| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,715.71 |
$7,759.15 |
1.9× |
| Abdomen 2 views (74019) |
$108.13 |
$308.94 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$412.84 |
$1,179.54 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$1,881.85 |
$5,376.69 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,881.85 |
$5,376.69 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$2,269.89 |
$6,485.38 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,208.49 |
$9,167.10 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,094.49 |
$5,984.25 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,094.49 |
$5,984.25 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$4,093.59 |
$11,695.96 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,236.94 |
$12,105.54 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$7,586.23 |
$21,674.94 |
2.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,924.72 |
$5,499.19 |
0.6× |
| Ankle 2 views (73600) |
$124.16 |
$354.73 |
1.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$241.81 |
$690.88 |
0.7× |
| Aortogram thoracic (75605) |
$4,247.37 |
$12,135.33 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,094.49 |
$5,984.25 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,881.85 |
$5,376.69 |
0.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,094.49 |
$5,984.25 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$3,640.28 |
$10,400.79 |
1.1× |
| Arthrogram elbow (73085) |
$281.81 |
$805.17 |
0.8× |
| Arthrogram hip (73525) |
$281.81 |
$805.17 |
0.8× |
| Arthrogram shoulder (73040) |
$281.81 |
$805.17 |
0.8× |
| Arthrogram wrist (73115) |
$281.81 |
$805.17 |
0.8× |
| Arthrography knee lt (73580) |
$281.81 |
$805.17 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$275.75 |
$787.84 |
1.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$321.87 |
$919.62 |
0.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$340.47 |
$972.75 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$479.24 |
$1,369.23 |
1.1× |
| Bone age studies (77072) |
$120.58 |
$344.49 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$471.87 |
$1,348.18 |
1.1× |
| Bone Marrow Imaging Limited Area (78102) |
$292.11 |
$834.58 |
0.7× |
| Bone survey complete (77075) |
$284.03 |
$811.50 |
2.6× |
| Brachytx isodose intermed (77317) |
$691.15 |
$1,974.71 |
1.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$499.66 |
$1,427.58 |
1.3× |
| Brain image w/flow 4 + views (78606) |
$457.89 |
$1,308.25 |
0.8× |
| Brain imaging < 4 static views (78600) |
$301.68 |
$861.94 |
0.7× |
| Brain imaging < 4 static views w vascular flow (78601) |
$470.60 |
$1,344.57 |
1.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$402.64 |
$1,150.39 |
0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,705.79 |
$4,873.68 |
1.1× |
| Brain Imaging Vascular Flow Only (78610) |
$402.64 |
$1,150.39 |
0.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$827.47 |
$2,364.20 |
2.2× |
| Cardiac shunt detection (78428) |
$323.11 |
$923.15 |
0.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$402.64 |
$1,150.39 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$139.93 |
$399.80 |
1.5× |
| Chest 1 view (71045) |
$56.57 |
$161.62 |
0.6× |
| Chest 3 views (71047) |
$56.57 |
$161.62 |
0.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$125.48 |
$358.51 |
0.7× |
| Clavicle complete (73000) |
$130.17 |
$371.90 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$65.19 |
$186.23 |
0.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$230.15 |
$657.56 |
1.2× |
| Corpora cavernosography (74445) |
$249.32 |
$712.34 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,579.89 |
$7,371.10 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,052.71 |
$5,864.86 |
8.2× |
| CT abdomen w contrast (74160) |
$1,474.31 |
$4,212.29 |
8.0× |
| CT abdomen w wo contrast (74170) |
$921.05 |
$2,631.55 |
5.0× |
| CT abdomen w/o contrast (74150) |
$691.70 |
$1,976.28 |
6.3× |
| CT angio hrt w/3d image (75574) |
$944.70 |
$2,699.13 |
2.6× |
| CT angiography upper extremity lt (73206) |
$790.21 |
$2,257.72 |
4.3× |
| CT c-spine w/o contrast (72125) |
$1,158.22 |
$3,309.20 |
10.5× |
| CT cervical spine with contrast (72126) |
$869.13 |
$2,483.21 |
2.4× |
| CT chest w/wo contrast (71270) |
$965.26 |
$2,757.88 |
5.2× |
| CT chest with contrast (71260) |
$1,211.70 |
$3,462 |
6.5× |
| CT head/brain with contrast (70460) |
$698.88 |
$1,996.80 |
3.8× |
| CT head/brain without and with contrast (70470) |
$800.26 |
$2,286.44 |
4.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$756.94 |
$2,162.66 |
2.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$103.64 |
$296.10 |
1.1× |
| CT hrt w/3d image congen (75573) |
$881.59 |
$2,518.82 |
2.4× |
| CT iac w contrast (70481) |
$806.50 |
$2,304.27 |
4.4× |
| CT limited/localized follow up study (76380) |
$271.07 |
$774.47 |
3.0× |
| CT lower ext w/o (73700) |
$1,044.32 |
$2,983.77 |
9.5× |
| CT lower extremity w wo contrast (73702) |
$676.92 |
$1,934.05 |
3.7× |
| CT lower extremity with contrast (73701) |
$675.68 |
$1,930.51 |
3.7× |
| CT lumbar spine w/o contrast (72131) |
$754.01 |
$2,154.30 |
6.8× |
| CT lumbar spine with contrast (72132) |
$935.78 |
$2,673.64 |
2.5× |
| CT maxillofacial w contrast (70487) |
$638.15 |
$1,823.28 |
3.4× |
| CT maxillofacial w/o contrast (70486) |
$566 |
$1,617.14 |
5.1× |
| CT maxillofacial w/wo contrast (70488) |
$727.08 |
$2,077.37 |
3.9× |
| CT neck soft tissue w contrast (70491) |
$1,112.95 |
$3,179.84 |
6.0× |
| CT orbits w/o contrast (70480) |
$634.24 |
$1,812.11 |
5.8× |
| CT pelvis w & w/o contrast (72194) |
$919.59 |
$2,627.39 |
5.0× |
| CT pelvis w/o contrast (72192) |
$717.61 |
$2,050.30 |
6.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,030.03 |
$2,942.94 |
5.6× |
| CT soft tissue neck w/o contrast (70490) |
$642.01 |
$1,834.29 |
5.8× |
| CT thoracic spine w/contrast (72129) |
$815.87 |
$2,331.03 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$669.29 |
$1,912.23 |
6.1× |
| CT thorax w/o contrast (71250) |
$1,054.09 |
$3,011.67 |
9.6× |
| CT unlisted procedure (76497) |
$93.29 |
$266.54 |
1.0× |
| CT upper extremity w/o contrast rt (73200) |
$592.52 |
$1,692.91 |
5.4× |
| CT upper extremity with contrast (73201) |
$727.62 |
$2,078.90 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,119.42 |
$3,198.34 |
6.0× |
| Cta Abdomen (74175) |
$1,061.48 |
$3,032.79 |
5.7× |
| CTA abdomen pelvis (74174) |
$1,851.50 |
$5,289.98 |
5.0× |
| CTA chest (71275) |
$458.02 |
$1,308.62 |
2.5× |
| Cta Head (70496) |
$1,543.92 |
$4,411.18 |
8.3× |
| CTA lwr ext w&w/o contrast (73706) |
$714.80 |
$2,042.27 |
3.9× |
| Cta Neck (70498) |
$1,567.12 |
$4,477.47 |
8.5× |
| Cta Pelvis (72191) |
$848.46 |
$2,424.17 |
4.6× |
| Cystography minimum 3 views rs&i (74430) |
$241.81 |
$690.88 |
0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$81.90 |
$234 |
0.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$124.23 |
$354.94 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$212.06 |
$605.87 |
1.9× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$119.51 |
$341.43 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$178.82 |
$510.90 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$89.20 |
$254.84 |
1.0× |
| Echo exam of eye (76529) |
$54.74 |
$156.39 |
0.6× |
| Echo exam of fetal heart (76825) |
$403.43 |
$1,152.65 |
0.7× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$180.29 |
$515.10 |
0.7× |
| Echoencephalography real time imaging (76506) |
$134.94 |
$385.54 |
1.2× |
| Esophageal motility (78258) |
$273.09 |
$780.23 |
0.6× |
| Esophagus (74220) |
$134.04 |
$382.97 |
0.7× |
| Fetal biophysical profile non-stress testing (76818) |
$180.42 |
$515.48 |
1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$226.56 |
$647.31 |
2.1× |
| Foot 2 views (73620) |
$109.02 |
$311.47 |
1.2× |
| Forearm 2 views (73090) |
$111.32 |
$318.05 |
1.2× |
| Gated Heart Planar Single (78472) |
$659.67 |
$1,884.75 |
1.6× |
| Hand 2 views (73120) |
$101.70 |
$290.57 |
0.9× |
| Hand 3 views (73130) |
$122.41 |
$349.72 |
1.3× |
| Heart Infarct Image (78466) |
$323.11 |
$923.15 |
0.8× |
| Heart infarct image w ef (78468) |
$315.48 |
$901.35 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,540.53 |
$7,258.65 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$402.64 |
$1,150.39 |
0.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$266.53 |
$761.50 |
0.6× |
| Ht muscle image spect sing (78451) |
$1,057.76 |
$3,022.16 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$97.40 |
$278.26 |
1.1× |
| Hysterosalpingogram (74740) |
$299.46 |
$855.60 |
1.2× |
| Kidney funcj study non-img radioisotopic study (78725) |
$295.54 |
$844.40 |
0.7× |
| Kidney imaging morphology (78700) |
$351.72 |
$1,004.89 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$470.89 |
$1,345.39 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$427.67 |
$1,221.89 |
0.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$553.85 |
$1,582.41 |
1.0× |
| Knee 3 views (73562) |
$160 |
$457.13 |
1.7× |
| Liver & spleen imaging static only (78215) |
$346.27 |
$989.32 |
0.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$483.29 |
$1,380.82 |
1.1× |
| Liver imaging static only (78201) |
$996.95 |
$2,848.41 |
1.7× |
| Liver imaging w/vascular flow (78202) |
$996.95 |
$2,848.41 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$415.05 |
$1,185.84 |
0.7× |
| Lung perfusion differential (78597) |
$307.24 |
$877.82 |
0.7× |
| Lung Ventilation Imaging (78579) |
$307.24 |
$877.82 |
0.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,496.91 |
$7,134.02 |
0.7× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,451.68 |
$4,147.63 |
0.9× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,603.08 |
$7,437.36 |
0.8× |
| Lymphoscintigraphy (78195) |
$566.84 |
$1,619.53 |
1.0× |
| Mammary ductogram or galactogram multiple (77054) |
$216.57 |
$618.76 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$237.53 |
$678.64 |
0.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$69.88 |
$199.64 |
0.8× |
| Meckels Diverticulum (78290) |
$358.16 |
$1,023.29 |
0.8× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$590.75 |
$1,687.85 |
1.5× |
| Mr elastography (76391) |
$441.33 |
$1,260.92 |
1.8× |
| Mr safety determination physician/other qhp (76016) |
$184.91 |
$528.30 |
2.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$124.74 |
$356.40 |
2.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$51.43 |
$146.94 |
1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$192.76 |
$550.74 |
1.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$507.62 |
$1,450.32 |
2.0× |
| MRA head w & w/o contrast (70546) |
$1,370.67 |
$3,916.20 |
3.7× |
| MRA head w/o contrast (70544) |
$685.66 |
$1,959.02 |
2.7× |
| MRA head with contrast (70545) |
$965.41 |
$2,758.31 |
2.6× |
| MRA neck w contrast (70548) |
$761.89 |
$2,176.81 |
2.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,073.32 |
$3,066.62 |
2.9× |
| MRA neck w/o contrast (70547) |
$679.50 |
$1,941.42 |
2.7× |
| MRI abdomen w contrast (74182) |
$923.65 |
$2,639 |
2.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,069.97 |
$3,057.04 |
2.9× |
| MRI abdomen w/o contrast (74181) |
$774.52 |
$2,212.89 |
3.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,011.83 |
$2,890.94 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$935.69 |
$2,673.39 |
1.1× |
| MRI bone marrow blood supply (77084) |
$729.55 |
$2,084.41 |
2.9× |
| MRI breast w/o contrast bilateral (77047) |
$441.33 |
$1,260.92 |
1.8× |
| MRI breast w/o contrast unilat (77046) |
$441.33 |
$1,260.92 |
1.8× |
| MRI c-spine with contrast (72142) |
$1,041.94 |
$2,976.97 |
2.8× |
| MRI cardiac w/o contrast (75557) |
$687.30 |
$1,963.71 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$1,459.59 |
$4,170.24 |
5.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,059.57 |
$3,027.33 |
2.9× |
| MRI chest w/o contrast (71550) |
$776.60 |
$2,218.83 |
3.1× |
| MRI chest with contrast (71551) |
$831.96 |
$2,377.01 |
1.0× |
| MRI fetal sngl/1st gestation (74712) |
$227.88 |
$651.08 |
0.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$723.37 |
$2,066.77 |
2.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$939.47 |
$2,684.19 |
3.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,223.53 |
$3,495.80 |
3.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,073.32 |
$3,066.62 |
2.9× |
| MRI pelvis w contrast (72196) |
$914.91 |
$2,614.02 |
2.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,092.27 |
$3,120.76 |
3.0× |
| MRI pelvis w/o contrast (72195) |
$747.03 |
$2,134.35 |
3.0× |
| MRI scan of arm joint before and after contrast (73223) |
$1,042.28 |
$2,977.94 |
2.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,044.08 |
$2,983.06 |
2.8× |
| MRI spectroscopy (76390) |
$928.97 |
$2,654.19 |
10.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,282.18 |
$3,663.37 |
3.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,072.43 |
$3,064.06 |
2.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,278.35 |
$3,652.41 |
3.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,079.44 |
$3,084.11 |
2.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,282.79 |
$3,665.09 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$990.10 |
$2,828.85 |
3.9× |
| MRI tmj (70336) |
$712.08 |
$2,034.51 |
2.8× |
| MRI upper ext joint w/o contrast (73221) |
$909.57 |
$2,598.77 |
3.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,004.57 |
$2,870.19 |
2.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$596.69 |
$1,704.81 |
2.4× |
| Myelogram Cervical (72240) |
$611.64 |
$1,747.53 |
0.7× |
| Myelogram Lumbar (72265) |
$561.52 |
$1,604.34 |
0.7× |
| Myelogram thoracic (72255) |
$563.06 |
$1,608.73 |
0.7× |
| Myelography 2 or more regions (72270) |
$503.22 |
$1,437.77 |
0.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,597.40 |
$4,563.99 |
1.2× |
| Myocardial infarct spect (78469) |
$983.97 |
$2,811.33 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,918.01 |
$5,480.01 |
1.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,168.14 |
$3,337.53 |
0.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,168.14 |
$3,337.53 |
0.8× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,072.98 |
$8,779.94 |
1.3× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,226.59 |
$6,361.67 |
1.0× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$2,226.59 |
$6,361.67 |
1.4× |
| Neck soft tissue (70360) |
$124.82 |
$356.61 |
1.4× |
| Nm adrenal scan (78075) |
$810.11 |
$2,314.59 |
0.6× |
| Nm bone marrow multiple (78103) |
$292.11 |
$834.58 |
0.7× |
| Nm bone marrow wb (78104) |
$300.21 |
$857.74 |
0.7× |
| Nm cisternogram (78630) |
$449.69 |
$1,284.81 |
0.8× |
| Nm csf leak detection (78650) |
$1,044.72 |
$2,984.89 |
0.8× |
| Nm gastric emptying study (78264) |
$379.49 |
$1,084.24 |
0.9× |
| Nm gastroesophageal reflux study (78262) |
$334.61 |
$956.01 |
0.8× |
| Nm peritoneal-venous shunt patency (78291) |
$290.94 |
$831.24 |
0.7× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,057.76 |
$3,022.16 |
0.8× |
| Nuclear medicine study of endocrine organs (78099) |
$307.24 |
$877.82 |
0.7× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$996.94 |
$2,848.40 |
0.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$377.76 |
$1,079.29 |
0.9× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$322.83 |
$922.36 |
0.8× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$277.12 |
$791.77 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$315.05 |
$900.14 |
1.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$134.92 |
$385.46 |
1.2× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$122.75 |
$350.70 |
0.9× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$86.93 |
$248.37 |
0.8× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$118.16 |
$337.58 |
1.1× |
| Orthopantogram (70355) |
$72.03 |
$205.80 |
0.8× |
| Osseous survey infant (77076) |
$305.48 |
$872.80 |
2.8× |
| Parathyrd planar w/spect&CT (78072) |
$452.65 |
$1,293.27 |
0.8× |
| Parathyrd planar w/wo subtrj (78071) |
$404.85 |
$1,156.69 |
1.0× |
| Parathyroid imaging (78070) |
$376.24 |
$1,074.96 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$119.42 |
$341.19 |
1.1× |
| Peritoneogram rs&i (74190) |
$433.91 |
$1,239.72 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$1,882.41 |
$5,378.31 |
1.2× |
| PET imaging for CT attenuation whole body (78816) |
$1,914.05 |
$5,468.69 |
1.3× |
| Pr csf ventriculography (78635) |
$367.68 |
$1,050.51 |
0.6× |
| Pr heart first pass single,planar (78481) |
$390.91 |
$1,116.87 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$987.77 |
$2,822.20 |
2.7× |
| Pr sono bone density measure,peripheral (76977) |
$81.90 |
$234 |
0.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,384.13 |
$6,811.78 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,374.42 |
$6,784.05 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$432.56 |
$1,235.86 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$433.32 |
$1,238.03 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$410.96 |
$1,174.15 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$56.38 |
$161.06 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$93.37 |
$266.75 |
0.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$93.37 |
$266.75 |
0.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$89.57 |
$255.89 |
0.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$178 |
$508.55 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$210.72 |
$602.04 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$56.57 |
$161.62 |
0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$108.13 |
$308.94 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$56.57 |
$161.62 |
0.6× |
| Radiologic exam colon single contrast study (74270) |
$318.93 |
$911.21 |
1.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$164.17 |
$469.03 |
0.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$211.43 |
$604.08 |
1.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$222.48 |
$635.64 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$56.38 |
$161.06 |
0.6× |
| Radiological examination surgical specimen (76098) |
$344 |
$982.86 |
0.6× |
| Radiopharm Dacryocystography (78660) |
$307.24 |
$877.82 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,384.09 |
$6,811.68 |
0.7× |
| Ribs bilateral 3 views (71110) |
$133.17 |
$380.46 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$501.90 |
$1,433.99 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$980.72 |
$2,802.05 |
1.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,057.76 |
$3,022.16 |
1.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,029.75 |
$2,942.14 |
0.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,168.14 |
$3,337.53 |
0.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,029.75 |
$2,942.14 |
0.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$456.40 |
$1,304 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$77.39 |
$221.11 |
0.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$213.63 |
$610.37 |
0.8× |
| Salivary gland imaging serial images (78231) |
$273.09 |
$780.23 |
0.6× |
| Scanogram (77073) |
$157.48 |
$449.93 |
1.4× |
| Scapula complete (73010) |
$141.99 |
$405.67 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$23.21 |
$66.31 |
1.0× |
| Sialogram (70390) |
$241.04 |
$688.68 |
1.0× |
| Small bowel series (74250) |
$194.31 |
$555.16 |
1.1× |
| Spec medical radj physics consltj (77370) |
$415.70 |
$1,187.71 |
2.9× |
| Special treatment procedure (77470) |
$1,124.42 |
$3,212.62 |
1.9× |
| Spine thoracic 3 views (72072) |
$165.88 |
$473.92 |
1.5× |
| Spleen imaging only (78185) |
$237.33 |
$678.07 |
0.6× |
| Tbs Technical Calculation Only (77091) |
$73.56 |
$210.16 |
0.8× |
| Testicular Imaging With Vascular Flow (78761) |
$351.72 |
$1,004.89 |
0.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$934.08 |
$2,668.80 |
2.4× |
| Therapeutic Enema (74283) |
$429.28 |
$1,226.50 |
2.3× |
| Thoracolumbar 2 views (72080) |
$179.33 |
$512.35 |
2.0× |
| Thyroid carcinoma metastases img addl study (78016) |
$318.66 |
$910.44 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$599.52 |
$1,712.89 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$474.97 |
$1,357.05 |
1.1× |
| Thyroid uptake measurement (78012) |
$285.90 |
$816.84 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$242.01 |
$691.44 |
0.6× |
| Tmj unilateral (70328) |
$80.13 |
$228.93 |
0.9× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$73.56 |
$210.16 |
0.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,003.89 |
$2,868.25 |
1.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$454.99 |
$1,299.97 |
1.1× |
| Ultrasound elastography first target lesion (76982) |
$242.97 |
$694.20 |
2.2× |
| Ultrasound scan of cornea to determine thickness (76514) |
$27.82 |
$79.48 |
0.9× |
| Ultrasound scan to determine eye length and lens power (76519) |
$84.20 |
$240.57 |
0.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$163.61 |
$467.43 |
0.4× |
| Ultrasound, abdomen limited (76705) |
$177.77 |
$507.90 |
1.6× |
| Umbilical-artery Doppler (OB) (76820) |
$212.06 |
$605.87 |
1.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$176.77 |
$505.03 |
1.9× |
| Unlisted fluoroscopic procedure (76496) |
$107.81 |
$308.02 |
1.2× |
| Unlisted magnetic resonance procedure (76498) |
$3,479.68 |
$9,941.95 |
37.9× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$307.24 |
$877.82 |
0.7× |
| Unlisted Ultrasound Procedure (76999) |
$54.74 |
$156.39 |
0.6× |
| Upper Extremity Infant (73092) |
$81.90 |
$234 |
0.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$351.72 |
$1,004.89 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$241.81 |
$690.88 |
1.0× |
| Urethrocystography voiding (74455) |
$241.81 |
$690.88 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$92.05 |
$263 |
0.8× |
| Us breast unilateral complete (76641) |
$77.41 |
$221.16 |
0.7× |
| Us breast unilateral limited (76642) |
$77.41 |
$221.16 |
0.8× |
| Us chest (76604) |
$145.73 |
$416.36 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$156.14 |
$446.11 |
1.4× |
| Us elastography parenchyma (76981) |
$242.97 |
$694.20 |
2.2× |
| Us fetal nuchal translucency 1st gestation (76813) |
$81.90 |
$234 |
0.7× |
| Us guided compression repair (76936) |
$215.41 |
$615.45 |
0.9× |
| Us infant hips dynamic (76885) |
$139.82 |
$399.47 |
1.5× |
| Us infant hips limited static (76886) |
$109.17 |
$311.91 |
1.2× |
| Us kidney transplant (76776) |
$166.68 |
$476.22 |
1.5× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$129.62 |
$370.34 |
1.2× |
| Us ob detailed single fetus (76811) |
$231.80 |
$662.26 |
0.9× |
| Us ob transvaginal (76817) |
$150.59 |
$430.25 |
1.4× |
| Us pelvic non ob complete (76856) |
$253.31 |
$723.72 |
2.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$245.97 |
$702.75 |
2.2× |
| Us pregnancy ltd (76815) |
$149.11 |
$426.01 |
1.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$155.57 |
$444.48 |
1.4× |
| Us retroperitoneal complete (76770) |
$166.68 |
$476.22 |
1.5× |
| Us retroperitoneal limited (76775) |
$225.08 |
$643.08 |
2.0× |
| Us scrotum and contents (76870) |
$208.65 |
$596.12 |
1.9× |
| Us soft tissue head/neck (76536) |
$124.77 |
$356.47 |
1.1× |
| Us spinal canal and contents (76800) |
$121.42 |
$346.89 |
1.1× |
| Us transrectal (76872) |
$277.63 |
$793.22 |
2.5× |
| Us transrectal prostate volume (76873) |
$277.63 |
$793.22 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$111.34 |
$318.11 |
1.0× |
| Us, eye b-scan (76512) |
$84.20 |
$240.57 |
0.8× |
| Venogram extremity bilateral (75822) |
$1,193.03 |
$3,408.63 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,094.49 |
$5,984.25 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,193.03 |
$3,408.63 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$1,193.03 |
$3,408.63 |
0.7× |
| Venography Renal Bilateral (75833) |
$5,936.05 |
$16,960.13 |
1.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,496.91 |
$7,134.02 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,269.89 |
$6,485.38 |
0.7× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,247.37 |
$12,135.33 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$55.78 |
$159.37 |
0.6× |
| Wrist 2 views (73100) |
$113.85 |
$325.26 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$229.15 |
$654.70 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$126.21 |
$360.59 |
1.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$125.74 |
$359.23 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$379.53 |
$1,084.36 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$95.94 |
$274.10 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$137.40 |
$392.55 |
1.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$178 |
$508.55 |
1.6× |
| X-ray exam hip uni 1 view (73501) |
$56.38 |
$161.06 |
0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$56.38 |
$161.06 |
0.6× |
| X-ray exam hip uni 4/> views (73503) |
$93.37 |
$266.75 |
0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$93.37 |
$266.75 |
0.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$178 |
$508.55 |
1.6× |
| X-ray exam of femur 1 (73551) |
$56.38 |
$161.06 |
0.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$214.57 |
$613.03 |
1.2× |
| X-ray eye for foreign body (70030) |
$139.32 |
$398.05 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$170.42 |
$486.89 |
1.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$149.96 |
$428.45 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$118.69 |
$339.10 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$94.54 |
$270.11 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$145.94 |
$416.96 |
1.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$149.16 |
$426.15 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$143.83 |
$410.93 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$60.27 |
$172.19 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$161.32 |
$460.91 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$172.15 |
$491.84 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$125.55 |
$358.70 |
1.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$138.52 |
$395.75 |
1.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$92.79 |
$265.09 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$178.72 |
$510.61 |
1.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$119.42 |
$341.19 |
1.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$592.16 |
$1,691.86 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$249.32 |
$712.34 |
0.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$55.81 |
$159.45 |
0.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$173.75 |
$496.42 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$229 |
$654.26 |
2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$144.51 |
$412.86 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$130.59 |
$373.10 |
1.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$135.83 |
$388.06 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$160.51 |
$458.59 |
1.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$74.76 |
$213.58 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$220.69 |
$630.54 |
2.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$146.16 |
$417.59 |
1.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$119.45 |
$341.26 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$117.55 |
$335.85 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$117.93 |
$336.92 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$111.89 |
$319.68 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$87.36 |
$249.60 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$121.22 |
$346.32 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$217.35 |
$620.99 |
2.0× |
| Xr chest 4+ views (71048) |
$108.13 |
$308.94 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$89.28 |
$255.06 |
1.0× |
| Xr shoulder 1 view (73020) |
$100.71 |
$287.73 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$181.67 |
$519.04 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$114.20 |
$326.28 |
1.2× |
| Xr tmj bilateral (70330) |
$155.98 |
$445.64 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$140.78 |
$402.22 |
1.5× |