| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,723.50 |
$6,630 |
2.6× |
| Abdomen 2 views (74019) |
$201 |
$404 |
1.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$592.50 |
$1,072.50 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$5,171.50 |
$8,789.50 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$5,160 |
$8,750.50 |
1.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$12,114 |
$20,381 |
2.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,985 |
$6,784.50 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,799 |
$6,719.50 |
2.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$13,460 |
$11,566 |
2.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,000.50 |
$6,836.50 |
1.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$7,799 |
$6,692.50 |
2.4× |
| Ankle 2 views (73600) |
$185.50 |
$369 |
2.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$468 |
$825 |
1.3× |
| Aortogram thoracic (75605) |
$12,114 |
$20,387 |
2.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,173 |
$8,794.50 |
1.6× |
| Aortography abdominal serialography rs&i (75625) |
$10,139 |
$8,698.50 |
3.1× |
| Arthrogram elbow (73085) |
$882 |
$1,470 |
2.4× |
| Arthrogram hip (73525) |
$882 |
$1,625 |
2.4× |
| Arthrogram shoulder (73040) |
$882 |
$1,620 |
2.4× |
| Arthrogram wrist (73115) |
$882 |
$1,622 |
2.4× |
| Arthrography knee lt (73580) |
$882 |
$1,640 |
2.4× |
| Basic radiation dosimetry calculation (77300) |
$375.50 |
$687 |
2.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$573.50 |
$1,009.50 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,082 |
$1,803 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$639.50 |
$1,139.50 |
1.5× |
| Bone age studies (77072) |
$169.50 |
$300 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$807 |
$1,432.50 |
1.9× |
| Bone survey complete (77075) |
$306 |
$559 |
2.8× |
| Brachytx isodose complex (77318) |
$1,103 |
$2,125.50 |
2.8× |
| Brachytx isodose intermed (77317) |
$1,862 |
$3,103 |
4.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,862 |
$3,103 |
4.8× |
| Brain image w/flow 4 + views (78606) |
$1,337 |
$2,228 |
2.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,696 |
$2,826 |
3.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,158 |
$5,391 |
2.1× |
| Brain Imaging Vascular Flow Only (78610) |
$1,337 |
$2,279 |
2.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,337 |
$2,228 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$176.50 |
$368 |
2.0× |
| Chest 1 view (71045) |
$161 |
$317 |
1.8× |
| Chest 3 views (71047) |
$179 |
$377 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$241 |
$448 |
1.3× |
| Clavicle complete (73000) |
$187 |
$372.50 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$662.50 |
$1,199 |
6.1× |
| Continuing medical physics consltj pr wk (77336) |
$677 |
$1,128 |
4.9× |
| Corpora cavernosography (74445) |
$128 |
$213 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,781 |
$3,144.50 |
4.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,466.50 |
$2,596.50 |
5.9× |
| CT abdomen w contrast (74160) |
$876 |
$1,571 |
4.8× |
| CT abdomen w wo contrast (74170) |
$1,145 |
$2,030.50 |
6.3× |
| CT abdomen w/o contrast (74150) |
$751.50 |
$1,356 |
6.9× |
| CT angio hrt w/3d image (75574) |
$1,801.50 |
$3,212.50 |
5.0× |
| CT angiography upper extremity lt (73206) |
$903.50 |
$1,663 |
5.0× |
| CT c-spine w/o contrast (72125) |
$689 |
$1,236 |
6.3× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$846.50 |
$1,463.50 |
4.6× |
| CT cervical spine w&w/o contrast (72127) |
$875.50 |
$1,570 |
4.8× |
| CT cervical spine with contrast (72126) |
$1,739.50 |
$3,005.50 |
4.8× |
| CT chest w/wo contrast (71270) |
$921 |
$1,644.50 |
5.1× |
| CT chest with contrast (71260) |
$870 |
$1,552 |
4.8× |
| CT colonography screening (74263) |
$2,877 |
$4,795 |
11.6× |
| CT colonography w/o cntrst (74261) |
$1,045.50 |
$1,953.50 |
9.6× |
| CT head/brain with contrast (70460) |
$868.50 |
$1,546 |
4.8× |
| CT head/brain without and with contrast (70470) |
$876 |
$1,571 |
4.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,766.50 |
$3,096.50 |
4.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$532 |
$937.50 |
5.9× |
| CT hrt w/3d image congen (75573) |
$1,809.50 |
$3,239.50 |
5.0× |
| CT iac w contrast (70481) |
$868.50 |
$1,546 |
4.8× |
| CT lower ext w/o (73700) |
$1,212 |
$2,281 |
11.2× |
| CT lower extremity w wo contrast (73702) |
$1,618 |
$3,033 |
8.9× |
| CT lower extremity with contrast (73701) |
$1,618 |
$3,001 |
8.9× |
| CT lumbar spine w & w/o contrast (72133) |
$875.50 |
$1,570 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$739.50 |
$1,319.50 |
6.8× |
| CT lumbar spine with contrast (72132) |
$1,739.50 |
$3,005.50 |
4.8× |
| CT maxillofacial w contrast (70487) |
$868.50 |
$1,546 |
4.8× |
| CT maxillofacial w/o contrast (70486) |
$651.50 |
$1,161 |
6.0× |
| CT maxillofacial w/wo contrast (70488) |
$875.50 |
$1,570 |
4.8× |
| CT neck soft tissue w contrast (70491) |
$881.50 |
$1,590 |
4.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,618 |
$2,696 |
8.9× |
| CT orbits w/o contrast (70480) |
$759 |
$1,377.50 |
7.0× |
| CT pelvis w & w/o contrast (72194) |
$1,053.50 |
$1,862 |
5.8× |
| CT pelvis w/o contrast (72192) |
$689 |
$1,243.50 |
6.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$514.50 |
$879.50 |
5.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$894 |
$1,631 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$673.50 |
$1,235 |
6.2× |
| CT thoracic spine w/contrast (72129) |
$873 |
$1,562 |
4.8× |
| CT thoracic spine w/o contrast (72128) |
$731 |
$1,305.50 |
6.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,618 |
$2,696 |
8.9× |
| CT thorax w/o contrast (71250) |
$720.50 |
$1,295.50 |
6.6× |
| CT unlisted procedure (76497) |
$515.50 |
$882.50 |
5.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,618 |
$3,014 |
8.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,212 |
$2,281 |
11.2× |
| CT upper extremity with contrast (73201) |
$3,351 |
$5,890 |
9.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,235 |
$2,266 |
6.8× |
| Cta Abdomen (74175) |
$1,060 |
$1,926.50 |
5.8× |
| CTA abdomen pelvis (74174) |
$1,855 |
$3,284.50 |
5.1× |
| CTA chest (71275) |
$936.50 |
$1,721 |
5.1× |
| Cta Head (70496) |
$1,004.50 |
$1,826.50 |
5.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,750.50 |
$3,047.50 |
4.8× |
| CTA lwr ext w&w/o contrast (73706) |
$1,618 |
$3,193 |
8.9× |
| Cta Neck (70498) |
$1,040.50 |
$1,887 |
5.7× |
| Cta Pelvis (72191) |
$903.50 |
$1,663 |
5.0× |
| Cystography minimum 3 views rs&i (74430) |
$441 |
$889 |
1.2× |
| Diskogram cervical (72285) |
$2,946 |
$5,013.50 |
1.5× |
| Diskography lumbar (72295) |
$3,008 |
$5,219.50 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$184 |
$324 |
1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$142.50 |
$255 |
1.6× |
| Dxa bone density study axial skeleton (77085) |
$319 |
$532 |
2.9× |
| Echoencephalography real time imaging (76506) |
$288.50 |
$537 |
2.7× |
| Esophagus (74220) |
$245 |
$461 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$310 |
$609 |
2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$295 |
$559 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$410.50 |
$161 |
1.7× |
| Foot 2 views (73620) |
$264 |
$546 |
2.9× |
| Forearm 2 views (73090) |
$181 |
$356.50 |
2.0× |
| Gated Heart Planar Single (78472) |
$772.50 |
$1,672.50 |
1.9× |
| Hand 2 views (73120) |
$319 |
$648 |
2.9× |
| Hand 3 views (73130) |
$264 |
$579 |
2.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$715.50 |
$1,270 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$790 |
$1,380.50 |
1.9× |
| Ht muscle image spect sing (78451) |
$1,691.50 |
$2,936.50 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$185.50 |
$369 |
2.1× |
| Hysterosalpingogram (74740) |
$382 |
$670 |
1.5× |
| Interstitial radiation source applic complex (77778) |
$2,185 |
$5,378 |
3.0× |
| Kidney imaging morphology (78700) |
$1,082 |
$1,803 |
2.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$717.50 |
$1,277 |
1.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$730.50 |
$1,321 |
1.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,303 |
$2,410 |
2.3× |
| Knee 3 views (73562) |
$200.50 |
$410 |
2.2× |
| Liver & spleen imaging static only (78215) |
$1,082 |
$1,803 |
2.6× |
| Lung perf&ventilat diferentl (78598) |
$711 |
$1,256 |
1.3× |
| Lung perfusion differential (78597) |
$578.50 |
$1,026.50 |
1.4× |
| Lung Ventilation Imaging (78579) |
$566 |
$984.50 |
1.4× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,401.50 |
$3,179.50 |
2.2× |
| Lymphoscintigraphy (78195) |
$729.50 |
$1,318 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$724 |
$1,206 |
2.9× |
| Meckels Diverticulum (78290) |
$1,082 |
$1,803 |
2.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,185.50 |
$2,399.50 |
3.0× |
| MRA head w & w/o contrast (70546) |
$1,560.50 |
$2,731 |
4.3× |
| MRA head w/o contrast (70544) |
$2,171 |
$3,827 |
8.8× |
| MRA head with contrast (70545) |
$2,645 |
$4,409 |
7.3× |
| MRA neck w contrast (70548) |
$1,401.50 |
$2,467.50 |
3.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,427.50 |
$2,537 |
3.9× |
| MRA neck w/o contrast (70547) |
$1,148.50 |
$2,019 |
4.6× |
| MRI abdomen w contrast (74182) |
$1,413.50 |
$2,507.50 |
3.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,645 |
$4,796 |
7.3× |
| MRI abdomen w/o contrast (74181) |
$1,162 |
$2,064 |
4.7× |
| MRI any jnt lwr ext with con lt (73722) |
$6,013 |
$10,450 |
7.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$6,013 |
$10,450 |
7.4× |
| MRI breast w/o contrast bilateral (77047) |
$1,169.50 |
$2,089 |
4.7× |
| MRI breast w/o contrast unilat (77046) |
$1,161.50 |
$2,062 |
4.7× |
| MRI c-spine with contrast (72142) |
$1,417.50 |
$2,520.50 |
3.9× |
| MRI cervical spine w/o contrast (72141) |
$1,163.50 |
$2,069 |
4.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,442 |
$2,603.50 |
4.0× |
| MRI chest w/o contrast (71550) |
$1,162.50 |
$2,066 |
4.7× |
| MRI chest with contrast (71551) |
$3,097.50 |
$5,314 |
3.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,884.50 |
$3,766 |
5.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,645 |
$4,857 |
7.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,465 |
$2,863 |
5.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,156 |
$2,044 |
4.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,515 |
$2,715 |
4.2× |
| MRI orbit/face/neck w/contrast (70542) |
$2,645 |
$4,409 |
7.3× |
| MRI pelvis w contrast (72196) |
$2,645 |
$4,409 |
7.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,645 |
$4,796 |
7.3× |
| MRI pelvis w/o contrast (72195) |
$2,171 |
$3,875 |
8.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,645 |
$4,979 |
7.3× |
| MRI scan of leg joint before and after contrast (73723) |
$2,849 |
$5,319 |
7.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,444 |
$2,609.50 |
4.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,645 |
$4,409 |
7.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,451 |
$2,620.50 |
4.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,416.50 |
$2,517.50 |
3.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,453 |
$2,624 |
4.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,163.50 |
$2,069 |
4.7× |
| MRI tmj (70336) |
$222 |
$522.50 |
0.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,433 |
$2,774 |
5.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,645 |
$4,979 |
7.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,599 |
$3,235 |
6.5× |
| Myelogram Cervical (72240) |
$2,005 |
$3,341 |
2.5× |
| Myelogram Lumbar (72265) |
$2,005 |
$3,341 |
2.5× |
| Myelogram thoracic (72255) |
$2,005 |
$3,341 |
2.5× |
| Myelography 2 or more regions (72270) |
$2,005 |
$3,341 |
2.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,704.50 |
$2,979.50 |
1.3× |
| Neck soft tissue (70360) |
$141.50 |
$252 |
1.6× |
| Nm cisternogram (78630) |
$703.50 |
$1,231 |
1.2× |
| Nm gastric emptying study (78264) |
$651 |
$1,154 |
1.6× |
| Nm gastroesophageal reflux study (78262) |
$1,082 |
$1,803 |
2.6× |
| Nm whole blood volume (78122) |
$525 |
$875 |
0.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,944 |
$7,365 |
2.7× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$3,242 |
$5,403 |
2.4× |
| Nuclear Rx Oral Admin (79005) |
$627 |
$1,200 |
2.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$299.50 |
$574 |
2.8× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$617 |
$1,255 |
4.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$511 |
$1,056 |
4.7× |
| Osseous survey infant (77076) |
$208 |
$409 |
1.9× |
| Osseous survey limited (77074) |
$319 |
$532 |
2.9× |
| Parathyrd planar w/spect&CT (78072) |
$808 |
$1,347 |
1.4× |
| Parathyroid imaging (78070) |
$620 |
$1,103.50 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$191 |
$371 |
1.8× |
| Peritoneogram rs&i (74190) |
$1,637 |
$2,729 |
2.9× |
| PET image w/CT, skull-thigh (78815) |
$3,208 |
$5,557 |
2.2× |
| PET imaging CT for attenuation limited area (78814) |
$3,194.50 |
$5,512 |
2.2× |
| PET imaging for CT attenuation whole body (78816) |
$3,407.50 |
$5,890 |
2.3× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$259.50 |
$432.50 |
0.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,645 |
$4,979 |
7.3× |
| Pr red cell survival study (78130) |
$319 |
$532 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$579.50 |
$1,029.50 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$778.50 |
$1,388.50 |
1.4× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$5,445.50 |
$9,121 |
5.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$846 |
$1,456.50 |
1.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$146 |
$266 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$176.50 |
$322 |
1.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$319 |
$686 |
2.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$38,757 |
$64,595 |
5.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,879 |
$4,798 |
5.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$532 |
$886 |
5.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$2,009 |
$3,349 |
5.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$208.50 |
$429 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$165.50 |
$332 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$207 |
$425 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$170 |
$346 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$267.50 |
$536 |
1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$250 |
$478 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$260 |
$512 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$459 |
$765 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$210 |
$416.50 |
2.3× |
| Radiological examination surgical specimen (76098) |
$818 |
$1,525 |
1.4× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$214.50 |
$358 |
0.5× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$113 |
$189 |
0.2× |
| Ribs bilateral 3 views (71110) |
$175 |
$317 |
1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,082 |
$1,803 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,242 |
$5,403 |
5.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,676 |
$2,885.50 |
3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,242 |
$5,403 |
2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,046 |
$6,743 |
2.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,242 |
$5,403 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$451 |
$923 |
1.9× |
| Sacroiliac Joints < 3 Views (72200) |
$169 |
$297 |
1.6× |
| Scanogram (77073) |
$210 |
$435 |
1.9× |
| Scapula complete (73010) |
$200 |
$378.50 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$119.50 |
$252 |
5.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$250.50 |
$702 |
2.3× |
| Sialogram (70390) |
$724 |
$1,206 |
2.9× |
| Simulation intermediate (77285) |
$994.50 |
$1,763.50 |
2.6× |
| Small bowel series (74250) |
$266 |
$514.50 |
1.5× |
| Spec medical radj physics consltj (77370) |
$491 |
$1,073 |
3.5× |
| Special dosimetry (77331) |
$677 |
$1,128 |
4.9× |
| Spine thoracic 3 views (72072) |
$171.50 |
$306 |
1.6× |
| Stereotactic body radiation delivery (77373) |
$8,955 |
$14,925 |
4.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,103.50 |
$2,126.50 |
2.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,014 |
$1,827.50 |
2.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$336 |
$560 |
1.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,023.50 |
$1,860.50 |
2.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$381 |
$705 |
2.7× |
| Thoracolumbar 2 views (72080) |
$171 |
$350 |
1.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$126.50 |
$353.50 |
0.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,082 |
$1,803 |
2.6× |
| Thyroid uptake measurement (78012) |
$1,082 |
$933.50 |
2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$567 |
$987.50 |
1.4× |
| Tmj unilateral (70328) |
$141.50 |
$252 |
1.6× |
| Treatment device intermediate (77333) |
$383 |
$713 |
2.7× |
| Treatment devices simple (77332) |
$365.50 |
$654 |
2.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,242 |
$5,403 |
5.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$575 |
$1,014.50 |
1.4× |
| Tx devices design & construction complex (77334) |
$999 |
$1,778.50 |
2.6× |
| Ultrasound elastography first target lesion (76982) |
$510 |
$850 |
4.7× |
| Ultrasound scan of cornea to determine thickness (76514) |
$67.50 |
$127 |
2.2× |
| Ultrasound scan to determine eye length and lens power (76519) |
$288.50 |
$537 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$352 |
$749 |
3.2× |
| Unlisted Ultrasound Procedure (76999) |
$272.50 |
$556.50 |
3.0× |
| Upper Extremity Infant (73092) |
$319 |
$576 |
2.9× |
| Urethrocystography retrograde rs&i (74450) |
$379 |
$660 |
1.5× |
| Urethrocystography voiding (74455) |
$379 |
$660 |
1.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$426 |
$710 |
2.3× |
| Us abdl aorta screen aaa (76706) |
$374.50 |
$824 |
3.4× |
| Us breast unilateral complete (76641) |
$369.50 |
$806 |
3.4× |
| Us breast unilateral limited (76642) |
$353 |
$746.50 |
3.9× |
| Us chest (76604) |
$320 |
$642 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$302.50 |
$584 |
2.8× |
| Us elastography parenchyma (76981) |
$287 |
$531 |
2.6× |
| Us infant hips dynamic (76885) |
$289.50 |
$548 |
3.2× |
| Us kidney transplant (76776) |
$295 |
$558 |
2.7× |
| Us ob transvaginal (76817) |
$294.50 |
$557 |
2.7× |
| Us pelvic non ob complete (76856) |
$291.50 |
$546 |
2.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$281 |
$512 |
2.6× |
| Us pregnancy ltd (76815) |
$345.50 |
$726 |
3.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$307 |
$599 |
2.8× |
| Us retroperitoneal complete (76770) |
$375.50 |
$827 |
3.5× |
| Us retroperitoneal limited (76775) |
$323 |
$652 |
3.0× |
| Us scrotum and contents (76870) |
$366.50 |
$797 |
3.4× |
| Us soft tissue head/neck (76536) |
$285 |
$525 |
2.6× |
| Us spinal canal and contents (76800) |
$324 |
$655 |
3.0× |
| Us transrectal (76872) |
$510 |
$1,378 |
4.7× |
| Us transrectal prostate volume (76873) |
$467 |
$1,105 |
4.3× |
| Us xtr non-vasc lmtd (76882) |
$510 |
$972 |
4.7× |
| Us, eye b-scan (76512) |
$511 |
$1,028 |
4.7× |
| Venogram extremity bilateral (75822) |
$2,616 |
$4,607.50 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$7,799 |
$6,697.50 |
2.4× |
| Venography caval superior serialography rs&i (75827) |
$3,796 |
$6,326 |
2.3× |
| Venography extremity unilateral rs&i (75820) |
$2,520.50 |
$4,290.50 |
1.5× |
| Venography Renal Bilateral (75833) |
$7,799 |
$6,756.50 |
2.4× |
| Venography renal unilateral selective rs&i (75831) |
$7,799 |
$6,688.50 |
2.4× |
| Wrist 2 views (73100) |
$188.50 |
$377.50 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$177 |
$324 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$164.50 |
$328 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$193 |
$390 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$426 |
$710 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$181 |
$356.50 |
2.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$187 |
$372.50 |
2.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$275 |
$490.50 |
2.5× |
| X-ray exam hip uni 1 view (73501) |
$264 |
$565 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$264 |
$618 |
2.9× |
| X-ray exam hip uni 4/> views (73503) |
$319 |
$607 |
2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$319 |
$734 |
2.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$346 |
$692.50 |
3.2× |
| X-ray exam of femur 1 (73551) |
$182 |
$358.50 |
2.0× |
| X-ray eye for foreign body (70030) |
$169 |
$343 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$189.50 |
$338.50 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$143 |
$256 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$264 |
$567 |
2.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$5,683 |
$4,879.50 |
2.6× |
| X-ray head for orthodontia (70350) |
$151.50 |
$285 |
1.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$179.50 |
$352.50 |
2.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$239.50 |
$487.50 |
2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$176.50 |
$369 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$185 |
$366.50 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$204 |
$414 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$242.50 |
$432 |
2.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$209.50 |
$425 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$174.50 |
$361 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$213 |
$444 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$206.50 |
$423 |
1.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$528.50 |
$1,026 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$173 |
$357 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$319 |
$579 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$218.50 |
$462 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$171.50 |
$306 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$168.50 |
$342 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$190 |
$381.50 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$164 |
$293.50 |
1.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$168.50 |
$341 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$209.50 |
$433 |
1.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$160 |
$400 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$264 |
$531 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$200.50 |
$411 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$169.50 |
$345 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$196.50 |
$389 |
1.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$181 |
$356 |
2.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$201.50 |
$413.50 |
2.2× |
| Xr arthrogram ankle (73615) |
$794 |
$1,475 |
2.2× |
| Xr c-spine 6 or more views (72052) |
$311.50 |
$635.50 |
2.9× |
| Xr chest 4+ views (71048) |
$211 |
$437 |
1.9× |
| Xr Cholecystography Oral Contrast (74290) |
$426 |
$710 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$196.50 |
$399 |
2.2× |
| Xr shoulder 1 view (73020) |
$168.50 |
$321 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$223 |
$473 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$185 |
$367.50 |
2.0× |
| Xr tmj bilateral (70330) |
$264 |
$440 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$264 |
$567 |
2.9× |