| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,965.94 |
$12,018 |
2.9× |
| Abdomen 1 View (74018) |
$133.65 |
$405 |
1.6× |
| Abdomen 2 views (74019) |
$217.47 |
$659 |
2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$677.16 |
$2,052 |
1.7× |
| Angio internal mammary (75756) |
$2,946.90 |
$8,930 |
1.0× |
| Angio pulmonary bilat (75743) |
$3,222.78 |
$9,766 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,620 |
$14,000 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,475 |
$7,500 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$3,853.41 |
$11,677 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,222.78 |
$9,766 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,946.90 |
$8,930 |
1.0× |
| Ankle 2 views (73600) |
$156.75 |
$475 |
1.8× |
| Aortography thoracic serialography rs&i (75605) |
$6,423.12 |
$19,464 |
1.2× |
| Artery X-Rays Abdomen (75726) |
$4,950 |
$15,000 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$4,620 |
$14,000 |
1.5× |
| Artery X-Rays Pelvis (75736) |
$3,906.87 |
$11,839 |
0.7× |
| Artery X-Rays Spine (75705) |
$4,950 |
$15,000 |
0.9× |
| Arthrogram hip (73525) |
$825 |
$2,500 |
2.4× |
| Arthrogram Wrist (73115) |
$660 |
$2,000 |
1.9× |
| Basic radiation dosimetry calculation (77300) |
$280.17 |
$849 |
2.1× |
| Bone age studies (77072) |
$196.02 |
$594 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$833.91 |
$2,527 |
2.1× |
| Bone Imaging Limited Area (78300) |
$927.63 |
$2,811 |
2.4× |
| Bone Imaging Multiple Areas (78305) |
$1,025.64 |
$3,108 |
2.6× |
| Bone Imaging Whole Body (78306) |
$1,143.12 |
$3,464 |
2.9× |
| Bone survey infant (77076) |
$330 |
$1,000 |
3.2× |
| Brachytx isodose complex (77318) |
$960.63 |
$2,911 |
2.6× |
| Brachytx isodose intermed (77317) |
$736.89 |
$2,233 |
2.0× |
| Brachytx Isodose Plan Simple (77316) |
$504.57 |
$1,529 |
1.4× |
| Brain Flow Imaging Only (78610) |
$879.45 |
$2,665 |
1.7× |
| Brain Image W/Flow < 4 Views (78601) |
$677.16 |
$2,052 |
1.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$879.45 |
$2,665 |
1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,833.41 |
$17,677 |
4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,845.03 |
$5,591 |
5.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,350.26 |
$7,122 |
3.1× |
| Cat Scan Follow-Up Study (76380) |
$400.29 |
$1,213 |
4.7× |
Chest 1 view (71045)
range across 5 matching MRF lines |
$81.51–$113.19 |
$247–$343 |
varies |
| Chest 2 views (71046) |
$136.95 |
$415 |
1.6× |
| Chest 3 views (71047) |
$145.53 |
$441 |
1.7× |
| Chest 4 or more views (71048) |
$177.54 |
$538 |
1.7× |
| Clavicle complete (73000) |
$220.77 |
$669 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$475.53 |
$1,441 |
4.7× |
| Continuing medical physics consltj pr wk (77336) |
$327.69 |
$993 |
2.5× |
| Contrast Exam Abdominl Aorta (75625) |
$2,805 |
$8,500 |
0.9× |
| Contrast X-Ray Bladder (74430) |
$495 |
$1,500 |
1.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$660 |
$2,000 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,488.20 |
$7,540 |
7.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,258.62 |
$3,814 |
5.4× |
| CT abdomen w contrast (74160) |
$1,143.78 |
$3,466 |
6.7× |
| CT abdomen w wo contrast (74170) |
$1,435.17 |
$4,349 |
8.4× |
| CT abdomen w/o contrast (74150) |
$857.01 |
$2,597 |
8.4× |
| CT Angio Abdomen and Pelvis (74174) |
$1,830.51 |
$5,547 |
5.4× |
| CT Angio Chest (71275) |
$1,102.53 |
$3,341 |
6.4× |
| CT Angio Head (70496) |
$1,252.68 |
$3,796 |
7.3× |
CT angio hrt w/3d image (75574)
range across 4 matching MRF lines |
$88.77–$888.36 |
$269–$2,692 |
varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,082.07 |
$3,279 |
6.3× |
| CT Angio Neck (70498) |
$1,042.47 |
$3,159 |
6.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,081.41 |
$3,277 |
6.3× |
| CT cervical spine w/ contrast (72126) |
$1,298.88 |
$3,936 |
3.8× |
| CT cervical spine w/o contrast (72125) |
$1,104.51 |
$3,347 |
10.8× |
| CT cervical spine w/wo cont (72127) |
$990 |
$3,000 |
5.8× |
| CT chest w contrast (71260) |
$1,111.77 |
$3,369 |
6.5× |
| CT chest w/wo contrast (71270) |
$1,409.43 |
$4,271 |
8.2× |
| CT head/brain with contrast (70460) |
$825 |
$2,500 |
4.8× |
| CT head/brain without and with contrast (70470) |
$990 |
$3,000 |
5.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$563.97 |
$1,709 |
1.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$206.25 |
$625 |
2.4× |
| CT hrt w/3d image congen (75573) |
$825 |
$2,500 |
2.4× |
| CT iac w contrast (70481) |
$840.18 |
$2,546 |
4.9× |
| CT l-spine w&w/o contrast (72133) |
$1,122 |
$3,400 |
6.5× |
| CT lower ext w/o (73700) |
$742.50 |
$2,250 |
7.3× |
| CT lower extremity w/contrast material (73701) |
$848.43 |
$2,571 |
4.9× |
| CT lumbar spine w contrast (72132) |
$1,155 |
$3,500 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$1,389.63 |
$4,211 |
13.6× |
| CT maxillofacial w contrast (70487) |
$702.57 |
$2,129 |
4.1× |
| CT maxillofacial wo contrast (70486) |
$749.10 |
$2,270 |
7.3× |
| CT neck tissue combo (70492) |
$1,196.58 |
$3,626 |
7.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$910.80 |
$2,760 |
5.3× |
| CT orbits w/o contrast (70480) |
$726 |
$2,200 |
7.1× |
| CT pelvis w&w/o contrast (72194) |
$990 |
$3,000 |
5.8× |
| CT pelvis w/o contrast (72192) |
$824.01 |
$2,497 |
8.1× |
| CT scan of leg combo (73702) |
$990 |
$3,000 |
5.8× |
| CT scans face/jaw combo (70488) |
$990 |
$3,000 |
5.8× |
| CT soft tissue neck w contrast (70491) |
$937.20 |
$2,840 |
5.5× |
| CT soft tissue neck w/o contrast (70490) |
$735.90 |
$2,230 |
7.2× |
| CT thoracic spine w contrast (72129) |
$1,204.50 |
$3,650 |
7.0× |
| CT thoracic spine w/o contrast (72128) |
$1,007.82 |
$3,054 |
9.9× |
| CT thoracic spine w/wo cont (72130) |
$998.25 |
$3,025 |
5.8× |
CT thorax w/o contrast (71250)
range across 5 matching MRF lines |
$723.36–$750.75 |
$2,192–$2,275 |
varies |
CT upper ext wo (73200)
range across 12 matching MRF lines |
$818.40–$825 |
$2,480–$2,500 |
varies |
| CT upper extremity w/o & w/contrast material (73202) |
$961.95 |
$2,915 |
5.6× |
| CT upper extremity with contrast (73201) |
$898.92 |
$2,724 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,388.64 |
$4,208 |
8.1× |
| Cta Abdomen (74175) |
$1,155 |
$3,500 |
6.7× |
| CTA pelvis (72191) |
$1,155 |
$3,500 |
6.7× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$573.87 |
$1,739 |
2.5× |
| Dilation ureters/urethra rs&i (74485) |
$1,433.85 |
$4,345 |
0.7× |
| Discography Cerv/Thor Spine (72285) |
$1,864.83 |
$5,651 |
1.0× |
| Diskography lumbar (72295) |
$2,550.57 |
$7,729 |
1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$147.51 |
$447 |
1.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$181.50 |
$550 |
1.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$388.74 |
$1,178 |
3.8× |
| Dxa Bone Density Axial (77080) |
$330 |
$1,000 |
3.2× |
| Echo exam of fetal heart (76825) |
$759 |
$2,300 |
1.4× |
| Echo exam uterus (76831) |
$439.89 |
$1,333 |
1.9× |
| Echo Guide For Artery Repair (76936) |
$1,474.44 |
$4,468 |
7.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$596.97 |
$1,809 |
2.6× |
| Esophagram (74220) |
$297 |
$900 |
1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$270.93 |
$821 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$330 |
$1,000 |
1.4× |
| Follow-Up Angiography (75898) |
$3,853.41 |
$11,677 |
1.2× |
Foot 2 views (73620)
range across 3 matching MRF lines |
$147.51–$165 |
$447–$500 |
varies |
| Forearm 2 views (73090) |
$221.43 |
$671 |
2.6× |
| Gastric emptying imaging study (78264) |
$1,071.51 |
$3,247 |
2.7× |
| Gastroesophageal Reflux Exam (78262) |
$803.22 |
$2,434 |
2.1× |
| Gated Heart Planar Single (78472) |
$825 |
$2,500 |
2.1× |
| Hand 2 views (73120) |
$165.99 |
$503 |
1.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,496.15 |
$16,655 |
1.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,258.75 |
$9,875 |
1.1× |
| Hepatobil Syst Image W/Drug (78227) |
$1,370.16 |
$4,152 |
2.6× |
| Hepatobiliary System Imaging (78226) |
$1,008.81 |
$3,057 |
2.6× |
| Ht Muscle Image Spect Sing (78451) |
$1,749 |
$5,300 |
1.4× |
| Hysterosalpingogram (74740) |
$825 |
$2,500 |
3.5× |
| Image fusion (77399) |
$275.55 |
$835 |
2.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$419.76 |
$1,272 |
4.9× |
| Infusion Ivp (74410) |
$768.90 |
$2,330 |
4.5× |
| Interstitial radiation source applic complex (77778) |
$1,442.76 |
$4,372 |
2.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$990 |
$3,000 |
1.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$825 |
$2,500 |
1.5× |
| Intracavitary radiation source applic simple (77761) |
$759 |
$2,300 |
1.4× |
| K Flow/Funct Image Multiple (78709) |
$1,377.42 |
$4,174 |
2.6× |
| K Flow/Funct Image W/Drug (78708) |
$1,003.86 |
$3,042 |
1.9× |
| K Flow/Funct Image W/O Drug (78707) |
$946.11 |
$2,867 |
1.8× |
| Kidney Imaging Morphol (78700) |
$660 |
$2,000 |
1.7× |
| Knee 3 Views (73562) |
$214.50 |
$650 |
2.5× |
| Leveen/Shunt Patency Exam (78291) |
$626.01 |
$1,897 |
1.6× |
| Liver & Spleen Imaging Static Only (78215) |
$1,143.12 |
$3,464 |
2.9× |
| Liver imaging static only (78201) |
$1,283.70 |
$3,890 |
2.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,233.21 |
$3,737 |
2.3× |
| Lung perfusion differential (78597) |
$677.16 |
$2,052 |
1.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,274.13 |
$3,861 |
2.4× |
| Lung Ventilation Imaging (78579) |
$711.48 |
$2,156 |
1.8× |
| Lymph System Imaging (78195) |
$807.84 |
$2,448 |
1.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,394.91 |
$4,227 |
0.9× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$1,394.91 |
$4,227 |
2.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,429.89 |
$4,333 |
0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$1,429.89 |
$4,333 |
0.5× |
| Magnetic Image Jaw Joint (70336) |
$990 |
$3,000 |
4.2× |
| Mammary ductogram or galactogram multiple (77054) |
$732.60 |
$2,220 |
3.1× |
| Mammary ductogram or galactogram single (77053) |
$280.50 |
$850 |
1.2× |
| Meckels Divert Exam (78290) |
$677.16 |
$2,052 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$745.47 |
$2,259 |
2.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,234.76 |
$6,772 |
6.6× |
| MRA head w/o contrast (70544) |
$1,089 |
$3,300 |
4.7× |
| MRA head with contrast (70545) |
$1,347.72 |
$4,084 |
4.0× |
| MRA neck w contrast (70548) |
$1,432.53 |
$4,341 |
4.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,010.03 |
$6,091 |
5.9× |
| MRA neck w/o contrast (70547) |
$990 |
$3,000 |
4.2× |
| MRI abdomen w contrast (74182) |
$1,155 |
$3,500 |
3.4× |
| MRI abdomen w/o contrast (74181) |
$1,014.75 |
$3,075 |
4.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,980 |
$6,000 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,815 |
$5,500 |
5.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,915.65 |
$5,805 |
2.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,743.29 |
$8,313 |
11.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$2,023.23 |
$6,131 |
8.7× |
| MRI cardiac w/o contrast (75557) |
$1,155 |
$3,500 |
5.0× |
| MRI cervical spine w contrast (72142) |
$1,485 |
$4,500 |
4.4× |
| MRI cervical spine w/o cont (72141) |
$1,828.86 |
$5,542 |
7.8× |
| MRI chest w/o contrast (71550) |
$1,446.72 |
$4,384 |
6.2× |
| MRI chest with contrast (71551) |
$1,155 |
$3,500 |
1.5× |
| MRI chest wo w contrast (71552) |
$1,815 |
$5,500 |
5.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,518 |
$4,600 |
4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,650 |
$5,000 |
4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,252.35 |
$3,795 |
5.4× |
| MRI lumbar spine w contrast (72149) |
$1,320 |
$4,000 |
3.9× |
Mri Neck Spine W/O & W/Dye (72156)
range across 2 matching MRF lines |
$2,475–$2,781.90 |
$7,500–$8,430 |
varies |
| MRI orbit face &/neck w/o contrast (70540) |
$1,446.72 |
$4,384 |
6.2× |
| MRI orbit face neck w contrast (70542) |
$1,320 |
$4,000 |
3.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,145 |
$6,500 |
6.3× |
| MRI pelvis w contrast (72196) |
$1,485 |
$4,500 |
4.4× |
| MRI pelvis w/o & w contrast (72197) |
$1,980 |
$6,000 |
5.8× |
| MRI pelvis w/o contrast (72195) |
$1,188 |
$3,600 |
5.1× |
| MRI spectroscopy (76390) |
$1,155 |
$3,500 |
13.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,474.44 |
$4,468 |
6.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,511.73 |
$4,581 |
4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,263.57 |
$3,829 |
5.4× |
Mri Uppr Extremity W/O&W/Dye (73220)
range across 8 matching MRF lines |
$1,942.05–$1,980 |
$5,885–$6,000 |
varies |
| MRI, abdomen, combo (74183) |
$2,707.98 |
$8,206 |
7.9× |
MRI, dorsal spine combo (72157)
range across 2 matching MRF lines |
$2,145–$2,679.27 |
$6,500–$8,119 |
varies |
| MRI, dorsal spine contrast (72147) |
$990 |
$3,000 |
2.9× |
| MRI, joint upper extrem (73221) |
$1,320 |
$4,000 |
5.7× |
| MRI, joint upper extrem combo (73223) |
$2,475 |
$7,500 |
7.3× |
MRI, lumbar spine combo (72158)
range across 3 matching MRF lines |
$2,310–$2,607.99 |
$7,000–$7,903 |
varies |
| Myelogram cervical (72240) |
$1,155 |
$3,500 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,200.44 |
$6,668 |
1.7× |
| N-invas est c ffr sw aly CTA (75580) |
$5,119.62 |
$15,514 |
6.1× |
| Neck soft tissue (70360) |
$127.05 |
$385 |
1.5× |
| Nm csf leak detection (78650) |
$1,716 |
$5,200 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,009.93 |
$9,121 |
2.2× |
| Nuclear Rx Oral Admin (79005) |
$726 |
$2,200 |
3.2× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$397.98 |
$1,206 |
4.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$196.02 |
$594 |
1.9× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$196.02 |
$594 |
1.9× |
| Optic foramina (70190) |
$273.90 |
$830 |
3.2× |
| Parathyroid Planar Imaging (78070) |
$825 |
$2,500 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$176.55 |
$535 |
1.7× |
| Peritoneogram Rs&I (74190) |
$573.87 |
$1,739 |
1.1× |
| Pet Image W/Ct Lmtd (78814) |
$330 |
$1,000 |
0.2× |
| PET image w/CT, full body (78816) |
$4,753.98 |
$14,406 |
3.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,698.87 |
$14,239 |
3.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,258.75 |
$9,875 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$837.54 |
$2,538 |
2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$265.98 |
$806 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$867.24 |
$2,628 |
1.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$211.20 |
$640 |
2.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$123.42 |
$374 |
1.5× |
| Radex elbow complete minimum 3 views (73080) |
$210.54 |
$638 |
2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$293.37 |
$889 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$162.03 |
$491 |
1.9× |
| Radex foot complete minimum 3 views (73630) |
$204.27 |
$619 |
2.4× |
| Radex Hand Minimum 3 Views (73130) |
$171.60 |
$520 |
2.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$145.53 |
$441 |
1.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$327.36 |
$992 |
3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$160.05 |
$485 |
1.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$150.15 |
$455 |
1.8× |
| Radex shoulder complete minimum 2 views (73030) |
$213.84 |
$648 |
2.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$145.53 |
$441 |
1.7× |
| Radex Spine 1 View Specify Level (72020) |
$200.31 |
$607 |
2.4× |
| Radex Sternum Minimum 2 Views (71120) |
$165 |
$500 |
1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$173.25 |
$525 |
2.0× |
| Radex Toe Minimum 2 Views (73660) |
$143.55 |
$435 |
1.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$196.02 |
$594 |
1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$197.34 |
$598 |
2.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,550 |
$35,000 |
1.6× |
| Radiation treatment delivery level 1 (77402) |
$282.48 |
$856 |
2.8× |
| Radiation treatment delivery level 2 (77407) |
$324.06 |
$982 |
0.9× |
| Radiation treatment delivery level 3 (77412) |
$450.45 |
$1,365 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$246.51 |
$747 |
2.4× |
| Radiologic exam colon double contrast study (74280) |
$466.62 |
$1,414 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$354.75 |
$1,075 |
2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$70.95 |
$215 |
0.4× |
| Radiologic exam knee complete 4/more views (73564) |
$231 |
$700 |
2.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$384.78 |
$1,166 |
3.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$413.16 |
$1,252 |
2.4× |
| Radiologic exam swallow function contrast study (74230) |
$297 |
$900 |
1.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$293.04 |
$888 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$495 |
$1,500 |
2.9× |
| Radiologic examination femur 1 view (73551) |
$123.75 |
$375 |
1.5× |
| Radiologic examination femur minimum 2 views (73552) |
$165 |
$500 |
1.9× |
| Radiologic examination knee 1/2 views (73560) |
$149.49 |
$453 |
1.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$330 |
$1,000 |
3.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$193.05 |
$585 |
2.3× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$718.08 |
$2,176 |
1.3× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$193.05 |
$585 |
2.3× |
| Renal Cyst Study (74470) |
$952.05 |
$2,885 |
1.8× |
| Ribs bilateral 3 views (71110) |
$330 |
$1,000 |
3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$677.16 |
$2,052 |
1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,897.50 |
$5,750 |
3.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,344.98 |
$7,106 |
4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,749 |
$5,300 |
3.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,716 |
$5,200 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,533.18 |
$4,646 |
6.7× |
| Rp Therapy Intravenous Administration (79101) |
$373.23 |
$1,131 |
1.6× |
| Scapula (73010) |
$238.92 |
$724 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$31.02 |
$94 |
1.3× |
| Sella turcica (70240) |
$206.25 |
$625 |
2.4× |
| Shoulder 1 view (73020) |
$144.21 |
$437 |
1.7× |
| Shoulder Arthrography (73040) |
$468.60 |
$1,420 |
1.4× |
| Sialogram (70390) |
$573.87 |
$1,739 |
2.5× |
| Skull less than 4 views (70250) |
$181.50 |
$550 |
1.8× |
| Special dosimetry (77331) |
$230.01 |
$697 |
1.8× |
| Special Physics Consult (77370) |
$418.11 |
$1,267 |
3.2× |
| Special teletherapy port plan (77321) |
$650.43 |
$1,971 |
1.8× |
| Special treatment procedure (77470) |
$1,269.51 |
$3,847 |
2.4× |
| Stereotactic Body Radiation Delivery (77373) |
$5,940 |
$18,000 |
3.4× |
| Sternoclavicular joints (71130) |
$247.50 |
$750 |
2.9× |
| Superior sagittal sinus venogram (75870) |
$3,853.41 |
$11,677 |
1.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$261.36 |
$792 |
2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$552.75 |
$1,675 |
1.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$495 |
$1,500 |
1.4× |
| Testicular Imaging W/Flow (78761) |
$767.91 |
$2,327 |
2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$803.55 |
$2,435 |
2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$862.95 |
$2,615 |
2.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$495 |
$1,500 |
3.8× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$286.11 |
$867 |
1.7× |
| Thoracic spine 2 views (72070) |
$187.77 |
$569 |
1.8× |
| Thoracic spine 3 views (72072) |
$221.76 |
$672 |
2.2× |
| Thoracolumbar 2 views (72080) |
$229.35 |
$695 |
2.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$905.85 |
$2,745 |
2.3× |
| Thyroid Met Imaging Body (78018) |
$879.45 |
$2,665 |
1.7× |
| Thyroid Uptake Measurement (78012) |
$561 |
$1,700 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$825 |
$2,500 |
2.1× |
| Tx Devices Design & Construction Complex (77334) |
$528 |
$1,600 |
1.4× |
| Tx devices design & construction intermediate (77333) |
$397.98 |
$1,206 |
3.0× |
| Tx devices design & construction simple (77332) |
$362.34 |
$1,098 |
2.8× |
| Ultrasound Breast Limited (76642) |
$193.05 |
$585 |
2.3× |
| Ultrasound Elastography Parenchyma (76981) |
$72.93 |
$221 |
0.7× |
| Ultrasound Exam Aaa Screen (76706) |
$195.36 |
$592 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$387.75 |
$1,175 |
3.8× |
| Umbilical-artery Doppler (OB) (76820) |
$282.15 |
$855 |
2.8× |
| Unlisted Dx Radiographic Procedure (76499) |
$115.50 |
$350 |
1.4× |
| Unlisted fluoroscopic procedure (76496) |
$165 |
$500 |
1.9× |
| Unlisted magnetic resonance procedure (76498) |
$825 |
$2,500 |
9.7× |
| Upper gi w/o kub (74240) |
$363 |
$1,100 |
2.1× |
| Ureteral Reflux Study (78740) |
$617.10 |
$1,870 |
1.6× |
| Urethrocystogram voiding (74455) |
$660 |
$2,000 |
2.8× |
| Urethrocystography retrograde (74450) |
$336.60 |
$1,020 |
1.4× |
| Us breast unilateral complete (76641) |
$259.38 |
$786 |
2.5× |
| Us chest (76604) |
$321.75 |
$975 |
3.1× |
| Us complete joint (76881) |
$352.77 |
$1,069 |
3.5× |
| Us exam, pelvic, limited (76857) |
$222.75 |
$675 |
2.2× |
| Us head (76506) |
$269.28 |
$816 |
2.6× |
| Us kidney transplant (76776) |
$280.50 |
$850 |
2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$264 |
$800 |
2.6× |
| Us ob detailed single fetus (76811) |
$436.59 |
$1,323 |
1.9× |
| Us ob limited 1 or more fetuses (76815) |
$280.50 |
$850 |
2.7× |
| Us ob transvaginal (76817) |
$330.33 |
$1,001 |
3.2× |
| Us pelvic non ob complete (76856) |
$372.57 |
$1,129 |
3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$282.15 |
$855 |
2.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$234.30 |
$710 |
2.3× |
| Us retroperitoneal complete (76770) |
$363 |
$1,100 |
3.6× |
| Us retroperitoneal limited (76775) |
$257.73 |
$781 |
2.5× |
| Us scrotum and contents (76870) |
$495 |
$1,500 |
4.8× |
| Us spinal canal and contents (76800) |
$244.86 |
$742 |
2.4× |
| Us thyroid (76536) |
$364.98 |
$1,106 |
3.6× |
| Us transrectal (76872) |
$376.86 |
$1,142 |
3.7× |
| Vein X-Ray Chest (75827) |
$1,893.87 |
$5,739 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,155 |
$3,500 |
0.4× |
| Venogram Sinus/Jugular (75860) |
$2,946.90 |
$8,930 |
1.0× |
| Venography Adrenal Unilateral (75840) |
$3,222.78 |
$9,766 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$2,086.26 |
$6,322 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,560.90 |
$4,730 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$825 |
$2,500 |
0.5× |
| Venography Renal Bilateral (75833) |
$3,222.78 |
$9,766 |
1.0× |
| Venography Renal Unilateral (75831) |
$3,853.41 |
$11,677 |
1.2× |
| Venous sampling by catheter (75893) |
$5,433.12 |
$16,464 |
1.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$927.63 |
$2,811 |
2.4× |
| Wrist 2 views (73100) |
$145.53 |
$441 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$260.70 |
$790 |
3.1× |
| X-ray antegrade pyelogram tube (74425) |
$439.89 |
$1,333 |
1.3× |
| X-Ray Aorta Leg Arteries (75630) |
$2,475 |
$7,500 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$155.76 |
$472 |
1.8× |
| X-Ray Exam Breast Specimen (76098) |
$495 |
$1,500 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$136.95 |
$415 |
1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$196.02 |
$594 |
1.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$115.50 |
$350 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$133.65 |
$405 |
1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$160.05 |
$485 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$206.25 |
$625 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$452.43 |
$1,371 |
4.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$335.94 |
$1,018 |
3.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$186.45 |
$565 |
2.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$345.51 |
$1,047 |
3.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$191.07 |
$579 |
1.9× |
| X-ray eye for foreign body (70030) |
$186.78 |
$566 |
2.2× |
| X-ray humerus (73060) |
$175.23 |
$531 |
2.1× |
| X-ray IV pyelogram (ivp) (74400) |
$439.89 |
$1,333 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$145.53 |
$441 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$136.95 |
$415 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$206.91 |
$627 |
2.0× |
| X-ray nose-rectum child f.b. (76010) |
$247.50 |
$750 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$267.30 |
$810 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$206.25 |
$625 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$202.95 |
$615 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$247.50 |
$750 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$231 |
$700 |
2.3× |
| X-ray thoracic spine 4 vw (72074) |
$286.77 |
$869 |
2.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$495 |
$1,500 |
1.5× |
| X-Rays Bone Length Studies (77073) |
$177.54 |
$538 |
1.7× |
| X-Rays Bone Survey Complete (77075) |
$445.50 |
$1,350 |
4.4× |
| Xr c-spine 4 or 5 views (72050) |
$272.25 |
$825 |
2.7× |
| Xr facial bones less than 3 views (70140) |
$191.40 |
$580 |
2.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$293.04 |
$888 |
2.9× |
| Xr orbits complete 4 views (70200) |
$330 |
$1,000 |
3.2× |