| Acute gastrointestinal blood loss imaging (78278) |
$289.98 |
$828.50 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$227.24 |
$649.25 |
0.1× |
| Ankle 2 views (73600) |
$198.72 |
$567.75 |
2.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$85.31 |
$243.75 |
0.3× |
| Arthrogram shoulder (73040) |
$141.84 |
$405.25 |
0.5× |
| Bone &/joint imaging whole body (78306) |
$420.26 |
$1,200.75 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$411.34 |
$1,175.25 |
1.1× |
| Brain image w/flow 4 + views (78606) |
$154.09 |
$440.25 |
0.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$169.40 |
$484 |
0.3× |
| Cervical spine 2 or 3 views (72040) |
$81.02 |
$231.50 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$52.94 |
$151.25 |
0.3× |
| Clavicle complete (73000) |
$60.64 |
$173.25 |
0.8× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$34.30 |
$98 |
0.2× |
| Corpora cavernosography (74445) |
$214.81 |
$613.75 |
2.3× |
| CT limited/localized follow up study (76380) |
$117.34 |
$335.25 |
1.5× |
| CT maxillofacial w/o contrast (70486) |
$143.32 |
$409.50 |
1.5× |
| CT thoracic spine w/contrast (72129) |
$420.26 |
$1,200.75 |
2.7× |
| Diskogram cervical (72285) |
$209.74 |
$599.25 |
0.1× |
| Echoencephalography real time imaging (76506) |
$70.79 |
$202.25 |
0.8× |
| Esophageal motility (78258) |
$177.01 |
$505.75 |
0.5× |
| Esophagus (74220) |
$97.12 |
$277.50 |
0.6× |
| Foot 2 views (73620) |
$55.65 |
$159 |
0.7× |
| Forearm 2 views (73090) |
$61.78 |
$176.50 |
0.8× |
| Gated Heart Planar Single (78472) |
$212.71 |
$607.75 |
0.6× |
| Hand 2 views (73120) |
$69.56 |
$198.75 |
0.7× |
| Hand 3 views (73130) |
$76.30 |
$218 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$60.64 |
$173.25 |
0.8× |
| Hysterosalpingogram (74740) |
$142.62 |
$407.50 |
0.7× |
| Kidney funcj study non-img radioisotopic study (78725) |
$125.30 |
$358 |
0.3× |
| Kidney imaging morphology (78700) |
$180.08 |
$514.50 |
0.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$234.15 |
$669 |
0.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$303.36 |
$866.75 |
0.6× |
| Knee 3 views (73562) |
$74.72 |
$213.50 |
1.0× |
| Lymphoscintigraphy (78195) |
$165.55 |
$473 |
0.3× |
| MRA head w/o contrast (70544) |
$181.12 |
$517.50 |
0.8× |
| MRI abdomen w/o contrast (74181) |
$400.75 |
$1,145 |
1.9× |
| MRI chest w/o contrast (71550) |
$505.58 |
$1,444.50 |
2.4× |
| Nm gastric emptying study (78264) |
$302.58 |
$864.50 |
0.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$199.24 |
$569.25 |
0.6× |
| Nuclr Rx Interstit Colloid (79300) |
$62.21 |
$177.75 |
0.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$52.50 |
$150 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$55.74 |
$159.25 |
0.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$55.21 |
$157.75 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$87.94 |
$251.25 |
0.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$150.06 |
$428.75 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$127.05 |
$363 |
0.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$42.45 |
$121.28 |
0.5× |
| Radiological examination surgical specimen (76098) |
$17.50 |
$50 |
0.0× |
| Scapula complete (73010) |
$71.49 |
$204.25 |
0.8× |
| Sella turcica (70240) |
$39.90 |
$114 |
0.5× |
| Small bowel series (74250) |
$101.68 |
$290.50 |
0.6× |
| Testicular Imaging With Vascular Flow (78761) |
$140.09 |
$400.25 |
0.4× |
| Tomogram (76100) |
$118.65 |
$339 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$182.88 |
$522.50 |
2.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$51.42 |
$146.90 |
0.7× |
| Upper Extremity Infant (73092) |
$38.72 |
$110.62 |
0.4× |
| Urethrocystography retrograde rs&i (74450) |
$59.91 |
$171.18 |
0.3× |
| Us chest (76604) |
$42.18 |
$120.50 |
0.4× |
| Us infant hips dynamic (76885) |
$143.32 |
$409.50 |
1.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$49.04 |
$140.12 |
0.5× |
| Us retroperitoneal limited (76775) |
$61.90 |
$176.88 |
0.7× |
| Us scrotum and contents (76870) |
$164.68 |
$470.50 |
1.8× |
| Us soft tissue head/neck (76536) |
$132.56 |
$378.75 |
1.4× |
| Vascular flow imaging (78445) |
$124.16 |
$354.75 |
0.3× |
| Vasogram (74440) |
$81.99 |
$234.25 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$417.38 |
$1,192.50 |
0.1× |
| Venography caval superior serialography rs&i (75827) |
$417.38 |
$1,192.50 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$146.48 |
$418.50 |
0.1× |
| Venography renal unilateral selective rs&i (75831) |
$417.38 |
$1,192.50 |
0.1× |
| Wrist 2 views (73100) |
$60.81 |
$173.75 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$84.26 |
$240.75 |
0.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$180.60 |
$516 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$191.88 |
$548.25 |
2.5× |
| X-ray exam hip uni 1 view (73501) |
$222.08 |
$634.50 |
2.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$128.45 |
$367 |
0.8× |
| X-ray eye for foreign body (70030) |
$55.82 |
$159.50 |
0.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$78.49 |
$224.25 |
0.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$40.69 |
$116.25 |
0.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$72.45 |
$207 |
0.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$55.12 |
$157.50 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$82.95 |
$237 |
0.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$44.89 |
$128.25 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$13.74 |
$39.25 |
0.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$128.40 |
$366.88 |
1.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$93.62 |
$267.50 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$32.99 |
$94.25 |
0.4× |
| X-ray of voice box or throat (70370) |
$62.88 |
$179.65 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$97.56 |
$278.75 |
1.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$70.70 |
$202 |
0.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$95.38 |
$272.50 |
0.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$66.06 |
$188.75 |
0.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$83.48 |
$238.50 |
0.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$90.30 |
$258 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$69.21 |
$197.75 |
0.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$71.05 |
$203 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$105.35 |
$301 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$56.44 |
$161.25 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$116.90 |
$334 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$66.59 |
$190.25 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$51.89 |
$148.25 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$81.55 |
$233 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$56.09 |
$160.25 |
0.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$67.11 |
$191.75 |
0.9× |
| Xr Cholecystography Oral Contrast (74290) |
$115.68 |
$330.50 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$57.58 |
$164.50 |
0.7× |
| Xr optic foramina (70190) |
$56.79 |
$162.25 |
0.7× |
| Xr shoulder 1 view (73020) |
$35.44 |
$101.25 |
0.5× |
| Xr spine cervical 4 or 5 views (72050) |
$117.95 |
$337 |
1.3× |
| Xr tibia/fibula 2 views (73590) |
$58.28 |
$166.50 |
0.7× |
| Xr tmj bilateral (70330) |
$81.02 |
$231.50 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$68.16 |
$194.75 |
0.9× |