| Abdomen 2 views (74019) |
$18.20 |
$52 |
0.2× |
| Acute gi blood loss imaging (78278) |
$146.65 |
$419 |
0.4× |
| Ankle 2 views (73600) |
$12.95 |
$37 |
0.1× |
| Arthrogram ankle (73615) |
$91.52 |
$261.50 |
0.3× |
| Arthrogram elbow (73085) |
$126.52 |
$361.50 |
0.4× |
| Arthrogram hip (73525) |
$91.88 |
$262.50 |
0.3× |
| Arthrogram knee (73580) |
$91.52 |
$261.50 |
0.3× |
| Arthrogram shoulder (73040) |
$107.98 |
$308.50 |
0.3× |
| Arthrogram wrist (73115) |
$126.35 |
$361 |
0.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$219.80 |
$628 |
0.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$271.25 |
$775 |
0.7× |
| Bone &/joint imaging whole body (78306) |
$260.92 |
$745.50 |
0.6× |
| Bone age studies (77072) |
$49.35 |
$141 |
0.5× |
| Bone Imaging 3 Phase (78315) |
$256.55 |
$733 |
0.6× |
| Bone survey complete (77075) |
$139.48 |
$398.50 |
1.3× |
| Bowel imaging (78290) |
$246.58 |
$704.50 |
0.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$188.12 |
$537.50 |
0.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,312.41 |
$3,749.75 |
0.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$74.90 |
$214 |
0.2× |
| Cervical spine 2 or 3 views (72040) |
$17.50 |
$50 |
0.2× |
| Chest 1 view (71045) |
$14.35 |
$41 |
0.2× |
| Chest xray 3 views (71047) |
$40.95 |
$117 |
0.5× |
| Cholecystography, oral contrast Non-Facility (74290) |
$61.95 |
$177 |
0.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$115.50 |
$330 |
0.6× |
| Clavicle complete (73000) |
$12.95 |
$37 |
0.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$63 |
$180 |
0.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$756.70 |
$2,162 |
2.1× |
| CT abdomen and pelvis without contrast (74176) |
$362.95 |
$1,037 |
1.5× |
| CT abdomen w contrast (74160) |
$421.92 |
$1,205.50 |
2.3× |
| CT abdomen w wo contrast (74170) |
$485.80 |
$1,388 |
2.7× |
| CT abdomen w/o contrast (74150) |
$372.58 |
$1,064.50 |
3.5× |
| CT angio hrt w/3d image (75574) |
$606.20 |
$1,732 |
1.7× |
| CT angio lwr extr w/o&w/dye (73706) |
$495.08 |
$1,414.50 |
2.7× |
| CT angiography upper extremity lt (73206) |
$491.40 |
$1,404 |
2.7× |
| CT c-spine w/contrast (72126) |
$437.68 |
$1,250.50 |
1.2× |
| CT c-spine w/o contrast (72125) |
$392.35 |
$1,121 |
3.6× |
| CT chest w contrast (71260) |
$463.75 |
$1,325 |
2.6× |
| CT chest w/wo contrast (71270) |
$551.25 |
$1,575 |
3.0× |
| CT colonography screening (74263) |
$284.90 |
$814 |
1.2× |
| CT colonography w/dye (74262) |
$348.25 |
$995 |
1.9× |
| CT colonography w/o cntrst (74261) |
$324.98 |
$928.50 |
3.0× |
| CT head/brain with contrast (70460) |
$340.90 |
$974 |
1.9× |
| CT head/brain without and with contrast (70470) |
$399 |
$1,140 |
2.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$122.85 |
$351 |
0.3× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$36.05 |
$103 |
0.4× |
| CT hrt w/3d image congen (75573) |
$163.98 |
$468.50 |
0.5× |
| CT iac w contrast (70481) |
$358.05 |
$1,023 |
2.0× |
| CT limited/localized follow up study (76380) |
$316.40 |
$904 |
3.5× |
| CT lower ext w/o (73700) |
$324.80 |
$928 |
3.0× |
| CT lower extremity w wo contrast (73702) |
$450.28 |
$1,286.50 |
2.5× |
| CT lower extremity w/contrast material (73701) |
$389.55 |
$1,113 |
2.2× |
| CT lumbar spine w/contrast (72132) |
$448.88 |
$1,282.50 |
1.2× |
| CT lumbar spine w/o contrast (72131) |
$390.42 |
$1,115.50 |
3.6× |
| CT maxillofacial w contrast (70487) |
$253.22 |
$723.50 |
1.4× |
| CT maxillofacial w/wo contrast (70488) |
$253.92 |
$725.50 |
1.4× |
| CT maxillofacial wo contrast (70486) |
$260.75 |
$745 |
2.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$437.50 |
$1,250 |
2.4× |
| CT orbits w/o contrast (70480) |
$293.65 |
$839 |
2.7× |
| CT pelvis w/o contrast (72192) |
$328.48 |
$938.50 |
3.0× |
| CT pelvis w/wo contrast (72194) |
$409.15 |
$1,169 |
2.3× |
| CT scan of arm combo (73202) |
$450.45 |
$1,287 |
2.5× |
| CT soft tissue neck w contrast (70491) |
$354.55 |
$1,013 |
2.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$407.22 |
$1,163.50 |
2.2× |
| CT soft tissue neck w/o contrast (70490) |
$307.12 |
$877.50 |
2.8× |
| CT thoracic spine w/contrast (72129) |
$437.68 |
$1,250.50 |
2.4× |
| CT thoracic spine w/o contrast (72128) |
$352.62 |
$1,007.50 |
3.3× |
| CT thorax w/o contrast (71250) |
$348.42 |
$995.50 |
3.2× |
| CT upper ext wo (73200) |
$324.80 |
$928 |
3.0× |
| CT upper extremity with contrast (73201) |
$389.55 |
$1,113 |
1.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$545.30 |
$1,558 |
3.0× |
| Cta Abdomen (74175) |
$518.70 |
$1,482 |
2.9× |
| CTA abdomen pelvis (74174) |
$595 |
$1,700 |
1.7× |
| CTA chest (71275) |
$647.50 |
$1,850 |
3.6× |
| Cta Head (70496) |
$647.50 |
$1,850 |
3.6× |
| Cta Neck (70498) |
$647.50 |
$1,850 |
3.6× |
| Cta Pelvis (72191) |
$407.92 |
$1,165.50 |
2.3× |
| Cystography minimum 3 views rs&i (74430) |
$48.30 |
$138 |
0.1× |
| Diskogram cervical (72285) |
$257.78 |
$736.50 |
0.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$71.05 |
$203 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$99.05 |
$283 |
0.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$44.98 |
$128.50 |
0.5× |
| Dxa bone density study axial skeleton (77085) |
$130.02 |
$371.50 |
1.2× |
| Esophagus (74220) |
$119.18 |
$340.50 |
0.7× |
| Facial bones min 3 views (70150) |
$19.95 |
$57 |
0.2× |
| Fetal biophysical profile non-stress testing (76818) |
$189.52 |
$541.50 |
1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$77.70 |
$222 |
0.7× |
| Fluoroscopy up to 1 hr (76000) |
$103.25 |
$295 |
0.4× |
| Foot 2 views (73620) |
$11.90 |
$34 |
0.1× |
| Forearm 2 views (73090) |
$18.20 |
$52 |
0.2× |
| Hand 2 views (73120) |
$12.60 |
$36 |
0.1× |
| Heart Infarct Image (78466) |
$128.80 |
$368 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$307.82 |
$879.50 |
0.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$289.80 |
$828 |
0.7× |
| Hysterosalpingogram (74740) |
$123.90 |
$354 |
0.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$288.40 |
$824 |
0.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$343.88 |
$982.50 |
0.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$238.70 |
$682 |
0.4× |
| Knee 3 views (73562) |
$18.20 |
$52 |
0.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$268.62 |
$767.50 |
0.7× |
| Lymphoscintigraphy (78195) |
$268.62 |
$767.50 |
0.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$613.20 |
$1,752 |
0.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$589.92 |
$1,685.50 |
1.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$668.32 |
$1,909.50 |
1.9× |
| Mammary ductogram or galactogram multiple (77054) |
$127.05 |
$363 |
0.5× |
| Mammary ductogram or galactogram single (77053) |
$79.62 |
$227.50 |
0.3× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$43.89 |
$125.40 |
0.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$5.95 |
$17 |
0.2× |
| MRA head w & w/o contrast (70546) |
$743.40 |
$2,124 |
2.1× |
| MRA head w/o contrast (70544) |
$577.50 |
$1,650 |
2.3× |
| MRA head with contrast (70545) |
$632.98 |
$1,808.50 |
1.8× |
| MRA neck w contrast (70548) |
$644.18 |
$1,840.50 |
1.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$753.20 |
$2,152 |
2.1× |
| MRA neck w/o contrast (70547) |
$482.65 |
$1,379 |
2.0× |
| MRI abdomen w contrast (74182) |
$661.68 |
$1,890.50 |
1.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$771.05 |
$2,203 |
2.1× |
| MRI abdomen w/o contrast (74181) |
$628.42 |
$1,795.50 |
2.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$648.90 |
$1,854 |
0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$726.95 |
$2,077 |
2.0× |
| MRI breast w/o contrast bilateral (77047) |
$715.22 |
$2,043.50 |
2.9× |
| MRI breast wo contrast unilateral (77046) |
$722.22 |
$2,063.50 |
2.9× |
| MRI c-spine with contrast (72142) |
$631.58 |
$1,804.50 |
1.8× |
| MRI cervical spine w/o contrast (72141) |
$589.75 |
$1,685 |
2.4× |
| MRI chest w/o & w/contrast material (71552) |
$779.28 |
$2,226.50 |
2.2× |
| MRI chest w/o contrast (71550) |
$505.40 |
$1,444 |
2.1× |
| MRI chest with contrast (71551) |
$554.58 |
$1,584.50 |
0.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,058.40 |
$3,024 |
2.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$539.18 |
$1,540.50 |
1.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$481.95 |
$1,377 |
2.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$577.50 |
$1,650 |
2.3× |
| MRI orbit face neck w contrast (70542) |
$577.85 |
$1,651 |
1.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$818.30 |
$2,338 |
2.3× |
| MRI pelvis w/contrast (72196) |
$692.12 |
$1,977.50 |
1.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$771.58 |
$2,204.50 |
2.1× |
| MRI pelvis w/o contrast (72195) |
$604.80 |
$1,728 |
2.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$761.95 |
$2,177 |
2.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$691.25 |
$1,975 |
1.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$856.80 |
$2,448 |
2.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$654.68 |
$1,870.50 |
1.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$747.25 |
$2,135 |
2.1× |
| MRI temporomandibular joint (70336) |
$466.55 |
$1,333 |
1.9× |
| MRI thoracic spine w/o contrast (72146) |
$545.65 |
$1,559 |
2.2× |
| MRI up ext w/o contrast (73218) |
$533.75 |
$1,525 |
2.2× |
| MRI upper ext joint w/o contrast (73221) |
$543.55 |
$1,553 |
2.2× |
| MRI, joint upper extrem combo (73223) |
$727.12 |
$2,077.50 |
2.0× |
| Myelogram Lumbar (72265) |
$167.48 |
$478.50 |
0.2× |
| Myocardial infarct spect (78469) |
$139.30 |
$398 |
0.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,034.95 |
$2,957 |
0.8× |
| Myocardial spect single study at rest or stress (78451) |
$1,045.80 |
$2,988 |
0.8× |
| Neck soft tissue (70360) |
$12.95 |
$37 |
0.1× |
| Nm gastric emptying study (78264) |
$230.30 |
$658 |
0.6× |
| Nm kidney scan w/flow (78701) |
$175 |
$500 |
0.4× |
| Noncardiac Vascular Flow Imaging (78445) |
$60.90 |
$174 |
0.1× |
| Nonvascular shunt X-ray (75809) |
$231.35 |
$661 |
2.1× |
| Ob us nuchal meas 1 gest (76813) |
$203.70 |
$582 |
1.9× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) |
$64.75 |
$185 |
0.6× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$14.28 |
$40.80 |
0.5× |
| Orthopantogram (70355) |
$36.40 |
$104 |
0.4× |
| Osseous survey limited (77074) |
$67.90 |
$194 |
0.6× |
| Parathyroid Planar Imaging (78070) |
$218.58 |
$624.50 |
0.5× |
| Pelvis 1 or 2 views (72170) |
$17.50 |
$50 |
0.2× |
| PET image w/CT, skull-thigh (78815) |
$1,366.05 |
$3,903 |
0.9× |
| PET imaging CT for attenuation limited area (78814) |
$1,305.06 |
$3,728.75 |
0.9× |
| PET imaging for CT attenuation whole body (78816) |
$1,367.28 |
$3,906.50 |
0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$109.72 |
$313.50 |
0.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$431.20 |
$1,232 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$56.52 |
$161.50 |
0.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$18.20 |
$52 |
0.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$12.60 |
$36 |
0.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$14 |
$40 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$56.70 |
$162 |
0.5× |
| Radex fingr minimum 2 views (73140) |
$18.20 |
$52 |
0.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$18.20 |
$52 |
0.2× |
| Radex Hand Minimum 3 Views (73130) |
$18.20 |
$52 |
0.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$41.82 |
$119.50 |
0.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$16.80 |
$48 |
0.2× |
| Radex Humerus Minimum 2 Views (73060) |
$18.20 |
$52 |
0.2× |
| Radex Kne 1/2 Views (73560) |
$12.95 |
$37 |
0.1× |
| Radex Kne Compl 4/More Views (73564) |
$23.80 |
$68 |
0.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$67.72 |
$193.50 |
0.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$13.30 |
$38 |
0.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$17.15 |
$49 |
0.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$21.70 |
$62 |
0.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$14 |
$40 |
0.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$16.80 |
$48 |
0.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$18.55 |
$53 |
0.2× |
| Radex Toe Minimum 2 Views (73660) |
$10.50 |
$30 |
0.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$12.25 |
$35 |
0.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$18.20 |
$52 |
0.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$14.35 |
$41 |
0.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$42.88 |
$122.50 |
0.4× |
| Radiologic exam chest 2 views (71046) |
$17.15 |
$49 |
0.2× |
| Radiologic exam colon single contrast study (74270) |
$123.02 |
$351.50 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$118.30 |
$338 |
0.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$100.62 |
$287.50 |
0.6× |
| Radiologic examination femur 1 view (73551) |
$45.85 |
$131 |
0.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$12.95 |
$37 |
0.1× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$63.70 |
$182 |
0.6× |
| Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) |
$28.88 |
$82.50 |
0.1× |
| Radiological examination surgical specimen (76098) |
$38.32 |
$109.50 |
0.1× |
| Ribs bilateral 3 views (71110) |
$59.15 |
$169 |
0.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$424.02 |
$1,211.50 |
0.8× |
| Sacroiliac Joints < 3 Views (72200) |
$46.02 |
$131.50 |
0.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$124.95 |
$357 |
0.5× |
| Scapula (73010) |
$14.35 |
$41 |
0.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$14.88 |
$42.50 |
0.6× |
| Sella turcica (70240) |
$31.32 |
$89.50 |
0.3× |
| Shoulder 1 view (73020) |
$12.60 |
$36 |
0.1× |
| Small bowel series (74250) |
$98.52 |
$281.50 |
0.5× |
| Spine thoracic 3 views (72072) |
$17.15 |
$49 |
0.2× |
| Testicular Imaging With Vascular Flow (78761) |
$167.30 |
$478 |
0.4× |
| Thoracolumbar 2 views (72080) |
$16.80 |
$48 |
0.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$344.92 |
$985.50 |
0.6× |
| Thyroid imaging w/blood flow (78013) |
$106.58 |
$304.50 |
0.3× |
| Thyroid uptake measurement (78012) |
$130.38 |
$372.50 |
0.3× |
| Tomogram (76100) |
$41.12 |
$117.50 |
0.4× |
| Ultrasound Exam Aaa Screen (76706) |
$138.78 |
$396.50 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$63.52 |
$181.50 |
0.6× |
| Umbilical-artery Doppler (OB) (76820) |
$81.72 |
$233.50 |
0.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$466.90 |
$1,334 |
5.2× |
| Unlisted ultrasound procedure (76999) |
$143.85 |
$411 |
1.6× |
| Ureteral reflux study (78740) |
$198.10 |
$566 |
0.5× |
| Urethrocystogram voiding (74455) |
$91.18 |
$260.50 |
0.4× |
| Urethrocystography retrograde rs&i (74450) |
$78.05 |
$223 |
0.3× |
| Us breast unilateral limited (76642) |
$51.10 |
$146 |
0.6× |
| Us chest (76604) |
$126.70 |
$362 |
1.2× |
| Us compl joint r-t w/image documentation (76881) |
$145.95 |
$417 |
1.4× |
| Us infant hips w manipulation (76885) |
$133.52 |
$381.50 |
1.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$112.70 |
$322 |
1.0× |
| Us ob detailed single fetus (76811) |
$280.70 |
$802 |
1.1× |
| Us ob limited (76815) |
$168 |
$480 |
1.6× |
| Us ob transvaginal (76817) |
$219.80 |
$628 |
2.0× |
| Us pelvic non ob complete (76856) |
$125.82 |
$359.50 |
1.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$37.45 |
$107 |
0.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$131.60 |
$376 |
1.2× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$218.40 |
$624 |
2.0× |
| Us retroperitoneal complete (76770) |
$171.15 |
$489 |
1.6× |
| Us retroperitoneal limited (76775) |
$127.92 |
$365.50 |
1.2× |
| Us scrotum and contents (76870) |
$126.88 |
$362.50 |
1.2× |
| Us soft tissue head/neck (76536) |
$128.10 |
$366 |
1.2× |
| Us spinal canal and contents (76800) |
$142.10 |
$406 |
1.3× |
| Us, eye b-scan (76512) |
$63 |
$180 |
0.6× |
| Venogram extremity bilateral (75822) |
$213.85 |
$611 |
0.1× |
| Venogram Extremity Unilateral (75820) |
$177.98 |
$508.50 |
0.1× |
| Venography caval superior serialography rs&i (75827) |
$304.50 |
$870 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$37.80 |
$108 |
0.4× |
| Wrist 2 views (73100) |
$18.20 |
$52 |
0.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$25.20 |
$72 |
0.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$15.75 |
$45 |
0.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$159.60 |
$456 |
0.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$12.60 |
$36 |
0.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$23.80 |
$68 |
0.3× |
| X-ray exam of femur 2/> (73552) |
$15.05 |
$43 |
0.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$17.32 |
$49.50 |
0.2× |
| X-ray IV pyelogram (ivp) (74400) |
$130.38 |
$372.50 |
0.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$13.65 |
$39 |
0.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$14 |
$40 |
0.2× |
| X-ray leg, infant (73592) |
$16.80 |
$48 |
0.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$113.75 |
$325 |
1.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$39.20 |
$112 |
0.4× |
| X-ray nose-rectum child f.b. (76010) |
$14.35 |
$41 |
0.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$54.42 |
$155.50 |
0.5× |
| X-ray retrograde pyelogram (74420) |
$114.62 |
$327.50 |
0.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$44.80 |
$128 |
0.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$21.35 |
$61 |
0.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$25.90 |
$74 |
0.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$14.35 |
$41 |
0.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$14 |
$40 |
0.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$19.60 |
$56 |
0.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$26.25 |
$75 |
0.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$19.60 |
$56 |
0.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$16.45 |
$47 |
0.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$34.48 |
$98.50 |
0.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$15.40 |
$44 |
0.2× |
| Xr bone length studies (77073) |
$33.25 |
$95 |
0.3× |
| Xr c-spine 4 or 5 views (72050) |
$24.85 |
$71 |
0.2× |
| Xr c-spine 6 or more views (72052) |
$27.30 |
$78 |
0.3× |
| Xr chest 4+ views (71048) |
$25.20 |
$72 |
0.2× |
| Xr urogram antegrade (74425) |
$118.30 |
$338 |
0.3× |