| 3-D radiotherapy plan dose-volume histograms (77295) |
$176.33 |
$262 |
0.1× |
| Abdomen 2 views (74019) |
$374.86 |
$557 |
3.5× |
| Acute gi blood loss imaging (78278) |
$1,498.77 |
$2,227 |
3.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,686.62 |
$3,992 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$3,037.25 |
$4,513 |
0.9× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,086.97 |
$3,101 |
0.4× |
| Ankle 2 views (73600) |
$264.49 |
$393 |
2.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,879.77 |
$4,279 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,576.92 |
$3,829 |
0.8× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$2,420.11 |
$3,596 |
0.7× |
| Arthrogram elbow (73085) |
$504.75 |
$750 |
1.4× |
| Arthrogram hip (73525) |
$306.89 |
$456 |
0.8× |
| Arthrogram knee (73580) |
$522.25 |
$776 |
1.4× |
| Arthrogram shoulder (73040) |
$668.96 |
$994 |
1.9× |
| Arthrogram wrist (73115) |
$374.86 |
$557 |
1.0× |
| Basic dosimetry (77300) |
$24.90 |
$37 |
0.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$887.69 |
$1,319 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$1,131.99 |
$1,682 |
2.7× |
| Bone age studies (77072) |
$202.57 |
$301 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,320.43 |
$1,962 |
3.2× |
| Bone survey complete (77075) |
$664.25 |
$987 |
6.1× |
| Bone survey infant (77076) |
$379.57 |
$564 |
3.5× |
| Bowel imaging (78290) |
$372.84 |
$554 |
0.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,175.06 |
$1,746 |
2.8× |
| Cervical spine 2 or 3 views (72040) |
$391.69 |
$582 |
4.3× |
| Chest 1 view (71045) |
$249.01 |
$370 |
2.8× |
| Chest xray 3 views (71047) |
$232.18 |
$345 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$421.97 |
$627 |
2.3× |
| Clavicle complete (73000) |
$270.55 |
$402 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,230.24 |
$1,828 |
11.4× |
| Continuing medical physics consltj pr wk (77336) |
$59.90 |
$89 |
0.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,716.90 |
$4,037 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,228.98 |
$3,312 |
9.0× |
| CT abdomen w contrast (74160) |
$1,376.96 |
$2,046 |
7.6× |
| CT abdomen w wo contrast (74170) |
$1,675.77 |
$2,490 |
9.2× |
| CT abdomen w/o contrast (74150) |
$1,115.16 |
$1,657 |
10.3× |
| CT angio hrt w/3d image (75574) |
$2,114.57 |
$3,142 |
5.9× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,693.94 |
$2,517 |
9.3× |
| CT angiography upper extremity lt (73206) |
$1,501.46 |
$2,231 |
8.3× |
| CT c-spine w/contrast (72126) |
$1,509.54 |
$2,243 |
4.2× |
| CT c-spine w/o contrast (72125) |
$1,490.70 |
$2,215 |
13.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,532.42 |
$2,277 |
8.4× |
| CT chest w contrast (71260) |
$1,438.20 |
$2,137 |
7.9× |
| CT chest w/wo contrast (71270) |
$1,445.60 |
$2,148 |
8.0× |
| CT head/brain with contrast (70460) |
$1,290.14 |
$1,917 |
7.1× |
| CT head/brain without and with contrast (70470) |
$1,488.68 |
$2,212 |
8.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$197.86 |
$294 |
0.5× |
| CT iac w contrast (70481) |
$1,356.77 |
$2,016 |
7.5× |
| CT limited/localized follow up study (76380) |
$604.35 |
$898 |
6.7× |
| CT lower ext w/o (73700) |
$1,348.69 |
$2,004 |
12.5× |
| CT lower extremity w wo contrast (73702) |
$1,811.72 |
$2,692 |
10.0× |
| CT lower extremity w/contrast material (73701) |
$1,403.21 |
$2,085 |
7.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,750.47 |
$2,601 |
9.6× |
| CT lumbar spine w/contrast (72132) |
$1,367.54 |
$2,032 |
3.8× |
| CT lumbar spine w/o contrast (72131) |
$1,359.46 |
$2,020 |
12.6× |
| CT maxillofacial w contrast (70487) |
$1,317.06 |
$1,957 |
7.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,554.63 |
$2,310 |
8.6× |
| CT maxillofacial wo contrast (70486) |
$1,282.74 |
$1,906 |
11.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,448.30 |
$2,152 |
8.0× |
| CT orbits w/o contrast (70480) |
$1,181.12 |
$1,755 |
10.9× |
| CT pelvis w/o contrast (72192) |
$1,269.95 |
$1,887 |
11.7× |
| CT pelvis w/wo contrast (72194) |
$1,543.19 |
$2,293 |
8.5× |
| CT scan of arm combo (73202) |
$1,386.38 |
$2,060 |
7.6× |
| CT soft tissue neck w contrast (70491) |
$1,340.62 |
$1,992 |
7.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,426.76 |
$2,120 |
7.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,101.03 |
$1,636 |
10.2× |
| CT thoracic spine w/contrast (72129) |
$1,311.68 |
$1,949 |
7.2× |
| CT thoracic spine w/o contrast (72128) |
$1,306.29 |
$1,941 |
12.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,516.27 |
$2,253 |
8.3× |
| CT thorax w/o contrast (71250) |
$1,269.28 |
$1,886 |
11.7× |
| CT upper ext wo (73200) |
$1,175.73 |
$1,747 |
10.9× |
| CT upper extremity with contrast (73201) |
$1,384.36 |
$2,057 |
3.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,088.32 |
$3,103 |
11.5× |
| Cta Abdomen (74175) |
$1,850.08 |
$2,749 |
10.2× |
| CTA abdomen pelvis (74174) |
$2,967.93 |
$4,410 |
8.2× |
| CTA chest (71275) |
$1,841.33 |
$2,736 |
10.1× |
| Cta Head (70496) |
$1,794.22 |
$2,666 |
9.9× |
| Cta Neck (70498) |
$1,792.20 |
$2,663 |
9.9× |
| Cta Pelvis (72191) |
$1,543.19 |
$2,293 |
8.5× |
| Cystography minimum 3 views rs&i (74430) |
$618.49 |
$919 |
1.7× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$1,259.18 |
$1,871 |
0.6× |
| Esophagus (74220) |
$419.28 |
$623 |
2.3× |
| Facial bones min 3 views (70150) |
$339.19 |
$504 |
3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$451.58 |
$671 |
4.2× |
| Fluoroscopy up to 1 hr (76000) |
$347.94 |
$517 |
1.4× |
| Foot 2 views (73620) |
$259.10 |
$385 |
2.9× |
| Forearm 2 views (73090) |
$264.49 |
$393 |
2.9× |
| Hand 2 views (73120) |
$198.54 |
$295 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,407.24 |
$2,091 |
2.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,245.05 |
$1,850 |
3.0× |
| Hysterosalpingogram (74740) |
$539.75 |
$802 |
2.2× |
| Interstitial radiation source applic complex (77778) |
$3,819.28 |
$5,675 |
5.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$932.10 |
$1,385 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,192.56 |
$1,772 |
2.1× |
| Knee 3 views (73562) |
$228.15 |
$339 |
2.5× |
| Liver & spleen imaging static only (78215) |
$819.04 |
$1,217 |
2.0× |
| Lung ventilation imaging (78579) |
$578.11 |
$859 |
1.4× |
| Lymphoscintigraphy (78195) |
$1,485.98 |
$2,208 |
2.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,158.31 |
$3,207 |
2.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,574.15 |
$2,339 |
4.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,445.68 |
$3,634 |
6.8× |
| Mammary ductogram or galactogram single (77053) |
$320.35 |
$476 |
1.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$170.94 |
$254 |
0.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$33.65 |
$50 |
1.1× |
| MRA head w & w/o contrast (70546) |
$2,335.98 |
$3,471 |
6.5× |
| MRA head w/o contrast (70544) |
$1,975.26 |
$2,935 |
8.0× |
| MRA head with contrast (70545) |
$1,460.41 |
$2,170 |
4.0× |
| MRA neck w contrast (70548) |
$1,860.84 |
$2,765 |
5.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,494.81 |
$3,707 |
6.9× |
| MRA neck w/o contrast (70547) |
$1,767.30 |
$2,626 |
7.2× |
| MRI abdomen w contrast (74182) |
$1,857.48 |
$2,760 |
5.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,697.38 |
$4,008 |
7.5× |
| MRI abdomen w/o contrast (74181) |
$2,013.62 |
$2,992 |
8.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,241.76 |
$3,331 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,407.32 |
$3,577 |
6.7× |
| MRI breast w/o contrast bilateral (77047) |
$2,539.90 |
$3,774 |
10.3× |
| MRI breast wo contrast unilateral (77046) |
$1,702.69 |
$2,530 |
6.9× |
| MRI c-spine with contrast (72142) |
$1,804.31 |
$2,681 |
5.0× |
| MRI cervical spine w/o contrast (72141) |
$1,978.62 |
$2,940 |
8.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,178.50 |
$3,237 |
6.0× |
| MRI chest w/o contrast (71550) |
$1,710.09 |
$2,541 |
6.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,621.26 |
$2,409 |
4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,456.45 |
$3,650 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,974.58 |
$2,934 |
8.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,753.17 |
$2,605 |
7.1× |
| MRI orbit face neck w contrast (70542) |
$1,867.58 |
$2,775 |
5.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,495.48 |
$3,708 |
6.9× |
| MRI pelvis w/contrast (72196) |
$2,086.30 |
$3,100 |
5.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,574.90 |
$3,826 |
7.1× |
| MRI pelvis w/o contrast (72195) |
$1,990.06 |
$2,957 |
8.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,561.44 |
$3,806 |
7.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,099.09 |
$3,119 |
5.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,613.93 |
$3,884 |
7.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,129.37 |
$3,164 |
5.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,519.04 |
$3,743 |
7.0× |
| MRI temporomandibular joint (70336) |
$1,704.71 |
$2,533 |
6.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,981.31 |
$2,944 |
8.0× |
| MRI up ext w/o contrast (73218) |
$1,989.39 |
$2,956 |
8.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,956.41 |
$2,907 |
7.9× |
| MRI, joint upper extrem combo (73223) |
$2,497.50 |
$3,711 |
6.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,612.59 |
$3,882 |
1.9× |
| Myocardial spect single study at rest or stress (78451) |
$2,128.03 |
$3,162 |
1.6× |
| Neck soft tissue (70360) |
$188.44 |
$280 |
2.1× |
| Nm gastric emptying study (78264) |
$1,222.84 |
$1,817 |
3.0× |
| Nonvascular shunt X-ray (75809) |
$116.43 |
$173 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,078.15 |
$1,602 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$623.87 |
$927 |
2.6× |
| Ob us nuchal meas 1 gest (76813) |
$354 |
$526 |
3.3× |
| Orthopantogram (70355) |
$224.11 |
$333 |
2.5× |
| Parathyrd planar w/spect&CT (78072) |
$712.03 |
$1,058 |
1.3× |
| Parathyroid Planar Imaging (78070) |
$710.69 |
$1,056 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$275.93 |
$410 |
2.5× |
| PET image w/CT, skull-thigh (78815) |
$3,961.28 |
$5,886 |
2.7× |
| PET imaging CT for attenuation limited area (78814) |
$2,887.84 |
$4,291 |
2.0× |
| PET imaging for CT attenuation whole body (78816) |
$3,785.63 |
$5,625 |
2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$681.08 |
$1,012 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,144.77 |
$1,701 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$694.54 |
$1,032 |
1.2× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$296.79 |
$441 |
3.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$182.38 |
$271 |
2.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$314.96 |
$468 |
3.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$228.15 |
$339 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$273.24 |
$406 |
2.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$269.87 |
$401 |
2.5× |
| Radex fingr minimum 2 views (73140) |
$214.01 |
$318 |
2.4× |
| Radex Foot Compl Minimum 3 Views (73630) |
$271.89 |
$404 |
3.0× |
| Radex Hand Minimum 3 Views (73130) |
$225.46 |
$335 |
2.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$259.78 |
$386 |
2.9× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$326.41 |
$485 |
3.0× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$345.25 |
$513 |
3.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$391.69 |
$582 |
3.6× |
| Radex Humerus Minimum 2 Views (73060) |
$281.99 |
$419 |
3.1× |
| Radex Kne 1/2 Views (73560) |
$261.80 |
$389 |
2.9× |
| Radex Kne Compl 4/More Views (73564) |
$360.73 |
$536 |
3.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$349.29 |
$519 |
3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$209.98 |
$312 |
2.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$257.09 |
$382 |
2.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$318.33 |
$473 |
3.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$162.87 |
$242 |
1.8× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$289.39 |
$430 |
2.7× |
| Radex Toe Minimum 2 Views (73660) |
$214.01 |
$318 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$181.71 |
$270 |
1.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$279.30 |
$415 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$261.80 |
$389 |
2.9× |
| Radiologic exam chest 2 views (71046) |
$259.10 |
$385 |
2.9× |
| Radiologic exam colon single contrast study (74270) |
$549.84 |
$817 |
3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$363.42 |
$540 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$520.90 |
$774 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$446.87 |
$664 |
2.5× |
| Radiologic examination femur 1 view (73551) |
$268.53 |
$399 |
3.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$281.99 |
$419 |
3.1× |
| Radiological examination surgical specimen (76098) |
$387.65 |
$576 |
0.7× |
| Renal Cyst Study (74470) |
$205.94 |
$306 |
0.4× |
| Ribs bilateral 3 views (71110) |
$231.51 |
$344 |
2.1× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$325.73 |
$484 |
0.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,663.66 |
$2,472 |
3.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,649.52 |
$2,451 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,578.19 |
$2,345 |
1.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,625.30 |
$2,415 |
1.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$325.73 |
$484 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$272.56 |
$405 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$181.71 |
$270 |
1.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$498.69 |
$741 |
2.0× |
| Scapula (73010) |
$230.17 |
$342 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$80.09 |
$119 |
3.4× |
| Shoulder 1 view (73020) |
$255.07 |
$379 |
2.8× |
| Simulation intermediate (77285) |
$265.84 |
$395 |
0.7× |
| Small bowel series (74250) |
$526.96 |
$783 |
2.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$29.61 |
$44 |
0.1× |
| Special dosimetry (77331) |
$107.68 |
$160 |
0.8× |
| Special Physics Consult (77370) |
$90.18 |
$134 |
0.6× |
| Special treatment procedure (77470) |
$20.19 |
$30 |
0.0× |
| Spine thoracic 3 views (72072) |
$366.78 |
$545 |
3.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$91.53 |
$136 |
0.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$50.48 |
$75 |
0.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$275.93 |
$410 |
0.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$170.94 |
$254 |
1.2× |
| Thoracolumbar 2 views (72080) |
$218.05 |
$324 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,273.32 |
$1,892 |
2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$862.79 |
$1,282 |
2.1× |
| Tmj unilateral (70328) |
$115.76 |
$172 |
1.3× |
| Treatment device complex (77334) |
$438.46 |
$651.50 |
1.1× |
| Treatment device intermediate (77333) |
$68.06 |
$101.13 |
0.5× |
| Treatment devices simple (77332) |
$10.10 |
$15 |
0.1× |
| Ultrasound breast complete (76641) |
$407.84 |
$606 |
3.8× |
| Ultrasound Exam Aaa Screen (76706) |
$376.88 |
$560 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$489.27 |
$727 |
4.5× |
| Umbilical-artery Doppler (OB) (76820) |
$267.85 |
$398 |
2.5× |
| Ureteral reflux study (78740) |
$316.31 |
$470 |
0.8× |
| Urethrocystogram voiding (74455) |
$616.47 |
$916 |
2.5× |
| Urethrocystography retrograde rs&i (74450) |
$452.93 |
$673 |
1.8× |
| Us breast unilateral limited (76642) |
$320.35 |
$476 |
3.6× |
| Us chest (76604) |
$345.25 |
$513 |
3.2× |
| Us elastography parenchyma (76981) |
$306.89 |
$456 |
2.8× |
| Us encephalogram (76506) |
$237.57 |
$353 |
2.2× |
| Us hips infant static (76886) |
$212.67 |
$316 |
2.4× |
| Us infant hips w manipulation (76885) |
$377.55 |
$561 |
4.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$354.68 |
$527 |
3.3× |
| Us ob limited (76815) |
$309.24 |
$459.50 |
2.9× |
| Us ob transvaginal (76817) |
$372.84 |
$554 |
3.4× |
| Us pelvic non ob complete (76856) |
$512.83 |
$762 |
4.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$238.24 |
$354 |
2.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$475.81 |
$707 |
4.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$425.34 |
$632 |
3.9× |
| Us retroperitoneal complete (76770) |
$490.62 |
$729 |
4.5× |
| Us retroperitoneal limited (76775) |
$432.07 |
$642 |
4.0× |
| Us scrotum and contents (76870) |
$449.56 |
$668 |
4.2× |
| Us soft tissue head/neck (76536) |
$425.34 |
$632 |
3.9× |
| Us spinal canal and contents (76800) |
$319.68 |
$475 |
3.0× |
| Us transrectal (76872) |
$409.86 |
$609 |
3.8× |
| Us transrectal prostate volume (76873) |
$1,551.26 |
$2,305 |
14.3× |
| Us, eye b-scan (76512) |
$82.11 |
$122 |
0.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$504.75 |
$750 |
4.7× |
| Venogram Extremity Unilateral (75820) |
$1,184.48 |
$1,760 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,942.43 |
$5,858 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$1,712.78 |
$2,545 |
1.1× |
| Wrist 2 views (73100) |
$264.49 |
$393 |
2.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$331.12 |
$492 |
3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$226.80 |
$337 |
2.5× |
| X-ray b.e. reductn intuss (74283) |
$442.83 |
$658 |
2.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$799.52 |
$1,188 |
4.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$264.49 |
$393 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$251.70 |
$374 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$364.09 |
$541 |
3.4× |
| X-ray exam of femur 2/> (73552) |
$291.41 |
$433 |
3.2× |
| X-ray eye for foreign body (70030) |
$265.16 |
$394 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$317.66 |
$472 |
3.5× |
| X-ray IV pyelogram (ivp) (74400) |
$376.88 |
$560 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$206.61 |
$307 |
2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$205.94 |
$306 |
2.3× |
| X-ray leg, infant (73592) |
$177.67 |
$264 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$391.69 |
$582 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$335.15 |
$498 |
3.1× |
| X-ray nose-rectum child f.b. (76010) |
$193.82 |
$288 |
2.2× |
| X-ray optic foramen (70190) |
$96.91 |
$144 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$308.23 |
$458 |
2.8× |
| X-ray retrograde pyelogram (74420) |
$653.48 |
$971 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$203.92 |
$303 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$350.63 |
$521 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$353.33 |
$525 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$329.77 |
$490 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$371.50 |
$552 |
4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$289.39 |
$430 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$310.93 |
$462 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$227.47 |
$338 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$205.26 |
$305 |
2.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$69.99 |
$104 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$275.93 |
$410 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$237.57 |
$353 |
2.2× |
| Xr bone length studies (77073) |
$271.89 |
$404 |
2.5× |
| Xr c-spine 4 or 5 views (72050) |
$452.26 |
$672 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$528.98 |
$786 |
4.9× |
| Xr urogram antegrade (74425) |
$536.38 |
$797 |
1.5× |