| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,997.75 |
$11,997 |
6.2× |
| Abdomen 2 views (74019) |
$862.50 |
$1,150 |
7.9× |
| Acute gi blood loss imaging (78278) |
$1,921.88 |
$2,562.50 |
4.6× |
| Angiography extremity bilateral rs&i (75716) |
$12,731.25 |
$16,975 |
3.9× |
| Angiography extremity unilateral rs&i (75710) |
$9,739.50 |
$12,986 |
3.0× |
| Angiography internal mammary rs&i (75756) |
$7,109.62 |
$9,479.50 |
2.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,378 |
$8,504 |
1.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$20,501.25 |
$27,335 |
6.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$11,739.75 |
$15,653 |
3.6× |
| Angiography Spinal Selective Rs&I (75705) |
$27,768.75 |
$37,025 |
4.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,388.50 |
$12,518 |
1.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,713.50 |
$3,618 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,960.50 |
$6,614 |
1.5× |
| Ankle 2 views (73600) |
$1,053.75 |
$1,405 |
11.6× |
| Aortogram thoracic (75605) |
$9,134.62 |
$12,179.50 |
1.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$13,353 |
$17,804 |
4.0× |
| Aortography abdominal serialography rs&i (75625) |
$8,670.75 |
$11,561 |
2.6× |
| Arthrogram ankle (73615) |
$2,636.25 |
$3,515 |
7.2× |
| Arthrogram hip (73525) |
$1,600.50 |
$2,134 |
4.4× |
| Arthrogram knee (73580) |
$1,389.75 |
$1,853 |
3.8× |
| Arthrogram shoulder (73040) |
$2,090.25 |
$2,787 |
5.7× |
| Arthrogram wrist (73115) |
$2,773.50 |
$3,698 |
7.6× |
| Basic dosimetry (77300) |
$2,165.25 |
$2,887 |
15.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$5,043.75 |
$6,725 |
12.1× |
| Bone &/joint imaging whole body (78306) |
$3,718.50 |
$4,958 |
8.9× |
| Bone age studies (77072) |
$556.88 |
$742.50 |
5.1× |
| Bone Imaging 3 Phase (78315) |
$4,515 |
$6,020 |
10.8× |
| Bone survey complete (77075) |
$1,542 |
$2,056 |
14.1× |
| Bone survey infant (77076) |
$782.62 |
$1,043.50 |
7.2× |
| Bowel imaging (78290) |
$2,391.75 |
$3,189 |
5.7× |
| Brachytx isodose complex (77318) |
$2,763.75 |
$3,685 |
7.1× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$2,304.75 |
$3,073 |
5.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$8,121.75 |
$10,829 |
5.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$3,447.75 |
$4,597 |
8.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,847.25 |
$6,463 |
13.3× |
| Cervical spine 2 or 3 views (72040) |
$1,370.25 |
$1,827 |
15.1× |
| Chest 1 view (71045) |
$1,038 |
$1,384 |
11.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,140.75 |
$1,521 |
6.2× |
| Clavicle complete (73000) |
$875.25 |
$1,167 |
9.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$403.50 |
$538 |
3.7× |
| Continuing medical physics consltj pr wk (77336) |
$1,332.75 |
$1,777 |
9.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$11,068.50 |
$14,758 |
30.4× |
| CT abdomen and pelvis without contrast (74176) |
$10,221.75 |
$13,629 |
41.0× |
| CT abdomen w contrast (74160) |
$7,938.75 |
$10,585 |
43.3× |
| CT abdomen w wo contrast (74170) |
$6,936.75 |
$9,249 |
37.9× |
| CT abdomen w/o contrast (74150) |
$5,738.62 |
$7,651.50 |
52.6× |
| CT angio hrt w/3d image (75574) |
$6,831.38 |
$9,108.50 |
18.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$5,809.12 |
$7,745.50 |
31.7× |
| CT angiography upper extremity lt (73206) |
$7,499.25 |
$9,999 |
40.9× |
| CT c-spine w/contrast (72126) |
$10,927.50 |
$14,570 |
30.0× |
| CT c-spine w/o contrast (72125) |
$9,221.25 |
$12,295 |
84.5× |
| CT cervical spine w&w/o contrast (72127) |
$13,061.25 |
$17,415 |
71.3× |
| CT chest w contrast (71260) |
$7,978.50 |
$10,638 |
43.6× |
| CT chest w/wo contrast (71270) |
$7,166.62 |
$9,555.50 |
39.1× |
| CT head/brain with contrast (70460) |
$7,117.12 |
$9,489.50 |
38.9× |
| CT head/brain without and with contrast (70470) |
$6,857.25 |
$9,143 |
37.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$6,102 |
$8,136 |
16.7× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$2,891.25 |
$3,855 |
31.8× |
| CT iac w contrast (70481) |
$9,970.50 |
$13,294 |
54.4× |
| CT limited/localized follow up study (76380) |
$1,839 |
$2,452 |
20.2× |
| CT lower ext w/o (73700) |
$4,143 |
$5,524 |
37.9× |
| CT lower extremity w wo contrast (73702) |
$6,375 |
$8,500 |
34.8× |
| CT lower extremity w/contrast material (73701) |
$5,250 |
$7,000 |
28.7× |
| CT lumbar spine w & w/o contrast (72133) |
$9,972.75 |
$13,297 |
54.4× |
| CT lumbar spine w/contrast (72132) |
$9,567.75 |
$12,757 |
26.3× |
| CT lumbar spine w/o contrast (72131) |
$9,428.25 |
$12,571 |
86.4× |
| CT maxillofacial w contrast (70487) |
$8,639.25 |
$11,519 |
47.2× |
| CT maxillofacial w/wo contrast (70488) |
$10,464.38 |
$13,952.50 |
57.1× |
| CT maxillofacial wo contrast (70486) |
$6,879 |
$9,172 |
63.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$10,557 |
$14,076 |
57.6× |
| CT orbits w/o contrast (70480) |
$7,660.50 |
$10,214 |
70.2× |
| CT pelvis w/o contrast (72192) |
$4,730.25 |
$6,307 |
43.3× |
| CT pelvis w/wo contrast (72194) |
$5,219.25 |
$6,959 |
28.5× |
| CT scan of arm combo (73202) |
$6,663.38 |
$8,884.50 |
36.4× |
| CT soft tissue neck w contrast (70491) |
$6,558 |
$8,744 |
35.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$8,217 |
$10,956 |
44.9× |
| CT soft tissue neck w/o contrast (70490) |
$6,279 |
$8,372 |
57.5× |
| CT thoracic spine w/contrast (72129) |
$4,837.50 |
$6,450 |
26.4× |
| CT thoracic spine w/o contrast (72128) |
$8,854.50 |
$11,806 |
81.1× |
| CT thoracic spine w/wo contrast (72130) |
$9,897.75 |
$13,197 |
54.0× |
| CT thorax w/o contrast (71250) |
$5,923.88 |
$7,898.50 |
54.3× |
| CT upper ext wo (73200) |
$5,514.75 |
$7,353 |
50.5× |
| CT upper extremity with contrast (73201) |
$7,778.25 |
$10,371 |
21.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$7,535.25 |
$10,047 |
41.1× |
| Cta Abdomen (74175) |
$6,895.12 |
$9,193.50 |
37.6× |
| CTA abdomen pelvis (74174) |
$6,584.25 |
$8,779 |
18.1× |
| CTA chest (71275) |
$9,799.12 |
$13,065.50 |
53.5× |
| Cta Head (70496) |
$7,797.75 |
$10,397 |
42.6× |
| Cta Neck (70498) |
$6,551.25 |
$8,735 |
35.8× |
| Cta Pelvis (72191) |
$10,110.75 |
$13,481 |
55.2× |
| Cystography minimum 3 views rs&i (74430) |
$1,211.25 |
$1,615 |
3.3× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$5,179.50 |
$6,906 |
2.4× |
| Diskography lumbar (72295) |
$6,138 |
$8,184 |
3.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,353.38 |
$1,804.50 |
12.4× |
| Dxa bone density study axial skeleton (77085) |
$1,059 |
$1,412 |
9.7× |
| Esophagus (74220) |
$1,227.75 |
$1,637 |
6.7× |
| Facial bones min 3 views (70150) |
$1,503.75 |
$2,005 |
13.8× |
| Fetal biophysical profile non-stress testing (76818) |
$1,805.25 |
$2,407 |
16.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,248 |
$1,664 |
11.4× |
| Fetal Echo (76825) |
$2,328 |
$3,104 |
4.1× |
| Fluoroscopy up to 1 hr (76000) |
$1,699.12 |
$2,265.50 |
6.8× |
| Foot 2 views (73620) |
$699.75 |
$933 |
7.7× |
| Forearm 2 views (73090) |
$1,292.25 |
$1,723 |
14.2× |
| Functional MRI brain by tech (70554) |
$5,953.50 |
$7,938 |
23.9× |
| Hand 2 views (73120) |
$761.62 |
$1,015.50 |
7.0× |
| Heart Infarct Image (78466) |
$7,049.25 |
$9,399 |
16.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$4,463.25 |
$5,951 |
7.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$4,758.75 |
$6,345 |
11.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,633.25 |
$3,511 |
4.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,960.25 |
$3,947 |
5.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,418.50 |
$4,558 |
6.0× |
| Knee 3 views (73562) |
$1,384.50 |
$1,846 |
15.2× |
| Liver & spleen imaging static only (78215) |
$3,195.75 |
$4,261 |
7.7× |
| Lung perfusion differential (78597) |
$3,273.75 |
$4,365 |
7.8× |
| Lung ventilation imaging (78579) |
$2,407.50 |
$3,210 |
5.8× |
| Lymphoscintigraphy (78195) |
$3,138 |
$4,184 |
5.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$7,737.38 |
$10,316.50 |
9.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$8,980.50 |
$11,974 |
24.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$11,724.75 |
$15,633 |
32.2× |
| Mammary ductogram or galactogram multiple (77054) |
$2,164.50 |
$2,886 |
8.7× |
| Mammary ductogram or galactogram single (77053) |
$2,164.50 |
$2,886 |
8.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$47.25 |
$63 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$488.25 |
$651 |
4.9× |
| Mr safety implt pos&/immoblj (76019) |
$639.75 |
$853 |
10.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$965.25 |
$1,287 |
3.9× |
| MRA head w & w/o contrast (70546) |
$7,710.38 |
$10,280.50 |
21.2× |
| MRA head w/o contrast (70544) |
$11,055.75 |
$14,741 |
44.4× |
| MRA head with contrast (70545) |
$8,156.62 |
$10,875.50 |
22.4× |
| MRA neck w contrast (70548) |
$9,946.50 |
$13,262 |
27.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$8,062.88 |
$10,750.50 |
22.1× |
| MRA neck w/o contrast (70547) |
$11,055.75 |
$14,741 |
44.4× |
| MRI abdomen w contrast (74182) |
$9,182.25 |
$12,243 |
25.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$10,221 |
$13,628 |
28.1× |
| MRI abdomen w/o contrast (74181) |
$7,840.12 |
$10,453.50 |
31.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$6,415.88 |
$8,554.50 |
7.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$8,590.50 |
$11,454 |
23.6× |
| MRI bone marrow blood supply (77084) |
$5,835 |
$7,780 |
23.4× |
| MRI breast w/o contrast bilateral (77047) |
$5,647.88 |
$7,530.50 |
22.7× |
| MRI breast wo contrast unilateral (77046) |
$4,613.62 |
$6,151.50 |
18.5× |
| MRI c-spine with contrast (72142) |
$6,435 |
$8,580 |
17.7× |
| MRI cardiac w/o cont stress (75559) |
$5,856 |
$7,808 |
10.3× |
| MRI cardiac w/o contrast (75557) |
$4,972.50 |
$6,630 |
20.0× |
| MRI cervical spine w/o contrast (72141) |
$11,487 |
$15,316 |
46.1× |
| MRI chest w/o & w/contrast material (71552) |
$5,407.50 |
$7,210 |
14.8× |
| MRI chest w/o contrast (71550) |
$4,848.38 |
$6,464.50 |
19.5× |
| MRI chest with contrast (71551) |
$6,344.25 |
$8,459 |
7.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$7,618.88 |
$10,158.50 |
20.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$8,086.88 |
$10,782.50 |
22.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,829.12 |
$9,105.50 |
27.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$6,634.12 |
$8,845.50 |
26.6× |
| MRI orbit face neck w contrast (70542) |
$8,521.12 |
$11,361.50 |
23.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$7,584.75 |
$10,113 |
20.8× |
| MRI pelvis w/contrast (72196) |
$7,002 |
$9,336 |
19.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,468.38 |
$8,624.50 |
17.8× |
| MRI pelvis w/o contrast (72195) |
$4,543.50 |
$6,058 |
18.2× |
| MRI spectroscopy (76390) |
$8,718.75 |
$11,625 |
95.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$11,514 |
$15,352 |
31.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$10,934.25 |
$14,579 |
30.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$9,769.50 |
$13,026 |
26.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$6,763.88 |
$9,018.50 |
18.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$8,662.12 |
$11,549.50 |
23.8× |
| MRI temporomandibular joint (70336) |
$6,299.25 |
$8,399 |
25.3× |
| MRI thoracic spine w/o contrast (72146) |
$11,933.25 |
$15,911 |
47.9× |
| MRI up ext w/o contrast (73218) |
$7,545.75 |
$10,061 |
30.3× |
| MRI upper ext joint w/o contrast (73221) |
$10,224 |
$13,632 |
41.0× |
| MRI, joint upper extrem combo (73223) |
$8,370 |
$11,160 |
23.0× |
| Myelogram Cervical (72240) |
$2,679 |
$3,572 |
3.3× |
| Myelogram Lumbar (72265) |
$3,243.75 |
$4,325 |
4.0× |
| Myelogram thoracic (72255) |
$3,317.25 |
$4,423 |
4.1× |
| Myelography 2 or more regions (72270) |
$4,077 |
$5,436 |
5.0× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$6,403.50 |
$8,538 |
4.7× |
| Myocardial Spect Multiple Studies (78452) |
$15,721.88 |
$20,962.50 |
11.6× |
| Myocardial spect single study at rest or stress (78451) |
$6,403.50 |
$8,538 |
4.7× |
| N-invas est c ffr sw aly CTA (75580) |
$7,308.75 |
$9,745 |
8.2× |
| Neck soft tissue (70360) |
$1,092 |
$1,456 |
12.0× |
| Nm adrenal scan (78075) |
$6,114.75 |
$8,153 |
4.5× |
| Nm bone marrow wb (78104) |
$3,614.25 |
$4,819 |
8.7× |
| Nm cisternogram (78630) |
$2,441.62 |
$3,255.50 |
4.3× |
| Nm gastric emptying study (78264) |
$2,186.25 |
$2,915 |
5.2× |
| Nonvascular shunt X-ray (75809) |
$990.75 |
$1,321 |
9.1× |
| Nuclear Rx Oral Admin (79005) |
$1,274.25 |
$1,699 |
5.2× |
| Orthopantogram (70355) |
$748.50 |
$998 |
8.2× |
| Osseous survey limited (77074) |
$1,063.50 |
$1,418 |
9.7× |
| Parathyroid Planar Imaging (78070) |
$2,644.50 |
$3,526 |
6.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$3,056.25 |
$4,075 |
7.3× |
| Pelvis 1 or 2 views (72170) |
$1,434.75 |
$1,913 |
13.1× |
| Perineogram (74775) |
$1,374 |
$1,832 |
5.5× |
| Peritoneogram after injection (74190) |
$906.75 |
$1,209 |
1.6× |
| PET image w/CT, skull-thigh (78815) |
$13,885.50 |
$18,514 |
9.3× |
| PET imaging CT for attenuation limited area (78814) |
$13,885.50 |
$18,514 |
9.3× |
| PET imaging for CT attenuation whole body (78816) |
$13,885.50 |
$18,514 |
9.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,374.50 |
$3,166 |
5.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,215.25 |
$4,287 |
5.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,103.75 |
$2,805 |
3.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$1,395 |
$1,860 |
15.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$972.75 |
$1,297 |
10.7× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$1,383 |
$1,844 |
15.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$2,185.50 |
$2,914 |
24.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$2,061 |
$2,748 |
18.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$1,700.62 |
$2,267.50 |
15.6× |
| Radex fingr minimum 2 views (73140) |
$987 |
$1,316 |
10.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$1,380 |
$1,840 |
15.2× |
| Radex Hand Minimum 3 Views (73130) |
$1,280.25 |
$1,707 |
14.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$945 |
$1,260 |
10.4× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$1,288.50 |
$1,718 |
11.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$1,325.25 |
$1,767 |
12.1× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,200.75 |
$1,601 |
11.0× |
| Radex Humerus Minimum 2 Views (73060) |
$1,008 |
$1,344 |
11.1× |
| Radex Kne 1/2 Views (73560) |
$1,328.25 |
$1,771 |
14.6× |
| Radex Kne Compl 4/More Views (73564) |
$1,362.75 |
$1,817 |
12.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$960.75 |
$1,281 |
8.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$1,050 |
$1,400 |
11.6× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$790.50 |
$1,054 |
7.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$1,422.75 |
$1,897 |
15.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$319.50 |
$426 |
3.5× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$705 |
$940 |
6.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$1,125.75 |
$1,501 |
12.4× |
| Radex Toe Minimum 2 Views (73660) |
$1,026 |
$1,368 |
11.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$547.50 |
$730 |
5.0× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$1,404 |
$1,872 |
15.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,700.62 |
$2,267.50 |
15.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$903 |
$1,204 |
9.9× |
| Radiologic exam chest 2 views (71046) |
$1,442.25 |
$1,923 |
15.9× |
| Radiologic exam colon single contrast study (74270) |
$1,469.25 |
$1,959 |
8.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,090.50 |
$1,454 |
6.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,462.50 |
$1,950 |
8.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$990 |
$1,320 |
5.4× |
| Radiologic examination femur 1 view (73551) |
$1,433.25 |
$1,911 |
15.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$839.25 |
$1,119 |
9.2× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$554.25 |
$739 |
5.1× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$554.25 |
$739 |
5.1× |
| Radiological examination surgical specimen (76098) |
$770.25 |
$1,027 |
1.3× |
| Ribs bilateral 3 views (71110) |
$1,770 |
$2,360 |
16.2× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$2,190.75 |
$2,921 |
5.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$4,844.25 |
$6,459 |
11.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$7,247.25 |
$9,663 |
12.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,063.75 |
$4,085 |
5.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,094.75 |
$6,793 |
9.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$7,247.25 |
$9,663 |
5.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$919.50 |
$1,226 |
3.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,238.25 |
$1,651 |
5.0× |
| Scapula (73010) |
$1,662.75 |
$2,217 |
15.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$373.50 |
$498 |
16.0× |
| Shoulder 1 view (73020) |
$881.25 |
$1,175 |
9.7× |
| Simulation intermediate (77285) |
$4,756.50 |
$6,342 |
12.2× |
| Small bowel series (74250) |
$1,818 |
$2,424 |
9.9× |
| Special dosimetry (77331) |
$1,232.25 |
$1,643 |
8.8× |
| Special Physics Consult (77370) |
$1,243.50 |
$1,658 |
8.9× |
| Special treatment procedure (77470) |
$4,134 |
$5,512 |
7.2× |
| Spine thoracic 3 views (72072) |
$1,759.50 |
$2,346 |
16.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$5,655.75 |
$7,541 |
14.5× |
| Testicular Imaging With Vascular Flow (78761) |
$4,456.50 |
$5,942 |
10.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,667 |
$3,556 |
6.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,696.50 |
$2,262 |
12.1× |
| Thoracolumbar 2 views (72080) |
$1,527 |
$2,036 |
16.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$4,226.25 |
$5,635 |
7.5× |
| Thyroid imaging w/blood flow (78013) |
$2,117.62 |
$2,823.50 |
5.1× |
| Thyroid uptake measurement (78012) |
$3,423 |
$4,564 |
8.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,881.50 |
$3,842 |
6.9× |
| Tmj unilateral (70328) |
$563.62 |
$751.50 |
6.2× |
| Tomogram (76100) |
$1,279.88 |
$1,706.50 |
11.7× |
| Treatment device complex (77334) |
$1,533 |
$2,044 |
3.9× |
| Treatment device intermediate (77333) |
$1,803.75 |
$2,405 |
12.9× |
| Treatment devices simple (77332) |
$1,314 |
$1,752 |
9.4× |
| Ultrasound breast complete (76641) |
$1,008 |
$1,344 |
9.2× |
| Ultrasound elastography first target lesion (76982) |
$436.50 |
$582 |
4.0× |
| Ultrasound, abdomen limited (76705) |
$1,368.75 |
$1,825 |
12.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$1,764 |
$2,352 |
19.4× |
| Ureteral reflux study (78740) |
$2,734.50 |
$3,646 |
6.6× |
| Urethrocystogram voiding (74455) |
$1,352.62 |
$1,803.50 |
5.4× |
| Urethrocystography retrograde rs&i (74450) |
$1,660.50 |
$2,214 |
6.7× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$2,169.75 |
$2,893 |
11.8× |
| Us breast unilateral limited (76642) |
$1,081.50 |
$1,442 |
11.9× |
| Us chest (76604) |
$1,020 |
$1,360 |
9.3× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$766.50 |
$1,022 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$978 |
$1,304 |
9.0× |
| Us elastography parenchyma (76981) |
$436.50 |
$582 |
4.0× |
| Us encephalogram (76506) |
$1,446.75 |
$1,929 |
13.3× |
| Us hips infant static (76886) |
$1,491.75 |
$1,989 |
16.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$737.25 |
$983 |
6.8× |
| Us ob detailed single fetus (76811) |
$575.25 |
$767 |
2.3× |
| Us ob limited (76815) |
$945.38 |
$1,260.50 |
8.7× |
| Us ob transvaginal (76817) |
$1,961.25 |
$2,615 |
18.0× |
| Us pelvic non ob complete (76856) |
$2,186.25 |
$2,915 |
20.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,317.75 |
$1,757 |
12.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$938.25 |
$1,251 |
8.6× |
| Us retroperitoneal complete (76770) |
$1,392.75 |
$1,857 |
12.8× |
| Us retroperitoneal limited (76775) |
$1,213.50 |
$1,618 |
11.1× |
| Us scrotum and contents (76870) |
$1,684.50 |
$2,246 |
15.4× |
| Us soft tissue head/neck (76536) |
$1,200.38 |
$1,600.50 |
11.0× |
| Us spinal canal and contents (76800) |
$1,861.50 |
$2,482 |
17.1× |
| Us transrectal prostate volume (76873) |
$636.75 |
$849 |
5.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,383.75 |
$1,845 |
12.7× |
| Venogram extremity bilateral (75822) |
$13,264.12 |
$17,685.50 |
8.1× |
| Venogram Extremity Unilateral (75820) |
$4,017.75 |
$5,357 |
2.4× |
| Venography caval inferior serialography rs&i (75825) |
$4,512 |
$6,016 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$4,735.50 |
$6,314 |
2.9× |
| Venography Renal Bilateral (75833) |
$11,837.25 |
$15,783 |
3.6× |
| Venography renal unilateral selective rs&i (75831) |
$6,474 |
$8,632 |
2.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$5,286 |
$7,048 |
1.6× |
| Venous sampling by catheter (75893) |
$18,501 |
$24,668 |
3.2× |
| Wrist 2 views (73100) |
$1,116 |
$1,488 |
12.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,394.25 |
$1,859 |
12.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$750 |
$1,000 |
8.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,924.88 |
$2,566.50 |
10.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,029 |
$1,372 |
11.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$654.75 |
$873 |
7.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,325.25 |
$1,767 |
12.1× |
| X-ray exam of femur 2/> (73552) |
$1,433.25 |
$1,911 |
15.8× |
| X-ray eye for foreign body (70030) |
$518.62 |
$691.50 |
5.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$1,026 |
$1,368 |
11.3× |
| X-ray IV pyelogram (ivp) (74400) |
$1,889.25 |
$2,519 |
10.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$831.75 |
$1,109 |
9.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$1,027.50 |
$1,370 |
11.3× |
| X-ray leg, infant (73592) |
$580.50 |
$774 |
6.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,551.75 |
$2,069 |
14.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$3,089.25 |
$4,119 |
28.3× |
| X-ray nose-rectum child f.b. (76010) |
$459 |
$612 |
5.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$991.50 |
$1,322 |
9.1× |
| X-ray retrograde pyelogram (74420) |
$2,264.25 |
$3,019 |
6.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,350.75 |
$1,801 |
14.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,671.75 |
$2,229 |
15.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,101 |
$1,468 |
10.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,080 |
$1,440 |
9.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,057.50 |
$1,410 |
11.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,074.38 |
$1,432.50 |
11.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,181.25 |
$1,575 |
10.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$693.75 |
$925 |
6.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$762.75 |
$1,017 |
8.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$974.25 |
$1,299 |
10.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$1,127.25 |
$1,503 |
12.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,057.50 |
$1,410 |
9.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$1,500.75 |
$2,001 |
13.7× |
| Xr bone length studies (77073) |
$783.75 |
$1,045 |
7.2× |
| Xr c-spine 4 or 5 views (72050) |
$1,733.62 |
$2,311.50 |
15.9× |
| Xr c-spine 6 or more views (72052) |
$1,011.75 |
$1,349 |
9.3× |
| Xr chest 4+ views (71048) |
$1,830.75 |
$2,441 |
16.8× |
| Xr urogram antegrade (74425) |
$2,640 |
$3,520 |
7.2× |