| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,752.50 |
$7,010 |
1.4× |
| Abdomen 2 views (74019) |
$88.75 |
$355 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$446.75 |
$1,787 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,070 |
$8,280 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,047 |
$8,188 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,423.25 |
$5,693 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$1,302 |
$5,208 |
0.5× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,047 |
$8,188 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,047 |
$8,188 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,047 |
$8,188 |
0.7× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,704.50 |
$6,818 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,704.50 |
$6,818 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$408.25 |
$1,633 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,482 |
$5,928 |
0.5× |
| Ankle 2 views (73600) |
$67.38 |
$269.50 |
0.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$163.75 |
$655 |
0.5× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,070 |
$8,280 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,047 |
$8,188 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$1,637.25 |
$6,549 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$1,119.25 |
$4,477 |
0.4× |
| Arthrogram hip (73525) |
$315.50 |
$1,262 |
1.0× |
| Arthrogram shoulder (73040) |
$287 |
$1,148 |
0.9× |
| Arthrogram wrist (73115) |
$287 |
$1,148 |
0.9× |
| Arthrography knee lt (73580) |
$287 |
$1,148 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$189.75 |
$759 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$279 |
$1,116 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$466.50 |
$1,866 |
1.3× |
| Bone age studies (77072) |
$70.25 |
$281 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$599.50 |
$2,398 |
1.7× |
| Bone survey complete (77075) |
$226.75 |
$907 |
2.4× |
| Brachytx isodose complex (77318) |
$419.88 |
$1,679.50 |
1.2× |
| Brachytx isodose intermed (77317) |
$373.75 |
$1,495 |
1.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$244.62 |
$978.50 |
0.7× |
| Brain image w/flow 4 + views (78606) |
$377 |
$1,508 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$74.50 |
$298 |
1.0× |
| Chest 1 view (71045) |
$80.25 |
$321 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$143 |
$572 |
0.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$568.50 |
$2,274 |
0.8× |
| Clavicle complete (73000) |
$54.50 |
$218 |
0.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$55.50 |
$222 |
0.6× |
| Continuing medical physics consltj pr wk (77336) |
$257 |
$1,028 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,633.75 |
$6,535 |
5.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,438.75 |
$5,755 |
6.7× |
| CT abdomen w contrast (74160) |
$1,117.25 |
$4,469 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,217.75 |
$4,871 |
7.7× |
| CT abdomen w/o contrast (74150) |
$846.50 |
$3,386 |
9.0× |
| CT angio hrt w/3d image (75574) |
$999.50 |
$3,998 |
3.2× |
| CT angiography upper extremity lt (73206) |
$999.50 |
$3,998 |
6.3× |
| CT c-spine w/o contrast (72125) |
$978.75 |
$3,915 |
10.4× |
| CT cervical spine w&w/o contrast (72127) |
$891 |
$3,564 |
5.6× |
| CT cervical spine with contrast (72126) |
$1,021 |
$4,084 |
3.3× |
| CT chest w/wo contrast (71270) |
$1,194.75 |
$4,779 |
7.6× |
| CT chest with contrast (71260) |
$1,110 |
$4,440 |
7.0× |
| CT colonography screening (74263) |
$323 |
$1,292 |
1.5× |
| CT colonography w/o cntrst (74261) |
$846.50 |
$3,386 |
9.0× |
| CT head/brain with contrast (70460) |
$794.50 |
$3,178 |
5.0× |
| CT head/brain without and with contrast (70470) |
$1,009.50 |
$4,038 |
6.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$67.25 |
$269 |
0.9× |
| CT iac w contrast (70481) |
$1,061.50 |
$4,246 |
6.7× |
| CT limited/localized follow up study (76380) |
$334 |
$1,336 |
4.3× |
| CT lower ext w/o (73700) |
$772.75 |
$3,091 |
8.2× |
| CT lower extremity w wo contrast (73702) |
$827 |
$3,308 |
5.2× |
| CT lower extremity with contrast (73701) |
$783.75 |
$3,135 |
5.0× |
| CT lumbar spine w & w/o contrast (72133) |
$891 |
$3,564 |
5.6× |
| CT lumbar spine w/o contrast (72131) |
$840.75 |
$3,363 |
8.9× |
| CT lumbar spine with contrast (72132) |
$928.25 |
$3,713 |
3.0× |
| CT maxillofacial w contrast (70487) |
$808.62 |
$3,234.50 |
5.1× |
| CT maxillofacial w/o contrast (70486) |
$582.50 |
$2,330 |
6.2× |
| CT maxillofacial w/wo contrast (70488) |
$971.12 |
$3,884.50 |
6.2× |
| CT neck soft tissue w contrast (70491) |
$917.25 |
$3,669 |
5.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,244 |
$4,976 |
7.9× |
| CT orbits w/o contrast (70480) |
$577.88 |
$2,311.50 |
6.1× |
| CT pelvis w & w/o contrast (72194) |
$1,213.75 |
$4,855 |
7.7× |
| CT pelvis w/o contrast (72192) |
$828.50 |
$3,314 |
8.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,053.75 |
$4,215 |
6.7× |
| CT soft tissue neck w/o contrast (70490) |
$798.75 |
$3,195 |
8.5× |
| CT thoracic spine w/contrast (72129) |
$886.25 |
$3,545 |
5.6× |
| CT thoracic spine w/o contrast (72128) |
$1,040.75 |
$4,163 |
11.1× |
| CT thoracic spine w/wo contrast (72130) |
$891 |
$3,564 |
5.6× |
| CT thorax w/o contrast (71250) |
$461.50 |
$1,846 |
4.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$868 |
$3,472 |
5.5× |
| CT upper extremity w/o contrast rt (73200) |
$753.50 |
$3,014 |
8.0× |
| CT upper extremity with contrast (73201) |
$783.75 |
$3,135 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,020.50 |
$4,082 |
6.5× |
| Cta Abdomen (74175) |
$1,249.25 |
$4,997 |
7.9× |
| CTA abdomen pelvis (74174) |
$2,040.50 |
$8,162 |
6.5× |
| CTA chest (71275) |
$1,303.75 |
$5,215 |
8.3× |
| Cta Head (70496) |
$999.50 |
$3,998 |
6.3× |
| CTA lwr ext w&w/o contrast (73706) |
$999.50 |
$3,998 |
6.3× |
| Cta Neck (70498) |
$999.50 |
$3,998 |
6.3× |
| Cystography minimum 3 views rs&i (74430) |
$204.50 |
$818 |
0.7× |
| Diskography lumbar (72295) |
$1,042.50 |
$4,170 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$225 |
$900 |
2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$121 |
$484 |
1.5× |
| Echoencephalography real time imaging (76506) |
$147.50 |
$590 |
1.6× |
| Esophagus (74220) |
$150 |
$600 |
1.0× |
| Fetal biophysical profile non-stress testing (76818) |
$213.50 |
$854 |
2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$309 |
$1,236 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$130.25 |
$521 |
0.6× |
| Foot 2 views (73620) |
$50.62 |
$202.50 |
0.6× |
| Forearm 2 views (73090) |
$54.25 |
$217 |
0.7× |
| Gated Heart Planar Single (78472) |
$442.50 |
$1,770 |
1.2× |
| Hand 2 views (73120) |
$52.25 |
$209 |
0.6× |
| Hand 3 views (73130) |
$80.50 |
$322 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,716.75 |
$6,867 |
2.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,857 |
$7,428 |
3.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,347.50 |
$9,390 |
3.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,047 |
$8,188 |
0.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$569.75 |
$2,279 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$569.75 |
$2,279 |
1.6× |
| Ht muscle image spect sing (78451) |
$1,837.75 |
$7,351 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$60.75 |
$243 |
0.8× |
| Hysterosalpingogram (74740) |
$225 |
$900 |
1.0× |
| Interstitial radiation source applic complex (77778) |
$2,596.25 |
$10,385 |
4.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$403.25 |
$1,613 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$644.25 |
$2,577 |
1.3× |
| Knee 3 views (73562) |
$89.25 |
$357 |
1.1× |
| Liver & spleen imaging static only (78215) |
$255.50 |
$1,022 |
0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$358.75 |
$1,435 |
1.0× |
| Lung perf&ventilat diferentl (78598) |
$799.75 |
$3,199 |
1.6× |
| Lung perfusion differential (78597) |
$523 |
$2,092 |
1.5× |
| Lung Ventilation Imaging (78579) |
$277.25 |
$1,109 |
0.8× |
| Lymphoscintigraphy (78195) |
$313 |
$1,252 |
0.6× |
| Meckels Diverticulum (78290) |
$279.25 |
$1,117 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$689.25 |
$2,757 |
2.0× |
| MRA head w/o contrast (70544) |
$930.25 |
$3,721 |
4.3× |
| MRA head with contrast (70545) |
$963 |
$3,852 |
3.1× |
| MRA neck w contrast (70548) |
$1,001.50 |
$4,006 |
3.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,518.50 |
$6,074 |
4.8× |
| MRA neck w/o contrast (70547) |
$977 |
$3,908 |
4.5× |
| MRI abdomen w contrast (74182) |
$1,289 |
$5,156 |
4.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,465.50 |
$5,862 |
4.7× |
| MRI abdomen w/o contrast (74181) |
$1,128 |
$4,512 |
5.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,025.50 |
$4,102 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,025.50 |
$4,102 |
1.5× |
| MRI breast w/o contrast bilateral (77047) |
$861.75 |
$3,447 |
4.0× |
| MRI breast w/o contrast unilat (77046) |
$861.75 |
$3,447 |
4.0× |
| MRI c-spine with contrast (72142) |
$1,250.50 |
$5,002 |
4.0× |
| MRI cervical spine w/o contrast (72141) |
$783.62 |
$3,134.50 |
3.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,465.50 |
$5,862 |
4.7× |
| MRI chest w/o contrast (71550) |
$876 |
$3,504 |
4.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,025.50 |
$4,102 |
3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,049.50 |
$4,198 |
3.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$932 |
$3,728 |
4.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$645.12 |
$2,580.50 |
3.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,252.25 |
$5,009 |
4.0× |
| MRI pelvis w contrast (72196) |
$1,042.25 |
$4,169 |
3.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,363.25 |
$5,453 |
4.3× |
| MRI pelvis w/o contrast (72195) |
$662.50 |
$2,650 |
3.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,132 |
$4,528 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,552.75 |
$6,211 |
4.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,719 |
$6,876 |
5.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,191.25 |
$4,765 |
3.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,701.50 |
$6,806 |
5.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,505.25 |
$6,021 |
4.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,637.25 |
$6,549 |
5.2× |
| MRI thoracic spine w/o contrast (72146) |
$773.12 |
$3,092.50 |
3.6× |
| MRI tmj (70336) |
$876 |
$3,504 |
4.1× |
| MRI upper ext joint w/o contrast (73221) |
$930.25 |
$3,721 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$999.50 |
$3,998 |
3.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$930.25 |
$3,721 |
4.3× |
| Myelogram Cervical (72240) |
$741 |
$2,964 |
1.1× |
| Myelogram Lumbar (72265) |
$593.25 |
$2,373 |
0.8× |
| Myelogram thoracic (72255) |
$741 |
$2,964 |
1.1× |
| Myelography 2 or more regions (72270) |
$593.25 |
$2,373 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$2,549 |
$10,196 |
2.2× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,162.50 |
$4,650 |
0.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,162.50 |
$4,650 |
0.9× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,813 |
$7,252 |
0.9× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,215.75 |
$8,863 |
1.1× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$2,215.75 |
$8,863 |
1.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$701 |
$2,804 |
0.9× |
| Neck soft tissue (70360) |
$54.50 |
$218 |
0.7× |
| Nm adrenal scan (78075) |
$1,092.50 |
$4,370 |
0.9× |
| Nm gastric emptying study (78264) |
$642 |
$2,568 |
1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,644.75 |
$6,579 |
1.3× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,875 |
$11,500 |
2.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$547.75 |
$2,191 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$156 |
$624 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$181.50 |
$726 |
1.9× |
| Osseous survey limited (77074) |
$204.50 |
$818 |
2.2× |
| Parathyrd planar w/spect&CT (78072) |
$472 |
$1,888 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$373 |
$1,492 |
1.0× |
| Parathyroid imaging (78070) |
$358.75 |
$1,435 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$44.25 |
$177 |
0.5× |
| Peritoneogram rs&i (74190) |
$279 |
$1,116 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$3,090.25 |
$12,361 |
2.4× |
| PET imaging for CT attenuation whole body (78816) |
$2,982.62 |
$11,930.50 |
2.3× |
| PET imaging limited area chest head/neck (78811) |
$2,875 |
$11,500 |
2.5× |
| PET whole body (78813) |
$2,875 |
$11,500 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,407.75 |
$5,631 |
4.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,047 |
$8,188 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$846.50 |
$3,386 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$243.50 |
$974 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$799.75 |
$3,199 |
1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$263 |
$1,052 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$99.25 |
$397 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$110 |
$440 |
1.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$124.50 |
$498 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$128.50 |
$514 |
1.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$182 |
$728 |
1.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,979 |
$15,916 |
0.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$257 |
$1,028 |
0.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$181.88 |
$727.50 |
2.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$214.25 |
$857 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$82 |
$328 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$80.25 |
$321 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$97.50 |
$390 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$103.25 |
$413 |
1.3× |
| Radiologic exam colon single contrast study (74270) |
$183.75 |
$735 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$319.25 |
$1,277 |
2.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$246.50 |
$986 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$106.50 |
$426 |
1.4× |
| Radiological examination surgical specimen (76098) |
$359.12 |
$1,436.50 |
0.7× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,047 |
$8,188 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,047 |
$8,188 |
0.7× |
| Ribs bilateral 3 views (71110) |
$78.75 |
$315 |
0.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$514.25 |
$2,057 |
1.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$590.25 |
$2,361 |
1.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,092.50 |
$4,370 |
2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,025 |
$4,100 |
0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,025 |
$4,100 |
0.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,162.50 |
$4,650 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$936 |
$3,744 |
4.5× |
| Sacroiliac Joints < 3 Views (72200) |
$47.75 |
$191 |
0.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$281.75 |
$1,127 |
1.3× |
| Scanogram (77073) |
$136.25 |
$545 |
1.4× |
| Scapula complete (73010) |
$50 |
$200 |
0.5× |
| Screening digital breast tomosynthesis (77063) |
$26.25 |
$105 |
1.1× |
| Simulation intermediate (77285) |
$442.50 |
$1,770 |
1.3× |
| Small bowel series (74250) |
$215 |
$860 |
1.4× |
| Spec medical radj physics consltj (77370) |
$278.75 |
$1,115 |
2.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$405.25 |
$1,621 |
1.2× |
| Special dosimetry (77331) |
$92.75 |
$371 |
0.8× |
| Special treatment procedure (77470) |
$887.75 |
$3,551 |
1.8× |
| Spine thoracic 3 views (72072) |
$117 |
$468 |
1.2× |
| Stereotactic body radiation delivery (77373) |
$1,599.25 |
$6,397 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$684.75 |
$2,739 |
0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$419.88 |
$1,679.50 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$373.75 |
$1,495 |
1.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$528 |
$2,112 |
1.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$224 |
$896 |
1.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$307.25 |
$1,229 |
0.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$386.25 |
$1,545 |
1.1× |
| Thyroid uptake measurement (78012) |
$317.75 |
$1,271 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$458 |
$1,832 |
1.3× |
| Tomogram (76100) |
$225 |
$900 |
2.4× |
| Treatment device intermediate (77333) |
$126.25 |
$505 |
1.0× |
| Treatment devices simple (77332) |
$140.50 |
$562 |
1.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,209.75 |
$4,839 |
2.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$373 |
$1,492 |
1.0× |
| Tx devices design & construction complex (77334) |
$528 |
$2,112 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$271.75 |
$1,087 |
2.9× |
| Umbilical-artery Doppler (OB) (76820) |
$141 |
$564 |
1.5× |
| Unlisted magnetic resonance procedure (76498) |
$414.25 |
$1,657 |
5.3× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$2,686.25 |
$10,745 |
7.5× |
| Upper Extremity Infant (73092) |
$70.75 |
$283 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$236.25 |
$945 |
1.1× |
| Urethrocystography voiding (74455) |
$245.25 |
$981 |
1.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$361.50 |
$1,446 |
2.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$451.50 |
$1,806 |
2.9× |
| Us abdl aorta screen aaa (76706) |
$100 |
$400 |
1.1× |
| Us breast unilateral complete (76641) |
$135 |
$540 |
1.4× |
| Us breast unilateral limited (76642) |
$114.50 |
$458 |
1.5× |
| Us chest (76604) |
$123.50 |
$494 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$183.25 |
$733 |
1.9× |
| Us guided compression repair (76936) |
$767.75 |
$3,071 |
4.0× |
| Us infant hips dynamic (76885) |
$215 |
$860 |
2.7× |
| Us infant hips limited static (76886) |
$148 |
$592 |
1.9× |
| Us kidney transplant (76776) |
$221.75 |
$887 |
2.4× |
| Us ob detailed single fetus (76811) |
$509 |
$2,036 |
2.4× |
| Us ob transvaginal (76817) |
$87.50 |
$350 |
0.9× |
| Us pelvic non ob complete (76856) |
$261.25 |
$1,045 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$159.50 |
$638 |
1.7× |
| Us pregnancy ltd (76815) |
$143.50 |
$574 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$179.75 |
$719 |
1.9× |
| Us retroperitoneal complete (76770) |
$224 |
$896 |
2.4× |
| Us retroperitoneal limited (76775) |
$244.25 |
$977 |
2.6× |
| Us scrotum and contents (76870) |
$163 |
$652 |
1.7× |
| Us soft tissue head/neck (76536) |
$220.25 |
$881 |
2.3× |
| Us spinal canal and contents (76800) |
$129.25 |
$517 |
1.4× |
| Us transrectal prostate volume (76873) |
$274 |
$1,096 |
2.9× |
| Us xtr non-vasc lmtd (76882) |
$134 |
$536 |
1.4× |
| Vascular flow imaging (78445) |
$334 |
$1,336 |
0.9× |
| Venogram extremity bilateral (75822) |
$663.25 |
$2,653 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,047 |
$8,188 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,061.75 |
$4,247 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$663.25 |
$2,653 |
0.5× |
| Venography Renal Bilateral (75833) |
$2,047 |
$8,188 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,637.25 |
$6,549 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$877.25 |
$3,509 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,047 |
$8,188 |
0.4× |
| Wrist 2 views (73100) |
$41.50 |
$166 |
0.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$97.50 |
$390 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$77.25 |
$309 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$60.75 |
$243 |
0.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$230 |
$920 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$51.12 |
$204.50 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$60.75 |
$243 |
0.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$157.75 |
$631 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$65.75 |
$263 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$128.50 |
$514 |
1.6× |
| X-ray exam hip uni 4/> views (73503) |
$142.25 |
$569 |
1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$142.25 |
$569 |
1.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$164.75 |
$659 |
1.8× |
| X-ray exam of femur 1 (73551) |
$59 |
$236 |
0.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$60.75 |
$243 |
0.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$51.75 |
$207 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$63.75 |
$255 |
0.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,101.50 |
$4,406 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$54.50 |
$218 |
0.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$65.75 |
$263 |
0.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$80.50 |
$322 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$60.75 |
$243 |
0.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$70.75 |
$283 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$70.75 |
$283 |
0.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$212 |
$848 |
2.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$110 |
$440 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$60.75 |
$243 |
0.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$110 |
$440 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$82 |
$328 |
0.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$96.50 |
$386 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$78.75 |
$315 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$78.75 |
$315 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$108 |
$432 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$70.75 |
$283 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$54.50 |
$218 |
0.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$80.50 |
$322 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$82 |
$328 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$41.50 |
$166 |
0.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$85.50 |
$342 |
0.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$67.62 |
$270.50 |
0.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$54.50 |
$218 |
0.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$93 |
$372 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$67.50 |
$270 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$65 |
$260 |
0.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$139.50 |
$558 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$41.50 |
$166 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$80.50 |
$322 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$97.75 |
$391 |
1.0× |
| Xr chest 4+ views (71048) |
$108 |
$432 |
1.1× |
| Xr Cholecystography Oral Contrast (74290) |
$163.75 |
$655 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$54.50 |
$218 |
0.7× |
| Xr shoulder 1 view (73020) |
$34.75 |
$139 |
0.4× |
| Xr spine cervical 4 or 5 views (72050) |
$148.50 |
$594 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$60.75 |
$243 |
0.8× |
| Xr tmj bilateral (70330) |
$109.50 |
$438 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$60.75 |
$243 |
0.8× |