| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,738.38 |
$9,476.75 |
3.5× |
| Abdomen 2 views (74019) |
$235.68 |
$471.35 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$996.35 |
$1,992.70 |
2.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$9,745.08 |
$19,490.15 |
3.2× |
| Angiography extremity bilateral rs&i (75716) |
$4,855.13 |
$9,710.25 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$2,427.55 |
$4,855.10 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$576.43 |
$1,152.85 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,327.08 |
$4,654.15 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,709.08 |
$5,418.15 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,354.55 |
$2,709.10 |
0.4× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,588.43 |
$3,176.85 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,364.93 |
$4,729.85 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$683.33 |
$1,366.65 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,114.10 |
$2,228.20 |
0.4× |
| Ankle 2 views (73600) |
$219.60 |
$439.20 |
2.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$557.50 |
$1,115 |
1.6× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,414.08 |
$4,828.15 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,068.53 |
$4,137.05 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,786.28 |
$5,572.55 |
0.9× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,158.23 |
$8,316.45 |
1.4× |
| Artery X-Rays Adrenal Gland (75731) |
$4,872.53 |
$9,745.05 |
1.6× |
| Arthrogram elbow (73085) |
$588.75 |
$1,177.50 |
1.7× |
| Arthrogram hip (73525) |
$588.75 |
$1,177.50 |
1.7× |
| Arthrogram shoulder (73040) |
$631.40 |
$1,262.80 |
1.9× |
| Arthrogram wrist (73115) |
$744.15 |
$1,488.30 |
2.2× |
| Arthrography knee lt (73580) |
$577.58 |
$1,155.15 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$514.05 |
$1,028.10 |
3.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,105.90 |
$2,211.80 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$1,396.88 |
$2,793.75 |
3.6× |
| Bone age studies (77072) |
$227.08 |
$454.15 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$1,393.93 |
$2,787.85 |
3.6× |
| Bone Marrow Imaging Limited Area (78102) |
$693.13 |
$1,386.25 |
1.8× |
| Bone survey complete (77075) |
$569.03 |
$1,138.05 |
5.6× |
| Brachytx isodose complex (77318) |
$1,860.08 |
$3,720.15 |
5.1× |
| Brachytx isodose intermed (77317) |
$1,680.28 |
$3,360.55 |
4.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,269.20 |
$2,538.40 |
3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,945.18 |
$5,890.35 |
2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,946.48 |
$3,892.95 |
5.7× |
| Cardiac shunt detection (78428) |
$860.63 |
$1,721.25 |
2.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$754.68 |
$1,509.35 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$299.28 |
$598.55 |
3.5× |
| Chest 1 view (71045) |
$186.83 |
$373.65 |
2.2× |
| Chest 3 views (71047) |
$193.95 |
$387.90 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$363.98 |
$727.95 |
2.1× |
| Cineradiography/videoradiography (76120) |
$392.20 |
$784.40 |
3.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$897.88 |
$1,795.75 |
1.2× |
| Clavicle complete (73000) |
$222.20 |
$444.40 |
2.6× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$110,980.50 |
$221,961 |
15.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$567.08 |
$1,134.15 |
5.6× |
| Continuing medical physics consltj pr wk (77336) |
$656 |
$1,312 |
5.0× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$324.20 |
$648.40 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,810.23 |
$7,620.45 |
11.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,874.83 |
$5,749.65 |
12.4× |
| CT abdomen w contrast (74160) |
$1,608.98 |
$3,217.95 |
9.4× |
| CT abdomen w wo contrast (74170) |
$2,143.33 |
$4,286.65 |
12.6× |
| CT abdomen w/o contrast (74150) |
$1,363.35 |
$2,726.70 |
13.4× |
| CT angio hrt w/3d image (75574) |
$1,765.68 |
$3,531.35 |
5.2× |
| CT angiography upper extremity lt (73206) |
$1,599.35 |
$3,198.70 |
9.4× |
| CT c-spine w/o contrast (72125) |
$1,513.95 |
$3,027.90 |
14.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,852.18 |
$5,704.35 |
16.7× |
| CT cervical spine with contrast (72126) |
$1,651.40 |
$3,302.80 |
4.9× |
| CT chest w/wo contrast (71270) |
$2,105.40 |
$4,210.80 |
12.4× |
| CT chest with contrast (71260) |
$1,608.98 |
$3,217.95 |
9.4× |
| CT colonography screening (74263) |
$1,747.40 |
$3,494.80 |
7.5× |
| CT colonography w/o cntrst (74261) |
$1,975.88 |
$3,951.75 |
19.4× |
| CT head/brain with contrast (70460) |
$1,520.45 |
$3,040.90 |
8.9× |
| CT head/brain without and with contrast (70470) |
$1,942.40 |
$3,884.80 |
11.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,350.03 |
$2,700.05 |
4.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$99.58 |
$199.15 |
1.2× |
| CT hrt w/3d image congen (75573) |
$1,998.15 |
$3,996.30 |
5.9× |
| CT iac w contrast (70481) |
$1,619.05 |
$3,238.10 |
9.5× |
| CT limited/localized follow up study (76380) |
$659.45 |
$1,318.90 |
7.8× |
| CT lower ext w/o (73700) |
$1,256.25 |
$2,512.50 |
12.4× |
| CT lower extremity w wo contrast (73702) |
$2,861.85 |
$5,723.70 |
16.8× |
| CT lower extremity with contrast (73701) |
$1,585.18 |
$3,170.35 |
9.3× |
| CT lumbar spine w & w/o contrast (72133) |
$2,152.98 |
$4,305.95 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$1,504.05 |
$3,008.10 |
14.8× |
| CT lumbar spine with contrast (72132) |
$1,850.88 |
$3,701.75 |
5.5× |
| CT maxillofacial w contrast (70487) |
$1,419.18 |
$2,838.35 |
8.3× |
| CT maxillofacial w/o contrast (70486) |
$1,145.38 |
$2,290.75 |
11.3× |
| CT maxillofacial w/wo contrast (70488) |
$2,301.08 |
$4,602.15 |
13.5× |
| CT neck soft tissue w contrast (70491) |
$1,667 |
$3,334 |
9.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,521.15 |
$5,042.30 |
14.8× |
| CT orbits w/o contrast (70480) |
$1,430.20 |
$2,860.40 |
14.1× |
| CT pelvis w & w/o contrast (72194) |
$2,101.63 |
$4,203.25 |
12.3× |
| CT pelvis w/o contrast (72192) |
$1,389.68 |
$2,779.35 |
13.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,038.68 |
$6,077.35 |
17.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,363.35 |
$2,726.70 |
13.4× |
| CT thoracic spine w/contrast (72129) |
$1,550.20 |
$3,100.40 |
9.1× |
| CT thoracic spine w/o contrast (72128) |
$1,425.85 |
$2,851.70 |
14.0× |
| CT thoracic spine w/wo contrast (72130) |
$2,745.60 |
$5,491.20 |
16.1× |
| CT thorax w/o contrast (71250) |
$1,350.03 |
$2,700.05 |
13.3× |
| CT unlisted procedure (76497) |
$1,268.98 |
$2,537.95 |
15.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,056.85 |
$4,113.70 |
12.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,607.53 |
$3,215.05 |
15.8× |
| CT upper extremity with contrast (73201) |
$1,687.88 |
$3,375.75 |
5.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,092.73 |
$4,185.45 |
12.3× |
| Cta Abdomen (74175) |
$2,092.73 |
$4,185.45 |
12.3× |
| CTA abdomen pelvis (74174) |
$2,839.85 |
$5,679.70 |
8.4× |
| CTA chest (71275) |
$2,094.23 |
$4,188.45 |
12.3× |
| Cta Head (70496) |
$2,094.23 |
$4,188.45 |
12.3× |
| CTA lwr ext w&w/o contrast (73706) |
$2,075.53 |
$4,151.05 |
12.2× |
| Cta Neck (70498) |
$2,326.75 |
$4,653.50 |
13.7× |
| Cta Pelvis (72191) |
$2,092.73 |
$4,185.45 |
12.3× |
| Cystography minimum 3 views rs&i (74430) |
$424.25 |
$848.50 |
1.3× |
| Dacryocystography (70170) |
$340.70 |
$681.40 |
1.5× |
| Diskography lumbar (72295) |
$1,476.23 |
$2,952.45 |
0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$279.13 |
$558.25 |
2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$342.58 |
$685.15 |
3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$144.18 |
$288.35 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$413.48 |
$826.95 |
4.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$227.25 |
$454.50 |
2.7× |
| Echo exam of fetal heart (76825) |
$765.73 |
$1,531.45 |
1.4× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$481.55 |
$963.10 |
2.1× |
| Echoencephalography real time imaging (76506) |
$388.98 |
$777.95 |
3.8× |
| Esophageal motility (78258) |
$655.45 |
$1,310.90 |
1.7× |
| Esophagus (74220) |
$425.03 |
$850.05 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$309.38 |
$618.75 |
3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$335.50 |
$671 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$422.03 |
$844.05 |
1.8× |
| Foot 2 views (73620) |
$193.18 |
$386.35 |
2.3× |
| Forearm 2 views (73090) |
$240.70 |
$481.40 |
2.8× |
| Functional MRI brain by tech (70554) |
$1,486.75 |
$2,973.50 |
6.4× |
| Gated Heart Planar Single (78472) |
$1,347.83 |
$2,695.65 |
3.5× |
| Hand 2 views (73120) |
$201.75 |
$403.50 |
2.0× |
| Hand 3 views (73130) |
$266.50 |
$533 |
3.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,668.85 |
$5,337.70 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,960.63 |
$5,921.25 |
4.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,695.50 |
$9,391 |
6.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,316.33 |
$4,632.65 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,502.55 |
$3,005.10 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,438.58 |
$2,877.15 |
3.7× |
| Ht muscle image spect sing (78451) |
$1,959.53 |
$3,919.05 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$231.50 |
$463 |
2.7× |
| Hysterosalpingogram (74740) |
$536.60 |
$1,073.20 |
2.3× |
| Image fusion (77399) |
$462.35 |
$924.70 |
3.5× |
| Interstitial radiation source applic complex (77778) |
$3,837.98 |
$7,675.95 |
5.7× |
| Kidney funcj study non-img radioisotopic study (78725) |
$545.55 |
$1,091.10 |
1.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,794.98 |
$3,589.95 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,884.80 |
$3,769.60 |
3.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,010.33 |
$4,020.65 |
3.8× |
| Knee 3 views (73562) |
$227.45 |
$454.90 |
2.7× |
| Liver & spleen imaging static only (78215) |
$1,140.78 |
$2,281.55 |
2.9× |
| Lung perf&ventilat diferentl (78598) |
$1,000.28 |
$2,000.55 |
1.9× |
| Lung perfusion differential (78597) |
$739.83 |
$1,479.65 |
1.9× |
| Lung Ventilation Imaging (78579) |
$669.08 |
$1,338.15 |
1.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,136.18 |
$2,272.35 |
0.4× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$3,474.65 |
$6,949.30 |
2.3× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$568.10 |
$1,136.20 |
0.2× |
| Lymphoscintigraphy (78195) |
$1,281.18 |
$2,562.35 |
2.4× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$420.28 |
$840.55 |
5.0× |
| Meckels Diverticulum (78290) |
$803.08 |
$1,606.15 |
2.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,645.35 |
$9,290.70 |
12.8× |
| Mr elastography (76391) |
$1,025.58 |
$2,051.15 |
4.4× |
| Mr safety determination physician/other qhp (76016) |
$146.55 |
$293.10 |
1.7× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$98.88 |
$197.75 |
1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$40.78 |
$81.55 |
1.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$152.78 |
$305.55 |
1.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$402.28 |
$804.55 |
1.7× |
| MRA head w & w/o contrast (70546) |
$2,570.48 |
$5,140.95 |
7.6× |
| MRA head w/o contrast (70544) |
$1,737 |
$3,474 |
7.5× |
| MRA head with contrast (70545) |
$2,136.60 |
$4,273.20 |
6.3× |
| MRA neck w contrast (70548) |
$2,030.23 |
$4,060.45 |
6.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,570.48 |
$5,140.95 |
7.6× |
| MRA neck w/o contrast (70547) |
$1,790.58 |
$3,581.15 |
7.7× |
| MRI abdomen w contrast (74182) |
$2,141.80 |
$4,283.60 |
6.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,518.40 |
$5,036.80 |
7.4× |
| MRI abdomen w/o contrast (74181) |
$1,765.28 |
$3,530.55 |
7.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,315.95 |
$4,631.90 |
3.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,309.30 |
$4,618.60 |
3.0× |
| MRI bone marrow blood supply (77084) |
$970.85 |
$1,941.70 |
4.2× |
| MRI breast w/o contrast bilateral (77047) |
$3,276.50 |
$6,553 |
14.1× |
| MRI c-spine with contrast (72142) |
$2,164.88 |
$4,329.75 |
6.4× |
| MRI cardiac w/o contrast (75557) |
$1,367.88 |
$2,735.75 |
5.9× |
| MRI cervical spine w/o contrast (72141) |
$1,947.58 |
$3,895.15 |
8.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,652.73 |
$5,305.45 |
7.8× |
| MRI chest w/o contrast (71550) |
$2,258.28 |
$4,516.55 |
9.7× |
| MRI chest with contrast (71551) |
$2,424 |
$4,848 |
3.2× |
| MRI fetal sngl/1st gestation (74712) |
$1,363.35 |
$2,726.70 |
5.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,410.45 |
$4,820.90 |
7.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,116.20 |
$4,232.40 |
6.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,699.03 |
$3,398.05 |
7.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,054.78 |
$4,109.55 |
8.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,552.60 |
$5,105.20 |
7.5× |
| MRI orbit/face/neck w/contrast (70542) |
$2,204.98 |
$4,409.95 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,235.95 |
$4,471.90 |
6.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,648.58 |
$5,297.15 |
7.8× |
| MRI pelvis w/o contrast (72195) |
$1,699.03 |
$3,398.05 |
7.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,650.10 |
$5,300.20 |
7.8× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,043.80 |
$4,087.60 |
2.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,495.38 |
$4,990.75 |
7.4× |
| MRI spectroscopy (76390) |
$1,025.58 |
$2,051.15 |
12.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,529.55 |
$5,059.10 |
7.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,415.68 |
$4,831.35 |
7.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,656.05 |
$5,312.10 |
7.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,413.48 |
$4,826.95 |
7.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,656.05 |
$5,312.10 |
7.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,013.08 |
$4,026.15 |
8.7× |
| MRI tmj (70336) |
$2,652.08 |
$5,304.15 |
11.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,938.28 |
$3,876.55 |
8.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,574.18 |
$5,148.35 |
7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,737 |
$3,474 |
7.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,487.58 |
$8,975.15 |
3.6× |
| Myocardial Spect Multiple Studies (78452) |
$3,341.83 |
$6,683.65 |
2.7× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$4,622.20 |
$9,244.40 |
3.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,311.85 |
$6,623.70 |
2.4× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,374.10 |
$6,748.20 |
1.6× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$5,083.90 |
$10,167.80 |
2.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$4,706.65 |
$9,413.30 |
5.6× |
| Neck soft tissue (70360) |
$237.43 |
$474.85 |
2.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$335.83 |
$671.65 |
0.9× |
| Nm bone marrow wb (78104) |
$1,003.80 |
$2,007.60 |
2.6× |
| Nm cisternogram (78630) |
$806.60 |
$1,613.20 |
1.5× |
| Nm gastric emptying study (78264) |
$1,331.43 |
$2,662.85 |
3.4× |
| Nm whole blood volume (78122) |
$1,051.55 |
$2,103.10 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,174.88 |
$16,349.75 |
6.1× |
| Nuclear Rx Oral Admin (79005) |
$1,140.15 |
$2,280.30 |
5.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$299.28 |
$598.55 |
2.9× |
| Orthopantogram (70355) |
$237.43 |
$474.85 |
2.8× |
| Osseous survey infant (77076) |
$410.73 |
$821.45 |
4.0× |
| Osseous survey limited (77074) |
$409.03 |
$818.05 |
4.0× |
| Parathyrd planar w/spect&CT (78072) |
$998.30 |
$1,996.60 |
1.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,094 |
$2,188 |
2.8× |
| Parathyroid imaging (78070) |
$1,041.95 |
$2,083.90 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$200.95 |
$401.90 |
2.0× |
| Peritoneogram rs&i (74190) |
$362.48 |
$724.95 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$3,975.50 |
$7,951 |
2.9× |
| PET imaging CT for attenuation limited area (78814) |
$3,960.15 |
$7,920.30 |
2.8× |
| PET imaging for CT attenuation whole body (78816) |
$4,174.25 |
$8,348.50 |
3.0× |
| Pr MRI brain w/ dye (70558) |
$429.65 |
$859.30 |
2.5× |
| Pr MRI brain w/o & w/ dye (70559) |
$3,676.13 |
$7,352.25 |
21.6× |
| Pr MRI brain w/o dye (70557) |
$1,059.45 |
$2,118.90 |
2.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,533.23 |
$5,066.45 |
7.5× |
| Proton trmt simple w/comp (77522) |
$3,826.55 |
$7,653.10 |
3.2× |
| Proton tx delivery complex (77525) |
$6,016.25 |
$12,032.50 |
5.0× |
| Proton tx delivery intermediate (77523) |
$4,402.28 |
$8,804.55 |
3.6× |
| Proton tx delivery simple w/o compensation (77520) |
$2,859.58 |
$5,719.15 |
5.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,268.18 |
$4,536.35 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,010.68 |
$2,021.35 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$669.08 |
$1,338.15 |
1.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,329.23 |
$2,658.45 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$374.98 |
$749.95 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$204.70 |
$409.40 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$409.40 |
$818.80 |
4.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$459.35 |
$918.70 |
4.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$271.95 |
$543.90 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$663.73 |
$1,327.45 |
6.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,124.25 |
$28,248.50 |
2.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$874.78 |
$1,749.55 |
1.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$552.40 |
$1,104.80 |
5.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$737.25 |
$1,474.50 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$352.83 |
$705.65 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$224.43 |
$448.85 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$309.38 |
$618.75 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$232.30 |
$464.60 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$594.68 |
$1,189.35 |
3.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$527.35 |
$1,054.70 |
3.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$497.93 |
$995.85 |
2.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$207.70 |
$415.40 |
2.5× |
| Radiological examination surgical specimen (76098) |
$353.38 |
$706.75 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,322.85 |
$4,645.70 |
0.8× |
| Ribs bilateral 3 views (71110) |
$614.78 |
$1,229.55 |
6.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,496.63 |
$2,993.25 |
3.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,496.63 |
$2,993.25 |
2.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,432.58 |
$2,865.15 |
2.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,496.63 |
$2,993.25 |
1.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,496.63 |
$2,993.25 |
1.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$761.95 |
$1,523.90 |
3.4× |
| Rp Therapy Intravenous Administration (79101) |
$806.38 |
$1,612.75 |
3.6× |
| Sacroiliac Joints < 3 Views (72200) |
$198.38 |
$396.75 |
2.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$497.93 |
$995.85 |
2.1× |
| Scanogram (77073) |
$209.93 |
$419.85 |
2.1× |
| Scapula complete (73010) |
$195.10 |
$390.20 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$40.18 |
$80.35 |
1.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$211.68 |
$423.35 |
2.1× |
| Sialogram (70390) |
$586.08 |
$1,172.15 |
2.5× |
| Simulation intermediate (77285) |
$1,585.10 |
$3,170.20 |
4.4× |
| Small bowel series (74250) |
$511.38 |
$1,022.75 |
3.0× |
| Spec medical radj physics consltj (77370) |
$738.73 |
$1,477.45 |
5.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,121.40 |
$2,242.80 |
3.1× |
| Special dosimetry (77331) |
$482.08 |
$964.15 |
3.7× |
| Special treatment procedure (77470) |
$2,052 |
$4,104 |
3.8× |
| Spine thoracic 3 views (72072) |
$331.63 |
$663.25 |
3.3× |
| Splenoportograpy rs&i (75810) |
$3,216.18 |
$6,432.35 |
1.0× |
| Stereotactic body radiation delivery (77373) |
$9,394.33 |
$18,788.65 |
5.4× |
| Superior sagittal sinus venogram (75870) |
$1,376.08 |
$2,752.15 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,350.43 |
$4,700.85 |
6.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,029.25 |
$2,058.50 |
2.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,743 |
$3,486 |
4.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$852.55 |
$1,705.10 |
6.5× |
| Therapeutic Enema (74283) |
$693.30 |
$1,386.60 |
4.1× |
| Thoracolumbar 2 views (72080) |
$279.88 |
$559.75 |
3.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,294.15 |
$2,588.30 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$478.75 |
$957.50 |
1.2× |
| Thyroid uptake measurement (78012) |
$671.33 |
$1,342.65 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$671.33 |
$1,342.65 |
1.7× |
| Treatment device intermediate (77333) |
$873.08 |
$1,746.15 |
6.7× |
| Treatment devices simple (77332) |
$664.88 |
$1,329.75 |
5.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,161.40 |
$4,322.80 |
4.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,075.78 |
$2,151.55 |
2.8× |
| Tx devices design & construction complex (77334) |
$1,140.03 |
$2,280.05 |
3.1× |
| Ultrasound, abdomen limited (76705) |
$473.20 |
$946.40 |
4.7× |
| Umbilical-artery Doppler (OB) (76820) |
$262.80 |
$525.60 |
2.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$326.43 |
$652.85 |
3.9× |
| Unlisted fluoroscopic procedure (76496) |
$324.85 |
$649.70 |
3.8× |
| Unlisted magnetic resonance procedure (76498) |
$687.49 |
$1,374.98 |
8.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,394.75 |
$2,789.50 |
14.1× |
| Unlisted Ultrasound Procedure (76999) |
$426.63 |
$853.25 |
5.0× |
| Upper Extremity Infant (73092) |
$166.03 |
$332.05 |
1.6× |
| Urethrocystography retrograde rs&i (74450) |
$554.28 |
$1,108.55 |
2.4× |
| Urethrocystography voiding (74455) |
$586.50 |
$1,173 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$692.18 |
$1,384.35 |
4.1× |
| Us abdl aorta screen aaa (76706) |
$428.73 |
$857.45 |
4.2× |
| Us breast unilateral complete (76641) |
$519.75 |
$1,039.50 |
5.1× |
| Us breast unilateral limited (76642) |
$346.53 |
$693.05 |
4.1× |
| Us chest (76604) |
$299.80 |
$599.60 |
3.0× |
| Us compl joint r-t w/image documentation (76881) |
$503.35 |
$1,006.70 |
5.0× |
| Us elastography parenchyma (76981) |
$275.98 |
$551.95 |
2.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$178.93 |
$357.85 |
1.8× |
| Us guided compression repair (76936) |
$401.68 |
$803.35 |
1.9× |
| Us infant hips dynamic (76885) |
$364.15 |
$728.30 |
4.3× |
| Us infant hips limited static (76886) |
$364.15 |
$728.30 |
4.3× |
| Us kidney transplant (76776) |
$487.73 |
$975.45 |
4.8× |
| Us ob detailed single fetus (76811) |
$553.05 |
$1,106.10 |
2.4× |
| Us ob transvaginal (76817) |
$385.58 |
$771.15 |
3.8× |
| Us pelvic non ob complete (76856) |
$643.80 |
$1,287.60 |
6.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$99.35 |
$198.70 |
1.0× |
| Us pregnancy ltd (76815) |
$272.60 |
$545.20 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$326.73 |
$653.45 |
3.2× |
| Us retroperitoneal complete (76770) |
$552.83 |
$1,105.65 |
5.4× |
| Us retroperitoneal limited (76775) |
$462.83 |
$925.65 |
4.6× |
| Us scrotum and contents (76870) |
$478.30 |
$956.60 |
4.7× |
| Us soft tissue head/neck (76536) |
$544.80 |
$1,089.60 |
5.4× |
| Us spinal canal and contents (76800) |
$406.38 |
$812.75 |
4.0× |
| Us transrectal (76872) |
$475.98 |
$951.95 |
4.7× |
| Us transrectal prostate volume (76873) |
$406.33 |
$812.65 |
4.0× |
| Us xtr non-vasc lmtd (76882) |
$479.30 |
$958.60 |
4.7× |
| Us, eye b-scan (76512) |
$335.68 |
$671.35 |
3.3× |
| Venogram extremity bilateral (75822) |
$2,310.90 |
$4,621.80 |
1.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,043.98 |
$4,087.95 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$2,036.18 |
$4,072.35 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,155.45 |
$2,310.90 |
0.8× |
| Venography Renal Bilateral (75833) |
$3,615.28 |
$7,230.55 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$1,807.68 |
$3,615.35 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,236.90 |
$2,473.80 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,841.18 |
$3,682.35 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$596.23 |
$1,192.45 |
7.1× |
| Wrist 2 views (73100) |
$169.03 |
$338.05 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$420.08 |
$840.15 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$210.68 |
$421.35 |
2.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$274.50 |
$549 |
3.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$820.15 |
$1,640.30 |
4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$203.98 |
$407.95 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$251.55 |
$503.10 |
3.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$511.65 |
$1,023.30 |
5.0× |
| X-ray exam hip uni 1 view (73501) |
$169.03 |
$338.05 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$229.70 |
$459.40 |
2.7× |
| X-ray exam hip uni 4/> views (73503) |
$275.63 |
$551.25 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$551.20 |
$1,102.40 |
5.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$374.13 |
$748.25 |
3.7× |
| X-ray exam of femur 1 (73551) |
$166.18 |
$332.35 |
2.0× |
| X-ray eye for foreign body (70030) |
$227.80 |
$455.60 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$337.95 |
$675.90 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$201.78 |
$403.55 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$262.03 |
$524.05 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$210.38 |
$420.75 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$193.95 |
$387.90 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$334.25 |
$668.50 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$433.25 |
$866.50 |
5.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$150.80 |
$301.60 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$278.40 |
$556.80 |
2.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$638.25 |
$1,276.50 |
6.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$364.75 |
$729.50 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$357.95 |
$715.90 |
4.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$162.35 |
$324.70 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$284.38 |
$568.75 |
2.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$246.43 |
$492.85 |
2.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$544.80 |
$1,089.60 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$663.18 |
$1,326.35 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$208.80 |
$417.60 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$307.43 |
$614.85 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$510.30 |
$1,020.60 |
5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$217.40 |
$434.80 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$231.50 |
$463 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$279.28 |
$558.55 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$324.53 |
$649.05 |
3.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$172.98 |
$345.95 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$492.33 |
$984.65 |
4.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$291.78 |
$583.55 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$218.83 |
$437.65 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$236.88 |
$473.75 |
2.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$225.58 |
$451.15 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$269.53 |
$539.05 |
2.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$356.55 |
$713.10 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$180.73 |
$361.45 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$229.33 |
$458.65 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$491.35 |
$982.70 |
4.8× |
| Xr chest 4+ views (71048) |
$255.33 |
$510.65 |
2.5× |
| Xr finger(s) 2+ views (73140) |
$187.60 |
$375.20 |
2.2× |
| Xr shoulder 1 view (73020) |
$171.23 |
$342.45 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$370.68 |
$741.35 |
3.6× |
| Xr tibia/fibula 2 views (73590) |
$211.48 |
$422.95 |
2.5× |
| Xr tmj bilateral (70330) |
$266.08 |
$532.15 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$216.65 |
$433.30 |
2.6× |