| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,255 |
$4,100 |
1.7× |
| Abdomen 1 View (74018) |
$142.45 |
$259 |
1.7× |
| Abdomen 2 views (74019) |
$155.65 |
$283 |
1.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,261.15 |
$2,293 |
3.2× |
| Angio pulmonary bilat (75743) |
$2,423.85 |
$4,407 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$2,263.80 |
$4,116 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$2,263.80 |
$4,116 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,840.30 |
$3,346 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,840.30 |
$3,346 |
0.6× |
| Ankle 2 views (73600) |
$157.30 |
$286 |
1.9× |
| Aortography thoracic serialography rs&i (75605) |
$3,065.70 |
$5,574 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$3,770.80 |
$6,856 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$3,065.70 |
$5,574 |
0.6× |
| Arthrogram ankle (73615) |
$832.70 |
$1,514 |
2.4× |
| Arthrogram hip (73525) |
$550 |
$1,000 |
1.6× |
| Arthrogram Wrist (73115) |
$832.70 |
$1,514 |
2.4× |
| Basic radiation dosimetry calculation (77300) |
$301.40 |
$548 |
2.3× |
| Bone age studies (77072) |
$79.75 |
$145 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$1,072.50 |
$1,950 |
2.8× |
| Bone Imaging Whole Body (78306) |
$1,089 |
$1,980 |
2.8× |
| Bone marrow imaging; multiple areas (78103) |
$501.05 |
$911 |
1.3× |
| Bone survey infant (77076) |
$260.70 |
$474 |
2.6× |
| Brain Image W/Flow < 4 Views (78601) |
$552.75 |
$1,005 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,393.60 |
$4,352 |
1.7× |
| Chest 1 view (71045) |
$105.05 |
$191 |
1.2× |
| Chest 2 views (71046) |
$134.20 |
$244 |
1.6× |
| Chest 3 views (71047) |
$233.75 |
$425 |
2.8× |
| Chest 4 or more views (71048) |
$248.05 |
$451 |
2.4× |
| Clavicle complete (73000) |
$144.10 |
$262 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$283.25 |
$515 |
2.8× |
| Continuing medical physics consltj pr wk (77336) |
$466.40 |
$848 |
3.6× |
| Contrast Exam Abdominl Aorta (75625) |
$2,263.80 |
$4,116 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$308.55 |
$561 |
0.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$532.95 |
$969 |
1.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$249.15 |
$453 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,832.50 |
$5,150 |
8.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,812.80 |
$3,296 |
7.8× |
| CT abdomen w contrast (74160) |
$1,133 |
$2,060 |
6.6× |
| CT abdomen w wo contrast (74170) |
$1,246.30 |
$2,266 |
7.3× |
| CT abdomen w/o contrast (74150) |
$1,019.70 |
$1,854 |
10.0× |
| CT Angio Abdomen and Pelvis (74174) |
$2,039.40 |
$3,708 |
6.0× |
| CT Angio Chest (71275) |
$1,699.50 |
$3,090 |
9.9× |
| CT Angio Head (70496) |
$2,152.70 |
$3,914 |
12.6× |
| CT angio hrt w/3d image (75574) |
$964.70 |
$1,754 |
2.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,246.30 |
$2,266 |
7.3× |
| CT Angio Neck (70498) |
$2,152.70 |
$3,914 |
12.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,246.30 |
$2,266 |
7.3× |
| CT cervical spine w/ contrast (72126) |
$1,416.25 |
$2,575 |
4.2× |
| CT cervical spine w/o contrast (72125) |
$1,133 |
$2,060 |
11.1× |
| CT chest w contrast (71260) |
$906.40 |
$1,648 |
5.3× |
| CT chest w/wo contrast (71270) |
$1,019.70 |
$1,854 |
6.0× |
| CT head/brain with contrast (70460) |
$1,133 |
$2,060 |
6.6× |
| CT head/brain without and with contrast (70470) |
$1,246.30 |
$2,266 |
7.3× |
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines |
$19.25–$54.45 |
$35–$99 |
varies |
| CT iac w contrast (70481) |
$1,812.80 |
$3,296 |
10.6× |
| CT lower ext w/o (73700) |
$1,019.70 |
$1,854 |
10.0× |
| CT lower extremity w/contrast material (73701) |
$1,133 |
$2,060 |
6.6× |
| CT lumbar spine w contrast (72132) |
$1,416.25 |
$2,575 |
4.2× |
| CT lumbar spine w/o contrast (72131) |
$1,133 |
$2,060 |
11.1× |
| CT maxillofacial w contrast (70487) |
$1,133 |
$2,060 |
6.6× |
| CT maxillofacial wo contrast (70486) |
$1,019.70 |
$1,854 |
10.0× |
| CT neck tissue combo (70492) |
$1,246.30 |
$2,266 |
7.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,926.10 |
$3,502 |
11.3× |
| CT orbits w/o contrast (70480) |
$1,699.50 |
$3,090 |
16.7× |
| CT pelvis w&w/o contrast (72194) |
$1,812.80 |
$3,296 |
10.6× |
| CT pelvis w/o contrast (72192) |
$1,586.20 |
$2,884 |
15.6× |
| CT scan of leg combo (73702) |
$2,266 |
$4,120 |
13.3× |
| CT scans face/jaw combo (70488) |
$1,246.30 |
$2,266 |
7.3× |
| CT soft tissue neck w contrast (70491) |
$1,133 |
$2,060 |
6.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,019.70 |
$1,854 |
10.0× |
| CT thoracic spine w contrast (72129) |
$1,416.25 |
$2,575 |
8.3× |
| CT thoracic spine w/o contrast (72128) |
$1,133 |
$2,060 |
11.1× |
| CT thorax w/o contrast (71250) |
$793.10 |
$1,442 |
7.8× |
| CT unlisted procedure (76497) |
$524.15 |
$953 |
6.2× |
| CT upper ext wo (73200) |
$1,019.70 |
$1,854 |
10.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,200 |
$4,000 |
12.9× |
| CT upper extremity with contrast (73201) |
$1,133 |
$2,060 |
3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,379.30 |
$4,326 |
13.9× |
| Cta Abdomen (74175) |
$2,039.40 |
$3,708 |
11.9× |
| CTA pelvis (72191) |
$1,812.80 |
$3,296 |
10.6× |
| Dxa Bone Density Axial (77080) |
$303.60 |
$552 |
3.0× |
| Dxa bone density study (77085) |
$251.90 |
$458 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$179.30 |
$326 |
2.1× |
| Echo exam uterus (76831) |
$572 |
$1,040 |
2.5× |
| Esophagram (74220) |
$358.60 |
$652 |
2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$364.65 |
$663 |
3.6× |
| Fluoroscopy up to 1 hr (76000) |
$155.10 |
$282 |
0.7× |
| Follow-Up Angiography (75898) |
$1,950.85 |
$3,547 |
0.6× |
| Foot 2 views (73620) |
$118.80 |
$216 |
1.4× |
| Forearm 2 views (73090) |
$98.45 |
$179 |
1.2× |
| Gastric emptying imaging study (78264) |
$1,777.60 |
$3,232 |
4.6× |
| Gated Heart Planar Single (78472) |
$807.95 |
$1,469 |
2.1× |
| Hand 2 views (73120) |
$181.50 |
$330 |
1.8× |
| Hepatobil Syst Image W/Drug (78227) |
$1,696.20 |
$3,084 |
3.2× |
| Hepatobiliary System Imaging (78226) |
$2,092.75 |
$3,805 |
5.4× |
| Ht Muscle Image Spect Sing (78451) |
$2,136.75 |
$3,885 |
1.7× |
| Hysterosalpingogram (74740) |
$336.05 |
$611 |
1.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$490.60 |
$892 |
5.8× |
| Infant hip ultrasound, limited static exam (76886) |
$539.55 |
$981 |
6.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,360.15 |
$2,473 |
2.6× |
| K Flow/Funct Image W/O Drug (78707) |
$1,073.60 |
$1,952 |
2.0× |
| Knee 3 Views (73562) |
$226.05 |
$411 |
2.7× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,653.30 |
$3,006 |
3.1× |
| Lung perfusion differential (78597) |
$1,427.25 |
$2,595 |
3.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,282.05 |
$2,331 |
2.4× |
| Lymph System Imaging (78195) |
$1,116.50 |
$2,030 |
2.1× |
| Magnetic Image Jaw Joint (70336) |
$2,327.60 |
$4,232 |
10.0× |
| Mammary ductogram or galactogram single (77053) |
$244.20 |
$444 |
1.0× |
| Meckels Divert Exam (78290) |
$512.05 |
$931 |
1.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,224.30 |
$2,226 |
3.4× |
| Mr safety determination physician/other qhp (76016) |
$135.30 |
$246 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$37.40 |
$68 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$140.80 |
$256 |
1.5× |
| Mr safety implt pos&/immoblj (76019) |
$91.30 |
$166 |
1.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$371.25 |
$675 |
1.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,327.50 |
$6,050 |
9.8× |
| MRA head w/o contrast (70544) |
$2,117.50 |
$3,850 |
9.1× |
| MRA head with contrast (70545) |
$2,722.50 |
$4,950 |
8.0× |
| MRA neck w contrast (70548) |
$2,722.50 |
$4,950 |
8.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,327.50 |
$6,050 |
9.8× |
| MRA neck w/o contrast (70547) |
$2,117.50 |
$3,850 |
9.1× |
| MRI abdomen w/o contrast (74181) |
$1,512.50 |
$2,750 |
6.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,025 |
$5,500 |
4.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,630 |
$6,600 |
10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,025 |
$5,500 |
4.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$4,268.55 |
$7,761 |
18.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,375 |
$2,500 |
5.9× |
| MRI cervical spine w contrast (72142) |
$1,925 |
$3,500 |
5.7× |
| MRI cervical spine w/o cont (72141) |
$1,650 |
$3,000 |
7.1× |
| MRI chest w/o contrast (71550) |
$1,512.50 |
$2,750 |
6.5× |
| MRI chest wo w contrast (71552) |
$2,722.50 |
$4,950 |
8.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,025 |
$5,500 |
8.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,630 |
$6,600 |
10.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,420 |
$4,400 |
10.4× |
| MRI lumbar spine w contrast (72149) |
$1,925 |
$3,500 |
5.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,200 |
$4,000 |
6.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,512.50 |
$2,750 |
6.5× |
| MRI orbit face neck w contrast (70542) |
$2,117.50 |
$3,850 |
6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,722.50 |
$4,950 |
8.0× |
| MRI pelvis w contrast (72196) |
$2,117.50 |
$3,850 |
6.2× |
| MRI pelvis w/o & w contrast (72197) |
$2,722.50 |
$4,950 |
8.0× |
| MRI pelvis w/o contrast (72195) |
$1,512.50 |
$2,750 |
6.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,650 |
$3,000 |
7.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,025 |
$5,500 |
8.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,420 |
$4,400 |
10.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,630 |
$6,600 |
10.7× |
| MRI, abdomen, combo (74183) |
$2,722.50 |
$4,950 |
8.0× |
| MRI, dorsal spine combo (72157) |
$2,200 |
$4,000 |
6.5× |
| MRI, dorsal spine contrast (72147) |
$1,925 |
$3,500 |
5.7× |
| MRI, joint upper extrem (73221) |
$2,420 |
$4,400 |
10.4× |
| MRI, joint upper extrem combo (73223) |
$3,630 |
$6,600 |
10.7× |
| MRI, lumbar spine combo (72158) |
$2,200 |
$4,000 |
6.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,933.15 |
$5,333 |
2.3× |
| Neck soft tissue (70360) |
$146.30 |
$266 |
1.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,715.05 |
$10,391 |
4.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$148.50 |
$270 |
1.5× |
| Panoramic X-ray of jaws (70355) |
$188.65 |
$343 |
2.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,419 |
$2,580 |
2.7× |
| Parathyroid Planar Imaging (78070) |
$864.05 |
$1,571 |
2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$501.05 |
$911 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$188.10 |
$342 |
1.8× |
| Peritoneogram Rs&I (74190) |
$441.10 |
$802 |
0.8× |
| Pet Image W/Ct Lmtd (78814) |
$2,200 |
$4,000 |
1.6× |
| PET image w/CT, full body (78816) |
$5,500 |
$10,000 |
3.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,400 |
$8,000 |
3.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$989.45 |
$1,799 |
2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$209.55 |
$381 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$405.90 |
$738 |
0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$199.65 |
$363 |
2.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$141.35 |
$257 |
1.7× |
| Radex elbow complete minimum 3 views (73080) |
$206.80 |
$376 |
2.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$168.30 |
$306 |
1.7× |
| Radex fingr minimum 2 views (73140) |
$124.30 |
$226 |
1.5× |
| Radex foot complete minimum 3 views (73630) |
$190.30 |
$346 |
2.2× |
| Radex Hand Minimum 3 Views (73130) |
$210.65 |
$383 |
2.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$112.20 |
$204 |
1.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$144.65 |
$263 |
1.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$151.25 |
$275 |
1.8× |
| Radex shoulder complete minimum 2 views (73030) |
$122.10 |
$222 |
1.4× |
| Radex Spine 1 View Specify Level (72020) |
$169.40 |
$308 |
2.0× |
| Radex Sternum Minimum 2 Views (71120) |
$135.85 |
$247 |
1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$124.85 |
$227 |
1.5× |
| Radex Toe Minimum 2 Views (73660) |
$159.50 |
$290 |
1.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$110 |
$200 |
1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$196.90 |
$358 |
2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$151.80 |
$276 |
1.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,268.80 |
$13,216 |
1.0× |
| Radiation treatment delivery level 3 (77412) |
$796.40 |
$1,448 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$321.75 |
$585 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$165 |
$300 |
1.6× |
| Radiologic exam colon double contrast study (74280) |
$944.90 |
$1,718 |
5.5× |
| Radiologic exam colon single contrast study (74270) |
$425.70 |
$774 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$331.10 |
$602 |
1.9× |
| Radiologic exam knee complete 4/more views (73564) |
$259.60 |
$472 |
2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$199.65 |
$363 |
2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$338.25 |
$615 |
2.0× |
| Radiologic exam swallow function contrast study (74230) |
$389.40 |
$708 |
2.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$535.15 |
$973 |
3.1× |
| Radiologic examination femur 1 view (73551) |
$104.50 |
$190 |
1.2× |
| Radiologic examination femur minimum 2 views (73552) |
$121 |
$220 |
1.4× |
| Radiologic examination knee 1/2 views (73560) |
$149.60 |
$272 |
1.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$205.70 |
$374 |
2.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$172.15 |
$313 |
2.0× |
| Ribs bilateral 3 views (71110) |
$151.25 |
$275 |
1.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$501.05 |
$911 |
1.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,788.05 |
$3,251 |
3.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,513.60 |
$2,752 |
2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,218.70 |
$4,034 |
1.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,711.05 |
$3,111 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$520.85 |
$947 |
2.3× |
| Scapula (73010) |
$157.30 |
$286 |
1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$93.50 |
$170 |
4.0× |
| Shoulder 1 view (73020) |
$108.90 |
$198 |
1.3× |
| Shoulder Arthrography (73040) |
$547.25 |
$995 |
1.6× |
| Skull less than 4 views (70250) |
$166.65 |
$303 |
1.6× |
| Special dosimetry (77331) |
$194.15 |
$353 |
1.5× |
| Special Physics Consult (77370) |
$580.25 |
$1,055 |
4.4× |
| Special treatment procedure (77470) |
$930.60 |
$1,692 |
1.7× |
| Stereotactic Body Radiation Delivery (77373) |
$3,975.95 |
$7,229 |
2.3× |
| Sternoclavicular joints (71130) |
$141.90 |
$258 |
1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,164.90 |
$2,118 |
3.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,617 |
$2,940 |
4.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$584.10 |
$1,062 |
4.5× |
| Thoracic spine 2 views (72070) |
$110.55 |
$201 |
1.1× |
| Thoracic spine 3 views (72072) |
$166.10 |
$302 |
1.6× |
| Thoracolumbar 2 views (72080) |
$164.45 |
$299 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$807.95 |
$1,469 |
2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$909.15 |
$1,653 |
2.3× |
| Tx Devices Design & Construction Complex (77334) |
$944.35 |
$1,717 |
2.6× |
| Tx devices design & construction intermediate (77333) |
$583 |
$1,060 |
4.4× |
| Tx devices design & construction simple (77332) |
$362.45 |
$659 |
2.8× |
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines |
$122.65–$332.75 |
$223–$605 |
varies |
| Ultrasound Elastography Parenchyma (76981) |
$158.95 |
$289 |
1.6× |
| Ultrasound Exam Aaa Screen (76706) |
$386.65 |
$703 |
3.8× |
| Ultrasound, abdomen limited (76705) |
$351.45 |
$639 |
3.4× |
| Upper gi w/o kub (74240) |
$311.85 |
$567 |
1.8× |
| Urethrocystogram voiding (74455) |
$398.20 |
$724 |
1.7× |
| Urethrocystography retrograde (74450) |
$310.75 |
$565 |
1.3× |
| Us breast unilateral complete (76641) |
$471.35 |
$857 |
4.6× |
| Us chest (76604) |
$307.45 |
$559 |
3.0× |
| Us complete joint (76881) |
$309.10 |
$562 |
3.0× |
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines |
$148.50–$207.35 |
$270–$377 |
varies |
| Us head (76506) |
$617.65 |
$1,123 |
6.1× |
| Us kidney transplant (76776) |
$193.60 |
$352 |
1.9× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines |
$148.50–$251.90 |
$270–$458 |
varies |
| Us ob limited 1 or more fetuses (76815) |
$462 |
$840 |
4.5× |
| Us ob transvaginal (76817) |
$429 |
$780 |
4.2× |
| Us pelvic non ob complete (76856) |
$448.80 |
$816 |
4.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$532.95 |
$969 |
5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$520.85 |
$947 |
5.1× |
| Us retroperitoneal complete (76770) |
$472.45 |
$859 |
4.6× |
Us retroperitoneal limited (76775)
range across 2 matching MRF lines |
$148.50–$319.55 |
$270–$581 |
varies |
| Us scrotum and contents (76870) |
$393.80 |
$716 |
3.9× |
| Us spinal canal and contents (76800) |
$141.35 |
$257 |
1.4× |
| Us thyroid (76536) |
$358.60 |
$652 |
3.5× |
| Us transrectal (76872) |
$301.40 |
$548 |
3.0× |
| Vein X-Ray Chest (75827) |
$1,729.20 |
$3,144 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$1,950.85 |
$3,547 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$1,960.20 |
$3,564 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,178.65 |
$2,143 |
0.8× |
| Venous sampling by catheter (75893) |
$3,249.40 |
$5,908 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$168.85 |
$307 |
2.0× |
| Wrist 2 views (73100) |
$168.85 |
$307 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$149.05 |
$271 |
1.8× |
| X-ray antegrade pyelogram tube (74425) |
$345.40 |
$628 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$176.55 |
$321 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$94.05 |
$171 |
1.1× |
| X-Ray Exam Breast Specimen (76098) |
$405.90 |
$738 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$151.25 |
$275 |
1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$255.75 |
$465 |
2.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$151.80 |
$276 |
1.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$211.20 |
$384 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$220 |
$400 |
2.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$223.85 |
$407 |
2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$230.45 |
$419 |
2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$244.20 |
$444 |
2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$186.45 |
$339 |
1.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$302.50 |
$550 |
3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$107.80 |
$196 |
1.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$343.20 |
$624 |
3.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$246.95 |
$449 |
2.4× |
| X-ray eye for foreign body (70030) |
$109.45 |
$199 |
1.3× |
| X-ray humerus (73060) |
$145.75 |
$265 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$303.60 |
$552 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$162.25 |
$295 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$130.35 |
$237 |
1.3× |
| X-ray nose-rectum child f.b. (76010) |
$101.20 |
$184 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$358.60 |
$652 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$148.50 |
$270 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$96.25 |
$175 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$182.60 |
$332 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$168.30 |
$306 |
1.7× |
| X-Ray Stress View (77071) |
$102.30 |
$186 |
1.2× |
| X-ray thoracic spine 4 vw (72074) |
$176 |
$320 |
1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$685.30 |
$1,246 |
2.0× |
| X-Rays Bone Length Studies (77073) |
$143 |
$260 |
1.4× |
| X-Rays Bone Survey Complete (77075) |
$363.55 |
$661 |
3.6× |
| Xr c-spine 4 or 5 views (72050) |
$323.95 |
$589 |
3.2× |
| Xr facial bones less than 3 views (70140) |
$151.80 |
$276 |
1.8× |
| Xr orbits complete 4 views (70200) |
$295.35 |
$537 |
2.9× |