| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,076.10 |
$8,460.17 |
3.7× |
| Abdomen 2 views (74019) |
$304.23 |
$507.05 |
2.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,108.76 |
$1,847.94 |
2.8× |
| Acute venous thrombus image (78456) |
$1,434.20 |
$2,390.34 |
1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,764.59 |
$6,274.32 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$4,230.17 |
$7,050.28 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$4,033.25 |
$6,722.09 |
1.3× |
| Angiography internal mammary rs&i (75756) |
$2,313.22 |
$3,855.37 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,837.73 |
$8,062.88 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,449.23 |
$7,415.38 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,150 |
$5,250 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$3,940.23 |
$6,567.05 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,832.33 |
$8,053.89 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$752.22 |
$1,253.70 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,168.15 |
$3,613.58 |
0.7× |
| Ankle 2 views (73600) |
$266.51 |
$444.18 |
3.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$649.53 |
$1,082.55 |
1.9× |
| Aortogram thoracic (75605) |
$4,624.39 |
$7,707.32 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,305.15 |
$5,508.58 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,596.92 |
$5,994.87 |
1.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,748.50 |
$6,247.50 |
1.2× |
| Artery X-Rays Adrenal Gland (75731) |
$6,385.15 |
$10,641.91 |
2.0× |
| Arthrogram elbow (73085) |
$960.60 |
$1,601 |
2.7× |
| Arthrogram hip (73525) |
$1,013.47 |
$1,689.12 |
2.9× |
| Arthrogram shoulder (73040) |
$868.44 |
$1,447.40 |
2.5× |
| Arthrogram wrist (73115) |
$1,109.48 |
$1,849.14 |
3.2× |
| Arthrography knee lt (73580) |
$923.65 |
$1,539.42 |
2.6× |
| Basic radiation dosimetry calculation (77300) |
$573.38 |
$955.63 |
4.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$911.58 |
$1,519.30 |
2.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$959.25 |
$1,598.75 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$1,688.24 |
$2,813.73 |
4.2× |
| Bone age studies (77072) |
$253.30 |
$422.16 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$1,665.65 |
$2,776.08 |
4.1× |
| Bone Marrow Imaging Limited Area (78102) |
$728.85 |
$1,214.75 |
1.8× |
| Bone survey complete (77075) |
$764.99 |
$1,274.99 |
7.3× |
| Brachytx isodose complex (77318) |
$1,705.88 |
$2,843.13 |
4.5× |
| Brachytx isodose intermed (77317) |
$1,143.22 |
$1,905.37 |
3.0× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$955.91 |
$1,593.18 |
2.5× |
| Brain image w/flow 4 + views (78606) |
$2,164.79 |
$3,607.98 |
4.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$2,494.61 |
$4,157.69 |
6.2× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,097.98 |
$1,829.97 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,510.38 |
$9,183.97 |
3.8× |
| Brain Imaging Vascular Flow Only (78610) |
$907.45 |
$1,512.41 |
1.7× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$57.55 |
$95.92 |
5.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,233 |
$2,055 |
3.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,082.29 |
$5,137.15 |
8.8× |
| Cardiac shunt detection (78428) |
$1,351.68 |
$2,252.80 |
3.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$907.45 |
$1,512.41 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$350.37 |
$583.95 |
4.0× |
| Chest 1 view (71045) |
$302.85 |
$504.75 |
3.5× |
| Chest 3 views (71047) |
$270.06 |
$450.10 |
3.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$437.26 |
$728.76 |
2.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,718.20 |
$2,863.67 |
2.2× |
| Clavicle complete (73000) |
$264.90 |
$441.50 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$222.53 |
$370.88 |
2.1× |
| Continuing medical physics consltj pr wk (77336) |
$627.64 |
$1,046.06 |
4.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$256.03 |
$426.72 |
1.5× |
| Corpora cavernosography (74445) |
$565.20 |
$942 |
5.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,508.22 |
$5,847.04 |
10.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,627.09 |
$4,378.48 |
11.0× |
| CT abdomen w contrast (74160) |
$1,994.07 |
$3,323.45 |
11.3× |
| CT abdomen w wo contrast (74170) |
$2,520 |
$4,200 |
14.3× |
| CT abdomen w/o contrast (74150) |
$1,546.55 |
$2,577.59 |
14.7× |
| CT angio hrt w/3d image (75574) |
$1,975.84 |
$3,293.07 |
5.6× |
| CT angiography upper extremity lt (73206) |
$2,647.52 |
$4,412.53 |
15.0× |
| CT c-spine w/o contrast (72125) |
$1,907.73 |
$3,179.55 |
18.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,520 |
$4,200 |
14.3× |
| CT cervical spine with contrast (72126) |
$2,205 |
$3,675 |
6.3× |
| CT chest w/wo contrast (71270) |
$2,191.03 |
$3,651.71 |
12.4× |
| CT chest with contrast (71260) |
$2,006.48 |
$3,344.13 |
11.4× |
| CT colonography screening (74263) |
$2,148.93 |
$3,581.55 |
9.0× |
| CT colonography w/dye (74262) |
$1,009.98 |
$1,683.30 |
5.7× |
| CT colonography w/o cntrst (74261) |
$647.39 |
$1,078.99 |
6.2× |
| CT head/brain with contrast (70460) |
$1,504.67 |
$2,507.79 |
8.5× |
| CT head/brain without and with contrast (70470) |
$1,782.60 |
$2,971 |
10.1× |
| 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) |
$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) |
$1,429.47 |
$2,382.45 |
8.1× |
| CT limited/localized follow up study (76380) |
$756 |
$1,260 |
8.6× |
| CT lower ext w/o (73700) |
$1,295.20 |
$2,158.67 |
12.3× |
| CT lower extremity w wo contrast (73702) |
$1,748 |
$2,913.33 |
9.9× |
| CT lower extremity with contrast (73701) |
$1,738.45 |
$2,897.41 |
9.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,553.11 |
$2,588.51 |
8.8× |
| CT lumbar spine w/o contrast (72131) |
$1,603.16 |
$2,671.94 |
15.3× |
| CT lumbar spine with contrast (72132) |
$1,890 |
$3,150 |
5.4× |
| CT maxillofacial w contrast (70487) |
$1,787.26 |
$2,978.76 |
10.1× |
| CT maxillofacial w/o contrast (70486) |
$1,518.96 |
$2,531.60 |
14.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,766.90 |
$2,944.83 |
10.0× |
| CT neck soft tissue w contrast (70491) |
$1,896.04 |
$3,160.06 |
10.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,447.65 |
$2,412.75 |
8.2× |
| CT orbits w/o contrast (70480) |
$1,358.20 |
$2,263.67 |
12.9× |
| CT pelvis w & w/o contrast (72194) |
$1,750.33 |
$2,917.22 |
9.9× |
| CT pelvis w/o contrast (72192) |
$1,348.46 |
$2,247.43 |
12.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$360.85 |
$601.41 |
4.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,139.83 |
$3,566.39 |
12.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,358.20 |
$2,263.67 |
12.9× |
| CT thoracic spine w/contrast (72129) |
$1,890 |
$3,150 |
10.7× |
| CT thoracic spine w/o contrast (72128) |
$1,637.21 |
$2,728.69 |
15.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,205 |
$3,675 |
12.5× |
| CT thorax w/o contrast (71250) |
$1,364.37 |
$2,273.95 |
13.0× |
| CT unlisted procedure (76497) |
$491.88 |
$819.80 |
5.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,563.15 |
$2,605.25 |
8.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,304.21 |
$2,173.68 |
12.4× |
| CT upper extremity with contrast (73201) |
$1,689.31 |
$2,815.52 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,245.33 |
$3,742.22 |
12.7× |
| Cta Abdomen (74175) |
$2,615.26 |
$4,358.77 |
14.8× |
| CTA abdomen pelvis (74174) |
$3,780 |
$6,300 |
10.8× |
| CTA chest (71275) |
$2,606.66 |
$4,344.44 |
14.8× |
| Cta Head (70496) |
$2,205 |
$3,675 |
12.5× |
| CTA lwr ext w&w/o contrast (73706) |
$2,835 |
$4,725 |
16.1× |
| Cta Neck (70498) |
$2,205 |
$3,675 |
12.5× |
| Cta Pelvis (72191) |
$2,985.67 |
$4,976.12 |
16.9× |
| Cystography minimum 3 views rs&i (74430) |
$674.86 |
$1,124.76 |
1.9× |
| Dacryocystography (70170) |
$864.68 |
$1,441.13 |
3.6× |
| Diskogram cervical (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) |
$304.60 |
$507.67 |
2.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$398.03 |
$663.38 |
3.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$274.76 |
$457.94 |
2.6× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$380.47 |
$634.11 |
3.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$369.04 |
$615.06 |
3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$344.92 |
$574.86 |
3.9× |
| Dxa bone density study axial skeleton (77085) |
$293.20 |
$488.66 |
2.8× |
| Echo exam of fetal heart (76825) |
$873.61 |
$1,456.01 |
1.6× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$527.29 |
$878.82 |
2.2× |
| Echoencephalography real time imaging (76506) |
$422.78 |
$704.63 |
4.0× |
| Esophageal motility (78258) |
$1,266.22 |
$2,110.37 |
3.2× |
| Esophagus (74220) |
$464.21 |
$773.68 |
2.6× |
| Fetal biophysical profile non-stress testing (76818) |
$504.08 |
$840.14 |
4.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$396.92 |
$661.54 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$457.89 |
$763.15 |
1.9× |
| Foot 2 views (73620) |
$313.58 |
$522.63 |
3.6× |
| Forearm 2 views (73090) |
$347.69 |
$579.48 |
4.0× |
| Functional MRI brain by phys/psych (70555) |
$1,560.51 |
$2,600.85 |
6.5× |
| Functional MRI brain by tech (70554) |
$1,886.68 |
$3,144.47 |
7.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,770.81 |
$2,951.35 |
3.2× |
| Gated Heart Planar Single (78472) |
$1,467.57 |
$2,445.95 |
3.7× |
| Hand 2 views (73120) |
$330.19 |
$550.31 |
3.1× |
| Hand 3 views (73130) |
$361.60 |
$602.66 |
4.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,491.18 |
$5,818.64 |
5.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,578.31 |
$5,963.85 |
5.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,579.44 |
$7,632.40 |
6.5× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$609.85 |
$1,016.42 |
1.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$397.29 |
$662.15 |
1.0× |
| Heart Infarct Image (78466) |
$840.74 |
$1,401.23 |
2.1× |
| Heart infarct image w ef (78468) |
$442.89 |
$738.15 |
0.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,372.97 |
$5,621.62 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,823.09 |
$3,038.49 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,624.99 |
$2,708.31 |
4.0× |
| Ht muscle image spect sing (78451) |
$2,874.74 |
$4,791.23 |
2.2× |
| Humerus Min 2 Views Left (73060) |
$327.49 |
$545.82 |
3.7× |
| Hysterosalpingogram (74740) |
$841.22 |
$1,402.04 |
3.5× |
| Image fusion (77399) |
$376.03 |
$626.72 |
2.8× |
| Interstitial radiation source applic complex (77778) |
$3,449.60 |
$5,749.34 |
4.9× |
| 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 - Xr Joint Anteroposterior 2+ Joints (77077) |
$181.62 |
$302.70 |
1.7× |
| Kidney funcj study non-img radioisotopic study (78725) |
$746.54 |
$1,244.23 |
1.9× |
| Kidney imaging morphology (78700) |
$923.43 |
$1,539.05 |
2.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,356.57 |
$2,260.95 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,573.06 |
$2,621.77 |
2.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,293.28 |
$2,155.46 |
2.4× |
| Knee 3 views (73562) |
$322.06 |
$536.77 |
3.7× |
| Liver & spleen imaging static only (78215) |
$1,080.29 |
$1,800.49 |
2.7× |
| 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) |
$1,569.02 |
$2,615.03 |
2.9× |
| Lung perf&ventilat diferentl (78598) |
$1,319.52 |
$2,199.20 |
2.4× |
| Lung perfusion differential (78597) |
$1,010.82 |
$1,684.70 |
2.5× |
| Lung Ventilation Imaging (78579) |
$801.37 |
$1,335.62 |
2.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,647.60 |
$4,412.67 |
0.8× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$972.06 |
$1,620.10 |
1.5× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,288.81 |
$2,148.02 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,494.49 |
$4,157.49 |
0.8× |
| Lymphoscintigraphy (78195) |
$1,530.86 |
$2,551.43 |
2.8× |
| Mammary ductogram or galactogram multiple (77054) |
$437 |
$728.33 |
1.8× |
| Mammary ductogram or galactogram single (77053) |
$346.42 |
$577.36 |
1.4× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$196.81 |
$328.02 |
2.3× |
| Meckels Diverticulum (78290) |
$1,009.15 |
$1,681.92 |
2.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$674.72 |
$1,124.54 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,834.52 |
$3,057.54 |
4.9× |
| Mr elastography (76391) |
$641.23 |
$1,068.72 |
2.7× |
| MRA head w & w/o contrast (70546) |
$2,646 |
$4,410 |
7.6× |
| MRA head w/o contrast (70544) |
$2,100.08 |
$3,500.13 |
8.8× |
| MRA head with contrast (70545) |
$1,852.76 |
$3,087.93 |
5.3× |
| MRA neck w contrast (70548) |
$3,074.64 |
$5,124.40 |
8.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,150.37 |
$5,250.62 |
9.0× |
| MRA neck w/o contrast (70547) |
$2,124.96 |
$3,541.60 |
8.9× |
| MRI abdomen w contrast (74182) |
$1,891.37 |
$3,152.29 |
5.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,835 |
$4,725 |
8.1× |
| MRI abdomen w/o contrast (74181) |
$1,896.63 |
$3,161.05 |
7.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,038.04 |
$3,396.74 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,956.58 |
$4,927.63 |
3.8× |
| MRI bone marrow blood supply (77084) |
$1,592.64 |
$2,654.40 |
6.6× |
| MRI breast w/o contrast bilateral (77047) |
$2,262.65 |
$3,771.09 |
9.4× |
| MRI breast w/o contrast unilat (77046) |
$326.21 |
$543.68 |
1.4× |
| MRI c-spine with contrast (72142) |
$2,131.05 |
$3,551.75 |
6.1× |
| MRI cardiac w/o cont stress (75559) |
$1,680.47 |
$2,800.79 |
3.1× |
| MRI cardiac w/o contrast (75557) |
$2,474.36 |
$4,123.93 |
10.3× |
| MRI cervical spine w/o contrast (72141) |
$2,146.54 |
$3,577.56 |
9.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,405.01 |
$4,008.35 |
6.9× |
| MRI chest w/o contrast (71550) |
$1,616.66 |
$2,694.44 |
6.7× |
| MRI chest with contrast (71551) |
$2,325.74 |
$3,876.24 |
3.0× |
| MRI fetal sngl/1st gestation (74712) |
$1,226.53 |
$2,044.21 |
5.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,011.63 |
$3,352.71 |
5.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,000 |
$5,000 |
8.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,933.52 |
$3,222.53 |
8.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,173.46 |
$3,622.44 |
9.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,097.59 |
$5,162.65 |
8.8× |
| MRI orbit/face/neck w/contrast (70542) |
$2,085.08 |
$3,475.13 |
5.9× |
| MRI pelvis w contrast (72196) |
$1,841.67 |
$3,069.45 |
5.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,132.19 |
$5,220.31 |
8.9× |
| MRI pelvis w/o contrast (72195) |
$2,274.19 |
$3,790.32 |
9.5× |
| MRI scan of arm joint before and after contrast (73223) |
$2,618.07 |
$4,363.45 |
7.5× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$3,780 |
$6,300 |
4.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,785.42 |
$4,642.37 |
7.9× |
| MRI spectroscopy (76390) |
$1,335.60 |
$2,226 |
15.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,391.76 |
$5,652.93 |
9.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,265.55 |
$3,775.92 |
6.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,963.87 |
$4,939.78 |
8.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,888.75 |
$3,147.92 |
5.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,570.01 |
$5,950.01 |
10.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,984.41 |
$3,307.35 |
8.3× |
| MRI tmj (70336) |
$2,374.65 |
$3,957.75 |
9.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,140.45 |
$3,567.41 |
8.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,636.74 |
$6,061.23 |
10.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,420.74 |
$4,034.57 |
10.1× |
| Myelogram Cervical (72240) |
$1,088.80 |
$1,814.66 |
1.4× |
| Myelogram Lumbar (72265) |
$1,334.09 |
$2,223.48 |
1.7× |
| Myelogram thoracic (72255) |
$1,370.02 |
$2,283.37 |
1.7× |
| Myelography 2 or more regions (72270) |
$1,569.51 |
$2,615.85 |
2.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,610.42 |
$7,684.03 |
3.5× |
| Myocardial infarct spect (78469) |
$1,061.26 |
$1,768.77 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,016.39 |
$6,693.99 |
3.1× |
| 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 Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,426.80 |
$5,711.33 |
4.0× |
| Neck soft tissue (70360) |
$258.94 |
$431.56 |
3.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$693 |
$1,155 |
1.7× |
| Nm adrenal scan (78075) |
$4,524.05 |
$7,540.09 |
3.5× |
| Nm bone marrow multiple (78103) |
$762.31 |
$1,270.51 |
1.9× |
| Nm bone marrow wb (78104) |
$973.73 |
$1,622.89 |
2.4× |
| Nm cisternogram (78630) |
$1,170.64 |
$1,951.06 |
2.1× |
| Nm csf leak detection (78650) |
$1,391.99 |
$2,319.99 |
1.1× |
| Nm gastric emptying study (78264) |
$1,591.77 |
$2,652.95 |
4.0× |
| Nm gastroesophageal reflux study (78262) |
$1,120.86 |
$1,868.10 |
2.8× |
| Nm peritoneal-venous shunt patency (78291) |
$661.40 |
$1,102.34 |
1.6× |
| Nm red cell sequestration (78140) |
$407.63 |
$679.39 |
1.0× |
| Nm whole blood volume (78122) |
$1,725.05 |
$2,875.08 |
3.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,552.05 |
$9,253.41 |
4.0× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$4,225.34 |
$7,042.23 |
2.9× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,334.46 |
$3,890.76 |
1.8× |
| Nuclear medicine of heart pumping function (78473) |
$1,405.04 |
$2,341.73 |
3.5× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$1,351.68 |
$2,252.80 |
2.5× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$4,658.45 |
$7,764.09 |
3.2× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$3,627.73 |
$6,046.21 |
2.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,451.18 |
$4,085.30 |
1.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$972.03 |
$1,620.05 |
2.4× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$1,366.16 |
$2,276.94 |
3.4× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,391.99 |
$2,319.99 |
3.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,136.87 |
$1,894.79 |
2.8× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$1,244.58 |
$2,074.30 |
2.3× |
| Nuclear Rx Oral Admin (79005) |
$1,114.72 |
$1,857.86 |
4.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$329.29 |
$548.81 |
3.1× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$544.58 |
$907.63 |
4.1× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$266.95 |
$444.92 |
2.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$355.75 |
$592.92 |
3.4× |
| Orthopantogram (70355) |
$202.98 |
$338.30 |
2.3× |
| Osseous survey infant (77076) |
$365.45 |
$609.08 |
3.5× |
| Osseous survey limited (77074) |
$443.14 |
$738.57 |
4.2× |
| Parathyrd planar w/spect&CT (78072) |
$2,087.09 |
$3,478.48 |
3.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,220.32 |
$2,033.86 |
3.0× |
| Parathyroid imaging (78070) |
$1,329.01 |
$2,215.02 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$295.57 |
$492.62 |
2.8× |
| Perineogram (74775) |
$603.14 |
$1,005.24 |
2.5× |
| Peritoneogram rs&i (74190) |
$510.85 |
$851.42 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$5,355 |
$8,925 |
3.7× |
| PET imaging CT for attenuation limited area (78814) |
$4,548.97 |
$7,581.61 |
3.2× |
| PET imaging for CT attenuation whole body (78816) |
$5,512.50 |
$9,187.50 |
3.8× |
| PET imaging limited area chest head/neck (78811) |
$3,677.40 |
$6,129 |
2.8× |
| 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× |
| Pr gi endoscopic ultrasound (76975) |
$582.31 |
$970.51 |
2.4× |
| Pr heart first pass single,planar (78481) |
$1,184.98 |
$1,974.96 |
2.2× |
| Pr MRI brain w/ dye (70558) |
$2,124.60 |
$3,541 |
12.1× |
| Pr MRI brain w/o dye (70557) |
$2,459.08 |
$4,098.47 |
4.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,857.68 |
$4,762.80 |
8.2× |
| Pr non-imaging heart function (78414) |
$1,222.94 |
$2,038.24 |
2.2× |
| Pr red cell survival study (78130) |
$815.35 |
$1,358.91 |
2.0× |
| Proton tx delivery intermediate (77523) |
$1,588.99 |
$2,648.32 |
1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,219.18 |
$3,698.64 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,846.73 |
$3,077.89 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,002.55 |
$1,670.92 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,850.17 |
$3,083.62 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$557.35 |
$928.91 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$150.11 |
$250.18 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$224.39 |
$373.99 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$354.61 |
$591.02 |
3.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$245.27 |
$408.78 |
2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$547.42 |
$912.36 |
5.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,323.27 |
$25,538.79 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$923.33 |
$1,538.89 |
1.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$438.35 |
$730.59 |
4.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$729.97 |
$1,216.62 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$334.82 |
$558.04 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$334.03 |
$556.71 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$306.98 |
$511.63 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$316.03 |
$526.72 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$618.16 |
$1,030.27 |
3.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$579.80 |
$966.33 |
3.3× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$385.39 |
$642.31 |
1.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$652.24 |
$1,087.07 |
3.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$714.77 |
$1,191.29 |
4.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$279.70 |
$466.16 |
3.2× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$184.20 |
$307 |
2.1× |
| Radiological examination surgical specimen (76098) |
$591.32 |
$985.53 |
1.1× |
| Radiopharm Dacryocystography (78660) |
$555.89 |
$926.49 |
1.4× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (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× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,418.29 |
$4,030.49 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,119.40 |
$5,199 |
1.0× |
| Ribs bilateral 3 views (71110) |
$412.76 |
$687.93 |
3.9× |
| 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 single day imaging (78802) |
$2,014.64 |
$3,357.73 |
3.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,205 |
$3,675 |
4.0× |
| 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) |
$2,771.08 |
$4,618.47 |
1.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,095.46 |
$3,492.43 |
1.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,073.40 |
$1,789 |
4.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$957.94 |
$1,596.56 |
4.1× |
| Rp Therapy Intravenous Administration (79101) |
$911.97 |
$1,519.95 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$227.93 |
$379.88 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$542.23 |
$903.71 |
2.3× |
| Salivary gland function study (78232) |
$1,123.67 |
$1,872.78 |
2.8× |
| Salivary gland imaging serial images (78231) |
$922.95 |
$1,538.25 |
2.3× |
| Scanogram (77073) |
$334.23 |
$557.05 |
3.2× |
| Scapula complete (73010) |
$256.03 |
$426.72 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$108.77 |
$181.28 |
4.7× |
| Sella turcica (70240) |
$200.74 |
$334.56 |
2.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$375.67 |
$626.12 |
3.6× |
| Sialogram (70390) |
$789.85 |
$1,316.42 |
3.3× |
| Simulation intermediate (77285) |
$960.78 |
$1,601.30 |
2.6× |
| Small bowel series (74250) |
$482.12 |
$803.54 |
2.7× |
| Spec medical radj physics consltj (77370) |
$740.34 |
$1,233.90 |
5.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,246.55 |
$2,077.58 |
3.3× |
| Special dosimetry (77331) |
$428.89 |
$714.82 |
3.2× |
| Special treatment procedure (77470) |
$1,832.30 |
$3,053.84 |
3.3× |
| Speech evaluation complex (70371) |
$409.97 |
$683.28 |
1.7× |
| Spine thoracic 3 views (72072) |
$416.90 |
$694.83 |
4.0× |
| Spleen imaging only (78185) |
$961.98 |
$1,603.30 |
2.4× |
| Splenoportograpy rs&i (75810) |
$1,880.40 |
$3,134 |
0.6× |
| Stereotactic body radiation delivery (77373) |
$7,726.73 |
$12,877.89 |
4.3× |
| 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 Technical Calculation Only (77091) |
$99.13 |
$165.22 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,093.52 |
$1,822.53 |
2.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$807.53 |
$1,345.89 |
2.1× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$813.60 |
$1,356 |
3.4× |
| Testicular Imaging With Vascular Flow (78761) |
$842.56 |
$1,404.27 |
2.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,890.05 |
$3,150.08 |
5.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$788.08 |
$1,313.46 |
5.8× |
| Therapeutic Enema (74283) |
$588.46 |
$980.77 |
3.3× |
| Thoracolumbar 2 views (72080) |
$283.39 |
$472.31 |
3.2× |
| Thyroid carcinoma metastases img addl study (78016) |
$731.35 |
$1,218.92 |
1.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,412.03 |
$2,353.38 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$577.80 |
$963 |
1.4× |
| Thyroid uptake measurement (78012) |
$487.55 |
$812.58 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,350.97 |
$2,251.61 |
3.4× |
| Tmj unilateral (70328) |
$232.70 |
$387.84 |
2.7× |
| Tomogram (76100) |
$370.64 |
$617.73 |
3.5× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$99.13 |
$165.22 |
1.1× |
| Treatment device intermediate (77333) |
$766.72 |
$1,277.86 |
5.7× |
| Treatment devices simple (77332) |
$634.32 |
$1,057.20 |
4.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,327.49 |
$5,545.81 |
6.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,147.41 |
$1,912.35 |
2.9× |
| Tx devices design & construction complex (77334) |
$1,117.81 |
$1,863.02 |
3.0× |
| Ultrasound elastography first target lesion (76982) |
$352.21 |
$587.01 |
3.4× |
| Ultrasound scan of cornea to determine thickness (76514) |
$111.56 |
$185.94 |
3.8× |
| Ultrasound scan to determine eye length and lens power (76519) |
$418.51 |
$697.52 |
4.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$237.74 |
$396.24 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$621.97 |
$1,036.61 |
5.9× |
| Umbilical-artery Doppler (OB) (76820) |
$302.24 |
$503.74 |
2.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$2,978.55 |
$4,964.25 |
34.1× |
| Unlisted fluoroscopic procedure (76496) |
$2,782.16 |
$4,636.94 |
31.8× |
| Unlisted magnetic resonance procedure (76498) |
$1,728 |
$2,880 |
19.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,540.47 |
$2,567.45 |
15.0× |
| Unlisted procedure, therapeutic radiology clinical treatment planning 2nd-5th Sessions (77299) |
$398.11 |
$663.52 |
2.9× |
| Unlisted Ultrasound Procedure (76999) |
$1,430.98 |
$2,384.96 |
16.4× |
| Upper Extremity Infant (73092) |
$230.04 |
$383.40 |
2.2× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$401.25 |
$668.75 |
4.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,298.73 |
$2,164.55 |
3.2× |
| Urethrocystography retrograde rs&i (74450) |
$639.39 |
$1,065.65 |
2.7× |
| Urethrocystography voiding (74455) |
$654.59 |
$1,090.99 |
2.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$762.13 |
$1,270.22 |
4.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$673.90 |
$1,123.16 |
3.8× |
| Us abdl aorta screen aaa (76706) |
$398.34 |
$663.90 |
3.8× |
| Us breast unilateral complete (76641) |
$409.50 |
$682.50 |
3.9× |
| Us breast unilateral limited (76642) |
$320.45 |
$534.09 |
3.7× |
| Us chest (76604) |
$411.22 |
$685.37 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$504.28 |
$840.46 |
4.8× |
| Us elastography parenchyma (76981) |
$369.82 |
$616.36 |
3.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$287.99 |
$479.98 |
2.7× |
| Us guided compression repair (76936) |
$512.15 |
$853.59 |
2.4× |
| Us infant hips dynamic (76885) |
$439.69 |
$732.82 |
5.0× |
| Us infant hips limited static (76886) |
$382.33 |
$637.22 |
4.4× |
| Us kidney transplant (76776) |
$573.04 |
$955.06 |
5.5× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$376.57 |
$627.62 |
3.6× |
| Us ob detailed single fetus (76811) |
$630.28 |
$1,050.47 |
2.6× |
| Us ob transvaginal (76817) |
$369.77 |
$616.28 |
3.5× |
| Us pelvic non ob complete (76856) |
$599.88 |
$999.80 |
5.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$447.46 |
$745.77 |
4.3× |
| Us pregnancy ltd (76815) |
$341.46 |
$569.10 |
3.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$568.75 |
$947.91 |
5.4× |
| Us retroperitoneal complete (76770) |
$623.48 |
$1,039.13 |
5.9× |
| Us retroperitoneal limited (76775) |
$497.80 |
$829.66 |
4.7× |
| Us scrotum and contents (76870) |
$634.57 |
$1,057.61 |
6.0× |
| Us soft tissue head/neck (76536) |
$583.84 |
$973.07 |
5.6× |
| Us spinal canal and contents (76800) |
$490.73 |
$817.88 |
4.7× |
| Us transrectal (76872) |
$409.15 |
$681.91 |
3.9× |
| Us transrectal prostate volume (76873) |
$572.08 |
$953.47 |
5.4× |
| Us xtr non-vasc lmtd (76882) |
$375.63 |
$626.05 |
3.6× |
| Us, eye b-scan (76512) |
$410.30 |
$683.83 |
3.9× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$1,880.11 |
$3,133.52 |
3.4× |
| Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) |
$659.02 |
$1,098.36 |
1.2× |
| Vascular flow imaging (78445) |
$608.56 |
$1,014.27 |
1.5× |
| Vasogram (74440) |
$817.69 |
$1,362.82 |
3.4× |
| Venogram extremity bilateral (75822) |
$1,876.79 |
$3,127.99 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$3,212.80 |
$5,354.67 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,889.23 |
$3,148.71 |
1.2× |
| Venography epidural rs&i (75872) |
$1,980.52 |
$3,300.86 |
3.1× |
| Venography extremity unilateral rs&i (75820) |
$1,280.17 |
$2,133.61 |
0.8× |
| Venography Renal Bilateral (75833) |
$6,704.41 |
$11,174.01 |
2.1× |
| Venography renal unilateral selective rs&i (75831) |
$2,978.55 |
$4,964.25 |
0.9× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,900.61 |
$3,167.69 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,410 |
$7,350 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$136.07 |
$226.79 |
1.6× |
| Wrist 2 views (73100) |
$248.60 |
$414.34 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$387.62 |
$646.04 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$271.58 |
$452.63 |
3.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$301.47 |
$502.45 |
3.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$715.78 |
$1,192.96 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$281.26 |
$468.76 |
3.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$383.96 |
$639.94 |
4.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$546.04 |
$910.07 |
5.2× |
| X-ray exam hip uni 1 view (73501) |
$110.03 |
$183.38 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$279.56 |
$465.93 |
3.2× |
| X-ray exam hip uni 4/> views (73503) |
$412.40 |
$687.33 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$638.09 |
$1,063.48 |
6.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$436 |
$726.67 |
4.2× |
| X-ray exam of femur 1 (73551) |
$208.24 |
$347.07 |
2.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$436.24 |
$727.06 |
2.5× |
| X-ray eye for foreign body (70030) |
$183.98 |
$306.63 |
2.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$363.20 |
$605.34 |
3.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$223.84 |
$373.07 |
2.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$355.50 |
$592.50 |
4.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$3,458.62 |
$5,764.36 |
1.6× |
| X-ray head for orthodontia (70350) |
$198.33 |
$330.55 |
2.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$250.10 |
$416.83 |
2.9× |
| X-ray IV pyelogram+drip infusn (74410) |
$709.58 |
$1,182.64 |
4.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$241.79 |
$402.98 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$463.18 |
$771.96 |
4.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$267.91 |
$446.51 |
3.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$230.68 |
$384.46 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$355.61 |
$592.69 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$557.39 |
$928.98 |
5.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$433.57 |
$722.62 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$253.72 |
$422.86 |
2.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$197.11 |
$328.52 |
2.3× |
| X-ray of voice box or throat (70370) |
$407.07 |
$678.45 |
4.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$323.29 |
$538.81 |
3.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$322.39 |
$537.32 |
3.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$706.71 |
$1,177.85 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$786.45 |
$1,310.75 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$335.98 |
$559.97 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$365.45 |
$609.09 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$485.44 |
$809.06 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$417.03 |
$695.05 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$257.93 |
$429.89 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$318.86 |
$531.44 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$390.25 |
$650.42 |
4.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$174.80 |
$291.34 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$408.24 |
$680.40 |
3.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$286.69 |
$477.82 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$252.77 |
$421.28 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$202.30 |
$337.16 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$244.81 |
$408.01 |
2.8× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$128.14 |
$213.57 |
1.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$373.36 |
$622.27 |
3.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$342 |
$570 |
3.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$251.71 |
$419.51 |
2.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$332.42 |
$554.04 |
3.8× |
| Xr arthrogram ankle (73615) |
$923.65 |
$1,539.42 |
2.6× |
| Xr c-spine 6 or more views (72052) |
$499 |
$831.66 |
4.8× |
| Xr chest 4+ views (71048) |
$349.13 |
$581.88 |
3.3× |
| Xr Cholecystography Oral Contrast (74290) |
$260.14 |
$433.56 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$244.52 |
$407.54 |
2.8× |
| Xr internal auditory meati complete (70134) |
$322.45 |
$537.42 |
0.6× |
| 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 optic foramina (70190) |
$200.74 |
$334.56 |
2.3× |
| Xr shoulder 1 view (73020) |
$369.70 |
$616.16 |
4.2× |
| Xr spine cervical 4 or 5 views (72050) |
$462.47 |
$770.79 |
4.4× |
| Xr tibia/fibula 2 views (73590) |
$358.69 |
$597.81 |
4.1× |
| Xr tmj bilateral (70330) |
$248.86 |
$414.76 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$256.78 |
$427.96 |
2.9× |