| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,729.75 |
$22,085 |
5.6× |
| Abdomen 2 views (74019) |
$600.48 |
$1,715.64 |
5.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$626.12 |
$1,788.89 |
1.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,037.93 |
$2,965.50 |
0.3× |
| Angiography extremity bilateral rs&i (75716) |
$2,727.20 |
$7,792 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$1,254.40 |
$3,584 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$739.62 |
$2,113.20 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,037.93 |
$2,965.50 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,007.37 |
$2,878.20 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,037.93 |
$2,965.50 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,037.93 |
$2,965.50 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$717.89 |
$2,051.10 |
0.2× |
| Ankle 2 views (73600) |
$431.72 |
$1,233.50 |
4.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$415.80 |
$1,188 |
1.2× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,037.93 |
$2,965.50 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,305.05 |
$9,443 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$1,190 |
$3,400 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$991.31 |
$2,832.30 |
0.3× |
| Artery X-Rays Adrenal Gland (75731) |
$1,037.93 |
$2,965.50 |
0.3× |
| Arthrogram elbow (73085) |
$575.82 |
$1,645.20 |
1.6× |
| Arthrogram hip (73525) |
$525.11 |
$1,500.30 |
1.5× |
| Arthrogram shoulder (73040) |
$683.20 |
$1,952 |
1.9× |
| Arthrogram wrist (73115) |
$475.65 |
$1,359 |
1.4× |
| Arthrography knee lt (73580) |
$613.31 |
$1,752.30 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$584.77 |
$1,670.76 |
4.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,063.65 |
$3,039 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,381.10 |
$3,946 |
3.4× |
| Bone age studies (77072) |
$206.35 |
$589.56 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,629.60 |
$4,656 |
4.1× |
| Bone survey complete (77075) |
$1,177.93 |
$3,365.50 |
11.2× |
| Brain image w/flow 4 + views (78606) |
$572.67 |
$1,636.20 |
1.0× |
| Brain imaging < 4 static views (78600) |
$438.80 |
$1,253.70 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$488.88 |
$1,396.80 |
1.2× |
| Brain Imaging Minimum 4 Static Views (78605) |
$469.98 |
$1,342.80 |
0.9× |
| Brain Imaging Vascular Flow Only (78610) |
$381.78 |
$1,090.80 |
0.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$674.73 |
$1,927.80 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$576.10 |
$1,646 |
6.6× |
| Chest 1 view (71045) |
$484.40 |
$1,384 |
5.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$956.74 |
$2,733.54 |
5.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,185.03 |
$3,385.80 |
1.5× |
| Clavicle complete (73000) |
$417.55 |
$1,193 |
4.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$112.14 |
$320.38 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$706.15 |
$2,017.56 |
5.2× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$226.80 |
$648 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,633.85 |
$21,811 |
21.8× |
| CT abdomen and pelvis without contrast (74176) |
$5,937.40 |
$16,964 |
24.8× |
| CT abdomen w contrast (74160) |
$4,113.09 |
$11,751.66 |
23.3× |
| CT abdomen w wo contrast (74170) |
$4,648 |
$13,280 |
26.4× |
| CT abdomen w/o contrast (74150) |
$2,385.60 |
$6,816 |
22.7× |
| CT angiography upper extremity lt (73206) |
$3,546.82 |
$10,133.75 |
20.1× |
| CT c-spine w/o contrast (72125) |
$3,108 |
$8,880 |
29.6× |
| CT cervical spine w&w/o contrast (72127) |
$4,723.95 |
$13,497 |
26.8× |
| CT cervical spine with contrast (72126) |
$4,040.40 |
$11,544 |
11.5× |
| CT chest w/wo contrast (71270) |
$4,193 |
$11,980 |
23.8× |
| CT chest with contrast (71260) |
$3,569.65 |
$10,199 |
20.3× |
| CT head/brain with contrast (70460) |
$3,529.05 |
$10,083 |
20.0× |
| CT head/brain without and with contrast (70470) |
$4,134.20 |
$11,812 |
23.5× |
| CT iac w contrast (70481) |
$1,720.60 |
$4,916 |
9.8× |
| CT limited/localized follow up study (76380) |
$291.69 |
$833.40 |
3.3× |
| CT lower ext w/o (73700) |
$1,802.85 |
$5,151 |
17.2× |
| CT lower extremity w wo contrast (73702) |
$2,722.65 |
$7,779 |
15.5× |
| CT lower extremity with contrast (73701) |
$2,325.75 |
$6,645 |
13.2× |
| CT lumbar spine w & w/o contrast (72133) |
$5,453.35 |
$15,581 |
30.9× |
| CT lumbar spine w/o contrast (72131) |
$3,541.09 |
$10,117.38 |
33.7× |
| CT lumbar spine with contrast (72132) |
$4,638.90 |
$13,254 |
13.2× |
| CT maxillofacial w contrast (70487) |
$2,936.15 |
$8,389 |
16.7× |
| CT maxillofacial w/o contrast (70486) |
$2,467.15 |
$7,049 |
23.5× |
| CT maxillofacial w/wo contrast (70488) |
$3,552.85 |
$10,151 |
20.2× |
| CT neck soft tissue w contrast (70491) |
$2,744.70 |
$7,842 |
15.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,007.25 |
$5,735 |
11.4× |
| CT orbits w/o contrast (70480) |
$1,509.20 |
$4,312 |
14.4× |
| CT pelvis w & w/o contrast (72194) |
$4,617.55 |
$13,193 |
26.2× |
| CT pelvis w/o contrast (72192) |
$2,758.35 |
$7,881 |
26.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,293.85 |
$9,411 |
18.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,223.20 |
$6,352 |
21.2× |
| CT thoracic spine w/contrast (72129) |
$4,420.85 |
$12,631 |
25.1× |
| CT thoracic spine w/o contrast (72128) |
$3,374.46 |
$9,641.30 |
32.1× |
| CT thoracic spine w/wo contrast (72130) |
$5,196.80 |
$14,848 |
29.5× |
| CT thorax w/o contrast (71250) |
$2,832.90 |
$8,093.98 |
27.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,073.05 |
$5,923 |
11.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,337.42 |
$3,821.20 |
12.7× |
| CT upper extremity with contrast (73201) |
$1,671.95 |
$4,777 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,274.66 |
$12,213.30 |
24.3× |
| Cta Abdomen (74175) |
$3,254.30 |
$9,298 |
18.5× |
| CTA abdomen pelvis (74174) |
$4,230.80 |
$12,088 |
12.1× |
| CTA chest (71275) |
$3,489.68 |
$9,970.50 |
19.8× |
| Cta Head (70496) |
$3,920 |
$11,200 |
22.2× |
| CTA lwr ext w&w/o contrast (73706) |
$3,450.47 |
$9,858.47 |
19.6× |
| Cta Neck (70498) |
$3,920 |
$11,200 |
22.2× |
| Cta Pelvis (72191) |
$1,865.33 |
$5,329.50 |
10.6× |
| Cystography minimum 3 views rs&i (74430) |
$477.40 |
$1,364 |
1.4× |
| Dacryocystography (70170) |
$849.24 |
$2,426.40 |
3.5× |
| Diskogram cervical (72285) |
$936.81 |
$2,676.60 |
0.5× |
| Diskography lumbar (72295) |
$865.62 |
$2,473.20 |
0.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$399.70 |
$1,142 |
3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$36.05 |
$103 |
0.4× |
| Echoencephalography real time imaging (76506) |
$461.79 |
$1,319.40 |
4.4× |
| Esophagus (74220) |
$905.71 |
$2,587.74 |
5.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$189.93 |
$542.64 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$605.84 |
$1,730.95 |
2.5× |
| Foot 2 views (73620) |
$428.05 |
$1,223 |
4.9× |
| Forearm 2 views (73090) |
$482.97 |
$1,379.91 |
5.5× |
| Functional MRI brain by tech (70554) |
$1,207.40 |
$3,449.70 |
5.0× |
| Gated Heart Planar Single (78472) |
$276.57 |
$790.20 |
0.7× |
| Hand 2 views (73120) |
$369.25 |
$1,055 |
3.5× |
| Hand 3 views (73130) |
$559.30 |
$1,598 |
6.4× |
| Heart Infarct Image (78466) |
$449.82 |
$1,285.20 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$895.60 |
$2,558.85 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$797.30 |
$2,278 |
2.0× |
| Ht muscle image spect sing (78451) |
$3,809.05 |
$10,883 |
2.9× |
| Humerus Min 2 Views Left (73060) |
$468.30 |
$1,338 |
5.4× |
| Hysterosalpingogram (74740) |
$312.90 |
$894 |
1.3× |
| Image fusion (77399) |
$1,032.50 |
$2,950 |
7.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$121.28 |
$346.50 |
1.2× |
| Kidney imaging morphology (78700) |
$491.09 |
$1,403.10 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$869.09 |
$2,483.10 |
1.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,614.20 |
$4,612 |
3.0× |
| Knee 3 views (73562) |
$583.23 |
$1,666.36 |
6.7× |
| Liver & spleen imaging static only (78215) |
$466.83 |
$1,333.80 |
1.2× |
| Liver imaging static only (78201) |
$459.59 |
$1,313.10 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$703.71 |
$2,010.60 |
1.3× |
| Lung perfusion differential (78597) |
$490.77 |
$1,402.20 |
1.2× |
| Lung Ventilation Imaging (78579) |
$596.05 |
$1,703 |
1.5× |
| Lymphoscintigraphy (78195) |
$888.99 |
$2,539.95 |
1.6× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$114.35 |
$326.70 |
1.3× |
| Meckels Diverticulum (78290) |
$807.98 |
$2,308.50 |
2.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,198.79 |
$6,282.25 |
5.8× |
| MRA head w & w/o contrast (70546) |
$922.04 |
$2,634.39 |
2.6× |
| MRA head w/o contrast (70544) |
$1,902.78 |
$5,436.51 |
7.9× |
| MRA head with contrast (70545) |
$1,102.82 |
$3,150.90 |
3.1× |
| MRA neck w contrast (70548) |
$1,599.15 |
$4,569 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,252.27 |
$6,435.05 |
6.4× |
| MRA neck w/o contrast (70547) |
$1,396.50 |
$3,990 |
5.8× |
| MRI abdomen w contrast (74182) |
$4,531.45 |
$12,947 |
12.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,034.60 |
$14,384.55 |
14.4× |
| MRI abdomen w/o contrast (74181) |
$2,920.40 |
$8,344 |
12.2× |
| MRI any jnt lwr ext with con lt (73722) |
$4,036.90 |
$11,534 |
5.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,442.55 |
$12,693 |
5.6× |
| MRI bone marrow blood supply (77084) |
$1,858.19 |
$5,309.10 |
7.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,304.10 |
$3,726 |
5.4× |
| MRI breast w/o contrast unilat (77046) |
$866.64 |
$2,476.10 |
3.6× |
| MRI c-spine with contrast (72142) |
$4,277.70 |
$12,222 |
12.2× |
| MRI cervical spine w/o contrast (72141) |
$3,453.45 |
$9,867 |
14.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,772.51 |
$5,064.30 |
5.1× |
| MRI chest w/o contrast (71550) |
$1,486.51 |
$4,247.17 |
6.2× |
| MRI chest with contrast (71551) |
$1,421.28 |
$4,060.80 |
1.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,100.70 |
$6,002 |
6.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,025.05 |
$8,643 |
8.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,217.22 |
$9,192.07 |
13.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,778.35 |
$5,081 |
7.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,654.05 |
$7,583 |
7.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,096.50 |
$5,990 |
6.0× |
| MRI pelvis w contrast (72196) |
$3,423.70 |
$9,782 |
9.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,034.60 |
$14,384.55 |
14.4× |
| MRI pelvis w/o contrast (72195) |
$3,423.70 |
$9,782 |
14.3× |
| MRI scan of arm joint before and after contrast (73223) |
$6,097.70 |
$17,422 |
17.4× |
| MRI scan of leg joint before and after contrast (73723) |
$4,974.55 |
$14,213 |
14.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,102.30 |
$14,578 |
14.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,840.10 |
$16,686 |
16.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,868.40 |
$19,624 |
19.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,785.20 |
$13,672 |
13.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,615.75 |
$16,045 |
16.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,322.90 |
$9,494 |
13.9× |
| MRI tmj (70336) |
$1,185.03 |
$3,385.80 |
4.9× |
| MRI upper ext joint w/o contrast (73221) |
$4,316.85 |
$12,333.84 |
18.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,601.90 |
$7,434 |
7.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,264.50 |
$6,470 |
9.4× |
| Myocardial infarct spect (78469) |
$725.13 |
$2,071.80 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$4,588.98 |
$13,111.35 |
3.5× |
| Neck soft tissue (70360) |
$179.60 |
$513.14 |
2.1× |
| Nm bone marrow wb (78104) |
$1,011.78 |
$2,890.80 |
2.5× |
| Nm gastric emptying study (78264) |
$860.65 |
$2,459 |
2.1× |
| Nm peritoneal-venous shunt patency (78291) |
$474.39 |
$1,355.40 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,681.53 |
$24,804.36 |
6.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$725.13 |
$2,071.80 |
1.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$520.70 |
$1,487.70 |
1.3× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$425.57 |
$1,215.90 |
0.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$456.75 |
$1,305 |
4.3× |
| Orthopantogram (70355) |
$187.74 |
$536.40 |
2.1× |
| Osseous survey infant (77076) |
$121.28 |
$346.50 |
1.2× |
| Parathyroid imaging (78070) |
$869.05 |
$2,483 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$466.61 |
$1,333.16 |
4.4× |
| Peritoneogram rs&i (74190) |
$600.08 |
$1,714.50 |
1.1× |
| PET image w/CT, skull-thigh (78815) |
$4,298.35 |
$12,281 |
3.0× |
| PET imaging CT for attenuation limited area (78814) |
$3,868.55 |
$11,053 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$4,384.45 |
$12,527 |
3.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,871 |
$11,060 |
11.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$419.65 |
$1,199 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,103.61 |
$3,153.15 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$497.24 |
$1,420.66 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$252.35 |
$721 |
2.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$568.05 |
$1,623 |
5.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$205.07 |
$585.90 |
2.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$900.55 |
$2,573 |
8.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$436.10 |
$1,246 |
0.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$120.65 |
$344.70 |
1.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$371.70 |
$1,062 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$166.95 |
$477 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$498.40 |
$1,424 |
5.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$387.45 |
$1,107 |
3.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$584.68 |
$1,670.50 |
6.7× |
| Radiologic exam colon single contrast study (74270) |
$903 |
$2,580 |
5.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$545.74 |
$1,559.25 |
3.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$679.70 |
$1,942 |
3.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$504.35 |
$1,441 |
5.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$164.75 |
$470.70 |
1.9× |
| Radiological examination surgical specimen (76098) |
$497.24 |
$1,420.66 |
0.9× |
| Ribs bilateral 3 views (71110) |
$562.80 |
$1,608 |
5.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$662.76 |
$1,893.60 |
1.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,185.10 |
$3,386 |
2.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,185.10 |
$3,386 |
2.2× |
| Sacroiliac Joints < 3 Views (72200) |
$449.40 |
$1,284 |
4.3× |
| Scanogram (77073) |
$361.29 |
$1,032.24 |
3.4× |
| Scapula complete (73010) |
$406.35 |
$1,161 |
3.9× |
| Screening digital breast tomosynthesis (77063) |
$36.75 |
$105 |
1.6× |
| Sella turcica (70240) |
$132.30 |
$378 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$341.67 |
$976.19 |
3.3× |
| Sialogram (70390) |
$561.96 |
$1,605.60 |
2.3× |
| Simulation intermediate (77285) |
$2,966.25 |
$8,475 |
7.9× |
| Small bowel series (74250) |
$703.50 |
$2,010 |
4.0× |
| Spec medical radj physics consltj (77370) |
$282.80 |
$808 |
2.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$987.57 |
$2,821.61 |
2.6× |
| Special dosimetry (77331) |
$267.75 |
$765 |
2.0× |
| Special treatment procedure (77470) |
$2,992.02 |
$8,548.62 |
5.4× |
| Speech evaluation complex (70371) |
$352.80 |
$1,008 |
1.5× |
| Spine thoracic 3 views (72072) |
$782.95 |
$2,237 |
7.5× |
| Spleen imaging only (78185) |
$513.45 |
$1,467 |
1.3× |
| Stereotactic body radiation delivery (77373) |
$3,238.55 |
$9,253 |
1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$402.57 |
$1,150.20 |
1.1× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$558.50 |
$1,595.70 |
2.3× |
| Testicular Imaging With Vascular Flow (78761) |
$412.34 |
$1,178.10 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,995.95 |
$8,559.84 |
8.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,797.60 |
$5,136 |
13.3× |
| Therapeutic Enema (74283) |
$425.57 |
$1,215.90 |
2.4× |
| Thoracolumbar 2 views (72080) |
$368.79 |
$1,053.66 |
4.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$527.29 |
$1,506.54 |
1.3× |
| Tmj unilateral (70328) |
$164.75 |
$470.70 |
1.9× |
| Tomogram (76100) |
$421.47 |
$1,204.20 |
4.0× |
| Treatment device intermediate (77333) |
$1,858.15 |
$5,309 |
13.8× |
| Treatment devices simple (77332) |
$528.50 |
$1,510 |
3.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,185.10 |
$3,386 |
2.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$427.77 |
$1,222.20 |
1.1× |
| Tx devices design & construction complex (77334) |
$1,704.68 |
$4,870.50 |
4.5× |
| Ultrasound, abdomen limited (76705) |
$923.65 |
$2,639 |
8.8× |
| Unlisted magnetic resonance procedure (76498) |
$2,516.85 |
$7,191 |
28.8× |
| Upper Extremity Infant (73092) |
$145.30 |
$415.14 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$567.88 |
$1,622.50 |
2.4× |
| Urethrocystography voiding (74455) |
$568.05 |
$1,623 |
2.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$382.03 |
$1,091.50 |
2.2× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$526.68 |
$1,504.80 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$716.45 |
$2,047 |
6.8× |
| Us breast unilateral complete (76641) |
$864.50 |
$2,470 |
8.2× |
| Us breast unilateral limited (76642) |
$700.35 |
$2,001 |
8.0× |
| Us chest (76604) |
$530.67 |
$1,516.20 |
5.1× |
| Us compl joint r-t w/image documentation (76881) |
$1,101.10 |
$3,146 |
10.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$295.60 |
$844.56 |
2.8× |
| Us guided compression repair (76936) |
$229.32 |
$655.20 |
1.1× |
| Us infant hips dynamic (76885) |
$460.53 |
$1,315.80 |
5.3× |
| Us infant hips limited static (76886) |
$301.46 |
$861.30 |
3.4× |
| Us ob transvaginal (76817) |
$383.67 |
$1,096.20 |
3.7× |
| Us pelvic non ob complete (76856) |
$1,094.45 |
$3,127 |
10.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$492.45 |
$1,407 |
4.7× |
| Us pregnancy ltd (76815) |
$337.75 |
$965 |
3.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,052.80 |
$3,008 |
10.0× |
| Us retroperitoneal complete (76770) |
$1,243.20 |
$3,552 |
11.8× |
| Us retroperitoneal limited (76775) |
$969.85 |
$2,771 |
9.2× |
| Us scrotum and contents (76870) |
$954.45 |
$2,727 |
9.1× |
| Us soft tissue head/neck (76536) |
$1,078.35 |
$3,081 |
10.3× |
| Us spinal canal and contents (76800) |
$408.70 |
$1,167.70 |
3.9× |
| Us xtr non-vasc lmtd (76882) |
$980 |
$2,800 |
9.3× |
| Vascular flow imaging (78445) |
$513.45 |
$1,467 |
1.3× |
| Venogram extremity bilateral (75822) |
$752.22 |
$2,149.20 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$420.53 |
$1,201.50 |
0.3× |
| Venography Renal Bilateral (75833) |
$2,128.35 |
$6,081 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,364.90 |
$9,614 |
1.1× |
| Wrist 2 views (73100) |
$641.90 |
$1,834 |
7.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$580.30 |
$1,658 |
5.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$146.79 |
$419.40 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$582.45 |
$1,664.13 |
6.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$505.75 |
$1,445 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$364.70 |
$1,042 |
4.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$552.30 |
$1,578 |
6.3× |
| X-ray exam hip uni 1 view (73501) |
$285.95 |
$817 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$571.92 |
$1,634.04 |
6.5× |
| X-ray eye for foreign body (70030) |
$111.20 |
$317.70 |
1.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$504.70 |
$1,442 |
4.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$292.95 |
$837 |
3.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$563.15 |
$1,609 |
6.4× |
| X-ray head for orthodontia (70350) |
$111.51 |
$318.60 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$357.35 |
$1,021 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$395.50 |
$1,130 |
4.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$670.95 |
$1,917 |
6.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$571.90 |
$1,634 |
6.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$140.66 |
$401.88 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$582.05 |
$1,663 |
5.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$890.40 |
$2,544 |
8.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$593.60 |
$1,696 |
5.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$306.95 |
$877 |
3.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$178.42 |
$509.75 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$218.30 |
$623.70 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$466.90 |
$1,334 |
4.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,772.15 |
$5,063.26 |
5.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$566.65 |
$1,619 |
6.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$542.50 |
$1,550 |
5.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$677.95 |
$1,937 |
6.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$528.85 |
$1,511 |
5.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$440.65 |
$1,259 |
5.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$617.40 |
$1,764 |
7.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$798.79 |
$2,282.25 |
9.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$193.41 |
$552.60 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$436.72 |
$1,247.75 |
4.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$428.75 |
$1,225 |
4.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$314.30 |
$898 |
3.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$184.28 |
$526.50 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$336.35 |
$961 |
3.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$439.95 |
$1,257 |
4.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$273 |
$780 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$121.59 |
$347.40 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$517.65 |
$1,479 |
5.9× |
| Xr arthrogram ankle (73615) |
$575.82 |
$1,645.20 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$679.70 |
$1,942 |
6.5× |
| Xr chest 4+ views (71048) |
$402.85 |
$1,151 |
3.8× |
| Xr Cholecystography Oral Contrast (74290) |
$232.16 |
$663.30 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$292.60 |
$836 |
3.3× |
| Xr internal auditory meati complete (70134) |
$190.26 |
$543.60 |
0.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$147.74 |
$422.10 |
1.4× |
| Xr myelogram posterior fossa (70010) |
$1,150.70 |
$3,287.70 |
3.3× |
| Xr optic foramina (70190) |
$166.95 |
$477 |
1.9× |
| Xr shoulder 1 view (73020) |
$339.50 |
$970 |
3.9× |
| Xr spine cervical 4 or 5 views (72050) |
$662.55 |
$1,893 |
6.3× |
| Xr tibia/fibula 2 views (73590) |
$601.65 |
$1,719 |
6.9× |
| Xr tmj bilateral (70330) |
$202.23 |
$577.80 |
2.3× |
| Xray knee 1 or 2 views rt (73560) |
$484.40 |
$1,384 |
5.5× |