| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,479.50 |
$5,510 |
1.5× |
| Abdomen 1 View (74018) |
$186.30 |
$414 |
1.8× |
| Abdomen 2 views (74019) |
$252.90 |
$562 |
2.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,727.10 |
$3,838 |
3.6× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$2,358.45 |
$5,241 |
1.5× |
| Adrenal Cortex & Medulla Img (78075) |
$2,365.20 |
$5,256 |
1.5× |
| Angio internal mammary (75756) |
$6,539.40 |
$14,532 |
1.7× |
| Angio pulmonary bilat (75743) |
$6,732.45 |
$14,961 |
1.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$6,595.20 |
$14,656 |
1.7× |
| Angiography extremity bilateral rs&i (75716) |
$5,556.60 |
$12,348 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$5,276.70 |
$11,726 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,595.20 |
$14,656 |
1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,245.20 |
$11,656 |
1.4× |
| Ankle 2 views (73600) |
$214.65 |
$477 |
2.1× |
| Aortography thoracic serialography rs&i (75605) |
$11,162.70 |
$24,806 |
1.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$6,595.20 |
$14,656 |
1.7× |
| Artery X-Rays Abdomen (75726) |
$10,495.80 |
$23,324 |
1.6× |
| Artery X-Rays Adrenal Gland (75731) |
$5,487.75 |
$12,195 |
1.5× |
| Artery X-Rays Pelvis (75736) |
$11,162.70 |
$24,806 |
1.7× |
| Artery X-Rays Spine (75705) |
$11,162.70 |
$24,806 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$443.25 |
$985 |
2.8× |
| Bone age studies (77072) |
$190.80 |
$424 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$1,233 |
$2,740 |
2.6× |
| Bone Imaging Limited Area (78300) |
$692.10 |
$1,538 |
1.4× |
| Bone Imaging Multiple Areas (78305) |
$774 |
$1,720 |
1.6× |
| Bone Imaging Whole Body (78306) |
$890.55 |
$1,979 |
1.9× |
| Bone marrow imaging limited area (78102) |
$692.10 |
$1,538 |
1.4× |
| Bone marrow imaging; multiple areas (78103) |
$825.75 |
$1,835 |
1.7× |
| Bone marrow imaging; whole body (78104) |
$1,201.05 |
$2,669 |
2.5× |
| Bone survey infant (77076) |
$190.80 |
$424 |
1.5× |
| Brachytx isodose complex (77318) |
$864.90 |
$1,922 |
1.9× |
| Brachytx isodose intermed (77317) |
$638.10 |
$1,418 |
1.4× |
| Brachytx Isodose Plan Simple (77316) |
$528.30 |
$1,174 |
1.2× |
| Brain Flow Imaging Only (78610) |
$897.30 |
$1,994 |
1.4× |
| Brain Image W/Flow < 4 Views (78601) |
$692.10 |
$1,538 |
1.4× |
| Brain imaging < 4 static views (78600) |
$692.10 |
$1,538 |
1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$897.30 |
$1,994 |
1.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$897.30 |
$1,994 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,640.60 |
$5,868 |
1.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$692.10 |
$1,538 |
1.4× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$1,121.40 |
$2,492 |
1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,973.05 |
$8,829 |
9.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$4,792.50 |
$10,650 |
5.1× |
| Cardiac Shunt Detection (78428) |
$906.30 |
$2,014 |
1.9× |
| Cardiovasc nucl exam unlisted (78499) |
$692.10 |
$1,538 |
1.4× |
| Cat Scan Follow-Up Study (76380) |
$458.10 |
$1,018 |
4.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$854.55 |
$1,899 |
1.3× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$897.30 |
$1,994 |
1.4× |
| Cerebrospinal Fluid Scan (78630) |
$897.30 |
$1,994 |
1.4× |
| Chest 1 view (71045) |
$186.30 |
$414 |
1.8× |
| Chest 2 views (71046) |
$247.95 |
$551 |
2.4× |
| Chest 3 views (71047) |
$309.60 |
$688 |
3.0× |
| Chest 4 or more views (71048) |
$388.35 |
$863 |
3.1× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$153.90 |
$342 |
1.2× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$70.65 |
$157 |
0.6× |
| Clavicle complete (73000) |
$193.50 |
$430 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$198 |
$440 |
1.6× |
| Continuing medical physics consltj pr wk (77336) |
$266.40 |
$592 |
1.7× |
| Contrast Exam Abdominl Aorta (75625) |
$5,276.70 |
$11,726 |
1.4× |
| Contrast X-Ray Bladder (74430) |
$655.65 |
$1,457 |
1.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$401.40 |
$892 |
1.9× |
| Corpora cavernosography (74445) |
$426.60 |
$948 |
3.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,027.25 |
$4,505 |
4.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,064.70 |
$2,366 |
3.7× |
| CT abdomen w contrast (74160) |
$1,484.10 |
$3,298 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,538.55 |
$3,419 |
7.3× |
| CT abdomen w/o contrast (74150) |
$909.90 |
$2,022 |
7.3× |
| CT Angio Abdomen and Pelvis (74174) |
$1,838.70 |
$4,086 |
4.4× |
| CT Angio Chest (71275) |
$1,715.40 |
$3,812 |
8.2× |
| CT Angio Head (70496) |
$1,377 |
$3,060 |
6.6× |
| CT angio hrt w/3d image (75574) |
$2,010.15 |
$4,467 |
4.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,086.65 |
$4,637 |
9.9× |
| CT Angio Neck (70498) |
$1,280.70 |
$2,846 |
6.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,990.70 |
$6,646 |
14.2× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$118.35 |
$263 |
0.6× |
| CT cervical spine w/ contrast (72126) |
$2,175.30 |
$4,834 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,246.05 |
$2,769 |
9.9× |
| CT cervical spine w/wo cont (72127) |
$2,585.70 |
$5,746 |
12.3× |
| CT chest w contrast (71260) |
$1,282.50 |
$2,850 |
6.1× |
| CT chest w/wo contrast (71270) |
$2,216.70 |
$4,926 |
10.5× |
| CT colonography screening (74263) |
$6,571.35 |
$14,603 |
23.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$4,542.75 |
$10,095 |
21.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,478.25 |
$3,285 |
11.8× |
| CT head/brain with contrast (70460) |
$1,123.65 |
$2,497 |
5.3× |
| CT head/brain without and with contrast (70470) |
$1,257.30 |
$2,794 |
6.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$401.40 |
$892 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$138.60 |
$308 |
1.3× |
| CT hrt w/3d image congen (75573) |
$401.40 |
$892 |
1.0× |
| CT iac w contrast (70481) |
$1,524.15 |
$3,387 |
7.3× |
| CT l-spine w&w/o contrast (72133) |
$2,605.05 |
$5,789 |
12.4× |
| CT lower ext w/o (73700) |
$1,251.90 |
$2,782 |
10.0× |
| CT lower extremity w/contrast material (73701) |
$1,255.05 |
$2,789 |
6.0× |
| CT lumbar spine w contrast (72132) |
$1,858.50 |
$4,130 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$957.15 |
$2,127 |
7.6× |
| CT maxillofacial w contrast (70487) |
$1,213.20 |
$2,696 |
5.8× |
| CT maxillofacial wo contrast (70486) |
$1,083.15 |
$2,407 |
8.6× |
| CT neck tissue combo (70492) |
$1,315.80 |
$2,924 |
6.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,947.05 |
$6,549 |
14.0× |
| CT orbits w/o contrast (70480) |
$1,140.75 |
$2,535 |
9.1× |
| CT pelvis w&w/o contrast (72194) |
$2,628.90 |
$5,842 |
12.5× |
| CT pelvis w/o contrast (72192) |
$1,149.75 |
$2,555 |
9.2× |
| CT scan of leg combo (73702) |
$2,726.10 |
$6,058 |
13.0× |
| CT scans face/jaw combo (70488) |
$2,739.60 |
$6,088 |
13.0× |
| CT soft tissue neck w contrast (70491) |
$1,282.05 |
$2,849 |
6.1× |
| CT soft tissue neck w/o contrast (70490) |
$972.45 |
$2,161 |
7.8× |
| CT thoracic spine w contrast (72129) |
$1,359.45 |
$3,021 |
6.5× |
| CT thoracic spine w/o contrast (72128) |
$958.50 |
$2,130 |
7.7× |
| CT thoracic spine w/wo cont (72130) |
$2,612.25 |
$5,805 |
12.4× |
| CT thorax w/o contrast (71250) |
$996.75 |
$2,215 |
8.0× |
| CT unlisted procedure (76497) |
$507.60 |
$1,128 |
4.9× |
| CT upper ext wo (73200) |
$939.60 |
$2,088 |
7.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,729.70 |
$6,066 |
13.0× |
| CT upper extremity with contrast (73201) |
$1,390.50 |
$3,090 |
3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,906.20 |
$4,236 |
9.1× |
| Cta Abdomen (74175) |
$1,302.75 |
$2,895 |
6.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$235.35 |
$523 |
0.6× |
| CTA pelvis (72191) |
$2,185.65 |
$4,857 |
10.4× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$520.65 |
$1,157 |
1.8× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) |
$897.30 |
$1,994 |
1.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$222.30 |
$494 |
1.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$303.30 |
$674 |
2.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$481.50 |
$1,070 |
3.8× |
| Dxa Bone Density Axial (77080) |
$311.40 |
$692 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$140.40 |
$312 |
1.3× |
| Echo exam of fetal heart (76825) |
$1,093.50 |
$2,430 |
1.7× |
| Echo exam uterus (76831) |
$641.25 |
$1,425 |
2.2× |
| Echo Guide For Artery Repair (76936) |
$499.05 |
$1,109 |
1.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$652.95 |
$1,451 |
2.3× |
| Echograp Trans R Pros Study (76873) |
$846.45 |
$1,881 |
6.8× |
| Esophageal Motility Study (78258) |
$1,149.30 |
$2,554 |
2.4× |
| Esophagram (74220) |
$470.70 |
$1,046 |
2.2× |
| Fetal Biophys Profile W/Nst (76818) |
$612 |
$1,360 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$445.05 |
$989 |
3.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,394.45 |
$5,321 |
8.4× |
| Fluoroscopy up to 1 hr (76000) |
$420.75 |
$935 |
1.5× |
| Follow-Up Angiography (75898) |
$5,177.70 |
$11,506 |
1.4× |
| Foot 2 views (73620) |
$233.55 |
$519 |
2.2× |
| Forearm 2 views (73090) |
$233.55 |
$519 |
2.2× |
| Gastric emptying imaging study (78264) |
$985.05 |
$2,189 |
2.1× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$990 |
$2,200 |
2.1× |
| Gastric Mucosa Imaging (78261) |
$692.10 |
$1,538 |
1.4× |
| Gastroesophageal Reflux Exam (78262) |
$692.10 |
$1,538 |
1.4× |
| Gastrointestinal Protein Loss (78282) |
$692.10 |
$1,538 |
1.4× |
| Gated Heart Planar Single (78472) |
$1,154.70 |
$2,566 |
2.4× |
| Gated Heart, Multiple (78473) |
$1,162.80 |
$2,584 |
2.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$993.60 |
$2,208 |
1.5× |
| Hand 2 views (73120) |
$238.95 |
$531 |
1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$3,551.40 |
$7,892 |
4.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,674.80 |
$5,944 |
3.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,278.90 |
$2,842 |
1.5× |
| Heart first pass single,planar (78481) |
$897.30 |
$1,994 |
1.4× |
| Heart Image (Pet) Multiple (78492) |
$2,640.60 |
$5,868 |
1.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,732.45 |
$14,961 |
1.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$6,595.20 |
$14,656 |
1.7× |
| Hepatobil Syst Image W/Drug (78227) |
$1,532.70 |
$3,406 |
2.4× |
| Hepatobiliary System Imaging (78226) |
$897.75 |
$1,995 |
1.9× |
| Ht Musc Image Planar Mult (78454) |
$2,365.20 |
$5,256 |
1.5× |
| Ht Muscle Image Spect Sing (78451) |
$2,365.20 |
$5,256 |
1.5× |
| Hysterosalpingogram (74740) |
$688.50 |
$1,530 |
2.4× |
| Image fusion (77399) |
$237.60 |
$528 |
1.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$746.55 |
$1,659 |
7.2× |
| Infant hip ultrasound, limited static exam (76886) |
$153 |
$340 |
1.5× |
| Interstitial radiation source applic complex (77778) |
$6,230.25 |
$13,845 |
7.5× |
| Intracavitary Radiation Source Applic Complex (77763) |
$5,209.65 |
$11,577 |
6.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$3,947.40 |
$8,772 |
6.0× |
| Intracavitary radiation source applic simple (77761) |
$2,978.10 |
$6,618 |
4.5× |
| Joint Survey Single View (77077) |
$231.75 |
$515 |
1.8× |
| K Flow/Funct Image Multiple (78709) |
$897.30 |
$1,994 |
1.4× |
| K Flow/Funct Image W/Drug (78708) |
$897.30 |
$1,994 |
1.4× |
| K Flow/Funct Image W/O Drug (78707) |
$897.30 |
$1,994 |
1.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$692.10 |
$1,538 |
1.4× |
| Kidney Imaging Morphol (78700) |
$692.10 |
$1,538 |
1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$820.35 |
$1,823 |
1.7× |
| Knee 3 Views (73562) |
$317.25 |
$705 |
3.0× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$692.10 |
$1,538 |
1.4× |
| Leveen/Shunt Patency Exam (78291) |
$1,257.30 |
$2,794 |
2.6× |
| Liver & Spleen Imaging Static Only (78215) |
$954.90 |
$2,122 |
2.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$955.80 |
$2,124 |
2.0× |
| Liver imaging static only (78201) |
$1,632.15 |
$3,627 |
2.5× |
| Liver imaging w/vascular flow (78202) |
$1,632.15 |
$3,627 |
2.5× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,474.20 |
$3,276 |
2.3× |
| Lung perfusion differential (78597) |
$692.10 |
$1,538 |
1.4× |
| Lung Ventilat&Perfus Imaging (78582) |
$930.15 |
$2,067 |
1.4× |
| Lung Ventilation Imaging (78579) |
$852.75 |
$1,895 |
1.8× |
| Lymph System Imaging (78195) |
$1,264.50 |
$2,810 |
1.9× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$2,986.20 |
$6,636 |
1.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,908.60 |
$10,908 |
1.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$4,050.90 |
$9,002 |
1.1× |
| Magnetic Image Jaw Joint (70336) |
$3,002.40 |
$6,672 |
10.5× |
| Magnetic Resonance Elastography (76391) |
$729 |
$1,620 |
2.5× |
| Meckels Divert Exam (78290) |
$1,660.50 |
$3,690 |
3.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$423.45 |
$941 |
0.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,017.35 |
$4,483 |
4.5× |
| Mr safety determination physician/other qhp (76016) |
$87.30 |
$194 |
0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$24.30 |
$54 |
0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$90.90 |
$202 |
0.8× |
| Mr safety implt pos&/immoblj (76019) |
$58.95 |
$131 |
0.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$238.95 |
$531 |
0.8× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,457 |
$5,460 |
5.9× |
| MRA head w/o contrast (70544) |
$2,003.40 |
$4,452 |
7.0× |
| MRA head with contrast (70545) |
$2,344.95 |
$5,211 |
5.6× |
| MRA neck w contrast (70548) |
$3,357.90 |
$7,462 |
8.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,035.15 |
$8,967 |
9.7× |
| MRA neck w/o contrast (70547) |
$2,362.05 |
$5,249 |
8.3× |
| MRI abdomen w contrast (74182) |
$2,415.15 |
$5,367 |
5.8× |
| MRI abdomen w/o contrast (74181) |
$1,729.35 |
$3,843 |
6.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,707.10 |
$8,238 |
3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,099.95 |
$9,111 |
9.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,250.45 |
$5,001 |
2.4× |
| MRI bone marrow blood supply (77084) |
$2,172.60 |
$4,828 |
7.6× |
| MRI brain functional w/o physician admnistration (70554) |
$715.50 |
$1,590 |
2.5× |
| MRI brain functional w/physician admnistration (70555) |
$1,030.95 |
$2,291 |
3.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$557.55 |
$1,239 |
1.9× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$535.50 |
$1,190 |
1.9× |
| MRI cardiac w/o cont stress (75559) |
$4,190.40 |
$9,312 |
6.4× |
| MRI cardiac w/o contrast (75557) |
$1,696.95 |
$3,771 |
5.9× |
| MRI cervical spine w contrast (72142) |
$3,258 |
$7,240 |
7.8× |
| MRI cervical spine w/o cont (72141) |
$1,827.45 |
$4,061 |
6.4× |
| MRI chest w/o contrast (71550) |
$3,948.75 |
$8,775 |
13.8× |
| MRI chest with contrast (71551) |
$4,417.20 |
$9,816 |
4.7× |
| MRI chest wo w contrast (71552) |
$5,106.60 |
$11,348 |
12.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,437.65 |
$5,417 |
5.8× |
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 2 matching MRF lines |
$2,528.55–$2,633.40 |
$5,619–$5,852 |
varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,159.55 |
$4,799 |
7.6× |
| MRI lumbar spine w contrast (72149) |
$3,944.70 |
$8,766 |
9.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,669.40 |
$5,932 |
6.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,512.80 |
$5,584 |
8.8× |
| MRI orbit face neck w contrast (70542) |
$2,554.20 |
$5,676 |
6.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,713.95 |
$6,031 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,741.85 |
$6,093 |
6.6× |
| MRI pelvis w/o & w contrast (72197) |
$2,750.40 |
$6,112 |
6.6× |
| MRI pelvis w/o contrast (72195) |
$2,050.20 |
$4,556 |
7.2× |
| MRI spectroscopy (76390) |
$2,185.65 |
$4,857 |
21.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,832.85 |
$4,073 |
6.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,415.15 |
$5,367 |
5.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,185.65 |
$4,857 |
7.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,838.15 |
$6,307 |
6.8× |
| MRI, abdomen, combo (74183) |
$2,756.25 |
$6,125 |
6.6× |
| MRI, dorsal spine combo (72157) |
$3,938.85 |
$8,753 |
9.4× |
| MRI, dorsal spine contrast (72147) |
$3,600.90 |
$8,002 |
8.6× |
| MRI, joint upper extrem (73221) |
$1,984.95 |
$4,411 |
6.9× |
| MRI, joint upper extrem combo (73223) |
$4,129.20 |
$9,176 |
9.9× |
| MRI, lumbar spine combo (72158) |
$2,637.90 |
$5,862 |
6.3× |
| Musculoskeletal Nuclear Exam (78399) |
$692.10 |
$1,538 |
1.4× |
| Myelogram cervical (72240) |
$1,627.65 |
$3,617 |
1.7× |
| Myelogram Lumbar (72265) |
$1,627.65 |
$3,617 |
1.7× |
| Myelography thoracic (72255) |
$1,627.65 |
$3,617 |
1.7× |
| Myelograpy 2/more regions rs&i (72270) |
$1,627.65 |
$3,617 |
1.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$692.10 |
$1,538 |
1.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,942.10 |
$6,538 |
1.9× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$897.30 |
$1,994 |
1.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,365.20 |
$5,256 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,454.30 |
$5,454 |
1.6× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$2,640.60 |
$5,868 |
1.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,640.60 |
$5,868 |
1.5× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$4,298.40 |
$9,552 |
1.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$4,276.80 |
$9,504 |
1.6× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$4,189.50 |
$9,310 |
2.3× |
| N-invas est c ffr sw aly CTA (75580) |
$1,578.15 |
$3,507 |
1.5× |
| Neck soft tissue (70360) |
$186.30 |
$414 |
1.8× |
| Nervous system nuclear exam (78699) |
$692.10 |
$1,538 |
1.4× |
| Nm csf leak detection (78650) |
$2,343.15 |
$5,207 |
1.5× |
| Nm myocard infarct spect (78469) |
$1,653.75 |
$3,675 |
2.5× |
| Nm red cell survival study (78130) |
$692.10 |
$1,538 |
1.4× |
| Nm unlisted gi procedure (78299) |
$692.10 |
$1,538 |
1.4× |
| Nm whole blood volume (78122) |
$897.30 |
$1,994 |
1.4× |
| Nonvascular Shunt X-Ray (75809) |
$879.75 |
$1,955 |
7.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,780.70 |
$12,846 |
3.5× |
| Nuclear medicine study of endocrine organs (78099) |
$696.60 |
$1,548 |
1.5× |
| Nuclear Rx Intra-Arterial (79445) |
$959.85 |
$2,133 |
3.4× |
| Nuclear Rx Oral Admin (79005) |
$1,055.70 |
$2,346 |
3.8× |
| Ob us nuchal meas 1 gest (76813) |
$617.40 |
$1,372 |
4.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$545.40 |
$1,212 |
4.4× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$453.60 |
$1,008 |
3.6× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$855.90 |
$1,902 |
5.4× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$376.65 |
$837 |
3.0× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$385.65 |
$857 |
3.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$486 |
$1,080 |
3.9× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$123.75 |
$275 |
3.6× |
| Panoramic X-ray of jaws (70355) |
$185.85 |
$413 |
1.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,458 |
$3,240 |
2.2× |
| Parathyroid Planar Imaging (78070) |
$746.55 |
$1,659 |
1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,229.40 |
$2,732 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$230.40 |
$512 |
1.8× |
| Pet Image Skull-Thigh (78812) |
$2,640.60 |
$5,868 |
1.5× |
| Pet Image W/Ct Lmtd (78814) |
$2,640.60 |
$5,868 |
1.5× |
| PET image w/CT, full body (78816) |
$3,207.60 |
$7,128 |
1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,796.30 |
$6,214 |
1.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,365.20 |
$5,256 |
1.5× |
| Pet Myocardial Sngl Study (78491) |
$2,640.60 |
$5,868 |
1.5× |
| PET whole body (78813) |
$2,640.60 |
$5,868 |
1.5× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$2,325.60 |
$5,168 |
1.5× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) |
$2,325.60 |
$5,168 |
1.5× |
| Platelet survival study Non-Facility (78191) |
$692.10 |
$1,538 |
1.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,595.20 |
$14,656 |
1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$759.60 |
$1,688 |
1.6× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$627.30 |
$1,394 |
0.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$71.10 |
$158 |
0.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$896.40 |
$1,992 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$226.35 |
$503 |
2.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$235.80 |
$524 |
2.3× |
| Radex elbow complete minimum 3 views (73080) |
$282.15 |
$627 |
2.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$325.80 |
$724 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$187.65 |
$417 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$263.25 |
$585 |
2.5× |
| Radex Hand Minimum 3 Views (73130) |
$242.10 |
$538 |
2.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$278.10 |
$618 |
2.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$475.20 |
$1,056 |
3.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$275.40 |
$612 |
2.6× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$736.20 |
$1,636 |
7.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$186.30 |
$414 |
1.8× |
| Radex shoulder complete minimum 2 views (73030) |
$256.05 |
$569 |
2.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$263.70 |
$586 |
2.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$3,310.20 |
$7,356 |
15.7× |
| Radex Spine 1 View Specify Level (72020) |
$186.30 |
$414 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$259.20 |
$576 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$401.85 |
$893 |
3.9× |
| Radex Toe Minimum 2 Views (73660) |
$191.25 |
$425 |
1.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$238.95 |
$531 |
1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$292.95 |
$651 |
2.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$260.10 |
$578 |
2.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$13,771.35 |
$30,603 |
1.6× |
| Radiation treatment delivery level 1 (77402) |
$350.10 |
$778 |
2.9× |
| Radiation treatment delivery level 2 (77407) |
$464.40 |
$1,032 |
1.0× |
| Radiation treatment delivery level 3 (77412) |
$664.65 |
$1,477 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$244.80 |
$544 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$332.10 |
$738 |
2.7× |
| Radiologic exam colon double contrast study (74280) |
$1,802.25 |
$4,005 |
8.6× |
| Radiologic exam colon single contrast study (74270) |
$811.35 |
$1,803 |
3.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$401.40 |
$892 |
1.9× |
| Radiologic exam knee complete 4/more views (73564) |
$367.20 |
$816 |
2.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$277.65 |
$617 |
2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$898.20 |
$1,996 |
4.3× |
| Radiologic exam swallow function contrast study (74230) |
$412.20 |
$916 |
2.0× |
| Radiologic exam teeth complete full mouth (70320) |
$503.10 |
$1,118 |
1.8× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$472.50 |
$1,050 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$597.60 |
$1,328 |
2.8× |
| Radiologic examination femur 1 view (73551) |
$186.30 |
$414 |
1.8× |
| Radiologic examination femur minimum 2 views (73552) |
$186.30 |
$414 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$263.70 |
$586 |
2.5× |
| Radiologic Examination Osseous Survey Limited (77074) |
$341.55 |
$759 |
2.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$341.55 |
$759 |
3.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$228.60 |
$508 |
2.2× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$185.85 |
$413 |
1.8× |
| Radiopharm Dacryocystography (78660) |
$692.10 |
$1,538 |
1.4× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,278.45 |
$2,841 |
4.6× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$692.10 |
$1,538 |
1.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$897.30 |
$1,994 |
1.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,850.85 |
$4,113 |
4.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$636.75 |
$1,415 |
1.4× |
| Ribs bilateral 3 views (71110) |
$335.25 |
$745 |
2.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$931.05 |
$2,069 |
1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$931.50 |
$2,070 |
1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,739.15 |
$6,087 |
4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,356.65 |
$5,237 |
3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,764.45 |
$3,921 |
2.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,365.20 |
$5,256 |
1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,640.60 |
$5,868 |
1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,298.15 |
$5,107 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$895.50 |
$1,990 |
3.2× |
| Salivary Gland Function Study (78232) |
$692.10 |
$1,538 |
1.4× |
| Salivary Gland Imaging (78230) |
$692.10 |
$1,538 |
1.4× |
| Salivary Gland Imaging Serial Images (78231) |
$692.10 |
$1,538 |
1.4× |
| Scapula (73010) |
$221.85 |
$493 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$84.15 |
$187 |
3.6× |
| Shoulder 1 view (73020) |
$186.30 |
$414 |
1.8× |
| Sialogram (70390) |
$845.10 |
$1,878 |
3.0× |
| Skull less than 4 views (70250) |
$309.60 |
$688 |
2.5× |
| Special dosimetry (77331) |
$301.05 |
$669 |
1.9× |
| Special Physics Consult (77370) |
$640.35 |
$1,423 |
4.0× |
| Special teletherapy port plan (77321) |
$638.10 |
$1,418 |
1.4× |
| Special treatment procedure (77470) |
$1,062 |
$2,360 |
1.6× |
| Spleen Imaging (78185) |
$692.10 |
$1,538 |
1.4× |
| Stereotactic Body Radiation Delivery (77373) |
$6,891.30 |
$15,314 |
3.2× |
| Sternoclavicular joints (71130) |
$303.75 |
$675 |
2.9× |
| Superior sagittal sinus venogram (75870) |
$4,950.45 |
$11,001 |
1.3× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$68.85 |
$153 |
0.6× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$68.85 |
$153 |
0.6× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$25.20 |
$56 |
0.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$850.50 |
$1,890 |
7.0× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$154.80 |
$344 |
1.5× |
| Tbs technical calculation only (77091) |
$154.80 |
$344 |
1.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$748.80 |
$1,664 |
1.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$614.25 |
$1,365 |
1.4× |
| Testicular Imaging W/Flow (78761) |
$692.10 |
$1,538 |
1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,511.10 |
$3,358 |
3.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,390.50 |
$3,090 |
3.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$624.60 |
$1,388 |
3.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,660.05 |
$3,689 |
7.9× |
| Thoracic spine 2 views (72070) |
$238.95 |
$531 |
1.9× |
| Thoracic spine 3 views (72072) |
$238.95 |
$531 |
1.9× |
| Thoracolumbar 2 views (72080) |
$320.40 |
$712 |
3.1× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
$692.10 |
$1,538 |
1.4× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$692.10 |
$1,538 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$823.05 |
$1,829 |
1.7× |
| Thyroid Met Imaging Body (78018) |
$1,152 |
$2,560 |
1.8× |
| Thyroid Uptake Measurement (78012) |
$692.10 |
$1,538 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$833.40 |
$1,852 |
1.7× |
| Tx Devices Design & Construction Complex (77334) |
$944.10 |
$2,098 |
2.1× |
| Tx devices design & construction intermediate (77333) |
$455.85 |
$1,013 |
2.8× |
| Tx devices design & construction simple (77332) |
$445.05 |
$989 |
2.8× |
| Ultrasound Breast Limited (76642) |
$258.30 |
$574 |
2.5× |
| Ultrasound elastography first target lesion (76982) |
$190.80 |
$424 |
1.5× |
| Ultrasound Elastography Parenchyma (76981) |
$190.80 |
$424 |
1.5× |
| Ultrasound Exam Aaa Screen (76706) |
$190.80 |
$424 |
1.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$321.30 |
$714 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$436.50 |
$970 |
3.5× |
| Umbilical-artery Doppler (OB) (76820) |
$202.50 |
$450 |
1.6× |
| Unlis px ther radiol clinical tx planning (77299) |
$237.60 |
$528 |
1.5× |
| Unlisted Dx Radiographic Procedure (76499) |
$186.30 |
$414 |
1.8× |
| Unlisted fluoroscopic procedure (76496) |
$58.95 |
$131 |
0.6× |
| Unlisted genitourinary px dx nuclear medicine (78799) |
$692.10 |
$1,538 |
1.4× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) |
$692.10 |
$1,538 |
1.4× |
| Unlisted magnetic resonance procedure (76498) |
$1,543.95 |
$3,431 |
14.8× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$692.10 |
$1,538 |
1.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$2,248.20 |
$4,996 |
18.4× |
| Unlisted respiratory px dx nuclear medicine (78599) |
$696.60 |
$1,548 |
1.5× |
| Unlisted us procedure (76999) |
$818.10 |
$1,818 |
7.8× |
| Upper gi w/o kub (74240) |
$416.70 |
$926 |
2.0× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$153.90 |
$342 |
13.9× |
| Urea breath test c-14 isotopic analysis (78268) |
$247.95 |
$551 |
2.6× |
| Ureteral Reflux Study (78740) |
$1,159.65 |
$2,577 |
2.4× |
| Urethrocystogram voiding (74455) |
$599.40 |
$1,332 |
2.1× |
| Urethrocystography retrograde (74450) |
$520.65 |
$1,157 |
1.8× |
| Us breast unilateral complete (76641) |
$287.10 |
$638 |
2.3× |
| Us chest (76604) |
$306.90 |
$682 |
2.4× |
| Us complete joint (76881) |
$370.35 |
$823 |
3.0× |
| Us exam, pelvic, limited (76857) |
$317.25 |
$705 |
2.5× |
| Us head (76506) |
$619.20 |
$1,376 |
4.9× |
| Us kidney transplant (76776) |
$605.25 |
$1,345 |
4.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$222.75 |
$495 |
1.8× |
| Us ob detailed single fetus (76811) |
$765.90 |
$1,702 |
2.7× |
| Us ob limited 1 or more fetuses (76815) |
$350.55 |
$779 |
2.8× |
| Us ob transvaginal (76817) |
$446.40 |
$992 |
3.6× |
| Us pelvic non ob complete (76856) |
$483.30 |
$1,074 |
3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$412.65 |
$917 |
3.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$499.05 |
$1,109 |
4.0× |
| Us retroperitoneal complete (76770) |
$525.60 |
$1,168 |
4.2× |
| Us retroperitoneal limited (76775) |
$445.95 |
$991 |
3.6× |
| Us scrotum and contents (76870) |
$464.40 |
$1,032 |
3.7× |
| Us spinal canal and contents (76800) |
$662.40 |
$1,472 |
5.3× |
| Us thyroid (76536) |
$456.75 |
$1,015 |
3.6× |
| Us transrectal (76872) |
$534.15 |
$1,187 |
4.3× |
| Vascular Flow Imaging (78445) |
$855.90 |
$1,902 |
1.8× |
| Vein X-Ray Chest (75827) |
$2,712.60 |
$6,028 |
1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$5,245.20 |
$11,656 |
1.4× |
| Vein X-Ray Spleen/Liver (75810) |
$5,541.75 |
$12,315 |
1.5× |
| Venogram Sinus/Jugular (75860) |
$6,539.40 |
$14,532 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$6,595.20 |
$14,656 |
1.7× |
| Venography extremity bilateral rs&i (75822) |
$3,136.05 |
$6,969 |
1.7× |
| Venography extremity unilateral rs&i (75820) |
$2,599.65 |
$5,777 |
1.4× |
| Venography Orbital Rs&I (75880) |
$1,282.05 |
$2,849 |
1.7× |
| Venography Renal Bilateral (75833) |
$6,732.45 |
$14,961 |
1.8× |
| Venography Renal Unilateral (75831) |
$6,595.20 |
$14,656 |
1.7× |
| Venous sampling by catheter (75893) |
$11,162.70 |
$24,806 |
1.7× |
| Venous thrombosis imaging (78457) |
$1,632.15 |
$3,627 |
2.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,674 |
$3,720 |
3.5× |
| Wrist 2 views (73100) |
$261.90 |
$582 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$246.15 |
$547 |
2.4× |
| X-ray antegrade pyelogram tube (74425) |
$819.90 |
$1,822 |
2.0× |
| X-Ray Aorta Leg Arteries (75630) |
$6,595.20 |
$14,656 |
1.7× |
| X-Ray Bend Only L-S Spine (72120) |
$250.20 |
$556 |
2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$238.50 |
$530 |
2.3× |
| X-Ray Exam Breast Specimen (76098) |
$735.75 |
$1,635 |
1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$186.30 |
$414 |
1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$238.95 |
$531 |
1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$255.15 |
$567 |
2.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$186.30 |
$414 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$186.30 |
$414 |
1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$238.95 |
$531 |
1.9× |
X-Ray Exam Hips Bi 2 Views (73521)
range across 2 matching MRF lines |
$13.95–$189 |
$31–$420 |
varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$221.85 |
$493 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$347.85 |
$773 |
2.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$528.30 |
$1,174 |
4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$216.45 |
$481 |
2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$553.05 |
$1,229 |
4.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$326.25 |
$725 |
2.6× |
| X-ray eye for foreign body (70030) |
$239.85 |
$533 |
2.3× |
| X-ray head for orthodontia (70350) |
$186.30 |
$414 |
1.8× |
| X-ray humerus (73060) |
$253.35 |
$563 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$221.85 |
$493 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$266.40 |
$592 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$245.25 |
$545 |
2.0× |
| X-ray nose-rectum child f.b. (76010) |
$186.30 |
$414 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$364.95 |
$811 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$238.95 |
$531 |
1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$238.95 |
$531 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$215.10 |
$478 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$322.20 |
$716 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$388.35 |
$863 |
3.1× |
| X-Ray Stress View (77071) |
$258.75 |
$575 |
2.5× |
| X-ray thoracic spine 4 vw (72074) |
$239.85 |
$533 |
1.9× |
| X-Ray Tmj Unilat (70328) |
$256.05 |
$569 |
2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$655.65 |
$1,457 |
1.6× |
| X-Rays Bone Length Studies (77073) |
$194.40 |
$432 |
1.6× |
| X-Rays Bone Survey Complete (77075) |
$512.10 |
$1,138 |
4.1× |
| Xr c-spine 4 or 5 views (72050) |
$389.70 |
$866 |
3.1× |
| Xr facial bones less than 3 views (70140) |
$251.10 |
$558 |
2.4× |
| Xr myelogram posterior fossa (70010) |
$819.90 |
$1,822 |
2.0× |
| Xr orbits complete 4 views (70200) |
$363.15 |
$807 |
2.9× |