| Abdomen 2 views (74019) |
$252.60 |
$421 |
2.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$938.40 |
$1,564 |
2.0× |
| Angiography extremity bilateral rs&i (75716) |
$1,332 |
$2,220 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$2,140.80 |
$3,568 |
0.6× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$940.20 |
$1,567 |
0.1× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,949.40 |
$3,249 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,277.60 |
$3,796 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,213.80 |
$2,023 |
0.3× |
| Ankle 2 views (73600) |
$136.80 |
$228 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$556.20 |
$927 |
1.3× |
| Aortogram thoracic (75605) |
$3,862.80 |
$6,438 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$2,014.20 |
$3,357 |
0.5× |
| Arthrogram elbow (73085) |
$1,142.40 |
$1,904 |
2.7× |
| Arthrogram hip (73525) |
$564 |
$940 |
1.3× |
| Arthrogram shoulder (73040) |
$532.80 |
$888 |
1.3× |
| Arthrogram wrist (73115) |
$532.80 |
$888 |
1.3× |
| Arthrography knee lt (73580) |
$532.80 |
$888 |
1.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$758.40 |
$1,264 |
1.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$233.40 |
$389 |
0.5× |
| Bone &/joint imaging whole body (78306) |
$1,529.40 |
$2,549 |
3.2× |
| Bone age studies (77072) |
$252.60 |
$421 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$431.40 |
$719 |
0.9× |
| Bone survey complete (77075) |
$252.60 |
$421 |
2.0× |
| Brain Imaging Vascular Flow Only (78610) |
$1,157.40 |
$1,929 |
1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,124.60 |
$3,541 |
5.1× |
| Cardiac shunt detection (78428) |
$700.80 |
$1,168 |
1.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$632.40 |
$1,054 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$136.80 |
$228 |
1.3× |
| Chest 1 view (71045) |
$136.80 |
$228 |
1.3× |
| Chest 3 views (71047) |
$223.20 |
$372 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$252.60 |
$421 |
1.2× |
| Clavicle complete (73000) |
$136.80 |
$228 |
1.3× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$556.20 |
$927 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$696.60 |
$1,161 |
1.7× |
| CT abdomen and pelvis without contrast (74176) |
$651 |
$1,085 |
2.3× |
| CT abdomen w contrast (74160) |
$612 |
$1,020 |
2.9× |
| CT abdomen w wo contrast (74170) |
$699.60 |
$1,166 |
3.3× |
| CT abdomen w/o contrast (74150) |
$398.40 |
$664 |
3.2× |
| CT angio hrt w/3d image (75574) |
$723.60 |
$1,206 |
1.7× |
| CT angiography upper extremity lt (73206) |
$672.60 |
$1,121 |
3.2× |
| CT c-spine w/o contrast (72125) |
$402.60 |
$671 |
3.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,345.20 |
$2,242 |
6.4× |
| CT cervical spine with contrast (72126) |
$1,166.40 |
$1,944 |
2.8× |
| CT chest w/wo contrast (71270) |
$699 |
$1,165 |
3.3× |
| CT chest with contrast (71260) |
$571.80 |
$953 |
2.7× |
| CT head/brain with contrast (70460) |
$556.20 |
$927 |
2.6× |
| CT head/brain without and with contrast (70470) |
$568.80 |
$948 |
2.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$376.80 |
$628 |
0.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$163.20 |
$272 |
1.6× |
| CT hrt w/3d image congen (75573) |
$877.80 |
$1,463 |
2.1× |
| CT iac w contrast (70481) |
$815.10 |
$1,358.50 |
3.9× |
| CT limited/localized follow up study (76380) |
$1,027.80 |
$1,713 |
9.9× |
| CT lower ext w/o (73700) |
$398.40 |
$664 |
3.2× |
| CT lower extremity w wo contrast (73702) |
$1,168.80 |
$1,948 |
5.6× |
| CT lower extremity with contrast (73701) |
$556.20 |
$927 |
2.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,345.20 |
$2,242 |
6.4× |
| CT lumbar spine w/o contrast (72131) |
$402.60 |
$671 |
3.2× |
| CT lumbar spine with contrast (72132) |
$1,005 |
$1,675 |
2.4× |
| CT maxillofacial w contrast (70487) |
$559.20 |
$932 |
2.7× |
| CT maxillofacial w/o contrast (70486) |
$399 |
$665 |
3.2× |
| CT maxillofacial w/wo contrast (70488) |
$699.60 |
$1,166 |
3.3× |
| CT neck soft tissue w contrast (70491) |
$556.20 |
$927 |
2.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,163.10 |
$1,938.50 |
5.5× |
| CT orbits w/o contrast (70480) |
$618.90 |
$1,031.50 |
4.9× |
| CT pelvis w & w/o contrast (72194) |
$699.60 |
$1,166 |
3.3× |
| CT pelvis w/o contrast (72192) |
$402.60 |
$671 |
3.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$680.40 |
$1,134 |
3.2× |
| CT soft tissue neck w/o contrast (70490) |
$398.40 |
$664 |
3.2× |
| CT thoracic spine w/contrast (72129) |
$1,166.40 |
$1,944 |
5.5× |
| CT thoracic spine w/o contrast (72128) |
$402.60 |
$671 |
3.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,345.20 |
$2,242 |
6.4× |
| CT thorax w/o contrast (71250) |
$402.60 |
$671 |
3.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,168.80 |
$1,948 |
5.6× |
| CT upper extremity w/o contrast rt (73200) |
$398.40 |
$664 |
3.2× |
| CT upper extremity with contrast (73201) |
$556.20 |
$927 |
1.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$646.20 |
$1,077 |
3.1× |
| Cta Abdomen (74175) |
$723 |
$1,205 |
3.4× |
| CTA abdomen pelvis (74174) |
$1,485.60 |
$2,476 |
3.6× |
| CTA chest (71275) |
$723 |
$1,205 |
3.4× |
| Cta Head (70496) |
$722.40 |
$1,204 |
3.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$822 |
$1,370 |
2.0× |
| CTA lwr ext w&w/o contrast (73706) |
$694.50 |
$1,157.50 |
3.3× |
| Cta Neck (70498) |
$722.40 |
$1,204 |
3.4× |
| Cta Pelvis (72191) |
$1,192.80 |
$1,988 |
5.7× |
| Cystography minimum 3 views rs&i (74430) |
$556.20 |
$927 |
1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$252.60 |
$421 |
2.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$252.60 |
$421 |
2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$252.60 |
$421 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$252.60 |
$421 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$136.80 |
$228 |
1.3× |
| Dxa bone density study axial skeleton (77085) |
$319.80 |
$533 |
2.6× |
| Echo exam of fetal heart (76825) |
$1,072.80 |
$1,788 |
1.6× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$511.80 |
$853 |
1.8× |
| Echoencephalography real time imaging (76506) |
$252.60 |
$421 |
2.0× |
| Esophagus (74220) |
$556.20 |
$927 |
2.6× |
| Fetal biophysical profile non-stress testing (76818) |
$255 |
$425 |
2.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$255 |
$425 |
2.0× |
| Fluoroscopy up to 1 hr (76000) |
$511.80 |
$853 |
1.8× |
| Foot 2 views (73620) |
$136.80 |
$228 |
1.3× |
| Forearm 2 views (73090) |
$136.80 |
$228 |
1.3× |
| Functional MRI brain by phys/psych (70555) |
$1,317.60 |
$2,196 |
4.6× |
| Functional MRI brain by tech (70554) |
$1,317.60 |
$2,196 |
4.6× |
| Gated Heart Planar Single (78472) |
$816.60 |
$1,361 |
1.7× |
| Hand 2 views (73120) |
$252.60 |
$421 |
2.0× |
| Hand 3 views (73130) |
$136.80 |
$228 |
1.3× |
| Heart Infarct Image (78466) |
$351.60 |
$586 |
0.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,933.40 |
$4,889 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$998.40 |
$1,664 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$854.40 |
$1,424 |
1.8× |
| Ht muscle image spect sing (78451) |
$1,112.40 |
$1,854 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$136.80 |
$228 |
1.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$252.60 |
$421 |
2.0× |
| Kidney imaging morphology (78700) |
$961.80 |
$1,603 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$998.40 |
$1,664 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,512 |
$2,520 |
2.3× |
| Knee 3 views (73562) |
$136.80 |
$228 |
1.3× |
| Liver & spleen imaging static only (78215) |
$105 |
$175 |
0.2× |
| Lung perfusion differential (78597) |
$769.20 |
$1,282 |
1.6× |
| Lung Ventilation Imaging (78579) |
$721.20 |
$1,202 |
1.5× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$719.40 |
$1,199 |
1.0× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$697.80 |
$1,163 |
0.4× |
| Lymphoscintigraphy (78195) |
$497.40 |
$829 |
0.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$136.80 |
$228 |
1.3× |
| Meckels Diverticulum (78290) |
$769.20 |
$1,282 |
1.6× |
| Mr elastography (76391) |
$381.60 |
$636 |
1.3× |
| Mr safety determination physician/other qhp (76016) |
$211.20 |
$352 |
2.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$142.80 |
$238 |
2.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$58.80 |
$98 |
1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$220.80 |
$368 |
1.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$580.20 |
$967 |
2.0× |
| MRA head w & w/o contrast (70546) |
$1,561.20 |
$2,602 |
3.7× |
| MRA head w/o contrast (70544) |
$1,317.60 |
$2,196 |
4.6× |
| MRA head with contrast (70545) |
$1,317.60 |
$2,196 |
3.2× |
| MRA neck w contrast (70548) |
$1,317.60 |
$2,196 |
3.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,496.40 |
$2,494 |
3.6× |
| MRA neck w/o contrast (70547) |
$1,317.60 |
$2,196 |
4.6× |
| MRI abdomen w contrast (74182) |
$1,317.60 |
$2,196 |
3.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,675.20 |
$2,792 |
4.0× |
| MRI abdomen w/o contrast (74181) |
$1,317.60 |
$2,196 |
4.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,500.60 |
$2,501 |
1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,500.60 |
$2,501 |
1.6× |
| MRI breast w/o contrast bilateral (77047) |
$495.60 |
$826 |
1.7× |
| MRI breast w/o contrast unilat (77046) |
$330 |
$550 |
1.2× |
| MRI c-spine with contrast (72142) |
$1,317.60 |
$2,196 |
3.2× |
| MRI cardiac w/o cont stress (75559) |
$1,317.60 |
$2,196 |
2.0× |
| MRI cardiac w/o contrast (75557) |
$1,512.60 |
$2,521 |
5.3× |
| MRI cervical spine w/o contrast (72141) |
$1,317.60 |
$2,196 |
4.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,662.60 |
$2,771 |
4.0× |
| MRI chest w/o contrast (71550) |
$1,317.60 |
$2,196 |
4.6× |
| MRI chest with contrast (71551) |
$1,317.60 |
$2,196 |
1.4× |
| MRI fetal sngl/1st gestation (74712) |
$557.40 |
$929 |
1.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,171.80 |
$1,953 |
2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$903.60 |
$1,506 |
2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$781.80 |
$1,303 |
2.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,317.60 |
$2,196 |
4.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,671 |
$2,785 |
4.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,453.50 |
$2,422.50 |
3.5× |
| MRI pelvis w contrast (72196) |
$1,317.60 |
$2,196 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,675.20 |
$2,792 |
4.0× |
| MRI pelvis w/o contrast (72195) |
$1,317.60 |
$2,196 |
4.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,561.20 |
$2,602 |
3.7× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,665 |
$2,775 |
1.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,561.20 |
$2,602 |
3.7× |
| MRI spectroscopy (76390) |
$1,320.60 |
$2,201 |
12.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,698 |
$2,830 |
4.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,317.60 |
$2,196 |
3.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,698 |
$2,830 |
4.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,317.60 |
$2,196 |
3.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,698 |
$2,830 |
4.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,317.60 |
$2,196 |
4.6× |
| MRI tmj (70336) |
$1,306.80 |
$2,178 |
4.6× |
| MRI upper ext joint w/o contrast (73221) |
$781.80 |
$1,303 |
2.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,005 |
$1,675 |
2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$781.80 |
$1,303 |
2.7× |
| Myelogram Cervical (72240) |
$505.20 |
$842 |
0.5× |
| Myelogram Lumbar (72265) |
$1,500.60 |
$2,501 |
1.6× |
| Myelogram thoracic (72255) |
$459.60 |
$766 |
0.5× |
| Myelography 2 or more regions (72270) |
$1,144.80 |
$1,908 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,112.40 |
$1,854 |
0.7× |
| Neck soft tissue (70360) |
$136.80 |
$228 |
1.3× |
| Nm cisternogram (78630) |
$651 |
$1,085 |
1.0× |
| Nm gastric emptying study (78264) |
$769.20 |
$1,282 |
1.6× |
| Nm red cell sequestration (78140) |
$552.60 |
$921 |
1.2× |
| Nm whole blood volume (78122) |
$411.60 |
$686 |
0.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,112.40 |
$1,854 |
0.7× |
| Nuclear medicine study of digestive tracts (78299) |
$276.60 |
$461 |
0.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,112.40 |
$1,854 |
0.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,653.60 |
$2,756 |
3.5× |
| Nuclear Rx Oral Admin (79005) |
$1,592.40 |
$2,654 |
5.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$258 |
$430 |
2.1× |
| Osseous survey infant (77076) |
$252.60 |
$421 |
2.0× |
| Osseous survey limited (77074) |
$252.60 |
$421 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$252.60 |
$421 |
2.0× |
| Perineogram (74775) |
$252.60 |
$421 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$3,729.60 |
$6,216 |
2.2× |
| PET imaging CT for attenuation limited area (78814) |
$2,073 |
$3,455 |
1.2× |
| PET imaging for CT attenuation whole body (78816) |
$4,299.60 |
$7,166 |
2.5× |
| Pr heart first pass single,planar (78481) |
$816.60 |
$1,361 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,005 |
$1,675 |
2.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,332 |
$2,220 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$632.40 |
$1,054 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$453 |
$755 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$511.80 |
$853 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$136.80 |
$228 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$252.60 |
$421 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$252.60 |
$421 |
2.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$788.40 |
$1,314 |
6.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$252.60 |
$421 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$136.80 |
$228 |
1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$327 |
$545 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$195 |
$325 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$556.20 |
$927 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$427.80 |
$713 |
2.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$556.20 |
$927 |
2.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$136.80 |
$228 |
1.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$5,493 |
$9,155 |
1.5× |
| Ribs bilateral 3 views (71110) |
$252.60 |
$421 |
2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,586 |
$4,310 |
5.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,549.80 |
$2,583 |
2.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$998.40 |
$1,664 |
1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,431.40 |
$5,719 |
2.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,191.40 |
$5,319 |
2.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$583.80 |
$973 |
2.1× |
| Rp Therapy Intravenous Administration (79101) |
$3,447 |
$5,745 |
12.3× |
| Scanogram (77073) |
$1,192.80 |
$1,988 |
9.5× |
| Scapula complete (73010) |
$252.60 |
$421 |
2.0× |
| Sialogram (70390) |
$453.60 |
$756 |
1.6× |
| Simulation intermediate (77285) |
$379.20 |
$632 |
0.8× |
| Small bowel series (74250) |
$252.60 |
$421 |
1.2× |
| Speech evaluation complex (70371) |
$589.20 |
$982 |
2.1× |
| Spine thoracic 3 views (72072) |
$252.60 |
$421 |
2.0× |
| Testicular Imaging With Vascular Flow (78761) |
$1,523.40 |
$2,539 |
3.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$454.80 |
$758 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$303 |
$505 |
1.9× |
| Therapeutic Enema (74283) |
$556.20 |
$927 |
2.6× |
| Thoracolumbar 2 views (72080) |
$136.80 |
$228 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,268.40 |
$2,114 |
1.9× |
| Thyroid uptake measurement (78012) |
$266.40 |
$444 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$779.40 |
$1,299 |
1.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,260 |
$2,100 |
2.6× |
| Ultrasound elastography first target lesion (76982) |
$162.60 |
$271 |
1.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$162.60 |
$271 |
0.4× |
| Ultrasound, abdomen limited (76705) |
$252.60 |
$421 |
2.0× |
| Umbilical-artery Doppler (OB) (76820) |
$252.60 |
$421 |
2.0× |
| Unlisted fluoroscopic procedure (76496) |
$796.20 |
$1,327 |
7.6× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) |
$515.40 |
$859 |
1.1× |
| Unlisted magnetic resonance procedure (76498) |
$1,718.40 |
$2,864 |
16.5× |
| Unlisted Ultrasound Procedure (76999) |
$208.20 |
$347 |
2.0× |
| Upper Extremity Infant (73092) |
$252.60 |
$421 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$511.80 |
$853 |
1.8× |
| Urethrocystography voiding (74455) |
$511.80 |
$853 |
1.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$564 |
$940 |
2.7× |
| Us breast unilateral complete (76641) |
$252.60 |
$421 |
2.0× |
| Us breast unilateral limited (76642) |
$379.80 |
$633 |
3.6× |
| Us chest (76604) |
$252.60 |
$421 |
2.0× |
| Us compl joint r-t w/image documentation (76881) |
$252.60 |
$421 |
2.0× |
| Us elastography parenchyma (76981) |
$217.20 |
$362 |
1.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$255 |
$425 |
2.0× |
| Us infant hips dynamic (76885) |
$136.80 |
$228 |
1.3× |
| Us infant hips limited static (76886) |
$136.80 |
$228 |
1.3× |
| Us kidney transplant (76776) |
$252.60 |
$421 |
2.0× |
| Us ob detailed single fetus (76811) |
$580.20 |
$967 |
2.0× |
| Us ob transvaginal (76817) |
$258 |
$430 |
2.1× |
| Us pelvic non ob complete (76856) |
$252.60 |
$421 |
2.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$252.60 |
$421 |
2.0× |
| Us pregnancy ltd (76815) |
$255 |
$425 |
2.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$414 |
$690 |
3.3× |
| Us retroperitoneal complete (76770) |
$252.60 |
$421 |
2.0× |
| Us retroperitoneal limited (76775) |
$252.60 |
$421 |
2.0× |
| Us scrotum and contents (76870) |
$252.60 |
$421 |
2.0× |
| Us soft tissue head/neck (76536) |
$252.60 |
$421 |
2.0× |
| Us spinal canal and contents (76800) |
$252.60 |
$421 |
2.0× |
| Us transrectal (76872) |
$428.40 |
$714 |
3.4× |
| Us xtr non-vasc lmtd (76882) |
$252.60 |
$421 |
2.0× |
| Us, eye b-scan (76512) |
$252.60 |
$421 |
2.0× |
| Venogram extremity bilateral (75822) |
$1,484.40 |
$2,474 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,010.60 |
$3,351 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$1,293.90 |
$2,156.50 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$1,141.80 |
$1,903 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$2,166.60 |
$3,611 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,098.60 |
$1,831 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,325.40 |
$2,209 |
0.2× |
| Wrist 2 views (73100) |
$136.80 |
$228 |
1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$136.80 |
$228 |
1.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$136.80 |
$228 |
1.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$556.20 |
$927 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$136.80 |
$228 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$136.80 |
$228 |
1.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$252.60 |
$421 |
2.0× |
| X-ray exam hip uni 1 view (73501) |
$136.80 |
$228 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$136.80 |
$228 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$295.80 |
$493 |
2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$252.60 |
$421 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$252.60 |
$421 |
2.0× |
| X-ray exam of femur 1 (73551) |
$136.80 |
$228 |
1.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$252.60 |
$421 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$279.60 |
$466 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$136.80 |
$228 |
1.3× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$226.20 |
$377 |
0.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$136.80 |
$228 |
1.3× |
| X-ray IV pyelogram+drip infusn (74410) |
$604.80 |
$1,008 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$136.80 |
$228 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$252.60 |
$421 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$136.80 |
$228 |
1.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$136.80 |
$228 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$252.60 |
$421 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$252.60 |
$421 |
2.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$144.60 |
$241 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$136.80 |
$228 |
1.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$136.80 |
$228 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$252.60 |
$421 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$252.60 |
$421 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,005 |
$1,675 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$136.80 |
$228 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$252.60 |
$421 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$252.60 |
$421 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$252.60 |
$421 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$136.80 |
$228 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$136.80 |
$228 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$136.80 |
$228 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$136.80 |
$228 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$252.60 |
$421 |
2.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$252.60 |
$421 |
2.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$136.80 |
$228 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$136.80 |
$228 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$136.80 |
$228 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$252.60 |
$421 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$136.80 |
$228 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$136.80 |
$228 |
1.3× |
| Xr arthrogram ankle (73615) |
$532.80 |
$888 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$252.60 |
$421 |
2.0× |
| Xr chest 4+ views (71048) |
$254.40 |
$424 |
2.0× |
| Xr finger(s) 2+ views (73140) |
$136.80 |
$228 |
1.3× |
| Xr shoulder 1 view (73020) |
$136.80 |
$228 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$252.60 |
$421 |
2.0× |
| Xr tibia/fibula 2 views (73590) |
$136.80 |
$228 |
1.3× |
| Xr tmj bilateral (70330) |
$420 |
$700 |
4.0× |
| Xray knee 1 or 2 views rt (73560) |
$136.80 |
$228 |
1.3× |