| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$5,128 |
— |
| Abdomen 1 View (74018) |
— |
$265 |
— |
| Abdomen 2 views (74019) |
— |
$338 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$2,159 |
— |
| Adrenal Cortex & Medulla Img (78075) |
— |
$2,979 |
— |
| Angio internal mammary (75756) |
— |
$1,748 |
— |
| Angio pulmonary bilat (75743) |
— |
$2,198 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$2,329 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$2,402 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$1,366 |
— |
| Ankle 2 views (73600) |
— |
$275 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$2,794 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$1,936 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$1,431 |
— |
| Artery X-Rays Spine (75705) |
— |
$1,931 |
— |
| Arthrogram hip (73525) |
— |
$1,171 |
— |
| Arthrogram Wrist (73115) |
— |
$1,236 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$849 |
— |
| Bone age studies (77072) |
— |
$305 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$2,221 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,431 |
— |
| Bone Imaging Whole Body (78306) |
— |
$2,055 |
— |
| Bone marrow imaging limited area (78102) |
— |
$1,029 |
— |
| Bone marrow imaging; multiple areas (78103) |
— |
$2,689 |
— |
| Bone survey infant (77076) |
— |
$636 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$807 |
— |
| Brain Image W/Flow < 4 Views (78601) |
— |
$1,435 |
— |
| Brain imaging < 4 static views (78600) |
— |
$1,660 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$2,278 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$7,364 |
— |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
— |
$1,536 |
— |
| Cardiac MRI w/w/o contrast & further seq (75561) |
— |
$4,827 |
— |
| Cardiac MRI w/w/o contrast w/stress (75563) |
— |
$5,815 |
— |
| Cardiac Shunt Detection (78428) |
— |
$1,392 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$1,458 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$2,329 |
— |
| Chest 1 view (71045) |
— |
$253 |
— |
| Chest 2 views (71046) |
— |
$323 |
— |
| Chest 3 views (71047) |
— |
$368 |
— |
| Chest 4 or more views (71048) |
— |
$422 |
— |
| Clavicle complete (73000) |
— |
$352 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$1,668 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$670 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$2,794 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$607 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$1,055 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$1,392 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$5,161 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$3,963 |
— |
| CT abdomen w contrast (74160) |
— |
$2,600 |
— |
CT abdomen w wo contrast (74170)
range across 2 matching MRF lines |
— |
$2,901–$3,263 |
— |
| CT abdomen w/o contrast (74150) |
— |
$2,319 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$5,168 |
— |
| CT Angio Chest (71275) |
— |
$4,068 |
— |
| CT Angio Head (70496) |
— |
$3,592 |
— |
| CT angio hrt w/3d image (75574) |
— |
$3,036 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$3,317 |
— |
| CT Angio Neck (70498) |
— |
$3,248 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$3,239 |
— |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
— |
$1,638 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$2,414 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$2,266 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$3,110 |
— |
| CT chest w contrast (71260) |
— |
$2,505 |
— |
| CT chest w/wo contrast (71270) |
— |
$2,543 |
— |
| CT colonography screening (74263) |
— |
$2,096 |
— |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
— |
$4,422 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$4,411 |
— |
| CT head/brain with contrast (70460) |
— |
$2,568 |
— |
| CT head/brain without and with contrast (70470) |
— |
$3,029 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$2,230 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$364 |
— |
| CT hrt w/3d image congen (75573) |
— |
$2,726 |
— |
| CT iac w contrast (70481) |
— |
$3,110 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$3,095 |
— |
| CT lower ext w/o (73700) |
— |
$2,208 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$2,278 |
— |
| CT lumbar spine w contrast (72132) |
— |
$2,673 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$2,558 |
— |
| CT maxillofacial w contrast (70487) |
— |
$2,186 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$2,145 |
— |
| CT neck tissue combo (70492) |
— |
$2,624 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$3,434 |
— |
| CT orbits w/o contrast (70480) |
— |
$2,203 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$3,138 |
— |
| CT pelvis w/o contrast (72192) |
— |
$2,166 |
— |
| CT scan of leg combo (73702) |
— |
$2,576 |
— |
| CT scans face/jaw combo (70488) |
— |
$2,248 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$2,502 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$2,382 |
— |
| CT thoracic spine w contrast (72129) |
— |
$2,624 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$2,413 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$3,135 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,975 |
— |
CT unlisted procedure (76497)
range across 2 matching MRF lines |
— |
$1,653–$1,908 |
— |
| CT upper ext wo (73200) |
— |
$2,225 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$3,265 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,225 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$4,864 |
— |
| Cta Abdomen (74175) |
— |
$3,665 |
— |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
— |
$4,380 |
— |
| CTA pelvis (72191) |
— |
$3,647 |
— |
| Dilation ureters/urethra rs&i (74485) |
— |
$2,295 |
— |
| Diskography lumbar (72295) |
— |
$2,308 |
— |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
— |
$293 |
— |
| Doppler Echo Fetal Spectral Display Complete (76827) |
— |
$613 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
— |
$847 |
— |
| Dxa Bone Density Axial (77080) |
— |
$701 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$193 |
— |
| Echo exam of fetal heart (76825) |
— |
$1,444 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$1,665 |
— |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
— |
$911 |
— |
| Echograp Trans R Pros Study (76873) |
— |
$806 |
— |
| Esophagram (74220) |
— |
$525 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$1,239 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$690 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$989 |
— |
| Follow-Up Angiography (75898) |
— |
$2,707 |
— |
| Foot 2 views (73620) |
— |
$338 |
— |
| Forearm 2 views (73090) |
— |
$375 |
— |
| Gastric emptying imaging study (78264) |
— |
$2,028 |
— |
| Gated Heart Planar Single (78472) |
— |
$1,812 |
— |
| Hand 2 views (73120) |
— |
$373 |
— |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
— |
$1,406 |
— |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
— |
$1,406 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$2,705 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$1,978 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$3,147 |
— |
| Hysterosalpingogram (74740) |
— |
$735 |
— |
| Image fusion (77399) |
— |
$340 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$896 |
— |
| Infusion Ivp (74410) |
— |
$1,083 |
— |
| Joint Survey Single View (77077) |
— |
$275 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$1,559 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$1,783 |
— |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
— |
$683 |
— |
| Knee 3 Views (73562) |
— |
$422 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$1,627 |
— |
| Liver imaging static only (78201) |
— |
$1,612 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$1,900 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$2,433 |
— |
| Lung Ventilation Imaging (78579) |
— |
$1,338 |
— |
| Lymph System Imaging (78195) |
— |
$2,849 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$3,609 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
— |
$6,270 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
— |
$5,696 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
— |
$7,492 |
— |
| Magnetic Resonance Elastography (76391) |
— |
$2,885 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$559 |
— |
| Meckels Divert Exam (78290) |
— |
$2,133 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$3,656 |
— |
| Mr safety determination physician/other qhp (76016) |
— |
$95 |
— |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
— |
$95 |
— |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
— |
$225 |
— |
| Mr safety implt pos&/immoblj (76019) |
— |
$345 |
— |
| Mr safety med physics xm customization plng&mntr (76017) |
— |
$585 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$6,465 |
— |
| MRA head w/o contrast (70544) |
— |
$3,370 |
— |
| MRA head with contrast (70545) |
— |
$3,760 |
— |
| MRA neck w contrast (70548) |
— |
$3,590 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$4,553 |
— |
| MRA neck w/o contrast (70547) |
— |
$3,395 |
— |
| MRI abdomen w contrast (74182) |
— |
$4,670 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$3,292 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$4,130 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$4,566 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$3,760 |
— |
| MRI bone marrow blood supply (77084) |
— |
$3,890 |
— |
| MRI brain functional w/o physician admnistration (70554) |
— |
$4,059 |
— |
| MRI brain functional w/physician admnistration (70555) |
— |
$4,059 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$4,209 |
— |
| MRI Breast Without Contrast Material Unilateral (77046) |
— |
$2,807 |
— |
| MRI cardiac w/o cont stress (75559) |
— |
$4,749 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$3,355 |
— |
| MRI cervical spine w contrast (72142) |
— |
$3,733 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$3,309 |
— |
| MRI chest w/o contrast (71550) |
— |
$4,310 |
— |
| MRI chest with contrast (71551) |
— |
$4,670 |
— |
| MRI chest wo w contrast (71552) |
— |
$5,878 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$3,292 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$4,007 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$3,018 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$3,668 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$4,930 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$3,200 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$3,785 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$4,670 |
— |
| MRI pelvis w contrast (72196) |
— |
$3,694 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$4,475 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$3,188 |
— |
| MRI spectroscopy (76390) |
— |
$2,289 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$3,200 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$4,059 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$3,771 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$4,944 |
— |
| MRI, abdomen, combo (74183) |
— |
$4,996 |
— |
| MRI, dorsal spine combo (72157) |
— |
$5,553 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$4,436 |
— |
| MRI, joint upper extrem (73221) |
— |
$3,013 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$4,579 |
— |
| MRI, lumbar spine combo (72158) |
— |
$5,210 |
— |
| Myelogram cervical (72240) |
— |
$1,834 |
— |
| Myelogram Lumbar (72265) |
— |
$1,912 |
— |
| Myelograpy 2/more regions rs&i (72270) |
— |
$1,963 |
— |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
— |
$1,188 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$4,032 |
— |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
— |
$5,333 |
— |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
— |
$6,270 |
— |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
— |
$6,830 |
— |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
— |
$7,154 |
— |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
— |
$6,504 |
— |
| N-invas est c ffr sw aly CTA (75580) |
— |
$13,078 |
— |
| Neck soft tissue (70360) |
— |
$279 |
— |
| Nm csf leak detection (78650) |
— |
$2,255 |
— |
| Nm myocard infarct spect (78469) |
— |
$1,350 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$8,051 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$1,897 |
— |
| Ob us nuchal meas 1 gest (76813) |
— |
$613 |
— |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
— |
$911 |
— |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
— |
$602 |
— |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
— |
$602 |
— |
| Panoramic X-ray of jaws (70355) |
— |
$353 |
— |
| Parathyroid imaging w/tomographic spect & CT (78072) |
— |
$2,433 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$1,496 |
— |
| Parathyroid planar imaging w/wo subtraction (78071) |
— |
$2,003 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$280 |
— |
| Pet Image W/Ct Lmtd (78814) |
— |
$6,790 |
— |
| PET image w/CT, full body (78816) |
— |
$6,790 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$6,790 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,743 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$470 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$604 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$375 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$329 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$363 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$520 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$265 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$396 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$443 |
— |
| Radex lower extremity infant minimum 2 views (73592) |
— |
$288 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$359 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$319 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$438 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$263 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$337 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$375 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$281 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$261 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$375 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$730 |
— |
Radiation treatment delivery level 1 (77402)
range across 2 matching MRF lines |
— |
$851–$1,046 |
— |
Radiation treatment delivery level 2 (77407)
range across 4 matching MRF lines |
— |
$846–$3,790 |
— |
Radiation treatment delivery level 3 (77412)
range across 4 matching MRF lines |
— |
$2,222–$3,790 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$502 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$367 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,029 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$815 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$774 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$478 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$395 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$764 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$752 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$854 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$330 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$390 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$337 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$523 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$373 |
— |
| Renal Cyst Study (74470) |
— |
$618 |
— |
| Ribs bilateral 3 views (71110) |
— |
$661 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$1,522 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$2,007 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$3,461 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$2,433 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$2,510 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$9,188 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$3,306 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$6,186 |
— |
| Scapula (73010) |
— |
$401 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$133 |
— |
| Shoulder 1 view (73020) |
— |
$296 |
— |
| Shoulder Arthrography (73040) |
— |
$1,159 |
— |
| Skull less than 4 views (70250) |
— |
$382 |
— |
| Special dosimetry (77331) |
— |
$529 |
— |
| Special Physics Consult (77370) |
— |
$638 |
— |
| Special teletherapy port plan (77321) |
— |
$1,549 |
— |
| Special treatment procedure (77470) |
— |
$3,231 |
— |
Stereotactic Body Radiation Delivery (77373)
range across 3 matching MRF lines |
— |
$4,749–$5,352 |
— |
| Sternoclavicular joints (71130) |
— |
$401 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$2,596 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$815 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$2,107 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$822 |
— |
| Thoracic spine 2 views (72070) |
— |
$400 |
— |
| Thoracic spine 3 views (72072) |
— |
$432 |
— |
| Thoracolumbar 2 views (72080) |
— |
$299 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,171 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$1,821 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$772 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$1,458 |
— |
| Tx Devices Design & Construction Complex (77334) |
— |
$1,447 |
— |
| Tx devices design & construction intermediate (77333) |
— |
$1,034 |
— |
| Tx devices design & construction simple (77332) |
— |
$588 |
— |
| Ultrasound Breast Limited (76642) |
— |
$716 |
— |
| Ultrasound elastography first target lesion (76982) |
— |
$714 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$834 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$900 |
— |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
— |
$2,595 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$825 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$847 |
— |
| Unlisted Dx Radiographic Procedure (76499) |
— |
$1,717 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$8,226 |
— |
| Unlisted us procedure (76999) |
— |
$1,301 |
— |
| Upper gi w/o kub (74240) |
— |
$835 |
— |
| Ureteral Reflux Study (78740) |
— |
$1,301 |
— |
| Urethrocystogram voiding (74455) |
— |
$642 |
— |
| Urethrocystography retrograde (74450) |
— |
$606 |
— |
| Us breast unilateral complete (76641) |
— |
$1,502 |
— |
| Us chest (76604) |
— |
$855 |
— |
| Us complete joint (76881) |
— |
$887 |
— |
| Us exam, pelvic, limited (76857) |
— |
$501 |
— |
| Us head (76506) |
— |
$812 |
— |
| Us kidney transplant (76776) |
— |
$1,132 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$887 |
— |
| Us ob detailed single fetus (76811) |
— |
$924 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$531 |
— |
| Us ob transvaginal (76817) |
— |
$732 |
— |
| Us pelvic non ob complete (76856) |
— |
$802 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$771 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$611 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,046 |
— |
| Us retroperitoneal limited (76775) |
— |
$900 |
— |
| Us scrotum and contents (76870) |
— |
$982 |
— |
| Us spinal canal and contents (76800) |
— |
$1,029 |
— |
| Us thyroid (76536) |
— |
$797 |
— |
| Us transrectal (76872) |
— |
$1,190 |
— |
| Vascular Flow Imaging (78445) |
— |
$1,476 |
— |
| Vein X-Ray Chest (75827) |
— |
$2,861 |
— |
| Venogram Sinus/Jugular (75860) |
— |
$1,392 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$2,861 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$1,112 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$951 |
— |
| Venography Renal Unilateral (75831) |
— |
$2,966 |
— |
| Venous sampling by catheter (75893) |
— |
$1,182 |
— |
| Wrist 2 views (73100) |
— |
$275 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$375 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$640 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$4,095 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$382 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$315 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$572 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$443 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$298 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$670 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$267 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$376 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$437 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$492 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$602 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$425 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$569 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$368 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$580 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$446 |
— |
| X-ray eye for foreign body (70030) |
— |
$473 |
— |
| X-ray humerus (73060) |
— |
$360 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,018 |
— |
| X-ray IV pyelogram+tomography (74415) |
— |
$1,149 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$310 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$283 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$408 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$181 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$737 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$383 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$280 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$383 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$414 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$537 |
— |
| X-Ray Stress View (77071) |
— |
$198 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$474 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$1,181 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$480 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$1,131 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$545 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$280 |
— |
| Xr orbits complete 4 views (70200) |
— |
$482 |
— |