| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,986.42 |
$5,149 |
2.1× |
| Abdomen 2 views (74019) |
$168.20 |
$290 |
1.6× |
| Acute gi blood loss imaging (78278) |
$803.88 |
$1,386 |
1.9× |
| Angiography extremity bilateral rs&i (75716) |
$4,510.95 |
$7,777.50 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$3,536.84 |
$6,098 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$8,152.48 |
$14,056 |
1.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,948.64 |
$6,808 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,433.60 |
$5,920 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$46,099.85 |
$79,482.50 |
8.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$7,848.56 |
$13,532 |
1.4× |
| Ankle 2 views (73600) |
$216.63 |
$373.50 |
2.4× |
| Aortogram thoracic (75605) |
$4,908.83 |
$8,463.50 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,048.40 |
$6,980 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,790.88 |
$6,536 |
1.2× |
| Basic dosimetry (77300) |
$5,063.40 |
$8,730 |
36.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$666.42 |
$1,149 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$841.58 |
$1,451 |
2.0× |
| Bone age studies (77072) |
$127.89 |
$220.50 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$969.76 |
$1,672 |
2.3× |
| Bone survey complete (77075) |
$364.24 |
$628 |
3.4× |
| Bone survey infant (77076) |
$252.30 |
$435 |
2.3× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$785.32 |
$1,354 |
1.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$908.28 |
$1,566 |
2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,318.92 |
$2,274 |
3.7× |
| Cervical spine 2 or 3 views (72040) |
$247.95 |
$427.50 |
2.8× |
| Chest 1 view (71045) |
$490.68 |
$846 |
5.4× |
| Chest xray 3 views (71047) |
$178.06 |
$307 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$331.18 |
$571 |
1.8× |
| Clavicle complete (73000) |
$216.63 |
$373.50 |
2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$537.08 |
$926 |
5.0× |
| Continuing medical physics consltj pr wk (77336) |
$368.30 |
$635 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,686.06 |
$2,907 |
4.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,246.42 |
$2,149 |
5.0× |
| CT abdomen w contrast (74160) |
$867.68 |
$1,496 |
4.8× |
| CT abdomen w wo contrast (74170) |
$999.92 |
$1,724 |
5.5× |
| CT abdomen w/o contrast (74150) |
$752.84 |
$1,298 |
7.0× |
| CT angio hrt w/3d image (75574) |
$1,455.80 |
$2,510 |
4.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,027.76 |
$1,772 |
5.7× |
| CT angiography upper extremity lt (73206) |
$1,003.40 |
$1,730 |
5.5× |
| CT c-spine w/contrast (72126) |
$944.82 |
$1,629 |
2.6× |
| CT c-spine w/o contrast (72125) |
$1,231.92 |
$2,124 |
11.4× |
| CT chest w contrast (71260) |
$1,398.96 |
$2,412 |
7.7× |
| CT chest w/wo contrast (71270) |
$1,072.42 |
$1,849 |
5.9× |
| CT colonography w/o cntrst (74261) |
$571.88 |
$986 |
5.3× |
| CT head/brain with contrast (70460) |
$877.47 |
$1,512.88 |
4.8× |
| CT head/brain without and with contrast (70470) |
$1,006.59 |
$1,735.50 |
5.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$951.20 |
$1,640 |
2.6× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$49 |
$84.48 |
0.5× |
| CT iac w contrast (70481) |
$850.43 |
$1,466.25 |
4.7× |
| CT limited/localized follow up study (76380) |
$880.44 |
$1,518 |
9.8× |
| CT lower ext w/o (73700) |
$1,115.34 |
$1,923 |
10.3× |
| CT lower extremity w/contrast material (73701) |
$1,282.82 |
$2,211.75 |
7.1× |
| CT lumbar spine w/contrast (72132) |
$961.64 |
$1,658 |
2.7× |
| CT lumbar spine w/o contrast (72131) |
$836.36 |
$1,442 |
7.7× |
| CT maxillofacial w contrast (70487) |
$895.11 |
$1,543.30 |
4.9× |
| CT maxillofacial wo contrast (70486) |
$778.36 |
$1,342 |
7.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$933.51 |
$1,609.50 |
5.1× |
| CT orbits w/o contrast (70480) |
$728.77 |
$1,256.50 |
6.7× |
| CT pelvis w/o contrast (72192) |
$731.96 |
$1,262 |
6.8× |
| CT pelvis w/wo contrast (72194) |
$923.94 |
$1,593 |
5.1× |
| CT soft tissue neck w contrast (70491) |
$796.34 |
$1,373 |
4.4× |
| CT soft tissue neck w/o contrast (70490) |
$676.86 |
$1,167 |
6.3× |
| CT thoracic spine w/contrast (72129) |
$961.64 |
$1,658 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$836.36 |
$1,442 |
7.7× |
| CT thorax w/o contrast (71250) |
$791.99 |
$1,365.50 |
7.3× |
| CT upper ext wo (73200) |
$1,137.96 |
$1,962 |
10.5× |
| CT upper extremity with contrast (73201) |
$872.32 |
$1,504 |
2.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,218 |
$2,100 |
6.7× |
| Cta Abdomen (74175) |
$1,038.20 |
$1,790 |
5.7× |
| CTA abdomen pelvis (74174) |
$1,520.18 |
$2,621 |
4.2× |
| CTA chest (71275) |
$1,449.42 |
$2,499 |
8.0× |
| Cta Head (70496) |
$1,685.19 |
$2,905.50 |
9.3× |
| Cta Neck (70498) |
$1,685.19 |
$2,905.50 |
9.3× |
| Cystography minimum 3 views rs&i (74430) |
$680.92 |
$1,174 |
1.9× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$1,818.88 |
$3,136 |
0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$214.60 |
$370 |
2.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$214.60 |
$370 |
2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$313.20 |
$540 |
2.9× |
| Echo exam of eye (76529) |
$175.74 |
$303 |
2.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$472.12 |
$814 |
1.9× |
| Esophagus (74220) |
$311.46 |
$537 |
1.7× |
| Facial bones min 3 views (70150) |
$192.56 |
$332 |
1.8× |
| Fetal biophysical profile non-stress testing (76818) |
$777.20 |
$1,340 |
7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,433.76 |
$2,472 |
13.2× |
| Fetal Echo (76825) |
$972.08 |
$1,676 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$387.44 |
$668 |
1.6× |
| Foot 2 views (73620) |
$140.94 |
$243 |
1.6× |
| Forearm 2 views (73090) |
$305.08 |
$526 |
3.4× |
| Hand 2 views (73120) |
$207.06 |
$357 |
1.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,881.44 |
$4,968 |
0.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,056.18 |
$1,821 |
1.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$988.90 |
$1,705 |
2.4× |
| Hysterosalpingogram (74740) |
$286.66 |
$494.25 |
1.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$265.06 |
$457 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,003.40 |
$1,730 |
1.8× |
| Knee 3 views (73562) |
$400.20 |
$690 |
4.4× |
| Lung perfusion differential (78597) |
$666.42 |
$1,149 |
1.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,948.64 |
$6,808 |
1.2× |
| Lymphoscintigraphy (78195) |
$883.92 |
$1,524 |
1.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,562.52 |
$2,694 |
1.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,637.84 |
$4,548 |
7.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$713.40 |
$1,230 |
1.8× |
| MRA head w & w/o contrast (70546) |
$1,668.08 |
$2,876 |
4.6× |
| MRA head w/o contrast (70544) |
$1,924.44 |
$3,318 |
7.8× |
| MRA neck w contrast (70548) |
$1,316.75 |
$2,270.25 |
3.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,549.18 |
$2,671 |
4.3× |
| MRA neck w/o contrast (70547) |
$1,120.78 |
$1,932.38 |
4.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,796.26 |
$3,097 |
5.0× |
| MRI abdomen w/o contrast (74181) |
$2,021.01 |
$3,484.50 |
8.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,534.10 |
$2,645 |
1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,601.30 |
$4,485 |
7.2× |
| MRI breast w/o contrast bilateral (77047) |
$1,010.94 |
$1,743 |
4.1× |
| MRI c-spine with contrast (72142) |
$1,566.58 |
$2,701 |
4.3× |
| MRI cardiac w/o contrast (75557) |
$989.48 |
$1,706 |
4.0× |
| MRI cervical spine w/o contrast (72141) |
$1,362.42 |
$2,349 |
5.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,513.80 |
$2,610 |
4.2× |
| MRI chest w/o contrast (71550) |
$1,130.42 |
$1,949 |
4.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,241.04 |
$5,588 |
9.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,492.84 |
$4,298 |
10.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,160.58 |
$2,001 |
4.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,657.64 |
$2,858 |
4.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,771.90 |
$3,055 |
4.9× |
| MRI pelvis w/o contrast (72195) |
$1,323.56 |
$2,282 |
5.4× |
| MRI spectroscopy (76390) |
$860.14 |
$1,483 |
9.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,771.32 |
$3,054 |
4.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,771.32 |
$3,054 |
4.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,566.58 |
$2,701 |
4.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,771.32 |
$3,054 |
4.9× |
| MRI temporomandibular joint (70336) |
$1,085.18 |
$1,871 |
4.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,362.42 |
$2,349 |
5.5× |
| MRI up ext w/o contrast (73218) |
$1,847.01 |
$3,184.50 |
7.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,038.41 |
$3,514.50 |
8.3× |
| MRI, joint upper extrem combo (73223) |
$2,650.02 |
$4,569 |
7.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,897.10 |
$4,995 |
2.2× |
| Myocardial spect single study at rest or stress (78451) |
$1,502.20 |
$2,590 |
1.1× |
| Neck soft tissue (70360) |
$129.34 |
$223 |
1.4× |
| Nm gastric emptying study (78264) |
$1,005.72 |
$1,734 |
2.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,777.54 |
$6,513 |
2.6× |
| Nuclear Rx Oral Admin (79005) |
$478.79 |
$825.50 |
2.0× |
| Ob us nuchal meas 1 gest (76813) |
$187.92 |
$324 |
1.7× |
| Parathyrd planar w/spect&CT (78072) |
$1,251.06 |
$2,157 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$246.21 |
$424.50 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$6,070.86 |
$10,467 |
4.1× |
| PET imaging for CT attenuation whole body (78816) |
$3,415.62 |
$5,889 |
2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$666.42 |
$1,149 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,013.84 |
$1,748 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$375.84 |
$648 |
0.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$338.72 |
$584 |
3.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$140.36 |
$242 |
1.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$171.10 |
$295 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$175.16 |
$302 |
1.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$213.44 |
$368 |
2.0× |
| Radex fingr minimum 2 views (73140) |
$195.46 |
$337 |
2.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$161.91 |
$279.15 |
1.8× |
| Radex Hand Minimum 3 Views (73130) |
$324.80 |
$560 |
3.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$149.35 |
$257.50 |
1.7× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$197.20 |
$340 |
1.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$193.72 |
$334 |
1.8× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$261.58 |
$451 |
2.4× |
| Radex Humerus Minimum 2 Views (73060) |
$171.68 |
$296 |
1.9× |
| Radex Kne 1/2 Views (73560) |
$321.90 |
$555 |
3.6× |
| Radex Kne Compl 4/More Views (73564) |
$339.30 |
$585 |
3.1× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$190.82 |
$329 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$161.24 |
$278 |
1.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$201.26 |
$347 |
1.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$434.42 |
$749 |
4.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$110.20 |
$190 |
1.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$176.90 |
$305 |
1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$149.06 |
$257 |
1.7× |
| Radex Toe Minimum 2 Views (73660) |
$200.10 |
$345 |
2.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$178.64 |
$308 |
1.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$257.52 |
$444 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$251.49 |
$433.60 |
2.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,754.60 |
$13,370 |
1.0× |
| Radiation treatment delivery level 1 (77402) |
$436.16 |
$752 |
4.1× |
| Radiation treatment delivery level 2 (77407) |
$1,368.22 |
$2,359 |
3.4× |
| Radiation treatment delivery level 3 (77412) |
$2,163.69 |
$3,730.50 |
3.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$281.88 |
$486 |
3.1× |
| Radiologic exam chest 2 views (71046) |
$168.78 |
$291 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$399.62 |
$689 |
2.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$357.86 |
$617 |
2.0× |
| Radiologic examination femur 1 view (73551) |
$219.68 |
$378.75 |
2.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$433.55 |
$747.50 |
4.8× |
| Radiological examination surgical specimen (76098) |
$764.15 |
$1,317.50 |
1.4× |
| Renal Cyst Study (74470) |
$557.96 |
$962 |
1.0× |
| Ribs bilateral 3 views (71110) |
$231.42 |
$399 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,006.80 |
$3,460 |
3.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,314.20 |
$3,990 |
1.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$658.88 |
$1,136 |
2.7× |
| Rp Therapy Intravenous Administration (79101) |
$560.28 |
$966 |
2.3× |
| Sacroiliac Joints < 3 Views (72200) |
$128.76 |
$222 |
1.2× |
| Scapula (73010) |
$155.44 |
$268 |
1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$141.52 |
$244 |
6.1× |
| Shoulder 1 view (73020) |
$149.72 |
$258.12 |
1.7× |
| Small bowel series (74250) |
$309.14 |
$533 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,345.60 |
$2,320 |
3.5× |
| Special Physics Consult (77370) |
$423.40 |
$730 |
3.0× |
| Special treatment procedure (77470) |
$1,246.42 |
$2,149 |
2.2× |
| Spine thoracic 3 views (72072) |
$199.52 |
$344 |
1.8× |
| Stereotactic Body Radiation Delivery (77373) |
$3,761.88 |
$6,486 |
2.0× |
| Superior sagittal sinus venogram (75870) |
$1,800.32 |
$3,104 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$926.26 |
$1,597 |
2.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,100.26 |
$1,897 |
2.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$785.90 |
$1,355 |
5.6× |
| Thoracolumbar 2 views (72080) |
$149.64 |
$258 |
1.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$934.96 |
$1,612 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$741.24 |
$1,278 |
1.8× |
| Treatment device complex (77334) |
$6,542.40 |
$11,280 |
16.9× |
| Treatment devices simple (77332) |
$458.20 |
$790 |
3.3× |
| Ultrasound breast complete (76641) |
$426.30 |
$735 |
3.9× |
| Ultrasound Exam Aaa Screen (76706) |
$260.42 |
$449 |
2.4× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$362.50 |
$625 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$486.33 |
$838.50 |
4.5× |
| Umbilical-artery Doppler (OB) (76820) |
$208.80 |
$360 |
1.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$176.32 |
$304 |
2.0× |
| Unlisted magnetic resonance procedure (76498) |
$1,159.42 |
$1,999 |
12.9× |
| Unlisted ultrasound procedure (76999) |
$168.78 |
$291 |
1.9× |
| Urethrocystogram voiding (74455) |
$457.04 |
$788 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$457.04 |
$788 |
1.9× |
| Us breast unilateral limited (76642) |
$244.76 |
$422 |
2.7× |
| Us chest (76604) |
$265.06 |
$457 |
2.4× |
| Us encephalogram (76506) |
$380.48 |
$656 |
3.5× |
| Us hips infant static (76886) |
$257.52 |
$444 |
2.9× |
| Us infant hips w manipulation (76885) |
$257.52 |
$444 |
2.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$395.85 |
$682.50 |
3.7× |
| Us ob detailed single fetus (76811) |
$997.60 |
$1,720 |
4.0× |
| Us ob limited (76815) |
$450.66 |
$777 |
4.2× |
| Us ob transvaginal (76817) |
$446.31 |
$769.50 |
4.1× |
| Us pelvic non ob complete (76856) |
$335.53 |
$578.50 |
3.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$239.83 |
$413.50 |
2.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$324.94 |
$560.25 |
3.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$488.94 |
$843 |
4.5× |
| Us retroperitoneal complete (76770) |
$321.90 |
$555 |
3.0× |
| Us retroperitoneal limited (76775) |
$399.33 |
$688.50 |
3.7× |
| Us scrotum and contents (76870) |
$318.42 |
$549 |
2.9× |
| Us soft tissue head/neck (76536) |
$434.13 |
$748.50 |
4.0× |
| Us spinal canal and contents (76800) |
$279.56 |
$482 |
2.6× |
| Us, eye b-scan (76512) |
$215.18 |
$371 |
2.0× |
| Us,transplanted kidney, real time/ doppler (76776) |
$391.50 |
$675 |
3.6× |
| Venogram extremity bilateral (75822) |
$1,565.42 |
$2,699 |
1.0× |
| Venogram Extremity Unilateral (75820) |
$1,201.18 |
$2,071 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,296.72 |
$5,684 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,648.36 |
$2,842 |
1.0× |
| Venography Renal Bilateral (75833) |
$2,908.12 |
$5,014 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$2,418.60 |
$4,170 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,105.90 |
$5,355 |
1.0× |
| Venous sampling by catheter (75893) |
$7,727.92 |
$13,324 |
1.3× |
| Wrist 2 views (73100) |
$292.32 |
$504 |
3.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$241.28 |
$416 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$158.34 |
$273 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$286.52 |
$494 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$343.36 |
$592 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$341.48 |
$588.75 |
3.2× |
| X-ray exam of femur 2/> (73552) |
$172.26 |
$297 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$171.68 |
$296 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$182.70 |
$315 |
2.0× |
| X-ray leg, infant (73592) |
$173.42 |
$299 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$176.90 |
$305 |
1.6× |
| X-ray nose-rectum child f.b. (76010) |
$133.69 |
$230.50 |
1.5× |
| X-ray retrograde pyelogram (74420) |
$1,776.83 |
$3,063.50 |
4.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$151.96 |
$262 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$211.12 |
$364 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$254.04 |
$438 |
2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$151.38 |
$261 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$149.06 |
$257 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$171.68 |
$296 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$215.76 |
$372 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$161.82 |
$279 |
1.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$140.36 |
$242 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$169.65 |
$292.50 |
1.6× |
| Xr bone length studies (77073) |
$229.68 |
$396 |
2.1× |
| Xr c-spine 4 or 5 views (72050) |
$214.31 |
$369.50 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$268.54 |
$463 |
2.5× |
| Xr urogram antegrade (74425) |
$870 |
$1,500 |
2.4× |