| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$1,619.29 |
$1,619.29 |
1.1× |
| Acute gi blood loss imaging (78278) |
$4,391.73 |
$4,391.73 |
10.5× |
| Angio adrenal bilat select (75733) |
$7,700.42 |
$7,700.42 |
2.3× |
| Angio adrenal unilat select (75731) |
$7,569.97 |
$7,569.97 |
2.3× |
| Angio extremity unilateral (75710) |
$18,137.91 |
$18,137.91 |
5.5× |
| Angio pulmonary unilateral (75741) |
$7,656.76 |
$7,656.76 |
2.3× |
| Angiogram extremity bilateral (75716) |
$12,668.12 |
$12,668.12 |
3.8× |
| Angiogram pelvic (75736) |
$11,029.19 |
$11,029.19 |
1.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,442.88 |
$9,442.88 |
2.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$11,920.86 |
$11,920.86 |
2.1× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$12,303.34 |
$12,303.34 |
3.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$7,656.76 |
$7,656.76 |
2.3× |
| Ankle 2 views (73600) |
$1,471.89 |
$1,471.89 |
16.2× |
| Arthrography knee lt (73580) |
$2,829.54 |
$2,829.54 |
7.8× |
| Arthrography wrist lt (73115) |
$2,829.54 |
$2,829.54 |
7.8× |
| Barium enema (74270) |
$3,576.90 |
$3,576.90 |
19.5× |
| Basic dosimetry (77300) |
$1,447.60 |
$1,447.60 |
10.3× |
| Bilat selctv renal venogram (75833) |
$5,321.71 |
$5,321.71 |
1.6× |
| Bone age studies (77072) |
$1,521.70 |
$1,521.70 |
13.9× |
| Bone imaging limited area (78300) |
$8,727.40 |
$8,727.40 |
20.9× |
| Bone marrow imaging whole body (78104) |
$8,090.70 |
$8,090.70 |
19.4× |
| Bone survey complete (77075) |
$4,181.60 |
$4,181.60 |
38.3× |
| Bowel imaging (78290) |
$8,566 |
$8,566 |
20.5× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$6,709.74 |
$6,709.74 |
17.2× |
| Brain flow imaging only - nm brain flow only brain death (78610) |
$7,966.52 |
$7,966.52 |
14.1× |
| Brain image w/flow 4 + views (78606) |
$10,645.38 |
$10,645.38 |
18.8× |
| Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or… (78483) |
$8,445.91 |
$8,445.91 |
14.9× |
| Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or… (78481) |
$2,668.17 |
$2,668.17 |
4.7× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$10,338.69 |
$10,338.69 |
24.8× |
| Cardiac shunt detection (78428) |
$1,599.62 |
$1,599.62 |
3.8× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Age Under 21 (78635) |
$6,035.82 |
$6,035.82 |
10.6× |
| Cerebrospinal fluid leakage (78650) |
$8,282.68 |
$8,282.68 |
6.1× |
| Cholecystography, oral contrast Other Diagnostic Radiology FS (74290) |
$3,446.23 |
$3,446.23 |
18.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$3,362.76 |
$3,362.76 |
18.4× |
| Cisternogram (78630) |
$12,130.20 |
$12,130.20 |
21.4× |
| Clavicle complete (73000) |
$1,048.92 |
$1,048.92 |
11.5× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$7,618.58 |
$7,618.58 |
41.6× |
| Continuing medical physics consltj pr wk (77336) |
$595.75 |
$595.75 |
4.2× |
| Contrast exam abdominl aorta (75625) |
$7,258.62 |
$7,258.62 |
2.2× |
| Contrast exam thoracic aorta (75605) |
$7,966.97 |
$7,966.97 |
1.4× |
| Corpora cavernosography (74445) |
$1,328.77 |
$1,328.77 |
12.2× |
| Csf shunt evaluation (78645) |
$8,281.28 |
$8,281.28 |
14.6× |
| CT - st neck w&wo contr (70492) |
$12,082.76 |
$12,082.76 |
66.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$20,840.35 |
$20,840.35 |
57.2× |
| CT abdomen and pelvis without contrast (74176) |
$16,321.89 |
$16,321.89 |
65.5× |
| CT abdomen w wo contrast (74170) |
$13,534.14 |
$13,534.14 |
73.9× |
| CT abdomen w/contrast (74160) |
$10,883.16 |
$10,883.16 |
59.4× |
| CT abdomen w/o contrast (74150) |
$10,009.59 |
$10,009.59 |
91.7× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$22,507.57 |
$22,507.57 |
61.8× |
| CT angio abdom w/o & w/dye (74175) |
$4,189.88 |
$4,189.88 |
22.9× |
| CT angio abdominal arteries (75635) |
$7,368.39 |
$7,368.39 |
40.2× |
| CT angio hrt w/3d image (75574) |
$15,446.33 |
$15,446.33 |
42.4× |
| CT angiograph pelv w/o&w/dye (72191) |
$3,034.06 |
$3,034.06 |
16.6× |
| CT cervical spine w/contrast (72126) |
$10,277.66 |
$10,277.66 |
28.2× |
| CT cervical spine w/o contrast (72125) |
$9,148.55 |
$9,148.55 |
83.8× |
| CT chest w/contrast (71260) |
$10,883.16 |
$10,883.16 |
59.4× |
| CT extremity upper w & w/o contrast (73202) |
$9,643.67 |
$9,643.67 |
52.6× |
| CT head/brain with contrast (70460) |
$10,589.87 |
$10,589.87 |
57.8× |
| CT head/brain without and with contrast (70470) |
$12,003.63 |
$12,003.63 |
65.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$15,116.56 |
$15,116.56 |
41.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$15,116.56 |
$15,116.56 |
166.3× |
| CT hrt w/3d image congen (75573) |
$16,563.36 |
$16,563.36 |
45.5× |
| CT limited/localized follow up study (76380) |
$6,200.78 |
$6,200.78 |
68.2× |
| CT lower ext w/wo contrast (73702) |
$17,371.36 |
$17,371.36 |
94.8× |
| CT lower extremity w contrast (73701) |
$16,342.13 |
$16,342.13 |
89.2× |
| CT lower extremity w/o contrast unilateral (73700) |
$14,882.67 |
$14,882.67 |
136.3× |
| CT lumbar spine w/contrast (72132) |
$10,277.66 |
$10,277.66 |
28.2× |
| CT lumbar spine w/o contrast (72131) |
$9,148.55 |
$9,148.55 |
83.8× |
| CT lumbar spine w/o then w/ con (72133) |
$13,560.68 |
$13,560.68 |
74.0× |
| CT maxillofacial area w/o contrast (70486) |
$9,020.77 |
$9,020.77 |
82.6× |
| CT maxillofacial w/contrast (70487) |
$10,634.84 |
$10,634.84 |
58.1× |
| CT maxillofacial w/o then w/ con (70488) |
$11,088.04 |
$11,088.04 |
60.5× |
| CT orbit sella ear w/o con (70480) |
$9,020.77 |
$9,020.77 |
82.6× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$11,984.76 |
$11,984.76 |
65.4× |
| CT pelvis w & w/o contrast (72194) |
$11,974.19 |
$11,974.19 |
65.4× |
| CT pelvis w/o contrast (72192) |
$9,968.21 |
$9,968.21 |
91.3× |
| CT soft tissue neck w/contrast (70491) |
$10,022.07 |
$10,022.07 |
54.7× |
| CT soft tissue neck w/o contrast (70490) |
$9,148.55 |
$9,148.55 |
83.8× |
| CT spine cervical w/wo contrast (72127) |
$11,174.67 |
$11,174.67 |
61.0× |
| CT thoracic spine w/contrast (72129) |
$8,212.14 |
$8,212.14 |
44.8× |
| CT thoracic spine w/o contrast (72128) |
$7,485.07 |
$7,485.07 |
68.6× |
| CT thoracic spine w/o then w/ con (72130) |
$14,166.19 |
$14,166.19 |
77.3× |
| CT thorax lung cancer scr c- (71271) |
$10,883.16 |
$10,883.16 |
99.7× |
| CT thorax w/o contrast (71250) |
$10,009.59 |
$10,009.59 |
91.7× |
| CT thorax w/o then w/ contrast (71270) |
$13,541.58 |
$13,541.58 |
73.9× |
| CT upper extremity w/dye (73201) |
$8,147.89 |
$8,147.89 |
22.4× |
| CT upper extremity w/o contrast rt (73200) |
$6,423.33 |
$6,423.33 |
58.8× |
| CTA chest w/wo contrast (71275) |
$13,140.56 |
$13,140.56 |
71.7× |
| CTA head w contrast (70496) |
$4,189.88 |
$4,189.88 |
22.9× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$9,688.10 |
$9,688.10 |
52.9× |
| Cta Neck (70498) |
$4,189.88 |
$4,189.88 |
22.9× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$4,189.88 |
$4,189.88 |
22.9× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Other Diagnostic Radiology FS (70170) |
$5,203.70 |
$5,203.70 |
20.9× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) |
$2,983.98 |
$2,983.98 |
5.3× |
| Dilation ureters/urethra rs&i (74485) |
$1,641.61 |
$1,641.61 |
0.8× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) |
$11,019.23 |
$11,019.23 |
5.4× |
| Diskography lumbar (72295) |
$10,263.68 |
$10,263.68 |
5.0× |
| Esophogram (74220) |
$2,059.88 |
$2,059.88 |
11.2× |
| Fetal biophysical profile non-stress testing (76818) |
$7,431.38 |
$7,431.38 |
68.1× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$2,424.61 |
$2,424.61 |
9.7× |
| Full mouth X-ray of teeth (70320) |
$5,668.15 |
$5,668.15 |
22.7× |
| Gastric emptying study (78264) |
$8,071.14 |
$8,071.14 |
19.3× |
| Gastroesophageal reflux study (78262) |
$5,318.52 |
$5,318.52 |
12.7× |
| Gated heart planar single (78472) |
$13,800.57 |
$13,800.57 |
33.1× |
| Heart infarct image (78466) |
$6,884.89 |
$6,884.89 |
16.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$7,898.06 |
$7,898.06 |
2.4× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$9,742.24 |
$9,742.24 |
3.0× |
| Hepatobil syst image w/drug (78227) |
$13,217.11 |
$13,217.11 |
23.3× |
| Hepatobiliary system imaging (78226) |
$11,014.28 |
$11,014.28 |
26.4× |
| Humerus min 2 views (73060) |
$1,506.46 |
$1,506.46 |
16.6× |
| Hysterosalpingography (74740) |
$2,831.18 |
$2,831.18 |
11.4× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$8,733.82 |
$8,733.82 |
20.9× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$4,762.84 |
$4,762.84 |
6.5× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$5,114.18 |
$5,114.18 |
13.1× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$5,681.65 |
$5,681.65 |
14.5× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$609.49 |
$609.49 |
1.6× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$609.49 |
$609.49 |
1.6× |
| Ivp (74400) |
$3,879.60 |
$3,879.60 |
21.2× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$10,574.56 |
$10,574.56 |
18.6× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$6,651.12 |
$6,651.12 |
11.7× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$5,924.25 |
$5,924.25 |
10.4× |
| Kidney w vascular flow (78701) |
$2,428.23 |
$2,428.23 |
5.8× |
| Liver & spleen; static only (78215) |
$10,472.89 |
$10,472.89 |
25.1× |
| Liver & spleen; w vasc flow (78216) |
$6,389.57 |
$6,389.57 |
15.3× |
| Liver imaging w/vascular flow (78202) |
$5,496.74 |
$5,496.74 |
9.7× |
| Lung perf&ventilat diferentl (78598) |
$19,265.44 |
$19,265.44 |
34.0× |
| Lung perfusion differential (78597) |
$9,614.21 |
$9,614.21 |
23.0× |
| Lung ventilat&perfus imaging (78582) |
$18,386.98 |
$18,386.98 |
32.4× |
| Lung ventilation imaging (78579) |
$11,905.36 |
$11,905.36 |
28.5× |
| Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75807) |
$4,352.72 |
$4,352.72 |
1.3× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$25,800.12 |
$25,800.12 |
70.8× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$22,145.39 |
$22,145.39 |
60.8× |
| Mammary ductogram multiple ducts (77054) |
$3,364.04 |
$3,364.04 |
13.5× |
| Mammary ductogram single (77053) |
$2,516.83 |
$2,516.83 |
10.1× |
| MRA head w & w/o contrast (70546) |
$18,819.61 |
$18,819.61 |
51.7× |
| MRA head w/o contrast (70544) |
$18,819.61 |
$18,819.61 |
75.5× |
| MRA neck w/contrast (70548) |
$18,819.61 |
$18,819.61 |
51.7× |
| MRA neck w/o contrast (70547) |
$18,819.61 |
$18,819.61 |
75.5× |
| MRA neck w/wo contrast (70549) |
$18,819.61 |
$18,819.61 |
51.7× |
| MRI abdomen w/contrast (74182) |
$20,069.10 |
$20,069.10 |
55.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$22,864.20 |
$22,864.20 |
62.8× |
| MRI abdomen w/o contrast (74181) |
$18,023.51 |
$18,023.51 |
72.3× |
| MRI any jnt lwr ext with con lt (73722) |
$22,145.39 |
$22,145.39 |
27.1× |
| MRI breast without contrast bilateral (77047) |
$18,037.21 |
$18,037.21 |
72.4× |
| MRI breast without contrast material unilateral (77046) |
$14,398.47 |
$14,398.47 |
57.8× |
| MRI cervical spine w/o contrast (72141) |
$16,635.48 |
$16,635.48 |
66.8× |
| MRI cervical spine with contrast (72142) |
$19,131.88 |
$19,131.88 |
52.5× |
| MRI chest w & w/o contrast (71552) |
$22,555.71 |
$22,555.71 |
61.9× |
| MRI chest w/contrast (71551) |
$17,714.91 |
$17,714.91 |
21.6× |
| MRI chest w/o contrast (71550) |
$17,714.91 |
$17,714.91 |
71.1× |
| MRI joint upper ext w/contrast (73222) |
$25,656.88 |
$25,656.88 |
31.3× |
| MRI joint upr extr w/o&w/dye (73223) |
$22,676.83 |
$22,676.83 |
62.2× |
| MRI joint upr extrem w/o dye (73221) |
$19,843.35 |
$19,843.35 |
79.6× |
| Mri Lower Extremity W/O Dye (73718) |
$16,794.98 |
$16,794.98 |
67.4× |
| MRI lumbar spine with contrast (72149) |
$18,206.98 |
$18,206.98 |
50.0× |
| MRI lumbar w/wo contrast (72158) |
$25,822.15 |
$25,822.15 |
70.9× |
| MRI lwr ext w/o jnts with con rt (73719) |
$17,304.73 |
$17,304.73 |
47.5× |
| MRI orbit/face/neck w/contrast (70542) |
$18,216.42 |
$18,216.42 |
50.0× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$18,216.42 |
$18,216.42 |
50.0× |
| MRI orbit/face/neck w/o contrast (70540) |
$23,057.10 |
$23,057.10 |
92.5× |
| MRI pelvis w/ contrast (72196) |
$23,258.17 |
$23,258.17 |
63.8× |
| MRI pelvis w/o contrast (72195) |
$18,417.45 |
$18,417.45 |
73.9× |
| MRI pelvis w/wo contrast (72197) |
$23,856.80 |
$23,856.80 |
65.5× |
| MRI spine cervical wo/w contrast (72156) |
$27,342.37 |
$27,342.37 |
75.1× |
| MRI spine thoracic w/contrast (72147) |
$19,170.42 |
$19,170.42 |
52.6× |
| MRI thoracic spine w wo contrast (72157) |
$27,405.68 |
$27,405.68 |
75.2× |
| MRI thoracic spine w/o contrast (72146) |
$16,674.04 |
$16,674.04 |
66.9× |
| MRI tmj (70336) |
$17,714.91 |
$17,714.91 |
71.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$17,836.05 |
$17,836.05 |
71.6× |
| Mri Upper Extremity W/Dye (73219) |
$16,214.43 |
$16,214.43 |
44.5× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$19,843.35 |
$19,843.35 |
54.5× |
| Myelogram thoracic (72255) |
$14,012.04 |
$14,012.04 |
17.1× |
| Myelography 2 or more regions (72270) |
$19,930.10 |
$19,930.10 |
24.3× |
| Myelography lumbosacral (72265) |
$14,012.04 |
$14,012.04 |
17.1× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$25,322.56 |
$25,322.56 |
17.0× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$25,322.56 |
$25,322.56 |
17.0× |
| Myocardial spect single study at rest or stress (78451) |
$12,671.01 |
$12,671.01 |
9.4× |
| Myocrd img PET metab eval single study (78459) |
$23,930.08 |
$23,930.08 |
17.7× |
| Nm bone 3 phase (78315) |
$10,511.25 |
$10,511.25 |
25.2× |
| Nm bone imaging whole body (78306) |
$10,419.64 |
$10,419.64 |
25.0× |
| Nm bone marrow scan limited (78102) |
$3,627.84 |
$3,627.84 |
8.7× |
| Nm bone marrow scan multiple (78103) |
$8,090.70 |
$8,090.70 |
19.4× |
| Nm bone multi (78305) |
$9,050.45 |
$9,050.45 |
21.7× |
| Nm heart perfusion spect stress rest (78452) |
$23,662.20 |
$23,662.20 |
17.5× |
| Nm liver image static only (78201) |
$11,553.75 |
$11,553.75 |
20.4× |
| Nm lymph system (78195) |
$8,733.82 |
$8,733.82 |
15.4× |
| Nm myocard infarct spect (78469) |
$13,311.55 |
$13,311.55 |
23.5× |
| Nm thyroid ca mets limited (78015) |
$5,740.33 |
$5,740.33 |
13.8× |
| Nose to rectum for fb child (76010) |
$4,814.96 |
$4,814.96 |
53.0× |
| Nuclear medicine study of brain, 4 static views or more (78605) |
$7,747.64 |
$7,747.64 |
13.7× |
| Nuclear medicine study of heart muscle following heart attack with measurement of internal blood volume ejected with… (78468) |
$713 |
$713 |
1.3× |
| Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume… (78494) |
$713 |
$713 |
1.7× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$6,447.93 |
$6,447.93 |
15.4× |
| Nuclear medicine study to assess blood clot in vein using radiolabeled peptide (78456) |
$7,049.68 |
$7,049.68 |
5.2× |
| Nuclear rx IV admin (79101) |
$8,986.29 |
$8,986.29 |
36.9× |
| Ob us < 14 wks single fetus (76801) |
$5,587.34 |
$5,587.34 |
51.2× |
| Oral radiopharm rx (79005) |
$15,289.56 |
$15,289.56 |
62.7× |
| Parathyroid imaging (78070) |
$6,144.04 |
$6,144.04 |
14.7× |
| Peritoneal-venous shunt patency test (78291) |
$8,532.33 |
$8,532.33 |
20.4× |
| PET brain metabolic eval (78608) |
$23,930.08 |
$23,930.08 |
16.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$23,425.88 |
$23,425.88 |
15.7× |
| PET imaging CT for attenuation limited area (78814) |
$23,425.88 |
$23,425.88 |
15.7× |
| PET imaging for CT attenuation whole body (78816) |
$23,425.88 |
$23,425.88 |
15.7× |
| PET imaging limited area chest head/neck (78811) |
$23,425.88 |
$23,425.88 |
17.3× |
| PET imaging whole body (78813) |
$24,090.02 |
$24,090.02 |
16.1× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Age Under 21 (78812) |
$23,425.88 |
$23,425.88 |
15.7× |
| Proton trmt intermediate (77523) |
$1,948.32 |
$1,948.32 |
1.5× |
| Proton trmt simple w/o comp (77520) |
$1,156.03 |
$1,156.03 |
2.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$14,342.11 |
$14,342.11 |
4.3× |
| Pulmonary perfusion imaging particulate (78580) |
$9,614.21 |
$9,614.21 |
23.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$996.88 |
$996.88 |
1.7× |
| Radex hip unilateral with pelvis 1 view (73501) |
$1,857.24 |
$1,857.24 |
20.4× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$1,915.83 |
$1,915.83 |
21.1× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$2,034.12 |
$2,034.12 |
18.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$3,811.46 |
$3,811.46 |
34.9× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$4,284.68 |
$4,284.68 |
39.2× |
| Radex spine cervical 2 or 3 views (72040) |
$2,713.76 |
$2,713.76 |
29.9× |
| Radex spine cervical 4 or 5 views (72050) |
$3,074.82 |
$3,074.82 |
28.2× |
| Radex spine cervical 6 or more views (72052) |
$3,416.59 |
$3,416.59 |
31.3× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$2,177.15 |
$2,177.15 |
24.0× |
| Radiation tx delivery lvl 1 (77402) |
$649.11 |
$649.11 |
6.1× |
| Radiation tx delivery lvl 2 (77407) |
$649.11 |
$649.11 |
1.6× |
| Radiation tx delivery lvl 3 (77412) |
$667.71 |
$667.71 |
1.2× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$2,561.65 |
$2,561.65 |
23.5× |
| Radiologic exam esophagus double contrast study (74221) |
$2,398.29 |
$2,398.29 |
13.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$3,906.93 |
$3,906.93 |
21.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$3,906.93 |
$3,906.93 |
21.3× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$1,486.61 |
$1,486.61 |
16.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,723.24 |
$1,723.24 |
19.0× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$2,472.88 |
$2,472.88 |
22.7× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) |
$2,818.52 |
$2,818.52 |
25.8× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration UNSCHEDULED (79300) |
$15,557.74 |
$15,557.74 |
63.8× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$16,824.63 |
$16,824.63 |
69.0× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$15,295.04 |
$15,295.04 |
62.8× |
| Renal cyst study (74470) |
$7,000.88 |
$7,000.88 |
12.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$8,474.79 |
$8,474.79 |
20.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$8,733.82 |
$8,733.82 |
20.9× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$6,165.18 |
$6,165.18 |
10.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$4,981.03 |
$4,981.03 |
8.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$9,501.57 |
$9,501.57 |
16.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$16,824.63 |
$16,824.63 |
69.0× |
| Saline infused sonohysterogram (76831) |
$4,906.47 |
$4,906.47 |
19.7× |
| Salivary gland funct study (78232) |
$8,877.87 |
$8,877.87 |
21.3× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$88.22 |
$88.22 |
3.8× |
| Selective spinal angiogram (75705) |
$11,029.19 |
$11,029.19 |
1.9× |
| Shoulder arthrogram (73040) |
$2,829.54 |
$2,829.54 |
7.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$5,348.78 |
$5,348.78 |
49.0× |
| Simulation complex (77290) |
$1,941.04 |
$1,941.04 |
5.0× |
| Simulation intermediate (77285) |
$817.27 |
$817.27 |
2.1× |
| Simulation simple (77280) |
$609.49 |
$609.49 |
4.3× |
| Small bowel series (74250) |
$3,700.54 |
$3,700.54 |
20.2× |
| Special dosimetry (77331) |
$1,651.52 |
$1,651.52 |
11.8× |
| Special physics consult (77370) |
$1,414.89 |
$1,414.89 |
10.1× |
| Special treatment procedure (77470) |
$2,737.84 |
$2,737.84 |
4.7× |
| Splenoportography (75810) |
$11,079.77 |
$11,079.77 |
3.4× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Other Diagnostic Radiology FS (70332) |
$2,035.29 |
$2,035.29 |
8.2× |
| Testicular imaging w/flow (78761) |
$5,753.13 |
$5,753.13 |
13.8× |
| Thyroid met imaging body (78018) |
$9,169.71 |
$9,169.71 |
16.2× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$8,631.36 |
$8,631.36 |
20.7× |
| Treatment device intermediate (77333) |
$717.84 |
$717.84 |
5.1× |
| Treatment devices complex (77334) |
$717.84 |
$717.84 |
1.8× |
| Treatment devices simple (77332) |
$717.84 |
$717.84 |
5.1× |
| Ultrasound breast limited (76642) |
$4,078.10 |
$4,078.10 |
44.9× |
| Ultrasound, abdomen limited (76705) |
$4,440.13 |
$4,440.13 |
40.7× |
| Unlisted CT procedure (76497) |
$3,949.26 |
$3,949.26 |
43.5× |
| Unlisted diagnostic radiographic procedure (76499) |
$8,953.55 |
$8,953.55 |
98.5× |
| Urethrocystography retrograde rs&i (74450) |
$2,707.87 |
$2,707.87 |
10.9× |
| Urethrocystography voiding (74455) |
$2,707 |
$2,707 |
10.9× |
| Urography antegrade (74425) |
$3,704.82 |
$3,704.82 |
10.2× |
| Urography retrograde w/wo kub (74420) |
$2,785.90 |
$2,785.90 |
7.6× |
| Us abdominal aorta real time screen study aaa (76706) |
$5,990.13 |
$5,990.13 |
54.9× |
| Us breast uni real time with image complete (76641) |
$4,468.33 |
$4,468.33 |
40.9× |
| Us chest (76604) |
$3,984.42 |
$3,984.42 |
36.5× |
| Us compl joint r-t w/image documentation (76881) |
$11,147.07 |
$11,147.07 |
102.1× |
| Us encephalogram (76506) |
$7,431.38 |
$7,431.38 |
68.1× |
| Us guided compression repair (76936) |
$12,964.35 |
$12,964.35 |
57.5× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$7,540.13 |
$7,540.13 |
83.0× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$6,439.50 |
$6,439.50 |
70.9× |
| Us kidney transplanted (76776) |
$9,945.66 |
$9,945.66 |
91.1× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$7,431.38 |
$7,431.38 |
68.1× |
| Us ob followup per fetus (76816) |
$6,329.27 |
$6,329.27 |
58.0× |
| Us ob limited 1 or more fetuses (76815) |
$3,797.59 |
$3,797.59 |
34.8× |
| Us obstetric transvaginal (76817) |
$4,477.15 |
$4,477.15 |
41.0× |
| Us pelvic limited or f/u non-ob (76857) |
$4,647.81 |
$4,647.81 |
42.6× |
| Us pelvis complete (76856) |
$5,418.75 |
$5,418.75 |
49.6× |
| Us retroperitoneal complete (76770) |
$4,911.38 |
$4,911.38 |
45.0× |
| Us retroperitoneal limited (76775) |
$5,899 |
$5,899 |
54.0× |
| Us scrotum (76870) |
$4,656.10 |
$4,656.10 |
42.6× |
| Us soft tissue head/neck (76536) |
$4,473.26 |
$4,473.26 |
41.0× |
| Us spinal canal (76800) |
$7,431.38 |
$7,431.38 |
68.1× |
| Us transrectal (76872) |
$4,170.87 |
$4,170.87 |
38.2× |
| Us transrectal prostate volume (76873) |
$9,851.92 |
$9,851.92 |
90.2× |
| Us unlstd proc (76999) |
$4,141.24 |
$4,141.24 |
45.6× |
| Vascular flow imaging (78445) |
$4,471.17 |
$4,471.17 |
10.7× |
| Vein X-ray liver w/hemodynam (75885) |
$10,485.99 |
$10,485.99 |
3.2× |
| Venogram extremity bilateral (75822) |
$1,927.38 |
$1,927.38 |
1.2× |
| Venogram ivc w serialography (75825) |
$8,463.56 |
$8,463.56 |
2.6× |
| Venogram svc w serialography (75827) |
$9,227.50 |
$9,227.50 |
5.6× |
| Venography ext unilateral (75820) |
$3,542.28 |
$3,542.28 |
2.2× |
| Venography renal unilateral selective rs&i (75831) |
$7,165.88 |
$7,165.88 |
2.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$8,746.57 |
$8,746.57 |
2.7× |
| Venous sampling by catheter (75893) |
$5,589.18 |
$5,589.18 |
1.0× |
| Venous thrombosis imaging - nm extremity veins thrombosis right (78457) |
$4,409.74 |
$4,409.74 |
7.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,279.37 |
$1,279.37 |
14.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,613.01 |
$1,613.01 |
17.7× |
| X-ray aorta leg arteries (75630) |
$16,275.26 |
$16,275.26 |
4.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$4,835.79 |
$4,835.79 |
26.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$1,678.36 |
$1,678.36 |
18.5× |
| X-ray exam hips bi 3-4 views (73522) |
$4,048.07 |
$4,048.07 |
37.1× |
| X-ray exam of finger(s) (73140) |
$1,540.91 |
$1,540.91 |
17.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$4,058.31 |
$4,058.31 |
22.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$2,479.90 |
$2,479.90 |
27.3× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$1,468.62 |
$1,468.62 |
16.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,702.50 |
$1,702.50 |
18.7× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$1,461.71 |
$1,461.71 |
13.4× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$1,692.08 |
$1,692.08 |
18.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$1,441.15 |
$1,441.15 |
15.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$1,441.15 |
$1,441.15 |
15.9× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$2,001.71 |
$2,001.71 |
22.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$2,210.49 |
$2,210.49 |
20.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$2,001.71 |
$2,001.71 |
22.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,606.12 |
$1,606.12 |
14.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,607.68 |
$1,607.68 |
14.7× |
| X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) |
$3,013.89 |
$3,013.89 |
27.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$2,297.47 |
$2,297.47 |
25.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$3,270.64 |
$3,270.64 |
30.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$2,101 |
$2,101 |
19.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,671.60 |
$1,671.60 |
18.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,647.54 |
$1,647.54 |
18.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$2,933.84 |
$2,933.84 |
32.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$2,672.29 |
$2,672.29 |
24.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,537.28 |
$1,537.28 |
14.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$1,702.50 |
$1,702.50 |
18.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$1,506.46 |
$1,506.46 |
16.6× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$1,513.29 |
$1,513.29 |
16.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,674.90 |
$1,674.90 |
18.4× |
| Xr abdomen 1 view (74018) |
$1,678.36 |
$1,678.36 |
18.5× |
| Xr abdomen 2 views (74019) |
$2,452.13 |
$2,452.13 |
22.5× |
| Xr abdomen 3 views (74021) |
$2,737.59 |
$2,737.59 |
25.1× |
| Xr arthrogram ankle (73615) |
$3,623.79 |
$3,623.79 |
9.9× |
| Xr arthrogram elbow (73085) |
$2,829.54 |
$2,829.54 |
7.8× |
| Xr arthrogram hip (73525) |
$2,829.54 |
$2,829.54 |
7.8× |
| Xr bone density axial (77080) |
$2,544.72 |
$2,544.72 |
23.3× |
| Xr bone survey infant (77076) |
$2,544.04 |
$2,544.04 |
23.3× |
| Xr chest 1 view (71045) |
$1,544.91 |
$1,544.91 |
17.0× |
| Xr chest 2 views (71046) |
$1,960.56 |
$1,960.56 |
21.6× |
| Xr chest 3 views (71047) |
$2,462.52 |
$2,462.52 |
27.1× |
| Xr cystogram 3+ views (74430) |
$2,632.33 |
$2,632.33 |
7.2× |
| Xr eye foreign body (70030) |
$2,049.91 |
$2,049.91 |
22.6× |
| Xr facial bones 3 views (70150) |
$3,356.62 |
$3,356.62 |
30.7× |
| Xr lower extremity 2 views infant (73592) |
$1,855.54 |
$1,855.54 |
20.4× |
| Xr mandible 4 views (70110) |
$2,232.21 |
$2,232.21 |
20.4× |
| Xr myelogram c-spine (72240) |
$14,012.04 |
$14,012.04 |
17.1× |
| Xr nasal bones (70160) |
$1,585.65 |
$1,585.65 |
17.4× |
| Xr pelvis 3 views (72190) |
$1,678.36 |
$1,678.36 |
15.4× |
| Xr sialogram (70390) |
$681.69 |
$681.69 |
2.7× |
| Xr spine 1 view (72020) |
$2,125.72 |
$2,125.72 |
23.4× |
| Xr sternum 2 views (71120) |
$2,084.29 |
$2,084.29 |
22.9× |
| Xr surgical specimen (76098) |
$808.23 |
$808.23 |
1.4× |
| Xr upper extremity 2 views infant (73092) |
$1,645.35 |
$1,645.35 |
15.1× |
| Xray elbow 2 views (73070) |
$1,080.08 |
$1,080.08 |
11.9× |
| Xray forearm 2 views (73090) |
$1,540.91 |
$1,540.91 |
17.0× |
| Xray internal auditory meati compl (70134) |
$1,260.18 |
$1,260.18 |
2.2× |
| Xray knee 1 or 2 views rt (73560) |
$2,001.71 |
$2,001.71 |
22.0× |
| Xray neck soft tissue (70360) |
$1,833.29 |
$1,833.29 |
20.2× |
| Xray optic foramina (70190) |
$1,516.77 |
$1,516.77 |
16.7× |
| Xray orbits complete min 4 views (70200) |
$3,322.29 |
$3,322.29 |
30.4× |
| Xray pelvis 1 or 2 views (72170) |
$1,678.36 |
$1,678.36 |
15.4× |
| Xray ribs bilateral 3 views (71110) |
$2,188.67 |
$2,188.67 |
20.0× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$2,297.47 |
$2,297.47 |
21.0× |
| Xray scapula complete (73010) |
$1,630.39 |
$1,630.39 |
14.9× |
| Xray shoulder 1 view (73020) |
$1,537.28 |
$1,537.28 |
16.9× |
| Xray sinuses paranasal <3 views (70210) |
$2,742.15 |
$2,742.15 |
30.2× |
| Xray spine thoracic 2 views (72070) |
$1,607.08 |
$1,607.08 |
14.7× |
| Xray spine thoracic 3 views (72072) |
$2,177.15 |
$2,177.15 |
19.9× |
| Xray tibia-fibula 2 views bil (73590) |
$1,509.79 |
$1,509.79 |
16.6× |
| Xray tmj's bilateral open-clsc (70330) |
$2,479.90 |
$2,479.90 |
27.3× |