| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,448.60 |
$4,081 |
1.8× |
| Abdomen 2 views (74019) |
$124.20 |
$207 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$563.40 |
$939 |
1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,700.80 |
$6,168 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$3,700.80 |
$6,168 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,530.40 |
$5,884 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$1,781.40 |
$2,969 |
0.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,700.80 |
$6,168 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,700.80 |
$6,168 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,022.80 |
$5,038 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$5,293.20 |
$8,822 |
0.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,293.20 |
$8,822 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$970.80 |
$1,618 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,106.60 |
$3,511 |
0.7× |
| Ankle 2 views (73600) |
$267 |
$445 |
3.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$400.80 |
$668 |
1.1× |
| Aortogram thoracic (75605) |
$3,700.80 |
$6,168 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,700.80 |
$6,168 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,700.80 |
$6,168 |
1.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,445.60 |
$4,076 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$2,574.60 |
$4,291 |
0.8× |
| Arthrogram elbow (73085) |
$373.20 |
$622 |
1.1× |
| Arthrogram hip (73525) |
$376.80 |
$628 |
1.1× |
| Arthrogram shoulder (73040) |
$373.20 |
$622 |
1.1× |
| Arthrogram wrist (73115) |
$276 |
$460 |
0.8× |
| Arthrography knee lt (73580) |
$306 |
$510 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$280.20 |
$467 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$348 |
$580 |
0.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$523.80 |
$873 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$725.40 |
$1,209 |
1.8× |
| Bone age studies (77072) |
$142.20 |
$237 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$547.80 |
$913 |
1.4× |
| Bone Marrow Imaging Limited Area (78102) |
$384 |
$640 |
1.0× |
| Bone survey complete (77075) |
$331.80 |
$553 |
3.2× |
| Brain image w/flow 4 + views (78606) |
$607.20 |
$1,012 |
1.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$544.80 |
$908 |
1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$825.60 |
$1,376 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$297.60 |
$496 |
3.4× |
| Chest 1 view (71045) |
$230.40 |
$384 |
2.6× |
| Chest 3 views (71047) |
$337.80 |
$563 |
3.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$145.80 |
$243 |
0.8× |
| Cineradiography/videoradiography (76120) |
$216 |
$360 |
2.1× |
| Clavicle complete (73000) |
$190.80 |
$318 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,484.40 |
$2,474 |
14.1× |
| Continuing medical physics consltj pr wk (77336) |
$281.40 |
$469 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,689.60 |
$2,816 |
4.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,622.40 |
$2,704 |
6.8× |
| CT abdomen w contrast (74160) |
$1,255.80 |
$2,093 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,463.40 |
$2,439 |
8.3× |
| CT abdomen w/o contrast (74150) |
$1,255.80 |
$2,093 |
12.0× |
| CT angio hrt w/3d image (75574) |
$991.80 |
$1,653 |
2.8× |
| CT angiography upper extremity lt (73206) |
$560.40 |
$934 |
3.2× |
| CT c-spine w/o contrast (72125) |
$2,009.40 |
$3,349 |
19.1× |
| CT cervical spine w&w/o contrast (72127) |
$2,070.60 |
$3,451 |
11.8× |
| CT cervical spine with contrast (72126) |
$2,009.40 |
$3,349 |
5.7× |
| CT chest w/wo contrast (71270) |
$1,728 |
$2,880 |
9.8× |
| CT chest with contrast (71260) |
$1,484.40 |
$2,474 |
8.4× |
| CT head/brain with contrast (70460) |
$2,661.60 |
$4,436 |
15.1× |
| CT head/brain without and with contrast (70470) |
$3,456 |
$5,760 |
19.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$853.20 |
$1,422 |
2.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$118.20 |
$197 |
1.4× |
| CT hrt w/3d image congen (75573) |
$1,047.60 |
$1,746 |
3.0× |
| CT iac w contrast (70481) |
$2,947.20 |
$4,912 |
16.7× |
| CT limited/localized follow up study (76380) |
$50.40 |
$84 |
0.6× |
| CT lower ext w/o (73700) |
$1,339.80 |
$2,233 |
12.8× |
| CT lower extremity w wo contrast (73702) |
$1,408.20 |
$2,347 |
8.0× |
| CT lower extremity with contrast (73701) |
$1,339.80 |
$2,233 |
7.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,587 |
$2,645 |
9.0× |
| CT lumbar spine w/o contrast (72131) |
$1,484.40 |
$2,474 |
14.1× |
| CT lumbar spine with contrast (72132) |
$1,484.40 |
$2,474 |
4.2× |
| CT maxillofacial w contrast (70487) |
$2,644.20 |
$4,407 |
15.0× |
| CT maxillofacial w/o contrast (70486) |
$2,644.20 |
$4,407 |
25.2× |
| CT maxillofacial w/wo contrast (70488) |
$2,773.80 |
$4,623 |
15.7× |
| CT neck soft tissue w contrast (70491) |
$2,160 |
$3,600 |
12.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,947.20 |
$4,912 |
16.7× |
| CT orbits w/o contrast (70480) |
$2,947.20 |
$4,912 |
28.1× |
| CT pelvis w & w/o contrast (72194) |
$1,285.80 |
$2,143 |
7.3× |
| CT pelvis w/o contrast (72192) |
$1,089.60 |
$1,816 |
10.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,533.80 |
$4,223 |
14.4× |
| CT soft tissue neck w/o contrast (70490) |
$2,146.20 |
$3,577 |
20.4× |
| CT thoracic spine w/contrast (72129) |
$1,484.40 |
$2,474 |
8.4× |
| CT thoracic spine w/o contrast (72128) |
$1,484.40 |
$2,474 |
14.1× |
| CT thorax w/o contrast (71250) |
$1,484.40 |
$2,474 |
14.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,116.60 |
$1,861 |
6.3× |
| CT upper extremity w/o contrast rt (73200) |
$978 |
$1,630 |
9.3× |
| CT upper extremity with contrast (73201) |
$978 |
$1,630 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$645.60 |
$1,076 |
3.7× |
| Cta Abdomen (74175) |
$560.40 |
$934 |
3.2× |
| CTA abdomen pelvis (74174) |
$584.40 |
$974 |
1.7× |
| CTA chest (71275) |
$560.40 |
$934 |
3.2× |
| Cta Head (70496) |
$1,102.20 |
$1,837 |
6.3× |
| CTA lwr ext w&w/o contrast (73706) |
$839.40 |
$1,399 |
4.8× |
| Cta Neck (70498) |
$1,102.20 |
$1,837 |
6.3× |
| Cystography minimum 3 views rs&i (74430) |
$295.80 |
$493 |
0.8× |
| Diskogram cervical (72285) |
$3,022.80 |
$5,038 |
1.5× |
| Diskography lumbar (72295) |
$3,022.80 |
$5,038 |
1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$85.20 |
$142 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$85.20 |
$142 |
0.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$213 |
$355 |
2.0× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$164.40 |
$274 |
1.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$258.60 |
$431 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$258.60 |
$431 |
3.0× |
| Echo exam of fetal heart (76825) |
$357 |
$595 |
0.7× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$335.40 |
$559 |
1.4× |
| Echoencephalography real time imaging (76506) |
$460.80 |
$768 |
4.4× |
| Esophagus (74220) |
$186.60 |
$311 |
1.1× |
| Fetal biophysical profile non-stress testing (76818) |
$203.40 |
$339 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$203.40 |
$339 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$197.40 |
$329 |
0.8× |
| Foot 2 views (73620) |
$267 |
$445 |
3.1× |
| Forearm 2 views (73090) |
$201.60 |
$336 |
2.3× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$308.40 |
$514 |
1.3× |
| Gated Heart Planar Single (78472) |
$1,188.60 |
$1,981 |
3.0× |
| Hand 2 views (73120) |
$139.20 |
$232 |
1.3× |
| Hand 3 views (73130) |
$185.40 |
$309 |
2.1× |
| Heart Infarct Image (78466) |
$417 |
$695 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,700.80 |
$6,168 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$668.40 |
$1,114 |
1.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$510 |
$850 |
1.3× |
| Ht muscle image spect sing (78451) |
$1,170.60 |
$1,951 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$267 |
$445 |
3.1× |
| Hysterosalpingogram (74740) |
$384 |
$640 |
1.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$321 |
$535 |
3.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$792.60 |
$1,321 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$455.40 |
$759 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$455.40 |
$759 |
0.8× |
| Knee 3 views (73562) |
$178.80 |
$298 |
2.0× |
| Liver & spleen imaging static only (78215) |
$397.80 |
$663 |
1.0× |
| Liver imaging static only (78201) |
$2,040.60 |
$3,401 |
3.7× |
| Liver imaging w/vascular flow (78202) |
$2,040.60 |
$3,401 |
3.7× |
| Lung perfusion differential (78597) |
$499.20 |
$832 |
1.2× |
| Lung Ventilation Imaging (78579) |
$521.40 |
$869 |
1.3× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,445.60 |
$4,076 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$964.80 |
$1,608 |
0.3× |
| Lymphoscintigraphy (78195) |
$396 |
$660 |
0.7× |
| Mammary ductogram or galactogram multiple (77054) |
$954 |
$1,590 |
4.0× |
| Mammary ductogram or galactogram single (77053) |
$763.80 |
$1,273 |
3.2× |
| Meckels Diverticulum (78290) |
$387.60 |
$646 |
1.0× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$241.80 |
$403 |
0.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,227.60 |
$2,046 |
3.3× |
| Mr safety determination physician/other qhp (76016) |
$94.20 |
$157 |
1.1× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$63.60 |
$106 |
1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$26.40 |
$44 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$98.40 |
$164 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$258.60 |
$431 |
1.1× |
| MRA head w & w/o contrast (70546) |
$1,250.40 |
$2,084 |
3.6× |
| MRA head w/o contrast (70544) |
$1,183.80 |
$1,973 |
4.9× |
| MRA head with contrast (70545) |
$1,183.80 |
$1,973 |
3.4× |
| MRA neck w contrast (70548) |
$1,183.80 |
$1,973 |
3.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,250.40 |
$2,084 |
3.6× |
| MRA neck w/o contrast (70547) |
$1,183.80 |
$1,973 |
4.9× |
| MRI abdomen w contrast (74182) |
$855.60 |
$1,426 |
2.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$912.90 |
$1,521.50 |
2.6× |
| MRI abdomen w/o contrast (74181) |
$855.60 |
$1,426 |
3.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,483.20 |
$2,472 |
1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,021.80 |
$1,703 |
1.3× |
| MRI bone marrow blood supply (77084) |
$940.80 |
$1,568 |
3.9× |
| MRI breast w/o contrast bilateral (77047) |
$373.80 |
$623 |
1.6× |
| MRI breast w/o contrast unilat (77046) |
$373.80 |
$623 |
1.6× |
| MRI c-spine with contrast (72142) |
$1,129.20 |
$1,882 |
3.2× |
| MRI cervical spine w/o contrast (72141) |
$1,129.20 |
$1,882 |
4.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,031.40 |
$1,719 |
2.9× |
| MRI chest w/o contrast (71550) |
$940.80 |
$1,568 |
3.9× |
| MRI chest with contrast (71551) |
$940.80 |
$1,568 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$929.40 |
$1,549 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,350 |
$2,250 |
3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,350 |
$2,250 |
5.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,129.20 |
$1,882 |
4.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,237.80 |
$2,063 |
3.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,129.20 |
$1,882 |
3.2× |
| MRI pelvis w contrast (72196) |
$855.60 |
$1,426 |
2.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,031.40 |
$1,719 |
2.9× |
| MRI pelvis w/o contrast (72195) |
$855.60 |
$1,426 |
3.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,102.80 |
$1,838 |
3.1× |
| MRI scan of leg joint before and after contrast (73723) |
$1,550.40 |
$2,584 |
4.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,182 |
$1,970 |
3.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$805.20 |
$1,342 |
2.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,031.40 |
$1,719 |
2.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$805.20 |
$1,342 |
2.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$913.80 |
$1,523 |
2.6× |
| MRI thoracic spine w/o contrast (72146) |
$677.40 |
$1,129 |
2.8× |
| MRI tmj (70336) |
$897 |
$1,495 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,021.80 |
$1,703 |
4.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,102.80 |
$1,838 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$929.40 |
$1,549 |
3.9× |
| Myelogram Cervical (72240) |
$912 |
$1,520 |
1.2× |
| Myelogram Lumbar (72265) |
$912 |
$1,520 |
1.2× |
| Myelogram thoracic (72255) |
$1,240.80 |
$2,068 |
1.6× |
| Myelography 2 or more regions (72270) |
$1,278.60 |
$2,131 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,267.80 |
$2,113 |
1.0× |
| Neck soft tissue (70360) |
$118.80 |
$198 |
1.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$265.80 |
$443 |
0.7× |
| Nm adrenal scan (78075) |
$807.60 |
$1,346 |
0.6× |
| Nm bone marrow multiple (78103) |
$490.80 |
$818 |
1.2× |
| Nm bone marrow wb (78104) |
$523.80 |
$873 |
1.3× |
| Nm cisternogram (78630) |
$579 |
$965 |
1.1× |
| Nm csf leak detection (78650) |
$700.20 |
$1,167 |
0.5× |
| Nm gastric emptying study (78264) |
$547.80 |
$913 |
1.4× |
| Nm peritoneal-venous shunt patency (78291) |
$469.80 |
$783 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,437.80 |
$4,063 |
1.8× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$348 |
$580 |
0.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$528 |
$880 |
1.3× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$2,040.60 |
$3,401 |
3.7× |
| Nuclear Rx Oral Admin (79005) |
$896.10 |
$1,493.50 |
3.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$267.60 |
$446 |
2.5× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$177.60 |
$296 |
1.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$172.80 |
$288 |
1.6× |
| Orthopantogram (70355) |
$312 |
$520 |
3.6× |
| Osseous survey infant (77076) |
$166.80 |
$278 |
1.6× |
| Osseous survey limited (77074) |
$481.80 |
$803 |
4.6× |
| Parathyrd planar w/spect&CT (78072) |
$521.40 |
$869 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$567.60 |
$946 |
1.4× |
| Parathyroid imaging (78070) |
$276 |
$460 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$211.20 |
$352 |
2.0× |
| Peritoneogram rs&i (74190) |
$1,105.20 |
$1,842 |
2.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,428.60 |
$2,381 |
4.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,700.80 |
$6,168 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,899.60 |
$3,166 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$400.20 |
$667 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$787.20 |
$1,312 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$384 |
$640 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$481.80 |
$803 |
4.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$331.80 |
$553 |
3.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$174 |
$290 |
1.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$227.40 |
$379 |
2.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,451.60 |
$24,086 |
2.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$354 |
$590 |
0.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$249 |
$415 |
2.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$361.20 |
$602 |
0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$297 |
$495 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$108 |
$180 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$130.20 |
$217 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$276 |
$460 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$169.80 |
$283 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$271.20 |
$452 |
1.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$187.20 |
$312 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$420.60 |
$701 |
4.8× |
| Radiological examination surgical specimen (76098) |
$1,382.40 |
$2,304 |
2.5× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,022.80 |
$5,038 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,700.80 |
$6,168 |
1.2× |
| Ribs bilateral 3 views (71110) |
$478.20 |
$797 |
4.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$643.80 |
$1,073 |
1.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$761.40 |
$1,269 |
1.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$807.60 |
$1,346 |
1.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,832.40 |
$3,054 |
1.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,078.40 |
$3,464 |
1.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,832.40 |
$3,054 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$290.40 |
$484 |
1.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$586.20 |
$977 |
2.5× |
| Sacroiliac Joints < 3 Views (72200) |
$167.40 |
$279 |
1.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$194.40 |
$324 |
0.8× |
| Scanogram (77073) |
$308.40 |
$514 |
2.9× |
| Scapula complete (73010) |
$277.20 |
$462 |
2.6× |
| Screening digital breast tomosynthesis (77063) |
$89.40 |
$149 |
3.8× |
| Sella turcica (70240) |
$151.80 |
$253 |
1.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$161.40 |
$269 |
1.5× |
| Sialogram (70390) |
$384 |
$640 |
1.6× |
| Simulation intermediate (77285) |
$471.60 |
$786 |
1.3× |
| Small bowel series (74250) |
$227.40 |
$379 |
1.3× |
| Spec medical radj physics consltj (77370) |
$187.80 |
$313 |
1.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$471.60 |
$786 |
1.3× |
| Special dosimetry (77331) |
$187.80 |
$313 |
1.4× |
| Special treatment procedure (77470) |
$932.40 |
$1,554 |
1.7× |
| Spine thoracic 3 views (72072) |
$331.80 |
$553 |
3.2× |
| Splenoportograpy rs&i (75810) |
$2,724.60 |
$4,541 |
0.9× |
| Stereotactic body radiation delivery (77373) |
$3,388.20 |
$5,647 |
1.9× |
| Superior sagittal sinus venogram (75870) |
$1,899.60 |
$3,166 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$703.20 |
$1,172 |
1.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$187.80 |
$313 |
0.5× |
| Testicular Imaging With Vascular Flow (78761) |
$303 |
$505 |
0.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$705.60 |
$1,176 |
1.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$281.40 |
$469 |
2.1× |
| Thoracolumbar 2 views (72080) |
$327 |
$545 |
3.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$705 |
$1,175 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$567.60 |
$946 |
1.4× |
| Thyroid uptake measurement (78012) |
$467.40 |
$779 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$703.80 |
$1,173 |
1.8× |
| Tmj unilateral (70328) |
$156.60 |
$261 |
1.8× |
| Treatment device intermediate (77333) |
$350.40 |
$584 |
2.6× |
| Treatment devices simple (77332) |
$350.40 |
$584 |
2.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,965 |
$3,275 |
3.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$643.80 |
$1,073 |
1.6× |
| Tx devices design & construction complex (77334) |
$516 |
$860 |
1.4× |
| Ultrasound scan of cornea to determine thickness (76514) |
$61.20 |
$102 |
2.1× |
| Ultrasound scan to determine eye length and lens power (76519) |
$170.40 |
$284 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$319.20 |
$532 |
3.0× |
| Umbilical-artery Doppler (OB) (76820) |
$294 |
$490 |
2.8× |
| Unlisted fluoroscopic procedure (76496) |
$145.20 |
$242 |
1.7× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$695.40 |
$1,159 |
1.7× |
| Unlisted Ultrasound Procedure (76999) |
$80.40 |
$134 |
0.9× |
| Upper Extremity Infant (73092) |
$142.20 |
$237 |
1.4× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$292.20 |
$487 |
0.7× |
| Urethrocystography retrograde rs&i (74450) |
$371.40 |
$619 |
1.5× |
| Urethrocystography voiding (74455) |
$295.80 |
$493 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$238.80 |
$398 |
1.4× |
| Us breast unilateral complete (76641) |
$302.40 |
$504 |
2.9× |
| Us breast unilateral limited (76642) |
$214.20 |
$357 |
2.5× |
| Us chest (76604) |
$96.60 |
$161 |
0.9× |
| Us compl joint r-t w/image documentation (76881) |
$265.20 |
$442 |
2.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$162.60 |
$271 |
1.5× |
| Us guided compression repair (76936) |
$460.20 |
$767 |
2.1× |
| Us infant hips limited static (76886) |
$202.80 |
$338 |
2.3× |
| Us ob detailed single fetus (76811) |
$655.80 |
$1,093 |
2.7× |
| Us ob transvaginal (76817) |
$232.20 |
$387 |
2.2× |
| Us pelvic non ob complete (76856) |
$492 |
$820 |
4.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$222.60 |
$371 |
2.1× |
| Us pregnancy ltd (76815) |
$191.40 |
$319 |
1.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$232.20 |
$387 |
2.2× |
| Us retroperitoneal complete (76770) |
$347.40 |
$579 |
3.3× |
| Us retroperitoneal limited (76775) |
$324.60 |
$541 |
3.1× |
| Us scrotum and contents (76870) |
$350.40 |
$584 |
3.3× |
| Us soft tissue head/neck (76536) |
$278.40 |
$464 |
2.7× |
| Us spinal canal and contents (76800) |
$107.40 |
$179 |
1.0× |
| Us transrectal (76872) |
$255.60 |
$426 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$132 |
$220 |
1.3× |
| Us, eye b-scan (76512) |
$170.40 |
$284 |
1.6× |
| Venogram extremity bilateral (75822) |
$1,314 |
$2,190 |
0.8× |
| Venogram orbital (75880) |
$817.20 |
$1,362 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$3,700.80 |
$6,168 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$2,110.20 |
$3,517 |
1.3× |
| Venography epidural rs&i (75872) |
$1,899.60 |
$3,166 |
3.0× |
| Venography extremity unilateral rs&i (75820) |
$903 |
$1,505 |
0.6× |
| Venography Renal Bilateral (75833) |
$3,700.80 |
$6,168 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$2,692.20 |
$4,487 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,899.60 |
$3,166 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,700.80 |
$6,168 |
0.7× |
| Wrist 2 views (73100) |
$253.20 |
$422 |
2.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$183 |
$305 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$185.40 |
$309 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$304.20 |
$507 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$308.40 |
$514 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$211.20 |
$352 |
2.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$277.80 |
$463 |
3.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$288.60 |
$481 |
2.7× |
| X-ray exam hip uni 1 view (73501) |
$169.20 |
$282 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$211.20 |
$352 |
2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$264.60 |
$441 |
2.5× |
| X-ray eye for foreign body (70030) |
$120 |
$200 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$264.60 |
$441 |
2.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$171.60 |
$286 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$304.20 |
$507 |
3.5× |
| X-ray head for orthodontia (70350) |
$121.80 |
$203 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$126 |
$210 |
1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$180 |
$300 |
2.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$220.20 |
$367 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$161.40 |
$269 |
1.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$142.20 |
$237 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$232.20 |
$387 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$481.80 |
$803 |
4.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$168.60 |
$281 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$142.20 |
$237 |
1.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$94.20 |
$157 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$180 |
$300 |
1.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$414 |
$690 |
3.9× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$780.60 |
$1,301 |
1.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$313.20 |
$522 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$375.60 |
$626 |
4.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$460.80 |
$768 |
4.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$433.80 |
$723 |
4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$220.80 |
$368 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$202.20 |
$337 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$277.20 |
$462 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$205.80 |
$343 |
2.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$156.60 |
$261 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$352.20 |
$587 |
3.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$280.20 |
$467 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$140.40 |
$234 |
1.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$186.60 |
$311 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$169.20 |
$282 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$430.20 |
$717 |
4.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$186.60 |
$311 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$277.20 |
$462 |
3.2× |
| Xr arthrogram ankle (73615) |
$276 |
$460 |
0.8× |
| Xr c-spine 6 or more views (72052) |
$667.20 |
$1,112 |
6.4× |
| Xr chest 4+ views (71048) |
$389.40 |
$649 |
3.7× |
| Xr Cholecystography Oral Contrast (74290) |
$176.40 |
$294 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$182.40 |
$304 |
2.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$170.40 |
$284 |
1.6× |
| Xr optic foramina (70190) |
$187.20 |
$312 |
2.1× |
| Xr shoulder 1 view (73020) |
$189 |
$315 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$540.60 |
$901 |
5.1× |
| Xr tibia/fibula 2 views (73590) |
$234.60 |
$391 |
2.7× |
| Xr tmj bilateral (70330) |
$232.20 |
$387 |
2.7× |
| Xray knee 1 or 2 views rt (73560) |
$156.60 |
$261 |
1.8× |