| Abdomen 2 views (74019) |
$972 |
$972 |
8.7× |
| Acute gi blood loss imaging (78278) |
$1,753 |
$1,753 |
4.1× |
| Angiography extremity bilateral rs&i (75716) |
$13,174 |
$13,174 |
3.9× |
| Angiography extremity unilateral rs&i (75710) |
$18,256 |
$18,256 |
5.4× |
| Angiography internal mammary rs&i (75756) |
$13,174 |
$13,174 |
3.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$22,537 |
$22,537 |
3.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,521 |
$8,521 |
2.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$18,256 |
$18,256 |
5.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$22,537 |
$22,537 |
3.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$5,193 |
$5,193 |
1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$6,391 |
$6,391 |
1.9× |
| Ankle 2 views (73600) |
$1,012 |
$1,012 |
10.9× |
| Aortogram thoracic (75605) |
$22,537 |
$22,537 |
3.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$13,174 |
$13,174 |
3.9× |
| Aortography abdominal serialography rs&i (75625) |
$13,174 |
$13,174 |
3.9× |
| Arthrogram ankle (73615) |
$2,237 |
$2,237 |
6.0× |
| Arthrogram elbow (73085) |
$1,524 |
$1,524 |
4.1× |
| Arthrogram hip (73525) |
$1,524 |
$1,524 |
4.1× |
| Arthrogram knee (73580) |
$2,237 |
$2,237 |
6.0× |
| Arthrogram shoulder (73040) |
$1,718 |
$1,718 |
4.6× |
| Arthrogram wrist (73115) |
$1,693 |
$1,693 |
4.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,383 |
$2,383 |
5.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$956 |
$956 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$2,665 |
$2,665 |
6.2× |
| Bone age studies (77072) |
$463 |
$463 |
4.1× |
| Bone Imaging 3 Phase (78315) |
$3,213 |
$3,213 |
7.5× |
| Bone survey complete (77075) |
$2,162 |
$2,162 |
19.4× |
| Bone survey infant (77076) |
$1,044 |
$1,044 |
9.4× |
| Bowel imaging (78290) |
$2,565 |
$2,565 |
6.0× |
| Brain imaging < 4 static views (78600) |
$1,384 |
$1,384 |
3.2× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$1,384 |
$1,384 |
3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,708 |
$1,708 |
2.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$12,557 |
$12,557 |
8.2× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$1,794 |
$1,794 |
3.1× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,496 |
$2,496 |
5.8× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$4,087 |
$4,087 |
4.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,088 |
$3,088 |
8.3× |
| Cervical spine 2 or 3 views (72040) |
$1,301 |
$1,301 |
14.0× |
| Chest 1 view (71045) |
$512 |
$512 |
5.5× |
| Chest xray 3 views (71047) |
$442 |
$442 |
4.8× |
| Cholecystography, oral contrast Non-Facility (74290) |
$880 |
$880 |
4.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,060 |
$1,060 |
5.7× |
| Clavicle complete (73000) |
$691 |
$691 |
7.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$601 |
$601 |
5.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$8,745 |
$8,745 |
23.5× |
| CT abdomen and pelvis without contrast (74176) |
$6,662 |
$6,662 |
26.1× |
| CT abdomen w contrast (74160) |
$6,045 |
$6,045 |
32.3× |
| CT abdomen w wo contrast (74170) |
$7,164 |
$7,164 |
38.3× |
| CT abdomen w/o contrast (74150) |
$4,716 |
$4,716 |
42.2× |
| CT angio hrt w/3d image (75574) |
$1,847 |
$1,847 |
5.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$6,006 |
$6,006 |
32.1× |
| CT angiography upper extremity lt (73206) |
$6,006 |
$6,006 |
32.1× |
| CT c-spine w/contrast (72126) |
$6,283 |
$6,283 |
16.9× |
| CT c-spine w/o contrast (72125) |
$6,072 |
$6,072 |
54.4× |
| CT cervical spine w&w/o contrast (72127) |
$6,670 |
$6,670 |
35.6× |
| CT chest w contrast (71260) |
$6,047 |
$6,047 |
32.3× |
| CT chest w/wo contrast (71270) |
$6,030 |
$6,030 |
32.2× |
| CT colonography w/dye (74262) |
$1,657 |
$1,657 |
8.8× |
| CT colonography w/o cntrst (74261) |
$1,330 |
$1,330 |
11.9× |
| CT head/brain with contrast (70460) |
$5,550 |
$5,550 |
29.6× |
| CT head/brain without and with contrast (70470) |
$7,744 |
$7,744 |
41.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,537 |
$1,537 |
4.1× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$279 |
$279 |
3.0× |
| CT hrt w/3d image congen (75573) |
$1,537 |
$1,537 |
4.1× |
| CT iac w contrast (70481) |
$7,269 |
$7,269 |
38.8× |
| CT lower ext w/o (73700) |
$5,207 |
$5,207 |
46.6× |
| CT lower extremity w wo contrast (73702) |
$6,805 |
$6,805 |
36.3× |
| CT lower extremity w/contrast material (73701) |
$5,633 |
$5,633 |
30.1× |
| CT lumbar spine w & w/o contrast (72133) |
$6,670 |
$6,670 |
35.6× |
| CT lumbar spine w/contrast (72132) |
$6,283 |
$6,283 |
16.9× |
| CT lumbar spine w/o contrast (72131) |
$5,488 |
$5,488 |
49.2× |
| CT maxillofacial w contrast (70487) |
$5,976 |
$5,976 |
31.9× |
| CT maxillofacial w/wo contrast (70488) |
$6,591 |
$6,591 |
35.2× |
| CT maxillofacial wo contrast (70486) |
$5,059 |
$5,059 |
45.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$7,638 |
$7,638 |
40.8× |
| CT orbits w/o contrast (70480) |
$6,896 |
$6,896 |
61.8× |
| CT pelvis w/o contrast (72192) |
$5,517 |
$5,517 |
49.4× |
| CT pelvis w/wo contrast (72194) |
$6,846 |
$6,846 |
36.6× |
| CT scan of arm combo (73202) |
$6,805 |
$6,805 |
36.3× |
| CT soft tissue neck w contrast (70491) |
$6,811 |
$6,811 |
36.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$7,380 |
$7,380 |
39.4× |
| CT soft tissue neck w/o contrast (70490) |
$4,839 |
$4,839 |
43.3× |
| CT thoracic spine w/contrast (72129) |
$6,329 |
$6,329 |
33.8× |
| CT thoracic spine w/o contrast (72128) |
$5,808 |
$5,808 |
52.0× |
| CT thoracic spine w/wo contrast (72130) |
$7,596 |
$7,596 |
40.6× |
| CT thorax w/o contrast (71250) |
$4,606 |
$4,606 |
41.3× |
| CT upper ext wo (73200) |
$4,807 |
$4,807 |
43.1× |
| CT upper extremity with contrast (73201) |
$5,606 |
$5,606 |
15.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$5,235 |
$5,235 |
28.0× |
| Cta Abdomen (74175) |
$6,006 |
$6,006 |
32.1× |
| CTA abdomen pelvis (74174) |
$3,941 |
$3,941 |
10.6× |
| CTA chest (71275) |
$7,607 |
$7,607 |
40.6× |
| Cta Head (70496) |
$7,013.50 |
$7,013.50 |
37.4× |
| Cta Neck (70498) |
$7,013.50 |
$7,013.50 |
37.4× |
| Cta Pelvis (72191) |
$6,006 |
$6,006 |
32.1× |
| Cystography minimum 3 views rs&i (74430) |
$1,332 |
$1,332 |
3.6× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$12,158 |
$12,158 |
5.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$2,056 |
$2,056 |
18.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$1,748 |
$1,748 |
18.8× |
| Esophagus (74220) |
$1,137 |
$1,137 |
6.1× |
| Facial bones min 3 views (70150) |
$1,101 |
$1,101 |
9.9× |
| Fetal biophysical profile non-stress testing (76818) |
$831 |
$831 |
7.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,775 |
$1,775 |
15.9× |
| Fluoroscopy up to 1 hr (76000) |
$999.50 |
$999.50 |
3.9× |
| Foot 2 views (73620) |
$1,012 |
$1,012 |
10.9× |
| Forearm 2 views (73090) |
$691 |
$691 |
7.4× |
| Gastric mucosa imaging (78261) |
$3,005 |
$3,005 |
7.0× |
| Hand 2 views (73120) |
$1,012 |
$1,012 |
9.1× |
| Heart Infarct Image (78466) |
$1,352 |
$1,352 |
3.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,929 |
$2,929 |
5.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,929 |
$2,929 |
6.9× |
| Hysterosalpingogram (74740) |
$1,064 |
$1,064 |
4.2× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$266 |
$266 |
0.6× |
| Kidney imaging morphology (78700) |
$833 |
$833 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,233 |
$2,233 |
3.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,574 |
$1,574 |
2.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,574 |
$1,574 |
2.7× |
| Knee 3 views (73562) |
$895 |
$895 |
9.6× |
| Liver & spleen imaging static only (78215) |
$1,295 |
$1,295 |
3.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,759 |
$1,759 |
4.1× |
| Liver imaging static only (78201) |
$4,764 |
$4,764 |
8.2× |
| Liver imaging w/vascular flow (78202) |
$4,764 |
$4,764 |
8.2× |
| Lung perf&ventilat diferentl (78598) |
$2,526 |
$2,526 |
4.4× |
| Lung perfusion differential (78597) |
$1,016 |
$1,016 |
2.4× |
| Lung ventilation imaging (78579) |
$917 |
$917 |
2.1× |
| Lymphoscintigraphy (78195) |
$3,202 |
$3,202 |
5.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$6,329 |
$6,329 |
7.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$6,331 |
$6,331 |
17.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$8,219 |
$8,219 |
22.1× |
| Mammary ductogram or galactogram multiple (77054) |
$3,555 |
$3,555 |
14.0× |
| Mammary ductogram or galactogram single (77053) |
$3,091 |
$3,091 |
12.1× |
| Mr safety determination physician/other qhp (76016) |
$407 |
$407 |
4.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$113 |
$113 |
3.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$425 |
$425 |
4.2× |
| Mr safety implt pos&/immoblj (76019) |
$275 |
$275 |
4.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$1,117 |
$1,117 |
4.4× |
| MRA head w & w/o contrast (70546) |
$9,603 |
$9,603 |
25.8× |
| MRA head w/o contrast (70544) |
$6,398 |
$6,398 |
25.1× |
| MRA head with contrast (70545) |
$7,712 |
$7,712 |
20.7× |
| MRA neck w contrast (70548) |
$7,712 |
$7,712 |
20.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$9,603 |
$9,603 |
25.8× |
| MRA neck w/o contrast (70547) |
$6,398 |
$6,398 |
25.1× |
| MRI abdomen w contrast (74182) |
$7,712 |
$7,712 |
20.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$9,603 |
$9,603 |
25.8× |
| MRI abdomen w/o contrast (74181) |
$6,398 |
$6,398 |
25.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$6,329 |
$6,329 |
7.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$8,219 |
$8,219 |
22.1× |
| MRI breast w/o contrast bilateral (77047) |
$3,182 |
$3,182 |
12.5× |
| MRI breast wo contrast unilateral (77046) |
$2,792 |
$2,792 |
11.0× |
| MRI c-spine with contrast (72142) |
$9,253 |
$9,253 |
24.8× |
| MRI cardiac w/o cont stress (75559) |
$3,959 |
$3,959 |
6.8× |
| MRI cardiac w/o contrast (75557) |
$3,704 |
$3,704 |
14.5× |
| MRI cervical spine w/o contrast (72141) |
$6,018 |
$6,018 |
23.6× |
| MRI chest w/o & w/contrast material (71552) |
$9,603 |
$9,603 |
25.8× |
| MRI chest w/o contrast (71550) |
$6,398 |
$6,398 |
25.1× |
| MRI chest with contrast (71551) |
$7,712 |
$7,712 |
9.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$9,603 |
$9,603 |
25.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$8,878 |
$8,878 |
23.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,398 |
$6,398 |
25.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$6,398 |
$6,398 |
25.1× |
| MRI orbit face neck w contrast (70542) |
$7,712 |
$7,712 |
20.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$9,603 |
$9,603 |
25.8× |
| MRI pelvis w/contrast (72196) |
$7,712 |
$7,712 |
20.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$9,603 |
$9,603 |
25.8× |
| MRI pelvis w/o contrast (72195) |
$7,525 |
$7,525 |
29.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$9,603 |
$9,603 |
25.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$7,905 |
$7,905 |
21.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$9,603 |
$9,603 |
25.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$7,712 |
$7,712 |
20.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$9,603 |
$9,603 |
25.8× |
| MRI temporomandibular joint (70336) |
$7,400 |
$7,400 |
29.0× |
| MRI thoracic spine w/o contrast (72146) |
$6,018 |
$6,018 |
23.6× |
| MRI up ext w/o contrast (73218) |
$6,329 |
$6,329 |
24.8× |
| MRI upper ext joint w/o contrast (73221) |
$6,398 |
$6,398 |
25.1× |
| MRI, joint upper extrem combo (73223) |
$8,175 |
$8,175 |
21.9× |
| Myelogram Cervical (72240) |
$2,200 |
$2,200 |
2.6× |
| Myelogram Lumbar (72265) |
$2,067 |
$2,067 |
2.5× |
| Myelogram thoracic (72255) |
$4,014 |
$4,014 |
4.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,983 |
$3,983 |
2.9× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$7,215 |
$7,215 |
5.2× |
| Myocardial Spect Multiple Studies (78452) |
$6,477 |
$6,477 |
4.7× |
| Myocardial spect single study at rest or stress (78451) |
$5,399 |
$5,399 |
3.9× |
| Neck soft tissue (70360) |
$627 |
$627 |
6.7× |
| Nm adrenal scan (78075) |
$4,764 |
$4,764 |
3.4× |
| Nm cisternogram (78630) |
$1,794 |
$1,794 |
3.1× |
| Nm gastric emptying study (78264) |
$1,971 |
$1,971 |
4.6× |
| Noncardiac Vascular Flow Imaging (78445) |
$1,384 |
$1,384 |
3.2× |
| Nuclear Rx Oral Admin (79005) |
$1,285 |
$1,285 |
5.2× |
| Osseous survey limited (77074) |
$739 |
$739 |
6.6× |
| Parathyroid Planar Imaging (78070) |
$2,669 |
$2,669 |
6.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,306 |
$1,306 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$877 |
$877 |
7.9× |
| PET image w/CT, skull-thigh (78815) |
$23,367 |
$23,367 |
15.3× |
| PET imaging CT for attenuation limited area (78814) |
$23,367 |
$23,367 |
15.3× |
| PET imaging for CT attenuation whole body (78816) |
$23,367 |
$23,367 |
15.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,121 |
$2,121 |
5.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,526 |
$2,526 |
4.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,682 |
$1,682 |
2.9× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$847 |
$847 |
9.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$680 |
$680 |
7.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$948 |
$948 |
10.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$421 |
$421 |
4.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$704 |
$704 |
6.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$1,123 |
$1,123 |
10.1× |
| Radex fingr minimum 2 views (73140) |
$647 |
$647 |
7.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$868 |
$868 |
9.3× |
| Radex Hand Minimum 3 Views (73130) |
$946 |
$946 |
10.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$603 |
$603 |
6.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$592 |
$592 |
5.3× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$592 |
$592 |
5.3× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,123 |
$1,123 |
10.1× |
| Radex Humerus Minimum 2 Views (73060) |
$618 |
$618 |
6.7× |
| Radex Kne 1/2 Views (73560) |
$548 |
$548 |
5.9× |
| Radex Kne Compl 4/More Views (73564) |
$1,027 |
$1,027 |
9.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$1,365 |
$1,365 |
12.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$811 |
$811 |
8.7× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$922 |
$922 |
8.3× |
| Radex Sho Compl Minimum 2 Views (73030) |
$1,176 |
$1,176 |
12.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$551 |
$551 |
5.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$987 |
$987 |
10.6× |
| Radex Toe Minimum 2 Views (73660) |
$568 |
$568 |
6.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$618 |
$618 |
5.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$523 |
$523 |
5.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,263 |
$1,263 |
11.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$718 |
$718 |
7.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$526 |
$526 |
4.7× |
| Radiologic exam chest 2 views (71046) |
$915 |
$915 |
9.8× |
| Radiologic exam colon single contrast study (74270) |
$1,761 |
$1,761 |
9.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$2,242 |
$2,242 |
12.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,491 |
$1,491 |
8.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,915 |
$1,915 |
10.2× |
| Radiologic examination femur 1 view (73551) |
$351 |
$351 |
3.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$647 |
$647 |
7.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$706 |
$706 |
7.6× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$625 |
$625 |
5.6× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$603 |
$603 |
6.5× |
| Radiological examination surgical specimen (76098) |
$1,918.50 |
$1,918.50 |
3.3× |
| Ribs bilateral 3 views (71110) |
$957 |
$957 |
8.6× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$884 |
$884 |
2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,202 |
$1,202 |
2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,595 |
$3,595 |
6.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,532 |
$2,532 |
4.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,822 |
$1,822 |
3.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$728 |
$728 |
2.9× |
| Salivary gland imaging (78230) |
$1,436 |
$1,436 |
3.4× |
| Scapula (73010) |
$706 |
$706 |
6.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$56 |
$56 |
2.4× |
| Sella turcica (70240) |
$403 |
$403 |
4.3× |
| Shoulder 1 view (73020) |
$480 |
$480 |
5.2× |
| Sialogram (70390) |
$970 |
$970 |
3.8× |
| Small bowel series (74250) |
$1,151 |
$1,151 |
6.1× |
| Spine thoracic 3 views (72072) |
$1,162 |
$1,162 |
10.4× |
| Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) |
$778 |
$778 |
1.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,684 |
$1,684 |
2.9× |
| Thyroid imaging w/blood flow (78013) |
$2,527 |
$2,527 |
5.9× |
| Thyroid uptake measurement (78012) |
$1,384 |
$1,384 |
3.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,166 |
$1,166 |
2.7× |
| Tmj unilateral (70328) |
$279 |
$279 |
3.0× |
| Tomogram (76100) |
$1,367 |
$1,367 |
12.2× |
| Ultrasound breast complete (76641) |
$1,139 |
$1,139 |
10.2× |
| Ultrasound Exam Aaa Screen (76706) |
$608 |
$608 |
5.4× |
| Ultrasound, abdomen limited (76705) |
$1,788 |
$1,788 |
16.0× |
| Umbilical-artery Doppler (OB) (76820) |
$772 |
$772 |
6.9× |
| Ureteral reflux study (78740) |
$1,588 |
$1,588 |
3.7× |
| Urethrocystogram voiding (74455) |
$1,932 |
$1,932 |
7.6× |
| Urethrocystography retrograde rs&i (74450) |
$1,885 |
$1,885 |
7.4× |
| Us breast unilateral limited (76642) |
$547 |
$547 |
5.9× |
| Us chest (76604) |
$2,266 |
$2,266 |
20.3× |
| Us compl joint r-t w/image documentation (76881) |
$1,332 |
$1,332 |
11.9× |
| Us encephalogram (76506) |
$1,462 |
$1,462 |
13.1× |
| Us hips infant static (76886) |
$1,593 |
$1,593 |
17.1× |
| Us infant hips w manipulation (76885) |
$1,844 |
$1,844 |
19.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$605 |
$605 |
5.4× |
| Us ob detailed single fetus (76811) |
$1,775 |
$1,775 |
7.0× |
| Us ob limited (76815) |
$1,018 |
$1,018 |
9.1× |
| Us ob transvaginal (76817) |
$1,009 |
$1,009 |
9.0× |
| Us pelvic non ob complete (76856) |
$1,823 |
$1,823 |
16.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,519 |
$1,519 |
13.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,722 |
$1,722 |
15.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$1,555 |
$1,555 |
13.9× |
| Us retroperitoneal complete (76770) |
$876 |
$876 |
7.8× |
| Us retroperitoneal limited (76775) |
$1,200 |
$1,200 |
10.7× |
| Us scrotum and contents (76870) |
$1,751 |
$1,751 |
15.7× |
| Us soft tissue head/neck (76536) |
$2,215 |
$2,215 |
19.8× |
| Us spinal canal and contents (76800) |
$794 |
$794 |
7.1× |
| Us transrectal (76872) |
$1,847 |
$1,847 |
16.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$736 |
$736 |
6.6× |
| Venogram extremity bilateral (75822) |
$4,282 |
$4,282 |
2.5× |
| Venogram Extremity Unilateral (75820) |
$9,549 |
$9,549 |
5.7× |
| Venography caval inferior serialography rs&i (75825) |
$14,665 |
$14,665 |
4.3× |
| Venography caval superior serialography rs&i (75827) |
$3,944 |
$3,944 |
2.3× |
| Venography Renal Bilateral (75833) |
$14,665 |
$14,665 |
4.3× |
| Venography renal unilateral selective rs&i (75831) |
$14,665 |
$14,665 |
4.3× |
| Vertebral fracture assessment via dxa (77086) |
$549 |
$549 |
5.9× |
| Wrist 2 views (73100) |
$1,012 |
$1,012 |
10.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,090 |
$1,090 |
9.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$737 |
$737 |
7.9× |
| X-ray b.e. reductn intuss (74283) |
$1,213 |
$1,213 |
6.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,696 |
$2,696 |
14.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,005 |
$1,005 |
10.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$351 |
$351 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$592 |
$592 |
5.3× |
| X-ray exam of femur 2/> (73552) |
$421 |
$421 |
4.5× |
| X-ray eye for foreign body (70030) |
$647 |
$647 |
7.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$293 |
$293 |
3.2× |
| X-ray IV pyelogram (ivp) (74400) |
$1,647 |
$1,647 |
8.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$734 |
$734 |
7.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$669 |
$669 |
7.2× |
| X-ray leg, infant (73592) |
$1,009 |
$1,009 |
10.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$959 |
$959 |
8.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,162 |
$1,162 |
10.4× |
| X-ray nose-rectum child f.b. (76010) |
$326 |
$326 |
3.5× |
| X-ray optic foramen (70190) |
$501 |
$501 |
5.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,020 |
$1,020 |
9.1× |
| X-ray retrograde pyelogram (74420) |
$2,685 |
$2,685 |
7.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$622 |
$622 |
6.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,247 |
$1,247 |
11.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,254 |
$1,254 |
11.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,000 |
$1,000 |
9.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$762 |
$762 |
8.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,167 |
$1,167 |
12.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,112 |
$1,112 |
10.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$748 |
$748 |
6.7× |
| X-Ray Small Bowel Enteroclysis (74251) |
$1,276 |
$1,276 |
6.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$795 |
$795 |
8.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$704 |
$704 |
7.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$917 |
$917 |
9.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,176 |
$1,176 |
10.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$987 |
$987 |
8.8× |
| Xr bone length studies (77073) |
$551 |
$551 |
4.9× |
| Xr c-spine 4 or 5 views (72050) |
$1,104 |
$1,104 |
9.9× |
| Xr c-spine 6 or more views (72052) |
$1,176 |
$1,176 |
10.5× |
| Xr chest 4+ views (71048) |
$1,062 |
$1,062 |
9.5× |
| Xr urogram antegrade (74425) |
$928 |
$928 |
2.5× |