| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$1,947 |
— |
| Abdomen 1 View (74018) |
— |
$690 |
— |
| Abdomen 2 views (74019) |
— |
$831 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$3,600 |
— |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
— |
$1,392 |
— |
| Adrenal Cortex & Medulla Img (78075) |
— |
$5,205 |
— |
| Angio pulmonary bilat (75743) |
— |
$20,433 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$12,725 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$13,885 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$13,623 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$13,623 |
— |
| Ankle 2 views (73600) |
— |
$1,006 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$14,612 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$38,026 |
— |
| Arthrogram ankle (73615) |
— |
$1,501 |
— |
| Arthrogram hip (73525) |
— |
$3,684 |
— |
| Arthrogram Wrist (73115) |
— |
$3,846 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$527 |
— |
| Bone age studies (77072) |
— |
$295 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$3,008 |
— |
| Bone Imaging Limited Area (78300) |
— |
$6,493 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$1,576 |
— |
| Bone Imaging Whole Body (78306) |
— |
$2,230 |
— |
| Bone marrow imaging limited area (78102) |
— |
$851 |
— |
| Bone marrow imaging; multiple areas (78103) |
— |
$1,125 |
— |
| Bone marrow imaging; whole body (78104) |
— |
$1,291 |
— |
| Bone survey infant (77076) |
— |
$938 |
— |
| Brachytx isodose complex (77318) |
— |
$1,909 |
— |
| Brachytx isodose intermed (77317) |
— |
$1,199 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$867 |
— |
| Brain Flow Imaging Only (78610) |
— |
$1,122 |
— |
| Brain Image W/Flow < 4 Views (78601) |
— |
$1,331 |
— |
| Brain imaging < 4 static views (78600) |
— |
$1,119 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$1,998 |
— |
| Brain Imaging Minimum 4 Static Views (78605) |
— |
$1,229 |
— |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
— |
$3,419 |
— |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
— |
$3,416 |
— |
| Cardiac Shunt Detection (78428) |
— |
$1,744 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$798 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$2,449 |
— |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
— |
$1,874 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$2,182 |
— |
| Chest 1 view (71045) |
— |
$678 |
— |
| Chest 2 views (71046) |
— |
$757 |
— |
| Chest 3 views (71047) |
— |
$707 |
— |
| Chest 4 or more views (71048) |
— |
$462 |
— |
| Clavicle complete (73000) |
— |
$1,196 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$908 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$13,876 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$1,127 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$1,554 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$1,687 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$8,709 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$5,051 |
— |
| CT abdomen w contrast (74160) |
— |
$5,082 |
— |
| CT abdomen w wo contrast (74170) |
— |
$6,391 |
— |
| CT abdomen w/o contrast (74150) |
— |
$3,874 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$3,240 |
— |
| CT Angio Chest (71275) |
— |
$5,778 |
— |
| CT Angio Head (70496) |
— |
$5,047 |
— |
| CT angio hrt w/3d image (75574) |
— |
$1,494 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$3,094 |
— |
| CT Angio Neck (70498) |
— |
$3,271 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$2,679 |
— |
| CT bone density (77078) |
— |
$411 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$6,252 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$5,070 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$8,620 |
— |
| CT chest w contrast (71260) |
— |
$3,228 |
— |
| CT chest w/wo contrast (71270) |
— |
$3,583 |
— |
| CT colonography screening (74263) |
— |
$1,147 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$1,105 |
— |
| CT head/brain with contrast (70460) |
— |
$3,130 |
— |
| CT head/brain without and with contrast (70470) |
— |
$3,780 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$2,066 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$480 |
— |
| CT hrt w/3d image congen (75573) |
— |
$1,515 |
— |
| CT iac w contrast (70481) |
— |
$5,144 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$7,559 |
— |
| CT lower ext w/o (73700) |
— |
$3,874 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$5,918 |
— |
| CT lumbar spine w contrast (72132) |
— |
$6,160 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$4,655 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,876 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$3,445 |
— |
| CT neck tissue combo (70492) |
— |
$4,950 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$7,296 |
— |
| CT orbits w/o contrast (70480) |
— |
$4,432 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$4,442 |
— |
| CT pelvis w/o contrast (72192) |
— |
$2,499 |
— |
| CT scan of leg combo (73702) |
— |
$6,101 |
— |
| CT scans face/jaw combo (70488) |
— |
$4,810 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$3,772 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$3,140 |
— |
| CT thoracic spine w contrast (72129) |
— |
$7,351 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$4,655 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$8,140 |
— |
| CT thorax w/o contrast (71250) |
— |
$2,039 |
— |
| CT unlisted procedure (76497) |
— |
$476 |
— |
| CT upper ext wo (73200) |
— |
$4,743 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$7,309 |
— |
| CT upper extremity with contrast (73201) |
— |
$6,596 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$6,789 |
— |
| Cta Abdomen (74175) |
— |
$3,870 |
— |
| CTA pelvis (72191) |
— |
$3,970 |
— |
| Dilation ureters/urethra rs&i (74485) |
— |
$2,836 |
— |
| Discography Cerv/Thor Spine (72285) |
— |
$4,944 |
— |
| Diskography lumbar (72295) |
— |
$4,944 |
— |
| Dxa Bone Density Axial (77080) |
— |
$1,628 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$964 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$1,905 |
— |
| Echograp Trans R Pros Study (76873) |
— |
$533 |
— |
| Esophageal Motility Study (78258) |
— |
$1,318 |
— |
| Esophagram (74220) |
— |
$1,691 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$2,084 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$1,581 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$1,670 |
— |
| Follow-Up Angiography (75898) |
— |
$4,695 |
— |
| Foot 2 views (73620) |
— |
$971 |
— |
| Forearm 2 views (73090) |
— |
$1,077 |
— |
| Gastric emptying imaging study (78264) |
— |
$5,382 |
— |
| Gastric Mucosa Imaging (78261) |
— |
$1,318 |
— |
| Gastroesophageal Reflux Exam (78262) |
— |
$1,318 |
— |
| Gated Heart Planar Single (78472) |
— |
$4,737 |
— |
| Gated Heart, Multiple (78473) |
— |
$6,391 |
— |
| Hand 2 views (73120) |
— |
$981 |
— |
| Heart first pass single,planar (78481) |
— |
$2,725 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$4,278 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$3,700 |
— |
| Ht Musc Image Planar Mult (78454) |
— |
$8,391 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$6,720 |
— |
| Hysterosalpingogram (74740) |
— |
$1,105 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$359 |
— |
| Infant hip ultrasound, limited static exam (76886) |
— |
$314 |
— |
| Infusion Ivp (74410) |
— |
$4,043 |
— |
| Interstitial radiation source applic complex (77778) |
— |
$6,937 |
— |
| Joint Survey Single View (77077) |
— |
$407 |
— |
| K Flow/Funct Image Multiple (78709) |
— |
$5,690 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$4,894 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$6,217 |
— |
| Kidney Imaging Morphol (78700) |
— |
$3,519 |
— |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
— |
$3,519 |
— |
| Knee 3 Views (73562) |
— |
$1,390 |
— |
| Leveen/Shunt Patency Exam (78291) |
— |
$1,066 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$1,889 |
— |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
— |
$1,171 |
— |
| Liver imaging static only (78201) |
— |
$1,331 |
— |
| Liver imaging w/vascular flow (78202) |
— |
$1,509 |
— |
| Lung perfusion differential (78597) |
— |
$1,000 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$2,647 |
— |
| Lymph System Imaging (78195) |
— |
$4,488 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$924 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$685 |
— |
| Meckels Divert Exam (78290) |
— |
$1,318 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$8,221 |
— |
| MRA head w/o contrast (70544) |
— |
$4,419 |
— |
| MRA head with contrast (70545) |
— |
$8,221 |
— |
| MRA neck w contrast (70548) |
— |
$4,099 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$8,221 |
— |
| MRA neck w/o contrast (70547) |
— |
$3,333 |
— |
| MRI abdomen w contrast (74182) |
— |
$12,015 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$11,723 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$12,298 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$12,582 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$11,024 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$4,740 |
— |
| MRI Breast Without Contrast Material Unilateral (77046) |
— |
$3,766 |
— |
| MRI cervical spine w contrast (72142) |
— |
$6,965 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$5,924 |
— |
| MRI chest w/o contrast (71550) |
— |
$2,039 |
— |
| MRI chest with contrast (71551) |
— |
$2,478 |
— |
| MRI chest wo w contrast (71552) |
— |
$3,316 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$15,498 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$13,579 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$9,743 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$8,388 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$8,791 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$3,346 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$4,491 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$7,135 |
— |
| MRI pelvis w contrast (72196) |
— |
$8,781 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$9,060 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$8,485 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$6,114 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$9,464 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$8,824 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$11,927 |
— |
| MRI, abdomen, combo (74183) |
— |
$8,355 |
— |
| MRI, dorsal spine combo (72157) |
— |
$9,312 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$7,621 |
— |
| MRI, joint upper extrem (73221) |
— |
$9,671 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$17,218 |
— |
| MRI, lumbar spine combo (72158) |
— |
$9,239 |
— |
| Myelogram cervical (72240) |
— |
$2,604 |
— |
| Myelogram Lumbar (72265) |
— |
$2,565 |
— |
| Myelography thoracic (72255) |
— |
$2,565 |
— |
| Myelograpy 2/more regions rs&i (72270) |
— |
$2,565 |
— |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
— |
$1,764 |
— |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
— |
$2,184 |
— |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
— |
$7,984 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$11,516 |
— |
| Neck soft tissue (70360) |
— |
$747 |
— |
| Nm csf leak detection (78650) |
— |
$1,874 |
— |
| Nm myocard infarct spect (78469) |
— |
$2,484 |
— |
| Nonvascular Shunt X-Ray (75809) |
— |
$615 |
— |
| Nuclear Rx Intra-Arterial (79445) |
— |
$709 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$2,111 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$3,216 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$596 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,158 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$1,047 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$1,450 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$1,188 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$851 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$1,366 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$1,062 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$1,010 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$1,138 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$1,232 |
— |
| Radex lower extremity infant minimum 2 views (73592) |
— |
$398 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$442 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$894 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$667 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$1,293 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$1,323 |
— |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
— |
$1,996 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$1,053 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$790 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$523 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$505 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$646 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$1,227 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$1,659 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$1,351 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$3,250 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$2,735 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$1,467 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$894 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$1,327 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$907 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$3,188 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$788 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$788 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$1,196 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$1,345 |
— |
| Radiologic Examination Salivary Gland Calculus (70380) |
— |
$230 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$1,071 |
— |
| Radiologic examination, teeth; single view Non-Facility (70300) |
— |
$523 |
— |
| Radiopharm Dacryocystography (78660) |
— |
$846 |
— |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) |
— |
$555 |
— |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
— |
$1,122 |
— |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
— |
$1,122 |
— |
| Ribs bilateral 3 views (71110) |
— |
$1,105 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$2,653 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$1,345 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$6,927 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$1,841 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$10,205 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$1,426 |
— |
| Salivary Gland Function Study (78232) |
— |
$608 |
— |
| Salivary Gland Imaging (78230) |
— |
$885 |
— |
| Salivary Gland Imaging Serial Images (78231) |
— |
$718 |
— |
| Scapula (73010) |
— |
$1,006 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$271 |
— |
| Sella turcica (70240) |
— |
$346 |
— |
| Shoulder 1 view (73020) |
— |
$959 |
— |
| Shoulder Arthrography (73040) |
— |
$2,402 |
— |
| Sialogram (70390) |
— |
$602 |
— |
| Skull less than 4 views (70250) |
— |
$882 |
— |
| Special Physics Consult (77370) |
— |
$794 |
— |
| Special treatment procedure (77470) |
— |
$2,642 |
— |
| Spleen Imaging (78185) |
— |
$836 |
— |
| Sternoclavicular joints (71130) |
— |
$924 |
— |
| Temporomandble Jt Arthrography Rs&I (70332) |
— |
$1,254 |
— |
| Testicular Imaging W/Flow (78761) |
— |
$1,062 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$1,628 |
— |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
— |
$1,097 |
— |
| Thoracic spine 2 views (72070) |
— |
$1,062 |
— |
| Thoracic spine 3 views (72072) |
— |
$1,591 |
— |
| Thoracolumbar 2 views (72080) |
— |
$527 |
— |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
— |
$1,898 |
— |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
— |
$1,327 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,855 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$3,548 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$1,414 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$2,879 |
— |
| Tx devices design & construction simple (77332) |
— |
$725 |
— |
| Ultrasound Breast Limited (76642) |
— |
$1,443 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$649 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$1,550 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$492 |
— |
| Unlisted fluoroscopic procedure (76496) |
— |
$316 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$1,522 |
— |
| Unlisted Procedure Clinical Brachytherapy (77799) |
— |
$4,058 |
— |
| Unlisted us procedure (76999) |
— |
$588 |
— |
| Upper gi w/o kub (74240) |
— |
$4,414 |
— |
| Ureteral Reflux Study (78740) |
— |
$1,058 |
— |
| Urethrocystogram voiding (74455) |
— |
$1,053 |
— |
| Urethrocystography retrograde (74450) |
— |
$1,136 |
— |
| Us breast unilateral complete (76641) |
— |
$1,443 |
— |
| Us chest (76604) |
— |
$1,242 |
— |
| Us complete joint (76881) |
— |
$1,570 |
— |
| Us exam, pelvic, limited (76857) |
— |
$2,217 |
— |
| Us head (76506) |
— |
$492 |
— |
| Us kidney transplant (76776) |
— |
$649 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$900 |
— |
| Us ob detailed single fetus (76811) |
— |
$1,536 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$1,066 |
— |
| Us ob transvaginal (76817) |
— |
$1,722 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,980 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$1,265 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$919 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,584 |
— |
| Us retroperitoneal limited (76775) |
— |
$1,505 |
— |
| Us scrotum and contents (76870) |
— |
$1,529 |
— |
| Us spinal canal and contents (76800) |
— |
$690 |
— |
| Us thyroid (76536) |
— |
$2,456 |
— |
| Us transrectal (76872) |
— |
$442 |
— |
| Vascular Flow Imaging (78445) |
— |
$1,051 |
— |
| Vein X-Ray Chest (75827) |
— |
$6,692 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$22,546 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$4,695 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$4,414 |
— |
| Venous thrombosis imaging (78457) |
— |
$1,392 |
— |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
— |
$971 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$259 |
— |
| Wrist 2 views (73100) |
— |
$1,062 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$414 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$2,071 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$13,876 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$1,081 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$1,180 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$685 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$527 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$877 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$1,659 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$608 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$608 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$1,010 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$1,010 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$1,010 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$1,097 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$1,132 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$940 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$1,443 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$924 |
— |
| X-ray eye for foreign body (70030) |
— |
$879 |
— |
| X-ray humerus (73060) |
— |
$1,311 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,550 |
— |
| X-ray IV pyelogram+tomography (74415) |
— |
$1,751 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$846 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$922 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$1,092 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$476 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$1,138 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$715 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$1,022 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$1,276 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$1,889 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$891 |
— |
| X-Ray Stress View (77071) |
— |
$252 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$1,232 |
— |
| X-Ray Tmj Unilat (70328) |
— |
$281 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$2,076 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$1,066 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$2,130 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$1,414 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$745 |
— |
| XR Mastoids < 3 Views Bilateral (70120) |
— |
$318 |
— |
| Xr orbits complete 4 views (70200) |
— |
$1,036 |
— |
| Xr Tomogram Single Plane (76100) |
— |
$909 |
— |