| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,927.20 |
$3,659 |
2.1× |
| Abdomen 1 View (74018) |
$109.60 |
$137 |
1.2× |
| Abdomen 2 views (74019) |
$187.20 |
$234 |
1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,029.60 |
$1,287 |
2.5× |
| Angio pulmonary bilat (75743) |
$2,811.20 |
$3,514 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$2,577.60 |
$3,222 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,543.20 |
$1,929 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,811.20 |
$3,514 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$628 |
$785 |
0.2× |
| Ankle 2 views (73600) |
$160 |
$200 |
1.8× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,387.20 |
$2,984 |
0.4× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$2,577.60 |
$3,222 |
0.5× |
| Artery X-Rays Pelvis (75736) |
$2,965.60 |
$3,707 |
0.5× |
| Basic radiation dosimetry calculation (77300) |
$220 |
$275 |
1.6× |
| Bone age studies (77072) |
$185.60 |
$232 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,025.60 |
$1,282 |
2.5× |
| Bone Imaging Limited Area (78300) |
$504 |
$630 |
1.2× |
| Bone Imaging Whole Body (78306) |
$888 |
$1,110 |
2.2× |
| Bone survey infant (77076) |
$311.20 |
$389 |
2.9× |
| Brachytx isodose complex (77318) |
$1,766.40 |
$2,208 |
4.6× |
| Brachytx isodose intermed (77317) |
$564 |
$705 |
1.5× |
| Brachytx Isodose Plan Simple (77316) |
$584 |
$730 |
1.5× |
| Brain Flow Imaging Only (78610) |
$500.80 |
$626 |
0.9× |
| Brain Image W/Flow < 4 Views (78601) |
$550.40 |
$688 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,910.40 |
$6,138 |
3.4× |
| Cat Scan Follow-Up Study (76380) |
$887.20 |
$1,109 |
10.0× |
| Cerebrospinal Fluid Scan (78630) |
$1,000 |
$1,250 |
1.8× |
| Chest 1 view (71045) |
$148 |
$185 |
1.7× |
| Chest 2 views (71046) |
$188 |
$235 |
2.1× |
| Chest 3 views (71047) |
$278.40 |
$348 |
3.1× |
| Chest 4 or more views (71048) |
$335.20 |
$419 |
3.1× |
| Clavicle complete (73000) |
$164 |
$205 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$489.60 |
$612 |
4.6× |
| Continuing medical physics consltj pr wk (77336) |
$443.20 |
$554 |
3.2× |
| Contrast Exam Abdominl Aorta (75625) |
$2,387.20 |
$2,984 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$220 |
$275 |
0.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,282.40 |
$4,103 |
9.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,313.60 |
$2,892 |
9.5× |
| CT abdomen w contrast (74160) |
$1,799.20 |
$2,249 |
10.0× |
| CT abdomen w wo contrast (74170) |
$2,098.40 |
$2,623 |
11.7× |
| CT abdomen w/o contrast (74150) |
$1,586.40 |
$1,983 |
14.9× |
| CT Angio Abdomen and Pelvis (74174) |
$3,192.80 |
$3,991 |
9.0× |
| CT Angio Chest (71275) |
$2,408.80 |
$3,011 |
13.4× |
| CT Angio Head (70496) |
$2,315.20 |
$2,894 |
12.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,741.60 |
$3,427 |
15.3× |
| CT Angio Neck (70498) |
$2,315.20 |
$2,894 |
12.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,756.80 |
$3,446 |
15.4× |
| CT cervical spine w/ contrast (72126) |
$1,661.60 |
$2,077 |
4.7× |
| CT cervical spine w/o contrast (72125) |
$1,389.60 |
$1,737 |
13.0× |
| CT cervical spine w/wo cont (72127) |
$1,661.60 |
$2,077 |
9.3× |
| CT chest w contrast (71260) |
$2,011.20 |
$2,514 |
11.2× |
| CT chest w/wo contrast (71270) |
$2,457.60 |
$3,072 |
13.7× |
| CT head/brain with contrast (70460) |
$1,331.20 |
$1,664 |
7.4× |
| CT head/brain without and with contrast (70470) |
$1,661.60 |
$2,077 |
9.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$423.20 |
$529 |
4.8× |
| CT iac w contrast (70481) |
$1,421.60 |
$1,777 |
7.9× |
| CT l-spine w&w/o contrast (72133) |
$2,397.60 |
$2,997 |
13.4× |
| CT lower ext w/o (73700) |
$1,630.40 |
$2,038 |
15.3× |
| CT lower extremity w/contrast material (73701) |
$1,656.80 |
$2,071 |
9.2× |
| CT lumbar spine w contrast (72132) |
$1,981.60 |
$2,477 |
5.6× |
| CT lumbar spine w/o contrast (72131) |
$1,576.80 |
$1,971 |
14.8× |
| CT maxillofacial w contrast (70487) |
$1,370.40 |
$1,713 |
7.6× |
| CT maxillofacial wo contrast (70486) |
$1,115.20 |
$1,394 |
10.4× |
| CT neck tissue combo (70492) |
$1,437.60 |
$1,797 |
8.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,636 |
$2,045 |
9.1× |
| CT orbits w/o contrast (70480) |
$1,204 |
$1,505 |
11.3× |
| CT pelvis w&w/o contrast (72194) |
$2,449.60 |
$3,062 |
13.7× |
| CT pelvis w/o contrast (72192) |
$1,451.20 |
$1,814 |
13.6× |
| CT scan of leg combo (73702) |
$2,152.80 |
$2,691 |
12.0× |
| CT scans face/jaw combo (70488) |
$1,720.80 |
$2,151 |
9.6× |
| CT soft tissue neck w contrast (70491) |
$1,754.40 |
$2,193 |
9.8× |
| CT soft tissue neck w/o contrast (70490) |
$915.20 |
$1,144 |
8.6× |
| CT thoracic spine w contrast (72129) |
$1,981.60 |
$2,477 |
11.1× |
| CT thoracic spine w/o contrast (72128) |
$1,656.80 |
$2,071 |
15.5× |
| CT thoracic spine w/wo cont (72130) |
$2,204 |
$2,755 |
12.3× |
| CT thorax w/o contrast (71250) |
$1,472.80 |
$1,841 |
13.8× |
| CT unlisted procedure (76497) |
$1,363.20 |
$1,704 |
15.3× |
| CT upper ext wo (73200) |
$1,393.60 |
$1,742 |
13.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,840 |
$2,300 |
10.3× |
| CT upper extremity with contrast (73201) |
$1,656.80 |
$2,071 |
4.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,892 |
$3,615 |
16.1× |
| Cta Abdomen (74175) |
$2,344 |
$2,930 |
13.1× |
| CTA pelvis (72191) |
$2,580 |
$3,225 |
14.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$393.60 |
$492 |
3.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$208 |
$260 |
1.9× |
| Dxa Bone Density Axial (77080) |
$269.60 |
$337 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$222.40 |
$278 |
2.5× |
| Echo exam of fetal heart (76825) |
$776.80 |
$971 |
1.4× |
| Echo exam uterus (76831) |
$326.40 |
$408 |
1.3× |
| Echo Guide For Artery Repair (76936) |
$623.20 |
$779 |
2.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$459.20 |
$574 |
1.9× |
| Echograp Trans R Pros Study (76873) |
$572.80 |
$716 |
5.4× |
| Esophagram (74220) |
$221.60 |
$277 |
1.2× |
| Fetal Biophys Profile W/Nst (76818) |
$384 |
$480 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$377.60 |
$472 |
3.5× |
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines |
$304–$316 |
$380–$395 |
varies |
| Foot 2 views (73620) |
$148 |
$185 |
1.7× |
| Forearm 2 views (73090) |
$175.20 |
$219 |
2.0× |
| Gastric emptying imaging study (78264) |
$860.80 |
$1,076 |
2.1× |
| Gated Heart Planar Single (78472) |
$720 |
$900 |
1.8× |
| GI Endoscopic US S&I (76975) |
$244.80 |
$306 |
1.0× |
| Hand 2 views (73120) |
$148 |
$185 |
1.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,291.20 |
$1,614 |
1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$513.60 |
$642 |
0.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$514.40 |
$643 |
0.2× |
| Hepatobil Syst Image W/Drug (78227) |
$1,404.80 |
$1,756 |
2.5× |
| Hepatobiliary System Imaging (78226) |
$891.20 |
$1,114 |
2.2× |
Ht Muscle Image Spect Sing (78451)
range across 4 matching MRF lines |
$448.80–$1,287.20 |
$561–$1,609 |
varies |
| Hysterosalpingogram (74740) |
$268.80 |
$336 |
1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$452 |
$565 |
5.1× |
| Joint Survey Single View (77077) |
$275.20 |
$344 |
2.6× |
| K Flow/Funct Image W/Drug (78708) |
$1,073.60 |
$1,342 |
1.9× |
| K Flow/Funct Image W/O Drug (78707) |
$810.40 |
$1,013 |
1.5× |
| Knee 3 Views (73562) |
$186.40 |
$233 |
2.1× |
| Liver & Spleen Imaging Static Only (78215) |
$679.20 |
$849 |
1.7× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,051.20 |
$1,314 |
1.9× |
| Lung perfusion differential (78597) |
$684 |
$855 |
1.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,005.60 |
$1,257 |
1.8× |
| Lung Ventilation Imaging (78579) |
$608 |
$760 |
1.5× |
| Lymph System Imaging (78195) |
$1,026.40 |
$1,283 |
1.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,112 |
$5,140 |
1.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$155.20 |
$194 |
0.0× |
| Magnetic Image Jaw Joint (70336) |
$1,512 |
$1,890 |
6.2× |
| Meckels Divert Exam (78290) |
$1,135.20 |
$1,419 |
2.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$621.60 |
$777 |
1.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,328.80 |
$4,161 |
9.3× |
| MRA head w/o contrast (70544) |
$2,309.60 |
$2,887 |
9.5× |
| MRA head with contrast (70545) |
$1,096 |
$1,370 |
3.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,633.60 |
$4,542 |
10.2× |
| MRA neck w/o contrast (70547) |
$1,815.20 |
$2,269 |
7.4× |
| MRI abdomen w contrast (74182) |
$2,291.20 |
$2,864 |
6.4× |
| MRI abdomen w/o contrast (74181) |
$1,992 |
$2,490 |
8.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,314.40 |
$2,893 |
2.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,957.60 |
$3,697 |
8.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,322.40 |
$2,903 |
2.9× |
| MRI bone marrow blood supply (77084) |
$2,331.20 |
$2,914 |
9.6× |
| MRI cervical spine w contrast (72142) |
$2,256.80 |
$2,821 |
6.3× |
| MRI cervical spine w/o cont (72141) |
$1,802.40 |
$2,253 |
7.4× |
| MRI chest w/o contrast (71550) |
$2,288 |
$2,860 |
9.4× |
| MRI chest wo w contrast (71552) |
$3,400.80 |
$4,251 |
9.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,809.60 |
$3,512 |
7.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,049.60 |
$3,812 |
8.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,284.80 |
$2,856 |
9.4× |
| MRI lumbar spine w contrast (72149) |
$2,471.20 |
$3,089 |
6.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,012.80 |
$3,766 |
8.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,841.60 |
$2,302 |
7.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,957.60 |
$3,697 |
8.3× |
| MRI pelvis w contrast (72196) |
$2,108 |
$2,635 |
5.9× |
| MRI pelvis w/o & w contrast (72197) |
$3,195.20 |
$3,994 |
9.0× |
| MRI pelvis w/o contrast (72195) |
$2,124 |
$2,655 |
8.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,920 |
$2,400 |
7.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,146.40 |
$2,683 |
8.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,957.60 |
$3,697 |
8.3× |
| MRI, abdomen, combo (74183) |
$3,170.40 |
$3,963 |
8.9× |
| MRI, dorsal spine combo (72157) |
$3,012.80 |
$3,766 |
8.5× |
| MRI, dorsal spine contrast (72147) |
$2,348.80 |
$2,936 |
6.6× |
| MRI, joint upper extrem (73221) |
$1,737.60 |
$2,172 |
7.1× |
| MRI, joint upper extrem combo (73223) |
$3,064 |
$3,830 |
8.6× |
| MRI, lumbar spine combo (72158) |
$3,012.80 |
$3,766 |
8.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,064 |
$2,580 |
1.6× |
| Neck soft tissue (70360) |
$92.80 |
$116 |
1.0× |
| Nm csf leak detection (78650) |
$997.60 |
$1,247 |
0.8× |
| Nonvascular Shunt X-Ray (75809) |
$196.80 |
$246 |
1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,613.60 |
$7,017 |
4.0× |
| Nuclear Rx Intra-Arterial (79445) |
$508.80 |
$636 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$442.40 |
$553 |
1.9× |
| Ob us nuchal meas 1 gest (76813) |
$288.80 |
$361 |
2.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$171.20 |
$214 |
1.6× |
| Optic foramina (70190) |
$213.60 |
$267 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$424 |
$530 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$807.20 |
$1,009 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$222.40 |
$278 |
2.1× |
| Pet Image W/Ct Lmtd (78814) |
$5,965.60 |
$7,457 |
4.1× |
| PET image w/CT, full body (78816) |
$6,262.40 |
$7,828 |
4.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$6,204.80 |
$7,756 |
4.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$798.40 |
$998 |
2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$194.40 |
$243 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$113.60 |
$142 |
0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$185.60 |
$232 |
2.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$149.60 |
$187 |
1.7× |
| Radex elbow complete minimum 3 views (73080) |
$222.40 |
$278 |
2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$292 |
$365 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$149.60 |
$187 |
1.7× |
| Radex foot complete minimum 3 views (73630) |
$165.60 |
$207 |
1.9× |
| Radex Hand Minimum 3 Views (73130) |
$185.60 |
$232 |
2.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$148 |
$185 |
1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$222.40 |
$278 |
2.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$246.40 |
$308 |
2.8× |
| Radex shoulder complete minimum 2 views (73030) |
$212 |
$265 |
2.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$185.60 |
$232 |
2.1× |
| Radex Spine 1 View Specify Level (72020) |
$126.40 |
$158 |
1.4× |
| Radex Sternum Minimum 2 Views (71120) |
$213.60 |
$267 |
2.4× |
| Radex Toe Minimum 2 Views (73660) |
$103.20 |
$129 |
1.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$229.60 |
$287 |
2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$211.20 |
$264 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$245.60 |
$307 |
2.3× |
Radiation Delivery Stereotactic Cranial Linear (77372)
range across 2 matching MRF lines |
$1,568.80–$12,304.80 |
$1,961–$15,381 |
varies |
| Radiation treatment delivery level 1 (77402) |
$443.20 |
$554 |
4.3× |
| Radiation treatment delivery level 2 (77407) |
$644.80 |
$806 |
1.6× |
| Radiation treatment delivery level 3 (77412) |
$687.20 |
$859 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$292 |
$365 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$152.80 |
$191 |
1.4× |
| Radiologic exam colon double contrast study (74280) |
$539.20 |
$674 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$378.40 |
$473 |
2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$233.60 |
$292 |
1.3× |
| Radiologic exam knee complete 4/more views (73564) |
$202.40 |
$253 |
1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$282.40 |
$353 |
2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$363.20 |
$454 |
2.0× |
| Radiologic exam swallow function contrast study (74230) |
$263.20 |
$329 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$305.60 |
$382 |
1.7× |
| Radiologic examination femur 1 view (73551) |
$77.60 |
$97 |
0.9× |
| Radiologic examination femur minimum 2 views (73552) |
$136.80 |
$171 |
1.5× |
| Radiologic examination knee 1/2 views (73560) |
$152 |
$190 |
1.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$162.40 |
$203 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$175.20 |
$219 |
2.0× |
| Ribs bilateral 3 views (71110) |
$324 |
$405 |
3.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,784 |
$2,230 |
3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,031.20 |
$1,289 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$158.40 |
$198 |
0.7× |
| Scapula (73010) |
$213.60 |
$267 |
2.0× |
| Shoulder 1 view (73020) |
$140.80 |
$176 |
1.6× |
| Skull less than 4 views (70250) |
$213.60 |
$267 |
2.0× |
| Special dosimetry (77331) |
$220 |
$275 |
1.6× |
| Special Physics Consult (77370) |
$533.60 |
$667 |
3.9× |
| Special teletherapy port plan (77321) |
$584 |
$730 |
1.5× |
| Special treatment procedure (77470) |
$1,459.20 |
$1,824 |
2.6× |
| Stereotactic Body Radiation Delivery (77373) |
$3,625.60 |
$4,532 |
2.0× |
| Sternoclavicular joints (71130) |
$235.20 |
$294 |
2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$584 |
$730 |
1.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$378.40 |
$473 |
1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,325.60 |
$1,657 |
3.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$908.80 |
$1,136 |
2.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$544.80 |
$681 |
4.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$340 |
$425 |
1.9× |
| Thoracic spine 2 views (72070) |
$243.20 |
$304 |
2.3× |
| Thoracic spine 3 views (72072) |
$292 |
$365 |
2.7× |
| Thoracolumbar 2 views (72080) |
$202.40 |
$253 |
2.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$828 |
$1,035 |
2.0× |
| Thyroid Met Imaging Body (78018) |
$957.60 |
$1,197 |
1.7× |
| Thyroid Uptake Measurement (78012) |
$319.20 |
$399 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$852 |
$1,065 |
2.1× |
| Tx Devices Design & Construction Complex (77334) |
$584 |
$730 |
1.5× |
| Tx devices design & construction intermediate (77333) |
$294.40 |
$368 |
2.1× |
| Tx devices design & construction simple (77332) |
$220 |
$275 |
1.6× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$141.60–$312 |
$177–$390 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$236 |
$295 |
2.2× |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
$211.20–$323.20 |
$264–$404 |
varies |
| Umbilical-artery Doppler (OB) (76820) |
$162.40 |
$203 |
1.5× |
| Upper gi w/o kub (74240) |
$248 |
$310 |
1.4× |
| Ureteral Reflux Study (78740) |
$611.20 |
$764 |
1.5× |
| Urethrocystogram voiding (74455) |
$342.40 |
$428 |
1.4× |
| Urethrocystography retrograde (74450) |
$307.20 |
$384 |
1.3× |
| Us bone density measurement (76977) |
$32 |
$40 |
0.3× |
| Us breast unilateral complete (76641) |
$312.80 |
$391 |
2.9× |
Us chest (76604)
range across 3 matching MRF lines |
$204.80–$248 |
$256–$310 |
varies |
| Us complete joint (76881) |
$421.60 |
$527 |
3.9× |
| Us exam, pelvic, limited (76857) |
$264.80 |
$331 |
2.5× |
| Us head (76506) |
$384 |
$480 |
3.6× |
| Us kidney transplant (76776) |
$461.60 |
$577 |
4.3× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines |
$132.80–$440 |
$166–$550 |
varies |
| Us ob detailed single fetus (76811) |
$338.40 |
$423 |
1.4× |
Us ob limited 1 or more fetuses (76815)
range across 3 matching MRF lines |
$194.40–$314.40 |
$243–$393 |
varies |
Us ob transvaginal (76817)
range across 2 matching MRF lines |
$87.20–$275.20 |
$109–$344 |
varies |
Us pelvic non ob complete (76856)
range across 2 matching MRF lines |
$364.80–$384.80 |
$456–$481 |
varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$497.60 |
$622 |
4.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$338.40 |
$423 |
3.2× |
| Us retroperitoneal complete (76770) |
$403.20 |
$504 |
3.8× |
Us retroperitoneal limited (76775)
range across 3 matching MRF lines |
$168–$338.40 |
$210–$423 |
varies |
| Us scrotum and contents (76870) |
$392 |
$490 |
3.7× |
| Us spinal canal and contents (76800) |
$304 |
$380 |
2.8× |
Us thyroid (76536)
range across 3 matching MRF lines |
$230.40–$372.80 |
$288–$466 |
varies |
| Us transrectal (76872) |
$443.20 |
$554 |
4.1× |
| Vein X-Ray Chest (75827) |
$355.20 |
$444 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$1,543.20 |
$1,929 |
0.5× |
| Venography extremity bilateral rs&i (75822) |
$526.40 |
$658 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$346.40 |
$433 |
0.2× |
| Venography Renal Bilateral (75833) |
$4,768 |
$5,960 |
1.5× |
| Venography Renal Unilateral (75831) |
$513.60 |
$642 |
0.2× |
| Wrist 2 views (73100) |
$100 |
$125 |
1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$292 |
$365 |
3.3× |
| X-ray antegrade pyelogram tube (74425) |
$342.40 |
$428 |
1.0× |
| X-Ray Aorta Leg Arteries (75630) |
$616.80 |
$771 |
0.2× |
| X-Ray Bend Only L-S Spine (72120) |
$115.20 |
$144 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$172 |
$215 |
1.9× |
| X-Ray Exam Breast Specimen (76098) |
$88 |
$110 |
0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$103.20 |
$129 |
1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$186.40 |
$233 |
1.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$357.60 |
$447 |
3.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$83.20 |
$104 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$122.40 |
$153 |
1.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$152 |
$190 |
1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$115.20 |
$144 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$136.80 |
$171 |
1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$162.40 |
$203 |
1.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$405.60 |
$507 |
3.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$204 |
$255 |
2.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$520 |
$650 |
4.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$297.60 |
$372 |
2.8× |
| X-ray humerus (73060) |
$175.20 |
$219 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$125.60 |
$157 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$160 |
$200 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$240 |
$300 |
2.2× |
| X-ray nose-rectum child f.b. (76010) |
$136.80 |
$171 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$340 |
$425 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$302.40 |
$378 |
2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$185.60 |
$232 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$271.20 |
$339 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$232 |
$290 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$204 |
$255 |
1.9× |
| X-ray thoracic spine 4 vw (72074) |
$456.80 |
$571 |
4.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$412.80 |
$516 |
1.2× |
| X-Rays Bone Length Studies (77073) |
$265.60 |
$332 |
2.5× |
| X-Rays Bone Survey Complete (77075) |
$629.60 |
$787 |
5.9× |
| Xr c-spine 4 or 5 views (72050) |
$360 |
$450 |
3.4× |
| Xr facial bones less than 3 views (70140) |
$206.40 |
$258 |
2.3× |
| Xr orbits complete 4 views (70200) |
$292 |
$365 |
2.7× |