| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,587.85 |
$11,725 |
2.4× |
| Abdomen 2 views (74019) |
$230.42 |
$753 |
2.1× |
| Acute gi blood loss imaging (78278) |
$1,308.15 |
$4,275 |
3.1× |
| Angiography extremity bilateral rs&i (75716) |
$3,738.40 |
$12,217 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$2,773.58 |
$9,064 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$1,595.18 |
$5,213 |
0.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,398.74 |
$11,107 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,600.40 |
$11,766 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,883.44 |
$9,423 |
0.9× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,179.64 |
$7,123 |
0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,884.06 |
$12,693 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,147.19 |
$3,749 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,525.10 |
$4,984 |
0.5× |
| Ankle 2 views (73600) |
$184.21 |
$602 |
2.0× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,104.67 |
$6,878 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,703.51 |
$8,835 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$3,115.69 |
$10,182 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$1,707.48 |
$5,580 |
0.5× |
| Basic dosimetry (77300) |
$297.43 |
$972 |
2.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$605.27 |
$1,978 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$911.27 |
$2,978 |
2.1× |
| Bone age studies (77072) |
$180.54 |
$590 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,116.59 |
$3,649 |
2.6× |
| Bone Marrow Imaging Limited Area (78102) |
$615.06 |
$2,010 |
1.4× |
| Bone survey complete (77075) |
$571.91 |
$1,869 |
5.1× |
| Bone survey infant (77076) |
$231.95 |
$758 |
2.1× |
| Bowel imaging (78290) |
$903.01 |
$2,951 |
2.1× |
| Brachytx isodose complex (77318) |
$1,993.59 |
$6,515 |
5.0× |
| Brachytx isodose intermed (77317) |
$1,993.59 |
$6,515 |
5.0× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$647.19 |
$2,115 |
1.6× |
| Brain imaging < 4 static views (78600) |
$375.16 |
$1,226 |
0.9× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$471.85 |
$1,542 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,603.46 |
$11,776 |
2.4× |
| Brain Imaging Vascular Flow Only (78610) |
$388.93 |
$1,271 |
0.7× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,057.23 |
$3,455 |
2.5× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$2,300.81 |
$7,519 |
2.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,814.89 |
$5,931 |
4.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$753.68 |
$2,463 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$224.60 |
$734 |
2.4× |
| Chest 1 view (71045) |
$171.05 |
$559 |
1.8× |
| Chest xray 3 views (71047) |
$226.13 |
$739 |
2.4× |
| Cholecystography, oral contrast Non-Facility (74290) |
$433.30 |
$1,416 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$473.38 |
$1,547 |
2.5× |
| Cineradiography/videoradiography (76120) |
$148.41 |
$485 |
1.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$357.71 |
$1,169 |
0.4× |
| Clavicle complete (73000) |
$184.52 |
$603 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$122.71 |
$401 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$453.49 |
$1,482 |
3.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,291.94 |
$7,490 |
6.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,926.27 |
$6,295 |
7.6× |
| CT abdomen w contrast (74160) |
$1,135.26 |
$3,710 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,383.73 |
$4,522 |
7.4× |
| CT abdomen w/o contrast (74150) |
$862 |
$2,817 |
7.7× |
| CT angio hrt w/3d image (75574) |
$569.47 |
$1,861 |
1.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,265 |
$4,134 |
6.8× |
| CT angiography upper extremity lt (73206) |
$1,158.21 |
$3,785 |
6.2× |
| CT c-spine w/contrast (72126) |
$1,050.19 |
$3,432 |
2.8× |
| CT c-spine w/o contrast (72125) |
$910.35 |
$2,975 |
8.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,471.86 |
$4,810 |
7.9× |
| CT chest w contrast (71260) |
$1,429.02 |
$4,670 |
7.6× |
| CT chest w/wo contrast (71270) |
$1,569.47 |
$5,129 |
8.4× |
| CT colonography screening (74263) |
$1,365.68 |
$4,463 |
5.4× |
| CT colonography w/o cntrst (74261) |
$1,200.13 |
$3,922 |
10.8× |
| CT head/brain with contrast (70460) |
$1,117.51 |
$3,652 |
6.0× |
| CT head/brain without and with contrast (70470) |
$1,273.57 |
$4,162 |
6.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$574.36 |
$1,877 |
1.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$176.26 |
$576 |
1.9× |
| CT hrt w/3d image congen (75573) |
$539.78 |
$1,764 |
1.4× |
| CT iac w contrast (70481) |
$1,117.51 |
$3,652 |
6.0× |
| CT limited/localized follow up study (76380) |
$372.71 |
$1,218 |
4.0× |
| CT lower ext w/o (73700) |
$868.43 |
$2,838 |
7.8× |
| CT lower extremity w wo contrast (73702) |
$1,288.57 |
$4,211 |
6.9× |
| CT lower extremity w/contrast material (73701) |
$1,081.40 |
$3,534 |
5.8× |
| CT lumbar spine w & w/o contrast (72133) |
$1,361.70 |
$4,450 |
7.3× |
| CT lumbar spine w/contrast (72132) |
$1,195.24 |
$3,906 |
3.2× |
| CT lumbar spine w/o contrast (72131) |
$943.40 |
$3,083 |
8.5× |
| CT maxillofacial w contrast (70487) |
$1,117.51 |
$3,652 |
6.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,273.57 |
$4,162 |
6.8× |
| CT maxillofacial wo contrast (70486) |
$826.20 |
$2,700 |
7.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,456.56 |
$4,760 |
7.8× |
| CT orbits w/o contrast (70480) |
$905.76 |
$2,960 |
8.1× |
| CT pelvis w/o contrast (72192) |
$855.88 |
$2,797 |
7.7× |
| CT pelvis w/wo contrast (72194) |
$1,257.97 |
$4,111 |
6.7× |
| CT scan of arm combo (73202) |
$1,090.89 |
$3,565 |
5.8× |
| CT soft tissue neck w contrast (70491) |
$1,117.51 |
$3,652 |
6.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,273.57 |
$4,162 |
6.8× |
| CT soft tissue neck w/o contrast (70490) |
$826.20 |
$2,700 |
7.4× |
| CT thoracic spine w/contrast (72129) |
$1,119.65 |
$3,659 |
6.0× |
| CT thoracic spine w/o contrast (72128) |
$932.99 |
$3,049 |
8.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,528.47 |
$4,995 |
8.2× |
| CT thorax w/o contrast (71250) |
$464.81 |
$1,519 |
4.2× |
| CT upper ext wo (73200) |
$809.37 |
$2,645 |
7.3× |
| CT upper extremity with contrast (73201) |
$1,037.95 |
$3,392 |
2.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,714.21 |
$5,602 |
9.2× |
| Cta Abdomen (74175) |
$1,429.33 |
$4,671 |
7.6× |
| CTA abdomen pelvis (74174) |
$2,013.79 |
$6,581 |
5.4× |
| CTA chest (71275) |
$1,477.98 |
$4,830 |
7.9× |
| Cta Head (70496) |
$1,823.76 |
$5,960 |
9.7× |
| Cta Neck (70498) |
$1,823.76 |
$5,960 |
9.7× |
| Cta Pelvis (72191) |
$1,420.45 |
$4,642 |
7.6× |
| Cystography minimum 3 views rs&i (74430) |
$401.78 |
$1,313 |
1.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$234.09 |
$765 |
0.9× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$567.63 |
$1,855 |
0.3× |
| Diskography lumbar (72295) |
$1,024.18 |
$3,347 |
0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$242.35 |
$792 |
2.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$384.95 |
$1,258 |
3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$281.83 |
$921 |
2.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$225.22 |
$736 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$146.88 |
$480 |
1.6× |
| Dxa bone density study axial skeleton (77085) |
$195.84 |
$640 |
1.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$314.26 |
$1,027 |
1.2× |
| Esophagus (74220) |
$453.19 |
$1,481 |
2.4× |
| Facial bones min 3 views (70150) |
$275.71 |
$901 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$254.90 |
$833 |
2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$279.38 |
$913 |
2.5× |
| Fetal Echo (76825) |
$488.07 |
$1,595 |
0.8× |
| Fluoroscopy up to 1 hr (76000) |
$455.63 |
$1,489 |
1.8× |
| Foot 2 views (73620) |
$186.05 |
$608 |
2.0× |
| Forearm 2 views (73090) |
$200.43 |
$655 |
2.2× |
| Functional MRI brain by tech (70554) |
$1,611.40 |
$5,266 |
6.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$787.64 |
$2,574 |
1.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,041.01 |
$3,402 |
1.8× |
| Hand 2 views (73120) |
$183.60 |
$600 |
1.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,761.64 |
$5,757 |
2.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,818.86 |
$5,944 |
2.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,005.83 |
$6,555 |
2.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,237.78 |
$7,313 |
0.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,154.23 |
$3,772 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,265.62 |
$4,136 |
2.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,035.50 |
$3,384 |
2.4× |
| Hysterosalpingogram (74740) |
$551.11 |
$1,801 |
2.2× |
| Interstitial radiation source applic complex (77778) |
$2,470.03 |
$8,072 |
3.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$232.87 |
$761 |
2.1× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$288.86 |
$944 |
0.7× |
| Kidney imaging morphology (78700) |
$674.42 |
$2,204 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$862 |
$2,817 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,070.39 |
$3,498 |
1.8× |
| Knee 3 views (73562) |
$247.86 |
$810 |
2.7× |
| Liver & spleen imaging static only (78215) |
$712.67 |
$2,329 |
1.7× |
| Liver imaging static only (78201) |
$529.69 |
$1,731 |
0.9× |
| Lung perfusion differential (78597) |
$795.91 |
$2,601 |
1.9× |
| Lung ventilation imaging (78579) |
$387.70 |
$1,267 |
0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,521.74 |
$4,973 |
0.5× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$733.79 |
$2,398 |
0.2× |
| Lymphoscintigraphy (78195) |
$891.38 |
$2,913 |
1.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,706.26 |
$5,576 |
2.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,794.38 |
$5,864 |
4.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,251.85 |
$7,359 |
6.0× |
| Magnetic Resonance Elastography (76391) |
$137.70 |
$450 |
0.5× |
| Mammary ductogram or galactogram single (77053) |
$206.24 |
$674 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,578.05 |
$8,425 |
6.4× |
| MRA head w & w/o contrast (70546) |
$2,436.68 |
$7,963 |
6.5× |
| MRA head w/o contrast (70544) |
$1,536.12 |
$5,020 |
6.0× |
| MRA head with contrast (70545) |
$1,560.91 |
$5,101 |
4.2× |
| MRA neck w contrast (70548) |
$1,706.87 |
$5,578 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,439.13 |
$7,971 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,445.54 |
$4,724 |
5.7× |
| MRI abdomen w contrast (74182) |
$1,832.63 |
$5,989 |
4.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,299.28 |
$7,514 |
6.2× |
| MRI abdomen w/o contrast (74181) |
$1,630.06 |
$5,327 |
6.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,794.38 |
$5,864 |
2.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,283.98 |
$7,464 |
6.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,334.60 |
$3,833 |
5.2× |
| MRI breast wo contrast unilateral (77046) |
$1,779.39 |
$5,815 |
7.0× |
| MRI c-spine with contrast (72142) |
$1,799.28 |
$5,880 |
4.8× |
| MRI cardiac w/o cont stress (75559) |
$1,200.44 |
$3,923 |
2.1× |
| MRI cardiac w/o contrast (75557) |
$1,377.61 |
$4,502 |
5.4× |
| MRI cervical spine w/o contrast (72141) |
$1,640.16 |
$5,360 |
6.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,337.23 |
$7,638 |
6.3× |
| MRI chest w/o contrast (71550) |
$1,714.82 |
$5,604 |
6.7× |
| MRI chest with contrast (71551) |
$2,151.18 |
$7,030 |
2.6× |
| MRI fetal sngl/1st gestation (74712) |
$137.70 |
$450 |
0.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,831.41 |
$5,985 |
4.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,232.58 |
$7,296 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,574.06 |
$5,144 |
6.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,427.80 |
$4,666 |
5.6× |
| MRI orbit face neck w contrast (70542) |
$2,032.76 |
$6,643 |
5.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,280.92 |
$7,454 |
6.1× |
| MRI pelvis w/contrast (72196) |
$1,852.22 |
$6,053 |
5.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,237.17 |
$7,311 |
6.0× |
| MRI pelvis w/o contrast (72195) |
$1,688.20 |
$5,517 |
6.6× |
| MRI spectroscopy (76390) |
$1,341.20 |
$4,383 |
14.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,333.25 |
$7,625 |
6.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,808.15 |
$5,909 |
4.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,326.52 |
$7,603 |
6.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,799.28 |
$5,880 |
4.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,270.83 |
$7,421 |
6.1× |
| MRI temporomandibular joint (70336) |
$1,425.96 |
$4,660 |
5.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,608.03 |
$5,255 |
6.3× |
| MRI up ext w/o contrast (73218) |
$1,649.65 |
$5,391 |
6.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,619.66 |
$5,293 |
6.4× |
| MRI, joint upper extrem combo (73223) |
$2,267.77 |
$7,411 |
6.1× |
| Myelogram Cervical (72240) |
$323.44 |
$1,057 |
0.4× |
| Myelogram Lumbar (72265) |
$323.44 |
$1,057 |
0.4× |
| Myelogram thoracic (72255) |
$323.44 |
$1,057 |
0.4× |
| Myelography 2 or more regions (72270) |
$388.31 |
$1,269 |
0.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,345.49 |
$7,665 |
1.7× |
| Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) |
$2,345.49 |
$7,665 |
1.5× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$2,898.13 |
$9,471 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,131.90 |
$6,967 |
1.5× |
| Myocardial spect single study at rest or stress (78451) |
$1,611.70 |
$5,267 |
1.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,115.39 |
$10,181 |
2.0× |
| N-invas est c ffr sw aly CTA (75580) |
$431.77 |
$1,411 |
0.5× |
| Neck soft tissue (70360) |
$173.20 |
$566 |
1.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$905.15 |
$2,958 |
2.2× |
| Nm adrenal scan (78075) |
$637.09 |
$2,082 |
0.5× |
| Nm cisternogram (78630) |
$1,011.94 |
$3,307 |
1.7× |
| Nm csf leak detection (78650) |
$1,215.43 |
$3,972 |
0.9× |
| Nm gastric emptying study (78264) |
$1,012.55 |
$3,309 |
2.4× |
| Nm gastroesophageal reflux study (78262) |
$661.88 |
$2,163 |
1.6× |
| Nm peritoneal-venous shunt patency (78291) |
$556.92 |
$1,820 |
1.3× |
| Nm red cell sequestration (78140) |
$574.67 |
$1,878 |
1.3× |
| Nonvascular shunt X-ray (75809) |
$447.98 |
$1,464 |
4.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,033.70 |
$16,450 |
3.4× |
| Nuclear Rx Oral Admin (79005) |
$525.10 |
$1,716 |
2.1× |
| Ob us nuchal meas 1 gest (76813) |
$387.40 |
$1,266 |
3.5× |
| Ophthalmic biometry by ultrasound echography, A-scan; Non-Facility (76516) |
$88.43 |
$289 |
0.8× |
| Orthopantogram (70355) |
$110.47 |
$361 |
1.2× |
| Osseous survey limited (77074) |
$285.50 |
$933 |
2.6× |
| Parathyrd planar w/spect&CT (78072) |
$1,007.05 |
$3,291 |
1.7× |
| Parathyroid Planar Imaging (78070) |
$645.66 |
$2,110 |
1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$887.40 |
$2,900 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$192.78 |
$630 |
1.7× |
| Peritoneogram after injection (74190) |
$390.15 |
$1,275 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$3,615.39 |
$11,815 |
2.4× |
| PET imaging CT for attenuation limited area (78814) |
$2,392.31 |
$7,818 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$3,690.05 |
$12,059 |
2.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,237.78 |
$7,313 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,304.48 |
$4,263 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$884.95 |
$2,892 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$936.05 |
$3,059 |
1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$463.28 |
$1,514 |
0.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$214.51 |
$701 |
2.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$194.62 |
$636 |
2.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$235.01 |
$768 |
2.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$198.90 |
$650 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$314.26 |
$1,027 |
2.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$403.92 |
$1,320 |
3.6× |
| Radex fingr minimum 2 views (73140) |
$168.30 |
$550 |
1.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$193.39 |
$632 |
2.1× |
| Radex Hand Minimum 3 Views (73130) |
$205.63 |
$672 |
2.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$182.68 |
$597 |
2.0× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$208.08 |
$680 |
1.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$273.56 |
$894 |
2.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$331.70 |
$1,084 |
3.0× |
| Radex Humerus Minimum 2 Views (73060) |
$209 |
$683 |
2.2× |
| Radex Kne 1/2 Views (73560) |
$206.86 |
$676 |
2.2× |
| Radex Kne Compl 4/More Views (73564) |
$275.71 |
$901 |
2.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$246.94 |
$807 |
2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$225.22 |
$736 |
2.4× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$248.17 |
$811 |
2.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$201.35 |
$658 |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$142.60 |
$466 |
1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$304.16 |
$994 |
3.3× |
| Radex Toe Minimum 2 Views (73660) |
$173.50 |
$567 |
1.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$125.77 |
$411 |
1.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$218.48 |
$714 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$426.56 |
$1,394 |
3.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$9,978.97 |
$32,611 |
1.3× |
| Radiation treatment delivery level 1 (77402) |
$370.87 |
$1,212 |
3.4× |
| Radiation treatment delivery level 2 (77407) |
$571.91 |
$1,869 |
1.4× |
| Radiation treatment delivery level 3 (77412) |
$818.24 |
$2,674 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$193.70 |
$633 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$253.67 |
$829 |
2.3× |
| Radiologic exam chest 2 views (71046) |
$188.19 |
$615 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$666.77 |
$2,179 |
3.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$503.37 |
$1,645 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$671.67 |
$2,195 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$532.13 |
$1,739 |
2.8× |
| Radiologic examination femur 1 view (73551) |
$137.09 |
$448 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$214.81 |
$702 |
2.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$120.87 |
$395 |
1.1× |
| Radiological examination surgical specimen (76098) |
$267.44 |
$874 |
0.5× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion Non-Facility (79403) |
$922.90 |
$3,016 |
3.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$818.24 |
$2,674 |
2.0× |
| Ribs bilateral 3 views (71110) |
$261.94 |
$856 |
2.3× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$573.14 |
$1,873 |
1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$769.28 |
$2,514 |
1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,946.16 |
$6,360 |
3.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,150.25 |
$3,759 |
2.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,418 |
$4,634 |
2.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,671.98 |
$5,464 |
1.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$590.27 |
$1,929 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$511.94 |
$1,673 |
2.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$308.14 |
$1,007 |
1.2× |
| Scapula (73010) |
$212.98 |
$696 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$20.20 |
$66 |
0.9× |
| Sella turcica (70240) |
$180.85 |
$591 |
1.9× |
| Shoulder 1 view (73020) |
$154.22 |
$504 |
1.7× |
| Simulation intermediate (77285) |
$903.92 |
$2,954 |
2.3× |
| Small bowel series (74250) |
$563.04 |
$1,840 |
3.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$734.40 |
$2,400 |
1.8× |
| Special dosimetry (77331) |
$306.61 |
$1,002 |
2.1× |
| Special Physics Consult (77370) |
$488.38 |
$1,596 |
3.4× |
| Special treatment procedure (77470) |
$1,772.66 |
$5,793 |
3.0× |
| Spine thoracic 3 views (72072) |
$261.94 |
$856 |
2.3× |
| Splenoportograpy rs&i (75810) |
$734.40 |
$2,400 |
0.2× |
| Stereotactic Body Radiation Delivery (77373) |
$8,173.57 |
$26,711 |
4.3× |
| Superior sagittal sinus venogram (75870) |
$1,322.84 |
$4,323 |
0.4× |
| Tbs technical calculation only (77091) |
$37.64 |
$123 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,894.75 |
$6,192 |
4.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,610.17 |
$5,262 |
4.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$757.35 |
$2,475 |
5.3× |
| Thoracolumbar 2 views (72080) |
$242.05 |
$791 |
2.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,057.23 |
$3,455 |
1.8× |
| Thyroid imaging w/blood flow (78013) |
$381.89 |
$1,248 |
0.9× |
| Thyroid uptake measurement (78012) |
$212.67 |
$695 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$762.25 |
$2,491 |
1.8× |
| Tmj unilateral (70328) |
$173.50 |
$567 |
1.9× |
| Tomogram (76100) |
$552.94 |
$1,807 |
5.0× |
| Treatment device complex (77334) |
$596.70 |
$1,950 |
1.5× |
| Treatment device intermediate (77333) |
$488.99 |
$1,598 |
3.4× |
| Treatment devices simple (77332) |
$356.18 |
$1,164 |
2.5× |
| Ultrasound breast complete (76641) |
$257.04 |
$840 |
2.3× |
| Ultrasound elastography first target lesion (76982) |
$301.72 |
$986 |
2.7× |
| Ultrasound Exam Aaa Screen (76706) |
$305.08 |
$997 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$398.72 |
$1,303 |
3.6× |
| Umbilical-artery Doppler (OB) (76820) |
$288.86 |
$944 |
2.6× |
| Unlisted fluoroscopic procedure (76496) |
$1,480.58 |
$4,838.50 |
15.9× |
| Unlisted magnetic resonance procedure (76498) |
$3,690.05 |
$12,059 |
39.7× |
| Ureteral reflux study (78740) |
$471.85 |
$1,542 |
1.1× |
| Urethrocystogram voiding (74455) |
$420.44 |
$1,374 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$363.83 |
$1,189 |
1.4× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$436.05 |
$1,425 |
2.3× |
| Us breast unilateral limited (76642) |
$257.04 |
$840 |
2.8× |
| Us chest (76604) |
$272.34 |
$890 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$268.97 |
$879 |
2.4× |
| Us elastography parenchyma (76981) |
$347 |
$1,134 |
3.1× |
| Us encephalogram (76506) |
$284.58 |
$930 |
2.5× |
| Us hips infant static (76886) |
$183.60 |
$600 |
2.0× |
| Us infant hips w manipulation (76885) |
$264.69 |
$865 |
2.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$244.19 |
$798 |
2.2× |
| Us ob detailed single fetus (76811) |
$635.87 |
$2,078 |
2.5× |
| Us ob limited (76815) |
$237.15 |
$775 |
2.1× |
| Us ob transvaginal (76817) |
$341.50 |
$1,116 |
3.1× |
| Us pelvic non ob complete (76856) |
$397.19 |
$1,298 |
3.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$300.49 |
$982 |
2.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$408.20 |
$1,334 |
3.7× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$236.84 |
$774 |
2.1× |
| Us retroperitoneal complete (76770) |
$459.61 |
$1,502 |
4.1× |
| Us retroperitoneal limited (76775) |
$341.19 |
$1,115 |
3.1× |
| Us scrotum and contents (76870) |
$406.37 |
$1,328 |
3.6× |
| Us soft tissue head/neck (76536) |
$377.91 |
$1,235 |
3.4× |
| Us spinal canal and contents (76800) |
$265.30 |
$867 |
2.4× |
| Us transrectal (76872) |
$461.14 |
$1,507 |
4.1× |
| Us transrectal prostate volume (76873) |
$523.26 |
$1,710 |
4.7× |
| Us, eye b-scan (76512) |
$438.19 |
$1,432 |
3.9× |
| Us,transplanted kidney, real time/ doppler (76776) |
$428.09 |
$1,399 |
3.8× |
| Venogram extremity bilateral (75822) |
$1,113.53 |
$3,639 |
0.7× |
| Venogram Extremity Unilateral (75820) |
$997.56 |
$3,260 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,323.76 |
$7,594 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,331.71 |
$4,352 |
0.8× |
| Venography Renal Bilateral (75833) |
$2,198.30 |
$7,184 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$3,063.37 |
$10,011 |
0.9× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,261.03 |
$7,389 |
0.7× |
| Venous sampling by catheter (75893) |
$3,220.65 |
$10,525 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$157.90 |
$516 |
1.7× |
| Wrist 2 views (73100) |
$173.50 |
$567 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$327.42 |
$1,070 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$242.66 |
$793 |
2.6× |
| X-ray b.e. reductn intuss (74283) |
$460.53 |
$1,505 |
2.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$738.68 |
$2,414 |
3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$202.57 |
$662 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$227.05 |
$742 |
2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$280.91 |
$918 |
2.5× |
| X-ray exam of femur 2/> (73552) |
$220.01 |
$719 |
2.4× |
| X-ray eye for foreign body (70030) |
$185.74 |
$607 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$185.44 |
$606 |
2.0× |
| X-ray IV pyelogram (ivp) (74400) |
$444.01 |
$1,451 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$169.52 |
$554 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$208.08 |
$680 |
2.2× |
| X-ray leg, infant (73592) |
$148.10 |
$484 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$264.69 |
$865 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$416.47 |
$1,361 |
3.7× |
| X-ray nose-rectum child f.b. (76010) |
$194 |
$634 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$275.71 |
$901 |
2.5× |
| X-ray retrograde pyelogram (74420) |
$617.51 |
$2,018 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$206.86 |
$676 |
2.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$290.09 |
$948 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$320.69 |
$1,048 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$229.50 |
$750 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$228.58 |
$747 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$226.13 |
$739 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$334.15 |
$1,092 |
3.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$212.67 |
$695 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$167.99 |
$549 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$193.09 |
$631 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$242.96 |
$794 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$242.66 |
$793 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$249.39 |
$815 |
2.2× |
| Xr bone length studies (77073) |
$250.31 |
$818 |
2.2× |
| Xr c-spine 4 or 5 views (72050) |
$310.28 |
$1,014 |
2.8× |
| Xr c-spine 6 or more views (72052) |
$355.27 |
$1,161 |
3.2× |
| Xr chest 4+ views (71048) |
$255.51 |
$835 |
2.3× |
| Xr urogram antegrade (74425) |
$536.72 |
$1,754 |
1.4× |