| 3-D radiotherapy plan dose-volume histograms (77295) |
$26,112.50 |
$52,225 |
19.5× |
| Abdomen 1 View (74018) |
$198 |
$396 |
2.3× |
| Abdomen 2 views (74019) |
$158 |
$316 |
1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$632.50 |
$1,265 |
1.6× |
| Adrenal Cortex & Medulla Img (78075) |
$3,178 |
$6,356 |
2.5× |
| Angio internal mammary (75756) |
$1,976.50 |
$3,953 |
0.6× |
| Angio pulmonary bilat (75743) |
$5,050 |
$10,100 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,143 |
$4,286 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,873.50 |
$3,747 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,541.50 |
$3,083 |
0.5× |
| Ankle 2 views (73600) |
$169 |
$338 |
2.0× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,370.50 |
$4,741 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,859.50 |
$7,719 |
1.3× |
| Artery X-Rays Abdomen (75726) |
$3,335.50 |
$6,671 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$472.50 |
$945 |
0.2× |
| Artery X-Rays Pelvis (75736) |
$3,380 |
$6,760 |
0.6× |
| Artery X-Rays Spine (75705) |
$3,464.50 |
$6,929 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$963 |
$1,926 |
7.4× |
| Bone age studies (77072) |
$350 |
$700 |
3.5× |
| Bone Imaging 3 Phase (78315) |
$3,837 |
$7,674 |
9.9× |
| Bone Imaging Whole Body (78306) |
$3,365.50 |
$6,731 |
8.7× |
| Bone marrow imaging limited area (78102) |
$999.50 |
$1,999 |
2.6× |
| Bone survey infant (77076) |
$503 |
$1,006 |
5.0× |
| Brachytx isodose complex (77318) |
$761.50 |
$1,523 |
2.1× |
| Brachytx isodose intermed (77317) |
$500.50 |
$1,001 |
1.4× |
| Brachytx Isodose Plan Simple (77316) |
$411 |
$822 |
1.1× |
| Brain Image W/Flow < 4 Views (78601) |
$380 |
$760 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,963 |
$15,926 |
5.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,116.50 |
$4,233 |
6.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,144.50 |
$4,289 |
2.8× |
| Cardiac Shunt Detection (78428) |
$874 |
$1,748 |
2.3× |
| Cat Scan Follow-Up Study (76380) |
$699 |
$1,398 |
8.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$914.50 |
$1,829 |
1.7× |
| Chest 1 view (71045) |
$175 |
$350 |
2.1× |
| Chest 2 views (71046) |
$216.50 |
$433 |
2.6× |
| Chest 3 views (71047) |
$262.50 |
$525 |
3.1× |
| Chest 4 or more views (71048) |
$286.50 |
$573 |
2.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$145.50 |
$291 |
1.4× |
| Clavicle complete (73000) |
$182 |
$364 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$178.50 |
$357 |
1.8× |
| Continuing medical physics consltj pr wk (77336) |
$1,395 |
$2,790 |
10.7× |
| Contrast Exam Abdominl Aorta (75625) |
$2,462 |
$4,924 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$328 |
$656 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,273 |
$6,546 |
9.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,853.50 |
$3,707 |
8.0× |
| CT abdomen w contrast (74160) |
$2,143 |
$4,286 |
12.6× |
| CT abdomen w wo contrast (74170) |
$2,432.50 |
$4,865 |
14.3× |
| CT abdomen w/o contrast (74150) |
$1,390.50 |
$2,781 |
13.7× |
| CT Angio Abdomen and Pelvis (74174) |
$3,025 |
$6,050 |
8.9× |
| CT Angio Chest (71275) |
$1,727.50 |
$3,455 |
10.2× |
| CT Angio Head (70496) |
$2,021 |
$4,042 |
11.9× |
| CT angio hrt w/3d image (75574) |
$1,555.50 |
$3,111 |
4.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,387 |
$2,774 |
8.2× |
| CT Angio Neck (70498) |
$2,030 |
$4,060 |
11.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,340 |
$2,680 |
7.9× |
| CT cervical spine w/ contrast (72126) |
$5,290 |
$10,580 |
15.6× |
| CT cervical spine w/o contrast (72125) |
$1,378 |
$2,756 |
13.6× |
| CT cervical spine w/wo cont (72127) |
$2,934 |
$5,868 |
17.2× |
| CT chest w contrast (71260) |
$1,441 |
$2,882 |
8.5× |
| CT chest w/wo contrast (71270) |
$1,195.50 |
$2,391 |
7.0× |
| CT colonography screening (74263) |
$624 |
$1,248 |
2.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,049.50 |
$2,099 |
10.4× |
| CT head/brain with contrast (70460) |
$1,605 |
$3,210 |
9.4× |
| CT head/brain without and with contrast (70470) |
$1,877.50 |
$3,755 |
11.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,555.50 |
$3,111 |
4.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$240.50 |
$481 |
2.8× |
| CT hrt w/3d image congen (75573) |
$1,555.50 |
$3,111 |
4.6× |
| CT iac w contrast (70481) |
$1,466.50 |
$2,933 |
8.6× |
| CT l-spine w&w/o contrast (72133) |
$1,377.50 |
$2,755 |
8.1× |
| CT lower ext w/o (73700) |
$1,150 |
$2,300 |
11.3× |
| CT lower extremity w/contrast material (73701) |
$1,449.50 |
$2,899 |
8.5× |
| CT lumbar spine w contrast (72132) |
$2,504 |
$5,008 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$651 |
$1,302 |
6.4× |
| CT maxillofacial w contrast (70487) |
$1,340 |
$2,680 |
7.9× |
| CT maxillofacial wo contrast (70486) |
$1,117.50 |
$2,235 |
11.0× |
| CT neck tissue combo (70492) |
$1,856.50 |
$3,713 |
10.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,602.50 |
$3,205 |
9.4× |
| CT orbits w/o contrast (70480) |
$1,242.50 |
$2,485 |
12.3× |
| CT pelvis w&w/o contrast (72194) |
$1,463.50 |
$2,927 |
8.6× |
| CT pelvis w/o contrast (72192) |
$688.50 |
$1,377 |
6.8× |
| CT scan of leg combo (73702) |
$1,759.50 |
$3,519 |
10.3× |
| CT scans face/jaw combo (70488) |
$1,642.50 |
$3,285 |
9.7× |
| CT soft tissue neck w contrast (70491) |
$1,534.50 |
$3,069 |
9.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,273 |
$2,546 |
12.6× |
| CT thoracic spine w contrast (72129) |
$2,433.50 |
$4,867 |
14.3× |
| CT thoracic spine w/o contrast (72128) |
$1,143 |
$2,286 |
11.3× |
| CT thoracic spine w/wo cont (72130) |
$2,428.50 |
$4,857 |
14.3× |
| CT thorax w/o contrast (71250) |
$648.50 |
$1,297 |
6.4× |
| CT upper ext wo (73200) |
$1,399 |
$2,798 |
13.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,163 |
$4,326 |
12.7× |
| CT upper extremity with contrast (73201) |
$1,734.50 |
$3,469 |
5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,708 |
$3,416 |
10.0× |
| Cta Abdomen (74175) |
$2,391 |
$4,782 |
14.1× |
| CTA pelvis (72191) |
$773 |
$1,546 |
4.5× |
| Diskography lumbar (72295) |
$1,178.50 |
$2,357 |
0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$343 |
$686 |
3.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$483.50 |
$967 |
4.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$113 |
$226 |
1.1× |
| Dxa Bone Density Axial (77080) |
$235.50 |
$471 |
2.3× |
| Echo exam of fetal heart (76825) |
$708 |
$1,416 |
1.3× |
| Echo exam uterus (76831) |
$311 |
$622 |
1.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$354.50 |
$709 |
1.5× |
| Echograp Trans R Pros Study (76873) |
$823 |
$1,646 |
8.1× |
| Esophagram (74220) |
$372.50 |
$745 |
2.2× |
| Fetal Biophys Profile W/Nst (76818) |
$348 |
$696 |
3.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$253.50 |
$507 |
2.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,902 |
$3,804 |
8.2× |
| Fluoroscopy up to 1 hr (76000) |
$698 |
$1,396 |
3.0× |
| Follow-Up Angiography (75898) |
$673.50 |
$1,347 |
0.2× |
| Foot 2 views (73620) |
$165.50 |
$331 |
2.0× |
| Forearm 2 views (73090) |
$194 |
$388 |
2.3× |
| Gastric emptying imaging study (78264) |
$3,535.50 |
$7,071 |
9.1× |
| Gated Heart Planar Single (78472) |
$1,288.50 |
$2,577 |
3.3× |
| Hand 2 views (73120) |
$179 |
$358 |
1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$11,318 |
$22,636 |
16.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$10,412 |
$20,824 |
15.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$9,394.50 |
$18,789 |
13.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,976.50 |
$3,953 |
0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1.81 |
$3.61 |
0.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,555.50 |
$3,111 |
3.0× |
| Hepatobiliary System Imaging (78226) |
$1,135.50 |
$2,271 |
2.9× |
| Ht Muscle Image Spect Sing (78451) |
$2,666 |
$5,332 |
2.1× |
| Hysterosalpingogram (74740) |
$281 |
$562 |
1.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$996.50 |
$1,993 |
11.8× |
| Infant hip ultrasound, limited static exam (76886) |
$727.50 |
$1,455 |
8.6× |
| Interstitial radiation source applic complex (77778) |
$3,004.50 |
$6,009 |
4.4× |
| Joint Survey Single View (77077) |
$341 |
$682 |
3.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,449.50 |
$2,899 |
2.8× |
| K Flow/Funct Image W/O Drug (78707) |
$1,927.50 |
$3,855 |
3.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$270.50 |
$541 |
0.7× |
| Kidney Imaging Morphol (78700) |
$1,580 |
$3,160 |
4.1× |
| Knee 3 Views (73562) |
$198 |
$396 |
2.3× |
| Liver & Spleen Imaging Static Only (78215) |
$802 |
$1,604 |
2.1× |
| Liver imaging static only (78201) |
$958.50 |
$1,917 |
1.8× |
| Lung perfusion differential (78597) |
$728 |
$1,456 |
1.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,104.50 |
$2,209 |
2.1× |
| Lymph System Imaging (78195) |
$1,202 |
$2,404 |
2.3× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$457 |
$914 |
0.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,976.50 |
$3,953 |
0.6× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$685 |
$1,370 |
0.2× |
| Magnetic Image Jaw Joint (70336) |
$2,062 |
$4,124 |
8.9× |
| Mammary ductogram or galactogram single (77053) |
$138.50 |
$277 |
0.6× |
| Meckels Divert Exam (78290) |
$1,580 |
$3,160 |
4.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$11,884 |
$23,768 |
32.7× |
| Mr safety determination physician/other qhp (76016) |
$105 |
$210 |
1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$29.50 |
$59 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$109.50 |
$219 |
1.2× |
| Mr safety implt pos&/immoblj (76019) |
$71 |
$142 |
1.2× |
| Mr safety med physics xm customization plng&mntr (76017) |
$287.50 |
$575 |
1.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,871.50 |
$5,743 |
8.5× |
| MRA head w/o contrast (70544) |
$1,544 |
$3,088 |
6.7× |
| MRA neck w contrast (70548) |
$1,227 |
$2,454 |
3.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,284 |
$4,568 |
6.8× |
| MRA neck w/o contrast (70547) |
$1,233.50 |
$2,467 |
5.3× |
| MRI abdomen w contrast (74182) |
$2,451.50 |
$4,903 |
7.2× |
| MRI abdomen w/o contrast (74181) |
$1,355 |
$2,710 |
5.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,857 |
$9,714 |
6.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,250 |
$6,500 |
9.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,876.50 |
$9,753 |
6.4× |
| MRI bone marrow blood supply (77084) |
$601.50 |
$1,203 |
2.6× |
| MRI brain functional w/o physician admnistration (70554) |
$2,077.50 |
$4,155 |
9.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$398.50 |
$797 |
1.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$870 |
$1,740 |
3.8× |
| MRI cardiac w/o contrast (75557) |
$1,866 |
$3,732 |
8.1× |
| MRI cervical spine w contrast (72142) |
$2,455 |
$4,910 |
7.3× |
| MRI cervical spine w/o cont (72141) |
$1,326 |
$2,652 |
5.7× |
| MRI chest w/o contrast (71550) |
$1,267 |
$2,534 |
5.5× |
| MRI chest wo w contrast (71552) |
$2,343.50 |
$4,687 |
6.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,151 |
$4,302 |
6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,161.50 |
$2,323 |
5.0× |
| MRI lumbar spine w contrast (72149) |
$2,643.50 |
$5,287 |
7.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,455 |
$4,910 |
7.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,258.50 |
$2,517 |
5.4× |
| MRI orbit face neck w contrast (70542) |
$2,277.50 |
$4,555 |
6.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,330 |
$4,660 |
6.9× |
| MRI pelvis w contrast (72196) |
$2,346.50 |
$4,693 |
6.9× |
| MRI pelvis w/o & w contrast (72197) |
$2,401 |
$4,802 |
7.1× |
| MRI pelvis w/o contrast (72195) |
$1,297 |
$2,594 |
5.6× |
| MRI spectroscopy (76390) |
$1,672 |
$3,344 |
19.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,405.50 |
$2,811 |
6.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$962.50 |
$1,925 |
4.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,782 |
$3,564 |
5.3× |
| MRI, abdomen, combo (74183) |
$2,508 |
$5,016 |
7.4× |
| MRI, dorsal spine combo (72157) |
$2,601.50 |
$5,203 |
7.7× |
| MRI, dorsal spine contrast (72147) |
$2,601.50 |
$5,203 |
7.7× |
| MRI, joint upper extrem (73221) |
$1,754.50 |
$3,509 |
7.6× |
| MRI, joint upper extrem combo (73223) |
$3,263.50 |
$6,527 |
9.6× |
| MRI, lumbar spine combo (72158) |
$2,643.50 |
$5,287 |
7.8× |
| Myelograpy 2/more regions rs&i (72270) |
$848 |
$1,696 |
1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,518 |
$7,036 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$3,212 |
$6,424 |
2.6× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,124 |
$2,248 |
0.8× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$3,153.50 |
$6,307 |
1.5× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$4,493 |
$8,986 |
2.1× |
| N-invas est c ffr sw aly CTA (75580) |
$3,125 |
$6,250 |
3.8× |
| Neck soft tissue (70360) |
$185.50 |
$371 |
2.2× |
| Nm csf leak detection (78650) |
$947 |
$1,894 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$39,098 |
$78,196 |
29.1× |
| Nuclear Rx Oral Admin (79005) |
$3,987.50 |
$7,975 |
17.6× |
| Ob us nuchal meas 1 gest (76813) |
$209 |
$418 |
2.1× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$117.50 |
$235 |
1.2× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$117.50 |
$235 |
1.2× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$361 |
$722 |
2.8× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$100.50 |
$201 |
1.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$135 |
$270 |
1.3× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$21.50 |
$43 |
0.8× |
| Panoramic X-ray of jaws (70355) |
$166 |
$332 |
2.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$4,129 |
$8,258 |
7.8× |
| Parathyroid Planar Imaging (78070) |
$2,493 |
$4,986 |
6.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$3,559.50 |
$7,119 |
9.2× |
| Pelvis 1 or 2 views (72170) |
$417 |
$834 |
4.1× |
| Peritoneogram Rs&I (74190) |
$387.50 |
$775 |
0.7× |
| Pet Image W/Ct Lmtd (78814) |
$2,516 |
$5,032 |
1.8× |
| PET image w/CT, full body (78816) |
$2,904.50 |
$5,809 |
2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,542 |
$7,084 |
2.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,976.50 |
$3,953 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$783 |
$1,566 |
2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$172.50 |
$345 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$408.50 |
$817 |
0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$180 |
$360 |
2.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$161.50 |
$323 |
1.9× |
| Radex elbow complete minimum 3 views (73080) |
$214.50 |
$429 |
2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$257 |
$514 |
2.5× |
| Radex fingr minimum 2 views (73140) |
$150.50 |
$301 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$186.50 |
$373 |
2.2× |
| Radex Hand Minimum 3 Views (73130) |
$200 |
$400 |
2.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$341 |
$682 |
4.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$180.50 |
$361 |
2.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$241 |
$482 |
2.9× |
| Radex shoulder complete minimum 2 views (73030) |
$227.50 |
$455 |
2.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$330.50 |
$661 |
3.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,751.50 |
$3,503 |
10.3× |
| Radex Spine 1 View Specify Level (72020) |
$156 |
$312 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$167.50 |
$335 |
2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$145.50 |
$291 |
1.7× |
| Radex Toe Minimum 2 Views (73660) |
$153 |
$306 |
1.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$92 |
$184 |
0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$204 |
$408 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$354 |
$708 |
3.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,006 |
$34,012 |
2.4× |
| Radiation treatment delivery level 1 (77402) |
$494 |
$988 |
5.0× |
| Radiation treatment delivery level 2 (77407) |
$329.50 |
$659 |
0.9× |
| Radiation treatment delivery level 3 (77412) |
$1,696.50 |
$3,393 |
3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$152.50 |
$305 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$146.50 |
$293 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$490.50 |
$981 |
2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$451.50 |
$903 |
2.7× |
| Radiologic exam knee complete 4/more views (73564) |
$219.50 |
$439 |
2.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$496 |
$992 |
4.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$431 |
$862 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$316 |
$632 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$399 |
$798 |
2.3× |
| Radiologic examination femur 1 view (73551) |
$354 |
$708 |
4.2× |
| Radiologic examination femur minimum 2 views (73552) |
$416 |
$832 |
4.9× |
| Radiologic examination knee 1/2 views (73560) |
$172.50 |
$345 |
2.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$339 |
$678 |
3.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$191 |
$382 |
2.3× |
| Ribs bilateral 3 views (71110) |
$288.50 |
$577 |
2.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,681 |
$3,362 |
4.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,517 |
$3,034 |
3.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,001.50 |
$4,003 |
3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$8,002.50 |
$16,005 |
15.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$961 |
$1,922 |
0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,201 |
$6,402 |
2.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,921 |
$3,842 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$759.50 |
$1,519 |
3.4× |
| Scapula (73010) |
$158.50 |
$317 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$64 |
$128 |
2.7× |
| Shoulder 1 view (73020) |
$178.50 |
$357 |
2.1× |
| Shoulder Arthrography (73040) |
$313.50 |
$627 |
0.9× |
| Skull less than 4 views (70250) |
$216 |
$432 |
2.1× |
| Special dosimetry (77331) |
$1,042 |
$2,084 |
8.0× |
| Special Physics Consult (77370) |
$2,229 |
$4,458 |
17.1× |
| Special treatment procedure (77470) |
$4,482 |
$8,964 |
8.4× |
| Speech evaluation, complex (70371) |
$720.50 |
$1,441 |
3.1× |
| Spleen Imaging (78185) |
$682.50 |
$1,365 |
1.8× |
| Srs Multisource (77371) |
$110,980.50 |
$221,961 |
15.5× |
| Stereotactic Body Radiation Delivery (77373) |
$11,313 |
$22,626 |
6.5× |
| Sternoclavicular joints (71130) |
$205 |
$410 |
2.4× |
| Superior sagittal sinus venogram (75870) |
$1,373.50 |
$2,747 |
0.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$1,729 |
$3,458 |
17.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,631.50 |
$3,263 |
4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$781 |
$1,562 |
2.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$4,058 |
$8,116 |
11.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$3,861 |
$7,722 |
10.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,429 |
$2,858 |
11.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$352.50 |
$705 |
2.1× |
| Thoracic spine 2 views (72070) |
$221.50 |
$443 |
2.2× |
| Thoracic spine 3 views (72072) |
$225 |
$450 |
2.2× |
| Thoracolumbar 2 views (72080) |
$211 |
$422 |
2.5× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$488 |
$976 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$2,066 |
$4,132 |
5.3× |
| Thyroid Met Imaging Body (78018) |
$3,252.50 |
$6,505 |
6.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,582.50 |
$5,165 |
6.7× |
| Tx Devices Design & Construction Complex (77334) |
$2,655.50 |
$5,311 |
7.3× |
| Tx devices design & construction intermediate (77333) |
$990.50 |
$1,981 |
7.6× |
| Tx devices design & construction simple (77332) |
$1,508.50 |
$3,017 |
11.6× |
| Ultrasound Breast Limited (76642) |
$210 |
$420 |
2.5× |
| Ultrasound Elastography Parenchyma (76981) |
$202 |
$404 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$174 |
$348 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$373 |
$746 |
3.7× |
| Umbilical-artery Doppler (OB) (76820) |
$215.50 |
$431 |
2.1× |
| Unlisted fluoroscopic procedure (76496) |
$548 |
$1,096 |
6.5× |
| Unlisted magnetic resonance procedure (76498) |
$561.50 |
$1,123 |
6.7× |
| Unlisted us procedure (76999) |
$167 |
$334 |
2.0× |
| Upper gi w/o kub (74240) |
$416 |
$832 |
2.4× |
| Ureteral Reflux Study (78740) |
$1,385 |
$2,770 |
3.6× |
| Urethrocystogram voiding (74455) |
$519.50 |
$1,039 |
2.2× |
| Urethrocystography retrograde (74450) |
$519.50 |
$1,039 |
2.2× |
| Us breast unilateral complete (76641) |
$256.50 |
$513 |
2.5× |
| Us chest (76604) |
$296.50 |
$593 |
2.9× |
| Us complete joint (76881) |
$679.50 |
$1,359 |
6.7× |
| Us exam, pelvic, limited (76857) |
$159 |
$318 |
1.6× |
| Us head (76506) |
$128 |
$256 |
1.3× |
| Us kidney transplant (76776) |
$401.50 |
$803 |
4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$383.50 |
$767 |
3.8× |
| Us ob detailed single fetus (76811) |
$490 |
$980 |
2.1× |
| Us ob limited 1 or more fetuses (76815) |
$254.50 |
$509 |
2.5× |
| Us ob transvaginal (76817) |
$85 |
$170 |
0.8× |
| Us pelvic non ob complete (76856) |
$538.50 |
$1,077 |
5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$304 |
$608 |
3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$265.50 |
$531 |
2.6× |
| Us retroperitoneal complete (76770) |
$465.50 |
$931 |
4.6× |
| Us retroperitoneal limited (76775) |
$237 |
$474 |
2.3× |
| Us scrotum and contents (76870) |
$422 |
$844 |
4.2× |
| Us spinal canal and contents (76800) |
$709.50 |
$1,419 |
7.0× |
| Us thyroid (76536) |
$438.50 |
$877 |
4.3× |
| Vascular Flow Imaging (78445) |
$276 |
$552 |
0.7× |
| Vein X-Ray Chest (75827) |
$581.50 |
$1,163 |
0.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,155 |
$2,310 |
0.4× |
| Venogram Sinus/Jugular (75860) |
$2,055.50 |
$4,111 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,092.50 |
$4,185 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,179 |
$2,358 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$1,036.50 |
$2,073 |
0.7× |
| Venography Renal Unilateral (75831) |
$1,976.50 |
$3,953 |
0.6× |
| Venous sampling by catheter (75893) |
$3,380 |
$6,760 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$37.50 |
$75 |
0.4× |
| Wrist 2 views (73100) |
$184 |
$368 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$260 |
$520 |
3.1× |
| X-ray antegrade pyelogram tube (74425) |
$408.50 |
$817 |
1.2× |
| X-Ray Aorta Leg Arteries (75630) |
$3,027.50 |
$6,055 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$251.50 |
$503 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$184.50 |
$369 |
2.2× |
| X-Ray Exam Breast Specimen (76098) |
$328 |
$656 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$157 |
$314 |
1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$252.50 |
$505 |
2.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$305.50 |
$611 |
3.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$169 |
$338 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$232 |
$464 |
2.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$289.50 |
$579 |
2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$210.50 |
$421 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$273.50 |
$547 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$317.50 |
$635 |
3.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$380 |
$760 |
3.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$228 |
$456 |
2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$386 |
$772 |
3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$277 |
$554 |
2.7× |
| X-ray eye for foreign body (70030) |
$102 |
$204 |
1.2× |
| X-ray humerus (73060) |
$165 |
$330 |
2.0× |
| X-ray IV pyelogram (ivp) (74400) |
$816.50 |
$1,633 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$132 |
$264 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$198 |
$396 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$216 |
$432 |
2.1× |
| X-ray nose-rectum child f.b. (76010) |
$97 |
$194 |
1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$341 |
$682 |
3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$408 |
$816 |
4.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$351 |
$702 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$351 |
$702 |
4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$287.50 |
$575 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$270 |
$540 |
2.7× |
| X-ray thoracic spine 4 vw (72074) |
$253.50 |
$507 |
2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$408.50 |
$817 |
1.2× |
| X-Rays Bone Length Studies (77073) |
$268 |
$536 |
2.6× |
| X-Rays Bone Survey Complete (77075) |
$457.50 |
$915 |
4.5× |
| Xr c-spine 4 or 5 views (72050) |
$313 |
$626 |
3.1× |
| Xr facial bones less than 3 views (70140) |
$185 |
$370 |
2.2× |
| Xr orbits complete 4 views (70200) |
$186.50 |
$373 |
1.8× |