| Abdomen 2 views (74019) |
$4,622.75 |
$4,622.75 |
42.3× |
| Acute gi blood loss imaging (78278) |
$4,809.50 |
$4,809.50 |
11.5× |
| Angio Adrenal Bilat Select (75733) |
$6,782.25 |
$6,782.25 |
2.1× |
| Angiography extremity bilateral rs&i (75716) |
$11,325.25 |
$11,325.25 |
3.4× |
| Angiography extremity unilateral rs&i (75710) |
$7,737 |
$7,737 |
2.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$8,143.75 |
$8,143.75 |
1.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$12,486 |
$12,486 |
3.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,461.50 |
$8,461.50 |
2.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$16,026.75 |
$16,026.75 |
2.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$13,592.75 |
$13,592.75 |
4.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$8,951.50 |
$8,951.50 |
2.7× |
| Aortogram thoracic (75605) |
$7,827.25 |
$7,827.25 |
1.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$11,393.75 |
$11,393.75 |
3.5× |
| Aortography abdominal serialography rs&i (75625) |
$13,142.62 |
$13,142.62 |
4.0× |
| Artery X-Rays Adrenal Gland (75731) |
$6,782.25 |
$6,782.25 |
2.1× |
| Arthrogram elbow (73085) |
$4,457 |
$4,457 |
12.2× |
| Arthrogram hip (73525) |
$3,202.25 |
$3,202.25 |
8.8× |
| Arthrogram knee (73580) |
$4,437 |
$4,437 |
12.2× |
| Arthrogram shoulder (73040) |
$4,457 |
$4,457 |
12.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$3,346.75 |
$3,346.75 |
8.0× |
| Bone &/joint imaging whole body (78306) |
$8,580.50 |
$8,580.50 |
20.6× |
| Bone age studies (77072) |
$2,195.75 |
$2,195.75 |
20.1× |
| Bone Imaging 3 Phase (78315) |
$6,257 |
$6,257 |
15.0× |
| Bone survey complete (77075) |
$5,397.50 |
$5,397.50 |
49.4× |
| Bone survey infant (77076) |
$1,107 |
$1,107 |
10.1× |
| Bowel imaging (78290) |
$2,314.50 |
$2,314.50 |
5.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$7,033.50 |
$7,033.50 |
12.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,565 |
$7,565 |
5.1× |
| Brain Imaging Vascular Flow Only (78610) |
$2,337.75 |
$2,337.75 |
4.1× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$4,745.25 |
$4,745.25 |
8.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$4,662.25 |
$4,662.25 |
11.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$3,479.25 |
$3,479.25 |
6.1× |
| Cervical spine 2 or 3 views (72040) |
$1,921.25 |
$1,921.25 |
21.1× |
| Chest 1 view (71045) |
$1,485.25 |
$1,485.25 |
16.3× |
| Chest xray 3 views (71047) |
$1,114 |
$1,114 |
12.3× |
| Cholecystography, oral contrast Non-Facility (74290) |
$1,367.75 |
$1,367.75 |
7.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,178.25 |
$1,178.25 |
6.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$3,879.25 |
$3,879.25 |
4.7× |
| Clavicle complete (73000) |
$1,950 |
$1,950 |
21.5× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$4,223 |
$4,223 |
23.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$22,631.75 |
$22,631.75 |
62.1× |
| CT abdomen and pelvis without contrast (74176) |
$19,352.50 |
$19,352.50 |
77.7× |
| CT abdomen w contrast (74160) |
$19,352.50 |
$19,352.50 |
105.7× |
| CT abdomen w wo contrast (74170) |
$22,631.75 |
$22,631.75 |
123.6× |
| CT abdomen w/o contrast (74150) |
$21,068 |
$21,068 |
193.0× |
| CT angio hrt w/3d image (75574) |
$15,598.25 |
$15,598.25 |
42.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$507 |
$507 |
2.8× |
| CT angiography upper extremity lt (73206) |
$18,786 |
$18,786 |
102.6× |
| CT c-spine w/contrast (72126) |
$8,639.50 |
$8,639.50 |
23.7× |
| CT c-spine w/o contrast (72125) |
$8,639.50 |
$8,639.50 |
79.1× |
| CT cervical spine w&w/o contrast (72127) |
$15,777.75 |
$15,777.75 |
86.1× |
| CT chest w contrast (71260) |
$19,807 |
$19,807 |
108.1× |
| CT chest w/wo contrast (71270) |
$19,807 |
$19,807 |
108.1× |
| CT head/brain with contrast (70460) |
$20,101.25 |
$20,101.25 |
109.7× |
| CT head/brain without and with contrast (70470) |
$21,662 |
$21,662 |
118.3× |
| CT iac w contrast (70481) |
$18,986 |
$18,986 |
103.7× |
| CT limited/localized follow up study (76380) |
$6,056.25 |
$6,056.25 |
66.6× |
| CT lower ext w/o (73700) |
$17,715.25 |
$17,715.25 |
162.3× |
| CT lower extremity w/contrast material (73701) |
$17,715.25 |
$17,715.25 |
96.7× |
| CT lumbar spine w & w/o contrast (72133) |
$21,362.25 |
$21,362.25 |
116.6× |
| CT lumbar spine w/contrast (72132) |
$16,292.50 |
$16,292.50 |
44.7× |
| CT lumbar spine w/o contrast (72131) |
$19,707.75 |
$19,707.75 |
180.5× |
| CT maxillofacial w contrast (70487) |
$16,755.50 |
$16,755.50 |
91.5× |
| CT maxillofacial w/wo contrast (70488) |
$20,101.25 |
$20,101.25 |
109.7× |
| CT maxillofacial wo contrast (70486) |
$16,755.50 |
$16,755.50 |
153.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$16,744.50 |
$16,744.50 |
91.4× |
| CT orbits w/o contrast (70480) |
$17,263.50 |
$17,263.50 |
158.1× |
| CT pelvis w/o contrast (72192) |
$19,747.25 |
$19,747.25 |
180.9× |
| CT pelvis w/wo contrast (72194) |
$20,861.25 |
$20,861.25 |
113.9× |
| CT soft tissue neck w contrast (70491) |
$6,999.75 |
$6,999.75 |
38.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$9,564.25 |
$9,564.25 |
52.2× |
| CT soft tissue neck w/o contrast (70490) |
$6,999.75 |
$6,999.75 |
64.1× |
| CT thoracic spine w/contrast (72129) |
$19,707.75 |
$19,707.75 |
107.6× |
| CT thoracic spine w/o contrast (72128) |
$19,707.75 |
$19,707.75 |
180.5× |
| CT thoracic spine w/wo contrast (72130) |
$19,707.75 |
$19,707.75 |
107.6× |
| CT thorax w/o contrast (71250) |
$19,807 |
$19,807 |
181.4× |
| CT upper ext wo (73200) |
$17,715.25 |
$17,715.25 |
162.3× |
| CT upper extremity with contrast (73201) |
$17,715.25 |
$17,715.25 |
48.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$13,071.75 |
$13,071.75 |
71.4× |
| CTA abdomen pelvis (74174) |
$1,818.75 |
$1,818.75 |
5.0× |
| CTA chest (71275) |
$19,807 |
$19,807 |
108.1× |
| Cta Head (70496) |
$20,101.25 |
$20,101.25 |
109.7× |
| Cta Neck (70498) |
$20,101.25 |
$20,101.25 |
109.7× |
| Cta Pelvis (72191) |
$682.75 |
$682.75 |
3.7× |
| Cystography minimum 3 views rs&i (74430) |
$2,364.50 |
$2,364.50 |
6.5× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$1,381 |
$1,381 |
5.5× |
| Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without… (78414) |
$2,133 |
$2,133 |
3.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,508 |
$1,508 |
13.8× |
| Esophagus (74220) |
$4,223 |
$4,223 |
23.1× |
| Facial bones min 3 views (70150) |
$3,256.75 |
$3,256.75 |
29.8× |
| Fetal biophysical profile non-stress testing (76818) |
$2,940.50 |
$2,940.50 |
26.9× |
| Fluoroscopy up to 1 hr (76000) |
$4,021.25 |
$4,021.25 |
16.1× |
| Forearm 2 views (73090) |
$1,950 |
$1,950 |
21.5× |
| Gastric mucosa imaging (78261) |
$2,314.50 |
$2,314.50 |
5.5× |
| Hand 2 views (73120) |
$1,363.25 |
$1,363.25 |
12.5× |
| Heart Infarct Image (78466) |
$6,037.25 |
$6,037.25 |
14.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$13,142.50 |
$13,142.50 |
4.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$13,731.75 |
$13,731.75 |
24.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$6,760.50 |
$6,760.50 |
16.2× |
| Hysterosalpingogram (74740) |
$5,827.50 |
$5,827.50 |
23.4× |
| Interstitial radiation source applic complex (77778) |
$17,806.75 |
$17,806.75 |
24.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$1,314.25 |
$1,314.25 |
12.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$8,734.50 |
$8,734.50 |
15.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$4,423.75 |
$4,423.75 |
7.8× |
| Knee 3 views (73562) |
$2,210.50 |
$2,210.50 |
24.3× |
| Liver & spleen imaging static only (78215) |
$4,203.50 |
$4,203.50 |
10.1× |
| Liver imaging static only (78201) |
$8,623 |
$8,623 |
15.2× |
| Lung perfusion differential (78597) |
$9,227.25 |
$9,227.25 |
22.1× |
| Lung ventilation imaging (78579) |
$11,719.50 |
$11,719.50 |
28.1× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$6,867 |
$6,867 |
10.5× |
| Lymphoscintigraphy (78195) |
$3,766 |
$3,766 |
6.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$9,144 |
$9,144 |
11.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$14,502.50 |
$14,502.50 |
39.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$15,262.50 |
$15,262.50 |
41.9× |
| Mammary ductogram or galactogram single (77053) |
$1,939.25 |
$1,939.25 |
7.8× |
| MRA head w & w/o contrast (70546) |
$17,202.50 |
$17,202.50 |
47.2× |
| MRA head w/o contrast (70544) |
$9,723.75 |
$9,723.75 |
39.0× |
| MRA head with contrast (70545) |
$10,973.25 |
$10,973.25 |
30.1× |
| MRA neck w contrast (70548) |
$1,047 |
$1,047 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$9,220.25 |
$9,220.25 |
25.3× |
| MRA neck w/o contrast (70547) |
$9,220.25 |
$9,220.25 |
37.0× |
| MRI abdomen w contrast (74182) |
$9,220.25 |
$9,220.25 |
25.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$13,947.50 |
$13,947.50 |
38.3× |
| MRI abdomen w/o contrast (74181) |
$9,220.25 |
$9,220.25 |
37.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$9,144 |
$9,144 |
11.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$9,901.25 |
$9,901.25 |
27.2× |
| MRI bone marrow blood supply (77084) |
$14,502.50 |
$14,502.50 |
58.2× |
| MRI breast w/o contrast bilateral (77047) |
$2,012.50 |
$2,012.50 |
8.1× |
| MRI breast wo contrast unilateral (77046) |
$1,083.75 |
$1,083.75 |
4.3× |
| MRI c-spine with contrast (72142) |
$18,069.25 |
$18,069.25 |
49.6× |
| MRI cervical spine w/o contrast (72141) |
$18,069.25 |
$18,069.25 |
72.5× |
| MRI chest w/o & w/contrast material (71552) |
$15,340.25 |
$15,340.25 |
42.1× |
| MRI chest w/o contrast (71550) |
$13,760.50 |
$13,760.50 |
55.2× |
| MRI chest with contrast (71551) |
$13,760.50 |
$13,760.50 |
16.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$14,502.50 |
$14,502.50 |
39.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$15,262.50 |
$15,262.50 |
41.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$18,069.25 |
$18,069.25 |
72.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$5,684.25 |
$5,684.25 |
22.8× |
| MRI orbit face neck w contrast (70542) |
$14,502.50 |
$14,502.50 |
39.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$15,262.50 |
$15,262.50 |
41.9× |
| MRI pelvis w/contrast (72196) |
$14,502.50 |
$14,502.50 |
39.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$15,262.50 |
$15,262.50 |
41.9× |
| MRI pelvis w/o contrast (72195) |
$18,069.25 |
$18,069.25 |
72.5× |
| MRI spectroscopy (76390) |
$7,889 |
$7,889 |
86.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$20,130.50 |
$20,130.50 |
55.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$18,069.25 |
$18,069.25 |
49.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$20,130.50 |
$20,130.50 |
55.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,952.75 |
$5,952.75 |
16.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$11,685.50 |
$11,685.50 |
32.1× |
| MRI temporomandibular joint (70336) |
$14,502.50 |
$14,502.50 |
58.2× |
| MRI thoracic spine w/o contrast (72146) |
$5,952.75 |
$5,952.75 |
23.9× |
| MRI up ext w/o contrast (73218) |
$9,144 |
$9,144 |
36.7× |
| MRI upper ext joint w/o contrast (73221) |
$9,901.25 |
$9,901.25 |
39.7× |
| MRI, joint upper extrem combo (73223) |
$9,901.25 |
$9,901.25 |
27.2× |
| Myelogram Cervical (72240) |
$4,090.62 |
$4,090.62 |
5.0× |
| Myelogram Lumbar (72265) |
$4,090.62 |
$4,090.62 |
5.0× |
| Myelogram thoracic (72255) |
$2,633.75 |
$2,633.75 |
3.2× |
| Myelography 2 or more regions (72270) |
$4,613.88 |
$4,613.88 |
5.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$7,565 |
$7,565 |
5.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$8,193 |
$8,193 |
6.1× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$16,391 |
$16,391 |
12.1× |
| Myocardial Spect Multiple Studies (78452) |
$16,392.25 |
$16,392.25 |
12.1× |
| Myocardial spect single study at rest or stress (78451) |
$8,193 |
$8,193 |
6.1× |
| Neck soft tissue (70360) |
$1,963.75 |
$1,963.75 |
21.6× |
| Nm cisternogram (78630) |
$7,625.50 |
$7,625.50 |
13.4× |
| Nm csf leak detection (78650) |
$5,812.50 |
$5,812.50 |
4.3× |
| Nm gastric emptying study (78264) |
$3,339 |
$3,339 |
8.0× |
| Nm gastroesophageal reflux study (78262) |
$3,815 |
$3,815 |
9.1× |
| Nm peritoneal-venous shunt patency (78291) |
$4,458.75 |
$4,458.75 |
10.7× |
| Noncardiac Vascular Flow Imaging (78445) |
$2,707 |
$2,707 |
6.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$10,302.25 |
$10,302.25 |
24.7× |
| Nuclear Rx Oral Admin (79005) |
$10,131.50 |
$10,131.50 |
41.6× |
| Osseous survey limited (77074) |
$4,265.25 |
$4,265.25 |
39.1× |
| Parathyroid Planar Imaging (78070) |
$4,247.50 |
$4,247.50 |
10.2× |
| Pelvis 1 or 2 views (72170) |
$3,208 |
$3,208 |
29.4× |
| PET image w/CT, skull-thigh (78815) |
$16,932.75 |
$16,932.75 |
11.3× |
| PET imaging CT for attenuation limited area (78814) |
$14,748.25 |
$14,748.25 |
9.9× |
| PET imaging for CT attenuation whole body (78816) |
$20,087.50 |
$20,087.50 |
13.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$6,324 |
$6,324 |
15.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$4,974.50 |
$4,974.50 |
8.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,592.50 |
$2,592.50 |
4.5× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$2,280 |
$2,280 |
25.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$1,914.25 |
$1,914.25 |
21.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$2,540.75 |
$2,540.75 |
28.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$317.25 |
$317.25 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$523.25 |
$523.25 |
4.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$800 |
$800 |
7.3× |
| Radex fingr minimum 2 views (73140) |
$2,086.50 |
$2,086.50 |
23.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$2,235.50 |
$2,235.50 |
24.6× |
| Radex Hand Minimum 3 Views (73130) |
$2,044.25 |
$2,044.25 |
22.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$317.25 |
$317.25 |
3.5× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$523.25 |
$523.25 |
4.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$419.50 |
$419.50 |
3.8× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$800 |
$800 |
7.3× |
| Radex Humerus Minimum 2 Views (73060) |
$2,129 |
$2,129 |
23.4× |
| Radex Kne 1/2 Views (73560) |
$1,474 |
$1,474 |
16.2× |
| Radex Kne Compl 4/More Views (73564) |
$2,562.75 |
$2,562.75 |
23.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$3,256.75 |
$3,256.75 |
29.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$2,430 |
$2,430 |
26.7× |
| Radex Sho Compl Minimum 2 Views (73030) |
$2,562.75 |
$2,562.75 |
28.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$1,339 |
$1,339 |
12.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$2,083.50 |
$2,083.50 |
22.9× |
| Radex Toe Minimum 2 Views (73660) |
$2,086.50 |
$2,086.50 |
23.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$651.25 |
$651.25 |
6.0× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$2,963.75 |
$2,963.75 |
32.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$800 |
$800 |
7.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$2,083.50 |
$2,083.50 |
22.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$4,622.75 |
$4,622.75 |
42.3× |
| Radiologic exam chest 2 views (71046) |
$1,699 |
$1,699 |
18.7× |
| Radiologic exam colon single contrast study (74270) |
$5,659.50 |
$5,659.50 |
30.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$935 |
$935 |
5.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$935 |
$935 |
5.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$835.50 |
$835.50 |
4.6× |
| Radiologic examination femur 1 view (73551) |
$317.25 |
$317.25 |
3.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$1,439.75 |
$1,439.75 |
15.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$2,235.50 |
$2,235.50 |
24.6× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$2,323.75 |
$2,323.75 |
4.1× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$2,585.75 |
$2,585.75 |
23.7× |
| Radiological examination surgical specimen (76098) |
$760.88 |
$760.88 |
1.3× |
| Renal Cyst Study (74470) |
$2,709 |
$2,709 |
4.7× |
| Ribs bilateral 3 views (71110) |
$4,285.75 |
$4,285.75 |
39.3× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,636.25 |
$1,636.25 |
3.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$6,257 |
$6,257 |
15.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$5,076.75 |
$5,076.75 |
9.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$5,583.25 |
$5,583.25 |
9.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,634 |
$5,634 |
9.9× |
| Rp Therapy Intravenous Administration (79101) |
$9,884.75 |
$9,884.75 |
40.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$4,550.25 |
$4,550.25 |
18.3× |
| Scapula (73010) |
$2,049.75 |
$2,049.75 |
18.8× |
| Sella turcica (70240) |
$2,004.75 |
$2,004.75 |
22.1× |
| Shoulder 1 view (73020) |
$2,210.50 |
$2,210.50 |
24.3× |
| Sialogram (70390) |
$3,834.25 |
$3,834.25 |
15.4× |
| Small bowel series (74250) |
$4,265.25 |
$4,265.25 |
23.3× |
| Spleen imaging only (78185) |
$7,831.25 |
$7,831.25 |
18.8× |
| Testicular Imaging With Vascular Flow (78761) |
$6,128.75 |
$6,128.75 |
14.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$10,372.75 |
$10,372.75 |
18.3× |
| Thyroid uptake measurement (78012) |
$5,474 |
$5,474 |
13.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$6,085.25 |
$6,085.25 |
14.6× |
| Tomogram (76100) |
$4,285.75 |
$4,285.75 |
39.3× |
| Ultrasound breast complete (76641) |
$2,537.50 |
$2,537.50 |
23.2× |
| Ultrasound Exam Aaa Screen (76706) |
$216.75 |
$216.75 |
2.0× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$1,253.25 |
$1,253.25 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$2,274.75 |
$2,274.75 |
20.8× |
| Ureteral reflux study (78740) |
$4,107.25 |
$4,107.25 |
9.8× |
| Urethrocystogram voiding (74455) |
$3,646 |
$3,646 |
14.6× |
| Urethrocystography retrograde rs&i (74450) |
$3,646 |
$3,646 |
14.6× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$5,685.50 |
$5,685.50 |
31.0× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$9,449.50 |
$9,449.50 |
51.6× |
| Us breast unilateral limited (76642) |
$2,537.50 |
$2,537.50 |
27.9× |
| Us chest (76604) |
$3,185.75 |
$3,185.75 |
29.2× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$2,966 |
$2,966 |
13.2× |
| Us compl joint r-t w/image documentation (76881) |
$2,665.50 |
$2,665.50 |
24.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$2,041.75 |
$2,041.75 |
18.7× |
| Us ob limited (76815) |
$1,984.50 |
$1,984.50 |
18.2× |
| Us ob transvaginal (76817) |
$4,920.50 |
$4,920.50 |
45.1× |
| Us pelvic non ob complete (76856) |
$5,646.25 |
$5,646.25 |
51.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,475.50 |
$1,475.50 |
13.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$3,067.25 |
$3,067.25 |
28.1× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$2,651.75 |
$2,651.75 |
24.3× |
| Us retroperitoneal complete (76770) |
$3,164 |
$3,164 |
29.0× |
| Us retroperitoneal limited (76775) |
$3,970 |
$3,970 |
36.4× |
| Us scrotum and contents (76870) |
$4,920.50 |
$4,920.50 |
45.1× |
| Us soft tissue head/neck (76536) |
$2,106 |
$2,106 |
19.3× |
| Us spinal canal and contents (76800) |
$4,162 |
$4,162 |
38.1× |
| Us transrectal (76872) |
$2,412.50 |
$2,412.50 |
22.1× |
| Us,transplanted kidney, real time/ doppler (76776) |
$2,357.75 |
$2,357.75 |
21.6× |
| Venogram adrenal unilat (75840) |
$8,492 |
$8,492 |
2.6× |
| Venogram extremity bilateral (75822) |
$4,628.25 |
$4,628.25 |
2.8× |
| Venogram Extremity Unilateral (75820) |
$4,408.25 |
$4,408.25 |
2.7× |
| Venography caval inferior serialography rs&i (75825) |
$9,437 |
$9,437 |
2.9× |
| Venography caval superior serialography rs&i (75827) |
$8,087.75 |
$8,087.75 |
4.9× |
| Venous sampling by catheter (75893) |
$12,471.50 |
$12,471.50 |
2.1× |
| Venous thrombosis imaging, venogram; unilateral Non-Facility (78457) |
$5,385.50 |
$5,385.50 |
9.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$611.75 |
$611.75 |
5.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$2,105.50 |
$2,105.50 |
23.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$6,480.50 |
$6,480.50 |
35.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,266.50 |
$1,266.50 |
13.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$317.25 |
$317.25 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$419.50 |
$419.50 |
3.8× |
| X-ray exam of femur 2/> (73552) |
$317.25 |
$317.25 |
3.5× |
| X-ray eye for foreign body (70030) |
$1,056.25 |
$1,056.25 |
11.6× |
| X-ray IV pyelogram (ivp) (74400) |
$5,071.50 |
$5,071.50 |
27.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$651.25 |
$651.25 |
7.2× |
| X-ray leg, infant (73592) |
$902.50 |
$902.50 |
9.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$2,176.75 |
$2,176.75 |
19.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$4,363.50 |
$4,363.50 |
40.0× |
| X-ray optic foramen (70190) |
$1,302.25 |
$1,302.25 |
14.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$4,265.25 |
$4,265.25 |
39.1× |
| X-ray retrograde pyelogram (74420) |
$3,217.50 |
$3,217.50 |
8.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$3,208 |
$3,208 |
35.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$611.75 |
$611.75 |
5.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$611.75 |
$611.75 |
5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$793 |
$793 |
7.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$2,280 |
$2,280 |
25.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$3,678.50 |
$3,678.50 |
40.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$3,766 |
$3,766 |
34.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,880.50 |
$1,880.50 |
17.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$890 |
$890 |
9.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$2,149 |
$2,149 |
23.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$2,612.75 |
$2,612.75 |
28.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$2,612.75 |
$2,612.75 |
23.9× |
| Xr bone length studies (77073) |
$1,467 |
$1,467 |
13.4× |
| Xr c-spine 4 or 5 views (72050) |
$3,876.50 |
$3,876.50 |
35.5× |
| Xr c-spine 6 or more views (72052) |
$3,996.75 |
$3,996.75 |
36.6× |
| Xr chest 4+ views (71048) |
$2,004.75 |
$2,004.75 |
18.4× |
| Xr urogram antegrade (74425) |
$2,699 |
$2,699 |
7.4× |