| 3-D radiotherapy plan dose-volume histograms (77295) |
$12,622.40 |
$18,032 |
9.5× |
| Abdomen 2 views (74019) |
$354.55 |
$506.50 |
3.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,408.40 |
$2,012 |
3.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,373.70 |
$3,391 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$4,427.50 |
$6,325 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$3,589.60 |
$5,128 |
1.2× |
| Angiography internal mammary rs&i (75756) |
$1,999.90 |
$2,857 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,084.20 |
$4,406 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,845.90 |
$2,637 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,627.50 |
$2,325 |
0.5× |
| Angiography Spinal Selective Rs&I (75705) |
$3,908.10 |
$5,583 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,751.30 |
$5,359 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,537.90 |
$2,197 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,710.10 |
$2,443 |
0.6× |
| Ankle 2 views (73600) |
$219.10 |
$313 |
2.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$806.75 |
$1,152.50 |
2.4× |
| Aortogram thoracic (75605) |
$3,439.10 |
$4,913 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,697 |
$6,710 |
1.6× |
| Aortography abdominal serialography rs&i (75625) |
$3,810.80 |
$5,444 |
1.3× |
| Artery X-Rays Adrenal Gland (75731) |
$1,547.70 |
$2,211 |
0.5× |
| Arthrogram elbow (73085) |
$387.10 |
$553 |
1.2× |
| Arthrogram hip (73525) |
$382.55 |
$546.50 |
1.1× |
| Arthrogram shoulder (73040) |
$618.80 |
$884 |
1.9× |
| Arthrogram wrist (73115) |
$276.85 |
$395.50 |
0.8× |
| Arthrography knee lt (73580) |
$269.15 |
$384.50 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$403.55 |
$576.50 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,105.60 |
$3,008 |
5.5× |
| Bone &/joint imaging whole body (78306) |
$2,264.50 |
$3,235 |
5.9× |
| Bone age studies (77072) |
$196.70 |
$281 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$2,801.05 |
$4,001.50 |
7.3× |
| Bone survey complete (77075) |
$682.15 |
$974.50 |
6.8× |
| Brachytx isodose complex (77318) |
$2,819.60 |
$4,028 |
7.9× |
| Brachytx isodose intermed (77317) |
$2,347.10 |
$3,353 |
6.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,878.10 |
$2,683 |
5.2× |
| Brain image w/flow 4 + views (78606) |
$1,287.30 |
$1,839 |
2.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$599.90 |
$857 |
1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,723.50 |
$9,605 |
4.9× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$667.80 |
$954 |
60.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,191.40 |
$1,702 |
3.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,337 |
$1,910 |
2.6× |
| Cervical spine 2 or 3 views (72040) |
$352.80 |
$504 |
4.2× |
| Chest 1 view (71045) |
$292.25 |
$417.50 |
3.5× |
| Chest 3 views (71047) |
$347.20 |
$496 |
4.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$499.10 |
$713 |
3.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$960.40 |
$1,372 |
1.3× |
| Clavicle complete (73000) |
$219.10 |
$313 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$265.65 |
$379.50 |
2.7× |
| Continuing medical physics consltj pr wk (77336) |
$781.20 |
$1,116 |
6.1× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$573.30 |
$819 |
3.4× |
| Corpora cavernosography (74445) |
$660.10 |
$943 |
6.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,378.55 |
$4,826.50 |
10.1× |
| CT abdomen and pelvis without contrast (74176) |
$2,466.80 |
$3,524 |
10.8× |
| CT abdomen w contrast (74160) |
$2,609.25 |
$3,727.50 |
15.6× |
| CT abdomen w wo contrast (74170) |
$2,975.70 |
$4,251 |
17.7× |
| CT abdomen w/o contrast (74150) |
$2,032.80 |
$2,904 |
20.3× |
| CT angio hrt w/3d image (75574) |
$1,894.90 |
$2,707 |
5.7× |
| CT angiography upper extremity lt (73206) |
$1,765.75 |
$2,522.50 |
10.5× |
| CT c-spine w/o contrast (72125) |
$1,562.05 |
$2,231.50 |
15.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,644.95 |
$3,778.50 |
15.8× |
| CT cervical spine with contrast (72126) |
$2,094.75 |
$2,992.50 |
6.3× |
| CT chest w/wo contrast (71270) |
$1,867.25 |
$2,667.50 |
11.1× |
| CT chest with contrast (71260) |
$1,640.10 |
$2,343 |
9.8× |
| CT colonography screening (74263) |
$1,394.40 |
$1,992 |
6.1× |
| CT head/brain with contrast (70460) |
$1,187.20 |
$1,696 |
7.1× |
| CT head/brain without and with contrast (70470) |
$1,404.20 |
$2,006 |
8.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$770.70 |
$1,101 |
2.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$186.90 |
$267 |
2.2× |
| CT iac w contrast (70481) |
$1,618.75 |
$2,312.50 |
9.7× |
| CT limited/localized follow up study (76380) |
$506.10 |
$723 |
6.1× |
| CT lower ext w/o (73700) |
$969.85 |
$1,385.50 |
9.7× |
| CT lower extremity w wo contrast (73702) |
$1,526.70 |
$2,181 |
9.1× |
| CT lower extremity with contrast (73701) |
$1,359.05 |
$1,941.50 |
8.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,996.40 |
$2,852 |
11.9× |
| CT lumbar spine w/o contrast (72131) |
$1,313.20 |
$1,876 |
13.1× |
| CT lumbar spine with contrast (72132) |
$1,823.85 |
$2,605.50 |
5.5× |
| CT maxillofacial w contrast (70487) |
$1,502.20 |
$2,146 |
9.0× |
| CT maxillofacial w/o contrast (70486) |
$1,263.15 |
$1,804.50 |
12.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,775.90 |
$2,537 |
10.6× |
| CT neck soft tissue w contrast (70491) |
$1,390.90 |
$1,987 |
8.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,859.20 |
$2,656 |
11.1× |
| CT orbits w/o contrast (70480) |
$1,387.05 |
$1,981.50 |
13.9× |
| CT pelvis w & w/o contrast (72194) |
$1,880.55 |
$2,686.50 |
11.2× |
| CT pelvis w/o contrast (72192) |
$1,208.90 |
$1,727 |
12.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,643.60 |
$2,348 |
9.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,171.10 |
$1,673 |
11.7× |
| CT thoracic spine w/contrast (72129) |
$1,642.20 |
$2,346 |
9.8× |
| CT thoracic spine w/o contrast (72128) |
$1,165.15 |
$1,664.50 |
11.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,350.30 |
$1,929 |
8.1× |
| CT thorax w/o contrast (71250) |
$1,250.20 |
$1,786 |
12.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,136.10 |
$1,623 |
11.4× |
| CT upper extremity with contrast (73201) |
$1,502.20 |
$2,146 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,348.50 |
$3,355 |
14.0× |
| Cta Abdomen (74175) |
$2,268 |
$3,240 |
13.5× |
| CTA abdomen pelvis (74174) |
$3,793.65 |
$5,419.50 |
11.4× |
| CTA chest (71275) |
$1,753.85 |
$2,505.50 |
10.5× |
| Cta Head (70496) |
$1,903.30 |
$2,719 |
11.4× |
| CTA lwr ext w&w/o contrast (73706) |
$1,831.55 |
$2,616.50 |
10.9× |
| Cta Neck (70498) |
$1,360.10 |
$1,943 |
8.1× |
| Cta Pelvis (72191) |
$1,238.30 |
$1,769 |
7.4× |
| Cystography minimum 3 views rs&i (74430) |
$764.40 |
$1,092 |
2.3× |
| Diskography lumbar (72295) |
$986.30 |
$1,409 |
0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$290.50 |
$415 |
2.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$416.50 |
$595 |
4.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$340.20 |
$486 |
3.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$447.65 |
$639.50 |
4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$90.30 |
$129 |
1.1× |
| Echo exam of fetal heart (76825) |
$542.50 |
$775 |
1.0× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$529.20 |
$756 |
2.3× |
| Echoencephalography real time imaging (76506) |
$301.70 |
$431 |
3.0× |
| Esophagus (74220) |
$547.75 |
$782.50 |
3.3× |
| Fetal biophysical profile non-stress testing (76818) |
$365.05 |
$521.50 |
3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$170.80 |
$244 |
1.7× |
| Fluoroscopy up to 1 hr (76000) |
$330.75 |
$472.50 |
1.5× |
| Foot 2 views (73620) |
$225.40 |
$322 |
2.7× |
| Forearm 2 views (73090) |
$225.40 |
$322 |
2.7× |
| Gated Heart Planar Single (78472) |
$877.80 |
$1,254 |
2.3× |
| Hand 2 views (73120) |
$190.40 |
$272 |
1.9× |
| Hand 3 views (73130) |
$215.60 |
$308 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,951.20 |
$4,216 |
4.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,376.80 |
$4,824 |
5.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,650.50 |
$5,215 |
5.5× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$645.40 |
$922 |
1.8× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$645.40 |
$922 |
1.8× |
| Heart Infarct Image (78466) |
$499.80 |
$714 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,911.70 |
$2,731 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,258.90 |
$3,227 |
4.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,040.85 |
$2,915.50 |
5.3× |
| Ht muscle image spect sing (78451) |
$5,971.70 |
$8,531 |
4.8× |
| Humerus Min 2 Views Left (73060) |
$217.35 |
$310.50 |
2.6× |
| Hysterosalpingogram (74740) |
$734.30 |
$1,049 |
3.2× |
| Interstitial radiation source applic complex (77778) |
$4,836.30 |
$6,909 |
7.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,950.20 |
$2,786 |
2.9× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,950.20 |
$2,786 |
3.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$133 |
$190 |
1.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,102.40 |
$4,432 |
6.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,687 |
$2,410 |
3.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$4,865.70 |
$6,951 |
9.4× |
| Knee 3 views (73562) |
$270.20 |
$386 |
3.2× |
| Liver & spleen imaging static only (78215) |
$3,087.70 |
$4,411 |
8.1× |
| Lung perf&ventilat diferentl (78598) |
$865.90 |
$1,237 |
1.7× |
| Lung perfusion differential (78597) |
$1,337.35 |
$1,910.50 |
3.5× |
| Lymphoscintigraphy (78195) |
$1,736.70 |
$2,481 |
3.3× |
| Mammary ductogram or galactogram multiple (77054) |
$976.50 |
$1,395 |
4.3× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$163.80 |
$234 |
2.0× |
| Meckels Diverticulum (78290) |
$1,578.50 |
$2,255 |
4.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,139.60 |
$1,628 |
3.2× |
| MRA head w & w/o contrast (70546) |
$2,162.65 |
$3,089.50 |
6.5× |
| MRA head w/o contrast (70544) |
$1,238.30 |
$1,769 |
5.4× |
| MRA head with contrast (70545) |
$2,058 |
$2,940 |
6.2× |
| MRA neck w contrast (70548) |
$1,237.95 |
$1,768.50 |
3.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,406.65 |
$2,009.50 |
4.2× |
| MRA neck w/o contrast (70547) |
$861.70 |
$1,231 |
3.8× |
| MRI abdomen w contrast (74182) |
$1,776.25 |
$2,537.50 |
5.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,429 |
$3,470 |
7.3× |
| MRI abdomen w/o contrast (74181) |
$1,599.85 |
$2,285.50 |
7.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,832.95 |
$2,618.50 |
2.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,905.40 |
$2,722 |
2.5× |
| MRI breast w/o contrast bilateral (77047) |
$245.70 |
$351 |
1.1× |
| MRI breast w/o contrast unilat (77046) |
$245.70 |
$351 |
1.1× |
| MRI c-spine with contrast (72142) |
$2,063.95 |
$2,948.50 |
6.2× |
| MRI cardiac w/o contrast (75557) |
$1,191.40 |
$1,702 |
5.2× |
| MRI cervical spine w/o contrast (72141) |
$1,568.35 |
$2,240.50 |
6.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,717.45 |
$2,453.50 |
5.2× |
| MRI chest w/o contrast (71550) |
$581.70 |
$831 |
2.6× |
| MRI fetal sngl/1st gestation (74712) |
$271.60 |
$388 |
1.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,916.95 |
$2,738.50 |
5.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,450.05 |
$2,071.50 |
6.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,502.20 |
$2,146 |
6.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,328.90 |
$3,327 |
7.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,342.90 |
$3,347 |
7.0× |
| MRI pelvis w contrast (72196) |
$1,494.50 |
$2,135 |
4.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,766.80 |
$2,524 |
5.3× |
| MRI pelvis w/o contrast (72195) |
$1,131.20 |
$1,616 |
5.0× |
| MRI scan of arm joint before and after contrast (73223) |
$2,121 |
$3,030 |
6.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,154.60 |
$3,078 |
6.5× |
| MRI spectroscopy (76390) |
$788.90 |
$1,127 |
9.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,651.60 |
$3,788 |
8.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,996.75 |
$2,852.50 |
6.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,580.90 |
$3,687 |
7.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,123.80 |
$3,034 |
6.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,412.55 |
$3,446.50 |
7.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,722 |
$2,460 |
7.6× |
| MRI tmj (70336) |
$514.50 |
$735 |
2.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,664.95 |
$2,378.50 |
7.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,138.85 |
$3,055.50 |
6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,337 |
$1,910 |
5.9× |
| Myelogram Cervical (72240) |
$1,188.60 |
$1,698 |
1.6× |
| Myelogram Lumbar (72265) |
$1,473.50 |
$2,105 |
2.0× |
| Myelogram thoracic (72255) |
$640.50 |
$915 |
0.9× |
| Myocardial infarct spect (78469) |
$1,068.20 |
$1,526 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$6,719.30 |
$9,599 |
5.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,402 |
$4,860 |
2.5× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$4,725.70 |
$6,751 |
2.2× |
| Neck soft tissue (70360) |
$261.45 |
$373.50 |
3.1× |
| Nm bone marrow multiple (78103) |
$1,522.50 |
$2,175 |
4.0× |
| Nm cisternogram (78630) |
$2,622.20 |
$3,746 |
5.1× |
| Nm gastric emptying study (78264) |
$2,081.80 |
$2,974 |
5.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,430.50 |
$10,615 |
5.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$5,357.10 |
$7,653 |
4.3× |
| Nuclear medicine of heart pumping function (78473) |
$1,465.10 |
$2,093 |
3.8× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$4,657.10 |
$6,653 |
3.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$3,675 |
$5,250 |
9.6× |
| Nuclear Rx Oral Admin (79005) |
$1,128.05 |
$1,611.50 |
5.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$422.80 |
$604 |
4.2× |
| Orthopantogram (70355) |
$101.50 |
$145 |
1.2× |
| Osseous survey infant (77076) |
$588.70 |
$841 |
5.9× |
| Osseous survey limited (77074) |
$770 |
$1,100 |
7.7× |
| Parathyrd planar w/spect&CT (78072) |
$1,528.10 |
$2,183 |
2.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,400 |
$2,000 |
3.7× |
| Parathyroid imaging (78070) |
$210.70 |
$301 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$218.05 |
$311.50 |
2.2× |
| Peritoneogram rs&i (74190) |
$366.10 |
$523 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$3,566.50 |
$5,095 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$3,566.50 |
$5,095 |
2.6× |
| PET imaging limited area chest head/neck (78811) |
$3,574.90 |
$5,107 |
2.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,260.30 |
$3,229 |
6.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,986.60 |
$2,838 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,894.20 |
$2,706 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,490.65 |
$2,129.50 |
3.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,975.05 |
$2,821.50 |
3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$723.80 |
$1,034 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$214.20 |
$306 |
2.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$223.30 |
$319 |
2.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$233.10 |
$333 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$147 |
$210 |
1.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$12,026.70 |
$17,181 |
1.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$997.50 |
$1,425 |
1.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$374.85 |
$535.50 |
3.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$771.40 |
$1,102 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$238.35 |
$340.50 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$281.05 |
$401.50 |
3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$354.55 |
$506.50 |
3.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$321.30 |
$459 |
3.9× |
| Radiologic exam colon single contrast study (74270) |
$786.80 |
$1,124 |
4.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$644.35 |
$920.50 |
3.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$659.75 |
$942.50 |
3.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$938 |
$1,340 |
5.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$196.70 |
$281 |
2.4× |
| Radiological examination surgical specimen (76098) |
$385.70 |
$551 |
0.7× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,373.70 |
$3,391 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,923.60 |
$2,748 |
0.6× |
| Ribs bilateral 3 views (71110) |
$237.30 |
$339 |
2.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,820 |
$2,600 |
3.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,209.25 |
$1,727.50 |
2.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,975 |
$4,250 |
2.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$586.60 |
$838 |
2.6× |
| Rp Therapy Intravenous Administration (79101) |
$1,195.60 |
$1,708 |
5.4× |
| Sacroiliac Joints < 3 Views (72200) |
$280.70 |
$401 |
2.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$571.20 |
$816 |
2.5× |
| Scanogram (77073) |
$103.60 |
$148 |
1.0× |
| Scapula complete (73010) |
$204.40 |
$292 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$17.50 |
$25 |
0.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$73.50 |
$105 |
0.7× |
| Sialogram (70390) |
$499.10 |
$713 |
2.2× |
| Simulation intermediate (77285) |
$2,351.30 |
$3,359 |
6.6× |
| Small bowel series (74250) |
$620.55 |
$886.50 |
3.7× |
| Spec medical radj physics consltj (77370) |
$916.30 |
$1,309 |
7.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,943.90 |
$2,777 |
5.4× |
| Special dosimetry (77331) |
$394.10 |
$563 |
3.1× |
| Special treatment procedure (77470) |
$2,333.80 |
$3,334 |
4.4× |
| Spine thoracic 3 views (72072) |
$243.95 |
$348.50 |
2.4× |
| Splenoportograpy rs&i (75810) |
$1,611.40 |
$2,302 |
0.5× |
| Stereotactic body radiation delivery (77373) |
$6,317.50 |
$9,025 |
3.7× |
| Superior sagittal sinus venogram (75870) |
$1,624.70 |
$2,321 |
0.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,839.60 |
$2,628 |
5.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,007.30 |
$1,439 |
2.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,602.30 |
$2,289 |
4.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$802.55 |
$1,146.50 |
6.2× |
| Therapeutic Enema (74283) |
$523.60 |
$748 |
3.1× |
| Thoracolumbar 2 views (72080) |
$237.65 |
$339.50 |
2.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,517.60 |
$2,168 |
2.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,057 |
$1,510 |
2.8× |
| Thyroid uptake measurement (78012) |
$563.50 |
$805 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$956.55 |
$1,366.50 |
2.5× |
| Treatment device intermediate (77333) |
$1,155 |
$1,650 |
9.0× |
| Treatment devices simple (77332) |
$1,032.50 |
$1,475 |
8.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,030 |
$2,900 |
3.9× |
| Tx devices design & construction complex (77334) |
$795.90 |
$1,137 |
2.2× |
| Ultrasound elastography first target lesion (76982) |
$241.50 |
$345 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$597.45 |
$853.50 |
6.0× |
| Umbilical-artery Doppler (OB) (76820) |
$340.20 |
$486 |
3.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$1,233.40 |
$1,762 |
14.8× |
| Unlisted fluoroscopic procedure (76496) |
$127.40 |
$182 |
1.5× |
| Unlisted magnetic resonance procedure (76498) |
$284.90 |
$407 |
3.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$2,022.30 |
$2,889 |
20.7× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$455 |
$650 |
1.2× |
| Unlisted Ultrasound Procedure (76999) |
$373.80 |
$534 |
4.5× |
| Upper Extremity Infant (73092) |
$157.50 |
$225 |
1.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,579.90 |
$2,257 |
4.1× |
| Urethrocystography retrograde rs&i (74450) |
$521.50 |
$745 |
2.3× |
| Urethrocystography voiding (74455) |
$826.35 |
$1,180.50 |
3.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$694.40 |
$992 |
4.1× |
| Us abdl aorta screen aaa (76706) |
$149.45 |
$213.50 |
1.5× |
| Us breast unilateral complete (76641) |
$526.75 |
$752.50 |
5.3× |
| Us breast unilateral limited (76642) |
$491.40 |
$702 |
5.9× |
| Us chest (76604) |
$243.60 |
$348 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$478.10 |
$683 |
4.8× |
| Us elastography parenchyma (76981) |
$241.50 |
$345 |
2.4× |
| Us fetal nuchal translucency 1st gestation (76813) |
$459.20 |
$656 |
4.6× |
| Us guided compression repair (76936) |
$958.30 |
$1,369 |
4.6× |
| Us infant hips dynamic (76885) |
$365.75 |
$522.50 |
4.4× |
| Us infant hips limited static (76886) |
$597.80 |
$854 |
7.2× |
| Us kidney transplant (76776) |
$462.70 |
$661 |
4.6× |
| Us ob detailed single fetus (76811) |
$413.70 |
$591 |
1.8× |
| Us ob transvaginal (76817) |
$487.55 |
$696.50 |
4.9× |
| Us pelvic non ob complete (76856) |
$817.60 |
$1,168 |
8.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$255.15 |
$364.50 |
2.6× |
| Us pregnancy ltd (76815) |
$385 |
$550 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$532.70 |
$761 |
5.3× |
| Us retroperitoneal complete (76770) |
$850.15 |
$1,214.50 |
8.5× |
| Us retroperitoneal limited (76775) |
$530.95 |
$758.50 |
5.3× |
| Us scrotum and contents (76870) |
$662.90 |
$947 |
6.6× |
| Us soft tissue head/neck (76536) |
$650.30 |
$929 |
6.5× |
| Us spinal canal and contents (76800) |
$368.55 |
$526.50 |
3.7× |
| Us transrectal (76872) |
$332.85 |
$475.50 |
3.3× |
| Us xtr non-vasc lmtd (76882) |
$310.80 |
$444 |
3.1× |
| Us, eye b-scan (76512) |
$293.30 |
$419 |
2.9× |
| Venogram extremity bilateral (75822) |
$1,110.20 |
$1,586 |
0.7× |
| Venogram orbital (75880) |
$1,040.20 |
$1,486 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,137.10 |
$3,053 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,959.30 |
$2,799 |
1.3× |
| Venography epidural rs&i (75872) |
$903 |
$1,290 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$844.55 |
$1,206.50 |
0.6× |
| Venography Renal Bilateral (75833) |
$1,777.30 |
$2,539 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$1,646.40 |
$2,352 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,016 |
$2,880 |
0.7× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,450.30 |
$4,929 |
0.6× |
| Wrist 2 views (73100) |
$203 |
$290 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$631.40 |
$902 |
6.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$193.20 |
$276 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$244.30 |
$349 |
2.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,067.15 |
$1,524.50 |
6.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$217.35 |
$310.50 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$247.45 |
$353.50 |
3.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$402.85 |
$575.50 |
4.0× |
| X-ray exam hip uni 1 view (73501) |
$134.05 |
$191.50 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$186.90 |
$267 |
2.2× |
| X-ray exam hip uni 4/> views (73503) |
$170.10 |
$243 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$242.55 |
$346.50 |
2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$240.45 |
$343.50 |
2.4× |
| X-ray exam of femur 1 (73551) |
$196.70 |
$281 |
2.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,134.70 |
$1,621 |
6.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$303.10 |
$433 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$254.80 |
$364 |
3.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$247.45 |
$353.50 |
3.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,445.50 |
$2,065 |
0.7× |
| X-ray head for orthodontia (70350) |
$105 |
$150 |
1.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$215.60 |
$308 |
2.6× |
| X-ray IV pyelogram+drip infusn (74410) |
$943.60 |
$1,348 |
5.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$184.10 |
$263 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$324.45 |
$463.50 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$222.60 |
$318 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$113.05 |
$161.50 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$342.65 |
$489.50 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$553.70 |
$791 |
5.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$235.20 |
$336 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$212.80 |
$304 |
2.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$228.55 |
$326.50 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$228.55 |
$326.50 |
2.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$280.35 |
$400.50 |
2.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$526.40 |
$752 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$908.95 |
$1,298.50 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$250.60 |
$358 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$368.55 |
$526.50 |
3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$442.75 |
$632.50 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$325.50 |
$465 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$303.10 |
$433 |
3.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$254.10 |
$363 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$435.75 |
$622.50 |
5.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$370.30 |
$529 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$320.60 |
$458 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$276.15 |
$394.50 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$240.10 |
$343 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$198.80 |
$284 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$228.20 |
$326 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$223.65 |
$319.50 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$153.30 |
$219 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$189.70 |
$271 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$246.05 |
$351.50 |
3.0× |
| Xr arthrogram ankle (73615) |
$373.80 |
$534 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$537.95 |
$768.50 |
5.4× |
| Xr chest 4+ views (71048) |
$435.40 |
$622 |
4.4× |
| Xr finger(s) 2+ views (73140) |
$190.05 |
$271.50 |
2.3× |
| Xr shoulder 1 view (73020) |
$212.80 |
$304 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$463.05 |
$661.50 |
4.6× |
| Xr tibia/fibula 2 views (73590) |
$249.90 |
$357 |
3.0× |
| Xr tmj bilateral (70330) |
$179.55 |
$256.50 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$241.50 |
$345 |
2.9× |