| 3-D radiotherapy plan dose-volume histograms (77295) |
$11,118.46 |
$11,118.46 |
6.7× |
| Abdomen 2 views (74019) |
$412 |
$412 |
3.3× |
| Angiography extremity bilateral rs&i (75716) |
$8,585 |
$8,585 |
2.3× |
| Angiography extremity unilateral rs&i (75710) |
$8,585 |
$8,585 |
2.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$14,311 |
$14,311 |
2.1× |
| Angiography Spinal Selective Rs&I (75705) |
$14,311 |
$14,311 |
2.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$14,311 |
$14,311 |
2.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$8,585 |
$8,585 |
2.3× |
| Ankle 2 views (73600) |
$364 |
$364 |
3.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,472 |
$1,472 |
3.5× |
| Aortogram thoracic (75605) |
$14,311 |
$14,311 |
2.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$8,585 |
$8,585 |
2.3× |
| Aortography abdominal serialography rs&i (75625) |
$8,585 |
$8,585 |
2.3× |
| Basic radiation dosimetry calculation (77300) |
$770.43 |
$770.43 |
4.8× |
| Bone &/joint imaging whole body (78306) |
$2,364 |
$2,364 |
4.9× |
| Bone Imaging 3 Phase (78315) |
$2,725 |
$2,725 |
5.7× |
| Bone survey complete (77075) |
$1,106 |
$1,106 |
8.8× |
| Brachytx isodose complex (77318) |
$2,513 |
$2,513 |
5.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,921 |
$5,921 |
3.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,969 |
$2,969 |
7.1× |
| Cervical spine 2 or 3 views (72040) |
$440 |
$440 |
4.2× |
| Chest 1 view (71045) |
$285 |
$285 |
2.7× |
| Chest 3 views (71047) |
$474 |
$474 |
4.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$714 |
$714 |
3.4× |
| Clavicle complete (73000) |
$360 |
$360 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$677 |
$677 |
5.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,135 |
$1,135 |
7.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,140 |
$3,140 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,278 |
$1,278 |
4.5× |
| CT abdomen w contrast (74160) |
$2,184 |
$2,184 |
10.4× |
| CT abdomen w wo contrast (74170) |
$2,475 |
$2,475 |
11.8× |
| CT abdomen w/o contrast (74150) |
$1,022 |
$1,022 |
8.2× |
| CT angio hrt w/3d image (75574) |
$3,220 |
$3,220 |
7.7× |
| CT angiography upper extremity lt (73206) |
$2,726 |
$2,726 |
13.0× |
| CT c-spine w/o contrast (72125) |
$1,045 |
$1,045 |
8.3× |
| CT cervical spine with contrast (72126) |
$1,410 |
$1,410 |
3.4× |
| CT chest w/wo contrast (71270) |
$1,756 |
$1,756 |
8.4× |
| CT chest with contrast (71260) |
$1,418 |
$1,418 |
6.7× |
| CT head/brain with contrast (70460) |
$1,201 |
$1,201 |
5.7× |
| CT head/brain without and with contrast (70470) |
$1,445 |
$1,445 |
6.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$452.50 |
$452.50 |
1.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$350 |
$350 |
3.4× |
| CT hrt w/3d image congen (75573) |
$2,820 |
$2,820 |
6.7× |
| CT iac w contrast (70481) |
$1,616 |
$1,616 |
7.7× |
| CT lower ext w/o (73700) |
$1,037 |
$1,037 |
8.3× |
| CT lower extremity w wo contrast (73702) |
$1,733 |
$1,733 |
8.2× |
| CT lower extremity with contrast (73701) |
$1,418 |
$1,418 |
6.7× |
| CT lumbar spine w/o contrast (72131) |
$1,037 |
$1,037 |
8.3× |
| CT lumbar spine with contrast (72132) |
$1,410 |
$1,410 |
3.4× |
| CT maxillofacial w contrast (70487) |
$1,255 |
$1,255 |
6.0× |
| CT maxillofacial w/o contrast (70486) |
$1,099 |
$1,099 |
8.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,597 |
$1,597 |
7.6× |
| CT neck soft tissue w contrast (70491) |
$1,523 |
$1,523 |
7.2× |
| CT orbits w/o contrast (70480) |
$1,239 |
$1,239 |
9.9× |
| CT pelvis w/o contrast (72192) |
$1,033 |
$1,033 |
8.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,865 |
$1,865 |
8.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,138 |
$1,138 |
9.1× |
| CT thoracic spine w/contrast (72129) |
$1,422 |
$1,422 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$1,041 |
$1,041 |
8.3× |
| CT thorax w/o contrast (71250) |
$1,689.90 |
$1,689.90 |
13.5× |
| CT unlisted procedure (76497) |
$488.50 |
$488.50 |
4.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,473 |
$1,473 |
11.8× |
| CT upper extremity with contrast (73201) |
$1,881 |
$1,881 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,745 |
$3,745 |
17.8× |
| Cta Abdomen (74175) |
$2,743 |
$2,743 |
13.0× |
| CTA abdomen pelvis (74174) |
$3,465 |
$3,465 |
8.3× |
| CTA chest (71275) |
$2,440 |
$2,440 |
11.6× |
| Cta Head (70496) |
$2,409 |
$2,409 |
11.5× |
| CTA lwr ext w&w/o contrast (73706) |
$2,987 |
$2,987 |
14.2× |
| Cta Neck (70498) |
$2,405 |
$2,405 |
11.4× |
| Cta Pelvis (72191) |
$2,751 |
$2,751 |
13.1× |
| Cystography minimum 3 views rs&i (74430) |
$1,472 |
$1,472 |
3.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$129.64 |
$129.64 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$208 |
$208 |
1.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$263 |
$263 |
2.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$258 |
$258 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$195 |
$195 |
1.9× |
| Dxa bone density study axial skeleton (77085) |
$585 |
$585 |
4.7× |
| Echo exam of fetal heart (76825) |
$890 |
$890 |
1.4× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$570 |
$570 |
2.0× |
| Echoencephalography real time imaging (76506) |
$221 |
$221 |
1.8× |
| Esophagus (74220) |
$714 |
$714 |
3.4× |
| Fetal biophysical profile non-stress testing (76818) |
$300 |
$300 |
2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$222 |
$222 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$486.40 |
$486.40 |
1.7× |
| Foot 2 views (73620) |
$317 |
$317 |
3.0× |
| Forearm 2 views (73090) |
$325 |
$325 |
3.1× |
| Functional MRI brain by phys/psych (70555) |
$4,755.10 |
$4,755.10 |
16.6× |
| Functional MRI brain by tech (70554) |
$3,651 |
$3,651 |
12.8× |
| Gated Heart Planar Single (78472) |
$408.50 |
$408.50 |
0.9× |
| Hand 2 views (73120) |
$348 |
$348 |
2.8× |
| Hand 3 views (73130) |
$406 |
$406 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$4,940.08 |
$4,940.08 |
5.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$5,914.36 |
$5,914.36 |
7.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$8,585 |
$8,585 |
2.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,639 |
$3,639 |
5.6× |
| Ht muscle image spect sing (78451) |
$2,519 |
$2,519 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$360 |
$360 |
3.5× |
| Hysterosalpingogram (74740) |
$921 |
$921 |
3.2× |
| Interstitial radiation source applic complex (77778) |
$7,538 |
$7,538 |
9.0× |
| Kidney imaging morphology (78700) |
$1,376 |
$1,376 |
2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,705 |
$1,705 |
2.6× |
| Knee 3 views (73562) |
$453 |
$453 |
4.3× |
| Liver & spleen imaging static only (78215) |
$1,578 |
$1,578 |
3.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$940 |
$940 |
2.0× |
| Lung perf&ventilat diferentl (78598) |
$2,417 |
$2,417 |
3.7× |
| Lung perfusion differential (78597) |
$1,534 |
$1,534 |
3.2× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$8,585 |
$8,585 |
2.3× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,202.60 |
$1,202.60 |
1.6× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,820.61 |
$1,820.61 |
1.0× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$11,447 |
$11,447 |
3.0× |
| Lymphoscintigraphy (78195) |
$2,728 |
$2,728 |
4.2× |
| Meckels Diverticulum (78290) |
$2,725 |
$2,725 |
5.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$5,322.71 |
$5,322.71 |
11.9× |
| Mr elastography (76391) |
$1,801 |
$1,801 |
6.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$43 |
$43 |
1.2× |
| MRA head w & w/o contrast (70546) |
$3,006 |
$3,006 |
7.2× |
| MRA head w/o contrast (70544) |
$1,853 |
$1,853 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,027 |
$3,027 |
7.2× |
| MRA neck w/o contrast (70547) |
$1,860 |
$1,860 |
6.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,826 |
$2,826 |
6.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,868 |
$2,868 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,861 |
$2,861 |
3.0× |
| MRI breast w/o contrast bilateral (77047) |
$1,720 |
$1,720 |
6.0× |
| MRI cardiac w/o cont stress (75559) |
$3,392 |
$3,392 |
5.2× |
| MRI cardiac w/o contrast (75557) |
$2,067 |
$2,067 |
7.2× |
| MRI cervical spine w/o contrast (72141) |
$1,434 |
$1,434 |
5.0× |
| MRI chest w/o & w/contrast material (71552) |
$4,430 |
$4,430 |
10.6× |
| MRI chest w/o contrast (71550) |
$3,245 |
$3,245 |
11.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,909 |
$1,909 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,944 |
$1,944 |
6.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,843 |
$2,843 |
6.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,819 |
$2,819 |
6.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,462 |
$3,462 |
8.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$3,536 |
$3,536 |
3.8× |
| MRI scan of leg joint before and after contrast (73723) |
$3,452 |
$3,452 |
8.3× |
| MRI spectroscopy (76390) |
$3,609 |
$3,609 |
34.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,539 |
$2,539 |
6.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,532 |
$2,532 |
6.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,546 |
$2,546 |
6.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,434 |
$1,434 |
5.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,622 |
$1,622 |
5.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,738 |
$3,738 |
8.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,882 |
$2,882 |
10.1× |
| Myelogram Cervical (72240) |
$2,192 |
$2,192 |
2.3× |
| Myelography 2 or more regions (72270) |
$296 |
$296 |
0.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$136.62 |
$136.62 |
0.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,638 |
$3,638 |
2.3× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$5,921 |
$5,921 |
3.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$5,921 |
$5,921 |
3.5× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$9,002 |
$9,002 |
3.4× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$190.88 |
$190.88 |
0.1× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,393 |
$2,393 |
2.3× |
| Neck soft tissue (70360) |
$352 |
$352 |
3.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,167.39 |
$1,167.39 |
2.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$495 |
$495 |
1.0× |
| Nm gastric emptying study (78264) |
$2,694 |
$2,694 |
5.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,978.16 |
$9,978.16 |
6.0× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$156.50 |
$156.50 |
0.1× |
| Nuclear Rx Oral Admin (79005) |
$469 |
$469 |
1.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$329 |
$329 |
2.6× |
| Orthopantogram (70355) |
$203 |
$203 |
1.9× |
| Parathyrd planar w/spect&CT (78072) |
$3,384 |
$3,384 |
5.2× |
| Pelvis 1 or 2 views (72170) |
$309 |
$309 |
2.5× |
| PET image w/CT, skull-thigh (78815) |
$8,882 |
$8,882 |
5.2× |
| PET imaging CT for attenuation limited area (78814) |
$8,882 |
$8,882 |
5.2× |
| PET imaging for CT attenuation whole body (78816) |
$8,882 |
$8,882 |
5.2× |
| Pr heart first pass single,planar (78481) |
$326 |
$326 |
0.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,840 |
$2,840 |
6.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$8,585 |
$8,585 |
2.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$9,100 |
$9,100 |
2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,842 |
$1,842 |
3.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,585 |
$2,585 |
4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,932 |
$1,932 |
2.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$217 |
$217 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$783 |
$783 |
6.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$459 |
$459 |
3.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,095 |
$1,095 |
8.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$26,266.24 |
$26,266.24 |
3.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,794 |
$1,794 |
2.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$895 |
$895 |
7.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$486 |
$486 |
3.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$332 |
$332 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$477 |
$477 |
3.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$374 |
$374 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$714 |
$714 |
3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$905 |
$905 |
4.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$714 |
$714 |
3.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$714 |
$714 |
3.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$394 |
$394 |
3.8× |
| Radiological examination surgical specimen (76098) |
$630.42 |
$630.42 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$8,585 |
$8,585 |
2.3× |
| Ribs bilateral 3 views (71110) |
$489 |
$489 |
3.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,079 |
$3,079 |
4.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$5,724 |
$5,724 |
3.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,555 |
$7,555 |
4.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,869 |
$3,869 |
2.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$536.74 |
$536.74 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$484 |
$484 |
1.7× |
| Sacroiliac Joints < 3 Views (72200) |
$367 |
$367 |
2.9× |
| Scapula complete (73010) |
$262 |
$262 |
2.1× |
| Screening digital breast tomosynthesis (77063) |
$114 |
$114 |
4.9× |
| Small bowel series (74250) |
$714 |
$714 |
3.4× |
| Spec medical radj physics consltj (77370) |
$1,715.02 |
$1,715.02 |
10.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,482.57 |
$2,482.57 |
5.5× |
| Special dosimetry (77331) |
$978.22 |
$978.22 |
6.1× |
| Special treatment procedure (77470) |
$5,229 |
$5,229 |
7.9× |
| Spine thoracic 3 views (72072) |
$436 |
$436 |
3.5× |
| Stereotactic body radiation delivery (77373) |
$7,354.32 |
$7,354.32 |
3.4× |
| Superior sagittal sinus venogram (75870) |
$8,585 |
$8,585 |
2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,513 |
$2,513 |
5.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,513 |
$2,513 |
5.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,757.23 |
$2,757.23 |
6.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,658.24 |
$1,658.24 |
10.3× |
| Thoracolumbar 2 views (72080) |
$386 |
$386 |
3.7× |
| Treatment device intermediate (77333) |
$1,102.29 |
$1,102.29 |
6.8× |
| Treatment devices simple (77332) |
$833.39 |
$833.39 |
5.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,057 |
$2,057 |
4.3× |
| Tx devices design & construction complex (77334) |
$3,423.19 |
$3,423.19 |
7.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$351 |
$351 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$284 |
$284 |
2.3× |
| Umbilical-artery Doppler (OB) (76820) |
$129.64 |
$129.64 |
1.0× |
| Unlisted fluoroscopic procedure (76496) |
$324 |
$324 |
3.1× |
| Unlisted magnetic resonance procedure (76498) |
$2,680 |
$2,680 |
25.7× |
| Unlisted Ultrasound Procedure (76999) |
$596.85 |
$596.85 |
5.7× |
| Urethrocystography retrograde rs&i (74450) |
$921 |
$921 |
3.2× |
| Urethrocystography voiding (74455) |
$921 |
$921 |
3.2× |
| Us abdl aorta screen aaa (76706) |
$378 |
$378 |
3.0× |
| Us breast unilateral complete (76641) |
$447 |
$447 |
3.6× |
| Us breast unilateral limited (76642) |
$342.50 |
$342.50 |
3.3× |
| Us chest (76604) |
$177 |
$177 |
1.4× |
| Us compl joint r-t w/image documentation (76881) |
$163 |
$163 |
1.3× |
| Us elastography parenchyma (76981) |
$357 |
$357 |
2.8× |
| Us fetal nuchal translucency 1st gestation (76813) |
$295 |
$295 |
2.4× |
| Us kidney transplant (76776) |
$542 |
$542 |
4.3× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$187 |
$187 |
1.5× |
| Us ob detailed single fetus (76811) |
$384 |
$384 |
1.3× |
| Us ob transvaginal (76817) |
$272 |
$272 |
2.2× |
| Us pelvic non ob complete (76856) |
$348 |
$348 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$129.64 |
$129.64 |
1.0× |
| Us pregnancy ltd (76815) |
$239 |
$239 |
1.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$336 |
$336 |
2.7× |
| Us retroperitoneal complete (76770) |
$351 |
$351 |
2.8× |
| Us retroperitoneal limited (76775) |
$138 |
$138 |
1.1× |
| Us scrotum and contents (76870) |
$337 |
$337 |
2.7× |
| Us soft tissue head/neck (76536) |
$406 |
$406 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$151 |
$151 |
1.2× |
| Us, eye b-scan (76512) |
$129.64 |
$129.64 |
1.0× |
| Venogram extremity bilateral (75822) |
$4,218 |
$4,218 |
2.2× |
| Venography caval inferior serialography rs&i (75825) |
$8,585 |
$8,585 |
2.3× |
| Venography epidural rs&i (75872) |
$1,625 |
$1,625 |
2.2× |
| Venography extremity unilateral rs&i (75820) |
$4,218 |
$4,218 |
2.2× |
| Venography renal unilateral selective rs&i (75831) |
$8,585 |
$8,585 |
2.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$8,585 |
$8,585 |
2.3× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$14,311 |
$14,311 |
2.1× |
| Wrist 2 views (73100) |
$379 |
$379 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$554 |
$554 |
4.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$317 |
$317 |
3.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$410 |
$410 |
3.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$714 |
$714 |
3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$325 |
$325 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$360 |
$360 |
3.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$887 |
$887 |
7.1× |
| X-ray exam hip uni 1 view (73501) |
$359 |
$359 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$522 |
$522 |
5.0× |
| X-ray exam hip uni 4/> views (73503) |
$656 |
$656 |
5.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$597 |
$597 |
4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$686 |
$686 |
5.5× |
| X-ray exam of femur 1 (73551) |
$329 |
$329 |
3.2× |
| X-ray eye for foreign body (70030) |
$359 |
$359 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$528 |
$528 |
4.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$359 |
$359 |
3.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$383 |
$383 |
3.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$321 |
$321 |
3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$429 |
$429 |
4.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$514 |
$514 |
4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$457 |
$457 |
4.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$444 |
$444 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$694 |
$694 |
5.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$455 |
$455 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$426 |
$426 |
4.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$539 |
$539 |
4.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$466 |
$466 |
3.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$855 |
$855 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$409 |
$409 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$470 |
$470 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$585 |
$585 |
4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$436 |
$436 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$360 |
$360 |
3.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$383 |
$383 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$420 |
$420 |
4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$500 |
$500 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$398 |
$398 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$274 |
$274 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$374 |
$374 |
3.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$363 |
$363 |
2.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$497 |
$497 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$326 |
$326 |
3.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$453 |
$453 |
4.3× |
| Xr c-spine 6 or more views (72052) |
$694 |
$694 |
5.5× |
| Xr chest 4+ views (71048) |
$507 |
$507 |
4.0× |
| Xr finger(s) 2+ views (73140) |
$419 |
$419 |
4.0× |
| Xr shoulder 1 view (73020) |
$240 |
$240 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$590 |
$590 |
4.7× |
| Xr tibia/fibula 2 views (73590) |
$352 |
$352 |
3.4× |
| Xr tmj bilateral (70330) |
$599 |
$599 |
5.7× |
| Xray knee 1 or 2 views rt (73560) |
$300 |
$300 |
2.9× |