Imaging prices at Winchester Hospital

Winchester, MA · every code in this section with a posted price and a Medicare benchmark.

379 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) $6,842 $6,842 4.1×
Abdomen 2 views (74019) $507 $507 4.0×
Acute gi blood loss imaging (78278) $764 $764 1.6×
Angiography extremity bilateral rs&i (75716) $6,560 $6,560 1.7×
Angiography extremity unilateral rs&i (75710) $8,581 $8,581 2.3×
Angiography pelvic slctv/supraslctv rs&i (75736) $9,903 $9,903 1.5×
Angiography pulmonary bilateral slctv rs&i (75743) $6,560 $6,560 1.7×
Angiography pulmonary unilateral slctv rs&i (75741) $6,560 $6,560 1.7×
Angiography Spinal Selective Rs&I (75705) $11,467 $11,467 1.7×
Angiography visceral slctv/supraslctv rs&i (75726) $10,362 $10,362 1.6×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $2,536 $2,536 0.7×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $2,809 $2,809 0.7×
Ankle 2 views (73600) $325 $325 3.1×
Aortogram thoracic (75605) $9,903 $9,903 1.5×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $8,581 $8,581 2.3×
Aortography abdominal serialography rs&i (75625) $6,560 $6,560 1.7×
Arthrogram ankle (73615) $1,478 $1,478 3.5×
Arthrogram elbow (73085) $1,341 $1,341 3.2×
Arthrogram hip (73525) $1,323 $1,323 3.2×
Arthrogram knee (73580) $1,284 $1,284 3.1×
Arthrogram shoulder (73040) $1,311 $1,311 3.1×
Arthrogram wrist (73115) $1,445 $1,445 3.5×
Basic dosimetry (77300) $684 $684 4.2×
Bone &/Joint Imaging Limited Area (78300) $748 $748 1.6×
Bone &/joint imaging whole body (78306) $906 $906 1.9×
Bone age studies (77072) $261 $261 2.1×
Bone Imaging 3 Phase (78315) $982 $982 2.0×
Bone survey complete (77075) $600 $600 4.8×
Bone survey infant (77076) $363 $363 2.9×
Bowel imaging (78290) $748 $748 1.6×
Brachytx isodose complex (77318) $1,955 $1,955 4.4×
Brachytx isodose intermed (77317) $1,955 $1,955 4.4×
Brachytx isodose pln smpl w/dosimetry cal (77316) $1,629 $1,629 3.6×
Brain Imaging Pet Metabolic Evaluation (78608) $3,863 $3,863 2.3×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $1,408 $1,408 2.9×
Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) $976 $976 2.0×
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) $2,672 $2,672 2.8×
Cardiac shunt detection (78428) $976 $976 2.0×
Cephalogram, orthodontic Non-Facility (70350) $209 $209 2.0×
Cervical spine 2 or 3 views (72040) $384 $384 3.7×
Chest 1 view (71045) $269 $269 2.6×
Chest xray 3 views (71047) $254 $254 2.4×
Cholecystography, oral contrast Non-Facility (74290) $355 $355 1.7×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $599 $599 2.8×
Clavicle complete (73000) $302 $302 2.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $997 $997 8.0×
Continuing medical physics consltj pr wk (77336) $684 $684 4.2×
Contrast Xray Throat/Cerv Esopha (74210) $431 $431 2.1×
CT abdomen and pelvis without and with contrast (74178) $2,458 $2,458 5.9×
CT abdomen and pelvis without contrast (74176) $2,458 $2,458 8.6×
CT abdomen w contrast (74160) $2,458 $2,458 11.7×
CT abdomen w wo contrast (74170) $2,458 $2,458 11.7×
CT abdomen w/o contrast (74150) $2,458 $2,458 19.6×
CT angio hrt w/3d image (75574) $1,108 $1,108 2.7×
CT angio lwr extr w/o&w/dye (73706) $2,458 $2,458 11.7×
CT angiography upper extremity lt (73206) $2,458 $2,458 11.7×
CT c-spine w/contrast (72126) $1,533 $1,533 3.7×
CT c-spine w/o contrast (72125) $1,533 $1,533 12.2×
CT cervical spine w&w/o contrast (72127) $1,533 $1,533 7.3×
CT chest w contrast (71260) $1,804 $1,804 8.6×
CT chest w/wo contrast (71270) $2,778 $2,778 13.2×
CT colonography screening (74263) $2,174 $2,174 7.6×
CT colonography w/o cntrst (74261) $2,458 $2,458 19.6×
CT head/brain with contrast (70460) $1,000 $1,000 4.8×
CT head/brain without and with contrast (70470) $1,204 $1,204 5.7×
CT heart contrast eval cardiac structure&morph (75572) $1,108 $1,108 2.7×
CT heart w/o contrast quant eval coronary calcium (75571) $277.50 $277.50 2.7×
CT iac w contrast (70481) $870 $870 4.1×
CT limited/localized follow up study (76380) $789 $789 7.6×
CT lower ext w/o (73700) $2,458 $2,458 19.6×
CT lower extremity w wo contrast (73702) $2,458 $2,458 11.7×
CT lower extremity w/contrast material (73701) $2,458 $2,458 11.7×
CT lumbar spine w & w/o contrast (72133) $2,458 $2,458 11.7×
CT lumbar spine w/contrast (72132) $2,769 $2,769 6.6×
CT lumbar spine w/o contrast (72131) $2,458 $2,458 19.6×
CT maxillofacial w contrast (70487) $1,533 $1,533 7.3×
CT maxillofacial w/wo contrast (70488) $1,002 $1,002 4.8×
CT maxillofacial wo contrast (70486) $1,533 $1,533 12.2×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,144 $1,144 5.4×
CT orbits w/o contrast (70480) $1,309 $1,309 10.4×
CT pelvis w/o contrast (72192) $2,458 $2,458 19.6×
CT pelvis w/wo contrast (72194) $2,458 $2,458 11.7×
CT scan of arm combo (73202) $2,458 $2,458 11.7×
CT soft tissue neck w contrast (70491) $1,474 $1,474 7.0×
CT soft tissue neck w/o & w/contrast material (70492) $1,533 $1,533 7.3×
CT soft tissue neck w/o contrast (70490) $1,238 $1,238 9.9×
CT thoracic spine w/contrast (72129) $2,458 $2,458 11.7×
CT thoracic spine w/o contrast (72128) $2,458 $2,458 19.6×
CT thoracic spine w/wo contrast (72130) $2,458 $2,458 11.7×
CT thorax w/o contrast (71250) $1,517 $1,517 12.1×
CT upper ext wo (73200) $2,458 $2,458 19.6×
CT upper extremity with contrast (73201) $2,458 $2,458 5.9×
Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) $1,499 $1,499 7.1×
Cta Abdomen (74175) $2,458 $2,458 11.7×
CTA abdomen pelvis (74174) $2,458 $2,458 5.9×
CTA chest (71275) $2,458 $2,458 11.7×
Cta Head (70496) $934 $934 4.4×
Cta Neck (70498) $1,082 $1,082 5.1×
Cta Pelvis (72191) $2,458 $2,458 11.7×
Cystography minimum 3 views rs&i (74430) $805 $805 1.9×
Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) $5,823 $5,823 2.3×
Diskogram cervical (72285) $6,985 $6,985 3.0×
Diskography lumbar (72295) $6,985 $6,985 3.0×
Doppler Fetal Mid Cerebral Artery (76821) $613 $613 4.9×
Dxa bone density study 1/> sites axial skel (77080) $537 $537 4.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $368 $368 3.5×
Dxa bone density study axial skeleton (77085) $388 $388 3.1×
Esophagus (74220) $431 $431 2.1×
Facial bones min 3 views (70150) $446 $446 3.6×
Fetal biophysical profile non-stress testing (76818) $416 $416 3.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $609 $609 4.9×
Fluoroscopy up to 1 hr (76000) $494 $494 1.7×
Foot 2 views (73620) $368 $368 3.5×
Forearm 2 views (73090) $463 $463 4.4×
Hand 2 views (73120) $325 $325 2.6×
Heart first pass single,planar (78481) $1,056 $1,056 1.6×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $6,560 $6,560 1.7×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $6,560 $6,560 1.7×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,256 $1,256 1.9×
Hepatobiliary syst imaging including gallbladder (78226) $1,626 $1,626 3.4×
Hysterosalpingogram (74740) $1,468 $1,468 5.1×
Image fusion (77399) $684 $684 4.2×
Interstitial radiation source applic complex (77778) $6,171 $6,171 7.4×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $278 $278 2.2×
Kidney imaging morphology (78700) $976 $976 2.0×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $1,423 $1,423 2.2×
Kidney img morphology vascular flow 1 w/rx (78708) $962 $962 1.5×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,256 $1,256 1.9×
Knee 3 views (73562) $483 $483 4.6×
Liver & spleen imaging static only (78215) $860 $860 1.8×
Liver & Spleen Imaging W/Vascular Flow (78216) $976 $976 2.0×
Lung perf&ventilat diferentl (78598) $1,377 $1,377 2.1×
Lung perfusion differential (78597) $976 $976 2.0×
Lung ventilation imaging (78579) $976 $976 2.0×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $3,846 $3,846 1.0×
Lymphoscintigraphy (78195) $1,039 $1,039 1.6×
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) $1,058 $1,058 1.1×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) $1,058 $1,058 2.5×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $1,058 $1,058 2.5×
Magnetic Resonance Elastography (76391) $21,332 $21,332 74.6×
Mammary ductogram or galactogram single (77053) $1,118 $1,118 3.9×
Mlc imrt design & construction per imrt plan (77338) $1,955 $1,955 4.4×
Mr safety determination physician/other qhp (76016) $273 $273 2.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $76 $76 2.2×
Mr safety implt electronics prepj supvj phys/qhp (76018) $348 $348 3.1×
Mr safety implt pos&/immoblj (76019) $184 $184 2.6×
Mr safety med physics xm customization plng&mntr (76017) $750 $750 2.6×
MRA head w & w/o contrast (70546) $2,645 $2,645 6.3×
MRA head w/o contrast (70544) $2,645 $2,645 9.2×
MRA head with contrast (70545) $2,645 $2,645 6.3×
MRA neck w contrast (70548) $2,645 $2,645 6.3×
Mra Neck W/O &W/Contrast Material (70549) $2,645 $2,645 6.3×
MRA neck w/o contrast (70547) $2,645 $2,645 9.2×
MRI abdomen w contrast (74182) $1,058 $1,058 2.5×
MRI abdomen w/o & w/contrast material (74183) $3,830 $3,830 9.2×
MRI abdomen w/o contrast (74181) $1,058 $1,058 3.7×
MRI any jt lower extrem w/contrast material (73722) $1,058 $1,058 1.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,058 $1,058 2.5×
MRI bone marrow blood supply (77084) $1,058 $1,058 3.7×
MRI breast w/o contrast bilateral (77047) $6,946 $6,946 24.3×
MRI breast wo contrast unilateral (77046) $6,314 $6,314 22.1×
MRI c-spine with contrast (72142) $2,645 $2,645 6.3×
MRI cardiac w/o contrast (75557) $1,058 $1,058 3.7×
MRI cervical spine w/o contrast (72141) $2,645 $2,645 9.2×
MRI chest w/o & w/contrast material (71552) $1,058 $1,058 2.5×
MRI chest w/o contrast (71550) $1,058 $1,058 3.7×
MRI chest with contrast (71551) $1,058 $1,058 1.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,058 $1,058 2.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,058 $1,058 2.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,058 $1,058 3.7×
MRI orbit face &/neck w/o contrast (70540) $2,645 $2,645 9.2×
MRI orbit face neck w contrast (70542) $2,645 $2,645 6.3×
MRI orbit/face/neck w&w/o cont (70543) $2,645 $2,645 6.3×
MRI pelvis w/contrast (72196) $1,058 $1,058 2.5×
MRI pelvis w/o & w/contrast material (72197) $1,058 $1,058 2.5×
MRI pelvis w/o contrast (72195) $1,058 $1,058 3.7×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,645 $2,645 6.3×
MRI spinal canal lumbar w/contrast material (72149) $1,058 $1,058 2.5×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,058 $1,058 2.5×
MRI spinal canal thoracic w/contrast matrl (72147) $1,058 $1,058 2.5×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,058 $1,058 2.5×
MRI temporomandibular joint (70336) $1,058 $1,058 3.7×
MRI thoracic spine w/o contrast (72146) $1,058 $1,058 3.7×
MRI up ext w/o contrast (73218) $1,058 $1,058 3.7×
MRI upper ext joint w/o contrast (73221) $1,058 $1,058 3.7×
MRI, joint upper extrem combo (73223) $1,058 $1,058 2.5×
Myelogram Cervical (72240) $1,376 $1,376 1.5×
Myelogram Lumbar (72265) $2,231 $2,231 2.4×
Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) $4,393 $4,393 2.6×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $3,172 $3,172 2.0×
Myocardial Perfusion Planar Multiple Studies (78454) $3,172 $3,172 2.0×
Myocardial Spect Multiple Studies (78452) $3,323 $3,323 2.1×
Myocardial spect single study at rest or stress (78451) $3,172 $3,172 2.0×
N-invas est c ffr sw aly CTA (75580) $3,625 $3,625 3.5×
Neck soft tissue (70360) $474 $474 4.5×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $1,408 $1,408 2.9×
Nm cardiac blood pool multiple (78473) $976 $976 2.0×
Nm cisternogram (78630) $1,229 $1,229 1.9×
Nm gastric emptying study (78264) $1,139 $1,139 2.4×
Noncardiac Vascular Flow Imaging (78445) $735 $735 1.5×
Ntsty modul radthx pln dose-vol histos (77301) $6,842 $6,842 4.1×
Nuclear Rx Oral Admin (79005) $1,452 $1,452 5.2×
Ob us nuchal meas 1 gest (76813) $882 $882 7.0×
Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) $105 $105 3.0×
Osseous survey limited (77074) $363 $363 2.9×
Parathyrd planar w/spect&CT (78072) $1,472 $1,472 2.3×
Parathyroid Planar Imaging (78070) $976 $976 2.0×
Parathyroid planar imaging w/wo subtraction (78071) $1,699 $1,699 3.5×
Pelvis 1 or 2 views (72170) $298 $298 2.4×
PET image w/CT, skull-thigh (78815) $8,657 $8,657 5.1×
PET imaging CT for attenuation limited area (78814) $6,620 $6,620 3.9×
PET imaging for CT attenuation whole body (78816) $11,076 $11,076 6.5×
Pet Imaging Limited Area Chest Head/Neck (78811) $3,602 $3,602 2.3×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $10,735 $10,735 2.8×
Pulmonary Perfusion Imaging Particulate (78580) $707 $707 1.5×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,476 $1,476 2.3×
Radex abscess/fistula/sinus tract rs&i (76080) $958 $958 1.5×
Radex Ankle Compl Minimum 3 Views (73610) $398 $398 3.8×
Radex Calcaneus Minimum 2 Views (73650) $441 $441 4.2×
Radex Elbw Compl Minimum 3 Views (73080) $440 $440 4.2×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $245 $245 2.3×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $245 $245 2.0×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) $610 $610 4.9×
Radex fingr minimum 2 views (73140) $424 $424 4.1×
Radex Foot Compl Minimum 3 Views (73630) $436 $436 4.2×
Radex Hand Minimum 3 Views (73130) $422 $422 4.0×
Radex Hip Unilateral With Pelvis 1 View (73501) $296 $296 2.8×
Radex Hips Bilateral With Pelvis 2 Views (73521) $369 $369 2.9×
Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) $369 $369 2.9×
Radex Humerus Minimum 2 Views (73060) $302 $302 2.9×
Radex Kne 1/2 Views (73560) $404 $404 3.9×
Radex Kne Compl 4/More Views (73564) $483 $483 3.9×
Radex Mndbl Compl Minimum 4 Views (70110) $479 $479 3.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $430 $430 4.1×
Radex Pelvis Compl Minimum 3 Views (72190) $363 $363 2.9×
Radex Sho Compl Minimum 2 Views (73030) $416 $416 4.0×
Radex Sinuses Paransl < 3 Views (70210) $345 $345 3.3×
Radex Spine Lumbosacral Only Bending 2/3 Views (72120) $360 $360 2.9×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $374 $374 3.6×
Radex Toe Minimum 2 Views (73660) $348 $348 3.3×
Radex upper extremity infant minimum 2 views (73092) $319 $319 2.5×
Radex Wrst Compl Minimum 3 Views (73110) $422 $422 4.0×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $406 $406 3.2×
Radiation treatment delivery level 1 (77402) $564 $564 4.6×
Radiation treatment delivery level 2 (77407) $937 $937 2.0×
Radiation treatment delivery level 3 (77412) $940 $940 1.4×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $351 $351 3.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $355 $355 2.8×
Radiologic exam chest 2 views (71046) $261 $261 2.5×
Radiologic exam colon single contrast study (74270) $775 $775 3.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $653 $653 3.1×
Radiologic exam upr gi trc double contrast study (74246) $611 $611 2.9×
Radiologic exam upr gi trc single contrast study (74240) $431 $431 2.1×
Radiologic examination femur 1 view (73551) $468 $468 4.5×
Radiologic Examination Salivary Gland Calculus (70380) $361 $361 3.5×
Radiologic examination tibia & fibula 2 views (73590) $383 $383 3.7×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $272 $272 0.4×
Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) $363 $363 2.9×
Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) $296 $296 2.4×
Radiological examination surgical specimen (76098) $2,166 $2,166 3.3×
Ribs bilateral 3 views (71110) $567 $567 4.5×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,171 $3,171 4.9×
Rp loclzj tum plnr whole body single day imaging (78802) $2,231 $2,231 3.4×
Rp loclzj tum spect 1 area single day imaging (78803) $2,231 $2,231 3.4×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $3,619 $3,619 2.3×
Sacroiliac Joints < 3 Views (72200) $280 $280 2.2×
Saline Infus Sonohysterography W/Color Doppler (76831) $1,006 $1,006 3.5×
Salivary gland imaging; with serial images Non-Facility (78231) $748 $748 1.6×
Scapula (73010) $298 $298 2.4×
Screening Digital Breast Tomosynthesis Bi (77063) $202 $202 8.6×
Sella turcica (70240) $301 $301 2.9×
Shoulder 1 view (73020) $416 $416 4.0×
Sialogram (70390) $958 $958 3.4×
Simulation intermediate (77285) $1,955 $1,955 4.4×
Small bowel series (74250) $638 $638 3.0×
Spec telethx port pln parts hemibdy tot bdy (77321) $1,955 $1,955 4.4×
Special dosimetry (77331) $684 $684 4.2×
Special Physics Consult (77370) $684 $684 4.2×
Special treatment procedure (77470) $2,932 $2,932 4.4×
Spine thoracic 3 views (72072) $398 $398 3.2×
Stereotactic Body Radiation Delivery (77373) $8,960 $8,960 4.2×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,792 $1,792 4.0×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,792 $1,792 4.0×
Testicular Imaging With Vascular Flow (78761) $962 $962 2.0×
Ther rad simulaj-aided field setting complex (77290) $1,955 $1,955 4.4×
Ther rad simulaj-aided field setting simple (77280) $827 $827 5.1×
Thoracolumbar 2 views (72080) $309 $309 3.0×
Thyroid imaging w/blood flow (78013) $700 $700 1.5×
Thyroid uptake measurement (78012) $670 $670 1.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,030 $1,030 2.1×
Tomogram (76100) $453 $453 3.6×
Treatment device complex (77334) $1,955 $1,955 4.4×
Treatment device intermediate (77333) $684 $684 4.2×
Treatment devices simple (77332) $684 $684 4.2×
Ultrasound breast complete (76641) $413 $413 3.3×
Ultrasound elastography first target lesion (76982) $414 $414 3.3×
Ultrasound Exam Aaa Screen (76706) $456 $456 3.6×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $745 $745 1.8×
Ultrasound, abdomen limited (76705) $609 $609 4.9×
Umbilical-artery Doppler (OB) (76820) $613 $613 4.9×
Unlisted Diagnostic Radiographic Procedure (76499) $934 $934 9.0×
Unlisted fluoroscopic procedure (76496) $188 $188 1.8×
Unlisted magnetic resonance procedure (76498) $313 $313 3.0×
Unlisted ultrasound procedure (76999) $306 $306 2.9×
Ureteral reflux study (78740) $962 $962 2.0×
Urethrocystogram voiding (74455) $775 $775 2.7×
Urethrocystography retrograde rs&i (74450) $865 $865 3.0×
Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) $775 $775 3.7×
Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) $796 $796 3.8×
Us breast unilateral limited (76642) $319 $319 3.1×
Us chest (76604) $363 $363 2.9×
Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) $899 $899 3.5×
Us compl joint r-t w/image documentation (76881) $625 $625 5.0×
Us elastography parenchyma (76981) $414 $414 3.3×
Us encephalogram (76506) $646 $646 5.2×
Us hips infant static (76886) $2,709 $2,709 26.0×
Us infant hips w manipulation (76885) $314 $314 3.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $456 $456 3.6×
Us ob detailed single fetus (76811) $900 $900 3.1×
Us ob limited (76815) $635 $635 5.1×
Us ob transvaginal (76817) $759 $759 6.1×
Us pelvic non ob complete (76856) $985 $985 7.9×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $1,005 $1,005 8.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $951 $951 7.6×
Us pg uter r-t img f-up tabdl appr pr fetus (76816) $456 $456 3.6×
Us retroperitoneal complete (76770) $693 $693 5.5×
Us retroperitoneal limited (76775) $408 $408 3.3×
Us scrotum and contents (76870) $911 $911 7.3×
Us soft tissue head/neck (76536) $759 $759 6.1×
Us spinal canal and contents (76800) $681 $681 5.4×
Us transrectal (76872) $388 $388 3.1×
Us transrectal prostate volume (76873) $388 $388 3.1×
Us, eye b-scan (76512) $388 $388 3.1×
Venogram extremity bilateral (75822) $2,302 $2,302 1.2×
Venogram Extremity Unilateral (75820) $1,902 $1,902 1.0×
Venography caval inferior serialography rs&i (75825) $6,560 $6,560 1.7×
Venography caval superior serialography rs&i (75827) $2,470 $2,470 1.3×
Venography Renal Bilateral (75833) $7,782 $7,782 2.1×
Venography renal unilateral selective rs&i (75831) $6,899 $6,899 1.8×
Venous sampling by catheter (75893) $9,903 $9,903 1.5×
Vertebral fracture assessment via dxa (77086) $303 $303 2.9×
Wrist 2 views (73100) $410 $410 3.9×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $409 $409 3.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $352 $352 3.4×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,658 $1,658 7.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $198 $198 1.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $296 $296 2.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $369 $369 2.9×
X-ray exam of femur 2/> (73552) $468 $468 4.5×
X-ray eye for foreign body (70030) $626 $626 6.0×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $198 $198 1.9×
X-ray IV pyelogram (ivp) (74400) $775 $775 3.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $469 $469 4.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $360 $360 3.5×
X-ray leg, infant (73592) $305 $305 2.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $369 $369 2.9×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $381 $381 3.0×
X-ray nose-rectum child f.b. (76010) $305 $305 2.9×
X-ray optic foramen (70190) $211 $211 2.0×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $347 $347 2.8×
X-ray retrograde pyelogram (74420) $1,507 $1,507 3.6×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $504 $504 4.8×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $466 $466 3.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $341 $341 2.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $298 $298 2.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $437 $437 4.2×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $455 $455 4.4×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $558 $558 4.5×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $474 $474 3.8×
X-Ray Spine One View - Xr Spine (72020) $291 $291 2.8×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $269 $269 2.6×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $452 $452 4.3×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $446 $446 3.6×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $355 $355 2.8×
Xr bone length studies (77073) $446 $446 3.6×
Xr c-spine 4 or 5 views (72050) $530 $530 4.2×
Xr c-spine 6 or more views (72052) $378 $378 3.0×
Xr chest 4+ views (71048) $410 $410 3.3×
Xr urogram antegrade (74425) $1,193 $1,193 2.9×