| 3-D radiotherapy plan dose-volume histograms (77295) |
$11,554.50 |
$11,554.50 |
7.9× |
| Abdomen 2 views (74019) |
$465.50 |
$465.50 |
4.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$6,177 |
$6,177 |
14.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$10,810.50 |
$10,810.50 |
3.2× |
| Angiography extremity bilateral rs&i (75716) |
$14,520.50 |
$14,520.50 |
4.4× |
| Angiography extremity unilateral rs&i (75710) |
$14,656 |
$14,656 |
4.4× |
| Angiography internal mammary rs&i (75756) |
$8,198.88 |
$8,198.88 |
2.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$9,048.25 |
$9,048.25 |
1.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$15,453 |
$15,453 |
4.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$13,175.75 |
$13,175.75 |
4.0× |
| Angiography Spinal Selective Rs&I (75705) |
$9,729.25 |
$9,729.25 |
1.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$14,520.50 |
$14,520.50 |
2.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,524.25 |
$2,524.25 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,925.38 |
$4,925.38 |
1.5× |
| Ankle 2 views (73600) |
$976.50 |
$976.50 |
10.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$2,456 |
$2,456 |
6.7× |
| Aortogram thoracic (75605) |
$14,520.50 |
$14,520.50 |
2.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$16,347.88 |
$16,347.88 |
4.9× |
| Aortography abdominal serialography rs&i (75625) |
$14,520.50 |
$14,520.50 |
4.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$10,024 |
$10,024 |
3.0× |
| Artery X-Rays Adrenal Gland (75731) |
$2,657.25 |
$2,657.25 |
0.8× |
| Arthrogram elbow (73085) |
$1,605 |
$1,605 |
4.4× |
| Arthrogram hip (73525) |
$1,147.25 |
$1,147.25 |
3.1× |
| Arthrogram shoulder (73040) |
$2,435 |
$2,435 |
6.6× |
| Arthrogram wrist (73115) |
$1,958.50 |
$1,958.50 |
5.3× |
| Arthrography knee lt (73580) |
$914.50 |
$914.50 |
2.5× |
| Basic radiation dosimetry calculation (77300) |
$2,396 |
$2,396 |
16.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,181.50 |
$2,181.50 |
5.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$8,198.75 |
$8,198.75 |
19.4× |
| Bone &/joint imaging whole body (78306) |
$11,716.75 |
$11,716.75 |
27.8× |
| Bone age studies (77072) |
$1,073.50 |
$1,073.50 |
9.7× |
| Bone Imaging 3 Phase (78315) |
$8,198.75 |
$8,198.75 |
19.4× |
| Bone Marrow Imaging Limited Area (78102) |
$2,157.50 |
$2,157.50 |
5.1× |
| Bone survey complete (77075) |
$4,936.50 |
$4,936.50 |
44.8× |
| Brain image w/flow 4 + views (78606) |
$4,919.75 |
$4,919.75 |
8.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$15,654.25 |
$15,654.25 |
10.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$21,902.75 |
$21,902.75 |
59.5× |
| Cervical spine 2 or 3 views (72040) |
$1,344.25 |
$1,344.25 |
14.6× |
| Chest 1 view (71045) |
$954.75 |
$954.75 |
10.4× |
| Chest 3 views (71047) |
$1,148.50 |
$1,148.50 |
12.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,545.50 |
$1,545.50 |
8.4× |
| Clavicle complete (73000) |
$914.50 |
$914.50 |
10.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$610 |
$610 |
5.5× |
| Continuing medical physics consltj pr wk (77336) |
$3,317.75 |
$3,317.75 |
23.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$13,024.50 |
$13,024.50 |
35.4× |
| CT abdomen and pelvis without contrast (74176) |
$8,262 |
$8,262 |
32.8× |
| CT abdomen w contrast (74160) |
$6,416.75 |
$6,416.75 |
34.7× |
| CT abdomen w wo contrast (74170) |
$8,888.75 |
$8,888.75 |
48.0× |
| CT abdomen w/o contrast (74150) |
$4,686.25 |
$4,686.25 |
42.5× |
| CT angio hrt w/3d image (75574) |
$2,567.25 |
$2,567.25 |
7.0× |
| CT angiography upper extremity lt (73206) |
$9,682 |
$9,682 |
52.3× |
| CT c-spine w/o contrast (72125) |
$2,603.75 |
$2,603.75 |
23.6× |
| CT cervical spine w&w/o contrast (72127) |
$17,900.50 |
$17,900.50 |
96.7× |
| CT cervical spine with contrast (72126) |
$8,021.50 |
$8,021.50 |
21.8× |
| CT chest w/wo contrast (71270) |
$8,888 |
$8,888 |
48.0× |
| CT chest with contrast (71260) |
$8,021.50 |
$8,021.50 |
43.4× |
| CT head/brain with contrast (70460) |
$8,021.50 |
$8,021.50 |
43.4× |
| CT head/brain without and with contrast (70470) |
$8,888 |
$8,888 |
48.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,567.25 |
$2,567.25 |
7.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$300.75 |
$300.75 |
3.3× |
| CT hrt w/3d image congen (75573) |
$2,567.25 |
$2,567.25 |
7.0× |
| CT iac w contrast (70481) |
$8,021.50 |
$8,021.50 |
43.4× |
| CT limited/localized follow up study (76380) |
$2,754.62 |
$2,754.62 |
30.0× |
| CT lower ext w/o (73700) |
$4,686.25 |
$4,686.25 |
42.5× |
| CT lower extremity w wo contrast (73702) |
$17,900.50 |
$17,900.50 |
96.7× |
| CT lower extremity with contrast (73701) |
$8,021.50 |
$8,021.50 |
43.4× |
| CT lumbar spine w & w/o contrast (72133) |
$17,900.50 |
$17,900.50 |
96.7× |
| CT lumbar spine w/o contrast (72131) |
$2,603.75 |
$2,603.75 |
23.6× |
| CT lumbar spine with contrast (72132) |
$8,021.50 |
$8,021.50 |
21.8× |
| CT maxillofacial w contrast (70487) |
$8,021.50 |
$8,021.50 |
43.4× |
| CT maxillofacial w/o contrast (70486) |
$4,686.25 |
$4,686.25 |
42.5× |
| CT maxillofacial w/wo contrast (70488) |
$8,888 |
$8,888 |
48.0× |
| CT neck soft tissue w contrast (70491) |
$8,021.50 |
$8,021.50 |
43.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$17,900.50 |
$17,900.50 |
96.7× |
| CT orbits w/o contrast (70480) |
$4,686.25 |
$4,686.25 |
42.5× |
| CT pelvis w & w/o contrast (72194) |
$8,888 |
$8,888 |
48.0× |
| CT pelvis w/o contrast (72192) |
$4,686.25 |
$4,686.25 |
42.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$10,186.75 |
$10,186.75 |
55.1× |
| CT soft tissue neck w/o contrast (70490) |
$4,686.25 |
$4,686.25 |
42.5× |
| CT thoracic spine w/contrast (72129) |
$8,021.50 |
$8,021.50 |
43.4× |
| CT thoracic spine w/o contrast (72128) |
$2,603.75 |
$2,603.75 |
23.6× |
| CT thoracic spine w/wo contrast (72130) |
$12,589.50 |
$12,589.50 |
68.0× |
| CT thorax w/o contrast (71250) |
$4,686.25 |
$4,686.25 |
42.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$17,900.50 |
$17,900.50 |
96.7× |
| CT upper extremity w/o contrast rt (73200) |
$9,070.50 |
$9,070.50 |
82.2× |
| CT upper extremity with contrast (73201) |
$12,649.50 |
$12,649.50 |
34.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$10,862.12 |
$10,862.12 |
58.7× |
| Cta Abdomen (74175) |
$10,966.38 |
$10,966.38 |
59.3× |
| CTA abdomen pelvis (74174) |
$15,599.88 |
$15,599.88 |
42.4× |
| CTA chest (71275) |
$13,160.88 |
$13,160.88 |
71.1× |
| Cta Head (70496) |
$9,155.25 |
$9,155.25 |
49.5× |
| CTA lwr ext w&w/o contrast (73706) |
$9,155.25 |
$9,155.25 |
49.5× |
| Cta Neck (70498) |
$9,155.25 |
$9,155.25 |
49.5× |
| Cta Pelvis (72191) |
$9,986.75 |
$9,986.75 |
54.0× |
| Cystography minimum 3 views rs&i (74430) |
$1,702 |
$1,702 |
4.6× |
| Dacryocystography (70170) |
$1,669.50 |
$1,669.50 |
6.6× |
| Diskography lumbar (72295) |
$4,814.75 |
$4,814.75 |
2.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$453.75 |
$453.75 |
4.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,318.50 |
$1,318.50 |
12.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,456.50 |
$1,456.50 |
13.2× |
| Echo exam of fetal heart (76825) |
$1,318.50 |
$1,318.50 |
2.3× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$957 |
$957 |
3.8× |
| Echoencephalography real time imaging (76506) |
$2,995.75 |
$2,995.75 |
27.2× |
| Esophagus (74220) |
$802.25 |
$802.25 |
4.3× |
| Fetal biophysical profile non-stress testing (76818) |
$2,960.25 |
$2,960.25 |
26.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,855.50 |
$1,855.50 |
16.8× |
| Fluoroscopy up to 1 hr (76000) |
$1,269.75 |
$1,269.75 |
5.0× |
| Foot 2 views (73620) |
$976.50 |
$976.50 |
10.6× |
| Forearm 2 views (73090) |
$976.50 |
$976.50 |
10.6× |
| Gated Heart Planar Single (78472) |
$8,725 |
$8,725 |
20.7× |
| Hand 2 views (73120) |
$909.75 |
$909.75 |
8.2× |
| Hand 3 views (73130) |
$986.25 |
$986.25 |
10.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$10,810.50 |
$10,810.50 |
3.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$7,199.50 |
$7,199.50 |
12.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$7,199.50 |
$7,199.50 |
17.1× |
| Ht muscle image spect sing (78451) |
$13,094 |
$13,094 |
9.6× |
| Humerus Min 2 Views Left (73060) |
$976.50 |
$976.50 |
10.6× |
| Hysterosalpingogram (74740) |
$1,543.25 |
$1,543.25 |
6.1× |
| Interstitial radiation source applic complex (77778) |
$40,217 |
$40,217 |
54.7× |
| Intracavitary Radiation Source Applic Complex (77763) |
$17,600 |
$17,600 |
24.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$14,105.75 |
$14,105.75 |
24.2× |
| Intracavitary radiation source applic simple (77761) |
$10,571.75 |
$10,571.75 |
18.1× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$21,935.50 |
$21,935.50 |
2.8× |
| Io rad tx deliver by elctrns (77425) |
$21,935.50 |
$21,935.50 |
2.8× |
| Kidney funcj study non-img radioisotopic study (78725) |
$5,692.25 |
$5,692.25 |
13.5× |
| Kidney imaging morphology (78700) |
$7,003.75 |
$7,003.75 |
16.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$9,111.50 |
$9,111.50 |
15.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$9,642 |
$9,642 |
16.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$10,609.25 |
$10,609.25 |
18.5× |
| Knee 3 views (73562) |
$1,024.25 |
$1,024.25 |
11.2× |
| Liver & spleen imaging static only (78215) |
$5,087.50 |
$5,087.50 |
12.1× |
| Liver imaging static only (78201) |
$3,147 |
$3,147 |
5.5× |
| Liver imaging w/vascular flow (78202) |
$4,919.75 |
$4,919.75 |
8.6× |
| Lung perf&ventilat diferentl (78598) |
$15,516.50 |
$15,516.50 |
27.1× |
| Lung perfusion differential (78597) |
$11,731 |
$11,731 |
27.8× |
| Lung Ventilation Imaging (78579) |
$3,789 |
$3,789 |
9.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$4,345 |
$4,345 |
1.3× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,800.75 |
$1,800.75 |
2.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$4,561.75 |
$4,561.75 |
1.4× |
| Lymphoscintigraphy (78195) |
$10,684.25 |
$10,684.25 |
18.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$579.75 |
$579.75 |
6.3× |
| Meckels Diverticulum (78290) |
$3,128.75 |
$3,128.75 |
7.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$11,039.75 |
$11,039.75 |
28.0× |
| Mr elastography (76391) |
$1,276.75 |
$1,276.75 |
5.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$81 |
$81 |
2.7× |
| MRA head w & w/o contrast (70546) |
$21,902.75 |
$21,902.75 |
59.5× |
| MRA head w/o contrast (70544) |
$10,795.50 |
$10,795.50 |
42.9× |
| MRA head with contrast (70545) |
$12,041.50 |
$12,041.50 |
32.7× |
| MRA neck w contrast (70548) |
$18,119.75 |
$18,119.75 |
49.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$21,902.75 |
$21,902.75 |
59.5× |
| MRA neck w/o contrast (70547) |
$10,795.50 |
$10,795.50 |
42.9× |
| MRI abdomen w contrast (74182) |
$16,755.75 |
$16,755.75 |
45.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$21,902.75 |
$21,902.75 |
59.5× |
| MRI abdomen w/o contrast (74181) |
$10,795.50 |
$10,795.50 |
42.9× |
| MRI any jnt lwr ext with con lt (73722) |
$18,119.75 |
$18,119.75 |
21.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$17,185.75 |
$17,185.75 |
20.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,276.75 |
$1,276.75 |
5.1× |
| MRI breast w/o contrast unilat (77046) |
$1,276.75 |
$1,276.75 |
5.1× |
| MRI c-spine with contrast (72142) |
$18,119.75 |
$18,119.75 |
49.2× |
| MRI cardiac w/o cont stress (75559) |
$2,175.25 |
$2,175.25 |
3.8× |
| MRI cardiac w/o contrast (75557) |
$15,173.50 |
$15,173.50 |
60.3× |
| MRI cervical spine w/o contrast (72141) |
$13,494.25 |
$13,494.25 |
53.6× |
| MRI chest w/o & w/contrast material (71552) |
$21,902.75 |
$21,902.75 |
59.5× |
| MRI chest w/o contrast (71550) |
$13,494.25 |
$13,494.25 |
53.6× |
| MRI chest with contrast (71551) |
$15,530 |
$15,530 |
18.8× |
| MRI fetal sngl/1st gestation (74712) |
$1,979.75 |
$1,979.75 |
7.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$16,251.75 |
$16,251.75 |
44.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$16,251.75 |
$16,251.75 |
44.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$13,494.25 |
$13,494.25 |
53.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$13,494.25 |
$13,494.25 |
53.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$17,521.75 |
$17,521.75 |
47.6× |
| MRI orbit/face/neck w/contrast (70542) |
$18,119.75 |
$18,119.75 |
49.2× |
| MRI pelvis w contrast (72196) |
$19,411.75 |
$19,411.75 |
52.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$17,521.75 |
$17,521.75 |
47.6× |
| MRI pelvis w/o contrast (72195) |
$13,494.25 |
$13,494.25 |
53.6× |
| MRI scan of arm joint before and after contrast (73223) |
$21,902.75 |
$21,902.75 |
59.5× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$8,664.25 |
$8,664.25 |
10.5× |
| MRI scan of leg joint before and after contrast (73723) |
$21,902.75 |
$21,902.75 |
59.5× |
| MRI spectroscopy (76390) |
$7,116.75 |
$7,116.75 |
77.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$21,902.75 |
$21,902.75 |
59.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$18,119.75 |
$18,119.75 |
49.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$17,521.75 |
$17,521.75 |
47.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$18,119.75 |
$18,119.75 |
49.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$17,521.75 |
$17,521.75 |
47.6× |
| MRI thoracic spine w/o contrast (72146) |
$13,494.25 |
$13,494.25 |
53.6× |
| MRI tmj (70336) |
$13,494.25 |
$13,494.25 |
53.6× |
| MRI upper ext joint w/o contrast (73221) |
$13,494.25 |
$13,494.25 |
53.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$21,902.75 |
$21,902.75 |
59.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$13,494.25 |
$13,494.25 |
53.6× |
| Myelogram Cervical (72240) |
$2,305.75 |
$2,305.75 |
2.8× |
| Myelogram Lumbar (72265) |
$3,371.50 |
$3,371.50 |
4.1× |
| Myelogram thoracic (72255) |
$3,004.50 |
$3,004.50 |
3.6× |
| Myelography 2 or more regions (72270) |
$3,384.25 |
$3,384.25 |
4.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$21,633.50 |
$21,633.50 |
15.8× |
| Myocardial infarct spect (78469) |
$8,283.50 |
$8,283.50 |
14.5× |
| Myocardial Spect Multiple Studies (78452) |
$13,094 |
$13,094 |
9.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$21,633.50 |
$21,633.50 |
9.3× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,456.75 |
$3,456.75 |
3.8× |
| Neck soft tissue (70360) |
$1,260 |
$1,260 |
13.7× |
| Nm bone marrow wb (78104) |
$2,157.50 |
$2,157.50 |
5.1× |
| Nm cisternogram (78630) |
$10,842.50 |
$10,842.50 |
18.9× |
| Nm csf leak detection (78650) |
$4,827.25 |
$4,827.25 |
3.5× |
| Nm gastric emptying study (78264) |
$7,645.75 |
$7,645.75 |
18.1× |
| Nm peritoneal-venous shunt patency (78291) |
$2,156.50 |
$2,156.50 |
5.1× |
| Nm whole blood volume (78122) |
$8,738.75 |
$8,738.75 |
15.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$29,364.25 |
$29,364.25 |
20.1× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$15,654.25 |
$15,654.25 |
10.4× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$2,028 |
$2,028 |
4.8× |
| Nuclear Rx Oral Admin (79005) |
$2,715 |
$2,715 |
11.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,114.50 |
$1,114.50 |
10.1× |
| Osseous survey infant (77076) |
$1,727.50 |
$1,727.50 |
15.7× |
| Osseous survey limited (77074) |
$2,830.75 |
$2,830.75 |
25.7× |
| Parathyrd planar w/spect&CT (78072) |
$17,264 |
$17,264 |
30.1× |
| Parathyrd planar w/wo subtrj (78071) |
$17,264 |
$17,264 |
40.9× |
| Parathyroid imaging (78070) |
$8,645.50 |
$8,645.50 |
20.5× |
| Pelvis 1 or 2 views (72170) |
$762.25 |
$762.25 |
6.9× |
| Perineogram (74775) |
$801 |
$801 |
3.2× |
| Peritoneogram rs&i (74190) |
$1,980 |
$1,980 |
3.4× |
| PET image w/CT, skull-thigh (78815) |
$15,654.25 |
$15,654.25 |
10.4× |
| PET imaging CT for attenuation limited area (78814) |
$15,654.25 |
$15,654.25 |
10.4× |
| PET imaging for CT attenuation whole body (78816) |
$15,654.25 |
$15,654.25 |
10.4× |
| PET imaging limited area chest head/neck (78811) |
$15,654.25 |
$15,654.25 |
11.5× |
| PET whole body (78813) |
$15,654.25 |
$15,654.25 |
10.4× |
| Platelet survival study (78191) |
$2,260.25 |
$2,260.25 |
5.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$21,902.75 |
$21,902.75 |
59.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$10,810.50 |
$10,810.50 |
3.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,263.50 |
$4,263.50 |
1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$4,185.25 |
$4,185.25 |
9.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$7,944 |
$7,944 |
13.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,306 |
$2,306 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$258.50 |
$258.50 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$427.25 |
$427.25 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$427.25 |
$427.25 |
3.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$1,449.75 |
$1,449.75 |
13.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$407.75 |
$407.75 |
3.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$5,728.75 |
$5,728.75 |
9.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$2,938 |
$2,938 |
27.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$3,746.75 |
$3,746.75 |
9.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$836.50 |
$836.50 |
7.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$240 |
$240 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$465.50 |
$465.50 |
4.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$1,018 |
$1,018 |
11.1× |
| Radiologic exam colon single contrast study (74270) |
$2,409.75 |
$2,409.75 |
13.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$659.75 |
$659.75 |
3.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$2,161.75 |
$2,161.75 |
11.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,892.75 |
$1,892.75 |
10.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$258.50 |
$258.50 |
2.8× |
| Radiological examination surgical specimen (76098) |
$598.75 |
$598.75 |
1.0× |
| Radiopharm Dacryocystography (78660) |
$3,319.75 |
$3,319.75 |
7.9× |
| Review by radiologist of adrenal gland vein image (75840) |
$10,810.50 |
$10,810.50 |
3.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$8,800.38 |
$8,800.38 |
2.6× |
| Ribs bilateral 3 views (71110) |
$1,429.25 |
$1,429.25 |
13.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$10,888.25 |
$10,888.25 |
19.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$12,940.75 |
$12,940.75 |
22.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$7,006.75 |
$7,006.75 |
5.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,948.50 |
$7,948.50 |
5.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$7,006.75 |
$7,006.75 |
5.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$5,418 |
$5,418 |
22.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$2,366.50 |
$2,366.50 |
9.6× |
| Rp Therapy Intravenous Administration (79101) |
$2,715 |
$2,715 |
11.0× |
| Sacroiliac Joints < 3 Views (72200) |
$646 |
$646 |
5.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$3,459 |
$3,459 |
13.7× |
| Salivary gland imaging serial images (78231) |
$2,028 |
$2,028 |
4.8× |
| Scanogram (77073) |
$1,233 |
$1,233 |
11.2× |
| Scapula complete (73010) |
$1,024.25 |
$1,024.25 |
9.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$845 |
$845 |
7.7× |
| Sialogram (70390) |
$1,429.25 |
$1,429.25 |
5.7× |
| Simulation intermediate (77285) |
$7,431.50 |
$7,431.50 |
18.8× |
| Small bowel series (74250) |
$1,224.25 |
$1,224.25 |
6.6× |
| Spec medical radj physics consltj (77370) |
$6,536.25 |
$6,536.25 |
46.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$10,725 |
$10,725 |
27.2× |
| Special dosimetry (77331) |
$5,728.75 |
$5,728.75 |
40.4× |
| Special treatment procedure (77470) |
$11,315 |
$11,315 |
19.4× |
| Speech evaluation complex (70371) |
$825.50 |
$825.50 |
3.3× |
| Spine thoracic 3 views (72072) |
$940.25 |
$940.25 |
8.5× |
| Splenoportograpy rs&i (75810) |
$4,263.50 |
$4,263.50 |
1.3× |
| Stereotactic body radiation delivery (77373) |
$9,528.25 |
$9,528.25 |
5.1× |
| Superior sagittal sinus venogram (75870) |
$4,351.50 |
$4,351.50 |
1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$39,759 |
$39,759 |
100.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$22,935.75 |
$22,935.75 |
58.1× |
| Testicular Imaging With Vascular Flow (78761) |
$5,542.50 |
$5,542.50 |
13.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$5,312.12 |
$5,312.12 |
13.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$3,788.75 |
$3,788.75 |
26.7× |
| Therapeutic Enema (74283) |
$874 |
$874 |
4.7× |
| Thoracolumbar 2 views (72080) |
$1,052 |
$1,052 |
11.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$5,840.50 |
$5,840.50 |
10.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$5,957.50 |
$5,957.50 |
14.1× |
| Thyroid uptake measurement (78012) |
$3,005 |
$3,005 |
7.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$5,459.50 |
$5,459.50 |
12.9× |
| Treatment device intermediate (77333) |
$5,174.25 |
$5,174.25 |
36.5× |
| Treatment devices simple (77332) |
$3,037.75 |
$3,037.75 |
21.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$14,763.50 |
$14,763.50 |
25.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,036.50 |
$2,036.50 |
4.8× |
| Tx devices design & construction complex (77334) |
$6,653.75 |
$6,653.75 |
16.8× |
| Ultrasound elastography first target lesion (76982) |
$513.25 |
$513.25 |
4.7× |
| Ultrasound, abdomen limited (76705) |
$2,300.50 |
$2,300.50 |
20.9× |
| Umbilical-artery Doppler (OB) (76820) |
$1,466.50 |
$1,466.50 |
13.3× |
| Unlisted magnetic resonance procedure (76498) |
$17,159.75 |
$17,159.75 |
186.9× |
| Upper Extremity Infant (73092) |
$873.50 |
$873.50 |
7.9× |
| Urethrocystography retrograde rs&i (74450) |
$2,443.50 |
$2,443.50 |
9.7× |
| Urethrocystography voiding (74455) |
$1,005.75 |
$1,005.75 |
4.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$2,424.75 |
$2,424.75 |
13.1× |
| Us abdl aorta screen aaa (76706) |
$499.25 |
$499.25 |
4.5× |
| Us breast unilateral complete (76641) |
$2,173.25 |
$2,173.25 |
19.7× |
| Us breast unilateral limited (76642) |
$2,173.25 |
$2,173.25 |
23.7× |
| Us chest (76604) |
$1,633.50 |
$1,633.50 |
14.8× |
| Us compl joint r-t w/image documentation (76881) |
$1,931.50 |
$1,931.50 |
17.5× |
| Us elastography parenchyma (76981) |
$513.25 |
$513.25 |
4.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$1,086.25 |
$1,086.25 |
9.8× |
| Us infant hips dynamic (76885) |
$1,926 |
$1,926 |
21.0× |
| Us infant hips limited static (76886) |
$1,707.25 |
$1,707.25 |
18.6× |
| Us kidney transplant (76776) |
$3,556.25 |
$3,556.25 |
32.2× |
| Us ob detailed single fetus (76811) |
$3,016 |
$3,016 |
12.0× |
| Us ob transvaginal (76817) |
$3,459 |
$3,459 |
31.4× |
| Us pelvic non ob complete (76856) |
$1,885.12 |
$1,885.12 |
17.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,869.12 |
$1,869.12 |
16.9× |
| Us pregnancy ltd (76815) |
$978 |
$978 |
8.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,271.88 |
$1,271.88 |
11.5× |
| Us retroperitoneal complete (76770) |
$3,019 |
$3,019 |
27.4× |
| Us retroperitoneal limited (76775) |
$2,274.12 |
$2,274.12 |
20.6× |
| Us scrotum and contents (76870) |
$1,781.50 |
$1,781.50 |
16.2× |
| Us soft tissue head/neck (76536) |
$2,984.62 |
$2,984.62 |
27.1× |
| Us spinal canal and contents (76800) |
$1,372.75 |
$1,372.75 |
12.4× |
| Us transrectal (76872) |
$2,677.25 |
$2,677.25 |
24.3× |
| Us transrectal prostate volume (76873) |
$2,677.25 |
$2,677.25 |
24.3× |
| Us xtr non-vasc lmtd (76882) |
$1,269 |
$1,269 |
11.5× |
| Vascular flow imaging (78445) |
$8,247 |
$8,247 |
19.6× |
| Venogram extremity bilateral (75822) |
$5,741.25 |
$5,741.25 |
3.5× |
| Venography caval inferior serialography rs&i (75825) |
$14,520.50 |
$14,520.50 |
4.4× |
| Venography caval superior serialography rs&i (75827) |
$4,684.88 |
$4,684.88 |
2.8× |
| Venography extremity unilateral rs&i (75820) |
$4,733.25 |
$4,733.25 |
2.9× |
| Venography Renal Bilateral (75833) |
$7,425.25 |
$7,425.25 |
2.2× |
| Venography renal unilateral selective rs&i (75831) |
$4,021.75 |
$4,021.75 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$10,810.50 |
$10,810.50 |
3.2× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$10,343.75 |
$10,343.75 |
1.8× |
| Vertebral fracture assessment via dxa (77086) |
$710.50 |
$710.50 |
7.7× |
| Wrist 2 views (73100) |
$960.75 |
$960.75 |
10.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,300.50 |
$1,300.50 |
11.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,147.25 |
$1,147.25 |
12.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,026.50 |
$1,026.50 |
11.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,496.75 |
$2,496.75 |
13.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$917 |
$917 |
10.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$1,037.25 |
$1,037.25 |
11.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$920.50 |
$920.50 |
8.3× |
| X-ray exam hip uni 1 view (73501) |
$258.50 |
$258.50 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$258.50 |
$258.50 |
2.8× |
| X-ray exam hip uni 4/> views (73503) |
$427.25 |
$427.25 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$427.25 |
$427.25 |
3.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$813 |
$813 |
7.4× |
| X-ray exam of femur 1 (73551) |
$258.50 |
$258.50 |
2.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,224.25 |
$1,224.25 |
6.6× |
| X-ray eye for foreign body (70030) |
$467.75 |
$467.75 |
5.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$1,441.50 |
$1,441.50 |
13.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$1,276.75 |
$1,276.75 |
13.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,094.50 |
$1,094.50 |
11.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$7,331.50 |
$7,331.50 |
3.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$814.50 |
$814.50 |
8.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$762.25 |
$762.25 |
8.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,024.25 |
$1,024.25 |
9.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$873.50 |
$873.50 |
9.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,052 |
$1,052 |
9.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$2,913.50 |
$2,913.50 |
26.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$1,128.25 |
$1,128.25 |
10.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$1,138.75 |
$1,138.75 |
12.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$711 |
$711 |
7.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,441.50 |
$1,441.50 |
13.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$960.75 |
$960.75 |
8.7× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$3,224.75 |
$3,224.75 |
5.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$2,443.50 |
$2,443.50 |
6.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$868.25 |
$868.25 |
9.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,809.75 |
$1,809.75 |
16.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,890.75 |
$1,890.75 |
17.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$696.75 |
$696.75 |
7.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,128.25 |
$1,128.25 |
12.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,545.50 |
$1,545.50 |
16.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$800.50 |
$800.50 |
8.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,497 |
$1,497 |
13.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$950.50 |
$950.50 |
8.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$940.25 |
$940.25 |
10.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$1,128.25 |
$1,128.25 |
12.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$960.75 |
$960.75 |
10.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$859.50 |
$859.50 |
7.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$762.25 |
$762.25 |
8.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,037.25 |
$1,037.25 |
11.3× |
| Xr arthrogram ankle (73615) |
$1,716.50 |
$1,716.50 |
4.7× |
| Xr c-spine 6 or more views (72052) |
$1,923 |
$1,923 |
17.4× |
| Xr chest 4+ views (71048) |
$2,036.25 |
$2,036.25 |
18.5× |
| Xr finger(s) 2+ views (73140) |
$624.50 |
$624.50 |
6.8× |
| Xr shoulder 1 view (73020) |
$762.25 |
$762.25 |
8.3× |
| Xr spine cervical 4 or 5 views (72050) |
$1,658 |
$1,658 |
15.0× |
| Xr tibia/fibula 2 views (73590) |
$960.75 |
$960.75 |
10.5× |
| Xr tmj bilateral (70330) |
$1,170.25 |
$1,170.25 |
12.7× |
| Xray knee 1 or 2 views rt (73560) |
$960.75 |
$960.75 |
10.5× |