| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,985.05 |
$5,365 |
1.3× |
| Abdomen 2 views (74019) |
$230.88 |
$624 |
2.1× |
| Acute gi blood loss imaging (78278) |
$1,434.86 |
$3,878 |
3.4× |
| Angiography extremity bilateral rs&i (75716) |
$3,839.49 |
$10,377 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$2,819.03 |
$7,619 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$1,319.42 |
$3,566 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,242.31 |
$8,763 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,054.20 |
$13,660 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,046.21 |
$8,233 |
0.9× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,579.53 |
$4,269 |
0.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,242.31 |
$8,763 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,620.19 |
$12,487 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,177.08 |
$5,884 |
0.6× |
| Ankle 2 views (73600) |
$218.30 |
$590 |
2.3× |
| Aortogram thoracic (75605) |
$3,226.03 |
$8,719 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,265.36 |
$11,528 |
1.3× |
| Aortography abdominal serialography rs&i (75625) |
$3,412.51 |
$9,223 |
1.0× |
| Arthrogram ankle (73615) |
$276.39 |
$747 |
0.7× |
| Arthrogram elbow (73085) |
$680.80 |
$1,840 |
1.8× |
| Arthrogram hip (73525) |
$703.74 |
$1,902 |
1.9× |
| Arthrogram knee (73580) |
$694.49 |
$1,877 |
1.9× |
| Arthrogram shoulder (73040) |
$682.28 |
$1,844 |
1.8× |
| Arthrogram wrist (73115) |
$626.41 |
$1,693 |
1.7× |
| Basic dosimetry (77300) |
$216.45 |
$585 |
1.5× |
| Bone &/joint imaging whole body (78306) |
$1,052.28 |
$2,844 |
2.5× |
| Bone age studies (77072) |
$230.88 |
$624 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,335.70 |
$3,610 |
3.1× |
| Bone survey complete (77075) |
$288.60 |
$780 |
2.6× |
| Bone survey infant (77076) |
$580.16 |
$1,568 |
5.2× |
| Bowel imaging (78290) |
$1,432.64 |
$3,872 |
3.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,431.53 |
$3,869 |
2.5× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$981.61 |
$2,653 |
2.3× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$2,409.44 |
$6,512 |
2.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,221.37 |
$3,301 |
3.3× |
| Cervical spine 2 or 3 views (72040) |
$278.61 |
$753 |
3.0× |
| Chest 1 view (71045) |
$166.50 |
$450 |
1.8× |
| Chest xray 3 views (71047) |
$203.87 |
$551 |
2.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$430.68 |
$1,164 |
2.3× |
| Clavicle complete (73000) |
$237.17 |
$641 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$775.89 |
$2,097 |
7.0× |
| Continuing medical physics consltj pr wk (77336) |
$474.71 |
$1,283 |
3.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,882.93 |
$5,089 |
5.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,255.04 |
$3,392 |
4.9× |
| CT abdomen w contrast (74160) |
$836.94 |
$2,262 |
4.5× |
| CT abdomen w wo contrast (74170) |
$1,045.99 |
$2,827 |
5.6× |
| CT abdomen w/o contrast (74150) |
$711.51 |
$1,923 |
6.4× |
| CT angio hrt w/3d image (75574) |
$1,050.06 |
$2,838 |
2.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$836.94 |
$2,262 |
4.5× |
| CT angiography upper extremity lt (73206) |
$720.02 |
$1,946 |
3.8× |
| CT c-spine w/contrast (72126) |
$497.65 |
$1,345 |
1.3× |
| CT c-spine w/o contrast (72125) |
$473.60 |
$1,280 |
4.2× |
| CT chest w contrast (71260) |
$836.94 |
$2,262 |
4.5× |
| CT chest w/wo contrast (71270) |
$890.96 |
$2,408 |
4.8× |
| CT head/brain with contrast (70460) |
$685.24 |
$1,852 |
3.7× |
| CT head/brain without and with contrast (70470) |
$765.53 |
$2,069 |
4.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$511.34 |
$1,382 |
1.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$120.44 |
$325.50 |
1.3× |
| CT hrt w/3d image congen (75573) |
$659.71 |
$1,783 |
1.8× |
| CT iac w contrast (70481) |
$497.65 |
$1,345 |
2.7× |
| CT limited/localized follow up study (76380) |
$176.86 |
$478 |
1.9× |
| CT lower ext w/o (73700) |
$669.33 |
$1,809 |
6.0× |
| CT lower extremity w/contrast material (73701) |
$795.13 |
$2,149 |
4.2× |
| CT lumbar spine w/contrast (72132) |
$861.73 |
$2,329 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$818.81 |
$2,213 |
7.3× |
| CT maxillofacial w contrast (70487) |
$496.54 |
$1,342 |
2.7× |
| CT maxillofacial w/wo contrast (70488) |
$691.53 |
$1,869 |
3.7× |
| CT maxillofacial wo contrast (70486) |
$402.93 |
$1,089 |
3.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$636.03 |
$1,719 |
3.4× |
| CT orbits w/o contrast (70480) |
$423.28 |
$1,144 |
3.8× |
| CT pelvis w/o contrast (72192) |
$767.38 |
$2,074 |
6.9× |
| CT pelvis w/wo contrast (72194) |
$1,076.70 |
$2,910 |
5.7× |
| CT soft tissue neck w contrast (70491) |
$512.45 |
$1,385 |
2.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$636.77 |
$1,721 |
3.4× |
| CT soft tissue neck w/o contrast (70490) |
$419.58 |
$1,134 |
3.8× |
| CT thoracic spine w/contrast (72129) |
$818.81 |
$2,213 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$695.97 |
$1,881 |
6.2× |
| CT thorax w/o contrast (71250) |
$397.56 |
$1,074.50 |
3.6× |
| CT upper ext wo (73200) |
$603.47 |
$1,631 |
5.4× |
| CT upper extremity with contrast (73201) |
$775.89 |
$2,097 |
2.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,045.99 |
$2,827 |
5.6× |
| Cta Abdomen (74175) |
$1,045.99 |
$2,827 |
5.6× |
| CTA abdomen pelvis (74174) |
$1,255.04 |
$3,392 |
3.4× |
| CTA chest (71275) |
$1,045.99 |
$2,827 |
5.6× |
| Cta Head (70496) |
$583.49 |
$1,577 |
3.1× |
| Cta Neck (70498) |
$949.05 |
$2,565 |
5.1× |
| Cta Pelvis (72191) |
$836.94 |
$2,262 |
4.5× |
| Cystography minimum 3 views rs&i (74430) |
$115.81 |
$313 |
0.3× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$2,037.96 |
$5,508 |
0.9× |
| Diskography lumbar (72295) |
$795.13 |
$2,149 |
0.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$464.72 |
$1,256 |
4.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$442.89 |
$1,197 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$245.31 |
$663 |
2.6× |
| Dxa bone density study axial skeleton (77085) |
$204.61 |
$553 |
1.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$484.70 |
$1,310 |
1.9× |
| Esophagus (74220) |
$397.38 |
$1,074 |
2.1× |
| Facial bones min 3 views (70150) |
$331.52 |
$896 |
3.0× |
| Fetal biophysical profile non-stress testing (76818) |
$564.62 |
$1,526 |
5.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$456.21 |
$1,233 |
4.1× |
| Fetal Echo (76825) |
$967.92 |
$2,616 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$426.98 |
$1,154 |
1.7× |
| Foot 2 views (73620) |
$121.73 |
$329 |
1.3× |
| Forearm 2 views (73090) |
$261.59 |
$707 |
2.8× |
| Hand 2 views (73120) |
$270.10 |
$730 |
2.4× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,554.85 |
$6,905 |
3.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,371.81 |
$9,113 |
4.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,118.95 |
$13,835 |
1.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,397.12 |
$3,776 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,903.65 |
$5,145 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,435.60 |
$3,880 |
3.4× |
| Hysterosalpingogram (74740) |
$417.73 |
$1,129 |
1.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$102.86 |
$278 |
0.9× |
| Kidney imaging morphology (78700) |
$658.23 |
$1,779 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$868.39 |
$2,347 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$888.74 |
$2,402 |
1.5× |
| Knee 3 views (73562) |
$148.37 |
$401 |
1.6× |
| Liver & spleen imaging static only (78215) |
$752.21 |
$2,033 |
1.8× |
| Lung perfusion differential (78597) |
$795.87 |
$2,151 |
1.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,378.62 |
$3,726 |
0.4× |
| Lymphoscintigraphy (78195) |
$1,343.10 |
$3,630 |
2.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,055.35 |
$5,555 |
2.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,363.93 |
$6,389 |
6.3× |
| Magnetic Resonance Elastography (76391) |
$1,432.27 |
$3,871 |
5.6× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$260.48 |
$704 |
2.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,451.88 |
$3,924 |
3.6× |
| MRA head w & w/o contrast (70546) |
$1,791.54 |
$4,842 |
4.8× |
| MRA head w/o contrast (70544) |
$1,194.36 |
$3,228 |
4.7× |
| MRA head with contrast (70545) |
$1,217.67 |
$3,291 |
3.3× |
| MRA neck w contrast (70548) |
$799.94 |
$2,162 |
2.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,776.74 |
$4,802 |
4.8× |
| MRA neck w/o contrast (70547) |
$1,312.76 |
$3,548 |
5.2× |
| MRI abdomen w contrast (74182) |
$2,169.68 |
$5,864 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,530.06 |
$6,838 |
6.8× |
| MRI abdomen w/o contrast (74181) |
$1,807.45 |
$4,885 |
7.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,987.64 |
$5,372 |
2.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,398.34 |
$6,482 |
6.4× |
| MRI breast w/o contrast bilateral (77047) |
$1,121.84 |
$3,032 |
4.4× |
| MRI c-spine with contrast (72142) |
$1,825.21 |
$4,933 |
4.9× |
| MRI cardiac w/o cont stress (75559) |
$1,732.71 |
$4,683 |
3.0× |
| MRI cardiac w/o contrast (75557) |
$943.50 |
$2,550 |
3.7× |
| MRI cervical spine w/o contrast (72141) |
$1,551.41 |
$4,193 |
6.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,398.34 |
$6,482 |
6.4× |
| MRI chest w/o contrast (71550) |
$1,918.45 |
$5,185 |
7.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,433.12 |
$6,576 |
6.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,747.51 |
$4,723 |
6.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,531.80 |
$4,140 |
6.0× |
| MRI orbit face neck w contrast (70542) |
$1,801.90 |
$4,870 |
4.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,072 |
$5,600 |
5.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,386.13 |
$6,449 |
6.4× |
| MRI pelvis w/o contrast (72195) |
$1,763.42 |
$4,766 |
6.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,099.01 |
$5,673 |
5.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,169.68 |
$5,864 |
5.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,494.54 |
$6,742 |
6.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,977.28 |
$5,344 |
5.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,494.54 |
$6,742 |
6.7× |
| MRI temporomandibular joint (70336) |
$1,918.45 |
$5,185 |
7.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,842.97 |
$4,981 |
7.2× |
| MRI up ext w/o contrast (73218) |
$1,747.51 |
$4,723 |
6.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,763.42 |
$4,766 |
6.9× |
| MRI, joint upper extrem combo (73223) |
$2,363.93 |
$6,389 |
6.3× |
| Myelogram Lumbar (72265) |
$1,108.89 |
$2,997 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,075.70 |
$5,610 |
1.5× |
| Myocardial spect single study at rest or stress (78451) |
$1,312.02 |
$3,546 |
0.9× |
| N-invas est c ffr sw aly CTA (75580) |
$376.66 |
$1,018 |
0.4× |
| Neck soft tissue (70360) |
$203.87 |
$551 |
2.2× |
| Nm cisternogram (78630) |
$1,457.43 |
$3,939 |
2.5× |
| Nm gastric emptying study (78264) |
$1,374.18 |
$3,714 |
3.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,150.40 |
$13,920 |
3.5× |
| Nuclear Rx Oral Admin (79005) |
$489.51 |
$1,323 |
2.0× |
| Ob us nuchal meas 1 gest (76813) |
$443.63 |
$1,199 |
4.0× |
| Orthopantogram (70355) |
$123.21 |
$333 |
1.3× |
| Osseous survey limited (77074) |
$265.29 |
$717 |
2.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,563.99 |
$4,227 |
2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,041.18 |
$2,814 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$237.17 |
$641 |
2.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,174.01 |
$3,173 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,097.42 |
$2,966 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,350.87 |
$3,651 |
2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$408.48 |
$1,104 |
0.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$274.54 |
$742 |
3.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$240.50 |
$650 |
2.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$300.81 |
$813 |
3.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$239.39 |
$647 |
2.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$266.03 |
$719 |
2.4× |
| Radex fingr minimum 2 views (73140) |
$90.65 |
$245 |
1.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$133.94 |
$362 |
1.4× |
| Radex Hand Minimum 3 Views (73130) |
$270.10 |
$730 |
2.9× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$225.70 |
$610 |
2.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$302.29 |
$817 |
2.7× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$409.22 |
$1,106 |
3.7× |
| Radex Humerus Minimum 2 Views (73060) |
$278.61 |
$753 |
3.0× |
| Radex Kne 1/2 Views (73560) |
$146.15 |
$395 |
1.6× |
| Radex Kne Compl 4/More Views (73564) |
$182.78 |
$494 |
1.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$211.64 |
$572 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$270.10 |
$730 |
2.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$276.76 |
$748 |
2.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$293.04 |
$792 |
3.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$166.13 |
$449 |
1.8× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$274.54 |
$742 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$341.51 |
$923 |
3.7× |
| Radex Toe Minimum 2 Views (73660) |
$200.17 |
$541 |
2.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$180.56 |
$488 |
1.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$278.61 |
$753 |
3.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$12,228.50 |
$33,050 |
1.6× |
| Radiation treatment delivery level 1 (77402) |
$664.89 |
$1,797 |
6.1× |
| Radiation treatment delivery level 2 (77407) |
$974.58 |
$2,634 |
2.4× |
| Radiation treatment delivery level 3 (77412) |
$1,564.36 |
$4,228 |
2.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$200.91 |
$543 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$260.85 |
$705 |
2.3× |
| Radiologic exam chest 2 views (71046) |
$188.70 |
$510 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$525.77 |
$1,421 |
2.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$352.24 |
$952 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$536.50 |
$1,450 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$436.23 |
$1,179 |
2.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$270.10 |
$730 |
2.9× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$167.24 |
$452 |
1.5× |
| Radiological examination surgical specimen (76098) |
$437.34 |
$1,182 |
0.7× |
| Renal Cyst Study (74470) |
$2,034.26 |
$5,498 |
3.5× |
| Ribs bilateral 3 views (71110) |
$342.99 |
$927 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,004.92 |
$2,716 |
2.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,318.05 |
$6,265 |
4.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,354.20 |
$3,660 |
2.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,341.62 |
$3,626 |
2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,593.81 |
$9,713 |
2.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,833.72 |
$4,956 |
1.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$434.38 |
$1,174 |
1.7× |
| Rp Therapy Intravenous Administration (79101) |
$518.74 |
$1,402 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$261.59 |
$707 |
2.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$524.29 |
$1,417 |
2.1× |
| Scapula (73010) |
$237.17 |
$641 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$63.27 |
$171 |
2.7× |
| Shoulder 1 view (73020) |
$237.17 |
$641 |
2.6× |
| Simulation intermediate (77285) |
$1,764.16 |
$4,768 |
4.4× |
| Small bowel series (74250) |
$451.77 |
$1,221 |
2.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$265.66 |
$718 |
0.7× |
| Special dosimetry (77331) |
$427.35 |
$1,155 |
3.0× |
| Special Physics Consult (77370) |
$581.64 |
$1,572 |
4.1× |
| Special treatment procedure (77470) |
$691.16 |
$1,868 |
1.2× |
| Stereotactic Body Radiation Delivery (77373) |
$2,918.56 |
$7,888 |
1.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$737.04 |
$1,992 |
1.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$381.47 |
$1,031 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,494.17 |
$6,741 |
6.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,226.18 |
$3,314 |
8.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,226.18 |
$3,314 |
2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$981.61 |
$2,653 |
2.3× |
| Tmj unilateral (70328) |
$177.97 |
$481 |
1.9× |
| Treatment device complex (77334) |
$557.96 |
$1,508 |
1.4× |
| Treatment device intermediate (77333) |
$522.81 |
$1,413 |
3.6× |
| Treatment devices simple (77332) |
$331.89 |
$897 |
2.3× |
| Ultrasound breast complete (76641) |
$298.59 |
$807 |
2.7× |
| Ultrasound elastography first target lesion (76982) |
$252.71 |
$683 |
2.3× |
| Ultrasound Exam Aaa Screen (76706) |
$431.79 |
$1,167 |
3.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$660.82 |
$1,786 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$519.11 |
$1,403 |
4.7× |
| Umbilical-artery Doppler (OB) (76820) |
$386.28 |
$1,044 |
3.5× |
| Unlisted magnetic resonance procedure (76498) |
$318.20 |
$860 |
3.4× |
| Ureteral reflux study (78740) |
$835.83 |
$2,259 |
2.0× |
| Urethrocystogram voiding (74455) |
$509.49 |
$1,377 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$979.39 |
$2,647 |
3.8× |
| Us breast unilateral limited (76642) |
$241.98 |
$654 |
2.6× |
| Us chest (76604) |
$365.19 |
$987 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$439.56 |
$1,188 |
3.9× |
| Us elastography parenchyma (76981) |
$252.71 |
$683 |
2.3× |
| Us encephalogram (76506) |
$363.34 |
$982 |
3.3× |
| Us hips infant static (76886) |
$364.45 |
$985 |
3.9× |
| Us infant hips w manipulation (76885) |
$382.95 |
$1,035 |
4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$212.01 |
$573 |
1.9× |
| Us ob detailed single fetus (76811) |
$886.89 |
$2,397 |
3.5× |
| Us ob limited (76815) |
$414.77 |
$1,121 |
3.7× |
| Us ob transvaginal (76817) |
$426.24 |
$1,152 |
3.8× |
| Us pelvic non ob complete (76856) |
$528.73 |
$1,429 |
4.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$411.07 |
$1,111 |
3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$604.58 |
$1,634 |
5.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$443.26 |
$1,198 |
4.0× |
| Us retroperitoneal complete (76770) |
$620.12 |
$1,676 |
5.6× |
| Us retroperitoneal limited (76775) |
$514.67 |
$1,391 |
4.6× |
| Us scrotum and contents (76870) |
$443.63 |
$1,199 |
4.0× |
| Us soft tissue head/neck (76536) |
$459.91 |
$1,243 |
4.1× |
| Us spinal canal and contents (76800) |
$685.98 |
$1,854 |
6.1× |
| Us transrectal (76872) |
$297.48 |
$804 |
2.7× |
| Us, eye b-scan (76512) |
$467.68 |
$1,264 |
4.2× |
| Us,transplanted kidney, real time/ doppler (76776) |
$293.78 |
$794 |
2.6× |
| Venogram extremity bilateral (75822) |
$1,279.46 |
$3,458 |
0.8× |
| Venogram Extremity Unilateral (75820) |
$1,622.45 |
$4,385 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,412.51 |
$9,223 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$2,986.27 |
$8,071 |
1.8× |
| Venography Renal Bilateral (75833) |
$2,837.90 |
$7,670 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,805.71 |
$7,583 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,207.16 |
$8,668 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$255.30 |
$690 |
2.7× |
| Wrist 2 views (73100) |
$261.59 |
$707 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$353.72 |
$956 |
3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$261.59 |
$707 |
2.8× |
| X-ray b.e. reductn intuss (74283) |
$623.08 |
$1,684 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$700.78 |
$1,894 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$278.61 |
$753 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$278.61 |
$753 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$329.30 |
$890 |
2.9× |
| X-ray exam of femur 2/> (73552) |
$270.10 |
$730 |
2.9× |
| X-ray eye for foreign body (70030) |
$138.38 |
$374 |
1.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$235.69 |
$637 |
2.5× |
| X-ray IV pyelogram (ivp) (74400) |
$473.23 |
$1,279 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$189.07 |
$511 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$247.53 |
$669 |
2.7× |
| X-ray leg, infant (73592) |
$180.56 |
$488 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$340.77 |
$921 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$487.29 |
$1,317 |
4.4× |
| X-ray nose-rectum child f.b. (76010) |
$128.02 |
$346 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$239.02 |
$646 |
2.1× |
| X-ray retrograde pyelogram (74420) |
$1,735.30 |
$4,690 |
4.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$245.31 |
$663 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$335.22 |
$906 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$345.21 |
$933 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$296.74 |
$802 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$293.04 |
$792 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$320.42 |
$866 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$431.79 |
$1,167 |
3.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$234.95 |
$635 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$213.49 |
$577 |
2.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$242.72 |
$656 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$278.61 |
$753 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$301.18 |
$814 |
2.7× |
| Xr bone length studies (77073) |
$377.40 |
$1,020 |
3.4× |
| Xr c-spine 4 or 5 views (72050) |
$409.22 |
$1,106 |
3.7× |
| Xr c-spine 6 or more views (72052) |
$442.89 |
$1,197 |
4.0× |
| Xr chest 4+ views (71048) |
$219.41 |
$593 |
2.0× |
| Xr urogram antegrade (74425) |
$1,735.30 |
$4,690 |
4.7× |