Imaging prices at Wesley Medical Center

Wichita, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $6,465 $6,465 5.1×
Abdomen 2 views (74019) $2,483 $2,483 25.8×
Acute gastrointestinal blood loss imaging (78278) $6,427 $6,427 17.4×
Angiography extremity bilateral rs&i (75716) $37,731 $37,731 13.0×
Angiography extremity unilateral rs&i (75710) $18,865 $18,865 6.5×
Angiography internal mammary rs&i (75756) $18,865 $18,865 6.5×
Angiography pelvic slctv/supraslctv rs&i (75736) $18,865 $18,865 3.7×
Angiography pulmonary bilateral slctv rs&i (75743) $22,223 $22,223 7.6×
Angiography pulmonary unilateral slctv rs&i (75741) $24,547 $24,547 8.4×
Angiography Spinal Selective Rs&I (75705) $18,865 $18,865 3.7×
Angiography visceral slctv/supraslctv rs&i (75726) $18,865 $18,865 3.7×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $12,618 $12,618 4.3×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $29,444 $29,444 10.1×
Ankle 2 views (73600) $1,780 $1,780 22.2×
Antegrade urography radiological supvj & interpj (74425) $2,566 $2,566 8.0×
Aortogram thoracic (75605) $18,865 $18,865 3.7×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $19,702 $19,702 6.8×
Aortography abdominal serialography rs&i (75625) $22,595 $22,595 7.8×
Arthrogram elbow (73085) $3,446 $3,446 10.7×
Arthrogram hip (73525) $3,446 $3,446 10.7×
Arthrogram shoulder (73040) $4,076 $4,076 12.7×
Arthrogram wrist (73115) $3,064 $3,064 9.5×
Arthrography knee lt (73580) $5,083 $5,083 15.8×
Basic radiation dosimetry calculation (77300) $1,559 $1,559 12.6×
Bone &/Joint Imaging Limited Area (78300) $3,816 $3,816 10.4×
Bone &/Joint Imaging Multiple Areas (78305) $4,767 $4,767 12.9×
Bone &/joint imaging whole body (78306) $4,829 $4,829 13.1×
Bone age studies (77072) $1,616 $1,616 16.8×
Bone Imaging 3 Phase (78315) $4,322 $4,322 11.7×
Bone survey complete (77075) $6,805 $6,805 70.6×
Brachytx isodose complex (77318) $7,371 $7,371 21.4×
Brachytx isodose intermed (77317) $6,224 $6,224 18.0×
Brachytx isodose pln smpl w/dosimetry cal (77316) $4,861 $4,861 14.1×
Brain Imaging Vascular Flow Only (78610) $6,525 $6,525 13.0×
Cardiac MRI w/w/o contrast & further seq (75561) $38,468 $38,468 119.7×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $4,367 $4,367 8.7×
Cervical spine 2 or 3 views (72040) $1,906 $1,906 23.8×
Chest 1 view (71045) $2,186 $2,186 27.3×
Chest 3 views (71047) $3,524 $3,524 43.9×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $3,924 $3,924 24.3×
Cisternography Positive Contrast Rs&I (70015) $2,427 $2,427 3.4×
Clavicle complete (73000) $1,906 $1,906 23.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $2,026 $2,026 21.0×
Continuing medical physics consltj pr wk (77336) $2,127 $2,127 17.2×
Corpora cavernosography (74445) $7,206 $7,206 74.8×
CT abdomen and pelvis without and with contrast (74178) $32,740 $32,740 101.8×
CT abdomen and pelvis without contrast (74176) $27,707 $27,707 126.0×
CT abdomen w contrast (74160) $13,851 $13,851 85.7×
CT abdomen w wo contrast (74170) $15,115 $15,115 93.5×
CT abdomen w/o contrast (74150) $12,599 $12,599 130.8×
CT angio hrt w/3d image (75574) $19,356 $19,356 60.2×
CT angiography upper extremity lt (73206) $15,024 $15,024 93.0×
CT c-spine w/o contrast (72125) $16,449 $16,449 170.7×
CT cervical spine w&w/o contrast (72127) $19,959 $19,959 123.5×
CT cervical spine with contrast (72126) $17,159 $17,159 53.4×
CT chest w/wo contrast (71270) $21,763 $21,763 134.6×
CT chest with contrast (71260) $19,356 $19,356 119.8×
CT head/brain with contrast (70460) $14,240 $14,240 88.1×
CT head/brain without and with contrast (70470) $16,636 $16,636 102.9×
CT heart contrast eval cardiac structure&morph (75572) $19,356 $19,356 60.2×
CT heart no contrast quant eval coronry calcium (75571) $99 $99 1.2×
CT hrt w/3d image congen (75573) $19,356 $19,356 60.2×
CT iac w contrast (70481) $14,057 $14,057 87.0×
CT limited/localized follow up study (76380) $10,242 $10,242 127.7×
CT lower ext w/o (73700) $13,933 $13,933 144.6×
CT lower extremity w wo contrast (73702) $16,884 $16,884 104.5×
CT lower extremity with contrast (73701) $15,024 $15,024 93.0×
CT lumbar spine w & w/o contrast (72133) $19,779 $19,779 122.4×
CT lumbar spine w/o contrast (72131) $16,997 $16,997 176.4×
CT lumbar spine with contrast (72132) $16,997 $16,997 52.9×
CT maxillofacial w contrast (70487) $13,329 $13,329 82.5×
CT maxillofacial w/o contrast (70486) $11,615 $11,615 120.6×
CT maxillofacial w/wo contrast (70488) $15,600 $15,600 96.5×
CT neck soft tissue w contrast (70491) $15,701 $15,701 97.1×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $17,859 $17,859 110.5×
CT orbits w/o contrast (70480) $12,229 $12,229 126.9×
CT pelvis w & w/o contrast (72194) $17,630 $17,630 109.1×
CT pelvis w/o contrast (72192) $15,115 $15,115 156.9×
CT soft tissue neck w/o & w/contrast material (70492) $17,637 $17,637 109.1×
CT soft tissue neck w/o contrast (70490) $14,532 $14,532 150.8×
CT thoracic spine w/contrast (72129) $16,449 $16,449 101.8×
CT thoracic spine w/o contrast (72128) $16,449 $16,449 170.7×
CT thoracic spine w/wo contrast (72130) $19,959 $19,959 123.5×
CT thorax w/o contrast (71250) $17,922 $17,922 186.0×
CT upper extremity w/o & w/contrast material (73202) $16,884 $16,884 104.5×
CT upper extremity w/o contrast rt (73200) $13,933 $13,933 144.6×
CT upper extremity with contrast (73201) $15,024 $15,024 46.7×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $13,851 $13,851 85.7×
Cta Abdomen (74175) $13,851 $13,851 85.7×
CTA abdomen pelvis (74174) $27,471 $27,471 85.4×
CTA chest (71275) $19,356 $19,356 119.8×
Cta Head (70496) $14,240 $14,240 88.1×
CTA lwr ext w&w/o contrast (73706) $15,024 $15,024 93.0×
Cta Neck (70498) $15,701 $15,701 97.1×
Cta Pelvis (72191) $16,365 $16,365 101.2×
Cystography minimum 3 views rs&i (74430) $5,476 $5,476 17.0×
Diskogram cervical (72285) $13,851 $13,851 7.7×
Diskography lumbar (72295) $12,976 $12,976 7.2×
Doppler Fetal Mid Cerebral Artery (76821) $2,301 $2,301 23.9×
Dxa bone density study 1/> sites axial skel (77080) $1,110.50 $1,110.50 11.5×
Echo exam of fetal heart (76825) $2,687 $2,687 5.3×
Echoencephalography real time imaging (76506) $3,092 $3,092 32.1×
Esophagus (74220) $3,375 $3,375 20.9×
Fetal biophysical profile non-stress testing (76818) $3,990 $3,990 41.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $1,711 $1,711 17.8×
Fluoroscopy up to 1 hr (76000) $2,746 $2,746 12.5×
Foot 2 views (73620) $1,968 $1,968 24.5×
Forearm 2 views (73090) $1,887 $1,887 23.5×
Gated Heart Planar Single (78472) $8,606 $8,606 23.4×
Hand 2 views (73120) $1,704 $1,704 17.7×
Hand 3 views (73130) $1,918 $1,918 23.9×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $5,882 $5,882 9.2×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $6,332 $6,332 9.9×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $6,800 $6,800 10.6×
Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) $1,528 $1,528 4.3×
Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) $1,528 $1,528 4.3×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $18,865 $18,865 6.5×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $5,201 $5,201 10.4×
Hepatobiliary syst imaging including gallbladder (78226) $5,201 $5,201 14.1×
Ht muscle image spect sing (78451) $8,494 $8,494 7.1×
Humerus Min 2 Views Left (73060) $1,964 $1,964 24.5×
Hysterosalpingogram (74740) $3,517 $3,517 16.0×
Interstitial radiation source applic complex (77778) $1,528 $1,528 2.4×
Intracavitary Radiation Source Applic Complex (77763) $1,528 $1,528 2.4×
Intracavitary Radiation Source Applic Intermed (77762) $2,980 $2,980 5.9×
Intracavitary radiation source applic simple (77761) $2,980 $2,980 5.9×
Intraop radiaj tx deliver xray single tx session (77424) $7,814 $7,814 1.2×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $1,345 $1,345 14.0×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $7,916 $7,916 15.8×
Kidney img morphology vascular flow 1 w/rx (78708) $11,824 $11,824 23.6×
Kidney Img Morphology Vascular Flow Multiple (78709) $10,660 $10,660 21.3×
Knee 3 views (73562) $1,859 $1,859 23.2×
Liver & spleen imaging static only (78215) $6,021 $6,021 16.3×
Liver imaging static only (78201) $6,103 $6,103 12.2×
Lung perf&ventilat diferentl (78598) $6,530 $6,530 13.1×
Lung perfusion differential (78597) $4,897 $4,897 13.3×
Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) $23,363 $23,363 8.0×
Lymphangio extrem unilat - ir lymphangiogram extremity (75801) $11,675 $11,675 20.2×
Lymphangiography extremity only bilateral rs&i (75803) $19,809 $19,809 13.7×
Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) $19,809 $19,809 6.8×
Lymphoscintigraphy (78195) $5,603 $5,603 11.2×
Mammary ductogram or galactogram multiple (77054) $4,844 $4,844 22.0×
Mammary ductogram or galactogram single (77053) $3,395.50 $3,395.50 15.4×
Manual appl stress pfrmd phys/qhp joint films (77071) $1,780 $1,780 22.2×
Meckels Diverticulum (78290) $4,927 $4,927 13.4×
Mlc imrt design & construction per imrt plan (77338) $13,220 $13,220 38.3×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $95 $95 3.6×
MRA head w & w/o contrast (70546) $16,088 $16,088 50.0×
MRA head w/o contrast (70544) $14,198 $14,198 64.6×
MRA head with contrast (70545) $15,137 $15,137 47.1×
MRA neck w contrast (70548) $15,137 $15,137 47.1×
Mra Neck W/O &W/Contrast Material (70549) $16,088 $16,088 50.0×
MRA neck w/o contrast (70547) $14,198 $14,198 64.6×
MRI abdomen w contrast (74182) $21,307 $21,307 66.3×
MRI abdomen w/o & w/contrast material (74183) $22,252 $22,252 69.2×
MRI abdomen w/o contrast (74181) $19,895 $19,895 90.5×
MRI any jnt lwr ext with con lt (73722) $18,409 $18,409 25.5×
MRI any jt upper extremity w/contrast matrl (73222) $19,961 $19,961 27.6×
MRI breast w/o contrast bilateral (77047) $25,815 $25,815 117.4×
MRI breast w/o contrast unilat (77046) $12,907 $12,907 58.7×
MRI c-spine with contrast (72142) $19,682 $19,682 61.2×
MRI cardiac w/o contrast (75557) $38,468 $38,468 175.0×
MRI cervical spine w/o contrast (72141) $18,753 $18,753 85.3×
MRI chest w/o & w/contrast material (71552) $21,100 $21,100 65.6×
MRI chest w/o contrast (71550) $19,231 $19,231 87.5×
MRI chest with contrast (71551) $20,170 $20,170 27.9×
MRI fetal sngl/1st gestation (74712) $17,232 $17,232 78.4×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $20,935 $20,935 65.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $18,796 $18,796 58.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $17,871 $17,871 81.3×
MRI orbit face &/neck w/o contrast (70540) $16,786 $16,786 76.3×
MRI orbit/face/neck w&w/o cont (70543) $18,670 $18,670 58.1×
MRI orbit/face/neck w/contrast (70542) $17,733 $17,733 55.2×
MRI pelvis w contrast (72196) $20,361 $20,361 63.3×
MRI pelvis w/o & w/contrast material (72197) $19,117 $19,117 59.5×
MRI pelvis w/o contrast (72195) $17,232 $17,232 78.4×
MRI scan of arm joint before and after contrast (73223) $20,901 $20,901 65.0×
MRI scan of heart before and after contrast with stress imaging (75563) $38,468 $38,468 53.3×
MRI scan of leg joint before and after contrast (73723) $19,344 $19,344 60.2×
MRI spinal canal cervical w/o & w/contr matrl (72156) $20,638 $20,638 64.2×
MRI spinal canal lumbar w/contrast material (72149) $19,375 $19,375 60.3×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $20,306 $20,306 63.2×
MRI spinal canal thoracic w/contrast matrl (72147) $19,091 $19,091 59.4×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $20,026 $20,026 62.3×
MRI thoracic spine w/o contrast (72146) $18,158 $18,158 82.6×
MRI tmj (70336) $16,786 $16,786 76.3×
MRI upper ext joint w/o contrast (73221) $19,006 $19,006 86.4×
MRI upper extrem other than jt w/o & w/contras (73220) $21,877 $21,877 68.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $19,993 $19,993 90.9×
Myelogram Cervical (72240) $8,740 $8,740 12.1×
Myelogram Lumbar (72265) $8,986 $8,986 12.4×
Myocardial infarct spect (78469) $8,357 $8,357 16.7×
Myocardial Spect Multiple Studies (78452) $10,240 $10,240 8.6×
Neck soft tissue (70360) $1,906 $1,906 23.8×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $5,267 $5,267 14.8×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $3,735 $3,735 10.1×
Nm bone marrow multiple (78103) $6,021 $6,021 16.3×
Nm cisternogram (78630) $5,872 $5,872 11.7×
Nm gastric emptying study (78264) $11,088 $11,088 30.1×
Nm gastroesophageal reflux study (78262) $10,677 $10,677 29.0×
Nm peritoneal-venous shunt patency (78291) $5,872 $5,872 15.9×
Ntsty modul radthx pln dose-vol histos (77301) $13,220 $13,220 10.4×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $5,677 $5,677 15.4×
Nuclear Rx Oral Admin (79005) $2,180 $2,180 10.1×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $2,435 $2,435 25.3×
Osseous survey infant (77076) $4,378.50 $4,378.50 45.4×
Osseous survey limited (77074) $2,917 $2,917 30.3×
Parathyrd planar w/spect&CT (78072) $14,363 $14,363 28.7×
Parathyroid imaging (78070) $8,393 $8,393 22.8×
Pelvis 1 or 2 views (72170) $2,914 $2,914 30.2×
Perineogram (74775) $7,081 $7,081 32.2×
Peritoneogram rs&i (74190) $4,235 $4,235 8.4×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $19,735 $19,735 61.4×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $24,547 $24,547 8.4×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $7,545 $7,545 2.6×
Pulmonary Perfusion Imaging Particulate (78580) $2,767 $2,767 7.5×
Pulmonary Ventilation & Perfusion Imaging (78582) $5,614 $5,614 11.2×
Radex abscess/fistula/sinus tract rs&i (76080) $3,120 $3,120 6.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $1,906 $1,906 23.8×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $3,155 $3,155 32.7×
Radex hips bilateral with pelvis 2 views (73521) $4,961 $4,961 51.5×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $4,919 $4,919 51.1×
Radiation Delivery Stereotactic Cranial Linear (77372) $116,707 $116,707 17.2×
Radiation treatment delivery 1 mev >= complex (77412) $2,786 $2,786 5.5×
Radiation treatment delivery 1 mev >= simple (77402) $1,934 $1,934 20.6×
Radiation tx delivery 1 mev >= intermediate (77407) $2,382 $2,382 6.7×
Radiolog exam mandible compl minimum 4 views (70110) $2,906 $2,906 30.2×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $2,186 $2,186 27.3×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $2,382 $2,382 29.7×
Radiologic exam colon single contrast study (74270) $4,138 $4,138 25.6×
Radiologic Exam Esophagus Double Contrast Study (74221) $4,338 $4,338 26.8×
Radiologic exam upr gi trc double contrast study (74246) $4,338 $4,338 26.8×
Radiologic exam upr gi trc single contrast study (74240) $4,338 $4,338 26.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $2,791 $2,791 34.8×
Radiological examination surgical specimen (76098) $2,427 $2,427 4.8×
Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) $1,825 $1,825 8.5×
Review by radiologist of adrenal gland vein image (75840) $18,865 $18,865 6.5×
Review by radiologist of liver vein image with assessment of blood flow (75889) $18,865 $18,865 6.5×
Ribs bilateral 3 views (71110) $3,097 $3,097 32.1×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $6,886 $6,886 18.7×
Rp loclzj tum plnr whole body single day imaging (78802) $6,615 $6,615 13.2×
Rp loclzj tum spect 1 area single day imaging (78803) $8,345 $8,345 16.7×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $8,345 $8,345 7.0×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $8,345 $8,345 6.3×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $8,345 $8,345 7.0×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $1,773 $1,773 8.2×
Rp therapy intra-arterial particulate admn (79445) $1,162 $1,162 5.4×
Rp Therapy Intravenous Administration (79101) $1,825 $1,825 8.5×
Saline Infus Sonohysterography W/Color Doppler (76831) $3,285 $3,285 14.9×
Salivary gland imaging serial images (78231) $5,201 $5,201 14.1×
Scanogram (77073) $3,264 $3,264 33.9×
Scapula complete (73010) $2,133 $2,133 22.1×
Screening digital breast tomosynthesis (77063) $102 $102 4.4×
Sella turcica (70240) $1,780 $1,780 22.2×
Shuntogram indwelling nonvascular shunt rs&i (75809) $3,075 $3,075 31.9×
Sialogram (70390) $3,497 $3,497 15.9×
Simulation intermediate (77285) $4,607 $4,607 13.4×
Small bowel series (74250) $4,164 $4,164 25.8×
Spec medical radj physics consltj (77370) $5,904 $5,904 47.7×
Spec telethx port pln parts hemibdy tot bdy (77321) $5,522 $5,522 16.0×
Special dosimetry (77331) $1,982 $1,982 16.0×
Special treatment procedure (77470) $3,846 $3,846 7.6×
Spine thoracic 3 views (72072) $3,155 $3,155 32.7×
Spleen imaging only (78185) $6,021 $6,021 16.3×
Splenoportograpy rs&i (75810) $7,545 $7,545 2.6×
Stereotactic body radiation delivery (77373) $31,569 $31,569 19.2×
Superior sagittal sinus venogram (75870) $9,716 $9,716 3.3×
Surface Applic Low Dose Rate Radionuclide Source (77789) $1,279 $1,279 13.6×
Telethx isodose pln cplx w/basic dosimetry (77307) $8,182 $8,182 23.7×
Telethx isodose pln smpl w/dosimetry calculation (77306) $4,913 $4,913 14.2×
Ther rad simulaj-aided field setting complex (77290) $5,654 $5,654 16.4×
Ther rad simulaj-aided field setting simple (77280) $3,421 $3,421 27.6×
Therapeutic Enema (74283) $4,488 $4,488 27.8×
Thoracolumbar 2 views (72080) $2,604 $2,604 32.5×
Thyroid carcinoma metastases img whole body (78018) $6,427 $6,427 12.8×
Thyroid Imaging With Vascular Flow (78013) $3,000 $3,000 8.1×
Thyroid uptake measurement (78012) $2,633 $2,633 7.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $3,685 $3,685 10.0×
Treatment device intermediate (77333) $2,943 $2,943 23.8×
Treatment devices simple (77332) $1,988 $1,988 16.1×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $6,615 $6,615 13.2×
Tx devices design & construction complex (77334) $3,897 $3,897 11.3×
Ultrasound, abdomen limited (76705) $3,594 $3,594 37.3×
Umbilical-artery Doppler (OB) (76820) $1,711 $1,711 17.8×
Unlisted Ultrasound Procedure (76999) $3,327 $3,327 41.5×
Upper Extremity Infant (73092) $2,917 $2,917 30.3×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $6,886 $6,886 18.7×
Urethrocystography retrograde rs&i (74450) $2,494 $2,494 11.3×
Urethrocystography voiding (74455) $4,719 $4,719 21.5×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $5,226 $5,226 32.3×
Us abdl aorta screen aaa (76706) $2,721 $2,721 28.2×
Us breast unilateral complete (76641) $2,041 $2,041 21.2×
Us breast unilateral limited (76642) $1,363 $1,363 17.0×
Us chest (76604) $2,946 $2,946 30.6×
Us compl joint r-t w/image documentation (76881) $3,043 $3,043 31.6×
Us guided compression repair (76936) $4,008 $4,008 20.1×
Us infant hips dynamic (76885) $2,860 $2,860 35.7×
Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $2,860 $2,860 29.7×
Us ob detailed single fetus (76811) $5,166 $5,166 23.5×
Us ob transvaginal (76817) $1,332 $1,332 13.8×
Us pelvic non ob complete (76856) $3,441 $3,441 35.7×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $2,716 $2,716 28.2×
Us pregnancy ltd (76815) $2,705 $2,705 28.1×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $3,182 $3,182 33.0×
Us retroperitoneal complete (76770) $4,127 $4,127 42.8×
Us retroperitoneal limited (76775) $2,721 $2,721 28.2×
Us scrotum and contents (76870) $3,056 $3,056 31.7×
Us soft tissue head/neck (76536) $3,327 $3,327 34.5×
Us spinal canal and contents (76800) $2,575 $2,575 26.7×
Us transrectal prostate volume (76873) $5,972 $5,972 62.0×
Us xtr non-vasc lmtd (76882) $2,860 $2,860 29.7×
Vascular flow imaging (78445) $3,423 $3,423 9.3×
Venogram extremity bilateral (75822) $13,925 $13,925 9.6×
Venography caval inferior serialography rs&i (75825) $20,543 $20,543 7.1×
Venography caval superior serialography rs&i (75827) $18,865 $18,865 13.0×
Venography epidural rs&i (75872) $9,716 $9,716 16.8×
Venography extremity unilateral rs&i (75820) $7,206 $7,206 5.0×
Venography Renal Bilateral (75833) $37,730 $37,730 13.0×
Venography renal unilateral selective rs&i (75831) $18,865 $18,865 6.5×
Venography venous sinus/jugular cath rs&i (75860) $4,033 $4,033 1.4×
Venous sampling thru cath w/wo angiography rs& (75893) $24,184 $24,184 4.7×
Wrist 2 views (73100) $1,704 $1,704 21.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $3,584 $3,584 37.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $2,464 $2,464 30.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $1,968 $1,968 24.5×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $7,391 $7,391 45.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $1,704 $1,704 21.2×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $1,918 $1,918 23.9×
X-ray exam entire spi 4/5 vw (72083) $4,158 $4,158 43.2×
X-ray exam hip uni 1 view (73501) $2,483 $2,483 31.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $2,884 $2,884 36.0×
X-ray exam hip uni 4/> views (73503) $3,438 $3,438 35.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $5,766 $5,766 59.9×
X-Ray Exam Hips Bi 5/> Views (73523) $6,871 $6,871 71.3×
X-ray exam of femur 1 (73551) $2,237 $2,237 27.9×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $7,392 $7,392 45.7×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $3,422 $3,422 35.5×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $1,503 $1,503 18.7×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $1,918 $1,918 23.9×
X-ray guide gu dilation - ir nephrostomy dilation (74485) $6,098 $6,098 3.2×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $1,780 $1,780 22.2×
X-ray IV pyelogram+drip infusn (74410) $3,937 $3,937 24.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $2,449 $2,449 30.5×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $2,129 $2,129 22.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $1,730 $1,730 21.6×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $2,746 $2,746 34.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $2,917 $2,917 30.3×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $4,158 $4,158 43.2×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $4,803 $4,803 49.9×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $1,968 $1,968 24.5×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $3,075 $3,075 38.3×
X-ray of voice box or throat (70370) $3,375 $3,375 42.1×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $2,604 $2,604 27.0×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $2,382 $2,382 29.7×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $2,382 $2,382 24.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $2,715 $2,715 28.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $2,604 $2,604 32.5×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $2,396 $2,396 29.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $3,120 $3,120 38.9×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $1,253 $1,253 15.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $2,998 $2,998 31.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $2,449 $2,449 25.4×
X-Ray Spine One View - Xr Spine (72020) $1,906 $1,906 23.8×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $2,647 $2,647 33.0×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $2,647 $2,647 33.0×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $2,917 $2,917 30.3×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $4,158 $4,158 43.2×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $1,570 $1,570 19.6×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $1,780 $1,780 22.2×
Xr arthrogram ankle (73615) $3,446 $3,446 10.7×
Xr c-spine 6 or more views (72052) $3,513 $3,513 36.5×
Xr chest 4+ views (71048) $6,753 $6,753 70.1×
Xr finger(s) 2+ views (73140) $1,296 $1,296 16.2×
Xr shoulder 1 view (73020) $1,485 $1,485 18.5×
Xr spine cervical 4 or 5 views (72050) $3,513 $3,513 36.5×
Xr tibia/fibula 2 views (73590) $2,318 $2,318 28.9×
Xr tmj bilateral (70330) $2,726 $2,726 34.0×
Xray knee 1 or 2 views rt (73560) $1,704 $1,704 21.2×