| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$13,652.50 |
— |
| Abdomen 1 View (74018) |
— |
$339.50 |
— |
| Abdomen 2 views (74019) |
— |
$368.50 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$1,929.50 |
— |
| Adrenal Cortex & Medulla Img (78075) |
— |
$5,737.50 |
— |
| Angio internal mammary (75756) |
— |
$3,373.50 |
— |
| Angio pulmonary bilat (75743) |
— |
$2,704.50 |
— |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
— |
$2,704.50 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$5,270 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$2,704.50 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$2,704.50 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$3,690 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$3,675.50 |
— |
| Artery X-Rays Spine (75705) |
— |
$2,837 |
— |
| Arthrogram ankle (73615) |
— |
$2,348 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$1,493.50 |
— |
| Bone age studies (77072) |
— |
$552 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$1,857.50 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,639 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$1,364.50 |
— |
| Bone Imaging Whole Body (78306) |
— |
$2,316.50 |
— |
| Bone marrow imaging limited area (78102) |
— |
$1,370 |
— |
| Bone marrow imaging; multiple areas (78103) |
— |
$1,282 |
— |
| Bone marrow imaging; whole body (78104) |
— |
$1,513.50 |
— |
| Bone survey infant (77076) |
— |
$1,247.50 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$1,761.50 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$2,119.50 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$3,931.50 |
— |
| Chest 1 view (71045) |
— |
$165.50 |
— |
| Chest 2 views (71046) |
— |
$456.50 |
— |
| Chest 3 views (71047) |
— |
$510.50 |
— |
| Chest 4 or more views (71048) |
— |
$627.50 |
— |
| Cholecystography Oral Contrast (74290) |
— |
$467.50 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$2,362.50 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$1,747 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$5,211.50 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$1,507 |
— |
| Contrast Xray Throat/Cerv Esopha (74210) |
— |
$416.50 |
— |
| Corpora cavernosography (74445) |
— |
$454 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$5,331.50 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$4,906.50 |
— |
| CT abdomen w contrast (74160) |
— |
$4,009.50 |
— |
| CT abdomen w wo contrast (74170) |
— |
$5,538.50 |
— |
| CT abdomen w/o contrast (74150) |
— |
$3,586.50 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$5,479 |
— |
| CT Angio Chest (71275) |
— |
$3,371 |
— |
| CT Angio Head (70496) |
— |
$4,079 |
— |
| CT angio hrt w/3d image (75574) |
— |
$2,732 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$2,823 |
— |
| CT Angio Neck (70498) |
— |
$4,294.50 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$1,887.50 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$2,897.50 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$2,819 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$2,953 |
— |
| CT chest w contrast (71260) |
— |
$3,725.50 |
— |
| CT chest w/wo contrast (71270) |
— |
$4,314 |
— |
| CT head/brain with contrast (70460) |
— |
$3,738 |
— |
| CT head/brain without and with contrast (70470) |
— |
$4,293 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$2,305.50 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$778.50 |
— |
| CT hrt w/3d image congen (75573) |
— |
$2,732 |
— |
| CT iac w contrast (70481) |
— |
$3,931.50 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$3,265 |
— |
| CT lower ext w/o (73700) |
— |
$2,633 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$2,654 |
— |
| CT lumbar spine w contrast (72132) |
— |
$3,017 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$2,778.50 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,426 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$3,196 |
— |
| CT neck tissue combo (70492) |
— |
$4,169.50 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$4,180.50 |
— |
| CT orbits w/o contrast (70480) |
— |
$3,659 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$2,140 |
— |
| CT pelvis w/o contrast (72192) |
— |
$2,358 |
— |
| CT scan of leg combo (73702) |
— |
$2,685 |
— |
| CT scans face/jaw combo (70488) |
— |
$4,117.50 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$3,905 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$2,764 |
— |
| CT thoracic spine w contrast (72129) |
— |
$3,024.50 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$2,740.50 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$3,266 |
— |
| CT thorax w/o contrast (71250) |
— |
$3,559.50 |
— |
| CT unlisted procedure (76497) |
— |
$1,208.50 |
— |
| CT upper ext wo (73200) |
— |
$2,362.50 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$2,926.50 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,761 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$5,239.50 |
— |
| Cta Abdomen (74175) |
— |
$5,103 |
— |
| CTA pelvis (72191) |
— |
$2,404.50 |
— |
| Dilation ureters/urethra rs&i (74485) |
— |
$1,224 |
— |
| Diskography lumbar (72295) |
— |
$1,864 |
— |
| Dxa Bone Density Axial (77080) |
— |
$811.50 |
— |
| Dxa bone density study (77085) |
— |
$887 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$233 |
— |
| Echo exam uterus (76831) |
— |
$1,381 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$2,034 |
— |
| Esophagram (74220) |
— |
$1,043 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$671 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$975.50 |
— |
| Follow-Up Angiography (75898) |
— |
$985 |
— |
| Gastric emptying imaging study (78264) |
— |
$2,581.50 |
— |
| Gastric Mucosa Imaging (78261) |
— |
$1,381 |
— |
| Gastroesophageal Reflux Exam (78262) |
— |
$1,618.50 |
— |
| Gated Heart Planar Single (78472) |
— |
$2,249 |
— |
| Heart first pass single,planar (78481) |
— |
$2,269 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$3,609.50 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$3,121.50 |
— |
| Ht Musc Image Planar Mult (78454) |
— |
$2,462 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$3,284 |
— |
| Hysterosalpingogram (74740) |
— |
$1,271 |
— |
| Image fusion (77399) |
— |
$4,110.50 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$858 |
— |
| Infant hip ultrasound, limited static exam (76886) |
— |
$961.50 |
— |
| Joint Survey Single View (77077) |
— |
$421 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$1,782.50 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$1,879.50 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$2,008.50 |
— |
| Liver imaging static only (78201) |
— |
$1,480.50 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$2,817.50 |
— |
| Lung perfusion differential (78597) |
— |
$2,414.50 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$1,913 |
— |
| Lung Ventilation Imaging (78579) |
— |
$1,813 |
— |
| Lymph System Imaging (78195) |
— |
$2,136 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$718 |
— |
| Meckels Divert Exam (78290) |
— |
$2,180 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$2,788.50 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$3,972.50 |
— |
| MRA head w/o contrast (70544) |
— |
$2,229.50 |
— |
| MRA head with contrast (70545) |
— |
$2,808 |
— |
| MRA neck w contrast (70548) |
— |
$2,620 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$4,603.50 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,470 |
— |
| MRI abdomen w contrast (74182) |
— |
$4,565.50 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$3,730 |
— |
| MRI cervical spine w contrast (72142) |
— |
$6,793 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$5,639.50 |
— |
| MRI chest w/o contrast (71550) |
— |
$3,350.50 |
— |
| MRI chest with contrast (71551) |
— |
$3,658 |
— |
| MRI chest wo w contrast (71552) |
— |
$5,547.50 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$5,912.50 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$8,433.50 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$3,492 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$3,871.50 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$4,216.50 |
— |
| MRI pelvis w contrast (72196) |
— |
$5,335.50 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$6,299 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$4,893 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$3,559.50 |
— |
| MRI, abdomen, combo (74183) |
— |
$5,512.50 |
— |
| MRI, dorsal spine combo (72157) |
— |
$5,437 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$4,306.50 |
— |
| MRI, lumbar spine combo (72158) |
— |
$7,690 |
— |
| Myelogram cervical (72240) |
— |
$2,077 |
— |
| Myelogram Lumbar (72265) |
— |
$1,501 |
— |
| Myelography thoracic (72255) |
— |
$1,494.50 |
— |
| Myelograpy 2/more regions rs&i (72270) |
— |
$2,453.50 |
— |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
— |
$1,032.50 |
— |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
— |
$1,639 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$6,230.50 |
— |
| Neck soft tissue (70360) |
— |
$656.50 |
— |
| Nm csf leak detection (78650) |
— |
$4,536 |
— |
| Nm red cell survival study (78130) |
— |
$2,559.50 |
— |
| Nonvascular Shunt X-Ray (75809) |
— |
$421 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$14,788 |
— |
| Optic foramina (70190) |
— |
$240.50 |
— |
| Parathyroid imaging w/tomographic spect & CT (78072) |
— |
$2,412.50 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$2,412.50 |
— |
| Parathyroid planar imaging w/wo subtraction (78071) |
— |
$2,412.50 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$435 |
— |
| PET image w/CT, full body (78816) |
— |
$10,667.50 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$10,667.50 |
— |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
— |
$1,095.50 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,489 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$997.50 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$2,133.50 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$586.50 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$556 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$600 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$765.50 |
— |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
— |
$644.50 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$972.50 |
— |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
— |
$1,077.50 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$582 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$482 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$563 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$752.50 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$607 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$7,498 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$1,402 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$1,864 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$2,290 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$631 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$533 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,650 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,235.50 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$1,039 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$454 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$1,230 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$861.50 |
— |
| Radiologic exam teeth complete full mouth (70320) |
— |
$164.50 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,099.50 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$385 |
— |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
— |
$432 |
— |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
— |
$3,828 |
— |
| Ribs bilateral 3 views (71110) |
— |
$793.50 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$2,172 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$2,511.50 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$3,551 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$3,551 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$1,805 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$1,632.50 |
— |
| Salivary Gland Imaging Serial Images (78231) |
— |
$1,536.50 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$548 |
— |
| Sella turcica (70240) |
— |
$1,286.50 |
— |
| Sialogram (70390) |
— |
$673 |
— |
| Skull less than 4 views (70250) |
— |
$316.50 |
— |
| Special dosimetry (77331) |
— |
$599 |
— |
| Special Physics Consult (77370) |
— |
$2,725.50 |
— |
| Special teletherapy port plan (77321) |
— |
$4,203 |
— |
| Special treatment procedure (77470) |
— |
$7,702 |
— |
| Speech evaluation, complex (70371) |
— |
$1,385.50 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$2,125 |
— |
| Sternoclavicular joints (71130) |
— |
$401.50 |
— |
| Superior sagittal sinus venogram (75870) |
— |
$3,094 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$3,132.50 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$2,392.50 |
— |
| Testicular Imaging W/Flow (78761) |
— |
$1,556.50 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$6,725.50 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$4,092.50 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$3,581 |
— |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
— |
$847 |
— |
| Thoracic spine 2 views (72070) |
— |
$689.50 |
— |
| Thoracic spine 3 views (72072) |
— |
$1,010.50 |
— |
| Thoracolumbar 2 views (72080) |
— |
$881.50 |
— |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
— |
$2,064 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,513.50 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$3,712 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$1,853 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$3,022.50 |
— |
| Tx Devices Design & Construction Complex (77334) |
— |
$3,447.50 |
— |
| Tx devices design & construction intermediate (77333) |
— |
$1,896 |
— |
| Tx devices design & construction simple (77332) |
— |
$1,556.50 |
— |
| Ultrasound elastography first target lesion (76982) |
— |
$708 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$830.50 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$259.50 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$1,284.50 |
— |
| Unlis px ther radiol clinical tx planning (77299) |
— |
$7,135 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$1,208.50 |
— |
| Unlisted us procedure (76999) |
— |
$760 |
— |
| Upper gi w/o kub (74240) |
— |
$931 |
— |
| Ureteral Reflux Study (78740) |
— |
$1,678 |
— |
| Urethrocystogram voiding (74455) |
— |
$2,470 |
— |
| Urethrocystography retrograde (74450) |
— |
$934 |
— |
| Us chest (76604) |
— |
$791 |
— |
| Us complete joint (76881) |
— |
$1,903 |
— |
| Us exam, pelvic, limited (76857) |
— |
$995 |
— |
| Us kidney transplant (76776) |
— |
$724.50 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$975.50 |
— |
| Us ob detailed single fetus (76811) |
— |
$1,895 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$948 |
— |
| Us ob transvaginal (76817) |
— |
$922 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,715 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$1,088.50 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$1,501 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,138.50 |
— |
| Us retroperitoneal limited (76775) |
— |
$746.50 |
— |
| Us scrotum and contents (76870) |
— |
$1,705.50 |
— |
| Us spinal canal and contents (76800) |
— |
$990.50 |
— |
| Us thyroid (76536) |
— |
$1,893 |
— |
| Us transrectal (76872) |
— |
$1,105 |
— |
| Vein X-Ray Chest (75827) |
— |
$4,334 |
— |
| Venogram Sinus/Jugular (75860) |
— |
$3,409.50 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$3,662 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$923.50 |
— |
| Venography Renal Bilateral (75833) |
— |
$2,964 |
— |
| Venography Renal Unilateral (75831) |
— |
$2,822 |
— |
| Venous sampling by catheter (75893) |
— |
$3,502 |
— |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
— |
$2,097.50 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$811.50 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$663.50 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$903.50 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$5,409.50 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$661 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$1,171.50 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$436 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$466.50 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$545 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$645.50 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$742.50 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$800.50 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$1,286.50 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$699.50 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$1,110.50 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$2,828.50 |
— |
| X-ray IV pyelogram+tomography (74415) |
— |
$2,884 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$262.50 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$549.50 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$791 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$271.50 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$1,120.50 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$582 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$395 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$478.50 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$2,206.50 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$1,083 |
— |
| X-Ray Stress View (77071) |
— |
$364 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$1,039 |
— |
| X-Ray Tmj Unilat (70328) |
— |
$320 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$1,442 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$718 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$1,207.50 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$753.50 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$385 |
— |
| XR Mastoids < 3 Views Bilateral (70120) |
— |
$438.50 |
— |
| Xr orbits complete 4 views (70200) |
— |
$424 |
— |
| Xr Tomogram Single Plane (76100) |
— |
$1,483.50 |
— |