| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,467.88 |
$6,084 |
2.6× |
| Abdomen 1 View (74018) |
$183.54 |
$322 |
2.2× |
| Abdomen 2 views (74019) |
$199.50 |
$350 |
1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$921.69 |
$1,617 |
2.4× |
| Angio pulmonary bilat (75743) |
$3,930.72 |
$6,896 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$3,146.40 |
$5,520 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,097.60 |
$3,680 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,620.29 |
$4,597 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,818.30 |
$3,190 |
0.6× |
| Ankle 2 views (73600) |
$50.73 |
$89 |
0.6× |
| Aortography thoracic serialography rs&i (75605) |
$3,133.86 |
$5,498 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$3,133.86 |
$5,498 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$3,133.86 |
$5,498 |
0.6× |
| Artery X-Rays Spine (75705) |
$3,133.86 |
$5,498 |
0.6× |
| Arthrogram hip (73525) |
$407.55 |
$715 |
1.2× |
| Arthrogram Wrist (73115) |
$407.55 |
$715 |
1.2× |
| Basic radiation dosimetry calculation (77300) |
$759.81 |
$1,333 |
5.8× |
| Bone age studies (77072) |
$60.99 |
$107 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$809.40 |
$1,420 |
2.1× |
| Bone Imaging Limited Area (78300) |
$478.23 |
$839 |
1.2× |
| Bone Imaging Whole Body (78306) |
$3,127.02 |
$5,486 |
8.0× |
| Bone marrow imaging limited area (78102) |
$434.34 |
$762 |
1.1× |
| Bone marrow imaging; whole body (78104) |
$652.08 |
$1,144 |
1.7× |
| Bone survey infant (77076) |
$75.81 |
$133 |
0.7× |
| Brachytx isodose complex (77318) |
$1,899.24 |
$3,332 |
5.2× |
| Brachytx isodose intermed (77317) |
$1,615.95 |
$2,835 |
4.4× |
| Brachytx Isodose Plan Simple (77316) |
$1,260.84 |
$2,212 |
3.4× |
| Brain Flow Imaging Only (78610) |
$713.64 |
$1,252 |
1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,365.72 |
$2,396 |
2.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,274.52 |
$2,236 |
0.9× |
| Cat Scan Follow-Up Study (76380) |
$195.51 |
$343 |
2.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$746.13 |
$1,309 |
1.4× |
| Cerebrospinal Fluid Scan (78630) |
$1,029.99 |
$1,807 |
1.9× |
| Chest 1 view (71045) |
$56.43 |
$99 |
0.7× |
| Chest 2 views (71046) |
$183.54 |
$322 |
2.2× |
| Chest 3 views (71047) |
$202.35 |
$355 |
2.4× |
| Chest 4 or more views (71048) |
$280.44 |
$492 |
2.7× |
| Clavicle complete (73000) |
$50.73 |
$89 |
0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$700.53 |
$1,229 |
6.8× |
| Continuing medical physics consltj pr wk (77336) |
$481.65 |
$845 |
3.7× |
| Contrast Exam Abdominl Aorta (75625) |
$2,097.60 |
$3,680 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$257.07 |
$451 |
0.8× |
| Contrast X-Ray Of Elbow (73085) |
$407.55 |
$715 |
1.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$407.55 |
$715 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$855.57 |
$1,501 |
2.5× |
| CT abdomen and pelvis without contrast (74176) |
$713.07 |
$1,251 |
3.1× |
| CT abdomen w contrast (74160) |
$439.47 |
$771 |
2.6× |
| CT abdomen w wo contrast (74170) |
$522.69 |
$917 |
3.0× |
| CT abdomen w/o contrast (74150) |
$309.51 |
$543 |
3.0× |
| CT Angio Abdomen and Pelvis (74174) |
$1,023.15 |
$1,795 |
3.0× |
| CT Angio Chest (71275) |
$713.07 |
$1,251 |
4.1× |
| CT Angio Head (70496) |
$714.78 |
$1,254 |
4.2× |
| CT angio hrt w/3d image (75574) |
$509.01 |
$893 |
1.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$530.10 |
$930 |
3.1× |
| CT Angio Neck (70498) |
$714.78 |
$1,254 |
4.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$477.66 |
$838 |
2.8× |
| CT cervical spine w/ contrast (72126) |
$428.64 |
$752 |
1.3× |
| CT cervical spine w/o contrast (72125) |
$380.76 |
$668 |
3.7× |
| CT cervical spine w/wo cont (72127) |
$475.38 |
$834 |
2.8× |
| CT chest w contrast (71260) |
$475.38 |
$834 |
2.8× |
| CT chest w/wo contrast (71270) |
$570.57 |
$1,001 |
3.3× |
| CT colonography screening (74263) |
$893.76 |
$1,568 |
3.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$552.90 |
$970 |
5.4× |
| CT head/brain with contrast (70460) |
$768.36 |
$1,348 |
4.5× |
| CT head/brain without and with contrast (70470) |
$837.90 |
$1,470 |
4.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$509.01 |
$893 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$27.93 |
$49 |
0.3× |
| CT iac w contrast (70481) |
$411.54 |
$722 |
2.4× |
| CT l-spine w&w/o contrast (72133) |
$570.57 |
$1,001 |
3.3× |
| CT lower ext w/o (73700) |
$270.18 |
$474 |
2.6× |
| CT lower extremity w/contrast material (73701) |
$338.01 |
$593 |
2.0× |
| CT lumbar spine w contrast (72132) |
$428.64 |
$752 |
1.3× |
| CT lumbar spine w/o contrast (72131) |
$369.36 |
$648 |
3.6× |
| CT maxillofacial w contrast (70487) |
$348.84 |
$612 |
2.0× |
| CT maxillofacial wo contrast (70486) |
$285.57 |
$501 |
2.8× |
| CT neck tissue combo (70492) |
$418.38 |
$734 |
2.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$471.39 |
$827 |
2.7× |
| CT orbits w/o contrast (70480) |
$348.27 |
$611 |
3.4× |
| CT pelvis w&w/o contrast (72194) |
$475.38 |
$834 |
2.8× |
| CT pelvis w/o contrast (72192) |
$333.45 |
$585 |
3.3× |
| CT scan of leg combo (73702) |
$448.59 |
$787 |
2.6× |
| CT scans face/jaw combo (70488) |
$434.91 |
$763 |
2.5× |
| CT soft tissue neck w contrast (70491) |
$380.76 |
$668 |
2.2× |
| CT soft tissue neck w/o contrast (70490) |
$268.47 |
$471 |
2.6× |
| CT thoracic spine w contrast (72129) |
$357.39 |
$627 |
2.1× |
| CT thoracic spine w/o contrast (72128) |
$286.14 |
$502 |
2.8× |
| CT thoracic spine w/wo cont (72130) |
$452.01 |
$793 |
2.6× |
| CT thorax w/o contrast (71250) |
$375.63 |
$659 |
3.7× |
| CT upper ext wo (73200) |
$269.61 |
$473 |
2.6× |
| CT upper extremity with contrast (73201) |
$334.59 |
$587 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$653.79 |
$1,147 |
3.8× |
| Cta Abdomen (74175) |
$594.51 |
$1,043 |
3.5× |
| CTA pelvis (72191) |
$649.23 |
$1,139 |
3.8× |
| Dilation ureters/urethra rs&i (74485) |
$1,533.87 |
$2,691 |
0.7× |
| Diskography lumbar (72295) |
$1,179.33 |
$2,069 |
0.6× |
| Dxa Bone Density Axial (77080) |
$117.99 |
$207 |
1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$58.71 |
$103 |
0.7× |
| Echo Guide For Artery Repair (76936) |
$373.92 |
$656 |
1.8× |
| Echograp Trans R Pros Study (76873) |
$180.69 |
$317 |
1.8× |
| Esophagram (74220) |
$118.56 |
$208 |
0.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$98.61 |
$173 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$140.22 |
$246 |
0.6× |
| Follow-Up Angiography (75898) |
$1,818.30 |
$3,190 |
0.6× |
| Foot 2 views (73620) |
$63.27 |
$111 |
0.7× |
| Forearm 2 views (73090) |
$71.25 |
$125 |
0.8× |
| Gastric emptying imaging study (78264) |
$767.22 |
$1,346 |
2.0× |
| Gated Heart Planar Single (78472) |
$2,181.96 |
$3,828 |
5.6× |
| Hand 2 views (73120) |
$60.99 |
$107 |
0.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$2,241.24 |
$3,932 |
3.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,005.26 |
$3,518 |
2.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,767 |
$3,100 |
2.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,818.30 |
$3,190 |
0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,818.30 |
$3,190 |
0.6× |
| Hepatobil Syst Image W/Drug (78227) |
$954.18 |
$1,674 |
1.8× |
| Hepatobiliary System Imaging (78226) |
$867.54 |
$1,522 |
2.2× |
| Ht Muscle Image Spect Sing (78451) |
$2,335.86 |
$4,098 |
1.8× |
| Hysterosalpingogram (74740) |
$238.83 |
$419 |
1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$194.94 |
$342 |
2.3× |
| Infant hip ultrasound, limited static exam (76886) |
$150.48 |
$264 |
1.8× |
| Interstitial radiation source applic complex (77778) |
$2,637.39 |
$4,627 |
3.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$5,662.95 |
$9,935 |
8.3× |
| Joint Survey Single View (77077) |
$66.12 |
$116 |
0.6× |
| K Flow/Funct Image Multiple (78709) |
$2,231.55 |
$3,915 |
4.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,092.12 |
$1,916 |
2.1× |
| K Flow/Funct Image W/O Drug (78707) |
$966.72 |
$1,696 |
1.8× |
| Knee 3 Views (73562) |
$142.50 |
$250 |
1.7× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,242.60 |
$2,180 |
2.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,439.25 |
$2,525 |
2.7× |
| Lymph System Imaging (78195) |
$910.86 |
$1,598 |
1.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$1,818.30 |
$3,190 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$543.21 |
$953 |
2.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$1,182.75 |
$2,075 |
6.9× |
| Mammary ductogram or galactogram multiple (77054) |
$281.58 |
$494 |
1.2× |
| Mammary ductogram or galactogram single (77053) |
$238.83 |
$419 |
1.0× |
| Meckels Divert Exam (78290) |
$892.62 |
$1,566 |
2.3× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$786.03 |
$1,379 |
2.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,340.42 |
$4,106 |
6.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$966.72 |
$1,696 |
2.8× |
| MRA head w/o contrast (70544) |
$852.72 |
$1,496 |
3.6× |
| MRA head with contrast (70545) |
$909.72 |
$1,596 |
2.7× |
| MRA neck w contrast (70548) |
$737.01 |
$1,293 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,101.24 |
$1,932 |
3.2× |
| MRA neck w/o contrast (70547) |
$697.68 |
$1,224 |
3.0× |
| MRI abdomen w/o contrast (74181) |
$772.92 |
$1,356 |
3.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$987.24 |
$1,732 |
1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,047.66 |
$1,838 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,112.64 |
$1,952 |
1.4× |
| MRI brain functional w/o physician admnistration (70554) |
$1,104.66 |
$1,938 |
4.7× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,064.19 |
$1,867 |
4.6× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$943.35 |
$1,655 |
4.0× |
| MRI cervical spine w contrast (72142) |
$923.97 |
$1,621 |
2.7× |
| MRI cervical spine w/o cont (72141) |
$866.97 |
$1,521 |
3.7× |
| MRI chest w/o contrast (71550) |
$708.51 |
$1,243 |
3.0× |
| MRI chest wo w contrast (71552) |
$1,043.67 |
$1,831 |
3.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,080.72 |
$1,896 |
3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$609.33 |
$1,069 |
2.6× |
| MRI lumbar spine w contrast (72149) |
$1,508.79 |
$2,647 |
4.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,070.46 |
$1,878 |
3.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$598.50 |
$1,050 |
2.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$896.04 |
$1,572 |
2.6× |
| MRI pelvis w/o & w contrast (72197) |
$905.16 |
$1,588 |
2.6× |
| MRI pelvis w/o contrast (72195) |
$633.84 |
$1,112 |
2.7× |
| MRI spectroscopy (76390) |
$519.84 |
$912 |
6.1× |
| MRI thoracic spine w/o contrast (72146) |
$808.26 |
$1,418 |
3.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$646.95 |
$1,135 |
2.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$908.58 |
$1,594 |
2.7× |
| MRI, abdomen, combo (74183) |
$1,451.79 |
$2,547 |
4.2× |
| MRI, dorsal spine combo (72157) |
$1,111.50 |
$1,950 |
3.3× |
| MRI, dorsal spine contrast (72147) |
$877.23 |
$1,539 |
2.6× |
| MRI, joint upper extrem (73221) |
$1,055.64 |
$1,852 |
4.5× |
| MRI, joint upper extrem combo (73223) |
$1,169.64 |
$2,052 |
3.4× |
| MRI, lumbar spine combo (72158) |
$1,100.67 |
$1,931 |
3.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,461.26 |
$4,318 |
1.9× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,150.26 |
$2,018 |
0.8× |
| N-invas est c ffr sw aly CTA (75580) |
$962.73 |
$1,689 |
1.1× |
| Neck soft tissue (70360) |
$50.73 |
$89 |
0.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$647.52 |
$1,136 |
1.7× |
| Nm csf leak detection (78650) |
$973.56 |
$1,708 |
0.8× |
| Nonvascular Shunt X-Ray (75809) |
$80.37 |
$141 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,693.16 |
$9,988 |
4.2× |
| Nuclear Rx Intra-Arterial (79445) |
$676.59 |
$1,187 |
3.0× |
| Nuclear Rx Oral Admin (79005) |
$727.32 |
$1,276 |
3.2× |
| Panoramic X-ray of jaws (70355) |
$50.73 |
$89 |
0.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$988.95 |
$1,735 |
1.9× |
| Parathyroid Planar Imaging (78070) |
$550.62 |
$966 |
1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$674.31 |
$1,183 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$62.70 |
$110 |
0.6× |
| PET image w/CT, full body (78816) |
$1,931.16 |
$3,388 |
1.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,898.67 |
$3,331 |
1.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,328.01 |
$7,593 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$648.09 |
$1,137 |
1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$101.46 |
$178 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$314.64 |
$552 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$103.74 |
$182 |
1.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$50.73 |
$89 |
0.6× |
| Radex elbow complete minimum 3 views (73080) |
$82.08 |
$144 |
1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$60.99 |
$107 |
0.6× |
| Radex fingr minimum 2 views (73140) |
$50.73 |
$89 |
0.6× |
| Radex foot complete minimum 3 views (73630) |
$103.74 |
$182 |
1.2× |
| Radex Hand Minimum 3 Views (73130) |
$103.74 |
$182 |
1.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$50.73 |
$89 |
0.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$50.73 |
$89 |
0.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$98.04 |
$172 |
1.1× |
| Radex shoulder complete minimum 2 views (73030) |
$103.74 |
$182 |
1.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$50.73 |
$89 |
0.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$173.85 |
$305 |
1.0× |
| Radex Spine 1 View Specify Level (72020) |
$63.84 |
$112 |
0.7× |
| Radex Sternum Minimum 2 Views (71120) |
$50.73 |
$89 |
0.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$51.30 |
$90 |
0.6× |
| Radex Toe Minimum 2 Views (73660) |
$50.73 |
$89 |
0.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$60.99 |
$107 |
0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$103.74 |
$182 |
1.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$226.86 |
$398 |
2.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$20,693.85 |
$36,305 |
2.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$60.99 |
$107 |
0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$215.46 |
$378 |
2.1× |
| Radiologic exam colon double contrast study (74280) |
$229.14 |
$402 |
1.3× |
| Radiologic exam colon single contrast study (74270) |
$167.01 |
$293 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$150.48 |
$264 |
0.9× |
| Radiologic exam knee complete 4/more views (73564) |
$183.54 |
$322 |
1.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$119.70 |
$210 |
1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$116.85 |
$205 |
0.7× |
| Radiologic exam swallow function contrast study (74230) |
$201.21 |
$353 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$200.07 |
$351 |
1.2× |
| Radiologic examination femur 1 view (73551) |
$90.06 |
$158 |
1.1× |
| Radiologic examination femur minimum 2 views (73552) |
$104.31 |
$183 |
1.2× |
| Radiologic examination knee 1/2 views (73560) |
$71.25 |
$125 |
0.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$78.09 |
$137 |
0.9× |
| Ribs bilateral 3 views (71110) |
$196.08 |
$344 |
1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,126.32 |
$1,976 |
2.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,688.34 |
$2,962 |
4.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,204.19 |
$3,867 |
4.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,204.19 |
$3,867 |
4.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,204.19 |
$3,867 |
4.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,204.19 |
$3,867 |
1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,501.16 |
$4,388 |
1.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,352.96 |
$4,128 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$727.32 |
$1,276 |
3.2× |
| Scapula (73010) |
$60.99 |
$107 |
0.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$13.11 |
$23 |
0.6× |
| Shoulder 1 view (73020) |
$50.73 |
$89 |
0.6× |
| Shoulder Arthrography (73040) |
$407.55 |
$715 |
1.2× |
| Skull less than 4 views (70250) |
$60.99 |
$107 |
0.6× |
| Special dosimetry (77331) |
$267.90 |
$470 |
2.0× |
| Special Physics Consult (77370) |
$484.50 |
$850 |
3.7× |
| Special teletherapy port plan (77321) |
$686.28 |
$1,204 |
1.9× |
| Special treatment procedure (77470) |
$1,483.14 |
$2,602 |
2.7× |
| Stereotactic Body Radiation Delivery (77373) |
$4,456.26 |
$7,818 |
2.5× |
| Sternoclavicular joints (71130) |
$50.73 |
$89 |
0.6× |
| Superior sagittal sinus venogram (75870) |
$2,301.09 |
$4,037 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$864.69 |
$1,517 |
2.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$441.75 |
$775 |
1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,531.02 |
$2,686 |
4.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$539.79 |
$947 |
4.1× |
| Thoracic spine 2 views (72070) |
$94.62 |
$166 |
0.9× |
| Thoracic spine 3 views (72072) |
$111.15 |
$195 |
1.1× |
| Thoracolumbar 2 views (72080) |
$99.18 |
$174 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$448.59 |
$787 |
1.1× |
| Thyroid Met Imaging Body (78018) |
$859.56 |
$1,508 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$657.21 |
$1,153 |
1.7× |
| Tx Devices Design & Construction Complex (77334) |
$1,017.45 |
$1,785 |
2.8× |
| Tx devices design & construction simple (77332) |
$506.16 |
$888 |
3.8× |
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines |
$233.70–$410.97 |
$410–$721 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$117.99 |
$207 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$410.97 |
$721 |
4.0× |
Unlisted magnetic resonance procedure (76498)
range across 2 matching MRF lines |
$789.45–$1,165.08 |
$1,385–$2,044 |
varies |
| Upper gi w/o kub (74240) |
$191.52 |
$336 |
1.1× |
| Urethrocystogram voiding (74455) |
$257.07 |
$451 |
1.1× |
| Urethrocystography retrograde (74450) |
$238.83 |
$419 |
1.0× |
Us breast unilateral complete (76641)
range across 2 matching MRF lines |
$254.79–$493.05 |
$447–$865 |
varies |
| Us chest (76604) |
$131.10 |
$230 |
1.3× |
| Us complete joint (76881) |
$156.18 |
$274 |
1.5× |
| Us exam, pelvic, limited (76857) |
$197.22 |
$346 |
1.9× |
| Us head (76506) |
$160.74 |
$282 |
1.6× |
| Us kidney transplant (76776) |
$205.20 |
$360 |
2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$83.22 |
$146 |
0.8× |
| Us ob limited 1 or more fetuses (76815) |
$144.21 |
$253 |
1.4× |
| Us ob transvaginal (76817) |
$120.27 |
$211 |
1.2× |
| Us pelvic non ob complete (76856) |
$253.08 |
$444 |
2.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$147.06 |
$258 |
1.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$135.66 |
$238 |
1.3× |
| Us retroperitoneal complete (76770) |
$410.97 |
$721 |
4.0× |
| Us retroperitoneal limited (76775) |
$225.72 |
$396 |
2.2× |
| Us scrotum and contents (76870) |
$232.56 |
$408 |
2.3× |
| Us spinal canal and contents (76800) |
$141.93 |
$249 |
1.4× |
| Us thyroid (76536) |
$410.97 |
$721 |
4.0× |
| Vein X-Ray Chest (75827) |
$913.14 |
$1,602 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$1,818.30 |
$3,190 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,040.03 |
$3,579 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,117.20 |
$1,960 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$913.14 |
$1,602 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,353.53 |
$4,129 |
0.8× |
| Venography Renal Unilateral (75831) |
$2,257.77 |
$3,961 |
0.7× |
| Venous sampling by catheter (75893) |
$3,133.86 |
$5,498 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$197.79 |
$347 |
2.3× |
| Wrist 2 views (73100) |
$54.72 |
$96 |
0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$50.73 |
$89 |
0.6× |
| X-ray antegrade pyelogram tube (74425) |
$257.07 |
$451 |
0.8× |
| X-Ray Aorta Leg Arteries (75630) |
$1,818.30 |
$3,190 |
0.6× |
| X-Ray Bend Only L-S Spine (72120) |
$63.84 |
$112 |
0.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$50.73 |
$89 |
0.6× |
| X-Ray Exam Breast Specimen (76098) |
$443.46 |
$778 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$50.73 |
$89 |
0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$83.79 |
$147 |
0.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$148.77 |
$261 |
1.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$50.73 |
$89 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$183.54 |
$322 |
2.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$210.33 |
$369 |
2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$104.31 |
$183 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$111.72 |
$196 |
1.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$119.13 |
$209 |
1.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$109.44 |
$192 |
1.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$91.20 |
$160 |
1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$132.81 |
$233 |
1.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$98.04 |
$172 |
1.0× |
| X-ray eye for foreign body (70030) |
$50.73 |
$89 |
0.6× |
| X-ray humerus (73060) |
$70.68 |
$124 |
0.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$50.73 |
$89 |
0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$63.84 |
$112 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$99.18 |
$174 |
1.0× |
| X-ray nose-rectum child f.b. (76010) |
$50.73 |
$89 |
0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$196.08 |
$344 |
1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$60.99 |
$107 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$76.95 |
$135 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$57 |
$100 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$65.55 |
$115 |
0.6× |
| X-ray thoracic spine 4 vw (72074) |
$122.55 |
$215 |
1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$243.96 |
$428 |
0.7× |
| X-Rays Bone Length Studies (77073) |
$60.99 |
$107 |
0.6× |
| X-Rays Bone Survey Complete (77075) |
$107.16 |
$188 |
1.0× |
| Xr c-spine 4 or 5 views (72050) |
$94.62 |
$166 |
0.9× |
| Xr facial bones less than 3 views (70140) |
$50.73 |
$89 |
0.6× |
| Xr orbits complete 4 views (70200) |
$60.99 |
$107 |
0.6× |