| 3-D radiotherapy plan dose-volume histograms (77295) |
$9,520.90 |
$18,032 |
7.5× |
| Abdomen 1 View (74018) |
$254.50 |
$482 |
3.2× |
| Abdomen 2 views (74019) |
$288.82 |
$547 |
3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,947.26 |
$3,688 |
5.3× |
| Angio internal mammary (75756) |
$1,508.50 |
$2,857 |
0.5× |
| Angio pulmonary bilat (75743) |
$1,392.34 |
$2,637 |
0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,790.45 |
$3,391 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$3,339.60 |
$6,325 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$2,707.58 |
$5,128 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,227.60 |
$2,325 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,289.90 |
$2,443 |
0.4× |
| Ankle 2 views (73600) |
$151.01 |
$286 |
1.9× |
| Aortography thoracic serialography rs&i (75605) |
$2,594.06 |
$4,913 |
0.5× |
| Artery X-Rays Abdomen (75726) |
$2,829.55 |
$5,359 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$1,167.41 |
$2,211 |
0.4× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$2,326.37 |
$4,406 |
0.5× |
| Artery X-Rays Spine (75705) |
$2,947.82 |
$5,583 |
0.6× |
| Arthrogram ankle (73615) |
$281.95 |
$534 |
0.9× |
| Arthrogram hip (73525) |
$380.69 |
$721 |
1.2× |
| Arthrogram Wrist (73115) |
$221.23 |
$419 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$529.06 |
$1,002 |
4.3× |
| Bone age studies (77072) |
$161.04 |
$305 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$2,323.20 |
$4,400 |
6.3× |
| Bone Imaging Limited Area (78300) |
$1,588.22 |
$3,008 |
4.3× |
| Bone Imaging Whole Body (78306) |
$2,006.40 |
$3,800 |
5.4× |
| Bone marrow imaging; multiple areas (78103) |
$1,148.40 |
$2,175 |
3.1× |
| Brachytx isodose complex (77318) |
$2,126.78 |
$4,028 |
6.2× |
| Brachytx isodose intermed (77317) |
$1,770.38 |
$3,353 |
5.1× |
| Brachytx Isodose Plan Simple (77316) |
$1,416.62 |
$2,683 |
4.1× |
| Brain Image W/Flow < 4 Views (78601) |
$452.50 |
$857 |
1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$970.99 |
$1,839 |
1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,071.44 |
$9,605 |
3.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$898.66 |
$1,702 |
2.8× |
| Cat Scan Follow-Up Study (76380) |
$381.74 |
$723 |
4.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,008.48 |
$1,910 |
2.0× |
| Cerebrospinal Fluid Scan (78630) |
$1,977.89 |
$3,746 |
3.9× |
| Chest 1 view (71045) |
$297.79 |
$564 |
3.7× |
| Chest 2 views (71046) |
$297.79 |
$564 |
3.7× |
| Chest 3 views (71047) |
$297.79 |
$564 |
3.7× |
| Chest 4 or more views (71048) |
$380.16 |
$720 |
3.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$724.42 |
$1,372 |
1.0× |
| Clavicle complete (73000) |
$162.62 |
$308 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$197.47 |
$374 |
2.0× |
| Continuing medical physics consltj pr wk (77336) |
$589.25 |
$1,116 |
4.8× |
| Contrast Exam Abdominl Aorta (75625) |
$2,874.43 |
$5,444 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$771.94 |
$1,462 |
2.4× |
| Contrast X-Ray Of Elbow (73085) |
$387.55 |
$734 |
1.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$221.23 |
$419 |
0.7× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$432.43 |
$819 |
2.7× |
| Corpora cavernosography (74445) |
$497.90 |
$943 |
5.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,535.46 |
$4,802 |
7.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,231.86 |
$4,227 |
10.1× |
| CT abdomen w contrast (74160) |
$2,606.74 |
$4,937 |
16.1× |
| CT abdomen w wo contrast (74170) |
$3,018.05 |
$5,716 |
18.6× |
| CT abdomen w/o contrast (74150) |
$2,225.52 |
$4,215 |
23.1× |
| CT Angio Abdomen and Pelvis (74174) |
$4,491.17 |
$8,506 |
14.0× |
| CT Angio Chest (71275) |
$1,448.83 |
$2,744 |
9.0× |
| CT Angio Head (70496) |
$1,612.51 |
$3,054 |
10.0× |
| CT angio hrt w/3d image (75574) |
$1,429.30 |
$2,707 |
4.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$974.16 |
$1,845 |
6.0× |
| CT Angio Neck (70498) |
$1,134.14 |
$2,148 |
7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,128.34 |
$2,137 |
7.0× |
| CT cervical spine w/ contrast (72126) |
$1,620.96 |
$3,070 |
5.0× |
| CT cervical spine w/o contrast (72125) |
$1,382.83 |
$2,619 |
14.3× |
| CT cervical spine w/wo cont (72127) |
$1,736.59 |
$3,289 |
10.7× |
| CT chest w contrast (71260) |
$1,466.78 |
$2,778 |
9.1× |
| CT chest w/wo contrast (71270) |
$1,698.05 |
$3,216 |
10.5× |
| CT colonography screening (74263) |
$1,051.78 |
$1,992 |
4.8× |
| CT head/brain with contrast (70460) |
$886.51 |
$1,679 |
5.5× |
| CT head/brain without and with contrast (70470) |
$1,025.38 |
$1,942 |
6.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$581.33 |
$1,101 |
1.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$140.98 |
$267 |
1.8× |
| CT iac w contrast (70481) |
$1,274.59 |
$2,414 |
7.9× |
| CT l-spine w&w/o contrast (72133) |
$1,274.06 |
$2,413 |
7.9× |
| CT lower ext w/o (73700) |
$646.27 |
$1,224 |
6.7× |
| CT lower extremity w/contrast material (73701) |
$758.74 |
$1,437 |
4.7× |
| CT lumbar spine w contrast (72132) |
$1,087.68 |
$2,060 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$928.75 |
$1,759 |
9.6× |
| CT maxillofacial w contrast (70487) |
$1,274.59 |
$2,414 |
7.9× |
| CT maxillofacial wo contrast (70486) |
$1,086.10 |
$2,057 |
11.3× |
| CT neck tissue combo (70492) |
$1,295.18 |
$2,453 |
8.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,474.70 |
$2,793 |
9.1× |
| CT orbits w/o contrast (70480) |
$1,086.10 |
$2,057 |
11.3× |
| CT pelvis w&w/o contrast (72194) |
$1,226.02 |
$2,322 |
7.6× |
| CT pelvis w/o contrast (72192) |
$902.88 |
$1,710 |
9.4× |
| CT scan of leg combo (73702) |
$875.95 |
$1,659 |
5.4× |
| CT scans face/jaw combo (70488) |
$1,474.70 |
$2,793 |
9.1× |
| CT soft tissue neck w contrast (70491) |
$1,119.89 |
$2,121 |
6.9× |
| CT soft tissue neck w/o contrast (70490) |
$954.62 |
$1,808 |
9.9× |
| CT thoracic spine w contrast (72129) |
$868.03 |
$1,644 |
5.4× |
| CT thoracic spine w/o contrast (72128) |
$739.73 |
$1,401 |
7.7× |
| CT thoracic spine w/wo cont (72130) |
$1,018.51 |
$1,929 |
6.3× |
| CT thorax w/o contrast (71250) |
$1,250.83 |
$2,369 |
13.0× |
| CT upper ext wo (73200) |
$835.30 |
$1,582 |
8.7× |
| CT upper extremity with contrast (73201) |
$878.06 |
$1,663 |
2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,666.40 |
$5,050 |
16.5× |
| Cta Abdomen (74175) |
$2,315.81 |
$4,386 |
14.3× |
| CTA pelvis (72191) |
$956.74 |
$1,812 |
5.9× |
| Dilation ureters/urethra rs&i (74485) |
$1,090.32 |
$2,065 |
0.6× |
| Diskography lumbar (72295) |
$1,079.23 |
$2,044 |
0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$219.12 |
$415 |
2.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$314.16 |
$595 |
3.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$256.61 |
$486 |
2.7× |
| Dxa Bone Density Axial (77080) |
$283.54 |
$537 |
2.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$68.11 |
$129 |
0.8× |
| Echo exam of fetal heart (76825) |
$409.20 |
$775 |
0.8× |
| Echo exam uterus (76831) |
$430.85 |
$816 |
2.0× |
| Echo Guide For Artery Repair (76936) |
$722.83 |
$1,369 |
3.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$399.17 |
$756 |
1.8× |
| Esophagram (74220) |
$432.43 |
$819 |
2.7× |
| Fetal Biophys Profile W/Nst (76818) |
$459.89 |
$871 |
4.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$189.02 |
$358 |
2.0× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$204.86 |
$388 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$226.51 |
$429 |
1.0× |
| Follow-Up Angiography (75898) |
$1,160.02 |
$2,197 |
0.4× |
| Foot 2 views (73620) |
$148.37 |
$281 |
1.8× |
| Forearm 2 views (73090) |
$153.65 |
$291 |
1.9× |
| Gastric emptying imaging study (78264) |
$2,023.30 |
$3,832 |
5.5× |
| Gated Heart Planar Single (78472) |
$1,105.10 |
$2,093 |
3.0× |
| Gated Heart, Multiple (78473) |
$1,105.10 |
$2,093 |
3.0× |
| Hand 2 views (73120) |
$131.47 |
$249 |
1.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$2,753.52 |
$5,215 |
4.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,547.07 |
$4,824 |
4.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,226.05 |
$4,216 |
3.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,450.94 |
$2,748 |
0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,441.97 |
$2,731 |
0.5× |
| Hepatobil Syst Image W/Drug (78227) |
$2,258.26 |
$4,277 |
4.5× |
| Hepatobiliary System Imaging (78226) |
$2,258.26 |
$4,277 |
6.1× |
| Ht Musc Image Planar Mult (78454) |
$4,040.78 |
$7,653 |
3.4× |
| Ht Muscle Image Spect Sing (78451) |
$6,698.21 |
$12,686 |
5.6× |
| Hysterosalpingogram (74740) |
$960.96 |
$1,820 |
4.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$507.41 |
$961 |
6.3× |
| Infant hip ultrasound, limited static exam (76886) |
$450.91 |
$854 |
5.6× |
| Infusion Ivp (74410) |
$711.74 |
$1,348 |
4.4× |
| Interstitial radiation source applic complex (77778) |
$3,647.95 |
$6,909 |
5.7× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,471.01 |
$2,786 |
2.3× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,471.01 |
$2,786 |
2.9× |
| Joint Survey Single View (77077) |
$100.32 |
$190 |
1.0× |
| K Flow/Funct Image Multiple (78709) |
$3,670.13 |
$6,951 |
7.3× |
| K Flow/Funct Image W/Drug (78708) |
$2,340.10 |
$4,432 |
4.7× |
| K Flow/Funct Image W/O Drug (78707) |
$2,340.10 |
$4,432 |
4.7× |
| Knee 3 Views (73562) |
$203.81 |
$386 |
2.5× |
| Liver & Spleen Imaging Static Only (78215) |
$2,329.01 |
$4,411 |
6.3× |
| Lung perfusion differential (78597) |
$1,563.94 |
$2,962 |
4.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,326.37 |
$4,406 |
4.6× |
| Lymph System Imaging (78195) |
$1,833.74 |
$3,473 |
3.7× |
| Magnetic Image Jaw Joint (70336) |
$388.08 |
$735 |
1.8× |
| Mammary ductogram or galactogram multiple (77054) |
$736.56 |
$1,395 |
3.3× |
| Meckels Divert Exam (78290) |
$2,030.16 |
$3,845 |
5.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$859.58 |
$1,628 |
2.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,994.78 |
$3,778 |
6.2× |
| MRA head w/o contrast (70544) |
$1,049.66 |
$1,988 |
4.8× |
| MRA head with contrast (70545) |
$1,552.32 |
$2,940 |
4.8× |
| MRA neck w contrast (70548) |
$1,560.24 |
$2,955 |
4.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,734.48 |
$3,285 |
5.4× |
| MRA neck w/o contrast (70547) |
$1,049.66 |
$1,988 |
4.8× |
| MRI abdomen w contrast (74182) |
$1,522.22 |
$2,883 |
4.7× |
| MRI abdomen w/o contrast (74181) |
$1,256.11 |
$2,379 |
5.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,607.76 |
$3,045 |
2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,791.50 |
$3,393 |
5.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,717.06 |
$3,252 |
2.4× |
| MRI Breast W/O Contrast Bilateral (77047) |
$185.33 |
$351 |
0.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$185.33 |
$351 |
0.8× |
| MRI cardiac w/o contrast (75557) |
$898.66 |
$1,702 |
4.1× |
| MRI cervical spine w contrast (72142) |
$2,040.19 |
$3,864 |
6.3× |
| MRI cervical spine w/o cont (72141) |
$1,492.66 |
$2,827 |
6.8× |
| MRI chest w/o contrast (71550) |
$627.26 |
$1,188 |
2.8× |
| MRI chest wo w contrast (71552) |
$2,203.34 |
$4,173 |
6.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,607.76 |
$3,045 |
5.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,791.50 |
$3,393 |
5.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,143.12 |
$2,165 |
5.2× |
| MRI lumbar spine w contrast (72149) |
$1,854.86 |
$3,513 |
5.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,699.14 |
$5,112 |
8.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,470.48 |
$2,785 |
6.7× |
| MRI orbit face neck w contrast (70542) |
$1,767.22 |
$3,347 |
5.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,290.46 |
$4,338 |
7.1× |
| MRI pelvis w contrast (72196) |
$1,127.28 |
$2,135 |
3.5× |
| MRI pelvis w/o & w contrast (72197) |
$1,206.48 |
$2,285 |
3.7× |
| MRI pelvis w/o contrast (72195) |
$764.54 |
$1,448 |
3.5× |
| MRI spectroscopy (76390) |
$595.06 |
$1,127 |
7.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,673.76 |
$3,170 |
7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,058.11 |
$2,004 |
4.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,740.82 |
$3,297 |
5.4× |
| MRI, abdomen, combo (74183) |
$2,205.46 |
$4,177 |
6.9× |
| MRI, dorsal spine combo (72157) |
$2,270.40 |
$4,300 |
7.1× |
| MRI, dorsal spine contrast (72147) |
$2,066.59 |
$3,914 |
6.4× |
| MRI, joint upper extrem (73221) |
$1,569.74 |
$2,973 |
7.1× |
| MRI, joint upper extrem combo (73223) |
$1,740.82 |
$3,297 |
5.4× |
| MRI, lumbar spine combo (72158) |
$2,456.26 |
$4,652 |
7.6× |
| Myelography thoracic (72255) |
$483.12 |
$915 |
0.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$376.99 |
$714 |
1.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,512.78 |
$6,653 |
2.9× |
| Myocardial Spect Multiple Studies (78452) |
$7,352.93 |
$13,926 |
6.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,566.08 |
$4,860 |
1.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$3,564.53 |
$6,751 |
1.8× |
| Neck soft tissue (70360) |
$237.60 |
$450 |
3.0× |
| Nm myocard infarct spect (78469) |
$805.73 |
$1,526 |
1.6× |
| Nonvascular Shunt X-Ray (75809) |
$451.44 |
$855 |
4.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,604.72 |
$10,615 |
4.4× |
| Nuclear Rx Intra-Arterial (79445) |
$442.46 |
$838 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$966.77 |
$1,831 |
4.5× |
| Ob us nuchal meas 1 gest (76813) |
$346.37 |
$656 |
3.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$221.23 |
$419 |
2.3× |
| Panoramic X-ray of jaws (70355) |
$76.56 |
$145 |
1.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,152.62 |
$2,183 |
2.3× |
| Parathyroid Planar Imaging (78070) |
$1,003.20 |
$1,900 |
2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,056 |
$2,000 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$161.04 |
$305 |
1.7× |
| Peritoneogram Rs&I (74190) |
$276.14 |
$523 |
0.5× |
| PET image w/CT, full body (78816) |
$2,690.16 |
$5,095 |
2.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,690.16 |
$5,095 |
2.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,696.50 |
$5,107 |
2.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,498.46 |
$2,838 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,755.07 |
$3,324 |
4.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$632.54 |
$1,198 |
6.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$945.12 |
$1,790 |
1.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$162.10 |
$307 |
2.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$139.39 |
$264 |
1.7× |
| Radex elbow complete minimum 3 views (73080) |
$159.98 |
$303 |
2.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$192.19 |
$364 |
2.0× |
| Radex fingr minimum 2 views (73140) |
$134.11 |
$254 |
1.7× |
| Radex foot complete minimum 3 views (73630) |
$148.37 |
$281 |
1.8× |
| Radex Hand Minimum 3 Views (73130) |
$144.14 |
$273 |
1.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$60.19 |
$114 |
0.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$111.41 |
$211 |
1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$160.51 |
$304 |
2.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$153.12 |
$290 |
1.9× |
| Radex shoulder complete minimum 2 views (73030) |
$164.74 |
$312 |
2.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$253.44 |
$480 |
3.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$855.89 |
$1,621 |
5.3× |
| Radex Spine 1 View Specify Level (72020) |
$190.61 |
$361 |
2.4× |
| Radex Sternum Minimum 2 Views (71120) |
$130.94 |
$248 |
1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$55.97 |
$106 |
0.7× |
| Radex Toe Minimum 2 Views (73660) |
$134.11 |
$254 |
1.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$64.42 |
$122 |
0.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$170.54 |
$323 |
2.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$9,071.57 |
$17,181 |
1.3× |
| Radiation treatment delivery level 1 (77402) |
$499.49 |
$946 |
5.3× |
| Radiation treatment delivery level 2 (77407) |
$581.86 |
$1,102 |
1.6× |
| Radiation treatment delivery level 3 (77412) |
$752.40 |
$1,425 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$155.23 |
$294 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$288.82 |
$547 |
3.0× |
| Radiologic exam colon double contrast study (74280) |
$929.81 |
$1,761 |
5.7× |
| Radiologic exam colon single contrast study (74270) |
$696.96 |
$1,320 |
4.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$578.16 |
$1,095 |
3.6× |
| Radiologic exam knee complete 4/more views (73564) |
$209.09 |
$396 |
2.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$182.69 |
$346 |
1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$643.63 |
$1,219 |
4.0× |
| Radiologic exam swallow function contrast study (74230) |
$557.57 |
$1,056 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$925.06 |
$1,752 |
5.7× |
| Radiologic examination femur 1 view (73551) |
$110.88 |
$210 |
1.4× |
| Radiologic examination femur minimum 2 views (73552) |
$110.88 |
$210 |
1.4× |
| Radiologic examination knee 1/2 views (73560) |
$163.15 |
$309 |
2.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$580.80 |
$1,100 |
6.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$154.18 |
$292 |
1.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$486.82 |
$922 |
1.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$486.82 |
$922 |
1.4× |
| Renal Cyst Study (74470) |
$397.06 |
$752 |
0.8× |
| Ribs bilateral 3 views (71110) |
$178.99 |
$339 |
1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,531.20 |
$2,900 |
3.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,372.80 |
$2,600 |
2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,584 |
$3,000 |
3.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,244 |
$4,250 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$901.82 |
$1,708 |
4.2× |
| Scapula (73010) |
$171.07 |
$324 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$13.20 |
$25 |
0.6× |
| Shoulder 1 view (73020) |
$148.37 |
$281 |
1.8× |
| Shoulder Arthrography (73040) |
$693.26 |
$1,313 |
2.2× |
| Sialogram (70390) |
$376.46 |
$713 |
1.7× |
| Skull less than 4 views (70250) |
$193.25 |
$366 |
2.0× |
| Special dosimetry (77331) |
$514.80 |
$975 |
4.2× |
| Special Physics Consult (77370) |
$691.15 |
$1,309 |
5.6× |
| Special teletherapy port plan (77321) |
$1,466.26 |
$2,777 |
4.2× |
| Special treatment procedure (77470) |
$1,760.35 |
$3,334 |
3.5× |
| Stereotactic Body Radiation Delivery (77373) |
$4,765.20 |
$9,025 |
2.9× |
| Sternoclavicular joints (71130) |
$52.27 |
$99 |
0.7× |
| Superior sagittal sinus venogram (75870) |
$1,225.49 |
$2,321 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,387.58 |
$2,628 |
4.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$759.79 |
$1,439 |
2.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,198.59 |
$4,164 |
6.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,773.55 |
$3,359 |
5.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,130.98 |
$2,142 |
9.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$729.70 |
$1,382 |
4.5× |
| Thoracic spine 2 views (72070) |
$112.99 |
$214 |
1.2× |
| Thoracic spine 3 views (72072) |
$115.63 |
$219 |
1.2× |
| Thoracolumbar 2 views (72080) |
$112.99 |
$214 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$797.28 |
$1,510 |
2.2× |
| Thyroid Met Imaging Body (78018) |
$2,082.43 |
$3,944 |
4.2× |
| Thyroid Uptake Measurement (78012) |
$425.04 |
$805 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$879.12 |
$1,665 |
2.4× |
| Tx Devices Design & Construction Complex (77334) |
$1,069.73 |
$2,026 |
3.1× |
| Tx devices design & construction intermediate (77333) |
$871.20 |
$1,650 |
7.0× |
| Tx devices design & construction simple (77332) |
$778.80 |
$1,475 |
6.3× |
| Ultrasound Breast Limited (76642) |
$393.36 |
$745 |
4.9× |
| Ultrasound elastography first target lesion (76982) |
$182.16 |
$345 |
1.9× |
| Ultrasound Elastography Parenchyma (76981) |
$182.16 |
$345 |
1.9× |
| Ultrasound Exam Aaa Screen (76706) |
$145.20 |
$275 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$505.30 |
$957 |
5.2× |
| Umbilical-artery Doppler (OB) (76820) |
$256.61 |
$486 |
2.7× |
| Unlisted Dx Radiographic Procedure (76499) |
$930.34 |
$1,762 |
11.6× |
| Unlisted fluoroscopic procedure (76496) |
$96.10 |
$182 |
1.2× |
| Unlisted magnetic resonance procedure (76498) |
$179.52 |
$340 |
2.2× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,525.39 |
$2,889 |
16.2× |
| Unlisted respiratory px dx nuclear medicine (78599) |
$343.20 |
$650 |
0.9× |
| Unlisted us procedure (76999) |
$353.23 |
$669 |
4.4× |
| Upper gi w/o kub (74240) |
$925.06 |
$1,752 |
5.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$503.71 |
$954 |
45.5× |
| Ureteral Reflux Study (78740) |
$1,191.70 |
$2,257 |
3.2× |
| Urethrocystogram voiding (74455) |
$905.52 |
$1,715 |
4.1× |
| Urethrocystography retrograde (74450) |
$719.66 |
$1,363 |
3.3× |
| Us breast unilateral complete (76641) |
$393.36 |
$745 |
4.1× |
| Us chest (76604) |
$183.74 |
$348 |
1.9× |
| Us complete joint (76881) |
$372.24 |
$705 |
3.9× |
| Us exam, pelvic, limited (76857) |
$79.73 |
$151 |
0.8× |
| Us head (76506) |
$299.38 |
$567 |
3.1× |
| Us kidney transplant (76776) |
$349.01 |
$661 |
3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$119.86 |
$227 |
1.2× |
| Us ob detailed single fetus (76811) |
$312.05 |
$591 |
1.4× |
| Us ob limited 1 or more fetuses (76815) |
$277.20 |
$525 |
2.9× |
| Us ob transvaginal (76817) |
$393.89 |
$746 |
4.1× |
| Us pelvic non ob complete (76856) |
$755.57 |
$1,431 |
7.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$439.82 |
$833 |
4.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$277.20 |
$525 |
2.9× |
| Us retroperitoneal complete (76770) |
$779.33 |
$1,476 |
8.1× |
| Us retroperitoneal limited (76775) |
$372.24 |
$705 |
3.9× |
| Us scrotum and contents (76870) |
$571.82 |
$1,083 |
5.9× |
| Us spinal canal and contents (76800) |
$487.34 |
$923 |
5.1× |
| Us thyroid (76536) |
$577.10 |
$1,093 |
6.0× |
| Us transrectal (76872) |
$312.05 |
$591 |
3.2× |
| Vein X-Ray Chest (75827) |
$1,477.87 |
$2,799 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,428.77 |
$2,706 |
0.5× |
| Vein X-Ray Skull Epidural (75872) |
$681.12 |
$1,290 |
1.2× |
| Vein X-Ray Spleen/Liver (75810) |
$1,215.46 |
$2,302 |
0.4× |
| Venogram Sinus/Jugular (75860) |
$1,520.64 |
$2,880 |
0.5× |
| Venography Adrenal Unilateral (75840) |
$1,790.45 |
$3,391 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,611.98 |
$3,053 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$837.41 |
$1,586 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$769.82 |
$1,458 |
0.5× |
| Venography Orbital Rs&I (75880) |
$784.61 |
$1,486 |
1.4× |
| Venography Renal Bilateral (75833) |
$1,340.59 |
$2,539 |
0.5× |
| Venography Renal Unilateral (75831) |
$1,241.86 |
$2,352 |
0.4× |
| Venous sampling by catheter (75893) |
$2,602.51 |
$4,929 |
0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$2,772 |
$5,250 |
7.5× |
| Wrist 2 views (73100) |
$135.70 |
$257 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$96.62 |
$183 |
1.2× |
| X-ray antegrade pyelogram tube (74425) |
$956.74 |
$1,812 |
3.0× |
| X-Ray Aorta Leg Arteries (75630) |
$3,542.88 |
$6,710 |
1.2× |
| X-Ray Bend Only L-S Spine (72120) |
$177.41 |
$336 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$159.98 |
$303 |
2.0× |
| X-Ray Exam Breast Specimen (76098) |
$275.62 |
$522 |
0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$176.88 |
$335 |
2.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$190.61 |
$361 |
2.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$196.94 |
$373 |
2.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$77.09 |
$146 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$102.43 |
$194 |
1.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$128.30 |
$243 |
1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$170.54 |
$323 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$174.24 |
$330 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$181.63 |
$344 |
1.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$359.57 |
$681 |
3.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$219.12 |
$415 |
2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$263.47 |
$499 |
2.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$285.12 |
$540 |
3.0× |
| X-ray head for orthodontia (70350) |
$79.20 |
$150 |
1.0× |
| X-ray humerus (73060) |
$166.32 |
$315 |
2.1× |
| X-ray IV pyelogram (ivp) (74400) |
$789.36 |
$1,495 |
4.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$138.86 |
$263 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$114.58 |
$217 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$257.66 |
$488 |
2.7× |
| X-ray nose-rectum child f.b. (76010) |
$234.43 |
$444 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$310.46 |
$588 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$211.73 |
$401 |
2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$211.73 |
$401 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$220.18 |
$417 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$265.58 |
$503 |
3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$193.25 |
$366 |
2.0× |
| X-Ray Stress View (77071) |
$123.55 |
$234 |
1.5× |
| X-ray thoracic spine 4 vw (72074) |
$115.63 |
$219 |
1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,110.91 |
$2,104 |
3.5× |
| X-Rays Bone Length Studies (77073) |
$123.55 |
$234 |
1.3× |
| X-Rays Bone Survey Complete (77075) |
$580.80 |
$1,100 |
6.0× |
| Xr c-spine 4 or 5 views (72050) |
$263.47 |
$499 |
2.7× |
| Xr facial bones less than 3 views (70140) |
$192.19 |
$364 |
2.4× |
| Xr orbits complete 4 views (70200) |
$92.93 |
$176 |
1.0× |