| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,514.30 |
$6,127 |
3.9× |
| Abdomen 1 View (74018) |
$573.30 |
$637 |
6.4× |
| Abdomen 2 views (74019) |
$888.30 |
$987 |
8.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,144.80 |
$1,272 |
2.8× |
| Angio pulmonary bilat (75743) |
$3,985.20 |
$4,428 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$5,828.40 |
$6,476 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$5,828.40 |
$6,476 |
1.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,548.70 |
$3,943 |
1.1× |
| Ankle 2 views (73600) |
$129.60 |
$144 |
1.5× |
| Aortography thoracic serialography rs&i (75605) |
$4,865.40 |
$5,406 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$7,030.80 |
$7,812 |
1.2× |
| Artery X-Rays Pelvis (75736) |
$5,688 |
$6,320 |
1.0× |
| Artery X-Rays Spine (75705) |
$6,100.20 |
$6,778 |
1.1× |
| Arthrogram hip (73525) |
$1,650.60 |
$1,834 |
4.6× |
| Arthrogram Wrist (73115) |
$1,080 |
$1,200 |
3.0× |
| Basic radiation dosimetry calculation (77300) |
$545.40 |
$606 |
4.0× |
| Bone age studies (77072) |
$763.20 |
$848 |
7.1× |
| Bone Imaging 3 Phase (78315) |
$3,301.20 |
$3,668 |
8.1× |
| Bone Imaging Limited Area (78300) |
$1,271.70 |
$1,413 |
3.1× |
| Bone Imaging Whole Body (78306) |
$2,763.90 |
$3,071 |
6.8× |
| Bone survey infant (77076) |
$835.20 |
$928 |
7.8× |
| Brachytx isodose intermed (77317) |
$1,824.30 |
$2,027 |
4.8× |
| Brachytx Isodose Plan Simple (77316) |
$1,213.20 |
$1,348 |
3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,561.40 |
$2,846 |
4.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,820.20 |
$7,578 |
4.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,254.30 |
$4,727 |
11.9× |
| Cat Scan Follow-Up Study (76380) |
$1,236.60 |
$1,374 |
13.9× |
| Cerebrospinal Fluid Scan (78630) |
$1,842.30 |
$2,047 |
3.3× |
Chest 1 view (71045)
range across 2 matching MRF lines |
$331.20–$509.40 |
$368–$566 |
varies |
Chest 2 views (71046)
range across 2 matching MRF lines |
$537.30–$826.20 |
$597–$918 |
varies |
| Chest 3 views (71047) |
$905.40 |
$1,006 |
10.2× |
| Chest 4 or more views (71048) |
$935.10 |
$1,039 |
8.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$545.40 |
$606 |
5.1× |
| Clavicle complete (73000) |
$193.50 |
$215 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,156.40 |
$2,396 |
20.2× |
| Continuing medical physics consltj pr wk (77336) |
$760.50 |
$845 |
5.5× |
| Contrast Exam Abdominl Aorta (75625) |
$5,702.40 |
$6,336 |
1.8× |
| Contrast X-Ray Bladder (74430) |
$941.40 |
$1,046 |
2.6× |
| Contrast X-Ray Of Elbow (73085) |
$1,016.10 |
$1,129 |
2.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,016.10 |
$1,129 |
2.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,335.10 |
$7,039 |
17.8× |
| CT abdomen and pelvis without contrast (74176) |
$6,335.10 |
$7,039 |
26.0× |
| CT abdomen w contrast (74160) |
$2,852.10 |
$3,169 |
15.9× |
| CT abdomen w wo contrast (74170) |
$3,231.90 |
$3,591 |
18.0× |
| CT abdomen w/o contrast (74150) |
$2,471.40 |
$2,746 |
23.1× |
| CT Angio Abdomen and Pelvis (74174) |
$5,937.30 |
$6,597 |
16.7× |
| CT Angio Chest (71275) |
$3,802.50 |
$4,225 |
21.2× |
| CT Angio Head (70496) |
$3,802.50 |
$4,225 |
21.2× |
| CT angio hrt w/3d image (75574) |
$6,805.80 |
$7,562 |
19.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,802.50 |
$4,225 |
21.2× |
| CT Angio Neck (70498) |
$3,802.50 |
$4,225 |
21.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,802.50 |
$4,225 |
21.2× |
| CT cervical spine w/ contrast (72126) |
$3,992.40 |
$4,436 |
11.2× |
| CT cervical spine w/o contrast (72125) |
$3,802.50 |
$4,225 |
35.6× |
| CT cervical spine w/wo cont (72127) |
$4,164.30 |
$4,627 |
23.2× |
| CT chest w contrast (71260) |
$3,802.50 |
$4,225 |
21.2× |
| CT chest w/wo contrast (71270) |
$3,992.40 |
$4,436 |
22.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$2,471.40 |
$2,746 |
23.1× |
| CT head/brain with contrast (70460) |
$3,992.40 |
$4,436 |
22.3× |
| CT head/brain without and with contrast (70470) |
$4,182.30 |
$4,647 |
23.3× |
| CT iac w contrast (70481) |
$2,852.10 |
$3,169 |
15.9× |
| CT l-spine w&w/o contrast (72133) |
$4,164.30 |
$4,627 |
23.2× |
| CT lower ext w/o (73700) |
$3,802.50 |
$4,225 |
35.6× |
| CT lower extremity w/contrast material (73701) |
$3,992.40 |
$4,436 |
22.3× |
| CT lumbar spine w contrast (72132) |
$3,992.40 |
$4,436 |
11.2× |
| CT lumbar spine w/o contrast (72131) |
$3,802.50 |
$4,225 |
35.6× |
| CT maxillofacial w contrast (70487) |
$3,992.40 |
$4,436 |
22.3× |
| CT maxillofacial wo contrast (70486) |
$3,802.50 |
$4,225 |
35.6× |
| CT neck tissue combo (70492) |
$3,611.70 |
$4,013 |
20.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,421.80 |
$3,802 |
19.1× |
| CT orbits w/o contrast (70480) |
$2,471.40 |
$2,746 |
23.1× |
| CT pelvis w&w/o contrast (72194) |
$4,164.30 |
$4,627 |
23.2× |
| CT pelvis w/o contrast (72192) |
$3,802.50 |
$4,225 |
35.6× |
| CT scan of leg combo (73702) |
$4,182.30 |
$4,647 |
23.3× |
| CT scans face/jaw combo (70488) |
$4,182.30 |
$4,647 |
23.3× |
| CT soft tissue neck w contrast (70491) |
$3,231.90 |
$3,591 |
18.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,916.90 |
$3,241 |
27.3× |
| CT thoracic spine w contrast (72129) |
$3,992.40 |
$4,436 |
22.3× |
| CT thoracic spine w/o contrast (72128) |
$3,802.50 |
$4,225 |
35.6× |
| CT thoracic spine w/wo cont (72130) |
$4,164.30 |
$4,627 |
23.2× |
| CT thorax w/o contrast (71250) |
$2,962.80 |
$3,292 |
27.7× |
| CT upper ext wo (73200) |
$3,802.50 |
$4,225 |
35.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$4,182.30 |
$4,647 |
23.3× |
| CT upper extremity with contrast (73201) |
$3,992.40 |
$4,436 |
11.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$5,674.50 |
$6,305 |
31.7× |
| Cta Abdomen (74175) |
$2,583 |
$2,870 |
14.4× |
| CTA pelvis (72191) |
$2,471.40 |
$2,746 |
13.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$145.80 |
$162 |
1.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$953.10 |
$1,059 |
8.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$197.10 |
$219 |
1.8× |
| Dxa Bone Density Axial (77080) |
$847.80 |
$942 |
7.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$468 |
$520 |
5.3× |
| Echo exam of fetal heart (76825) |
$1,719.90 |
$1,911 |
3.1× |
| Echo Guide For Artery Repair (76936) |
$2,707.20 |
$3,008 |
12.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$2,156.40 |
$2,396 |
8.8× |
| Echograp Trans R Pros Study (76873) |
$935.10 |
$1,039 |
8.8× |
| Esophagram (74220) |
$1,143.90 |
$1,271 |
6.4× |
| Fetal Biophys Profile W/Nst (76818) |
$1,160.10 |
$1,289 |
10.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,016.10 |
$1,129 |
9.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$4,803.30 |
$5,337 |
19.7× |
| Fluoroscopy up to 1 hr (76000) |
$799.20 |
$888 |
3.3× |
| Follow-Up Angiography (75898) |
$2,833.20 |
$3,148 |
0.9× |
| Foot 2 views (73620) |
$252 |
$280 |
2.8× |
| Forearm 2 views (73090) |
$256.50 |
$285 |
2.9× |
| Gastric emptying imaging study (78264) |
$3,296.70 |
$3,663 |
8.1× |
| Gastroesophageal Reflux Exam (78262) |
$2,266.20 |
$2,518 |
5.5× |
| Gated Heart Planar Single (78472) |
$1,646.10 |
$1,829 |
4.0× |
| Hand 2 views (73120) |
$190.80 |
$212 |
1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$6,273 |
$6,970 |
8.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$6,807.60 |
$7,564 |
9.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$4,425.30 |
$4,917 |
6.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,301.10 |
$4,779 |
1.3× |
| Hepatobil Syst Image W/Drug (78227) |
$3,168 |
$3,520 |
5.7× |
| Hepatobiliary System Imaging (78226) |
$3,168 |
$3,520 |
7.8× |
| Ht Muscle Image Spect Sing (78451) |
$2,844.90 |
$3,161 |
2.2× |
| Hysterosalpingogram (74740) |
$1,369.80 |
$1,522 |
5.6× |
| Image fusion (77399) |
$1,190.70 |
$1,323 |
8.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,440.90 |
$1,601 |
16.2× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) |
$13,455.90 |
$14,951 |
1.8× |
| K Flow/Funct Image W/Drug (78708) |
$3,168 |
$3,520 |
5.7× |
| K Flow/Funct Image W/O Drug (78707) |
$1,885.50 |
$2,095 |
3.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$695.70 |
$773 |
1.7× |
| Kidney Imaging Morphol (78700) |
$1,206 |
$1,340 |
3.0× |
| Knee 3 Views (73562) |
$256.50 |
$285 |
2.9× |
| Liver & Spleen Imaging Static Only (78215) |
$1,372.50 |
$1,525 |
3.4× |
| Liver imaging w/vascular flow (78202) |
$3,403.80 |
$3,782 |
6.1× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,420.10 |
$2,689 |
4.4× |
| Lung perfusion differential (78597) |
$1,954.80 |
$2,172 |
4.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,090.70 |
$2,323 |
3.8× |
| Lymph System Imaging (78195) |
$3,548.70 |
$3,943 |
6.4× |
| Magnetic Image Jaw Joint (70336) |
$4,803.30 |
$5,337 |
19.7× |
| Magnetic Resonance Elastography (76391) |
$990 |
$1,100 |
4.1× |
| Meckels Divert Exam (78290) |
$1,737.90 |
$1,931 |
4.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,440.90 |
$1,601 |
3.8× |
| Mra Head W/O & W/Contrast Material (70546) |
$5,068.80 |
$5,632 |
14.2× |
| MRA head w/o contrast (70544) |
$4,054.50 |
$4,505 |
16.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,575.50 |
$6,195 |
15.6× |
| MRA neck w/o contrast (70547) |
$5,068.80 |
$5,632 |
20.8× |
| MRI abdomen w/o contrast (74181) |
$4,054.50 |
$4,505 |
16.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$5,321.70 |
$5,913 |
6.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,575.50 |
$6,195 |
15.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$5,321.70 |
$5,913 |
6.6× |
| MRI bone marrow blood supply (77084) |
$4,803.30 |
$5,337 |
19.7× |
| MRI Breast W/O Contrast Bilateral (77047) |
$4,803.30 |
$5,337 |
19.7× |
| MRI cardiac w/o contrast (75557) |
$4,803.30 |
$5,337 |
19.7× |
| MRI cervical spine w contrast (72142) |
$5,321.70 |
$5,913 |
14.9× |
| MRI cervical spine w/o cont (72141) |
$5,068.80 |
$5,632 |
20.8× |
| MRI chest w/o contrast (71550) |
$4,308.30 |
$4,787 |
17.7× |
| MRI chest wo w contrast (71552) |
$4,803.30 |
$5,337 |
13.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,321.70 |
$5,913 |
14.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,068.80 |
$5,632 |
20.8× |
| MRI lumbar spine w contrast (72149) |
$4,967.10 |
$5,519 |
13.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$5,575.50 |
$6,195 |
15.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,054.50 |
$4,505 |
16.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$5,068.80 |
$5,632 |
14.2× |
| MRI pelvis w/o & w contrast (72197) |
$4,054.50 |
$4,505 |
11.4× |
| MRI pelvis w/o contrast (72195) |
$3,294.90 |
$3,661 |
13.5× |
| MRI thoracic spine w/o contrast (72146) |
$5,068.80 |
$5,632 |
20.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,826.70 |
$5,363 |
19.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$5,321.70 |
$5,913 |
14.9× |
| MRI, abdomen, combo (74183) |
$5,068.80 |
$5,632 |
14.2× |
| MRI, dorsal spine combo (72157) |
$5,575.50 |
$6,195 |
15.6× |
| MRI, dorsal spine contrast (72147) |
$5,310 |
$5,900 |
14.9× |
| MRI, joint upper extrem (73221) |
$5,068.80 |
$5,632 |
20.8× |
| MRI, joint upper extrem combo (73223) |
$5,575.50 |
$6,195 |
15.6× |
| MRI, lumbar spine combo (72158) |
$5,068.80 |
$5,632 |
14.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$8,246.70 |
$9,163 |
6.2× |
| Myocardial Spect Multiple Studies (78452) |
$6,491.70 |
$7,213 |
4.9× |
| N-invas est c ffr sw aly CTA (75580) |
$2,259.90 |
$2,511 |
2.6× |
| Neck soft tissue (70360) |
$509.40 |
$566 |
5.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,393.20 |
$1,548 |
3.4× |
| Nonvascular Shunt X-Ray (75809) |
$743.40 |
$826 |
7.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,027.30 |
$6,697 |
4.3× |
| Nuclear Rx Intra-Arterial (79445) |
$1,901.70 |
$2,113 |
8.0× |
| Nuclear Rx Oral Admin (79005) |
$2,156.40 |
$2,396 |
9.0× |
| Ob us nuchal meas 1 gest (76813) |
$2,054.70 |
$2,283 |
19.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$103.50 |
$115 |
1.0× |
| Panoramic X-ray of jaws (70355) |
$433.80 |
$482 |
4.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$3,504.60 |
$3,894 |
6.3× |
| Parathyroid Planar Imaging (78070) |
$2,397.60 |
$2,664 |
5.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,325.60 |
$2,584 |
5.7× |
| Pelvis 1 or 2 views (72170) |
$153 |
$170 |
1.4× |
| PET image w/CT, full body (78816) |
$10,513.80 |
$11,682 |
7.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$10,513.80 |
$11,682 |
7.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,791.70 |
$4,213 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,617.30 |
$1,797 |
4.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$1,002.60 |
$1,114 |
9.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$986.40 |
$1,096 |
1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$256.50 |
$285 |
2.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$129.60 |
$144 |
1.5× |
| Radex elbow complete minimum 3 views (73080) |
$256.50 |
$285 |
2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$726.30 |
$807 |
6.8× |
| Radex fingr minimum 2 views (73140) |
$162 |
$180 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$320.40 |
$356 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$320.40 |
$356 |
3.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$953.10 |
$1,059 |
10.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$118.80 |
$132 |
1.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$256.50 |
$285 |
2.9× |
| Radex shoulder complete minimum 2 views (73030) |
$402.30 |
$447 |
4.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$156.60 |
$174 |
1.8× |
| Radex Spine 1 View Specify Level (72020) |
$509.40 |
$566 |
5.7× |
| Radex Sternum Minimum 2 Views (71120) |
$90.90 |
$101 |
1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$626.40 |
$696 |
7.0× |
| Radex Toe Minimum 2 Views (73660) |
$256.50 |
$285 |
2.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$763.20 |
$848 |
7.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$269.10 |
$299 |
3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$805.50 |
$895 |
7.5× |
| Radiation treatment delivery level 1 (77402) |
$745.20 |
$828 |
7.1× |
| Radiation treatment delivery level 3 (77412) |
$1,699.20 |
$1,888 |
3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$423.90 |
$471 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$738.90 |
$821 |
6.9× |
| Radiologic exam colon double contrast study (74280) |
$2,535.30 |
$2,817 |
14.1× |
| Radiologic exam colon single contrast study (74270) |
$1,269 |
$1,410 |
7.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,143.90 |
$1,271 |
6.4× |
| Radiologic exam knee complete 4/more views (73564) |
$320.40 |
$356 |
3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$206.10 |
$229 |
1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,242 |
$1,380 |
6.9× |
| Radiologic exam swallow function contrast study (74230) |
$888.30 |
$987 |
5.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,521.90 |
$1,691 |
8.5× |
| Radiologic examination femur 1 view (73551) |
$193.50 |
$215 |
2.2× |
| Radiologic examination femur minimum 2 views (73552) |
$256.50 |
$285 |
2.9× |
| Radiologic examination knee 1/2 views (73560) |
$162 |
$180 |
1.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$1,192.50 |
$1,325 |
11.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$256.50 |
$285 |
2.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$6,807.60 |
$7,564 |
17.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$6,482.70 |
$7,203 |
16.5× |
| Renal Cyst Study (74470) |
$1,011.60 |
$1,124 |
1.8× |
| Ribs bilateral 3 views (71110) |
$153 |
$170 |
1.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$2,850.30 |
$3,167 |
7.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$6,306.30 |
$7,007 |
11.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$4,173.30 |
$4,637 |
7.5× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 5 matching MRF lines |
$3,111.30–$3,932.10 |
$3,457–$4,369 |
varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$7,101.90 |
$7,891 |
5.4× |
| Rp Therapy Intravenous Administration (79101) |
$1,354.50 |
$1,505 |
5.7× |
| Scapula (73010) |
$146.70 |
$163 |
1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$71.10 |
$79 |
3.0× |
| Shoulder 1 view (73020) |
$383.40 |
$426 |
4.3× |
| Shoulder Arthrography (73040) |
$1,650.60 |
$1,834 |
4.6× |
| Skull less than 4 views (70250) |
$853.20 |
$948 |
8.0× |
| Special dosimetry (77331) |
$505.80 |
$562 |
3.7× |
| Special Physics Consult (77370) |
$1,190.70 |
$1,323 |
8.7× |
| Special teletherapy port plan (77321) |
$2,332.80 |
$2,592 |
6.1× |
| Special treatment procedure (77470) |
$2,994.30 |
$3,327 |
5.3× |
| Srs Multisource (77371) |
$15,900.30 |
$17,667 |
2.1× |
| Stereotactic Body Radiation Delivery (77373) |
$10,006.20 |
$11,118 |
5.5× |
| Sternoclavicular joints (71130) |
$608.40 |
$676 |
6.8× |
| Superior sagittal sinus venogram (75870) |
$2,833.20 |
$3,148 |
0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,786.50 |
$1,985 |
4.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,846.70 |
$3,163 |
7.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,052.10 |
$1,169 |
7.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$2,106.90 |
$2,341 |
11.8× |
| Thoracic spine 2 views (72070) |
$509.40 |
$566 |
4.8× |
| Thoracic spine 3 views (72072) |
$535.50 |
$595 |
5.0× |
| Thoracolumbar 2 views (72080) |
$869.40 |
$966 |
9.8× |
| Thyroid Met Imaging Body (78018) |
$3,120.30 |
$3,467 |
5.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,052.90 |
$2,281 |
5.0× |
| Tx Devices Design & Construction Complex (77334) |
$2,353.50 |
$2,615 |
6.2× |
| Tx devices design & construction intermediate (77333) |
$920.70 |
$1,023 |
6.7× |
| Tx devices design & construction simple (77332) |
$696.60 |
$774 |
5.1× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$537.30–$805.50 |
$597–$895 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$888.30 |
$987 |
8.3× |
| Ultrasound, abdomen limited (76705) |
$1,208.70 |
$1,343 |
11.3× |
| Umbilical-artery Doppler (OB) (76820) |
$145.80 |
$162 |
1.4× |
| Unlisted fluoroscopic procedure (76496) |
$912.60 |
$1,014 |
10.3× |
| Upper gi w/o kub (74240) |
$1,475.10 |
$1,639 |
8.2× |
| Urethrocystogram voiding (74455) |
$2,250.90 |
$2,501 |
9.2× |
| Urethrocystography retrograde (74450) |
$1,016.10 |
$1,129 |
4.2× |
Us breast unilateral complete (76641)
range across 3 matching MRF lines |
$1,556.10–$2,334.60 |
$1,729–$2,594 |
varies |
| Us chest (76604) |
$1,067.40 |
$1,186 |
10.0× |
| Us complete joint (76881) |
$1,521.90 |
$1,691 |
14.2× |
| Us exam, pelvic, limited (76857) |
$242.10 |
$269 |
2.3× |
| Us head (76506) |
$1,628.10 |
$1,809 |
15.2× |
| Us kidney transplant (76776) |
$1,073.70 |
$1,193 |
10.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$874.80 |
$972 |
8.2× |
| Us ob detailed single fetus (76811) |
$2,054.70 |
$2,283 |
8.4× |
| Us ob limited 1 or more fetuses (76815) |
$725.40 |
$806 |
6.8× |
| Us ob transvaginal (76817) |
$573.30 |
$637 |
5.4× |
Us pelvic non ob complete (76856)
range across 2 matching MRF lines |
$136.80–$1,173.60 |
$152–$1,304 |
varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,521.90 |
$1,691 |
14.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$573.30 |
$637 |
5.4× |
| Us retroperitoneal complete (76770) |
$1,308.60 |
$1,454 |
12.3× |
| Us retroperitoneal limited (76775) |
$801 |
$890 |
7.5× |
| Us scrotum and contents (76870) |
$1,204.20 |
$1,338 |
11.3× |
| Us spinal canal and contents (76800) |
$1,512 |
$1,680 |
14.2× |
| Us thyroid (76536) |
$953.10 |
$1,059 |
8.9× |
| Vein X-Ray Chest (75827) |
$3,507.30 |
$3,897 |
2.2× |
| Vein X-Ray Spleen/Liver (75810) |
$4,084.20 |
$4,538 |
1.3× |
| Venogram Sinus/Jugular (75860) |
$5,155.20 |
$5,728 |
1.6× |
| Venography Adrenal Unilateral (75840) |
$2,914.20 |
$3,238 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$4,728.60 |
$5,254 |
1.5× |
| Venography extremity bilateral rs&i (75822) |
$2,552.40 |
$2,836 |
1.6× |
| Venography extremity unilateral rs&i (75820) |
$2,021.40 |
$2,246 |
1.3× |
| Venography Renal Unilateral (75831) |
$4,084.20 |
$4,538 |
1.3× |
| Venous sampling by catheter (75893) |
$6,100.20 |
$6,778 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$238.50 |
$265 |
2.7× |
| Wrist 2 views (73100) |
$256.50 |
$285 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$339.30 |
$377 |
3.8× |
| X-ray antegrade pyelogram tube (74425) |
$1,253.70 |
$1,393 |
3.5× |
| X-Ray Aorta Leg Arteries (75630) |
$3,469.50 |
$3,855 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$637.20 |
$708 |
6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$193.50 |
$215 |
2.2× |
| X-Ray Exam Breast Specimen (76098) |
$895.50 |
$995 |
1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$318.60 |
$354 |
3.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$605.70 |
$673 |
5.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$726.30 |
$807 |
6.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$162 |
$180 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$256.50 |
$285 |
2.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$320.40 |
$356 |
3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$213.30 |
$237 |
2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$320.40 |
$356 |
3.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$346.50 |
$385 |
3.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$763.20 |
$848 |
7.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$509.40 |
$566 |
5.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$883.80 |
$982 |
8.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$384.30 |
$427 |
3.6× |
| X-ray eye for foreign body (70030) |
$1,271.70 |
$1,413 |
14.3× |
| X-ray humerus (73060) |
$256.50 |
$285 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$748.80 |
$832 |
8.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$218.70 |
$243 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$509.40 |
$566 |
4.8× |
| X-ray nose-rectum child f.b. (76010) |
$213.30 |
$237 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$729.90 |
$811 |
6.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$524.70 |
$583 |
4.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$493.20 |
$548 |
4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$256.50 |
$285 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$429.30 |
$477 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,269.90 |
$1,411 |
11.9× |
| X-Ray Stress View (77071) |
$383.40 |
$426 |
4.3× |
| X-ray thoracic spine 4 vw (72074) |
$763.20 |
$848 |
7.1× |
| X-Ray Tmj Unilat (70328) |
$423.90 |
$471 |
4.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,269 |
$1,410 |
3.6× |
| X-Rays Bone Length Studies (77073) |
$576 |
$640 |
5.4× |
| X-Rays Bone Survey Complete (77075) |
$1,265.40 |
$1,406 |
11.8× |
| Xr c-spine 4 or 5 views (72050) |
$763.20 |
$848 |
7.1× |
| Xr facial bones less than 3 views (70140) |
$603.90 |
$671 |
6.8× |
| Xr orbits complete 4 views (70200) |
$505.80 |
$562 |
4.7× |