| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,710 |
$3,710 |
2.9× |
| Abdomen 2 views (74019) |
$362 |
$362 |
3.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$530.31 |
$530.31 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$3,866.50 |
$3,866.50 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$3,866.50 |
$3,866.50 |
1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$899 |
$899 |
0.3× |
| Ankle 2 views (73600) |
$117 |
$117 |
1.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$244 |
$244 |
0.8× |
| Aortogram thoracic (75605) |
$4,878 |
$4,878 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,980 |
$2,980 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,678.50 |
$3,678.50 |
1.3× |
| Arthrogram elbow (73085) |
$739 |
$739 |
2.3× |
| Arthrogram hip (73525) |
$630 |
$630 |
2.0× |
| Arthrogram shoulder (73040) |
$739 |
$739 |
2.3× |
| Arthrogram wrist (73115) |
$630 |
$630 |
2.0× |
| Arthrography knee lt (73580) |
$756 |
$756 |
2.4× |
| Basic radiation dosimetry calculation (77300) |
$285 |
$285 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,301.66 |
$1,301.66 |
3.6× |
| Bone &/joint imaging whole body (78306) |
$699.50 |
$699.50 |
1.9× |
| Bone age studies (77072) |
$192 |
$192 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,127 |
$1,127 |
3.1× |
| Bone survey complete (77075) |
$194 |
$194 |
2.0× |
| Brain image w/flow 4 + views (78606) |
$1,030 |
$1,030 |
2.1× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$34 |
$34 |
3.1× |
| Cervical spine 2 or 3 views (72040) |
$324 |
$324 |
4.1× |
| Chest 1 view (71045) |
$190 |
$190 |
2.4× |
| Chest 3 views (71047) |
$173.75 |
$173.75 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$350 |
$350 |
2.2× |
| Cineradiography/videoradiography (76120) |
$195.04 |
$195.04 |
2.0× |
| Clavicle complete (73000) |
$308 |
$308 |
3.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$200 |
$200 |
2.1× |
| Continuing medical physics consltj pr wk (77336) |
$285 |
$285 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,629 |
$3,629 |
11.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,657 |
$1,657 |
7.6× |
| CT abdomen w contrast (74160) |
$1,980 |
$1,980 |
12.4× |
| CT abdomen w wo contrast (74170) |
$2,074 |
$2,074 |
13.0× |
| CT abdomen w/o contrast (74150) |
$1,620 |
$1,620 |
17.0× |
| CT angio hrt w/3d image (75574) |
$972 |
$972 |
3.1× |
| CT angiography upper extremity lt (73206) |
$420.28 |
$420.28 |
2.6× |
| CT c-spine w/o contrast (72125) |
$1,458 |
$1,458 |
15.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,920 |
$1,920 |
12.0× |
| CT cervical spine with contrast (72126) |
$1,798 |
$1,798 |
5.7× |
| CT chest w/wo contrast (71270) |
$2,825 |
$2,825 |
17.7× |
| CT chest with contrast (71260) |
$1,926 |
$1,926 |
12.0× |
| CT colonography screening (74263) |
$984 |
$984 |
4.5× |
| CT colonography w/o cntrst (74261) |
$994 |
$994 |
10.4× |
| CT head/brain with contrast (70460) |
$1,680 |
$1,680 |
10.5× |
| CT head/brain without and with contrast (70470) |
$2,504 |
$2,504 |
15.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$150.25 |
$150.25 |
1.9× |
| CT iac w contrast (70481) |
$1,404 |
$1,404 |
8.8× |
| CT lower ext w/o (73700) |
$755 |
$755 |
7.9× |
| CT lower extremity w wo contrast (73702) |
$1,254 |
$1,254 |
7.8× |
| CT lower extremity with contrast (73701) |
$907 |
$907 |
5.7× |
| CT lumbar spine w & w/o contrast (72133) |
$2,160 |
$2,160 |
13.5× |
| CT lumbar spine w/o contrast (72131) |
$1,512 |
$1,512 |
15.9× |
| CT lumbar spine with contrast (72132) |
$1,944 |
$1,944 |
6.1× |
| CT maxillofacial w contrast (70487) |
$1,945 |
$1,945 |
12.2× |
| CT maxillofacial w/o contrast (70486) |
$1,730 |
$1,730 |
18.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,945 |
$1,945 |
12.2× |
| CT neck soft tissue w contrast (70491) |
$1,404 |
$1,404 |
8.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,984 |
$1,984 |
12.4× |
| CT orbits w/o contrast (70480) |
$1,269 |
$1,269 |
13.3× |
| CT pelvis w & w/o contrast (72194) |
$1,980 |
$1,980 |
12.4× |
| CT pelvis w/o contrast (72192) |
$1,080 |
$1,080 |
11.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,568 |
$2,568 |
16.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,320 |
$1,320 |
13.8× |
| CT thoracic spine w/contrast (72129) |
$1,404 |
$1,404 |
8.8× |
| CT thoracic spine w/o contrast (72128) |
$1,350 |
$1,350 |
14.2× |
| CT thoracic spine w/wo contrast (72130) |
$2,052 |
$2,052 |
12.8× |
| CT thorax w/o contrast (71250) |
$1,555 |
$1,555 |
16.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,174 |
$1,174 |
7.3× |
| CT upper extremity w/o contrast rt (73200) |
$755 |
$755 |
7.9× |
| CT upper extremity with contrast (73201) |
$907 |
$907 |
2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,700 |
$2,700 |
16.9× |
| Cta Abdomen (74175) |
$1,512 |
$1,512 |
9.5× |
| CTA abdomen pelvis (74174) |
$4,483 |
$4,483 |
14.1× |
| CTA chest (71275) |
$1,166 |
$1,166 |
7.3× |
| Cta Head (70496) |
$2,971 |
$2,971 |
18.6× |
| CTA lwr ext w&w/o contrast (73706) |
$420.28 |
$420.28 |
2.6× |
| Cta Neck (70498) |
$1,082 |
$1,082 |
6.8× |
| Cta Pelvis (72191) |
$2,971 |
$2,971 |
18.6× |
| Cystography minimum 3 views rs&i (74430) |
$583 |
$583 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$539 |
$539 |
5.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$96.30 |
$96.30 |
1.2× |
| Esophagus (74220) |
$361 |
$361 |
2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$196 |
$196 |
2.1× |
| Fluoroscopy up to 1 hr (76000) |
$258.76 |
$258.76 |
1.2× |
| Foot 2 views (73620) |
$156 |
$156 |
2.0× |
| Forearm 2 views (73090) |
$258 |
$258 |
3.3× |
| Gated Heart Planar Single (78472) |
$990 |
$990 |
2.7× |
| Hand 2 views (73120) |
$156 |
$156 |
1.6× |
| Hand 3 views (73130) |
$289 |
$289 |
3.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,222 |
$1,222 |
2.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$972 |
$972 |
2.7× |
| Ht muscle image spect sing (78451) |
$2,536 |
$2,536 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$278 |
$278 |
3.5× |
| Hysterosalpingogram (74740) |
$778 |
$778 |
3.6× |
| Interstitial radiation source applic complex (77778) |
$1,868 |
$1,868 |
2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$602.16 |
$602.16 |
1.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$852 |
$852 |
1.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$600 |
$600 |
1.2× |
| Knee 3 views (73562) |
$289 |
$289 |
3.6× |
| Liver & spleen imaging static only (78215) |
$642 |
$642 |
1.8× |
| Lung perf&ventilat diferentl (78598) |
$898 |
$898 |
1.8× |
| Lymphoscintigraphy (78195) |
$1,260 |
$1,260 |
2.5× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$72 |
$72 |
0.9× |
| Meckels Diverticulum (78290) |
$388 |
$388 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$473 |
$473 |
1.4× |
| Mr safety determination physician/other qhp (76016) |
$176 |
$176 |
2.2× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$119 |
$119 |
2.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$49 |
$49 |
1.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$183.50 |
$183.50 |
2.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$483 |
$483 |
2.2× |
| MRA head w/o contrast (70544) |
$1,584 |
$1,584 |
7.3× |
| MRA head with contrast (70545) |
$1,705 |
$1,705 |
5.4× |
| MRA neck w contrast (70548) |
$1,696 |
$1,696 |
5.3× |
| MRA neck w/o contrast (70547) |
$1,322 |
$1,322 |
6.1× |
| MRI abdomen w contrast (74182) |
$3,240 |
$3,240 |
10.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,110 |
$3,110 |
9.8× |
| MRI abdomen w/o contrast (74181) |
$3,082 |
$3,082 |
14.2× |
| MRI any jnt lwr ext with con lt (73722) |
$3,360 |
$3,360 |
4.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,300 |
$3,300 |
4.6× |
| MRI breast w/o contrast bilateral (77047) |
$470 |
$470 |
2.2× |
| MRI breast w/o contrast unilat (77046) |
$470 |
$470 |
2.2× |
| MRI c-spine with contrast (72142) |
$3,720 |
$3,720 |
11.7× |
| MRI cervical spine w/o contrast (72141) |
$3,564 |
$3,564 |
16.4× |
| MRI chest w/o & w/contrast material (71552) |
$767 |
$767 |
2.4× |
| MRI chest w/o contrast (71550) |
$2,065 |
$2,065 |
9.5× |
| MRI chest with contrast (71551) |
$2,592 |
$2,592 |
3.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,000 |
$3,000 |
9.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,280 |
$2,280 |
7.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,244 |
$2,244 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,484 |
$2,484 |
11.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,840 |
$3,840 |
12.1× |
| MRI orbit/face/neck w/contrast (70542) |
$3,168 |
$3,168 |
10.0× |
| MRI pelvis w contrast (72196) |
$3,348 |
$3,348 |
10.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,780 |
$3,780 |
11.9× |
| MRI pelvis w/o contrast (72195) |
$3,024 |
$3,024 |
13.9× |
| MRI scan of arm joint before and after contrast (73223) |
$4,366 |
$4,366 |
13.7× |
| MRI scan of leg joint before and after contrast (73723) |
$3,600 |
$3,600 |
11.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,366 |
$4,366 |
13.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,720 |
$3,720 |
11.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,366 |
$4,366 |
13.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,242 |
$3,242 |
10.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,366 |
$4,366 |
13.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,808 |
$2,808 |
12.9× |
| MRI tmj (70336) |
$1,998 |
$1,998 |
9.2× |
| MRI upper ext joint w/o contrast (73221) |
$3,082 |
$3,082 |
14.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,672 |
$3,672 |
11.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,700 |
$2,700 |
12.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,654.50 |
$2,654.50 |
2.2× |
| Myocardial infarct spect (78469) |
$769 |
$769 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,867 |
$2,867 |
2.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,979 |
$2,979 |
2.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,979 |
$2,979 |
2.3× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,979 |
$2,979 |
1.5× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$3,901 |
$3,901 |
1.9× |
| Neck soft tissue (70360) |
$360 |
$360 |
4.5× |
| Nm gastric emptying study (78264) |
$1,057 |
$1,057 |
2.9× |
| Nm whole blood volume (78122) |
$1,464 |
$1,464 |
3.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,348 |
$9,348 |
7.4× |
| Nuclear Rx Oral Admin (79005) |
$462 |
$462 |
2.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$312 |
$312 |
3.3× |
| Osseous survey infant (77076) |
$272 |
$272 |
2.9× |
| Osseous survey limited (77074) |
$486 |
$486 |
5.1× |
| Parathyrd planar w/wo subtrj (78071) |
$720 |
$720 |
2.0× |
| Parathyroid imaging (78070) |
$713 |
$713 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$244 |
$244 |
2.6× |
| PET image w/CT, skull-thigh (78815) |
$2,979 |
$2,979 |
2.3× |
| PET imaging CT for attenuation limited area (78814) |
$2,979 |
$2,979 |
2.3× |
| PET imaging for CT attenuation whole body (78816) |
$2,979 |
$2,979 |
2.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,672 |
$3,672 |
11.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$736 |
$736 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,264 |
$1,264 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$275 |
$275 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$208 |
$208 |
2.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$175 |
$175 |
1.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$276 |
$276 |
2.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$13,837 |
$13,837 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$743 |
$743 |
1.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$500 |
$500 |
5.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$638 |
$638 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$533 |
$533 |
5.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$207.75 |
$207.75 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$228 |
$228 |
2.9× |
| Radiologic exam colon single contrast study (74270) |
$810 |
$810 |
5.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$855 |
$855 |
5.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$733 |
$733 |
4.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$263 |
$263 |
3.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$74 |
$74 |
0.9× |
| Radiological examination surgical specimen (76098) |
$432 |
$432 |
0.9× |
| Ribs bilateral 3 views (71110) |
$665 |
$665 |
7.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,146.32 |
$1,146.32 |
3.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,524.53 |
$1,524.53 |
3.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,790.53 |
$1,790.53 |
3.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,259.06 |
$2,259.06 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$980 |
$980 |
4.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$410 |
$410 |
1.9× |
| Scanogram (77073) |
$254 |
$254 |
2.7× |
| Scapula complete (73010) |
$233 |
$233 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$60 |
$60 |
2.6× |
| Sella turcica (70240) |
$122 |
$122 |
1.5× |
| Sialogram (70390) |
$275 |
$275 |
1.3× |
| Simulation intermediate (77285) |
$1,418 |
$1,418 |
4.2× |
| Small bowel series (74250) |
$378 |
$378 |
2.4× |
| Spec medical radj physics consltj (77370) |
$1,092 |
$1,092 |
8.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,427 |
$1,427 |
4.2× |
| Special dosimetry (77331) |
$650 |
$650 |
5.3× |
| Special treatment procedure (77470) |
$1,889 |
$1,889 |
3.7× |
| Spine thoracic 3 views (72072) |
$292 |
$292 |
3.1× |
| Spleen imaging only (78185) |
$439 |
$439 |
1.2× |
| Splenoportograpy rs&i (75810) |
$2,479 |
$2,479 |
0.9× |
| Stereotactic body radiation delivery (77373) |
$4,214 |
$4,214 |
2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,305.50 |
$1,305.50 |
3.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$616 |
$616 |
1.8× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$1,056 |
$1,056 |
4.9× |
| Testicular Imaging With Vascular Flow (78761) |
$520 |
$520 |
1.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,630 |
$1,630 |
4.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,064 |
$1,064 |
8.7× |
| Thoracolumbar 2 views (72080) |
$204 |
$204 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$311 |
$311 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$984 |
$984 |
2.7× |
| Tomogram (76100) |
$780 |
$780 |
8.2× |
| Treatment device intermediate (77333) |
$468 |
$468 |
3.8× |
| Treatment devices simple (77332) |
$468 |
$468 |
3.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,625.07 |
$1,625.07 |
3.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$823.16 |
$823.16 |
2.3× |
| Tx devices design & construction complex (77334) |
$670 |
$670 |
2.0× |
| Ultrasound elastography first target lesion (76982) |
$213.76 |
$213.76 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$427 |
$427 |
4.5× |
| Unlisted fluoroscopic procedure (76496) |
$98 |
$98 |
1.2× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$169 |
$169 |
1.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$520 |
$520 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$268 |
$268 |
1.2× |
| Urethrocystography voiding (74455) |
$1,026 |
$1,026 |
4.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,024 |
$1,024 |
6.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$988 |
$988 |
6.2× |
| Us abdl aorta screen aaa (76706) |
$248 |
$248 |
2.6× |
| Us breast unilateral complete (76641) |
$258 |
$258 |
2.7× |
| Us breast unilateral limited (76642) |
$258 |
$258 |
3.3× |
| Us chest (76604) |
$222.22 |
$222.22 |
2.3× |
| Us elastography parenchyma (76981) |
$213.76 |
$213.76 |
2.2× |
| Us guided compression repair (76936) |
$428 |
$428 |
2.2× |
| Us infant hips dynamic (76885) |
$156 |
$156 |
2.0× |
| Us infant hips limited static (76886) |
$249.52 |
$249.52 |
3.1× |
| Us ob transvaginal (76817) |
$254 |
$254 |
2.7× |
| Us pelvic non ob complete (76856) |
$674 |
$674 |
7.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$163 |
$163 |
1.7× |
| Us pregnancy ltd (76815) |
$254 |
$254 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$218.73 |
$218.73 |
2.3× |
| Us retroperitoneal complete (76770) |
$674 |
$674 |
7.1× |
| Us retroperitoneal limited (76775) |
$211.57 |
$211.57 |
2.2× |
| Us scrotum and contents (76870) |
$462 |
$462 |
4.8× |
| Us soft tissue head/neck (76536) |
$390 |
$390 |
4.1× |
| Us spinal canal and contents (76800) |
$95.50 |
$95.50 |
1.0× |
| Us transrectal (76872) |
$286 |
$286 |
3.0× |
| Us xtr non-vasc lmtd (76882) |
$562 |
$562 |
5.9× |
| Venogram extremity bilateral (75822) |
$2,749.54 |
$2,749.54 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,534.52 |
$3,534.52 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$2,664.04 |
$2,664.04 |
1.9× |
| Venography extremity unilateral rs&i (75820) |
$943.46 |
$943.46 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$2,479 |
$2,479 |
0.9× |
| Wrist 2 views (73100) |
$130 |
$130 |
1.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$605 |
$605 |
6.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$174 |
$174 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$289 |
$289 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,070 |
$1,070 |
6.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$173 |
$173 |
2.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$233 |
$233 |
2.9× |
| X-ray exam hip uni 1 view (73501) |
$104 |
$104 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$240 |
$240 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$175 |
$175 |
1.8× |
| X-ray exam of femur 1 (73551) |
$263 |
$263 |
3.3× |
| X-ray eye for foreign body (70030) |
$108 |
$108 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$486 |
$486 |
5.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$168 |
$168 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$289 |
$289 |
3.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$161 |
$161 |
2.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$840 |
$840 |
5.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$430 |
$430 |
4.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$259 |
$259 |
2.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$373 |
$373 |
4.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$192 |
$192 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$335 |
$335 |
3.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,026 |
$1,026 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$337 |
$337 |
4.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$337 |
$337 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$665 |
$665 |
7.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$162 |
$162 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$378 |
$378 |
4.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$419 |
$419 |
5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$432 |
$432 |
5.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$172 |
$172 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$540 |
$540 |
5.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$154.12 |
$154.12 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$287 |
$287 |
3.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$180 |
$180 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$259 |
$259 |
3.3× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$121 |
$121 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$216 |
$216 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$289 |
$289 |
3.6× |
| Xr arthrogram ankle (73615) |
$792 |
$792 |
2.5× |
| Xr c-spine 6 or more views (72052) |
$387 |
$387 |
4.1× |
| Xr Cholecystography Oral Contrast (74290) |
$294 |
$294 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$192 |
$192 |
2.4× |
| Xr internal auditory meati complete (70134) |
$154 |
$154 |
0.3× |
| Xr shoulder 1 view (73020) |
$246 |
$246 |
3.1× |
| Xr spine cervical 4 or 5 views (72050) |
$424 |
$424 |
4.4× |
| Xr tibia/fibula 2 views (73590) |
$204 |
$204 |
2.6× |
| Xr tmj bilateral (70330) |
$190 |
$190 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$110.50 |
$110.50 |
1.4× |