| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,227.20 |
$7,784 |
3.9× |
| Abdomen 1 View (74018) |
$254.40 |
$318 |
2.5× |
| Abdomen 2 views (74019) |
$369.60 |
$462 |
3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,678.40 |
$2,098 |
3.6× |
| Angio internal mammary (75756) |
$3,455.20 |
$4,319 |
0.9× |
| Angio pulmonary bilat (75743) |
$4,600 |
$5,750 |
1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,455.20 |
$4,319 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$5,042.40 |
$6,303 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$4,005.60 |
$5,007 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,455.20 |
$4,319 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,455.20 |
$4,319 |
0.9× |
| Ankle 2 views (73600) |
$214.40 |
$268 |
2.1× |
| Aortography thoracic serialography rs&i (75605) |
$4,384 |
$5,480 |
0.7× |
| Artery X-Rays Abdomen (75726) |
$3,455.20 |
$4,319 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$3,455.20 |
$4,319 |
0.9× |
| Artery X-Rays Pelvis (75736) |
$3,455.20 |
$4,319 |
0.5× |
| Artery X-Rays Spine (75705) |
$3,956 |
$4,945 |
0.6× |
| Arthrogram ankle (73615) |
$845.60 |
$1,057 |
2.1× |
| Arthrogram hip (73525) |
$1,007.20 |
$1,259 |
2.5× |
| Basic radiation dosimetry calculation (77300) |
$501.60 |
$627 |
3.2× |
| Bone age studies (77072) |
$156 |
$195 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$1,649.60 |
$2,062 |
3.6× |
| Bone Imaging Limited Area (78300) |
$1,420.80 |
$1,776 |
3.1× |
| Bone Imaging Multiple Areas (78305) |
$1,495.20 |
$1,869 |
3.2× |
| Bone Imaging Whole Body (78306) |
$1,649.60 |
$2,062 |
3.6× |
| Bone marrow imaging limited area (78102) |
$791.20 |
$989 |
1.7× |
| Bone marrow imaging; multiple areas (78103) |
$894.40 |
$1,118 |
1.9× |
| Bone marrow imaging; whole body (78104) |
$1,848 |
$2,310 |
4.0× |
| Bone survey infant (77076) |
$440 |
$550 |
3.6× |
| Brachytx isodose complex (77318) |
$1,251.20 |
$1,564 |
2.9× |
| Brain Image W/Flow < 4 Views (78601) |
$918.40 |
$1,148 |
2.0× |
| Brain imaging < 4 static views (78600) |
$833.60 |
$1,042 |
1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,271.20 |
$1,589 |
2.0× |
| Cat Scan Follow-Up Study (76380) |
$579.20 |
$724 |
5.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,302.40 |
$1,628 |
2.1× |
| Cerebrospinal Fluid Scan (78630) |
$1,652 |
$2,065 |
2.6× |
| Chest 1 view (71045) |
$163.20 |
$204 |
1.6× |
| Chest 2 views (71046) |
$220.80 |
$276 |
2.2× |
| Chest 3 views (71047) |
$258.40 |
$323 |
2.6× |
| Chest 4 or more views (71048) |
$343.20 |
$429 |
2.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$224 |
$280 |
1.8× |
| Clavicle complete (73000) |
$217.60 |
$272 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$239.20 |
$299 |
2.0× |
| Continuing medical physics consltj pr wk (77336) |
$919.20 |
$1,149 |
5.9× |
| Contrast Exam Abdominl Aorta (75625) |
$4,844 |
$6,055 |
1.3× |
| Contrast X-Ray Bladder (74430) |
$678.40 |
$848 |
1.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,082.40 |
$1,353 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,031.20 |
$3,789 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,880 |
$2,350 |
6.8× |
| CT abdomen w contrast (74160) |
$2,594.40 |
$3,243 |
12.7× |
| CT abdomen w wo contrast (74170) |
$3,005.60 |
$3,757 |
14.8× |
| CT abdomen w/o contrast (74150) |
$1,504.80 |
$1,881 |
12.4× |
| CT Angio Abdomen and Pelvis (74174) |
$4,001.60 |
$5,002 |
9.9× |
| CT Angio Chest (71275) |
$2,420 |
$3,025 |
11.9× |
| CT Angio Head (70496) |
$2,199.20 |
$2,749 |
10.8× |
| CT angio hrt w/3d image (75574) |
$2,078.40 |
$2,598 |
5.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,231.20 |
$1,539 |
6.0× |
| CT Angio Neck (70498) |
$2,152 |
$2,690 |
10.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,053.60 |
$1,317 |
5.2× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,228 |
$1,535 |
6.0× |
| CT cervical spine w/ contrast (72126) |
$3,081.60 |
$3,852 |
7.6× |
| CT cervical spine w/o contrast (72125) |
$1,533.60 |
$1,917 |
12.6× |
| CT cervical spine w/wo cont (72127) |
$3,434.40 |
$4,293 |
16.9× |
| CT chest w contrast (71260) |
$2,652.80 |
$3,316 |
13.0× |
| CT chest w/wo contrast (71270) |
$2,908 |
$3,635 |
14.3× |
| CT head/brain with contrast (70460) |
$2,080 |
$2,600 |
10.2× |
| CT head/brain without and with contrast (70470) |
$2,456 |
$3,070 |
12.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$156 |
$195 |
1.5× |
| CT iac w contrast (70481) |
$1,624 |
$2,030 |
8.0× |
| CT l-spine w&w/o contrast (72133) |
$2,772 |
$3,465 |
13.6× |
| CT lower ext w/o (73700) |
$1,246.40 |
$1,558 |
10.3× |
| CT lower extremity w/contrast material (73701) |
$1,856.80 |
$2,321 |
9.1× |
| CT lumbar spine w contrast (72132) |
$2,604 |
$3,255 |
6.4× |
| CT lumbar spine w/o contrast (72131) |
$2,100 |
$2,625 |
17.3× |
| CT maxillofacial w contrast (70487) |
$1,952.80 |
$2,441 |
9.6× |
| CT maxillofacial wo contrast (70486) |
$1,251.20 |
$1,564 |
10.3× |
| CT neck tissue combo (70492) |
$2,779.20 |
$3,474 |
13.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,331.20 |
$2,914 |
11.4× |
| CT orbits w/o contrast (70480) |
$1,376 |
$1,720 |
11.3× |
| CT pelvis w&w/o contrast (72194) |
$2,822.40 |
$3,528 |
13.9× |
| CT pelvis w/o contrast (72192) |
$1,471.20 |
$1,839 |
12.1× |
| CT scan of leg combo (73702) |
$2,237.60 |
$2,797 |
11.0× |
| CT scans face/jaw combo (70488) |
$2,556.80 |
$3,196 |
12.6× |
| CT soft tissue neck w contrast (70491) |
$2,456 |
$3,070 |
12.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,771.20 |
$2,214 |
14.6× |
| CT thoracic spine w contrast (72129) |
$2,304.80 |
$2,881 |
11.3× |
| CT thoracic spine w/o contrast (72128) |
$1,585.60 |
$1,982 |
13.1× |
| CT thoracic spine w/wo cont (72130) |
$2,640 |
$3,300 |
13.0× |
| CT thorax w/o contrast (71250) |
$1,488.80 |
$1,861 |
12.3× |
| CT upper ext wo (73200) |
$1,452.80 |
$1,816 |
12.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,267.20 |
$2,834 |
11.1× |
| CT upper extremity with contrast (73201) |
$1,934.40 |
$2,418 |
4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,355.20 |
$2,944 |
11.6× |
| Cta Abdomen (74175) |
$2,556 |
$3,195 |
12.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,456 |
$3,070 |
6.1× |
| CTA pelvis (72191) |
$1,568.80 |
$1,961 |
7.7× |
| Diskography lumbar (72295) |
$4,728 |
$5,910 |
2.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$348.80 |
$436 |
2.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$664 |
$830 |
5.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$624 |
$780 |
5.1× |
| Dxa Bone Density Axial (77080) |
$514.40 |
$643 |
4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$184.80 |
$231 |
1.8× |
| Echo exam of fetal heart (76825) |
$854.40 |
$1,068 |
1.3× |
| Echo exam uterus (76831) |
$587.20 |
$734 |
2.1× |
| Echo Guide For Artery Repair (76936) |
$1,666.40 |
$2,083 |
6.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$547.20 |
$684 |
2.0× |
| Esophagram (74220) |
$607.20 |
$759 |
3.0× |
| Fetal Biophys Profile W/Nst (76818) |
$683.20 |
$854 |
5.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$683.20 |
$854 |
5.6× |
Fluoroscopy up to 1 hr (76000)
range across 3 matching MRF lines |
$704–$749.60 |
$880–$937 |
varies |
| Follow-Up Angiography (75898) |
$848 |
$1,060 |
0.2× |
| Foot 2 views (73620) |
$210.40 |
$263 |
2.1× |
| Forearm 2 views (73090) |
$212 |
$265 |
2.1× |
| Gastric emptying imaging study (78264) |
$1,548 |
$1,935 |
3.3× |
| Gastroesophageal Reflux Exam (78262) |
$995.20 |
$1,244 |
2.1× |
| Gated Heart Planar Single (78472) |
$2,624.80 |
$3,281 |
5.7× |
| Gated Heart, Multiple (78473) |
$3,532 |
$4,415 |
7.6× |
| Hand 2 views (73120) |
$212 |
$265 |
1.7× |
| Heart first pass single,planar (78481) |
$1,260 |
$1,575 |
2.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,455.20 |
$4,319 |
0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,455.20 |
$4,319 |
0.9× |
| Hepatobil Syst Image W/Drug (78227) |
$1,523.20 |
$1,904 |
2.4× |
| Hepatobiliary System Imaging (78226) |
$1,428.80 |
$1,786 |
3.1× |
| Ht Musc Image Planar Mult (78454) |
$3,182.40 |
$3,978 |
2.1× |
| Ht Muscle Image Spect Sing (78451) |
$2,252.80 |
$2,816 |
1.5× |
| Hysterosalpingogram (74740) |
$763.20 |
$954 |
2.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$702.40 |
$878 |
7.0× |
| Interstitial radiation source applic complex (77778) |
$3,564 |
$4,455 |
4.4× |
| K Flow/Funct Image Multiple (78709) |
$1,527.20 |
$1,909 |
2.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,527.20 |
$1,909 |
2.4× |
| K Flow/Funct Image W/O Drug (78707) |
$1,334.40 |
$1,668 |
2.1× |
| Knee 3 Views (73562) |
$272.80 |
$341 |
2.7× |
| Leveen/Shunt Patency Exam (78291) |
$1,152.80 |
$1,441 |
2.5× |
| Liver & Spleen Imaging Static Only (78215) |
$1,040 |
$1,300 |
2.2× |
| Liver imaging static only (78201) |
$1,192 |
$1,490 |
1.9× |
| Lung perfusion differential (78597) |
$1,624.80 |
$2,031 |
3.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,236.80 |
$1,546 |
2.0× |
| Lymph System Imaging (78195) |
$1,423.20 |
$1,779 |
2.3× |
| Magnetic Image Jaw Joint (70336) |
$538.40 |
$673 |
1.9× |
| Meckels Divert Exam (78290) |
$1,076.80 |
$1,346 |
2.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,464 |
$3,080 |
5.7× |
| Mr safety determination physician/other qhp (76016) |
$196 |
$245 |
1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$54.40 |
$68 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$204 |
$255 |
1.8× |
| Mr safety implt pos&/immoblj (76019) |
$132 |
$165 |
1.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$538.40 |
$673 |
1.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,248.80 |
$4,061 |
8.0× |
| MRA head w/o contrast (70544) |
$2,080.80 |
$2,601 |
7.5× |
| MRA head with contrast (70545) |
$2,664.80 |
$3,331 |
6.6× |
| MRA neck w contrast (70548) |
$2,080.80 |
$2,601 |
5.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,824.80 |
$3,531 |
7.0× |
| MRA neck w/o contrast (70547) |
$2,021.60 |
$2,527 |
7.3× |
| MRI abdomen w contrast (74182) |
$3,040 |
$3,800 |
7.5× |
| MRI abdomen w/o contrast (74181) |
$2,358.40 |
$2,948 |
8.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,347.20 |
$2,934 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,501.60 |
$4,377 |
8.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,124.80 |
$3,906 |
3.4× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,936 |
$2,420 |
7.0× |
| MRI cervical spine w contrast (72142) |
$3,043.20 |
$3,804 |
7.5× |
MRI cervical spine w/o cont (72141)
range across 2 matching MRF lines |
$2,446.40–$2,605.60 |
$3,058–$3,257 |
varies |
| MRI chest w/o contrast (71550) |
$2,357.60 |
$2,947 |
8.5× |
| MRI chest wo w contrast (71552) |
$3,464 |
$4,330 |
8.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,330.40 |
$2,913 |
5.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,768.80 |
$3,461 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,097.60 |
$2,622 |
7.6× |
| MRI lumbar spine w contrast (72149) |
$3,124.80 |
$3,906 |
7.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,532 |
$4,415 |
8.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,136 |
$2,670 |
7.7× |
| MRI orbit face neck w contrast (70542) |
$2,683.20 |
$3,354 |
6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,356 |
$4,195 |
8.3× |
| MRI pelvis w contrast (72196) |
$3,228 |
$4,035 |
8.0× |
| MRI pelvis w/o & w contrast (72197) |
$3,464.80 |
$4,331 |
8.6× |
| MRI pelvis w/o contrast (72195) |
$1,929.60 |
$2,412 |
7.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,605.60 |
$3,257 |
9.4× |
MRI upper extremity oth than jt w/contr matrl (73219)
range across 3 matching MRF lines |
$1,926.40–$2,172.80 |
$2,408–$2,716 |
varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,022.40 |
$2,528 |
7.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,743.20 |
$3,429 |
6.8× |
| MRI, abdomen, combo (74183) |
$3,484.80 |
$4,356 |
8.6× |
| MRI, dorsal spine combo (72157) |
$3,532 |
$4,415 |
8.7× |
| MRI, dorsal spine contrast (72147) |
$2,840.80 |
$3,551 |
7.0× |
| MRI, joint upper extrem (73221) |
$2,780.80 |
$3,476 |
10.0× |
| MRI, joint upper extrem combo (73223) |
$3,469.60 |
$4,337 |
8.6× |
| MRI, lumbar spine combo (72158) |
$3,532 |
$4,415 |
8.7× |
| Myelogram cervical (72240) |
$1,406.40 |
$1,758 |
1.5× |
| Myelogram Lumbar (72265) |
$1,352.80 |
$1,691 |
1.5× |
| Myelography thoracic (72255) |
$1,640.80 |
$2,051 |
1.8× |
| Myelograpy 2/more regions rs&i (72270) |
$1,628 |
$2,035 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$3,528 |
$4,410 |
2.3× |
| Neck soft tissue (70360) |
$316 |
$395 |
3.1× |
| Nm csf leak detection (78650) |
$3,031.20 |
$3,789 |
2.0× |
| Nonvascular Shunt X-Ray (75809) |
$306.40 |
$383 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,541.60 |
$9,427 |
4.7× |
| Nuclear Rx Intra-Arterial (79445) |
$808.80 |
$1,011 |
3.0× |
| Nuclear Rx Oral Admin (79005) |
$1,523.20 |
$1,904 |
5.6× |
| Ob us nuchal meas 1 gest (76813) |
$398.40 |
$498 |
3.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$236.80 |
$296 |
2.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,518.40 |
$1,898 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$913.60 |
$1,142 |
2.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,030.40 |
$1,288 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$201.60 |
$252 |
1.7× |
| Peritoneogram Rs&I (74190) |
$524 |
$655 |
0.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,949.60 |
$4,937 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,624.80 |
$2,031 |
3.5× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$2,160.80 |
$2,701 |
2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$515.20 |
$644 |
4.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$595.20 |
$744 |
0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$252.80 |
$316 |
2.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$214.40 |
$268 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$265.60 |
$332 |
2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$341.60 |
$427 |
2.8× |
| Radex fingr minimum 2 views (73140) |
$220 |
$275 |
2.2× |
| Radex foot complete minimum 3 views (73630) |
$244.80 |
$306 |
2.4× |
| Radex Hand Minimum 3 Views (73130) |
$247.20 |
$309 |
2.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$195.20 |
$244 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$254.40 |
$318 |
2.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$237.60 |
$297 |
2.4× |
| Radex shoulder complete minimum 2 views (73030) |
$233.60 |
$292 |
2.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$237.60 |
$297 |
2.4× |
| Radex Spine 1 View Specify Level (72020) |
$167.20 |
$209 |
1.7× |
| Radex Sternum Minimum 2 Views (71120) |
$237.60 |
$297 |
2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$374.40 |
$468 |
3.7× |
| Radex Toe Minimum 2 Views (73660) |
$226.40 |
$283 |
2.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$189.60 |
$237 |
1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$287.20 |
$359 |
2.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$23,488.80 |
$29,361 |
2.7× |
| Radiation treatment delivery level 1 (77402) |
$236.80 |
$296 |
2.0× |
| Radiation treatment delivery level 2 (77407) |
$896 |
$1,120 |
2.0× |
| Radiation treatment delivery level 3 (77412) |
$1,283.20 |
$1,604 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$341.60 |
$427 |
2.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$390.40 |
$488 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$1,053.60 |
$1,317 |
5.2× |
| Radiologic exam knee complete 4/more views (73564) |
$328.80 |
$411 |
2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$325.60 |
$407 |
2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$781.60 |
$977 |
3.8× |
| Radiologic exam swallow function contrast study (74230) |
$607.20 |
$759 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$840 |
$1,050 |
4.1× |
| Radiologic examination femur 1 view (73551) |
$197.60 |
$247 |
2.0× |
| Radiologic examination femur minimum 2 views (73552) |
$241.60 |
$302 |
2.4× |
| Radiologic examination knee 1/2 views (73560) |
$233.60 |
$292 |
2.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$206.40 |
$258 |
2.0× |
| Renal Cyst Study (74470) |
$924 |
$1,155 |
1.5× |
| Ribs bilateral 3 views (71110) |
$297.60 |
$372 |
2.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,512 |
$1,890 |
3.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,848 |
$2,310 |
4.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,520 |
$3,150 |
4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,184 |
$2,730 |
3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,856 |
$3,570 |
4.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,528 |
$4,410 |
2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,864 |
$4,830 |
2.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,192 |
$3,990 |
2.1× |
| Rp Therapy Intravenous Administration (79101) |
$1,174.40 |
$1,468 |
4.3× |
| Scapula (73010) |
$212 |
$265 |
1.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$53.60 |
$67 |
2.3× |
| Shoulder 1 view (73020) |
$180.80 |
$226 |
1.8× |
| Shoulder Arthrography (73040) |
$945.60 |
$1,182 |
2.3× |
| Skull less than 4 views (70250) |
$264 |
$330 |
2.2× |
| Special dosimetry (77331) |
$632.80 |
$791 |
4.1× |
| Special Physics Consult (77370) |
$895.20 |
$1,119 |
5.7× |
| Special teletherapy port plan (77321) |
$1,368.80 |
$1,711 |
3.1× |
| Special treatment procedure (77470) |
$3,069.60 |
$3,837 |
4.8× |
| Stereotactic Body Radiation Delivery (77373) |
$5,911.20 |
$7,389 |
2.8× |
| Sternoclavicular joints (71130) |
$340 |
$425 |
3.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,182.40 |
$1,478 |
2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$596 |
$745 |
1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,823.20 |
$2,279 |
4.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,193.60 |
$1,492 |
2.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$949.60 |
$1,187 |
6.1× |
| Thoracic spine 2 views (72070) |
$248.80 |
$311 |
2.0× |
| Thoracic spine 3 views (72072) |
$284.80 |
$356 |
2.3× |
| Thoracolumbar 2 views (72080) |
$258.40 |
$323 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$780 |
$975 |
1.7× |
| Thyroid Met Imaging Body (78018) |
$1,612.80 |
$2,016 |
2.6× |
| Thyroid Uptake Measurement (78012) |
$918.40 |
$1,148 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,134.40 |
$1,418 |
2.4× |
| Tx Devices Design & Construction Complex (77334) |
$1,224.80 |
$1,531 |
2.8× |
| Tx devices design & construction intermediate (77333) |
$831.20 |
$1,039 |
5.3× |
| Tx devices design & construction simple (77332) |
$673.60 |
$842 |
4.3× |
| Ultrasound Breast Limited (76642) |
$266.40 |
$333 |
2.6× |
| Ultrasound Exam Aaa Screen (76706) |
$312 |
$390 |
2.6× |
Ultrasound, abdomen limited (76705)
range across 4 matching MRF lines |
$619.20–$659.20 |
$774–$824 |
varies |
| Umbilical-artery Doppler (OB) (76820) |
$640 |
$800 |
5.3× |
| Unlisted Dx Radiographic Procedure (76499) |
$190.40 |
$238 |
1.9× |
Unlisted magnetic resonance procedure (76498)
range across 2 matching MRF lines |
$1,294.40–$3,044.80 |
$1,618–$3,806 |
varies |
| Upper gi w/o kub (74240) |
$717.60 |
$897 |
3.5× |
| Ureteral Reflux Study (78740) |
$654.40 |
$818 |
1.4× |
| Urethrocystogram voiding (74455) |
$847.20 |
$1,059 |
3.1× |
| Urethrocystography retrograde (74450) |
$778.40 |
$973 |
2.8× |
| Us bone density measurement (76977) |
$264.80 |
$331 |
2.2× |
| Us breast unilateral complete (76641) |
$283.20 |
$354 |
2.3× |
| Us chest (76604) |
$638.40 |
$798 |
5.3× |
| Us complete joint (76881) |
$379.20 |
$474 |
3.1× |
| Us exam, pelvic, limited (76857) |
$512 |
$640 |
4.2× |
| Us head (76506) |
$472 |
$590 |
3.9× |
| Us kidney transplant (76776) |
$722.40 |
$903 |
6.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$222.40 |
$278 |
1.8× |
| Us ob detailed single fetus (76811) |
$1,304.80 |
$1,631 |
4.7× |
| Us ob limited 1 or more fetuses (76815) |
$662.40 |
$828 |
5.5× |
| Us ob transvaginal (76817) |
$542.40 |
$678 |
4.5× |
| Us pelvic non ob complete (76856) |
$702.40 |
$878 |
5.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$566.40 |
$708 |
4.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$422.40 |
$528 |
3.5× |
| Us retroperitoneal complete (76770) |
$883.20 |
$1,104 |
7.3× |
| Us retroperitoneal limited (76775) |
$484.80 |
$606 |
4.0× |
| Us scrotum and contents (76870) |
$736 |
$920 |
6.1× |
| Us spinal canal and contents (76800) |
$406.40 |
$508 |
3.3× |
| Us thyroid (76536) |
$676.80 |
$846 |
5.6× |
| Us transrectal (76872) |
$304 |
$380 |
2.5× |
| Vein X-Ray Chest (75827) |
$2,796 |
$3,495 |
1.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,633.60 |
$3,292 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$3,455.20 |
$4,319 |
0.9× |
| Venography Adrenal Unilateral (75840) |
$3,455.20 |
$4,319 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$4,022.40 |
$5,028 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$2,647.20 |
$3,309 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$2,020.80 |
$2,526 |
1.1× |
| Venography Renal Bilateral (75833) |
$3,455.20 |
$4,319 |
0.9× |
| Venography Renal Unilateral (75831) |
$3,455.20 |
$4,319 |
0.9× |
| Venous sampling by catheter (75893) |
$4,120 |
$5,150 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$170.40 |
$213 |
1.7× |
| Wrist 2 views (73100) |
$244.80 |
$306 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$283.20 |
$354 |
2.8× |
| X-ray antegrade pyelogram tube (74425) |
$696 |
$870 |
1.7× |
| X-Ray Aorta Leg Arteries (75630) |
$4,933.60 |
$6,167 |
1.3× |
| X-Ray Bend Only L-S Spine (72120) |
$388 |
$485 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$217.60 |
$272 |
2.2× |
| X-Ray Exam Breast Specimen (76098) |
$256.80 |
$321 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$197.60 |
$247 |
2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$276.80 |
$346 |
2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$528 |
$660 |
4.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$159.20 |
$199 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$237.60 |
$297 |
2.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$265.60 |
$332 |
2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$293.60 |
$367 |
2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$338.40 |
$423 |
2.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$484.80 |
$606 |
4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$297.60 |
$372 |
2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$502.40 |
$628 |
4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$287.20 |
$359 |
2.4× |
| X-ray eye for foreign body (70030) |
$525.60 |
$657 |
5.2× |
| X-ray humerus (73060) |
$225.60 |
$282 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$325.60 |
$407 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$257.60 |
$322 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$316.80 |
$396 |
2.6× |
| X-ray nose-rectum child f.b. (76010) |
$191.20 |
$239 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$395.20 |
$494 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$269.60 |
$337 |
2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$225.60 |
$282 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$220.80 |
$276 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$287.20 |
$359 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$317.60 |
$397 |
2.6× |
| X-Ray Stress View (77071) |
$166.40 |
$208 |
1.6× |
| X-ray thoracic spine 4 vw (72074) |
$267.20 |
$334 |
2.2× |
| X-Ray Tmj Unilat (70328) |
$249.60 |
$312 |
2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$860 |
$1,075 |
2.1× |
| X-Rays Bone Length Studies (77073) |
$324 |
$405 |
2.7× |
| X-Rays Bone Survey Complete (77075) |
$598.40 |
$748 |
4.9× |
| Xr c-spine 4 or 5 views (72050) |
$401.60 |
$502 |
3.3× |
| Xr facial bones less than 3 views (70140) |
$325.60 |
$407 |
3.2× |
| Xr orbits complete 4 views (70200) |
$304.80 |
$381 |
2.5× |