| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,593 |
$8,593 |
6.4× |
| Abdomen 2 views (74019) |
$689 |
$689 |
6.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,433 |
$1,433 |
3.7× |
| Angiography extremity bilateral rs&i (75716) |
$16,484 |
$16,484 |
5.4× |
| Angiography extremity unilateral rs&i (75710) |
$5,681 |
$5,681 |
1.9× |
| Angiography internal mammary rs&i (75756) |
$3,817 |
$3,817 |
1.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$11,555 |
$11,555 |
2.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,943 |
$5,943 |
1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,544 |
$5,544 |
1.8× |
| Angiography Spinal Selective Rs&I (75705) |
$5,599 |
$5,599 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,943 |
$5,943 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,096 |
$2,096 |
0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,351 |
$2,351 |
0.8× |
| Ankle 2 views (73600) |
$428 |
$428 |
5.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$894 |
$894 |
2.7× |
| Aortogram thoracic (75605) |
$6,237 |
$6,237 |
1.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,943 |
$5,943 |
1.9× |
| Aortography abdominal serialography rs&i (75625) |
$16,484 |
$16,484 |
5.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$6,677 |
$6,677 |
2.2× |
| Arthrogram elbow (73085) |
$2,229 |
$2,229 |
6.6× |
| Arthrogram hip (73525) |
$1,298 |
$1,298 |
3.8× |
| Arthrogram shoulder (73040) |
$2,229 |
$2,229 |
6.6× |
| Arthrogram wrist (73115) |
$2,331 |
$2,331 |
6.9× |
| Arthrography knee lt (73580) |
$1,391 |
$1,391 |
4.1× |
| Basic radiation dosimetry calculation (77300) |
$459 |
$459 |
3.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,001.50 |
$2,001.50 |
5.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,328 |
$1,328 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$2,856 |
$2,856 |
7.4× |
| Bone age studies (77072) |
$395 |
$395 |
3.9× |
| Bone Imaging 3 Phase (78315) |
$2,585 |
$2,585 |
6.7× |
| Bone survey complete (77075) |
$871 |
$871 |
8.6× |
| Brachytx isodose complex (77318) |
$3,023 |
$3,023 |
8.4× |
| Brachytx isodose intermed (77317) |
$1,611 |
$1,611 |
4.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,377 |
$1,377 |
3.8× |
| Brain image w/flow 4 + views (78606) |
$3,242 |
$3,242 |
6.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$9,162 |
$9,162 |
6.6× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$626 |
$626 |
56.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,947 |
$1,947 |
3.7× |
| Cervical spine 2 or 3 views (72040) |
$871 |
$871 |
10.4× |
| Chest 1 view (71045) |
$583 |
$583 |
6.9× |
| Chest 3 views (71047) |
$1,282 |
$1,282 |
15.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$755 |
$755 |
4.5× |
| Clavicle complete (73000) |
$495 |
$495 |
5.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$340 |
$340 |
3.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,051 |
$1,051 |
8.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,312 |
$6,312 |
18.7× |
| CT abdomen and pelvis without contrast (74176) |
$4,576 |
$4,576 |
19.8× |
| CT abdomen w contrast (74160) |
$2,995 |
$2,995 |
17.7× |
| CT abdomen w wo contrast (74170) |
$2,317 |
$2,317 |
13.7× |
| CT abdomen w/o contrast (74150) |
$1,967 |
$1,967 |
19.5× |
| CT angio hrt w/3d image (75574) |
$2,719 |
$2,719 |
8.1× |
| CT angiography upper extremity lt (73206) |
$3,433 |
$3,433 |
20.2× |
| CT c-spine w/o contrast (72125) |
$2,513 |
$2,513 |
24.9× |
| CT cervical spine w&w/o contrast (72127) |
$4,232 |
$4,232 |
25.0× |
| CT cervical spine with contrast (72126) |
$2,945 |
$2,945 |
8.7× |
| CT chest w/wo contrast (71270) |
$3,709 |
$3,709 |
21.9× |
| CT chest with contrast (71260) |
$3,355 |
$3,355 |
19.8× |
| CT colonography w/dye (74262) |
$2,249 |
$2,249 |
13.3× |
| CT colonography w/o cntrst (74261) |
$2,249 |
$2,249 |
22.3× |
| CT head/brain with contrast (70460) |
$2,945 |
$2,945 |
17.4× |
| CT head/brain without and with contrast (70470) |
$3,306 |
$3,306 |
19.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,709 |
$3,709 |
11.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$99 |
$99 |
1.2× |
| CT hrt w/3d image congen (75573) |
$3,709 |
$3,709 |
11.0× |
| CT iac w contrast (70481) |
$2,945 |
$2,945 |
17.4× |
| CT limited/localized follow up study (76380) |
$1,658 |
$1,658 |
19.7× |
| CT lower ext w/o (73700) |
$1,967 |
$1,967 |
19.5× |
| CT lower extremity w wo contrast (73702) |
$2,898 |
$2,898 |
17.1× |
| CT lower extremity with contrast (73701) |
$2,995 |
$2,995 |
17.7× |
| CT lumbar spine w & w/o contrast (72133) |
$2,898 |
$2,898 |
17.1× |
| CT lumbar spine w/o contrast (72131) |
$1,967 |
$1,967 |
19.5× |
| CT lumbar spine with contrast (72132) |
$2,581 |
$2,581 |
7.7× |
| CT maxillofacial w contrast (70487) |
$2,945 |
$2,945 |
17.4× |
| CT maxillofacial w/o contrast (70486) |
$1,951 |
$1,951 |
19.3× |
| CT maxillofacial w/wo contrast (70488) |
$3,758 |
$3,758 |
22.2× |
| CT neck soft tissue w contrast (70491) |
$2,945 |
$2,945 |
17.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,306 |
$3,306 |
19.5× |
| CT orbits w/o contrast (70480) |
$1,951 |
$1,951 |
19.3× |
| CT pelvis w & w/o contrast (72194) |
$2,898 |
$2,898 |
17.1× |
| CT pelvis w/o contrast (72192) |
$1,967 |
$1,967 |
19.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,306 |
$3,306 |
19.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,951 |
$1,951 |
19.3× |
| CT thoracic spine w/contrast (72129) |
$2,581 |
$2,581 |
15.2× |
| CT thoracic spine w/o contrast (72128) |
$1,967 |
$1,967 |
19.5× |
| CT thoracic spine w/wo contrast (72130) |
$3,709 |
$3,709 |
21.9× |
| CT thorax w/o contrast (71250) |
$2,203 |
$2,203 |
21.8× |
| CT unlisted procedure (76497) |
$2,996 |
$2,996 |
35.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,294 |
$3,294 |
19.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,967 |
$1,967 |
19.5× |
| CT upper extremity with contrast (73201) |
$2,995 |
$2,995 |
8.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,940 |
$3,940 |
23.2× |
| Cta Abdomen (74175) |
$2,719 |
$2,719 |
16.0× |
| CTA abdomen pelvis (74174) |
$5,436 |
$5,436 |
16.1× |
| CTA chest (71275) |
$3,845 |
$3,845 |
22.7× |
| Cta Head (70496) |
$3,376 |
$3,376 |
19.9× |
| CTA lwr ext w&w/o contrast (73706) |
$3,433 |
$3,433 |
20.2× |
| Cta Neck (70498) |
$3,376 |
$3,376 |
19.9× |
| Cta Pelvis (72191) |
$3,433 |
$3,433 |
20.2× |
| Cystography minimum 3 views rs&i (74430) |
$1,442 |
$1,442 |
4.3× |
| Diskogram cervical (72285) |
$1,980 |
$1,980 |
1.0× |
| Diskography lumbar (72295) |
$3,449 |
$3,449 |
1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$632 |
$632 |
6.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,102 |
$1,102 |
10.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$686 |
$686 |
6.8× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$953 |
$953 |
9.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$676 |
$676 |
6.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$256 |
$256 |
3.0× |
| Dxa bone density study axial skeleton (77085) |
$609 |
$609 |
6.0× |
| Echo exam of fetal heart (76825) |
$6,780 |
$6,780 |
12.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$4,144 |
$4,144 |
18.0× |
| Echoencephalography real time imaging (76506) |
$1,442 |
$1,442 |
14.3× |
| Esophagus (74220) |
$736 |
$736 |
4.3× |
| Fetal biophysical profile non-stress testing (76818) |
$1,323 |
$1,323 |
13.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,442 |
$1,442 |
14.3× |
| Fluoroscopy up to 1 hr (76000) |
$1,295 |
$1,295 |
5.6× |
| Foot 2 views (73620) |
$562 |
$562 |
6.7× |
| Forearm 2 views (73090) |
$563 |
$563 |
6.7× |
| Gated Heart Planar Single (78472) |
$1,849 |
$1,849 |
4.8× |
| Hand 2 views (73120) |
$508 |
$508 |
5.0× |
| Hand 3 views (73130) |
$562 |
$562 |
6.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$5,883 |
$5,883 |
8.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,965 |
$6,965 |
10.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$8,052 |
$8,052 |
12.0× |
| Heart Infarct Image (78466) |
$1,849 |
$1,849 |
4.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,933 |
$2,933 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,307 |
$2,307 |
4.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,518 |
$2,518 |
6.5× |
| Ht muscle image spect sing (78451) |
$1,659 |
$1,659 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$588 |
$588 |
7.0× |
| Hysterosalpingogram (74740) |
$1,767 |
$1,767 |
7.7× |
| Interstitial radiation source applic complex (77778) |
$10,883 |
$10,883 |
16.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,941 |
$1,941 |
3.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,941 |
$1,941 |
3.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,737 |
$3,737 |
7.1× |
| Knee 3 views (73562) |
$627 |
$627 |
7.5× |
| Liver & spleen imaging static only (78215) |
$1,870 |
$1,870 |
4.8× |
| Liver imaging w/vascular flow (78202) |
$5,167 |
$5,167 |
9.8× |
| Lung perf&ventilat diferentl (78598) |
$1,564 |
$1,564 |
3.0× |
| Lung Ventilation Imaging (78579) |
$903 |
$903 |
2.3× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,812 |
$1,812 |
0.6× |
| Lymphoscintigraphy (78195) |
$2,238 |
$2,238 |
4.3× |
| Mammary ductogram or galactogram multiple (77054) |
$516 |
$516 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$2,060 |
$2,060 |
8.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$256 |
$256 |
3.0× |
| Meckels Diverticulum (78290) |
$1,511 |
$1,511 |
3.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$6,508 |
$6,508 |
18.0× |
| MRA head w & w/o contrast (70546) |
$4,610 |
$4,610 |
13.7× |
| MRA head w/o contrast (70544) |
$3,323 |
$3,323 |
14.4× |
| MRA head with contrast (70545) |
$6,174 |
$6,174 |
18.3× |
| MRA neck w contrast (70548) |
$6,174 |
$6,174 |
18.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,323 |
$4,323 |
12.8× |
| MRA neck w/o contrast (70547) |
$3,323 |
$3,323 |
14.4× |
| MRI abdomen w contrast (74182) |
$7,289 |
$7,289 |
21.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,353 |
$5,353 |
15.9× |
| MRI abdomen w/o contrast (74181) |
$4,120 |
$4,120 |
17.9× |
| MRI any jnt lwr ext with con lt (73722) |
$4,133 |
$4,133 |
5.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,133 |
$4,133 |
5.5× |
| MRI breast w/o contrast bilateral (77047) |
$3,408 |
$3,408 |
14.8× |
| MRI breast w/o contrast unilat (77046) |
$4,174 |
$4,174 |
18.1× |
| MRI c-spine with contrast (72142) |
$3,146 |
$3,146 |
9.3× |
| MRI cervical spine w/o contrast (72141) |
$3,010 |
$3,010 |
13.1× |
| MRI chest w/o & w/contrast material (71552) |
$5,220 |
$5,220 |
15.5× |
| MRI chest w/o contrast (71550) |
$3,923 |
$3,923 |
17.0× |
| MRI chest with contrast (71551) |
$7,289 |
$7,289 |
9.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$5,851 |
$5,851 |
17.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,133 |
$4,133 |
12.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,438 |
$3,438 |
14.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,010 |
$3,010 |
13.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,610 |
$4,610 |
13.7× |
| MRI orbit/face/neck w/contrast (70542) |
$4,825 |
$4,825 |
14.3× |
| MRI pelvis w contrast (72196) |
$6,789 |
$6,789 |
20.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,220 |
$5,220 |
15.5× |
| MRI pelvis w/o contrast (72195) |
$3,660 |
$3,660 |
15.9× |
| MRI scan of arm joint before and after contrast (73223) |
$5,220 |
$5,220 |
15.5× |
| MRI scan of leg joint before and after contrast (73723) |
$5,266 |
$5,266 |
15.6× |
| MRI spectroscopy (76390) |
$6,165 |
$6,165 |
73.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,610 |
$4,610 |
13.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,642 |
$4,642 |
13.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,220 |
$5,220 |
15.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,133 |
$4,133 |
12.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,492 |
$5,492 |
16.3× |
| MRI thoracic spine w/o contrast (72146) |
$3,923 |
$3,923 |
17.0× |
| MRI tmj (70336) |
$3,438 |
$3,438 |
14.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,438 |
$3,438 |
14.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$5,220 |
$5,220 |
15.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,438 |
$3,438 |
14.9× |
| Myelogram Cervical (72240) |
$797 |
$797 |
1.1× |
| Myelogram Lumbar (72265) |
$797 |
$797 |
1.1× |
| Myelogram thoracic (72255) |
$797 |
$797 |
1.1× |
| Myelography 2 or more regions (72270) |
$1,448 |
$1,448 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$5,554 |
$5,554 |
4.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,644 |
$1,644 |
2.0× |
| Neck soft tissue (70360) |
$373 |
$373 |
4.4× |
| Nm cisternogram (78630) |
$3,242 |
$3,242 |
6.2× |
| Nm gastric emptying study (78264) |
$1,932 |
$1,932 |
5.0× |
| Nm peritoneal-venous shunt patency (78291) |
$2,043 |
$2,043 |
5.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$13,511 |
$13,511 |
10.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$5,554 |
$5,554 |
4.4× |
| Nuclear medicine study of digestive tracts (78299) |
$2,275 |
$2,275 |
5.9× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$4,567 |
$4,567 |
3.6× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,648 |
$1,648 |
4.3× |
| Nuclear Rx Oral Admin (79005) |
$2,257 |
$2,257 |
10.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,270 |
$1,270 |
12.6× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$634 |
$634 |
6.3× |
| Orthopantogram (70355) |
$559 |
$559 |
6.6× |
| Osseous survey infant (77076) |
$661 |
$661 |
6.5× |
| Osseous survey limited (77074) |
$871 |
$871 |
8.6× |
| Parathyrd planar w/spect&CT (78072) |
$3,270 |
$3,270 |
6.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,593 |
$1,593 |
4.1× |
| Parathyroid imaging (78070) |
$1,593 |
$1,593 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$544 |
$544 |
5.4× |
| Peritoneogram rs&i (74190) |
$726 |
$726 |
1.4× |
| PET image w/CT, skull-thigh (78815) |
$9,162 |
$9,162 |
6.6× |
| PET imaging CT for attenuation limited area (78814) |
$9,162 |
$9,162 |
6.6× |
| PET imaging for CT attenuation whole body (78816) |
$9,162 |
$9,162 |
6.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$5,266 |
$5,266 |
15.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,681 |
$5,681 |
1.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,349 |
$3,349 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,870 |
$1,870 |
4.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,666 |
$1,666 |
3.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$880 |
$880 |
1.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$395 |
$395 |
4.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$661 |
$661 |
6.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$661 |
$661 |
6.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$702 |
$702 |
6.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$981 |
$981 |
9.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,960 |
$14,960 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,327 |
$1,327 |
2.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$930 |
$930 |
9.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,142 |
$1,142 |
3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$562 |
$562 |
5.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$679 |
$679 |
8.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$680 |
$680 |
6.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$965 |
$965 |
11.5× |
| Radiologic exam colon single contrast study (74270) |
$1,063 |
$1,063 |
6.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$638 |
$638 |
3.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,122 |
$1,122 |
6.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,031 |
$1,031 |
6.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$199 |
$199 |
2.4× |
| Radiological examination surgical specimen (76098) |
$3,697 |
$3,697 |
7.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,129 |
$1,129 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,599 |
$4,599 |
1.5× |
| Ribs bilateral 3 views (71110) |
$724 |
$724 |
7.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,334 |
$3,334 |
8.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$4,589 |
$4,589 |
8.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,776.50 |
$3,776.50 |
7.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,589 |
$4,589 |
3.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$5,206 |
$5,206 |
3.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,589 |
$4,589 |
3.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$2,901 |
$2,901 |
12.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$827 |
$827 |
3.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,085 |
$1,085 |
4.8× |
| Sacroiliac Joints < 3 Views (72200) |
$560 |
$560 |
5.5× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$896 |
$896 |
3.9× |
| Salivary gland imaging serial images (78231) |
$901 |
$901 |
2.3× |
| Scanogram (77073) |
$358 |
$358 |
3.5× |
| Scapula complete (73010) |
$462 |
$462 |
4.6× |
| Screening digital breast tomosynthesis (77063) |
$117 |
$117 |
5.0× |
| Sella turcica (70240) |
$267 |
$267 |
3.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$539 |
$539 |
5.3× |
| Sialogram (70390) |
$305 |
$305 |
1.3× |
| Simulation intermediate (77285) |
$1,167 |
$1,167 |
3.2× |
| Small bowel series (74250) |
$803 |
$803 |
4.7× |
| Spec medical radj physics consltj (77370) |
$1,655 |
$1,655 |
12.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,044 |
$1,044 |
2.9× |
| Special dosimetry (77331) |
$206 |
$206 |
1.6× |
| Special treatment procedure (77470) |
$2,879 |
$2,879 |
5.4× |
| Spine thoracic 3 views (72072) |
$617 |
$617 |
6.1× |
| Splenoportograpy rs&i (75810) |
$2,065 |
$2,065 |
0.7× |
| Stereotactic body radiation delivery (77373) |
$7,979 |
$7,979 |
4.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$5,285 |
$5,285 |
53.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,811 |
$2,811 |
7.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,196 |
$2,196 |
6.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,015 |
$2,015 |
5.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$930 |
$930 |
7.2× |
| Thoracolumbar 2 views (72080) |
$562 |
$562 |
6.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,512 |
$2,512 |
4.8× |
| Thyroid uptake measurement (78012) |
$345 |
$345 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$562 |
$562 |
1.5× |
| Tmj unilateral (70328) |
$358 |
$358 |
4.3× |
| Treatment device intermediate (77333) |
$718 |
$718 |
5.5× |
| Treatment devices simple (77332) |
$1,443 |
$1,443 |
11.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,632 |
$4,632 |
8.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,328 |
$1,328 |
3.4× |
| Tx devices design & construction complex (77334) |
$930 |
$930 |
2.6× |
| Ultrasound scan to determine eye length and lens power (76519) |
$953 |
$953 |
9.4× |
| Ultrasound, abdomen limited (76705) |
$1,331 |
$1,331 |
13.2× |
| Umbilical-artery Doppler (OB) (76820) |
$651 |
$651 |
6.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$221 |
$221 |
2.6× |
| Unlisted fluoroscopic procedure (76496) |
$729 |
$729 |
8.7× |
| Unlisted Ultrasound Procedure (76999) |
$507 |
$507 |
6.0× |
| Upper Extremity Infant (73092) |
$562 |
$562 |
5.6× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$114 |
$114 |
1.2× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$2,308 |
$2,308 |
6.0× |
| Urethrocystography retrograde rs&i (74450) |
$910 |
$910 |
3.9× |
| Urethrocystography voiding (74455) |
$1,442 |
$1,442 |
6.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,442 |
$1,442 |
8.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$534 |
$534 |
3.1× |
| Us abdl aorta screen aaa (76706) |
$1,026 |
$1,026 |
10.2× |
| Us breast unilateral complete (76641) |
$618 |
$618 |
6.1× |
| Us breast unilateral limited (76642) |
$605.50 |
$605.50 |
7.2× |
| Us chest (76604) |
$1,346 |
$1,346 |
13.3× |
| Us compl joint r-t w/image documentation (76881) |
$898 |
$898 |
8.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$379 |
$379 |
3.8× |
| Us guided compression repair (76936) |
$1,078 |
$1,078 |
5.2× |
| Us infant hips dynamic (76885) |
$1,173 |
$1,173 |
13.9× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$411 |
$411 |
4.1× |
| Us ob detailed single fetus (76811) |
$1,210 |
$1,210 |
5.2× |
| Us ob transvaginal (76817) |
$812 |
$812 |
8.0× |
| Us pelvic non ob complete (76856) |
$1,280 |
$1,280 |
12.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$973 |
$973 |
9.6× |
| Us pregnancy ltd (76815) |
$876 |
$876 |
8.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,280 |
$1,280 |
12.7× |
| Us retroperitoneal complete (76770) |
$1,140 |
$1,140 |
11.3× |
| Us retroperitoneal limited (76775) |
$929 |
$929 |
9.2× |
| Us scrotum and contents (76870) |
$947 |
$947 |
9.4× |
| Us soft tissue head/neck (76536) |
$950 |
$950 |
9.4× |
| Us spinal canal and contents (76800) |
$1,173 |
$1,173 |
11.6× |
| Us transrectal (76872) |
$1,455 |
$1,455 |
14.4× |
| Us transrectal prostate volume (76873) |
$862 |
$862 |
8.5× |
| Us xtr non-vasc lmtd (76882) |
$876 |
$876 |
8.7× |
| Venogram extremity bilateral (75822) |
$2,319 |
$2,319 |
1.5× |
| Venography caval inferior serialography rs&i (75825) |
$5,355 |
$5,355 |
1.8× |
| Venography caval superior serialography rs&i (75827) |
$3,375 |
$3,375 |
2.2× |
| Venography extremity unilateral rs&i (75820) |
$2,175 |
$2,175 |
1.4× |
| Venography Renal Bilateral (75833) |
$5,486 |
$5,486 |
1.8× |
| Venography renal unilateral selective rs&i (75831) |
$16,484 |
$16,484 |
5.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,967 |
$2,967 |
1.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$11,179 |
$11,179 |
2.1× |
| Vertebral fracture assessment via dxa (77086) |
$211 |
$211 |
2.5× |
| Wrist 2 views (73100) |
$445 |
$445 |
5.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$874 |
$874 |
8.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$462 |
$462 |
5.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$563 |
$563 |
6.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,253 |
$1,253 |
7.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$457 |
$457 |
5.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$567 |
$567 |
6.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$595 |
$595 |
5.9× |
| X-ray exam hip uni 1 view (73501) |
$395 |
$395 |
4.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$199 |
$199 |
2.4× |
| X-ray exam hip uni 4/> views (73503) |
$643 |
$643 |
6.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$328 |
$328 |
3.2× |
| X-ray exam of femur 1 (73551) |
$199 |
$199 |
2.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,128 |
$1,128 |
6.7× |
| X-ray eye for foreign body (70030) |
$378 |
$378 |
4.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$596 |
$596 |
5.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$455 |
$455 |
5.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$563 |
$563 |
6.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$913 |
$913 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$562 |
$562 |
6.7× |
| X-ray IV pyelogram+drip infusn (74410) |
$870 |
$870 |
5.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$508 |
$508 |
6.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$859 |
$859 |
8.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$765 |
$765 |
9.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$562 |
$562 |
6.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$908 |
$908 |
9.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,098 |
$1,098 |
10.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$661 |
$661 |
6.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$501 |
$501 |
6.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$577 |
$577 |
5.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$494 |
$494 |
4.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$656 |
$656 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$662 |
$662 |
7.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$662 |
$662 |
6.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$777 |
$777 |
7.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$553 |
$553 |
5.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$562 |
$562 |
6.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$562 |
$562 |
6.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$680 |
$680 |
8.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$291 |
$291 |
3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,011 |
$1,011 |
10.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$968 |
$968 |
9.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$770 |
$770 |
9.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$387 |
$387 |
4.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$531 |
$531 |
6.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$562 |
$562 |
5.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$500 |
$500 |
4.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$462 |
$462 |
5.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$563 |
$563 |
6.7× |
| Xr c-spine 6 or more views (72052) |
$778 |
$778 |
7.7× |
| Xr chest 4+ views (71048) |
$1,295 |
$1,295 |
12.8× |
| Xr finger(s) 2+ views (73140) |
$462 |
$462 |
5.5× |
| Xr shoulder 1 view (73020) |
$295 |
$295 |
3.5× |
| Xr spine cervical 4 or 5 views (72050) |
$864 |
$864 |
8.5× |
| Xr tibia/fibula 2 views (73590) |
$611 |
$611 |
7.3× |
| Xr tmj bilateral (70330) |
$386 |
$386 |
4.6× |
| Xray knee 1 or 2 views rt (73560) |
$852 |
$852 |
10.1× |