| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,407.52 |
$7,628 |
4.3× |
| Abdomen 2 views (74019) |
$345.66 |
$411.50 |
3.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,052.96 |
$2,444 |
4.8× |
| Angiography extremity bilateral rs&i (75716) |
$9,198 |
$10,950 |
2.7× |
| Angiography extremity unilateral rs&i (75710) |
$5,531.82 |
$6,585.50 |
1.6× |
| Angiography internal mammary rs&i (75756) |
$9,025.38 |
$10,744.50 |
2.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$7,227.36 |
$8,604 |
1.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,692.22 |
$4,395.50 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,852.24 |
$4,586 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$17,025.12 |
$20,268 |
2.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$13,761.30 |
$16,382.50 |
2.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$7,086.24 |
$8,436 |
2.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,971.12 |
$5,918 |
1.5× |
| Ankle 2 views (73600) |
$230.58 |
$274.50 |
2.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$863.94 |
$1,028.50 |
2.3× |
| Aortogram thoracic (75605) |
$5,853.96 |
$6,969 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,932.48 |
$5,872 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$4,932.48 |
$5,872 |
1.4× |
| Arthrogram elbow (73085) |
$833.28 |
$992 |
2.2× |
| Arthrogram hip (73525) |
$1,018.50 |
$1,212.50 |
2.7× |
| Arthrogram shoulder (73040) |
$1,018.50 |
$1,212.50 |
2.7× |
| Arthrogram wrist (73115) |
$1,089.48 |
$1,297 |
2.9× |
| Arthrography knee lt (73580) |
$1,089.48 |
$1,297 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$771.12 |
$918 |
5.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,441.44 |
$1,716 |
3.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,606.50 |
$1,912.50 |
3.7× |
| Bone &/joint imaging whole body (78306) |
$2,052.96 |
$2,444 |
4.8× |
| Bone age studies (77072) |
$223.02 |
$265.50 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$2,456.16 |
$2,924 |
5.7× |
| Bone Marrow Imaging Limited Area (78102) |
$1,569.54 |
$1,868.50 |
3.6× |
| Bone survey complete (77075) |
$1,118.04 |
$1,331 |
9.9× |
| Brachytx isodose complex (77318) |
$1,696.80 |
$2,020 |
4.2× |
| Brachytx isodose intermed (77317) |
$1,696.80 |
$2,020 |
4.2× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,696.80 |
$2,020 |
4.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$2,131.50 |
$2,537.50 |
4.9× |
| Brain Imaging Minimum 4 Static Views (78605) |
$2,172.66 |
$2,586.50 |
3.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,237.44 |
$8,616 |
4.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,905.12 |
$2,268 |
5.1× |
| Cardiac shunt detection (78428) |
$1,449 |
$1,725 |
3.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,090.34 |
$2,488.50 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$392.70 |
$467.50 |
4.2× |
| Chest 1 view (71045) |
$246.54 |
$293.50 |
2.6× |
| Chest 3 views (71047) |
$246.54 |
$293.50 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$353.64 |
$421 |
1.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$978.18 |
$1,164.50 |
1.2× |
| Clavicle complete (73000) |
$392.70 |
$467.50 |
4.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$940.38 |
$1,119.50 |
8.3× |
| Continuing medical physics consltj pr wk (77336) |
$758.52 |
$903 |
5.2× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$341.88 |
$407 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,056.80 |
$6,020 |
13.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,935.38 |
$3,494.50 |
11.4× |
| CT abdomen w contrast (74160) |
$2,941.26 |
$3,501.50 |
15.5× |
| CT abdomen w wo contrast (74170) |
$3,309.18 |
$3,939.50 |
17.5× |
| CT abdomen w/o contrast (74150) |
$2,264.22 |
$2,695.50 |
20.0× |
| CT angio hrt w/3d image (75574) |
$2,364.60 |
$2,815 |
6.3× |
| CT angiography upper extremity lt (73206) |
$2,606.10 |
$3,102.50 |
13.7× |
| CT c-spine w/o contrast (72125) |
$2,108.82 |
$2,510.50 |
18.7× |
| CT cervical spine w&w/o contrast (72127) |
$3,430.98 |
$4,084.50 |
18.1× |
| CT cervical spine with contrast (72126) |
$3,196.62 |
$3,805.50 |
8.5× |
| CT chest w/wo contrast (71270) |
$3,562.86 |
$4,241.50 |
18.8× |
| CT chest with contrast (71260) |
$3,795.96 |
$4,519 |
20.0× |
| CT colonography screening (74263) |
$700.98 |
$834.50 |
2.7× |
| CT colonography w/dye (74262) |
$1,044.96 |
$1,244 |
5.5× |
| CT colonography w/o cntrst (74261) |
$976.50 |
$1,162.50 |
8.6× |
| CT head/brain with contrast (70460) |
$2,206.68 |
$2,627 |
11.6× |
| CT head/brain without and with contrast (70470) |
$4,391.10 |
$5,227.50 |
23.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,032.36 |
$1,229 |
2.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$167.16 |
$199 |
1.8× |
| CT hrt w/3d image congen (75573) |
$1,335.18 |
$1,589.50 |
3.5× |
| CT iac w contrast (70481) |
$2,479.68 |
$2,952 |
13.1× |
| CT limited/localized follow up study (76380) |
$288.96 |
$344 |
3.1× |
| CT lower ext w/o (73700) |
$1,938.30 |
$2,307.50 |
17.2× |
| CT lower extremity w wo contrast (73702) |
$2,730.84 |
$3,251 |
14.4× |
| CT lower extremity with contrast (73701) |
$2,486.40 |
$2,960 |
13.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,120.60 |
$3,715 |
16.5× |
| CT lumbar spine w/o contrast (72131) |
$1,936.20 |
$2,305 |
17.1× |
| CT lumbar spine with contrast (72132) |
$2,755.62 |
$3,280.50 |
7.3× |
| CT maxillofacial w contrast (70487) |
$2,648.94 |
$3,153.50 |
14.0× |
| CT maxillofacial w/o contrast (70486) |
$2,198.28 |
$2,617 |
19.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,947.14 |
$3,508.50 |
15.5× |
| CT neck soft tissue w contrast (70491) |
$3,703.14 |
$4,408.50 |
19.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,947.14 |
$3,508.50 |
15.5× |
| CT orbits w/o contrast (70480) |
$1,610.28 |
$1,917 |
14.3× |
| CT pelvis w & w/o contrast (72194) |
$2,709.84 |
$3,226 |
14.3× |
| CT pelvis w/o contrast (72192) |
$1,505.28 |
$1,792 |
13.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,543.54 |
$4,218.50 |
18.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,489.74 |
$1,773.50 |
13.2× |
| CT thoracic spine w/contrast (72129) |
$2,848.44 |
$3,391 |
15.0× |
| CT thoracic spine w/o contrast (72128) |
$2,232.72 |
$2,658 |
19.8× |
| CT thoracic spine w/wo contrast (72130) |
$3,460.38 |
$4,119.50 |
18.3× |
| CT thorax w/o contrast (71250) |
$2,453.64 |
$2,921 |
21.7× |
| CT unlisted procedure (76497) |
$344.40 |
$410 |
3.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,867.76 |
$3,414 |
15.1× |
| CT upper extremity w/o contrast rt (73200) |
$2,031.96 |
$2,419 |
18.0× |
| CT upper extremity with contrast (73201) |
$2,612.40 |
$3,110 |
6.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,496.94 |
$5,353.50 |
23.7× |
| Cta Abdomen (74175) |
$3,647.70 |
$4,342.50 |
19.2× |
| CTA abdomen pelvis (74174) |
$5,855.64 |
$6,971 |
15.5× |
| CTA chest (71275) |
$4,286.10 |
$5,102.50 |
22.6× |
| Cta Head (70496) |
$2,457.84 |
$2,926 |
13.0× |
| CTA lwr ext w&w/o contrast (73706) |
$2,449.86 |
$2,916.50 |
12.9× |
| Cta Neck (70498) |
$2,453.64 |
$2,921 |
12.9× |
| Cta Pelvis (72191) |
$3,664.92 |
$4,363 |
19.3× |
| Cystography minimum 3 views rs&i (74430) |
$863.94 |
$1,028.50 |
2.3× |
| Diskogram cervical (72285) |
$9,445.38 |
$11,244.50 |
4.5× |
| Diskography lumbar (72295) |
$9,507.54 |
$11,318.50 |
4.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$444.78 |
$529.50 |
3.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$890.40 |
$1,060 |
7.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$373.38 |
$444.50 |
3.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$457.38 |
$544.50 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$180.18 |
$214.50 |
1.9× |
| Echo exam of fetal heart (76825) |
$1,068.06 |
$1,271.50 |
1.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$879.06 |
$1,046.50 |
3.4× |
| Echoencephalography real time imaging (76506) |
$560.28 |
$667 |
5.0× |
| Esophagus (74220) |
$341.88 |
$407 |
1.8× |
| Fetal biophysical profile non-stress testing (76818) |
$1,121.40 |
$1,335 |
9.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$899.22 |
$1,070.50 |
8.0× |
| Fluoroscopy up to 1 hr (76000) |
$478.38 |
$569.50 |
1.9× |
| Foot 2 views (73620) |
$282.66 |
$336.50 |
3.0× |
| Forearm 2 views (73090) |
$282.66 |
$336.50 |
3.0× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$2,753.52 |
$3,278 |
4.7× |
| Gastrointestinal Protein Loss (78282) |
$1,488.48 |
$1,772 |
3.4× |
| Gated Heart Planar Single (78472) |
$2,325.12 |
$2,768 |
5.4× |
| Hand 2 views (73120) |
$282.66 |
$336.50 |
2.5× |
| Hand 3 views (73130) |
$318.78 |
$379.50 |
3.4× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,579.24 |
$4,261 |
4.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,579.24 |
$4,261 |
4.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,579.24 |
$4,261 |
4.8× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,071 |
$1,275 |
2.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,071 |
$1,275 |
2.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$7,121.52 |
$8,478 |
2.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,622.88 |
$1,932 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,622.88 |
$1,932 |
3.8× |
| Ht muscle image spect sing (78451) |
$3,580.08 |
$4,262 |
2.6× |
| Humerus Min 2 Views Left (73060) |
$282.66 |
$336.50 |
3.0× |
| Hysterosalpingogram (74740) |
$1,065.12 |
$1,268 |
4.1× |
| Image fusion (77399) |
$544.32 |
$648 |
3.7× |
| Interstitial radiation source applic complex (77778) |
$4,643.52 |
$5,528 |
6.2× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,392.32 |
$2,848 |
3.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,925.28 |
$2,292 |
3.2× |
| Intracavitary radiation source applic simple (77761) |
$1,725.36 |
$2,054 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$308.28 |
$367 |
2.7× |
| Kidney imaging morphology (78700) |
$1,606.50 |
$1,912.50 |
3.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,496.08 |
$4,162 |
6.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$4,405.38 |
$5,244.50 |
7.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,983.24 |
$2,361 |
3.4× |
| Knee 3 views (73562) |
$282.66 |
$336.50 |
3.0× |
| Liver & spleen imaging static only (78215) |
$1,685.46 |
$2,006.50 |
3.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,417.52 |
$2,878 |
5.6× |
| Liver imaging w/vascular flow (78202) |
$2,052.96 |
$2,444 |
3.5× |
| Lung perf&ventilat diferentl (78598) |
$3,217.62 |
$3,830.50 |
5.5× |
| Lung perfusion differential (78597) |
$1,606.50 |
$1,912.50 |
3.7× |
| Lung Ventilation Imaging (78579) |
$1,559.88 |
$1,857 |
3.6× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$9,025.38 |
$10,744.50 |
2.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$3,736.74 |
$4,448.50 |
1.1× |
| Lymphoscintigraphy (78195) |
$2,449.02 |
$2,915.50 |
4.2× |
| Mammary ductogram or galactogram multiple (77054) |
$755.16 |
$899 |
2.9× |
| Mammary ductogram or galactogram single (77053) |
$755.16 |
$899 |
2.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$234.36 |
$279 |
2.5× |
| Meckels Diverticulum (78290) |
$1,523.34 |
$1,813.50 |
3.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$987.84 |
$1,176 |
2.4× |
| Mr elastography (76391) |
$1,852.20 |
$2,205 |
7.2× |
| MRA head w & w/o contrast (70546) |
$4,012.68 |
$4,777 |
10.6× |
| MRA head w/o contrast (70544) |
$2,777.46 |
$3,306.50 |
10.8× |
| MRA head with contrast (70545) |
$3,551.52 |
$4,228 |
9.4× |
| MRA neck w contrast (70548) |
$3,482.64 |
$4,146 |
9.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,012.68 |
$4,777 |
10.6× |
| MRA neck w/o contrast (70547) |
$2,777.46 |
$3,306.50 |
10.8× |
| MRI abdomen w contrast (74182) |
$3,026.52 |
$3,603 |
8.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,073.58 |
$4,849.50 |
10.8× |
| MRI abdomen w/o contrast (74181) |
$2,847.18 |
$3,389.50 |
11.0× |
| MRI any jnt lwr ext with con lt (73722) |
$3,872.82 |
$4,610.50 |
4.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,006.38 |
$4,769.50 |
4.7× |
| MRI breast w/o contrast bilateral (77047) |
$784.98 |
$934.50 |
3.0× |
| MRI breast w/o contrast unilat (77046) |
$784.98 |
$934.50 |
3.0× |
| MRI c-spine with contrast (72142) |
$3,118.92 |
$3,713 |
8.3× |
| MRI cardiac w/o contrast (75557) |
$1,757.70 |
$2,092.50 |
6.8× |
| MRI cervical spine w/o contrast (72141) |
$3,222.66 |
$3,836.50 |
12.5× |
| MRI chest w/o & w/contrast material (71552) |
$4,059.72 |
$4,833 |
10.8× |
| MRI chest w/o contrast (71550) |
$2,709.84 |
$3,226 |
10.5× |
| MRI chest with contrast (71551) |
$2,634.24 |
$3,136 |
3.1× |
| MRI fetal sngl/1st gestation (74712) |
$973.56 |
$1,159 |
3.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,992.92 |
$3,563 |
7.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,104.66 |
$4,886.50 |
10.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,408.30 |
$4,057.50 |
13.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,827.44 |
$3,366 |
11.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,288.22 |
$6,295.50 |
14.0× |
| MRI pelvis w contrast (72196) |
$3,094.56 |
$3,684 |
8.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,354.56 |
$5,184 |
11.6× |
| MRI pelvis w/o contrast (72195) |
$2,948.40 |
$3,510 |
11.4× |
| MRI scan of arm joint before and after contrast (73223) |
$4,887.54 |
$5,818.50 |
13.0× |
| MRI scan of leg joint before and after contrast (73723) |
$4,868.64 |
$5,796 |
12.9× |
| MRI spectroscopy (76390) |
$2,683.38 |
$3,194.50 |
28.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,273.96 |
$7,469 |
16.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,209.22 |
$3,820.50 |
8.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,534.76 |
$6,589 |
14.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,236.52 |
$3,853 |
8.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,128.64 |
$7,296 |
16.3× |
| MRI thoracic spine w/o contrast (72146) |
$3,368.82 |
$4,010.50 |
13.1× |
| MRI tmj (70336) |
$2,709.84 |
$3,226 |
10.5× |
| MRI upper ext joint w/o contrast (73221) |
$3,441.90 |
$4,097.50 |
13.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,137.42 |
$4,925.50 |
11.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,941.68 |
$3,502 |
11.4× |
| Myelogram Cervical (72240) |
$1,795.50 |
$2,137.50 |
2.1× |
| Myelogram Lumbar (72265) |
$1,795.50 |
$2,137.50 |
2.1× |
| Myelogram thoracic (72255) |
$1,728.72 |
$2,058 |
2.0× |
| Myelography 2 or more regions (72270) |
$1,729.98 |
$2,059.50 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,211.34 |
$5,013.50 |
3.0× |
| Neck soft tissue (70360) |
$267.12 |
$318 |
2.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,599.36 |
$1,904 |
3.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,485.96 |
$1,769 |
3.4× |
| Nm adrenal scan (78075) |
$5,013.12 |
$5,968 |
3.6× |
| Nm bone marrow wb (78104) |
$1,606.50 |
$1,912.50 |
3.7× |
| Nm cisternogram (78630) |
$3,326.40 |
$3,960 |
5.7× |
| Nm csf leak detection (78650) |
$2,349.06 |
$2,796.50 |
1.7× |
| Nm gastric emptying study (78264) |
$2,052.96 |
$2,444 |
4.8× |
| Nm gastroesophageal reflux study (78262) |
$1,215.48 |
$1,447 |
2.8× |
| Nm peritoneal-venous shunt patency (78291) |
$1,612.38 |
$1,919.50 |
3.7× |
| Nm red cell sequestration (78140) |
$1,097.46 |
$1,306.50 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,389.48 |
$8,797 |
4.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,749.72 |
$2,083 |
4.1× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$2,498.58 |
$2,974.50 |
5.8× |
| Nuclear Rx Oral Admin (79005) |
$1,464.96 |
$1,744 |
5.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$425.46 |
$506.50 |
3.8× |
| Orthopantogram (70355) |
$282.66 |
$336.50 |
3.0× |
| Osseous survey infant (77076) |
$320.46 |
$381.50 |
2.8× |
| Osseous survey limited (77074) |
$288.54 |
$343.50 |
2.6× |
| Parathyrd planar w/spect&CT (78072) |
$2,952.60 |
$3,515 |
5.0× |
| Parathyrd planar w/wo subtrj (78071) |
$2,952.60 |
$3,515 |
6.8× |
| Parathyroid imaging (78070) |
$1,758.96 |
$2,094 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$282.66 |
$336.50 |
2.5× |
| Peritoneogram rs&i (74190) |
$2,231.04 |
$2,656 |
3.8× |
| PET image w/CT, skull-thigh (78815) |
$9,929.22 |
$11,820.50 |
6.4× |
| PET imaging CT for attenuation limited area (78814) |
$9,737.28 |
$11,592 |
6.3× |
| PET imaging for CT attenuation whole body (78816) |
$9,929.22 |
$11,820.50 |
6.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$5,638.92 |
$6,713 |
15.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,515.40 |
$4,185 |
1.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,945.88 |
$3,507 |
0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,048.76 |
$2,439 |
4.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,217.62 |
$3,830.50 |
5.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,065.12 |
$1,268 |
1.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$253.26 |
$301.50 |
2.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$420.84 |
$501 |
3.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$420.84 |
$501 |
3.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$282.66 |
$336.50 |
2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$801.78 |
$954.50 |
7.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$20,568.24 |
$24,486 |
2.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,549.80 |
$1,845 |
2.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$739.20 |
$880 |
6.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$970.20 |
$1,155 |
2.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$320.46 |
$381.50 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$270.48 |
$322 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$406.98 |
$484.50 |
3.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$336 |
$400 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$507.78 |
$604.50 |
2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$599.34 |
$713.50 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$599.34 |
$713.50 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$507.78 |
$604.50 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$253.26 |
$301.50 |
2.7× |
| Radiological examination surgical specimen (76098) |
$876.12 |
$1,043 |
1.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$7,121.52 |
$8,478 |
2.1× |
| Ribs bilateral 3 views (71110) |
$302.82 |
$360.50 |
2.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,981.16 |
$3,549 |
5.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$4,060.14 |
$4,833.50 |
6.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,817.84 |
$6,926 |
3.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$6,433.56 |
$7,659 |
4.6× |
| Rp Therapy Intravenous Administration (79101) |
$840.42 |
$1,000.50 |
3.3× |
| Sacroiliac Joints < 3 Views (72200) |
$399 |
$475 |
3.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,100.40 |
$1,310 |
4.3× |
| Salivary gland imaging (78230) |
$989.10 |
$1,177.50 |
2.3× |
| Scanogram (77073) |
$282.66 |
$336.50 |
2.5× |
| Scapula complete (73010) |
$282.66 |
$336.50 |
2.5× |
| Screening digital breast tomosynthesis (77063) |
$80.64 |
$96 |
3.4× |
| Sialogram (70390) |
$1,043.70 |
$1,242.50 |
4.0× |
| Simulation intermediate (77285) |
$1,499.40 |
$1,785 |
3.7× |
| Small bowel series (74250) |
$526.26 |
$626.50 |
2.8× |
| Spec medical radj physics consltj (77370) |
$1,705.20 |
$2,030 |
11.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,606.08 |
$1,912 |
4.0× |
| Special dosimetry (77331) |
$771.12 |
$918 |
5.3× |
| Special treatment procedure (77470) |
$2,844.24 |
$3,386 |
4.8× |
| Spine thoracic 3 views (72072) |
$392.70 |
$467.50 |
3.5× |
| Spleen imaging only (78185) |
$1,185.66 |
$1,411.50 |
2.7× |
| Stereotactic body radiation delivery (77373) |
$11,001.48 |
$13,097 |
5.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,738.80 |
$2,070 |
4.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,122.24 |
$1,336 |
2.8× |
| Testicular Imaging With Vascular Flow (78761) |
$1,254.96 |
$1,494 |
2.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,711.08 |
$2,037 |
4.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$761.04 |
$906 |
5.2× |
| Thoracolumbar 2 views (72080) |
$366.66 |
$436.50 |
3.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,739.66 |
$3,261.50 |
4.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,336.44 |
$1,591 |
3.1× |
| Thyroid uptake measurement (78012) |
$621.60 |
$740 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,971.90 |
$2,347.50 |
4.6× |
| Treatment device intermediate (77333) |
$1,349.04 |
$1,606 |
9.3× |
| Treatment devices simple (77332) |
$1,349.04 |
$1,606 |
9.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,761.94 |
$4,478.50 |
6.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,384.76 |
$2,839 |
5.5× |
| Tx devices design & construction complex (77334) |
$1,569.96 |
$1,869 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$874.44 |
$1,041 |
7.7× |
| Umbilical-artery Doppler (OB) (76820) |
$430.92 |
$513 |
3.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$280.14 |
$333.50 |
3.0× |
| Unlisted fluoroscopic procedure (76496) |
$260.82 |
$310.50 |
2.8× |
| Unlisted magnetic resonance procedure (76498) |
$1,735.44 |
$2,066 |
18.5× |
| Unlisted Ultrasound Procedure (76999) |
$296.52 |
$353 |
3.2× |
| Upper Extremity Infant (73092) |
$320.46 |
$381.50 |
2.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,194.90 |
$1,422.50 |
2.8× |
| Urethrocystography retrograde rs&i (74450) |
$863.94 |
$1,028.50 |
3.4× |
| Urethrocystography voiding (74455) |
$1,028.16 |
$1,224 |
4.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,398.60 |
$1,665 |
7.4× |
| Us abdl aorta screen aaa (76706) |
$464.52 |
$553 |
4.1× |
| Us breast unilateral complete (76641) |
$477.12 |
$568 |
4.2× |
| Us breast unilateral limited (76642) |
$357.84 |
$426 |
3.8× |
| Us chest (76604) |
$485.94 |
$578.50 |
4.3× |
| Us compl joint r-t w/image documentation (76881) |
$852.60 |
$1,015 |
7.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$444.78 |
$529.50 |
3.9× |
| Us guided compression repair (76936) |
$592.62 |
$705.50 |
2.5× |
| Us infant hips dynamic (76885) |
$552.72 |
$658 |
5.9× |
| Us infant hips limited static (76886) |
$552.72 |
$658 |
5.9× |
| Us kidney transplant (76776) |
$874.44 |
$1,041 |
7.7× |
| Us ob detailed single fetus (76811) |
$444.78 |
$529.50 |
1.7× |
| Us ob transvaginal (76817) |
$549.78 |
$654.50 |
4.9× |
| Us pelvic non ob complete (76856) |
$874.44 |
$1,041 |
7.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$560.28 |
$667 |
5.0× |
| Us pregnancy ltd (76815) |
$485.94 |
$578.50 |
4.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$485.94 |
$578.50 |
4.3× |
| Us retroperitoneal complete (76770) |
$874.44 |
$1,041 |
7.7× |
| Us retroperitoneal limited (76775) |
$874.44 |
$1,041 |
7.7× |
| Us scrotum and contents (76870) |
$874.44 |
$1,041 |
7.7× |
| Us soft tissue head/neck (76536) |
$376.32 |
$448 |
3.3× |
| Us spinal canal and contents (76800) |
$702.24 |
$836 |
6.2× |
| Us transrectal (76872) |
$480.48 |
$572 |
4.3× |
| Us xtr non-vasc lmtd (76882) |
$663.60 |
$790 |
5.9× |
| Vascular flow imaging (78445) |
$906.78 |
$1,079.50 |
2.1× |
| Venogram extremity bilateral (75822) |
$2,802.24 |
$3,336 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$7,829.64 |
$9,321 |
2.3× |
| Venography caval superior serialography rs&i (75827) |
$2,350.32 |
$2,798 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,995.84 |
$2,376 |
1.2× |
| Venography Renal Bilateral (75833) |
$3,416.70 |
$4,067.50 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$3,416.70 |
$4,067.50 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,960.20 |
$5,905 |
1.5× |
| Wrist 2 views (73100) |
$230.58 |
$274.50 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$480.48 |
$572 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$336 |
$400 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$510.72 |
$608 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$282.66 |
$336.50 |
3.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$801.78 |
$954.50 |
7.1× |
| X-ray exam hip uni 1 view (73501) |
$286.86 |
$341.50 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$286.86 |
$341.50 |
3.1× |
| X-ray exam hip uni 4/> views (73503) |
$420.84 |
$501 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$420.84 |
$501 |
3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$801.78 |
$954.50 |
7.1× |
| X-ray exam of femur 1 (73551) |
$253.26 |
$301.50 |
2.7× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$921.90 |
$1,097.50 |
4.9× |
| X-ray eye for foreign body (70030) |
$372.54 |
$443.50 |
4.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$388.50 |
$462.50 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$366.24 |
$436 |
3.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$282.66 |
$336.50 |
3.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$3,301.62 |
$3,930.50 |
1.5× |
| X-ray head for orthodontia (70350) |
$290.64 |
$346 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$282.66 |
$336.50 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$216.72 |
$258 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$259.56 |
$309 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$282.66 |
$336.50 |
2.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$473.34 |
$563.50 |
4.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$320.46 |
$381.50 |
2.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$193.20 |
$230 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$392.70 |
$467.50 |
3.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$282.66 |
$336.50 |
2.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$927.36 |
$1,104 |
2.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$320.46 |
$381.50 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$472.50 |
$562.50 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$387.66 |
$461.50 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$235.20 |
$280 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$473.34 |
$563.50 |
4.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$282.66 |
$336.50 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$392.70 |
$467.50 |
4.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$338.52 |
$403 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$390.60 |
$465 |
4.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$392.70 |
$467.50 |
3.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$392.70 |
$467.50 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$282.66 |
$336.50 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$282.66 |
$336.50 |
3.0× |
| Xr arthrogram ankle (73615) |
$609.84 |
$726 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$656.88 |
$782 |
5.8× |
| Xr chest 4+ views (71048) |
$464.52 |
$553 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$365.82 |
$435.50 |
3.9× |
| Xr optic foramina (70190) |
$295.68 |
$352 |
3.1× |
| Xr shoulder 1 view (73020) |
$202.86 |
$241.50 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$656.88 |
$782 |
5.8× |
| Xr tibia/fibula 2 views (73590) |
$392.70 |
$467.50 |
4.2× |
| Xr tmj bilateral (70330) |
$282.66 |
$336.50 |
3.0× |
| Xray knee 1 or 2 views rt (73560) |
$282.66 |
$336.50 |
3.0× |