 1.3×
Nuclear Rx Oral Admin (79005) $1,088.32 $2,864 4.8×
Osseous survey infant (77076) $314.26 $827 3.1×
Osseous survey limited (77074) $343.52 $904 3.4×
Parathyrd planar w/spect&CT (78072) $522.88 $1,376 1.0×
Parathyroid imaging (78070) $433.96 $1,142 1.1×
Pelvis 1 or 2 views (72170) $175.94 $463 1.7×
Perineogram (74775) $294.50 $775 1.3×
PET image w/CT, skull-thigh (78815) $3,538.94 $9,313 2.6×
PET imaging CT for attenuation limited area (78814) $2,824.92 $7,434 2.0×
PET imaging for CT attenuation whole body (78816) $3,538.94 $9,313 2.6×
Pr csf ventriculography (78635) $615.98 $1,621 1.2×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,237.28 $3,256 3.7×
Pulmonary Perfusion Imaging Particulate (78580) $764.56 $2,012 2.0×
Pulmonary Ventilation & Perfusion Imaging (78582) $649.42 $1,709 1.2×
Radex abscess/fistula/sinus tract rs&i (76080) $557.84 $1,468 1.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $436.24 $1,148 4.3×
Radex hips bilateral with pelvis 2 views (73521) $199.50 $525 2.0×
Radex mastoids compl minimum 3 views pr side (70130) $227.62 $599 2.2×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $129.96 $342 1.3×
Radiolog exam mandible compl minimum 4 views (70110) $391.40 $1,030 3.9×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $102.98 $271 1.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $106.78 $281 1.1×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $164.54 $433 2.0×
Radiologic exam colon single contrast study (74270) $479.18 $1,261 2.8×
Radiologic exam upr gi trc double contrast study (74246) $774.06 $2,037 4.6×
Radiologic exam upr gi trc single contrast study (74240) $417.62 $1,099 2.5×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $145.16 $382 1.7×
Radiological examination surgical specimen (76098) $258.78 $681 0.5×
Ribs bilateral 3 views (71110) $330.22 $869 3.3×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $882.36 $2,321.99 2.3×
Rp loclzj tum plnr whole body single day imaging (78802) $1,316.70 $3,465 2.5×
Rp loclzj tum spect 1 area single day imaging (78803) $1,243.36 $3,272 2.4×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,004.15 $2,642.50 0.8×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $1,279.08 $3,366 0.9×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $1,127.46 $2,967 0.9×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $800.28 $2,106 3.5×
Rp Therapy Intravenous Administration (79101) $662.34 $1,743 2.9×
Sacroiliac Joints < 3 Views (72200) $166.44 $438 1.6×
Scanogram (77073) $179.93 $473.50 1.8×
Scapula complete (73010) $265.24 $698 2.6×
Screening digital breast tomosynthesis (77063) $55.48 $146 2.4×
Sella turcica (70240) $45.22 $119 0.5×
Shuntogram indwelling nonvascular shunt rs&i (75809) $313.12 $824 3.1×
Sialogram (70390) $177.46 $467 0.8×
Small bowel series (74250) $566.96 $1,492 3.3×
Speech evaluation complex (70371) $111.72 $294 0.5×
Spine thoracic 3 views (72072) $235.60 $620 2.3×
Therapeutic Enema (74283) $133.76 $352 0.8×
Thoracolumbar 2 views (72080) $307.80 $810 3.7×
Thyroid carcinoma metastases img whole body (78018) $1,005.48 $2,646 1.9×
Thyroid Imaging With Vascular Flow (78013) $463.22 $1,219 1.2×
Thyroid uptake measurement (78012) $247 $650 0.6×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $741.76 $1,952 1.9×
Tmj unilateral (70328) $101.46 $267 1.2×
Tomogram (76100) $303.62 $799 3.0×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $2,248.08 $5,916 4.3×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $609.14 $1,603 1.6×
Ultrasound elastography first target lesion (76982) $263.72 $694 2.6×
Ultrasound, abdomen limited (76705) $443.46 $1,167 4.4×
Unlisted fluoroscopic procedure (76496) $114.38 $301 1.4×
Unlisted magnetic resonance procedure (76498) $1,528.17 $4,021.50 18.1×
Unlisted miscellaneous px dx nuclear medicine (78999) $304 $800 0.8×
Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) $2,797.42 $7,361.62 7.2×
Upper Extremity Infant (73092) $95.38 $251 0.9×
Urethrocystography retrograde rs&i (74450) $273.60 $720 1.2×
Urethrocystography voiding (74455) $351.88 $926 1.5×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $150.10 $395 0.9×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $286.90 $755 1.7×
Us abdl aorta screen aaa (76706) $275.50 $725 2.7×
Us breast unilateral complete (76641) $341.24 $898 3.4×
Us breast unilateral limited (76642) $256.88 $676 3.0×
Us chest (76604) $432.44 $1,138 4.3×
Us compl joint r-t w/image documentation (76881) $388.74 $1,023 3.8×
Us elastography parenchyma (76981) $263.72 $694 2.6×
Us guided compression repair (76936) $334.78 $881 1.6×
Us infant hips dynamic (76885) $153.52 $404 1.8×
Us kidney transplant (76776) $362.14 $953 3.6×
Us ob transvaginal (76817) $355.68 $936 3.5×
Us pelvic non ob complete (76856) $660.82 $1,739 6.5×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $297.54 $783 2.9×
Us pregnancy ltd (76815) $304 $800 3.0×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $407.36 $1,072 4.0×
Us retroperitoneal complete (76770) $470.82 $1,239 4.7×
Us retroperitoneal limited (76775) $379.24 $998 3.7×
Us scrotum and contents (76870) $448.02 $1,179 4.4×
Us soft tissue head/neck (76536) $411.54 $1,083 4.1×
Us spinal canal and contents (76800) $556.32 $1,464 5.5×
Us transrectal (76872) $1,254 $3,300 12.4×
Us xtr non-vasc lmtd (76882) $273.60 $720 2.7×
Venogram extremity bilateral (75822) $1,706.20 $4,490 1.1×
Venography extremity unilateral rs&i (75820) $1,406 $3,700 0.9×
Vertebral fracture assessment via dxa (77086) $65.74 $173 0.8×
Wrist 2 views (73100) $123.88 $326 1.5×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $156.56 $412 1.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $180.50 $475 2.1×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $394.06 $1,037 4.7×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $525.16 $1,382 3.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $161.50 $425 1.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $285.76 $752 3.4×
X-ray exam hip uni 1 view (73501) $121.98 $321 1.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $193.42 $509 2.3×
X-ray exam hip uni 4/> views (73503) $129.96 $342 1.3×
X-Ray Exam Hips Bi 3-4 Views (73522) $248.71 $654.50 2.5×
X-Ray Exam Hips Bi 5/> Views (73523) $206.34 $543 2.0×
X-ray exam of femur 1 (73551) $155.04 $408 1.8×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $570.38 $1,501 3.4×
X-ray eye for foreign body (70030) $104.88 $276 1.2×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $326.42 $859 3.2×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $199.88 $526 2.4×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $314.64 $828 3.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $123.88 $326 1.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $185.82 $489 2.2×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $296.40 $780 2.9×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $160.36 $422 1.9×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $149.72 $394 1.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $279.68 $736 2.8×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $569.24 $1,498 5.6×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $367.08 $966 3.6×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $238.26 $627 2.8×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $185.44 $488 2.2×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $239.40 $630 2.4×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $380 $1,000 3.8×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $393.68 $1,036 1.2×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $115.90 $305 1.4×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $256.88 $676 2.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $435.86 $1,147 4.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $233.32 $614 2.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $193.80 $510 2.3×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $202.16 $532 2.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $178.22 $469 2.1×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $166.82 $439 2.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $438.90 $1,155 4.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $224.58 $591 2.2×
X-Ray Spine One View - Xr Spine (72020) $165.68 $436 2.0×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $194.56 $512 2.3×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $75.24 $198 0.9×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $115.90 $305 1.1×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $148.20 $390 1.5×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $170.62 $449 2.0×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $202.16 $532 2.4×
Xr c-spine 6 or more views (72052) $460.18 $1,211 4.5×
Xr chest 4+ views (71048) $112.86 $297 1.1×
Xr Cholecystography Oral Contrast (74290) $177.08 $466 1.0×
Xr finger(s) 2+ views (73140) $116.28 $306 1.4×
XR Mastoids < 3 Views Bilateral (70120) $192.28 $506 1.9×
Xr myelogram posterior fossa (70010) $1,230.82 $3,239 3.6×
Xr shoulder 1 view (73020) $107.16 $282 1.3×
Xr spine cervical 4 or 5 views (72050) $388.74 $1,023 3.8×
Xr tibia/fibula 2 views (73590) $141.36 $372 1.7×
Xr tmj bilateral (70330) $102.60 $270 1.2×
Xray knee 1 or 2 views rt (73560) $201.40 $530 2.4×