| 3-D radiotherapy plan dose-volume histograms (77295) |
$17,264.79 |
$17,264.79 |
12.4× |
| Abdomen 2 views (74019) |
$970.44 |
$970.44 |
9.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$4,136.96 |
$4,136.96 |
10.3× |
| Acute venous thrombus image (78456) |
$7,914.43 |
$7,914.43 |
6.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$24,918.97 |
$24,918.97 |
7.9× |
| Angiography extremity bilateral rs&i (75716) |
$14,054.70 |
$14,054.70 |
4.4× |
| Angiography extremity unilateral rs&i (75710) |
$12,856.11 |
$12,856.11 |
4.1× |
| Angiography internal mammary rs&i (75756) |
$26,878.38 |
$26,878.38 |
8.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$24,918.97 |
$24,918.97 |
4.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$24,918.97 |
$24,918.97 |
7.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$24,918.97 |
$24,918.97 |
7.9× |
| Angiography Spinal Selective Rs&I (75705) |
$28,738.77 |
$28,738.77 |
5.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$28,738.77 |
$28,738.77 |
5.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$8,053.69 |
$8,053.69 |
2.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$8,053.84 |
$8,053.84 |
2.5× |
| Ankle 2 views (73600) |
$751.25 |
$751.25 |
8.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$2,480.90 |
$2,480.90 |
7.1× |
| Aortogram thoracic (75605) |
$14,753.63 |
$14,753.63 |
2.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$14,920.33 |
$14,920.33 |
4.7× |
| Aortography abdominal serialography rs&i (75625) |
$13,160.36 |
$13,160.36 |
4.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$14,313.80 |
$14,313.80 |
4.5× |
| Artery X-Rays Adrenal Gland (75731) |
$24,918.97 |
$24,918.97 |
7.9× |
| Arthrogram elbow (73085) |
$3,295.90 |
$3,295.90 |
9.4× |
| Arthrogram hip (73525) |
$2,608.84 |
$2,608.84 |
7.4× |
| Arthrogram shoulder (73040) |
$3,491.32 |
$3,491.32 |
10.0× |
| Arthrogram wrist (73115) |
$3,975.69 |
$3,975.69 |
11.3× |
| Arthrography knee lt (73580) |
$3,962.71 |
$3,962.71 |
11.3× |
| Basic radiation dosimetry calculation (77300) |
$1,793.89 |
$1,793.89 |
13.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$3,341.54 |
$3,341.54 |
8.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$5,007.98 |
$5,007.98 |
12.5× |
| Bone &/joint imaging whole body (78306) |
$4,789.54 |
$4,789.54 |
11.9× |
| Bone age studies (77072) |
$989.07 |
$989.07 |
9.4× |
| Bone Imaging 3 Phase (78315) |
$5,238.46 |
$5,238.46 |
13.0× |
| Bone Marrow Imaging Limited Area (78102) |
$3,597.15 |
$3,597.15 |
9.0× |
| Bone survey complete (77075) |
$1,743.57 |
$1,743.57 |
16.6× |
| Brachytx isodose complex (77318) |
$3,061.36 |
$3,061.36 |
8.1× |
| Brachytx isodose intermed (77317) |
$3,061.36 |
$3,061.36 |
8.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,101.46 |
$1,101.46 |
2.9× |
| Brain image w/flow 4 + views (78606) |
$5,423.41 |
$5,423.41 |
9.9× |
| Brain imaging < 4 static views (78600) |
$1,723.25 |
$1,723.25 |
4.3× |
| Brain imaging < 4 static views w vascular flow (78601) |
$5,423.41 |
$5,423.41 |
13.5× |
| Brain Imaging Minimum 4 Static Views (78605) |
$5,423.41 |
$5,423.41 |
9.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$18,949.73 |
$18,949.73 |
13.2× |
| Brain Imaging Vascular Flow Only (78610) |
$6,270.99 |
$6,270.99 |
11.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$2,159.27 |
$2,159.27 |
5.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$6,267.38 |
$6,267.38 |
17.9× |
| Cervical spine 2 or 3 views (72040) |
$931.25 |
$931.25 |
10.7× |
| Chest 1 view (71045) |
$854.12 |
$854.12 |
9.8× |
| Chest 3 views (71047) |
$939.48 |
$939.48 |
10.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,495.74 |
$1,495.74 |
8.5× |
| Cineradiography/videoradiography (76120) |
$604.31 |
$604.31 |
5.8× |
| Clavicle complete (73000) |
$921.70 |
$921.70 |
10.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$446.28 |
$446.28 |
4.2× |
| Continuing medical physics consltj pr wk (77336) |
$2,258.39 |
$2,258.39 |
16.7× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$1,141.74 |
$1,141.74 |
6.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$12,741.45 |
$12,741.45 |
36.4× |
| CT abdomen and pelvis without contrast (74176) |
$9,179.30 |
$9,179.30 |
38.3× |
| CT abdomen w contrast (74160) |
$7,086.04 |
$7,086.04 |
40.2× |
| CT abdomen w wo contrast (74170) |
$8,640.05 |
$8,640.05 |
49.0× |
| CT abdomen w/o contrast (74150) |
$5,756.68 |
$5,756.68 |
54.8× |
| CT angio hrt w/3d image (75574) |
$4,411.56 |
$4,411.56 |
12.6× |
| CT angiography upper extremity lt (73206) |
$6,956.65 |
$6,956.65 |
39.5× |
| CT c-spine w/o contrast (72125) |
$7,071.58 |
$7,071.58 |
67.3× |
| CT cervical spine w&w/o contrast (72127) |
$6,878.03 |
$6,878.03 |
39.0× |
| CT cervical spine with contrast (72126) |
$8,262.59 |
$8,262.59 |
23.6× |
| CT chest w/wo contrast (71270) |
$7,998.61 |
$7,998.61 |
45.4× |
| CT chest with contrast (71260) |
$7,433.92 |
$7,433.92 |
42.2× |
| CT colonography screening (74263) |
$3,162.01 |
$3,162.01 |
13.2× |
| CT colonography w/o cntrst (74261) |
$549.86 |
$549.86 |
5.2× |
| CT head/brain with contrast (70460) |
$5,793.09 |
$5,793.09 |
32.9× |
| CT head/brain without and with contrast (70470) |
$7,679.37 |
$7,679.37 |
43.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$4,120.15 |
$4,120.15 |
11.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,812.11 |
$1,812.11 |
20.7× |
| CT hrt w/3d image congen (75573) |
$3,755.67 |
$3,755.67 |
10.7× |
| CT iac w contrast (70481) |
$6,296.52 |
$6,296.52 |
35.7× |
| CT lower ext w/o (73700) |
$5,630.44 |
$5,630.44 |
53.6× |
| CT lower extremity w wo contrast (73702) |
$6,367.69 |
$6,367.69 |
36.1× |
| CT lower extremity with contrast (73701) |
$7,317.03 |
$7,317.03 |
41.5× |
| CT lumbar spine w & w/o contrast (72133) |
$7,480.47 |
$7,480.47 |
42.5× |
| CT lumbar spine w/o contrast (72131) |
$6,694.59 |
$6,694.59 |
63.7× |
| CT lumbar spine with contrast (72132) |
$6,877.66 |
$6,877.66 |
19.6× |
| CT maxillofacial w contrast (70487) |
$7,213.77 |
$7,213.77 |
40.9× |
| CT maxillofacial w/o contrast (70486) |
$5,828.66 |
$5,828.66 |
55.5× |
| CT maxillofacial w/wo contrast (70488) |
$7,443.71 |
$7,443.71 |
42.2× |
| CT neck soft tissue w contrast (70491) |
$7,204.37 |
$7,204.37 |
40.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$7,500.73 |
$7,500.73 |
42.6× |
| CT orbits w/o contrast (70480) |
$6,013.94 |
$6,013.94 |
57.3× |
| CT pelvis w & w/o contrast (72194) |
$6,880.85 |
$6,880.85 |
39.1× |
| CT pelvis w/o contrast (72192) |
$6,023.61 |
$6,023.61 |
57.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$7,367.28 |
$7,367.28 |
41.8× |
| CT soft tissue neck w/o contrast (70490) |
$6,214.34 |
$6,214.34 |
59.2× |
| CT thoracic spine w/contrast (72129) |
$7,033.49 |
$7,033.49 |
39.9× |
| CT thoracic spine w/o contrast (72128) |
$6,192.21 |
$6,192.21 |
59.0× |
| CT thoracic spine w/wo contrast (72130) |
$8,045.62 |
$8,045.62 |
45.7× |
| CT thorax w/o contrast (71250) |
$5,492.67 |
$5,492.67 |
52.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$7,072.13 |
$7,072.13 |
40.1× |
| CT upper extremity w/o contrast rt (73200) |
$5,223.39 |
$5,223.39 |
49.7× |
| CT upper extremity with contrast (73201) |
$6,599.75 |
$6,599.75 |
18.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$6,527.44 |
$6,527.44 |
37.0× |
| Cta Abdomen (74175) |
$7,366 |
$7,366 |
41.8× |
| CTA abdomen pelvis (74174) |
$11,448.46 |
$11,448.46 |
32.7× |
| CTA chest (71275) |
$7,575.88 |
$7,575.88 |
43.0× |
| Cta Head (70496) |
$7,007.27 |
$7,007.27 |
39.8× |
| CTA lwr ext w&w/o contrast (73706) |
$9,239.34 |
$9,239.34 |
52.4× |
| Cta Neck (70498) |
$5,937.44 |
$5,937.44 |
33.7× |
| Cta Pelvis (72191) |
$6,212.29 |
$6,212.29 |
35.3× |
| Cystography minimum 3 views rs&i (74430) |
$2,235.18 |
$2,235.18 |
6.4× |
| Diskogram cervical (72285) |
$19,070.12 |
$19,070.12 |
9.7× |
| Diskography lumbar (72295) |
$17,988.03 |
$17,988.03 |
9.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$539.57 |
$539.57 |
5.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,338.09 |
$1,338.09 |
12.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$699.95 |
$699.95 |
8.0× |
| Dxa bone density study axial skeleton (77085) |
$578.91 |
$578.91 |
5.5× |
| Echo exam of eye (76529) |
$350.62 |
$350.62 |
4.0× |
| Echo exam of fetal heart (76825) |
$2,394.66 |
$2,394.66 |
4.4× |
| Echoencephalography real time imaging (76506) |
$1,312.37 |
$1,312.37 |
12.5× |
| Esophagus (74220) |
$1,415.58 |
$1,415.58 |
8.0× |
| Fetal biophysical profile non-stress testing (76818) |
$1,339.25 |
$1,339.25 |
12.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$811.51 |
$811.51 |
7.7× |
| Fluoroscopy up to 1 hr (76000) |
$1,552.63 |
$1,552.63 |
6.5× |
| Foot 2 views (73620) |
$776.37 |
$776.37 |
8.9× |
| Forearm 2 views (73090) |
$944.49 |
$944.49 |
10.8× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$805.06 |
$805.06 |
3.4× |
| Gated Heart Planar Single (78472) |
$4,893.13 |
$4,893.13 |
12.2× |
| Hand 2 views (73120) |
$812.52 |
$812.52 |
7.7× |
| Hand 3 views (73130) |
$911.90 |
$911.90 |
10.4× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$6,926.23 |
$6,926.23 |
9.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,926.23 |
$6,926.23 |
9.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$6,926.23 |
$6,926.23 |
9.9× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,933.45 |
$1,933.45 |
5.0× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,933.45 |
$1,933.45 |
5.0× |
| Heart Infarct Image (78466) |
$3,635.57 |
$3,635.57 |
9.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$24,918.97 |
$24,918.97 |
7.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$5,161.48 |
$5,161.48 |
9.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$4,342.84 |
$4,342.84 |
10.8× |
| Ht muscle image spect sing (78451) |
$8,391.29 |
$8,391.29 |
6.5× |
| Humerus Min 2 Views Left (73060) |
$864.85 |
$864.85 |
9.9× |
| Hysterosalpingogram (74740) |
$2,609.68 |
$2,609.68 |
10.9× |
| Interstitial radiation source applic complex (77778) |
$14,888.58 |
$14,888.58 |
21.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$3,853.23 |
$3,853.23 |
5.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$3,853.23 |
$3,853.23 |
6.9× |
| Kidney funcj study non-img radioisotopic study (78725) |
$1,544.52 |
$1,544.52 |
3.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,089.32 |
$3,089.32 |
5.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,089.32 |
$3,089.32 |
5.7× |
| Knee 3 views (73562) |
$906.82 |
$906.82 |
10.4× |
| Liver & spleen imaging static only (78215) |
$3,753.24 |
$3,753.24 |
9.3× |
| Liver imaging static only (78201) |
$2,992.57 |
$2,992.57 |
5.5× |
| Liver imaging w/vascular flow (78202) |
$9,295.43 |
$9,295.43 |
17.0× |
| Lung perf&ventilat diferentl (78598) |
$5,063.05 |
$5,063.05 |
9.3× |
| Lung perfusion differential (78597) |
$3,750.47 |
$3,750.47 |
9.3× |
| Lung Ventilation Imaging (78579) |
$2,733.45 |
$2,733.45 |
6.8× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$8,623.67 |
$8,623.67 |
2.7× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$3,280.10 |
$3,280.10 |
5.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$7,914.43 |
$7,914.43 |
5.0× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$7,914.43 |
$7,914.43 |
2.5× |
| Lymphoscintigraphy (78195) |
$4,780.98 |
$4,780.98 |
8.8× |
| Mammary ductogram or galactogram multiple (77054) |
$3,280.10 |
$3,280.10 |
13.7× |
| Mammary ductogram or galactogram single (77053) |
$2,552.97 |
$2,552.97 |
10.7× |
| Meckels Diverticulum (78290) |
$4,947.24 |
$4,947.24 |
12.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$14,812.58 |
$14,812.58 |
39.4× |
| MRA head w & w/o contrast (70546) |
$7,093.19 |
$7,093.19 |
20.2× |
| MRA head w/o contrast (70544) |
$7,477.03 |
$7,477.03 |
31.2× |
| MRA head with contrast (70545) |
$7,536.82 |
$7,536.82 |
21.5× |
| MRA neck w contrast (70548) |
$7,753.11 |
$7,753.11 |
22.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$10,780.15 |
$10,780.15 |
30.8× |
| MRA neck w/o contrast (70547) |
$7,103.68 |
$7,103.68 |
29.6× |
| MRI abdomen w contrast (74182) |
$8,197.01 |
$8,197.01 |
23.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$11,883.34 |
$11,883.34 |
33.9× |
| MRI abdomen w/o contrast (74181) |
$7,848.46 |
$7,848.46 |
32.7× |
| MRI any jnt lwr ext with con lt (73722) |
$7,836.64 |
$7,836.64 |
10.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$9,911.91 |
$9,911.91 |
12.6× |
| MRI bone marrow blood supply (77084) |
$3,134.59 |
$3,134.59 |
13.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,521.03 |
$1,521.03 |
6.3× |
| MRI breast w/o contrast unilat (77046) |
$1,521.03 |
$1,521.03 |
6.3× |
| MRI c-spine with contrast (72142) |
$8,342.90 |
$8,342.90 |
23.8× |
| MRI cardiac w/o contrast (75557) |
$6,959.21 |
$6,959.21 |
29.0× |
| MRI cervical spine w/o contrast (72141) |
$8,390.76 |
$8,390.76 |
35.0× |
| MRI chest w/o & w/contrast material (71552) |
$11,349.48 |
$11,349.48 |
32.4× |
| MRI chest w/o contrast (71550) |
$8,644.88 |
$8,644.88 |
36.1× |
| MRI chest with contrast (71551) |
$4,156.11 |
$4,156.11 |
5.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,156.11 |
$4,156.11 |
11.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$7,413.68 |
$7,413.68 |
21.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$7,815.16 |
$7,815.16 |
32.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$7,981.38 |
$7,981.38 |
33.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$11,858.54 |
$11,858.54 |
33.8× |
| MRI orbit/face/neck w/contrast (70542) |
$7,818.71 |
$7,818.71 |
22.3× |
| MRI pelvis w contrast (72196) |
$8,450.29 |
$8,450.29 |
24.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$12,162.80 |
$12,162.80 |
34.7× |
| MRI pelvis w/o contrast (72195) |
$7,404.44 |
$7,404.44 |
30.9× |
| MRI scan of arm joint before and after contrast (73223) |
$10,956.66 |
$10,956.66 |
31.3× |
| MRI scan of leg joint before and after contrast (73723) |
$12,894.51 |
$12,894.51 |
36.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$11,690.22 |
$11,690.22 |
33.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$10,971.42 |
$10,971.42 |
31.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$12,460.98 |
$12,460.98 |
35.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$8,619.79 |
$8,619.79 |
24.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$12,344.34 |
$12,344.34 |
35.2× |
| MRI thoracic spine w/o contrast (72146) |
$8,580.96 |
$8,580.96 |
35.8× |
| MRI tmj (70336) |
$7,813.07 |
$7,813.07 |
32.6× |
| MRI upper ext joint w/o contrast (73221) |
$7,890.46 |
$7,890.46 |
32.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$11,989.38 |
$11,989.38 |
34.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$8,920.49 |
$8,920.49 |
37.2× |
| Myelogram Cervical (72240) |
$5,978.44 |
$5,978.44 |
7.6× |
| Myelogram Lumbar (72265) |
$5,978.44 |
$5,978.44 |
7.6× |
| Myelogram thoracic (72255) |
$5,978.44 |
$5,978.44 |
7.6× |
| Myelography 2 or more regions (72270) |
$5,978.44 |
$5,978.44 |
7.6× |
| Myocardial Spect Multiple Studies (78452) |
$11,413.63 |
$11,413.63 |
8.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$4,658 |
$4,658 |
5.4× |
| Neck soft tissue (70360) |
$778.77 |
$778.77 |
8.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,880.66 |
$1,880.66 |
4.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,909.02 |
$1,909.02 |
4.8× |
| Nm bone marrow multiple (78103) |
$3,569.43 |
$3,569.43 |
8.9× |
| Nm bone marrow wb (78104) |
$4,161.97 |
$4,161.97 |
10.4× |
| Nm cisternogram (78630) |
$5,044.83 |
$5,044.83 |
9.2× |
| Nm gastric emptying study (78264) |
$4,424.24 |
$4,424.24 |
11.0× |
| Nm gastroesophageal reflux study (78262) |
$2,969.10 |
$2,969.10 |
7.4× |
| Nm peritoneal-venous shunt patency (78291) |
$1,640.83 |
$1,640.83 |
4.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$16,420.63 |
$16,420.63 |
11.8× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$11,478.38 |
$11,478.38 |
8.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$5,497.56 |
$5,497.56 |
13.7× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$3,280.10 |
$3,280.10 |
8.2× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$3,280.10 |
$3,280.10 |
6.0× |
| Nuclear Rx Oral Admin (79005) |
$3,003.36 |
$3,003.36 |
12.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$811.51 |
$811.51 |
7.7× |
| Osseous survey infant (77076) |
$924.83 |
$924.83 |
8.8× |
| Osseous survey limited (77074) |
$2,009.65 |
$2,009.65 |
19.1× |
| Parathyrd planar w/spect&CT (78072) |
$1,879.36 |
$1,879.36 |
3.4× |
| Parathyroid imaging (78070) |
$3,283.55 |
$3,283.55 |
8.2× |
| Pelvis 1 or 2 views (72170) |
$855.96 |
$855.96 |
8.2× |
| PET image w/CT, skull-thigh (78815) |
$19,535.94 |
$19,535.94 |
13.6× |
| PET imaging CT for attenuation limited area (78814) |
$19,845.19 |
$19,845.19 |
13.8× |
| PET imaging for CT attenuation whole body (78816) |
$17,042.46 |
$17,042.46 |
11.9× |
| PET imaging limited area chest head/neck (78811) |
$30,592.61 |
$30,592.61 |
23.5× |
| PET whole body (78813) |
$34,986.69 |
$34,986.69 |
24.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$10,873.20 |
$10,873.20 |
31.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$13,874.80 |
$13,874.80 |
4.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$5,412.14 |
$5,412.14 |
1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$4,108.77 |
$4,108.77 |
10.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$6,057.02 |
$6,057.02 |
11.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$3,280.10 |
$3,280.10 |
6.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$604.93 |
$604.93 |
6.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,001.74 |
$1,001.74 |
9.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,001.74 |
$1,001.74 |
9.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$924.83 |
$924.83 |
8.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,909.77 |
$1,909.77 |
18.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$95,077.83 |
$95,077.83 |
12.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$4,111.72 |
$4,111.72 |
7.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$974.48 |
$974.48 |
9.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,554.94 |
$1,554.94 |
4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$1,065.71 |
$1,065.71 |
10.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$826.65 |
$826.65 |
9.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$970.44 |
$970.44 |
9.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$876.24 |
$876.24 |
10.0× |
| Radiologic exam colon single contrast study (74270) |
$1,714.95 |
$1,714.95 |
9.7× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$3,670.13 |
$3,670.13 |
15.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$2,057.62 |
$2,057.62 |
11.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,950.76 |
$1,950.76 |
11.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$604.93 |
$604.93 |
6.9× |
| Radiological examination surgical specimen (76098) |
$3,280.10 |
$3,280.10 |
6.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$13,819.50 |
$13,819.50 |
4.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$15,392.59 |
$15,392.59 |
4.9× |
| Ribs bilateral 3 views (71110) |
$956.36 |
$956.36 |
9.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$4,891.04 |
$4,891.04 |
12.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$6,086.10 |
$6,086.10 |
11.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$6,367.95 |
$6,367.95 |
11.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$7,947.35 |
$7,947.35 |
6.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$9,015.34 |
$9,015.34 |
6.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$7,947.35 |
$7,947.35 |
6.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$5,625.69 |
$5,625.69 |
24.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,254.02 |
$1,254.02 |
5.3× |
| Rp Therapy Intravenous Administration (79101) |
$7,221.17 |
$7,221.17 |
30.8× |
| Sacroiliac Joints < 3 Views (72200) |
$722.38 |
$722.38 |
6.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$2,379.66 |
$2,379.66 |
9.9× |
| Scanogram (77073) |
$948.19 |
$948.19 |
9.0× |
| Scapula complete (73010) |
$918.86 |
$918.86 |
8.7× |
| Screening digital breast tomosynthesis (77063) |
$188.46 |
$188.46 |
8.1× |
| Sella turcica (70240) |
$577.77 |
$577.77 |
6.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,032.36 |
$1,032.36 |
9.8× |
| Sialogram (70390) |
$3,027.48 |
$3,027.48 |
12.6× |
| Simulation intermediate (77285) |
$5,736.40 |
$5,736.40 |
15.3× |
| Small bowel series (74250) |
$1,567.09 |
$1,567.09 |
8.9× |
| Spec medical radj physics consltj (77370) |
$3,165.81 |
$3,165.81 |
23.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$4,784.76 |
$4,784.76 |
12.7× |
| Special dosimetry (77331) |
$1,206.31 |
$1,206.31 |
8.9× |
| Special treatment procedure (77470) |
$7,440.34 |
$7,440.34 |
13.4× |
| Spine thoracic 3 views (72072) |
$1,082.04 |
$1,082.04 |
10.3× |
| Splenoportograpy rs&i (75810) |
$13,123.08 |
$13,123.08 |
4.1× |
| Stereotactic body radiation delivery (77373) |
$18,522.84 |
$18,522.84 |
10.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$1,880.66 |
$1,880.66 |
18.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,101.46 |
$1,101.46 |
2.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,101.46 |
$1,101.46 |
2.9× |
| Testicular Imaging With Vascular Flow (78761) |
$4,094.01 |
$4,094.01 |
10.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$6,211.03 |
$6,211.03 |
16.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,750.20 |
$2,750.20 |
20.4× |
| Therapeutic Enema (74283) |
$1,469.50 |
$1,469.50 |
8.3× |
| Thoracolumbar 2 views (72080) |
$404.42 |
$404.42 |
4.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$4,681.65 |
$4,681.65 |
8.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,848.44 |
$1,848.44 |
4.6× |
| Thyroid uptake measurement (78012) |
$1,840.98 |
$1,840.98 |
4.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,744.54 |
$2,744.54 |
6.8× |
| Tmj unilateral (70328) |
$577.77 |
$577.77 |
6.6× |
| Tomogram (76100) |
$924.83 |
$924.83 |
8.8× |
| Treatment device intermediate (77333) |
$2,493.61 |
$2,493.61 |
18.5× |
| Treatment devices simple (77332) |
$2,911.51 |
$2,911.51 |
21.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$11,925.60 |
$11,925.60 |
21.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$3,672.40 |
$3,672.40 |
9.1× |
| Tx devices design & construction complex (77334) |
$3,461.27 |
$3,461.27 |
9.2× |
| Ultrasound elastography first target lesion (76982) |
$742.26 |
$742.26 |
7.1× |
| Ultrasound, abdomen limited (76705) |
$1,766.33 |
$1,766.33 |
16.8× |
| Umbilical-artery Doppler (OB) (76820) |
$811.51 |
$811.51 |
7.7× |
| Unlisted magnetic resonance procedure (76498) |
$2,787.45 |
$2,787.45 |
31.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$2,420.52 |
$2,420.52 |
23.6× |
| Unlisted Ultrasound Procedure (76999) |
$412.20 |
$412.20 |
4.7× |
| Upper Extremity Infant (73092) |
$924.83 |
$924.83 |
8.8× |
| Urethrocystography retrograde rs&i (74450) |
$1,809.70 |
$1,809.70 |
7.6× |
| Urethrocystography voiding (74455) |
$2,429.76 |
$2,429.76 |
10.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$3,146.14 |
$3,146.14 |
17.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$2,462.36 |
$2,462.36 |
14.0× |
| Us abdl aorta screen aaa (76706) |
$1,378.06 |
$1,378.06 |
13.1× |
| Us breast unilateral complete (76641) |
$892.36 |
$892.36 |
8.5× |
| Us breast unilateral limited (76642) |
$594.10 |
$594.10 |
6.8× |
| Us chest (76604) |
$1,312.37 |
$1,312.37 |
12.5× |
| Us compl joint r-t w/image documentation (76881) |
$1,312.37 |
$1,312.37 |
12.5× |
| Us elastography parenchyma (76981) |
$742.26 |
$742.26 |
7.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$539.57 |
$539.57 |
5.1× |
| Us guided compression repair (76936) |
$2,023.87 |
$2,023.87 |
9.3× |
| Us infant hips dynamic (76885) |
$412.20 |
$412.20 |
4.7× |
| Us infant hips limited static (76886) |
$892.36 |
$892.36 |
10.2× |
| Us kidney transplant (76776) |
$1,716.53 |
$1,716.53 |
16.3× |
| Us ob detailed single fetus (76811) |
$2,514.65 |
$2,514.65 |
10.5× |
| Us ob transvaginal (76817) |
$1,368.72 |
$1,368.72 |
13.0× |
| Us pelvic non ob complete (76856) |
$2,030.76 |
$2,030.76 |
19.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,200.21 |
$1,200.21 |
11.4× |
| Us pregnancy ltd (76815) |
$1,005.86 |
$1,005.86 |
9.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,434.96 |
$1,434.96 |
13.7× |
| Us retroperitoneal complete (76770) |
$1,751.51 |
$1,751.51 |
16.7× |
| Us retroperitoneal limited (76775) |
$1,312.37 |
$1,312.37 |
12.5× |
| Us scrotum and contents (76870) |
$1,764.39 |
$1,764.39 |
16.8× |
| Us soft tissue head/neck (76536) |
$1,580.29 |
$1,580.29 |
15.0× |
| Us spinal canal and contents (76800) |
$892.36 |
$892.36 |
8.5× |
| Us transrectal (76872) |
$1,576.38 |
$1,576.38 |
15.0× |
| Us transrectal prostate volume (76873) |
$4,945.29 |
$4,945.29 |
47.1× |
| Us xtr non-vasc lmtd (76882) |
$1,279.98 |
$1,279.98 |
12.2× |
| Us, eye b-scan (76512) |
$766.47 |
$766.47 |
7.3× |
| Vascular flow imaging (78445) |
$3,280.10 |
$3,280.10 |
8.2× |
| Venogram extremity bilateral (75822) |
$5,256.78 |
$5,256.78 |
3.3× |
| Venography caval inferior serialography rs&i (75825) |
$13,783.71 |
$13,783.71 |
4.3× |
| Venography caval superior serialography rs&i (75827) |
$6,219.01 |
$6,219.01 |
3.9× |
| Venography extremity unilateral rs&i (75820) |
$5,595.70 |
$5,595.70 |
3.5× |
| Venography Renal Bilateral (75833) |
$13,819.50 |
$13,819.50 |
4.4× |
| Venography renal unilateral selective rs&i (75831) |
$13,819.50 |
$13,819.50 |
4.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$26,878.38 |
$26,878.38 |
8.5× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$24,918.97 |
$24,918.97 |
4.5× |
| Wrist 2 views (73100) |
$879.43 |
$879.43 |
10.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,256.83 |
$1,256.83 |
12.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,197.43 |
$1,197.43 |
13.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$924.13 |
$924.13 |
10.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,279.74 |
$2,279.74 |
12.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$940.03 |
$940.03 |
10.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$946.43 |
$946.43 |
10.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,909.77 |
$1,909.77 |
18.2× |
| X-ray exam hip uni 1 view (73501) |
$604.93 |
$604.93 |
6.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$604.93 |
$604.93 |
6.9× |
| X-ray exam hip uni 4/> views (73503) |
$1,001.74 |
$1,001.74 |
9.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,001.74 |
$1,001.74 |
9.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,909.77 |
$1,909.77 |
18.2× |
| X-ray exam of femur 1 (73551) |
$604.93 |
$604.93 |
6.9× |
| X-ray eye for foreign body (70030) |
$609.57 |
$609.57 |
7.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$1,314.78 |
$1,314.78 |
12.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$878.23 |
$878.23 |
10.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$923.04 |
$923.04 |
10.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$6,622.27 |
$6,622.27 |
3.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$798.80 |
$798.80 |
9.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$965.76 |
$965.76 |
11.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,007.27 |
$1,007.27 |
9.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$710.31 |
$710.31 |
8.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$924.83 |
$924.83 |
10.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,017.36 |
$1,017.36 |
9.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,550.25 |
$1,550.25 |
14.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$954.89 |
$954.89 |
10.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$1,897.78 |
$1,897.78 |
21.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,006.20 |
$1,006.20 |
9.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$960.50 |
$960.50 |
9.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$2,866.34 |
$2,866.34 |
8.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$730.14 |
$730.14 |
8.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$759.16 |
$759.16 |
7.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,356.27 |
$1,356.27 |
12.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$803.20 |
$803.20 |
7.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$878.39 |
$878.39 |
10.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$940.31 |
$940.31 |
10.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,045.03 |
$1,045.03 |
12.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$867.56 |
$867.56 |
9.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,360.21 |
$1,360.21 |
13.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$948.59 |
$948.59 |
9.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$809.40 |
$809.40 |
9.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$605.83 |
$605.83 |
6.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$786.75 |
$786.75 |
9.0× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$577.77 |
$577.77 |
6.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,021.68 |
$1,021.68 |
9.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$1,174.05 |
$1,174.05 |
11.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$788.02 |
$788.02 |
9.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,019.27 |
$1,019.27 |
11.7× |
| Xr arthrogram ankle (73615) |
$3,295.90 |
$3,295.90 |
9.4× |
| Xr c-spine 6 or more views (72052) |
$1,375 |
$1,375 |
13.1× |
| Xr chest 4+ views (71048) |
$1,304.86 |
$1,304.86 |
12.4× |
| Xr finger(s) 2+ views (73140) |
$759.01 |
$759.01 |
8.7× |
| Xr internal auditory meati complete (70134) |
$924.83 |
$924.83 |
1.7× |
| Xr optic foramina (70190) |
$924.83 |
$924.83 |
10.6× |
| Xr shoulder 1 view (73020) |
$858.97 |
$858.97 |
9.8× |
| Xr spine cervical 4 or 5 views (72050) |
$1,367.86 |
$1,367.86 |
13.0× |
| Xr tibia/fibula 2 views (73590) |
$923.93 |
$923.93 |
10.6× |
| Xr tmj bilateral (70330) |
$643.28 |
$643.28 |
7.4× |
| Xray knee 1 or 2 views rt (73560) |
$870.39 |
$870.39 |
10.0× |