| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,140.60 |
$12,232 |
1.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$476.18 |
$2,721 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,525.43 |
$14,431 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$1,625.23 |
$9,287 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,491.18 |
$8,521 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$580.65 |
$3,318 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,531.90 |
$14,468 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$917.53 |
$5,243 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$668.15 |
$3,818 |
0.2× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,087.10 |
$6,212 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,694.88 |
$9,685 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$493.85 |
$2,822 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$515.73 |
$2,947 |
0.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$383.95 |
$2,194 |
1.1× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$851.20 |
$4,864 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,913.63 |
$10,935 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,543.15 |
$8,818 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$591.68 |
$3,381 |
0.2× |
| Basic radiation dosimetry calculation (77300) |
$621.78 |
$3,553 |
4.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$657.13 |
$3,755 |
1.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$793.63 |
$4,535 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$853.48 |
$4,877 |
2.1× |
| Bone age studies (77072) |
$144.38 |
$825 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,006.95 |
$5,754 |
2.5× |
| Bone survey complete (77075) |
$291.90 |
$1,668 |
2.8× |
| Brachytx isodose complex (77318) |
$812 |
$4,640 |
2.2× |
| Brachytx isodose intermed (77317) |
$677.43 |
$3,871 |
1.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$634.03 |
$3,623 |
1.7× |
| Brain image w/flow 4 + views (78606) |
$906.68 |
$5,181 |
1.7× |
| Brain imaging < 4 static views w vascular flow (78601) |
$341.08 |
$1,949 |
0.8× |
| Brain Imaging Vascular Flow Only (78610) |
$180.08 |
$1,029 |
0.3× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$25.38 |
$145 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$178.33 |
$1,019 |
1.0× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$15,441.30 |
$88,236 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$84.70 |
$484 |
0.8× |
| Continuing medical physics consltj pr wk (77336) |
$233.63 |
$1,335 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,489.25 |
$8,510 |
4.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,400.70 |
$8,004 |
5.8× |
| CT abdomen w contrast (74160) |
$746.20 |
$4,264 |
4.2× |
| CT abdomen w wo contrast (74170) |
$793.80 |
$4,536 |
4.5× |
| CT abdomen w/o contrast (74150) |
$666.93 |
$3,811 |
6.4× |
| CT angio hrt w/3d image (75574) |
$711.03 |
$4,063 |
2.0× |
| CT c-spine w/o contrast (72125) |
$568.58 |
$3,249 |
5.4× |
| CT cervical spine w&w/o contrast (72127) |
$693.53 |
$3,963 |
3.9× |
| CT cervical spine with contrast (72126) |
$625.45 |
$3,574 |
1.8× |
| CT chest w/wo contrast (71270) |
$761.78 |
$4,353 |
4.3× |
| CT chest with contrast (71260) |
$645.58 |
$3,689 |
3.7× |
| CT head/brain with contrast (70460) |
$745.33 |
$4,259 |
4.2× |
| CT head/brain without and with contrast (70470) |
$837.38 |
$4,785 |
4.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$147.70 |
$844 |
0.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$76.13 |
$435 |
0.9× |
| CT hrt w/3d image congen (75573) |
$147.70 |
$844 |
0.4× |
| CT iac w contrast (70481) |
$518 |
$2,960 |
2.9× |
| CT limited/localized follow up study (76380) |
$294.53 |
$1,683 |
3.4× |
| CT lumbar spine w & w/o contrast (72133) |
$813.23 |
$4,647 |
4.6× |
| CT lumbar spine w/o contrast (72131) |
$527.98 |
$3,017 |
5.0× |
| CT lumbar spine with contrast (72132) |
$691.78 |
$3,953 |
2.0× |
| CT maxillofacial w contrast (70487) |
$734.48 |
$4,197 |
4.2× |
| CT maxillofacial w/o contrast (70486) |
$550.73 |
$3,147 |
5.2× |
| CT maxillofacial w/wo contrast (70488) |
$793.10 |
$4,532 |
4.5× |
| CT neck soft tissue w contrast (70491) |
$611.28 |
$3,493 |
3.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$604.63 |
$3,455 |
3.4× |
| CT orbits w/o contrast (70480) |
$454.48 |
$2,597 |
4.3× |
| CT pelvis w & w/o contrast (72194) |
$692.30 |
$3,956 |
3.9× |
| CT pelvis w/o contrast (72192) |
$484.23 |
$2,767 |
4.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$745.85 |
$4,262 |
4.2× |
| CT soft tissue neck w/o contrast (70490) |
$85.75 |
$490 |
0.8× |
| CT thoracic spine w/contrast (72129) |
$524.30 |
$2,996 |
3.0× |
| CT thoracic spine w/o contrast (72128) |
$468.13 |
$2,675 |
4.5× |
| CT thoracic spine w/wo contrast (72130) |
$613.38 |
$3,505 |
3.5× |
| CT thorax w/o contrast (71250) |
$565.43 |
$3,231 |
5.4× |
| CT unlisted procedure (76497) |
$39.03 |
$223 |
0.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$657.65 |
$3,758 |
3.7× |
| Cta Abdomen (74175) |
$766.85 |
$4,382 |
4.4× |
| CTA abdomen pelvis (74174) |
$1,050.35 |
$6,002 |
3.0× |
| CTA chest (71275) |
$670.60 |
$3,832 |
3.8× |
| Cta Head (70496) |
$587.83 |
$3,359 |
3.3× |
| Cta Neck (70498) |
$617.75 |
$3,530 |
3.5× |
| Cta Pelvis (72191) |
$499.28 |
$2,853 |
2.8× |
| Cystography minimum 3 views rs&i (74430) |
$199.50 |
$1,140 |
0.6× |
| Diskography lumbar (72295) |
$525.88 |
$3,005 |
0.3× |
| Echoencephalography real time imaging (76506) |
$177.28 |
$1,013 |
1.7× |
| Esophagus (74220) |
$191.80 |
$1,096 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$301.53 |
$1,723 |
2.9× |
| Fluoroscopy up to 1 hr (76000) |
$237.48 |
$1,357 |
1.0× |
| Gated Heart Planar Single (78472) |
$591.33 |
$3,379 |
1.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,233.75 |
$7,050 |
1.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,432.90 |
$8,188 |
2.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,491.18 |
$8,521 |
2.1× |
| Heart Infarct Image (78466) |
$573.65 |
$3,278 |
1.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$575.23 |
$3,287 |
0.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$621.95 |
$3,554 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$584.68 |
$3,341 |
1.5× |
| Ht muscle image spect sing (78451) |
$1,351.88 |
$7,725 |
1.0× |
| Hysterosalpingogram (74740) |
$310.10 |
$1,772 |
1.3× |
| Interstitial radiation source applic complex (77778) |
$1,121.93 |
$6,411 |
1.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$892.15 |
$5,098 |
1.3× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$686.62 |
$3,923.50 |
1.2× |
| Intracavitary radiation source applic simple (77761) |
$468.65 |
$2,678 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$763 |
$4,360 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$620.20 |
$3,544 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,203.30 |
$6,876 |
2.2× |
| Liver & spleen imaging static only (78215) |
$404.60 |
$2,312 |
1.0× |
| Lung perf&ventilat diferentl (78598) |
$338.80 |
$1,936 |
0.6× |
| Lung perfusion differential (78597) |
$258.65 |
$1,478 |
0.6× |
| Lung Ventilation Imaging (78579) |
$248.15 |
$1,418 |
0.6× |
| Lymphoscintigraphy (78195) |
$606.73 |
$3,467 |
1.1× |
| Meckels Diverticulum (78290) |
$467.08 |
$2,669 |
1.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,325.93 |
$13,291 |
6.2× |
| Mr safety determination physician/other qhp (76016) |
$39.03 |
$223 |
0.4× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$26.25 |
$150 |
0.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$11.03 |
$63 |
0.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$40.78 |
$233 |
0.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$106.93 |
$611 |
0.4× |
| MRA head w & w/o contrast (70546) |
$931.53 |
$5,323 |
2.7× |
| MRA head w/o contrast (70544) |
$608.83 |
$3,479 |
2.5× |
| MRA head with contrast (70545) |
$639.28 |
$3,653 |
1.8× |
| MRA neck w contrast (70548) |
$1,017.63 |
$5,815 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,433.25 |
$8,190 |
4.1× |
| MRA neck w/o contrast (70547) |
$888.65 |
$5,078 |
3.7× |
| MRI abdomen w contrast (74182) |
$1,160.43 |
$6,631 |
3.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$718.46 |
$4,105.50 |
2.1× |
| MRI abdomen w/o contrast (74181) |
$426.83 |
$2,439 |
1.8× |
| MRI breast w/o contrast bilateral (77047) |
$226.80 |
$1,296 |
0.9× |
| MRI breast w/o contrast unilat (77046) |
$226.80 |
$1,296 |
0.9× |
| MRI c-spine with contrast (72142) |
$1,260.18 |
$7,201 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$869.05 |
$4,966 |
3.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,137.50 |
$6,500 |
3.2× |
| MRI chest w/o contrast (71550) |
$787.50 |
$4,500 |
3.3× |
| MRI chest with contrast (71551) |
$962.50 |
$5,500 |
1.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$674.63 |
$3,855 |
2.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,006.78 |
$5,753 |
2.9× |
| MRI orbit/face/neck w/contrast (70542) |
$795.38 |
$4,545 |
2.3× |
| MRI pelvis w contrast (72196) |
$880.78 |
$5,033 |
2.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,100.93 |
$6,291 |
3.1× |
| MRI pelvis w/o contrast (72195) |
$649.60 |
$3,712 |
2.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,460.03 |
$8,343 |
4.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,051.40 |
$6,008 |
3.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,250.03 |
$7,143 |
3.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$910.53 |
$5,203 |
2.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,250.03 |
$7,143 |
3.6× |
| MRI thoracic spine w/o contrast (72146) |
$827.75 |
$4,730 |
3.5× |
| MRI tmj (70336) |
$485.45 |
$2,774 |
2.0× |
| Myelogram Cervical (72240) |
$492.98 |
$2,817 |
0.6× |
| Myelogram Lumbar (72265) |
$518.70 |
$2,964 |
0.7× |
| Myelogram thoracic (72255) |
$280 |
$1,600 |
0.4× |
| Myelography 2 or more regions (72270) |
$303.98 |
$1,737 |
0.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,875.48 |
$10,717 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,755.78 |
$10,033 |
1.4× |
| Neck soft tissue (70360) |
$126.88 |
$725 |
1.5× |
| Nm adrenal scan (78075) |
$282.98 |
$1,617 |
0.2× |
| Nm cisternogram (78630) |
$510.83 |
$2,919 |
0.9× |
| Nm gastric emptying study (78264) |
$786.80 |
$4,496 |
2.0× |
| Nm gastroesophageal reflux study (78262) |
$509.60 |
$2,912 |
1.3× |
| Nm red cell sequestration (78140) |
$512.58 |
$2,929 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,802.28 |
$16,013 |
2.0× |
| Nuclear medicine of heart pumping function (78473) |
$614.60 |
$3,512 |
1.5× |
| Nuclear medicine study of kidney and blood flow (78701) |
$738.15 |
$4,218 |
1.8× |
| Nuclear Rx Oral Admin (79005) |
$590.63 |
$3,375 |
2.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$339.68 |
$1,941 |
3.2× |
| Osseous survey infant (77076) |
$315.35 |
$1,802 |
3.0× |
| Osseous survey limited (77074) |
$192.68 |
$1,101 |
1.8× |
| Parathyrd planar w/spect&CT (78072) |
$587.65 |
$3,358 |
1.1× |
| Parathyroid imaging (78070) |
$380.45 |
$2,174 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$2,270.10 |
$12,972 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$2,315.60 |
$13,232 |
1.6× |
| PET imaging limited area chest head/neck (78811) |
$1,327.55 |
$7,586 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$970.73 |
$5,547 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$515.73 |
$2,947 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$312.73 |
$1,787 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$421.40 |
$2,408 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$219.80 |
$1,256 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$341.25 |
$1,950 |
3.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$597.28 |
$3,413 |
5.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$34.13 |
$195 |
0.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,794.80 |
$10,256 |
17.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,263.90 |
$41,508 |
1.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$507.50 |
$2,900 |
0.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$91.62 |
$523.50 |
0.9× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$104.13 |
$595 |
0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$148.05 |
$846 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$343.53 |
$1,963 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$492.10 |
$2,812 |
2.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$287.53 |
$1,643 |
1.6× |
| Radiological examination surgical specimen (76098) |
$287.88 |
$1,645 |
0.5× |
| Review by radiologist of adrenal gland vein image (75840) |
$493.85 |
$2,822 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$575.23 |
$3,287 |
0.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$807.10 |
$4,612 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,873.12 |
$10,703.50 |
3.4× |
| Rp Therapy Intravenous Administration (79101) |
$354.20 |
$2,024 |
1.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$331.10 |
$1,892 |
1.4× |
| Scanogram (77073) |
$61.95 |
$354 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$34.83 |
$199 |
1.5× |
| Sella turcica (70240) |
$35.88 |
$205 |
0.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$110.95 |
$634 |
1.1× |
| Sialogram (70390) |
$198.28 |
$1,133 |
0.8× |
| Simulation intermediate (77285) |
$1,137.50 |
$6,500 |
3.0× |
| Small bowel series (74250) |
$249.55 |
$1,426 |
1.4× |
| Spec medical radj physics consltj (77370) |
$394.98 |
$2,257 |
2.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$588.35 |
$3,362 |
1.6× |
| Special dosimetry (77331) |
$153.30 |
$876 |
1.1× |
| Special treatment procedure (77470) |
$690.38 |
$3,945 |
1.2× |
| Speech evaluation complex (70371) |
$99.58 |
$569 |
0.4× |
| Stereotactic body radiation delivery (77373) |
$4,166.75 |
$23,810 |
2.3× |
| Superior sagittal sinus venogram (75870) |
$493.85 |
$2,822 |
0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$305.90 |
$1,748 |
0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$247.80 |
$1,416 |
0.7× |
| Testicular Imaging With Vascular Flow (78761) |
$500.15 |
$2,858 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,798.13 |
$10,275 |
4.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$787.50 |
$4,500 |
5.8× |
| Therapeutic Enema (74283) |
$1,409.28 |
$8,053 |
8.0× |
| Thoracolumbar 2 views (72080) |
$104.65 |
$598 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$809.03 |
$4,623 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$216.48 |
$1,237 |
0.5× |
| Thyroid uptake measurement (78012) |
$145.78 |
$833 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$415.98 |
$2,377 |
1.0× |
| Tomogram (76100) |
$54.08 |
$309 |
0.5× |
| Treatment device intermediate (77333) |
$665 |
$3,800 |
4.9× |
| Treatment devices simple (77332) |
$371 |
$2,120 |
2.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$405.74 |
$2,318.50 |
1.0× |
| Tx devices design & construction complex (77334) |
$773.33 |
$4,419 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$231.70 |
$1,324 |
2.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$35 |
$200 |
0.4× |
| Unlisted magnetic resonance procedure (76498) |
$35.18 |
$201 |
0.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$564.90 |
$3,228 |
5.5× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$389.03 |
$2,223 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$164.68 |
$941 |
1.9× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$57.40 |
$328 |
0.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$351.05 |
$2,006 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$364.88 |
$2,085 |
1.5× |
| Urethrocystography voiding (74455) |
$364.88 |
$2,085 |
1.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$191.98 |
$1,097 |
1.1× |
| Us abdl aorta screen aaa (76706) |
$176.58 |
$1,009 |
1.7× |
| Us breast unilateral limited (76642) |
$221.20 |
$1,264 |
2.5× |
| Us chest (76604) |
$180.08 |
$1,029 |
1.7× |
| Us compl joint r-t w/image documentation (76881) |
$203.53 |
$1,163 |
1.9× |
| Us guided compression repair (76936) |
$360.68 |
$2,061 |
1.7× |
| Us infant hips dynamic (76885) |
$183.93 |
$1,051 |
2.1× |
| Us ob transvaginal (76817) |
$284.73 |
$1,627 |
2.7× |
| Us pelvic non ob complete (76856) |
$295.40 |
$1,688 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$138.95 |
$794 |
1.3× |
| Us pregnancy ltd (76815) |
$249.73 |
$1,427 |
2.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$282.98 |
$1,617 |
2.7× |
| Us retroperitoneal complete (76770) |
$274.58 |
$1,569 |
2.6× |
| Us retroperitoneal limited (76775) |
$266.35 |
$1,522 |
2.5× |
| Us spinal canal and contents (76800) |
$103.25 |
$590 |
1.0× |
| Us transrectal prostate volume (76873) |
$85.58 |
$489 |
0.8× |
| Vascular flow imaging (78445) |
$315.35 |
$1,802 |
0.8× |
| Venogram extremity bilateral (75822) |
$356.65 |
$2,038 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$945.53 |
$5,403 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$536.90 |
$3,068 |
0.3× |
| Venography epidural rs&i (75872) |
$258.13 |
$1,475 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$639.45 |
$3,654 |
0.4× |
| Venography Renal Bilateral (75833) |
$899.68 |
$5,141 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$1,052.28 |
$6,013 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$580.65 |
$3,318 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$851.20 |
$4,864 |
0.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$156.28 |
$893 |
1.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$404.25 |
$2,310 |
2.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,194.38 |
$6,825 |
11.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$166.25 |
$950 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$124.95 |
$714 |
1.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$889.70 |
$5,084 |
0.4× |
| X-ray IV pyelogram+drip infusn (74410) |
$191.98 |
$1,097 |
1.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$176.93 |
$1,011 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$124.43 |
$711 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$160.65 |
$918 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$102.73 |
$587 |
1.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$166.25 |
$950 |
0.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$383.95 |
$2,194 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$188.30 |
$1,076 |
1.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$148.05 |
$846 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$164.50 |
$940 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$133.70 |
$764 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$236.95 |
$1,354 |
2.3× |
| Xr chest 4+ views (71048) |
$169.23 |
$967 |
1.6× |
| Xr Cholecystography Oral Contrast (74290) |
$178.85 |
$1,022 |
1.0× |
| Xr optic foramina (70190) |
$123.90 |
$708 |
1.4× |
| Xr tmj bilateral (70330) |
$72.80 |
$416 |
0.8× |