| Abdomen 2 views (74019) |
$687.20 |
$981.72 |
6.0× |
| Acute gi blood loss imaging (78278) |
$1,421.70 |
$2,031 |
3.2× |
| Angiography extremity bilateral rs&i (75716) |
$7,963.70 |
$11,376.71 |
2.3× |
| Angiography extremity unilateral rs&i (75710) |
$9,079.11 |
$12,970.15 |
2.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$13,065.20 |
$18,664.58 |
2.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,477.16 |
$12,110.23 |
2.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,477.16 |
$12,110.23 |
2.4× |
| Angiography Spinal Selective Rs&I (75705) |
$17,581.96 |
$25,117.08 |
2.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$32,826.21 |
$46,894.59 |
5.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$5,461.15 |
$7,801.64 |
1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,461.15 |
$7,801.64 |
1.6× |
| Ankle 2 views (73600) |
$429.65 |
$613.78 |
4.5× |
| Aortogram thoracic (75605) |
$9,574.76 |
$13,678.22 |
1.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$8,457.18 |
$12,081.69 |
2.4× |
| Aortography abdominal serialography rs&i (75625) |
$10,208.40 |
$14,583.43 |
3.0× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$9,508.11 |
$13,583.01 |
2.7× |
| Arthrogram hip (73525) |
$1,413.36 |
$2,019.08 |
3.7× |
| Arthrogram knee (73580) |
$769.87 |
$1,099.81 |
2.0× |
| Arthrogram shoulder (73040) |
$1,121.34 |
$1,601.90 |
2.9× |
| Arthrogram wrist (73115) |
$1,199.84 |
$1,714.06 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$923.30 |
$1,319 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$1,849.26 |
$2,641.81 |
4.2× |
| Bone age studies (77072) |
$216.43 |
$309.19 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,600.60 |
$2,286.57 |
3.7× |
| Bone survey complete (77075) |
$638.34 |
$911.92 |
5.6× |
| Bone survey infant (77076) |
$215.89 |
$308.41 |
1.9× |
| Bowel imaging (78290) |
$1,339.86 |
$1,914.08 |
3.1× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$1,266.77 |
$1,809.67 |
2.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,499.21 |
$10,713.15 |
4.8× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$1,266.77 |
$1,809.67 |
2.1× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,800.74 |
$2,572.48 |
4.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,890.27 |
$2,700.38 |
4.9× |
| Cervical spine 2 or 3 views (72040) |
$413 |
$590 |
4.3× |
| Chest 1 view (71045) |
$683.96 |
$977.08 |
7.2× |
| Chest xray 3 views (71047) |
$142.65 |
$203.79 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$490 |
$700 |
2.5× |
| Clavicle complete (73000) |
$270.77 |
$386.82 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$499.70 |
$713.86 |
4.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,796.41 |
$2,566.30 |
4.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,337.14 |
$1,910.20 |
5.1× |
| CT abdomen w contrast (74160) |
$1,099.66 |
$1,570.94 |
5.7× |
| CT abdomen w wo contrast (74170) |
$1,231.58 |
$1,759.40 |
6.4× |
| CT abdomen w/o contrast (74150) |
$654.24 |
$934.62 |
5.7× |
| CT angio hrt w/3d image (75574) |
$696.96 |
$995.65 |
1.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,160.31 |
$1,657.58 |
6.0× |
| CT angiography upper extremity lt (73206) |
$841.52 |
$1,202.17 |
4.4× |
| CT c-spine w/contrast (72126) |
$1,701.80 |
$2,431.16 |
4.5× |
| CT c-spine w/o contrast (72125) |
$707 |
$1,010 |
6.2× |
| CT cervical spine w&w/o contrast (72127) |
$970.20 |
$1,386 |
5.0× |
| CT chest w contrast (71260) |
$1,099.66 |
$1,570.94 |
5.7× |
| CT chest w/wo contrast (71270) |
$1,038.80 |
$1,484 |
5.4× |
| CT colonography screening (74263) |
$572.28 |
$817.54 |
2.2× |
| CT colonography w/o cntrst (74261) |
$272.97 |
$389.95 |
2.4× |
| CT head/brain with contrast (70460) |
$1,099.66 |
$1,570.94 |
5.7× |
| CT head/brain without and with contrast (70470) |
$1,231.58 |
$1,759.40 |
6.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$660.07 |
$942.96 |
1.7× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$426.15 |
$608.78 |
4.5× |
| CT iac w contrast (70481) |
$1,016.66 |
$1,452.37 |
5.3× |
| CT limited/localized follow up study (76380) |
$283.85 |
$405.50 |
3.0× |
| CT lower ext w/o (73700) |
$596.20 |
$851.71 |
5.2× |
| CT lower extremity w wo contrast (73702) |
$1,069.96 |
$1,528.51 |
5.6× |
| CT lower extremity w/contrast material (73701) |
$1,522.66 |
$2,175.24 |
7.9× |
| CT lumbar spine w & w/o contrast (72133) |
$791.73 |
$1,131.04 |
4.1× |
| CT lumbar spine w/contrast (72132) |
$1,698.10 |
$2,425.84 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$707 |
$1,010 |
6.2× |
| CT maxillofacial w contrast (70487) |
$1,153.45 |
$1,647.78 |
6.0× |
| CT maxillofacial w/wo contrast (70488) |
$897.40 |
$1,282 |
4.7× |
| CT maxillofacial wo contrast (70486) |
$749.70 |
$1,071 |
6.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,057.35 |
$1,510.50 |
5.5× |
| CT orbits w/o contrast (70480) |
$854.38 |
$1,220.53 |
7.5× |
| CT pelvis w/o contrast (72192) |
$629.62 |
$899.46 |
5.5× |
| CT pelvis w/wo contrast (72194) |
$1,173.20 |
$1,676 |
6.1× |
| CT scan of arm combo (73202) |
$893.23 |
$1,276.04 |
4.6× |
| CT soft tissue neck w contrast (70491) |
$1,061.70 |
$1,516.70 |
5.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$674.51 |
$963.58 |
3.5× |
| CT soft tissue neck w/o contrast (70490) |
$671.30 |
$959 |
5.9× |
| CT thoracic spine w/contrast (72129) |
$1,099.66 |
$1,570.94 |
5.7× |
| CT thoracic spine w/o contrast (72128) |
$707 |
$1,010 |
6.2× |
| CT thoracic spine w/wo contrast (72130) |
$791.73 |
$1,131.04 |
4.1× |
| CT thorax w/o contrast (71250) |
$665.09 |
$950.12 |
5.8× |
| CT unlisted procedure (76497) |
$218.53 |
$312.19 |
2.3× |
| CT upper ext wo (73200) |
$511 |
$730 |
4.5× |
| CT upper extremity with contrast (73201) |
$1,558.14 |
$2,225.92 |
4.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,384.26 |
$1,977.52 |
7.2× |
| Cta Abdomen (74175) |
$764.91 |
$1,092.73 |
4.0× |
| CTA abdomen pelvis (74174) |
$1,929.93 |
$2,757.04 |
5.0× |
| CTA chest (71275) |
$1,401.98 |
$2,002.82 |
7.3× |
| Cta Head (70496) |
$902.86 |
$1,289.79 |
4.7× |
| Cta Neck (70498) |
$897.11 |
$1,281.58 |
4.7× |
| Cta Pelvis (72191) |
$904.79 |
$1,292.55 |
4.7× |
| Cystography minimum 3 views rs&i (74430) |
$1,509.04 |
$2,155.77 |
3.9× |
| Diskography lumbar (72295) |
$7,294.18 |
$10,420.25 |
3.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$454.10 |
$648.72 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$133.66 |
$190.94 |
1.4× |
| Dxa bone density study axial skeleton (77085) |
$216.43 |
$309.19 |
1.9× |
| Esophagus (74220) |
$807.06 |
$1,152.94 |
4.2× |
| Facial bones min 3 views (70150) |
$377.80 |
$539.72 |
3.3× |
| Fetal biophysical profile non-stress testing (76818) |
$306.63 |
$438.04 |
2.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$377.83 |
$539.76 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$763.51 |
$1,090.73 |
2.9× |
| Foot 2 views (73620) |
$334.35 |
$477.64 |
3.5× |
| Forearm 2 views (73090) |
$364.66 |
$520.94 |
3.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,479.78 |
$2,113.98 |
3.4× |
| Hand 2 views (73120) |
$527 |
$752.86 |
4.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$11,387.22 |
$16,267.46 |
3.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,792.34 |
$2,560.49 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,495.97 |
$2,137.10 |
3.4× |
| Hysterosalpingogram (74740) |
$768.15 |
$1,097.36 |
2.9× |
| Interstitial radiation source applic complex (77778) |
$4,266.16 |
$6,094.51 |
5.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$512.78 |
$732.54 |
4.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,925.39 |
$2,750.56 |
3.2× |
| Knee 3 views (73562) |
$469.78 |
$671.11 |
4.9× |
| Liver & spleen imaging static only (78215) |
$1,144.47 |
$1,634.96 |
2.6× |
| Liver imaging static only (78201) |
$1,408.74 |
$2,012.49 |
2.4× |
| Liver imaging w/vascular flow (78202) |
$1,235.39 |
$1,764.84 |
2.1× |
| Lung perf&ventilat diferentl (78598) |
$2,197.54 |
$3,139.35 |
3.7× |
| Lymphoscintigraphy (78195) |
$1,963.15 |
$2,804.50 |
3.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,154.66 |
$4,506.66 |
3.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$970.39 |
$1,386.27 |
2.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,292.14 |
$3,274.48 |
6.0× |
| Mammary ductogram or galactogram multiple (77054) |
$754.89 |
$1,078.41 |
2.9× |
| Mammary ductogram or galactogram single (77053) |
$766.21 |
$1,094.59 |
2.9× |
| MRA head w & w/o contrast (70546) |
$1,468.88 |
$2,098.40 |
3.8× |
| MRA head w/o contrast (70544) |
$1,318.50 |
$1,883.58 |
5.0× |
| MRA head with contrast (70545) |
$980.09 |
$1,400.13 |
2.6× |
| MRA neck w contrast (70548) |
$1,866.17 |
$2,665.95 |
4.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,869.18 |
$2,670.25 |
4.9× |
| MRA neck w/o contrast (70547) |
$1,310.65 |
$1,872.36 |
5.0× |
| MRI abdomen w contrast (74182) |
$970.39 |
$1,386.27 |
2.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,205.62 |
$3,150.89 |
5.8× |
| MRI abdomen w/o contrast (74181) |
$1,370.01 |
$1,957.15 |
5.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,818.34 |
$4,026.19 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,098.03 |
$2,997.18 |
5.5× |
| MRI breast w/o contrast bilateral (77047) |
$1,096.24 |
$1,566.06 |
4.2× |
| MRI c-spine with contrast (72142) |
$1,413.74 |
$2,019.64 |
3.7× |
| MRI cardiac w/o contrast (75557) |
$1,213.48 |
$1,733.54 |
4.6× |
| MRI cervical spine w/o contrast (72141) |
$1,343.70 |
$1,919.58 |
5.1× |
| MRI chest w/o & w/contrast material (71552) |
$1,866.17 |
$2,665.95 |
4.9× |
| MRI chest w/o contrast (71550) |
$1,165.71 |
$1,665.30 |
4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,418.24 |
$2,026.06 |
3.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,310.55 |
$3,300.78 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,370.01 |
$1,957.15 |
5.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,559.60 |
$2,228 |
6.0× |
| MRI orbit face neck w contrast (70542) |
$1,706.54 |
$2,437.92 |
4.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,100.70 |
$3,001 |
5.5× |
| MRI pelvis w/contrast (72196) |
$970.39 |
$1,386.27 |
2.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,205.62 |
$3,150.89 |
5.8× |
| MRI pelvis w/o contrast (72195) |
$1,370.01 |
$1,957.15 |
5.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,100.70 |
$3,001 |
5.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$970.39 |
$1,386.27 |
2.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,100.70 |
$3,001 |
5.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$970.39 |
$1,386.27 |
2.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,100.70 |
$3,001 |
5.5× |
| MRI temporomandibular joint (70336) |
$1,015.44 |
$1,450.62 |
3.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,402.16 |
$2,003.08 |
5.4× |
| MRI up ext w/o contrast (73218) |
$1,165.71 |
$1,665.30 |
4.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,370.01 |
$1,957.15 |
5.2× |
| MRI, joint upper extrem combo (73223) |
$2,100.70 |
$3,001 |
5.5× |
| Myelogram Cervical (72240) |
$2,552.98 |
$3,647.10 |
3.0× |
| Myelogram Lumbar (72265) |
$2,552.98 |
$3,647.10 |
3.0× |
| Myelography 2 or more regions (72270) |
$2,033.75 |
$2,905.36 |
2.4× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$1,236.80 |
$1,766.86 |
2.1× |
| Myocardial infarct spect (78469) |
$1,236.80 |
$1,766.86 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$4,564.71 |
$6,521.01 |
3.2× |
| Myocardial spect single study at rest or stress (78451) |
$2,682.23 |
$3,831.75 |
1.9× |
| Neck soft tissue (70360) |
$507.72 |
$725.31 |
5.3× |
| Nm cisternogram (78630) |
$1,052.75 |
$1,503.93 |
1.8× |
| Nm csf leak detection (78650) |
$1,845.08 |
$2,635.84 |
1.3× |
| Nm gastric emptying study (78264) |
$1,763.06 |
$2,518.66 |
4.0× |
| Nonvascular shunt X-ray (75809) |
$314.44 |
$449.20 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$1,098.34 |
$1,569.06 |
4.3× |
| Osseous survey limited (77074) |
$720.85 |
$1,029.79 |
6.3× |
| Parathyroid Planar Imaging (78070) |
$1,379.71 |
$1,971.02 |
3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,136.51 |
$1,623.58 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$434.82 |
$621.16 |
3.8× |
| PET image w/CT, skull-thigh (78815) |
$6,707.12 |
$9,581.60 |
4.3× |
| PET imaging for CT attenuation whole body (78816) |
$6,707.12 |
$9,581.60 |
4.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$11,387.22 |
$16,267.46 |
3.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,680.48 |
$5,257.83 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,537.98 |
$2,197.12 |
3.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,915.20 |
$2,736 |
3.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,509.77 |
$2,156.82 |
2.5× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$700 |
$1,000 |
7.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$283.24 |
$404.63 |
3.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$467.41 |
$667.73 |
4.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$337.36 |
$481.95 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$846.97 |
$1,209.96 |
7.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$426.68 |
$609.54 |
3.7× |
| Radex fingr minimum 2 views (73140) |
$396.28 |
$566.12 |
4.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$407.78 |
$582.54 |
4.3× |
| Radex Hand Minimum 3 Views (73130) |
$459.01 |
$655.73 |
4.8× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$264.60 |
$378 |
2.8× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$231.34 |
$330.49 |
2.0× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$428.54 |
$612.20 |
3.7× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$712.82 |
$1,018.31 |
6.2× |
| Radex Humerus Minimum 2 Views (73060) |
$431.22 |
$616.03 |
4.5× |
| Radex Kne 1/2 Views (73560) |
$413.94 |
$591.34 |
4.3× |
| Radex Kne Compl 4/More Views (73564) |
$524.17 |
$748.81 |
4.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$433.55 |
$619.36 |
3.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$255.20 |
$364.58 |
2.7× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$525.78 |
$751.12 |
4.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$433.55 |
$619.36 |
4.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$135 |
$192.86 |
1.4× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$299.14 |
$427.34 |
2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$115.85 |
$165.50 |
1.2× |
| Radex Toe Minimum 2 Views (73660) |
$283.24 |
$404.63 |
3.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$314.44 |
$449.20 |
2.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$344 |
$491.42 |
3.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$426.68 |
$609.54 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$356.49 |
$509.26 |
3.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$503.12 |
$718.74 |
4.4× |
| Radiologic exam chest 2 views (71046) |
$367.53 |
$525.04 |
3.9× |
| Radiologic exam colon single contrast study (74270) |
$721.95 |
$1,031.36 |
3.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$782.33 |
$1,117.62 |
4.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$819.44 |
$1,170.62 |
4.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$815.09 |
$1,164.41 |
4.2× |
| Radiologic examination femur 1 view (73551) |
$201.46 |
$287.80 |
2.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$368.94 |
$527.04 |
3.9× |
| Radiological examination surgical specimen (76098) |
$1,651.58 |
$2,359.40 |
2.8× |
| Ribs bilateral 3 views (71110) |
$216.43 |
$309.19 |
1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,249.24 |
$1,784.64 |
2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$5,142.47 |
$7,346.38 |
8.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,798.46 |
$8,283.51 |
9.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$5,775.94 |
$8,251.34 |
4.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,046.65 |
$4,352.35 |
2.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$998.70 |
$1,426.71 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$445.53 |
$636.47 |
3.9× |
| Scapula (73010) |
$445.53 |
$636.47 |
3.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$110.64 |
$158.06 |
4.7× |
| Shoulder 1 view (73020) |
$398.64 |
$569.49 |
4.2× |
| Small bowel series (74250) |
$924.22 |
$1,320.31 |
4.8× |
| Spine thoracic 3 views (72072) |
$433.55 |
$619.36 |
3.8× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$202.99 |
$289.99 |
2.1× |
| Tbs technical calculation only (77091) |
$207.99 |
$297.13 |
2.2× |
| Thoracolumbar 2 views (72080) |
$270.77 |
$386.82 |
2.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,752.60 |
$2,503.72 |
2.9× |
| Thyroid uptake measurement (78012) |
$878.18 |
$1,254.54 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,348.46 |
$1,926.37 |
3.1× |
| Tmj unilateral (70328) |
$196.48 |
$280.68 |
2.1× |
| Ultrasound breast complete (76641) |
$674.71 |
$963.87 |
5.9× |
| Ultrasound Exam Aaa Screen (76706) |
$457.56 |
$653.66 |
4.0× |
| Ultrasound, abdomen limited (76705) |
$445.73 |
$636.76 |
3.9× |
| Umbilical-artery Doppler (OB) (76820) |
$210.66 |
$300.94 |
1.8× |
| Unlisted magnetic resonance procedure (76498) |
$294.81 |
$421.16 |
3.1× |
| Ureteral reflux study (78740) |
$1,392.79 |
$1,989.70 |
3.2× |
| Urethrocystogram voiding (74455) |
$1,112.34 |
$1,589.06 |
4.3× |
| Urethrocystography retrograde rs&i (74450) |
$873.85 |
$1,248.36 |
3.3× |
| Us breast unilateral limited (76642) |
$429.72 |
$613.89 |
4.5× |
| Us chest (76604) |
$615.80 |
$879.70 |
5.4× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$959.38 |
$1,370.54 |
4.1× |
| Us encephalogram (76506) |
$394.96 |
$564.23 |
3.4× |
| Us hips infant static (76886) |
$303.78 |
$433.98 |
3.2× |
| Us infant hips w manipulation (76885) |
$210.66 |
$300.94 |
2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$484.18 |
$691.69 |
4.2× |
| Us ob detailed single fetus (76811) |
$549.42 |
$784.88 |
2.1× |
| Us ob limited (76815) |
$424.88 |
$606.98 |
3.7× |
| Us ob transvaginal (76817) |
$579.73 |
$828.18 |
5.1× |
| Us pelvic non ob complete (76856) |
$565.96 |
$808.51 |
4.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$478.25 |
$683.22 |
4.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$378.42 |
$540.59 |
3.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$365.19 |
$521.70 |
3.2× |
| Us retroperitoneal complete (76770) |
$615.80 |
$879.70 |
5.4× |
| Us retroperitoneal limited (76775) |
$586.60 |
$838 |
5.1× |
| Us scrotum and contents (76870) |
$514.57 |
$735.10 |
4.5× |
| Us soft tissue head/neck (76536) |
$586.60 |
$838 |
5.1× |
| Us spinal canal and contents (76800) |
$209.10 |
$298.72 |
1.8× |
| Us transrectal (76872) |
$899.01 |
$1,284.30 |
7.8× |
| Us transrectal prostate volume (76873) |
$629.98 |
$899.96 |
5.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$445.53 |
$636.47 |
3.9× |
| Venogram extremity bilateral (75822) |
$2,692.48 |
$3,846.40 |
1.6× |
| Venogram Extremity Unilateral (75820) |
$2,972.80 |
$4,246.85 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$10,684.80 |
$15,264 |
3.1× |
| Venography caval superior serialography rs&i (75827) |
$3,680.48 |
$5,257.83 |
2.1× |
| Venography Renal Bilateral (75833) |
$11,387.22 |
$16,267.46 |
3.3× |
| Venography renal unilateral selective rs&i (75831) |
$11,468.23 |
$16,383.18 |
3.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,680.48 |
$5,257.83 |
1.1× |
| Venous sampling by catheter (75893) |
$11,640.25 |
$16,628.93 |
1.9× |
| Wrist 2 views (73100) |
$351.18 |
$501.68 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$564.31 |
$806.16 |
4.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$212.70 |
$303.85 |
2.2× |
| X-ray b.e. reductn intuss (74283) |
$553.34 |
$790.48 |
2.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$656.60 |
$938 |
3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$330.88 |
$472.69 |
3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$290.94 |
$415.63 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$387.22 |
$553.17 |
3.4× |
| X-ray exam of femur 2/> (73552) |
$377.67 |
$539.53 |
4.0× |
| X-ray eye for foreign body (70030) |
$135 |
$192.86 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$184.73 |
$263.90 |
1.9× |
| X-ray IV pyelogram (ivp) (74400) |
$878.31 |
$1,254.72 |
4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$239.18 |
$341.68 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$270.77 |
$386.82 |
2.8× |
| X-ray leg, infant (73592) |
$215.89 |
$308.41 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$326.01 |
$465.72 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$492.30 |
$703.28 |
4.3× |
| X-ray nose-rectum child f.b. (76010) |
$135 |
$192.86 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$416.17 |
$594.53 |
3.6× |
| X-ray retrograde pyelogram (74420) |
$1,423.67 |
$2,033.82 |
3.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$270.77 |
$386.82 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$390.19 |
$557.42 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$433.55 |
$619.36 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$433.55 |
$619.36 |
3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$277.62 |
$396.60 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$385.81 |
$551.16 |
4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$379.66 |
$542.37 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$507.37 |
$724.81 |
4.4× |
| X-Ray Small Bowel Enteroclysis (74251) |
$499.91 |
$714.16 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$310.59 |
$443.70 |
3.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$236.80 |
$338.29 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$270.77 |
$386.82 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$332.11 |
$474.44 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$433.55 |
$619.36 |
3.8× |
| Xr bone length studies (77073) |
$445.53 |
$636.47 |
3.9× |
| Xr c-spine 4 or 5 views (72050) |
$454.10 |
$648.72 |
4.0× |
| Xr c-spine 6 or more views (72052) |
$433.55 |
$619.36 |
3.8× |
| Xr chest 4+ views (71048) |
$479.65 |
$685.21 |
4.2× |
| Xr urogram antegrade (74425) |
$1,107.04 |
$1,581.48 |
2.9× |