| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,923.25 |
$9,231 |
4.2× |
| Abdomen 2 views (74019) |
$395.62 |
$527.50 |
3.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$10,974 |
$14,632 |
1.6× |
| Ankle 2 views (73600) |
$285 |
$380 |
2.7× |
| Basic dosimetry (77300) |
$767.25 |
$1,023 |
4.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$642 |
$856 |
1.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,420.50 |
$1,894 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,423.12 |
$1,897.50 |
3.0× |
| Bone Imaging 3 Phase (78315) |
$1,696.50 |
$2,262 |
3.5× |
| Bone survey complete (77075) |
$1,073.25 |
$1,431 |
8.6× |
| Brachytx isodose complex (77318) |
$1,485 |
$1,980 |
3.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,036.88 |
$5,382.50 |
2.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,527.38 |
$2,036.50 |
3.2× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$4,865.25 |
$6,487 |
5.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,906 |
$5,208 |
9.3× |
| Cervical spine 2 or 3 views (72040) |
$380.25 |
$507 |
3.6× |
| Chest 1 view (71045) |
$304.50 |
$406 |
2.9× |
| Chest xray 3 views (71047) |
$629.25 |
$839 |
6.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$929.25 |
$1,239 |
4.4× |
| Clavicle complete (73000) |
$275.25 |
$367 |
2.6× |
| Continuing medical physics consltj pr wk (77336) |
$842.62 |
$1,123.50 |
5.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,834.25 |
$3,779 |
6.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,738.12 |
$2,317.50 |
6.1× |
| CT abdomen w contrast (74160) |
$1,617.75 |
$2,157 |
7.7× |
| CT abdomen w wo contrast (74170) |
$2,187 |
$2,916 |
10.4× |
| CT abdomen w/o contrast (74150) |
$1,302.75 |
$1,737 |
10.4× |
| CT angio hrt w/3d image (75574) |
$3,162.75 |
$4,217 |
7.6× |
| CT angiography upper extremity lt (73206) |
$2,490 |
$3,320 |
11.8× |
| CT c-spine w/contrast (72126) |
$1,924.12 |
$2,565.50 |
4.6× |
| CT c-spine w/o contrast (72125) |
$1,527.75 |
$2,037 |
12.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,364 |
$3,152 |
11.2× |
| CT chest w contrast (71260) |
$1,668.75 |
$2,225 |
7.9× |
| CT chest w/wo contrast (71270) |
$2,029.12 |
$2,705.50 |
9.7× |
| CT head/brain with contrast (70460) |
$1,377.38 |
$1,836.50 |
6.6× |
| CT head/brain without and with contrast (70470) |
$1,669.50 |
$2,226 |
7.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$697.50 |
$930 |
1.7× |
| CT iac w contrast (70481) |
$2,023.50 |
$2,698 |
9.6× |
| CT limited/localized follow up study (76380) |
$689.25 |
$919 |
6.6× |
| CT lower ext w/o (73700) |
$1,313.25 |
$1,751 |
10.5× |
| CT lower extremity w wo contrast (73702) |
$2,055.75 |
$2,741 |
9.8× |
| CT lower extremity w/contrast material (73701) |
$1,643.62 |
$2,191.50 |
7.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,378.25 |
$3,171 |
11.3× |
| CT lumbar spine w/contrast (72132) |
$1,926.75 |
$2,569 |
4.6× |
| CT lumbar spine w/o contrast (72131) |
$1,524.75 |
$2,033 |
12.2× |
| CT maxillofacial w contrast (70487) |
$1,713.75 |
$2,285 |
8.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,851 |
$2,468 |
8.8× |
| CT maxillofacial wo contrast (70486) |
$1,421.25 |
$1,895 |
11.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,101.50 |
$2,802 |
10.0× |
| CT orbits w/o contrast (70480) |
$1,748.25 |
$2,331 |
14.0× |
| CT pelvis w/o contrast (72192) |
$1,140.38 |
$1,520.50 |
9.1× |
| CT pelvis w/wo contrast (72194) |
$1,964.62 |
$2,619.50 |
9.3× |
| CT scan of arm combo (73202) |
$1,907.25 |
$2,543 |
9.1× |
| CT soft tissue neck w contrast (70491) |
$1,690.50 |
$2,254 |
8.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,075.25 |
$2,767 |
9.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,392 |
$1,856 |
11.1× |
| CT thoracic spine w/contrast (72129) |
$1,930.12 |
$2,573.50 |
9.2× |
| CT thoracic spine w/o contrast (72128) |
$1,526.25 |
$2,035 |
12.2× |
| CT thoracic spine w/wo contrast (72130) |
$2,383.50 |
$3,178 |
11.3× |
| CT thorax w/o contrast (71250) |
$1,354.12 |
$1,805.50 |
10.8× |
| CT unlisted procedure (76497) |
$2,343.75 |
$3,125 |
22.5× |
| CT upper ext wo (73200) |
$1,193.62 |
$1,591.50 |
9.5× |
| CT upper extremity with contrast (73201) |
$1,450.12 |
$1,933.50 |
3.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,998.50 |
$3,998 |
14.3× |
| Cta Abdomen (74175) |
$2,796.75 |
$3,729 |
13.3× |
| CTA abdomen pelvis (74174) |
$2,892.75 |
$3,857 |
6.9× |
| CTA chest (71275) |
$2,145.75 |
$2,861 |
10.2× |
| Cta Head (70496) |
$3,759 |
$5,012 |
17.9× |
| Cta Neck (70498) |
$3,781.50 |
$5,042 |
18.0× |
| Cystography minimum 3 views rs&i (74430) |
$883.50 |
$1,178 |
2.1× |
| Esophagus (74220) |
$935.25 |
$1,247 |
4.4× |
| Facial bones min 3 views (70150) |
$443.62 |
$591.50 |
3.5× |
| Foot 2 views (73620) |
$298.88 |
$398.50 |
2.9× |
| Forearm 2 views (73090) |
$271.50 |
$362 |
2.6× |
| Functional MRI brain by tech (70554) |
$3,339.75 |
$4,453 |
11.7× |
| Hand 2 views (73120) |
$327.38 |
$436.50 |
2.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,768.12 |
$2,357.50 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,390.88 |
$1,854.50 |
2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,338.75 |
$1,785 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,334.25 |
$1,779 |
2.1× |
| Knee 3 views (73562) |
$421.12 |
$561.50 |
4.0× |
| Liver & spleen imaging static only (78215) |
$719.25 |
$959 |
1.5× |
| Lung perf&ventilat diferentl (78598) |
$1,413.75 |
$1,885 |
2.2× |
| Lung perfusion differential (78597) |
$1,113.75 |
$1,485 |
2.3× |
| Lymphoscintigraphy (78195) |
$1,400.25 |
$1,867 |
2.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,669.75 |
$4,893 |
3.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$3,915 |
$5,220 |
9.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,582.50 |
$6,110 |
11.0× |
| Magnetic Resonance Elastography (76391) |
$1,021.88 |
$1,362.50 |
3.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,670.25 |
$6,227 |
10.4× |
| MRA head w & w/o contrast (70546) |
$4,034.25 |
$5,379 |
9.6× |
| MRA head w/o contrast (70544) |
$2,892.75 |
$3,857 |
10.1× |
| MRA head with contrast (70545) |
$2,783.25 |
$3,711 |
6.7× |
| MRA neck w contrast (70548) |
$3,399.38 |
$4,532.50 |
8.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,023.88 |
$6,698.50 |
12.0× |
| MRA neck w/o contrast (70547) |
$2,889.38 |
$3,852.50 |
10.1× |
| MRI abdomen w contrast (74182) |
$3,624 |
$4,832 |
8.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,584 |
$6,112 |
11.0× |
| MRI abdomen w/o contrast (74181) |
$2,977.50 |
$3,970 |
10.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,557 |
$6,076 |
4.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,824.75 |
$6,433 |
11.5× |
| MRI bone marrow blood supply (77084) |
$3,391.88 |
$4,522.50 |
11.9× |
| MRI breast w/o contrast bilateral (77047) |
$4,847.25 |
$6,463 |
17.0× |
| MRI breast wo contrast unilateral (77046) |
$4,039.50 |
$5,386 |
14.1× |
| MRI c-spine with contrast (72142) |
$4,300.88 |
$5,734.50 |
10.3× |
| MRI cervical spine w/o contrast (72141) |
$3,173.62 |
$4,231.50 |
11.1× |
| MRI chest w/o & w/contrast material (71552) |
$5,029.50 |
$6,706 |
12.0× |
| MRI chest w/o contrast (71550) |
$3,326.25 |
$4,435 |
11.6× |
| MRI chest with contrast (71551) |
$3,613.50 |
$4,818 |
3.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,669.75 |
$4,893 |
8.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,407.38 |
$5,876.50 |
10.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,937 |
$3,916 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,893.12 |
$3,857.50 |
10.1× |
| MRI orbit face neck w contrast (70542) |
$4,152 |
$5,536 |
9.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,701.38 |
$6,268.50 |
11.2× |
| MRI pelvis w/contrast (72196) |
$3,664.50 |
$4,886 |
8.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,575.75 |
$6,101 |
10.9× |
| MRI pelvis w/o contrast (72195) |
$3,248.62 |
$4,331.50 |
11.4× |
| MRI spectroscopy (76390) |
$3,203.25 |
$4,271 |
30.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,025.38 |
$6,700.50 |
12.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,741.75 |
$4,989 |
8.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,966.50 |
$6,622 |
11.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,326.62 |
$4,435.50 |
8.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,635.38 |
$6,180.50 |
11.1× |
| MRI temporomandibular joint (70336) |
$2,343 |
$3,124 |
8.2× |
| MRI thoracic spine w/o contrast (72146) |
$3,048.38 |
$4,064.50 |
10.7× |
| MRI up ext w/o contrast (73218) |
$3,427.50 |
$4,570 |
12.0× |
| MRI upper ext joint w/o contrast (73221) |
$3,048 |
$4,064 |
10.7× |
| MRI, joint upper extrem combo (73223) |
$4,501.88 |
$6,002.50 |
10.8× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$5,445 |
$7,260 |
2.1× |
| N-invas est c ffr sw aly CTA (75580) |
$17,894.25 |
$23,859 |
17.4× |
| Neck soft tissue (70360) |
$279.38 |
$372.50 |
2.7× |
| Nm bone marrow multi (78103) |
$877.50 |
$1,170 |
1.8× |
| Nm cisternogram (78630) |
$958.50 |
$1,278 |
1.5× |
| Nm gastric emptying study (78264) |
$1,419 |
$1,892 |
3.0× |
| Nm peritoneal-venous shunt patency (78291) |
$574.50 |
$766 |
1.2× |
| Nm red cell sequestration (78140) |
$500.25 |
$667 |
1.0× |
| Noncardiac Vascular Flow Imaging (78445) |
$638.25 |
$851 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$13,867.88 |
$18,490.50 |
8.4× |
| Osseous survey limited (77074) |
$953.25 |
$1,271 |
7.6× |
| Parathyrd planar w/spect&CT (78072) |
$1,972.88 |
$2,630.50 |
3.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$988.50 |
$1,318 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$282.38 |
$376.50 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$4,125 |
$5,500 |
2.4× |
| PET imaging CT for attenuation limited area (78814) |
$3,215.62 |
$4,287.50 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$4,515 |
$6,020 |
2.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$3,306.75 |
$4,409 |
2.1× |
| PET whole body (78813) |
$5,197.50 |
$6,930 |
3.0× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$3,118.50 |
$4,158 |
1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,476.75 |
$1,969 |
3.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,611 |
$2,148 |
2.5× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$377.25 |
$503 |
3.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$375.75 |
$501 |
3.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$394.12 |
$525.50 |
3.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$538.50 |
$718 |
4.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$645 |
$860 |
5.1× |
| Radex fingr minimum 2 views (73140) |
$422.25 |
$563 |
4.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$355.50 |
$474 |
3.4× |
| Radex Hand Minimum 3 Views (73130) |
$372.38 |
$496.50 |
3.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$268.12 |
$357.50 |
2.6× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$459.38 |
$612.50 |
3.7× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$408.38 |
$544.50 |
3.3× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$580.50 |
$774 |
4.6× |
| Radex Humerus Minimum 2 Views (73060) |
$292.12 |
$389.50 |
2.8× |
| Radex Kne 1/2 Views (73560) |
$340.12 |
$453.50 |
3.3× |
| Radex Kne Compl 4/More Views (73564) |
$849 |
$1,132 |
6.8× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$466.50 |
$622 |
3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$449.25 |
$599 |
4.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$409.50 |
$546 |
3.3× |
| Radex Sho Compl Minimum 2 Views (73030) |
$333 |
$444 |
3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$566.62 |
$755.50 |
5.4× |
| Radex Toe Minimum 2 Views (73660) |
$305.25 |
$407 |
2.9× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$425.25 |
$567 |
4.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$722.25 |
$963 |
5.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,520.12 |
$20,693.50 |
1.8× |
| Radiation treatment delivery level 1 (77402) |
$1,005.75 |
$1,341 |
8.2× |
| Radiation treatment delivery level 2 (77407) |
$1,054.50 |
$1,406 |
2.3× |
| Radiation treatment delivery level 3 (77412) |
$1,632.75 |
$2,177 |
2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$240.38 |
$320.50 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$401.25 |
$535 |
3.2× |
| Radiologic exam chest 2 views (71046) |
$378 |
$504 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$1,620.75 |
$2,161 |
7.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$786 |
$1,048 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,319.25 |
$1,759 |
6.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,120.50 |
$1,494 |
5.3× |
| Radiologic examination femur 1 view (73551) |
$190.50 |
$254 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$316.12 |
$421.50 |
3.0× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$168.75 |
$225 |
1.3× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion Non-Facility (79403) |
$379.50 |
$506 |
1.4× |
| Ribs bilateral 3 views (71110) |
$413.62 |
$551.50 |
3.3× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,169.25 |
$1,559 |
2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,442.25 |
$1,923 |
3.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,846.25 |
$3,795 |
4.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,618.12 |
$2,157.50 |
2.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,938.75 |
$2,585 |
3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,513 |
$4,684 |
2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,970.12 |
$5,293.50 |
2.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,919 |
$3,892 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$759.38 |
$1,012.50 |
2.7× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$477 |
$636 |
1.0× |
| Scapula (73010) |
$340.12 |
$453.50 |
2.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$141.38 |
$188.50 |
6.0× |
| Shoulder 1 view (73020) |
$426.38 |
$568.50 |
4.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$994.12 |
$1,325.50 |
2.2× |
| Special dosimetry (77331) |
$412.50 |
$550 |
2.6× |
| Special Physics Consult (77370) |
$898.88 |
$1,198.50 |
5.6× |
| Special treatment procedure (77470) |
$3,512.25 |
$4,683 |
5.3× |
| Spine thoracic 3 views (72072) |
$433.12 |
$577.50 |
3.5× |
| Stereotactic Body Radiation Delivery (77373) |
$14,462.25 |
$19,283 |
6.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$943.12 |
$1,257.50 |
2.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$750 |
$1,000 |
1.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,527.25 |
$4,703 |
7.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,750.50 |
$2,334 |
10.9× |
| Thoracolumbar 2 views (72080) |
$417.38 |
$556.50 |
4.0× |
| Thyroid imaging w/blood flow (78013) |
$654.75 |
$873 |
1.4× |
| Tmj unilateral (70328) |
$358.12 |
$477.50 |
3.4× |
| Treatment device complex (77334) |
$1,649.25 |
$2,199 |
3.7× |
| Treatment device intermediate (77333) |
$838.88 |
$1,118.50 |
5.2× |
| Treatment devices simple (77332) |
$730.50 |
$974 |
4.5× |
| Ultrasound breast complete (76641) |
$423 |
$564 |
3.4× |
| Ultrasound Exam Aaa Screen (76706) |
$386.62 |
$515.50 |
3.1× |
| Ultrasound, abdomen limited (76705) |
$546 |
$728 |
4.4× |
| Unlisted magnetic resonance procedure (76498) |
$7,324.88 |
$9,766.50 |
70.2× |
| Us breast unilateral limited (76642) |
$536.25 |
$715 |
5.1× |
| Us chest (76604) |
$435.75 |
$581 |
3.5× |
| Us compl joint r-t w/image documentation (76881) |
$647.25 |
$863 |
5.2× |
| Us elastography parenchyma (76981) |
$345 |
$460 |
2.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$542.25 |
$723 |
4.3× |
| Us ob limited (76815) |
$651 |
$868 |
5.2× |
| Us ob transvaginal (76817) |
$767.25 |
$1,023 |
6.1× |
| Us pelvic non ob complete (76856) |
$653.25 |
$871 |
5.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$495.38 |
$660.50 |
4.0× |
| Us retroperitoneal complete (76770) |
$681.75 |
$909 |
5.4× |
| Us retroperitoneal limited (76775) |
$518.25 |
$691 |
4.1× |
| Us scrotum and contents (76870) |
$573.38 |
$764.50 |
4.6× |
| Us soft tissue head/neck (76536) |
$664.50 |
$886 |
5.3× |
| Us,transplanted kidney, real time/ doppler (76776) |
$690 |
$920 |
5.5× |
| Venogram Extremity Unilateral (75820) |
$2,011.50 |
$2,682 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$6,264.75 |
$8,353 |
1.7× |
| Wrist 2 views (73100) |
$402 |
$536 |
3.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$492 |
$656 |
3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$352.12 |
$469.50 |
3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$327.38 |
$436.50 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$404.62 |
$539.50 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$502.50 |
$670 |
4.0× |
| X-ray exam of femur 2/> (73552) |
$369 |
$492 |
3.5× |
| X-ray eye for foreign body (70030) |
$399 |
$532 |
3.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$351.38 |
$468.50 |
3.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$357 |
$476 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$443.62 |
$591.50 |
4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$468 |
$624 |
3.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$417.38 |
$556.50 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$322.50 |
$430 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$561.38 |
$748.50 |
4.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$630.38 |
$840.50 |
5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$355.88 |
$474.50 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$336.38 |
$448.50 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$440.25 |
$587 |
4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$627 |
$836 |
5.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$419.25 |
$559 |
3.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$271.12 |
$361.50 |
2.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$505.50 |
$674 |
4.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$371.25 |
$495 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$384.75 |
$513 |
3.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$559.50 |
$746 |
4.5× |
| Xr c-spine 4 or 5 views (72050) |
$619.50 |
$826 |
4.9× |
| Xr c-spine 6 or more views (72052) |
$783.38 |
$1,044.50 |
6.3× |
| Xr chest 4+ views (71048) |
$562.12 |
$749.50 |
4.5× |