| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,754.37 |
$9,362.50 |
2.6× |
| Abdomen 2 views (74019) |
$138.35 |
$345 |
1.3× |
| Acute gi blood loss imaging (78278) |
$589.07 |
$1,469 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$3,446.20 |
$8,594 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,446.20 |
$8,594 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$3,446.20 |
$8,594 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,930.08 |
$14,788.23 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,447.42 |
$8,597.06 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,457.94 |
$8,623.28 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$5,944.83 |
$14,825 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,939.99 |
$14,812.93 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,962.90 |
$4,895 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,797.73 |
$6,976.86 |
0.9× |
| Ankle 2 views (73600) |
$142.76 |
$356 |
1.6× |
| Aortogram thoracic (75605) |
$5,930.68 |
$14,789.70 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,446.20 |
$8,594 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$3,450.66 |
$8,605.11 |
1.1× |
| Arthrogram hip (73525) |
$550.98 |
$1,374 |
1.5× |
| Arthrogram shoulder (73040) |
$534.54 |
$1,333 |
1.5× |
| Basic dosimetry (77300) |
$227.93 |
$568.40 |
1.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$575.84 |
$1,436 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$637.89 |
$1,590.73 |
1.5× |
| Bone age studies (77072) |
$137.14 |
$341.99 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$572.23 |
$1,427 |
1.4× |
| Bone survey complete (77075) |
$240.60 |
$600 |
2.2× |
| Bone survey infant (77076) |
$211.33 |
$527 |
2.0× |
| Bowel imaging (78290) |
$534.94 |
$1,334 |
1.3× |
| Brachytx isodose complex (77318) |
$1,796.31 |
$4,479.56 |
4.6× |
| Brachytx isodose intermed (77317) |
$1,655.73 |
$4,129 |
4.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$659.25 |
$1,644 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,122.90 |
$5,294 |
1.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$572.63 |
$1,428 |
1.4× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$1,213.83 |
$3,027 |
1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$637.59 |
$1,590 |
1.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$610.33 |
$1,522 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$150.78 |
$376 |
1.7× |
| Chest 1 view (71045) |
$128.45 |
$320.32 |
1.4× |
| Chest xray 3 views (71047) |
$93.84 |
$234 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$297.15 |
$741 |
1.6× |
| Clavicle complete (73000) |
$185.97 |
$463.75 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$278.30 |
$694 |
2.6× |
| Continuing medical physics consltj pr wk (77336) |
$307.15 |
$765.96 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$817.28 |
$2,038.10 |
2.3× |
| CT abdomen and pelvis without contrast (74176) |
$511.28 |
$1,275 |
2.1× |
| CT abdomen w contrast (74160) |
$623.96 |
$1,556 |
3.4× |
| CT abdomen w wo contrast (74170) |
$719.40 |
$1,794 |
4.0× |
| CT abdomen w/o contrast (74150) |
$470.78 |
$1,174 |
4.4× |
| CT angio hrt w/3d image (75574) |
$1,008.12 |
$2,514 |
2.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$512.78 |
$1,278.75 |
2.8× |
| CT angiography upper extremity lt (73206) |
$657.14 |
$1,638.75 |
3.6× |
| CT c-spine w/contrast (72126) |
$550.98 |
$1,374 |
1.5× |
| CT c-spine w/o contrast (72125) |
$472.36 |
$1,177.95 |
4.4× |
| CT cervical spine w&w/o contrast (72127) |
$349.28 |
$871 |
1.9× |
| CT chest w contrast (71260) |
$573.92 |
$1,431.21 |
3.2× |
| CT chest w/wo contrast (71270) |
$391.78 |
$977 |
2.2× |
| CT colonography screening (74263) |
$1,401.50 |
$3,495 |
5.7× |
| CT colonography w/o cntrst (74261) |
$678.90 |
$1,693 |
6.3× |
| CT head/brain with contrast (70460) |
$480.40 |
$1,198 |
2.7× |
| CT head/brain without and with contrast (70470) |
$480.40 |
$1,198 |
2.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,123.21 |
$2,801 |
3.1× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$111.48 |
$278 |
1.2× |
| CT hrt w/3d image congen (75573) |
$528.12 |
$1,317 |
1.5× |
| CT iac w contrast (70481) |
$527.87 |
$1,316.38 |
2.9× |
| CT limited/localized follow up study (76380) |
$288.92 |
$720.50 |
3.2× |
| CT lower ext w/o (73700) |
$531.42 |
$1,325.23 |
4.9× |
| CT lower extremity w wo contrast (73702) |
$415.04 |
$1,035 |
2.3× |
| CT lower extremity w/contrast material (73701) |
$692.93 |
$1,728 |
3.8× |
| CT lumbar spine w & w/o contrast (72133) |
$369.73 |
$922 |
2.0× |
| CT lumbar spine w/contrast (72132) |
$627.17 |
$1,564 |
1.7× |
| CT lumbar spine w/o contrast (72131) |
$470.72 |
$1,173.84 |
4.4× |
| CT maxillofacial w contrast (70487) |
$573.03 |
$1,429 |
3.2× |
| CT maxillofacial w/wo contrast (70488) |
$573.03 |
$1,429 |
3.2× |
| CT maxillofacial wo contrast (70486) |
$561.31 |
$1,399.76 |
5.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$531.73 |
$1,326 |
2.9× |
| CT orbits w/o contrast (70480) |
$528.99 |
$1,319.16 |
4.9× |
| CT pelvis w/o contrast (72192) |
$502.86 |
$1,254 |
4.7× |
| CT pelvis w/wo contrast (72194) |
$407.30 |
$1,015.69 |
2.2× |
| CT scan of arm combo (73202) |
$403.01 |
$1,005 |
2.2× |
| CT soft tissue neck w contrast (70491) |
$562.23 |
$1,402.05 |
3.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$573.43 |
$1,430 |
3.2× |
| CT soft tissue neck w/o contrast (70490) |
$573.43 |
$1,430 |
5.3× |
| CT thoracic spine w/contrast (72129) |
$329.63 |
$822 |
1.8× |
| CT thoracic spine w/o contrast (72128) |
$465.57 |
$1,161 |
4.3× |
| CT thoracic spine w/wo contrast (72130) |
$384.56 |
$959 |
2.1× |
| CT thorax w/o contrast (71250) |
$470.78 |
$1,174 |
4.4× |
| CT upper ext wo (73200) |
$516.68 |
$1,288.46 |
4.8× |
| CT upper extremity with contrast (73201) |
$688.72 |
$1,717.50 |
1.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$619.95 |
$1,546 |
3.4× |
| Cta Abdomen (74175) |
$506.87 |
$1,264 |
2.8× |
| CTA abdomen pelvis (74174) |
$834.23 |
$2,080.36 |
2.3× |
| CTA chest (71275) |
$641.98 |
$1,600.95 |
3.5× |
| Cta Head (70496) |
$565.12 |
$1,409.27 |
3.1× |
| Cta Neck (70498) |
$638.05 |
$1,591.13 |
3.5× |
| Cta Pelvis (72191) |
$662.06 |
$1,651 |
3.7× |
| Cystography minimum 3 views rs&i (74430) |
$534.54 |
$1,333 |
1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$179.24 |
$446.97 |
1.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$222.96 |
$556 |
2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$213.74 |
$533 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$158.40 |
$394.99 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$200.50 |
$500 |
2.2× |
| Dxa bone density study axial skeleton (77085) |
$175.24 |
$437 |
1.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$446.32 |
$1,113 |
1.8× |
| Esophagus (74220) |
$292.32 |
$728.96 |
1.6× |
| Facial bones min 3 views (70150) |
$138.35 |
$345 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$565.41 |
$1,410 |
5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$251.83 |
$628 |
2.3× |
| Fetal Echo (76825) |
$600.70 |
$1,498 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$332.03 |
$828 |
1.3× |
| Foot 2 views (73620) |
$145.92 |
$363.88 |
1.6× |
| Forearm 2 views (73090) |
$142.82 |
$356.13 |
1.6× |
| Functional MRI brain by tech (70554) |
$640 |
$1,596 |
2.6× |
| Hand 2 views (73120) |
$170.63 |
$425.50 |
1.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$943.56 |
$2,353 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$943.56 |
$2,353 |
1.3× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$943.56 |
$2,353 |
1.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,446.20 |
$8,594 |
1.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,446.20 |
$8,594 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$722.61 |
$1,802 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$572.63 |
$1,428 |
1.4× |
| Hysterosalpingogram (74740) |
$446.32 |
$1,113 |
1.8× |
| Interstitial radiation source applic complex (77778) |
$3,591.76 |
$8,957 |
5.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$920.10 |
$2,294.50 |
1.3× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$1,022.15 |
$2,549 |
2.5× |
| Kidney imaging morphology (78700) |
$449.12 |
$1,120 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$588.67 |
$1,468 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$650.83 |
$1,623 |
1.2× |
| Knee 3 views (73562) |
$193.48 |
$482.50 |
2.2× |
| Liver & spleen imaging static only (78215) |
$487.22 |
$1,215 |
1.2× |
| Lung perfusion differential (78597) |
$492.83 |
$1,229 |
1.2× |
| Lung ventilation imaging (78579) |
$589.07 |
$1,469 |
1.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,470.66 |
$8,655 |
1.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,786.06 |
$4,454 |
0.5× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$1,721.50 |
$4,293 |
1.1× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$729.02 |
$1,818 |
1.1× |
| Lymphoscintigraphy (78195) |
$572.43 |
$1,427.50 |
1.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$963.61 |
$2,403 |
1.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$873.38 |
$2,178 |
2.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,166.66 |
$2,909.36 |
3.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$482.41 |
$1,203 |
1.2× |
| MRA head w & w/o contrast (70546) |
$765.93 |
$1,910.04 |
2.1× |
| MRA head w/o contrast (70544) |
$756.04 |
$1,885.38 |
3.1× |
| MRA head with contrast (70545) |
$772.73 |
$1,927 |
2.1× |
| MRA neck w contrast (70548) |
$610.73 |
$1,523 |
1.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$606.98 |
$1,513.66 |
1.7× |
| MRA neck w/o contrast (70547) |
$610.73 |
$1,523 |
2.5× |
| MRI abdomen w contrast (74182) |
$609.12 |
$1,519 |
1.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,253.53 |
$3,126 |
3.5× |
| MRI abdomen w/o contrast (74181) |
$832.08 |
$2,075 |
3.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$850.62 |
$2,121.25 |
1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,148.46 |
$2,863.96 |
3.2× |
| MRI breast w/o contrast bilateral (77047) |
$523.71 |
$1,306 |
2.1× |
| MRI c-spine with contrast (72142) |
$578.65 |
$1,443 |
1.6× |
| MRI cardiac w/o cont stress (75559) |
$738.65 |
$1,842 |
1.3× |
| MRI cardiac w/o contrast (75557) |
$637.59 |
$1,590 |
2.6× |
| MRI cervical spine w/o contrast (72141) |
$753.02 |
$1,877.86 |
3.1× |
| MRI chest w/o & w/contrast material (71552) |
$622.42 |
$1,552.16 |
1.7× |
| MRI chest w/o contrast (71550) |
$622.36 |
$1,552 |
2.5× |
| MRI chest with contrast (71551) |
$622.36 |
$1,552 |
0.8× |
| MRI fetal sngl/1st gestation (74712) |
$555.39 |
$1,385 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$873.68 |
$2,178.75 |
2.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,161.82 |
$2,897.30 |
3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,091.72 |
$2,722.50 |
4.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$567.82 |
$1,416 |
2.3× |
| MRI orbit face neck w contrast (70542) |
$579.05 |
$1,444 |
1.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$567.82 |
$1,416 |
1.6× |
| MRI pelvis w/contrast (72196) |
$686.92 |
$1,713 |
1.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,239.53 |
$3,091.09 |
3.4× |
| MRI pelvis w/o contrast (72195) |
$804.81 |
$2,007 |
3.3× |
| MRI spectroscopy (76390) |
$594.69 |
$1,483 |
6.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,162.10 |
$2,898 |
3.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$560.60 |
$1,398 |
1.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,222.25 |
$3,048 |
3.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$550.98 |
$1,374 |
1.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,159.30 |
$2,891 |
3.2× |
| MRI temporomandibular joint (70336) |
$490.43 |
$1,223 |
2.0× |
| MRI thoracic spine w/o contrast (72146) |
$722.21 |
$1,801 |
2.9× |
| MRI up ext w/o contrast (73218) |
$1,091.72 |
$2,722.50 |
4.4× |
| MRI upper ext joint w/o contrast (73221) |
$823.94 |
$2,054.71 |
3.3× |
| MRI, joint upper extrem combo (73223) |
$1,115.99 |
$2,782.99 |
3.1× |
| Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) |
$1,903.95 |
$4,748 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,401.95 |
$3,496.11 |
1.0× |
| Myocardial spect single study at rest or stress (78451) |
$1,546.40 |
$3,856.34 |
1.2× |
| N-invas est c ffr sw aly CTA (75580) |
$2,063.55 |
$5,146 |
2.3× |
| Neck soft tissue (70360) |
$136.75 |
$341 |
1.5× |
| Nm cisternogram (78630) |
$906.26 |
$2,260 |
1.6× |
| Nm csf leak detection (78650) |
$1,546.26 |
$3,856 |
1.2× |
| Nm gastric emptying study (78264) |
$566.22 |
$1,412 |
1.4× |
| Nm peritoneal-venous shunt patency (78291) |
$492.83 |
$1,229 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,110.77 |
$10,251.29 |
2.9× |
| Nuclear Rx Oral Admin (79005) |
$311.58 |
$777 |
1.3× |
| Ob us nuchal meas 1 gest (76813) |
$346.99 |
$865.30 |
3.2× |
| Ophthalmic biometry by ultrasound echography, A-scan; Non-Facility (76516) |
$178.45 |
$445 |
1.7× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) |
$178.85 |
$446 |
1.7× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$235.79 |
$588 |
2.2× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter… (76510) |
$235.79 |
$588 |
1.7× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$243.22 |
$606.52 |
8.1× |
| Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) |
$193.69 |
$483 |
1.8× |
| Osseous survey limited (77074) |
$302.76 |
$755 |
2.8× |
| Parathyrd planar w/spect&CT (78072) |
$1,061.05 |
$2,646 |
1.9× |
| Parathyroid Planar Imaging (78070) |
$500.05 |
$1,247 |
1.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$872.18 |
$2,175 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$145.17 |
$362 |
1.3× |
| Perineogram (74775) |
$446.32 |
$1,113 |
1.8× |
| Peritoneogram after injection (74190) |
$600.70 |
$1,498 |
1.1× |
| PET image w/CT, skull-thigh (78815) |
$2,499.55 |
$6,233.28 |
1.7× |
| PET imaging for CT attenuation whole body (78816) |
$1,992.09 |
$4,967.80 |
1.3× |
| PET whole body (78813) |
$1,802 |
$4,493.75 |
1.2× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$1,799.24 |
$4,486.89 |
1.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,446.20 |
$8,594 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,928.41 |
$4,809 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$492.83 |
$1,229 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$589.07 |
$1,469 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$574.24 |
$1,432 |
1.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$145.60 |
$363.09 |
1.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$145.36 |
$362.50 |
1.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$182.86 |
$456.01 |
2.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$108.68 |
$271 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$153.59 |
$383 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$208.12 |
$519 |
1.9× |
| Radex fingr minimum 2 views (73140) |
$145.17 |
$362 |
1.6× |
| Radex Foot Compl Minimum 3 Views (73630) |
$147.16 |
$366.98 |
1.6× |
| Radex Hand Minimum 3 Views (73130) |
$143.18 |
$357.03 |
1.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$95.44 |
$238 |
1.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$147.17 |
$367 |
1.4× |
| Radex Humerus Minimum 2 Views (73060) |
$153.38 |
$382.50 |
1.7× |
| Radex Kne 1/2 Views (73560) |
$151.16 |
$376.93 |
1.7× |
| Radex Kne Compl 4/More Views (73564) |
$241.61 |
$602.50 |
2.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$198.50 |
$495 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$112.69 |
$281 |
1.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$281.91 |
$703 |
2.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$148.78 |
$371 |
1.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$99.45 |
$248 |
1.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$138.35 |
$345 |
1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$127.92 |
$319 |
1.4× |
| Radex Toe Minimum 2 Views (73660) |
$143.56 |
$358 |
1.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$177.95 |
$443.75 |
1.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$182.35 |
$454.73 |
2.0× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) |
$10,391.36 |
$25,913.61 |
1.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$8,479.15 |
$21,145 |
1.1× |
| Radiation treatment delivery level 1 (77402) |
$199.30 |
$497 |
1.9× |
| Radiation treatment delivery level 2 (77407) |
$431.08 |
$1,075 |
1.1× |
| Radiation treatment delivery level 3 (77412) |
$382.56 |
$954 |
0.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$100.25 |
$250 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$134.34 |
$335 |
1.2× |
| Radiologic exam chest 2 views (71046) |
$143.16 |
$356.99 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$320.80 |
$800 |
1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$301.16 |
$751 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$301.16 |
$751 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$302.36 |
$754 |
1.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$142.84 |
$356.19 |
1.6× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$113.89 |
$284 |
1.1× |
| Radiological examination surgical specimen (76098) |
$574.24 |
$1,432 |
1.0× |
| Ribs bilateral 3 views (71110) |
$138.35 |
$345 |
1.3× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$492.98 |
$1,229.36 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,545.32 |
$3,853.66 |
2.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,546.26 |
$3,856 |
2.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,703.45 |
$4,248 |
1.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,588.37 |
$3,961 |
1.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$283.11 |
$706 |
1.2× |
| Rp Therapy Intravenous Administration (79101) |
$312.78 |
$780 |
1.3× |
| Sacroiliac Joints < 3 Views (72200) |
$214.54 |
$535 |
2.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$445.52 |
$1,111 |
1.8× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$492.83 |
$1,229 |
1.2× |
| Scapula (73010) |
$172.94 |
$431.25 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$42.91 |
$107 |
1.8× |
| Shoulder 1 view (73020) |
$124.82 |
$311.25 |
1.4× |
| Simulation intermediate (77285) |
$582.26 |
$1,452 |
1.5× |
| Small bowel series (74250) |
$653.63 |
$1,630 |
3.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$690.70 |
$1,722.44 |
1.8× |
| Special dosimetry (77331) |
$393.03 |
$980.10 |
2.8× |
| Special Physics Consult (77370) |
$370.98 |
$925.12 |
2.7× |
| Special treatment procedure (77470) |
$890 |
$2,219.45 |
1.6× |
| Spine thoracic 3 views (72072) |
$182.46 |
$455 |
1.7× |
| Spleen imaging only (78185) |
$449.12 |
$1,120 |
1.1× |
| Splenoportograpy rs&i (75810) |
$3,470.66 |
$8,655 |
1.1× |
| Stereotactic Body Radiation Delivery (77373) |
$2,593.70 |
$6,468.04 |
1.4× |
| Superior sagittal sinus venogram (75870) |
$1,828.76 |
$4,560.50 |
0.6× |
| Tbs technical calculation only (77091) |
$93.81 |
$233.94 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$388.14 |
$967.90 |
1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$365.32 |
$911 |
0.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,059.79 |
$2,642.87 |
2.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$964.01 |
$2,404 |
6.9× |
| Thoracolumbar 2 views (72080) |
$108.68 |
$271 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$589.07 |
$1,469 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$471.18 |
$1,175 |
1.1× |
| Tmj unilateral (70328) |
$127.92 |
$319 |
1.4× |
| Treatment device complex (77334) |
$447.96 |
$1,117.10 |
1.2× |
| Treatment device intermediate (77333) |
$288.32 |
$719 |
2.1× |
| Treatment devices simple (77332) |
$264.14 |
$658.69 |
1.9× |
| Ultrasound breast complete (76641) |
$181.96 |
$453.75 |
1.7× |
| Ultrasound Exam Aaa Screen (76706) |
$161.22 |
$402.04 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$216.91 |
$540.92 |
2.0× |
| Umbilical-artery Doppler (OB) (76820) |
$213.74 |
$533 |
2.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$328.42 |
$819 |
3.7× |
| Unlisted fluoroscopic procedure (76496) |
$402.61 |
$1,004 |
4.5× |
| Unlisted magnetic resonance procedure (76498) |
$1,636.08 |
$4,080 |
18.2× |
| Urethrocystogram voiding (74455) |
$439.10 |
$1,095 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$445.52 |
$1,111 |
1.8× |
| Us breast unilateral limited (76642) |
$247.62 |
$617.50 |
2.8× |
| Us chest (76604) |
$178.40 |
$444.87 |
1.7× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$374.14 |
$933 |
1.7× |
| Us elastography parenchyma (76981) |
$162.01 |
$404 |
1.5× |
| Us encephalogram (76506) |
$170.03 |
$424 |
1.6× |
| Us hips infant static (76886) |
$173.24 |
$432 |
1.9× |
| Us infant hips w manipulation (76885) |
$178.45 |
$445 |
2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$252.63 |
$630 |
2.3× |
| Us ob detailed single fetus (76811) |
$402.40 |
$1,003.48 |
1.6× |
| Us ob limited (76815) |
$253.50 |
$632.17 |
2.3× |
| Us ob transvaginal (76817) |
$230.98 |
$576 |
2.1× |
| Us pelvic non ob complete (76856) |
$236.22 |
$589.08 |
2.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$227.19 |
$566.55 |
2.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$266.26 |
$663.98 |
2.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$392.18 |
$978 |
3.6× |
| Us retroperitoneal complete (76770) |
$229.78 |
$573 |
2.1× |
| Us retroperitoneal limited (76775) |
$232.18 |
$579 |
2.2× |
| Us scrotum and contents (76870) |
$248.21 |
$618.97 |
2.3× |
| Us soft tissue head/neck (76536) |
$247.82 |
$618 |
2.3× |
| Us spinal canal and contents (76800) |
$178.45 |
$445 |
1.7× |
| Us, eye b-scan (76512) |
$198.14 |
$494.11 |
1.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$223.36 |
$557 |
2.1× |
| Venogram extremity bilateral (75822) |
$1,721.50 |
$4,293 |
1.1× |
| Venogram Extremity Unilateral (75820) |
$1,452.03 |
$3,621 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,446.20 |
$8,594 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$1,452.03 |
$3,621 |
0.9× |
| Venography Renal Bilateral (75833) |
$3,446.20 |
$8,594 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$3,446.20 |
$8,594 |
1.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,446.20 |
$8,594 |
1.1× |
| Venous sampling by catheter (75893) |
$5,948.76 |
$14,834.80 |
1.0× |
| Wrist 2 views (73100) |
$146.03 |
$364.16 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$175.64 |
$438 |
2.0× |
| X-ray b.e. reductn intuss (74283) |
$313.19 |
$781 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$341.26 |
$851 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$146.87 |
$366.25 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$101.06 |
$252 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$164.41 |
$410 |
1.5× |
| X-ray exam of femur 2/> (73552) |
$137.85 |
$343.75 |
1.5× |
| X-ray eye for foreign body (70030) |
$121.91 |
$304 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$140.76 |
$351 |
1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$143.56 |
$358 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$263.86 |
$658 |
2.9× |
| X-ray leg, infant (73592) |
$178.95 |
$446.25 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$153.44 |
$382.62 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$149.58 |
$373 |
1.4× |
| X-ray nose-rectum child f.b. (76010) |
$122.71 |
$306 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$137.55 |
$343 |
1.3× |
| X-ray retrograde pyelogram (74420) |
$446.32 |
$1,113 |
1.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$111.08 |
$277 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$184.46 |
$460 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$230.18 |
$574 |
2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$134.34 |
$335 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$97.84 |
$243.98 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$155.59 |
$388 |
1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$254.64 |
$635 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$138.35 |
$345 |
1.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$155.19 |
$387 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$143.56 |
$358 |
1.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$158.40 |
$395 |
1.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$151.18 |
$377 |
1.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$140.35 |
$350 |
1.3× |
| Xr bone length studies (77073) |
$178.45 |
$445 |
1.7× |
| Xr c-spine 4 or 5 views (72050) |
$200.91 |
$501 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$144.77 |
$361 |
1.3× |
| Xr urogram antegrade (74425) |
$446.32 |
$1,113 |
1.2× |