| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,208.10 |
$6,474 |
3.3× |
| Abdomen 2 views (74019) |
$578.50 |
$890 |
5.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,368.90 |
$2,106 |
3.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,905.80 |
$2,932 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$3,963.70 |
$6,098 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$2,345.20 |
$3,608 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$4,325.10 |
$6,654 |
1.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,402.45 |
$6,773 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,687.15 |
$7,211 |
1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,009.80 |
$3,092 |
0.7× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,124.85 |
$3,269 |
0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,861.05 |
$9,017 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,468.75 |
$6,875 |
1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,089.10 |
$3,214 |
0.7× |
| Ankle 2 views (73600) |
$297.70 |
$458 |
3.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$965.25 |
$1,485 |
3.0× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,529.80 |
$3,892 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,303.65 |
$6,621 |
1.5× |
| Aortography abdominal serialography rs&i (75625) |
$1,936.35 |
$2,979 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,468.75 |
$6,875 |
1.5× |
| Artery X-Rays Adrenal Gland (75731) |
$2,042.30 |
$3,142 |
0.7× |
| Arthrogram elbow (73085) |
$2,409.55 |
$3,707 |
7.4× |
| Arthrogram hip (73525) |
$658.45 |
$1,013 |
2.0× |
| Arthrogram shoulder (73040) |
$774.15 |
$1,191 |
2.4× |
| Arthrogram wrist (73115) |
$390.65 |
$601 |
1.2× |
| Arthrography knee lt (73580) |
$432.90 |
$666 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$380.90 |
$586 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,233.70 |
$1,898 |
3.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,472.25 |
$2,265 |
4.0× |
| Bone &/joint imaging whole body (78306) |
$1,828.45 |
$2,813 |
4.9× |
| Bone age studies (77072) |
$163.80 |
$252 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$2,290.60 |
$3,524 |
6.2× |
| Bone Marrow Imaging Limited Area (78102) |
$876.20 |
$1,348 |
2.4× |
| Bone survey complete (77075) |
$960.05 |
$1,477 |
9.9× |
| Brain image w/flow 4 + views (78606) |
$1,867.45 |
$2,873 |
3.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,713.45 |
$5,713 |
2.8× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$754 |
$1,160 |
68.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,020.55 |
$4,647 |
9.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,320.15 |
$2,031 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$344.50 |
$530 |
4.3× |
| Chest 1 view (71045) |
$175.50 |
$270 |
2.2× |
| Chest 3 views (71047) |
$537.55 |
$827 |
6.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$557.05 |
$857 |
3.4× |
| Clavicle complete (73000) |
$681.85 |
$1,049 |
8.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$343.85 |
$529 |
3.5× |
| Continuing medical physics consltj pr wk (77336) |
$393.25 |
$605 |
3.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,442.05 |
$3,757 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,185.65 |
$4,901 |
14.4× |
| CT abdomen w contrast (74160) |
$1,282.45 |
$1,973 |
7.9× |
| CT abdomen w wo contrast (74170) |
$1,282.45 |
$1,973 |
7.9× |
| CT abdomen w/o contrast (74150) |
$1,282.45 |
$1,973 |
13.2× |
| CT angio hrt w/3d image (75574) |
$1,552.20 |
$2,388 |
4.8× |
| CT angiography upper extremity lt (73206) |
$1,709.50 |
$2,630 |
10.5× |
| CT c-spine w/o contrast (72125) |
$1,282.45 |
$1,973 |
13.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,709.50 |
$2,630 |
10.5× |
| CT cervical spine with contrast (72126) |
$1,282.45 |
$1,973 |
4.0× |
| CT chest w/wo contrast (71270) |
$1,709.50 |
$2,630 |
10.5× |
| CT chest with contrast (71260) |
$1,282.45 |
$1,973 |
7.9× |
| CT colonography screening (74263) |
$1,799.85 |
$2,769 |
8.1× |
| CT colonography w/dye (74262) |
$1,709.50 |
$2,630 |
10.5× |
| CT colonography w/o cntrst (74261) |
$1,709.50 |
$2,630 |
17.6× |
| CT head/brain with contrast (70460) |
$1,709.50 |
$2,630 |
10.5× |
| CT head/brain without and with contrast (70470) |
$1,282.45 |
$1,973 |
7.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,552.20 |
$2,388 |
4.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$268.50 |
$268.50 |
3.3× |
| CT hrt w/3d image congen (75573) |
$2,069.60 |
$3,184 |
6.4× |
| CT iac w contrast (70481) |
$1,282.45 |
$1,973 |
7.9× |
| CT limited/localized follow up study (76380) |
$1,799.85 |
$2,769 |
22.2× |
| CT lower ext w/o (73700) |
$1,350.05 |
$2,077 |
13.9× |
| CT lower extremity w wo contrast (73702) |
$1,799.85 |
$2,769 |
11.0× |
| CT lower extremity with contrast (73701) |
$1,799.85 |
$2,769 |
11.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,709.50 |
$2,630 |
10.5× |
| CT lumbar spine w/o contrast (72131) |
$1,282.45 |
$1,973 |
13.2× |
| CT lumbar spine with contrast (72132) |
$1,282.45 |
$1,973 |
4.0× |
| CT maxillofacial w contrast (70487) |
$1,709.50 |
$2,630 |
10.5× |
| CT maxillofacial w/o contrast (70486) |
$1,282.45 |
$1,973 |
13.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,709.50 |
$2,630 |
10.5× |
| CT neck soft tissue w contrast (70491) |
$1,552.20 |
$2,388 |
9.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,709.50 |
$2,630 |
10.5× |
| CT orbits w/o contrast (70480) |
$1,282.45 |
$1,973 |
13.2× |
| CT pelvis w & w/o contrast (72194) |
$1,709.50 |
$2,630 |
10.5× |
| CT pelvis w/o contrast (72192) |
$1,282.45 |
$1,973 |
13.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,552.20 |
$2,388 |
9.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,552.20 |
$2,388 |
16.0× |
| CT thoracic spine w/contrast (72129) |
$1,709.50 |
$2,630 |
10.5× |
| CT thoracic spine w/o contrast (72128) |
$1,709.50 |
$2,630 |
17.6× |
| CT thoracic spine w/wo contrast (72130) |
$1,709.50 |
$2,630 |
10.5× |
| CT thorax w/o contrast (71250) |
$1,282.45 |
$1,973 |
13.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,709.50 |
$2,630 |
10.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,282.45 |
$1,973 |
13.2× |
| CT upper extremity with contrast (73201) |
$2,906.80 |
$4,472 |
9.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,282.45 |
$1,973 |
7.9× |
| Cta Abdomen (74175) |
$3,043.95 |
$4,683 |
18.7× |
| CTA abdomen pelvis (74174) |
$1,794 |
$2,760 |
5.5× |
| CTA chest (71275) |
$2,172.95 |
$3,343 |
13.3× |
| Cta Head (70496) |
$2,069.60 |
$3,184 |
12.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,282.45 |
$1,973 |
7.9× |
| Cta Neck (70498) |
$1,709.50 |
$2,630 |
10.5× |
| Cta Pelvis (72191) |
$2,069.60 |
$3,184 |
12.7× |
| Cystography minimum 3 views rs&i (74430) |
$585 |
$900 |
1.8× |
| Diskogram cervical (72285) |
$2,280.85 |
$3,509 |
1.3× |
| Diskography lumbar (72295) |
$2,167.10 |
$3,334 |
1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$241.80 |
$372 |
2.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$335.40 |
$516 |
3.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$351.65 |
$541 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$421.85 |
$649 |
5.2× |
| Echo exam of fetal heart (76825) |
$944.45 |
$1,453 |
1.9× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$472.55 |
$727 |
2.1× |
| Echoencephalography real time imaging (76506) |
$543.40 |
$836 |
5.6× |
| Esophagus (74220) |
$609.05 |
$937 |
3.7× |
| Fetal biophysical profile non-stress testing (76818) |
$664.30 |
$1,022 |
6.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$587.60 |
$904 |
6.0× |
| Fluoroscopy up to 1 hr (76000) |
$464.10 |
$714 |
2.1× |
| Foot 2 views (73620) |
$393.90 |
$606 |
4.9× |
| Forearm 2 views (73090) |
$367.25 |
$565 |
4.5× |
| Gated Heart Planar Single (78472) |
$1,250.60 |
$1,924 |
3.4× |
| Hand 2 views (73120) |
$226.20 |
$348 |
2.3× |
| Hand 3 views (73130) |
$404.95 |
$623 |
5.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,554.20 |
$5,468 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,874.95 |
$4,423 |
5.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,237.30 |
$3,442 |
6.0× |
| Ht muscle image spect sing (78451) |
$2,538.25 |
$3,905 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$250.90 |
$386 |
3.1× |
| Hysterosalpingogram (74740) |
$445.90 |
$686 |
2.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$525.85 |
$809 |
5.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,350.70 |
$2,078 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,801.15 |
$2,771 |
3.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,502.50 |
$3,850 |
5.0× |
| Knee 3 views (73562) |
$243.10 |
$374 |
3.0× |
| Liver & spleen imaging static only (78215) |
$1,426.75 |
$2,195 |
3.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$287.30 |
$442 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$1,716.65 |
$2,641 |
3.4× |
| Lung perf&ventilat diferentl (78598) |
$3,016.65 |
$4,641 |
6.0× |
| Lung perfusion differential (78597) |
$1,899.95 |
$2,923 |
5.1× |
| Lung Ventilation Imaging (78579) |
$2,093.65 |
$3,221 |
5.6× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,861.60 |
$2,864 |
0.6× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$4,468.75 |
$6,875 |
7.7× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,657.50 |
$2,550 |
1.1× |
| Lymphoscintigraphy (78195) |
$1,594.45 |
$2,453 |
3.2× |
| Mammary ductogram or galactogram multiple (77054) |
$2,409.55 |
$3,707 |
10.9× |
| Mammary ductogram or galactogram single (77053) |
$763.75 |
$1,175 |
3.4× |
| Meckels Diverticulum (78290) |
$2,126.80 |
$3,272 |
5.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,035.45 |
$1,593 |
3.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$50.05 |
$77 |
1.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$187.85 |
$289 |
2.1× |
| MRA head w & w/o contrast (70546) |
$3,116.10 |
$4,794 |
9.6× |
| MRA head w/o contrast (70544) |
$2,085.85 |
$3,209 |
9.4× |
| MRA head with contrast (70545) |
$2,780.70 |
$4,278 |
8.6× |
| MRA neck w contrast (70548) |
$2,361.45 |
$3,633 |
7.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,205.80 |
$4,932 |
9.9× |
| MRA neck w/o contrast (70547) |
$3,148.60 |
$4,844 |
14.2× |
| MRI abdomen w contrast (74182) |
$3,262.35 |
$5,019 |
10.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,743 |
$4,220 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$2,446.60 |
$3,764 |
11.0× |
| MRI any jnt lwr ext with con lt (73722) |
$3,262.35 |
$5,019 |
4.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,446.60 |
$3,764 |
3.4× |
| MRI breast w/o contrast bilateral (77047) |
$3,262.35 |
$5,019 |
14.7× |
| MRI c-spine with contrast (72142) |
$2,723.50 |
$4,190 |
8.4× |
| MRI cardiac w/o contrast (75557) |
$2,694.90 |
$4,146 |
12.1× |
| MRI cervical spine w/o contrast (72141) |
$2,042.95 |
$3,143 |
9.2× |
| MRI chest w/o & w/contrast material (71552) |
$3,052.40 |
$4,696 |
9.4× |
| MRI chest w/o contrast (71550) |
$2,723.50 |
$4,190 |
12.3× |
| MRI chest with contrast (71551) |
$2,723.50 |
$4,190 |
3.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,234.40 |
$4,976 |
10.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,262.35 |
$5,019 |
10.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,446.60 |
$3,764 |
11.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,893.15 |
$4,451 |
13.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,276 |
$5,040 |
10.1× |
| MRI orbit/face/neck w/contrast (70542) |
$2,893.15 |
$4,451 |
8.9× |
| MRI pelvis w contrast (72196) |
$3,006.90 |
$4,626 |
9.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,371.55 |
$5,187 |
10.4× |
| MRI pelvis w/o contrast (72195) |
$3,006.90 |
$4,626 |
13.5× |
| MRI scan of arm joint before and after contrast (73223) |
$2,743 |
$4,220 |
8.5× |
| MRI scan of leg joint before and after contrast (73723) |
$2,743 |
$4,220 |
8.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,265.90 |
$3,486 |
7.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,694.90 |
$4,146 |
8.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,265.90 |
$3,486 |
7.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,694.90 |
$4,146 |
8.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,265.90 |
$3,486 |
7.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,396.25 |
$5,225 |
15.3× |
| MRI tmj (70336) |
$2,837.25 |
$4,365 |
12.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,446.60 |
$3,764 |
11.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,625.70 |
$5,578 |
11.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,234.40 |
$4,976 |
14.6× |
| Myelogram Cervical (72240) |
$2,409.55 |
$3,707 |
3.3× |
| Myelogram Lumbar (72265) |
$2,409.55 |
$3,707 |
3.3× |
| Myelogram thoracic (72255) |
$2,409.55 |
$3,707 |
3.3× |
| Myelography 2 or more regions (72270) |
$2,409.55 |
$3,707 |
3.3× |
| Myocardial infarct spect (78469) |
$1,875.90 |
$2,886 |
3.7× |
| Myocardial Spect Multiple Studies (78452) |
$3,173.95 |
$4,883 |
2.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$4,306.25 |
$6,625 |
5.4× |
| Neck soft tissue (70360) |
$477.10 |
$734 |
5.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$219.70 |
$338 |
0.6× |
| Nm cisternogram (78630) |
$2,084.55 |
$3,207 |
4.1× |
| Nm gastric emptying study (78264) |
$1,817.40 |
$2,796 |
4.9× |
| Nm peritoneal-venous shunt patency (78291) |
$1,432.60 |
$2,204 |
3.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,445.80 |
$14,532 |
7.3× |
| Nuclear medicine of heart pumping function (78473) |
$828.75 |
$1,275 |
2.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,566.50 |
$2,410 |
4.2× |
| Nuclear Rx Oral Admin (79005) |
$853.45 |
$1,313 |
3.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$824.85 |
$1,269 |
8.5× |
| Orthopantogram (70355) |
$500.50 |
$770 |
6.2× |
| Osseous survey infant (77076) |
$307.45 |
$473 |
3.2× |
| Osseous survey limited (77074) |
$83.20 |
$128 |
0.9× |
| Parathyrd planar w/wo subtrj (78071) |
$5,335.20 |
$8,208 |
14.3× |
| Parathyroid imaging (78070) |
$2,527.20 |
$3,888 |
6.8× |
| Pelvis 1 or 2 views (72170) |
$273 |
$420 |
2.8× |
| Peritoneogram rs&i (74190) |
$590.20 |
$908 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$3,113.50 |
$4,790 |
2.3× |
| PET imaging CT for attenuation limited area (78814) |
$3,528.85 |
$5,429 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$4,150.90 |
$6,386 |
3.1× |
| Pr gi endoscopic ultrasound (76975) |
$174.85 |
$269 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,743 |
$4,220 |
8.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,634.50 |
$7,130 |
1.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,634.50 |
$7,130 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,343.55 |
$2,067 |
3.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,298.75 |
$5,075 |
6.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$390 |
$600 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$629.85 |
$969 |
7.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$629.85 |
$969 |
6.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$439.40 |
$676 |
4.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$969.80 |
$1,492 |
10.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,149.85 |
$21,769 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,008.50 |
$3,090 |
3.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$399.10 |
$614 |
4.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,567.15 |
$2,411 |
4.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$612.30 |
$942 |
6.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$438.10 |
$674 |
5.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$537.55 |
$827 |
5.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$466.70 |
$718 |
5.8× |
| Radiologic exam colon single contrast study (74270) |
$910.65 |
$1,401 |
5.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$700.05 |
$1,077 |
4.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$917.80 |
$1,412 |
5.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,205.75 |
$1,855 |
7.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$327.60 |
$504 |
4.0× |
| Radiological examination surgical specimen (76098) |
$367.90 |
$566 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,781.05 |
$5,817 |
1.3× |
| Ribs bilateral 3 views (71110) |
$475.80 |
$732 |
4.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,742.65 |
$2,681 |
4.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,742.65 |
$2,681 |
3.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,268.20 |
$5,028 |
6.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,742.65 |
$2,681 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$4,028.05 |
$6,197 |
18.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$2,157.35 |
$3,319 |
9.9× |
| Rp Therapy Intravenous Administration (79101) |
$1,212.25 |
$1,865 |
5.6× |
| Sacroiliac Joints < 3 Views (72200) |
$83.20 |
$128 |
0.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$623.35 |
$959 |
2.8× |
| Scanogram (77073) |
$521.30 |
$802 |
5.4× |
| Scapula complete (73010) |
$369.85 |
$569 |
3.8× |
| Screening digital breast tomosynthesis (77063) |
$71.50 |
$110 |
3.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$2,409.55 |
$3,707 |
24.8× |
| Simulation intermediate (77285) |
$799.50 |
$1,230 |
2.3× |
| Small bowel series (74250) |
$1,106.30 |
$1,702 |
6.8× |
| Spec medical radj physics consltj (77370) |
$937.95 |
$1,443 |
7.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,114.45 |
$3,253 |
6.1× |
| Special dosimetry (77331) |
$436.80 |
$672 |
3.5× |
| Special treatment procedure (77470) |
$2,458.30 |
$3,782 |
4.8× |
| Spine thoracic 3 views (72072) |
$387.40 |
$596 |
4.0× |
| Splenoportograpy rs&i (75810) |
$4,468.75 |
$6,875 |
1.5× |
| Stereotactic body radiation delivery (77373) |
$12,116.65 |
$18,641 |
7.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,152.15 |
$3,311 |
6.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,593.15 |
$2,451 |
4.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,884.35 |
$2,899 |
5.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$799.50 |
$1,230 |
6.4× |
| Thoracolumbar 2 views (72080) |
$185.90 |
$286 |
2.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,424.80 |
$2,192 |
2.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,200.55 |
$1,847 |
3.2× |
| Thyroid uptake measurement (78012) |
$897 |
$1,380 |
2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$3,045.25 |
$4,685 |
8.2× |
| Tmj unilateral (70328) |
$62.40 |
$96 |
0.8× |
| Treatment device intermediate (77333) |
$956.15 |
$1,471 |
7.6× |
| Treatment devices simple (77332) |
$754.65 |
$1,161 |
6.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,289 |
$5,060 |
6.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,099.15 |
$1,691 |
3.0× |
| Tx devices design & construction complex (77334) |
$1,479.40 |
$2,276 |
4.2× |
| Ultrasound, abdomen limited (76705) |
$868.40 |
$1,336 |
8.9× |
| Umbilical-artery Doppler (OB) (76820) |
$394.55 |
$607 |
4.1× |
| Unlisted fluoroscopic procedure (76496) |
$62.40 |
$96 |
0.8× |
| Unlisted Ultrasound Procedure (76999) |
$179.40 |
$276 |
2.2× |
| Upper Extremity Infant (73092) |
$179.40 |
$276 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$592.15 |
$911 |
2.7× |
| Urethrocystography voiding (74455) |
$617.50 |
$950 |
2.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$604.50 |
$930 |
3.7× |
| Us abdl aorta screen aaa (76706) |
$572.65 |
$881 |
5.9× |
| Us breast unilateral complete (76641) |
$703.30 |
$1,082 |
7.2× |
| Us breast unilateral limited (76642) |
$793.65 |
$1,221 |
9.8× |
| Us chest (76604) |
$889.85 |
$1,369 |
9.2× |
| Us compl joint r-t w/image documentation (76881) |
$263.25 |
$405 |
2.7× |
| Us elastography parenchyma (76981) |
$829.40 |
$1,276 |
8.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$523.90 |
$806 |
5.4× |
| Us guided compression repair (76936) |
$2,087.15 |
$3,211 |
10.4× |
| Us ob detailed single fetus (76811) |
$887.90 |
$1,366 |
4.0× |
| Us ob transvaginal (76817) |
$820.95 |
$1,263 |
8.4× |
| Us pelvic non ob complete (76856) |
$797.55 |
$1,227 |
8.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$793 |
$1,220 |
8.2× |
| Us pregnancy ltd (76815) |
$483.60 |
$744 |
5.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$837.20 |
$1,288 |
8.6× |
| Us retroperitoneal complete (76770) |
$1,146.60 |
$1,764 |
11.8× |
| Us retroperitoneal limited (76775) |
$626.60 |
$964 |
6.4× |
| Us scrotum and contents (76870) |
$1,134.25 |
$1,745 |
11.7× |
| Us soft tissue head/neck (76536) |
$1,085.50 |
$1,670 |
11.2× |
| Us spinal canal and contents (76800) |
$450.45 |
$693 |
4.6× |
| Us transrectal (76872) |
$631.15 |
$971 |
6.5× |
| Us xtr non-vasc lmtd (76882) |
$797.55 |
$1,227 |
8.2× |
| Us, eye b-scan (76512) |
$487.50 |
$750 |
5.0× |
| Venogram extremity bilateral (75822) |
$834.60 |
$1,284 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,953.90 |
$3,006 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,953.90 |
$3,006 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$661.05 |
$1,017 |
0.5× |
| Venography Renal Bilateral (75833) |
$2,057.25 |
$3,165 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$2,057.25 |
$3,165 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,634.50 |
$7,130 |
1.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,634.50 |
$7,130 |
0.9× |
| Wrist 2 views (73100) |
$186.55 |
$287 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$438.75 |
$675 |
5.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$362.70 |
$558 |
4.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,179.75 |
$1,815 |
7.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$322.40 |
$496 |
4.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$429 |
$660 |
5.3× |
| X-ray exam hip uni 1 view (73501) |
$299 |
$460 |
3.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$239.20 |
$368 |
3.0× |
| X-ray exam hip uni 4/> views (73503) |
$83.20 |
$128 |
0.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$554.45 |
$853 |
5.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$83.20 |
$128 |
0.9× |
| X-ray exam of femur 1 (73551) |
$173.55 |
$267 |
2.1× |
| X-ray eye for foreign body (70030) |
$778.05 |
$1,197 |
9.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$358.80 |
$552 |
3.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$289.90 |
$446 |
3.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$442 |
$680 |
5.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,084.20 |
$1,668 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$244.40 |
$376 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$493.35 |
$759 |
6.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$400.40 |
$616 |
4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$389.35 |
$599 |
4.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$178.10 |
$274 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$306.15 |
$471 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$923 |
$1,420 |
9.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$408.20 |
$628 |
4.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$450.45 |
$693 |
5.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$62.40 |
$96 |
0.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$792.35 |
$1,219 |
8.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$333.45 |
$513 |
3.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$4,468.75 |
$6,875 |
8.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$772.20 |
$1,188 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$323.05 |
$497 |
4.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$354.90 |
$546 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$510.90 |
$786 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$609.70 |
$938 |
6.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$432.25 |
$665 |
5.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$276.25 |
$425 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$431.60 |
$664 |
5.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$281.45 |
$433 |
3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$647.40 |
$996 |
6.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$176.80 |
$272 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$151.45 |
$233 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$507.65 |
$781 |
6.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$434.20 |
$668 |
5.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$151.45 |
$233 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$516.75 |
$795 |
5.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$269.10 |
$414 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$365.30 |
$562 |
4.5× |
| Xr arthrogram ankle (73615) |
$658.45 |
$1,013 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$752.05 |
$1,157 |
7.7× |
| Xr chest 4+ views (71048) |
$692.90 |
$1,066 |
7.1× |
| Xr finger(s) 2+ views (73140) |
$258.05 |
$397 |
3.2× |
| Xr shoulder 1 view (73020) |
$154.70 |
$238 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$479.05 |
$737 |
4.9× |
| Xr tibia/fibula 2 views (73590) |
$398.45 |
$613 |
4.9× |
| Xr tmj bilateral (70330) |
$586.30 |
$902 |
7.2× |
| Xray knee 1 or 2 views rt (73560) |
$275.60 |
$424 |
3.4× |