| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,114.40 |
$3,524 |
1.5× |
| Abdomen 2 views (74019) |
$255 |
$425 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$753.60 |
$1,256 |
1.9× |
| Angiography extremity bilateral rs&i (75716) |
$4,593.60 |
$3,914 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$4,593.60 |
$7,656 |
1.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$7,014 |
$11,690 |
1.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,593.60 |
$7,656 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,593.60 |
$7,656 |
1.5× |
| Angiography Spinal Selective Rs&I (75705) |
$7,925.40 |
$13,209 |
1.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$7,128 |
$11,880 |
1.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,068.60 |
$3,498.50 |
1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,468.20 |
$7,447 |
1.4× |
| Ankle 2 views (73600) |
$194.40 |
$324 |
2.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$684.60 |
$1,141 |
2.0× |
| Aortogram thoracic (75605) |
$7,925.40 |
$13,209 |
1.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,409 |
$4,015 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$4,593.60 |
$7,656 |
1.5× |
| Aortography thoracic w/o serialography rs&i (75600) |
$253.80 |
$423 |
0.1× |
| Arthrogram elbow (73085) |
$570.60 |
$951 |
1.6× |
| Arthrogram hip (73525) |
$570.60 |
$951 |
1.6× |
| Arthrogram shoulder (73040) |
$570.60 |
$951 |
1.6× |
| Arthrogram wrist (73115) |
$758.40 |
$1,264 |
2.2× |
| Arthrography knee lt (73580) |
$870.60 |
$1,451 |
2.5× |
| Basic radiation dosimetry calculation (77300) |
$320.40 |
$534 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$569.40 |
$949 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$905.70 |
$1,509.50 |
2.3× |
| Bone age studies (77072) |
$198.60 |
$331 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$834 |
$1,390 |
2.1× |
| Bone Marrow Imaging Limited Area (78102) |
$569.40 |
$949 |
1.4× |
| Bone survey complete (77075) |
$410.40 |
$684 |
3.9× |
| Brachytx isodose complex (77318) |
$709.80 |
$1,183 |
1.9× |
| Brachytx isodose intermed (77317) |
$525.60 |
$876 |
1.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$525.60 |
$876 |
1.4× |
| Brain image w/flow 4 + views (78606) |
$750.60 |
$1,251 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,859 |
$4,765 |
2.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$742.20 |
$1,237 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$300 |
$500 |
3.4× |
| Chest 1 view (71045) |
$235.20 |
$392 |
2.7× |
| Chest 3 views (71047) |
$253.20 |
$422 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$267 |
$445 |
1.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,375.80 |
$2,293 |
1.8× |
| Clavicle complete (73000) |
$165.60 |
$276 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$646.20 |
$1,077 |
6.2× |
| Continuing medical physics consltj pr wk (77336) |
$268.20 |
$447 |
2.0× |
| Corpora cavernosography (74445) |
$198.60 |
$331 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,560 |
$2,600 |
4.5× |
| CT abdomen and pelvis without contrast (74176) |
$908.40 |
$1,514 |
3.8× |
| CT abdomen w contrast (74160) |
$1,044 |
$1,740 |
5.9× |
| CT abdomen w wo contrast (74170) |
$1,380 |
$2,300 |
7.9× |
| CT abdomen w/o contrast (74150) |
$823.80 |
$1,373 |
7.9× |
| CT angio hrt w/3d image (75574) |
$1,395 |
$2,325 |
4.0× |
| CT angiography upper extremity lt (73206) |
$951 |
$1,585 |
5.4× |
| CT c-spine w/o contrast (72125) |
$866.40 |
$1,444 |
8.3× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$353.40 |
$589 |
2.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,368 |
$2,280 |
7.8× |
| CT cervical spine with contrast (72126) |
$1,228.20 |
$2,047 |
3.5× |
| CT chest w/wo contrast (71270) |
$1,156.20 |
$1,927 |
6.6× |
| CT chest with contrast (71260) |
$960 |
$1,600 |
5.5× |
| CT colonography screening (74263) |
$310.80 |
$518 |
1.3× |
| CT colonography w/o cntrst (74261) |
$579 |
$965 |
5.5× |
| CT head/brain with contrast (70460) |
$921 |
$1,535 |
5.2× |
| CT head/brain without and with contrast (70470) |
$1,152 |
$1,920 |
6.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$720 |
$1,200 |
2.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$147.90 |
$246.50 |
1.7× |
| CT iac w contrast (70481) |
$795 |
$1,325 |
4.5× |
| CT lower ext w/o (73700) |
$637.80 |
$1,063 |
6.1× |
| CT lower extremity w wo contrast (73702) |
$1,140.60 |
$1,901 |
6.5× |
| CT lower extremity with contrast (73701) |
$897.60 |
$1,496 |
5.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,375.20 |
$2,292 |
7.8× |
| CT lumbar spine w/o contrast (72131) |
$948 |
$1,580 |
9.1× |
| CT lumbar spine with contrast (72132) |
$1,228.20 |
$2,047 |
3.5× |
| CT maxillofacial w contrast (70487) |
$1,222.20 |
$2,037 |
7.0× |
| CT maxillofacial w/o contrast (70486) |
$780.60 |
$1,301 |
7.5× |
| CT neck soft tissue w contrast (70491) |
$1,065 |
$1,775 |
6.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$850.80 |
$1,418 |
4.8× |
| CT orbits w/o contrast (70480) |
$607.80 |
$1,013 |
5.8× |
| CT pelvis w & w/o contrast (72194) |
$1,228.20 |
$2,047 |
7.0× |
| CT pelvis w/o contrast (72192) |
$837 |
$1,395 |
8.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,395 |
$2,325 |
7.9× |
| CT soft tissue neck w/o contrast (70490) |
$810 |
$1,350 |
7.7× |
| CT thoracic spine w/contrast (72129) |
$1,228.20 |
$2,047 |
7.0× |
| CT thoracic spine w/o contrast (72128) |
$601.80 |
$1,003 |
5.7× |
| CT thoracic spine w/wo contrast (72130) |
$900 |
$1,500 |
5.1× |
| CT thorax w/o contrast (71250) |
$775.20 |
$1,292 |
7.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$974.40 |
$1,624 |
5.5× |
| CT upper extremity w/o contrast rt (73200) |
$681.60 |
$1,136 |
6.5× |
| CT upper extremity with contrast (73201) |
$766.20 |
$1,277 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,235.40 |
$2,059 |
7.0× |
| Cta Abdomen (74175) |
$1,021.20 |
$1,702 |
5.8× |
| CTA abdomen pelvis (74174) |
$1,254.60 |
$2,091 |
3.6× |
| CTA chest (71275) |
$1,314 |
$2,190 |
7.5× |
| Cta Head (70496) |
$1,395 |
$2,325 |
7.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,790 |
$4,650 |
8.0× |
| CTA lwr ext w&w/o contrast (73706) |
$777 |
$1,295 |
4.4× |
| Cta Neck (70498) |
$1,395 |
$2,325 |
7.9× |
| Cta Pelvis (72191) |
$1,653.60 |
$2,756 |
9.4× |
| Cystography minimum 3 views rs&i (74430) |
$684.60 |
$1,141 |
2.0× |
| Diskography lumbar (72295) |
$6,689.40 |
$11,149 |
3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$265.20 |
$442 |
2.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$234 |
$390 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$189 |
$315 |
2.2× |
| Dxa bone density study axial skeleton (77085) |
$175.80 |
$293 |
1.7× |
| Echoencephalography real time imaging (76506) |
$246 |
$410 |
2.3× |
| Esophagus (74220) |
$390 |
$650 |
2.2× |
| Fetal biophysical profile non-stress testing (76818) |
$604.20 |
$1,007 |
5.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$490.20 |
$817 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$209.40 |
$349 |
0.9× |
| Foot 2 views (73620) |
$161.40 |
$269 |
1.9× |
| Forearm 2 views (73090) |
$190.80 |
$318 |
2.2× |
| Gated Heart Planar Single (78472) |
$661.80 |
$1,103 |
1.7× |
| Hand 2 views (73120) |
$198.60 |
$331 |
1.9× |
| Hand 3 views (73130) |
$227.40 |
$379 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,061.40 |
$1,769 |
1.5× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,066.80 |
$1,778 |
1.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,073.40 |
$1,789 |
1.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$840.60 |
$1,401 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$790.20 |
$1,317 |
2.0× |
| Ht muscle image spect sing (78451) |
$1,951.80 |
$3,253 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$186 |
$310 |
2.1× |
| Hysterosalpingogram (74740) |
$436.20 |
$727 |
1.8× |
| Interstitial radiation source applic complex (77778) |
$2,229.60 |
$3,716 |
3.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$261.60 |
$436 |
2.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$604.80 |
$1,008 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$726.60 |
$1,211 |
1.3× |
| Knee 3 views (73562) |
$240 |
$400 |
2.8× |
| Liver & spleen imaging static only (78215) |
$662.40 |
$1,104 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$951.60 |
$1,586 |
1.7× |
| Lung perfusion differential (78597) |
$512.40 |
$854 |
1.3× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$895.80 |
$1,493 |
1.4× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$4,468.20 |
$7,447 |
1.4× |
| Lymphoscintigraphy (78195) |
$742.20 |
$1,237 |
1.4× |
| Meckels Diverticulum (78290) |
$482.40 |
$804 |
1.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,416.60 |
$2,361 |
3.8× |
| Mr elastography (76391) |
$917.40 |
$1,529 |
3.8× |
| Mr safety determination physician/other qhp (76016) |
$132 |
$220 |
1.5× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$89.40 |
$149 |
1.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$36.60 |
$61 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$137.40 |
$229 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$362.40 |
$604 |
1.5× |
| MRA head w & w/o contrast (70546) |
$1,104 |
$1,840 |
3.2× |
| MRA head w/o contrast (70544) |
$745.20 |
$1,242 |
3.1× |
| MRA head with contrast (70545) |
$759.90 |
$1,266.50 |
2.2× |
| MRA neck w contrast (70548) |
$773.70 |
$1,289.50 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,123.20 |
$1,872 |
3.2× |
| MRA neck w/o contrast (70547) |
$532.80 |
$888 |
2.2× |
| MRI abdomen w contrast (74182) |
$1,096.20 |
$1,827 |
3.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,165.20 |
$1,942 |
3.3× |
| MRI abdomen w/o contrast (74181) |
$688.80 |
$1,148 |
2.9× |
| MRI any jnt lwr ext with con lt (73722) |
$1,089 |
$1,815 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,767 |
$2,945 |
2.3× |
| MRI breast w/o contrast bilateral (77047) |
$1,477.20 |
$2,462 |
6.2× |
| MRI breast w/o contrast unilat (77046) |
$701.40 |
$1,169 |
2.9× |
| MRI c-spine with contrast (72142) |
$733.20 |
$1,222 |
2.1× |
| MRI cervical spine w/o contrast (72141) |
$662.70 |
$1,104.50 |
2.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,800 |
$3,000 |
5.2× |
| MRI chest w/o contrast (71550) |
$868.80 |
$1,448 |
3.6× |
| MRI chest with contrast (71551) |
$1,089 |
$1,815 |
1.4× |
| MRI fetal sngl/1st gestation (74712) |
$455.40 |
$759 |
1.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$949.20 |
$1,582 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,233 |
$2,055 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,099.20 |
$1,832 |
4.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$526.20 |
$877 |
2.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,396.80 |
$2,328 |
4.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,080 |
$1,800 |
3.1× |
| MRI pelvis w contrast (72196) |
$945 |
$1,575 |
2.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,234.80 |
$2,058 |
3.5× |
| MRI pelvis w/o contrast (72195) |
$930.60 |
$1,551 |
3.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,152.80 |
$3,588 |
6.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,146 |
$1,910 |
3.3× |
| MRI spectroscopy (76390) |
$409.20 |
$682 |
4.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$883.50 |
$1,472.50 |
2.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,119.60 |
$1,866 |
3.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$882.30 |
$1,470.50 |
2.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$822.30 |
$1,370.50 |
2.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$819 |
$1,365 |
2.3× |
| MRI thoracic spine w/o contrast (72146) |
$595.20 |
$992 |
2.5× |
| MRI tmj (70336) |
$911.40 |
$1,519 |
3.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,003.80 |
$1,673 |
4.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,154.40 |
$1,924 |
3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$883.20 |
$1,472 |
3.7× |
| Myelogram Cervical (72240) |
$1,146.60 |
$1,911 |
1.5× |
| Myelogram Lumbar (72265) |
$1,146.60 |
$1,911 |
1.5× |
| Myelogram thoracic (72255) |
$1,146.60 |
$1,911 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,142.40 |
$1,904 |
1.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,349 |
$3,915 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$2,052 |
$3,420 |
1.6× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,641.80 |
$4,403 |
1.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,354.40 |
$3,924 |
1.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$4,029.60 |
$6,716 |
1.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,792.80 |
$2,988 |
2.1× |
| Neck soft tissue (70360) |
$191.40 |
$319 |
2.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$379.20 |
$632 |
0.9× |
| Nm bone marrow multiple (78103) |
$684 |
$1,140 |
1.7× |
| Nm bone marrow wb (78104) |
$855 |
$1,425 |
2.1× |
| Nm cisternogram (78630) |
$1,017 |
$1,695 |
1.9× |
| Nm csf leak detection (78650) |
$1,951.80 |
$3,253 |
1.5× |
| Nm gastric emptying study (78264) |
$720 |
$1,200 |
1.8× |
| Nm peritoneal-venous shunt patency (78291) |
$571.80 |
$953 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,808 |
$4,680 |
2.0× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$2,367 |
$3,945 |
1.7× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$2,190.60 |
$3,651 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$555.60 |
$926 |
2.4× |
| Osseous survey infant (77076) |
$313.20 |
$522 |
3.0× |
| Osseous survey limited (77074) |
$283.20 |
$472 |
2.7× |
| Parathyroid imaging (78070) |
$675 |
$1,125 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$234 |
$390 |
2.2× |
| PET image w/CT, skull-thigh (78815) |
$2,190.60 |
$3,651 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$2,593.20 |
$4,322 |
1.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,351.20 |
$2,252 |
3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$612.60 |
$1,021 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$739.20 |
$1,232 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$924.30 |
$1,540.50 |
1.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$160.80 |
$268 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$198.60 |
$331 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$255 |
$425 |
2.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$247.80 |
$413 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$370.80 |
$618 |
3.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$10,959 |
$18,265 |
1.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$386.40 |
$644 |
0.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$189 |
$315 |
1.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$386.40 |
$644 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$222 |
$370 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$210 |
$350 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$312 |
$520 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$246 |
$410 |
2.8× |
| Radiologic exam colon single contrast study (74270) |
$343.20 |
$572 |
2.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$652.80 |
$1,088 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$192 |
$320 |
1.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$490.20 |
$817 |
2.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$180 |
$300 |
2.1× |
| Radiological examination surgical specimen (76098) |
$870 |
$1,450 |
1.6× |
| Review by radiologist of adrenal gland vein image (75840) |
$4,593.60 |
$7,656 |
1.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,833.80 |
$4,723 |
0.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,860 |
$3,100 |
3.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,749.60 |
$2,916 |
3.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,749.60 |
$2,916 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$385.80 |
$643 |
1.7× |
| Sacroiliac Joints < 3 Views (72200) |
$198.60 |
$331 |
1.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$440.40 |
$734 |
1.8× |
| Scanogram (77073) |
$198.60 |
$331 |
1.9× |
| Scapula complete (73010) |
$199.20 |
$332 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$90 |
$150 |
3.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$171.60 |
$286 |
1.6× |
| Small bowel series (74250) |
$371.40 |
$619 |
2.1× |
| Spec medical radj physics consltj (77370) |
$230.40 |
$384 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$642 |
$1,070 |
1.7× |
| Special dosimetry (77331) |
$213 |
$355 |
1.6× |
| Special treatment procedure (77470) |
$1,063.20 |
$1,772 |
1.9× |
| Spine thoracic 3 views (72072) |
$300 |
$500 |
2.9× |
| Stereotactic body radiation delivery (77373) |
$2,518.80 |
$4,198 |
1.4× |
| Superior sagittal sinus venogram (75870) |
$4,468.20 |
$7,447 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$551.40 |
$919 |
1.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$525.60 |
$876 |
1.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$685.20 |
$1,142 |
1.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$343.20 |
$572 |
2.5× |
| Thoracolumbar 2 views (72080) |
$160.80 |
$268 |
1.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$822 |
$1,370 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$765 |
$1,275 |
1.9× |
| Tomogram (76100) |
$198.60 |
$331 |
1.9× |
| Treatment devices simple (77332) |
$212.40 |
$354 |
1.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,749.60 |
$2,916 |
3.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$569.40 |
$949 |
1.4× |
| Tx devices design & construction complex (77334) |
$525.60 |
$876 |
1.4× |
| Ultrasound elastography first target lesion (76982) |
$846 |
$1,410 |
8.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$729.60 |
$1,216 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$517.20 |
$862 |
4.9× |
| Umbilical-artery Doppler (OB) (76820) |
$204.60 |
$341 |
2.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$118.80 |
$198 |
1.4× |
| Unlisted Ultrasound Procedure (76999) |
$729.60 |
$1,216 |
8.4× |
| Upper Extremity Infant (73092) |
$280.20 |
$467 |
2.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$510.60 |
$851 |
1.3× |
| Urethrocystography retrograde rs&i (74450) |
$433.20 |
$722 |
1.8× |
| Urethrocystography voiding (74455) |
$467.40 |
$779 |
2.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$505.20 |
$842 |
2.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$636.60 |
$1,061 |
3.6× |
| Us abdl aorta screen aaa (76706) |
$201 |
$335 |
1.9× |
| Us breast unilateral complete (76641) |
$313.80 |
$523 |
3.0× |
| Us breast unilateral limited (76642) |
$267.60 |
$446 |
3.1× |
| Us chest (76604) |
$444.90 |
$741.50 |
4.2× |
| Us elastography parenchyma (76981) |
$846 |
$1,410 |
8.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$300 |
$500 |
2.9× |
| Us guided compression repair (76936) |
$457.20 |
$762 |
2.1× |
| Us infant hips dynamic (76885) |
$301.80 |
$503 |
3.5× |
| Us infant hips limited static (76886) |
$246 |
$410 |
2.8× |
| Us ob detailed single fetus (76811) |
$433.20 |
$722 |
1.8× |
| Us ob transvaginal (76817) |
$390 |
$650 |
3.7× |
| Us pelvic non ob complete (76856) |
$615 |
$1,025 |
5.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$237.60 |
$396 |
2.3× |
| Us pregnancy ltd (76815) |
$258 |
$430 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$390 |
$650 |
3.7× |
| Us retroperitoneal complete (76770) |
$630.60 |
$1,051 |
6.0× |
| Us retroperitoneal limited (76775) |
$484.80 |
$808 |
4.6× |
| Us scrotum and contents (76870) |
$610.80 |
$1,018 |
5.8× |
| Us soft tissue head/neck (76536) |
$601.20 |
$1,002 |
5.7× |
| Us spinal canal and contents (76800) |
$435 |
$725 |
4.2× |
| Us transrectal (76872) |
$261 |
$435 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$375 |
$625 |
3.6× |
| Venogram extremity bilateral (75822) |
$2,400 |
$4,000 |
1.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,440.80 |
$4,068 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$1,230.60 |
$2,051 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$2,044.20 |
$3,407 |
1.3× |
| Venography Renal Bilateral (75833) |
$4,593.60 |
$7,656 |
1.5× |
| Venography renal unilateral selective rs&i (75831) |
$4,593.60 |
$7,656 |
1.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,440.80 |
$4,068 |
0.8× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,208.40 |
$7,014 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$139.20 |
$232 |
1.6× |
| Wrist 2 views (73100) |
$161.40 |
$269 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$339 |
$565 |
3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$240 |
$400 |
2.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$202.80 |
$338 |
2.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$512.40 |
$854 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$186.60 |
$311 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$190.20 |
$317 |
2.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$345 |
$575 |
3.3× |
| X-ray exam hip uni 1 view (73501) |
$161.40 |
$269 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$199.20 |
$332 |
2.3× |
| X-ray exam of femur 1 (73551) |
$161.40 |
$269 |
1.9× |
| X-ray eye for foreign body (70030) |
$161.40 |
$269 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$248.40 |
$414 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$169.20 |
$282 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$204.60 |
$341 |
2.3× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$3,432 |
$5,720 |
1.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$161.40 |
$269 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$160.80 |
$268 |
1.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$61.20 |
$102 |
0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$52.20 |
$87 |
0.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$166.80 |
$278 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$300 |
$500 |
2.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$442.20 |
$737 |
4.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$336 |
$560 |
3.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$202.80 |
$338 |
2.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$255.60 |
$426 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$199.20 |
$332 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$300 |
$500 |
2.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$684.60 |
$1,141 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$161.40 |
$269 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$240 |
$400 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$300 |
$500 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$198.60 |
$331 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$255 |
$425 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$216.60 |
$361 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$207.60 |
$346 |
2.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$161.40 |
$269 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$283.20 |
$472 |
2.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$198.60 |
$331 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$210 |
$350 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$253.20 |
$422 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$201.60 |
$336 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$300 |
$500 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$360 |
$600 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$180 |
$300 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$192 |
$320 |
2.2× |
| Xr arthrogram ankle (73615) |
$684.60 |
$1,141 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$450 |
$750 |
4.3× |
| Xr chest 4+ views (71048) |
$267.60 |
$446 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$161.40 |
$269 |
1.9× |
| Xr shoulder 1 view (73020) |
$161.40 |
$269 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$390 |
$650 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$216.60 |
$361 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$161.40 |
$269 |
1.9× |