| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,467.95 |
$6,935.90 |
2.5× |
| Abdomen 1 View (74018) |
$13.10 |
$26.10 |
0.2× |
| Abdomen 2 views (74019) |
$15.20 |
$30.40 |
0.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$56.90 |
$113.70 |
0.1× |
| Adrenal Cortex & Medulla Img (78075) |
$43 |
$85.90 |
0.0× |
| Angio pulmonary bilat (75743) |
$266.20 |
$532.40 |
0.1× |
Angiography extremity bilateral rs&i (75716)
range across 3 matching MRF lines |
$82.10–$783.60 |
$164.20–$1,567.10 |
varies |
Angiography extremity unilateral rs&i (75710)
range across 4 matching MRF lines |
$69.90–$802.70 |
$139.70–$1,605.40 |
varies |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$52.10 |
$104.10 |
0.0× |
| Ankle 2 views (73600) |
$12.30 |
$24.50 |
0.1× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$62 |
$124 |
0.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,905.65 |
$5,811.30 |
0.9× |
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure |
$63.80 |
$127.60 |
0.0× |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$223.20 |
$446.30 |
0.0× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$321.60 |
$643.20 |
0.1× |
| Arthrogram ankle (73615) |
$29.80 |
$59.60 |
0.1× |
| Arthrogram hip (73525) |
$37.70 |
$75.40 |
0.1× |
| Arthrogram Wrist (73115) |
$30.70 |
$61.30 |
0.1× |
| Basic radiation dosimetry calculation (77300) |
$213.55 |
$427.10 |
1.6× |
| Bone age studies (77072) |
$13.70 |
$27.40 |
0.1× |
| Bone Imaging 3 Phase (78315) |
$65 |
$130 |
0.2× |
| Bone Imaging Limited Area (78300) |
$41.10 |
$82.10 |
0.1× |
| Bone Imaging Multiple Areas (78305) |
$53.30 |
$106.60 |
0.1× |
| Bone Imaging Whole Body (78306) |
$53.30 |
$106.60 |
0.1× |
| Bone marrow imaging limited area (78102) |
$31.10 |
$62.10 |
0.1× |
| Bone marrow imaging; multiple areas (78103) |
$41.30 |
$82.60 |
0.1× |
| Bone marrow imaging; whole body (78104) |
$44.60 |
$89.10 |
0.1× |
| Bone survey infant (77076) |
$37.90 |
$75.80 |
0.4× |
| Brain Flow Imaging Only (78610) |
$17.70 |
$35.30 |
0.0× |
| Brain Image W/Flow < 4 Views (78601) |
$29.10 |
$58.20 |
0.1× |
| Brain imaging < 4 static views (78600) |
$26.20 |
$52.40 |
0.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$36.50 |
$72.90 |
0.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$31.10 |
$62.10 |
0.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$77.70 |
$155.30 |
0.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$83.10 |
$166.20 |
0.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$138.10 |
$276.20 |
0.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$159.60 |
$319.10 |
0.2× |
| Cat Scan Follow-Up Study (76380) |
$55.70 |
$111.40 |
0.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$32.40 |
$64.70 |
0.1× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$36.50 |
$72.90 |
0.1× |
| Cerebrospinal Fluid Scan (78630) |
$39.30 |
$78.60 |
0.1× |
| Chest 1 view (71045) |
$12.30 |
$24.50 |
0.1× |
| Chest 2 views (71046) |
$13.70 |
$27.40 |
0.2× |
| Chest 3 views (71047) |
$16.50 |
$32.90 |
0.2× |
| Chest 4 or more views (71048) |
$20.50 |
$41 |
0.2× |
| Clavicle complete (73000) |
$13.10 |
$26.10 |
0.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$102 |
$203.90 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$348.95 |
$697.90 |
2.6× |
Contrast Exam Abdominl Aorta (75625)
range across 3 matching MRF lines |
$71.80–$308 |
$143.60–$615.90 |
varies |
| Contrast X-Ray Bladder (74430) |
$18.40 |
$36.80 |
0.1× |
| Contrast X-Ray Of Elbow (73085) |
$31.80 |
$63.60 |
0.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$38.30 |
$76.50 |
0.1× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$30.20 |
$60.30 |
0.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$128.70 |
$257.40 |
0.4× |
| CT abdomen and pelvis without contrast (74176) |
$110.90 |
$221.70 |
0.5× |
| CT abdomen w contrast (74160) |
$82.10 |
$164.20 |
0.5× |
| CT abdomen w wo contrast (74170) |
$88.90 |
$177.80 |
0.5× |
| CT abdomen w/o contrast (74150) |
$77.30 |
$154.60 |
0.7× |
| CT Angio Abdomen and Pelvis (74174) |
$140.30 |
$280.60 |
0.4× |
| CT Angio Chest (71275) |
$123.20 |
$246.40 |
0.7× |
| CT Angio Head (70496) |
$112.90 |
$225.70 |
0.6× |
| CT angio hrt w/3d image (75574) |
$128.20 |
$256.40 |
0.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$121.20 |
$242.30 |
0.7× |
| CT Angio Neck (70498) |
$112.30 |
$224.50 |
0.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$115 |
$230 |
0.7× |
| CT cervical spine w/ contrast (72126) |
$69.70 |
$139.40 |
0.2× |
| CT cervical spine w/o contrast (72125) |
$68.50 |
$137 |
0.7× |
| CT cervical spine w/wo cont (72127) |
$82.10 |
$164.20 |
0.5× |
| CT chest w contrast (71260) |
$79.40 |
$158.70 |
0.5× |
| CT chest w/wo contrast (71270) |
$88.90 |
$177.80 |
0.5× |
| CT colonography screening (74263) |
$124.40 |
$248.70 |
0.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$130.20 |
$260.30 |
1.2× |
| CT head/brain with contrast (70460) |
$88.90 |
$177.80 |
0.5× |
| CT head/brain without and with contrast (70470) |
$82.10 |
$164.20 |
0.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$94.10 |
$188.20 |
0.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$29 |
$58 |
0.3× |
| CT hrt w/3d image congen (75573) |
$137.40 |
$274.80 |
0.4× |
| CT iac w contrast (70481) |
$88.90 |
$177.80 |
0.5× |
| CT l-spine w&w/o contrast (72133) |
$68.60 |
$137.10 |
0.4× |
| CT lower ext w/o (73700) |
$67.10 |
$134.20 |
0.6× |
| CT lower extremity w/contrast material (73701) |
$75.20 |
$150.40 |
0.4× |
| CT lumbar spine w contrast (72132) |
$78.80 |
$157.50 |
0.2× |
| CT lumbar spine w/o contrast (72131) |
$65 |
$130 |
0.6× |
| CT maxillofacial w contrast (70487) |
$82.80 |
$165.60 |
0.5× |
| CT maxillofacial wo contrast (70486) |
$72.60 |
$145.20 |
0.7× |
| CT neck tissue combo (70492) |
$92.40 |
$184.80 |
0.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$92.40 |
$184.80 |
0.5× |
| CT orbits w/o contrast (70480) |
$82.80 |
$165.60 |
0.8× |
| CT pelvis w&w/o contrast (72194) |
$78.80 |
$157.50 |
0.5× |
| CT pelvis w/o contrast (72192) |
$69.10 |
$138.10 |
0.7× |
| CT scan of leg combo (73702) |
$78.80 |
$157.50 |
0.5× |
| CT scans face/jaw combo (70488) |
$92.40 |
$184.80 |
0.5× |
| CT soft tissue neck w contrast (70491) |
$88.90 |
$177.80 |
0.5× |
| CT soft tissue neck w/o contrast (70490) |
$82.10 |
$164.20 |
0.8× |
| CT thoracic spine w contrast (72129) |
$109.50 |
$219 |
0.6× |
| CT thoracic spine w/o contrast (72128) |
$65 |
$130 |
0.6× |
| CT thoracic spine w/wo cont (72130) |
$68.90 |
$137.70 |
0.4× |
| CT thorax w/o contrast (71250) |
$65 |
$130 |
0.6× |
| CT unlisted procedure (76497) |
$47.30 |
$94.60 |
0.5× |
| CT upper ext wo (73200) |
$67.10 |
$134.20 |
0.6× |
CT upper extremity w/o & w/contrast material (73202)
range across 4 matching MRF lines |
$66.20–$329 |
$132.40–$657.90 |
varies |
| CT upper extremity with contrast (73201) |
$78.40 |
$156.80 |
0.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$150.60 |
$301.10 |
0.9× |
| Cta Abdomen (74175) |
$121.80 |
$243.60 |
0.7× |
| CTA pelvis (72191) |
$116.30 |
$232.60 |
0.7× |
| Discography Cerv/Thor Spine (72285) |
$59.60 |
$119.20 |
0.0× |
Diskography lumbar (72295)
range across 3 matching MRF lines |
$43.10–$50 |
$86.20–$100 |
varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$30.30 |
$60.50 |
0.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$31 |
$62 |
0.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$37.60 |
$75.10 |
0.4× |
| Dxa Bone Density Axial (77080) |
$13.70 |
$27.40 |
0.1× |
Dxa bone density study (77085)
range across 2 matching MRF lines |
$13.80–$24 |
$27.50–$47.90 |
varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$15.10 |
$30.20 |
0.2× |
| Echo exam of fetal heart (76825) |
$67.70 |
$135.40 |
0.1× |
Echo exam uterus (76831)
range across 2 matching MRF lines |
$30.10–$46.60 |
$60.20–$93.10 |
varies |
| Echo Guide For Artery Repair (76936) |
$114.20 |
$228.30 |
0.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$44.40 |
$88.80 |
0.2× |
| Echograp Trans R Pros Study (76873) |
$88.60 |
$177.20 |
0.9× |
| Esophageal Motility Study (78258) |
$43 |
$85.90 |
0.1× |
| Esophagram (74220) |
$100 |
$199.90 |
0.6× |
| Fetal Biophys Profile W/Nst (76818) |
$103.40 |
$206.80 |
1.0× |
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 9 matching MRF lines |
$31.50–$35.60 |
$62.90–$71.10 |
varies |
| Fluoroscopy up to 1 hr (76000) |
$14.40 |
$28.70 |
0.1× |
Follow-Up Angiography (75898)
range across 2 matching MRF lines |
$101.80–$869.20 |
$203.60–$1,738.40 |
varies |
| Foot 2 views (73620) |
$12.30 |
$24.50 |
0.1× |
| Forearm 2 views (73090) |
$12.30 |
$24.50 |
0.1× |
| Gastric emptying imaging study (78264) |
$51.40 |
$102.80 |
0.1× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$56.50 |
$112.90 |
0.1× |
| Gastric Mucosa Imaging (78261) |
$39.30 |
$78.60 |
0.1× |
| Gastroesophageal Reflux Exam (78262) |
$38.40 |
$76.80 |
0.1× |
| Gated Heart Planar Single (78472) |
$53.60 |
$107.20 |
0.1× |
| Gated Heart, Multiple (78473) |
$82.70 |
$165.40 |
0.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$62.20 |
$124.40 |
0.1× |
| Hand 2 views (73120) |
$12.30 |
$24.50 |
0.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,073.20 |
$4,146.40 |
3.0× |
| Heart first pass single,planar (78481) |
$55.70 |
$111.40 |
0.1× |
| Heart Image (Pet) Multiple (78492) |
$94.10 |
$188.20 |
0.1× |
| Hepatobil Syst Image W/Drug (78227) |
$58.20 |
$116.30 |
0.1× |
| Hepatobiliary System Imaging (78226) |
$30.80 |
$61.60 |
0.1× |
| Ht Musc Image Planar Mult (78454) |
$77.70 |
$155.40 |
0.1× |
| Ht Muscle Image Spect Sing (78451) |
$86.20 |
$172.40 |
0.1× |
| Hysterosalpingogram (74740) |
$24.70 |
$49.30 |
0.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$40.20 |
$80.40 |
0.5× |
| Infant hip ultrasound, limited static exam (76886) |
$33.70 |
$67.40 |
0.4× |
| Infusion Ivp (74410) |
$24.50 |
$48.90 |
0.1× |
| Joint Survey Single View (77077) |
$22.60 |
$45.10 |
0.2× |
| K Flow/Funct Image Multiple (78709) |
$79.80 |
$159.60 |
0.1× |
| K Flow/Funct Image W/Drug (78708) |
$78.80 |
$157.50 |
0.1× |
| K Flow/Funct Image W/O Drug (78707) |
$60.30 |
$120.50 |
0.1× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$21.30 |
$42.60 |
0.1× |
| Kidney Imaging Morphol (78700) |
$25.80 |
$51.60 |
0.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$27.50 |
$54.90 |
0.1× |
| Knee 3 Views (73562) |
$15.10 |
$30.20 |
0.2× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$35.50 |
$71 |
0.1× |
| Leveen/Shunt Patency Exam (78291) |
$50 |
$99.90 |
0.1× |
| Liver & Spleen Imaging Static Only (78215) |
$28.30 |
$56.50 |
0.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$32 |
$64 |
0.1× |
| Liver imaging static only (78201) |
$24.60 |
$49.10 |
0.0× |
| Liver imaging w/vascular flow (78202) |
$27.50 |
$54.90 |
0.1× |
| Lung Perf&Ventilat Diferentl (78598) |
$48.30 |
$96.60 |
0.1× |
| Lung perfusion differential (78597) |
$41.30 |
$82.60 |
0.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$61.90 |
$123.70 |
0.1× |
| Lung Ventilation Imaging (78579) |
$27.80 |
$55.60 |
0.1× |
| Lymph System Imaging (78195) |
$68.80 |
$137.50 |
0.1× |
| Magnetic Image Jaw Joint (70336) |
$95.90 |
$191.70 |
0.4× |
| Mammary ductogram or galactogram multiple (77054) |
$20.60 |
$41.20 |
0.1× |
| Mammary ductogram or galactogram single (77053) |
$16.70 |
$33.30 |
0.1× |
| Meckels Divert Exam (78290) |
$39.30 |
$78.60 |
0.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,623.40 |
$7,246.80 |
9.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$80.70 |
$161.40 |
0.2× |
| MRA head w/o contrast (70544) |
$72.50 |
$145 |
0.3× |
| MRA head with contrast (70545) |
$65 |
$130 |
0.2× |
| MRA neck w contrast (70548) |
$76.60 |
$153.20 |
0.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$116.30 |
$232.60 |
0.3× |
| MRA neck w/o contrast (70547) |
$76.60 |
$153.20 |
0.3× |
| MRI abdomen w contrast (74182) |
$102.60 |
$205.20 |
0.3× |
| MRI abdomen w/o contrast (74181) |
$93.80 |
$187.50 |
0.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$106.10 |
$212.20 |
0.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$138.20 |
$276.40 |
0.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$106.10 |
$212.20 |
0.1× |
| MRI brain functional w/physician admnistration (70555) |
$136.60 |
$273.20 |
0.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$86.90 |
$173.70 |
0.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$78.90 |
$157.70 |
0.3× |
| MRI cardiac w/o cont stress (75559) |
$154.20 |
$308.40 |
0.3× |
| MRI cardiac w/o contrast (75557) |
$125.60 |
$251.10 |
0.5× |
| MRI cervical spine w contrast (72142) |
$115 |
$230 |
0.3× |
| MRI cervical spine w/o cont (72141) |
$95.90 |
$191.70 |
0.4× |
| MRI chest w/o contrast (71550) |
$79.60 |
$159.10 |
0.3× |
| MRI chest with contrast (71551) |
$93.80 |
$187.50 |
0.1× |
| MRI chest wo w contrast (71552) |
$140.30 |
$280.60 |
0.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$106.10 |
$212.20 |
0.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$138.20 |
$276.40 |
0.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$87.60 |
$175.20 |
0.4× |
| MRI lumbar spine w contrast (72149) |
$116.30 |
$232.60 |
0.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$147.20 |
$294.30 |
0.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$88.90 |
$177.80 |
0.4× |
| MRI orbit face neck w contrast (70542) |
$91.90 |
$183.80 |
0.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$136.90 |
$273.70 |
0.4× |
| MRI pelvis w contrast (72196) |
$670.70 |
$1,341.30 |
1.9× |
| MRI pelvis w/o & w contrast (72197) |
$143.60 |
$287.20 |
0.4× |
| MRI pelvis w/o contrast (72195) |
$95.90 |
$191.70 |
0.4× |
| MRI spectroscopy (76390) |
$76.50 |
$153 |
0.9× |
| MRI thoracic spine w/o contrast (72146) |
$95.90 |
$191.70 |
0.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$88.80 |
$177.50 |
0.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$86.90 |
$173.80 |
0.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$138.20 |
$276.40 |
0.4× |
| MRI, abdomen, combo (74183) |
$145.10 |
$290.10 |
0.4× |
| MRI, dorsal spine combo (72157) |
$147.20 |
$294.30 |
0.4× |
| MRI, dorsal spine contrast (72147) |
$96.80 |
$193.60 |
0.3× |
| MRI, joint upper extrem (73221) |
$90.30 |
$180.60 |
0.4× |
| MRI, joint upper extrem combo (73223) |
$138.20 |
$276.40 |
0.4× |
| MRI, lumbar spine combo (72158) |
$147.80 |
$295.60 |
0.4× |
| Myelogram cervical (72240) |
$165.60 |
$331.10 |
0.2× |
| Myelogram Lumbar (72265) |
$54.60 |
$109.20 |
0.1× |
| Myelography thoracic (72255) |
$498.90 |
$997.70 |
0.6× |
| Myelograpy 2/more regions rs&i (72270) |
$54.70 |
$109.40 |
0.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$40.90 |
$81.80 |
0.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$82.30 |
$164.60 |
0.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$57.70 |
$115.30 |
0.0× |
| Myocardial Spect Multiple Studies (78452) |
$100.60 |
$201.20 |
0.1× |
| N-invas est c ffr sw aly CTA (75580) |
$35.40 |
$70.70 |
0.0× |
| Neck soft tissue (70360) |
$10.90 |
$21.80 |
0.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$43.70 |
$87.30 |
0.1× |
| Nm csf leak detection (78650) |
$34.90 |
$69.70 |
0.0× |
| Nm myocard infarct spect (78469) |
$55.40 |
$110.80 |
0.1× |
Nonvascular Shunt X-Ray (75809)
range across 2 matching MRF lines |
$24.40–$25.30 |
$48.70–$50.60 |
varies |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,269.90 |
$6,539.80 |
2.4× |
| Nuclear Rx Intra-Arterial (79445) |
$134.20 |
$268.30 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$111.50 |
$223 |
0.5× |
| Ob us nuchal meas 1 gest (76813) |
$48.60 |
$97.20 |
0.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$29.40 |
$58.80 |
0.3× |
| Panoramic X-ray of jaws (70355) |
$13.30 |
$26.50 |
0.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$89.20 |
$178.40 |
0.2× |
| Parathyroid Planar Imaging (78070) |
$51.40 |
$102.80 |
0.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$68.40 |
$136.80 |
0.2× |
| Pelvis 1 or 2 views (72170) |
$6.90 |
$13.80 |
0.1× |
| Pet Image W/Ct Lmtd (78814) |
$106.50 |
$213 |
0.1× |
| PET image w/CT, full body (78816) |
$136.60 |
$273.20 |
0.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$136.10 |
$272.10 |
0.1× |
| Pet Myocardial Sngl Study (78491) |
$80.10 |
$160.10 |
0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$42.60 |
$85.10 |
0.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$21.90 |
$43.80 |
0.2× |
Radex abscess/fistula/sinus tract rs&i (76080)
range across 3 matching MRF lines |
$121.80–$121.90 |
$243.60–$243.70 |
varies |
| Radex Ankle Complete Minimum 3 Views (73610) |
$13.10 |
$26.10 |
0.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$12.30 |
$24.50 |
0.1× |
| Radex elbow complete minimum 3 views (73080) |
$13.10 |
$26.10 |
0.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$16.50 |
$32.90 |
0.2× |
| Radex fingr minimum 2 views (73140) |
$10.90 |
$21.80 |
0.1× |
| Radex foot complete minimum 3 views (73630) |
$12.30 |
$24.50 |
0.1× |
| Radex Hand Minimum 3 Views (73130) |
$12.30 |
$24.50 |
0.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$12.30 |
$24.50 |
0.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$13.70 |
$27.40 |
0.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$10.90 |
$21.80 |
0.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$15.10 |
$30.20 |
0.2× |
| Radex shoulder complete minimum 2 views (73030) |
$13.70 |
$27.40 |
0.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$10.90 |
$21.80 |
0.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$59.60 |
$119.20 |
0.3× |
| Radex Spine 1 View Specify Level (72020) |
$10.30 |
$20.60 |
0.1× |
| Radex Sternum Minimum 2 Views (71120) |
$220.40 |
$440.80 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$16.50 |
$32.90 |
0.2× |
| Radex Toe Minimum 2 Views (73660) |
$10.30 |
$20.60 |
0.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$12.30 |
$24.50 |
0.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$13.10 |
$26.10 |
0.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$30.80 |
$61.60 |
0.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,015.95 |
$30,031.90 |
2.0× |
| Radiation treatment delivery level 3 (77412) |
$296.90 |
$593.80 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$16.50 |
$32.90 |
0.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$17.80 |
$35.50 |
0.2× |
| Radiologic exam colon double contrast study (74280) |
$70.80 |
$141.50 |
0.4× |
| Radiologic exam colon single contrast study (74270) |
$39.30 |
$78.50 |
0.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$37.90 |
$75.80 |
0.2× |
| Radiologic exam knee complete 4/more views (73564) |
$17.10 |
$34.20 |
0.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$17.10 |
$34.20 |
0.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$27.20 |
$54.40 |
0.2× |
| Radiologic exam swallow function contrast study (74230) |
$30.40 |
$60.70 |
0.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$51.50 |
$102.90 |
0.3× |
| Radiologic examination femur 1 view (73551) |
$13.70 |
$27.40 |
0.2× |
| Radiologic examination femur minimum 2 views (73552) |
$17.10 |
$34.20 |
0.2× |
| Radiologic examination knee 1/2 views (73560) |
$13.70 |
$27.40 |
0.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$30.10 |
$60.20 |
0.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$13.10 |
$26.10 |
0.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$245.40 |
$490.80 |
0.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,477.25 |
$2,954.50 |
3.8× |
| Renal Cyst Study (74470) |
$25.30 |
$50.60 |
0.0× |
| Ribs bilateral 3 views (71110) |
$17.10 |
$34.20 |
0.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$39.30 |
$78.60 |
0.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$46.70 |
$93.40 |
0.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$60.60 |
$121.10 |
0.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$48.70 |
$97.30 |
0.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$74 |
$148 |
0.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$95.30 |
$190.50 |
0.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$84.10 |
$168.10 |
0.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$64.70 |
$129.40 |
0.1× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$128.10 |
$256.20 |
0.6× |
| Rp Therapy Intravenous Administration (79101) |
$111.70 |
$223.30 |
0.5× |
| Scapula (73010) |
$13.70 |
$27.40 |
0.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$24 |
$47.90 |
1.0× |
| Shoulder 1 view (73020) |
$10.30 |
$20.60 |
0.1× |
| Shoulder Arthrography (73040) |
$37.70 |
$75.40 |
0.1× |
| Sialogram (70390) |
$9.20 |
$18.40 |
0.0× |
| Skull less than 4 views (70250) |
$17.10 |
$34.20 |
0.2× |
| Special Physics Consult (77370) |
$387.40 |
$774.80 |
2.9× |
| Special teletherapy port plan (77321) |
$399.90 |
$799.80 |
1.1× |
| Special treatment procedure (77470) |
$986.75 |
$1,973.50 |
1.8× |
| Spleen Imaging (78185) |
$23.30 |
$46.60 |
0.1× |
| Stereotactic Body Radiation Delivery (77373) |
$6,668.55 |
$13,337.10 |
3.7× |
| Sternoclavicular joints (71130) |
$14.40 |
$28.70 |
0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$311.40 |
$622.80 |
0.8× |
| Testicular Imaging W/Flow (78761) |
$41.80 |
$83.50 |
0.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$804.95 |
$1,609.90 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$462 |
$924 |
3.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$78.20 |
$156.30 |
0.4× |
| Thoracic spine 2 views (72070) |
$13.70 |
$27.40 |
0.1× |
| Thoracic spine 3 views (72072) |
$13.70 |
$27.40 |
0.1× |
| Thoracolumbar 2 views (72080) |
$17.10 |
$34.20 |
0.2× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
$40.10 |
$80.10 |
0.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$38.40 |
$76.80 |
0.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$21.30 |
$42.60 |
0.1× |
| Thyroid Met Imaging Body (78018) |
$48.30 |
$96.60 |
0.1× |
| Thyroid Uptake Measurement (78012) |
$13.10 |
$26.10 |
0.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$32.80 |
$65.60 |
0.1× |
| Tx Devices Design & Construction Complex (77334) |
$428 |
$856 |
1.1× |
| Tx devices design & construction simple (77332) |
$299.45 |
$598.90 |
2.2× |
| Ultrasound Breast Limited (76642) |
$41.10 |
$82.10 |
0.5× |
| Ultrasound Elastography Parenchyma (76981) |
$30.20 |
$60.30 |
0.3× |
Ultrasound Exam Aaa Screen (76706)
range across 2 matching MRF lines |
$30.90–$32.40 |
$61.80–$64.70 |
varies |
Ultrasound, abdomen limited (76705)
range across 4 matching MRF lines |
$36.30–$38.30 |
$72.60–$76.50 |
varies |
| Umbilical-artery Doppler (OB) (76820) |
$27.20 |
$54.30 |
0.3× |
| Upper gi w/o kub (74240) |
$39.80 |
$79.60 |
0.2× |
| Ureteral Reflux Study (78740) |
$32 |
$64 |
0.1× |
| Urethrocystogram voiding (74455) |
$19 |
$37.90 |
0.1× |
| Urethrocystography retrograde (74450) |
$17.70 |
$35.30 |
0.1× |
| Us breast unilateral complete (76641) |
$44.50 |
$88.90 |
0.4× |
Us chest (76604)
range across 2 matching MRF lines |
$35.50–$157.40 |
$71–$314.70 |
varies |
Us complete joint (76881)
range across 11 matching MRF lines |
$26.10–$41.10 |
$52.10–$82.10 |
varies |
| Us exam, pelvic, limited (76857) |
$26.20 |
$52.40 |
0.3× |
| Us head (76506) |
$34.90 |
$69.70 |
0.3× |
| Us kidney transplant (76776) |
$41.80 |
$83.50 |
0.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$31.90 |
$63.80 |
0.3× |
| Us ob detailed single fetus (76811) |
$101.40 |
$202.80 |
0.4× |
| Us ob limited 1 or more fetuses (76815) |
$36.50 |
$72.90 |
0.4× |
| Us ob transvaginal (76817) |
$44.70 |
$89.30 |
0.4× |
| Us pelvic non ob complete (76856) |
$30.20 |
$60.40 |
0.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$58.20 |
$116.40 |
0.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$39.20 |
$78.30 |
0.4× |
| Us retroperitoneal complete (76770) |
$47.90 |
$95.70 |
0.5× |
Us retroperitoneal limited (76775)
range across 4 matching MRF lines |
$23.30–$37.70 |
$46.60–$75.40 |
varies |
| Us scrotum and contents (76870) |
$27.40 |
$54.70 |
0.3× |
| Us spinal canal and contents (76800) |
$66.10 |
$132.10 |
0.6× |
| Us thyroid (76536) |
$36.90 |
$73.70 |
0.4× |
| Us transrectal (76872) |
$43.40 |
$86.80 |
0.4× |
| Vascular Flow Imaging (78445) |
$28.30 |
$56.50 |
0.1× |
| Vein X-Ray Chest (75827) |
— |
$121.10 |
— |
| Venography caval inferior serialography rs&i (75825) |
$1,334.55 |
$2,669.10 |
0.4× |
| Venography extremity bilateral rs&i (75822) |
$282.60 |
$565.20 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$223.70 |
$447.40 |
0.1× |
| Venography Renal Unilateral (75831) |
$217.60 |
$435.20 |
0.1× |
Vertebral fracture assessment via dxa (77086)
range across 2 matching MRF lines |
$7.90–$17.10 |
$15.70–$34.20 |
varies |
| Wrist 2 views (73100) |
$13.10 |
$26.10 |
0.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$15.10 |
$30.20 |
0.2× |
| X-ray antegrade pyelogram tube (74425) |
$79.40 |
$158.70 |
0.2× |
| X-Ray Aorta Leg Arteries (75630) |
$101.40 |
$202.70 |
0.0× |
| X-Ray Bend Only L-S Spine (72120) |
$17.10 |
$34.20 |
0.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$12.30 |
$24.50 |
0.1× |
| X-Ray Exam Breast Specimen (76098) |
$47.90 |
$95.80 |
0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$20.50 |
$41 |
0.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$24 |
$47.90 |
0.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$27.40 |
$54.70 |
0.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$13.10 |
$26.10 |
0.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$16.50 |
$32.90 |
0.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$19.90 |
$39.70 |
0.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$19.20 |
$38.40 |
0.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$22.60 |
$45.10 |
0.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$26 |
$51.90 |
0.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$24 |
$47.90 |
0.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$17.10 |
$34.20 |
0.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$24.70 |
$49.30 |
0.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$17.10 |
$34.20 |
0.2× |
| X-ray eye for foreign body (70030) |
$10.90 |
$21.80 |
0.1× |
| X-ray humerus (73060) |
$11.70 |
$23.30 |
0.1× |
| X-ray IV pyelogram (ivp) (74400) |
$28.50 |
$56.90 |
0.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$11.70 |
$23.30 |
0.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$13.70 |
$27.40 |
0.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$17.10 |
$34.20 |
0.2× |
| X-ray nose-rectum child f.b. (76010) |
$13.10 |
$26.10 |
0.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$20.50 |
$41 |
0.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$13.70 |
$27.40 |
0.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$13.10 |
$26.10 |
0.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$13.10 |
$26.10 |
0.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$17.10 |
$34.20 |
0.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$21.90 |
$43.80 |
0.2× |
| X-Ray Stress View (77071) |
$56.60 |
$113.20 |
0.7× |
| X-ray thoracic spine 4 vw (72074) |
$13.70 |
$27.40 |
0.1× |
X-Ray Urinary Tract Exam With Contrast Material (74420)
range across 3 matching MRF lines |
$24–$375 |
$47.90–$750 |
varies |
| X-Rays Bone Length Studies (77073) |
$20.50 |
$41 |
0.2× |
| X-Rays Bone Survey Complete (77075) |
$35.50 |
$71 |
0.3× |
| Xr c-spine 4 or 5 views (72050) |
$20.50 |
$41 |
0.2× |
| Xr facial bones less than 3 views (70140) |
$13.70 |
$27.40 |
0.2× |
| Xr orbits complete 4 views (70200) |
$17.80 |
$35.60 |
0.2× |