| Abdomen 2 views (74019) |
$260.64 |
$543 |
2.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$3,174.72 |
$6,614 |
7.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,256 |
$4,700 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$1,478.88 |
$3,081 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,423.68 |
$2,966 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,485.60 |
$3,095 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,458.24 |
$3,038 |
0.5× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,602.72 |
$3,339 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,390.08 |
$2,896 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,692 |
$3,525 |
0.5× |
| Ankle 2 views (73600) |
$309.12 |
$644 |
3.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,139.04 |
$2,373 |
3.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,334.40 |
$2,780 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,245.12 |
$2,594 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,342.72 |
$6,964 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$2,036.16 |
$4,242 |
0.6× |
| Arthrogram elbow (73085) |
$1,027.20 |
$2,140 |
2.9× |
| Arthrogram hip (73525) |
$1,039.20 |
$2,165 |
3.0× |
| Arthrogram shoulder (73040) |
$1,324.56 |
$2,759.50 |
3.8× |
| Arthrogram wrist (73115) |
$1,369.68 |
$2,853.50 |
3.9× |
| Arthrography knee lt (73580) |
$1,249.44 |
$2,603 |
3.6× |
| Bone &/joint imaging whole body (78306) |
$2,687.52 |
$5,599 |
6.7× |
| Bone age studies (77072) |
$170.40 |
$355 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$3,136.32 |
$6,534 |
7.8× |
| Bone survey complete (77075) |
$734.88 |
$1,531 |
7.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$2,040 |
$4,250 |
5.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,543.04 |
$11,548 |
3.9× |
| Brain Imaging Vascular Flow Only (78610) |
$1,716.48 |
$3,576 |
3.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,901.60 |
$6,045 |
8.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$3,128.64 |
$6,518 |
5.8× |
| Cervical spine 2 or 3 views (72040) |
$290.88 |
$606 |
3.3× |
| Chest 1 view (71045) |
$217.20 |
$452.50 |
2.5× |
| Chest 3 views (71047) |
$293.76 |
$612 |
3.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,022.40 |
$2,130 |
5.8× |
| Clavicle complete (73000) |
$305.76 |
$637 |
3.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,725.60 |
$9,845 |
13.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,933.92 |
$4,029 |
8.1× |
| CT abdomen w contrast (74160) |
$3,329.76 |
$6,937 |
19.0× |
| CT abdomen w wo contrast (74170) |
$3,765.12 |
$7,844 |
21.4× |
| CT abdomen w/o contrast (74150) |
$1,540.80 |
$3,210 |
14.7× |
| CT angio hrt w/3d image (75574) |
$3,994.56 |
$8,322 |
11.4× |
| CT angiography upper extremity lt (73206) |
$5,085.36 |
$10,594.50 |
28.9× |
| CT c-spine w/o contrast (72125) |
$1,899.36 |
$3,957 |
18.1× |
| CT cervical spine w&w/o contrast (72127) |
$3,157.92 |
$6,579 |
18.0× |
| CT cervical spine with contrast (72126) |
$2,554.08 |
$5,321 |
7.3× |
| CT chest w/wo contrast (71270) |
$2,622.72 |
$5,464 |
14.9× |
| CT chest with contrast (71260) |
$2,127.36 |
$4,432 |
12.1× |
| CT head/brain with contrast (70460) |
$1,806.72 |
$3,764 |
10.3× |
| CT head/brain without and with contrast (70470) |
$2,169.60 |
$4,520 |
12.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,767.68 |
$5,766 |
7.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,359.84 |
$2,833 |
15.6× |
| CT hrt w/3d image congen (75573) |
$3,516.96 |
$7,327 |
10.1× |
| CT iac w contrast (70481) |
$3,102.72 |
$6,464 |
17.7× |
| CT limited/localized follow up study (76380) |
$1,643.52 |
$3,424 |
18.9× |
| CT lower ext w/o (73700) |
$1,963.92 |
$4,091.50 |
18.8× |
| CT lower extremity w wo contrast (73702) |
$2,622.72 |
$5,464 |
14.9× |
| CT lower extremity with contrast (73701) |
$2,133.12 |
$4,444 |
12.1× |
| CT lumbar spine w & w/o contrast (72133) |
$3,165.60 |
$6,595 |
18.0× |
| CT lumbar spine w/o contrast (72131) |
$1,884.48 |
$3,926 |
18.0× |
| CT lumbar spine with contrast (72132) |
$2,561.28 |
$5,336 |
7.3× |
| CT maxillofacial w contrast (70487) |
$1,885.44 |
$3,928 |
10.7× |
| CT maxillofacial w/o contrast (70486) |
$1,668 |
$3,475 |
15.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,380.80 |
$4,960 |
13.6× |
| CT neck soft tissue w contrast (70491) |
$2,278.08 |
$4,746 |
13.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,690.72 |
$7,689 |
21.0× |
| CT orbits w/o contrast (70480) |
$2,398.56 |
$4,997 |
22.9× |
| CT pelvis w & w/o contrast (72194) |
$3,746.88 |
$7,806 |
21.3× |
| CT pelvis w/o contrast (72192) |
$1,559.04 |
$3,248 |
14.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$1,065.60 |
$2,220 |
12.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,779.68 |
$5,791 |
15.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,710.24 |
$3,563 |
16.3× |
| CT thoracic spine w/contrast (72129) |
$2,576.16 |
$5,367 |
14.7× |
| CT thoracic spine w/o contrast (72128) |
$1,899.36 |
$3,957 |
18.1× |
| CT thoracic spine w/wo contrast (72130) |
$3,187.20 |
$6,640 |
18.1× |
| CT thorax w/o contrast (71250) |
$1,565.28 |
$3,261 |
14.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,668.16 |
$7,642 |
20.9× |
| CT upper extremity w/o contrast rt (73200) |
$2,734.56 |
$5,697 |
26.1× |
| CT upper extremity with contrast (73201) |
$2,792.16 |
$5,817 |
8.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$5,668.32 |
$11,809 |
32.3× |
| Cta Abdomen (74175) |
$4,212 |
$8,775 |
24.0× |
| CTA abdomen pelvis (74174) |
$5,293.92 |
$11,029 |
15.1× |
| CTA chest (71275) |
$3,722.40 |
$7,755 |
21.2× |
| Cta Head (70496) |
$3,680.16 |
$7,667 |
20.9× |
| CTA lwr ext w&w/o contrast (73706) |
$5,590.08 |
$11,646 |
31.8× |
| Cta Neck (70498) |
$3,674.40 |
$7,655 |
20.9× |
| Cta Pelvis (72191) |
$4,206.24 |
$8,763 |
23.9× |
| Cystography minimum 3 views rs&i (74430) |
$260.64 |
$543 |
0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$238.56 |
$497 |
2.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$443.04 |
$923 |
4.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$577.92 |
$1,204 |
5.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$287.52 |
$599 |
2.7× |
| Echo exam of fetal heart (76825) |
$1,917.12 |
$3,994 |
3.5× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,232.16 |
$2,567 |
5.2× |
| Echoencephalography real time imaging (76506) |
$868.80 |
$1,810 |
8.3× |
| Esophagus (74220) |
$708.48 |
$1,476 |
4.0× |
| Fetal biophysical profile non-stress testing (76818) |
$692.16 |
$1,442 |
6.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$498.24 |
$1,038 |
4.8× |
| Fluoroscopy up to 1 hr (76000) |
$280.80 |
$585 |
1.2× |
| Foot 2 views (73620) |
$317.28 |
$661 |
3.6× |
| Forearm 2 views (73090) |
$272.16 |
$567 |
3.1× |
| Functional MRI brain by phys/psych (70555) |
$3,043.68 |
$6,341 |
12.7× |
| Functional MRI brain by tech (70554) |
$3,312.48 |
$6,901 |
13.9× |
| Hand 2 views (73120) |
$292.32 |
$609 |
2.8× |
| Hand 3 views (73130) |
$359.28 |
$748.50 |
4.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,499.52 |
$3,124 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$4,160.16 |
$8,667 |
7.6× |
| Ht muscle image spect sing (78451) |
$2,892.96 |
$6,027 |
2.2× |
| Humerus Min 2 Views Left (73060) |
$305.76 |
$637 |
3.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$307.20 |
$640 |
2.9× |
| Kidney funcj study non-img radioisotopic study (78725) |
$1,023.84 |
$2,133 |
2.6× |
| Kidney imaging morphology (78700) |
$1,595.04 |
$3,323 |
4.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,986.72 |
$4,139 |
3.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,355.04 |
$2,823 |
2.5× |
| Knee 3 views (73562) |
$397.44 |
$828 |
4.6× |
| Liver & spleen imaging static only (78215) |
$1,842.24 |
$3,838 |
4.6× |
| Lung perfusion differential (78597) |
$1,758.72 |
$3,664 |
4.4× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$756.48 |
$1,576 |
0.2× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$2,639.52 |
$5,499 |
4.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$2,778.72 |
$5,789 |
1.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,906.40 |
$6,055 |
0.9× |
| Lymphoscintigraphy (78195) |
$3,128.64 |
$6,518 |
5.8× |
| Meckels Diverticulum (78290) |
$3,136.32 |
$6,534 |
7.8× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$7,476.48 |
$15,576 |
20.0× |
| Mr elastography (76391) |
$1,774.08 |
$3,696 |
7.4× |
| MRA head w & w/o contrast (70546) |
$2,371.68 |
$4,941 |
6.8× |
| MRA head w/o contrast (70544) |
$1,452.48 |
$3,026 |
6.1× |
| MRA head with contrast (70545) |
$1,562.88 |
$3,256 |
4.5× |
| MRA neck w contrast (70548) |
$2,068.80 |
$4,310 |
5.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,069.60 |
$6,395 |
8.8× |
| MRA neck w/o contrast (70547) |
$1,878.24 |
$3,913 |
7.9× |
| MRI abdomen w contrast (74182) |
$2,625.12 |
$5,469 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,796.96 |
$5,827 |
8.0× |
| MRI abdomen w/o contrast (74181) |
$1,512.48 |
$3,151 |
6.3× |
| MRI any jnt lwr ext with con lt (73722) |
$2,732.40 |
$5,692.50 |
3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,725.20 |
$5,677.50 |
3.5× |
| MRI c-spine with contrast (72142) |
$2,266.56 |
$4,722 |
6.5× |
| MRI cardiac w/o contrast (75557) |
$2,028 |
$4,225 |
8.5× |
| MRI cervical spine w/o contrast (72141) |
$1,434.24 |
$2,988 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$4,343.04 |
$9,048 |
12.4× |
| MRI chest w/o contrast (71550) |
$3,192.96 |
$6,652 |
13.4× |
| MRI chest with contrast (71551) |
$3,469.44 |
$7,228 |
4.4× |
| MRI fetal sngl/1st gestation (74712) |
$2,853.12 |
$5,944 |
11.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,781.20 |
$7,877.50 |
10.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,769.12 |
$5,769 |
7.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,371.20 |
$4,940 |
9.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,930.56 |
$4,022 |
8.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,826.72 |
$5,889 |
8.1× |
| MRI orbit/face/neck w/contrast (70542) |
$2,281.92 |
$4,754 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,225.76 |
$4,637 |
6.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,785.92 |
$5,804 |
8.0× |
| MRI pelvis w/o contrast (72195) |
$1,904.64 |
$3,968 |
8.0× |
| MRI scan of arm joint before and after contrast (73223) |
$3,305.04 |
$6,885.50 |
9.5× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$3,420.48 |
$7,126 |
4.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,290.40 |
$6,855 |
9.4× |
| MRI spectroscopy (76390) |
$1,708.80 |
$3,560 |
19.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,524.32 |
$5,259 |
7.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,214.72 |
$4,614 |
6.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,513.28 |
$5,236 |
7.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,240.64 |
$4,668 |
6.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,528.16 |
$5,267 |
7.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,434.24 |
$2,988 |
6.0× |
| MRI tmj (70336) |
$2,322.72 |
$4,839 |
9.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,770.24 |
$3,688 |
7.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,593.36 |
$9,569.50 |
13.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,553.44 |
$7,403 |
14.9× |
| Myelogram Cervical (72240) |
$708.48 |
$1,476 |
0.9× |
| Myelogram Lumbar (72265) |
$701.76 |
$1,462 |
0.9× |
| Myelogram thoracic (72255) |
$708.48 |
$1,476 |
0.9× |
| Myelography 2 or more regions (72270) |
$965.28 |
$2,011 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$4,160.16 |
$8,667 |
3.2× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,522.40 |
$5,255 |
1.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,522.40 |
$5,255 |
1.8× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,933.60 |
$8,195 |
1.8× |
| Neck soft tissue (70360) |
$227.04 |
$473 |
2.6× |
| Nm gastric emptying study (78264) |
$3,090.72 |
$6,439 |
7.7× |
| Nm gastroesophageal reflux study (78262) |
$2,253.60 |
$4,695 |
5.6× |
| Nm peritoneal-venous shunt patency (78291) |
$2,325.60 |
$4,845 |
5.8× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$5,537.28 |
$11,536 |
3.9× |
| Nuclear Rx Oral Admin (79005) |
$582.24 |
$1,213 |
2.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$723.36 |
$1,507 |
6.9× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$314.88 |
$656 |
2.4× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$225.12 |
$469 |
2.1× |
| Orthopantogram (70355) |
$83.52 |
$174 |
1.0× |
| Osseous survey infant (77076) |
$741.60 |
$1,545 |
7.1× |
| Osseous survey limited (77074) |
$444.48 |
$926 |
4.2× |
| Parathyrd planar w/spect&CT (78072) |
$3,814.08 |
$7,946 |
7.0× |
| Parathyrd planar w/wo subtrj (78071) |
$3,086.88 |
$6,431 |
7.7× |
| Parathyroid imaging (78070) |
$2,694.72 |
$5,614 |
6.7× |
| Pelvis 1 or 2 views (72170) |
$197.28 |
$411 |
1.9× |
| Perineogram (74775) |
$784.32 |
$1,634 |
3.3× |
| PET image w/CT, skull-thigh (78815) |
$5,529.60 |
$11,520 |
3.9× |
| PET imaging for CT attenuation whole body (78816) |
$5,527.68 |
$11,516 |
3.9× |
| PET whole body (78813) |
$5,537.28 |
$11,536 |
3.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,515.76 |
$7,324.50 |
10.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,485.60 |
$3,095 |
0.5× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,506.24 |
$3,138 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,124 |
$4,425 |
5.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$354.24 |
$738 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$303.84 |
$633 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$554.40 |
$1,155 |
5.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$307.20 |
$640 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$792 |
$1,650 |
7.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$320.64 |
$668 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$213.60 |
$445 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$303.84 |
$633 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$233.76 |
$487 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$901.44 |
$1,878 |
5.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$730.08 |
$1,521 |
4.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$334.08 |
$696 |
3.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,492.80 |
$3,110 |
0.5× |
| Ribs bilateral 3 views (71110) |
$303.84 |
$633 |
2.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,866.08 |
$5,971 |
5.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,486.72 |
$7,264 |
6.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,577.44 |
$13,703 |
5.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$8,556.96 |
$17,827 |
6.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,335.36 |
$9,032 |
3.3× |
| Sacroiliac Joints < 3 Views (72200) |
$250.56 |
$522 |
2.4× |
| Scanogram (77073) |
$320.64 |
$668 |
3.1× |
| Scapula complete (73010) |
$188.64 |
$393 |
1.8× |
| Sella turcica (70240) |
$240.48 |
$501 |
2.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$594.72 |
$1,239 |
5.7× |
| Sialogram (70390) |
$1,005.60 |
$2,095 |
4.2× |
| Small bowel series (74250) |
$721.44 |
$1,503 |
4.1× |
| Speech evaluation complex (70371) |
$671.52 |
$1,399 |
2.8× |
| Spine thoracic 3 views (72072) |
$287.52 |
$599 |
2.7× |
| Superior sagittal sinus venogram (75870) |
$2,056.80 |
$4,285 |
0.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$734.88 |
$1,531 |
3.1× |
| Therapeutic Enema (74283) |
$1,336.80 |
$2,785 |
7.6× |
| Thoracolumbar 2 views (72080) |
$247.20 |
$515 |
2.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,869.92 |
$5,979 |
5.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,830.72 |
$3,814 |
4.6× |
| Thyroid uptake measurement (78012) |
$818.40 |
$1,705 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,268.48 |
$4,726 |
5.7× |
| Tomogram (76100) |
$621.60 |
$1,295 |
5.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$6,337.44 |
$13,203 |
11.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,344.80 |
$4,885 |
5.9× |
| Ultrasound scan of cornea to determine thickness (76514) |
$37.92 |
$79 |
1.3× |
| Ultrasound scan to determine eye length and lens power (76519) |
$387.84 |
$808 |
3.7× |
| Ultrasound, abdomen limited (76705) |
$623.04 |
$1,298 |
6.0× |
| Umbilical-artery Doppler (OB) (76820) |
$221.28 |
$461 |
2.1× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$731.52 |
$1,524 |
8.4× |
| Unlisted magnetic resonance procedure (76498) |
$1,865.76 |
$3,887 |
21.4× |
| Upper Extremity Infant (73092) |
$360.96 |
$752 |
3.4× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$2,063.04 |
$4,298 |
5.2× |
| Urethrocystography retrograde rs&i (74450) |
$479.52 |
$999 |
2.0× |
| Urethrocystography voiding (74455) |
$898.56 |
$1,872 |
3.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,135.68 |
$2,366 |
6.5× |
| Us breast unilateral complete (76641) |
$891.12 |
$1,856.50 |
8.5× |
| Us breast unilateral limited (76642) |
$550.08 |
$1,146 |
6.3× |
| Us chest (76604) |
$311.52 |
$649 |
3.0× |
| Us compl joint r-t w/image documentation (76881) |
$173.28 |
$361 |
1.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$636.96 |
$1,327 |
6.1× |
| Us guided compression repair (76936) |
$1,744.32 |
$3,634 |
8.1× |
| Us infant hips dynamic (76885) |
$1,058.88 |
$2,206 |
12.1× |
| Us infant hips limited static (76886) |
$478.56 |
$997 |
5.5× |
| Us kidney transplant (76776) |
$1,173.12 |
$2,444 |
11.2× |
| Us ob detailed single fetus (76811) |
$892.80 |
$1,860 |
3.7× |
| Us ob transvaginal (76817) |
$384.96 |
$802 |
3.7× |
| Us pelvic non ob complete (76856) |
$761.28 |
$1,586 |
7.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$263.04 |
$548 |
2.5× |
| Us pregnancy ltd (76815) |
$526.08 |
$1,096 |
5.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$737.28 |
$1,536 |
7.0× |
| Us retroperitoneal complete (76770) |
$768.48 |
$1,601 |
7.3× |
| Us retroperitoneal limited (76775) |
$328.80 |
$685 |
3.1× |
| Us scrotum and contents (76870) |
$474.24 |
$988 |
4.5× |
| Us soft tissue head/neck (76536) |
$878.88 |
$1,831 |
8.4× |
| Us spinal canal and contents (76800) |
$1,024.32 |
$2,134 |
9.8× |
| Us xtr non-vasc lmtd (76882) |
$252.48 |
$526 |
2.4× |
| Us, eye b-scan (76512) |
$230.16 |
$479.50 |
2.2× |
| Venogram extremity bilateral (75822) |
$658.08 |
$1,371 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$945.36 |
$1,969.50 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$1,016.88 |
$2,118.50 |
0.6× |
| Venography epidural rs&i (75872) |
$1,547.52 |
$3,224 |
2.5× |
| Venography extremity unilateral rs&i (75820) |
$604.80 |
$1,260 |
0.4× |
| Venography Renal Bilateral (75833) |
$1,616.64 |
$3,368 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$1,416.96 |
$2,952 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,506.24 |
$3,138 |
0.5× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,630.08 |
$3,396 |
0.3× |
| Wrist 2 views (73100) |
$390.72 |
$814 |
4.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$347.52 |
$724 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$197.28 |
$411 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$355.92 |
$741.50 |
4.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,387.20 |
$2,890 |
7.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$267.12 |
$556.50 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$305.76 |
$637 |
3.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$621.60 |
$1,295 |
5.9× |
| X-ray exam hip uni 1 view (73501) |
$237.12 |
$494 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$364.32 |
$759 |
4.2× |
| X-ray exam hip uni 4/> views (73503) |
$464.16 |
$967 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$397.44 |
$828 |
3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$467.52 |
$974 |
4.5× |
| X-ray exam of femur 1 (73551) |
$267.12 |
$556.50 |
3.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$350.88 |
$731 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$227.04 |
$473 |
2.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$330.72 |
$689 |
3.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,671.36 |
$3,482 |
0.8× |
| X-ray head for orthodontia (70350) |
$80.16 |
$167 |
0.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$263.76 |
$549.50 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$300.48 |
$626 |
3.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$447.84 |
$933 |
4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$320.64 |
$668 |
3.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$360.96 |
$752 |
4.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$293.76 |
$612 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$474.24 |
$988 |
4.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$300.48 |
$626 |
2.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$297.12 |
$619 |
3.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$210.24 |
$438 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$347.52 |
$724 |
3.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$303.84 |
$633 |
2.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$264 |
$550 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$287.52 |
$599 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$243.84 |
$508 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$322.32 |
$671.50 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$274.08 |
$571 |
3.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$240.48 |
$501 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$313.92 |
$654 |
3.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$274.08 |
$571 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$167.04 |
$348 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$310.56 |
$647 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$243.84 |
$508 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$233.76 |
$487 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$327.36 |
$682 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$230.40 |
$480 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$409.20 |
$852.50 |
4.7× |
| Xr arthrogram ankle (73615) |
$1,299.60 |
$2,707.50 |
3.7× |
| Xr c-spine 6 or more views (72052) |
$480.96 |
$1,002 |
4.6× |
| Xr chest 4+ views (71048) |
$313.92 |
$654 |
3.0× |
| Xr Cholecystography Oral Contrast (74290) |
$718.08 |
$1,496 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$313.92 |
$654 |
3.6× |
| Xr myelogram posterior fossa (70010) |
$634.56 |
$1,322 |
1.8× |
| Xr shoulder 1 view (73020) |
$180.24 |
$375.50 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$404.16 |
$842 |
3.9× |
| Xr tibia/fibula 2 views (73590) |
$360.96 |
$752 |
4.1× |
| Xr tmj bilateral (70330) |
$417.60 |
$870 |
4.8× |
| Xray knee 1 or 2 views rt (73560) |
$330.72 |
$689 |
3.8× |