| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,282 |
$6,410 |
1.0× |
| Abdomen 2 views (74019) |
$89.60 |
$448 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$298.80 |
$1,494 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$1,574.60 |
$7,873 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,094.80 |
$5,474 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,561 |
$7,805 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$380 |
$1,900 |
0.1× |
| Ankle 2 views (73600) |
$65.90 |
$329.50 |
0.8× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,619.20 |
$8,096 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,574.60 |
$7,873 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$1,574.60 |
$7,873 |
0.5× |
| Arthrogram elbow (73085) |
$254.80 |
$1,274 |
0.8× |
| Arthrogram hip (73525) |
$242.60 |
$1,213 |
0.8× |
| Arthrogram shoulder (73040) |
$254.80 |
$1,274 |
0.8× |
| Arthrogram wrist (73115) |
$234.80 |
$1,174 |
0.7× |
| Arthrography knee lt (73580) |
$242.60 |
$1,213 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$146 |
$730 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$302 |
$1,510 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$466 |
$2,330 |
1.3× |
| Bone age studies (77072) |
$57 |
$285 |
0.6× |
| Bone Imaging 3 Phase (78315) |
$369 |
$1,845 |
1.0× |
| Bone survey complete (77075) |
$183.20 |
$916 |
1.9× |
| Brachytx isodose complex (77318) |
$569.20 |
$2,846 |
1.7× |
| Brachytx isodose intermed (77317) |
$476.40 |
$2,382 |
1.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$334.20 |
$1,671 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$94 |
$470 |
1.2× |
| Chest 1 view (71045) |
$77 |
$385 |
1.0× |
| Chest 3 views (71047) |
$83.40 |
$417 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$128.20 |
$641 |
0.8× |
| Clavicle complete (73000) |
$84.40 |
$422 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$42.60 |
$213 |
0.4× |
| Continuing medical physics consltj pr wk (77336) |
$229.40 |
$1,147 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,709.80 |
$8,549 |
5.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,259.20 |
$6,296 |
5.8× |
| CT abdomen w contrast (74160) |
$738.60 |
$3,693 |
4.6× |
| CT abdomen w wo contrast (74170) |
$855 |
$4,275 |
5.4× |
| CT abdomen w/o contrast (74150) |
$630.40 |
$3,152 |
6.6× |
| CT angio hrt w/3d image (75574) |
$951.20 |
$4,756 |
3.0× |
| CT angiography upper extremity lt (73206) |
$714 |
$3,570 |
4.5× |
| CT c-spine w/o contrast (72125) |
$645.20 |
$3,226 |
6.8× |
| CT cervical spine w&w/o contrast (72127) |
$720.60 |
$3,603 |
4.5× |
| CT cervical spine with contrast (72126) |
$691.60 |
$3,458 |
2.2× |
| CT chest w/wo contrast (71270) |
$855 |
$4,275 |
5.4× |
| CT chest with contrast (71260) |
$738.60 |
$3,693 |
4.6× |
| CT head/brain with contrast (70460) |
$738.60 |
$3,693 |
4.6× |
| CT head/brain without and with contrast (70470) |
$855 |
$4,275 |
5.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$53.80 |
$269 |
0.7× |
| CT iac w contrast (70481) |
$579 |
$2,895 |
3.6× |
| CT limited/localized follow up study (76380) |
$286.80 |
$1,434 |
3.6× |
| CT lower ext w/o (73700) |
$630.40 |
$3,152 |
6.6× |
| CT lower extremity w wo contrast (73702) |
$749.40 |
$3,747 |
4.7× |
| CT lower extremity with contrast (73701) |
$855.20 |
$4,276 |
5.4× |
| CT lumbar spine w & w/o contrast (72133) |
$890.20 |
$4,451 |
5.6× |
| CT lumbar spine w/o contrast (72131) |
$661.60 |
$3,308 |
7.0× |
| CT lumbar spine with contrast (72132) |
$691.60 |
$3,458 |
2.2× |
| CT maxillofacial w contrast (70487) |
$468.60 |
$2,343 |
2.9× |
| CT maxillofacial w/o contrast (70486) |
$443.80 |
$2,219 |
4.7× |
| CT maxillofacial w/wo contrast (70488) |
$740.60 |
$3,703 |
4.7× |
| CT neck soft tissue w contrast (70491) |
$738.60 |
$3,693 |
4.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$873.60 |
$4,368 |
5.5× |
| CT orbits w/o contrast (70480) |
$440.60 |
$2,203 |
4.6× |
| CT pelvis w & w/o contrast (72194) |
$855 |
$4,275 |
5.4× |
| CT pelvis w/o contrast (72192) |
$596.10 |
$2,980.50 |
6.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$861.20 |
$4,306 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$630.40 |
$3,152 |
6.6× |
| CT thoracic spine w/contrast (72129) |
$726 |
$3,630 |
4.6× |
| CT thoracic spine w/o contrast (72128) |
$630.40 |
$3,152 |
6.6× |
| CT thoracic spine w/wo contrast (72130) |
$777.20 |
$3,886 |
4.9× |
| CT thorax w/o contrast (71250) |
$630.40 |
$3,152 |
6.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$777.20 |
$3,886 |
4.9× |
| CT upper extremity w/o contrast rt (73200) |
$630.40 |
$3,152 |
6.6× |
| CT upper extremity with contrast (73201) |
$686.50 |
$3,432.50 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$823.60 |
$4,118 |
5.2× |
| Cta Abdomen (74175) |
$823.60 |
$4,118 |
5.2× |
| CTA abdomen pelvis (74174) |
$1,648.80 |
$8,244 |
5.2× |
| CTA chest (71275) |
$823.60 |
$4,118 |
5.2× |
| Cta Head (70496) |
$663.40 |
$3,317 |
4.2× |
| CTA lwr ext w&w/o contrast (73706) |
$650.50 |
$3,252.50 |
4.1× |
| Cta Neck (70498) |
$663.40 |
$3,317 |
4.2× |
| Cta Pelvis (72191) |
$823.60 |
$4,118 |
5.2× |
| Cystography minimum 3 views rs&i (74430) |
$223.80 |
$1,119 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$96 |
$480 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$37.60 |
$188 |
0.5× |
| Echoencephalography real time imaging (76506) |
$147.80 |
$739 |
1.6× |
| Esophagus (74220) |
$138.60 |
$693 |
0.9× |
| Fetal biophysical profile non-stress testing (76818) |
$290 |
$1,450 |
3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$237.60 |
$1,188 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$192.40 |
$962 |
0.9× |
| Foot 2 views (73620) |
$54.40 |
$272 |
0.7× |
| Forearm 2 views (73090) |
$75 |
$375 |
0.9× |
| Gated Heart Planar Single (78472) |
$368.60 |
$1,843 |
1.0× |
| Hand 2 views (73120) |
$47.50 |
$237.50 |
0.5× |
| Hand 3 views (73130) |
$81.40 |
$407 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,918.80 |
$9,594 |
3.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,073.80 |
$10,369 |
3.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,149.80 |
$10,749 |
3.4× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$97.80 |
$489 |
0.3× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$97.80 |
$489 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$367.40 |
$1,837 |
0.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$329.80 |
$1,649 |
0.9× |
| Ht muscle image spect sing (78451) |
$965.60 |
$4,828 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$68.60 |
$343 |
0.9× |
| Hysterosalpingogram (74740) |
$156 |
$780 |
0.7× |
| Image fusion (77399) |
$111.40 |
$557 |
0.9× |
| Interstitial radiation source applic complex (77778) |
$2,621.40 |
$13,107 |
4.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$409.80 |
$2,049 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$520.60 |
$2,603 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$526.80 |
$2,634 |
1.1× |
| Knee 3 views (73562) |
$93.80 |
$469 |
1.2× |
| Liver & spleen imaging static only (78215) |
$223.60 |
$1,118 |
0.6× |
| Lung perf&ventilat diferentl (78598) |
$615.20 |
$3,076 |
1.2× |
| Lung perfusion differential (78597) |
$402.40 |
$2,012 |
1.1× |
| Lung Ventilation Imaging (78579) |
$213.20 |
$1,066 |
0.6× |
| Lymphoscintigraphy (78195) |
$286.80 |
$1,434 |
0.6× |
| Mammary ductogram or galactogram multiple (77054) |
$194.80 |
$974 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$113.20 |
$566 |
0.5× |
| Meckels Diverticulum (78290) |
$304.60 |
$1,523 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$650.40 |
$3,252 |
1.9× |
| MRA head w & w/o contrast (70546) |
$1,218.60 |
$6,093 |
3.8× |
| MRA head w/o contrast (70544) |
$802.40 |
$4,012 |
3.7× |
| MRA neck w contrast (70548) |
$924 |
$4,620 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,237.40 |
$6,187 |
3.9× |
| MRA neck w/o contrast (70547) |
$802.40 |
$4,012 |
3.7× |
| MRI abdomen w contrast (74182) |
$825.40 |
$4,127 |
2.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,237.40 |
$6,187 |
3.9× |
| MRI abdomen w/o contrast (74181) |
$802.40 |
$4,012 |
3.7× |
| MRI any jnt lwr ext with con lt (73722) |
$948 |
$4,740 |
1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$948 |
$4,740 |
1.3× |
| MRI breast w/o contrast bilateral (77047) |
$847 |
$4,235 |
3.9× |
| MRI breast w/o contrast unilat (77046) |
$662.80 |
$3,314 |
3.1× |
| MRI c-spine with contrast (72142) |
$948 |
$4,740 |
3.0× |
| MRI cervical spine w/o contrast (72141) |
$802.40 |
$4,012 |
3.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,237.40 |
$6,187 |
3.9× |
| MRI chest w/o contrast (71550) |
$802.40 |
$4,012 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$858.40 |
$4,292 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$802.40 |
$4,012 |
3.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$802.40 |
$4,012 |
3.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,031.40 |
$5,157 |
3.3× |
| MRI pelvis w contrast (72196) |
$825.40 |
$4,127 |
2.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$948 |
$4,740 |
3.0× |
| MRI pelvis w/o contrast (72195) |
$802.40 |
$4,012 |
3.7× |
| MRI scan of arm joint before and after contrast (73223) |
$1,237.40 |
$6,187 |
3.9× |
| MRI scan of leg joint before and after contrast (73723) |
$1,237.40 |
$6,187 |
3.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,017.80 |
$5,089 |
3.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$948 |
$4,740 |
3.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,076.80 |
$5,384 |
3.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$948 |
$4,740 |
3.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,017.80 |
$5,089 |
3.2× |
| MRI thoracic spine w/o contrast (72146) |
$822.40 |
$4,112 |
3.8× |
| MRI tmj (70336) |
$761.60 |
$3,808 |
3.5× |
| MRI upper ext joint w/o contrast (73221) |
$802.40 |
$4,012 |
3.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,237.40 |
$6,187 |
3.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$802.40 |
$4,012 |
3.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,343.40 |
$6,717 |
1.1× |
| Neck soft tissue (70360) |
$71.60 |
$358 |
0.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$133.20 |
$666 |
0.4× |
| Nm gastric emptying study (78264) |
$474.80 |
$2,374 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,265.20 |
$6,326 |
1.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$317 |
$1,585 |
0.9× |
| Nuclear Rx Oral Admin (79005) |
$203.70 |
$1,018.50 |
1.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$144.60 |
$723 |
1.5× |
| Osseous survey infant (77076) |
$104.60 |
$523 |
1.1× |
| Osseous survey limited (77074) |
$183.60 |
$918 |
1.9× |
| Parathyrd planar w/wo subtrj (78071) |
$359.40 |
$1,797 |
1.0× |
| Parathyroid imaging (78070) |
$227.40 |
$1,137 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$77.40 |
$387 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$2,495.60 |
$12,478 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$2,495.60 |
$12,478 |
1.9× |
| PET whole body (78813) |
$2,211.60 |
$11,058 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,237.40 |
$6,187 |
3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$340 |
$1,700 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$615.20 |
$3,076 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$241.20 |
$1,206 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$76.40 |
$382 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$84.60 |
$423 |
0.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$95.80 |
$479 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$120 |
$600 |
1.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$140 |
$700 |
1.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,365.60 |
$16,828 |
0.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$223.60 |
$1,118 |
0.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$153 |
$765 |
1.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$190.80 |
$954 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$114.20 |
$571 |
1.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$77 |
$385 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$114.60 |
$573 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$81.80 |
$409 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$159.20 |
$796 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$320.40 |
$1,602 |
2.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$168.60 |
$843 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$82 |
$410 |
1.0× |
| Radiological examination surgical specimen (76098) |
$282.90 |
$1,414.50 |
0.6× |
| Ribs bilateral 3 views (71110) |
$118.40 |
$592 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$489.60 |
$2,448 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$770 |
$3,850 |
1.6× |
| Rp Therapy Intravenous Administration (79101) |
$258.80 |
$1,294 |
1.2× |
| Sacroiliac Joints < 3 Views (72200) |
$75.20 |
$376 |
0.8× |
| Scapula complete (73010) |
$91.90 |
$459.50 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$20.20 |
$101 |
0.9× |
| Simulation intermediate (77285) |
$277.40 |
$1,387 |
0.8× |
| Small bowel series (74250) |
$225.80 |
$1,129 |
1.4× |
| Spec medical radj physics consltj (77370) |
$255 |
$1,275 |
2.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$246.60 |
$1,233 |
0.7× |
| Special dosimetry (77331) |
$79.60 |
$398 |
0.7× |
| Special treatment procedure (77470) |
$792.40 |
$3,962 |
1.6× |
| Spine thoracic 3 views (72072) |
$115.40 |
$577 |
1.2× |
| Stereotactic body radiation delivery (77373) |
$2,459 |
$12,295 |
1.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$485.80 |
$2,429 |
1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$390.60 |
$1,953 |
1.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$406.20 |
$2,031 |
1.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$252.80 |
$1,264 |
2.1× |
| Thoracolumbar 2 views (72080) |
$102.60 |
$513 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$307.80 |
$1,539 |
0.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$269.80 |
$1,349 |
0.7× |
| Thyroid uptake measurement (78012) |
$244.40 |
$1,222 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$190.80 |
$954 |
0.5× |
| Tmj unilateral (70328) |
$33.20 |
$166 |
0.4× |
| Treatment device intermediate (77333) |
$136.80 |
$684 |
1.1× |
| Treatment devices simple (77332) |
$129.20 |
$646 |
1.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,086.60 |
$5,433 |
2.2× |
| Tx devices design & construction complex (77334) |
$406.20 |
$2,031 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$131.80 |
$659 |
1.4× |
| Unlisted magnetic resonance procedure (76498) |
$325 |
$1,625 |
4.1× |
| Urethrocystography voiding (74455) |
$150.20 |
$751 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$214.40 |
$1,072 |
1.3× |
| Us abdl aorta screen aaa (76706) |
$77 |
$385 |
0.8× |
| Us breast unilateral complete (76641) |
$158.40 |
$792 |
1.7× |
| Us breast unilateral limited (76642) |
$121.40 |
$607 |
1.5× |
| Us chest (76604) |
$99.40 |
$497 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$147.80 |
$739 |
1.6× |
| Us elastography parenchyma (76981) |
$75.60 |
$378 |
0.8× |
| Us infant hips dynamic (76885) |
$165.40 |
$827 |
2.1× |
| Us infant hips limited static (76886) |
$113.80 |
$569 |
1.4× |
| Us ob transvaginal (76817) |
$221.60 |
$1,108 |
2.3× |
| Us pelvic non ob complete (76856) |
$241 |
$1,205 |
2.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$122.60 |
$613 |
1.3× |
| Us pregnancy ltd (76815) |
$142.30 |
$711.50 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$231.60 |
$1,158 |
2.4× |
| Us retroperitoneal complete (76770) |
$229.20 |
$1,146 |
2.4× |
| Us retroperitoneal limited (76775) |
$152.80 |
$764 |
1.6× |
| Us scrotum and contents (76870) |
$268 |
$1,340 |
2.8× |
| Us soft tissue head/neck (76536) |
$196.60 |
$983 |
2.1× |
| Us spinal canal and contents (76800) |
$99.40 |
$497 |
1.0× |
| Us transrectal (76872) |
$210.80 |
$1,054 |
2.2× |
| Us transrectal prostate volume (76873) |
$210.80 |
$1,054 |
2.2× |
| Us xtr non-vasc lmtd (76882) |
$93.60 |
$468 |
1.0× |
| Venogram extremity bilateral (75822) |
$510.20 |
$2,551 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,574.60 |
$7,873 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$557.80 |
$2,789 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$485.80 |
$2,429 |
0.3× |
| Wrist 2 views (73100) |
$54.40 |
$272 |
0.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$151.20 |
$756 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$93.80 |
$469 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$84.40 |
$422 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$196.80 |
$984 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$60.20 |
$301 |
0.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$89 |
$445 |
1.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$121.40 |
$607 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$50.60 |
$253 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$98.80 |
$494 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$109.40 |
$547 |
1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$109.40 |
$547 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$126.80 |
$634 |
1.3× |
| X-ray exam of femur 1 (73551) |
$45.40 |
$227 |
0.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$158.20 |
$791 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$77.40 |
$387 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$83.40 |
$417 |
1.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$52.80 |
$264 |
0.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$74.60 |
$373 |
0.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$101.20 |
$506 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$57 |
$285 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$115.40 |
$577 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$133 |
$665 |
1.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$77.40 |
$387 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$84.40 |
$422 |
1.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$84.60 |
$423 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$110 |
$550 |
1.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$106.80 |
$534 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$96.40 |
$482 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$145.20 |
$726 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$194.80 |
$974 |
2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$82 |
$410 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$78 |
$390 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$94 |
$470 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$106.80 |
$534 |
1.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$64.20 |
$321 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$124 |
$620 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$93.80 |
$469 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$54.40 |
$272 |
0.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$103.20 |
$516 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$107.40 |
$537 |
1.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$129 |
$645 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$58 |
$290 |
0.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$83.60 |
$418 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$145.20 |
$726 |
1.5× |
| Xr chest 4+ views (71048) |
$98.80 |
$494 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$65.40 |
$327 |
0.8× |
| Xr shoulder 1 view (73020) |
$54.40 |
$272 |
0.7× |
| Xr spine cervical 4 or 5 views (72050) |
$114.20 |
$571 |
1.2× |
| Xr tibia/fibula 2 views (73590) |
$83.40 |
$417 |
1.1× |
| Xr tmj bilateral (70330) |
$113.80 |
$569 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$83.20 |
$416 |
1.1× |