Elliot Health System is a non-profit organization serving your healthcare needs since 1890.

Radiology Price Lists

Access to csv file
https://www.elliothospital.org/website/ehs-2020-price-lists/Radiology.csv


ABCD
1
CategoryCharge CodeDescription1/1/2020
Unit Charge
2
RADIOLOGY361000200THC SACROPLASTY UNILATERAL $ 6,540.00
3
RADIOLOGY361000201THC SACROPLASTY BILATERAL $ 7,586.00
4
RADIOLOGY3200070030HC XR EYE FOREIGN BODY UNILAT $ 275.00
5
RADIOLOGY3200070100HC XR MANDIBLE 1-3 VIEWS $ 323.00
6
RADIOLOGY3200070110HC XR MANDIBLE 4+ VIEWS $ 362.00
7
RADIOLOGY3200070140HC FACIAL BONES 1-2VIEWS $ 403.00
8
RADIOLOGY3200070150HC XR FACIAL BONES 3+ VIEWS $ 567.00
9
RADIOLOGY3200070160HC NASAL BONES 3+ VIEWS $ 462.00
10
RADIOLOGY3200070200HC XR ORBITS 1-3 VIEWS $ 408.00
11
RADIOLOGY3200070210HC FACIAL/SINUSES 1-2 VIEWS $ 284.00
12
RADIOLOGY3200070220HC XR FACIAL/SINUSES 3+ VIEWS $ 548.00
13
RADIOLOGY3200070250HC SKULL 1-3 VIEWS $ 401.00
14
RADIOLOGY3200070260HC XR SKULL 4+ VIEWS $ 738.00
15
RADIOLOGY3200070328TMJ OPEN/CLOSED UNI $ 304.00
16
RADIOLOGY3200070330HC XR TMJ OPEN/CLOSED BILAT $ 584.00
17
RADIOLOGY6100070336HC MR TM JOINT(S) $ 3,750.00
18
RADIOLOGY3200070355HC PANOREX $ 210.00
19
RADIOLOGY3200070360HC NECK SOFT TISSUE $ 406.00
20
RADIOLOGY3510070450HC CT HEAD WO CONTRAST $ 1,570.00
21
RADIOLOGY3510070460HC CT HEAD WITH CONTRAST $ 1,864.00
22
RADIOLOGY3510070470HC CT HEAD WO&W CONTRAST $ 2,453.00
23
RADIOLOGY3510070480HC CT ORBIT/SELLA/POST FOSSA/IAC WO CONTRAST $ 1,668.00
24
RADIOLOGY3510070481CLAVICLE $ 1,962.00
25
RADIOLOGY3510070482HC SELLA W/O & W/CONTRAST $ 2,507.00
26
RADIOLOGY3510070486HC CT MAXILLOFACIAL WO CONTRAST $ 1,516.00
27
RADIOLOGY3510070487HC CT MAXILLOFACIAL WITH CONTRAST $ 1,819.00
28
RADIOLOGY3510070488HC MAXILLOFACIAL W/O & W/CONTRAST $ 2,725.00
29
RADIOLOGY3500070490HC CT NECK WO CONTRAST $ 1,516.00
30
RADIOLOGY3500070491HC CT NECK WITH CONTRAST $ 2,021.00
31
RADIOLOGY3500070492HC CT NECK WO&W CONTRAST $ 2,453.00
32
RADIOLOGY3510070496HC CTA HEAD WITH CONTRAST $ 1,962.00
33
RADIOLOGY3500070498HC CTA NECK WITH CONTRAST $ 1,962.00
34
RADIOLOGY6100070540HC MR ORBIT/FACE/NECK WO CONTRAST $ 3,470.00
35
RADIOLOGY6100070542HC MR ORBIT/FACE/NECK WITH CONTRAST $ 4,082.00
36
RADIOLOGY6100070543HC MR ORBIT/FACE/NECK WO&W CONTRAST $ 4,694.00
37
RADIOLOGY6150070544HC MRA HEAD WO CONTRAST $ 3,001.00
38
RADIOLOGY6150070546HC MRA HEAD WO&W CONTRAST $ 4,060.00
39
RADIOLOGY6150070547HC MRA NECK WO CONTRAST $ 2,974.00
40
RADIOLOGY6150070549HC MRA NECK WO&W CONTRAST $ 4,024.00
41
RADIOLOGY6110070551HC MR BRAIN WO CONTRAST $ 3,784.00
42
RADIOLOGY6110070552HC MR BRAIN WITH CONTRAST $ 4,452.00
43
RADIOLOGY6110070553HC MR BRAIN WO&W CONTRAST $ 5,120.00
44
RADIOLOGY7100000003HC CATEGORY B PACU PER MIN $ 21.00
45
RADIOLOGY7100000004HC CATEGORY C PACU PER MIN $ 28.00
46
RADIOLOGY7100000005HC CATEGORY D PACU PER MIN $ 37.00
47
RADIOLOGY7100000006HC RECOVERY ROOM LEVEL 2 PER MINUTE $ 8.00
48
RADIOLOGY7100000007HC RECOVERY ADDL PER 15MIN $ 73.00
49
RADIOLOGY7100000012HC RECOVERY PER 1/2 HR PUL LAB $ 162.00
50
RADIOLOGY3200071045HC XR CHEST 1 VIEW $ 368.00
51
RADIOLOGY3200071046HC XR CHEST 2 VIEWS $ 414.00
52
RADIOLOGY3200071047HC XR CHEST 3 VIEWS $ 450.00
53
RADIOLOGY3200071100RIBS 2VEIW $ 419.00
54
RADIOLOGY3200071101RIBS 3+VIEWS $ 573.00
55
RADIOLOGY3200071110HC XR RIBS 3 VIEWS BILAT $ 616.00
56
RADIOLOGY3200071120HC XR STERNUM 2+ VIEWS $ 476.00
57
RADIOLOGY3200071130HC XR STERNOCLAVICULAR JOINTS 3+ VIEWS $ 415.00
58
RADIOLOGY3500071250HC CT CHEST WO CONTRAST $ 2,269.00
59
RADIOLOGY3500071260HC CT CHEST WITH CONTRAST $ 2,521.00
60
RADIOLOGY3500071275HC CTA CHEST WITH CONTRAST $ 3,151.00
61
RADIOLOGY6100071550HC MR CHEST WO CONTRAST $ 3,750.00
62
RADIOLOGY6100071552HC MR CHEST WO&W CONTRAST $ 4,688.00
63
RADIOLOGY6180171555HC MRA CHEST WO CONTRAST $ 4,621.00
64
RADIOLOGY6181871555HC MRA CHEST WO&W CONTRAST $ 4,621.00
65
RADIOLOGY3200072020HC SPINE 1 VIEW $ 365.00
66
RADIOLOGY3200072040HC XR SPINE CERVICAL 2-3 VIEWS $ 476.00
67
RADIOLOGY3200072050HC XR SPINE CERVICAL 4-5 VIEWS $ 699.00
68
RADIOLOGY3200072052HC XR SPINE CERVICAL 6+ VIEWS $ 815.00
69
RADIOLOGY3200072070HC SPINE THORACIC 2 VIEWS $ 513.00
70
RADIOLOGY3200072081HC XR SPINE ENTIRE 1 VIEW $ 460.00
71
RADIOLOGY3200072082HC XR SPINE ENTIRE 2-3 VIEWS $ 473.00
72
RADIOLOGY3200072100HC XR SPINE LUMBAR 2-3 VIEWS $ 584.00
73
RADIOLOGY3200072110HC XR SPINE LUMBAR 4+ VIEWS $ 766.00
74
RADIOLOGY3200072114HC XR SPINE LUMBAR 6+ VIEWS $ 922.00
75
RADIOLOGY3200072120HC XR SPINE LUMBAR BENDING ONLY 2-3 VIEWS $ 469.00
76
RADIOLOGY3500072125HC CT SPINE CERVICAL WO CONTRAST $ 1,668.00
77
RADIOLOGY3500072126HC CT SPINE CERVICAL WITH CONTRAST $ 1,962.00
78
RADIOLOGY3500072128HC CT SPINE THORACIC WO CONTRAST $ 2,096.00
79
RADIOLOGY3500072129HC CT SPINE THORACIC WITH CONTRAST $ 2,467.00
80
RADIOLOGY3500072131HC CT SPINE LUMBAR WO CONTRAST $ 2,467.00
81
RADIOLOGY3500072132HC CT SPINE LUMBAR WITH CONTRAST $ 2,596.00
82
RADIOLOGY6120072141HC MR SPINE CERVICAL WO CONTRAST $ 3,514.00
83
RADIOLOGY6120072142HC MR SPINE CERVICAL WITH CONTRAST $ 4,134.00
84
RADIOLOGY6120072146HC MR SPINE THORACIC WO CONTRAST $ 3,603.00
85
RADIOLOGY6120072147HC SPINE-THORACIC W/CON $ 3,864.00
86
RADIOLOGY6120072148HC MR SPINE LUMBAR WO CONTRAST $ 3,603.00
87
RADIOLOGY6120072149HC MR SPINE LUMBAR WITH CONTRAST $ 4,240.00
88
RADIOLOGY6120072156HC MR SPINE CERVICAL WO&W CONTRAST $ 4,755.00
89
RADIOLOGY6120072157HC MR SPINE THORACIC WO&W CONTRAST $ 4,876.00
90
RADIOLOGY6120072158HC MR SPINE LUMBAR WO&W CONTRAST $ 4,876.00
91
RADIOLOGY6120072159MR ANGIO SPINE W/O & W/DYE $ 2,663.00
92
RADIOLOGY3200072170HC XR PELVIS 1-2 VIEWS $ 406.00
93
RADIOLOGY3200072190HC XR PELVIS 3+ VIEWS $ 473.00
94
RADIOLOGY3500072191HC CTA PELVIS W/CONTR MAT INCL NONCONTR IMAGES $ 2,521.00
95
RADIOLOGY3500072192HC CT PELVIS WO CONTRAST $ 1,891.00
96
RADIOLOGY3500072193HC CT PELVIS WITH CONTRAST $ 2,395.00
97
RADIOLOGY3500072194HC CT PELVIS WO&W CONTRAST $ 2,521.00
98
RADIOLOGY6100072195HC MR PELVIS WO CONTRAST $ 3,447.00
99
RADIOLOGY6100072197HC MR PELVIS WO&W CONTRAST $ 4,663.00
100
RADIOLOGY6100072198HC MRA PELVIS WO&W CONTRAST $ 4,663.00
101
RADIOLOGY3200072200HC XR SACROILIAC JOINTS 1-2 VIEWS $ 447.00
102
RADIOLOGY3200072202HC XR SACROILIAC JOINTS 3+ VIEWS $ 507.00
103
RADIOLOGY3200072220HC XR SACRUM/COCCYX 1-2 VIEWS $ 500.00
104
RADIOLOGY3200072265HC S&I MYELOGRAM LUMBAR $ 1,715.00
105
RADIOLOGY3200073000CLAVICLE $ 406.00
106
RADIOLOGY3200073010SCAPULA $ 406.00
107
RADIOLOGY3200073020SHOULDER ONE VIEW $ 406.00
108
RADIOLOGY3200073030SHOULDER MIN 2 VIEWS $ 500.00
109
RADIOLOGY3200073040ARTHOGRAM SHOULDER RT S&I $ 1,055.00
110
RADIOLOGY3200073050HC XR ACROMIOCLAVICULAR JOINTS BILAT $ 447.00
111
RADIOLOGY3200073060HUMERUS MIN 2 VIEWS $ 476.00
112
RADIOLOGY3200073070ELBOW 2VIEW $ 476.00
113
RADIOLOGY3200173080ELBOW MIN 3 VIEWS $ 514.00
114
RADIOLOGY3200073085HC ARTHROGRAM ELBOW S&I $ 1,053.00
115
RADIOLOGY3200073090FOREARM 2 VIEWS $ 447.00
116
RADIOLOGY3200073092EXTREMITY UPPER INFANT 2 VIEWS $ 308.00
117
RADIOLOGY3200173100WRIST 2VIEW $ 447.00
118
RADIOLOGY3200073110WRIST MIN 3 VIEWS $ 476.00
119
RADIOLOGY3200073115ARTHROGRAM WRIST S&I $ 923.00
120
RADIOLOGY3200073120HAND 2VIEW $ 462.00
121
RADIOLOGY3200073130HAND MIN 3 VIEWS PER SIDE $ 500.00
122
RADIOLOGY3200073140HC XR FINGER(S) 2+ VIEWS $ 355.00
123
RADIOLOGY3500073200EXTREM UPPER W/O CONTRAST $ 1,818.00
124
RADIOLOGY3500173200HC MATERIALISE CT SCAN UPPER EXT W/O CONTRAST $ 1,572.00
125
RADIOLOGY3500073201EXTREM UPPER W/CONTRAST $ 2,337.00
126
RADIOLOGY3500073206HC CTA EXTREMITY UPPER WITH CONTRAST $ 2,168.00
127
RADIOLOGY6100073218EXT-UPR $ 3,416.00
128
RADIOLOGY6100073220EXT UPR WO/W CONTRAST $ 4,621.00
129
RADIOLOGY6100073221EXT-UPR JT W/O CONT $ 3,447.00
130
RADIOLOGY6100073222EXT UPR JT W/CONTRAST $ 4,018.00
131
RADIOLOGY6100073223EXT UPR JT WO/W CONTRAST $ 4,621.00
132
RADIOLOGY6180073225HC MRA UPR EXT LT WO FOL W CONT $ 4,212.00
133
RADIOLOGY3200073501HC XR HIP 1 VIEW UNILAT $ 385.00
134
RADIOLOGY3200073502HC XR HIP 2-3 VIEWS UNILATIERAL $ 476.00
135
RADIOLOGY3200073521HC X-RAY EXAM HIPS BILAT 2 VIEWS $ 952.00
136
RADIOLOGY3200073522HC XR HIPS 3-4 VIEWS BILAT $ 562.00
137
RADIOLOGY3200073523HC XR HIPS 5+ VIEWS BILAT $ 699.00
138
RADIOLOGY3200073525ARTHROGRAM HIP S&I $ 1,089.00
139
RADIOLOGY3200073552HC XR FEMUR 2+ VIEWS $ 462.00
140
RADIOLOGY3200073560KNEE 1/2 VIEWS $ 453.00
141
RADIOLOGY3200073562KNEE 3 VIEW $ 530.00
142
RADIOLOGY3200073564KNEE COMP 4 OR MORE VIEWS $ 500.00
143
RADIOLOGY3200073565HC XR KNEES STANDING 1 VIEW $ 423.00
144
RADIOLOGY3200073580ARTHROGRAM KNEE S&I $ 1,023.00
145
RADIOLOGY3200073590LOWER LEG 2 VIEWS $ 462.00
146
RADIOLOGY3200073592EXTREMITY LOWER INFANT 2 VIEWS $ 308.00
147
RADIOLOGY3200073600ANKLE 2VIEW AP&LAT $ 373.00
148
RADIOLOGY3200073610ANKLE MIN 3 VIEWS $ 469.00
149
RADIOLOGY3200073620FOOT 2 VIEWS $ 410.00
150
RADIOLOGY3200073630FOOT MIN 3 VIEWS $ 476.00
151
RADIOLOGY3200073650HEEL MIN 2 VIEWS $ 411.00
152
RADIOLOGY3200073660HC XR TOE(S) 2+ VIEWS $ 342.00
153
RADIOLOGY3500073700EXTREM LOWER W/O CONTRAST $ 2,017.00
154
RADIOLOGY3500173700MAKO CT EXTREMITY LOWER W/O CONTRAST $ 2,017.00
155
RADIOLOGY3500073701EXTREM LOWER W/CONTRAST $ 2,395.00
156
RADIOLOGY3500073706HC CTA EXTREMITY LOWER WITH CONTRAST $ 2,521.00
157
RADIOLOGY6100073718EXT LWR W/O CONT $ 3,416.00
158
RADIOLOGY6100073720EXT LWR WO/W CONTRAST $ 4,756.00
159
RADIOLOGY6100073721EXT LWR JT W/O CONT $ 3,633.00
160
RADIOLOGY6100073722EXT LWR JT W/CONTRAST $ 3,884.00
161
RADIOLOGY6100073723EXT LWR JT WO/W CONT $ 4,688.00
162
RADIOLOGY6101873725MRA LWR EXT W/O FOL W/CONT $ 4,239.00
163
RADIOLOGY3200074018HC XR ABDOMEN 1 VIEW $ 400.00
164
RADIOLOGY3200074019HC XR ABDOMEN 2 VIEWS $ 459.00
165
RADIOLOGY3200074021HC X-RAY EXAM ABDOMEN 3+ VIEWS $ 520.00
166
RADIOLOGY3200074022HC XR ABDOMEN 2+ VIEWS & 1 VIEW CHEST $ 704.00
167
RADIOLOGY3500074150HC CT ABDOMEN WO CONTRAST $ 2,143.00
168
RADIOLOGY3500074160HC CT ABDOMEN WITH CONTRAST $ 2,521.00
169
RADIOLOGY3500074170HC CT ABDOMEN WO&W CONTRAST $ 3,151.00
170
RADIOLOGY3500074174HC CTA ABDOMEN & PELVIS WITH CONTRAST $ 3,781.00
171
RADIOLOGY3500074175HC CTA ABDOMEN WITH CONTRAST $ 3,151.00
172
RADIOLOGY3500074176HC CT ABDOMEN & PELVIS WO CONTRAST $ 3,781.00
173
RADIOLOGY3500074177HC CT ABDOMEN & PELVIS WITH CONTRAST $ 4,411.00
174
RADIOLOGY3500074178HC CT ABDOMEN & PELVIS WO&W CONTRAST $ 5,672.00
175
RADIOLOGY6100074181HC MR ABDOMEN WO CONTRAST $ 3,533.00
176
RADIOLOGY6100074182HC MR ABDOMEN WITH CONTRAST $ 4,240.00
177
RADIOLOGY6100074183HC MR ABDOMEN WO&W CONTRAST $ 4,946.00
178
RADIOLOGY6181874185HC MRA ABDOMEN WO&W $ 4,876.00
179
RADIOLOGY3200074220HC XR ESOPHAGUS $ 791.00
180
RADIOLOGY3200074230HC XR SWALLOWING WITH SPEECH EVAL $ 858.00
181
RADIOLOGY3200074240HC XR UPPER GI WO KUB $ 869.00
182
RADIOLOGY3200074241HC XR UPPER GI WITH KUB $ 1,015.00
183
RADIOLOGY3200074245HC XR UPPER GI WITH SMALL BOWEL $ 1,341.00
184
RADIOLOGY3200074246HC XR UPPER GI WITH AIR WO KUB $ 1,067.00
185
RADIOLOGY3200074247HC XR UPPER GI WITH AIR WITH KUB $ 1,124.00
186
RADIOLOGY3200074249HC XR UPPER GI WITH AIR WITH SMALL BOWEL $ 1,413.00
187
RADIOLOGY3200074250HC SMALL BOWEL SERIES $ 900.00
188
RADIOLOGY3200074270HC XR COLON DIAGNOSTIC $ 1,046.00
189
RADIOLOGY3200074280HC XR COLON WITH AIR DIAGNOSTIC $ 1,395.00
190
RADIOLOGY3200074283HC XR COLON THERAPEUTIC $ 964.00
191
RADIOLOGY3200074300HC XR CHOLANGIOGRAM OPERATIVE $ 900.00
192
RADIOLOGY3200074301HC XR CHOLANGIOGRAM OPERATIVE ADDITIONAL $ 494.00
193
RADIOLOGY3200074328HC S&I ERCP BILIARY $ 1,450.00
194
RADIOLOGY3200074330HC S&I ERCP BILIARY & PANCREAS $ 1,450.00
195
RADIOLOGY3200074400HC XR UROGRAPHY INTRAVENOUS $ 943.00
196
RADIOLOGY3200074420HC S&I UROGRAPHY RETROGRADE $ 3,455.00
197
RADIOLOGY3200074425HC S&I UROGRAPHY ANTEGRADE $ 3,455.00
198
RADIOLOGY3200074450HC S&I URETHROGRAM RETROGRADE $ 1,950.00
199
RADIOLOGY3200074455HC S&I CYSTOGRAM/VCUG $ 1,015.00
200
RADIOLOGY3200074485HC S&I GU DILATION $ 4,057.00
201
RADIOLOGY3200074740HC S&I HYSTEROSALPINGOGRAM $ 832.00
202
RADIOLOGY3200075605HC S&I AORTA THORACIC $ 5,275.00
203
RADIOLOGY3200075625HC S&I AORTA ABDOMINAL $ 5,275.00
204
RADIOLOGY3200075630HC S&I AORTA & BILAT RUNOFF $ 6,594.00
205
RADIOLOGY3500075635HC CTA ABDOMEN & BILAT RUNOFF WITH CONTRAST $ 3,151.00
206
RADIOLOGY3200075710HC S&I EXTREMITY ARTERIAL UNILAT $ 5,275.00
207
RADIOLOGY3200075716HC S&I EXTREMITY ARTERIAL BILAT $ 5,935.00
208
RADIOLOGY3200075726HC S&I VISCERAL ARTERIAL SELECTIVE $ 5,012.00
209
RADIOLOGY3200075736HC S&I PELVIC ARTERIAL SELECTIVE $ 5,012.00
210
RADIOLOGY3200075741HC ANGIOGRAPHY PULMONARY UNI $ 4,709.00
211
RADIOLOGY3200075743HC S&I PULMONARY ARTERIAL SELECTIVE BILAT $ 7,814.00
212
RADIOLOGY3200075746HC S&I PULMONARY NON SELECTIVE $ 3,365.00
213
RADIOLOGY3200075774HC S&I ARTERIAL SELECTIVE EA ADDITIONAL $ 1,253.00
214
RADIOLOGY3200075820HC S&I EXTREMITY VENOUS UNILAT $ 1,451.00
215
RADIOLOGY3200175820HC S&I EXTREMITY VENOUS UNILAT $ 1,451.00
216
RADIOLOGY3200075822HC S&I EXTREMITY VENOUS BILAT $ 1,978.00
217
RADIOLOGY3200075825HC S&I INFERIOR VENA CAVA $ 5,275.00
218
RADIOLOGY3200075827HC S&I SUPERIOR VENA CAVA $ 4,616.00
219
RADIOLOGY3200075831HC BEIN X-RAY KIDNEY $ 4,337.00
220
RADIOLOGY3200075889HC S&I HEPATIC VENOUS W PRESSURES $ 7,914.00
221
RADIOLOGY3200075901HC S&I FIBRIN SHEATH REMOVAL CVAD CVC SEPARATE ACCESS $ 1,323.00
222
RADIOLOGY3200075970HC S&I TRANSCATHETER BX $ 4,057.00
223
RADIOLOGY3200075984HC S&I EXCHANGE DRAIN CATHETER $ 1,052.00
224
RADIOLOGY3200075989ABSCESS DRAINAGE W/CATH PLCMT S&I $ 1,885.00
225
RADIOLOGY3200076000HC XR FLUORO UP TO 1 HOUR $ 660.00
226
RADIOLOGY3200076010HC XR FB NOSE TO RECTUM CHILD 1 VIEW $ 255.00
227
RADIOLOGY3200076080HC S&I ABSCESS/FISTULA/SINUS TRACT $ 813.00
228
RADIOLOGY3200076098SPECIMEN BREAST (76098) $ 969.00
229
RADIOLOGY3500076377HC XR 3D INDEPENDENT WORKSTATION $ 726.00
230
RADIOLOGY3500076380HC CT SCAN FOLLOW UP STUDY $ 508.00
231
RADIOLOGY6100076391HC MR ELASTOGRAPHY $ 2,800.00
232
RADIOLOGY4020076506HC US ECHOENCEPHALOGRAPHY $ 706.00
233
RADIOLOGY4020176512HC OPHTH US B W/NON-QUANT A $ 908.00
234
RADIOLOGY4020276512HC OPHTH US B W/NON-QUANT A $ 908.00
235
RADIOLOGY4020076536HC US SOFT TISSUE HEAD/NECK $ 893.00
236
RADIOLOGY4020176536HC US EXAM OF HEAD AND NECK $ 893.00
237
RADIOLOGY4020276536HC HEAD/NECK SOFT TISSUE $ 893.00
238
RADIOLOGY4020076604HC US CHEST REAL TIME W/IMAGE $ 753.00
239
RADIOLOGY4020176604HC US CHEST REAL TIME W/IMAGE $ 753.00
240
RADIOLOGY4020276604HC US CHEST REAL TIME W/IMAGE $ 753.00
241
RADIOLOGY4020076641HC US BREAST UNILAT COMPLETE $ 581.00
242
RADIOLOGY4020076642US BREAST LIMITED $ 790.00
243
RADIOLOGY4020076700HC US ABDOMEN COMPLETE $ 1,385.00
244
RADIOLOGY4020076705HC US ABDOMEN LIMITED $ 1,048.00
245
RADIOLOGY4020176705HC ABDOMINAL LIMITED NON-OBS $ 1,048.00
246
RADIOLOGY4020276705HC US ABD/PELVIC LIMITED NON-OBS (FAST) (76705) $ 1,048.00
247
RADIOLOGY4020076706HC US ABDOMNIAL AORTA AAA SCREENING $ 838.00
248
RADIOLOGY4020076770HC US RETROPERITONEAL COMPLETE (76770) $ 1,205.00
249
RADIOLOGY4020076775HC US RETROPERITONEAL LIMITED $ 1,000.00
250
RADIOLOGY4020176775HC US RETROPERITONEUM LIMITED $ 1,000.00
251
RADIOLOGY4020276775HC RETROPERITONEUM LIMITED $ 1,000.00
252
RADIOLOGY4020076800HC US SPINAL CANAL $ 1,332.00
253
RADIOLOGY4020276800HC US SPINAL CANAL $ 1,332.00
254
RADIOLOGY4020276815HC OBS LIMITED (76815) $ 806.00
255
RADIOLOGY4020076856HC US PELVIS COMPLETE $ 1,026.00
256
RADIOLOGY4020076857HC US PELVIS LIMITED $ 799.00
257
RADIOLOGY4020176857HC PELVIC LIMITED NON-OBS (76857) $ 799.00
258
RADIOLOGY4020276857HC PELVIC LIMITED NON-OBS $ 799.00
259
RADIOLOGY4020076870HC US SCROTUM $ 862.00
260
RADIOLOGY4020176870HC US SCROTUM $ 862.00
261
RADIOLOGY4020076872HC ULTRASOUND TRANSRECTAL $ 578.00
262
RADIOLOGY4020076881HC US EXTREMITY COMPLETE $ 853.00
263
RADIOLOGY4020076882HC US EXTREMITY LIMITED $ 721.00
264
RADIOLOGY4020176882HC US EXTREMITY LIMITED $ 721.00
265
RADIOLOGY4020276882HC LIMITED US EXTREMITY NONVASC W/IMAGE $ 721.00
266
RADIOLOGY4020076885HC US INFANT HIPS WITH MANIPULATION $ 743.00
267
RADIOLOGY4020076886HC US INFANT HIPS WO MANIPULATION $ 708.00
268
RADIOLOGY4020076930HC S&I US GUIDANCE PERICARDIOCENTESIS $ 639.00
269
RADIOLOGY4020076937HC S&I US GUIDANCE VASCULAR ACCESS $ 662.00
270
RADIOLOGY4020176937HC US GUIDANCE VENOUS ACCESS $ 662.00
271
RADIOLOGY4020276937HC US GUIDANCE VASCULAR ACCESS $ 662.00
272
RADIOLOGY4020076942HC US GUIDANCE NDL PLCMT $ 1,309.00
273
RADIOLOGY4020276942HC US GUIDE NDL PLACEMENT (BX,ASP) (76942) $ 1,309.00
274
RADIOLOGY4020076946HC S&I US GUIDANCE AMNIOCENTESIS $ 970.00
275
RADIOLOGY4020076965HC US GUIDANCE FOR INTERSTITIAL RADIOELEMENT APPLICATION $ 1,174.00
276
RADIOLOGY4020076978HC US TRGT DYN MICROBUBB 1ST LESION $ 1,284.00
277
RADIOLOGY4020076979HC US TRGT DYN MICROBUBB EA ADDL $ 350.00
278
RADIOLOGY4020076981HC US ELASTOGRAPHY PARENCHYMA $ 491.00
279
RADIOLOGY4020076982HC US ELASTOGRAPHY 1ST TARGET LESION $ 491.00
280
RADIOLOGY4020076983HC US ELASTOGRAPHY EA ADDL TARGET LESION $ 180.00
281
RADIOLOGY4020076998HC US GUIDANCE INTRAOPERATIVE $ 1,096.00
282
RADIOLOGY3200077001HC S&I FLUORO CVAD $ 957.00
283
RADIOLOGY3200077002HC S&I FLUORO NEEDLE PLACEMENT $ 740.00
284
RADIOLOGY3200077003HC S&I FLUORO SPINAL NEEDLE PLACEMENT $ 851.00
285
RADIOLOGY3500077011HC CT STEREOTATIC LOCALIZATION $ 1,765.00
286
RADIOLOGY3500077012HC S&I CT NEEDLE PLACEMENT $ 2,527.00
287
RADIOLOGY3500077013HC CT GUID FOR TISSUE ABLATION $ 3,486.00
288
RADIOLOGY3200077071HC MANUAL STRESS APPLICATION MD/QHCP $ 445.00
289
RADIOLOGY3200077072HC XR BONE AGE STUDY $ 394.00
290
RADIOLOGY3200077073HC BONE LENGTH STUDY $ 645.00
291
RADIOLOGY3200077074HC XR BONE SURVEY LIMITED $ 683.00
292
RADIOLOGY3200077076HC BONE SURVEY INFANT $ 991.00
293
RADIOLOGY3200077077HC JOINT SURVEY SINGLE VIEW $ 176.00
294
RADIOLOGY3200077080HC XR BONE DENSITY HIP/PELVIS/SPINE $ 812.00
295
RADIOLOGY3200077081HC XR BONE DENSITY WRIST/HEEL $ 419.00
296
RADIOLOGY3200077086HC BONE DENSITY VERTEBRAL FX ASSESSMENT $ 396.00
297
RADIOLOGY1500099SIMULATION SIMPLE $ 2,134.00
298
RADIOLOGY1500107SIMULATION INTERMEDIATE $ 3,162.00
299
RADIOLOGY1500115SIMULATION COMPLEX SET $ 4,340.00
300
RADIOLOGY1905102RESPIRATORY MOTION MANAGEMENT SIMULATION $ 3,811.00
301
RADIOLOGY19053633D SIMULATION-AIDED FILED SET $ 3,454.00
302
RADIOLOGY3410078014HC NM THYROID IMAGING WITH UPTAKE $ 1,854.00
303
RADIOLOGY3410078018HC NM THYROID METASTATIC IMAGING WHOLE BODY $ 2,316.00
304
RADIOLOGY3410078195HC NM LYMPHATIC/LYMPH NODE IMAGING $ 2,536.00
305
RADIOLOGY3410078226HC NM HEPATOBILIARY IMAGING $ 2,711.00
306
RADIOLOGY3410078227HC NM HEPATOBILIARY IMAGING WITH PHARM $ 3,596.00
307
RADIOLOGY3410078306HC NM BONE/JOINT IMAGING WHOLE BODY $ 1,839.00
308
RADIOLOGY3410078315HC NM BONE/JOINT IMAGING 3 PHASE $ 2,522.00
309
RADIOLOGY3410078320HC NM BONE/JOINT SPECT $ 1,557.00
310
RADIOLOGY3410078630HC NM CSF CISTERNOGRAPHY $ 2,752.00
311
RADIOLOGY3410078801HC NM LOCALIZATION/DISTRIBUTION RADIOPHARM MULTIPLE AREAS $ 1,898.00
312
RADIOLOGY3410078802HC NM LOCALIZATION/DISTRIBUTION RADIOPHARM WHOLE BODY 1 DAY $ 2,557.00
313
RADIOLOGY3410078803HC NM LOCALIZATION/DISTRIBUTION RADIOPHARM SPECT $ 2,533.00
314
RADIOLOGY3410078806HC NM LOCALIZATION INFLAMMATORY RADIOPHARM WHOLE BODY $ 2,626.00
315
RADIOLOGY7610093880HC USV DUPLEX EXTRACRANIAL ARTERIES COMPLETE $ 1,298.00
316
RADIOLOGY9210093882HC USV DUPLEX EXTRACRANIAL LIMITED/UNILAT $ 941.00
317
RADIOLOGY9210093922HC NON INVASIVE LIMITED BILAT EXTREMITY ARTERIES $ 627.00
318
RADIOLOGY9210093923HC NON INVASIVE COMPLETE BILAT EXTREMITY ARTERIES $ 1,042.00
319
RADIOLOGY9210093924HC NON INVASIVE LOWER EXTREMITY ARTERIES WITH TREADMILL STRESS $ 1,170.00
320
RADIOLOGY9210093925HC USV DUPLEX LOWER EXTREMITY COMPLETE BILAT ARTERIAL $ 1,449.00
321
RADIOLOGY9210093926HC USV DUPLEX LOWER EXTREMITY LIMITED/UNILAT ARTERIAL $ 1,018.00
322
RADIOLOGY9210093930HC USV DUPLEX UPPER EXTREMITY COMPLETE BILAT ARTERIAL $ 1,450.00
323
RADIOLOGY9210093931HC USV DUPLEX UPPER EXTREMITY LIMITED/UNILAT ARTERIAL $ 1,024.00
324
RADIOLOGY9210093970HC USV DUPLEX EXTREMITY COMPLETE BILAT VENOUS $ 1,666.00
325
RADIOLOGY9210093971HC USV DUPLEX EXTREMITY LIMITED/UNILAT VENOUS $ 1,186.00
326
RADIOLOGY9210193971HC US DUPLEX EXTREMITY LIMITED/UNILAT VENOUS $ 1,186.00
327
RADIOLOGY9210093975HC USV DUPLEX ORGAN INFLOW/OUTFLOW COMPLETE $ 1,379.00
328
RADIOLOGY9210193975HC US DOPPLER COMPLETE $ 1,379.00
329
RADIOLOGY9210093976HC USV DUPLEX ORGAN INFLOW/OUTFLOW LIMITED $ 1,154.00
330
RADIOLOGY9210093978HC USV DUPLEX AORTA/IVC/ILIAC/BYPASS COMPLETE $ 1,450.00
331
RADIOLOGY9210093979HC USV DUPLEX AORTA/IVC/ILIAC/BYPASS LIMITED/UNILAT $ 1,024.00
332
RADIOLOGY9210093990HC USV DUPLEX HEMODIALYSIS ACCESS $ 541.00
333
RADIOLOGY35000G0297HC CT LOW DOSE LUNG SCREENING $ 2,337.00