| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,818.40 |
$6,364 |
2.8× |
| Abdomen 2 views (74019) |
$276 |
$460 |
2.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$693.60 |
$1,156 |
1.7× |
| Angiography extremity bilateral rs&i (75716) |
$4,145.40 |
$6,909 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$3,842.40 |
$6,404 |
1.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,387.60 |
$10,646 |
1.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,145.20 |
$5,242 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,842.40 |
$6,404 |
1.2× |
| Angiography Spinal Selective Rs&I (75705) |
$6,169.80 |
$10,283 |
1.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,971.80 |
$9,953 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,651.80 |
$2,753 |
0.5× |
| Ankle 2 views (73600) |
$323.40 |
$539 |
3.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,310.40 |
$7,184 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$4,468.80 |
$7,448 |
1.4× |
| Artery X-Rays Adrenal Gland (75731) |
$4,296.60 |
$7,161 |
1.4× |
| Arthrogram elbow (73085) |
$574.20 |
$957 |
1.7× |
| Arthrogram shoulder (73040) |
$518.40 |
$864 |
1.5× |
| Arthrogram wrist (73115) |
$518.40 |
$864 |
1.5× |
| Arthrography knee lt (73580) |
$435.60 |
$726 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$547.20 |
$912 |
4.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$766.80 |
$1,278 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$534.60 |
$891 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$1,114.20 |
$1,857 |
2.8× |
| Bone age studies (77072) |
$135 |
$225 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$1,378.20 |
$2,297 |
3.5× |
| Bone Marrow Imaging Limited Area (78102) |
$697.80 |
$1,163 |
1.8× |
| Bone survey complete (77075) |
$502.80 |
$838 |
4.8× |
| Brachytx isodose intermed (77317) |
$650.40 |
$1,084 |
1.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$503.40 |
$839 |
1.4× |
| Brain image w/flow 4 + views (78606) |
$657.60 |
$1,096 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,122.40 |
$5,204 |
2.2× |
| Brain Imaging Vascular Flow Only (78610) |
$504 |
$840 |
0.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$490.20 |
$817 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$527.40 |
$879 |
6.1× |
| Chest 1 view (71045) |
$284.55 |
$474.25 |
3.3× |
| Chest 3 views (71047) |
$201 |
$335 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$391.20 |
$652 |
2.2× |
| Cisternography Positive Contrast Rs&I (70015) |
$955.20 |
$1,592 |
1.2× |
| Clavicle complete (73000) |
$321.60 |
$536 |
3.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$127.80 |
$213 |
1.2× |
| Continuing medical physics consltj pr wk (77336) |
$484.20 |
$807 |
3.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,865.20 |
$6,442 |
11.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,807.40 |
$4,679 |
11.8× |
| CT abdomen w contrast (74160) |
$2,179.20 |
$3,632 |
12.5× |
| CT abdomen w wo contrast (74170) |
$2,598.60 |
$4,331 |
14.9× |
| CT abdomen w/o contrast (74150) |
$1,894.80 |
$3,158 |
18.2× |
| CT angio hrt w/3d image (75574) |
$532.80 |
$888 |
1.5× |
| CT angiography upper extremity lt (73206) |
$1,720.20 |
$2,867 |
9.9× |
| CT c-spine w/o contrast (72125) |
$1,486.80 |
$2,478 |
14.3× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$600 |
$1,000 |
3.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,485 |
$2,475 |
8.5× |
| CT cervical spine with contrast (72126) |
$1,636.80 |
$2,728 |
4.7× |
| CT chest w/wo contrast (71270) |
$1,432.20 |
$2,387 |
8.2× |
| CT chest with contrast (71260) |
$1,714.80 |
$2,858 |
9.8× |
| CT head/brain with contrast (70460) |
$1,641.60 |
$2,736 |
9.4× |
| CT head/brain without and with contrast (70470) |
$1,864.80 |
$3,108 |
10.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$390 |
$650 |
1.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$259.20 |
$432 |
3.0× |
| CT hrt w/3d image congen (75573) |
$348 |
$580 |
1.0× |
| CT iac w contrast (70481) |
$1,712.40 |
$2,854 |
9.8× |
| CT limited/localized follow up study (76380) |
$757.80 |
$1,263 |
8.7× |
| CT lower ext w/o (73700) |
$1,026.60 |
$1,711 |
9.9× |
| CT lower extremity w wo contrast (73702) |
$1,524.60 |
$2,541 |
8.7× |
| CT lower extremity with contrast (73701) |
$1,677 |
$2,795 |
9.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,646.40 |
$2,744 |
9.4× |
| CT lumbar spine w/o contrast (72131) |
$1,559.40 |
$2,599 |
15.0× |
| CT lumbar spine with contrast (72132) |
$1,884 |
$3,140 |
5.4× |
| CT maxillofacial w contrast (70487) |
$1,665.60 |
$2,776 |
9.5× |
| CT maxillofacial w/o contrast (70486) |
$1,357.80 |
$2,263 |
13.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,785.60 |
$2,976 |
10.2× |
| CT neck soft tissue w contrast (70491) |
$1,751.40 |
$2,919 |
10.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,882.20 |
$3,137 |
10.8× |
| CT orbits w/o contrast (70480) |
$1,394.40 |
$2,324 |
13.4× |
| CT pelvis w & w/o contrast (72194) |
$1,725 |
$2,875 |
9.9× |
| CT pelvis w/o contrast (72192) |
$1,297.20 |
$2,162 |
12.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,909.80 |
$3,183 |
10.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,428.60 |
$2,381 |
13.7× |
| CT thoracic spine w/contrast (72129) |
$1,677 |
$2,795 |
9.6× |
| CT thoracic spine w/o contrast (72128) |
$1,369.20 |
$2,282 |
13.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,891.20 |
$3,152 |
10.8× |
| CT thorax w/o contrast (71250) |
$1,332.60 |
$2,221 |
12.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,524.60 |
$2,541 |
8.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,318.80 |
$2,198 |
12.7× |
| CT upper extremity with contrast (73201) |
$1,341.60 |
$2,236 |
3.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,732.20 |
$2,887 |
9.9× |
| Cta Abdomen (74175) |
$3,152.40 |
$5,254 |
18.1× |
| CTA abdomen pelvis (74174) |
$897.60 |
$1,496 |
2.6× |
| CTA chest (71275) |
$2,010.60 |
$3,351 |
11.5× |
| Cta Head (70496) |
$1,834.80 |
$3,058 |
10.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,600 |
$6,000 |
10.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,296.80 |
$3,828 |
13.2× |
| Cta Neck (70498) |
$2,222.40 |
$3,704 |
12.7× |
| Cta Pelvis (72191) |
$2,059.80 |
$3,433 |
11.8× |
| Cystography minimum 3 views rs&i (74430) |
$463.80 |
$773 |
1.3× |
| Diskography lumbar (72295) |
$3,175.80 |
$5,293 |
1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$114.60 |
$191 |
1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$462.60 |
$771 |
4.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$190.80 |
$318 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$451.20 |
$752 |
4.3× |
| Echoencephalography real time imaging (76506) |
$646.20 |
$1,077 |
6.2× |
| Esophagus (74220) |
$438 |
$730 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$651 |
$1,085 |
6.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$291.60 |
$486 |
2.8× |
| Fluoroscopy up to 1 hr (76000) |
$792.60 |
$1,321 |
3.3× |
| Foot 2 views (73620) |
$337.50 |
$562.50 |
3.9× |
| Forearm 2 views (73090) |
$407.70 |
$679.50 |
4.7× |
| Gated Heart Planar Single (78472) |
$1,106.40 |
$1,844 |
2.8× |
| Hand 2 views (73120) |
$308.10 |
$513.50 |
3.0× |
| Hand 3 views (73130) |
$418.50 |
$697.50 |
4.8× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,608.60 |
$2,681 |
2.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,104.20 |
$3,507 |
3.0× |
| Heart infarct image w ef (78468) |
$574.80 |
$958 |
1.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,242.60 |
$7,071 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$415.20 |
$692 |
0.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,383.60 |
$2,306 |
3.5× |
| Ht muscle image spect sing (78451) |
$2,371.20 |
$3,952 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$244.80 |
$408 |
2.8× |
| Hysterosalpingogram (74740) |
$374.40 |
$624 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,050.60 |
$1,751 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,620 |
$2,700 |
3.0× |
| Knee 3 views (73562) |
$447.90 |
$746.50 |
5.2× |
| Liver & spleen imaging static only (78215) |
$637.80 |
$1,063 |
1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$526.20 |
$877 |
1.3× |
| Lung perf&ventilat diferentl (78598) |
$400.20 |
$667 |
0.7× |
| Lung perfusion differential (78597) |
$255.60 |
$426 |
0.6× |
| Lung Ventilation Imaging (78579) |
$255.60 |
$426 |
0.6× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$4,242.60 |
$7,071 |
1.3× |
| Lymphoscintigraphy (78195) |
$1,497 |
$2,495 |
2.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$126 |
$210 |
1.5× |
| Meckels Diverticulum (78290) |
$993.60 |
$1,656 |
2.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$520.80 |
$868 |
1.4× |
| Mr elastography (76391) |
$325.20 |
$542 |
1.4× |
| MRA head w & w/o contrast (70546) |
$3,550.20 |
$5,917 |
10.2× |
| MRA head w/o contrast (70544) |
$3,049.80 |
$5,083 |
12.8× |
| MRA neck w contrast (70548) |
$2,462.40 |
$4,104 |
7.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,008.60 |
$6,681 |
11.5× |
| MRA neck w/o contrast (70547) |
$2,841.60 |
$4,736 |
12.0× |
| MRI abdomen w contrast (74182) |
$4,726.80 |
$7,878 |
13.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,437.80 |
$9,063 |
15.7× |
| MRI abdomen w/o contrast (74181) |
$2,372.40 |
$3,954 |
10.0× |
| MRI any jnt lwr ext with con lt (73722) |
$2,521.80 |
$4,203 |
3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,913.60 |
$4,856 |
3.7× |
| MRI breast w/o contrast bilateral (77047) |
$345.60 |
$576 |
1.5× |
| MRI c-spine with contrast (72142) |
$2,807.40 |
$4,679 |
8.1× |
| MRI cervical spine w/o contrast (72141) |
$3,091.80 |
$5,153 |
13.0× |
| MRI chest w/o & w/contrast material (71552) |
$3,975 |
$6,625 |
11.4× |
| MRI chest w/o contrast (71550) |
$2,878.80 |
$4,798 |
12.1× |
| MRI fetal sngl/1st gestation (74712) |
$463.80 |
$773 |
2.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,192.20 |
$1,987 |
3.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,128.40 |
$5,214 |
13.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,508.20 |
$5,847 |
14.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,642.80 |
$7,738 |
13.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,508.40 |
$2,514 |
4.3× |
| MRI pelvis w contrast (72196) |
$518.40 |
$864 |
1.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,187.40 |
$6,979 |
12.1× |
| MRI pelvis w/o contrast (72195) |
$3,033 |
$5,055 |
12.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,890.80 |
$4,818 |
8.3× |
| MRI scan of leg joint before and after contrast (73723) |
$2,925 |
$4,875 |
8.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,092.60 |
$6,821 |
11.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,442.80 |
$5,738 |
9.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,239 |
$7,065 |
12.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,914.20 |
$4,857 |
8.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,462.20 |
$7,437 |
12.8× |
| MRI thoracic spine w/o contrast (72146) |
$3,234 |
$5,390 |
13.6× |
| MRI tmj (70336) |
$1,788 |
$2,980 |
7.5× |
| MRI upper ext joint w/o contrast (73221) |
$3,350.10 |
$5,583.50 |
14.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,183.40 |
$3,639 |
6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,692 |
$2,820 |
7.1× |
| Myelogram Cervical (72240) |
$1,059 |
$1,765 |
1.4× |
| Myelogram Lumbar (72265) |
$1,059.60 |
$1,766 |
1.4× |
| Myelography 2 or more regions (72270) |
$1,258.20 |
$2,097 |
1.6× |
| Myocardial infarct spect (78469) |
$1,386.60 |
$2,311 |
2.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,107.60 |
$6,846 |
3.2× |
| Neck soft tissue (70360) |
$235.20 |
$392 |
2.7× |
| Nm cisternogram (78630) |
$966 |
$1,610 |
1.8× |
| Nm csf leak detection (78650) |
$960 |
$1,600 |
0.7× |
| Nm gastric emptying study (78264) |
$1,239 |
$2,065 |
3.1× |
| Nm gastroesophageal reflux study (78262) |
$604.80 |
$1,008 |
1.5× |
| Nm peritoneal-venous shunt patency (78291) |
$753 |
$1,255 |
1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,917.40 |
$6,529 |
2.8× |
| Nuclear medicine of heart pumping function (78473) |
$1,471.20 |
$2,452 |
3.7× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$3,427.20 |
$5,712 |
2.4× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$480 |
$800 |
1.2× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$587.40 |
$979 |
1.5× |
| Nuclear Rx Oral Admin (79005) |
$1,041.60 |
$1,736 |
4.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$456.60 |
$761 |
4.4× |
| Orthopantogram (70355) |
$247.80 |
$413 |
2.9× |
| Osseous survey infant (77076) |
$105 |
$175 |
1.0× |
| Osseous survey limited (77074) |
$173.40 |
$289 |
1.7× |
| Parathyrd planar w/wo subtrj (78071) |
$574.80 |
$958 |
1.4× |
| Parathyroid imaging (78070) |
$841.20 |
$1,402 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$267 |
$445 |
2.6× |
| PET image w/CT, skull-thigh (78815) |
$3,952.20 |
$6,587 |
2.8× |
| PET imaging CT for attenuation limited area (78814) |
$3,683.40 |
$6,139 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$4,125 |
$6,875 |
2.9× |
| PET imaging limited area chest head/neck (78811) |
$1,854 |
$3,090 |
1.4× |
| PET whole body (78813) |
$3,427.20 |
$5,712 |
2.4× |
| Pr heart first pass single,planar (78481) |
$790.20 |
$1,317 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,823 |
$4,705 |
8.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,242.60 |
$7,071 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,199.40 |
$6,999 |
1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$991.80 |
$1,653 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$503.40 |
$839 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$390.60 |
$651 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$246 |
$410 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$191.40 |
$319 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$192 |
$320 |
1.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$190.80 |
$318 |
1.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$325.80 |
$543 |
3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,799.60 |
$24,666 |
2.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$607.80 |
$1,013 |
1.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$353.40 |
$589 |
3.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$576 |
$960 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$372.60 |
$621 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$234 |
$390 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$326.40 |
$544 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$294.30 |
$490.50 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$639.60 |
$1,066 |
3.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$289.20 |
$482 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$558 |
$930 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$545.40 |
$909 |
3.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$115.50 |
$192.50 |
1.3× |
| Radiological examination surgical specimen (76098) |
$637.20 |
$1,062 |
1.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,188.60 |
$6,981 |
1.3× |
| Ribs bilateral 3 views (71110) |
$333 |
$555 |
3.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,183.80 |
$1,973 |
3.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,506 |
$2,510 |
2.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$931.20 |
$1,552 |
1.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,804.80 |
$3,008 |
1.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,047.20 |
$3,412 |
1.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,804.80 |
$3,008 |
1.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$534.60 |
$891 |
2.3× |
| Rp Therapy Intravenous Administration (79101) |
$727.80 |
$1,213 |
3.1× |
| Sacroiliac Joints < 3 Views (72200) |
$82.80 |
$138 |
0.8× |
| Salivary gland function study (78232) |
$496.80 |
$828 |
1.2× |
| Salivary gland imaging (78230) |
$316.20 |
$527 |
0.8× |
| Scanogram (77073) |
$230.40 |
$384 |
2.2× |
| Scapula complete (73010) |
$204.60 |
$341 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$50.40 |
$84 |
2.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$396.60 |
$661 |
3.8× |
| Simulation intermediate (77285) |
$796.20 |
$1,327 |
2.1× |
| Small bowel series (74250) |
$424.80 |
$708 |
2.4× |
| Spec medical radj physics consltj (77370) |
$679.80 |
$1,133 |
5.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$792 |
$1,320 |
2.1× |
| Special dosimetry (77331) |
$341.40 |
$569 |
2.6× |
| Special treatment procedure (77470) |
$1,474.80 |
$2,458 |
2.7× |
| Spine thoracic 3 views (72072) |
$324 |
$540 |
3.1× |
| Splenoportograpy rs&i (75810) |
$2,675.40 |
$4,459 |
0.9× |
| Stereotactic body radiation delivery (77373) |
$4,022.40 |
$6,704 |
2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$790.80 |
$1,318 |
2.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$360 |
$600 |
1.0× |
| Testicular Imaging With Vascular Flow (78761) |
$492 |
$820 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,213.80 |
$2,023 |
3.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$594.60 |
$991 |
4.4× |
| Therapeutic Enema (74283) |
$451.20 |
$752 |
2.6× |
| Thoracolumbar 2 views (72080) |
$303 |
$505 |
3.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,816.20 |
$3,027 |
3.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$227.40 |
$379 |
0.6× |
| Thyroid uptake measurement (78012) |
$172.80 |
$288 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$444.60 |
$741 |
1.1× |
| Tmj unilateral (70328) |
$114.60 |
$191 |
1.3× |
| Treatment device intermediate (77333) |
$792 |
$1,320 |
5.9× |
| Treatment devices simple (77332) |
$384.60 |
$641 |
2.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,020.80 |
$3,368 |
3.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,039.20 |
$1,732 |
2.6× |
| Tx devices design & construction complex (77334) |
$871.20 |
$1,452 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$579.60 |
$966 |
5.6× |
| Umbilical-artery Doppler (OB) (76820) |
$139.20 |
$232 |
1.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$109.20 |
$182 |
1.3× |
| Unlisted magnetic resonance procedure (76498) |
$126 |
$210 |
1.5× |
| Upper Extremity Infant (73092) |
$257.40 |
$429 |
2.5× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$568.20 |
$947 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$463.80 |
$773 |
2.0× |
| Urethrocystography voiding (74455) |
$562.80 |
$938 |
2.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$853.80 |
$1,423 |
4.9× |
| Us abdl aorta screen aaa (76706) |
$215.40 |
$359 |
2.1× |
| Us breast unilateral complete (76641) |
$329.10 |
$548.50 |
3.2× |
| Us breast unilateral limited (76642) |
$249.30 |
$415.50 |
2.9× |
| Us chest (76604) |
$316.80 |
$528 |
3.0× |
| Us compl joint r-t w/image documentation (76881) |
$477 |
$795 |
4.6× |
| Us infant hips dynamic (76885) |
$669.60 |
$1,116 |
7.7× |
| Us infant hips limited static (76886) |
$514.80 |
$858 |
5.9× |
| Us kidney transplant (76776) |
$265.20 |
$442 |
2.5× |
| Us ob detailed single fetus (76811) |
$864 |
$1,440 |
3.6× |
| Us ob transvaginal (76817) |
$642 |
$1,070 |
6.2× |
| Us pelvic non ob complete (76856) |
$631.20 |
$1,052 |
6.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$314.40 |
$524 |
3.0× |
| Us pregnancy ltd (76815) |
$318.60 |
$531 |
3.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$642 |
$1,070 |
6.2× |
| Us retroperitoneal complete (76770) |
$706.80 |
$1,178 |
6.8× |
| Us retroperitoneal limited (76775) |
$402 |
$670 |
3.9× |
| Us scrotum and contents (76870) |
$543.60 |
$906 |
5.2× |
| Us soft tissue head/neck (76536) |
$582.60 |
$971 |
5.6× |
| Us spinal canal and contents (76800) |
$774.60 |
$1,291 |
7.4× |
| Us transrectal (76872) |
$153 |
$255 |
1.5× |
| Us transrectal prostate volume (76873) |
$537 |
$895 |
5.2× |
| Us xtr non-vasc lmtd (76882) |
$491.40 |
$819 |
4.7× |
| Vascular flow imaging (78445) |
$279.60 |
$466 |
0.7× |
| Venogram extremity bilateral (75822) |
$1,723.20 |
$2,872 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,842.40 |
$6,404 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$1,980 |
$3,300 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,150.80 |
$1,918 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$3,842.40 |
$6,404 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,842.40 |
$6,404 |
1.2× |
| Wrist 2 views (73100) |
$249.30 |
$415.50 |
2.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$439.20 |
$732 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$253.80 |
$423 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$447.90 |
$746.50 |
5.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$779.40 |
$1,299 |
4.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$365.10 |
$608.50 |
4.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$558 |
$930 |
6.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$325.80 |
$543 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$180.60 |
$301 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$231.60 |
$386 |
2.7× |
| X-ray exam hip uni 4/> views (73503) |
$360 |
$600 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$192 |
$320 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$325.80 |
$543 |
3.1× |
| X-ray exam of femur 1 (73551) |
$115.20 |
$192 |
1.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$369.60 |
$616 |
3.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$177 |
$295 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$449.10 |
$748.50 |
5.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$241.80 |
$403 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$201.60 |
$336 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$440.10 |
$733.50 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$175.20 |
$292 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$210.30 |
$350.50 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$310.80 |
$518 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$609.60 |
$1,016 |
5.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$290.40 |
$484 |
2.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$257.40 |
$429 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$237.60 |
$396 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$382.80 |
$638 |
3.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$154.20 |
$257 |
1.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,003.20 |
$1,672 |
2.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$243 |
$405 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$322.20 |
$537 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$379.80 |
$633 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$195.60 |
$326 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$200.40 |
$334 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$654 |
$1,090 |
7.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$388.80 |
$648 |
4.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$258 |
$430 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$362.40 |
$604 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$300 |
$500 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$270.60 |
$451 |
3.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$191.40 |
$319 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$279.60 |
$466 |
3.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$312 |
$520 |
3.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$363 |
$605 |
3.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$190.80 |
$318 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$354.90 |
$591.50 |
4.1× |
| Xr arthrogram ankle (73615) |
$518.40 |
$864 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$534.60 |
$891 |
5.1× |
| Xr chest 4+ views (71048) |
$202.20 |
$337 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$279 |
$465 |
3.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$159.60 |
$266 |
1.5× |
| Xr shoulder 1 view (73020) |
$178.20 |
$297 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$682.20 |
$1,137 |
6.6× |
| Xr tibia/fibula 2 views (73590) |
$329.40 |
$549 |
3.8× |
| Xr tmj bilateral (70330) |
$451.20 |
$752 |
5.2× |
| Xray knee 1 or 2 views rt (73560) |
$253.20 |
$422 |
2.9× |