Imaging prices at East Carroll Parish Hospital

Lake Providence, LA · every code in this section with a posted price and a Medicare benchmark.

484 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $358.50 $478 0.3×
Abdomen 2 views (74019) $253.15 $337.53 2.7×
Acute gastrointestinal blood loss imaging (78278) $260.25 $347 0.7×
Acute venous thrombus image (78456) $239.25 $319 0.2×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $134.25 $179 0.0×
Angiography extremity bilateral rs&i (75716) $136.50 $182 0.0×
Angiography extremity unilateral rs&i (75710) $120 $160 0.0×
Angiography internal mammary rs&i (75756) $123.75 $165 0.0×
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure
$118.50 $158 0.0×
Angiography pulmonary bilateral slctv rs&i (75743) $126 $168 0.0×
Angiography pulmonary unilateral slctv rs&i (75741) $111.75 $149 0.0×
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure
$174.75 $233 0.0×
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure
$110.25 $147 0.0×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $65.25 $87 0.0×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $112.50 $150 0.0×
Ankle 2 views (73600) $80.22 $106.95 1.0×
Antegrade urography radiological supvj & interpj (74425) $14.25 $19 0.0×
Aortogram thoracic (75605)
likely a partial charge, not the full procedure
$102 $136 0.0×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $126.75 $169 0.0×
Aortography abdominal serialography rs&i (75625) $102 $136 0.0×
Aortography thoracic w/o serialography rs&i (75600) $144 $192 0.1×
Artery X-Rays Adrenal Gland (75731) $125.25 $167 0.0×
Arthrogram elbow (73085) $72 $96 0.2×
Arthrogram hip (73525) $74.25 $99 0.2×
Arthrogram shoulder (73040) $73.50 $98 0.2×
Arthrogram wrist (73115) $78 $104 0.2×
Arthrography knee lt (73580) $83.25 $111 0.3×
Basic radiation dosimetry calculation (77300) $46.50 $62 0.4×
Bone &/Joint Imaging Limited Area (78300) $135 $180 0.4×
Bone &/Joint Imaging Multiple Areas (78305) $172.50 $230 0.5×
Bone &/joint imaging whole body (78306) $188.25 $251 0.5×
Bone age studies (77072) $17.25 $23 0.2×
Bone Imaging 3 Phase (78315) $258.75 $345 0.7×
Bone Marrow Imaging Limited Area (78102) $126.75 $169 0.3×
Bone survey complete (77075) $93.75 $125 1.0×
Brachytx isodose complex (77318) $258 $344 0.8×
Brachytx isodose intermed (77317) $178.50 $238 0.5×
Brachytx isodose pln smpl w/dosimetry cal (77316) $136.50 $182 0.4×
Brain image w/flow 4 + views (78606) $247.50 $330 0.5×
Brain imaging < 4 static views (78600) $137.25 $183 0.4×
Brain imaging < 4 static views w vascular flow (78601) $159.75 $213 0.4×
Brain Imaging Minimum 4 Static Views (78605) $147.75 $197 0.3×
Brain Imaging Pet Metabolic Evaluation (78608) $57 $76 0.0×
Brain Imaging Vascular Flow Only (78610) $129 $172 0.3×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $168 $224 0.5×
Cardiac MRI w/w/o contrast & further seq (75561) $309 $412 1.0×
Cardiac shunt detection (78428) $135 $180 0.4×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $240.75 $321 0.5×
Cervical spine 2 or 3 views (72040) $137.22 $182.95 1.7×
Chest 1 view (71045) $72.58 $96.78 0.9×
Chest 3 views (71047) $25.50 $34 0.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $93 $124 0.6×
Cineradiography/videoradiography (76120) $66 $88 0.7×
Cisternography Positive Contrast Rs&I (70015) $113.25 $151 0.2×
Clavicle complete (73000) $130.09 $173.45 1.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $569.25 $759 6.0×
Continuing medical physics consltj pr wk (77336) $54.75 $73 0.4×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $56.25 $75 0.4×
Corpora cavernosography (74445) $45 $60 0.5×
CT abdomen and pelvis without and with contrast (74178) $996.48 $1,328.64 3.1×
CT abdomen and pelvis without contrast (74176) $592.26 $789.68 2.7×
CT abdomen w contrast (74160) $537.54 $716.72 3.4×
CT abdomen w wo contrast (74170) $549.16 $732.22 3.4×
CT abdomen w/o contrast (74150) $308.28 $411.03 3.2×
CT angio hrt w/3d image (75574) $304.50 $406 1.0×
CT angiography upper extremity lt (73206) $572.42 $763.22 3.6×
CT c-spine w/o contrast (72125) $320.28 $427.03 3.4×
CT cervical spine w&w/o contrast (72127) $195.75 $261 1.2×
CT cervical spine with contrast (72126) $166.50 $222 0.5×
CT chest w/wo contrast (71270) $553.66 $738.22 3.5×
CT chest with contrast (71260) $537.16 $716.22 3.4×
CT colonography w/dye (74262) $393.75 $525 2.5×
CT colonography w/o cntrst (74261) $352.50 $470 3.7×
CT head/brain with contrast (70460) $513.16 $684.22 3.2×
CT head/brain without and with contrast (70470) $524.04 $698.72 3.3×
CT heart contrast eval cardiac structure&morph (75572) $207 $276 0.7×
CT heart no contrast quant eval coronry calcium (75571) $73.50 $98 0.9×
CT hrt w/3d image congen (75573) $284.25 $379 0.9×
CT iac w contrast (70481) $200.25 $267 1.3×
CT limited/localized follow up study (76380) $107.25 $143 1.4×
CT lower ext w/o (73700) $318.02 $424.03 3.3×
CT lower extremity w wo contrast (73702) $198 $264 1.2×
CT lower extremity with contrast (73701) $163.50 $218 1.0×
CT lumbar spine w & w/o contrast (72133) $195.75 $261 1.2×
CT lumbar spine w/o contrast (72131) $318.02 $424.03 3.3×
CT lumbar spine with contrast (72132) $165.75 $221 0.5×
CT maxillofacial w contrast (70487) $515.42 $687.22 3.2×
CT maxillofacial w/o contrast (70486) $304.15 $405.53 3.2×
CT maxillofacial w/wo contrast (70488) $149.25 $199 0.9×
CT neck soft tissue w contrast (70491) $539.79 $719.72 3.4×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $256.24 $341.66 1.6×
CT orbits w/o contrast (70480) $169.50 $226 1.8×
CT pelvis w & w/o contrast (72194) $548.04 $730.72 3.4×
CT pelvis w/o contrast (72192) $306.78 $409.03 3.2×
CT scan for measuring calcium and other minerals in bone (77078) $218.62 $291.50 2.8×
CT soft tissue neck w/o & w/contrast material (70492) $201.75 $269 1.3×
CT soft tissue neck w/o contrast (70490) $323.65 $431.53 3.4×
CT thoracic spine w/contrast (72129) $166.50 $222 1.0×
CT thoracic spine w/o contrast (72128) $318.40 $424.53 3.3×
CT thoracic spine w/wo contrast (72130) $195.75 $261 1.2×
CT thorax w/o contrast (71250) $318.78 $425.03 3.3×
CT upper extremity w/o & w/contrast material (73202) $500.60 $667.48 3.1×
CT upper extremity w/o contrast rt (73200) $318.02 $424.03 3.3×
CT upper extremity with contrast (73201) $404.66 $539.54 1.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $592.29 $789.72 3.7×
Cta Abdomen (74175) $643.52 $858.02 4.0×
CTA abdomen pelvis (74174) $802.62 $1,070.15 2.5×
CTA chest (71275) $563.04 $750.72 3.5×
Cta Head (70496) $561.16 $748.22 3.5×
CTA lwr ext w&w/o contrast (73706) $689.06 $918.75 4.3×
Cta Neck (70498) $560.79 $747.72 3.5×
Cta Pelvis (72191) $564.54 $752.72 3.5×
Cystography minimum 3 views rs&i (74430) $27.75 $37 0.1×
Dacryocystography (70170) $12 $16 0.1×
Diskogram cervical (72285) $84.75 $113 0.0×
Diskography lumbar (72295) $72 $96 0.0×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $40.50 $54 0.4×
Doppler Echo Fetal Spectral Display Complete (76827) $56.25 $75 0.6×
Doppler Fetal Mid Cerebral Artery (76821) $69 $92 0.7×
Dx ophthalmic us ant segment immersion uni/bi (76513) $71.25 $95 0.7×
Dxa bone density study 1/> sites axial skel (77080) $30 $40 0.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $21 $28 0.3×
Dxa bone density study axial skeleton (77085) $41.25 $55 0.4×
Echo exam of eye (76529) $59.25 $79 0.7×
Echo exam of fetal heart (76825) $203.25 $271 0.4×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $120.75 $161 0.6×
Echoencephalography real time imaging (76506) $87 $116 0.9×
Esophageal motility (78258) $164.25 $219 0.5×
Esophagus (74220) $64.50 $86 0.4×
Fetal biophysical profile non-stress testing (76818) $90 $120 0.9×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $66 $88 0.7×
Fluoroscopy up to 1 hr (76000) $34.50 $46 0.2×
Foot 2 views (73620) $79.46 $105.95 1.0×
Forearm 2 views (73090) $130.09 $173.45 1.6×
Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) $39 $52 0.2×
Functional MRI brain by phys/psych (70555) $100.50 $134 0.5×
Functional MRI brain by tech (70554) $326.25 $435 1.5×
Gastric mucosa imaging (78261) $188.25 $251 0.5×
Gastrointestinal Protein Loss (78282) $15 $20 0.0×
Gated Heart Planar Single (78472) $172.50 $230 0.5×
Hand 2 views (73120) $136.32 $181.76 1.4×
Hand 3 views (73130) $134.22 $178.95 1.7×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $174 $232 0.3×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $357 $476 0.6×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $567.75 $757 0.9×
Heart Infarct Image (78466) $145.50 $194 0.4×
Heart infarct image w ef (78468) $144.75 $193 0.3×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $107.25 $143 0.0×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $333.75 $445 0.7×
Hepatobiliary syst imaging including gallbladder (78226) $246.75 $329 0.7×
High energy neutron radj tx dlvr 1/> isocenter (77423) $35.25 $47 0.1×
Ht muscle image spect sing (78451) $255 $340 0.2×
Humerus Min 2 Views Left (73060) $120 $160 1.5×
Hyperthermia ntrstl prb 5/< (77610) $737.25 $983 1.5×
Hysterosalpingogram (74740) $54.75 $73 0.3×
Interstitial radiation source applic complex (77778) $648 $864 1.0×
Intracavitary Radiation Source Applic Complex (77763) $541.50 $722 0.9×
Intracavitary Radiation Source Applic Intermed (77762) $398.25 $531 0.8×
Intracavitary radiation source applic simple (77761) $285.75 $381 0.6×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $27.75 $37 0.3×
Kidney funcj study non-img radioisotopic study (78725) $81 $108 0.2×
Kidney imaging morphology (78700) $127.50 $170 0.4×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $174 $232 0.4×
Kidney img morphology vascular flow 1 w/rx (78708) $131.25 $175 0.3×
Kidney Img Morphology Vascular Flow Multiple (78709) $270 $360 0.5×
Knee 3 views (73562) $82.46 $109.95 1.0×
Liver & spleen imaging static only (78215) $144.75 $193 0.4×
Liver & Spleen Imaging W/Vascular Flow (78216) $93.75 $125 0.3×
Liver imaging static only (78201) $140.25 $187 0.3×
Liver imaging w/vascular flow (78202) $149.25 $199 0.3×
Lung perf&ventilat diferentl (78598) $228 $304 0.5×
Lung perfusion differential (78597) $150.75 $201 0.4×
Lung Ventilation Imaging (78579) $137.25 $183 0.4×
Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) $46.50 $62 0.0×
Lymphangio extrem unilat - ir lymphangiogram extremity (75801) $33.75 $45 0.1×
Lymphangiography extremity only bilateral rs&i (75803) $46.50 $62 0.0×
Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) $32.25 $43 0.0×
Lymphoscintigraphy (78195) $265.50 $354 0.5×
Mammary ductogram or galactogram multiple (77054) $55.50 $74 0.3×
Mammary ductogram or galactogram single (77053) $42.75 $57 0.2×
Manual appl stress pfrmd phys/qhp joint films (77071) $35.25 $47 0.4×
Meckels Diverticulum (78290) $247.50 $330 0.7×
Mlc imrt design & construction per imrt plan (77338) $369.75 $493 1.1×
MRA head w & w/o contrast (70546) $432 $576 1.4×
MRA head w/o contrast (70544) $1,048.50 $1,398 4.8×
MRA head with contrast (70545) $278.25 $371 0.9×
MRA neck w contrast (70548) $297.75 $397 0.9×
Mra Neck W/O &W/Contrast Material (70549) $434.25 $579 1.4×
MRA neck w/o contrast (70547) $283.50 $378 1.3×
MRI abdomen w contrast (74182) $328.50 $438 1.0×
MRI abdomen w/o & w/contrast material (74183) $366.75 $489 1.2×
MRI abdomen w/o contrast (74181) $240.75 $321 1.1×
MRI any jnt lwr ext with con lt (73722) $276 $368 0.4×
MRI any jt upper extremity w/contrast matrl (73222) $273.75 $365 0.4×
MRI bone marrow blood supply (77084) $282.75 $377 1.3×
MRI c-spine with contrast (72142) $234.75 $313 0.7×
MRI cardiac w/o cont stress (75559) $316.50 $422 0.6×
MRI cardiac w/o contrast (75557) $232.50 $310 1.1×
MRI cervical spine w/o contrast (72141) $162.75 $217 0.7×
MRI chest w/o & w/contrast material (71552) $419.25 $559 1.3×
MRI chest w/o contrast (71550) $299.25 $399 1.4×
MRI chest with contrast (71551) $330.75 $441 0.5×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $291.75 $389 0.9×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $292.50 $390 0.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $263.25 $351 1.2×
MRI orbit face &/neck w/o contrast (70540) $258.75 $345 1.2×
MRI orbit/face/neck w&w/o cont (70543) $356.25 $475 1.1×
MRI orbit/face/neck w/contrast (70542) $291 $388 0.9×
MRI pelvis w contrast (72196) $297.75 $397 0.9×
MRI pelvis w/o & w/contrast material (72197) $366 $488 1.2×
MRI pelvis w/o contrast (72195) $271.50 $362 1.2×
MRI scan of arm joint before and after contrast (73223) $339.75 $453 1.1×
MRI scan of heart before and after contrast with stress imaging (75563) $366.75 $489 0.5×
MRI scan of leg joint before and after contrast (73723) $341.25 $455 1.1×
MRI spinal canal cervical w/o & w/contr matrl (72156) $276 $368 0.9×
MRI spinal canal lumbar w/contrast material (72149) $232.50 $310 0.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $275.25 $367 0.9×
MRI spinal canal thoracic w/contrast matrl (72147) $233.25 $311 0.7×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $276.75 $369 0.9×
MRI thoracic spine w/o contrast (72146) $162.75 $217 0.7×
MRI tmj (70336) $231.75 $309 1.1×
MRI upper ext joint w/o contrast (73221) $171 $228 0.8×
MRI upper extrem other than jt w/o & w/contras (73220) $361.50 $482 1.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $262.50 $350 1.2×
Myelogram Cervical (72240) $72.75 $97 0.1×
Myelogram Lumbar (72265) $67.50 $90 0.1×
Myelogram thoracic (72255) $72 $96 0.1×
Myelography 2 or more regions (72270) $94.50 $126 0.1×
Myocardial Imaging Pet Metabolic Evaluation (78459) $56.25 $75 0.0×
Myocardial infarct spect (78469) $170.25 $227 0.3×
Myocardial Spect Multiple Studies (78452) $352.50 $470 0.3×
Neck soft tissue (70360) $80.22 $106.95 1.0×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $276 $368 0.8×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $33 $44 0.1×
Nm adrenal scan (78075) $335.25 $447 0.3×
Nm bone marrow multiple (78103) $165 $220 0.5×
Nm bone marrow wb (78104) $183 $244 0.5×
Nm cisternogram (78630) $252.75 $337 0.5×
Nm csf leak detection (78650) $248.25 $331 0.2×
Nm gastric emptying study (78264) $216 $288 0.6×
Nm gastroesophageal reflux study (78262) $181.50 $242 0.5×
Nm peritoneal-venous shunt patency (78291) $186 $248 0.5×
Nm red cell sequestration (78140) $102 $136 0.3×
Nm whole blood volume (78122) $72 $96 0.1×
Ntsty modul radthx pln dose-vol histos (77301) $1,398 $1,864 1.1×
Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) $70.50 $94 0.1×
Nuclear medicine of heart muscle at rest with stress (78454) $324.75 $433 0.3×
Nuclear medicine of heart pumping function (78473) $216.75 $289 0.6×
Nuclear medicine of heart pumping function by first pass technique (78483) $179.25 $239 0.4×
Nuclear medicine study from skull base to mid-thigh (78812) $74.25 $99 0.1×
Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) $56.25 $75 0.0×
Nuclear medicine study of heart muscle at rest with stress (78453) $227.25 $303 0.2×
Nuclear medicine study of kidney and blood flow (78701) $156.75 $209 0.4×
Nuclear medicine study of limited area for thyroid cancer (78015) $164.25 $219 0.5×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $153.75 $205 0.4×
Nuclear medicine study to assess blood clot in vein of side (78457) $131.25 $175 0.3×
Nuclear Rx Oral Admin (79005) $102.75 $137 0.5×
Nuclr Rx Interstit Colloid (79300) $56.25 $75 0.3×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $84.75 $113 0.9×
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) $126.75 $169 1.0×
Ophthalmic biometry us echograpy a-scan (76516) $58.50 $78 0.6×
Ophthalmic us dx quantitative a-scan only (76511) $76.50 $102 0.8×
Orthopantogram (70355) $15 $20 0.2×
Osseous survey infant (77076) $69.75 $93 0.7×
Osseous survey limited (77074) $47.25 $63 0.5×
Parathyrd planar w/spect&CT (78072) $306 $408 0.6×
Parathyrd planar w/wo subtrj (78071) $267 $356 0.7×
Parathyroid imaging (78070) $223.50 $298 0.6×
Pelvis 1 or 2 views (72170) $186.58 $248.76 2.0×
Perineogram (74775) $24.75 $33 0.1×
Peritoneogram rs&i (74190) $18.75 $25 0.0×
PET image w/CT, skull-thigh (78815) $94.50 $126 0.1×
PET imaging CT for attenuation limited area (78814) $86.25 $115 0.1×
PET imaging for CT attenuation whole body (78816) $95.25 $127 0.1×
PET imaging limited area chest head/neck (78811) $60.75 $81 0.1×
PET whole body (78813) $77.25 $103 0.1×
Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) $72 $96 0.1×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) $76.50 $102 0.1×
Platelet survival study (78191) $208.50 $278 0.6×
Pr csf ventriculography (78635) $252.75 $337 0.5×
Pr gi endoscopic ultrasound (76975) $33.75 $45 0.2×
Pr heart first pass single,planar (78481) $131.25 $175 0.3×
Pr MRI brain w/ dye (70558) $127.50 $170 0.8×
Pr MRI brain w/o & w/ dye (70559) $127.50 $170 0.8×
Pr MRI brain w/o dye (70557) $115.50 $154 0.2×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $363.75 $485 1.1×
Pr non-imaging heart function (78414) $18 $24 0.0×
Pr red cell survival study (78130) $117.75 $157 0.3×
Pr sono bone density measure,peripheral (76977) $5.25 $7 0.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $117 $156 0.0×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $118.50 $158 0.0×
Pulmonary Perfusion Imaging Particulate (78580) $177.75 $237 0.5×
Pulmonary Ventilation & Perfusion Imaging (78582) $249.75 $333 0.5×
Radex abscess/fistula/sinus tract rs&i (76080) $41.25 $55 0.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $163.50 $218 1.7×
Radex hips bilateral with pelvis 2 views (73521) $253.15 $337.53 2.7×
Radex mastoids compl minimum 3 views pr side (70130) $39.75 $53 0.4×
Radiation Delivery Stereotactic Cranial Linear (77372)
likely a partial charge, not the full procedure
$756 $1,008 0.1×
Radiolog exam mandible compl minimum 4 views (70110) $140.45 $187.26 1.5×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $130.09 $173.45 1.6×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $140.18 $186.90 1.8×
Radiologic exam colon single contrast study (74270) $108.75 $145 0.7×
Radiologic exam teeth prtl exam < full mouth (70310) $28.50 $38 0.1×
Radiologic exam upr gi trc double contrast study (74246) $97.50 $130 0.6×
Radiologic exam upr gi trc single contrast study (74240) $84.38 $112.50 0.5×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $140.18 $186.90 1.8×
Radiologic Examination Salivary Gland Calculus (70380) $26.25 $35 0.3×
Radiological examination surgical specimen (76098) $12 $16 0.0×
Radiopharm Dacryocystography (78660) $131.25 $175 0.4×
Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) $97.50 $130 0.5×
Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) $102.75 $137 0.5×
Red Cell Volume Determination Spx 1 Sampling (78120) $69.75 $93 0.2×
Red Cell Volume Determination Spx Mult Samplings (78121) $78.75 $105 0.2×
Review by radiologist of adrenal gland vein image (75840) $109.50 $146 0.0×
Review by radiologist of liver vein image with assessment of blood flow (75889) $106.50 $142 0.0×
Ribs bilateral 3 views (71110) $27.75 $37 0.3×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $194.25 $259 0.5×
Rp loclzj tum plnr whole body single day imaging (78802) $241.50 $322 0.5×
Rp loclzj tum spect 1 area single day imaging (78803) $254.25 $339 0.5×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $142.50 $190 0.7×
Rp therapy intra-arterial particulate admn (79445) $91.50 $122 0.4×
Rp Therapy Intravenous Administration (79101) $108 $144 0.5×
Sacroiliac Joints < 3 Views (72200) $21 $28 0.2×
Saline Infus Sonohysterography W/Color Doppler (76831) $87 $116 0.4×
Salivary gland function study (78232) $74.25 $99 0.2×
Salivary gland imaging (78230) $129 $172 0.4×
Salivary gland imaging serial images (78231) $96.75 $129 0.3×
Scanogram (77073) $27 $36 0.3×
Scapula complete (73010) $180.20 $240.26 1.9×
Screening digital breast tomosynthesis (77063) $42 $56 1.8×
Sella turcica (70240) $21.75 $29 0.3×
Shuntogram indwelling nonvascular shunt rs&i (75809) $72 $96 0.8×
Sialogram (70390) $68.25 $91 0.3×
Simulation intermediate (77285) $306.75 $409 0.9×
Small bowel series (74250) $75.75 $101 0.5×
Spec medical radj physics consltj (77370) $83.25 $111 0.7×
Spec telethx port pln parts hemibdy tot bdy (77321) $68.25 $91 0.2×
Special dosimetry (77331) $48 $64 0.4×
Special treatment procedure (77470) $116.25 $155 0.2×
Speech evaluation complex (70371) $66.75 $89 0.3×
Spine thoracic 3 views (72072) $25.50 $34 0.3×
Spleen imaging only (78185) $157.50 $210 0.4×
Splenoportograpy rs&i (75810) $45.75 $61 0.0×
Stereotactic body radiation delivery (77373) $960 $1,280 0.6×
Superior sagittal sinus venogram (75870) $109.50 $146 0.0×
Surface Applic Low Dose Rate Radionuclide Source (77789) $87.75 $117 0.9×
Telethx isodose pln cplx w/basic dosimetry (77307) $210 $280 0.6×
Telethx isodose pln smpl w/dosimetry calculation (77306) $107.25 $143 0.3×
Temporomandble Jt Arthrography Rs&I (70332) $60 $80 0.3×
Testicular Imaging With Vascular Flow (78761) $157.50 $210 0.4×
Ther rad simulaj-aided field setting complex (77290) $367.50 $490 1.1×
Ther rad simulaj-aided field setting simple (77280) $195 $260 1.6×
Therapeutic Enema (74283) $152.25 $203 1.0×
Thoracolumbar 2 views (72080) $24.75 $33 0.3×
Thyroid carcinoma metastases img addl study (78016) $210.75 $281 0.6×
Thyroid carcinoma metastases img whole body (78018) $232.50 $310 0.5×
Thyroid Imaging With Vascular Flow (78013) $141 $188 0.4×
Thyroid uptake measurement (78012) $59.25 $79 0.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $179.25 $239 0.5×
Tmj unilateral (70328) $22.50 $30 0.3×
Tomogram (76100) $67.50 $90 0.7×
Treatment device intermediate (77333) $39.75 $53 0.3×
Treatment devices simple (77332) $60.75 $81 0.5×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $423 $564 0.9×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $141.75 $189 0.4×
Tx devices design & construction complex (77334) $111.75 $149 0.3×
Ultrasound scan of cornea to determine thickness (76514) $12 $16 0.5×
Ultrasound scan to determine eye length and lens power (76519) $62.25 $83 0.7×
Ultrasound, abdomen limited (76705) $170.66 $227.55 1.8×
Umbilical-artery Doppler (OB) (76820) $35.25 $47 0.4×
Unlisted Diagnostic Radiographic Procedure (76499) $55.50 $74 0.7×
Unlisted Procedure Clinical Brachytherapy (77799) $390.38 $520.50 4.2×
Upper Extremity Infant (73092) $20.25 $27 0.2×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $287.88 $383.83 0.8×
Urethrocystography retrograde rs&i (74450) $12.75 $17 0.1×
Urethrocystography voiding (74455) $59.25 $79 0.3×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $79.50 $106 0.5×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $99 $132 0.6×
Us abdl aorta screen aaa (76706) $219.73 $292.98 2.3×
Us breast unilateral complete (76641) $307.46 $409.95 3.2×
Us breast unilateral limited (76642) $186.73 $248.98 2.4×
Us chest (76604) $198.75 $265 2.1×
Us compl joint r-t w/image documentation (76881) $85.50 $114 0.9×
Us fetal nuchal translucency 1st gestation (76813) $90.75 $121 1.0×
Us guided compression repair (76936) $200.25 $267 1.0×
Us infant hips dynamic (76885) $105.75 $141 1.3×
Us infant hips limited static (76886) $78 $104 1.0×
Us kidney transplant (76776) $114.75 $153 1.2×
Us ob detailed single fetus (76811) $135.75 $181 0.6×
Us ob transvaginal (76817) $162.58 $216.76 1.7×
Us pelvic non ob complete (76856) $167.08 $222.76 1.8×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $214.12 $285.50 2.2×
Us pregnancy ltd (76815) $63 $84 0.7×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $92.25 $123 1.0×
Us retroperitoneal complete (76770) $168.20 $224.26 1.8×
Us retroperitoneal limited (76775) $42.75 $57 0.4×
Us scrotum and contents (76870) $151.32 $201.76 1.6×
Us soft tissue head/neck (76536) $253.15 $337.53 2.7×
Us spinal canal and contents (76800) $102 $136 1.1×
Us transrectal (76872) $69 $92 0.7×
Us transrectal prostate volume (76873) $123.75 $165 1.3×
Us xtr non-vasc lmtd (76882) $140.08 $186.76 1.5×
Us, eye b-scan (76512) $69.75 $93 0.7×
Use of body cavity probe generated heat to increase temperature of cancer cell (77620) $333.75 $445 0.7×
Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) $291 $388 0.8×
Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) $549 $732 0.9×
Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) $725.25 $967 1.4×
Vascular flow imaging (78445) $133.50 $178 0.4×
Vasogram (74440) $57.75 $77 0.3×
Venogram extremity bilateral (75822) $101.25 $135 0.1×
Venogram orbital (75880) $106.50 $142 0.2×
Venography caval inferior serialography rs&i (75825) $100.50 $134 0.0×
Venography caval superior serialography rs&i (75827) $101.25 $135 0.1×
Venography epidural rs&i (75872) $109.50 $146 0.2×
Venography extremity unilateral rs&i (75820) $84 $112 0.1×
Venography Renal Bilateral (75833) $123 $164 0.0×
Venography renal unilateral selective rs&i (75831) $103.50 $138 0.0×
Venography venous sinus/jugular cath rs&i (75860) $105.75 $141 0.0×
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure
$86.25 $115 0.0×
Vertebral fracture assessment via dxa (77086) $26.25 $35 0.3×
Wrist 2 views (73100) $15.28 $20.38 0.2×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $142.70 $190.26 1.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $197.96 $263.95 2.5×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $134.22 $178.95 1.7×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $153.75 $205 1.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $80.22 $106.95 1.0×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $130.09 $173.45 1.6×
X-ray exam hip uni 1 view (73501) $19.50 $26 0.2×
X-Ray Exam Hip Uni 2-3 Views (73502) $140.18 $186.90 1.8×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $275.25 $367 1.7×
X-ray eye for foreign body (70030) $20.25 $27 0.3×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $198.20 $264.26 2.1×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $128.25 $171 1.6×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $128.25 $171 1.6×
X-ray guide gu dilation - ir nephrostomy dilation (74485) $66.75 $89 0.0×
X-ray head for orthodontia (70350) $14.25 $19 0.2×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $79.84 $106.45 1.0×
X-ray IV pyelogram+drip infusn (74410) $77.25 $103 0.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $128.25 $171 1.6×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $198.95 $265.26 2.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $24 $32 0.3×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $20.25 $27 0.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $143.25 $191 1.5×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $81.78 $109.04 0.9×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $29.25 $39 0.3×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $141.72 $188.95 1.8×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $19.50 $26 0.2×
X-ray of voice box or throat (70370) $58.50 $78 0.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $30.75 $41 0.3×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $27.75 $37 0.3×
X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) $20.25 $27 0.0×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $14.25 $19 0.0×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $140.18 $186.90 1.8×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $27 $36 0.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $34.50 $46 0.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $138.58 $184.76 1.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $20.25 $27 0.3×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $134.22 $178.95 1.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $141.72 $188.95 1.8×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $128.25 $171 1.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $143.08 $190.76 1.5×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $190.70 $254.26 2.0×
X-Ray Spine One View - Xr Spine (72020) $16.50 $22 0.2×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $26.25 $35 0.3×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $134.22 $178.95 1.7×
X-Ray Teeth Single - Xr Teeth 1 View (70300) $11.25 $15 0.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $190.70 $254.26 2.0×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $28.50 $38 0.3×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $128.25 $171 1.6×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $134.22 $178.95 1.7×
Xr arthrogram ankle (73615) $72 $96 0.2×
Xr c-spine 6 or more views (72052) $41.25 $55 0.4×
Xr chest 4+ views (71048) $30.75 $41 0.3×
Xr Cholecystography Oral Contrast (74290) $51 $68 0.3×
Xr finger(s) 2+ views (73140) $134.22 $178.95 1.7×
Xr internal auditory meati complete (70134) $37.50 $50 0.1×
XR Mastoids < 3 Views Bilateral (70120) $24.75 $33 0.3×
Xr myelogram posterior fossa (70010) $54 $72 0.2×
Xr optic foramina (70190) $25.50 $34 0.3×
Xr shoulder 1 view (73020) $17.25 $23 0.2×
Xr spine cervical 4 or 5 views (72050) $143.08 $190.76 1.5×
Xr tibia/fibula 2 views (73590) $130.09 $173.45 1.6×
Xr tmj bilateral (70330) $34.50 $46 0.4×
Xray knee 1 or 2 views rt (73560) $120 $160 1.5×