Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
X-ray of foot, minimum of 3 views
Ultrasound of leg arteries or artery grafts
X-ray of chest, 1 view
Vascular & Interventional Radiology
Ultrasonic guidance for blood vessel access
Ct scan head or brain without contrast
X-ray of chest, 2 views
Ct scan of blood vessels of chest with contrast
X-ray of knee, 1-2 views
X-ray of ankle, minimum of 3 views
Radiology - Body Imaging
Aspiration of fluid from chest cavity using imaging guidance
X-ray of hip, 2-3 views
X-ray of shoulder, minimum of 2 views
Ct scan of upper spine without contrast
Ct scan of chest with contrast
X-ray of abdomen, 1 view
Ct scan of abdomen and pelvis without contrast
Insertion of tunneled central venous tube for infusion (5 years or older)
Neuroradiology
Nuclear Radiology
Ct scan of face without contrast
Imaging of urinary tract following injection of a contrast agent
Diagnostic Radiology
Ultrasound study of arm or leg veins with compression and maneuvers
Physician visit costs
Radiology - Nuclear Radiology
X-ray of hip, 1 view
X-ray of wrist, minimum of 3 views
Pediatric Radiology
Ct scan of abdomen and pelvis with contrast
Limited ultrasound scan of abdomen
Radiology - Neuroradiology
X-ray of lower leg, 2 views
Radiology - Pediatric Radiology
Ct scan of lower spine without contrast
Ultrasound scan of head and neck soft tissue
X-ray of thigh bone, minimum 2 views
X-ray of lower and sacral spine, 2-3 views
Complete ultrasound scan behind abdominal cavity
Ultrasound of both sides of head and neck blood flow
Ct scan of chest without contrast
Radiology - Diagnostic Radiology
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