| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,284.60 |
$2,141 |
1.0× |
| Abdomen 2 views (74019) |
$207.60 |
$346 |
2.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$655.20 |
$1,092 |
1.7× |
| Angiography extremity bilateral rs&i (75716) |
$3,192.60 |
$5,321 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,778 |
$4,630 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$1,359.60 |
$2,266 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,660 |
$6,100 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,056 |
$6,760 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,610.20 |
$6,017 |
1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,513.60 |
$5,856 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,163.40 |
$1,939 |
0.4× |
| Ankle 2 views (73600) |
$274.20 |
$457 |
3.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$666 |
$1,110 |
2.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,013.80 |
$5,023 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$2,430 |
$4,050 |
0.8× |
| Arthrogram shoulder (73040) |
$620.40 |
$1,034 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$393.60 |
$656 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$883.20 |
$1,472 |
2.3× |
| Bone &/joint imaging whole body (78306) |
$1,279.20 |
$2,132 |
3.3× |
| Bone age studies (77072) |
$133.20 |
$222 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$1,458.60 |
$2,431 |
3.8× |
| Bone survey complete (77075) |
$481.80 |
$803 |
4.8× |
| Brachytx isodose complex (77318) |
$2,622.60 |
$4,371 |
7.3× |
| Brachytx isodose intermed (77317) |
$1,573.80 |
$2,623 |
4.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,390.20 |
$2,317 |
3.9× |
| Brain image w/flow 4 + views (78606) |
$349.20 |
$582 |
0.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$245.40 |
$409 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,074 |
$1,790 |
3.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$308.40 |
$514 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$310.20 |
$517 |
3.7× |
| Chest 1 view (71045) |
$123 |
$205 |
1.5× |
| Chest 3 views (71047) |
$387.60 |
$646 |
4.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$171.60 |
$286 |
1.0× |
| Clavicle complete (73000) |
$235.80 |
$393 |
2.8× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$36,743.40 |
$61,239 |
5.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$70.80 |
$118 |
0.7× |
| Continuing medical physics consltj pr wk (77336) |
$475.80 |
$793 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,732.40 |
$4,554 |
8.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,548 |
$2,580 |
6.7× |
| CT abdomen w contrast (74160) |
$1,787.40 |
$2,979 |
10.6× |
| CT abdomen w wo contrast (74170) |
$2,031 |
$3,385 |
12.0× |
| CT abdomen w/o contrast (74150) |
$1,157.40 |
$1,929 |
11.5× |
| CT angio hrt w/3d image (75574) |
$339 |
$565 |
1.0× |
| CT angiography upper extremity lt (73206) |
$526.80 |
$878 |
3.1× |
| CT c-spine w/o contrast (72125) |
$1,701 |
$2,835 |
16.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,922.40 |
$3,204 |
11.4× |
| CT cervical spine with contrast (72126) |
$2,449.80 |
$4,083 |
7.3× |
| CT chest w/wo contrast (71270) |
$1,583.40 |
$2,639 |
9.4× |
| CT chest with contrast (71260) |
$1,414.20 |
$2,357 |
8.4× |
| CT colonography w/dye (74262) |
$196.20 |
$327 |
1.2× |
| CT head/brain with contrast (70460) |
$1,425 |
$2,375 |
8.4× |
| CT head/brain without and with contrast (70470) |
$1,907.40 |
$3,179 |
11.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$45 |
$75 |
0.5× |
| CT iac w contrast (70481) |
$586.80 |
$978 |
3.5× |
| CT limited/localized follow up study (76380) |
$247.80 |
$413 |
3.0× |
| CT lower ext w/o (73700) |
$1,067.40 |
$1,779 |
10.6× |
| CT lower extremity w wo contrast (73702) |
$1,633.20 |
$2,722 |
9.7× |
| CT lower extremity with contrast (73701) |
$1,345.20 |
$2,242 |
8.0× |
| CT lumbar spine w & w/o contrast (72133) |
$973.20 |
$1,622 |
5.8× |
| CT lumbar spine w/o contrast (72131) |
$457.20 |
$762 |
4.5× |
| CT lumbar spine with contrast (72132) |
$1,429.80 |
$2,383 |
4.3× |
| CT maxillofacial w contrast (70487) |
$1,411.20 |
$2,352 |
8.4× |
| CT maxillofacial w/o contrast (70486) |
$1,176 |
$1,960 |
11.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,729.20 |
$2,882 |
10.2× |
| CT neck soft tissue w contrast (70491) |
$1,288.80 |
$2,148 |
7.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$641.40 |
$1,069 |
3.8× |
| CT orbits w/o contrast (70480) |
$496.80 |
$828 |
4.9× |
| CT pelvis w & w/o contrast (72194) |
$3,414 |
$5,690 |
20.2× |
| CT pelvis w/o contrast (72192) |
$1,524 |
$2,540 |
15.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,521 |
$2,535 |
9.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,057.20 |
$1,762 |
10.5× |
| CT thoracic spine w/contrast (72129) |
$3,234.60 |
$5,391 |
19.1× |
| CT thoracic spine w/o contrast (72128) |
$1,617.60 |
$2,696 |
16.1× |
| CT thoracic spine w/wo contrast (72130) |
$3,622.80 |
$6,038 |
21.4× |
| CT thorax w/o contrast (71250) |
$707.40 |
$1,179 |
7.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,727.40 |
$2,879 |
10.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,121.40 |
$1,869 |
11.1× |
| CT upper extremity with contrast (73201) |
$1,390.80 |
$2,318 |
4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,780.80 |
$2,968 |
10.5× |
| Cta Abdomen (74175) |
$2,433.60 |
$4,056 |
14.4× |
| CTA abdomen pelvis (74174) |
$3,080.40 |
$5,134 |
9.2× |
| CTA chest (71275) |
$2,538.60 |
$4,231 |
15.0× |
| Cta Head (70496) |
$1,308 |
$2,180 |
7.7× |
| Cta Neck (70498) |
$1,714.80 |
$2,858 |
10.1× |
| Cta Pelvis (72191) |
$567 |
$945 |
3.4× |
| Cystography minimum 3 views rs&i (74430) |
$168.60 |
$281 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$298.20 |
$497 |
3.0× |
| Echoencephalography real time imaging (76506) |
$210.60 |
$351 |
2.1× |
| Esophagus (74220) |
$350.40 |
$584 |
2.1× |
| Fetal biophysical profile non-stress testing (76818) |
$377.40 |
$629 |
3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$275.40 |
$459 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$310.20 |
$517 |
1.3× |
| Foot 2 views (73620) |
$87.60 |
$146 |
1.0× |
| Forearm 2 views (73090) |
$217.80 |
$363 |
2.6× |
| Hand 2 views (73120) |
$178.20 |
$297 |
1.8× |
| Hand 3 views (73130) |
$201.60 |
$336 |
2.4× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,276.80 |
$2,128 |
1.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,323.20 |
$3,872 |
3.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,051 |
$5,085 |
4.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,382.40 |
$2,304 |
2.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,009.20 |
$1,682 |
2.6× |
| Ht muscle image spect sing (78451) |
$2,893.20 |
$4,822 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$171.60 |
$286 |
2.0× |
| Hysterosalpingogram (74740) |
$708.60 |
$1,181 |
3.1× |
| Interstitial radiation source applic complex (77778) |
$957 |
$1,595 |
1.4× |
| Intracavitary radiation source applic simple (77761) |
$282.60 |
$471 |
0.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,516.20 |
$2,527 |
2.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,083 |
$1,805 |
2.1× |
| Knee 3 views (73562) |
$288.60 |
$481 |
3.4× |
| Liver & spleen imaging static only (78215) |
$244.20 |
$407 |
0.6× |
| Lung perf&ventilat diferentl (78598) |
$789.60 |
$1,316 |
1.5× |
| Lung perfusion differential (78597) |
$829.20 |
$1,382 |
2.2× |
| Lung Ventilation Imaging (78579) |
$396 |
$660 |
1.0× |
| Lymphoscintigraphy (78195) |
$937.20 |
$1,562 |
1.8× |
| Mammary ductogram or galactogram single (77053) |
$360 |
$600 |
1.6× |
| Meckels Diverticulum (78290) |
$424.80 |
$708 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,959.60 |
$3,266 |
5.4× |
| MRA head w & w/o contrast (70546) |
$1,989.60 |
$3,316 |
5.9× |
| MRA head w/o contrast (70544) |
$1,876.80 |
$3,128 |
8.2× |
| MRA head with contrast (70545) |
$1,896 |
$3,160 |
5.6× |
| MRA neck w contrast (70548) |
$1,809.60 |
$3,016 |
5.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,900.20 |
$3,167 |
5.7× |
| MRA neck w/o contrast (70547) |
$1,138.20 |
$1,897 |
5.0× |
| MRI abdomen w contrast (74182) |
$2,354.40 |
$3,924 |
7.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,478 |
$4,130 |
7.4× |
| MRI abdomen w/o contrast (74181) |
$1,486.80 |
$2,478 |
6.5× |
| MRI any jnt lwr ext with con lt (73722) |
$4,142.40 |
$6,904 |
5.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,621.60 |
$6,036 |
4.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,623.60 |
$2,706 |
7.1× |
| MRI c-spine with contrast (72142) |
$1,921.20 |
$3,202 |
5.7× |
| MRI cardiac w/o contrast (75557) |
$622.80 |
$1,038 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$1,864.80 |
$3,108 |
8.1× |
| MRI chest w/o & w/contrast material (71552) |
$1,643.40 |
$2,739 |
4.9× |
| MRI chest w/o contrast (71550) |
$986.40 |
$1,644 |
4.3× |
| MRI chest with contrast (71551) |
$1,429.80 |
$2,383 |
1.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,953 |
$3,255 |
5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,011.80 |
$3,353 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,273.80 |
$2,123 |
5.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,243.20 |
$2,072 |
5.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,071.80 |
$3,453 |
6.2× |
| MRI orbit/face/neck w/contrast (70542) |
$2,071.80 |
$3,453 |
6.2× |
| MRI pelvis w contrast (72196) |
$1,944.60 |
$3,241 |
5.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,047.20 |
$3,412 |
6.1× |
| MRI pelvis w/o contrast (72195) |
$1,228.20 |
$2,047 |
5.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,268.60 |
$3,781 |
6.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,473.80 |
$4,123 |
7.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,014.20 |
$3,357 |
6.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,566.80 |
$4,278 |
7.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,566.80 |
$4,278 |
7.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,691.60 |
$4,486 |
8.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,691.60 |
$4,486 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,611.60 |
$2,686 |
7.0× |
| MRI tmj (70336) |
$463.80 |
$773 |
2.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,366.80 |
$2,278 |
5.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,056.20 |
$3,427 |
6.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,357.20 |
$2,262 |
5.9× |
| Myelogram Cervical (72240) |
$816 |
$1,360 |
1.1× |
| Myelography 2 or more regions (72270) |
$771.60 |
$1,286 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$3,485.40 |
$5,809 |
2.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$782.40 |
$1,304 |
0.9× |
| Neck soft tissue (70360) |
$151.80 |
$253 |
1.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$278.40 |
$464 |
0.7× |
| Nm bone marrow wb (78104) |
$300 |
$500 |
0.8× |
| Nm cisternogram (78630) |
$378 |
$630 |
0.7× |
| Nm csf leak detection (78650) |
$1,277.40 |
$2,129 |
1.0× |
| Nm gastric emptying study (78264) |
$1,661.40 |
$2,769 |
4.3× |
| Nm gastroesophageal reflux study (78262) |
$227.40 |
$379 |
0.6× |
| Nm peritoneal-venous shunt patency (78291) |
$192 |
$320 |
0.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,576.60 |
$5,961 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$167.40 |
$279 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$304.20 |
$507 |
3.0× |
| Osseous survey infant (77076) |
$530.40 |
$884 |
5.3× |
| Osseous survey limited (77074) |
$323.40 |
$539 |
3.2× |
| Parathyrd planar w/wo subtrj (78071) |
$427.20 |
$712 |
1.1× |
| Parathyroid imaging (78070) |
$584.40 |
$974 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$153.60 |
$256 |
1.5× |
| Peritoneogram rs&i (74190) |
$466.20 |
$777 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$4,440.60 |
$7,401 |
3.2× |
| PET imaging CT for attenuation limited area (78814) |
$3,641.40 |
$6,069 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$4,440.60 |
$7,401 |
3.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,113.80 |
$3,523 |
6.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$635.40 |
$1,059 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$507.60 |
$846 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$528 |
$880 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$134.40 |
$224 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$216.60 |
$361 |
2.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$69 |
$115 |
0.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$306 |
$510 |
3.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$574.20 |
$957 |
1.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$103.80 |
$173 |
1.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$135.60 |
$226 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$83.40 |
$139 |
0.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$108 |
$180 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$334.80 |
$558 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$490.20 |
$817 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$273.60 |
$456 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$99.60 |
$166 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$721.20 |
$1,202 |
1.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$7,564.80 |
$12,608 |
14.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,602.60 |
$2,671 |
3.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$322.20 |
$537 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$184.20 |
$307 |
0.8× |
| Scanogram (77073) |
$58.20 |
$97 |
0.6× |
| Scapula complete (73010) |
$136.80 |
$228 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$41.10 |
$68.50 |
1.8× |
| Simulation intermediate (77285) |
$1,096.20 |
$1,827 |
3.0× |
| Small bowel series (74250) |
$138.60 |
$231 |
0.8× |
| Spec medical radj physics consltj (77370) |
$661.20 |
$1,102 |
5.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$428.40 |
$714 |
1.2× |
| Special dosimetry (77331) |
$358.80 |
$598 |
2.8× |
| Special treatment procedure (77470) |
$1,980.60 |
$3,301 |
3.7× |
| Spine thoracic 3 views (72072) |
$363.60 |
$606 |
3.6× |
| Stereotactic body radiation delivery (77373) |
$1,111.80 |
$1,853 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,851 |
$3,085 |
5.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,442.40 |
$2,404 |
4.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$692.40 |
$1,154 |
5.3× |
| Thoracolumbar 2 views (72080) |
$111.60 |
$186 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,981.20 |
$3,302 |
3.8× |
| Thyroid uptake measurement (78012) |
$220.20 |
$367 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$721.80 |
$1,203 |
1.9× |
| Treatment devices simple (77332) |
$588 |
$980 |
4.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,554.60 |
$2,591 |
3.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$5,080.80 |
$8,468 |
13.2× |
| Tx devices design & construction complex (77334) |
$963.60 |
$1,606 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$618.60 |
$1,031 |
6.1× |
| Umbilical-artery Doppler (OB) (76820) |
$151.20 |
$252 |
1.5× |
| Upper Extremity Infant (73092) |
$174.60 |
$291 |
1.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$406.80 |
$678 |
1.1× |
| Urethrocystography retrograde rs&i (74450) |
$239.40 |
$399 |
1.0× |
| Urethrocystography voiding (74455) |
$434.40 |
$724 |
1.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,332 |
$2,220 |
7.9× |
| Us abdl aorta screen aaa (76706) |
$161.40 |
$269 |
1.6× |
| Us breast unilateral complete (76641) |
$172.20 |
$287 |
1.7× |
| Us breast unilateral limited (76642) |
$141.60 |
$236 |
1.7× |
| Us chest (76604) |
$127.80 |
$213 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$283.20 |
$472 |
2.8× |
| Us elastography parenchyma (76981) |
$190.20 |
$317 |
1.9× |
| Us infant hips dynamic (76885) |
$143.40 |
$239 |
1.7× |
| Us kidney transplant (76776) |
$78.60 |
$131 |
0.8× |
| Us ob detailed single fetus (76811) |
$293.40 |
$489 |
1.3× |
| Us ob transvaginal (76817) |
$472.80 |
$788 |
4.7× |
| Us pelvic non ob complete (76856) |
$180.60 |
$301 |
1.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$180.60 |
$301 |
1.8× |
| Us pregnancy ltd (76815) |
$411 |
$685 |
4.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$259.80 |
$433 |
2.6× |
| Us retroperitoneal complete (76770) |
$1,041.60 |
$1,736 |
10.3× |
| Us retroperitoneal limited (76775) |
$528.60 |
$881 |
5.2× |
| Us scrotum and contents (76870) |
$697.80 |
$1,163 |
6.9× |
| Us soft tissue head/neck (76536) |
$419.40 |
$699 |
4.2× |
| Us spinal canal and contents (76800) |
$120.60 |
$201 |
1.2× |
| Us transrectal prostate volume (76873) |
$629.40 |
$1,049 |
6.2× |
| Us xtr non-vasc lmtd (76882) |
$160.80 |
$268 |
1.6× |
| Venogram extremity bilateral (75822) |
$1,302 |
$2,170 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,190.80 |
$5,318 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$798 |
$1,330 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$1,111.20 |
$1,852 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,154 |
$3,590 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,984.80 |
$3,308 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,359.60 |
$2,266 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,371.20 |
$3,952 |
0.4× |
| Wrist 2 views (73100) |
$93.60 |
$156 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$207.60 |
$346 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$97.80 |
$163 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$291.60 |
$486 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$686.40 |
$1,144 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$199.20 |
$332 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$231 |
$385 |
2.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$262.20 |
$437 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$84.60 |
$141 |
1.0× |
| X-ray exam hip uni 4/> views (73503) |
$177.60 |
$296 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$167.40 |
$279 |
1.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$176.40 |
$294 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$301.80 |
$503 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$280.80 |
$468 |
3.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$204.60 |
$341 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$320.40 |
$534 |
3.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$87 |
$145 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$360 |
$600 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$629.40 |
$1,049 |
6.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$414.60 |
$691 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$204 |
$340 |
2.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$51.60 |
$86 |
0.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$113.40 |
$189 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$183 |
$305 |
1.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$666 |
$1,110 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$271.20 |
$452 |
3.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$311.40 |
$519 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$383.40 |
$639 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$235.80 |
$393 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$233.40 |
$389 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$249.60 |
$416 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$126.60 |
$211 |
1.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$100.20 |
$167 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$267 |
$445 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$213.60 |
$356 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$87 |
$145 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$184.20 |
$307 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$150.60 |
$251 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$356.40 |
$594 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$205.20 |
$342 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$103.80 |
$173 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$521.40 |
$869 |
5.2× |
| Xr chest 4+ views (71048) |
$457.80 |
$763 |
4.5× |
| Xr finger(s) 2+ views (73140) |
$213.60 |
$356 |
2.5× |
| Xr shoulder 1 view (73020) |
$195 |
$325 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$422.40 |
$704 |
4.2× |
| Xr tibia/fibula 2 views (73590) |
$244.20 |
$407 |
2.9× |
| Xr tmj bilateral (70330) |
$62.40 |
$104 |
0.7× |
| Xray knee 1 or 2 views rt (73560) |
$251.40 |
$419 |
3.0× |