| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,149.58 |
$4,845.50 |
2.2× |
| Abdomen 2 views (74019) |
$133.02 |
$204.65 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$858.10 |
$1,320.15 |
2.1× |
| Acute venous thrombus image (78456) |
$723.65 |
$1,113.30 |
0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,548.62 |
$2,382.50 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$5,592.42 |
$8,603.72 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$3,036.77 |
$4,671.95 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$2,800.24 |
$4,308.05 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,207.71 |
$6,473.40 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,433 |
$6,820 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,433 |
$6,820 |
1.4× |
| Angiography Spinal Selective Rs&I (75705) |
$4,034.68 |
$6,207.20 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,207.38 |
$6,472.90 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,108.18 |
$1,704.90 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,216.50 |
$3,410 |
0.7× |
| Ankle 2 views (73600) |
$165.75 |
$255 |
1.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$272.97 |
$419.95 |
0.8× |
| Aortogram thoracic (75605) |
$3,990.64 |
$6,139.45 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,095 |
$6,300 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$2,661.44 |
$4,094.52 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,382.46 |
$2,126.85 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$988.30 |
$1,520.45 |
0.3× |
| Arthrogram elbow (73085) |
$383.21 |
$589.55 |
1.1× |
| Arthrogram hip (73525) |
$779.76 |
$1,199.62 |
2.2× |
| Arthrogram shoulder (73040) |
$679.82 |
$1,045.87 |
1.9× |
| Arthrogram wrist (73115) |
$612.35 |
$942.08 |
1.7× |
| Arthrography knee lt (73580) |
$820.56 |
$1,262.40 |
2.3× |
| Basic radiation dosimetry calculation (77300) |
$305.50 |
$470 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$653.02 |
$1,004.65 |
1.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$431.34 |
$663.60 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$622.22 |
$957.25 |
1.5× |
| Bone age studies (77072) |
$123.40 |
$189.85 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$725.82 |
$1,116.65 |
1.7× |
| Bone Marrow Imaging Limited Area (78102) |
$322.14 |
$495.60 |
0.8× |
| Bone survey complete (77075) |
$223.57 |
$343.95 |
2.1× |
| Brachytx isodose complex (77318) |
$732.46 |
$1,126.85 |
1.9× |
| Brachytx isodose intermed (77317) |
$647.14 |
$995.60 |
1.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$601.74 |
$925.75 |
1.5× |
| Brain image w/flow 4 + views (78606) |
$665.60 |
$1,024 |
1.2× |
| Brain imaging < 4 static views (78600) |
$351.91 |
$541.40 |
0.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$715.46 |
$1,100.70 |
1.7× |
| Brain Imaging Minimum 4 Static Views (78605) |
$610.06 |
$938.55 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,214.88 |
$3,407.50 |
1.5× |
| Brain Imaging Vascular Flow Only (78610) |
$599.40 |
$922.15 |
1.1× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$31.70 |
$48.78 |
2.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$415.87 |
$639.80 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,298.48 |
$1,997.65 |
3.6× |
| Cardiac shunt detection (78428) |
$411.58 |
$633.20 |
1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$974 |
$1,498.45 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$143 |
$220 |
1.6× |
| Chest 1 view (71045) |
$149.50 |
$230 |
1.7× |
| Chest 3 views (71047) |
$145.92 |
$224.50 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$200.98 |
$309.20 |
1.1× |
| Cineradiography/videoradiography (76120) |
$127.34 |
$195.90 |
1.2× |
| Cisternography Positive Contrast Rs&I (70015) |
$273.72 |
$421.10 |
0.3× |
| Clavicle complete (73000) |
$153.47 |
$236.10 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$123.30 |
$189.70 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$211.22 |
$324.96 |
1.5× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$192.01 |
$295.40 |
1.1× |
| Corpora cavernosography (74445) |
$247.82 |
$381.25 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$965.94 |
$1,486.05 |
2.7× |
| CT abdomen and pelvis without contrast (74176) |
$563.16 |
$866.40 |
2.3× |
| CT abdomen w contrast (74160) |
$710.97 |
$1,093.80 |
3.9× |
| CT abdomen w wo contrast (74170) |
$877.11 |
$1,349.40 |
4.8× |
| CT abdomen w/o contrast (74150) |
$575.48 |
$885.35 |
5.3× |
| CT angio hrt w/3d image (75574) |
$838.02 |
$1,289.25 |
2.3× |
| CT angiography upper extremity lt (73206) |
$1,122.28 |
$1,726.58 |
6.2× |
| CT c-spine w/o contrast (72125) |
$587.76 |
$904.25 |
5.4× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$183.30 |
$282 |
1.0× |
| CT cervical spine w&w/o contrast (72127) |
$777.66 |
$1,196.40 |
4.3× |
| CT cervical spine with contrast (72126) |
$738.86 |
$1,136.70 |
2.0× |
| CT chest w/wo contrast (71270) |
$805.45 |
$1,239.15 |
4.4× |
| CT chest with contrast (71260) |
$731.25 |
$1,125 |
4.0× |
| CT colonography screening (74263) |
$1,490.12 |
$2,292.50 |
6.0× |
| CT colonography w/dye (74262) |
$1,295 |
$1,992.30 |
7.1× |
| CT colonography w/o cntrst (74261) |
$1,199.22 |
$1,844.95 |
11.0× |
| CT head/brain with contrast (70460) |
$628.39 |
$966.75 |
3.5× |
| CT head/brain without and with contrast (70470) |
$730.73 |
$1,124.20 |
4.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$683.18 |
$1,051.05 |
1.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$257.08 |
$395.50 |
2.8× |
| CT hrt w/3d image congen (75573) |
$799.47 |
$1,229.95 |
2.2× |
| CT iac w contrast (70481) |
$752.96 |
$1,158.40 |
4.1× |
| CT limited/localized follow up study (76380) |
$521.24 |
$801.90 |
5.8× |
| CT lower ext w/o (73700) |
$873.46 |
$1,343.78 |
8.0× |
| CT lower extremity w wo contrast (73702) |
$1,195.69 |
$1,839.52 |
6.6× |
| CT lower extremity with contrast (73701) |
$1,017.86 |
$1,565.92 |
5.6× |
| CT lumbar spine w & w/o contrast (72133) |
$817.28 |
$1,257.35 |
4.5× |
| CT lumbar spine w/o contrast (72131) |
$586.40 |
$902.15 |
5.4× |
| CT lumbar spine with contrast (72132) |
$738.18 |
$1,135.65 |
2.0× |
| CT maxillofacial w contrast (70487) |
$695.96 |
$1,070.70 |
3.8× |
| CT maxillofacial w/o contrast (70486) |
$193.15 |
$297.15 |
1.8× |
| CT maxillofacial w/wo contrast (70488) |
$785.24 |
$1,208.05 |
4.3× |
| CT neck soft tissue w contrast (70491) |
$731.25 |
$1,125 |
4.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$852.54 |
$1,311.60 |
4.7× |
| CT orbits w/o contrast (70480) |
$658.42 |
$1,012.95 |
6.1× |
| CT pelvis w & w/o contrast (72194) |
$768.56 |
$1,182.40 |
4.2× |
| CT pelvis w/o contrast (72192) |
$570.70 |
$878 |
5.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$382.50 |
$588.45 |
4.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$807.17 |
$1,241.80 |
4.4× |
| CT soft tissue neck w/o contrast (70490) |
$592.22 |
$911.10 |
5.5× |
| CT thoracic spine w/contrast (72129) |
$681.98 |
$1,049.20 |
3.7× |
| CT thoracic spine w/o contrast (72128) |
$587.44 |
$903.75 |
5.4× |
| CT thoracic spine w/wo contrast (72130) |
$775.29 |
$1,192.75 |
4.3× |
| CT thorax w/o contrast (71250) |
$650 |
$1,000 |
6.0× |
| CT unlisted procedure (76497) |
$1,218.75 |
$1,875 |
13.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,186.96 |
$1,826.10 |
6.5× |
| CT upper extremity w/o contrast rt (73200) |
$872.96 |
$1,343.02 |
8.0× |
| CT upper extremity with contrast (73201) |
$1,014.24 |
$1,560.38 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,021.41 |
$1,571.40 |
5.6× |
| Cta Abdomen (74175) |
$842.86 |
$1,296.70 |
4.6× |
| CTA abdomen pelvis (74174) |
$970.10 |
$1,492.45 |
2.7× |
| CTA chest (71275) |
$936.39 |
$1,440.60 |
5.1× |
| Cta Head (70496) |
$982.12 |
$1,510.95 |
5.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$382.20 |
$588 |
1.1× |
| CTA lwr ext w&w/o contrast (73706) |
$1,242.34 |
$1,911.30 |
6.8× |
| Cta Neck (70498) |
$986.90 |
$1,518.30 |
5.4× |
| Cta Pelvis (72191) |
$804.38 |
$1,237.50 |
4.4× |
| Cystography minimum 3 views rs&i (74430) |
$306.77 |
$471.95 |
0.8× |
| Dacryocystography (70170) |
$96.92 |
$149.10 |
0.4× |
| Diskogram cervical (72285) |
$817.38 |
$1,257.50 |
0.4× |
| Diskography lumbar (72295) |
$787.34 |
$1,211.30 |
0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$144.10 |
$221.70 |
1.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$173.26 |
$266.55 |
1.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$193.38 |
$297.50 |
1.8× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$151.62 |
$233.25 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$173.84 |
$267.45 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$66.76 |
$102.70 |
0.7× |
| Dxa bone density study axial skeleton (77085) |
$176.15 |
$271 |
1.6× |
| Echo exam of eye (76529) |
$126.95 |
$195.30 |
1.4× |
| Echo exam of fetal heart (76825) |
$671.38 |
$1,032.90 |
1.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$305.89 |
$470.60 |
1.2× |
| Echoencephalography real time imaging (76506) |
$363 |
$558.45 |
3.3× |
| Esophageal motility (78258) |
$431.99 |
$664.60 |
1.0× |
| Esophagus (74220) |
$320.36 |
$492.85 |
1.8× |
| Fetal biophysical profile non-stress testing (76818) |
$201.50 |
$310 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$178.30 |
$274.30 |
1.6× |
| Fluoroscopy up to 1 hr (76000) |
$309.46 |
$476.10 |
1.2× |
| Foot 2 views (73620) |
$138.94 |
$213.75 |
1.5× |
| Forearm 2 views (73090) |
$173.74 |
$267.30 |
1.9× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$101.24 |
$155.75 |
0.4× |
| Functional MRI brain by phys/psych (70555) |
$841.26 |
$1,294.25 |
3.4× |
| Functional MRI brain by tech (70554) |
$1,187.48 |
$1,826.90 |
4.8× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$729.95 |
$1,123 |
1.3× |
| Gastric mucosa imaging (78261) |
$754.84 |
$1,161.30 |
1.8× |
| Gastrointestinal Protein Loss (78282) |
$45.76 |
$70.40 |
0.1× |
| Gated Heart Planar Single (78472) |
$741.65 |
$1,141 |
1.8× |
| Hand 2 views (73120) |
$282.75 |
$435 |
2.6× |
| Hand 3 views (73130) |
$307.13 |
$472.50 |
3.4× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$892.78 |
$1,373.50 |
1.2× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,134.90 |
$1,746 |
1.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,404 |
$2,160 |
1.9× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$497.58 |
$765.50 |
1.2× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,287.98 |
$1,981.50 |
3.2× |
| Heart Infarct Image (78466) |
$359.71 |
$553.40 |
0.9× |
| Heart infarct image w ef (78468) |
$455.91 |
$701.40 |
0.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,631.14 |
$4,047.90 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$913.22 |
$1,404.95 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$803.40 |
$1,236 |
1.9× |
| Ht muscle image spect sing (78451) |
$1,321.36 |
$2,032.85 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$175.99 |
$270.75 |
1.9× |
| Hyperthermia ntrstl prb 5/< (77610) |
$1,265.81 |
$1,947.40 |
2.2× |
| Hysterosalpingogram (74740) |
$301.66 |
$464.10 |
1.2× |
| Interstitial radiation source applic complex (77778) |
$2,340.65 |
$3,601 |
3.2× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,699.66 |
$2,614.85 |
2.4× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,223.79 |
$1,882.75 |
2.1× |
| Intracavitary radiation source applic simple (77761) |
$667.78 |
$1,027.35 |
1.2× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$4,699.50 |
$7,230 |
0.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$156.84 |
$241.30 |
1.4× |
| Kidney funcj study non-img radioisotopic study (78725) |
$597.22 |
$918.80 |
1.4× |
| Kidney imaging morphology (78700) |
$340.21 |
$523.40 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$733.52 |
$1,128.50 |
1.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$678.28 |
$1,043.50 |
1.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$702.98 |
$1,081.50 |
1.2× |
| Knee 3 views (73562) |
$282.75 |
$435 |
3.1× |
| Liver & spleen imaging static only (78215) |
$693.39 |
$1,066.75 |
1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$263.45 |
$405.30 |
0.6× |
| Liver imaging static only (78201) |
$1,496.92 |
$2,302.95 |
2.7× |
| Liver imaging w/vascular flow (78202) |
$400.40 |
$616 |
0.7× |
| Lung perf&ventilat diferentl (78598) |
$770.74 |
$1,185.75 |
1.4× |
| Lung perfusion differential (78597) |
$662.22 |
$1,018.80 |
1.6× |
| Lung Ventilation Imaging (78579) |
$635.60 |
$977.85 |
1.5× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,454.70 |
$3,776.45 |
0.7× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$676.88 |
$1,041.35 |
1.0× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$672.04 |
$1,033.90 |
0.4× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$807.86 |
$1,242.85 |
0.2× |
| Lymphoscintigraphy (78195) |
$783.28 |
$1,205.05 |
1.4× |
| Mammary ductogram or galactogram multiple (77054) |
$236.92 |
$364.50 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$100.17 |
$154.10 |
0.4× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$85.35 |
$131.30 |
0.9× |
| Meckels Diverticulum (78290) |
$611.68 |
$941.05 |
1.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$1,276.60 |
$1,964 |
3.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$927.26 |
$1,426.55 |
2.4× |
| Mr elastography (76391) |
$180.22 |
$277.25 |
0.7× |
| Mr safety determination physician/other qhp (76016) |
$136.50 |
$210 |
1.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$39 |
$60 |
1.3× |
| MRA head w & w/o contrast (70546) |
$1,365 |
$2,100 |
3.8× |
| MRA head w/o contrast (70544) |
$1,083.36 |
$1,666.70 |
4.4× |
| MRA head with contrast (70545) |
$1,462.28 |
$2,249.65 |
4.0× |
| MRA neck w contrast (70548) |
$1,492.30 |
$2,295.85 |
4.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,430 |
$2,200 |
3.9× |
| MRA neck w/o contrast (70547) |
$1,153.43 |
$1,774.50 |
4.7× |
| MRI abdomen w contrast (74182) |
$1,538.03 |
$2,366.20 |
4.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,617.92 |
$2,489.10 |
4.5× |
| MRI abdomen w/o contrast (74181) |
$1,034.64 |
$1,591.75 |
4.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,748.32 |
$2,689.72 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,739.11 |
$2,675.55 |
2.1× |
| MRI bone marrow blood supply (77084) |
$1,017.84 |
$1,565.90 |
4.1× |
| MRI breast w/o contrast bilateral (77047) |
$599.62 |
$922.50 |
2.4× |
| MRI breast w/o contrast unilat (77046) |
$305.82 |
$470.50 |
1.2× |
| MRI c-spine with contrast (72142) |
$1,217.42 |
$1,872.95 |
3.4× |
| MRI cardiac w/o cont stress (75559) |
$1,406.18 |
$2,163.35 |
2.5× |
| MRI cardiac w/o contrast (75557) |
$1,040.91 |
$1,601.40 |
4.2× |
| MRI cervical spine w/o contrast (72141) |
$1,042.14 |
$1,603.30 |
4.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,625.06 |
$2,500.10 |
4.5× |
| MRI chest w/o contrast (71550) |
$1,165 |
$1,792.30 |
4.7× |
| MRI chest with contrast (71551) |
$1,642.48 |
$2,526.90 |
2.0× |
| MRI fetal sngl/1st gestation (74712) |
$582.08 |
$895.50 |
2.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,598.90 |
$2,459.85 |
4.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,330.16 |
$3,584.85 |
6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,635.37 |
$2,515.95 |
6.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,086.84 |
$1,672.05 |
4.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,697.41 |
$2,611.40 |
4.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,192.16 |
$1,834.10 |
3.3× |
| MRI pelvis w contrast (72196) |
$1,527.50 |
$2,350 |
4.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,617.92 |
$2,489.10 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$1,100.48 |
$1,693.05 |
4.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,418.68 |
$3,721.05 |
6.7× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,474.98 |
$2,269.20 |
1.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,418.68 |
$3,721.05 |
6.7× |
| MRI spectroscopy (76390) |
$1,219.01 |
$1,875.40 |
13.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,637.71 |
$2,519.55 |
4.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,478.30 |
$2,274.30 |
4.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,628.48 |
$2,505.35 |
4.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,419.60 |
$2,184 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,637.71 |
$2,519.55 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,043.51 |
$1,605.40 |
4.2× |
| MRI tmj (70336) |
$1,028.14 |
$1,581.75 |
4.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,599.54 |
$2,460.82 |
6.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,418.68 |
$3,721.05 |
6.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,653.80 |
$2,544.30 |
6.7× |
| Myelogram Cervical (72240) |
$468.94 |
$721.45 |
0.6× |
| Myelogram Lumbar (72265) |
$599.50 |
$922.30 |
0.7× |
| Myelogram thoracic (72255) |
$496.66 |
$764.10 |
0.6× |
| Myelography 2 or more regions (72270) |
$830.02 |
$1,276.95 |
1.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,214.88 |
$3,407.50 |
1.6× |
| Myocardial infarct spect (78469) |
$1,552.88 |
$2,389.05 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$1,712.82 |
$2,635.10 |
1.3× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,006.04 |
$1,547.75 |
0.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,002.62 |
$1,542.50 |
0.7× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,539.20 |
$2,368 |
0.7× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$1,876.47 |
$2,886.88 |
0.8× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$1,869.16 |
$2,875.62 |
1.2× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,244.75 |
$1,915 |
1.4× |
| Neck soft tissue (70360) |
$100.49 |
$154.60 |
1.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$670.93 |
$1,032.20 |
1.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$521.40 |
$802.16 |
1.3× |
| Nm adrenal scan (78075) |
$858.33 |
$1,320.50 |
0.6× |
| Nm bone marrow multiple (78103) |
$422.50 |
$650 |
1.0× |
| Nm bone marrow wb (78104) |
$479.83 |
$738.20 |
1.2× |
| Nm cisternogram (78630) |
$1,017.96 |
$1,566.10 |
1.8× |
| Nm csf leak detection (78650) |
$1,633.55 |
$2,513.15 |
1.2× |
| Nm gastric emptying study (78264) |
$662.78 |
$1,019.65 |
1.6× |
| Nm gastroesophageal reflux study (78262) |
$479.77 |
$738.10 |
1.2× |
| Nm peritoneal-venous shunt patency (78291) |
$720.40 |
$1,108.30 |
1.7× |
| Nm red cell sequestration (78140) |
$294.84 |
$453.60 |
0.7× |
| Nm whole blood volume (78122) |
$746.07 |
$1,147.80 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,358.06 |
$5,166.25 |
2.3× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,461.43 |
$2,248.35 |
1.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,710.44 |
$2,631.45 |
1.3× |
| Nuclear medicine of heart pumping function (78473) |
$810.32 |
$1,246.65 |
2.0× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$616.98 |
$949.20 |
1.1× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$192.47 |
$296.10 |
0.1× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,407.51 |
$2,165.40 |
0.9× |
| Nuclear medicine study of digestive tracts (78299) |
$1,625 |
$2,500 |
3.9× |
| Nuclear medicine study of endocrine organs (78099) |
$975 |
$1,500 |
2.3× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,583.60 |
$2,436.30 |
1.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$418.80 |
$644.30 |
1.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$408.85 |
$629 |
1.0× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$615.55 |
$947 |
1.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$373.36 |
$574.40 |
0.9× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$371.28 |
$571.20 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$450.94 |
$693.75 |
1.9× |
| Nuclr Rx Interstit Colloid (79300) |
$238.23 |
$366.50 |
1.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$190.12 |
$292.50 |
1.8× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$243.40 |
$374.45 |
1.8× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$144.04 |
$221.60 |
1.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$201.37 |
$309.80 |
1.9× |
| Orthopantogram (70355) |
$118.62 |
$182.50 |
1.3× |
| Osseous survey infant (77076) |
$225.46 |
$346.85 |
2.1× |
| Osseous survey limited (77074) |
$362.48 |
$557.65 |
3.3× |
| Parathyrd planar w/spect&CT (78072) |
$818.16 |
$1,258.70 |
1.5× |
| Parathyrd planar w/wo subtrj (78071) |
$867.33 |
$1,334.35 |
2.1× |
| Parathyroid imaging (78070) |
$653.02 |
$1,004.65 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$139.66 |
$214.85 |
1.3× |
| Perineogram (74775) |
$144.69 |
$222.60 |
0.6× |
| Peritoneogram rs&i (74190) |
$386.42 |
$594.50 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$2,233.66 |
$3,436.40 |
1.5× |
| PET imaging CT for attenuation limited area (78814) |
$2,546.02 |
$3,916.95 |
1.7× |
| PET imaging for CT attenuation whole body (78816) |
$2,236.39 |
$3,440.60 |
1.5× |
| PET imaging limited area chest head/neck (78811) |
$1,377.12 |
$2,118.65 |
1.0× |
| PET whole body (78813) |
$198.64 |
$305.60 |
0.1× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$178.17 |
$274.10 |
0.1× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$164.58 |
$253.20 |
0.1× |
| Platelet survival study (78191) |
$502.32 |
$772.80 |
1.2× |
| Pr csf ventriculography (78635) |
$668.53 |
$1,028.50 |
1.2× |
| Pr gi endoscopic ultrasound (76975) |
$158.34 |
$243.60 |
0.6× |
| Pr heart first pass single,planar (78481) |
$418.41 |
$643.70 |
0.7× |
| Pr MRI brain w/ dye (70558) |
$269.30 |
$414.30 |
1.5× |
| Pr MRI brain w/o & w/ dye (70559) |
$254.15 |
$391 |
1.4× |
| Pr MRI brain w/o dye (70557) |
$239.14 |
$367.90 |
0.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,417.66 |
$3,719.48 |
6.7× |
| Pr non-imaging heart function (78414) |
$34.71 |
$53.40 |
0.1× |
| Pr red cell survival study (78130) |
$282.56 |
$434.70 |
0.7× |
| Pr sono bone density measure,peripheral (76977) |
$52.59 |
$80.90 |
0.5× |
| Proton trmt simple w/comp (77522) |
$1,109.47 |
$1,706.88 |
0.9× |
| Proton tx delivery complex (77525) |
$1,402.10 |
$2,157.08 |
1.1× |
| Proton tx delivery intermediate (77523) |
$1,316.76 |
$2,025.78 |
1.0× |
| Proton tx delivery simple w/o compensation (77520) |
$1,080.32 |
$1,662.03 |
1.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,034.15 |
$1,591 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,358.40 |
$2,089.85 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$720.82 |
$1,108.95 |
1.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$707.76 |
$1,088.85 |
1.3× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$805.02 |
$1,238.50 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$265.92 |
$409.10 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$80.60 |
$124 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$147.55 |
$227 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$204.75 |
$315 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$155.45 |
$239.15 |
1.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$174.20 |
$268 |
1.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,531.96 |
$11,587.62 |
1.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$910 |
$1,400 |
1.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$377 |
$580 |
3.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$474.50 |
$730 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$140.82 |
$216.65 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$149.50 |
$230 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$234 |
$360 |
2.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$109.52 |
$168.50 |
1.2× |
| Radiologic exam colon single contrast study (74270) |
$454.90 |
$699.85 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$146.33 |
$225.12 |
0.8× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$71.24 |
$109.60 |
0.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$347.66 |
$534.85 |
1.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$318.24 |
$489.60 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$221.82 |
$341.25 |
2.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$68.97 |
$106.10 |
0.8× |
| Radiological examination surgical specimen (76098) |
$466.67 |
$717.95 |
0.8× |
| Radiopharm Dacryocystography (78660) |
$348.99 |
$536.90 |
0.8× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$340.60 |
$524 |
1.4× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$339.24 |
$521.90 |
1.4× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$166.08 |
$255.50 |
0.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$688.42 |
$1,059.10 |
1.2× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,313.62 |
$2,020.95 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,631.14 |
$4,047.90 |
0.8× |
| Ribs bilateral 3 views (71110) |
$143.23 |
$220.35 |
1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$721.60 |
$1,110.15 |
1.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,645.54 |
$2,531.60 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,018.65 |
$1,567.15 |
1.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,093.54 |
$1,682.38 |
0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,105.08 |
$1,700.12 |
0.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,081.03 |
$1,663.12 |
0.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$504.53 |
$776.20 |
2.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$445.12 |
$684.80 |
1.8× |
| Rp Therapy Intravenous Administration (79101) |
$461.66 |
$710.25 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$146.25 |
$225 |
1.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$296.63 |
$456.35 |
1.2× |
| Salivary gland function study (78232) |
$257.99 |
$396.90 |
0.6× |
| Salivary gland imaging (78230) |
$324.74 |
$499.60 |
0.8× |
| Salivary gland imaging serial images (78231) |
$240.96 |
$370.70 |
0.6× |
| Scanogram (77073) |
$134.68 |
$207.20 |
1.2× |
| Scapula complete (73010) |
$197.73 |
$304.20 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$117 |
$180 |
5.0× |
| Sella turcica (70240) |
$55.32 |
$85.10 |
0.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$252.62 |
$388.65 |
2.3× |
| Sialogram (70390) |
$191 |
$293.85 |
0.8× |
| Simulation intermediate (77285) |
$742.69 |
$1,142.60 |
1.9× |
| Small bowel series (74250) |
$258.90 |
$398.30 |
1.4× |
| Spec medical radj physics consltj (77370) |
$297.72 |
$458.02 |
2.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$718.22 |
$1,104.95 |
1.8× |
| Special dosimetry (77331) |
$299.88 |
$461.35 |
2.1× |
| Special treatment procedure (77470) |
$1,088.75 |
$1,675 |
1.9× |
| Speech evaluation complex (70371) |
$183.30 |
$282 |
0.7× |
| Spine thoracic 3 views (72072) |
$151.48 |
$233.05 |
1.4× |
| Spleen imaging only (78185) |
$414.38 |
$637.50 |
1.0× |
| Splenoportograpy rs&i (75810) |
$1,020.44 |
$1,569.90 |
0.3× |
| Stereotactic body radiation delivery (77373) |
$2,516.14 |
$3,870.99 |
1.4× |
| Superior sagittal sinus venogram (75870) |
$988.62 |
$1,520.95 |
0.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$270.44 |
$416.05 |
2.6× |
| Tbs Technical Calculation Only (77091) |
$130 |
$200 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$550.22 |
$846.50 |
1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$671.42 |
$1,032.95 |
1.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$178.82 |
$275.10 |
0.7× |
| Testicular Imaging With Vascular Flow (78761) |
$394.49 |
$606.90 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,065.22 |
$1,638.80 |
2.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$490.75 |
$755 |
3.5× |
| Therapeutic Enema (74283) |
$389.03 |
$598.50 |
2.1× |
| Thoracolumbar 2 views (72080) |
$138.71 |
$213.40 |
1.5× |
| Thyroid carcinoma metastases img addl study (78016) |
$633.36 |
$974.40 |
1.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$825.44 |
$1,269.90 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$706.94 |
$1,087.60 |
1.7× |
| Thyroid uptake measurement (78012) |
$574.54 |
$883.90 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$609.44 |
$937.60 |
1.5× |
| Tmj unilateral (70328) |
$89.96 |
$138.40 |
1.0× |
| Tomogram (76100) |
$251.16 |
$386.40 |
2.3× |
| Treatment device intermediate (77333) |
$435.50 |
$670 |
3.1× |
| Treatment devices simple (77332) |
$364.32 |
$560.50 |
2.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,923.06 |
$2,958.55 |
3.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$660.18 |
$1,015.65 |
1.6× |
| Tx devices design & construction complex (77334) |
$614.90 |
$946 |
1.6× |
| Ultrasound elastography first target lesion (76982) |
$96.52 |
$148.50 |
0.9× |
| Ultrasound scan of cornea to determine thickness (76514) |
$32.50 |
$50 |
1.1× |
| Ultrasound scan to determine eye length and lens power (76519) |
$160.42 |
$246.80 |
1.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$187.20 |
$288 |
0.5× |
| Ultrasound, abdomen limited (76705) |
$276.80 |
$425.85 |
2.5× |
| Umbilical-artery Doppler (OB) (76820) |
$139.23 |
$214.20 |
1.3× |
| Unlisted cardiovascular procedure, diagnostic nuclear medicine UNSCHEDULED (78499) |
$975 |
$1,500 |
2.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$393.25 |
$605 |
4.4× |
| Unlisted fluoroscopic procedure (76496) |
$97.50 |
$150 |
1.1× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) |
$975 |
$1,500 |
2.3× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine UNSCHEDULED (78199) |
$1,950 |
$3,000 |
4.7× |
| Unlisted magnetic resonance procedure (76498) |
$1,098.50 |
$1,690 |
12.2× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$641.74 |
$987.30 |
1.5× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$975 |
$1,500 |
2.3× |
| Unlisted nervous system procedure, diagnostic nuclear medicine UNSCHEDULED (78699) |
$641.74 |
$987.30 |
1.5× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$167.70 |
$258 |
1.6× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$975 |
$1,500 |
2.3× |
| Upper Extremity Infant (73092) |
$116.22 |
$178.80 |
1.1× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$162.50 |
$250 |
1.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$661.31 |
$1,017.40 |
1.6× |
| Urethrocystography retrograde rs&i (74450) |
$279.11 |
$429.40 |
1.1× |
| Urethrocystography voiding (74455) |
$312.16 |
$480.25 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$438.75 |
$675 |
2.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$257.34 |
$395.90 |
1.4× |
| Us abdl aorta screen aaa (76706) |
$233.80 |
$359.70 |
2.2× |
| Us breast unilateral complete (76641) |
$469.22 |
$721.88 |
4.3× |
| Us breast unilateral limited (76642) |
$373.57 |
$574.72 |
4.1× |
| Us chest (76604) |
$284.31 |
$437.40 |
2.6× |
| Us compl joint r-t w/image documentation (76881) |
$230.04 |
$353.90 |
2.1× |
| Us elastography parenchyma (76981) |
$96.52 |
$148.50 |
0.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$201.50 |
$310 |
1.9× |
| Us guided compression repair (76936) |
$892.12 |
$1,372.50 |
4.0× |
| Us infant hips dynamic (76885) |
$429.62 |
$660.95 |
4.8× |
| Us infant hips limited static (76886) |
$165.56 |
$254.70 |
1.8× |
| Us kidney transplant (76776) |
$360.40 |
$554.45 |
3.3× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$174.04 |
$267.75 |
1.6× |
| Us ob detailed single fetus (76811) |
$227.50 |
$350 |
0.9× |
| Us ob transvaginal (76817) |
$206.12 |
$317.10 |
1.9× |
| Us pelvic non ob complete (76856) |
$289.90 |
$446 |
2.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$248.20 |
$381.85 |
2.3× |
| Us pregnancy ltd (76815) |
$168.54 |
$259.30 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$211.25 |
$325 |
1.9× |
| Us retroperitoneal complete (76770) |
$348.08 |
$535.50 |
3.2× |
| Us retroperitoneal limited (76775) |
$237.25 |
$365 |
2.2× |
| Us scrotum and contents (76870) |
$289.90 |
$446 |
2.7× |
| Us soft tissue head/neck (76536) |
$275.18 |
$423.35 |
2.5× |
| Us spinal canal and contents (76800) |
$292.99 |
$450.75 |
2.7× |
| Us transrectal (76872) |
$302.87 |
$465.95 |
2.8× |
| Us transrectal prostate volume (76873) |
$260.88 |
$401.35 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$154.38 |
$237.50 |
1.4× |
| Us, eye b-scan (76512) |
$289.58 |
$445.50 |
2.7× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$1,140.36 |
$1,754.40 |
2.0× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) |
$732.49 |
$1,126.90 |
1.8× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) |
$1,279.79 |
$1,968.90 |
1.8× |
| Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) |
$1,912.56 |
$2,942.40 |
3.3× |
| Vascular flow imaging (78445) |
$337.87 |
$519.80 |
0.8× |
| Vasogram (74440) |
$163.15 |
$251 |
0.7× |
| Venogram extremity bilateral (75822) |
$892.52 |
$1,373.10 |
0.5× |
| Venogram orbital (75880) |
$602.13 |
$926.35 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,631.46 |
$4,048.40 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$1,754.35 |
$2,699 |
1.1× |
| Venography epidural rs&i (75872) |
$621.08 |
$955.50 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$690.62 |
$1,062.50 |
0.4× |
| Venography Renal Bilateral (75833) |
$1,131.98 |
$1,741.50 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$2,652.30 |
$4,080.45 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,631.46 |
$4,048.40 |
0.8× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,308.82 |
$6,628.95 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$88.40 |
$136 |
1.0× |
| Wrist 2 views (73100) |
$178.72 |
$274.95 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$194.94 |
$299.90 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$79.89 |
$122.90 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$214.50 |
$330 |
2.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$517.40 |
$796 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$174.82 |
$268.95 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$205.63 |
$316.35 |
2.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$157.95 |
$243 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$146.25 |
$225 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$149.50 |
$230 |
1.7× |
| X-ray exam hip uni 4/> views (73503) |
$234 |
$360 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$234 |
$360 |
2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$156.98 |
$241.50 |
1.4× |
| X-ray exam of femur 1 (73551) |
$162.82 |
$250.50 |
1.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,009.64 |
$1,553.30 |
5.5× |
| X-ray eye for foreign body (70030) |
$132.60 |
$204 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$149.02 |
$229.25 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$146.25 |
$225 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$263.25 |
$405 |
2.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$932.62 |
$1,434.80 |
0.4× |
| X-ray head for orthodontia (70350) |
$75.72 |
$116.50 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$149.13 |
$229.42 |
1.7× |
| X-ray IV pyelogram+drip infusn (74410) |
$219.12 |
$337.10 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$108.26 |
$166.55 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$196.18 |
$301.80 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$152.10 |
$234 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$180.91 |
$278.32 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$142.32 |
$218.95 |
1.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$199.52 |
$306.95 |
1.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$162.40 |
$249.85 |
1.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$143.84 |
$221.30 |
1.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$81.64 |
$125.60 |
0.9× |
| X-ray of voice box or throat (70370) |
$158.90 |
$244.45 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$221.32 |
$340.50 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$148.92 |
$229.10 |
1.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$306.22 |
$471.10 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$543.56 |
$836.25 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$120.42 |
$185.25 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$134 |
$206.15 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$170.86 |
$262.85 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$136.28 |
$209.65 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$99.06 |
$152.40 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$216.16 |
$332.55 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$234 |
$360 |
2.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$119.18 |
$183.35 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$152.92 |
$235.25 |
1.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$132.34 |
$203.60 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$175.50 |
$270 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$128.15 |
$197.15 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$104.98 |
$161.50 |
1.2× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$46.12 |
$70.95 |
0.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$136.14 |
$209.45 |
1.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$175.37 |
$269.80 |
1.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$170.53 |
$262.35 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$228.25 |
$351.15 |
2.5× |
| Xr arthrogram ankle (73615) |
$183.63 |
$282.50 |
0.5× |
| Xr c-spine 6 or more views (72052) |
$215.64 |
$331.75 |
2.0× |
| Xr chest 4+ views (71048) |
$219.70 |
$338 |
2.0× |
| Xr Cholecystography Oral Contrast (74290) |
$130.39 |
$200.60 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$221.47 |
$340.72 |
2.5× |
| Xr internal auditory meati complete (70134) |
$88.73 |
$136.50 |
0.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$63.51 |
$97.70 |
0.6× |
| Xr myelogram posterior fossa (70010) |
$370.63 |
$570.20 |
1.0× |
| Xr optic foramina (70190) |
$64.87 |
$99.80 |
0.7× |
| Xr shoulder 1 view (73020) |
$219.38 |
$337.50 |
2.4× |
| Xr spine cervical 4 or 5 views (72050) |
$170.82 |
$262.80 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$195 |
$300 |
2.2× |
| Xr tmj bilateral (70330) |
$117 |
$180 |
1.3× |
| Xray knee 1 or 2 views rt (73560) |
$307.13 |
$472.50 |
3.4× |