| Abdomen 1 View (74018) |
— |
$529 |
— |
| Abdomen 2 views (74019) |
— |
$614 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$2,847 |
— |
| Angio pulmonary bilat (75743) |
— |
$8,004 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$10,964 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$10,177 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$8,004 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$4,767 |
— |
Ankle 2 views (73600)
range across 4 matching MRF lines |
— |
$426–$477 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$8,004 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$7,959 |
— |
| Artery X-Rays Spine (75705) |
— |
$7,688 |
— |
| Arthrogram ankle (73615) |
— |
$995 |
— |
| Arthrogram hip (73525) |
— |
$1,173 |
— |
| Arthrogram Wrist (73115) |
— |
$805 |
— |
| Bone age studies (77072) |
— |
$568 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$6,028 |
— |
| Bone Imaging Limited Area (78300) |
— |
$3,635 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$4,361 |
— |
| Bone Imaging Whole Body (78306) |
— |
$5,517 |
— |
| Bone marrow imaging; whole body (78104) |
— |
$5,517 |
— |
| Brain Flow Imaging Only (78610) |
— |
$1,706 |
— |
| Brain Image W/Flow < 4 Views (78601) |
— |
$2,416 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$2,791 |
— |
| Brain Imaging Minimum 4 Static Views (78605) |
— |
$1,706 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$8,669 |
— |
| Cardiac MRI w/w/o contrast & further seq (75561) |
— |
$7,626 |
— |
| Cardiac Shunt Detection (78428) |
— |
$1,893 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$2,331 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$3,635 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$3,719 |
— |
| Chest 1 view (71045) |
— |
$482 |
— |
| Chest 2 views (71046) |
— |
$614 |
— |
| Chest 3 views (71047) |
— |
$657 |
— |
| Chest 4 or more views (71048) |
— |
$677 |
— |
Clavicle complete (73000)
range across 4 matching MRF lines |
— |
$454–$504 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$1,383 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$805 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$995 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$11,456 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$6,859 |
— |
| CT abdomen w contrast (74160) |
— |
$4,562 |
— |
| CT abdomen w wo contrast (74170) |
— |
$5,516 |
— |
| CT abdomen w/o contrast (74150) |
— |
$3,473 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$9,740 |
— |
| CT Angio Chest (71275) |
— |
$5,563 |
— |
| CT Angio Head (70496) |
— |
$4,391 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$4,362 |
— |
| CT Angio Neck (70498) |
— |
$4,391 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$4,644 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$5,666 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$4,941 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$6,666 |
— |
| CT chest w contrast (71260) |
— |
$4,627 |
— |
| CT chest w/wo contrast (71270) |
— |
$4,912 |
— |
| CT head/brain with contrast (70460) |
— |
$3,702 |
— |
| CT head/brain without and with contrast (70470) |
— |
$4,659 |
— |
| CT iac w contrast (70481) |
— |
$5,193 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$6,773 |
— |
| CT lower ext w/o (73700) |
— |
$2,865 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$3,720 |
— |
| CT lumbar spine w contrast (72132) |
— |
$5,299 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$4,054 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,862 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$3,303 |
— |
| CT neck tissue combo (70492) |
— |
$5,002 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$5,212 |
— |
| CT orbits w/o contrast (70480) |
— |
$3,629 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$4,911 |
— |
| CT pelvis w/o contrast (72192) |
— |
$3,691 |
— |
| CT scan of leg combo (73702) |
— |
$4,381 |
— |
| CT scans face/jaw combo (70488) |
— |
$7,430 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$3,809 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$3,080 |
— |
| CT thoracic spine w contrast (72129) |
— |
$5,563 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$4,887 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$7,263 |
— |
| CT thorax w/o contrast (71250) |
— |
$2,989 |
— |
| CT upper ext wo (73200) |
— |
$2,982 |
— |
| CT upper extremity with contrast (73201) |
— |
$3,179 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$5,789 |
— |
| Cta Abdomen (74175) |
— |
$4,668 |
— |
| CTA pelvis (72191) |
— |
$4,980 |
— |
| Dilation ureters/urethra rs&i (74485) |
— |
$4,183 |
— |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
— |
$658 |
— |
| Doppler Echo Fetal Spectral Display Complete (76827) |
— |
$1,345 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
— |
$1,233 |
— |
| Dxa Bone Density Axial (77080) |
— |
$1,536 |
— |
| Dxa bone density study (77085) |
— |
$1,014 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$610 |
— |
| Echo exam of fetal heart (76825) |
— |
$1,986 |
— |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
— |
$839 |
— |
| Esophageal Motility Study (78258) |
— |
$1,603 |
— |
| Esophagram (74220) |
— |
$1,116 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$1,369 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$1,528 |
— |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
— |
$4,613 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$732 |
— |
| Follow-Up Angiography (75898) |
— |
$680 |
— |
Foot 2 views (73620)
range across 4 matching MRF lines |
— |
$426–$477 |
— |
Forearm 2 views (73090)
range across 4 matching MRF lines |
— |
$454–$504 |
— |
| Gastric emptying imaging study (78264) |
— |
$3,922 |
— |
| Gastroesophageal Reflux Exam (78262) |
— |
$3,922 |
— |
| Gated Heart Planar Single (78472) |
— |
$4,060 |
— |
Hand 2 views (73120)
range across 4 matching MRF lines |
— |
$426–$477 |
— |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
— |
$5,089 |
— |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
— |
$4,356 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$3,486 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$2,749 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$3,635 |
— |
| Hysterosalpingogram (74740) |
— |
$1,688 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$1,583 |
— |
| Infant hip ultrasound, limited static exam (76886) |
— |
$1,398 |
— |
| Joint Survey Single View (77077) |
— |
$1,050 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$4,496 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$3,948 |
— |
| Kidney Imaging Morphol (78700) |
— |
$3,780 |
— |
| Knee 3 Views (73562) |
— |
$539 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$1,914 |
— |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
— |
$2,624 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$4,788 |
— |
| Lung perfusion differential (78597) |
— |
$2,955 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$4,943 |
— |
| Lymph System Imaging (78195) |
— |
$2,791 |
— |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
— |
$2,253 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$5,208 |
— |
| Magnetic Resonance Elastography (76391) |
— |
$6,790 |
— |
| Meckels Divert Exam (78290) |
— |
$3,780 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$11,855 |
— |
| MRA head w/o contrast (70544) |
— |
$6,958 |
— |
| MRA head with contrast (70545) |
— |
$7,011 |
— |
| MRA neck w contrast (70548) |
— |
$6,717 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$9,107 |
— |
| MRA neck w/o contrast (70547) |
— |
$6,010 |
— |
| MRI abdomen w contrast (74182) |
— |
$6,807 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$6,442 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$7,069 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$11,528 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$5,847 |
— |
| MRI brain functional w/o physician admnistration (70554) |
— |
$5,392 |
— |
| MRI brain functional w/physician admnistration (70555) |
— |
$5,279 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$6,485 |
— |
| MRI cervical spine w contrast (72142) |
— |
$7,448 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$7,126 |
— |
| MRI chest w/o contrast (71550) |
— |
$4,285 |
— |
| MRI chest with contrast (71551) |
— |
$4,717 |
— |
| MRI chest wo w contrast (71552) |
— |
$9,214 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$5,850 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$9,883 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$5,654 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$8,211 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$10,533 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$6,236 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$7,795 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$8,754 |
— |
| MRI pelvis w contrast (72196) |
— |
$6,807 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$10,167 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$6,442 |
— |
| MRI spectroscopy (76390) |
— |
$4,832 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$6,602 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$5,550 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$5,550 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$9,214 |
— |
| MRI, abdomen, combo (74183) |
— |
$10,167 |
— |
| MRI, dorsal spine combo (72157) |
— |
$10,431 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$7,745 |
— |
| MRI, joint upper extrem (73221) |
— |
$6,859 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$10,262 |
— |
| MRI, lumbar spine combo (72158) |
— |
$12,376 |
— |
| Myelogram cervical (72240) |
— |
$2,098 |
— |
| Myelogram Lumbar (72265) |
— |
$3,173 |
— |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
— |
$8,461 |
— |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
— |
$4,058 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$6,807 |
— |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
— |
$8,308 |
— |
| Neck soft tissue (70360) |
— |
$414 |
— |
| Nm csf leak detection (78650) |
— |
$2,364 |
— |
| Nm unlisted gi procedure (78299) |
— |
$2,107 |
— |
| Ob us nuchal meas 1 gest (76813) |
— |
$1,682 |
— |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
— |
$945 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$1,468 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$504 |
— |
| Perineogram (74775) |
— |
$1,104 |
— |
| Peritoneogram Rs&I (74190) |
— |
$1,200 |
— |
| Pet Image Skull-Thigh (78812) |
— |
$10,261 |
— |
| Pet Image W/Ct Lmtd (78814) |
— |
$8,088 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$9,216 |
— |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
— |
$9,521 |
— |
| PET whole body (78813) |
— |
$10,784 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$700 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$994 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$509 |
— |
Radex Calcaneus Minimum 2 Views (73650)
range across 4 matching MRF lines |
— |
$416–$461 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$539 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$987 |
— |
Radex fingr minimum 2 views (73140)
range across 4 matching MRF lines |
— |
$374–$414 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$509 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$509 |
— |
Radex lower extremity infant minimum 2 views (73592)
range across 4 matching MRF lines |
— |
$426–$477 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$511 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$880 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$539 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$588 |
— |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
— |
$3,219 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$414 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$616 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$788 |
— |
Radex Toe Minimum 2 Views (73660)
range across 4 matching MRF lines |
— |
$374–$414 |
— |
Radex upper extremity infant minimum 2 views (73092)
range across 4 matching MRF lines |
— |
$426–$477 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$509 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$1,309 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$720 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$673 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$2,081 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,599 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$1,116 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$639 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$1,217 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$1,217 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,548 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$437 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$539 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$504 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$939 |
— |
Radiologic examination tibia & fibula 2 views (73590)
range across 4 matching MRF lines |
— |
$454–$504 |
— |
| Renal Cyst Study (74470) |
— |
$1,769 |
— |
| Ribs bilateral 3 views (71110) |
— |
$744 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$1,772 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$2,791 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$2,549 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$4,793 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$3,312 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$4,946 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$6,719 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$5,274 |
— |
| Scapula (73010) |
— |
$575 |
— |
| Shoulder 1 view (73020) |
— |
$461 |
— |
| Shoulder Arthrography (73040) |
— |
$822 |
— |
| Skull less than 4 views (70250) |
— |
$588 |
— |
| Sternoclavicular joints (71130) |
— |
$614 |
— |
| Temporomandble Jt Arthrography Rs&I (70332) |
— |
$2,534 |
— |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
— |
$1,429 |
— |
| Thoracic spine 2 views (72070) |
— |
$616 |
— |
| Thoracic spine 3 views (72072) |
— |
$700 |
— |
| Thoracolumbar 2 views (72080) |
— |
$639 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$2,624 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$3,497 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$3,344 |
— |
| Ultrasound Breast Limited (76642) |
— |
$500 |
— |
| Ultrasound elastography first target lesion (76982) |
— |
$925 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$1,080 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$1,323 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$1,318 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$11,463 |
— |
| Unlisted respiratory px dx nuclear medicine (78599) |
— |
$2,496 |
— |
| Unlisted us procedure (76999) |
— |
$198 |
— |
| Upper gi w/o kub (74240) |
— |
$1,316 |
— |
| Ureteral Reflux Study (78740) |
— |
$2,013 |
— |
| Urethrocystogram voiding (74455) |
— |
$1,479 |
— |
| Urethrocystography retrograde (74450) |
— |
$2,445 |
— |
| Us breast unilateral complete (76641) |
— |
$649 |
— |
| Us chest (76604) |
— |
$1,211 |
— |
| Us complete joint (76881) |
— |
$1,838 |
— |
| Us exam, pelvic, limited (76857) |
— |
$994 |
— |
| Us head (76506) |
— |
$1,398 |
— |
| Us kidney transplant (76776) |
— |
$1,386 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$1,323 |
— |
| Us ob detailed single fetus (76811) |
— |
$2,706 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$999 |
— |
| Us ob transvaginal (76817) |
— |
$1,242 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,426 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$1,469 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$1,045 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,838 |
— |
| Us scrotum and contents (76870) |
— |
$1,426 |
— |
| Us spinal canal and contents (76800) |
— |
$1,323 |
— |
| Us thyroid (76536) |
— |
$1,323 |
— |
| Vascular Flow Imaging (78445) |
— |
$1,893 |
— |
| Vein X-Ray Chest (75827) |
— |
$8,004 |
— |
| Venogram Sinus/Jugular (75860) |
— |
$8,004 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$8,004 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$945 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$1,350 |
— |
| Venography Renal Unilateral (75831) |
— |
$5,003 |
— |
| Venous sampling by catheter (75893) |
— |
$5,033 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$298 |
— |
Wrist 2 views (73100)
range across 4 matching MRF lines |
— |
$426–$477 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$639 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$1,580 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$7,922 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$936 |
— |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 4 matching MRF lines |
— |
$454–$504 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$553 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$974 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$1,092 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$489 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$539 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$594 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$818 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$973 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$1,171 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$1,483 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$572 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$1,062 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$1,016 |
— |
| X-ray eye for foreign body (70030) |
— |
$588 |
— |
X-ray humerus (73060)
range across 4 matching MRF lines |
— |
$486–$539 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,566 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$504 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$539 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$639 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$819 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$1,214 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$588 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$587 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$615 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$744 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$847 |
— |
| X-Ray Tmj Unilat (70328) |
— |
$896 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$1,566 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$744 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$1,343 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$847 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$588 |
— |
| Xr orbits complete 4 views (70200) |
— |
$840 |
— |