| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,739.84 |
— |
1.0× |
| Abdomen 1 View (74018) |
$84.72 |
— |
0.8× |
| Abdomen 2 views (74019) |
$101.61 |
— |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$282.47 |
— |
0.1× |
| Angiography extremity unilateral rs&i (75710) |
$271.79 |
— |
0.1× |
| Ankle 2 views (73600) |
$96.42 |
— |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$226.86 |
— |
1.4× |
| Bone age studies (77072) |
$67.84 |
— |
0.5× |
| Bone Imaging Whole Body (78306) |
$942.99 |
— |
1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,038.58 |
— |
2.4× |
| Chest 1 view (71045) |
$67.84 |
— |
0.6× |
| Chest 2 views (71046) |
$91.20 |
— |
0.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$356.23 |
— |
2.7× |
| Continuing medical physics consltj pr wk (77336) |
$328.27 |
— |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,037.29 |
— |
2.4× |
| CT abdomen and pelvis without contrast (74176) |
$418.61 |
— |
1.4× |
| CT abdomen w contrast (74160) |
$686.25 |
— |
3.1× |
| CT Angio Abdomen and Pelvis (74174) |
$1,157.35 |
— |
2.7× |
| CT Angio Chest (71275) |
$689.38 |
— |
3.1× |
| CT Angio Head (70496) |
$689.38 |
— |
3.1× |
| CT angio hrt w/3d image (75574) |
$689.38 |
— |
1.6× |
| CT Angio Neck (70498) |
$689.38 |
— |
3.1× |
| CT cervical spine w/o contrast (72125) |
$341.96 |
— |
2.6× |
| CT chest w contrast (71260) |
$461.49 |
— |
2.1× |
| CT head/brain with contrast (70460) |
$392.64 |
— |
1.8× |
| CT head/brain without and with contrast (70470) |
$470.58 |
— |
2.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$292.60 |
— |
2.7× |
| CT lower ext w/o (73700) |
$339.35 |
— |
2.6× |
| CT lumbar spine w/o contrast (72131) |
$339.35 |
— |
2.6× |
| CT maxillofacial wo contrast (70486) |
$360.13 |
— |
2.8× |
| CT orbits w/o contrast (70480) |
$405.62 |
— |
3.1× |
| CT pelvis w&w/o contrast (72194) |
$687.81 |
— |
3.1× |
| CT pelvis w/o contrast (72192) |
$338.06 |
— |
2.6× |
| CT soft tissue neck w contrast (70491) |
$495.26 |
— |
2.3× |
| CT thorax w/o contrast (71250) |
$338.06 |
— |
2.6× |
| Dxa Bone Density Axial (77080) |
$108.11 |
— |
0.8× |
| Dxa bone density study (77085) |
$141.88 |
— |
1.1× |
| Echo exam uterus (76831) |
$323.75 |
— |
1.1× |
| Echograp Trans R Pros Study (76873) |
$384.84 |
— |
2.9× |
| Esophagram (74220) |
$282.19 |
— |
1.3× |
| Fetal Biophys Profile W/Nst (76818) |
$253.89 |
— |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$183.44 |
— |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$109.40 |
— |
0.4× |
| Ht Muscle Image Spect Sing (78451) |
$1,012.12 |
— |
0.6× |
| Hysterosalpingogram (74740) |
$313.38 |
— |
1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$313.66 |
— |
2.9× |
| Knee 3 Views (73562) |
$125 |
— |
1.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$909.26 |
— |
1.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,076.80 |
— |
2.5× |
| MRA head w/o contrast (70544) |
$659.24 |
— |
2.2× |
| MRA neck w/o contrast (70547) |
$661.81 |
— |
2.2× |
| MRI abdomen w/o contrast (74181) |
$532.92 |
— |
1.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,000.92 |
— |
1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,211.92 |
— |
2.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$605.95 |
— |
2.0× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$608.56 |
— |
2.0× |
| MRI cervical spine w contrast (72142) |
$803.45 |
— |
1.8× |
| MRI cervical spine w/o cont (72141) |
$508.52 |
— |
1.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$783.96 |
— |
1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,001.44 |
— |
2.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$672.22 |
— |
2.3× |
| MRI lumbar spine w contrast (72149) |
$783.96 |
— |
1.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$893.08 |
— |
2.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,005.34 |
— |
2.3× |
| MRI pelvis w/o & w contrast (72197) |
$992.35 |
— |
2.3× |
| MRI pelvis w/o contrast (72195) |
$677.41 |
— |
2.3× |
| MRI thoracic spine w/o contrast (72146) |
$508.52 |
— |
1.7× |
| MRI, abdomen, combo (74183) |
$996.25 |
— |
2.3× |
| MRI, dorsal spine combo (72157) |
$894.37 |
— |
2.1× |
| MRI, dorsal spine contrast (72147) |
$793.04 |
— |
1.8× |
| MRI, joint upper extrem (73221) |
$576.08 |
— |
1.9× |
| MRI, lumbar spine combo (72158) |
$889.18 |
— |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,463.76 |
— |
0.9× |
| N-invas est c ffr sw aly CTA (75580) |
$2,453.32 |
— |
2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,457.18 |
— |
3.2× |
| Ob us nuchal meas 1 gest (76813) |
$243.21 |
— |
1.9× |
| Pelvis 1 or 2 views (72170) |
$76.93 |
— |
0.6× |
| PET image w/CT, full body (78816) |
$5,676.38 |
— |
3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,676.38 |
— |
3.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$112.01 |
— |
1.0× |
| Radex foot complete minimum 3 views (73630) |
$104.21 |
— |
1.0× |
| Radex Hand Minimum 3 Views (73130) |
$110.69 |
— |
1.0× |
| Radex shoulder complete minimum 2 views (73030) |
$100.32 |
— |
0.9× |
| Radex Spine 1 View Specify Level (72020) |
$66.52 |
— |
0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$127.60 |
— |
1.2× |
| Radiation treatment delivery level 3 (77412) |
$809.62 |
— |
1.2× |
| Radiologic exam knee complete 4/more views (73564) |
$139.27 |
— |
1.1× |
| Radiologic exam swallow function contrast study (74230) |
$409.52 |
— |
1.9× |
| Radiologic examination knee 1/2 views (73560) |
$102.89 |
— |
0.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,227.79 |
— |
1.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,529.20 |
— |
0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$90.95 |
— |
3.9× |
| Shoulder 1 view (73020) |
$56.14 |
— |
0.5× |
| Stereotactic Body Radiation Delivery (77373) |
$27,566.46 |
— |
12.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,451.72 |
— |
3.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$891.52 |
— |
5.3× |
| Thoracic spine 2 views (72070) |
$91.20 |
— |
0.7× |
| Thyroid Met Imaging Body (78018) |
$1,009.51 |
— |
1.5× |
| Tx Devices Design & Construction Complex (77334) |
$441.59 |
— |
0.9× |
| Ultrasound Breast Limited (76642) |
$206.83 |
— |
1.9× |
| Ultrasound Exam Aaa Screen (76706) |
$317.28 |
— |
2.4× |
| Ultrasound, abdomen limited (76705) |
$235.41 |
— |
1.8× |
| Unlisted magnetic resonance procedure (76498) |
$1,104.49 |
— |
10.2× |
| Upper gi w/o kub (74240) |
$344.57 |
— |
1.6× |
| Us breast unilateral complete (76641) |
$270.50 |
— |
2.1× |
| Us complete joint (76881) |
$112.01 |
— |
0.9× |
| Us exam, pelvic, limited (76857) |
$96.42 |
— |
0.7× |
| Us kidney transplant (76776) |
$447.46 |
— |
3.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$130.18 |
— |
1.0× |
| Us ob detailed single fetus (76811) |
$331.09 |
— |
1.1× |
| Us ob limited 1 or more fetuses (76815) |
$199.04 |
— |
1.5× |
| Us ob transvaginal (76817) |
$225.04 |
— |
1.7× |
| Us pelvic non ob complete (76856) |
$288.70 |
— |
2.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$278.29 |
— |
2.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$271.79 |
— |
2.1× |
| Us retroperitoneal complete (76770) |
$291.28 |
— |
2.2× |
| Us retroperitoneal limited (76775) |
$119.81 |
— |
0.9× |
| Us scrotum and contents (76870) |
$278.29 |
— |
2.1× |
| Us spinal canal and contents (76800) |
$343.25 |
— |
2.6× |
| Us thyroid (76536) |
$334.16 |
— |
2.6× |
| Us transrectal (76872) |
$418.61 |
— |
3.2× |
| X-Ray Exam Breast Specimen (76098) |
$100.32 |
— |
0.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$215.95 |
— |
1.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$92.52 |
— |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$141.88 |
— |
1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$119.81 |
— |
0.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$154.86 |
— |
1.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$113.30 |
— |
1.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$187.34 |
— |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$114.59 |
— |
0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$205.54 |
— |
0.5× |
| X-Rays Bone Length Studies (77073) |
$126.28 |
— |
1.0× |
| Xr c-spine 4 or 5 views (72050) |
$157.47 |
— |
1.2× |