| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,149.28 |
$11,664 |
1.8× |
| Abdomen 1 View (74018) |
$135.54 |
$502 |
1.2× |
| Abdomen 2 views (74019) |
$171.72 |
$636 |
1.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$695.13 |
$2,574.55 |
1.4× |
| Angio internal mammary (75756) |
$594 |
$2,200 |
0.2× |
| Angiography extremity bilateral rs&i (75716) |
$1,371.97 |
$5,081.37 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$944.73 |
$3,499 |
0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$993.60 |
$3,680 |
0.3× |
| Ankle 2 views (73600) |
$117.99 |
$437 |
1.1× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$1,708.02 |
$6,326.01 |
0.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$976.21 |
$3,615.60 |
0.2× |
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure |
$1,391.87 |
$5,155.08 |
0.2× |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$1,166.40 |
$4,320 |
0.2× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$1,849.50 |
$6,850 |
0.3× |
| Arthrogram ankle (73615) |
$349.92 |
$1,296 |
0.8× |
| Arthrogram hip (73525) |
$447.31 |
$1,656.72 |
1.0× |
| Arthrogram Wrist (73115) |
$488.11 |
$1,807.80 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$220.32 |
$816 |
1.3× |
| Bone age studies (77072) |
$146.59 |
$542.91 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$978.94 |
$3,625.72 |
2.0× |
| Bone Imaging Limited Area (78300) |
$304.22 |
$1,126.73 |
0.6× |
| Bone Imaging Whole Body (78306) |
$787.32 |
$2,916 |
1.6× |
| Bone marrow imaging limited area (78102) |
$1,797.61 |
$6,657.80 |
3.6× |
| Bone marrow imaging; multiple areas (78103) |
$589.95 |
$2,185 |
1.2× |
| Bone marrow imaging; whole body (78104) |
$611.58 |
$2,265.12 |
1.2× |
| Bone survey infant (77076) |
$203.26 |
$752.82 |
1.6× |
| Brachytx isodose complex (77318) |
$432 |
$1,600 |
0.9× |
| Brachytx isodose intermed (77317) |
$472.50 |
$1,750 |
1.0× |
| Brachytx Isodose Plan Simple (77316) |
$551.07 |
$2,041 |
1.2× |
| Brain Flow Imaging Only (78610) |
$270 |
$1,000 |
0.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$446.51 |
$1,653.75 |
0.9× |
Cardiac MRI w/w/o contrast & further seq (75561)
range across 2 matching MRF lines |
$1,487.16–$1,606.23 |
$5,508–$5,949 |
varies |
| Cat Scan Follow-Up Study (76380) |
$340.55 |
$1,261.28 |
3.1× |
| Cerebrospinal Fluid Scan (78630) |
$702 |
$2,600 |
1.0× |
| Chest 1 view (71045) |
$124.47 |
$461 |
1.1× |
| Chest 2 views (71046) |
$154.44 |
$572 |
1.4× |
| Chest 3 views (71047) |
$223.83 |
$829.01 |
2.1× |
| Chest 4 or more views (71048) |
$216.51 |
$801.89 |
1.7× |
| Clavicle complete (73000) |
$135.54 |
$502 |
1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$784.89 |
$2,907 |
6.0× |
| Continuing medical physics consltj pr wk (77336) |
$286.47 |
$1,061 |
1.7× |
| Contrast Exam Abdominl Aorta (75625) |
$1,165.32 |
$4,316 |
0.3× |
| Contrast X-Ray Bladder (74430) |
$214.06 |
$792.81 |
0.5× |
| Contrast X-Ray Of Elbow (73085) |
$218.70 |
$810 |
0.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$249.48 |
$924 |
0.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$284.50 |
$1,053.69 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,235.87 |
$8,281 |
5.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,480.14 |
$5,482 |
5.0× |
| CT abdomen w contrast (74160) |
$1,165.32 |
$4,316 |
5.3× |
| CT abdomen w wo contrast (74170) |
$1,291.14 |
$4,782 |
5.9× |
| CT abdomen w/o contrast (74150) |
$913.41 |
$3,383 |
7.0× |
| CT Angio Abdomen and Pelvis (74174) |
$2,232.90 |
$8,270 |
5.1× |
| CT Angio Chest (71275) |
$1,385.64 |
$5,132 |
6.3× |
| CT Angio Head (70496) |
$1,228.23 |
$4,549 |
5.6× |
| CT angio hrt w/3d image (75574) |
$1,133.73 |
$4,199 |
2.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,165.32 |
$4,316 |
5.3× |
| CT Angio Neck (70498) |
$1,228.23 |
$4,549 |
5.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,070.82 |
$3,966 |
4.9× |
| CT cervical spine w/ contrast (72126) |
$1,007.64 |
$3,732 |
2.3× |
| CT cervical spine w/o contrast (72125) |
$944.73 |
$3,499 |
7.2× |
| CT cervical spine w/wo cont (72127) |
$1,074.74 |
$3,980.52 |
4.9× |
| CT chest w contrast (71260) |
$1,228.23 |
$4,549 |
5.6× |
| CT chest w/wo contrast (71270) |
$972.97 |
$3,603.60 |
4.4× |
| CT head/brain with contrast (70460) |
$976.32 |
$3,616 |
4.5× |
| CT head/brain without and with contrast (70470) |
$1,039.23 |
$3,849 |
4.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$216 |
$800 |
0.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$27 |
$100 |
0.2× |
| CT hrt w/3d image congen (75573) |
$216 |
$800 |
0.5× |
| CT iac w contrast (70481) |
$1,102.14 |
$4,082 |
5.0× |
| CT l-spine w&w/o contrast (72133) |
$1,071.81 |
$3,969.67 |
4.9× |
| CT lower ext w/o (73700) |
$913.41 |
$3,383 |
7.0× |
| CT lower extremity w/contrast material (73701) |
$1,007.64 |
$3,732 |
4.6× |
| CT lumbar spine w contrast (72132) |
$1,039.23 |
$3,849 |
2.4× |
| CT lumbar spine w/o contrast (72131) |
$1,007.64 |
$3,732 |
7.7× |
| CT maxillofacial w contrast (70487) |
$976.32 |
$3,616 |
4.5× |
| CT maxillofacial wo contrast (70486) |
$929.07 |
$3,441 |
7.1× |
| CT neck tissue combo (70492) |
$1,133.73 |
$4,199 |
5.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,108.08 |
$4,104 |
5.1× |
| CT orbits w/o contrast (70480) |
$913.41 |
$3,383 |
7.0× |
| CT pelvis w&w/o contrast (72194) |
$1,102.14 |
$4,082 |
5.0× |
| CT pelvis w/o contrast (72192) |
$913.41 |
$3,383 |
7.0× |
| CT scan of leg combo (73702) |
$1,020.60 |
$3,780 |
4.7× |
| CT scans face/jaw combo (70488) |
$1,025.97 |
$3,799.90 |
4.7× |
| CT soft tissue neck w contrast (70491) |
$1,070.82 |
$3,966 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$818.91 |
$3,033 |
6.3× |
| CT thoracic spine w contrast (72129) |
$1,007.64 |
$3,732 |
4.6× |
| CT thoracic spine w/o contrast (72128) |
$881.82 |
$3,266 |
6.8× |
| CT thoracic spine w/wo cont (72130) |
$1,151.41 |
$4,264.49 |
5.3× |
| CT thorax w/o contrast (71250) |
$1,007.64 |
$3,732 |
7.7× |
| CT upper ext wo (73200) |
$944.73 |
$3,499 |
7.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,074.74 |
$3,980.52 |
4.9× |
| CT upper extremity with contrast (73201) |
$1,007.64 |
$3,732 |
2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,259.82 |
$4,666 |
5.8× |
| Cta Abdomen (74175) |
$1,196.64 |
$4,432 |
5.5× |
| CTA pelvis (72191) |
$1,007.64 |
$3,732 |
4.6× |
| Diskography lumbar (72295) |
$513 |
$1,900.01 |
0.2× |
| Dxa Bone Density Axial (77080) |
$223.56 |
$828 |
1.7× |
| Dxa bone density study (77085) |
$255.15 |
$945 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$109.82 |
$406.75 |
1.0× |
| Echo exam uterus (76831) |
$223.94 |
$829.40 |
0.8× |
| Echo Guide For Artery Repair (76936) |
$1,234.79 |
$4,573.30 |
4.6× |
| Esophagram (74220) |
$264.01 |
$977.82 |
1.2× |
| Fetal Biophys Profile W/Nst (76818) |
$245.32 |
$908.60 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$256.77 |
$951 |
2.0× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,240.65 |
$4,595 |
4.2× |
Fluoroscopy up to 1 hr (76000)
range across 3 matching MRF lines |
$193.05–$286.47 |
$715.01–$1,061 |
varies |
| Foot 2 views (73620) |
$117.99 |
$437 |
1.1× |
| Forearm 2 views (73090) |
$126.09 |
$467 |
1.2× |
| Gastric emptying imaging study (78264) |
$692.82 |
$2,566 |
1.4× |
| Gated Heart Planar Single (78472) |
$976.32 |
$3,616 |
2.0× |
| Gated Heart, Multiple (78473) |
$370.66 |
$1,372.80 |
0.7× |
| Hand 2 views (73120) |
$122.85 |
$455 |
0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$1,498.50 |
$5,550 |
1.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,755 |
$6,500 |
2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,999.46 |
$11,109.12 |
3.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$983 |
$3,640.75 |
0.2× |
| Hepatobil Syst Image W/Drug (78227) |
$692.82 |
$2,566 |
1.0× |
| Hepatobiliary System Imaging (78226) |
$629.91 |
$2,333 |
1.3× |
| Ht Muscle Image Spect Sing (78451) |
$535.82 |
$1,984.50 |
0.3× |
| Hysterosalpingogram (74740) |
$325.29 |
$1,204.77 |
1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$263.31 |
$975.23 |
2.4× |
| Interstitial radiation source applic complex (77778) |
$972 |
$3,600 |
1.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$174.15 |
$645 |
0.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$122.85 |
$455 |
0.2× |
| Intracavitary radiation source applic simple (77761) |
$94.50 |
$350 |
0.1× |
| Joint Survey Single View (77077) |
$167.52 |
$620.44 |
1.3× |
| K Flow/Funct Image Multiple (78709) |
$661.23 |
$2,449 |
1.0× |
| K Flow/Funct Image W/Drug (78708) |
$729.69 |
$2,702.56 |
1.1× |
| K Flow/Funct Image W/O Drug (78707) |
$481.27 |
$1,782.49 |
0.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$521.42 |
$1,931.18 |
1.0× |
| Knee 3 Views (73562) |
$157.41 |
$583 |
1.4× |
| Leveen/Shunt Patency Exam (78291) |
$203.85 |
$755 |
0.4× |
| Liver & Spleen Imaging Static Only (78215) |
$379.57 |
$1,405.81 |
0.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$769.91 |
$2,851.51 |
1.1× |
| Lymph System Imaging (78195) |
$708.48 |
$2,624 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$1,228.23 |
$4,549 |
4.1× |
| Mammary ductogram or galactogram multiple (77054) |
$174.15 |
$645 |
0.6× |
| Mammary ductogram or galactogram single (77053) |
$145.80 |
$540 |
0.5× |
| Meckels Divert Exam (78290) |
$329.25 |
$1,219.45 |
0.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,732.05 |
$6,415 |
3.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$30.78 |
$114 |
0.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$302.67 |
$1,121 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,511.73 |
$5,599 |
3.5× |
| MRA head w/o contrast (70544) |
$1,165.32 |
$4,316 |
3.9× |
| MRA head with contrast (70545) |
$1,404.81 |
$5,203 |
3.2× |
| MRA neck w contrast (70548) |
$1,037.84 |
$3,843.86 |
2.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,480.14 |
$5,482 |
3.4× |
| MRA neck w/o contrast (70547) |
$1,165.32 |
$4,316 |
3.9× |
| MRI abdomen w contrast (74182) |
$1,195.56 |
$4,428 |
2.7× |
| MRI abdomen w/o contrast (74181) |
$1,259.82 |
$4,666 |
4.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,511.73 |
$5,599 |
1.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,637.55 |
$6,065 |
3.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,464.48 |
$5,424 |
1.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,108.89 |
$4,107 |
3.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$891 |
$3,300 |
3.0× |
| MRI cardiac w/o contrast (75557) |
$1,354.32 |
$5,016 |
4.5× |
| MRI cervical spine w contrast (72142) |
$1,118.92 |
$4,144.16 |
2.6× |
| MRI cervical spine w/o cont (72141) |
$1,322.73 |
$4,899 |
4.4× |
| MRI chest w/o contrast (71550) |
$1,165.32 |
$4,316 |
3.9× |
| MRI chest with contrast (71551) |
$1,026 |
$3,800 |
1.0× |
| MRI chest wo w contrast (71552) |
$1,574.64 |
$5,832 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$965.68 |
$3,576.60 |
2.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,390.91 |
$5,151.51 |
3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,165.32 |
$4,316 |
3.9× |
| MRI lumbar spine w contrast (72149) |
$1,511.73 |
$5,599 |
3.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,606.23 |
$5,949 |
3.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,133.73 |
$4,199 |
3.8× |
| MRI orbit face neck w contrast (70542) |
$838.35 |
$3,105 |
1.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,637.55 |
$6,065 |
3.8× |
| MRI pelvis w contrast (72196) |
$1,135.14 |
$4,204.22 |
2.6× |
| MRI pelvis w/o & w contrast (72197) |
$1,574.64 |
$5,832 |
3.6× |
| MRI pelvis w/o contrast (72195) |
$1,259.82 |
$4,666 |
4.2× |
| MRI spectroscopy (76390) |
$1,846.26 |
$6,838 |
17.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,322.73 |
$4,899 |
4.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,354.19 |
$5,015.50 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,165.32 |
$4,316 |
3.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,543.05 |
$5,715 |
3.5× |
| MRI, abdomen, combo (74183) |
$1,700.73 |
$6,299 |
3.9× |
| MRI, dorsal spine combo (72157) |
$1,606.23 |
$5,949 |
3.7× |
| MRI, dorsal spine contrast (72147) |
$1,464.48 |
$5,424 |
3.4× |
| MRI, joint upper extrem (73221) |
$1,354.32 |
$5,016 |
4.5× |
| MRI, joint upper extrem combo (73223) |
$1,574.64 |
$5,832 |
3.6× |
| MRI, lumbar spine combo (72158) |
$1,669.14 |
$6,182 |
3.8× |
| Myelogram cervical (72240) |
$407.72 |
$1,510.08 |
0.4× |
| Myelogram Lumbar (72265) |
$463.33 |
$1,716.02 |
0.5× |
| Myelograpy 2/more regions rs&i (72270) |
$277.99 |
$1,029.60 |
0.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,304.10 |
$4,830 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$1,464.48 |
$5,424 |
0.9× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,297.35 |
$4,805 |
0.7× |
| Neck soft tissue (70360) |
$120.80 |
$447.42 |
1.1× |
| Nonvascular Shunt X-Ray (75809) |
$167.03 |
$618.64 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,991.87 |
$11,081 |
1.7× |
| Nuclear Rx Intra-Arterial (79445) |
$347.41 |
$1,286.72 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$449.81 |
$1,665.96 |
1.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$156.35 |
$579.08 |
1.2× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$114.48 |
$424.01 |
0.9× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$51.30 |
$190 |
0.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$133.46 |
$494.28 |
1.0× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$57.24 |
$212.01 |
1.6× |
| Panoramic X-ray of jaws (70355) |
$126.21 |
$467.45 |
1.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$362.07 |
$1,341 |
0.5× |
| Parathyroid Planar Imaging (78070) |
$470.27 |
$1,741.74 |
0.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$583.78 |
$2,162.16 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$149.58 |
$554 |
1.1× |
| Pet Image W/Ct Lmtd (78814) |
$1,608.75 |
$5,958.33 |
0.9× |
| PET image w/CT, full body (78816) |
$2,015.55 |
$7,465 |
1.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,015.55 |
$7,465 |
1.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$992.25 |
$3,675 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$447.38 |
$1,656.98 |
0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$179.55 |
$665 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$406.52 |
$1,505.64 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$160.65 |
$595 |
1.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$122.85 |
$455 |
1.1× |
| Radex elbow complete minimum 3 views (73080) |
$157.41 |
$583 |
1.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$203.26 |
$752.82 |
1.6× |
| Radex fingr minimum 2 views (73140) |
$154.44 |
$572 |
1.4× |
| Radex foot complete minimum 3 views (73630) |
$163.89 |
$607 |
1.5× |
| Radex Hand Minimum 3 Views (73130) |
$154.44 |
$572 |
1.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$175.02 |
$648.23 |
1.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$47.99 |
$177.75 |
0.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$162.82 |
$603.03 |
1.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$145.48 |
$538.83 |
1.3× |
| Radex shoulder complete minimum 2 views (73030) |
$160.65 |
$595 |
1.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$102.17 |
$378.40 |
0.9× |
| Radex Spine 1 View Specify Level (72020) |
$187.38 |
$694 |
1.7× |
| Radex Sternum Minimum 2 Views (71120) |
$162.82 |
$603.03 |
1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$264.27 |
$978.79 |
2.4× |
| Radex Toe Minimum 2 Views (73660) |
$122.85 |
$455 |
1.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$131.79 |
$488.11 |
1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$155.79 |
$577 |
1.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$220.32 |
$816 |
1.7× |
Radiation Delivery Stereotactic Cranial Linear (77372)
unusually low: confirm this is the full procedure |
$3,779.19 |
$13,997 |
0.4× |
| Radiation treatment delivery level 1 (77402) |
$148.50 |
$550 |
1.2× |
| Radiation treatment delivery level 2 (77407) |
$202.50 |
$750 |
0.4× |
| Radiation treatment delivery level 3 (77412) |
$378 |
$1,400 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$223.83 |
$829.01 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$177.93 |
$659 |
1.4× |
| Radiologic exam colon double contrast study (74280) |
$569.34 |
$2,108.67 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$3,779.19 |
$13,997 |
17.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$207.90 |
$770 |
0.9× |
| Radiologic exam knee complete 4/more views (73564) |
$185.76 |
$688 |
1.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$171.02 |
$633.42 |
1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$314.82 |
$1,166 |
1.4× |
| Radiologic exam swallow function contrast study (74230) |
$251.91 |
$933 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$378 |
$1,400 |
1.7× |
| Radiologic examination femur 1 view (73551) |
$110.81 |
$410.40 |
1.0× |
| Radiologic examination femur minimum 2 views (73552) |
$129.06 |
$478 |
1.2× |
| Radiologic examination knee 1/2 views (73560) |
$129.06 |
$478 |
1.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$81 |
$300.01 |
0.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$35.52 |
$131.56 |
0.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$135.54 |
$502 |
1.2× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$135 |
$500 |
0.2× |
| Ribs bilateral 3 views (71110) |
$207.44 |
$768.31 |
1.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$309.28 |
$1,145.47 |
0.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,166.40 |
$4,320 |
1.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$761.97 |
$2,822.10 |
1.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$944.73 |
$3,499 |
1.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$445.50 |
$1,650 |
0.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$459 |
$1,700 |
0.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$432 |
$1,600 |
0.3× |
| Rp Therapy Intravenous Administration (79101) |
$347.41 |
$1,286.72 |
1.2× |
| Salivary Gland Imaging (78230) |
$270 |
$1,000 |
0.5× |
| Scapula (73010) |
$162.82 |
$603.03 |
1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$135.63 |
$502.32 |
5.8× |
| Shoulder 1 view (73020) |
$141.51 |
$524.11 |
1.3× |
| Shoulder Arthrography (73040) |
$488.11 |
$1,807.80 |
1.1× |
| Sialogram (70390) |
$246.83 |
$914.17 |
0.8× |
| Skull less than 4 views (70250) |
$133.92 |
$496 |
1.0× |
| Special dosimetry (77331) |
$178.70 |
$661.85 |
1.1× |
| Special Physics Consult (77370) |
$440.91 |
$1,633 |
2.6× |
| Special teletherapy port plan (77321) |
$409.32 |
$1,516 |
0.9× |
| Special treatment procedure (77470) |
$1,354.32 |
$5,016 |
2.0× |
| Stereotactic Body Radiation Delivery (77373) |
$4,094.01 |
$15,163 |
1.8× |
| Sternoclavicular joints (71130) |
$183.04 |
$677.92 |
1.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$214.65 |
$795 |
1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$850.23 |
$3,149 |
1.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$850.23 |
$3,149 |
1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,070.82 |
$3,966 |
2.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$324 |
$1,200 |
0.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$692.82 |
$2,566 |
4.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$154.52 |
$572.28 |
0.7× |
| Thoracic spine 2 views (72070) |
$141.75 |
$525 |
1.1× |
| Thoracic spine 3 views (72072) |
$157.41 |
$583 |
1.2× |
| Thoracolumbar 2 views (72080) |
$192.24 |
$712 |
1.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$315.15 |
$1,167.22 |
0.6× |
| Thyroid Met Imaging Body (78018) |
$1,724.08 |
$6,385.48 |
2.5× |
| Thyroid Uptake Measurement (78012) |
$349.92 |
$1,296 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$382.51 |
$1,416.69 |
0.8× |
| Tx Devices Design & Construction Complex (77334) |
$440.91 |
$1,633 |
0.9× |
| Tx devices design & construction intermediate (77333) |
$193.24 |
$715.71 |
1.2× |
| Tx devices design & construction simple (77332) |
$172.46 |
$638.73 |
1.0× |
| Ultrasound Breast Limited (76642) |
$314.82 |
$1,166 |
2.9× |
| Ultrasound elastography first target lesion (76982) |
$155.52 |
$576 |
1.2× |
| Ultrasound Elastography Parenchyma (76981) |
$162 |
$600 |
1.2× |
| Ultrasound Exam Aaa Screen (76706) |
$251.91 |
$933 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$393.66 |
$1,458 |
3.0× |
| Umbilical-artery Doppler (OB) (76820) |
$261.70 |
$969.26 |
2.0× |
| Unlisted magnetic resonance procedure (76498) |
$375.21 |
$1,389.67 |
3.5× |
| Unlisted us procedure (76999) |
$87.58 |
$324.36 |
0.8× |
| Upper gi w/o kub (74240) |
$270.81 |
$1,003 |
1.2× |
| Urethrocystogram voiding (74455) |
$283.50 |
$1,050 |
1.0× |
| Urethrocystography retrograde (74450) |
$325.29 |
$1,204.77 |
1.1× |
| Us breast unilateral complete (76641) |
$378 |
$1,400 |
2.9× |
| Us chest (76604) |
$283.50 |
$1,050 |
2.2× |
| Us complete joint (76881) |
$247.28 |
$915.85 |
1.9× |
| Us exam, pelvic, limited (76857) |
$256.77 |
$951 |
2.0× |
| Us head (76506) |
$179.25 |
$663.89 |
1.4× |
| Us kidney transplant (76776) |
$420.03 |
$1,555.65 |
3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$182.79 |
$677 |
1.4× |
| Us ob detailed single fetus (76811) |
$297 |
$1,100 |
1.0× |
| Us ob limited 1 or more fetuses (76815) |
$204.66 |
$758 |
1.6× |
| Us ob transvaginal (76817) |
$251.91 |
$933 |
1.9× |
| Us pelvic non ob complete (76856) |
$384.21 |
$1,423 |
2.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$381.39 |
$1,412.57 |
2.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$251.91 |
$933 |
1.9× |
| Us retroperitoneal complete (76770) |
$409.32 |
$1,516 |
3.1× |
| Us retroperitoneal limited (76775) |
$299.16 |
$1,108 |
2.3× |
| Us scrotum and contents (76870) |
$378 |
$1,400 |
2.9× |
| Us spinal canal and contents (76800) |
$419.67 |
$1,554.32 |
3.2× |
| Us thyroid (76536) |
$409.32 |
$1,516 |
3.1× |
| Us transrectal (76872) |
$248.67 |
$921 |
1.9× |
| Vein X-Ray Chest (75827) |
$1,219.92 |
$4,518.21 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$810 |
$3,000 |
0.2× |
| Venography caval inferior serialography rs&i (75825) |
$944.73 |
$3,499 |
0.2× |
| Venography extremity bilateral rs&i (75822) |
$935.42 |
$3,464.52 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$813.39 |
$3,012.57 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$70.88 |
$262.50 |
0.7× |
| Wrist 2 views (73100) |
$132.30 |
$490 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$187.22 |
$693.42 |
1.7× |
| X-ray antegrade pyelogram tube (74425) |
$406.52 |
$1,505.64 |
0.9× |
| X-Ray Aorta Leg Arteries (75630) |
$1,165.32 |
$4,316 |
0.3× |
| X-Ray Bend Only L-S Spine (72120) |
$155.68 |
$576.60 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$119.61 |
$443 |
1.1× |
| X-Ray Exam Breast Specimen (76098) |
$157.41 |
$583 |
0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$215.46 |
$798.01 |
2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$220.32 |
$816 |
1.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$213.58 |
$791.05 |
1.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$110.16 |
$408 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$179.55 |
$665 |
1.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$144.32 |
$534.53 |
1.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$239.38 |
$886.59 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$245.98 |
$911.02 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$256.61 |
$950.40 |
2.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$325.39 |
$1,205.13 |
2.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$157.41 |
$583 |
1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$256.91 |
$951.53 |
2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$157.41 |
$583 |
1.2× |
| X-ray eye for foreign body (70030) |
$222.10 |
$822.59 |
2.0× |
| X-ray humerus (73060) |
$126.09 |
$467 |
1.2× |
| X-ray IV pyelogram (ivp) (74400) |
$360.96 |
$1,336.89 |
1.6× |
| X-ray IV pyelogram+tomography (74415) |
$322.79 |
$1,195.50 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$113.07 |
$418.79 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$126.09 |
$467 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$165.24 |
$612 |
1.3× |
| X-ray nose-rectum child f.b. (76010) |
$126.21 |
$467.45 |
1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$233.94 |
$866.45 |
1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$135.54 |
$502 |
1.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$126.09 |
$467 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$135.54 |
$502 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$133.92 |
$496 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$254.16 |
$941.35 |
1.9× |
| X-ray thoracic spine 4 vw (72074) |
$213.37 |
$790.27 |
1.6× |
| X-Ray Tmj Unilat (70328) |
$122.03 |
$451.95 |
1.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$378.49 |
$1,401.81 |
0.9× |
| X-Rays Bone Length Studies (77073) |
$270.28 |
$1,001.02 |
2.1× |
| X-Rays Bone Survey Complete (77075) |
$493.79 |
$1,828.84 |
3.8× |
| Xr c-spine 4 or 5 views (72050) |
$204.66 |
$758 |
1.6× |
| Xr facial bones less than 3 views (70140) |
$110.16 |
$408 |
1.0× |
| Xr orbits complete 4 views (70200) |
$236.03 |
$874.20 |
1.8× |