| Abdomen 2 views (74019) |
$395.20 |
$608 |
3.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$585.65 |
$901 |
1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,494.70 |
$3,838 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$3,576.30 |
$5,502 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$1,912.95 |
$2,943 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$3,581.50 |
$5,510 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,344.60 |
$6,684 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,652.65 |
$4,081 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,885.32 |
$2,900.50 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$4,118.40 |
$6,336 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,263.08 |
$9,635.50 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$935.35 |
$1,439 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,217.12 |
$1,872.50 |
0.4× |
| Ankle 2 views (73600) |
$178.10 |
$274 |
1.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$439.40 |
$676 |
1.2× |
| Aortogram thoracic (75605) |
$4,124.25 |
$6,345 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,494.70 |
$3,838 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$4,080.05 |
$6,277 |
1.2× |
| Artery X-Rays Adrenal Gland (75731) |
$1,032.20 |
$1,588 |
0.3× |
| Arthrogram elbow (73085) |
$906.10 |
$1,394 |
2.5× |
| Arthrogram hip (73525) |
$842.72 |
$1,296.50 |
2.3× |
| Arthrogram shoulder (73040) |
$1,006.85 |
$1,549 |
2.7× |
| Arthrogram wrist (73115) |
$362.05 |
$557 |
1.0× |
| Arthrography knee lt (73580) |
$638.30 |
$982 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$480.35 |
$739 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$2,975.70 |
$4,578 |
7.1× |
| Bone age studies (77072) |
$191.42 |
$294.50 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$2,476.50 |
$3,810 |
5.9× |
| Bone survey complete (77075) |
$510.25 |
$785 |
4.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$8,553.35 |
$13,159 |
5.7× |
| Brain Imaging Vascular Flow Only (78610) |
$1,708.20 |
$2,628 |
3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,601.65 |
$5,541 |
9.8× |
| Cardiac shunt detection (78428) |
$522.60 |
$804 |
1.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$3,107.65 |
$4,781 |
5.4× |
| Cervical spine 2 or 3 views (72040) |
$241.80 |
$372 |
2.6× |
| Chest 1 view (71045) |
$458.25 |
$705 |
5.0× |
| Chest 3 views (71047) |
$553.15 |
$851 |
6.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$414.05 |
$637 |
2.2× |
| Clavicle complete (73000) |
$165.10 |
$254 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,795 |
$4,300 |
7.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,946.10 |
$2,994 |
7.7× |
| CT abdomen w contrast (74160) |
$2,050.10 |
$3,154 |
11.1× |
| CT abdomen w wo contrast (74170) |
$2,322.45 |
$3,573 |
12.6× |
| CT abdomen w/o contrast (74150) |
$1,742.65 |
$2,681 |
15.8× |
| CT angio hrt w/3d image (75574) |
$2,050.10 |
$3,154 |
5.6× |
| CT angiography upper extremity lt (73206) |
$2,050.10 |
$3,154 |
11.1× |
| CT c-spine w/o contrast (72125) |
$1,539.85 |
$2,369 |
14.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,322.45 |
$3,573 |
12.6× |
| CT cervical spine with contrast (72126) |
$2,050.10 |
$3,154 |
5.6× |
| CT chest w/wo contrast (71270) |
$2,496.65 |
$3,841 |
13.5× |
| CT chest with contrast (71260) |
$1,831.05 |
$2,817 |
9.9× |
| CT head/brain with contrast (70460) |
$1,811.55 |
$2,787 |
9.8× |
| CT head/brain without and with contrast (70470) |
$2,299.05 |
$3,537 |
12.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,066.35 |
$3,179 |
5.6× |
| CT hrt w/3d image congen (75573) |
$2,014.35 |
$3,099 |
5.5× |
| CT iac w contrast (70481) |
$1,930.82 |
$2,970.50 |
10.4× |
| CT limited/localized follow up study (76380) |
$230.10 |
$354 |
2.5× |
| CT lower ext w/o (73700) |
$1,742.65 |
$2,681 |
15.8× |
| CT lower extremity w wo contrast (73702) |
$2,138.50 |
$3,290 |
11.6× |
| CT lower extremity with contrast (73701) |
$2,050.10 |
$3,154 |
11.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,322.45 |
$3,573 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$1,742.65 |
$2,681 |
15.8× |
| CT lumbar spine with contrast (72132) |
$2,050.10 |
$3,154 |
5.6× |
| CT maxillofacial w contrast (70487) |
$1,897.35 |
$2,919 |
10.3× |
| CT maxillofacial w/o contrast (70486) |
$1,621.10 |
$2,494 |
14.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,182.05 |
$3,357 |
11.8× |
| CT neck soft tissue w contrast (70491) |
$1,811.55 |
$2,787 |
9.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,322.45 |
$3,573 |
12.6× |
| CT orbits w/o contrast (70480) |
$1,742.65 |
$2,681 |
15.8× |
| CT pelvis w & w/o contrast (72194) |
$2,322.45 |
$3,573 |
12.6× |
| CT pelvis w/o contrast (72192) |
$1,742.65 |
$2,681 |
15.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,182.05 |
$3,357 |
11.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,742.65 |
$2,681 |
15.8× |
| CT thoracic spine w/contrast (72129) |
$2,050.10 |
$3,154 |
11.1× |
| CT thoracic spine w/o contrast (72128) |
$1,742.65 |
$2,681 |
15.8× |
| CT thoracic spine w/wo contrast (72130) |
$2,322.45 |
$3,573 |
12.6× |
| CT thorax w/o contrast (71250) |
$1,539.85 |
$2,369 |
14.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,322.45 |
$3,573 |
12.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,742.65 |
$2,681 |
15.8× |
| CT upper extremity with contrast (73201) |
$2,050.10 |
$3,154 |
5.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,340 |
$3,600 |
12.6× |
| Cta Abdomen (74175) |
$2,050.10 |
$3,154 |
11.1× |
| CTA abdomen pelvis (74174) |
$2,470 |
$3,800 |
6.7× |
| CTA chest (71275) |
$1,811.55 |
$2,787 |
9.8× |
| Cta Head (70496) |
$1,811.55 |
$2,787 |
9.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,050.10 |
$3,154 |
5.6× |
| CTA lwr ext w&w/o contrast (73706) |
$2,226.90 |
$3,426 |
12.0× |
| Cta Neck (70498) |
$1,811.55 |
$2,787 |
9.8× |
| Cta Pelvis (72191) |
$1,907.10 |
$2,934 |
10.3× |
| Cystography minimum 3 views rs&i (74430) |
$927.55 |
$1,427 |
2.5× |
| Dacryocystography (70170) |
$380.25 |
$585 |
1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$624 |
$960 |
5.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$624 |
$960 |
5.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$624 |
$960 |
5.7× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$1,264.25 |
$1,945 |
11.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$414.05 |
$637 |
3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$422.50 |
$650 |
4.6× |
| Echo exam of eye (76529) |
$209.95 |
$323 |
2.3× |
| Echo exam of fetal heart (76825) |
$1,688.05 |
$2,597 |
2.9× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$912.60 |
$1,404 |
3.6× |
| Echoencephalography real time imaging (76506) |
$748.15 |
$1,151 |
6.8× |
| Esophagus (74220) |
$265.85 |
$409 |
1.4× |
| Fetal biophysical profile non-stress testing (76818) |
$923 |
$1,420 |
8.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$624 |
$960 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$986.70 |
$1,518 |
3.9× |
| Foot 2 views (73620) |
$169 |
$260 |
1.8× |
| Forearm 2 views (73090) |
$175.82 |
$270.50 |
1.9× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$58.50 |
$90 |
0.2× |
| Functional MRI brain by phys/psych (70555) |
$3,601.65 |
$5,541 |
14.3× |
| Functional MRI brain by tech (70554) |
$3,911.70 |
$6,018 |
15.5× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$574.60 |
$884 |
1.0× |
| Gated Heart Planar Single (78472) |
$1,392.95 |
$2,143 |
3.3× |
| Hand 2 views (73120) |
$154.70 |
$238 |
1.4× |
| Hand 3 views (73130) |
$203.78 |
$313.50 |
2.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,158.02 |
$4,858.50 |
0.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,345.20 |
$3,608 |
4.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,135.90 |
$3,286 |
5.1× |
| Humerus Min 2 Views Left (73060) |
$179.72 |
$276.50 |
2.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$231.40 |
$356 |
2.1× |
| Kidney funcj study non-img radioisotopic study (78725) |
$3,494.40 |
$5,376 |
8.3× |
| Kidney imaging morphology (78700) |
$522.60 |
$804 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$653.25 |
$1,005 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,118.65 |
$1,721 |
2.0× |
| Knee 3 views (73562) |
$260.98 |
$401.50 |
2.8× |
| Liver & spleen imaging static only (78215) |
$522.60 |
$804 |
1.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$522.60 |
$804 |
1.2× |
| Lung perf&ventilat diferentl (78598) |
$3,310.45 |
$5,093 |
5.8× |
| Lung perfusion differential (78597) |
$1,567.15 |
$2,411 |
3.7× |
| Lung Ventilation Imaging (78579) |
$575.90 |
$886 |
1.4× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,817.10 |
$4,334 |
0.8× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$859.95 |
$1,323 |
1.3× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,158.30 |
$1,782 |
0.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,682.20 |
$2,588 |
0.5× |
| Lymphoscintigraphy (78195) |
$2,767.05 |
$4,257 |
4.8× |
| Meckels Diverticulum (78290) |
$2,750.80 |
$4,232 |
6.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$715.65 |
$1,101 |
1.8× |
| Mr elastography (76391) |
$2,773.55 |
$4,267 |
11.0× |
| Mr safety determination physician/other qhp (76016) |
$223.60 |
$344 |
2.4× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$150.15 |
$231 |
2.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$76.70 |
$118 |
2.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$150.15 |
$231 |
1.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$223.60 |
$344 |
0.9× |
| MRA head w & w/o contrast (70546) |
$3,182.40 |
$4,896 |
8.6× |
| MRA head w/o contrast (70544) |
$2,451.15 |
$3,771 |
9.7× |
| MRA head with contrast (70545) |
$2,838.55 |
$4,367 |
7.7× |
| MRA neck w contrast (70548) |
$3,212.30 |
$4,942 |
8.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,601.65 |
$5,541 |
9.8× |
| MRA neck w/o contrast (70547) |
$2,451.15 |
$3,771 |
9.7× |
| MRI abdomen w contrast (74182) |
$2,988.05 |
$4,597 |
8.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,182.40 |
$4,896 |
8.6× |
| MRI abdomen w/o contrast (74181) |
$2,773.55 |
$4,267 |
11.0× |
| MRI any jnt lwr ext with con lt (73722) |
$3,212.30 |
$4,942 |
3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,212.30 |
$4,942 |
3.9× |
| MRI bone marrow blood supply (77084) |
$3,244.80 |
$4,992 |
12.9× |
| MRI c-spine with contrast (72142) |
$2,838.55 |
$4,367 |
7.7× |
| MRI cardiac w/o contrast (75557) |
$2,773.55 |
$4,267 |
11.0× |
| MRI cervical spine w/o contrast (72141) |
$2,773.55 |
$4,267 |
11.0× |
| MRI chest w/o & w/contrast material (71552) |
$3,601.65 |
$5,541 |
9.8× |
| MRI chest w/o contrast (71550) |
$2,773.55 |
$4,267 |
11.0× |
| MRI chest with contrast (71551) |
$3,487.90 |
$5,366 |
4.2× |
| MRI fetal sngl/1st gestation (74712) |
$2,451.15 |
$3,771 |
9.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,244.80 |
$4,992 |
8.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,773.55 |
$4,267 |
11.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,212.30 |
$4,942 |
12.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,182.40 |
$4,896 |
8.6× |
| MRI orbit/face/neck w/contrast (70542) |
$3,048.50 |
$4,690 |
8.3× |
| MRI pelvis w contrast (72196) |
$3,048.50 |
$4,690 |
8.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,601.65 |
$5,541 |
9.8× |
| MRI pelvis w/o contrast (72195) |
$2,773.55 |
$4,267 |
11.0× |
| MRI scan of arm joint before and after contrast (73223) |
$3,601.65 |
$5,541 |
9.8× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$3,555.50 |
$5,470 |
4.3× |
| MRI scan of leg joint before and after contrast (73723) |
$3,601.65 |
$5,541 |
9.8× |
| MRI spectroscopy (76390) |
$2,476.50 |
$3,810 |
27.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,182.40 |
$4,896 |
8.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,838.55 |
$4,367 |
7.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,182.40 |
$4,896 |
8.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,888.60 |
$4,444 |
7.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,182.40 |
$4,896 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$3,601.65 |
$5,541 |
14.3× |
| MRI tmj (70336) |
$2,773.55 |
$4,267 |
11.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,773.55 |
$4,267 |
11.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,601.65 |
$5,541 |
9.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,773.55 |
$4,267 |
11.0× |
| Myelogram Cervical (72240) |
$705.90 |
$1,086 |
0.9× |
| Myelogram Lumbar (72265) |
$705.90 |
$1,086 |
0.9× |
| Myelogram thoracic (72255) |
$705.90 |
$1,086 |
0.9× |
| Myelography 2 or more regions (72270) |
$1,045.20 |
$1,608 |
1.3× |
| Myocardial infarct spect (78469) |
$1,253.85 |
$1,929 |
2.2× |
| Neck soft tissue (70360) |
$244.08 |
$375.50 |
2.7× |
| Nm bone marrow multiple (78103) |
$522.60 |
$804 |
1.2× |
| Nm bone marrow wb (78104) |
$612.95 |
$943 |
1.5× |
| Nm cisternogram (78630) |
$612.95 |
$943 |
1.1× |
| Nm csf leak detection (78650) |
$1,253.85 |
$1,929 |
0.9× |
| Nm gastric emptying study (78264) |
$3,723.85 |
$5,729 |
8.8× |
| Nm gastroesophageal reflux study (78262) |
$541.45 |
$833 |
1.3× |
| Nuclear medicine of heart pumping function (78473) |
$1,794 |
$2,760 |
4.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$574.60 |
$884 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$1,400.75 |
$2,155 |
5.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$624 |
$960 |
5.7× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$831.35 |
$1,279 |
5.9× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$855.40 |
$1,316 |
7.8× |
| Orthopantogram (70355) |
$196.30 |
$302 |
2.1× |
| Osseous survey infant (77076) |
$426.40 |
$656 |
3.9× |
| Osseous survey limited (77074) |
$249.92 |
$384.50 |
2.3× |
| Parathyrd planar w/spect&CT (78072) |
$4,482.40 |
$6,896 |
7.8× |
| Pelvis 1 or 2 views (72170) |
$171.28 |
$263.50 |
1.6× |
| Perineogram (74775) |
$685.75 |
$1,055 |
2.7× |
| Peritoneogram rs&i (74190) |
$498.55 |
$767 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$8,251.10 |
$12,694 |
5.5× |
| PET imaging CT for attenuation limited area (78814) |
$8,596.90 |
$13,226 |
5.7× |
| PET imaging for CT attenuation whole body (78816) |
$9,428.25 |
$14,505 |
6.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,601.65 |
$5,541 |
9.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,558.75 |
$5,475 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,068.60 |
$1,644 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$612.95 |
$943 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$674.70 |
$1,038 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$490.10 |
$754 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$183.95 |
$283 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$258.05 |
$397 |
2.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$190.45 |
$293 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$180.38 |
$277.50 |
1.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$395.20 |
$608 |
3.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$208.65 |
$321 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$369.20 |
$568 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$463.45 |
$713 |
4.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$503.10 |
$774 |
5.5× |
| Radiologic exam colon single contrast study (74270) |
$722.80 |
$1,112 |
3.9× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$20.80 |
$32 |
0.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$404.30 |
$622 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$245.05 |
$377 |
2.7× |
| Radiological examination surgical specimen (76098) |
$449.15 |
$691 |
0.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,494.70 |
$3,838 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,971.48 |
$4,571.50 |
0.9× |
| Ribs bilateral 3 views (71110) |
$346.12 |
$532.50 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$612.95 |
$943 |
1.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,568.50 |
$5,490 |
6.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,228.55 |
$4,967 |
5.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,323.10 |
$3,574 |
1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,832.75 |
$7,435 |
3.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,276.95 |
$3,503 |
1.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,400.75 |
$2,155 |
5.7× |
| Salivary gland imaging (78230) |
$522.60 |
$804 |
1.2× |
| Scanogram (77073) |
$272.68 |
$419.50 |
2.5× |
| Scapula complete (73010) |
$170.95 |
$263 |
1.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$406.90 |
$626 |
3.7× |
| Sialogram (70390) |
$797.55 |
$1,227 |
3.2× |
| Small bowel series (74250) |
$442.65 |
$681 |
2.4× |
| Speech evaluation complex (70371) |
$349.38 |
$537.50 |
1.4× |
| Spine thoracic 3 views (72072) |
$280.15 |
$431 |
2.5× |
| Splenoportograpy rs&i (75810) |
$1,293.50 |
$1,990 |
0.4× |
| Superior sagittal sinus venogram (75870) |
$1,757.60 |
$2,704 |
0.5× |
| Therapeutic Enema (74283) |
$1,048.45 |
$1,613 |
5.7× |
| Thoracolumbar 2 views (72080) |
$271.70 |
$418 |
3.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$4,069.65 |
$6,261 |
7.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$612.95 |
$943 |
1.5× |
| Thyroid uptake measurement (78012) |
$612.95 |
$943 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$3,730.35 |
$5,739 |
8.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,392.70 |
$6,758 |
7.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$565.50 |
$870 |
1.3× |
| Ultrasound scan of cornea to determine thickness (76514) |
$126.75 |
$195 |
4.2× |
| Ultrasound scan to determine eye length and lens power (76519) |
$85.15 |
$131 |
0.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$624 |
$960 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$637 |
$980 |
5.8× |
| Umbilical-artery Doppler (OB) (76820) |
$624 |
$960 |
5.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$2,284.75 |
$3,515 |
24.9× |
| Unlisted fluoroscopic procedure (76496) |
$679.25 |
$1,045 |
7.4× |
| Unlisted magnetic resonance procedure (76498) |
$3,459.95 |
$5,323 |
37.7× |
| Unlisted Ultrasound Procedure (76999) |
$624 |
$960 |
6.8× |
| Upper Extremity Infant (73092) |
$201.82 |
$310.50 |
1.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$522.60 |
$804 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$780 |
$1,200 |
3.1× |
| Urethrocystography voiding (74455) |
$872.30 |
$1,342 |
3.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$409.50 |
$630 |
2.2× |
| Us breast unilateral limited (76642) |
$507.98 |
$781.50 |
5.5× |
| Us chest (76604) |
$624 |
$960 |
5.7× |
| Us compl joint r-t w/image documentation (76881) |
$752.70 |
$1,158 |
6.8× |
| Us elastography parenchyma (76981) |
$624 |
$960 |
5.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$787.80 |
$1,212 |
7.1× |
| Us guided compression repair (76936) |
$947.70 |
$1,458 |
4.2× |
| Us infant hips dynamic (76885) |
$624 |
$960 |
6.8× |
| Us infant hips limited static (76886) |
$624 |
$960 |
6.8× |
| Us ob detailed single fetus (76811) |
$1,218.75 |
$1,875 |
4.8× |
| Us ob transvaginal (76817) |
$624 |
$960 |
5.7× |
| Us pelvic non ob complete (76856) |
$773.50 |
$1,190 |
7.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$624 |
$960 |
5.7× |
| Us pregnancy ltd (76815) |
$624 |
$960 |
5.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$624 |
$960 |
5.7× |
| Us retroperitoneal complete (76770) |
$733.20 |
$1,128 |
6.6× |
| Us retroperitoneal limited (76775) |
$631.15 |
$971 |
5.7× |
| Us scrotum and contents (76870) |
$624 |
$960 |
5.7× |
| Us soft tissue head/neck (76536) |
$626.28 |
$963.50 |
5.7× |
| Us spinal canal and contents (76800) |
$624 |
$960 |
5.7× |
| Us xtr non-vasc lmtd (76882) |
$624 |
$960 |
5.7× |
| Us, eye b-scan (76512) |
$861.58 |
$1,325.50 |
7.8× |
| Venogram extremity bilateral (75822) |
$1,448.85 |
$2,229 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$1,912.95 |
$2,943 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,448.52 |
$2,228.50 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,090.70 |
$1,678 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,444.98 |
$3,761.50 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,960.40 |
$3,016 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,995.82 |
$3,070.50 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,312.75 |
$6,635 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$126.10 |
$194 |
1.4× |
| Wrist 2 views (73100) |
$137.80 |
$212 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$376.02 |
$578.50 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$346.78 |
$533.50 |
3.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$215.48 |
$331.50 |
2.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$837.20 |
$1,288 |
4.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$172.90 |
$266 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$256.75 |
$395 |
2.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$351.65 |
$541 |
3.2× |
| X-ray exam hip uni 1 view (73501) |
$164.12 |
$252.50 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$222.95 |
$343 |
2.4× |
| X-ray exam hip uni 4/> views (73503) |
$269.75 |
$415 |
2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$276.90 |
$426 |
2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$340.92 |
$524.50 |
3.1× |
| X-ray exam of femur 1 (73551) |
$205.08 |
$315.50 |
2.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$509.60 |
$784 |
2.8× |
| X-ray eye for foreign body (70030) |
$159.90 |
$246 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$366.60 |
$564 |
3.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$231.72 |
$356.50 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$227.50 |
$350 |
2.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,774.50 |
$2,730 |
0.8× |
| X-ray head for orthodontia (70350) |
$43.88 |
$67.50 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$161.52 |
$248.50 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$217.42 |
$334.50 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$373.75 |
$575 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$294.45 |
$453 |
3.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$294.78 |
$453.50 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$245.70 |
$378 |
2.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$276.90 |
$426 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$189.15 |
$291 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$274.30 |
$422 |
2.5× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$1,571.70 |
$2,418 |
2.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$409.50 |
$630 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$182.32 |
$280.50 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$233.11 |
$358.62 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$465.40 |
$716 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$219.38 |
$337.50 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$260.98 |
$401.50 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$203.12 |
$312.50 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$180.70 |
$278 |
2.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$156.65 |
$241 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$326.95 |
$503 |
3.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$203.12 |
$312.50 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$195 |
$300 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$424.45 |
$653 |
4.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$211.25 |
$325 |
2.3× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$14.95 |
$23 |
0.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$233.68 |
$359.50 |
2.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$358.80 |
$552 |
3.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$179.72 |
$276.50 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$190.45 |
$293 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$349.70 |
$538 |
3.2× |
| Xr chest 4+ views (71048) |
$571.35 |
$879 |
5.2× |
| Xr Cholecystography Oral Contrast (74290) |
$205.40 |
$316 |
1.1× |
| Xr finger(s) 2+ views (73140) |
$189.80 |
$292 |
2.1× |
| Xr optic foramina (70190) |
$180.38 |
$277.50 |
2.0× |
| Xr shoulder 1 view (73020) |
$166.08 |
$255.50 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$322.40 |
$496 |
2.9× |
| Xr tibia/fibula 2 views (73590) |
$189.80 |
$292 |
2.1× |
| Xr tmj bilateral (70330) |
$214.82 |
$330.50 |
2.3× |
| Xray knee 1 or 2 views rt (73560) |
$215.48 |
$331.50 |
2.3× |