| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,990.80 |
$22,477 |
6.5× |
| Abdomen 2 views (74019) |
$610 |
$1,525 |
5.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,273.20 |
$5,683 |
5.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,792.40 |
$11,981 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$4,792.40 |
$11,981 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$5,649.20 |
$14,123 |
1.8× |
| Angiography internal mammary rs&i (75756) |
$2,015.20 |
$5,038 |
0.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,271.60 |
$13,179 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,792.40 |
$11,981 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,005.60 |
$5,014 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,015.20 |
$5,038 |
0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,299.20 |
$15,748 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,226 |
$3,065 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,015.20 |
$5,038 |
0.6× |
| Ankle 2 views (73600) |
$404 |
$1,010 |
4.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$891.20 |
$2,228 |
2.5× |
| Aortogram thoracic (75605) |
$5,208 |
$13,020 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$9,202.80 |
$23,007 |
2.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,957.60 |
$7,394 |
0.9× |
| Aortography thoracic w/o serialography rs&i (75600) |
$8,799.60 |
$21,999 |
2.8× |
| Artery X-Rays Adrenal Gland (75731) |
$4,792.40 |
$11,981 |
1.5× |
| Arthrogram elbow (73085) |
$2,592.40 |
$6,481 |
7.4× |
| Arthrogram hip (73525) |
$1,653.20 |
$4,133 |
4.7× |
| Arthrogram shoulder (73040) |
$1,186 |
$2,965 |
3.4× |
| Arthrogram wrist (73115) |
$906.80 |
$2,267 |
2.6× |
| Arthrography knee lt (73580) |
$1,244 |
$3,110 |
3.5× |
| Basic radiation dosimetry calculation (77300) |
$503.20 |
$1,258 |
3.7× |
| Bone &/joint imaging whole body (78306) |
$1,776 |
$4,440 |
4.4× |
| Bone age studies (77072) |
$576.80 |
$1,442 |
5.5× |
| Bone Imaging 3 Phase (78315) |
$2,209.60 |
$5,524 |
5.5× |
| Bone survey complete (77075) |
$3,836.80 |
$9,592 |
36.5× |
| Brain image w/flow 4 + views (78606) |
$1,527.60 |
$3,819 |
2.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,124.80 |
$2,812 |
2.1× |
| Brain Imaging Vascular Flow Only (78610) |
$809.60 |
$2,024 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$560 |
$1,400 |
6.4× |
| Chest 1 view (71045) |
$396 |
$990 |
4.5× |
| Chest 3 views (71047) |
$411.60 |
$1,029 |
4.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$550.40 |
$1,376 |
3.1× |
| Cisternography Positive Contrast Rs&I (70015) |
$2,507.20 |
$6,268 |
3.2× |
| Clavicle complete (73000) |
$466.80 |
$1,167 |
5.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$4,578.40 |
$11,446 |
43.6× |
| Continuing medical physics consltj pr wk (77336) |
$1,086 |
$2,715 |
8.0× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$538.40 |
$1,346 |
3.1× |
| Corpora cavernosography (74445) |
$624 |
$1,560 |
5.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$10,156 |
$25,390 |
29.0× |
| CT abdomen and pelvis without contrast (74176) |
$5,344.20 |
$13,360.50 |
22.3× |
| CT abdomen w contrast (74160) |
$5,076 |
$12,690 |
28.8× |
| CT abdomen w wo contrast (74170) |
$5,583.60 |
$13,959 |
31.7× |
| CT abdomen w/o contrast (74150) |
$4,100 |
$10,250 |
39.0× |
| CT angio hrt w/3d image (75574) |
$804 |
$2,010 |
2.3× |
| CT angiography upper extremity lt (73206) |
$2,812 |
$7,030 |
16.0× |
| CT c-spine w/o contrast (72125) |
$3,833.60 |
$9,584 |
36.5× |
| CT cervical spine w&w/o contrast (72127) |
$2,975.20 |
$7,438 |
16.9× |
| CT cervical spine with contrast (72126) |
$4,216.80 |
$10,542 |
12.0× |
| CT chest w/wo contrast (71270) |
$4,985.60 |
$12,464 |
28.3× |
| CT chest with contrast (71260) |
$4,532.40 |
$11,331 |
25.7× |
| CT head/brain with contrast (70460) |
$5,104.40 |
$12,761 |
29.0× |
| CT head/brain without and with contrast (70470) |
$5,614.80 |
$14,037 |
31.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$172 |
$430 |
2.0× |
| CT iac w contrast (70481) |
$4,559.60 |
$11,399 |
25.9× |
| CT limited/localized follow up study (76380) |
$573.60 |
$1,434 |
6.6× |
| CT lower ext w/o (73700) |
$2,994.40 |
$7,486 |
28.5× |
| CT lower extremity w wo contrast (73702) |
$4,083.20 |
$10,208 |
23.2× |
| CT lower extremity with contrast (73701) |
$1,288.40 |
$3,221 |
7.3× |
| CT lumbar spine w & w/o contrast (72133) |
$4,617.20 |
$11,543 |
26.2× |
| CT lumbar spine w/o contrast (72131) |
$3,816 |
$9,540 |
36.3× |
| CT lumbar spine with contrast (72132) |
$4,197.60 |
$10,494 |
12.0× |
| CT maxillofacial w contrast (70487) |
$4,517.20 |
$11,293 |
25.6× |
| CT maxillofacial w/o contrast (70486) |
$4,100 |
$10,250 |
39.0× |
| CT maxillofacial w/wo contrast (70488) |
$4,968.80 |
$12,422 |
28.2× |
| CT neck soft tissue w contrast (70491) |
$4,065.60 |
$10,164 |
23.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,539.40 |
$8,848.50 |
20.1× |
| CT orbits w/o contrast (70480) |
$4,061.20 |
$10,153 |
38.7× |
| CT pelvis w & w/o contrast (72194) |
$6,204 |
$15,510 |
35.2× |
| CT pelvis w/o contrast (72192) |
$5,076 |
$12,690 |
48.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$328.80 |
$822 |
3.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,394.80 |
$10,987 |
24.9× |
| CT soft tissue neck w/o contrast (70490) |
$3,132.40 |
$7,831 |
29.8× |
| CT thoracic spine w/contrast (72129) |
$2,618 |
$6,545 |
14.9× |
| CT thoracic spine w/o contrast (72128) |
$3,780.80 |
$9,452 |
36.0× |
| CT thoracic spine w/wo contrast (72130) |
$3,184.80 |
$7,962 |
18.1× |
| CT thorax w/o contrast (71250) |
$4,120.40 |
$10,301 |
39.2× |
| CT unlisted procedure (76497) |
$1,237.20 |
$3,093 |
14.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,212.80 |
$3,032 |
6.9× |
| CT upper extremity w/o contrast rt (73200) |
$2,883.20 |
$7,208 |
27.5× |
| CT upper extremity with contrast (73201) |
$1,288.40 |
$3,221 |
3.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,388.80 |
$5,972 |
13.6× |
| Cta Abdomen (74175) |
$3,278 |
$8,195 |
18.6× |
| CTA abdomen pelvis (74174) |
$4,100.80 |
$10,252 |
11.7× |
| CTA chest (71275) |
$3,877.20 |
$9,693 |
22.0× |
| Cta Head (70496) |
$3,717.20 |
$9,293 |
21.1× |
| CTA lwr ext w&w/o contrast (73706) |
$2,661.40 |
$6,653.50 |
15.1× |
| Cta Neck (70498) |
$2,743.20 |
$6,858 |
15.6× |
| Cta Pelvis (72191) |
$2,315.20 |
$5,788 |
13.1× |
| Cystography minimum 3 views rs&i (74430) |
$658.80 |
$1,647 |
1.9× |
| Diskogram cervical (72285) |
$7,551.20 |
$18,878 |
3.8× |
| Diskography lumbar (72295) |
$7,082.40 |
$17,706 |
3.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$523.40 |
$1,308.50 |
5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$158.40 |
$396 |
1.8× |
| Echoencephalography real time imaging (76506) |
$910.40 |
$2,276 |
8.7× |
| Esophagus (74220) |
$611.60 |
$1,529 |
3.5× |
| Fetal biophysical profile non-stress testing (76818) |
$271.60 |
$679 |
2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$271.60 |
$679 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$320.80 |
$802 |
1.3× |
| Foot 2 views (73620) |
$355.60 |
$889 |
4.1× |
| Forearm 2 views (73090) |
$385.20 |
$963 |
4.4× |
| Gated Heart Planar Single (78472) |
$2,439.60 |
$6,099 |
6.1× |
| Hand 2 views (73120) |
$401.60 |
$1,004 |
3.8× |
| Hand 3 views (73130) |
$454.80 |
$1,137 |
5.2× |
| Heart Infarct Image (78466) |
$2,397.20 |
$5,993 |
6.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,015.20 |
$5,038 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,022.20 |
$2,555.50 |
1.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,068.40 |
$2,671 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$440.80 |
$1,102 |
5.0× |
| Hysterosalpingogram (74740) |
$1,019.20 |
$2,548 |
4.3× |
| Kidney imaging morphology (78700) |
$1,613.60 |
$4,034 |
4.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$916.40 |
$2,291 |
1.7× |
| Knee 3 views (73562) |
$569.20 |
$1,423 |
6.5× |
| Liver & spleen imaging static only (78215) |
$1,592.80 |
$3,982 |
4.0× |
| Liver imaging static only (78201) |
$663.20 |
$1,658 |
1.2× |
| Liver imaging w/vascular flow (78202) |
$663.20 |
$1,658 |
1.2× |
| Lung perf&ventilat diferentl (78598) |
$899.20 |
$2,248 |
1.6× |
| Lung perfusion differential (78597) |
$576.40 |
$1,441 |
1.4× |
| Lung Ventilation Imaging (78579) |
$576.40 |
$1,441 |
1.4× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,226 |
$3,065 |
0.4× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,226 |
$3,065 |
1.9× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,226 |
$3,065 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,226 |
$3,065 |
0.4× |
| Lymphoscintigraphy (78195) |
$1,089 |
$2,722.50 |
2.0× |
| Mammary ductogram or galactogram multiple (77054) |
$530.80 |
$1,327 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$394 |
$985 |
1.6× |
| Meckels Diverticulum (78290) |
$1,392.40 |
$3,481 |
3.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,607.20 |
$4,018 |
4.3× |
| MRA head w & w/o contrast (70546) |
$2,566 |
$6,415 |
7.3× |
| MRA head w/o contrast (70544) |
$3,555.20 |
$8,888 |
14.8× |
| MRA head with contrast (70545) |
$2,504.40 |
$6,261 |
7.1× |
| MRA neck w contrast (70548) |
$2,604.80 |
$6,512 |
7.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,054.80 |
$7,637 |
8.7× |
| MRA neck w/o contrast (70547) |
$2,699.20 |
$6,748 |
11.3× |
| MRI abdomen w contrast (74182) |
$3,419.60 |
$8,549 |
9.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,737.80 |
$11,844.50 |
13.5× |
| MRI abdomen w/o contrast (74181) |
$4,031.20 |
$10,078 |
16.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,011.20 |
$5,028 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,011.20 |
$5,028 |
2.6× |
| MRI breast w/o contrast bilateral (77047) |
$2,074.80 |
$5,187 |
8.7× |
| MRI c-spine with contrast (72142) |
$3,419.60 |
$8,549 |
9.8× |
| MRI cervical spine w/o contrast (72141) |
$4,466.80 |
$11,167 |
18.6× |
| MRI chest w/o & w/contrast material (71552) |
$4,070.80 |
$10,177 |
11.6× |
| MRI chest w/o contrast (71550) |
$4,296.80 |
$10,742 |
17.9× |
| MRI chest with contrast (71551) |
$3,337.40 |
$8,343.50 |
4.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,337.40 |
$8,343.50 |
9.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,471.20 |
$8,678 |
9.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,558 |
$13,895 |
23.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,388 |
$10,970 |
18.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,309.60 |
$13,274 |
15.2× |
| MRI orbit/face/neck w/contrast (70542) |
$4,042.20 |
$10,105.50 |
11.5× |
| MRI pelvis w contrast (72196) |
$3,321.80 |
$8,304.50 |
9.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,066 |
$12,665 |
14.5× |
| MRI pelvis w/o contrast (72195) |
$4,605.60 |
$11,514 |
19.2× |
| MRI scan of arm joint before and after contrast (73223) |
$3,016.80 |
$7,542 |
8.6× |
| MRI scan of leg joint before and after contrast (73723) |
$3,295.20 |
$8,238 |
9.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,913.60 |
$12,284 |
14.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,321.80 |
$8,304.50 |
9.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,624.80 |
$14,062 |
16.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,085.60 |
$10,214 |
11.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,226.80 |
$13,067 |
14.9× |
| MRI thoracic spine w/o contrast (72146) |
$4,466.80 |
$11,167 |
18.6× |
| MRI tmj (70336) |
$1,271.20 |
$3,178 |
5.3× |
| MRI upper ext joint w/o contrast (73221) |
$4,302.40 |
$10,756 |
17.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,256.80 |
$10,642 |
12.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,869.60 |
$9,674 |
16.1× |
| Myelogram Cervical (72240) |
$933.60 |
$2,334 |
1.2× |
| Myelogram Lumbar (72265) |
$1,882 |
$4,705 |
2.4× |
| Myelogram thoracic (72255) |
$869.60 |
$2,174 |
1.1× |
| Myelography 2 or more regions (72270) |
$1,924.80 |
$4,812 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,399.60 |
$5,999 |
1.8× |
| Neck soft tissue (70360) |
$598 |
$1,495 |
6.8× |
| Nm bone marrow wb (78104) |
$1,446 |
$3,615 |
3.6× |
| Nm cisternogram (78630) |
$1,849.20 |
$4,623 |
3.4× |
| Nm gastric emptying study (78264) |
$1,515.60 |
$3,789 |
3.8× |
| Nm gastroesophageal reflux study (78262) |
$1,440.80 |
$3,602 |
3.6× |
| Nm peritoneal-venous shunt patency (78291) |
$936 |
$2,340 |
2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,945.60 |
$14,864 |
4.3× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$4,466.40 |
$11,166 |
3.4× |
| Nuclear medicine of heart pumping function (78473) |
$1,834.40 |
$4,586 |
4.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,745.60 |
$4,364 |
1.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$771.20 |
$1,928 |
1.9× |
| Nuclear Rx Oral Admin (79005) |
$2,043.20 |
$5,108 |
8.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$488 |
$1,220 |
4.6× |
| Osseous survey infant (77076) |
$5,301.40 |
$13,253.50 |
50.5× |
| Osseous survey limited (77074) |
$162.80 |
$407 |
1.6× |
| Parathyrd planar w/wo subtrj (78071) |
$817.60 |
$2,044 |
2.0× |
| Parathyroid imaging (78070) |
$1,331.20 |
$3,328 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$410.40 |
$1,026 |
3.9× |
| PET image w/CT, skull-thigh (78815) |
$2,770.60 |
$6,926.50 |
1.9× |
| PET imaging CT for attenuation limited area (78814) |
$4,593.60 |
$11,484 |
3.2× |
| PET imaging for CT attenuation whole body (78816) |
$16,440.60 |
$41,101.50 |
11.4× |
| Pr heart first pass single,planar (78481) |
$1,215.60 |
$3,039 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,857.60 |
$9,644 |
11.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$10,932 |
$27,330 |
3.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,792.40 |
$11,981 |
1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,722.80 |
$4,307 |
4.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,642 |
$4,105 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$531.60 |
$1,329 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$241.20 |
$603 |
2.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$512 |
$1,280 |
4.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$353.20 |
$883 |
3.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$212.80 |
$532 |
2.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$925.60 |
$2,314 |
1.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$540 |
$1,350 |
5.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$784.80 |
$1,962 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$608.80 |
$1,522 |
5.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$396 |
$990 |
4.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$514.20 |
$1,285.50 |
4.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$425.60 |
$1,064 |
4.9× |
| Radiologic exam colon single contrast study (74270) |
$935.20 |
$2,338 |
5.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$948.80 |
$2,372 |
5.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,075.20 |
$2,688 |
6.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$516.40 |
$1,291 |
5.9× |
| Radiological examination surgical specimen (76098) |
$495.60 |
$1,239 |
0.9× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,015.20 |
$5,038 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$10,512.40 |
$26,281 |
3.3× |
| Ribs bilateral 3 views (71110) |
$809.60 |
$2,024 |
7.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,863.20 |
$7,158 |
7.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,998.40 |
$7,496 |
5.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,539.20 |
$3,848 |
2.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,704 |
$16,760 |
5.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,905.20 |
$14,763 |
4.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$5,152.80 |
$12,882 |
4.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,177.60 |
$2,944 |
5.0× |
| Sacroiliac Joints < 3 Views (72200) |
$175.60 |
$439 |
1.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$543.60 |
$1,359 |
2.3× |
| Scanogram (77073) |
$1,071.40 |
$2,678.50 |
10.2× |
| Scapula complete (73010) |
$492.80 |
$1,232 |
4.7× |
| Screening digital breast tomosynthesis (77063) |
$249.20 |
$623 |
10.7× |
| Sella turcica (70240) |
$344.60 |
$861.50 |
3.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$331.60 |
$829 |
3.2× |
| Sialogram (70390) |
$462.80 |
$1,157 |
1.9× |
| Simulation intermediate (77285) |
$1,160.40 |
$2,901 |
3.1× |
| Small bowel series (74250) |
$963.20 |
$2,408 |
5.5× |
| Spec medical radj physics consltj (77370) |
$1,170.80 |
$2,927 |
8.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,713.60 |
$4,284 |
4.6× |
| Special dosimetry (77331) |
$819.60 |
$2,049 |
6.1× |
| Special treatment procedure (77470) |
$2,520.40 |
$6,301 |
4.5× |
| Spine thoracic 3 views (72072) |
$580 |
$1,450 |
5.5× |
| Splenoportograpy rs&i (75810) |
$2,015.20 |
$5,038 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,911.20 |
$4,778 |
5.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,048.80 |
$2,622 |
2.8× |
| Testicular Imaging With Vascular Flow (78761) |
$1,020.80 |
$2,552 |
2.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,963.20 |
$4,908 |
5.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$982.80 |
$2,457 |
7.3× |
| Thoracolumbar 2 views (72080) |
$242.60 |
$606.50 |
2.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$5,050 |
$12,625 |
9.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$593.20 |
$1,483 |
1.5× |
| Thyroid uptake measurement (78012) |
$434.60 |
$1,086.50 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,439.60 |
$3,599 |
3.6× |
| Tmj unilateral (70328) |
$369.80 |
$924.50 |
4.2× |
| Tomogram (76100) |
$653.60 |
$1,634 |
6.2× |
| Treatment device intermediate (77333) |
$746.80 |
$1,867 |
5.5× |
| Treatment devices simple (77332) |
$569.20 |
$1,423 |
4.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,110.40 |
$5,276 |
3.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,189.60 |
$2,974 |
3.0× |
| Tx devices design & construction complex (77334) |
$1,329.60 |
$3,324 |
3.5× |
| Ultrasound elastography first target lesion (76982) |
$185.60 |
$464 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$995.20 |
$2,488 |
9.5× |
| Unlisted magnetic resonance procedure (76498) |
$712 |
$1,780 |
8.1× |
| Upper Extremity Infant (73092) |
$198.40 |
$496 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$497.20 |
$1,243 |
2.1× |
| Urethrocystography voiding (74455) |
$1,055.80 |
$2,639.50 |
4.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$934.80 |
$2,337 |
5.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$849 |
$2,122.50 |
4.8× |
| Us abdl aorta screen aaa (76706) |
$377.60 |
$944 |
3.6× |
| Us breast unilateral complete (76641) |
$679.20 |
$1,698 |
6.5× |
| Us breast unilateral limited (76642) |
$972.40 |
$2,431 |
11.1× |
| Us chest (76604) |
$827 |
$2,067.50 |
7.9× |
| Us compl joint r-t w/image documentation (76881) |
$814 |
$2,035 |
7.8× |
| Us elastography parenchyma (76981) |
$185.60 |
$464 |
1.8× |
| Us fetal nuchal translucency 1st gestation (76813) |
$195.20 |
$488 |
1.9× |
| Us guided compression repair (76936) |
$616 |
$1,540 |
2.8× |
| Us infant hips dynamic (76885) |
$551.40 |
$1,378.50 |
6.3× |
| Us kidney transplant (76776) |
$639.40 |
$1,598.50 |
6.1× |
| Us ob detailed single fetus (76811) |
$541.20 |
$1,353 |
2.3× |
| Us ob transvaginal (76817) |
$623 |
$1,557.50 |
5.9× |
| Us pelvic non ob complete (76856) |
$961.60 |
$2,404 |
9.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,145.20 |
$2,863 |
10.9× |
| Us pregnancy ltd (76815) |
$637.60 |
$1,594 |
6.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$329.20 |
$823 |
3.1× |
| Us retroperitoneal complete (76770) |
$1,047.80 |
$2,619.50 |
10.0× |
| Us retroperitoneal limited (76775) |
$876.40 |
$2,191 |
8.3× |
| Us scrotum and contents (76870) |
$775 |
$1,937.50 |
7.4× |
| Us soft tissue head/neck (76536) |
$724.80 |
$1,812 |
6.9× |
| Us spinal canal and contents (76800) |
$567 |
$1,417.50 |
5.4× |
| Us transrectal (76872) |
$655.20 |
$1,638 |
6.2× |
| Us xtr non-vasc lmtd (76882) |
$364.80 |
$912 |
3.5× |
| Vascular flow imaging (78445) |
$894.40 |
$2,236 |
2.2× |
| Venogram extremity bilateral (75822) |
$1,853.60 |
$4,634 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$2,015.20 |
$5,038 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,996 |
$4,990 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,118.40 |
$2,796 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,015.20 |
$5,038 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$2,015.20 |
$5,038 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,015.20 |
$5,038 |
0.6× |
| Wrist 2 views (73100) |
$309.20 |
$773 |
3.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$634.40 |
$1,586 |
6.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$252.60 |
$631.50 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$425.60 |
$1,064 |
4.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,180 |
$2,950 |
6.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$410.40 |
$1,026 |
4.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$471.20 |
$1,178 |
5.4× |
| X-ray exam hip uni 1 view (73501) |
$384.20 |
$960.50 |
4.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$529.20 |
$1,323 |
6.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$931.20 |
$2,328 |
8.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$786.80 |
$1,967 |
4.5× |
| X-ray eye for foreign body (70030) |
$133.20 |
$333 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$549.60 |
$1,374 |
5.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$456.80 |
$1,142 |
5.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$386.40 |
$966 |
4.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$434 |
$1,085 |
5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$213.20 |
$533 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$529.20 |
$1,323 |
5.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$372.80 |
$932 |
4.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$240.60 |
$601.50 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$485.20 |
$1,213 |
4.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$469.60 |
$1,174 |
4.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$471.20 |
$1,178 |
4.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$448.80 |
$1,122 |
5.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$198.40 |
$496 |
2.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$434.80 |
$1,087 |
4.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$468.80 |
$1,172 |
4.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$738 |
$1,845 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$529.20 |
$1,323 |
6.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$539.60 |
$1,349 |
5.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$721.20 |
$1,803 |
6.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$495.20 |
$1,238 |
4.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$392 |
$980 |
4.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$494.80 |
$1,237 |
5.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$757.60 |
$1,894 |
8.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$470.80 |
$1,177 |
5.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$820 |
$2,050 |
7.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$594.40 |
$1,486 |
5.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$302.40 |
$756 |
3.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$388.40 |
$971 |
4.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$447.40 |
$1,118.50 |
5.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$527.20 |
$1,318 |
5.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$671.20 |
$1,678 |
6.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$293.60 |
$734 |
3.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$410.40 |
$1,026 |
4.7× |
| Xr c-spine 6 or more views (72052) |
$1,080 |
$2,700 |
10.3× |
| Xr chest 4+ views (71048) |
$207.80 |
$519.50 |
2.0× |
| Xr Cholecystography Oral Contrast (74290) |
$677.20 |
$1,693 |
3.8× |
| Xr finger(s) 2+ views (73140) |
$335.60 |
$839 |
3.8× |
| Xr internal auditory meati complete (70134) |
$698.40 |
$1,746 |
1.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$159.60 |
$399 |
1.5× |
| Xr optic foramina (70190) |
$363.60 |
$909 |
4.2× |
| Xr shoulder 1 view (73020) |
$264.40 |
$661 |
3.0× |
| Xr spine cervical 4 or 5 views (72050) |
$766.60 |
$1,916.50 |
7.3× |
| Xr tibia/fibula 2 views (73590) |
$469.60 |
$1,174 |
5.4× |
| Xr tmj bilateral (70330) |
$617.60 |
$1,544 |
7.1× |
| Xray knee 1 or 2 views rt (73560) |
$395.60 |
$989 |
4.5× |