| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,541.80 |
$13,377.89 |
1.5× |
| Abdomen 1 View (74018) |
$85.50 |
$450 |
0.8× |
| Abdomen 2 views (74019) |
$85.50 |
$450 |
0.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$747.01 |
$3,931.62 |
1.5× |
| Adrenal Cortex & Medulla Img (78075) |
$726.18 |
$3,822 |
0.4× |
| Angio internal mammary (75756) |
$736.16 |
$3,874.54 |
0.2× |
| Angio pulmonary bilat (75743) |
$508.44 |
$2,676 |
0.1× |
| Angiography extremity bilateral rs&i (75716) |
$951.22 |
$5,006.40 |
0.2× |
Angiography extremity unilateral rs&i (75710)
range across 2 matching MRF lines |
$598.50–$1,358.43 |
$3,150–$7,149.61 |
varies |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,016.88 |
$5,352 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$736.16 |
$3,874.54 |
0.2× |
| Ankle 2 views (73600) |
$77.14 |
$406 |
0.7× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$1,016.88 |
$5,352 |
0.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,099.05 |
$5,784.46 |
0.3× |
Artery X-Rays Abdomen (75726)
range across 2 matching MRF lines |
$1,079.22–$1,133.18 |
$5,680.08–$5,964.09 |
varies |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$532 |
$2,800 |
0.1× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$508.44 |
$2,676 |
0.1× |
| Arthrogram ankle (73615) |
$318.44 |
$1,676 |
0.7× |
| Arthrogram hip (73525) |
$353.77 |
$1,861.97 |
0.8× |
| Arthrogram Wrist (73115) |
$156.01 |
$821.10 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$177.80 |
$935.80 |
1.1× |
| Bone age studies (77072) |
$85.50 |
$450 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$986.54 |
$5,192.33 |
2.0× |
| Bone Imaging Limited Area (78300) |
$335.92 |
$1,768 |
0.7× |
| Bone Imaging Multiple Areas (78305) |
$482.22 |
$2,538 |
1.0× |
| Bone Imaging Whole Body (78306) |
$748.54 |
$3,939.71 |
1.5× |
| Bone marrow imaging limited area (78102) |
$274.93 |
$1,447 |
0.6× |
| Bone marrow imaging; whole body (78104) |
$535.02 |
$2,815.89 |
1.1× |
| Bone survey infant (77076) |
$122.63 |
$645.41 |
0.9× |
| Brachytx isodose complex (77318) |
$382.68 |
$2,014.11 |
0.8× |
| Brachytx isodose intermed (77317) |
$264.07 |
$1,389.83 |
0.6× |
| Brachytx Isodose Plan Simple (77316) |
$202.81 |
$1,067.43 |
0.4× |
| Brain Flow Imaging Only (78610) |
$296.53 |
$1,560.69 |
0.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,050.10 |
$5,526.85 |
1.5× |
| Brain Imaging Minimum 4 Static Views (78605) |
$457.90 |
$2,410 |
0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,425.19 |
$7,501 |
0.8× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$352.28 |
$1,854.12 |
0.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,197 |
$6,300 |
2.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$598.88 |
$3,152 |
0.6× |
| Cardiac Shunt Detection (78428) |
$296.53 |
$1,560.69 |
0.6× |
| Cardiovasc nucl exam unlisted (78499) |
$296.53 |
$1,560.69 |
0.6× |
| Cat Scan Follow-Up Study (76380) |
$427.88 |
$2,252 |
3.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$780.38 |
$4,107.28 |
1.2× |
| Cerebrospinal Fluid Scan (78630) |
$670.89 |
$3,531 |
1.0× |
| Chest 1 view (71045) |
$85.50 |
$450 |
0.8× |
| Chest 2 views (71046) |
$94.24 |
$496 |
0.9× |
| Chest 3 views (71047) |
$94.24 |
$496 |
0.9× |
| Chest 4 or more views (71048) |
$65.08 |
$342.50 |
0.5× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$74.63 |
$392.79 |
0.6× |
| Cholecystography Oral Contrast (74290) |
$90.64 |
$477.06 |
0.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$488.45 |
$2,570.77 |
0.5× |
| Clavicle complete (73000) |
$65.28 |
$343.60 |
0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$763.69 |
$4,019.40 |
5.9× |
| Continuing medical physics consltj pr wk (77336) |
$238.14 |
$1,253.39 |
1.4× |
| Contrast Exam Abdominl Aorta (75625) |
$1,070.08 |
$5,632 |
0.3× |
| Contrast X-Ray Bladder (74430) |
$166.88 |
$878.33 |
0.4× |
| Contrast X-Ray Of Elbow (73085) |
$233.56 |
$1,229.24 |
0.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$239.75 |
$1,261.84 |
0.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$101.56 |
$534.53 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,086.96 |
$10,984 |
4.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,428.80 |
$7,520 |
4.8× |
| CT abdomen w contrast (74160) |
$1,160.19 |
$6,106.25 |
5.3× |
| CT abdomen w wo contrast (74170) |
$1,316.95 |
$6,931.31 |
6.0× |
| CT abdomen w/o contrast (74150) |
$827.45 |
$4,355.01 |
6.3× |
| CT Angio Abdomen and Pelvis (74174) |
$1,984.12 |
$10,442.73 |
4.6× |
| CT Angio Chest (71275) |
$1,265.85 |
$6,662.39 |
5.8× |
| CT Angio Head (70496) |
$1,369.92 |
$7,210.08 |
6.3× |
| CT angio hrt w/3d image (75574) |
$1,029.11 |
$5,416.36 |
2.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$898.32 |
$4,728 |
4.1× |
| CT Angio Neck (70498) |
$1,405.23 |
$7,395.94 |
6.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$898.32 |
$4,728 |
4.1× |
| CT bone density (77078) |
$231.13 |
$1,216.46 |
2.1× |
| CT cervical spine w/ contrast (72126) |
$1,477.46 |
$7,776.08 |
3.4× |
| CT cervical spine w/o contrast (72125) |
$727.32 |
$3,828 |
5.6× |
| CT cervical spine w/wo cont (72127) |
$1,654.01 |
$8,705.31 |
7.6× |
| CT chest w contrast (71260) |
$1,614.15 |
$8,495.54 |
7.4× |
| CT chest w/wo contrast (71270) |
$1,807.03 |
$9,510.66 |
8.3× |
| CT colonography screening (74263) |
$366.21 |
$1,927.40 |
1.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$453.49 |
$2,386.80 |
2.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$339.47 |
$1,786.68 |
2.6× |
| CT head/brain with contrast (70460) |
$986.08 |
$5,189.87 |
4.5× |
| CT head/brain without and with contrast (70470) |
$1,046.55 |
$5,508.18 |
4.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,029.11 |
$5,416.36 |
2.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$96.69 |
$4,603.98 |
0.9× |
| CT hrt w/3d image congen (75573) |
$135.73 |
$714.35 |
0.3× |
| CT iac w contrast (70481) |
$870.48 |
$4,581.46 |
4.0× |
| CT l-spine w&w/o contrast (72133) |
$1,704.04 |
$8,968.61 |
7.8× |
| CT lower ext w/o (73700) |
$615.60 |
$3,240 |
4.7× |
| CT lower extremity w/contrast material (73701) |
$1,110.41 |
$5,844.25 |
5.1× |
| CT lumbar spine w contrast (72132) |
$1,522.13 |
$8,011.21 |
3.5× |
| CT lumbar spine w/o contrast (72131) |
$727.32 |
$3,828 |
5.6× |
| CT maxillofacial w contrast (70487) |
$988.95 |
$5,205.02 |
4.5× |
| CT maxillofacial wo contrast (70486) |
$815.93 |
$4,294.38 |
6.3× |
| CT neck tissue combo (70492) |
$1,164.47 |
$6,128.78 |
5.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$898.32 |
$4,728 |
4.1× |
| CT orbits w/o contrast (70480) |
$737.79 |
$3,883.11 |
5.7× |
| CT pelvis w&w/o contrast (72194) |
$1,043.48 |
$5,492 |
4.8× |
| CT pelvis w/o contrast (72192) |
$819.70 |
$4,314.20 |
6.3× |
| CT scan of leg combo (73702) |
$988.71 |
$5,203.76 |
4.5× |
| CT scans face/jaw combo (70488) |
$1,140.13 |
$6,000.67 |
5.2× |
| CT soft tissue neck w contrast (70491) |
$986.84 |
$5,193.90 |
4.5× |
| CT soft tissue neck w/o contrast (70490) |
$809.22 |
$4,259.04 |
6.2× |
| CT thoracic spine w contrast (72129) |
$1,477.46 |
$7,776.08 |
6.7× |
| CT thoracic spine w/o contrast (72128) |
$727.32 |
$3,828 |
5.6× |
| CT thoracic spine w/wo cont (72130) |
$1,654.01 |
$8,705.31 |
7.6× |
| CT thorax w/o contrast (71250) |
$886.60 |
$4,666.33 |
6.8× |
| CT unlisted procedure (76497) |
$109.44 |
$576 |
1.0× |
| CT upper ext wo (73200) |
$736.45 |
$3,876.07 |
5.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,141.46 |
$6,007.69 |
5.2× |
| CT upper extremity with contrast (73201) |
$913.28 |
$4,806.73 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$898.32 |
$4,728 |
4.1× |
| Cta Abdomen (74175) |
$1,567.34 |
$8,249.14 |
7.2× |
| CTA pelvis (72191) |
$898.32 |
$4,728 |
4.1× |
| Dilation ureters/urethra rs&i (74485) |
$255.36 |
$1,344 |
0.1× |
| Discography Cerv/Thor Spine (72285) |
$677.92 |
$3,568 |
0.3× |
| Diskography lumbar (72295) |
$634.41 |
$3,339 |
0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$99.22 |
$522.21 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$141.78 |
$746.20 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$109.93 |
$578.57 |
0.8× |
| Dxa Bone Density Axial (77080) |
$111.78 |
$588.30 |
0.9× |
| Dxa bone density study (77085) |
$106.45 |
$560.28 |
0.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$69.26 |
$364.52 |
0.6× |
| Echo exam of fetal heart (76825) |
$350.54 |
$1,844.94 |
0.5× |
| Echo exam uterus (76831) |
$164.55 |
$866.04 |
0.6× |
| Echo Guide For Artery Repair (76936) |
$412.78 |
$2,172.50 |
1.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$371.57 |
$1,955.64 |
1.2× |
| Echograp Trans R Pros Study (76873) |
$171.76 |
$903.99 |
1.3× |
| Esophageal Motility Study (78258) |
$739.44 |
$3,891.78 |
1.5× |
| Esophagram (74220) |
$145.44 |
$765.45 |
0.7× |
| Fetal Biophys Profile W/Nst (76818) |
$249.28 |
$1,312 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$566.99 |
$2,984.16 |
4.3× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$235.38 |
$1,238.84 |
0.8× |
| Fluoroscopy up to 1 hr (76000) |
$354.64 |
$1,866.54 |
1.2× |
| Follow-Up Angiography (75898) |
$42.28 |
$222.50 |
0.0× |
| Foot 2 views (73620) |
$77.14 |
$406 |
0.7× |
| Forearm 2 views (73090) |
$80.40 |
$423.15 |
0.7× |
| Gastric emptying imaging study (78264) |
$863.32 |
$4,543.81 |
1.7× |
| Gastroesophageal Reflux Exam (78262) |
$573.23 |
$3,017 |
1.1× |
| Gated Heart Planar Single (78472) |
$612.12 |
$3,221.68 |
1.2× |
| Gated Heart, Multiple (78473) |
$422.75 |
$2,225 |
0.8× |
| Hand 2 views (73120) |
$71.12 |
$374.33 |
0.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$1,524.55 |
$8,023.96 |
1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,397.36 |
$7,354.52 |
1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,270.42 |
$6,686.42 |
1.5× |
| Heart first pass single,planar (78481) |
$294.26 |
$1,548.75 |
0.4× |
| Heart Image (Pet) Multiple (78492) |
$2,149.67 |
$11,314.04 |
1.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,016.88 |
$5,352 |
0.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,016.88 |
$5,352 |
0.3× |
| Hepatobil Syst Image W/Drug (78227) |
$2,334.73 |
$12,288.05 |
3.4× |
| Hepatobiliary System Imaging (78226) |
$978.06 |
$5,147.69 |
2.0× |
| Ht Musc Image Planar Mult (78454) |
$1,157.86 |
$6,094.01 |
0.7× |
| Ht Muscle Image Spect Sing (78451) |
$539.22 |
$2,838 |
0.3× |
| Hyperthermia external generated superficial (77600) |
$587.05 |
$3,089.72 |
1.2× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) |
$1,611.94 |
$8,483.90 |
2.3× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) |
$1,611.94 |
$8,483.90 |
2.3× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) |
$847.88 |
$4,462.54 |
1.2× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) |
$1,016.14 |
$5,348.10 |
1.2× |
| Hysterosalpingogram (74740) |
$98.29 |
$517.31 |
0.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$288.30 |
$1,517.38 |
2.7× |
| Infant hip ultrasound, limited static exam (76886) |
$288.30 |
$1,517.38 |
2.7× |
| Infusion Ivp (74410) |
$957.16 |
$5,037.69 |
4.4× |
| Interstitial radiation source applic complex (77778) |
$486.16 |
$2,558.76 |
0.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$573.61 |
$3,018.98 |
0.7× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$404.90 |
$2,131.05 |
0.6× |
| Intracavitary radiation source applic simple (77761) |
$320.69 |
$1,687.84 |
0.5× |
| Joint Survey Single View (77077) |
$39.89 |
$209.97 |
0.3× |
| K Flow/Funct Image Multiple (78709) |
$982.21 |
$5,169.55 |
1.4× |
| K Flow/Funct Image W/Drug (78708) |
$604.20 |
$3,180 |
0.9× |
| K Flow/Funct Image W/O Drug (78707) |
$628.65 |
$3,308.67 |
0.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$296.53 |
$1,560.69 |
0.6× |
| Kidney Imaging Morphol (78700) |
$402.61 |
$2,119 |
0.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$475.76 |
$2,504 |
1.0× |
| Knee 3 Views (73562) |
$128.82 |
$678 |
1.2× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$337.92 |
$1,778.52 |
0.7× |
| Leveen/Shunt Patency Exam (78291) |
$402.61 |
$2,119 |
0.8× |
| Liver & Spleen Imaging Static Only (78215) |
$390.26 |
$2,054 |
0.8× |
| Liver imaging static only (78201) |
$317.11 |
$1,669 |
0.5× |
| Liver imaging w/vascular flow (78202) |
$390.26 |
$2,054 |
0.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,654.77 |
$8,709.34 |
2.4× |
| Lung perfusion differential (78597) |
$1,074.58 |
$5,655.69 |
2.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$726.18 |
$3,822 |
1.1× |
| Lung Ventilation Imaging (78579) |
$670.89 |
$3,531 |
1.3× |
| Lymph System Imaging (78195) |
$941.08 |
$4,953.05 |
1.4× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$437.19 |
$2,301 |
0.2× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$218.60 |
$1,150.50 |
0.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$748.31 |
$3,938.46 |
0.2× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$516.89 |
$2,720.48 |
0.1× |
| Magnetic Image Jaw Joint (70336) |
$1,054.88 |
$5,552 |
3.5× |
| Magnetic Resonance Elastography (76391) |
$163.15 |
$858.69 |
0.5× |
| Mammary ductogram or galactogram multiple (77054) |
$350.92 |
$1,846.93 |
1.2× |
| Mammary ductogram or galactogram single (77053) |
$212.61 |
$1,119 |
0.7× |
| Meckels Divert Exam (78290) |
$402.61 |
$2,119 |
0.8× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$87.61 |
$461.10 |
0.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$952.80 |
$5,014.75 |
2.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,133.51 |
$11,229 |
4.9× |
| MRA head w/o contrast (70544) |
$1,262.40 |
$6,644.21 |
4.2× |
| MRA head with contrast (70545) |
$1,881.08 |
$9,900.41 |
4.3× |
| MRA neck w contrast (70548) |
$1,197 |
$6,300 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,567.88 |
$8,252 |
3.6× |
| MRA neck w/o contrast (70547) |
$1,098.25 |
$5,780.25 |
3.7× |
| MRI abdomen w contrast (74182) |
$1,783.20 |
$9,385.24 |
4.1× |
| MRI abdomen w/o contrast (74181) |
$1,549.97 |
$8,157.76 |
5.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,790.85 |
$9,425.55 |
1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,031.13 |
$10,690.14 |
4.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,197 |
$6,300 |
1.2× |
| MRI bone marrow blood supply (77084) |
$870.85 |
$4,583.44 |
2.9× |
| MRI brain functional w/o physician admnistration (70554) |
$671.71 |
$3,535.32 |
2.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,458.39 |
$7,675.75 |
4.9× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$868.43 |
$4,570.69 |
2.9× |
| MRI cardiac w/o cont stress (75559) |
$1,798.39 |
$9,465.22 |
2.6× |
| MRI cardiac w/o contrast (75557) |
$1,197 |
$6,300 |
4.0× |
| MRI cervical spine w contrast (72142) |
$1,532.86 |
$8,067.66 |
3.5× |
| MRI cervical spine w/o cont (72141) |
$1,333.27 |
$7,017.20 |
4.5× |
| MRI chest w/o contrast (71550) |
$1,097.27 |
$5,775.13 |
3.7× |
| MRI chest with contrast (71551) |
$1,197 |
$6,300 |
1.2× |
| MRI chest wo w contrast (71552) |
$1,859.92 |
$9,789.05 |
4.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,830.09 |
$9,632.07 |
4.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,075.72 |
$10,924.82 |
4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,228.23 |
$6,464.38 |
4.1× |
| MRI lumbar spine w contrast (72149) |
$1,689.20 |
$8,890.53 |
3.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,840.19 |
$9,685.22 |
4.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,094.84 |
$5,762.34 |
3.7× |
| MRI orbit face neck w contrast (70542) |
$1,197 |
$6,300 |
2.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,855.79 |
$9,767.29 |
4.3× |
| MRI pelvis w contrast (72196) |
$1,197 |
$6,300 |
2.7× |
| MRI pelvis w/o & w contrast (72197) |
$1,567.88 |
$8,252 |
3.6× |
| MRI pelvis w/o contrast (72195) |
$1,054.88 |
$5,552 |
3.5× |
| MRI spectroscopy (76390) |
$563.92 |
$2,968 |
5.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,453.71 |
$7,651.08 |
4.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,418.29 |
$7,464.66 |
3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,054.88 |
$5,552 |
3.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,608.70 |
$8,466.86 |
3.7× |
| MRI, abdomen, combo (74183) |
$2,140.08 |
$11,263.56 |
4.9× |
| MRI, dorsal spine combo (72157) |
$1,840.19 |
$9,685.22 |
4.2× |
| MRI, dorsal spine contrast (72147) |
$1,672.63 |
$8,803.30 |
3.8× |
| MRI, joint upper extrem (73221) |
$1,201.85 |
$6,325.51 |
4.0× |
| MRI, joint upper extrem combo (73223) |
$2,031.13 |
$10,690.14 |
4.7× |
| MRI, lumbar spine combo (72158) |
$1,916.10 |
$10,084.72 |
4.4× |
| Myelogram cervical (72240) |
$513 |
$2,700 |
0.5× |
| Myelogram Lumbar (72265) |
$444.85 |
$2,341.34 |
0.5× |
| Myelography thoracic (72255) |
$181.03 |
$952.77 |
0.2× |
| Myelograpy 2/more regions rs&i (72270) |
$521.25 |
$2,743.44 |
0.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,863.51 |
$9,807.95 |
1.2× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$294.26 |
$1,548.75 |
0.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$961.02 |
$5,057.98 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,215.75 |
$6,398.71 |
0.8× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$2,149.67 |
$11,314.04 |
1.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,149.67 |
$11,314.04 |
1.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$2,149.67 |
$11,314.04 |
0.8× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$2,090.86 |
$11,004.54 |
1.1× |
| N-invas est c ffr sw aly CTA (75580) |
$682.86 |
$3,594 |
0.6× |
| Neck soft tissue (70360) |
$68.40 |
$360 |
0.6× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$187.16 |
$985.05 |
0.4× |
| Nm myocard infarct spect (78469) |
$315.62 |
$1,661.18 |
0.5× |
| Nm red cell survival study (78130) |
$344.48 |
$1,813.06 |
0.7× |
| Nm whole blood volume (78122) |
$604.20 |
$3,180 |
0.9× |
| Nonvascular Shunt X-Ray (75809) |
$133.07 |
$700.35 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,537.90 |
$13,357.37 |
1.5× |
| Nuclear Rx Intra-Arterial (79445) |
$281.64 |
$1,482.33 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$353.78 |
$1,862 |
1.2× |
| Ob us nuchal meas 1 gest (76813) |
$116.52 |
$613.24 |
0.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$99.11 |
$521.65 |
0.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$71.73 |
$377.55 |
0.5× |
| Optic foramina (70190) |
$61.95 |
$326.03 |
0.6× |
| Panoramic X-ray of jaws (70355) |
$41.52 |
$218.52 |
0.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$592.06 |
$3,116.08 |
0.9× |
| Parathyroid Planar Imaging (78070) |
$736.04 |
$3,873.87 |
1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$540.57 |
$2,845.12 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$83.89 |
$441.53 |
0.6× |
| Peritoneogram Rs&I (74190) |
$603.85 |
$3,178.14 |
0.9× |
| Pet Image Skull-Thigh (78812) |
$1,863.51 |
$9,807.95 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$1,425.19 |
$7,501 |
0.8× |
| PET image w/CT, full body (78816) |
$1,425.19 |
$7,501 |
0.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,712.47 |
$19,539.30 |
2.1× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,863.51 |
$9,807.95 |
1.2× |
| Pet Myocardial Sngl Study (78491) |
$1,063.24 |
$5,595.98 |
0.6× |
| PET whole body (78813) |
$1,863.51 |
$9,807.95 |
1.0× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$902.77 |
$4,751.44 |
0.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$866.08 |
$4,558.31 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$463.60 |
$2,440 |
0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$188.82 |
$993.77 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$128.44 |
$676 |
0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$86.09 |
$453.08 |
0.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$63.08 |
$332 |
0.6× |
| Radex elbow complete minimum 3 views (73080) |
$84.59 |
$445.20 |
0.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$74.21 |
$390.60 |
0.6× |
| Radex fingr minimum 2 views (73140) |
$137.06 |
$721.35 |
1.3× |
| Radex foot complete minimum 3 views (73630) |
$86.09 |
$453.08 |
0.8× |
| Radex Hand Minimum 3 Views (73130) |
$173.20 |
$911.60 |
1.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$41.30 |
$217.35 |
0.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$136.80 |
$720 |
1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$68.40 |
$360 |
0.6× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$109.75 |
$577.62 |
1.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$64.60 |
$340 |
0.6× |
| Radex shoulder complete minimum 2 views (73030) |
$169.18 |
$890.40 |
1.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$81.74 |
$430.22 |
0.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$138.40 |
$728.44 |
0.6× |
| Radex Spine 1 View Specify Level (72020) |
$154.28 |
$812 |
1.4× |
| Radex Sternum Minimum 2 Views (71120) |
$64.60 |
$340 |
0.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$68.40 |
$360 |
0.6× |
| Radex Toe Minimum 2 Views (73660) |
$66.73 |
$351.21 |
0.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$62.63 |
$329.65 |
0.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$84.59 |
$445.20 |
0.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$111.06 |
$584.50 |
0.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$29,152.74 |
$153,435.45 |
3.2× |
| Radiation treatment delivery level 1 (77402) |
$332.44 |
$1,749.67 |
2.6× |
| Radiation treatment delivery level 2 (77407) |
$416.57 |
$2,192.46 |
0.9× |
| Radiation treatment delivery level 3 (77412) |
$571.96 |
$3,010.30 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$68.40 |
$360 |
0.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$86.56 |
$455.60 |
0.7× |
| Radiologic exam colon double contrast study (74280) |
$443.25 |
$2,332.89 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$158.27 |
$833 |
0.7× |
| Radiologic exam knee complete 4/more views (73564) |
$128.34 |
$675.50 |
1.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$120.60 |
$634.73 |
0.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$149.96 |
$789.26 |
0.7× |
| Radiologic exam swallow function contrast study (74230) |
$121.30 |
$638.40 |
0.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$128.44 |
$676 |
0.6× |
| Radiologic examination femur 1 view (73551) |
$71.55 |
$376.56 |
0.7× |
| Radiologic examination femur minimum 2 views (73552) |
$35.53 |
$187 |
0.3× |
| Radiologic examination knee 1/2 views (73560) |
$78 |
$410.55 |
0.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$164.27 |
$864.57 |
1.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$50.26 |
$264.54 |
0.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$92.38 |
$486.23 |
0.9× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$55.43 |
$291.72 |
0.1× |
| Radiopharm Dacryocystography (78660) |
$259.58 |
$1,366.20 |
0.5× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$334.50 |
$1,760.55 |
0.5× |
| Renal Cyst Study (74470) |
$659.25 |
$3,469.74 |
1.0× |
| Ribs bilateral 3 views (71110) |
$85.50 |
$450 |
0.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$468.35 |
$2,465 |
0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$631.68 |
$3,324.61 |
1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$993.43 |
$5,228.60 |
1.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$726.18 |
$3,822 |
1.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$884.83 |
$4,657 |
1.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,062.89 |
$5,594.16 |
0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,352.77 |
$7,119.84 |
0.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$966.26 |
$5,085.60 |
0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$405.05 |
$2,131.84 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$353.78 |
$1,862 |
1.2× |
| Salivary Gland Function Study (78232) |
$85.63 |
$450.71 |
0.2× |
| Salivary Gland Imaging Serial Images (78231) |
$296.53 |
$1,560.69 |
0.6× |
| Scapula (73010) |
$72.15 |
$379.73 |
0.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$30.72 |
$161.68 |
1.3× |
| Sella turcica (70240) |
$35.10 |
$184.75 |
0.3× |
| Shoulder 1 view (73020) |
$77.14 |
$406 |
0.7× |
| Shoulder Arthrography (73040) |
$267.05 |
$1,405.53 |
0.6× |
| Sialogram (70390) |
$137.58 |
$724.09 |
0.5× |
| Skull less than 4 views (70250) |
$59.65 |
$313.95 |
0.5× |
| Special dosimetry (77331) |
$35.23 |
$185.42 |
0.2× |
| Special Physics Consult (77370) |
$362.03 |
$1,905.44 |
2.2× |
| Special teletherapy port plan (77321) |
$127.68 |
$671.98 |
0.3× |
| Special treatment procedure (77470) |
$15,351.31 |
$80,796.35 |
22.3× |
| Spleen Imaging (78185) |
$332.04 |
$1,747.58 |
0.7× |
| Srs Multisource (77371) |
$29,152.74 |
$153,435.45 |
3.2× |
| Stereotactic Body Radiation Delivery (77373) |
$29,152.74 |
$153,435.45 |
13.1× |
| Sternoclavicular joints (71130) |
$60.04 |
$316 |
0.6× |
| Superior sagittal sinus venogram (75870) |
$1,016.88 |
$5,352 |
0.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$101.44 |
$533.88 |
0.8× |
| Tbs technical calculation only (77091) |
$31.88 |
$167.78 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$287.92 |
$1,515.36 |
0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$215.94 |
$1,136.52 |
0.5× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$140.74 |
$740.76 |
0.5× |
| Testicular Imaging W/Flow (78761) |
$426.93 |
$2,247 |
0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,016.81 |
$5,351.64 |
2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$610.04 |
$3,210.74 |
1.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$345.74 |
$1,819.70 |
2.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$87.35 |
$459.73 |
0.4× |
| Thoracic spine 2 views (72070) |
$54.37 |
$286.18 |
0.4× |
| Thoracic spine 3 views (72072) |
$62.27 |
$327.75 |
0.5× |
| Thoracolumbar 2 views (72080) |
$64.60 |
$340 |
0.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$238.26 |
$1,254 |
0.5× |
| Thyroid Met Imaging Body (78018) |
$997.86 |
$5,251.91 |
1.5× |
| Thyroid Uptake Measurement (78012) |
$134.14 |
$706 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$593.56 |
$3,124 |
1.2× |
| Tx Devices Design & Construction Complex (77334) |
$472.16 |
$2,485.04 |
1.0× |
| Tx devices design & construction intermediate (77333) |
$165.19 |
$869.40 |
1.0× |
| Tx devices design & construction simple (77332) |
$254.89 |
$1,341.53 |
1.5× |
| Ultrasound Breast Limited (76642) |
$257.67 |
$1,356.15 |
2.4× |
| Ultrasound elastography first target lesion (76982) |
$82.62 |
$434.84 |
0.6× |
| Ultrasound Elastography Parenchyma (76981) |
$82.62 |
$434.84 |
0.6× |
| Ultrasound Exam Aaa Screen (76706) |
$84.15 |
$442.89 |
0.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$148.14 |
$779.69 |
0.3× |
| Ultrasound, abdomen limited (76705) |
$307.13 |
$1,616.48 |
2.4× |
| Umbilical-artery Doppler (OB) (76820) |
$64.61 |
$340.03 |
0.5× |
| Unlisted Dx Radiographic Procedure (76499) |
$157.21 |
$827.40 |
1.4× |
| Unlisted fluoroscopic procedure (76496) |
$41.52 |
$218.52 |
0.4× |
| Unlisted genitourinary px dx nuclear medicine (78799) |
$296.53 |
$1,560.69 |
0.6× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) |
$238.49 |
$1,255.20 |
0.5× |
| Unlisted magnetic resonance procedure (76498) |
$543.09 |
$2,858.37 |
5.0× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$189.37 |
$996.70 |
0.4× |
| Unlisted respiratory px dx nuclear medicine (78599) |
$296.53 |
$1,560.69 |
0.6× |
| Unlisted us procedure (76999) |
$171 |
$900 |
1.6× |
| Upper gi w/o kub (74240) |
$171 |
$900 |
0.8× |
| Ureteral Reflux Study (78740) |
$280.63 |
$1,477 |
0.6× |
| Urethrocystogram voiding (74455) |
$128.44 |
$676 |
0.4× |
| Urethrocystography retrograde (74450) |
$336.24 |
$1,769.70 |
1.1× |
| Us breast unilateral complete (76641) |
$384.75 |
$2,025 |
2.9× |
| Us chest (76604) |
$275.88 |
$1,452 |
2.1× |
| Us complete joint (76881) |
$544.36 |
$2,865.04 |
4.2× |
| Us exam, pelvic, limited (76857) |
$271.55 |
$1,429.20 |
2.1× |
| Us head (76506) |
$171 |
$900 |
1.3× |
| Us kidney transplant (76776) |
$228 |
$1,200 |
1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$169.09 |
$889.93 |
1.3× |
| Us ob detailed single fetus (76811) |
$342 |
$1,800 |
1.1× |
| Us ob limited 1 or more fetuses (76815) |
$643.65 |
$3,387.63 |
4.9× |
| Us ob transvaginal (76817) |
$743.21 |
$3,911.62 |
5.7× |
| Us pelvic non ob complete (76856) |
$399.50 |
$2,102.62 |
3.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$549.40 |
$2,891.60 |
4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$142.88 |
$752 |
1.1× |
| Us retroperitoneal complete (76770) |
$359.88 |
$1,894.09 |
2.8× |
| Us retroperitoneal limited (76775) |
$183.47 |
$965.64 |
1.4× |
| Us scrotum and contents (76870) |
$352.56 |
$1,855.57 |
2.7× |
| Us spinal canal and contents (76800) |
$143.60 |
$755.78 |
1.1× |
| Us thyroid (76536) |
$374.51 |
$1,971.12 |
2.9× |
| Us transrectal (76872) |
$171 |
$900 |
1.3× |
| Vein X-Ray Chest (75827) |
$508.44 |
$2,676 |
0.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$375.46 |
$1,976.11 |
0.1× |
| Vein X-Ray Skull Epidural (75872) |
$736.16 |
$3,874.54 |
0.9× |
| Venogram Sinus/Jugular (75860) |
$508.44 |
$2,676 |
0.1× |
| Venography Adrenal Unilateral (75840) |
$736.16 |
$3,874.54 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$895.66 |
$4,713.98 |
0.2× |
| Venography extremity bilateral rs&i (75822) |
$128.44 |
$676 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$336.17 |
$1,769.32 |
0.2× |
| Venography Orbital Rs&I (75880) |
$569.57 |
$2,997.75 |
0.7× |
| Venography Renal Bilateral (75833) |
$1,016.88 |
$5,352 |
0.3× |
| Venography Renal Unilateral (75831) |
$508.44 |
$2,676 |
0.1× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$317.20 |
$1,669.50 |
0.0× |
| Venous thrombosis imaging (78457) |
$355.84 |
$1,872.84 |
0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$536.75 |
$2,825 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$48.12 |
$253.28 |
0.4× |
| Wrist 2 views (73100) |
$61.37 |
$323.01 |
0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$61.79 |
$325.21 |
0.6× |
| X-ray antegrade pyelogram tube (74425) |
$480.83 |
$2,530.68 |
1.1× |
| X-Ray Aorta Leg Arteries (75630) |
$964.72 |
$5,077.50 |
0.2× |
| X-Ray Bend Only L-S Spine (72120) |
$146.60 |
$771.59 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$65.62 |
$345.35 |
0.6× |
| X-Ray Exam Breast Specimen (76098) |
$272.56 |
$1,434.51 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$128.44 |
$676 |
1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$64.60 |
$340 |
0.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$111.06 |
$584.50 |
0.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$235.60 |
$1,240 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$63.08 |
$332 |
0.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$58.24 |
$306.50 |
0.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$58.24 |
$306.50 |
0.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$63.07 |
$331.95 |
0.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$111.06 |
$584.50 |
0.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$128.44 |
$676 |
1.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$91.54 |
$481.80 |
0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$154.66 |
$813.98 |
1.2× |
X-Ray Exam Unilat Ribs/Chest (71101)
range across 2 matching MRF lines |
$116.61–$124.12 |
$613.73–$653.26 |
varies |
| X-ray eye for foreign body (70030) |
$35.10 |
$184.75 |
0.3× |
| X-ray humerus (73060) |
$68.53 |
$360.68 |
0.6× |
| X-ray IV pyelogram (ivp) (74400) |
$256.88 |
$1,352 |
1.2× |
| X-ray IV pyelogram+tomography (74415) |
$1,117.30 |
$5,880.53 |
5.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$62.86 |
$330.86 |
0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$82.39 |
$433.62 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$92.57 |
$487.20 |
0.7× |
| X-ray nose-rectum child f.b. (76010) |
$129.20 |
$680 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$102.60 |
$540 |
0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$55.41 |
$291.61 |
0.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$64.60 |
$340 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$64.60 |
$340 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$143.24 |
$753.90 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$185.14 |
$974.40 |
1.4× |
| X-Ray Stress View (77071) |
$82.48 |
$434.12 |
0.8× |
| X-ray thoracic spine 4 vw (72074) |
$67.45 |
$355.01 |
0.5× |
| X-Ray Tmj Unilat (70328) |
$54.13 |
$284.91 |
0.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$480.83 |
$2,530.68 |
1.1× |
| X-Rays Bone Length Studies (77073) |
$47.50 |
$250 |
0.4× |
| X-Rays Bone Survey Complete (77075) |
$220.78 |
$1,162 |
1.7× |
| Xr c-spine 4 or 5 views (72050) |
$117.81 |
$620.05 |
0.9× |
| Xr facial bones less than 3 views (70140) |
$84.59 |
$445.20 |
0.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$45.35 |
$238.68 |
0.3× |
| Xr orbits complete 4 views (70200) |
$68.40 |
$360 |
0.5× |
| Xr Tomogram Single Plane (76100) |
$113.57 |
$597.74 |
0.9× |