| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,677.13 |
$4,700 |
1.3× |
| Abdomen 2 views (74019) |
$209.11 |
$586 |
2.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$559.88 |
$1,569 |
1.5× |
| Acute venous thrombus image (78456) |
$828.22 |
$2,321 |
0.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,420.92 |
$3,982 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$1,576.15 |
$4,417 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,294.96 |
$3,629 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,628.60 |
$4,564 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,197.54 |
$3,356 |
0.4× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,824.86 |
$5,114 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$414.65 |
$1,162 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,197.54 |
$3,356 |
0.4× |
| Ankle 2 views (73600) |
$219.10 |
$614 |
2.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$193.05 |
$541 |
0.6× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,158.50 |
$6,049 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,294.96 |
$3,629 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,294.96 |
$3,629 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$1,214.32 |
$3,403 |
0.4× |
| Arthrogram elbow (73085) |
$332.58 |
$932 |
1.0× |
| Arthrogram hip (73525) |
$401.44 |
$1,125 |
1.2× |
| Arthrogram shoulder (73040) |
$390.74 |
$1,095 |
1.2× |
| Arthrogram wrist (73115) |
$307.95 |
$863 |
0.9× |
| Arthrography knee lt (73580) |
$225.52 |
$632 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$201.62 |
$565 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$903.87 |
$2,533 |
2.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$566.66 |
$1,588 |
1.5× |
| Bone &/joint imaging whole body (78306) |
$1,348.84 |
$3,780 |
3.6× |
| Bone age studies (77072) |
$122.76 |
$344 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$1,780.61 |
$4,990 |
4.7× |
| Bone survey complete (77075) |
$504.93 |
$1,415 |
5.1× |
| Brachytx isodose complex (77318) |
$405.37 |
$1,136 |
1.2× |
| Brachytx isodose intermed (77317) |
$405.37 |
$1,136 |
1.2× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$151.66 |
$425 |
0.4× |
| Brain image w/flow 4 + views (78606) |
$221.24 |
$620 |
0.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$443.19 |
$1,242 |
1.2× |
| Brain Imaging Vascular Flow Only (78610) |
$221.24 |
$620 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$224.81 |
$630 |
2.8× |
| Chest 1 view (71045) |
$139.35 |
$390.50 |
1.7× |
| Chest 3 views (71047) |
$220.17 |
$617 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$333.29 |
$934 |
2.0× |
| Clavicle complete (73000) |
$220.89 |
$619 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,050.17 |
$2,943 |
10.7× |
| Continuing medical physics consltj pr wk (77336) |
$202.33 |
$567 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,037.74 |
$8,513 |
9.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,476.09 |
$6,939 |
11.1× |
| CT abdomen w contrast (74160) |
$1,176.85 |
$3,298 |
7.2× |
| CT abdomen w wo contrast (74170) |
$1,307.45 |
$3,664 |
7.9× |
| CT abdomen w/o contrast (74150) |
$1,608.26 |
$4,507 |
16.4× |
| CT angio hrt w/3d image (75574) |
$147.02 |
$412 |
0.4× |
| CT angiography upper extremity lt (73206) |
$697.26 |
$1,954 |
4.2× |
| CT c-spine w/o contrast (72125) |
$1,359.90 |
$3,811 |
13.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,414.50 |
$3,964 |
8.6× |
| CT cervical spine with contrast (72126) |
$1,359.90 |
$3,811 |
4.2× |
| CT chest w/wo contrast (71270) |
$1,109.76 |
$3,110 |
6.7× |
| CT chest with contrast (71260) |
$1,193.26 |
$3,344 |
7.3× |
| CT head/brain with contrast (70460) |
$1,256.42 |
$3,521 |
7.6× |
| CT head/brain without and with contrast (70470) |
$1,367.40 |
$3,832 |
8.3× |
| CT iac w contrast (70481) |
$944.19 |
$2,646 |
5.7× |
| CT lower ext w/o (73700) |
$568.80 |
$1,594 |
5.8× |
| CT lower extremity w wo contrast (73702) |
$764.88 |
$2,143.50 |
4.6× |
| CT lower extremity with contrast (73701) |
$614.48 |
$1,722 |
3.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,478.37 |
$4,143 |
9.0× |
| CT lumbar spine w/o contrast (72131) |
$1,421.28 |
$3,983 |
14.5× |
| CT lumbar spine with contrast (72132) |
$1,563.66 |
$4,382 |
4.8× |
| CT maxillofacial w contrast (70487) |
$1,100.84 |
$3,085 |
6.7× |
| CT maxillofacial w/o contrast (70486) |
$1,038.75 |
$2,911 |
10.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,132.24 |
$3,173 |
6.9× |
| CT neck soft tissue w contrast (70491) |
$1,098.34 |
$3,078 |
6.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,116.54 |
$3,129 |
6.8× |
| CT orbits w/o contrast (70480) |
$907.79 |
$2,544 |
9.3× |
| CT pelvis w & w/o contrast (72194) |
$1,160.43 |
$3,252 |
7.1× |
| CT pelvis w/o contrast (72192) |
$1,008.78 |
$2,827 |
10.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,032.33 |
$2,893 |
6.3× |
| CT soft tissue neck w/o contrast (70490) |
$988.44 |
$2,770 |
10.1× |
| CT thoracic spine w/contrast (72129) |
$969.53 |
$2,717 |
5.9× |
| CT thoracic spine w/o contrast (72128) |
$1,020.55 |
$2,860 |
10.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,010.21 |
$2,831 |
6.1× |
| CT thorax w/o contrast (71250) |
$1,050.17 |
$2,943 |
10.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$936.34 |
$2,624 |
5.7× |
| CT upper extremity w/o contrast rt (73200) |
$965.24 |
$2,705 |
9.8× |
| CT upper extremity with contrast (73201) |
$897.80 |
$2,516 |
2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$627.68 |
$1,759 |
3.8× |
| Cta Abdomen (74175) |
$618.04 |
$1,732 |
3.8× |
| CTA abdomen pelvis (74174) |
$950.61 |
$2,664 |
2.9× |
| CTA chest (71275) |
$1,165.79 |
$3,267 |
7.1× |
| Cta Head (70496) |
$974.52 |
$2,731 |
5.9× |
| CTA lwr ext w&w/o contrast (73706) |
$563.45 |
$1,579 |
3.4× |
| Cta Neck (70498) |
$1,299.60 |
$3,642 |
7.9× |
| Cta Pelvis (72191) |
$1,069.44 |
$2,997 |
6.5× |
| Cystography minimum 3 views rs&i (74430) |
$108.84 |
$305 |
0.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$402.70 |
$1,128.50 |
4.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$372.90 |
$1,045 |
4.6× |
| Echoencephalography real time imaging (76506) |
$382.89 |
$1,073 |
3.9× |
| Esophagus (74220) |
$387.17 |
$1,085 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$393.24 |
$1,102 |
4.0× |
| Fluoroscopy up to 1 hr (76000) |
$193.41 |
$542 |
0.9× |
| Foot 2 views (73620) |
$273.70 |
$767 |
3.4× |
| Forearm 2 views (73090) |
$246.22 |
$690 |
3.0× |
| Gated Heart Planar Single (78472) |
$528.83 |
$1,482 |
1.4× |
| Hand 2 views (73120) |
$162.72 |
$456 |
1.7× |
| Hand 3 views (73130) |
$210.18 |
$589 |
2.6× |
| Heart Infarct Image (78466) |
$317.23 |
$889 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$665.50 |
$1,865 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$652.30 |
$1,828 |
1.7× |
| Ht muscle image spect sing (78451) |
$613.40 |
$1,719 |
0.5× |
| Humerus Min 2 Views Left (73060) |
$270.13 |
$757 |
3.3× |
| Hysterosalpingogram (74740) |
$476.38 |
$1,335 |
2.1× |
| Interstitial radiation source applic complex (77778) |
$1,571.86 |
$4,405 |
2.4× |
| Intracavitary Radiation Source Applic Complex (77763) |
$530.98 |
$1,488 |
0.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$530.98 |
$1,488 |
1.0× |
| Intracavitary radiation source applic simple (77761) |
$530.98 |
$1,488 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$496.36 |
$1,391 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,153.30 |
$3,232 |
2.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$518.84 |
$1,454 |
1.0× |
| Knee 3 views (73562) |
$315.09 |
$883 |
3.9× |
| Liver & spleen imaging static only (78215) |
$117.05 |
$328 |
0.3× |
| Liver imaging w/vascular flow (78202) |
$481.38 |
$1,349 |
0.9× |
| Lung perf&ventilat diferentl (78598) |
$744.72 |
$2,087 |
1.5× |
| Lung perfusion differential (78597) |
$224.81 |
$630 |
0.6× |
| Lung Ventilation Imaging (78579) |
$481.73 |
$1,350 |
1.3× |
| Lymphoscintigraphy (78195) |
$403.23 |
$1,130 |
0.8× |
| Mammary ductogram or galactogram multiple (77054) |
$251.57 |
$705 |
1.1× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$69.23 |
$194 |
0.8× |
| Meckels Diverticulum (78290) |
$270.13 |
$757 |
0.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,093.91 |
$5,868 |
6.0× |
| Mr safety determination physician/other qhp (76016) |
$81.72 |
$229 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$22.84 |
$64 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$85.65 |
$240 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$224.81 |
$630 |
1.0× |
| MRA head w & w/o contrast (70546) |
$1,101.56 |
$3,087 |
3.4× |
| MRA head w/o contrast (70544) |
$1,090.85 |
$3,057 |
4.9× |
| MRA head with contrast (70545) |
$840 |
$2,354 |
2.6× |
| MRA neck w contrast (70548) |
$927.06 |
$2,598 |
2.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,287.11 |
$3,607 |
3.9× |
| MRA neck w/o contrast (70547) |
$1,090.85 |
$3,057 |
4.9× |
| MRI abdomen w contrast (74182) |
$1,143.66 |
$3,205 |
3.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,447.33 |
$4,056 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$984.16 |
$2,758 |
4.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,257.85 |
$3,525 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,083.36 |
$3,036 |
1.5× |
| MRI c-spine with contrast (72142) |
$1,426.63 |
$3,998 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$1,160.08 |
$3,251 |
5.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,190.76 |
$3,337 |
3.6× |
| MRI chest w/o contrast (71550) |
$964.53 |
$2,703 |
4.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,226.09 |
$3,436 |
3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,359.55 |
$3,810 |
4.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,203.25 |
$3,372 |
5.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$885.67 |
$2,482 |
4.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,526.90 |
$4,279 |
4.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,038.40 |
$2,910 |
3.2× |
| MRI pelvis w contrast (72196) |
$1,136.88 |
$3,186 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,227.52 |
$3,440 |
3.7× |
| MRI pelvis w/o contrast (72195) |
$1,136.88 |
$3,186 |
5.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,218.95 |
$3,416 |
3.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,319.58 |
$3,698 |
4.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,670.35 |
$4,681 |
5.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,399.87 |
$3,923 |
4.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,453.75 |
$4,074 |
4.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,357.76 |
$3,805 |
4.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,108.69 |
$3,107 |
3.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,131.53 |
$3,171 |
5.1× |
| MRI tmj (70336) |
$623.75 |
$1,748 |
2.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,128.68 |
$3,163 |
5.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,059.45 |
$2,969 |
3.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,190.41 |
$3,336 |
5.3× |
| Myelogram Cervical (72240) |
$588.78 |
$1,650 |
0.8× |
| Myelogram Lumbar (72265) |
$671.93 |
$1,883 |
0.9× |
| Myelography 2 or more regions (72270) |
$559.52 |
$1,568 |
0.8× |
| Myocardial infarct spect (78469) |
$689.05 |
$1,931 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,271.62 |
$6,366 |
1.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$888.52 |
$2,490 |
1.1× |
| Neck soft tissue (70360) |
$249.79 |
$700 |
3.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$204.83 |
$574 |
0.6× |
| Nm adrenal scan (78075) |
$1,026.26 |
$2,876 |
0.8× |
| Nm cisternogram (78630) |
$724.38 |
$2,030 |
1.4× |
| Nm gastric emptying study (78264) |
$1,321.72 |
$3,704 |
3.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,597.20 |
$4,476 |
1.2× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$817.87 |
$2,292 |
0.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$288.68 |
$809 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$191.63 |
$537 |
0.9× |
| Osseous survey infant (77076) |
$156.66 |
$439 |
1.6× |
| Parathyrd planar w/wo subtrj (78071) |
$155.23 |
$435 |
0.4× |
| Parathyroid imaging (78070) |
$156.30 |
$438 |
0.4× |
| Pelvis 1 or 2 views (72170) |
$196.26 |
$550 |
2.0× |
| Perineogram (74775) |
$194.48 |
$545 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$2,123.89 |
$5,952 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$1,444.47 |
$4,048 |
1.1× |
| Pr heart first pass single,planar (78481) |
$535.26 |
$1,500 |
1.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,275.33 |
$3,574 |
3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$244.08 |
$684 |
0.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$642.31 |
$1,800 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$195.91 |
$549 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$121.33 |
$340 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$348.28 |
$976 |
3.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$141.31 |
$396 |
1.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$102.77 |
$288 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$138.81 |
$389 |
1.4× |
Radiation Delivery Stereotactic Cranial Linear (77372)
unusually low: confirm this is the full procedure |
$3,372.10 |
$9,450 |
0.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$281.19 |
$788 |
0.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$142.38 |
$399 |
1.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$214.82 |
$602 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$233.20 |
$653.50 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$282.26 |
$791 |
3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$160.94 |
$451 |
1.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$214.11 |
$600 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$366.83 |
$1,028 |
2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$287.97 |
$807 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$291.36 |
$816.50 |
1.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$158.08 |
$443 |
1.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$279.76 |
$784 |
3.4× |
| Radiological examination surgical specimen (76098) |
$155.23 |
$435 |
0.3× |
| Ribs bilateral 3 views (71110) |
$372.54 |
$1,044 |
3.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,010.92 |
$2,833 |
2.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$527.05 |
$1,477 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$850.88 |
$2,384.50 |
1.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$516.70 |
$1,448 |
0.4× |
| Sacroiliac Joints < 3 Views (72200) |
$142.38 |
$399 |
1.5× |
| Scanogram (77073) |
$149.88 |
$420 |
1.5× |
| Scapula complete (73010) |
$184.85 |
$518 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$31.41 |
$88 |
1.3× |
| Simulation intermediate (77285) |
$487.44 |
$1,366 |
1.4× |
| Small bowel series (74250) |
$467.99 |
$1,311.50 |
2.8× |
| Spec medical radj physics consltj (77370) |
$198.41 |
$556 |
1.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$433.92 |
$1,216 |
1.2× |
| Special dosimetry (77331) |
$175.21 |
$491 |
1.4× |
| Special treatment procedure (77470) |
$634.10 |
$1,777 |
1.2× |
| Spine thoracic 3 views (72072) |
$78.87 |
$221 |
0.8× |
| Stereotactic body radiation delivery (77373) |
$1,069.44 |
$2,997 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$433.92 |
$1,216 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$169.50 |
$475 |
0.5× |
| Testicular Imaging With Vascular Flow (78761) |
$439.98 |
$1,233 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$513.13 |
$1,438 |
1.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$205.19 |
$575 |
1.6× |
| Thoracolumbar 2 views (72080) |
$235.16 |
$659 |
2.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$508.85 |
$1,426 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$474.60 |
$1,330 |
1.3× |
| Thyroid uptake measurement (78012) |
$759.35 |
$2,128 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$318.66 |
$893 |
0.8× |
| Tmj unilateral (70328) |
$137.03 |
$384 |
1.7× |
| Tomogram (76100) |
$429.28 |
$1,203 |
4.4× |
| Treatment device intermediate (77333) |
$329.72 |
$924 |
2.6× |
| Treatment devices simple (77332) |
$359.34 |
$1,007 |
2.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,404.15 |
$3,935 |
2.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$155.23 |
$435 |
0.4× |
| Tx devices design & construction complex (77334) |
$370.40 |
$1,038 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$841.78 |
$2,359 |
8.6× |
| Unlisted magnetic resonance procedure (76498) |
$76.01 |
$213 |
0.9× |
| Upper Extremity Infant (73092) |
$123.47 |
$346 |
1.3× |
| Urethrocystography voiding (74455) |
$553.64 |
$1,551.50 |
2.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$332.58 |
$932 |
2.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$695.12 |
$1,948 |
4.2× |
| Us abdl aorta screen aaa (76706) |
$364.33 |
$1,021 |
3.7× |
| Us breast unilateral complete (76641) |
$658.72 |
$1,846 |
6.7× |
| Us breast unilateral limited (76642) |
$425 |
$1,191 |
5.2× |
| Us chest (76604) |
$178.07 |
$499 |
1.8× |
| Us compl joint r-t w/image documentation (76881) |
$394.31 |
$1,105 |
4.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$201.97 |
$566 |
2.1× |
| Us guided compression repair (76936) |
$2,059.66 |
$5,772 |
10.2× |
| Us infant hips dynamic (76885) |
$196.98 |
$552 |
2.4× |
| Us kidney transplant (76776) |
$355.41 |
$996 |
3.6× |
| Us ob transvaginal (76817) |
$428.92 |
$1,202 |
4.4× |
| Us pelvic non ob complete (76856) |
$720.46 |
$2,019 |
7.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$497.43 |
$1,394 |
5.1× |
| Us pregnancy ltd (76815) |
$523.48 |
$1,467 |
5.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$602.34 |
$1,688 |
6.1× |
| Us retroperitoneal complete (76770) |
$1,773.48 |
$4,970 |
18.1× |
| Us retroperitoneal limited (76775) |
$555.95 |
$1,558 |
5.7× |
| Us scrotum and contents (76870) |
$592.35 |
$1,660 |
6.0× |
| Us soft tissue head/neck (76536) |
$462.11 |
$1,295 |
4.7× |
| Us spinal canal and contents (76800) |
$246.58 |
$691 |
2.5× |
| Us transrectal (76872) |
$1,632.53 |
$4,575 |
16.6× |
| Us xtr non-vasc lmtd (76882) |
$145.60 |
$408 |
1.5× |
| Venogram extremity bilateral (75822) |
$1,398.80 |
$3,920 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$1,281.76 |
$3,592 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$1,153.30 |
$3,232 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$508.85 |
$1,426 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,200.40 |
$3,364 |
0.4× |
| Wrist 2 views (73100) |
$256.93 |
$720 |
3.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$395.92 |
$1,109.50 |
4.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$190.91 |
$535 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$260.49 |
$730 |
3.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$670.86 |
$1,880 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$256.57 |
$719 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$312.59 |
$876 |
3.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$233.38 |
$654 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$65.31 |
$183 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$174.50 |
$489 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$115.98 |
$325 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$294.75 |
$826 |
3.0× |
| X-ray eye for foreign body (70030) |
$99.92 |
$280 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$282.80 |
$792.50 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$223.03 |
$625 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$321.87 |
$902 |
3.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$187.70 |
$526 |
2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$226.24 |
$634 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$361.84 |
$1,014 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$190.02 |
$532.50 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$126.32 |
$354 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$310.45 |
$870 |
3.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$327.94 |
$919 |
3.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$75.65 |
$212 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$310.09 |
$869 |
3.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$183.60 |
$514.50 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$15.71 |
$44 |
0.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$89.93 |
$252 |
0.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$64.59 |
$181 |
0.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$293.32 |
$822 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$406.26 |
$1,138.50 |
4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$313.66 |
$879 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$241.23 |
$676 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$299.92 |
$840.50 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$262.82 |
$736.50 |
3.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$90.10 |
$252.50 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$317.41 |
$889.50 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$188.24 |
$527.50 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$144.17 |
$404 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$129.54 |
$363 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$203.04 |
$569 |
2.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$253.71 |
$711 |
2.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$284.05 |
$796 |
2.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$168.79 |
$473 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$282.26 |
$791 |
3.5× |
| Xr arthrogram ankle (73615) |
$203.76 |
$571 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$263.35 |
$738 |
2.7× |
| Xr chest 4+ views (71048) |
$220.17 |
$617 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$237.30 |
$665 |
2.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$179.49 |
$503 |
1.8× |
| Xr shoulder 1 view (73020) |
$192.70 |
$540 |
2.4× |
| Xr spine cervical 4 or 5 views (72050) |
$350.77 |
$983 |
3.6× |
| Xr tibia/fibula 2 views (73590) |
$285.47 |
$800 |
3.5× |
| Xr tmj bilateral (70330) |
$204.83 |
$574 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$286.19 |
$802 |
3.5× |