| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,519.28 |
$17,156 |
4.8× |
| Abdomen 1 View (74018) |
$196.08 |
$516 |
2.3× |
| Abdomen 2 views (74019) |
$217.74 |
$573 |
2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$494.76 |
$1,302 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$1,523.80 |
$4,010 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,362.68 |
$3,586 |
0.4× |
| Ankle 2 views (73600) |
$117.80 |
$310 |
1.4× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$1,637.80 |
$4,310 |
0.3× |
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure |
$1,637.80 |
$4,310 |
0.3× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$1,823.62 |
$4,799 |
0.3× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$1,637.80 |
$4,310 |
0.3× |
| Arthrogram Wrist (73115) |
$253.46 |
$667 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$598.12 |
$1,574 |
4.5× |
| Bone age studies (77072) |
$194.56 |
$512 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,464.90 |
$3,855 |
3.7× |
| Bone Imaging Limited Area (78300) |
$509.58 |
$1,341 |
1.3× |
| Bone Imaging Whole Body (78306) |
$1,351.66 |
$3,557 |
3.4× |
| Bone survey infant (77076) |
$194.94 |
$513 |
1.9× |
| Brachytx isodose complex (77318) |
$915.04 |
$2,408 |
2.5× |
| Brachytx isodose intermed (77317) |
$510.34 |
$1,343 |
1.4× |
| Brachytx Isodose Plan Simple (77316) |
$351.50 |
$925 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,402.74 |
$6,323 |
1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,303.02 |
$3,429 |
3.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$1,455.40 |
$3,830 |
1.9× |
| Cat Scan Follow-Up Study (76380) |
$298.30 |
$785 |
3.5× |
| Chest 1 view (71045) |
$123.88 |
$326 |
1.4× |
| Chest 2 views (71046) |
$126.92 |
$334 |
1.5× |
| Chest 4 or more views (71048) |
$159.98 |
$421 |
1.6× |
| Clavicle complete (73000) |
$111.34 |
$293 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$88.54 |
$233 |
0.9× |
| Continuing medical physics consltj pr wk (77336) |
$719.72 |
$1,894 |
5.4× |
| Contrast Exam Abdominl Aorta (75625) |
$1,427.66 |
$3,757 |
0.5× |
| Contrast X-Ray Bladder (74430) |
$215.84 |
$568 |
0.6× |
| Contrast X-Ray Of Elbow (73085) |
$224.20 |
$590 |
0.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,806.52 |
$4,754 |
5.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,485.80 |
$3,910 |
6.3× |
| CT abdomen w contrast (74160) |
$843.60 |
$2,220 |
4.9× |
| CT abdomen w wo contrast (74170) |
$964.06 |
$2,537 |
5.6× |
| CT abdomen w/o contrast (74150) |
$682.86 |
$1,797 |
6.6× |
| CT Angio Abdomen and Pelvis (74174) |
$1,896.96 |
$4,992 |
5.5× |
| CT Angio Chest (71275) |
$943.16 |
$2,482 |
5.5× |
| CT Angio Head (70496) |
$886.16 |
$2,332 |
5.1× |
| CT angio hrt w/3d image (75574) |
$888.44 |
$2,338 |
2.6× |
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 2 matching MRF lines |
$1,200.04–$1,800.06 |
$3,158–$4,737 |
varies |
| CT Angio Neck (70498) |
$1,067.42 |
$2,809 |
6.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$960.64 |
$2,528 |
5.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$314.64 |
$828 |
1.8× |
| CT cervical spine w/ contrast (72126) |
$1,015.36 |
$2,672 |
3.0× |
| CT cervical spine w/o contrast (72125) |
$795.34 |
$2,093 |
7.7× |
| CT cervical spine w/wo cont (72127) |
$1,114.54 |
$2,933 |
6.5× |
| CT chest w contrast (71260) |
$639.92 |
$1,684 |
3.7× |
| CT chest w/wo contrast (71270) |
$898.32 |
$2,364 |
5.2× |
| CT head/brain with contrast (70460) |
$729.60 |
$1,920 |
4.2× |
| CT head/brain without and with contrast (70470) |
$843.98 |
$2,221 |
4.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$514.90 |
$1,355 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$37.62 |
$99 |
0.4× |
| CT iac w contrast (70481) |
$819.66 |
$2,157 |
4.8× |
| CT l-spine w&w/o contrast (72133) |
$1,127.46 |
$2,967 |
6.5× |
| CT lower ext w/o (73700) |
$622.44 |
$1,638 |
6.1× |
CT lower extremity w/contrast material (73701)
range across 2 matching MRF lines |
$726.18–$1,089.46 |
$1,911–$2,867 |
varies |
| CT lumbar spine w contrast (72132) |
$1,015.36 |
$2,672 |
3.0× |
| CT lumbar spine w/o contrast (72131) |
$666.52 |
$1,754 |
6.5× |
| CT maxillofacial w contrast (70487) |
$787.74 |
$2,073 |
4.6× |
| CT maxillofacial wo contrast (70486) |
$684.38 |
$1,801 |
6.7× |
| CT neck tissue combo (70492) |
$1,016.50 |
$2,675 |
5.9× |
| CT orbits w/o contrast (70480) |
$657.40 |
$1,730 |
6.4× |
| CT pelvis w&w/o contrast (72194) |
$943.92 |
$2,484 |
5.5× |
| CT pelvis w/o contrast (72192) |
$520.98 |
$1,371 |
5.1× |
| CT scan of leg combo (73702) |
$1,143.04 |
$3,008 |
6.6× |
| CT scans face/jaw combo (70488) |
$805.22 |
$2,119 |
4.7× |
| CT soft tissue neck w contrast (70491) |
$781.28 |
$2,056 |
4.5× |
| CT soft tissue neck w/o contrast (70490) |
$593.18 |
$1,561 |
5.8× |
| CT thoracic spine w contrast (72129) |
$1,015.36 |
$2,672 |
5.9× |
| CT thoracic spine w/o contrast (72128) |
$693.88 |
$1,826 |
6.7× |
| CT thoracic spine w/wo cont (72130) |
$1,250.20 |
$3,290 |
7.2× |
| CT thorax w/o contrast (71250) |
$492.48 |
$1,296 |
4.8× |
| CT upper ext wo (73200) |
$602.68 |
$1,586 |
5.9× |
| CT upper extremity with contrast (73201) |
$708.70 |
$1,865 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$642.20 |
$1,690 |
3.7× |
| Cta Abdomen (74175) |
$1,012.32 |
$2,664 |
5.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,953.58 |
$5,141 |
5.7× |
| CTA pelvis (72191) |
$991.04 |
$2,608 |
5.7× |
| Dilation ureters/urethra rs&i (74485) |
$692.74 |
$1,823 |
0.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$212.42 |
$559 |
2.1× |
| Dxa Bone Density Axial (77080) |
$136.80 |
$360 |
1.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$114 |
$300 |
1.3× |
| Echograp Trans R Pros Study (76873) |
$258.78 |
$681 |
2.5× |
| Esophagram (74220) |
$178.60 |
$470 |
1.0× |
| Fetal Biophys Profile W/Nst (76818) |
$253.84 |
$668 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$242.06 |
$637 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$237.12 |
$624 |
1.0× |
| Follow-Up Angiography (75898) |
$946.58 |
$2,491 |
0.3× |
| Foot 2 views (73620) |
$102.60 |
$270 |
1.2× |
| Forearm 2 views (73090) |
$126.54 |
$333 |
1.5× |
| Gastric emptying imaging study (78264) |
$1,181.04 |
$3,108 |
3.0× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,401.06 |
$3,687 |
3.6× |
| Gated Heart Planar Single (78472) |
$644.48 |
$1,696 |
1.6× |
| Hand 2 views (73120) |
$122.36 |
$322 |
1.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,103.30 |
$5,535 |
3.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,890.88 |
$4,976 |
2.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,442.10 |
$3,795 |
0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,267.30 |
$3,335 |
0.4× |
| Hepatobil Syst Image W/Drug (78227) |
$1,253.62 |
$3,299 |
2.3× |
| Hepatobiliary System Imaging (78226) |
$606.86 |
$1,597 |
1.5× |
| Ht Muscle Image Spect Sing (78451) |
$1,803.10 |
$4,745 |
1.4× |
| Hysterosalpingogram (74740) |
$454.86 |
$1,197 |
1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$201.02 |
$529 |
2.3× |
| Infant hip ultrasound, limited static exam (76886) |
$76.76 |
$202 |
0.9× |
| Interstitial radiation source applic complex (77778) |
$3,111.06 |
$8,187 |
4.5× |
| K Flow/Funct Image W/Drug (78708) |
$631.94 |
$1,663 |
1.2× |
| K Flow/Funct Image W/O Drug (78707) |
$596.98 |
$1,571 |
1.1× |
| Knee 3 Views (73562) |
$133.38 |
$351 |
1.6× |
| Lymph System Imaging (78195) |
$511.10 |
$1,345 |
1.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$946.58 |
$2,491 |
0.3× |
| Magnetic Image Jaw Joint (70336) |
$769.12 |
$2,024 |
3.3× |
| Meckels Divert Exam (78290) |
$403.94 |
$1,063 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$639.92 |
$1,684 |
1.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,636.28 |
$4,306 |
4.8× |
| MRA head w/o contrast (70544) |
$884.26 |
$2,327 |
3.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,173.06 |
$3,087 |
3.4× |
| MRA neck w/o contrast (70547) |
$790.02 |
$2,079 |
3.4× |
| MRI abdomen w contrast (74182) |
$1,429.56 |
$3,762 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$919.98 |
$2,421 |
3.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,499.86 |
$3,947 |
1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,730.14 |
$4,553 |
5.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,465.28 |
$3,856 |
1.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$714.40 |
$1,880 |
3.0× |
| MRI cardiac w/o contrast (75557) |
$1,006.62 |
$2,649 |
4.3× |
| MRI cervical spine w/o cont (72141) |
$951.90 |
$2,505 |
4.1× |
| MRI chest w/o contrast (71550) |
$960.64 |
$2,528 |
4.1× |
| MRI chest wo w contrast (71552) |
$1,306.06 |
$3,437 |
3.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,744.58 |
$4,591 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,197 |
$3,150 |
5.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,379.78 |
$3,631 |
4.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$861.84 |
$2,268 |
3.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,364.20 |
$3,590 |
4.0× |
| MRI pelvis w/o & w contrast (72197) |
$1,559.52 |
$4,104 |
4.5× |
| MRI pelvis w/o contrast (72195) |
$896.80 |
$2,360 |
3.8× |
| MRI spectroscopy (76390) |
$780.52 |
$2,054 |
9.1× |
| MRI thoracic spine w/o contrast (72146) |
$938.60 |
$2,470 |
4.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$780.90 |
$2,055 |
3.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,291.24 |
$3,398 |
3.8× |
| MRI, abdomen, combo (74183) |
$1,516.20 |
$3,990 |
4.4× |
| MRI, dorsal spine combo (72157) |
$1,713.42 |
$4,509 |
5.0× |
| MRI, joint upper extrem (73221) |
$1,076.92 |
$2,834 |
4.6× |
| MRI, joint upper extrem combo (73223) |
$1,548.50 |
$4,075 |
4.5× |
| MRI, lumbar spine combo (72158) |
$1,442.10 |
$3,795 |
4.2× |
| Myelogram Lumbar (72265) |
$461.70 |
$1,215 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,698.38 |
$7,101 |
2.1× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$2,137.88 |
$5,626 |
1.0× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$2,342.32 |
$6,164 |
1.1× |
| N-invas est c ffr sw aly CTA (75580) |
$2,319.14 |
$6,103 |
2.7× |
| Neck soft tissue (70360) |
$107.16 |
$282 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,950.64 |
$13,028 |
3.6× |
| Nuclear Rx Intra-Arterial (79445) |
$269.42 |
$709 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$1,094.02 |
$2,879 |
4.8× |
| Panoramic X-ray of jaws (70355) |
$99.94 |
$263 |
1.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,116.82 |
$2,939 |
2.1× |
| Parathyroid Planar Imaging (78070) |
$436.24 |
$1,148 |
1.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$913.52 |
$2,404 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$112.48 |
$296 |
1.1× |
| Pet Image W/Ct Lmtd (78814) |
$2,071.76 |
$5,452 |
1.5× |
| PET image w/CT, full body (78816) |
$2,518.26 |
$6,627 |
1.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,503.44 |
$6,588 |
1.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,077.30 |
$2,835 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$526.68 |
$1,386 |
1.3× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$640.30 |
$1,685 |
0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$311.22 |
$819 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$198.74 |
$523 |
0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$128.44 |
$338 |
1.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$92.34 |
$243 |
1.1× |
| Radex elbow complete minimum 3 views (73080) |
$128.06 |
$337 |
1.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$217.36 |
$572 |
2.1× |
| Radex fingr minimum 2 views (73140) |
$100.32 |
$264 |
1.2× |
| Radex foot complete minimum 3 views (73630) |
$126.16 |
$332 |
1.5× |
| Radex Hand Minimum 3 Views (73130) |
$126.92 |
$334 |
1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$121.98 |
$321 |
1.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$128.82 |
$339 |
1.5× |
| Radex shoulder complete minimum 2 views (73030) |
$130.72 |
$344 |
1.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$120.08 |
$316 |
1.4× |
| Radex Spine 1 View Specify Level (72020) |
$101.84 |
$268 |
1.2× |
| Radex Sternum Minimum 2 Views (71120) |
$112.86 |
$297 |
1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$105.26 |
$277 |
1.2× |
| Radex Toe Minimum 2 Views (73660) |
$105.26 |
$277 |
1.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$129.96 |
$342 |
1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$126.54 |
$333 |
1.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$4,938.10 |
$12,995 |
0.7× |
| Radiation treatment delivery level 1 (77402) |
$868.30 |
$2,285 |
8.7× |
| Radiation treatment delivery level 2 (77407) |
$1,064 |
$2,800 |
2.8× |
| Radiation treatment delivery level 3 (77412) |
$1,311 |
$3,450 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$165.30 |
$435 |
1.6× |
| Radiologic exam colon double contrast study (74280) |
$288.04 |
$758 |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$268.28 |
$706 |
1.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$260.68 |
$686 |
1.5× |
| Radiologic exam knee complete 4/more views (73564) |
$163.78 |
$431 |
1.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$143.26 |
$377 |
1.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$231.42 |
$609 |
1.3× |
| Radiologic exam swallow function contrast study (74230) |
$178.22 |
$469 |
1.0× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$106.78 |
$281 |
0.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$414.96 |
$1,092 |
2.4× |
| Radiologic examination femur 1 view (73551) |
$92.34 |
$243 |
1.1× |
| Radiologic examination femur minimum 2 views (73552) |
$122.36 |
$322 |
1.4× |
| Radiologic examination knee 1/2 views (73560) |
$116.66 |
$307 |
1.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$128.06 |
$337 |
1.5× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$35.72 |
$94 |
0.4× |
| Radiopharm Dacryocystography (78660) |
$185.82 |
$489 |
0.5× |
| Renal Cyst Study (74470) |
$332.88 |
$876 |
0.6× |
| Ribs bilateral 3 views (71110) |
$180.50 |
$475 |
1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,604.74 |
$4,223 |
3.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,660.60 |
$4,370 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$448.78 |
$1,181 |
2.0× |
| Scapula (73010) |
$115.90 |
$305 |
1.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$41.80 |
$110 |
1.8× |
| Shoulder 1 view (73020) |
$114.76 |
$302 |
1.3× |
| Shoulder Arthrography (73040) |
$299.06 |
$787 |
0.9× |
| Skull less than 4 views (70250) |
$152.38 |
$401 |
1.5× |
| Special dosimetry (77331) |
$184.30 |
$485 |
1.4× |
| Special Physics Consult (77370) |
$446.50 |
$1,175 |
3.4× |
| Special teletherapy port plan (77321) |
$913.52 |
$2,404 |
2.5× |
| Special treatment procedure (77470) |
$1,832.36 |
$4,822 |
3.4× |
| Stereotactic Body Radiation Delivery (77373) |
$2,262.14 |
$5,953 |
1.3× |
| Sternoclavicular joints (71130) |
$116.28 |
$306 |
1.4× |
| Superior sagittal sinus venogram (75870) |
$946.58 |
$2,491 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,230.44 |
$3,238 |
3.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$633.84 |
$1,668 |
1.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,545.84 |
$4,068 |
4.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$819.66 |
$2,157 |
6.2× |
| Thoracic spine 2 views (72070) |
$133.38 |
$351 |
1.3× |
| Thoracic spine 3 views (72072) |
$155.80 |
$410 |
1.5× |
| Thoracolumbar 2 views (72080) |
$115.90 |
$305 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$352.64 |
$928 |
0.9× |
| Thyroid Met Imaging Body (78018) |
$1,463 |
$3,850 |
2.7× |
| Thyroid Uptake Measurement (78012) |
$233.32 |
$614 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$880.46 |
$2,317 |
2.2× |
| Tx Devices Design & Construction Complex (77334) |
$1,063.62 |
$2,799 |
2.9× |
| Tx devices design & construction simple (77332) |
$531.24 |
$1,398 |
4.0× |
| Ultrasound Breast Limited (76642) |
$194.56 |
$512 |
2.3× |
| Ultrasound Elastography Parenchyma (76981) |
$146.30 |
$385 |
1.4× |
| Ultrasound Exam Aaa Screen (76706) |
$101.84 |
$268 |
1.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$356.44 |
$938 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$304 |
$800 |
3.0× |
| Umbilical-artery Doppler (OB) (76820) |
$196.08 |
$516 |
1.9× |
| Unlisted fluoroscopic procedure (76496) |
$99.94 |
$263 |
1.2× |
| Upper gi w/o kub (74240) |
$270.18 |
$711 |
1.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$11.40 |
$30 |
1.0× |
| Urea breath test c-14 isotopic analysis (78268) |
$131.48 |
$346 |
1.4× |
| Ureteral Reflux Study (78740) |
$517.18 |
$1,361 |
1.3× |
| Urethrocystogram voiding (74455) |
$215.46 |
$567 |
0.9× |
| Urethrocystography retrograde (74450) |
$227.24 |
$598 |
1.0× |
Us breast unilateral complete (76641)
range across 4 matching MRF lines |
$232.56–$348.84 |
$612–$918 |
varies |
| Us chest (76604) |
$153.14 |
$403 |
1.5× |
| Us complete joint (76881) |
$288.04 |
$758 |
2.8× |
| Us exam, pelvic, limited (76857) |
$294.88 |
$776 |
2.9× |
| Us head (76506) |
$117.42 |
$309 |
1.1× |
| Us kidney transplant (76776) |
$197.22 |
$519 |
1.9× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 3 matching MRF lines |
$214.32–$321.48 |
$564–$846 |
varies |
| Us ob detailed single fetus (76811) |
$352.26 |
$927 |
1.5× |
| Us ob limited 1 or more fetuses (76815) |
$197.22 |
$519 |
1.9× |
| Us ob transvaginal (76817) |
$195.70 |
$515 |
1.9× |
| Us pelvic non ob complete (76856) |
$376.58 |
$991 |
3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$200.26 |
$527 |
1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$229.52 |
$604 |
2.2× |
| Us retroperitoneal complete (76770) |
$251.18 |
$661 |
2.4× |
| Us retroperitoneal limited (76775) |
$161.12 |
$424 |
1.6× |
| Us scrotum and contents (76870) |
$322.24 |
$848 |
3.1× |
| Us spinal canal and contents (76800) |
$220.02 |
$579 |
2.1× |
| Us thyroid (76536) |
$341.24 |
$898 |
3.3× |
| Us transrectal (76872) |
$310.46 |
$817 |
3.0× |
| Vein X-Ray Chest (75827) |
$1,151.78 |
$3,031 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$946.58 |
$2,491 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,086.42 |
$2,859 |
0.3× |
| Venography extremity bilateral rs&i (75822) |
$664.24 |
$1,748 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$641.82 |
$1,689 |
0.4× |
| Venography Renal Bilateral (75833) |
$1,622.98 |
$4,271 |
0.5× |
| Venography Renal Unilateral (75831) |
$1,428.04 |
$3,758 |
0.5× |
| Wrist 2 views (73100) |
$109.82 |
$289 |
1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$113.62 |
$299 |
1.3× |
| X-Ray Aorta Leg Arteries (75630) |
$1,521.52 |
$4,004 |
0.5× |
| X-Ray Bend Only L-S Spine (72120) |
$171 |
$450 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$118.18 |
$311 |
1.4× |
| X-Ray Exam Breast Specimen (76098) |
$241.30 |
$635 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$219.64 |
$578 |
2.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$283.48 |
$746 |
2.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$107.16 |
$282 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$121.60 |
$320 |
1.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$169.10 |
$445 |
1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$155.42 |
$409 |
1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$202.54 |
$533 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$238.26 |
$627 |
2.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$246.24 |
$648 |
2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$126.16 |
$332 |
1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$269.42 |
$709 |
2.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$176.32 |
$464 |
1.7× |
| X-ray eye for foreign body (70030) |
$64.60 |
$170 |
0.8× |
| X-ray humerus (73060) |
$115.52 |
$304 |
1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$109.82 |
$289 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$143.26 |
$377 |
1.4× |
| X-ray nose-rectum child f.b. (76010) |
$71.06 |
$187 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$192.66 |
$507 |
1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$144.78 |
$381 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$128.44 |
$338 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$133.76 |
$352 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$187.34 |
$493 |
1.8× |
| X-ray thoracic spine 4 vw (72074) |
$180.12 |
$474 |
1.8× |
| X-Ray Tmj Unilat (70328) |
$65.74 |
$173 |
0.8× |
| X-Rays Bone Length Studies (77073) |
$147.06 |
$387 |
1.4× |
| X-Rays Bone Survey Complete (77075) |
$193.04 |
$508 |
1.9× |
| Xr c-spine 4 or 5 views (72050) |
$206.34 |
$543 |
2.0× |
| Xr facial bones less than 3 views (70140) |
$105.64 |
$278 |
1.2× |