| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,626 |
$7,252 |
2.7× |
| Abdomen 1 View (74018) |
$175.50 |
$351 |
2.0× |
| Abdomen 2 views (74019) |
$190.50 |
$381 |
1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,009 |
$2,018 |
2.6× |
| Angio pulmonary bilat (75743) |
$3,165 |
$6,330 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$2,974.50 |
$5,949 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,735 |
$5,470 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,512.50 |
$5,025 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,223 |
$4,446 |
0.7× |
| Ankle 2 views (73600) |
$184 |
$368 |
2.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,847.50 |
$3,695 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$2,959.50 |
$5,919 |
0.5× |
| Artery X-Rays Pelvis (75736) |
$2,844 |
$5,688 |
0.5× |
| Artery X-Rays Spine (75705) |
$2,857.50 |
$5,715 |
0.5× |
| Arthrogram hip (73525) |
$417.50 |
$835 |
1.2× |
| Arthrogram Wrist (73115) |
$423 |
$846 |
1.2× |
| Basic radiation dosimetry calculation (77300) |
$615 |
$1,230 |
4.6× |
| Bone age studies (77072) |
$175 |
$350 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$985 |
$1,970 |
2.5× |
| Bone Imaging Limited Area (78300) |
$698 |
$1,396 |
1.8× |
| Bone Imaging Whole Body (78306) |
$924.50 |
$1,849 |
2.4× |
| Bone marrow imaging; whole body (78104) |
$864 |
$1,728 |
2.2× |
| Bone survey infant (77076) |
$245.50 |
$491 |
2.4× |
| Brain Flow Imaging Only (78610) |
$283.50 |
$567 |
0.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$921 |
$1,842 |
1.7× |
| Cardiac Shunt Detection (78428) |
$863 |
$1,726 |
2.2× |
| Cat Scan Follow-Up Study (76380) |
$387.50 |
$775 |
4.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$820 |
$1,640 |
1.5× |
| Cerebrospinal Fluid Scan (78630) |
$1,023 |
$2,046 |
1.9× |
| Chest 1 view (71045) |
$244.50 |
$489 |
2.9× |
| Chest 2 views (71046) |
$300.50 |
$601 |
3.5× |
| Chest 3 views (71047) |
$358.50 |
$717 |
4.2× |
| Chest 4 or more views (71048) |
$406.50 |
$813 |
4.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$422 |
$844 |
0.5× |
| Clavicle complete (73000) |
$184 |
$368 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,459.50 |
$2,919 |
14.2× |
| Continuing medical physics consltj pr wk (77336) |
$456 |
$912 |
3.4× |
| Contrast Exam Abdominl Aorta (75625) |
$2,479 |
$4,958 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$320.50 |
$641 |
0.9× |
| Contrast X-Ray Of Elbow (73085) |
$315.50 |
$631 |
0.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$524 |
$1,048 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,649.50 |
$7,299 |
10.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,478 |
$4,956 |
10.6× |
| CT abdomen w contrast (74160) |
$1,711 |
$3,422 |
9.9× |
| CT abdomen w wo contrast (74170) |
$2,043 |
$4,086 |
11.8× |
| CT abdomen w/o contrast (74150) |
$1,288.50 |
$2,577 |
12.5× |
| CT Angio Abdomen and Pelvis (74174) |
$3,859.50 |
$7,719 |
11.2× |
| CT Angio Chest (71275) |
$2,230 |
$4,460 |
12.9× |
| CT Angio Head (70496) |
$2,180.50 |
$4,361 |
12.6× |
| CT angio hrt w/3d image (75574) |
$3,050.50 |
$6,101 |
8.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,657 |
$3,314 |
9.6× |
| CT Angio Neck (70498) |
$2,328.50 |
$4,657 |
13.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,385.50 |
$2,771 |
8.0× |
| CT cervical spine w/ contrast (72126) |
$1,799 |
$3,598 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,582 |
$3,164 |
15.4× |
| CT cervical spine w/wo cont (72127) |
$1,967.50 |
$3,935 |
11.4× |
| CT chest w contrast (71260) |
$1,765.50 |
$3,531 |
10.2× |
| CT chest w/wo contrast (71270) |
$2,017.50 |
$4,035 |
11.7× |
| CT head/brain with contrast (70460) |
$1,391 |
$2,782 |
8.1× |
| CT head/brain without and with contrast (70470) |
$1,707.50 |
$3,415 |
9.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$86 |
$172 |
1.0× |
| CT iac w contrast (70481) |
$1,512.50 |
$3,025 |
8.8× |
| CT l-spine w&w/o contrast (72133) |
$1,967.50 |
$3,935 |
11.4× |
| CT lower ext w/o (73700) |
$929 |
$1,858 |
9.0× |
| CT lower extremity w/contrast material (73701) |
$1,446 |
$2,892 |
8.4× |
| CT lumbar spine w contrast (72132) |
$1,637 |
$3,274 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$1,495 |
$2,990 |
14.5× |
| CT maxillofacial w contrast (70487) |
$1,381.50 |
$2,763 |
8.0× |
| CT maxillofacial wo contrast (70486) |
$1,318 |
$2,636 |
12.8× |
| CT neck tissue combo (70492) |
$1,815 |
$3,630 |
10.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,815 |
$3,630 |
10.5× |
| CT orbits w/o contrast (70480) |
$1,340.50 |
$2,681 |
13.0× |
| CT pelvis w&w/o contrast (72194) |
$1,607.50 |
$3,215 |
9.3× |
| CT pelvis w/o contrast (72192) |
$1,190.50 |
$2,381 |
11.6× |
| CT scan of leg combo (73702) |
$1,629 |
$3,258 |
9.4× |
| CT scans face/jaw combo (70488) |
$1,576.50 |
$3,153 |
9.1× |
| CT soft tissue neck w contrast (70491) |
$1,512.50 |
$3,025 |
8.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,313.50 |
$2,627 |
12.8× |
| CT thoracic spine w contrast (72129) |
$1,470 |
$2,940 |
8.5× |
| CT thoracic spine w/o contrast (72128) |
$1,425 |
$2,850 |
13.9× |
| CT thoracic spine w/wo cont (72130) |
$1,967.50 |
$3,935 |
11.4× |
| CT thorax w/o contrast (71250) |
$1,459.50 |
$2,919 |
14.2× |
| CT upper ext wo (73200) |
$1,014.50 |
$2,029 |
9.9× |
| CT upper extremity with contrast (73201) |
$1,446 |
$2,892 |
4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,938.50 |
$9,877 |
28.6× |
| Cta Abdomen (74175) |
$2,118 |
$4,236 |
12.3× |
| CTA pelvis (72191) |
$2,089.50 |
$4,179 |
12.1× |
| Dilation ureters/urethra rs&i (74485) |
$1,130.50 |
$2,261 |
0.5× |
| Diskography lumbar (72295) |
$1,834 |
$3,668 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$113.50 |
$227 |
1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$395.50 |
$791 |
3.8× |
| Dxa Bone Density Axial (77080) |
$374 |
$748 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$339 |
$678 |
4.0× |
| Echo exam of fetal heart (76825) |
$593 |
$1,186 |
1.1× |
| Echo exam uterus (76831) |
$380.50 |
$761 |
1.6× |
| Echo Guide For Artery Repair (76936) |
$910.50 |
$1,821 |
4.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$565 |
$1,130 |
2.4× |
| Esophagram (74220) |
$280.50 |
$561 |
1.6× |
| Fetal Biophys Profile W/Nst (76818) |
$453 |
$906 |
4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$453 |
$906 |
4.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$472 |
$944 |
2.0× |
| Fluoroscopy up to 1 hr (76000) |
$392 |
$784 |
1.7× |
| Foot 2 views (73620) |
$184 |
$368 |
2.1× |
| Forearm 2 views (73090) |
$184 |
$368 |
2.1× |
| Gastric emptying imaging study (78264) |
$1,181.50 |
$2,363 |
3.0× |
| Gated Heart Planar Single (78472) |
$1,066.50 |
$2,133 |
2.7× |
| Hand 2 views (73120) |
$184 |
$368 |
1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,351.50 |
$4,703 |
0.8× |
| Hepatobil Syst Image W/Drug (78227) |
$1,287.50 |
$2,575 |
2.4× |
| Hepatobiliary System Imaging (78226) |
$859.50 |
$1,719 |
2.2× |
| Ht Muscle Image Spect Sing (78451) |
$1,762.50 |
$3,525 |
1.4× |
| Hysterosalpingogram (74740) |
$525.50 |
$1,051 |
2.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$370.50 |
$741 |
4.3× |
| Infant hip ultrasound, limited static exam (76886) |
$370.50 |
$741 |
4.3× |
| Intracavitary radiation source applic simple (77761) |
$1,540 |
$3,080 |
2.8× |
| K Flow/Funct Image Multiple (78709) |
$2,044.50 |
$4,089 |
3.8× |
| K Flow/Funct Image W/Drug (78708) |
$124.50 |
$249 |
0.2× |
| K Flow/Funct Image W/O Drug (78707) |
$1,553.50 |
$3,107 |
2.9× |
| Knee 3 Views (73562) |
$180.50 |
$361 |
2.1× |
| Liver & Spleen Imaging Static Only (78215) |
$681.50 |
$1,363 |
1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,066.50 |
$2,133 |
2.7× |
| Liver imaging w/vascular flow (78202) |
$802 |
$1,604 |
1.5× |
| Lung perfusion differential (78597) |
$1,287 |
$2,574 |
3.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,204.50 |
$2,409 |
2.3× |
| Lymph System Imaging (78195) |
$1,000.50 |
$2,001 |
1.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,791 |
$3,582 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$684.50 |
$1,369 |
2.9× |
| Meckels Divert Exam (78290) |
$762.50 |
$1,525 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,724 |
$9,448 |
12.8× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,674 |
$5,348 |
7.8× |
| MRA head w/o contrast (70544) |
$2,131 |
$4,262 |
9.1× |
| MRA head with contrast (70545) |
$2,229.50 |
$4,459 |
6.5× |
| MRA neck w contrast (70548) |
$2,229.50 |
$4,459 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,674 |
$5,348 |
7.8× |
| MRA neck w/o contrast (70547) |
$2,131 |
$4,262 |
9.1× |
| MRI abdomen w contrast (74182) |
$2,536 |
$5,072 |
7.4× |
| MRI abdomen w/o contrast (74181) |
$2,313.50 |
$4,627 |
9.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,403 |
$4,806 |
3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,887 |
$5,774 |
8.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,403 |
$4,806 |
3.1× |
| MRI brain functional w/o physician admnistration (70554) |
$1,434.50 |
$2,869 |
6.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,298 |
$4,596 |
9.8× |
| MRI cervical spine w contrast (72142) |
$2,495 |
$4,990 |
7.3× |
| MRI cervical spine w/o cont (72141) |
$2,027 |
$4,054 |
8.6× |
| MRI chest w/o contrast (71550) |
$2,625.50 |
$5,251 |
11.2× |
| MRI chest with contrast (71551) |
$2,179.10 |
$4,358.19 |
2.8× |
| MRI chest wo w contrast (71552) |
$2,942 |
$5,884 |
8.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,403 |
$4,806 |
7.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,403 |
$4,806 |
7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,834.50 |
$3,669 |
7.8× |
| MRI lumbar spine w contrast (72149) |
$2,585 |
$5,170 |
7.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,796 |
$5,592 |
8.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,089 |
$4,178 |
8.9× |
| MRI orbit face neck w contrast (70542) |
$2,691.50 |
$5,383 |
7.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,096 |
$6,192 |
9.0× |
| MRI pelvis w contrast (72196) |
$2,385.50 |
$4,771 |
6.9× |
| MRI pelvis w/o & w contrast (72197) |
$2,887 |
$5,774 |
8.4× |
| MRI pelvis w/o contrast (72195) |
$2,089 |
$4,178 |
8.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,211 |
$4,422 |
9.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,089 |
$4,178 |
6.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,767.50 |
$3,535 |
7.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,403 |
$4,806 |
7.0× |
| MRI, abdomen, combo (74183) |
$2,887 |
$5,774 |
8.4× |
| MRI, dorsal spine combo (72157) |
$3,049 |
$6,098 |
8.9× |
| MRI, dorsal spine contrast (72147) |
$2,719.50 |
$5,439 |
7.9× |
| MRI, joint upper extrem (73221) |
$1,722 |
$3,444 |
7.3× |
| MRI, joint upper extrem combo (73223) |
$2,887 |
$5,774 |
8.4× |
| MRI, lumbar spine combo (72158) |
$2,897.50 |
$5,795 |
8.4× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$248.50 |
$497 |
0.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,195.50 |
$6,391 |
2.5× |
| N-invas est c ffr sw aly CTA (75580) |
$4,786.50 |
$9,573 |
5.7× |
| Neck soft tissue (70360) |
$184 |
$368 |
2.1× |
| Nonvascular Shunt X-Ray (75809) |
$124.50 |
$249 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,111.50 |
$2,223 |
0.8× |
| Nuclear Rx Intra-Arterial (79445) |
$878.50 |
$1,757 |
3.8× |
| Nuclear Rx Oral Admin (79005) |
$1,222 |
$2,444 |
5.3× |
| Ob us nuchal meas 1 gest (76813) |
$395.50 |
$791 |
3.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$306 |
$612 |
3.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,538.50 |
$5,077 |
4.8× |
| Parathyroid Planar Imaging (78070) |
$765.50 |
$1,531 |
1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,130 |
$4,260 |
5.4× |
| Pelvis 1 or 2 views (72170) |
$192.50 |
$385 |
1.9× |
| PET image w/CT, full body (78816) |
$3,846 |
$7,692 |
2.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,846 |
$7,692 |
2.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$680.50 |
$1,361 |
1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$283 |
$566 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$277.50 |
$555 |
0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$132.50 |
$265 |
1.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$184 |
$368 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$283 |
$566 |
3.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$252 |
$504 |
2.4× |
| Radex fingr minimum 2 views (73140) |
$132.50 |
$265 |
1.5× |
| Radex foot complete minimum 3 views (73630) |
$138 |
$276 |
1.6× |
| Radex Hand Minimum 3 Views (73130) |
$132.50 |
$265 |
1.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$95.50 |
$191 |
1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$245.50 |
$491 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$184 |
$368 |
2.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$212.50 |
$425 |
2.5× |
| Radex shoulder complete minimum 2 views (73030) |
$233 |
$466 |
2.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$132.50 |
$265 |
1.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$360.50 |
$721 |
2.1× |
| Radex Spine 1 View Specify Level (72020) |
$175 |
$350 |
2.0× |
| Radex Sternum Minimum 2 Views (71120) |
$239.50 |
$479 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$217 |
$434 |
2.5× |
| Radex Toe Minimum 2 Views (73660) |
$184 |
$368 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$160.50 |
$321 |
1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$254.50 |
$509 |
3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$289 |
$578 |
2.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,329 |
$34,658 |
2.4× |
| Radiation treatment delivery level 1 (77402) |
$301.50 |
$603 |
3.0× |
| Radiation treatment delivery level 2 (77407) |
$386 |
$772 |
1.0× |
| Radiation treatment delivery level 3 (77412) |
$491.50 |
$983 |
0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$245.50 |
$491 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$233.50 |
$467 |
2.3× |
| Radiologic exam colon double contrast study (74280) |
$694 |
$1,388 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$440 |
$880 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$270.50 |
$541 |
1.6× |
| Radiologic exam knee complete 4/more views (73564) |
$202.50 |
$405 |
2.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$227 |
$454 |
2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$311 |
$622 |
1.8× |
| Radiologic exam swallow function contrast study (74230) |
$340 |
$680 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$420 |
$840 |
2.4× |
| Radiologic examination femur 1 view (73551) |
$213.50 |
$427 |
2.5× |
| Radiologic examination femur minimum 2 views (73552) |
$213.50 |
$427 |
2.5× |
| Radiologic examination knee 1/2 views (73560) |
$150.50 |
$301 |
1.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$565 |
$1,130 |
5.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$184 |
$368 |
2.1× |
| Ribs bilateral 3 views (71110) |
$625.50 |
$1,251 |
6.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$664 |
$1,328 |
1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$806 |
$1,612 |
2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,040.50 |
$4,081 |
3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,239 |
$2,478 |
2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,063 |
$2,126 |
2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,241 |
$4,482 |
1.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,029.50 |
$4,059 |
1.6× |
| Rp Therapy Intravenous Administration (79101) |
$871 |
$1,742 |
3.8× |
| Scapula (73010) |
$252 |
$504 |
2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$33 |
$66 |
1.4× |
| Sella turcica (70240) |
$124.50 |
$249 |
1.5× |
| Shoulder 1 view (73020) |
$133 |
$266 |
1.6× |
| Shoulder Arthrography (73040) |
$500.50 |
$1,001 |
1.5× |
| Sialogram (70390) |
$389.50 |
$779 |
1.7× |
| Skull less than 4 views (70250) |
$157.50 |
$315 |
1.5× |
| Special dosimetry (77331) |
$413.50 |
$827 |
3.1× |
| Special teletherapy port plan (77321) |
$1,148.50 |
$2,297 |
3.1× |
| Special treatment procedure (77470) |
$1,980 |
$3,960 |
3.6× |
| Stereotactic Body Radiation Delivery (77373) |
$5,821.50 |
$11,643 |
3.3× |
| Sternoclavicular joints (71130) |
$167.50 |
$335 |
2.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$963.50 |
$1,927 |
2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$776.50 |
$1,553 |
2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,880 |
$5,760 |
7.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,252 |
$4,504 |
6.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,535 |
$3,070 |
11.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$663 |
$1,326 |
3.8× |
| Thoracic spine 2 views (72070) |
$257.50 |
$515 |
2.5× |
| Thoracic spine 3 views (72072) |
$260 |
$520 |
2.5× |
| Thoracolumbar 2 views (72080) |
$84.50 |
$169 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$353 |
$706 |
0.9× |
| Thyroid Met Imaging Body (78018) |
$1,170 |
$2,340 |
2.2× |
| Thyroid Uptake Measurement (78012) |
$340 |
$680 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$640.50 |
$1,281 |
1.6× |
| Tx Devices Design & Construction Complex (77334) |
$1,461 |
$2,922 |
4.0× |
| Tx devices design & construction intermediate (77333) |
$595 |
$1,190 |
4.5× |
| Ultrasound Breast Limited (76642) |
$414.50 |
$829 |
4.8× |
| Ultrasound Elastography Parenchyma (76981) |
$281 |
$562 |
2.7× |
| Ultrasound Exam Aaa Screen (76706) |
$95.50 |
$191 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$395.50 |
$791 |
3.8× |
| Umbilical-artery Doppler (OB) (76820) |
$395.50 |
$791 |
3.8× |
| Unlisted magnetic resonance procedure (76498) |
$696.50 |
$1,393 |
8.1× |
| Unlisted us procedure (76999) |
$434 |
$868 |
5.1× |
| Upper gi w/o kub (74240) |
$376 |
$752 |
2.2× |
| Ureteral Reflux Study (78740) |
$805 |
$1,610 |
2.0× |
| Urethrocystogram voiding (74455) |
$304 |
$608 |
1.3× |
| Urethrocystography retrograde (74450) |
$315.50 |
$631 |
1.3× |
| Us breast unilateral complete (76641) |
$414.50 |
$829 |
4.0× |
| Us chest (76604) |
$343.50 |
$687 |
3.3× |
| Us complete joint (76881) |
$491.50 |
$983 |
4.8× |
| Us exam, pelvic, limited (76857) |
$395.50 |
$791 |
3.8× |
| Us head (76506) |
$395.50 |
$791 |
3.8× |
| Us kidney transplant (76776) |
$408.50 |
$817 |
4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$395.50 |
$791 |
3.8× |
| Us ob detailed single fetus (76811) |
$520.50 |
$1,041 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$395.50 |
$791 |
3.8× |
| Us ob transvaginal (76817) |
$453 |
$906 |
4.4× |
| Us pelvic non ob complete (76856) |
$425 |
$850 |
4.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$414 |
$828 |
4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$395.50 |
$791 |
3.8× |
| Us retroperitoneal complete (76770) |
$447.50 |
$895 |
4.3× |
| Us retroperitoneal limited (76775) |
$408 |
$816 |
4.0× |
| Us scrotum and contents (76870) |
$395.50 |
$791 |
3.8× |
| Us spinal canal and contents (76800) |
$533.50 |
$1,067 |
5.2× |
| Us thyroid (76536) |
$474 |
$948 |
4.6× |
| Vein X-Ray Chest (75827) |
$2,210 |
$4,420 |
1.4× |
| Venogram Sinus/Jugular (75860) |
$2,102.50 |
$4,205 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,297 |
$4,594 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$948 |
$1,896 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$813 |
$1,626 |
0.5× |
| Venography Renal Bilateral (75833) |
$2,662 |
$5,324 |
0.9× |
| Venography Renal Unilateral (75831) |
$2,162.50 |
$4,325 |
0.7× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,002.50 |
$4,005 |
0.4× |
| Wrist 2 views (73100) |
$184 |
$368 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$182 |
$364 |
2.1× |
| X-ray antegrade pyelogram tube (74425) |
$320.50 |
$641 |
0.9× |
| X-Ray Aorta Leg Arteries (75630) |
$2,974.50 |
$5,949 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$75 |
$150 |
0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$184 |
$368 |
2.1× |
| X-Ray Exam Breast Specimen (76098) |
$419 |
$838 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$233.50 |
$467 |
2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$233.50 |
$467 |
2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$233.50 |
$467 |
2.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$121 |
$242 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$227.50 |
$455 |
2.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$280.50 |
$561 |
2.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$455 |
$910 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$455 |
$910 |
4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$380.50 |
$761 |
3.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$283.50 |
$567 |
2.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$237.50 |
$475 |
2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$271 |
$542 |
2.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$229 |
$458 |
2.2× |
| X-ray eye for foreign body (70030) |
$232 |
$464 |
2.7× |
| X-ray humerus (73060) |
$184 |
$368 |
2.1× |
| X-ray IV pyelogram (ivp) (74400) |
$577 |
$1,154 |
3.3× |
| X-ray IV pyelogram+tomography (74415) |
$703.50 |
$1,407 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$98 |
$196 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$205 |
$410 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$153.50 |
$307 |
1.5× |
| X-ray nose-rectum child f.b. (76010) |
$165.50 |
$331 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$263 |
$526 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$218.50 |
$437 |
2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$202 |
$404 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$230.50 |
$461 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$252 |
$504 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$283.50 |
$567 |
2.8× |
| X-ray thoracic spine 4 vw (72074) |
$363 |
$726 |
3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$315.50 |
$631 |
0.9× |
| X-Rays Bone Length Studies (77073) |
$245.50 |
$491 |
2.4× |
| X-Rays Bone Survey Complete (77075) |
$276.50 |
$553 |
2.7× |
| Xr c-spine 4 or 5 views (72050) |
$297.50 |
$595 |
2.9× |
| Xr facial bones less than 3 views (70140) |
$157.50 |
$315 |
1.8× |
| Xr orbits complete 4 views (70200) |
$233 |
$466 |
2.3× |