| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,574.53 |
$6,443 |
3.6× |
| Abdomen 2 views (74019) |
$371.33 |
$523 |
3.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,155.88 |
$1,628 |
3.1× |
| Angiography extremity bilateral rs&i (75716) |
$4,830.13 |
$6,803 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$9,606.30 |
$13,530 |
3.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,065.85 |
$7,135 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,495.15 |
$11,965 |
2.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,797.08 |
$5,348 |
1.3× |
| Angiography Spinal Selective Rs&I (75705) |
$4,815.93 |
$6,783 |
0.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$10,094.07 |
$14,217 |
2.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,467.57 |
$2,067 |
0.5× |
| Ankle 2 views (73600) |
$355.71 |
$501 |
4.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,004.65 |
$1,415 |
3.1× |
| Aortography abdominal serialography rs&i (75625) |
$6,372.96 |
$8,976 |
2.2× |
| Arthrogram elbow (73085) |
$653.91 |
$921 |
2.0× |
| Arthrogram hip (73525) |
$869.75 |
$1,225 |
2.7× |
| Arthrogram shoulder (73040) |
$881.11 |
$1,241 |
2.7× |
| Arthrogram wrist (73115) |
$1,123.93 |
$1,583 |
3.5× |
| Arthrography knee lt (73580) |
$943.59 |
$1,329 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$430.97 |
$607 |
3.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,060.74 |
$1,494 |
2.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,099.79 |
$1,549 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,448.40 |
$2,040 |
3.9× |
| Bone age studies (77072) |
$309.56 |
$436 |
3.2× |
| Bone Imaging 3 Phase (78315) |
$1,487.45 |
$2,095 |
4.0× |
| Bone Marrow Imaging Limited Area (78102) |
$1,263.80 |
$1,780 |
3.4× |
| Bone survey complete (77075) |
$653.91 |
$921 |
6.7× |
| Brachytx isodose complex (77318) |
$1,495.97 |
$2,107 |
4.3× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$912.35 |
$1,285 |
2.6× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,453.37 |
$2,047 |
3.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,867.69 |
$4,039 |
2.2× |
| Brain Imaging Vascular Flow Only (78610) |
$2,556 |
$3,600 |
5.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,996.59 |
$5,629 |
12.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,563.42 |
$2,202 |
3.1× |
| Cervical spine 2 or 3 views (72040) |
$469.31 |
$661 |
5.8× |
| Chest 1 view (71045) |
$208.74 |
$294 |
2.6× |
| Chest 3 views (71047) |
$286.84 |
$404 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$446.59 |
$629 |
2.7× |
| Clavicle complete (73000) |
$342.22 |
$482 |
4.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$154.07 |
$217 |
1.6× |
| Continuing medical physics consltj pr wk (77336) |
$522.56 |
$736 |
4.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,875.25 |
$8,275 |
18.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,094.57 |
$5,767 |
18.5× |
| CT abdomen w contrast (74160) |
$2,822.25 |
$3,975 |
17.3× |
| CT abdomen w wo contrast (74170) |
$3,432.14 |
$4,834 |
21.0× |
| CT abdomen w/o contrast (74150) |
$2,455.18 |
$3,458 |
25.2× |
| CT angio hrt w/3d image (75574) |
$2,632.68 |
$3,708 |
8.1× |
| CT angiography upper extremity lt (73206) |
$2,563.81 |
$3,611 |
15.7× |
| CT c-spine w/o contrast (72125) |
$2,330.22 |
$3,282 |
24.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,698 |
$3,800 |
16.5× |
| CT cervical spine with contrast (72126) |
$2,633.39 |
$3,709 |
8.1× |
| CT chest w/wo contrast (71270) |
$3,182.22 |
$4,482 |
19.5× |
| CT chest with contrast (71260) |
$2,771.13 |
$3,903 |
17.0× |
| CT colonography screening (74263) |
$1,870.14 |
$2,634 |
8.4× |
| CT colonography w/o cntrst (74261) |
$1,951.79 |
$2,749 |
20.1× |
| CT head/brain with contrast (70460) |
$2,264.19 |
$3,189 |
13.9× |
| CT head/brain without and with contrast (70470) |
$2,492.10 |
$3,510 |
15.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,896.41 |
$2,671 |
5.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$108.63 |
$153 |
1.3× |
| CT hrt w/3d image congen (75573) |
$2,498.49 |
$3,519 |
7.7× |
| CT iac w contrast (70481) |
$1,974.51 |
$2,781 |
12.1× |
| CT limited/localized follow up study (76380) |
$794.49 |
$1,119 |
9.8× |
| CT lower ext w/o (73700) |
$1,481.06 |
$2,086 |
15.2× |
| CT lower extremity w wo contrast (73702) |
$1,382.37 |
$1,947 |
8.5× |
| CT lower extremity with contrast (73701) |
$1,747.31 |
$2,461 |
10.7× |
| CT lumbar spine w & w/o contrast (72133) |
$3,145.30 |
$4,430 |
19.3× |
| CT lumbar spine w/o contrast (72131) |
$2,262.06 |
$3,186 |
23.3× |
| CT lumbar spine with contrast (72132) |
$2,726.40 |
$3,840 |
8.4× |
| CT maxillofacial w contrast (70487) |
$2,520.50 |
$3,550 |
15.4× |
| CT maxillofacial w/o contrast (70486) |
$2,078.17 |
$2,927 |
21.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,851.36 |
$4,016 |
17.5× |
| CT neck soft tissue w contrast (70491) |
$2,396.25 |
$3,375 |
14.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,357.91 |
$3,321 |
14.5× |
| CT orbits w/o contrast (70480) |
$1,879.37 |
$2,647 |
19.3× |
| CT pelvis w & w/o contrast (72194) |
$3,077.85 |
$4,335 |
18.9× |
| CT pelvis w/o contrast (72192) |
$2,125.03 |
$2,993 |
21.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,759.77 |
$3,887 |
16.9× |
| CT soft tissue neck w/o contrast (70490) |
$2,003.62 |
$2,822 |
20.6× |
| CT thoracic spine w/contrast (72129) |
$2,265.61 |
$3,191 |
13.9× |
| CT thoracic spine w/o contrast (72128) |
$2,036.99 |
$2,869 |
20.9× |
| CT thoracic spine w/wo contrast (72130) |
$2,565.23 |
$3,613 |
15.7× |
| CT thorax w/o contrast (71250) |
$2,311.05 |
$3,255 |
23.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,629.84 |
$3,704 |
16.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,964.57 |
$2,767 |
20.2× |
| CT upper extremity with contrast (73201) |
$2,174.73 |
$3,063 |
6.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,252.51 |
$4,581 |
19.9× |
| Cta Abdomen (74175) |
$2,996.91 |
$4,221 |
18.4× |
| CTA abdomen pelvis (74174) |
$4,835.10 |
$6,810 |
14.9× |
| CTA chest (71275) |
$3,126.13 |
$4,403 |
19.2× |
| Cta Head (70496) |
$2,849.94 |
$4,014 |
17.5× |
| CTA lwr ext w&w/o contrast (73706) |
$1,991.55 |
$2,805 |
12.2× |
| Cta Neck (70498) |
$2,735.63 |
$3,853 |
16.8× |
| Cta Pelvis (72191) |
$3,054.42 |
$4,302 |
18.7× |
| Cystography minimum 3 views rs&i (74430) |
$577.23 |
$813 |
1.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$301.04 |
$424 |
3.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$618.41 |
$871 |
6.4× |
| Dxa bone density study axial skeleton (77085) |
$598.53 |
$843 |
6.2× |
| Echoencephalography real time imaging (76506) |
$756.15 |
$1,065 |
7.8× |
| Esophagus (74220) |
$601.37 |
$847 |
3.7× |
| Fetal biophysical profile non-stress testing (76818) |
$942.17 |
$1,327 |
9.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$636.87 |
$897 |
6.5× |
| Fluoroscopy up to 1 hr (76000) |
$621.25 |
$875 |
2.8× |
| Foot 2 views (73620) |
$352.87 |
$497 |
4.4× |
| Forearm 2 views (73090) |
$378.43 |
$533 |
4.7× |
| Gated Heart Planar Single (78472) |
$1,300.01 |
$1,831 |
3.5× |
| Hand 2 views (73120) |
$441.62 |
$622 |
4.5× |
| Hand 3 views (73130) |
$485.64 |
$684 |
6.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,716.14 |
$5,234 |
5.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,521.99 |
$6,369 |
7.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,235.79 |
$3,149 |
4.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,051.19 |
$2,889 |
5.5× |
| Ht muscle image spect sing (78451) |
$2,820.12 |
$3,972 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$261.28 |
$368 |
3.2× |
| Hysterosalpingogram (74740) |
$756.15 |
$1,065 |
3.4× |
| Interstitial radiation source applic complex (77778) |
$6,039.97 |
$8,507 |
9.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$299.62 |
$422 |
3.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,334.80 |
$1,880 |
2.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,393.02 |
$1,962 |
2.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,475.38 |
$2,078 |
2.9× |
| Knee 3 views (73562) |
$477.12 |
$672 |
5.9× |
| Liver & spleen imaging static only (78215) |
$1,741.63 |
$2,453 |
4.7× |
| Lung perf&ventilat diferentl (78598) |
$1,889.31 |
$2,661 |
3.7× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$5,244.77 |
$7,387 |
1.8× |
| Lymphoscintigraphy (78195) |
$1,890.02 |
$2,662 |
3.7× |
| Mammary ductogram or galactogram single (77053) |
$577.23 |
$813 |
2.6× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$338.67 |
$477 |
4.2× |
| Meckels Diverticulum (78290) |
$1,020.27 |
$1,437 |
2.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,665.66 |
$2,346 |
4.8× |
| Mr safety determination physician/other qhp (76016) |
$9,052.50 |
$12,750 |
111.8× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$9,052.50 |
$12,750 |
165.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$9,052.50 |
$12,750 |
336.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$9,052.50 |
$12,750 |
102.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$9,052.50 |
$12,750 |
40.8× |
| MRA head w & w/o contrast (70546) |
$4,559.62 |
$6,422 |
14.1× |
| MRA head w/o contrast (70544) |
$2,928.75 |
$4,125 |
13.2× |
| MRA head with contrast (70545) |
$2,940.11 |
$4,141 |
9.1× |
| MRA neck w contrast (70548) |
$3,073.59 |
$4,329 |
9.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,989.10 |
$4,210 |
9.2× |
| MRA neck w/o contrast (70547) |
$2,683.09 |
$3,779 |
12.1× |
| MRI abdomen w contrast (74182) |
$3,836.84 |
$5,404 |
11.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,647.66 |
$6,546 |
14.3× |
| MRI abdomen w/o contrast (74181) |
$3,476.16 |
$4,896 |
15.7× |
| MRI any jnt lwr ext with con lt (73722) |
$3,755.90 |
$5,290 |
5.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,696.26 |
$5,206 |
5.1× |
| MRI breast w/o contrast bilateral (77047) |
$2,664.63 |
$3,753 |
12.0× |
| MRI breast w/o contrast unilat (77046) |
$2,460.15 |
$3,465 |
11.1× |
| MRI c-spine with contrast (72142) |
$3,863.82 |
$5,442 |
11.9× |
| MRI cardiac w/o contrast (75557) |
$3,718.98 |
$5,238 |
16.8× |
| MRI cervical spine w/o contrast (72141) |
$3,307.18 |
$4,658 |
14.9× |
| MRI chest w/o & w/contrast material (71552) |
$3,214.88 |
$4,528 |
9.9× |
| MRI chest w/o contrast (71550) |
$2,550.32 |
$3,592 |
11.5× |
| MRI fetal sngl/1st gestation (74712) |
$3,298.66 |
$4,646 |
14.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,439.24 |
$4,844 |
10.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,765.13 |
$5,303 |
11.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,530.83 |
$4,973 |
15.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,102.70 |
$4,370 |
14.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,051.26 |
$5,706 |
12.5× |
| MRI orbit/face/neck w/contrast (70542) |
$2,773.97 |
$3,907 |
8.5× |
| MRI pelvis w contrast (72196) |
$3,358.30 |
$4,730 |
10.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,287.69 |
$6,039 |
13.2× |
| MRI pelvis w/o contrast (72195) |
$3,271.68 |
$4,608 |
14.7× |
| MRI scan of arm joint before and after contrast (73223) |
$4,534.77 |
$6,387 |
14.0× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$4,392.06 |
$6,186 |
6.0× |
| MRI scan of leg joint before and after contrast (73723) |
$4,605.06 |
$6,486 |
14.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,720.79 |
$6,649 |
14.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,012.21 |
$5,651 |
12.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,662.57 |
$6,567 |
14.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,189.64 |
$3,084 |
6.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,236.18 |
$4,558 |
10.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,161.95 |
$3,045 |
9.7× |
| MRI tmj (70336) |
$2,519.08 |
$3,548 |
11.4× |
| MRI upper ext joint w/o contrast (73221) |
$3,630.23 |
$5,113 |
16.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,196.81 |
$5,911 |
12.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,584.08 |
$5,048 |
16.2× |
| Myelography 2 or more regions (72270) |
$1,750.86 |
$2,466 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$5,038.16 |
$7,096 |
4.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,262.84 |
$6,004 |
3.2× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,846.71 |
$2,601 |
2.3× |
| Neck soft tissue (70360) |
$267.67 |
$377 |
3.3× |
| Nm cisternogram (78630) |
$2,138.52 |
$3,012 |
4.2× |
| Nm csf leak detection (78650) |
$1,912.03 |
$2,693 |
1.6× |
| Nm gastric emptying study (78264) |
$1,326.99 |
$1,869 |
3.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,429.69 |
$6,239 |
3.4× |
| Nuclear medicine of heart pumping function (78473) |
$852.71 |
$1,201 |
2.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,005.36 |
$1,416 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$2,039.12 |
$2,872 |
9.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$627.64 |
$884 |
6.5× |
| Orthopantogram (70355) |
$279.03 |
$393 |
3.4× |
| Osseous survey infant (77076) |
$384.11 |
$541 |
4.0× |
| Osseous survey limited (77074) |
$463.63 |
$653 |
4.8× |
| Parathyrd planar w/wo subtrj (78071) |
$744.08 |
$1,048 |
2.0× |
| Parathyroid imaging (78070) |
$1,645.78 |
$2,318 |
4.4× |
| Pelvis 1 or 2 views (72170) |
$250.63 |
$353 |
2.6× |
| Perineogram (74775) |
$574.39 |
$809 |
2.6× |
| Peritoneogram rs&i (74190) |
$887.50 |
$1,250 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$5,289.50 |
$7,450 |
4.0× |
| PET imaging CT for attenuation limited area (78814) |
$5,484.75 |
$7,725 |
4.1× |
| PET imaging for CT attenuation whole body (78816) |
$5,556.46 |
$7,826 |
4.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,261.42 |
$6,002 |
13.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,942.70 |
$8,370 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$869.75 |
$1,225 |
2.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,434.91 |
$2,021 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$786.68 |
$1,108 |
1.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$466.47 |
$657 |
5.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$391.21 |
$551 |
4.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$533.92 |
$752 |
5.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$324.47 |
$457 |
3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$615.57 |
$867 |
6.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$24,188.99 |
$34,069 |
3.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$832.12 |
$1,172 |
1.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$501.97 |
$707 |
5.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$661.72 |
$932 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$364.23 |
$513 |
3.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$367.07 |
$517 |
4.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$374.88 |
$528 |
3.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$253.47 |
$357 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$944.30 |
$1,330 |
5.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$700.06 |
$986 |
4.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$935.07 |
$1,317 |
5.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$881.82 |
$1,242 |
5.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$404.70 |
$570 |
5.0× |
| Radiological examination surgical specimen (76098) |
$571.55 |
$805 |
1.1× |
| Ribs bilateral 3 views (71110) |
$479.96 |
$676 |
4.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,045.19 |
$4,289 |
6.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,639.78 |
$3,718 |
5.2× |
| Rp Therapy Intravenous Administration (79101) |
$2,241.47 |
$3,157 |
10.3× |
| Sacroiliac Joints < 3 Views (72200) |
$332.28 |
$468 |
3.4× |
| Scanogram (77073) |
$318.79 |
$449 |
3.3× |
| Scapula complete (73010) |
$401.15 |
$565 |
4.1× |
| Screening digital breast tomosynthesis (77063) |
$125.67 |
$177 |
5.4× |
| Sella turcica (70240) |
$203.77 |
$287 |
2.5× |
| Small bowel series (74250) |
$668.11 |
$941 |
4.1× |
| Spec medical radj physics consltj (77370) |
$704.32 |
$992 |
5.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$956.37 |
$1,347 |
2.7× |
| Special treatment procedure (77470) |
$2,120.77 |
$2,987 |
4.1× |
| Spine thoracic 3 views (72072) |
$537.47 |
$757 |
5.5× |
| Stereotactic body radiation delivery (77373) |
$8,865.77 |
$12,487 |
5.3× |
| Superior sagittal sinus venogram (75870) |
$2,211.65 |
$3,115 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,360.36 |
$1,916 |
3.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$852 |
$1,200 |
2.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,370.30 |
$1,930 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$705.03 |
$993 |
5.6× |
| Therapeutic Enema (74283) |
$1,211.97 |
$1,707 |
7.4× |
| Thoracolumbar 2 views (72080) |
$482.80 |
$680 |
6.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,017.11 |
$2,841 |
4.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$947.14 |
$1,334 |
2.5× |
| Thyroid uptake measurement (78012) |
$401.15 |
$565 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,406.51 |
$1,981 |
3.8× |
| Tmj unilateral (70328) |
$269.09 |
$379 |
3.3× |
| Treatment device intermediate (77333) |
$1,268.06 |
$1,786 |
10.1× |
| Treatment devices simple (77332) |
$986.90 |
$1,390 |
7.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,186.16 |
$5,896 |
8.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,004.33 |
$2,823 |
5.4× |
| Tx devices design & construction complex (77334) |
$1,861.62 |
$2,622 |
5.3× |
| Ultrasound elastography first target lesion (76982) |
$310.27 |
$437 |
3.2× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$624.80 |
$880 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$937.20 |
$1,320 |
9.6× |
| Umbilical-artery Doppler (OB) (76820) |
$413.93 |
$583 |
4.3× |
| Unlisted fluoroscopic procedure (76496) |
$579.36 |
$816 |
7.2× |
| Unlisted Ultrasound Procedure (76999) |
$377.72 |
$532 |
4.7× |
| Upper Extremity Infant (73092) |
$314.53 |
$443 |
3.2× |
| Urethrocystography retrograde rs&i (74450) |
$772.48 |
$1,088 |
3.5× |
| Urethrocystography voiding (74455) |
$742.66 |
$1,046 |
3.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,008.20 |
$1,420 |
6.2× |
| Us abdl aorta screen aaa (76706) |
$708.58 |
$998 |
7.3× |
| Us breast unilateral complete (76641) |
$509.78 |
$718 |
5.2× |
| Us breast unilateral limited (76642) |
$631.90 |
$890 |
7.8× |
| Us chest (76604) |
$425.29 |
$599 |
4.4× |
| Us compl joint r-t w/image documentation (76881) |
$919.45 |
$1,295 |
9.5× |
| Us elastography parenchyma (76981) |
$207.32 |
$292 |
2.1× |
| Us infant hips dynamic (76885) |
$561.61 |
$791 |
6.9× |
| Us infant hips limited static (76886) |
$620.54 |
$874 |
7.7× |
| Us kidney transplant (76776) |
$578.65 |
$815 |
6.0× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$637.58 |
$898 |
6.6× |
| Us ob detailed single fetus (76811) |
$1,159.43 |
$1,633 |
5.2× |
| Us ob transvaginal (76817) |
$689.41 |
$971 |
7.1× |
| Us pelvic non ob complete (76856) |
$883.95 |
$1,245 |
9.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$651.07 |
$917 |
6.7× |
| Us pregnancy ltd (76815) |
$588.59 |
$829 |
6.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$772.48 |
$1,088 |
7.9× |
| Us retroperitoneal complete (76770) |
$562.32 |
$792 |
5.8× |
| Us retroperitoneal limited (76775) |
$621.96 |
$876 |
6.4× |
| Us scrotum and contents (76870) |
$668.11 |
$941 |
6.9× |
| Us soft tissue head/neck (76536) |
$801.59 |
$1,129 |
8.2× |
| Us spinal canal and contents (76800) |
$618.41 |
$871 |
6.4× |
| Us xtr non-vasc lmtd (76882) |
$653.91 |
$921 |
6.7× |
| Venogram extremity bilateral (75822) |
$2,115.80 |
$2,980 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$3,595.44 |
$5,064 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$2,932.30 |
$4,130 |
2.0× |
| Venography extremity unilateral rs&i (75820) |
$3,459.12 |
$4,872 |
2.4× |
| Venography Renal Bilateral (75833) |
$8,125.24 |
$11,444 |
2.8× |
| Venography renal unilateral selective rs&i (75831) |
$8,125.24 |
$11,444 |
2.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,391.99 |
$3,369 |
0.8× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$8,044.30 |
$11,330 |
1.6× |
| Wrist 2 views (73100) |
$306.72 |
$432 |
3.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$557.35 |
$785 |
5.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$300.33 |
$423 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$436.65 |
$615 |
5.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,172.92 |
$1,652 |
7.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$362.10 |
$510 |
4.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$438.07 |
$617 |
5.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$352.87 |
$497 |
3.6× |
| X-ray exam hip uni 1 view (73501) |
$372.75 |
$525 |
4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$393.34 |
$554 |
4.9× |
| X-ray exam hip uni 4/> views (73503) |
$567.29 |
$799 |
5.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$591.43 |
$833 |
6.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$736.98 |
$1,038 |
7.6× |
| X-ray exam of femur 1 (73551) |
$421.03 |
$593 |
5.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$360.68 |
$508 |
3.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$254.18 |
$358 |
3.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$435.94 |
$614 |
5.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$338.67 |
$477 |
4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$260.57 |
$367 |
3.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$494.87 |
$697 |
5.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$352.16 |
$496 |
4.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$306.72 |
$432 |
3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$504.81 |
$711 |
5.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$812.95 |
$1,145 |
8.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$505.52 |
$712 |
5.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$406.83 |
$573 |
5.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$205.90 |
$290 |
2.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$401.15 |
$565 |
4.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$328.02 |
$462 |
3.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$974.83 |
$1,373 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$362.10 |
$510 |
4.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$438.07 |
$617 |
4.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$618.41 |
$871 |
6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$437.36 |
$616 |
4.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$267.67 |
$377 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$455.82 |
$642 |
5.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$519.72 |
$732 |
6.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$302.46 |
$426 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$636.16 |
$896 |
6.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$411.80 |
$580 |
4.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$337.96 |
$476 |
4.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$269.09 |
$379 |
3.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$381.27 |
$537 |
4.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$476.41 |
$671 |
4.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$551.67 |
$777 |
5.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$290.39 |
$409 |
3.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$378.43 |
$533 |
4.7× |
| Xr arthrogram ankle (73615) |
$515.46 |
$726 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$712.13 |
$1,003 |
7.3× |
| Xr chest 4+ views (71048) |
$364.23 |
$513 |
3.7× |
| Xr finger(s) 2+ views (73140) |
$286.13 |
$403 |
3.5× |
| Xr shoulder 1 view (73020) |
$314.53 |
$443 |
3.9× |
| Xr spine cervical 4 or 5 views (72050) |
$591.43 |
$833 |
6.1× |
| Xr tibia/fibula 2 views (73590) |
$367.07 |
$517 |
4.5× |
| Xr tmj bilateral (70330) |
$331.57 |
$467 |
4.1× |
| Xray knee 1 or 2 views rt (73560) |
$326.60 |
$460 |
4.0× |