| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,002.69 |
$8,337.81 |
3.6× |
| Abdomen 1 View (74018) |
$367.60 |
$612.67 |
4.2× |
| Abdomen 2 views (74019) |
$316.47 |
$527.45 |
3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,459.85 |
$2,433.09 |
3.6× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$1,505.91 |
$2,509.85 |
1.2× |
| Adrenal Cortex & Medulla Img (78075) |
$4,684.17 |
$7,806.95 |
3.6× |
| Angio internal mammary (75756) |
$1,943.48 |
$3,239.14 |
0.6× |
| Angio pulmonary bilat (75743) |
$3,290.84 |
$5,484.74 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,764.59 |
$6,274.32 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$5,479.80 |
$9,133 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$5,479.80 |
$9,133 |
1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,344.80 |
$3,908 |
0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,079.54 |
$3,465.90 |
0.7× |
| Ankle 2 views (73600) |
$302.50 |
$504.17 |
3.5× |
| Aortography thoracic serialography rs&i (75605) |
$3,728.24 |
$6,213.74 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$6,446.54 |
$10,744.23 |
2.0× |
| Artery X-Rays Abdomen (75726) |
$6,332.20 |
$10,553.67 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$6,446.54 |
$10,744.23 |
2.0× |
| Artery X-Rays Pelvis (75736) |
$4,917.40 |
$8,195.67 |
0.9× |
| Artery X-Rays Spine (75705) |
$6,385.15 |
$10,641.92 |
1.1× |
| Arthrogram ankle (73615) |
$969.83 |
$1,616.39 |
2.8× |
| Arthrogram hip (73525) |
$923.65 |
$1,539.42 |
2.6× |
| Arthrogram Wrist (73115) |
$989.23 |
$1,648.72 |
2.8× |
| Basic radiation dosimetry calculation (77300) |
$509 |
$848.33 |
3.8× |
| Bone age studies (77072) |
$292.97 |
$488.29 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,798.90 |
$2,998.17 |
4.5× |
| Bone Imaging Limited Area (78300) |
$868.17 |
$1,446.95 |
2.2× |
| Bone Imaging Multiple Areas (78305) |
$1,158.29 |
$1,930.49 |
2.9× |
| Bone Imaging Whole Body (78306) |
$1,823.30 |
$3,038.83 |
4.5× |
| Bone marrow imaging limited area (78102) |
$723 |
$1,205 |
1.8× |
| Bone marrow imaging; multiple areas (78103) |
$1,010.08 |
$1,683.46 |
2.5× |
| Bone marrow imaging; whole body (78104) |
$1,010.08 |
$1,683.46 |
2.5× |
| Bone survey infant (77076) |
$364.91 |
$608.19 |
3.5× |
| Brachytx isodose complex (77318) |
$1,484.81 |
$2,474.68 |
3.9× |
| Brachytx isodose intermed (77317) |
$1,008.74 |
$1,681.23 |
2.7× |
| Brachytx Isodose Plan Simple (77316) |
$793.62 |
$1,322.70 |
2.1× |
| Brain Flow Imaging Only (78610) |
$952.82 |
$1,588.03 |
1.7× |
| Brain Image W/Flow < 4 Views (78601) |
$1,905.29 |
$3,175.48 |
4.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,901.40 |
$3,169 |
3.5× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,152.88 |
$1,921.47 |
2.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,264.68 |
$7,107.80 |
3.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,233 |
$2,055 |
3.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$1,419.26 |
$2,365.44 |
2.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,959 |
$4,931.66 |
8.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,538 |
$4,230 |
3.2× |
| Cardiac Shunt Detection (78428) |
$1,284.09 |
$2,140.15 |
3.2× |
| Cat Scan Follow-Up Study (76380) |
$769.75 |
$1,282.92 |
8.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$952.82 |
$1,588.03 |
1.7× |
| Cerebrospinal Fluid Scan (78630) |
$1,653.39 |
$2,755.65 |
3.0× |
| Chest 1 view (71045) |
$349.81 |
$583.02 |
4.0× |
| Chest 2 views (71046) |
$412.77 |
$687.95 |
4.7× |
| Chest 3 views (71047) |
$264.55 |
$440.92 |
3.0× |
| Chest 4 or more views (71048) |
$334.02 |
$556.70 |
3.2× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$388.47 |
$647.45 |
3.7× |
| Cholecystography Oral Contrast (74290) |
$268.84 |
$448.06 |
1.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$2,050.99 |
$3,418.31 |
2.6× |
| Clavicle complete (73000) |
$300.05 |
$500.09 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$240.33 |
$400.55 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$602.12 |
$1,003.54 |
4.5× |
| Contrast Exam Abdominl Aorta (75625) |
$5,479.80 |
$9,133 |
1.7× |
| Contrast X-Ray Bladder (74430) |
$803.25 |
$1,338.75 |
2.3× |
| Contrast X-Ray Of Elbow (73085) |
$1,047.42 |
$1,745.70 |
3.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$942.13 |
$1,570.21 |
2.7× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$362.98 |
$604.96 |
2.1× |
| Corpora cavernosography (74445) |
$593.46 |
$989.10 |
5.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,135.82 |
$6,893.04 |
11.8× |
| CT abdomen and pelvis without contrast (74176) |
$3,629.39 |
$6,048.98 |
15.1× |
| CT abdomen w contrast (74160) |
$2,670.05 |
$4,450.09 |
15.2× |
| CT abdomen w wo contrast (74170) |
$2,721.60 |
$4,536 |
15.4× |
| CT abdomen w/o contrast (74150) |
$2,116.45 |
$3,527.42 |
20.2× |
| CT Angio Abdomen and Pelvis (74174) |
$5,068.40 |
$8,447.34 |
14.5× |
| CT Angio Chest (71275) |
$2,579.30 |
$4,298.84 |
14.6× |
| CT Angio Head (70496) |
$2,381.40 |
$3,969 |
13.5× |
| CT angio hrt w/3d image (75574) |
$2,118.60 |
$3,531 |
6.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,061.80 |
$5,103 |
17.4× |
| CT Angio Neck (70498) |
$2,381.40 |
$3,969 |
13.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,213.55 |
$3,689.25 |
12.6× |
| CT bone density (77078) |
$343.66 |
$572.77 |
3.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,188.65 |
$1,981.08 |
6.7× |
| CT cervical spine w/ contrast (72126) |
$2,381.40 |
$3,969 |
6.8× |
| CT cervical spine w/o contrast (72125) |
$2,109.78 |
$3,516.30 |
20.1× |
| CT cervical spine w/wo cont (72127) |
$2,721.60 |
$4,536 |
15.4× |
| CT chest w contrast (71260) |
$2,659.49 |
$4,432.48 |
15.1× |
| CT chest w/wo contrast (71270) |
$2,676.20 |
$4,460.34 |
15.2× |
| CT colonography screening (74263) |
$2,809.07 |
$4,681.78 |
11.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,009.98 |
$1,683.30 |
5.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$665.89 |
$1,109.82 |
6.3× |
| CT head/brain with contrast (70460) |
$1,762.24 |
$2,937.06 |
10.0× |
| CT head/brain without and with contrast (70470) |
$2,277.85 |
$3,796.41 |
12.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,876.48 |
$3,127.46 |
5.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$218.90 |
$364.83 |
2.5× |
| CT hrt w/3d image congen (75573) |
$1,055.98 |
$1,759.97 |
3.0× |
| CT iac w contrast (70481) |
$1,988.25 |
$3,313.75 |
11.3× |
| CT l-spine w&w/o contrast (72133) |
$1,677.35 |
$2,795.59 |
9.5× |
| CT lower ext w/o (73700) |
$1,890.36 |
$3,150.60 |
18.0× |
| CT lower extremity w/contrast material (73701) |
$2,252.48 |
$3,754.13 |
12.8× |
| CT lumbar spine w contrast (72132) |
$2,381.40 |
$3,969 |
6.8× |
| CT lumbar spine w/o contrast (72131) |
$1,655.02 |
$2,758.37 |
15.8× |
| CT maxillofacial w contrast (70487) |
$2,561.70 |
$4,269.50 |
14.5× |
| CT maxillofacial wo contrast (70486) |
$2,137.91 |
$3,563.18 |
20.4× |
| CT neck tissue combo (70492) |
$2,426.43 |
$4,044.05 |
13.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,785.08 |
$2,975.13 |
10.1× |
| CT orbits w/o contrast (70480) |
$1,845.88 |
$3,076.46 |
17.6× |
| CT pelvis w&w/o contrast (72194) |
$2,227.92 |
$3,713.20 |
12.6× |
| CT pelvis w/o contrast (72192) |
$1,890.36 |
$3,150.60 |
18.0× |
| CT scan of leg combo (73702) |
$2,192.20 |
$3,653.67 |
12.4× |
| CT scans face/jaw combo (70488) |
$2,265.86 |
$3,776.43 |
12.9× |
| CT soft tissue neck w contrast (70491) |
$2,598.34 |
$4,330.56 |
14.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,744.52 |
$2,907.54 |
16.6× |
| CT thoracic spine w contrast (72129) |
$2,041.20 |
$3,402 |
11.6× |
| CT thoracic spine w/o contrast (72128) |
$1,980.37 |
$3,300.62 |
18.9× |
| CT thoracic spine w/wo cont (72130) |
$2,381.40 |
$3,969 |
13.5× |
| CT thorax w/o contrast (71250) |
$1,166.90 |
$1,944.83 |
11.1× |
CT unlisted procedure (76497)
range across 11 matching MRF lines |
$322.92–$4,603.28 |
$538.20–$7,672.13 |
varies |
| CT upper ext wo (73200) |
$1,951.64 |
$3,252.74 |
18.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,841.10 |
$3,068.50 |
10.4× |
| CT upper extremity with contrast (73201) |
$2,067.90 |
$3,446.50 |
5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,424.96 |
$4,041.60 |
13.8× |
| Cta Abdomen (74175) |
$3,136.30 |
$5,227.16 |
17.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,762.80 |
$7,938 |
13.6× |
| CTA pelvis (72191) |
$1,983.85 |
$3,306.41 |
11.3× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$907.91 |
$1,513.18 |
3.8× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) |
$1,284.09 |
$2,140.15 |
2.4× |
| Dilation ureters/urethra rs&i (74485) |
$3,129.23 |
$5,215.38 |
1.5× |
| Discography Cerv/Thor Spine (72285) |
$5,618.23 |
$9,363.71 |
2.9× |
| Diskography lumbar (72295) |
$5,618.23 |
$9,363.71 |
2.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$284.85 |
$474.75 |
2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$306.05 |
$510.09 |
2.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$267.75 |
$446.25 |
2.5× |
| Dxa Bone Density Axial (77080) |
$370.36 |
$617.26 |
3.5× |
| Dxa bone density study (77085) |
$300.82 |
$501.37 |
2.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$235.55 |
$392.58 |
2.7× |
| Echo exam of fetal heart (76825) |
$805.36 |
$1,342.27 |
1.5× |
| Echo exam uterus (76831) |
$552.03 |
$920.05 |
2.3× |
| Echo Guide For Artery Repair (76936) |
$612.68 |
$1,021.13 |
2.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$767.01 |
$1,278.35 |
3.2× |
| Echograp Trans R Pros Study (76873) |
$531.67 |
$886.11 |
5.1× |
| Esophageal Motility Study (78258) |
$1,329.53 |
$2,215.89 |
3.3× |
| Esophagram (74220) |
$501.34 |
$835.57 |
2.8× |
| Fetal Biophys Profile W/Nst (76818) |
$541.74 |
$902.90 |
5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$421.33 |
$702.21 |
4.0× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,176.47 |
$1,960.78 |
4.9× |
| Fluoroscopy up to 1 hr (76000) |
$664.78 |
$1,107.96 |
2.8× |
| Follow-Up Angiography (75898) |
$786.60 |
$1,311 |
0.2× |
| Foot 2 views (73620) |
$338.66 |
$564.44 |
3.9× |
| Forearm 2 views (73090) |
$372.73 |
$621.22 |
4.3× |
| Gastric emptying imaging study (78264) |
$1,402.87 |
$2,338.11 |
3.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,389.15 |
$2,315.25 |
3.5× |
| Gastroesophageal Reflux Exam (78262) |
$1,110.50 |
$1,850.84 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,397.69 |
$2,329.48 |
3.5× |
| Gated Heart, Multiple (78473) |
$1,370.99 |
$2,284.98 |
3.4× |
| GI Endoscopic US S&I (76975) |
$611.42 |
$1,019.04 |
2.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,770.81 |
$2,951.35 |
3.2× |
| Hand 2 views (73120) |
$342.93 |
$571.55 |
3.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$4,017.34 |
$6,695.56 |
5.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,424.21 |
$5,707.02 |
4.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$3,496.27 |
$5,827.11 |
5.0× |
| Heart first pass single,planar (78481) |
$1,219.89 |
$2,033.15 |
2.2× |
| Heart Image (Pet) Multiple (78492) |
$4,225.34 |
$7,042.23 |
2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,119.40 |
$5,199 |
1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$6,446.54 |
$10,744.23 |
2.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,968.31 |
$3,280.52 |
3.6× |
| Hepatobiliary System Imaging (78226) |
$1,754.98 |
$2,924.97 |
4.4× |
| Ht Musc Image Planar Mult (78454) |
$2,334.46 |
$3,890.77 |
1.8× |
| Ht Muscle Image Spect Sing (78451) |
$3,699.01 |
$6,165.01 |
2.8× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) |
$659.02 |
$1,098.36 |
1.2× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) |
$1,880.11 |
$3,133.52 |
3.4× |
| Hysterosalpingogram (74740) |
$815.96 |
$1,359.94 |
3.4× |
| Image fusion (77399) |
$376.03 |
$626.72 |
2.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$462.36 |
$770.60 |
5.3× |
| Infant hip ultrasound, limited static exam (76886) |
$321.35 |
$535.59 |
3.7× |
| Infusion Ivp (74410) |
$823.49 |
$1,372.48 |
4.7× |
| Interstitial radiation source applic complex (77778) |
$3,167.17 |
$5,278.62 |
4.5× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,773.02 |
$2,955.04 |
2.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,521.98 |
$2,536.64 |
2.7× |
| Intracavitary radiation source applic simple (77761) |
$1,269.97 |
$2,116.61 |
2.3× |
| Joint Survey Single View (77077) |
$190.70 |
$317.83 |
1.8× |
| K Flow/Funct Image Multiple (78709) |
$1,319.61 |
$2,199.35 |
2.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,698.91 |
$2,831.51 |
3.1× |
| K Flow/Funct Image W/O Drug (78707) |
$1,398.79 |
$2,331.31 |
2.6× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$783.86 |
$1,306.44 |
2.0× |
| Kidney Imaging Morphol (78700) |
$1,144.04 |
$1,906.73 |
2.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,008.39 |
$1,680.65 |
2.5× |
| Knee 3 Views (73562) |
$417.08 |
$695.13 |
4.8× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$407.63 |
$679.39 |
1.0× |
| Leveen/Shunt Patency Exam (78291) |
$694.48 |
$1,157.46 |
1.7× |
| Liver & Spleen Imaging Static Only (78215) |
$1,123.50 |
$1,872.50 |
2.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,246.79 |
$2,077.98 |
3.1× |
| Liver imaging static only (78201) |
$1,328.66 |
$2,214.44 |
2.4× |
| Liver imaging w/vascular flow (78202) |
$1,498.22 |
$2,497.04 |
2.7× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,425.08 |
$2,375.14 |
2.6× |
| Lung perfusion differential (78597) |
$1,023.08 |
$1,705.13 |
2.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,041.20 |
$3,402 |
3.7× |
| Lung Ventilation Imaging (78579) |
$962.14 |
$1,603.56 |
2.4× |
| Lymph System Imaging (78195) |
$1,526.38 |
$2,543.96 |
2.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,288.81 |
$2,148.02 |
0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$984.85 |
$1,641.41 |
1.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,643.68 |
$4,406.13 |
0.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,494.49 |
$4,157.49 |
0.8× |
| Magnetic Image Jaw Joint (70336) |
$2,374.65 |
$3,957.75 |
9.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$2,124.60 |
$3,541 |
12.1× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$2,459.08 |
$4,098.47 |
4.5× |
| Magnetic Resonance Elastography (76391) |
$641.23 |
$1,068.72 |
2.7× |
| Mammary ductogram or galactogram multiple (77054) |
$437 |
$728.33 |
1.8× |
| Mammary ductogram or galactogram single (77053) |
$346.42 |
$577.36 |
1.4× |
| Meckels Divert Exam (78290) |
$905.95 |
$1,509.91 |
2.3× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$534.14 |
$890.24 |
1.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,677.86 |
$2,796.44 |
4.5× |
| Mr safety determination physician/other qhp (76016) |
$186 |
$310 |
2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$50.40 |
$84 |
1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$204.73 |
$341.22 |
2.1× |
| Mr safety implt pos&/immoblj (76019) |
$137.25 |
$228.75 |
2.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$513.60 |
$856 |
2.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,183.04 |
$5,305.07 |
9.1× |
| MRA head w/o contrast (70544) |
$2,485.31 |
$4,142.19 |
10.4× |
| MRA head with contrast (70545) |
$2,264.12 |
$3,773.54 |
6.5× |
| MRA neck w contrast (70548) |
$2,177.26 |
$3,628.76 |
6.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,719.39 |
$4,532.32 |
7.8× |
| MRA neck w/o contrast (70547) |
$2,288.98 |
$3,814.97 |
9.5× |
| MRI abdomen w contrast (74182) |
$2,612.36 |
$4,353.94 |
7.5× |
| MRI abdomen w/o contrast (74181) |
$2,742.65 |
$4,571.09 |
11.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,551.43 |
$4,252.39 |
3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,008.26 |
$5,013.76 |
8.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,838.31 |
$4,730.52 |
3.6× |
| MRI bone marrow blood supply (77084) |
$1,592.64 |
$2,654.40 |
6.6× |
| MRI brain functional w/o physician admnistration (70554) |
$1,601.46 |
$2,669.10 |
6.7× |
| MRI brain functional w/physician admnistration (70555) |
$1,486.20 |
$2,477 |
6.2× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,443.67 |
$4,072.78 |
10.2× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,645.45 |
$2,742.41 |
6.9× |
| MRI cardiac w/o cont stress (75559) |
$1,680.47 |
$2,800.79 |
3.1× |
| MRI cardiac w/o contrast (75557) |
$2,445.07 |
$4,075.12 |
10.2× |
| MRI cervical spine w contrast (72142) |
$2,301.53 |
$3,835.89 |
6.6× |
| MRI cervical spine w/o cont (72141) |
$2,539.19 |
$4,231.98 |
10.6× |
| MRI chest w/o contrast (71550) |
$1,746 |
$2,910 |
7.3× |
| MRI chest with contrast (71551) |
$2,584.06 |
$4,306.76 |
3.3× |
| MRI chest wo w contrast (71552) |
$2,479.34 |
$4,132.24 |
7.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,770.20 |
$4,617 |
7.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,086.29 |
$5,143.82 |
8.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,485.95 |
$4,143.25 |
10.4× |
| MRI lumbar spine w contrast (72149) |
$2,446.79 |
$4,077.99 |
7.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,663.10 |
$6,105.16 |
10.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,347.34 |
$3,912.24 |
9.8× |
| MRI orbit face neck w contrast (70542) |
$2,580.02 |
$4,300.03 |
7.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,345.40 |
$5,575.66 |
9.5× |
| MRI pelvis w contrast (72196) |
$2,087.21 |
$3,478.68 |
6.0× |
| MRI pelvis w/o & w contrast (72197) |
$3,382.76 |
$5,637.93 |
9.7× |
| MRI pelvis w/o contrast (72195) |
$2,456.13 |
$4,093.55 |
10.2× |
| MRI spectroscopy (76390) |
$1,442.45 |
$2,404.08 |
16.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,192.54 |
$3,654.23 |
9.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,565 |
$4,275 |
7.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,370.78 |
$3,951.30 |
9.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,633.38 |
$6,055.63 |
10.4× |
| MRI, abdomen, combo (74183) |
$3,387.55 |
$5,645.91 |
9.7× |
| MRI, dorsal spine combo (72157) |
$3,855.61 |
$6,426.01 |
11.0× |
| MRI, dorsal spine contrast (72147) |
$2,039.85 |
$3,399.75 |
5.8× |
| MRI, joint upper extrem (73221) |
$2,311.68 |
$3,852.80 |
9.6× |
| MRI, joint upper extrem combo (73223) |
$3,182.18 |
$5,303.63 |
9.1× |
| MRI, lumbar spine combo (72158) |
$3,167.94 |
$5,279.90 |
9.0× |
| Myelogram cervical (72240) |
$1,133.23 |
$1,888.71 |
1.4× |
| Myelogram Lumbar (72265) |
$1,334.09 |
$2,223.48 |
1.7× |
| Myelography thoracic (72255) |
$1,370.02 |
$2,283.37 |
1.7× |
| Myelograpy 2/more regions rs&i (72270) |
$1,821.46 |
$3,035.76 |
2.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$1,114.32 |
$1,857.20 |
2.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,549.60 |
$5,916 |
2.7× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$465.04 |
$775.07 |
0.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,334.46 |
$3,890.77 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,337.71 |
$7,229.51 |
3.3× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,731.60 |
$2,886 |
1.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,731.60 |
$2,886 |
1.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$2,700.60 |
$4,501 |
1.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$3,300.60 |
$5,501 |
1.5× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$2,700.60 |
$4,501 |
1.8× |
| N-invas est c ffr sw aly CTA (75580) |
$3,700.94 |
$6,168.24 |
4.3× |
| Neck soft tissue (70360) |
$237.76 |
$396.27 |
2.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$748.44 |
$1,247.40 |
1.9× |
| Nm csf leak detection (78650) |
$1,405.38 |
$2,342.30 |
1.1× |
| Nm myocard infarct spect (78469) |
$1,231.62 |
$2,052.70 |
2.3× |
| Nm red cell survival study (78130) |
$856.11 |
$1,426.85 |
2.1× |
| Nm whole blood volume (78122) |
$1,811.30 |
$3,018.84 |
3.3× |
| Nonvascular Shunt X-Ray (75809) |
$316.80 |
$528 |
3.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,418.88 |
$9,031.46 |
3.9× |
| Nuclear Rx Intra-Arterial (79445) |
$1,034.57 |
$1,724.28 |
4.4× |
| Nuclear Rx Oral Admin (79005) |
$1,020.34 |
$1,700.57 |
4.4× |
| Ob us nuchal meas 1 gest (76813) |
$268.90 |
$448.16 |
2.6× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$421.57 |
$702.61 |
4.0× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$413.30 |
$688.83 |
3.9× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$601.90 |
$1,003.16 |
4.5× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$256.09 |
$426.82 |
2.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$380.47 |
$634.11 |
3.6× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$100.69 |
$167.81 |
3.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$368.05 |
$613.42 |
3.5× |
| Optic foramina (70190) |
$210.77 |
$351.29 |
2.4× |
| Panoramic X-ray of jaws (70355) |
$203.49 |
$339.15 |
2.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,987.70 |
$3,312.84 |
3.6× |
| Parathyroid Planar Imaging (78070) |
$1,356.79 |
$2,261.31 |
3.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,492.94 |
$2,488.23 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$440.66 |
$734.43 |
4.2× |
| Perineogram (74775) |
$633.30 |
$1,055.50 |
2.6× |
| Peritoneogram Rs&I (74190) |
$510.85 |
$851.42 |
0.9× |
| Pet Image Skull-Thigh (78812) |
$4,795.47 |
$7,992.45 |
3.3× |
| Pet Image W/Ct Lmtd (78814) |
$4,484.45 |
$7,474.09 |
3.1× |
| PET image w/CT, full body (78816) |
$5,953.50 |
$9,922.50 |
4.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,602.44 |
$9,337.40 |
3.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$3,809.11 |
$6,348.52 |
2.9× |
| Pet Myocardial Sngl Study (78491) |
$3,627.73 |
$6,046.21 |
2.5× |
| PET whole body (78813) |
$4,795.47 |
$7,992.45 |
3.3× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$1,982.90 |
$3,304.83 |
1.5× |
| Proton tx delivery intermediate (77523) |
$1,444.54 |
$2,407.56 |
1.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,330.14 |
$3,883.57 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,100.39 |
$1,833.98 |
2.7× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$1,188.31 |
$1,980.52 |
1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$468.03 |
$780.05 |
4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$735.32 |
$1,225.54 |
1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$356.32 |
$593.86 |
4.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$287.12 |
$478.53 |
3.3× |
| Radex elbow complete minimum 3 views (73080) |
$440.72 |
$734.53 |
5.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$409.45 |
$682.41 |
3.9× |
| Radex fingr minimum 2 views (73140) |
$297.18 |
$495.30 |
3.4× |
| Radex foot complete minimum 3 views (73630) |
$406.02 |
$676.70 |
4.6× |
| Radex Hand Minimum 3 Views (73130) |
$382.93 |
$638.22 |
4.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$254.12 |
$423.53 |
2.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$235.84 |
$393.06 |
2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$305.39 |
$508.98 |
3.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$427.43 |
$712.39 |
4.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$385.50 |
$642.50 |
4.4× |
| Radex shoulder complete minimum 2 views (73030) |
$399.22 |
$665.36 |
4.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$249.35 |
$415.59 |
2.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$458.05 |
$763.42 |
2.6× |
| Radex Spine 1 View Specify Level (72020) |
$332.48 |
$554.13 |
3.8× |
| Radex Sternum Minimum 2 Views (71120) |
$331.66 |
$552.77 |
3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$277.69 |
$462.82 |
3.2× |
| Radex Toe Minimum 2 Views (73660) |
$333.33 |
$555.55 |
3.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$253.40 |
$422.34 |
2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$415.32 |
$692.20 |
4.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$591.20 |
$985.34 |
5.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,723.13 |
$27,871.88 |
2.3× |
| Radiation treatment delivery level 1 (77402) |
$1,800 |
$3,000 |
17.6× |
| Radiation treatment delivery level 2 (77407) |
$2,730 |
$4,550 |
7.0× |
| Radiation treatment delivery level 3 (77412) |
$3,600 |
$6,000 |
6.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$379.70 |
$632.83 |
3.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$344.12 |
$573.54 |
3.3× |
| Radiologic exam colon double contrast study (74280) |
$922.66 |
$1,537.77 |
5.2× |
| Radiologic exam colon single contrast study (74270) |
$718.03 |
$1,196.72 |
4.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$579.55 |
$965.91 |
3.3× |
| Radiologic exam knee complete 4/more views (73564) |
$518.08 |
$863.47 |
4.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$400.75 |
$667.92 |
3.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$602.88 |
$1,004.80 |
3.4× |
| Radiologic exam swallow function contrast study (74230) |
$633.71 |
$1,056.18 |
3.6× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$425.96 |
$709.94 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$665.87 |
$1,109.79 |
3.8× |
| Radiologic examination femur 1 view (73551) |
$236.14 |
$393.57 |
2.7× |
| Radiologic examination femur minimum 2 views (73552) |
$287.82 |
$479.70 |
3.3× |
| Radiologic examination knee 1/2 views (73560) |
$379.64 |
$632.73 |
4.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$366 |
$610 |
3.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$184.20 |
$307 |
2.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$342.47 |
$570.78 |
3.9× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$338.57 |
$564.29 |
0.6× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$149.08 |
$248.46 |
1.7× |
| Radiopharm Dacryocystography (78660) |
$583.70 |
$972.83 |
1.5× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,171.04 |
$1,951.73 |
5.0× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$1,982.90 |
$3,304.83 |
3.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$627.28 |
$1,045.46 |
1.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$425.50 |
$709.16 |
1.1× |
| Renal Cyst Study (74470) |
$820.15 |
$1,366.92 |
1.5× |
| Ribs bilateral 3 views (71110) |
$425.96 |
$709.94 |
4.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,185.84 |
$1,976.40 |
3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,726.41 |
$2,877.35 |
4.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,534.30 |
$5,890.50 |
6.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,014.64 |
$3,357.73 |
3.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,381.40 |
$3,969 |
4.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,215.46 |
$3,692.44 |
1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,513.45 |
$4,189.09 |
1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,810.13 |
$3,016.89 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,085.69 |
$1,809.49 |
4.6× |
| Rp Therapy Intravenous Administration (79101) |
$795.01 |
$1,325.01 |
3.4× |
| Salivary Gland Function Study (78232) |
$1,179.85 |
$1,966.42 |
2.9× |
| Salivary Gland Imaging Serial Images (78231) |
$879 |
$1,465 |
2.2× |
| Scapula (73010) |
$311.92 |
$519.86 |
3.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$77.46 |
$129.10 |
3.3× |
| Sella turcica (70240) |
$210.77 |
$351.29 |
2.4× |
| Shoulder 1 view (73020) |
$320.82 |
$534.70 |
3.7× |
| Shoulder Arthrography (73040) |
$888.08 |
$1,480.13 |
2.5× |
| Sialogram (70390) |
$829.34 |
$1,382.23 |
3.5× |
| Skull less than 4 views (70250) |
$312.96 |
$521.60 |
3.0× |
| Special dosimetry (77331) |
$422.48 |
$704.14 |
3.1× |
| Special Physics Consult (77370) |
$699.60 |
$1,166 |
5.2× |
| Special teletherapy port plan (77321) |
$1,056.31 |
$1,760.51 |
2.8× |
| Special treatment procedure (77470) |
$2,125.57 |
$3,542.62 |
3.8× |
| Speech evaluation, complex (70371) |
$409.96 |
$683.27 |
1.7× |
| Spleen Imaging (78185) |
$1,010.08 |
$1,683.46 |
2.5× |
| Stereotactic Body Radiation Delivery (77373) |
$7,426.37 |
$12,377.28 |
4.1× |
| Sternoclavicular joints (71130) |
$221.11 |
$368.51 |
2.5× |
| Superior sagittal sinus venogram (75870) |
$1,834.89 |
$3,058.15 |
0.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$314.07 |
$523.45 |
3.1× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$99.13 |
$165.22 |
1.1× |
| Tbs technical calculation only (77091) |
$99.13 |
$165.22 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,391.17 |
$2,318.62 |
3.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$813.43 |
$1,355.72 |
2.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$813.60 |
$1,356 |
3.4× |
| Testicular Imaging W/Flow (78761) |
$1,200.74 |
$2,001.24 |
3.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,601.60 |
$2,669.33 |
4.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,159.03 |
$1,931.72 |
3.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$699.60 |
$1,166 |
5.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$538.88 |
$898.14 |
3.1× |
| Thoracic spine 2 views (72070) |
$403.23 |
$672.05 |
3.8× |
| Thoracic spine 3 views (72072) |
$508.78 |
$847.96 |
4.8× |
| Thoracolumbar 2 views (72080) |
$306.05 |
$510.09 |
3.5× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
$767.93 |
$1,279.88 |
1.9× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$1,247.37 |
$2,078.95 |
3.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$577.80 |
$963 |
1.4× |
| Thyroid Met Imaging Body (78018) |
$1,244.83 |
$2,074.71 |
2.3× |
| Thyroid Uptake Measurement (78012) |
$589.22 |
$982.04 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,364.77 |
$2,274.61 |
3.4× |
| Tx Devices Design & Construction Complex (77334) |
$1,075.03 |
$1,791.72 |
2.9× |
| Tx devices design & construction intermediate (77333) |
$634.99 |
$1,058.31 |
4.7× |
| Tx devices design & construction simple (77332) |
$685.07 |
$1,141.78 |
5.1× |
| Ultrasound Breast Limited (76642) |
$346.09 |
$576.82 |
4.0× |
| Ultrasound elastography first target lesion (76982) |
$353.09 |
$588.48 |
3.4× |
| Ultrasound Elastography Parenchyma (76981) |
$353.09 |
$588.48 |
3.4× |
| Ultrasound Exam Aaa Screen (76706) |
$419.75 |
$699.59 |
4.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$237.74 |
$396.24 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$604.43 |
$1,007.39 |
5.8× |
| Umbilical-artery Doppler (OB) (76820) |
$303.43 |
$505.72 |
2.9× |
| Unlis px ther radiol clinical tx planning (77299) |
$398.11 |
$663.52 |
2.9× |
Unlisted Dx Radiographic Procedure (76499)
range across 6 matching MRF lines |
$2,330.14–$6,446.54 |
$3,883.57–$10,744.23 |
varies |
Unlisted fluoroscopic procedure (76496)
range across 11 matching MRF lines |
$412.02–$3,433.99 |
$686.70–$5,723.32 |
varies |
Unlisted magnetic resonance procedure (76498)
range across 5 matching MRF lines |
$651.82–$2,280 |
$1,086.36–$3,800 |
varies |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,540.47 |
$2,567.45 |
15.0× |
Unlisted us procedure (76999)
range across 5 matching MRF lines |
$272.16–$3,075.41 |
$453.60–$5,125.68 |
varies |
| Upper gi w/o kub (74240) |
$622.09 |
$1,036.82 |
3.5× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$60.43 |
$100.72 |
5.5× |
| Urea breath test c-14 isotopic analysis (78268) |
$421.31 |
$702.19 |
4.5× |
| Ureteral Reflux Study (78740) |
$1,200.74 |
$2,001.24 |
3.0× |
| Urethrocystogram voiding (74455) |
$712.66 |
$1,187.77 |
3.0× |
| Urethrocystography retrograde (74450) |
$946.62 |
$1,577.70 |
3.9× |
| Us breast unilateral complete (76641) |
$386.64 |
$644.40 |
3.7× |
| Us chest (76604) |
$444.12 |
$740.20 |
4.2× |
| Us complete joint (76881) |
$499.95 |
$833.25 |
4.8× |
| Us exam, pelvic, limited (76857) |
$483.26 |
$805.43 |
4.6× |
| Us head (76506) |
$444.58 |
$740.96 |
4.2× |
| Us kidney transplant (76776) |
$601.20 |
$1,002 |
5.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$435.94 |
$726.57 |
4.2× |
| Us ob detailed single fetus (76811) |
$631.20 |
$1,052 |
2.6× |
| Us ob limited 1 or more fetuses (76815) |
$459 |
$765 |
4.4× |
| Us ob transvaginal (76817) |
$509 |
$848.33 |
4.8× |
| Us pelvic non ob complete (76856) |
$520.36 |
$867.27 |
5.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$580.03 |
$966.71 |
5.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$352.11 |
$586.85 |
3.4× |
| Us retroperitoneal complete (76770) |
$673.36 |
$1,122.26 |
6.4× |
| Us retroperitoneal limited (76775) |
$460.28 |
$767.13 |
4.4× |
| Us scrotum and contents (76870) |
$767.02 |
$1,278.36 |
7.3× |
| Us spinal canal and contents (76800) |
$491.43 |
$819.05 |
4.7× |
| Us thyroid (76536) |
$644.89 |
$1,074.81 |
6.1× |
| Us transrectal (76872) |
$515.63 |
$859.38 |
4.9× |
| Vascular Flow Imaging (78445) |
$608.56 |
$1,014.27 |
1.5× |
| Vasogram (74440) |
$858.58 |
$1,430.96 |
3.6× |
| Vein X-Ray Chest (75827) |
$1,864.99 |
$3,108.32 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,948.80 |
$3,248 |
0.6× |
| Vein X-Ray Skull Epidural (75872) |
$2,079.54 |
$3,465.90 |
3.3× |
| Vein X-Ray Spleen/Liver (75810) |
$1,880.40 |
$3,134 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$1,855.99 |
$3,093.32 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$2,325.28 |
$3,875.47 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,115.24 |
$5,192.06 |
1.0× |
| Venography extremity bilateral rs&i (75822) |
$2,010.86 |
$3,351.44 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,200.91 |
$2,001.51 |
0.8× |
| Venography Renal Bilateral (75833) |
$6,446.54 |
$10,744.23 |
2.0× |
| Venography Renal Unilateral (75831) |
$2,650.18 |
$4,416.96 |
0.8× |
| Venous sampling by catheter (75893) |
$4,200 |
$7,000 |
0.8× |
| Venous thrombosis imaging (78457) |
$1,306.82 |
$2,178.03 |
2.4× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,193.73 |
$1,989.55 |
3.0× |
| Vertebral fracture assessment via dxa (77086) |
$136.07 |
$226.79 |
1.6× |
| Wrist 2 views (73100) |
$318.11 |
$530.18 |
3.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$299.18 |
$498.63 |
3.4× |
| X-ray antegrade pyelogram tube (74425) |
$673.30 |
$1,122.16 |
1.9× |
| X-Ray Aorta Leg Arteries (75630) |
$3,683.78 |
$6,139.64 |
1.2× |
| X-Ray Bend Only L-S Spine (72120) |
$423.69 |
$706.15 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$349.14 |
$581.90 |
4.0× |
| X-Ray Exam Breast Specimen (76098) |
$565.09 |
$941.82 |
1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$317.59 |
$529.32 |
3.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$453.73 |
$756.22 |
4.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$560.57 |
$934.29 |
5.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$248.67 |
$414.45 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$310.59 |
$517.65 |
3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$433.02 |
$721.70 |
4.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$382.98 |
$638.30 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$409.24 |
$682.07 |
3.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$477.22 |
$795.37 |
4.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$626.63 |
$1,044.39 |
6.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$418.55 |
$697.59 |
4.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$643.60 |
$1,072.67 |
6.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$370.58 |
$617.64 |
3.5× |
| X-ray eye for foreign body (70030) |
$189.70 |
$316.16 |
2.2× |
| X-ray head for orthodontia (70350) |
$219.76 |
$366.26 |
2.5× |
| X-ray humerus (73060) |
$399.22 |
$665.36 |
4.6× |
| X-ray IV pyelogram (ivp) (74400) |
$683.08 |
$1,138.47 |
3.9× |
| X-ray IV pyelogram+tomography (74415) |
$680.59 |
$1,134.31 |
3.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$303.05 |
$505.08 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$300.65 |
$501.09 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$474.69 |
$791.15 |
4.5× |
| X-ray nose-rectum child f.b. (76010) |
$217.15 |
$361.91 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$589.58 |
$982.63 |
5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$309.11 |
$515.18 |
2.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$246.98 |
$411.64 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$327.92 |
$546.53 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$419.51 |
$699.19 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$449.72 |
$749.53 |
4.3× |
| X-Ray Stress View (77071) |
$196.81 |
$328.02 |
2.3× |
| X-ray thoracic spine 4 vw (72074) |
$395.59 |
$659.32 |
3.8× |
| X-Ray Tmj Unilat (70328) |
$256.34 |
$427.24 |
2.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$782.02 |
$1,303.36 |
2.2× |
| X-Rays Bone Length Studies (77073) |
$361.81 |
$603.01 |
3.4× |
| X-Rays Bone Survey Complete (77075) |
$747.36 |
$1,245.60 |
7.1× |
| Xr c-spine 4 or 5 views (72050) |
$606.65 |
$1,011.09 |
5.8× |
| Xr facial bones less than 3 views (70140) |
$241.75 |
$402.92 |
2.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$293.81 |
$489.69 |
2.8× |
| Xr myelogram posterior fossa (70010) |
$2,078.98 |
$3,464.96 |
5.9× |
| Xr orbits complete 4 views (70200) |
$339.16 |
$565.27 |
3.2× |
| Xr Tomogram Single Plane (76100) |
$370.64 |
$617.73 |
3.5× |