| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$11,229.12 |
$11,229.12 |
7.8× |
| 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× |
| Angio adrenal unilat select (75731) |
$26,854.65 |
$26,854.65 |
8.1× |
| Angio extremity unilateral (75710) |
$8,023.82 |
$8,023.82 |
2.4× |
| Angio pulmonary unilateral (75741) |
$8,121.80 |
$8,121.80 |
2.5× |
| Angiogram extremity bilateral (75716) |
$9,864.54 |
$9,864.54 |
3.0× |
| Angiogram pelvic (75736) |
$14,090.10 |
$14,090.10 |
2.4× |
| Angiography internal mammary rs&i (75756) |
$8,023.82 |
$8,023.82 |
2.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,495.69 |
$9,495.69 |
2.9× |
| 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× |
| Aortography thoracic w/o serialography rs&i (75600) |
$8,023.82 |
$8,023.82 |
2.4× |
| Arthrography knee lt (73580) |
$3,495.47 |
$3,495.47 |
9.6× |
| Arthrography wrist lt (73115) |
$3,425.21 |
$3,425.21 |
9.4× |
| Barium enema (74270) |
$1,594.07 |
$1,594.07 |
8.7× |
| Basic dosimetry (77300) |
$817.14 |
$817.14 |
5.8× |
| Bilat selctv renal venogram (75833) |
$26,854.65 |
$26,854.65 |
8.1× |
| Bone age studies (77072) |
$773.97 |
$773.97 |
7.1× |
| Bone imaging limited area (78300) |
$1,530.24 |
$1,530.24 |
3.7× |
| Bone survey complete (77075) |
$875.44 |
$875.44 |
8.0× |
| Bowel imaging (78290) |
$1,916.52 |
$1,916.52 |
4.6× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$1,985.79 |
$1,985.79 |
5.1× |
| Brain flow imaging only - nm brain flow only brain death (78610) |
$1,305.79 |
$1,305.79 |
2.3× |
| Brain image w/flow 4 + views (78606) |
$4,228.74 |
$4,228.74 |
7.5× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$3,951.75 |
$3,951.75 |
9.5× |
| Card MRI w/stress img & dye (75563) |
$7,308.76 |
$7,308.76 |
8.9× |
| 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 blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or… (78481) |
$3,654.02 |
$3,654.02 |
6.4× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$5,440.42 |
$5,440.42 |
13.0× |
| Cardiac MRI w/stress img (75559) |
$5,928.41 |
$5,928.41 |
10.4× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$3,602.24 |
$3,602.24 |
9.9× |
| Cerebrospinal fluid leakage (78650) |
$11,728.14 |
$11,728.14 |
8.7× |
| Cholecystography, oral contrast Other Diagnostic Radiology FS (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× |
| Cisternogram (78630) |
$4,191.86 |
$4,191.86 |
7.4× |
| Cisternography, positive contrast, radiological supervision and interpretation Other Diagnostic Radiology FS (70015) |
$7,308.76 |
$7,308.76 |
8.9× |
| Clavicle complete (73000) |
$1,063.59 |
$1,063.59 |
11.7× |
| Computed tomographic (CT) colonography, screening, including image postprocessing UNSCHEDULED (74263) |
$3,401.46 |
$3,401.46 |
13.7× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Age Under 21 (77078) |
$1,083.82 |
$1,083.82 |
11.9× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$8,461.54 |
$8,461.54 |
46.2× |
| Continuing medical physics consltj pr wk (77336) |
$1,162.11 |
$1,162.11 |
8.3× |
| Contrast exam abdominl aorta (75625) |
$8,023.82 |
$8,023.82 |
2.4× |
| Contrast exam thoracic aorta (75605) |
$14,090.10 |
$14,090.10 |
2.4× |
| Corpora cavernosography (74445) |
$1,344.82 |
$1,344.82 |
12.3× |
| Csf shunt evaluation (78645) |
$1,429.79 |
$1,429.79 |
2.5× |
| CT - st neck w&wo contr (70492) |
$9,292.69 |
$9,292.69 |
50.7× |
| 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 wo contrast (74170) |
$7,925.34 |
$7,925.34 |
43.3× |
| CT abdomen w/contrast (74160) |
$5,541.51 |
$5,541.51 |
30.3× |
| CT abdomen w/o contrast (74150) |
$6,844.73 |
$6,844.73 |
62.7× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$14,348.12 |
$14,348.12 |
39.4× |
| CT angio abdom w/o & w/dye (74175) |
$10,680.65 |
$10,680.65 |
58.3× |
| CT angio abdominal arteries (75635) |
$14,101.57 |
$14,101.57 |
77.0× |
| CT angio hrt w/3d image (75574) |
$1,808.35 |
$1,808.35 |
5.0× |
| CT angiograph pelv w/o&w/dye (72191) |
$7,279.87 |
$7,279.87 |
39.7× |
| CT cervical spine w/contrast (72126) |
$5,722.93 |
$5,722.93 |
15.7× |
| CT cervical spine w/o contrast (72125) |
$8,334.18 |
$8,334.18 |
76.3× |
| CT chest w/contrast (71260) |
$7,880.57 |
$7,880.57 |
43.0× |
| CT colonography diag w cont (74262) |
$1,808.35 |
$1,808.35 |
9.9× |
| CT colonography w/o cntrst (74261) |
$1,477.19 |
$1,477.19 |
13.5× |
| CT extremity upper w & w/o contrast (73202) |
$8,831.99 |
$8,831.99 |
48.2× |
| 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 limited/localized follow up study (76380) |
$2,572.71 |
$2,572.71 |
28.3× |
| CT lower ext w/wo contrast (73702) |
$9,027.48 |
$9,027.48 |
49.3× |
| CT lower extremity w contrast (73701) |
$7,902.23 |
$7,902.23 |
43.1× |
| CT lower extremity w/o contrast unilateral (73700) |
$6,771.08 |
$6,771.08 |
62.0× |
| 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 lumbar spine w/o then w/ con (72133) |
$10,728.83 |
$10,728.83 |
58.6× |
| CT maxillofacial area w/o contrast (70486) |
$6,904.22 |
$6,904.22 |
63.2× |
| CT maxillofacial w/contrast (70487) |
$8,411.53 |
$8,411.53 |
45.9× |
| CT maxillofacial w/o then w/ con (70488) |
$9,590.02 |
$9,590.02 |
52.4× |
| CT orbit sella ear w/o con (70480) |
$7,225.50 |
$7,225.50 |
66.2× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$9,665.73 |
$9,665.73 |
52.8× |
| CT pelvis w & w/o contrast (72194) |
$8,325.53 |
$8,325.53 |
45.5× |
| CT pelvis w/o contrast (72192) |
$7,492.98 |
$7,492.98 |
68.6× |
| CT soft tissue neck w/contrast (70491) |
$8,657.33 |
$8,657.33 |
47.3× |
| CT soft tissue neck w/o contrast (70490) |
$7,022.49 |
$7,022.49 |
64.3× |
| CT spine cervical w/wo contrast (72127) |
$10,596.31 |
$10,596.31 |
57.8× |
| 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/o then w/ con (72130) |
$8,980.80 |
$8,980.80 |
49.0× |
| CT thorax lung cancer scr c- (71271) |
$2,046.32 |
$2,046.32 |
18.7× |
| CT thorax w/o contrast (71250) |
$5,123.82 |
$5,123.82 |
46.9× |
| CT thorax w/o then w/ contrast (71270) |
$6,296.33 |
$6,296.33 |
34.4× |
| CT upper extremity w/dye (73201) |
$8,338.78 |
$8,338.78 |
22.9× |
| CT upper extremity w/o contrast rt (73200) |
$6,646.48 |
$6,646.48 |
60.9× |
| CTA chest w/wo contrast (71275) |
$6,296.33 |
$6,296.33 |
34.4× |
| CTA head w contrast (70496) |
$10,926.81 |
$10,926.81 |
59.7× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$5,707.05 |
$5,707.05 |
31.2× |
| Cta Neck (70498) |
$13,196.26 |
$13,196.26 |
72.0× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$6,197.28 |
$6,197.28 |
33.8× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Other Diagnostic Radiology FS (70170) |
$2,833.35 |
$2,833.35 |
11.4× |
| Dilation ureters/urethra rs&i (74485) |
$5,559.71 |
$5,559.71 |
2.5× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) |
$22,966.31 |
$22,966.31 |
11.3× |
| Diskography lumbar (72295) |
$6,598.98 |
$6,598.98 |
3.2× |
| Doppler echo fetal spectral display complete (76827) |
$1,344.82 |
$1,344.82 |
12.3× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$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 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× |
| Esophogram (74220) |
$1,102.75 |
$1,102.75 |
6.0× |
| Fetal biophysical profile non-stress testing (76818) |
$1,791.80 |
$1,791.80 |
16.4× |
| Fetal biophysical profile w/o nst (76819) |
$1,421.84 |
$1,421.84 |
13.0× |
| Fetal echo complete (76825) |
$5,928.41 |
$5,928.41 |
10.4× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$1,525.57 |
$1,525.57 |
6.1× |
| 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× |
| Gastric emptying study (78264) |
$4,998.76 |
$4,998.76 |
12.0× |
| Gastroesophageal reflux study (78262) |
$3,951.75 |
$3,951.75 |
9.5× |
| Gated heart planar single (78472) |
$3,654.02 |
$3,654.02 |
8.8× |
| 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 infarct image (78466) |
$3,951.75 |
$3,951.75 |
9.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$8,023.82 |
$8,023.82 |
2.4× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$8,023.82 |
$8,023.82 |
2.4× |
| Hepatobil syst image w/drug (78227) |
$4,656.91 |
$4,656.91 |
8.2× |
| Hepatobiliary system imaging (78226) |
$1,891.53 |
$1,891.53 |
4.5× |
| Humerus min 2 views (73060) |
$1,493.37 |
$1,493.37 |
16.4× |
| Hysterosalpingography (74740) |
$1,742.59 |
$1,742.59 |
7.0× |
| Imrt planning (77301) |
$16,618.24 |
$16,618.24 |
11.5× |
| Infusion of radioelement (77750) |
$1,581.48 |
$1,581.48 |
3.9× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$3,951.75 |
$3,951.75 |
9.5× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (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× |
| Intraoperative radiation treatment delivery, x-ray, single treatment session 2nd-5th Sessions (77424) |
$35,192.81 |
$35,192.81 |
4.6× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$1,614.62 |
$1,614.62 |
4.1× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$1,358.39 |
$1,358.39 |
3.5× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$1,770.01 |
$1,770.01 |
4.5× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$1,223.91 |
$1,223.91 |
3.1× |
| Ivp (74400) |
$1,646.31 |
$1,646.31 |
9.0× |
| Ivp w tomography (74415) |
$1,778.26 |
$1,778.26 |
9.7× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,977.66 |
$1,977.66 |
3.5× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,651.16 |
$1,651.16 |
2.9× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,755.85 |
$1,755.85 |
3.1× |
| Kidney w vascular flow (78701) |
$1,521.22 |
$1,521.22 |
3.6× |
| Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) Age Under 21 (78140) |
$1,116.50 |
$1,116.50 |
2.7× |
| Liver & spleen; static only (78215) |
$1,592.04 |
$1,592.04 |
3.8× |
| Liver & spleen; w vasc 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 ventilat&perfus imaging (78582) |
$3,878.56 |
$3,878.56 |
6.8× |
| Lung ventilation imaging (78579) |
$3,951.75 |
$3,951.75 |
9.5× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75803) |
$12,975.70 |
$12,975.70 |
7.9× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75801) |
$6,317.82 |
$6,317.82 |
9.6× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75807) |
$26,854.65 |
$26,854.65 |
8.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$26,854.65 |
$26,854.65 |
8.1× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$8,040.57 |
$8,040.57 |
22.1× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$6,387.80 |
$6,387.80 |
17.5× |
| Mammary ductogram multiple ducts (77054) |
$2,833.35 |
$2,833.35 |
11.4× |
| Mammary ductogram single (77053) |
$2,833.35 |
$2,833.35 |
11.4× |
| Mlc device(s) for imrt (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/contrast (70545) |
$7,318.03 |
$7,318.03 |
20.1× |
| MRA head w/o contrast (70544) |
$5,763.15 |
$5,763.15 |
23.1× |
| MRA neck w/contrast (70548) |
$7,421.40 |
$7,421.40 |
20.4× |
| MRA neck w/o contrast (70547) |
$4,417.07 |
$4,417.07 |
17.7× |
| MRA neck w/wo contrast (70549) |
$7,738.49 |
$7,738.49 |
21.2× |
| 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 jnt lwr ext with con lt (73722) |
$7,308.76 |
$7,308.76 |
8.9× |
| MRI breast without contrast bilateral (77047) |
$5,222.75 |
$5,222.75 |
21.0× |
| MRI breast without contrast material unilateral (77046) |
$2,833.35 |
$2,833.35 |
11.4× |
| 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 cervical spine with contrast (72142) |
$6,554.38 |
$6,554.38 |
18.0× |
| MRI chest w & w/o contrast (71552) |
$7,513.52 |
$7,513.52 |
20.6× |
| MRI chest w/contrast (71551) |
$7,308.76 |
$7,308.76 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,833.35 |
$2,833.35 |
11.4× |
| MRI elastography (76391) |
$785.61 |
$785.61 |
3.2× |
| MRI fetal sngl/1st gestation (74712) |
$2,833.35 |
$2,833.35 |
11.4× |
| MRI joint upper ext w/contrast (73222) |
$5,896.42 |
$5,896.42 |
7.2× |
| MRI joint upr extr w/o&w/dye (73223) |
$7,607.01 |
$7,607.01 |
20.9× |
| MRI joint upr extrem w/o dye (73221) |
$3,342.78 |
$3,342.78 |
13.4× |
| Mri Lower Extremity W/O Dye (73718) |
$5,849.33 |
$5,849.33 |
23.5× |
| MRI lumbar spine with contrast (72149) |
$6,783.32 |
$6,783.32 |
18.6× |
| MRI lumbar w/wo contrast (72158) |
$8,443.80 |
$8,443.80 |
23.2× |
| MRI lwr ext w/o jnts with con rt (73719) |
$6,164.45 |
$6,164.45 |
16.9× |
| MRI orbit/face/neck w/contrast (70542) |
$5,940.95 |
$5,940.95 |
16.3× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$7,877.64 |
$7,877.64 |
21.6× |
| MRI orbit/face/neck w/o contrast (70540) |
$4,946.43 |
$4,946.43 |
19.9× |
| MRI pelvis w/ contrast (72196) |
$6,098.47 |
$6,098.47 |
16.7× |
| MRI pelvis w/o contrast (72195) |
$5,191.26 |
$5,191.26 |
20.8× |
| MRI pelvis w/wo contrast (72197) |
$7,761.69 |
$7,761.69 |
21.3× |
| MRI spectroscopy (76390) |
$6,477.52 |
$6,477.52 |
71.3× |
| MRI spine cervical wo/w contrast (72156) |
$4,537.69 |
$4,537.69 |
12.5× |
| MRI spine thoracic w/contrast (72147) |
$6,617.86 |
$6,617.86 |
18.2× |
| MRI thoracic spine w wo contrast (72157) |
$8,270.26 |
$8,270.26 |
22.7× |
| MRI thoracic spine w/o contrast (72146) |
$5,992.06 |
$5,992.06 |
24.0× |
| MRI tmj (70336) |
$2,232.73 |
$2,232.73 |
9.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,753.13 |
$4,753.13 |
19.1× |
| Mri Upper Extremity W/Dye (73219) |
$5,673.90 |
$5,673.90 |
15.6× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$7,515.42 |
$7,515.42 |
20.6× |
| 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× |
| Myelography lumbosacral (72265) |
$4,974.35 |
$4,974.35 |
6.1× |
| 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 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 single study at rest or stress (78451) |
$4,819.89 |
$4,819.89 |
3.6× |
| Myocrd img PET metab eval single study (78459) |
$11,728.14 |
$11,728.14 |
8.7× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$12,607.33 |
$12,607.33 |
14.1× |
| Nm bone 3 phase (78315) |
$2,508.89 |
$2,508.89 |
6.0× |
| Nm bone imaging whole body (78306) |
$2,099.64 |
$2,099.64 |
5.0× |
| Nm bone marrow scan limited (78102) |
$3,951.75 |
$3,951.75 |
9.5× |
| Nm bone multi (78305) |
$2,028.46 |
$2,028.46 |
4.9× |
| Nm heart perfusion spect stress rest (78452) |
$11,728.14 |
$11,728.14 |
8.7× |
| Nm kidney function (78725) |
$3,951.75 |
$3,951.75 |
9.5× |
| Nm lymph system (78195) |
$6,360.96 |
$6,360.96 |
11.2× |
| Nm myocard infarct spect (78469) |
$4,228.74 |
$4,228.74 |
7.5× |
| Nm thyroid imaging only (78013) |
$3,951.75 |
$3,951.75 |
9.5× |
| Nose to rectum for fb child (76010) |
$506.47 |
$506.47 |
5.6× |
| Nuclear medicine study of salivary gland with serial images (78231) |
$1,116.50 |
$1,116.50 |
2.7× |
| Nuclear rx IV admin (79101) |
$2,443.15 |
$2,443.15 |
10.0× |
| Ob us < 14 wks single fetus (76801) |
$1,652.08 |
$1,652.08 |
15.1× |
| Ob us nuchal meas 1 gest (76813) |
$1,851.28 |
$1,851.28 |
17.0× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$1,344.82 |
$1,344.82 |
12.3× |
| Oral radiopharm rx (79005) |
$3,213.70 |
$3,213.70 |
13.2× |
| Orthopantogram (70355) |
$783.49 |
$783.49 |
8.6× |
| Parathyrd planar w/spect&CT (78072) |
$2,305.08 |
$2,305.08 |
4.1× |
| Parathyroid 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× |
| Peritoneal-venous shunt patency test (78291) |
$3,951.75 |
$3,951.75 |
9.5× |
| Peritoneogram rs&i (74190) |
$5,928.41 |
$5,928.41 |
10.4× |
| PET brain metabolic eval (78608) |
$14,593.75 |
$14,593.75 |
9.8× |
| PET imaging CT attenuation skull base mid-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 imaging whole body (78813) |
$20,101.44 |
$20,101.44 |
13.5× |
| Plasma volume multiple (78111) |
$3,350.28 |
$3,350.28 |
2.5× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Age Under 21 (78812) |
$18,761.34 |
$18,761.34 |
12.6× |
| 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× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,761.45 |
$1,761.45 |
3.1× |
| 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 entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$3,139.90 |
$3,139.90 |
28.8× |
| Radex hip unilateral with pelvis 1 view (73501) |
$1,707.62 |
$1,707.62 |
18.8× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$2,240.42 |
$2,240.42 |
24.7× |
| 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 spine cervical 2 or 3 views (72040) |
$2,020.82 |
$2,020.82 |
22.2× |
| Radex spine cervical 4 or 5 views (72050) |
$2,243.62 |
$2,243.62 |
20.6× |
| Radex spine cervical 6 or more views (72052) |
$2,476.05 |
$2,476.05 |
22.7× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$1,631.43 |
$1,631.43 |
18.0× |
| Radiation delivery stereotactic cranial linear (77372) |
$28,702.20 |
$28,702.20 |
3.7× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77371) |
$35,192.81 |
$35,192.81 |
4.6× |
| Radiation tx delivery lvl 1 (77402) |
$703.14 |
$703.14 |
6.6× |
| Radiation tx delivery lvl 2 (77407) |
$938.60 |
$938.60 |
2.3× |
| Radiation tx delivery lvl 3 (77412) |
$1,516.22 |
$1,516.22 |
2.6× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$1,344.82 |
$1,344.82 |
12.3× |
| Radiologic exam phrnx&/crv esoph contrast study (74210) |
$1,646.31 |
$1,646.31 |
9.0× |
| 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 - Xr Femur 1 Vw Right (73551) |
$954.28 |
$954.28 |
10.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,433.45 |
$1,433.45 |
15.8× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$1,693.50 |
$1,693.50 |
15.5× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) |
$1,344.82 |
$1,344.82 |
12.3× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$2,282.84 |
$2,282.84 |
20.9× |
| Radiologic examination, teeth; partial examination, less than full mouth Other Diagnostic Radiology FS (70310) |
$3,149.19 |
$3,149.19 |
12.6× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion UNSCHEDULED (79403) |
$3,246.03 |
$3,246.03 |
13.3× |
| Red cell mass multiple (78121) |
$1,192.56 |
$1,192.56 |
2.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$3,082.61 |
$3,082.61 |
7.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$3,082.61 |
$3,082.61 |
7.7× |
| Renal cyst study (74470) |
$5,928.41 |
$5,928.41 |
10.4× |
| 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× |
| Saline infused sonohysterogram (76831) |
$2,833.35 |
$2,833.35 |
11.4× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$218.99 |
$218.99 |
9.4× |
| Selective spinal angiogram (75705) |
$46,619.20 |
$46,619.20 |
8.0× |
| Shoulder arthrogram (73040) |
$1,337.76 |
$1,337.76 |
3.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,344.82 |
$1,344.82 |
12.3× |
| Simulation complex (77290) |
$2,131.28 |
$2,131.28 |
5.5× |
| Simulation intermediate (77285) |
$1,508 |
$1,508 |
3.9× |
| Simulation simple (77280) |
$1,068.79 |
$1,068.79 |
7.6× |
| 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× |
| Splenoportography (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 application of low dose rate radionuclide source 2nd-5th Sessions (77789) |
$728.14 |
$728.14 |
6.8× |
| Tbs technical calculation only (77091) |
$299 |
$299 |
3.3× |
| Therapeutic enema barium or air (74283) |
$1,646.31 |
$1,646.31 |
9.0× |
| Thyroid met imaging body (78018) |
$3,425.59 |
$3,425.59 |
6.0× |
| Thyroid uptake single/multiple quant 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× |
| Treatment device intermediate (77333) |
$1,022.18 |
$1,022.18 |
7.3× |
| Treatment devices complex (77334) |
$3,681.61 |
$3,681.61 |
9.4× |
| Treatment devices simple (77332) |
$711.32 |
$711.32 |
5.1× |
| Ultrasound breast limited (76642) |
$1,553.45 |
$1,553.45 |
17.1× |
| 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 CT procedure (76497) |
$1,083.82 |
$1,083.82 |
11.9× |
| 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); acquisition for analysis Other Outpatient (78267) |
$359.25 |
$359.25 |
32.5× |
| Urea breath test, C-14 (isotopic); analysis Other Outpatient (78268) |
$1,457.22 |
$1,457.22 |
15.4× |
| Ureteral reflux study (78740) |
$3,951.75 |
$3,951.75 |
9.5× |
| Urethrocystography retrograde rs&i (74450) |
$2,833.35 |
$2,833.35 |
11.4× |
| Urethrocystography voiding (74455) |
$1,558.31 |
$1,558.31 |
6.3× |
| Urography antegrade (74425) |
$1,700.88 |
$1,700.88 |
4.7× |
| Urography retrograde w/wo kub (74420) |
$1,252.72 |
$1,252.72 |
3.4× |
| Urography, infusion, drip technique and/or bolus technique; Other Diagnostic Radiology FS (74410) |
$1,646.31 |
$1,646.31 |
9.0× |
| Us abdominal aorta real time screen study aaa (76706) |
$1,066.77 |
$1,066.77 |
9.8× |
| Us breast uni real time with image complete (76641) |
$2,331.74 |
$2,331.74 |
21.4× |
| Us chest (76604) |
$1,893.70 |
$1,893.70 |
17.3× |
| 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 guided compression repair (76936) |
$2,194.29 |
$2,194.29 |
9.7× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$1,580.20 |
$1,580.20 |
17.4× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$986.70 |
$986.70 |
10.9× |
| Us kidney transplanted (76776) |
$2,294.20 |
$2,294.20 |
21.0× |
| Us lmtd jt/fcl eval 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 followup per fetus (76816) |
$1,414.91 |
$1,414.91 |
13.0× |
| Us ob limited 1 or more fetuses (76815) |
$1,180.21 |
$1,180.21 |
10.8× |
| Us obstetric transvaginal (76817) |
$1,728.92 |
$1,728.92 |
15.8× |
| Us pelvic limited or f/u non-ob (76857) |
$1,791.06 |
$1,791.06 |
16.4× |
| Us pelvis complete (76856) |
$2,785.92 |
$2,785.92 |
25.5× |
| 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 (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 (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× |
| Vascular flow imaging (78445) |
$3,951.75 |
$3,951.75 |
9.5× |
| Vein X-ray liver w/hemodynam (75885) |
$26,854.65 |
$26,854.65 |
8.1× |
| Venogram epidural (75872) |
$6,317.82 |
$6,317.82 |
9.6× |
| Venogram extremity bilateral (75822) |
$6,080.06 |
$6,080.06 |
3.7× |
| Venogram ivc w serialography (75825) |
$8,023.82 |
$8,023.82 |
2.4× |
| Venogram svc w serialography (75827) |
$12,975.70 |
$12,975.70 |
7.9× |
| Venography adrenal unilateral selective rs&i (75840) |
$26,854.65 |
$26,854.65 |
8.1× |
| Venography ext unilateral (75820) |
$4,342.90 |
$4,342.90 |
2.6× |
| 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, orbital, radiological supervision and interpretation Other Diagnostic Radiology FS (75880) |
$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× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,096.69 |
$1,096.69 |
12.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,669.55 |
$1,669.55 |
18.4× |
| X-ray aorta leg arteries (75630) |
$8,023.82 |
$8,023.82 |
2.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,258.21 |
$2,258.21 |
12.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$1,259.62 |
$1,259.62 |
13.9× |
| X-ray exam hips bi 3-4 views (73522) |
$1,665.96 |
$1,665.96 |
15.3× |
| X-ray exam of finger(s) (73140) |
$955.54 |
$955.54 |
10.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$2,488.23 |
$2,488.23 |
27.4× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$1,031.47 |
$1,031.47 |
11.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,139.24 |
$1,139.24 |
12.5× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$1,125.12 |
$1,125.12 |
10.3× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$1,231.66 |
$1,231.66 |
13.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$962.28 |
$962.28 |
10.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$1,043.34 |
$1,043.34 |
11.5× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$1,478.60 |
$1,478.60 |
16.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,739.51 |
$1,739.51 |
15.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$2,366.62 |
$2,366.62 |
26.0× |
| 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 Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) |
$1,494.73 |
$1,494.73 |
13.7× |
| X-ray perineogram (74775) |
$2,833.35 |
$2,833.35 |
11.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,044.77 |
$1,044.77 |
11.5× |
| X-Ray Ribs, Chest 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 Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$664.50 |
$664.50 |
6.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,662.46 |
$1,662.46 |
18.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,868.10 |
$1,868.10 |
20.6× |
| 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 Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$982.20 |
$982.20 |
10.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$888.16 |
$888.16 |
9.8× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$1,329.28 |
$1,329.28 |
14.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,597.04 |
$1,597.04 |
17.6× |
| Xr abdomen 1 view (74018) |
$978.47 |
$978.47 |
10.8× |
| Xr abdomen 2 views (74019) |
$1,204.27 |
$1,204.27 |
11.0× |
| Xr abdomen 3 views (74021) |
$1,430.07 |
$1,430.07 |
13.1× |
| Xr arthrogram ankle (73615) |
$3,981.54 |
$3,981.54 |
10.9× |
| Xr arthrogram elbow (73085) |
$3,582.22 |
$3,582.22 |
9.8× |
| Xr arthrogram hip (73525) |
$2,698.83 |
$2,698.83 |
7.4× |
| Xr bone density appendicular (77081) |
$837.72 |
$837.72 |
9.2× |
| Xr bone density axial (77080) |
$1,476.02 |
$1,476.02 |
13.5× |
| Xr bone length study (77073) |
$895.42 |
$895.42 |
8.2× |
| Xr bone survey infant (77076) |
$1,422.31 |
$1,422.31 |
13.0× |
| Xr bone survey limited (77074) |
$581.73 |
$581.73 |
5.3× |
| Xr chest 1 view (71045) |
$865.98 |
$865.98 |
9.5× |
| Xr chest 2 views (71046) |
$1,158.09 |
$1,158.09 |
12.7× |
| Xr chest 3 views (71047) |
$1,291.86 |
$1,291.86 |
14.2× |
| Xr cystogram 3+ views (74430) |
$1,241.87 |
$1,241.87 |
3.4× |
| Xr eye foreign body (70030) |
$986.70 |
$986.70 |
10.9× |
| Xr facial bones 3 views (70150) |
$2,646.40 |
$2,646.40 |
24.2× |
| Xr lower extremity 2 views infant (73592) |
$1,026 |
$1,026 |
11.3× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$431.61 |
$431.61 |
4.0× |
| Xr mandible 4 views (70110) |
$2,445.26 |
$2,445.26 |
22.4× |
| Xr myelogram c-spine (72240) |
$4,806.90 |
$4,806.90 |
5.9× |
| Xr nasal bones (70160) |
$1,341.54 |
$1,341.54 |
14.8× |
| Xr pelvis 3 views (72190) |
$1,967.61 |
$1,967.61 |
18.0× |
| Xr spine 1 view (72020) |
$1,134.39 |
$1,134.39 |
12.5× |
| Xr sternum 2 views (71120) |
$1,580.12 |
$1,580.12 |
17.4× |
| Xr stress view joint (77071) |
$1,096.69 |
$1,096.69 |
12.1× |
| Xr surgical specimen (76098) |
$1,761.45 |
$1,761.45 |
3.1× |
| Xr upper extremity 2 views infant (73092) |
$837.89 |
$837.89 |
7.7× |
| Xray elbow 2 views (73070) |
$1,197.98 |
$1,197.98 |
13.2× |
| Xray forearm 2 views (73090) |
$1,282.89 |
$1,282.89 |
14.1× |
| Xray knee 1 or 2 views rt (73560) |
$1,233.39 |
$1,233.39 |
13.6× |
| Xray neck soft tissue (70360) |
$716.34 |
$716.34 |
7.9× |
| Xray orbits complete min 4 views (70200) |
$1,956.71 |
$1,956.71 |
17.9× |
| Xray pelvis 1 or 2 views (72170) |
$1,280.97 |
$1,280.97 |
11.7× |
| Xray ribs bilateral 3 views (71110) |
$1,468.50 |
$1,468.50 |
13.5× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$2,223.77 |
$2,223.77 |
20.4× |
| Xray scapula complete (73010) |
$923.52 |
$923.52 |
8.5× |
| Xray shoulder 1 view (73020) |
$566.11 |
$566.11 |
6.2× |
| Xray sinuses paranasal <3 views (70210) |
$1,056.67 |
$1,056.67 |
11.6× |
| Xray spine thoracic 2 views (72070) |
$1,187.03 |
$1,187.03 |
10.9× |
| Xray spine thoracic 3 views (72072) |
$2,117.56 |
$2,117.56 |
19.4× |
| Xray tibia-fibula 2 views bil (73590) |
$1,418.45 |
$1,418.45 |
15.6× |
| Xray tmj open - closed unilat (70328) |
$1,096.69 |
$1,096.69 |
12.1× |
| Xray tmj's bilateral open-clsc (70330) |
$1,096.69 |
$1,096.69 |
12.1× |