| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,402.90 |
$9,147 |
3.2× |
| Abdomen 1 View (74018) |
$333.20 |
$476 |
2.6× |
| Abdomen 2 views (74019) |
$314.30 |
$449 |
2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,441.60 |
$3,488 |
4.2× |
| Angio internal mammary (75756) |
$3,864 |
$5,520 |
0.8× |
| Angio pulmonary bilat (75743) |
$5,361.30 |
$7,659 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$5,874.40 |
$8,392 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$4,613.70 |
$6,591 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$4,613.70 |
$6,591 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,127.20 |
$5,896 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,964.80 |
$5,664 |
0.9× |
| Ankle 2 views (73600) |
$223.30 |
$319 |
1.8× |
| Aortography thoracic serialography rs&i (75605) |
$6,604.50 |
$9,435 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,588.50 |
$6,555 |
1.0× |
| Artery X-Rays Abdomen (75726) |
$9,487.80 |
$13,554 |
1.2× |
| Artery X-Rays Adrenal Gland (75731) |
$4,953.20 |
$7,076 |
1.1× |
| Artery X-Rays Pelvis (75736) |
$6,661.20 |
$9,516 |
0.8× |
| Artery X-Rays Spine (75705) |
$6,303.50 |
$9,005 |
0.8× |
| Arthrogram ankle (73615) |
$868 |
$1,240 |
1.7× |
| Arthrogram hip (73525) |
$657.30 |
$939 |
1.3× |
| Arthrogram Wrist (73115) |
$819 |
$1,170 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$719.60 |
$1,028 |
3.7× |
| Bone age studies (77072) |
$441.70 |
$631 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$2,119.60 |
$3,028 |
3.6× |
| Bone Imaging Limited Area (78300) |
$1,442 |
$2,060 |
2.5× |
| Bone Imaging Multiple Areas (78305) |
$1,684.90 |
$2,407 |
2.9× |
| Bone Imaging Whole Body (78306) |
$3,065.30 |
$4,379 |
5.2× |
| Bone survey infant (77076) |
$364.70 |
$521 |
2.4× |
| Brachytx isodose complex (77318) |
$3,442.60 |
$4,918 |
6.3× |
| Brachytx isodose intermed (77317) |
$1,346.10 |
$1,923 |
2.5× |
| Brachytx Isodose Plan Simple (77316) |
$1,346.10 |
$1,923 |
2.5× |
| Brain Flow Imaging Only (78610) |
$1,341.20 |
$1,916 |
1.7× |
| Brain Image W/Flow < 4 Views (78601) |
$1,877.40 |
$2,682 |
3.2× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,616.30 |
$2,309 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,069.70 |
$8,671 |
2.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,502.10 |
$5,003 |
6.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$3,502.10 |
$5,003 |
3.1× |
| Cat Scan Follow-Up Study (76380) |
$247.10 |
$353 |
1.9× |
| Cerebrospinal Fluid Scan (78630) |
$2,363.90 |
$3,377 |
3.0× |
| Chest 1 view (71045) |
$373.10 |
$533 |
2.9× |
| Chest 2 views (71046) |
$377.30 |
$539 |
3.0× |
| Chest 3 views (71047) |
$424.90 |
$607 |
3.3× |
| Chest 4 or more views (71048) |
$514.50 |
$735 |
3.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$287 |
$410 |
1.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$2,457.70 |
$3,511 |
2.1× |
| Clavicle complete (73000) |
$329 |
$470 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,309.70 |
$1,871 |
8.6× |
| Continuing medical physics consltj pr wk (77336) |
$604.80 |
$864 |
3.1× |
| Contrast Exam Abdominl Aorta (75625) |
$4,912.60 |
$7,018 |
1.1× |
| Contrast X-Ray Bladder (74430) |
$673.40 |
$962 |
1.3× |
| Contrast X-Ray Of Elbow (73085) |
$816.20 |
$1,166 |
1.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,030.40 |
$1,472 |
2.0× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$329.70 |
$471 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,615.90 |
$3,737 |
5.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,242.80 |
$3,204 |
6.4× |
| CT abdomen w contrast (74160) |
$1,345.40 |
$1,922 |
5.2× |
| CT abdomen w wo contrast (74170) |
$1,532.30 |
$2,189 |
6.0× |
| CT abdomen w/o contrast (74150) |
$1,121.40 |
$1,602 |
7.3× |
| CT Angio Abdomen and Pelvis (74174) |
$2,615.90 |
$3,737 |
5.1× |
| CT Angio Chest (71275) |
$1,705.20 |
$2,436 |
6.6× |
CT Angio Head (70496)
range across 2 matching MRF lines |
$2,052.40–$3,979.50 |
$2,932–$5,685 |
varies |
| CT angio hrt w/3d image (75574) |
$2,334.50 |
$3,335 |
4.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,990.80 |
$2,844 |
7.8× |
| CT Angio Neck (70498) |
$2,298.10 |
$3,283 |
9.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,505.30 |
$3,579 |
9.8× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$2,149.70 |
$3,071 |
8.4× |
| CT cervical spine w/ contrast (72126) |
$2,347.80 |
$3,354 |
4.6× |
| CT cervical spine w/o contrast (72125) |
$2,106.30 |
$3,009 |
13.8× |
| CT cervical spine w/wo cont (72127) |
$2,526.30 |
$3,609 |
9.8× |
| CT chest w contrast (71260) |
$1,498 |
$2,140 |
5.8× |
| CT chest w/wo contrast (71270) |
$2,884.70 |
$4,121 |
11.2× |
| CT colonography screening (74263) |
$994.70 |
$1,421 |
2.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,140.30 |
$1,629 |
4.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$994.70 |
$1,421 |
6.5× |
| CT head/brain with contrast (70460) |
$2,149.70 |
$3,071 |
8.4× |
| CT head/brain without and with contrast (70470) |
$2,419.20 |
$3,456 |
9.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$550.20 |
$786 |
1.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$112.70 |
$161 |
0.9× |
| CT iac w contrast (70481) |
$2,599.80 |
$3,714 |
10.1× |
| CT l-spine w&w/o contrast (72133) |
$3,992.10 |
$5,703 |
15.6× |
| CT lower ext w/o (73700) |
$1,898.40 |
$2,712 |
12.4× |
| CT lower extremity w/contrast material (73701) |
$2,010.40 |
$2,872 |
7.8× |
| CT lumbar spine w contrast (72132) |
$3,769.50 |
$5,385 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$2,085.30 |
$2,979 |
13.6× |
| CT maxillofacial w contrast (70487) |
$2,610.30 |
$3,729 |
10.2× |
| CT maxillofacial wo contrast (70486) |
$1,829.10 |
$2,613 |
12.0× |
| CT neck tissue combo (70492) |
$2,974.30 |
$4,249 |
11.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,835.70 |
$4,051 |
11.1× |
| CT orbits w/o contrast (70480) |
$2,362.50 |
$3,375 |
15.4× |
| CT pelvis w&w/o contrast (72194) |
$2,765 |
$3,950 |
10.8× |
| CT pelvis w/o contrast (72192) |
$2,249.80 |
$3,214 |
14.7× |
| CT scan of leg combo (73702) |
$2,627.80 |
$3,754 |
10.2× |
| CT scans face/jaw combo (70488) |
$2,893.80 |
$4,134 |
11.3× |
| CT soft tissue neck w contrast (70491) |
$2,174.20 |
$3,106 |
8.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,102.10 |
$3,003 |
13.7× |
| CT thoracic spine w contrast (72129) |
$3,420.90 |
$4,887 |
13.3× |
| CT thoracic spine w/o contrast (72128) |
$2,659.30 |
$3,799 |
17.4× |
| CT thoracic spine w/wo cont (72130) |
$1,801.10 |
$2,573 |
7.0× |
| CT thorax w/o contrast (71250) |
$1,247.40 |
$1,782 |
8.2× |
| CT upper ext wo (73200) |
$1,940.40 |
$2,772 |
12.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,239.30 |
$3,199 |
8.7× |
| CT upper extremity with contrast (73201) |
$2,004.10 |
$2,863 |
3.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,121.40 |
$1,602 |
4.4× |
| Cta Abdomen (74175) |
$1,121.40 |
$1,602 |
4.4× |
CTA head&neck c+ w/noncontrast img&post-pxessing (70471)
range across 2 matching MRF lines |
$4,350.50–$6,277.60 |
$6,215–$8,968 |
varies |
| CTA pelvis (72191) |
$2,970.10 |
$4,243 |
11.6× |
| Dilation ureters/urethra rs&i (74485) |
$2,522.10 |
$3,603 |
0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$594.30 |
$849 |
3.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$594.30 |
$849 |
3.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$422.10 |
$603 |
2.8× |
| Dxa Bone Density Axial (77080) |
$337.40 |
$482 |
2.2× |
| Dxa bone density study (77085) |
$422.10 |
$603 |
2.8× |
| Echo Guide For Artery Repair (76936) |
$1,428.70 |
$2,041 |
4.5× |
| Echograp Trans R Pros Study (76873) |
$754.60 |
$1,078 |
4.9× |
| Esophagram (74220) |
$877.80 |
$1,254 |
3.4× |
| Fetal Biophys Profile W/Nst (76818) |
$865.20 |
$1,236 |
5.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$626.50 |
$895 |
4.1× |
| Fluoroscopy up to 1 hr (76000) |
$1,186.50 |
$1,695 |
3.4× |
| Follow-Up Angiography (75898) |
$3,964.80 |
$5,664 |
0.9× |
| Foot 2 views (73620) |
$226.80 |
$324 |
1.8× |
| Forearm 2 views (73090) |
$274.40 |
$392 |
2.2× |
| Gastric emptying imaging study (78264) |
$2,979.90 |
$4,257 |
5.1× |
| Gated Heart Planar Single (78472) |
$2,674.70 |
$3,821 |
4.6× |
| Hand 2 views (73120) |
$229.60 |
$328 |
1.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,953.20 |
$7,076 |
1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$4,587.10 |
$6,553 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,347.50 |
$1,925 |
1.7× |
| Hepatobiliary System Imaging (78226) |
$1,347.50 |
$1,925 |
2.3× |
| Ht Muscle Image Spect Sing (78451) |
$2,139.20 |
$3,056 |
1.1× |
| Hysterosalpingogram (74740) |
$1,037.40 |
$1,482 |
3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$373.80 |
$534 |
2.9× |
| Infant hip ultrasound, limited static exam (76886) |
$347.20 |
$496 |
2.7× |
| Interstitial radiation source applic complex (77778) |
$2,870 |
$4,100 |
2.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$5,198.20 |
$7,426 |
5.1× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$4,473.70 |
$6,391 |
5.5× |
| Intracavitary radiation source applic simple (77761) |
$4,909.10 |
$7,013 |
6.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,722.70 |
$2,461 |
2.2× |
| K Flow/Funct Image W/O Drug (78707) |
$1,369.20 |
$1,956 |
1.7× |
| Knee 3 Views (73562) |
$360.50 |
$515 |
2.8× |
| Leveen/Shunt Patency Exam (78291) |
$1,202.60 |
$1,718 |
2.1× |
| Liver & Spleen Imaging Static Only (78215) |
$1,973.30 |
$2,819 |
3.4× |
| Liver imaging static only (78201) |
$1,492.40 |
$2,132 |
1.9× |
| Liver imaging w/vascular flow (78202) |
$1,492.40 |
$2,132 |
1.9× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,451.10 |
$2,073 |
1.8× |
| Lung perfusion differential (78597) |
$928.90 |
$1,327 |
1.6× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,451.10 |
$2,073 |
1.8× |
| Lymph System Imaging (78195) |
$2,343.60 |
$3,348 |
3.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$7,288.40 |
$10,412 |
1.6× |
| Magnetic Image Jaw Joint (70336) |
$1,933.40 |
$2,762 |
5.5× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$1,881.60 |
$2,688 |
7.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$1,811.60 |
$2,588 |
2.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$3,303.30 |
$4,719 |
12.9× |
| Mammary ductogram or galactogram multiple (77054) |
$711.90 |
$1,017 |
2.0× |
| Mammary ductogram or galactogram single (77053) |
$594.30 |
$849 |
1.7× |
| Meckels Divert Exam (78290) |
$2,030.70 |
$2,901 |
3.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$8,689.10 |
$12,413 |
15.9× |
| Mr safety determination physician/other qhp (76016) |
$247.10 |
$353 |
1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$68.60 |
$98 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$257.60 |
$368 |
1.9× |
| Mr safety implt pos&/immoblj (76019) |
$165.90 |
$237 |
1.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$676.90 |
$967 |
1.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,596.30 |
$3,709 |
5.1× |
| MRA head w/o contrast (70544) |
$1,773.10 |
$2,533 |
5.1× |
| MRA head with contrast (70545) |
$2,367.40 |
$3,382 |
4.6× |
| MRA neck w contrast (70548) |
$973.70 |
$1,391 |
1.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,221.50 |
$1,745 |
2.4× |
| MRA neck w/o contrast (70547) |
$788.90 |
$1,127 |
2.3× |
| MRI abdomen w contrast (74182) |
$3,112.90 |
$4,447 |
6.1× |
| MRI abdomen w/o contrast (74181) |
$2,766.40 |
$3,952 |
7.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,055.60 |
$1,508 |
0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,332.10 |
$1,903 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,426.60 |
$2,038 |
1.2× |
| MRI bone marrow blood supply (77084) |
$1,411.20 |
$2,016 |
4.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,822.10 |
$2,603 |
5.2× |
| MRI cardiac w/o cont stress (75559) |
$2,291.10 |
$3,273 |
2.9× |
| MRI cardiac w/o contrast (75557) |
$2,289.70 |
$3,271 |
6.6× |
| MRI cervical spine w contrast (72142) |
$1,087.80 |
$1,554 |
2.1× |
| MRI cervical spine w/o cont (72141) |
$928.90 |
$1,327 |
2.7× |
| MRI chest w/o contrast (71550) |
$1,687 |
$2,410 |
4.8× |
| MRI chest with contrast (71551) |
$2,207.80 |
$3,154 |
1.9× |
| MRI chest wo w contrast (71552) |
$3,345.30 |
$4,779 |
6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,054.90 |
$1,507 |
2.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,334.90 |
$1,907 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$870.80 |
$1,244 |
2.5× |
| MRI lumbar spine w contrast (72149) |
$890.40 |
$1,272 |
1.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,247.40 |
$1,782 |
2.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,224.60 |
$3,178 |
6.4× |
| MRI orbit face neck w contrast (70542) |
$2,530.50 |
$3,615 |
5.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,896.20 |
$5,566 |
7.6× |
| MRI pelvis w contrast (72196) |
$1,047.90 |
$1,497 |
2.1× |
| MRI pelvis w/o & w contrast (72197) |
$1,326.50 |
$1,895 |
2.6× |
| MRI pelvis w/o contrast (72195) |
$863.10 |
$1,233 |
2.5× |
| MRI spectroscopy (76390) |
$2,277.80 |
$3,254 |
17.9× |
| MRI thoracic spine w/o contrast (72146) |
$681.10 |
$973 |
2.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,066.80 |
$1,524 |
2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$882 |
$1,260 |
2.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,348.90 |
$1,927 |
2.6× |
| MRI, abdomen, combo (74183) |
$3,343.20 |
$4,776 |
6.6× |
| MRI, dorsal spine combo (72157) |
$1,039.50 |
$1,485 |
2.0× |
| MRI, dorsal spine contrast (72147) |
$820.40 |
$1,172 |
1.6× |
| MRI, joint upper extrem (73221) |
$882.70 |
$1,261 |
2.5× |
| MRI, joint upper extrem combo (73223) |
$1,350.30 |
$1,929 |
2.6× |
| MRI, lumbar spine combo (72158) |
$1,122.80 |
$1,604 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,992.50 |
$4,275 |
1.6× |
| N-invas est c ffr sw aly CTA (75580) |
$4,139.80 |
$5,914 |
3.3× |
| Neck soft tissue (70360) |
$255.50 |
$365 |
2.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$658 |
$940 |
1.2× |
| Nm csf leak detection (78650) |
$2,139.20 |
$3,056 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,756.60 |
$13,938 |
4.8× |
| Nuclear Rx Intra-Arterial (79445) |
$1,488.90 |
$2,127 |
4.4× |
| Nuclear Rx Oral Admin (79005) |
$1,486.80 |
$2,124 |
4.4× |
| Ob us nuchal meas 1 gest (76813) |
$364.70 |
$521 |
2.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,639.40 |
$2,342 |
2.1× |
| Parathyroid Planar Imaging (78070) |
$1,639.40 |
$2,342 |
2.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,639.40 |
$2,342 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$277.20 |
$396 |
1.8× |
| Pet Image W/Ct Lmtd (78814) |
$8,023.40 |
$11,462 |
3.8× |
| PET image w/CT, full body (78816) |
$8,435 |
$12,050 |
4.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$8,079.40 |
$11,542 |
3.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$4,058.60 |
$5,798 |
2.1× |
| PET whole body (78813) |
$7,125.30 |
$10,179 |
3.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$10,403.40 |
$14,862 |
2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,071.70 |
$1,531 |
1.8× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$1,663.20 |
$2,376 |
1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$543.90 |
$777 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$759.50 |
$1,085 |
1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$366.80 |
$524 |
2.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$270.90 |
$387 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$302.40 |
$432 |
2.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$537.60 |
$768 |
3.5× |
| Radex fingr minimum 2 views (73140) |
$258.30 |
$369 |
2.0× |
| Radex foot complete minimum 3 views (73630) |
$336.70 |
$481 |
2.6× |
| Radex Hand Minimum 3 Views (73130) |
$334.60 |
$478 |
2.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$303.10 |
$433 |
2.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$705.60 |
$1,008 |
4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$368.90 |
$527 |
2.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$412.30 |
$589 |
3.2× |
| Radex shoulder complete minimum 2 views (73030) |
$350 |
$500 |
2.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$417.90 |
$597 |
3.3× |
| Radex Spine 1 View Specify Level (72020) |
$394.80 |
$564 |
3.1× |
| Radex Sternum Minimum 2 Views (71120) |
$364.70 |
$521 |
2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$431.90 |
$617 |
3.4× |
| Radex Toe Minimum 2 Views (73660) |
$255.50 |
$365 |
2.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$273 |
$390 |
1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$312.90 |
$447 |
2.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,397.80 |
$24,854 |
1.6× |
| Radiation treatment delivery level 1 (77402) |
$709.10 |
$1,013 |
4.8× |
| Radiation treatment delivery level 2 (77407) |
$868.70 |
$1,241 |
1.5× |
| Radiation treatment delivery level 3 (77412) |
$1,062.60 |
$1,518 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$592.90 |
$847 |
3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$513.10 |
$733 |
3.4× |
| Radiologic exam colon double contrast study (74280) |
$1,516.20 |
$2,166 |
5.9× |
| Radiologic exam colon single contrast study (74270) |
$1,189.30 |
$1,699 |
4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$835.80 |
$1,194 |
3.3× |
| Radiologic exam knee complete 4/more views (73564) |
$368.20 |
$526 |
2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$401.10 |
$573 |
2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$800.10 |
$1,143 |
3.1× |
| Radiologic exam swallow function contrast study (74230) |
$833.70 |
$1,191 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$644 |
$920 |
2.5× |
| Radiologic examination femur 1 view (73551) |
$221.20 |
$316 |
1.7× |
| Radiologic examination femur minimum 2 views (73552) |
$372.40 |
$532 |
2.9× |
| Radiologic examination knee 1/2 views (73560) |
$333.90 |
$477 |
2.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$1,733.90 |
$2,477 |
11.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$300.30 |
$429 |
2.4× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$156.80 |
$224 |
1.2× |
| Renal Cyst Study (74470) |
$966.70 |
$1,381 |
1.2× |
| Ribs bilateral 3 views (71110) |
$667.80 |
$954 |
4.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,435 |
$2,050 |
2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,469.30 |
$2,099 |
2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,720.90 |
$3,887 |
3.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,615.20 |
$3,736 |
3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,022.60 |
$4,318 |
3.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,758.90 |
$8,227 |
2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$5,075.70 |
$7,251 |
2.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,779.40 |
$2,542 |
5.2× |
| Rp Therapy Intravenous Administration (79101) |
$1,347.50 |
$1,925 |
3.9× |
| Scapula (73010) |
$336.70 |
$481 |
2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$98.70 |
$141 |
4.2× |
| Shoulder 1 view (73020) |
$270.90 |
$387 |
2.1× |
| Shoulder Arthrography (73040) |
$654.50 |
$935 |
1.3× |
| Skull less than 4 views (70250) |
$352.80 |
$504 |
2.3× |
| Special dosimetry (77331) |
$675.50 |
$965 |
3.4× |
| Special Physics Consult (77370) |
$707 |
$1,010 |
3.6× |
| Special teletherapy port plan (77321) |
$1,274.70 |
$1,821 |
2.3× |
| Special treatment procedure (77470) |
$1,633.80 |
$2,334 |
2.0× |
| Stereotactic Body Radiation Delivery (77373) |
$8,668.10 |
$12,383 |
3.3× |
| Sternoclavicular joints (71130) |
$376.60 |
$538 |
3.0× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$755.30 |
$1,079 |
5.1× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$755.30 |
$1,079 |
5.1× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$755.30 |
$1,079 |
13.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$608.30 |
$869 |
4.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,862 |
$2,660 |
3.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,331.70 |
$3,331 |
4.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,510.90 |
$3,587 |
4.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,132.90 |
$3,047 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,411.20 |
$2,016 |
7.2× |
| Thoracic spine 2 views (72070) |
$432.60 |
$618 |
2.8× |
| Thoracic spine 3 views (72072) |
$530.60 |
$758 |
3.5× |
| Thoracolumbar 2 views (72080) |
$470.40 |
$672 |
3.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$841.40 |
$1,202 |
1.4× |
| Thyroid Met Imaging Body (78018) |
$2,575.30 |
$3,679 |
3.2× |
| Thyroid Uptake Measurement (78012) |
$898.10 |
$1,283 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,433.60 |
$2,048 |
2.5× |
| Tx Devices Design & Construction Complex (77334) |
$1,535.10 |
$2,193 |
2.8× |
| Tx devices design & construction intermediate (77333) |
$929.60 |
$1,328 |
4.7× |
| Tx devices design & construction simple (77332) |
$548.10 |
$783 |
2.8× |
| Ultrasound Breast Limited (76642) |
$426.30 |
$609 |
3.3× |
| Ultrasound elastography first target lesion (76982) |
$338.10 |
$483 |
2.2× |
| Ultrasound Elastography Parenchyma (76981) |
$338.10 |
$483 |
2.2× |
| Ultrasound Exam Aaa Screen (76706) |
$971.60 |
$1,388 |
6.4× |
| Ultrasound, abdomen limited (76705) |
$676.20 |
$966 |
4.4× |
| Umbilical-artery Doppler (OB) (76820) |
$422.10 |
$603 |
2.8× |
| Unlisted Dx Radiographic Procedure (76499) |
$73.50 |
$105 |
0.6× |
| Unlisted fluoroscopic procedure (76496) |
$218.40 |
$312 |
1.7× |
| Upper gi w/o kub (74240) |
$1,054.90 |
$1,507 |
4.1× |
| Ureteral Reflux Study (78740) |
$1,225.70 |
$1,751 |
2.1× |
| Urethrocystogram voiding (74455) |
$1,040.20 |
$1,486 |
3.0× |
| Urethrocystography retrograde (74450) |
$838.60 |
$1,198 |
2.4× |
Us breast unilateral complete (76641)
range across 2 matching MRF lines |
$559.30–$1,118.60 |
$799–$1,598 |
varies |
| Us chest (76604) |
$719.60 |
$1,028 |
4.7× |
| Us complete joint (76881) |
$655.20 |
$936 |
4.3× |
| Us exam, pelvic, limited (76857) |
$593.60 |
$848 |
3.9× |
| Us head (76506) |
$475.30 |
$679 |
3.1× |
| Us kidney transplant (76776) |
$1,238.30 |
$1,769 |
8.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$422.10 |
$603 |
2.8× |
| Us ob detailed single fetus (76811) |
$823.20 |
$1,176 |
2.4× |
| Us ob limited 1 or more fetuses (76815) |
$611.10 |
$873 |
4.0× |
| Us ob transvaginal (76817) |
$749.70 |
$1,071 |
4.9× |
| Us pelvic non ob complete (76856) |
$1,039.50 |
$1,485 |
6.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$564.90 |
$807 |
3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$543.90 |
$777 |
3.6× |
| Us retroperitoneal complete (76770) |
$1,010.10 |
$1,443 |
6.6× |
| Us retroperitoneal limited (76775) |
$1,238.30 |
$1,769 |
8.1× |
| Us scrotum and contents (76870) |
$847.70 |
$1,211 |
5.5× |
| Us spinal canal and contents (76800) |
$611.10 |
$873 |
4.0× |
| Us thyroid (76536) |
$988.40 |
$1,412 |
6.5× |
| Us transrectal (76872) |
$1,007.30 |
$1,439 |
6.6× |
| Vein X-Ray Chest (75827) |
$2,808.40 |
$4,012 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,964.80 |
$5,664 |
0.9× |
| Vein X-Ray Skull Epidural (75872) |
$3,927 |
$5,610 |
4.3× |
| Venogram Sinus/Jugular (75860) |
$3,769.50 |
$5,385 |
0.8× |
| Venography Adrenal Unilateral (75840) |
$4,127.20 |
$5,896 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$4,953.20 |
$7,076 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$2,472.40 |
$3,532 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$1,948.10 |
$2,783 |
0.8× |
| Venography Renal Bilateral (75833) |
$4,953.20 |
$7,076 |
1.1× |
| Venography Renal Unilateral (75831) |
$4,127.20 |
$5,896 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$274.40 |
$392 |
2.2× |
| Wrist 2 views (73100) |
$223.30 |
$319 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$446.60 |
$638 |
3.5× |
| X-ray antegrade pyelogram tube (74425) |
$902.30 |
$1,289 |
1.8× |
| X-Ray Aorta Leg Arteries (75630) |
$5,833.10 |
$8,333 |
1.3× |
| X-Ray Bend Only L-S Spine (72120) |
$629.30 |
$899 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$332.50 |
$475 |
2.6× |
| X-Ray Exam Breast Specimen (76098) |
$854.70 |
$1,221 |
1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$223.30 |
$319 |
1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$420.70 |
$601 |
2.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$352.10 |
$503 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$453.60 |
$648 |
3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$470.40 |
$672 |
3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$554.40 |
$792 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$634.90 |
$907 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$700 |
$1,000 |
4.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$781.90 |
$1,117 |
5.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$478.80 |
$684 |
3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$780.50 |
$1,115 |
5.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$509.60 |
$728 |
3.3× |
| X-ray eye for foreign body (70030) |
$219.80 |
$314 |
1.7× |
| X-ray humerus (73060) |
$274.40 |
$392 |
2.2× |
| X-ray IV pyelogram (ivp) (74400) |
$1,254.40 |
$1,792 |
4.9× |
| X-ray IV pyelogram+tomography (74415) |
$1,325.80 |
$1,894 |
5.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$267.40 |
$382 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$441.70 |
$631 |
2.9× |
| X-ray nose-rectum child f.b. (76010) |
$333.90 |
$477 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$573.30 |
$819 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$480.90 |
$687 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$369.60 |
$528 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$554.40 |
$792 |
4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$590.10 |
$843 |
3.9× |
| X-ray thoracic spine 4 vw (72074) |
$373.80 |
$534 |
2.4× |
| X-Ray Tmj Unilat (70328) |
$490 |
$700 |
3.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,268.40 |
$1,812 |
2.5× |
| X-Rays Bone Length Studies (77073) |
$541.10 |
$773 |
3.5× |
| X-Rays Bone Survey Complete (77075) |
$1,733.90 |
$2,477 |
11.3× |
| Xr c-spine 4 or 5 views (72050) |
$588 |
$840 |
3.8× |
| Xr facial bones less than 3 views (70140) |
$559.30 |
$799 |
4.4× |
| Xr orbits complete 4 views (70200) |
$690.20 |
$986 |
4.5× |