| Abdomen 2 views (74019) |
$367.20 |
$408 |
3.0× |
| Acute gi blood loss imaging (78278) |
$1,812.60 |
$2,014 |
3.8× |
| Angio Adrenal Bilat Select (75733) |
$3,536.10 |
$3,929 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$2,360.25 |
$2,622.50 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$2,289.15 |
$2,543.50 |
0.6× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,895.85 |
$2,106.50 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,604.40 |
$5,116 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,195.55 |
$2,439.50 |
0.6× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,961.55 |
$2,179.50 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,908.35 |
$3,231.50 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,458 |
$1,620 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,350.35 |
$2,611.50 |
0.6× |
| Ankle 2 views (73600) |
$282.15 |
$313.50 |
2.7× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,289.15 |
$2,543.50 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,289.15 |
$2,543.50 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$2,289.15 |
$2,543.50 |
0.6× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$3,702.15 |
$4,113.50 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$3,213.45 |
$3,570.50 |
0.9× |
| Arthrogram ankle (73615) |
$981.90 |
$1,091 |
2.4× |
| Arthrogram elbow (73085) |
$981.90 |
$1,091 |
2.4× |
| Arthrogram hip (73525) |
$981.90 |
$1,091 |
2.4× |
| Arthrogram knee (73580) |
$981.90 |
$1,091 |
2.4× |
| Arthrogram shoulder (73040) |
$981.90 |
$1,091 |
2.4× |
| Arthrogram wrist (73115) |
$981.90 |
$1,091 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$918 |
$1,020 |
1.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,400.40 |
$1,556 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,651.95 |
$1,835.50 |
3.5× |
| Bone age studies (77072) |
$313.65 |
$348.50 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,679.85 |
$1,866.50 |
3.6× |
| Bowel imaging (78290) |
$1,501.65 |
$1,668.50 |
3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,214.45 |
$2,460.50 |
3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,774.05 |
$5,304.50 |
2.8× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$1,476.45 |
$1,640.50 |
2.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$2,034 |
$2,260 |
4.3× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,034 |
$2,260 |
4.3× |
| Cardiac shunt detection (78428) |
$989.10 |
$1,099 |
2.1× |
| Cardiovasc nucl exam unlisted (78499) |
$1,278 |
$1,420 |
2.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$908.10 |
$1,009 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$375.75 |
$417.50 |
3.7× |
| Chest 1 view (71045) |
$315.45 |
$350.50 |
3.1× |
| Chest xray 3 views (71047) |
$476.10 |
$529 |
4.6× |
| Cholecystography, oral contrast Non-Facility (74290) |
$642.15 |
$713.50 |
3.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$913.72 |
$1,015.25 |
4.4× |
| Cineradiography/videoradiography (76120) |
$375.75 |
$417.50 |
3.0× |
| Clavicle complete (73000) |
$282.15 |
$313.50 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,214.45 |
$2,460.50 |
17.9× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$529.65 |
$588.50 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,178.60 |
$5,754 |
12.6× |
| CT abdomen and pelvis without contrast (74176) |
$4,428.90 |
$4,921 |
15.7× |
| CT abdomen w contrast (74160) |
$2,335.95 |
$2,595.50 |
11.3× |
| CT abdomen w wo contrast (74170) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT abdomen w/o contrast (74150) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT angio hrt w/3d image (75574) |
$2,087.55 |
$2,319.50 |
5.1× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT angiography upper extremity lt (73206) |
$1,332 |
$1,480 |
6.4× |
| CT c-spine w/contrast (72126) |
$2,335.95 |
$2,595.50 |
5.7× |
| CT c-spine w/o contrast (72125) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT chest w contrast (71260) |
$2,335.95 |
$2,595.50 |
11.3× |
| CT chest w/wo contrast (71270) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT colonography w/o cntrst (74261) |
$2,214 |
$2,460 |
17.9× |
| CT head/brain with contrast (70460) |
$2,002.50 |
$2,225 |
9.7× |
| CT head/brain without and with contrast (70470) |
$2,103.30 |
$2,337 |
10.2× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$506.25 |
$562.50 |
4.9× |
| CT iac w contrast (70481) |
$2,335.95 |
$2,595.50 |
11.3× |
| CT lower ext w/o (73700) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT lower extremity w wo contrast (73702) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT lower extremity w/contrast material (73701) |
$2,335.95 |
$2,595.50 |
11.3× |
| CT lumbar spine w & w/o contrast (72133) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT lumbar spine w/contrast (72132) |
$2,335.95 |
$2,595.50 |
5.7× |
| CT lumbar spine w/o contrast (72131) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT maxillofacial w contrast (70487) |
$1,946.70 |
$2,163 |
9.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,043.45 |
$2,270.50 |
9.9× |
| CT maxillofacial wo contrast (70486) |
$1,878.30 |
$2,087 |
15.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT orbits w/o contrast (70480) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT pelvis w/o contrast (72192) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT pelvis w/wo contrast (72194) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT scan of arm combo (73202) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT soft tissue neck w contrast (70491) |
$2,335.95 |
$2,595.50 |
11.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT thoracic spine w/contrast (72129) |
$2,335.95 |
$2,595.50 |
11.3× |
| CT thoracic spine w/o contrast (72128) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT thoracic spine w/wo contrast (72130) |
$2,590.65 |
$2,878.50 |
12.5× |
| CT thorax w/o contrast (71250) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT upper ext wo (73200) |
$2,214.45 |
$2,460.50 |
17.9× |
| CT upper extremity with contrast (73201) |
$2,335.95 |
$2,595.50 |
5.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$5,178.60 |
$5,754 |
25.0× |
| Cta Abdomen (74175) |
$2,590.65 |
$2,878.50 |
12.5× |
| CTA abdomen pelvis (74174) |
$5,178.60 |
$5,754 |
12.6× |
| CTA chest (71275) |
$2,590.65 |
$2,878.50 |
12.5× |
| Cta Head (70496) |
$2,590.65 |
$2,878.50 |
12.5× |
| Cta Neck (70498) |
$2,590.65 |
$2,878.50 |
12.5× |
| Cta Pelvis (72191) |
$2,590.65 |
$2,878.50 |
12.5× |
| Cystography minimum 3 views rs&i (74430) |
$529.65 |
$588.50 |
1.3× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$482.40 |
$536 |
1.7× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$2,509.20 |
$2,788 |
1.0× |
| Diskogram cervical (72285) |
$3,117.60 |
$3,464 |
1.4× |
| Diskography lumbar (72295) |
$3,117.60 |
$3,464 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$388.12 |
$431.25 |
3.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$370.80 |
$412 |
3.6× |
| Esophageal motility (78258) |
$1,030.95 |
$1,145.50 |
2.2× |
| Esophagus (74220) |
$529.65 |
$588.50 |
2.6× |
| Facial bones min 3 views (70150) |
$607.95 |
$675.50 |
4.9× |
| Fluoroscopy up to 1 hr (76000) |
$1,120.28 |
$1,244.75 |
4.0× |
| Foot 2 views (73620) |
$282.15 |
$313.50 |
2.7× |
| Forearm 2 views (73090) |
$282.15 |
$313.50 |
2.7× |
| Hand 2 views (73120) |
$282.15 |
$313.50 |
2.3× |
| Heart first pass single,planar (78481) |
$922.95 |
$1,025.50 |
1.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,402.90 |
$3,781 |
0.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,350.35 |
$2,611.50 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,966.05 |
$2,184.50 |
3.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,764.45 |
$1,960.50 |
3.7× |
| Hysterosalpingogram (74740) |
$1,655.10 |
$1,839 |
5.9× |
| Kidney imaging morphology (78700) |
$1,054.80 |
$1,172 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,090.48 |
$2,322.75 |
3.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,695.95 |
$2,995.50 |
4.2× |
| Knee 3 views (73562) |
$328.95 |
$365.50 |
3.2× |
| Liver & spleen imaging static only (78215) |
$1,568.25 |
$1,742.50 |
3.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,581.75 |
$1,757.50 |
3.3× |
| Liver imaging static only (78201) |
$1,125 |
$1,250 |
1.8× |
| Liver imaging w/vascular flow (78202) |
$1,287.45 |
$1,430.50 |
2.0× |
| Lung perfusion differential (78597) |
$1,348.20 |
$1,498 |
2.9× |
| Lung ventilation imaging (78579) |
$1,751.40 |
$1,946 |
3.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,138.05 |
$1,264.50 |
0.3× |
| Lymphoscintigraphy (78195) |
$801.90 |
$891 |
1.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,032.20 |
$2,258 |
2.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,032.20 |
$2,258 |
4.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,570.30 |
$3,967 |
8.7× |
| Mammary ductogram or galactogram multiple (77054) |
$684.45 |
$760.50 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$492.30 |
$547 |
1.7× |
| MRA head w & w/o contrast (70546) |
$3,721.95 |
$4,135.50 |
9.0× |
| MRA head w/o contrast (70544) |
$2,186.10 |
$2,429 |
7.8× |
| MRA head with contrast (70545) |
$2,186.10 |
$2,429 |
5.3× |
| MRA neck w contrast (70548) |
$2,186.10 |
$2,429 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,721.95 |
$4,135.50 |
9.0× |
| MRA neck w/o contrast (70547) |
$2,186.10 |
$2,429 |
7.8× |
| MRI abdomen w contrast (74182) |
$2,032.20 |
$2,258 |
4.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,570.30 |
$3,967 |
8.7× |
| MRI abdomen w/o contrast (74181) |
$2,032.20 |
$2,258 |
7.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,032.20 |
$2,258 |
2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,570.30 |
$3,967 |
8.7× |
| MRI bone marrow blood supply (77084) |
$2,032.20 |
$2,258 |
7.2× |
| MRI c-spine with contrast (72142) |
$2,032.20 |
$2,258 |
4.9× |
| MRI cervical spine w/o contrast (72141) |
$2,032.20 |
$2,258 |
7.2× |
| MRI chest w/o & w/contrast material (71552) |
$3,570.30 |
$3,967 |
8.7× |
| MRI chest w/o contrast (71550) |
$2,032.20 |
$2,258 |
7.2× |
| MRI chest with contrast (71551) |
$2,032.20 |
$2,258 |
2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,032.20 |
$2,258 |
4.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,570.30 |
$3,967 |
8.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,032.20 |
$2,258 |
7.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,032.20 |
$2,258 |
7.2× |
| MRI orbit face neck w contrast (70542) |
$2,032.20 |
$2,258 |
4.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,570.30 |
$3,967 |
8.7× |
| MRI pelvis w/contrast (72196) |
$2,032.20 |
$2,258 |
4.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,570.30 |
$3,967 |
8.7× |
| MRI pelvis w/o contrast (72195) |
$2,032.20 |
$2,258 |
7.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,570.30 |
$3,967 |
8.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,032.20 |
$2,258 |
4.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,570.30 |
$3,967 |
8.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,032.20 |
$2,258 |
4.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,570.30 |
$3,967 |
8.7× |
| MRI temporomandibular joint (70336) |
$2,032.20 |
$2,258 |
7.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,032.20 |
$2,258 |
7.2× |
| MRI up ext w/o contrast (73218) |
$2,032.20 |
$2,258 |
7.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,032.20 |
$2,258 |
7.2× |
| MRI, joint upper extrem combo (73223) |
$3,570.30 |
$3,967 |
8.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,774.05 |
$5,304.50 |
3.1× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$4,774.05 |
$5,304.50 |
2.8× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$4,774.05 |
$5,304.50 |
2.8× |
| Myocardial infarct spect (78469) |
$1,448.10 |
$1,609 |
2.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,930.50 |
$2,145 |
1.3× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$2,295.45 |
$2,550.50 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,044.25 |
$3,382.50 |
2.0× |
| Myocardial spect single study at rest or stress (78451) |
$2,299.50 |
$2,555 |
1.5× |
| Neck soft tissue (70360) |
$313.65 |
$348.50 |
3.1× |
| Nm bone marrow wb (78104) |
$1,879.65 |
$2,088.50 |
4.0× |
| Nm cardiac blood pool multiple (78473) |
$2,269.80 |
$2,522 |
4.8× |
| Nm cisternogram (78630) |
$1,948.50 |
$2,165 |
3.0× |
| Nm csf leak detection (78650) |
$1,190.25 |
$1,322.50 |
0.8× |
| Nm gastric emptying study (78264) |
$1,744.20 |
$1,938 |
3.7× |
| Nm gastroesophageal reflux study (78262) |
$1,186.65 |
$1,318.50 |
2.5× |
| Nm kidney scan w/flow (78701) |
$1,356.30 |
$1,507 |
2.9× |
| Nm peritoneal-venous shunt patency (78291) |
$925.20 |
$1,028 |
2.0× |
| Nm red cell sequestration (78140) |
$2,488.95 |
$2,765.50 |
5.3× |
| Noncardiac Vascular Flow Imaging (78445) |
$894.15 |
$993.50 |
1.9× |
| Nonvascular shunt X-ray (75809) |
$519.30 |
$577 |
4.2× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,494.45 |
$1,660.50 |
3.2× |
| Nuclear Rx Oral Admin (79005) |
$2,320.20 |
$2,578 |
8.4× |
| Osseous survey limited (77074) |
$1,127.70 |
$1,253 |
9.1× |
| Parathyroid Planar Imaging (78070) |
$1,226.70 |
$1,363 |
2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,372.50 |
$1,525 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$282.15 |
$313.50 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$4,932 |
$5,480 |
2.9× |
| PET imaging CT for attenuation limited area (78814) |
$4,932 |
$5,480 |
2.9× |
| PET imaging for CT attenuation whole body (78816) |
$4,932 |
$5,480 |
2.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$4,774.05 |
$5,304.50 |
3.1× |
| PET whole body (78813) |
$4,774.05 |
$5,304.50 |
2.8× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$4,774.05 |
$5,304.50 |
2.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,350.35 |
$2,611.50 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,350.35 |
$2,611.50 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,348.20 |
$1,498 |
2.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,338.20 |
$2,598 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$642.15 |
$713.50 |
1.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$375.75 |
$417.50 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$282.15 |
$313.50 |
2.7× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$375.75 |
$417.50 |
3.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$282.15 |
$313.50 |
2.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$906.75 |
$1,007.50 |
7.3× |
| Radex fingr minimum 2 views (73140) |
$282.15 |
$313.50 |
2.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$375.75 |
$417.50 |
3.7× |
| Radex Hand Minimum 3 Views (73130) |
$375.75 |
$417.50 |
3.7× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$282.15 |
$313.50 |
2.7× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$564.75 |
$627.50 |
4.6× |
| Radex Humerus Minimum 2 Views (73060) |
$313.65 |
$348.50 |
3.1× |
| Radex Kne 1/2 Views (73560) |
$282.15 |
$313.50 |
2.7× |
| Radex Kne Compl 4/More Views (73564) |
$375.75 |
$417.50 |
3.0× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$607.95 |
$675.50 |
4.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$375.75 |
$417.50 |
3.7× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$797.85 |
$886.50 |
6.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$375.75 |
$417.50 |
3.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$313.65 |
$348.50 |
3.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$529.65 |
$588.50 |
4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$482.40 |
$536 |
4.7× |
| Radex Toe Minimum 2 Views (73660) |
$282.15 |
$313.50 |
2.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$375.75 |
$417.50 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$315.45 |
$350.50 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$476.10 |
$529 |
3.9× |
| Radiologic exam chest 2 views (71046) |
$375.75 |
$417.50 |
3.7× |
| Radiologic exam colon single contrast study (74270) |
$925.20 |
$1,028 |
4.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$689.85 |
$766.50 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$680.85 |
$756.50 |
3.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$375.75 |
$417.50 |
3.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$326.25 |
$362.50 |
3.2× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$809.55 |
$899.50 |
1.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$607.95 |
$675.50 |
4.9× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$460.80 |
$512 |
3.7× |
| Radiological examination surgical specimen (76098) |
$219.60 |
$244 |
0.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,660.95 |
$1,845.50 |
6.0× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion Non-Facility (79403) |
$2,398.95 |
$2,665.50 |
8.7× |
| Renal Cyst Study (74470) |
$1,898.55 |
$2,109.50 |
2.9× |
| Ribs bilateral 3 views (71110) |
$593.55 |
$659.50 |
4.8× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,879.20 |
$2,088 |
4.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,017.80 |
$2,242 |
4.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,868.65 |
$4,298.50 |
6.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,720.70 |
$3,023 |
4.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,723.50 |
$1,915 |
2.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,798.20 |
$1,998 |
1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,240.10 |
$2,489 |
1.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,658.70 |
$1,843 |
1.1× |
| Rp Therapy Intravenous Administration (79101) |
$779.85 |
$866.50 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$282.15 |
$313.50 |
2.3× |
| Scapula (73010) |
$375.75 |
$417.50 |
3.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$48.15 |
$53.50 |
2.1× |
| Sella turcica (70240) |
$313.65 |
$348.50 |
3.1× |
| Shoulder 1 view (73020) |
$282.15 |
$313.50 |
2.7× |
| Sialogram (70390) |
$529.65 |
$588.50 |
1.9× |
| Small bowel series (74250) |
$766.35 |
$851.50 |
3.7× |
| Spine thoracic 3 views (72072) |
$565.20 |
$628 |
4.6× |
| Spleen imaging only (78185) |
$1,204.88 |
$1,338.75 |
2.6× |
| Splenoportograpy rs&i (75810) |
$2,350.35 |
$2,611.50 |
0.6× |
| Superior sagittal sinus venogram (75870) |
$2,350.35 |
$2,611.50 |
0.6× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$394.20 |
$438 |
1.4× |
| Testicular Imaging With Vascular Flow (78761) |
$959.85 |
$1,066.50 |
2.0× |
| Thoracolumbar 2 views (72080) |
$375.75 |
$417.50 |
3.7× |
| Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) |
$1,190.70 |
$1,323 |
2.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,561.50 |
$1,735 |
2.4× |
| Thyroid imaging w/blood flow (78013) |
$1,434.15 |
$1,593.50 |
3.0× |
| Thyroid uptake measurement (78012) |
$764.55 |
$849.50 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,579.50 |
$1,755 |
3.3× |
| Tmj unilateral (70328) |
$375.75 |
$417.50 |
3.7× |
| Ultrasound breast complete (76641) |
$341.10 |
$379 |
2.8× |
| Ultrasound elastography first target lesion (76982) |
$253.35 |
$281.50 |
2.1× |
| Ultrasound Exam Aaa Screen (76706) |
$642.15 |
$713.50 |
5.2× |
| Ultrasound, abdomen limited (76705) |
$642.15 |
$713.50 |
5.2× |
| Unlisted gastrointestinal px dx nuclear medicine (78299) |
$476.55 |
$529.50 |
1.0× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$544.05 |
$604.50 |
1.2× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$83.70 |
$93 |
7.6× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$445.05 |
$494.50 |
4.7× |
| Ureteral reflux study (78740) |
$904.95 |
$1,005.50 |
1.9× |
| Urethrocystogram voiding (74455) |
$737.55 |
$819.50 |
2.6× |
| Urethrocystography retrograde rs&i (74450) |
$529.65 |
$588.50 |
1.9× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$1,203.75 |
$1,337.50 |
5.8× |
| Us breast unilateral limited (76642) |
$341.10 |
$379 |
3.3× |
| Us chest (76604) |
$642.15 |
$713.50 |
5.2× |
| Us compl joint r-t w/image documentation (76881) |
$642.15 |
$713.50 |
5.2× |
| Us elastography parenchyma (76981) |
$253.35 |
$281.50 |
2.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$642.15 |
$713.50 |
5.2× |
| Us pelvic non ob complete (76856) |
$692.10 |
$769 |
5.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$642.15 |
$713.50 |
5.2× |
| Us retroperitoneal complete (76770) |
$692.10 |
$769 |
5.6× |
| Us retroperitoneal limited (76775) |
$642.15 |
$713.50 |
5.2× |
| Us scrotum and contents (76870) |
$692.10 |
$769 |
5.6× |
| Us soft tissue head/neck (76536) |
$692.10 |
$769 |
5.6× |
| Us transrectal (76872) |
$641.70 |
$713 |
5.2× |
| Us,transplanted kidney, real time/ doppler (76776) |
$692.10 |
$769 |
5.6× |
| Venogram adrenal unilat (75840) |
$4,236.30 |
$4,707 |
1.1× |
| Venogram extremity bilateral (75822) |
$1,845 |
$2,050 |
1.0× |
| Venogram Extremity Unilateral (75820) |
$1,186.65 |
$1,318.50 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$3,413.70 |
$3,793 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$2,350.35 |
$2,611.50 |
1.3× |
| Venography Orbital Rs&I (75880) |
$854.10 |
$949 |
1.2× |
| Venography Renal Bilateral (75833) |
$3,536.10 |
$3,929 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$3,213.45 |
$3,570.50 |
0.9× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,879.55 |
$3,199.50 |
0.8× |
| Venography, epidural, radiological supervision and interpretation Non-Facility (75872) |
$2,350.35 |
$2,611.50 |
3.2× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,350.35 |
$2,611.50 |
0.4× |
| Venous thrombosis imaging, venogram; unilateral Non-Facility (78457) |
$799.20 |
$888 |
1.2× |
| Wrist 2 views (73100) |
$282.15 |
$313.50 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$336.15 |
$373.50 |
2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$375.75 |
$417.50 |
3.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,168.65 |
$1,298.50 |
5.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$282.15 |
$313.50 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$460.80 |
$512 |
4.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$921.82 |
$1,024.25 |
7.5× |
| X-ray exam of femur 2/> (73552) |
$375.75 |
$417.50 |
3.7× |
| X-ray eye for foreign body (70030) |
$323.55 |
$359.50 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$375.75 |
$417.50 |
3.7× |
| X-ray IV pyelogram (ivp) (74400) |
$692.10 |
$769 |
3.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$375.75 |
$417.50 |
3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$476.10 |
$529 |
3.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$834.30 |
$927 |
6.8× |
| X-ray optic foramen (70190) |
$375.75 |
$417.50 |
3.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$607.95 |
$675.50 |
4.9× |
| X-ray retrograde pyelogram (74420) |
$879.08 |
$976.75 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$395.55 |
$439.50 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$607.95 |
$675.50 |
4.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$931.50 |
$1,035 |
7.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$642.15 |
$713.50 |
5.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$375.75 |
$417.50 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$529.65 |
$588.50 |
5.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$607.95 |
$675.50 |
4.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$375.75 |
$417.50 |
3.0× |
| X-Ray Small Bowel Enteroclysis (74251) |
$870.30 |
$967 |
4.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$282.15 |
$313.50 |
2.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$642.15 |
$713.50 |
6.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$375.75 |
$417.50 |
3.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$375.75 |
$417.50 |
3.0× |
| Xr bone length studies (77073) |
$642.15 |
$713.50 |
5.2× |
| Xr c-spine 4 or 5 views (72050) |
$643.50 |
$715 |
5.2× |
| Xr c-spine 6 or more views (72052) |
$766.35 |
$851.50 |
6.2× |
| Xr chest 4+ views (71048) |
$578.70 |
$643 |
4.7× |
| Xr myelogram posterior fossa (70010) |
$1,816.65 |
$2,018.50 |
4.4× |
| Xr urogram antegrade (74425) |
$1,655.10 |
$1,839 |
4.0× |