| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,579.57 |
$10,510.50 |
4.6× |
| Abdomen 2 views (74019) |
$259.79 |
$415 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,671.77 |
$4,268 |
6.4× |
| Angiography extremity bilateral rs&i (75716) |
$4,343.18 |
$6,938 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$4,594.84 |
$7,340 |
1.4× |
| Angiography internal mammary rs&i (75756) |
$5,172.01 |
$8,262 |
1.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$8,883.57 |
$14,191 |
1.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,824.58 |
$7,707 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,824.58 |
$7,707 |
1.5× |
| Angiography Spinal Selective Rs&I (75705) |
$8,285.11 |
$13,235 |
1.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$7,289.14 |
$11,644 |
1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,172.01 |
$8,262 |
1.6× |
| Ankle 2 views (73600) |
$240.70 |
$384.50 |
2.7× |
| Aortogram thoracic (75605) |
$8,285.11 |
$13,235 |
1.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,594.84 |
$7,340 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$5,049 |
$8,065.50 |
1.5× |
| Arthrogram elbow (73085) |
$602.84 |
$963 |
1.7× |
| Arthrogram hip (73525) |
$536.80 |
$857.50 |
1.5× |
| Arthrogram shoulder (73040) |
$667.32 |
$1,066 |
1.8× |
| Arthrogram wrist (73115) |
$544 |
$869 |
1.5× |
| Arthrography knee lt (73580) |
$573.10 |
$915.50 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$616.61 |
$985 |
4.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$983.13 |
$1,570.50 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$1,475.80 |
$2,357.50 |
3.6× |
| Bone age studies (77072) |
$199.70 |
$319 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,770.96 |
$2,829 |
4.3× |
| Bone survey complete (77075) |
$747.44 |
$1,194 |
6.9× |
| Cervical spine 2 or 3 views (72040) |
$297.66 |
$475.50 |
3.3× |
| Chest 1 view (71045) |
$214.40 |
$342.50 |
2.4× |
| Chest 3 views (71047) |
$262.29 |
$419 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$545.56 |
$871.50 |
3.0× |
| Clavicle complete (73000) |
$224.74 |
$359 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$246.33 |
$393.50 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$814.43 |
$1,301 |
5.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,614.60 |
$8,969 |
15.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,807.92 |
$4,485.50 |
11.3× |
| CT abdomen w contrast (74160) |
$2,116.82 |
$3,381.50 |
11.6× |
| CT abdomen w wo contrast (74170) |
$2,890.56 |
$4,617.50 |
15.9× |
| CT abdomen w/o contrast (74150) |
$1,685.50 |
$2,692.50 |
15.5× |
| CT angio hrt w/3d image (75574) |
$2,174.41 |
$3,473.50 |
6.0× |
| CT angiography upper extremity lt (73206) |
$2,339.36 |
$3,737 |
12.8× |
| CT c-spine w/o contrast (72125) |
$1,634.17 |
$2,610.50 |
15.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,770.96 |
$2,829 |
9.7× |
| CT cervical spine with contrast (72126) |
$1,475.80 |
$2,357.50 |
4.1× |
| CT chest w/wo contrast (71270) |
$2,147.49 |
$3,430.50 |
11.8× |
| CT chest with contrast (71260) |
$1,866.42 |
$2,981.50 |
10.2× |
| CT head/brain with contrast (70460) |
$1,475.80 |
$2,357.50 |
8.1× |
| CT head/brain without and with contrast (70470) |
$1,912.74 |
$3,055.50 |
10.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,110.25 |
$3,371 |
5.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$111.12 |
$177.50 |
1.2× |
| CT iac w contrast (70481) |
$1,475.80 |
$2,357.50 |
8.1× |
| CT limited/localized follow up study (76380) |
$626.63 |
$1,001 |
6.9× |
| CT lower ext w/o (73700) |
$1,489.26 |
$2,379 |
13.7× |
| CT lower extremity w wo contrast (73702) |
$1,814.15 |
$2,898 |
10.0× |
| CT lower extremity with contrast (73701) |
$1,475.80 |
$2,357.50 |
8.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,770.96 |
$2,829 |
9.7× |
| CT lumbar spine w/o contrast (72131) |
$1,686.76 |
$2,694.50 |
15.5× |
| CT lumbar spine with contrast (72132) |
$1,640.12 |
$2,620 |
4.5× |
| CT maxillofacial w contrast (70487) |
$1,744.04 |
$2,786 |
9.6× |
| CT maxillofacial w/o contrast (70486) |
$1,435.42 |
$2,293 |
13.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,770.96 |
$2,829 |
9.7× |
| CT neck soft tissue w contrast (70491) |
$1,940.28 |
$3,099.50 |
10.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,770.96 |
$2,829 |
9.7× |
| CT orbits w/o contrast (70480) |
$1,986.62 |
$3,173.50 |
18.3× |
| CT pelvis w & w/o contrast (72194) |
$1,770.96 |
$2,829 |
9.7× |
| CT pelvis w/o contrast (72192) |
$1,582.84 |
$2,528.50 |
14.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,050.15 |
$3,275 |
11.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,934.02 |
$3,089.50 |
17.8× |
| CT thoracic spine w/contrast (72129) |
$1,475.80 |
$2,357.50 |
8.1× |
| CT thoracic spine w/o contrast (72128) |
$1,858.90 |
$2,969.50 |
17.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,709.92 |
$2,731.50 |
9.4× |
| CT thorax w/o contrast (71250) |
$1,466.72 |
$2,343 |
13.5× |
| CT unlisted procedure (76497) |
$1,053.56 |
$1,683 |
11.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,770.96 |
$2,829 |
9.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,418.20 |
$2,265.50 |
13.1× |
| CT upper extremity with contrast (73201) |
$2,139.98 |
$3,418.50 |
5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,456.74 |
$3,924.50 |
13.5× |
| Cta Abdomen (74175) |
$2,456.74 |
$3,924.50 |
13.5× |
| CTA abdomen pelvis (74174) |
$3,100.58 |
$4,953 |
8.6× |
| CTA chest (71275) |
$2,382.56 |
$3,806 |
13.1× |
| Cta Head (70496) |
$2,456.74 |
$3,924.50 |
13.5× |
| CTA lwr ext w&w/o contrast (73706) |
$2,456.74 |
$3,924.50 |
13.5× |
| Cta Neck (70498) |
$2,456.74 |
$3,924.50 |
13.5× |
| Cta Pelvis (72191) |
$2,396.33 |
$3,828 |
13.2× |
| Cystography minimum 3 views rs&i (74430) |
$805.04 |
$1,286 |
2.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$460.74 |
$736 |
4.2× |
| Echo exam of fetal heart (76825) |
$735.24 |
$1,174.50 |
1.3× |
| Echoencephalography real time imaging (76506) |
$810.98 |
$1,295.50 |
7.5× |
| Esophagus (74220) |
$517.08 |
$826 |
2.8× |
| Fetal biophysical profile non-stress testing (76818) |
$431.94 |
$690 |
4.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$433.20 |
$692 |
4.0× |
| Fluoroscopy up to 1 hr (76000) |
$605.03 |
$966.50 |
2.4× |
| Foot 2 views (73620) |
$199.70 |
$319 |
2.2× |
| Forearm 2 views (73090) |
$257.91 |
$412 |
2.9× |
| Gated Heart Planar Single (78472) |
$1,475.80 |
$2,357.50 |
3.6× |
| Hand 2 views (73120) |
$357.44 |
$571 |
3.3× |
| Hand 3 views (73130) |
$304.86 |
$487 |
3.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$4,003.90 |
$6,396 |
7.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,920.92 |
$4,666 |
7.0× |
| Ht muscle image spect sing (78451) |
$3,370.70 |
$5,384.50 |
2.5× |
| Humerus Min 2 Views Left (73060) |
$282.32 |
$451 |
3.1× |
| Hysterosalpingogram (74740) |
$777.18 |
$1,241.50 |
3.1× |
| Image fusion (77399) |
$444.14 |
$709.50 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,007.23 |
$1,609 |
1.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,531.51 |
$2,446.50 |
2.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,013.22 |
$3,216 |
3.6× |
| Knee 3 views (73562) |
$346.18 |
$553 |
3.8× |
| Liver & spleen imaging static only (78215) |
$983.13 |
$1,570.50 |
2.4× |
| Lung perf&ventilat diferentl (78598) |
$78.25 |
$125 |
0.1× |
| Lung perfusion differential (78597) |
$1,210.68 |
$1,934 |
2.9× |
| Lymphoscintigraphy (78195) |
$1,574.70 |
$2,515.50 |
2.8× |
| Mammary ductogram or galactogram multiple (77054) |
$605.97 |
$968 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$478.26 |
$764 |
1.9× |
| Meckels Diverticulum (78290) |
$2,681.16 |
$4,283 |
6.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,732.80 |
$4,365.50 |
7.0× |
| MRA head w & w/o contrast (70546) |
$436.95 |
$698 |
1.2× |
| MRA head w/o contrast (70544) |
$2,496.80 |
$3,988.50 |
10.1× |
| MRA neck w contrast (70548) |
$2,216.04 |
$3,540 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,180.78 |
$8,276 |
14.3× |
| MRA neck w/o contrast (70547) |
$2,013.22 |
$3,216 |
8.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,161.92 |
$5,051 |
8.7× |
| MRI abdomen w/o contrast (74181) |
$2,204.78 |
$3,522 |
8.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,163.14 |
$3,455.50 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,965.33 |
$3,139.50 |
2.4× |
| MRI breast w/o contrast bilateral (77047) |
$2,229.18 |
$3,561 |
9.0× |
| MRI breast w/o contrast unilat (77046) |
$1,688.32 |
$2,697 |
6.8× |
| MRI c-spine with contrast (72142) |
$2,013.22 |
$3,216 |
5.6× |
| MRI cervical spine w/o contrast (72141) |
$2,476.14 |
$3,955.50 |
10.0× |
| MRI chest w/o & w/contrast material (71552) |
$4,737.88 |
$7,568.50 |
13.1× |
| MRI chest w/o contrast (71550) |
$3,404.50 |
$5,438.50 |
13.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,396.33 |
$3,828 |
6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,216.04 |
$3,540 |
6.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,770.96 |
$2,829 |
7.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,013.22 |
$3,216 |
8.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,127.50 |
$4,996 |
8.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,013.22 |
$3,216 |
5.6× |
| MRI pelvis w contrast (72196) |
$2,417.61 |
$3,862 |
6.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,874.59 |
$4,592 |
7.9× |
| MRI pelvis w/o contrast (72195) |
$2,338.74 |
$3,736 |
9.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,456.74 |
$3,924.50 |
6.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,396.95 |
$3,829 |
6.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,591.36 |
$5,737 |
9.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,163.14 |
$3,455.50 |
6.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,452.08 |
$5,514.50 |
9.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,013.22 |
$3,216 |
5.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,166.62 |
$5,058.50 |
8.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,795.72 |
$4,466 |
11.3× |
| MRI tmj (70336) |
$1,770.96 |
$2,829 |
7.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,962.82 |
$3,135.50 |
7.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,456.74 |
$3,924.50 |
6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,770.96 |
$2,829 |
7.1× |
| Myelogram Cervical (72240) |
$1,298.95 |
$2,075 |
1.6× |
| Myelogram thoracic (72255) |
$1,298.95 |
$2,075 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,490.92 |
$7,174 |
3.3× |
| Neck soft tissue (70360) |
$229.12 |
$366 |
2.5× |
| Nm gastric emptying study (78264) |
$1,770.96 |
$2,829 |
4.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$15,142.94 |
$24,190 |
10.5× |
| Nuclear Rx Oral Admin (79005) |
$1,453.57 |
$2,322 |
6.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$162.76 |
$260 |
1.5× |
| Osseous survey infant (77076) |
$395.94 |
$632.50 |
3.6× |
| Osseous survey limited (77074) |
$395.94 |
$632.50 |
3.6× |
| Parathyrd planar w/wo subtrj (78071) |
$1,464.22 |
$2,339 |
3.5× |
| Parathyroid imaging (78070) |
$1,770.96 |
$2,829 |
4.3× |
| Pelvis 1 or 2 views (72170) |
$248.84 |
$397.50 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$5,750.44 |
$9,186 |
3.9× |
| PET imaging CT for attenuation limited area (78814) |
$13,055.23 |
$20,855 |
8.8× |
| PET imaging for CT attenuation whole body (78816) |
$12,744.42 |
$20,358.50 |
8.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,852.06 |
$4,556 |
7.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,824.58 |
$7,707 |
1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,146.52 |
$1,831.50 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,878.97 |
$4,599 |
5.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,886.45 |
$3,013.50 |
3.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$334.91 |
$535 |
3.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$514.57 |
$822 |
4.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$383.42 |
$612.50 |
3.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$254.78 |
$407 |
2.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,715.86 |
$2,741 |
3.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,722.75 |
$2,752 |
16.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,699.59 |
$2,715 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$332.40 |
$531 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$283.58 |
$453 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$282.32 |
$451 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$236.62 |
$378 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$718.65 |
$1,148 |
3.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$519.90 |
$830.50 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$595.95 |
$952 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$528.66 |
$844.50 |
2.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$240.70 |
$384.50 |
2.7× |
| Radiological examination surgical specimen (76098) |
$475.13 |
$759 |
0.8× |
| Ribs bilateral 3 views (71110) |
$355.57 |
$568 |
3.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,821.66 |
$2,910 |
4.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,013.22 |
$3,216 |
3.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,965.33 |
$3,139.50 |
3.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,145.30 |
$3,427 |
1.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,145.30 |
$3,427 |
1.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$387.80 |
$619.50 |
1.6× |
| Sacroiliac Joints < 3 Views (72200) |
$199.70 |
$319 |
1.8× |
| Scanogram (77073) |
$329.28 |
$526 |
3.0× |
| Scapula complete (73010) |
$248.84 |
$397.50 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$41.63 |
$66.50 |
1.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$511.44 |
$817 |
4.7× |
| Small bowel series (74250) |
$514.57 |
$822 |
2.8× |
| Spec medical radj physics consltj (77370) |
$1,294.88 |
$2,068.50 |
9.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,397.54 |
$2,232.50 |
3.6× |
| Special dosimetry (77331) |
$549.32 |
$877.50 |
3.9× |
| Special treatment procedure (77470) |
$2,635.78 |
$4,210.50 |
4.6× |
| Spine thoracic 3 views (72072) |
$382.49 |
$611 |
3.5× |
| Stereotactic body radiation delivery (77373) |
$12,048.94 |
$19,247.50 |
6.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,866.42 |
$2,981.50 |
4.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,874.87 |
$2,995 |
4.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,632.36 |
$5,802.50 |
9.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,255.76 |
$2,006 |
9.0× |
| Thoracolumbar 2 views (72080) |
$297.66 |
$475.50 |
3.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,965.33 |
$3,139.50 |
3.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,635.74 |
$2,613 |
3.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,823.54 |
$2,913 |
4.4× |
| Tmj unilateral (70328) |
$267.62 |
$427.50 |
3.0× |
| Treatment device intermediate (77333) |
$959.34 |
$1,532.50 |
6.9× |
| Treatment devices simple (77332) |
$706.75 |
$1,129 |
5.1× |
| Tx devices design & construction complex (77334) |
$1,206.93 |
$1,928 |
3.1× |
| Ultrasound, abdomen limited (76705) |
$591.57 |
$945 |
5.4× |
| Umbilical-artery Doppler (OB) (76820) |
$169.96 |
$271.50 |
1.6× |
| Unlisted fluoroscopic procedure (76496) |
$1,141.20 |
$1,823 |
12.6× |
| Unlisted magnetic resonance procedure (76498) |
$282.96 |
$452 |
3.1× |
| Upper Extremity Infant (73092) |
$153.68 |
$245.50 |
1.4× |
| Urethrocystography voiding (74455) |
$612.23 |
$978 |
2.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$837.59 |
$1,338 |
4.6× |
| Us abdl aorta screen aaa (76706) |
$433.19 |
$692 |
4.0× |
| Us breast unilateral complete (76641) |
$444.78 |
$710.50 |
4.1× |
| Us breast unilateral limited (76642) |
$347.12 |
$554.50 |
3.8× |
| Us chest (76604) |
$465.74 |
$744 |
4.3× |
| Us compl joint r-t w/image documentation (76881) |
$1,682.38 |
$2,687.50 |
15.5× |
| Us guided compression repair (76936) |
$394.07 |
$629.50 |
1.8× |
| Us infant hips dynamic (76885) |
$974.68 |
$1,557 |
10.8× |
| Us infant hips limited static (76886) |
$655.74 |
$1,047.50 |
7.3× |
| Us kidney transplant (76776) |
$657.30 |
$1,050 |
6.1× |
| Us ob detailed single fetus (76811) |
$180.92 |
$289 |
0.7× |
| Us ob transvaginal (76817) |
$373.72 |
$597 |
3.4× |
| Us pelvic non ob complete (76856) |
$669.51 |
$1,069.50 |
6.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$523.34 |
$836 |
4.8× |
| Us pregnancy ltd (76815) |
$314.26 |
$502 |
2.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$492.66 |
$787 |
4.5× |
| Us retroperitoneal complete (76770) |
$689.85 |
$1,102 |
6.4× |
| Us retroperitoneal limited (76775) |
$519.90 |
$830.50 |
4.8× |
| Us scrotum and contents (76870) |
$591.57 |
$945 |
5.4× |
| Us soft tissue head/neck (76536) |
$519.90 |
$830.50 |
4.8× |
| Us spinal canal and contents (76800) |
$395.94 |
$632.50 |
3.6× |
| Us transrectal (76872) |
$492.66 |
$787 |
4.5× |
| Us transrectal prostate volume (76873) |
$538.36 |
$860 |
5.0× |
| Us xtr non-vasc lmtd (76882) |
$476.70 |
$761.50 |
4.4× |
| Venogram extremity bilateral (75822) |
$1,850.76 |
$2,956.50 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$4,824.58 |
$7,707 |
1.5× |
| Venography caval superior serialography rs&i (75827) |
$2,381.30 |
$3,804 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$2,909.96 |
$4,648.50 |
1.8× |
| Venography Renal Bilateral (75833) |
$5,172.01 |
$8,262 |
1.6× |
| Venography renal unilateral selective rs&i (75831) |
$5,172.01 |
$8,262 |
1.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$5,172.01 |
$8,262 |
1.6× |
| Wrist 2 views (73100) |
$199.70 |
$319 |
2.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$456.98 |
$730 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$234.12 |
$374 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$264.48 |
$422.50 |
2.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$709.88 |
$1,134 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$277.32 |
$443 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$300.17 |
$479.50 |
3.3× |
| X-ray exam hip uni 1 view (73501) |
$371.53 |
$593.50 |
4.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$302.98 |
$484 |
3.4× |
| X-ray exam hip uni 4/> views (73503) |
$309.24 |
$494 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$417.86 |
$667.50 |
3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$749.95 |
$1,198 |
6.9× |
| X-ray exam of femur 1 (73551) |
$141.79 |
$226.50 |
1.6× |
| X-ray eye for foreign body (70030) |
$199.70 |
$319 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$340.54 |
$544 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$224.74 |
$359 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$279.82 |
$447 |
3.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$199.70 |
$319 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$214.72 |
$343 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$321.46 |
$513.50 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$246.96 |
$394.50 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$175.28 |
$280 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$400.96 |
$640.50 |
3.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$714.26 |
$1,141 |
6.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$400.96 |
$640.50 |
3.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$296.41 |
$473.50 |
3.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$264.48 |
$422.50 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$297.66 |
$475.50 |
2.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$297.66 |
$475.50 |
2.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,250.44 |
$1,997.50 |
3.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$248.84 |
$397.50 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$347.12 |
$554.50 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$444.78 |
$710.50 |
4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$254.78 |
$407 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$248.84 |
$397.50 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$279.20 |
$446 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$347.12 |
$554.50 |
3.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$199.70 |
$319 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$395.94 |
$632.50 |
3.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$264.48 |
$422.50 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$248.84 |
$397.50 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$254.78 |
$407 |
2.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$272.62 |
$435.50 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$297.66 |
$475.50 |
2.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$199.70 |
$319 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$291.40 |
$465.50 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$627.25 |
$1,002 |
5.8× |
| Xr chest 4+ views (71048) |
$278.57 |
$445 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$204.70 |
$327 |
2.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$340.54 |
$544 |
3.1× |
| Xr shoulder 1 view (73020) |
$199.70 |
$319 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$460.74 |
$736 |
4.2× |
| Xr tibia/fibula 2 views (73590) |
$277.94 |
$444 |
3.1× |
| Xr tmj bilateral (70330) |
$329.28 |
$526 |
3.6× |
| Xray knee 1 or 2 views rt (73560) |
$246.96 |
$394.50 |
2.7× |