| Abdomen 2 views (74019) |
$361.20 |
$602 |
3.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,345.80 |
$2,243 |
3.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,234.60 |
$5,391 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$5,525.40 |
$9,209 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$5,525.40 |
$9,209 |
1.7× |
| Angiography internal mammary rs&i (75756) |
$2,827.20 |
$4,712 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$9,441.60 |
$15,736 |
1.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,524.80 |
$9,208 |
1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,525.40 |
$9,209 |
1.7× |
| Angiography Spinal Selective Rs&I (75705) |
$3,438 |
$5,730 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,546.60 |
$5,911 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,993.20 |
$3,322 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,548.20 |
$4,247 |
0.8× |
| Ankle 2 views (73600) |
$212.10 |
$353.50 |
2.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$754.80 |
$1,258 |
2.1× |
| Aortogram thoracic (75605) |
$3,438 |
$5,730 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,525.40 |
$9,209 |
1.7× |
| Aortography abdominal serialography rs&i (75625) |
$5,525.40 |
$9,209 |
1.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,666.40 |
$4,444 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$2,444.40 |
$4,074 |
0.7× |
| Arthrogram elbow (73085) |
$342.60 |
$571 |
0.9× |
| Arthrogram hip (73525) |
$1,026.60 |
$1,711 |
2.8× |
| Arthrogram shoulder (73040) |
$754.80 |
$1,258 |
2.1× |
| Arthrogram wrist (73115) |
$448.80 |
$748 |
1.2× |
| Arthrography knee lt (73580) |
$754.80 |
$1,258 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$868.80 |
$1,448 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$1,483.80 |
$2,473 |
3.6× |
| Bone age studies (77072) |
$223.80 |
$373 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,947.60 |
$3,246 |
4.7× |
| Bone survey complete (77075) |
$753.60 |
$1,256 |
6.9× |
| Brain image w/flow 4 + views (78606) |
$1,003.20 |
$1,672 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,630 |
$6,050 |
2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,659 |
$2,765 |
4.6× |
| Cardiac shunt detection (78428) |
$1,588.20 |
$2,647 |
3.8× |
| Cervical spine 2 or 3 views (72040) |
$263.40 |
$439 |
2.9× |
| Chest 1 view (71045) |
$200.40 |
$334 |
2.2× |
| Chest 3 views (71047) |
$282 |
$470 |
3.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$414.60 |
$691 |
2.3× |
| Cineradiography/videoradiography (76120) |
$338.40 |
$564 |
3.1× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,467 |
$2,445 |
1.8× |
| Clavicle complete (73000) |
$294.60 |
$491 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$159 |
$265 |
1.5× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$418.80 |
$698 |
2.3× |
| Corpora cavernosography (74445) |
$318.60 |
$531 |
2.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,738 |
$6,230 |
10.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,002.80 |
$3,338 |
8.1× |
| CT abdomen w contrast (74160) |
$1,813.20 |
$3,022 |
10.0× |
| CT abdomen w wo contrast (74170) |
$2,209.80 |
$3,683 |
12.1× |
| CT abdomen w/o contrast (74150) |
$1,440 |
$2,400 |
13.3× |
| CT angio hrt w/3d image (75574) |
$1,621.80 |
$2,703 |
4.5× |
| CT angiography upper extremity lt (73206) |
$2,501.40 |
$4,169 |
13.7× |
| CT c-spine w/o contrast (72125) |
$1,299.60 |
$2,166 |
12.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,734 |
$2,890 |
9.5× |
| CT cervical spine with contrast (72126) |
$2,109 |
$3,515 |
5.8× |
| CT chest w/wo contrast (71270) |
$2,020.80 |
$3,368 |
11.1× |
| CT chest with contrast (71260) |
$2,050.20 |
$3,417 |
11.3× |
| CT colonography screening (74263) |
$1,581 |
$2,635 |
6.4× |
| CT colonography w/dye (74262) |
$1,660.20 |
$2,767 |
9.1× |
| CT colonography w/o cntrst (74261) |
$1,412.40 |
$2,354 |
13.0× |
| CT head/brain with contrast (70460) |
$1,413.30 |
$2,355.50 |
7.8× |
| CT head/brain without and with contrast (70470) |
$1,604.10 |
$2,673.50 |
8.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,290 |
$2,150 |
3.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$75 |
$125 |
0.8× |
| CT hrt w/3d image congen (75573) |
$1,078.20 |
$1,797 |
3.0× |
| CT iac w contrast (70481) |
$1,714.80 |
$2,858 |
9.4× |
| CT limited/localized follow up study (76380) |
$421.80 |
$703 |
4.7× |
| CT lower ext w/o (73700) |
$1,199.40 |
$1,999 |
11.0× |
| CT lower extremity w wo contrast (73702) |
$1,914.60 |
$3,191 |
10.5× |
| CT lower extremity with contrast (73701) |
$1,711.20 |
$2,852 |
9.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,167.20 |
$3,612 |
11.9× |
| CT lumbar spine w/o contrast (72131) |
$1,463.10 |
$2,438.50 |
13.5× |
| CT lumbar spine with contrast (72132) |
$1,774.80 |
$2,958 |
4.9× |
| CT maxillofacial w contrast (70487) |
$1,531.20 |
$2,552 |
8.4× |
| CT maxillofacial w/o contrast (70486) |
$1,189.80 |
$1,983 |
11.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,854 |
$3,090 |
10.2× |
| CT neck soft tissue w contrast (70491) |
$1,459.20 |
$2,432 |
8.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,863.60 |
$3,106 |
10.2× |
| CT orbits w/o contrast (70480) |
$1,530.60 |
$2,551 |
14.1× |
| CT pelvis w & w/o contrast (72194) |
$1,887.30 |
$3,145.50 |
10.4× |
| CT pelvis w/o contrast (72192) |
$1,012.80 |
$1,688 |
9.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$468 |
$780 |
5.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,108.70 |
$3,514.50 |
11.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,247.40 |
$2,079 |
11.5× |
| CT thoracic spine w/contrast (72129) |
$2,012.40 |
$3,354 |
11.0× |
| CT thoracic spine w/o contrast (72128) |
$1,554.90 |
$2,591.50 |
14.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,684.80 |
$2,808 |
9.3× |
| CT thorax w/o contrast (71250) |
$1,442.70 |
$2,404.50 |
13.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,011.50 |
$3,352.50 |
11.0× |
| CT upper extremity w/o contrast rt (73200) |
$1,459.20 |
$2,432 |
13.4× |
| CT upper extremity with contrast (73201) |
$1,882.20 |
$3,137 |
5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,537.70 |
$4,229.50 |
13.9× |
| Cta Abdomen (74175) |
$1,893 |
$3,155 |
10.4× |
| CTA abdomen pelvis (74174) |
$4,640.40 |
$7,734 |
12.8× |
| CTA chest (71275) |
$1,852.80 |
$3,088 |
10.2× |
| Cta Head (70496) |
$1,813.20 |
$3,022 |
10.0× |
| CTA lwr ext w&w/o contrast (73706) |
$2,432.40 |
$4,054 |
13.4× |
| Cta Neck (70498) |
$2,196.60 |
$3,661 |
12.1× |
| Cta Pelvis (72191) |
$2,540.40 |
$4,234 |
13.9× |
| Cystography minimum 3 views rs&i (74430) |
$580.20 |
$967 |
1.6× |
| Dacryocystography (70170) |
$524.40 |
$874 |
2.1× |
| Diskogram cervical (72285) |
$3,598.80 |
$5,998 |
1.8× |
| Diskography lumbar (72295) |
$3,598.80 |
$5,998 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$349.20 |
$582 |
3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$166.80 |
$278 |
1.8× |
| Echoencephalography real time imaging (76506) |
$493.20 |
$822 |
4.5× |
| Esophagus (74220) |
$570 |
$950 |
3.1× |
| Fetal biophysical profile non-stress testing (76818) |
$395.40 |
$659 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$508.80 |
$848 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$412.20 |
$687 |
1.7× |
| Foot 2 views (73620) |
$206.40 |
$344 |
2.3× |
| Forearm 2 views (73090) |
$252.60 |
$421 |
2.8× |
| Gated Heart Planar Single (78472) |
$1,566.60 |
$2,611 |
3.8× |
| Hand 2 views (73120) |
$295.80 |
$493 |
2.7× |
| Hand 3 views (73130) |
$352.80 |
$588 |
3.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,601.60 |
$4,336 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,827.60 |
$3,046 |
3.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,827.60 |
$3,046 |
4.4× |
| Ht muscle image spect sing (78451) |
$2,838 |
$4,730 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$253.80 |
$423 |
2.8× |
| Hysterosalpingogram (74740) |
$529.80 |
$883 |
2.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$223.80 |
$373 |
2.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,326.60 |
$2,211 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,418.40 |
$2,364 |
2.5× |
| Knee 3 views (73562) |
$375 |
$625 |
4.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,324.80 |
$2,208 |
3.2× |
| Liver imaging w/vascular flow (78202) |
$1,003.20 |
$1,672 |
1.8× |
| Lung perf&ventilat diferentl (78598) |
$1,501.80 |
$2,503 |
2.7× |
| Lung Ventilation Imaging (78579) |
$1,030.80 |
$1,718 |
2.5× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,748.60 |
$4,581 |
0.8× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,450.20 |
$2,417 |
2.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$2,882.40 |
$4,804 |
1.8× |
| Lymphoscintigraphy (78195) |
$1,486.20 |
$2,477 |
2.6× |
| Mammary ductogram or galactogram multiple (77054) |
$578.40 |
$964 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$617.40 |
$1,029 |
2.5× |
| Meckels Diverticulum (78290) |
$1,300.80 |
$2,168 |
3.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$50.40 |
$84 |
1.7× |
| MRA head w & w/o contrast (70546) |
$3,124.80 |
$5,208 |
8.6× |
| MRA head w/o contrast (70544) |
$2,159.40 |
$3,599 |
8.7× |
| MRA head with contrast (70545) |
$2,209.20 |
$3,682 |
6.1× |
| MRA neck w contrast (70548) |
$2,107.80 |
$3,513 |
5.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,708.40 |
$4,514 |
7.5× |
| MRA neck w/o contrast (70547) |
$1,750.80 |
$2,918 |
7.1× |
| MRI abdomen w contrast (74182) |
$2,277 |
$3,795 |
6.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,917.80 |
$4,863 |
8.1× |
| MRI abdomen w/o contrast (74181) |
$2,287.80 |
$3,813 |
9.2× |
| MRI any jnt lwr ext with con lt (73722) |
$2,274.60 |
$3,791 |
2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,524.80 |
$4,208 |
3.1× |
| MRI bone marrow blood supply (77084) |
$1,860 |
$3,100 |
7.5× |
| MRI breast w/o contrast bilateral (77047) |
$600 |
$1,000 |
2.4× |
| MRI breast w/o contrast unilat (77046) |
$472.20 |
$787 |
1.9× |
| MRI c-spine with contrast (72142) |
$2,400 |
$4,000 |
6.6× |
| MRI cardiac w/o cont stress (75559) |
$1,284 |
$2,140 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$717.60 |
$1,196 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$2,097.60 |
$3,496 |
8.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,818.20 |
$4,697 |
7.8× |
| MRI chest w/o contrast (71550) |
$2,375.40 |
$3,959 |
9.6× |
| MRI chest with contrast (71551) |
$2,829.60 |
$4,716 |
3.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,789.20 |
$2,982 |
4.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,850.40 |
$3,084 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,704 |
$2,840 |
6.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,865.90 |
$4,776.50 |
11.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,348.90 |
$5,581.50 |
9.2× |
| MRI orbit/face/neck w/contrast (70542) |
$2,948.40 |
$4,914 |
8.1× |
| MRI pelvis w contrast (72196) |
$2,323.50 |
$3,872.50 |
6.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,523.60 |
$4,206 |
7.0× |
| MRI pelvis w/o contrast (72195) |
$1,938.30 |
$3,230.50 |
7.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,835 |
$4,725 |
7.8× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,799.40 |
$2,999 |
2.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,758.20 |
$4,597 |
7.6× |
| MRI spectroscopy (76390) |
$830.40 |
$1,384 |
9.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,642.40 |
$4,404 |
7.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,524.80 |
$4,208 |
7.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,068.40 |
$5,114 |
8.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,401.80 |
$4,003 |
6.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,036.60 |
$5,061 |
8.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,307 |
$3,845 |
9.3× |
| MRI tmj (70336) |
$2,109.90 |
$3,516.50 |
8.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,813.20 |
$3,022 |
7.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,982.40 |
$3,304 |
5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,666.40 |
$4,444 |
10.8× |
| Myelogram Cervical (72240) |
$1,524.60 |
$2,541 |
1.9× |
| Myelogram Lumbar (72265) |
$1,524.60 |
$2,541 |
1.9× |
| Myelogram thoracic (72255) |
$1,467 |
$2,445 |
1.8× |
| Myelography 2 or more regions (72270) |
$1,762.80 |
$2,938 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$3,654.60 |
$6,091 |
2.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,033.60 |
$5,056 |
2.0× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$4,516.80 |
$7,528 |
2.0× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,439.20 |
$5,732 |
3.9× |
| Neck soft tissue (70360) |
$246.60 |
$411 |
2.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$773.40 |
$1,289 |
1.9× |
| Nm bone marrow wb (78104) |
$1,127.40 |
$1,879 |
2.7× |
| Nm cisternogram (78630) |
$1,725.60 |
$2,876 |
3.1× |
| Nm csf leak detection (78650) |
$1,306.20 |
$2,177 |
1.0× |
| Nm gastric emptying study (78264) |
$1,507.80 |
$2,513 |
3.6× |
| Nm peritoneal-venous shunt patency (78291) |
$1,020 |
$1,700 |
2.5× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$4,194.60 |
$6,991 |
2.8× |
| Nuclear Rx Oral Admin (79005) |
$1,308 |
$2,180 |
5.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$322.20 |
$537 |
3.0× |
| Orthopantogram (70355) |
$166.80 |
$278 |
1.8× |
| Osseous survey infant (77076) |
$365.40 |
$609 |
3.4× |
| Osseous survey limited (77074) |
$264.60 |
$441 |
2.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,366.80 |
$2,278 |
2.4× |
| Parathyrd planar w/wo subtrj (78071) |
$1,813.20 |
$3,022 |
4.4× |
| Parathyroid imaging (78070) |
$1,221 |
$2,035 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$270.60 |
$451 |
2.5× |
| Peritoneogram rs&i (74190) |
$991.20 |
$1,652 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$4,789.20 |
$7,982 |
3.2× |
| PET imaging CT for attenuation limited area (78814) |
$4,166.40 |
$6,944 |
2.8× |
| PET imaging for CT attenuation whole body (78816) |
$4,929.60 |
$8,216 |
3.3× |
| PET whole body (78813) |
$4,550.40 |
$7,584 |
3.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,871.60 |
$4,786 |
7.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,512.20 |
$4,187 |
0.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,993.20 |
$3,322 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,057.20 |
$1,762 |
2.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,908 |
$3,180 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,331.40 |
$2,219 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$166.80 |
$278 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$269.40 |
$449 |
2.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$399.60 |
$666 |
3.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$250.20 |
$417 |
2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$265.20 |
$442 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$407.40 |
$679 |
3.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$237 |
$395 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$253.20 |
$422 |
2.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$247.50 |
$412.50 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$784.80 |
$1,308 |
4.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$367.20 |
$612 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$648.60 |
$1,081 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$576.60 |
$961 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$255.60 |
$426 |
2.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$166.80 |
$278 |
1.8× |
| Radiological examination surgical specimen (76098) |
$1,093.20 |
$1,822 |
1.9× |
| Radiopharm Dacryocystography (78660) |
$773.40 |
$1,289 |
1.9× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,413.80 |
$4,023 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,110.80 |
$3,518 |
0.6× |
| Ribs bilateral 3 views (71110) |
$312.60 |
$521 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,324.40 |
$3,874 |
4.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,679 |
$4,465 |
2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,147.20 |
$6,912 |
2.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,213 |
$5,355 |
2.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$608.40 |
$1,014 |
2.5× |
| Rp Therapy Intravenous Administration (79101) |
$955.80 |
$1,593 |
3.9× |
| Sacroiliac Joints < 3 Views (72200) |
$223.80 |
$373 |
2.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$472.20 |
$787 |
1.9× |
| Salivary gland imaging (78230) |
$773.40 |
$1,289 |
1.9× |
| Scanogram (77073) |
$223.80 |
$373 |
2.1× |
| Scapula complete (73010) |
$448.80 |
$748 |
4.1× |
| Screening digital breast tomosynthesis (77063) |
$62.70 |
$104.50 |
2.7× |
| Sella turcica (70240) |
$187.20 |
$312 |
2.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$424.20 |
$707 |
3.9× |
| Simulation intermediate (77285) |
$1,540.80 |
$2,568 |
4.0× |
| Small bowel series (74250) |
$436.80 |
$728 |
2.4× |
| Spine thoracic 3 views (72072) |
$338.40 |
$564 |
3.1× |
| Splenoportograpy rs&i (75810) |
$2,133 |
$3,555 |
0.7× |
| Superior sagittal sinus venogram (75870) |
$1,993.20 |
$3,322 |
0.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,816.20 |
$3,027 |
4.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$935.40 |
$1,559 |
6.7× |
| Therapeutic Enema (74283) |
$781.80 |
$1,303 |
4.3× |
| Thoracolumbar 2 views (72080) |
$238.20 |
$397 |
2.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,496.40 |
$2,494 |
2.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$773.40 |
$1,289 |
1.9× |
| Thyroid uptake measurement (78012) |
$459 |
$765 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,275.60 |
$2,126 |
3.1× |
| Tmj unilateral (70328) |
$166.80 |
$278 |
1.8× |
| Tomogram (76100) |
$223.80 |
$373 |
2.1× |
| Treatment device intermediate (77333) |
$715.20 |
$1,192 |
5.1× |
| Treatment devices simple (77332) |
$379.20 |
$632 |
2.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,706 |
$4,510 |
4.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,366.20 |
$2,277 |
3.3× |
| Tx devices design & construction complex (77334) |
$1,088.40 |
$1,814 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$339.60 |
$566 |
3.1× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$166.80 |
$278 |
1.8× |
| Unlisted magnetic resonance procedure (76498) |
$768 |
$1,280 |
8.5× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$773.40 |
$1,289 |
1.9× |
| Unlisted Ultrasound Procedure (76999) |
$205.20 |
$342 |
2.3× |
| Upper Extremity Infant (73092) |
$271.20 |
$452 |
2.5× |
| Urethrocystography retrograde rs&i (74450) |
$670.20 |
$1,117 |
2.7× |
| Urethrocystography voiding (74455) |
$531 |
$885 |
2.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$472.80 |
$788 |
2.6× |
| Us abdl aorta screen aaa (76706) |
$297.60 |
$496 |
2.7× |
| Us breast unilateral complete (76641) |
$314.40 |
$524 |
2.9× |
| Us breast unilateral limited (76642) |
$267.60 |
$446 |
3.0× |
| Us chest (76604) |
$270 |
$450 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$471.60 |
$786 |
4.3× |
| Us elastography parenchyma (76981) |
$1,042.20 |
$1,737 |
9.6× |
| Us guided compression repair (76936) |
$679.80 |
$1,133 |
3.0× |
| Us infant hips dynamic (76885) |
$507.60 |
$846 |
5.6× |
| Us infant hips limited static (76886) |
$260.40 |
$434 |
2.9× |
| Us kidney transplant (76776) |
$269.40 |
$449 |
2.5× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$315 |
$525 |
2.9× |
| Us ob transvaginal (76817) |
$396.60 |
$661 |
3.7× |
| Us pelvic non ob complete (76856) |
$304.20 |
$507 |
2.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$416.40 |
$694 |
3.8× |
| Us pregnancy ltd (76815) |
$414.60 |
$691 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$330 |
$550 |
3.0× |
| Us retroperitoneal complete (76770) |
$503.40 |
$839 |
4.6× |
| Us retroperitoneal limited (76775) |
$376.80 |
$628 |
3.5× |
| Us scrotum and contents (76870) |
$504.60 |
$841 |
4.6× |
| Us soft tissue head/neck (76536) |
$480 |
$800 |
4.4× |
| Us spinal canal and contents (76800) |
$368.70 |
$614.50 |
3.4× |
| Us transrectal (76872) |
$450.60 |
$751 |
4.2× |
| Us xtr non-vasc lmtd (76882) |
$375.60 |
$626 |
3.5× |
| Vasogram (74440) |
$1,668.60 |
$2,781 |
6.7× |
| Venogram extremity bilateral (75822) |
$2,190 |
$3,650 |
1.3× |
| Venogram orbital (75880) |
$2,412.60 |
$4,021 |
3.7× |
| Venography caval inferior serialography rs&i (75825) |
$5,525.40 |
$9,209 |
1.7× |
| Venography caval superior serialography rs&i (75827) |
$1,743 |
$2,905 |
1.1× |
| Venography epidural rs&i (75872) |
$2,241.60 |
$3,736 |
3.4× |
| Venography extremity unilateral rs&i (75820) |
$1,371.60 |
$2,286 |
0.8× |
| Venography Renal Bilateral (75833) |
$5,525.40 |
$9,209 |
1.7× |
| Venography renal unilateral selective rs&i (75831) |
$5,524.80 |
$9,208 |
1.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,993.20 |
$3,322 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,504.60 |
$5,841 |
0.6× |
| Wrist 2 views (73100) |
$246.60 |
$411 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$477.60 |
$796 |
4.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$238.80 |
$398 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$282 |
$470 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,097.40 |
$1,829 |
6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$246.60 |
$411 |
2.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$300.60 |
$501 |
3.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$254.40 |
$424 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$165 |
$275 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$276.60 |
$461 |
3.1× |
| X-ray exam hip uni 4/> views (73503) |
$223.80 |
$373 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$594.60 |
$991 |
5.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$655.80 |
$1,093 |
6.0× |
| X-ray exam of femur 1 (73551) |
$205.80 |
$343 |
2.3× |
| X-ray eye for foreign body (70030) |
$214.80 |
$358 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$415.20 |
$692 |
3.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$333.60 |
$556 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$290.40 |
$484 |
3.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,241.40 |
$2,069 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$246.60 |
$411 |
2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$166.80 |
$278 |
1.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$412.20 |
$687 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$315.60 |
$526 |
3.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$222 |
$370 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$351.60 |
$586 |
3.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$357.60 |
$596 |
3.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$492 |
$820 |
4.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$321 |
$535 |
3.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$258 |
$430 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$359.40 |
$599 |
3.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$427.20 |
$712 |
3.9× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$991.20 |
$1,652 |
1.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$754.80 |
$1,258 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$261 |
$435 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$311.40 |
$519 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$502.20 |
$837 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$270.60 |
$451 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$301.80 |
$503 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$330 |
$550 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$354.60 |
$591 |
3.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$275.40 |
$459 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$410.40 |
$684 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$276 |
$460 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$217.80 |
$363 |
2.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$245.40 |
$409 |
2.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$166.80 |
$278 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$276 |
$460 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$286.80 |
$478 |
2.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$246.60 |
$411 |
2.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$281.40 |
$469 |
3.1× |
| Xr arthrogram ankle (73615) |
$754.80 |
$1,258 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$492 |
$820 |
4.5× |
| Xr chest 4+ views (71048) |
$295.80 |
$493 |
2.7× |
| Xr finger(s) 2+ views (73140) |
$187.20 |
$312 |
2.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$223.80 |
$373 |
2.1× |
| Xr shoulder 1 view (73020) |
$250.20 |
$417 |
2.8× |
| Xr spine cervical 4 or 5 views (72050) |
$354 |
$590 |
3.3× |
| Xr tibia/fibula 2 views (73590) |
$250.20 |
$417 |
2.8× |
| Xr tmj bilateral (70330) |
$261.60 |
$436 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$341.40 |
$569 |
3.8× |