| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,010 |
$3,350 |
1.2× |
| Abdomen 1 View (74018) |
$122.40 |
$204 |
1.1× |
| Abdomen 2 views (74019) |
$181.80 |
$303 |
1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$696 |
$1,160 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$3,860.40 |
$6,434 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,860.40 |
$6,434 |
1.0× |
| Ankle 2 views (73600) |
$108.60 |
$181 |
1.0× |
| Aortography thoracic serialography rs&i (75605) |
$4,310.40 |
$7,184 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$3,860.40 |
$6,434 |
0.6× |
| Arthrogram hip (73525) |
$660 |
$1,100 |
1.5× |
| Arthrogram Wrist (73115) |
$660 |
$1,100 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$239.40 |
$399 |
1.4× |
| Bone age studies (77072) |
$146.40 |
$244 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$540 |
$900 |
1.1× |
| Bone Imaging Limited Area (78300) |
$480.60 |
$801 |
1.0× |
| Bone Imaging Whole Body (78306) |
$684.60 |
$1,141 |
1.4× |
| Bone survey infant (77076) |
$134.40 |
$224 |
1.0× |
| Cerebrospinal Fluid Scan (78630) |
$1,176.60 |
$1,961 |
1.7× |
| Chest 1 view (71045) |
$109.80 |
$183 |
1.0× |
| Chest 2 views (71046) |
$139.20 |
$232 |
1.3× |
| Chest 3 views (71047) |
$165.60 |
$276 |
1.5× |
| Chest 4 or more views (71048) |
$181.80 |
$303 |
1.4× |
| Clavicle complete (73000) |
$147 |
$245 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$600.60 |
$1,001 |
4.6× |
| Continuing medical physics consltj pr wk (77336) |
$325.80 |
$543 |
1.9× |
| Contrast Exam Abdominl Aorta (75625) |
$3,860.40 |
$6,434 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$228.60 |
$381 |
0.5× |
| Contrast X-Ray Of Elbow (73085) |
$660 |
$1,100 |
1.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$660 |
$1,100 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$627.60 |
$1,046 |
1.4× |
| CT abdomen and pelvis without contrast (74176) |
$249.60 |
$416 |
0.8× |
| CT abdomen w contrast (74160) |
$669.60 |
$1,116 |
3.1× |
| CT abdomen w wo contrast (74170) |
$795 |
$1,325 |
3.6× |
| CT abdomen w/o contrast (74150) |
$507 |
$845 |
3.9× |
| CT Angio Abdomen and Pelvis (74174) |
$1,114.80 |
$1,858 |
2.6× |
| CT Angio Chest (71275) |
$799.20 |
$1,332 |
3.7× |
| CT Angio Head (70496) |
$796.80 |
$1,328 |
3.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$540.60 |
$901 |
2.5× |
| CT Angio Neck (70498) |
$796.80 |
$1,328 |
3.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$798.60 |
$1,331 |
3.6× |
| CT cervical spine w/ contrast (72126) |
$669.60 |
$1,116 |
1.5× |
| CT cervical spine w/o contrast (72125) |
$507 |
$845 |
3.9× |
| CT cervical spine w/wo cont (72127) |
$794.40 |
$1,324 |
3.6× |
| CT chest w contrast (71260) |
$669.60 |
$1,116 |
3.1× |
| CT chest w/wo contrast (71270) |
$794.40 |
$1,324 |
3.6× |
| CT head/brain with contrast (70460) |
$606.60 |
$1,011 |
2.8× |
| CT head/brain without and with contrast (70470) |
$753 |
$1,255 |
3.4× |
| CT iac w contrast (70481) |
$670.20 |
$1,117 |
3.1× |
| CT l-spine w&w/o contrast (72133) |
$794.40 |
$1,324 |
3.6× |
| CT lower ext w/o (73700) |
$507.60 |
$846 |
3.9× |
| CT lower extremity w/contrast material (73701) |
$663.60 |
$1,106 |
3.0× |
| CT lumbar spine w contrast (72132) |
$669.60 |
$1,116 |
1.5× |
| CT lumbar spine w/o contrast (72131) |
$507 |
$845 |
3.9× |
| CT maxillofacial w contrast (70487) |
$652.20 |
$1,087 |
3.0× |
| CT maxillofacial wo contrast (70486) |
$507.60 |
$846 |
3.9× |
| CT neck tissue combo (70492) |
$795 |
$1,325 |
3.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$795 |
$1,325 |
3.6× |
| CT orbits w/o contrast (70480) |
$507.60 |
$846 |
3.9× |
| CT pelvis w&w/o contrast (72194) |
$795 |
$1,325 |
3.6× |
| CT pelvis w/o contrast (72192) |
$507 |
$845 |
3.9× |
| CT scan of leg combo (73702) |
$795 |
$1,325 |
3.6× |
| CT scans face/jaw combo (70488) |
$795 |
$1,325 |
3.6× |
| CT soft tissue neck w contrast (70491) |
$642 |
$1,070 |
2.9× |
| CT soft tissue neck w/o contrast (70490) |
$507.60 |
$846 |
3.9× |
| CT thoracic spine w contrast (72129) |
$669.60 |
$1,116 |
3.1× |
| CT thoracic spine w/o contrast (72128) |
$507 |
$845 |
3.9× |
| CT thoracic spine w/wo cont (72130) |
$794.40 |
$1,324 |
3.6× |
| CT thorax w/o contrast (71250) |
$507 |
$845 |
3.9× |
| CT unlisted procedure (76497) |
$624 |
$1,040 |
5.7× |
| CT upper ext wo (73200) |
$507.60 |
$846 |
3.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$795 |
$1,325 |
3.6× |
| CT upper extremity with contrast (73201) |
$659.40 |
$1,099 |
1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$540.60 |
$901 |
2.5× |
| Cta Abdomen (74175) |
$799.20 |
$1,332 |
3.7× |
| CTA pelvis (72191) |
$799.20 |
$1,332 |
3.7× |
| Dxa Bone Density Axial (77080) |
$240 |
$400 |
1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$121.20 |
$202 |
1.1× |
| Echo exam of fetal heart (76825) |
$728.40 |
$1,214 |
1.1× |
| Echograp Trans R Pros Study (76873) |
$363.60 |
$606 |
2.8× |
| Esophagram (74220) |
$291 |
$485 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$181.80 |
$303 |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$252 |
$420 |
0.8× |
| Follow-Up Angiography (75898) |
$198.60 |
$331 |
0.1× |
| Foot 2 views (73620) |
$50.40 |
$84 |
0.5× |
| Forearm 2 views (73090) |
$108.60 |
$181 |
1.0× |
| Gastric emptying imaging study (78264) |
$840.60 |
$1,401 |
1.7× |
| Gated Heart Planar Single (78472) |
$900 |
$1,500 |
1.8× |
| Gated Heart, Multiple (78473) |
$2,320.80 |
$3,868 |
4.7× |
| Hand 2 views (73120) |
$52.20 |
$87 |
0.4× |
| Hepatobil Syst Image W/Drug (78227) |
$636.60 |
$1,061 |
0.9× |
| Hepatobiliary System Imaging (78226) |
$636.60 |
$1,061 |
1.3× |
| Ht Muscle Image Spect Sing (78451) |
$742.80 |
$1,238 |
0.5× |
| Hysterosalpingogram (74740) |
$369.60 |
$616 |
1.2× |
| Joint Survey Single View (77077) |
$141.60 |
$236 |
1.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,260.60 |
$2,101 |
1.9× |
| K Flow/Funct Image W/O Drug (78707) |
$1,260.60 |
$2,101 |
1.9× |
| Knee 3 Views (73562) |
$130.80 |
$218 |
1.2× |
| Liver & Spleen Imaging Static Only (78215) |
$516.60 |
$861 |
1.0× |
| Lung Perf&Ventilat Diferentl (78598) |
$574.80 |
$958 |
0.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$574.80 |
$958 |
0.8× |
| Lung Ventilation Imaging (78579) |
$552 |
$920 |
1.1× |
| Lymph System Imaging (78195) |
$622.80 |
$1,038 |
0.9× |
| Magnetic Image Jaw Joint (70336) |
$2,766.60 |
$4,611 |
9.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,193.40 |
$1,989 |
2.6× |
| Mr safety determination physician/other qhp (76016) |
$152.40 |
$254 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$42 |
$70 |
1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$159 |
$265 |
1.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$418.80 |
$698 |
1.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$981.60 |
$1,636 |
2.3× |
| MRA head w/o contrast (70544) |
$682.20 |
$1,137 |
2.3× |
| MRA head with contrast (70545) |
$737.40 |
$1,229 |
1.7× |
| MRA neck w contrast (70548) |
$737.40 |
$1,229 |
1.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$981.60 |
$1,636 |
2.3× |
| MRA neck w/o contrast (70547) |
$682.20 |
$1,137 |
2.3× |
| MRI abdomen w contrast (74182) |
$739.80 |
$1,233 |
1.7× |
| MRI abdomen w/o contrast (74181) |
$684 |
$1,140 |
2.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$739.80 |
$1,233 |
0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$979.20 |
$1,632 |
2.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$739.80 |
$1,233 |
0.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,793.40 |
$2,989 |
6.0× |
| MRI cervical spine w contrast (72142) |
$736.20 |
$1,227 |
1.7× |
| MRI cervical spine w/o cont (72141) |
$682.20 |
$1,137 |
2.3× |
| MRI chest w/o contrast (71550) |
$684.60 |
$1,141 |
2.3× |
| MRI chest wo w contrast (71552) |
$981.60 |
$1,636 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$739.80 |
$1,233 |
1.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$979.80 |
$1,633 |
2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$685.80 |
$1,143 |
2.3× |
| MRI lumbar spine w contrast (72149) |
$736.20 |
$1,227 |
1.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$975 |
$1,625 |
2.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$685.80 |
$1,143 |
2.3× |
| MRI orbit face neck w contrast (70542) |
$697.80 |
$1,163 |
1.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$979.80 |
$1,633 |
2.2× |
| MRI pelvis w contrast (72196) |
$739.20 |
$1,232 |
1.7× |
| MRI pelvis w/o & w contrast (72197) |
$978.60 |
$1,631 |
2.2× |
| MRI pelvis w/o contrast (72195) |
$684.60 |
$1,141 |
2.3× |
| MRI thoracic spine w/o contrast (72146) |
$682.20 |
$1,137 |
2.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$685.80 |
$1,143 |
2.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$982.80 |
$1,638 |
2.3× |
| MRI, abdomen, combo (74183) |
$978.60 |
$1,631 |
2.2× |
| MRI, dorsal spine combo (72157) |
$975 |
$1,625 |
2.2× |
| MRI, dorsal spine contrast (72147) |
$736.20 |
$1,227 |
1.7× |
| MRI, joint upper extrem (73221) |
$685.80 |
$1,143 |
2.3× |
| MRI, joint upper extrem combo (73223) |
$979.20 |
$1,632 |
2.2× |
| MRI, lumbar spine combo (72158) |
$975 |
$1,625 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$804.60 |
$1,341 |
0.5× |
| Neck soft tissue (70360) |
$109.80 |
$183 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,494.40 |
$5,824 |
2.0× |
| Nuclear Rx Oral Admin (79005) |
$274.80 |
$458 |
0.9× |
| Ob us nuchal meas 1 gest (76813) |
$94.80 |
$158 |
0.7× |
| Optic foramina (70190) |
$118.80 |
$198 |
1.1× |
| Parathyroid Planar Imaging (78070) |
$408.60 |
$681 |
0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$282 |
$470 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$117 |
$195 |
0.9× |
| Pet Image W/Ct Lmtd (78814) |
$3,189.60 |
$5,316 |
1.8× |
| PET image w/CT, full body (78816) |
$3,189.60 |
$5,316 |
1.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,189.60 |
$5,316 |
1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$516.60 |
$861 |
1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$134.40 |
$224 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$322.20 |
$537 |
0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$122.40 |
$204 |
1.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$108.60 |
$181 |
1.0× |
| Radex elbow complete minimum 3 views (73080) |
$122.40 |
$204 |
1.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$181.80 |
$303 |
1.4× |
| Radex fingr minimum 2 views (73140) |
$91.20 |
$152 |
0.8× |
| Radex foot complete minimum 3 views (73630) |
$122.40 |
$204 |
1.1× |
| Radex Hand Minimum 3 Views (73130) |
$122.40 |
$204 |
1.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$122.40 |
$204 |
1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$193.80 |
$323 |
1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$147 |
$245 |
1.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$121.20 |
$202 |
1.1× |
| Radex shoulder complete minimum 2 views (73030) |
$133.80 |
$223 |
1.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$50.40 |
$84 |
0.5× |
| Radex Spine 1 View Specify Level (72020) |
$108.60 |
$181 |
1.0× |
| Radex Sternum Minimum 2 Views (71120) |
$146.40 |
$244 |
1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$155.40 |
$259 |
1.4× |
| Radex Toe Minimum 2 Views (73660) |
$108.60 |
$181 |
1.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$122.40 |
$204 |
0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$122.40 |
$204 |
1.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$221.40 |
$369 |
1.7× |
| Radiation treatment delivery level 3 (77412) |
$483.60 |
$806 |
0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$149.40 |
$249 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$225.60 |
$376 |
1.7× |
| Radiologic exam colon double contrast study (74280) |
$545.40 |
$909 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$392.40 |
$654 |
1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$274.80 |
$458 |
1.3× |
| Radiologic exam knee complete 4/more views (73564) |
$155.40 |
$259 |
1.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$159.60 |
$266 |
1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$291 |
$485 |
1.3× |
| Radiologic exam swallow function contrast study (74230) |
$412.20 |
$687 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$432 |
$720 |
2.0× |
| Radiologic examination femur 1 view (73551) |
$70.20 |
$117 |
0.6× |
| Radiologic examination femur minimum 2 views (73552) |
$122.40 |
$204 |
1.1× |
| Radiologic examination knee 1/2 views (73560) |
$122.40 |
$204 |
1.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$134.40 |
$224 |
1.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$122.40 |
$204 |
1.1× |
| Ribs bilateral 3 views (71110) |
$226.20 |
$377 |
1.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$648 |
$1,080 |
1.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,617.60 |
$2,696 |
2.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,764.20 |
$4,607 |
4.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,764.20 |
$4,607 |
1.7× |
| Rp Therapy Intravenous Administration (79101) |
$900 |
$1,500 |
3.1× |
| Scapula (73010) |
$122.40 |
$204 |
0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$45 |
$75 |
1.9× |
| Shoulder 1 view (73020) |
$102.60 |
$171 |
0.9× |
| Shoulder Arthrography (73040) |
$660 |
$1,100 |
1.5× |
| Skull less than 4 views (70250) |
$155.40 |
$259 |
1.2× |
| Sternoclavicular joints (71130) |
$146.40 |
$244 |
1.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$910.20 |
$1,517 |
1.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$487.80 |
$813 |
2.9× |
| Thoracic spine 2 views (72070) |
$159.60 |
$266 |
1.2× |
| Thoracic spine 3 views (72072) |
$176.40 |
$294 |
1.4× |
| Thoracolumbar 2 views (72080) |
$66.60 |
$111 |
0.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$420 |
$700 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$451.80 |
$753 |
0.9× |
| Tx Devices Design & Construction Complex (77334) |
$543 |
$905 |
1.2× |
| Tx devices design & construction simple (77332) |
$257.40 |
$429 |
1.5× |
| Ultrasound Breast Limited (76642) |
$124.20 |
$207 |
1.1× |
| Ultrasound Exam Aaa Screen (76706) |
$248.40 |
$414 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$181.80 |
$303 |
1.4× |
| Upper gi w/o kub (74240) |
$447.60 |
$746 |
2.0× |
| Urethrocystogram voiding (74455) |
$304.20 |
$507 |
1.0× |
| Urethrocystography retrograde (74450) |
$312 |
$520 |
1.0× |
| Us breast unilateral complete (76641) |
$126 |
$210 |
1.0× |
| Us chest (76604) |
$181.80 |
$303 |
1.4× |
| Us exam, pelvic, limited (76857) |
$122.40 |
$204 |
0.9× |
| Us head (76506) |
$181.80 |
$303 |
1.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$122.40 |
$204 |
0.9× |
| Us ob detailed single fetus (76811) |
$257.40 |
$429 |
0.9× |
| Us ob limited 1 or more fetuses (76815) |
$94.80 |
$158 |
0.7× |
| Us ob transvaginal (76817) |
$181.80 |
$303 |
1.4× |
| Us pelvic non ob complete (76856) |
$181.80 |
$303 |
1.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$181.80 |
$303 |
1.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$94.80 |
$158 |
0.7× |
| Us retroperitoneal complete (76770) |
$150 |
$250 |
1.1× |
| Us retroperitoneal limited (76775) |
$181.80 |
$303 |
1.4× |
| Us scrotum and contents (76870) |
$181.80 |
$303 |
1.4× |
| Us spinal canal and contents (76800) |
$122.40 |
$204 |
0.9× |
| Us thyroid (76536) |
$181.80 |
$303 |
1.4× |
| Us transrectal (76872) |
$181.80 |
$303 |
1.4× |
| Venogram Sinus/Jugular (75860) |
$734.40 |
$1,224 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$1,193.40 |
$1,989 |
0.6× |
| Wrist 2 views (73100) |
$57 |
$95 |
0.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$133.80 |
$223 |
1.2× |
| X-ray antegrade pyelogram tube (74425) |
$228.60 |
$381 |
0.5× |
| X-Ray Bend Only L-S Spine (72120) |
$235.20 |
$392 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$57 |
$95 |
0.5× |
| X-Ray Exam Breast Specimen (76098) |
$391.80 |
$653 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$82.80 |
$138 |
0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$136.20 |
$227 |
1.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$181.80 |
$303 |
1.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$75.60 |
$126 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$130.80 |
$218 |
1.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$152.40 |
$254 |
1.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$136.20 |
$227 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$250.20 |
$417 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$175.20 |
$292 |
1.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$242.40 |
$404 |
1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$251.40 |
$419 |
2.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$242.40 |
$404 |
1.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$191.40 |
$319 |
1.5× |
| X-ray eye for foreign body (70030) |
$114.60 |
$191 |
1.1× |
| X-ray humerus (73060) |
$119.40 |
$199 |
1.1× |
| X-ray IV pyelogram (ivp) (74400) |
$274.80 |
$458 |
1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$66 |
$110 |
0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$146.40 |
$244 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$158.40 |
$264 |
1.2× |
| X-ray nose-rectum child f.b. (76010) |
$64.80 |
$108 |
0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$134.40 |
$224 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$145.80 |
$243 |
1.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$133.80 |
$223 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$133.80 |
$223 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$181.80 |
$303 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$200.40 |
$334 |
1.5× |
| X-ray thoracic spine 4 vw (72074) |
$191.40 |
$319 |
1.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$439.20 |
$732 |
1.0× |
| X-Rays Bone Length Studies (77073) |
$200.40 |
$334 |
1.5× |
| X-Rays Bone Survey Complete (77075) |
$266.40 |
$444 |
2.0× |
| Xr c-spine 4 or 5 views (72050) |
$229.80 |
$383 |
1.8× |
| Xr orbits complete 4 views (70200) |
$181.80 |
$303 |
1.4× |