| 3-D radiotherapy plan dose-volume histograms (77295) |
$995 |
$9,950 |
0.7× |
| Abdomen 2 views (74019) |
$110.80 |
$1,108 |
1.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$302.10 |
$3,021 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$340.60 |
$3,406 |
0.1× |
| Angiography extremity unilateral rs&i (75710) |
$340.60 |
$3,406 |
0.1× |
| Angiography internal mammary rs&i (75756) |
$974.80 |
$9,748 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,121.80 |
$11,218 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$853 |
$8,530 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$974.80 |
$9,748 |
0.3× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,647.70 |
$16,477 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,424.80 |
$24,248 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$395.50 |
$3,955 |
0.1× |
| Ankle 2 views (73600) |
$106 |
$1,060 |
1.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$297 |
$2,970 |
0.8× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$743.90 |
$7,439 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$340.60 |
$3,406 |
0.1× |
| Aortography abdominal serialography rs&i (75625) |
$340.60 |
$3,406 |
0.1× |
| Arthrogram hip (73525) |
$62.20 |
$622 |
0.2× |
| Arthrogram shoulder (73040) |
$166.50 |
$1,665 |
0.5× |
| Arthrogram wrist (73115) |
$102.10 |
$1,021 |
0.3× |
| Arthrography knee lt (73580) |
$150.50 |
$1,505 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$60.20 |
$602 |
0.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$407.30 |
$4,073 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$407.30 |
$4,073 |
1.0× |
| Bone age studies (77072) |
$85 |
$850 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$838.40 |
$8,384 |
2.1× |
| Bone survey complete (77075) |
$180.90 |
$1,809 |
1.7× |
| Brachytx isodose complex (77318) |
$405.60 |
$4,056 |
1.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$168.60 |
$1,686 |
0.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$309.30 |
$3,093 |
0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$680.80 |
$6,808 |
0.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$254.70 |
$2,547 |
0.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$416.60 |
$4,166 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$117 |
$1,170 |
1.3× |
| Chest 1 view (71045) |
$59.80 |
$598 |
0.7× |
| Chest 3 views (71047) |
$91.50 |
$915 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$185.30 |
$1,853 |
1.1× |
| Clavicle complete (73000) |
$74.88 |
$748.75 |
0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$140.40 |
$1,404 |
1.3× |
| Continuing medical physics consltj pr wk (77336) |
$191.70 |
$1,917 |
1.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,266 |
$12,660 |
3.6× |
| CT abdomen and pelvis without contrast (74176) |
$564.30 |
$5,643 |
2.4× |
| CT abdomen w contrast (74160) |
$712.70 |
$7,127 |
4.0× |
| CT abdomen w wo contrast (74170) |
$1,065.60 |
$10,656 |
6.0× |
| CT abdomen w/o contrast (74150) |
$388 |
$3,880 |
3.7× |
| CT angio hrt w/3d image (75574) |
$1,038 |
$10,380 |
3.0× |
| CT angiography upper extremity lt (73206) |
$298 |
$2,980 |
1.7× |
| CT c-spine w/o contrast (72125) |
$340.20 |
$3,402 |
3.2× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$179.30 |
$1,793 |
1.0× |
| CT cervical spine w&w/o contrast (72127) |
$303.80 |
$3,038 |
1.7× |
| CT cervical spine with contrast (72126) |
$366.70 |
$3,667 |
1.0× |
| CT chest w/wo contrast (71270) |
$500.30 |
$5,003 |
2.8× |
| CT chest with contrast (71260) |
$621.30 |
$6,213 |
3.5× |
| CT head/brain with contrast (70460) |
$191 |
$1,910 |
1.1× |
| CT head/brain without and with contrast (70470) |
$292.20 |
$2,922 |
1.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$519.50 |
$5,195 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$156.30 |
$1,563 |
1.8× |
| CT hrt w/3d image congen (75573) |
$742.10 |
$7,421 |
2.1× |
| CT iac w contrast (70481) |
$181.50 |
$1,815 |
1.0× |
| CT limited/localized follow up study (76380) |
$62.30 |
$623 |
0.7× |
| CT lower ext w/o (73700) |
$254.38 |
$2,543.75 |
2.4× |
| CT lower extremity w wo contrast (73702) |
$325.12 |
$3,251.25 |
1.8× |
| CT lower extremity with contrast (73701) |
$286.50 |
$2,865 |
1.6× |
| CT lumbar spine w & w/o contrast (72133) |
$400.10 |
$4,001 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$431.40 |
$4,314 |
4.1× |
| CT lumbar spine with contrast (72132) |
$506.50 |
$5,065 |
1.4× |
| CT maxillofacial w contrast (70487) |
$186.50 |
$1,865 |
1.1× |
| CT maxillofacial w/o contrast (70486) |
$170.30 |
$1,703 |
1.6× |
| CT maxillofacial w/wo contrast (70488) |
$151.60 |
$1,516 |
0.9× |
| CT neck soft tissue w contrast (70491) |
$188.70 |
$1,887 |
1.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$204.50 |
$2,045 |
1.2× |
| CT orbits w/o contrast (70480) |
$160.90 |
$1,609 |
1.5× |
| CT pelvis w & w/o contrast (72194) |
$680 |
$6,800 |
3.9× |
| CT pelvis w/o contrast (72192) |
$163 |
$1,630 |
1.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$216.60 |
$2,166 |
1.2× |
| CT soft tissue neck w/o contrast (70490) |
$170.30 |
$1,703 |
1.6× |
| CT thoracic spine w/contrast (72129) |
$458.40 |
$4,584 |
2.6× |
| CT thoracic spine w/o contrast (72128) |
$402.30 |
$4,023 |
3.8× |
| CT thoracic spine w/wo contrast (72130) |
$497.90 |
$4,979 |
2.8× |
| CT thorax w/o contrast (71250) |
$543.20 |
$5,432 |
5.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$458.40 |
$4,584 |
2.6× |
| CT upper extremity w/o contrast rt (73200) |
$199 |
$1,990 |
1.9× |
| CT upper extremity with contrast (73201) |
$415.88 |
$4,158.75 |
1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,055.30 |
$10,553 |
6.0× |
| Cta Abdomen (74175) |
$726.90 |
$7,269 |
4.1× |
| CTA abdomen pelvis (74174) |
$964.20 |
$9,642 |
2.8× |
| CTA chest (71275) |
$690.20 |
$6,902 |
3.9× |
| Cta Head (70496) |
$358.50 |
$3,585 |
2.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$717 |
$7,170 |
2.0× |
| CTA lwr ext w&w/o contrast (73706) |
$369.75 |
$3,697.50 |
2.1× |
| Cta Neck (70498) |
$358.50 |
$3,585 |
2.0× |
| Cta Pelvis (72191) |
$237.50 |
$2,375 |
1.3× |
| Cystography minimum 3 views rs&i (74430) |
$75.60 |
$756 |
0.2× |
| Diskography lumbar (72295) |
$1,803.40 |
$18,034 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$58.10 |
$581 |
0.6× |
| Echoencephalography real time imaging (76506) |
$291.50 |
$2,915 |
2.8× |
| Esophagus (74220) |
$69.70 |
$697 |
0.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$266.60 |
$2,666 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$108.20 |
$1,082 |
0.5× |
| Foot 2 views (73620) |
$115 |
$1,150 |
1.3× |
| Forearm 2 views (73090) |
$120 |
$1,200 |
1.4× |
| Gated Heart Planar Single (78472) |
$1,002 |
$10,020 |
2.5× |
| Hand 2 views (73120) |
$149.50 |
$1,495 |
1.4× |
| Hand 3 views (73130) |
$109.75 |
$1,097.50 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$557.70 |
$5,577 |
0.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$632.90 |
$6,329 |
0.9× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$646.30 |
$6,463 |
1.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$486.60 |
$4,866 |
0.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$658.10 |
$6,581 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$657.10 |
$6,571 |
1.6× |
| Ht muscle image spect sing (78451) |
$359.80 |
$3,598 |
0.3× |
| Humerus Min 2 Views Left (73060) |
$117.25 |
$1,172.50 |
1.3× |
| Hysterosalpingogram (74740) |
$319.80 |
$3,198 |
1.3× |
| Interstitial radiation source applic complex (77778) |
$1,844.40 |
$18,444 |
2.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$776.10 |
$7,761 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$776.10 |
$7,761 |
1.4× |
| Knee 3 views (73562) |
$155.38 |
$1,553.75 |
1.8× |
| Liver & spleen imaging static only (78215) |
$334.70 |
$3,347 |
0.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$257.70 |
$2,577 |
0.6× |
| Liver imaging static only (78201) |
$200.60 |
$2,006 |
0.4× |
| Lung perf&ventilat diferentl (78598) |
$341.10 |
$3,411 |
0.6× |
| Lymphoscintigraphy (78195) |
$546.60 |
$5,466 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$286.20 |
$2,862 |
1.2× |
| Meckels Diverticulum (78290) |
$375.70 |
$3,757 |
0.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,434.70 |
$14,347 |
3.8× |
| Mr safety determination physician/other qhp (76016) |
$27.90 |
$279 |
0.3× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$18.80 |
$188 |
0.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$7.90 |
$79 |
0.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$29 |
$290 |
0.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$76.30 |
$763 |
0.3× |
| MRA head w & w/o contrast (70546) |
$426.90 |
$4,269 |
1.2× |
| MRA head w/o contrast (70544) |
$338.40 |
$3,384 |
1.4× |
| MRA head with contrast (70545) |
$346.30 |
$3,463 |
1.0× |
| MRA neck w contrast (70548) |
$346.30 |
$3,463 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$426.90 |
$4,269 |
1.2× |
| MRA neck w/o contrast (70547) |
$338.40 |
$3,384 |
1.4× |
| MRI abdomen w contrast (74182) |
$615.80 |
$6,158 |
1.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$831.10 |
$8,311 |
2.4× |
| MRI abdomen w/o contrast (74181) |
$369 |
$3,690 |
1.5× |
| MRI any jnt lwr ext with con lt (73722) |
$1,238.12 |
$12,381.25 |
1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,238.12 |
$12,381.25 |
1.6× |
| MRI breast w/o contrast bilateral (77047) |
$577.70 |
$5,777 |
2.4× |
| MRI c-spine with contrast (72142) |
$797.90 |
$7,979 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$160.20 |
$1,602 |
0.7× |
| MRI cervical spine w/o contrast (72141) |
$693.80 |
$6,938 |
2.9× |
| MRI chest w/o & w/contrast material (71552) |
$719.50 |
$7,195 |
2.1× |
| MRI chest w/o contrast (71550) |
$766.50 |
$7,665 |
3.2× |
| MRI fetal sngl/1st gestation (74712) |
$369.30 |
$3,693 |
1.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$761.90 |
$7,619 |
2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$734 |
$7,340 |
2.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$797.88 |
$7,978.75 |
3.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$392.90 |
$3,929 |
1.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$519.40 |
$5,194 |
1.5× |
| MRI orbit/face/neck w/contrast (70542) |
$451.70 |
$4,517 |
1.3× |
| MRI pelvis w contrast (72196) |
$439.90 |
$4,399 |
1.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$766.50 |
$7,665 |
2.2× |
| MRI pelvis w/o contrast (72195) |
$369.30 |
$3,693 |
1.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,139.10 |
$11,391 |
3.3× |
| MRI scan of leg joint before and after contrast (73723) |
$876.30 |
$8,763 |
2.5× |
| MRI spectroscopy (76390) |
$300.90 |
$3,009 |
3.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$809 |
$8,090 |
2.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$881.40 |
$8,814 |
2.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$893.80 |
$8,938 |
2.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$617 |
$6,170 |
1.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$893.80 |
$8,938 |
2.6× |
| MRI thoracic spine w/o contrast (72146) |
$766.50 |
$7,665 |
3.2× |
| MRI tmj (70336) |
$234.75 |
$2,347.50 |
1.0× |
| MRI upper ext joint w/o contrast (73221) |
$828.25 |
$8,282.50 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$613.40 |
$6,134 |
1.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$463.80 |
$4,638 |
1.9× |
| Myocardial infarct spect (78469) |
$432.20 |
$4,322 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$677.60 |
$6,776 |
0.5× |
| Neck soft tissue (70360) |
$84 |
$840 |
1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$160.10 |
$1,601 |
0.4× |
| Nm cisternogram (78630) |
$543 |
$5,430 |
1.0× |
| Nm gastric emptying study (78264) |
$764.30 |
$7,643 |
1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,128.20 |
$11,282 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$192.90 |
$1,929 |
0.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$70.60 |
$706 |
0.7× |
| Osseous survey infant (77076) |
$73.20 |
$732 |
0.7× |
| Osseous survey limited (77074) |
$258.30 |
$2,583 |
2.5× |
| Parathyrd planar w/spect&CT (78072) |
$559.80 |
$5,598 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$486.80 |
$4,868 |
1.2× |
| Parathyroid imaging (78070) |
$423.30 |
$4,233 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$24.40 |
$244 |
0.2× |
| Peritoneogram rs&i (74190) |
$201.90 |
$2,019 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$1,002.20 |
$10,022 |
0.7× |
| PET imaging CT for attenuation limited area (78814) |
$950.30 |
$9,503 |
0.7× |
| PET imaging for CT attenuation whole body (78816) |
$1,958.40 |
$19,584 |
1.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$844.10 |
$8,441 |
2.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,026.70 |
$10,267 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$946.30 |
$9,463 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$298.90 |
$2,989 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$841.70 |
$8,417 |
1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$119.60 |
$1,196 |
0.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$43.60 |
$436 |
0.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$47.90 |
$479 |
0.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$76.60 |
$766 |
0.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$56.50 |
$565 |
0.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$5,980.50 |
$59,805 |
0.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$685 |
$6,850 |
1.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$105.40 |
$1,054 |
1.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$520 |
$5,200 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$314.70 |
$3,147 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$68 |
$680 |
0.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$110.80 |
$1,108 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$65.90 |
$659 |
0.8× |
| Radiologic exam colon single contrast study (74270) |
$131.30 |
$1,313 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$294.30 |
$2,943 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$131.30 |
$1,313 |
0.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$33.75 |
$337.50 |
0.4× |
| Radiological examination surgical specimen (76098) |
$190.50 |
$1,905 |
0.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$340.60 |
$3,406 |
0.1× |
| Ribs bilateral 3 views (71110) |
$121.10 |
$1,211 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$153.60 |
$1,536 |
0.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$530 |
$5,300 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$676.50 |
$6,765 |
1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,169.50 |
$11,695 |
0.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,063.10 |
$10,631 |
0.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$106.50 |
$1,065 |
0.5× |
| Rp Therapy Intravenous Administration (79101) |
$111.30 |
$1,113 |
0.5× |
| Sacroiliac Joints < 3 Views (72200) |
$47.10 |
$471 |
0.4× |
| Salivary gland function study (78232) |
$318.60 |
$3,186 |
0.8× |
| Scanogram (77073) |
$57 |
$570 |
0.5× |
| Scapula complete (73010) |
$67.80 |
$678 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$49.90 |
$499 |
2.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$45.90 |
$459 |
0.4× |
| Simulation intermediate (77285) |
$315.30 |
$3,153 |
0.8× |
| Small bowel series (74250) |
$47.40 |
$474 |
0.3× |
| Spec medical radj physics consltj (77370) |
$97.90 |
$979 |
0.7× |
| Special dosimetry (77331) |
$139.60 |
$1,396 |
1.0× |
| Special treatment procedure (77470) |
$390.50 |
$3,905 |
0.7× |
| Spine thoracic 3 views (72072) |
$138.20 |
$1,382 |
1.3× |
| Stereotactic body radiation delivery (77373) |
$1,639.10 |
$16,391 |
0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$325.70 |
$3,257 |
0.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$112.10 |
$1,121 |
0.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$470.60 |
$4,706 |
1.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$252.30 |
$2,523 |
1.9× |
| Therapeutic Enema (74283) |
$55.50 |
$555 |
0.3× |
| Thoracolumbar 2 views (72080) |
$39.10 |
$391 |
0.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$653.80 |
$6,538 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$390.10 |
$3,901 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$463.70 |
$4,637 |
1.2× |
| Tmj unilateral (70328) |
$19.60 |
$196 |
0.2× |
| Treatment device intermediate (77333) |
$111.60 |
$1,116 |
0.8× |
| Treatment devices simple (77332) |
$85.60 |
$856 |
0.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$878.60 |
$8,786 |
1.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$135.60 |
$1,356 |
0.3× |
| Tx devices design & construction complex (77334) |
$319.70 |
$3,197 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$258.50 |
$2,585 |
2.5× |
| Unlisted magnetic resonance procedure (76498) |
$30.10 |
$301 |
0.3× |
| Upper Extremity Infant (73092) |
$55.50 |
$555 |
0.5× |
| Urethrocystography retrograde rs&i (74450) |
$119.60 |
$1,196 |
0.5× |
| Urethrocystography voiding (74455) |
$182.40 |
$1,824 |
0.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$168.60 |
$1,686 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$34.80 |
$348 |
0.3× |
| Us breast unilateral complete (76641) |
$129.40 |
$1,294 |
1.2× |
| Us breast unilateral limited (76642) |
$93.12 |
$931.25 |
1.1× |
| Us chest (76604) |
$258.50 |
$2,585 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$290.30 |
$2,903 |
2.8× |
| Us guided compression repair (76936) |
$93.60 |
$936 |
0.4× |
| Us infant hips dynamic (76885) |
$319.70 |
$3,197 |
3.7× |
| Us infant hips limited static (76886) |
$290.50 |
$2,905 |
3.3× |
| Us kidney transplant (76776) |
$138.90 |
$1,389 |
1.3× |
| Us ob transvaginal (76817) |
$70.60 |
$706 |
0.7× |
| Us pelvic non ob complete (76856) |
$330.50 |
$3,305 |
3.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$286.30 |
$2,863 |
2.7× |
| Us pregnancy ltd (76815) |
$125.40 |
$1,254 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$235.70 |
$2,357 |
2.2× |
| Us retroperitoneal complete (76770) |
$286.30 |
$2,863 |
2.7× |
| Us retroperitoneal limited (76775) |
$198.40 |
$1,984 |
1.9× |
| Us scrotum and contents (76870) |
$306.10 |
$3,061 |
2.9× |
| Us soft tissue head/neck (76536) |
$290.50 |
$2,905 |
2.8× |
| Us spinal canal and contents (76800) |
$79.10 |
$791 |
0.8× |
| Us xtr non-vasc lmtd (76882) |
$330.38 |
$3,303.75 |
3.1× |
| Venogram extremity bilateral (75822) |
$649.50 |
$6,495 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$340.60 |
$3,406 |
0.1× |
| Venography caval superior serialography rs&i (75827) |
$270.90 |
$2,709 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$479 |
$4,790 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,170.30 |
$11,703 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,063.90 |
$10,639 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$946.30 |
$9,463 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,730.90 |
$17,309 |
0.3× |
| Wrist 2 views (73100) |
$131.12 |
$1,311.25 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$135.40 |
$1,354 |
1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$28 |
$280 |
0.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$126.50 |
$1,265 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$142.80 |
$1,428 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$106.88 |
$1,068.75 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$127.50 |
$1,275 |
1.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$52 |
$520 |
0.5× |
| X-ray exam hip uni 1 view (73501) |
$19.70 |
$197 |
0.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$30.80 |
$308 |
0.4× |
| X-ray exam hip uni 4/> views (73503) |
$47.10 |
$471 |
0.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$120.60 |
$1,206 |
1.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$132.80 |
$1,328 |
1.3× |
| X-ray exam of femur 1 (73551) |
$43.75 |
$437.50 |
0.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$82.20 |
$822 |
0.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$561.10 |
$5,611 |
5.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$157.20 |
$1,572 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$129.88 |
$1,298.75 |
1.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$699.70 |
$6,997 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$90.25 |
$902.50 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$286.10 |
$2,861 |
3.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$170.88 |
$1,708.75 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$44.80 |
$448 |
0.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$54.88 |
$548.75 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$133.70 |
$1,337 |
1.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$179.60 |
$1,796 |
1.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$59 |
$590 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$29.20 |
$292 |
0.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$111.70 |
$1,117 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$437.30 |
$4,373 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$41.50 |
$415 |
0.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$185.70 |
$1,857 |
0.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$333.40 |
$3,334 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$93.80 |
$938 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$103.20 |
$1,032 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$151.10 |
$1,511 |
1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$51.80 |
$518 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$84.20 |
$842 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$109.12 |
$1,091.25 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$105.40 |
$1,054 |
1.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$69.30 |
$693 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$96.80 |
$968 |
0.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$40.70 |
$407 |
0.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$86.60 |
$866 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$25.70 |
$257 |
0.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$67.80 |
$678 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$128.90 |
$1,289 |
1.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$151.90 |
$1,519 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$47.50 |
$475 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$116.12 |
$1,161.25 |
1.3× |
| Xr arthrogram ankle (73615) |
$112.10 |
$1,121 |
0.3× |
| Xr c-spine 6 or more views (72052) |
$158.70 |
$1,587 |
1.5× |
| Xr chest 4+ views (71048) |
$100.60 |
$1,006 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$119.25 |
$1,192.50 |
1.4× |
| Xr shoulder 1 view (73020) |
$84.75 |
$847.50 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$138.20 |
$1,382 |
1.3× |
| Xr tibia/fibula 2 views (73590) |
$88.75 |
$887.50 |
1.0× |
| Xr tmj bilateral (70330) |
$25.60 |
$256 |
0.3× |
| Xray knee 1 or 2 views rt (73560) |
$129.88 |
$1,298.75 |
1.5× |