| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,449.15 |
$9,887 |
3.4× |
| Abdomen 1 View (74018) |
$285.75 |
$635 |
3.5× |
| Abdomen 2 views (74019) |
$322.65 |
$717 |
3.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,504.80 |
$3,344 |
4.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,732.30 |
$8,294 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,321 |
$7,380 |
1.1× |
| Ankle 2 views (73600) |
$188.10 |
$418 |
2.3× |
| Artery X-Rays Abdomen (75726) |
$3,636.45 |
$8,081 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$5,679.90 |
$12,622 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$516.15 |
$1,147 |
4.1× |
| Bone age studies (77072) |
$290.70 |
$646 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$1,656.45 |
$3,681 |
4.4× |
| Bone Imaging Limited Area (78300) |
$477.90 |
$1,062 |
1.3× |
| Bone Imaging Multiple Areas (78305) |
$1,524.15 |
$3,387 |
4.0× |
| Bone Imaging Whole Body (78306) |
$1,309.95 |
$2,911 |
3.5× |
| Bone survey infant (77076) |
$252 |
$560 |
2.5× |
| Brachytx isodose complex (77318) |
$1,302.30 |
$2,894 |
3.7× |
| Brachytx isodose intermed (77317) |
$1,657.35 |
$3,683 |
4.7× |
| Brachytx Isodose Plan Simple (77316) |
$1,193.85 |
$2,653 |
3.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,098.05 |
$11,329 |
3.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,513.35 |
$3,363 |
4.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,215.90 |
$2,702 |
3.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$407.25 |
$905 |
0.8× |
| Cerebrospinal Fluid Scan (78630) |
$1,601.55 |
$3,559 |
3.1× |
| Chest 1 view (71045) |
$128.70 |
$286 |
1.6× |
| Chest 2 views (71046) |
$218.70 |
$486 |
2.7× |
| Chest 3 views (71047) |
$239.85 |
$533 |
2.9× |
| Chest 4 or more views (71048) |
$257.40 |
$572 |
2.6× |
| Clavicle complete (73000) |
$290.70 |
$646 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$126.90 |
$282 |
1.3× |
| Continuing medical physics consltj pr wk (77336) |
$602.55 |
$1,339 |
4.7× |
| Contrast Exam Abdominl Aorta (75625) |
$3,204 |
$7,120 |
1.1× |
| Contrast X-Ray Bladder (74430) |
$753.30 |
$1,674 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,675.80 |
$3,724 |
5.1× |
| CT abdomen and pelvis without contrast (74176) |
$717.30 |
$1,594 |
3.2× |
| CT abdomen w contrast (74160) |
$796.05 |
$1,769 |
4.8× |
| CT abdomen w wo contrast (74170) |
$1,014.75 |
$2,255 |
6.1× |
| CT abdomen w/o contrast (74150) |
$391.05 |
$869 |
4.0× |
| CT Angio Abdomen and Pelvis (74174) |
$1,675.80 |
$3,724 |
5.1× |
| CT Angio Chest (71275) |
$971.10 |
$2,158 |
5.9× |
| CT Angio Head (70496) |
$842.40 |
$1,872 |
5.1× |
| CT angio hrt w/3d image (75574) |
$971.10 |
$2,158 |
2.9× |
| CT Angio Neck (70498) |
$842.40 |
$1,872 |
5.1× |
Ct Angio Upr Extrm W/O&W/Dye (73206)
range across 2 matching MRF lines |
$872.10–$1,099.80 |
$1,938–$2,444 |
varies |
| CT cervical spine w/ contrast (72126) |
$780.75 |
$1,735 |
2.4× |
| CT cervical spine w/o contrast (72125) |
$583.65 |
$1,297 |
5.9× |
| CT cervical spine w/wo cont (72127) |
$738.45 |
$1,641 |
4.5× |
| CT chest w contrast (71260) |
$756.90 |
$1,682 |
4.6× |
| CT chest w/wo contrast (71270) |
$738.45 |
$1,641 |
4.5× |
| CT head/brain with contrast (70460) |
$724.95 |
$1,611 |
4.4× |
| CT head/brain without and with contrast (70470) |
$842.40 |
$1,872 |
5.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$971.10 |
$2,158 |
2.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$42.30 |
$94 |
0.5× |
| CT iac w contrast (70481) |
$724.95 |
$1,611 |
4.4× |
| CT l-spine w&w/o contrast (72133) |
$738.45 |
$1,641 |
4.5× |
| CT lower ext w/o (73700) |
$478.35 |
$1,063 |
4.8× |
| CT lower extremity w/contrast material (73701) |
$522.90 |
$1,162 |
3.2× |
| CT lumbar spine w contrast (72132) |
$756.90 |
$1,682 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$565.65 |
$1,257 |
5.7× |
| CT maxillofacial w contrast (70487) |
$724.95 |
$1,611 |
4.4× |
| CT maxillofacial wo contrast (70486) |
$512.10 |
$1,138 |
5.2× |
| CT neck tissue combo (70492) |
$834.30 |
$1,854 |
5.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$842.40 |
$1,872 |
5.1× |
| CT orbits w/o contrast (70480) |
$493.20 |
$1,096 |
5.0× |
| CT pelvis w/o contrast (72192) |
$565.65 |
$1,257 |
5.7× |
| CT scan of leg combo (73702) |
$662.40 |
$1,472 |
4.0× |
| CT scans face/jaw combo (70488) |
$620.55 |
$1,379 |
3.7× |
| CT soft tissue neck w contrast (70491) |
$724.95 |
$1,611 |
4.4× |
| CT soft tissue neck w/o contrast (70490) |
$512.10 |
$1,138 |
5.2× |
| CT thoracic spine w contrast (72129) |
$756.90 |
$1,682 |
4.6× |
| CT thoracic spine w/o contrast (72128) |
$565.65 |
$1,257 |
5.7× |
| CT thoracic spine w/wo cont (72130) |
$738.45 |
$1,641 |
4.5× |
| CT thorax w/o contrast (71250) |
$565.65 |
$1,257 |
5.7× |
| CT upper ext wo (73200) |
$478.35 |
$1,063 |
4.8× |
| CT upper extremity with contrast (73201) |
$522.90 |
$1,162 |
1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$971.10 |
$2,158 |
5.9× |
| Cta Abdomen (74175) |
$1,014.75 |
$2,255 |
6.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$135.45 |
$301 |
1.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$74.70 |
$166 |
0.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$396.90 |
$882 |
4.0× |
| Dxa Bone Density Axial (77080) |
$255.60 |
$568 |
2.6× |
| Dxa bone density study (77085) |
$184.05 |
$409 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$153 |
$340 |
1.9× |
| Echo exam of fetal heart (76825) |
$481.05 |
$1,069 |
0.9× |
| Echo exam uterus (76831) |
$491.40 |
$1,092 |
2.2× |
| Echo Guide For Artery Repair (76936) |
$270 |
$600 |
1.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$481.05 |
$1,069 |
2.1× |
| Echograp Trans R Pros Study (76873) |
$502.20 |
$1,116 |
5.1× |
| Esophagram (74220) |
$417.60 |
$928 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$466.65 |
$1,037 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$310.95 |
$691 |
1.4× |
| Foot 2 views (73620) |
$188.10 |
$418 |
2.3× |
| Forearm 2 views (73090) |
$276.30 |
$614 |
3.4× |
| Gastric emptying imaging study (78264) |
$1,330.20 |
$2,956 |
3.5× |
| Gastroesophageal Reflux Exam (78262) |
$1,643.85 |
$3,653 |
4.3× |
| Gated Heart Planar Single (78472) |
$1,721.70 |
$3,826 |
4.6× |
| Hand 2 views (73120) |
$188.10 |
$418 |
1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$9,270 |
$20,600 |
14.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,794.40 |
$8,432 |
5.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$3,567.60 |
$7,928 |
5.4× |
| Hepatobil Syst Image W/Drug (78227) |
$1,336.95 |
$2,971 |
2.6× |
| Hepatobiliary System Imaging (78226) |
$1,336.95 |
$2,971 |
3.5× |
| Ht Musc Image Planar Mult (78454) |
$2,388.15 |
$5,307 |
1.9× |
| Ht Muscle Image Spect Sing (78451) |
$2,281.95 |
$5,071 |
1.9× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) |
$554.85 |
$1,233 |
0.8× |
| Hysterosalpingogram (74740) |
$823.50 |
$1,830 |
3.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$301.50 |
$670 |
3.7× |
| Infant hip ultrasound, limited static exam (76886) |
$284.40 |
$632 |
3.5× |
| Interstitial radiation source applic complex (77778) |
$4,111.20 |
$9,136 |
6.2× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,716.75 |
$3,815 |
2.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,387.35 |
$3,083 |
2.7× |
| Intracavitary radiation source applic simple (77761) |
$1,057.05 |
$2,349 |
2.0× |
| K Flow/Funct Image Multiple (78709) |
$1,940.40 |
$4,312 |
3.8× |
| K Flow/Funct Image W/Drug (78708) |
$1,764.90 |
$3,922 |
3.4× |
| K Flow/Funct Image W/O Drug (78707) |
$1,030.05 |
$2,289 |
2.0× |
| Knee 3 Views (73562) |
$356.40 |
$792 |
4.3× |
| Leveen/Shunt Patency Exam (78291) |
$1,411.20 |
$3,136 |
3.7× |
| Liver & Spleen Imaging Static Only (78215) |
$1,010.70 |
$2,246 |
2.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,966.95 |
$4,371 |
5.2× |
| Liver imaging static only (78201) |
$2,078.55 |
$4,619 |
4.0× |
| Lung Perf&Ventilat Diferentl (78598) |
$994.95 |
$2,211 |
1.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,334.15 |
$5,187 |
4.5× |
| Lung Ventilation Imaging (78579) |
$623.25 |
$1,385 |
1.6× |
| Lymph System Imaging (78195) |
$886.05 |
$1,969 |
1.7× |
| Magnetic Image Jaw Joint (70336) |
$736.65 |
$1,637 |
3.3× |
| Mammary ductogram or galactogram multiple (77054) |
$815.85 |
$1,813 |
3.6× |
| Mammary ductogram or galactogram single (77053) |
$556.20 |
$1,236 |
2.5× |
| Meckels Divert Exam (78290) |
$1,437.30 |
$3,194 |
3.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$935.10 |
$2,078 |
2.6× |
| Mr safety determination physician/other qhp (76016) |
$68.40 |
$152 |
0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$18.90 |
$42 |
0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$71.55 |
$159 |
0.8× |
| Mr safety implt pos&/immoblj (76019) |
$46.35 |
$103 |
0.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$187.65 |
$417 |
0.8× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,230.75 |
$2,735 |
3.7× |
| MRA head w/o contrast (70544) |
$860.85 |
$1,913 |
3.8× |
| MRA head with contrast (70545) |
$927.90 |
$2,062 |
2.8× |
| MRA neck w contrast (70548) |
$927.90 |
$2,062 |
2.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,230.75 |
$2,735 |
3.7× |
| MRA neck w/o contrast (70547) |
$860.85 |
$1,913 |
3.8× |
| MRI abdomen w contrast (74182) |
$1,179.90 |
$2,622 |
3.6× |
| MRI abdomen w/o contrast (74181) |
$774 |
$1,720 |
3.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,020.15 |
$2,267 |
1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,352.25 |
$3,005 |
4.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,020.15 |
$2,267 |
1.4× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,013.40 |
$2,252 |
4.5× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,013.40 |
$2,252 |
4.5× |
| MRI cardiac w/o contrast (75557) |
$1,003.05 |
$2,229 |
4.4× |
| MRI cervical spine w contrast (72142) |
$936.90 |
$2,082 |
2.8× |
| MRI cervical spine w/o cont (72141) |
$690.75 |
$1,535 |
3.1× |
| MRI chest w/o contrast (71550) |
$1,013.40 |
$2,252 |
4.5× |
| MRI chest with contrast (71551) |
$1,065.60 |
$2,368 |
1.4× |
| MRI chest wo w contrast (71552) |
$1,565.55 |
$3,479 |
4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,020.15 |
$2,267 |
3.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,352.25 |
$3,005 |
4.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$736.65 |
$1,637 |
3.3× |
| MRI lumbar spine w contrast (72149) |
$1,179.90 |
$2,622 |
3.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,051.65 |
$2,337 |
3.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$441.90 |
$982 |
2.0× |
| MRI orbit face neck w contrast (70542) |
$713.25 |
$1,585 |
2.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$979.20 |
$2,176 |
3.0× |
| MRI pelvis w contrast (72196) |
$1,179.90 |
$2,622 |
3.6× |
| MRI pelvis w/o & w contrast (72197) |
$1,338.30 |
$2,974 |
4.1× |
| MRI pelvis w/o contrast (72195) |
$774 |
$1,720 |
3.4× |
| MRI thoracic spine w/o contrast (72146) |
$869.40 |
$1,932 |
3.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,020.15 |
$2,267 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$736.65 |
$1,637 |
3.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,352.25 |
$3,005 |
4.1× |
| MRI, abdomen, combo (74183) |
$1,338.30 |
$2,974 |
4.1× |
| MRI, dorsal spine combo (72157) |
$1,324.80 |
$2,944 |
4.0× |
| MRI, dorsal spine contrast (72147) |
$1,179.90 |
$2,622 |
3.6× |
| MRI, joint upper extrem (73221) |
$736.65 |
$1,637 |
3.3× |
| MRI, joint upper extrem combo (73223) |
$1,352.25 |
$3,005 |
4.1× |
| MRI, lumbar spine combo (72158) |
$1,325.25 |
$2,945 |
4.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$717.30 |
$1,594 |
1.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,356.90 |
$9,682 |
3.6× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$801.45 |
$1,781 |
1.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,755 |
$3,900 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,759.85 |
$6,133 |
2.3× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,836 |
$4,080 |
1.4× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$2,404.35 |
$5,343 |
1.2× |
| Neck soft tissue (70360) |
$332.10 |
$738 |
4.0× |
| Nm csf leak detection (78650) |
$2,239.20 |
$4,976 |
1.8× |
| Nm myocard infarct spect (78469) |
$1,513.35 |
$3,363 |
2.9× |
| Nonvascular Shunt X-Ray (75809) |
$256.05 |
$569 |
2.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,355.10 |
$9,678 |
3.3× |
| Nuclear Rx Oral Admin (79005) |
$1,589.40 |
$3,532 |
7.2× |
| Ob us nuchal meas 1 gest (76813) |
$463.95 |
$1,031 |
4.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$68.40 |
$152 |
0.7× |
| Panoramic X-ray of jaws (70355) |
$276.30 |
$614 |
3.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$914.85 |
$2,033 |
1.8× |
| Parathyroid Planar Imaging (78070) |
$692.10 |
$1,538 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$240.75 |
$535 |
2.4× |
| Perineogram (74775) |
$634.05 |
$1,409 |
2.8× |
| Pet Image W/Ct Lmtd (78814) |
$3,705.75 |
$8,235 |
2.7× |
| PET image w/CT, full body (78816) |
$3,705.75 |
$8,235 |
2.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,705.75 |
$8,235 |
2.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,509.75 |
$3,355 |
4.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$476.10 |
$1,058 |
4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$677.25 |
$1,505 |
1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$319.50 |
$710 |
3.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$279.90 |
$622 |
3.4× |
| Radex elbow complete minimum 3 views (73080) |
$249.75 |
$555 |
3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$356.40 |
$792 |
3.6× |
| Radex fingr minimum 2 views (73140) |
$265.50 |
$590 |
3.2× |
| Radex foot complete minimum 3 views (73630) |
$276.30 |
$614 |
3.4× |
| Radex Hand Minimum 3 Views (73130) |
$319.50 |
$710 |
3.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$249.75 |
$555 |
3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$241.20 |
$536 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$356.40 |
$792 |
4.3× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$165.15 |
$367 |
2.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$276.30 |
$614 |
3.4× |
| Radex shoulder complete minimum 2 views (73030) |
$261.90 |
$582 |
3.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$133.20 |
$296 |
1.6× |
| Radex Spine 1 View Specify Level (72020) |
$185.85 |
$413 |
2.3× |
| Radex Sternum Minimum 2 Views (71120) |
$302.85 |
$673 |
3.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$337.95 |
$751 |
4.1× |
| Radex Toe Minimum 2 Views (73660) |
$265.50 |
$590 |
3.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$249.75 |
$555 |
2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$351.45 |
$781 |
4.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$12,983.40 |
$28,852 |
1.9× |
| Radiation treatment delivery level 1 (77402) |
$396.90 |
$882 |
4.1× |
| Radiation treatment delivery level 2 (77407) |
$850.50 |
$1,890 |
2.3× |
| Radiation treatment delivery level 3 (77412) |
$850.50 |
$1,890 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$309.60 |
$688 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$332.10 |
$738 |
3.4× |
| Radiologic exam colon double contrast study (74280) |
$842.40 |
$1,872 |
5.1× |
| Radiologic exam colon single contrast study (74270) |
$514.35 |
$1,143 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$379.35 |
$843 |
2.3× |
| Radiologic exam knee complete 4/more views (73564) |
$378 |
$840 |
3.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$327.15 |
$727 |
3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$514.35 |
$1,143 |
3.1× |
| Radiologic exam swallow function contrast study (74230) |
$665.55 |
$1,479 |
4.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$588.60 |
$1,308 |
3.5× |
| Radiologic examination femur minimum 2 views (73552) |
$302.85 |
$673 |
3.7× |
| Radiologic examination knee 1/2 views (73560) |
$278.55 |
$619 |
3.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$432.90 |
$962 |
4.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$270 |
$600 |
3.3× |
| Ribs bilateral 3 views (71110) |
$356.40 |
$792 |
3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,548.90 |
$3,442 |
4.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,703.70 |
$3,786 |
4.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,223 |
$4,940 |
4.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,864.35 |
$4,143 |
3.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,341.70 |
$7,426 |
2.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,050.65 |
$4,557 |
1.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,234.35 |
$2,743 |
5.6× |
| Salivary Gland Imaging Serial Images (78231) |
$912.15 |
$2,027 |
2.4× |
| Scapula (73010) |
$290.70 |
$646 |
2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$83.70 |
$186 |
3.6× |
| Shoulder 1 view (73020) |
$203.85 |
$453 |
2.5× |
| Sialogram (70390) |
$582.75 |
$1,295 |
2.6× |
| Skull less than 4 views (70250) |
$276.30 |
$614 |
2.8× |
| Special dosimetry (77331) |
$330.75 |
$735 |
2.6× |
| Special Physics Consult (77370) |
$841.05 |
$1,869 |
6.6× |
| Special teletherapy port plan (77321) |
$1,302.30 |
$2,894 |
3.7× |
| Special treatment procedure (77470) |
$1,959.75 |
$4,355 |
3.7× |
| Stereotactic Body Radiation Delivery (77373) |
$4,589.55 |
$10,199 |
2.7× |
| Sternoclavicular joints (71130) |
$302.85 |
$673 |
3.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,333.35 |
$2,963 |
3.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,169.55 |
$2,599 |
3.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,757.70 |
$3,906 |
5.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,415.25 |
$3,145 |
4.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$766.35 |
$1,703 |
6.0× |
| Thoracic spine 2 views (72070) |
$278.55 |
$619 |
2.8× |
| Thoracic spine 3 views (72072) |
$307.80 |
$684 |
3.1× |
| Thoracolumbar 2 views (72080) |
$124.20 |
$276 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$310.95 |
$691 |
0.8× |
| Thyroid Met Imaging Body (78018) |
$1,687.95 |
$3,751 |
3.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$546.75 |
$1,215 |
1.4× |
| Tx Devices Design & Construction Complex (77334) |
$1,035.45 |
$2,301 |
2.9× |
| Tx devices design & construction intermediate (77333) |
$851.40 |
$1,892 |
6.7× |
| Tx devices design & construction simple (77332) |
$523.80 |
$1,164 |
4.1× |
| Ultrasound Breast Limited (76642) |
$256.95 |
$571 |
3.1× |
| Ultrasound elastography first target lesion (76982) |
$642.15 |
$1,427 |
6.5× |
| Ultrasound Elastography Parenchyma (76981) |
$642.15 |
$1,427 |
6.5× |
| Ultrasound Exam Aaa Screen (76706) |
$235.80 |
$524 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$431.10 |
$958 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$284.40 |
$632 |
2.9× |
| Upper gi w/o kub (74240) |
$565.65 |
$1,257 |
3.4× |
| Ureteral Reflux Study (78740) |
$1,251.90 |
$2,782 |
3.3× |
| Urethrocystography retrograde (74450) |
$772.65 |
$1,717 |
3.4× |
| Us breast unilateral complete (76641) |
$256.95 |
$571 |
2.6× |
| Us chest (76604) |
$274.50 |
$610 |
2.8× |
| Us exam, pelvic, limited (76857) |
$283.95 |
$631 |
2.9× |
| Us head (76506) |
$301.50 |
$670 |
3.0× |
| Us kidney transplant (76776) |
$384.30 |
$854 |
3.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$238.50 |
$530 |
2.4× |
| Us ob detailed single fetus (76811) |
$702.45 |
$1,561 |
3.1× |
| Us ob limited 1 or more fetuses (76815) |
$279.90 |
$622 |
2.8× |
| Us ob transvaginal (76817) |
$306.45 |
$681 |
3.1× |
| Us pelvic non ob complete (76856) |
$447.75 |
$995 |
4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$309.15 |
$687 |
3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$279.90 |
$622 |
2.8× |
| Us retroperitoneal complete (76770) |
$376.65 |
$837 |
3.8× |
| Us retroperitoneal limited (76775) |
$376.65 |
$837 |
3.8× |
| Us scrotum and contents (76870) |
$412.65 |
$917 |
4.2× |
| Us spinal canal and contents (76800) |
$473.85 |
$1,053 |
4.8× |
| Us thyroid (76536) |
$388.35 |
$863 |
3.9× |
| Us transrectal (76872) |
$493.20 |
$1,096 |
5.0× |
| Vascular Flow Imaging (78445) |
$1,090.80 |
$2,424 |
2.9× |
| Venography caval inferior serialography rs&i (75825) |
$1,864.80 |
$4,144 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$1,734.75 |
$3,855 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$997.65 |
$2,217 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$114.75 |
$255 |
1.4× |
| Wrist 2 views (73100) |
$265.05 |
$589 |
3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$356.40 |
$792 |
4.3× |
| X-ray antegrade pyelogram tube (74425) |
$772.65 |
$1,717 |
2.3× |
| X-Ray Aorta Leg Arteries (75630) |
$4,726.35 |
$10,503 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$225.90 |
$502 |
2.7× |
| X-Ray Exam Breast Specimen (76098) |
$291.15 |
$647 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$176.40 |
$392 |
2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$264.15 |
$587 |
2.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$176.40 |
$392 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$309.60 |
$688 |
3.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$402.30 |
$894 |
4.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$396.45 |
$881 |
4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$450 |
$1,000 |
4.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$505.35 |
$1,123 |
5.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$278.55 |
$619 |
3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$468.45 |
$1,041 |
4.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$397.35 |
$883 |
4.0× |
| X-ray eye for foreign body (70030) |
$176.40 |
$392 |
2.1× |
| X-ray humerus (73060) |
$344.25 |
$765 |
4.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$290.70 |
$646 |
2.9× |
| X-ray nose-rectum child f.b. (76010) |
$106.20 |
$236 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$397.35 |
$883 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$309.60 |
$688 |
3.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$240.30 |
$534 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$337.95 |
$751 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$309.60 |
$688 |
3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$388.35 |
$863 |
3.9× |
| X-ray thoracic spine 4 vw (72074) |
$356.40 |
$792 |
3.6× |
| X-Ray Tmj Unilat (70328) |
$337.95 |
$751 |
4.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$850.05 |
$1,889 |
2.6× |
| X-Rays Bone Length Studies (77073) |
$304.65 |
$677 |
3.1× |
| X-Rays Bone Survey Complete (77075) |
$526.95 |
$1,171 |
5.3× |
| Xr c-spine 4 or 5 views (72050) |
$434.70 |
$966 |
4.4× |
| Xr facial bones less than 3 views (70140) |
$244.35 |
$543 |
3.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$241.20 |
$536 |
2.4× |
| Xr orbits complete 4 views (70200) |
$162 |
$360 |
1.6× |