| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,927 |
$3,854 |
1.2× |
| Abdomen 2 views (74019) |
$548 |
$1,096 |
4.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$949 |
$1,898 |
2.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,934.50 |
$7,869 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$3,934.50 |
$7,869 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,934.50 |
$7,869 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$3,934.50 |
$7,869 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,757.50 |
$13,515 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,934.50 |
$7,869 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,934.50 |
$7,869 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$6,757.50 |
$13,515 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,757.50 |
$13,515 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,934.50 |
$7,869 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,934.50 |
$7,869 |
1.1× |
| Ankle 2 views (73600) |
$311 |
$622 |
3.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$856 |
$1,712 |
2.1× |
| Aortogram thoracic (75605) |
$6,757.50 |
$13,515 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,934.50 |
$7,869 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$3,934.50 |
$7,869 |
1.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,934.50 |
$7,869 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$3,934.50 |
$7,869 |
1.1× |
| Arthrogram elbow (73085) |
$595 |
$1,190 |
1.4× |
| Arthrogram hip (73525) |
$543 |
$1,086 |
1.3× |
| Arthrogram shoulder (73040) |
$595 |
$1,190 |
1.4× |
| Arthrogram wrist (73115) |
$595 |
$1,190 |
1.4× |
| Arthrography knee lt (73580) |
$595 |
$1,190 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$478.50 |
$957 |
3.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$502.50 |
$1,005 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$1,749.50 |
$3,499 |
3.7× |
| Bone age studies (77072) |
$266 |
$532 |
2.2× |
| Bone Marrow Imaging Limited Area (78102) |
$820.50 |
$1,641 |
1.7× |
| Bone survey complete (77075) |
$1,267 |
$2,534 |
10.3× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$916.50 |
$1,833 |
2.1× |
| Brain image w/flow 4 + views (78606) |
$1,301 |
$2,602 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,178.50 |
$4,357 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,468.50 |
$4,937 |
6.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$673 |
$1,346 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$358.50 |
$717 |
3.5× |
| Chest 1 view (71045) |
$243.50 |
$487 |
2.4× |
| Chest 3 views (71047) |
$358.50 |
$717 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$745 |
$1,490 |
3.6× |
| Cineradiography/videoradiography (76120) |
$161.50 |
$323 |
1.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$988 |
$1,976 |
1.1× |
| Clavicle complete (73000) |
$313.50 |
$627 |
3.0× |
| Continuing medical physics consltj pr wk (77336) |
$1,092 |
$2,184 |
6.9× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$264.50 |
$529 |
1.3× |
| Corpora cavernosography (74445) |
$277.50 |
$555 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,816.50 |
$5,633 |
6.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,677 |
$3,354 |
5.9× |
| CT abdomen w contrast (74160) |
$2,356.50 |
$4,713 |
11.4× |
| CT abdomen w wo contrast (74170) |
$2,281 |
$4,562 |
11.0× |
| CT abdomen w/o contrast (74150) |
$1,937.50 |
$3,875 |
15.7× |
| CT angio hrt w/3d image (75574) |
$2,515 |
$5,030 |
6.1× |
| CT angiography upper extremity lt (73206) |
$287.50 |
$575 |
1.4× |
| CT c-spine w/o contrast (72125) |
$1,517.50 |
$3,035 |
12.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,937.50 |
$3,875 |
9.4× |
| CT cervical spine with contrast (72126) |
$1,414 |
$2,828 |
3.4× |
| CT chest w/wo contrast (71270) |
$2,527.50 |
$5,055 |
12.2× |
| CT chest with contrast (71260) |
$1,751.50 |
$3,503 |
8.5× |
| CT head/brain with contrast (70460) |
$1,543.50 |
$3,087 |
7.4× |
| CT head/brain without and with contrast (70470) |
$2,461.50 |
$4,923 |
11.9× |
| CT iac w contrast (70481) |
$1,711.50 |
$3,423 |
8.3× |
| CT limited/localized follow up study (76380) |
$1,221 |
$2,442 |
11.9× |
| CT lower ext w/o (73700) |
$1,431.50 |
$2,863 |
11.6× |
| CT lower extremity w wo contrast (73702) |
$2,067.50 |
$4,135 |
10.0× |
| CT lower extremity with contrast (73701) |
$1,726.50 |
$3,453 |
8.3× |
| CT lumbar spine w & w/o contrast (72133) |
$2,082.50 |
$4,165 |
10.1× |
| CT lumbar spine w/o contrast (72131) |
$1,225.50 |
$2,451 |
9.9× |
| CT lumbar spine with contrast (72132) |
$2,222 |
$4,444 |
5.4× |
| CT maxillofacial w contrast (70487) |
$1,510.50 |
$3,021 |
7.3× |
| CT maxillofacial w/o contrast (70486) |
$1,431.50 |
$2,863 |
11.6× |
| CT maxillofacial w/wo contrast (70488) |
$2,857.50 |
$5,715 |
13.8× |
| CT neck soft tissue w contrast (70491) |
$1,639 |
$3,278 |
7.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,442.50 |
$4,885 |
11.8× |
| CT orbits w/o contrast (70480) |
$1,431.50 |
$2,863 |
11.6× |
| CT pelvis w & w/o contrast (72194) |
$2,111.50 |
$4,223 |
10.2× |
| CT pelvis w/o contrast (72192) |
$1,507.50 |
$3,015 |
12.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,507 |
$5,014 |
12.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,369 |
$2,738 |
11.1× |
| CT thoracic spine w/contrast (72129) |
$1,696.50 |
$3,393 |
8.2× |
| CT thoracic spine w/o contrast (72128) |
$1,499 |
$2,998 |
12.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,776.50 |
$3,553 |
8.6× |
| CT thorax w/o contrast (71250) |
$1,431.50 |
$2,863 |
11.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,736 |
$3,472 |
8.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,139.50 |
$2,279 |
9.2× |
| CT upper extremity with contrast (73201) |
$1,213 |
$2,426 |
2.9× |
| Cta Abdomen (74175) |
$2,358 |
$4,716 |
11.4× |
| CTA chest (71275) |
$1,926 |
$3,852 |
9.3× |
| Cta Head (70496) |
$1,699 |
$3,398 |
8.2× |
| CTA lwr ext w&w/o contrast (73706) |
$327 |
$654 |
1.6× |
| Cta Neck (70498) |
$3,085.50 |
$6,171 |
14.9× |
| Cystography minimum 3 views rs&i (74430) |
$543 |
$1,086 |
1.3× |
| Dacryocystography (70170) |
$339.50 |
$679 |
1.2× |
| Diskogram cervical (72285) |
$2,441 |
$4,882 |
1.1× |
| Diskography lumbar (72295) |
$2,441 |
$4,882 |
1.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$287 |
$574 |
2.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$868.50 |
$1,737 |
7.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$346 |
$692 |
2.8× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$161.50 |
$323 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$802.50 |
$1,605 |
6.5× |
| Echo exam of eye (76529) |
$110.50 |
$221 |
1.1× |
| Echo exam of fetal heart (76825) |
$1,160.50 |
$2,321 |
1.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$390.50 |
$781 |
1.4× |
| Echoencephalography real time imaging (76506) |
$682 |
$1,364 |
5.5× |
| Esophageal motility (78258) |
$502.50 |
$1,005 |
1.1× |
| Esophagus (74220) |
$424 |
$848 |
2.0× |
| Fetal biophysical profile non-stress testing (76818) |
$177.50 |
$355 |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$710.50 |
$1,421 |
2.5× |
| Foot 2 views (73620) |
$424 |
$848 |
4.1× |
| Forearm 2 views (73090) |
$291.50 |
$583 |
2.8× |
| Functional MRI brain by phys/psych (70555) |
$2,565 |
$5,130 |
9.1× |
| Functional MRI brain by tech (70554) |
$3,174 |
$6,348 |
11.3× |
| Gated Heart Planar Single (78472) |
$987 |
$1,974 |
2.1× |
| Hand 2 views (73120) |
$326.50 |
$653 |
2.6× |
| Hand 3 views (73130) |
$320 |
$640 |
3.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,690 |
$3,380 |
2.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,934.50 |
$7,869 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,679.50 |
$3,359 |
3.6× |
| Ht muscle image spect sing (78451) |
$1,924 |
$3,848 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$303.50 |
$607 |
3.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$161.50 |
$323 |
1.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$707 |
$1,414 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$978 |
$1,956 |
1.5× |
| Knee 3 views (73562) |
$405.50 |
$811 |
3.9× |
| Liver & spleen imaging static only (78215) |
$1,046.50 |
$2,093 |
2.2× |
| Lung Ventilation Imaging (78579) |
$1,109 |
$2,218 |
2.3× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$3,934.50 |
$7,869 |
1.1× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$981 |
$1,962 |
1.3× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$2,536 |
$5,072 |
1.4× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$3,934.50 |
$7,869 |
1.1× |
| Lymphoscintigraphy (78195) |
$673 |
$1,346 |
1.0× |
| Meckels Diverticulum (78290) |
$1,837.50 |
$3,675 |
3.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,752.50 |
$3,505 |
4.0× |
| Mr elastography (76391) |
$363 |
$726 |
1.3× |
| Mr safety determination physician/other qhp (76016) |
$116.50 |
$233 |
1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$33 |
$66 |
1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$173.50 |
$347 |
1.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$370.50 |
$741 |
1.3× |
| MRA head w & w/o contrast (70546) |
$1,903.50 |
$3,807 |
4.6× |
| MRA head w/o contrast (70544) |
$1,417 |
$2,834 |
5.0× |
| MRA head with contrast (70545) |
$1,193 |
$2,386 |
2.9× |
| MRA neck w contrast (70548) |
$1,131 |
$2,262 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,483.50 |
$2,967 |
3.6× |
| MRA neck w/o contrast (70547) |
$1,181 |
$2,362 |
4.2× |
| MRI abdomen w contrast (74182) |
$2,246.50 |
$4,493 |
5.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,828 |
$5,656 |
6.9× |
| MRI abdomen w/o contrast (74181) |
$2,032.50 |
$4,065 |
7.2× |
| MRI any jnt lwr ext with con lt (73722) |
$2,682 |
$5,364 |
2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,125 |
$4,250 |
2.3× |
| MRI bone marrow blood supply (77084) |
$2,154 |
$4,308 |
7.6× |
| MRI c-spine with contrast (72142) |
$2,029 |
$4,058 |
4.9× |
| MRI cardiac w/o cont stress (75559) |
$1,987 |
$3,974 |
3.1× |
| MRI cardiac w/o contrast (75557) |
$2,381.50 |
$4,763 |
8.4× |
| MRI cervical spine w/o contrast (72141) |
$2,030 |
$4,060 |
7.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,448 |
$4,896 |
5.9× |
| MRI chest w/o contrast (71550) |
$2,183.50 |
$4,367 |
7.7× |
| MRI chest with contrast (71551) |
$988 |
$1,976 |
1.1× |
| MRI fetal sngl/1st gestation (74712) |
$2,992 |
$5,984 |
10.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,058 |
$4,116 |
5.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,722.50 |
$7,445 |
9.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,156.50 |
$4,313 |
7.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,003.50 |
$4,007 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,635 |
$7,270 |
8.8× |
| MRI orbit/face/neck w/contrast (70542) |
$2,668 |
$5,336 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,027.50 |
$4,055 |
4.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,828 |
$5,656 |
6.9× |
| MRI pelvis w/o contrast (72195) |
$2,166.50 |
$4,333 |
7.7× |
| MRI scan of arm joint before and after contrast (73223) |
$2,300.50 |
$4,601 |
5.6× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,289 |
$4,578 |
2.5× |
| MRI scan of leg joint before and after contrast (73723) |
$3,320 |
$6,640 |
8.1× |
| MRI spectroscopy (76390) |
$2,117 |
$4,234 |
20.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,936 |
$7,872 |
9.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,029 |
$4,058 |
4.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,211 |
$6,422 |
7.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,029 |
$4,058 |
4.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,549 |
$7,098 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,953 |
$3,906 |
6.9× |
| MRI tmj (70336) |
$2,040 |
$4,080 |
7.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,183.50 |
$4,367 |
7.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,448 |
$4,896 |
5.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,173.50 |
$4,347 |
7.7× |
| Myelogram Cervical (72240) |
$988 |
$1,976 |
1.1× |
| Myelogram Lumbar (72265) |
$988 |
$1,976 |
1.1× |
| Myelogram thoracic (72255) |
$988 |
$1,976 |
1.1× |
| Myelography 2 or more regions (72270) |
$988 |
$1,976 |
1.1× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,369 |
$2,738 |
1.3× |
| Neck soft tissue (70360) |
$285.50 |
$571 |
2.8× |
| Nm cisternogram (78630) |
$1,691.50 |
$3,383 |
2.6× |
| Nm csf leak detection (78650) |
$1,924 |
$3,848 |
1.3× |
| Nm gastric emptying study (78264) |
$1,358 |
$2,716 |
2.9× |
| Nm gastroesophageal reflux study (78262) |
$710 |
$1,420 |
1.5× |
| Nm peritoneal-venous shunt patency (78291) |
$927.50 |
$1,855 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,211 |
$10,422 |
3.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,848 |
$3,696 |
3.9× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,351.50 |
$2,703 |
2.9× |
| Nuclear Rx Oral Admin (79005) |
$1,507.50 |
$3,015 |
5.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$258 |
$516 |
2.1× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$262.50 |
$525 |
1.7× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$161.50 |
$323 |
1.3× |
| Osseous survey infant (77076) |
$556.50 |
$1,113 |
4.5× |
| Osseous survey limited (77074) |
$251 |
$502 |
2.0× |
| Parathyrd planar w/spect&CT (78072) |
$924 |
$1,848 |
1.4× |
| Parathyroid imaging (78070) |
$713 |
$1,426 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$289 |
$578 |
2.3× |
| Perineogram (74775) |
$363 |
$726 |
1.3× |
| Peritoneogram rs&i (74190) |
$685.50 |
$1,371 |
1.1× |
| PET image w/CT, skull-thigh (78815) |
$5,007.50 |
$10,015 |
3.0× |
| PET imaging CT for attenuation limited area (78814) |
$3,678.50 |
$7,357 |
2.2× |
| PET imaging for CT attenuation whole body (78816) |
$6,181 |
$12,362 |
3.7× |
| Pr MRI brain w/ dye (70558) |
$3,122.50 |
$6,245 |
15.1× |
| Pr MRI brain w/o & w/ dye (70559) |
$4,993 |
$9,986 |
24.1× |
| Pr MRI brain w/o dye (70557) |
$2,461 |
$4,922 |
3.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,151 |
$4,302 |
5.2× |
| Proton trmt simple w/comp (77522) |
$5,510.50 |
$11,021 |
3.7× |
| Proton tx delivery complex (77525) |
$7,613.50 |
$15,227 |
5.2× |
| Proton tx delivery intermediate (77523) |
$5,510.50 |
$11,021 |
3.7× |
| Proton tx delivery simple w/o compensation (77520) |
$2,308 |
$4,616 |
3.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,934.50 |
$7,869 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,934.50 |
$7,869 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,156 |
$2,312 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$749.50 |
$1,499 |
1.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$547 |
$1,094 |
5.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$609 |
$1,218 |
4.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$437.50 |
$875 |
3.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$249.50 |
$499 |
2.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$797.50 |
$1,595 |
6.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,051.50 |
$22,103 |
1.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$389.50 |
$779 |
0.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$298 |
$596 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$460 |
$920 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$278.50 |
$557 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$797.50 |
$1,595 |
6.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$283.50 |
$567 |
2.8× |
| Radiologic exam colon single contrast study (74270) |
$719 |
$1,438 |
3.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$295 |
$590 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$481.50 |
$963 |
2.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$763 |
$1,526 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$393.50 |
$787 |
3.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,934.50 |
$7,869 |
1.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,934.50 |
$7,869 |
1.1× |
| Ribs bilateral 3 views (71110) |
$369 |
$738 |
3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$676.50 |
$1,353 |
1.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,564.50 |
$7,129 |
5.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,038 |
$4,076 |
3.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,823.50 |
$3,647 |
1.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,858 |
$3,716 |
1.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$373.50 |
$747 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$1,497 |
$2,994 |
5.4× |
| Sacroiliac Joints < 3 Views (72200) |
$198.50 |
$397 |
1.6× |
| Salivary gland imaging (78230) |
$502.50 |
$1,005 |
1.1× |
| Scanogram (77073) |
$466 |
$932 |
3.8× |
| Scapula complete (73010) |
$314.50 |
$629 |
2.5× |
| Sella turcica (70240) |
$136.50 |
$273 |
1.3× |
| Sialogram (70390) |
$363 |
$726 |
1.3× |
| Small bowel series (74250) |
$364 |
$728 |
1.8× |
| Spec medical radj physics consltj (77370) |
$1,246 |
$2,492 |
7.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$920 |
$1,840 |
2.1× |
| Special dosimetry (77331) |
$1,032.50 |
$2,065 |
6.5× |
| Special treatment procedure (77470) |
$1,445.50 |
$2,891 |
2.2× |
| Speech evaluation complex (70371) |
$624.50 |
$1,249 |
2.2× |
| Spine thoracic 3 views (72072) |
$443 |
$886 |
3.6× |
| Spleen imaging only (78185) |
$859 |
$1,718 |
1.8× |
| Splenoportograpy rs&i (75810) |
$3,934.50 |
$7,869 |
1.1× |
| Stereotactic body radiation delivery (77373) |
$4,843 |
$9,686 |
2.3× |
| Superior sagittal sinus venogram (75870) |
$3,934.50 |
$7,869 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,397 |
$2,794 |
3.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,014 |
$2,028 |
2.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$766.50 |
$1,533 |
2.7× |
| Testicular Imaging With Vascular Flow (78761) |
$1,246.50 |
$2,493 |
2.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,659.50 |
$7,319 |
8.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,218.50 |
$4,437 |
14.0× |
| Therapeutic Enema (74283) |
$432.50 |
$865 |
2.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$761.50 |
$1,523 |
1.2× |
| Thyroid uptake measurement (78012) |
$735 |
$1,470 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$502.50 |
$1,005 |
1.1× |
| Tmj unilateral (70328) |
$206.50 |
$413 |
2.0× |
| Treatment device intermediate (77333) |
$847 |
$1,694 |
5.3× |
| Treatment devices simple (77332) |
$427.50 |
$855 |
2.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,165.50 |
$6,331 |
4.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$590.50 |
$1,181 |
1.3× |
| Tx devices design & construction complex (77334) |
$984.50 |
$1,969 |
2.2× |
| Ultrasound elastography first target lesion (76982) |
$202.50 |
$405 |
1.6× |
| Ultrasound scan of cornea to determine thickness (76514) |
$42 |
$84 |
1.2× |
| Ultrasound scan to determine eye length and lens power (76519) |
$329.50 |
$659 |
2.7× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$285 |
$570 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$627 |
$1,254 |
5.1× |
| Umbilical-artery Doppler (OB) (76820) |
$324 |
$648 |
2.6× |
| Unlisted magnetic resonance procedure (76498) |
$1,470.50 |
$2,941 |
14.3× |
| Upper Extremity Infant (73092) |
$324.50 |
$649 |
2.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,057 |
$2,114 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$339.50 |
$679 |
1.2× |
| Urethrocystography voiding (74455) |
$757.50 |
$1,515 |
2.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$392.50 |
$785 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$606.50 |
$1,213 |
4.9× |
| Us breast unilateral complete (76641) |
$640 |
$1,280 |
5.2× |
| Us breast unilateral limited (76642) |
$596 |
$1,192 |
5.8× |
| Us chest (76604) |
$640 |
$1,280 |
5.2× |
| Us compl joint r-t w/image documentation (76881) |
$616 |
$1,232 |
5.0× |
| Us elastography parenchyma (76981) |
$203.50 |
$407 |
1.6× |
| Us infant hips dynamic (76885) |
$911.50 |
$1,823 |
8.9× |
| Us kidney transplant (76776) |
$403.50 |
$807 |
3.3× |
| Us ob detailed single fetus (76811) |
$694.50 |
$1,389 |
2.5× |
| Us ob transvaginal (76817) |
$557.50 |
$1,115 |
4.5× |
| Us pelvic non ob complete (76856) |
$658 |
$1,316 |
5.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$564.50 |
$1,129 |
4.6× |
| Us pregnancy ltd (76815) |
$622 |
$1,244 |
5.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$669.50 |
$1,339 |
5.4× |
| Us retroperitoneal complete (76770) |
$740.50 |
$1,481 |
6.0× |
| Us retroperitoneal limited (76775) |
$649.50 |
$1,299 |
5.3× |
| Us scrotum and contents (76870) |
$540.50 |
$1,081 |
4.4× |
| Us soft tissue head/neck (76536) |
$706 |
$1,412 |
5.7× |
| Us spinal canal and contents (76800) |
$666.50 |
$1,333 |
5.4× |
| Us xtr non-vasc lmtd (76882) |
$631.50 |
$1,263 |
5.1× |
| Us, eye b-scan (76512) |
$396 |
$792 |
3.2× |
| Venogram extremity bilateral (75822) |
$2,536 |
$5,072 |
1.4× |
| Venogram orbital (75880) |
$981 |
$1,962 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$3,934.50 |
$7,869 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$1,942 |
$3,884 |
1.0× |
| Venography epidural rs&i (75872) |
$981 |
$1,962 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,942 |
$3,884 |
1.0× |
| Venography Renal Bilateral (75833) |
$3,934.50 |
$7,869 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$3,934.50 |
$7,869 |
1.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,934.50 |
$7,869 |
1.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$6,757.50 |
$13,515 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$154.50 |
$309 |
1.5× |
| Wrist 2 views (73100) |
$308 |
$616 |
3.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$314 |
$628 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$267 |
$534 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$353 |
$706 |
3.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,252.50 |
$2,505 |
6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$295 |
$590 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$329.50 |
$659 |
3.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$833.50 |
$1,667 |
6.7× |
| X-ray exam hip uni 1 view (73501) |
$291 |
$582 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$348.50 |
$697 |
3.4× |
| X-ray exam hip uni 4/> views (73503) |
$723 |
$1,446 |
5.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$576 |
$1,152 |
4.7× |
| X-ray exam of femur 1 (73551) |
$349.50 |
$699 |
3.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$553 |
$1,106 |
2.7× |
| X-ray eye for foreign body (70030) |
$397 |
$794 |
3.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$530 |
$1,060 |
4.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$521 |
$1,042 |
5.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$330.50 |
$661 |
3.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,561 |
$5,122 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$316 |
$632 |
3.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$289.50 |
$579 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$424.50 |
$849 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$276 |
$552 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$326.50 |
$653 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$364 |
$728 |
2.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$724.50 |
$1,449 |
5.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$407 |
$814 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$335 |
$670 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$256 |
$512 |
2.5× |
| X-ray of voice box or throat (70370) |
$295.50 |
$591 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$452.50 |
$905 |
3.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$315 |
$630 |
2.6× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$685.50 |
$1,371 |
1.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$543 |
$1,086 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$290.50 |
$581 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$402.50 |
$805 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$633.50 |
$1,267 |
5.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$201 |
$402 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$324 |
$648 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$347.50 |
$695 |
3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$445 |
$890 |
4.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$399 |
$798 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$435 |
$870 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$336 |
$672 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$285 |
$570 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$134 |
$268 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$257.50 |
$515 |
2.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$401 |
$802 |
3.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$457 |
$914 |
3.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$282.50 |
$565 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$335.50 |
$671 |
3.3× |
| Xr arthrogram ankle (73615) |
$595 |
$1,190 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$161.50 |
$323 |
1.3× |
| Xr chest 4+ views (71048) |
$432.50 |
$865 |
3.5× |
| Xr Cholecystography Oral Contrast (74290) |
$264.50 |
$529 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$254 |
$508 |
2.5× |
| Xr internal auditory meati complete (70134) |
$685.50 |
$1,371 |
1.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$161.50 |
$323 |
1.3× |
| Xr myelogram posterior fossa (70010) |
$652 |
$1,304 |
1.6× |
| Xr shoulder 1 view (73020) |
$261.50 |
$523 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$457 |
$914 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$382 |
$764 |
3.7× |
| Xr tmj bilateral (70330) |
$255 |
$510 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$292.50 |
$585 |
2.8× |