| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,534.07 |
$10,949.36 |
1.9× |
| Abdomen 2 views (74019) |
$192.66 |
$832.46 |
1.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,408.97 |
$6,087.96 |
3.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$5,995.48 |
$25,905.62 |
2.0× |
| Angiography extremity bilateral rs&i (75716) |
$4,435.02 |
$19,163.10 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$4,594.84 |
$19,977.56 |
1.5× |
| Angiography internal mammary rs&i (75756) |
$2,094.70 |
$9,050.94 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,886.24 |
$16,791.90 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,995.48 |
$25,905.62 |
2.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,991.04 |
$17,244.70 |
1.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,886.24 |
$16,791.90 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$546.20 |
$2,360.07 |
0.2× |
| Ankle 2 views (73600) |
$163.65 |
$711.53 |
2.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$516.70 |
$2,232.60 |
1.5× |
| Aortogram thoracic (75605) |
$3,886.24 |
$16,791.90 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,886.24 |
$16,791.90 |
1.3× |
| Aortography abdominal serialography rs&i (75625) |
$3,886.24 |
$16,791.90 |
1.3× |
| Artery X-Rays Adrenal Gland (75731) |
$5,995.48 |
$25,905.62 |
2.0× |
| Arthrogram elbow (73085) |
$561.55 |
$2,410.10 |
1.7× |
| Arthrogram hip (73525) |
$597.66 |
$2,565.05 |
1.8× |
| Arthrogram shoulder (73040) |
$581.52 |
$2,495.81 |
1.7× |
| Arthrogram wrist (73115) |
$443.56 |
$1,912.58 |
1.3× |
| Arthrography knee lt (73580) |
$574.61 |
$2,466.15 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$325.32 |
$1,405.68 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$633.92 |
$2,739.10 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$617.16 |
$2,666.70 |
1.6× |
| Bone age studies (77072) |
$203.33 |
$878.54 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$633.92 |
$2,739.10 |
1.7× |
| Bone Marrow Imaging Limited Area (78102) |
$779.05 |
$3,366.16 |
2.0× |
| Bone survey complete (77075) |
$203.33 |
$878.54 |
2.0× |
| Brain image w/flow 4 + views (78606) |
$601.28 |
$2,598.06 |
1.2× |
| Brain Imaging Vascular Flow Only (78610) |
$468.68 |
$2,025.12 |
0.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$468.68 |
$2,025.12 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$309.97 |
$1,347.69 |
3.7× |
| Chest 1 view (71045) |
$149.03 |
$639.63 |
1.8× |
| Chest 3 views (71047) |
$112.42 |
$485.79 |
1.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$390.72 |
$1,688.24 |
2.3× |
| Clavicle complete (73000) |
$184.99 |
$799.33 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$91.64 |
$395.96 |
0.9× |
| Continuing medical physics consltj pr wk (77336) |
$313.42 |
$1,345.15 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,826.66 |
$16,534.44 |
11.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,640.39 |
$11,408.74 |
11.5× |
| CT abdomen w contrast (74160) |
$1,349.96 |
$5,832.98 |
8.0× |
| CT abdomen w wo contrast (74170) |
$1,932.84 |
$8,351.56 |
11.5× |
| CT abdomen w/o contrast (74150) |
$1,290.16 |
$5,574.60 |
12.9× |
| CT angio hrt w/3d image (75574) |
$1,375.48 |
$5,943.27 |
4.1× |
| CT angiography upper extremity lt (73206) |
$1,849.01 |
$7,971.87 |
11.0× |
| CT c-spine w/o contrast (72125) |
$1,279.79 |
$5,529.78 |
12.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,309.30 |
$5,657.32 |
7.8× |
| CT cervical spine with contrast (72126) |
$856.38 |
$3,700.32 |
2.6× |
| CT chest w/wo contrast (71270) |
$1,895.37 |
$8,189.62 |
11.3× |
| CT chest with contrast (71260) |
$1,436.07 |
$6,205.08 |
8.5× |
| CT head/brain with contrast (70460) |
$1,091.62 |
$4,716.76 |
6.5× |
| CT head/brain without and with contrast (70470) |
$1,685.65 |
$7,283.45 |
10.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$345.49 |
$1,492.80 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$149.90 |
$647.71 |
1.8× |
| CT iac w contrast (70481) |
$1,089.22 |
$4,706.38 |
6.5× |
| CT limited/localized follow up study (76380) |
$904.22 |
$3,907.04 |
10.8× |
| CT lower ext w/o (73700) |
$1,149.82 |
$4,968.21 |
11.5× |
| CT lower extremity w wo contrast (73702) |
$1,247.90 |
$5,391.98 |
7.4× |
| CT lower extremity with contrast (73701) |
$1,210.42 |
$5,230.09 |
7.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,074.78 |
$8,964.80 |
12.3× |
| CT lumbar spine w/o contrast (72131) |
$1,799.68 |
$7,776.18 |
17.9× |
| CT lumbar spine with contrast (72132) |
$1,799.68 |
$7,776.18 |
5.4× |
| CT maxillofacial w contrast (70487) |
$1,091.62 |
$4,716.76 |
6.5× |
| CT maxillofacial w/o contrast (70486) |
$995.12 |
$4,299.80 |
9.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,695.23 |
$7,324.86 |
10.1× |
| CT neck soft tissue w contrast (70491) |
$1,207.23 |
$5,216.28 |
7.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,091.62 |
$4,716.76 |
6.5× |
| CT orbits w/o contrast (70480) |
$1,051.75 |
$4,544.46 |
10.5× |
| CT pelvis w & w/o contrast (72194) |
$2,123.42 |
$9,175.02 |
12.6× |
| CT pelvis w/o contrast (72192) |
$1,479.14 |
$6,391.18 |
14.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,207.23 |
$5,216.28 |
7.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,207.23 |
$5,216.28 |
12.0× |
| CT thoracic spine w/contrast (72129) |
$889.08 |
$3,841.62 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$1,823.61 |
$7,879.56 |
18.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,125.89 |
$4,864.83 |
6.7× |
| CT thorax w/o contrast (71250) |
$1,547.92 |
$6,643.45 |
15.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,792.30 |
$7,727.37 |
10.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,129.90 |
$4,882.12 |
11.3× |
| CT upper extremity with contrast (73201) |
$1,190.48 |
$5,143.93 |
3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,973.50 |
$8,527.25 |
11.7× |
| Cta Abdomen (74175) |
$1,879.42 |
$8,120.72 |
11.2× |
| CTA abdomen pelvis (74174) |
$3,422.66 |
$14,788.80 |
10.2× |
| CTA chest (71275) |
$2,152.14 |
$9,299.06 |
12.8× |
| Cta Head (70496) |
$2,240.63 |
$9,681.44 |
13.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,849.01 |
$7,971.87 |
11.0× |
| Cta Neck (70498) |
$1,207.23 |
$5,216.28 |
7.2× |
| Cta Pelvis (72191) |
$1,714.36 |
$7,407.54 |
10.2× |
| Cystography minimum 3 views rs&i (74430) |
$394.71 |
$1,705.49 |
1.2× |
| Diskogram cervical (72285) |
$4,614.42 |
$19,938.28 |
2.5× |
| Diskography lumbar (72295) |
$4,614.42 |
$19,938.28 |
2.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$163.48 |
$706.36 |
1.6× |
| Dxa bone density study axial skeleton (77085) |
$163.48 |
$706.36 |
1.6× |
| Echoencephalography real time imaging (76506) |
$350.86 |
$1,515.99 |
3.5× |
| Esophagus (74220) |
$373.16 |
$1,612.40 |
2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$269.51 |
$1,164.52 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$310.18 |
$1,340.24 |
1.4× |
| Foot 2 views (73620) |
$196.66 |
$844.04 |
2.4× |
| Forearm 2 views (73090) |
$97.29 |
$420.36 |
1.2× |
| Gated Heart Planar Single (78472) |
$1,263.85 |
$5,460.92 |
3.3× |
| Hand 2 views (73120) |
$157.84 |
$681.54 |
1.6× |
| Hand 3 views (73130) |
$236.02 |
$1,019.84 |
2.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$674.36 |
$2,913.78 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$674.36 |
$2,913.78 |
1.8× |
| Ht muscle image spect sing (78451) |
$2,869.23 |
$12,314.28 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$200.94 |
$868.25 |
2.4× |
| Hysterosalpingogram (74740) |
$531.06 |
$2,294.61 |
2.3× |
| Image fusion (77399) |
$361.22 |
$1,560.78 |
2.8× |
| Interstitial radiation source applic complex (77778) |
$6,522.55 |
$28,183.02 |
9.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,355.55 |
$5,857.14 |
2.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,355.55 |
$5,857.14 |
2.6× |
| Intracavitary radiation source applic simple (77761) |
$1,355.55 |
$5,857.14 |
2.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$137.15 |
$592.61 |
1.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,264.64 |
$5,464.34 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$871.53 |
$3,765.76 |
1.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,708.78 |
$7,383.38 |
3.3× |
| Knee 3 views (73562) |
$169.84 |
$733.82 |
2.0× |
| Liver & spleen imaging static only (78215) |
$674.58 |
$2,914.76 |
1.8× |
| Lung perf&ventilat diferentl (78598) |
$1,047.22 |
$4,524.92 |
2.0× |
| Lung perfusion differential (78597) |
$1,047.22 |
$4,524.92 |
2.7× |
| Lung Ventilation Imaging (78579) |
$459.44 |
$1,985.18 |
1.2× |
| Lymphoscintigraphy (78195) |
$833.26 |
$3,600.42 |
1.6× |
| Mammary ductogram or galactogram multiple (77054) |
$612.38 |
$2,646.02 |
2.7× |
| Mammary ductogram or galactogram single (77053) |
$460.44 |
$1,989.52 |
2.0× |
| Meckels Diverticulum (78290) |
$578.90 |
$2,501.34 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$683.34 |
$2,952.64 |
1.9× |
| Mr safety determination physician/other qhp (76016) |
$85.18 |
$368.05 |
1.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$57.46 |
$248.29 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$22.82 |
$97.96 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$88.80 |
$383.68 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$233.84 |
$1,010.39 |
1.0× |
| MRA head w & w/o contrast (70546) |
$2,812.38 |
$12,070.29 |
8.4× |
| MRA head w/o contrast (70544) |
$2,293.07 |
$9,841.51 |
10.0× |
| MRA head with contrast (70545) |
$782.03 |
$3,356.34 |
2.3× |
| MRA neck w contrast (70548) |
$1,163.05 |
$4,991.65 |
3.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,697.15 |
$11,575.75 |
8.1× |
| MRA neck w/o contrast (70547) |
$1,189.17 |
$5,103.73 |
5.2× |
| MRI abdomen w contrast (74182) |
$960.25 |
$4,121.23 |
2.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,043.42 |
$8,770.03 |
6.1× |
| MRI abdomen w/o contrast (74181) |
$1,862.12 |
$7,991.92 |
8.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,206.60 |
$5,205.21 |
1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,391.35 |
$5,998.14 |
1.9× |
| MRI breast w/o contrast bilateral (77047) |
$1,509.70 |
$6,523.22 |
6.6× |
| MRI breast w/o contrast unilat (77046) |
$1,191.52 |
$5,148.38 |
5.2× |
| MRI c-spine with contrast (72142) |
$1,219.89 |
$5,235.59 |
3.6× |
| MRI cervical spine w/o contrast (72141) |
$1,899.76 |
$8,153.46 |
8.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,550.42 |
$10,946.02 |
7.6× |
| MRI chest w/o contrast (71550) |
$2,286.16 |
$9,811.86 |
10.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,433.38 |
$10,579.90 |
7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,021.04 |
$4,398.44 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,264.46 |
$5,458.24 |
5.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,623.97 |
$6,969.81 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,276.17 |
$9,768.95 |
6.8× |
| MRI orbit/face/neck w/contrast (70542) |
$1,722.31 |
$7,391.88 |
5.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,148.07 |
$13,511.01 |
9.4× |
| MRI pelvis w/o contrast (72195) |
$2,479.75 |
$10,642.70 |
10.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,273.24 |
$9,812.83 |
6.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,859.72 |
$8,027.76 |
5.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,875.38 |
$12,340.70 |
8.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,259.86 |
$5,407.11 |
3.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,545.05 |
$10,922.95 |
7.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,229.89 |
$5,278.48 |
3.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,680.25 |
$11,503.20 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,981.96 |
$8,506.26 |
8.7× |
| MRI tmj (70336) |
$967.87 |
$4,169.39 |
4.2× |
| MRI upper ext joint w/o contrast (73221) |
$1,763.02 |
$7,566.63 |
7.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,591.40 |
$11,186.18 |
7.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,667.32 |
$7,197.30 |
7.3× |
| Myelogram Cervical (72240) |
$1,078.86 |
$4,661.61 |
1.4× |
| Myelogram Lumbar (72265) |
$1,078.86 |
$4,661.61 |
1.4× |
| Myelogram thoracic (72255) |
$1,078.86 |
$4,661.61 |
1.4× |
| Myelography 2 or more regions (72270) |
$1,698.40 |
$7,338.56 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,070.50 |
$13,178.11 |
2.5× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$984.22 |
$4,252.69 |
1.2× |
| Neck soft tissue (70360) |
$240.81 |
$1,040.50 |
2.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$478.44 |
$2,067.24 |
1.3× |
| Nm cisternogram (78630) |
$1,413.76 |
$6,108.63 |
2.7× |
| Nm gastric emptying study (78264) |
$1,135.47 |
$4,906.19 |
3.0× |
| Nm gastroesophageal reflux study (78262) |
$527.87 |
$2,280.85 |
1.4× |
| Nm peritoneal-venous shunt patency (78291) |
$474.58 |
$2,050.57 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,534.07 |
$10,949.36 |
1.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$526.27 |
$2,273.95 |
1.4× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$554.18 |
$2,394.56 |
1.1× |
| Nuclear Rx Oral Admin (79005) |
$891.46 |
$3,851.90 |
4.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$122.52 |
$529.43 |
1.2× |
| Osseous survey infant (77076) |
$203.33 |
$878.54 |
2.0× |
| Osseous survey limited (77074) |
$203.33 |
$878.54 |
2.0× |
| Parathyrd planar w/wo subtrj (78071) |
$579 |
$2,501.80 |
1.5× |
| Parathyroid imaging (78070) |
$876.33 |
$3,786.50 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$193.76 |
$837.19 |
1.9× |
| PET image w/CT, skull-thigh (78815) |
$5,937.58 |
$25,483.16 |
4.3× |
| PET imaging CT for attenuation limited area (78814) |
$5,937.58 |
$25,483.16 |
4.3× |
| PET imaging for CT attenuation whole body (78816) |
$6,163.10 |
$26,629.90 |
4.5× |
| Platelet survival study (78191) |
$714.46 |
$3,087.06 |
1.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,835.18 |
$7,921.84 |
5.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$683.34 |
$2,952.64 |
1.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$779.92 |
$3,369.92 |
1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$440.33 |
$1,902.61 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$114.20 |
$493.46 |
1.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$189.13 |
$817.19 |
1.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$189.13 |
$817.19 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$137.15 |
$592.61 |
1.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$12,237.61 |
$52,521.92 |
1.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$289.03 |
$1,240.49 |
0.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$149.76 |
$642.75 |
1.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$149.76 |
$642.75 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$441.74 |
$1,908.72 |
4.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$212.89 |
$919.86 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$192.66 |
$832.46 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$212.80 |
$913.31 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$386.73 |
$1,671 |
2.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$355.40 |
$1,535.60 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$380.22 |
$1,653.14 |
2.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$195.07 |
$848.14 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$118.38 |
$514.71 |
1.4× |
| Radiological examination surgical specimen (76098) |
$762.67 |
$3,273.25 |
1.5× |
| Ribs bilateral 3 views (71110) |
$246.40 |
$1,064.64 |
2.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,581.89 |
$6,835.12 |
3.0× |
| Rp Therapy Intravenous Administration (79101) |
$677.77 |
$2,928.56 |
3.0× |
| Sacroiliac Joints < 3 Views (72200) |
$121.51 |
$528.29 |
1.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,274.20 |
$5,505.66 |
5.6× |
| Scanogram (77073) |
$237.48 |
$1,023.85 |
2.4× |
| Scapula complete (73010) |
$184.99 |
$799.33 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$10.14 |
$43.82 |
0.4× |
| Sialogram (70390) |
$440.33 |
$1,902.61 |
1.9× |
| Simulation intermediate (77285) |
$644.28 |
$2,783.87 |
1.8× |
| Small bowel series (74250) |
$353.24 |
$1,526.26 |
2.1× |
| Spec medical radj physics consltj (77370) |
$313.42 |
$1,345.15 |
2.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$725.61 |
$3,135.25 |
2.0× |
| Special dosimetry (77331) |
$325.32 |
$1,405.68 |
2.5× |
| Special treatment procedure (77470) |
$1,058.91 |
$4,575.42 |
2.0× |
| Spine thoracic 3 views (72072) |
$270.31 |
$1,167.98 |
2.7× |
| Stereotactic body radiation delivery (77373) |
$2,710.29 |
$11,632.13 |
1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$725.61 |
$3,135.25 |
2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$325.32 |
$1,405.68 |
0.9× |
| Testicular Imaging With Vascular Flow (78761) |
$976 |
$4,217.14 |
2.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$725.61 |
$3,135.25 |
2.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$325.32 |
$1,405.68 |
2.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,689.65 |
$7,300.74 |
3.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$269.75 |
$1,165.57 |
0.7× |
| Thyroid uptake measurement (78012) |
$205.01 |
$885.82 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$418.80 |
$1,809.58 |
1.1× |
| Tmj unilateral (70328) |
$145.19 |
$623.15 |
1.7× |
| Tomogram (76100) |
$228.06 |
$985.42 |
2.3× |
| Treatment device intermediate (77333) |
$534.25 |
$2,308.40 |
4.1× |
| Treatment devices simple (77332) |
$474.44 |
$2,050 |
3.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,917 |
$8,283.08 |
3.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$887.48 |
$3,834.71 |
2.3× |
| Tx devices design & construction complex (77334) |
$558.18 |
$2,411.78 |
1.6× |
| Ultrasound elastography first target lesion (76982) |
$111.47 |
$481.64 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$476.30 |
$2,044.19 |
4.7× |
| Umbilical-artery Doppler (OB) (76820) |
$158.91 |
$682.02 |
1.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$92.22 |
$398.45 |
1.1× |
| Unlisted magnetic resonance procedure (76498) |
$113.16 |
$485.65 |
1.4× |
| Unlisted Ultrasound Procedure (76999) |
$791.64 |
$3,420.54 |
9.5× |
| Upper Extremity Infant (73092) |
$150.04 |
$646.90 |
1.5× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$830.08 |
$3,586.67 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$394.71 |
$1,705.49 |
1.7× |
| Urethrocystography voiding (74455) |
$394.71 |
$1,705.49 |
1.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$516.70 |
$2,232.60 |
3.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$533.45 |
$2,304.96 |
3.2× |
| Us abdl aorta screen aaa (76706) |
$152.73 |
$659.93 |
1.5× |
| Us breast unilateral complete (76641) |
$147.57 |
$641.61 |
1.5× |
| Us breast unilateral limited (76642) |
$147.57 |
$641.61 |
1.8× |
| Us chest (76604) |
$350.86 |
$1,515.99 |
3.5× |
| Us compl joint r-t w/image documentation (76881) |
$244.48 |
$1,056.35 |
2.4× |
| Us elastography parenchyma (76981) |
$111.47 |
$481.64 |
1.1× |
| Us guided compression repair (76936) |
$195.26 |
$843.72 |
0.9× |
| Us infant hips dynamic (76885) |
$172.24 |
$744.20 |
2.1× |
| Us infant hips limited static (76886) |
$154.70 |
$668.42 |
1.9× |
| Us ob transvaginal (76817) |
$767.09 |
$3,314.48 |
7.6× |
| Us pelvic non ob complete (76856) |
$522.38 |
$2,241.98 |
5.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$241.60 |
$1,043.94 |
2.4× |
| Us pregnancy ltd (76815) |
$362.01 |
$1,564.20 |
3.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$269.51 |
$1,164.52 |
2.7× |
| Us retroperitoneal complete (76770) |
$516.70 |
$2,232.60 |
5.2× |
| Us retroperitoneal limited (76775) |
$259.65 |
$1,114.38 |
2.6× |
| Us scrotum and contents (76870) |
$259.65 |
$1,114.38 |
2.6× |
| Us soft tissue head/neck (76536) |
$389.47 |
$1,671.56 |
3.9× |
| Us spinal canal and contents (76800) |
$211.32 |
$913.07 |
2.1× |
| Us transrectal (76872) |
$269.51 |
$1,164.52 |
2.7× |
| Us transrectal prostate volume (76873) |
$269.51 |
$1,164.52 |
2.7× |
| Us xtr non-vasc lmtd (76882) |
$152.06 |
$656.74 |
1.5× |
| Venogram extremity bilateral (75822) |
$2,094.70 |
$9,050.94 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$5,995.48 |
$25,905.62 |
2.0× |
| Venography caval superior serialography rs&i (75827) |
$2,094.70 |
$9,050.94 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,228.26 |
$5,307.12 |
0.8× |
| Wrist 2 views (73100) |
$227.26 |
$981.94 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$414.64 |
$1,791.61 |
4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$207.32 |
$895.82 |
2.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$253.56 |
$1,095.62 |
3.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$796.58 |
$3,441.90 |
4.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$171.16 |
$739.08 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$200.14 |
$864.79 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$114.20 |
$493.46 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$114.20 |
$493.46 |
1.4× |
| X-ray exam hip uni 4/> views (73503) |
$189.13 |
$817.19 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$189.13 |
$817.19 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$360.58 |
$1,557.99 |
3.6× |
| X-ray exam of femur 1 (73551) |
$231.12 |
$991.93 |
2.8× |
| X-ray eye for foreign body (70030) |
$137.15 |
$592.61 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$360.42 |
$1,557.31 |
3.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$242.41 |
$1,047.40 |
2.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$215.28 |
$930.20 |
2.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$200.14 |
$864.79 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$256.76 |
$1,109.42 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$363.62 |
$1,571.12 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$700.59 |
$3,006.83 |
8.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$225.66 |
$972.94 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$406.66 |
$1,757.14 |
4.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$419.42 |
$1,812.26 |
4.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$387.30 |
$1,673.46 |
3.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$335.70 |
$1,450.50 |
4.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$137.15 |
$592.61 |
1.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$214.50 |
$926.82 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$200.85 |
$873.24 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$535.61 |
$2,328.74 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$183.60 |
$787.99 |
2.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$237.38 |
$1,018.80 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$338.10 |
$1,460.88 |
3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$234.43 |
$1,012.93 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$230.45 |
$995.74 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$200.94 |
$868.25 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$363.62 |
$1,571.12 |
4.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$226.44 |
$978.44 |
2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$398.69 |
$1,722.67 |
4.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$261.54 |
$1,130.06 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$169.04 |
$730.44 |
2.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$104.97 |
$456.37 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$101.26 |
$437.53 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$88.51 |
$382.44 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$302.20 |
$1,305.79 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$186.59 |
$806.24 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$231.24 |
$999.16 |
2.8× |
| Xr arthrogram ankle (73615) |
$596.29 |
$2,576.49 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$409.05 |
$1,767.46 |
4.1× |
| Xr chest 4+ views (71048) |
$207.40 |
$890.15 |
2.1× |
| Xr Cholecystography Oral Contrast (74290) |
$269.51 |
$1,164.52 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$184.99 |
$799.33 |
2.2× |
| Xr shoulder 1 view (73020) |
$189.77 |
$819.97 |
2.3× |
| Xr spine cervical 4 or 5 views (72050) |
$397.10 |
$1,715.82 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$251.98 |
$1,088.76 |
3.0× |
| Xr tmj bilateral (70330) |
$476.04 |
$2,056.90 |
5.7× |
| Xray knee 1 or 2 views rt (73560) |
$161.86 |
$699.38 |
1.9× |