| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$6,565.40 |
$6,565.40 |
4.5× |
| Acute gi blood loss imaging (78278) |
$2,545.74 |
$2,545.74 |
6.1× |
| Angio extremity unilateral (75710) |
$9,926.25 |
$9,926.25 |
3.0× |
| Angio pulmonary unilateral (75741) |
$9,926.25 |
$9,926.25 |
3.0× |
| Angiogram extremity bilateral (75716) |
$9,926.25 |
$9,926.25 |
3.0× |
| Angiogram pelvic (75736) |
$9,926.25 |
$9,926.25 |
1.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,926.25 |
$9,926.25 |
3.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$20,642.46 |
$20,642.46 |
3.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,208.13 |
$3,208.13 |
1.0× |
| Ankle 2 views (73600) |
$618.35 |
$618.35 |
6.8× |
| Arthrography knee lt (73580) |
$1,370.11 |
$1,370.11 |
3.8× |
| Arthrography wrist lt (73115) |
$818.76 |
$818.76 |
2.2× |
| Barium enema (74270) |
$1,119.95 |
$1,119.95 |
6.1× |
| Basic dosimetry (77300) |
$563.22 |
$563.22 |
4.0× |
| Bone age studies (77072) |
$569.31 |
$569.31 |
5.2× |
| Bone imaging limited area (78300) |
$4,497.61 |
$4,497.61 |
10.8× |
| Bone survey complete (77075) |
$4,580.67 |
$4,580.67 |
42.0× |
| Bowel imaging (78290) |
$3,632.14 |
$3,632.14 |
8.7× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$1,341.43 |
$1,341.43 |
3.4× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$1,291.11 |
$1,291.11 |
3.1× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$4,716.55 |
$4,716.55 |
11.3× |
| Cholecystography, oral contrast Other Diagnostic Radiology FS (74290) |
$1,243.79 |
$1,243.79 |
6.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,182.30 |
$1,182.30 |
6.5× |
| Clavicle complete (73000) |
$827.94 |
$827.94 |
9.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$3,674.90 |
$3,674.90 |
20.1× |
| Continuing medical physics consltj pr wk (77336) |
$878.99 |
$878.99 |
6.3× |
| Contrast exam abdominl aorta (75625) |
$6,440.61 |
$6,440.61 |
2.0× |
| Contrast exam thoracic aorta (75605) |
$9,926.25 |
$9,926.25 |
1.7× |
| CT - st neck w&wo contr (70492) |
$2,720.03 |
$2,720.03 |
14.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$8,584.85 |
$8,584.85 |
23.6× |
| CT abdomen and pelvis without contrast (74176) |
$8,193.63 |
$8,193.63 |
32.9× |
| CT abdomen w wo contrast (74170) |
$6,259.05 |
$6,259.05 |
34.2× |
| CT abdomen w/contrast (74160) |
$5,723.42 |
$5,723.42 |
31.2× |
| CT abdomen w/o contrast (74150) |
$5,462.61 |
$5,462.61 |
50.0× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$8,026.41 |
$8,026.41 |
22.0× |
| CT angio abdom w/o & w/dye (74175) |
$8,026.41 |
$8,026.41 |
43.8× |
| CT angio abdominal arteries (75635) |
$8,513.90 |
$8,513.90 |
46.5× |
| CT angio hrt w/3d image (75574) |
$1,937.92 |
$1,937.92 |
5.3× |
| CT angiograph pelv w/o&w/dye (72191) |
$6,927.07 |
$6,927.07 |
37.8× |
| CT cervical spine w/contrast (72126) |
$5,765.54 |
$5,765.54 |
15.8× |
| CT cervical spine w/o contrast (72125) |
$4,620.05 |
$4,620.05 |
42.3× |
| CT chest w/contrast (71260) |
$4,583.87 |
$4,583.87 |
25.0× |
| CT extremity upper w & w/o contrast (73202) |
$4,379.51 |
$4,379.51 |
23.9× |
| CT head/brain with contrast (70460) |
$3,773.53 |
$3,773.53 |
20.6× |
| CT head/brain without and with contrast (70470) |
$3,918.52 |
$3,918.52 |
21.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$267.73 |
$267.73 |
2.9× |
| CT limited/localized follow up study (76380) |
$509.54 |
$509.54 |
5.6× |
| CT lower ext w/wo contrast (73702) |
$3,518 |
$3,518 |
19.2× |
| CT lower extremity w contrast (73701) |
$2,969.05 |
$2,969.05 |
16.2× |
| CT lower extremity w/o contrast unilateral (73700) |
$2,226.78 |
$2,226.78 |
20.4× |
| CT lumbar spine w/contrast (72132) |
$4,801.86 |
$4,801.86 |
13.2× |
| CT lumbar spine w/o contrast (72131) |
$4,241.10 |
$4,241.10 |
38.8× |
| CT lumbar spine w/o then w/ con (72133) |
$5,018.38 |
$5,018.38 |
27.4× |
| CT maxillofacial area w/o contrast (70486) |
$3,161.88 |
$3,161.88 |
29.0× |
| CT maxillofacial w/contrast (70487) |
$3,666.03 |
$3,666.03 |
20.0× |
| CT maxillofacial w/o then w/ con (70488) |
$4,318.66 |
$4,318.66 |
23.6× |
| CT orbit sella ear w/o con (70480) |
$3,347.69 |
$3,347.69 |
30.7× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$4,327.40 |
$4,327.40 |
23.6× |
| CT pelvis w & w/o contrast (72194) |
$5,196.71 |
$5,196.71 |
28.4× |
| CT pelvis w/o contrast (72192) |
$3,810.37 |
$3,810.37 |
34.9× |
| CT soft tissue neck w/contrast (70491) |
$2,648.47 |
$2,648.47 |
14.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,039.09 |
$2,039.09 |
18.7× |
| CT spine cervical w/wo contrast (72127) |
$6,146.70 |
$6,146.70 |
33.6× |
| CT thoracic spine w/contrast (72129) |
$4,947.05 |
$4,947.05 |
27.0× |
| CT thoracic spine w/o contrast (72128) |
$4,766.49 |
$4,766.49 |
43.7× |
| CT thorax lung cancer scr c- (71271) |
$1,790.42 |
$1,790.42 |
16.4× |
| CT thorax w/o contrast (71250) |
$3,818.23 |
$3,818.23 |
35.0× |
| CT thorax w/o then w/ contrast (71270) |
$5,267.33 |
$5,267.33 |
28.8× |
| CT upper extremity w/dye (73201) |
$3,961.81 |
$3,961.81 |
10.9× |
| CT upper extremity w/o contrast rt (73200) |
$3,471.65 |
$3,471.65 |
31.8× |
| CTA chest w/wo contrast (71275) |
$4,776.25 |
$4,776.25 |
26.1× |
| CTA head w contrast (70496) |
$5,724.67 |
$5,724.67 |
31.3× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$5,155.67 |
$5,155.67 |
28.1× |
| Cta Neck (70498) |
$4,999.60 |
$4,999.60 |
27.3× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$5,155.67 |
$5,155.67 |
28.1× |
| Dxa bone density study axial skeleton (77085) |
$540 |
$540 |
4.9× |
| Esophogram (74220) |
$1,182.30 |
$1,182.30 |
6.5× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$740.86 |
$740.86 |
3.0× |
| Gastric emptying study (78264) |
$2,825.46 |
$2,825.46 |
6.8× |
| Gated heart planar single (78472) |
$3,632.14 |
$3,632.14 |
8.7× |
| Hepatobil syst image w/drug (78227) |
$1,275.05 |
$1,275.05 |
2.2× |
| Hepatobiliary system imaging (78226) |
$1,275.05 |
$1,275.05 |
3.1× |
| Humerus min 2 views (73060) |
$827.94 |
$827.94 |
9.1× |
| Imrt planning (77301) |
$18,219.88 |
$18,219.88 |
12.6× |
| 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× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$1,341.43 |
$1,341.43 |
3.4× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$482.59 |
$482.59 |
1.2× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$482.59 |
$482.59 |
1.2× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$482.59 |
$482.59 |
1.2× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$2,118.08 |
$2,118.08 |
3.7× |
| Lung perfusion differential (78597) |
$879.80 |
$879.80 |
2.1× |
| Lung ventilat&perfus imaging (78582) |
$1,373.45 |
$1,373.45 |
2.4× |
| Lung ventilation imaging (78579) |
$1,183.35 |
$1,183.35 |
2.8× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75807) |
$12,609.73 |
$12,609.73 |
3.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$8,799.02 |
$8,799.02 |
24.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$8,799.02 |
$8,799.02 |
24.2× |
| Mlc device(s) for imrt (77338) |
$753.45 |
$753.45 |
1.9× |
| Mr safety determination physician/other qhp (76016) |
$210.74 |
$210.74 |
2.3× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$140.35 |
$140.35 |
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 med physics xm customization plng&mntr (76017) |
$580.70 |
$580.70 |
2.3× |
| MRA head w & w/o contrast (70546) |
$5,139.12 |
$5,139.12 |
14.1× |
| MRA head w/o contrast (70544) |
$4,206.89 |
$4,206.89 |
16.9× |
| MRA neck w/contrast (70548) |
$4,211.69 |
$4,211.69 |
11.6× |
| MRA neck w/o contrast (70547) |
$4,211.69 |
$4,211.69 |
16.9× |
| MRA neck w/wo contrast (70549) |
$5,139.12 |
$5,139.12 |
14.1× |
| MRI abdomen w/contrast (74182) |
$4,568.54 |
$4,568.54 |
12.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$6,800.31 |
$6,800.31 |
18.7× |
| MRI abdomen w/o contrast (74181) |
$6,059.52 |
$6,059.52 |
24.3× |
| MRI any jnt lwr ext with con lt (73722) |
$7,560.36 |
$7,560.36 |
9.2× |
| MRI breast without contrast bilateral (77047) |
$3,315.94 |
$3,315.94 |
13.3× |
| MRI cervical spine w/o contrast (72141) |
$5,666.42 |
$5,666.42 |
22.7× |
| MRI cervical spine with contrast (72142) |
$5,400.39 |
$5,400.39 |
14.8× |
| MRI chest w & w/o contrast (71552) |
$5,702.71 |
$5,702.71 |
15.7× |
| MRI chest w/contrast (71551) |
$2,114.61 |
$2,114.61 |
2.6× |
| MRI chest w/o contrast (71550) |
$4,819.78 |
$4,819.78 |
19.3× |
| MRI joint upper ext w/contrast (73222) |
$5,472.88 |
$5,472.88 |
6.7× |
| MRI joint upr extr w/o&w/dye (73223) |
$6,349.80 |
$6,349.80 |
17.4× |
| MRI joint upr extrem w/o dye (73221) |
$5,140.32 |
$5,140.32 |
20.6× |
| Mri Lower Extremity W/O Dye (73718) |
$6,514.68 |
$6,514.68 |
26.1× |
| MRI lumbar spine with contrast (72149) |
$5,713.77 |
$5,713.77 |
15.7× |
| MRI lumbar w/wo contrast (72158) |
$7,520.61 |
$7,520.61 |
20.6× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$4,957.86 |
$4,957.86 |
13.6× |
| MRI orbit/face/neck w/o contrast (70540) |
$5,528.39 |
$5,528.39 |
22.2× |
| MRI pelvis w/ contrast (72196) |
$5,515.28 |
$5,515.28 |
15.1× |
| MRI pelvis w/o contrast (72195) |
$5,468.13 |
$5,468.13 |
21.9× |
| MRI pelvis w/wo contrast (72197) |
$6,500.13 |
$6,500.13 |
17.8× |
| MRI spine cervical wo/w contrast (72156) |
$6,930.33 |
$6,930.33 |
19.0× |
| MRI spine thoracic w/contrast (72147) |
$5,977.87 |
$5,977.87 |
16.4× |
| MRI thoracic spine w wo contrast (72157) |
$7,145.02 |
$7,145.02 |
19.6× |
| MRI thoracic spine w/o contrast (72146) |
$5,841.78 |
$5,841.78 |
23.4× |
| MRI tmj (70336) |
$4,686.75 |
$4,686.75 |
18.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$5,472.88 |
$5,472.88 |
22.0× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$6,349.80 |
$6,349.80 |
17.4× |
| Myelography 2 or more regions (72270) |
$3,079.85 |
$3,079.85 |
3.8× |
| Myelography lumbosacral (72265) |
$2,525.25 |
$2,525.25 |
3.1× |
| Myocardial spect single study at rest or stress (78451) |
$3,034.22 |
$3,034.22 |
2.2× |
| Myocrd img PET metab eval single study (78459) |
$5,946.91 |
$5,946.91 |
4.4× |
| Nm bone 3 phase (78315) |
$2,310.64 |
$2,310.64 |
5.5× |
| Nm bone imaging whole body (78306) |
$5,109.37 |
$5,109.37 |
12.2× |
| Nm bone marrow scan limited (78102) |
$2,181.11 |
$2,181.11 |
5.2× |
| Nm heart perfusion spect stress rest (78452) |
$9,151.31 |
$9,151.31 |
6.8× |
| Nm lymph system (78195) |
$2,596.41 |
$2,596.41 |
4.6× |
| Nose to rectum for fb child (76010) |
$220 |
$220 |
2.4× |
| Ob us < 14 wks single fetus (76801) |
$1,070.03 |
$1,070.03 |
9.8× |
| Parathyrd planar w/spect&CT (78072) |
$2,546.90 |
$2,546.90 |
4.5× |
| Peritoneogram rs&i (74190) |
$37,805.01 |
$37,805.01 |
66.3× |
| PET brain metabolic eval (78608) |
$6,891.35 |
$6,891.35 |
4.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$11,184.15 |
$11,184.15 |
7.5× |
| PET imaging for CT attenuation whole body (78816) |
$11,187.77 |
$11,187.77 |
7.5× |
| PET imaging whole body (78813) |
$10,531.58 |
$10,531.58 |
7.1× |
| Pulmonary perfusion imaging particulate (78580) |
$4,394.27 |
$4,394.27 |
10.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,025.42 |
$1,025.42 |
1.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$2,376 |
$2,376 |
26.1× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$613.43 |
$613.43 |
5.6× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$1,387.23 |
$1,387.23 |
12.7× |
| Radex hip unilateral with pelvis 1 view (73501) |
$781.81 |
$781.81 |
8.6× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$781.81 |
$781.81 |
8.6× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$2,254.19 |
$2,254.19 |
20.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,162.73 |
$1,162.73 |
10.7× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$1,179.85 |
$1,179.85 |
10.8× |
| Radex spine cervical 2 or 3 views (72040) |
$827.94 |
$827.94 |
9.1× |
| Radex spine cervical 4 or 5 views (72050) |
$1,621.76 |
$1,621.76 |
14.9× |
| Radex spine cervical 6 or more views (72052) |
$1,866.33 |
$1,866.33 |
17.1× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$1,054.43 |
$1,054.43 |
11.6× |
| Radiation delivery stereotactic cranial linear (77372) |
$26,680.93 |
$26,680.93 |
3.5× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77371) |
$27,584.98 |
$27,584.98 |
3.6× |
| Radiation tx delivery lvl 1 (77402) |
$847.72 |
$847.72 |
8.0× |
| Radiation tx delivery lvl 2 (77407) |
$835.14 |
$835.14 |
2.1× |
| Radiation tx delivery lvl 3 (77412) |
$1,169.12 |
$1,169.12 |
2.0× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$1,506.71 |
$1,506.71 |
13.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,625.22 |
$1,625.22 |
8.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,019.60 |
$1,019.60 |
5.6× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$312.12 |
$312.12 |
3.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$874.03 |
$874.03 |
9.6× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$1,368.51 |
$1,368.51 |
12.5× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$1,016.37 |
$1,016.37 |
9.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$4,497.61 |
$4,497.61 |
10.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,508.95 |
$3,508.95 |
6.2× |
| 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× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$103.18 |
$103.18 |
4.4× |
| Selective spinal angiogram (75705) |
$6,440.61 |
$6,440.61 |
1.1× |
| Shoulder arthrogram (73040) |
$1,187.22 |
$1,187.22 |
3.3× |
| Simulation complex (77290) |
$3,279.84 |
$3,279.84 |
8.4× |
| Simulation simple (77280) |
$1,945.76 |
$1,945.76 |
13.9× |
| Small bowel series (74250) |
$1,028.12 |
$1,028.12 |
5.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,635.64 |
$1,635.64 |
4.2× |
| Special dosimetry (77331) |
$759.48 |
$759.48 |
5.4× |
| Special physics consult (77370) |
$1,345.49 |
$1,345.49 |
9.6× |
| Special treatment procedure (77470) |
$2,713.76 |
$2,713.76 |
4.7× |
| Splenoportography (75810) |
$6,440.61 |
$6,440.61 |
2.0× |
| Stereotactic body radiation delivery (77373) |
$6,110.77 |
$6,110.77 |
3.3× |
| Tbs technical calculation only (77091) |
$215.13 |
$215.13 |
2.4× |
| Therapeutic enema barium or air (74283) |
$1,139.02 |
$1,139.02 |
6.2× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$796.54 |
$796.54 |
1.9× |
| Treatment device intermediate (77333) |
$802.19 |
$802.19 |
5.7× |
| Treatment devices complex (77334) |
$1,379.62 |
$1,379.62 |
3.5× |
| Treatment devices simple (77332) |
$657.10 |
$657.10 |
4.7× |
| Ultrasound breast limited (76642) |
$355.48 |
$355.48 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$1,762.52 |
$1,762.52 |
16.1× |
| Urethrocystography retrograde rs&i (74450) |
$517.22 |
$517.22 |
2.1× |
| Urethrocystography voiding (74455) |
$2,194.53 |
$2,194.53 |
8.8× |
| Urography antegrade (74425) |
$1,028.35 |
$1,028.35 |
2.8× |
| Urography retrograde w/wo kub (74420) |
$1,214.36 |
$1,214.36 |
3.3× |
| Us abdominal aorta real time screen study aaa (76706) |
$425.53 |
$425.53 |
3.9× |
| Us breast uni real time with image complete (76641) |
$470.88 |
$470.88 |
4.3× |
| Us chest (76604) |
$1,004.02 |
$1,004.02 |
9.2× |
| Us compl joint r-t w/image documentation (76881) |
$935.19 |
$935.19 |
8.6× |
| Us encephalogram (76506) |
$1,628.80 |
$1,628.80 |
14.9× |
| Us kidney transplanted (76776) |
$1,492.64 |
$1,492.64 |
13.7× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$745.94 |
$745.94 |
6.8× |
| Us ob limited 1 or more fetuses (76815) |
$1,762.52 |
$1,762.52 |
16.1× |
| Us obstetric transvaginal (76817) |
$911.63 |
$911.63 |
8.4× |
| Us pelvic limited or f/u non-ob (76857) |
$858.22 |
$858.22 |
7.9× |
| Us pelvis complete (76856) |
$1,543.56 |
$1,543.56 |
14.1× |
| Us retroperitoneal complete (76770) |
$1,159.63 |
$1,159.63 |
10.6× |
| Us retroperitoneal limited (76775) |
$1,762.52 |
$1,762.52 |
16.1× |
| Us scrotum (76870) |
$962.70 |
$962.70 |
8.8× |
| Us soft tissue head/neck (76536) |
$1,493.28 |
$1,493.28 |
13.7× |
| Venogram extremity bilateral (75822) |
$3,709 |
$3,709 |
2.3× |
| Venogram ivc w serialography (75825) |
$10,153.40 |
$10,153.40 |
3.1× |
| Venogram svc w serialography (75827) |
$4,222.55 |
$4,222.55 |
2.6× |
| Venography ext unilateral (75820) |
$3,208.13 |
$3,208.13 |
2.0× |
| Venography renal unilateral selective rs&i (75831) |
$6,343.48 |
$6,343.48 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$908.10 |
$908.10 |
10.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$827.94 |
$827.94 |
9.1× |
| X-ray aorta leg arteries (75630) |
$9,926.25 |
$9,926.25 |
3.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,829.51 |
$1,829.51 |
10.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$934.16 |
$934.16 |
10.3× |
| X-ray exam hips bi 3-4 views (73522) |
$270 |
$270 |
2.5× |
| X-ray exam of finger(s) (73140) |
$645.48 |
$645.48 |
7.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$1,012.35 |
$1,012.35 |
11.1× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$827.94 |
$827.94 |
9.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$763.78 |
$763.78 |
8.4× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$681.59 |
$681.59 |
6.2× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$781.81 |
$781.81 |
8.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$725.69 |
$725.69 |
8.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$827.94 |
$827.94 |
9.1× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$801.47 |
$801.47 |
8.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$827.94 |
$827.94 |
7.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$364.68 |
$364.68 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,311.05 |
$1,311.05 |
12.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$2,702.27 |
$2,702.27 |
24.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$966.25 |
$966.25 |
10.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,403.25 |
$1,403.25 |
12.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$934.16 |
$934.16 |
8.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$398.92 |
$398.92 |
3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$934.16 |
$934.16 |
10.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$882.05 |
$882.05 |
9.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,064.48 |
$1,064.48 |
11.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,134.64 |
$1,134.64 |
10.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$705.64 |
$705.64 |
6.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$641.52 |
$641.52 |
7.1× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$713.71 |
$713.71 |
7.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$802.52 |
$802.52 |
8.8× |
| Xr abdomen 1 view (74018) |
$732.15 |
$732.15 |
8.1× |
| Xr abdomen 2 views (74019) |
$1,095.56 |
$1,095.56 |
10.0× |
| Xr abdomen 3 views (74021) |
$959.96 |
$959.96 |
8.8× |
| Xr arthrogram ankle (73615) |
$781.01 |
$781.01 |
2.1× |
| Xr arthrogram elbow (73085) |
$1,224.60 |
$1,224.60 |
3.4× |
| Xr arthrogram hip (73525) |
$1,222.46 |
$1,222.46 |
3.4× |
| Xr bone density appendicular (77081) |
$473.09 |
$473.09 |
5.2× |
| Xr bone density axial (77080) |
$473.09 |
$473.09 |
4.3× |
| Xr bone length study (77073) |
$475.52 |
$475.52 |
4.4× |
| Xr bone survey infant (77076) |
$747.76 |
$747.76 |
6.8× |
| Xr bone survey limited (77074) |
$1,214.83 |
$1,214.83 |
11.1× |
| Xr chest 1 view (71045) |
$674.53 |
$674.53 |
7.4× |
| Xr chest 2 views (71046) |
$1,274.94 |
$1,274.94 |
14.0× |
| Xr chest 3 views (71047) |
$2,557.73 |
$2,557.73 |
28.1× |
| Xr cystogram 3+ views (74430) |
$1,099.06 |
$1,099.06 |
3.0× |
| Xr eye foreign body (70030) |
$330.66 |
$330.66 |
3.6× |
| Xr facial bones 3 views (70150) |
$1,311.05 |
$1,311.05 |
12.0× |
| Xr lower extremity 2 views infant (73592) |
$835.95 |
$835.95 |
9.2× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$922.17 |
$922.17 |
8.4× |
| Xr mandible 4 views (70110) |
$1,355.14 |
$1,355.14 |
12.4× |
| Xr myelogram c-spine (72240) |
$3,012.09 |
$3,012.09 |
3.7× |
| Xr nasal bones (70160) |
$682.97 |
$682.97 |
7.5× |
| Xr pelvis 3 views (72190) |
$1,012.35 |
$1,012.35 |
9.3× |
| Xr spine 1 view (72020) |
$618.22 |
$618.22 |
6.8× |
| Xr sternum 2 views (71120) |
$934.16 |
$934.16 |
10.3× |
| Xr surgical specimen (76098) |
$1,428.17 |
$1,428.17 |
2.5× |
| Xr upper extremity 2 views infant (73092) |
$739.73 |
$739.73 |
6.8× |
| Xray elbow 2 views (73070) |
$827.94 |
$827.94 |
9.1× |
| Xray forearm 2 views (73090) |
$827.94 |
$827.94 |
9.1× |
| Xray knee 1 or 2 views rt (73560) |
$827.94 |
$827.94 |
9.1× |
| Xray neck soft tissue (70360) |
$614.65 |
$614.65 |
6.8× |
| Xray orbits complete min 4 views (70200) |
$1,295.84 |
$1,295.84 |
11.9× |
| Xray pelvis 1 or 2 views (72170) |
$809.90 |
$809.90 |
7.4× |
| Xray ribs bilateral 3 views (71110) |
$1,214.83 |
$1,214.83 |
11.1× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$1,196.79 |
$1,196.79 |
11.0× |
| Xray scapula complete (73010) |
$934.16 |
$934.16 |
8.6× |
| Xray shoulder 1 view (73020) |
$348.46 |
$348.46 |
3.8× |
| Xray sinuses paranasal <3 views (70210) |
$681.59 |
$681.59 |
7.5× |
| Xray spine thoracic 2 views (72070) |
$270 |
$270 |
2.5× |
| Xray spine thoracic 3 views (72072) |
$1,054.43 |
$1,054.43 |
9.7× |
| Xray tibia-fibula 2 views bil (73590) |
$629.46 |
$629.46 |
6.9× |
| Xray tmj open - closed unilat (70328) |
$112.27 |
$112.27 |
1.2× |
| Xray tmj's bilateral open-clsc (70330) |
$1,162.73 |
$1,162.73 |
12.8× |