| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,462.07 |
$8,419 |
3.2× |
| Abdomen 1 View (74018) |
$184.97 |
$349 |
2.1× |
| Abdomen 2 views (74019) |
$190.27 |
$359 |
1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,035.09 |
$1,953 |
2.6× |
| Angio internal mammary (75756) |
$1,674.80 |
$3,160 |
0.5× |
| Angio pulmonary bilat (75743) |
$1,853.41 |
$3,497 |
0.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,674.80 |
$3,160 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,362.74 |
$4,458 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,610.14 |
$3,038 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,690.70 |
$3,190 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,685.40 |
$3,180 |
0.5× |
| Ankle 2 views (73600) |
$159.53 |
$301 |
1.8× |
| Aortography thoracic serialography rs&i (75605) |
$2,885.85 |
$5,445 |
0.5× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,738.40 |
$3,280 |
0.5× |
| Artery X-Rays Abdomen (75726) |
$2,885.85 |
$5,445 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,674.80 |
$3,160 |
0.5× |
| Artery X-Rays Pelvis (75736) |
$2,885.85 |
$5,445 |
0.5× |
| Artery X-Rays Spine (75705) |
$2,885.85 |
$5,445 |
0.5× |
| Arthrogram hip (73525) |
$570.81 |
$1,077 |
1.6× |
| Arthrogram Wrist (73115) |
$496.61 |
$937 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$504.56 |
$952 |
3.7× |
| Bone age studies (77072) |
$117.13 |
$221 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$2,441.18 |
$4,606 |
6.0× |
| Bone Imaging Limited Area (78300) |
$1,896.87 |
$3,579 |
4.7× |
| Bone Imaging Multiple Areas (78305) |
$1,980.61 |
$3,737 |
4.9× |
| Bone Imaging Whole Body (78306) |
$2,294.90 |
$4,330 |
5.7× |
| Bone marrow imaging limited area (78102) |
$1,455.38 |
$2,746 |
3.6× |
| Bone survey infant (77076) |
$200.34 |
$378 |
1.9× |
| Brachytx isodose complex (77318) |
$1,574.10 |
$2,970 |
4.2× |
| Brachytx isodose intermed (77317) |
$1,399.20 |
$2,640 |
3.7× |
| Brachytx Isodose Plan Simple (77316) |
$1,166 |
$2,200 |
3.1× |
| Brain Image W/Flow < 4 Views (78601) |
$828.39 |
$1,563 |
2.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,205.22 |
$2,274 |
2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,859.88 |
$5,396 |
2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,563.61 |
$4,837 |
7.3× |
| Cat Scan Follow-Up Study (76380) |
$493.43 |
$931 |
5.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,075.90 |
$2,030 |
2.0× |
| Cerebrospinal Fluid Scan (78630) |
$3,318.86 |
$6,262 |
6.0× |
| Chest 1 view (71045) |
$132.50 |
$250 |
1.5× |
| Chest 2 views (71046) |
$137.27 |
$259 |
1.6× |
| Chest 3 views (71047) |
$142.57 |
$269 |
1.6× |
| Chest 4 or more views (71048) |
$218.36 |
$412 |
2.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$292.56 |
$552 |
2.8× |
| Clavicle complete (73000) |
$164.83 |
$311 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$328.60 |
$620 |
3.1× |
| Continuing medical physics consltj pr wk (77336) |
$567.63 |
$1,071 |
4.2× |
| Contrast Exam Abdominl Aorta (75625) |
$2,590.64 |
$4,888 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$471.70 |
$890 |
1.3× |
| Contrast X-Ray Of Elbow (73085) |
$557.03 |
$1,051 |
1.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$603.67 |
$1,139 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,227.06 |
$4,202 |
6.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,497.25 |
$2,825 |
6.2× |
| CT abdomen w contrast (74160) |
$1,226.95 |
$2,315 |
6.9× |
| CT abdomen w wo contrast (74170) |
$1,459.09 |
$2,753 |
8.2× |
| CT abdomen w/o contrast (74150) |
$901 |
$1,700 |
8.5× |
| CT Angio Abdomen and Pelvis (74174) |
$2,856.70 |
$5,390 |
8.1× |
| CT Angio Chest (71275) |
$1,692.29 |
$3,193 |
9.5× |
| CT Angio Head (70496) |
$1,124.13 |
$2,121 |
6.3× |
| CT angio hrt w/3d image (75574) |
$1,878.85 |
$3,545 |
5.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,634.52 |
$3,084 |
9.2× |
| CT Angio Neck (70498) |
$1,456.97 |
$2,749 |
8.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,474.99 |
$2,783 |
8.3× |
| CT cervical spine w/ contrast (72126) |
$1,208.40 |
$2,280 |
3.4× |
| CT cervical spine w/o contrast (72125) |
$1,012.83 |
$1,911 |
9.6× |
| CT cervical spine w/wo cont (72127) |
$1,352.56 |
$2,552 |
7.6× |
| CT chest w contrast (71260) |
$1,073.25 |
$2,025 |
6.0× |
| CT chest w/wo contrast (71270) |
$1,259.28 |
$2,376 |
7.1× |
| CT colonography screening (74263) |
$553.32 |
$1,044 |
2.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$487.60 |
$920 |
4.6× |
| CT head/brain with contrast (70460) |
$935.45 |
$1,765 |
5.3× |
| CT head/brain without and with contrast (70470) |
$1,264.58 |
$2,386 |
7.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,523.86 |
$4,762 |
7.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$25.97 |
$49 |
0.3× |
| CT iac w contrast (70481) |
$1,137.38 |
$2,146 |
6.4× |
| CT l-spine w&w/o contrast (72133) |
$1,835.39 |
$3,463 |
10.3× |
| CT lower ext w/o (73700) |
$902.59 |
$1,703 |
8.5× |
| CT lower extremity w/contrast material (73701) |
$1,007 |
$1,900 |
5.7× |
| CT lumbar spine w contrast (72132) |
$1,256.10 |
$2,370 |
3.6× |
| CT lumbar spine w/o contrast (72131) |
$1,041.45 |
$1,965 |
9.8× |
| CT maxillofacial w contrast (70487) |
$1,052.05 |
$1,985 |
5.9× |
| CT maxillofacial wo contrast (70486) |
$780.16 |
$1,472 |
7.4× |
| CT neck tissue combo (70492) |
$1,644.59 |
$3,103 |
9.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,448.49 |
$2,733 |
8.2× |
| CT orbits w/o contrast (70480) |
$1,009.65 |
$1,905 |
9.5× |
| CT pelvis w&w/o contrast (72194) |
$1,290.55 |
$2,435 |
7.3× |
| CT pelvis w/o contrast (72192) |
$851.18 |
$1,606 |
8.0× |
| CT scan of leg combo (73702) |
$1,216.88 |
$2,296 |
6.9× |
| CT scans face/jaw combo (70488) |
$1,160.70 |
$2,190 |
6.5× |
| CT soft tissue neck w contrast (70491) |
$1,230.13 |
$2,321 |
6.9× |
| CT soft tissue neck w/o contrast (70490) |
$881.92 |
$1,664 |
8.3× |
| CT thoracic spine w contrast (72129) |
$1,122.01 |
$2,117 |
6.3× |
| CT thoracic spine w/o contrast (72128) |
$926.97 |
$1,749 |
8.8× |
| CT thoracic spine w/wo cont (72130) |
$1,396.02 |
$2,634 |
7.9× |
| CT thorax w/o contrast (71250) |
$892.52 |
$1,684 |
8.4× |
| CT upper ext wo (73200) |
$838.46 |
$1,582 |
7.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,212.11 |
$2,287 |
6.8× |
| CT upper extremity with contrast (73201) |
$978.91 |
$1,847 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,702.36 |
$3,212 |
9.6× |
| Cta Abdomen (74175) |
$1,586.82 |
$2,994 |
8.9× |
| CTA pelvis (72191) |
$1,557.14 |
$2,938 |
8.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$239.03 |
$451 |
2.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$363.05 |
$685 |
3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$293.09 |
$553 |
2.8× |
| Dxa Bone Density Axial (77080) |
$251.22 |
$474 |
2.4× |
| Echo exam of fetal heart (76825) |
$416.58 |
$786 |
0.8× |
| Echo exam uterus (76831) |
$800.30 |
$1,510 |
3.3× |
| Echo Guide For Artery Repair (76936) |
$634.41 |
$1,197 |
2.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$311.64 |
$588 |
1.3× |
| Esophagram (74220) |
$256.52 |
$484 |
1.4× |
| Fetal Biophys Profile W/Nst (76818) |
$720.80 |
$1,360 |
6.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$346.09 |
$653 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$403.86 |
$762 |
1.7× |
| Follow-Up Angiography (75898) |
$714.44 |
$1,348 |
0.2× |
| Foot 2 views (73620) |
$173.84 |
$328 |
2.0× |
| Forearm 2 views (73090) |
$157.94 |
$298 |
1.8× |
| Gastric emptying imaging study (78264) |
$2,417.33 |
$4,561 |
6.0× |
| Gated Heart Planar Single (78472) |
$2,329.35 |
$4,395 |
5.8× |
| Hand 2 views (73120) |
$161.12 |
$304 |
1.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$3,410.55 |
$6,435 |
4.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,902.28 |
$5,476 |
4.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$3,235.65 |
$6,105 |
4.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,674.80 |
$3,160 |
0.5× |
| Hepatobil Syst Image W/Drug (78227) |
$2,261.51 |
$4,267 |
4.1× |
| Hepatobiliary System Imaging (78226) |
$2,144.38 |
$4,046 |
5.3× |
| Ht Muscle Image Spect Sing (78451) |
$4,147.25 |
$7,825 |
3.2× |
| Hysterosalpingogram (74740) |
$469.58 |
$886 |
1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$586.71 |
$1,107 |
6.7× |
| Infant hip ultrasound, limited static exam (76886) |
$175.96 |
$332 |
2.0× |
| Joint Survey Single View (77077) |
$112.89 |
$213 |
1.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,700.24 |
$3,208 |
3.1× |
| K Flow/Funct Image W/O Drug (78707) |
$1,488.24 |
$2,808 |
2.7× |
| Knee 3 Views (73562) |
$169.60 |
$320 |
1.9× |
| Leveen/Shunt Patency Exam (78291) |
$1,127.84 |
$2,128 |
2.8× |
| Liver & Spleen Imaging Static Only (78215) |
$975.20 |
$1,840 |
2.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,986.44 |
$3,748 |
3.6× |
| Lung perfusion differential (78597) |
$2,554.07 |
$4,819 |
6.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,046.33 |
$3,861 |
3.7× |
| Lung Ventilation Imaging (78579) |
$1,122.54 |
$2,118 |
2.8× |
| Lymph System Imaging (78195) |
$2,194.73 |
$4,141 |
4.0× |
| Magnetic Image Jaw Joint (70336) |
$2,030.96 |
$3,832 |
8.4× |
| Mammary ductogram or galactogram multiple (77054) |
$361.46 |
$682 |
1.5× |
| Mammary ductogram or galactogram single (77053) |
$298.39 |
$563 |
1.2× |
| Meckels Divert Exam (78290) |
$1,035.09 |
$1,953 |
2.6× |
Medical physics dose eval radiation expos w/rprt (76145)
range across 2 matching MRF lines |
$238.50–$1,042.51 |
$450–$1,967 |
varies |
| Mlc imrt design & construction per imrt plan (77338) |
$860.72 |
$1,624 |
2.3× |
| Mr safety determination physician/other qhp (76016) |
$163.24 |
$308 |
1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$45.58 |
$86 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$170.13 |
$321 |
1.8× |
| Mr safety implt pos&/immoblj (76019) |
$110.24 |
$208 |
1.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$448.38 |
$846 |
1.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,825.43 |
$5,331 |
8.0× |
| MRA head w/o contrast (70544) |
$1,821.61 |
$3,437 |
7.5× |
| MRA head with contrast (70545) |
$2,258.33 |
$4,261 |
6.4× |
| MRA neck w contrast (70548) |
$2,204.27 |
$4,159 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,080.36 |
$5,812 |
8.7× |
| MRA neck w/o contrast (70547) |
$1,957.82 |
$3,694 |
8.1× |
| MRI abdomen w contrast (74182) |
$2,091.91 |
$3,947 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,972.66 |
$3,722 |
8.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,370.69 |
$4,473 |
3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,152.97 |
$5,949 |
8.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,607.07 |
$4,919 |
3.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,980.72 |
$5,624 |
12.3× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$2,662.72 |
$5,024 |
11.0× |
| MRI cardiac w/o contrast (75557) |
$2,059.58 |
$3,886 |
8.5× |
| MRI cervical spine w contrast (72142) |
$2,857.76 |
$5,392 |
8.1× |
| MRI cervical spine w/o cont (72141) |
$2,001.81 |
$3,777 |
8.3× |
| MRI chest w/o contrast (71550) |
$1,632.93 |
$3,081 |
6.8× |
| MRI chest with contrast (71551) |
$1,688.58 |
$3,186 |
2.1× |
| MRI chest wo w contrast (71552) |
$1,775.50 |
$3,350 |
5.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,417.86 |
$4,562 |
6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,114.81 |
$5,877 |
8.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,041.03 |
$3,851 |
8.5× |
| MRI lumbar spine w contrast (72149) |
$2,650 |
$5,000 |
7.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,371.86 |
$6,362 |
9.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,488.35 |
$4,695 |
10.3× |
| MRI orbit face neck w contrast (70542) |
$2,556.72 |
$4,824 |
7.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,724.73 |
$5,141 |
7.7× |
| MRI pelvis w contrast (72196) |
$2,457.61 |
$4,637 |
7.0× |
| MRI pelvis w/o & w contrast (72197) |
$2,753.88 |
$5,196 |
7.8× |
| MRI pelvis w/o contrast (72195) |
$2,180.95 |
$4,115 |
9.0× |
| MRI spectroscopy (76390) |
$963.54 |
$1,818 |
10.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,027.25 |
$3,825 |
8.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,235.01 |
$4,217 |
9.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,100.50 |
$5,850 |
8.8× |
| MRI, abdomen, combo (74183) |
$2,148.62 |
$4,054 |
6.1× |
| MRI, dorsal spine combo (72157) |
$3,271.69 |
$6,173 |
9.3× |
| MRI, dorsal spine contrast (72147) |
$2,073.89 |
$3,913 |
5.9× |
| MRI, joint upper extrem (73221) |
$2,154.98 |
$4,066 |
8.9× |
| MRI, joint upper extrem combo (73223) |
$3,096.79 |
$5,843 |
8.8× |
| MRI, lumbar spine combo (72158) |
$3,045.91 |
$5,747 |
8.6× |
| Myelogram cervical (72240) |
$1,172.36 |
$2,212 |
1.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,658.48 |
$5,016 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$5,144.71 |
$9,707 |
3.9× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$2,762.89 |
$5,213 |
1.9× |
| N-invas est c ffr sw aly CTA (75580) |
$1,572.51 |
$2,967 |
1.8× |
| Neck soft tissue (70360) |
$162.18 |
$306 |
1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,980.94 |
$9,398 |
3.6× |
| Nuclear Rx Intra-Arterial (79445) |
$1,087.56 |
$2,052 |
4.6× |
| Nuclear Rx Oral Admin (79005) |
$1,405.56 |
$2,652 |
6.0× |
| Ob us nuchal meas 1 gest (76813) |
$398.56 |
$752 |
3.8× |
| Panoramic X-ray of jaws (70355) |
$144.16 |
$272 |
1.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$3,586.51 |
$6,767 |
6.5× |
| Parathyroid Planar Imaging (78070) |
$2,322.99 |
$4,383 |
5.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,128.48 |
$4,016 |
5.3× |
| Pelvis 1 or 2 views (72170) |
$152.11 |
$287 |
1.4× |
| Peritoneogram Rs&I (74190) |
$664.09 |
$1,253 |
1.2× |
| PET image w/CT, full body (78816) |
$4,717 |
$8,900 |
3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,452 |
$8,400 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,674.80 |
$3,160 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,897.93 |
$3,581 |
4.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$298.92 |
$564 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$493.43 |
$931 |
0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$170.66 |
$322 |
1.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$152.11 |
$287 |
1.7× |
| Radex elbow complete minimum 3 views (73080) |
$163.77 |
$309 |
1.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$274.54 |
$518 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$162.71 |
$307 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$187.09 |
$353 |
2.1× |
| Radex Hand Minimum 3 Views (73130) |
$163.24 |
$308 |
1.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$133.03 |
$251 |
1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$152.64 |
$288 |
1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$198.22 |
$374 |
2.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$239.03 |
$451 |
2.7× |
| Radex shoulder complete minimum 2 views (73030) |
$176.49 |
$333 |
2.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$181.79 |
$343 |
2.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$244.33 |
$461 |
1.4× |
| Radex Spine 1 View Specify Level (72020) |
$172.78 |
$326 |
2.0× |
| Radex Sternum Minimum 2 Views (71120) |
$178.61 |
$337 |
2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$242.74 |
$458 |
2.8× |
| Radex Toe Minimum 2 Views (73660) |
$126.67 |
$239 |
1.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$142.04 |
$268 |
1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$162.18 |
$306 |
1.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$202.99 |
$383 |
1.9× |
Radiation Delivery Stereotactic Cranial Linear (77372)
range across 3 matching MRF lines |
$7,019.32–$17,271.64 |
$13,244–$32,588 |
varies |
| Radiation treatment delivery level 1 (77402) |
$795 |
$1,500 |
7.7× |
| Radiation treatment delivery level 3 (77412) |
$1,839.10 |
$3,470 |
3.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$213.06 |
$402 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$195.04 |
$368 |
1.8× |
| Radiologic exam colon double contrast study (74280) |
$849.59 |
$1,603 |
4.8× |
| Radiologic exam colon single contrast study (74270) |
$334.96 |
$632 |
1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$279.84 |
$528 |
1.6× |
| Radiologic exam knee complete 4/more views (73564) |
$199.28 |
$376 |
1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$198.75 |
$375 |
1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$461.10 |
$870 |
2.6× |
| Radiologic exam swallow function contrast study (74230) |
$253.87 |
$479 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$359.34 |
$678 |
2.0× |
| Radiologic examination femur 1 view (73551) |
$110.77 |
$209 |
1.3× |
| Radiologic examination femur minimum 2 views (73552) |
$245.92 |
$464 |
2.8× |
| Radiologic examination knee 1/2 views (73560) |
$153.17 |
$289 |
1.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$184.97 |
$349 |
1.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$171.72 |
$324 |
1.9× |
| Ribs bilateral 3 views (71110) |
$262.88 |
$496 |
2.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,283.66 |
$2,422 |
3.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,283.66 |
$2,422 |
3.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,267.98 |
$6,166 |
5.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$3,267.98 |
$6,166 |
5.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,267.98 |
$6,166 |
5.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,436.63 |
$8,371 |
3.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,031.82 |
$9,494 |
3.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$4,436.63 |
$8,371 |
3.4× |
| Rp Therapy Intravenous Administration (79101) |
$1,730.45 |
$3,265 |
7.3× |
| Scapula (73010) |
$169.60 |
$320 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$21.73 |
$41 |
0.9× |
| Shoulder 1 view (73020) |
$142.04 |
$268 |
1.6× |
| Shoulder Arthrography (73040) |
$218.89 |
$413 |
0.6× |
| Sialogram (70390) |
$413.93 |
$781 |
1.7× |
| Skull less than 4 views (70250) |
$172.78 |
$326 |
1.6× |
| Special dosimetry (77331) |
$392.73 |
$741 |
2.9× |
| Special Physics Consult (77370) |
$732.46 |
$1,382 |
5.4× |
| Special treatment procedure (77470) |
$1,849.17 |
$3,489 |
3.3× |
Stereotactic Body Radiation Delivery (77373)
range across 3 matching MRF lines |
$7,019.32–$17,271.64 |
$13,244–$32,588 |
varies |
| Sternoclavicular joints (71130) |
$244.86 |
$462 |
2.8× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$115.54 |
$218 |
1.3× |
| Tbs technical calculation only (77091) |
$115.54 |
$218 |
1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$4,756.22 |
$8,974 |
12.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,449.02 |
$2,734 |
3.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,426.23 |
$2,691 |
3.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$639.71 |
$1,207 |
4.7× |
| Thoracic spine 2 views (72070) |
$166.95 |
$315 |
1.6× |
| Thoracic spine 3 views (72072) |
$199.81 |
$377 |
1.9× |
| Thoracolumbar 2 views (72080) |
$170.66 |
$322 |
1.9× |
| Thyroid Met Imaging Body (78018) |
$2,540.82 |
$4,794 |
4.6× |
| Thyroid Uptake Measurement (78012) |
$567.10 |
$1,070 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,335.60 |
$2,520 |
3.3× |
| Tx Devices Design & Construction Complex (77334) |
$1,007 |
$1,900 |
2.7× |
| Tx devices design & construction simple (77332) |
$619.04 |
$1,168 |
4.6× |
| Ultrasound Breast Limited (76642) |
$498.73 |
$941 |
5.7× |
| Ultrasound Exam Aaa Screen (76706) |
$271.36 |
$512 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$581.94 |
$1,098 |
5.5× |
| Umbilical-artery Doppler (OB) (76820) |
$284.08 |
$536 |
2.7× |
| Upper gi w/o kub (74240) |
$269.24 |
$508 |
1.5× |
| Urethrocystogram voiding (74455) |
$437.25 |
$825 |
1.8× |
| Urethrocystography retrograde (74450) |
$253.87 |
$479 |
1.1× |
| Us breast unilateral complete (76641) |
$528.41 |
$997 |
5.0× |
| Us chest (76604) |
$504.03 |
$951 |
4.8× |
| Us complete joint (76881) |
$513.57 |
$969 |
4.9× |
| Us exam, pelvic, limited (76857) |
$435.13 |
$821 |
4.1× |
| Us head (76506) |
$485.48 |
$916 |
4.6× |
| Us kidney transplant (76776) |
$610.03 |
$1,151 |
5.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$239.03 |
$451 |
2.3× |
| Us ob detailed single fetus (76811) |
$652.96 |
$1,232 |
2.7× |
| Us ob limited 1 or more fetuses (76815) |
$410.22 |
$774 |
3.9× |
| Us ob transvaginal (76817) |
$515.16 |
$972 |
4.9× |
| Us pelvic non ob complete (76856) |
$604.20 |
$1,140 |
5.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$619.57 |
$1,169 |
5.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$390.61 |
$737 |
3.7× |
| Us retroperitoneal complete (76770) |
$549.61 |
$1,037 |
5.2× |
| Us retroperitoneal limited (76775) |
$453.15 |
$855 |
4.3× |
| Us scrotum and contents (76870) |
$579.82 |
$1,094 |
5.5× |
| Us spinal canal and contents (76800) |
$701.19 |
$1,323 |
6.6× |
| Us thyroid (76536) |
$538.48 |
$1,016 |
5.1× |
| Us transrectal (76872) |
$741.47 |
$1,399 |
7.0× |
| Vein X-Ray Chest (75827) |
$951.88 |
$1,796 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$1,674.80 |
$3,160 |
0.5× |
| Venography Adrenal Unilateral (75840) |
$1,674.80 |
$3,160 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,674.80 |
$3,160 |
0.5× |
| Venography extremity bilateral rs&i (75822) |
$838.99 |
$1,583 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$841.11 |
$1,587 |
0.5× |
| Venography Renal Bilateral (75833) |
$1,674.80 |
$3,160 |
0.5× |
| Venography Renal Unilateral (75831) |
$1,675.33 |
$3,161 |
0.5× |
| Venous sampling by catheter (75893) |
$2,885.85 |
$5,445 |
0.5× |
| Wrist 2 views (73100) |
$151.05 |
$285 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$201.40 |
$380 |
2.3× |
| X-ray antegrade pyelogram tube (74425) |
$488.66 |
$922 |
1.4× |
| X-Ray Aorta Leg Arteries (75630) |
$2,096.68 |
$3,956 |
0.7× |
| X-Ray Bend Only L-S Spine (72120) |
$298.92 |
$564 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$147.87 |
$279 |
1.7× |
| X-Ray Exam Breast Specimen (76098) |
$289.91 |
$547 |
0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$116.07 |
$219 |
1.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$152.64 |
$288 |
1.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$180.20 |
$340 |
1.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$269.24 |
$508 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$327.54 |
$618 |
3.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$344.50 |
$650 |
3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$351.39 |
$663 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$374.71 |
$707 |
3.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$449.97 |
$849 |
4.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$393.26 |
$742 |
3.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$187.62 |
$354 |
2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$322.77 |
$609 |
3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$239.03 |
$451 |
2.3× |
| X-ray eye for foreign body (70030) |
$127.20 |
$240 |
1.4× |
| X-ray humerus (73060) |
$166.42 |
$314 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$154.23 |
$291 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$154.76 |
$292 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$205.64 |
$388 |
1.9× |
| X-ray nose-rectum child f.b. (76010) |
$94.34 |
$178 |
1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$262.88 |
$496 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$199.81 |
$377 |
1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$180.20 |
$340 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$182.32 |
$344 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$320.12 |
$604 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$257.05 |
$485 |
2.4× |
| X-ray thoracic spine 4 vw (72074) |
$225.25 |
$425 |
2.1× |
| X-Ray Tmj Unilat (70328) |
$148.40 |
$280 |
1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$539.01 |
$1,017 |
1.5× |
| X-Rays Bone Length Studies (77073) |
$218.36 |
$412 |
2.1× |
| X-Rays Bone Survey Complete (77075) |
$399.09 |
$753 |
3.8× |
| Xr c-spine 4 or 5 views (72050) |
$249.63 |
$471 |
2.4× |
| Xr facial bones less than 3 views (70140) |
$234.79 |
$443 |
2.7× |
| Xr orbits complete 4 views (70200) |
$196.63 |
$371 |
1.9× |