| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,011.12 |
$5,571 |
2.7× |
| Abdomen 1 View (74018) |
$326.16 |
$453 |
3.5× |
| Abdomen 2 views (74019) |
$568.08 |
$789 |
5.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,103.76 |
$1,533 |
2.6× |
| Angio internal mammary (75756) |
$5,364.72 |
$7,451 |
1.6× |
| Angio pulmonary bilat (75743) |
$6,229.44 |
$8,652 |
1.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$5,364.72 |
$7,451 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$4,433.76 |
$6,158 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$3,965.76 |
$5,508 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,680.80 |
$7,890 |
1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,965.76 |
$5,508 |
1.2× |
| Ankle 2 views (73600) |
$343.44 |
$477 |
3.7× |
| Aortography thoracic serialography rs&i (75605) |
$8,920.08 |
$12,389 |
1.5× |
| Artery X-Rays Abdomen (75726) |
$6,811.20 |
$9,460 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$3,965.76 |
$5,508 |
1.2× |
| Artery X-Rays Pelvis (75736) |
$9,185.76 |
$12,758 |
1.5× |
| Artery X-Rays Spine (75705) |
$8,920.08 |
$12,389 |
1.5× |
| Arthrogram ankle (73615) |
$1,025.28 |
$1,424 |
2.7× |
| Arthrogram hip (73525) |
$1,199.52 |
$1,666 |
3.2× |
| Arthrogram Wrist (73115) |
$982.80 |
$1,365 |
2.6× |
| Basic radiation dosimetry calculation (77300) |
$415.44 |
$577 |
2.9× |
| Bone age studies (77072) |
$647.28 |
$899 |
5.8× |
| Bone Imaging 3 Phase (78315) |
$1,390.32 |
$1,931 |
3.2× |
| Bone Imaging Limited Area (78300) |
$506.16 |
$703 |
1.2× |
| Bone Imaging Whole Body (78306) |
$1,752.48 |
$2,434 |
4.1× |
| Bone survey infant (77076) |
$577.44 |
$802 |
5.2× |
| Brachytx isodose complex (77318) |
$1,082.88 |
$1,504 |
2.7× |
| Brain Image W/Flow < 4 Views (78601) |
$757.44 |
$1,052 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,340.80 |
$4,640 |
2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,011.12 |
$5,571 |
10.7× |
| Cat Scan Follow-Up Study (76380) |
$1,511.28 |
$2,099 |
16.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$986.40 |
$1,370 |
1.7× |
| Cerebrospinal Fluid Scan (78630) |
$678.24 |
$942 |
1.2× |
| Chest 1 view (71045) |
$282.24 |
$392 |
3.0× |
| Chest 2 views (71046) |
$475.20 |
$660 |
5.1× |
| Chest 3 views (71047) |
$389.52 |
$541 |
4.2× |
Chest 4 or more views (71048)
range across 2 matching MRF lines |
$383.76–$582.48 |
$533–$809 |
varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$243.36 |
$338 |
2.2× |
| Clavicle complete (73000) |
$402.48 |
$559 |
4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$197.28 |
$274 |
1.8× |
| Continuing medical physics consltj pr wk (77336) |
$478.08 |
$664 |
3.3× |
| Contrast Exam Abdominl Aorta (75625) |
$4,062.96 |
$5,643 |
1.2× |
| Contrast X-Ray Bladder (74430) |
$1,061.28 |
$1,474 |
2.8× |
| Contrast X-Ray Of Elbow (73085) |
$925.92 |
$1,286 |
2.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,036.80 |
$1,440 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,628.24 |
$7,817 |
15.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,429.36 |
$4,763 |
13.4× |
| CT abdomen w contrast (74160) |
$1,991.52 |
$2,766 |
10.6× |
| CT abdomen w wo contrast (74170) |
$2,813.76 |
$3,908 |
15.0× |
| CT abdomen w/o contrast (74150) |
$1,755.36 |
$2,438 |
15.7× |
| CT Angio Abdomen and Pelvis (74174) |
$5,116.32 |
$7,106 |
13.7× |
| CT Angio Chest (71275) |
$2,759.04 |
$3,832 |
14.7× |
| CT Angio Head (70496) |
$2,224.08 |
$3,089 |
11.8× |
| CT angio hrt w/3d image (75574) |
$1,427.04 |
$1,982 |
3.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,178.72 |
$3,026 |
11.6× |
| CT Angio Neck (70498) |
$2,224.08 |
$3,089 |
11.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,530.80 |
$3,515 |
13.5× |
| CT cervical spine w/ contrast (72126) |
$2,532.96 |
$3,518 |
6.8× |
| CT cervical spine w/o contrast (72125) |
$2,168.64 |
$3,012 |
19.4× |
| CT cervical spine w/wo cont (72127) |
$2,586.96 |
$3,593 |
13.8× |
| CT chest w contrast (71260) |
$2,331.36 |
$3,238 |
12.4× |
| CT chest w/wo contrast (71270) |
$2,991.60 |
$4,155 |
15.9× |
| CT head/brain with contrast (70460) |
$1,810.08 |
$2,514 |
9.6× |
| CT head/brain without and with contrast (70470) |
$2,224.08 |
$3,089 |
11.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$533.52 |
$741 |
1.4× |
| CT iac w contrast (70481) |
$1,843.92 |
$2,561 |
9.8× |
| CT l-spine w&w/o contrast (72133) |
$2,493.36 |
$3,463 |
13.3× |
| CT lower ext w/o (73700) |
$1,393.20 |
$1,935 |
12.4× |
| CT lower extremity w/contrast material (73701) |
$1,563.12 |
$2,171 |
8.3× |
| CT lumbar spine w contrast (72132) |
$2,347.20 |
$3,260 |
6.3× |
| CT lumbar spine w/o contrast (72131) |
$2,164.32 |
$3,006 |
19.3× |
| CT maxillofacial w contrast (70487) |
$2,024.64 |
$2,812 |
10.8× |
| CT maxillofacial wo contrast (70486) |
$1,834.56 |
$2,548 |
16.4× |
| CT neck tissue combo (70492) |
$2,140.56 |
$2,973 |
11.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,746 |
$2,425 |
9.3× |
| CT orbits w/o contrast (70480) |
$1,672.56 |
$2,323 |
14.9× |
| CT pelvis w&w/o contrast (72194) |
$2,446.56 |
$3,398 |
13.0× |
| CT pelvis w/o contrast (72192) |
$1,755.36 |
$2,438 |
15.7× |
| CT scan of leg combo (73702) |
$1,953.36 |
$2,713 |
10.4× |
| CT scans face/jaw combo (70488) |
$2,121.84 |
$2,947 |
11.3× |
| CT soft tissue neck w contrast (70491) |
$2,053.44 |
$2,852 |
10.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,448.64 |
$2,012 |
12.9× |
| CT thoracic spine w contrast (72129) |
$2,155.68 |
$2,994 |
11.5× |
| CT thoracic spine w/o contrast (72128) |
$2,164.32 |
$3,006 |
19.3× |
| CT thoracic spine w/wo cont (72130) |
$2,493.36 |
$3,463 |
13.3× |
| CT thorax w/o contrast (71250) |
$2,164.32 |
$3,006 |
19.3× |
| CT upper ext wo (73200) |
$1,368.72 |
$1,901 |
12.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,784.16 |
$2,478 |
9.5× |
| CT upper extremity with contrast (73201) |
$1,733.76 |
$2,408 |
4.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,302.48 |
$1,809 |
6.9× |
| Cta Abdomen (74175) |
$2,520 |
$3,500 |
13.4× |
| CTA pelvis (72191) |
$2,446.56 |
$3,398 |
13.0× |
| Dilation ureters/urethra rs&i (74485) |
$3,651.84 |
$5,072 |
1.6× |
| Diskography lumbar (72295) |
$3,615.12 |
$5,021 |
1.7× |
| Dxa Bone Density Axial (77080) |
$421.20 |
$585 |
3.8× |
| Dxa bone density study (77085) |
$244.80 |
$340 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$308.16 |
$428 |
3.3× |
| Echo exam uterus (76831) |
$694.80 |
$965 |
2.7× |
| Echo Guide For Artery Repair (76936) |
$789.84 |
$1,097 |
3.4× |
| Echograp Trans R Pros Study (76873) |
$284.40 |
$395 |
2.5× |
| Esophagram (74220) |
$703.44 |
$977 |
3.7× |
| Fetal Biophys Profile W/Nst (76818) |
$226.08 |
$314 |
2.0× |
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines |
$226.08–$681.84 |
$314–$947 |
varies |
| Fluoroscopy up to 1 hr (76000) |
$624.24 |
$867 |
2.4× |
| Follow-Up Angiography (75898) |
$3,965.76 |
$5,508 |
1.2× |
| Foot 2 views (73620) |
$364.32 |
$506 |
3.9× |
| Forearm 2 views (73090) |
$352.80 |
$490 |
3.8× |
| Gastric emptying imaging study (78264) |
$1,387.44 |
$1,927 |
3.2× |
| Gated Heart Planar Single (78472) |
$1,517.04 |
$2,107 |
3.5× |
| Hand 2 views (73120) |
$272.16 |
$378 |
2.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,364.72 |
$7,451 |
1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$5,364.72 |
$7,451 |
1.6× |
| Hepatobil Syst Image W/Drug (78227) |
$2,008.08 |
$2,789 |
3.5× |
| Hepatobiliary System Imaging (78226) |
$1,618.56 |
$2,248 |
3.8× |
| Ht Muscle Image Spect Sing (78451) |
$1,645.20 |
$2,285 |
1.2× |
| Hysterosalpingogram (74740) |
$633.60 |
$880 |
2.5× |
| Image fusion (77399) |
$415.44 |
$577 |
2.9× |
| Interstitial radiation source applic complex (77778) |
$2,370.24 |
$3,292 |
3.2× |
| Joint Survey Single View (77077) |
$246.24 |
$342 |
2.2× |
| K Flow/Funct Image Multiple (78709) |
$2,580.48 |
$3,584 |
4.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,436.40 |
$1,995 |
2.5× |
| K Flow/Funct Image W/O Drug (78707) |
$1,265.76 |
$1,758 |
2.2× |
| Knee 3 Views (73562) |
$471.60 |
$655 |
5.1× |
| Liver & Spleen Imaging Static Only (78215) |
$772.56 |
$1,073 |
1.8× |
| Lung perfusion differential (78597) |
$2,304.72 |
$3,201 |
5.4× |
| Lymph System Imaging (78195) |
$1,204.56 |
$1,673 |
2.1× |
| Magnetic Image Jaw Joint (70336) |
$3,295.44 |
$4,577 |
12.9× |
| Mammary ductogram or galactogram multiple (77054) |
$370.08 |
$514 |
1.4× |
| Mammary ductogram or galactogram single (77053) |
$304.56 |
$423 |
1.2× |
| Meckels Divert Exam (78290) |
$812.88 |
$1,129 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,082.88 |
$1,504 |
2.7× |
| Mr safety determination physician/other qhp (76016) |
$222.48 |
$309 |
2.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$71.28 |
$99 |
2.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$261.36 |
$363 |
2.6× |
| Mr safety implt pos&/immoblj (76019) |
$156.24 |
$217 |
2.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$783.36 |
$1,088 |
3.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,135.52 |
$2,966 |
5.7× |
| MRA head w/o contrast (70544) |
$2,079.36 |
$2,888 |
8.1× |
| MRA head with contrast (70545) |
$2,106 |
$2,925 |
5.6× |
| MRA neck w contrast (70548) |
$2,131.92 |
$2,961 |
5.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,448 |
$3,400 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,938.24 |
$2,692 |
7.6× |
| MRI abdomen w contrast (74182) |
$3,272.40 |
$4,545 |
8.8× |
| MRI abdomen w/o contrast (74181) |
$3,102.48 |
$4,309 |
12.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,798.72 |
$5,276 |
4.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,147.20 |
$5,760 |
11.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,638.88 |
$5,054 |
4.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,438.72 |
$4,776 |
13.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,877.76 |
$2,608 |
7.3× |
| MRI cardiac w/o contrast (75557) |
$2,656.80 |
$3,690 |
10.4× |
| MRI cervical spine w contrast (72142) |
$3,696.48 |
$5,134 |
9.9× |
| MRI cervical spine w/o cont (72141) |
$2,106.72 |
$2,926 |
8.2× |
| MRI chest w/o contrast (71550) |
$1,995.12 |
$2,771 |
7.8× |
| MRI chest with contrast (71551) |
$2,178.72 |
$3,026 |
2.6× |
| MRI chest wo w contrast (71552) |
$2,468.16 |
$3,428 |
6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,952 |
$4,100 |
7.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,335.04 |
$4,632 |
8.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,815.20 |
$3,910 |
11.0× |
| MRI lumbar spine w contrast (72149) |
$4,255.20 |
$5,910 |
11.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,792.24 |
$5,267 |
10.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,134.80 |
$2,965 |
8.3× |
| MRI orbit face neck w contrast (70542) |
$2,191.68 |
$3,044 |
5.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,313.44 |
$4,602 |
8.9× |
| MRI pelvis w contrast (72196) |
$3,638.88 |
$5,054 |
9.7× |
| MRI pelvis w/o & w contrast (72197) |
$4,276.80 |
$5,940 |
11.4× |
| MRI pelvis w/o contrast (72195) |
$3,528 |
$4,900 |
13.8× |
| MRI spectroscopy (76390) |
$3,223.44 |
$4,477 |
34.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,338.56 |
$3,248 |
9.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,756.88 |
$3,829 |
7.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,425.68 |
$3,369 |
9.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,087.36 |
$4,288 |
8.3× |
| MRI, abdomen, combo (74183) |
$4,090.32 |
$5,681 |
10.9× |
| MRI, dorsal spine combo (72157) |
$4,360.32 |
$6,056 |
11.7× |
| MRI, dorsal spine contrast (72147) |
$4,255.20 |
$5,910 |
11.4× |
| MRI, joint upper extrem (73221) |
$3,413.52 |
$4,741 |
13.4× |
| MRI, joint upper extrem combo (73223) |
$3,858.48 |
$5,359 |
10.3× |
| MRI, lumbar spine combo (72158) |
$5,173.92 |
$7,186 |
13.8× |
| Myelogram cervical (72240) |
$1,553.76 |
$2,158 |
1.8× |
| Myelogram Lumbar (72265) |
$1,553.76 |
$2,158 |
1.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$717.84 |
$997 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$4,446 |
$6,175 |
3.2× |
| N-invas est c ffr sw aly CTA (75580) |
$4,338.72 |
$6,026 |
4.7× |
| Neck soft tissue (70360) |
$326.16 |
$453 |
3.5× |
| Nm myocard infarct spect (78469) |
$678.24 |
$942 |
1.2× |
| Nonvascular Shunt X-Ray (75809) |
$603.36 |
$838 |
5.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,011.12 |
$5,571 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$1,893.60 |
$2,630 |
7.6× |
| Ob us nuchal meas 1 gest (76813) |
$845.28 |
$1,174 |
7.5× |
| Parathyroid Planar Imaging (78070) |
$996.48 |
$1,384 |
2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$795.60 |
$1,105 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$300.96 |
$418 |
2.7× |
| Peritoneogram Rs&I (74190) |
$1,020.96 |
$1,418 |
1.7× |
| PET image w/CT, full body (78816) |
$3,216.96 |
$4,468 |
2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,409.92 |
$4,736 |
2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,364.72 |
$7,451 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,101.60 |
$1,530 |
2.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$668.16 |
$928 |
6.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$906.48 |
$1,259 |
1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$395.28 |
$549 |
4.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$349.92 |
$486 |
3.8× |
| Radex elbow complete minimum 3 views (73080) |
$402.48 |
$559 |
4.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$612 |
$850 |
5.5× |
| Radex fingr minimum 2 views (73140) |
$327.60 |
$455 |
3.5× |
| Radex foot complete minimum 3 views (73630) |
$395.28 |
$549 |
4.2× |
| Radex Hand Minimum 3 Views (73130) |
$354.96 |
$493 |
3.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$182.88 |
$254 |
2.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$509.76 |
$708 |
4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$297.36 |
$413 |
3.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$434.88 |
$604 |
4.7× |
| Radex shoulder complete minimum 2 views (73030) |
$374.40 |
$520 |
4.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$340.56 |
$473 |
3.7× |
| Radex Spine 1 View Specify Level (72020) |
$411.84 |
$572 |
4.4× |
| Radex Sternum Minimum 2 Views (71120) |
$436.32 |
$606 |
4.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$469.44 |
$652 |
5.0× |
Radex Toe Minimum 2 Views (73660)
range across 2 matching MRF lines |
$323.28–$449 |
$449 |
varies |
| Radex upper extremity infant minimum 2 views (73092) |
$349.92 |
$486 |
3.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$327.60 |
$455 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$772.56 |
$1,073 |
6.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$25,716.24 |
$35,717 |
3.3× |
| Radiation treatment delivery level 1 (77402) |
$392.40 |
$545 |
3.6× |
| Radiation treatment delivery level 2 (77407) |
$754.56 |
$1,048 |
1.8× |
| Radiation treatment delivery level 3 (77412) |
$867.60 |
$1,205 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$469.44 |
$652 |
4.2× |
| Radiologic exam colon double contrast study (74280) |
$1,052.64 |
$1,462 |
5.6× |
| Radiologic exam colon single contrast study (74270) |
$881.28 |
$1,224 |
4.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$677.52 |
$941 |
3.6× |
| Radiologic exam knee complete 4/more views (73564) |
$498.96 |
$693 |
4.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$347.76 |
$483 |
3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$807.12 |
$1,121 |
4.3× |
| Radiologic exam swallow function contrast study (74230) |
$828 |
$1,150 |
4.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$974.16 |
$1,353 |
5.2× |
| Radiologic examination femur 1 view (73551) |
$144.72 |
$201 |
1.6× |
| Radiologic examination femur minimum 2 views (73552) |
$166.32 |
$231 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$395.28 |
$549 |
4.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$509.76 |
$708 |
4.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$423.36 |
$588 |
4.5× |
| Renal Cyst Study (74470) |
$691.20 |
$960 |
1.2× |
| Ribs bilateral 3 views (71110) |
$564.48 |
$784 |
5.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,797.84 |
$2,497 |
4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,645.20 |
$2,285 |
2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,645.20 |
$2,285 |
2.8× |
| Scapula (73010) |
$349.92 |
$486 |
3.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$53.28 |
$74 |
2.3× |
| Shoulder 1 view (73020) |
$311.04 |
$432 |
3.3× |
| Shoulder Arthrography (73040) |
$1,174.32 |
$1,631 |
3.1× |
| Sialogram (70390) |
$582.48 |
$809 |
2.3× |
| Skull less than 4 views (70250) |
$349.92 |
$486 |
3.1× |
| Special dosimetry (77331) |
$415.44 |
$577 |
2.9× |
| Special Physics Consult (77370) |
$415.44 |
$577 |
2.9× |
| Special teletherapy port plan (77321) |
$1,082.88 |
$1,504 |
2.7× |
| Special treatment procedure (77470) |
$1,748.88 |
$2,429 |
3.0× |
| Srs Multisource (77371) |
$25,716.24 |
$35,717 |
3.3× |
| Stereotactic Body Radiation Delivery (77373) |
$6,539.76 |
$9,083 |
3.4× |
| Sternoclavicular joints (71130) |
$421.20 |
$585 |
4.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,082.88 |
$1,504 |
2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,082.88 |
$1,504 |
2.7× |
| Testicular Imaging W/Flow (78761) |
$859.68 |
$1,194 |
2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,245.60 |
$1,730 |
3.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,082.88 |
$1,504 |
2.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$415.44 |
$577 |
2.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$594.72 |
$826 |
3.2× |
| Thoracic spine 2 views (72070) |
$432.72 |
$601 |
3.9× |
| Thoracic spine 3 views (72072) |
$575.28 |
$799 |
5.1× |
| Thoracolumbar 2 views (72080) |
$198 |
$275 |
2.1× |
| Thyroid Met Imaging Body (78018) |
$2,235.60 |
$3,105 |
3.8× |
| Thyroid Uptake Measurement (78012) |
$506.16 |
$703 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,190.88 |
$1,654 |
2.8× |
| Tx Devices Design & Construction Complex (77334) |
$1,245.60 |
$1,730 |
3.1× |
| Tx devices design & construction intermediate (77333) |
$452.88 |
$629 |
3.1× |
| Tx devices design & construction simple (77332) |
$452.88 |
$629 |
3.1× |
| Ultrasound Breast Limited (76642) |
$473.76 |
$658 |
5.1× |
| Ultrasound Exam Aaa Screen (76706) |
$299.52 |
$416 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$1,314.72 |
$1,826 |
11.7× |
| Umbilical-artery Doppler (OB) (76820) |
$392.40 |
$545 |
3.5× |
| Unlisted magnetic resonance procedure (76498) |
$503.28 |
$699 |
5.4× |
| Upper gi w/o kub (74240) |
$990 |
$1,375 |
5.3× |
| Ureteral Reflux Study (78740) |
$757.44 |
$1,052 |
1.8× |
| Urethrocystogram voiding (74455) |
$770.40 |
$1,070 |
3.0× |
| Urethrocystography retrograde (74450) |
$750.96 |
$1,043 |
2.9× |
| Us breast unilateral complete (76641) |
$825.12 |
$1,146 |
7.4× |
| Us chest (76604) |
$898.56 |
$1,248 |
8.0× |
| Us complete joint (76881) |
$628.56 |
$873 |
5.6× |
| Us exam, pelvic, limited (76857) |
$544.32 |
$756 |
4.9× |
| Us head (76506) |
$925.20 |
$1,285 |
8.3× |
| Us kidney transplant (76776) |
$830.16 |
$1,153 |
7.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$540.72 |
$751 |
4.8× |
| Us ob detailed single fetus (76811) |
$964.80 |
$1,340 |
3.8× |
| Us ob limited 1 or more fetuses (76815) |
$714.96 |
$993 |
6.4× |
| Us ob transvaginal (76817) |
$879.12 |
$1,221 |
7.8× |
| Us pelvic non ob complete (76856) |
$1,341.36 |
$1,863 |
12.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$895.68 |
$1,244 |
8.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$720.72 |
$1,001 |
6.4× |
| Us retroperitoneal complete (76770) |
$1,429.92 |
$1,986 |
12.8× |
| Us retroperitoneal limited (76775) |
$852.48 |
$1,184 |
7.6× |
| Us scrotum and contents (76870) |
$1,093.68 |
$1,519 |
9.8× |
| Us thyroid (76536) |
$1,037.52 |
$1,441 |
9.3× |
| Us transrectal (76872) |
$1,141.20 |
$1,585 |
10.2× |
| Vein X-Ray Chest (75827) |
$1,957.68 |
$2,719 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,965.76 |
$5,508 |
1.2× |
| Venogram Sinus/Jugular (75860) |
$5,673.60 |
$7,880 |
1.7× |
| Venography Adrenal Unilateral (75840) |
$5,364.72 |
$7,451 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$3,965.76 |
$5,508 |
1.2× |
| Venography extremity bilateral rs&i (75822) |
$2,117.52 |
$2,941 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,957.68 |
$2,719 |
1.2× |
| Venography Renal Bilateral (75833) |
$5,364.72 |
$7,451 |
1.6× |
| Venography Renal Unilateral (75831) |
$5,364.72 |
$7,451 |
1.6× |
| Venous sampling by catheter (75893) |
$8,920.08 |
$12,389 |
1.5× |
| Vertebral fracture assessment via dxa (77086) |
$182.16 |
$253 |
2.0× |
| Wrist 2 views (73100) |
$387.36 |
$538 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$401.04 |
$557 |
4.3× |
| X-ray antegrade pyelogram tube (74425) |
$916.56 |
$1,273 |
2.5× |
| X-Ray Aorta Leg Arteries (75630) |
$4,418.64 |
$6,137 |
1.3× |
| X-Ray Bend Only L-S Spine (72120) |
$141.84 |
$197 |
1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$327.60 |
$455 |
3.5× |
| X-Ray Exam Breast Specimen (76098) |
$600.48 |
$834 |
1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$144.72 |
$201 |
1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$238.32 |
$331 |
2.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$166.32 |
$231 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$166.32 |
$231 |
1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$255.60 |
$355 |
2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$288.72 |
$401 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$307.44 |
$427 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$534.24 |
$742 |
4.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$882.72 |
$1,226 |
7.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$561.60 |
$780 |
6.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$821.52 |
$1,141 |
7.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$307.44 |
$427 |
2.7× |
| X-ray eye for foreign body (70030) |
$234 |
$325 |
2.5× |
| X-ray humerus (73060) |
$402.48 |
$559 |
4.3× |
| X-ray IV pyelogram (ivp) (74400) |
$1,154.88 |
$1,604 |
6.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$282.96 |
$393 |
3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$500.40 |
$695 |
5.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$702 |
$975 |
6.3× |
| X-ray nose-rectum child f.b. (76010) |
$316.08 |
$439 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$705.60 |
$980 |
6.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$429.84 |
$597 |
3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$339.12 |
$471 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$432.72 |
$601 |
4.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$461.52 |
$641 |
4.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$469.44 |
$652 |
4.2× |
| X-Ray Stress View (77071) |
$206.64 |
$287 |
2.2× |
| X-ray thoracic spine 4 vw (72074) |
$627.84 |
$872 |
5.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$864 |
$1,200 |
2.3× |
| X-Rays Bone Length Studies (77073) |
$469.44 |
$652 |
4.2× |
| X-Rays Bone Survey Complete (77075) |
$1,123.20 |
$1,560 |
10.0× |
| Xr c-spine 4 or 5 views (72050) |
$912.96 |
$1,268 |
8.1× |
| Xr facial bones less than 3 views (70140) |
$364.32 |
$506 |
3.9× |
| Xr orbits complete 4 views (70200) |
$469.44 |
$652 |
4.2× |
| Xr Tomogram Single Plane (76100) |
$2,203.20 |
$3,060 |
19.7× |