| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,576.81 |
$12,421 |
5.3× |
| Abdomen 2 views (74019) |
$386.13 |
$633 |
3.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,163.88 |
$1,908 |
2.8× |
| Angiography extremity bilateral rs&i (75716) |
$3,880.82 |
$6,362 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,559.96 |
$5,836 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,308.03 |
$5,423 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,833.05 |
$3,005 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,529.27 |
$2,507 |
0.5× |
| Angiography Spinal Selective Rs&I (75705) |
$3,273.26 |
$5,366 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,599 |
$5,900 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$924.76 |
$1,516 |
0.3× |
| Ankle 2 views (73600) |
$250.71 |
$411 |
2.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$680.76 |
$1,116 |
1.9× |
| Aortogram thoracic (75605) |
$2,924.95 |
$4,795 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,664.48 |
$4,368 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$3,134.79 |
$5,139 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$1,833.05 |
$3,005 |
0.6× |
| Arthrogram hip (73525) |
$986.37 |
$1,617 |
2.7× |
| Arthrogram shoulder (73040) |
$849.12 |
$1,392 |
2.3× |
| Arthrogram wrist (73115) |
$574.01 |
$941 |
1.6× |
| Arthrography knee lt (73580) |
$954.04 |
$1,564 |
2.6× |
| Basic radiation dosimetry calculation (77300) |
$680.15 |
$1,115 |
4.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$836.31 |
$1,371 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$936.35 |
$1,535 |
2.3× |
| Bone &/joint imaging whole body (78306) |
$1,639.07 |
$2,687 |
3.9× |
| Bone age studies (77072) |
$148.84 |
$244 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,856.23 |
$3,043 |
4.5× |
| Bone survey complete (77075) |
$893.65 |
$1,465 |
8.2× |
| Brachytx isodose intermed (77317) |
$1,939.80 |
$3,180 |
5.0× |
| Brain image w/flow 4 + views (78606) |
$814.96 |
$1,336 |
1.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,162.66 |
$1,906 |
2.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$764.33 |
$1,253 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$355.63 |
$583 |
3.9× |
| Chest 1 view (71045) |
$303.17 |
$497 |
3.4× |
| Chest 3 views (71047) |
$269.62 |
$442 |
3.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$498.37 |
$817 |
2.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,257.82 |
$2,062 |
1.5× |
| Clavicle complete (73000) |
$290.36 |
$476 |
3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,212.07 |
$1,987 |
11.2× |
| Continuing medical physics consltj pr wk (77336) |
$1,032.73 |
$1,693 |
7.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,188.05 |
$8,505 |
14.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,759.64 |
$4,524 |
11.1× |
| CT abdomen w contrast (74160) |
$2,221.62 |
$3,642 |
12.2× |
| CT abdomen w wo contrast (74170) |
$2,466.23 |
$4,043 |
13.5× |
| CT abdomen w/o contrast (74150) |
$1,666.52 |
$2,732 |
15.4× |
| CT angio hrt w/3d image (75574) |
$240.34 |
$394 |
0.7× |
| CT angiography upper extremity lt (73206) |
$2,072.17 |
$3,397 |
11.4× |
| CT c-spine w/o contrast (72125) |
$1,603.08 |
$2,628 |
14.8× |
| CT cervical spine w&w/o contrast (72127) |
$2,142.32 |
$3,512 |
11.8× |
| CT cervical spine with contrast (72126) |
$2,028.25 |
$3,325 |
5.6× |
| CT chest w/wo contrast (71270) |
$2,584.57 |
$4,237 |
14.2× |
| CT chest with contrast (71260) |
$2,241.14 |
$3,674 |
12.3× |
| CT colonography screening (74263) |
$2,803.56 |
$4,596 |
11.3× |
| CT colonography w/dye (74262) |
$1,650.05 |
$2,705 |
9.1× |
| CT colonography w/o cntrst (74261) |
$1,321.26 |
$2,166 |
12.2× |
| CT head/brain with contrast (70460) |
$1,632.97 |
$2,677 |
9.0× |
| CT head/brain without and with contrast (70470) |
$1,956.88 |
$3,208 |
10.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$218.38 |
$358 |
0.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$174.46 |
$286 |
1.9× |
| CT hrt w/3d image congen (75573) |
$218.38 |
$358 |
0.6× |
| CT iac w contrast (70481) |
$2,067.90 |
$3,390 |
11.4× |
| CT limited/localized follow up study (76380) |
$745.42 |
$1,222 |
8.2× |
| CT lower ext w/o (73700) |
$1,442.04 |
$2,364 |
13.3× |
| CT lower extremity w wo contrast (73702) |
$2,090.47 |
$3,427 |
11.5× |
| CT lower extremity with contrast (73701) |
$1,859.89 |
$3,049 |
10.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,027.64 |
$3,324 |
11.1× |
| CT lumbar spine w/o contrast (72131) |
$1,747.65 |
$2,865 |
16.1× |
| CT lumbar spine with contrast (72132) |
$1,939.80 |
$3,180 |
5.4× |
| CT maxillofacial w contrast (70487) |
$1,778.15 |
$2,915 |
9.8× |
| CT maxillofacial w/o contrast (70486) |
$1,389.58 |
$2,278 |
12.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,806.21 |
$2,961 |
9.9× |
| CT neck soft tissue w contrast (70491) |
$1,944.07 |
$3,187 |
10.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,477.21 |
$4,061 |
13.6× |
| CT orbits w/o contrast (70480) |
$1,862.94 |
$3,054 |
17.2× |
| CT pelvis w & w/o contrast (72194) |
$1,200.18 |
$1,967.50 |
6.6× |
| CT pelvis w/o contrast (72192) |
$1,472.54 |
$2,414 |
13.6× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$268.40 |
$440 |
3.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,390.59 |
$3,919 |
13.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,496.94 |
$2,454 |
13.8× |
| CT thoracic spine w/contrast (72129) |
$1,951.39 |
$3,199 |
10.7× |
| CT thoracic spine w/o contrast (72128) |
$1,697.02 |
$2,782 |
15.6× |
| CT thoracic spine w/wo contrast (72130) |
$1,968.47 |
$3,227 |
10.8× |
| CT thorax w/o contrast (71250) |
$1,189.50 |
$1,950 |
11.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,165.50 |
$3,550 |
11.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,535.98 |
$2,518 |
14.1× |
| CT upper extremity with contrast (73201) |
$1,797.06 |
$2,946 |
5.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,602.87 |
$4,267 |
14.3× |
| Cta Abdomen (74175) |
$3,136.01 |
$5,141 |
17.2× |
| CTA abdomen pelvis (74174) |
$2,649.23 |
$4,343 |
7.3× |
| CTA chest (71275) |
$2,471.72 |
$4,052 |
13.6× |
| Cta Head (70496) |
$1,993.48 |
$3,268 |
10.9× |
| CTA lwr ext w&w/o contrast (73706) |
$2,067.90 |
$3,390 |
11.4× |
| Cta Neck (70498) |
$2,168.55 |
$3,555 |
11.9× |
| Cta Pelvis (72191) |
$1,046.76 |
$1,716 |
5.7× |
| Cystography minimum 3 views rs&i (74430) |
$515.45 |
$845 |
1.4× |
| Diskogram cervical (72285) |
$1,180.35 |
$1,935 |
0.6× |
| Diskography lumbar (72295) |
$2,162.45 |
$3,545 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$214.72 |
$352 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$513.62 |
$842 |
4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$205.57 |
$337 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$457.50 |
$750 |
4.2× |
| Echoencephalography real time imaging (76506) |
$596.58 |
$978 |
5.5× |
| Esophagus (74220) |
$630.74 |
$1,034 |
3.5× |
| Fetal biophysical profile non-stress testing (76818) |
$529.48 |
$868 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$529.48 |
$868 |
4.9× |
| Fluoroscopy up to 1 hr (76000) |
$534.97 |
$877 |
2.2× |
| Foot 2 views (73620) |
$203.13 |
$333 |
2.2× |
| Forearm 2 views (73090) |
$264.74 |
$434 |
2.9× |
| Gated Heart Planar Single (78472) |
$1,667.13 |
$2,733 |
4.0× |
| Hand 2 views (73120) |
$297.68 |
$488 |
2.7× |
| Hand 3 views (73130) |
$345.87 |
$567 |
3.8× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,243.37 |
$5,317 |
4.5× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,757.20 |
$4,520 |
3.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,394.46 |
$2,286 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,629.92 |
$2,672 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,438.99 |
$2,359 |
3.5× |
| Ht muscle image spect sing (78451) |
$1,513.41 |
$2,481 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$284.87 |
$467 |
3.2× |
| Hysterosalpingogram (74740) |
$875.35 |
$1,435 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,322.48 |
$2,168 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,485.96 |
$2,436 |
2.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,500.60 |
$2,460 |
2.7× |
| Knee 3 views (73562) |
$387.35 |
$635 |
4.3× |
| Liver & spleen imaging static only (78215) |
$727.12 |
$1,192 |
1.8× |
| Liver imaging static only (78201) |
$631.35 |
$1,035 |
1.1× |
| Lung perf&ventilat diferentl (78598) |
$1,536.59 |
$2,519 |
2.7× |
| Lung perfusion differential (78597) |
$844.85 |
$1,385 |
2.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$883.89 |
$1,449 |
0.3× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$977.22 |
$1,602 |
0.3× |
| Lymphoscintigraphy (78195) |
$1,537.81 |
$2,521 |
2.7× |
| Mammary ductogram or galactogram single (77053) |
$506.91 |
$831 |
2.0× |
| Meckels Diverticulum (78290) |
$869.25 |
$1,425 |
2.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,627.06 |
$5,946 |
9.3× |
| Mr safety determination physician/other qhp (76016) |
$75.03 |
$123 |
0.8× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$50.63 |
$83 |
0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$20.74 |
$34 |
0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$78.69 |
$129 |
0.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$206.18 |
$338 |
0.8× |
| MRA head w & w/o contrast (70546) |
$3,703.31 |
$6,071 |
10.2× |
| MRA head w/o contrast (70544) |
$2,536.38 |
$4,158 |
10.2× |
| MRA head with contrast (70545) |
$2,612.63 |
$4,283 |
7.2× |
| MRA neck w contrast (70548) |
$2,127.68 |
$3,488 |
5.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,743.78 |
$4,498 |
7.6× |
| MRA neck w/o contrast (70547) |
$1,763.51 |
$2,891 |
7.1× |
| MRI abdomen w contrast (74182) |
$2,818.81 |
$4,621 |
7.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,175.05 |
$5,205 |
8.8× |
| MRI abdomen w/o contrast (74181) |
$2,494.90 |
$4,090 |
10.1× |
| MRI any jnt lwr ext with con lt (73722) |
$2,189.90 |
$3,590 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,189.90 |
$3,590 |
2.7× |
| MRI breast w/o contrast bilateral (77047) |
$2,827.96 |
$4,636 |
11.4× |
| MRI breast w/o contrast unilat (77046) |
$1,941.02 |
$3,182 |
7.8× |
| MRI c-spine with contrast (72142) |
$3,218.97 |
$5,277 |
8.9× |
| MRI cervical spine w/o contrast (72141) |
$1,621.99 |
$2,659 |
6.5× |
| MRI chest w/o & w/contrast material (71552) |
$3,212.26 |
$5,266 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,687.66 |
$4,406 |
10.8× |
| MRI chest with contrast (71551) |
$2,949.96 |
$4,836 |
3.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,989.82 |
$3,262 |
5.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,070.95 |
$3,395 |
5.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,667.74 |
$2,734 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,307.42 |
$5,422 |
13.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,641.70 |
$5,970 |
10.1× |
| MRI orbit/face/neck w/contrast (70542) |
$3,419.05 |
$5,605 |
9.4× |
| MRI pelvis w contrast (72196) |
$2,594.33 |
$4,253 |
7.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,646.79 |
$4,339 |
7.3× |
| MRI pelvis w/o contrast (72195) |
$2,250.29 |
$3,689 |
9.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,347.89 |
$3,849 |
6.5× |
| MRI scan of leg joint before and after contrast (73723) |
$2,347.89 |
$3,849 |
6.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,544.92 |
$4,172 |
7.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,919.46 |
$4,786 |
8.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,345.45 |
$3,845 |
6.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,501 |
$4,100 |
6.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,075.83 |
$3,403 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,650.66 |
$2,706 |
6.7× |
| MRI tmj (70336) |
$1,661.03 |
$2,723 |
6.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,751.92 |
$2,872 |
7.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,146.59 |
$3,519 |
5.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,596.98 |
$2,618 |
6.4× |
| Myelogram Cervical (72240) |
$1,044.32 |
$1,712 |
1.3× |
| Myelogram Lumbar (72265) |
$1,251.11 |
$2,051 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,825 |
$6,270.50 |
2.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,088.85 |
$1,785 |
1.2× |
| Neck soft tissue (70360) |
$268.40 |
$440 |
3.0× |
| Nm csf leak detection (78650) |
$1,389.58 |
$2,278 |
1.0× |
| Nm gastric emptying study (78264) |
$1,613.45 |
$2,645 |
3.9× |
| Nm peritoneal-venous shunt patency (78291) |
$561.81 |
$921 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,236.83 |
$13,503 |
5.7× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,111.82 |
$3,462 |
1.6× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$407.48 |
$668 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$603.90 |
$990 |
2.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$395.28 |
$648 |
3.6× |
| Osseous survey infant (77076) |
$348.31 |
$571 |
3.2× |
| Osseous survey limited (77074) |
$250.10 |
$410 |
2.3× |
| Parathyrd planar w/spect&CT (78072) |
$879.62 |
$1,442 |
1.6× |
| Parathyrd planar w/wo subtrj (78071) |
$1,026.63 |
$1,683 |
2.5× |
| Parathyroid imaging (78070) |
$1,107.15 |
$1,815 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$281.82 |
$462 |
2.6× |
| Peritoneogram rs&i (74190) |
$1,025.41 |
$1,681 |
1.8× |
| PET image w/CT, skull-thigh (78815) |
$5,986.24 |
$9,813.50 |
4.0× |
| PET imaging CT for attenuation limited area (78814) |
$5,183.78 |
$8,498 |
3.5× |
| PET imaging for CT attenuation whole body (78816) |
$5,677.88 |
$9,308 |
3.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,232.60 |
$3,660 |
6.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,673.02 |
$4,382 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,237.69 |
$2,029 |
3.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,461.56 |
$2,396 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,055.30 |
$1,730 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$261.08 |
$428 |
2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$606.95 |
$995 |
5.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$455.67 |
$747 |
4.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$233.63 |
$383 |
2.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,552.56 |
$25,496 |
2.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,456.07 |
$2,387 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$395.89 |
$649 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$279.99 |
$459 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$303.17 |
$497 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$900.36 |
$1,476 |
4.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$654.53 |
$1,073 |
3.6× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$117.12 |
$192 |
0.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$708.21 |
$1,161 |
3.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$649.04 |
$1,064 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$278.16 |
$456 |
3.1× |
| Radiological examination surgical specimen (76098) |
$386.74 |
$634 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,613.45 |
$2,645 |
0.5× |
| Ribs bilateral 3 views (71110) |
$412.97 |
$677 |
3.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,343.22 |
$2,202 |
3.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,316.17 |
$3,797 |
4.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,775.71 |
$2,911 |
3.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$391.92 |
$642.50 |
1.6× |
| Rp Therapy Intravenous Administration (79101) |
$636.23 |
$1,043 |
2.6× |
| Sacroiliac Joints < 3 Views (72200) |
$258.64 |
$424 |
2.4× |
| Scanogram (77073) |
$289.75 |
$475 |
2.7× |
| Scapula complete (73010) |
$353.19 |
$579 |
3.3× |
| Screening digital breast tomosynthesis (77063) |
$53.68 |
$88 |
2.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$744.81 |
$1,221 |
6.9× |
| Sialogram (70390) |
$512.40 |
$840 |
2.1× |
| Simulation intermediate (77285) |
$1,598.81 |
$2,621 |
4.1× |
| Small bowel series (74250) |
$661.85 |
$1,085 |
3.6× |
| Spec medical radj physics consltj (77370) |
$1,331.63 |
$2,183 |
9.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,484.74 |
$2,434 |
3.8× |
| Special treatment procedure (77470) |
$2,627.88 |
$4,308 |
4.6× |
| Spine thoracic 3 views (72072) |
$416.63 |
$683 |
3.8× |
| Stereotactic body radiation delivery (77373) |
$11,095.90 |
$18,190 |
6.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,594.94 |
$4,254 |
6.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,546.35 |
$2,535 |
4.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,294.21 |
$3,761 |
5.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,297.47 |
$2,127 |
9.3× |
| Thoracolumbar 2 views (72080) |
$265.96 |
$436 |
2.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,597.59 |
$2,619 |
2.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$585.60 |
$960 |
1.4× |
| Thyroid uptake measurement (78012) |
$331.84 |
$544 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,007.11 |
$1,651 |
2.4× |
| Treatment device intermediate (77333) |
$644.16 |
$1,056 |
4.6× |
| Treatment devices simple (77332) |
$563.64 |
$924 |
4.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,748.05 |
$4,505 |
4.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,312.11 |
$2,151 |
3.2× |
| Tx devices design & construction complex (77334) |
$1,329.19 |
$2,179 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$516.06 |
$846 |
4.8× |
| Umbilical-artery Doppler (OB) (76820) |
$265.35 |
$435 |
2.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$32.94 |
$54 |
0.4× |
| Unlisted fluoroscopic procedure (76496) |
$958.92 |
$1,572 |
10.6× |
| Unlisted magnetic resonance procedure (76498) |
$655.75 |
$1,075 |
7.3× |
| Unlisted Ultrasound Procedure (76999) |
$387.35 |
$635 |
4.3× |
| Upper Extremity Infant (73092) |
$203.74 |
$334 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$739.32 |
$1,212 |
3.0× |
| Urethrocystography voiding (74455) |
$755.79 |
$1,239 |
3.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$811.91 |
$1,331 |
4.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$940.62 |
$1,542 |
5.2× |
| Us abdl aorta screen aaa (76706) |
$187.88 |
$308 |
1.7× |
| Us breast unilateral complete (76641) |
$491.66 |
$806 |
4.5× |
| Us breast unilateral limited (76642) |
$491.66 |
$806 |
5.4× |
| Us chest (76604) |
$406.26 |
$666 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$691.74 |
$1,134 |
6.4× |
| Us infant hips dynamic (76885) |
$421.51 |
$691 |
4.7× |
| Us infant hips limited static (76886) |
$395.89 |
$649 |
4.4× |
| Us kidney transplant (76776) |
$709.43 |
$1,163 |
6.5× |
| Us ob transvaginal (76817) |
$645.38 |
$1,058 |
5.9× |
| Us pelvic non ob complete (76856) |
$797.27 |
$1,307 |
7.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$414.80 |
$680 |
3.8× |
| Us pregnancy ltd (76815) |
$421.51 |
$691 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$688.69 |
$1,129 |
6.3× |
| Us retroperitoneal complete (76770) |
$804.59 |
$1,319 |
7.4× |
| Us retroperitoneal limited (76775) |
$522.77 |
$857 |
4.8× |
| Us scrotum and contents (76870) |
$719.19 |
$1,179 |
6.6× |
| Us soft tissue head/neck (76536) |
$612.44 |
$1,004 |
5.6× |
| Us spinal canal and contents (76800) |
$511.18 |
$838 |
4.7× |
| Us xtr non-vasc lmtd (76882) |
$571.57 |
$937 |
5.3× |
| Venogram extremity bilateral (75822) |
$1,561.60 |
$2,560 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$2,425.97 |
$3,977 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,504.26 |
$2,466 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,259.04 |
$2,064 |
0.8× |
| Venography Renal Bilateral (75833) |
$2,305.80 |
$3,780 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,613.45 |
$2,645 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$499.59 |
$819 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,883.07 |
$3,087 |
0.3× |
| Wrist 2 views (73100) |
$216.55 |
$355 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$506.30 |
$830 |
4.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$308.05 |
$505 |
3.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$330.01 |
$541 |
3.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,154.73 |
$1,893 |
6.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$276.94 |
$454 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$352.58 |
$578 |
3.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$230.58 |
$378 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$132.37 |
$217 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$154.33 |
$253 |
1.7× |
| X-ray exam hip uni 4/> views (73503) |
$197.64 |
$324 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$459.94 |
$754 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$399.55 |
$655 |
3.7× |
| X-ray exam of femur 1 (73551) |
$133.59 |
$219 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$410.53 |
$673 |
3.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$113.46 |
$186 |
1.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$336.72 |
$552 |
3.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,399.95 |
$2,295 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$174.46 |
$286 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$190.32 |
$312 |
2.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$395.28 |
$648 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$195.81 |
$321 |
2.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$142.74 |
$234 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$428.83 |
$703 |
4.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$573.40 |
$940 |
5.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$527.04 |
$864 |
4.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$292.80 |
$480 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$235.46 |
$386 |
2.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$418.46 |
$686 |
3.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$315.37 |
$517 |
2.9× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$883.89 |
$1,449 |
1.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$762.50 |
$1,250 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$267.18 |
$438 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$366 |
$600 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$480.07 |
$787 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$435.54 |
$714 |
4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$261.08 |
$428 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$330.01 |
$541 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$358.07 |
$587 |
4.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$264.74 |
$434 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$442.25 |
$725 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$311.71 |
$511 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$283.04 |
$464 |
3.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$220.21 |
$361 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$121.39 |
$199 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$277.55 |
$455 |
2.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$331.84 |
$544 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$247.05 |
$405 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$311.10 |
$510 |
3.4× |
| Xr c-spine 6 or more views (72052) |
$665.51 |
$1,091 |
6.1× |
| Xr chest 4+ views (71048) |
$469.09 |
$769 |
4.3× |
| Xr finger(s) 2+ views (73140) |
$222.04 |
$364 |
2.5× |
| Xr shoulder 1 view (73020) |
$218.38 |
$358 |
2.4× |
| Xr spine cervical 4 or 5 views (72050) |
$485.56 |
$796 |
4.5× |
| Xr tibia/fibula 2 views (73590) |
$301.95 |
$495 |
3.3× |
| Xr tmj bilateral (70330) |
$217.77 |
$357 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$364.17 |
$597 |
4.0× |