| 3-D radiotherapy plan dose-volume histograms (77295) |
$10,051 |
$10,051 |
7.6× |
| Abdomen 2 views (74019) |
$500 |
$500 |
5.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,349 |
$1,349 |
3.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,326 |
$4,326 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$4,735 |
$4,735 |
1.6× |
| Angiography internal mammary rs&i (75756) |
$3,229 |
$3,229 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,826 |
$4,826 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,303 |
$4,303 |
1.4× |
| Angiography Spinal Selective Rs&I (75705) |
$3,182 |
$3,182 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,397 |
$5,397 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$782 |
$782 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,711 |
$2,711 |
0.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,054 |
$1,054 |
3.2× |
| Aortogram thoracic (75605) |
$3,652 |
$3,652 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,372 |
$3,372 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$2,765 |
$2,765 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$738 |
$738 |
5.7× |
| Bone &/joint imaging whole body (78306) |
$2,301 |
$2,301 |
6.0× |
| Bone age studies (77072) |
$372 |
$372 |
3.7× |
| Bone Imaging 3 Phase (78315) |
$2,669 |
$2,669 |
7.0× |
| Bone Marrow Imaging Limited Area (78102) |
$1,540 |
$1,540 |
4.0× |
| Bone survey complete (77075) |
$598 |
$598 |
6.0× |
| Brachytx isodose complex (77318) |
$2,494 |
$2,494 |
7.0× |
| Brachytx isodose intermed (77317) |
$1,774 |
$1,774 |
5.0× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,459 |
$1,459 |
4.1× |
| Brain image w/flow 4 + views (78606) |
$1,605 |
$1,605 |
3.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,465 |
$6,465 |
4.7× |
| Brain Imaging Vascular Flow Only (78610) |
$1,415 |
$1,415 |
2.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$673 |
$673 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$458 |
$458 |
5.5× |
| Chest 1 view (71045) |
$430 |
$430 |
5.2× |
| Chest 3 views (71047) |
$709 |
$709 |
8.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$485 |
$485 |
2.9× |
| Cineradiography/videoradiography (76120) |
$162 |
$162 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,392 |
$2,392 |
23.9× |
| Continuing medical physics consltj pr wk (77336) |
$908 |
$908 |
7.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,397 |
$6,397 |
19.2× |
| CT abdomen and pelvis without contrast (74176) |
$5,129 |
$5,129 |
22.5× |
| CT abdomen w contrast (74160) |
$2,717 |
$2,717 |
16.2× |
| CT abdomen w wo contrast (74170) |
$3,123 |
$3,123 |
18.6× |
| CT abdomen w/o contrast (74150) |
$2,311 |
$2,311 |
23.1× |
| CT angio hrt w/3d image (75574) |
$1,536 |
$1,536 |
4.6× |
| CT c-spine w/o contrast (72125) |
$2,541 |
$2,541 |
25.4× |
| CT cervical spine w&w/o contrast (72127) |
$3,912 |
$3,912 |
23.3× |
| CT cervical spine with contrast (72126) |
$3,328 |
$3,328 |
10.0× |
| CT chest w/wo contrast (71270) |
$3,513 |
$3,513 |
20.9× |
| CT chest with contrast (71260) |
$2,952 |
$2,952 |
17.6× |
| CT head/brain with contrast (70460) |
$3,639 |
$3,639 |
21.7× |
| CT head/brain without and with contrast (70470) |
$4,284 |
$4,284 |
25.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,461 |
$2,461 |
7.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$728 |
$728 |
8.7× |
| CT hrt w/3d image congen (75573) |
$1,987 |
$1,987 |
6.0× |
| CT iac w contrast (70481) |
$2,432 |
$2,432 |
14.5× |
| CT limited/localized follow up study (76380) |
$1,170 |
$1,170 |
14.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,984 |
$3,984 |
23.7× |
| CT lumbar spine w/o contrast (72131) |
$2,570 |
$2,570 |
25.7× |
| CT lumbar spine with contrast (72132) |
$3,367 |
$3,367 |
10.1× |
| CT maxillofacial w contrast (70487) |
$2,822 |
$2,822 |
16.8× |
| CT maxillofacial w/o contrast (70486) |
$2,372 |
$2,372 |
23.7× |
| CT maxillofacial w/wo contrast (70488) |
$3,462 |
$3,462 |
20.6× |
| CT neck soft tissue w contrast (70491) |
$2,389 |
$2,389 |
14.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,876 |
$2,876 |
17.1× |
| CT orbits w/o contrast (70480) |
$2,115 |
$2,115 |
21.2× |
| CT pelvis w & w/o contrast (72194) |
$3,978 |
$3,978 |
23.7× |
| CT pelvis w/o contrast (72192) |
$2,030 |
$2,030 |
20.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,891 |
$2,891 |
17.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,935 |
$1,935 |
19.4× |
| CT thoracic spine w/contrast (72129) |
$3,008 |
$3,008 |
17.9× |
| CT thoracic spine w/o contrast (72128) |
$2,279 |
$2,279 |
22.8× |
| CT thoracic spine w/wo contrast (72130) |
$3,555 |
$3,555 |
21.2× |
| CT thorax w/o contrast (71250) |
$2,333 |
$2,333 |
23.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,639 |
$2,639 |
15.7× |
| Cta Abdomen (74175) |
$3,304 |
$3,304 |
19.7× |
| CTA abdomen pelvis (74174) |
$4,130 |
$4,130 |
12.4× |
| CTA chest (71275) |
$2,530 |
$2,530 |
15.1× |
| Cta Head (70496) |
$2,366 |
$2,366 |
14.1× |
| Cta Neck (70498) |
$2,687 |
$2,687 |
16.0× |
| Cta Pelvis (72191) |
$2,577 |
$2,577 |
15.4× |
| Cystography minimum 3 views rs&i (74430) |
$579 |
$579 |
1.7× |
| Diskogram cervical (72285) |
$5,726 |
$5,726 |
3.1× |
| Diskography lumbar (72295) |
$3,470 |
$3,470 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$515 |
$515 |
5.2× |
| Echoencephalography real time imaging (76506) |
$602 |
$602 |
6.0× |
| Esophagus (74220) |
$558 |
$558 |
3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$464 |
$464 |
4.6× |
| Fluoroscopy up to 1 hr (76000) |
$780 |
$780 |
3.4× |
| Gastric mucosa imaging (78261) |
$565 |
$565 |
1.5× |
| Gated Heart Planar Single (78472) |
$774 |
$774 |
2.0× |
| Heart Infarct Image (78466) |
$1,415 |
$1,415 |
3.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,557 |
$2,557 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,375 |
$2,375 |
4.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,734 |
$1,734 |
4.5× |
| Ht muscle image spect sing (78451) |
$4,786 |
$4,786 |
3.9× |
| Hysterosalpingogram (74740) |
$905 |
$905 |
4.0× |
| Interstitial radiation source applic complex (77778) |
$6,915 |
$6,915 |
10.4× |
| Intracavitary Radiation Source Applic Complex (77763) |
$4,526 |
$4,526 |
6.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$3,636 |
$3,636 |
6.9× |
| Intracavitary radiation source applic simple (77761) |
$3,419 |
$3,419 |
6.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$151 |
$151 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,098 |
$2,098 |
4.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,577 |
$1,577 |
3.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,344 |
$3,344 |
6.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,130 |
$1,130 |
3.0× |
| Liver imaging static only (78201) |
$1,412 |
$1,412 |
2.7× |
| Lung perf&ventilat diferentl (78598) |
$1,525 |
$1,525 |
2.9× |
| Lung perfusion differential (78597) |
$1,425 |
$1,425 |
3.7× |
| Lung Ventilation Imaging (78579) |
$1,479 |
$1,479 |
3.9× |
| Lymphoscintigraphy (78195) |
$1,681 |
$1,681 |
3.2× |
| Meckels Diverticulum (78290) |
$1,222 |
$1,222 |
3.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$6,018 |
$6,018 |
16.8× |
| Mr safety determination physician/other qhp (76016) |
$264 |
$264 |
3.2× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$178 |
$178 |
3.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$73 |
$73 |
2.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$275 |
$275 |
3.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$725 |
$725 |
3.2× |
| MRA head w & w/o contrast (70546) |
$5,740 |
$5,740 |
17.2× |
| MRA head w/o contrast (70544) |
$3,752 |
$3,752 |
16.4× |
| MRA head with contrast (70545) |
$3,939 |
$3,939 |
11.8× |
| MRA neck w contrast (70548) |
$2,155 |
$2,155 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,031 |
$3,031 |
9.1× |
| MRA neck w/o contrast (70547) |
$1,907 |
$1,907 |
8.4× |
| MRI abdomen w contrast (74182) |
$3,411 |
$3,411 |
10.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,789 |
$3,789 |
11.4× |
| MRI abdomen w/o contrast (74181) |
$2,160 |
$2,160 |
9.5× |
| MRI bone marrow blood supply (77084) |
$2,541 |
$2,541 |
11.1× |
| MRI c-spine with contrast (72142) |
$5,440 |
$5,440 |
16.3× |
| MRI cervical spine w/o contrast (72141) |
$3,726 |
$3,726 |
16.3× |
| MRI chest w/o & w/contrast material (71552) |
$4,041 |
$4,041 |
12.1× |
| MRI chest w/o contrast (71550) |
$2,506 |
$2,506 |
11.0× |
| MRI chest with contrast (71551) |
$2,951 |
$2,951 |
3.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,813 |
$1,813 |
7.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,706 |
$2,706 |
8.1× |
| MRI orbit/face/neck w/contrast (70542) |
$2,165 |
$2,165 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,878 |
$2,878 |
8.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,597 |
$3,597 |
10.8× |
| MRI pelvis w/o contrast (72195) |
$2,446 |
$2,446 |
10.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,297 |
$6,297 |
18.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,547 |
$5,547 |
16.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,555 |
$6,555 |
19.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,970 |
$4,970 |
14.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,847 |
$5,847 |
17.5× |
| MRI thoracic spine w/o contrast (72146) |
$3,450 |
$3,450 |
15.1× |
| MRI tmj (70336) |
$2,619 |
$2,619 |
11.5× |
| Myelogram Cervical (72240) |
$1,242 |
$1,242 |
1.7× |
| Myelogram Lumbar (72265) |
$1,415 |
$1,415 |
1.9× |
| Myelogram thoracic (72255) |
$1,096 |
$1,096 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,641 |
$1,641 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$5,766 |
$5,766 |
4.7× |
| Neck soft tissue (70360) |
$272 |
$272 |
3.3× |
| Nm bone marrow wb (78104) |
$1,155 |
$1,155 |
3.0× |
| Nm cisternogram (78630) |
$2,858 |
$2,858 |
5.5× |
| Nm csf leak detection (78650) |
$2,287 |
$2,287 |
1.8× |
| Nm gastric emptying study (78264) |
$1,734 |
$1,734 |
4.5× |
| Nm gastroesophageal reflux study (78262) |
$1,342 |
$1,342 |
3.5× |
| Nm peritoneal-venous shunt patency (78291) |
$1,173 |
$1,173 |
3.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,349 |
$5,349 |
4.0× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$5,758 |
$5,758 |
4.2× |
| Nuclear Rx Oral Admin (79005) |
$763 |
$763 |
3.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$683 |
$683 |
6.8× |
| Orthopantogram (70355) |
$276 |
$276 |
3.3× |
| Osseous survey infant (77076) |
$640 |
$640 |
6.4× |
| Osseous survey limited (77074) |
$395 |
$395 |
4.0× |
| Parathyroid imaging (78070) |
$1,464 |
$1,464 |
3.8× |
| Pelvis 1 or 2 views (72170) |
$380 |
$380 |
3.8× |
| Peritoneogram rs&i (74190) |
$1,148 |
$1,148 |
2.2× |
| PET image w/CT, skull-thigh (78815) |
$7,228 |
$7,228 |
5.3× |
| PET imaging CT for attenuation limited area (78814) |
$6,505 |
$6,505 |
4.8× |
| PET imaging for CT attenuation whole body (78816) |
$7,373 |
$7,373 |
5.4× |
| PET whole body (78813) |
$5,194 |
$5,194 |
3.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,182 |
$3,182 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,557 |
$2,557 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,641 |
$2,641 |
5.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$548 |
$548 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$458 |
$458 |
5.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$764 |
$764 |
7.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$403 |
$403 |
4.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$396 |
$396 |
4.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,052 |
$1,052 |
10.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$18,111 |
$18,111 |
2.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,427 |
$1,427 |
2.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$621 |
$621 |
6.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$774 |
$774 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$463 |
$463 |
4.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$370 |
$370 |
4.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$500 |
$500 |
5.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$559 |
$559 |
6.7× |
| Radiologic exam colon single contrast study (74270) |
$869 |
$869 |
5.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$629 |
$629 |
3.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$635 |
$635 |
3.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,182 |
$3,182 |
1.1× |
| Ribs bilateral 3 views (71110) |
$427 |
$427 |
4.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,393 |
$1,393 |
3.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,559 |
$1,559 |
3.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,924 |
$1,924 |
3.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,323 |
$1,323 |
5.9× |
| Rp Therapy Intravenous Administration (79101) |
$4,068 |
$4,068 |
18.2× |
| Salivary gland imaging serial images (78231) |
$786 |
$786 |
2.1× |
| Scanogram (77073) |
$404 |
$404 |
4.0× |
| Screening digital breast tomosynthesis (77063) |
$181 |
$181 |
7.7× |
| Sella turcica (70240) |
$248 |
$248 |
3.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$257 |
$257 |
2.6× |
| Sialogram (70390) |
$561 |
$561 |
2.5× |
| Simulation intermediate (77285) |
$2,511 |
$2,511 |
7.0× |
| Small bowel series (74250) |
$877 |
$877 |
5.2× |
| Spec medical radj physics consltj (77370) |
$1,417 |
$1,417 |
11.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$711 |
$711 |
2.0× |
| Special dosimetry (77331) |
$446 |
$446 |
3.5× |
| Special treatment procedure (77470) |
$2,409 |
$2,409 |
4.6× |
| Splenoportograpy rs&i (75810) |
$3,229 |
$3,229 |
1.1× |
| Stereotactic body radiation delivery (77373) |
$6,149 |
$6,149 |
3.6× |
| Superior sagittal sinus venogram (75870) |
$2,557 |
$2,557 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,915 |
$2,915 |
8.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,516 |
$1,516 |
4.2× |
| Testicular Imaging With Vascular Flow (78761) |
$1,284 |
$1,284 |
3.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,616 |
$2,616 |
7.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,517 |
$1,517 |
11.8× |
| Therapeutic Enema (74283) |
$789 |
$789 |
4.7× |
| Thoracolumbar 2 views (72080) |
$486 |
$486 |
5.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,070 |
$2,070 |
4.0× |
| Thyroid uptake measurement (78012) |
$441 |
$441 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,438 |
$1,438 |
3.8× |
| Treatment device intermediate (77333) |
$1,698 |
$1,698 |
13.2× |
| Treatment devices simple (77332) |
$513 |
$513 |
4.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,316 |
$3,316 |
6.4× |
| Tx devices design & construction complex (77334) |
$1,602 |
$1,602 |
4.5× |
| Ultrasound, abdomen limited (76705) |
$878 |
$878 |
8.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$7,865 |
$7,865 |
80.6× |
| Unlisted Ultrasound Procedure (76999) |
$447 |
$447 |
5.4× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,284 |
$1,284 |
3.4× |
| Urethrocystography retrograde rs&i (74450) |
$472 |
$472 |
2.1× |
| Urethrocystography voiding (74455) |
$679 |
$679 |
3.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$2,108 |
$2,108 |
12.6× |
| Us abdl aorta screen aaa (76706) |
$564 |
$564 |
5.6× |
| Us chest (76604) |
$629 |
$629 |
6.3× |
| Us guided compression repair (76936) |
$437 |
$437 |
2.1× |
| Us infant hips limited static (76886) |
$425 |
$425 |
5.1× |
| Us kidney transplant (76776) |
$825 |
$825 |
8.3× |
| Us ob transvaginal (76817) |
$574 |
$574 |
5.7× |
| Us pelvic non ob complete (76856) |
$1,128 |
$1,128 |
11.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,128 |
$1,128 |
11.3× |
| Us pregnancy ltd (76815) |
$505 |
$505 |
5.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$436 |
$436 |
4.4× |
| Us retroperitoneal complete (76770) |
$738 |
$738 |
7.4× |
| Us retroperitoneal limited (76775) |
$376 |
$376 |
3.8× |
| Us scrotum and contents (76870) |
$752 |
$752 |
7.5× |
| Us soft tissue head/neck (76536) |
$678 |
$678 |
6.8× |
| Us spinal canal and contents (76800) |
$307 |
$307 |
3.1× |
| Us transrectal (76872) |
$490 |
$490 |
4.9× |
| Us transrectal prostate volume (76873) |
$645 |
$645 |
6.5× |
| Vascular flow imaging (78445) |
$1,415 |
$1,415 |
3.7× |
| Venogram extremity bilateral (75822) |
$2,389 |
$2,389 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$5,047 |
$5,047 |
1.7× |
| Venography caval superior serialography rs&i (75827) |
$2,473 |
$2,473 |
1.6× |
| Venography epidural rs&i (75872) |
$3,229 |
$3,229 |
5.4× |
| Venography Renal Bilateral (75833) |
$4,389 |
$4,389 |
1.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,182 |
$3,182 |
1.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,182 |
$3,182 |
0.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$500 |
$500 |
5.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$474 |
$474 |
5.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,217 |
$1,217 |
7.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$860 |
$860 |
8.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$522 |
$522 |
5.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$600 |
$600 |
6.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$2,876 |
$2,876 |
17.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$489 |
$489 |
4.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$217 |
$217 |
2.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,825 |
$1,825 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$363 |
$363 |
4.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$458 |
$458 |
4.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$718 |
$718 |
7.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$472 |
$472 |
4.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$428 |
$428 |
5.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$191 |
$191 |
2.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$596 |
$596 |
6.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$570 |
$570 |
5.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,054 |
$1,054 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$514 |
$514 |
5.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$382 |
$382 |
3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$318 |
$318 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$489 |
$489 |
5.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$421 |
$421 |
5.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$514 |
$514 |
5.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$405 |
$405 |
4.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$375 |
$375 |
4.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$263 |
$263 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$410 |
$410 |
4.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$431 |
$431 |
4.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$586 |
$586 |
5.9× |
| Xr c-spine 6 or more views (72052) |
$723 |
$723 |
7.2× |
| Xr chest 4+ views (71048) |
$761 |
$761 |
7.6× |
| Xr Cholecystography Oral Contrast (74290) |
$403 |
$403 |
2.4× |
| Xr optic foramina (70190) |
$308 |
$308 |
3.7× |
| Xr spine cervical 4 or 5 views (72050) |
$609 |
$609 |
6.1× |
| Xr tmj bilateral (70330) |
$442 |
$442 |
5.3× |