| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,539.20 |
$8,464 |
1.8× |
| Abdomen 1 View (74018) |
$132.30 |
$441 |
1.5× |
| Abdomen 2 views (74019) |
$150 |
$500 |
1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$501.30 |
$1,671 |
1.3× |
| Angio internal mammary (75756) |
$10,161.30 |
$33,871 |
3.2× |
| Angio pulmonary bilat (75743) |
$1,330.80 |
$4,436 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$2,032.20 |
$6,774 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,935.60 |
$6,452 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,175.10 |
$3,917 |
0.4× |
| Ankle 2 views (73600) |
$134.10 |
$447 |
1.5× |
| Aortography thoracic serialography rs&i (75605) |
$3,581.40 |
$11,938 |
0.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,050 |
$3,500 |
0.3× |
| Artery X-Rays Abdomen (75726) |
$3,581.40 |
$11,938 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$3,581.40 |
$11,938 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$256.50 |
$855 |
1.9× |
| Bone age studies (77072) |
$106.50 |
$355 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$668.70 |
$2,229 |
1.7× |
| Bone Imaging Limited Area (78300) |
$445.80 |
$1,486 |
1.1× |
| Bone Imaging Whole Body (78306) |
$767.70 |
$2,559 |
1.9× |
| Bone survey infant (77076) |
$108.60 |
$362 |
1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$575.70 |
$1,919 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,721.70 |
$5,739 |
1.2× |
| Cat Scan Follow-Up Study (76380) |
$371.40 |
$1,238 |
4.3× |
| Chest 1 view (71045) |
$105.30 |
$351 |
1.2× |
| Chest 2 views (71046) |
$126 |
$420 |
1.4× |
| Chest 3 views (71047) |
$148.50 |
$495 |
1.7× |
| Chest 4 or more views (71048) |
$152.10 |
$507 |
1.5× |
| Clavicle complete (73000) |
$123 |
$410 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$213 |
$710 |
2.0× |
| Continuing medical physics consltj pr wk (77336) |
$314.40 |
$1,048 |
2.3× |
| Contrast Exam Abdominl Aorta (75625) |
$1,935.60 |
$6,452 |
0.6× |
| Contrast X-Ray Bladder (74430) |
$326.40 |
$1,088 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,770 |
$5,900 |
5.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,350 |
$4,500 |
5.6× |
| CT abdomen w contrast (74160) |
$748.80 |
$2,496 |
4.3× |
| CT abdomen w wo contrast (74170) |
$981 |
$3,270 |
5.6× |
| CT abdomen w/o contrast (74150) |
$594.90 |
$1,983 |
5.7× |
| CT Angio Abdomen and Pelvis (74174) |
$1,584.90 |
$5,283 |
4.5× |
| CT Angio Chest (71275) |
$1,164 |
$3,880 |
6.6× |
| CT Angio Head (70496) |
$946.50 |
$3,155 |
5.4× |
| CT angio hrt w/3d image (75574) |
$887.40 |
$2,958 |
2.5× |
| CT Angio Neck (70498) |
$1,187.10 |
$3,957 |
6.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$809.10 |
$2,697 |
4.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$134.40 |
$448 |
0.8× |
| CT cervical spine w/ contrast (72126) |
$707.70 |
$2,359 |
2.0× |
| CT cervical spine w/o contrast (72125) |
$765.60 |
$2,552 |
7.3× |
| CT cervical spine w/wo cont (72127) |
$1,012.50 |
$3,375 |
5.8× |
| CT chest w contrast (71260) |
$780 |
$2,600 |
4.4× |
| CT chest w/wo contrast (71270) |
$825 |
$2,750 |
4.7× |
| CT head/brain with contrast (70460) |
$773.40 |
$2,578 |
4.4× |
| CT head/brain without and with contrast (70470) |
$980.70 |
$3,269 |
5.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$177.30 |
$591 |
2.0× |
| CT iac w contrast (70481) |
$633.60 |
$2,112 |
3.6× |
| CT l-spine w&w/o contrast (72133) |
$990 |
$3,300 |
5.6× |
| CT lower ext w/o (73700) |
$553.50 |
$1,845 |
5.3× |
| CT lower extremity w/contrast material (73701) |
$652.20 |
$2,174 |
3.7× |
| CT lumbar spine w contrast (72132) |
$900 |
$3,000 |
2.6× |
| CT lumbar spine w/o contrast (72131) |
$810 |
$2,700 |
7.7× |
| CT maxillofacial w contrast (70487) |
$845.40 |
$2,818 |
4.8× |
| CT maxillofacial wo contrast (70486) |
$690.90 |
$2,303 |
6.6× |
| CT neck tissue combo (70492) |
$794.40 |
$2,648 |
4.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$806.70 |
$2,689 |
4.6× |
| CT orbits w/o contrast (70480) |
$607.50 |
$2,025 |
5.8× |
| CT pelvis w&w/o contrast (72194) |
$978.90 |
$3,263 |
5.6× |
| CT pelvis w/o contrast (72192) |
$822.30 |
$2,741 |
7.9× |
| CT scan of leg combo (73702) |
$683.40 |
$2,278 |
3.9× |
| CT scans face/jaw combo (70488) |
$1,012.20 |
$3,374 |
5.8× |
| CT soft tissue neck w contrast (70491) |
$779.70 |
$2,599 |
4.4× |
| CT soft tissue neck w/o contrast (70490) |
$599.70 |
$1,999 |
5.7× |
| CT thoracic spine w contrast (72129) |
$805.80 |
$2,686 |
4.6× |
| CT thoracic spine w/o contrast (72128) |
$728.70 |
$2,429 |
7.0× |
| CT thoracic spine w/wo cont (72130) |
$837.90 |
$2,793 |
4.8× |
| CT thorax w/o contrast (71250) |
$767.40 |
$2,558 |
7.3× |
| CT upper ext wo (73200) |
$624 |
$2,080 |
6.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$704.70 |
$2,349 |
4.0× |
| CT upper extremity with contrast (73201) |
$678 |
$2,260 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,069.50 |
$3,565 |
6.1× |
| Cta Abdomen (74175) |
$1,095 |
$3,650 |
6.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,651.20 |
$5,504 |
4.7× |
| CTA pelvis (72191) |
$689.40 |
$2,298 |
3.9× |
| Dxa Bone Density Axial (77080) |
$158.10 |
$527 |
1.5× |
| Esophageal Motility Study (78258) |
$330 |
$1,100 |
0.8× |
| Esophagram (74220) |
$241.80 |
$806 |
1.4× |
| Fetal Biophys Profile W/Nst (76818) |
$321.60 |
$1,072 |
3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$197.40 |
$658 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$230.10 |
$767 |
1.0× |
| Follow-Up Angiography (75898) |
$2,032.20 |
$6,774 |
0.6× |
| Foot 2 views (73620) |
$109.80 |
$366 |
1.3× |
| Forearm 2 views (73090) |
$127.50 |
$425 |
1.5× |
| Gastric emptying imaging study (78264) |
$597.90 |
$1,993 |
1.5× |
| Gated Heart Planar Single (78472) |
$697.20 |
$2,324 |
1.7× |
| Hand 2 views (73120) |
$96 |
$320 |
0.9× |
| Hepatobil Syst Image W/Drug (78227) |
$823.80 |
$2,746 |
1.5× |
| Hepatobiliary System Imaging (78226) |
$716.10 |
$2,387 |
1.8× |
| Ht Muscle Image Spect Sing (78451) |
$719.10 |
$2,397 |
0.6× |
| Hysterosalpingogram (74740) |
$421.50 |
$1,405 |
1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$254.40 |
$848 |
2.9× |
| Joint Survey Single View (77077) |
$126 |
$420 |
1.2× |
| K Flow/Funct Image Multiple (78709) |
$624.30 |
$2,081 |
1.1× |
| K Flow/Funct Image W/Drug (78708) |
$830.70 |
$2,769 |
1.5× |
| K Flow/Funct Image W/O Drug (78707) |
$700.50 |
$2,335 |
1.3× |
| Knee 3 Views (73562) |
$145.80 |
$486 |
1.7× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$402.30 |
$1,341 |
1.0× |
| Liver & Spleen Imaging Static Only (78215) |
$663.90 |
$2,213 |
1.7× |
| Lung perfusion differential (78597) |
$597.90 |
$1,993 |
1.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$474.30 |
$1,581 |
0.9× |
| Lymph System Imaging (78195) |
$617.70 |
$2,059 |
1.1× |
| Magnetic Image Jaw Joint (70336) |
$596.10 |
$1,987 |
2.5× |
| Mammary ductogram or galactogram multiple (77054) |
$251.10 |
$837 |
1.1× |
| Mammary ductogram or galactogram single (77053) |
$198.60 |
$662 |
0.8× |
| Meckels Divert Exam (78290) |
$480 |
$1,600 |
1.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$690 |
$2,300 |
1.8× |
| MRA head w/o contrast (70544) |
$753.30 |
$2,511 |
3.2× |
| MRA neck w contrast (70548) |
$772.50 |
$2,575 |
2.2× |
| MRA neck w/o contrast (70547) |
$926.40 |
$3,088 |
3.9× |
| MRI abdomen w/o contrast (74181) |
$930 |
$3,100 |
3.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,087.50 |
$3,625 |
1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,206 |
$4,020 |
3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,087.50 |
$3,625 |
1.4× |
| MRI brain functional w/o physician admnistration (70554) |
$946.20 |
$3,154 |
4.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$702.60 |
$2,342 |
2.9× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$856.80 |
$2,856 |
3.6× |
| MRI cervical spine w/o cont (72141) |
$884.70 |
$2,949 |
3.7× |
| MRI chest w/o contrast (71550) |
$812.40 |
$2,708 |
3.4× |
| MRI chest wo w contrast (71552) |
$1,263.90 |
$4,213 |
3.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,206 |
$4,020 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$834.30 |
$2,781 |
3.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,346.40 |
$4,488 |
3.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$888.90 |
$2,963 |
3.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,346.40 |
$4,488 |
3.9× |
| MRI pelvis w/o & w contrast (72197) |
$1,313.70 |
$4,379 |
3.8× |
| MRI pelvis w/o contrast (72195) |
$877.80 |
$2,926 |
3.7× |
| MRI thoracic spine w/o contrast (72146) |
$895.50 |
$2,985 |
3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,084.80 |
$3,616 |
4.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,206 |
$4,020 |
3.5× |
| MRI, abdomen, combo (74183) |
$1,206 |
$4,020 |
3.5× |
| MRI, dorsal spine combo (72157) |
$1,278.60 |
$4,262 |
3.7× |
| MRI, joint upper extrem (73221) |
$860.40 |
$2,868 |
3.6× |
| MRI, joint upper extrem combo (73223) |
$1,478.70 |
$4,929 |
4.2× |
| MRI, lumbar spine combo (72158) |
$1,278.60 |
$4,262 |
3.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,771.20 |
$5,904 |
1.4× |
| Neck soft tissue (70360) |
$119.40 |
$398 |
1.4× |
| Nm unlisted gi procedure (78299) |
$176.10 |
$587 |
0.4× |
| Nonvascular Shunt X-Ray (75809) |
$148.50 |
$495 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,196.80 |
$10,656 |
2.3× |
| Parathyroid Planar Imaging (78070) |
$408.90 |
$1,363 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$108.30 |
$361 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$1,926.90 |
$6,423 |
1.3× |
| PET image w/CT, full body (78816) |
$1,926.90 |
$6,423 |
1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,926.90 |
$6,423 |
1.3× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,197.80 |
$7,326 |
1.7× |
| PET whole body (78813) |
$2,197.80 |
$7,326 |
1.5× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) |
$937.50 |
$3,125 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$557.10 |
$1,857 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$250.80 |
$836 |
0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$165.60 |
$552 |
1.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$90 |
$300 |
1.0× |
| Radex elbow complete minimum 3 views (73080) |
$158.70 |
$529 |
1.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$171.90 |
$573 |
1.6× |
| Radex fingr minimum 2 views (73140) |
$117.60 |
$392 |
1.3× |
| Radex foot complete minimum 3 views (73630) |
$120 |
$400 |
1.4× |
| Radex Hand Minimum 3 Views (73130) |
$118.20 |
$394 |
1.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$60.30 |
$201 |
0.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$165.30 |
$551 |
1.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$161.70 |
$539 |
1.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$132 |
$440 |
1.5× |
| Radex shoulder complete minimum 2 views (73030) |
$158.40 |
$528 |
1.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$126 |
$420 |
1.4× |
| Radex Spine 1 View Specify Level (72020) |
$129.60 |
$432 |
1.5× |
| Radex Sternum Minimum 2 Views (71120) |
$133.20 |
$444 |
1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$148.20 |
$494 |
1.7× |
| Radex Toe Minimum 2 Views (73660) |
$105 |
$350 |
1.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$108 |
$360 |
1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$139.50 |
$465 |
1.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$243.60 |
$812 |
2.3× |
| Radiation treatment delivery level 1 (77402) |
$186 |
$620 |
1.8× |
| Radiation treatment delivery level 2 (77407) |
$310.20 |
$1,034 |
0.8× |
| Radiation treatment delivery level 3 (77412) |
$444.60 |
$1,482 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$154.20 |
$514 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$180 |
$600 |
1.7× |
| Radiologic exam colon double contrast study (74280) |
$460.50 |
$1,535 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$351.60 |
$1,172 |
2.0× |
| Radiologic exam knee complete 4/more views (73564) |
$167.70 |
$559 |
1.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$149.10 |
$497 |
1.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$310.80 |
$1,036 |
1.8× |
| Radiologic exam swallow function contrast study (74230) |
$255.60 |
$852 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$310.20 |
$1,034 |
1.8× |
| Radiologic examination femur 1 view (73551) |
$104.10 |
$347 |
1.2× |
| Radiologic examination femur minimum 2 views (73552) |
$126.60 |
$422 |
1.5× |
| Radiologic examination knee 1/2 views (73560) |
$126.90 |
$423 |
1.5× |
| Radiologic Examination Osseous Survey Limited (77074) |
$221.70 |
$739 |
2.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$150.90 |
$503 |
1.7× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$1,071 |
$3,570 |
2.7× |
| Ribs bilateral 3 views (71110) |
$156.60 |
$522 |
1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,005.30 |
$3,351 |
1.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$873.60 |
$2,912 |
1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$914.10 |
$3,047 |
1.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,131.30 |
$3,771 |
0.9× |
| Salivary Gland Function Study (78232) |
$425.40 |
$1,418 |
1.1× |
| Salivary Gland Imaging (78230) |
$320.40 |
$1,068 |
0.8× |
| Scapula (73010) |
$139.50 |
$465 |
1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$48.90 |
$163 |
2.1× |
| Sella turcica (70240) |
$89.40 |
$298 |
1.0× |
| Shoulder 1 view (73020) |
$113.40 |
$378 |
1.3× |
| Shoulder Arthrography (73040) |
$408.60 |
$1,362 |
1.2× |
| Skull less than 4 views (70250) |
$113.10 |
$377 |
1.1× |
| Special dosimetry (77331) |
$128.10 |
$427 |
1.0× |
| Special Physics Consult (77370) |
$471.90 |
$1,573 |
3.5× |
| Special teletherapy port plan (77321) |
$362.70 |
$1,209 |
1.0× |
| Special treatment procedure (77470) |
$1,082.40 |
$3,608 |
2.0× |
| Stereotactic Body Radiation Delivery (77373) |
$3,780 |
$12,600 |
2.1× |
| Sternoclavicular joints (71130) |
$85.20 |
$284 |
1.0× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$82.20 |
$274 |
0.8× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$82.20 |
$274 |
0.8× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$30 |
$100 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,102.20 |
$3,674 |
2.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$303.30 |
$1,011 |
0.8× |
| Testicular Imaging W/Flow (78761) |
$348.60 |
$1,162 |
0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,044.60 |
$3,482 |
2.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$646.20 |
$2,154 |
1.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$434.10 |
$1,447 |
3.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$247.80 |
$826 |
1.4× |
| Thoracic spine 2 views (72070) |
$150 |
$500 |
1.4× |
| Thoracic spine 3 views (72072) |
$156.60 |
$522 |
1.5× |
| Thoracolumbar 2 views (72080) |
$126 |
$420 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$340.80 |
$1,136 |
0.9× |
| Thyroid Uptake Measurement (78012) |
$282.30 |
$941 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$539.70 |
$1,799 |
1.3× |
| Tx Devices Design & Construction Complex (77334) |
$650.70 |
$2,169 |
1.7× |
| Tx devices design & construction intermediate (77333) |
$406.80 |
$1,356 |
3.0× |
| Tx devices design & construction simple (77332) |
$263.40 |
$878 |
2.0× |
| Ultrasound Breast Limited (76642) |
$172.50 |
$575 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$157.80 |
$526 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$294 |
$980 |
2.8× |
| Umbilical-artery Doppler (OB) (76820) |
$97.80 |
$326 |
0.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$179.10 |
$597 |
2.1× |
| Unlisted fluoroscopic procedure (76496) |
$62.10 |
$207 |
0.7× |
| Upper gi w/o kub (74240) |
$320.10 |
$1,067 |
1.8× |
| Urethrocystogram voiding (74455) |
$282.30 |
$941 |
1.2× |
| Urethrocystography retrograde (74450) |
$237 |
$790 |
1.0× |
| Us breast unilateral complete (76641) |
$314.40 |
$1,048 |
3.0× |
| Us chest (76604) |
$217.50 |
$725 |
2.1× |
| Us complete joint (76881) |
$191.40 |
$638 |
1.8× |
| Us exam, pelvic, limited (76857) |
$198 |
$660 |
1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$172.20 |
$574 |
1.6× |
| Us ob detailed single fetus (76811) |
$348.30 |
$1,161 |
1.5× |
| Us ob limited 1 or more fetuses (76815) |
$198 |
$660 |
1.9× |
| Us ob transvaginal (76817) |
$175.80 |
$586 |
1.7× |
| Us pelvic non ob complete (76856) |
$373.50 |
$1,245 |
3.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$306.90 |
$1,023 |
2.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$207.30 |
$691 |
2.0× |
| Us retroperitoneal complete (76770) |
$378.60 |
$1,262 |
3.6× |
| Us retroperitoneal limited (76775) |
$264.30 |
$881 |
2.5× |
| Us scrotum and contents (76870) |
$304.20 |
$1,014 |
2.9× |
| Us spinal canal and contents (76800) |
$282.90 |
$943 |
2.7× |
| Us thyroid (76536) |
$315.90 |
$1,053 |
3.0× |
| Us transrectal (76872) |
$162.30 |
$541 |
1.5× |
| Vasogram (74440) |
$187.20 |
$624 |
0.8× |
| Vein X-Ray Chest (75827) |
$693.90 |
$2,313 |
0.4× |
| Venogram Sinus/Jugular (75860) |
$2,540.40 |
$8,468 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,032.20 |
$6,774 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$1,519.80 |
$5,066 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$900 |
$3,000 |
0.6× |
| Venography Renal Bilateral (75833) |
$3,505.50 |
$11,685 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$97.20 |
$324 |
1.1× |
| Wrist 2 views (73100) |
$130.50 |
$435 |
1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$119.10 |
$397 |
1.4× |
| X-ray antegrade pyelogram tube (74425) |
$248.10 |
$827 |
0.7× |
| X-Ray Aorta Leg Arteries (75630) |
$2,468.70 |
$8,229 |
0.8× |
| X-Ray Bend Only L-S Spine (72120) |
$131.10 |
$437 |
1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$137.40 |
$458 |
1.6× |
| X-Ray Exam Breast Specimen (76098) |
$351.60 |
$1,172 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$131.10 |
$437 |
1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$183.90 |
$613 |
1.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$163.20 |
$544 |
1.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$104.10 |
$347 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$114 |
$380 |
1.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$131.10 |
$437 |
1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$132.90 |
$443 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$177.90 |
$593 |
1.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$189.60 |
$632 |
1.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$302.40 |
$1,008 |
2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$150.30 |
$501 |
1.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$240 |
$800 |
2.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$170.40 |
$568 |
1.6× |
| X-ray eye for foreign body (70030) |
$71.40 |
$238 |
0.8× |
| X-ray humerus (73060) |
$129.30 |
$431 |
1.5× |
| X-ray IV pyelogram+tomography (74415) |
$530.70 |
$1,769 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$137.70 |
$459 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$60.30 |
$201 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$176.10 |
$587 |
1.7× |
| X-ray nose-rectum child f.b. (76010) |
$132.90 |
$443 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$190.50 |
$635 |
1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$115.50 |
$385 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$146.40 |
$488 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$159.90 |
$533 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$170.40 |
$568 |
1.6× |
| X-Ray Tmj Unilat (70328) |
$70.50 |
$235 |
0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$369.30 |
$1,231 |
1.1× |
| X-Rays Bone Length Studies (77073) |
$120 |
$400 |
1.1× |
| X-Rays Bone Survey Complete (77075) |
$192.60 |
$642 |
1.8× |
| Xr c-spine 4 or 5 views (72050) |
$203.70 |
$679 |
1.9× |
| Xr facial bones less than 3 views (70140) |
$157.20 |
$524 |
1.8× |
| Xr orbits complete 4 views (70200) |
$238.20 |
$794 |
2.3× |
| Xr Tomogram Single Plane (76100) |
$328.80 |
$1,096 |
3.1× |