| 3-D radiotherapy plan dose-volume histograms (77295) |
$505.79 |
$2,528.96 |
0.4× |
| Abdomen 2 views (74019) |
$165.76 |
$828.80 |
1.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$864.64 |
$4,323.20 |
2.2× |
| Angiography extremity bilateral rs&i (75716) |
$1,264.62 |
$6,323.12 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,165.43 |
$5,827.14 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$923.55 |
$4,617.76 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,052.04 |
$5,260.20 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,369.72 |
$6,848.60 |
0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,262.36 |
$6,311.80 |
0.4× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,052.04 |
$5,260.20 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,078.90 |
$5,394.48 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$209.10 |
$1,045.52 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,262.36 |
$6,311.80 |
0.4× |
| Ankle 2 views (73600) |
$130.59 |
$652.96 |
1.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$409.70 |
$2,048.48 |
1.2× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$593.26 |
$2,966.32 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,182.94 |
$5,914.70 |
0.4× |
| Aortography abdominal serialography rs&i (75625) |
$1,113.20 |
$5,566 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$923.33 |
$4,616.64 |
0.3× |
| Arthrogram elbow (73085) |
$469.50 |
$2,347.52 |
1.3× |
| Arthrogram hip (73525) |
$596.29 |
$2,981.44 |
1.7× |
| Arthrogram shoulder (73040) |
$426.72 |
$2,133.60 |
1.2× |
| Arthrogram wrist (73115) |
$281.79 |
$1,408.96 |
0.8× |
| Arthrography knee lt (73580) |
$519.46 |
$2,597.28 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$130.93 |
$654.64 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$506.24 |
$2,531.20 |
1.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$746.82 |
$3,734.08 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,261.34 |
$6,306.72 |
3.1× |
| Bone age studies (77072) |
$75.94 |
$379.68 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$1,142.52 |
$5,712.56 |
2.8× |
| Bone survey complete (77075) |
$546.56 |
$2,732.80 |
5.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$781.98 |
$3,909.92 |
1.9× |
| Brain Imaging Minimum 4 Static Views (78605) |
$689.47 |
$3,447.36 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,717.41 |
$8,587.04 |
1.2× |
| Brain Imaging Vascular Flow Only (78610) |
$716.58 |
$3,582.88 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,111.42 |
$10,557.12 |
6.0× |
| Cardiac shunt detection (78428) |
$457.63 |
$2,288.16 |
1.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$694.62 |
$3,473.12 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$137.98 |
$689.92 |
1.6× |
| Chest 1 view (71045) |
$138.88 |
$694.40 |
1.6× |
| Chest 3 views (71047) |
$165.54 |
$827.68 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$326.82 |
$1,634.08 |
1.9× |
| Cineradiography/videoradiography (76120) |
$198.02 |
$990.08 |
1.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$443.74 |
$2,218.72 |
0.6× |
| Clavicle complete (73000) |
$109.76 |
$548.80 |
1.3× |
| Continuing medical physics consltj pr wk (77336) |
$144.03 |
$720.16 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,264.90 |
$26,324.48 |
15.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,571.46 |
$17,857.28 |
14.9× |
| CT abdomen w contrast (74160) |
$2,034.82 |
$10,174.08 |
11.5× |
| CT abdomen w wo contrast (74170) |
$2,675.01 |
$13,375.04 |
15.2× |
| CT abdomen w/o contrast (74150) |
$1,035.56 |
$5,177.76 |
9.9× |
| CT angio hrt w/3d image (75574) |
$2,356.14 |
$11,780.72 |
6.7× |
| CT angiography upper extremity lt (73206) |
$1,261.57 |
$6,307.84 |
7.2× |
| CT c-spine w/o contrast (72125) |
$1,776.10 |
$8,880.48 |
16.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,568.45 |
$7,842.24 |
8.9× |
| CT cervical spine with contrast (72126) |
$1,528.13 |
$7,640.64 |
4.4× |
| CT chest w/wo contrast (71270) |
$2,381.12 |
$11,905.60 |
13.5× |
| CT chest with contrast (71260) |
$1,916.10 |
$9,580.48 |
10.9× |
| CT head/brain with contrast (70460) |
$1,506.62 |
$7,533.12 |
8.6× |
| CT head/brain without and with contrast (70470) |
$2,356.70 |
$11,783.52 |
13.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$992.10 |
$4,960.48 |
2.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,830.53 |
$9,152.64 |
20.9× |
| CT hrt w/3d image congen (75573) |
$746.82 |
$3,734.08 |
2.1× |
| CT iac w contrast (70481) |
$1,673.50 |
$8,367.52 |
9.5× |
| CT lower ext w/o (73700) |
$1,186.98 |
$5,934.88 |
11.3× |
| CT lower extremity w wo contrast (73702) |
$1,332.58 |
$6,662.88 |
7.6× |
| CT lower extremity with contrast (73701) |
$1,228.42 |
$6,142.08 |
7.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,568.45 |
$7,842.24 |
8.9× |
| CT lumbar spine w/o contrast (72131) |
$1,776.10 |
$8,880.48 |
16.9× |
| CT lumbar spine with contrast (72132) |
$1,389.25 |
$6,946.24 |
4.0× |
| CT maxillofacial w contrast (70487) |
$1,926.62 |
$9,633.12 |
10.9× |
| CT maxillofacial w/o contrast (70486) |
$1,777.22 |
$8,886.08 |
16.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,468.82 |
$12,344.08 |
14.0× |
| CT neck soft tissue w contrast (70491) |
$1,682.91 |
$8,414.56 |
9.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,736.45 |
$8,682.24 |
9.9× |
| CT orbits w/o contrast (70480) |
$1,321.71 |
$6,608.56 |
12.6× |
| CT pelvis w & w/o contrast (72194) |
$2,094.40 |
$10,472 |
11.9× |
| CT pelvis w/o contrast (72192) |
$528.42 |
$2,642.08 |
5.0× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$333.87 |
$1,669.36 |
3.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,356.70 |
$11,783.52 |
13.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,455.55 |
$7,277.76 |
13.9× |
| CT thoracic spine w/contrast (72129) |
$1,528.13 |
$7,640.64 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$1,776.10 |
$8,880.48 |
16.9× |
| CT thoracic spine w/wo contrast (72130) |
$1,568.45 |
$7,842.24 |
8.9× |
| CT thorax w/o contrast (71250) |
$1,013.16 |
$5,065.76 |
9.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,053.47 |
$5,267.36 |
6.0× |
| CT upper extremity w/o contrast rt (73200) |
$798.12 |
$3,990.56 |
7.6× |
| CT upper extremity with contrast (73201) |
$1,064 |
$5,320 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,964.03 |
$9,820.16 |
11.1× |
| Cta Abdomen (74175) |
$3,018.85 |
$15,094.24 |
17.1× |
| CTA abdomen pelvis (74174) |
$4,482.69 |
$22,413.44 |
12.8× |
| CTA chest (71275) |
$2,509.92 |
$12,549.60 |
14.2× |
| Cta Head (70496) |
$1,992.93 |
$9,964.64 |
11.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,387.68 |
$6,938.40 |
7.9× |
| Cta Neck (70498) |
$1,992.93 |
$9,964.64 |
11.3× |
| Cta Pelvis (72191) |
$1,946.78 |
$9,733.92 |
11.0× |
| Cystography minimum 3 views rs&i (74430) |
$325.25 |
$1,626.24 |
0.9× |
| Dacryocystography (70170) |
$280.45 |
$1,402.24 |
1.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$1,081.70 |
$5,408.48 |
10.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$2,164.06 |
$10,820.32 |
20.6× |
| Echo exam of fetal heart (76825) |
$2,488.64 |
$12,443.20 |
4.5× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,243.87 |
$6,219.36 |
5.2× |
| Echoencephalography real time imaging (76506) |
$196.22 |
$981.12 |
1.9× |
| Esophageal motility (78258) |
$584.86 |
$2,924.32 |
1.5× |
| Esophagus (74220) |
$339.81 |
$1,699.04 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$292.32 |
$1,461.60 |
1.2× |
| Foot 2 views (73620) |
$136.53 |
$682.64 |
1.6× |
| Forearm 2 views (73090) |
$135.18 |
$675.92 |
1.5× |
| Gastric mucosa imaging (78261) |
$830.14 |
$4,150.72 |
2.1× |
| Gated Heart Planar Single (78472) |
$1,113.95 |
$5,569.76 |
2.8× |
| Hand 2 views (73120) |
$129.70 |
$648.48 |
1.2× |
| Hand 3 views (73130) |
$176.51 |
$882.56 |
2.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,178.24 |
$5,891.20 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$699.78 |
$3,498.88 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,038.69 |
$5,193.44 |
2.6× |
| Ht muscle image spect sing (78451) |
$1,432.70 |
$7,163.52 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$126.78 |
$633.92 |
1.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$192.52 |
$962.64 |
1.8× |
| Kidney funcj study non-img radioisotopic study (78725) |
$680.51 |
$3,402.56 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,136.35 |
$5,681.76 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,746.53 |
$8,732.64 |
3.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$907.42 |
$4,537.12 |
1.7× |
| Knee 3 views (73562) |
$181.66 |
$908.32 |
2.1× |
| Liver & spleen imaging static only (78215) |
$594.27 |
$2,971.36 |
1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$404.10 |
$2,020.48 |
1.0× |
| Lymphoscintigraphy (78195) |
$796.32 |
$3,981.60 |
1.5× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$83.22 |
$416.08 |
1.0× |
| Meckels Diverticulum (78290) |
$778.62 |
$3,893.12 |
1.9× |
| MRA head w & w/o contrast (70546) |
$2,471.17 |
$12,355.84 |
7.1× |
| MRA head w/o contrast (70544) |
$1,228.19 |
$6,140.96 |
5.1× |
| MRA head with contrast (70545) |
$1,162.56 |
$5,812.80 |
3.3× |
| MRA neck w contrast (70548) |
$1,111.71 |
$5,558.56 |
3.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,399.26 |
$11,996.32 |
6.8× |
| MRA neck w/o contrast (70547) |
$878.75 |
$4,393.76 |
3.7× |
| MRI abdomen w contrast (74182) |
$1,091.78 |
$5,458.88 |
3.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,905.06 |
$14,525.28 |
8.3× |
| MRI abdomen w/o contrast (74181) |
$1,268.06 |
$6,340.32 |
5.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,090.43 |
$5,452.16 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,090.43 |
$5,452.16 |
1.4× |
| MRI bone marrow blood supply (77084) |
$1,239.39 |
$6,196.96 |
5.2× |
| MRI c-spine with contrast (72142) |
$1,227.97 |
$6,139.84 |
3.5× |
| MRI cardiac w/o cont stress (75559) |
$616 |
$3,080 |
1.1× |
| MRI cardiac w/o contrast (75557) |
$1,646.62 |
$8,233.12 |
6.9× |
| MRI cervical spine w/o contrast (72141) |
$1,430.02 |
$7,150.08 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,882.88 |
$14,414.40 |
8.2× |
| MRI chest w/o contrast (71550) |
$1,061.31 |
$5,306.56 |
4.4× |
| MRI chest with contrast (71551) |
$1,091.78 |
$5,458.88 |
1.4× |
| MRI fetal sngl/1st gestation (74712) |
$1,219.90 |
$6,099.52 |
5.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,109.70 |
$5,548.48 |
3.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,090.43 |
$5,452.16 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,239.17 |
$6,195.84 |
5.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,472.13 |
$7,360.64 |
6.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,948.06 |
$14,740.32 |
8.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,382.08 |
$6,910.40 |
3.9× |
| MRI pelvis w contrast (72196) |
$1,057.06 |
$5,285.28 |
3.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,750.50 |
$13,752.48 |
7.8× |
| MRI pelvis w/o contrast (72195) |
$1,402.91 |
$7,014.56 |
5.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,898.78 |
$14,493.92 |
8.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,537.47 |
$12,687.36 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,744.67 |
$13,723.36 |
7.8× |
| MRI spectroscopy (76390) |
$1,300.10 |
$6,500.48 |
14.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,815.23 |
$14,076.16 |
8.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,116.42 |
$5,582.08 |
3.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,815.23 |
$14,076.16 |
8.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,227.97 |
$6,139.84 |
3.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,815.23 |
$14,076.16 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,586.82 |
$7,934.08 |
6.6× |
| MRI tmj (70336) |
$1,905.12 |
$9,525.60 |
7.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,408.96 |
$7,044.80 |
5.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,696.96 |
$13,484.80 |
7.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,691.87 |
$8,459.36 |
7.1× |
| Myelogram Cervical (72240) |
$488.99 |
$2,444.96 |
0.6× |
| Myelogram Lumbar (72265) |
$426.72 |
$2,133.60 |
0.5× |
| Myelogram thoracic (72255) |
$426.72 |
$2,133.60 |
0.5× |
| Myelography 2 or more regions (72270) |
$670.21 |
$3,351.04 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,671.58 |
$18,357.92 |
2.8× |
| Neck soft tissue (70360) |
$171.14 |
$855.68 |
2.0× |
| Nm adrenal scan (78075) |
$10,234.11 |
$51,170.56 |
7.9× |
| Nm bone marrow wb (78104) |
$821.63 |
$4,108.16 |
2.0× |
| Nm cisternogram (78630) |
$1,202.88 |
$6,014.40 |
2.2× |
| Nm csf leak detection (78650) |
$939.90 |
$4,699.52 |
0.7× |
| Nm gastric emptying study (78264) |
$1,281.28 |
$6,406.40 |
3.2× |
| Nm gastroesophageal reflux study (78262) |
$857.70 |
$4,288.48 |
2.1× |
| Nm peritoneal-venous shunt patency (78291) |
$620.26 |
$3,101.28 |
1.5× |
| Nm red cell sequestration (78140) |
$796.32 |
$3,981.60 |
2.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$956.03 |
$4,780.16 |
0.7× |
| Nuclear medicine of heart pumping function (78473) |
$1,913.18 |
$9,565.92 |
4.8× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$1,219.68 |
$6,098.40 |
2.2× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$477.34 |
$2,386.72 |
0.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,148 |
$5,740 |
2.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$811.33 |
$4,056.64 |
2.0× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$535.81 |
$2,679.04 |
1.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$194.88 |
$974.40 |
1.5× |
| Orthopantogram (70355) |
$94.30 |
$471.52 |
1.1× |
| Osseous survey infant (77076) |
$424.48 |
$2,122.40 |
4.0× |
| Osseous survey limited (77074) |
$320.77 |
$1,603.84 |
3.1× |
| Parathyrd planar w/spect&CT (78072) |
$1,568 |
$7,840 |
2.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,533.73 |
$7,668.64 |
3.8× |
| Parathyroid imaging (78070) |
$1,687.17 |
$8,435.84 |
4.2× |
| Pelvis 1 or 2 views (72170) |
$138.32 |
$691.60 |
1.3× |
| Perineogram (74775) |
$551.26 |
$2,756.32 |
2.3× |
| Peritoneogram rs&i (74190) |
$318.30 |
$1,591.52 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$1,663.21 |
$8,316.04 |
1.2× |
| PET imaging CT for attenuation limited area (78814) |
$1,956.60 |
$9,783.01 |
1.4× |
| PET imaging for CT attenuation whole body (78816) |
$1,956.60 |
$9,783.01 |
1.4× |
| Pr heart first pass single,planar (78481) |
$1,060.86 |
$5,304.32 |
1.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,553.60 |
$12,768 |
7.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,231.78 |
$6,158.88 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$999.71 |
$4,998.56 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$455.39 |
$2,276.96 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$184.13 |
$920.64 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$383.72 |
$1,918.56 |
3.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$206.75 |
$1,033.76 |
2.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$209.44 |
$1,047.20 |
2.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$412.38 |
$2,061.92 |
3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$204.06 |
$1,020.32 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$142.91 |
$714.56 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$213.70 |
$1,068.48 |
2.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$179.65 |
$898.24 |
2.1× |
| Radiologic exam colon single contrast study (74270) |
$447.44 |
$2,237.20 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$348.54 |
$1,742.72 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$638.62 |
$3,193.12 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$513.18 |
$2,565.92 |
2.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$181.66 |
$908.32 |
2.1× |
| Radiological examination surgical specimen (76098) |
$43.23 |
$216.16 |
0.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,071.17 |
$5,355.84 |
0.3× |
| Ribs bilateral 3 views (71110) |
$208.54 |
$1,042.72 |
2.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,120.67 |
$5,603.36 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,389.80 |
$6,949.04 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,100.96 |
$5,504.80 |
0.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,013.60 |
$5,068 |
0.8× |
| Sacroiliac Joints < 3 Views (72200) |
$127.23 |
$636.16 |
1.2× |
| Salivary gland imaging (78230) |
$439.71 |
$2,198.56 |
1.1× |
| Scanogram (77073) |
$357.96 |
$1,789.76 |
3.4× |
| Scapula complete (73010) |
$146.84 |
$734.16 |
1.4× |
| Sella turcica (70240) |
$104.83 |
$524.16 |
1.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$407.68 |
$2,038.40 |
3.9× |
| Sialogram (70390) |
$238.34 |
$1,191.68 |
1.0× |
| Small bowel series (74250) |
$325.92 |
$1,629.60 |
1.8× |
| Special dosimetry (77331) |
$103.49 |
$517.44 |
0.8× |
| Special treatment procedure (77470) |
$627.20 |
$3,136 |
1.1× |
| Speech evaluation complex (70371) |
$279.22 |
$1,396.08 |
1.2× |
| Spine thoracic 3 views (72072) |
$205.97 |
$1,029.84 |
2.0× |
| Splenoportograpy rs&i (75810) |
$2,509.02 |
$12,545.12 |
0.8× |
| Superior sagittal sinus venogram (75870) |
$874.94 |
$4,374.72 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$283.58 |
$1,417.92 |
0.8× |
| Testicular Imaging With Vascular Flow (78761) |
$595.72 |
$2,978.64 |
1.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$783.55 |
$3,917.76 |
2.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$321.44 |
$1,607.20 |
2.4× |
| Therapeutic Enema (74283) |
$532.67 |
$2,663.36 |
3.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,097.60 |
$5,488 |
2.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$463.23 |
$2,316.16 |
1.2× |
| Thyroid uptake measurement (78012) |
$301.28 |
$1,506.40 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$484.29 |
$2,421.44 |
1.2× |
| Tmj unilateral (70328) |
$90.05 |
$450.24 |
1.0× |
| Tomogram (76100) |
$283.36 |
$1,416.80 |
2.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,198.62 |
$5,993.12 |
2.2× |
| Tx devices design & construction complex (77334) |
$300.61 |
$1,503.04 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$305.54 |
$1,527.68 |
2.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$343.73 |
$1,718.64 |
3.9× |
| Unlisted magnetic resonance procedure (76498) |
$2,777.60 |
$13,888 |
31.8× |
| Unlisted Ultrasound Procedure (76999) |
$258.94 |
$1,294.72 |
3.0× |
| Upper Extremity Infant (73092) |
$224.22 |
$1,121.12 |
2.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$947.52 |
$4,737.60 |
2.4× |
| Urethrocystography retrograde rs&i (74450) |
$446.32 |
$2,231.60 |
1.9× |
| Urethrocystography voiding (74455) |
$432.77 |
$2,163.84 |
1.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$315.39 |
$1,576.96 |
1.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$421.34 |
$2,106.72 |
2.4× |
| Us breast unilateral complete (76641) |
$276.42 |
$1,382.08 |
2.6× |
| Us breast unilateral limited (76642) |
$221.31 |
$1,106.56 |
2.5× |
| Us chest (76604) |
$309.79 |
$1,548.96 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$206.98 |
$1,034.88 |
2.0× |
| Us elastography parenchyma (76981) |
$369.60 |
$1,848 |
3.5× |
| Us guided compression repair (76936) |
$446.38 |
$2,231.90 |
2.1× |
| Us infant hips dynamic (76885) |
$315.62 |
$1,578.08 |
3.6× |
| Us infant hips limited static (76886) |
$254.69 |
$1,273.44 |
2.9× |
| Us kidney transplant (76776) |
$431.87 |
$2,159.36 |
4.1× |
| Us pelvic non ob complete (76856) |
$595.62 |
$2,978.08 |
5.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$458.98 |
$2,294.88 |
4.4× |
| Us pregnancy ltd (76815) |
$370.50 |
$1,852.48 |
3.5× |
| Us retroperitoneal complete (76770) |
$391.10 |
$1,955.52 |
3.7× |
| Us scrotum and contents (76870) |
$456.51 |
$2,282.56 |
4.3× |
| Us soft tissue head/neck (76536) |
$364.90 |
$1,824.48 |
3.5× |
| Us spinal canal and contents (76800) |
$428.51 |
$2,142.56 |
4.1× |
| Us xtr non-vasc lmtd (76882) |
$317.86 |
$1,589.28 |
3.0× |
| Us, eye b-scan (76512) |
$250.21 |
$1,251.04 |
2.4× |
| Venogram extremity bilateral (75822) |
$225.57 |
$1,127.84 |
0.1× |
| Venography caval inferior serialography rs&i (75825) |
$588.68 |
$2,943.36 |
0.2× |
| Venography caval superior serialography rs&i (75827) |
$109.76 |
$548.80 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$361.31 |
$1,806.56 |
0.2× |
| Venography Renal Bilateral (75833) |
$1,093.56 |
$5,467.84 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$944.83 |
$4,724.16 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$409.64 |
$2,048.20 |
0.1× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$1,071.17 |
$5,355.84 |
0.2× |
| Wrist 2 views (73100) |
$104.50 |
$522.48 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$168.45 |
$842.24 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$126.78 |
$633.92 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$169.46 |
$847.28 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$491.12 |
$2,455.60 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$130.59 |
$652.96 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$181.66 |
$908.32 |
2.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$345.41 |
$1,727.04 |
3.3× |
| X-ray exam hip uni 1 view (73501) |
$147.62 |
$738.08 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$158.48 |
$792.40 |
1.8× |
| X-ray exam of femur 1 (73551) |
$127.01 |
$635.04 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$206.08 |
$1,030.40 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$159.71 |
$798.56 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$177.86 |
$889.28 |
2.0× |
| X-ray head for orthodontia (70350) |
$62.27 |
$311.36 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$103.48 |
$517.44 |
1.2× |
| X-ray IV pyelogram+drip infusn (74410) |
$358.40 |
$1,792 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$118.50 |
$592.48 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$188.38 |
$941.92 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$120.96 |
$604.80 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$243.94 |
$1,219.68 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$184.13 |
$920.64 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$217.73 |
$1,088.64 |
2.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$137.98 |
$689.92 |
1.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$137.20 |
$686 |
1.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$171.14 |
$855.68 |
2.0× |
| X-ray of voice box or throat (70370) |
$183.68 |
$918.40 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$227.58 |
$1,137.92 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$211.01 |
$1,055.04 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$604.80 |
$3,024 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$183.90 |
$919.52 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$174.72 |
$873.60 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$237.66 |
$1,188.32 |
2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$207.42 |
$1,037.12 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$150.30 |
$751.52 |
1.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$120.74 |
$603.68 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$235.31 |
$1,176.56 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$104.38 |
$521.92 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$214.03 |
$1,070.16 |
2.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$161.50 |
$807.52 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$97.44 |
$487.20 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$123.65 |
$618.24 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$163.74 |
$818.72 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$167.10 |
$835.52 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$184.69 |
$923.44 |
1.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$105.50 |
$527.52 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$107.18 |
$535.92 |
1.2× |
| Xr arthrogram ankle (73615) |
$426.72 |
$2,133.60 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$257.26 |
$1,286.32 |
2.4× |
| Xr chest 4+ views (71048) |
$224.90 |
$1,124.48 |
2.1× |
| Xr Cholecystography Oral Contrast (74290) |
$197.12 |
$985.60 |
1.1× |
| Xr finger(s) 2+ views (73140) |
$128.13 |
$640.64 |
1.5× |
| Xr internal auditory meati complete (70134) |
$177.18 |
$885.92 |
0.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$155.90 |
$779.52 |
1.5× |
| Xr optic foramina (70190) |
$123.87 |
$619.36 |
1.4× |
| Xr shoulder 1 view (73020) |
$103.49 |
$517.44 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$192.64 |
$963.20 |
1.8× |
| Xr tibia/fibula 2 views (73590) |
$176.51 |
$882.56 |
2.0× |
| Xr tmj bilateral (70330) |
$214.14 |
$1,070.72 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$135.07 |
$675.36 |
1.5× |