| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,831.64 |
$6,742 |
2.0× |
| Abdomen 2 views (74019) |
$85.68 |
$204 |
0.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$664.86 |
$1,583 |
1.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,682.56 |
$8,768 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$2,436.42 |
$5,801 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,985.34 |
$4,727 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$1,648.50 |
$3,925 |
0.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,852.22 |
$6,791 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,677.14 |
$13,517 |
1.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,368.40 |
$8,020 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$2,852.22 |
$6,791 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,985.78 |
$7,109 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$927.36 |
$2,208 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,406.20 |
$8,110 |
1.1× |
| Ankle 2 views (73600) |
$73.50 |
$175 |
0.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$278.46 |
$663 |
0.8× |
| Aortogram thoracic (75605) |
$3,202.92 |
$7,626 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,342.34 |
$5,577 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$1,921.92 |
$4,576 |
0.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,978.64 |
$7,092 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,454.90 |
$5,845 |
0.8× |
| Arthrogram elbow (73085) |
$230.58 |
$549 |
0.6× |
| Arthrogram hip (73525) |
$230.58 |
$549 |
0.6× |
| Arthrogram shoulder (73040) |
$413.28 |
$984 |
1.2× |
| Arthrogram wrist (73115) |
$236.46 |
$563 |
0.7× |
| Arthrography knee lt (73580) |
$230.58 |
$549 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$275.94 |
$657 |
2.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$745.92 |
$1,776 |
1.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$760.20 |
$1,810 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,035.30 |
$2,465 |
2.5× |
| Bone age studies (77072) |
$67.20 |
$160 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$1,307.04 |
$3,112 |
3.2× |
| Bone Marrow Imaging Limited Area (78102) |
$343.98 |
$819 |
0.8× |
| Bone survey complete (77075) |
$130.62 |
$311 |
1.2× |
| Brachytx isodose complex (77318) |
$687.96 |
$1,638 |
1.8× |
| Brachytx isodose intermed (77317) |
$651.84 |
$1,552 |
1.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$494.34 |
$1,177 |
1.3× |
| Brain image w/flow 4 + views (78606) |
$583.80 |
$1,390 |
1.1× |
| Brain imaging < 4 static views (78600) |
$328.02 |
$781 |
0.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$385.14 |
$917 |
0.9× |
| Brain Imaging Minimum 4 Static Views (78605) |
$351.54 |
$837 |
0.6× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$251.16 |
$598 |
22.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$658.56 |
$1,568 |
1.8× |
| Cardiac shunt detection (78428) |
$636.30 |
$1,515 |
1.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$514.50 |
$1,225 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$78.96 |
$188 |
0.9× |
| Chest 1 view (71045) |
$78.96 |
$188 |
0.9× |
| Chest 3 views (71047) |
$132.30 |
$315 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$181.44 |
$432 |
1.0× |
| Clavicle complete (73000) |
$78.96 |
$188 |
0.9× |
| Continuing medical physics consltj pr wk (77336) |
$279.72 |
$666 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,275.96 |
$3,038 |
3.6× |
| CT abdomen and pelvis without contrast (74176) |
$850.50 |
$2,025 |
3.5× |
| CT abdomen w contrast (74160) |
$490.14 |
$1,167 |
2.7× |
| CT abdomen w wo contrast (74170) |
$588 |
$1,400 |
3.3× |
| CT abdomen w/o contrast (74150) |
$391.86 |
$933 |
3.7× |
| CT angio hrt w/3d image (75574) |
$523.74 |
$1,247 |
1.5× |
| CT angiography upper extremity lt (73206) |
$727.44 |
$1,732 |
4.1× |
| CT c-spine w/o contrast (72125) |
$649.32 |
$1,546 |
6.1× |
| CT cervical spine w&w/o contrast (72127) |
$973.98 |
$2,319 |
5.4× |
| CT cervical spine with contrast (72126) |
$811.86 |
$1,933 |
2.3× |
| CT chest w/wo contrast (71270) |
$694.26 |
$1,653 |
3.9× |
| CT chest with contrast (71260) |
$578.76 |
$1,378 |
3.2× |
| CT colonography screening (74263) |
$576.24 |
$1,372 |
2.4× |
| CT colonography w/dye (74262) |
$430.50 |
$1,025 |
2.4× |
| CT colonography w/o cntrst (74261) |
$344.40 |
$820 |
3.2× |
| CT head/brain with contrast (70460) |
$811.86 |
$1,933 |
4.5× |
| CT head/brain without and with contrast (70470) |
$973.98 |
$2,319 |
5.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$415.38 |
$989 |
1.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$73.08 |
$174 |
0.8× |
| CT hrt w/3d image congen (75573) |
$498.54 |
$1,187 |
1.4× |
| CT iac w contrast (70481) |
$811.86 |
$1,933 |
4.5× |
| CT limited/localized follow up study (76380) |
$245.70 |
$585 |
2.8× |
| CT lower ext w/o (73700) |
$649.32 |
$1,546 |
6.1× |
| CT lower extremity w wo contrast (73702) |
$973.98 |
$2,319 |
5.4× |
| CT lower extremity with contrast (73701) |
$811.86 |
$1,933 |
4.5× |
| CT lumbar spine w & w/o contrast (72133) |
$963.48 |
$2,294 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$642.18 |
$1,529 |
6.0× |
| CT lumbar spine with contrast (72132) |
$803.04 |
$1,912 |
2.3× |
| CT maxillofacial w contrast (70487) |
$811.86 |
$1,933 |
4.5× |
| CT maxillofacial w/o contrast (70486) |
$649.32 |
$1,546 |
6.1× |
| CT maxillofacial w/wo contrast (70488) |
$973.98 |
$2,319 |
5.4× |
| CT neck soft tissue w contrast (70491) |
$813.96 |
$1,938 |
4.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$973.98 |
$2,319 |
5.4× |
| CT orbits w/o contrast (70480) |
$649.32 |
$1,546 |
6.1× |
| CT pelvis w & w/o contrast (72194) |
$577.92 |
$1,376 |
3.2× |
| CT pelvis w/o contrast (72192) |
$385.14 |
$917 |
3.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$976.50 |
$2,325 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$651 |
$1,550 |
6.1× |
| CT thoracic spine w/contrast (72129) |
$809.34 |
$1,927 |
4.5× |
| CT thoracic spine w/o contrast (72128) |
$647.22 |
$1,541 |
6.1× |
| CT thoracic spine w/wo contrast (72130) |
$971.04 |
$2,312 |
5.4× |
| CT thorax w/o contrast (71250) |
$462.84 |
$1,102 |
4.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$692.58 |
$1,649 |
3.9× |
| CT upper extremity w/o contrast rt (73200) |
$461.58 |
$1,099 |
4.3× |
| CT upper extremity with contrast (73201) |
$577.08 |
$1,374 |
1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$685.86 |
$1,633 |
3.8× |
| Cta Abdomen (74175) |
$617.40 |
$1,470 |
3.4× |
| CTA abdomen pelvis (74174) |
$1,339.80 |
$3,190 |
3.8× |
| CTA chest (71275) |
$729.12 |
$1,736 |
4.1× |
| Cta Head (70496) |
$1,022.70 |
$2,435 |
5.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,022.70 |
$2,435 |
5.7× |
| Cta Neck (70498) |
$1,025.64 |
$2,442 |
5.7× |
| Cta Pelvis (72191) |
$606.90 |
$1,445 |
3.4× |
| Cystography minimum 3 views rs&i (74430) |
$315.42 |
$751 |
0.9× |
| Diskogram cervical (72285) |
$2,344.44 |
$5,582 |
1.2× |
| Diskography lumbar (72295) |
$1,344 |
$3,200 |
0.7× |
| Echoencephalography real time imaging (76506) |
$107.94 |
$257 |
1.0× |
| Esophagus (74220) |
$143.22 |
$341 |
0.8× |
| Fetal biophysical profile non-stress testing (76818) |
$226.80 |
$540 |
2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$162.54 |
$387 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$385.56 |
$918 |
1.6× |
| Foot 2 views (73620) |
$68.04 |
$162 |
0.8× |
| Forearm 2 views (73090) |
$70.98 |
$169 |
0.8× |
| Gated Heart Planar Single (78472) |
$781.62 |
$1,861 |
1.9× |
| Hand 2 views (73120) |
$68.88 |
$164 |
0.6× |
| Hand 3 views (73130) |
$78.96 |
$188 |
0.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,834.56 |
$4,368 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,285.22 |
$5,441 |
3.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,376.78 |
$5,659 |
3.3× |
| Heart Infarct Image (78466) |
$452.34 |
$1,077 |
1.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,954.68 |
$4,654 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,071.84 |
$2,552 |
1.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$758.10 |
$1,805 |
1.9× |
| Ht muscle image spect sing (78451) |
$556.50 |
$1,325 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$78.96 |
$188 |
0.9× |
| Hysterosalpingogram (74740) |
$290.22 |
$691 |
1.2× |
| Interstitial radiation source applic complex (77778) |
$1,666.56 |
$3,968 |
2.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,125.18 |
$2,679 |
1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$787.50 |
$1,875 |
1.4× |
| Intracavitary radiation source applic simple (77761) |
$596.40 |
$1,420 |
1.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$67.20 |
$160 |
0.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$837.48 |
$1,994 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$790.44 |
$1,882 |
1.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$868.14 |
$2,067 |
1.6× |
| Knee 3 views (73562) |
$78.96 |
$188 |
0.9× |
| Liver & spleen imaging static only (78215) |
$557.76 |
$1,328 |
1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$362.88 |
$864 |
0.9× |
| Lung perf&ventilat diferentl (78598) |
$768.60 |
$1,830 |
1.4× |
| Lung perfusion differential (78597) |
$499.38 |
$1,189 |
1.2× |
| Lung Ventilation Imaging (78579) |
$430.92 |
$1,026 |
1.1× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,648.50 |
$3,925 |
0.5× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$705.60 |
$1,680 |
1.1× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,492.26 |
$3,553 |
0.9× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$952.56 |
$2,268 |
0.3× |
| Lymphoscintigraphy (78195) |
$961.80 |
$2,290 |
1.7× |
| Mammary ductogram or galactogram multiple (77054) |
$231.42 |
$551 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$175.98 |
$419 |
0.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$99.54 |
$237 |
1.1× |
| Meckels Diverticulum (78290) |
$632.52 |
$1,506 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$459.48 |
$1,094 |
1.2× |
| Mr safety determination physician/other qhp (76016) |
$55.44 |
$132 |
0.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$125.16 |
$298 |
2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$15.96 |
$38 |
0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$81.90 |
$195 |
0.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$194.04 |
$462 |
0.8× |
| MRA head w & w/o contrast (70546) |
$859.32 |
$2,046 |
2.4× |
| MRA head w/o contrast (70544) |
$572.88 |
$1,364 |
2.4× |
| MRA head with contrast (70545) |
$716.10 |
$1,705 |
2.0× |
| MRA neck w contrast (70548) |
$777.84 |
$1,852 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$933.24 |
$2,222 |
2.6× |
| MRA neck w/o contrast (70547) |
$622.02 |
$1,481 |
2.6× |
| MRI abdomen w contrast (74182) |
$982.38 |
$2,339 |
2.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,178.94 |
$2,807 |
3.3× |
| MRI abdomen w/o contrast (74181) |
$785.82 |
$1,871 |
3.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,000.86 |
$2,383 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,000.86 |
$2,383 |
1.2× |
| MRI bone marrow blood supply (77084) |
$640.50 |
$1,525 |
2.6× |
| MRI breast w/o contrast bilateral (77047) |
$668.22 |
$1,591 |
2.7× |
| MRI breast w/o contrast unilat (77046) |
$445.62 |
$1,061 |
1.8× |
| MRI c-spine with contrast (72142) |
$998.34 |
$2,377 |
2.8× |
| MRI cardiac w/o contrast (75557) |
$438.90 |
$1,045 |
1.8× |
| MRI cervical spine w/o contrast (72141) |
$798.42 |
$1,901 |
3.3× |
| MRI chest w/o & w/contrast material (71552) |
$1,201.62 |
$2,861 |
3.4× |
| MRI chest w/o contrast (71550) |
$800.94 |
$1,907 |
3.3× |
| MRI chest with contrast (71551) |
$1,001.28 |
$2,384 |
1.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$771.96 |
$1,838 |
2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,000.86 |
$2,383 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$800.52 |
$1,906 |
3.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$646.38 |
$1,539 |
2.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$969.78 |
$2,309 |
2.7× |
| MRI orbit/face/neck w/contrast (70542) |
$808.08 |
$1,924 |
2.3× |
| MRI pelvis w contrast (72196) |
$994.14 |
$2,367 |
2.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,192.80 |
$2,840 |
3.3× |
| MRI pelvis w/o contrast (72195) |
$795.06 |
$1,893 |
3.3× |
| MRI scan of arm joint before and after contrast (73223) |
$1,200.78 |
$2,859 |
3.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,200.78 |
$2,859 |
3.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,197.84 |
$2,852 |
3.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,000.86 |
$2,383 |
2.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,200.78 |
$2,859 |
3.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$995.40 |
$2,370 |
2.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,194.48 |
$2,844 |
3.4× |
| MRI thoracic spine w/o contrast (72146) |
$796.32 |
$1,896 |
3.3× |
| MRI tmj (70336) |
$602.70 |
$1,435 |
2.5× |
| MRI upper ext joint w/o contrast (73221) |
$800.52 |
$1,906 |
3.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$926.10 |
$2,205 |
2.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$617.40 |
$1,470 |
2.5× |
| Myelogram Cervical (72240) |
$693.42 |
$1,651 |
0.9× |
| Myelogram Lumbar (72265) |
$609.84 |
$1,452 |
0.8× |
| Myelogram thoracic (72255) |
$640.50 |
$1,525 |
0.8× |
| Myelography 2 or more regions (72270) |
$619.92 |
$1,476 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$671.16 |
$1,598 |
0.5× |
| Neck soft tissue (70360) |
$78.96 |
$188 |
0.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$234.36 |
$558 |
0.6× |
| Nm bone marrow multiple (78103) |
$440.16 |
$1,048 |
1.1× |
| Nm bone marrow wb (78104) |
$501.90 |
$1,195 |
1.2× |
| Nm cisternogram (78630) |
$550.62 |
$1,311 |
1.0× |
| Nm csf leak detection (78650) |
$900.06 |
$2,143 |
0.7× |
| Nm gastric emptying study (78264) |
$956.34 |
$2,277 |
2.3× |
| Nm gastroesophageal reflux study (78262) |
$590.10 |
$1,405 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,102.12 |
$7,386 |
2.2× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$671.16 |
$1,598 |
0.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$556.50 |
$1,325 |
0.4× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$404.04 |
$962 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$1,077.72 |
$2,566 |
4.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$129.78 |
$309 |
1.2× |
| Orthopantogram (70355) |
$53.34 |
$127 |
0.6× |
| Osseous survey infant (77076) |
$97.44 |
$232 |
0.9× |
| Osseous survey limited (77074) |
$67.20 |
$160 |
0.6× |
| Parathyrd planar w/spect&CT (78072) |
$801.78 |
$1,909 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$484.26 |
$1,153 |
1.2× |
| Parathyroid imaging (78070) |
$538.44 |
$1,282 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$78.96 |
$188 |
0.7× |
| Peritoneogram rs&i (74190) |
$345.66 |
$823 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$2,877 |
$6,850 |
2.0× |
| Pr heart first pass single,planar (78481) |
$728.70 |
$1,735 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,200.78 |
$2,859 |
3.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,669.10 |
$6,355 |
0.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,639.28 |
$6,284 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$594.30 |
$1,415 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,298.22 |
$3,091 |
2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$345.66 |
$823 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$60.06 |
$143 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$94.08 |
$224 |
0.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$112.98 |
$269 |
1.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$73.92 |
$176 |
0.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$106.26 |
$253 |
1.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$6,318.48 |
$15,044 |
0.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$329.70 |
$785 |
0.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$236.04 |
$562 |
2.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$294 |
$700 |
0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$78.96 |
$188 |
0.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$71.82 |
$171 |
0.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$99.96 |
$238 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$99.96 |
$238 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$181.44 |
$432 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$150.78 |
$359 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$229.32 |
$546 |
1.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$200.76 |
$478 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$78.96 |
$188 |
0.9× |
| Radiological examination surgical specimen (76098) |
$168 |
$400 |
0.3× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$183.12 |
$436 |
0.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,441.88 |
$5,814 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,171.82 |
$5,171 |
0.7× |
| Ribs bilateral 3 views (71110) |
$94.92 |
$226 |
0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$515.34 |
$1,227 |
1.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$822.78 |
$1,959 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,367.52 |
$3,256 |
2.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,178.52 |
$2,806 |
0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,220.52 |
$2,906 |
0.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,103.34 |
$2,627 |
0.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$567 |
$1,350 |
2.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$257.46 |
$613 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$67.20 |
$160 |
0.6× |
| Scanogram (77073) |
$67.20 |
$160 |
0.6× |
| Scapula complete (73010) |
$63 |
$150 |
0.6× |
| Sella turcica (70240) |
$55.44 |
$132 |
0.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$285.60 |
$680 |
2.7× |
| Simulation intermediate (77285) |
$696.78 |
$1,659 |
1.8× |
| Small bowel series (74250) |
$181.44 |
$432 |
1.0× |
| Spec medical radj physics consltj (77370) |
$480.06 |
$1,143 |
3.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$701.40 |
$1,670 |
1.8× |
| Special dosimetry (77331) |
$381.78 |
$909 |
2.8× |
| Special treatment procedure (77470) |
$813.96 |
$1,938 |
1.4× |
| Speech evaluation complex (70371) |
$152.46 |
$363 |
0.6× |
| Spine thoracic 3 views (72072) |
$84 |
$200 |
0.8× |
| Spleen imaging only (78185) |
$284.76 |
$678 |
0.7× |
| Splenoportograpy rs&i (75810) |
$1,648.50 |
$3,925 |
0.5× |
| Stereotactic body radiation delivery (77373) |
$3,062.22 |
$7,291 |
1.7× |
| Superior sagittal sinus venogram (75870) |
$1,575.84 |
$3,752 |
0.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$667.80 |
$1,590 |
1.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$277.62 |
$661 |
0.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$152.46 |
$363 |
0.6× |
| Testicular Imaging With Vascular Flow (78761) |
$253.26 |
$603 |
0.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$807.66 |
$1,923 |
2.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$464.52 |
$1,106 |
3.4× |
| Therapeutic Enema (74283) |
$172.20 |
$410 |
1.0× |
| Thoracolumbar 2 views (72080) |
$78.96 |
$188 |
0.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$947.10 |
$2,255 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$480.48 |
$1,144 |
1.2× |
| Thyroid uptake measurement (78012) |
$278.46 |
$663 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,013.88 |
$2,414 |
2.5× |
| Tmj unilateral (70328) |
$55.44 |
$132 |
0.6× |
| Tomogram (76100) |
$77.28 |
$184 |
0.7× |
| Treatment device intermediate (77333) |
$362.88 |
$864 |
2.6× |
| Treatment devices simple (77332) |
$232.68 |
$554 |
1.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,504.44 |
$3,582 |
2.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$386.40 |
$920 |
0.9× |
| Tx devices design & construction complex (77334) |
$547.68 |
$1,304 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$281.40 |
$670 |
2.6× |
| Unlisted magnetic resonance procedure (76498) |
$1,249.50 |
$2,975 |
14.1× |
| Upper Extremity Infant (73092) |
$77.70 |
$185 |
0.7× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$2,089.50 |
$4,975 |
22.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$253.26 |
$603 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$206.22 |
$491 |
0.8× |
| Urethrocystography voiding (74455) |
$220.08 |
$524 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$444.78 |
$1,059 |
2.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$542.64 |
$1,292 |
3.0× |
| Us breast unilateral complete (76641) |
$171.36 |
$408 |
1.6× |
| Us breast unilateral limited (76642) |
$140.28 |
$334 |
1.6× |
| Us chest (76604) |
$171.36 |
$408 |
1.6× |
| Us compl joint r-t w/image documentation (76881) |
$282.66 |
$673 |
2.6× |
| Us guided compression repair (76936) |
$328.02 |
$781 |
1.5× |
| Us infant hips dynamic (76885) |
$107.94 |
$257 |
1.2× |
| Us infant hips limited static (76886) |
$78.96 |
$188 |
0.9× |
| Us kidney transplant (76776) |
$281.40 |
$670 |
2.6× |
| Us ob detailed single fetus (76811) |
$265.02 |
$631 |
1.1× |
| Us ob transvaginal (76817) |
$186.06 |
$443 |
1.7× |
| Us pelvic non ob complete (76856) |
$281.40 |
$670 |
2.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$225.12 |
$536 |
2.1× |
| Us pregnancy ltd (76815) |
$161.70 |
$385 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$281.40 |
$670 |
2.6× |
| Us retroperitoneal complete (76770) |
$281.40 |
$670 |
2.6× |
| Us retroperitoneal limited (76775) |
$147 |
$350 |
1.4× |
| Us scrotum and contents (76870) |
$281.40 |
$670 |
2.6× |
| Us soft tissue head/neck (76536) |
$169.26 |
$403 |
1.6× |
| Us spinal canal and contents (76800) |
$166.74 |
$397 |
1.6× |
| Us transrectal (76872) |
$269.64 |
$642 |
2.5× |
| Us transrectal prostate volume (76873) |
$228.48 |
$544 |
2.1× |
| Us xtr non-vasc lmtd (76882) |
$182.28 |
$434 |
1.7× |
| Venogram extremity bilateral (75822) |
$1,171.38 |
$2,789 |
0.7× |
| Venogram orbital (75880) |
$2,291.94 |
$5,457 |
3.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,648.50 |
$3,925 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$995.40 |
$2,370 |
0.6× |
| Venography epidural rs&i (75872) |
$2,441.88 |
$5,814 |
3.8× |
| Venography extremity unilateral rs&i (75820) |
$1,020.60 |
$2,430 |
0.6× |
| Venography Renal Bilateral (75833) |
$3,837.96 |
$9,138 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$2,168.46 |
$5,163 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,575.84 |
$3,752 |
0.5× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$2,852.22 |
$6,791 |
0.5× |
| Wrist 2 views (73100) |
$68.88 |
$164 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$130.62 |
$311 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$55.44 |
$132 |
0.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$78.96 |
$188 |
0.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$188.58 |
$449 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$70.98 |
$169 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$78.96 |
$188 |
0.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$105.84 |
$252 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$102.90 |
$245 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$111.30 |
$265 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$166.32 |
$396 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$150.78 |
$359 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$242.76 |
$578 |
2.3× |
| X-ray exam of femur 1 (73551) |
$60.06 |
$143 |
0.7× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$412.86 |
$983 |
2.3× |
| X-ray eye for foreign body (70030) |
$78.96 |
$188 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$67.20 |
$160 |
0.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$55.44 |
$132 |
0.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$78.96 |
$188 |
0.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$644.28 |
$1,534 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$72.24 |
$172 |
0.8× |
| X-ray IV pyelogram+drip infusn (74410) |
$464.94 |
$1,107 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$55.44 |
$132 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$87.36 |
$208 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$87.78 |
$209 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$58.38 |
$139 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$78.96 |
$188 |
0.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$127.26 |
$303 |
1.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$68.88 |
$164 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$78.96 |
$188 |
0.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$55.44 |
$132 |
0.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$78.96 |
$188 |
0.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$94.50 |
$225 |
0.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$278.46 |
$663 |
0.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$71.82 |
$171 |
0.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$81.90 |
$195 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$112.56 |
$268 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$90.30 |
$215 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$78.96 |
$188 |
0.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$78.96 |
$188 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$67.20 |
$160 |
0.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$55.44 |
$132 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$82.32 |
$196 |
0.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$78.96 |
$188 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$63 |
$150 |
0.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$74.76 |
$178 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$58.38 |
$139 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$78.96 |
$188 |
0.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$92.40 |
$220 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$78.96 |
$188 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$78.96 |
$188 |
0.9× |
| Xr arthrogram ankle (73615) |
$281.82 |
$671 |
0.8× |
| Xr c-spine 6 or more views (72052) |
$129.36 |
$308 |
1.2× |
| Xr chest 4+ views (71048) |
$141.54 |
$337 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$78.96 |
$188 |
0.9× |
| Xr optic foramina (70190) |
$55.44 |
$132 |
0.6× |
| Xr shoulder 1 view (73020) |
$62.58 |
$149 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$108.36 |
$258 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$78.96 |
$188 |
0.9× |
| Xr tmj bilateral (70330) |
$103.74 |
$247 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$55.44 |
$132 |
0.6× |