| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,756.36 |
$16,458 |
3.8× |
| Abdomen 2 views (74019) |
$143.92 |
$498 |
1.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$982.60 |
$3,400 |
2.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$756.02 |
$2,616 |
0.3× |
| Angiography extremity bilateral rs&i (75716) |
$1,708.72 |
$5,912.50 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,385.32 |
$4,793.50 |
0.5× |
| Angiography internal mammary rs&i (75756) |
$705.02 |
$2,439.50 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$928.84 |
$3,214 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$673.22 |
$2,329.50 |
0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$628.14 |
$2,173.50 |
0.2× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,363.36 |
$4,717.50 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,415.66 |
$4,898.50 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$593.46 |
$2,053.50 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$645.20 |
$2,232.50 |
0.2× |
| Ankle 2 views (73600) |
$87.13 |
$301.50 |
1.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$477.14 |
$1,651 |
1.5× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$976.39 |
$3,378.50 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,653.66 |
$5,722 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,629.82 |
$5,639.50 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$567.88 |
$1,965 |
0.2× |
| Arthrogram elbow (73085) |
$198.26 |
$686 |
0.6× |
| Arthrogram hip (73525) |
$194.78 |
$674 |
0.6× |
| Arthrogram shoulder (73040) |
$354.75 |
$1,227.50 |
1.1× |
| Arthrogram wrist (73115) |
$107.80 |
$373 |
0.3× |
| Arthrography knee lt (73580) |
$118.92 |
$411.50 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$264.29 |
$914.50 |
2.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$801.40 |
$2,773 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$1,092.42 |
$3,780 |
3.0× |
| Bone age studies (77072) |
$89.45 |
$309.50 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$1,107.30 |
$3,831.50 |
3.1× |
| Bone survey complete (77075) |
$322.82 |
$1,117 |
3.4× |
| Brachytx isodose complex (77318) |
$1,062.51 |
$3,676.50 |
3.1× |
| Brachytx isodose intermed (77317) |
$884.48 |
$3,060.50 |
2.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$707.76 |
$2,449 |
2.1× |
| Brain image w/flow 4 + views (78606) |
$490 |
$1,695.50 |
1.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$228.31 |
$790 |
0.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,559.24 |
$8,855.50 |
2.0× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$254.04 |
$879 |
23.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$499.54 |
$1,728.50 |
1.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$508.78 |
$1,760.50 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$121.82 |
$421.50 |
1.5× |
| Chest 1 view (71045) |
$135.26 |
$468 |
1.7× |
| Chest 3 views (71047) |
$135.26 |
$468 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$278.02 |
$962 |
1.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$361.25 |
$1,250 |
0.5× |
| Clavicle complete (73000) |
$90.46 |
$313 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$104.62 |
$362 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$294.34 |
$1,018.50 |
2.4× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$215.60 |
$746 |
1.4× |
| Corpora cavernosography (74445) |
$248.26 |
$859 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,344.14 |
$4,651 |
4.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,183.31 |
$4,094.50 |
5.5× |
| CT abdomen w contrast (74160) |
$1,382 |
$4,782 |
8.7× |
| CT abdomen w wo contrast (74170) |
$1,600.04 |
$5,536.50 |
10.1× |
| CT abdomen w/o contrast (74150) |
$1,179.99 |
$4,083 |
12.4× |
| CT angio hrt w/3d image (75574) |
$757.76 |
$2,622 |
2.4× |
| CT angiography upper extremity lt (73206) |
$598.23 |
$2,070 |
3.8× |
| CT c-spine w/o contrast (72125) |
$717.58 |
$2,483 |
7.6× |
| CT cervical spine w&w/o contrast (72127) |
$901.24 |
$3,118.50 |
5.7× |
| CT cervical spine with contrast (72126) |
$841.42 |
$2,911.50 |
2.7× |
| CT chest w/wo contrast (71270) |
$900.24 |
$3,115 |
5.7× |
| CT chest with contrast (71260) |
$777.56 |
$2,690.50 |
4.9× |
| CT colonography screening (74263) |
$557.62 |
$1,929.50 |
2.6× |
| CT head/brain with contrast (70460) |
$460.09 |
$1,592 |
2.9× |
| CT head/brain without and with contrast (70470) |
$532.20 |
$1,841.50 |
3.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$308.22 |
$1,066.50 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$74.70 |
$258.50 |
0.9× |
| CT iac w contrast (70481) |
$661.52 |
$2,289 |
4.2× |
| CT limited/localized follow up study (76380) |
$202.30 |
$700 |
2.6× |
| CT lower ext w/o (73700) |
$342.61 |
$1,185.50 |
3.6× |
| CT lower extremity w wo contrast (73702) |
$464.42 |
$1,607 |
2.9× |
| CT lower extremity with contrast (73701) |
$402.14 |
$1,391.50 |
2.5× |
| CT lumbar spine w & w/o contrast (72133) |
$675.54 |
$2,337.50 |
4.2× |
| CT lumbar spine w/o contrast (72131) |
$492.31 |
$1,703.50 |
5.2× |
| CT lumbar spine with contrast (72132) |
$576.70 |
$1,995.50 |
1.8× |
| CT maxillofacial w contrast (70487) |
$661.52 |
$2,289 |
4.2× |
| CT maxillofacial w/o contrast (70486) |
$563.70 |
$1,950.50 |
5.9× |
| CT maxillofacial w/wo contrast (70488) |
$765.42 |
$2,648.50 |
4.8× |
| CT neck soft tissue w contrast (70491) |
$581.18 |
$2,011 |
3.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$765.42 |
$2,648.50 |
4.8× |
| CT orbits w/o contrast (70480) |
$563.70 |
$1,950.50 |
5.9× |
| CT pelvis w & w/o contrast (72194) |
$649.96 |
$2,249 |
4.1× |
| CT pelvis w/o contrast (72192) |
$478.73 |
$1,656.50 |
5.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$672.22 |
$2,326 |
4.2× |
| CT soft tissue neck w/o contrast (70490) |
$495.49 |
$1,714.50 |
5.2× |
| CT thoracic spine w/contrast (72129) |
$460.24 |
$1,592.50 |
2.9× |
| CT thoracic spine w/o contrast (72128) |
$392.18 |
$1,357 |
4.1× |
| CT thoracic spine w/wo contrast (72130) |
$540 |
$1,868.50 |
3.4× |
| CT thorax w/o contrast (71250) |
$663.26 |
$2,295 |
7.0× |
| CT upper extremity w/o contrast rt (73200) |
$442.75 |
$1,532 |
4.7× |
| CT upper extremity with contrast (73201) |
$465.58 |
$1,611 |
1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,413.64 |
$4,891.50 |
8.9× |
| Cta Abdomen (74175) |
$1,227.67 |
$4,248 |
7.7× |
| CTA abdomen pelvis (74174) |
$2,381.07 |
$8,239 |
7.5× |
| CTA chest (71275) |
$768.16 |
$2,658 |
4.8× |
| Cta Head (70496) |
$836.94 |
$2,896 |
5.3× |
| CTA lwr ext w&w/o contrast (73706) |
$516.44 |
$1,787 |
3.2× |
| Cta Neck (70498) |
$588.69 |
$2,037 |
3.7× |
| Cta Pelvis (72191) |
$507.20 |
$1,755 |
3.2× |
| Cystography minimum 3 views rs&i (74430) |
$384.80 |
$1,331.50 |
1.2× |
| Diskography lumbar (72295) |
$378.59 |
$1,310 |
0.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$120.95 |
$418.50 |
1.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$173.40 |
$600 |
1.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$131.35 |
$454.50 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$157.65 |
$545.50 |
1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$37.86 |
$131 |
0.5× |
| Echo exam of fetal heart (76825) |
$225.86 |
$781.50 |
0.5× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$220.22 |
$762 |
1.0× |
| Echoencephalography real time imaging (76506) |
$165.16 |
$571.50 |
1.7× |
| Esophagus (74220) |
$215.60 |
$746 |
1.4× |
| Fetal biophysical profile non-stress testing (76818) |
$253.74 |
$878 |
2.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$104.33 |
$361 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$115.89 |
$401 |
0.5× |
| Foot 2 views (73620) |
$82.51 |
$285.50 |
1.0× |
| Forearm 2 views (73090) |
$85.40 |
$295.50 |
1.1× |
| Gated Heart Planar Single (78472) |
$557.62 |
$1,929.50 |
1.5× |
| Hand 2 views (73120) |
$73.12 |
$253 |
0.8× |
| Hand 3 views (73130) |
$76.58 |
$265 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,088.08 |
$3,765 |
1.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,272.47 |
$4,403 |
2.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,507.14 |
$5,215 |
2.4× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$266.46 |
$922 |
0.8× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$266.46 |
$922 |
0.8× |
| Heart Infarct Image (78466) |
$190.16 |
$658 |
0.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$567.16 |
$1,962.50 |
0.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,139.52 |
$3,943 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,139.52 |
$3,943 |
3.1× |
| Ht muscle image spect sing (78451) |
$3,380 |
$11,695.50 |
2.9× |
| Humerus Min 2 Views Left (73060) |
$92.48 |
$320 |
1.2× |
| Hysterosalpingogram (74740) |
$479.16 |
$1,658 |
2.2× |
| Interstitial radiation source applic complex (77778) |
$1,822.44 |
$6,306 |
2.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$734.92 |
$2,543 |
1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$734.92 |
$2,543 |
1.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$55.78 |
$193 |
0.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,180.86 |
$4,086 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,180.86 |
$4,086 |
2.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,852.06 |
$6,408.50 |
3.8× |
| Knee 3 views (73562) |
$101.87 |
$352.50 |
1.3× |
| Liver & spleen imaging static only (78215) |
$1,175.36 |
$4,067 |
3.2× |
| Lung perfusion differential (78597) |
$789.26 |
$2,731 |
2.2× |
| Lymphoscintigraphy (78195) |
$925.24 |
$3,201.50 |
1.9× |
| Mammary ductogram or galactogram multiple (77054) |
$334.66 |
$1,158 |
1.5× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$68.64 |
$237.50 |
0.9× |
| Meckels Diverticulum (78290) |
$1,024.36 |
$3,544.50 |
2.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$390.72 |
$1,352 |
1.2× |
| MRA head w & w/o contrast (70546) |
$1,035.34 |
$3,582.50 |
3.3× |
| MRA head w/o contrast (70544) |
$583.34 |
$2,018.50 |
2.7× |
| MRA head with contrast (70545) |
$862.81 |
$2,985.50 |
2.7× |
| MRA neck w contrast (70548) |
$867.14 |
$3,000.50 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$964.10 |
$3,336 |
3.0× |
| MRA neck w/o contrast (70547) |
$583.34 |
$2,018.50 |
2.7× |
| MRI abdomen w contrast (74182) |
$846.05 |
$2,927.50 |
2.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,225.79 |
$4,241.50 |
3.9× |
| MRI abdomen w/o contrast (74181) |
$698.22 |
$2,416 |
3.2× |
| MRI any jnt lwr ext with con lt (73722) |
$893.59 |
$3,092 |
1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$954.42 |
$3,302.50 |
1.3× |
| MRI breast w/o contrast bilateral (77047) |
$103.03 |
$356.50 |
0.5× |
| MRI breast w/o contrast unilat (77046) |
$103.03 |
$356.50 |
0.5× |
| MRI c-spine with contrast (72142) |
$1,134.04 |
$3,924 |
3.6× |
| MRI cardiac w/o contrast (75557) |
$499.54 |
$1,728.50 |
2.3× |
| MRI cervical spine w/o contrast (72141) |
$829.58 |
$2,870.50 |
3.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,224.64 |
$4,237.50 |
3.9× |
| MRI chest w/o contrast (71550) |
$348.68 |
$1,206.50 |
1.6× |
| MRI fetal sngl/1st gestation (74712) |
$113.86 |
$394 |
0.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$893.59 |
$3,092 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$635.37 |
$2,198.50 |
2.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$817.30 |
$2,828 |
3.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,273.04 |
$4,405 |
4.0× |
| MRI orbit/face/neck w/contrast (70542) |
$982.16 |
$3,398.50 |
3.1× |
| MRI pelvis w contrast (72196) |
$626.56 |
$2,168 |
2.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$670.62 |
$2,320.50 |
2.1× |
| MRI pelvis w/o contrast (72195) |
$424.98 |
$1,470.50 |
2.0× |
| MRI scan of arm joint before and after contrast (73223) |
$967.57 |
$3,348 |
3.1× |
| MRI scan of leg joint before and after contrast (73723) |
$995.75 |
$3,445.50 |
3.1× |
| MRI spectroscopy (76390) |
$330.76 |
$1,144.50 |
4.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,500.20 |
$5,191 |
4.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,031.01 |
$3,567.50 |
3.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,365.24 |
$4,724 |
4.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,148.64 |
$3,974.50 |
3.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,261.92 |
$4,366.50 |
4.0× |
| MRI thoracic spine w/o contrast (72146) |
$930.29 |
$3,219 |
4.3× |
| MRI tmj (70336) |
$215.74 |
$746.50 |
1.0× |
| MRI upper ext joint w/o contrast (73221) |
$872.50 |
$3,019 |
4.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$967.57 |
$3,348 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$588.12 |
$2,035 |
2.7× |
| Myelogram thoracic (72255) |
$247.24 |
$855.50 |
0.3× |
| Myocardial infarct spect (78469) |
$406.76 |
$1,407.50 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$3,710.47 |
$12,839 |
3.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,404.54 |
$4,860 |
1.1× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,951.04 |
$6,751 |
1.0× |
| Neck soft tissue (70360) |
$118.49 |
$410 |
1.5× |
| Nm bone marrow multiple (78103) |
$579.59 |
$2,005.50 |
1.6× |
| Nm cisternogram (78630) |
$998.06 |
$3,453.50 |
2.0× |
| Nm gastric emptying study (78264) |
$1,021.04 |
$3,533 |
2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,799.98 |
$9,688.50 |
2.2× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,452.66 |
$5,026.50 |
1.2× |
| Nuclear medicine of heart pumping function (78473) |
$557.62 |
$1,929.50 |
1.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,508.24 |
$8,679 |
2.1× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,398.90 |
$4,840.50 |
3.9× |
| Nuclear Rx Oral Admin (79005) |
$487.84 |
$1,688 |
2.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$152.88 |
$529 |
1.6× |
| Orthopantogram (70355) |
$42.48 |
$147 |
0.5× |
| Osseous survey limited (77074) |
$322.82 |
$1,117 |
3.4× |
| Parathyrd planar w/spect&CT (78072) |
$581.76 |
$2,013 |
1.2× |
| Parathyrd planar w/wo subtrj (78071) |
$390.44 |
$1,351 |
1.1× |
| Parathyroid imaging (78070) |
$621.06 |
$2,149 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$89.45 |
$309.50 |
0.9× |
| Peritoneogram rs&i (74190) |
$117.19 |
$405.50 |
0.2× |
| PET image w/CT, skull-thigh (78815) |
$1,357.58 |
$4,697.50 |
1.0× |
| PET imaging for CT attenuation whole body (78816) |
$1,357.58 |
$4,697.50 |
1.0× |
| PET imaging limited area chest head/neck (78811) |
$1,475.92 |
$5,107 |
1.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$995.75 |
$3,445.50 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$695.19 |
$2,405.50 |
0.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$747.64 |
$2,587 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$885.64 |
$3,064.50 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,173.92 |
$4,062 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$471.22 |
$1,630.50 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$98.26 |
$340 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$105.92 |
$366.50 |
1.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$94.80 |
$328 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$61.99 |
$214.50 |
0.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$4,531.96 |
$15,681.50 |
0.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$375.84 |
$1,300.50 |
0.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$249.55 |
$863.50 |
2.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$290.74 |
$1,006 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$86.27 |
$298.50 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$120.22 |
$416 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$143.92 |
$498 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$135.26 |
$468 |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$347.66 |
$1,203 |
2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$288.28 |
$997.50 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$461.10 |
$1,595.50 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$461.10 |
$1,595.50 |
2.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$61.56 |
$213 |
0.8× |
| Radiological examination surgical specimen (76098) |
$96.96 |
$335.50 |
0.2× |
| Review by radiologist of adrenal gland vein image (75840) |
$697.50 |
$2,413.50 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$624.68 |
$2,161.50 |
0.2× |
| Ribs bilateral 3 views (71110) |
$99.42 |
$344 |
1.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$716.86 |
$2,480.50 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$774.08 |
$2,678.50 |
1.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,228.25 |
$4,250 |
1.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$223.40 |
$773 |
1.1× |
| Rp Therapy Intravenous Administration (79101) |
$455.03 |
$1,574.50 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$117.62 |
$407 |
1.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$237.84 |
$823 |
1.1× |
| Scanogram (77073) |
$68.64 |
$237.50 |
0.7× |
| Scapula complete (73010) |
$95.08 |
$329 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$7.23 |
$25 |
0.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$224.99 |
$778.50 |
2.4× |
| Sialogram (70390) |
$187.85 |
$650 |
0.9× |
| Simulation intermediate (77285) |
$886.08 |
$3,066 |
2.6× |
| Small bowel series (74250) |
$320.79 |
$1,110 |
2.0× |
| Spec medical radj physics consltj (77370) |
$345.21 |
$1,194.50 |
2.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$732.62 |
$2,535 |
2.2× |
| Special dosimetry (77331) |
$257.07 |
$889.50 |
2.1× |
| Special treatment procedure (77470) |
$879.43 |
$3,043 |
1.8× |
| Spine thoracic 3 views (72072) |
$64.30 |
$222.50 |
0.7× |
| Splenoportograpy rs&i (75810) |
$579.59 |
$2,005.50 |
0.2× |
| Stereotactic body radiation delivery (77373) |
$2,282.67 |
$7,898.50 |
1.4× |
| Superior sagittal sinus venogram (75870) |
$528.44 |
$1,828.50 |
0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$693.16 |
$2,398.50 |
2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$379.60 |
$1,313.50 |
1.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,098.34 |
$3,800.50 |
3.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$565 |
$1,955 |
4.6× |
| Therapeutic Enema (74283) |
$373.39 |
$1,292 |
2.3× |
| Thoracolumbar 2 views (72080) |
$62.86 |
$217.50 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,050.95 |
$3,636.50 |
2.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$402.44 |
$1,392.50 |
1.1× |
| Thyroid uptake measurement (78012) |
$214.44 |
$742 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$443.62 |
$1,535 |
1.2× |
| Treatment device intermediate (77333) |
$399.83 |
$1,383.50 |
3.3× |
| Treatment devices simple (77332) |
$398.82 |
$1,380 |
3.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$880.30 |
$3,046 |
1.8× |
| Tx devices design & construction complex (77334) |
$534.36 |
$1,849 |
1.6× |
| Ultrasound elastography first target lesion (76982) |
$100.43 |
$347.50 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$278.88 |
$965 |
2.9× |
| Umbilical-artery Doppler (OB) (76820) |
$131.35 |
$454.50 |
1.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$475.98 |
$1,647 |
6.0× |
| Unlisted fluoroscopic procedure (76496) |
$49.13 |
$170 |
0.6× |
| Unlisted magnetic resonance procedure (76498) |
$98.26 |
$340 |
1.2× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$762.10 |
$2,637 |
8.2× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$173.11 |
$599 |
0.5× |
| Unlisted Ultrasound Procedure (76999) |
$194.78 |
$674 |
2.5× |
| Upper Extremity Infant (73092) |
$34.68 |
$120 |
0.4× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$601.26 |
$2,080.50 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$358.94 |
$1,242 |
1.7× |
| Urethrocystography voiding (74455) |
$451.42 |
$1,562 |
2.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$393.62 |
$1,362 |
2.5× |
| Us abdl aorta screen aaa (76706) |
$80.06 |
$277 |
0.8× |
| Us breast unilateral complete (76641) |
$217.04 |
$751 |
2.3× |
| Us breast unilateral limited (76642) |
$217.04 |
$751 |
2.7× |
| Us chest (76604) |
$101.44 |
$351 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$205.48 |
$711 |
2.2× |
| Us elastography parenchyma (76981) |
$100.43 |
$347.50 |
1.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$191.02 |
$661 |
2.0× |
| Us guided compression repair (76936) |
$369.78 |
$1,279.50 |
1.9× |
| Us infant hips dynamic (76885) |
$279.90 |
$968.50 |
3.5× |
| Us infant hips limited static (76886) |
$248.83 |
$861 |
3.2× |
| Us kidney transplant (76776) |
$192.62 |
$666.50 |
2.0× |
| Us ob detailed single fetus (76811) |
$172.10 |
$595.50 |
0.8× |
| Us ob transvaginal (76817) |
$217.32 |
$752 |
2.3× |
| Us pelvic non ob complete (76856) |
$417.03 |
$1,443 |
4.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$44.08 |
$152.50 |
0.5× |
| Us pregnancy ltd (76815) |
$152.88 |
$529 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$242.62 |
$839.50 |
2.6× |
| Us retroperitoneal complete (76770) |
$430.03 |
$1,488 |
4.5× |
| Us retroperitoneal limited (76775) |
$205.34 |
$710.50 |
2.2× |
| Us scrotum and contents (76870) |
$305.04 |
$1,055.50 |
3.2× |
| Us soft tissue head/neck (76536) |
$318.34 |
$1,101.50 |
3.4× |
| Us spinal canal and contents (76800) |
$268.77 |
$930 |
2.8× |
| Us transrectal (76872) |
$172.10 |
$595.50 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$66.04 |
$228.50 |
0.7× |
| Us, eye b-scan (76512) |
$122.10 |
$422.50 |
1.3× |
| Venogram extremity bilateral (75822) |
$371.51 |
$1,285.50 |
0.3× |
| Venogram orbital (75880) |
$401.42 |
$1,389 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$824.81 |
$2,854 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$756.17 |
$2,616.50 |
0.5× |
| Venography epidural rs&i (75872) |
$348.54 |
$1,206 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$325.56 |
$1,126.50 |
0.2× |
| Venography Renal Bilateral (75833) |
$558.35 |
$1,932 |
0.2× |
| Venography renal unilateral selective rs&i (75831) |
$527.86 |
$1,826.50 |
0.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$511.24 |
$1,769 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$900.09 |
$3,114.50 |
0.2× |
| Wrist 2 views (73100) |
$75.43 |
$261 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$315.44 |
$1,091.50 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$53.76 |
$186 |
0.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$86.99 |
$301 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$463.56 |
$1,604 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$88.87 |
$307.50 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$88.87 |
$307.50 |
1.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$109.54 |
$379 |
1.2× |
| X-ray exam hip uni 1 view (73501) |
$42.77 |
$148 |
0.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$56.94 |
$197 |
0.7× |
| X-ray exam hip uni 4/> views (73503) |
$71.24 |
$246.50 |
0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$96.82 |
$335 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$101.01 |
$349.50 |
1.1× |
| X-ray exam of femur 1 (73551) |
$61.56 |
$213 |
0.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$426.71 |
$1,476.50 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$106.79 |
$369.50 |
1.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$106.79 |
$369.50 |
1.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$82.51 |
$285.50 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$382.35 |
$1,323 |
0.2× |
| X-ray head for orthodontia (70350) |
$43.35 |
$150 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$77.46 |
$268 |
1.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$354.89 |
$1,228 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$77.16 |
$267 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$103.32 |
$357.50 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$63.72 |
$220.50 |
0.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$33.52 |
$116 |
0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$143.20 |
$495.50 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$199.84 |
$691.50 |
2.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$98.54 |
$341 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$89.16 |
$308.50 |
1.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$116.90 |
$404.50 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$51.58 |
$178.50 |
0.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$101.58 |
$351.50 |
1.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$197.96 |
$685 |
0.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$554.02 |
$1,917 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$85.11 |
$294.50 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$158.52 |
$548.50 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$172.53 |
$597 |
1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$117.62 |
$407 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$122.39 |
$423.50 |
1.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$91.62 |
$317 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$147.68 |
$511 |
1.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$140.89 |
$487.50 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$107.36 |
$371.50 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$107.36 |
$371.50 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$105.92 |
$366.50 |
1.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$22.68 |
$78.50 |
0.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$72.82 |
$252 |
0.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$62.86 |
$217.50 |
0.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$64.30 |
$222.50 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$74.56 |
$258 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$85.11 |
$294.50 |
1.1× |
| Xr arthrogram ankle (73615) |
$156.78 |
$542.50 |
0.5× |
| Xr c-spine 6 or more views (72052) |
$146.38 |
$506.50 |
1.5× |
| Xr chest 4+ views (71048) |
$172.82 |
$598 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$74.56 |
$258 |
0.9× |
| Xr shoulder 1 view (73020) |
$82.51 |
$285.50 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$146.38 |
$506.50 |
1.5× |
| Xr tibia/fibula 2 views (73590) |
$85.69 |
$296.50 |
1.1× |
| Xr tmj bilateral (70330) |
$31.06 |
$107.50 |
0.4× |
| Xray knee 1 or 2 views rt (73560) |
$90.74 |
$314 |
1.1× |