| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,626 |
$7,252 |
2.7× |
| Abdomen 2 views (74019) |
$190.50 |
$381 |
1.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,009 |
$2,018 |
2.6× |
| 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 pelvic slctv/supraslctv rs&i (75736) |
$2,844 |
$5,688 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,165 |
$6,330 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,512.50 |
$5,025 |
0.8× |
| Angiography Spinal Selective Rs&I (75705) |
$2,857.50 |
$5,715 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,959.50 |
$5,919 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,223 |
$4,446 |
0.7× |
| Ankle 2 views (73600) |
$184 |
$368 |
2.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$320.50 |
$641 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,974.50 |
$5,949 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$2,479 |
$4,958 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,847.50 |
$3,695 |
0.6× |
| Arthrogram elbow (73085) |
$315.50 |
$631 |
0.9× |
| Arthrogram hip (73525) |
$417.50 |
$835 |
1.2× |
| Arthrogram shoulder (73040) |
$500.50 |
$1,001 |
1.5× |
| Arthrogram wrist (73115) |
$423 |
$846 |
1.2× |
| Arthrography knee lt (73580) |
$524 |
$1,048 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$615 |
$1,230 |
4.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$698 |
$1,396 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$924.50 |
$1,849 |
2.4× |
| Bone age studies (77072) |
$175 |
$350 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$985 |
$1,970 |
2.5× |
| Bone survey complete (77075) |
$276.50 |
$553 |
2.7× |
| Brain image w/flow 4 + views (78606) |
$921 |
$1,842 |
1.7× |
| Brain Imaging Vascular Flow Only (78610) |
$283.50 |
$567 |
0.5× |
| Cardiac shunt detection (78428) |
$863 |
$1,726 |
2.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$820 |
$1,640 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$237.50 |
$475 |
2.8× |
| Chest 1 view (71045) |
$244.50 |
$489 |
2.9× |
| Chest 3 views (71047) |
$358.50 |
$717 |
4.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$340 |
$680 |
2.0× |
| 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× |
| 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 hrt w/3d image (75574) |
$3,050.50 |
$6,101 |
8.9× |
| CT angiography upper extremity lt (73206) |
$1,385.50 |
$2,771 |
8.0× |
| CT c-spine w/o contrast (72125) |
$1,582 |
$3,164 |
15.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,967.50 |
$3,935 |
11.4× |
| CT cervical spine with contrast (72126) |
$1,799 |
$3,598 |
5.2× |
| CT chest w/wo contrast (71270) |
$2,017.50 |
$4,035 |
11.7× |
| CT chest with contrast (71260) |
$1,765.50 |
$3,531 |
10.2× |
| 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 limited/localized follow up study (76380) |
$387.50 |
$775 |
4.5× |
| CT lower ext w/o (73700) |
$929 |
$1,858 |
9.0× |
| CT lower extremity w wo contrast (73702) |
$1,629 |
$3,258 |
9.4× |
| CT lower extremity with contrast (73701) |
$1,446 |
$2,892 |
8.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,967.50 |
$3,935 |
11.4× |
| CT lumbar spine w/o contrast (72131) |
$1,495 |
$2,990 |
14.5× |
| CT lumbar spine with contrast (72132) |
$1,637 |
$3,274 |
4.8× |
| CT maxillofacial w contrast (70487) |
$1,381.50 |
$2,763 |
8.0× |
| CT maxillofacial w/o contrast (70486) |
$1,318 |
$2,636 |
12.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,576.50 |
$3,153 |
9.1× |
| CT neck soft tissue w contrast (70491) |
$1,512.50 |
$3,025 |
8.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) |
$1,815 |
$3,630 |
10.5× |
| 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 contrast (72130) |
$1,967.50 |
$3,935 |
11.4× |
| CT thorax w/o contrast (71250) |
$1,459.50 |
$2,919 |
14.2× |
| CT upper extremity w/o contrast rt (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 abdomen pelvis (74174) |
$3,859.50 |
$7,719 |
11.2× |
| CTA chest (71275) |
$2,230 |
$4,460 |
12.9× |
| Cta Head (70496) |
$2,180.50 |
$4,361 |
12.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,657 |
$3,314 |
9.6× |
| Cta Neck (70498) |
$2,328.50 |
$4,657 |
13.5× |
| Cta Pelvis (72191) |
$2,089.50 |
$4,179 |
12.1× |
| Cystography minimum 3 views rs&i (74430) |
$320.50 |
$641 |
0.9× |
| 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 study 1/> sites axial skel (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 fetal cardiovasc w/wo m-mode repeat std (76826) |
$565 |
$1,130 |
2.4× |
| Echoencephalography real time imaging (76506) |
$395.50 |
$791 |
3.8× |
| Esophagus (74220) |
$280.50 |
$561 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$453 |
$906 |
4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$453 |
$906 |
4.4× |
| 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× |
| Functional MRI brain by tech (70554) |
$1,434.50 |
$2,869 |
6.1× |
| Gated Heart Planar Single (78472) |
$1,066.50 |
$2,133 |
2.7× |
| Hand 2 views (73120) |
$184 |
$368 |
1.8× |
| Hand 3 views (73130) |
$132.50 |
$265 |
1.5× |
| Heart infarct image w ef (78468) |
$248.50 |
$497 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,287.50 |
$2,575 |
2.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$859.50 |
$1,719 |
2.2× |
| Ht muscle image spect sing (78451) |
$1,762.50 |
$3,525 |
1.4× |
| Humerus Min 2 Views Left (73060) |
$184 |
$368 |
2.1× |
| Hysterosalpingogram (74740) |
$525.50 |
$1,051 |
2.2× |
| Intracavitary radiation source applic simple (77761) |
$1,540 |
$3,080 |
2.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,553.50 |
$3,107 |
2.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$124.50 |
$249 |
0.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,044.50 |
$4,089 |
3.8× |
| 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× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,791 |
$3,582 |
0.6× |
| Lymphoscintigraphy (78195) |
$1,000.50 |
$2,001 |
1.9× |
| Meckels Diverticulum (78290) |
$762.50 |
$1,525 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,724 |
$9,448 |
12.8× |
| MRA head w & w/o contrast (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 & w/contrast material (74183) |
$2,887 |
$5,774 |
8.4× |
| MRI abdomen w/o contrast (74181) |
$2,313.50 |
$4,627 |
9.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,403 |
$4,806 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,403 |
$4,806 |
3.1× |
| MRI breast w/o contrast bilateral (77047) |
$2,298 |
$4,596 |
9.8× |
| MRI c-spine with contrast (72142) |
$2,495 |
$4,990 |
7.3× |
| MRI cervical spine w/o contrast (72141) |
$2,027 |
$4,054 |
8.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,942 |
$5,884 |
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 fetal sngl/1st gestation (74712) |
$472 |
$944 |
2.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,089 |
$4,178 |
6.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$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 orbit face &/neck w/o contrast (70540) |
$2,089 |
$4,178 |
8.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,096 |
$6,192 |
9.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,691.50 |
$5,383 |
7.8× |
| MRI pelvis w contrast (72196) |
$2,385.50 |
$4,771 |
6.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,887 |
$5,774 |
8.4× |
| MRI pelvis w/o contrast (72195) |
$2,089 |
$4,178 |
8.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,887 |
$5,774 |
8.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,887 |
$5,774 |
8.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,796 |
$5,592 |
8.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,585 |
$5,170 |
7.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,897.50 |
$5,795 |
8.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,719.50 |
$5,439 |
7.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,049 |
$6,098 |
8.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,211 |
$4,422 |
9.4× |
| MRI tmj (70336) |
$684.50 |
$1,369 |
2.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,722 |
$3,444 |
7.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,403 |
$4,806 |
7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,767.50 |
$3,535 |
7.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,195.50 |
$6,391 |
2.5× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$4,786.50 |
$9,573 |
5.7× |
| Neck soft tissue (70360) |
$184 |
$368 |
2.1× |
| Nm bone marrow wb (78104) |
$864 |
$1,728 |
2.2× |
| Nm cisternogram (78630) |
$1,023 |
$2,046 |
1.9× |
| Nm gastric emptying study (78264) |
$1,181.50 |
$2,363 |
3.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,111.50 |
$2,223 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$1,222 |
$2,444 |
5.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$395.50 |
$791 |
3.8× |
| Osseous survey infant (77076) |
$245.50 |
$491 |
2.4× |
| Osseous survey limited (77074) |
$565 |
$1,130 |
5.5× |
| Parathyrd planar w/spect&CT (78072) |
$2,538.50 |
$5,077 |
4.8× |
| Parathyrd planar w/wo subtrj (78071) |
$2,130 |
$4,260 |
5.4× |
| Parathyroid imaging (78070) |
$765.50 |
$1,531 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$192.50 |
$385 |
1.9× |
| PET image w/CT, skull-thigh (78815) |
$3,846 |
$7,692 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$3,846 |
$7,692 |
2.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,403 |
$4,806 |
7.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$680.50 |
$1,361 |
1.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,204.50 |
$2,409 |
2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$277.50 |
$555 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$233.50 |
$467 |
2.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$233.50 |
$467 |
2.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$455 |
$910 |
4.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$245.50 |
$491 |
2.4× |
| 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 1 mev >= complex (77412) |
$491.50 |
$983 |
0.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$301.50 |
$603 |
3.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$386 |
$772 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$245.50 |
$491 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$175.50 |
$351 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$233.50 |
$467 |
2.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$300.50 |
$601 |
3.5× |
| 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 upr gi trc double contrast study (74246) |
$420 |
$840 |
2.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$376 |
$752 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$213.50 |
$427 |
2.5× |
| Radiological examination surgical specimen (76098) |
$419 |
$838 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,351.50 |
$4,703 |
0.8× |
| Ribs bilateral 3 views (71110) |
$625.50 |
$1,251 |
6.1× |
| 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 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 1 day imaging (78830) |
$2,029.50 |
$4,059 |
1.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$878.50 |
$1,757 |
3.8× |
| Rp Therapy Intravenous Administration (79101) |
$871 |
$1,742 |
3.8× |
| Sacroiliac Joints < 3 Views (72200) |
$202 |
$404 |
2.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$380.50 |
$761 |
1.6× |
| Scanogram (77073) |
$245.50 |
$491 |
2.4× |
| Scapula complete (73010) |
$252 |
$504 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$33 |
$66 |
1.4× |
| Sella turcica (70240) |
$124.50 |
$249 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$124.50 |
$249 |
1.2× |
| Sialogram (70390) |
$389.50 |
$779 |
1.7× |
| Simulation intermediate (77285) |
$2,252 |
$4,504 |
6.1× |
| Small bowel series (74250) |
$311 |
$622 |
1.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,148.50 |
$2,297 |
3.1× |
| Special dosimetry (77331) |
$413.50 |
$827 |
3.1× |
| Special treatment procedure (77470) |
$1,980 |
$3,960 |
3.6× |
| Spine thoracic 3 views (72072) |
$260 |
$520 |
2.5× |
| Stereotactic body radiation delivery (77373) |
$5,821.50 |
$11,643 |
3.3× |
| 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 simple (77280) |
$1,535 |
$3,070 |
11.6× |
| Therapeutic Enema (74283) |
$663 |
$1,326 |
3.8× |
| Thoracolumbar 2 views (72080) |
$84.50 |
$169 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,170 |
$2,340 |
2.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$353 |
$706 |
0.9× |
| Thyroid uptake measurement (78012) |
$340 |
$680 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$640.50 |
$1,281 |
1.6× |
| Treatment device intermediate (77333) |
$595 |
$1,190 |
4.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,040.50 |
$4,081 |
3.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$664 |
$1,328 |
1.7× |
| Tx devices design & construction complex (77334) |
$1,461 |
$2,922 |
4.0× |
| 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 Ultrasound Procedure (76999) |
$434 |
$868 |
5.1× |
| Upper Extremity Infant (73092) |
$160.50 |
$321 |
1.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$805 |
$1,610 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$315.50 |
$631 |
1.3× |
| Urethrocystography voiding (74455) |
$304 |
$608 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$577 |
$1,154 |
3.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$703.50 |
$1,407 |
4.1× |
| Us abdl aorta screen aaa (76706) |
$95.50 |
$191 |
0.9× |
| Us breast unilateral complete (76641) |
$414.50 |
$829 |
4.0× |
| Us breast unilateral limited (76642) |
$414.50 |
$829 |
4.8× |
| Us chest (76604) |
$343.50 |
$687 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$491.50 |
$983 |
4.8× |
| Us elastography parenchyma (76981) |
$281 |
$562 |
2.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$395.50 |
$791 |
3.8× |
| Us guided compression repair (76936) |
$910.50 |
$1,821 |
4.3× |
| Us infant hips dynamic (76885) |
$370.50 |
$741 |
4.3× |
| Us infant hips limited static (76886) |
$370.50 |
$741 |
4.3× |
| Us kidney transplant (76776) |
$408.50 |
$817 |
4.0× |
| Us ob detailed single fetus (76811) |
$520.50 |
$1,041 |
2.2× |
| Us ob transvaginal (76817) |
$453 |
$906 |
4.4× |
| Us pelvic non ob complete (76856) |
$425 |
$850 |
4.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$395.50 |
$791 |
3.8× |
| Us pregnancy ltd (76815) |
$395.50 |
$791 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$414 |
$828 |
4.0× |
| 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 soft tissue head/neck (76536) |
$474 |
$948 |
4.6× |
| Us spinal canal and contents (76800) |
$533.50 |
$1,067 |
5.2× |
| Us xtr non-vasc lmtd (76882) |
$395.50 |
$791 |
3.8× |
| Us, eye b-scan (76512) |
$306 |
$612 |
3.0× |
| Venogram extremity bilateral (75822) |
$948 |
$1,896 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,297 |
$4,594 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$2,210 |
$4,420 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$813 |
$1,626 |
0.5× |
| Venography Renal Bilateral (75833) |
$2,662 |
$5,324 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$2,162.50 |
$4,325 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,102.50 |
$4,205 |
0.7× |
Venous sampling thru cath w/wo angiography rs& (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 Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$283 |
$566 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$182 |
$364 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$132.50 |
$265 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$694 |
$1,388 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$184 |
$368 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$283 |
$566 |
3.3× |
| 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 3-4 Views (73522) |
$455 |
$910 |
4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$380.50 |
$761 |
3.7× |
| X-ray exam of femur 1 (73551) |
$213.50 |
$427 |
2.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$360.50 |
$721 |
2.1× |
| X-ray eye for foreign body (70030) |
$232 |
$464 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$252 |
$504 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$157.50 |
$315 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$138 |
$276 |
1.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,130.50 |
$2,261 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$184 |
$368 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$98 |
$196 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$202.50 |
$405 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$205 |
$410 |
2.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$95.50 |
$191 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$153.50 |
$307 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$283.50 |
$567 |
2.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$75 |
$150 |
0.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$184 |
$368 |
2.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$165.50 |
$331 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$233 |
$466 |
2.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$227 |
$454 |
2.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$315.50 |
$631 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$212.50 |
$425 |
2.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$229 |
$458 |
2.2× |
| 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 Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$230.50 |
$461 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$233 |
$466 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$252 |
$504 |
2.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$132.50 |
$265 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$283.50 |
$567 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$157.50 |
$315 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$175 |
$350 |
2.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$167.50 |
$335 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$239.50 |
$479 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$257.50 |
$515 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$363 |
$726 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$184 |
$368 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$254.50 |
$509 |
3.0× |
| Xr c-spine 6 or more views (72052) |
$271 |
$542 |
2.6× |
| Xr chest 4+ views (71048) |
$406.50 |
$813 |
4.0× |
| Xr finger(s) 2+ views (73140) |
$132.50 |
$265 |
1.5× |
| Xr shoulder 1 view (73020) |
$133 |
$266 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$297.50 |
$595 |
2.9× |
| Xr tibia/fibula 2 views (73590) |
$184 |
$368 |
2.1× |
| Xr tmj bilateral (70330) |
$217 |
$434 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$150.50 |
$301 |
1.8× |