| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,347.06 |
$6,347.06 |
4.4× |
| Abdomen 2 views (74019) |
$962.76 |
$962.76 |
8.8× |
| Acute gi blood loss imaging (78278) |
$2,747.13 |
$2,747.13 |
6.6× |
| Angiography extremity bilateral rs&i (75716) |
$9,926.25 |
$9,926.25 |
3.0× |
| Angiography extremity unilateral rs&i (75710) |
$9,926.25 |
$9,926.25 |
3.0× |
| Angiography internal mammary rs&i (75756) |
$10,046.69 |
$10,046.69 |
3.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$11,557.23 |
$11,557.23 |
2.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,926.25 |
$9,926.25 |
3.0× |
| Angiography Spinal Selective Rs&I (75705) |
$11,524.16 |
$11,524.16 |
2.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$20,642.46 |
$20,642.46 |
3.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$6,921.01 |
$6,921.01 |
2.1× |
| Ankle 2 views (73600) |
$596.61 |
$596.61 |
6.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$9,926.25 |
$9,926.25 |
3.0× |
| Aortography abdominal serialography rs&i (75625) |
$9,926.25 |
$9,926.25 |
3.0× |
| Arthrogram knee (73580) |
$1,572.77 |
$1,572.77 |
4.3× |
| Arthrogram shoulder (73040) |
$3,579.19 |
$3,579.19 |
9.8× |
| Basic dosimetry (77300) |
$544.50 |
$544.50 |
3.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$4,608.45 |
$4,608.45 |
11.0× |
| Bone &/joint imaging whole body (78306) |
$5,053.66 |
$5,053.66 |
12.1× |
| Bone age studies (77072) |
$547.64 |
$547.64 |
5.0× |
| Bone Imaging 3 Phase (78315) |
$2,493.42 |
$2,493.42 |
6.0× |
| Bone Marrow Imaging Limited Area (78102) |
$1,582.37 |
$1,582.37 |
3.8× |
| Bone survey complete (77075) |
$2,360.37 |
$2,360.37 |
21.6× |
| Bone survey infant (77076) |
$719.29 |
$719.29 |
6.6× |
| Bowel imaging (78290) |
$3,499.52 |
$3,499.52 |
8.4× |
| Brachytx isodose complex (77318) |
$1,341.43 |
$1,341.43 |
3.4× |
| Brachytx isodose intermed (77317) |
$1,342.65 |
$1,342.65 |
3.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$482.59 |
$482.59 |
1.2× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$1,151.98 |
$1,151.98 |
2.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$3,206.31 |
$3,206.31 |
5.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,514.36 |
$6,514.36 |
4.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$3,919.46 |
$3,919.46 |
9.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,326.50 |
$4,326.50 |
11.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,550.73 |
$1,550.73 |
2.7× |
| Cervical spine 2 or 3 views (72040) |
$796.43 |
$796.43 |
8.8× |
| Chest 1 view (71045) |
$761.67 |
$761.67 |
8.4× |
| Chest xray 3 views (71047) |
$1,403.50 |
$1,403.50 |
15.4× |
| Cholecystography, oral contrast Non-Facility (74290) |
$1,314.27 |
$1,314.27 |
7.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,249.30 |
$1,249.30 |
6.8× |
| Clavicle complete (73000) |
$796.43 |
$796.43 |
8.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,172.18 |
$2,172.18 |
19.9× |
| Continuing medical physics consltj pr wk (77336) |
$849.78 |
$849.78 |
6.1× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$527.96 |
$527.96 |
2.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$9,704.56 |
$9,704.56 |
26.6× |
| CT abdomen and pelvis without contrast (74176) |
$8,469.36 |
$8,469.36 |
34.0× |
| CT abdomen w contrast (74160) |
$5,916.05 |
$5,916.05 |
32.3× |
| CT abdomen w wo contrast (74170) |
$6,469.69 |
$6,469.69 |
35.3× |
| CT abdomen w/o contrast (74150) |
$5,646.44 |
$5,646.44 |
51.7× |
| CT angio hrt w/3d image (75574) |
$1,959.57 |
$1,959.57 |
5.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$5,320.89 |
$5,320.89 |
29.0× |
| CT angiography upper extremity lt (73206) |
$4,565.41 |
$4,565.41 |
24.9× |
| CT c-spine w/contrast (72126) |
$5,959.59 |
$5,959.59 |
16.4× |
| CT c-spine w/o contrast (72125) |
$4,798.99 |
$4,798.99 |
44.0× |
| CT cervical spine w&w/o contrast (72127) |
$6,051 |
$6,051 |
33.0× |
| CT chest w contrast (71260) |
$5,278.40 |
$5,278.40 |
28.8× |
| CT chest w/wo contrast (71270) |
$5,582.20 |
$5,582.20 |
30.5× |
| CT head/brain with contrast (70460) |
$4,055.36 |
$4,055.36 |
22.1× |
| CT head/brain without and with contrast (70470) |
$4,321 |
$4,321 |
23.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$851.96 |
$851.96 |
2.3× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$121.55 |
$121.55 |
1.3× |
| CT iac w contrast (70481) |
$2,572.07 |
$2,572.07 |
14.0× |
| CT limited/localized follow up study (76380) |
$526.69 |
$526.69 |
5.8× |
| CT lower ext w/o (73700) |
$3,716.42 |
$3,716.42 |
34.0× |
| CT lower extremity w wo contrast (73702) |
$7,517.87 |
$7,517.87 |
41.0× |
| CT lower extremity w/contrast material (73701) |
$4,087.84 |
$4,087.84 |
22.3× |
| CT lumbar spine w & w/o contrast (72133) |
$5,105.26 |
$5,105.26 |
27.9× |
| CT lumbar spine w/contrast (72132) |
$4,644.91 |
$4,644.91 |
12.7× |
| CT lumbar spine w/o contrast (72131) |
$4,489.05 |
$4,489.05 |
41.1× |
| CT maxillofacial w contrast (70487) |
$2,222.93 |
$2,222.93 |
12.1× |
| CT maxillofacial w/wo contrast (70488) |
$2,879.32 |
$2,879.32 |
15.7× |
| CT maxillofacial wo contrast (70486) |
$2,134.35 |
$2,134.35 |
19.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,163.77 |
$3,163.77 |
17.3× |
| CT orbits w/o contrast (70480) |
$1,952.72 |
$1,952.72 |
17.9× |
| CT pelvis w/o contrast (72192) |
$4,282.37 |
$4,282.37 |
39.2× |
| CT pelvis w/wo contrast (72194) |
$5,495.57 |
$5,495.57 |
30.0× |
| CT scan of arm combo (73202) |
$6,947.76 |
$6,947.76 |
37.9× |
| CT soft tissue neck w contrast (70491) |
$2,871.30 |
$2,871.30 |
15.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,247.93 |
$3,247.93 |
17.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,210.83 |
$2,210.83 |
20.3× |
| CT thoracic spine w/contrast (72129) |
$5,582.20 |
$5,582.20 |
30.5× |
| CT thoracic spine w/o contrast (72128) |
$4,614.13 |
$4,614.13 |
42.3× |
| CT thoracic spine w/wo contrast (72130) |
$5,783.07 |
$5,783.07 |
31.6× |
| CT thorax w/o contrast (71250) |
$4,344.31 |
$4,344.31 |
39.8× |
| CT unlisted procedure (76497) |
$6,092.04 |
$6,092.04 |
67.0× |
| CT upper ext wo (73200) |
$3,778.58 |
$3,778.58 |
34.6× |
| CT upper extremity with contrast (73201) |
$4,266.15 |
$4,266.15 |
11.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$8,800.42 |
$8,800.42 |
48.0× |
| Cta Abdomen (74175) |
$8,296.52 |
$8,296.52 |
45.3× |
| CTA abdomen pelvis (74174) |
$8,296.52 |
$8,296.52 |
22.8× |
| CTA chest (71275) |
$5,278.40 |
$5,278.40 |
28.8× |
| Cta Head (70496) |
$6,211.22 |
$6,211.22 |
33.9× |
| Cta Neck (70498) |
$5,414.69 |
$5,414.69 |
29.6× |
| Cta Pelvis (72191) |
$7,199 |
$7,199 |
39.3× |
| Cystography minimum 3 views rs&i (74430) |
$1,811.23 |
$1,811.23 |
5.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$455.10 |
$455.10 |
4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$425.83 |
$425.83 |
4.7× |
| Dxa bone density study axial skeleton (77085) |
$501.44 |
$501.44 |
4.6× |
| Esophagus (74220) |
$1,090.75 |
$1,090.75 |
6.0× |
| Facial bones min 3 views (70150) |
$1,261.16 |
$1,261.16 |
11.6× |
| Fetal biophysical profile non-stress testing (76818) |
$1,012.36 |
$1,012.36 |
9.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,014.90 |
$1,014.90 |
9.3× |
| Fluoroscopy up to 1 hr (76000) |
$1,243.01 |
$1,243.01 |
5.0× |
| Foot 2 views (73620) |
$796.43 |
$796.43 |
8.8× |
| Forearm 2 views (73090) |
$796.43 |
$796.43 |
8.8× |
| Hand 2 views (73120) |
$688.44 |
$688.44 |
6.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$6,794.84 |
$6,794.84 |
2.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,203.02 |
$1,203.02 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,203.02 |
$1,203.02 |
2.9× |
| Hysterosalpingogram (74740) |
$1,386.85 |
$1,386.85 |
5.6× |
| Interstitial radiation source applic complex (77778) |
$3,143.28 |
$3,143.28 |
4.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,096.75 |
$2,096.75 |
2.9× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,603.67 |
$1,603.67 |
2.8× |
| Intracavitary Radiation Source Applic Simple (77761) |
$1,603.67 |
$1,603.67 |
2.8× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$25,375.10 |
$25,375.10 |
3.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$4,179.74 |
$4,179.74 |
7.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,285.63 |
$2,285.63 |
4.0× |
| Knee 3 views (73562) |
$873.56 |
$873.56 |
9.6× |
| Liver & spleen imaging static only (78215) |
$3,790.45 |
$3,790.45 |
9.1× |
| Lung perf&ventilat diferentl (78598) |
$1,297.23 |
$1,297.23 |
2.3× |
| Lung perfusion differential (78597) |
$830.08 |
$830.08 |
2.0× |
| Lymphoscintigraphy (78195) |
$2,801.82 |
$2,801.82 |
4.9× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$5,889.59 |
$5,889.59 |
7.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$7,023.57 |
$7,023.57 |
19.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$727.48 |
$727.48 |
1.9× |
| Mr safety determination physician/other qhp (76016) |
$210.74 |
$210.74 |
2.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$58.85 |
$58.85 |
1.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$220.91 |
$220.91 |
2.2× |
| Mr safety implt pos&/immoblj (76019) |
$140.35 |
$140.35 |
2.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$580.70 |
$580.70 |
2.3× |
| MRA head w & w/o contrast (70546) |
$5,995.41 |
$5,995.41 |
16.5× |
| MRA head w/o contrast (70544) |
$4,913.48 |
$4,913.48 |
19.7× |
| MRA head with contrast (70545) |
$5,404.82 |
$5,404.82 |
14.8× |
| MRA neck w contrast (70548) |
$5,404.82 |
$5,404.82 |
14.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,995.41 |
$5,995.41 |
16.5× |
| MRA neck w/o contrast (70547) |
$4,913.48 |
$4,913.48 |
19.7× |
| MRI abdomen w contrast (74182) |
$6,689.73 |
$6,689.73 |
18.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$7,507.61 |
$7,507.61 |
20.6× |
| MRI abdomen w/o contrast (74181) |
$6,155.65 |
$6,155.65 |
24.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$10,343.68 |
$10,343.68 |
12.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$9,714.10 |
$9,714.10 |
26.7× |
| MRI breast w/o contrast bilateral (77047) |
$2,673.55 |
$2,673.55 |
10.7× |
| MRI c-spine with contrast (72142) |
$5,962.04 |
$5,962.04 |
16.4× |
| MRI cervical spine w/o contrast (72141) |
$5,962.04 |
$5,962.04 |
23.9× |
| MRI chest w/o & w/contrast material (71552) |
$6,295.83 |
$6,295.83 |
17.3× |
| MRI chest w/o contrast (71550) |
$3,683.42 |
$3,683.42 |
14.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$9,095.18 |
$9,095.18 |
25.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$9,700.76 |
$9,700.76 |
26.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$7,204.40 |
$7,204.40 |
28.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,043.82 |
$4,043.82 |
16.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$7,306.05 |
$7,306.05 |
20.1× |
| MRI pelvis w/contrast (72196) |
$6,088.87 |
$6,088.87 |
16.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$7,430.81 |
$7,430.81 |
20.4× |
| MRI pelvis w/o contrast (72195) |
$4,972.46 |
$4,972.46 |
20.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$7,651.15 |
$7,651.15 |
21.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$6,599.61 |
$6,599.61 |
18.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$7,531 |
$7,531 |
20.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$6,599.61 |
$6,599.61 |
18.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$7,888.14 |
$7,888.14 |
21.7× |
| MRI temporomandibular joint (70336) |
$4,613.86 |
$4,613.86 |
18.5× |
| MRI thoracic spine w/o contrast (72146) |
$6,449.38 |
$6,449.38 |
25.9× |
| MRI up ext w/o contrast (73218) |
$5,472.88 |
$5,472.88 |
22.0× |
| MRI upper ext joint w/o contrast (73221) |
$5,664.91 |
$5,664.91 |
22.7× |
| MRI, joint upper extrem combo (73223) |
$6,880.03 |
$6,880.03 |
18.9× |
| Myelogram Cervical (72240) |
$5,727.92 |
$5,727.92 |
7.0× |
| Myelogram Lumbar (72265) |
$5,062.69 |
$5,062.69 |
6.2× |
| Myelography 2 or more regions (72270) |
$6,165.19 |
$6,165.19 |
7.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,522.13 |
$5,522.13 |
4.1× |
| Myocardial Spect Multiple Studies (78452) |
$9,875.04 |
$9,875.04 |
7.3× |
| Myocardial spect single study at rest or stress (78451) |
$2,707.20 |
$2,707.20 |
2.0× |
| Neck soft tissue (70360) |
$649.49 |
$649.49 |
7.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$706.86 |
$706.86 |
1.7× |
| Nm gastric emptying study (78264) |
$3,048.97 |
$3,048.97 |
7.3× |
| Nm kidney scan w/flow (78701) |
$3,426.83 |
$3,426.83 |
8.2× |
| Nonvascular shunt X-ray (75809) |
$344.17 |
$344.17 |
3.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$17,613.98 |
$17,613.98 |
12.2× |
| Nuclear Rx Oral Admin (79005) |
$1,030.07 |
$1,030.07 |
4.2× |
| Osseous survey limited (77074) |
$1,631.41 |
$1,631.41 |
14.9× |
| Parathyrd planar w/spect&CT (78072) |
$2,364.98 |
$2,364.98 |
4.2× |
| Parathyroid Planar Imaging (78070) |
$1,314.35 |
$1,314.35 |
3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,603.53 |
$2,603.53 |
6.2× |
| Pelvis 1 or 2 views (72170) |
$779.08 |
$779.08 |
7.1× |
| Peritoneogram after injection (74190) |
$4,547.25 |
$4,547.25 |
8.0× |
| PET image w/CT, skull-thigh (78815) |
$10,857.95 |
$10,857.95 |
7.3× |
| PET imaging CT for attenuation limited area (78814) |
$13,813.44 |
$13,813.44 |
9.3× |
| PET imaging for CT attenuation whole body (78816) |
$12,351.33 |
$12,351.33 |
8.3× |
| PET whole body (78813) |
$7,854.48 |
$7,854.48 |
5.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$4,741.87 |
$4,741.87 |
11.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,295.84 |
$1,295.84 |
2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$781.96 |
$781.96 |
1.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$796.43 |
$796.43 |
8.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$698.07 |
$698.07 |
7.7× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$898.60 |
$898.60 |
9.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$509.86 |
$509.86 |
5.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,722.05 |
$1,722.05 |
15.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$590.09 |
$590.09 |
5.4× |
| Radex fingr minimum 2 views (73140) |
$620.93 |
$620.93 |
6.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$734.70 |
$734.70 |
8.1× |
| Radex Hand Minimum 3 Views (73130) |
$752.05 |
$752.05 |
8.3× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$752.05 |
$752.05 |
8.3× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$2,093.19 |
$2,093.19 |
19.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$1,118.41 |
$1,118.41 |
10.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,095.58 |
$1,095.58 |
10.0× |
| Radex Humerus Minimum 2 Views (73060) |
$796.43 |
$796.43 |
8.8× |
| Radex Kne 1/2 Views (73560) |
$796.43 |
$796.43 |
8.8× |
| Radex Kne Compl 4/More Views (73564) |
$827.49 |
$827.49 |
7.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$1,303.61 |
$1,303.61 |
11.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$796.43 |
$796.43 |
8.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$522.59 |
$522.59 |
4.8× |
| Radex Sho Compl Minimum 2 Views (73030) |
$848.48 |
$848.48 |
9.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$337.24 |
$337.24 |
3.7× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$592 |
$592 |
5.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$705.79 |
$705.79 |
7.8× |
| Radex Toe Minimum 2 Views (73660) |
$617.09 |
$617.09 |
6.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$781 |
$781 |
7.2× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$765.33 |
$765.33 |
8.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,334.45 |
$1,334.45 |
12.2× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) |
$128,049.54 |
$128,049.54 |
16.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$26,680.93 |
$26,680.93 |
3.5× |
| Radiation treatment delivery level 1 (77402) |
$770.65 |
$770.65 |
7.2× |
| Radiation treatment delivery level 2 (77407) |
$851.71 |
$851.71 |
2.1× |
| Radiation treatment delivery level 3 (77412) |
$909.98 |
$909.98 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$773.68 |
$773.68 |
8.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,014.35 |
$1,014.35 |
9.3× |
| Radiologic exam chest 2 views (71046) |
$1,474.34 |
$1,474.34 |
16.2× |
| Radiologic exam colon single contrast study (74270) |
$1,184.35 |
$1,184.35 |
6.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,717.31 |
$1,717.31 |
9.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,077.38 |
$1,077.38 |
5.9× |
| Radiologic examination femur 1 view (73551) |
$306.76 |
$306.76 |
3.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$605.51 |
$605.51 |
6.7× |
| Radiological examination surgical specimen (76098) |
$1,428.17 |
$1,428.17 |
2.5× |
| Ribs bilateral 3 views (71110) |
$1,168.59 |
$1,168.59 |
10.7× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$4,853.42 |
$4,853.42 |
11.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$5,842.02 |
$5,842.02 |
10.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,933.76 |
$3,933.76 |
6.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,862.48 |
$3,862.48 |
2.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,104.46 |
$1,104.46 |
4.5× |
| Rp Therapy Intravenous Administration (79101) |
$2,035.07 |
$2,035.07 |
8.4× |
| Sacroiliac Joints < 3 Views (72200) |
$383.76 |
$383.76 |
3.5× |
| Scapula (73010) |
$898.60 |
$898.60 |
8.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$103.18 |
$103.18 |
4.4× |
| Shoulder 1 view (73020) |
$315.77 |
$315.77 |
3.5× |
| Simulation intermediate (77285) |
$1,866.55 |
$1,866.55 |
4.8× |
| Small bowel series (74250) |
$1,388.76 |
$1,388.76 |
7.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,581.26 |
$1,581.26 |
4.0× |
| Special dosimetry (77331) |
$621.19 |
$621.19 |
4.4× |
| Special Physics Consult (77370) |
$1,300.75 |
$1,300.75 |
9.3× |
| Special treatment procedure (77470) |
$2,623.53 |
$2,623.53 |
4.5× |
| Spine thoracic 3 views (72072) |
$1,014.34 |
$1,014.34 |
9.3× |
| Stereotactic Body Radiation Delivery (77373) |
$14,194.32 |
$14,194.32 |
7.6× |
| Tbs technical calculation only (77091) |
$220.51 |
$220.51 |
2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$482.59 |
$482.59 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$482.59 |
$482.59 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,170.80 |
$3,170.80 |
8.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,881.04 |
$1,881.04 |
13.4× |
| Thoracolumbar 2 views (72080) |
$1,014.34 |
$1,014.34 |
11.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$3,444.84 |
$3,444.84 |
6.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,557.24 |
$1,557.24 |
3.7× |
| Tmj unilateral (70328) |
$330.18 |
$330.18 |
3.6× |
| Treatment device complex (77334) |
$1,333.75 |
$1,333.75 |
3.4× |
| Treatment device intermediate (77333) |
$656.30 |
$656.30 |
4.7× |
| Treatment devices simple (77332) |
$635.26 |
$635.26 |
4.5× |
| Ultrasound breast complete (76641) |
$444.03 |
$444.03 |
4.1× |
| Ultrasound Exam Aaa Screen (76706) |
$300.55 |
$300.55 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$2,008.97 |
$2,008.97 |
18.4× |
| Umbilical-artery Doppler (OB) (76820) |
$1,064.69 |
$1,064.69 |
9.8× |
| Unlisted fluoroscopic procedure (76496) |
$286.89 |
$286.89 |
3.2× |
| Urethrocystogram voiding (74455) |
$2,575.45 |
$2,575.45 |
10.3× |
| Urethrocystography retrograde rs&i (74450) |
$1,213.50 |
$1,213.50 |
4.9× |
| Us breast unilateral limited (76642) |
$370.01 |
$370.01 |
4.1× |
| Us chest (76604) |
$1,145.26 |
$1,145.26 |
10.5× |
| Us compl joint r-t w/image documentation (76881) |
$949.63 |
$949.63 |
8.7× |
| Us encephalogram (76506) |
$1,487.83 |
$1,487.83 |
13.6× |
| Us infant hips w manipulation (76885) |
$1,319.92 |
$1,319.92 |
14.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$758.82 |
$758.82 |
7.0× |
| Us ob limited (76815) |
$2,010.39 |
$2,010.39 |
18.4× |
| Us ob transvaginal (76817) |
$1,039.84 |
$1,039.84 |
9.5× |
| Us pelvic non ob complete (76856) |
$1,580.85 |
$1,580.85 |
14.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$978.85 |
$978.85 |
9.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,216.88 |
$1,216.88 |
11.1× |
| Us retroperitoneal complete (76770) |
$1,322.71 |
$1,322.71 |
12.1× |
| Us retroperitoneal limited (76775) |
$928.91 |
$928.91 |
8.5× |
| Us scrotum and contents (76870) |
$1,098.09 |
$1,098.09 |
10.1× |
| Us soft tissue head/neck (76536) |
$804.12 |
$804.12 |
7.4× |
| Us spinal canal and contents (76800) |
$967.75 |
$967.75 |
8.9× |
| Us transrectal prostate volume (76873) |
$1,283.85 |
$1,283.85 |
11.8× |
| Us, eye b-scan (76512) |
$386.15 |
$386.15 |
3.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,702.61 |
$1,702.61 |
15.6× |
| Venogram extremity bilateral (75822) |
$3,152.67 |
$3,152.67 |
1.9× |
| Venogram Extremity Unilateral (75820) |
$3,208.13 |
$3,208.13 |
2.0× |
| Venography caval inferior serialography rs&i (75825) |
$9,926.25 |
$9,926.25 |
3.0× |
| Venography caval superior serialography rs&i (75827) |
$6,921.01 |
$6,921.01 |
4.2× |
| Venography renal unilateral selective rs&i (75831) |
$5,906.26 |
$5,906.26 |
1.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,229.52 |
$2,229.52 |
0.7× |
| Wrist 2 views (73100) |
$731.35 |
$731.35 |
8.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,446.06 |
$1,446.06 |
13.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$873.56 |
$873.56 |
9.6× |
| X-ray b.e. reductn intuss (74283) |
$1,057.65 |
$1,057.65 |
5.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,933.20 |
$1,933.20 |
10.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$796.43 |
$796.43 |
8.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$992.18 |
$992.18 |
10.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$270.12 |
$270.12 |
2.5× |
| X-ray exam of femur 2/> (73552) |
$840.79 |
$840.79 |
9.3× |
| X-ray eye for foreign body (70030) |
$330.47 |
$330.47 |
3.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$401.10 |
$401.10 |
4.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$669.18 |
$669.18 |
7.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$286.89 |
$286.89 |
3.2× |
| X-ray leg, infant (73592) |
$804.12 |
$804.12 |
8.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,261.16 |
$1,261.16 |
11.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,934.17 |
$1,934.17 |
17.7× |
| X-ray nose-rectum child f.b. (76010) |
$106.96 |
$106.96 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,180.07 |
$1,180.07 |
10.8× |
| X-ray retrograde pyelogram (74420) |
$1,291.72 |
$1,291.72 |
3.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$929.48 |
$929.48 |
10.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,151.26 |
$1,151.26 |
10.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,349.88 |
$1,349.88 |
12.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$898.60 |
$898.60 |
8.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$898.60 |
$898.60 |
9.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,023.98 |
$1,023.98 |
11.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,091.46 |
$1,091.46 |
10.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$678.79 |
$678.79 |
6.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$655.66 |
$655.66 |
7.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$898.60 |
$898.60 |
9.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$549.60 |
$549.60 |
5.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$977.70 |
$977.70 |
9.0× |
| Xr bone length studies (77073) |
$507.14 |
$507.14 |
4.6× |
| Xr c-spine 4 or 5 views (72050) |
$1,560.08 |
$1,560.08 |
14.3× |
| Xr c-spine 6 or more views (72052) |
$1,795.32 |
$1,795.32 |
16.4× |
| Xr urogram antegrade (74425) |
$1,028.35 |
$1,028.35 |
2.8× |