| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,344.25 |
$5,377 |
1.0× |
| Abdomen 2 views (74019) |
$190.06 |
$760.25 |
1.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$507.63 |
$2,030.50 |
1.4× |
| Acute venous thrombus image (78456) |
$554.25 |
$2,217 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,311.25 |
$9,245 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,311.25 |
$9,245 |
0.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,564.56 |
$14,258.25 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,553.50 |
$6,214 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,553.50 |
$6,214 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,564.56 |
$14,258.25 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$324.19 |
$1,296.75 |
0.1× |
| Ankle 2 views (73600) |
$84.19 |
$336.75 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$259.38 |
$1,037.50 |
0.8× |
| Aortogram thoracic (75605) |
$3,564.88 |
$14,259.50 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,311.25 |
$9,245 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,311.25 |
$9,245 |
0.8× |
| Arthrogram elbow (73085) |
$327.38 |
$1,309.50 |
1.0× |
| Arthrogram hip (73525) |
$371.44 |
$1,485.75 |
1.1× |
| Arthrogram shoulder (73040) |
$455.75 |
$1,823 |
1.4× |
| Arthrogram wrist (73115) |
$293.56 |
$1,174.25 |
0.9× |
| Arthrography knee lt (73580) |
$226.63 |
$906.50 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$124.47 |
$497.88 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$391.63 |
$1,566.50 |
1.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$499.50 |
$1,998 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$812.81 |
$3,251.25 |
2.2× |
| Bone age studies (77072) |
$114 |
$456 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$659.19 |
$2,636.75 |
1.8× |
| Bone Marrow Imaging Limited Area (78102) |
$315.75 |
$1,263 |
0.8× |
| Bone survey complete (77075) |
$525.81 |
$2,103.25 |
5.3× |
| Brain image w/flow 4 + views (78606) |
$491.38 |
$1,965.50 |
1.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$449.63 |
$1,798.50 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,474.31 |
$5,897.25 |
1.1× |
| Brain Imaging Vascular Flow Only (78610) |
$304.56 |
$1,218.25 |
0.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$387.19 |
$1,548.75 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$202.56 |
$810.25 |
2.5× |
| Chest 1 view (71045) |
$108.19 |
$432.75 |
1.3× |
| Chest 3 views (71047) |
$184.69 |
$738.75 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$154.56 |
$618.25 |
0.9× |
| Clavicle complete (73000) |
$112.25 |
$449 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$185.88 |
$743.50 |
1.9× |
| Continuing medical physics consltj pr wk (77336) |
$383.06 |
$1,532.25 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,640.81 |
$6,563.25 |
5.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,376.69 |
$5,506.75 |
6.1× |
| CT abdomen w contrast (74160) |
$970.88 |
$3,883.50 |
5.9× |
| CT abdomen w wo contrast (74170) |
$1,003.06 |
$4,012.25 |
6.1× |
| CT abdomen w/o contrast (74150) |
$704.44 |
$2,817.75 |
7.2× |
| CT angio hrt w/3d image (75574) |
$644.25 |
$2,577 |
2.0× |
| CT angiography upper extremity lt (73206) |
$872.75 |
$3,491 |
5.3× |
| CT c-spine w/o contrast (72125) |
$905.19 |
$3,620.75 |
9.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,076.81 |
$4,307.25 |
6.5× |
| CT cervical spine with contrast (72126) |
$1,003.69 |
$4,014.75 |
3.1× |
| CT chest w/wo contrast (71270) |
$919.25 |
$3,677 |
5.6× |
| CT chest with contrast (71260) |
$872.31 |
$3,489.25 |
5.3× |
| CT head/brain with contrast (70460) |
$769.88 |
$3,079.50 |
4.7× |
| CT head/brain without and with contrast (70470) |
$870.75 |
$3,483 |
5.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$644.25 |
$2,577 |
2.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$15 |
$60 |
0.2× |
| CT hrt w/3d image congen (75573) |
$736.25 |
$2,945 |
2.2× |
| CT iac w contrast (70481) |
$769.88 |
$3,079.50 |
4.7× |
| CT limited/localized follow up study (76380) |
$185.88 |
$743.50 |
2.3× |
| CT lower ext w/o (73700) |
$633.56 |
$2,534.25 |
6.4× |
| CT lower extremity w wo contrast (73702) |
$700.56 |
$2,802.25 |
4.2× |
| CT lower extremity with contrast (73701) |
$658.94 |
$2,635.75 |
4.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,076.81 |
$4,307.25 |
6.5× |
| CT lumbar spine w/o contrast (72131) |
$905.19 |
$3,620.75 |
9.2× |
| CT lumbar spine with contrast (72132) |
$1,003.69 |
$4,014.75 |
3.1× |
| CT maxillofacial w contrast (70487) |
$704.44 |
$2,817.75 |
4.3× |
| CT maxillofacial w/o contrast (70486) |
$154.94 |
$619.75 |
1.6× |
| CT maxillofacial w/wo contrast (70488) |
$736.44 |
$2,945.75 |
4.5× |
| CT neck soft tissue w contrast (70491) |
$845.50 |
$3,382 |
5.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$872.75 |
$3,491 |
5.3× |
| CT orbits w/o contrast (70480) |
$669.31 |
$2,677.25 |
6.8× |
| CT pelvis w & w/o contrast (72194) |
$888.38 |
$3,553.50 |
5.4× |
| CT pelvis w/o contrast (72192) |
$696.94 |
$2,787.75 |
7.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$903.88 |
$3,615.50 |
5.5× |
| CT soft tissue neck w/o contrast (70490) |
$581.75 |
$2,327 |
5.9× |
| CT thoracic spine w/contrast (72129) |
$1,003.69 |
$4,014.75 |
6.1× |
| CT thoracic spine w/o contrast (72128) |
$905.19 |
$3,620.75 |
9.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,076.81 |
$4,307.25 |
6.5× |
| CT thorax w/o contrast (71250) |
$745.94 |
$2,983.75 |
7.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$793.31 |
$3,173.25 |
4.8× |
| CT upper extremity w/o contrast rt (73200) |
$728.94 |
$2,915.75 |
7.4× |
| CT upper extremity with contrast (73201) |
$761.19 |
$3,044.75 |
2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$872.75 |
$3,491 |
5.3× |
| Cta Abdomen (74175) |
$914.25 |
$3,657 |
5.5× |
| CTA abdomen pelvis (74174) |
$1,562.19 |
$6,248.75 |
4.8× |
| CTA chest (71275) |
$1,003.69 |
$4,014.75 |
6.1× |
| Cta Head (70496) |
$872.75 |
$3,491 |
5.3× |
| CTA lwr ext w&w/o contrast (73706) |
$752.94 |
$3,011.75 |
4.6× |
| Cta Neck (70498) |
$783.38 |
$3,133.50 |
4.7× |
| Cta Pelvis (72191) |
$872.75 |
$3,491 |
5.3× |
| Cystography minimum 3 views rs&i (74430) |
$233.69 |
$934.75 |
0.7× |
| Diskogram cervical (72285) |
$1,219 |
$4,876 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$193.38 |
$773.50 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$154.88 |
$619.50 |
1.9× |
| Dxa bone density study axial skeleton (77085) |
$86.38 |
$345.50 |
0.9× |
| Echo exam of eye (76529) |
$58.94 |
$235.75 |
0.7× |
| Esophagus (74220) |
$177.88 |
$711.50 |
1.1× |
| Fetal biophysical profile non-stress testing (76818) |
$132.50 |
$530 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$78.56 |
$314.25 |
0.8× |
| Fluoroscopy up to 1 hr (76000) |
$169.47 |
$677.88 |
0.8× |
| Foot 2 views (73620) |
$73.13 |
$292.50 |
0.9× |
| Forearm 2 views (73090) |
$112.25 |
$449 |
1.4× |
| Gated Heart Planar Single (78472) |
$696.13 |
$2,784.50 |
1.9× |
| Hand 2 views (73120) |
$87.94 |
$351.75 |
0.9× |
| Hand 3 views (73130) |
$112.25 |
$449 |
1.4× |
| Heart Infarct Image (78466) |
$304.56 |
$1,218.25 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$672 |
$2,688 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$540.13 |
$2,160.50 |
1.4× |
| Ht muscle image spect sing (78451) |
$1,179.88 |
$4,719.50 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$138 |
$552 |
1.7× |
| Hysterosalpingogram (74740) |
$350.38 |
$1,401.50 |
1.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$73.13 |
$292.50 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$572.81 |
$2,291.25 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$579.31 |
$2,317.25 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$825.13 |
$3,300.50 |
1.6× |
| Knee 3 views (73562) |
$205.25 |
$821 |
2.5× |
| Liver & spleen imaging static only (78215) |
$512.94 |
$2,051.75 |
1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$460.13 |
$1,840.50 |
1.2× |
| Lung perf&ventilat diferentl (78598) |
$664.25 |
$2,657 |
1.3× |
| Lung Ventilation Imaging (78579) |
$364.56 |
$1,458.25 |
1.0× |
| Lymphoscintigraphy (78195) |
$544.94 |
$2,179.75 |
1.1× |
| Meckels Diverticulum (78290) |
$460.13 |
$1,840.50 |
1.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$563.13 |
$2,252.50 |
1.6× |
| MRA head w & w/o contrast (70546) |
$1,487.88 |
$5,951.50 |
4.5× |
| MRA head w/o contrast (70544) |
$1,342.44 |
$5,369.75 |
6.0× |
| MRA head with contrast (70545) |
$1,409.56 |
$5,638.25 |
4.3× |
| MRA neck w contrast (70548) |
$1,342.44 |
$5,369.75 |
4.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,409.56 |
$5,638.25 |
4.3× |
| MRA neck w/o contrast (70547) |
$1,062.19 |
$4,248.75 |
4.7× |
| MRI abdomen w contrast (74182) |
$1,099.75 |
$4,399 |
3.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,265.94 |
$5,063.75 |
3.9× |
| MRI abdomen w/o contrast (74181) |
$1,051.28 |
$4,205.12 |
4.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,279.44 |
$5,117.75 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,273.63 |
$5,094.50 |
1.7× |
| MRI bone marrow blood supply (77084) |
$1,342.44 |
$5,369.75 |
6.0× |
| MRI breast w/o contrast bilateral (77047) |
$1,274.44 |
$5,097.75 |
5.7× |
| MRI breast w/o contrast unilat (77046) |
$980.44 |
$3,921.75 |
4.4× |
| MRI c-spine with contrast (72142) |
$1,342.44 |
$5,369.75 |
4.1× |
| MRI cervical spine w/o contrast (72141) |
$1,013.63 |
$4,054.50 |
4.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,345.31 |
$5,381.25 |
4.1× |
| MRI chest w/o contrast (71550) |
$1,062.19 |
$4,248.75 |
4.7× |
| MRI chest with contrast (71551) |
$1,225.81 |
$4,903.25 |
1.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,273.63 |
$5,094.50 |
3.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,244 |
$4,976 |
3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,119.63 |
$4,478.50 |
5.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$965.38 |
$3,861.50 |
4.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,260.75 |
$5,043 |
3.8× |
| MRI orbit/face/neck w/contrast (70542) |
$1,099.75 |
$4,399 |
3.4× |
| MRI pelvis w contrast (72196) |
$1,062.19 |
$4,248.75 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,383.19 |
$5,532.75 |
4.2× |
| MRI pelvis w/o contrast (72195) |
$951.31 |
$3,805.25 |
4.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,347 |
$5,388 |
4.1× |
| MRI scan of leg joint before and after contrast (73723) |
$1,417.88 |
$5,671.50 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,480.13 |
$5,920.50 |
4.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,342.44 |
$5,369.75 |
4.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,480.13 |
$5,920.50 |
4.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,342.44 |
$5,369.75 |
4.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,480.13 |
$5,920.50 |
4.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,115.50 |
$4,462 |
5.0× |
| MRI tmj (70336) |
$1,062.19 |
$4,248.75 |
4.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,062.19 |
$4,248.75 |
4.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,347 |
$5,388 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,062.19 |
$4,248.75 |
4.7× |
| Myocardial infarct spect (78469) |
$490.50 |
$1,962 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,813.88 |
$7,255.50 |
1.5× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,365.19 |
$5,460.75 |
1.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,365.19 |
$5,460.75 |
1.0× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,476.88 |
$5,907.50 |
0.7× |
| Neck soft tissue (70360) |
$155.94 |
$623.75 |
1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$204.31 |
$817.25 |
0.5× |
| Nm bone marrow multiple (78103) |
$462.25 |
$1,849 |
1.2× |
| Nm bone marrow wb (78104) |
$544.94 |
$2,179.75 |
1.4× |
| Nm cisternogram (78630) |
$664.25 |
$2,657 |
1.3× |
| Nm csf leak detection (78650) |
$435.81 |
$1,743.25 |
0.4× |
| Nm gastric emptying study (78264) |
$718.75 |
$2,875 |
1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,068.38 |
$4,273.50 |
0.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$449.19 |
$1,796.75 |
1.2× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$304.56 |
$1,218.25 |
0.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$377.44 |
$1,509.75 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$394.88 |
$1,579.50 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$403.19 |
$1,612.75 |
1.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$109.44 |
$437.75 |
1.1× |
| Osseous survey infant (77076) |
$105.13 |
$420.50 |
1.1× |
| Osseous survey limited (77074) |
$126.19 |
$504.75 |
1.3× |
| Parathyrd planar w/wo subtrj (78071) |
$262.75 |
$1,051 |
0.7× |
| Parathyroid imaging (78070) |
$365.44 |
$1,461.75 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$92 |
$368 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$1,365.06 |
$5,460.25 |
1.0× |
| PET imaging for CT attenuation whole body (78816) |
$1,365.06 |
$5,460.25 |
1.0× |
| Pr heart first pass single,planar (78481) |
$490.50 |
$1,962 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,417.88 |
$5,671.50 |
4.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$773.25 |
$3,093 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,045.50 |
$4,182 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$240.25 |
$961 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$168.50 |
$674 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$178.56 |
$714.25 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$123.06 |
$492.25 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$149.25 |
$597 |
1.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$182.88 |
$731.50 |
1.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$193.84 |
$775.38 |
0.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$126.31 |
$505.25 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$209.63 |
$838.50 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$105.56 |
$422.25 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$146.88 |
$587.50 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$462.25 |
$1,849 |
2.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$303.31 |
$1,213.25 |
1.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$390.75 |
$1,563 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$179.63 |
$718.50 |
2.2× |
| Ribs bilateral 3 views (71110) |
$152.94 |
$611.75 |
1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$558.25 |
$2,233 |
1.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$674.94 |
$2,699.75 |
1.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$775.75 |
$3,103 |
1.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$785.31 |
$3,141.25 |
3.6× |
| Rp Therapy Intravenous Administration (79101) |
$1,054 |
$4,216 |
4.8× |
| Scanogram (77073) |
$83.94 |
$335.75 |
0.9× |
| Scapula complete (73010) |
$184.25 |
$737 |
1.9× |
| Sella turcica (70240) |
$129.81 |
$519.25 |
1.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$309.56 |
$1,238.25 |
3.1× |
| Sialogram (70390) |
$234.75 |
$939 |
1.0× |
| Small bowel series (74250) |
$243.25 |
$973 |
1.5× |
| Special dosimetry (77331) |
$60.88 |
$243.50 |
0.5× |
| Special treatment procedure (77470) |
$502.44 |
$2,009.75 |
1.0× |
| Spine thoracic 3 views (72072) |
$196.66 |
$786.62 |
2.0× |
| Stereotactic body radiation delivery (77373) |
$1,515.13 |
$6,060.50 |
0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$225.25 |
$901 |
0.6× |
| Testicular Imaging With Vascular Flow (78761) |
$304.56 |
$1,218.25 |
0.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$813.25 |
$3,253 |
2.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$103.44 |
$413.75 |
0.8× |
| Therapeutic Enema (74283) |
$344.94 |
$1,379.75 |
2.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$610.81 |
$2,443.25 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$228.81 |
$915.25 |
0.6× |
| Thyroid uptake measurement (78012) |
$163.88 |
$655.50 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$326.69 |
$1,306.75 |
0.9× |
| Tomogram (76100) |
$294 |
$1,176 |
3.0× |
| Treatment device intermediate (77333) |
$81.69 |
$326.75 |
0.6× |
| Treatment devices simple (77332) |
$81.69 |
$326.75 |
0.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,112.88 |
$4,451.50 |
2.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$373.19 |
$1,492.75 |
1.0× |
| Tx devices design & construction complex (77334) |
$273.50 |
$1,094 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$272.38 |
$1,089.50 |
2.8× |
| Umbilical-artery Doppler (OB) (76820) |
$110.13 |
$440.50 |
1.1× |
| Unlisted magnetic resonance procedure (76498) |
$820.38 |
$3,281.50 |
10.0× |
| Upper Extremity Infant (73092) |
$60.94 |
$243.75 |
0.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$304.56 |
$1,218.25 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$207 |
$828 |
0.9× |
| Urethrocystography voiding (74455) |
$276.56 |
$1,106.25 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$326.75 |
$1,307 |
2.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$337.25 |
$1,349 |
2.0× |
| Us abdl aorta screen aaa (76706) |
$96.38 |
$385.50 |
1.0× |
| Us breast unilateral complete (76641) |
$281.56 |
$1,126.25 |
2.9× |
| Us breast unilateral limited (76642) |
$175 |
$700 |
2.1× |
| Us chest (76604) |
$188.75 |
$755 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$133.25 |
$533 |
1.4× |
| Us guided compression repair (76936) |
$2,819.13 |
$11,276.50 |
13.9× |
| Us infant hips dynamic (76885) |
$642.81 |
$2,571.25 |
7.9× |
| Us kidney transplant (76776) |
$264 |
$1,056 |
2.7× |
| Us ob transvaginal (76817) |
$168.88 |
$675.50 |
1.7× |
| Us pelvic non ob complete (76856) |
$332.88 |
$1,331.50 |
3.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$187.69 |
$750.75 |
1.9× |
| Us pregnancy ltd (76815) |
$142.31 |
$569.25 |
1.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$156.19 |
$624.75 |
1.6× |
| Us retroperitoneal complete (76770) |
$318.94 |
$1,275.75 |
3.2× |
| Us retroperitoneal limited (76775) |
$308.81 |
$1,235.25 |
3.1× |
| Us scrotum and contents (76870) |
$193.38 |
$773.50 |
2.0× |
| Us soft tissue head/neck (76536) |
$230.25 |
$921 |
2.3× |
| Us spinal canal and contents (76800) |
$139.81 |
$559.25 |
1.4× |
| Us transrectal (76872) |
$328.81 |
$1,315.25 |
3.3× |
| Us xtr non-vasc lmtd (76882) |
$345.31 |
$1,381.25 |
3.5× |
| Us, eye b-scan (76512) |
$79.44 |
$317.75 |
0.8× |
| Vascular flow imaging (78445) |
$304.56 |
$1,218.25 |
0.8× |
| Venogram extremity bilateral (75822) |
$787.69 |
$3,150.75 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,450 |
$9,800 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$885 |
$3,540 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$807.06 |
$3,228.25 |
0.5× |
| Venography Renal Bilateral (75833) |
$2,139.81 |
$8,559.25 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$2,139.81 |
$8,559.25 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,026.75 |
$4,107 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$61.56 |
$246.25 |
0.8× |
| Wrist 2 views (73100) |
$117 |
$468 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$256 |
$1,024 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$155.94 |
$623.75 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$112.25 |
$449 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$462.25 |
$1,849 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$112.25 |
$449 |
1.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$138 |
$552 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$194.94 |
$779.75 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$123.06 |
$492.25 |
1.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$179.63 |
$718.50 |
1.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$502.81 |
$2,011.25 |
3.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$197.94 |
$791.75 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$117 |
$468 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$117 |
$468 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$239.56 |
$958.25 |
2.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$114 |
$456 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$210.38 |
$841.50 |
2.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$300 |
$1,200 |
3.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$168.44 |
$673.75 |
2.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$161.25 |
$645 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$263.32 |
$1,053.25 |
2.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$128.63 |
$514.50 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$465.75 |
$1,863 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$165.69 |
$662.75 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$210.38 |
$841.50 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$214.75 |
$859 |
2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$105.56 |
$422.25 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$179.63 |
$718.50 |
2.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$138 |
$552 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$197.94 |
$791.75 |
2.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$148.50 |
$594 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$197.94 |
$791.75 |
2.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$168.44 |
$673.75 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$84.69 |
$338.75 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$129.81 |
$519.25 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$168.44 |
$673.75 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$182.94 |
$731.75 |
1.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$72.19 |
$288.75 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$63.31 |
$253.25 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$171.88 |
$687.50 |
2.1× |
| Xr arthrogram ankle (73615) |
$297.56 |
$1,190.25 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$304.13 |
$1,216.50 |
3.1× |
| Xr chest 4+ views (71048) |
$146.88 |
$587.50 |
1.5× |
| Xr Cholecystography Oral Contrast (74290) |
$135.31 |
$541.25 |
0.8× |
| Xr finger(s) 2+ views (73140) |
$97.50 |
$390 |
1.2× |
| Xr optic foramina (70190) |
$152.38 |
$609.50 |
1.9× |
| Xr shoulder 1 view (73020) |
$97.50 |
$390 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$291.50 |
$1,166 |
3.0× |
| Xr tibia/fibula 2 views (73590) |
$138 |
$552 |
1.7× |
| Xr tmj bilateral (70330) |
$207.63 |
$830.50 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$149.63 |
$598.50 |
1.8× |