| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,076.37 |
$8,460.62 |
3.7× |
| Acute gi blood loss imaging (78278) |
$1,325.40 |
$2,209 |
3.3× |
| Angiography internal mammary rs&i (75756) |
$1,629.33 |
$2,715.55 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,273.68 |
$5,456.13 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,313.88 |
$7,189.80 |
0.8× |
| Angiography, adrenal, bilateral, selective, radiological supervision and interpretation Age Under 21 (75733) |
$2,924.46 |
$4,874.10 |
0.9× |
| Angiography, adrenal, unilateral, selective, radiological supervision and interpretation Age Under 21 (75731) |
$1,853.47 |
$3,089.11 |
0.6× |
| Angiography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75716) |
$3,340.21 |
$5,567.02 |
1.1× |
| Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) |
$2,911.87 |
$4,853.12 |
0.9× |
| Angiography, pelvic, selective or supraselective, radiological supervision and interpretation Age Under 21 (75736) |
$3,697.61 |
$6,162.68 |
0.7× |
| Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation Age Under 21 (75741) |
$3,150 |
$5,250 |
1.0× |
| Angiography, spinal, selective, radiological supervision and interpretation Age Under 21 (75705) |
$3,791.29 |
$6,318.82 |
0.7× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$1,795.50 |
$2,992.50 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,704.33 |
$2,840.55 |
0.5× |
| Ankle 2 views (73600) |
$201.43 |
$335.72 |
2.3× |
| Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision… (75630) |
$3,154.93 |
$5,258.21 |
1.0× |
| Aortography, abdominal, by serialography, radiological supervision and interpretation Age Under 21 (75625) |
$3,138.05 |
$5,230.08 |
1.0× |
| Aortography, thoracic, by serialography, radiological supervision and interpretation Age Under 21 (75605) |
$2,932.65 |
$4,887.75 |
0.5× |
| Aortography, thoracic, without serialography, radiological supervision and interpretation Age Under 21 (75600) |
$3,570 |
$5,950 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$437.97 |
$729.95 |
3.2× |
| Brain flow imaging only - nm brain flow only brain death (78610) |
$472.92 |
$788.20 |
0.9× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$1,063.48 |
$1,772.47 |
2.6× |
| Brain imaging, minimum 4 static views; with vascular flow Age Under 21 (78606) |
$1,438.59 |
$2,397.65 |
2.6× |
| Brain imaging, positron emission tomography (PET); metabolic evaluation Age Under 21 (78608) |
$3,028.73 |
$5,047.88 |
2.1× |
| Card MRI w/stress img & dye (75563) |
$3,780 |
$6,300 |
4.8× |
| Cardiac MRI morphology & function w/o contrast (75557) |
$2,474.36 |
$4,123.93 |
10.3× |
| Cardiac MRI w/stress img (75559) |
$1,506.82 |
$2,511.37 |
2.7× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$3,082.29 |
$5,137.15 |
8.8× |
| Cholecystography, oral contrast Age Under 21 (74290) |
$186.25 |
$310.41 |
1.1× |
| Cineradiography/videoradiography (76120) |
$393.44 |
$655.74 |
3.7× |
| Cisternography, positive contrast, radiological supervision and interpretation Age Under 21 (70015) |
$1,336.32 |
$2,227.20 |
1.7× |
| Clavicle complete (73000) |
$218.79 |
$364.65 |
2.5× |
| Complex dynamic pharyngeal and speech evaluation by cine or video recording Age Under 21 (70371) |
$527.06 |
$878.44 |
2.2× |
| Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material Age Under… (74261) |
$647.22 |
$1,078.70 |
6.2× |
| Computed tomographic (CT) colonography, screening, including image postprocessing (74263) |
$1,172.27 |
$1,953.79 |
4.9× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$5,465.29 |
$9,108.82 |
15.6× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$3,286.30 |
$5,477.16 |
18.7× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$2,563.10 |
$4,271.83 |
14.5× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$3,494.98 |
$5,824.97 |
19.8× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$2,835 |
$4,725 |
16.1× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$3,246.73 |
$5,411.22 |
18.4× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$3,198.62 |
$5,331.04 |
18.2× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$3,138.19 |
$5,230.31 |
17.8× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$2,835 |
$4,725 |
16.1× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,588.30 |
$2,647.16 |
15.1× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$1,915.82 |
$3,193.04 |
10.9× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$1,553.11 |
$2,588.51 |
8.8× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,855.93 |
$3,093.22 |
10.5× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,578.28 |
$2,630.46 |
15.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,429.47 |
$2,382.45 |
8.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,554.50 |
$2,590.83 |
14.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$1,447.65 |
$2,412.75 |
8.2× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$2,139.83 |
$3,566.39 |
12.1× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$3,150 |
$5,250 |
17.9× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$2,835 |
$4,725 |
16.1× |
| Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose… (77336) |
$642.95 |
$1,071.58 |
4.8× |
| Corpora cavernosography, radiological supervision and interpretation Age Under 21 (74445) |
$565.20 |
$942 |
5.4× |
| Csf shunt evaluation (78645) |
$895.95 |
$1,493.25 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,863.08 |
$6,438.46 |
11.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,276 |
$5,460 |
13.7× |
| CT abdomen w & w/o contrast (74170) |
$2,835 |
$4,725 |
16.1× |
| CT abdomen w/contrast (74160) |
$2,835 |
$4,725 |
16.1× |
| CT abdomen w/o contrast (74150) |
$2,016 |
$3,360 |
19.2× |
| CT angio hrt w/3d image (75574) |
$1,975.84 |
$3,293.07 |
5.6× |
| CT cervical spine w/contrast (72126) |
$2,133.88 |
$3,556.47 |
6.1× |
| CT cervical spine w/o contrast (72125) |
$1,890.98 |
$3,151.64 |
18.0× |
| CT chest w/contrast (71260) |
$1,855.46 |
$3,092.44 |
10.5× |
| CT extremity upper w & w/o contrast (73202) |
$1,708.67 |
$2,847.78 |
9.7× |
| CT extremity upper w/o contrast (73200) |
$1,710.48 |
$2,850.80 |
16.3× |
| CT head/brain with contrast (70460) |
$1,556.84 |
$2,594.74 |
8.8× |
| CT head/brain without and with contrast (70470) |
$1,890.64 |
$3,151.06 |
10.7× |
| CT heart c+ cardiac strux&morph cgen hrt ds (75573) |
$934.40 |
$1,557.33 |
2.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,954.66 |
$3,257.77 |
5.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$79 |
$131.67 |
0.9× |
| CT l-spine w/contrast (72132) |
$2,205 |
$3,675 |
6.3× |
| CT limited/localized follow up study (76380) |
$687.44 |
$1,145.74 |
7.9× |
| CT lower extremity w/dye (73701) |
$2,222.14 |
$3,703.57 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$1,902.58 |
$3,170.97 |
18.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,766.85 |
$2,944.75 |
10.0× |
| CT neck w/contrast (70491) |
$1,837.21 |
$3,062.01 |
10.4× |
| CT neck w/o contrast (70490) |
$1,425.62 |
$2,376.03 |
13.6× |
| CT pelvis w & w/o contrast (72194) |
$1,895.99 |
$3,159.98 |
10.8× |
| CT pelvis w/o contrast (72192) |
$1,501.72 |
$2,502.87 |
14.3× |
| CT thoracic spine w/contrast (72129) |
$2,105.72 |
$3,509.53 |
12.0× |
| CT thoracic spine w/o contrast (72128) |
$1,750.41 |
$2,917.35 |
16.7× |
| CT thorax lung cancer scr c- (71271) |
$170.42 |
$284.03 |
1.6× |
| CT thorax w/o contrast (71250) |
$1,555.66 |
$2,592.77 |
14.8× |
| CT upper extremity w/dye (73201) |
$2,220.61 |
$3,701.02 |
6.3× |
| CTA head w contrast (70496) |
$3,281.71 |
$5,469.51 |
18.6× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$301.92 |
$503.20 |
0.9× |
| Dilation ureters/urethra rs&i (74485) |
$1,525.20 |
$2,542 |
0.7× |
| Discography, cervical or thoracic, radiological supervision and interpretation Age Under 21 (72285) |
$2,050.91 |
$3,418.19 |
1.0× |
| Diskography lumbar s&i (72295) |
$2,183.55 |
$3,639.25 |
1.1× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete Age Under 21 (76827) |
$399.45 |
$665.75 |
3.8× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$294.76 |
$491.27 |
2.8× |
| Doppler fetal mid cerebral artery (76821) |
$346.50 |
$577.50 |
3.3× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$352.96 |
$588.26 |
3.4× |
| Dxa bone density study axial skeleton (77085) |
$365.14 |
$608.57 |
3.5× |
| Dxa bone density/peripheral (77081) |
$204.10 |
$340.17 |
2.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76825) |
$792.02 |
$1,320.04 |
1.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$378 |
$630 |
1.6× |
| Fetal biophys profile w/o nst (76819) |
$374.98 |
$624.97 |
3.6× |
| Fetal biophysical profile non-stress testing (76818) |
$535.29 |
$892.15 |
5.1× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$429.44 |
$715.74 |
1.8× |
| Full mouth X-ray of teeth (70320) |
$204.53 |
$340.89 |
0.9× |
| Gastroesophageal reflux study (78262) |
$493.75 |
$822.91 |
1.2× |
| Gated heart planar single (78472) |
$1,471.14 |
$2,451.90 |
3.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,980.47 |
$3,300.78 |
2.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,763.29 |
$2,938.82 |
2.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,599.36 |
$2,665.60 |
2.3× |
| Heart infarct image (78466) |
$840.74 |
$1,401.23 |
2.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,373.60 |
$3,956 |
0.7× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Age Under… (75889) |
$3,119.40 |
$5,199 |
1.0× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,759.85 |
$2,933.08 |
3.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,824.46 |
$3,040.76 |
4.5× |
| Ht muscle image spect sing (78451) |
$2,837.84 |
$4,729.73 |
2.2× |
| Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less) (77600) |
$893.86 |
$1,489.76 |
2.3× |
| Image fusion (77399) |
$376.03 |
$626.72 |
2.8× |
| Infusion or instillation of radioelement solution (includes 3-month follow-up care) (77750) |
$600.89 |
$1,001.49 |
1.6× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$454.74 |
$757.90 |
1.1× |
| Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial… (77301) |
$5,552.23 |
$9,253.71 |
4.0× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$1,162.45 |
$1,937.41 |
1.7× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$1,312.07 |
$2,186.78 |
3.3× |
| Intracavitary radiation source application - complex (77763) |
$1,107.14 |
$1,845.24 |
1.6× |
| Intracavitary radiation source application - intermediate (77762) |
$3,384.04 |
$5,640.06 |
6.1× |
| Intracavitary radiation source application - simple (77761) |
$796.97 |
$1,328.29 |
1.4× |
| Isodose brachytherapy complex 10+ sources (77318) |
$705.45 |
$1,175.75 |
1.9× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$592.62 |
$987.70 |
1.6× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$633.91 |
$1,056.51 |
1.7× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$1,554.92 |
$2,591.53 |
4.1× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$620.10 |
$1,033.50 |
1.6× |
| Kidney imaging morphol - nm kidney cortex (78700) |
$499.97 |
$833.29 |
1.2× |
| Kidney imaging morphology; with vascular flow Age Under 21 (78701) |
$651.59 |
$1,085.99 |
1.6× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,193.73 |
$1,989.55 |
2.2× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,359.29 |
$2,265.49 |
2.5× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,573.06 |
$2,621.77 |
2.9× |
| Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic) Age Under 21 (78140) |
$445.14 |
$741.90 |
1.1× |
| Leveen/shunt patency exam (78291) |
$441.21 |
$735.35 |
1.1× |
| Liver and spleen imaging (78215) |
$1,362.52 |
$2,270.87 |
3.4× |
| Liver and spleen imaging; with vascular flow Age Under 21 (78216) |
$504.82 |
$841.37 |
1.3× |
| Liver imaging (78201) |
$1,184.35 |
$1,973.92 |
2.2× |
| Liver imaging with flow (78202) |
$1,255.15 |
$2,091.92 |
2.3× |
| Lung perf&ventilat diferentl (78598) |
$1,491.60 |
$2,486 |
2.7× |
| Lung perfusion imaging (78580) |
$1,248.53 |
$2,080.89 |
3.1× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Age Under 21 (75801) |
$700.80 |
$1,168 |
1.1× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Age Under 21 (75807) |
$1,238.59 |
$2,064.32 |
0.4× |
| Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation Age Under 21 (75805) |
$2,494.49 |
$4,157.49 |
0.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$3,591 |
$5,985 |
10.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,541.64 |
$2,569.40 |
4.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,958.76 |
$3,264.60 |
8.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$3,591 |
$5,985 |
10.2× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$1,593.28 |
$2,655.46 |
4.5× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$2,362.50 |
$3,937.50 |
9.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$1,447.90 |
$2,413.16 |
4.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,150 |
$5,250 |
9.0× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$1,624.02 |
$2,706.70 |
4.6× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$2,835 |
$4,725 |
8.1× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$3,432.72 |
$5,721.20 |
9.8× |
| Magnetic resonance elastography (76391) |
$1,806.10 |
$3,010.16 |
7.5× |
| Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part… (70554) |
$987.52 |
$1,645.86 |
4.1× |
| Mammary ductogram single (77053) |
$273.85 |
$456.41 |
1.1× |
| Mandible min 4v (70110) |
$167.80 |
$279.67 |
1.6× |
| Med physic dos eval rad exps (76145) |
$798.01 |
$1,330.02 |
2.1× |
| MRA head w/o contrast (70544) |
$2,712.76 |
$4,521.26 |
11.3× |
| MRA neck w/ contrast (70548) |
$3,074.64 |
$5,124.40 |
8.8× |
| MRA neck w/o contrast (70547) |
$2,615.17 |
$4,358.62 |
10.9× |
| MRI abdomen w/contrast (74182) |
$1,688.40 |
$2,814 |
4.8× |
| MRI abdomen w/o contrast (74181) |
$2,035.14 |
$3,391.90 |
8.5× |
| MRI abdomen w/wo contrast (74183) |
$3,528 |
$5,880 |
10.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,217.20 |
$3,695.33 |
2.8× |
| MRI bone marrow (77084) |
$1,349.86 |
$2,249.77 |
5.6× |
| MRI brain w/dye (70558) |
$2,320.06 |
$3,866.77 |
13.2× |
| MRI brain w/o & w/dye (70559) |
$2,604.71 |
$4,341.19 |
14.8× |
| MRI brain w/o dye (70557) |
$2,005.45 |
$3,342.42 |
3.7× |
| MRI breast c- bilateral (77047) |
$1,928.89 |
$3,214.81 |
8.0× |
| MRI breast without contrast material unilateral (77046) |
$1,780.67 |
$2,967.78 |
7.4× |
| MRI c-spine w&w/o cont (72156) |
$3,654 |
$6,090 |
10.4× |
| MRI cervical spine w/contrast (72142) |
$2,065.89 |
$3,443.15 |
5.9× |
| MRI chest w/contrast (71551) |
$1,581.08 |
$2,635.13 |
2.0× |
| MRI chest w/o contrast (71550) |
$1,475.69 |
$2,459.49 |
6.2× |
| MRI chest w/wo contrast (71552) |
$2,101.98 |
$3,503.30 |
6.0× |
| MRI fetal sngl/1st gestation (74712) |
$1,136.26 |
$1,893.77 |
4.7× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,179.63 |
$3,632.71 |
6.2× |
| MRI joint upr extrem w/dye (73222) |
$2,646 |
$4,410 |
3.4× |
| MRI joint upr extrem w/o dye (73221) |
$1,655.89 |
$2,759.82 |
6.9× |
| MRI lumbar spine w/contrast (72149) |
$2,019.98 |
$3,366.63 |
5.8× |
| MRI lumbar spine w/wo contrast (72158) |
$2,959.56 |
$4,932.60 |
8.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,780 |
$6,300 |
10.8× |
| MRI pelvis w & w/o contrast (72197) |
$3,465 |
$5,775 |
9.9× |
| MRI pelvis w/contrast (72196) |
$1,615.88 |
$2,693.13 |
4.6× |
| MRI pelvis w/o contrast (72195) |
$2,520 |
$4,200 |
10.5× |
| MRI spectroscopy (76390) |
$1,322.36 |
$2,203.93 |
15.1× |
| MRI spine cervical w/o contrast (72141) |
$2,098.23 |
$3,497.05 |
8.8× |
| MRI t-spine w&w/o cont (72157) |
$3,664.56 |
$6,107.60 |
10.5× |
| MRI thoracic spine w/contrast (72147) |
$1,716.17 |
$2,860.29 |
4.9× |
| MRI thoracic spine w/o contrst (72146) |
$1,883.72 |
$3,139.53 |
7.9× |
| MRI tmj (70336) |
$1,535.89 |
$2,559.82 |
6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,920.46 |
$3,200.77 |
8.0× |
| Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per… (77338) |
$1,834.19 |
$3,056.98 |
4.9× |
| Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical),… (72270) |
$1,615.24 |
$2,692.06 |
2.1× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78432) |
$2,700.60 |
$4,501 |
1.8× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$1,584.32 |
$2,640.54 |
1.1× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78430) |
$1,731.60 |
$2,886 |
1.2× |
| Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first… (78453) |
$1,255.15 |
$2,091.92 |
1.0× |
| Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first… (78454) |
$1,595.26 |
$2,658.77 |
1.2× |
| Myocardial spect multiple studies (78452) |
$4,068.19 |
$6,780.31 |
3.1× |
| Myocrd img PET 2rtracer CT (78433) |
$3,300.60 |
$5,501 |
1.5× |
| Myocrd img PET metab eval single study (78459) |
$2,145.78 |
$3,576.30 |
1.6× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,731.60 |
$2,886 |
1.2× |
| Myocrd img PET rst&strs CT (78431) |
$2,700.60 |
$4,501 |
1.2× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$4,753.07 |
$7,921.79 |
5.5× |
| Nm bone 3 phase (78315) |
$1,736.24 |
$2,893.74 |
4.3× |
| Nm bone imaging whole body (78306) |
$1,688.24 |
$2,813.73 |
4.2× |
| Nm bone marrow ltd (78102) |
$650.24 |
$1,083.74 |
1.6× |
| Nm bone marrow multi (78103) |
$367.06 |
$611.77 |
0.9× |
| Nm bone marrow wb (78104) |
$452.36 |
$753.93 |
1.1× |
| Nm csf cisternogram (78630) |
$1,489.99 |
$2,483.31 |
2.7× |
| Nm csf leak detection (78650) |
$1,433.25 |
$2,388.75 |
1.1× |
| Nm gastric emptying (78264) |
$1,723.28 |
$2,872.13 |
4.3× |
| Nm lung ventilation imaging (78579) |
$767.34 |
$1,278.90 |
1.9× |
| Nm lymph system (78195) |
$1,795.81 |
$2,993.01 |
3.3× |
| Nm myocard infarct spect (78469) |
$1,490.58 |
$2,484.30 |
2.7× |
| Non-cardiac vascular flow imaging (ie, angiography, venography) Age Under 21 (78445) |
$367.06 |
$611.77 |
0.9× |
| Nuclear medicine study for detecting heart shunt (78428) |
$1,354.80 |
$2,258 |
3.4× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$1,234.50 |
$2,057.50 |
3.1× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$446.03 |
$743.39 |
1.1× |
| Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume… (78494) |
$566.74 |
$944.57 |
1.4× |
| Nuclear medicine study of salivary gland with serial images (78231) |
$367.06 |
$611.77 |
0.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$609.73 |
$1,016.22 |
1.5× |
| Ob us limited fetus(s) (76815) |
$312.49 |
$520.81 |
3.0× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$339.35 |
$565.58 |
3.2× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$264.70 |
$441.16 |
2.5× |
| Optic foramina (70190) |
$138.73 |
$231.21 |
1.6× |
| Panoramic X-ray of jaws (70355) |
$202.98 |
$338.30 |
2.3× |
| Parathyrd planar w/spect&CT (78072) |
$2,087.09 |
$3,478.48 |
3.8× |
| Parathyroid planar imaging (78070) |
$1,410.04 |
$2,350.06 |
3.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,734.89 |
$2,891.49 |
4.3× |
| Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation Age… (75885) |
$2,376.74 |
$3,961.24 |
0.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,796.08 |
$6,326.80 |
2.6× |
| PET imaging CT for attenuation limited area (78814) |
$4,095 |
$6,825 |
2.9× |
| PET imaging for CT attenuation whole body (78816) |
$4,843.57 |
$8,072.62 |
3.4× |
| PET imaging whole body (78813) |
$5,148.14 |
$8,580.24 |
3.6× |
| Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) Age Under 21 (78811) |
$2,253.07 |
$3,755.12 |
1.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,730.74 |
$2,884.57 |
0.5× |
| Pulmonary ventilation & perfusion imaging (78582) |
$2,205 |
$3,675 |
4.0× |
| Quant differential pulm perfusion w/wo imaging (78597) |
$1,110.34 |
$1,850.56 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$455.59 |
$759.31 |
0.8× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$173.80 |
$289.66 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$430.52 |
$717.53 |
4.1× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$499.82 |
$833.04 |
4.8× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$575.76 |
$959.60 |
5.5× |
| Radex hip unilateral with pelvis 1 view (73501) |
$181.91 |
$303.19 |
2.1× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$274.12 |
$456.87 |
3.1× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$300 |
$500 |
2.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$323.29 |
$538.82 |
3.1× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$505.22 |
$842.04 |
4.8× |
| Radex spine cervical 2 or 3 views (72040) |
$301.66 |
$502.77 |
3.5× |
| Radex spine cervical 4 or 5 views (72050) |
$419.48 |
$699.14 |
4.0× |
| Radex spine cervical 6 or more views (72052) |
$442.25 |
$737.09 |
4.2× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$276.47 |
$460.78 |
3.2× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77371) |
$31,800 |
$53,000 |
4.3× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77372) |
$12,099.50 |
$20,165.83 |
1.6× |
| Radiation tx delivery lvl 1 (77402) |
$338.25 |
$563.75 |
3.3× |
| Radiation tx delivery lvl 2 (77407) |
$331.16 |
$551.94 |
0.9× |
| Radiation tx delivery lvl 3 (77412) |
$669.73 |
$1,116.21 |
1.2× |
| Radiologic exam abdomen 3+ views (74021) |
$226.40 |
$377.33 |
2.2× |
| Radiologic exam chest 3 views (71047) |
$253.79 |
$422.99 |
2.9× |
| Radiologic exam chest 4+ views (71048) |
$364.40 |
$607.33 |
3.5× |
| Radiologic exam colon double contrast study (74280) |
$727.65 |
$1,212.75 |
4.1× |
| Radiologic exam colon single contrast study (74270) |
$586.63 |
$977.72 |
3.3× |
| Radiologic exam esophagus double contrast study (74221) |
$579.80 |
$966.33 |
3.3× |
| Radiologic exam esophagus single contrast study (74220) |
$464.21 |
$773.68 |
2.6× |
| Radiologic exam small int single contrast study (74250) |
$520.07 |
$866.78 |
3.0× |
| Radiologic exam swallow function contrast study (74230) |
$467.66 |
$779.44 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$609.05 |
$1,015.08 |
3.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$513.92 |
$856.54 |
2.9× |
| Radiologic examination femur 1 view (73551) |
$147.19 |
$245.31 |
1.7× |
| Radiologic examination femur minimum 2 views (73552) |
$268.93 |
$448.21 |
3.1× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$105.03 |
$175.05 |
1.2× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$274.30 |
$457.17 |
3.1× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$387.62 |
$646.04 |
3.7× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$270.32 |
$450.53 |
3.1× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$301.75 |
$502.91 |
3.5× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$112.15 |
$186.92 |
1.3× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$338.25 |
$563.75 |
3.9× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$294.25 |
$490.41 |
3.4× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$277.58 |
$462.63 |
3.2× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$330.74 |
$551.24 |
3.1× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$112.15 |
$186.92 |
1.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$220.50 |
$367.50 |
2.1× |
| Radiologic examination, mastoids; less than 3 views per side Age Under 21 (70120) |
$193.41 |
$322.35 |
1.8× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$238.79 |
$397.98 |
2.7× |
| Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s),… (74210) |
$200.39 |
$333.99 |
1.1× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$509.72 |
$849.53 |
4.9× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$365.45 |
$609.09 |
3.5× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$150.68 |
$251.13 |
1.4× |
| Radiologic examination, salivary gland for calculus Age Under 21 (70380) |
$124.24 |
$207.07 |
1.4× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$242.40 |
$404 |
0.7× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$284.14 |
$473.57 |
3.3× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Age Under 21 (76100) |
$300 |
$500 |
2.9× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$140.58 |
$234.30 |
1.6× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$256.98 |
$428.30 |
2.4× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$312.53 |
$520.89 |
3.0× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$316.02 |
$526.70 |
3.0× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$496.22 |
$827.03 |
4.7× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$400.21 |
$667.01 |
3.8× |
| Radiologic examination, teeth; partial examination, less than full mouth Age Under 21 (70310) |
$152.17 |
$253.62 |
0.6× |
| Radiologic examination, teeth; single view Age Under 21 (70300) |
$69.80 |
$116.34 |
0.8× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$286.54 |
$477.56 |
3.3× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$184.96 |
$308.26 |
2.1× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$286.40 |
$477.33 |
3.3× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$105.03 |
$175.05 |
1.2× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$143.82 |
$239.70 |
1.4× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$202.30 |
$337.16 |
2.3× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$177.64 |
$296.07 |
2.0× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$105.03 |
$175.05 |
1.0× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$2,521.35 |
$4,202.25 |
4.6× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$749.55 |
$1,249.25 |
3.2× |
| Radiopharmaceutical therapy, by intravenous administration Age Under 21 (79101) |
$755.45 |
$1,259.09 |
3.2× |
| Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) |
$1,402.07 |
$2,336.79 |
6.0× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion (79403) |
$878.33 |
$1,463.89 |
3.7× |
| Radiopharmaceutical therapy, unlisted procedure (79999) |
$2,430.66 |
$4,051.10 |
10.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$397.29 |
$662.15 |
1.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$397.29 |
$662.15 |
1.0× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$650.89 |
$1,084.82 |
2.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,495.02 |
$2,491.70 |
3.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,484.34 |
$2,473.90 |
3.7× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$3,108.76 |
$5,181.26 |
5.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,014.64 |
$3,357.73 |
3.7× |
| Rp loclzj tum spect 2 areas (78831) |
$2,612.61 |
$4,354.35 |
2.0× |
| Rp loclzj tum spect w/CT 1 (78830) |
$2,783.69 |
$4,639.49 |
2.1× |
| Rp loclzj tum spect w/CT 2 (78832) |
$3,753.45 |
$6,255.75 |
2.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,094.34 |
$1,823.90 |
4.7× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$409.50 |
$682.50 |
1.7× |
| Scapula complete (73010) |
$207.26 |
$345.44 |
2.0× |
| Screening digital breast tomosynthesis bi (77063) |
$88.17 |
$146.95 |
— |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$726.11 |
$1,210.19 |
6.9× |
| Simulation intermediate (77285) |
$669.97 |
$1,116.61 |
1.8× |
| Special dosimetry (77331) |
$499.97 |
$833.29 |
3.7× |
| Special physics consult (77370) |
$875.62 |
$1,459.36 |
6.5× |
| Special teletherapy port plan (77321) |
$491.17 |
$818.62 |
1.3× |
| Special treatment procedure (77470) |
$1,655.11 |
$2,758.51 |
3.0× |
| Spleen imaging only, with or without vascular flow Age Under 21 (78185) |
$367.06 |
$611.77 |
0.9× |
| Splenoportography, radiological supervision and interpretation Age Under 21 (75810) |
$2,148.46 |
$3,580.76 |
0.7× |
| Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance,… (77373) |
$7,726.73 |
$12,877.89 |
4.3× |
| Surface application of low dose rate radionuclide source (77789) |
$130.96 |
$218.27 |
1.3× |
| Tbs technical calculation only (77091) |
$99.13 |
$165.22 |
1.1× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Age Under 21 (70332) |
$255.35 |
$425.58 |
1.1× |
| Testicular imaging with vascular flow Age Under 21 (78761) |
$449.57 |
$749.28 |
1.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,515.14 |
$2,525.24 |
4.0× |
| Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium… (74283) |
$215.11 |
$358.52 |
1.2× |
| Thyroid imaging with vascular flow (78013) |
$673.01 |
$1,121.69 |
1.7× |
| Thyroid met imaging body (78018) |
$1,596.56 |
$2,660.93 |
2.9× |
| Thyroid uptake single/multiple quant measurement (78012) |
$680.77 |
$1,134.61 |
1.7× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,350.97 |
$2,251.61 |
3.4× |
| Tr simulation simple (77280) |
$772.92 |
$1,288.20 |
5.7× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$99.13 |
$165.22 |
1.1× |
| Treatment device complex (77334) |
$1,117.85 |
$1,863.08 |
3.0× |
| Treatment device intermediate (77333) |
$676.58 |
$1,127.64 |
5.0× |
| Treatment device simple (77332) |
$243.11 |
$405.18 |
1.8× |
| Ultrasound breast limited (76642) |
$320.55 |
$534.25 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$582.79 |
$971.32 |
5.5× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$292.83 |
$488.05 |
2.8× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$705.04 |
$1,175.06 |
6.7× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$639.34 |
$1,065.56 |
2.7× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$612.02 |
$1,020.04 |
5.8× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$633.62 |
$1,056.03 |
6.0× |
| Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) Age Under 21 (76873) |
$459.40 |
$765.66 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$354.31 |
$590.52 |
3.4× |
| Unlisted CT procedure (76497) |
$1,532.52 |
$2,554.20 |
17.5× |
| Unlisted fluoroscopic procedure (76496) |
$2,263.57 |
$3,772.61 |
25.9× |
| Unlisted magnetic resonance procedure (eg, diagnostic, interventional) Age Under 21 (76498) |
$1,728 |
$2,880 |
19.8× |
| Unlisted miscellaneous procedure, diagnostic nuclear medicine (78999) |
$433.58 |
$722.64 |
1.1× |
| Unlisted procedure, clinical brachytherapy (77799) |
$1,244.40 |
$2,074 |
12.1× |
| Urea breath test, C-14 (isotopic); acquisition for analysis Other Outpatient (78267) |
$32.60 |
$54.34 |
2.9× |
| Urea breath test, C-14 (isotopic); analysis Other Outpatient (78268) |
$197.34 |
$328.90 |
2.1× |
| Ureteral reflux study (78740) |
$400.83 |
$668.05 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$569.52 |
$949.20 |
2.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$636.85 |
$1,061.42 |
3.6× |
| Urography antegrade rs&i (74425) |
$549.41 |
$915.69 |
1.6× |
| Urography, infusion, drip technique and/or bolus technique; Age Under 21 (74410) |
$690.85 |
$1,151.41 |
3.9× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Age Under 21 (74415) |
$673.80 |
$1,123 |
3.8× |
| Us abdominal aorta real time screen study aaa (76706) |
$398.34 |
$663.90 |
3.8× |
| Us breast uni real time with image complete (76641) |
$409.50 |
$682.50 |
3.9× |
| Us chest (76604) |
$551.06 |
$918.44 |
5.2× |
| Us compl joint r-t w/image documentation (76881) |
$577.47 |
$962.45 |
5.5× |
| Us elastography organ (76981) |
$215.09 |
$358.49 |
2.0× |
| Us encephalogram (76506) |
$459.59 |
$765.99 |
4.4× |
| Us exam, pelvic, limited (76857) |
$518.75 |
$864.58 |
4.9× |
| Us guided compression repair (76936) |
$687.35 |
$1,145.58 |
3.2× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$403.88 |
$673.14 |
4.6× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$220.50 |
$367.50 |
2.5× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$265.61 |
$442.68 |
2.5× |
| US OB Follow-Up/Repeat (76816) |
$364.19 |
$606.98 |
3.5× |
| Us ob transvaginal (76817) |
$502.36 |
$837.26 |
4.8× |
| Us retroperitoneal complete (76770) |
$640.49 |
$1,067.48 |
6.1× |
| Us retroperitoneal ltd (76775) |
$480.37 |
$800.61 |
4.6× |
| Us scrotum (76870) |
$567.17 |
$945.29 |
5.4× |
| Us soft tissue head/neck (76536) |
$583.84 |
$973.07 |
5.6× |
| Us spinal canal (76800) |
$417.22 |
$695.37 |
4.0× |
| Us transrectal (76872) |
$504.78 |
$841.30 |
4.8× |
| Us trgt dyn mbubb 1st les (76978) |
$622.88 |
$1,038.14 |
1.8× |
| Us unlstd proc (76999) |
$1,394.43 |
$2,324.05 |
16.0× |
| Use 1st target lesion (76982) |
$370.74 |
$617.90 |
3.5× |
| Venogram sinus/jugular (75860) |
$1,900.61 |
$3,167.69 |
0.6× |
| Venography adrenal unilateral selective rs&i (75840) |
$2,833.34 |
$4,722.24 |
0.9× |
| Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) |
$2,464.14 |
$4,106.90 |
28.2× |
| Venography renal unilateral selective rs&i (75831) |
$2,679.11 |
$4,465.19 |
0.8× |
| Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) |
$2,731.54 |
$4,552.56 |
0.9× |
| Venography, caval, superior, with serialography, radiological supervision and interpretation Age Under 21 (75827) |
$1,791.31 |
$2,985.52 |
1.1× |
| Venography, epidural, radiological supervision and interpretation Age Under 21 (75872) |
$1,006.40 |
$1,677.34 |
1.6× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$1,331.50 |
$2,219.16 |
0.8× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$1,111.95 |
$1,853.25 |
0.7× |
| Venography, orbital, radiological supervision and interpretation Age Under 21 (75880) |
$1,128.41 |
$1,880.69 |
1.8× |
| Venography, superior sagittal sinus, radiological supervision and interpretation Age Under 21 (75870) |
$1,965.60 |
$3,276 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,410 |
$7,350 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$267.91 |
$446.52 |
3.1× |
| X-ray exam hips bi 3-4 views (73522) |
$403.85 |
$673.08 |
3.8× |
| X-ray exam of finger(s) (73140) |
$201.88 |
$336.46 |
2.3× |
| X-ray exam of knee 1 or 2 (73560) |
$252.96 |
$421.60 |
2.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$290.91 |
$484.85 |
1.7× |
| X-ray exam ribs bil 3 views (71110) |
$352.81 |
$588.02 |
3.4× |
| X-ray exam ribs uni 2 views (71100) |
$274.37 |
$457.29 |
3.1× |
| X-ray heel (73650) |
$112.12 |
$186.86 |
1.3× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$158.26 |
$263.77 |
1.5× |
| X-ray retrograde pyelogram (74420) |
$666.08 |
$1,110.14 |
1.9× |
| Xr abdomen 1 view (74018) |
$229.30 |
$382.16 |
2.6× |
| Xr abdomen 2 views (74019) |
$292.87 |
$488.11 |
2.8× |
| Xr arthrogram ankle (73615) |
$495.58 |
$825.96 |
1.4× |
| Xr arthrogram elbow (73085) |
$495.60 |
$826 |
1.4× |
| Xr arthrogram hip (73525) |
$520.38 |
$867.30 |
1.5× |
| Xr arthrogram knee (73580) |
$495.60 |
$826 |
1.4× |
| Xr arthrogram wrist (73115) |
$495.58 |
$825.96 |
1.4× |
| Xr bone age studies (77072) |
$162.07 |
$270.12 |
1.5× |
| Xr bone length study (77073) |
$289.73 |
$482.88 |
2.8× |
| Xr bone survey infant (77076) |
$215.84 |
$359.74 |
2.1× |
| Xr bone survey ltd (77074) |
$298.33 |
$497.21 |
2.8× |
| Xr chest 1 view (71045) |
$203.74 |
$339.57 |
2.3× |
| Xr chest 2 views (71046) |
$364.65 |
$607.75 |
4.2× |
| Xr eye foreign body (70030) |
$276 |
$460 |
3.2× |
| Xr facial bones 3+ views (70150) |
$260.92 |
$434.87 |
2.5× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$266.59 |
$444.32 |
3.0× |
| Xr forearm 2 views (73090) |
$294.10 |
$490.16 |
3.4× |
| Xr hand 2v (73120) |
$294.44 |
$490.74 |
2.8× |
| Xr hysterosalpingogram (74740) |
$650.38 |
$1,083.96 |
2.7× |
| Xr joint survey 1 view (77077) |
$124.24 |
$207.07 |
1.2× |
| Xr myelogram c-spine (72240) |
$875.40 |
$1,459 |
1.1× |
| Xr myelogram l-spine (72265) |
$1,350.68 |
$2,251.14 |
1.7× |
| Xr myelogram t-spine (72255) |
$1,014.13 |
$1,690.21 |
1.3× |
| Xr neck soft tissue (70360) |
$177.68 |
$296.13 |
2.0× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$295.59 |
$492.65 |
3.4× |
| Xr osseous survey complete (77075) |
$750.73 |
$1,251.21 |
7.1× |
| Xr pelvis 1-2 views (72170) |
$250.78 |
$417.96 |
2.4× |
| Xr pelvis min 3 view (72190) |
$329.51 |
$549.19 |
3.1× |
| Xr peritoneogram (74190) |
$563.20 |
$938.67 |
1.0× |
| Xr sacrum/coccyx 2+ views (72220) |
$257.93 |
$429.89 |
3.0× |
| Xr sella turcica (70240) |
$92.48 |
$154.13 |
1.1× |
| Xr shoulder 1 view (73020) |
$248.71 |
$414.51 |
2.8× |
| Xr sialogram (70390) |
$273.85 |
$456.42 |
1.1× |
| Xr sinuses 3+ views (70220) |
$303.74 |
$506.24 |
3.5× |
| Xr skull min 4 view (70260) |
$350.76 |
$584.60 |
3.3× |
| Xr spine 1 view (72020) |
$262.15 |
$436.91 |
3.0× |
| Xr spine thoracic 3v (72072) |
$366.62 |
$611.03 |
3.5× |
| Xr sternum 2+ views (71120) |
$202.07 |
$336.79 |
2.3× |
| Xr stress view joint (77071) |
$101.73 |
$169.55 |
1.2× |
| Xr surgical specimen (76098) |
$424.89 |
$708.15 |
0.8× |
| Xr t-spine 2 views (72070) |
$289.63 |
$482.72 |
2.8× |
| Xr tibia/fibula 2 views (73590) |
$283.77 |
$472.95 |
3.2× |
| Xr tmj bilateral (70330) |
$497.71 |
$829.52 |
5.7× |
| Xr tmj unilateral (70328) |
$107.12 |
$178.54 |
1.2× |
| Xr venogram renal bilat (75833) |
$2,786.27 |
$4,643.79 |
0.9× |
| Xr wrist 2 views (73100) |
$270.53 |
$450.88 |
3.1× |