| 3-D radiotherapy plan dose-volume histograms (77295) |
$9,612.30 |
$10,680.33 |
6.0× |
| Abdomen 2 views (74019) |
$481.79 |
$535.32 |
4.0× |
| Acute gi blood loss imaging (78278) |
$1,802.74 |
$2,003.04 |
3.9× |
| Angio Adrenal Bilat Select (75733) |
$4,568.57 |
$5,076.19 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$7,183.65 |
$7,981.83 |
2.0× |
| Angiography extremity unilateral rs&i (75710) |
$7,053.63 |
$7,837.37 |
1.9× |
| Angiography internal mammary rs&i (75756) |
$3,150.54 |
$3,500.60 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$7,524.50 |
$8,360.56 |
1.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,000.90 |
$8,889.89 |
2.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,532.23 |
$6,146.92 |
1.5× |
| Angiography Spinal Selective Rs&I (75705) |
$9,399.52 |
$10,443.91 |
1.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$7,462.14 |
$8,291.26 |
1.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,328.07 |
$2,586.74 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,009.40 |
$3,343.78 |
0.8× |
| Ankle 2 views (73600) |
$395.60 |
$439.55 |
3.9× |
| Aortogram thoracic (75605) |
$7,162.27 |
$7,958.08 |
1.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$7,436.76 |
$8,263.07 |
2.0× |
| Aortography abdominal serialography rs&i (75625) |
$7,033.78 |
$7,815.31 |
1.9× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$6,290.23 |
$6,989.14 |
1.7× |
| Artery X-Rays Adrenal Gland (75731) |
$4,320.43 |
$4,800.48 |
1.2× |
| Arthrogram ankle (73615) |
$1,277.86 |
$1,419.84 |
3.2× |
| Arthrogram elbow (73085) |
$1,274.44 |
$1,416.04 |
3.1× |
| Arthrogram hip (73525) |
$1,604.07 |
$1,782.30 |
4.0× |
| Arthrogram knee (73580) |
$1,363.08 |
$1,514.54 |
3.4× |
| Arthrogram shoulder (73040) |
$1,622.28 |
$1,802.54 |
4.0× |
| Arthrogram wrist (73115) |
$1,390.23 |
$1,544.70 |
3.4× |
| Basic dosimetry (77300) |
$790.92 |
$878.80 |
5.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,666.98 |
$1,852.20 |
3.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,713.66 |
$1,904.06 |
3.7× |
| Bone &/joint imaging whole body (78306) |
$1,937.68 |
$2,152.98 |
4.2× |
| Bone age studies (77072) |
$344.92 |
$383.25 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$2,118.14 |
$2,353.48 |
4.6× |
| Bone Marrow Imaging Limited Area (78102) |
$1,184.61 |
$1,316.23 |
2.6× |
| Bone survey complete (77075) |
$733.17 |
$814.64 |
6.0× |
| Bone survey infant (77076) |
$320.11 |
$355.68 |
2.6× |
| Bowel imaging (78290) |
$1,176.74 |
$1,307.49 |
2.5× |
| Brachytx isodose complex (77318) |
$2,457.90 |
$2,731 |
5.7× |
| Brachytx isodose intermed (77317) |
$2,071.72 |
$2,301.91 |
4.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,693.96 |
$1,882.18 |
3.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$6,018.05 |
$6,686.72 |
9.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,279.27 |
$6,976.97 |
3.8× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$1,120.10 |
$1,244.55 |
1.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$2,586.80 |
$2,874.22 |
5.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,425.64 |
$2,695.15 |
5.2× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$3,851.64 |
$4,279.60 |
4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,634.58 |
$2,927.31 |
6.5× |
| Cardiac shunt detection (78428) |
$959.88 |
$1,066.53 |
2.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,846.73 |
$2,051.92 |
2.9× |
| Cervical spine 2 or 3 views (72040) |
$440.12 |
$489.02 |
4.4× |
| Chest 1 view (71045) |
$446.95 |
$496.61 |
4.4× |
| Chest xray 3 views (71047) |
$724.55 |
$805.06 |
7.2× |
| Cholecystography, oral contrast Non-Facility (74290) |
$484.64 |
$538.49 |
2.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$890.29 |
$989.21 |
4.4× |
| Cineradiography/videoradiography (76120) |
$577.86 |
$642.07 |
4.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$2,210.32 |
$2,455.91 |
2.4× |
| Clavicle complete (73000) |
$430.48 |
$478.31 |
4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$575.06 |
$638.95 |
4.7× |
| Continuing medical physics consltj pr wk (77336) |
$1,174.94 |
$1,305.49 |
7.5× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$559.52 |
$621.69 |
2.7× |
| Corpora cavernosography (74445) |
$831.30 |
$923.67 |
6.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,959.32 |
$5,510.36 |
12.2× |
| CT abdomen and pelvis without contrast (74176) |
$3,291.62 |
$3,657.36 |
11.9× |
| CT abdomen w contrast (74160) |
$2,157.10 |
$2,396.78 |
10.6× |
| CT abdomen w wo contrast (74170) |
$2,752.74 |
$3,058.60 |
13.5× |
| CT abdomen w/o contrast (74150) |
$2,100 |
$2,333.32 |
17.3× |
| CT angio hrt w/3d image (75574) |
$1,829.05 |
$2,032.28 |
4.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,749.32 |
$4,165.91 |
18.4× |
| CT angiography upper extremity lt (73206) |
$3,261.83 |
$3,624.25 |
16.0× |
| CT c-spine w/contrast (72126) |
$2,280.84 |
$2,534.26 |
5.6× |
| CT c-spine w/o contrast (72125) |
$1,983.32 |
$2,203.68 |
16.3× |
| CT cervical spine w&w/o contrast (72127) |
$2,829.52 |
$3,143.91 |
13.9× |
| CT chest w contrast (71260) |
$2,373.40 |
$2,637.12 |
11.7× |
| CT chest w/wo contrast (71270) |
$2,636.74 |
$2,929.71 |
12.9× |
| CT colonography screening (74263) |
$1,550.95 |
$1,723.28 |
5.6× |
| CT colonography w/dye (74262) |
$1,621.89 |
$1,802.10 |
8.0× |
| CT colonography w/o cntrst (74261) |
$1,437.70 |
$1,597.44 |
11.8× |
| CT head/brain with contrast (70460) |
$2,018.42 |
$2,242.70 |
9.9× |
| CT head/brain without and with contrast (70470) |
$2,468.76 |
$2,743.07 |
12.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,022.11 |
$1,135.68 |
2.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$126.17 |
$140.19 |
1.2× |
| CT hrt w/3d image congen (75573) |
$1,547.38 |
$1,719.31 |
3.8× |
| CT iac w contrast (70481) |
$2,133.74 |
$2,370.82 |
10.5× |
| CT limited/localized follow up study (76380) |
$870.34 |
$967.04 |
8.6× |
| CT lower ext w/o (73700) |
$2,014.42 |
$2,238.25 |
16.6× |
| CT lower extremity w wo contrast (73702) |
$2,537.34 |
$2,819.27 |
12.5× |
| CT lower extremity w/contrast material (73701) |
$1,996.24 |
$2,218.05 |
9.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,910.62 |
$3,234.02 |
14.3× |
| CT lumbar spine w/contrast (72132) |
$2,360.70 |
$2,623 |
5.8× |
| CT lumbar spine w/o contrast (72131) |
$2,072.84 |
$2,303.16 |
17.1× |
| CT maxillofacial w contrast (70487) |
$2,888.33 |
$3,209.26 |
14.2× |
| CT maxillofacial w/wo contrast (70488) |
$3,387.24 |
$3,763.60 |
16.6× |
| CT maxillofacial wo contrast (70486) |
$2,014.42 |
$2,238.25 |
16.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,517.20 |
$2,796.88 |
12.4× |
| CT orbits w/o contrast (70480) |
$1,547.75 |
$1,719.72 |
12.7× |
| CT pelvis w/o contrast (72192) |
$2,058.12 |
$2,286.80 |
17.0× |
| CT pelvis w/wo contrast (72194) |
$3,569.90 |
$3,966.54 |
17.5× |
| CT scan of arm combo (73202) |
$2,606.90 |
$2,896.55 |
12.8× |
| CT soft tissue neck w contrast (70491) |
$2,209.96 |
$2,455.52 |
10.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,238.37 |
$2,487.08 |
11.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,822.04 |
$2,024.49 |
15.0× |
| CT thoracic spine w/contrast (72129) |
$2,010.22 |
$2,233.58 |
9.9× |
| CT thoracic spine w/o contrast (72128) |
$1,756.68 |
$1,951.88 |
14.5× |
| CT thoracic spine w/wo contrast (72130) |
$2,920.68 |
$3,245.20 |
14.3× |
| CT thorax w/o contrast (71250) |
$1,703.22 |
$1,892.46 |
14.0× |
| CT unlisted procedure (76497) |
$824.46 |
$916.06 |
8.2× |
| CT upper ext wo (73200) |
$2,014.42 |
$2,238.25 |
16.6× |
| CT upper extremity with contrast (73201) |
$1,979.87 |
$2,199.86 |
4.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,506.61 |
$2,785.12 |
12.3× |
| Cta Abdomen (74175) |
$3,659.85 |
$4,066.50 |
18.0× |
| CTA abdomen pelvis (74174) |
$5,464.77 |
$6,071.96 |
13.5× |
| CTA chest (71275) |
$2,604.52 |
$2,893.92 |
12.8× |
| Cta Head (70496) |
$2,516.30 |
$2,795.88 |
12.4× |
| Cta Neck (70498) |
$2,338.78 |
$2,598.64 |
11.5× |
| Cta Pelvis (72191) |
$2,810.57 |
$3,122.85 |
13.8× |
| Cystography minimum 3 views rs&i (74430) |
$779.07 |
$865.63 |
1.9× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$1,391.32 |
$1,545.91 |
5.0× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$4,618.19 |
$5,131.32 |
1.9× |
| Diskogram cervical (72285) |
$2,404.77 |
$2,671.97 |
1.1× |
| Diskography lumbar (72295) |
$4,118.67 |
$4,576.30 |
1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$278.99 |
$309.99 |
2.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$569.23 |
$632.48 |
4.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$418.78 |
$465.31 |
3.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$647.22 |
$719.14 |
5.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$215.02 |
$238.91 |
2.1× |
| Dxa bone density study axial skeleton (77085) |
$691.90 |
$768.78 |
5.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,035.28 |
$1,150.31 |
3.7× |
| Esophageal motility (78258) |
$772.48 |
$858.31 |
1.7× |
| Esophagus (74220) |
$571.88 |
$635.42 |
2.8× |
| Facial bones min 3 views (70150) |
$568.68 |
$631.88 |
4.7× |
| Fetal biophysical profile non-stress testing (76818) |
$869.63 |
$966.26 |
7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$608.40 |
$676 |
5.0× |
| Fetal Echo (76825) |
$1,434.89 |
$1,594.32 |
2.3× |
| Fluoroscopy up to 1 hr (76000) |
$858.18 |
$953.54 |
3.1× |
| Foot 2 views (73620) |
$407.16 |
$452.40 |
4.0× |
| Forearm 2 views (73090) |
$448.88 |
$498.75 |
4.4× |
| Functional MRI brain by phys/psych (70555) |
$2,343.33 |
$2,603.70 |
8.5× |
| Functional MRI brain by tech (70554) |
$2,396.49 |
$2,662.76 |
8.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,568.05 |
$1,742.28 |
3.4× |
| Gastrointestinal endoscopic ultrasound, supervision and interpretation Non-Facility (76975) |
$671.64 |
$746.27 |
2.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,730.77 |
$1,923.08 |
2.7× |
| Hand 2 views (73120) |
$489.60 |
$544 |
4.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$4,703 |
$5,225.56 |
5.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,862.10 |
$7,624.56 |
8.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$10,690.32 |
$11,878.14 |
13.2× |
| Heart first pass single,planar (78481) |
$1,123.24 |
$1,248.05 |
1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,605.35 |
$7,339.28 |
1.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$6,519.20 |
$7,243.55 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,684.35 |
$1,871.50 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,534.44 |
$1,704.93 |
3.3× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) |
$2,612.25 |
$2,902.50 |
4.1× |
| Hysterosalpingogram (74740) |
$1,066.48 |
$1,184.98 |
3.8× |
| Image fusion (77399) |
$902.25 |
$1,002.50 |
5.8× |
| Interstitial radiation source applic complex (77778) |
$5,535.50 |
$6,150.56 |
6.8× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) |
$8,853.57 |
$9,837.30 |
1.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$401.24 |
$445.82 |
3.3× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$1,181.97 |
$1,313.30 |
2.5× |
| Kidney imaging morphology (78700) |
$1,081.08 |
$1,201.20 |
2.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,287.38 |
$2,541.54 |
3.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,861.36 |
$2,068.18 |
3.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,195.26 |
$2,439.18 |
3.5× |
| Knee 3 views (73562) |
$445.61 |
$495.12 |
4.4× |
| Liver & spleen imaging static only (78215) |
$1,049.45 |
$1,166.06 |
2.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,316.39 |
$1,462.66 |
2.8× |
| Liver imaging static only (78201) |
$2,832.38 |
$3,147.09 |
4.5× |
| Liver imaging w/vascular flow (78202) |
$3,369.55 |
$3,743.94 |
5.3× |
| Lung perf&ventilat diferentl (78598) |
$1,943 |
$2,158.89 |
3.1× |
| Lung perfusion differential (78597) |
$1,633.55 |
$1,815.06 |
3.5× |
| Lung ventilation imaging (78579) |
$1,441.78 |
$1,601.98 |
3.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,016.33 |
$3,351.48 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,453.99 |
$1,615.54 |
0.4× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$1,509.61 |
$1,677.34 |
0.8× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$1,229.90 |
$1,366.56 |
1.7× |
| Lymphoscintigraphy (78195) |
$1,744.01 |
$1,937.79 |
2.8× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,275 |
$3,638.89 |
3.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial… (70558) |
$1,674.88 |
$1,860.98 |
8.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial… (70557) |
$1,488.52 |
$1,653.91 |
2.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial… (70559) |
$3,457.42 |
$3,841.58 |
17.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,503.04 |
$2,781.15 |
6.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,015.81 |
$3,350.90 |
7.4× |
| Magnetic Resonance Elastography (76391) |
$1,990.90 |
$2,212.11 |
7.2× |
| Mammary ductogram or galactogram multiple (77054) |
$801.94 |
$891.05 |
2.9× |
| Mammary ductogram or galactogram single (77053) |
$1,091 |
$1,212.22 |
3.9× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$166.08 |
$184.53 |
1.6× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$626.79 |
$696.43 |
1.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$7,728.76 |
$8,587.50 |
17.8× |
| Mr safety determination physician/other qhp (76016) |
$2,657.54 |
$2,952.82 |
26.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$127.62 |
$141.80 |
3.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$90.90 |
$101 |
0.8× |
| Mr safety implt pos&/immoblj (76019) |
$86.30 |
$95.89 |
1.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$864 |
$960 |
3.1× |
| MRA head w & w/o contrast (70546) |
$3,568.88 |
$3,965.43 |
8.8× |
| MRA head w/o contrast (70544) |
$2,962.48 |
$3,291.65 |
10.7× |
| MRA head with contrast (70545) |
$2,874.94 |
$3,194.38 |
7.1× |
| MRA neck w contrast (70548) |
$2,757.88 |
$3,064.32 |
6.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,070.48 |
$4,522.76 |
10.0× |
| MRA neck w/o contrast (70547) |
$2,699.73 |
$2,999.70 |
9.7× |
| MRI abdomen w contrast (74182) |
$4,629.32 |
$5,143.69 |
11.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,928.16 |
$5,475.72 |
12.2× |
| MRI abdomen w/o contrast (74181) |
$3,202.34 |
$3,558.15 |
11.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,008.16 |
$3,342.40 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,958.44 |
$5,509.38 |
12.2× |
| MRI bone marrow blood supply (77084) |
$2,547.42 |
$2,830.47 |
9.2× |
| MRI breast w/o contrast bilateral (77047) |
$3,449.10 |
$3,832.34 |
12.4× |
| MRI breast wo contrast unilateral (77046) |
$3,000.39 |
$3,333.76 |
10.8× |
| MRI c-spine with contrast (72142) |
$3,364.62 |
$3,738.47 |
8.3× |
| MRI cardiac w/o cont stress (75559) |
$1,635.88 |
$1,817.64 |
2.6× |
| MRI cardiac w/o contrast (75557) |
$2,585.67 |
$2,872.96 |
9.3× |
| MRI cervical spine w/o contrast (72141) |
$3,132.06 |
$3,480.07 |
11.3× |
| MRI chest w/o & w/contrast material (71552) |
$3,725.46 |
$4,139.40 |
9.2× |
| MRI chest w/o contrast (71550) |
$3,069.40 |
$3,410.44 |
11.1× |
| MRI chest with contrast (71551) |
$1,682.64 |
$1,869.60 |
1.8× |
| MRI fetal sngl/1st gestation (74712) |
$1,321.72 |
$1,468.58 |
4.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,670.80 |
$2,967.56 |
6.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,690.57 |
$4,100.63 |
9.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,179.66 |
$3,532.95 |
11.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,728.56 |
$3,031.74 |
9.8× |
| MRI orbit face neck w contrast (70542) |
$3,535.86 |
$3,928.73 |
8.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,868.34 |
$4,298.16 |
9.5× |
| MRI pelvis w/contrast (72196) |
$3,113.46 |
$3,459.40 |
7.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,922.67 |
$4,358.52 |
9.7× |
| MRI pelvis w/o contrast (72195) |
$2,766.36 |
$3,073.74 |
10.0× |
| MRI spectroscopy (76390) |
$1,547.38 |
$1,719.31 |
15.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,978.82 |
$4,420.91 |
9.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,756.22 |
$4,173.58 |
9.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,705.18 |
$5,227.98 |
11.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,316.80 |
$3,685.34 |
8.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,338.43 |
$4,820.48 |
10.7× |
| MRI temporomandibular joint (70336) |
$2,919.74 |
$3,244.15 |
10.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,954.48 |
$3,282.74 |
10.7× |
| MRI up ext w/o contrast (73218) |
$3,124.87 |
$3,472.08 |
11.3× |
| MRI upper ext joint w/o contrast (73221) |
$3,411 |
$3,790 |
12.3× |
| MRI, joint upper extrem combo (73223) |
$4,622.20 |
$5,135.78 |
11.4× |
| Myelogram Cervical (72240) |
$2,356.85 |
$2,618.72 |
2.6× |
| Myelogram Lumbar (72265) |
$1,781.68 |
$1,979.64 |
2.0× |
| Myelogram thoracic (72255) |
$1,791.52 |
$1,990.58 |
2.0× |
| Myelography 2 or more regions (72270) |
$1,953.78 |
$2,170.87 |
2.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$6,230.95 |
$6,923.28 |
4.1× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78433) |
$3,580.99 |
$3,978.88 |
1.4× |
| Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) |
$5,411.95 |
$6,013.28 |
3.3× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$2,458.79 |
$2,731.99 |
1.5× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$5,105.95 |
$5,673.28 |
2.0× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$5,640.29 |
$6,266.99 |
3.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,782.20 |
$3,091.33 |
1.9× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$5,206.97 |
$5,785.52 |
3.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,212.26 |
$3,569.18 |
2.1× |
| Myocardial spect single study at rest or stress (78451) |
$2,997.73 |
$3,330.81 |
2.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,439.45 |
$4,932.72 |
2.7× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$3,478.64 |
$3,865.16 |
2.0× |
| N-invas est c ffr sw aly CTA (75580) |
$4,654.73 |
$5,171.92 |
4.7× |
| Neck soft tissue (70360) |
$429.58 |
$477.32 |
4.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$869.80 |
$966.44 |
1.9× |
| Nm adrenal scan (78075) |
$2,534.19 |
$2,815.77 |
1.7× |
| Nm bone marrow wb (78104) |
$1,509.08 |
$1,676.75 |
3.3× |
| Nm cardiac blood pool multiple (78473) |
$1,918.48 |
$2,131.64 |
4.1× |
| Nm cisternogram (78630) |
$1,736.93 |
$1,929.92 |
2.8× |
| Nm csf leak detection (78650) |
$1,395.52 |
$1,550.58 |
0.9× |
| Nm gastric emptying study (78264) |
$1,802.48 |
$2,002.75 |
3.9× |
| Nm gastroesophageal reflux study (78262) |
$1,518.70 |
$1,687.45 |
3.3× |
| Nm peritoneal-venous shunt patency (78291) |
$952.25 |
$1,058.06 |
2.1× |
| Nm red cell sequestration (78140) |
$1,362.02 |
$1,513.36 |
2.9× |
| Noncardiac Vascular Flow Imaging (78445) |
$941.80 |
$1,046.45 |
2.0× |
| Nonvascular shunt X-ray (75809) |
$644.90 |
$716.56 |
5.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$13,102.54 |
$14,558.38 |
8.2× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,441.61 |
$1,601.79 |
3.1× |
| Nuclear Rx Oral Admin (79005) |
$1,592.63 |
$1,769.59 |
5.9× |
| Ob us nuchal meas 1 gest (76813) |
$476.49 |
$529.43 |
3.9× |
| Ophthalmic biometry by ultrasound echography, A-scan; Non-Facility (76516) |
$370.19 |
$411.32 |
3.0× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) |
$417.02 |
$463.35 |
3.4× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$618.24 |
$686.92 |
5.1× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$83.63 |
$92.92 |
2.5× |
| Orthopantogram (70355) |
$275.40 |
$306 |
2.7× |
| Osseous survey limited (77074) |
$495.21 |
$550.23 |
4.1× |
| Parathyrd planar w/spect&CT (78072) |
$2,231.49 |
$2,479.43 |
3.5× |
| Parathyroid Planar Imaging (78070) |
$1,782.14 |
$1,980.16 |
3.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,782.22 |
$1,980.24 |
3.8× |
| Pelvis 1 or 2 views (72170) |
$443.53 |
$492.82 |
3.7× |
| Perineogram (74775) |
$783.90 |
$871 |
2.8× |
| Peritoneogram after injection (74190) |
$1,278.58 |
$1,420.64 |
2.0× |
| PET image w/CT, skull-thigh (78815) |
$7,200.14 |
$8,000.15 |
4.3× |
| PET imaging CT for attenuation limited area (78814) |
$6,678.97 |
$7,421.08 |
4.0× |
| PET imaging for CT attenuation whole body (78816) |
$6,272.60 |
$6,969.55 |
3.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$6,619.48 |
$7,354.98 |
4.4× |
| PET whole body (78813) |
$5,095.27 |
$5,661.41 |
3.1× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$4,531.45 |
$5,034.94 |
3.0× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$4,329.54 |
$4,810.60 |
2.6× |
| Proton trmt simple w/comp (77522) |
$6,947.10 |
$7,719 |
4.8× |
| Proton tx delivery complex (77525) |
$8,705.86 |
$9,673.18 |
6.0× |
| Proton tx delivery intermediate (77523) |
$5,878.70 |
$6,531.90 |
4.1× |
| Proton tx delivery simple w/o compensation (77520) |
$6,947.10 |
$7,719 |
10.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,035.01 |
$4,483.34 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,411.74 |
$4,901.94 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,369.43 |
$1,521.59 |
2.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,148.61 |
$2,387.34 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,143.79 |
$1,270.88 |
1.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$398.59 |
$442.88 |
3.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$309.02 |
$343.35 |
3.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$379.85 |
$422.06 |
3.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$281.12 |
$312.36 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$556.63 |
$618.48 |
4.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$676.17 |
$751.30 |
5.6× |
| Radex fingr minimum 2 views (73140) |
$432 |
$480 |
4.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$441.18 |
$490.20 |
4.4× |
| Radex Hand Minimum 3 Views (73130) |
$459.45 |
$510.50 |
4.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$381.70 |
$424.12 |
3.8× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$475.02 |
$527.80 |
3.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$670.50 |
$745 |
5.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$787.07 |
$874.52 |
6.5× |
| Radex Humerus Minimum 2 Views (73060) |
$389.19 |
$432.43 |
3.9× |
| Radex Kne 1/2 Views (73560) |
$506.20 |
$562.44 |
5.0× |
| Radex Kne Compl 4/More Views (73564) |
$489.08 |
$543.42 |
4.0× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$440.39 |
$489.32 |
3.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$517.45 |
$574.94 |
5.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$474.19 |
$526.88 |
3.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$379.88 |
$422.09 |
3.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$369.45 |
$410.50 |
3.7× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$584.42 |
$649.36 |
4.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$304.20 |
$338 |
3.0× |
| Radex Toe Minimum 2 Views (73660) |
$414.53 |
$460.59 |
4.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$316.17 |
$351.30 |
2.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$452.48 |
$502.75 |
4.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$829.11 |
$921.24 |
6.8× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) |
$107,372.96 |
$119,303.29 |
12.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$28,080 |
$31,200 |
3.3× |
| Radiation treatment delivery level 1 (77402) |
$877.30 |
$974.77 |
7.4× |
| Radiation treatment delivery level 2 (77407) |
$1,052.54 |
$1,169.50 |
2.4× |
| Radiation treatment delivery level 3 (77412) |
$1,442.07 |
$1,602.30 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$408.08 |
$453.42 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$592.76 |
$658.62 |
4.9× |
| Radiologic exam chest 2 views (71046) |
$532.93 |
$592.14 |
5.3× |
| Radiologic exam colon single contrast study (74270) |
$994.97 |
$1,105.52 |
4.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$799.82 |
$888.69 |
3.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$881 |
$978.89 |
4.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$824.99 |
$916.66 |
4.1× |
| Radiologic examination femur 1 view (73551) |
$392.61 |
$436.23 |
3.9× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$181.35 |
$201.50 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$471.66 |
$524.07 |
4.7× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$513.38 |
$570.42 |
4.2× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$330.64 |
$367.38 |
2.7× |
| Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) |
$116.32 |
$129.25 |
0.4× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$116.32 |
$129.25 |
1.2× |
| Radiological examination surgical specimen (76098) |
$815.75 |
$906.39 |
1.3× |
| Radiopharm Dacryocystography (78660) |
$828.92 |
$921.02 |
1.8× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
$1,619.96 |
$1,799.95 |
6.0× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,619.96 |
$1,799.95 |
6.0× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion Non-Facility (79403) |
$1,616.23 |
$1,795.81 |
6.0× |
| Red cell survival study Non-Facility (78130) |
$1,054.66 |
$1,171.84 |
2.3× |
| Red cell volume determination (separate procedure); multiple samplings Non-Facility (78121) |
$4,045.42 |
$4,494.91 |
6.4× |
| Renal Cyst Study (74470) |
$964.58 |
$1,071.76 |
1.5× |
| Ribs bilateral 3 views (71110) |
$539.38 |
$599.32 |
4.4× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,665.58 |
$1,850.64 |
3.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,872.15 |
$3,191.28 |
6.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$7,422.64 |
$8,247.38 |
11.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,960.26 |
$3,289.18 |
4.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,722.50 |
$4,136.11 |
5.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$5,364.98 |
$5,961.09 |
3.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$6,817.39 |
$7,574.88 |
4.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,015.26 |
$4,461.39 |
2.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$898.14 |
$997.93 |
3.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,325 |
$1,472.22 |
4.9× |
| Sacroiliac Joints < 3 Views (72200) |
$382.24 |
$424.72 |
3.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$796.43 |
$884.92 |
2.9× |
| Salivary gland function study (78232) |
$1,151.40 |
$1,279.33 |
2.5× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$759.84 |
$844.27 |
1.6× |
| Scapula (73010) |
$516.67 |
$574.08 |
4.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$83.92 |
$93.24 |
3.6× |
| Sella turcica (70240) |
$220.63 |
$245.14 |
2.2× |
| Shoulder 1 view (73020) |
$455.72 |
$506.36 |
4.5× |
| Sialogram (70390) |
$728.32 |
$809.25 |
2.6× |
| Simulation intermediate (77285) |
$2,268.46 |
$2,520.52 |
5.2× |
| Small bowel series (74250) |
$892.94 |
$992.16 |
4.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,879.33 |
$2,088.14 |
4.3× |
| Special dosimetry (77331) |
$724.38 |
$804.86 |
4.6× |
| Special Physics Consult (77370) |
$1,530.19 |
$1,700.21 |
9.8× |
| Special treatment procedure (77470) |
$3,927.96 |
$4,364.40 |
6.1× |
| Speech evaluation complex (70371) |
$657.24 |
$730.27 |
2.4× |
| Spine thoracic 3 views (72072) |
$421.24 |
$468.05 |
3.5× |
| Splenoportograpy rs&i (75810) |
$3,348.26 |
$3,720.29 |
0.9× |
| Stereotactic Body Radiation Delivery (77373) |
$12,916.29 |
$14,351.43 |
6.2× |
| Superior sagittal sinus venogram (75870) |
$3,029.65 |
$3,366.28 |
0.8× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$211.54 |
$235.04 |
2.1× |
| Tbs technical calculation only (77091) |
$241.49 |
$268.32 |
2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,535.14 |
$3,927.93 |
8.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,575.66 |
$2,861.84 |
5.9× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$837.80 |
$930.89 |
3.0× |
| Testicular Imaging With Vascular Flow (78761) |
$1,181.89 |
$1,313.21 |
2.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,687.57 |
$2,986.18 |
6.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,451.66 |
$1,612.96 |
9.3× |
| Thoracolumbar 2 views (72080) |
$422.23 |
$469.14 |
4.2× |
| Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) |
$1,318.06 |
$1,464.51 |
2.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,973.80 |
$2,193.10 |
3.1× |
| Thyroid imaging w/blood flow (78013) |
$1,060.49 |
$1,178.32 |
2.3× |
| Thyroid uptake measurement (78012) |
$548.27 |
$609.19 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,078.82 |
$1,198.69 |
2.3× |
| Tmj unilateral (70328) |
$252.44 |
$280.49 |
2.5× |
| Tomogram (76100) |
$622.89 |
$692.10 |
5.1× |
| Treatment device complex (77334) |
$2,012 |
$2,235.56 |
4.6× |
| Treatment device intermediate (77333) |
$1,271.41 |
$1,412.68 |
8.1× |
| Treatment devices simple (77332) |
$1,002.20 |
$1,113.55 |
6.4× |
| Ultrasound breast complete (76641) |
$682.85 |
$758.72 |
5.6× |
| Ultrasound elastography first target lesion (76982) |
$189.14 |
$210.16 |
1.6× |
| Ultrasound Exam Aaa Screen (76706) |
$711.02 |
$790.03 |
5.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$629.26 |
$699.18 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$858.44 |
$953.82 |
7.1× |
| Umbilical-artery Doppler (OB) (76820) |
$449.05 |
$498.94 |
3.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$613.76 |
$681.95 |
6.1× |
| Unlisted fluoroscopic procedure (76496) |
$3,052.62 |
$3,391.80 |
30.2× |
| Unlisted magnetic resonance procedure (76498) |
$1,538.48 |
$1,709.42 |
15.2× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$339.50 |
$377.23 |
0.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$323.50 |
$359.45 |
2.7× |
| Unlisted procedure, therapeutic radiology clinical treatment planning 2nd-5th Sessions (77299) |
$347 |
$385.55 |
2.2× |
| Unlisted ultrasound procedure (76999) |
$244.80 |
$272 |
2.4× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$192.40 |
$213.78 |
17.4× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$234.15 |
$260.17 |
2.5× |
| Ureteral reflux study (78740) |
$1,029.63 |
$1,144.03 |
2.2× |
| Urethrocystogram voiding (74455) |
$1,046.45 |
$1,162.72 |
3.8× |
| Urethrocystography retrograde rs&i (74450) |
$1,012.75 |
$1,125.28 |
3.7× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$174.38 |
$193.75 |
0.9× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,027.73 |
$1,141.92 |
5.0× |
| Us breast unilateral limited (76642) |
$698.35 |
$775.94 |
6.9× |
| Us chest (76604) |
$730.04 |
$811.16 |
6.0× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$1,263.63 |
$1,404.03 |
5.0× |
| Us compl joint r-t w/image documentation (76881) |
$532.01 |
$591.12 |
4.4× |
| Us elastography parenchyma (76981) |
$402.36 |
$447.07 |
3.3× |
| Us encephalogram (76506) |
$682.85 |
$758.72 |
5.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$576.76 |
$640.84 |
4.8× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$1,216.70 |
$1,351.89 |
10.0× |
| Us ob detailed single fetus (76811) |
$971.57 |
$1,079.52 |
3.5× |
| Us ob limited (76815) |
$578.96 |
$643.29 |
4.8× |
| Us ob transvaginal (76817) |
$692.64 |
$769.60 |
5.7× |
| Us pelvic non ob complete (76856) |
$864.49 |
$960.55 |
7.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$696.13 |
$773.48 |
5.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$775.58 |
$861.75 |
6.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$518.36 |
$575.95 |
4.3× |
| Us retroperitoneal complete (76770) |
$999.18 |
$1,110.20 |
8.2× |
| Us retroperitoneal limited (76775) |
$707.82 |
$786.46 |
5.8× |
| Us scrotum and contents (76870) |
$896.26 |
$995.84 |
7.4× |
| Us soft tissue head/neck (76536) |
$889.42 |
$988.24 |
7.3× |
| Us spinal canal and contents (76800) |
$425.41 |
$472.68 |
3.5× |
| Us transrectal (76872) |
$394.61 |
$438.46 |
3.3× |
| Us transrectal prostate volume (76873) |
$1,016.76 |
$1,129.74 |
8.4× |
| Us, eye b-scan (76512) |
$403.66 |
$448.52 |
3.3× |
| Us,transplanted kidney, real time/ doppler (76776) |
$749.05 |
$832.28 |
6.2× |
| Venogram adrenal unilat (75840) |
$6,209.91 |
$6,899.90 |
1.7× |
| Venogram extremity bilateral (75822) |
$2,302.39 |
$2,558.21 |
1.3× |
| Venogram Extremity Unilateral (75820) |
$2,269.18 |
$2,521.31 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$5,565.60 |
$6,184 |
1.5× |
| Venography caval superior serialography rs&i (75827) |
$3,296.59 |
$3,662.88 |
1.8× |
| Venography Orbital Rs&I (75880) |
$1,868.56 |
$2,076.18 |
2.6× |
| Venography Renal Bilateral (75833) |
$4,982.69 |
$5,536.32 |
1.4× |
| Venography renal unilateral selective rs&i (75831) |
$4,520.15 |
$5,022.39 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,790.78 |
$5,323.08 |
1.3× |
| Venography, epidural, radiological supervision and interpretation Non-Facility (75872) |
$4,245.70 |
$4,717.44 |
5.8× |
| Venous sampling by catheter (75893) |
$7,390.66 |
$8,211.84 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$262.08 |
$291.20 |
2.6× |
| Whole blood volume determination, including separate measurement of plasma volume and red cell volume… (78122) |
$1,859.56 |
$2,066.18 |
2.9× |
| Wrist 2 views (73100) |
$448.88 |
$498.75 |
4.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$638.24 |
$709.15 |
5.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$360 |
$400 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,548.12 |
$1,720.13 |
7.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$448.88 |
$498.75 |
4.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$399.58 |
$443.97 |
4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$689.73 |
$766.37 |
5.7× |
| X-ray exam of femur 2/> (73552) |
$357.15 |
$396.83 |
3.5× |
| X-ray eye for foreign body (70030) |
$603.82 |
$670.92 |
6.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$387.91 |
$431.01 |
3.8× |
| X-ray IV pyelogram (ivp) (74400) |
$1,645.31 |
$1,828.12 |
8.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$431.71 |
$479.68 |
4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$323.44 |
$359.38 |
3.2× |
| X-ray leg, infant (73592) |
$320.82 |
$356.46 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$480.96 |
$534.40 |
4.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$822.14 |
$913.49 |
6.8× |
| X-ray nose-rectum child f.b. (76010) |
$372.45 |
$413.83 |
3.7× |
| X-ray optic foramen (70190) |
$223.90 |
$248.78 |
2.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$473.70 |
$526.33 |
3.9× |
| X-ray retrograde pyelogram (74420) |
$1,567.80 |
$1,742 |
3.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$409.54 |
$455.04 |
4.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$379.61 |
$421.78 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$482.87 |
$536.52 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$375.04 |
$416.71 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$376.79 |
$418.65 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$375.10 |
$416.77 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$483.39 |
$537.10 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$475.38 |
$528.20 |
3.9× |
| X-Ray Small Bowel Enteroclysis (74251) |
$1,865.52 |
$2,072.80 |
9.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$340.26 |
$378.08 |
3.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$491.15 |
$545.72 |
4.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$406.60 |
$451.78 |
4.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$410.68 |
$456.30 |
3.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$465.50 |
$517.22 |
3.8× |
| Xr bone length studies (77073) |
$379.80 |
$422 |
3.1× |
| Xr c-spine 4 or 5 views (72050) |
$532.68 |
$591.86 |
4.4× |
| Xr c-spine 6 or more views (72052) |
$643.45 |
$714.94 |
5.3× |
| Xr chest 4+ views (71048) |
$784.72 |
$871.91 |
6.5× |
| Xr urogram antegrade (74425) |
$1,023.15 |
$1,136.83 |
2.5× |