| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) |
$5,193.15 |
$6,491.44 |
3.5× |
| Acute gi blood loss imaging (78278) |
$1,320.34 |
$1,650.42 |
3.1× |
| Angio adrenal bilat select (75733) |
$3,542.94 |
$4,428.68 |
1.1× |
| Angio adrenal unilat select (75731) |
$3,542.94 |
$4,428.68 |
1.1× |
| Angio extremity unilateral (75710) |
$3,833.81 |
$4,792.26 |
1.1× |
| Angio pulmonary unilateral (75741) |
$3,527.68 |
$4,409.60 |
1.0× |
| Angiogram extremity bilateral (75716) |
$4,305.92 |
$5,382.39 |
1.3× |
| Angiogram pelvic (75736) |
$6,960.38 |
$8,700.48 |
1.2× |
| Angiography internal mammary rs&i (75756) |
$2,713.60 |
$3,392 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,527.68 |
$4,409.60 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,579.86 |
$11,974.82 |
1.6× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$4,853.38 |
$6,066.72 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,308.90 |
$4,136.12 |
1.0× |
| Ankle 2 views (73600) |
$420.61 |
$525.76 |
4.5× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,813.46 |
$4,766.82 |
1.1× |
| Barium enema (74270) |
$504.56 |
$630.70 |
2.7× |
| Basic dosimetry (77300) |
$708.93 |
$886.16 |
5.0× |
| Bilat selctv renal venogram (75833) |
$4,106.02 |
$5,132.52 |
1.2× |
| Bone age studies (77072) |
$289.17 |
$361.46 |
2.6× |
| Bone imaging limited area (78300) |
$1,191.44 |
$1,489.30 |
2.8× |
| Bone survey complete (77075) |
$1,231.30 |
$1,539.12 |
11.1× |
| Bowel imaging (78290) |
$725.04 |
$906.30 |
1.7× |
| Brachytx isodose pln cplx w/dosimetry cal (77318) |
$1,440.75 |
$1,800.94 |
3.6× |
| Brain image w/flow 4 + views (78606) |
$1,079.50 |
$1,349.38 |
1.9× |
| Brain imaging, less than 4 static views; with vascular flow Age Under 21 (78601) |
$1,209.25 |
$1,511.56 |
2.8× |
| Card MRI w/stress img & dye (75563) |
$1,803.70 |
$2,254.62 |
2.2× |
| Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or… (78483) |
$2,081.84 |
$2,602.30 |
3.6× |
| Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or… (78481) |
$1,534.03 |
$1,917.54 |
2.7× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) |
$1,205.86 |
$1,507.32 |
2.8× |
| Cardiac MRI w/stress img (75559) |
$1,803.70 |
$2,254.62 |
3.1× |
| Cardiac MRI w/wo contrast & further seq (75561) |
$1,803.70 |
$2,254.62 |
4.9× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Age Under 21 (78635) |
$1,528.94 |
$1,911.18 |
2.6× |
| Cerebrospinal fluid leakage (78650) |
$1,696 |
$2,120 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,020.99 |
$1,276.24 |
5.5× |
| Cisternogram (78630) |
$1,792.67 |
$2,240.84 |
3.1× |
| Cisternography, positive contrast, radiological supervision and interpretation Other Diagnostic Radiology FS (70015) |
$1,170.24 |
$1,462.80 |
1.4× |
| Clavicle complete (73000) |
$420.61 |
$525.76 |
4.5× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,757.06 |
$2,196.32 |
9.4× |
| Continuing medical physics consltj pr wk (77336) |
$708.93 |
$886.16 |
5.0× |
| Contrast exam abdominl aorta (75625) |
$3,444.58 |
$4,305.72 |
1.0× |
| Contrast exam thoracic aorta (75605) |
$5,766.40 |
$7,208 |
1.0× |
| Csf shunt evaluation (78645) |
$1,293.20 |
$1,616.50 |
2.2× |
| CT - st neck w&wo contr (70492) |
$2,296.38 |
$2,870.48 |
12.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,535.96 |
$5,669.94 |
12.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,812.18 |
$2,265.22 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,884.26 |
$2,355.32 |
10.1× |
| CT abdomen w/contrast (74160) |
$1,639.18 |
$2,048.98 |
8.8× |
| CT abdomen w/o contrast (74150) |
$1,355.14 |
$1,693.94 |
12.2× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) |
$2,371.86 |
$2,964.82 |
6.4× |
| CT angio abdom w/o & w/dye (74175) |
$1,534.16 |
$1,917.70 |
8.2× |
| CT angio abdominal arteries (75635) |
$5,444.16 |
$6,805.20 |
29.2× |
| CT angiograph pelv w/o&w/dye (72191) |
$1,534.03 |
$1,917.54 |
8.2× |
| CT cervical spine w/contrast (72126) |
$2,612.69 |
$3,265.86 |
7.0× |
| CT cervical spine w/o contrast (72125) |
$2,298.08 |
$2,872.60 |
20.6× |
| CT chest w/contrast (71260) |
$1,692.61 |
$2,115.76 |
9.1× |
| CT extremity upper w & w/o contrast (73202) |
$1,692.18 |
$2,115.23 |
9.1× |
| CT head/brain with contrast (70460) |
$1,812.18 |
$2,265.22 |
9.7× |
| CT head/brain without and with contrast (70470) |
$2,298.08 |
$2,872.60 |
12.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,646.82 |
$2,058.52 |
4.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$951.46 |
$1,189.32 |
10.3× |
| CT lower ext w/wo contrast (73702) |
$1,717.58 |
$2,146.98 |
9.2× |
| CT lower extremity w contrast (73701) |
$1,339.84 |
$1,674.80 |
7.2× |
| CT lower extremity w/o contrast unilateral (73700) |
$1,122.75 |
$1,403.44 |
10.1× |
| CT lumbar spine w/contrast (72132) |
$2,674.76 |
$3,343.45 |
7.2× |
| CT lumbar spine w/o contrast (72131) |
$2,290.45 |
$2,863.06 |
20.6× |
| CT lumbar spine w/o then w/ con (72133) |
$1,692.61 |
$2,115.76 |
9.1× |
| CT maxillofacial area w/o contrast (70486) |
$1,526.40 |
$1,908 |
13.7× |
| CT maxillofacial w/contrast (70487) |
$1,757.06 |
$2,196.32 |
9.4× |
| CT maxillofacial w/o then w/ con (70488) |
$2,089.47 |
$2,611.84 |
11.2× |
| CT orbit sella ear w/o con (70480) |
$1,513.68 |
$1,892.10 |
13.6× |
| CT orbit/ear/fossa w/o then w/ con (70482) |
$1,825.32 |
$2,281.65 |
9.8× |
| CT pelvis w & w/o contrast (72194) |
$1,884.26 |
$2,355.32 |
10.1× |
| CT pelvis w/o contrast (72192) |
$1,249.95 |
$1,562.44 |
11.2× |
| CT soft tissue neck w/contrast (70491) |
$1,845.25 |
$2,306.56 |
9.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,651.06 |
$2,063.82 |
14.8× |
| CT spine cervical w/wo contrast (72127) |
$2,845.04 |
$3,556.30 |
15.2× |
| CT thoracic spine w/contrast (72129) |
$2,545.70 |
$3,182.12 |
13.6× |
| CT thoracic spine w/o contrast (72128) |
$1,121.06 |
$1,401.32 |
10.1× |
| CT thoracic spine w/o then w/ con (72130) |
$1,692.61 |
$2,115.76 |
9.1× |
| CT thorax lung cancer scr c- (71271) |
$343.44 |
$429.30 |
3.1× |
| CT thorax w/o contrast (71250) |
$1,249.95 |
$1,562.44 |
11.2× |
| CT thorax w/o then w/ contrast (71270) |
$1,884.26 |
$2,355.32 |
10.1× |
| CT upper extremity w/dye (73201) |
$1,339.84 |
$1,674.80 |
3.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,122.77 |
$1,403.46 |
10.1× |
| CTA chest w/wo contrast (71275) |
$1,586.61 |
$1,983.26 |
8.5× |
| CTA head w contrast (70496) |
$3,855.01 |
$4,818.76 |
20.6× |
| CTA lower extremity w/wo contrast unilateral (73706) |
$3,163.21 |
$3,954.01 |
16.9× |
| Cta Neck (70498) |
$1,958.03 |
$2,447.54 |
10.5× |
| CTA upper extremity w/wo contrast unilateral (73206) |
$2,089.62 |
$2,612.02 |
11.2× |
| Dilation ureters/urethra rs&i (74485) |
$2,968 |
$3,710 |
1.3× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) |
$4,094.14 |
$5,117.68 |
2.0× |
| Dxa bone density study axial skeleton (77085) |
$619.42 |
$774.27 |
5.6× |
| Esophogram (74220) |
$464.70 |
$580.88 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$251.86 |
$314.82 |
2.3× |
| Fetal biophysical profile w/o nst (76819) |
$545.26 |
$681.58 |
4.9× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$579.18 |
$723.98 |
2.3× |
| Gastric emptying study (78264) |
$1,874.08 |
$2,342.60 |
4.4× |
| Gated heart planar single (78472) |
$1,087.14 |
$1,358.92 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,664.21 |
$4,580.26 |
4.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,357.02 |
$5,446.28 |
5.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,825.97 |
$6,032.46 |
6.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,431.01 |
$4,288.76 |
1.0× |
| Hepatobil syst image w/drug (78227) |
$884.46 |
$1,105.58 |
1.5× |
| Hepatobiliary system imaging (78226) |
$1,060 |
$1,325 |
2.5× |
| Humerus min 2 views (73060) |
$228.96 |
$286.20 |
2.5× |
| Hysterosalpingography (74740) |
$1,082.90 |
$1,353.62 |
4.3× |
| Imrt planning (77301) |
$5,396.67 |
$6,745.84 |
3.7× |
| Infusion of radioelement (77750) |
$1,065.09 |
$1,331.36 |
2.6× |
| Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when… (77778) |
$4,464.72 |
$5,580.90 |
6.0× |
| Intracavitary radiation source applic complex (77763) |
$3,674.38 |
$4,592.98 |
5.0× |
| Intracavitary radiation source applic intermed (77762) |
$2,527.04 |
$3,158.80 |
4.3× |
| Intracavitary radiation source applic simple (77761) |
$2,527.04 |
$3,158.80 |
4.3× |
| Isodose brachytherapy intermed 5 to 10 sources (77317) |
$1,156.63 |
$1,445.79 |
2.9× |
| Isodose brachytherapy plan simple 1 to 4 source (77316) |
$800.51 |
$1,000.64 |
2.0× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$1,299.98 |
$1,624.98 |
3.3× |
| Isodose teletherapy plan simple 1 or 2 port w/cal (77306) |
$655.50 |
$819.38 |
1.6× |
| Ivp (74400) |
$994.70 |
$1,243.38 |
5.3× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,102.40 |
$1,378 |
1.9× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,143.10 |
$1,428.88 |
2.0× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,978.38 |
$2,472.98 |
3.4× |
| Kidney w vascular flow (78701) |
$1,221.12 |
$1,526.40 |
2.9× |
| Liver & spleen; static only (78215) |
$1,611.20 |
$2,014 |
3.8× |
| Liver & spleen; w vasc flow (78216) |
$1,655.30 |
$2,069.12 |
3.9× |
| Liver imaging w/vascular flow (78202) |
$1,252.50 |
$1,565.62 |
2.2× |
| Lung perfusion differential (78597) |
$794.58 |
$993.22 |
1.9× |
| Lung ventilat&perfus imaging (78582) |
$1,437.36 |
$1,796.70 |
2.5× |
| Lung ventilation imaging (78579) |
$1,302.53 |
$1,628.16 |
3.1× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$3,418.29 |
$4,272.86 |
9.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$2,078.44 |
$2,598.06 |
5.6× |
| Mammary ductogram multiple ducts (77054) |
$684.34 |
$855.42 |
2.7× |
| Mammary ductogram single (77053) |
$585.97 |
$732.46 |
2.3× |
| Med physic dos eval rad exps (76145) |
$537.72 |
$672.15 |
1.4× |
| Mlc device(s) for imrt (77338) |
$1,506.90 |
$1,883.62 |
3.8× |
| MRA head w & w/o contrast (70546) |
$4,097.49 |
$5,121.86 |
11.0× |
| MRA head w/contrast (70545) |
$2,671.02 |
$3,338.77 |
7.2× |
| MRA head w/o contrast (70544) |
$2,677.22 |
$3,346.52 |
10.5× |
| MRA neck w/contrast (70548) |
$2,974.78 |
$3,718.48 |
8.0× |
| MRA neck w/o contrast (70547) |
$2,677.14 |
$3,346.42 |
10.5× |
| MRA neck w/wo contrast (70549) |
$3,720.18 |
$4,650.22 |
10.0× |
| MRI abdomen w/contrast (74182) |
$3,037.54 |
$3,796.92 |
8.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,733.74 |
$4,667.18 |
10.1× |
| MRI abdomen w/o contrast (74181) |
$2,369.31 |
$2,961.64 |
9.3× |
| MRI any jnt lwr ext with con lt (73722) |
$2,143.74 |
$2,679.68 |
2.6× |
| MRI brain w/o & w/dye (70559) |
$1,267.76 |
$1,584.70 |
6.8× |
| MRI brain w/o dye (70557) |
$919.23 |
$1,149.04 |
1.6× |
| MRI breast without contrast bilateral (77047) |
$3,083.33 |
$3,854.16 |
12.1× |
| MRI breast without contrast material unilateral (77046) |
$2,615.23 |
$3,269.04 |
10.3× |
| MRI cardiac w/o contrast (75557) |
$1,803.70 |
$2,254.62 |
7.1× |
| MRI cervical spine w/o contrast (72141) |
$2,041.14 |
$2,551.42 |
8.0× |
| MRI cervical spine with contrast (72142) |
$2,456.62 |
$3,070.77 |
6.6× |
| MRI chest w & w/o contrast (71552) |
$1,267.93 |
$1,584.91 |
3.4× |
| MRI chest w/contrast (71551) |
$2,281.97 |
$2,852.46 |
2.7× |
| MRI chest w/o contrast (71550) |
$2,078.44 |
$2,598.06 |
8.2× |
| MRI joint upper ext w/contrast (73222) |
$2,214.12 |
$2,767.66 |
2.7× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,143.74 |
$2,679.68 |
5.8× |
| MRI joint upr extrem w/o dye (73221) |
$2,144.59 |
$2,680.74 |
8.4× |
| Mri Lower Extremity W/O Dye (73718) |
$2,284.51 |
$2,855.64 |
9.0× |
| MRI lumbar spine with contrast (72149) |
$2,492.27 |
$3,115.34 |
6.7× |
| MRI lumbar w/wo contrast (72158) |
$2,974.02 |
$3,717.52 |
8.0× |
| MRI lwr ext w/o jnts with con rt (73719) |
$2,143.74 |
$2,679.68 |
5.8× |
| MRI orbit/face/neck w/contrast (70542) |
$2,694.10 |
$3,367.62 |
7.3× |
| MRI orbit/face/neck w/o & w/contrast (70543) |
$3,597.22 |
$4,496.52 |
9.7× |
| MRI orbit/face/neck w/o contrast (70540) |
$2,144.59 |
$2,680.74 |
8.4× |
| MRI pelvis w/ contrast (72196) |
$2,041.14 |
$2,551.42 |
5.5× |
| MRI pelvis w/o contrast (72195) |
$3,736.29 |
$4,670.36 |
14.7× |
| MRI pelvis w/wo contrast (72197) |
$4,140.78 |
$5,175.98 |
11.1× |
| MRI spine cervical wo/w contrast (72156) |
$3,001.92 |
$3,752.40 |
8.1× |
| MRI spine thoracic w/contrast (72147) |
$2,492.27 |
$3,115.34 |
6.7× |
| MRI thoracic spine w wo contrast (72157) |
$3,001.92 |
$3,752.40 |
8.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,041.14 |
$2,551.42 |
8.0× |
| MRI tmj (70336) |
$2,144.59 |
$2,680.74 |
8.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,062.34 |
$2,577.92 |
8.1× |
| Mri Upper Extremity W/Dye (73219) |
$2,143.74 |
$2,679.68 |
5.8× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) |
$2,144.59 |
$2,680.74 |
5.8× |
| Myelogram thoracic (72255) |
$1,743.49 |
$2,179.36 |
2.1× |
| Myelography lumbosacral (72265) |
$2,242.96 |
$2,803.70 |
2.7× |
| Myocardial spect single study at rest or stress (78451) |
$3,108.77 |
$3,885.96 |
2.3× |
| Nm bone 3 phase (78315) |
$1,924.15 |
$2,405.19 |
4.5× |
| Nm bone imaging whole body (78306) |
$1,234.69 |
$1,543.36 |
2.9× |
| Nm bone multi (78305) |
$1,060 |
$1,325 |
2.5× |
| Nm heart perfusion spect stress rest (78452) |
$4,662.30 |
$5,827.88 |
3.4× |
| Nm liver image static only (78201) |
$1,270.30 |
$1,587.88 |
2.2× |
| Nm thyroid ca mets limited (78015) |
$1,129.02 |
$1,411.28 |
2.7× |
| Nm thyroid imaging only (78013) |
$592.75 |
$740.94 |
1.4× |
| Nuclear medicine study of brain, less than 4 static views (78600) |
$368.88 |
$461.10 |
0.9× |
| Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume… (78494) |
$1,631.55 |
$2,039.44 |
3.8× |
| Nuclear medicine study of salivary gland with serial images (78231) |
$534.24 |
$667.80 |
1.3× |
| Nuclear medicine study to assess blood clot in vein using radiolabeled peptide (78456) |
$2,167.49 |
$2,709.36 |
1.6× |
| Nuclear rx IV admin (79101) |
$1,356.80 |
$1,696 |
5.5× |
| Ob us < 14 wks single fetus (76801) |
$781.86 |
$977.32 |
7.0× |
| Ob us nuchal meas 1 gest (76813) |
$537.63 |
$672.04 |
4.8× |
| Oral radiopharm rx (79005) |
$1,556.08 |
$1,945.10 |
6.3× |
| Parathyroid imaging (78070) |
$744.54 |
$930.68 |
1.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,674.80 |
$2,093.50 |
3.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$6,003.84 |
$7,504.80 |
3.9× |
| PET imaging CT for attenuation limited area (78814) |
$5,886.82 |
$7,358.52 |
3.9× |
| PET imaging for CT attenuation whole body (78816) |
$6,186.16 |
$7,732.70 |
4.1× |
| PET imaging limited area chest head/neck (78811) |
$2,505.84 |
$3,132.30 |
1.8× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Age Under 21 (78812) |
$3,744.77 |
$4,680.96 |
2.5× |
| Pulmonary perfusion imaging particulate (78580) |
$993.01 |
$1,241.26 |
2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$914.14 |
$1,142.68 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$180.46 |
$225.57 |
1.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$413.40 |
$516.75 |
3.7× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$569.77 |
$712.21 |
5.1× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$569.77 |
$712.21 |
5.1× |
| Radex hip unilateral with pelvis 1 view (73501) |
$420.61 |
$525.76 |
4.5× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$420.61 |
$525.76 |
4.5× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$487.60 |
$609.50 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$630.06 |
$787.58 |
5.7× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$658.97 |
$823.71 |
5.9× |
| Radex spine cervical 2 or 3 views (72040) |
$420.61 |
$525.76 |
4.5× |
| Radex spine cervical 4 or 5 views (72050) |
$784.40 |
$980.50 |
7.0× |
| Radex spine cervical 6 or more views (72052) |
$446.90 |
$558.62 |
4.0× |
| Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) |
$420.61 |
$525.76 |
4.5× |
| Radiation delivery stereotactic cranial linear (77372) |
$16,954.91 |
$21,193.64 |
2.2× |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)… (77371) |
$49,149.23 |
$61,436.54 |
6.3× |
| Radiation tx delivery lvl 1 (77402) |
$306.13 |
$382.66 |
2.8× |
| Radiation tx delivery lvl 2 (77407) |
$390.08 |
$487.60 |
0.9× |
| Radiation tx delivery lvl 3 (77412) |
$727.58 |
$909.48 |
1.2× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) |
$502.86 |
$628.58 |
4.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$995.55 |
$1,244.44 |
5.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$931.10 |
$1,163.88 |
5.0× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) |
$487.60 |
$609.50 |
5.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$395.97 |
$494.96 |
4.3× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$754.72 |
$943.40 |
6.8× |
| Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) |
$312.91 |
$391.14 |
2.8× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration UNSCHEDULED (79300) |
$689.42 |
$861.78 |
2.8× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$1,032.02 |
$1,290.02 |
4.2× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion UNSCHEDULED (79403) |
$1,857.12 |
$2,321.40 |
7.5× |
| Radiopharmaceutical therapy, unlisted procedure UNSCHEDULED (79999) |
$689.42 |
$861.78 |
2.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,819.81 |
$2,274.76 |
4.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,221.12 |
$1,526.40 |
2.9× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$3,300 |
$4,124.99 |
5.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,889.98 |
$3,612.48 |
5.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,889.98 |
$3,612.48 |
5.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,110.26 |
$5,137.82 |
3.0× |
| Rp loclzj tum spect CT 2area/sep acquisj img (78832) |
$4,664 |
$5,830 |
3.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,110.26 |
$5,137.82 |
3.0× |
| Saline infused sonohysterogram (76831) |
$636 |
$795 |
2.5× |
| Salivary gland imaging (78230) |
$517.28 |
$646.60 |
1.2× |
| Screening digital breast tomosynthesis; bilateral (77063) |
$172.84 |
$216.05 |
7.4× |
| Selective spinal angiogram (75705) |
$5,544.22 |
$6,930.28 |
0.9× |
| Shoulder arthrogram (73040) |
$926.02 |
$1,157.52 |
2.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$613.95 |
$767.44 |
5.5× |
| Simulation complex (77290) |
$1,715.50 |
$2,144.38 |
4.3× |
| Simulation intermediate (77285) |
$1,354.26 |
$1,692.82 |
3.4× |
| Simulation simple (77280) |
$908.21 |
$1,135.26 |
6.3× |
| Small bowel series (74250) |
$518.98 |
$648.72 |
2.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,172.78 |
$1,465.98 |
2.9× |
| Special dosimetry (77331) |
$708.93 |
$886.16 |
5.0× |
| Special physics consult (77370) |
$875.98 |
$1,094.98 |
6.1× |
| Special treatment procedure (77470) |
$2,202.26 |
$2,752.82 |
3.7× |
| Spleen imaging only (78185) |
$750.48 |
$938.10 |
1.8× |
| Splenoportography (75810) |
$4,034.78 |
$5,043.48 |
1.2× |
| Stereotactic body radiation delivery (77373) |
$5,350.88 |
$6,688.60 |
2.8× |
| Superior sagittal sinus venogram (75870) |
$4,853.38 |
$6,066.72 |
1.4× |
| Surface application of low dose rate radionuclide source 2nd-5th Sessions (77789) |
$708.93 |
$886.16 |
6.5× |
| Testicular imaging w/flow (78761) |
$565.62 |
$707.02 |
1.3× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Age Under 21 (78016) |
$625.82 |
$782.28 |
1.5× |
| Thyroid met imaging body (78018) |
$2,163.25 |
$2,704.06 |
3.7× |
| Thyroid uptake single/multiple quant measurement (78012) |
$376.51 |
$470.64 |
0.9× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$476.58 |
$595.72 |
1.1× |
| Treatment device intermediate (77333) |
$749.63 |
$937.04 |
5.2× |
| Treatment devices complex (77334) |
$1,196.53 |
$1,495.66 |
3.0× |
| Treatment devices simple (77332) |
$585.97 |
$732.46 |
4.1× |
| Ultrasound breast limited (76642) |
$462.16 |
$577.70 |
5.0× |
| Ultrasound, abdomen limited (76705) |
$812.38 |
$1,015.48 |
7.3× |
| Unlisted procedure, clinical brachytherapy (77799) |
$1,924.96 |
$2,406.20 |
17.7× |
| Urethrocystography retrograde rs&i (74450) |
$1,036.26 |
$1,295.32 |
4.1× |
| Urethrocystography voiding (74455) |
$803.06 |
$1,003.82 |
3.2× |
| Urography antegrade (74425) |
$1,062.54 |
$1,328.18 |
2.9× |
| Urography retrograde w/wo kub (74420) |
$722.50 |
$903.12 |
1.9× |
| Us abdominal aorta real time screen study aaa (76706) |
$479.12 |
$598.90 |
4.3× |
| Us breast uni real time with image complete (76641) |
$559.68 |
$699.60 |
5.0× |
| Us chest (76604) |
$619.89 |
$774.86 |
5.6× |
| Us compl joint r-t w/image documentation (76881) |
$362.94 |
$453.68 |
3.3× |
| Us encephalogram (76506) |
$723.34 |
$904.18 |
6.5× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$242.53 |
$303.16 |
2.6× |
| Us kidney transplanted (76776) |
$888.70 |
$1,110.88 |
8.0× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) |
$541.87 |
$677.34 |
4.9× |
| Us ob detailed single fetus (76811) |
$1,003.18 |
$1,253.98 |
3.9× |
| Us ob limited 1 or more fetuses (76815) |
$342.16 |
$427.71 |
3.1× |
| Us obstetric transvaginal (76817) |
$599.54 |
$749.42 |
5.4× |
| Us pelvic limited or f/u non-ob (76857) |
$585.12 |
$731.40 |
5.3× |
| Us pelvis complete (76856) |
$823.41 |
$1,029.26 |
7.4× |
| Us retroperitoneal complete (76770) |
$723.34 |
$904.18 |
6.5× |
| Us retroperitoneal limited (76775) |
$723.34 |
$904.18 |
6.5× |
| Us scrotum (76870) |
$822.56 |
$1,028.20 |
7.4× |
| Us soft tissue head/neck (76536) |
$675.43 |
$844.29 |
6.1× |
| Us spinal canal (76800) |
$814.93 |
$1,018.66 |
7.3× |
| Us transrectal (76872) |
$677.76 |
$847.20 |
6.1× |
| Us transrectal prostate volume (76873) |
$806.45 |
$1,008.06 |
7.2× |
| Us unlstd proc (76999) |
$681.79 |
$852.24 |
7.4× |
| Vasography, vesiculography, or epididymography, radiological supervision and interpretation Other Diagnostic Radiology… (74440) |
$584.27 |
$730.34 |
2.3× |
| Venogram extremity bilateral (75822) |
$2,226.42 |
$2,783.03 |
1.3× |
| Venogram ivc w serialography (75825) |
$3,527.77 |
$4,409.71 |
1.0× |
| Venogram svc w serialography (75827) |
$3,571.36 |
$4,464.19 |
2.1× |
| Venography adrenal unilateral selective rs&i (75840) |
$4,019.52 |
$5,024.40 |
1.2× |
| Venography ext unilateral (75820) |
$1,988.56 |
$2,485.70 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$3,743.50 |
$4,679.37 |
1.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,555.66 |
$4,444.58 |
1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$267.97 |
$334.96 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$420.61 |
$525.76 |
4.5× |
| X-ray aorta leg arteries (75630) |
$3,882.14 |
$4,852.68 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$656.22 |
$820.28 |
3.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$248.46 |
$310.58 |
2.7× |
| X-ray exam hips bi 3-4 views (73522) |
$487.60 |
$609.50 |
4.4× |
| X-ray exam of finger(s) (73140) |
$373.97 |
$467.46 |
4.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$964.18 |
$1,205.22 |
5.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$299.34 |
$374.18 |
3.2× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) |
$420.61 |
$525.76 |
4.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$248.46 |
$310.58 |
2.7× |
| X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) |
$209.46 |
$261.82 |
1.9× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) |
$308.67 |
$385.84 |
3.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$420.61 |
$525.76 |
4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$420.61 |
$525.76 |
4.5× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) |
$420.61 |
$525.76 |
4.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$474.58 |
$593.23 |
4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$420.61 |
$525.76 |
4.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$275.60 |
$344.50 |
2.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$937.89 |
$1,172.36 |
8.4× |
| X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) |
$312.06 |
$390.08 |
2.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$489.30 |
$611.62 |
5.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$398.56 |
$498.20 |
3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$420.61 |
$525.76 |
3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$209.46 |
$261.82 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$420.61 |
$525.76 |
4.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$267.97 |
$334.96 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$312.06 |
$390.08 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$770.83 |
$963.54 |
6.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$245.07 |
$306.34 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$206.91 |
$258.64 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$420.61 |
$525.76 |
4.5× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) |
$420.61 |
$525.76 |
4.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$248.46 |
$310.58 |
2.7× |
| Xr abdomen 1 view (74018) |
$217.94 |
$272.42 |
2.4× |
| Xr abdomen 2 views (74019) |
$407.04 |
$508.80 |
3.7× |
| Xr abdomen 3 views (74021) |
$466.40 |
$583 |
4.2× |
| Xr arthrogram hip (73525) |
$917.54 |
$1,146.92 |
2.5× |
| Xr bone density appendicular (77081) |
$680.94 |
$851.18 |
7.3× |
| Xr bone density axial (77080) |
$289.17 |
$361.46 |
2.6× |
| Xr bone length study (77073) |
$357.86 |
$447.32 |
3.2× |
| Xr bone survey limited (77074) |
$953.15 |
$1,191.44 |
8.6× |
| Xr chest 1 view (71045) |
$214.54 |
$268.18 |
2.3× |
| Xr chest 2 views (71046) |
$180.62 |
$225.78 |
1.9× |
| Xr chest 3 views (71047) |
$318 |
$397.50 |
3.4× |
| Xr cystogram 3+ views (74430) |
$934.50 |
$1,168.12 |
2.5× |
| Xr facial bones 3 views (70150) |
$312.06 |
$390.08 |
2.8× |
| Xr lower extremity 2 views infant (73592) |
$215.39 |
$269.24 |
2.3× |
| Xr mandible 4 views (70110) |
$658.90 |
$823.62 |
5.9× |
| Xr myelogram c-spine (72240) |
$2,327.76 |
$2,909.70 |
2.8× |
| Xr nasal bones (70160) |
$420.61 |
$525.76 |
4.5× |
| Xr pelvis 3 views (72190) |
$267.97 |
$334.96 |
2.4× |
| Xr sialogram (70390) |
$594.45 |
$743.06 |
2.3× |
| Xr spine 1 view (72020) |
$312.91 |
$391.14 |
3.4× |
| Xr sternum 2 views (71120) |
$259.49 |
$324.36 |
2.8× |
| Xr surgical specimen (76098) |
$1,148.19 |
$1,435.24 |
2.0× |
| Xray elbow 2 views (73070) |
$209.46 |
$261.82 |
2.3× |
| Xray forearm 2 views (73090) |
$420.61 |
$525.76 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$420.61 |
$525.76 |
4.5× |
| Xray neck soft tissue (70360) |
$420.61 |
$525.76 |
4.5× |
| Xray optic foramina (70190) |
$367.18 |
$458.98 |
4.0× |
| Xray orbits complete min 4 views (70200) |
$312.06 |
$390.08 |
2.8× |
| Xray pelvis 1 or 2 views (72170) |
$223.02 |
$278.78 |
2.0× |
| Xray ribs bilateral 3 views (71110) |
$350.22 |
$437.78 |
3.1× |
| Xray ribs unilat w/ pa chest 3v rt (71101) |
$623.28 |
$779.10 |
5.6× |
| Xray scapula complete (73010) |
$420.61 |
$525.76 |
3.8× |
| Xray shoulder 1 view (73020) |
$209.46 |
$261.82 |
2.3× |
| Xray sinuses paranasal <3 views (70210) |
$252.70 |
$315.88 |
2.7× |
| Xray spine thoracic 2 views (72070) |
$193.22 |
$241.52 |
1.7× |
| Xray spine thoracic 3 views (72072) |
$494.38 |
$617.98 |
4.4× |
| Xray tibia-fibula 2 views bil (73590) |
$420.61 |
$525.76 |
4.5× |
| Xray tmj open - closed unilat (70328) |
$420.61 |
$525.76 |
4.5× |
| Xray tmj's bilateral open-clsc (70330) |
$312.91 |
$391.14 |
3.4× |