| 3-D radiotherapy plan dose-volume histograms (77295) |
$581.73 |
$2,908.64 |
0.4× |
| Abdomen 2 views (74019) |
$190.62 |
$953.12 |
1.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$994.34 |
$4,971.68 |
2.5× |
| Angiography extremity bilateral rs&i (75716) |
$1,454.36 |
$7,271.81 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,340.17 |
$6,700.85 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$1,061.98 |
$5,309.92 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,209.78 |
$6,048.90 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,574.98 |
$7,874.90 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,451.78 |
$7,258.90 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,209.78 |
$6,048.90 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,240.62 |
$6,203.12 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$240.36 |
$1,201.76 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,451.78 |
$7,258.90 |
0.5× |
| Ankle 2 views (73600) |
$150.08 |
$750.40 |
1.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$471.08 |
$2,355.36 |
1.3× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$682.19 |
$3,410.96 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,360.48 |
$6,802.40 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,280.18 |
$6,400.90 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,061.76 |
$5,308.80 |
0.3× |
| Arthrogram elbow (73085) |
$539.84 |
$2,699.20 |
1.5× |
| Arthrogram hip (73525) |
$685.66 |
$3,428.32 |
2.0× |
| Arthrogram shoulder (73040) |
$490.78 |
$2,453.92 |
1.4× |
| Arthrogram wrist (73115) |
$324.13 |
$1,620.64 |
0.9× |
| Arthrography knee lt (73580) |
$597.41 |
$2,987.04 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$150.64 |
$753.20 |
1.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$582.18 |
$2,910.88 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$858.82 |
$4,294.08 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$1,450.40 |
$7,252 |
3.6× |
| Bone age studies (77072) |
$87.36 |
$436.80 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$1,313.87 |
$6,569.36 |
3.3× |
| Bone survey complete (77075) |
$628.54 |
$3,142.72 |
6.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$899.36 |
$4,496.80 |
2.2× |
| Brain Imaging Minimum 4 Static Views (78605) |
$792.96 |
$3,964.80 |
1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,975.01 |
$9,875.04 |
1.4× |
| Brain Imaging Vascular Flow Only (78610) |
$824.10 |
$4,120.48 |
1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,427.94 |
$12,139.68 |
6.9× |
| Cardiac shunt detection (78428) |
$526.18 |
$2,630.88 |
1.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$798.78 |
$3,993.92 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$158.59 |
$792.96 |
1.8× |
| Chest 1 view (71045) |
$159.71 |
$798.56 |
1.8× |
| Chest 3 views (71047) |
$190.29 |
$951.44 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$375.88 |
$1,879.36 |
2.1× |
| Cineradiography/videoradiography (76120) |
$227.81 |
$1,139.04 |
2.2× |
| Cisternography Positive Contrast Rs&I (70015) |
$510.27 |
$2,551.36 |
0.6× |
| Clavicle complete (73000) |
$126.22 |
$631.12 |
1.4× |
| Continuing medical physics consltj pr wk (77336) |
$165.54 |
$827.68 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,054.50 |
$30,272.48 |
17.3× |
| CT abdomen and pelvis without contrast (74176) |
$4,107.26 |
$20,536.32 |
17.1× |
| CT abdomen w contrast (74160) |
$2,340.13 |
$11,700.64 |
13.3× |
| CT abdomen w wo contrast (74170) |
$3,076.19 |
$15,380.96 |
17.5× |
| CT abdomen w/o contrast (74150) |
$1,190.78 |
$5,953.92 |
11.3× |
| CT angio hrt w/3d image (75574) |
$2,709.50 |
$13,547.52 |
7.7× |
| CT angiography upper extremity lt (73206) |
$1,450.85 |
$7,254.24 |
8.2× |
| CT c-spine w/o contrast (72125) |
$2,042.43 |
$10,212.16 |
19.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,803.65 |
$9,018.24 |
10.2× |
| CT cervical spine with contrast (72126) |
$1,757.50 |
$8,787.52 |
5.0× |
| CT chest w/wo contrast (71270) |
$2,738.18 |
$13,690.88 |
15.5× |
| CT chest with contrast (71260) |
$2,203.49 |
$11,017.44 |
12.5× |
| CT head/brain with contrast (70460) |
$1,732.64 |
$8,663.20 |
9.8× |
| CT head/brain without and with contrast (70470) |
$2,710.18 |
$13,550.88 |
15.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,141.06 |
$5,705.28 |
3.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$2,105.15 |
$10,525.76 |
24.1× |
| CT hrt w/3d image congen (75573) |
$858.82 |
$4,294.08 |
2.5× |
| CT iac w contrast (70481) |
$1,924.61 |
$9,623.04 |
10.9× |
| CT lower ext w/o (73700) |
$1,365.06 |
$6,825.28 |
13.0× |
| CT lower extremity w wo contrast (73702) |
$1,532.38 |
$7,661.92 |
8.7× |
| CT lower extremity with contrast (73701) |
$1,412.77 |
$7,063.84 |
8.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,803.65 |
$9,018.24 |
10.2× |
| CT lumbar spine w/o contrast (72131) |
$2,042.43 |
$10,212.16 |
19.4× |
| CT lumbar spine with contrast (72132) |
$1,597.57 |
$7,987.84 |
4.6× |
| CT maxillofacial w contrast (70487) |
$2,215.58 |
$11,077.92 |
12.6× |
| CT maxillofacial w/o contrast (70486) |
$2,043.78 |
$10,218.88 |
19.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,839.09 |
$14,195.44 |
16.1× |
| CT neck soft tissue w contrast (70491) |
$1,935.36 |
$9,676.80 |
11.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,996.96 |
$9,984.80 |
11.3× |
| CT orbits w/o contrast (70480) |
$1,519.96 |
$7,599.76 |
14.5× |
| CT pelvis w & w/o contrast (72194) |
$2,408.67 |
$12,043.36 |
13.7× |
| CT pelvis w/o contrast (72192) |
$607.71 |
$3,038.56 |
5.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$383.94 |
$1,919.68 |
4.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,710.18 |
$13,550.88 |
15.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,673.95 |
$8,369.76 |
15.9× |
| CT thoracic spine w/contrast (72129) |
$1,757.50 |
$8,787.52 |
10.0× |
| CT thoracic spine w/o contrast (72128) |
$2,042.43 |
$10,212.16 |
19.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,803.65 |
$9,018.24 |
10.2× |
| CT thorax w/o contrast (71250) |
$1,165.02 |
$5,825.12 |
11.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,211.39 |
$6,056.96 |
6.9× |
| CT upper extremity w/o contrast rt (73200) |
$917.84 |
$4,589.20 |
8.7× |
| CT upper extremity with contrast (73201) |
$1,223.49 |
$6,117.44 |
3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,258.59 |
$11,292.96 |
12.8× |
| Cta Abdomen (74175) |
$3,471.78 |
$17,358.88 |
19.7× |
| CTA abdomen pelvis (74174) |
$5,155.14 |
$25,775.68 |
14.7× |
| CTA chest (71275) |
$2,886.46 |
$14,432.32 |
16.4× |
| Cta Head (70496) |
$2,291.74 |
$11,458.72 |
13.0× |
| CTA lwr ext w&w/o contrast (73706) |
$1,595.78 |
$7,978.88 |
9.1× |
| Cta Neck (70498) |
$2,291.74 |
$11,458.72 |
13.0× |
| Cta Pelvis (72191) |
$2,238.88 |
$11,194.40 |
12.7× |
| Cystography minimum 3 views rs&i (74430) |
$374.08 |
$1,870.40 |
1.1× |
| Dacryocystography (70170) |
$322.56 |
$1,612.80 |
1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$1,243.87 |
$6,219.36 |
11.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$2,488.64 |
$12,443.20 |
23.7× |
| Echo exam of fetal heart (76825) |
$2,862.05 |
$14,310.24 |
5.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,430.46 |
$7,152.32 |
6.0× |
| Echoencephalography real time imaging (76506) |
$225.57 |
$1,127.84 |
2.1× |
| Esophageal motility (78258) |
$672.67 |
$3,363.36 |
1.7× |
| Esophagus (74220) |
$390.66 |
$1,953.28 |
2.2× |
| Fluoroscopy up to 1 hr (76000) |
$336.22 |
$1,681.12 |
1.4× |
| Foot 2 views (73620) |
$156.91 |
$784.56 |
1.8× |
| Forearm 2 views (73090) |
$155.46 |
$777.28 |
1.8× |
| Gastric mucosa imaging (78261) |
$954.69 |
$4,773.44 |
2.4× |
| Gated Heart Planar Single (78472) |
$1,281.06 |
$6,405.28 |
3.2× |
| Hand 2 views (73120) |
$149.07 |
$745.36 |
1.4× |
| Hand 3 views (73130) |
$202.94 |
$1,014.72 |
2.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,354.98 |
$6,774.88 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$804.83 |
$4,024.16 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,194.59 |
$5,972.96 |
3.0× |
| Ht muscle image spect sing (78451) |
$1,647.52 |
$8,237.60 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$145.82 |
$729.12 |
1.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$221.42 |
$1,107.12 |
2.1× |
| Kidney funcj study non-img radioisotopic study (78725) |
$782.66 |
$3,913.28 |
1.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,306.82 |
$6,534.08 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,008.61 |
$10,043.04 |
3.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,043.62 |
$5,218.08 |
1.9× |
| Knee 3 views (73562) |
$208.77 |
$1,043.84 |
2.4× |
| Liver & spleen imaging static only (78215) |
$683.42 |
$3,417.12 |
1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$464.80 |
$2,324 |
1.2× |
| Lymphoscintigraphy (78195) |
$915.71 |
$4,578.56 |
1.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$95.76 |
$478.80 |
1.1× |
| Meckels Diverticulum (78290) |
$895.55 |
$4,477.76 |
2.2× |
| MRA head w & w/o contrast (70546) |
$2,841.89 |
$14,209.44 |
8.1× |
| MRA head w/o contrast (70544) |
$1,412.32 |
$7,061.60 |
5.9× |
| MRA head with contrast (70545) |
$1,337.06 |
$6,685.28 |
3.8× |
| MRA neck w contrast (70548) |
$1,278.37 |
$6,391.84 |
3.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,759.01 |
$13,795.04 |
7.9× |
| MRA neck w/o contrast (70547) |
$1,010.46 |
$5,052.32 |
4.2× |
| MRI abdomen w contrast (74182) |
$1,255.52 |
$6,277.60 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,340.74 |
$16,703.68 |
9.5× |
| MRI abdomen w/o contrast (74181) |
$1,458.24 |
$7,291.20 |
6.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,253.95 |
$6,269.76 |
1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,253.95 |
$6,269.76 |
1.6× |
| MRI bone marrow blood supply (77084) |
$1,425.31 |
$7,126.56 |
5.9× |
| MRI c-spine with contrast (72142) |
$1,412.32 |
$7,061.60 |
4.0× |
| MRI cardiac w/o cont stress (75559) |
$708.51 |
$3,542.56 |
1.3× |
| MRI cardiac w/o contrast (75557) |
$1,893.70 |
$9,468.48 |
7.9× |
| MRI cervical spine w/o contrast (72141) |
$1,644.61 |
$8,223.04 |
6.9× |
| MRI chest w/o & w/contrast material (71552) |
$3,315.42 |
$16,577.12 |
9.5× |
| MRI chest w/o contrast (71550) |
$1,220.58 |
$6,102.88 |
5.1× |
| MRI chest with contrast (71551) |
$1,255.52 |
$6,277.60 |
1.6× |
| MRI fetal sngl/1st gestation (74712) |
$1,402.91 |
$7,014.56 |
5.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,276.13 |
$6,380.64 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,253.95 |
$6,269.76 |
3.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,425.09 |
$7,125.44 |
5.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,692.77 |
$8,463.84 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,390.24 |
$16,951.20 |
9.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,589.28 |
$7,946.40 |
4.5× |
| MRI pelvis w contrast (72196) |
$1,215.65 |
$6,078.24 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,163.10 |
$15,815.52 |
9.0× |
| MRI pelvis w/o contrast (72195) |
$1,613.25 |
$8,066.24 |
6.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,333.57 |
$16,667.84 |
9.5× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,918.05 |
$14,590.24 |
3.7× |
| MRI scan of leg joint before and after contrast (73723) |
$3,156.38 |
$15,781.92 |
9.0× |
| MRI spectroscopy (76390) |
$1,494.98 |
$7,474.88 |
17.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,237.47 |
$16,187.36 |
9.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,283.97 |
$6,419.84 |
3.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,237.47 |
$16,187.36 |
9.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,412.32 |
$7,061.60 |
4.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,237.47 |
$16,187.36 |
9.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,824.93 |
$9,124.64 |
7.6× |
| MRI tmj (70336) |
$2,190.72 |
$10,953.60 |
9.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,620.19 |
$8,100.96 |
6.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,101.50 |
$15,507.52 |
8.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,945.66 |
$9,728.32 |
8.1× |
| Myelogram Cervical (72240) |
$562.24 |
$2,811.20 |
0.7× |
| Myelogram Lumbar (72265) |
$490.78 |
$2,453.92 |
0.6× |
| Myelogram thoracic (72255) |
$490.78 |
$2,453.92 |
0.6× |
| Myelography 2 or more regions (72270) |
$770.78 |
$3,853.92 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,222.18 |
$21,110.88 |
3.2× |
| Neck soft tissue (70360) |
$196.90 |
$984.48 |
2.3× |
| Nm adrenal scan (78075) |
$11,769.18 |
$58,845.92 |
9.0× |
| Nm bone marrow wb (78104) |
$944.83 |
$4,724.16 |
2.4× |
| Nm cisternogram (78630) |
$1,383.42 |
$6,917.12 |
2.5× |
| Nm csf leak detection (78650) |
$1,080.80 |
$5,404 |
0.8× |
| Nm gastric emptying study (78264) |
$1,473.47 |
$7,367.36 |
3.7× |
| Nm gastroesophageal reflux study (78262) |
$986.27 |
$4,931.36 |
2.5× |
| Nm peritoneal-venous shunt patency (78291) |
$713.22 |
$3,566.08 |
1.8× |
| Nm red cell sequestration (78140) |
$915.71 |
$4,578.56 |
2.3× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,099.39 |
$5,496.96 |
0.8× |
| Nuclear medicine of heart pumping function (78473) |
$2,200.13 |
$11,000.64 |
5.5× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$1,402.69 |
$7,013.44 |
2.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$549.02 |
$2,745.12 |
0.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,320.03 |
$6,600.16 |
3.3× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$932.96 |
$4,664.80 |
2.3× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$616.22 |
$3,081.12 |
1.1× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$224.22 |
$1,121.12 |
1.7× |
| Orthopantogram (70355) |
$108.42 |
$542.08 |
1.2× |
| Osseous survey infant (77076) |
$488.10 |
$2,440.48 |
4.6× |
| Osseous survey limited (77074) |
$368.82 |
$1,844.08 |
3.5× |
| Parathyroid imaging (78070) |
$1,940.29 |
$9,701.44 |
4.8× |
| Pelvis 1 or 2 views (72170) |
$159.04 |
$795.20 |
1.5× |
| Perineogram (74775) |
$633.92 |
$3,169.60 |
2.6× |
| Peritoneogram rs&i (74190) |
$366.02 |
$1,830.08 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$1,912.73 |
$9,563.66 |
1.3× |
| PET imaging CT for attenuation limited area (78814) |
$2,250 |
$11,249.98 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$2,250 |
$11,249.98 |
1.6× |
| Pr heart first pass single,planar (78481) |
$1,219.90 |
$6,099.52 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,936.64 |
$14,683.20 |
8.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,416.58 |
$7,082.88 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,149.57 |
$5,747.84 |
2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$523.71 |
$2,618.56 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$211.68 |
$1,058.40 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$441.16 |
$2,205.84 |
4.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$261.63 |
$1,308.16 |
2.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$240.80 |
$1,204 |
2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$474.21 |
$2,371.04 |
4.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$234.53 |
$1,172.64 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$164.19 |
$820.96 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$245.73 |
$1,228.64 |
2.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$206.53 |
$1,032.64 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$514.53 |
$2,572.64 |
2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$400.74 |
$2,003.68 |
2.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$734.50 |
$3,672.48 |
4.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$590.24 |
$2,951.20 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$208.77 |
$1,043.84 |
2.4× |
| Radiological examination surgical specimen (76098) |
$49.73 |
$248.64 |
0.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,231.78 |
$6,158.88 |
0.4× |
| Ribs bilateral 3 views (71110) |
$239.90 |
$1,199.52 |
2.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,288.67 |
$6,443.36 |
2.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,598.24 |
$7,991.20 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,266.05 |
$6,330.24 |
0.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,165.70 |
$5,828.48 |
0.9× |
| Sacroiliac Joints < 3 Views (72200) |
$146.27 |
$731.36 |
1.4× |
| Salivary gland imaging (78230) |
$505.57 |
$2,527.84 |
1.3× |
| Scanogram (77073) |
$411.82 |
$2,059.12 |
3.9× |
| Scapula complete (73010) |
$169.01 |
$845.04 |
1.6× |
| Sella turcica (70240) |
$120.51 |
$602.56 |
1.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$468.83 |
$2,344.16 |
4.5× |
| Sialogram (70390) |
$274.18 |
$1,370.88 |
1.1× |
| Small bowel series (74250) |
$374.75 |
$1,873.76 |
2.1× |
| Special dosimetry (77331) |
$118.94 |
$594.72 |
0.9× |
| Special treatment procedure (77470) |
$721.28 |
$3,606.40 |
1.3× |
| Speech evaluation complex (70371) |
$321.10 |
$1,605.52 |
1.3× |
| Spine thoracic 3 views (72072) |
$237 |
$1,184.96 |
2.3× |
| Splenoportograpy rs&i (75810) |
$2,885.34 |
$14,426.72 |
0.9× |
| Superior sagittal sinus venogram (75870) |
$1,006.21 |
$5,031.04 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$326.14 |
$1,630.72 |
0.9× |
| Testicular Imaging With Vascular Flow (78761) |
$685.10 |
$3,425.52 |
1.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$901.15 |
$4,505.76 |
2.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$369.60 |
$1,848 |
2.7× |
| Therapeutic Enema (74283) |
$612.64 |
$3,063.20 |
3.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,262.24 |
$6,311.20 |
2.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$532.90 |
$2,664.48 |
1.3× |
| Thyroid uptake measurement (78012) |
$346.30 |
$1,731.52 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$556.86 |
$2,784.32 |
1.4× |
| Tmj unilateral (70328) |
$103.49 |
$517.44 |
1.2× |
| Tomogram (76100) |
$325.92 |
$1,629.60 |
3.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,378.50 |
$6,892.48 |
2.5× |
| Tx devices design & construction complex (77334) |
$345.63 |
$1,728.16 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$351.34 |
$1,756.72 |
3.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$395.25 |
$1,976.24 |
4.5× |
| Unlisted magnetic resonance procedure (76498) |
$3,194.24 |
$15,971.20 |
36.5× |
| Unlisted Ultrasound Procedure (76999) |
$297.81 |
$1,489.04 |
3.4× |
| Upper Extremity Infant (73092) |
$257.82 |
$1,289.12 |
2.5× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,089.76 |
$5,448.80 |
2.7× |
| Urethrocystography retrograde rs&i (74450) |
$513.30 |
$2,566.48 |
2.1× |
| Urethrocystography voiding (74455) |
$497.73 |
$2,488.64 |
2.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$362.66 |
$1,813.28 |
2.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$484.51 |
$2,422.56 |
2.7× |
| Us chest (76604) |
$356.27 |
$1,781.36 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$238.11 |
$1,190.56 |
2.3× |
| Us guided compression repair (76936) |
$513.48 |
$2,567.40 |
2.4× |
| Us infant hips dynamic (76885) |
$363.10 |
$1,815.52 |
4.2× |
| Us infant hips limited static (76886) |
$292.99 |
$1,464.96 |
3.4× |
| Us kidney transplant (76776) |
$496.61 |
$2,483.04 |
4.7× |
| Us pelvic non ob complete (76856) |
$684.99 |
$3,424.96 |
6.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$527.97 |
$2,639.84 |
5.0× |
| Us pregnancy ltd (76815) |
$426.27 |
$2,131.36 |
4.1× |
| Us retroperitoneal complete (76770) |
$449.79 |
$2,248.96 |
4.3× |
| Us scrotum and contents (76870) |
$525.06 |
$2,625.28 |
5.0× |
| Us soft tissue head/neck (76536) |
$419.78 |
$2,098.88 |
4.0× |
| Us spinal canal and contents (76800) |
$492.80 |
$2,464 |
4.7× |
| Us xtr non-vasc lmtd (76882) |
$365.57 |
$1,827.84 |
3.5× |
| Us, eye b-scan (76512) |
$287.84 |
$1,439.20 |
2.7× |
| Venogram extremity bilateral (75822) |
$259.39 |
$1,296.96 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$677.04 |
$3,385.20 |
0.2× |
| Venography caval superior serialography rs&i (75827) |
$126.11 |
$630.56 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$415.52 |
$2,077.60 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,257.54 |
$6,287.68 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,086.62 |
$5,433.12 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$471.02 |
$2,355.10 |
0.1× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,231.78 |
$6,158.88 |
0.2× |
| Wrist 2 views (73100) |
$120.06 |
$600.32 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$193.76 |
$968.80 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$145.82 |
$729.12 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$194.77 |
$973.84 |
2.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$564.70 |
$2,823.52 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$150.08 |
$750.40 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$208.77 |
$1,043.84 |
2.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$397.15 |
$1,985.76 |
3.8× |
| X-ray exam hip uni 1 view (73501) |
$169.79 |
$848.96 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$182.22 |
$911.12 |
2.1× |
| X-ray exam of femur 1 (73551) |
$146.05 |
$730.24 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$236.99 |
$1,184.96 |
2.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$183.68 |
$918.40 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$204.74 |
$1,023.68 |
2.3× |
| X-ray head for orthodontia (70350) |
$71.68 |
$358.40 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$118.94 |
$594.72 |
1.4× |
| X-ray IV pyelogram+drip infusn (74410) |
$412.16 |
$2,060.80 |
2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$136.19 |
$680.96 |
1.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$216.61 |
$1,083.04 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$139 |
$694.96 |
1.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$280.56 |
$1,402.80 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$211.68 |
$1,058.40 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$250.43 |
$1,252.16 |
2.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$158.59 |
$792.96 |
1.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$157.81 |
$789.04 |
1.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$196.90 |
$984.48 |
2.3× |
| X-ray of voice box or throat (70370) |
$211.23 |
$1,056.16 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$261.63 |
$1,308.16 |
2.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$242.82 |
$1,214.08 |
2.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$695.30 |
$3,476.48 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$211.46 |
$1,057.28 |
2.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$200.93 |
$1,004.64 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$273.39 |
$1,366.96 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$238.56 |
$1,192.80 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$172.92 |
$864.64 |
2.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$138.88 |
$694.40 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$270.48 |
$1,352.40 |
3.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$120.06 |
$600.32 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$246.06 |
$1,230.32 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$185.70 |
$928.48 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$112 |
$560 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$142.24 |
$711.20 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$188.38 |
$941.92 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$192.19 |
$960.96 |
1.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$212.46 |
$1,062.32 |
2.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$121.18 |
$605.92 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$123.31 |
$616.56 |
1.4× |
| Xr arthrogram ankle (73615) |
$490.78 |
$2,453.92 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$295.80 |
$1,478.96 |
2.8× |
| Xr chest 4+ views (71048) |
$258.72 |
$1,293.60 |
2.5× |
| Xr Cholecystography Oral Contrast (74290) |
$226.69 |
$1,133.44 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$147.39 |
$736.96 |
1.7× |
| Xr internal auditory meati complete (70134) |
$203.84 |
$1,019.20 |
0.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$179.20 |
$896 |
1.7× |
| Xr optic foramina (70190) |
$142.46 |
$712.32 |
1.6× |
| Xr shoulder 1 view (73020) |
$119.06 |
$595.28 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$221.54 |
$1,107.68 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$202.94 |
$1,014.72 |
2.3× |
| Xr tmj bilateral (70330) |
$246.40 |
$1,232 |
2.8× |
| Xray knee 1 or 2 views rt (73560) |
$155.23 |
$776.16 |
1.8× |