| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,552.25 |
$7,552.25 |
5.7× |
| Abdomen 2 views (74019) |
$844 |
$844 |
8.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,570.50 |
$1,570.50 |
4.1× |
| Angiography extremity bilateral rs&i (75716) |
$4,709.50 |
$4,709.50 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$3,992.75 |
$3,992.75 |
1.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$9,483 |
$9,483 |
1.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,531 |
$8,531 |
2.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$9,130.75 |
$9,130.75 |
3.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$11,291.25 |
$11,291.25 |
2.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,531.75 |
$3,531.75 |
1.2× |
| Ankle 2 views (73600) |
$511.50 |
$511.50 |
6.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$739 |
$739 |
2.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$6,365 |
$6,365 |
2.1× |
| Aortography abdominal serialography rs&i (75625) |
$6,372 |
$6,372 |
2.1× |
| Arthrogram shoulder (73040) |
$1,974 |
$1,974 |
5.9× |
| Basic radiation dosimetry calculation (77300) |
$669.50 |
$669.50 |
5.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,281.50 |
$2,281.50 |
6.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,310.50 |
$2,310.50 |
6.0× |
| Bone &/joint imaging whole body (78306) |
$2,421.12 |
$2,421.12 |
6.3× |
| Bone age studies (77072) |
$563.75 |
$563.75 |
5.6× |
| Bone Imaging 3 Phase (78315) |
$2,547.75 |
$2,547.75 |
6.7× |
| Bone survey complete (77075) |
$1,359 |
$1,359 |
13.6× |
| Brachytx isodose intermed (77317) |
$1,594.25 |
$1,594.25 |
4.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,476 |
$1,476 |
4.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,355.25 |
$1,355.25 |
3.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,157.25 |
$4,157.25 |
12.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$752.50 |
$752.50 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$1,239.88 |
$1,239.88 |
14.9× |
| Chest 1 view (71045) |
$460.75 |
$460.75 |
5.5× |
| Chest 3 views (71047) |
$920.25 |
$920.25 |
11.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,457.50 |
$1,457.50 |
8.7× |
| Clavicle complete (73000) |
$716.75 |
$716.75 |
8.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$434.88 |
$434.88 |
4.4× |
| Continuing medical physics consltj pr wk (77336) |
$802.25 |
$802.25 |
6.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$9,602.50 |
$9,602.50 |
28.8× |
| CT abdomen and pelvis without contrast (74176) |
$6,939.62 |
$6,939.62 |
30.4× |
| CT abdomen w contrast (74160) |
$4,192.38 |
$4,192.38 |
25.0× |
| CT abdomen w wo contrast (74170) |
$4,981.25 |
$4,981.25 |
29.7× |
| CT abdomen w/o contrast (74150) |
$3,470.25 |
$3,470.25 |
34.7× |
| CT angio hrt w/3d image (75574) |
$5,300.50 |
$5,300.50 |
15.9× |
| CT angiography upper extremity lt (73206) |
$5,871.50 |
$5,871.50 |
35.0× |
| CT c-spine w/o contrast (72125) |
$4,378.50 |
$4,378.50 |
43.8× |
| CT cervical spine w&w/o contrast (72127) |
$5,784.25 |
$5,784.25 |
34.5× |
| CT cervical spine with contrast (72126) |
$6,025.50 |
$6,025.50 |
18.1× |
| CT chest w/wo contrast (71270) |
$5,300.50 |
$5,300.50 |
31.6× |
| CT chest with contrast (71260) |
$4,053.12 |
$4,053.12 |
24.2× |
| CT head/brain with contrast (70460) |
$4,052.12 |
$4,052.12 |
24.2× |
| CT head/brain without and with contrast (70470) |
$4,480.88 |
$4,480.88 |
26.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$5,300.50 |
$5,300.50 |
15.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$150 |
$150 |
1.8× |
| CT hrt w/3d image congen (75573) |
$435.50 |
$435.50 |
1.3× |
| CT iac w contrast (70481) |
$3,066.12 |
$3,066.12 |
18.3× |
| CT limited/localized follow up study (76380) |
$1,722.25 |
$1,722.25 |
20.7× |
| CT lower ext w/o (73700) |
$3,015.50 |
$3,015.50 |
30.2× |
| CT lower extremity w wo contrast (73702) |
$2,951 |
$2,951 |
17.6× |
| CT lower extremity with contrast (73701) |
$3,534.75 |
$3,534.75 |
21.1× |
| CT lumbar spine w & w/o contrast (72133) |
$6,073.50 |
$6,073.50 |
36.2× |
| CT lumbar spine w/o contrast (72131) |
$4,378.50 |
$4,378.50 |
43.8× |
| CT lumbar spine with contrast (72132) |
$4,780.12 |
$4,780.12 |
14.3× |
| CT maxillofacial w contrast (70487) |
$2,717.38 |
$2,717.38 |
16.2× |
| CT maxillofacial w/o contrast (70486) |
$3,096.50 |
$3,096.50 |
31.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,951 |
$2,951 |
17.6× |
| CT neck soft tissue w contrast (70491) |
$4,482.25 |
$4,482.25 |
26.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$6,369.25 |
$6,369.25 |
38.0× |
| CT orbits w/o contrast (70480) |
$3,037.12 |
$3,037.12 |
30.4× |
| CT pelvis w & w/o contrast (72194) |
$4,557 |
$4,557 |
27.2× |
| CT pelvis w/o contrast (72192) |
$3,468.62 |
$3,468.62 |
34.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$5,099.62 |
$5,099.62 |
30.4× |
| CT soft tissue neck w/o contrast (70490) |
$4,158.62 |
$4,158.62 |
41.6× |
| CT thoracic spine w/contrast (72129) |
$6,025.50 |
$6,025.50 |
35.9× |
| CT thoracic spine w/o contrast (72128) |
$4,260.25 |
$4,260.25 |
42.6× |
| CT thoracic spine w/wo contrast (72130) |
$478.75 |
$478.75 |
2.9× |
| CT thorax w/o contrast (71250) |
$3,326.50 |
$3,326.50 |
33.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,951 |
$2,951 |
17.6× |
| CT upper extremity w/o contrast rt (73200) |
$3,982.62 |
$3,982.62 |
39.9× |
| CT upper extremity with contrast (73201) |
$2,859 |
$2,859 |
8.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$6,544.50 |
$6,544.50 |
39.0× |
| Cta Abdomen (74175) |
$5,825.75 |
$5,825.75 |
34.7× |
| CTA abdomen pelvis (74174) |
$11,743.25 |
$11,743.25 |
35.2× |
| CTA chest (71275) |
$5,825.75 |
$5,825.75 |
34.7× |
| Cta Head (70496) |
$5,871.50 |
$5,871.50 |
35.0× |
| CTA lwr ext w&w/o contrast (73706) |
$5,871.50 |
$5,871.50 |
35.0× |
| Cta Neck (70498) |
$5,871.50 |
$5,871.50 |
35.0× |
| Cta Pelvis (72191) |
$5,871.50 |
$5,871.50 |
35.0× |
| Cystography minimum 3 views rs&i (74430) |
$600.50 |
$600.50 |
1.8× |
| Diskography lumbar (72295) |
$2,911.75 |
$2,911.75 |
1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$429 |
$429 |
4.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$429 |
$429 |
4.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$429 |
$429 |
4.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$525.75 |
$525.75 |
5.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$540.75 |
$540.75 |
6.5× |
| Dxa bone density study axial skeleton (77085) |
$777.25 |
$777.25 |
7.8× |
| Echo exam of eye (76529) |
$860.25 |
$860.25 |
10.3× |
| Echo exam of fetal heart (76825) |
$1,074.25 |
$1,074.25 |
2.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,074.25 |
$1,074.25 |
4.7× |
| Echoencephalography real time imaging (76506) |
$1,160 |
$1,160 |
11.6× |
| Esophagus (74220) |
$921.75 |
$921.75 |
5.5× |
| Fetal biophysical profile non-stress testing (76818) |
$1,144.88 |
$1,144.88 |
11.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$913.50 |
$913.50 |
9.1× |
| Fluoroscopy up to 1 hr (76000) |
$1,902 |
$1,902 |
8.3× |
| Foot 2 views (73620) |
$900.88 |
$900.88 |
10.8× |
| Forearm 2 views (73090) |
$746.50 |
$746.50 |
9.0× |
| Gated Heart Planar Single (78472) |
$1,587 |
$1,587 |
4.2× |
| Hand 2 views (73120) |
$609 |
$609 |
6.1× |
| Hand 3 views (73130) |
$772 |
$772 |
9.3× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,057 |
$3,057 |
4.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,057 |
$3,057 |
4.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,057 |
$3,057 |
4.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,158.88 |
$2,158.88 |
4.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,085 |
$2,085 |
5.5× |
| Ht muscle image spect sing (78451) |
$4,922.50 |
$4,922.50 |
4.0× |
| Humerus Min 2 Views Left (73060) |
$600.50 |
$600.50 |
7.2× |
| Hysterosalpingogram (74740) |
$1,241.75 |
$1,241.75 |
5.4× |
| Image fusion (77399) |
$1,242.25 |
$1,242.25 |
9.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,277.50 |
$1,277.50 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,790.25 |
$1,790.25 |
3.4× |
| Knee 3 views (73562) |
$1,111 |
$1,111 |
13.4× |
| Liver & spleen imaging static only (78215) |
$1,071.50 |
$1,071.50 |
2.8× |
| Lung perfusion differential (78597) |
$1,782.50 |
$1,782.50 |
4.7× |
| Lung Ventilation Imaging (78579) |
$1,097.75 |
$1,097.75 |
2.9× |
| Lymphoscintigraphy (78195) |
$907.50 |
$907.50 |
1.7× |
| Mammary ductogram or galactogram single (77053) |
$568.50 |
$568.50 |
2.5× |
| Meckels Diverticulum (78290) |
$1,136 |
$1,136 |
3.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,683 |
$1,683 |
4.7× |
| MRA head w & w/o contrast (70546) |
$1,083.25 |
$1,083.25 |
3.2× |
| MRA head w/o contrast (70544) |
$1,280 |
$1,280 |
5.6× |
| MRA head with contrast (70545) |
$1,557.50 |
$1,557.50 |
4.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,307.25 |
$6,307.25 |
18.9× |
| MRA neck w/o contrast (70547) |
$1,782.75 |
$1,782.75 |
7.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,766 |
$5,766 |
17.3× |
| MRI abdomen w/o contrast (74181) |
$5,057.62 |
$5,057.62 |
22.2× |
| MRI any jnt lwr ext with con lt (73722) |
$5,138 |
$5,138 |
6.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$5,138 |
$5,138 |
6.9× |
| MRI breast w/o contrast bilateral (77047) |
$772.25 |
$772.25 |
3.4× |
| MRI c-spine with contrast (72142) |
$5,550.75 |
$5,550.75 |
16.6× |
| MRI cardiac w/o cont stress (75559) |
$1,370 |
$1,370 |
2.6× |
| MRI cardiac w/o contrast (75557) |
$3,243 |
$3,243 |
14.2× |
| MRI cervical spine w/o contrast (72141) |
$5,463 |
$5,463 |
24.0× |
| MRI chest w/o & w/contrast material (71552) |
$6,307.25 |
$6,307.25 |
18.9× |
| MRI chest w/o contrast (71550) |
$5,533 |
$5,533 |
24.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$5,756.75 |
$5,756.75 |
17.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$978 |
$978 |
2.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,737.50 |
$5,737.50 |
25.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$5,533 |
$5,533 |
24.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$6,228 |
$6,228 |
18.7× |
| MRI pelvis w contrast (72196) |
$5,550.75 |
$5,550.75 |
16.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,228 |
$6,228 |
18.7× |
| MRI pelvis w/o contrast (72195) |
$5,463 |
$5,463 |
24.0× |
| MRI scan of arm joint before and after contrast (73223) |
$5,838.75 |
$5,838.75 |
17.5× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,974 |
$1,974 |
2.6× |
| MRI scan of leg joint before and after contrast (73723) |
$8,758.12 |
$8,758.12 |
26.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,228 |
$6,228 |
18.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,550.75 |
$5,550.75 |
16.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,228 |
$6,228 |
18.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,550.75 |
$5,550.75 |
16.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,228 |
$6,228 |
18.7× |
| MRI thoracic spine w/o contrast (72146) |
$5,463 |
$5,463 |
24.0× |
| MRI tmj (70336) |
$5,140.50 |
$5,140.50 |
22.5× |
| MRI upper ext joint w/o contrast (73221) |
$5,121.50 |
$5,121.50 |
22.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$6,541.25 |
$6,541.25 |
19.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$5,665.38 |
$5,665.38 |
24.8× |
| Myocardial Spect Multiple Studies (78452) |
$7,240.50 |
$7,240.50 |
5.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,542 |
$2,542 |
3.1× |
| Neck soft tissue (70360) |
$754.62 |
$754.62 |
9.1× |
| Nm cisternogram (78630) |
$2,337.50 |
$2,337.50 |
4.5× |
| Nm gastric emptying study (78264) |
$1,854.25 |
$1,854.25 |
4.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,996.25 |
$4,996.25 |
3.8× |
| Nuclear Rx Oral Admin (79005) |
$1,637.25 |
$1,637.25 |
7.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,485.25 |
$1,485.25 |
14.9× |
| Orthopantogram (70355) |
$1,235.75 |
$1,235.75 |
14.9× |
| Osseous survey infant (77076) |
$841.75 |
$841.75 |
8.4× |
| Osseous survey limited (77074) |
$877.75 |
$877.75 |
8.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,083.50 |
$1,083.50 |
2.8× |
| Parathyroid imaging (78070) |
$1,431 |
$1,431 |
3.7× |
| Pelvis 1 or 2 views (72170) |
$435.88 |
$435.88 |
4.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$9,811.75 |
$9,811.75 |
29.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,355.25 |
$1,355.25 |
3.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,450.75 |
$2,450.75 |
4.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,370 |
$1,370 |
2.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$267.50 |
$267.50 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,004.50 |
$1,004.50 |
10.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$443 |
$443 |
4.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$863.25 |
$863.25 |
8.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$13,643.75 |
$13,643.75 |
1.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$938.25 |
$938.25 |
1.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$750.75 |
$750.75 |
7.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$828.75 |
$828.75 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$1,038.62 |
$1,038.62 |
10.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$613.75 |
$613.75 |
7.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,074.25 |
$1,074.25 |
10.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$690.50 |
$690.50 |
8.3× |
| Radiologic exam colon single contrast study (74270) |
$1,386.50 |
$1,386.50 |
8.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$921.75 |
$921.75 |
5.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,706.25 |
$1,706.25 |
10.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,014.25 |
$1,014.25 |
6.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$401.12 |
$401.12 |
4.8× |
| Radiological examination surgical specimen (76098) |
$1,203.75 |
$1,203.75 |
2.3× |
| Ribs bilateral 3 views (71110) |
$709.25 |
$709.25 |
7.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,987.75 |
$3,987.75 |
7.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,403 |
$1,403 |
2.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,569.25 |
$4,569.25 |
3.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,428.50 |
$1,428.50 |
6.4× |
| Scanogram (77073) |
$600.50 |
$600.50 |
6.0× |
| Scapula complete (73010) |
$664.75 |
$664.75 |
6.7× |
| Screening digital breast tomosynthesis (77063) |
$104 |
$104 |
4.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$840 |
$840 |
8.4× |
| Simulation intermediate (77285) |
$1,720.25 |
$1,720.25 |
4.8× |
| Small bowel series (74250) |
$1,519 |
$1,519 |
9.1× |
| Spec medical radj physics consltj (77370) |
$1,242.25 |
$1,242.25 |
9.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,250.50 |
$1,250.50 |
3.5× |
| Special dosimetry (77331) |
$524.25 |
$524.25 |
4.1× |
| Special treatment procedure (77470) |
$4,492.25 |
$4,492.25 |
8.5× |
| Spine thoracic 3 views (72072) |
$1,049 |
$1,049 |
10.5× |
| Stereotactic body radiation delivery (77373) |
$4,477.25 |
$4,477.25 |
2.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$438.75 |
$438.75 |
4.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,949.25 |
$1,949.25 |
5.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$996.50 |
$996.50 |
2.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,202.75 |
$2,202.75 |
6.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,172.75 |
$1,172.75 |
9.1× |
| Therapeutic Enema (74283) |
$1,876 |
$1,876 |
11.2× |
| Thoracolumbar 2 views (72080) |
$672 |
$672 |
8.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,147.75 |
$2,147.75 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$2,063.50 |
$2,063.50 |
5.4× |
| Thyroid uptake measurement (78012) |
$575.50 |
$575.50 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,308 |
$2,308 |
6.0× |
| Treatment device intermediate (77333) |
$1,599.50 |
$1,599.50 |
12.5× |
| Treatment devices simple (77332) |
$687.50 |
$687.50 |
5.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,513.25 |
$4,513.25 |
8.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,153.75 |
$1,153.75 |
3.0× |
| Tx devices design & construction complex (77334) |
$1,683 |
$1,683 |
4.7× |
| Ultrasound, abdomen limited (76705) |
$1,165.12 |
$1,165.12 |
11.7× |
| Umbilical-artery Doppler (OB) (76820) |
$746 |
$746 |
7.5× |
| Unlisted magnetic resonance procedure (76498) |
$5,550.75 |
$5,550.75 |
66.7× |
| Upper Extremity Infant (73092) |
$482.50 |
$482.50 |
4.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$2,157 |
$2,157 |
5.6× |
| Urethrocystography retrograde rs&i (74450) |
$1,376 |
$1,376 |
6.0× |
| Urethrocystography voiding (74455) |
$2,145.50 |
$2,145.50 |
9.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$2,310.50 |
$2,310.50 |
13.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$723 |
$723 |
4.3× |
| Us abdl aorta screen aaa (76706) |
$723.12 |
$723.12 |
7.2× |
| Us breast unilateral complete (76641) |
$1,341.75 |
$1,341.75 |
13.4× |
| Us breast unilateral limited (76642) |
$1,118.38 |
$1,118.38 |
13.4× |
| Us chest (76604) |
$974.88 |
$974.88 |
9.8× |
| Us compl joint r-t w/image documentation (76881) |
$928 |
$928 |
9.3× |
| Us elastography parenchyma (76981) |
$261.75 |
$261.75 |
2.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$729 |
$729 |
7.3× |
| Us guided compression repair (76936) |
$1,610.75 |
$1,610.75 |
7.8× |
| Us infant hips dynamic (76885) |
$1,093.75 |
$1,093.75 |
13.1× |
| Us infant hips limited static (76886) |
$250 |
$250 |
3.0× |
| Us kidney transplant (76776) |
$363.50 |
$363.50 |
3.6× |
| Us ob detailed single fetus (76811) |
$2,191.50 |
$2,191.50 |
9.6× |
| Us ob transvaginal (76817) |
$1,010 |
$1,010 |
10.1× |
| Us pelvic non ob complete (76856) |
$1,321.50 |
$1,321.50 |
13.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,293.75 |
$1,293.75 |
12.9× |
| Us pregnancy ltd (76815) |
$1,300.88 |
$1,300.88 |
13.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,473.12 |
$1,473.12 |
14.7× |
| Us retroperitoneal complete (76770) |
$1,578 |
$1,578 |
15.8× |
| Us retroperitoneal limited (76775) |
$960.12 |
$960.12 |
9.6× |
| Us scrotum and contents (76870) |
$1,401 |
$1,401 |
14.0× |
| Us soft tissue head/neck (76536) |
$1,323.25 |
$1,323.25 |
13.2× |
| Us spinal canal and contents (76800) |
$920 |
$920 |
9.2× |
| Us transrectal (76872) |
$1,227 |
$1,227 |
12.3× |
| Us xtr non-vasc lmtd (76882) |
$598.75 |
$598.75 |
6.0× |
| Venogram extremity bilateral (75822) |
$6,036.25 |
$6,036.25 |
4.0× |
| Venography caval inferior serialography rs&i (75825) |
$4,985.75 |
$4,985.75 |
1.7× |
| Venography caval superior serialography rs&i (75827) |
$2,002.50 |
$2,002.50 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$3,402.25 |
$3,402.25 |
2.3× |
| Venography renal unilateral selective rs&i (75831) |
$6,753.75 |
$6,753.75 |
2.2× |
| Wrist 2 views (73100) |
$646 |
$646 |
7.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,148.62 |
$1,148.62 |
11.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,035.25 |
$1,035.25 |
12.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$882.25 |
$882.25 |
10.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,303.75 |
$2,303.75 |
13.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$772 |
$772 |
9.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$1,114.25 |
$1,114.25 |
13.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$866.75 |
$866.75 |
8.7× |
| X-ray exam hip uni 1 view (73501) |
$267.50 |
$267.50 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$267.50 |
$267.50 |
3.2× |
| X-ray exam hip uni 4/> views (73503) |
$443 |
$443 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$443 |
$443 |
4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$843.50 |
$843.50 |
8.4× |
| X-ray exam of femur 1 (73551) |
$267.50 |
$267.50 |
3.2× |
| X-ray eye for foreign body (70030) |
$857 |
$857 |
10.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$667.62 |
$667.62 |
6.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$891.75 |
$891.75 |
10.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$891.75 |
$891.75 |
10.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,024.12 |
$1,024.12 |
10.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$559.38 |
$559.38 |
6.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$541.25 |
$541.25 |
6.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,298.38 |
$1,298.38 |
13.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,699 |
$1,699 |
17.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$849.25 |
$849.25 |
8.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$649.88 |
$649.88 |
7.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$316.50 |
$316.50 |
3.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$704.88 |
$704.88 |
7.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$759.25 |
$759.25 |
7.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,019.25 |
$1,019.25 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$578.25 |
$578.25 |
7.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$697.75 |
$697.75 |
7.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$819.50 |
$819.50 |
8.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,036.50 |
$1,036.50 |
10.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$831.62 |
$831.62 |
10.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,037.50 |
$1,037.50 |
12.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$903.25 |
$903.25 |
10.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$406.75 |
$406.75 |
4.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$780.25 |
$780.25 |
7.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$638.38 |
$638.38 |
6.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$621.62 |
$621.62 |
7.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$353 |
$353 |
4.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$670.62 |
$670.62 |
8.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$713.62 |
$713.62 |
7.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$891.75 |
$891.75 |
10.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$992.62 |
$992.62 |
11.9× |
| Xr c-spine 6 or more views (72052) |
$1,602.12 |
$1,602.12 |
16.0× |
| Xr chest 4+ views (71048) |
$1,150.75 |
$1,150.75 |
11.5× |
| Xr finger(s) 2+ views (73140) |
$641.75 |
$641.75 |
7.7× |
| Xr shoulder 1 view (73020) |
$716.75 |
$716.75 |
8.6× |
| Xr spine cervical 4 or 5 views (72050) |
$1,547.25 |
$1,547.25 |
15.5× |
| Xr tibia/fibula 2 views (73590) |
$1,051 |
$1,051 |
12.6× |
| Xr tmj bilateral (70330) |
$961 |
$961 |
11.6× |
| Xray knee 1 or 2 views rt (73560) |
$619.25 |
$619.25 |
7.4× |