| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,886.28 |
$9,772.56 |
3.3× |
| Abdomen 2 views (74019) |
$310.50 |
$621 |
2.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,282.75 |
$2,565.49 |
3.0× |
| Angiography extremity bilateral rs&i (75716) |
$4,696.40 |
$9,392.80 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$3,604.75 |
$7,209.50 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$1,677.34 |
$3,354.67 |
0.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,271.19 |
$6,542.37 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,102.41 |
$6,204.81 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,123.53 |
$4,247.05 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,790.07 |
$7,580.13 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,677.34 |
$3,354.67 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,381.11 |
$4,762.22 |
0.7× |
| Ankle 2 views (73600) |
$177.66 |
$355.31 |
1.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$510.02 |
$1,020.03 |
1.4× |
| Aortogram thoracic (75605) |
$3,537.71 |
$7,075.42 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,154.14 |
$8,308.27 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,696.68 |
$7,393.35 |
1.1× |
| Arthrogram elbow (73085) |
$530.73 |
$1,061.45 |
1.4× |
| Arthrogram shoulder (73040) |
$915.92 |
$1,831.84 |
2.5× |
| Arthrogram wrist (73115) |
$669.81 |
$1,339.61 |
1.8× |
| Arthrography knee lt (73580) |
$734.38 |
$1,468.75 |
2.0× |
| Basic radiation dosimetry calculation (77300) |
$432.32 |
$864.63 |
3.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$815.52 |
$1,631.03 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,203.10 |
$2,406.19 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$1,670.74 |
$3,341.48 |
3.9× |
| Bone age studies (77072) |
$220.78 |
$441.56 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$2,473.37 |
$4,946.74 |
5.8× |
| Bone Marrow Imaging Limited Area (78102) |
$914.51 |
$1,829.02 |
2.1× |
| Bone survey complete (77075) |
$478.68 |
$957.36 |
4.3× |
| Brachytx isodose complex (77318) |
$931.91 |
$1,863.82 |
2.3× |
| Brachytx isodose intermed (77317) |
$768.14 |
$1,536.28 |
1.9× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$661.22 |
$1,322.44 |
1.7× |
| Brain image w/flow 4 + views (78606) |
$1,016.74 |
$2,033.47 |
1.8× |
| Brain imaging < 4 static views (78600) |
$1,217.68 |
$2,435.35 |
2.9× |
| Brain imaging < 4 static views w vascular flow (78601) |
$548.30 |
$1,096.60 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,387.43 |
$2,774.86 |
3.7× |
| Cardiac shunt detection (78428) |
$796.38 |
$1,592.76 |
1.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,080.47 |
$2,160.94 |
1.9× |
| Cervical spine 2 or 3 views (72040) |
$217.70 |
$435.40 |
2.3× |
| Chest 1 view (71045) |
$142.91 |
$285.82 |
1.5× |
| Chest 3 views (71047) |
$174.75 |
$349.49 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$438.14 |
$876.27 |
2.3× |
| Clavicle complete (73000) |
$177.66 |
$355.31 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$97.75 |
$195.50 |
0.9× |
| Continuing medical physics consltj pr wk (77336) |
$607.25 |
$1,214.50 |
4.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,482.26 |
$10,964.52 |
14.7× |
| CT abdomen and pelvis without contrast (74176) |
$3,346.86 |
$6,693.72 |
13.1× |
| CT abdomen w contrast (74160) |
$1,665.64 |
$3,331.27 |
8.9× |
| CT abdomen w wo contrast (74170) |
$2,048.01 |
$4,096.01 |
10.9× |
| CT abdomen w/o contrast (74150) |
$1,589.76 |
$3,179.52 |
14.3× |
| CT angio hrt w/3d image (75574) |
$2,142.21 |
$4,284.42 |
5.8× |
| CT angiography upper extremity lt (73206) |
$1,455.09 |
$2,910.18 |
7.8× |
| CT c-spine w/o contrast (72125) |
$1,644.93 |
$3,289.86 |
14.7× |
| CT cervical spine with contrast (72126) |
$2,386.47 |
$4,772.93 |
6.4× |
| CT chest w/wo contrast (71270) |
$1,718.96 |
$3,437.92 |
9.2× |
| CT chest with contrast (71260) |
$1,338.11 |
$2,676.22 |
7.1× |
| CT head/brain with contrast (70460) |
$1,277.34 |
$2,554.68 |
6.8× |
| CT head/brain without and with contrast (70470) |
$2,055.49 |
$4,110.97 |
11.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,211 |
$2,422 |
3.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$119.12 |
$238.24 |
1.3× |
| CT iac w contrast (70481) |
$1,388.95 |
$2,777.89 |
7.4× |
| CT limited/localized follow up study (76380) |
$570.49 |
$1,140.98 |
6.1× |
| CT lower ext w/o (73700) |
$1,418.17 |
$2,836.34 |
12.7× |
| CT lower extremity w wo contrast (73702) |
$1,620.95 |
$3,241.90 |
8.7× |
| CT lower extremity with contrast (73701) |
$1,702.33 |
$3,404.65 |
9.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,677.58 |
$3,355.16 |
9.0× |
| CT lumbar spine w/o contrast (72131) |
$1,397.99 |
$2,795.97 |
12.5× |
| CT lumbar spine with contrast (72132) |
$1,655.41 |
$3,310.82 |
4.4× |
| CT maxillofacial w contrast (70487) |
$1,605.81 |
$3,211.61 |
8.6× |
| CT maxillofacial w/o contrast (70486) |
$1,255.19 |
$2,510.38 |
11.3× |
| CT maxillofacial w/wo contrast (70488) |
$2,075.05 |
$4,150.09 |
11.1× |
| CT neck soft tissue w contrast (70491) |
$1,679.37 |
$3,358.73 |
9.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,473.59 |
$2,947.18 |
7.9× |
| CT orbits w/o contrast (70480) |
$1,255.19 |
$2,510.38 |
11.3× |
| CT pelvis w & w/o contrast (72194) |
$1,653.15 |
$3,306.29 |
8.8× |
| CT pelvis w/o contrast (72192) |
$1,384.08 |
$2,768.16 |
12.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,911.09 |
$3,822.17 |
10.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,589.04 |
$3,178.08 |
14.2× |
| CT thoracic spine w/contrast (72129) |
$2,386.47 |
$4,772.93 |
12.8× |
| CT thoracic spine w/o contrast (72128) |
$2,044.09 |
$4,088.17 |
18.3× |
| CT thorax w/o contrast (71250) |
$1,272.19 |
$2,544.37 |
11.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,473.59 |
$2,947.18 |
7.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,245.15 |
$2,490.30 |
11.2× |
| CT upper extremity with contrast (73201) |
$1,319.50 |
$2,639 |
3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,036.58 |
$4,073.15 |
10.9× |
| Cta Abdomen (74175) |
$1,884.59 |
$3,769.18 |
10.1× |
| CTA abdomen pelvis (74174) |
$3,769.17 |
$7,538.34 |
10.1× |
| CTA chest (71275) |
$2,101.48 |
$4,202.95 |
11.2× |
| Cta Head (70496) |
$2,188.28 |
$4,376.56 |
11.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,251.17 |
$6,502.34 |
8.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,786.89 |
$3,573.78 |
9.5× |
| Cta Neck (70498) |
$2,314.06 |
$4,628.12 |
12.4× |
| Cta Pelvis (72191) |
$1,653.15 |
$3,306.29 |
8.8× |
| Cystography minimum 3 views rs&i (74430) |
$676.03 |
$1,352.05 |
1.8× |
| Diskogram cervical (72285) |
$1,829.60 |
$3,659.19 |
0.9× |
| Diskography lumbar (72295) |
$1,681.52 |
$3,363.03 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$788.54 |
$1,577.08 |
7.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$470.31 |
$940.61 |
4.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$215.58 |
$431.16 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$214.13 |
$428.25 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$214.57 |
$429.14 |
1.9× |
| Echo exam of fetal heart (76825) |
$982.85 |
$1,965.69 |
1.7× |
| Echoencephalography real time imaging (76506) |
$412.50 |
$824.99 |
3.7× |
| Esophagus (74220) |
$439.85 |
$879.69 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$668.71 |
$1,337.41 |
6.0× |
| Fluoroscopy up to 1 hr (76000) |
$264.17 |
$528.33 |
1.0× |
| Foot 2 views (73620) |
$155.07 |
$310.13 |
1.7× |
| Forearm 2 views (73090) |
$124.26 |
$248.51 |
1.3× |
| Gated Heart Planar Single (78472) |
$1,731.71 |
$3,463.41 |
4.1× |
| Hand 2 views (73120) |
$164.30 |
$328.60 |
1.5× |
| Hand 3 views (73130) |
$184.84 |
$369.67 |
2.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,246.20 |
$4,492.39 |
3.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,574.51 |
$5,149.02 |
3.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,876.20 |
$5,752.39 |
3.9× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,072.25 |
$2,144.50 |
2.6× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,158.28 |
$2,316.56 |
2.8× |
| Heart Infarct Image (78466) |
$796.38 |
$1,592.76 |
1.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,310.48 |
$6,620.96 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,752.11 |
$3,504.21 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$918.12 |
$1,836.23 |
2.2× |
| Ht muscle image spect sing (78451) |
$2,110.24 |
$4,220.47 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$296.90 |
$593.80 |
3.2× |
| Hysterosalpingogram (74740) |
$260.80 |
$521.59 |
1.0× |
| Interstitial radiation source applic complex (77778) |
$835.45 |
$1,670.89 |
1.1× |
| Kidney funcj study non-img radioisotopic study (78725) |
$732.76 |
$1,465.52 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,084.91 |
$2,169.82 |
1.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,881.04 |
$3,762.07 |
3.2× |
| Knee 3 views (73562) |
$277.26 |
$554.51 |
3.0× |
| Liver & spleen imaging static only (78215) |
$985.39 |
$1,970.78 |
2.3× |
| Lung perf&ventilat diferentl (78598) |
$855.73 |
$1,711.46 |
1.5× |
| Lung perfusion differential (78597) |
$531.88 |
$1,063.76 |
1.2× |
| Lymphoscintigraphy (78195) |
$2,425.35 |
$4,850.69 |
4.2× |
| Meckels Diverticulum (78290) |
$571.12 |
$1,142.24 |
1.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,323.35 |
$4,646.70 |
5.8× |
| MRA head w & w/o contrast (70546) |
$1,600.83 |
$3,201.65 |
4.3× |
| MRA head w/o contrast (70544) |
$1,562.44 |
$3,124.87 |
6.1× |
| MRA neck w contrast (70548) |
$1,551.49 |
$3,102.98 |
4.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,958.52 |
$3,917.04 |
5.3× |
| MRA neck w/o contrast (70547) |
$1,329.87 |
$2,659.74 |
5.2× |
| MRI abdomen w contrast (74182) |
$2,091.10 |
$4,182.19 |
5.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,820.51 |
$5,641.02 |
7.6× |
| MRI abdomen w/o contrast (74181) |
$2,101.38 |
$4,202.75 |
8.3× |
| MRI any jnt lwr ext with con lt (73722) |
$2,154.39 |
$4,308.78 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,154.39 |
$4,308.78 |
2.6× |
| MRI c-spine with contrast (72142) |
$2,765.07 |
$5,530.14 |
7.4× |
| MRI cardiac w/o cont stress (75559) |
$824.27 |
$1,648.54 |
1.4× |
| MRI cardiac w/o contrast (75557) |
$1,658.22 |
$3,316.44 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$2,437.12 |
$4,874.24 |
9.6× |
| MRI chest w/o & w/contrast material (71552) |
$2,376.81 |
$4,753.62 |
6.4× |
| MRI chest w/o contrast (71550) |
$1,760.28 |
$3,520.55 |
6.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,329.87 |
$2,659.74 |
3.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,804.73 |
$3,609.45 |
7.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,769.82 |
$3,539.64 |
7.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,341.42 |
$4,682.83 |
6.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,846.31 |
$3,692.61 |
5.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,442.23 |
$4,884.46 |
6.6× |
| MRI pelvis w/o contrast (72195) |
$1,242.01 |
$2,484.01 |
4.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,377.23 |
$4,754.45 |
6.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,387.43 |
$2,774.86 |
1.7× |
| MRI scan of leg joint before and after contrast (73723) |
$2,377.23 |
$4,754.45 |
6.4× |
| MRI spectroscopy (76390) |
$1,330.50 |
$2,661 |
14.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,083.85 |
$6,167.69 |
8.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,030.94 |
$4,061.87 |
5.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,956.68 |
$5,913.35 |
7.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,821.14 |
$5,642.27 |
7.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,962.80 |
$5,925.59 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,315.27 |
$4,630.54 |
9.1× |
| MRI tmj (70336) |
$1,742.10 |
$3,484.20 |
6.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,381.65 |
$2,763.29 |
5.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,377.23 |
$4,754.45 |
6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,263.71 |
$2,527.42 |
5.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,814.28 |
$5,628.56 |
2.0× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,355.44 |
$2,710.87 |
1.5× |
| Neck soft tissue (70360) |
$199.86 |
$399.72 |
2.2× |
| Nm bone marrow multiple (78103) |
$914.51 |
$1,829.02 |
2.1× |
| Nm cisternogram (78630) |
$1,217.68 |
$2,435.35 |
2.1× |
| Nm gastric emptying study (78264) |
$1,938.49 |
$3,876.97 |
4.5× |
| Nm whole blood volume (78122) |
$1,149.57 |
$2,299.13 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,837.29 |
$7,674.57 |
2.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$592.04 |
$1,184.08 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$1,237.26 |
$2,474.52 |
5.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$506.92 |
$1,013.84 |
4.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$498.01 |
$996.02 |
4.5× |
| Orthopantogram (70355) |
$139.82 |
$279.64 |
1.5× |
| Osseous survey infant (77076) |
$216.79 |
$433.57 |
1.9× |
| Osseous survey limited (77074) |
$358.14 |
$716.28 |
3.2× |
| Parathyrd planar w/wo subtrj (78071) |
$622.66 |
$1,245.32 |
1.5× |
| Parathyroid imaging (78070) |
$1,295.03 |
$2,590.06 |
3.0× |
| Pelvis 1 or 2 views (72170) |
$184.84 |
$369.67 |
1.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,858.35 |
$3,716.69 |
5.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,082.79 |
$8,165.58 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,677.34 |
$3,354.67 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$918.80 |
$1,837.60 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,034.78 |
$4,069.56 |
3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$292.20 |
$584.39 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$130.08 |
$260.15 |
1.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$373.98 |
$747.96 |
3.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$399.39 |
$798.77 |
3.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$296.20 |
$592.39 |
2.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$13,918.67 |
$27,837.33 |
1.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$526.30 |
$1,052.60 |
0.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$384.70 |
$769.39 |
3.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$318.41 |
$636.82 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$346.57 |
$693.14 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$219.93 |
$439.85 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$201.69 |
$403.38 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$145.62 |
$291.24 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$590.33 |
$1,180.66 |
3.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$271.78 |
$543.55 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$489.39 |
$978.78 |
2.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$593.79 |
$1,187.58 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$212.22 |
$424.44 |
2.3× |
| Radiological examination surgical specimen (76098) |
$302.53 |
$605.06 |
0.5× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,441.57 |
$4,883.14 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,158.22 |
$8,316.44 |
1.2× |
| Ribs bilateral 3 views (71110) |
$313.82 |
$627.63 |
2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,106.98 |
$2,213.95 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,643.87 |
$3,287.73 |
2.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,584.69 |
$3,169.38 |
2.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$617.17 |
$1,234.33 |
2.5× |
| Rp Therapy Intravenous Administration (79101) |
$678.88 |
$1,357.76 |
2.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$191.32 |
$382.63 |
0.8× |
| Scanogram (77073) |
$445.46 |
$890.91 |
4.0× |
| Scapula complete (73010) |
$292.56 |
$585.12 |
2.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$509.16 |
$1,018.32 |
4.6× |
| Sialogram (70390) |
$514.30 |
$1,028.59 |
2.0× |
| Simulation intermediate (77285) |
$1,044.43 |
$2,088.85 |
2.6× |
| Small bowel series (74250) |
$439.85 |
$879.69 |
2.4× |
| Spec medical radj physics consltj (77370) |
$1,014.62 |
$2,029.24 |
7.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$755.75 |
$1,511.50 |
1.9× |
| Special dosimetry (77331) |
$394.31 |
$788.61 |
2.7× |
| Special treatment procedure (77470) |
$2,837.21 |
$5,674.41 |
4.8× |
| Spine thoracic 3 views (72072) |
$264.94 |
$529.87 |
2.4× |
| Stereotactic body radiation delivery (77373) |
$4,766.85 |
$9,533.70 |
2.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$777.08 |
$1,554.16 |
1.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$893.28 |
$1,786.55 |
2.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,597.69 |
$3,195.38 |
4.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$816.53 |
$1,633.05 |
5.7× |
| Thoracolumbar 2 views (72080) |
$188.11 |
$376.22 |
2.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,395.50 |
$2,790.99 |
2.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$374.57 |
$749.13 |
0.9× |
| Thyroid uptake measurement (78012) |
$912.12 |
$1,824.24 |
2.1× |
| Tmj unilateral (70328) |
$154.77 |
$309.53 |
1.7× |
| Treatment device intermediate (77333) |
$530.89 |
$1,061.78 |
3.7× |
| Treatment devices simple (77332) |
$388.41 |
$776.82 |
2.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,296.18 |
$2,592.35 |
3.0× |
| Tx devices design & construction complex (77334) |
$975.77 |
$1,951.54 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$450.70 |
$901.40 |
4.0× |
| Umbilical-artery Doppler (OB) (76820) |
$634.91 |
$1,269.82 |
5.7× |
| Unlisted Ultrasound Procedure (76999) |
$482.26 |
$964.52 |
5.2× |
| Upper Extremity Infant (73092) |
$144.62 |
$289.24 |
1.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$646.56 |
$1,293.11 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$514.30 |
$1,028.59 |
2.0× |
| Urethrocystography voiding (74455) |
$770.55 |
$1,541.09 |
3.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$500.61 |
$1,001.21 |
2.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$566.05 |
$1,132.10 |
3.0× |
| Us abdl aorta screen aaa (76706) |
$388.68 |
$777.36 |
3.5× |
| Us breast unilateral complete (76641) |
$176.85 |
$353.70 |
1.6× |
| Us breast unilateral limited (76642) |
$176.85 |
$353.70 |
1.9× |
| Us chest (76604) |
$437.66 |
$875.32 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$506.47 |
$1,012.93 |
4.5× |
| Us guided compression repair (76936) |
$690.93 |
$1,381.85 |
3.0× |
| Us infant hips dynamic (76885) |
$503.12 |
$1,006.24 |
5.4× |
| Us infant hips limited static (76886) |
$353.42 |
$706.83 |
3.8× |
| Us kidney transplant (76776) |
$394.91 |
$789.81 |
3.5× |
| Us ob detailed single fetus (76811) |
$673.20 |
$1,346.39 |
2.6× |
| Us ob transvaginal (76817) |
$569.48 |
$1,138.96 |
5.1× |
| Us pelvic non ob complete (76856) |
$540.88 |
$1,081.75 |
4.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$323.47 |
$646.94 |
2.9× |
| Us pregnancy ltd (76815) |
$413.05 |
$826.09 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$648.93 |
$1,297.85 |
5.8× |
| Us retroperitoneal complete (76770) |
$766.59 |
$1,533.18 |
6.9× |
| Us retroperitoneal limited (76775) |
$544.51 |
$1,089.01 |
4.9× |
| Us scrotum and contents (76870) |
$504.79 |
$1,009.57 |
4.5× |
| Us soft tissue head/neck (76536) |
$449.18 |
$898.36 |
4.0× |
| Us spinal canal and contents (76800) |
$468.95 |
$937.89 |
4.2× |
| Us transrectal prostate volume (76873) |
$276.02 |
$552.03 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$306.54 |
$613.07 |
2.7× |
| Vascular flow imaging (78445) |
$403.78 |
$807.56 |
0.9× |
| Venogram extremity bilateral (75822) |
$1,114.01 |
$2,228.01 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,412.88 |
$4,825.76 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$2,347.53 |
$4,695.06 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,212.72 |
$2,425.43 |
0.7× |
| Venography Renal Bilateral (75833) |
$5,010.70 |
$10,021.39 |
1.5× |
| Venography renal unilateral selective rs&i (75831) |
$3,625.74 |
$7,251.47 |
1.1× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,880.75 |
$5,761.50 |
0.5× |
| Wrist 2 views (73100) |
$154.15 |
$308.29 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$321.76 |
$643.51 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$216.79 |
$433.57 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$288.56 |
$577.12 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$866.43 |
$1,732.86 |
4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$124.26 |
$248.51 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$232.08 |
$464.15 |
2.5× |
| X-ray exam hip uni 1 view (73501) |
$324.12 |
$648.24 |
3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$477.74 |
$955.47 |
5.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$512.36 |
$1,024.72 |
4.6× |
| X-ray exam of femur 1 (73551) |
$130.08 |
$260.15 |
1.4× |
| X-ray eye for foreign body (70030) |
$68.58 |
$137.15 |
0.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$256.72 |
$513.44 |
2.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$219.93 |
$439.85 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$184.84 |
$369.67 |
2.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,387.61 |
$2,775.22 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$177.66 |
$355.31 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$193.40 |
$386.79 |
2.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$294.86 |
$589.72 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$114.86 |
$229.72 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$109.66 |
$219.32 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$291.64 |
$583.27 |
2.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$303.79 |
$607.57 |
2.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$157.68 |
$315.35 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$296.90 |
$593.80 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$95.72 |
$191.43 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$257.74 |
$515.47 |
2.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$380.08 |
$760.16 |
3.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$494.45 |
$988.89 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$261.09 |
$522.17 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$263.91 |
$527.82 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$286 |
$572 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$243.03 |
$486.06 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$280.73 |
$561.45 |
3.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$232.08 |
$464.15 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$246.64 |
$493.27 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$219.92 |
$439.84 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$325.81 |
$651.62 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$193.40 |
$386.79 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$113.82 |
$227.63 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$219.93 |
$439.85 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$214.80 |
$429.59 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$264.94 |
$529.87 |
2.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$335.02 |
$670.03 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$177.66 |
$355.31 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$184.84 |
$369.67 |
2.0× |
| Xr arthrogram ankle (73615) |
$716.48 |
$1,432.96 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$410.11 |
$820.22 |
3.7× |
| Xr chest 4+ views (71048) |
$292.66 |
$585.32 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$124.26 |
$248.51 |
1.3× |
| Xr shoulder 1 view (73020) |
$148.05 |
$296.09 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$291.64 |
$583.27 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$155.07 |
$310.13 |
1.7× |
| Xr tmj bilateral (70330) |
$271.30 |
$542.60 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$155.07 |
$310.13 |
1.7× |