| 3-D radiotherapy plan dose-volume histograms (77295) |
$14,267.50 |
$14,267.50 |
9.3× |
| Abdomen 2 views (74019) |
$653 |
$653 |
5.6× |
| Acute gi blood loss imaging (78278) |
$1,890 |
$1,890 |
4.2× |
| Ankle 2 views (73600) |
$338 |
$338 |
3.5× |
| Arthrogram ankle (73615) |
$2,597 |
$2,597 |
6.7× |
| Arthrogram elbow (73085) |
$2,597 |
$2,597 |
6.7× |
| Arthrogram hip (73525) |
$2,469 |
$2,469 |
6.4× |
| Arthrogram knee (73580) |
$2,597 |
$2,597 |
6.7× |
| Arthrogram shoulder (73040) |
$2,597 |
$2,597 |
6.7× |
| Arthrogram wrist (73115) |
$1,439 |
$1,439 |
3.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,890 |
$1,890 |
4.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,890 |
$1,890 |
4.2× |
| Bone &/joint imaging whole body (78306) |
$1,890 |
$1,890 |
4.2× |
| Bone age studies (77072) |
$324.50 |
$324.50 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,890 |
$1,890 |
4.2× |
| Bone survey complete (77075) |
$620 |
$620 |
5.3× |
| Bone survey infant (77076) |
$620 |
$620 |
5.3× |
| Bowel imaging (78290) |
$1,890 |
$1,890 |
4.2× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,890 |
$1,890 |
4.2× |
| Cervical spine 2 or 3 views (72040) |
$338 |
$338 |
3.5× |
| Chest 1 view (71045) |
$338 |
$338 |
3.5× |
| Chest xray 3 views (71047) |
$403 |
$403 |
4.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$620 |
$620 |
3.2× |
| Clavicle complete (73000) |
$338 |
$338 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$504 |
$504 |
4.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,463 |
$4,463 |
11.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,299 |
$4,299 |
16.2× |
| CT abdomen w contrast (74160) |
$2,051 |
$2,051 |
10.5× |
| CT abdomen w wo contrast (74170) |
$2,051 |
$2,051 |
10.5× |
| CT abdomen w/o contrast (74150) |
$929 |
$929 |
8.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,703 |
$3,703 |
18.9× |
| CT angiography upper extremity lt (73206) |
$2,576 |
$2,576 |
13.2× |
| CT c-spine w/contrast (72126) |
$2,900 |
$2,900 |
7.5× |
| CT c-spine w/o contrast (72125) |
$2,104 |
$2,104 |
18.1× |
| CT cervical spine w&w/o contrast (72127) |
$2,051 |
$2,051 |
10.5× |
| CT chest w contrast (71260) |
$2,051 |
$2,051 |
10.5× |
| CT chest w/wo contrast (71270) |
$2,051 |
$2,051 |
10.5× |
| CT head/brain with contrast (70460) |
$2,051 |
$2,051 |
10.5× |
| CT head/brain without and with contrast (70470) |
$2,051 |
$2,051 |
10.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,368 |
$1,368 |
3.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$131.50 |
$131.50 |
1.4× |
| CT iac w contrast (70481) |
$2,051 |
$2,051 |
10.5× |
| CT lower ext w/o (73700) |
$1,998 |
$1,998 |
17.2× |
| CT lower extremity w wo contrast (73702) |
$2,051 |
$2,051 |
10.5× |
| CT lower extremity w/contrast material (73701) |
$2,262 |
$2,262 |
11.6× |
| CT lumbar spine w & w/o contrast (72133) |
$2,051 |
$2,051 |
10.5× |
| CT lumbar spine w/contrast (72132) |
$2,687 |
$2,687 |
6.9× |
| CT lumbar spine w/o contrast (72131) |
$1,506 |
$1,506 |
12.9× |
| CT maxillofacial w contrast (70487) |
$2,051 |
$2,051 |
10.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,051 |
$2,051 |
10.5× |
| CT maxillofacial wo contrast (70486) |
$1,596 |
$1,596 |
13.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,051 |
$2,051 |
10.5× |
| CT orbits w/o contrast (70480) |
$543.50 |
$543.50 |
4.7× |
| CT pelvis w/o contrast (72192) |
$1,596 |
$1,596 |
13.7× |
| CT pelvis w/wo contrast (72194) |
$2,051 |
$2,051 |
10.5× |
| CT scan of arm combo (73202) |
$2,467.50 |
$2,467.50 |
12.6× |
| CT soft tissue neck w contrast (70491) |
$2,051 |
$2,051 |
10.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,051 |
$2,051 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,869 |
$1,869 |
16.0× |
| CT thoracic spine w/contrast (72129) |
$2,051 |
$2,051 |
10.5× |
| CT thoracic spine w/o contrast (72128) |
$1,506 |
$1,506 |
12.9× |
| CT thoracic spine w/wo contrast (72130) |
$2,051 |
$2,051 |
10.5× |
| CT thorax w/o contrast (71250) |
$2,005.50 |
$2,005.50 |
17.2× |
| CT upper ext wo (73200) |
$1,495 |
$1,495 |
12.8× |
| CT upper extremity with contrast (73201) |
$2,538.50 |
$2,538.50 |
6.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$3,372 |
$3,372 |
17.3× |
| Cta Abdomen (74175) |
$2,573 |
$2,573 |
13.2× |
| CTA abdomen pelvis (74174) |
$3,266 |
$3,266 |
8.4× |
| CTA chest (71275) |
$4,032 |
$4,032 |
20.6× |
| Cta Head (70496) |
$2,653 |
$2,653 |
13.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,641 |
$2,641 |
6.8× |
| Cta Neck (70498) |
$2,653 |
$2,653 |
13.6× |
| Cta Pelvis (72191) |
$2,051 |
$2,051 |
10.5× |
| Cystography minimum 3 views rs&i (74430) |
$1,368 |
$1,368 |
3.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$620 |
$620 |
5.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$338 |
$338 |
3.5× |
| Esophagus (74220) |
$1,368 |
$1,368 |
7.0× |
| Facial bones min 3 views (70150) |
$347.50 |
$347.50 |
3.0× |
| Fetal biophysical profile non-stress testing (76818) |
$620 |
$620 |
5.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$620 |
$620 |
5.3× |
| Fluoroscopy up to 1 hr (76000) |
$821 |
$821 |
3.1× |
| Foot 2 views (73620) |
$338 |
$338 |
3.5× |
| Forearm 2 views (73090) |
$338 |
$338 |
3.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,890 |
$1,890 |
4.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$2,450 |
$2,450 |
4.0× |
| Hand 2 views (73120) |
$620 |
$620 |
5.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,450 |
$2,450 |
4.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,890 |
$1,890 |
4.2× |
| Hysterosalpingogram (74740) |
$1,257 |
$1,257 |
4.7× |
| Interstitial radiation source applic complex (77778) |
$6,330 |
$6,330 |
8.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$620 |
$620 |
5.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,450 |
$2,450 |
4.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,450 |
$2,450 |
4.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,450 |
$2,450 |
4.0× |
| Knee 3 views (73562) |
$338 |
$338 |
3.5× |
| Liver & spleen imaging static only (78215) |
$1,890 |
$1,890 |
4.2× |
| Lung perfusion differential (78597) |
$1,890 |
$1,890 |
4.2× |
| Lymphoscintigraphy (78195) |
$2,450 |
$2,450 |
4.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$4,212 |
$4,212 |
4.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$3,509 |
$3,509 |
9.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,171.50 |
$4,171.50 |
10.7× |
| MRA head w & w/o contrast (70546) |
$3,703 |
$3,703 |
9.5× |
| MRA head w/o contrast (70544) |
$1,885 |
$1,885 |
7.1× |
| MRA head with contrast (70545) |
$2,051 |
$2,051 |
5.3× |
| MRA neck w contrast (70548) |
$2,051 |
$2,051 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,703 |
$3,703 |
9.5× |
| MRA neck w/o contrast (70547) |
$1,885 |
$1,885 |
7.1× |
| MRI abdomen w contrast (74182) |
$3,703 |
$3,703 |
9.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,703 |
$3,703 |
9.5× |
| MRI abdomen w/o contrast (74181) |
$1,885 |
$1,885 |
7.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,320 |
$4,320 |
4.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,703 |
$3,703 |
9.5× |
| MRI bone marrow blood supply (77084) |
$1,872 |
$1,872 |
7.0× |
| MRI breast w/o contrast bilateral (77047) |
$2,944 |
$2,944 |
11.1× |
| MRI breast wo contrast unilateral (77046) |
$2,944 |
$2,944 |
11.1× |
| MRI c-spine with contrast (72142) |
$3,699 |
$3,699 |
9.5× |
| MRI cervical spine w/o contrast (72141) |
$1,885 |
$1,885 |
7.1× |
| MRI chest w/o & w/contrast material (71552) |
$3,703 |
$3,703 |
9.5× |
| MRI chest w/o contrast (71550) |
$1,885 |
$1,885 |
7.1× |
| MRI chest with contrast (71551) |
$3,248 |
$3,248 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,755.50 |
$2,755.50 |
7.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,273.50 |
$4,273.50 |
11.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,327 |
$2,327 |
8.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,397 |
$2,397 |
9.0× |
| MRI orbit face neck w contrast (70542) |
$3,703 |
$3,703 |
9.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,703 |
$3,703 |
9.5× |
| MRI pelvis w/contrast (72196) |
$3,703 |
$3,703 |
9.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,703 |
$3,703 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$1,885 |
$1,885 |
7.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,703 |
$3,703 |
9.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,703 |
$3,703 |
9.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,703 |
$3,703 |
9.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,703 |
$3,703 |
9.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,703 |
$3,703 |
9.5× |
| MRI temporomandibular joint (70336) |
$1,084 |
$1,084 |
4.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,284 |
$2,284 |
8.6× |
| MRI up ext w/o contrast (73218) |
$1,885 |
$1,885 |
7.1× |
| MRI upper ext joint w/o contrast (73221) |
$2,290.50 |
$2,290.50 |
8.6× |
| MRI, joint upper extrem combo (73223) |
$3,894.50 |
$3,894.50 |
10.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,586 |
$3,586 |
2.5× |
| Myocardial Spect Multiple Studies (78452) |
$4,297 |
$4,297 |
3.0× |
| Neck soft tissue (70360) |
$192.50 |
$192.50 |
2.0× |
| Nm gastric emptying study (78264) |
$1,890 |
$1,890 |
4.2× |
| Nm gastroesophageal reflux study (78262) |
$1,890 |
$1,890 |
4.2× |
| Noncardiac Vascular Flow Imaging (78445) |
$63 |
$63 |
0.1× |
| Nonvascular shunt X-ray (75809) |
$620 |
$620 |
5.3× |
| Nuclear Rx Oral Admin (79005) |
$1,650 |
$1,650 |
6.3× |
| Ob us nuchal meas 1 gest (76813) |
$620 |
$620 |
5.3× |
| Osseous survey limited (77074) |
$620 |
$620 |
5.3× |
| Parathyroid Planar Imaging (78070) |
$1,890 |
$1,890 |
4.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,055 |
$2,055 |
4.6× |
| Pelvis 1 or 2 views (72170) |
$620 |
$620 |
5.3× |
| PET image w/CT, skull-thigh (78815) |
$5,945 |
$5,945 |
3.7× |
| PET imaging CT for attenuation limited area (78814) |
$4,352 |
$4,352 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$9,632 |
$9,632 |
6.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,890 |
$1,890 |
4.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,450 |
$2,450 |
4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,257 |
$1,257 |
2.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$338 |
$338 |
3.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$338 |
$338 |
3.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$338 |
$338 |
3.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$338 |
$338 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$620 |
$620 |
5.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$620 |
$620 |
5.3× |
| Radex fingr minimum 2 views (73140) |
$356 |
$356 |
3.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$338 |
$338 |
3.5× |
| Radex Hand Minimum 3 Views (73130) |
$344 |
$344 |
3.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$338 |
$338 |
3.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$620 |
$620 |
5.3× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$620 |
$620 |
5.3× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$620 |
$620 |
5.3× |
| Radex Humerus Minimum 2 Views (73060) |
$338 |
$338 |
3.5× |
| Radex Kne 1/2 Views (73560) |
$338 |
$338 |
3.5× |
| Radex Kne Compl 4/More Views (73564) |
$620 |
$620 |
5.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$620 |
$620 |
5.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$199 |
$199 |
2.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$620 |
$620 |
5.3× |
| Radex Sho Compl Minimum 2 Views (73030) |
$299 |
$299 |
3.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$197 |
$197 |
2.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$620 |
$620 |
5.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$338 |
$338 |
3.5× |
| Radex Toe Minimum 2 Views (73660) |
$279 |
$279 |
2.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$620 |
$620 |
5.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$338 |
$338 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$620 |
$620 |
5.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$338 |
$338 |
3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$653 |
$653 |
5.6× |
| Radiologic exam chest 2 views (71046) |
$370 |
$370 |
3.8× |
| Radiologic exam colon single contrast study (74270) |
$1,368 |
$1,368 |
7.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$867 |
$867 |
4.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$871.50 |
$871.50 |
4.5× |
| Radiologic examination femur 1 view (73551) |
$338 |
$338 |
3.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$338 |
$338 |
3.5× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$620 |
$620 |
5.3× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$620 |
$620 |
5.3× |
| Radiological examination surgical specimen (76098) |
$528 |
$528 |
0.9× |
| Ribs bilateral 3 views (71110) |
$620 |
$620 |
5.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,450 |
$2,450 |
4.0× |
| Sacroiliac Joints < 3 Views (72200) |
$53 |
$53 |
0.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,257 |
$1,257 |
4.7× |
| Scapula (73010) |
$620 |
$620 |
5.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$109 |
$109 |
4.7× |
| Shoulder 1 view (73020) |
$338 |
$338 |
3.5× |
| Small bowel series (74250) |
$620 |
$620 |
3.2× |
| Special dosimetry (77331) |
$407.50 |
$407.50 |
2.7× |
| Special Physics Consult (77370) |
$1,519 |
$1,519 |
10.1× |
| Special treatment procedure (77470) |
$3,465 |
$3,465 |
5.6× |
| Spine thoracic 3 views (72072) |
$620 |
$620 |
5.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,009 |
$2,009 |
4.8× |
| Thoracolumbar 2 views (72080) |
$338 |
$338 |
3.5× |
| Thyroid imaging w/blood flow (78013) |
$1,890 |
$1,890 |
4.2× |
| Thyroid uptake measurement (78012) |
$1,890 |
$1,890 |
4.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,890 |
$1,890 |
4.2× |
| Tmj unilateral (70328) |
$248 |
$248 |
2.6× |
| Tomogram (76100) |
$620 |
$620 |
5.3× |
| Treatment devices simple (77332) |
$1,235 |
$1,235 |
8.2× |
| Ultrasound breast complete (76641) |
$620 |
$620 |
5.3× |
| Ultrasound Exam Aaa Screen (76706) |
$620 |
$620 |
5.3× |
| Ultrasound, abdomen limited (76705) |
$620 |
$620 |
5.3× |
| Unlisted ultrasound procedure (76999) |
$356 |
$356 |
3.7× |
| Urethrocystogram voiding (74455) |
$1,257 |
$1,257 |
4.7× |
| Urethrocystography retrograde rs&i (74450) |
$1,257 |
$1,257 |
4.7× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,368 |
$1,368 |
7.0× |
| Us breast unilateral limited (76642) |
$380.50 |
$380.50 |
3.9× |
| Us chest (76604) |
$620 |
$620 |
5.3× |
| Us infant hips w manipulation (76885) |
$338 |
$338 |
3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$620 |
$620 |
5.3× |
| Us ob detailed single fetus (76811) |
$620 |
$620 |
2.3× |
| Us ob limited (76815) |
$620 |
$620 |
5.3× |
| Us ob transvaginal (76817) |
$620 |
$620 |
5.3× |
| Us pelvic non ob complete (76856) |
$442 |
$442 |
3.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$620 |
$620 |
5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$620 |
$620 |
5.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$620 |
$620 |
5.3× |
| Us retroperitoneal complete (76770) |
$620 |
$620 |
5.3× |
| Us retroperitoneal limited (76775) |
$653 |
$653 |
5.6× |
| Us scrotum and contents (76870) |
$620 |
$620 |
5.3× |
| Us soft tissue head/neck (76536) |
$620 |
$620 |
5.3× |
| Us spinal canal and contents (76800) |
$620 |
$620 |
5.3× |
| Us transrectal prostate volume (76873) |
$1,057.50 |
$1,057.50 |
9.1× |
| Us,transplanted kidney, real time/ doppler (76776) |
$620 |
$620 |
5.3× |
| Wrist 2 views (73100) |
$338 |
$338 |
3.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$620 |
$620 |
5.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$338 |
$338 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,368 |
$1,368 |
7.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$338 |
$338 |
3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$338 |
$338 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$620 |
$620 |
5.3× |
| X-ray exam of femur 2/> (73552) |
$358 |
$358 |
3.7× |
| X-ray eye for foreign body (70030) |
$338 |
$338 |
3.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$197 |
$197 |
2.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,368 |
$1,368 |
7.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$64 |
$64 |
0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$340 |
$340 |
3.5× |
| X-ray leg, infant (73592) |
$338 |
$338 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$620 |
$620 |
5.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$620 |
$620 |
5.3× |
| X-ray nose-rectum child f.b. (76010) |
$338 |
$338 |
3.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$347.50 |
$347.50 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$338 |
$338 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$620 |
$620 |
5.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$620 |
$620 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$620 |
$620 |
5.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$338 |
$338 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$202 |
$202 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$348 |
$348 |
3.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$341 |
$341 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$338 |
$338 |
3.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$338 |
$338 |
3.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$338 |
$338 |
3.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$620 |
$620 |
5.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$83 |
$83 |
0.7× |
| Xr bone length studies (77073) |
$620 |
$620 |
5.3× |
| Xr c-spine 4 or 5 views (72050) |
$620 |
$620 |
5.3× |
| Xr c-spine 6 or more views (72052) |
$620 |
$620 |
5.3× |
| Xr chest 4+ views (71048) |
$620 |
$620 |
5.3× |