| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,601.79 |
$12,782.75 |
3.3× |
| Abdomen 2 views (74019) |
$149.22 |
$414.50 |
1.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$908.24 |
$2,522.88 |
2.3× |
| Acute venous thrombus image (78456) |
$508.41 |
$1,412.25 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$2,025.27 |
$5,625.75 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,948.14 |
$5,411.50 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$643.23 |
$1,786.75 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,841.13 |
$5,114.25 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,744.73 |
$7,624.25 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,829.88 |
$5,083 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,841.13 |
$5,114.25 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,025.27 |
$5,625.75 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$515.07 |
$1,430.75 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$643.23 |
$1,786.75 |
0.2× |
| Ankle 2 views (73600) |
$95.04 |
$264 |
1.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$541.53 |
$1,504.25 |
1.5× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,841.13 |
$5,114.25 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,142.99 |
$5,952.75 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,142.99 |
$5,952.75 |
0.7× |
| Arthrogram elbow (73085) |
$327.06 |
$908.50 |
0.9× |
| Arthrogram hip (73525) |
$306.27 |
$850.75 |
0.9× |
| Arthrogram shoulder (73040) |
$389.07 |
$1,080.75 |
1.1× |
| Arthrogram wrist (73115) |
$275.13 |
$764.25 |
0.8× |
| Arthrography knee lt (73580) |
$250.02 |
$694.50 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$440.37 |
$1,223.25 |
3.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$314.01 |
$872.25 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$918.27 |
$2,550.75 |
2.3× |
| Bone age studies (77072) |
$115.20 |
$320 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$1,049.90 |
$2,916.38 |
2.6× |
| Bone survey complete (77075) |
$341.82 |
$949.50 |
3.3× |
| Brachytx isodose complex (77318) |
$1,007.06 |
$2,797.38 |
2.7× |
| Brain image w/flow 4 + views (78606) |
$495.54 |
$1,376.50 |
0.9× |
| Brain imaging < 4 static views (78600) |
$198.18 |
$550.50 |
0.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$198.18 |
$550.50 |
0.5× |
| Brain Imaging Minimum 4 Static Views (78605) |
$504.63 |
$1,401.75 |
0.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$830.66 |
$2,307.38 |
2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,290.78 |
$3,585.50 |
3.7× |
| Cardiac shunt detection (78428) |
$830.66 |
$2,307.38 |
2.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$673.11 |
$1,869.75 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$190.71 |
$529.75 |
2.2× |
| Chest 1 view (71045) |
$120.69 |
$335.25 |
1.4× |
| Chest 3 views (71047) |
$148.77 |
$413.25 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$107.37 |
$298.25 |
0.6× |
| Clavicle complete (73000) |
$117.99 |
$327.75 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$650.56 |
$1,807.12 |
6.2× |
| Continuing medical physics consltj pr wk (77336) |
$615.24 |
$1,709 |
4.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$147.78 |
$410.50 |
0.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,973.25 |
$5,481.25 |
5.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,431.45 |
$3,976.25 |
6.0× |
| CT abdomen w contrast (74160) |
$946.30 |
$2,628.62 |
5.4× |
| CT abdomen w wo contrast (74170) |
$986.44 |
$2,740.12 |
5.6× |
| CT abdomen w/o contrast (74150) |
$715.68 |
$1,988 |
6.8× |
| CT angiography upper extremity lt (73206) |
$948.15 |
$2,633.75 |
5.4× |
| CT c-spine w/o contrast (72125) |
$768.24 |
$2,134 |
7.3× |
| CT cervical spine w&w/o contrast (72127) |
$886.72 |
$2,463.12 |
5.0× |
| CT cervical spine with contrast (72126) |
$853.11 |
$2,369.75 |
2.4× |
| CT chest w/wo contrast (71270) |
$1,046.38 |
$2,906.62 |
5.9× |
| CT chest with contrast (71260) |
$1,027.66 |
$2,854.62 |
5.8× |
| CT head/brain with contrast (70460) |
$742.32 |
$2,062 |
4.2× |
| CT head/brain without and with contrast (70470) |
$867.96 |
$2,411 |
4.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$584.06 |
$1,622.38 |
1.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$54 |
$150 |
0.6× |
| CT iac w contrast (70481) |
$601.11 |
$1,669.75 |
3.4× |
| CT limited/localized follow up study (76380) |
$511.78 |
$1,421.62 |
5.9× |
| CT lower ext w/o (73700) |
$701.82 |
$1,949.50 |
6.7× |
| CT lower extremity w wo contrast (73702) |
$948.15 |
$2,633.75 |
5.4× |
| CT lower extremity with contrast (73701) |
$716.40 |
$1,990 |
4.1× |
| CT lumbar spine w & w/o contrast (72133) |
$865.30 |
$2,403.62 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$748.53 |
$2,079.25 |
7.1× |
| CT lumbar spine with contrast (72132) |
$833.49 |
$2,315.25 |
2.4× |
| CT maxillofacial w contrast (70487) |
$677.66 |
$1,882.38 |
3.8× |
| CT maxillofacial w/o contrast (70486) |
$511.78 |
$1,421.62 |
4.9× |
| CT maxillofacial w/wo contrast (70488) |
$709.29 |
$1,970.25 |
4.0× |
| CT neck soft tissue w contrast (70491) |
$803.38 |
$2,231.62 |
4.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$824.98 |
$2,291.62 |
4.7× |
| CT orbits w/o contrast (70480) |
$542.70 |
$1,507.50 |
5.2× |
| CT pelvis w & w/o contrast (72194) |
$896.85 |
$2,491.25 |
5.1× |
| CT pelvis w/o contrast (72192) |
$715.68 |
$1,988 |
6.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$986.44 |
$2,740.12 |
5.6× |
| CT soft tissue neck w/o contrast (70490) |
$619.65 |
$1,721.25 |
5.9× |
| CT thoracic spine w/contrast (72129) |
$775.62 |
$2,154.50 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$392.72 |
$1,090.88 |
3.7× |
| CT thoracic spine w/wo contrast (72130) |
$969.08 |
$2,691.88 |
5.5× |
| CT thorax w/o contrast (71250) |
$715.68 |
$1,988 |
6.8× |
| CT unlisted procedure (76497) |
$722.79 |
$2,007.75 |
8.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,139.58 |
$3,165.50 |
6.5× |
| CT upper extremity w/o contrast rt (73200) |
$655.29 |
$1,820.25 |
6.2× |
| CT upper extremity with contrast (73201) |
$651.42 |
$1,809.50 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$500.26 |
$1,389.62 |
2.8× |
| Cta Abdomen (74175) |
$978.80 |
$2,718.88 |
5.6× |
| CTA abdomen pelvis (74174) |
$978.80 |
$2,718.88 |
2.8× |
| CTA chest (71275) |
$986.26 |
$2,739.62 |
5.6× |
| Cta Head (70496) |
$1,087.65 |
$3,021.25 |
6.2× |
| CTA lwr ext w&w/o contrast (73706) |
$1,303.56 |
$3,621 |
7.4× |
| Cta Neck (70498) |
$978.80 |
$2,718.88 |
5.6× |
| Cta Pelvis (72191) |
$889.83 |
$2,471.75 |
5.1× |
| Cystography minimum 3 views rs&i (74430) |
$504.27 |
$1,400.75 |
1.4× |
| Diskogram cervical (72285) |
$1,417.05 |
$3,936.25 |
0.7× |
| Diskography lumbar (72295) |
$1,714.50 |
$4,762.50 |
0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$89.10 |
$247.50 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$233.55 |
$648.75 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$75.42 |
$209.50 |
0.9× |
| Echoencephalography real time imaging (76506) |
$87.52 |
$243.12 |
0.8× |
| Esophagus (74220) |
$257.40 |
$715 |
1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$106.96 |
$297.12 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$305.10 |
$847.50 |
1.3× |
| Foot 2 views (73620) |
$102.69 |
$285.25 |
1.2× |
| Forearm 2 views (73090) |
$134.37 |
$373.25 |
1.5× |
| Gated Heart Planar Single (78472) |
$953.14 |
$2,647.62 |
2.4× |
| Hand 2 views (73120) |
$140.58 |
$390.50 |
1.3× |
| Hand 3 views (73130) |
$115.20 |
$320 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,841.13 |
$5,114.25 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,189.48 |
$3,304.12 |
2.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,071.72 |
$2,977 |
2.7× |
| Ht muscle image spect sing (78451) |
$1,652.54 |
$4,590.38 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$117.99 |
$327.75 |
1.3× |
| Hysterosalpingogram (74740) |
$284.04 |
$789 |
1.2× |
| Interstitial radiation source applic complex (77778) |
$2,522.88 |
$7,008 |
3.6× |
| Kidney imaging morphology (78700) |
$420.44 |
$1,167.88 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$830.07 |
$2,305.75 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,183.05 |
$3,286.25 |
2.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$819.40 |
$2,276.12 |
1.5× |
| Knee 3 views (73562) |
$134.37 |
$373.25 |
1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$387.72 |
$1,077 |
1.0× |
| Liver imaging static only (78201) |
$685.22 |
$1,903.38 |
1.3× |
| Lung perf&ventilat diferentl (78598) |
$1,453.68 |
$4,038 |
2.7× |
| Lung Ventilation Imaging (78579) |
$502.06 |
$1,394.62 |
1.3× |
| Lymphoscintigraphy (78195) |
$910.71 |
$2,529.75 |
1.7× |
| Mammary ductogram or galactogram multiple (77054) |
$194.94 |
$541.50 |
0.8× |
| Mammary ductogram or galactogram single (77053) |
$188.10 |
$522.50 |
0.8× |
| Meckels Diverticulum (78290) |
$551.30 |
$1,531.38 |
1.4× |
| Mr elastography (76391) |
$459.54 |
$1,276.50 |
1.9× |
| Mr safety determination physician/other qhp (76016) |
$111.60 |
$310 |
1.3× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$75.60 |
$210 |
1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$34.02 |
$94.50 |
1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$115.92 |
$322 |
1.2× |
| Mr safety med physics xm customization plng&mntr (76017) |
$304.92 |
$847 |
1.3× |
| MRA head w & w/o contrast (70546) |
$1,290.78 |
$3,585.50 |
3.7× |
| MRA head w/o contrast (70544) |
$915.98 |
$2,544.38 |
3.8× |
| MRA head with contrast (70545) |
$940.36 |
$2,612.12 |
2.7× |
| MRA neck w contrast (70548) |
$940.36 |
$2,612.12 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,290.78 |
$3,585.50 |
3.7× |
| MRA neck w/o contrast (70547) |
$848.25 |
$2,356.25 |
3.5× |
| MRI abdomen w contrast (74182) |
$940.36 |
$2,612.12 |
2.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,394.06 |
$3,872.38 |
4.0× |
| MRI abdomen w/o contrast (74181) |
$915.98 |
$2,544.38 |
3.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,168.20 |
$3,245 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$915.98 |
$2,544.38 |
1.2× |
| MRI bone marrow blood supply (77084) |
$786.15 |
$2,183.75 |
3.3× |
| MRI c-spine with contrast (72142) |
$940.36 |
$2,612.12 |
2.7× |
| MRI cardiac w/o contrast (75557) |
$921.56 |
$2,559.88 |
3.8× |
| MRI cervical spine w/o contrast (72141) |
$915.98 |
$2,544.38 |
3.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,394.06 |
$3,872.38 |
4.0× |
| MRI chest w/o contrast (71550) |
$848.25 |
$2,356.25 |
3.5× |
| MRI chest with contrast (71551) |
$940.36 |
$2,612.12 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$940.36 |
$2,612.12 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$940.36 |
$2,612.12 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$915.98 |
$2,544.38 |
3.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$848.25 |
$2,356.25 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,394.06 |
$3,872.38 |
4.0× |
| MRI orbit/face/neck w/contrast (70542) |
$940.36 |
$2,612.12 |
2.7× |
| MRI pelvis w contrast (72196) |
$940.36 |
$2,612.12 |
2.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,394.06 |
$3,872.38 |
4.0× |
| MRI pelvis w/o contrast (72195) |
$915.98 |
$2,544.38 |
3.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,229.31 |
$3,414.75 |
3.5× |
| MRI scan of leg joint before and after contrast (73723) |
$1,327.68 |
$3,688 |
3.8× |
| MRI spectroscopy (76390) |
$864.86 |
$2,402.38 |
9.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,394.06 |
$3,872.38 |
4.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$940.36 |
$2,612.12 |
2.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,394.06 |
$3,872.38 |
4.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$940.36 |
$2,612.12 |
2.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,394.06 |
$3,872.38 |
4.0× |
| MRI thoracic spine w/o contrast (72146) |
$915.98 |
$2,544.38 |
3.8× |
| MRI tmj (70336) |
$915.98 |
$2,544.38 |
3.8× |
| MRI upper ext joint w/o contrast (73221) |
$915.98 |
$2,544.38 |
3.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,290.78 |
$3,585.50 |
3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$915.98 |
$2,544.38 |
3.8× |
| Myelogram Cervical (72240) |
$512.91 |
$1,424.75 |
0.7× |
| Myelogram Lumbar (72265) |
$1,217.07 |
$3,380.75 |
1.5× |
| Myelogram thoracic (72255) |
$506.16 |
$1,406 |
0.6× |
| Myelography 2 or more regions (72270) |
$1,154.70 |
$3,207.50 |
1.5× |
| Myocardial infarct spect (78469) |
$830.66 |
$2,307.38 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,319.39 |
$6,442.75 |
1.8× |
| Neck soft tissue (70360) |
$164.70 |
$457.50 |
1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$269.91 |
$749.75 |
0.7× |
| Nm bone marrow wb (78104) |
$829.44 |
$2,304 |
2.1× |
| Nm cisternogram (78630) |
$707.90 |
$1,966.38 |
1.3× |
| Nm csf leak detection (78650) |
$673.11 |
$1,869.75 |
0.5× |
| Nm gastric emptying study (78264) |
$1,295.50 |
$3,598.62 |
3.2× |
| Nm gastroesophageal reflux study (78262) |
$672.75 |
$1,868.75 |
1.7× |
| Nm peritoneal-venous shunt patency (78291) |
$305.91 |
$849.75 |
0.8× |
| Nuclear medicine of heart pumping function (78473) |
$830.66 |
$2,307.38 |
2.1× |
| Nuclear medicine study of kidney and blood flow (78701) |
$420.44 |
$1,167.88 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$581.44 |
$1,615.12 |
1.4× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$428.26 |
$1,189.62 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$946.80 |
$2,630 |
4.0× |
| Orthopantogram (70355) |
$131.85 |
$366.25 |
1.5× |
| Osseous survey infant (77076) |
$141.93 |
$394.25 |
1.4× |
| Osseous survey limited (77074) |
$276.30 |
$767.50 |
2.6× |
| Parathyroid imaging (78070) |
$791.64 |
$2,199 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$123.12 |
$342 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$2,928.96 |
$8,136 |
2.0× |
| PET imaging CT for attenuation limited area (78814) |
$2,731.32 |
$7,587 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$3,019.90 |
$8,388.62 |
2.1× |
| Pr csf ventriculography (78635) |
$673.11 |
$1,869.75 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,394.06 |
$3,872.38 |
4.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,841.13 |
$5,114.25 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$643.23 |
$1,786.75 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$607.28 |
$1,686.88 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,211.04 |
$3,364 |
2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$188.10 |
$522.50 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$142.29 |
$395.25 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$333.27 |
$925.75 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$292.23 |
$811.75 |
2.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$121.14 |
$336.50 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$135.27 |
$375.75 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$233.55 |
$648.75 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$149.22 |
$414.50 |
1.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$148.77 |
$413.25 |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$329.40 |
$915 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$255.33 |
$709.25 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$262.08 |
$728 |
1.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$124.74 |
$346.50 |
1.4× |
| Radiological examination surgical specimen (76098) |
$349.38 |
$970.50 |
0.6× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,829.88 |
$5,083 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,841.13 |
$5,114.25 |
0.6× |
| Ribs bilateral 3 views (71110) |
$166.32 |
$462 |
1.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,556.60 |
$4,323.88 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,156.77 |
$3,213.25 |
2.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,053.45 |
$2,926.25 |
0.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$572.76 |
$1,591 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$110.16 |
$306 |
1.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$162.36 |
$451 |
0.7× |
| Salivary gland imaging serial images (78231) |
$318.38 |
$884.38 |
0.8× |
| Scanogram (77073) |
$91.35 |
$253.75 |
0.9× |
| Scapula complete (73010) |
$139.32 |
$387 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$37.04 |
$102.88 |
1.6× |
| Sella turcica (70240) |
$63.90 |
$177.50 |
0.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$71.73 |
$199.25 |
0.7× |
| Sialogram (70390) |
$188.10 |
$522.50 |
0.8× |
| Small bowel series (74250) |
$257.85 |
$716.25 |
1.5× |
| Special treatment procedure (77470) |
$764.14 |
$2,122.62 |
1.4× |
| Spine thoracic 3 views (72072) |
$154.26 |
$428.50 |
1.5× |
| Tbs Technical Calculation Only (77091) |
$73.71 |
$204.75 |
0.8× |
| Testicular Imaging With Vascular Flow (78761) |
$397.76 |
$1,104.88 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,371.02 |
$3,808.38 |
3.6× |
| Thoracolumbar 2 views (72080) |
$57.96 |
$161 |
0.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,054.62 |
$2,929.50 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$259.02 |
$719.50 |
0.6× |
| Thyroid uptake measurement (78012) |
$244.76 |
$679.88 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$654.21 |
$1,817.25 |
1.6× |
| Tomogram (76100) |
$209.16 |
$581 |
2.0× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$73.71 |
$204.75 |
0.8× |
| Treatment devices simple (77332) |
$393.34 |
$1,092.62 |
2.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,556.60 |
$4,323.88 |
2.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$661.50 |
$1,837.50 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$359.01 |
$997.25 |
3.4× |
| Umbilical-artery Doppler (OB) (76820) |
$89.10 |
$247.50 |
0.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$78.21 |
$217.25 |
0.9× |
| Unlisted fluoroscopic procedure (76496) |
$78.57 |
$218.25 |
0.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,290.78 |
$3,585.50 |
14.8× |
| Upper Extremity Infant (73092) |
$42.21 |
$117.25 |
0.4× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$676.35 |
$1,878.75 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$172.62 |
$479.50 |
0.7× |
| Urethrocystography voiding (74455) |
$504.27 |
$1,400.75 |
2.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$532.53 |
$1,479.25 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$291.33 |
$809.25 |
2.8× |
| Us breast unilateral complete (76641) |
$203.94 |
$566.50 |
1.9× |
| Us breast unilateral limited (76642) |
$153 |
$425 |
1.8× |
| Us chest (76604) |
$147.60 |
$410 |
1.4× |
| Us compl joint r-t w/image documentation (76881) |
$290.61 |
$807.25 |
2.8× |
| Us guided compression repair (76936) |
$278.42 |
$773.38 |
1.3× |
| Us infant hips dynamic (76885) |
$70.29 |
$195.25 |
0.8× |
| Us infant hips limited static (76886) |
$73.44 |
$204 |
0.8× |
| Us ob detailed single fetus (76811) |
$328.95 |
$913.75 |
1.4× |
| Us ob transvaginal (76817) |
$204.48 |
$568 |
1.9× |
| Us pelvic non ob complete (76856) |
$274.32 |
$762 |
2.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$253.62 |
$704.50 |
2.4× |
| Us pregnancy ltd (76815) |
$124.47 |
$345.75 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$195.70 |
$543.62 |
1.9× |
| Us retroperitoneal complete (76770) |
$306.76 |
$852.12 |
2.9× |
| Us retroperitoneal limited (76775) |
$291.33 |
$809.25 |
2.8× |
| Us scrotum and contents (76870) |
$276.12 |
$767 |
2.6× |
| Us soft tissue head/neck (76536) |
$196.65 |
$546.25 |
1.9× |
| Us spinal canal and contents (76800) |
$91.84 |
$255.12 |
0.9× |
| Us transrectal (76872) |
$142.11 |
$394.75 |
1.4× |
| Us transrectal prostate volume (76873) |
$321.66 |
$893.50 |
3.1× |
| Us xtr non-vasc lmtd (76882) |
$167.04 |
$464 |
1.6× |
| Vascular flow imaging (78445) |
$198.63 |
$551.75 |
0.5× |
| Venogram extremity bilateral (75822) |
$954.27 |
$2,650.75 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,948.14 |
$5,411.50 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$655.65 |
$1,821.25 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$636.21 |
$1,767.25 |
0.4× |
| Venography Renal Bilateral (75833) |
$2,744.73 |
$7,624.25 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$1,829.88 |
$5,083 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$643.23 |
$1,786.75 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,841.13 |
$5,114.25 |
0.3× |
| Wrist 2 views (73100) |
$140.58 |
$390.50 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$158.13 |
$439.25 |
1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$95.58 |
$265.50 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$140.58 |
$390.50 |
1.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$321.30 |
$892.50 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$117.99 |
$327.75 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$124.74 |
$346.50 |
1.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$228.24 |
$634 |
2.2× |
| X-ray exam hip uni 1 view (73501) |
$206.64 |
$574 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$194.76 |
$541 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$192.15 |
$533.75 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$247.59 |
$687.75 |
2.4× |
| X-ray eye for foreign body (70030) |
$135.99 |
$377.75 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$139.23 |
$386.75 |
1.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$107.28 |
$298 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$140.58 |
$390.50 |
1.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$317.61 |
$882.25 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$127.08 |
$353 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$107.28 |
$298 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$147.60 |
$410 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$243.09 |
$675.25 |
2.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$134.37 |
$373.25 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$196.11 |
$544.75 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$221.22 |
$614.50 |
2.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$151.11 |
$419.75 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$113.94 |
$316.50 |
1.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$108.72 |
$302 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$156.87 |
$435.75 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$110.16 |
$306 |
1.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$188.10 |
$522.50 |
0.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$504.27 |
$1,400.75 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$173.07 |
$480.75 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$189.27 |
$525.75 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$181.17 |
$503.25 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$110.16 |
$306 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$131.67 |
$365.75 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$145.98 |
$405.50 |
1.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$112.95 |
$313.75 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$198.81 |
$552.25 |
1.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$124.74 |
$346.50 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$123.48 |
$343 |
1.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$113.58 |
$315.50 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$103.59 |
$287.75 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$139.95 |
$388.75 |
1.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$133.56 |
$371 |
1.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$124.74 |
$346.50 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$140.58 |
$390.50 |
1.6× |
| Xr arthrogram ankle (73615) |
$125.01 |
$347.25 |
0.4× |
| Xr c-spine 6 or more views (72052) |
$199.53 |
$554.25 |
1.9× |
| Xr chest 4+ views (71048) |
$138.42 |
$384.50 |
1.3× |
| Xr Cholecystography Oral Contrast (74290) |
$126.36 |
$351 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$123.12 |
$342 |
1.4× |
| Xr shoulder 1 view (73020) |
$96.39 |
$267.75 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$226.17 |
$628.25 |
2.2× |
| Xr tibia/fibula 2 views (73590) |
$134.37 |
$373.25 |
1.5× |
| Xr tmj bilateral (70330) |
$84.87 |
$235.75 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$121.50 |
$337.50 |
1.4× |