| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,587.85 |
$11,725 |
2.4× |
| Abdomen 1 View (74018) |
$193.70 |
$633 |
2.1× |
| Abdomen 2 views (74019) |
$230.42 |
$753 |
2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,308.15 |
$4,275 |
3.1× |
| Adrenal Cortex & Medulla Img (78075) |
$637.09 |
$2,082 |
0.5× |
| Angio internal mammary (75756) |
$1,595.18 |
$5,213 |
0.5× |
| Angio pulmonary bilat (75743) |
$3,600.40 |
$11,766 |
1.1× |
| 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 pulmonary unilateral slctv rs&i (75741) |
$2,883.44 |
$9,423 |
0.9× |
| 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× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,104.67 |
$6,878 |
0.4× |
| Artery X-Rays Abdomen (75726) |
$3,884.06 |
$12,693 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$1,707.48 |
$5,580 |
0.5× |
| Artery X-Rays Pelvis (75736) |
$3,398.74 |
$11,107 |
0.6× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$2,179.64 |
$7,123 |
0.4× |
| Basic radiation dosimetry calculation (77300) |
$297.43 |
$972 |
2.1× |
| Bone age studies (77072) |
$180.54 |
$590 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,116.59 |
$3,649 |
2.6× |
| Bone Imaging Limited Area (78300) |
$605.27 |
$1,978 |
1.4× |
| Bone Imaging Whole Body (78306) |
$911.27 |
$2,978 |
2.1× |
| Bone marrow imaging limited area (78102) |
$615.06 |
$2,010 |
1.4× |
| Bone survey infant (77076) |
$231.95 |
$758 |
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 Plan Simple (77316) |
$647.19 |
$2,115 |
1.6× |
| Brain Flow Imaging Only (78610) |
$388.93 |
$1,271 |
0.7× |
| Brain Image W/Flow < 4 Views (78601) |
$471.85 |
$1,542 |
1.1× |
| Brain imaging < 4 static views (78600) |
$375.16 |
$1,226 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,603.46 |
$11,776 |
2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,814.89 |
$5,931 |
4.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,300.81 |
$7,519 |
2.7× |
| Cat Scan Follow-Up Study (76380) |
$372.71 |
$1,218 |
4.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$753.68 |
$2,463 |
1.3× |
| Cerebrospinal Fluid Scan (78630) |
$1,011.94 |
$3,307 |
1.7× |
| Chest 1 view (71045) |
$171.05 |
$559 |
1.8× |
| Chest 2 views (71046) |
$188.19 |
$615 |
2.0× |
| Chest 3 views (71047) |
$226.13 |
$739 |
2.4× |
| Chest 4 or more views (71048) |
$255.51 |
$835 |
2.3× |
| Cholecystography Oral Contrast (74290) |
$433.30 |
$1,416 |
2.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (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× |
| Contrast Exam Abdominl Aorta (75625) |
$3,115.69 |
$10,182 |
0.9× |
| Contrast X-Ray Bladder (74430) |
$401.78 |
$1,313 |
1.1× |
| 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 Abdomen and Pelvis (74174) |
$2,013.79 |
$6,581 |
5.4× |
| CT Angio Chest (71275) |
$1,477.98 |
$4,830 |
7.9× |
| CT Angio Head (70496) |
$1,823.76 |
$5,960 |
9.7× |
| 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 Angio Neck (70498) |
$1,823.76 |
$5,960 |
9.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,158.21 |
$3,785 |
6.2× |
| CT cervical spine w/ contrast (72126) |
$1,050.19 |
$3,432 |
2.8× |
| CT cervical spine w/o contrast (72125) |
$910.35 |
$2,975 |
8.2× |
| CT cervical spine w/wo cont (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 colonogrphy dx image postprocess w/o contrast (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 no contrast quant eval coronry 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 l-spine w&w/o contrast (72133) |
$1,361.70 |
$4,450 |
7.3× |
| CT lower ext w/o (73700) |
$868.43 |
$2,838 |
7.8× |
| CT lower extremity w/contrast material (73701) |
$1,081.40 |
$3,534 |
5.8× |
| 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 wo contrast (70486) |
$826.20 |
$2,700 |
7.4× |
| CT neck tissue combo (70492) |
$1,273.57 |
$4,162 |
6.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,456.56 |
$4,760 |
7.8× |
| CT orbits w/o contrast (70480) |
$905.76 |
$2,960 |
8.1× |
| CT pelvis w&w/o contrast (72194) |
$1,257.97 |
$4,111 |
6.7× |
| CT pelvis w/o contrast (72192) |
$855.88 |
$2,797 |
7.7× |
| CT scan of leg combo (73702) |
$1,288.57 |
$4,211 |
6.9× |
| CT scans face/jaw combo (70488) |
$1,273.57 |
$4,162 |
6.8× |
| CT soft tissue neck w contrast (70491) |
$1,117.51 |
$3,652 |
6.0× |
| 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 cont (72130) |
$1,528.47 |
$4,995 |
8.2× |
CT thorax w/o contrast (71250)
range across 2 matching MRF lines |
$85.37–$844.25 |
$279–$2,759 |
varies |
| CT upper ext wo (73200) |
$809.37 |
$2,645 |
7.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,090.89 |
$3,565 |
5.8× |
| CT upper extremity with contrast (73201) |
$1,037.95 |
$3,392 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,714.21 |
$5,602 |
9.2× |
| Cta Abdomen (74175) |
$1,429.33 |
$4,671 |
7.6× |
| CTA pelvis (72191) |
$1,420.45 |
$4,642 |
7.6× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$234.09 |
$765 |
0.9× |
| Dilation ureters/urethra rs&i (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 Axial (77080) |
$225.22 |
$736 |
2.0× |
| Dxa bone density study (77085) |
$195.84 |
$640 |
1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$146.88 |
$480 |
1.6× |
| Echo exam of fetal heart (76825) |
$488.07 |
$1,595 |
0.8× |
| Echo exam uterus (76831) |
$308.14 |
$1,007 |
1.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$314.26 |
$1,027 |
1.2× |
| Echograp Trans R Pros Study (76873) |
$523.26 |
$1,710 |
4.7× |
| Esophagram (74220) |
$453.19 |
$1,481 |
2.4× |
| Fetal Biophys Profile W/Nst (76818) |
$254.90 |
$833 |
2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$279.38 |
$913 |
2.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$137.70 |
$450 |
0.5× |
| Fluoroscopy up to 1 hr (76000) |
$455.63 |
$1,489 |
1.8× |
| Follow-Up Angiography (75898) |
$1,147.19 |
$3,749 |
0.3× |
| Foot 2 views (73620) |
$186.05 |
$608 |
2.0× |
| Forearm 2 views (73090) |
$200.43 |
$655 |
2.2× |
| Gastric emptying imaging study (78264) |
$1,012.55 |
$3,309 |
2.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$787.64 |
$2,574 |
1.8× |
| Gastroesophageal Reflux Exam (78262) |
$661.88 |
$2,163 |
1.6× |
| Gated Heart Planar Single (78472) |
$1,057.23 |
$3,455 |
2.5× |
| 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/Icav Brchtx (77772) |
$2,005.83 |
$6,555 |
2.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,818.86 |
$5,944 |
2.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,761.64 |
$5,757 |
2.4× |
| 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 Image W/Drug (78227) |
$1,265.62 |
$4,136 |
2.2× |
| Hepatobiliary System Imaging (78226) |
$1,035.50 |
$3,384 |
2.4× |
| Ht Muscle Image Spect Sing (78451) |
$1,611.70 |
$5,267 |
1.2× |
| Hysterosalpingogram (74740) |
$551.11 |
$1,801 |
2.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$264.69 |
$865 |
2.8× |
| Infant hip ultrasound, limited static exam (76886) |
$183.60 |
$600 |
2.0× |
| Interstitial radiation source applic complex (77778) |
$2,470.03 |
$8,072 |
3.3× |
| Joint Survey Single View (77077) |
$232.87 |
$761 |
2.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,070.39 |
$3,498 |
1.8× |
| K Flow/Funct Image W/O Drug (78707) |
$862 |
$2,817 |
1.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$288.86 |
$944 |
0.7× |
| Kidney Imaging Morphol (78700) |
$674.42 |
$2,204 |
1.6× |
| Knee 3 Views (73562) |
$247.86 |
$810 |
2.7× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$574.67 |
$1,878 |
1.3× |
| Leveen/Shunt Patency Exam (78291) |
$556.92 |
$1,820 |
1.3× |
| 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 Ventilat&Perfus Imaging (78582) |
$936.05 |
$3,059 |
1.6× |
| Lung Ventilation Imaging (78579) |
$387.70 |
$1,267 |
0.9× |
| Lymph System Imaging (78195) |
$891.38 |
$2,913 |
1.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,521.74 |
$4,973 |
0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$733.79 |
$2,398 |
0.2× |
| Magnetic Image Jaw Joint (70336) |
$1,425.96 |
$4,660 |
5.6× |
| Magnetic Resonance Elastography (76391) |
$137.70 |
$450 |
0.5× |
| Mammary ductogram or galactogram single (77053) |
$206.24 |
$674 |
0.8× |
| Meckels Divert Exam (78290) |
$903.01 |
$2,951 |
2.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,578.05 |
$8,425 |
6.4× |
| Mra Head W/O & W/Contrast Material (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 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 any jt upper extremity w/contrast matrl (73222) |
$1,706.26 |
$5,576 |
2.0× |
| MRI brain functional w/o physician admnistration (70554) |
$1,611.40 |
$5,266 |
6.3× |
MRI Breast W/O Contrast Bilateral (77047)
range across 2 matching MRF lines |
$466–$2,203.20 |
$466–$7,200 |
varies |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,779.39 |
$5,815 |
7.0× |
| 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 contrast (72142) |
$1,799.28 |
$5,880 |
4.8× |
| MRI cervical spine w/o cont (72141) |
$1,640.16 |
$5,360 |
6.4× |
| 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 chest wo w contrast (71552) |
$2,337.23 |
$7,638 |
6.3× |
| 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 lumbar spine w contrast (72149) |
$1,808.15 |
$5,909 |
4.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,333.25 |
$7,625 |
6.3× |
| 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 Orbt/Fac/Nck W/O &W/Dye (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 (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 thoracic spine w/o contrast (72146) |
$1,608.03 |
$5,255 |
6.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,794.38 |
$5,864 |
4.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,649.65 |
$5,391 |
6.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,251.85 |
$7,359 |
6.0× |
| MRI, abdomen, combo (74183) |
$2,299.28 |
$7,514 |
6.2× |
| MRI, dorsal spine combo (72157) |
$2,270.83 |
$7,421 |
6.1× |
| MRI, dorsal spine contrast (72147) |
$1,799.28 |
$5,880 |
4.8× |
| MRI, joint upper extrem (73221) |
$1,619.66 |
$5,293 |
6.4× |
| MRI, joint upper extrem combo (73223) |
$2,267.77 |
$7,411 |
6.1× |
| MRI, lumbar spine combo (72158) |
$2,326.52 |
$7,603 |
6.2× |
| Myelogram cervical (72240) |
$323.44 |
$1,057 |
0.4× |
| Myelogram Lumbar (72265) |
$323.44 |
$1,057 |
0.4× |
| Myelography thoracic (72255) |
$323.44 |
$1,057 |
0.4× |
| Myelograpy 2/more regions rs&i (72270) |
$388.31 |
$1,269 |
0.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,345.49 |
$7,665 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$2,131.90 |
$6,967 |
1.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$2,345.49 |
$7,665 |
1.5× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,115.39 |
$10,181 |
2.0× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$2,898.13 |
$9,471 |
1.2× |
| 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 csf leak detection (78650) |
$1,215.43 |
$3,972 |
0.9× |
| 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 Intra-Arterial (79445) |
$590.27 |
$1,929 |
2.4× |
| 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 US Echograpy a-Scan (76516) |
$88.43 |
$289 |
0.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$438.19 |
$1,432 |
3.9× |
| Panoramic X-ray of jaws (70355) |
$110.47 |
$361 |
1.2× |
| Parathyroid imaging w/tomographic 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 Rs&I (74190) |
$390.15 |
$1,275 |
0.7× |
| Pet Image W/Ct Lmtd (78814) |
$2,392.31 |
$7,818 |
1.6× |
| PET image w/CT, full body (78816) |
$3,690.05 |
$12,059 |
2.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,615.39 |
$11,815 |
2.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,237.78 |
$7,313 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$884.95 |
$2,892 |
2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$327.42 |
$1,070 |
2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$463.28 |
$1,514 |
0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$214.51 |
$701 |
2.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$194.62 |
$636 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$235.01 |
$768 |
2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$275.71 |
$901 |
2.5× |
| Radex fingr minimum 2 views (73140) |
$168.30 |
$550 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$193.39 |
$632 |
2.1× |
| Radex Hand Minimum 3 Views (73130) |
$205.63 |
$672 |
2.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$148.10 |
$484 |
1.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$120.87 |
$395 |
1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$225.22 |
$736 |
2.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$206.86 |
$676 |
2.2× |
| Radex shoulder complete minimum 2 views (73030) |
$201.35 |
$658 |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$142.60 |
$466 |
1.5× |
| Radex Spine 1 View Specify Level (72020) |
$167.99 |
$549 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$242.96 |
$794 |
2.6× |
| 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 Wrist Complete 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× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$246.94 |
$807 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$253.67 |
$829 |
2.3× |
| Radiologic exam colon double contrast study (74280) |
$738.68 |
$2,414 |
3.9× |
| 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 knee complete 4/more views (73564) |
$275.71 |
$901 |
2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$248.17 |
$811 |
2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$563.04 |
$1,840 |
3.0× |
| Radiologic exam swallow function contrast study (74230) |
$473.38 |
$1,547 |
2.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$671.67 |
$2,195 |
3.6× |
| Radiologic examination femur 1 view (73551) |
$137.09 |
$448 |
1.5× |
| Radiologic examination femur minimum 2 views (73552) |
$220.01 |
$719 |
2.4× |
| Radiologic examination knee 1/2 views (73560) |
$206.86 |
$676 |
2.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$285.50 |
$933 |
2.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$214.81 |
$702 |
2.3× |
| 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/acquisj 1day img (78830) |
$1,671.98 |
$5,464 |
1.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$922.90 |
$3,016 |
3.7× |
| Rp Therapy Intravenous Administration (79101) |
$511.94 |
$1,673 |
2.1× |
| 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× |
| Skull less than 4 views (70250) |
$212.67 |
$695 |
1.9× |
| Special dosimetry (77331) |
$306.61 |
$1,002 |
2.1× |
| Special Physics Consult (77370) |
$488.38 |
$1,596 |
3.4× |
| Special teletherapy port plan (77321) |
$734.40 |
$2,400 |
1.8× |
| Special treatment procedure (77470) |
$1,772.66 |
$5,793 |
3.0× |
| Stereotactic Body Radiation Delivery (77373) |
$8,173.57 |
$26,711 |
4.3× |
| Sternoclavicular joints (71130) |
$193.09 |
$631 |
2.1× |
| 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 Intermed (77285) |
$903.92 |
$2,954 |
2.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$757.35 |
$2,475 |
5.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$460.53 |
$1,505 |
2.5× |
| Thoracic spine 2 views (72070) |
$242.66 |
$793 |
2.2× |
| Thoracic spine 3 views (72072) |
$261.94 |
$856 |
2.3× |
| Thoracolumbar 2 views (72080) |
$242.05 |
$791 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$381.89 |
$1,248 |
0.9× |
| Thyroid Met Imaging Body (78018) |
$1,057.23 |
$3,455 |
1.8× |
| 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× |
| Tx Devices Design & Construction Complex (77334) |
$596.70 |
$1,950 |
1.5× |
| Tx devices design & construction intermediate (77333) |
$488.99 |
$1,598 |
3.4× |
| Tx devices design & construction simple (77332) |
$356.18 |
$1,164 |
2.5× |
| Ultrasound Breast Limited (76642) |
$257.04 |
$840 |
2.8× |
| Ultrasound elastography first target lesion (76982) |
$301.72 |
$986 |
2.7× |
| Ultrasound Elastography Parenchyma (76981) |
$347 |
$1,134 |
3.1× |
| 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)
range across 4 matching MRF lines |
$359.86–$1,546.22 |
$1,176–$5,053 |
varies |
| Unlisted magnetic resonance procedure (76498) |
$3,690.05 |
$12,059 |
39.7× |
| Upper gi w/o kub (74240) |
$532.13 |
$1,739 |
2.8× |
| Ureteral Reflux Study (78740) |
$471.85 |
$1,542 |
1.1× |
| Urethrocystogram voiding (74455) |
$420.44 |
$1,374 |
1.7× |
| Urethrocystography retrograde (74450) |
$363.83 |
$1,189 |
1.4× |
| Us breast unilateral complete (76641) |
$257.04 |
$840 |
2.3× |
| Us chest (76604) |
$272.34 |
$890 |
2.4× |
| Us complete joint (76881) |
$268.97 |
$879 |
2.4× |
| Us exam, pelvic, limited (76857) |
$300.49 |
$982 |
2.7× |
| Us head (76506) |
$284.58 |
$930 |
2.5× |
| Us kidney transplant (76776) |
$428.09 |
$1,399 |
3.8× |
| 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 1 or more fetuses (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 pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$408.20 |
$1,334 |
3.7× |
| Us preg uterus real time f/u trnsabdl per 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 spinal canal and contents (76800) |
$265.30 |
$867 |
2.4× |
| Us thyroid (76536) |
$377.91 |
$1,235 |
3.4× |
| Us transrectal (76872) |
$461.14 |
$1,507 |
4.1× |
| Vein X-Ray Chest (75827) |
$1,331.71 |
$4,352 |
0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,304.48 |
$4,263 |
0.4× |
| Vein X-Ray Spleen/Liver (75810) |
$734.40 |
$2,400 |
0.2× |
| Venogram Sinus/Jugular (75860) |
$2,261.03 |
$7,389 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,323.76 |
$7,594 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,113.53 |
$3,639 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$997.56 |
$3,260 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,198.30 |
$7,184 |
0.7× |
| Venography Renal Unilateral (75831) |
$3,063.37 |
$10,011 |
0.9× |
| 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 Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$242.66 |
$793 |
2.6× |
| X-ray antegrade pyelogram tube (74425) |
$536.72 |
$1,754 |
1.4× |
| X-Ray Aorta Leg Arteries (75630) |
$2,703.51 |
$8,835 |
0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$202.57 |
$662 |
2.2× |
| X-Ray Exam Breast Specimen (76098) |
$267.44 |
$874 |
0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$198.90 |
$650 |
2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$314.26 |
$1,027 |
2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$403.92 |
$1,320 |
3.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$182.68 |
$597 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$227.05 |
$742 |
2.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$208.08 |
$680 |
1.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$273.56 |
$894 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$280.91 |
$918 |
2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$331.70 |
$1,084 |
3.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$416.47 |
$1,361 |
3.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$224.60 |
$734 |
2.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$355.27 |
$1,161 |
3.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$290.09 |
$948 |
2.6× |
| X-ray eye for foreign body (70030) |
$185.74 |
$607 |
2.0× |
| X-ray humerus (73060) |
$209 |
$683 |
2.2× |
| X-ray IV pyelogram (ivp) (74400) |
$444.01 |
$1,451 |
2.4× |
| X-ray IV pyelogram+tomography (74415) |
$436.05 |
$1,425 |
2.3× |
| 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 Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$264.69 |
$865 |
2.4× |
| X-ray nose-rectum child f.b. (76010) |
$194 |
$634 |
2.1× |
| 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 thoracic spine 4 vw (72074) |
$249.39 |
$815 |
2.2× |
| X-Ray Tmj Unilat (70328) |
$173.50 |
$567 |
1.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$617.51 |
$2,018 |
1.7× |
| X-Rays Bone Length Studies (77073) |
$250.31 |
$818 |
2.2× |
| X-Rays Bone Survey Complete (77075) |
$571.91 |
$1,869 |
5.1× |
| Xr c-spine 4 or 5 views (72050) |
$310.28 |
$1,014 |
2.8× |
| Xr facial bones less than 3 views (70140) |
$185.44 |
$606 |
2.0× |
| Xr orbits complete 4 views (70200) |
$275.71 |
$901 |
2.5× |
| Xr Tomogram Single Plane (76100) |
$552.94 |
$1,807 |
5.0× |