| Abdomen 2 views (74019) |
$92.26 |
$153.78 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$563.82 |
$939.70 |
1.5× |
| Acute venous thrombus image (78456) |
$462.39 |
$770.65 |
0.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,165.91 |
$3,609.85 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,094.72 |
$3,491.20 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,692 |
$2,820 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$849.90 |
$1,416.50 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,713.36 |
$2,855.60 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,177.31 |
$3,628.85 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,507.74 |
$2,512.90 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,308.56 |
$2,180.92 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,713.36 |
$2,855.60 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$310.77 |
$517.95 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,082.97 |
$1,804.95 |
0.4× |
| Ankle 2 views (73600) |
$73.20 |
$122 |
0.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$209.72 |
$349.52 |
0.7× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,390.35 |
$2,317.25 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,567.83 |
$2,613.05 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$1,452.45 |
$2,420.75 |
0.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,713.36 |
$2,855.60 |
0.6× |
| Arthrogram elbow (73085) |
$197.10 |
$328.50 |
0.6× |
| Arthrogram hip (73525) |
$315.18 |
$525.30 |
1.0× |
| Arthrogram shoulder (73040) |
$267.78 |
$446.30 |
0.8× |
| Arthrogram wrist (73115) |
$215.26 |
$358.78 |
0.7× |
| Arthrography knee lt (73580) |
$246.99 |
$411.65 |
0.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$317.67 |
$529.45 |
0.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$319.80 |
$533 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$511.44 |
$852.40 |
1.4× |
| Bone age studies (77072) |
$110.10 |
$183.50 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$704.37 |
$1,173.95 |
1.9× |
| Bone Marrow Imaging Limited Area (78102) |
$225.30 |
$375.50 |
0.6× |
| Bone survey complete (77075) |
$130.80 |
$218 |
1.4× |
| Brain image w/flow 4 + views (78606) |
$577.44 |
$962.40 |
1.2× |
| Brain imaging < 4 static views (78600) |
$231.33 |
$385.55 |
0.6× |
| Brain imaging < 4 static views w vascular flow (78601) |
$406.65 |
$677.75 |
1.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$274.44 |
$457.40 |
0.5× |
| Brain Imaging Vascular Flow Only (78610) |
$423.33 |
$705.55 |
0.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$279.72 |
$466.20 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$126.24 |
$210.40 |
1.6× |
| Chest 1 view (71045) |
$82.08 |
$136.80 |
1.0× |
| Chest 3 views (71047) |
$88.98 |
$148.30 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$103.56 |
$172.60 |
0.6× |
| Cineradiography/videoradiography (76120) |
$472.32 |
$787.20 |
4.9× |
| Clavicle complete (73000) |
$90.27 |
$150.45 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$642 |
$1,070 |
6.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,584 |
$2,640 |
4.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,080 |
$1,800 |
4.9× |
| CT abdomen w contrast (74160) |
$597.93 |
$996.55 |
3.7× |
| CT abdomen w wo contrast (74170) |
$1,141.50 |
$1,902.50 |
7.1× |
| CT abdomen w/o contrast (74150) |
$597.93 |
$996.55 |
6.2× |
| CT angio hrt w/3d image (75574) |
$960.12 |
$1,600.20 |
3.0× |
| CT angiography upper extremity lt (73206) |
$966.84 |
$1,611.40 |
6.0× |
| CT c-spine w/o contrast (72125) |
$642 |
$1,070 |
6.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,225.62 |
$2,042.70 |
7.6× |
| CT cervical spine with contrast (72126) |
$642 |
$1,070 |
2.0× |
| CT chest w/wo contrast (71270) |
$1,225.62 |
$2,042.70 |
7.6× |
| CT chest with contrast (71260) |
$642 |
$1,070 |
4.0× |
| CT head/brain with contrast (70460) |
$563.82 |
$939.70 |
3.5× |
| CT head/brain without and with contrast (70470) |
$1,076.40 |
$1,794 |
6.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$108 |
$180 |
1.3× |
| CT iac w contrast (70481) |
$563.82 |
$939.70 |
3.5× |
| CT limited/localized follow up study (76380) |
$370.08 |
$616.80 |
4.6× |
| CT lower ext w/o (73700) |
$563.82 |
$939.70 |
5.9× |
| CT lower extremity with contrast (73701) |
$564.90 |
$941.50 |
3.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,225.62 |
$2,042.70 |
7.6× |
| CT lumbar spine w/o contrast (72131) |
$642 |
$1,070 |
6.7× |
| CT lumbar spine with contrast (72132) |
$642 |
$1,070 |
2.0× |
| CT maxillofacial w contrast (70487) |
$563.82 |
$939.70 |
3.5× |
| CT maxillofacial w/o contrast (70486) |
$563.82 |
$939.70 |
5.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,076.40 |
$1,794 |
6.7× |
| CT neck soft tissue w contrast (70491) |
$563.82 |
$939.70 |
3.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,076.40 |
$1,794 |
6.7× |
| CT orbits w/o contrast (70480) |
$563.82 |
$939.70 |
5.9× |
| CT pelvis w & w/o contrast (72194) |
$862.50 |
$1,437.50 |
5.3× |
| CT pelvis w/o contrast (72192) |
$642 |
$1,070 |
6.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,076.40 |
$1,794 |
6.7× |
| CT soft tissue neck w/o contrast (70490) |
$563.82 |
$939.70 |
5.9× |
| CT thoracic spine w/contrast (72129) |
$642 |
$1,070 |
4.0× |
| CT thoracic spine w/o contrast (72128) |
$642 |
$1,070 |
6.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,225.62 |
$2,042.70 |
7.6× |
| CT thorax w/o contrast (71250) |
$642 |
$1,070 |
6.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,076.40 |
$1,794 |
6.7× |
| CT upper extremity w/o contrast rt (73200) |
$563.82 |
$939.70 |
5.9× |
| CT upper extremity with contrast (73201) |
$563.82 |
$939.70 |
1.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,080 |
$1,800 |
6.7× |
| Cta Abdomen (74175) |
$1,058.16 |
$1,763.60 |
6.5× |
| CTA abdomen pelvis (74174) |
$1,843.20 |
$3,072 |
5.7× |
| CTA chest (71275) |
$1,089.90 |
$1,816.50 |
6.7× |
| Cta Head (70496) |
$947.82 |
$1,579.70 |
5.9× |
| CTA lwr ext w&w/o contrast (73706) |
$966.84 |
$1,611.40 |
6.0× |
| Cta Neck (70498) |
$947.82 |
$1,579.70 |
5.9× |
| Cta Pelvis (72191) |
$907.20 |
$1,512 |
5.6× |
| Cystography minimum 3 views rs&i (74430) |
$142.14 |
$236.90 |
0.4× |
| Dacryocystography (70170) |
$257.76 |
$429.60 |
1.2× |
| Diskogram cervical (72285) |
$1,160.46 |
$1,934.10 |
0.6× |
| Diskography lumbar (72295) |
$1,149.87 |
$1,916.45 |
0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$154.98 |
$258.30 |
1.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$204.12 |
$340.20 |
2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$211.68 |
$352.80 |
2.2× |
| Echo exam of fetal heart (76825) |
$332.79 |
$554.65 |
0.7× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$196.77 |
$327.95 |
0.9× |
| Echoencephalography real time imaging (76506) |
$229.53 |
$382.55 |
2.4× |
| Esophagus (74220) |
$170.10 |
$283.50 |
1.1× |
| Fetal biophysical profile non-stress testing (76818) |
$208.65 |
$347.75 |
2.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$144.50 |
$240.82 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$186.27 |
$310.45 |
0.8× |
| Foot 2 views (73620) |
$73.20 |
$122 |
0.9× |
| Forearm 2 views (73090) |
$98.34 |
$163.90 |
1.2× |
| Gated Heart Planar Single (78472) |
$455.10 |
$758.50 |
1.2× |
| Hand 2 views (73120) |
$73.20 |
$122 |
0.8× |
| Hand 3 views (73130) |
$107.91 |
$179.85 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,507.74 |
$2,512.90 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$484.80 |
$808 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$484.80 |
$808 |
1.3× |
| Ht muscle image spect sing (78451) |
$1,339.35 |
$2,232.25 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$108.63 |
$181.05 |
1.4× |
| Hysterosalpingogram (74740) |
$113.94 |
$189.90 |
0.5× |
| Kidney funcj study non-img radioisotopic study (78725) |
$276.09 |
$460.15 |
0.7× |
| Kidney imaging morphology (78700) |
$346.32 |
$577.20 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$710.16 |
$1,183.60 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$498.96 |
$831.60 |
1.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$777.57 |
$1,295.95 |
1.6× |
| Knee 3 views (73562) |
$118.17 |
$196.95 |
1.5× |
| Liver & spleen imaging static only (78215) |
$338.46 |
$564.10 |
0.9× |
| Liver imaging static only (78201) |
$274.44 |
$457.40 |
0.5× |
| Liver imaging w/vascular flow (78202) |
$296.07 |
$493.45 |
0.6× |
| Lymphoscintigraphy (78195) |
$394.17 |
$656.95 |
0.8× |
| Meckels Diverticulum (78290) |
$363.42 |
$605.70 |
1.0× |
| MRA head w & w/o contrast (70546) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRA head w/o contrast (70544) |
$710.16 |
$1,183.60 |
3.2× |
| MRA head with contrast (70545) |
$710.16 |
$1,183.60 |
2.2× |
| MRA neck w contrast (70548) |
$710.16 |
$1,183.60 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRA neck w/o contrast (70547) |
$710.16 |
$1,183.60 |
3.2× |
| MRI abdomen w contrast (74182) |
$710.16 |
$1,183.60 |
2.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$710.16 |
$1,183.60 |
3.2× |
| MRI any jnt lwr ext with con lt (73722) |
$710.16 |
$1,183.60 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$710.16 |
$1,183.60 |
1.0× |
| MRI c-spine with contrast (72142) |
$1,513.92 |
$2,523.20 |
4.7× |
| MRI cervical spine w/o contrast (72141) |
$710.16 |
$1,183.60 |
3.2× |
| MRI chest w/o & w/contrast material (71552) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRI chest w/o contrast (71550) |
$710.16 |
$1,183.60 |
3.2× |
| MRI chest with contrast (71551) |
$710.16 |
$1,183.60 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$710.16 |
$1,183.60 |
2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$710.16 |
$1,183.60 |
2.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$710.16 |
$1,183.60 |
3.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$710.16 |
$1,183.60 |
3.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRI orbit/face/neck w/contrast (70542) |
$710.16 |
$1,183.60 |
2.2× |
| MRI pelvis w contrast (72196) |
$710.16 |
$1,183.60 |
2.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRI pelvis w/o contrast (72195) |
$710.16 |
$1,183.60 |
3.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRI spectroscopy (76390) |
$710.16 |
$1,183.60 |
8.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,908.12 |
$3,180.20 |
5.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$710.16 |
$1,183.60 |
2.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,513.92 |
$2,523.20 |
4.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,908.12 |
$3,180.20 |
5.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,232.88 |
$2,054.80 |
5.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,032.98 |
$1,721.62 |
4.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,355.79 |
$2,259.65 |
4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$710.16 |
$1,183.60 |
3.2× |
| Myelogram Lumbar (72265) |
$1,832.88 |
$3,054.80 |
2.5× |
| Myelogram thoracic (72255) |
$1,832.88 |
$3,054.80 |
2.5× |
| Myelography 2 or more regions (72270) |
$1,832.88 |
$3,054.80 |
2.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,298.88 |
$2,164.80 |
1.1× |
| Myocardial infarct spect (78469) |
$475.68 |
$792.80 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,383.70 |
$2,306.18 |
1.2× |
| Neck soft tissue (70360) |
$102.03 |
$170.05 |
1.3× |
| Nm adrenal scan (78075) |
$741.60 |
$1,236 |
0.6× |
| Nm bone marrow multiple (78103) |
$280.47 |
$467.45 |
0.8× |
| Nm bone marrow wb (78104) |
$343.98 |
$573.30 |
0.9× |
| Nm cisternogram (78630) |
$732.63 |
$1,221.05 |
1.5× |
| Nm csf leak detection (78650) |
$577.44 |
$962.40 |
0.5× |
| Nm gastric emptying study (78264) |
$493.95 |
$823.25 |
1.3× |
| Nm gastroesophageal reflux study (78262) |
$509.76 |
$849.60 |
1.4× |
| Nm peritoneal-venous shunt patency (78291) |
$285 |
$475 |
0.8× |
| Nm whole blood volume (78122) |
$552.18 |
$920.30 |
1.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,347.56 |
$2,245.92 |
1.1× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,098.72 |
$1,831.20 |
0.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$300.06 |
$500.10 |
0.8× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$233.61 |
$389.35 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$343.23 |
$572.05 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$98.97 |
$164.95 |
1.0× |
| Osseous survey infant (77076) |
$110.37 |
$183.95 |
1.1× |
| Parathyroid imaging (78070) |
$210.39 |
$350.65 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$99.84 |
$166.40 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$1,487.40 |
$2,479 |
1.1× |
| PET imaging CT for attenuation limited area (78814) |
$1,487.40 |
$2,479 |
1.1× |
| PET imaging for CT attenuation whole body (78816) |
$1,487.40 |
$2,479 |
1.1× |
| Pr csf ventriculography (78635) |
$577.44 |
$962.40 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,355.79 |
$2,259.65 |
4.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,507.74 |
$2,512.90 |
0.5× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,038 |
$1,730 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$410.79 |
$684.65 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$174.90 |
$291.50 |
0.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$114.78 |
$191.30 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$166.62 |
$277.70 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$106.44 |
$177.40 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$127.89 |
$213.15 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$230.10 |
$383.50 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$281.13 |
$468.55 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$336.90 |
$561.50 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$86.19 |
$143.65 |
1.1× |
| Radiological examination surgical specimen (76098) |
$260.13 |
$433.55 |
0.5× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$308.73 |
$514.55 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,507.74 |
$2,512.90 |
0.5× |
| Ribs bilateral 3 views (71110) |
$174.63 |
$291.05 |
1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$435.12 |
$725.20 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$759.66 |
$1,266.10 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$884.68 |
$1,474.48 |
1.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$229.83 |
$383.05 |
1.1× |
| Rp Therapy Intravenous Administration (79101) |
$359.10 |
$598.50 |
1.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$334.98 |
$558.30 |
1.5× |
| Scanogram (77073) |
$71.52 |
$119.20 |
0.7× |
| Scapula complete (73010) |
$92.49 |
$154.15 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$215.46 |
$359.10 |
2.2× |
| Sialogram (70390) |
$226.05 |
$376.75 |
1.0× |
| Small bowel series (74250) |
$186.12 |
$310.20 |
1.2× |
| Spine thoracic 3 views (72072) |
$159.27 |
$265.45 |
1.7× |
| Spleen imaging only (78185) |
$276.48 |
$460.80 |
0.8× |
| Superior sagittal sinus venogram (75870) |
$1,155.78 |
$1,926.30 |
0.4× |
| Testicular Imaging With Vascular Flow (78761) |
$378.08 |
$630.12 |
1.0× |
| Therapeutic Enema (74283) |
$95.64 |
$159.40 |
0.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$672.78 |
$1,121.30 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$212.91 |
$354.85 |
0.6× |
| Tmj unilateral (70328) |
$44.07 |
$73.45 |
0.5× |
| Tomogram (76100) |
$186.72 |
$311.20 |
1.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$814.98 |
$1,358.30 |
1.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$425.76 |
$709.60 |
1.2× |
| Ultrasound elastography first target lesion (76982) |
$229.53 |
$382.55 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$229.53 |
$382.55 |
2.4× |
| Umbilical-artery Doppler (OB) (76820) |
$188.25 |
$313.75 |
2.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$593.76 |
$989.60 |
7.4× |
| Upper Extremity Infant (73092) |
$73.20 |
$122 |
0.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$346.32 |
$577.20 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$255.44 |
$425.72 |
1.2× |
| Urethrocystography voiding (74455) |
$189 |
$315 |
0.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$257.79 |
$429.65 |
1.6× |
| Us breast unilateral complete (76641) |
$228.96 |
$381.60 |
2.4× |
| Us chest (76604) |
$126.39 |
$210.65 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$262.11 |
$436.85 |
2.7× |
| Us elastography parenchyma (76981) |
$229.53 |
$382.55 |
2.4× |
| Us guided compression repair (76936) |
$642.66 |
$1,071.10 |
3.2× |
| Us infant hips dynamic (76885) |
$204.12 |
$340.20 |
2.5× |
| Us kidney transplant (76776) |
$200.34 |
$333.90 |
2.1× |
| Us ob detailed single fetus (76811) |
$333.48 |
$555.80 |
1.5× |
| Us ob transvaginal (76817) |
$134.70 |
$224.50 |
1.4× |
| Us pelvic non ob complete (76856) |
$233.61 |
$389.35 |
2.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$175.38 |
$292.30 |
1.8× |
| Us pregnancy ltd (76815) |
$144 |
$240 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$340.53 |
$567.55 |
3.5× |
| Us retroperitoneal complete (76770) |
$330.15 |
$550.25 |
3.4× |
| Us retroperitoneal limited (76775) |
$148.17 |
$246.95 |
1.5× |
| Us scrotum and contents (76870) |
$251.97 |
$419.95 |
2.6× |
| Us soft tissue head/neck (76536) |
$379.77 |
$632.95 |
3.9× |
| Us spinal canal and contents (76800) |
$129.75 |
$216.25 |
1.3× |
| Us transrectal (76872) |
$233.61 |
$389.35 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$274.44 |
$457.40 |
2.8× |
| Venogram extremity bilateral (75822) |
$526.71 |
$877.85 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,507.74 |
$2,512.90 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$1,116.33 |
$1,860.55 |
0.8× |
| Venography epidural rs&i (75872) |
$660.24 |
$1,100.40 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$526.71 |
$877.85 |
0.4× |
| Venography Renal Bilateral (75833) |
$2,165.91 |
$3,609.85 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,507.74 |
$2,512.90 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,155.78 |
$1,926.30 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,083.47 |
$3,472.45 |
0.4× |
| Wrist 2 views (73100) |
$76.32 |
$127.20 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$93.75 |
$156.25 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$86.94 |
$144.90 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$110.10 |
$183.50 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$333.39 |
$555.65 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$78.15 |
$130.25 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$119.64 |
$199.40 |
1.5× |
| X-ray exam hip uni 1 view (73501) |
$112.17 |
$186.95 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$136.86 |
$228.10 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$149.73 |
$249.55 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$94.50 |
$157.50 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$106.44 |
$177.40 |
1.3× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$276.90 |
$461.50 |
0.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$90.27 |
$150.45 |
1.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$188.79 |
$314.65 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$74.85 |
$124.75 |
0.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$93.12 |
$155.20 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$73.20 |
$122 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$138 |
$230 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$236.34 |
$393.90 |
2.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$116.70 |
$194.50 |
1.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$74.88 |
$124.80 |
0.9× |
| X-ray of voice box or throat (70370) |
$165.48 |
$275.80 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$143.85 |
$239.75 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$107.16 |
$178.60 |
1.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$174.90 |
$291.50 |
0.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$274.28 |
$457.12 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$105.69 |
$176.15 |
1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$164.88 |
$274.80 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$87.69 |
$146.15 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$110.85 |
$184.75 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$153.39 |
$255.65 |
1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$166.62 |
$277.70 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$113.04 |
$188.40 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$135.06 |
$225.10 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$64.26 |
$107.10 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$99.03 |
$165.05 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$105.69 |
$176.15 |
1.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$85.14 |
$141.90 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$113.04 |
$188.40 |
1.4× |
| Xr arthrogram ankle (73615) |
$197.10 |
$328.50 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$214.32 |
$357.20 |
2.2× |
| Xr chest 4+ views (71048) |
$74.85 |
$124.75 |
0.8× |
| Xr Cholecystography Oral Contrast (74290) |
$95.25 |
$158.75 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$83.67 |
$139.45 |
1.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$57.39 |
$95.65 |
0.6× |
| Xr shoulder 1 view (73020) |
$83.67 |
$139.45 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$182.04 |
$303.40 |
1.9× |
| Xr tibia/fibula 2 views (73590) |
$112.29 |
$187.15 |
1.4× |
| Xr tmj bilateral (70330) |
$88.17 |
$146.95 |
1.1× |
| Xray knee 1 or 2 views rt (73560) |
$81.64 |
$136.08 |
1.0× |