| 3-D radiotherapy plan dose-volume histograms (77295) |
$9,427.20 |
$11,784 |
5.3× |
| Abdomen 1 View (74018) |
$412.80 |
$516 |
3.7× |
| Abdomen 2 views (74019) |
$692.80 |
$866 |
5.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,432.80 |
$3,041 |
4.7× |
| Angio internal mammary (75756) |
$10,567.20 |
$13,209 |
2.6× |
| Angio pulmonary bilat (75743) |
$5,488 |
$6,860 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$7,012 |
$8,765 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$5,932 |
$7,415 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$9,405.20 |
$11,756.50 |
2.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$9,405.20 |
$11,756.50 |
2.3× |
| Ankle 2 views (73600) |
$562.40 |
$703 |
5.0× |
| Aortography thoracic serialography rs&i (75605) |
$6,156.80 |
$7,696 |
0.9× |
| Aortography thoracic w/o serialography rs&i (75600) |
$9,405.20 |
$11,756.50 |
2.3× |
| Artery X-Rays Abdomen (75726) |
$11,631.20 |
$14,539 |
1.6× |
| Artery X-Rays Adrenal Gland (75731) |
$9,405.20 |
$11,756.50 |
2.3× |
| Artery X-Rays Pelvis (75736) |
$16,215.20 |
$20,269 |
2.3× |
| Artery X-Rays Spine (75705) |
$11,631.20 |
$14,539 |
1.6× |
| Arthrogram ankle (73615) |
$2,198.40 |
$2,748 |
4.9× |
| Arthrogram hip (73525) |
$2,020.80 |
$2,526 |
4.5× |
| Arthrogram Wrist (73115) |
$1,134.40 |
$1,418 |
2.5× |
| Basic radiation dosimetry calculation (77300) |
$1,122.40 |
$1,403 |
6.5× |
| Bone age studies (77072) |
$561.60 |
$702 |
4.2× |
| Bone Imaging 3 Phase (78315) |
$3,531.20 |
$4,414 |
6.9× |
| Bone Imaging Limited Area (78300) |
$2,096.80 |
$2,621 |
4.1× |
| Bone Imaging Whole Body (78306) |
$3,568.80 |
$4,461 |
6.9× |
| Bone marrow imaging; whole body (78104) |
$1,520 |
$1,900 |
3.0× |
| Bone survey infant (77076) |
$324.40 |
$405.50 |
2.4× |
| Brachytx isodose complex (77318) |
$2,719.20 |
$3,399 |
5.6× |
| Brachytx isodose intermed (77317) |
$2,240 |
$2,800 |
4.7× |
| Brachytx Isodose Plan Simple (77316) |
$1,760 |
$2,200 |
3.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,368 |
$2,960 |
3.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,720 |
$8,400 |
3.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,501.60 |
$5,627 |
10.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$4,759.20 |
$5,949 |
4.7× |
| Cat Scan Follow-Up Study (76380) |
$456.80 |
$571 |
4.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,594.86 |
$1,993.57 |
2.3× |
| Cerebrospinal Fluid Scan (78630) |
$1,954.40 |
$2,443 |
2.8× |
| Chest 1 view (71045) |
$352 |
$440 |
3.1× |
| Chest 2 views (71046) |
$477.60 |
$597 |
4.3× |
| Chest 3 views (71047) |
$526.40 |
$658 |
4.7× |
| Chest 4 or more views (71048) |
$568 |
$710 |
4.2× |
| Clavicle complete (73000) |
$644 |
$805 |
5.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$433.60 |
$542 |
3.2× |
| Continuing medical physics consltj pr wk (77336) |
$1,338.40 |
$1,673 |
7.7× |
| Contrast Exam Abdominl Aorta (75625) |
$9,404.80 |
$11,756 |
2.3× |
| Contrast X-Ray Bladder (74430) |
$1,027.20 |
$1,284 |
2.3× |
| Contrast X-Ray Of Elbow (73085) |
$1,134.40 |
$1,418 |
2.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,134.40 |
$1,418 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,503.20 |
$8,129 |
14.5× |
| CT abdomen and pelvis without contrast (74176) |
$4,040.80 |
$5,051 |
13.2× |
| CT abdomen w contrast (74160) |
$4,666.40 |
$5,833 |
20.7× |
| CT abdomen w wo contrast (74170) |
$3,499.20 |
$4,374 |
15.5× |
| CT abdomen w/o contrast (74150) |
$2,547.20 |
$3,184 |
18.9× |
| CT Angio Abdomen and Pelvis (74174) |
$6,279.20 |
$7,849 |
14.0× |
| CT Angio Chest (71275) |
$4,000 |
$5,000 |
17.7× |
| CT Angio Head (70496) |
$3,840 |
$4,800 |
17.0× |
| CT angio hrt w/3d image (75574) |
$3,948.80 |
$4,936 |
8.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$5,011.20 |
$6,264 |
22.2× |
| CT Angio Neck (70498) |
$3,760 |
$4,700 |
16.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$4,236 |
$5,295 |
18.8× |
| CT cervical spine w/ contrast (72126) |
$3,558.40 |
$4,448 |
7.9× |
| CT cervical spine w/o contrast (72125) |
$3,360 |
$4,200 |
25.0× |
| CT cervical spine w/wo cont (72127) |
$4,076.80 |
$5,096 |
18.1× |
| CT chest w contrast (71260) |
$3,600 |
$4,500 |
16.0× |
| CT chest w/wo contrast (71270) |
$4,157.60 |
$5,197 |
18.4× |
| CT head/brain with contrast (70460) |
$2,400 |
$3,000 |
10.6× |
| CT head/brain without and with contrast (70470) |
$3,866.40 |
$4,833 |
17.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,937.60 |
$3,672 |
6.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$672.80 |
$841 |
6.0× |
| CT iac w contrast (70481) |
$4,150.40 |
$5,188 |
18.4× |
| CT l-spine w&w/o contrast (72133) |
$5,068.80 |
$6,336 |
22.5× |
| CT lower ext w/o (73700) |
$3,192 |
$3,990 |
23.7× |
| CT lower extremity w/contrast material (73701) |
$3,892.80 |
$4,866 |
17.3× |
| CT lumbar spine w contrast (72132) |
$3,923.20 |
$4,904 |
8.7× |
| CT lumbar spine w/o contrast (72131) |
$3,000 |
$3,750 |
22.3× |
| CT maxillofacial w contrast (70487) |
$3,306.40 |
$4,133 |
14.7× |
| CT maxillofacial wo contrast (70486) |
$2,800 |
$3,500 |
20.8× |
| CT neck tissue combo (70492) |
$3,336 |
$4,170 |
14.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$4,004 |
$5,005 |
17.7× |
| CT orbits w/o contrast (70480) |
$3,468.80 |
$4,336 |
25.8× |
| CT pelvis w&w/o contrast (72194) |
$1,746.40 |
$2,183 |
7.7× |
| CT pelvis w/o contrast (72192) |
$3,365.60 |
$4,207 |
25.0× |
| CT scan of leg combo (73702) |
$5,649.60 |
$7,062 |
25.0× |
| CT scans face/jaw combo (70488) |
$3,346.40 |
$4,183 |
14.8× |
| CT soft tissue neck w contrast (70491) |
$3,147.20 |
$3,934 |
14.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,777.60 |
$3,472 |
20.7× |
| CT thoracic spine w contrast (72129) |
$3,737.60 |
$4,672 |
16.6× |
| CT thoracic spine w/o contrast (72128) |
$3,342.40 |
$4,178 |
24.9× |
| CT thoracic spine w/wo cont (72130) |
$6,168.80 |
$7,711 |
27.3× |
| CT thorax w/o contrast (71250) |
$2,458.40 |
$3,073 |
18.3× |
| CT upper ext wo (73200) |
$3,198.40 |
$3,998 |
23.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$4,822.40 |
$6,028 |
21.4× |
| CT upper extremity with contrast (73201) |
$3,074.40 |
$3,843 |
6.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,096.80 |
$5,121 |
18.2× |
| Cta Abdomen (74175) |
$3,583.20 |
$4,479 |
15.9× |
| CTA pelvis (72191) |
$3,680 |
$4,600 |
16.3× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$979.20 |
$1,224 |
3.2× |
| Dilation ureters/urethra rs&i (74485) |
$6,009.60 |
$7,512 |
2.2× |
| Discography Cerv/Thor Spine (72285) |
$5,696.80 |
$7,121 |
2.3× |
| Diskography lumbar (72295) |
$6,728 |
$8,410 |
2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$456.80 |
$571 |
3.4× |
| Dxa Bone Density Axial (77080) |
$481.60 |
$602 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$454.40 |
$568 |
4.1× |
| Echo exam of fetal heart (76825) |
$1,878.40 |
$2,348 |
2.7× |
| Echo exam uterus (76831) |
$927.20 |
$1,159 |
3.0× |
| Echo Guide For Artery Repair (76936) |
$924 |
$1,155 |
3.3× |
| Echograp Trans R Pros Study (76873) |
$617.60 |
$772 |
4.6× |
| Esophagram (74220) |
$1,085.60 |
$1,357 |
4.8× |
| Fetal Biophys Profile W/Nst (76818) |
$320.80 |
$401 |
2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,089.60 |
$1,362 |
8.1× |
| Fluoroscopy up to 1 hr (76000) |
$702.40 |
$878 |
2.3× |
| Follow-Up Angiography (75898) |
$9,404.80 |
$11,756 |
2.3× |
| Foot 2 views (73620) |
$541.60 |
$677 |
4.8× |
| Forearm 2 views (73090) |
$486.40 |
$608 |
4.3× |
| Gastric emptying imaging study (78264) |
$2,976 |
$3,720 |
5.8× |
| Gastroesophageal Reflux Exam (78262) |
$1,250.40 |
$1,563 |
2.4× |
| Gated Heart Planar Single (78472) |
$1,216.98 |
$1,521.22 |
2.4× |
| Hand 2 views (73120) |
$396.80 |
$496 |
3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$6,812 |
$8,515 |
7.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$6,292.80 |
$7,866 |
7.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$5,032 |
$6,290 |
5.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$9,405.20 |
$11,756.50 |
2.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$7,539.20 |
$9,424 |
1.9× |
| Hepatobil Syst Image W/Drug (78227) |
$2,574.40 |
$3,218 |
3.7× |
| Hepatobiliary System Imaging (78226) |
$2,352.80 |
$2,941 |
4.6× |
| Ht Muscle Image Spect Sing (78451) |
$4,456.80 |
$5,571 |
2.7× |
| Hysterosalpingogram (74740) |
$896.80 |
$1,121 |
2.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$890.40 |
$1,113 |
8.0× |
| Infant hip ultrasound, limited static exam (76886) |
$268 |
$335 |
2.4× |
| Infusion Ivp (74410) |
$542.40 |
$678 |
2.4× |
| Interstitial radiation source applic complex (77778) |
$5,149.60 |
$6,437 |
5.7× |
| Joint Survey Single View (77077) |
$236 |
$295 |
1.8× |
| K Flow/Funct Image Multiple (78709) |
$2,400 |
$3,000 |
3.4× |
| Knee 3 Views (73562) |
$564.80 |
$706 |
5.0× |
| Leveen/Shunt Patency Exam (78291) |
$1,398.40 |
$1,748 |
2.7× |
| Liver & Spleen Imaging Static Only (78215) |
$1,692 |
$2,115 |
3.3× |
| Liver imaging static only (78201) |
$1,460 |
$1,825 |
2.1× |
| Lung Perf&Ventilat Diferentl (78598) |
$3,456 |
$4,320 |
4.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$3,512.80 |
$4,391 |
5.0× |
| Lung Ventilation Imaging (78579) |
$5,030.40 |
$6,288 |
9.8× |
| Lymph System Imaging (78195) |
$3,605.60 |
$4,507 |
5.2× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$9,404.80 |
$11,756 |
2.3× |
| Magnetic Image Jaw Joint (70336) |
$5,249.60 |
$6,562 |
17.1× |
| Mammary ductogram or galactogram multiple (77054) |
$1,267.20 |
$1,584 |
4.1× |
| Mammary ductogram or galactogram single (77053) |
$1,140 |
$1,425 |
3.7× |
| Meckels Divert Exam (78290) |
$3,192 |
$3,990 |
6.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,214.40 |
$4,018 |
6.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,397.60 |
$4,247 |
7.6× |
| MRA head w/o contrast (70544) |
$3,598.40 |
$4,498 |
11.7× |
| MRA head with contrast (70545) |
$5,393.60 |
$6,742 |
12.0× |
| MRA neck w contrast (70548) |
$5,551.20 |
$6,939 |
12.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$8,256.80 |
$10,321 |
18.4× |
| MRA neck w/o contrast (70547) |
$3,860 |
$4,825 |
12.6× |
| MRI abdomen w contrast (74182) |
$4,872.80 |
$6,091 |
10.9× |
| MRI abdomen w/o contrast (74181) |
$3,978.40 |
$4,973 |
13.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,708 |
$5,885 |
4.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$6,650.40 |
$8,313 |
14.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,260.80 |
$5,326 |
4.2× |
| MRI brain functional w/o physician admnistration (70554) |
$3,764.80 |
$4,706 |
12.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,160.80 |
$3,951 |
10.3× |
| MRI cardiac w/o contrast (75557) |
$6,379.20 |
$7,974 |
20.8× |
| MRI cervical spine w contrast (72142) |
$5,806.40 |
$7,258 |
12.9× |
| MRI cervical spine w/o cont (72141) |
$4,432.80 |
$5,541 |
14.4× |
| MRI chest w/o contrast (71550) |
$4,798.40 |
$5,998 |
15.6× |
| MRI chest with contrast (71551) |
$8,038.40 |
$10,048 |
8.0× |
| MRI chest wo w contrast (71552) |
$9,488.80 |
$11,861 |
21.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,401.60 |
$3,002 |
5.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,597.60 |
$6,997 |
12.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,044.80 |
$5,056 |
13.2× |
| MRI lumbar spine w contrast (72149) |
$5,844.80 |
$7,306 |
13.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$7,256.80 |
$9,071 |
16.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,625.60 |
$5,782 |
15.1× |
| MRI orbit face neck w contrast (70542) |
$2,061.60 |
$2,577 |
4.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$8,189.60 |
$10,237 |
18.3× |
| MRI pelvis w contrast (72196) |
$5,539.20 |
$6,924 |
12.3× |
| MRI pelvis w/o & w contrast (72197) |
$7,278.40 |
$9,098 |
16.2× |
| MRI pelvis w/o contrast (72195) |
$4,929.60 |
$6,162 |
16.1× |
| MRI spectroscopy (76390) |
$2,591.20 |
$3,239 |
23.2× |
| MRI thoracic spine w/o contrast (72146) |
$4,182.40 |
$5,228 |
13.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$4,323.20 |
$5,404 |
9.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,689.60 |
$4,612 |
12.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$5,884.80 |
$7,356 |
13.1× |
| MRI, abdomen, combo (74183) |
$5,413.60 |
$6,767 |
12.1× |
| MRI, dorsal spine combo (72157) |
$7,524.80 |
$9,406 |
16.8× |
| MRI, dorsal spine contrast (72147) |
$5,556 |
$6,945 |
12.4× |
| MRI, joint upper extrem (73221) |
$4,378.40 |
$5,473 |
14.3× |
| MRI, joint upper extrem combo (73223) |
$6,653.60 |
$8,317 |
14.8× |
| MRI, lumbar spine combo (72158) |
$6,685.60 |
$8,357 |
14.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,211.20 |
$6,514 |
3.1× |
| Myocardial Spect Multiple Studies (78452) |
$6,092.80 |
$7,616 |
3.7× |
| Neck soft tissue (70360) |
$490.40 |
$613 |
4.4× |
| Nervous system nuclear exam (78699) |
$1,216.80 |
$1,521 |
2.4× |
| Nm csf leak detection (78650) |
$3,907.20 |
$4,884 |
2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$13,427.20 |
$16,784 |
7.5× |
| Nuclear Rx Intra-Arterial (79445) |
$1,111.20 |
$1,389 |
3.7× |
| Nuclear Rx Oral Admin (79005) |
$2,240 |
$2,800 |
7.5× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$431.20 |
$539 |
3.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$415.20 |
$519 |
3.1× |
| Panoramic X-ray of jaws (70355) |
$564 |
$705 |
5.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,405.60 |
$3,007 |
3.4× |
| Parathyroid Planar Imaging (78070) |
$1,998.40 |
$2,498 |
3.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,216.98 |
$1,521.22 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$544.80 |
$681 |
4.1× |
| Peritoneogram Rs&I (74190) |
$2,367.20 |
$2,959 |
3.4× |
| Pet Image Skull-Thigh (78812) |
$6,859.20 |
$8,574 |
3.7× |
| Pet Image W/Ct Lmtd (78814) |
$8,364 |
$10,455 |
4.5× |
| PET image w/CT, full body (78816) |
$11,712 |
$14,640 |
6.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$8,000 |
$10,000 |
4.3× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$5,630.40 |
$7,038 |
3.4× |
| PET whole body (78813) |
$7,721.60 |
$9,652 |
4.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,360.80 |
$6,701 |
1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,971.20 |
$2,464 |
3.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$637.60 |
$797 |
4.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,627.80 |
$2,034.75 |
2.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$624 |
$780 |
5.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$458.40 |
$573 |
4.1× |
| Radex elbow complete minimum 3 views (73080) |
$624 |
$780 |
5.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$728 |
$910 |
5.4× |
| Radex fingr minimum 2 views (73140) |
$412.80 |
$516 |
3.7× |
| Radex foot complete minimum 3 views (73630) |
$640 |
$800 |
5.7× |
| Radex Hand Minimum 3 Views (73130) |
$530.40 |
$663 |
4.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$268 |
$335 |
2.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$528.80 |
$661 |
3.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$672 |
$840 |
6.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$629.60 |
$787 |
5.6× |
| Radex shoulder complete minimum 2 views (73030) |
$673.60 |
$842 |
6.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$447.20 |
$559 |
4.0× |
| Radex Spine 1 View Specify Level (72020) |
$516 |
$645 |
4.6× |
| Radex Sternum Minimum 2 Views (71120) |
$528 |
$660 |
4.7× |
| Radex Toe Minimum 2 Views (73660) |
$446.40 |
$558 |
4.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$324.40 |
$405.50 |
2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$620.80 |
$776 |
5.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,405.60 |
$1,757 |
10.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$31,654.40 |
$39,568 |
3.3× |
| Radiation treatment delivery level 1 (77402) |
$875.20 |
$1,094 |
6.7× |
| Radiation treatment delivery level 2 (77407) |
$1,040 |
$1,300 |
2.1× |
| Radiation treatment delivery level 3 (77412) |
$1,782.40 |
$2,228 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$577.60 |
$722 |
4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$937.60 |
$1,172 |
7.0× |
| Radiologic exam colon double contrast study (74280) |
$908 |
$1,135 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$1,132 |
$1,415 |
5.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$891.20 |
$1,114 |
4.0× |
| Radiologic exam knee complete 4/more views (73564) |
$522.40 |
$653 |
3.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$626.40 |
$783 |
4.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,032 |
$1,290 |
4.6× |
| Radiologic exam swallow function contrast study (74230) |
$889.60 |
$1,112 |
3.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$908.80 |
$1,136 |
4.0× |
| Radiologic examination femur 1 view (73551) |
$422.40 |
$528 |
3.8× |
| Radiologic examination femur minimum 2 views (73552) |
$368.80 |
$461 |
3.3× |
| Radiologic examination knee 1/2 views (73560) |
$416 |
$520 |
3.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$423.20 |
$529 |
3.8× |
| Ribs bilateral 3 views (71110) |
$684 |
$855 |
5.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,491.20 |
$1,864 |
2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,189.60 |
$5,237 |
6.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$9,258.40 |
$11,573 |
13.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$4,000 |
$5,000 |
5.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,749.60 |
$4,687 |
2.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,184 |
$1,480 |
3.9× |
| Rp Therapy Intravenous Administration (79101) |
$1,554.40 |
$1,943 |
5.2× |
| Scapula (73010) |
$741.60 |
$927 |
5.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$136 |
$170 |
5.8× |
| Shoulder 1 view (73020) |
$678.40 |
$848 |
6.1× |
| Shoulder Arthrography (73040) |
$2,880 |
$3,600 |
6.4× |
| Skull less than 4 views (70250) |
$566.40 |
$708 |
4.2× |
| Special dosimetry (77331) |
$1,176 |
$1,470 |
6.8× |
| Special Physics Consult (77370) |
$1,812.80 |
$2,266 |
10.5× |
| Special teletherapy port plan (77321) |
$2,627.20 |
$3,284 |
5.5× |
| Special treatment procedure (77470) |
$3,730.40 |
$4,663 |
5.2× |
| Stereotactic Body Radiation Delivery (77373) |
$15,596.80 |
$19,496 |
6.8× |
| Sternoclavicular joints (71130) |
$632 |
$790 |
5.6× |
| Superior sagittal sinus venogram (75870) |
$9,404.80 |
$11,756 |
2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$4,458.40 |
$5,573 |
9.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,463.20 |
$1,829 |
3.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$4,128.80 |
$5,161 |
8.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,733.60 |
$3,417 |
5.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,115.20 |
$2,644 |
12.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$2,818.40 |
$3,523 |
12.5× |
| Thoracic spine 2 views (72070) |
$588.80 |
$736 |
4.4× |
| Thoracic spine 3 views (72072) |
$605.60 |
$757 |
4.5× |
| Thoracolumbar 2 views (72080) |
$577.60 |
$722 |
5.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,216.80 |
$1,521 |
2.4× |
| Thyroid Met Imaging Body (78018) |
$3,743.20 |
$4,679 |
5.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,756.80 |
$2,196 |
3.4× |
| Tx Devices Design & Construction Complex (77334) |
$2,164.80 |
$2,706 |
4.5× |
| Tx devices design & construction intermediate (77333) |
$1,256.80 |
$1,571 |
7.3× |
| Tx devices design & construction simple (77332) |
$976.80 |
$1,221 |
5.7× |
| Ultrasound Breast Limited (76642) |
$604.80 |
$756 |
5.4× |
| Ultrasound Exam Aaa Screen (76706) |
$588.80 |
$736 |
4.4× |
| Ultrasound, abdomen limited (76705) |
$992 |
$1,240 |
7.4× |
| Umbilical-artery Doppler (OB) (76820) |
$760.80 |
$951 |
5.7× |
| Unlisted fluoroscopic procedure (76496) |
$11,631.20 |
$14,539 |
103.9× |
| Unlisted magnetic resonance procedure (76498) |
$3,998.40 |
$4,998 |
35.7× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$1,336.80 |
$1,671 |
2.6× |
| Unlisted us procedure (76999) |
$697.60 |
$872 |
6.2× |
| Upper gi w/o kub (74240) |
$1,013.60 |
$1,267 |
4.5× |
| Ureteral Reflux Study (78740) |
$1,216.80 |
$1,521 |
2.4× |
| Urethrocystogram voiding (74455) |
$1,139.20 |
$1,424 |
3.7× |
| Urethrocystography retrograde (74450) |
$940 |
$1,175 |
3.1× |
| Us breast unilateral complete (76641) |
$728 |
$910 |
5.4× |
| Us chest (76604) |
$908 |
$1,135 |
6.8× |
| Us complete joint (76881) |
$1,563.20 |
$1,954 |
11.6× |
| Us exam, pelvic, limited (76857) |
$644 |
$805 |
4.8× |
| Us head (76506) |
$360 |
$450 |
2.7× |
| Us kidney transplant (76776) |
$1,480.80 |
$1,851 |
11.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$909.60 |
$1,137 |
6.8× |
| Us ob detailed single fetus (76811) |
$1,205.60 |
$1,507 |
3.9× |
| Us ob limited 1 or more fetuses (76815) |
$701.60 |
$877 |
5.2× |
| Us ob transvaginal (76817) |
$1,032 |
$1,290 |
7.7× |
| Us pelvic non ob complete (76856) |
$1,202.40 |
$1,503 |
8.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,060 |
$1,325 |
7.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$840.80 |
$1,051 |
6.3× |
| Us retroperitoneal complete (76770) |
$1,042.40 |
$1,303 |
7.8× |
| Us retroperitoneal limited (76775) |
$875.20 |
$1,094 |
6.5× |
| Us scrotum and contents (76870) |
$1,132.80 |
$1,416 |
8.4× |
| Us spinal canal and contents (76800) |
$324.40 |
$405.50 |
2.4× |
| Us thyroid (76536) |
$997.60 |
$1,247 |
7.4× |
| Us transrectal (76872) |
$735.20 |
$919 |
5.5× |
| Vein X-Ray Chest (75827) |
$4,320 |
$5,400 |
2.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,100.80 |
$3,876 |
0.8× |
| Venogram Sinus/Jugular (75860) |
$5,120 |
$6,400 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$4,871.20 |
$6,089 |
1.2× |
| Venography extremity bilateral rs&i (75822) |
$4,725.60 |
$5,906.99 |
2.3× |
| Venography extremity unilateral rs&i (75820) |
$2,401.60 |
$3,002 |
1.2× |
| Venography Renal Bilateral (75833) |
$4,852.80 |
$6,066 |
1.2× |
| Venography Renal Unilateral (75831) |
$4,677.81 |
$5,847.26 |
1.2× |
| Venous sampling by catheter (75893) |
$9,280 |
$11,600 |
1.3× |
| Vertebral fracture assessment via dxa (77086) |
$268 |
$335 |
2.4× |
| Wrist 2 views (73100) |
$516 |
$645 |
4.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$777.60 |
$972 |
6.9× |
| X-ray antegrade pyelogram tube (74425) |
$810.40 |
$1,013 |
1.8× |
| X-Ray Aorta Leg Arteries (75630) |
$8,340.80 |
$10,426 |
2.1× |
| X-Ray Bend Only L-S Spine (72120) |
$821.60 |
$1,027 |
6.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$478.40 |
$598 |
4.3× |
| X-Ray Exam Breast Specimen (76098) |
$846.40 |
$1,058 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$232 |
$290 |
2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$603.20 |
$754 |
4.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$920.80 |
$1,151 |
6.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$607.20 |
$759 |
5.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$374.40 |
$468 |
3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$543.20 |
$679 |
4.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$851.20 |
$1,064 |
6.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$642.40 |
$803 |
5.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$1,105.60 |
$1,382 |
8.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$616.80 |
$771 |
4.6× |
| X-ray eye for foreign body (70030) |
$347.20 |
$434 |
3.1× |
| X-ray humerus (73060) |
$609.60 |
$762 |
5.4× |
| X-ray IV pyelogram+tomography (74415) |
$542.40 |
$678 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$356 |
$445 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$266.40 |
$333 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$569.60 |
$712 |
4.2× |
| X-ray nose-rectum child f.b. (76010) |
$211.20 |
$264 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$811.20 |
$1,014 |
6.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$787.20 |
$984 |
5.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$415.20 |
$519 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$666.40 |
$833 |
6.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$501.60 |
$627 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$905.60 |
$1,132 |
6.7× |
| X-ray thoracic spine 4 vw (72074) |
$368 |
$460 |
2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,061.60 |
$1,327 |
2.4× |
| X-Rays Bone Length Studies (77073) |
$704.80 |
$881 |
5.2× |
| X-Rays Bone Survey Complete (77075) |
$1,454.40 |
$1,818 |
10.8× |
| Xr c-spine 4 or 5 views (72050) |
$955.20 |
$1,194 |
7.1× |
| Xr facial bones less than 3 views (70140) |
$387.20 |
$484 |
3.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$336 |
$420 |
2.5× |
| Xr orbits complete 4 views (70200) |
$615.20 |
$769 |
4.6× |
| Xr Tomogram Single Plane (76100) |
$324 |
$405 |
2.4× |