| 3-D radiotherapy plan dose-volume histograms (77295) |
$10,325.45 |
$10,325.45 |
8.0× |
| Abdomen 2 views (74019) |
$259.49 |
$259.49 |
2.7× |
| Ankle 2 views (73600) |
$333.85 |
$333.85 |
4.1× |
| Bone age studies (77072) |
$228 |
$228 |
2.3× |
| Bone survey complete (77075) |
$636.46 |
$636.46 |
6.5× |
| Brachytx isodose complex (77318) |
$2,649.10 |
$2,649.10 |
7.6× |
| Brachytx isodose intermed (77317) |
$4,464.03 |
$4,464.03 |
12.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$4,242.71 |
$4,242.71 |
12.2× |
| Cervical spine 2 or 3 views (72040) |
$459.69 |
$459.69 |
5.7× |
| Chest 1 view (71045) |
$863.03 |
$863.03 |
10.7× |
| Clavicle complete (73000) |
$708.18 |
$708.18 |
8.7× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$100,225.33 |
$100,225.33 |
14.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,381.72 |
$1,381.72 |
14.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,627.63 |
$7,627.63 |
23.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,041.18 |
$4,041.18 |
18.2× |
| CT abdomen w contrast (74160) |
$2,951.45 |
$2,951.45 |
18.1× |
| CT abdomen w wo contrast (74170) |
$3,438.28 |
$3,438.28 |
21.1× |
| CT abdomen w/o contrast (74150) |
$1,840.89 |
$1,840.89 |
18.9× |
| CT angiography upper extremity lt (73206) |
$3,410.60 |
$3,410.60 |
20.9× |
| CT c-spine w/o contrast (72125) |
$3,036.94 |
$3,036.94 |
31.2× |
| CT cervical spine w&w/o contrast (72127) |
$3,491.94 |
$3,491.94 |
21.4× |
| CT chest w/wo contrast (71270) |
$2,883.17 |
$2,883.17 |
17.7× |
| CT chest with contrast (71260) |
$2,485.28 |
$2,485.28 |
15.2× |
| CT head/brain with contrast (70460) |
$4,893.42 |
$4,893.42 |
30.0× |
| CT head/brain without and with contrast (70470) |
$3,976.57 |
$3,976.57 |
24.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$124.98 |
$124.98 |
1.5× |
| CT iac w contrast (70481) |
$4,169.88 |
$4,169.88 |
25.5× |
| CT lower ext w/o (73700) |
$2,737.43 |
$2,737.43 |
28.1× |
| CT lower extremity w wo contrast (73702) |
$3,915.03 |
$3,915.03 |
24.0× |
| CT lower extremity with contrast (73701) |
$2,310.39 |
$2,310.39 |
14.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,364.65 |
$3,364.65 |
20.6× |
| CT lumbar spine w/o contrast (72131) |
$2,800.72 |
$2,800.72 |
28.8× |
| CT lumbar spine with contrast (72132) |
$3,179.37 |
$3,179.37 |
9.8× |
| CT maxillofacial w contrast (70487) |
$3,027.57 |
$3,027.57 |
18.5× |
| CT maxillofacial w/o contrast (70486) |
$2,763.30 |
$2,763.30 |
28.4× |
| CT maxillofacial w/wo contrast (70488) |
$3,291.94 |
$3,291.94 |
20.2× |
| CT neck soft tissue w contrast (70491) |
$2,941.22 |
$2,941.22 |
18.0× |
| CT orbits w/o contrast (70480) |
$1,734.90 |
$1,734.90 |
17.8× |
| CT pelvis w & w/o contrast (72194) |
$3,563.50 |
$3,563.50 |
21.8× |
| CT pelvis w/o contrast (72192) |
$2,249.49 |
$2,249.49 |
23.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,253.04 |
$3,253.04 |
19.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,570.10 |
$1,570.10 |
16.1× |
| CT thoracic spine w/contrast (72129) |
$1,281.81 |
$1,281.81 |
7.8× |
| CT thoracic spine w/o contrast (72128) |
$999.42 |
$999.42 |
10.3× |
| CT thorax w/o contrast (71250) |
$2,198.94 |
$2,198.94 |
22.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,053.24 |
$2,053.24 |
12.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,758.02 |
$1,758.02 |
18.1× |
| CT upper extremity with contrast (73201) |
$2,581.74 |
$2,581.74 |
7.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,551.38 |
$2,551.38 |
15.6× |
| Cta Abdomen (74175) |
$2,239.28 |
$2,239.28 |
13.7× |
| CTA abdomen pelvis (74174) |
$4,301.91 |
$4,301.91 |
13.2× |
| CTA chest (71275) |
$1,160.09 |
$1,160.09 |
7.1× |
| Cta Head (70496) |
$2,844.31 |
$2,844.31 |
17.4× |
| CTA lwr ext w&w/o contrast (73706) |
$3,714.29 |
$3,714.29 |
22.7× |
| Cta Neck (70498) |
$2,801.09 |
$2,801.09 |
17.2× |
| Echoencephalography real time imaging (76506) |
$450.29 |
$450.29 |
4.6× |
| Esophagus (74220) |
$495.55 |
$495.55 |
3.0× |
| Fluoroscopy up to 1 hr (76000) |
$1,202.55 |
$1,202.55 |
5.4× |
| Foot 2 views (73620) |
$333.85 |
$333.85 |
4.1× |
| Forearm 2 views (73090) |
$311.18 |
$311.18 |
3.8× |
| Hand 2 views (73120) |
$706.33 |
$706.33 |
7.3× |
| Hand 3 views (73130) |
$681.92 |
$681.92 |
8.4× |
| Humerus Min 2 Views Left (73060) |
$290.95 |
$290.95 |
3.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$9,394.74 |
$9,394.74 |
14.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$7,147.27 |
$7,147.27 |
13.9× |
| Intracavitary radiation source applic simple (77761) |
$7,147.27 |
$7,147.27 |
13.9× |
| Knee 3 views (73562) |
$505.77 |
$505.77 |
6.2× |
| Mr safety determination physician/other qhp (76016) |
$224.19 |
$224.19 |
2.8× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$149.30 |
$149.30 |
2.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$62.60 |
$62.60 |
2.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$235.01 |
$235.01 |
2.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$617.75 |
$617.75 |
2.8× |
| MRA head w/o contrast (70544) |
$3,804.73 |
$3,804.73 |
17.1× |
| MRA neck w contrast (70548) |
$3,578.13 |
$3,578.13 |
11.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,498.42 |
$4,498.42 |
13.8× |
| MRA neck w/o contrast (70547) |
$2,702.10 |
$2,702.10 |
12.2× |
| MRI abdomen w contrast (74182) |
$4,478.52 |
$4,478.52 |
13.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,734.46 |
$5,734.46 |
17.7× |
| MRI abdomen w/o contrast (74181) |
$4,289.83 |
$4,289.83 |
19.3× |
| MRI c-spine with contrast (72142) |
$6,115.70 |
$6,115.70 |
18.8× |
| MRI cervical spine w/o contrast (72141) |
$5,638.41 |
$5,638.41 |
25.4× |
| MRI chest w/o & w/contrast material (71552) |
$4,288.38 |
$4,288.38 |
13.2× |
| MRI chest w/o contrast (71550) |
$3,674.99 |
$3,674.99 |
16.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,071.03 |
$5,071.03 |
22.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,389.76 |
$3,389.76 |
15.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,602.23 |
$5,602.23 |
17.2× |
| MRI pelvis w contrast (72196) |
$5,269.87 |
$5,269.87 |
16.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$7,110.19 |
$7,110.19 |
21.9× |
| MRI pelvis w/o contrast (72195) |
$6,180.18 |
$6,180.18 |
27.8× |
| MRI scan of arm joint before and after contrast (73223) |
$5,066.69 |
$5,066.69 |
15.6× |
| MRI scan of leg joint before and after contrast (73723) |
$6,478.49 |
$6,478.49 |
19.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,844.57 |
$6,844.57 |
21.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$7,523.12 |
$7,523.12 |
23.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,573.76 |
$5,573.76 |
17.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$7,593.18 |
$7,593.18 |
23.4× |
| MRI thoracic spine w/o contrast (72146) |
$5,819.74 |
$5,819.74 |
26.2× |
| MRI upper ext joint w/o contrast (73221) |
$4,668.43 |
$4,668.43 |
21.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$5,880.55 |
$5,880.55 |
18.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,161.62 |
$4,161.62 |
18.7× |
| Myocardial Spect Multiple Studies (78452) |
$9,213.21 |
$9,213.21 |
7.6× |
| Neck soft tissue (70360) |
$309.60 |
$309.60 |
3.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$12,499.97 |
$12,499.97 |
9.7× |
| Osseous survey infant (77076) |
$702.65 |
$702.65 |
7.2× |
| Pelvis 1 or 2 views (72170) |
$306.95 |
$306.95 |
3.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$5,977.55 |
$5,977.55 |
18.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$364.28 |
$364.28 |
3.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$798.12 |
$798.12 |
8.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,883.78 |
$2,883.78 |
5.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,330.34 |
$1,330.34 |
14.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,950.25 |
$1,950.25 |
5.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$392.45 |
$392.45 |
4.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$326.93 |
$326.93 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,088.16 |
$1,088.16 |
11.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$953.85 |
$953.85 |
11.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$622.36 |
$622.36 |
3.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$375.29 |
$375.29 |
4.6× |
| Ribs bilateral 3 views (71110) |
$641.35 |
$641.35 |
6.6× |
| Sacroiliac Joints < 3 Views (72200) |
$639.76 |
$639.76 |
6.6× |
| Scapula complete (73010) |
$453.93 |
$453.93 |
4.7× |
| Screening digital breast tomosynthesis (77063) |
$106 |
$106 |
4.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,667.45 |
$1,667.45 |
4.8× |
| Spine thoracic 3 views (72072) |
$1,724.90 |
$1,724.90 |
17.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$5,400.81 |
$5,400.81 |
15.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$511.67 |
$511.67 |
1.5× |
| Thoracolumbar 2 views (72080) |
$295.17 |
$295.17 |
3.6× |
| Tmj unilateral (70328) |
$1,055.86 |
$1,055.86 |
13.0× |
| Tx devices design & construction complex (77334) |
$5,459.23 |
$5,459.23 |
15.7× |
| Ultrasound, abdomen limited (76705) |
$979.40 |
$979.40 |
10.1× |
| Upper Extremity Infant (73092) |
$636.34 |
$636.34 |
6.5× |
| Us abdl aorta screen aaa (76706) |
$948.77 |
$948.77 |
9.7× |
| Us breast unilateral complete (76641) |
$285.79 |
$285.79 |
2.9× |
| Us breast unilateral limited (76642) |
$199.23 |
$199.23 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$583.77 |
$583.77 |
6.0× |
| Us ob transvaginal (76817) |
$723.21 |
$723.21 |
7.4× |
| Us pelvic non ob complete (76856) |
$1,836.55 |
$1,836.55 |
18.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$2,290.20 |
$2,290.20 |
23.5× |
| Us pregnancy ltd (76815) |
$893.11 |
$893.11 |
9.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$672.97 |
$672.97 |
6.9× |
| Us retroperitoneal complete (76770) |
$2,362.97 |
$2,362.97 |
24.3× |
| Us retroperitoneal limited (76775) |
$802.22 |
$802.22 |
8.2× |
| Us scrotum and contents (76870) |
$856.95 |
$856.95 |
8.8× |
| Us soft tissue head/neck (76536) |
$648.35 |
$648.35 |
6.7× |
| Us xtr non-vasc lmtd (76882) |
$498.06 |
$498.06 |
5.1× |
| Wrist 2 views (73100) |
$333.85 |
$333.85 |
4.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$418.70 |
$418.70 |
4.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$280.78 |
$280.78 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$270.33 |
$270.33 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$326.59 |
$326.59 |
4.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,644.11 |
$1,644.11 |
16.9× |
| X-ray exam hip uni 1 view (73501) |
$972.59 |
$972.59 |
12.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$334.43 |
$334.43 |
4.1× |
| X-ray exam hip uni 4/> views (73503) |
$526.58 |
$526.58 |
5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$310.78 |
$310.78 |
3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,439.09 |
$1,439.09 |
14.8× |
| X-ray exam of femur 1 (73551) |
$156.30 |
$156.30 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$434.90 |
$434.90 |
4.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$333.85 |
$333.85 |
4.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$443.28 |
$443.28 |
5.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$294.87 |
$294.87 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$1,004.50 |
$1,004.50 |
12.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$464.39 |
$464.39 |
4.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$456.56 |
$456.56 |
5.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$636.34 |
$636.34 |
7.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,372.78 |
$1,372.78 |
14.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$774.43 |
$774.43 |
8.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$847.46 |
$847.46 |
8.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$361.40 |
$361.40 |
4.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$642.16 |
$642.16 |
7.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$362.45 |
$362.45 |
3.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$284.27 |
$284.27 |
2.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$478.87 |
$478.87 |
5.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,027.91 |
$1,027.91 |
10.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$513.89 |
$513.89 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$891.22 |
$891.22 |
9.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$301.14 |
$301.14 |
3.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$380.30 |
$380.30 |
4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$442.98 |
$442.98 |
5.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$846.15 |
$846.15 |
10.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$293.38 |
$293.38 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$1,198.64 |
$1,198.64 |
14.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,239.27 |
$1,239.27 |
12.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$2,043.23 |
$2,043.23 |
21.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$239.91 |
$239.91 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$275.78 |
$275.78 |
3.4× |
| Xr c-spine 6 or more views (72052) |
$742.68 |
$742.68 |
7.6× |
| Xr finger(s) 2+ views (73140) |
$265.55 |
$265.55 |
3.3× |
| Xr shoulder 1 view (73020) |
$620.81 |
$620.81 |
7.7× |
| Xr spine cervical 4 or 5 views (72050) |
$1,938.73 |
$1,938.73 |
19.9× |
| Xr tibia/fibula 2 views (73590) |
$455.65 |
$455.65 |
5.6× |
| Xray knee 1 or 2 views rt (73560) |
$271.13 |
$271.13 |
3.3× |