| 3-D radiotherapy plan dose-volume histograms (77295) |
$11,485.94 |
$11,485.94 |
8.4× |
| Abdomen 2 views (74019) |
$533.07 |
$533.07 |
5.2× |
| Acute gi blood loss imaging (78278) |
$1,766.77 |
$1,766.77 |
4.5× |
| Angiography extremity bilateral rs&i (75716) |
$12,727.74 |
$12,727.74 |
4.1× |
| Angiography extremity unilateral rs&i (75710) |
$12,727.74 |
$12,727.74 |
4.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,044.04 |
$6,044.04 |
1.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$6,044.04 |
$6,044.04 |
1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,744.80 |
$7,744.80 |
2.5× |
| Angiography Spinal Selective Rs&I (75705) |
$7,744.80 |
$7,744.80 |
1.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,044.04 |
$6,044.04 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$8,655.90 |
$8,655.90 |
2.8× |
| Ankle 2 views (73600) |
$657.48 |
$657.48 |
7.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$7,744.80 |
$7,744.80 |
2.5× |
| Aortography abdominal serialography rs&i (75625) |
$7,744.80 |
$7,744.80 |
2.5× |
| Arthrogram hip (73525) |
$1,205.74 |
$1,205.74 |
3.5× |
| Arthrogram knee (73580) |
$1,205.74 |
$1,205.74 |
3.5× |
| Arthrogram shoulder (73040) |
$1,205.74 |
$1,205.74 |
3.5× |
| Basic dosimetry (77300) |
$537.06 |
$537.06 |
4.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,111.84 |
$1,111.84 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$2,221.14 |
$2,221.14 |
5.6× |
| Bone age studies (77072) |
$619.40 |
$619.40 |
6.0× |
| Bone Imaging 3 Phase (78315) |
$2,221.14 |
$2,221.14 |
5.6× |
| Bone survey complete (77075) |
$1,322.52 |
$1,322.52 |
12.8× |
| Bone survey infant (77076) |
$1,055.99 |
$1,055.99 |
10.2× |
| Brachytx isodose complex (77318) |
$2,981.10 |
$2,981.10 |
8.1× |
| Brachytx isodose intermed (77317) |
$2,385.31 |
$2,385.31 |
6.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,967.82 |
$1,967.82 |
5.3× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$3,470.05 |
$3,470.05 |
8.8× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$4,168.15 |
$4,168.15 |
10.6× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$7,308.28 |
$7,308.28 |
9.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,095.41 |
$3,095.41 |
9.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$627.26 |
$627.26 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$441.69 |
$441.69 |
5.1× |
| Chest 1 view (71045) |
$436.61 |
$436.61 |
5.1× |
| Chest xray 3 views (71047) |
$752.37 |
$752.37 |
8.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,187.99 |
$1,187.99 |
6.9× |
| Clavicle complete (73000) |
$708.22 |
$708.22 |
8.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$417.12 |
$417.12 |
4.0× |
| Continuing medical physics consltj pr wk (77336) |
$1,151.74 |
$1,151.74 |
8.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,326.63 |
$4,326.63 |
12.6× |
| CT abdomen and pelvis without contrast (74176) |
$3,232.68 |
$3,232.68 |
13.7× |
| CT abdomen w contrast (74160) |
$1,750.33 |
$1,750.33 |
10.1× |
| CT abdomen w wo contrast (74170) |
$2,163.28 |
$2,163.28 |
12.5× |
| CT abdomen w/o contrast (74150) |
$1,615.11 |
$1,615.11 |
15.6× |
| CT angio hrt w/3d image (75574) |
$1,666.74 |
$1,666.74 |
4.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,313.79 |
$3,313.79 |
19.1× |
| CT angiography upper extremity lt (73206) |
$3,313.79 |
$3,313.79 |
19.1× |
| CT c-spine w/contrast (72126) |
$2,959.80 |
$2,959.80 |
8.6× |
| CT c-spine w/o contrast (72125) |
$2,151.02 |
$2,151.02 |
20.8× |
| CT chest w contrast (71260) |
$1,809.32 |
$1,809.32 |
10.4× |
| CT chest w/wo contrast (71270) |
$2,259.17 |
$2,259.17 |
13.0× |
| CT head/brain with contrast (70460) |
$2,868.86 |
$2,868.86 |
16.6× |
| CT head/brain without and with contrast (70470) |
$3,687.47 |
$3,687.47 |
21.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,666.74 |
$1,666.74 |
4.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$69 |
$69 |
0.8× |
| CT hrt w/3d image congen (75573) |
$1,396.52 |
$1,396.52 |
4.1× |
| CT iac w contrast (70481) |
$5,233.73 |
$5,233.73 |
30.2× |
| CT limited/localized follow up study (76380) |
$609.65 |
$609.65 |
7.1× |
| CT lower ext w/o (73700) |
$1,204.57 |
$1,204.57 |
11.7× |
| CT lower extremity w wo contrast (73702) |
$1,919.73 |
$1,919.73 |
11.1× |
| CT lower extremity w/contrast material (73701) |
$1,907.66 |
$1,907.66 |
11.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,991.21 |
$1,991.21 |
11.5× |
| CT lumbar spine w/contrast (72132) |
$2,959.80 |
$2,959.80 |
8.6× |
| CT lumbar spine w/o contrast (72131) |
$2,455.84 |
$2,455.84 |
23.8× |
| CT maxillofacial w contrast (70487) |
$3,468.67 |
$3,468.67 |
20.0× |
| CT maxillofacial w/wo contrast (70488) |
$4,265.17 |
$4,265.17 |
24.6× |
| CT maxillofacial wo contrast (70486) |
$3,018.78 |
$3,018.78 |
29.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$5,909.77 |
$5,909.77 |
34.1× |
| CT orbits w/o contrast (70480) |
$2,822.13 |
$2,822.13 |
27.3× |
| CT pelvis w/o contrast (72192) |
$1,615.11 |
$1,615.11 |
15.6× |
| CT pelvis w/wo contrast (72194) |
$2,163.28 |
$2,163.28 |
12.5× |
| CT scan of arm combo (73202) |
$2,111.70 |
$2,111.70 |
12.2× |
| CT soft tissue neck w contrast (70491) |
$1,811.75 |
$1,811.75 |
10.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,259.17 |
$2,259.17 |
13.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,514.29 |
$1,514.29 |
14.7× |
| CT thoracic spine w/contrast (72129) |
$2,959.80 |
$2,959.80 |
17.1× |
| CT thoracic spine w/o contrast (72128) |
$2,202.65 |
$2,202.65 |
21.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,991.21 |
$1,991.21 |
11.5× |
| CT thorax w/o contrast (71250) |
$1,514.29 |
$1,514.29 |
14.7× |
| CT upper ext wo (73200) |
$1,204.57 |
$1,204.57 |
11.7× |
| CT upper extremity with contrast (73201) |
$1,907.66 |
$1,907.66 |
5.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$4,877.27 |
$4,877.27 |
28.1× |
| Cta Abdomen (74175) |
$2,627.91 |
$2,627.91 |
15.2× |
| CTA abdomen pelvis (74174) |
$4,707.66 |
$4,707.66 |
13.7× |
| CTA chest (71275) |
$4,331.54 |
$4,331.54 |
25.0× |
| Cta Head (70496) |
$2,994.22 |
$2,994.22 |
17.3× |
| Cta Neck (70498) |
$4,348.73 |
$4,348.73 |
25.1× |
| Cta Pelvis (72191) |
$2,077.28 |
$2,077.28 |
12.0× |
| Cystography minimum 3 views rs&i (74430) |
$1,038.21 |
$1,038.21 |
3.0× |
| Diskogram cervical (72285) |
$4,696.12 |
$4,696.12 |
2.4× |
| Diskography lumbar (72295) |
$4,696.12 |
$4,696.12 |
2.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$381.97 |
$381.97 |
3.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$466.98 |
$466.98 |
4.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$624.43 |
$624.43 |
6.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$246.86 |
$246.86 |
2.9× |
| Dxa bone density study axial skeleton (77085) |
$871.29 |
$871.29 |
8.4× |
| Esophagus (74220) |
$1,218.47 |
$1,218.47 |
7.0× |
| Facial bones min 3 views (70150) |
$1,043.28 |
$1,043.28 |
10.1× |
| Fetal biophysical profile non-stress testing (76818) |
$600.63 |
$600.63 |
5.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$576.90 |
$576.90 |
5.6× |
| Fluoroscopy up to 1 hr (76000) |
$500.62 |
$500.62 |
2.1× |
| Foot 2 views (73620) |
$660 |
$660 |
7.7× |
| Forearm 2 views (73090) |
$690.46 |
$690.46 |
8.0× |
| Gastric mucosa imaging (78261) |
$1,634.74 |
$1,634.74 |
4.1× |
| Hand 2 views (73120) |
$657.48 |
$657.48 |
6.4× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,415.09 |
$3,415.09 |
5.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,415.09 |
$3,415.09 |
5.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,415.09 |
$3,415.09 |
5.0× |
| Heart first pass single,planar (78481) |
$1,690.61 |
$1,690.61 |
3.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$7,744.80 |
$7,744.80 |
2.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$7,040.73 |
$7,040.73 |
2.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,444.49 |
$2,444.49 |
4.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,030.73 |
$2,030.73 |
5.1× |
| Hysterosalpingogram (74740) |
$1,314.93 |
$1,314.93 |
5.6× |
| Kidney imaging morphology (78700) |
$2,695.43 |
$2,695.43 |
6.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,949.52 |
$1,949.52 |
3.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,949.52 |
$1,949.52 |
3.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$5,561.75 |
$5,561.75 |
10.4× |
| Knee 3 views (73562) |
$863.10 |
$863.10 |
10.0× |
| Liver & spleen imaging static only (78215) |
$2,190.67 |
$2,190.67 |
5.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$8,655.90 |
$8,655.90 |
2.8× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$1,862.91 |
$1,862.91 |
1.2× |
| Lymphoscintigraphy (78195) |
$1,551 |
$1,551 |
2.9× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,674.22 |
$2,674.22 |
3.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,674.22 |
$2,674.22 |
7.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,147.76 |
$3,147.76 |
9.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$6,929.32 |
$6,929.32 |
18.7× |
| MRA head w/o contrast (70544) |
$2,442.46 |
$2,442.46 |
10.4× |
| MRA head with contrast (70545) |
$2,806.35 |
$2,806.35 |
8.1× |
| MRA neck w contrast (70548) |
$2,614.39 |
$2,614.39 |
7.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,294.81 |
$3,294.81 |
9.6× |
| MRA neck w/o contrast (70547) |
$2,442.46 |
$2,442.46 |
10.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,580.25 |
$5,580.25 |
16.2× |
| MRI abdomen w/o contrast (74181) |
$4,501.07 |
$4,501.07 |
19.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,674.22 |
$2,674.22 |
3.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,147.76 |
$3,147.76 |
9.1× |
| MRI c-spine with contrast (72142) |
$3,115.37 |
$3,115.37 |
9.0× |
| MRI cardiac w/o cont stress (75559) |
$1,668.43 |
$1,668.43 |
3.1× |
| MRI cardiac w/o contrast (75557) |
$1,835.27 |
$1,835.27 |
7.8× |
| MRI cervical spine w/o contrast (72141) |
$2,357.69 |
$2,357.69 |
10.0× |
| MRI chest w/o & w/contrast material (71552) |
$5,966.55 |
$5,966.55 |
17.3× |
| MRI chest w/o contrast (71550) |
$4,673.05 |
$4,673.05 |
19.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,674.22 |
$2,674.22 |
7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,147.76 |
$3,147.76 |
9.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,420 |
$2,420 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$872.30 |
$872.30 |
3.7× |
| MRI orbit face neck w contrast (70542) |
$959.51 |
$959.51 |
2.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,054.24 |
$1,054.24 |
3.1× |
| MRI pelvis w/contrast (72196) |
$5,337.65 |
$5,337.65 |
15.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,777.16 |
$5,777.16 |
16.8× |
| MRI pelvis w/o contrast (72195) |
$4,934.75 |
$4,934.75 |
20.9× |
| MRI spectroscopy (76390) |
$3,080.45 |
$3,080.45 |
35.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,622.54 |
$3,622.54 |
10.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,115.37 |
$3,115.37 |
9.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,922.26 |
$4,922.26 |
14.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,115.37 |
$3,115.37 |
9.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,622.54 |
$3,622.54 |
10.5× |
| MRI temporomandibular joint (70336) |
$2,564.60 |
$2,564.60 |
10.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,357.69 |
$2,357.69 |
10.0× |
| MRI up ext w/o contrast (73218) |
$2,420 |
$2,420 |
10.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,420 |
$2,420 |
10.3× |
| MRI, joint upper extrem combo (73223) |
$3,147.76 |
$3,147.76 |
9.1× |
| Myelogram Cervical (72240) |
$2,240.78 |
$2,240.78 |
2.9× |
| Myelogram Lumbar (72265) |
$1,302.21 |
$1,302.21 |
1.7× |
| Myelography 2 or more regions (72270) |
$2,240.78 |
$2,240.78 |
2.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$19,560.50 |
$19,560.50 |
15.3× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78433) |
$7,368.67 |
$7,368.67 |
3.4× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$10,450.51 |
$10,450.51 |
4.8× |
| Myocardial Spect Multiple Studies (78452) |
$5,021.02 |
$5,021.02 |
3.9× |
| Myocardial spect single study at rest or stress (78451) |
$5,021.02 |
$5,021.02 |
3.9× |
| N-invas est c ffr sw aly CTA (75580) |
$2,390.48 |
$2,390.48 |
2.8× |
| Neck soft tissue (70360) |
$672.71 |
$672.71 |
7.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,137.22 |
$1,137.22 |
2.9× |
| Nm bone marrow wb (78104) |
$2,131.94 |
$2,131.94 |
5.4× |
| Nm cisternogram (78630) |
$3,470.05 |
$3,470.05 |
6.5× |
| Nm gastric emptying study (78264) |
$1,310.76 |
$1,310.76 |
3.3× |
| Nonvascular shunt X-ray (75809) |
$621.92 |
$621.92 |
6.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,139.83 |
$5,139.83 |
3.8× |
| Nuclear Rx Oral Admin (79005) |
$1,551 |
$1,551 |
6.7× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter… (76510) |
$576.90 |
$576.90 |
4.4× |
| Parathyrd planar w/spect&CT (78072) |
$5,120.91 |
$5,120.91 |
9.5× |
| Parathyroid Planar Imaging (78070) |
$1,773.93 |
$1,773.93 |
4.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,452.42 |
$2,452.42 |
6.2× |
| Pelvis 1 or 2 views (72170) |
$347.75 |
$347.75 |
3.4× |
| PET image w/CT, skull-thigh (78815) |
$2,787.03 |
$2,787.03 |
2.0× |
| PET imaging CT for attenuation limited area (78814) |
$2,787.03 |
$2,787.03 |
2.0× |
| PET imaging for CT attenuation whole body (78816) |
$2,533.66 |
$2,533.66 |
1.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$3,081.08 |
$3,081.08 |
2.4× |
| PET whole body (78813) |
$3,081.08 |
$3,081.08 |
2.2× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$3,081.08 |
$3,081.08 |
2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$7,744.80 |
$7,744.80 |
2.5× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,995.07 |
$4,995.07 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,634.74 |
$1,634.74 |
4.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,685.53 |
$1,685.53 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,944.47 |
$1,944.47 |
3.6× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$753.91 |
$753.91 |
8.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$647.27 |
$647.27 |
7.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$751.37 |
$751.37 |
8.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$396.96 |
$396.96 |
4.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$657.34 |
$657.34 |
6.4× |
| Radex fingr minimum 2 views (73140) |
$350.31 |
$350.31 |
4.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$751.37 |
$751.37 |
8.7× |
| Radex Hand Minimum 3 Views (73130) |
$751.37 |
$751.37 |
8.7× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$396.96 |
$396.96 |
4.6× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$657.34 |
$657.34 |
6.4× |
| Radex Humerus Minimum 2 Views (73060) |
$708.22 |
$708.22 |
8.2× |
| Radex Kne 1/2 Views (73560) |
$583.85 |
$583.85 |
6.8× |
| Radex Kne Compl 4/More Views (73564) |
$1,017.94 |
$1,017.94 |
9.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$1,007.78 |
$1,007.78 |
9.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$314.75 |
$314.75 |
3.7× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$941.75 |
$941.75 |
9.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$936.67 |
$936.67 |
10.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$444.24 |
$444.24 |
5.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$901.13 |
$901.13 |
10.5× |
| Radex Toe Minimum 2 Views (73660) |
$322.38 |
$322.38 |
3.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$502.60 |
$502.60 |
4.9× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$751.37 |
$751.37 |
8.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,253.36 |
$1,253.36 |
12.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$43,126.74 |
$43,126.74 |
5.9× |
| Radiation treatment delivery level 3 (77412) |
$908.37 |
$908.37 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$378.22 |
$378.22 |
4.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$79.71 |
$79.71 |
0.8× |
| Radiologic exam chest 2 views (71046) |
$558.45 |
$558.45 |
6.5× |
| Radiologic exam colon single contrast study (74270) |
$1,533.22 |
$1,533.22 |
8.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,530.67 |
$1,530.67 |
8.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,375.85 |
$1,375.85 |
7.9× |
| Radiologic examination femur 1 view (73551) |
$396.96 |
$396.96 |
4.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$708.22 |
$708.22 |
8.2× |
| Radiological examination surgical specimen (76098) |
$1,556.06 |
$1,556.06 |
2.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,538.06 |
$1,538.06 |
4.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,538.06 |
$1,538.06 |
4.0× |
| Ribs bilateral 3 views (71110) |
$1,226.08 |
$1,226.08 |
11.9× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,977.47 |
$1,977.47 |
5.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$5,774.96 |
$5,774.96 |
10.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,061.38 |
$3,061.38 |
5.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,061.38 |
$3,061.38 |
5.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,135.77 |
$1,135.77 |
4.9× |
| Rp Therapy Intravenous Administration (79101) |
$1,477.38 |
$1,477.38 |
6.4× |
| Sacroiliac Joints < 3 Views (72200) |
$418.86 |
$418.86 |
4.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$626.92 |
$626.92 |
2.7× |
| Scapula (73010) |
$662.54 |
$662.54 |
6.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$9.17 |
$9.17 |
0.4× |
| Shoulder 1 view (73020) |
$401.06 |
$401.06 |
4.7× |
| Sialogram (70390) |
$1,071.26 |
$1,071.26 |
4.5× |
| Simulation intermediate (77285) |
$1,697.20 |
$1,697.20 |
4.6× |
| Small bowel series (74250) |
$1,241.31 |
$1,241.31 |
7.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,545.16 |
$1,545.16 |
4.2× |
| Special dosimetry (77331) |
$423.78 |
$423.78 |
3.2× |
| Special Physics Consult (77370) |
$1,346.86 |
$1,346.86 |
10.1× |
| Special treatment procedure (77470) |
$3,390.19 |
$3,390.19 |
6.2× |
| Spine thoracic 3 views (72072) |
$741.22 |
$741.22 |
7.2× |
| Splenoportograpy rs&i (75810) |
$6,400.66 |
$6,400.66 |
2.1× |
| Stereotactic Body Radiation Delivery (77373) |
$8,402.13 |
$8,402.13 |
4.8× |
| Superior sagittal sinus venogram (75870) |
$4,368.66 |
$4,368.66 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,251.03 |
$2,251.03 |
6.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,995.09 |
$1,995.09 |
5.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,102.10 |
$2,102.10 |
5.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$668.03 |
$668.03 |
5.0× |
| Thoracolumbar 2 views (72080) |
$911.32 |
$911.32 |
10.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,936.85 |
$1,936.85 |
3.6× |
| Thyroid imaging w/blood flow (78013) |
$1,142.60 |
$1,142.60 |
2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,773.93 |
$1,773.93 |
4.5× |
| Tmj unilateral (70328) |
$304.65 |
$304.65 |
3.5× |
| Treatment device complex (77334) |
$1,208.37 |
$1,208.37 |
3.3× |
| Treatment device intermediate (77333) |
$746.83 |
$746.83 |
5.6× |
| Treatment devices simple (77332) |
$511.89 |
$511.89 |
3.9× |
| Ultrasound breast complete (76641) |
$609.72 |
$609.72 |
5.9× |
| Ultrasound Exam Aaa Screen (76706) |
$619.40 |
$619.40 |
6.0× |
| Ultrasound, abdomen limited (76705) |
$613.76 |
$613.76 |
5.9× |
| Umbilical-artery Doppler (OB) (76820) |
$634.83 |
$634.83 |
6.1× |
| Unlisted fluoroscopic procedure (76496) |
$322.38 |
$322.38 |
3.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$1,083.92 |
$1,083.92 |
98.0× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$986.84 |
$986.84 |
10.5× |
| Urethrocystogram voiding (74455) |
$1,038.21 |
$1,038.21 |
4.4× |
| Urethrocystography retrograde rs&i (74450) |
$1,038.21 |
$1,038.21 |
4.4× |
| Us breast unilateral limited (76642) |
$304.87 |
$304.87 |
3.5× |
| Us chest (76604) |
$711.26 |
$711.26 |
6.9× |
| Us compl joint r-t w/image documentation (76881) |
$590.07 |
$590.07 |
5.7× |
| Us encephalogram (76506) |
$1,949.35 |
$1,949.35 |
18.9× |
| Us infant hips w manipulation (76885) |
$877.20 |
$877.20 |
10.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$381.97 |
$381.97 |
3.7× |
| Us ob limited (76815) |
$413.59 |
$413.59 |
4.0× |
| Us ob transvaginal (76817) |
$613.76 |
$613.76 |
5.9× |
| Us pelvic non ob complete (76856) |
$1,169.60 |
$1,169.60 |
11.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$600.63 |
$600.63 |
5.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$648.03 |
$648.03 |
6.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$381.97 |
$381.97 |
3.7× |
| Us retroperitoneal complete (76770) |
$1,307.90 |
$1,307.90 |
12.7× |
| Us retroperitoneal limited (76775) |
$500.50 |
$500.50 |
4.8× |
| Us scrotum and contents (76870) |
$1,074.78 |
$1,074.78 |
10.4× |
| Us soft tissue head/neck (76536) |
$921.99 |
$921.99 |
8.9× |
| Us spinal canal and contents (76800) |
$626.92 |
$626.92 |
6.1× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,156.41 |
$1,156.41 |
11.2× |
| Venogram extremity bilateral (75822) |
$2,043.44 |
$2,043.44 |
1.3× |
| Venogram Extremity Unilateral (75820) |
$2,043.44 |
$2,043.44 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$11,806.29 |
$11,806.29 |
3.8× |
| Venography caval superior serialography rs&i (75827) |
$4,368.66 |
$4,368.66 |
2.8× |
| Venography Renal Bilateral (75833) |
$11,801.20 |
$11,801.20 |
3.8× |
| Venography renal unilateral selective rs&i (75831) |
$7,744.80 |
$7,744.80 |
2.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,368.66 |
$4,368.66 |
1.4× |
| Venous sampling by catheter (75893) |
$7,744.80 |
$7,744.80 |
1.4× |
| Vertebral fracture assessment via dxa (77086) |
$418.43 |
$418.43 |
4.9× |
| Wrist 2 views (73100) |
$660 |
$660 |
7.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,342.85 |
$1,342.85 |
15.6× |
| X-ray b.e. reductn intuss (74283) |
$601.62 |
$601.62 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,731.24 |
$1,731.24 |
10.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$418.20 |
$418.20 |
4.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$396.96 |
$396.96 |
4.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$657.34 |
$657.34 |
6.4× |
| X-ray exam of femur 2/> (73552) |
$396.96 |
$396.96 |
4.6× |
| X-ray eye for foreign body (70030) |
$255.74 |
$255.74 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$289.40 |
$289.40 |
3.4× |
| X-ray IV pyelogram (ivp) (74400) |
$1,820.05 |
$1,820.05 |
10.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$538.15 |
$538.15 |
6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$411.25 |
$411.25 |
4.8× |
| X-ray leg, infant (73592) |
$322.38 |
$322.38 |
3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$736.15 |
$736.15 |
7.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$2,081.54 |
$2,081.54 |
20.2× |
| X-ray nose-rectum child f.b. (76010) |
$281.80 |
$281.80 |
3.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$855.46 |
$855.46 |
8.3× |
| X-ray retrograde pyelogram (74420) |
$1,531.94 |
$1,531.94 |
4.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$614.31 |
$614.31 |
7.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$982.39 |
$982.39 |
9.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,375.85 |
$1,375.85 |
13.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$520.38 |
$520.38 |
5.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$944.31 |
$944.31 |
11.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$865.59 |
$865.59 |
10.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,177.84 |
$1,177.84 |
11.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$642.24 |
$642.24 |
6.2× |
| X-Ray Small Bowel Enteroclysis (74251) |
$1,383.44 |
$1,383.44 |
8.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$322.38 |
$322.38 |
3.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$1,319.76 |
$1,319.76 |
15.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$708.22 |
$708.22 |
8.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$662.54 |
$662.54 |
6.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$954.47 |
$954.47 |
9.2× |
| Xr bone length studies (77073) |
$860.53 |
$860.53 |
8.3× |
| Xr c-spine 4 or 5 views (72050) |
$827.53 |
$827.53 |
8.0× |
| Xr c-spine 6 or more views (72052) |
$1,375.85 |
$1,375.85 |
13.3× |
| Xr chest 4+ views (71048) |
$984.92 |
$984.92 |
9.5× |
| Xr urogram antegrade (74425) |
$1,034.40 |
$1,034.40 |
3.0× |