| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$3,928.10 |
$3,928.10 |
2.7× |
| Acute gi blood loss imaging (78278) |
$7,558.73 |
$7,558.73 |
18.1× |
| Angio extremity unilateral (75710) |
$17,990.20 |
$17,990.20 |
5.5× |
| Angio pulmonary unilateral (75741) |
$19,927.22 |
$19,927.22 |
6.0× |
| Angiogram extremity bilateral (75716) |
$22,316.56 |
$22,316.56 |
6.8× |
| Angiogram pelvic (75736) |
$21,806.60 |
$21,806.60 |
3.8× |
| Angiography internal mammary rs&i (75756) |
$17,573.30 |
$17,573.30 |
5.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$33,140.38 |
$33,140.38 |
10.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$15,225.26 |
$15,225.26 |
2.6× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$3,104.31 |
$3,104.31 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$14,233.74 |
$14,233.74 |
4.3× |
| Ankle 2 views (73600) |
$5,022.42 |
$5,022.42 |
55.3× |
| Arthrography knee lt (73580) |
$5,746.50 |
$5,746.50 |
15.8× |
| Arthrography wrist lt (73115) |
$6,328.30 |
$6,328.30 |
17.4× |
| Barium enema (74270) |
$7,754.79 |
$7,754.79 |
42.3× |
| Basic dosimetry (77300) |
$1,799.60 |
$1,799.60 |
12.8× |
| Bilat selctv renal venogram (75833) |
$13,945.18 |
$13,945.18 |
4.2× |
| Bone age studies (77072) |
$3,466.68 |
$3,466.68 |
31.8× |
| Bone imaging limited area (78300) |
$5,541.40 |
$5,541.40 |
13.3× |
| Bone marrow imaging whole body (78104) |
$6,939.74 |
$6,939.74 |
16.6× |
| Bone survey complete (77075) |
$5,908.74 |
$5,908.74 |
54.1× |
| Bowel imaging (78290) |
$3,943.68 |
$3,943.68 |
9.4× |
| Brain flow imaging only - nm brain flow only brain death (78610) |
$4,822.50 |
$4,822.50 |
8.5× |
| Brain image w/flow 4 + views (78606) |
$7,693.71 |
$7,693.71 |
13.6× |
| Card MRI w/stress img & dye (75563) |
$39,662.95 |
$39,662.95 |
48.5× |
| Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or… (78481) |
$3,645.85 |
$3,645.85 |
6.4× |
| Cardiac MRI w/stress img (75559) |
$35,696.65 |
$35,696.65 |
62.6× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$39,662.95 |
$39,662.95 |
108.9× |
| Cholecystography, oral contrast Other Diagnostic Radiology FS (74290) |
$2,923.64 |
$2,923.64 |
16.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$6,282.72 |
$6,282.72 |
34.3× |
| Cisternogram (78630) |
$7,165.53 |
$7,165.53 |
12.6× |
| Clavicle complete (73000) |
$4,223.21 |
$4,223.21 |
46.5× |
| Computed tomographic (CT) colonography, screening, including image postprocessing UNSCHEDULED (74263) |
$8,243.59 |
$8,243.59 |
33.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$12,473.84 |
$12,473.84 |
68.1× |
| Contrast exam abdominl aorta (75625) |
$31,110.86 |
$31,110.86 |
9.4× |
| Contrast exam thoracic aorta (75605) |
$15,804.18 |
$15,804.18 |
2.7× |
| Csf shunt evaluation (78645) |
$4,757.95 |
$4,757.95 |
8.4× |
| CT - st neck w&wo contr (70492) |
$27,458.12 |
$27,458.12 |
149.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$48,392.45 |
$48,392.45 |
132.8× |
| CT abdomen and pelvis without contrast (74176) |
$31,599.17 |
$31,599.17 |
126.8× |
| CT abdomen w wo contrast (74170) |
$16,616.41 |
$16,616.41 |
90.7× |
| CT abdomen w/contrast (74160) |
$26,292.13 |
$26,292.13 |
143.5× |
| CT abdomen w/o contrast (74150) |
$18,153.14 |
$18,153.14 |
166.3× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$23,046.37 |
$23,046.37 |
63.3× |
| CT angio abdom w/o & w/dye (74175) |
$11,521.64 |
$11,521.64 |
62.9× |
| CT angio abdominal arteries (75635) |
$21,031.23 |
$21,031.23 |
114.8× |
| CT angio hrt w/3d image (75574) |
$22,897.16 |
$22,897.16 |
62.8× |
| CT angiograph pelv w/o&w/dye (72191) |
$11,521.64 |
$11,521.64 |
62.9× |
| CT cervical spine w/contrast (72126) |
$25,236.87 |
$25,236.87 |
69.3× |
| CT cervical spine w/o contrast (72125) |
$14,441.27 |
$14,441.27 |
132.3× |
| CT chest w/contrast (71260) |
$26,292.13 |
$26,292.13 |
143.5× |
| CT colonography diag w cont (74262) |
$17,148.63 |
$17,148.63 |
93.6× |
| CT colonography w/o cntrst (74261) |
$8,243.59 |
$8,243.59 |
75.5× |
| CT extremity upper w & w/o contrast (73202) |
$16,491.80 |
$16,491.80 |
90.0× |
| CT head/brain with contrast (70460) |
$21,463.48 |
$21,463.48 |
117.2× |
| CT head/brain without and with contrast (70470) |
$27,458.12 |
$27,458.12 |
149.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$24,729.24 |
$24,729.24 |
67.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$12,033.88 |
$12,033.88 |
132.4× |
| CT hrt w/3d image congen (75573) |
$17,148.63 |
$17,148.63 |
47.1× |
| CT limited/localized follow up study (76380) |
$6,868.38 |
$6,868.38 |
75.6× |
| CT lower ext w/wo contrast (73702) |
$16,491.80 |
$16,491.80 |
90.0× |
| CT lower extremity w contrast (73701) |
$13,436.79 |
$13,436.79 |
73.4× |
| CT lower extremity w/o contrast unilateral (73700) |
$13,436.79 |
$13,436.79 |
123.1× |
| CT lumbar spine w/contrast (72132) |
$25,236.87 |
$25,236.87 |
69.3× |
| CT lumbar spine w/o contrast (72131) |
$20,248.25 |
$20,248.25 |
185.5× |
| CT lumbar spine w/o then w/ con (72133) |
$39,307.42 |
$39,307.42 |
214.6× |
| CT maxillofacial area w/o contrast (70486) |
$25,236.87 |
$25,236.87 |
231.2× |
| CT maxillofacial w/contrast (70487) |
$26,292.13 |
$26,292.13 |
143.5× |
| CT maxillofacial w/o then w/ con (70488) |
$27,458.12 |
$27,458.12 |
149.9× |
| CT orbit sella ear w/o con (70480) |
$8,195.89 |
$8,195.89 |
75.1× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$16,437.96 |
$16,437.96 |
89.7× |
| CT pelvis w & w/o contrast (72194) |
$24,287.75 |
$24,287.75 |
132.6× |
| CT pelvis w/o contrast (72192) |
$13,436.79 |
$13,436.79 |
123.1× |
| CT soft tissue neck w/contrast (70491) |
$26,292.13 |
$26,292.13 |
143.5× |
| CT soft tissue neck w/o contrast (70490) |
$25,236.87 |
$25,236.87 |
231.2× |
| CT spine cervical w/wo contrast (72127) |
$39,307.42 |
$39,307.42 |
214.6× |
| CT thoracic spine w/contrast (72129) |
$25,236.87 |
$25,236.87 |
137.8× |
| CT thoracic spine w/o contrast (72128) |
$14,441.27 |
$14,441.27 |
132.3× |
| CT thoracic spine w/o then w/ con (72130) |
$39,307.42 |
$39,307.42 |
214.6× |
| CT thorax w/o contrast (71250) |
$25,236.87 |
$25,236.87 |
231.2× |
| CT thorax w/o then w/ contrast (71270) |
$30,531.59 |
$30,531.59 |
166.7× |
| CT upper extremity w/dye (73201) |
$13,436.79 |
$13,436.79 |
36.9× |
| CT upper extremity w/o contrast rt (73200) |
$11,344.74 |
$11,344.74 |
103.9× |
| CTA chest w/wo contrast (71275) |
$10,081.83 |
$10,081.83 |
55.0× |
| CTA head w contrast (70496) |
$11,521.64 |
$11,521.64 |
62.9× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$11,521.64 |
$11,521.64 |
62.9× |
| Cta Neck (70498) |
$11,521.64 |
$11,521.64 |
62.9× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$11,521.64 |
$11,521.64 |
62.9× |
| Dilation ureters/urethra rs&i (74485) |
$4,279.90 |
$4,279.90 |
2.0× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) |
$9,863.55 |
$9,863.55 |
4.8× |
| Diskography lumbar (72295) |
$8,874.74 |
$8,874.74 |
4.4× |
| Doppler echo fetal spectral display complete (76827) |
$3,427.70 |
$3,427.70 |
31.4× |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study… (76828) |
$1,372.66 |
$1,372.66 |
12.6× |
| Echo exam of eye (76529) |
$3,427.70 |
$3,427.70 |
37.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,372.66 |
$1,372.66 |
5.5× |
| Esophogram (74220) |
$5,022.42 |
$5,022.42 |
27.4× |
| Fetal biophysical profile non-stress testing (76818) |
$1,340.99 |
$1,340.99 |
12.3× |
| Fetal echo complete (76825) |
$3,427.70 |
$3,427.70 |
6.0× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$7,281.27 |
$7,281.27 |
29.2× |
| Gastric emptying study (78264) |
$10,255.34 |
$10,255.34 |
24.6× |
| Gastroesophageal reflux study (78262) |
$10,255.34 |
$10,255.34 |
24.6× |
| Gated heart planar single (78472) |
$9,166.73 |
$9,166.73 |
22.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,956.49 |
$2,956.49 |
0.9× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Other… (75889) |
$2,956.49 |
$2,956.49 |
0.9× |
| Hepatobil syst image w/drug (78227) |
$16,272.10 |
$16,272.10 |
28.7× |
| Hepatobiliary system imaging (78226) |
$14,884.19 |
$14,884.19 |
35.7× |
| Humerus min 2 views (73060) |
$4,223.21 |
$4,223.21 |
46.5× |
| Hysterosalpingography (74740) |
$13,070.94 |
$13,070.94 |
52.5× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$1,113.56 |
$1,113.56 |
1.5× |
| Ivp (74400) |
$3,336.91 |
$3,336.91 |
18.2× |
| Ivp w tomography (74415) |
$8,410.56 |
$8,410.56 |
45.9× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$14,925.26 |
$14,925.26 |
26.3× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$10,476.88 |
$10,476.88 |
18.5× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$9,920.82 |
$9,920.82 |
17.5× |
| Liver & spleen; static only (78215) |
$5,586.89 |
$5,586.89 |
13.4× |
| Lung perfusion differential (78597) |
$9,691.96 |
$9,691.96 |
23.2× |
| Lung ventilat&perfus imaging (78582) |
$8,358.32 |
$8,358.32 |
14.7× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75803) |
$12,758.06 |
$12,758.06 |
7.8× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Other Diagnostic Radiology FS (75801) |
$6,676.70 |
$6,676.70 |
10.2× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$31,708.91 |
$31,708.91 |
87.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$26,267.33 |
$26,267.33 |
72.1× |
| MRA head w & w/o contrast (70546) |
$31,592.66 |
$31,592.66 |
86.7× |
| MRA head w/contrast (70545) |
$14,682.04 |
$14,682.04 |
40.3× |
| MRA head w/o contrast (70544) |
$8,012.91 |
$8,012.91 |
32.2× |
| MRA neck w/contrast (70548) |
$22,820.28 |
$22,820.28 |
62.6× |
| MRA neck w/o contrast (70547) |
$22,820.28 |
$22,820.28 |
91.6× |
| MRA neck w/wo contrast (70549) |
$31,592.66 |
$31,592.66 |
86.7× |
| MRI abdomen w/contrast (74182) |
$28,129 |
$28,129 |
77.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$32,546.91 |
$32,546.91 |
89.3× |
| MRI abdomen w/o contrast (74181) |
$9,373.31 |
$9,373.31 |
37.6× |
| MRI any jnt lwr ext with con lt (73722) |
$21,728.64 |
$21,728.64 |
26.5× |
| MRI cardiac w/o contrast (75557) |
$35,696.65 |
$35,696.65 |
143.3× |
| MRI cervical spine w/o contrast (72141) |
$8,012.91 |
$8,012.91 |
32.2× |
| MRI cervical spine with contrast (72142) |
$24,168.58 |
$24,168.58 |
66.3× |
| MRI chest w & w/o contrast (71552) |
$32,546.91 |
$32,546.91 |
89.3× |
| MRI chest w/contrast (71551) |
$24,333.18 |
$24,333.18 |
29.7× |
| MRI chest w/o contrast (71550) |
$8,012.91 |
$8,012.91 |
32.2× |
| MRI joint upper ext w/contrast (73222) |
$17,670.98 |
$17,670.98 |
21.6× |
| MRI joint upr extr w/o&w/dye (73223) |
$31,708.91 |
$31,708.91 |
87.0× |
| MRI joint upr extrem w/o dye (73221) |
$8,012.91 |
$8,012.91 |
32.2× |
| Mri Lower Extremity W/O Dye (73718) |
$21,654.64 |
$21,654.64 |
86.9× |
| MRI lumbar spine with contrast (72149) |
$24,168.58 |
$24,168.58 |
66.3× |
| MRI lumbar w/wo contrast (72158) |
$32,181.51 |
$32,181.51 |
88.3× |
| MRI lwr ext w/o jnts with con rt (73719) |
$22,853.49 |
$22,853.49 |
62.7× |
| MRI orbit/face/neck w/contrast (70542) |
$24,333.18 |
$24,333.18 |
66.8× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$32,352.13 |
$32,352.13 |
88.8× |
| MRI orbit/face/neck w/o contrast (70540) |
$8,012.91 |
$8,012.91 |
32.2× |
| MRI pelvis w/ contrast (72196) |
$22,820.28 |
$22,820.28 |
62.6× |
| MRI pelvis w/o contrast (72195) |
$6,806.76 |
$6,806.76 |
27.3× |
| MRI pelvis w/wo contrast (72197) |
$31,592.66 |
$31,592.66 |
86.7× |
| MRI spine cervical wo/w contrast (72156) |
$32,181.51 |
$32,181.51 |
88.3× |
| MRI spine thoracic w/contrast (72147) |
$24,523.42 |
$24,523.42 |
67.3× |
| MRI thoracic spine w wo contrast (72157) |
$32,546.91 |
$32,546.91 |
89.3× |
| MRI thoracic spine w/o contrast (72146) |
$8,012.91 |
$8,012.91 |
32.2× |
| MRI tmj (70336) |
$24,333.18 |
$24,333.18 |
97.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$8,012.91 |
$8,012.91 |
32.2× |
| Mri Upper Extremity W/Dye (73219) |
$23,694.50 |
$23,694.50 |
65.0× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$31,708.91 |
$31,708.91 |
87.0× |
| Myelogram thoracic (72255) |
$11,569.60 |
$11,569.60 |
14.1× |
| Myelography 2 or more regions (72270) |
$3,695.53 |
$3,695.53 |
4.5× |
| Myelography lumbosacral (72265) |
$11,569.60 |
$11,569.60 |
14.1× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$7,258.80 |
$7,258.80 |
4.9× |
| Myocardial perfusion planar 1 study rest/stress (78453) |
$21,694.67 |
$21,694.67 |
16.0× |
| Myocardial perfusion planar multiple studies (78454) |
$21,694.67 |
$21,694.67 |
16.0× |
| Myocardial spect single study at rest or stress (78451) |
$21,694.67 |
$21,694.67 |
16.0× |
| Nm adrenal imaging (78075) |
$7,083.37 |
$7,083.37 |
5.2× |
| Nm bone 3 phase (78315) |
$5,523.80 |
$5,523.80 |
13.2× |
| Nm bone imaging whole body (78306) |
$13,528.54 |
$13,528.54 |
32.4× |
| Nm bone marrow scan limited (78102) |
$3,808.87 |
$3,808.87 |
9.1× |
| Nm bone marrow scan multiple (78103) |
$5,374.31 |
$5,374.31 |
12.9× |
| Nm heart perfusion spect stress rest (78452) |
$21,694.67 |
$21,694.67 |
16.0× |
| Nm liver image static only (78201) |
$1,172.25 |
$1,172.25 |
2.1× |
| Nm lymph system (78195) |
$7,096.57 |
$7,096.57 |
12.5× |
| Nm thyroid imaging only (78013) |
$2,589.52 |
$2,589.52 |
6.2× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$7,693.71 |
$7,693.71 |
18.4× |
| Nuclear medicine study to assess blood clot in vein using radiolabeled peptide (78456) |
$4,822.50 |
$4,822.50 |
3.6× |
| Ob us < 14 wks single fetus (76801) |
$3,744.47 |
$3,744.47 |
34.3× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$3,427.70 |
$3,427.70 |
31.4× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$3,427.70 |
$3,427.70 |
31.4× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$3,427.70 |
$3,427.70 |
31.4× |
| Oral radiopharm rx (79005) |
$11,164.96 |
$11,164.96 |
45.8× |
| Parathyroid imaging (78070) |
$7,814.02 |
$7,814.02 |
18.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$10,280.28 |
$10,280.28 |
24.6× |
| Peritoneogram rs&i (74190) |
$1,615.67 |
$1,615.67 |
2.8× |
| PET brain metabolic eval (78608) |
$7,258.80 |
$7,258.80 |
4.9× |
| PET imaging limited area chest head/neck (78811) |
$7,258.80 |
$7,258.80 |
5.4× |
| PET imaging whole body (78813) |
$7,258.80 |
$7,258.80 |
4.9× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Age Under 21 (78812) |
$7,258.80 |
$7,258.80 |
4.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,374.80 |
$4,374.80 |
1.3× |
| Pulmonary perfusion imaging particulate (78580) |
$8,358.32 |
$8,358.32 |
20.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$4,214.66 |
$4,214.66 |
7.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$1,253.47 |
$1,253.47 |
13.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,489.15 |
$1,489.15 |
13.6× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$2,199.55 |
$2,199.55 |
20.1× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$2,436.93 |
$2,436.93 |
22.3× |
| Radex hip unilateral with pelvis 1 view (73501) |
$5,934.35 |
$5,934.35 |
65.3× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$8,132.19 |
$8,132.19 |
89.5× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$9,580.34 |
$9,580.34 |
87.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$7,696.73 |
$7,696.73 |
70.5× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$13,542.28 |
$13,542.28 |
124.0× |
| Radex spine cervical 2 or 3 views (72040) |
$5,136.84 |
$5,136.84 |
56.5× |
| Radex spine cervical 4 or 5 views (72050) |
$7,445.69 |
$7,445.69 |
68.2× |
| Radex spine cervical 6 or more views (72052) |
$8,357.61 |
$8,357.61 |
76.6× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$5,042.91 |
$5,042.91 |
46.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$2,614.89 |
$2,614.89 |
14.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$2,478.27 |
$2,478.27 |
13.5× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$2,110.75 |
$2,110.75 |
23.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$4,223.21 |
$4,223.21 |
46.5× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$6,253.71 |
$6,253.71 |
57.3× |
| Radiologic examination, mastoids; less than 3 views per side Other Diagnostic Radiology FS (70120) |
$8,468.61 |
$8,468.61 |
77.6× |
| Radiologic examination, salivary gland for calculus Other Diagnostic Radiology FS (70380) |
$8,468.61 |
$8,468.61 |
93.2× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) |
$6,098.29 |
$6,098.29 |
55.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$14,181.42 |
$14,181.42 |
34.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$5,066.05 |
$5,066.05 |
12.1× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$7,083.37 |
$7,083.37 |
12.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$6,877.97 |
$6,877.97 |
12.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$6,533.20 |
$6,533.20 |
11.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$15,867.17 |
$15,867.17 |
65.1× |
| Saline infused sonohysterogram (76831) |
$6,530.71 |
$6,530.71 |
26.2× |
| Salivary gland imaging (78230) |
$4,314.87 |
$4,314.87 |
10.3× |
| Selective spinal angiogram (75705) |
$9,905.98 |
$9,905.98 |
1.7× |
| Shoulder arthrogram (73040) |
$6,796.48 |
$6,796.48 |
18.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$9,618.04 |
$9,618.04 |
88.1× |
| Simulation complex (77290) |
$1,684.10 |
$1,684.10 |
4.3× |
| Small bowel series (74250) |
$5,908.74 |
$5,908.74 |
32.3× |
| Special physics consult (77370) |
$1,802.90 |
$1,802.90 |
12.8× |
| Special treatment procedure (77470) |
$1,683 |
$1,683 |
2.9× |
| Splenoportography (75810) |
$11,008.89 |
$11,008.89 |
3.3× |
| Superior sagittal sinus venogram (75870) |
$12,071.92 |
$12,071.92 |
3.7× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Other Diagnostic Radiology FS (70332) |
$3,505.37 |
$3,505.37 |
14.1× |
| Testicular imaging w/flow (78761) |
$6,735.66 |
$6,735.66 |
16.1× |
| Thyroid met imaging body (78018) |
$9,916.42 |
$9,916.42 |
17.5× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$14,678.77 |
$14,678.77 |
35.2× |
| Treatment devices simple (77332) |
$197.99 |
$197.99 |
1.4× |
| Ultrasound breast limited (76642) |
$2,813.96 |
$2,813.96 |
31.0× |
| Ultrasound, abdomen limited (76705) |
$3,390.75 |
$3,390.75 |
31.1× |
| Unlisted magnetic resonance procedure (76498) |
$8,012.91 |
$8,012.91 |
88.2× |
| Urethrocystography retrograde rs&i (74450) |
$5,878 |
$5,878 |
23.6× |
| Urethrocystography voiding (74455) |
$15,622.29 |
$15,622.29 |
62.7× |
| Urography antegrade (74425) |
$5,908.74 |
$5,908.74 |
16.2× |
| Urography retrograde w/wo kub (74420) |
$7,898.24 |
$7,898.24 |
21.7× |
| Us breast uni real time with image complete (76641) |
$4,220.94 |
$4,220.94 |
38.7× |
| Us chest (76604) |
$1,191.84 |
$1,191.84 |
10.9× |
| Us compl joint r-t w/image documentation (76881) |
$3,349.83 |
$3,349.83 |
30.7× |
| Us guided compression repair (76936) |
$2,945.94 |
$2,945.94 |
13.1× |
| Us kidney transplanted (76776) |
$2,679.33 |
$2,679.33 |
24.5× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$2,894.46 |
$2,894.46 |
26.5× |
| Us ob detailed single fetus (76811) |
$4,424.20 |
$4,424.20 |
17.8× |
| Us ob limited 1 or more fetuses (76815) |
$1,682.84 |
$1,682.84 |
15.4× |
| Us obstetric transvaginal (76817) |
$7,267.18 |
$7,267.18 |
66.6× |
| Us pelvic limited or f/u non-ob (76857) |
$2,392.92 |
$2,392.92 |
21.9× |
| Us pelvis complete (76856) |
$3,749.75 |
$3,749.75 |
34.3× |
| Us retroperitoneal complete (76770) |
$4,230.17 |
$4,230.17 |
38.7× |
| Us retroperitoneal limited (76775) |
$4,603.70 |
$4,603.70 |
42.2× |
| Us scrotum (76870) |
$4,034.84 |
$4,034.84 |
37.0× |
| Us soft tissue head/neck (76536) |
$4,040.11 |
$4,040.11 |
37.0× |
| Us transrectal (76872) |
$3,640.20 |
$3,640.20 |
33.3× |
| Us transrectal prostate volume (76873) |
$2,907.66 |
$2,907.66 |
26.6× |
| Us unlstd proc (76999) |
$2,679.33 |
$2,679.33 |
29.5× |
| Vascular flow imaging (78445) |
$4,822.50 |
$4,822.50 |
11.6× |
| Vein X-ray liver w/hemodynam (75885) |
$21,855.47 |
$21,855.47 |
6.6× |
| Venogram extremity bilateral (75822) |
$8,393.07 |
$8,393.07 |
5.1× |
| Venogram ivc w serialography (75825) |
$6,920.18 |
$6,920.18 |
2.1× |
| Venogram svc w serialography (75827) |
$6,920.18 |
$6,920.18 |
4.2× |
| Venography ext unilateral (75820) |
$6,786.26 |
$6,786.26 |
4.1× |
| Venography renal unilateral selective rs&i (75831) |
$6,605.62 |
$6,605.62 |
2.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$6,451.51 |
$6,451.51 |
2.0× |
| Venous sampling by catheter (75893) |
$13,281.11 |
$13,281.11 |
2.3× |
| Venous thrombosis imaging - nm extremity veins thrombosis right (78457) |
$3,843.92 |
$3,843.92 |
6.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$4,979.74 |
$4,979.74 |
54.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$4,171.97 |
$4,171.97 |
45.9× |
| X-ray aorta leg arteries (75630) |
$33,167.51 |
$33,167.51 |
10.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$9,670.85 |
$9,670.85 |
52.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$4,223.21 |
$4,223.21 |
46.5× |
| X-ray exam hips bi 3-4 views (73522) |
$12,092.41 |
$12,092.41 |
110.8× |
| X-ray exam of finger(s) (73140) |
$2,923.64 |
$2,923.64 |
32.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$10,080.71 |
$10,080.71 |
55.0× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$2,862.16 |
$2,862.16 |
31.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$4,223.21 |
$4,223.21 |
46.5× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$2,293.47 |
$2,293.47 |
21.0× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$3,157.58 |
$3,157.58 |
34.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$4,223.21 |
$4,223.21 |
46.5× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$4,516.93 |
$4,516.93 |
49.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$5,162.45 |
$5,162.45 |
47.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$1,707.72 |
$1,707.72 |
18.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$5,681.62 |
$5,681.62 |
52.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$11,130.96 |
$11,130.96 |
102.0× |
| X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) |
$5,174.41 |
$5,174.41 |
47.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$3,644.29 |
$3,644.29 |
40.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$6,253.71 |
$6,253.71 |
57.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$5,700.39 |
$5,700.39 |
52.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$3,686.98 |
$3,686.98 |
40.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$4,243.70 |
$4,243.70 |
46.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$4,223.21 |
$4,223.21 |
46.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$6,388.60 |
$6,388.60 |
58.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$3,068.79 |
$3,068.79 |
28.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$3,456.44 |
$3,456.44 |
38.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$2,923.64 |
$2,923.64 |
32.2× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$2,090.25 |
$2,090.25 |
23.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$3,383.01 |
$3,383.01 |
37.2× |
| Xr abdomen 1 view (74018) |
$4,199.29 |
$4,199.29 |
46.2× |
| Xr abdomen 2 views (74019) |
$6,253.71 |
$6,253.71 |
57.3× |
| Xr abdomen 3 views (74021) |
$6,253.71 |
$6,253.71 |
57.3× |
| Xr arthrogram ankle (73615) |
$4,071.65 |
$4,071.65 |
11.2× |
| Xr arthrogram elbow (73085) |
$7,556.69 |
$7,556.69 |
20.7× |
| Xr arthrogram hip (73525) |
$7,170.74 |
$7,170.74 |
19.7× |
| Xr chest 1 view (71045) |
$2,252.42 |
$2,252.42 |
24.8× |
| Xr chest 2 views (71046) |
$2,568.96 |
$2,568.96 |
28.3× |
| Xr chest 3 views (71047) |
$5,854.09 |
$5,854.09 |
64.4× |
| Xr cystogram 3+ views (74430) |
$2,909.96 |
$2,909.96 |
8.0× |
| Xr eye foreign body (70030) |
$3,155.88 |
$3,155.88 |
34.7× |
| Xr facial bones 3 views (70150) |
$5,908.74 |
$5,908.74 |
54.1× |
| Xr mandible 4 views (70110) |
$4,199.29 |
$4,199.29 |
38.5× |
| Xr myelogram c-spine (72240) |
$11,569.60 |
$11,569.60 |
14.1× |
| Xr nasal bones (70160) |
$2,718.71 |
$2,718.71 |
29.9× |
| Xr pelvis 3 views (72190) |
$5,620.13 |
$5,620.13 |
51.5× |
| Xr sella turcica (70240) |
$2,315.68 |
$2,315.68 |
25.5× |
| Xr sialogram (70390) |
$5,908.74 |
$5,908.74 |
23.7× |
| Xr spine 1 view (72020) |
$1,941.69 |
$1,941.69 |
21.4× |
| Xr sternum 2 views (71120) |
$3,707.47 |
$3,707.47 |
40.8× |
| Xr surgical specimen (76098) |
$1,432.78 |
$1,432.78 |
2.5× |
| Xray elbow 2 views (73070) |
$3,644.29 |
$3,644.29 |
40.1× |
| Xray forearm 2 views (73090) |
$4,223.21 |
$4,223.21 |
46.5× |
| Xray internal auditory meati compl (70134) |
$5,770.40 |
$5,770.40 |
10.1× |
| Xray knee 1 or 2 views rt (73560) |
$1,359.35 |
$1,359.35 |
15.0× |
| Xray neck soft tissue (70360) |
$3,553.78 |
$3,553.78 |
39.1× |
| Xray optic foramina (70190) |
$5,158.20 |
$5,158.20 |
56.8× |
| Xray orbits complete min 4 views (70200) |
$5,432.28 |
$5,432.28 |
49.8× |
| Xray pelvis 1 or 2 views (72170) |
$4,171.97 |
$4,171.97 |
38.2× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$5,908.74 |
$5,908.74 |
54.1× |
| Xray scapula complete (73010) |
$3,270.29 |
$3,270.29 |
30.0× |
| Xray shoulder 1 view (73020) |
$1,910.94 |
$1,910.94 |
21.0× |
| Xray spine thoracic 2 views (72070) |
$5,555.22 |
$5,555.22 |
50.9× |
| Xray spine thoracic 3 views (72072) |
$8,012.65 |
$8,012.65 |
73.4× |
| Xray tibia-fibula 2 views bil (73590) |
$4,223.21 |
$4,223.21 |
46.5× |
| Xray tmj open - closed unilat (70328) |
$2,778.48 |
$2,778.48 |
30.6× |
| Xray tmj's bilateral open-clsc (70330) |
$5,555.22 |
$5,555.22 |
61.1× |