| 3-D radiotherapy plan dose-volume histograms (77295) |
$11,229.12 |
$11,229.12 |
7.8× |
| Abdomen 2 views (74019) |
$1,204.27 |
$1,204.27 |
11.0× |
| Acute gi blood loss imaging (78278) |
$5,028.21 |
$5,028.21 |
12.0× |
| Angio Adrenal Bilat Select (75733) |
$26,854.65 |
$26,854.65 |
8.1× |
| Angiography extremity bilateral rs&i (75716) |
$9,864.54 |
$9,864.54 |
3.0× |
| Angiography extremity unilateral rs&i (75710) |
$8,023.82 |
$8,023.82 |
2.4× |
| Angiography internal mammary rs&i (75756) |
$8,023.82 |
$8,023.82 |
2.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$14,090.10 |
$14,090.10 |
2.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,495.69 |
$9,495.69 |
2.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,121.80 |
$8,121.80 |
2.5× |
| Angiography Spinal Selective Rs&I (75705) |
$46,619.20 |
$46,619.20 |
8.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$14,090.10 |
$14,090.10 |
2.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$8,023.82 |
$8,023.82 |
2.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$8,023.82 |
$8,023.82 |
2.4× |
| Ankle 2 views (73600) |
$1,028.66 |
$1,028.66 |
11.3× |
| Aortogram thoracic (75605) |
$14,090.10 |
$14,090.10 |
2.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$8,023.82 |
$8,023.82 |
2.4× |
| Aortography abdominal serialography rs&i (75625) |
$8,023.82 |
$8,023.82 |
2.4× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$8,023.82 |
$8,023.82 |
2.4× |
| Artery X-Rays Adrenal Gland (75731) |
$26,854.65 |
$26,854.65 |
8.1× |
| Arthrogram ankle (73615) |
$3,981.54 |
$3,981.54 |
10.9× |
| Arthrogram elbow (73085) |
$3,582.22 |
$3,582.22 |
9.8× |
| Arthrogram hip (73525) |
$2,698.83 |
$2,698.83 |
7.4× |
| Arthrogram knee (73580) |
$3,495.47 |
$3,495.47 |
9.6× |
| Arthrogram shoulder (73040) |
$1,337.76 |
$1,337.76 |
3.7× |
| Arthrogram wrist (73115) |
$3,425.21 |
$3,425.21 |
9.4× |
| Basic dosimetry (77300) |
$817.14 |
$817.14 |
5.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,530.24 |
$1,530.24 |
3.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,028.46 |
$2,028.46 |
4.9× |
| Bone &/joint imaging whole body (78306) |
$2,099.64 |
$2,099.64 |
5.0× |
| Bone age studies (77072) |
$773.97 |
$773.97 |
7.1× |
| Bone Imaging 3 Phase (78315) |
$2,508.89 |
$2,508.89 |
6.0× |
| Bone Marrow Imaging Limited Area (78102) |
$3,951.75 |
$3,951.75 |
9.5× |
| Bone survey complete (77075) |
$875.44 |
$875.44 |
8.0× |
| Bone survey infant (77076) |
$1,422.31 |
$1,422.31 |
13.0× |
| Bowel imaging (78290) |
$1,916.52 |
$1,916.52 |
4.6× |
| Brachytx isodose complex (77318) |
$1,985.79 |
$1,985.79 |
5.1× |
| Brachytx isodose intermed (77317) |
$1,614.62 |
$1,614.62 |
4.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,358.39 |
$1,358.39 |
3.5× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$3,951.75 |
$3,951.75 |
9.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$4,228.74 |
$4,228.74 |
7.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$14,593.75 |
$14,593.75 |
9.8× |
| Brain Imaging Vascular Flow Only (78610) |
$1,305.79 |
$1,305.79 |
2.3× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$3,654.02 |
$3,654.02 |
8.8× |
| Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or… (78483) |
$5,467.49 |
$5,467.49 |
9.6× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$7,308.76 |
$7,308.76 |
8.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,602.24 |
$3,602.24 |
9.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,429.79 |
$1,429.79 |
2.5× |
| Cervical spine 2 or 3 views (72040) |
$2,020.82 |
$2,020.82 |
22.2× |
| Chest 1 view (71045) |
$865.98 |
$865.98 |
9.5× |
| Chest xray 3 views (71047) |
$1,291.86 |
$1,291.86 |
14.2× |
| Cholecystography, oral contrast Non-Facility (74290) |
$1,646.31 |
$1,646.31 |
9.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,139.09 |
$1,139.09 |
6.2× |
| Cineradiography/videoradiography (76120) |
$1,344.82 |
$1,344.82 |
12.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$7,308.76 |
$7,308.76 |
8.9× |
| Clavicle complete (73000) |
$1,063.59 |
$1,063.59 |
11.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,046.32 |
$2,046.32 |
18.7× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$1,083.82 |
$1,083.82 |
11.9× |
| Continuing medical physics consltj pr wk (77336) |
$1,162.11 |
$1,162.11 |
8.3× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$1,646.31 |
$1,646.31 |
9.0× |
| Corpora cavernosography (74445) |
$1,344.82 |
$1,344.82 |
12.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$15,632.01 |
$15,632.01 |
42.9× |
| CT abdomen and pelvis without contrast (74176) |
$13,573.71 |
$13,573.71 |
54.5× |
| CT abdomen w contrast (74160) |
$5,541.51 |
$5,541.51 |
30.3× |
| CT abdomen w wo contrast (74170) |
$7,925.34 |
$7,925.34 |
43.3× |
| CT abdomen w/o contrast (74150) |
$6,844.73 |
$6,844.73 |
62.7× |
| CT angio hrt w/3d image (75574) |
$1,808.35 |
$1,808.35 |
5.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$5,707.05 |
$5,707.05 |
31.2× |
| CT angiography upper extremity lt (73206) |
$6,197.28 |
$6,197.28 |
33.8× |
| CT c-spine w/contrast (72126) |
$5,722.93 |
$5,722.93 |
15.7× |
| CT c-spine w/o contrast (72125) |
$8,334.18 |
$8,334.18 |
76.3× |
| CT cervical spine w&w/o contrast (72127) |
$10,596.31 |
$10,596.31 |
57.8× |
| CT chest w contrast (71260) |
$7,880.57 |
$7,880.57 |
43.0× |
| CT chest w/wo contrast (71270) |
$6,296.33 |
$6,296.33 |
34.4× |
| CT colonography screening (74263) |
$3,401.46 |
$3,401.46 |
13.7× |
| CT colonography w/dye (74262) |
$1,808.35 |
$1,808.35 |
9.9× |
| CT colonography w/o cntrst (74261) |
$1,477.19 |
$1,477.19 |
13.5× |
| CT head/brain with contrast (70460) |
$8,189.96 |
$8,189.96 |
44.7× |
| CT head/brain without and with contrast (70470) |
$9,524.76 |
$9,524.76 |
52.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,147.56 |
$2,147.56 |
5.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$1,150.55 |
$1,150.55 |
12.7× |
| CT hrt w/3d image congen (75573) |
$1,808.35 |
$1,808.35 |
5.0× |
| CT iac w contrast (70481) |
$8,461.54 |
$8,461.54 |
46.2× |
| CT limited/localized follow up study (76380) |
$2,572.71 |
$2,572.71 |
28.3× |
| CT lower ext w/o (73700) |
$6,771.08 |
$6,771.08 |
62.0× |
| CT lower extremity w wo contrast (73702) |
$9,027.48 |
$9,027.48 |
49.3× |
| CT lower extremity w/contrast material (73701) |
$7,902.23 |
$7,902.23 |
43.1× |
| CT lumbar spine w & w/o contrast (72133) |
$10,728.83 |
$10,728.83 |
58.6× |
| CT lumbar spine w/contrast (72132) |
$8,472.61 |
$8,472.61 |
23.3× |
| CT lumbar spine w/o contrast (72131) |
$7,813.32 |
$7,813.32 |
71.6× |
| CT maxillofacial w contrast (70487) |
$8,411.53 |
$8,411.53 |
45.9× |
| CT maxillofacial w/wo contrast (70488) |
$9,590.02 |
$9,590.02 |
52.4× |
| CT maxillofacial wo contrast (70486) |
$6,904.22 |
$6,904.22 |
63.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$9,665.73 |
$9,665.73 |
52.8× |
| CT orbits w/o contrast (70480) |
$7,225.50 |
$7,225.50 |
66.2× |
| CT pelvis w/o contrast (72192) |
$7,492.98 |
$7,492.98 |
68.6× |
| CT pelvis w/wo contrast (72194) |
$8,325.53 |
$8,325.53 |
45.5× |
| CT scan of arm combo (73202) |
$8,831.99 |
$8,831.99 |
48.2× |
| CT soft tissue neck w contrast (70491) |
$8,657.33 |
$8,657.33 |
47.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$9,292.69 |
$9,292.69 |
50.7× |
| CT soft tissue neck w/o contrast (70490) |
$7,022.49 |
$7,022.49 |
64.3× |
| CT thoracic spine w/contrast (72129) |
$8,266.23 |
$8,266.23 |
45.1× |
| CT thoracic spine w/o contrast (72128) |
$7,653.92 |
$7,653.92 |
70.1× |
| CT thoracic spine w/wo contrast (72130) |
$8,980.80 |
$8,980.80 |
49.0× |
| CT thorax w/o contrast (71250) |
$5,123.82 |
$5,123.82 |
46.9× |
| CT unlisted procedure (76497) |
$1,083.82 |
$1,083.82 |
11.9× |
| CT upper ext wo (73200) |
$6,646.48 |
$6,646.48 |
60.9× |
| CT upper extremity with contrast (73201) |
$8,338.78 |
$8,338.78 |
22.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$14,101.57 |
$14,101.57 |
77.0× |
| Cta Abdomen (74175) |
$10,680.65 |
$10,680.65 |
58.3× |
| CTA abdomen pelvis (74174) |
$14,348.12 |
$14,348.12 |
39.4× |
| CTA chest (71275) |
$6,296.33 |
$6,296.33 |
34.4× |
| Cta Head (70496) |
$10,926.81 |
$10,926.81 |
59.7× |
| Cta Neck (70498) |
$13,196.26 |
$13,196.26 |
72.0× |
| Cta Pelvis (72191) |
$7,279.87 |
$7,279.87 |
39.7× |
| Cystography minimum 3 views rs&i (74430) |
$1,241.87 |
$1,241.87 |
3.4× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$2,833.35 |
$2,833.35 |
11.4× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$5,559.71 |
$5,559.71 |
2.5× |
| Diskogram cervical (72285) |
$22,966.31 |
$22,966.31 |
11.3× |
| Diskography lumbar (72295) |
$6,598.98 |
$6,598.98 |
3.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$1,344.82 |
$1,344.82 |
12.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,344.82 |
$1,344.82 |
12.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,736.50 |
$1,736.50 |
15.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,476.02 |
$1,476.02 |
13.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$837.72 |
$837.72 |
9.2× |
| Dxa bone density study axial skeleton (77085) |
$427.91 |
$427.91 |
3.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$2,833.35 |
$2,833.35 |
11.4× |
| Esophageal motility (78258) |
$3,951.75 |
$3,951.75 |
9.5× |
| Esophagus (74220) |
$1,102.75 |
$1,102.75 |
6.0× |
| Facial bones min 3 views (70150) |
$2,646.40 |
$2,646.40 |
24.2× |
| Fetal biophysical profile non-stress testing (76818) |
$1,791.80 |
$1,791.80 |
16.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,421.84 |
$1,421.84 |
13.0× |
| Fetal Echo (76825) |
$5,928.41 |
$5,928.41 |
10.4× |
| Fluoroscopy up to 1 hr (76000) |
$1,525.57 |
$1,525.57 |
6.1× |
| Foot 2 views (73620) |
$1,031.47 |
$1,031.47 |
11.3× |
| Forearm 2 views (73090) |
$1,282.89 |
$1,282.89 |
14.1× |
| Functional MRI brain by phys/psych (70555) |
$2,833.35 |
$2,833.35 |
11.4× |
| Functional MRI brain by tech (70554) |
$2,833.35 |
$2,833.35 |
11.4× |
| Hand 2 views (73120) |
$1,125.12 |
$1,125.12 |
10.3× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,519.18 |
$3,519.18 |
4.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,552.89 |
$4,552.89 |
6.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$9,093.19 |
$9,093.19 |
12.5× |
| Heart first pass single,planar (78481) |
$3,654.02 |
$3,654.02 |
6.4× |
| Heart Infarct Image (78466) |
$3,951.75 |
$3,951.75 |
9.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$8,023.82 |
$8,023.82 |
2.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$8,023.82 |
$8,023.82 |
2.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$4,656.91 |
$4,656.91 |
8.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,891.53 |
$1,891.53 |
4.5× |
| Hysterosalpingogram (74740) |
$1,742.59 |
$1,742.59 |
7.0× |
| Interstitial radiation source applic complex (77778) |
$10,491.27 |
$10,491.27 |
14.4× |
| Intracavitary Radiation Source Applic Complex (77763) |
$4,409.66 |
$4,409.66 |
6.1× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$3,666.28 |
$3,666.28 |
6.4× |
| Intracavitary Radiation Source Applic Simple (77761) |
$2,473.39 |
$2,473.39 |
4.3× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$35,192.81 |
$35,192.81 |
4.6× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$3,951.75 |
$3,951.75 |
9.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,651.16 |
$1,651.16 |
2.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,755.85 |
$1,755.85 |
3.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,977.66 |
$1,977.66 |
3.5× |
| Knee 3 views (73562) |
$1,478.60 |
$1,478.60 |
16.3× |
| Liver & spleen imaging static only (78215) |
$1,592.04 |
$1,592.04 |
3.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$3,951.75 |
$3,951.75 |
9.5× |
| Liver imaging w/vascular flow (78202) |
$4,228.74 |
$4,228.74 |
7.5× |
| Lung perf&ventilat diferentl (78598) |
$4,661.02 |
$4,661.02 |
8.2× |
| Lung perfusion differential (78597) |
$3,951.75 |
$3,951.75 |
9.5× |
| Lung ventilation imaging (78579) |
$3,951.75 |
$3,951.75 |
9.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$26,854.65 |
$26,854.65 |
8.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$26,854.65 |
$26,854.65 |
8.1× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$12,975.70 |
$12,975.70 |
7.9× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$6,317.82 |
$6,317.82 |
9.6× |
| Lymphoscintigraphy (78195) |
$6,360.96 |
$6,360.96 |
11.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$5,896.42 |
$5,896.42 |
7.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$5,673.90 |
$5,673.90 |
15.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$7,515.42 |
$7,515.42 |
20.6× |
| Magnetic Resonance Elastography (76391) |
$785.61 |
$785.61 |
3.2× |
| Mammary ductogram or galactogram multiple (77054) |
$2,833.35 |
$2,833.35 |
11.4× |
| Mammary ductogram or galactogram single (77053) |
$2,833.35 |
$2,833.35 |
11.4× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$1,096.69 |
$1,096.69 |
12.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,223.91 |
$1,223.91 |
3.1× |
| MRA head w & w/o contrast (70546) |
$7,760.17 |
$7,760.17 |
21.3× |
| MRA head w/o contrast (70544) |
$5,763.15 |
$5,763.15 |
23.1× |
| MRA head with contrast (70545) |
$7,318.03 |
$7,318.03 |
20.1× |
| MRA neck w contrast (70548) |
$7,421.40 |
$7,421.40 |
20.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$7,738.49 |
$7,738.49 |
21.2× |
| MRA neck w/o contrast (70547) |
$4,417.07 |
$4,417.07 |
17.7× |
| MRI abdomen w contrast (74182) |
$6,371.24 |
$6,371.24 |
17.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$8,070.45 |
$8,070.45 |
22.2× |
| MRI abdomen w/o contrast (74181) |
$5,638.72 |
$5,638.72 |
22.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$7,308.76 |
$7,308.76 |
8.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$8,040.57 |
$8,040.57 |
22.1× |
| MRI breast w/o contrast bilateral (77047) |
$5,222.75 |
$5,222.75 |
21.0× |
| MRI breast wo contrast unilateral (77046) |
$2,833.35 |
$2,833.35 |
11.4× |
| MRI c-spine with contrast (72142) |
$6,554.38 |
$6,554.38 |
18.0× |
| MRI cardiac w/o cont stress (75559) |
$5,928.41 |
$5,928.41 |
10.4× |
| MRI cardiac w/o contrast (75557) |
$4,452.58 |
$4,452.58 |
17.9× |
| MRI cervical spine w/o contrast (72141) |
$2,931.18 |
$2,931.18 |
11.8× |
| MRI chest w/o & w/contrast material (71552) |
$7,513.52 |
$7,513.52 |
20.6× |
| MRI chest w/o contrast (71550) |
$2,833.35 |
$2,833.35 |
11.4× |
| MRI chest with contrast (71551) |
$7,308.76 |
$7,308.76 |
8.9× |
| MRI fetal sngl/1st gestation (74712) |
$2,833.35 |
$2,833.35 |
11.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$6,164.45 |
$6,164.45 |
16.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$6,387.80 |
$6,387.80 |
17.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,849.33 |
$5,849.33 |
23.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,946.43 |
$4,946.43 |
19.9× |
| MRI orbit face neck w contrast (70542) |
$5,940.95 |
$5,940.95 |
16.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$7,877.64 |
$7,877.64 |
21.6× |
| MRI pelvis w/contrast (72196) |
$6,098.47 |
$6,098.47 |
16.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$7,761.69 |
$7,761.69 |
21.3× |
| MRI pelvis w/o contrast (72195) |
$5,191.26 |
$5,191.26 |
20.8× |
| MRI spectroscopy (76390) |
$6,477.52 |
$6,477.52 |
71.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,537.69 |
$4,537.69 |
12.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$6,783.32 |
$6,783.32 |
18.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$8,443.80 |
$8,443.80 |
23.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$6,617.86 |
$6,617.86 |
18.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$8,270.26 |
$8,270.26 |
22.7× |
| MRI temporomandibular joint (70336) |
$2,232.73 |
$2,232.73 |
9.0× |
| MRI thoracic spine w/o contrast (72146) |
$5,992.06 |
$5,992.06 |
24.0× |
| MRI up ext w/o contrast (73218) |
$4,753.13 |
$4,753.13 |
19.1× |
| MRI upper ext joint w/o contrast (73221) |
$3,342.78 |
$3,342.78 |
13.4× |
| MRI, joint upper extrem combo (73223) |
$7,607.01 |
$7,607.01 |
20.9× |
| Myelogram Cervical (72240) |
$4,806.90 |
$4,806.90 |
5.9× |
| Myelogram Lumbar (72265) |
$4,974.35 |
$4,974.35 |
6.1× |
| Myelogram thoracic (72255) |
$3,261.15 |
$3,261.15 |
4.0× |
| Myelography 2 or more regions (72270) |
$3,442.91 |
$3,442.91 |
4.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$11,728.14 |
$11,728.14 |
8.7× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$14,593.75 |
$14,593.75 |
9.8× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$14,593.75 |
$14,593.75 |
9.8× |
| Myocardial infarct spect (78469) |
$4,228.74 |
$4,228.74 |
7.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$4,878.66 |
$4,878.66 |
3.6× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$6,808.27 |
$6,808.27 |
5.0× |
| Myocardial Spect Multiple Studies (78452) |
$11,728.14 |
$11,728.14 |
8.7× |
| Myocardial spect single study at rest or stress (78451) |
$4,819.89 |
$4,819.89 |
3.6× |
| N-invas est c ffr sw aly CTA (75580) |
$12,607.33 |
$12,607.33 |
14.1× |
| Neck soft tissue (70360) |
$716.34 |
$716.34 |
7.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,581.48 |
$1,581.48 |
3.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$3,951.75 |
$3,951.75 |
9.5× |
| Nm cardiac blood pool multiple (78473) |
$5,440.42 |
$5,440.42 |
13.0× |
| Nm cisternogram (78630) |
$4,191.86 |
$4,191.86 |
7.4× |
| Nm csf leak detection (78650) |
$11,728.14 |
$11,728.14 |
8.7× |
| Nm gastric emptying study (78264) |
$4,998.76 |
$4,998.76 |
12.0× |
| Nm gastroesophageal reflux study (78262) |
$3,951.75 |
$3,951.75 |
9.5× |
| Nm kidney scan w/flow (78701) |
$1,521.22 |
$1,521.22 |
3.6× |
| Nm peritoneal-venous shunt patency (78291) |
$3,951.75 |
$3,951.75 |
9.5× |
| Nm red cell sequestration (78140) |
$1,116.50 |
$1,116.50 |
2.7× |
| Noncardiac Vascular Flow Imaging (78445) |
$3,951.75 |
$3,951.75 |
9.5× |
| Nonvascular shunt X-ray (75809) |
$1,344.82 |
$1,344.82 |
12.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$16,618.24 |
$16,618.24 |
11.5× |
| Nuclear Rx Oral Admin (79005) |
$3,213.70 |
$3,213.70 |
13.2× |
| Ob us nuchal meas 1 gest (76813) |
$1,851.28 |
$1,851.28 |
17.0× |
| Orthopantogram (70355) |
$783.49 |
$783.49 |
8.6× |
| Osseous survey limited (77074) |
$581.73 |
$581.73 |
5.3× |
| Parathyrd planar w/spect&CT (78072) |
$2,305.08 |
$2,305.08 |
4.1× |
| Parathyroid Planar Imaging (78070) |
$1,184.56 |
$1,184.56 |
2.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,760.83 |
$1,760.83 |
4.2× |
| Pelvis 1 or 2 views (72170) |
$1,280.97 |
$1,280.97 |
11.7× |
| Perineogram (74775) |
$2,833.35 |
$2,833.35 |
11.4× |
| Peritoneogram after injection (74190) |
$5,928.41 |
$5,928.41 |
10.4× |
| PET image w/CT, skull-thigh (78815) |
$24,121.72 |
$24,121.72 |
16.2× |
| PET imaging CT for attenuation limited area (78814) |
$14,593.75 |
$14,593.75 |
9.8× |
| PET imaging for CT attenuation whole body (78816) |
$26,801.92 |
$26,801.92 |
17.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$11,728.14 |
$11,728.14 |
8.7× |
| PET whole body (78813) |
$20,101.44 |
$20,101.44 |
13.5× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$3,350.28 |
$3,350.28 |
2.5× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$18,761.34 |
$18,761.34 |
12.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$26,854.65 |
$26,854.65 |
8.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$26,854.65 |
$26,854.65 |
8.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$3,083.23 |
$3,083.23 |
7.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,878.56 |
$3,878.56 |
6.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,761.45 |
$1,761.45 |
3.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$1,669.55 |
$1,669.55 |
18.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$962.28 |
$962.28 |
10.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$1,259.62 |
$1,259.62 |
13.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$1,556.42 |
$1,556.42 |
17.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$2,188.66 |
$2,188.66 |
20.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$3,120.93 |
$3,120.93 |
28.6× |
| Radex fingr minimum 2 views (73140) |
$955.54 |
$955.54 |
10.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$1,139.24 |
$1,139.24 |
12.5× |
| Radex Hand Minimum 3 Views (73130) |
$1,231.66 |
$1,231.66 |
13.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$1,707.62 |
$1,707.62 |
18.8× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$2,728.35 |
$2,728.35 |
25.0× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$1,269.31 |
$1,269.31 |
11.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,784.97 |
$1,784.97 |
16.4× |
| Radex Humerus Minimum 2 Views (73060) |
$1,493.37 |
$1,493.37 |
16.4× |
| Radex Kne 1/2 Views (73560) |
$1,233.39 |
$1,233.39 |
13.6× |
| Radex Kne Compl 4/More Views (73564) |
$1,739.51 |
$1,739.51 |
15.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$2,445.26 |
$2,445.26 |
22.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$1,341.54 |
$1,341.54 |
14.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$1,967.61 |
$1,967.61 |
18.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$1,868.10 |
$1,868.10 |
20.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$1,056.67 |
$1,056.67 |
11.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$431.61 |
$431.61 |
4.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$1,096.69 |
$1,096.69 |
12.1× |
| Radex Toe Minimum 2 Views (73660) |
$888.16 |
$888.16 |
9.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$837.89 |
$837.89 |
7.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$1,597.04 |
$1,597.04 |
17.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$3,139.90 |
$3,139.90 |
28.8× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) |
$35,192.81 |
$35,192.81 |
4.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$28,702.20 |
$28,702.20 |
3.7× |
| Radiation treatment delivery level 1 (77402) |
$703.14 |
$703.14 |
6.6× |
| Radiation treatment delivery level 2 (77407) |
$938.60 |
$938.60 |
2.3× |
| Radiation treatment delivery level 3 (77412) |
$1,516.22 |
$1,516.22 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$978.47 |
$978.47 |
10.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,430.07 |
$1,430.07 |
13.1× |
| Radiologic exam chest 2 views (71046) |
$1,158.09 |
$1,158.09 |
12.7× |
| Radiologic exam colon single contrast study (74270) |
$1,594.07 |
$1,594.07 |
8.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$2,057.13 |
$2,057.13 |
11.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,516.80 |
$1,516.80 |
8.3× |
| Radiologic examination femur 1 view (73551) |
$954.28 |
$954.28 |
10.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$1,418.45 |
$1,418.45 |
15.6× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$1,494.73 |
$1,494.73 |
13.7× |
| Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) |
$3,149.19 |
$3,149.19 |
12.6× |
| Radiological examination surgical specimen (76098) |
$1,761.45 |
$1,761.45 |
3.1× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion Non-Facility (79403) |
$3,246.03 |
$3,246.03 |
13.3× |
| Red cell volume determination (separate procedure); multiple samplings Non-Facility (78121) |
$1,192.56 |
$1,192.56 |
2.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$3,082.61 |
$3,082.61 |
7.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$3,082.61 |
$3,082.61 |
7.7× |
| Renal Cyst Study (74470) |
$5,928.41 |
$5,928.41 |
10.4× |
| Ribs bilateral 3 views (71110) |
$1,468.50 |
$1,468.50 |
13.5× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$2,047.30 |
$2,047.30 |
4.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,249.78 |
$2,249.78 |
5.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,104.69 |
$3,104.69 |
5.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,452.26 |
$2,452.26 |
4.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,329.67 |
$3,329.67 |
5.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,454.56 |
$4,454.56 |
3.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$997.17 |
$997.17 |
4.1× |
| Rp Therapy Intravenous Administration (79101) |
$2,443.15 |
$2,443.15 |
10.0× |
| Sacroiliac Joints < 3 Views (72200) |
$664.50 |
$664.50 |
6.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$2,833.35 |
$2,833.35 |
11.4× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$1,116.50 |
$1,116.50 |
2.7× |
| Scapula (73010) |
$923.52 |
$923.52 |
8.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$218.99 |
$218.99 |
9.4× |
| Shoulder 1 view (73020) |
$566.11 |
$566.11 |
6.2× |
| Simulation intermediate (77285) |
$1,508 |
$1,508 |
3.9× |
| Small bowel series (74250) |
$1,903.56 |
$1,903.56 |
10.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,624.09 |
$1,624.09 |
4.2× |
| Special dosimetry (77331) |
$942.28 |
$942.28 |
6.7× |
| Special Physics Consult (77370) |
$1,661.78 |
$1,661.78 |
11.8× |
| Special treatment procedure (77470) |
$3,449 |
$3,449 |
6.0× |
| Speech evaluation complex (70371) |
$917.20 |
$917.20 |
3.7× |
| Spine thoracic 3 views (72072) |
$2,117.56 |
$2,117.56 |
19.4× |
| Splenoportograpy rs&i (75810) |
$26,854.65 |
$26,854.65 |
8.1× |
| Stereotactic Body Radiation Delivery (77373) |
$10,119.58 |
$10,119.58 |
5.4× |
| Superior sagittal sinus venogram (75870) |
$26,854.65 |
$26,854.65 |
8.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$728.14 |
$728.14 |
6.8× |
| Tbs technical calculation only (77091) |
$299 |
$299 |
3.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,770.01 |
$1,770.01 |
4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,223.91 |
$1,223.91 |
3.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,131.28 |
$2,131.28 |
5.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,068.79 |
$1,068.79 |
7.6× |
| Thoracolumbar 2 views (72080) |
$1,631.43 |
$1,631.43 |
18.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$3,425.59 |
$3,425.59 |
6.0× |
| Thyroid imaging w/blood flow (78013) |
$3,951.75 |
$3,951.75 |
9.5× |
| Thyroid uptake measurement (78012) |
$4,194.99 |
$4,194.99 |
10.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,186.03 |
$1,186.03 |
2.8× |
| Tmj unilateral (70328) |
$1,096.69 |
$1,096.69 |
12.1× |
| Tomogram (76100) |
$1,344.82 |
$1,344.82 |
12.3× |
| Treatment device complex (77334) |
$3,681.61 |
$3,681.61 |
9.4× |
| Treatment device intermediate (77333) |
$1,022.18 |
$1,022.18 |
7.3× |
| Treatment devices simple (77332) |
$711.32 |
$711.32 |
5.1× |
| Ultrasound breast complete (76641) |
$2,331.74 |
$2,331.74 |
21.4× |
| Ultrasound Exam Aaa Screen (76706) |
$1,066.77 |
$1,066.77 |
9.8× |
| Ultrasound, abdomen limited (76705) |
$2,532.21 |
$2,532.21 |
23.2× |
| Umbilical-artery Doppler (OB) (76820) |
$1,785.59 |
$1,785.59 |
16.4× |
| Unlisted fluoroscopic procedure (76496) |
$986.70 |
$986.70 |
10.9× |
| Unlisted magnetic resonance procedure (76498) |
$986.70 |
$986.70 |
10.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$359.25 |
$359.25 |
32.5× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$1,457.22 |
$1,457.22 |
15.4× |
| Ureteral reflux study (78740) |
$3,951.75 |
$3,951.75 |
9.5× |
| Urethrocystogram voiding (74455) |
$1,558.31 |
$1,558.31 |
6.3× |
| Urethrocystography retrograde rs&i (74450) |
$2,833.35 |
$2,833.35 |
11.4× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$1,646.31 |
$1,646.31 |
9.0× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,778.26 |
$1,778.26 |
9.7× |
| Us breast unilateral limited (76642) |
$1,553.45 |
$1,553.45 |
17.1× |
| Us chest (76604) |
$1,893.70 |
$1,893.70 |
17.3× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$2,194.29 |
$2,194.29 |
9.7× |
| Us compl joint r-t w/image documentation (76881) |
$1,943.72 |
$1,943.72 |
17.8× |
| Us elastography parenchyma (76981) |
$1,344.82 |
$1,344.82 |
12.3× |
| Us encephalogram (76506) |
$1,872.60 |
$1,872.60 |
17.2× |
| Us hips infant static (76886) |
$986.70 |
$986.70 |
10.9× |
| Us infant hips w manipulation (76885) |
$1,580.20 |
$1,580.20 |
17.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$1,880 |
$1,880 |
17.2× |
| Us ob detailed single fetus (76811) |
$3,198.77 |
$3,198.77 |
12.8× |
| Us ob limited (76815) |
$1,180.21 |
$1,180.21 |
10.8× |
| Us ob transvaginal (76817) |
$1,728.92 |
$1,728.92 |
15.8× |
| Us pelvic non ob complete (76856) |
$2,785.92 |
$2,785.92 |
25.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,791.06 |
$1,791.06 |
16.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,652.08 |
$1,652.08 |
15.1× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$1,414.91 |
$1,414.91 |
13.0× |
| Us retroperitoneal complete (76770) |
$2,706.27 |
$2,706.27 |
24.8× |
| Us retroperitoneal limited (76775) |
$2,267.71 |
$2,267.71 |
20.8× |
| Us scrotum and contents (76870) |
$2,229.12 |
$2,229.12 |
20.4× |
| Us soft tissue head/neck (76536) |
$2,443.11 |
$2,443.11 |
22.4× |
| Us spinal canal and contents (76800) |
$1,381.02 |
$1,381.02 |
12.7× |
| Us transrectal (76872) |
$1,282.98 |
$1,282.98 |
11.8× |
| Us transrectal prostate volume (76873) |
$1,344.82 |
$1,344.82 |
12.3× |
| Us, eye b-scan (76512) |
$1,344.82 |
$1,344.82 |
12.3× |
| Us,transplanted kidney, real time/ doppler (76776) |
$2,294.20 |
$2,294.20 |
21.0× |
| Venogram adrenal unilat (75840) |
$26,854.65 |
$26,854.65 |
8.1× |
| Venogram extremity bilateral (75822) |
$6,080.06 |
$6,080.06 |
3.7× |
| Venogram Extremity Unilateral (75820) |
$4,342.90 |
$4,342.90 |
2.6× |
| Venography caval inferior serialography rs&i (75825) |
$8,023.82 |
$8,023.82 |
2.4× |
| Venography caval superior serialography rs&i (75827) |
$12,975.70 |
$12,975.70 |
7.9× |
| Venography Orbital Rs&I (75880) |
$6,317.82 |
$6,317.82 |
9.6× |
| Venography Renal Bilateral (75833) |
$26,854.65 |
$26,854.65 |
8.1× |
| Venography renal unilateral selective rs&i (75831) |
$26,854.65 |
$26,854.65 |
8.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$26,854.65 |
$26,854.65 |
8.1× |
| Venography, epidural, radiological supervision and interpretation Non-Facility (75872) |
$6,317.82 |
$6,317.82 |
9.6× |
| Venous sampling by catheter (75893) |
$46,619.20 |
$46,619.20 |
8.0× |
| Vertebral fracture assessment via dxa (77086) |
$986.70 |
$986.70 |
10.9× |
| Wrist 2 views (73100) |
$1,329.28 |
$1,329.28 |
14.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,693.50 |
$1,693.50 |
15.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,096.69 |
$1,096.69 |
12.1× |
| X-ray b.e. reductn intuss (74283) |
$1,646.31 |
$1,646.31 |
9.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,258.21 |
$2,258.21 |
12.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,197.98 |
$1,197.98 |
13.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$2,240.42 |
$2,240.42 |
24.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,665.96 |
$1,665.96 |
15.3× |
| X-ray exam of femur 2/> (73552) |
$1,433.45 |
$1,433.45 |
15.8× |
| X-ray eye for foreign body (70030) |
$986.70 |
$986.70 |
10.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$2,488.23 |
$2,488.23 |
27.4× |
| X-ray IV pyelogram (ivp) (74400) |
$1,646.31 |
$1,646.31 |
9.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$1,043.34 |
$1,043.34 |
11.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$2,366.62 |
$2,366.62 |
26.0× |
| X-ray leg, infant (73592) |
$1,026 |
$1,026 |
11.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,857.44 |
$1,857.44 |
17.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$2,843.17 |
$2,843.17 |
26.0× |
| X-ray nose-rectum child f.b. (76010) |
$506.47 |
$506.47 |
5.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,956.71 |
$1,956.71 |
17.9× |
| X-ray retrograde pyelogram (74420) |
$1,252.72 |
$1,252.72 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,044.77 |
$1,044.77 |
11.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$2,223.77 |
$2,223.77 |
20.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$2,447.82 |
$2,447.82 |
22.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,123.95 |
$1,123.95 |
10.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,662.46 |
$1,662.46 |
18.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$2,055.21 |
$2,055.21 |
22.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$2,283.89 |
$2,283.89 |
20.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$2,046.21 |
$2,046.21 |
18.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$1,134.39 |
$1,134.39 |
12.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$982.20 |
$982.20 |
10.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$1,580.12 |
$1,580.12 |
17.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,187.03 |
$1,187.03 |
10.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$2,282.84 |
$2,282.84 |
20.9× |
| Xr bone length studies (77073) |
$895.42 |
$895.42 |
8.2× |
| Xr c-spine 4 or 5 views (72050) |
$2,243.62 |
$2,243.62 |
20.6× |
| Xr c-spine 6 or more views (72052) |
$2,476.05 |
$2,476.05 |
22.7× |
| Xr chest 4+ views (71048) |
$1,344.82 |
$1,344.82 |
12.3× |
| Xr urogram antegrade (74425) |
$1,700.88 |
$1,700.88 |
4.7× |