| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,213.80 |
$6,069 |
0.7× |
| Abdomen 1 View (74018) |
$51.45 |
$257.25 |
0.5× |
| Abdomen 2 views (74019) |
$74.13 |
$370.65 |
0.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$184.80 |
$924 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$1,083.60 |
$5,418 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$953.40 |
$4,767 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,587.60 |
$7,938 |
0.4× |
| Ankle 2 views (73600) |
$48.72 |
$243.60 |
0.4× |
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure |
$1,497.30 |
$7,486.50 |
0.2× |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$1,194.90 |
$5,974.50 |
0.2× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$2,625 |
$13,125 |
0.4× |
| Arthrogram ankle (73615) |
$115.50 |
$577.50 |
0.3× |
| Arthrogram hip (73525) |
$142.80 |
$714 |
0.3× |
| Arthrogram Wrist (73115) |
$130.20 |
$651 |
0.3× |
| Basic radiation dosimetry calculation (77300) |
$138.60 |
$693 |
0.8× |
| Bone age studies (77072) |
$88.62 |
$443.10 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$329.70 |
$1,648.50 |
0.7× |
| Bone Imaging Limited Area (78300) |
$153.30 |
$766.50 |
0.3× |
| Bone Imaging Whole Body (78306) |
$283.50 |
$1,417.50 |
0.6× |
| Bone survey infant (77076) |
$121.80 |
$609 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,583.40 |
$7,917 |
0.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$789.60 |
$3,948 |
1.8× |
| Chest 1 view (71045) |
$60.27 |
$301.35 |
0.6× |
| Chest 2 views (71046) |
$66.15 |
$330.75 |
0.6× |
| Chest 3 views (71047) |
$62.79 |
$313.95 |
0.6× |
| Chest 4 or more views (71048) |
$76.23 |
$381.15 |
0.6× |
| Clavicle complete (73000) |
$51.66 |
$258.30 |
0.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$64.26 |
$321.30 |
0.5× |
| Continuing medical physics consltj pr wk (77336) |
$142.80 |
$714 |
0.9× |
| Contrast Exam Abdominl Aorta (75625) |
$953.40 |
$4,767 |
0.2× |
| Contrast X-Ray Bladder (74430) |
$82.74 |
$413.70 |
0.2× |
| Contrast X-Ray Of Elbow (73085) |
$115.50 |
$577.50 |
0.3× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$86.58 |
$432.89 |
0.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,018.50 |
$5,092.50 |
2.3× |
| CT abdomen and pelvis without contrast (74176) |
$573.30 |
$2,866.50 |
1.9× |
| CT abdomen w contrast (74160) |
$369.60 |
$1,848 |
1.7× |
| CT abdomen w wo contrast (74170) |
$504 |
$2,520 |
2.3× |
| CT abdomen w/o contrast (74150) |
$231 |
$1,155 |
1.8× |
| CT Angio Abdomen and Pelvis (74174) |
$1,337.70 |
$6,688.50 |
3.1× |
| CT Angio Chest (71275) |
$550.20 |
$2,751 |
2.5× |
| CT Angio Head (70496) |
$537.60 |
$2,688 |
2.5× |
| CT angio hrt w/3d image (75574) |
$663.60 |
$3,318 |
1.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$573.30 |
$2,866.50 |
2.6× |
| CT Angio Neck (70498) |
$573.30 |
$2,866.50 |
2.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$590.10 |
$2,950.50 |
2.7× |
| CT cervical spine w/ contrast (72126) |
$354.90 |
$1,774.50 |
0.8× |
| CT cervical spine w/o contrast (72125) |
$315 |
$1,575 |
2.4× |
| CT cervical spine w/wo cont (72127) |
$447.30 |
$2,236.50 |
2.0× |
| CT chest w contrast (71260) |
$392.70 |
$1,963.50 |
1.8× |
| CT chest w/wo contrast (71270) |
$411.60 |
$2,058 |
1.9× |
| CT colonography screening (74263) |
$714 |
$3,570 |
2.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$448.39 |
$2,241.94 |
2.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$413.70 |
$2,068.50 |
3.2× |
| CT head/brain with contrast (70460) |
$327.60 |
$1,638 |
1.5× |
| CT head/brain without and with contrast (70470) |
$386.40 |
$1,932 |
1.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$130.20 |
$651 |
1.2× |
| CT iac w contrast (70481) |
$302.40 |
$1,512 |
1.4× |
| CT l-spine w&w/o contrast (72133) |
$455.70 |
$2,278.50 |
2.1× |
| CT lower ext w/o (73700) |
$268.80 |
$1,344 |
2.1× |
| CT lower extremity w/contrast material (73701) |
$352.80 |
$1,764 |
1.6× |
| CT lumbar spine w contrast (72132) |
$336 |
$1,680 |
0.8× |
| CT lumbar spine w/o contrast (72131) |
$306.60 |
$1,533 |
2.3× |
| CT maxillofacial w contrast (70487) |
$243.60 |
$1,218 |
1.1× |
| CT maxillofacial wo contrast (70486) |
$249.90 |
$1,249.50 |
1.9× |
| CT neck tissue combo (70492) |
$447.30 |
$2,236.50 |
2.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$352.80 |
$1,764 |
1.6× |
| CT orbits w/o contrast (70480) |
$235.20 |
$1,176 |
1.8× |
| CT pelvis w&w/o contrast (72194) |
$504 |
$2,520 |
2.3× |
| CT pelvis w/o contrast (72192) |
$310.80 |
$1,554 |
2.4× |
| CT scan of leg combo (73702) |
$472.50 |
$2,362.50 |
2.2× |
| CT scans face/jaw combo (70488) |
$365.40 |
$1,827 |
1.7× |
| CT soft tissue neck w contrast (70491) |
$359.10 |
$1,795.50 |
1.6× |
| CT soft tissue neck w/o contrast (70490) |
$273 |
$1,365 |
2.1× |
| CT thoracic spine w contrast (72129) |
$336 |
$1,680 |
1.5× |
| CT thoracic spine w/o contrast (72128) |
$310.80 |
$1,554 |
2.4× |
| CT thoracic spine w/wo cont (72130) |
$455.70 |
$2,278.50 |
2.1× |
| CT thorax w/o contrast (71250) |
$300.30 |
$1,501.50 |
2.3× |
| CT upper ext wo (73200) |
$264.60 |
$1,323 |
2.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$462 |
$2,310 |
2.1× |
| CT upper extremity with contrast (73201) |
$382.20 |
$1,911 |
0.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$663.60 |
$3,318 |
3.0× |
| Cta Abdomen (74175) |
$579.60 |
$2,898 |
2.6× |
| CTA pelvis (72191) |
$630 |
$3,150 |
2.9× |
| Dxa Bone Density Axial (77080) |
$58.59 |
$292.95 |
0.4× |
| Dxa bone density study (77085) |
$84.91 |
$424.53 |
0.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$35.49 |
$177.45 |
0.3× |
| Echo exam uterus (76831) |
$216.68 |
$1,083.39 |
0.7× |
| Echo Guide For Artery Repair (76936) |
$159.60 |
$798 |
0.6× |
| Esophagram (74220) |
$98.07 |
$490.35 |
0.4× |
| Fetal Biophys Profile W/Nst (76818) |
$84.91 |
$424.53 |
0.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$159.66 |
$798.32 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$184.80 |
$924 |
0.6× |
| Foot 2 views (73620) |
$46.20 |
$231 |
0.4× |
| Forearm 2 views (73090) |
$55.65 |
$278.25 |
0.5× |
| Gastric emptying imaging study (78264) |
$205.80 |
$1,029 |
0.4× |
| Gated Heart Planar Single (78472) |
$243.60 |
$1,218 |
0.5× |
| Hand 2 views (73120) |
$46.20 |
$231 |
0.4× |
| Hepatobil Syst Image W/Drug (78227) |
$241.50 |
$1,207.50 |
0.4× |
| Hepatobiliary System Imaging (78226) |
$241.50 |
$1,207.50 |
0.5× |
| Ht Muscle Image Spect Sing (78451) |
$329.70 |
$1,648.50 |
0.2× |
| Hysterosalpingogram (74740) |
$172.20 |
$861 |
0.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$72.66 |
$363.30 |
0.7× |
| K Flow/Funct Image W/Drug (78708) |
$249.90 |
$1,249.50 |
0.4× |
| K Flow/Funct Image W/O Drug (78707) |
$277.20 |
$1,386 |
0.4× |
| Knee 3 Views (73562) |
$144.48 |
$722.40 |
1.3× |
| Liver & Spleen Imaging Static Only (78215) |
$222.60 |
$1,113 |
0.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$184.80 |
$924 |
0.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$706.31 |
$3,531.53 |
1.0× |
| Lymph System Imaging (78195) |
$260.40 |
$1,302 |
0.4× |
| Magnetic Image Jaw Joint (70336) |
$924 |
$4,620 |
3.1× |
| Mammary ductogram or galactogram multiple (77054) |
$134.40 |
$672 |
0.5× |
| Mammary ductogram or galactogram single (77053) |
$126 |
$630 |
0.4× |
| Meckels Divert Exam (78290) |
$184.80 |
$924 |
0.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$184.80 |
$924 |
0.4× |
| Mr safety determination physician/other qhp (76016) |
$70.30 |
$351.51 |
0.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$19.56 |
$97.78 |
0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$73.29 |
$366.44 |
0.6× |
| Mr safety implt pos&/immoblj (76019) |
$47.43 |
$237.13 |
0.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$257.33 |
$1,286.67 |
0.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$856.80 |
$4,284 |
2.0× |
| MRA head w/o contrast (70544) |
$779.10 |
$3,895.50 |
2.6× |
| MRA head with contrast (70545) |
$837.90 |
$4,189.50 |
1.9× |
| MRA neck w contrast (70548) |
$783.30 |
$3,916.50 |
1.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$871.50 |
$4,357.50 |
2.0× |
| MRA neck w/o contrast (70547) |
$716.10 |
$3,580.50 |
2.4× |
| MRI abdomen w contrast (74182) |
$816.90 |
$4,084.50 |
1.9× |
| MRI abdomen w/o contrast (74181) |
$779.10 |
$3,895.50 |
2.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$779.10 |
$3,895.50 |
0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$934.50 |
$4,672.50 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$816.90 |
$4,084.50 |
0.8× |
| MRI bone marrow blood supply (77084) |
$630 |
$3,150 |
2.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$892.50 |
$4,462.50 |
3.0× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$798 |
$3,990 |
2.7× |
| MRI cervical spine w contrast (72142) |
$894.60 |
$4,473 |
2.1× |
| MRI cervical spine w/o cont (72141) |
$798 |
$3,990 |
2.7× |
| MRI chest w/o contrast (71550) |
$779.10 |
$3,895.50 |
2.6× |
| MRI chest wo w contrast (71552) |
$911.40 |
$4,557 |
2.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$751.80 |
$3,759 |
1.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$911.40 |
$4,557 |
2.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$714 |
$3,570 |
2.4× |
| MRI lumbar spine w contrast (72149) |
$823.20 |
$4,116 |
1.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$951.30 |
$4,756.50 |
2.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$779.10 |
$3,895.50 |
2.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$911.40 |
$4,557 |
2.1× |
| MRI pelvis w contrast (72196) |
$907.20 |
$4,536 |
2.1× |
| MRI pelvis w/o & w contrast (72197) |
$963.90 |
$4,819.50 |
2.2× |
| MRI pelvis w/o contrast (72195) |
$779.10 |
$3,895.50 |
2.6× |
| MRI thoracic spine w/o contrast (72146) |
$779.10 |
$3,895.50 |
2.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$726.60 |
$3,633 |
1.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$743.40 |
$3,717 |
2.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$911.40 |
$4,557 |
2.1× |
| MRI, abdomen, combo (74183) |
$835.80 |
$4,179 |
1.9× |
| MRI, dorsal spine combo (72157) |
$951.30 |
$4,756.50 |
2.2× |
| MRI, dorsal spine contrast (72147) |
$865.20 |
$4,326 |
2.0× |
| MRI, joint upper extrem (73221) |
$714 |
$3,570 |
2.4× |
| MRI, joint upper extrem combo (73223) |
$871.50 |
$4,357.50 |
2.0× |
| MRI, lumbar spine combo (72158) |
$970.20 |
$4,851 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$678.30 |
$3,391.50 |
0.4× |
| Neck soft tissue (70360) |
$60.06 |
$300.30 |
0.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,060.50 |
$5,302.50 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$249.90 |
$1,249.50 |
0.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$119.07 |
$595.35 |
0.9× |
| Optic foramina (70190) |
$52.29 |
$261.45 |
0.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$852.60 |
$4,263 |
1.3× |
| Parathyroid Planar Imaging (78070) |
$336.66 |
$1,683.29 |
0.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$320.84 |
$1,604.20 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$50.61 |
$253.05 |
0.4× |
| Pet Image W/Ct Lmtd (78814) |
$1,789.41 |
$8,947.05 |
1.0× |
| PET image w/CT, full body (78816) |
$1,936.20 |
$9,681 |
1.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,990.80 |
$9,954 |
1.1× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,583.40 |
$7,917 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$119.70 |
$598.50 |
0.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$184.80 |
$924 |
1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$62.16 |
$310.80 |
0.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$53.34 |
$266.70 |
0.5× |
| Radex elbow complete minimum 3 views (73080) |
$59.64 |
$298.20 |
0.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$108.15 |
$540.75 |
0.8× |
| Radex fingr minimum 2 views (73140) |
$40.11 |
$200.55 |
0.4× |
| Radex foot complete minimum 3 views (73630) |
$59.22 |
$296.10 |
0.5× |
| Radex Hand Minimum 3 Views (73130) |
$56.91 |
$284.55 |
0.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$57.96 |
$289.80 |
0.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$99.75 |
$498.75 |
0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$75.39 |
$376.95 |
0.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$70.98 |
$354.90 |
0.7× |
| Radex shoulder complete minimum 2 views (73030) |
$65.52 |
$327.60 |
0.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$86.73 |
$433.65 |
0.8× |
| Radex Spine 1 View Specify Level (72020) |
$49.35 |
$246.75 |
0.5× |
| Radex Sternum Minimum 2 Views (71120) |
$62.16 |
$310.80 |
0.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$81.90 |
$409.50 |
0.8× |
| Radex Toe Minimum 2 Views (73660) |
$41.16 |
$205.80 |
0.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$55.44 |
$277.20 |
0.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$60.06 |
$300.30 |
0.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$204.75 |
$1,023.75 |
1.6× |
| Radiation treatment delivery level 1 (77402) |
$168 |
$840 |
1.3× |
| Radiation treatment delivery level 2 (77407) |
$309.38 |
$1,546.92 |
0.6× |
| Radiation treatment delivery level 3 (77412) |
$277.20 |
$1,386 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$89.46 |
$447.30 |
0.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$84.91 |
$424.53 |
0.7× |
| Radiologic exam colon double contrast study (74280) |
$212.10 |
$1,060.50 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$121.80 |
$609 |
0.6× |
| Radiologic exam knee complete 4/more views (73564) |
$77.28 |
$386.40 |
0.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$90.30 |
$451.50 |
0.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$130.20 |
$651 |
0.6× |
| Radiologic exam swallow function contrast study (74230) |
$103.74 |
$518.70 |
0.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$80.64 |
$403.20 |
0.4× |
| Radiologic examination femur 1 view (73551) |
$111.09 |
$555.45 |
1.0× |
| Radiologic examination femur minimum 2 views (73552) |
$71.40 |
$357 |
0.7× |
| Radiologic examination knee 1/2 views (73560) |
$49.14 |
$245.70 |
0.5× |
| Radiologic Examination Osseous Survey Limited (77074) |
$194.25 |
$971.25 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$58.59 |
$292.95 |
0.5× |
| Ribs bilateral 3 views (71110) |
$83.79 |
$418.95 |
0.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$842.10 |
$4,210.50 |
1.2× |
| Scapula (73010) |
$59.22 |
$296.10 |
0.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$57.33 |
$286.65 |
2.5× |
| Shoulder 1 view (73020) |
$46.20 |
$231 |
0.4× |
| Shoulder Arthrography (73040) |
$226.80 |
$1,134 |
0.5× |
| Sialogram (70390) |
$210 |
$1,050 |
0.7× |
| Skull less than 4 views (70250) |
$69.72 |
$348.60 |
0.5× |
| Special dosimetry (77331) |
$84.84 |
$424.20 |
0.5× |
| Special Physics Consult (77370) |
$53.55 |
$267.75 |
0.3× |
| Special treatment procedure (77470) |
$485.10 |
$2,425.50 |
0.7× |
| Stereotactic Body Radiation Delivery (77373) |
$1,432.20 |
$7,161 |
0.6× |
| Sternoclavicular joints (71130) |
$50.82 |
$254.10 |
0.5× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$81.85 |
$409.23 |
0.6× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$81.85 |
$409.23 |
0.6× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$29.96 |
$149.82 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$222.60 |
$1,113 |
0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$268.80 |
$1,344 |
0.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$91.56 |
$457.80 |
0.5× |
| Thoracic spine 2 views (72070) |
$68.25 |
$341.25 |
0.5× |
| Thoracic spine 3 views (72072) |
$159.81 |
$799.05 |
1.2× |
| Thoracolumbar 2 views (72080) |
$66.36 |
$331.80 |
0.6× |
| Thyroid Uptake Measurement (78012) |
$142.80 |
$714 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$241.50 |
$1,207.50 |
0.5× |
| Tx Devices Design & Construction Complex (77334) |
$462 |
$2,310 |
1.0× |
| Tx devices design & construction intermediate (77333) |
$201.60 |
$1,008 |
1.2× |
| Tx devices design & construction simple (77332) |
$23.52 |
$117.60 |
0.1× |
| Ultrasound Breast Limited (76642) |
$102.48 |
$512.40 |
0.9× |
| Ultrasound Elastography Parenchyma (76981) |
$159.60 |
$798 |
1.2× |
| Ultrasound Exam Aaa Screen (76706) |
$95.34 |
$476.70 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$163.80 |
$819 |
1.3× |
| Umbilical-artery Doppler (OB) (76820) |
$124.32 |
$621.60 |
1.0× |
| Unlisted Dx Radiographic Procedure (76499) |
$160.23 |
$801.15 |
1.5× |
| Unlisted us procedure (76999) |
$156.33 |
$781.65 |
1.4× |
| Upper gi w/o kub (74240) |
$142.14 |
$710.70 |
0.6× |
| Urethrocystography retrograde (74450) |
$111.30 |
$556.50 |
0.4× |
| Us breast unilateral complete (76641) |
$102.48 |
$512.40 |
0.8× |
| Us chest (76604) |
$92.19 |
$460.95 |
0.7× |
| Us complete joint (76881) |
$134.40 |
$672 |
1.0× |
| Us exam, pelvic, limited (76857) |
$130.20 |
$651 |
1.0× |
| Us head (76506) |
$168 |
$840 |
1.3× |
| Us kidney transplant (76776) |
$95.76 |
$478.80 |
0.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$89.25 |
$446.25 |
0.7× |
| Us ob detailed single fetus (76811) |
$224.70 |
$1,123.50 |
0.8× |
| Us ob limited 1 or more fetuses (76815) |
$140.70 |
$703.50 |
1.1× |
| Us ob transvaginal (76817) |
$134.40 |
$672 |
1.0× |
| Us pelvic non ob complete (76856) |
$134.40 |
$672 |
1.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$172.20 |
$861 |
1.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$119.70 |
$598.50 |
0.9× |
| Us retroperitoneal complete (76770) |
$153.30 |
$766.50 |
1.2× |
| Us retroperitoneal limited (76775) |
$153.30 |
$766.50 |
1.2× |
| Us scrotum and contents (76870) |
$130.20 |
$651 |
1.0× |
| Us spinal canal and contents (76800) |
$126 |
$630 |
1.0× |
| Us thyroid (76536) |
$130.20 |
$651 |
1.0× |
| Us transrectal (76872) |
$159.60 |
$798 |
1.2× |
| Vein X-Ray Chest (75827) |
$579.60 |
$2,898 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,745.10 |
$8,725.50 |
0.4× |
| Venography extremity bilateral rs&i (75822) |
$277.20 |
$1,386 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$306.60 |
$1,533 |
0.2× |
| Venography Renal Unilateral (75831) |
$1,194.90 |
$5,974.50 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$57.96 |
$289.80 |
0.5× |
| Wrist 2 views (73100) |
$46.20 |
$231 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$68.04 |
$340.20 |
0.6× |
| X-ray antegrade pyelogram tube (74425) |
$81.26 |
$406.30 |
0.2× |
| X-Ray Bend Only L-S Spine (72120) |
$142.59 |
$712.95 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$46.20 |
$231 |
0.4× |
| X-Ray Exam Breast Specimen (76098) |
$239.40 |
$1,197 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$94.29 |
$471.45 |
0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$121.80 |
$609 |
0.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$194.25 |
$971.25 |
1.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$45.36 |
$226.80 |
0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$130.20 |
$651 |
1.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$168 |
$840 |
1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$158.34 |
$791.70 |
1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$171.57 |
$857.85 |
1.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$89.46 |
$447.30 |
0.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$142.80 |
$714 |
1.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$66.15 |
$330.75 |
0.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$123.90 |
$619.50 |
0.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$95.34 |
$476.70 |
0.7× |
| X-ray eye for foreign body (70030) |
$76.02 |
$380.10 |
0.7× |
| X-ray head for orthodontia (70350) |
$46.87 |
$234.34 |
0.4× |
| X-ray humerus (73060) |
$60.69 |
$303.45 |
0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$102.69 |
$513.45 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$55.02 |
$275.10 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$69.51 |
$347.55 |
0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$95.34 |
$476.70 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$74.34 |
$371.70 |
0.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$84.91 |
$424.53 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$63 |
$315 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$98.07 |
$490.35 |
0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$99.75 |
$498.75 |
0.8× |
| X-ray thoracic spine 4 vw (72074) |
$157.50 |
$787.50 |
1.2× |
| X-Ray Tmj Unilat (70328) |
$97.23 |
$486.15 |
0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$126 |
$630 |
0.3× |
| X-Rays Bone Length Studies (77073) |
$81.48 |
$407.40 |
0.6× |
| X-Rays Bone Survey Complete (77075) |
$126 |
$630 |
1.0× |
| Xr c-spine 4 or 5 views (72050) |
$92.40 |
$462 |
0.7× |
| Xr facial bones less than 3 views (70140) |
$56.91 |
$284.55 |
0.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$56.60 |
$283.02 |
0.4× |
| Xr orbits complete 4 views (70200) |
$103.74 |
$518.70 |
0.8× |