| 3-D radiotherapy plan dose-volume histograms (77295) |
$831.04 |
$3,011 |
0.6× |
| Abdomen 2 views (74019) |
$168.91 |
$612 |
1.5× |
| Acute gi blood loss imaging (78278) |
$979.80 |
$3,550 |
2.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$968.21 |
$3,508 |
0.3× |
| Ankle 2 views (73600) |
$148.49 |
$538 |
1.6× |
| Arthrogram elbow (73085) |
$549.24 |
$1,990 |
1.5× |
| Arthrogram hip (73525) |
$549.24 |
$1,990 |
1.5× |
| Arthrogram shoulder (73040) |
$549.24 |
$1,990 |
1.5× |
| Basic dosimetry (77300) |
$136.34 |
$494 |
0.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$430.56 |
$1,560 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$599.20 |
$2,171 |
1.4× |
| Bone age studies (77072) |
$176.36 |
$639 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$855.32 |
$3,099 |
2.0× |
| Bone survey complete (77075) |
$464.23 |
$1,682 |
4.2× |
| Bone survey infant (77076) |
$214.18 |
$776 |
1.9× |
| Bowel imaging (78290) |
$420.62 |
$1,524 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,150.59 |
$7,792 |
1.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$905.28 |
$3,280 |
2.1× |
| Cervical spine 2 or 3 views (72040) |
$179.40 |
$650 |
1.9× |
| Chest 1 view (71045) |
$148.49 |
$538 |
1.6× |
| Chest xray 3 views (71047) |
$156.49 |
$567 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$275.17 |
$997 |
1.5× |
| Clavicle complete (73000) |
$148.49 |
$538 |
1.6× |
| Continuing medical physics consltj pr wk (77336) |
$237.64 |
$861 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,611.56 |
$5,839 |
4.3× |
| CT abdomen and pelvis without contrast (74176) |
$966.55 |
$3,502 |
3.8× |
| CT abdomen w contrast (74160) |
$1,018.99 |
$3,692 |
5.4× |
| CT abdomen w wo contrast (74170) |
$1,264.91 |
$4,583 |
6.8× |
| CT abdomen w/o contrast (74150) |
$698.83 |
$2,532 |
6.3× |
| CT angio hrt w/3d image (75574) |
$349.69 |
$1,267 |
0.9× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,048.25 |
$3,798 |
5.6× |
| CT angiography upper extremity lt (73206) |
$1,048.25 |
$3,798 |
5.6× |
| CT c-spine w/contrast (72126) |
$1,000.22 |
$3,624 |
2.7× |
| CT c-spine w/o contrast (72125) |
$803.71 |
$2,912 |
7.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,070.05 |
$3,877 |
5.7× |
| CT chest w contrast (71260) |
$1,020.92 |
$3,699 |
5.5× |
| CT chest w/wo contrast (71270) |
$1,142.92 |
$4,141 |
6.1× |
| CT colonography screening (74263) |
$1,574.58 |
$5,705 |
6.2× |
| CT colonography w/o cntrst (74261) |
$708.22 |
$2,566 |
6.3× |
| CT head/brain with contrast (70460) |
$781.08 |
$2,830 |
4.2× |
| CT head/brain without and with contrast (70470) |
$1,031.96 |
$3,739 |
5.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$194.58 |
$705 |
0.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$88.32 |
$320 |
1.0× |
| CT iac w contrast (70481) |
$1,036.93 |
$3,757 |
5.5× |
| CT limited/localized follow up study (76380) |
$461.20 |
$1,671 |
5.0× |
| CT lower ext w/o (73700) |
$792.12 |
$2,870 |
7.1× |
| CT lower extremity w wo contrast (73702) |
$968.76 |
$3,510 |
5.2× |
| CT lower extremity w/contrast material (73701) |
$924.32 |
$3,349 |
4.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,098.48 |
$3,980 |
5.9× |
| CT lumbar spine w/contrast (72132) |
$1,018.99 |
$3,692 |
2.7× |
| CT lumbar spine w/o contrast (72131) |
$808.13 |
$2,928 |
7.2× |
| CT maxillofacial w contrast (70487) |
$947.78 |
$3,434 |
5.1× |
| CT maxillofacial w/wo contrast (70488) |
$841.52 |
$3,049 |
4.5× |
| CT maxillofacial wo contrast (70486) |
$739.13 |
$2,678 |
6.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,262.15 |
$4,573 |
6.7× |
| CT orbits w/o contrast (70480) |
$672.89 |
$2,438 |
6.0× |
| CT pelvis w/o contrast (72192) |
$704.90 |
$2,554 |
6.3× |
| CT pelvis w/wo contrast (72194) |
$962.69 |
$3,488 |
5.1× |
| CT scan of arm combo (73202) |
$1,102.62 |
$3,995 |
5.9× |
| CT soft tissue neck w contrast (70491) |
$1,017.06 |
$3,685 |
5.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,205.57 |
$4,368 |
6.4× |
| CT soft tissue neck w/o contrast (70490) |
$698.83 |
$2,532 |
6.3× |
| CT thoracic spine w/contrast (72129) |
$1,017.06 |
$3,685 |
5.4× |
| CT thoracic spine w/o contrast (72128) |
$803.71 |
$2,912 |
7.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,021.20 |
$3,700 |
5.5× |
| CT thorax w/o contrast (71250) |
$758.17 |
$2,747 |
6.8× |
| CT upper ext wo (73200) |
$737.75 |
$2,673 |
6.6× |
| CT upper extremity with contrast (73201) |
$1,102.62 |
$3,995 |
3.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,205.57 |
$4,368 |
6.4× |
| Cta Abdomen (74175) |
$1,048.25 |
$3,798 |
5.6× |
| CTA abdomen pelvis (74174) |
$1,454.24 |
$5,269 |
3.9× |
| CTA chest (71275) |
$1,048.25 |
$3,798 |
5.6× |
| Cta Head (70496) |
$1,178.24 |
$4,269 |
6.3× |
| Cta Neck (70498) |
$1,178.24 |
$4,269 |
6.3× |
| Cta Pelvis (72191) |
$1,048.25 |
$3,798 |
5.6× |
| Cystography minimum 3 views rs&i (74430) |
$478.86 |
$1,735 |
1.3× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$2,038.54 |
$7,386 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$236.53 |
$857 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$63.48 |
$230 |
0.7× |
| Esophagus (74220) |
$327.61 |
$1,187 |
1.7× |
| Facial bones min 3 views (70150) |
$226.87 |
$822 |
2.0× |
| Fetal biophysical profile non-stress testing (76818) |
$358.52 |
$1,299 |
3.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$341.14 |
$1,236 |
3.1× |
| Fluoroscopy up to 1 hr (76000) |
$475.82 |
$1,724 |
1.9× |
| Foot 2 views (73620) |
$133.58 |
$484 |
1.4× |
| Forearm 2 views (73090) |
$135.52 |
$491 |
1.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$535.44 |
$1,940 |
0.9× |
| Hand 2 views (73120) |
$143.52 |
$520 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,045.21 |
$3,787 |
1.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$845.66 |
$3,064 |
2.0× |
| Hysterosalpingogram (74740) |
$377.29 |
$1,367 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$530.75 |
$1,923 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$545.38 |
$1,976 |
0.9× |
| Knee 3 views (73562) |
$169.46 |
$614 |
1.8× |
| Liver & spleen imaging static only (78215) |
$566.90 |
$2,054 |
1.3× |
| Lung perf&ventilat diferentl (78598) |
$764.24 |
$2,769 |
1.3× |
| Lymphoscintigraphy (78195) |
$854.50 |
$3,096 |
1.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,076.40 |
$3,900 |
1.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,001.05 |
$3,627 |
2.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,261.87 |
$4,572 |
3.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$768.11 |
$2,783 |
1.9× |
| MRA head w & w/o contrast (70546) |
$2,483.72 |
$8,999 |
6.7× |
| MRA head w/o contrast (70544) |
$1,261.87 |
$4,572 |
5.0× |
| MRA head with contrast (70545) |
$1,261.87 |
$4,572 |
3.4× |
| MRA neck w contrast (70548) |
$1,424.16 |
$5,160 |
3.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,483.72 |
$8,999 |
6.7× |
| MRA neck w/o contrast (70547) |
$1,424.16 |
$5,160 |
5.6× |
| MRI abdomen w contrast (74182) |
$1,355.99 |
$4,913 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,559.40 |
$5,650 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$1,355.99 |
$4,913 |
5.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,087.44 |
$3,940 |
1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,983.06 |
$7,185 |
5.3× |
| MRI breast w/o contrast bilateral (77047) |
$285.11 |
$1,033 |
1.1× |
| MRI breast wo contrast unilateral (77046) |
$271.58 |
$984 |
1.1× |
| MRI c-spine with contrast (72142) |
$1,702.64 |
$6,169 |
4.6× |
| MRI cervical spine w/o contrast (72141) |
$1,355.99 |
$4,913 |
5.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,483.72 |
$8,999 |
6.7× |
| MRI chest w/o contrast (71550) |
$1,355.99 |
$4,913 |
5.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,060.12 |
$3,841 |
2.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,451.21 |
$5,258 |
3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,042.73 |
$3,778 |
4.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,355.99 |
$4,913 |
5.3× |
| MRI orbit face neck w contrast (70542) |
$1,355.99 |
$4,913 |
3.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,365.60 |
$8,571 |
6.4× |
| MRI pelvis w/contrast (72196) |
$1,115.87 |
$4,043 |
3.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,818.29 |
$6,588 |
4.9× |
| MRI pelvis w/o contrast (72195) |
$1,042.73 |
$3,778 |
4.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,365.60 |
$8,571 |
6.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,702.64 |
$6,169 |
4.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,296.60 |
$8,321 |
6.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,355.99 |
$4,913 |
3.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,330.82 |
$8,445 |
6.3× |
| MRI temporomandibular joint (70336) |
$925.43 |
$3,353 |
3.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,355.99 |
$4,913 |
5.3× |
| MRI up ext w/o contrast (73218) |
$906.66 |
$3,285 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,063.43 |
$3,853 |
4.2× |
| MRI, joint upper extrem combo (73223) |
$1,987.75 |
$7,202 |
5.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,397.34 |
$8,686 |
1.7× |
| Myocardial spect single study at rest or stress (78451) |
$2,032.19 |
$7,363 |
1.5× |
| Neck soft tissue (70360) |
$148.49 |
$538 |
1.6× |
| Nm gastric emptying study (78264) |
$817.51 |
$2,962 |
1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,255.37 |
$15,418 |
2.9× |
| Nuclear Rx Oral Admin (79005) |
$433.04 |
$1,569 |
1.7× |
| Ob us nuchal meas 1 gest (76813) |
$72.31 |
$262 |
0.6× |
| Parathyrd planar w/spect&CT (78072) |
$355.21 |
$1,287 |
0.6× |
| Parathyroid Planar Imaging (78070) |
$420.62 |
$1,524 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$942.54 |
$3,415 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$194.58 |
$705 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$2,446.19 |
$8,863 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$2,446.19 |
$8,863 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$581.53 |
$2,107 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$812.27 |
$2,943 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$436.91 |
$1,583 |
0.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$154.01 |
$558 |
1.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$142.69 |
$517 |
1.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$151.80 |
$550 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$181.88 |
$659 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$183.82 |
$666 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$197.06 |
$714 |
1.8× |
| Radex fingr minimum 2 views (73140) |
$129.17 |
$468 |
1.4× |
| Radex Foot Compl Minimum 3 Views (73630) |
$152.35 |
$552 |
1.6× |
| Radex Hand Minimum 3 Views (73130) |
$148.49 |
$538 |
1.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$104.88 |
$380 |
1.1× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$143.52 |
$520 |
1.3× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$143.52 |
$520 |
1.3× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$247.85 |
$898 |
2.2× |
| Radex Humerus Minimum 2 Views (73060) |
$131.93 |
$478 |
1.4× |
| Radex Kne 1/2 Views (73560) |
$148.49 |
$538 |
1.6× |
| Radex Kne Compl 4/More Views (73564) |
$199.82 |
$724 |
1.8× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$226.87 |
$822 |
2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$177.19 |
$642 |
1.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$207 |
$750 |
1.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$183.54 |
$665 |
2.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$123.37 |
$447 |
1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$181.88 |
$659 |
2.0× |
| Radex Toe Minimum 2 Views (73660) |
$142.69 |
$517 |
1.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$143.52 |
$520 |
1.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$129.72 |
$470 |
1.4× |
| Radiation treatment delivery level 1 (77402) |
$107.36 |
$389 |
1.0× |
| Radiation treatment delivery level 2 (77407) |
$659.36 |
$2,389 |
1.6× |
| Radiation treatment delivery level 3 (77412) |
$665.99 |
$2,413 |
1.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$148.49 |
$538 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$168.91 |
$612 |
1.5× |
| Radiologic exam chest 2 views (71046) |
$150.97 |
$547 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$348.86 |
$1,264 |
1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$235.43 |
$853 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$327.61 |
$1,187 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$304.15 |
$1,102 |
1.6× |
| Radiologic examination femur 1 view (73551) |
$60.72 |
$220 |
0.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$148.49 |
$538 |
1.6× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$231.01 |
$837 |
2.1× |
| Radiological examination surgical specimen (76098) |
$673.16 |
$2,439 |
1.2× |
| Ribs bilateral 3 views (71110) |
$210.86 |
$764 |
1.9× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$572.42 |
$2,074 |
1.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,292.51 |
$4,683 |
2.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,292.51 |
$4,683 |
2.2× |
| Sacroiliac Joints < 3 Views (72200) |
$143.52 |
$520 |
1.3× |
| Scapula (73010) |
$151.80 |
$550 |
1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$95.77 |
$347 |
4.1× |
| Shoulder 1 view (73020) |
$112.33 |
$407 |
1.2× |
| Simulation intermediate (77285) |
$649.98 |
$2,355 |
1.6× |
| Small bowel series (74250) |
$332.58 |
$1,205 |
1.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$335.89 |
$1,217 |
0.8× |
| Special dosimetry (77331) |
$89.42 |
$324 |
0.6× |
| Special Physics Consult (77370) |
$396.34 |
$1,436 |
2.8× |
| Special treatment procedure (77470) |
$593.95 |
$2,152 |
1.0× |
| Spine thoracic 3 views (72072) |
$210.86 |
$764 |
1.9× |
| Stereotactic Body Radiation Delivery (77373) |
$2,662.30 |
$9,646 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$754.31 |
$2,733 |
1.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$725.05 |
$2,627 |
1.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,175.48 |
$4,259 |
2.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$649.15 |
$2,352 |
4.5× |
| Thoracolumbar 2 views (72080) |
$177.19 |
$642 |
1.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$779.15 |
$2,823 |
1.3× |
| Thyroid imaging w/blood flow (78013) |
$504.25 |
$1,827 |
1.2× |
| Thyroid uptake measurement (78012) |
$420.62 |
$1,524 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$602.78 |
$2,184 |
1.4× |
| Treatment device complex (77334) |
$272.41 |
$987 |
0.7× |
| Treatment device intermediate (77333) |
$164.22 |
$595 |
1.1× |
| Treatment devices simple (77332) |
$161.46 |
$585 |
1.1× |
| Ultrasound breast complete (76641) |
$201.76 |
$731 |
1.8× |
| Ultrasound Exam Aaa Screen (76706) |
$302.77 |
$1,097 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$308.29 |
$1,117 |
2.8× |
| Umbilical-artery Doppler (OB) (76820) |
$193.48 |
$701 |
1.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$70.93 |
$257 |
0.8× |
| Urethrocystogram voiding (74455) |
$285.66 |
$1,035 |
1.1× |
| Urethrocystography retrograde rs&i (74450) |
$380.33 |
$1,378 |
1.5× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$546.20 |
$1,979 |
2.9× |
| Us breast unilateral limited (76642) |
$148.49 |
$538 |
1.6× |
| Us chest (76604) |
$356.04 |
$1,290 |
3.2× |
| Us compl joint r-t w/image documentation (76881) |
$306.08 |
$1,109 |
2.7× |
| Us encephalogram (76506) |
$416.48 |
$1,509 |
3.7× |
| Us infant hips w manipulation (76885) |
$240.67 |
$872 |
2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$165.05 |
$598 |
1.5× |
| Us ob limited (76815) |
$190.44 |
$690 |
1.7× |
| Us ob transvaginal (76817) |
$358.52 |
$1,299 |
3.2× |
| Us pelvic non ob complete (76856) |
$366.80 |
$1,329 |
3.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$143.52 |
$520 |
1.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$373.70 |
$1,354 |
3.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$358.52 |
$1,299 |
3.2× |
| Us retroperitoneal complete (76770) |
$415.66 |
$1,506 |
3.7× |
| Us retroperitoneal limited (76775) |
$302.77 |
$1,097 |
2.7× |
| Us scrotum and contents (76870) |
$416.48 |
$1,509 |
3.7× |
| Us soft tissue head/neck (76536) |
$310.78 |
$1,126 |
2.8× |
| Us spinal canal and contents (76800) |
$306.08 |
$1,109 |
2.7× |
| Us transrectal (76872) |
$214.18 |
$776 |
1.9× |
| Us, eye b-scan (76512) |
$110.95 |
$402 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,593.62 |
$5,774 |
0.9× |
| Venogram Extremity Unilateral (75820) |
$784.67 |
$2,843 |
0.5× |
| Wrist 2 views (73100) |
$86.66 |
$314 |
0.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$226.87 |
$822 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$181.88 |
$659 |
2.0× |
| X-ray b.e. reductn intuss (74283) |
$290.35 |
$1,052 |
1.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$355.76 |
$1,289 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$140.48 |
$509 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$182.16 |
$660 |
2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$165.05 |
$598 |
1.5× |
| X-ray exam of femur 2/> (73552) |
$186.58 |
$676 |
2.0× |
| X-ray eye for foreign body (70030) |
$148.49 |
$538 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$179.12 |
$649 |
1.9× |
| X-ray IV pyelogram (ivp) (74400) |
$569.94 |
$2,065 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$179.12 |
$649 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$133.58 |
$484 |
1.4× |
| X-ray leg, infant (73592) |
$98.81 |
$358 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$199.82 |
$724 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$288.70 |
$1,046 |
2.6× |
| X-ray nose-rectum child f.b. (76010) |
$131.10 |
$475 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$179.12 |
$649 |
1.6× |
| X-ray retrograde pyelogram (74420) |
$549.24 |
$1,990 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$151.80 |
$550 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$254.47 |
$922 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$281.24 |
$1,019 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$143.52 |
$520 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$150.97 |
$547 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$231.01 |
$837 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$226.87 |
$822 |
2.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$199.82 |
$724 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$117.02 |
$424 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$179.12 |
$649 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$177.19 |
$642 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$173.60 |
$629 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$273.52 |
$991 |
2.5× |
| Xr bone length studies (77073) |
$177.19 |
$642 |
1.6× |
| Xr c-spine 4 or 5 views (72050) |
$229.36 |
$831 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$277.38 |
$1,005 |
2.5× |
| Xr chest 4+ views (71048) |
$193.48 |
$701 |
1.7× |
| Xr urogram antegrade (74425) |
$477.76 |
$1,731 |
1.3× |