| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,124.05 |
$6,804.50 |
4.3× |
| Acute gi blood loss imaging (78278) |
$1,285.20 |
$1,428 |
3.1× |
| Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) |
$3,465 |
$3,850 |
1.1× |
| Ankle 2 views (73600) |
$175.50 |
$195 |
2.0× |
| Aortography, thoracic, by serialography, radiological supervision and interpretation Age Under 21 (75605) |
$7,774.20 |
$8,638 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$405 |
$450 |
2.9× |
| Brain imaging, positron emission tomography (PET); metabolic evaluation Age Under 21 (78608) |
$4,464 |
$4,960 |
3.1× |
| Clavicle complete (73000) |
$182.70 |
$203 |
2.1× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$2,651.40 |
$2,946 |
7.4× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$2,110.50 |
$2,345 |
11.8× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$2,380.50 |
$2,645 |
13.3× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,855.80 |
$2,062 |
10.4× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,645.20 |
$1,828 |
9.2× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,730.70 |
$1,923 |
9.7× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,110.50 |
$2,345 |
11.8× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$450 |
$500 |
2.5× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,800 |
$2,000 |
16.9× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$1,646.10 |
$1,829 |
9.2× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$450 |
$500 |
2.5× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,755 |
$1,950 |
9.8× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,471.50 |
$1,635 |
13.8× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,332.90 |
$1,481 |
7.4× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,210.50 |
$1,345 |
11.3× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$1,963.80 |
$2,182 |
11.0× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,883.25 |
$2,092.50 |
10.5× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$2,051.10 |
$2,279 |
11.4× |
| Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose… (77336) |
$615.60 |
$684 |
4.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,041.90 |
$4,491 |
11.3× |
| CT abdomen and pelvis without contrast (74176) |
$3,150.90 |
$3,501 |
12.9× |
| CT abdomen w & w/o contrast (74170) |
$2,205 |
$2,450 |
12.3× |
| CT abdomen w/contrast (74160) |
$1,926 |
$2,140 |
10.7× |
| CT abdomen w/o contrast (74150) |
$1,665 |
$1,850 |
15.6× |
| CT cervical spine w/contrast (72126) |
$1,777.50 |
$1,975 |
5.0× |
| CT cervical spine w/o contrast (72125) |
$1,639.80 |
$1,822 |
15.4× |
| CT chest w/contrast (71260) |
$1,771.20 |
$1,968 |
9.9× |
| CT extremity upper w & w/o contrast (73202) |
$1,646.10 |
$1,829 |
9.2× |
| CT extremity upper w/o contrast (73200) |
$1,710 |
$1,900 |
16.0× |
| CT head/brain with contrast (70460) |
$1,689.30 |
$1,877 |
9.4× |
| CT head/brain without and with contrast (70470) |
$1,967.40 |
$2,186 |
11.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$180 |
$200 |
2.0× |
| CT l-spine w/contrast (72132) |
$1,867.50 |
$2,075 |
5.2× |
| CT lower extremity w/dye (73701) |
$1,464.30 |
$1,627 |
8.2× |
| CT lumbar spine w/o contrast (72131) |
$1,728 |
$1,920 |
16.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,723.95 |
$1,915.50 |
9.6× |
| CT neck w/contrast (70491) |
$1,651.50 |
$1,835 |
9.2× |
| CT neck w/o contrast (70490) |
$1,271.70 |
$1,413 |
11.9× |
| CT pelvis w & w/o contrast (72194) |
$1,935.90 |
$2,151 |
10.8× |
| CT pelvis w/o contrast (72192) |
$1,633.50 |
$1,815 |
15.3× |
| CT thoracic spine w/contrast (72129) |
$1,866.60 |
$2,074 |
10.4× |
| CT thoracic spine w/o contrast (72128) |
$1,395 |
$1,550 |
13.1× |
| CT thorax lung cancer scr c- (71271) |
$315 |
$350 |
2.9× |
| CT thorax w/o contrast (71250) |
$1,516.50 |
$1,685 |
14.2× |
| CT upper extremity w/dye (73201) |
$967.50 |
$1,075 |
2.7× |
| CTA head w contrast (70496) |
$1,715.40 |
$1,906 |
9.6× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$427.50 |
$475 |
1.2× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$461.25 |
$512.50 |
4.3× |
| Dxa bone density/peripheral (77081) |
$290.70 |
$323 |
3.3× |
| Fetal biophysical profile non-stress testing (76818) |
$393.30 |
$437 |
3.7× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$489.60 |
$544 |
2.0× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,305 |
$1,450 |
2.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,175.85 |
$1,306.50 |
2.9× |
| Ht muscle image spect sing (78451) |
$3,006 |
$3,340 |
2.3× |
| Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial… (77301) |
$6,581.70 |
$7,313 |
4.7× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$778.95 |
$865.50 |
1.9× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$2,536.20 |
$2,818 |
6.6× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$2,077.65 |
$2,308.50 |
5.4× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,486.80 |
$1,652 |
2.7× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,486.80 |
$1,652 |
2.7× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,486.80 |
$1,652 |
2.7× |
| Lung perfusion imaging (78580) |
$1,159.20 |
$1,288 |
2.8× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$2,313 |
$2,570 |
6.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$652.50 |
$725 |
1.8× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,786.50 |
$1,985 |
7.3× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$2,312.55 |
$2,569.50 |
6.5× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$1,080 |
$1,200 |
3.0× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$1,337.85 |
$1,486.50 |
5.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$652.50 |
$725 |
1.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,009.70 |
$2,233 |
5.6× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,719 |
$1,910 |
4.8× |
| MRA head w/o contrast (70544) |
$1,215 |
$1,350 |
5.0× |
| MRA neck w/ contrast (70548) |
$1,080 |
$1,200 |
3.0× |
| MRA neck w/o contrast (70547) |
$1,035 |
$1,150 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$1,668.60 |
$1,854 |
6.8× |
| MRI abdomen w/wo contrast (74183) |
$1,942.20 |
$2,158 |
5.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,155.50 |
$2,395 |
2.7× |
| MRI breast c- bilateral (77047) |
$1,832.40 |
$2,036 |
7.5× |
| MRI c-spine w&w/o cont (72156) |
$2,811.60 |
$3,124 |
7.9× |
| MRI cervical spine w/contrast (72142) |
$2,062.80 |
$2,292 |
5.8× |
| MRI chest w/o contrast (71550) |
$1,602 |
$1,780 |
6.6× |
| MRI chest w/wo contrast (71552) |
$2,246.40 |
$2,496 |
6.3× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,313 |
$2,570 |
6.5× |
| MRI joint upr extrem w/dye (73222) |
$2,155.50 |
$2,395 |
2.7× |
| MRI joint upr extrem w/o dye (73221) |
$1,957.50 |
$2,175 |
8.0× |
| MRI lumbar spine w/contrast (72149) |
$2,255.40 |
$2,506 |
6.3× |
| MRI lumbar spine w/wo contrast (72158) |
$2,848.50 |
$3,165 |
8.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,465.10 |
$2,739 |
6.9× |
| MRI pelvis w & w/o contrast (72197) |
$2,726.10 |
$3,029 |
7.6× |
| MRI pelvis w/contrast (72196) |
$2,726.10 |
$3,029 |
7.6× |
| MRI pelvis w/o contrast (72195) |
$1,687.50 |
$1,875 |
6.9× |
| MRI spine cervical w/o contrast (72141) |
$1,941.75 |
$2,157.50 |
8.0× |
| MRI t-spine w&w/o cont (72157) |
$2,811.60 |
$3,124 |
7.9× |
| MRI thoracic spine w/contrast (72147) |
$2,061.90 |
$2,291 |
5.8× |
| MRI thoracic spine w/o contrst (72146) |
$1,827 |
$2,030 |
7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,310.40 |
$1,456 |
5.4× |
| Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per… (77338) |
$4,010.40 |
$4,456 |
10.5× |
| Myocardial spect multiple studies (78452) |
$3,433.50 |
$3,815 |
2.6× |
| N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) |
$2,893.05 |
$3,214.50 |
3.3× |
| Nm bone 3 phase (78315) |
$1,393.20 |
$1,548 |
3.4× |
| Nm bone imaging whole body (78306) |
$1,170 |
$1,300 |
2.9× |
| Nm gastric emptying (78264) |
$1,170 |
$1,300 |
2.9× |
| Nm lymph system (78195) |
$1,305 |
$1,450 |
2.4× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$997.20 |
$1,108 |
2.4× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$1,340.10 |
$1,489 |
3.3× |
| Ob us limited fetus(s) (76815) |
$253.80 |
$282 |
2.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,484.10 |
$1,649 |
2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,945.80 |
$2,162 |
4.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,978.70 |
$6,643 |
4.1× |
| PET imaging for CT attenuation whole body (78816) |
$6,632.10 |
$7,369 |
4.5× |
| Pulmonary ventilation & perfusion imaging (78582) |
$1,486.80 |
$1,652 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$549.45 |
$610.50 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$130.50 |
$145 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$355.50 |
$395 |
3.3× |
| Radex hip unilateral with pelvis 1 view (73501) |
$180 |
$200 |
2.0× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$198 |
$220 |
2.2× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$215.10 |
$239 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$238.50 |
$265 |
2.2× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$522 |
$580 |
4.9× |
| Radex spine cervical 2 or 3 views (72040) |
$292.50 |
$325 |
3.3× |
| Radex spine cervical 4 or 5 views (72050) |
$367.20 |
$408 |
3.4× |
| Radex spine cervical 6 or more views (72052) |
$553.50 |
$615 |
5.2× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$229.50 |
$255 |
2.6× |
| Radiation tx delivery lvl 1 (77402) |
$294.30 |
$327 |
2.8× |
| Radiation tx delivery lvl 3 (77412) |
$646.20 |
$718 |
1.1× |
| Radiologic exam chest 3 views (71047) |
$261.90 |
$291 |
2.9× |
| Radiologic exam chest 4+ views (71048) |
$352.80 |
$392 |
3.3× |
| Radiologic exam colon double contrast study (74280) |
$713.70 |
$793 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$437.40 |
$486 |
2.4× |
| Radiologic exam esophagus double contrast study (74221) |
$574.20 |
$638 |
3.2× |
| Radiologic exam esophagus single contrast study (74220) |
$574.20 |
$638 |
3.2× |
| Radiologic exam small int single contrast study (74250) |
$437.40 |
$486 |
2.4× |
| Radiologic exam swallow function contrast study (74230) |
$400.50 |
$445 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$574.20 |
$638 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$544.50 |
$605 |
3.0× |
| Radiologic examination femur 1 view (73551) |
$238.50 |
$265 |
2.7× |
| Radiologic examination femur minimum 2 views (73552) |
$202.50 |
$225 |
2.3× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$152.55 |
$169.50 |
1.7× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$226.80 |
$252 |
2.6× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$349.20 |
$388 |
3.3× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$193.50 |
$215 |
2.2× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$247.50 |
$275 |
2.8× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$133.20 |
$148 |
1.5× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$226.80 |
$252 |
2.6× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$231.30 |
$257 |
2.6× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$229.50 |
$255 |
2.1× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$168.75 |
$187.50 |
1.9× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$301.50 |
$335 |
2.8× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$274.50 |
$305 |
2.6× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$202.50 |
$225 |
1.9× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$675 |
$750 |
1.9× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$230.40 |
$256 |
2.6× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$172.35 |
$191.50 |
1.9× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$148.50 |
$165 |
1.4× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$274.50 |
$305 |
2.6× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$256.50 |
$285 |
2.4× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$387.90 |
$431 |
3.6× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$220.50 |
$245 |
2.5× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$179.55 |
$199.50 |
2.0× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$198 |
$220 |
2.2× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$145.35 |
$161.50 |
1.6× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$225.45 |
$250.50 |
2.1× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$181.35 |
$201.50 |
2.0× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$177.30 |
$197 |
2.0× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$140.85 |
$156.50 |
1.3× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$1,800 |
$2,000 |
3.2× |
| Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) |
$747 |
$830 |
3.1× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$436.50 |
$485 |
1.8× |
| Rp loclzj tum spect w/CT 1 (78830) |
$2,448 |
$2,720 |
1.9× |
| Rp loclzj tum spect w/CT 2 (78832) |
$2,745.90 |
$3,051 |
1.9× |
| Scapula complete (73010) |
$225 |
$250 |
2.1× |
| Screening digital breast tomosynthesis bi (77063) |
$77.40 |
$86 |
— |
| Special dosimetry (77331) |
$397.80 |
$442 |
2.9× |
| Special physics consult (77370) |
$600.75 |
$667.50 |
4.4× |
| Special treatment procedure (77470) |
$1,800 |
$2,000 |
3.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,190.70 |
$1,323 |
3.1× |
| Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium… (74283) |
$735.75 |
$817.50 |
4.1× |
| Thyroid met imaging body (78018) |
$913.05 |
$1,014.50 |
1.6× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,170 |
$1,300 |
2.9× |
| Tr simulation simple (77280) |
$1,642.50 |
$1,825 |
12.0× |
| Treatment device complex (77334) |
$1,190.70 |
$1,323 |
3.1× |
| Treatment device intermediate (77333) |
$1,030.50 |
$1,145 |
7.5× |
| Treatment device simple (77332) |
$495 |
$550 |
3.6× |
| Ultrasound breast limited (76642) |
$337.50 |
$375 |
3.8× |
| Ultrasound, abdomen limited (76705) |
$509.85 |
$566.50 |
4.8× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$355.50 |
$395 |
3.3× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$560.70 |
$623 |
5.2× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$536.85 |
$596.50 |
5.0× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$1,149.30 |
$1,277 |
10.8× |
| Unlisted fluoroscopic procedure (76496) |
$278.10 |
$309 |
3.1× |
| Urethrocystography retrograde rs&i (74450) |
$436.50 |
$485 |
1.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$552.60 |
$614 |
3.1× |
| Urography antegrade rs&i (74425) |
$404.10 |
$449 |
1.1× |
| Us abdominal aorta real time screen study aaa (76706) |
$364.50 |
$405 |
3.4× |
| Us breast uni real time with image complete (76641) |
$270 |
$300 |
2.5× |
| Us chest (76604) |
$270 |
$300 |
2.5× |
| Us encephalogram (76506) |
$417.15 |
$463.50 |
3.9× |
| Us exam, pelvic, limited (76857) |
$472.50 |
$525 |
4.4× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$256.95 |
$285.50 |
2.9× |
| Us ob transvaginal (76817) |
$558 |
$620 |
5.2× |
| Us retroperitoneal complete (76770) |
$972.90 |
$1,081 |
9.1× |
| Us retroperitoneal ltd (76775) |
$441.90 |
$491 |
4.1× |
| Us scrotum (76870) |
$541.80 |
$602 |
5.1× |
| Us soft tissue head/neck (76536) |
$486 |
$540 |
4.6× |
| Us unlstd proc (76999) |
$252 |
$280 |
2.8× |
| Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) |
$3,589.29 |
$3,988.10 |
1.1× |
| Venography, caval, superior, with serialography, radiological supervision and interpretation Age Under 21 (75827) |
$2,011.95 |
$2,235.50 |
1.3× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$2,547.45 |
$2,830.50 |
1.6× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$1,987.65 |
$2,208.50 |
1.2× |
| X-ray exam hips bi 3-4 views (73522) |
$301.50 |
$335 |
2.8× |
| X-ray exam of finger(s) (73140) |
$198 |
$220 |
2.2× |
| X-ray exam of knee 1 or 2 (73560) |
$202.50 |
$225 |
2.3× |
| X-ray exam ribs bil 3 views (71110) |
$301.50 |
$335 |
2.8× |
| X-ray exam ribs uni 2 views (71100) |
$193.50 |
$215 |
2.2× |
| X-ray heel (73650) |
$171 |
$190 |
1.9× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$292.50 |
$325 |
2.7× |
| X-ray retrograde pyelogram (74420) |
$659.70 |
$733 |
1.9× |
| Xr abdomen 1 view (74018) |
$212.40 |
$236 |
2.4× |
| Xr abdomen 2 views (74019) |
$292.50 |
$325 |
2.7× |
| Xr arthrogram elbow (73085) |
$675 |
$750 |
1.9× |
| Xr arthrogram hip (73525) |
$675 |
$750 |
1.9× |
| Xr arthrogram knee (73580) |
$565.65 |
$628.50 |
1.6× |
| Xr arthrogram wrist (73115) |
$444.60 |
$494 |
1.2× |
| Xr bone age studies (77072) |
$117 |
$130 |
1.1× |
| Xr bone length study (77073) |
$261 |
$290 |
2.4× |
| Xr bone survey infant (77076) |
$191.25 |
$212.50 |
1.8× |
| Xr bone survey ltd (77074) |
$238.50 |
$265 |
2.2× |
| Xr chest 1 view (71045) |
$182.70 |
$203 |
2.1× |
| Xr chest 2 views (71046) |
$225 |
$250 |
2.5× |
| Xr eye foreign body (70030) |
$306 |
$340 |
3.4× |
| Xr facial bones 3+ views (70150) |
$249.30 |
$277 |
2.3× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$226.80 |
$252 |
2.6× |
| Xr forearm 2 views (73090) |
$220.50 |
$245 |
2.5× |
| Xr hand 2v (73120) |
$211.50 |
$235 |
2.0× |
| Xr hysterosalpingogram (74740) |
$509.40 |
$566 |
2.1× |
| Xr neck soft tissue (70360) |
$103.50 |
$115 |
1.2× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$220.50 |
$245 |
2.5× |
| Xr osseous survey complete (77075) |
$495 |
$550 |
4.6× |
| Xr pelvis 1-2 views (72170) |
$211.50 |
$235 |
2.0× |
| Xr pelvis min 3 view (72190) |
$193.50 |
$215 |
1.8× |
| Xr sacrum/coccyx 2+ views (72220) |
$180 |
$200 |
2.0× |
| Xr shoulder 1 view (73020) |
$148.50 |
$165 |
1.7× |
| Xr sinuses 3+ views (70220) |
$267.30 |
$297 |
3.0× |
| Xr skull min 4 view (70260) |
$346.95 |
$385.50 |
3.2× |
| Xr spine 1 view (72020) |
$139.50 |
$155 |
1.6× |
| Xr spine thoracic 3v (72072) |
$2,285.10 |
$2,539 |
21.4× |
| Xr sternum 2+ views (71120) |
$207 |
$230 |
2.3× |
| Xr surgical specimen (76098) |
$553.50 |
$615 |
1.0× |
| Xr t-spine 2 views (72070) |
$352.80 |
$392 |
3.3× |
| Xr tibia/fibula 2 views (73590) |
$175.50 |
$195 |
2.0× |
| Xr tmj bilateral (70330) |
$208.80 |
$232 |
2.3× |
| Xr wrist 2 views (73100) |
$198 |
$220 |
2.2× |