| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,237.75 |
$4,317 |
2.0× |
| Abdomen 2 views (74019) |
$293.25 |
$391 |
2.3× |
| Angiography extremity bilateral rs&i (75716) |
$5,937 |
$7,916 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$5,274 |
$7,032 |
1.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$6,645.75 |
$8,861 |
1.8× |
| Basic dosimetry (77300) |
$358.50 |
$478 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$1,173 |
$1,564 |
2.4× |
| Bone age studies (77072) |
$174 |
$232 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$1,632.75 |
$2,177 |
3.4× |
| Bone survey complete (77075) |
$600 |
$800 |
4.8× |
| Cervical spine 2 or 3 views (72040) |
$291.75 |
$389 |
2.8× |
| Chest 1 view (71045) |
$170.25 |
$227 |
1.6× |
| Chest xray 3 views (71047) |
$286.50 |
$382 |
2.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$697.50 |
$930 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$617.25 |
$823 |
4.9× |
| Continuing medical physics consltj pr wk (77336) |
$358.50 |
$478 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,199.75 |
$2,933 |
5.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,068 |
$1,424 |
3.7× |
| CT abdomen w contrast (74160) |
$1,654.50 |
$2,206 |
7.9× |
| CT abdomen w wo contrast (74170) |
$2,568.75 |
$3,425 |
12.2× |
| CT abdomen w/o contrast (74150) |
$1,010.62 |
$1,347.50 |
8.1× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,517 |
$3,356 |
12.0× |
| CT c-spine w/contrast (72126) |
$1,684.50 |
$2,246 |
4.0× |
| CT c-spine w/o contrast (72125) |
$1,419 |
$1,892 |
11.3× |
| CT chest w contrast (71260) |
$1,726.50 |
$2,302 |
8.2× |
| CT head/brain without and with contrast (70470) |
$1,734.75 |
$2,313 |
8.3× |
| CT iac w contrast (70481) |
$2,117.25 |
$2,823 |
10.1× |
| CT lower ext w/o (73700) |
$1,393.50 |
$1,858 |
11.1× |
| CT lumbar spine w/contrast (72132) |
$1,704 |
$2,272 |
4.1× |
| CT lumbar spine w/o contrast (72131) |
$1,419.75 |
$1,893 |
11.3× |
| CT maxillofacial w contrast (70487) |
$1,806 |
$2,408 |
8.6× |
| CT maxillofacial wo contrast (70486) |
$1,479.75 |
$1,973 |
11.8× |
| CT orbits w/o contrast (70480) |
$1,173.75 |
$1,565 |
9.4× |
| CT pelvis w/o contrast (72192) |
$1,332.75 |
$1,777 |
10.6× |
| CT pelvis w/wo contrast (72194) |
$2,154.75 |
$2,873 |
10.3× |
| CT soft tissue neck w contrast (70491) |
$1,499.25 |
$1,999 |
7.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,438.50 |
$1,918 |
11.5× |
| CT thoracic spine w/contrast (72129) |
$1,677 |
$2,236 |
8.0× |
| CT thoracic spine w/o contrast (72128) |
$1,434.75 |
$1,913 |
11.5× |
| CT thorax w/o contrast (71250) |
$1,424.25 |
$1,899 |
11.4× |
| CT unlisted procedure (76497) |
$2,730.75 |
$3,641 |
26.2× |
| CT upper ext wo (73200) |
$1,382.25 |
$1,843 |
11.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,823.75 |
$3,765 |
13.4× |
| Cta Abdomen (74175) |
$2,559.75 |
$3,413 |
12.2× |
| CTA abdomen pelvis (74174) |
$2,686.50 |
$3,582 |
6.4× |
| CTA chest (71275) |
$1,955.25 |
$2,607 |
9.3× |
| Cta Head (70496) |
$3,552 |
$4,736 |
16.9× |
| Cta Neck (70498) |
$3,569.25 |
$4,759 |
17.0× |
| Cystography minimum 3 views rs&i (74430) |
$668.25 |
$891 |
1.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$333.75 |
$445 |
2.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$197.25 |
$263 |
1.9× |
| Esophagus (74220) |
$717.75 |
$957 |
3.4× |
| Facial bones min 3 views (70150) |
$241.50 |
$322 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$668.25 |
$891 |
2.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,009.25 |
$2,679 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,443.75 |
$1,925 |
3.0× |
| Hysterosalpingogram (74740) |
$634.50 |
$846 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,095.75 |
$1,461 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,368 |
$1,824 |
2.1× |
| Knee 3 views (73562) |
$275.25 |
$367 |
2.6× |
| Lung perfusion differential (78597) |
$885.75 |
$1,181 |
1.8× |
| Lymphoscintigraphy (78195) |
$1,671 |
$2,228 |
2.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,390.25 |
$3,187 |
5.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,003.25 |
$2,671 |
4.5× |
| MRA head w & w/o contrast (70546) |
$2,587.50 |
$3,450 |
6.2× |
| MRA head w/o contrast (70544) |
$1,730.25 |
$2,307 |
6.1× |
| MRA neck w contrast (70548) |
$1,803 |
$2,404 |
4.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,612.25 |
$3,483 |
6.2× |
| MRA neck w/o contrast (70547) |
$1,733.25 |
$2,311 |
6.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,364 |
$3,152 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,494 |
$1,992 |
5.2× |
| MRI breast w/o contrast bilateral (77047) |
$1,990.50 |
$2,654 |
7.0× |
| MRI c-spine with contrast (72142) |
$1,971.75 |
$2,629 |
4.7× |
| MRI cervical spine w/o contrast (72141) |
$1,586.25 |
$2,115 |
5.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,774.25 |
$3,699 |
6.6× |
| MRI chest w/o contrast (71550) |
$2,002.50 |
$2,670 |
7.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,921.50 |
$2,562 |
4.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,742.25 |
$2,323 |
6.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,825.50 |
$2,434 |
4.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,386.50 |
$3,182 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,776.75 |
$2,369 |
6.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,288.25 |
$3,051 |
5.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,256 |
$3,008 |
5.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,102.25 |
$2,803 |
5.0× |
| MRI temporomandibular joint (70336) |
$1,548 |
$2,064 |
5.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,585.50 |
$2,114 |
5.5× |
| MRI up ext w/o contrast (73218) |
$1,806.75 |
$2,409 |
6.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,293.75 |
$1,725 |
4.5× |
| MRI, joint upper extrem combo (73223) |
$1,580.25 |
$2,107 |
3.8× |
| Myocardial Spect Multiple Studies (78452) |
$3,051.75 |
$4,069 |
2.0× |
| Myocardial spect single study at rest or stress (78451) |
$3,072.75 |
$4,097 |
2.0× |
| Neck soft tissue (70360) |
$213.75 |
$285 |
2.0× |
| Nm gastric emptying study (78264) |
$1,386.75 |
$1,849 |
2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,798 |
$9,064 |
4.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,822.50 |
$2,430 |
3.8× |
| Pelvis 1 or 2 views (72170) |
$171.75 |
$229 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$953.25 |
$1,271 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$657.75 |
$877 |
1.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$247.50 |
$330 |
2.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$274.50 |
$366 |
2.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$193.50 |
$258 |
1.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$354 |
$472 |
2.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$384 |
$512 |
3.1× |
| Radex fingr minimum 2 views (73140) |
$243.75 |
$325 |
2.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$244.50 |
$326 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$244.50 |
$326 |
2.3× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$216 |
$288 |
1.7× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$310.50 |
$414 |
2.5× |
| Radex Humerus Minimum 2 Views (73060) |
$222.75 |
$297 |
2.1× |
| Radex Kne 1/2 Views (73560) |
$219 |
$292 |
2.1× |
| Radex Kne Compl 4/More Views (73564) |
$318 |
$424 |
2.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$237 |
$316 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$252 |
$336 |
2.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$197.25 |
$263 |
1.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$226.50 |
$302 |
2.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$272.25 |
$363 |
2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$372.75 |
$497 |
3.6× |
| Radex Toe Minimum 2 Views (73660) |
$231.75 |
$309 |
2.2× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$280.50 |
$374 |
2.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$4,789.50 |
$6,386 |
0.5× |
| Radiation treatment delivery level 3 (77412) |
$1,154.25 |
$1,539 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$149.25 |
$199 |
1.4× |
| Radiologic exam chest 2 views (71046) |
$231.75 |
$309 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$935.25 |
$1,247 |
4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$484.50 |
$646 |
2.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,018.50 |
$1,358 |
4.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$842.25 |
$1,123 |
4.0× |
| Radiological examination surgical specimen (76098) |
$660 |
$880 |
1.0× |
| Ribs bilateral 3 views (71110) |
$308.25 |
$411 |
2.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,546.50 |
$2,062 |
2.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,224.50 |
$2,966 |
3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,855.75 |
$5,141 |
2.5× |
| Sacroiliac Joints < 3 Views (72200) |
$228 |
$304 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$135.75 |
$181 |
5.8× |
| Special Physics Consult (77370) |
$612 |
$816 |
3.8× |
| Special treatment procedure (77470) |
$1,290.75 |
$1,721 |
1.9× |
| Spine thoracic 3 views (72072) |
$291 |
$388 |
2.3× |
| Stereotactic Body Radiation Delivery (77373) |
$7,128.75 |
$9,505 |
3.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$468 |
$624 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,237.25 |
$2,983 |
5.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$903.75 |
$1,205 |
5.6× |
| Thoracolumbar 2 views (72080) |
$219.75 |
$293 |
2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,102.50 |
$1,470 |
2.3× |
| Treatment device complex (77334) |
$711 |
$948 |
1.6× |
| Ultrasound Exam Aaa Screen (76706) |
$225.75 |
$301 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$394.50 |
$526 |
3.1× |
| Umbilical-artery Doppler (OB) (76820) |
$315 |
$420 |
2.5× |
| Urethrocystography retrograde rs&i (74450) |
$577.50 |
$770 |
2.0× |
| Us breast unilateral limited (76642) |
$183.75 |
$245 |
1.8× |
| Us chest (76604) |
$249.75 |
$333 |
2.0× |
| Us compl joint r-t w/image documentation (76881) |
$418.50 |
$558 |
3.3× |
| Us elastography parenchyma (76981) |
$267 |
$356 |
2.1× |
| Us hips infant static (76886) |
$372.75 |
$497 |
3.6× |
| Us infant hips w manipulation (76885) |
$500.25 |
$667 |
4.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$187.50 |
$250 |
1.5× |
| Us ob detailed single fetus (76811) |
$655.50 |
$874 |
2.3× |
| Us ob limited (76815) |
$315 |
$420 |
2.5× |
| Us ob transvaginal (76817) |
$355.50 |
$474 |
2.8× |
| Us pelvic non ob complete (76856) |
$451.50 |
$602 |
3.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$384 |
$512 |
3.1× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$419.25 |
$559 |
3.3× |
| Us retroperitoneal complete (76770) |
$469.50 |
$626 |
3.7× |
| Us retroperitoneal limited (76775) |
$402 |
$536 |
3.2× |
| Us scrotum and contents (76870) |
$444 |
$592 |
3.5× |
| Us soft tissue head/neck (76536) |
$416.25 |
$555 |
3.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$375.75 |
$501 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$228.75 |
$305 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$257.25 |
$343 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$183.75 |
$245 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$308.25 |
$411 |
2.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$401.25 |
$535 |
3.2× |
| X-ray nose-rectum child f.b. (76010) |
$209.25 |
$279 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$236.25 |
$315 |
1.9× |
| X-ray retrograde pyelogram (74420) |
$686.25 |
$915 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$225.75 |
$301 |
1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$273 |
$364 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$222 |
$296 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$290.25 |
$387 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$360 |
$480 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$180.75 |
$241 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$251.25 |
$335 |
2.0× |
| Xr bone length studies (77073) |
$195 |
$260 |
1.6× |
| Xr c-spine 4 or 5 views (72050) |
$408 |
$544 |
3.3× |
| Xr c-spine 6 or more views (72052) |
$516 |
$688 |
4.1× |
| Xr chest 4+ views (71048) |
$359.25 |
$479 |
2.9× |