| Abdomen 2 views (74019) |
$307.20 |
$384 |
2.6× |
| Ankle 2 views (73600) |
$225.60 |
$282 |
2.3× |
| Arthrogram ankle (73615) |
$547.20 |
$684 |
1.4× |
| Arthrogram elbow (73085) |
$1,367.20 |
$1,709 |
3.5× |
| Arthrogram hip (73525) |
$615.20 |
$769 |
1.6× |
| Arthrogram knee (73580) |
$615.20 |
$769 |
1.6× |
| Arthrogram shoulder (73040) |
$498.40 |
$623 |
1.3× |
| Arthrogram wrist (73115) |
$455.20 |
$569 |
1.2× |
| Bone age studies (77072) |
$116.80 |
$146 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$1,385.60 |
$1,732 |
3.1× |
| Bone survey complete (77075) |
$969.60 |
$1,212 |
8.3× |
| Bone survey infant (77076) |
$384.80 |
$481 |
3.3× |
| Cervical spine 2 or 3 views (72040) |
$308.80 |
$386 |
3.2× |
| Chest 1 view (71045) |
$210.40 |
$263 |
2.2× |
| Chest xray 3 views (71047) |
$252 |
$315 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$460.80 |
$576 |
2.4× |
| Clavicle complete (73000) |
$256.80 |
$321 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$868.80 |
$1,086 |
7.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,861.60 |
$3,577 |
7.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,872.80 |
$2,341 |
7.0× |
| CT abdomen w contrast (74160) |
$2,369.60 |
$2,962 |
12.1× |
| CT abdomen w wo contrast (74170) |
$2,450.40 |
$3,063 |
12.5× |
| CT abdomen w/o contrast (74150) |
$1,520 |
$1,900 |
13.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,532 |
$3,165 |
13.0× |
| CT angiography upper extremity lt (73206) |
$2,532 |
$3,165 |
13.0× |
| CT c-spine w/contrast (72126) |
$1,748 |
$2,185 |
4.5× |
| CT c-spine w/o contrast (72125) |
$1,466.40 |
$1,833 |
12.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,423.20 |
$3,029 |
12.4× |
| CT chest w contrast (71260) |
$2,359.20 |
$2,949 |
12.1× |
| CT chest w/wo contrast (71270) |
$2,644 |
$3,305 |
13.5× |
| CT head/brain with contrast (70460) |
$1,960 |
$2,450 |
10.0× |
| CT head/brain without and with contrast (70470) |
$2,206.40 |
$2,758 |
11.3× |
| CT iac w contrast (70481) |
$2,475.20 |
$3,094 |
12.7× |
| CT limited/localized follow up study (76380) |
$1,066.40 |
$1,333 |
11.0× |
| CT lower ext w/o (73700) |
$1,342.40 |
$1,678 |
11.5× |
| CT lower extremity w wo contrast (73702) |
$2,791.20 |
$3,489 |
14.3× |
| CT lower extremity w/contrast material (73701) |
$2,059.20 |
$2,574 |
10.5× |
| CT lumbar spine w & w/o contrast (72133) |
$2,132 |
$2,665 |
10.9× |
| CT lumbar spine w/contrast (72132) |
$1,848 |
$2,310 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$1,440 |
$1,800 |
12.4× |
| CT maxillofacial w contrast (70487) |
$2,292.80 |
$2,866 |
11.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,292.80 |
$2,866 |
11.7× |
| CT maxillofacial wo contrast (70486) |
$965.60 |
$1,207 |
8.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,403.20 |
$4,254 |
17.4× |
| CT orbits w/o contrast (70480) |
$1,444.80 |
$1,806 |
12.4× |
| CT pelvis w/o contrast (72192) |
$1,476 |
$1,845 |
12.7× |
| CT pelvis w/wo contrast (72194) |
$2,363.20 |
$2,954 |
12.1× |
| CT scan of arm combo (73202) |
$2,610.40 |
$3,263 |
13.4× |
| CT soft tissue neck w contrast (70491) |
$2,039.20 |
$2,549 |
10.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,056.80 |
$2,571 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,221.60 |
$1,527 |
10.5× |
| CT thoracic spine w/contrast (72129) |
$1,942.40 |
$2,428 |
9.9× |
| CT thoracic spine w/o contrast (72128) |
$1,440 |
$1,800 |
12.4× |
| CT thoracic spine w/wo contrast (72130) |
$2,423.20 |
$3,029 |
12.4× |
| CT thorax w/o contrast (71250) |
$1,447.20 |
$1,809 |
12.4× |
| CT upper ext wo (73200) |
$1,342.40 |
$1,678 |
11.5× |
| CT upper extremity with contrast (73201) |
$2,045.60 |
$2,557 |
5.3× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,317.60 |
$2,897 |
11.9× |
| Cta Abdomen (74175) |
$2,256 |
$2,820 |
11.5× |
| CTA abdomen pelvis (74174) |
$1,648 |
$2,060 |
4.2× |
| CTA chest (71275) |
$2,261.60 |
$2,827 |
11.6× |
| Cta Head (70496) |
$1,992.80 |
$2,491 |
10.2× |
| Cta Neck (70498) |
$2,212 |
$2,765 |
11.3× |
| Cta Pelvis (72191) |
$2,532 |
$3,165 |
13.0× |
| Cystography minimum 3 views rs&i (74430) |
$574.40 |
$718 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$418.40 |
$523 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$254.40 |
$318 |
2.6× |
| Dxa bone density study axial skeleton (77085) |
$418.40 |
$523 |
3.6× |
| Esophagus (74220) |
$608.80 |
$761 |
3.1× |
| Facial bones min 3 views (70150) |
$250.40 |
$313 |
2.1× |
| Fetal biophysical profile non-stress testing (76818) |
$330.40 |
$413 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$655.20 |
$819 |
5.6× |
| Fluoroscopy up to 1 hr (76000) |
$322.40 |
$403 |
1.2× |
| Foot 2 views (73620) |
$247.20 |
$309 |
2.5× |
| Forearm 2 views (73090) |
$256.80 |
$321 |
2.6× |
| Hand 2 views (73120) |
$247.20 |
$309 |
2.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,720.80 |
$2,151 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,176 |
$1,470 |
2.6× |
| Hysterosalpingogram (74740) |
$618.40 |
$773 |
2.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,265.60 |
$4,082 |
5.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,363.20 |
$4,204 |
5.6× |
| Knee 3 views (73562) |
$286.40 |
$358 |
3.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,239.20 |
$2,799 |
2.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$3,279.20 |
$4,099 |
8.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,808 |
$4,760 |
9.8× |
| Mammary ductogram or galactogram single (77053) |
$1,026.40 |
$1,283 |
3.9× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$376 |
$470 |
3.9× |
| MRA head w & w/o contrast (70546) |
$4,865.60 |
$6,082 |
12.5× |
| MRA head w/o contrast (70544) |
$2,436 |
$3,045 |
9.2× |
| MRA head with contrast (70545) |
$4,076.80 |
$5,096 |
10.5× |
| MRA neck w contrast (70548) |
$3,412 |
$4,265 |
8.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,982.40 |
$3,728 |
7.7× |
| MRA neck w/o contrast (70547) |
$3,238.40 |
$4,048 |
12.2× |
| MRI abdomen w contrast (74182) |
$2,910.40 |
$3,638 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,079.20 |
$2,599 |
5.3× |
| MRI abdomen w/o contrast (74181) |
$1,735.20 |
$2,169 |
6.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,266.40 |
$2,833 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,779.20 |
$3,474 |
7.1× |
| MRI bone marrow blood supply (77084) |
$1,330.40 |
$1,663 |
5.0× |
| MRI c-spine with contrast (72142) |
$3,351.20 |
$4,189 |
8.6× |
| MRI cervical spine w/o contrast (72141) |
$2,367.20 |
$2,959 |
8.9× |
| MRI chest w/o & w/contrast material (71552) |
$2,800.80 |
$3,501 |
7.2× |
| MRI chest w/o contrast (71550) |
$1,692.80 |
$2,116 |
6.4× |
| MRI chest with contrast (71551) |
$1,895.20 |
$2,369 |
2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,276.80 |
$4,096 |
8.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,573.60 |
$3,217 |
6.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,709.60 |
$2,137 |
6.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,636 |
$2,045 |
6.2× |
| MRI orbit face neck w contrast (70542) |
$3,082.40 |
$3,853 |
7.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,058.40 |
$2,573 |
5.3× |
| MRI pelvis w/contrast (72196) |
$3,824.80 |
$4,781 |
9.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,008 |
$3,760 |
7.7× |
| MRI pelvis w/o contrast (72195) |
$1,738.40 |
$2,173 |
6.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,760.80 |
$3,451 |
7.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,351.20 |
$2,939 |
6.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,592.80 |
$3,241 |
6.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,368 |
$4,210 |
8.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,604.80 |
$3,256 |
6.7× |
| MRI temporomandibular joint (70336) |
$2,148 |
$2,685 |
8.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,385.60 |
$2,982 |
9.0× |
| MRI up ext w/o contrast (73218) |
$3,059.20 |
$3,824 |
11.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,655.20 |
$2,069 |
6.2× |
| MRI, joint upper extrem combo (73223) |
$2,856.80 |
$3,571 |
7.3× |
| Myelogram Cervical (72240) |
$664 |
$830 |
0.8× |
| Myelogram Lumbar (72265) |
$664 |
$830 |
0.8× |
| Myelogram thoracic (72255) |
$664 |
$830 |
0.8× |
| Myelography 2 or more regions (72270) |
$955.20 |
$1,194 |
1.1× |
| Neck soft tissue (70360) |
$222.40 |
$278 |
2.3× |
| Nm gastric emptying study (78264) |
$1,671.20 |
$2,089 |
3.8× |
| Ob us nuchal meas 1 gest (76813) |
$228 |
$285 |
2.0× |
| Osseous survey limited (77074) |
$384.80 |
$481 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$232.80 |
$291 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$447.20 |
$559 |
0.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$265.60 |
$332 |
2.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$234.40 |
$293 |
2.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$277.60 |
$347 |
2.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$159.20 |
$199 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$352 |
$440 |
3.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$278.40 |
$348 |
2.4× |
| Radex fingr minimum 2 views (73140) |
$296.80 |
$371 |
3.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$265.60 |
$332 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$265.60 |
$332 |
2.7× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$138.40 |
$173 |
1.4× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$247.20 |
$309 |
2.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$182.40 |
$228 |
1.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$404.80 |
$506 |
3.5× |
| Radex Humerus Minimum 2 Views (73060) |
$281.60 |
$352 |
2.9× |
| Radex Kne 1/2 Views (73560) |
$247.20 |
$309 |
2.5× |
| Radex Kne Compl 4/More Views (73564) |
$320 |
$400 |
2.7× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$231.20 |
$289 |
2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$228 |
$285 |
2.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$245.60 |
$307 |
2.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$281.60 |
$352 |
2.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$174.40 |
$218 |
1.8× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$322.40 |
$403 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$564 |
$705 |
5.8× |
| Radex Toe Minimum 2 Views (73660) |
$284 |
$355 |
2.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$384.80 |
$481 |
3.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$266.40 |
$333 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$329.60 |
$412 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$262.40 |
$328 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$241.60 |
$302 |
2.1× |
| Radiologic exam chest 2 views (71046) |
$292 |
$365 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$1,038.40 |
$1,298 |
5.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$408.80 |
$511 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$873.60 |
$1,092 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$644.80 |
$806 |
3.3× |
| Radiologic examination femur 1 view (73551) |
$254.40 |
$318 |
2.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$168.40 |
$210.50 |
1.7× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$752 |
$940 |
6.5× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$381.60 |
$477 |
3.3× |
| Radiological examination surgical specimen (76098) |
$383.20 |
$479 |
0.6× |
| Ribs bilateral 3 views (71110) |
$384.80 |
$481 |
3.3× |
| Sacroiliac Joints < 3 Views (72200) |
$171.20 |
$214 |
1.5× |
| Scapula (73010) |
$165.60 |
$207 |
1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$86.40 |
$108 |
3.7× |
| Shoulder 1 view (73020) |
$212.80 |
$266 |
2.2× |
| Sialogram (70390) |
$631.20 |
$789 |
2.4× |
| Small bowel series (74250) |
$762.40 |
$953 |
3.9× |
| Speech evaluation complex (70371) |
$752.80 |
$941 |
2.8× |
| Spine thoracic 3 views (72072) |
$228.80 |
$286 |
2.0× |
| Thoracolumbar 2 views (72080) |
$200.80 |
$251 |
2.1× |
| Tomogram (76100) |
$904.80 |
$1,131 |
7.8× |
| Ultrasound breast complete (76641) |
$506.40 |
$633 |
4.3× |
| Ultrasound Exam Aaa Screen (76706) |
$383.20 |
$479 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$706.40 |
$883 |
6.1× |
| Umbilical-artery Doppler (OB) (76820) |
$159.20 |
$199 |
1.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$100.27 |
$125.33 |
1.0× |
| Unlisted magnetic resonance procedure (76498) |
$1,413.60 |
$1,767 |
14.6× |
| Urethrocystogram voiding (74455) |
$734.40 |
$918 |
2.8× |
| Urethrocystography retrograde rs&i (74450) |
$729.60 |
$912 |
2.7× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$854.40 |
$1,068 |
4.4× |
| Us breast unilateral limited (76642) |
$514.40 |
$643 |
5.3× |
| Us chest (76604) |
$238.40 |
$298 |
2.0× |
| Us compl joint r-t w/image documentation (76881) |
$974.40 |
$1,218 |
8.4× |
| Us elastography parenchyma (76981) |
$393.60 |
$492 |
3.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$873.60 |
$1,092 |
7.5× |
| Us ob detailed single fetus (76811) |
$394.40 |
$493 |
1.5× |
| Us ob limited (76815) |
$478.40 |
$598 |
4.1× |
| Us ob transvaginal (76817) |
$298.40 |
$373 |
2.6× |
| Us pelvic non ob complete (76856) |
$676.80 |
$846 |
5.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$400.40 |
$500.50 |
3.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$352 |
$440 |
3.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$478.40 |
$598 |
4.1× |
| Us retroperitoneal complete (76770) |
$706.40 |
$883 |
6.1× |
| Us retroperitoneal limited (76775) |
$706.40 |
$883 |
6.1× |
| Us scrotum and contents (76870) |
$686.40 |
$858 |
5.9× |
| Us soft tissue head/neck (76536) |
$656.80 |
$821 |
5.6× |
| Us spinal canal and contents (76800) |
$528 |
$660 |
4.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$655.20 |
$819 |
5.6× |
| Venogram extremity bilateral (75822) |
$1,086.40 |
$1,358 |
0.6× |
| Venogram Extremity Unilateral (75820) |
$724.80 |
$906 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$254.40 |
$318 |
2.6× |
| Wrist 2 views (73100) |
$165.20 |
$206.50 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$282.40 |
$353 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$213.60 |
$267 |
2.2× |
| X-ray b.e. reductn intuss (74283) |
$610.40 |
$763 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,423.20 |
$1,779 |
7.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$151.20 |
$189 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$225.60 |
$282 |
2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$334.40 |
$418 |
2.9× |
| X-ray exam of femur 2/> (73552) |
$163.20 |
$204 |
1.7× |
| X-ray eye for foreign body (70030) |
$196 |
$245 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$163.20 |
$204 |
1.7× |
| X-ray IV pyelogram (ivp) (74400) |
$781.60 |
$977 |
4.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$183.20 |
$229 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$185.60 |
$232 |
1.9× |
| X-ray leg, infant (73592) |
$384.80 |
$481 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$328.80 |
$411 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$776 |
$970 |
6.7× |
| X-ray nose-rectum child f.b. (76010) |
$241.60 |
$302 |
2.5× |
| X-ray optic foramen (70190) |
$381.60 |
$477 |
3.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$252.80 |
$316 |
2.2× |
| X-ray retrograde pyelogram (74420) |
$933.60 |
$1,167 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$359.20 |
$449 |
3.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$220 |
$275 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$308.80 |
$386 |
2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$384.80 |
$481 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$277.60 |
$347 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$213.60 |
$267 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$256 |
$320 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$327.20 |
$409 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$408.80 |
$511 |
4.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$220 |
$275 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$184.80 |
$231 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$286.40 |
$358 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$384.80 |
$481 |
3.3× |
| Xr bone length studies (77073) |
$361.60 |
$452 |
3.1× |
| Xr c-spine 4 or 5 views (72050) |
$449.60 |
$562 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$500.80 |
$626 |
4.3× |
| Xr chest 4+ views (71048) |
$384.80 |
$481 |
3.3× |
| Xr urogram antegrade (74425) |
$1,070.40 |
$1,338 |
2.8× |