| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,899.22 |
$4,999 |
2.7× |
| Abdomen 2 views (74019) |
$220.74 |
$283 |
2.0× |
| Ankle 2 views (73600) |
$194.22 |
$249 |
2.1× |
| Basic dosimetry (77300) |
$3,345.42 |
$4,289 |
23.8× |
| Bone &/joint imaging whole body (78306) |
$1,077.96 |
$1,382 |
2.6× |
| Bone age studies (77072) |
$171.99 |
$220.50 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,304.16 |
$1,672 |
3.1× |
| Bone survey complete (77075) |
$475.02 |
$609 |
4.3× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$2,028 |
$2,600 |
2.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,758.90 |
$2,255 |
4.8× |
| Cervical spine 2 or 3 views (72040) |
$222.30 |
$285 |
2.4× |
| Chest 1 view (71045) |
$226.20 |
$290 |
2.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$445.38 |
$571 |
2.4× |
| Clavicle complete (73000) |
$188.76 |
$242 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$703.56 |
$902 |
6.4× |
| Continuing medical physics consltj pr wk (77336) |
$487.89 |
$625.50 |
3.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,067 |
$2,650 |
5.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,589.64 |
$2,038 |
6.4× |
| CT abdomen w wo contrast (74170) |
$1,316.64 |
$1,688 |
7.2× |
| CT abdomen w/o contrast (74150) |
$960.96 |
$1,232 |
8.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,382.16 |
$1,772 |
7.5× |
| CT angiography upper extremity lt (73206) |
$1,349.40 |
$1,730 |
7.3× |
| CT c-spine w/contrast (72126) |
$1,270.62 |
$1,629 |
3.5× |
| CT c-spine w/o contrast (72125) |
$1,088.49 |
$1,395.50 |
9.9× |
| CT chest w contrast (71260) |
$1,221.48 |
$1,566 |
6.6× |
| CT head/brain with contrast (70460) |
$1,197.50 |
$1,535.25 |
6.5× |
| CT head/brain without and with contrast (70470) |
$1,334 |
$1,710.25 |
7.3× |
| CT iac w contrast (70481) |
$1,143.68 |
$1,466.25 |
6.2× |
| CT lower ext w/o (73700) |
$1,499.94 |
$1,923 |
13.7× |
| CT lower extremity w/contrast material (73701) |
$1,725.16 |
$2,211.75 |
9.4× |
| CT lumbar spine w/contrast (72132) |
$1,293.24 |
$1,658 |
3.5× |
| CT lumbar spine w/o contrast (72131) |
$1,072.50 |
$1,375 |
9.8× |
| CT maxillofacial w contrast (70487) |
$1,167.66 |
$1,497 |
6.4× |
| CT maxillofacial wo contrast (70486) |
$1,015.56 |
$1,302 |
9.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,292.85 |
$1,657.50 |
7.0× |
| CT orbits w/o contrast (70480) |
$965.64 |
$1,238 |
8.8× |
| CT pelvis w/o contrast (72192) |
$955.50 |
$1,225 |
8.7× |
| CT soft tissue neck w contrast (70491) |
$1,055.34 |
$1,353 |
5.7× |
| CT soft tissue neck w/o contrast (70490) |
$904.02 |
$1,159 |
8.3× |
| CT thoracic spine w/o contrast (72128) |
$1,072.50 |
$1,375 |
9.8× |
| CT thorax w/o contrast (71250) |
$1,065.09 |
$1,365.50 |
9.7× |
| CT upper ext wo (73200) |
$971.88 |
$1,246 |
8.9× |
| CT upper extremity with contrast (73201) |
$1,145.43 |
$1,468.50 |
3.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,588.86 |
$2,037 |
8.6× |
| Cta Abdomen (74175) |
$1,396.20 |
$1,790 |
7.6× |
| CTA abdomen pelvis (74174) |
$2,044.38 |
$2,621 |
5.6× |
| CTA chest (71275) |
$1,280.37 |
$1,641.50 |
7.0× |
| Cta Head (70496) |
$1,466.40 |
$1,880 |
8.0× |
| Cta Neck (70498) |
$1,466.40 |
$1,880 |
8.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$281.97 |
$361.50 |
2.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$280.80 |
$360 |
2.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$280.80 |
$360 |
2.6× |
| Echo exam of eye (76529) |
$229.32 |
$294 |
2.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$634.92 |
$814 |
2.5× |
| Esophagus (74220) |
$406.38 |
$521 |
2.2× |
| Facial bones min 3 views (70150) |
$258.96 |
$332 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$507 |
$650 |
4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$482.04 |
$618 |
4.4× |
| Fetal Echo (76825) |
$652.08 |
$836 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$508.56 |
$652 |
2.0× |
| Foot 2 views (73620) |
$189.54 |
$243 |
2.1× |
| Forearm 2 views (73090) |
$205.14 |
$263 |
2.3× |
| Hand 2 views (73120) |
$180.96 |
$232 |
1.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,379.04 |
$1,768 |
2.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,329.90 |
$1,705 |
3.2× |
| Hysterosalpingogram (74740) |
$481.26 |
$617 |
1.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$191.10 |
$245 |
1.7× |
| Knee 3 views (73562) |
$269.10 |
$345 |
3.0× |
| Lymphoscintigraphy (78195) |
$1,188.72 |
$1,524 |
2.1× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,074.02 |
$2,659 |
2.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,150.46 |
$2,757 |
5.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$913.38 |
$1,171 |
2.3× |
| MRA head w/o contrast (70544) |
$1,700.01 |
$2,179.50 |
6.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,022.54 |
$2,593 |
5.5× |
| MRA neck w/o contrast (70547) |
$1,458.41 |
$1,869.75 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,355.60 |
$3,020 |
6.4× |
| MRI abdomen w/o contrast (74181) |
$1,811.94 |
$2,323 |
7.3× |
| 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 |
6.4× |
| MRI cardiac w/o contrast (75557) |
$1,330.68 |
$1,706 |
5.3× |
| MRI cervical spine w/o contrast (72141) |
$1,803.75 |
$2,312.50 |
7.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,976.52 |
$2,534 |
5.4× |
| MRI chest w/o contrast (71550) |
$1,425.06 |
$1,827 |
5.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,487.38 |
$4,471 |
9.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,676.22 |
$2,149 |
6.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,196.48 |
$2,816 |
6.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,313.48 |
$2,966 |
6.3× |
| MRI pelvis w/o contrast (72195) |
$1,668.42 |
$2,139 |
6.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,308.02 |
$2,959 |
6.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,345.07 |
$3,006.50 |
6.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,308.02 |
$2,959 |
6.3× |
| MRI temporomandibular joint (70336) |
$1,459.38 |
$1,871 |
5.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,775.28 |
$2,276 |
7.1× |
| MRI up ext w/o contrast (73218) |
$1,654.38 |
$2,121 |
6.6× |
| MRI upper ext joint w/o contrast (73221) |
$2,705.04 |
$3,468 |
10.8× |
| MRI, joint upper extrem combo (73223) |
$2,375.88 |
$3,046 |
6.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,754.96 |
$3,532 |
2.0× |
| Neck soft tissue (70360) |
$168.48 |
$216 |
1.8× |
| Nm gastric emptying study (78264) |
$1,312.74 |
$1,683 |
3.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,931.94 |
$6,323 |
3.4× |
| Ob us nuchal meas 1 gest (76813) |
$240.24 |
$308 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$216.06 |
$277 |
2.0× |
| PET image w/CT, skull-thigh (78815) |
$4,493.97 |
$5,761.50 |
3.0× |
| PET imaging for CT attenuation whole body (78816) |
$4,593.42 |
$5,889 |
3.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,363.44 |
$1,748 |
2.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$339.30 |
$435 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$188.76 |
$242 |
2.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$221.52 |
$284 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$282.36 |
$362 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$180.96 |
$232 |
2.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$326.43 |
$418.50 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$312.39 |
$400.50 |
3.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$196.56 |
$252 |
2.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$260.52 |
$334 |
2.4× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$346.32 |
$444 |
3.2× |
| Radex Humerus Minimum 2 Views (73060) |
$223.86 |
$287 |
2.5× |
| Radex Kne 1/2 Views (73560) |
$334.62 |
$429 |
3.7× |
| Radex Kne Compl 4/More Views (73564) |
$304.20 |
$390 |
2.8× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$256.62 |
$329 |
2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$216.84 |
$278 |
2.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$270.66 |
$347 |
2.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$237.90 |
$305 |
2.6× |
| 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) |
$233.22 |
$299 |
2.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$230.88 |
$296 |
2.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$10,428.60 |
$13,370 |
1.4× |
| Radiation treatment delivery level 2 (77407) |
$1,254.24 |
$1,608 |
3.1× |
| Radiation treatment delivery level 3 (77412) |
$774.54 |
$993 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$187.20 |
$240 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$255.84 |
$328 |
2.3× |
| Radiologic exam chest 2 views (71046) |
$339.69 |
$435.50 |
3.7× |
| Radiologic exam colon single contrast study (74270) |
$537.42 |
$689 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$467.22 |
$599 |
2.5× |
| Radiologic examination femur 1 view (73551) |
$233.22 |
$299 |
2.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$233.22 |
$299 |
2.6× |
| Radiological examination surgical specimen (76098) |
$411.06 |
$527 |
0.7× |
| Scapula (73010) |
$205.92 |
$264 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$157.95 |
$202.50 |
6.8× |
| Shoulder 1 view (73020) |
$201.34 |
$258.12 |
2.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$904.80 |
$1,160 |
2.3× |
| Special Physics Consult (77370) |
$554.58 |
$711 |
3.9× |
| Special treatment procedure (77470) |
$1,627.08 |
$2,086 |
2.8× |
| Spine thoracic 3 views (72072) |
$260.52 |
$334 |
2.4× |
| Stereotactic Body Radiation Delivery (77373) |
$4,911.66 |
$6,297 |
2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,245.66 |
$1,597 |
3.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,479.66 |
$1,897 |
3.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$918.84 |
$1,178 |
6.5× |
| Thoracolumbar 2 views (72080) |
$201.24 |
$258 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$967.20 |
$1,240 |
2.3× |
| Treatment device complex (77334) |
$854.10 |
$1,095 |
2.2× |
| Treatment devices simple (77332) |
$519.48 |
$666 |
3.7× |
| Ultrasound breast complete (76641) |
$382.20 |
$490 |
3.5× |
| Ultrasound Exam Aaa Screen (76706) |
$340.08 |
$436 |
3.1× |
| 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) |
$478.53 |
$613.50 |
5.2× |
| Us chest (76604) |
$350.22 |
$449 |
3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$532.35 |
$682.50 |
4.9× |
| Us ob detailed single fetus (76811) |
$640.38 |
$821 |
2.6× |
| Us ob limited (76815) |
$391.56 |
$502 |
3.6× |
| Us ob transvaginal (76817) |
$400.14 |
$513 |
3.7× |
| Us pelvic non ob complete (76856) |
$451.23 |
$578.50 |
4.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$317.46 |
$407 |
2.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$403.26 |
$517 |
3.7× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$425.10 |
$545 |
3.9× |
| Us retroperitoneal complete (76770) |
$430.95 |
$552.50 |
3.9× |
| Us retroperitoneal limited (76775) |
$354.12 |
$454 |
3.2× |
| Us scrotum and contents (76870) |
$428.22 |
$549 |
3.9× |
| Us soft tissue head/neck (76536) |
$389.22 |
$499 |
3.6× |
| Us, eye b-scan (76512) |
$282.36 |
$362 |
2.6× |
| 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 Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$212.94 |
$273 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$194.22 |
$249 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$346.32 |
$444 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$306.15 |
$392.50 |
2.8× |
| X-ray exam of femur 2/> (73552) |
$224.64 |
$288 |
2.5× |
| X-ray eye for foreign body (70030) |
$223.86 |
$287 |
2.5× |
| X-ray leg, infant (73592) |
$226.20 |
$290 |
2.5× |
| 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) |
$177.06 |
$227 |
1.9× |
| X-ray retrograde pyelogram (74420) |
$2,574 |
$3,300 |
7.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$198.12 |
$254 |
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 |
3.1× |
| 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 Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$223.86 |
$287 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$193.44 |
$248 |
2.1× |
| 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) |
$226.59 |
$290.50 |
2.1× |
| Xr c-spine 4 or 5 views (72050) |
$291.72 |
$374 |
2.7× |