| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,677.90 |
$12,397 |
5.9× |
| Abdomen 2 views (74019) |
$401.10 |
$573 |
3.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,740.90 |
$2,487 |
4.1× |
| Angiography extremity bilateral rs&i (75716) |
$6,154.40 |
$8,792 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$3,686.20 |
$5,266 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$3,840.20 |
$5,486 |
1.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,594.70 |
$9,421 |
1.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$7,097.30 |
$10,139 |
2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,416.30 |
$6,309 |
1.3× |
| Angiography Spinal Selective Rs&I (75705) |
$4,507.30 |
$6,439 |
0.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,594 |
$9,420 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,685.90 |
$3,837 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,838.70 |
$8,341 |
1.8× |
| Ankle 2 views (73600) |
$249.90 |
$357 |
2.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$810.60 |
$1,158 |
2.2× |
| Aortogram thoracic (75605) |
$4,507.30 |
$6,439 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,776.50 |
$5,395 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$2,893.80 |
$4,134 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$5,694.50 |
$8,135 |
1.7× |
| Arthrogram elbow (73085) |
$996.10 |
$1,423 |
2.7× |
| Arthrogram hip (73525) |
$996.10 |
$1,423 |
2.7× |
| Arthrogram shoulder (73040) |
$996.10 |
$1,423 |
2.7× |
| Arthrogram wrist (73115) |
$996.10 |
$1,423 |
2.7× |
| Arthrography knee lt (73580) |
$996.10 |
$1,423 |
2.7× |
| Basic radiation dosimetry calculation (77300) |
$595.70 |
$851 |
4.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,330 |
$1,900 |
3.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,834 |
$2,620 |
4.3× |
| Bone &/joint imaging whole body (78306) |
$2,018.80 |
$2,884 |
4.8× |
| Bone age studies (77072) |
$207.20 |
$296 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$2,110.50 |
$3,015 |
5.0× |
| Bone survey complete (77075) |
$579.60 |
$828 |
5.3× |
| Brachytx isodose complex (77318) |
$1,760.50 |
$2,515 |
4.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,084.30 |
$1,549 |
2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,310.20 |
$7,586 |
3.5× |
| Brain Imaging Vascular Flow Only (78610) |
$1,708 |
$2,440 |
3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,070.60 |
$2,958 |
5.6× |
| Cardiac shunt detection (78428) |
$786.10 |
$1,123 |
1.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,395.10 |
$1,993 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$403.90 |
$577 |
4.4× |
| Chest 1 view (71045) |
$378.70 |
$541 |
4.1× |
| Chest 3 views (71047) |
$442.40 |
$632 |
4.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$510.30 |
$729 |
2.8× |
| Clavicle complete (73000) |
$308 |
$440 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,225.70 |
$1,751 |
11.1× |
| Continuing medical physics consltj pr wk (77336) |
$1,106.70 |
$1,581 |
7.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,942 |
$7,060 |
13.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,175.20 |
$4,536 |
12.6× |
| CT abdomen w contrast (74160) |
$1,852.90 |
$2,647 |
10.0× |
| CT abdomen w wo contrast (74170) |
$2,221.10 |
$3,173 |
12.0× |
| CT abdomen w/o contrast (74150) |
$1,599.50 |
$2,285 |
14.5× |
| CT angio hrt w/3d image (75574) |
$1,420.30 |
$2,029 |
3.9× |
| CT angiography upper extremity lt (73206) |
$2,072 |
$2,960 |
11.2× |
| CT c-spine w/o contrast (72125) |
$1,746.50 |
$2,495 |
15.8× |
| CT cervical spine w&w/o contrast (72127) |
$2,615.20 |
$3,736 |
14.1× |
| CT cervical spine with contrast (72126) |
$2,333.10 |
$3,333 |
6.3× |
| CT chest w/wo contrast (71270) |
$2,634.10 |
$3,763 |
14.2× |
| CT chest with contrast (71260) |
$2,152.50 |
$3,075 |
11.6× |
| CT head/brain with contrast (70460) |
$2,283.40 |
$3,262 |
12.3× |
| CT head/brain without and with contrast (70470) |
$2,685.90 |
$3,837 |
14.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,136.80 |
$1,624 |
3.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$208.60 |
$298 |
2.3× |
| CT hrt w/3d image congen (75573) |
$1,343.30 |
$1,919 |
3.7× |
| CT iac w contrast (70481) |
$2,763.60 |
$3,948 |
14.9× |
| CT limited/localized follow up study (76380) |
$996.10 |
$1,423 |
10.9× |
| CT lower ext w/o (73700) |
$1,225.70 |
$1,751 |
11.1× |
| CT lower extremity w wo contrast (73702) |
$2,037.70 |
$2,911 |
11.0× |
| CT lower extremity with contrast (73701) |
$1,653.40 |
$2,362 |
8.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,050.30 |
$2,929 |
11.1× |
| CT lumbar spine w/o contrast (72131) |
$1,579.90 |
$2,257 |
14.3× |
| CT lumbar spine with contrast (72132) |
$1,709.40 |
$2,442 |
4.6× |
| CT maxillofacial w contrast (70487) |
$1,733.20 |
$2,476 |
9.4× |
| CT maxillofacial w/o contrast (70486) |
$1,225 |
$1,750 |
11.1× |
| CT maxillofacial w/wo contrast (70488) |
$2,177.70 |
$3,111 |
11.8× |
| CT neck soft tissue w contrast (70491) |
$1,644.30 |
$2,349 |
8.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,178 |
$4,540 |
17.2× |
| CT orbits w/o contrast (70480) |
$2,380 |
$3,400 |
21.6× |
| CT pelvis w & w/o contrast (72194) |
$1,896.30 |
$2,709 |
10.2× |
| CT pelvis w/o contrast (72192) |
$1,664.60 |
$2,378 |
15.1× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$934.50 |
$1,335 |
10.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,941.10 |
$2,773 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,579.90 |
$2,257 |
14.3× |
| CT thoracic spine w/contrast (72129) |
$1,866.90 |
$2,667 |
10.1× |
| CT thoracic spine w/o contrast (72128) |
$1,614.90 |
$2,307 |
14.6× |
| CT thoracic spine w/wo contrast (72130) |
$2,190.30 |
$3,129 |
11.8× |
| CT thorax w/o contrast (71250) |
$1,228.50 |
$1,755 |
11.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,745.80 |
$2,494 |
9.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,430.80 |
$2,044 |
13.0× |
| CT upper extremity with contrast (73201) |
$1,644.30 |
$2,349 |
4.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,775.90 |
$2,537 |
9.6× |
| Cta Abdomen (74175) |
$2,332.40 |
$3,332 |
12.6× |
| CTA abdomen pelvis (74174) |
$5,189.10 |
$7,413 |
14.1× |
| CTA chest (71275) |
$3,142.30 |
$4,489 |
17.0× |
| Cta Head (70496) |
$2,151.10 |
$3,073 |
11.6× |
| CTA lwr ext w&w/o contrast (73706) |
$2,139.90 |
$3,057 |
11.6× |
| Cta Neck (70498) |
$2,151.10 |
$3,073 |
11.6× |
| Cta Pelvis (72191) |
$2,821.70 |
$4,031 |
15.2× |
| Cystography minimum 3 views rs&i (74430) |
$1,433.60 |
$2,048 |
3.9× |
| Dacryocystography (70170) |
$842.80 |
$1,204 |
3.3× |
| Diskogram cervical (72285) |
$4,176.90 |
$5,967 |
2.0× |
| Diskography lumbar (72295) |
$3,903.20 |
$5,576 |
1.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$667.10 |
$953 |
6.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$864.50 |
$1,235 |
7.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$607.60 |
$868 |
5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$303.80 |
$434 |
3.3× |
| Echo exam of eye (76529) |
$177.10 |
$253 |
1.9× |
| Echo exam of fetal heart (76825) |
$995.40 |
$1,422 |
1.7× |
| Echoencephalography real time imaging (76506) |
$714.70 |
$1,021 |
6.5× |
| Esophagus (74220) |
$611.10 |
$873 |
3.3× |
| Fetal biophysical profile non-stress testing (76818) |
$714.70 |
$1,021 |
6.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$536.20 |
$766 |
4.9× |
| Fluoroscopy up to 1 hr (76000) |
$702.10 |
$1,003 |
2.8× |
| Foot 2 views (73620) |
$251.30 |
$359 |
2.7× |
| Forearm 2 views (73090) |
$254.10 |
$363 |
2.8× |
| Gated Heart Planar Single (78472) |
$3,384.50 |
$4,835 |
8.0× |
| Hand 2 views (73120) |
$336 |
$480 |
3.0× |
| Hand 3 views (73130) |
$403.90 |
$577 |
4.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,813.60 |
$5,448 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,358.30 |
$3,369 |
4.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,303.70 |
$3,291 |
5.5× |
| Ht muscle image spect sing (78451) |
$4,037.60 |
$5,768 |
3.0× |
| Humerus Min 2 Views Left (73060) |
$254.10 |
$363 |
2.8× |
| Hysterosalpingogram (74740) |
$1,494.50 |
$2,135 |
5.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$351.40 |
$502 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,368.10 |
$3,383 |
4.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,368.10 |
$3,383 |
4.1× |
| Knee 3 views (73562) |
$322.70 |
$461 |
3.5× |
| Liver & spleen imaging static only (78215) |
$1,491.70 |
$2,131 |
3.5× |
| Liver imaging static only (78201) |
$1,383.90 |
$1,977 |
2.4× |
| Lung perf&ventilat diferentl (78598) |
$2,616.60 |
$3,738 |
4.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,685.90 |
$3,837 |
0.8× |
| Lymphoscintigraphy (78195) |
$1,602.30 |
$2,289 |
2.8× |
| Mammary ductogram or galactogram single (77053) |
$722.40 |
$1,032 |
2.9× |
| Meckels Diverticulum (78290) |
$1,740.90 |
$2,487 |
4.1× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$506.10 |
$723 |
1.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,712.20 |
$2,446 |
4.3× |
| MRA head w & w/o contrast (70546) |
$3,491.60 |
$4,988 |
9.5× |
| MRA head w/o contrast (70544) |
$3,109.40 |
$4,442 |
12.4× |
| MRA head with contrast (70545) |
$3,249.40 |
$4,642 |
8.8× |
| MRA neck w contrast (70548) |
$3,491.60 |
$4,988 |
9.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,029.20 |
$5,756 |
10.9× |
| MRA neck w/o contrast (70547) |
$3,109.40 |
$4,442 |
12.4× |
| MRI abdomen w contrast (74182) |
$2,774.10 |
$3,963 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,942.10 |
$4,203 |
8.0× |
| MRI abdomen w/o contrast (74181) |
$2,154.60 |
$3,078 |
8.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,924.30 |
$2,749 |
2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,353.40 |
$3,362 |
2.8× |
| MRI bone marrow blood supply (77084) |
$2,522.10 |
$3,603 |
10.0× |
| MRI breast w/o contrast bilateral (77047) |
$1,390.20 |
$1,986 |
5.5× |
| MRI breast w/o contrast unilat (77046) |
$515.20 |
$736 |
2.0× |
| MRI c-spine with contrast (72142) |
$2,741.20 |
$3,916 |
7.4× |
| MRI cardiac w/o contrast (75557) |
$1,353.10 |
$1,933 |
5.4× |
| MRI cervical spine w/o contrast (72141) |
$2,109.80 |
$3,014 |
8.4× |
| MRI chest w/o & w/contrast material (71552) |
$3,290.70 |
$4,701 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,297.40 |
$3,282 |
9.1× |
| MRI fetal sngl/1st gestation (74712) |
$3,609.20 |
$5,156 |
14.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,676.50 |
$2,395 |
4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,496.20 |
$3,566 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,606.50 |
$2,295 |
6.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,297.40 |
$3,282 |
9.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,970.80 |
$4,244 |
8.1× |
| MRI orbit/face/neck w/contrast (70542) |
$2,698.50 |
$3,855 |
7.3× |
| MRI pelvis w contrast (72196) |
$2,869.30 |
$4,099 |
7.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,271.80 |
$4,674 |
8.9× |
| MRI pelvis w/o contrast (72195) |
$2,439.50 |
$3,485 |
9.7× |
| MRI scan of arm joint before and after contrast (73223) |
$2,843.40 |
$4,062 |
7.7× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,408.70 |
$3,441 |
2.9× |
| MRI scan of leg joint before and after contrast (73723) |
$2,599.10 |
$3,713 |
7.1× |
| MRI spectroscopy (76390) |
$1,096.20 |
$1,566 |
11.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,878.40 |
$4,112 |
7.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,741.20 |
$3,916 |
7.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,878.40 |
$4,112 |
7.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,741.20 |
$3,916 |
7.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,878.40 |
$4,112 |
7.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,231.60 |
$3,188 |
8.9× |
| MRI tmj (70336) |
$2,077.60 |
$2,968 |
8.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,836.80 |
$2,624 |
7.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,083.50 |
$4,405 |
8.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,568 |
$2,240 |
6.2× |
| Myelogram Cervical (72240) |
$1,685.60 |
$2,408 |
2.0× |
| Myelogram Lumbar (72265) |
$1,694 |
$2,420 |
2.0× |
| Myelogram thoracic (72255) |
$1,570.10 |
$2,243 |
1.9× |
| Myelography 2 or more regions (72270) |
$2,139.90 |
$3,057 |
2.6× |
| Myocardial Spect Multiple Studies (78452) |
$5,352.20 |
$7,646 |
3.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,240.70 |
$3,201 |
2.5× |
| Neck soft tissue (70360) |
$256.20 |
$366 |
2.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$906.50 |
$1,295 |
2.1× |
| Nm adrenal scan (78075) |
$1,887.90 |
$2,697 |
1.4× |
| Nm cisternogram (78630) |
$1,807.40 |
$2,582 |
3.2× |
| Nm gastric emptying study (78264) |
$2,358.30 |
$3,369 |
5.6× |
| Nm peritoneal-venous shunt patency (78291) |
$837.90 |
$1,197 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$10,122.70 |
$14,461 |
6.9× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$6,349.70 |
$9,071 |
4.2× |
| Nuclear medicine study of endocrine organs (78099) |
$822.82 |
$1,175.45 |
2.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,724.10 |
$2,463 |
4.1× |
| Nuclear Rx Oral Admin (79005) |
$2,275 |
$3,250 |
9.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$529.20 |
$756 |
4.8× |
| Orthopantogram (70355) |
$228.20 |
$326 |
2.5× |
| Osseous survey infant (77076) |
$609 |
$870 |
5.5× |
| Osseous survey limited (77074) |
$317.10 |
$453 |
2.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,098.30 |
$1,569 |
2.6× |
| Parathyroid imaging (78070) |
$1,095.50 |
$1,565 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$338.80 |
$484 |
3.1× |
| Peritoneogram rs&i (74190) |
$1,666 |
$2,380 |
2.9× |
| PET image w/CT, skull-thigh (78815) |
$5,310.20 |
$7,586 |
3.5× |
| PET imaging CT for attenuation limited area (78814) |
$5,040.70 |
$7,201 |
3.3× |
| PET imaging for CT attenuation whole body (78816) |
$5,841.50 |
$8,345 |
3.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,843.40 |
$4,062 |
7.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,286.80 |
$6,124 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,686.20 |
$5,266 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,400 |
$2,000 |
3.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,805.60 |
$4,008 |
4.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,800.05 |
$2,571.50 |
3.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$204.40 |
$292 |
2.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$233.10 |
$333 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$388.50 |
$555 |
3.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$435.40 |
$622 |
3.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$277.90 |
$397 |
2.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,931.60 |
$24,188 |
2.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,311.10 |
$1,873 |
2.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$433.30 |
$619 |
4.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$442.40 |
$632 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$400.40 |
$572 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$389.90 |
$557 |
4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$435.40 |
$622 |
3.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$403.90 |
$577 |
4.4× |
| Radiologic exam colon single contrast study (74270) |
$903 |
$1,290 |
4.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$785.40 |
$1,122 |
4.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$903 |
$1,290 |
4.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$678.30 |
$969 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$284.90 |
$407 |
3.1× |
| Radiological examination surgical specimen (76098) |
$452.90 |
$647 |
0.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,686.20 |
$5,266 |
1.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,286.80 |
$6,124 |
1.3× |
| Ribs bilateral 3 views (71110) |
$430.50 |
$615 |
3.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,821.40 |
$2,602 |
4.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,981.70 |
$2,831 |
3.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,868.90 |
$5,527 |
6.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,922.10 |
$5,603 |
2.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,578.80 |
$3,684 |
1.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$805 |
$1,150 |
3.3× |
| Rp Therapy Intravenous Administration (79101) |
$4,967.20 |
$7,096 |
20.2× |
| Sacroiliac Joints < 3 Views (72200) |
$284.90 |
$407 |
2.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$714.70 |
$1,021 |
2.8× |
| Scanogram (77073) |
$403.90 |
$577 |
3.7× |
| Scapula complete (73010) |
$351.40 |
$502 |
3.2× |
| Screening digital breast tomosynthesis (77063) |
$59.50 |
$85 |
2.5× |
| Sella turcica (70240) |
$133 |
$190 |
1.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,087.10 |
$1,553 |
9.9× |
| Sialogram (70390) |
$1,201.90 |
$1,717 |
4.8× |
| Simulation intermediate (77285) |
$1,305.50 |
$1,865 |
3.3× |
| Small bowel series (74250) |
$785.40 |
$1,122 |
4.2× |
| Spec medical radj physics consltj (77370) |
$522.90 |
$747 |
3.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,472.80 |
$2,104 |
3.7× |
| Special dosimetry (77331) |
$1,224.30 |
$1,749 |
8.6× |
| Special treatment procedure (77470) |
$2,056.60 |
$2,938 |
3.5× |
| Spine thoracic 3 views (72072) |
$401.10 |
$573 |
3.6× |
| Splenoportograpy rs&i (75810) |
$3,845.10 |
$5,493 |
1.2× |
| Stereotactic body radiation delivery (77373) |
$11,090.10 |
$15,843 |
5.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,507.10 |
$2,153 |
3.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$802.90 |
$1,147 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,957.20 |
$2,796 |
5.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,035.30 |
$1,479 |
7.3× |
| Therapeutic Enema (74283) |
$785.40 |
$1,122 |
4.2× |
| Thoracolumbar 2 views (72080) |
$335.30 |
$479 |
3.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,278.50 |
$3,255 |
4.0× |
| Thyroid uptake measurement (78012) |
$781.20 |
$1,116 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,460.20 |
$2,086 |
3.5× |
| Tmj unilateral (70328) |
$434.70 |
$621 |
4.7× |
| Tomogram (76100) |
$609 |
$870 |
5.5× |
| Treatment device intermediate (77333) |
$1,208.90 |
$1,727 |
8.5× |
| Treatment devices simple (77332) |
$958.30 |
$1,369 |
6.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,042.50 |
$5,775 |
7.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$828.80 |
$1,184 |
2.0× |
| Tx devices design & construction complex (77334) |
$1,712.20 |
$2,446 |
4.3× |
| Ultrasound elastography first target lesion (76982) |
$238 |
$340 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$616.70 |
$881 |
5.6× |
| Umbilical-artery Doppler (OB) (76820) |
$864.50 |
$1,235 |
7.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$1,425.21 |
$2,036.01 |
15.5× |
| Unlisted fluoroscopic procedure (76496) |
$560 |
$800 |
6.1× |
| Unlisted magnetic resonance procedure (76498) |
$3,566.20 |
$5,094.56 |
38.8× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$754.58 |
$1,077.96 |
1.8× |
| Unlisted Ultrasound Procedure (76999) |
$206.72 |
$295.31 |
2.3× |
| Upper Extremity Infant (73092) |
$351.40 |
$502 |
3.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,246.70 |
$1,781 |
5.0× |
| Urethrocystography voiding (74455) |
$1,246.70 |
$1,781 |
5.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$810.60 |
$1,158 |
4.4× |
| Us abdl aorta screen aaa (76706) |
$735 |
$1,050 |
6.7× |
| Us breast unilateral complete (76641) |
$501.90 |
$717 |
4.6× |
| Us breast unilateral limited (76642) |
$454.30 |
$649 |
4.9× |
| Us chest (76604) |
$822.50 |
$1,175 |
7.5× |
| Us compl joint r-t w/image documentation (76881) |
$822.50 |
$1,175 |
7.5× |
| Us elastography parenchyma (76981) |
$256.20 |
$366 |
2.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$761.60 |
$1,088 |
6.9× |
| Us guided compression repair (76936) |
$1,679.30 |
$2,399 |
7.4× |
| Us infant hips dynamic (76885) |
$714.70 |
$1,021 |
7.8× |
| Us infant hips limited static (76886) |
$379.40 |
$542 |
4.1× |
| Us kidney transplant (76776) |
$822.50 |
$1,175 |
7.5× |
| Us ob detailed single fetus (76811) |
$1,246.70 |
$1,781 |
5.0× |
| Us ob transvaginal (76817) |
$822.50 |
$1,175 |
7.5× |
| Us pelvic non ob complete (76856) |
$714.70 |
$1,021 |
6.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$529.20 |
$756 |
4.8× |
| Us pregnancy ltd (76815) |
$415.80 |
$594 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$822.50 |
$1,175 |
7.5× |
| Us retroperitoneal complete (76770) |
$697.20 |
$996 |
6.3× |
| Us retroperitoneal limited (76775) |
$619.50 |
$885 |
5.6× |
| Us scrotum and contents (76870) |
$822.50 |
$1,175 |
7.5× |
| Us soft tissue head/neck (76536) |
$834.40 |
$1,192 |
7.6× |
| Us spinal canal and contents (76800) |
$714.70 |
$1,021 |
6.5× |
| Us transrectal prostate volume (76873) |
$1,067.50 |
$1,525 |
9.7× |
| Us xtr non-vasc lmtd (76882) |
$642.60 |
$918 |
5.8× |
| Us, eye b-scan (76512) |
$295.40 |
$422 |
2.7× |
| Venogram extremity bilateral (75822) |
$2,268.70 |
$3,241 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$3,318 |
$4,740 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$3,517.50 |
$5,025 |
2.1× |
| Venography extremity unilateral rs&i (75820) |
$1,881.60 |
$2,688 |
1.1× |
| Venography Renal Bilateral (75833) |
$4,416.30 |
$6,309 |
1.3× |
| Venography renal unilateral selective rs&i (75831) |
$4,109.70 |
$5,871 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,813.60 |
$5,448 |
1.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,507.30 |
$6,439 |
0.8× |
| Wrist 2 views (73100) |
$242.20 |
$346 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$499.10 |
$713 |
4.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$403.90 |
$577 |
4.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$304.50 |
$435 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,076.60 |
$1,538 |
5.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$242.20 |
$346 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$310.80 |
$444 |
3.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$265.30 |
$379 |
2.4× |
| X-ray exam hip uni 1 view (73501) |
$308 |
$440 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$468.30 |
$669 |
5.1× |
| X-ray exam hip uni 4/> views (73503) |
$599.20 |
$856 |
5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$506.10 |
$723 |
4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$595 |
$850 |
5.4× |
| X-ray exam of femur 1 (73551) |
$228.90 |
$327 |
2.5× |
| X-ray eye for foreign body (70030) |
$392 |
$560 |
4.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$282.80 |
$404 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$271.60 |
$388 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$322.70 |
$461 |
3.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,697.10 |
$3,853 |
1.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$263.20 |
$376 |
2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$379.40 |
$542 |
4.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$403.90 |
$577 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$172.90 |
$247 |
1.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$396.20 |
$566 |
4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$375.20 |
$536 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$700.70 |
$1,001 |
6.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$403.90 |
$577 |
3.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$351.40 |
$502 |
3.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$338.80 |
$484 |
3.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$403.90 |
$577 |
3.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$349.30 |
$499 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$351.40 |
$502 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$401.10 |
$573 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$609 |
$870 |
5.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$403.90 |
$577 |
3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$261.10 |
$373 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$254.10 |
$363 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$403.90 |
$577 |
4.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$354.90 |
$507 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$537.60 |
$768 |
4.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$351.40 |
$502 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$291.90 |
$417 |
3.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$403.90 |
$577 |
4.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$351.40 |
$502 |
3.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$361.90 |
$517 |
3.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$574 |
$820 |
5.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$288.40 |
$412 |
3.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$310.80 |
$444 |
3.4× |
| Xr c-spine 6 or more views (72052) |
$700.70 |
$1,001 |
6.4× |
| Xr chest 4+ views (71048) |
$461.30 |
$659 |
4.2× |
| Xr finger(s) 2+ views (73140) |
$351.40 |
$502 |
3.8× |
| Xr shoulder 1 view (73020) |
$249.20 |
$356 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$613.90 |
$877 |
5.6× |
| Xr tibia/fibula 2 views (73590) |
$254.10 |
$363 |
2.8× |
| Xr tmj bilateral (70330) |
$500.50 |
$715 |
5.5× |
| Xray knee 1 or 2 views rt (73560) |
$275.80 |
$394 |
3.0× |