| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,071.89 |
$5,755.25 |
1.5× |
| Abdomen 2 views (74019) |
$254.02 |
$705.62 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$653.94 |
$1,816.50 |
1.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,798.81 |
$10,552.25 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$3,166.65 |
$8,796.25 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,162.87 |
$8,785.75 |
1.0× |
| Angiography internal mammary rs&i (75756) |
$1,269.90 |
$3,527.50 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,743.34 |
$4,842.62 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,063.78 |
$8,510.50 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,001.96 |
$5,561 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$3,868.74 |
$10,746.50 |
0.7× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,708.65 |
$4,746.25 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$536.40 |
$1,490 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$999.86 |
$2,777.38 |
0.3× |
| Ankle 2 views (73600) |
$231.03 |
$641.75 |
2.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$350.46 |
$973.50 |
1.0× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,303.96 |
$6,399.88 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,706.62 |
$7,518.38 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,458.62 |
$6,829.50 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$2,254.77 |
$6,263.25 |
0.7× |
| Arthrogram elbow (73085) |
$439.83 |
$1,221.75 |
1.3× |
| Arthrogram hip (73525) |
$469.35 |
$1,303.75 |
1.3× |
| Arthrogram shoulder (73040) |
$550.35 |
$1,528.75 |
1.6× |
| Arthrogram wrist (73115) |
$477.32 |
$1,325.88 |
1.4× |
| Arthrography knee lt (73580) |
$535.10 |
$1,486.38 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$227.52 |
$632 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$368.19 |
$1,022.75 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$872.46 |
$2,423.50 |
2.2× |
| Bone age studies (77072) |
$117 |
$325 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$1,175.13 |
$3,264.25 |
2.9× |
| Bone Marrow Imaging Limited Area (78102) |
$669.38 |
$1,859.38 |
1.7× |
| Bone survey complete (77075) |
$678.96 |
$1,886 |
6.5× |
| Brachytx isodose complex (77318) |
$415.89 |
$1,155.25 |
1.1× |
| Brachytx isodose intermed (77317) |
$387.18 |
$1,075.50 |
1.0× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$151.02 |
$419.50 |
0.4× |
| Brain image w/flow 4 + views (78606) |
$612.63 |
$1,701.75 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$499.77 |
$1,388.25 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,640.87 |
$7,335.75 |
1.8× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$235.17 |
$653.25 |
21.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,392.34 |
$3,867.62 |
4.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$317.61 |
$882.25 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$267.21 |
$742.25 |
3.1× |
| Chest 1 view (71045) |
$269.01 |
$747.25 |
3.1× |
| Chest 3 views (71047) |
$135.50 |
$376.38 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$687.38 |
$1,909.38 |
3.9× |
| Clavicle complete (73000) |
$283.41 |
$787.25 |
3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$113.58 |
$315.50 |
1.1× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$380.07 |
$1,055.75 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,543.57 |
$9,843.25 |
10.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,440.26 |
$6,778.50 |
10.2× |
| CT abdomen w contrast (74160) |
$1,397.88 |
$3,883 |
7.9× |
| CT abdomen w wo contrast (74170) |
$1,524.24 |
$4,234 |
8.7× |
| CT abdomen w/o contrast (74150) |
$1,203.12 |
$3,342 |
11.5× |
| CT angio hrt w/3d image (75574) |
$903.42 |
$2,509.50 |
2.6× |
| CT angiography upper extremity lt (73206) |
$994.32 |
$2,762 |
5.6× |
| CT c-spine w/o contrast (72125) |
$1,464.84 |
$4,069 |
13.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,758.24 |
$4,884 |
10.0× |
| CT cervical spine with contrast (72126) |
$1,514.43 |
$4,206.75 |
4.3× |
| CT chest w/wo contrast (71270) |
$2,218.59 |
$6,162.75 |
12.6× |
| CT chest with contrast (71260) |
$2,120.67 |
$5,890.75 |
12.0× |
| CT colonography screening (74263) |
$391.68 |
$1,088 |
1.6× |
| CT colonography w/dye (74262) |
$348.70 |
$968.62 |
2.0× |
| CT colonography w/o cntrst (74261) |
$227.34 |
$631.50 |
2.2× |
| CT head/brain with contrast (70460) |
$1,132.78 |
$3,146.62 |
6.4× |
| CT head/brain without and with contrast (70470) |
$1,260.58 |
$3,501.62 |
7.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$854.64 |
$2,374 |
2.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$45.18 |
$125.50 |
0.5× |
| CT hrt w/3d image congen (75573) |
$854.64 |
$2,374 |
2.4× |
| CT iac w contrast (70481) |
$1,024.83 |
$2,846.75 |
5.8× |
| CT limited/localized follow up study (76380) |
$139.23 |
$386.75 |
1.6× |
| CT lower ext w/o (73700) |
$632.07 |
$1,755.75 |
6.0× |
| CT lower extremity w wo contrast (73702) |
$865.80 |
$2,405 |
4.9× |
| CT lower extremity with contrast (73701) |
$805.64 |
$2,237.88 |
4.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,421.82 |
$3,949.50 |
8.1× |
| CT lumbar spine w/o contrast (72131) |
$639.63 |
$1,776.75 |
6.1× |
| CT lumbar spine with contrast (72132) |
$892.12 |
$2,478.12 |
2.5× |
| CT maxillofacial w contrast (70487) |
$1,305.36 |
$3,626 |
7.4× |
| CT maxillofacial w/o contrast (70486) |
$890.82 |
$2,474.50 |
8.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,218.74 |
$3,385.38 |
6.9× |
| CT neck soft tissue w contrast (70491) |
$1,147.10 |
$3,186.38 |
6.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,481.22 |
$4,114.50 |
8.4× |
| CT orbits w/o contrast (70480) |
$855.58 |
$2,376.62 |
8.1× |
| CT pelvis w & w/o contrast (72194) |
$1,482.26 |
$4,117.38 |
8.4× |
| CT pelvis w/o contrast (72192) |
$1,017.63 |
$2,826.75 |
9.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$532.44 |
$1,479 |
6.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,231.24 |
$3,420.12 |
7.0× |
| CT soft tissue neck w/o contrast (70490) |
$878.58 |
$2,440.50 |
8.4× |
| CT thoracic spine w/contrast (72129) |
$2,035.40 |
$5,653.88 |
11.6× |
| CT thoracic spine w/o contrast (72128) |
$1,873.98 |
$5,205.50 |
17.8× |
| CT thoracic spine w/wo contrast (72130) |
$2,484.86 |
$6,902.38 |
14.1× |
| CT thorax w/o contrast (71250) |
$378.27 |
$1,050.75 |
3.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,528.29 |
$4,245.25 |
8.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,086.03 |
$3,016.75 |
10.3× |
| CT upper extremity with contrast (73201) |
$1,129.28 |
$3,136.88 |
3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,433.88 |
$3,983 |
8.1× |
| Cta Abdomen (74175) |
$1,732.41 |
$4,812.25 |
9.8× |
| CTA abdomen pelvis (74174) |
$2,433.28 |
$6,759.12 |
6.9× |
| CTA chest (71275) |
$487.62 |
$1,354.50 |
2.8× |
| Cta Head (70496) |
$837.40 |
$2,326.12 |
4.8× |
| CTA lwr ext w&w/o contrast (73706) |
$1,483.20 |
$4,120 |
8.4× |
| Cta Neck (70498) |
$824.58 |
$2,290.50 |
4.7× |
| Cta Pelvis (72191) |
$1,029.06 |
$2,858.50 |
5.8× |
| Cystography minimum 3 views rs&i (74430) |
$770.85 |
$2,141.25 |
2.2× |
| Diskogram cervical (72285) |
$5,291.37 |
$14,698.25 |
2.7× |
| Diskography lumbar (72295) |
$2,951.19 |
$8,197.75 |
1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$208.76 |
$579.88 |
2.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$208.76 |
$579.88 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$300.60 |
$835 |
2.9× |
| Dxa bone density study axial skeleton (77085) |
$210.42 |
$584.50 |
2.0× |
| Echo exam of eye (76529) |
$104.22 |
$289.50 |
1.2× |
| Echo exam of fetal heart (76825) |
$701.28 |
$1,948 |
1.3× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$962.73 |
$2,674.25 |
4.0× |
| Echoencephalography real time imaging (76506) |
$948.69 |
$2,635.25 |
9.0× |
| Esophagus (74220) |
$209.70 |
$582.50 |
1.2× |
| Fetal biophysical profile non-stress testing (76818) |
$274.32 |
$762 |
2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$161.91 |
$449.75 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$150.93 |
$419.25 |
0.6× |
| Foot 2 views (73620) |
$255.51 |
$709.75 |
2.9× |
| Forearm 2 views (73090) |
$282.06 |
$783.50 |
3.2× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$70.20 |
$195 |
0.3× |
| Functional MRI brain by phys/psych (70555) |
$1,310.98 |
$3,641.62 |
5.5× |
| Functional MRI brain by tech (70554) |
$1,165.50 |
$3,237.50 |
4.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$742.36 |
$2,062.12 |
1.4× |
| Gated Heart Planar Single (78472) |
$676.76 |
$1,879.88 |
1.7× |
| Hand 2 views (73120) |
$261.18 |
$725.50 |
2.5× |
| Hand 3 views (73130) |
$302.58 |
$840.50 |
3.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$558.36 |
$1,551 |
0.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$558.36 |
$1,551 |
0.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$558.36 |
$1,551 |
0.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,920.14 |
$8,111.50 |
0.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,513.26 |
$4,203.50 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,007.55 |
$2,798.75 |
2.5× |
| Ht muscle image spect sing (78451) |
$932.40 |
$2,590 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$271.98 |
$755.50 |
3.1× |
| Hysterosalpingogram (74740) |
$477.40 |
$1,326.12 |
2.0× |
| Interstitial radiation source applic complex (77778) |
$2,011.14 |
$5,586.50 |
2.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$835.83 |
$2,321.75 |
1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$835.83 |
$2,321.75 |
1.5× |
| Intracavitary radiation source applic simple (77761) |
$835.83 |
$2,321.75 |
1.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$163.08 |
$453 |
1.6× |
| Kidney imaging morphology (78700) |
$808.24 |
$2,245.12 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,112.40 |
$3,090 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,180.80 |
$3,280 |
2.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$590.85 |
$1,641.25 |
1.1× |
| Knee 3 views (73562) |
$367.29 |
$1,020.25 |
4.2× |
| Liver & spleen imaging static only (78215) |
$568.80 |
$1,580 |
1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$832.68 |
$2,313 |
2.1× |
| Liver imaging static only (78201) |
$355.64 |
$987.88 |
0.7× |
| Lung perf&ventilat diferentl (78598) |
$455.54 |
$1,265.38 |
0.8× |
| Lung perfusion differential (78597) |
$326.88 |
$908 |
0.8× |
| Lung Ventilation Imaging (78579) |
$237.24 |
$659 |
0.6× |
| Lymphoscintigraphy (78195) |
$566.50 |
$1,573.62 |
1.0× |
| Mammary ductogram or galactogram multiple (77054) |
$535.50 |
$1,487.50 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$600.12 |
$1,667 |
2.5× |
| Meckels Diverticulum (78290) |
$726.12 |
$2,017 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$664.02 |
$1,844.50 |
1.8× |
| Mr elastography (76391) |
$357.75 |
$993.75 |
1.5× |
| Mr safety determination physician/other qhp (76016) |
$116.06 |
$322.38 |
1.3× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$78.62 |
$218.38 |
1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$32.22 |
$89.50 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$120.56 |
$334.88 |
1.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$317.12 |
$880.88 |
1.3× |
| MRA head w & w/o contrast (70546) |
$2,652.75 |
$7,368.75 |
7.6× |
| MRA head w/o contrast (70544) |
$879.62 |
$2,443.38 |
3.7× |
| MRA head with contrast (70545) |
$1,293.30 |
$3,592.50 |
3.7× |
| MRA neck w contrast (70548) |
$1,011.78 |
$2,810.50 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,232.46 |
$3,423.50 |
3.5× |
| MRA neck w/o contrast (70547) |
$838.62 |
$2,329.50 |
3.5× |
| MRI abdomen w contrast (74182) |
$1,821.96 |
$5,061 |
5.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,015.01 |
$5,597.25 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,621.71 |
$4,504.75 |
6.8× |
| MRI any jnt lwr ext with con lt (73722) |
$847.62 |
$2,354.50 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,673.91 |
$4,649.75 |
2.1× |
| MRI breast w/o contrast bilateral (77047) |
$585.58 |
$1,626.62 |
2.4× |
| MRI breast w/o contrast unilat (77046) |
$795.51 |
$2,209.75 |
3.3× |
| MRI c-spine with contrast (72142) |
$2,110.95 |
$5,863.75 |
6.0× |
| MRI cardiac w/o cont stress (75559) |
$1,165.50 |
$3,237.50 |
2.1× |
| MRI cardiac w/o contrast (75557) |
$812.79 |
$2,257.75 |
3.4× |
| MRI cervical spine w/o contrast (72141) |
$1,782 |
$4,950 |
7.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,247.76 |
$3,466 |
3.6× |
| MRI chest w/o contrast (71550) |
$841.32 |
$2,337 |
3.5× |
| MRI chest with contrast (71551) |
$971.19 |
$2,697.75 |
1.2× |
| MRI fetal sngl/1st gestation (74712) |
$432.27 |
$1,200.75 |
1.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,517.04 |
$4,214 |
4.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,271.34 |
$3,531.50 |
3.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$593.46 |
$1,648.50 |
2.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,227.15 |
$3,408.75 |
5.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,461.32 |
$6,837 |
7.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,400.49 |
$3,890.25 |
4.0× |
| MRI pelvis w contrast (72196) |
$1,676.61 |
$4,657.25 |
4.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,763.01 |
$4,897.25 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,350.99 |
$3,752.75 |
5.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,944 |
$5,400 |
5.5× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$4,640.90 |
$12,891.38 |
5.9× |
| MRI scan of leg joint before and after contrast (73723) |
$1,188.81 |
$3,302.25 |
3.4× |
| MRI spectroscopy (76390) |
$2,169.54 |
$6,026.50 |
24.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,122.56 |
$5,896 |
6.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,558.08 |
$4,328 |
4.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,434.41 |
$6,762.25 |
6.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,603.71 |
$4,454.75 |
4.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,434.41 |
$6,762.25 |
6.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,242.99 |
$3,452.75 |
5.2× |
| MRI tmj (70336) |
$887.54 |
$2,465.38 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$775.08 |
$2,153 |
3.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,944 |
$5,400 |
5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$696.33 |
$1,934.25 |
2.9× |
| Myelogram Cervical (72240) |
$1,084.10 |
$3,011.38 |
1.4× |
| Myelogram Lumbar (72265) |
$1,703.88 |
$4,733 |
2.2× |
| Myelogram thoracic (72255) |
$270.90 |
$752.50 |
0.3× |
| Myelography 2 or more regions (72270) |
$1,954.53 |
$5,429.25 |
2.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,798.38 |
$4,995.50 |
1.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,284.84 |
$3,569 |
1.5× |
| Neck soft tissue (70360) |
$208.66 |
$579.62 |
2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$476.64 |
$1,324 |
1.2× |
| Nm adrenal scan (78075) |
$1,322.19 |
$3,672.75 |
1.0× |
| Nm cisternogram (78630) |
$795.02 |
$2,208.38 |
1.5× |
| Nm csf leak detection (78650) |
$1,009.94 |
$2,805.38 |
0.8× |
| Nm gastric emptying study (78264) |
$322.52 |
$895.88 |
0.8× |
| Nm gastroesophageal reflux study (78262) |
$374.85 |
$1,041.25 |
0.9× |
| Nm peritoneal-venous shunt patency (78291) |
$310.28 |
$861.88 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,984.05 |
$5,511.25 |
1.4× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,066.67 |
$5,740.75 |
1.6× |
| Nuclear medicine of heart pumping function (78473) |
$1,055.74 |
$2,932.62 |
2.6× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,544.30 |
$7,067.50 |
1.8× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,498.05 |
$4,161.25 |
1.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$343.89 |
$955.25 |
0.9× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$577.26 |
$1,603.50 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$304.92 |
$847 |
1.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$309.15 |
$858.75 |
2.9× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$274.90 |
$763.62 |
2.6× |
| Orthopantogram (70355) |
$103.41 |
$287.25 |
1.2× |
| Osseous survey infant (77076) |
$203.40 |
$565 |
1.9× |
| Osseous survey limited (77074) |
$115.65 |
$321.25 |
1.1× |
| Parathyrd planar w/spect&CT (78072) |
$703.44 |
$1,954 |
1.3× |
| Parathyrd planar w/wo subtrj (78071) |
$496.62 |
$1,379.50 |
1.2× |
| Parathyroid imaging (78070) |
$460.58 |
$1,279.38 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$230.85 |
$641.25 |
2.2× |
| Perineogram (74775) |
$367.52 |
$1,020.88 |
1.5× |
| PET image w/CT, skull-thigh (78815) |
$2,778.30 |
$7,717.50 |
1.9× |
| PET imaging CT for attenuation limited area (78814) |
$2,460.51 |
$6,834.75 |
1.7× |
| PET imaging for CT attenuation whole body (78816) |
$2,350.22 |
$6,528.38 |
1.6× |
| PET imaging limited area chest head/neck (78811) |
$2,256.84 |
$6,269 |
1.7× |
| PET whole body (78813) |
$2,713.41 |
$7,537.25 |
1.9× |
| Pr MRI brain w/ dye (70558) |
$1,821.96 |
$5,061 |
10.3× |
| Pr MRI brain w/o & w/ dye (70559) |
$2,061 |
$5,725 |
11.7× |
| Pr MRI brain w/o dye (70557) |
$1,222.20 |
$3,395 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,882.89 |
$5,230.25 |
5.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,064.76 |
$11,291 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,313.91 |
$3,649.75 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$464.85 |
$1,291.25 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,231.11 |
$3,419.75 |
2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$267.39 |
$742.75 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$97.78 |
$271.62 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$175.64 |
$487.88 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$175.64 |
$487.88 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$218.97 |
$608.25 |
2.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$335.07 |
$930.75 |
3.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$408.06 |
$1,133.50 |
0.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$211.50 |
$587.50 |
2.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$211.50 |
$587.50 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$216.58 |
$601.62 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$252.63 |
$701.75 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$269.01 |
$747.25 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$292.95 |
$813.75 |
1.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$289.08 |
$803 |
1.6× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$112.68 |
$313 |
0.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$289.08 |
$803 |
1.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$289.08 |
$803 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$106.24 |
$295.12 |
1.2× |
| Radiological examination surgical specimen (76098) |
$209.16 |
$581 |
0.4× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$501.75 |
$1,393.75 |
2.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,548.84 |
$9,857.88 |
1.1× |
| Ribs bilateral 3 views (71110) |
$252.50 |
$701.38 |
2.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,122.80 |
$3,118.88 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,180.80 |
$3,280 |
2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,763.10 |
$4,897.50 |
1.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,755.90 |
$4,877.50 |
1.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,763.10 |
$4,897.50 |
1.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,040.40 |
$2,890 |
4.4× |
| Sacroiliac Joints < 3 Views (72200) |
$124.06 |
$344.62 |
1.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$465.48 |
$1,293 |
1.9× |
| Salivary gland function study (78232) |
$267.48 |
$743 |
0.7× |
| Salivary gland imaging (78230) |
$592.38 |
$1,645.50 |
1.5× |
| Salivary gland imaging serial images (78231) |
$592.38 |
$1,645.50 |
1.5× |
| Scanogram (77073) |
$105.93 |
$294.25 |
1.0× |
| Scapula complete (73010) |
$278.10 |
$772.50 |
2.6× |
| Screening digital breast tomosynthesis (77063) |
$61.38 |
$170.50 |
2.6× |
| Sella turcica (70240) |
$82.22 |
$228.38 |
0.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$301.41 |
$837.25 |
2.9× |
| Sialogram (70390) |
$463.50 |
$1,287.50 |
1.9× |
| Simulation intermediate (77285) |
$664.02 |
$1,844.50 |
1.8× |
| Small bowel series (74250) |
$310.95 |
$863.75 |
1.8× |
| Spec medical radj physics consltj (77370) |
$509.58 |
$1,415.50 |
3.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$238.95 |
$663.75 |
0.6× |
| Special dosimetry (77331) |
$238.95 |
$663.75 |
1.8× |
| Special treatment procedure (77470) |
$909.18 |
$2,525.50 |
1.6× |
| Speech evaluation complex (70371) |
$257.85 |
$716.25 |
1.1× |
| Spine thoracic 3 views (72072) |
$315.68 |
$876.88 |
3.0× |
| Splenoportograpy rs&i (75810) |
$3,548.84 |
$9,857.88 |
1.1× |
| Superior sagittal sinus venogram (75870) |
$467.46 |
$1,298.50 |
0.1× |
| Tbs Technical Calculation Only (77091) |
$123.30 |
$342.50 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$230.76 |
$641 |
0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$149.94 |
$416.50 |
0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$400.95 |
$1,113.75 |
1.7× |
| Testicular Imaging With Vascular Flow (78761) |
$762.34 |
$2,117.62 |
1.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$582.93 |
$1,619.25 |
1.5× |
| Therapeutic Enema (74283) |
$417.20 |
$1,158.88 |
2.4× |
| Thoracolumbar 2 views (72080) |
$211.46 |
$587.38 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$489.92 |
$1,360.88 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$202.64 |
$562.88 |
0.5× |
| Thyroid uptake measurement (78012) |
$181.53 |
$504.25 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$270.86 |
$752.38 |
0.7× |
| Tmj unilateral (70328) |
$206.64 |
$574 |
2.4× |
| Tomogram (76100) |
$131.94 |
$366.50 |
1.3× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$123.30 |
$342.50 |
1.4× |
| Treatment device intermediate (77333) |
$455.22 |
$1,264.50 |
3.4× |
| Treatment devices simple (77332) |
$418.14 |
$1,161.50 |
3.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,154.06 |
$5,983.50 |
3.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,263.87 |
$3,510.75 |
3.1× |
| Tx devices design & construction complex (77334) |
$746.10 |
$2,072.50 |
2.0× |
| Ultrasound elastography first target lesion (76982) |
$390.64 |
$1,085.12 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$205.60 |
$571.12 |
2.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$105.93 |
$294.25 |
1.2× |
| Unlisted magnetic resonance procedure (76498) |
$1,165.50 |
$3,237.50 |
13.3× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$482.40 |
$1,340 |
1.2× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$835.83 |
$2,321.75 |
8.2× |
| Unlisted Ultrasound Procedure (76999) |
$88.47 |
$245.75 |
1.0× |
| Upper Extremity Infant (73092) |
$216.99 |
$602.75 |
2.1× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$178.65 |
$496.25 |
1.9× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$762.34 |
$2,117.62 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$429.80 |
$1,193.88 |
1.8× |
| Urethrocystography voiding (74455) |
$499.59 |
$1,387.75 |
2.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$280.89 |
$780.25 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$245.88 |
$683 |
2.3× |
| Us breast unilateral complete (76641) |
$157.05 |
$436.25 |
1.5× |
| Us breast unilateral limited (76642) |
$265.68 |
$738 |
3.0× |
| Us chest (76604) |
$181.58 |
$504.38 |
1.7× |
| Us compl joint r-t w/image documentation (76881) |
$154.62 |
$429.50 |
1.5× |
| Us elastography parenchyma (76981) |
$390.64 |
$1,085.12 |
3.7× |
| Us guided compression repair (76936) |
$878.22 |
$2,439.50 |
4.0× |
| Us infant hips dynamic (76885) |
$185.67 |
$515.75 |
2.1× |
| Us infant hips limited static (76886) |
$179.78 |
$499.38 |
2.1× |
| Us kidney transplant (76776) |
$364.95 |
$1,013.75 |
3.5× |
| Us ob detailed single fetus (76811) |
$588.69 |
$1,635.25 |
2.5× |
| Us ob transvaginal (76817) |
$256.50 |
$712.50 |
2.4× |
| Us pelvic non ob complete (76856) |
$215.60 |
$598.88 |
2.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$263.34 |
$731.50 |
2.5× |
| Us pregnancy ltd (76815) |
$236.52 |
$657 |
2.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$159.80 |
$443.88 |
1.5× |
| Us retroperitoneal complete (76770) |
$236.52 |
$657 |
2.3× |
| Us retroperitoneal limited (76775) |
$197.55 |
$548.75 |
1.9× |
| Us scrotum and contents (76870) |
$532.53 |
$1,479.25 |
5.1× |
| Us soft tissue head/neck (76536) |
$269.28 |
$748 |
2.6× |
| Us spinal canal and contents (76800) |
$226.40 |
$628.88 |
2.2× |
| Us transrectal (76872) |
$283.14 |
$786.50 |
2.7× |
| Us transrectal prostate volume (76873) |
$297.36 |
$826 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$271.76 |
$754.88 |
2.6× |
| Us, eye b-scan (76512) |
$158.26 |
$439.62 |
1.5× |
| Vascular flow imaging (78445) |
$610.74 |
$1,696.50 |
1.5× |
| Venogram extremity bilateral (75822) |
$993.78 |
$2,760.50 |
0.6× |
| Venogram orbital (75880) |
$1,147.10 |
$3,186.38 |
1.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,428.88 |
$6,746.88 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$913.05 |
$2,536.25 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$555.21 |
$1,542.25 |
0.4× |
| Venography Renal Bilateral (75833) |
$3,548.84 |
$9,857.88 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$1,747.35 |
$4,853.75 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$922.86 |
$2,563.50 |
0.3× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,216.02 |
$8,933.38 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$131.40 |
$365 |
1.5× |
| Wrist 2 views (73100) |
$228.78 |
$635.50 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$300.92 |
$835.88 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$196.16 |
$544.88 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$334.53 |
$929.25 |
3.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$447.12 |
$1,242 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$244.08 |
$678 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$368.01 |
$1,022.25 |
4.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$335.07 |
$930.75 |
3.2× |
| X-ray exam hip uni 1 view (73501) |
$106.24 |
$295.12 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$106.24 |
$295.12 |
1.2× |
| X-ray exam hip uni 4/> views (73503) |
$175.64 |
$487.88 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$175.64 |
$487.88 |
1.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$335.07 |
$930.75 |
3.2× |
| X-ray exam of femur 1 (73551) |
$106.24 |
$295.12 |
1.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$209.16 |
$581 |
1.2× |
| X-ray eye for foreign body (70030) |
$94.23 |
$261.75 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$229.10 |
$636.38 |
2.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$120.82 |
$335.62 |
1.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$319.14 |
$886.50 |
3.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$458.96 |
$1,274.88 |
0.2× |
| X-ray head for orthodontia (70350) |
$101.88 |
$283 |
1.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$248.13 |
$689.25 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$129.74 |
$360.38 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$407.70 |
$1,132.50 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$183.96 |
$511 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$164.97 |
$458.25 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$269.82 |
$749.50 |
2.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$422.91 |
$1,174.75 |
4.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$253.71 |
$704.75 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$228.92 |
$635.88 |
2.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$168.84 |
$469 |
1.9× |
| X-ray of voice box or throat (70370) |
$108.09 |
$300.25 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$255.69 |
$710.25 |
2.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$324.63 |
$901.75 |
3.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$437 |
$1,213.88 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$252.99 |
$702.75 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$131.94 |
$366.50 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$346.95 |
$963.75 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$162.54 |
$451.50 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$102.06 |
$283.50 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$308.16 |
$856 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$193.41 |
$537.25 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$116.82 |
$324.50 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$268.56 |
$746 |
2.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$160.56 |
$446 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$184.18 |
$511.62 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$132.26 |
$367.38 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$207.76 |
$577.12 |
2.4× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$87.21 |
$242.25 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$228.69 |
$635.25 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$178.88 |
$496.88 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$310.50 |
$862.50 |
3.6× |
| Xr arthrogram ankle (73615) |
$469.35 |
$1,303.75 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$388.12 |
$1,078.12 |
3.7× |
| Xr chest 4+ views (71048) |
$159.57 |
$443.25 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$175.54 |
$487.62 |
2.0× |
| Xr optic foramina (70190) |
$131.94 |
$366.50 |
1.5× |
| Xr shoulder 1 view (73020) |
$213.39 |
$592.75 |
2.4× |
| Xr spine cervical 4 or 5 views (72050) |
$357.39 |
$992.75 |
3.4× |
| Xr tibia/fibula 2 views (73590) |
$227.43 |
$631.75 |
2.6× |
| Xr tmj bilateral (70330) |
$124.78 |
$346.62 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$309.24 |
$859 |
3.5× |