| 3-D radiotherapy plan dose-volume histograms (77295) |
$9,377.55 |
$20,839 |
5.3× |
| Abdomen 1 View (74018) |
$876.15 |
$1,947 |
7.8× |
| Abdomen 2 views (74019) |
$496.35 |
$1,103 |
3.7× |
Acute Gastrointestinal Blood Loss Imaging (78278)
range across 2 matching MRF lines |
$851.85–$2,617.20 |
$1,893–$5,816 |
varies |
| Adrenal Cortex & Medulla Img (78075) |
$1,107.45 |
$2,461 |
0.7× |
| Angio pulmonary bilat (75743) |
$4,579.65 |
$10,177 |
1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$6,751.35 |
$15,003 |
1.7× |
| Angiography extremity bilateral rs&i (75716) |
$6,878.70 |
$15,286 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$6,878.70 |
$15,286 |
1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,579.65 |
$10,177 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$6,250.95 |
$13,891 |
1.5× |
| Ankle 2 views (73600) |
$752.85 |
$1,673 |
6.7× |
| Aortography thoracic serialography rs&i (75605) |
$6,751.35 |
$15,003 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$6,751.35 |
$15,003 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$6,250.95 |
$13,891 |
1.5× |
| Artery X-Rays Pelvis (75736) |
$6,751.35 |
$15,003 |
0.9× |
| Artery X-Rays Spine (75705) |
$7,834.05 |
$17,409 |
1.1× |
| Arthrogram ankle (73615) |
$303.30 |
$674 |
0.7× |
| Arthrogram hip (73525) |
$874.35 |
$1,943 |
1.9× |
| Arthrogram Wrist (73115) |
$231.75 |
$515 |
0.5× |
| Basic radiation dosimetry calculation (77300) |
$630.90 |
$1,402 |
3.6× |
| Bone age studies (77072) |
$599.40 |
$1,332 |
4.5× |
| Bone Imaging 3 Phase (78315) |
$1,966.50 |
$4,370 |
3.8× |
| Bone Imaging Limited Area (78300) |
$1,359 |
$3,020 |
2.6× |
| Bone Imaging Multiple Areas (78305) |
$1,134 |
$2,520 |
2.2× |
| Bone Imaging Whole Body (78306) |
$2,362.50 |
$5,250 |
4.6× |
| Bone marrow imaging limited area (78102) |
$874.35 |
$1,943 |
1.7× |
| Bone marrow imaging; whole body (78104) |
$1,291.95 |
$2,871 |
2.5× |
| Bone survey infant (77076) |
$864.90 |
$1,922 |
6.4× |
| Brain Flow Imaging Only (78610) |
$1,271.25 |
$2,825 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,053.45 |
$2,341 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$785.70 |
$1,746 |
1.8× |
| Cat Scan Follow-Up Study (76380) |
$139.50 |
$310 |
1.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$661.50 |
$1,470 |
0.9× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$996.30 |
$2,214 |
1.4× |
| Cerebrospinal Fluid Scan (78630) |
$1,686.60 |
$3,748 |
2.4× |
| Chest 1 view (71045) |
$761.85 |
$1,693 |
6.8× |
| Chest 2 views (71046) |
$761.85 |
$1,693 |
6.8× |
| Chest 3 views (71047) |
$706.50 |
$1,570 |
6.3× |
| Chest 4 or more views (71048) |
$989.10 |
$2,198 |
7.4× |
| Clavicle complete (73000) |
$770.85 |
$1,713 |
6.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$225 |
$500 |
1.7× |
| Continuing medical physics consltj pr wk (77336) |
$879.30 |
$1,954 |
5.1× |
| Contrast Exam Abdominl Aorta (75625) |
$6,878.70 |
$15,286 |
1.7× |
| Contrast X-Ray Bladder (74430) |
$564.75 |
$1,255 |
1.3× |
| Contrast X-Ray Of Elbow (73085) |
$303.30 |
$674 |
0.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$378.90 |
$842 |
0.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,375 |
$7,500 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,925 |
$6,500 |
9.5× |
| CT abdomen w contrast (74160) |
$2,250 |
$5,000 |
10.0× |
| CT abdomen w wo contrast (74170) |
$2,250 |
$5,000 |
10.0× |
| CT abdomen w/o contrast (74150) |
$2,250 |
$5,000 |
16.7× |
| CT Angio Abdomen and Pelvis (74174) |
$2,925 |
$6,500 |
6.5× |
| CT Angio Chest (71275) |
$2,250 |
$5,000 |
10.0× |
| CT Angio Head (70496) |
$2,250 |
$5,000 |
10.0× |
| CT angio hrt w/3d image (75574) |
$3,375 |
$7,500 |
7.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,925 |
$6,500 |
13.0× |
| CT Angio Neck (70498) |
$2,250 |
$5,000 |
10.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,250 |
$5,000 |
10.0× |
| CT cervical spine w/ contrast (72126) |
$2,250 |
$5,000 |
5.0× |
| CT cervical spine w/o contrast (72125) |
$2,250 |
$5,000 |
16.7× |
| CT cervical spine w/wo cont (72127) |
$2,250 |
$5,000 |
10.0× |
| CT chest w contrast (71260) |
$2,250 |
$5,000 |
10.0× |
| CT chest w/wo contrast (71270) |
$2,250 |
$5,000 |
10.0× |
| CT head/brain with contrast (70460) |
$2,925 |
$6,500 |
13.0× |
| CT head/brain without and with contrast (70470) |
$2,250 |
$5,000 |
10.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,375 |
$7,500 |
7.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$2,250 |
$5,000 |
20.1× |
| CT iac w contrast (70481) |
$2,250 |
$5,000 |
10.0× |
| CT l-spine w&w/o contrast (72133) |
$2,250 |
$5,000 |
10.0× |
| CT lower ext w/o (73700) |
$2,250 |
$5,000 |
16.7× |
| CT lower extremity w/contrast material (73701) |
$2,250 |
$5,000 |
10.0× |
| CT lumbar spine w contrast (72132) |
$2,250 |
$5,000 |
5.0× |
| CT lumbar spine w/o contrast (72131) |
$2,250 |
$5,000 |
16.7× |
| CT maxillofacial w contrast (70487) |
$2,250 |
$5,000 |
10.0× |
| CT maxillofacial wo contrast (70486) |
$2,250 |
$5,000 |
16.7× |
| CT neck tissue combo (70492) |
$2,250 |
$5,000 |
10.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,250 |
$5,000 |
10.0× |
| CT orbits w/o contrast (70480) |
$2,250 |
$5,000 |
16.7× |
| CT pelvis w&w/o contrast (72194) |
$2,250 |
$5,000 |
10.0× |
| CT pelvis w/o contrast (72192) |
$2,250 |
$5,000 |
16.7× |
| CT scan of leg combo (73702) |
$2,250 |
$5,000 |
10.0× |
| CT scans face/jaw combo (70488) |
$2,250 |
$5,000 |
10.0× |
| CT soft tissue neck w contrast (70491) |
$2,250 |
$5,000 |
10.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,250 |
$5,000 |
16.7× |
| CT thoracic spine w contrast (72129) |
$2,250 |
$5,000 |
10.0× |
| CT thoracic spine w/o contrast (72128) |
$2,250 |
$5,000 |
16.7× |
| CT thoracic spine w/wo cont (72130) |
$2,250 |
$5,000 |
10.0× |
| CT thorax w/o contrast (71250) |
$2,250 |
$5,000 |
16.7× |
| CT upper ext wo (73200) |
$2,250 |
$5,000 |
16.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,250 |
$5,000 |
10.0× |
| CT upper extremity with contrast (73201) |
$2,250 |
$5,000 |
5.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,375 |
$7,500 |
15.0× |
| Cta Abdomen (74175) |
$2,250 |
$5,000 |
10.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,500 |
$10,000 |
10.0× |
| CTA pelvis (72191) |
$2,250 |
$5,000 |
10.0× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) |
$570.15 |
$1,267 |
0.8× |
| Discography Cerv/Thor Spine (72285) |
$2,708.10 |
$6,018 |
1.1× |
| Diskography lumbar (72295) |
$6,250.95 |
$13,891 |
2.5× |
| Dxa Bone Density Axial (77080) |
$306 |
$680 |
2.3× |
| Echo exam uterus (76831) |
$405 |
$900 |
1.3× |
| Echo Guide For Artery Repair (76936) |
$1,557.45 |
$3,461 |
5.6× |
| Esophagram (74220) |
$1,030.50 |
$2,290 |
4.6× |
| Fetal Biophys Profile W/Nst (76818) |
$211.50 |
$470 |
1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$286.65 |
$637 |
2.1× |
| Fluoroscopy up to 1 hr (76000) |
$428.85 |
$953 |
1.4× |
| Follow-Up Angiography (75898) |
$3,081.15 |
$6,847 |
0.8× |
| Foot 2 views (73620) |
$789.75 |
$1,755 |
7.1× |
| Forearm 2 views (73090) |
$782.55 |
$1,739 |
7.0× |
| Gastric emptying imaging study (78264) |
$2,478.15 |
$5,507 |
4.8× |
| Gastroesophageal Reflux Exam (78262) |
$708.30 |
$1,574 |
1.4× |
| Gated Heart Planar Single (78472) |
$537.30 |
$1,194 |
1.0× |
| Gated Heart, Multiple (78473) |
$501.75 |
$1,115 |
1.0× |
| Hand 2 views (73120) |
$740.70 |
$1,646 |
5.5× |
| Heart first pass single,planar (78481) |
$759.15 |
$1,687 |
1.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,751.35 |
$15,003 |
1.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$6,372 |
$14,160 |
1.6× |
Hepatobil Syst Image W/Drug (78227)
range across 2 matching MRF lines |
$1,015.20–$2,263.50 |
$2,256–$5,030 |
varies |
| Hepatobiliary System Imaging (78226) |
$1,220.85 |
$2,713 |
2.4× |
| Ht Muscle Image Spect Sing (78451) |
$2,328.75 |
$5,175 |
1.4× |
| Hysterosalpingogram (74740) |
$897.75 |
$1,995 |
2.9× |
| Image fusion (77399) |
$530.10 |
$1,178 |
3.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$195.75 |
$435 |
1.7× |
| Infant hip ultrasound, limited static exam (76886) |
$129.15 |
$287 |
1.2× |
| Joint Survey Single View (77077) |
$313.20 |
$696 |
2.3× |
| K Flow/Funct Image Multiple (78709) |
$4,821.30 |
$10,714 |
6.9× |
| K Flow/Funct Image W/Drug (78708) |
$2,210.40 |
$4,912 |
3.2× |
| K Flow/Funct Image W/O Drug (78707) |
$871.20 |
$1,936 |
1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,664.55 |
$3,699 |
3.2× |
| Knee 3 Views (73562) |
$670.05 |
$1,489 |
6.0× |
| Leveen/Shunt Patency Exam (78291) |
$942.75 |
$2,095 |
1.8× |
| Liver imaging w/vascular flow (78202) |
$676.35 |
$1,503 |
1.0× |
| Lung perfusion differential (78597) |
$1,475.10 |
$3,278 |
2.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,221.65 |
$4,937 |
3.2× |
| Lung Ventilation Imaging (78579) |
$772.20 |
$1,716 |
1.5× |
| Lymph System Imaging (78195) |
$1,266.30 |
$2,814 |
1.8× |
| Magnetic Image Jaw Joint (70336) |
$501.75 |
$1,115 |
1.6× |
| Meckels Divert Exam (78290) |
$1,080.90 |
$2,402 |
2.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,525.40 |
$5,612 |
5.2× |
| Mr safety determination physician/other qhp (76016) |
$113.40 |
$252 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$31.50 |
$70 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$118.35 |
$263 |
1.0× |
| Mr safety implt pos&/immoblj (76019) |
$76.50 |
$170 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$311.40 |
$692 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,631.70 |
$3,626 |
3.6× |
| MRA head w/o contrast (70544) |
$1,797.30 |
$3,994 |
5.9× |
| MRA head with contrast (70545) |
$1,631.70 |
$3,626 |
3.6× |
| MRA neck w contrast (70548) |
$916.65 |
$2,037 |
2.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,057.95 |
$2,351 |
2.4× |
| MRA neck w/o contrast (70547) |
$1,797.30 |
$3,994 |
5.9× |
| MRI abdomen w contrast (74182) |
$1,228.95 |
$2,731 |
2.7× |
| MRI abdomen w/o contrast (74181) |
$3,726.90 |
$8,282 |
12.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,057.95 |
$2,351 |
1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,664.10 |
$3,698 |
3.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,579.05 |
$3,509 |
1.6× |
| MRI bone marrow blood supply (77084) |
$785.70 |
$1,746 |
2.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$642.60 |
$1,428 |
2.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$596.25 |
$1,325 |
1.9× |
| MRI cervical spine w contrast (72142) |
$3,915 |
$8,700 |
8.7× |
| MRI cervical spine w/o cont (72141) |
$3,726.90 |
$8,282 |
12.1× |
| MRI chest w/o contrast (71550) |
$3,726.90 |
$8,282 |
12.1× |
| MRI chest with contrast (71551) |
$1,579.05 |
$3,509 |
1.6× |
| MRI chest wo w contrast (71552) |
$1,057.95 |
$2,351 |
2.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$916.65 |
$2,037 |
2.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,726.90 |
$8,282 |
8.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$916.65 |
$2,037 |
3.0× |
| MRI lumbar spine w contrast (72149) |
$3,915 |
$8,700 |
8.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,806.90 |
$10,682 |
10.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$585.45 |
$1,301 |
1.9× |
| MRI orbit face neck w contrast (70542) |
$1,057.95 |
$2,351 |
2.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,726.90 |
$8,282 |
8.3× |
| MRI pelvis w contrast (72196) |
$3,726.90 |
$8,282 |
8.3× |
| MRI pelvis w/o & w contrast (72197) |
$1,228.95 |
$2,731 |
2.7× |
| MRI pelvis w/o contrast (72195) |
$1,228.95 |
$2,731 |
4.0× |
| MRI spectroscopy (76390) |
$642.60 |
$1,428 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$3,726.90 |
$8,282 |
12.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,057.95 |
$2,351 |
2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,404 |
$3,120 |
4.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,450.60 |
$7,668 |
7.7× |
| MRI, abdomen, combo (74183) |
$1,228.95 |
$2,731 |
2.7× |
| MRI, dorsal spine combo (72157) |
$4,806.90 |
$10,682 |
10.7× |
| MRI, dorsal spine contrast (72147) |
$3,915 |
$8,700 |
8.7× |
| MRI, joint upper extrem (73221) |
$2,057.40 |
$4,572 |
6.7× |
| MRI, joint upper extrem combo (73223) |
$1,664.10 |
$3,698 |
3.7× |
| MRI, lumbar spine combo (72158) |
$4,806.90 |
$10,682 |
10.7× |
| Myelogram cervical (72240) |
$1,235.25 |
$2,745 |
1.2× |
| Myelogram Lumbar (72265) |
$1,235.25 |
$2,745 |
1.2× |
| Myelography thoracic (72255) |
$1,235.25 |
$2,745 |
1.2× |
| Myelograpy 2/more regions rs&i (72270) |
$1,713.15 |
$3,807 |
1.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,674 |
$3,720 |
1.0× |
Myocardial Spect Multiple Studies (78452)
range across 2 matching MRF lines |
$2,859.75–$3,058.65 |
$6,355–$6,797 |
varies |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$1,674 |
$3,720 |
0.6× |
| Neck soft tissue (70360) |
$396.45 |
$881 |
3.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$842.85 |
$1,873 |
1.6× |
| Nm csf leak detection (78650) |
$737.10 |
$1,638 |
0.4× |
| Nm myocard infarct spect (78469) |
$1,878.75 |
$4,175 |
2.7× |
| Nonvascular Shunt X-Ray (75809) |
$306 |
$680 |
2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$11,437.65 |
$25,417 |
6.4× |
| Nuclear Rx Intra-Arterial (79445) |
$737.10 |
$1,638 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$645.75 |
$1,435 |
2.2× |
| Ob us nuchal meas 1 gest (76813) |
$220.50 |
$490 |
1.6× |
| Panoramic X-ray of jaws (70355) |
$294.75 |
$655 |
2.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,500.30 |
$3,334 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$784.80 |
$1,744 |
5.8× |
| Pet Image W/Ct Lmtd (78814) |
$2,385 |
$5,300 |
1.3× |
| PET image w/CT, full body (78816) |
$2,551.95 |
$5,671 |
1.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,348.10 |
$5,218 |
1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,579.65 |
$10,177 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,522.80 |
$3,384 |
3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$1,744.65 |
$3,877 |
13.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,153.80 |
$2,564 |
1.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$864 |
$1,920 |
7.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$743.85 |
$1,653 |
6.6× |
| Radex elbow complete minimum 3 views (73080) |
$843.30 |
$1,874 |
7.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$653.85 |
$1,453 |
4.9× |
| Radex fingr minimum 2 views (73140) |
$728.10 |
$1,618 |
6.5× |
| Radex foot complete minimum 3 views (73630) |
$840.60 |
$1,868 |
7.5× |
| Radex Hand Minimum 3 Views (73130) |
$864 |
$1,920 |
7.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$845.55 |
$1,879 |
7.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$396.45 |
$881 |
2.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$951.30 |
$2,114 |
8.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$374.85 |
$833 |
3.3× |
| Radex shoulder complete minimum 2 views (73030) |
$902.70 |
$2,006 |
8.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$306.45 |
$681 |
2.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$447.30 |
$994 |
2.0× |
| Radex Spine 1 View Specify Level (72020) |
$864 |
$1,920 |
7.7× |
| Radex Sternum Minimum 2 Views (71120) |
$596.70 |
$1,326 |
5.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$455.40 |
$1,012 |
4.1× |
| Radex Toe Minimum 2 Views (73660) |
$714.60 |
$1,588 |
6.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$251.10 |
$558 |
1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$864 |
$1,920 |
7.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$708.75 |
$1,575 |
5.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,008.85 |
$33,353 |
1.6× |
| Radiation treatment delivery level 1 (77402) |
$1,090.35 |
$2,423 |
8.3× |
| Radiation treatment delivery level 2 (77407) |
$1,313.55 |
$2,919 |
2.6× |
| Radiation treatment delivery level 3 (77412) |
$1,314 |
$2,920 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$1,109.70 |
$2,466 |
8.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,144.80 |
$2,544 |
8.5× |
| Radiologic exam colon double contrast study (74280) |
$1,275.30 |
$2,834 |
5.7× |
| Radiologic exam colon single contrast study (74270) |
$1,109.25 |
$2,465 |
4.9× |
| Radiologic exam knee complete 4/more views (73564) |
$724.05 |
$1,609 |
5.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$1,039.95 |
$2,311 |
7.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,275.30 |
$2,834 |
5.7× |
| Radiologic exam swallow function contrast study (74230) |
$1,024.65 |
$2,277 |
4.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,337.40 |
$2,972 |
5.9× |
| Radiologic examination femur 1 view (73551) |
$365.40 |
$812 |
3.3× |
| Radiologic examination femur minimum 2 views (73552) |
$435.15 |
$967 |
3.9× |
| Radiologic examination knee 1/2 views (73560) |
$639 |
$1,420 |
5.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$226.35 |
$503 |
1.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$320.85 |
$713 |
2.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$782.55 |
$1,739 |
7.0× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$396.45 |
$881 |
0.6× |
| Renal Cyst Study (74470) |
$939.60 |
$2,088 |
1.3× |
| Ribs bilateral 3 views (71110) |
$320.85 |
$713 |
2.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$907.20 |
$2,016 |
1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,134 |
$2,520 |
2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,805.75 |
$6,235 |
4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,190.25 |
$2,645 |
1.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,454.85 |
$3,233 |
2.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,505.60 |
$5,568 |
1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,844 |
$6,320 |
1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,505.60 |
$5,568 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$503.10 |
$1,118 |
1.7× |
| Scapula (73010) |
$843.30 |
$1,874 |
6.3× |
| Sella turcica (70240) |
$320.85 |
$713 |
2.9× |
| Shoulder 1 view (73020) |
$668.70 |
$1,486 |
6.0× |
| Shoulder Arthrography (73040) |
$1,143.45 |
$2,541 |
2.5× |
| Skull less than 4 views (70250) |
$761.85 |
$1,693 |
5.7× |
| Special dosimetry (77331) |
$593.10 |
$1,318 |
3.4× |
| Special Physics Consult (77370) |
$1,146.15 |
$2,547 |
6.6× |
| Special teletherapy port plan (77321) |
$3,617.55 |
$8,039 |
7.5× |
| Special treatment procedure (77470) |
$2,050.20 |
$4,556 |
2.9× |
| Stereotactic Body Radiation Delivery (77373) |
$5,546.25 |
$12,325 |
2.4× |
| Sternoclavicular joints (71130) |
$553.95 |
$1,231 |
4.9× |
| Superior sagittal sinus venogram (75870) |
$2,734.65 |
$6,077 |
0.7× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$235.80 |
$524 |
1.8× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$235.80 |
$524 |
1.8× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$86.40 |
$192 |
1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$4,564.80 |
$10,144 |
9.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,985.40 |
$4,412 |
4.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,135.25 |
$4,745 |
4.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,606.95 |
$3,571 |
3.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,256.85 |
$2,793 |
7.3× |
| Thoracic spine 2 views (72070) |
$340.20 |
$756 |
2.5× |
| Thoracic spine 3 views (72072) |
$915.75 |
$2,035 |
6.8× |
| Thoracolumbar 2 views (72080) |
$826.65 |
$1,837 |
7.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$842.85 |
$1,873 |
1.6× |
| Thyroid Met Imaging Body (78018) |
$2,404.35 |
$5,343 |
3.4× |
| Thyroid Uptake Measurement (78012) |
$374.40 |
$832 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,291.95 |
$2,871 |
2.5× |
| Tx Devices Design & Construction Complex (77334) |
$1,758.15 |
$3,907 |
3.7× |
| Tx devices design & construction intermediate (77333) |
$801.90 |
$1,782 |
4.6× |
| Tx devices design & construction simple (77332) |
$667.80 |
$1,484 |
3.9× |
| Ultrasound Breast Limited (76642) |
$939.15 |
$2,087 |
8.4× |
| Ultrasound Exam Aaa Screen (76706) |
$269.55 |
$599 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$1,377.90 |
$3,062 |
10.2× |
| Umbilical-artery Doppler (OB) (76820) |
$228.15 |
$507 |
1.7× |
| Unlisted magnetic resonance procedure (76498) |
$501.75 |
$1,115 |
4.5× |
| Unlisted us procedure (76999) |
$129.15 |
$287 |
1.2× |
| Upper gi w/o kub (74240) |
$1,395.90 |
$3,102 |
6.2× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$600.75 |
$1,335 |
54.3× |
| Ureteral Reflux Study (78740) |
$871.20 |
$1,936 |
1.7× |
| Urethrocystogram voiding (74455) |
$558 |
$1,240 |
1.8× |
| Urethrocystography retrograde (74450) |
$382.05 |
$849 |
1.2× |
| Us chest (76604) |
$982.35 |
$2,183 |
7.3× |
| Us complete joint (76881) |
$1,533.60 |
$3,408 |
11.4× |
| Us exam, pelvic, limited (76857) |
$595.35 |
$1,323 |
4.4× |
| Us head (76506) |
$1,347.30 |
$2,994 |
10.0× |
| Us kidney transplant (76776) |
$1,415.25 |
$3,145 |
10.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$1,358.10 |
$3,018 |
10.1× |
| Us ob detailed single fetus (76811) |
$1,298.25 |
$2,885 |
4.2× |
| Us ob limited 1 or more fetuses (76815) |
$283.95 |
$631 |
2.1× |
| Us ob transvaginal (76817) |
$1,298.25 |
$2,885 |
9.7× |
| Us pelvic non ob complete (76856) |
$893.25 |
$1,985 |
6.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,298.25 |
$2,885 |
9.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$211.50 |
$470 |
1.6× |
| Us retroperitoneal complete (76770) |
$1,007.55 |
$2,239 |
7.5× |
| Us retroperitoneal limited (76775) |
$177.30 |
$394 |
1.3× |
| Us scrotum and contents (76870) |
$609.30 |
$1,354 |
4.5× |
| Us spinal canal and contents (76800) |
$211.50 |
$470 |
1.6× |
| Us thyroid (76536) |
$1,007.55 |
$2,239 |
7.5× |
| Us transrectal (76872) |
$113.85 |
$253 |
0.8× |
| Vein X-Ray Chest (75827) |
$2,244.15 |
$4,987 |
1.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,805.85 |
$4,013 |
0.4× |
| Vein X-Ray Skull Epidural (75872) |
$6,250.95 |
$13,891 |
7.7× |
| Vein X-Ray Spleen/Liver (75810) |
$2,116.80 |
$4,704 |
0.5× |
| Venogram Sinus/Jugular (75860) |
$6,751.35 |
$15,003 |
1.7× |
| Venography Adrenal Unilateral (75840) |
$6,751.35 |
$15,003 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$6,751.35 |
$15,003 |
1.7× |
| Venography extremity bilateral rs&i (75822) |
$1,805.85 |
$4,013 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,659.60 |
$3,688 |
0.8× |
| Venography Orbital Rs&I (75880) |
$6,250.95 |
$13,891 |
7.7× |
| Venography Renal Bilateral (75833) |
$6,751.35 |
$15,003 |
1.7× |
| Venography Renal Unilateral (75831) |
$6,751.35 |
$15,003 |
1.7× |
| Venous sampling by catheter (75893) |
$7,834.05 |
$17,409 |
1.1× |
| Wrist 2 views (73100) |
$637.65 |
$1,417 |
5.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$566.10 |
$1,258 |
5.1× |
| X-ray antegrade pyelogram tube (74425) |
$874.35 |
$1,943 |
1.9× |
| X-Ray Aorta Leg Arteries (75630) |
$6,878.70 |
$15,286 |
1.7× |
| X-Ray Bend Only L-S Spine (72120) |
$967.05 |
$2,149 |
7.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$782.55 |
$1,739 |
7.0× |
| X-Ray Exam Breast Specimen (76098) |
$874.35 |
$1,943 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$571.95 |
$1,271 |
5.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$617.85 |
$1,373 |
4.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$656.10 |
$1,458 |
4.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$352.35 |
$783 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$469.80 |
$1,044 |
4.2× |
X-Ray Exam Hip Uni 4/> Views (73503)
range across 2 matching MRF lines |
$396.45–$724.05 |
$881–$1,609 |
varies |
| X-Ray Exam Hips Bi 2 Views (73521) |
$483.75 |
$1,075 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$505.35 |
$1,123 |
3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$551.25 |
$1,225 |
4.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$523.80 |
$1,164 |
3.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$864 |
$1,920 |
7.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$1,322.55 |
$2,939 |
9.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$670.05 |
$1,489 |
5.0× |
| X-ray eye for foreign body (70030) |
$145.80 |
$324 |
1.3× |
| X-ray humerus (73060) |
$782.55 |
$1,739 |
7.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,692.45 |
$3,761 |
7.5× |
| X-ray IV pyelogram+tomography (74415) |
$610.65 |
$1,357 |
2.7× |
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100)
range across 2 matching MRF lines |
$320.85–$933.30 |
$713–$2,074 |
varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$263.70 |
$586 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$923.85 |
$2,053 |
6.9× |
| X-ray nose-rectum child f.b. (76010) |
$691.65 |
$1,537 |
6.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,442.70 |
$3,206 |
10.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$910.80 |
$2,024 |
6.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$306 |
$680 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$880.65 |
$1,957 |
7.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$499.95 |
$1,111 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,235.70 |
$2,746 |
9.2× |
| X-Ray Stress View (77071) |
$195.75 |
$435 |
1.7× |
| X-ray thoracic spine 4 vw (72074) |
$396.45 |
$881 |
2.9× |
| X-Ray Tmj Unilat (70328) |
$403.20 |
$896 |
3.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,323 |
$2,940 |
2.9× |
| X-Rays Bone Length Studies (77073) |
$361.80 |
$804 |
2.7× |
| X-Rays Bone Survey Complete (77075) |
$1,849.05 |
$4,109 |
13.8× |
| Xr c-spine 4 or 5 views (72050) |
$1,131.75 |
$2,515 |
8.4× |
| Xr facial bones less than 3 views (70140) |
$542.70 |
$1,206 |
4.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$320.85 |
$713 |
2.4× |
| Xr orbits complete 4 views (70200) |
$580.50 |
$1,290 |
4.3× |