| Abdomen 1 View (74018) |
$309.70 |
$326 |
3.7× |
| Abdomen 2 views (74019) |
$368.60 |
$388 |
3.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$4,313 |
$4,540 |
11.1× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$4,263.60 |
$4,488 |
3.4× |
| Angio internal mammary (75756) |
$1,918.05 |
$2,019 |
0.6× |
| Angio pulmonary bilat (75743) |
$1,546.60 |
$1,628 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,124.20 |
$2,236 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,850.60 |
$1,948 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,510.50 |
$1,590 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,650.15 |
$1,737 |
0.5× |
| Ankle 2 views (73600) |
$377.15 |
$397 |
4.5× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$1,429.75 |
$1,505 |
0.3× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$1,624.50 |
$1,710 |
0.3× |
| Artery X-Rays Adrenal Gland (75731) |
$1,990.25 |
$2,095 |
0.6× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$1,824 |
$1,920 |
0.3× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$2,246.75 |
$2,365 |
0.4× |
| Arthrogram hip (73525) |
$1,249.25 |
$1,315 |
3.7× |
| Arthrogram Wrist (73115) |
$1,388.90 |
$1,462 |
4.1× |
| Basic radiation dosimetry calculation (77300) |
$563.35 |
$593 |
4.3× |
| Bone age studies (77072) |
$238.45 |
$251 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$4,288.30 |
$4,514 |
11.0× |
| Bone Imaging Limited Area (78300) |
$2,153.65 |
$2,267 |
5.5× |
| Bone Imaging Multiple Areas (78305) |
$2,722.70 |
$2,866 |
7.0× |
| Bone Imaging Whole Body (78306) |
$3,007.70 |
$3,166 |
7.7× |
| Bone marrow imaging limited area (78102) |
$1,852.50 |
$1,950 |
4.8× |
| Bone survey infant (77076) |
$1,082.05 |
$1,139 |
10.7× |
| Brachytx isodose complex (77318) |
$3,359.20 |
$3,536 |
9.2× |
| Brachytx Isodose Plan Simple (77316) |
$1,910.45 |
$2,011 |
5.3× |
| Brain Flow Imaging Only (78610) |
$2,509.90 |
$2,642 |
4.8× |
| Brain Image W/Flow < 4 Views (78601) |
$2,702.75 |
$2,845 |
7.0× |
| Brain imaging < 4 static views (78600) |
$2,340.80 |
$2,464 |
6.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$4,759.50 |
$5,010 |
9.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$2,489 |
$2,620 |
4.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$18,032.90 |
$18,982 |
13.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$6,087.60 |
$6,408 |
18.0× |
| Cardiac Shunt Detection (78428) |
$2,047.25 |
$2,155 |
5.3× |
| Cerebrospinal Fluid Scan (78630) |
$4,326.30 |
$4,554 |
8.2× |
| Chest 1 view (71045) |
$189.05 |
$199 |
2.2× |
| Chest 2 views (71046) |
$353.40 |
$372 |
4.2× |
| Chest 3 views (71047) |
$446.50 |
$470 |
5.3× |
| Chest 4 or more views (71048) |
$456 |
$480 |
4.5× |
| Clavicle complete (73000) |
$330.60 |
$348 |
3.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$290.80 |
$306.10 |
2.9× |
| Continuing medical physics consltj pr wk (77336) |
$1,294.85 |
$1,363 |
9.9× |
| Contrast Exam Abdominl Aorta (75625) |
$1,418.35 |
$1,493 |
0.5× |
| Contrast X-Ray Bladder (74430) |
$366.70 |
$386 |
1.1× |
| Contrast X-Ray Of Elbow (73085) |
$1,179.90 |
$1,242 |
3.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,537.10 |
$1,618 |
4.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,219.30 |
$5,494 |
15.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,302.80 |
$2,424 |
9.9× |
| CT abdomen w contrast (74160) |
$3,458.95 |
$3,641 |
20.3× |
| CT abdomen w wo contrast (74170) |
$3,988.10 |
$4,198 |
23.4× |
| CT abdomen w/o contrast (74150) |
$1,842.05 |
$1,939 |
18.1× |
| CT Angio Abdomen and Pelvis (74174) |
$5,744.65 |
$6,047 |
17.0× |
| CT Angio Chest (71275) |
$4,307.30 |
$4,534 |
25.3× |
| CT Angio Head (70496) |
$3,397.20 |
$3,576 |
19.9× |
| CT angio hrt w/3d image (75574) |
$4,873.50 |
$5,130 |
14.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$4,886.80 |
$5,144 |
28.7× |
| CT Angio Neck (70498) |
$3,333.55 |
$3,509 |
19.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$4,884.90 |
$5,142 |
28.7× |
| CT cervical spine w/ contrast (72126) |
$2,753.10 |
$2,898 |
8.1× |
| CT cervical spine w/o contrast (72125) |
$1,834.45 |
$1,931 |
18.1× |
| CT cervical spine w/wo cont (72127) |
$3,391.50 |
$3,570 |
19.9× |
| CT chest w contrast (71260) |
$3,437.10 |
$3,618 |
20.2× |
| CT chest w/wo contrast (71270) |
$4,237 |
$4,460 |
24.9× |
| CT colonography screening (74263) |
$3,979.55 |
$4,189 |
17.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$4,822.20 |
$5,076 |
28.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$2,296.15 |
$2,417 |
22.6× |
| CT head/brain with contrast (70460) |
$1,707.15 |
$1,797 |
10.0× |
| CT head/brain without and with contrast (70470) |
$2,090.95 |
$2,201 |
12.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$4,085.95 |
$4,301 |
12.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$263.15 |
$277 |
3.1× |
| CT hrt w/3d image congen (75573) |
$4,837.40 |
$5,092 |
14.3× |
| CT iac w contrast (70481) |
$3,367.75 |
$3,545 |
19.8× |
| CT l-spine w&w/o contrast (72133) |
$4,275.95 |
$4,501 |
25.1× |
| CT lower ext w/o (73700) |
$2,301.85 |
$2,423 |
22.7× |
| CT lower extremity w/contrast material (73701) |
$3,477.95 |
$3,661 |
20.4× |
| CT lumbar spine w contrast (72132) |
$3,475.10 |
$3,658 |
10.3× |
| CT lumbar spine w/o contrast (72131) |
$2,301.85 |
$2,423 |
22.7× |
| CT maxillofacial w contrast (70487) |
$1,833.50 |
$1,930 |
10.8× |
| CT maxillofacial wo contrast (70486) |
$1,591.25 |
$1,675 |
15.7× |
| CT neck tissue combo (70492) |
$3,345.90 |
$3,522 |
19.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,724.95 |
$3,921 |
21.9× |
| CT orbits w/o contrast (70480) |
$1,834.45 |
$1,931 |
18.1× |
| CT pelvis w&w/o contrast (72194) |
$4,119.20 |
$4,336 |
24.2× |
| CT pelvis w/o contrast (72192) |
$1,890.50 |
$1,990 |
18.6× |
| CT scan of leg combo (73702) |
$4,396.60 |
$4,628 |
25.8× |
| CT scans face/jaw combo (70488) |
$2,300.90 |
$2,422 |
13.5× |
| CT soft tissue neck w contrast (70491) |
$2,720.80 |
$2,864 |
16.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,834.45 |
$1,931 |
18.1× |
| CT thoracic spine w contrast (72129) |
$3,484.60 |
$3,668 |
20.5× |
| CT thoracic spine w/o contrast (72128) |
$2,301.85 |
$2,423 |
22.7× |
| CT thoracic spine w/wo cont (72130) |
$4,311.10 |
$4,538 |
25.3× |
| CT thorax w/o contrast (71250) |
$2,314.20 |
$2,436 |
22.8× |
| CT unlisted procedure (76497) |
$685.90 |
$722 |
8.1× |
| CT upper ext wo (73200) |
$2,301.85 |
$2,423 |
22.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$4,450.75 |
$4,685 |
26.1× |
| CT upper extremity with contrast (73201) |
$3,387.70 |
$3,566 |
10.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,886.80 |
$5,144 |
28.7× |
| Cta Abdomen (74175) |
$4,472.60 |
$4,708 |
26.3× |
| CTA pelvis (72191) |
$6,355.50 |
$6,690 |
37.3× |
| Dilation ureters/urethra rs&i (74485) |
$1,140.95 |
$1,201 |
0.6× |
| Diskography lumbar (72295) |
$969 |
$1,020 |
0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$431.30 |
$454 |
4.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$811.30 |
$854 |
8.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$992.75 |
$1,045 |
9.8× |
| Dxa Bone Density Axial (77080) |
$550.05 |
$579 |
5.4× |
| Dxa bone density study (77085) |
$705.85 |
$743 |
7.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$300.20 |
$316 |
3.6× |
| Echo exam of fetal heart (76825) |
$3,340.20 |
$3,516 |
6.3× |
| Echo exam uterus (76831) |
$1,410.75 |
$1,485 |
6.1× |
| Echo Guide For Artery Repair (76936) |
$3,032.40 |
$3,192 |
14.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$2,118.50 |
$2,230 |
9.1× |
| Esophagram (74220) |
$1,120.05 |
$1,179 |
6.6× |
| Fetal Biophys Profile W/Nst (76818) |
$1,174.20 |
$1,236 |
11.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$855.95 |
$901 |
8.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$5,652.50 |
$5,950 |
24.4× |
| Fluoroscopy up to 1 hr (76000) |
$661.20 |
$696 |
2.9× |
| Follow-Up Angiography (75898) |
$729.60 |
$768 |
0.2× |
| Foot 2 views (73620) |
$318.25 |
$335 |
3.8× |
| Forearm 2 views (73090) |
$300.20 |
$316 |
3.6× |
| Gastric emptying imaging study (78264) |
$4,275.95 |
$4,501 |
11.0× |
| Gastroesophageal Reflux Exam (78262) |
$3,513.10 |
$3,698 |
9.0× |
| Gated Heart Planar Single (78472) |
$2,603 |
$2,740 |
6.7× |
| Gated Heart, Multiple (78473) |
$3,219.55 |
$3,389 |
8.3× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$6,051.50 |
$6,370 |
11.5× |
| Hand 2 views (73120) |
$308.75 |
$325 |
3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$6,640.50 |
$6,990 |
9.8× |
| Heart Image (Pet) Multiple (78492) |
$15,222.80 |
$16,024 |
11.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,550.40 |
$1,632 |
0.5× |
| Hepatobil Syst Image W/Drug (78227) |
$4,565.70 |
$4,806 |
8.7× |
| Hepatobiliary System Imaging (78226) |
$4,239.85 |
$4,463 |
10.9× |
| Ht Muscle Image Spect Sing (78451) |
$3,926.35 |
$4,133 |
3.1× |
| Hysterosalpingogram (74740) |
$1,294.85 |
$1,363 |
5.6× |
| Image fusion (77399) |
$323.66 |
$340.70 |
2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,573.20 |
$1,656 |
18.6× |
| Infant hip ultrasound, limited static exam (76886) |
$1,316.70 |
$1,386 |
15.6× |
| Interstitial radiation source applic complex (77778) |
$6,113.25 |
$6,435 |
9.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$8,748.55 |
$9,209 |
12.9× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$7,875.50 |
$8,290 |
14.7× |
| Intracavitary radiation source applic simple (77761) |
$4,375.70 |
$4,606 |
8.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,651.10 |
$1,738 |
3.1× |
| K Flow/Funct Image W/O Drug (78707) |
$2,671.40 |
$2,812 |
5.1× |
| Kidney Imaging Morphol (78700) |
$2,148.90 |
$2,262 |
5.5× |
| Knee 3 Views (73562) |
$460.75 |
$485 |
5.5× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$1,526.65 |
$1,607 |
3.9× |
| Liver & Spleen Imaging Static Only (78215) |
$2,456.70 |
$2,586 |
6.3× |
| Liver imaging static only (78201) |
$2,402.55 |
$2,529 |
4.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$3,838 |
$4,040 |
7.3× |
| Lung perfusion differential (78597) |
$2,384.50 |
$2,510 |
6.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$4,047.95 |
$4,261 |
7.7× |
| Lung Ventilation Imaging (78579) |
$2,331.30 |
$2,454 |
6.0× |
| Lymph System Imaging (78195) |
$4,295.90 |
$4,522 |
8.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$3,911.15 |
$4,117 |
2.6× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$3,280.35 |
$3,453 |
5.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$6,360.25 |
$6,695 |
2.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$4,212.30 |
$4,434 |
1.4× |
| Magnetic Image Jaw Joint (70336) |
$5,069.20 |
$5,336 |
21.9× |
| Mammary ductogram or galactogram multiple (77054) |
$525.35 |
$553 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$388.55 |
$409 |
1.7× |
| Meckels Divert Exam (78290) |
$4,313.95 |
$4,541 |
11.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,732.90 |
$4,982 |
13.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$186.20 |
$196 |
6.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$7,390.05 |
$7,779 |
21.8× |
| MRA head w/o contrast (70544) |
$4,424.15 |
$4,657 |
19.1× |
| MRA head with contrast (70545) |
$5,343.75 |
$5,625 |
15.8× |
| MRA neck w contrast (70548) |
$5,768.40 |
$6,072 |
17.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$7,390.05 |
$7,779 |
21.8× |
| MRA neck w/o contrast (70547) |
$4,424.15 |
$4,657 |
19.1× |
| MRI abdomen w contrast (74182) |
$7,544.90 |
$7,942 |
22.3× |
| MRI abdomen w/o contrast (74181) |
$5,333.30 |
$5,614 |
23.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$6,188.30 |
$6,514 |
8.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$7,436.60 |
$7,828 |
21.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$6,131.30 |
$6,454 |
8.1× |
| MRI bone marrow blood supply (77084) |
$5,638.25 |
$5,935 |
24.3× |
| MRI brain functional w/o physician admnistration (70554) |
$5,638.25 |
$5,935 |
24.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,631.85 |
$3,823 |
15.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$3,640.40 |
$3,832 |
15.7× |
| MRI cardiac w/o contrast (75557) |
$4,185.70 |
$4,406 |
18.1× |
| MRI cervical spine w contrast (72142) |
$3,853.20 |
$4,056 |
11.4× |
| MRI cervical spine w/o cont (72141) |
$2,436.75 |
$2,565 |
10.5× |
| MRI chest w/o contrast (71550) |
$5,592.65 |
$5,887 |
24.1× |
| MRI chest with contrast (71551) |
$7,710.20 |
$8,116 |
10.1× |
| MRI chest wo w contrast (71552) |
$9,272 |
$9,760 |
27.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$6,634.80 |
$6,984 |
19.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$8,151 |
$8,580 |
24.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,643 |
$5,940 |
24.3× |
| MRI lumbar spine w contrast (72149) |
$4,744.30 |
$4,994 |
14.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,316.80 |
$4,544 |
12.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,464.05 |
$4,699 |
19.3× |
| MRI orbit face neck w contrast (70542) |
$5,225 |
$5,500 |
15.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$6,314.65 |
$6,647 |
18.6× |
| MRI pelvis w contrast (72196) |
$6,673.75 |
$7,025 |
19.7× |
| MRI pelvis w/o & w contrast (72197) |
$8,094.95 |
$8,521 |
23.9× |
| MRI pelvis w/o contrast (72195) |
$5,599.30 |
$5,894 |
24.2× |
| MRI spectroscopy (76390) |
$4,216.10 |
$4,438 |
49.9× |
| MRI thoracic spine w/o contrast (72146) |
$3,078 |
$3,240 |
13.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$6,639.55 |
$6,989 |
19.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$5,643 |
$5,940 |
24.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$8,100.65 |
$8,527 |
23.9× |
| MRI, abdomen, combo (74183) |
$8,112.05 |
$8,539 |
23.9× |
| MRI, dorsal spine combo (72157) |
$5,459.65 |
$5,747 |
16.1× |
| MRI, dorsal spine contrast (72147) |
$4,818.40 |
$5,072 |
14.2× |
| MRI, joint upper extrem (73221) |
$3,437.10 |
$3,618 |
14.8× |
| MRI, joint upper extrem combo (73223) |
$7,409.05 |
$7,799 |
21.9× |
| MRI, lumbar spine combo (72158) |
$5,441.60 |
$5,728 |
16.1× |
| Myelography thoracic (72255) |
$864.50 |
$910 |
1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$18,018.65 |
$18,967 |
14.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,670.80 |
$3,864 |
2.9× |
| Myocardial Spect Multiple Studies (78452) |
$5,642.05 |
$5,939 |
4.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$191.90 |
$202 |
0.1× |
| N-invas est c ffr sw aly CTA (75580) |
$16,364.70 |
$17,226 |
19.6× |
| Neck soft tissue (70360) |
$335.35 |
$353 |
4.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$2,484.25 |
$2,615 |
6.6× |
| Nm csf leak detection (78650) |
$4,307.30 |
$4,534 |
3.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$25,232 |
$26,560 |
18.8× |
| Nuclear Rx Intra-Arterial (79445) |
$705.85 |
$743 |
3.1× |
| Nuclear Rx Oral Admin (79005) |
$678.30 |
$714 |
3.0× |
| Ob us nuchal meas 1 gest (76813) |
$1,040.25 |
$1,095 |
10.2× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$588.05 |
$619 |
5.8× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$1,408.85 |
$1,483 |
10.9× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$825.55 |
$869 |
8.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$1,633.05 |
$1,719 |
16.1× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$174.80 |
$184 |
6.2× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$839.80 |
$884 |
8.3× |
| Panoramic X-ray of jaws (70355) |
$160.55 |
$169 |
1.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$4,878.25 |
$5,135 |
9.2× |
| Parathyroid Planar Imaging (78070) |
$3,744.90 |
$3,942 |
9.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$4,322.50 |
$4,550 |
11.1× |
| Pelvis 1 or 2 views (72170) |
$399 |
$420 |
3.9× |
| Peritoneogram Rs&I (74190) |
$902.50 |
$950 |
1.7× |
| Pet Image W/Ct Lmtd (78814) |
$17,951.20 |
$18,896 |
12.9× |
| PET image w/CT, full body (78816) |
$17,919.85 |
$18,863 |
12.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$17,902.75 |
$18,845 |
12.9× |
| Pet Myocardial Sngl Study (78491) |
$5,874.80 |
$6,184 |
4.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,527.60 |
$1,608 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,926 |
$3,080 |
7.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$486.40 |
$512 |
4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$494 |
$520 |
0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$394.25 |
$415 |
4.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$331.55 |
$349 |
3.9× |
| Radex elbow complete minimum 3 views (73080) |
$390.45 |
$411 |
4.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$493.05 |
$519 |
4.9× |
| Radex fingr minimum 2 views (73140) |
$426.55 |
$449 |
5.0× |
| Radex foot complete minimum 3 views (73630) |
$362.90 |
$382 |
4.3× |
| Radex Hand Minimum 3 Views (73130) |
$380 |
$400 |
4.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$344.85 |
$363 |
4.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$657.40 |
$692 |
6.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$414.20 |
$436 |
4.9× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$1,033.60 |
$1,088 |
12.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$379.05 |
$399 |
4.5× |
| Radex shoulder complete minimum 2 views (73030) |
$337.25 |
$355 |
4.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$361.95 |
$381 |
4.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$3,286.05 |
$3,459 |
19.3× |
| Radex Spine 1 View Specify Level (72020) |
$250.80 |
$264 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$336.30 |
$354 |
4.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$602.30 |
$634 |
7.1× |
| Radex Toe Minimum 2 Views (73660) |
$378.10 |
$398 |
4.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$331.55 |
$349 |
3.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$462.65 |
$487 |
5.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,065.90 |
$1,122 |
10.5× |
| Radiation treatment delivery level 1 (77402) |
$2,376.90 |
$2,502 |
24.0× |
| Radiation treatment delivery level 3 (77412) |
$4,343.40 |
$4,572 |
8.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$437 |
$460 |
4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$436.05 |
$459 |
4.3× |
| Radiologic exam colon double contrast study (74280) |
$2,807.25 |
$2,955 |
16.5× |
| Radiologic exam colon single contrast study (74270) |
$1,736.60 |
$1,828 |
10.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,257.80 |
$1,324 |
7.4× |
| Radiologic exam knee complete 4/more views (73564) |
$487.35 |
$513 |
4.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$480.70 |
$506 |
4.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,388.90 |
$1,462 |
8.2× |
| Radiologic exam swallow function contrast study (74230) |
$1,712.85 |
$1,803 |
10.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,590.30 |
$1,674 |
9.3× |
| Radiologic examination femur 1 view (73551) |
$340.10 |
$358 |
4.0× |
| Radiologic examination femur minimum 2 views (73552) |
$402.80 |
$424 |
4.8× |
| Radiologic examination knee 1/2 views (73560) |
$395.20 |
$416 |
4.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$733.40 |
$772 |
7.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$353.40 |
$372 |
4.2× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$154.85 |
$163 |
1.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$4,608.45 |
$4,851 |
12.3× |
| Renal Cyst Study (74470) |
$869.25 |
$915 |
1.6× |
| Ribs bilateral 3 views (71110) |
$413.25 |
$435 |
4.1× |
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines |
$211.85–$238.25 |
$223–$250.79 |
varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,181.55 |
$3,349 |
8.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$7,411.90 |
$7,802 |
14.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$4,064.10 |
$4,278 |
7.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$4,155.30 |
$4,374 |
7.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$8,720.05 |
$9,179 |
6.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$11,533.95 |
$12,141 |
8.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$5,853.90 |
$6,162 |
4.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,359.45 |
$1,431 |
6.0× |
| Rp Therapy Intravenous Administration (79101) |
$669.75 |
$705 |
3.0× |
| Salivary Gland Function Study (78232) |
$1,132.40 |
$1,192 |
2.9× |
| Salivary Gland Imaging Serial Images (78231) |
$1,495.30 |
$1,574 |
3.9× |
| Scapula (73010) |
$365.75 |
$385 |
3.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$54.15 |
$57 |
2.3× |
| Sella turcica (70240) |
$350.55 |
$369 |
4.1× |
| Shoulder 1 view (73020) |
$262.20 |
$276 |
3.1× |
| Shoulder Arthrography (73040) |
$1,251.15 |
$1,317 |
3.7× |
| Skull less than 4 views (70250) |
$409.45 |
$431 |
4.0× |
| Special dosimetry (77331) |
$308.75 |
$325 |
2.4× |
| Special Physics Consult (77370) |
$1,984.55 |
$2,089 |
15.2× |
| Special teletherapy port plan (77321) |
$712.50 |
$750 |
2.0× |
| Special treatment procedure (77470) |
$783.75 |
$825 |
1.5× |
| Speech evaluation, complex (70371) |
$828.40 |
$872 |
3.6× |
| Spleen Imaging (78185) |
$2,767.35 |
$2,913 |
7.1× |
| Srs Multisource (77371) |
$107,815.50 |
$113,490 |
15.1× |
| Stereotactic Body Radiation Delivery (77373) |
$22,463.70 |
$23,646 |
12.9× |
| Sternoclavicular joints (71130) |
$435.10 |
$458 |
5.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$1,002.25 |
$1,055 |
10.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,309.45 |
$2,431 |
6.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,268.25 |
$1,335 |
3.5× |
| Testicular Imaging W/Flow (78761) |
$2,488.05 |
$2,619 |
6.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$7,164.90 |
$7,542 |
19.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$3,932.05 |
$4,139 |
30.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,756.55 |
$1,849 |
10.3× |
| Thoracic spine 2 views (72070) |
$397.10 |
$418 |
3.9× |
| Thoracic spine 3 views (72072) |
$411.35 |
$433 |
4.1× |
| Thoracolumbar 2 views (72080) |
$342.95 |
$361 |
4.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$2,687.55 |
$2,829 |
6.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$2,463.35 |
$2,593 |
6.3× |
| Thyroid Met Imaging Body (78018) |
$3,909.25 |
$4,115 |
7.4× |
| Thyroid Uptake Measurement (78012) |
$993.70 |
$1,046 |
2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$3,121.70 |
$3,286 |
8.0× |
| Tx Devices Design & Construction Complex (77334) |
$2,751.20 |
$2,896 |
7.6× |
| Tx devices design & construction intermediate (77333) |
$160.55 |
$169 |
1.2× |
| Tx devices design & construction simple (77332) |
$893.95 |
$941 |
6.8× |
| Ultrasound Breast Limited (76642) |
$944.30 |
$994 |
11.2× |
| Ultrasound Elastography Parenchyma (76981) |
$1,349 |
$1,420 |
13.3× |
| Ultrasound Exam Aaa Screen (76706) |
$1,152.35 |
$1,213 |
11.3× |
| Ultrasound, abdomen limited (76705) |
$1,072.55 |
$1,129 |
10.6× |
| Umbilical-artery Doppler (OB) (76820) |
$372.40 |
$392 |
3.7× |
Unlisted Dx Radiographic Procedure (76499)
range across 3 matching MRF lines |
$47.02–$122.64 |
$49.50–$129.10 |
varies |
Unlisted magnetic resonance procedure (76498)
range across 5 matching MRF lines |
$2,681.85–$14,606.25 |
$2,823–$15,375 |
varies |
| Upper gi w/o kub (74240) |
$1,334.75 |
$1,405 |
7.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$154.85 |
$163 |
14.0× |
| Urea breath test c-14 isotopic analysis (78268) |
$1,287.25 |
$1,355 |
13.6× |
| Ureteral Reflux Study (78740) |
$2,725.55 |
$2,869 |
7.0× |
| Urethrocystogram voiding (74455) |
$1,116.25 |
$1,175 |
4.8× |
| Urethrocystography retrograde (74450) |
$1,005.10 |
$1,058 |
4.3× |
| Us breast unilateral complete (76641) |
$1,224.55 |
$1,289 |
12.1× |
| Us chest (76604) |
$1,063.05 |
$1,119 |
10.5× |
| Us complete joint (76881) |
$1,441.15 |
$1,517 |
14.2× |
| Us exam, pelvic, limited (76857) |
$393.30 |
$414 |
3.9× |
| Us head (76506) |
$1,492.45 |
$1,571 |
14.7× |
| Us kidney transplant (76776) |
$2,057.70 |
$2,166 |
20.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$195.70 |
$206 |
1.9× |
| Us ob detailed single fetus (76811) |
$1,467.75 |
$1,545 |
6.3× |
| Us ob limited 1 or more fetuses (76815) |
$902.50 |
$950 |
8.9× |
| Us ob transvaginal (76817) |
$1,024.10 |
$1,078 |
10.1× |
| Us pelvic non ob complete (76856) |
$1,308.15 |
$1,377 |
12.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,274.90 |
$1,342 |
12.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$1,252.10 |
$1,318 |
12.3× |
| Us retroperitoneal complete (76770) |
$1,330.95 |
$1,401 |
13.1× |
| Us retroperitoneal limited (76775) |
$497.80 |
$524 |
4.9× |
| Us scrotum and contents (76870) |
$615.60 |
$648 |
6.1× |
| Us spinal canal and contents (76800) |
$1,398.40 |
$1,472 |
13.8× |
| Us thyroid (76536) |
$1,525.70 |
$1,606 |
15.0× |
| Us transrectal (76872) |
$1,648.25 |
$1,735 |
16.2× |
| Vein X-Ray Chest (75827) |
$1,424.05 |
$1,499 |
0.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,538.05 |
$1,619 |
0.5× |
| Vein X-Ray Spleen/Liver (75810) |
$8,679.20 |
$9,136 |
2.8× |
| Venogram Sinus/Jugular (75860) |
$1,501 |
$1,580 |
0.5× |
| Venography Adrenal Unilateral (75840) |
$1,587.45 |
$1,671 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,378.45 |
$1,451 |
0.4× |
| Venography extremity bilateral rs&i (75822) |
$1,464.90 |
$1,542 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,386.05 |
$1,459 |
0.9× |
| Venography Renal Bilateral (75833) |
$1,603.60 |
$1,688 |
0.5× |
| Venography Renal Unilateral (75831) |
$1,480.10 |
$1,558 |
0.5× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$1,592.20 |
$1,676 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$461.70 |
$486 |
5.5× |
| Wrist 2 views (73100) |
$358.15 |
$377 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$432.25 |
$455 |
5.1× |
| X-ray antegrade pyelogram tube (74425) |
$899.65 |
$947 |
2.7× |
| X-Ray Aorta Leg Arteries (75630) |
$1,429.75 |
$1,505 |
0.5× |
| X-Ray Bend Only L-S Spine (72120) |
$507.30 |
$534 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$330.60 |
$348 |
3.9× |
| X-Ray Exam Breast Specimen (76098) |
$152 |
$160 |
0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$447.45 |
$471 |
5.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$807.50 |
$850 |
8.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$880.65 |
$927 |
8.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$351.50 |
$370 |
4.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$528.20 |
$556 |
6.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$650.75 |
$685 |
6.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$492.10 |
$518 |
4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$589 |
$620 |
5.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$713.45 |
$751 |
7.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$382.85 |
$403 |
4.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$670.70 |
$706 |
6.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$393.30 |
$414 |
3.9× |
| X-ray eye for foreign body (70030) |
$331.55 |
$349 |
3.9× |
| X-ray head for orthodontia (70350) |
$168.15 |
$177 |
2.0× |
| X-ray humerus (73060) |
$358.15 |
$377 |
4.2× |
| X-ray IV pyelogram (ivp) (74400) |
$1,905.70 |
$2,006 |
11.2× |
| X-ray IV pyelogram+tomography (74415) |
$1,945.60 |
$2,048 |
11.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$412.30 |
$434 |
4.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$473.10 |
$498 |
5.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$416.10 |
$438 |
4.1× |
| X-ray nose-rectum child f.b. (76010) |
$287.85 |
$303 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$542.45 |
$571 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$407.55 |
$429 |
4.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$505.40 |
$532 |
5.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$339.15 |
$357 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$432.25 |
$455 |
5.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$486.40 |
$512 |
4.8× |
| X-ray thoracic spine 4 vw (72074) |
$494.95 |
$521 |
4.9× |
| X-Ray Tmj Unilat (70328) |
$375.25 |
$395 |
4.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,811.65 |
$1,907 |
5.3× |
| X-Rays Bone Length Studies (77073) |
$376.20 |
$396 |
3.7× |
| X-Rays Bone Survey Complete (77075) |
$1,060.20 |
$1,116 |
10.4× |
| Xr c-spine 4 or 5 views (72050) |
$510.15 |
$537 |
5.0× |
| Xr facial bones less than 3 views (70140) |
$327.75 |
$345 |
3.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$432.25 |
$455 |
4.3× |
| Xr orbits complete 4 views (70200) |
$486.40 |
$512 |
4.8× |
| Xr Tomogram Single Plane (76100) |
$1,042.15 |
$1,097 |
10.3× |