| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,267.20 |
$2,112 |
1.1× |
| Abdomen 2 views (74019) |
$168 |
$280 |
1.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$414 |
$690 |
1.2× |
| Ankle 2 views (73600) |
$60 |
$100 |
0.8× |
| Arthrogram elbow (73085) |
$489 |
$815 |
1.6× |
| Arthrogram hip (73525) |
$405 |
$675 |
1.3× |
| Arthrogram shoulder (73040) |
$501 |
$835 |
1.7× |
| Arthrogram wrist (73115) |
$489 |
$815 |
1.6× |
| Arthrography knee lt (73580) |
$489 |
$815 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$372.30 |
$620.50 |
1.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$384.15 |
$640.25 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$618 |
$1,030 |
1.8× |
| Bone age studies (77072) |
$168 |
$280 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$643.50 |
$1,072.50 |
1.9× |
| Bone survey complete (77075) |
$145.20 |
$242 |
1.6× |
| Brain image w/flow 4 + views (78606) |
$456.60 |
$761 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,220 |
$3,700 |
1.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$600 |
$1,000 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$102 |
$170 |
1.4× |
| Chest 1 view (71045) |
$72 |
$120 |
1.0× |
| Chest 3 views (71047) |
$90 |
$150 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$282 |
$470 |
1.9× |
| Clavicle complete (73000) |
$49.50 |
$82.50 |
0.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$168 |
$280 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,644 |
$2,740 |
5.5× |
| CT abdomen and pelvis without contrast (74176) |
$924 |
$1,540 |
4.5× |
| CT abdomen w contrast (74160) |
$552.60 |
$921 |
3.7× |
| CT abdomen w wo contrast (74170) |
$668.40 |
$1,114 |
4.4× |
| CT abdomen w/o contrast (74150) |
$459 |
$765 |
5.1× |
| CT angio hrt w/3d image (75574) |
$540 |
$900 |
1.8× |
| CT angiography upper extremity lt (73206) |
$720 |
$1,200 |
4.8× |
| CT c-spine w/o contrast (72125) |
$483 |
$805 |
5.4× |
| CT cervical spine w&w/o contrast (72127) |
$622.20 |
$1,037 |
4.1× |
| CT cervical spine with contrast (72126) |
$563.70 |
$939.50 |
1.9× |
| CT chest w/wo contrast (71270) |
$668.40 |
$1,114 |
4.4× |
| CT chest with contrast (71260) |
$564.30 |
$940.50 |
3.7× |
| CT head/brain with contrast (70460) |
$639 |
$1,065 |
4.2× |
| CT head/brain without and with contrast (70470) |
$693.60 |
$1,156 |
4.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$540 |
$900 |
1.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$120 |
$200 |
1.6× |
| CT hrt w/3d image congen (75573) |
$540 |
$900 |
1.8× |
| CT iac w contrast (70481) |
$576 |
$960 |
3.8× |
| CT lower ext w/o (73700) |
$297 |
$495 |
3.3× |
| CT lower extremity w wo contrast (73702) |
$576 |
$960 |
3.8× |
| CT lower extremity with contrast (73701) |
$576 |
$960 |
3.8× |
| CT lumbar spine w & w/o contrast (72133) |
$668.40 |
$1,114 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$483 |
$805 |
5.4× |
| CT lumbar spine with contrast (72132) |
$575.70 |
$959.50 |
1.9× |
| CT maxillofacial w contrast (70487) |
$576 |
$960 |
3.8× |
| CT maxillofacial w/o contrast (70486) |
$297 |
$495 |
3.3× |
| CT maxillofacial w/wo contrast (70488) |
$576 |
$960 |
3.8× |
| CT neck soft tissue w contrast (70491) |
$576 |
$960 |
3.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$576 |
$960 |
3.8× |
| CT orbits w/o contrast (70480) |
$297 |
$495 |
3.3× |
| CT pelvis w & w/o contrast (72194) |
$978 |
$1,630 |
6.5× |
| CT pelvis w/o contrast (72192) |
$465.60 |
$776 |
5.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$576 |
$960 |
3.8× |
| CT soft tissue neck w/o contrast (70490) |
$465 |
$775 |
5.2× |
| CT thoracic spine w/contrast (72129) |
$563.70 |
$939.50 |
3.7× |
| CT thoracic spine w/o contrast (72128) |
$483 |
$805 |
5.4× |
| CT thoracic spine w/wo contrast (72130) |
$622.20 |
$1,037 |
4.1× |
| CT thorax w/o contrast (71250) |
$465.60 |
$776 |
5.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$576 |
$960 |
3.8× |
| CT upper extremity w/o contrast rt (73200) |
$297 |
$495 |
3.3× |
| CT upper extremity with contrast (73201) |
$576 |
$960 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$720 |
$1,200 |
4.8× |
| Cta Abdomen (74175) |
$720 |
$1,200 |
4.8× |
| CTA abdomen pelvis (74174) |
$576 |
$960 |
1.9× |
| CTA chest (71275) |
$648 |
$1,080 |
4.3× |
| Cta Head (70496) |
$834 |
$1,390 |
5.5× |
| CTA lwr ext w&w/o contrast (73706) |
$720 |
$1,200 |
4.8× |
| Cta Neck (70498) |
$840 |
$1,400 |
5.6× |
| Cta Pelvis (72191) |
$720 |
$1,200 |
4.8× |
| Cystography minimum 3 views rs&i (74430) |
$162 |
$270 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$162 |
$270 |
1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$108 |
$180 |
1.4× |
| Esophagus (74220) |
$240 |
$400 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$108 |
$180 |
1.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$162 |
$270 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$300 |
$500 |
1.5× |
| Foot 2 views (73620) |
$45 |
$75 |
0.6× |
| Forearm 2 views (73090) |
$61.16 |
$101.94 |
0.8× |
| Gated Heart Planar Single (78472) |
$540 |
$900 |
1.6× |
| Hand 2 views (73120) |
$144 |
$240 |
1.6× |
| Hand 3 views (73130) |
$63.49 |
$105.82 |
0.8× |
| Heart Infarct Image (78466) |
$479.70 |
$799.50 |
1.4× |
| Heart infarct image w ef (78468) |
$322.80 |
$538 |
0.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$660 |
$1,100 |
1.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$480 |
$800 |
1.4× |
| Ht muscle image spect sing (78451) |
$695.40 |
$1,159 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$63.49 |
$105.82 |
0.8× |
| Hysterosalpingogram (74740) |
$181.50 |
$302.50 |
0.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$73.20 |
$122 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$516 |
$860 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$425.10 |
$708.50 |
0.9× |
| Knee 3 views (73562) |
$69 |
$115 |
0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$438 |
$730 |
1.3× |
| Liver imaging w/vascular flow (78202) |
$780 |
$1,300 |
1.7× |
| Lung Ventilation Imaging (78579) |
$397.80 |
$663 |
1.2× |
| Lymphoscintigraphy (78195) |
$762 |
$1,270 |
1.6× |
| Meckels Diverticulum (78290) |
$384 |
$640 |
1.1× |
| MRA head w & w/o contrast (70546) |
$1,296 |
$2,160 |
4.3× |
| MRA head w/o contrast (70544) |
$819 |
$1,365 |
4.0× |
| MRA head with contrast (70545) |
$1,056 |
$1,760 |
3.5× |
| MRA neck w contrast (70548) |
$840 |
$1,400 |
2.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,320 |
$2,200 |
4.4× |
| MRA neck w/o contrast (70547) |
$864 |
$1,440 |
4.2× |
| MRI abdomen w contrast (74182) |
$1,008 |
$1,680 |
3.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,116 |
$1,860 |
3.7× |
| MRI abdomen w/o contrast (74181) |
$693 |
$1,155 |
3.4× |
| MRI any jnt lwr ext with con lt (73722) |
$948 |
$1,580 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$948 |
$1,580 |
1.4× |
| MRI c-spine with contrast (72142) |
$840 |
$1,400 |
2.8× |
| MRI cervical spine w/o contrast (72141) |
$720 |
$1,200 |
3.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,260 |
$2,100 |
4.2× |
| MRI chest w/o contrast (71550) |
$840 |
$1,400 |
4.1× |
| MRI chest with contrast (71551) |
$960 |
$1,600 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,116 |
$1,860 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$840 |
$1,400 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$780 |
$1,300 |
3.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$693 |
$1,155 |
3.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,116 |
$1,860 |
3.7× |
| MRI orbit/face/neck w/contrast (70542) |
$864 |
$1,440 |
2.9× |
| MRI pelvis w contrast (72196) |
$840 |
$1,400 |
2.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,140 |
$1,900 |
3.8× |
| MRI pelvis w/o contrast (72195) |
$780 |
$1,300 |
3.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,080 |
$1,800 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,080 |
$1,800 |
3.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,140 |
$1,900 |
3.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$840 |
$1,400 |
2.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,140 |
$1,900 |
3.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$780 |
$1,300 |
2.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,080 |
$1,800 |
3.6× |
| MRI thoracic spine w/o contrast (72146) |
$720 |
$1,200 |
3.5× |
| MRI tmj (70336) |
$660 |
$1,100 |
3.2× |
| MRI upper ext joint w/o contrast (73221) |
$720 |
$1,200 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,116 |
$1,860 |
3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$693 |
$1,155 |
3.4× |
| Myelogram Cervical (72240) |
$1,116 |
$1,860 |
1.7× |
| Myelogram Lumbar (72265) |
$330 |
$550 |
0.5× |
| Myelogram thoracic (72255) |
$1,116 |
$1,860 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,040 |
$3,400 |
1.8× |
| Neck soft tissue (70360) |
$51 |
$85 |
0.7× |
| Nm adrenal scan (78075) |
$2,028 |
$3,380 |
1.8× |
| Nm bone marrow wb (78104) |
$371.70 |
$619.50 |
1.1× |
| Nm cisternogram (78630) |
$780 |
$1,300 |
1.7× |
| Nm csf leak detection (78650) |
$2,040 |
$3,400 |
1.8× |
| Nm gastric emptying study (78264) |
$457.20 |
$762 |
1.3× |
| Nuclear medicine of heart pumping function (78473) |
$375 |
$625 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$372 |
$620 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$315 |
$525 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$365.40 |
$609 |
1.8× |
| Osseous survey infant (77076) |
$84 |
$140 |
0.9× |
| Parathyrd planar w/wo subtrj (78071) |
$600 |
$1,000 |
1.7× |
| Parathyroid imaging (78070) |
$261 |
$435 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$69 |
$115 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$1,959 |
$3,265 |
1.6× |
| PET imaging CT for attenuation limited area (78814) |
$1,819.44 |
$3,032.40 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$1,959 |
$3,265 |
1.6× |
| PET whole body (78813) |
$1,819.44 |
$3,032.40 |
1.5× |
| Pr heart first pass single,planar (78481) |
$471.30 |
$785.50 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,140 |
$1,900 |
3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$251.40 |
$419 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$600 |
$1,000 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$88.20 |
$147 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$150 |
$250 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$144 |
$240 |
1.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$72 |
$120 |
0.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$180 |
$300 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$75 |
$125 |
0.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$90 |
$150 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$87 |
$145 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$261 |
$435 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$126 |
$210 |
0.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$282 |
$470 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$216 |
$360 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$165 |
$275 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$90 |
$150 |
1.2× |
| Ribs bilateral 3 views (71110) |
$115.50 |
$192.50 |
1.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,028 |
$3,380 |
4.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,028 |
$3,380 |
4.3× |
| Sacroiliac Joints < 3 Views (72200) |
$57.60 |
$96 |
0.6× |
| Scanogram (77073) |
$126 |
$210 |
1.4× |
| Scapula complete (73010) |
$61.20 |
$102 |
0.7× |
| Screening digital breast tomosynthesis (77063) |
$78 |
$130 |
3.3× |
| Sella turcica (70240) |
$40.20 |
$67 |
0.5× |
| Simulation intermediate (77285) |
$360 |
$600 |
1.1× |
| Small bowel series (74250) |
$115.50 |
$192.50 |
0.8× |
| Spine thoracic 3 views (72072) |
$78 |
$130 |
0.9× |
| Testicular Imaging With Vascular Flow (78761) |
$410.40 |
$684 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$624 |
$1,040 |
1.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$144 |
$240 |
1.2× |
| Therapeutic Enema (74283) |
$126 |
$210 |
0.8× |
| Thoracolumbar 2 views (72080) |
$108 |
$180 |
1.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$618 |
$1,030 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$270 |
$450 |
0.8× |
| Thyroid uptake measurement (78012) |
$205.20 |
$342 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$457.20 |
$762 |
1.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,028 |
$3,380 |
4.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$527.40 |
$879 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$396 |
$660 |
4.4× |
| Upper Extremity Infant (73092) |
$144 |
$240 |
1.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$306.90 |
$511.50 |
0.9× |
| Urethrocystography voiding (74455) |
$513 |
$855 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$162 |
$270 |
1.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$181.50 |
$302.50 |
1.2× |
| Us abdl aorta screen aaa (76706) |
$165 |
$275 |
1.8× |
| Us breast unilateral complete (76641) |
$154.50 |
$257.50 |
1.7× |
| Us breast unilateral limited (76642) |
$108 |
$180 |
1.4× |
| Us chest (76604) |
$144 |
$240 |
1.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$162 |
$270 |
1.8× |
| Us ob transvaginal (76817) |
$145.20 |
$242 |
1.6× |
| Us pelvic non ob complete (76856) |
$145.20 |
$242 |
1.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$96 |
$160 |
1.1× |
| Us pregnancy ltd (76815) |
$96 |
$160 |
1.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$135 |
$225 |
1.5× |
| Us retroperitoneal complete (76770) |
$394.80 |
$658 |
4.4× |
| Us retroperitoneal limited (76775) |
$144 |
$240 |
1.6× |
| Us scrotum and contents (76870) |
$201 |
$335 |
2.2× |
| Us soft tissue head/neck (76536) |
$144 |
$240 |
1.6× |
| Us spinal canal and contents (76800) |
$144 |
$240 |
1.6× |
| Us transrectal (76872) |
$162 |
$270 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$168 |
$280 |
1.9× |
| Venogram extremity bilateral (75822) |
$720 |
$1,200 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$660 |
$1,100 |
0.5× |
| Wrist 2 views (73100) |
$49.50 |
$82.50 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$87 |
$145 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$48.90 |
$81.50 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$63.60 |
$106 |
0.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$192 |
$320 |
1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$61.16 |
$101.94 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$63.60 |
$106 |
0.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$180 |
$300 |
2.0× |
| X-ray exam hip uni 1 view (73501) |
$60 |
$100 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$72 |
$120 |
1.0× |
| X-ray exam hip uni 4/> views (73503) |
$98.40 |
$164 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$150 |
$250 |
1.7× |
| X-ray exam of femur 1 (73551) |
$84 |
$140 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$82.50 |
$137.50 |
0.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$51 |
$85 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$63.60 |
$106 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$60 |
$100 |
0.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$57.30 |
$95.50 |
0.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$78 |
$130 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$108 |
$180 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$108 |
$180 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$78 |
$130 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$146.40 |
$244 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$55.20 |
$92 |
0.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$180 |
$300 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$64.50 |
$107.50 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$144 |
$240 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$144 |
$240 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$61.20 |
$102 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$53.10 |
$88.50 |
0.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$72 |
$120 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$73.20 |
$122 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$58.20 |
$97 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$90 |
$150 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$60 |
$100 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$108 |
$180 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$60 |
$100 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$72 |
$120 |
0.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$45 |
$75 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$60.60 |
$101 |
0.8× |
| Xr arthrogram ankle (73615) |
$489 |
$815 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$162 |
$270 |
1.8× |
| Xr chest 4+ views (71048) |
$174 |
$290 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$49.50 |
$82.50 |
0.7× |
| Xr shoulder 1 view (73020) |
$49.50 |
$82.50 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$102 |
$170 |
1.1× |
| Xr tibia/fibula 2 views (73590) |
$63.60 |
$106 |
0.8× |
| Xr tmj bilateral (70330) |
$90.30 |
$150.50 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$60 |
$100 |
0.8× |