| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,482.19 |
$9,136.98 |
3.9× |
| Abdomen 1 View (74018) |
$360.75 |
$601.25 |
4.1× |
| Abdomen 2 views (74019) |
$328.57 |
$547.61 |
3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,197.47 |
$1,995.78 |
3.0× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$1,434.20 |
$2,390.34 |
1.1× |
| Adrenal Cortex & Medulla Img (78075) |
$4,524.05 |
$7,540.09 |
3.5× |
| Angio internal mammary (75756) |
$2,498.28 |
$4,163.80 |
0.8× |
| Angio pulmonary bilat (75743) |
$4,805.17 |
$8,008.61 |
1.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,764.59 |
$6,274.32 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$4,442.19 |
$7,403.65 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$4,355.92 |
$7,259.86 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,402 |
$5,670 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,168.15 |
$3,613.58 |
0.7× |
| Ankle 2 views (73600) |
$287.83 |
$479.71 |
3.3× |
| Aortography thoracic serialography rs&i (75605) |
$4,994.35 |
$8,323.91 |
0.9× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,748.50 |
$6,247.50 |
1.2× |
| Artery X-Rays Abdomen (75726) |
$5,218.92 |
$8,698.20 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$6,385.15 |
$10,641.91 |
2.0× |
| Artery X-Rays Pelvis (75736) |
$5,219.35 |
$8,698.91 |
0.9× |
| Artery X-Rays Spine (75705) |
$4,255.45 |
$7,092.41 |
0.8× |
| Arthrogram ankle (73615) |
$923.65 |
$1,539.42 |
2.6× |
| Arthrogram hip (73525) |
$1,006.12 |
$1,676.86 |
2.9× |
| Arthrogram Wrist (73115) |
$1,109.48 |
$1,849.14 |
3.2× |
| Basic radiation dosimetry calculation (77300) |
$619.25 |
$1,032.08 |
4.6× |
| Bone age studies (77072) |
$273.56 |
$455.93 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,798.90 |
$2,998.17 |
4.5× |
| Bone Imaging Limited Area (78300) |
$911.58 |
$1,519.30 |
2.3× |
| Bone Imaging Multiple Areas (78305) |
$959.25 |
$1,598.75 |
2.4× |
| Bone Imaging Whole Body (78306) |
$1,823.30 |
$3,038.83 |
4.5× |
| Bone marrow imaging limited area (78102) |
$728.85 |
$1,214.75 |
1.8× |
| Bone marrow imaging; multiple areas (78103) |
$762.31 |
$1,270.51 |
1.9× |
| Bone marrow imaging; whole body (78104) |
$973.73 |
$1,622.89 |
2.4× |
| Bone survey infant (77076) |
$394.69 |
$657.81 |
3.8× |
| Brachytx isodose complex (77318) |
$1,842.35 |
$3,070.58 |
4.9× |
| Brachytx isodose intermed (77317) |
$1,234.68 |
$2,057.80 |
3.3× |
| Brachytx Isodose Plan Simple (77316) |
$1,032.38 |
$1,720.63 |
2.7× |
| Brain Flow Imaging Only (78610) |
$907.45 |
$1,512.41 |
1.7× |
| Brain Image W/Flow < 4 Views (78601) |
$2,694.19 |
$4,490.31 |
6.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,337.97 |
$3,896.62 |
4.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,097.98 |
$1,829.97 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,359.28 |
$8,932.14 |
3.7× |
| 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) |
$1,351.68 |
$2,252.80 |
2.5× |
| 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) |
$3,780 |
$6,300 |
4.8× |
| Cardiac Shunt Detection (78428) |
$1,351.68 |
$2,252.80 |
3.4× |
| Cat Scan Follow-Up Study (76380) |
$769.75 |
$1,282.92 |
8.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$907.45 |
$1,512.41 |
1.7× |
| Cerebrospinal Fluid Scan (78630) |
$1,170.64 |
$1,951.06 |
2.1× |
| Chest 1 view (71045) |
$327.08 |
$545.13 |
3.7× |
| Chest 2 views (71046) |
$341.32 |
$568.86 |
3.9× |
| Chest 3 views (71047) |
$270.06 |
$450.10 |
3.1× |
| Chest 4 or more views (71048) |
$377.06 |
$628.43 |
3.6× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$376.57 |
$627.62 |
3.6× |
| Cholecystography Oral Contrast (74290) |
$260.14 |
$433.56 |
1.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,718.20 |
$2,863.67 |
2.2× |
| Clavicle complete (73000) |
$286.09 |
$476.82 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$240.33 |
$400.55 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$677.84 |
$1,129.74 |
5.0× |
| Contrast Exam Abdominl Aorta (75625) |
$3,884.68 |
$6,474.46 |
1.2× |
| Contrast X-Ray Bladder (74430) |
$728.84 |
$1,214.74 |
2.1× |
| Contrast X-Ray Of Elbow (73085) |
$960.60 |
$1,601 |
2.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$923.65 |
$1,539.42 |
2.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$256.03 |
$426.72 |
1.5× |
| Corpora cavernosography (74445) |
$565.20 |
$942 |
5.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,788.88 |
$6,314.80 |
10.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,837.26 |
$4,728.76 |
11.8× |
| CT abdomen w contrast (74160) |
$2,153.60 |
$3,589.33 |
12.2× |
| CT abdomen w wo contrast (74170) |
$2,721.60 |
$4,536 |
15.4× |
| CT abdomen w/o contrast (74150) |
$1,670.28 |
$2,783.80 |
15.9× |
| CT Angio Abdomen and Pelvis (74174) |
$4,082.40 |
$6,804 |
11.6× |
| CT Angio Chest (71275) |
$2,815.20 |
$4,692 |
16.0× |
| CT Angio Head (70496) |
$2,381.40 |
$3,969 |
13.5× |
| CT angio hrt w/3d image (75574) |
$2,133.91 |
$3,556.52 |
6.1× |
| 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) |
$2,859.32 |
$4,765.53 |
16.2× |
| CT bone density (77078) |
$360.85 |
$601.41 |
4.1× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,279.66 |
$2,132.76 |
7.3× |
| CT cervical spine w/ contrast (72126) |
$2,381.40 |
$3,969 |
6.8× |
| CT cervical spine w/o contrast (72125) |
$2,060.35 |
$3,433.91 |
19.6× |
| CT cervical spine w/wo cont (72127) |
$2,520 |
$4,200 |
14.3× |
| CT chest w contrast (71260) |
$2,167 |
$3,611.66 |
12.3× |
| CT chest w/wo contrast (71270) |
$2,366.31 |
$3,943.85 |
13.4× |
| CT colonography screening (74263) |
$2,062.97 |
$3,438.29 |
8.6× |
| 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) |
$699.19 |
$1,165.31 |
6.7× |
| CT head/brain with contrast (70460) |
$1,625.05 |
$2,708.41 |
9.2× |
| CT head/brain without and with contrast (70470) |
$1,925.21 |
$3,208.68 |
10.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,111.03 |
$3,518.39 |
6.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$217.63 |
$362.71 |
2.5× |
| CT hrt w/3d image congen (75573) |
$934.40 |
$1,557.33 |
2.7× |
| CT iac w contrast (70481) |
$1,543.83 |
$2,573.05 |
8.8× |
| CT l-spine w&w/o contrast (72133) |
$1,677.35 |
$2,795.59 |
9.5× |
| CT lower ext w/o (73700) |
$1,398.82 |
$2,331.36 |
13.3× |
| CT lower extremity w/contrast material (73701) |
$1,877.52 |
$3,129.20 |
10.7× |
| CT lumbar spine w contrast (72132) |
$2,041.20 |
$3,402 |
5.8× |
| CT lumbar spine w/o contrast (72131) |
$1,731.42 |
$2,885.70 |
16.5× |
| CT maxillofacial w contrast (70487) |
$1,930.24 |
$3,217.06 |
11.0× |
| CT maxillofacial wo contrast (70486) |
$1,640.48 |
$2,734.13 |
15.6× |
| CT neck tissue combo (70492) |
$2,311.02 |
$3,851.70 |
13.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,563.46 |
$2,605.77 |
8.9× |
| CT orbits w/o contrast (70480) |
$1,466.86 |
$2,444.76 |
14.0× |
| CT pelvis w&w/o contrast (72194) |
$1,890.36 |
$3,150.60 |
10.7× |
| CT pelvis w/o contrast (72192) |
$1,456.33 |
$2,427.22 |
13.9× |
| CT scan of leg combo (73702) |
$1,887.84 |
$3,146.40 |
10.7× |
| CT scans face/jaw combo (70488) |
$1,908.25 |
$3,180.42 |
10.8× |
| CT soft tissue neck w contrast (70491) |
$2,047.72 |
$3,412.86 |
11.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,466.86 |
$2,444.76 |
14.0× |
| CT thoracic spine w contrast (72129) |
$2,041.20 |
$3,402 |
11.6× |
| CT thoracic spine w/o contrast (72128) |
$1,768.19 |
$2,946.99 |
16.8× |
| CT thoracic spine w/wo cont (72130) |
$2,381.40 |
$3,969 |
13.5× |
| CT thorax w/o contrast (71250) |
$1,473.52 |
$2,455.87 |
14.0× |
CT unlisted procedure (76497)
range across 11 matching MRF lines |
$322.92–$3,679.86 |
$538.20–$6,133.10 |
varies |
| CT upper ext wo (73200) |
$1,408.54 |
$2,347.57 |
13.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,688.20 |
$2,813.67 |
9.6× |
| CT upper extremity with contrast (73201) |
$1,824.46 |
$3,040.76 |
5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,424.96 |
$4,041.60 |
13.8× |
| Cta Abdomen (74175) |
$2,824.48 |
$4,707.47 |
16.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,762.80 |
$7,938 |
13.6× |
| CTA pelvis (72191) |
$3,224.53 |
$5,374.21 |
18.3× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$864.68 |
$1,441.13 |
3.6× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) |
$1,222.94 |
$2,038.24 |
2.2× |
| Dilation ureters/urethra rs&i (74485) |
$3,458.62 |
$5,764.36 |
1.6× |
| Discography Cerv/Thor Spine (72285) |
$5,350.69 |
$8,917.82 |
2.7× |
| Diskography lumbar (72295) |
$5,350.69 |
$8,917.82 |
2.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$328.97 |
$548.28 |
3.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$429.87 |
$716.45 |
4.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$267.75 |
$446.25 |
2.5× |
| Dxa Bone Density Axial (77080) |
$398.56 |
$664.26 |
3.8× |
| Dxa bone density study (77085) |
$293.20 |
$488.66 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$372.51 |
$620.85 |
4.3× |
| Echo exam of fetal heart (76825) |
$943.49 |
$1,572.49 |
1.7× |
| Echo exam uterus (76831) |
$585.61 |
$976.01 |
2.4× |
| Echo Guide For Artery Repair (76936) |
$512.15 |
$853.59 |
2.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$569.48 |
$949.13 |
2.4× |
| Echograp Trans R Pros Study (76873) |
$617.85 |
$1,029.75 |
5.9× |
| Esophageal Motility Study (78258) |
$1,266.22 |
$2,110.37 |
3.2× |
| 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) |
$428.68 |
$714.46 |
4.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,324.65 |
$2,207.75 |
5.5× |
| Fluoroscopy up to 1 hr (76000) |
$494.52 |
$824.20 |
2.1× |
| Follow-Up Angiography (75898) |
$752.22 |
$1,253.70 |
0.2× |
| Foot 2 views (73620) |
$338.66 |
$564.44 |
3.9× |
| Forearm 2 views (73090) |
$375.50 |
$625.84 |
4.3× |
| Gastric emptying imaging study (78264) |
$1,719.11 |
$2,865.19 |
4.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,391.99 |
$2,319.99 |
3.5× |
| Gastroesophageal Reflux Exam (78262) |
$1,120.86 |
$1,868.10 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,584.98 |
$2,641.63 |
3.9× |
| Gated Heart, Multiple (78473) |
$1,405.04 |
$2,341.73 |
3.5× |
| GI Endoscopic US S&I (76975) |
$582.31 |
$970.51 |
2.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,770.81 |
$2,951.35 |
3.2× |
| Hand 2 views (73120) |
$356.60 |
$594.33 |
3.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$4,945.79 |
$8,242.99 |
7.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,864.58 |
$6,440.96 |
5.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$3,770.48 |
$6,284.13 |
5.4× |
| Heart first pass single,planar (78481) |
$1,184.98 |
$1,974.96 |
2.2× |
| Heart Image (Pet) Multiple (78492) |
$4,225.34 |
$7,042.23 |
2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,368.95 |
$5,614.92 |
1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,642.81 |
$6,071.35 |
1.1× |
| Hepatobil Syst Image W/Drug (78227) |
$1,968.94 |
$3,281.57 |
3.6× |
| Hepatobiliary System Imaging (78226) |
$1,754.98 |
$2,924.97 |
4.4× |
| Ht Musc Image Planar Mult (78454) |
$2,334.46 |
$3,890.76 |
1.8× |
| Ht Muscle Image Spect Sing (78451) |
$3,104.72 |
$5,174.53 |
2.4× |
| 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) |
$908.52 |
$1,514.20 |
3.8× |
| Image fusion (77399) |
$376.03 |
$626.72 |
2.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$474.87 |
$791.45 |
5.4× |
| Infant hip ultrasound, limited static exam (76886) |
$412.92 |
$688.20 |
4.7× |
| Infusion Ivp (74410) |
$709.58 |
$1,182.64 |
4.0× |
| Interstitial radiation source applic complex (77778) |
$3,725.57 |
$6,209.29 |
5.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,717.51 |
$2,862.51 |
2.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,521.98 |
$2,536.64 |
2.7× |
| Intracavitary radiation source applic simple (77761) |
$1,203.12 |
$2,005.20 |
2.2× |
| Joint Survey Single View (77077) |
$181.62 |
$302.70 |
1.7× |
| K Flow/Funct Image Multiple (78709) |
$1,293.28 |
$2,155.46 |
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) |
$1,465.10 |
$2,441.83 |
2.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$746.54 |
$1,244.23 |
1.9× |
| Kidney Imaging Morphol (78700) |
$997.30 |
$1,662.17 |
2.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$972.03 |
$1,620.05 |
2.4× |
| Knee 3 Views (73562) |
$347.83 |
$579.71 |
4.0× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$407.63 |
$679.39 |
1.0× |
| Leveen/Shunt Patency Exam (78291) |
$661.40 |
$1,102.34 |
1.6× |
| Liver & Spleen Imaging Static Only (78215) |
$1,166.72 |
$1,944.53 |
2.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,194.01 |
$1,990.01 |
3.0× |
| Liver imaging static only (78201) |
$827.28 |
$1,378.80 |
1.5× |
| Liver imaging w/vascular flow (78202) |
$1,694.54 |
$2,824.23 |
3.1× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,425.08 |
$2,375.14 |
2.6× |
| Lung perfusion differential (78597) |
$1,091.69 |
$1,819.48 |
2.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,998.19 |
$3,330.31 |
3.7× |
| Lung Ventilation Imaging (78579) |
$865.48 |
$1,442.47 |
2.2× |
| Lymph System Imaging (78195) |
$1,653.32 |
$2,755.54 |
3.0× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,288.81 |
$2,148.02 |
0.8× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$972.06 |
$1,620.10 |
1.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,859.41 |
$4,765.68 |
0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,494.49 |
$4,157.49 |
0.8× |
| Magnetic Image Jaw Joint (70336) |
$2,564.62 |
$4,274.37 |
10.7× |
| 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) |
$1,089.88 |
$1,816.47 |
2.7× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$674.72 |
$1,124.54 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,981.28 |
$3,302.14 |
5.3× |
| 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) |
$2,857.68 |
$4,762.80 |
8.2× |
| MRA head w/o contrast (70544) |
$2,268.08 |
$3,780.14 |
9.5× |
| MRA head with contrast (70545) |
$2,000.98 |
$3,334.96 |
5.7× |
| MRA neck w contrast (70548) |
$2,951.65 |
$4,919.42 |
8.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,402.40 |
$5,670.67 |
9.7× |
| MRA neck w/o contrast (70547) |
$2,294.96 |
$3,824.93 |
9.6× |
| MRI abdomen w contrast (74182) |
$2,042.68 |
$3,404.47 |
5.8× |
| MRI abdomen w/o contrast (74181) |
$2,048.36 |
$3,413.93 |
8.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,201.09 |
$3,668.48 |
2.8× |
| 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) |
$2,895.55 |
$4,825.92 |
3.7× |
| MRI bone marrow blood supply (77084) |
$1,592.64 |
$2,654.40 |
6.6× |
| MRI brain functional w/o physician admnistration (70554) |
$1,886.68 |
$3,144.47 |
7.9× |
| MRI brain functional w/physician admnistration (70555) |
$1,560.51 |
$2,600.85 |
6.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,443.67 |
$4,072.78 |
10.2× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$326.21 |
$543.68 |
1.4× |
| 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) |
$2,318.26 |
$3,863.76 |
9.7× |
| MRI chest w/o contrast (71550) |
$1,746 |
$2,910 |
7.3× |
| MRI chest with contrast (71551) |
$2,325.74 |
$3,876.24 |
3.0× |
| MRI chest wo w contrast (71552) |
$2,597.41 |
$4,329.02 |
7.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,000 |
$5,000 |
8.6× |
| 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) |
$2,088.20 |
$3,480.33 |
8.7× |
| 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) |
$2,251.88 |
$3,753.14 |
6.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,345.40 |
$5,575.66 |
9.5× |
| MRI pelvis w contrast (72196) |
$1,989.01 |
$3,315.01 |
5.7× |
| 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) |
$2,143.16 |
$3,571.94 |
8.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,011.63 |
$3,352.71 |
5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,614.40 |
$4,357.34 |
10.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,552.73 |
$5,921.21 |
10.1× |
| MRI, abdomen, combo (74183) |
$3,061.80 |
$5,103 |
8.7× |
| 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) |
$2,827.52 |
$4,712.53 |
8.1× |
| MRI, lumbar spine combo (72158) |
$3,200.98 |
$5,334.96 |
9.1× |
| Myelogram cervical (72240) |
$1,088.80 |
$1,814.66 |
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) |
$1,569.51 |
$2,615.85 |
2.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$840.74 |
$1,401.23 |
2.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,979.25 |
$8,298.75 |
3.8× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$442.89 |
$738.15 |
0.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,451.18 |
$4,085.30 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,337.71 |
$7,229.51 |
3.3× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,904.76 |
$3,174.60 |
1.3× |
| 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) |
$279.65 |
$466.08 |
3.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$748.44 |
$1,247.40 |
1.9× |
| Nm csf leak detection (78650) |
$1,391.99 |
$2,319.99 |
1.1× |
| Nm myocard infarct spect (78469) |
$1,061.26 |
$1,768.77 |
1.9× |
| Nm red cell survival study (78130) |
$815.35 |
$1,358.91 |
2.0× |
| Nm whole blood volume (78122) |
$1,725.05 |
$2,875.08 |
3.2× |
| Nonvascular Shunt X-Ray (75809) |
$375.67 |
$626.12 |
3.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,996.21 |
$9,993.68 |
4.3× |
| Nuclear Rx Intra-Arterial (79445) |
$1,034.57 |
$1,724.28 |
4.4× |
| Nuclear Rx Oral Admin (79005) |
$1,203.89 |
$2,006.49 |
5.1× |
| Ob us nuchal meas 1 gest (76813) |
$311.03 |
$518.38 |
3.0× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$401.77 |
$669.62 |
3.8× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$380.47 |
$634.11 |
3.6× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$588.14 |
$980.24 |
4.4× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$280.25 |
$467.09 |
2.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$393.89 |
$656.48 |
3.8× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$107.10 |
$178.50 |
3.7× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$355.75 |
$592.92 |
3.4× |
| Optic foramina (70190) |
$200.74 |
$334.56 |
2.3× |
| Panoramic X-ray of jaws (70355) |
$219.22 |
$365.36 |
2.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,081.21 |
$3,468.68 |
3.8× |
| Parathyroid Planar Imaging (78070) |
$1,435.33 |
$2,392.22 |
3.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,317.94 |
$2,196.57 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$319.22 |
$532.03 |
3.0× |
| Perineogram (74775) |
$603.14 |
$1,005.24 |
2.5× |
| Peritoneogram Rs&I (74190) |
$510.85 |
$851.42 |
0.9× |
| Pet Image Skull-Thigh (78812) |
$4,658.45 |
$7,764.09 |
3.2× |
| Pet Image W/Ct Lmtd (78814) |
$4,912.88 |
$8,188.14 |
3.4× |
| 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) |
$3,677.40 |
$6,129 |
2.8× |
| Pet Myocardial Sngl Study (78491) |
$3,627.73 |
$6,046.21 |
2.5× |
| PET whole body (78813) |
$4,567.11 |
$7,611.85 |
3.2× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$1,964.02 |
$3,273.36 |
1.5× |
| Proton tx delivery intermediate (77523) |
$1,588.99 |
$2,648.32 |
1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,396.72 |
$3,994.53 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,082.75 |
$1,804.59 |
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) |
$418.63 |
$697.72 |
4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$601.93 |
$1,003.22 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$325.59 |
$542.65 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$270.11 |
$450.18 |
3.1× |
| Radex elbow complete minimum 3 views (73080) |
$414.68 |
$691.14 |
4.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$392.26 |
$653.77 |
3.7× |
| Radex fingr minimum 2 views (73140) |
$264.08 |
$440.14 |
3.0× |
| Radex foot complete minimum 3 views (73630) |
$383.94 |
$639.90 |
4.4× |
| Radex Hand Minimum 3 Views (73130) |
$390.52 |
$650.87 |
4.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$249.13 |
$415.22 |
2.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$245.27 |
$408.78 |
2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$274.01 |
$456.69 |
3.1× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$407.07 |
$678.45 |
4.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$362.86 |
$604.77 |
4.2× |
| Radex shoulder complete minimum 2 views (73030) |
$344.38 |
$573.96 |
3.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$188.79 |
$314.65 |
2.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$471.13 |
$785.22 |
2.7× |
| Radex Spine 1 View Specify Level (72020) |
$272.99 |
$454.98 |
3.1× |
| Radex Sternum Minimum 2 Views (71120) |
$264.39 |
$440.65 |
3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$268.76 |
$447.94 |
3.1× |
| Radex Toe Minimum 2 Views (73660) |
$271.84 |
$453.07 |
3.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$248.44 |
$414.07 |
2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$359.02 |
$598.36 |
4.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$591.21 |
$985.35 |
5.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,549.13 |
$27,581.89 |
2.2× |
| Radiation treatment delivery level 1 (77402) |
$1,800 |
$3,000 |
17.6× |
| Radiation treatment delivery level 2 (77407) |
$2,550 |
$4,250 |
6.6× |
| Radiation treatment delivery level 3 (77412) |
$3,000 |
$5,000 |
5.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$361.61 |
$602.68 |
3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$331.54 |
$552.56 |
3.2× |
| Radiologic exam colon double contrast study (74280) |
$773.04 |
$1,288.40 |
4.4× |
| Radiologic exam colon single contrast study (74270) |
$667.61 |
$1,112.69 |
3.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$579.55 |
$965.91 |
3.3× |
| Radiologic exam knee complete 4/more views (73564) |
$500.23 |
$833.72 |
4.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$348.19 |
$580.31 |
3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$520.69 |
$867.82 |
3.0× |
| Radiologic exam swallow function contrast study (74230) |
$472.24 |
$787.06 |
2.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$385.39 |
$642.31 |
1.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$704.42 |
$1,174.04 |
4.0× |
| Radiologic examination femur 1 view (73551) |
$224.90 |
$374.84 |
2.6× |
| Radiologic examination femur minimum 2 views (73552) |
$302.07 |
$503.45 |
3.5× |
| Radiologic examination knee 1/2 views (73560) |
$277.32 |
$462.20 |
3.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$478.60 |
$797.66 |
4.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$184.20 |
$307 |
2.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$387.38 |
$645.63 |
4.4× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$322.45 |
$537.42 |
0.6× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$138.40 |
$230.66 |
1.6× |
| Radiopharm Dacryocystography (78660) |
$555.89 |
$926.49 |
1.4× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,115.27 |
$1,858.78 |
4.8× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$1,888.48 |
$3,147.46 |
3.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$658.64 |
$1,097.73 |
1.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$397.29 |
$662.15 |
1.0× |
| Renal Cyst Study (74470) |
$706.71 |
$1,177.85 |
1.3× |
| Ribs bilateral 3 views (71110) |
$445.78 |
$742.96 |
4.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,147.41 |
$1,912.35 |
2.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,429.07 |
$2,381.78 |
3.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,593.68 |
$5,989.47 |
6.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,175.81 |
$3,626.35 |
4.0× |
| 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) |
$2,109.97 |
$3,516.61 |
1.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,992.77 |
$4,987.95 |
2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,263.09 |
$3,771.82 |
1.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,073.40 |
$1,789 |
4.6× |
| Rp Therapy Intravenous Administration (79101) |
$984.93 |
$1,641.55 |
4.2× |
| Salivary Gland Function Study (78232) |
$1,123.67 |
$1,872.78 |
2.8× |
| Salivary Gland Imaging Serial Images (78231) |
$996.79 |
$1,661.31 |
2.5× |
| Scapula (73010) |
$276.52 |
$460.86 |
2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$117.47 |
$195.78 |
5.0× |
| Sella turcica (70240) |
$200.74 |
$334.56 |
2.3× |
| Shoulder 1 view (73020) |
$399.27 |
$665.45 |
4.6× |
| Shoulder Arthrography (73040) |
$937.91 |
$1,563.19 |
2.7× |
| Sialogram (70390) |
$789.85 |
$1,316.42 |
3.3× |
| Skull less than 4 views (70250) |
$309.63 |
$516.05 |
2.9× |
| Special dosimetry (77331) |
$463.21 |
$772.01 |
3.4× |
| Special Physics Consult (77370) |
$799.57 |
$1,332.61 |
5.9× |
| Special teletherapy port plan (77321) |
$1,346.27 |
$2,243.79 |
3.6× |
| Special treatment procedure (77470) |
$1,978.89 |
$3,298.15 |
3.6× |
| Speech evaluation, complex (70371) |
$409.97 |
$683.28 |
1.7× |
| Spleen Imaging (78185) |
$961.98 |
$1,603.30 |
2.4× |
| Stereotactic Body Radiation Delivery (77373) |
$8,344.87 |
$13,908.12 |
4.6× |
| Sternoclavicular joints (71130) |
$218.48 |
$364.13 |
2.5× |
| Superior sagittal sinus venogram (75870) |
$1,864.02 |
$3,106.70 |
0.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$285.42 |
$475.70 |
2.8× |
| 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) |
$1,181 |
$1,968.33 |
3.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$872.14 |
$1,453.56 |
2.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$813.60 |
$1,356 |
3.4× |
| Testicular Imaging W/Flow (78761) |
$842.56 |
$1,404.27 |
2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,041.25 |
$3,402.09 |
5.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$960.78 |
$1,601.30 |
2.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$851.12 |
$1,418.54 |
6.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$635.54 |
$1,059.23 |
3.6× |
| Thoracic spine 2 views (72070) |
$403.23 |
$672.05 |
3.8× |
| Thoracic spine 3 views (72072) |
$450.25 |
$750.42 |
4.3× |
| Thoracolumbar 2 views (72080) |
$306.05 |
$510.09 |
3.5× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
$731.35 |
$1,218.92 |
1.8× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$1,366.16 |
$2,276.94 |
3.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$577.80 |
$963 |
1.4× |
| Thyroid Met Imaging Body (78018) |
$1,524.99 |
$2,541.65 |
2.8× |
| Thyroid Uptake Measurement (78012) |
$526.55 |
$877.59 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,459.04 |
$2,431.74 |
3.6× |
| Tx Devices Design & Construction Complex (77334) |
$1,207.24 |
$2,012.06 |
3.2× |
| Tx devices design & construction intermediate (77333) |
$828.05 |
$1,380.09 |
6.1× |
| 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) |
$352.21 |
$587.01 |
3.4× |
| Ultrasound Elastography Parenchyma (76981) |
$399.40 |
$665.67 |
3.8× |
| Ultrasound Exam Aaa Screen (76706) |
$430.21 |
$717.01 |
4.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$237.74 |
$396.24 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$671.72 |
$1,119.54 |
6.4× |
| Umbilical-artery Doppler (OB) (76820) |
$322.20 |
$537 |
3.1× |
| 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 |
$2,219.18–$6,139.57 |
$3,698.64–$10,232.61 |
varies |
Unlisted fluoroscopic procedure (76496)
range across 12 matching MRF lines |
$428.50–$3,501 |
$714.17–$5,835 |
varies |
Unlisted magnetic resonance procedure (76498)
range across 6 matching MRF lines |
$651.82–$2,052 |
$1,086.36–$3,420 |
varies |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,540.47 |
$2,567.45 |
15.0× |
Unlisted us procedure (76999)
range across 5 matching MRF lines |
$259.20–$2,861.95 |
$432–$4,769.92 |
varies |
| Upper gi w/o kub (74240) |
$771.95 |
$1,286.59 |
4.4× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$57.55 |
$95.92 |
5.2× |
| Urea breath test c-14 isotopic analysis (78268) |
$401.25 |
$668.75 |
4.3× |
| Ureteral Reflux Study (78740) |
$1,298.73 |
$2,164.55 |
3.2× |
| Urethrocystogram voiding (74455) |
$706.96 |
$1,178.27 |
2.9× |
| Urethrocystography retrograde (74450) |
$690.54 |
$1,150.90 |
2.9× |
| Us breast unilateral complete (76641) |
$442.26 |
$737.10 |
4.2× |
| Us chest (76604) |
$444.12 |
$740.20 |
4.2× |
| Us complete joint (76881) |
$544.62 |
$907.70 |
5.2× |
| Us exam, pelvic, limited (76857) |
$483.26 |
$805.43 |
4.6× |
| Us head (76506) |
$456.60 |
$761 |
4.3× |
| Us kidney transplant (76776) |
$618.88 |
$1,031.46 |
5.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$405.68 |
$676.13 |
3.9× |
| Us ob detailed single fetus (76811) |
$680.71 |
$1,134.51 |
2.8× |
| 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) |
$647.87 |
$1,079.78 |
6.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$614.24 |
$1,023.74 |
5.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$355.63 |
$592.71 |
3.4× |
| Us retroperitoneal complete (76770) |
$673.36 |
$1,122.26 |
6.4× |
| Us retroperitoneal limited (76775) |
$537.62 |
$896.03 |
5.1× |
| Us scrotum and contents (76870) |
$685.33 |
$1,142.22 |
6.5× |
| Us spinal canal and contents (76800) |
$529.99 |
$883.31 |
5.0× |
| Us thyroid (76536) |
$630.55 |
$1,050.92 |
6.0× |
| Us transrectal (76872) |
$441.88 |
$736.46 |
4.2× |
| Vascular Flow Imaging (78445) |
$608.56 |
$1,014.27 |
1.5× |
| Vasogram (74440) |
$817.69 |
$1,362.82 |
3.4× |
| Vein X-Ray Chest (75827) |
$2,040.37 |
$3,400.61 |
1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,994.47 |
$3,324.12 |
0.6× |
| Vein X-Ray Skull Epidural (75872) |
$1,980.52 |
$3,300.86 |
3.1× |
| Vein X-Ray Spleen/Liver (75810) |
$1,880.40 |
$3,134 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$2,052.67 |
$3,421.11 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$2,418.29 |
$4,030.49 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$3,469.82 |
$5,783.04 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$2,026.94 |
$3,378.23 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,382.58 |
$2,304.30 |
0.9× |
| Venography Renal Bilateral (75833) |
$6,704.41 |
$11,174.01 |
2.1× |
| Venography Renal Unilateral (75831) |
$3,216.83 |
$5,361.39 |
1.0× |
| Venous sampling by catheter (75893) |
$4,762.80 |
$7,938 |
0.9× |
| Venous thrombosis imaging (78457) |
$1,244.58 |
$2,074.30 |
2.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,136.87 |
$1,894.79 |
2.8× |
| Vertebral fracture assessment via dxa (77086) |
$136.07 |
$226.79 |
1.6× |
| Wrist 2 views (73100) |
$268.49 |
$447.49 |
3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$293.30 |
$488.84 |
3.4× |
| X-ray antegrade pyelogram tube (74425) |
$701.49 |
$1,169.15 |
2.0× |
| X-Ray Aorta Leg Arteries (75630) |
$3,569.56 |
$5,949.27 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$468.26 |
$780.43 |
4.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$303.76 |
$506.26 |
3.5× |
| X-Ray Exam Breast Specimen (76098) |
$638.62 |
$1,064.37 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$162.11 |
$270.19 |
1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$242.35 |
$403.91 |
2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$560.57 |
$934.29 |
5.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$118.83 |
$198.05 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$301.92 |
$503.20 |
3.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$445.39 |
$742.32 |
4.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$382.98 |
$638.30 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$647.97 |
$1,079.95 |
6.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$470.88 |
$784.80 |
4.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$601.98 |
$1,003.30 |
5.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$378.40 |
$630.67 |
4.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$538.91 |
$898.19 |
5.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$394.69 |
$657.82 |
3.8× |
| X-ray eye for foreign body (70030) |
$183.98 |
$306.63 |
2.1× |
| X-ray head for orthodontia (70350) |
$214.19 |
$356.99 |
2.5× |
| X-ray humerus (73060) |
$353.69 |
$589.49 |
4.0× |
| X-ray IV pyelogram (ivp) (74400) |
$823.10 |
$1,371.84 |
4.7× |
| X-ray IV pyelogram+tomography (74415) |
$673.90 |
$1,123.16 |
3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$261.13 |
$435.22 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$289.34 |
$482.23 |
3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$384.07 |
$640.11 |
3.7× |
| X-ray nose-rectum child f.b. (76010) |
$212.88 |
$354.80 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$524.27 |
$873.78 |
5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$450.39 |
$750.65 |
4.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$246.16 |
$410.27 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$278.57 |
$464.28 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$421.47 |
$702.45 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$440.90 |
$734.83 |
4.2× |
| X-Ray Stress View (77071) |
$196.81 |
$328.02 |
2.3× |
| X-ray thoracic spine 4 vw (72074) |
$369.36 |
$615.60 |
3.5× |
| X-Ray Tmj Unilat (70328) |
$251.32 |
$418.87 |
2.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$849.37 |
$1,415.61 |
2.4× |
| X-Rays Bone Length Studies (77073) |
$360.97 |
$601.61 |
3.4× |
| X-Rays Bone Survey Complete (77075) |
$826.19 |
$1,376.99 |
7.9× |
| Xr c-spine 4 or 5 views (72050) |
$499.47 |
$832.45 |
4.8× |
| Xr facial bones less than 3 views (70140) |
$241.75 |
$402.92 |
2.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$279.82 |
$466.36 |
2.7× |
| Xr myelogram posterior fossa (70010) |
$1,979.98 |
$3,299.96 |
5.6× |
| Xr orbits complete 4 views (70200) |
$349.15 |
$581.91 |
3.3× |
| Xr Tomogram Single Plane (76100) |
$370.64 |
$617.73 |
3.5× |