| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$1,947 |
— |
| Abdomen 2 views (74019) |
— |
$831 |
— |
| Acute gastrointestinal blood loss imaging (78278) |
— |
$3,600 |
— |
| Acute venous thrombus image (78456) |
— |
$1,392 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$12,725 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$13,885 |
— |
| Angiography pulmonary bilateral slctv rs&i (75743) |
— |
$20,433 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$13,623 |
— |
| Angiography visceral slctv/supraslctv rs&i (75726) |
— |
$38,026 |
— |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
— |
$4,695 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$13,623 |
— |
| Ankle 2 views (73600) |
— |
$1,006 |
— |
| Antegrade urography radiological supvj & interpj (74425) |
— |
$2,071 |
— |
| Aortogram thoracic (75605) |
— |
$14,612 |
— |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
— |
$13,876 |
— |
| Aortography abdominal serialography rs&i (75625) |
— |
$13,876 |
— |
| Arthrogram elbow (73085) |
— |
$1,554 |
— |
| Arthrogram hip (73525) |
— |
$3,684 |
— |
| Arthrogram shoulder (73040) |
— |
$2,402 |
— |
| Arthrogram wrist (73115) |
— |
$3,846 |
— |
| Arthrography knee lt (73580) |
— |
$1,687 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$527 |
— |
| Bone &/Joint Imaging Limited Area (78300) |
— |
$6,493 |
— |
| Bone &/Joint Imaging Multiple Areas (78305) |
— |
$1,576 |
— |
| Bone &/joint imaging whole body (78306) |
— |
$2,230 |
— |
| Bone age studies (77072) |
— |
$295 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$3,008 |
— |
| Bone Marrow Imaging Limited Area (78102) |
— |
$851 |
— |
| Bone survey complete (77075) |
— |
$2,130 |
— |
| Brachytx isodose complex (77318) |
— |
$1,909 |
— |
| Brachytx isodose intermed (77317) |
— |
$1,199 |
— |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
— |
$867 |
— |
| Brain image w/flow 4 + views (78606) |
— |
$1,998 |
— |
| Brain imaging < 4 static views (78600) |
— |
$1,119 |
— |
| Brain imaging < 4 static views w vascular flow (78601) |
— |
$1,331 |
— |
| Brain Imaging Minimum 4 Static Views (78605) |
— |
$1,229 |
— |
| Brain Imaging Vascular Flow Only (78610) |
— |
$1,122 |
— |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
— |
$3,419 |
— |
| Cardiac shunt detection (78428) |
— |
$1,744 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$2,449 |
— |
| Cervical spine 2 or 3 views (72040) |
— |
$940 |
— |
| Chest 1 view (71045) |
— |
$678 |
— |
| Chest 3 views (71047) |
— |
$707 |
— |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
— |
$907 |
— |
| Clavicle complete (73000) |
— |
$1,196 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$908 |
— |
| 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 hrt w/3d image (75574) |
— |
$1,494 |
— |
| CT angiography upper extremity lt (73206) |
— |
$2,679 |
— |
| CT c-spine w/o contrast (72125) |
— |
$5,070 |
— |
| CT cervical spine w&w/o contrast (72127) |
— |
$8,620 |
— |
| CT cervical spine with contrast (72126) |
— |
$6,252 |
— |
| CT chest w/wo contrast (71270) |
— |
$3,583 |
— |
| CT chest with contrast (71260) |
— |
$3,228 |
— |
| CT colonography screening (74263) |
— |
$1,147 |
— |
| CT colonography w/o cntrst (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 limited/localized follow up study (76380) |
— |
$798 |
— |
| CT lower ext w/o (73700) |
— |
$3,874 |
— |
| CT lower extremity w wo contrast (73702) |
— |
$6,101 |
— |
| CT lower extremity with contrast (73701) |
— |
$5,918 |
— |
| CT lumbar spine w & w/o contrast (72133) |
— |
$7,559 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$4,655 |
— |
| CT lumbar spine with contrast (72132) |
— |
$6,160 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,876 |
— |
| CT maxillofacial w/o contrast (70486) |
— |
$3,445 |
— |
| CT maxillofacial w/wo contrast (70488) |
— |
$4,810 |
— |
| CT neck soft tissue w contrast (70491) |
— |
$3,772 |
— |
| CT orbit sella/post fossa/ear w/o & w/contr matr (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 for measuring calcium and other minerals in bone (77078) |
— |
$411 |
— |
| CT soft tissue neck w/o & w/contrast material (70492) |
— |
$4,950 |
— |
| 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 contrast (72130) |
— |
$8,140 |
— |
| CT thorax w/o contrast (71250) |
— |
$2,039 |
— |
| CT unlisted procedure (76497) |
— |
$476 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$7,309 |
— |
| CT upper extremity w/o contrast rt (73200) |
— |
$4,743 |
— |
| 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 abdomen pelvis (74174) |
— |
$3,240 |
— |
| CTA chest (71275) |
— |
$5,778 |
— |
| Cta Head (70496) |
— |
$5,047 |
— |
| CTA lwr ext w&w/o contrast (73706) |
— |
$3,094 |
— |
| Cta Neck (70498) |
— |
$3,271 |
— |
| Cta Pelvis (72191) |
— |
$3,970 |
— |
| Cystography minimum 3 views rs&i (74430) |
— |
$1,127 |
— |
| Diskogram cervical (72285) |
— |
$4,944 |
— |
| Diskography lumbar (72295) |
— |
$4,944 |
— |
| Dxa bone density study 1/> sites axial skel (77080) |
— |
$1,628 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$964 |
— |
| Echoencephalography real time imaging (76506) |
— |
$492 |
— |
| Esophageal motility (78258) |
— |
$1,318 |
— |
| Esophagus (74220) |
— |
$1,691 |
— |
| Fetal biophysical profile non-stress testing (76818) |
— |
$2,084 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$1,581 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$1,670 |
— |
| Foot 2 views (73620) |
— |
$971 |
— |
| Forearm 2 views (73090) |
— |
$1,077 |
— |
| Gastric mucosa imaging (78261) |
— |
$1,318 |
— |
| Gated Heart Planar Single (78472) |
— |
$4,737 |
— |
| Hand 2 views (73120) |
— |
$981 |
— |
| Hand 3 views (73130) |
— |
$1,232 |
— |
| Heart Infarct Image (78466) |
— |
$1,764 |
— |
| Heart infarct image w ef (78468) |
— |
$2,184 |
— |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
— |
$4,278 |
— |
| Hepatobiliary syst imaging including gallbladder (78226) |
— |
$3,700 |
— |
| Ht muscle image spect sing (78451) |
— |
$6,720 |
— |
| Humerus Min 2 Views Left (73060) |
— |
$1,311 |
— |
| Hysterosalpingogram (74740) |
— |
$1,105 |
— |
| Interstitial radiation source applic complex (77778) |
— |
$6,937 |
— |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
— |
$407 |
— |
| Kidney imaging morphology (78700) |
— |
$3,519 |
— |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
— |
$6,217 |
— |
| Kidney img morphology vascular flow 1 w/rx (78708) |
— |
$4,894 |
— |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
— |
$5,690 |
— |
| Knee 3 views (73562) |
— |
$1,390 |
— |
| 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 |
— |
| Lymphoscintigraphy (78195) |
— |
$4,488 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$924 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$685 |
— |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
— |
$252 |
— |
| Meckels Diverticulum (78290) |
— |
$1,318 |
— |
| MRA head w & w/o contrast (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 & w/contrast material (74183) |
— |
$8,355 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$11,723 |
— |
| MRI any jnt lwr ext with con lt (73722) |
— |
$12,298 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$11,024 |
— |
| MRI breast w/o contrast bilateral (77047) |
— |
$4,740 |
— |
| MRI breast w/o contrast unilat (77046) |
— |
$3,766 |
— |
| MRI c-spine with contrast (72142) |
— |
$6,965 |
— |
| MRI cervical spine w/o contrast (72141) |
— |
$5,924 |
— |
| MRI chest w/o & w/contrast material (71552) |
— |
$3,316 |
— |
| MRI chest w/o contrast (71550) |
— |
$2,039 |
— |
| MRI chest with contrast (71551) |
— |
$2,478 |
— |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
— |
$9,464 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$15,498 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$9,743 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$3,346 |
— |
| MRI orbit/face/neck w&w/o cont (70543) |
— |
$7,135 |
— |
| MRI orbit/face/neck w/contrast (70542) |
— |
$4,491 |
— |
| MRI pelvis w contrast (72196) |
— |
$8,781 |
— |
| MRI pelvis w/o & w/contrast material (72197) |
— |
$9,060 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$8,485 |
— |
| MRI scan of arm joint before and after contrast (73223) |
— |
$17,218 |
— |
| MRI scan of leg joint before and after contrast (73723) |
— |
$12,582 |
— |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
— |
$8,791 |
— |
| MRI spinal canal lumbar w/contrast material (72149) |
— |
$8,388 |
— |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
— |
$9,239 |
— |
| MRI spinal canal thoracic w/contrast matrl (72147) |
— |
$7,621 |
— |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
— |
$9,312 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$6,114 |
— |
| MRI upper ext joint w/o contrast (73221) |
— |
$9,671 |
— |
| MRI upper extrem other than jt w/o & w/contras (73220) |
— |
$11,927 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$8,824 |
— |
| Myelogram Cervical (72240) |
— |
$2,604 |
— |
| Myelogram Lumbar (72265) |
— |
$2,565 |
— |
| Myelogram thoracic (72255) |
— |
$2,565 |
— |
| Myelography 2 or more regions (72270) |
— |
$2,565 |
— |
| Myocardial infarct spect (78469) |
— |
$2,484 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$11,516 |
— |
| Neck soft tissue (70360) |
— |
$747 |
— |
| Nm adrenal scan (78075) |
— |
$5,205 |
— |
| Nm bone marrow multiple (78103) |
— |
$1,125 |
— |
| Nm bone marrow wb (78104) |
— |
$1,291 |
— |
| Nm cisternogram (78630) |
— |
$2,182 |
— |
| Nm csf leak detection (78650) |
— |
$1,874 |
— |
| Nm gastric emptying study (78264) |
— |
$5,382 |
— |
| Nm gastroesophageal reflux study (78262) |
— |
$1,318 |
— |
| Nm peritoneal-venous shunt patency (78291) |
— |
$1,066 |
— |
| Nuclear medicine of heart muscle at rest with stress (78454) |
— |
$8,391 |
— |
| Nuclear medicine of heart pumping function (78473) |
— |
$6,391 |
— |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
— |
$3,416 |
— |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
— |
$7,984 |
— |
| Nuclear medicine study of kidney and blood flow (78701) |
— |
$3,519 |
— |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
— |
$1,327 |
— |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
— |
$971 |
— |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
— |
$1,392 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$2,111 |
— |
| Nuclr Rx Interstit Colloid (79300) |
— |
$555 |
— |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
— |
$919 |
— |
| Osseous survey infant (77076) |
— |
$938 |
— |
| Osseous survey limited (77074) |
— |
$1,345 |
— |
| Parathyroid imaging (78070) |
— |
$3,216 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$596 |
— |
| Pr csf ventriculography (78635) |
— |
$1,874 |
— |
| Pr heart first pass single,planar (78481) |
— |
$2,725 |
— |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
— |
$13,579 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,158 |
— |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
— |
$2,647 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$1,450 |
— |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
— |
$527 |
— |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
— |
$877 |
— |
| Radex hips bilateral with pelvis 2 views (73521) |
— |
$1,010 |
— |
| Radex mastoids compl minimum 3 views pr side (70130) |
— |
$442 |
— |
| 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 Abdomen 1 View - Xr Abdomen 1 View (74018) |
— |
$690 |
— |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
— |
$757 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$2,735 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$3,188 |
— |
| Radiologic exam upr gi trc single contrast study (74240) |
— |
$4,414 |
— |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
— |
$788 |
— |
| Radiologic Examination Salivary Gland Calculus (70380) |
— |
$230 |
— |
| Radiological examination surgical specimen (76098) |
— |
$685 |
— |
| Radiopharm Dacryocystography (78660) |
— |
$846 |
— |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
— |
$1,122 |
— |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
— |
$1,122 |
— |
| Ribs bilateral 3 views (71110) |
— |
$1,105 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$1,345 |
— |
| 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 intra-arterial particulate admn (79445) |
— |
$709 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$1,426 |
— |
| Sacroiliac Joints < 3 Views (72200) |
— |
$1,022 |
— |
| Salivary gland function study (78232) |
— |
$608 |
— |
| Salivary gland imaging (78230) |
— |
$885 |
— |
| Salivary gland imaging serial images (78231) |
— |
$718 |
— |
| Scanogram (77073) |
— |
$1,066 |
— |
| Scapula complete (73010) |
— |
$1,006 |
— |
| Screening digital breast tomosynthesis (77063) |
— |
$271 |
— |
| Sella turcica (70240) |
— |
$346 |
— |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
— |
$615 |
— |
| Sialogram (70390) |
— |
$602 |
— |
| Small bowel series (74250) |
— |
$1,327 |
— |
| Spec medical radj physics consltj (77370) |
— |
$794 |
— |
| Special treatment procedure (77470) |
— |
$2,642 |
— |
| Spine thoracic 3 views (72072) |
— |
$1,591 |
— |
| Spleen imaging only (78185) |
— |
$836 |
— |
| Temporomandble Jt Arthrography Rs&I (70332) |
— |
$1,254 |
— |
| Testicular Imaging With Vascular Flow (78761) |
— |
$1,062 |
— |
| Ther rad simulaj-aided field setting complex (77290) |
— |
$1,628 |
— |
| Therapeutic Enema (74283) |
— |
$1,097 |
— |
| Thoracolumbar 2 views (72080) |
— |
$527 |
— |
| Thyroid carcinoma metastases img addl study (78016) |
— |
$1,898 |
— |
| Thyroid carcinoma metastases img whole body (78018) |
— |
$3,548 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,855 |
— |
| Thyroid uptake measurement (78012) |
— |
$1,414 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$2,879 |
— |
| Tmj unilateral (70328) |
— |
$281 |
— |
| Tomogram (76100) |
— |
$909 |
— |
| Treatment devices simple (77332) |
— |
$725 |
— |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
— |
$6,927 |
— |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
— |
$2,653 |
— |
| 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 Ultrasound Procedure (76999) |
— |
$588 |
— |
| Upper Extremity Infant (73092) |
— |
$646 |
— |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
— |
$1,058 |
— |
| Urethrocystography retrograde rs&i (74450) |
— |
$1,136 |
— |
| Urethrocystography voiding (74455) |
— |
$1,053 |
— |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
— |
$1,550 |
— |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
— |
$1,751 |
— |
| Us abdl aorta screen aaa (76706) |
— |
$649 |
— |
| Us breast unilateral complete (76641) |
— |
$1,443 |
— |
| Us breast unilateral limited (76642) |
— |
$1,443 |
— |
| Us chest (76604) |
— |
$1,242 |
— |
| Us compl joint r-t w/image documentation (76881) |
— |
$1,570 |
— |
| Us guided compression repair (76936) |
— |
$1,905 |
— |
| Us infant hips dynamic (76885) |
— |
$359 |
— |
| Us infant hips limited static (76886) |
— |
$314 |
— |
| Us kidney transplant (76776) |
— |
$649 |
— |
| Us ob detailed single fetus (76811) |
— |
$1,536 |
— |
| Us ob transvaginal (76817) |
— |
$1,722 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,980 |
— |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
— |
$2,217 |
— |
| Us pregnancy ltd (76815) |
— |
$1,066 |
— |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
— |
$1,265 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,584 |
— |
| Us retroperitoneal limited (76775) |
— |
$1,505 |
— |
| Us scrotum and contents (76870) |
— |
$1,529 |
— |
| Us soft tissue head/neck (76536) |
— |
$2,456 |
— |
| Us spinal canal and contents (76800) |
— |
$690 |
— |
| Us transrectal (76872) |
— |
$442 |
— |
| Us transrectal prostate volume (76873) |
— |
$533 |
— |
| Us xtr non-vasc lmtd (76882) |
— |
$900 |
— |
| Vascular flow imaging (78445) |
— |
$1,051 |
— |
| Venogram extremity bilateral (75822) |
— |
$4,695 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$22,546 |
— |
| Venography caval superior serialography rs&i (75827) |
— |
$6,692 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$4,414 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$259 |
— |
| Wrist 2 views (73100) |
— |
$1,062 |
— |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
— |
$1,047 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$414 |
— |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
— |
$1,188 |
— |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
— |
$3,250 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$1,180 |
— |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
— |
$1,366 |
— |
| 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 3-4 Views (73522) |
— |
$1,010 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$1,097 |
— |
| X-ray exam of femur 1 (73551) |
— |
$788 |
— |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
— |
$1,996 |
— |
| X-ray eye for foreign body (70030) |
— |
$879 |
— |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
— |
$1,062 |
— |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
— |
$745 |
— |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
— |
$1,138 |
— |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
— |
$2,836 |
— |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
— |
$851 |
— |
| X-ray IV pyelogram+drip infusn (74410) |
— |
$4,043 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$846 |
— |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
— |
$1,467 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$922 |
— |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
— |
$398 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$1,092 |
— |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
— |
$1,132 |
— |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
— |
$1,081 |
— |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
— |
$894 |
— |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
— |
$476 |
— |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
— |
$1,036 |
— |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
— |
$894 |
— |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
— |
$2,076 |
— |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
— |
$667 |
— |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
— |
$924 |
— |
| 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 Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$1,276 |
— |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
— |
$1,293 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$1,889 |
— |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
— |
$1,323 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$891 |
— |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
— |
$882 |
— |
| X-Ray Spine One View - Xr Spine (72020) |
— |
$1,053 |
— |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
— |
$924 |
— |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
— |
$790 |
— |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
— |
$523 |
— |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
— |
$1,062 |
— |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
— |
$1,232 |
— |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
— |
$505 |
— |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
— |
$1,227 |
— |
| Xr arthrogram ankle (73615) |
— |
$1,501 |
— |
| Xr c-spine 6 or more views (72052) |
— |
$1,443 |
— |
| Xr chest 4+ views (71048) |
— |
$462 |
— |
| Xr finger(s) 2+ views (73140) |
— |
$1,010 |
— |
| XR Mastoids < 3 Views Bilateral (70120) |
— |
$318 |
— |
| Xr shoulder 1 view (73020) |
— |
$959 |
— |
| Xr spine cervical 4 or 5 views (72050) |
— |
$1,414 |
— |
| Xr tibia/fibula 2 views (73590) |
— |
$1,071 |
— |
| Xr tmj bilateral (70330) |
— |
$523 |
— |
| Xray knee 1 or 2 views rt (73560) |
— |
$1,196 |
— |