| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,347.88 |
$6,689.04 |
2.7× |
| Abdomen 2 views (74019) |
$418.11 |
$643.24 |
3.4× |
| Acute gi blood loss imaging (78278) |
$1,931.59 |
$2,971.67 |
4.1× |
| Angio Adrenal Bilat Select (75733) |
$4,402.98 |
$6,773.82 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$4,402.98 |
$6,773.82 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$4,402.98 |
$6,773.82 |
1.2× |
| Angiography internal mammary rs&i (75756) |
$4,402.98 |
$6,773.82 |
1.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$7,596.67 |
$11,687.19 |
1.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,402.98 |
$6,773.82 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,402.98 |
$6,773.82 |
1.2× |
| Angiography Spinal Selective Rs&I (75705) |
$9,749.82 |
$14,999.73 |
1.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,749.82 |
$14,999.73 |
1.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$5,551.86 |
$8,541.33 |
1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,402.98 |
$6,773.82 |
1.2× |
| Ankle 2 views (73600) |
$205.93 |
$316.82 |
2.0× |
| Aortogram thoracic (75605) |
$7,596.67 |
$11,687.19 |
1.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,402.98 |
$6,773.82 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$4,402.98 |
$6,773.82 |
1.2× |
| Artery X-Rays Adrenal Gland (75731) |
$4,402.98 |
$6,773.82 |
1.2× |
| Arthrogram ankle (73615) |
$690.64 |
$1,062.52 |
1.7× |
| Arthrogram elbow (73085) |
$767.38 |
$1,180.58 |
1.9× |
| Arthrogram hip (73525) |
$767.38 |
$1,180.58 |
1.9× |
| Arthrogram knee (73580) |
$690.64 |
$1,062.52 |
1.7× |
| Arthrogram shoulder (73040) |
$767.38 |
$1,180.58 |
1.9× |
| Arthrogram wrist (73115) |
$690.64 |
$1,062.52 |
1.7× |
| Basic dosimetry (77300) |
$616.01 |
$947.71 |
3.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,028.35 |
$1,582.08 |
2.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,204 |
$1,852.31 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,349.95 |
$2,076.85 |
2.9× |
| Bone age studies (77072) |
$390.23 |
$600.36 |
3.2× |
| Bone Imaging 3 Phase (78315) |
$1,907.44 |
$2,934.52 |
4.0× |
| Bone Marrow Imaging Limited Area (78102) |
$1,286.86 |
$1,979.78 |
2.7× |
| Bone survey complete (77075) |
$575.61 |
$885.56 |
4.7× |
| Bone survey infant (77076) |
$407.30 |
$626.61 |
3.3× |
| Bowel imaging (78290) |
$1,920.61 |
$2,954.79 |
4.1× |
| Brachytx isodose complex (77318) |
$2,227.54 |
$3,426.99 |
5.0× |
| Brachytx isodose intermed (77317) |
$1,684.10 |
$2,590.92 |
3.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,093.74 |
$1,682.67 |
2.5× |
| Brain imaging < 4 static views (78600) |
$1,054.45 |
$1,622.23 |
2.2× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$914.54 |
$1,406.98 |
1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,922.81 |
$2,958.17 |
3.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$8,155.62 |
$12,547.11 |
4.8× |
| Brain Imaging Vascular Flow Only (78610) |
$932.07 |
$1,433.96 |
1.5× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$1,358.80 |
$2,090.46 |
2.1× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,483.90 |
$2,282.92 |
3.1× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$2,868.22 |
$4,412.64 |
3.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,471.43 |
$3,802.20 |
6.0× |
| Cardiac shunt detection (78428) |
$1,559.32 |
$2,398.95 |
3.3× |
| Cardiovasc nucl exam unlisted (78499) |
$1,054.45 |
$1,622.23 |
2.2× |
| Cephalogram, orthodontic Non-Facility (70350) |
$205.08 |
$315.50 |
2.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$932.07 |
$1,433.96 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$340.33 |
$523.58 |
3.3× |
| Chest 1 view (71045) |
$413.09 |
$635.53 |
4.0× |
| Chest xray 3 views (71047) |
$648.99 |
$998.45 |
6.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$960.49 |
$1,477.68 |
4.6× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,814.05 |
$2,790.84 |
2.0× |
| Clavicle complete (73000) |
$417.92 |
$642.94 |
4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,465.65 |
$2,254.85 |
11.9× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$288.67 |
$444.11 |
2.8× |
| Continuing medical physics consltj pr wk (77336) |
$886.43 |
$1,363.74 |
5.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$375.16 |
$577.17 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,598.26 |
$3,997.32 |
6.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,698.63 |
$2,613.28 |
6.0× |
| CT abdomen w contrast (74160) |
$1,485.36 |
$2,285.17 |
7.2× |
| CT abdomen w wo contrast (74170) |
$1,871.58 |
$2,879.35 |
9.0× |
| CT abdomen w/o contrast (74150) |
$1,188.30 |
$1,828.16 |
9.6× |
| CT angio hrt w/3d image (75574) |
$1,319.16 |
$2,029.48 |
3.2× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,121.02 |
$3,263.12 |
10.2× |
| CT angiography upper extremity lt (73206) |
$1,476.94 |
$2,272.21 |
7.1× |
| CT c-spine w/contrast (72126) |
$1,895.52 |
$2,916.18 |
4.6× |
| CT c-spine w/o contrast (72125) |
$1,712.13 |
$2,634.04 |
13.9× |
| CT cere prfu aly c+wo CT/CTA (70473) |
$1,377.03 |
$2,118.51 |
6.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,465.08 |
$3,792.43 |
11.9× |
| CT chest w contrast (71260) |
$2,130.21 |
$3,277.25 |
10.3× |
| CT chest w/wo contrast (71270) |
$2,370.91 |
$3,647.56 |
11.4× |
| CT colonography screening (74263) |
$591.17 |
$909.49 |
2.1× |
| CT colonography w/dye (74262) |
$1,496.47 |
$2,302.26 |
7.2× |
| CT colonography w/o cntrst (74261) |
$1,301.26 |
$2,001.94 |
10.5× |
| CT head/brain with contrast (70460) |
$1,257.43 |
$1,934.51 |
6.1× |
| CT head/brain without and with contrast (70470) |
$1,526.88 |
$2,349.04 |
7.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,207.65 |
$1,857.92 |
2.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$320.83 |
$493.58 |
3.1× |
| CT hrt w/3d image congen (75573) |
$1,516.56 |
$2,333.17 |
3.7× |
| CT iac w contrast (70481) |
$1,407.16 |
$2,164.86 |
6.8× |
| CT limited/localized follow up study (76380) |
$631.48 |
$971.50 |
6.1× |
| CT lower ext w/o (73700) |
$1,160.58 |
$1,785.50 |
9.4× |
| CT lower extremity w wo contrast (73702) |
$1,415.13 |
$2,177.12 |
6.8× |
| CT lower extremity w/contrast material (73701) |
$1,333.87 |
$2,052.11 |
6.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,341.84 |
$3,602.83 |
11.3× |
| CT lumbar spine w/contrast (72132) |
$2,036.32 |
$3,132.80 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$1,777.91 |
$2,735.25 |
14.4× |
| CT maxillofacial w contrast (70487) |
$1,565.76 |
$2,408.86 |
7.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,904.80 |
$2,930.46 |
9.2× |
| CT maxillofacial wo contrast (70486) |
$1,323.44 |
$2,036.06 |
10.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,446.82 |
$2,225.87 |
7.0× |
| CT orbits w/o contrast (70480) |
$1,164.48 |
$1,791.51 |
9.4× |
| CT pelvis w/o contrast (72192) |
$1,514.37 |
$2,329.80 |
12.3× |
| CT pelvis w/wo contrast (72194) |
$2,523.99 |
$3,883.06 |
12.2× |
| CT scan of arm combo (73202) |
$1,783.80 |
$2,744.31 |
8.6× |
| CT soft tissue neck w contrast (70491) |
$1,223.96 |
$1,883.02 |
5.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,479.45 |
$2,276.07 |
7.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,063.48 |
$1,636.13 |
8.6× |
| CT thoracic spine w/contrast (72129) |
$1,862.18 |
$2,864.89 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$1,396.40 |
$2,148.31 |
11.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,066.23 |
$3,178.82 |
10.0× |
| CT thorax w/o contrast (71250) |
$1,465.65 |
$2,254.85 |
11.9× |
| CT unlisted procedure (76497) |
$1,655.02 |
$2,546.18 |
16.1× |
| CT upper ext wo (73200) |
$1,304.31 |
$2,006.63 |
10.6× |
| CT upper extremity with contrast (73201) |
$1,485.71 |
$2,285.70 |
3.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,892.77 |
$2,911.95 |
9.1× |
| Cta Abdomen (74175) |
$2,196.36 |
$3,379.02 |
10.6× |
| CTA abdomen pelvis (74174) |
$2,722 |
$4,187.69 |
6.6× |
| CTA chest (71275) |
$2,204.05 |
$3,390.85 |
10.6× |
| Cta Head (70496) |
$2,024.83 |
$3,115.13 |
9.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,805.02 |
$5,853.88 |
9.2× |
| Cta Neck (70498) |
$1,780.19 |
$2,738.75 |
8.6× |
| Cta Pelvis (72191) |
$2,245.43 |
$3,454.50 |
10.8× |
| Cystography minimum 3 views rs&i (74430) |
$1,204.07 |
$1,852.42 |
2.9× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$691.14 |
$1,063.29 |
2.5× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$3,459.70 |
$5,322.62 |
1.4× |
| Diskogram cervical (72285) |
$4,088.44 |
$6,289.91 |
1.8× |
| Diskography lumbar (72295) |
$4,088.44 |
$6,289.91 |
1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$432.65 |
$665.62 |
3.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$468.30 |
$720.46 |
3.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$433.60 |
$667.07 |
3.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$548.50 |
$843.85 |
4.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$365.36 |
$562.09 |
3.6× |
| Dxa bone density study axial skeleton (77085) |
$876.09 |
$1,347.83 |
7.1× |
| Echo exam of eye (76529) |
$149.20 |
$229.54 |
1.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,025.04 |
$1,576.98 |
3.6× |
| Esophageal motility (78258) |
$906.01 |
$1,393.86 |
1.9× |
| Esophagus (74220) |
$844.89 |
$1,299.83 |
4.1× |
| Facial bones min 3 views (70150) |
$372.31 |
$572.78 |
3.0× |
| Fetal biophysical profile non-stress testing (76818) |
$458.56 |
$705.48 |
3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$515.88 |
$793.66 |
4.2× |
| Fetal Echo (76825) |
$873.92 |
$1,344.49 |
1.4× |
| Foot 2 views (73620) |
$205.93 |
$316.82 |
2.0× |
| Forearm 2 views (73090) |
$417.92 |
$642.94 |
4.1× |
| Functional MRI brain by phys/psych (70555) |
$1,183.98 |
$1,821.50 |
4.2× |
| Functional MRI brain by tech (70554) |
$1,183.98 |
$1,821.50 |
4.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,380.29 |
$2,123.52 |
2.9× |
| Gastric mucosa imaging (78261) |
$1,054.45 |
$1,622.23 |
2.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,831.41 |
$2,817.55 |
2.9× |
| Hand 2 views (73120) |
$278.61 |
$428.63 |
2.3× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,611.04 |
$5,555.45 |
4.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,611.04 |
$5,555.45 |
4.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,611.04 |
$5,555.45 |
4.4× |
| Heart first pass single,planar (78481) |
$1,530.44 |
$2,354.53 |
2.4× |
| Heart Infarct Image (78466) |
$1,415.56 |
$2,177.78 |
3.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,402.98 |
$6,773.82 |
1.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,402.98 |
$6,773.82 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,603.21 |
$4,004.94 |
4.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,896.47 |
$2,917.65 |
4.0× |
| Hysterosalpingogram (74740) |
$1,112.71 |
$1,711.86 |
3.9× |
| Interstitial radiation source applic complex (77778) |
$3,763.75 |
$5,790.38 |
4.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,461.06 |
$2,247.79 |
1.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,217.50 |
$1,873.08 |
1.9× |
| Intracavitary Radiation Source Applic Simple (77761) |
$1,057.65 |
$1,627.16 |
1.6× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$38,202.77 |
$58,773.49 |
4.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$201.38 |
$309.81 |
1.6× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$1,054.45 |
$1,622.23 |
2.2× |
| Kidney imaging morphology (78700) |
$1,275.76 |
$1,962.71 |
2.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,762.57 |
$2,711.64 |
2.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,502.97 |
$2,312.26 |
2.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,649.52 |
$2,537.72 |
2.6× |
| Knee 3 views (73562) |
$384.52 |
$591.56 |
3.7× |
| Liver & spleen imaging static only (78215) |
$1,026.19 |
$1,578.76 |
2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,054.45 |
$1,622.23 |
2.2× |
| Liver imaging static only (78201) |
$3,597.15 |
$5,534.08 |
5.6× |
| Liver imaging w/vascular flow (78202) |
$3,597.15 |
$5,534.08 |
5.6× |
| Lung perf&ventilat diferentl (78598) |
$1,705.56 |
$2,623.94 |
2.7× |
| Lung perfusion differential (78597) |
$742.66 |
$1,142.56 |
1.6× |
| Lung ventilation imaging (78579) |
$1,044.80 |
$1,607.39 |
2.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$5,852.86 |
$9,004.40 |
1.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$5,551.86 |
$8,541.33 |
1.5× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$3,045.13 |
$4,684.81 |
1.6× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$1,726.36 |
$2,655.94 |
2.3× |
| Lymphoscintigraphy (78195) |
$1,918.41 |
$2,951.40 |
3.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,587.14 |
$3,980.22 |
2.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,478.49 |
$3,813.06 |
6.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,655.53 |
$4,085.43 |
6.4× |
| Mammary ductogram or galactogram multiple (77054) |
$761.87 |
$1,172.10 |
2.7× |
| Mammary ductogram or galactogram single (77053) |
$718.38 |
$1,105.20 |
2.5× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$115.57 |
$177.80 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,780.40 |
$2,739.08 |
4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$78.73 |
$121.13 |
2.3× |
| MRA head w & w/o contrast (70546) |
$2,295.77 |
$3,531.95 |
5.6× |
| MRA head w/o contrast (70544) |
$1,450.12 |
$2,230.95 |
5.1× |
| MRA head with contrast (70545) |
$1,616.02 |
$2,486.19 |
3.9× |
| MRA neck w contrast (70548) |
$1,975.97 |
$3,039.96 |
4.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,776.61 |
$4,271.70 |
6.7× |
| MRA neck w/o contrast (70547) |
$1,481.97 |
$2,279.96 |
5.3× |
| MRI abdomen w contrast (74182) |
$1,935.97 |
$2,978.41 |
4.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,723.14 |
$4,189.45 |
6.6× |
| MRI abdomen w/o contrast (74181) |
$1,683.39 |
$2,589.83 |
6.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,857.47 |
$2,857.65 |
2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,637.64 |
$4,057.90 |
6.4× |
| MRI breast w/o contrast bilateral (77047) |
$1,559.62 |
$2,399.41 |
5.5× |
| MRI breast wo contrast unilateral (77046) |
$1,559.62 |
$2,399.41 |
5.5× |
| MRI c-spine with contrast (72142) |
$2,755.79 |
$4,239.67 |
6.7× |
| MRI cardiac w/o cont stress (75559) |
$1,838.63 |
$2,828.66 |
2.8× |
| MRI cardiac w/o contrast (75557) |
$1,443.83 |
$2,221.28 |
5.1× |
| MRI cervical spine w/o contrast (72141) |
$2,396.86 |
$3,687.48 |
8.5× |
| MRI chest w/o & w/contrast material (71552) |
$3,165.86 |
$4,870.56 |
7.7× |
| MRI chest w/o contrast (71550) |
$2,380.81 |
$3,662.79 |
8.4× |
| MRI chest with contrast (71551) |
$2,677.02 |
$4,118.49 |
2.9× |
| MRI fetal sngl/1st gestation (74712) |
$595.71 |
$916.47 |
2.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,822.02 |
$2,803.10 |
4.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,150.77 |
$3,308.88 |
5.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,584.35 |
$2,437.46 |
5.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,903.27 |
$2,928.10 |
6.8× |
| MRI orbit face neck w contrast (70542) |
$2,093.59 |
$3,220.90 |
5.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,294.40 |
$3,529.84 |
5.6× |
| MRI pelvis w/contrast (72196) |
$2,856.35 |
$4,394.39 |
6.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,213.52 |
$6,482.34 |
10.2× |
| MRI pelvis w/o contrast (72195) |
$2,380.81 |
$3,662.79 |
8.4× |
| MRI spectroscopy (76390) |
$2,545.43 |
$3,916.05 |
24.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,855.74 |
$5,931.91 |
9.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,755.79 |
$4,239.67 |
6.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,855.74 |
$5,931.91 |
9.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,755.79 |
$4,239.67 |
6.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,855.74 |
$5,931.91 |
9.4× |
| MRI temporomandibular joint (70336) |
$1,777.54 |
$2,734.67 |
6.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,396.86 |
$3,687.48 |
8.5× |
| MRI up ext w/o contrast (73218) |
$2,258.71 |
$3,474.94 |
8.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,207.83 |
$3,396.66 |
7.8× |
| MRI, joint upper extrem combo (73223) |
$2,728.88 |
$4,198.28 |
6.6× |
| Myelogram Cervical (72240) |
$1,094.84 |
$1,684.37 |
1.2× |
| Myelogram Lumbar (72265) |
$1,094.16 |
$1,683.33 |
1.2× |
| Myelogram thoracic (72255) |
$1,094.84 |
$1,684.37 |
1.2× |
| Myelography 2 or more regions (72270) |
$1,094.16 |
$1,683.33 |
1.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,525.22 |
$5,423.41 |
2.3× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78433) |
$8,205.57 |
$12,623.95 |
3.2× |
| Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall… (78429) |
$4,304.90 |
$6,622.93 |
2.5× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$5,830.29 |
$8,969.68 |
3.5× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$6,713.92 |
$10,329.10 |
2.6× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$5,830.29 |
$8,969.68 |
3.5× |
| Myocardial infarct spect (78469) |
$1,540.39 |
$2,369.83 |
2.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,667.16 |
$5,641.79 |
2.4× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$3,667.16 |
$5,641.79 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$4,075.25 |
$6,269.61 |
2.7× |
| Myocardial spect single study at rest or stress (78451) |
$3,673.90 |
$5,652.15 |
2.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,304.90 |
$6,622.93 |
2.5× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$8,205.57 |
$12,623.95 |
4.6× |
| N-invas est c ffr sw aly CTA (75580) |
$3,062.71 |
$4,711.86 |
3.0× |
| Neck soft tissue (70360) |
$286.02 |
$440.03 |
2.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$993.02 |
$1,527.73 |
2.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,054.45 |
$1,622.23 |
2.2× |
| Nm adrenal scan (78075) |
$4,882.90 |
$7,512.16 |
3.2× |
| Nm bone marrow multi (78103) |
$1,286.86 |
$1,979.78 |
2.7× |
| Nm bone marrow wb (78104) |
$1,371.23 |
$2,109.59 |
2.9× |
| Nm cisternogram (78630) |
$1,700.46 |
$2,616.09 |
2.7× |
| Nm csf leak detection (78650) |
$2,689.32 |
$4,137.42 |
1.8× |
| Nm gastric emptying study (78264) |
$1,916.22 |
$2,948.03 |
4.1× |
| Nm gastroesophageal reflux study (78262) |
$816.17 |
$1,255.65 |
1.7× |
| Nm kidney scan w/flow (78701) |
$1,354.80 |
$2,084.31 |
2.9× |
| Nm peritoneal-venous shunt patency (78291) |
$1,054.45 |
$1,622.23 |
2.2× |
| Nm red cell sequestration (78140) |
$1,054.45 |
$1,622.23 |
2.2× |
| Noncardiac Vascular Flow Imaging (78445) |
$1,054.45 |
$1,622.23 |
2.2× |
| Nonvascular shunt X-ray (75809) |
$671.74 |
$1,033.45 |
5.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$9,411.59 |
$14,479.37 |
5.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,130.98 |
$1,739.97 |
2.4× |
| Nuclear Rx Oral Admin (79005) |
$1,117.02 |
$1,718.49 |
4.1× |
| Ob us nuchal meas 1 gest (76813) |
$361.60 |
$556.30 |
2.9× |
| Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation Non-Facility (76519) |
$618.35 |
$951.30 |
5.0× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$72.92 |
$112.19 |
2.1× |
| Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) |
$229.87 |
$353.64 |
1.9× |
| Orthopantogram (70355) |
$161.99 |
$249.21 |
1.6× |
| Osseous survey limited (77074) |
$310.90 |
$478.30 |
2.5× |
| Parathyrd planar w/spect&CT (78072) |
$2,166.40 |
$3,332.92 |
3.4× |
| Parathyroid Planar Imaging (78070) |
$1,681.30 |
$2,586.61 |
3.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,927.20 |
$2,964.92 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$278.61 |
$428.63 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$6,847.74 |
$10,534.98 |
4.1× |
| PET imaging CT for attenuation limited area (78814) |
$5,228.87 |
$8,044.41 |
3.1× |
| PET imaging for CT attenuation whole body (78816) |
$7,904.44 |
$12,160.68 |
4.7× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,521.87 |
$3,879.80 |
1.6× |
| PET whole body (78813) |
$5,533.70 |
$8,513.39 |
3.3× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$3,667.16 |
$5,641.79 |
2.4× |
| Platelet survival study Non-Facility (78191) |
$1,054.45 |
$1,622.23 |
2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,640.77 |
$7,139.65 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$5,551.86 |
$8,541.33 |
1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,334.80 |
$2,053.54 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,817.47 |
$2,796.11 |
2.8× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$3,062.71 |
$4,711.86 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$929.55 |
$1,430.08 |
1.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$301.03 |
$463.13 |
2.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$308.90 |
$475.22 |
3.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$492.44 |
$757.59 |
4.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$151.39 |
$232.90 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$205.48 |
$316.13 |
1.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$201.38 |
$309.81 |
1.6× |
| Radex fingr minimum 2 views (73140) |
$325.54 |
$500.84 |
3.2× |
| Radex Foot Compl Minimum 3 Views (73630) |
$242.66 |
$373.32 |
2.4× |
| Radex Hand Minimum 3 Views (73130) |
$328.29 |
$505.06 |
3.2× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$115.57 |
$177.80 |
1.1× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$201.38 |
$309.81 |
1.6× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$177.57 |
$273.19 |
1.4× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$338.53 |
$520.82 |
2.7× |
| Radex Humerus Minimum 2 Views (73060) |
$278.61 |
$428.63 |
2.7× |
| Radex Kne 1/2 Views (73560) |
$193.82 |
$298.18 |
1.9× |
| Radex Kne Compl 4/More Views (73564) |
$451.40 |
$694.46 |
3.7× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$346.56 |
$533.17 |
2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$217.60 |
$334.77 |
2.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$407.30 |
$626.61 |
3.3× |
| Radex Sho Compl Minimum 2 Views (73030) |
$344.67 |
$530.26 |
3.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$229.78 |
$353.50 |
2.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$504.40 |
$776 |
4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$342.67 |
$527.19 |
3.3× |
| Radex Toe Minimum 2 Views (73660) |
$205.93 |
$316.82 |
2.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$213.26 |
$328.10 |
1.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$310.90 |
$478.30 |
3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$201.38 |
$309.81 |
1.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,208.55 |
$21,859.30 |
1.6× |
| Radiation treatment delivery level 1 (77402) |
$352.55 |
$542.39 |
2.9× |
| Radiation treatment delivery level 2 (77407) |
$1,332.75 |
$2,050.38 |
2.9× |
| Radiation treatment delivery level 3 (77412) |
$1,909.26 |
$2,937.33 |
2.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$319.14 |
$490.98 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$350.79 |
$539.68 |
2.8× |
| Radiologic exam chest 2 views (71046) |
$437.57 |
$673.18 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$951.43 |
$1,463.74 |
4.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$978.78 |
$1,505.81 |
4.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$480.71 |
$739.55 |
2.3× |
| Radiologic examination femur 1 view (73551) |
$115.57 |
$177.80 |
1.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$205.93 |
$316.82 |
2.0× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$231.36 |
$355.94 |
1.9× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$231.36 |
$355.94 |
1.9× |
| Radiologic examination, teeth; complete, full mouth Non-Facility (70320) |
$310.64 |
$477.91 |
1.1× |
| Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) |
$310.64 |
$477.91 |
1.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$119.10 |
$183.23 |
1.2× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$160.51 |
$246.94 |
1.6× |
| Radiological examination surgical specimen (76098) |
$879.55 |
$1,353.16 |
1.4× |
| Radiopharm Dacryocystography (78660) |
$911.72 |
$1,402.65 |
1.9× |
| Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion Non-Facility (79403) |
$1,906.35 |
$2,932.85 |
6.9× |
| Red cell survival study Non-Facility (78130) |
$1,054.45 |
$1,622.23 |
2.2× |
| Red cell volume determination (separate procedure); multiple samplings Non-Facility (78121) |
$1,358.80 |
$2,090.46 |
2.1× |
| Renal Cyst Study (74470) |
$1,262.86 |
$1,942.86 |
2.0× |
| Ribs bilateral 3 views (71110) |
$321.87 |
$495.19 |
2.6× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,465.91 |
$2,255.24 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,093.20 |
$1,681.85 |
2.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,675.46 |
$7,193.01 |
7.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,452.18 |
$3,772.58 |
3.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,452.18 |
$3,772.58 |
3.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,794.91 |
$5,838.32 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,304.90 |
$6,622.93 |
2.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,794.91 |
$5,838.32 |
2.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,408.99 |
$2,167.68 |
5.1× |
| Rp Therapy Intravenous Administration (79101) |
$1,387.01 |
$2,133.86 |
5.0× |
| Sacroiliac Joints < 3 Views (72200) |
$277.55 |
$427 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,130.47 |
$1,739.18 |
4.0× |
| Salivary gland function study (78232) |
$906.47 |
$1,394.57 |
1.9× |
| Salivary gland imaging (78230) |
$1,054.45 |
$1,622.23 |
2.2× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$824.38 |
$1,268.28 |
1.7× |
| Scapula (73010) |
$417.92 |
$642.94 |
3.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$153.56 |
$236.25 |
6.6× |
| Shoulder 1 view (73020) |
$290.72 |
$447.27 |
2.8× |
| Sialogram (70390) |
$732 |
$1,126.16 |
2.6× |
| Simulation intermediate (77285) |
$2,331.32 |
$3,586.64 |
5.3× |
| Small bowel series (74250) |
$1,216.38 |
$1,871.36 |
5.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,355.22 |
$2,084.96 |
3.1× |
| Special dosimetry (77331) |
$700.78 |
$1,078.12 |
4.4× |
| Special Physics Consult (77370) |
$886.43 |
$1,363.74 |
5.6× |
| Special treatment procedure (77470) |
$1,583.56 |
$2,436.25 |
2.4× |
| Spine thoracic 3 views (72072) |
$142.17 |
$218.73 |
1.2× |
| Spleen imaging only (78185) |
$1,054.45 |
$1,622.23 |
2.2× |
| Splenoportograpy rs&i (75810) |
$4,402.98 |
$6,773.82 |
1.2× |
| Stereotactic Body Radiation Delivery (77373) |
$12,561.80 |
$19,325.84 |
5.9× |
| Superior sagittal sinus venogram (75870) |
$5,852.86 |
$9,004.40 |
1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,987.44 |
$6,134.53 |
9.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$3,511.08 |
$5,401.66 |
7.9× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$412.65 |
$634.84 |
1.5× |
| Testicular Imaging With Vascular Flow (78761) |
$1,472.05 |
$2,264.69 |
3.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,656.37 |
$4,086.72 |
6.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$859.94 |
$1,322.98 |
5.4× |
| Thoracolumbar 2 views (72080) |
$278.61 |
$428.63 |
2.7× |
| Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) |
$1,401.01 |
$2,155.40 |
3.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,527.32 |
$3,888.19 |
3.9× |
| Thyroid imaging w/blood flow (78013) |
$1,381.09 |
$2,124.76 |
2.9× |
| Thyroid uptake measurement (78012) |
$718.09 |
$1,104.76 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,605.43 |
$2,469.89 |
3.4× |
| Tmj unilateral (70328) |
$205.82 |
$316.64 |
2.0× |
| Treatment device complex (77334) |
$1,970.02 |
$3,030.80 |
4.5× |
| Treatment device intermediate (77333) |
$912.16 |
$1,403.33 |
5.7× |
| Treatment devices simple (77332) |
$875.69 |
$1,347.21 |
5.5× |
| Ultrasound breast complete (76641) |
$920.84 |
$1,416.68 |
7.5× |
| Ultrasound elastography first target lesion (76982) |
$858.64 |
$1,320.99 |
7.0× |
| Ultrasound Exam Aaa Screen (76706) |
$438.37 |
$674.42 |
3.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$589.40 |
$906.77 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$366.59 |
$563.99 |
3.0× |
| Umbilical-artery Doppler (OB) (76820) |
$288.57 |
$443.95 |
2.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$744.65 |
$1,145.61 |
7.2× |
| Unlisted fluoroscopic procedure (76496) |
$161.23 |
$248.04 |
1.6× |
| Unlisted gastrointestinal px dx nuclear medicine (78299) |
$1,063.43 |
$1,636.05 |
2.3× |
| Unlisted magnetic resonance procedure (76498) |
$2,317.02 |
$3,564.65 |
22.5× |
| Unlisted ultrasound procedure (76999) |
$115.57 |
$177.80 |
1.1× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$521.14 |
$801.76 |
47.1× |
| Ureteral reflux study (78740) |
$1,054.45 |
$1,622.23 |
2.2× |
| Urethrocystogram voiding (74455) |
$1,203.51 |
$1,851.55 |
4.3× |
| Urethrocystography retrograde rs&i (74450) |
$569.24 |
$875.75 |
2.0× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$501.49 |
$771.53 |
2.4× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$501.49 |
$771.53 |
2.4× |
| Us breast unilateral limited (76642) |
$920.84 |
$1,416.68 |
9.0× |
| Us chest (76604) |
$399.15 |
$614.07 |
3.2× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$852.59 |
$1,311.68 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$415.94 |
$639.91 |
3.4× |
| Us elastography parenchyma (76981) |
$858.64 |
$1,320.99 |
7.0× |
| Us encephalogram (76506) |
$426.29 |
$655.83 |
3.5× |
| Us hips infant static (76886) |
$358.15 |
$551 |
3.5× |
| Us infant hips w manipulation (76885) |
$422.27 |
$649.65 |
4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$305.30 |
$469.69 |
2.5× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$244.16 |
$375.63 |
2.0× |
| Us ob detailed single fetus (76811) |
$642.79 |
$988.90 |
2.3× |
| Us ob limited (76815) |
$409.75 |
$630.38 |
3.3× |
| Us ob transvaginal (76817) |
$630.51 |
$970.02 |
5.1× |
| Us pelvic non ob complete (76856) |
$630.51 |
$970.02 |
5.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$396.55 |
$610.08 |
3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$630.51 |
$970.02 |
5.1× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$612.57 |
$942.41 |
5.0× |
| Us retroperitoneal complete (76770) |
$534.75 |
$822.69 |
4.3× |
| Us retroperitoneal limited (76775) |
$321.09 |
$493.98 |
2.6× |
| Us scrotum and contents (76870) |
$528.24 |
$812.68 |
4.3× |
| Us soft tissue head/neck (76536) |
$466.03 |
$716.97 |
3.8× |
| Us spinal canal and contents (76800) |
$507.59 |
$780.90 |
4.1× |
| Us transrectal (76872) |
$714.98 |
$1,099.97 |
5.8× |
| Us transrectal prostate volume (76873) |
$1,027.87 |
$1,581.34 |
8.3× |
| Us, eye b-scan (76512) |
$215.02 |
$330.80 |
1.7× |
| Us,transplanted kidney, real time/ doppler (76776) |
$523.93 |
$806.04 |
4.2× |
| Venogram adrenal unilat (75840) |
$4,402.98 |
$6,773.82 |
1.2× |
| Venogram extremity bilateral (75822) |
$2,350.92 |
$3,616.80 |
1.3× |
| Venogram Extremity Unilateral (75820) |
$2,350.92 |
$3,616.80 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$4,402.98 |
$6,773.82 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$2,254.38 |
$3,468.27 |
1.2× |
| Venography Renal Bilateral (75833) |
$4,402.98 |
$6,773.82 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$4,402.98 |
$6,773.82 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,402.98 |
$6,773.82 |
1.2× |
| Venous sampling by catheter (75893) |
$9,254.94 |
$14,238.37 |
1.4× |
| Venous thrombosis imaging, venogram; unilateral Non-Facility (78457) |
$2,444.77 |
$3,761.19 |
3.8× |
| Wrist 2 views (73100) |
$278.61 |
$428.63 |
2.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$517.09 |
$795.52 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$251.55 |
$387 |
2.4× |
| X-ray b.e. reductn intuss (74283) |
$401.19 |
$617.22 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,354.34 |
$2,083.60 |
6.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$417.92 |
$642.94 |
4.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$134.39 |
$206.76 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$177.57 |
$273.19 |
1.4× |
| X-ray exam of femur 2/> (73552) |
$173.36 |
$266.70 |
1.7× |
| X-ray eye for foreign body (70030) |
$418.11 |
$643.24 |
4.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$205.93 |
$316.82 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$301.03 |
$463.13 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$144.20 |
$221.85 |
1.4× |
| X-ray leg, infant (73592) |
$173.36 |
$266.70 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$407.30 |
$626.61 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$515.55 |
$793.16 |
4.2× |
| X-ray nose-rectum child f.b. (76010) |
$589.12 |
$906.34 |
5.7× |
| X-ray optic foramen (70190) |
$115.57 |
$177.80 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$209.80 |
$322.77 |
1.7× |
| X-ray retrograde pyelogram (74420) |
$729.64 |
$1,122.53 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$296.91 |
$456.78 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$302.07 |
$464.72 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$342.67 |
$527.19 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$298.22 |
$458.80 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$399.52 |
$614.65 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$297.06 |
$457.02 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$372.31 |
$572.78 |
3.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$270.37 |
$415.96 |
2.2× |
| X-Ray Small Bowel Enteroclysis (74251) |
$1,094.67 |
$1,684.10 |
5.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$234.77 |
$361.18 |
2.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$420.50 |
$646.92 |
4.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$278.61 |
$428.63 |
2.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$193.82 |
$298.18 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$321.53 |
$494.66 |
2.6× |
| Xr bone length studies (77073) |
$401.72 |
$618.03 |
3.3× |
| Xr c-spine 4 or 5 views (72050) |
$492.84 |
$758.21 |
4.0× |
| Xr c-spine 6 or more views (72052) |
$588.80 |
$905.84 |
4.8× |
| Xr chest 4+ views (71048) |
$649.32 |
$998.95 |
5.3× |
| Xr urogram antegrade (74425) |
$2,593.87 |
$3,990.57 |
6.3× |