| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,017.50 |
$6,690 |
3.6× |
| Abdomen 2 views (74019) |
$427.50 |
$570 |
4.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,998 |
$2,664 |
5.0× |
| Angiography extremity bilateral rs&i (75716) |
$8,959.50 |
$11,946 |
2.8× |
| Angiography extremity unilateral rs&i (75710) |
$9,095.25 |
$12,127 |
2.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,273.75 |
$12,365 |
1.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$865.50 |
$1,154 |
0.3× |
| Ankle 2 views (73600) |
$299.25 |
$399 |
3.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$649.12 |
$865.50 |
1.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$9,273.75 |
$12,365 |
2.9× |
| Aortography abdominal serialography rs&i (75625) |
$8,916.75 |
$11,889 |
2.8× |
| Arthrogram elbow (73085) |
$321 |
$428 |
0.9× |
| Arthrogram hip (73525) |
$353.62 |
$471.50 |
1.0× |
| Arthrogram shoulder (73040) |
$353.62 |
$471.50 |
1.0× |
| Arthrogram wrist (73115) |
$321 |
$428 |
0.9× |
| Arthrography knee lt (73580) |
$405 |
$540 |
1.2× |
| Basic radiation dosimetry calculation (77300) |
$1,131 |
$1,508 |
8.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,059 |
$1,412 |
2.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,535.25 |
$2,047 |
3.8× |
| Bone &/joint imaging whole body (78306) |
$1,911.38 |
$2,548.50 |
4.8× |
| Bone age studies (77072) |
$352.88 |
$470.50 |
3.4× |
| Bone Imaging 3 Phase (78315) |
$1,953 |
$2,604 |
4.9× |
| Bone survey complete (77075) |
$752.62 |
$1,003.50 |
7.2× |
| Brachytx isodose intermed (77317) |
$1,263.75 |
$1,685 |
3.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,263.75 |
$1,685 |
3.4× |
| Brain image w/flow 4 + views (78606) |
$1,288.50 |
$1,718 |
2.4× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$69 |
$92 |
6.2× |
| Cervical spine 2 or 3 views (72040) |
$331.50 |
$442 |
3.8× |
| Chest 1 view (71045) |
$309.38 |
$412.50 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$327 |
$436 |
1.9× |
| Clavicle complete (73000) |
$244.50 |
$326 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$933.38 |
$1,244.50 |
8.9× |
| Continuing medical physics consltj pr wk (77336) |
$582.75 |
$777 |
4.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,541.62 |
$6,055.50 |
13.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,477 |
$4,636 |
14.5× |
| CT abdomen w contrast (74160) |
$2,320.50 |
$3,094 |
13.2× |
| CT abdomen w wo contrast (74170) |
$2,727 |
$3,636 |
15.5× |
| CT abdomen w/o contrast (74150) |
$2,135.62 |
$2,847.50 |
20.4× |
| CT angio hrt w/3d image (75574) |
$993.75 |
$1,325 |
2.8× |
| CT angiography upper extremity lt (73206) |
$1,590 |
$2,120 |
9.1× |
| CT c-spine w/o contrast (72125) |
$2,727 |
$3,636 |
26.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,660.25 |
$3,547 |
15.1× |
| CT cervical spine with contrast (72126) |
$2,881.50 |
$3,842 |
8.2× |
| CT chest w/wo contrast (71270) |
$2,732.25 |
$3,643 |
15.6× |
| CT chest with contrast (71260) |
$2,320.50 |
$3,094 |
13.2× |
| CT head/brain with contrast (70460) |
$2,173.50 |
$2,898 |
12.4× |
| CT head/brain without and with contrast (70470) |
$2,577.75 |
$3,437 |
14.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$41.25 |
$55 |
0.5× |
| CT iac w contrast (70481) |
$2,661.75 |
$3,549 |
15.2× |
| CT limited/localized follow up study (76380) |
$394.50 |
$526 |
4.5× |
| CT lower ext w/o (73700) |
$1,863 |
$2,484 |
17.8× |
| CT lower extremity w wo contrast (73702) |
$1,815 |
$2,420 |
10.3× |
| CT lower extremity with contrast (73701) |
$1,521 |
$2,028 |
8.7× |
| CT lumbar spine w & w/o contrast (72133) |
$2,727 |
$3,636 |
15.5× |
| CT lumbar spine w/o contrast (72131) |
$2,727 |
$3,636 |
26.0× |
| CT lumbar spine with contrast (72132) |
$2,257.12 |
$3,009.50 |
6.5× |
| CT maxillofacial w contrast (70487) |
$2,213.25 |
$2,951 |
12.6× |
| CT maxillofacial w/o contrast (70486) |
$1,821.75 |
$2,429 |
17.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,246.25 |
$2,995 |
12.8× |
| CT neck soft tissue w contrast (70491) |
$2,190.38 |
$2,920.50 |
12.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,523 |
$3,364 |
14.4× |
| CT orbits w/o contrast (70480) |
$2,484 |
$3,312 |
23.7× |
| CT pelvis w & w/o contrast (72194) |
$2,692.12 |
$3,589.50 |
15.3× |
| CT pelvis w/o contrast (72192) |
$2,122.50 |
$2,830 |
20.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$607.50 |
$810 |
7.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,309.50 |
$1,746 |
7.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,948.88 |
$2,598.50 |
18.6× |
| CT thoracic spine w/contrast (72129) |
$2,231.25 |
$2,975 |
12.7× |
| CT thoracic spine w/o contrast (72128) |
$2,727 |
$3,636 |
26.0× |
| CT thoracic spine w/wo contrast (72130) |
$2,732.25 |
$3,643 |
15.6× |
| CT thorax w/o contrast (71250) |
$2,122.50 |
$2,830 |
20.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,788.38 |
$2,384.50 |
10.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,936.88 |
$2,582.50 |
18.5× |
| CT upper extremity with contrast (73201) |
$1,761.75 |
$2,349 |
5.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,268 |
$3,024 |
12.9× |
| Cta Abdomen (74175) |
$2,551.12 |
$3,401.50 |
14.5× |
| CTA abdomen pelvis (74174) |
$3,820.88 |
$5,094.50 |
10.9× |
| CTA chest (71275) |
$2,551.12 |
$3,401.50 |
14.5× |
| Cta Head (70496) |
$2,394.38 |
$3,192.50 |
13.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,642.75 |
$4,857 |
10.4× |
| Cta Neck (70498) |
$2,410.12 |
$3,213.50 |
13.7× |
| Cta Pelvis (72191) |
$2,589 |
$3,452 |
14.7× |
| Cystography minimum 3 views rs&i (74430) |
$164.62 |
$219.50 |
0.5× |
| Diskogram cervical (72285) |
$10,146.75 |
$13,529 |
5.2× |
| Diskography lumbar (72295) |
$9,663.75 |
$12,885 |
4.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$131.25 |
$175 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$373.12 |
$497.50 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$195.75 |
$261 |
2.2× |
| Echoencephalography real time imaging (76506) |
$1,051.50 |
$1,402 |
10.0× |
| Esophagus (74220) |
$552.75 |
$737 |
3.1× |
| Fetal biophysical profile non-stress testing (76818) |
$411 |
$548 |
3.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$669 |
$892 |
6.4× |
| Fluoroscopy up to 1 hr (76000) |
$648.75 |
$865 |
2.7× |
| Foot 2 views (73620) |
$276 |
$368 |
3.2× |
| Forearm 2 views (73090) |
$276 |
$368 |
3.2× |
| Gated Heart Planar Single (78472) |
$2,310.75 |
$3,081 |
5.8× |
| Hand 2 views (73120) |
$276 |
$368 |
2.6× |
| Hand 3 views (73130) |
$339.75 |
$453 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,663.25 |
$3,551 |
3.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,790.75 |
$3,721 |
4.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,678.88 |
$2,238.50 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,511.25 |
$2,015 |
3.8× |
| Ht muscle image spect sing (78451) |
$3,418.12 |
$4,557.50 |
2.6× |
| Humerus Min 2 Views Left (73060) |
$280.12 |
$373.50 |
3.2× |
| Hysterosalpingogram (74740) |
$277.50 |
$370 |
1.2× |
| Image fusion (77399) |
$396.38 |
$528.50 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$376.50 |
$502 |
3.6× |
| Kidney imaging morphology (78700) |
$1,526.25 |
$2,035 |
3.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,873.50 |
$2,498 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,013.38 |
$2,684.50 |
3.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,072.25 |
$2,763 |
3.8× |
| Knee 3 views (73562) |
$541.50 |
$722 |
6.2× |
| Liver & spleen imaging static only (78215) |
$1,224.75 |
$1,633 |
3.1× |
| Lung perf&ventilat diferentl (78598) |
$2,986.50 |
$3,982 |
5.5× |
| Lymphoscintigraphy (78195) |
$1,654.12 |
$2,205.50 |
3.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$207 |
$276 |
2.4× |
| Meckels Diverticulum (78290) |
$1,266.75 |
$1,689 |
3.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,295.25 |
$5,727 |
11.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$60.75 |
$81 |
2.1× |
| MRA head w & w/o contrast (70546) |
$1,605 |
$2,140 |
4.6× |
| MRA head w/o contrast (70544) |
$932.62 |
$1,243.50 |
3.9× |
| MRA head with contrast (70545) |
$1,661.25 |
$2,215 |
4.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$932.62 |
$1,243.50 |
2.7× |
| MRA neck w/o contrast (70547) |
$932.62 |
$1,243.50 |
3.9× |
| MRI abdomen w contrast (74182) |
$2,301.75 |
$3,069 |
6.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,226.38 |
$2,968.50 |
6.4× |
| MRI abdomen w/o contrast (74181) |
$2,226.38 |
$2,968.50 |
9.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,368.75 |
$1,825 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,301 |
$3,068 |
2.9× |
| MRI breast w/o contrast bilateral (77047) |
$2,226.38 |
$2,968.50 |
9.3× |
| MRI breast w/o contrast unilat (77046) |
$2,301.75 |
$3,069 |
9.6× |
| MRI c-spine with contrast (72142) |
$2,254.50 |
$3,006 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$2,226.38 |
$2,968.50 |
9.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,583 |
$3,444 |
7.4× |
| MRI chest w/o contrast (71550) |
$2,226.38 |
$2,968.50 |
9.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,301.75 |
$3,069 |
9.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,226.38 |
$2,968.50 |
9.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,498.25 |
$3,331 |
7.1× |
| MRI pelvis w contrast (72196) |
$2,301.75 |
$3,069 |
6.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,226.38 |
$2,968.50 |
6.4× |
| MRI pelvis w/o contrast (72195) |
$2,226.38 |
$2,968.50 |
9.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,226.38 |
$2,968.50 |
6.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,128.88 |
$2,838.50 |
6.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,498.25 |
$3,331 |
7.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,254.50 |
$3,006 |
6.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,498.25 |
$3,331 |
7.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,254.50 |
$3,006 |
6.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,498.25 |
$3,331 |
7.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,226.38 |
$2,968.50 |
9.3× |
| MRI tmj (70336) |
$2,301.75 |
$3,069 |
9.6× |
| MRI upper ext joint w/o contrast (73221) |
$2,226.38 |
$2,968.50 |
9.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,301.75 |
$3,069 |
6.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,301.75 |
$3,069 |
9.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$6,382.50 |
$8,510 |
4.9× |
| Myocardial Spect Multiple Studies (78452) |
$6,056.62 |
$8,075.50 |
4.7× |
| Neck soft tissue (70360) |
$212.25 |
$283 |
2.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$842.25 |
$1,123 |
2.2× |
| Nm gastric emptying study (78264) |
$1,680.38 |
$2,240.50 |
4.2× |
| Nm whole blood volume (78122) |
$1,949.25 |
$2,599 |
3.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,868.25 |
$6,491 |
3.5× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,984.50 |
$2,646 |
1.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$987 |
$1,316 |
0.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,526.25 |
$2,035 |
3.8× |
| Nuclear Rx Oral Admin (79005) |
$1,807.50 |
$2,410 |
7.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$309.75 |
$413 |
3.0× |
| Orthopantogram (70355) |
$168.75 |
$225 |
1.9× |
| Osseous survey infant (77076) |
$771 |
$1,028 |
7.4× |
| Parathyrd planar w/wo subtrj (78071) |
$1,289.62 |
$1,719.50 |
3.2× |
| Parathyroid imaging (78070) |
$1,251.75 |
$1,669 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$276 |
$368 |
2.6× |
| PET image w/CT, skull-thigh (78815) |
$6,201.75 |
$8,269 |
4.3× |
| PET imaging CT for attenuation limited area (78814) |
$6,382.50 |
$8,510 |
4.5× |
| PET imaging for CT attenuation whole body (78816) |
$6,201.75 |
$8,269 |
4.3× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$506.25 |
$675 |
0.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,301.75 |
$3,069 |
6.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$885 |
$1,180 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,414.50 |
$1,886 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$217.50 |
$290 |
0.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$250.88 |
$334.50 |
2.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$515.25 |
$687 |
4.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$388.50 |
$518 |
3.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,368 |
$1,824 |
2.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$547.12 |
$729.50 |
5.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,383 |
$1,844 |
3.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$379.12 |
$505.50 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$250.88 |
$334.50 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$331.50 |
$442 |
3.8× |
| Radiologic exam colon single contrast study (74270) |
$766.50 |
$1,022 |
4.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$697.50 |
$930 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$376.50 |
$502 |
4.3× |
| Radiological examination surgical specimen (76098) |
$1,078.50 |
$1,438 |
2.0× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$922.50 |
$1,230 |
2.3× |
| Ribs bilateral 3 views (71110) |
$427.50 |
$570 |
4.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,595.25 |
$2,127 |
4.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,310.75 |
$3,081 |
4.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,463.75 |
$3,285 |
4.5× |
| Rp Therapy Intravenous Administration (79101) |
$1,087.88 |
$1,450.50 |
4.7× |
| Sacroiliac Joints < 3 Views (72200) |
$219.38 |
$292.50 |
2.1× |
| Scanogram (77073) |
$158.62 |
$211.50 |
1.5× |
| Scapula complete (73010) |
$352.88 |
$470.50 |
3.4× |
| Screening digital breast tomosynthesis (77063) |
$172.50 |
$230 |
7.4× |
| Sialogram (70390) |
$257.25 |
$343 |
1.1× |
| Simulation intermediate (77285) |
$1,492.50 |
$1,990 |
4.0× |
| Small bowel series (74250) |
$766.50 |
$1,022 |
4.4× |
| Spec medical radj physics consltj (77370) |
$582.75 |
$777 |
4.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,450.12 |
$1,933.50 |
3.9× |
| Special dosimetry (77331) |
$600 |
$800 |
4.5× |
| Special treatment procedure (77470) |
$1,713 |
$2,284 |
3.1× |
| Spine thoracic 3 views (72072) |
$388.50 |
$518 |
3.7× |
| Stereotactic body radiation delivery (77373) |
$4,120.88 |
$5,494.50 |
2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,450.12 |
$1,933.50 |
3.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$600 |
$800 |
1.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,407.75 |
$1,877 |
3.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$582.75 |
$777 |
4.3× |
| Thoracolumbar 2 views (72080) |
$217.50 |
$290 |
2.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,207.25 |
$2,943 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$772.50 |
$1,030 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,276.50 |
$1,702 |
3.2× |
| Tomogram (76100) |
$225 |
$300 |
2.1× |
| Treatment device intermediate (77333) |
$1,109.25 |
$1,479 |
8.2× |
| Treatment devices simple (77332) |
$1,077.75 |
$1,437 |
8.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,310.62 |
$1,747.50 |
3.3× |
| Tx devices design & construction complex (77334) |
$1,108.88 |
$1,478.50 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$1,021.50 |
$1,362 |
9.8× |
| Umbilical-artery Doppler (OB) (76820) |
$417 |
$556 |
4.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$37.50 |
$50 |
0.4× |
| Unlisted procedure, therapeutic radiology clinical treatment planning 2nd-5th Sessions (77299) |
$549.75 |
$733 |
4.1× |
| Unlisted Ultrasound Procedure (76999) |
$609 |
$812 |
7.0× |
| Upper Extremity Infant (73092) |
$384.75 |
$513 |
3.7× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$537.75 |
$717 |
5.7× |
| Urethrocystography retrograde rs&i (74450) |
$280.12 |
$373.50 |
1.2× |
| Urethrocystography voiding (74455) |
$225 |
$300 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$824.25 |
$1,099 |
4.7× |
| Us abdl aorta screen aaa (76706) |
$396.75 |
$529 |
3.8× |
| Us breast unilateral complete (76641) |
$735 |
$980 |
7.0× |
| Us breast unilateral limited (76642) |
$735 |
$980 |
8.4× |
| Us chest (76604) |
$1,195.12 |
$1,593.50 |
11.4× |
| Us compl joint r-t w/image documentation (76881) |
$1,195.12 |
$1,593.50 |
11.4× |
| Us guided compression repair (76936) |
$1,230 |
$1,640 |
5.7× |
| Us kidney transplant (76776) |
$1,195.12 |
$1,593.50 |
11.4× |
| Us ob detailed single fetus (76811) |
$661.50 |
$882 |
2.8× |
| Us ob transvaginal (76817) |
$792 |
$1,056 |
7.6× |
| Us pelvic non ob complete (76856) |
$1,230.75 |
$1,641 |
11.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$512.25 |
$683 |
4.9× |
| Us pregnancy ltd (76815) |
$527.25 |
$703 |
5.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$464.62 |
$619.50 |
4.4× |
| Us retroperitoneal complete (76770) |
$1,195.12 |
$1,593.50 |
11.4× |
| Us retroperitoneal limited (76775) |
$1,021.50 |
$1,362 |
9.8× |
| Us scrotum and contents (76870) |
$1,195.12 |
$1,593.50 |
11.4× |
| Us soft tissue head/neck (76536) |
$1,172.25 |
$1,563 |
11.2× |
| Us spinal canal and contents (76800) |
$439.50 |
$586 |
4.2× |
| Us transrectal (76872) |
$261 |
$348 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$1,195.12 |
$1,593.50 |
11.4× |
| Vascular flow imaging (78445) |
$772.50 |
$1,030 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$9,273.75 |
$12,365 |
2.9× |
| Venography caval superior serialography rs&i (75827) |
$3,001.50 |
$4,002 |
1.9× |
| Venography extremity unilateral rs&i (75820) |
$2,892 |
$3,856 |
1.8× |
| Wrist 2 views (73100) |
$244.50 |
$326 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$669.75 |
$893 |
6.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$339.75 |
$453 |
3.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$543.38 |
$724.50 |
6.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$919.50 |
$1,226 |
5.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$276 |
$368 |
3.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$413.25 |
$551 |
4.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$765.75 |
$1,021 |
7.3× |
| X-ray exam hip uni 1 view (73501) |
$269.25 |
$359 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$456 |
$608 |
5.2× |
| X-ray exam hip uni 4/> views (73503) |
$579 |
$772 |
5.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$609.75 |
$813 |
5.8× |
| X-ray exam of femur 1 (73551) |
$236.25 |
$315 |
2.7× |
| X-ray eye for foreign body (70030) |
$269.25 |
$359 |
3.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$447 |
$596 |
4.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$352.88 |
$470.50 |
4.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$491.25 |
$655 |
5.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$362.25 |
$483 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$257.25 |
$343 |
3.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$703.50 |
$938 |
6.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$148.50 |
$198 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$375 |
$500 |
4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$540.75 |
$721 |
5.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$595.12 |
$793.50 |
5.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$292.12 |
$389.50 |
3.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$388.50 |
$518 |
4.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$379.12 |
$505.50 |
3.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$403.50 |
$538 |
3.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$614.25 |
$819 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$352.88 |
$470.50 |
4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$425.25 |
$567 |
4.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$367.50 |
$490 |
4.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$679.12 |
$905.50 |
7.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$379.12 |
$505.50 |
4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$427.50 |
$570 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$287.25 |
$383 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$225 |
$300 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$352.88 |
$470.50 |
4.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$379.12 |
$505.50 |
3.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$388.50 |
$518 |
3.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$510 |
$680 |
5.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$523.50 |
$698 |
6.0× |
| Xr arthrogram ankle (73615) |
$362.25 |
$483 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$609.75 |
$813 |
5.8× |
| Xr chest 4+ views (71048) |
$417 |
$556 |
4.0× |
| Xr finger(s) 2+ views (73140) |
$424.50 |
$566 |
4.9× |
| Xr shoulder 1 view (73020) |
$317.25 |
$423 |
3.6× |
| Xr spine cervical 4 or 5 views (72050) |
$512.25 |
$683 |
4.9× |
| Xr tibia/fibula 2 views (73590) |
$361.50 |
$482 |
4.1× |
| Xr tmj bilateral (70330) |
$376.50 |
$502 |
4.3× |
| Xray knee 1 or 2 views rt (73560) |
$330.75 |
$441 |
3.8× |