| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,016.22 |
$5,149 |
2.8× |
| Abdomen 2 views (74019) |
$226.20 |
$290 |
2.1× |
| Ankle 2 views (73600) |
$194.22 |
$249 |
2.2× |
| Basic dosimetry (77300) |
$3,631.68 |
$4,656 |
26.2× |
| Bone &/joint imaging whole body (78306) |
$1,131.78 |
$1,451 |
2.7× |
| Bone age studies (77072) |
$171.99 |
$220.50 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,304.16 |
$1,672 |
3.2× |
| Bone survey complete (77075) |
$475.02 |
$609 |
4.4× |
| Cervical spine 2 or 3 views (72040) |
$222.30 |
$285 |
2.5× |
| Chest 1 view (71045) |
$395.46 |
$507 |
4.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$445.38 |
$571 |
2.5× |
| Clavicle complete (73000) |
$191.49 |
$245.50 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$722.28 |
$926 |
6.7× |
| Continuing medical physics consltj pr wk (77336) |
$495.30 |
$635 |
3.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,371.98 |
$3,041 |
6.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,793.22 |
$2,299 |
7.3× |
| CT abdomen w contrast (74160) |
$1,166.88 |
$1,496 |
6.4× |
| CT abdomen w wo contrast (74170) |
$1,372.80 |
$1,760 |
7.6× |
| CT abdomen w/o contrast (74150) |
$1,012.44 |
$1,298 |
9.4× |
| CT angiography upper extremity lt (73206) |
$1,317.03 |
$1,688.50 |
7.3× |
| CT c-spine w/o contrast (72125) |
$1,331.46 |
$1,707 |
12.3× |
| CT chest w contrast (71260) |
$1,372.80 |
$1,760 |
7.6× |
| CT chest w/wo contrast (71270) |
$1,578.72 |
$2,024 |
8.7× |
| CT iac w contrast (70481) |
$1,143.68 |
$1,466.25 |
6.3× |
| CT lower ext w/o (73700) |
$999.96 |
$1,282 |
9.3× |
| CT lower extremity w/contrast material (73701) |
$1,725.16 |
$2,211.75 |
9.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,462.50 |
$1,875 |
8.1× |
| CT lumbar spine w/o contrast (72131) |
$1,233.96 |
$1,582 |
11.4× |
| CT maxillofacial w contrast (70487) |
$1,203.77 |
$1,543.30 |
6.6× |
| CT maxillofacial wo contrast (70486) |
$1,046.76 |
$1,342 |
9.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,255.41 |
$1,609.50 |
6.9× |
| CT orbits w/o contrast (70480) |
$994.50 |
$1,275 |
9.2× |
| CT pelvis w/o contrast (72192) |
$984.36 |
$1,262 |
9.1× |
| CT soft tissue neck w contrast (70491) |
$1,070.94 |
$1,373 |
5.9× |
| CT soft tissue neck w/o contrast (70490) |
$910.26 |
$1,167 |
8.4× |
| CT thoracic spine w/o contrast (72128) |
$1,233.96 |
$1,582 |
11.4× |
| CT thorax w/o contrast (71250) |
$1,166.88 |
$1,496 |
10.8× |
| CT upper ext wo (73200) |
$1,020.24 |
$1,308 |
9.5× |
| CT upper extremity with contrast (73201) |
$1,145.43 |
$1,468.50 |
3.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,638 |
$2,100 |
9.0× |
| Cta Abdomen (74175) |
$1,396.20 |
$1,790 |
7.7× |
| CTA abdomen pelvis (74174) |
$2,044.38 |
$2,621 |
5.7× |
| CTA chest (71275) |
$1,299.48 |
$1,666 |
7.2× |
| Cta Head (70496) |
$1,510.86 |
$1,937 |
8.3× |
| Cta Neck (70498) |
$1,510.86 |
$1,937 |
8.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$288.60 |
$370 |
2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$284.70 |
$365 |
2.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$280.80 |
$360 |
2.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$300.30 |
$385 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$296.40 |
$380 |
3.3× |
| Esophagus (74220) |
$418.86 |
$537 |
2.3× |
| Facial bones min 3 views (70150) |
$258.96 |
$332 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$522.60 |
$670 |
4.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$482.04 |
$618 |
4.5× |
| Fetal Echo (76825) |
$652.86 |
$837 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$521.04 |
$668 |
2.1× |
| Foot 2 views (73620) |
$187.59 |
$240.50 |
2.1× |
| Forearm 2 views (73090) |
$205.14 |
$263 |
2.3× |
| Hand 2 views (73120) |
$371.28 |
$476 |
3.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,420.38 |
$1,821 |
2.5× |
| Knee 3 views (73562) |
$403.65 |
$517.50 |
4.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,101.32 |
$2,694 |
2.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,364.96 |
$3,032 |
6.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$959.40 |
$1,230 |
2.5× |
| MRA head w & w/o contrast (70546) |
$2,243.28 |
$2,876 |
6.2× |
| MRA head w/o contrast (70544) |
$1,725.36 |
$2,212 |
7.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,083.38 |
$2,671 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,415.66 |
$3,097 |
6.7× |
| MRI abdomen w/o contrast (74181) |
$1,751.49 |
$2,245.50 |
7.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,063.10 |
$2,645 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,332.20 |
$2,990 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$1,926.60 |
$2,470 |
7.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,035.80 |
$2,610 |
5.7× |
| MRI chest w/o contrast (71550) |
$1,425.06 |
$1,827 |
5.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,596.58 |
$4,611 |
10.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,677.39 |
$2,150.50 |
6.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,163.72 |
$2,774 |
6.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,382.90 |
$3,055 |
6.6× |
| MRI pelvis w/o contrast (72195) |
$1,779.96 |
$2,282 |
7.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,382.12 |
$3,054 |
6.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,382.12 |
$3,054 |
6.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,382.12 |
$3,054 |
6.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,926.60 |
$2,470 |
7.8× |
| MRI up ext w/o contrast (73218) |
$1,655.94 |
$2,123 |
6.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,827.54 |
$2,343 |
7.4× |
| MRI, joint upper extrem combo (73223) |
$2,375.88 |
$3,046 |
6.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,886 |
$3,700 |
2.2× |
| Neck soft tissue (70360) |
$173.94 |
$223 |
1.9× |
| Nm gastric emptying study (78264) |
$1,352.52 |
$1,734 |
3.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,080.14 |
$6,513 |
3.6× |
| Ob us nuchal meas 1 gest (76813) |
$252.72 |
$324 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$220.74 |
$283 |
2.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$339.30 |
$435 |
3.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$188.76 |
$242 |
2.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$230.10 |
$295 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$262.86 |
$337 |
2.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$326.43 |
$418.50 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$327.60 |
$420 |
3.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$351.78 |
$451 |
3.3× |
| Radex Humerus Minimum 2 Views (73060) |
$230.88 |
$296 |
2.6× |
| Radex Kne 1/2 Views (73560) |
$351 |
$450 |
3.9× |
| Radex Kne Compl 4/More Views (73564) |
$456.30 |
$585 |
4.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$216.84 |
$278 |
2.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$353.34 |
$453 |
3.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$148.20 |
$190 |
1.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$237.90 |
$305 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$179.40 |
$230 |
2.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$240.24 |
$308 |
2.2× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$230.88 |
$296 |
2.6× |
| Radiation treatment delivery level 1 (77402) |
$586.56 |
$752 |
5.6× |
| Radiation treatment delivery level 2 (77407) |
$1,840.02 |
$2,359 |
4.6× |
| Radiation treatment delivery level 3 (77412) |
$1,939.86 |
$2,487 |
3.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$196.56 |
$252 |
2.2× |
| Radiologic exam chest 2 views (71046) |
$226.98 |
$291 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$481.26 |
$617 |
2.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$342.81 |
$439.50 |
3.8× |
| Ribs bilateral 3 views (71110) |
$311.22 |
$399 |
2.9× |
| Sacroiliac Joints < 3 Views (72200) |
$173.16 |
$222 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$169.65 |
$217.50 |
7.3× |
| Shoulder 1 view (73020) |
$202.22 |
$259.25 |
2.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$904.80 |
$1,160 |
2.3× |
| Special Physics Consult (77370) |
$584.22 |
$749 |
4.2× |
| Special treatment procedure (77470) |
$1,676.22 |
$2,149 |
2.9× |
| Spine thoracic 3 views (72072) |
$268.32 |
$344 |
2.5× |
| Stereotactic Body Radiation Delivery (77373) |
$5,059.08 |
$6,486 |
2.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,479.66 |
$1,897 |
3.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,056.90 |
$1,355 |
7.6× |
| Thoracolumbar 2 views (72080) |
$226.98 |
$291 |
2.5× |
| Treatment device complex (77334) |
$3,519.36 |
$4,512 |
9.1× |
| Treatment devices simple (77332) |
$616.20 |
$790 |
4.4× |
| Ultrasound breast complete (76641) |
$382.20 |
$490 |
3.5× |
| Ultrasound Exam Aaa Screen (76706) |
$350.22 |
$449 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$436.02 |
$559 |
4.0× |
| Umbilical-artery Doppler (OB) (76820) |
$280.80 |
$360 |
2.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$118.56 |
$152 |
1.3× |
| Us breast unilateral limited (76642) |
$493.74 |
$633 |
5.5× |
| Us chest (76604) |
$356.46 |
$457 |
3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$354.90 |
$455 |
3.3× |
| Us ob detailed single fetus (76811) |
$670.80 |
$860 |
2.7× |
| Us ob limited (76815) |
$404.04 |
$518 |
3.7× |
| Us ob transvaginal (76817) |
$400.14 |
$513 |
3.7× |
| Us pelvic non ob complete (76856) |
$457.86 |
$587 |
4.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$327.60 |
$420 |
3.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$413.40 |
$530 |
3.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$438.36 |
$562 |
4.1× |
| Us retroperitoneal complete (76770) |
$432.90 |
$555 |
4.0× |
| Us retroperitoneal limited (76775) |
$358.02 |
$459 |
3.3× |
| Us scrotum and contents (76870) |
$428.22 |
$549 |
4.0× |
| Us soft tissue head/neck (76536) |
$389.22 |
$499 |
3.6× |
| Wrist 2 views (73100) |
$196.56 |
$252 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$324.48 |
$416 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$195.78 |
$251 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$346.32 |
$444 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$306.15 |
$392.50 |
2.8× |
| X-ray exam of femur 2/> (73552) |
$231.66 |
$297 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$245.70 |
$315 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$237.90 |
$305 |
2.2× |
| X-ray nose-rectum child f.b. (76010) |
$182.52 |
$234 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$201.24 |
$258 |
2.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$283.92 |
$364 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$341.64 |
$438 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$203.58 |
$261 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$200.46 |
$257 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$197.34 |
$253 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$230.88 |
$296 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$193.44 |
$248 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$188.76 |
$242 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$228.15 |
$292.50 |
2.1× |
| Xr c-spine 4 or 5 views (72050) |
$291.72 |
$374 |
2.7× |