| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,441.09 |
$4,068.48 |
1.9× |
| Abdomen 2 views (74019) |
$195.10 |
$325.16 |
2.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$465.82 |
$776.36 |
1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,476.46 |
$2,460.76 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,429.04 |
$4,048.40 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,768.98 |
$2,948.30 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$1,179.68 |
$1,966.13 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,429.04 |
$4,048.40 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,429.04 |
$4,048.40 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,108.92 |
$1,848.20 |
0.4× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$997.82 |
$1,663.04 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,429.04 |
$4,048.40 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$376.14 |
$626.90 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,108.92 |
$1,848.20 |
0.4× |
| Ankle 2 views (73600) |
$75.61 |
$126.02 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$281.83 |
$469.71 |
0.9× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,429.04 |
$4,048.40 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,429.04 |
$4,048.40 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,429.04 |
$4,048.40 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,429.04 |
$4,048.40 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$1,845.57 |
$3,075.95 |
0.6× |
| Arthrogram elbow (73085) |
$320.70 |
$534.50 |
1.0× |
| Arthrogram hip (73525) |
$320.70 |
$534.50 |
1.0× |
| Arthrogram shoulder (73040) |
$305.44 |
$509.06 |
1.0× |
| Arthrogram wrist (73115) |
$320.70 |
$534.50 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$236.08 |
$393.47 |
1.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$452.06 |
$753.43 |
1.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$390.32 |
$650.54 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$684.72 |
$1,141.20 |
1.9× |
| Bone age studies (77072) |
$80.30 |
$133.83 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$640.70 |
$1,067.84 |
1.8× |
| Bone Marrow Imaging Limited Area (78102) |
$498.92 |
$831.53 |
1.4× |
| Bone survey complete (77075) |
$222.63 |
$371.05 |
2.4× |
| Brain image w/flow 4 + views (78606) |
$503.81 |
$839.68 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,745.98 |
$2,909.96 |
1.3× |
| Brain Imaging Vascular Flow Only (78610) |
$503.81 |
$839.68 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$631.92 |
$1,053.20 |
2.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$402.52 |
$670.87 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$84.40 |
$140.66 |
1.1× |
| Chest 1 view (71045) |
$86.05 |
$143.42 |
1.1× |
| Chest 3 views (71047) |
$86.05 |
$143.42 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$225.79 |
$376.31 |
1.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$317.89 |
$529.81 |
0.4× |
| Clavicle complete (73000) |
$86.05 |
$143.42 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$166.73 |
$277.89 |
1.8× |
| Continuing medical physics consltj pr wk (77336) |
$295.30 |
$492.16 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,445.62 |
$2,409.38 |
4.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,149.84 |
$1,916.38 |
5.3× |
| CT abdomen w contrast (74160) |
$832.12 |
$1,386.87 |
5.2× |
| CT abdomen w wo contrast (74170) |
$1,046.08 |
$1,743.46 |
6.6× |
| CT abdomen w/o contrast (74150) |
$810.80 |
$1,351.33 |
8.6× |
| CT angio hrt w/3d image (75574) |
$279.12 |
$465.20 |
0.9× |
| CT angiography upper extremity lt (73206) |
$1,120.36 |
$1,867.26 |
7.1× |
| CT c-spine w/o contrast (72125) |
$889.80 |
$1,483 |
9.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,169.97 |
$1,949.96 |
7.4× |
| CT cervical spine with contrast (72126) |
$1,009.36 |
$1,682.27 |
3.2× |
| CT chest w/wo contrast (71270) |
$1,064.23 |
$1,773.72 |
6.7× |
| CT chest with contrast (71260) |
$922.58 |
$1,537.63 |
5.8× |
| CT head/brain with contrast (70460) |
$687.64 |
$1,146.07 |
4.3× |
| CT head/brain without and with contrast (70470) |
$989.56 |
$1,649.27 |
6.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$126.40 |
$210.66 |
1.6× |
| CT iac w contrast (70481) |
$865.66 |
$1,442.78 |
5.5× |
| CT limited/localized follow up study (76380) |
$398.17 |
$663.62 |
5.1× |
| CT lower ext w/o (73700) |
$757.12 |
$1,261.86 |
8.0× |
| CT lower extremity w wo contrast (73702) |
$805.27 |
$1,342.12 |
5.1× |
| CT lower extremity with contrast (73701) |
$892.72 |
$1,487.86 |
5.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,264.76 |
$2,107.93 |
8.0× |
| CT lumbar spine w/o contrast (72131) |
$1,074.73 |
$1,791.22 |
11.4× |
| CT lumbar spine with contrast (72132) |
$1,009.36 |
$1,682.27 |
3.2× |
| CT maxillofacial w contrast (70487) |
$508.68 |
$847.80 |
3.2× |
| CT maxillofacial w/o contrast (70486) |
$595.27 |
$992.12 |
6.3× |
| CT maxillofacial w/wo contrast (70488) |
$873.17 |
$1,455.28 |
5.5× |
| CT neck soft tissue w contrast (70491) |
$802.32 |
$1,337.20 |
5.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$951.14 |
$1,585.23 |
6.0× |
| CT orbits w/o contrast (70480) |
$706.94 |
$1,178.24 |
7.5× |
| CT pelvis w & w/o contrast (72194) |
$1,025.96 |
$1,709.93 |
6.5× |
| CT pelvis w/o contrast (72192) |
$667.44 |
$1,112.41 |
7.1× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$139.87 |
$233.12 |
1.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$953.70 |
$1,589.50 |
6.0× |
| CT soft tissue neck w/o contrast (70490) |
$757.12 |
$1,261.86 |
8.0× |
| CT thoracic spine w/contrast (72129) |
$841.59 |
$1,402.65 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$967.10 |
$1,611.84 |
10.2× |
| CT thoracic spine w/wo contrast (72130) |
$525.70 |
$876.17 |
3.3× |
| CT thorax w/o contrast (71250) |
$794.44 |
$1,324.07 |
8.4× |
| CT unlisted procedure (76497) |
$185.42 |
$309.03 |
2.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,195.16 |
$1,991.93 |
7.5× |
| CT upper extremity w/o contrast rt (73200) |
$672.09 |
$1,120.16 |
7.1× |
| CT upper extremity with contrast (73201) |
$837.73 |
$1,396.22 |
2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,277.60 |
$2,129.33 |
8.0× |
| Cta Abdomen (74175) |
$1,181.26 |
$1,968.76 |
7.4× |
| CTA abdomen pelvis (74174) |
$451.52 |
$752.54 |
1.4× |
| CTA chest (71275) |
$1,171.76 |
$1,952.94 |
7.4× |
| Cta Head (70496) |
$1,122.94 |
$1,871.56 |
7.1× |
| CTA lwr ext w&w/o contrast (73706) |
$967.13 |
$1,611.88 |
6.1× |
| Cta Neck (70498) |
$1,099.51 |
$1,832.52 |
6.9× |
| Cta Pelvis (72191) |
$805.75 |
$1,342.91 |
5.1× |
| Cystography minimum 3 views rs&i (74430) |
$287.46 |
$479.10 |
0.9× |
| Dacryocystography (70170) |
$305.92 |
$509.86 |
1.4× |
| Diskogram cervical (72285) |
$1,100.38 |
$1,833.96 |
0.6× |
| Diskography lumbar (72295) |
$1,100.38 |
$1,833.96 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$161.70 |
$269.50 |
1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$80.18 |
$133.64 |
1.0× |
| Echo exam of fetal heart (76825) |
$186.32 |
$310.53 |
0.4× |
| Echoencephalography real time imaging (76506) |
$150.20 |
$250.34 |
1.6× |
| Esophageal motility (78258) |
$368.44 |
$614.07 |
1.0× |
| Esophagus (74220) |
$200.52 |
$334.20 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$253.93 |
$423.22 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$156.59 |
$260.99 |
0.7× |
| Foot 2 views (73620) |
$75.61 |
$126.02 |
1.0× |
| Forearm 2 views (73090) |
$86.05 |
$143.42 |
1.1× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$76.41 |
$127.35 |
0.4× |
| Gastric mucosa imaging (78261) |
$368.44 |
$614.07 |
1.0× |
| Gated Heart Planar Single (78472) |
$930.68 |
$1,551.13 |
2.6× |
| Hand 2 views (73120) |
$74.16 |
$123.60 |
0.8× |
| Hand 3 views (73130) |
$86.05 |
$143.42 |
1.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$997.82 |
$1,663.04 |
0.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$661.95 |
$1,103.25 |
1.8× |
| Ht muscle image spect sing (78451) |
$683.21 |
$1,138.68 |
0.6× |
| Humerus Min 2 Views Left (73060) |
$86.05 |
$143.42 |
1.1× |
| Hysterosalpingogram (74740) |
$345.13 |
$575.22 |
1.6× |
| Interstitial radiation source applic complex (77778) |
$1,669.31 |
$2,782.18 |
2.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$4,292.12 |
$7,153.53 |
6.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$4,292.12 |
$7,153.53 |
8.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$88.56 |
$147.60 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$697.15 |
$1,161.92 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$471.03 |
$785.05 |
1.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$484.33 |
$807.21 |
1.0× |
| Knee 3 views (73562) |
$110.50 |
$184.18 |
1.4× |
| Liver & spleen imaging static only (78215) |
$579.81 |
$966.35 |
1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$737.87 |
$1,229.78 |
2.0× |
| Liver imaging static only (78201) |
$407.38 |
$678.96 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$407.38 |
$678.96 |
0.8× |
| Lung Ventilation Imaging (78579) |
$367.42 |
$612.36 |
1.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$369.79 |
$616.32 |
0.1× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$324.53 |
$540.88 |
0.6× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$324.53 |
$540.88 |
0.2× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$369.79 |
$616.32 |
0.1× |
| Lymphoscintigraphy (78195) |
$487.35 |
$812.25 |
1.0× |
| Mammary ductogram or galactogram multiple (77054) |
$197.81 |
$329.68 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$197.81 |
$329.68 |
0.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$80.30 |
$133.83 |
1.0× |
| Meckels Diverticulum (78290) |
$368.44 |
$614.07 |
1.0× |
| MRA head w & w/o contrast (70546) |
$1,079.47 |
$1,799.12 |
3.4× |
| MRA head w/o contrast (70544) |
$385.06 |
$641.78 |
1.8× |
| MRA head with contrast (70545) |
$488.12 |
$813.54 |
1.5× |
| MRA neck w contrast (70548) |
$734.83 |
$1,224.71 |
2.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,266.97 |
$2,111.62 |
4.0× |
| MRA neck w/o contrast (70547) |
$377.51 |
$629.19 |
1.7× |
| MRI abdomen w contrast (74182) |
$741.26 |
$1,235.43 |
2.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$727 |
$1,211.67 |
2.3× |
| MRI abdomen w/o contrast (74181) |
$392.62 |
$654.36 |
1.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,141.66 |
$1,902.76 |
1.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,097.75 |
$1,829.58 |
1.5× |
| MRI c-spine with contrast (72142) |
$741.26 |
$1,235.43 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$587.99 |
$979.99 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$385.06 |
$641.78 |
1.8× |
| MRI chest w/o & w/contrast material (71552) |
$858.05 |
$1,430.09 |
2.7× |
| MRI chest w/o contrast (71550) |
$604.25 |
$1,007.09 |
2.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$712.75 |
$1,187.91 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$442.87 |
$738.12 |
1.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$392.62 |
$654.36 |
1.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$392.62 |
$654.36 |
1.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$741.26 |
$1,235.43 |
2.3× |
| MRI orbit/face/neck w/contrast (70542) |
$712.75 |
$1,187.91 |
2.3× |
| MRI pelvis w contrast (72196) |
$741.26 |
$1,235.43 |
2.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$727 |
$1,211.67 |
2.3× |
| MRI pelvis w/o contrast (72195) |
$392.62 |
$654.36 |
1.8× |
| MRI scan of arm joint before and after contrast (73223) |
$741.26 |
$1,235.43 |
2.3× |
| MRI scan of leg joint before and after contrast (73723) |
$741.26 |
$1,235.43 |
2.3× |
| MRI spectroscopy (76390) |
$797.14 |
$1,328.56 |
10.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$727 |
$1,211.67 |
2.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$741.26 |
$1,235.43 |
2.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$727 |
$1,211.67 |
2.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$741.26 |
$1,235.43 |
2.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$727 |
$1,211.67 |
2.3× |
| MRI thoracic spine w/o contrast (72146) |
$385.06 |
$641.78 |
1.8× |
| MRI tmj (70336) |
$377.51 |
$629.19 |
1.7× |
| MRI upper ext joint w/o contrast (73221) |
$392.62 |
$654.36 |
1.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$741.26 |
$1,235.43 |
2.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$392.62 |
$654.36 |
1.8× |
| Myelogram Cervical (72240) |
$297.98 |
$496.64 |
0.4× |
| Myelogram thoracic (72255) |
$2,429.04 |
$4,048.40 |
3.4× |
| Myelography 2 or more regions (72270) |
$305.17 |
$508.61 |
0.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,085.54 |
$1,809.24 |
0.9× |
| Neck soft tissue (70360) |
$84.40 |
$140.66 |
1.1× |
| Nm cisternogram (78630) |
$538.97 |
$898.29 |
1.1× |
| Nm csf leak detection (78650) |
$402.52 |
$670.87 |
0.3× |
| Nm gastric emptying study (78264) |
$611.85 |
$1,019.75 |
1.7× |
| Nm red cell sequestration (78140) |
$434.01 |
$723.35 |
1.2× |
| Nuclear medicine of heart pumping function (78473) |
$744.70 |
$1,241.16 |
2.1× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,466.96 |
$4,111.60 |
1.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$623.99 |
$1,039.99 |
1.7× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$361.28 |
$602.13 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$341.84 |
$569.74 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$121.81 |
$203.01 |
1.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$182.06 |
$303.43 |
1.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$182.06 |
$303.43 |
1.9× |
| Orthopantogram (70355) |
$72.70 |
$121.17 |
0.9× |
| Osseous survey infant (77076) |
$125.24 |
$208.74 |
1.3× |
| Osseous survey limited (77074) |
$208.42 |
$347.37 |
2.2× |
| Parathyroid imaging (78070) |
$387.14 |
$645.23 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$84.40 |
$140.66 |
0.9× |
| Peritoneogram rs&i (74190) |
$369.79 |
$616.32 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$2,519.53 |
$4,199.21 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$3,427.44 |
$5,712.40 |
2.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$741.26 |
$1,235.43 |
2.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,429.04 |
$4,048.40 |
0.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,476.46 |
$2,460.76 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$651.37 |
$1,085.62 |
1.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$662.71 |
$1,104.52 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$403.72 |
$672.87 |
0.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$173.40 |
$289 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$190.21 |
$317.01 |
2.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$72.70 |
$121.17 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$86.05 |
$143.42 |
0.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$84.40 |
$140.66 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$84.40 |
$140.66 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$195.79 |
$326.32 |
1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$289.94 |
$483.24 |
1.8× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$76.41 |
$127.35 |
0.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$213.95 |
$356.58 |
1.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$224.55 |
$374.25 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$107.77 |
$179.62 |
1.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$72.70 |
$121.17 |
0.9× |
| Radiological examination surgical specimen (76098) |
$84.40 |
$140.66 |
0.2× |
| Review by radiologist of adrenal gland vein image (75840) |
$756.29 |
$1,260.49 |
0.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,429.04 |
$4,048.40 |
0.8× |
| Ribs bilateral 3 views (71110) |
$86.05 |
$143.42 |
0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$409.62 |
$682.70 |
1.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$913.79 |
$1,522.99 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$555.67 |
$926.12 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$75.61 |
$126.02 |
0.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$287.05 |
$478.41 |
1.3× |
| Scanogram (77073) |
$82.74 |
$137.90 |
0.9× |
| Scapula complete (73010) |
$86.05 |
$143.42 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$41.48 |
$69.14 |
1.8× |
| Sella turcica (70240) |
$72.70 |
$121.17 |
0.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$313.82 |
$523.04 |
3.3× |
| Sialogram (70390) |
$282.25 |
$470.42 |
1.3× |
| Simulation intermediate (77285) |
$768.81 |
$1,281.35 |
2.3× |
| Small bowel series (74250) |
$234.47 |
$390.79 |
1.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$607.37 |
$1,012.29 |
1.8× |
| Special dosimetry (77331) |
$250.51 |
$417.51 |
2.1× |
| Special treatment procedure (77470) |
$1,091.17 |
$1,818.61 |
2.2× |
| Speech evaluation complex (70371) |
$132.02 |
$220.03 |
0.6× |
| Spine thoracic 3 views (72072) |
$74.16 |
$123.60 |
0.8× |
| Splenoportograpy rs&i (75810) |
$1,108.92 |
$1,848.20 |
0.4× |
| Superior sagittal sinus venogram (75870) |
$756.29 |
$1,260.49 |
0.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$305.44 |
$509.06 |
1.4× |
| Testicular Imaging With Vascular Flow (78761) |
$639.56 |
$1,065.94 |
1.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$740.49 |
$1,234.15 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$375.89 |
$626.48 |
3.1× |
| Therapeutic Enema (74283) |
$151.45 |
$252.41 |
1.0× |
| Thoracolumbar 2 views (72080) |
$75.61 |
$126.02 |
1.0× |
| Thyroid carcinoma metastases img addl study (78016) |
$409.62 |
$682.70 |
1.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$471.40 |
$785.67 |
1.0× |
| Tmj unilateral (70328) |
$86.05 |
$143.42 |
1.1× |
| Tomogram (76100) |
$200.79 |
$334.65 |
2.1× |
| Treatment devices simple (77332) |
$386.78 |
$644.63 |
3.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,116.55 |
$1,860.91 |
2.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$409.62 |
$682.70 |
1.1× |
| Tx devices design & construction complex (77334) |
$519.23 |
$865.39 |
1.5× |
| Ultrasound scan of cornea to determine thickness (76514) |
$71.20 |
$118.66 |
2.7× |
| Ultrasound scan to determine eye length and lens power (76519) |
$182.06 |
$303.43 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$266.36 |
$443.94 |
2.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$181.43 |
$302.38 |
2.3× |
| Unlisted fluoroscopic procedure (76496) |
$150.57 |
$250.95 |
1.9× |
| Unlisted magnetic resonance procedure (76498) |
$653.96 |
$1,089.94 |
8.3× |
| Unlisted Ultrasound Procedure (76999) |
$115.74 |
$192.90 |
1.5× |
| Upper Extremity Infant (73092) |
$75.61 |
$126.02 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$293.10 |
$488.50 |
1.4× |
| Urethrocystography voiding (74455) |
$281.83 |
$469.71 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$282.62 |
$471.04 |
1.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$464.58 |
$774.30 |
2.9× |
| Us abdl aorta screen aaa (76706) |
$314.36 |
$523.94 |
3.3× |
| Us breast unilateral complete (76641) |
$219.48 |
$365.80 |
2.3× |
| Us breast unilateral limited (76642) |
$219.48 |
$365.80 |
2.8× |
| Us chest (76604) |
$238.30 |
$397.17 |
2.5× |
| Us compl joint r-t w/image documentation (76881) |
$182.72 |
$304.53 |
1.9× |
| Us guided compression repair (76936) |
$382.60 |
$637.66 |
2.0× |
| Us infant hips dynamic (76885) |
$150.20 |
$250.34 |
1.9× |
| Us ob detailed single fetus (76811) |
$414.29 |
$690.49 |
1.9× |
| Us ob transvaginal (76817) |
$166.48 |
$277.46 |
1.8× |
| Us pelvic non ob complete (76856) |
$271.78 |
$452.96 |
2.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$181.19 |
$301.98 |
1.9× |
| Us pregnancy ltd (76815) |
$120.37 |
$200.62 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$336.59 |
$560.99 |
3.6× |
| Us retroperitoneal complete (76770) |
$294.24 |
$490.40 |
3.1× |
| Us retroperitoneal limited (76775) |
$262.10 |
$436.84 |
2.8× |
| Us scrotum and contents (76870) |
$264.04 |
$440.06 |
2.8× |
| Us soft tissue head/neck (76536) |
$226.40 |
$377.34 |
2.4× |
| Us spinal canal and contents (76800) |
$150.20 |
$250.34 |
1.6× |
| Us transrectal (76872) |
$195.48 |
$325.80 |
2.1× |
| Us transrectal prostate volume (76873) |
$200.27 |
$333.78 |
2.1× |
| Us xtr non-vasc lmtd (76882) |
$120.50 |
$200.83 |
1.3× |
| Us, eye b-scan (76512) |
$182.06 |
$303.43 |
1.9× |
| Vascular flow imaging (78445) |
$341.84 |
$569.74 |
0.9× |
| Venogram extremity bilateral (75822) |
$728.66 |
$1,214.43 |
0.5× |
| Venogram orbital (75880) |
$756.29 |
$1,260.49 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$997.82 |
$1,663.04 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$1,028.62 |
$1,714.36 |
0.7× |
| Venography epidural rs&i (75872) |
$756.29 |
$1,260.49 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$728.66 |
$1,214.43 |
0.5× |
| Venography Renal Bilateral (75833) |
$997.82 |
$1,663.04 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$756.29 |
$1,260.49 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$728.66 |
$1,214.43 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$728.66 |
$1,214.43 |
0.1× |
| Wrist 2 views (73100) |
$75.61 |
$126.02 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$195.90 |
$326.50 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$84.40 |
$140.66 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$251.66 |
$419.42 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$75.61 |
$126.02 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$84.40 |
$140.66 |
1.1× |
| X-ray exam hip uni 1 view (73501) |
$105.66 |
$176.10 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$107.77 |
$179.62 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$178.50 |
$297.50 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$181.84 |
$303.07 |
1.9× |
| X-ray eye for foreign body (70030) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$86.05 |
$143.42 |
0.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$84.40 |
$140.66 |
1.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$261.55 |
$435.91 |
0.1× |
| X-ray head for orthodontia (70350) |
$72.70 |
$121.17 |
0.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$86.05 |
$143.42 |
1.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$399.30 |
$665.50 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$74.16 |
$123.60 |
0.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$86.05 |
$143.42 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$75.61 |
$126.02 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$84.40 |
$140.66 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$148.31 |
$247.18 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$148.31 |
$247.18 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$75.61 |
$126.02 |
1.0× |
| X-ray of voice box or throat (70370) |
$132.02 |
$220.03 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$84.40 |
$140.66 |
0.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$72.70 |
$121.17 |
0.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$197.81 |
$329.68 |
0.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$305.93 |
$509.88 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$84.40 |
$140.66 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$74.16 |
$123.60 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$125.24 |
$208.74 |
1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$74.16 |
$123.60 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$74.16 |
$123.60 |
0.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$75.61 |
$126.02 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$148.31 |
$247.18 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$74.16 |
$123.60 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$72.70 |
$121.17 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$84.40 |
$140.66 |
1.1× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$76.41 |
$127.35 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$145.46 |
$242.42 |
1.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$72.70 |
$121.17 |
0.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$86.05 |
$143.42 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$84.40 |
$140.66 |
1.1× |
| Xr arthrogram ankle (73615) |
$320.70 |
$534.50 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$145.46 |
$242.42 |
1.5× |
| Xr chest 4+ views (71048) |
$86.05 |
$143.42 |
0.9× |
| Xr Cholecystography Oral Contrast (74290) |
$148.22 |
$247.04 |
0.9× |
| Xr finger(s) 2+ views (73140) |
$84.40 |
$140.66 |
1.1× |
| Xr internal auditory meati complete (70134) |
$122.79 |
$204.65 |
0.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$72.70 |
$121.17 |
0.8× |
| Xr optic foramina (70190) |
$82.74 |
$137.90 |
1.1× |
| Xr shoulder 1 view (73020) |
$75.61 |
$126.02 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$145.46 |
$242.42 |
1.5× |
| Xr tibia/fibula 2 views (73590) |
$84.40 |
$140.66 |
1.1× |
| Xr tmj bilateral (70330) |
$82.74 |
$137.90 |
1.1× |
| Xray knee 1 or 2 views rt (73560) |
$84.40 |
$140.66 |
1.1× |