| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,893.50 |
$2,705 |
1.5× |
| Abdomen 2 views (74019) |
$217 |
$310 |
2.3× |
| Ankle 2 views (73600) |
$165.90 |
$237 |
2.1× |
| Basic radiation dosimetry calculation (77300) |
$259 |
$370 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$776.30 |
$1,109 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$770.70 |
$1,101 |
2.1× |
| Bone age studies (77072) |
$145.60 |
$208 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$781.90 |
$1,117 |
2.1× |
| Bone survey complete (77075) |
$553 |
$790 |
5.8× |
| Cervical spine 2 or 3 views (72040) |
$197.40 |
$282 |
2.5× |
| Chest 1 view (71045) |
$109.20 |
$156 |
1.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$402.50 |
$575 |
2.5× |
| Clavicle complete (73000) |
$133.70 |
$191 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$373.80 |
$534 |
3.9× |
| Continuing medical physics consltj pr wk (77336) |
$579.60 |
$828 |
4.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$867.30 |
$1,239 |
2.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,114.40 |
$1,592 |
5.1× |
| CT abdomen w contrast (74160) |
$1,117.20 |
$1,596 |
6.9× |
| CT abdomen w wo contrast (74170) |
$1,192.10 |
$1,703 |
7.4× |
| CT abdomen w/o contrast (74150) |
$1,026.20 |
$1,466 |
10.7× |
| CT angiography upper extremity lt (73206) |
$1,236.55 |
$1,766.50 |
7.7× |
| CT c-spine w/o contrast (72125) |
$977.20 |
$1,396 |
10.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,129.10 |
$1,613 |
7.0× |
| CT cervical spine with contrast (72126) |
$1,070.30 |
$1,529 |
3.3× |
| CT chest w/wo contrast (71270) |
$1,600.20 |
$2,286 |
9.9× |
| CT chest with contrast (71260) |
$1,505.70 |
$2,151 |
9.3× |
| CT head/brain with contrast (70460) |
$935.20 |
$1,336 |
5.8× |
| CT head/brain without and with contrast (70470) |
$1,543.50 |
$2,205 |
9.6× |
| CT lower ext w/o (73700) |
$1,070.30 |
$1,529 |
11.1× |
| CT lower extremity w wo contrast (73702) |
$1,400.70 |
$2,001 |
8.7× |
| CT lower extremity with contrast (73701) |
$1,039.50 |
$1,485 |
6.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,303.40 |
$1,862 |
8.1× |
| CT lumbar spine w/o contrast (72131) |
$1,117.20 |
$1,596 |
11.6× |
| CT lumbar spine with contrast (72132) |
$1,209.60 |
$1,728 |
3.8× |
| CT maxillofacial w contrast (70487) |
$1,747.90 |
$2,497 |
10.8× |
| CT maxillofacial w/o contrast (70486) |
$1,003.45 |
$1,433.50 |
10.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,787.10 |
$2,553 |
11.1× |
| CT neck soft tissue w contrast (70491) |
$1,396.50 |
$1,995 |
8.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,624.70 |
$2,321 |
10.1× |
| CT orbits w/o contrast (70480) |
$1,236.90 |
$1,767 |
12.9× |
| CT pelvis w & w/o contrast (72194) |
$1,309 |
$1,870 |
8.1× |
| CT pelvis w/o contrast (72192) |
$1,163.40 |
$1,662 |
12.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,488.20 |
$2,126 |
9.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,303.40 |
$1,862 |
13.6× |
| CT thoracic spine w/contrast (72129) |
$762.30 |
$1,089 |
4.7× |
| CT thoracic spine w/o contrast (72128) |
$560.70 |
$801 |
5.8× |
| CT thoracic spine w/wo contrast (72130) |
$725.90 |
$1,037 |
4.5× |
| CT thorax w/o contrast (71250) |
$1,414.70 |
$2,021 |
14.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$784 |
$1,120 |
4.9× |
| CT upper extremity w/o contrast rt (73200) |
$748.30 |
$1,069 |
7.8× |
| CT upper extremity with contrast (73201) |
$762.30 |
$1,089 |
2.4× |
| Cta Abdomen (74175) |
$1,219.40 |
$1,742 |
7.6× |
| CTA abdomen pelvis (74174) |
$1,267 |
$1,810 |
3.9× |
| CTA chest (71275) |
$1,562.05 |
$2,231.50 |
9.7× |
| Cta Head (70496) |
$1,543.50 |
$2,205 |
9.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,400.70 |
$2,001 |
8.7× |
| Cta Neck (70498) |
$1,488.20 |
$2,126 |
9.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$235.20 |
$336 |
2.4× |
| Echoencephalography real time imaging (76506) |
$566.30 |
$809 |
5.9× |
| Esophagus (74220) |
$273 |
$390 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$352.10 |
$503 |
3.7× |
| Fluoroscopy up to 1 hr (76000) |
$284.90 |
$407 |
1.3× |
| Foot 2 views (73620) |
$130.90 |
$187 |
1.6× |
| Forearm 2 views (73090) |
$182 |
$260 |
2.3× |
| Hand 2 views (73120) |
$150.50 |
$215 |
1.6× |
| Hand 3 views (73130) |
$197.40 |
$282 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$784.70 |
$1,121 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$748.30 |
$1,069 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$134.75 |
$192.50 |
1.7× |
| Hysterosalpingogram (74740) |
$206.50 |
$295 |
0.9× |
| Image fusion (77399) |
$276.50 |
$395 |
2.2× |
| Knee 3 views (73562) |
$174.30 |
$249 |
2.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,588.30 |
$2,269 |
4.6× |
| MRA head w/o contrast (70544) |
$1,446.90 |
$2,067 |
6.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,464 |
$3,520 |
7.7× |
| MRI abdomen w/o contrast (74181) |
$2,120.30 |
$3,029 |
9.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,925.70 |
$2,751 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,983.80 |
$2,834 |
2.8× |
| MRI cervical spine w/o contrast (72141) |
$2,009 |
$2,870 |
9.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,329.30 |
$1,899 |
6.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,804.20 |
$4,006 |
8.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,512.30 |
$3,589 |
7.8× |
| MRI pelvis w/o contrast (72195) |
$1,912.40 |
$2,732 |
8.7× |
| MRI scan of arm joint before and after contrast (73223) |
$2,315.60 |
$3,308 |
7.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,315.60 |
$3,308 |
7.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,496.20 |
$3,566 |
7.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,496.20 |
$3,566 |
7.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,487.80 |
$3,554 |
7.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,785.70 |
$2,551 |
8.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,779.40 |
$2,542 |
8.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,353.10 |
$1,933 |
4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,329.30 |
$1,899 |
6.1× |
| Myelogram Cervical (72240) |
$2,671.20 |
$3,816 |
3.7× |
| Myelogram Lumbar (72265) |
$2,939.30 |
$4,199 |
4.1× |
| Myocardial Spect Multiple Studies (78452) |
$1,722 |
$2,460 |
1.4× |
| Neck soft tissue (70360) |
$249.90 |
$357 |
3.1× |
| Nm gastric emptying study (78264) |
$900.90 |
$1,287 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,622.85 |
$5,175.50 |
2.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$458.50 |
$655 |
4.8× |
| Parathyroid imaging (78070) |
$468.30 |
$669 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$182 |
$260 |
1.9× |
| PET image w/CT, skull-thigh (78815) |
$4,716.60 |
$6,738 |
3.6× |
| PET imaging for CT attenuation whole body (78816) |
$4,633.30 |
$6,619 |
3.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,974.70 |
$2,821 |
6.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,151.50 |
$1,645 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$291.90 |
$417 |
3.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$352.10 |
$503 |
3.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,132.60 |
$1,618 |
2.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$508.20 |
$726 |
5.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$838.60 |
$1,198 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$287.70 |
$411 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$166.60 |
$238 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$237.30 |
$339 |
2.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$200.90 |
$287 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$1,049.30 |
$1,499 |
6.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$402.50 |
$575 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$464.10 |
$663 |
2.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$183.75 |
$262.50 |
2.3× |
| Radiological examination surgical specimen (76098) |
$711.90 |
$1,017 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$245.70 |
$351 |
2.6× |
| Scanogram (77073) |
$394.10 |
$563 |
4.1× |
| Scapula complete (73010) |
$145.60 |
$208 |
1.5× |
| Screening digital breast tomosynthesis (77063) |
$105.70 |
$151 |
4.5× |
| Small bowel series (74250) |
$353.15 |
$504.50 |
2.2× |
| Spec medical radj physics consltj (77370) |
$489.30 |
$699 |
4.0× |
| Special dosimetry (77331) |
$239.40 |
$342 |
1.9× |
| Spine thoracic 3 views (72072) |
$265.30 |
$379 |
2.8× |
| Stereotactic body radiation delivery (77373) |
$3,938.20 |
$5,626 |
2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$731.85 |
$1,045.50 |
2.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$915.95 |
$1,308.50 |
2.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$527.45 |
$753.50 |
4.3× |
| Thyroid uptake measurement (78012) |
$269.50 |
$385 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$802.90 |
$1,147 |
2.2× |
| Treatment devices simple (77332) |
$205.80 |
$294 |
1.7× |
| Tx devices design & construction complex (77334) |
$490 |
$700 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$337.40 |
$482 |
3.5× |
| Urethrocystography retrograde rs&i (74450) |
$513.80 |
$734 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$247.80 |
$354 |
2.6× |
| Us breast unilateral complete (76641) |
$239.40 |
$342 |
2.5× |
| Us breast unilateral limited (76642) |
$200.20 |
$286 |
2.5× |
| Us chest (76604) |
$368.20 |
$526 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$440.30 |
$629 |
4.6× |
| Us infant hips dynamic (76885) |
$595.70 |
$851 |
7.4× |
| Us ob transvaginal (76817) |
$160.30 |
$229 |
1.7× |
| Us pelvic non ob complete (76856) |
$522.90 |
$747 |
5.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$245.70 |
$351 |
2.6× |
| Us pregnancy ltd (76815) |
$203 |
$290 |
2.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$235.90 |
$337 |
2.5× |
| Us retroperitoneal complete (76770) |
$583.10 |
$833 |
6.1× |
| Us retroperitoneal limited (76775) |
$348.60 |
$498 |
3.6× |
| Us scrotum and contents (76870) |
$466.20 |
$666 |
4.8× |
| Us soft tissue head/neck (76536) |
$708.40 |
$1,012 |
7.4× |
| Us spinal canal and contents (76800) |
$275.80 |
$394 |
2.9× |
| Us xtr non-vasc lmtd (76882) |
$247.80 |
$354 |
2.6× |
| Wrist 2 views (73100) |
$151.90 |
$217 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$337.40 |
$482 |
3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$193.20 |
$276 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$241.15 |
$344.50 |
3.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,155 |
$1,650 |
7.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$133 |
$190 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$188.30 |
$269 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$179.20 |
$256 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$178.15 |
$254.50 |
2.2× |
| X-ray exam hip uni 4/> views (73503) |
$212.45 |
$303.50 |
2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$447.30 |
$639 |
4.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$308 |
$440 |
3.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$197.40 |
$282 |
2.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$131.25 |
$187.50 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$172.90 |
$247 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$265.30 |
$379 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$301.70 |
$431 |
3.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$127.40 |
$182 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$262.50 |
$375 |
2.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$401.80 |
$574 |
4.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$206.50 |
$295 |
2.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$123.20 |
$176 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$229.60 |
$328 |
2.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$515.20 |
$736 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$229.25 |
$327.50 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$263.90 |
$377 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$284.90 |
$407 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$196 |
$280 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$216.30 |
$309 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$168.70 |
$241 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$252.70 |
$361 |
3.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$177.80 |
$254 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$313.60 |
$448 |
3.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$189.70 |
$271 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$162.75 |
$232.50 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$233.80 |
$334 |
2.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$135.10 |
$193 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$189.70 |
$271 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$254.10 |
$363 |
2.6× |
| Xr chest 4+ views (71048) |
$391.30 |
$559 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$154 |
$220 |
1.9× |
| Xr shoulder 1 view (73020) |
$153.30 |
$219 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$299.60 |
$428 |
3.1× |
| Xr tibia/fibula 2 views (73590) |
$141.40 |
$202 |
1.8× |
| Xray knee 1 or 2 views rt (73560) |
$155.75 |
$222.50 |
1.9× |