| Ankle 2 views (73600) |
$1,412.76 |
$1,412.76 |
15.5× |
| Bone age studies (77072) |
$712.75 |
$712.75 |
6.5× |
| Bone survey complete (77075) |
$1,925.54 |
$1,925.54 |
17.6× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$2,013.11 |
$2,013.11 |
5.1× |
| Clavicle complete (73000) |
$1,244.01 |
$1,244.01 |
13.7× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$6,084.02 |
$6,084.02 |
33.2× |
| CT - st neck w&wo contr (70492) |
$2,357.21 |
$2,357.21 |
12.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$16,386.70 |
$16,386.70 |
45.0× |
| CT abdomen and pelvis without contrast (74176) |
$11,071.81 |
$11,071.81 |
44.4× |
| CT abdomen w wo contrast (74170) |
$8,528.64 |
$8,528.64 |
46.6× |
| CT abdomen w/contrast (74160) |
$6,526.92 |
$6,526.92 |
35.6× |
| CT abdomen w/o contrast (74150) |
$5,615.40 |
$5,615.40 |
51.4× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$15,221.87 |
$15,221.87 |
41.8× |
| CT angio abdom w/o & w/dye (74175) |
$7,070.78 |
$7,070.78 |
38.6× |
| CT angio abdominal arteries (75635) |
$7,781.07 |
$7,781.07 |
42.5× |
| CT angiograph pelv w/o&w/dye (72191) |
$2,357.21 |
$2,357.21 |
12.9× |
| CT cervical spine w/contrast (72126) |
$5,129.09 |
$5,129.09 |
14.1× |
| CT cervical spine w/o contrast (72125) |
$5,533.46 |
$5,533.46 |
50.7× |
| CT chest w/contrast (71260) |
$6,626.19 |
$6,626.19 |
36.2× |
| CT head/brain without and with contrast (70470) |
$7,445.40 |
$7,445.40 |
40.6× |
| CT lower ext w/wo contrast (73702) |
$2,357.21 |
$2,357.21 |
12.9× |
| CT lower extremity w contrast (73701) |
$5,841.38 |
$5,841.38 |
31.9× |
| CT lower extremity w/o contrast unilateral (73700) |
$5,312.42 |
$5,312.42 |
48.7× |
| CT lumbar spine w/contrast (72132) |
$5,129.09 |
$5,129.09 |
14.1× |
| CT lumbar spine w/o contrast (72131) |
$5,496.16 |
$5,496.16 |
50.3× |
| CT maxillofacial area w/o contrast (70486) |
$6,454.91 |
$6,454.91 |
59.1× |
| CT maxillofacial w/contrast (70487) |
$6,805.89 |
$6,805.89 |
37.2× |
| CT maxillofacial w/o then w/ con (70488) |
$5,907.21 |
$5,907.21 |
32.2× |
| CT orbit sella ear w/o con (70480) |
$5,733.05 |
$5,733.05 |
52.5× |
| CT pelvis w/o contrast (72192) |
$5,456.44 |
$5,456.44 |
50.0× |
| CT soft tissue neck w/contrast (70491) |
$6,496.89 |
$6,496.89 |
35.5× |
| CT soft tissue neck w/o contrast (70490) |
$5,304.97 |
$5,304.97 |
48.6× |
| CT spine cervical w/wo contrast (72127) |
$2,357.21 |
$2,357.21 |
12.9× |
| CT thoracic spine w/contrast (72129) |
$2,357.21 |
$2,357.21 |
12.9× |
| CT thoracic spine w/o contrast (72128) |
$6,134.47 |
$6,134.47 |
56.2× |
| CT thorax w/o contrast (71250) |
$4,547.42 |
$4,547.42 |
41.7× |
| CT thorax w/o then w/ contrast (71270) |
$2,357.21 |
$2,357.21 |
12.9× |
| CT upper extremity w/dye (73201) |
$6,047.53 |
$6,047.53 |
16.6× |
| CT upper extremity w/o contrast rt (73200) |
$4,097.95 |
$4,097.95 |
37.5× |
| CTA chest w/wo contrast (71275) |
$7,683.51 |
$7,683.51 |
41.9× |
| CTA head w contrast (70496) |
$7,036.91 |
$7,036.91 |
38.4× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$5,755.17 |
$5,755.17 |
31.4× |
| Cta Neck (70498) |
$7,367.07 |
$7,367.07 |
40.2× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$2,357.21 |
$2,357.21 |
12.9× |
| Fetal biophysical profile w/o nst (76819) |
$1,925.54 |
$1,925.54 |
17.6× |
| Humerus min 2 views (73060) |
$1,506.44 |
$1,506.44 |
16.6× |
| Imrt planning (77301) |
$16,846.89 |
$16,846.89 |
11.7× |
| Intracavitary radiation source applic complex (77763) |
$4,470.33 |
$4,470.33 |
6.1× |
| Intracavitary radiation source applic intermed (77762) |
$3,716.73 |
$3,716.73 |
6.4× |
| Intracavitary radiation source applic simple (77761) |
$2,507.42 |
$2,507.42 |
4.3× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$1,636.83 |
$1,636.83 |
4.2× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$1,377.08 |
$1,377.08 |
3.5× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$1,794.37 |
$1,794.37 |
4.6× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$1,083.84 |
$1,083.84 |
2.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$5,129.09 |
$5,129.09 |
14.1× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$5,129.09 |
$5,129.09 |
14.1× |
| Mr safety determination physician/other qhp (76016) |
$252.89 |
$252.89 |
2.8× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$168.42 |
$168.42 |
2.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$70.61 |
$70.61 |
2.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$265.09 |
$265.09 |
2.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$696.84 |
$696.84 |
2.8× |
| MRA head w & w/o contrast (70546) |
$5,129.09 |
$5,129.09 |
14.1× |
| MRA head w/o contrast (70544) |
$4,056.83 |
$4,056.83 |
16.3× |
| MRA neck w/o contrast (70547) |
$4,056.83 |
$4,056.83 |
16.3× |
| MRA neck w/wo contrast (70549) |
$5,129.09 |
$5,129.09 |
14.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$9,720.98 |
$9,720.98 |
26.7× |
| MRI abdomen w/o contrast (74181) |
$4,056.83 |
$4,056.83 |
16.3× |
| MRI cervical spine w/o contrast (72141) |
$8,378.38 |
$8,378.38 |
33.6× |
| MRI joint upr extr w/o&w/dye (73223) |
$7,148.88 |
$7,148.88 |
19.6× |
| MRI joint upr extrem w/o dye (73221) |
$6,687.41 |
$6,687.41 |
26.8× |
| Mri Lower Extremity W/O Dye (73718) |
$6,119.88 |
$6,119.88 |
24.6× |
| MRI lumbar w/wo contrast (72158) |
$9,555.24 |
$9,555.24 |
26.2× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$5,129.09 |
$5,129.09 |
14.1× |
| MRI orbit/face/neck w/o contrast (70540) |
$4,056.83 |
$4,056.83 |
16.3× |
| MRI pelvis w/o contrast (72195) |
$4,056.83 |
$4,056.83 |
16.3× |
| MRI pelvis w/wo contrast (72197) |
$5,129.09 |
$5,129.09 |
14.1× |
| MRI spine cervical wo/w contrast (72156) |
$5,129.09 |
$5,129.09 |
14.1× |
| MRI thoracic spine w wo contrast (72157) |
$8,794.33 |
$8,794.33 |
24.1× |
| MRI thoracic spine w/o contrast (72146) |
$7,553.79 |
$7,553.79 |
30.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,056.83 |
$4,056.83 |
16.3× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$5,129.09 |
$5,129.09 |
14.1× |
| Nose to rectum for fb child (76010) |
$1,412.76 |
$1,412.76 |
15.5× |
| Ob us < 14 wks single fetus (76801) |
$1,840.65 |
$1,840.65 |
16.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$295.77 |
$295.77 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,925.54 |
$1,925.54 |
17.6× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$1,925.54 |
$1,925.54 |
17.6× |
| Radex hip unilateral with pelvis 1 view (73501) |
$1,840.09 |
$1,840.09 |
20.2× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$2,024.77 |
$2,024.77 |
22.3× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$2,375.74 |
$2,375.74 |
21.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,119.45 |
$1,119.45 |
10.3× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$1,925.54 |
$1,925.54 |
17.6× |
| Radex spine cervical 2 or 3 views (72040) |
$1,461.08 |
$1,461.08 |
16.1× |
| Radex spine cervical 4 or 5 views (72050) |
$2,290.42 |
$2,290.42 |
21.0× |
| Radex spine cervical 6 or more views (72052) |
$1,925.54 |
$1,925.54 |
17.6× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$1,412.76 |
$1,412.76 |
15.5× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77371) |
$35,677.03 |
$35,677.03 |
4.6× |
| Radiation tx delivery lvl 1 (77402) |
$712.81 |
$712.81 |
6.7× |
| Radiation tx delivery lvl 2 (77407) |
$951.51 |
$951.51 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,363.86 |
$1,363.86 |
15.0× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$1,841.26 |
$1,841.26 |
16.9× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$1,925.54 |
$1,925.54 |
17.6× |
| Ultrasound, abdomen limited (76705) |
$2,369.66 |
$2,369.66 |
21.7× |
| Us abdominal aorta real time screen study aaa (76706) |
$1,925.54 |
$1,925.54 |
17.6× |
| Us chest (76604) |
$1,925.54 |
$1,925.54 |
17.6× |
| Us compl joint r-t w/image documentation (76881) |
$1,925.54 |
$1,925.54 |
17.6× |
| Us kidney transplanted (76776) |
$1,925.54 |
$1,925.54 |
17.6× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$2,287.86 |
$2,287.86 |
21.0× |
| Us ob detailed single fetus (76811) |
$4,056.83 |
$4,056.83 |
16.3× |
| Us ob followup per fetus (76816) |
$858.96 |
$858.96 |
7.9× |
| Us ob limited 1 or more fetuses (76815) |
$1,273.45 |
$1,273.45 |
11.7× |
| Us obstetric transvaginal (76817) |
$1,840.65 |
$1,840.65 |
16.9× |
| Us pelvic limited or f/u non-ob (76857) |
$1,407.07 |
$1,407.07 |
12.9× |
| Us pelvis complete (76856) |
$2,637.02 |
$2,637.02 |
24.2× |
| Us retroperitoneal complete (76770) |
$2,416.02 |
$2,416.02 |
22.1× |
| Us retroperitoneal limited (76775) |
$1,780.66 |
$1,780.66 |
16.3× |
| Us scrotum (76870) |
$2,372.40 |
$2,372.40 |
21.7× |
| Us soft tissue head/neck (76536) |
$2,118.78 |
$2,118.78 |
19.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,493.47 |
$1,493.47 |
16.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$1,542.02 |
$1,542.02 |
17.0× |
| X-ray exam hips bi 3-4 views (73522) |
$319.57 |
$319.57 |
2.9× |
| X-ray exam of finger(s) (73140) |
$793.67 |
$793.67 |
8.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$1,134.89 |
$1,134.89 |
12.5× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$1,017.23 |
$1,017.23 |
11.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,493.47 |
$1,493.47 |
16.4× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$1,062.59 |
$1,062.59 |
9.7× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$1,438.38 |
$1,438.38 |
15.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$1,227.82 |
$1,227.82 |
13.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$1,137.98 |
$1,137.98 |
12.5× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$1,626.27 |
$1,626.27 |
17.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,820.64 |
$1,820.64 |
16.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,613.33 |
$1,613.33 |
14.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$2,617.61 |
$2,617.61 |
24.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,542.02 |
$1,542.02 |
17.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$2,501 |
$2,501 |
22.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,062.59 |
$1,062.59 |
9.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$1,925.54 |
$1,925.54 |
17.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,532.33 |
$1,532.33 |
16.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,542.02 |
$1,542.02 |
17.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,629.52 |
$1,629.52 |
17.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$2,212.65 |
$2,212.65 |
20.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,529.09 |
$1,529.09 |
14.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$1,412.76 |
$1,412.76 |
15.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$764.56 |
$764.56 |
8.4× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$1,062.59 |
$1,062.59 |
11.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,493.47 |
$1,493.47 |
16.4× |
| Xr abdomen 1 view (74018) |
$913.59 |
$913.59 |
10.1× |
| Xr abdomen 2 views (74019) |
$1,209.50 |
$1,209.50 |
11.1× |
| Xr abdomen 3 views (74021) |
$1,925.54 |
$1,925.54 |
17.6× |
| Xr bone survey infant (77076) |
$1,925.54 |
$1,925.54 |
17.6× |
| Xr chest 1 view (71045) |
$713.92 |
$713.92 |
7.9× |
| Xr chest 2 views (71046) |
$964.64 |
$964.64 |
10.6× |
| Xr chest 3 views (71047) |
$1,412.76 |
$1,412.76 |
15.5× |
| Xr facial bones 3 views (70150) |
$2,096.01 |
$2,096.01 |
19.2× |
| Xr lower extremity 2 views infant (73592) |
$1,013.54 |
$1,013.54 |
11.2× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$1,925.54 |
$1,925.54 |
17.6× |
| Xr mandible 4 views (70110) |
$1,502.89 |
$1,502.89 |
13.8× |
| Xr nasal bones (70160) |
$1,373.59 |
$1,373.59 |
15.1× |
| Xr pelvis 3 views (72190) |
$1,925.54 |
$1,925.54 |
17.6× |
| Xr sternum 2 views (71120) |
$1,386.55 |
$1,386.55 |
15.3× |
| Xr upper extremity 2 views infant (73092) |
$939.50 |
$939.50 |
8.6× |
| Xray elbow 2 views (73070) |
$1,386.55 |
$1,386.55 |
15.3× |
| Xray forearm 2 views (73090) |
$1,383.28 |
$1,383.28 |
15.2× |
| Xray knee 1 or 2 views rt (73560) |
$1,444.89 |
$1,444.89 |
15.9× |
| Xray neck soft tissue (70360) |
$831.40 |
$831.40 |
9.1× |
| Xray orbits complete min 4 views (70200) |
$1,877.07 |
$1,877.07 |
17.2× |
| Xray pelvis 1 or 2 views (72170) |
$1,146.83 |
$1,146.83 |
10.5× |
| Xray ribs bilateral 3 views (71110) |
$2,290.42 |
$2,290.42 |
21.0× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$1,785.03 |
$1,785.03 |
16.4× |
| Xray scapula complete (73010) |
$1,308.84 |
$1,308.84 |
12.0× |
| Xray shoulder 1 view (73020) |
$1,412.76 |
$1,412.76 |
15.5× |
| Xray sinuses paranasal <3 views (70210) |
$1,412.76 |
$1,412.76 |
15.5× |
| Xray spine thoracic 2 views (72070) |
$1,804.49 |
$1,804.49 |
16.5× |
| Xray spine thoracic 3 views (72072) |
$1,924.32 |
$1,924.32 |
17.6× |
| Xray tibia-fibula 2 views bil (73590) |
$1,383.28 |
$1,383.28 |
15.2× |
| Xray tmj open - closed unilat (70328) |
$1,412.76 |
$1,412.76 |
15.5× |
| Xray tmj's bilateral open-clsc (70330) |
$1,412.76 |
$1,412.76 |
15.5× |