| Acute gi blood loss imaging (78278) |
$10,206 |
$10,206 |
24.4× |
| Angio extremity unilateral (75710) |
$12,470.50 |
$12,470.50 |
3.8× |
| Angiogram extremity bilateral (75716) |
$15,959 |
$15,959 |
4.8× |
| Angiogram pelvic (75736) |
$20,376.75 |
$20,376.75 |
3.5× |
| Angiography internal mammary rs&i (75756) |
$13,174.25 |
$13,174.25 |
4.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$20,376.75 |
$20,376.75 |
3.5× |
| Ankle 2 views (73600) |
$1,573 |
$1,573 |
17.3× |
| Arthrography knee lt (73580) |
$6,036.62 |
$6,036.62 |
16.6× |
| Arthrography wrist lt (73115) |
$3,907 |
$3,907 |
10.7× |
| Barium enema (74270) |
$4,542 |
$4,542 |
24.8× |
| Basic dosimetry (77300) |
$724 |
$724 |
5.2× |
| Bone age studies (77072) |
$698.25 |
$698.25 |
6.4× |
| Bone imaging limited area (78300) |
$4,327.75 |
$4,327.75 |
10.4× |
| Bone survey complete (77075) |
$1,547.50 |
$1,547.50 |
14.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$2,467.75 |
$2,467.75 |
13.5× |
| Clavicle complete (73000) |
$1,555 |
$1,555 |
17.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$11,342.25 |
$11,342.25 |
61.9× |
| Continuing medical physics consltj pr wk (77336) |
$356.75 |
$356.75 |
2.5× |
| Contrast exam abdominl aorta (75625) |
$7,821 |
$7,821 |
2.4× |
| Contrast exam thoracic aorta (75605) |
$20,376.75 |
$20,376.75 |
3.5× |
| CT - st neck w&wo contr (70492) |
$12,019.50 |
$12,019.50 |
65.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$23,886.75 |
$23,886.75 |
65.6× |
| CT abdomen and pelvis without contrast (74176) |
$21,326.88 |
$21,326.88 |
85.6× |
| CT abdomen w wo contrast (74170) |
$11,948.12 |
$11,948.12 |
65.2× |
| CT abdomen w/contrast (74160) |
$11,306.88 |
$11,306.88 |
61.7× |
| CT abdomen w/o contrast (74150) |
$10,666.88 |
$10,666.88 |
97.7× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$2,499 |
$2,499 |
6.9× |
| CT angio abdom w/o & w/dye (74175) |
$11,948.12 |
$11,948.12 |
65.2× |
| CT angio abdominal arteries (75635) |
$11,948.12 |
$11,948.12 |
65.2× |
| CT angiograph pelv w/o&w/dye (72191) |
$11,948.12 |
$11,948.12 |
65.2× |
| CT cervical spine w/contrast (72126) |
$11,659.50 |
$11,659.50 |
32.0× |
| CT cervical spine w/o contrast (72125) |
$10,666.88 |
$10,666.88 |
97.7× |
| CT chest w/contrast (71260) |
$10,026.38 |
$10,026.38 |
54.7× |
| CT extremity upper w & w/o contrast (73202) |
$9,418.75 |
$9,418.75 |
51.4× |
| CT head/brain with contrast (70460) |
$11,342.25 |
$11,342.25 |
61.9× |
| CT head/brain without and with contrast (70470) |
$11,948.12 |
$11,948.12 |
65.2× |
| CT lower ext w/wo contrast (73702) |
$9,418.75 |
$9,418.75 |
51.4× |
| CT lower extremity w contrast (73701) |
$8,320.38 |
$8,320.38 |
45.4× |
| CT lower extremity w/o contrast unilateral (73700) |
$7,684.88 |
$7,684.88 |
70.4× |
| CT lumbar spine w/contrast (72132) |
$11,659.50 |
$11,659.50 |
32.0× |
| CT lumbar spine w/o contrast (72131) |
$10,666.88 |
$10,666.88 |
97.7× |
| CT lumbar spine w/o then w/ con (72133) |
$24,425.50 |
$24,425.50 |
133.3× |
| CT maxillofacial area w/o contrast (70486) |
$10,666.88 |
$10,666.88 |
97.7× |
| CT maxillofacial w/contrast (70487) |
$11,342.25 |
$11,342.25 |
61.9× |
| CT maxillofacial w/o then w/ con (70488) |
$12,517.50 |
$12,517.50 |
68.3× |
| CT orbit sella ear w/o con (70480) |
$10,666.88 |
$10,666.88 |
97.7× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$10,666.88 |
$10,666.88 |
58.2× |
| CT pelvis w & w/o contrast (72194) |
$11,948.12 |
$11,948.12 |
65.2× |
| CT pelvis w/o contrast (72192) |
$10,666.88 |
$10,666.88 |
97.7× |
| CT soft tissue neck w/contrast (70491) |
$11,342.25 |
$11,342.25 |
61.9× |
| CT soft tissue neck w/o contrast (70490) |
$10,666.88 |
$10,666.88 |
97.7× |
| CT spine cervical w/wo contrast (72127) |
$22,316.25 |
$22,316.25 |
121.8× |
| CT thoracic spine w/contrast (72129) |
$11,917 |
$11,917 |
65.1× |
| CT thoracic spine w/o contrast (72128) |
$10,666.88 |
$10,666.88 |
97.7× |
| CT thoracic spine w/o then w/ con (72130) |
$23,084 |
$23,084 |
126.0× |
| CT thorax lung cancer scr c- (71271) |
$982.50 |
$982.50 |
9.0× |
| CT thorax w/o contrast (71250) |
$9,387.25 |
$9,387.25 |
86.0× |
| CT thorax w/o then w/ contrast (71270) |
$10,666.88 |
$10,666.88 |
58.2× |
| CT upper extremity w/dye (73201) |
$8,320.38 |
$8,320.38 |
22.8× |
| CT upper extremity w/o contrast rt (73200) |
$7,684.88 |
$7,684.88 |
70.4× |
| CTA chest w/wo contrast (71275) |
$10,666.88 |
$10,666.88 |
58.2× |
| CTA head w contrast (70496) |
$11,378.75 |
$11,378.75 |
62.1× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$22,732.25 |
$22,732.25 |
124.1× |
| Cta Neck (70498) |
$11,378.75 |
$11,378.75 |
62.1× |
| Esophogram (74220) |
$2,939.75 |
$2,939.75 |
16.0× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$2,119.50 |
$2,119.50 |
8.5× |
| Gastric emptying study (78264) |
$8,259.50 |
$8,259.50 |
19.8× |
| Gated heart planar single (78472) |
$2,437 |
$2,437 |
5.8× |
| Hepatobil syst image w/drug (78227) |
$1,348.50 |
$1,348.50 |
2.4× |
| Hepatobiliary system imaging (78226) |
$1,348.50 |
$1,348.50 |
3.2× |
| Humerus min 2 views (73060) |
$2,762.12 |
$2,762.12 |
30.4× |
| Imrt planning (77301) |
$6,246 |
$6,246 |
4.3× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$7,902.50 |
$7,902.50 |
13.9× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$7,902.50 |
$7,902.50 |
13.9× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$8,852.75 |
$8,852.75 |
15.6× |
| Liver & spleen; static only (78215) |
$7,193.50 |
$7,193.50 |
17.2× |
| Lung ventilat&perfus imaging (78582) |
$1,457.25 |
$1,457.25 |
2.6× |
| Lung ventilation imaging (78579) |
$933.75 |
$933.75 |
2.2× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$8,844.50 |
$8,844.50 |
24.3× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$8,844.50 |
$8,844.50 |
24.3× |
| Mlc device(s) for imrt (77338) |
$1,013 |
$1,013 |
2.6× |
| MRA head w & w/o contrast (70546) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRA head w/o contrast (70544) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRA neck w/contrast (70548) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRA neck w/o contrast (70547) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI abdomen w/o contrast (74181) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRI any jnt lwr ext with con lt (73722) |
$8,844.50 |
$8,844.50 |
10.8× |
| MRI cervical spine w/o contrast (72141) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRI cervical spine with contrast (72142) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI chest w & w/o contrast (71552) |
$7,641 |
$7,641 |
21.0× |
| MRI chest w/o contrast (71550) |
$6,426.50 |
$6,426.50 |
25.8× |
| MRI joint upper ext w/contrast (73222) |
$8,844.50 |
$8,844.50 |
10.8× |
| MRI joint upr extrem w/o dye (73221) |
$7,197.25 |
$7,197.25 |
28.9× |
| Mri Lower Extremity W/O Dye (73718) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRI lumbar spine with contrast (72149) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI lumbar w/wo contrast (72158) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI orbit/face/neck w/contrast (70542) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI orbit/face/neck w/o contrast (70540) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRI pelvis w/o contrast (72195) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRI pelvis w/wo contrast (72197) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI spine cervical wo/w contrast (72156) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI spine thoracic w/contrast (72147) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI thoracic spine w wo contrast (72157) |
$8,844.50 |
$8,844.50 |
24.3× |
| MRI thoracic spine w/o contrast (72146) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$7,197.25 |
$7,197.25 |
28.9× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$8,844.50 |
$8,844.50 |
24.3× |
| Myocardial spect single study at rest or stress (78451) |
$7,513 |
$7,513 |
5.6× |
| Nm bone 3 phase (78315) |
$6,410 |
$6,410 |
15.4× |
| Nm bone imaging whole body (78306) |
$11,166.75 |
$11,166.75 |
26.7× |
| Nm heart perfusion spect stress rest (78452) |
$23,745 |
$23,745 |
17.6× |
| Nm lymph system (78195) |
$7,527 |
$7,527 |
13.3× |
| Nose to rectum for fb child (76010) |
$291.50 |
$291.50 |
3.2× |
| Ob us < 14 wks single fetus (76801) |
$3,773.25 |
$3,773.25 |
34.6× |
| Parathyroid imaging (78070) |
$6,959.50 |
$6,959.50 |
16.7× |
| Pulmonary perfusion imaging particulate (78580) |
$6,952.75 |
$6,952.75 |
16.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$923.75 |
$923.75 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$2,471.75 |
$2,471.75 |
27.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$2,471.75 |
$2,471.75 |
22.6× |
| Radex hip unilateral with pelvis 1 view (73501) |
$2,974.50 |
$2,974.50 |
32.7× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$4,006.25 |
$4,006.25 |
44.1× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$4,006.25 |
$4,006.25 |
36.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$6,071 |
$6,071 |
55.6× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$6,071 |
$6,071 |
55.6× |
| Radex spine cervical 2 or 3 views (72040) |
$1,489 |
$1,489 |
16.4× |
| Radex spine cervical 4 or 5 views (72050) |
$2,976.50 |
$2,976.50 |
27.3× |
| Radex spine cervical 6 or more views (72052) |
$3,000 |
$3,000 |
27.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$4,344 |
$4,344 |
23.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$3,942.25 |
$3,942.25 |
21.5× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$1,100.50 |
$1,100.50 |
12.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$2,233.50 |
$2,233.50 |
24.6× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$2,329.50 |
$2,329.50 |
21.3× |
| Radiologic examination, mastoids; less than 3 views per side Other Diagnostic Radiology FS (70120) |
$193.50 |
$193.50 |
1.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$3,095.25 |
$3,095.25 |
7.4× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$18,904.25 |
$18,904.25 |
33.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$9,942.50 |
$9,942.50 |
17.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,764.75 |
$5,764.75 |
10.2× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$182.75 |
$182.75 |
7.8× |
| Shoulder arthrogram (73040) |
$3,000.62 |
$3,000.62 |
8.2× |
| Small bowel series (74250) |
$3,287.75 |
$3,287.75 |
17.9× |
| Thyroid uptake single/multiple quant measurement (78012) |
$4,280.25 |
$4,280.25 |
10.3× |
| Ultrasound, abdomen limited (76705) |
$3,662.50 |
$3,662.50 |
33.5× |
| Us abdominal aorta real time screen study aaa (76706) |
$425.75 |
$425.75 |
3.9× |
| Us breast uni real time with image complete (76641) |
$2,166.75 |
$2,166.75 |
19.8× |
| Us chest (76604) |
$399.62 |
$399.62 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$420.88 |
$420.88 |
3.9× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$303.25 |
$303.25 |
2.8× |
| Us ob limited 1 or more fetuses (76815) |
$224.25 |
$224.25 |
2.1× |
| Us obstetric transvaginal (76817) |
$464.25 |
$464.25 |
4.3× |
| Us pelvic limited or f/u non-ob (76857) |
$241.75 |
$241.75 |
2.2× |
| Us pelvis complete (76856) |
$4,339.75 |
$4,339.75 |
39.8× |
| Us retroperitoneal complete (76770) |
$3,307 |
$3,307 |
30.3× |
| Us retroperitoneal limited (76775) |
$1,658.50 |
$1,658.50 |
15.2× |
| Us scrotum (76870) |
$3,354 |
$3,354 |
30.7× |
| Us soft tissue head/neck (76536) |
$3,125 |
$3,125 |
28.6× |
| Venogram extremity bilateral (75822) |
$2,648 |
$2,648 |
1.6× |
| Venography ext unilateral (75820) |
$2,648 |
$2,648 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,740.75 |
$1,740.75 |
19.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$2,136.25 |
$2,136.25 |
23.5× |
| X-ray aorta leg arteries (75630) |
$17,459 |
$17,459 |
5.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$4,490.75 |
$4,490.75 |
24.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$2,290.75 |
$2,290.75 |
25.2× |
| X-ray exam hips bi 3-4 views (73522) |
$6,071 |
$6,071 |
55.6× |
| X-ray exam of finger(s) (73140) |
$1,673.50 |
$1,673.50 |
18.4× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$1,405.25 |
$1,405.25 |
15.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,979.25 |
$1,979.25 |
21.8× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$1,374.25 |
$1,374.25 |
12.6× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$2,056 |
$2,056 |
22.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$2,004.75 |
$2,004.75 |
22.1× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$2,087 |
$2,087 |
23.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$2,252.75 |
$2,252.75 |
20.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$2,540.75 |
$2,540.75 |
23.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$3,846 |
$3,846 |
35.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,365.75 |
$1,365.75 |
15.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$4,555 |
$4,555 |
41.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$2,221.25 |
$2,221.25 |
20.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,842.50 |
$1,842.50 |
20.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$2,298.75 |
$2,298.75 |
25.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$2,721.25 |
$2,721.25 |
29.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$2,846.75 |
$2,846.75 |
26.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,616.75 |
$1,616.75 |
14.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$2,221.25 |
$2,221.25 |
24.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$1,573 |
$1,573 |
17.3× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$1,405.25 |
$1,405.25 |
15.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,964.75 |
$1,964.75 |
21.6× |
| Xr abdomen 1 view (74018) |
$689.50 |
$689.50 |
7.6× |
| Xr abdomen 2 views (74019) |
$1,997.75 |
$1,997.75 |
18.3× |
| Xr arthrogram ankle (73615) |
$4,051.50 |
$4,051.50 |
11.1× |
| Xr arthrogram hip (73525) |
$4,055.25 |
$4,055.25 |
11.1× |
| Xr bone survey infant (77076) |
$1,547.50 |
$1,547.50 |
14.2× |
| Xr bone survey limited (77074) |
$1,547.50 |
$1,547.50 |
14.2× |
| Xr chest 1 view (71045) |
$689.50 |
$689.50 |
7.6× |
| Xr chest 2 views (71046) |
$1,365.75 |
$1,365.75 |
15.0× |
| Xr chest 3 views (71047) |
$2,179.75 |
$2,179.75 |
24.0× |
| Xr cystogram 3+ views (74430) |
$2,934 |
$2,934 |
8.1× |
| Xr facial bones 3 views (70150) |
$2,391.25 |
$2,391.25 |
21.9× |
| Xr lower extremity 2 views infant (73592) |
$1,996 |
$1,996 |
22.0× |
| Xr mandible 4 views (70110) |
$2,694.50 |
$2,694.50 |
24.7× |
| Xr nasal bones (70160) |
$2,171 |
$2,171 |
23.9× |
| Xr spine 1 view (72020) |
$346.25 |
$346.25 |
3.8× |
| Xr sternum 2 views (71120) |
$2,050.50 |
$2,050.50 |
22.6× |
| Xr surgical specimen (76098) |
$1,129.50 |
$1,129.50 |
2.0× |
| Xr upper extremity 2 views infant (73092) |
$3,991.75 |
$3,991.75 |
36.6× |
| Xray elbow 2 views (73070) |
$1,979.25 |
$1,979.25 |
21.8× |
| Xray forearm 2 views (73090) |
$1,997.75 |
$1,997.75 |
22.0× |
| Xray knee 1 or 2 views rt (73560) |
$1,923.25 |
$1,923.25 |
21.2× |
| Xray neck soft tissue (70360) |
$1,840.75 |
$1,840.75 |
20.3× |
| Xray orbits complete min 4 views (70200) |
$2,531.25 |
$2,531.25 |
23.2× |
| Xray pelvis 1 or 2 views (72170) |
$1,942.25 |
$1,942.25 |
17.8× |
| Xray ribs bilateral 3 views (71110) |
$1,547.50 |
$1,547.50 |
14.2× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$2,756 |
$2,756 |
25.2× |
| Xray scapula complete (73010) |
$3,766.75 |
$3,766.75 |
34.5× |
| Xray shoulder 1 view (73020) |
$1,154 |
$1,154 |
12.7× |
| Xray spine thoracic 2 views (72070) |
$1,973.75 |
$1,973.75 |
18.1× |
| Xray spine thoracic 3 views (72072) |
$1,973.75 |
$1,973.75 |
18.1× |
| Xray tibia-fibula 2 views bil (73590) |
$2,041.25 |
$2,041.25 |
22.5× |
| Xray tmj's bilateral open-clsc (70330) |
$2,373.50 |
$2,373.50 |
26.1× |