| Acute gi blood loss imaging (78278) |
$999.97 |
$999.97 |
2.4× |
| Angio adrenal bilat select (75733) |
$1,397.97 |
$1,397.97 |
0.4× |
| Angio adrenal unilat select (75731) |
$1,207.50 |
$1,207.50 |
0.4× |
| Angio extremity unilateral (75710) |
$8,059.93 |
$8,059.93 |
2.4× |
| Angio pulmonary unilateral (75741) |
$3,665.55 |
$3,665.55 |
1.1× |
| Angiogram extremity bilateral (75716) |
$9,665.62 |
$9,665.62 |
2.9× |
| Angiogram pelvic (75736) |
$9,624.83 |
$9,624.83 |
1.7× |
| Angiography internal mammary rs&i (75756) |
$3,262.30 |
$3,262.30 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,740.59 |
$9,740.59 |
3.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$15,755.83 |
$15,755.83 |
2.7× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$711.11 |
$711.11 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,397.97 |
$1,397.97 |
0.4× |
| Ankle 2 views (73600) |
$469.67 |
$469.67 |
5.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$9,220.21 |
$9,220.21 |
2.8× |
| Arthrography knee lt (73580) |
$1,508.22 |
$1,508.22 |
4.1× |
| Arthrography wrist lt (73115) |
$1,691.24 |
$1,691.24 |
4.6× |
| Barium enema (74270) |
$1,306.46 |
$1,306.46 |
7.1× |
| Basic dosimetry (77300) |
$739.20 |
$739.20 |
5.3× |
| Bilat selctv renal venogram (75833) |
$11,570.74 |
$11,570.74 |
3.5× |
| Bone age studies (77072) |
$486.20 |
$486.20 |
4.5× |
| Bone imaging limited area (78300) |
$1,975.68 |
$1,975.68 |
4.7× |
| Bone marrow imaging whole body (78104) |
$1,080.45 |
$1,080.45 |
2.6× |
| Bone survey complete (77075) |
$825.77 |
$825.77 |
7.6× |
| Bowel imaging (78290) |
$429.98 |
$429.98 |
1.0× |
| Brain flow imaging only - nm brain flow only brain death (78610) |
$1,531.60 |
$1,531.60 |
2.7× |
| Brain image w/flow 4 + views (78606) |
$1,480.66 |
$1,480.66 |
2.6× |
| Card MRI w/stress img & dye (75563) |
$2,691.20 |
$2,691.20 |
3.3× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$3,975.62 |
$3,975.62 |
9.5× |
| Cardiac MRI w/stress img (75559) |
$2,691.20 |
$2,691.20 |
4.7× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$2,691.20 |
$2,691.20 |
7.4× |
| Cerebrospinal fluid leakage (78650) |
$2,741.51 |
$2,741.51 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,139.99 |
$1,139.99 |
6.2× |
| Cisternogram (78630) |
$2,518.11 |
$2,518.11 |
4.4× |
| Cisternography, positive contrast, radiological supervision and interpretation Other Diagnostic Radiology FS (70015) |
$2,767.28 |
$2,767.28 |
3.4× |
| Clavicle complete (73000) |
$791.60 |
$791.60 |
8.7× |
| Computed tomographic (CT) colonography, screening, including image postprocessing UNSCHEDULED (74263) |
$1,380.33 |
$1,380.33 |
5.5× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$3,223.98 |
$3,223.98 |
17.6× |
| Contrast exam abdominl aorta (75625) |
$9,588.44 |
$9,588.44 |
2.9× |
| Contrast exam thoracic aorta (75605) |
$9,254.39 |
$9,254.39 |
1.6× |
| Corpora cavernosography (74445) |
$547.94 |
$547.94 |
5.0× |
| CT - st neck w&wo contr (70492) |
$3,520.28 |
$3,520.28 |
19.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$9,402.12 |
$9,402.12 |
25.8× |
| CT abdomen and pelvis without contrast (74176) |
$7,644.74 |
$7,644.74 |
30.7× |
| CT abdomen w wo contrast (74170) |
$4,952.98 |
$4,952.98 |
27.0× |
| CT abdomen w/contrast (74160) |
$4,824.54 |
$4,824.54 |
26.3× |
| CT abdomen w/o contrast (74150) |
$4,286.52 |
$4,286.52 |
39.3× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$7,136.48 |
$7,136.48 |
19.6× |
| CT angio abdom w/o & w/dye (74175) |
$3,913.88 |
$3,913.88 |
21.4× |
| CT angio abdominal arteries (75635) |
$3,933.72 |
$3,933.72 |
21.5× |
| CT angio hrt w/3d image (75574) |
$2,234.77 |
$2,234.77 |
6.1× |
| CT angiograph pelv w/o&w/dye (72191) |
$3,776.06 |
$3,776.06 |
20.6× |
| CT cervical spine w/contrast (72126) |
$3,905.06 |
$3,905.06 |
10.7× |
| CT cervical spine w/o contrast (72125) |
$4,738.55 |
$4,738.55 |
43.4× |
| CT chest w/contrast (71260) |
$4,425.44 |
$4,425.44 |
24.2× |
| CT colonography diag w cont (74262) |
$1,652.65 |
$1,652.65 |
9.0× |
| CT colonography w/o cntrst (74261) |
$1,435.46 |
$1,435.46 |
13.1× |
| CT extremity upper w & w/o contrast (73202) |
$3,433.19 |
$3,433.19 |
18.7× |
| CT head/brain with contrast (70460) |
$3,708.81 |
$3,708.81 |
20.2× |
| CT head/brain without and with contrast (70470) |
$4,368.11 |
$4,368.11 |
23.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,169.72 |
$2,169.72 |
6.0× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$756.32 |
$756.32 |
8.3× |
| CT hrt w/3d image congen (75573) |
$2,169.72 |
$2,169.72 |
6.0× |
| CT limited/localized follow up study (76380) |
$789.39 |
$789.39 |
8.7× |
| CT lower ext w/wo contrast (73702) |
$4,343.48 |
$4,343.48 |
23.7× |
| CT lower extremity w contrast (73701) |
$3,780.11 |
$3,780.11 |
20.6× |
| CT lower extremity w/o contrast unilateral (73700) |
$5,863.20 |
$5,863.20 |
53.7× |
| CT lumbar spine w/contrast (72132) |
$4,171.86 |
$4,171.86 |
11.5× |
| CT lumbar spine w/o contrast (72131) |
$4,508.12 |
$4,508.12 |
41.3× |
| CT lumbar spine w/o then w/ con (72133) |
$4,254.55 |
$4,254.55 |
23.2× |
| CT maxillofacial area w/o contrast (70486) |
$3,384.68 |
$3,384.68 |
31.0× |
| CT maxillofacial w/contrast (70487) |
$3,419.40 |
$3,419.40 |
18.7× |
| CT maxillofacial w/o then w/ con (70488) |
$3,502.64 |
$3,502.64 |
19.1× |
| CT orbit sella ear w/o con (70480) |
$2,376.99 |
$2,376.99 |
21.8× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$3,578.16 |
$3,578.16 |
19.5× |
| CT pelvis w & w/o contrast (72194) |
$4,518.05 |
$4,518.05 |
24.7× |
| CT pelvis w/o contrast (72192) |
$3,326.24 |
$3,326.24 |
30.5× |
| CT soft tissue neck w/contrast (70491) |
$3,305.30 |
$3,305.30 |
18.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,164.21 |
$2,164.21 |
19.8× |
| CT spine cervical w/wo contrast (72127) |
$4,115.63 |
$4,115.63 |
22.5× |
| CT thoracic spine w/contrast (72129) |
$3,405.62 |
$3,405.62 |
18.6× |
| CT thoracic spine w/o contrast (72128) |
$3,519.18 |
$3,519.18 |
32.2× |
| CT thoracic spine w/o then w/ con (72130) |
$3,433.19 |
$3,433.19 |
18.7× |
| CT thorax lung cancer scr c- (71271) |
$1,620.68 |
$1,620.68 |
14.8× |
| CT thorax w/o contrast (71250) |
$3,834.50 |
$3,834.50 |
35.1× |
| CT thorax w/o then w/ contrast (71270) |
$4,679.01 |
$4,679.01 |
25.5× |
| CT upper extremity w/dye (73201) |
$3,124.49 |
$3,124.49 |
8.6× |
| CT upper extremity w/o contrast rt (73200) |
$2,897.37 |
$2,897.37 |
26.5× |
| CTA chest w/wo contrast (71275) |
$3,863.16 |
$3,863.16 |
21.1× |
| CTA head w contrast (70496) |
$3,881.90 |
$3,881.90 |
21.2× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$3,859.85 |
$3,859.85 |
21.1× |
| Cta Neck (70498) |
$3,881.90 |
$3,881.90 |
21.2× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$3,843.32 |
$3,843.32 |
21.0× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Other Diagnostic Radiology FS (70170) |
$199.55 |
$199.55 |
0.8× |
| Dilation ureters/urethra rs&i (74485) |
$637.25 |
$637.25 |
0.3× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) |
$934.92 |
$934.92 |
0.5× |
| Diskography lumbar (72295) |
$934.92 |
$934.92 |
0.5× |
| Doppler echo fetal spectral display complete (76827) |
$756.32 |
$756.32 |
6.9× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$472.97 |
$472.97 |
4.3× |
| Doppler fetal mid cerebral artery (76821) |
$962.48 |
$962.48 |
8.8× |
| Dxa bone density study axial skeleton (77085) |
$868.77 |
$868.77 |
8.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$552.35 |
$552.35 |
2.2× |
| Esophageal motility (78258) |
$576.61 |
$576.61 |
1.4× |
| Esophogram (74220) |
$984.53 |
$984.53 |
5.4× |
| Fetal biophysical profile non-stress testing (76818) |
$1,053.99 |
$1,053.99 |
9.7× |
| Fetal biophysical profile w/o nst (76819) |
$962.48 |
$962.48 |
8.8× |
| Fetal echo complete (76825) |
$1,396.87 |
$1,396.87 |
2.4× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$995.56 |
$995.56 |
4.0× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$3,087 |
$3,087 |
5.4× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit Age Under 21 (78265) |
$2,494.96 |
$2,494.96 |
6.0× |
| Gastric emptying study (78264) |
$635.04 |
$635.04 |
1.5× |
| Gastroesophageal reflux study (78262) |
$335.16 |
$335.16 |
0.8× |
| Gated heart planar single (78472) |
$1,087.62 |
$1,087.62 |
2.6× |
| Heart infarct image (78466) |
$565.58 |
$565.58 |
1.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$11,051.46 |
$11,051.46 |
3.4× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$11,051.46 |
$11,051.46 |
3.4× |
| Hepatobil syst image w/drug (78227) |
$1,750.77 |
$1,750.77 |
3.1× |
| Hepatobiliary system imaging (78226) |
$1,586.50 |
$1,586.50 |
3.8× |
| Humerus min 2 views (73060) |
$608.03 |
$608.03 |
6.7× |
| Hysterosalpingography (74740) |
$1,486.17 |
$1,486.17 |
6.0× |
| Ivp w tomography (74415) |
$2,005.45 |
$2,005.45 |
10.9× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$2,218.23 |
$2,218.23 |
3.9× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$3,028.57 |
$3,028.57 |
5.3× |
| Kidney w vascular flow (78701) |
$1,205.49 |
$1,205.49 |
2.9× |
| Liver & spleen; static only (78215) |
$1,586.50 |
$1,586.50 |
3.8× |
| Lung perf&ventilat diferentl (78598) |
$3,041.80 |
$3,041.80 |
5.4× |
| Lung perfusion differential (78597) |
$1,818.02 |
$1,818.02 |
4.4× |
| Lung ventilat&perfus imaging (78582) |
$2,604.11 |
$2,604.11 |
4.6× |
| Lung ventilation imaging (78579) |
$1,628.39 |
$1,628.39 |
3.9× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75803) |
$3,324.04 |
$3,324.04 |
2.0× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75807) |
$3,153.15 |
$3,153.15 |
1.0× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$5,241.29 |
$5,241.29 |
14.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$3,599.53 |
$3,599.53 |
9.9× |
| Mammary ductogram multiple ducts (77054) |
$1,416.71 |
$1,416.71 |
5.7× |
| Mammary ductogram single (77053) |
$1,416.71 |
$1,416.71 |
5.7× |
| Mr safety determination physician/other qhp (76016) |
$184.91 |
$184.91 |
2.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$124.74 |
$124.74 |
2.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$51.43 |
$51.43 |
1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$192.76 |
$192.76 |
1.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$510.76 |
$510.76 |
2.0× |
| MRA head w & w/o contrast (70546) |
$3,598.56 |
$3,598.56 |
9.9× |
| MRA head w/contrast (70545) |
$3,529.10 |
$3,529.10 |
9.7× |
| MRA head w/o contrast (70544) |
$2,911.70 |
$2,911.70 |
11.7× |
| MRA neck w/contrast (70548) |
$3,313.01 |
$3,313.01 |
9.1× |
| MRA neck w/o contrast (70547) |
$3,363.73 |
$3,363.73 |
13.5× |
| MRA neck w/wo contrast (70549) |
$3,556.67 |
$3,556.67 |
9.8× |
| MRI abdomen w/contrast (74182) |
$3,307.50 |
$3,307.50 |
9.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,255.65 |
$4,255.65 |
11.7× |
| MRI abdomen w/o contrast (74181) |
$3,400.11 |
$3,400.11 |
13.6× |
| MRI any jnt lwr ext with con lt (73722) |
$3,953.57 |
$3,953.57 |
4.8× |
| MRI bone marrow (77084) |
$3,195.05 |
$3,195.05 |
12.8× |
| MRI breast without contrast bilateral (77047) |
$1,368.20 |
$1,368.20 |
5.5× |
| MRI breast without contrast material unilateral (77046) |
$684.65 |
$684.65 |
2.7× |
| MRI cardiac w/o contrast (75557) |
$3,257.89 |
$3,257.89 |
13.1× |
| MRI cervical spine w/o contrast (72141) |
$4,390.16 |
$4,390.16 |
17.6× |
| MRI cervical spine with contrast (72142) |
$4,550.02 |
$4,550.02 |
12.5× |
| MRI chest w & w/o contrast (71552) |
$4,999.84 |
$4,999.84 |
13.7× |
| MRI chest w/contrast (71551) |
$4,846.59 |
$4,846.59 |
5.9× |
| MRI chest w/o contrast (71550) |
$4,695.55 |
$4,695.55 |
18.8× |
| MRI fetal sngl/1st gestation (74712) |
$778.37 |
$778.37 |
3.1× |
| MRI joint upper ext w/contrast (73222) |
$4,002.08 |
$4,002.08 |
4.9× |
| MRI joint upr extr w/o&w/dye (73223) |
$3,498.24 |
$3,498.24 |
9.6× |
| MRI joint upr extrem w/o dye (73221) |
$4,914.95 |
$4,914.95 |
19.7× |
| Mri Lower Extremity W/O Dye (73718) |
$4,152.94 |
$4,152.94 |
16.7× |
| MRI lumbar spine with contrast (72149) |
$3,774.96 |
$3,774.96 |
10.4× |
| MRI lumbar w/wo contrast (72158) |
$4,480.56 |
$4,480.56 |
12.3× |
| MRI lwr ext w/o jnts with con rt (73719) |
$3,485.37 |
$3,485.37 |
9.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,164.21 |
$2,164.21 |
5.9× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$2,467.76 |
$2,467.76 |
6.8× |
| MRI orbit/face/neck w/o contrast (70540) |
$2,015.37 |
$2,015.37 |
8.1× |
| MRI pelvis w/ contrast (72196) |
$2,949.19 |
$2,949.19 |
8.1× |
| MRI pelvis w/o contrast (72195) |
$2,830.12 |
$2,830.12 |
11.4× |
| MRI pelvis w/wo contrast (72197) |
$3,919.02 |
$3,919.02 |
10.8× |
| MRI spectroscopy (76390) |
$748.60 |
$748.60 |
8.2× |
| MRI spine cervical wo/w contrast (72156) |
$4,606.25 |
$4,606.25 |
12.6× |
| MRI spine thoracic w/contrast (72147) |
$3,849.93 |
$3,849.93 |
10.6× |
| MRI thoracic spine w wo contrast (72157) |
$3,901.75 |
$3,901.75 |
10.7× |
| MRI thoracic spine w/o contrast (72146) |
$3,813.55 |
$3,813.55 |
15.3× |
| MRI tmj (70336) |
$2,847.76 |
$2,847.76 |
11.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,165.06 |
$3,165.06 |
12.7× |
| Mri Upper Extremity W/Dye (73219) |
$2,770.58 |
$2,770.58 |
7.6× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$3,904.95 |
$3,904.95 |
10.7× |
| Myelogram thoracic (72255) |
$1,470.74 |
$1,470.74 |
1.8× |
| Myelography 2 or more regions (72270) |
$2,823.50 |
$2,823.50 |
3.4× |
| Myelography lumbosacral (72265) |
$4,555.53 |
$4,555.53 |
5.6× |
| Myocardial perfusion planar 1 study rest/stress (78453) |
$799.31 |
$799.31 |
0.6× |
| Myocardial perfusion planar multiple studies (78454) |
$2,138.85 |
$2,138.85 |
1.6× |
| Myocardial spect single study at rest or stress (78451) |
$2,299.82 |
$2,299.82 |
1.7× |
| Myocrd img PET metab eval single study (78459) |
$5,734.10 |
$5,734.10 |
4.2× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$2,091.60 |
$2,091.60 |
2.3× |
| Nm adrenal imaging (78075) |
$303.19 |
$303.19 |
0.2× |
| Nm bone 3 phase (78315) |
$1,995.53 |
$1,995.53 |
4.8× |
| Nm bone imaging whole body (78306) |
$2,130.03 |
$2,130.03 |
5.1× |
| Nm bone marrow scan limited (78102) |
$1,212.75 |
$1,212.75 |
2.9× |
| Nm heart perfusion spect stress rest (78452) |
$5,439.74 |
$5,439.74 |
4.0× |
| Nm kidney imaging morphology (78700) |
$1,149.91 |
$1,149.91 |
2.8× |
| Nm liver image static only (78201) |
$1,048.48 |
$1,048.48 |
1.8× |
| Nm lymph system (78195) |
$1,007.69 |
$1,007.69 |
1.8× |
| Nm thyroid imaging only (78013) |
$2,021.99 |
$2,021.99 |
4.8× |
| Nose to rectum for fb child (76010) |
$195.14 |
$195.14 |
2.1× |
| Nuclear medicine study of salivary gland with serial images (78231) |
$1,132.27 |
$1,132.27 |
2.7× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$449.82 |
$449.82 |
1.1× |
| Nuclear medicine study to assess blood clot in vein using radiolabeled peptide (78456) |
$449.82 |
$449.82 |
0.3× |
| Nuclear rx IV admin (79101) |
$931.61 |
$931.61 |
3.8× |
| Ob us < 14 wks single fetus (76801) |
$905.15 |
$905.15 |
8.3× |
| Ob us nuchal meas 1 gest (76813) |
$1,130.06 |
$1,130.06 |
10.4× |
| Oral radiopharm rx (79005) |
$4,160.84 |
$4,160.84 |
17.1× |
| Orthopantogram (70355) |
$394.70 |
$394.70 |
4.3× |
| Parathyrd planar w/spect&CT (78072) |
$2,091.44 |
$2,091.44 |
3.7× |
| Parathyroid imaging (78070) |
$1,049.58 |
$1,049.58 |
2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,035.22 |
$2,035.22 |
4.9× |
| Peritoneal-venous shunt patency test (78291) |
$1,038.56 |
$1,038.56 |
2.5× |
| Peritoneogram rs&i (74190) |
$2,686.79 |
$2,686.79 |
4.7× |
| PET brain metabolic eval (78608) |
$6,219.20 |
$6,219.20 |
4.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,294.14 |
$7,294.14 |
4.9× |
| PET imaging CT for attenuation limited area (78814) |
$5,908.30 |
$5,908.30 |
4.0× |
| PET imaging for CT attenuation whole body (78816) |
$7,365.80 |
$7,365.80 |
4.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,397.97 |
$1,397.97 |
0.4× |
| Pulmonary perfusion imaging particulate (78580) |
$841.21 |
$841.21 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,354.97 |
$1,354.97 |
2.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$174.20 |
$174.20 |
1.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$296.57 |
$296.57 |
2.7× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$567.79 |
$567.79 |
5.2× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$546.84 |
$546.84 |
5.0× |
| Radex hip unilateral with pelvis 1 view (73501) |
$179.71 |
$179.71 |
2.0× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$680.40 |
$680.40 |
7.5× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$300.98 |
$300.98 |
2.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$299.88 |
$299.88 |
2.7× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$567.79 |
$567.79 |
5.2× |
| Radex spine cervical 2 or 3 views (72040) |
$657.09 |
$657.09 |
7.2× |
| Radex spine cervical 4 or 5 views (72050) |
$999.97 |
$999.97 |
9.2× |
| Radex spine cervical 6 or more views (72052) |
$1,004.38 |
$1,004.38 |
9.2× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$868.88 |
$868.88 |
9.6× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$396.90 |
$396.90 |
3.6× |
| Radiologic exam esophagus double contrast study (74221) |
$983.43 |
$983.43 |
5.4× |
| Radiologic exam phrnx&/crv esoph contrast study (74210) |
$636.30 |
$636.30 |
3.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,120.14 |
$1,120.14 |
6.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,567.76 |
$1,567.76 |
8.6× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$180.81 |
$180.81 |
2.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$177.50 |
$177.50 |
2.0× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$657.09 |
$657.09 |
6.0× |
| Radiologic examination, mastoids; less than 3 views per side Other Diagnostic Radiology FS (70120) |
$560.70 |
$560.70 |
5.1× |
| Radiologic examination, salivary gland for calculus Other Diagnostic Radiology FS (70380) |
$198.45 |
$198.45 |
2.2× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) |
$776.16 |
$776.16 |
7.1× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$787.50 |
$787.50 |
7.2× |
| Renal cyst study (74470) |
$547.94 |
$547.94 |
1.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$839 |
$839 |
2.0× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$4,247.57 |
$4,247.57 |
7.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,860.65 |
$1,860.65 |
3.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,072.39 |
$2,072.39 |
3.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,642.63 |
$4,642.63 |
3.4× |
| Rp loclzj tum spect CT 2area/sep acquisj img (78832) |
$4,642.63 |
$4,642.63 |
3.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,092.48 |
$4,092.48 |
3.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$3,846.62 |
$3,846.62 |
15.8× |
| Saline infused sonohysterogram (76831) |
$1,194.01 |
$1,194.01 |
4.8× |
| Salivary gland funct study (78232) |
$1,074.94 |
$1,074.94 |
2.6× |
| Salivary gland imaging (78230) |
$1,132.27 |
$1,132.27 |
2.7× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$442.10 |
$442.10 |
18.9× |
Selective spinal angiogram (75705)
likely a partial charge, not the full procedure |
$1,582.09 |
$1,582.09 |
0.3× |
| Shoulder arthrogram (73040) |
$1,394.11 |
$1,394.11 |
3.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$281.98 |
$281.98 |
2.6× |
| Small bowel series (74250) |
$1,132.27 |
$1,132.27 |
6.2× |
| Spleen imaging only (78185) |
$363.83 |
$363.83 |
0.9× |
| Splenoportography (75810) |
$11,083.43 |
$11,083.43 |
3.4× |
| Superior sagittal sinus venogram (75870) |
$1,397.97 |
$1,397.97 |
0.4× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Other Diagnostic Radiology FS (70332) |
$1,048.95 |
$1,048.95 |
4.2× |
| Testicular imaging w/flow (78761) |
$352.80 |
$352.80 |
0.8× |
| Thyroid met imaging body (78018) |
$1,556.18 |
$1,556.18 |
2.7× |
| Thyroid uptake single/multiple quant measurement (78012) |
$987.84 |
$987.84 |
2.4× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$3,005.42 |
$3,005.42 |
7.2× |
| Ultrasound breast limited (76642) |
$869.87 |
$869.87 |
9.6× |
| Ultrasound, abdomen limited (76705) |
$1,840.07 |
$1,840.07 |
16.9× |
| Ultrasound, elastography; first target lesion (76982) |
$1,216.06 |
$1,216.06 |
11.1× |
| Umbilical-artery Doppler (OB) (76820) |
$674.73 |
$674.73 |
6.2× |
| Unlisted fluoroscopic procedure (76496) |
$636.30 |
$636.30 |
7.0× |
| Unlisted magnetic resonance procedure (76498) |
$2,980.79 |
$2,980.79 |
32.8× |
| Ureteral reflux study (78740) |
$2,132.24 |
$2,132.24 |
5.1× |
| Urethrocystography retrograde rs&i (74450) |
$1,205.03 |
$1,205.03 |
4.8× |
| Urethrocystography voiding (74455) |
$1,456.40 |
$1,456.40 |
5.8× |
| Urography antegrade (74425) |
$1,158.73 |
$1,158.73 |
3.2× |
| Urography retrograde w/wo kub (74420) |
$1,205.03 |
$1,205.03 |
3.3× |
| Urography, infusion, drip technique and/or bolus technique; Other Diagnostic Radiology FS (74410) |
$1,986.71 |
$1,986.71 |
10.8× |
| Us abdominal aorta real time screen study aaa (76706) |
$1,238.11 |
$1,238.11 |
11.3× |
| Us breast uni real time with image complete (76641) |
$1,287.72 |
$1,287.72 |
11.8× |
| Us chest (76604) |
$962.48 |
$962.48 |
8.8× |
| Us compl joint r-t w/image documentation (76881) |
$847.82 |
$847.82 |
7.8× |
| Us elastography parenchyma (76981) |
$710.01 |
$710.01 |
6.5× |
| Us encephalogram (76506) |
$638.40 |
$638.40 |
5.8× |
| Us guided compression repair (76936) |
$813.65 |
$813.65 |
3.6× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$847.82 |
$847.82 |
9.3× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$807.03 |
$807.03 |
8.9× |
| Us kidney transplanted (76776) |
$1,198.42 |
$1,198.42 |
11.0× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$616.85 |
$616.85 |
5.7× |
| Us ob detailed single fetus (76811) |
$989.49 |
$989.49 |
4.0× |
| Us ob followup per fetus (76816) |
$256.88 |
$256.88 |
2.4× |
| Us ob limited 1 or more fetuses (76815) |
$602.70 |
$602.70 |
5.5× |
| Us obstetric transvaginal (76817) |
$952.56 |
$952.56 |
8.7× |
| Us pelvic limited or f/u non-ob (76857) |
$955.87 |
$955.87 |
8.8× |
| Us pelvis complete (76856) |
$937.13 |
$937.13 |
8.6× |
| Us retroperitoneal complete (76770) |
$1,244.72 |
$1,244.72 |
11.4× |
| Us retroperitoneal limited (76775) |
$1,192.36 |
$1,192.36 |
10.9× |
| Us scrotum (76870) |
$792.70 |
$792.70 |
7.3× |
| Us soft tissue head/neck (76536) |
$884.21 |
$884.21 |
8.1× |
| Us spinal canal (76800) |
$457.54 |
$457.54 |
4.2× |
| Us transrectal (76872) |
$1,216.06 |
$1,216.06 |
11.1× |
| Us transrectal prostate volume (76873) |
$1,237.95 |
$1,237.95 |
11.3× |
| Us unlstd proc (76999) |
$781.65 |
$781.65 |
8.6× |
| Vasography, vesiculography, or epididymography, radiological supervision and interpretation Other Diagnostic Radiology… (74440) |
$636.30 |
$636.30 |
2.6× |
| Vein X-ray liver w/hemodynam (75885) |
$1,397.97 |
$1,397.97 |
0.4× |
| Venogram epidural (75872) |
$3,777.17 |
$3,777.17 |
5.8× |
| Venogram extremity bilateral (75822) |
$4,220.37 |
$4,220.37 |
2.6× |
| Venogram ivc w serialography (75825) |
$10,991.93 |
$10,991.93 |
3.3× |
| Venogram svc w serialography (75827) |
$3,120.08 |
$3,120.08 |
1.9× |
| Venography adrenal unilateral selective rs&i (75840) |
$895.23 |
$895.23 |
0.3× |
| Venography ext unilateral (75820) |
$2,422.35 |
$2,422.35 |
1.5× |
| Venography renal unilateral selective rs&i (75831) |
$5,943.58 |
$5,943.58 |
1.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,928.21 |
$3,928.21 |
1.2× |
| Venography, orbital, radiological supervision and interpretation Other Diagnostic Radiology FS (75880) |
$1,397.97 |
$1,397.97 |
2.1× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$1,397.97 |
$1,397.97 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$181.91 |
$181.91 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$362.72 |
$362.72 |
4.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$575.51 |
$575.51 |
6.3× |
| X-ray aorta leg arteries (75630) |
$9,214.70 |
$9,214.70 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,267.88 |
$1,267.88 |
6.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$409.03 |
$409.03 |
4.5× |
| X-ray exam hips bi 3-4 views (73522) |
$298.78 |
$298.78 |
2.7× |
| X-ray exam of finger(s) (73140) |
$357.21 |
$357.21 |
3.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$636.30 |
$636.30 |
3.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$554.56 |
$554.56 |
6.1× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$421.71 |
$421.71 |
4.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$616.57 |
$616.57 |
6.8× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$592.04 |
$592.04 |
5.4× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$606.10 |
$606.10 |
6.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$472.97 |
$472.97 |
5.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$554.56 |
$554.56 |
6.1× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$1,179.68 |
$1,179.68 |
13.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,004.38 |
$1,004.38 |
9.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$351.70 |
$351.70 |
3.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$820.26 |
$820.26 |
7.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,610.75 |
$1,610.75 |
14.8× |
| X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) |
$493.92 |
$493.92 |
4.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$461.40 |
$461.40 |
5.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$766.24 |
$766.24 |
7.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$509.36 |
$509.36 |
4.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$506.67 |
$506.67 |
4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$551.25 |
$551.25 |
6.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$622.91 |
$622.91 |
6.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,071.63 |
$1,071.63 |
11.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$928.31 |
$928.31 |
8.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$502.74 |
$502.74 |
4.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$272.32 |
$272.32 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$275.96 |
$275.96 |
3.0× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$653.78 |
$653.78 |
7.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$601.41 |
$601.41 |
6.6× |
| Xr abdomen 1 view (74018) |
$463.79 |
$463.79 |
5.1× |
| Xr abdomen 2 views (74019) |
$584.33 |
$584.33 |
5.4× |
| Xr abdomen 3 views (74021) |
$877.59 |
$877.59 |
8.0× |
| Xr arthrogram ankle (73615) |
$1,509.32 |
$1,509.32 |
4.1× |
| Xr arthrogram elbow (73085) |
$2,337.88 |
$2,337.88 |
6.4× |
| Xr arthrogram hip (73525) |
$1,508.22 |
$1,508.22 |
4.1× |
| Xr bone density axial (77080) |
$776.16 |
$776.16 |
7.1× |
| Xr bone length study (77073) |
$233.73 |
$233.73 |
2.1× |
| Xr bone survey infant (77076) |
$450.92 |
$450.92 |
4.1× |
| Xr bone survey limited (77074) |
$786.45 |
$786.45 |
7.2× |
| Xr chest 1 view (71045) |
$428.04 |
$428.04 |
4.7× |
| Xr chest 2 views (71046) |
$575.69 |
$575.69 |
6.3× |
| Xr chest 3 views (71047) |
$465.26 |
$465.26 |
5.1× |
| Xr cystogram 3+ views (74430) |
$1,273.39 |
$1,273.39 |
3.5× |
| Xr eye foreign body (70030) |
$176.10 |
$176.10 |
1.9× |
| Xr facial bones 3 views (70150) |
$588.74 |
$588.74 |
5.4× |
| Xr joint survey 1 view (77077) |
$245.86 |
$245.86 |
2.3× |
| Xr lower extremity 2 views infant (73592) |
$323.03 |
$323.03 |
3.6× |
| Xr lumbar spine 4 views w/ flex ext (72120) |
$741.98 |
$741.98 |
6.8× |
| Xr mandible 4 views (70110) |
$642.76 |
$642.76 |
5.9× |
| Xr myelogram c-spine (72240) |
$4,369.21 |
$4,369.21 |
5.3× |
| Xr nasal bones (70160) |
$429.98 |
$429.98 |
4.7× |
| Xr pelvis 3 views (72190) |
$813.65 |
$813.65 |
7.5× |
| Xr sella turcica (70240) |
$302.09 |
$302.09 |
3.3× |
| Xr sialogram (70390) |
$1,357.18 |
$1,357.18 |
5.4× |
| Xr spine 1 view (72020) |
$620.71 |
$620.71 |
6.8× |
| Xr sternum 2 views (71120) |
$732.06 |
$732.06 |
8.1× |
| Xr stress view joint (77071) |
$319.20 |
$319.20 |
3.5× |
| Xr surgical specimen (76098) |
$189.63 |
$189.63 |
0.3× |
| Xr upper extremity 2 views infant (73092) |
$517.07 |
$517.07 |
4.7× |
| Xray elbow 2 views (73070) |
$717.73 |
$717.73 |
7.9× |
| Xray forearm 2 views (73090) |
$585.15 |
$585.15 |
6.4× |
| Xray knee 1 or 2 views rt (73560) |
$630.63 |
$630.63 |
6.9× |
| Xray neck soft tissue (70360) |
$429.98 |
$429.98 |
4.7× |
| Xray orbits complete min 4 views (70200) |
$1,310.87 |
$1,310.87 |
12.0× |
| Xray pelvis 1 or 2 views (72170) |
$798.21 |
$798.21 |
7.3× |
| Xray ribs bilateral 3 views (71110) |
$517.07 |
$517.07 |
4.7× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$708.36 |
$708.36 |
6.5× |
| Xray scapula complete (73010) |
$505.50 |
$505.50 |
4.6× |
| Xray shoulder 1 view (73020) |
$398 |
$398 |
4.4× |
| Xray sinuses paranasal <3 views (70210) |
$280.04 |
$280.04 |
3.1× |
| Xray spine thoracic 2 views (72070) |
$847.82 |
$847.82 |
7.8× |
| Xray spine thoracic 3 views (72072) |
$495.02 |
$495.02 |
4.5× |
| Xray tibia-fibula 2 views bil (73590) |
$735 |
$735 |
8.1× |
| Xray tmj open - closed unilat (70328) |
$346.50 |
$346.50 |
3.8× |
| Xray tmj's bilateral open-clsc (70330) |
$685.76 |
$685.76 |
7.5× |