| 3-D radiotherapy plan dose-volume histograms (77295) |
$319.42 |
$456.31 |
0.2× |
| Abdomen 2 views (74019) |
$336.70 |
$481 |
3.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$700.76 |
$1,001.10 |
1.7× |
| Acute venous thrombus image (78456) |
$211.67 |
$302.38 |
0.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$133.97 |
$191.39 |
0.0× |
| Angiography extremity bilateral rs&i (75716) |
$137.96 |
$197.08 |
0.0× |
| Angiography extremity unilateral rs&i (75710) |
$115.49 |
$164.99 |
0.0× |
| Angiography internal mammary rs&i (75756) |
$120.60 |
$172.29 |
0.0× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$113.65 |
$162.36 |
0.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$124.73 |
$178.19 |
0.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$107.51 |
$153.58 |
0.0× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$164.49 |
$234.98 |
0.0× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$108.07 |
$154.38 |
0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$111.08 |
$158.68 |
0.0× |
| Ankle 2 views (73600) |
$128.21 |
$183.16 |
1.5× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$100.51 |
$143.59 |
0.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$121.10 |
$173 |
0.0× |
| Aortography abdominal serialography rs&i (75625) |
$100.21 |
$143.15 |
0.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$136.91 |
$195.59 |
0.0× |
| Artery X-Rays Adrenal Gland (75731) |
$119.65 |
$170.93 |
0.0× |
| Arthrogram elbow (73085) |
$208.12 |
$297.32 |
0.6× |
| Arthrogram hip (73525) |
$263.87 |
$376.96 |
0.8× |
| Arthrogram shoulder (73040) |
$485.41 |
$693.44 |
1.4× |
| Arthrogram wrist (73115) |
$211.10 |
$301.57 |
0.6× |
| Arthrography knee lt (73580) |
$438.86 |
$626.94 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$44.39 |
$63.41 |
0.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$479.84 |
$685.48 |
1.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$152.71 |
$218.16 |
0.4× |
| Bone &/joint imaging whole body (78306) |
$733.35 |
$1,047.64 |
1.8× |
| Bone age studies (77072) |
$95.72 |
$136.74 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$843.02 |
$1,204.31 |
2.1× |
| Bone Marrow Imaging Limited Area (78102) |
$111.72 |
$159.60 |
0.3× |
| Bone survey complete (77075) |
$343.20 |
$490.29 |
3.3× |
| Brain image w/flow 4 + views (78606) |
$466.86 |
$666.95 |
0.9× |
| Brain imaging < 4 static views (78600) |
$120.73 |
$172.47 |
0.3× |
| Brain imaging < 4 static views w vascular flow (78601) |
$142.65 |
$203.78 |
0.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$268.72 |
$383.89 |
0.5× |
| Brain Imaging Vascular Flow Only (78610) |
$114.69 |
$163.84 |
0.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$150.94 |
$215.63 |
0.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$285.40 |
$407.72 |
0.8× |
| Cardiac shunt detection (78428) |
$121.16 |
$173.09 |
0.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$212.60 |
$303.71 |
0.4× |
| Cervical spine 2 or 3 views (72040) |
$157.26 |
$224.66 |
1.8× |
| Chest 1 view (71045) |
$118.30 |
$169 |
1.4× |
| Chest 3 views (71047) |
$316.40 |
$452 |
3.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$253.54 |
$362.21 |
1.4× |
| Cineradiography/videoradiography (76120) |
$61.11 |
$87.30 |
0.6× |
| Cisternography Positive Contrast Rs&I (70015) |
$101.54 |
$145.05 |
0.1× |
| Clavicle complete (73000) |
$134.63 |
$192.32 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$837.90 |
$1,197 |
8.0× |
| Continuing medical physics consltj pr wk (77336) |
$47.98 |
$68.54 |
0.4× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$52.16 |
$74.51 |
0.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,026.06 |
$2,894.38 |
5.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,660.52 |
$2,372.16 |
6.9× |
| CT abdomen w contrast (74160) |
$1,082.09 |
$1,545.84 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,146.42 |
$1,637.74 |
6.5× |
| CT abdomen w/o contrast (74150) |
$855.52 |
$1,222.18 |
8.1× |
| CT angio hrt w/3d image (75574) |
$1,405.28 |
$2,007.54 |
4.0× |
| CT angiography upper extremity lt (73206) |
$1,346.52 |
$1,923.60 |
7.6× |
| CT c-spine w/o contrast (72125) |
$854.64 |
$1,220.90 |
8.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,474.91 |
$2,107.02 |
8.4× |
| CT cervical spine with contrast (72126) |
$1,153.21 |
$1,647.44 |
3.3× |
| CT chest w/wo contrast (71270) |
$1,129.09 |
$1,612.98 |
6.4× |
| CT chest with contrast (71260) |
$978.93 |
$1,398.47 |
5.6× |
| CT colonography screening (74263) |
$489.62 |
$699.46 |
2.0× |
| CT colonography w/dye (74262) |
$346.70 |
$495.29 |
2.0× |
| CT colonography w/o cntrst (74261) |
$315.99 |
$451.42 |
3.0× |
| CT head/brain with contrast (70460) |
$972.90 |
$1,389.86 |
5.5× |
| CT head/brain without and with contrast (70470) |
$1,240.24 |
$1,771.78 |
7.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$189.82 |
$271.17 |
0.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$167.70 |
$239.56 |
1.9× |
| CT hrt w/3d image congen (75573) |
$261.03 |
$372.90 |
0.7× |
| CT iac w contrast (70481) |
$974.24 |
$1,391.77 |
5.5× |
| CT limited/localized follow up study (76380) |
$238.31 |
$340.44 |
2.7× |
| CT lower ext w/o (73700) |
$777.56 |
$1,110.80 |
7.4× |
| CT lower extremity w wo contrast (73702) |
$1,050.25 |
$1,500.36 |
6.0× |
| CT lower extremity with contrast (73701) |
$939.78 |
$1,342.54 |
5.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,232.12 |
$1,760.18 |
7.0× |
| CT lumbar spine w/o contrast (72131) |
$897.52 |
$1,282.16 |
8.5× |
| CT lumbar spine with contrast (72132) |
$1,046.92 |
$1,495.61 |
3.0× |
| CT maxillofacial w contrast (70487) |
$1,032.60 |
$1,475.14 |
5.9× |
| CT maxillofacial w/o contrast (70486) |
$786.98 |
$1,124.26 |
7.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,112.03 |
$1,588.62 |
6.3× |
| CT neck soft tissue w contrast (70491) |
$985.58 |
$1,407.97 |
5.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,128.50 |
$1,612.15 |
6.4× |
| CT orbits w/o contrast (70480) |
$886.51 |
$1,266.44 |
8.4× |
| CT pelvis w & w/o contrast (72194) |
$1,221.98 |
$1,745.68 |
6.9× |
| CT pelvis w/o contrast (72192) |
$834.35 |
$1,191.92 |
7.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$73.75 |
$105.36 |
0.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,145.12 |
$1,635.88 |
6.5× |
| CT soft tissue neck w/o contrast (70490) |
$802.86 |
$1,146.95 |
7.6× |
| CT thoracic spine w/contrast (72129) |
$1,276.41 |
$1,823.44 |
7.2× |
| CT thoracic spine w/o contrast (72128) |
$825.30 |
$1,179 |
7.9× |
| CT thoracic spine w/wo contrast (72130) |
$1,606.84 |
$2,295.49 |
9.1× |
| CT thorax w/o contrast (71250) |
$815.05 |
$1,164.36 |
7.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,443.40 |
$2,062.01 |
8.2× |
| CT upper extremity w/o contrast rt (73200) |
$703.36 |
$1,004.80 |
6.7× |
| CT upper extremity with contrast (73201) |
$1,254.21 |
$1,791.72 |
3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,426 |
$2,037.14 |
8.1× |
| Cta Abdomen (74175) |
$1,375.14 |
$1,964.48 |
7.8× |
| CTA abdomen pelvis (74174) |
$2,269.22 |
$3,241.75 |
6.5× |
| CTA chest (71275) |
$1,372.31 |
$1,960.44 |
7.8× |
| Cta Head (70496) |
$1,542.80 |
$2,204 |
8.8× |
| CTA lwr ext w&w/o contrast (73706) |
$1,214.56 |
$1,735.08 |
6.9× |
| Cta Neck (70498) |
$1,383.82 |
$1,976.88 |
7.9× |
| Cta Pelvis (72191) |
$1,501.62 |
$2,145.16 |
8.5× |
| Cystography minimum 3 views rs&i (74430) |
$208 |
$297.14 |
0.6× |
| Diskogram cervical (72285) |
$77.18 |
$110.25 |
0.0× |
| Diskography lumbar (72295) |
$66.40 |
$94.85 |
0.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$35.36 |
$50.51 |
0.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$50.10 |
$71.57 |
0.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$62.48 |
$89.25 |
0.6× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$63.59 |
$90.84 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$180.88 |
$258.40 |
1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$18.33 |
$26.19 |
0.2× |
| Echo exam of eye (76529) |
$53.01 |
$75.73 |
0.6× |
| Echo exam of fetal heart (76825) |
$288.22 |
$411.75 |
0.5× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$108 |
$154.28 |
0.5× |
| Echoencephalography real time imaging (76506) |
$207.64 |
$296.62 |
2.0× |
| Esophageal motility (78258) |
$281.66 |
$402.37 |
0.7× |
| Esophagus (74220) |
$396.62 |
$566.60 |
2.3× |
| Fetal biophysical profile non-stress testing (76818) |
$81.35 |
$116.22 |
0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$265.65 |
$379.50 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$236.02 |
$337.18 |
1.0× |
| Foot 2 views (73620) |
$126 |
$180 |
1.4× |
| Forearm 2 views (73090) |
$128.68 |
$183.83 |
1.5× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$35.10 |
$50.14 |
0.1× |
| Functional MRI brain by tech (70554) |
$297.23 |
$424.62 |
1.2× |
| Gastric mucosa imaging (78261) |
$291 |
$415.70 |
0.7× |
| Gated Heart Planar Single (78472) |
$926.32 |
$1,323.32 |
2.3× |
| Hand 2 views (73120) |
$131.36 |
$187.66 |
1.3× |
| Hand 3 views (73130) |
$151.65 |
$216.64 |
1.7× |
| Heart Infarct Image (78466) |
$120.97 |
$172.82 |
0.3× |
| Heart infarct image w ef (78468) |
$130.40 |
$186.28 |
0.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$103.50 |
$147.85 |
0.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$863.60 |
$1,233.72 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$778.42 |
$1,112.04 |
1.9× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) |
$31.91 |
$45.58 |
0.1× |
| Ht muscle image spect sing (78451) |
$916.69 |
$1,309.56 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$126.59 |
$180.84 |
1.4× |
| Hyperthermia ntrstl prb 5/< (77610) |
$642.74 |
$918.20 |
1.2× |
| Hysterosalpingogram (74740) |
$332.59 |
$475.13 |
1.4× |
| Interstitial radiation source applic complex (77778) |
$581.06 |
$830.09 |
0.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$483.29 |
$690.42 |
0.7× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$339.98 |
$485.68 |
0.6× |
| Intracavitary radiation source applic simple (77761) |
$255.84 |
$365.48 |
0.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$26.71 |
$38.16 |
0.3× |
| Kidney funcj study non-img radioisotopic study (78725) |
$71.90 |
$102.72 |
0.2× |
| Kidney imaging morphology (78700) |
$351.36 |
$501.95 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$407.48 |
$582.10 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$623.04 |
$890.06 |
1.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$598.90 |
$855.56 |
1.1× |
| Knee 3 views (73562) |
$151.38 |
$216.26 |
1.7× |
| Liver & spleen imaging static only (78215) |
$511.84 |
$731.19 |
1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$426.78 |
$609.68 |
1.1× |
| Liver imaging static only (78201) |
$123.18 |
$175.97 |
0.2× |
| Liver imaging w/vascular flow (78202) |
$379.42 |
$542.02 |
0.7× |
| Lung perf&ventilat diferentl (78598) |
$202.85 |
$289.79 |
0.4× |
| Lung perfusion differential (78597) |
$133.78 |
$191.12 |
0.3× |
| Lung Ventilation Imaging (78579) |
$123.10 |
$175.86 |
0.3× |
| Lymphoscintigraphy (78195) |
$712.94 |
$1,018.48 |
1.3× |
| Mammary ductogram or galactogram multiple (77054) |
$112.24 |
$160.35 |
0.5× |
| Mammary ductogram or galactogram single (77053) |
$39.30 |
$56.14 |
0.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$33.76 |
$48.23 |
0.4× |
| Meckels Diverticulum (78290) |
$459.38 |
$656.26 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$330.19 |
$471.70 |
0.9× |
| Mr safety determination physician/other qhp (76016) |
$154 |
$220 |
1.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$42.70 |
$61 |
1.5× |
| MRA head w & w/o contrast (70546) |
$397.88 |
$568.40 |
1.1× |
| MRA head w/o contrast (70544) |
$988.77 |
$1,412.53 |
4.1× |
| MRA head with contrast (70545) |
$260.97 |
$372.81 |
0.7× |
| MRA neck w contrast (70548) |
$1,294.21 |
$1,848.87 |
3.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,607.92 |
$2,297.02 |
4.6× |
| MRA neck w/o contrast (70547) |
$1,180.56 |
$1,686.52 |
4.9× |
| MRI abdomen w contrast (74182) |
$1,279.72 |
$1,828.17 |
3.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,544.23 |
$2,206.04 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$1,102.08 |
$1,574.40 |
4.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,358.81 |
$1,941.16 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$255.80 |
$365.43 |
0.3× |
| MRI bone marrow blood supply (77084) |
$258.06 |
$368.65 |
1.1× |
| MRI c-spine with contrast (72142) |
$1,457.89 |
$2,082.70 |
4.2× |
| MRI cardiac w/o cont stress (75559) |
$293.49 |
$419.27 |
0.5× |
| MRI cardiac w/o contrast (75557) |
$217.37 |
$310.53 |
0.9× |
| MRI cervical spine w/o contrast (72141) |
$1,092.42 |
$1,560.60 |
4.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,671.72 |
$2,388.18 |
4.8× |
| MRI chest w/o contrast (71550) |
$1,361.84 |
$1,945.49 |
5.7× |
| MRI chest with contrast (71551) |
$308.18 |
$440.25 |
0.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$273.72 |
$391.03 |
0.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$274.64 |
$392.34 |
0.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,186.04 |
$1,694.34 |
4.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,243.24 |
$1,776.06 |
5.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,015.17 |
$2,878.82 |
5.8× |
| MRI orbit/face/neck w/contrast (70542) |
$1,395.25 |
$1,993.22 |
4.0× |
| MRI pelvis w contrast (72196) |
$1,486.89 |
$2,124.13 |
4.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,604.56 |
$2,292.22 |
4.6× |
| MRI pelvis w/o contrast (72195) |
$1,153.18 |
$1,647.40 |
4.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,543.25 |
$2,204.64 |
4.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$336.55 |
$480.79 |
0.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,599.71 |
$2,285.30 |
4.6× |
| MRI spectroscopy (76390) |
$289.92 |
$414.17 |
3.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,574.52 |
$2,249.31 |
4.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,284.64 |
$1,835.21 |
3.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,528.30 |
$2,183.28 |
4.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,285 |
$1,835.72 |
3.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,733.54 |
$2,476.48 |
4.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,120.77 |
$1,601.10 |
4.7× |
| MRI tmj (70336) |
$1,105.67 |
$1,579.52 |
4.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,226.84 |
$1,752.64 |
5.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,694.77 |
$2,421.10 |
4.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,263.40 |
$1,804.86 |
5.3× |
| Myelogram Cervical (72240) |
$701.85 |
$1,002.64 |
0.9× |
| Myelogram Lumbar (72265) |
$981.79 |
$1,402.56 |
1.2× |
| Myelogram thoracic (72255) |
$667.60 |
$953.70 |
0.8× |
| Myelography 2 or more regions (72270) |
$130.77 |
$186.82 |
0.2× |
| Myocardial infarct spect (78469) |
$149.49 |
$213.55 |
0.3× |
| Myocardial Spect Multiple Studies (78452) |
$315.11 |
$450.16 |
0.2× |
| Neck soft tissue (70360) |
$128.34 |
$183.34 |
1.5× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$246.41 |
$352.02 |
0.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$30.63 |
$43.75 |
0.1× |
| Nm adrenal scan (78075) |
$279.75 |
$399.64 |
0.2× |
| Nm bone marrow multiple (78103) |
$148.41 |
$212.01 |
0.4× |
| Nm bone marrow wb (78104) |
$160.46 |
$229.23 |
0.4× |
| Nm cisternogram (78630) |
$668.09 |
$954.42 |
1.2× |
| Nm csf leak detection (78650) |
$221.16 |
$315.94 |
0.2× |
| Nm gastric emptying study (78264) |
$671.14 |
$958.78 |
1.7× |
| Nm gastroesophageal reflux study (78262) |
$356.98 |
$509.98 |
0.9× |
| Nm peritoneal-venous shunt patency (78291) |
$166.12 |
$237.31 |
0.4× |
| Nm red cell sequestration (78140) |
$90 |
$128.57 |
0.2× |
| Nm whole blood volume (78122) |
$65.16 |
$93.09 |
0.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,271.99 |
$1,817.13 |
0.9× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$713.97 |
$1,019.96 |
0.5× |
| Nuclear medicine of heart pumping function (78473) |
$193.08 |
$275.83 |
0.5× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$160.47 |
$229.24 |
0.3× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$579.78 |
$828.26 |
0.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$383.04 |
$547.21 |
1.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$143.88 |
$205.54 |
0.4× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$108.05 |
$154.35 |
0.3× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$128.93 |
$184.18 |
0.2× |
| Nuclear Rx Oral Admin (79005) |
$91.79 |
$131.13 |
0.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$341.38 |
$487.68 |
3.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$118.15 |
$168.79 |
0.9× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$51.85 |
$74.07 |
0.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$68.31 |
$97.59 |
0.7× |
| Orthopantogram (70355) |
$13.92 |
$19.89 |
0.2× |
| Osseous survey infant (77076) |
$71.18 |
$101.68 |
0.7× |
| Osseous survey limited (77074) |
$256.02 |
$365.74 |
2.4× |
| Parathyrd planar w/spect&CT (78072) |
$289.39 |
$413.42 |
0.5× |
| Parathyrd planar w/wo subtrj (78071) |
$231.31 |
$330.44 |
0.6× |
| Parathyroid imaging (78070) |
$612.06 |
$874.37 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$152.46 |
$217.80 |
1.5× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$64.91 |
$92.73 |
0.0× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$61.86 |
$88.37 |
0.0× |
| Platelet survival study (78191) |
$112.49 |
$160.70 |
0.3× |
| Pr csf ventriculography (78635) |
$223.07 |
$318.67 |
0.4× |
| Pr heart first pass single,planar (78481) |
$117.50 |
$167.86 |
0.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,536.08 |
$2,194.41 |
4.4× |
| Pr red cell survival study (78130) |
$112.49 |
$160.70 |
0.3× |
| Pr sono bone density measure,peripheral (76977) |
$4.65 |
$6.64 |
0.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$112.37 |
$160.53 |
0.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$111.76 |
$159.66 |
0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$504.28 |
$720.40 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$931.68 |
$1,330.98 |
1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$218.02 |
$311.46 |
0.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$319.20 |
$456 |
3.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$114.48 |
$163.54 |
1.1× |
Radiation Delivery Stereotactic Cranial Linear (77372)
likely a partial charge, not the full procedure |
$670.12 |
$957.32 |
0.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$154.79 |
$221.13 |
0.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$89.79 |
$128.27 |
0.9× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$163.06 |
$232.94 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$207.23 |
$296.04 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$242.90 |
$347 |
2.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$90.30 |
$129 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$365.01 |
$521.44 |
2.1× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$25.33 |
$36.18 |
0.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$528.14 |
$754.49 |
3.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$394.80 |
$564 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$242.90 |
$347 |
2.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$25.35 |
$36.21 |
0.3× |
| Radiological examination surgical specimen (76098) |
$563.50 |
$805 |
1.0× |
| Radiopharm Dacryocystography (78660) |
$122.93 |
$175.62 |
0.3× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$98.45 |
$140.64 |
0.4× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$106.34 |
$151.91 |
0.5× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$62.63 |
$89.47 |
0.2× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$66.27 |
$94.67 |
0.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$107.69 |
$153.84 |
0.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$102.81 |
$146.87 |
0.0× |
| Ribs bilateral 3 views (71110) |
$223.34 |
$319.06 |
2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$510.80 |
$729.71 |
1.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$212.50 |
$303.57 |
0.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$726.12 |
$1,037.32 |
1.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$129.80 |
$185.43 |
0.6× |
| Rp Therapy Intravenous Administration (79101) |
$97.18 |
$138.83 |
0.4× |
| Sacroiliac Joints < 3 Views (72200) |
$19.83 |
$28.33 |
0.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$298.16 |
$425.94 |
1.2× |
| Salivary gland function study (78232) |
$65.84 |
$94.06 |
0.2× |
| Salivary gland imaging (78230) |
$90.38 |
$129.11 |
0.2× |
| Salivary gland imaging serial images (78231) |
$85.53 |
$122.18 |
0.2× |
| Scanogram (77073) |
$185.88 |
$265.54 |
1.8× |
| Scapula complete (73010) |
$164.34 |
$234.78 |
1.6× |
| Screening digital breast tomosynthesis (77063) |
$86.80 |
$124 |
3.7× |
| Sella turcica (70240) |
$61.38 |
$87.69 |
0.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$133.38 |
$190.54 |
1.3× |
| Sialogram (70390) |
$128.28 |
$183.25 |
0.5× |
| Simulation intermediate (77285) |
$273.33 |
$390.47 |
0.7× |
| Small bowel series (74250) |
$308 |
$440 |
1.7× |
| Spec medical radj physics consltj (77370) |
$73.40 |
$104.86 |
0.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$60.68 |
$86.68 |
0.2× |
| Special dosimetry (77331) |
$42.60 |
$60.85 |
0.3× |
| Special treatment procedure (77470) |
$103.59 |
$147.98 |
0.2× |
| Speech evaluation complex (70371) |
$62.08 |
$88.68 |
0.3× |
| Spine thoracic 3 views (72072) |
$222.84 |
$318.35 |
2.1× |
| Spleen imaging only (78185) |
$345.08 |
$492.97 |
0.9× |
| Stereotactic body radiation delivery (77373) |
$802.38 |
$1,146.26 |
0.4× |
| Superior sagittal sinus venogram (75870) |
$103.96 |
$148.51 |
0.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$78.05 |
$111.50 |
0.8× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$55.48 |
$79.25 |
0.2× |
| Testicular Imaging With Vascular Flow (78761) |
$139.14 |
$198.77 |
0.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$328.34 |
$469.05 |
0.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$175.48 |
$250.69 |
1.3× |
| Therapeutic Enema (74283) |
$155.46 |
$222.09 |
0.9× |
| Thoracolumbar 2 views (72080) |
$24.25 |
$34.64 |
0.3× |
| Thyroid carcinoma metastases img addl study (78016) |
$185.33 |
$264.76 |
0.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$880.62 |
$1,258.02 |
1.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$544.28 |
$777.55 |
1.4× |
| Thyroid uptake measurement (78012) |
$236.72 |
$338.18 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$656.18 |
$937.40 |
1.6× |
| Tmj unilateral (70328) |
$21.23 |
$30.33 |
0.2× |
| Tomogram (76100) |
$188.08 |
$268.69 |
1.8× |
| Treatment device intermediate (77333) |
$35.64 |
$50.91 |
0.3× |
| Treatment devices simple (77332) |
$52.72 |
$75.31 |
0.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$373.42 |
$533.46 |
0.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$288.37 |
$411.96 |
0.7× |
| Tx devices design & construction complex (77334) |
$98.93 |
$141.33 |
0.3× |
| Ultrasound scan of cornea to determine thickness (76514) |
$10.19 |
$14.55 |
0.4× |
| Ultrasound scan to determine eye length and lens power (76519) |
$55.94 |
$79.91 |
0.5× |
| Ultrasound, abdomen limited (76705) |
$278.38 |
$397.68 |
2.7× |
| Umbilical-artery Doppler (OB) (76820) |
$32.70 |
$46.72 |
0.3× |
| Unlisted Ultrasound Procedure (76999) |
$182 |
$260 |
2.1× |
| Upper Extremity Infant (73092) |
$68.24 |
$97.50 |
0.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$320.68 |
$458.12 |
0.8× |
| Urethrocystography voiding (74455) |
$275.80 |
$394.01 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$473.66 |
$676.66 |
2.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$280.22 |
$400.31 |
1.6× |
| Us breast unilateral complete (76641) |
$413.70 |
$591 |
3.9× |
| Us breast unilateral limited (76642) |
$372.40 |
$532 |
4.3× |
| Us chest (76604) |
$220.34 |
$314.78 |
2.1× |
| Us compl joint r-t w/image documentation (76881) |
$337.98 |
$482.82 |
3.2× |
| Us fetal nuchal translucency 1st gestation (76813) |
$162.96 |
$232.80 |
1.6× |
| Us guided compression repair (76936) |
$180.02 |
$257.17 |
0.8× |
| Us infant hips dynamic (76885) |
$130.50 |
$186.44 |
1.5× |
| Us infant hips limited static (76886) |
$70.62 |
$100.89 |
0.8× |
| Us kidney transplant (76776) |
$101.85 |
$145.50 |
1.0× |
| Us ob detailed single fetus (76811) |
$364.74 |
$521.06 |
1.5× |
| Us ob transvaginal (76817) |
$312.30 |
$446.14 |
3.0× |
| Us pelvic non ob complete (76856) |
$353.19 |
$504.56 |
3.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$177.41 |
$253.44 |
1.7× |
| Us pregnancy ltd (76815) |
$229.44 |
$327.78 |
2.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$367.50 |
$524.99 |
3.5× |
| Us retroperitoneal complete (76770) |
$368 |
$525.72 |
3.5× |
| Us retroperitoneal limited (76775) |
$273.46 |
$390.66 |
2.6× |
| Us scrotum and contents (76870) |
$289.56 |
$413.66 |
2.8× |
| Us soft tissue head/neck (76536) |
$299.16 |
$427.38 |
2.8× |
| Us spinal canal and contents (76800) |
$92.30 |
$131.85 |
0.9× |
| Us transrectal (76872) |
$179.86 |
$256.94 |
1.7× |
| Us transrectal prostate volume (76873) |
$114.44 |
$163.49 |
1.1× |
| Us xtr non-vasc lmtd (76882) |
$239.56 |
$342.22 |
2.3× |
| Us, eye b-scan (76512) |
$62.73 |
$89.61 |
0.6× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$237.38 |
$339.11 |
0.4× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) |
$258.23 |
$368.90 |
0.7× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) |
$466.72 |
$666.74 |
0.7× |
| Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) |
$643.91 |
$919.87 |
1.2× |
| Vascular flow imaging (78445) |
$295.68 |
$422.40 |
0.7× |
| Vasogram (74440) |
$54.45 |
$77.78 |
0.2× |
| Venogram extremity bilateral (75822) |
$620.18 |
$885.98 |
0.4× |
| Venogram orbital (75880) |
$89.32 |
$127.60 |
0.1× |
| Venography caval inferior serialography rs&i (75825) |
$96.81 |
$138.30 |
0.0× |
| Venography caval superior serialography rs&i (75827) |
$97.99 |
$139.98 |
0.1× |
| Venography epidural rs&i (75872) |
$99.82 |
$142.60 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$810.05 |
$1,157.22 |
0.5× |
| Venography Renal Bilateral (75833) |
$119.14 |
$170.20 |
0.0× |
| Venography renal unilateral selective rs&i (75831) |
$104.01 |
$148.59 |
0.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$101.63 |
$145.19 |
0.0× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$83.09 |
$118.70 |
0.0× |
| Wrist 2 views (73100) |
$119.66 |
$170.94 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$209.24 |
$298.92 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$160.60 |
$229.44 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$145.58 |
$207.97 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$501.37 |
$716.24 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$130.18 |
$185.98 |
1.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$146.98 |
$209.97 |
1.7× |
| X-ray exam hip uni 1 view (73501) |
$225.40 |
$322 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$248.50 |
$355 |
2.8× |
| X-ray exam hip uni 4/> views (73503) |
$389.90 |
$557 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$395.50 |
$565 |
3.8× |
| X-ray exam of femur 1 (73551) |
$205.80 |
$294 |
2.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$273.06 |
$390.08 |
1.5× |
| X-ray eye for foreign body (70030) |
$82.95 |
$118.50 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$200.11 |
$285.87 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$183.65 |
$262.36 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$148.39 |
$211.98 |
1.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$63.97 |
$91.39 |
0.0× |
| X-ray head for orthodontia (70350) |
$14.32 |
$20.46 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$114.80 |
$164 |
1.3× |
| X-ray IV pyelogram+drip infusn (74410) |
$73.75 |
$105.35 |
0.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$110.94 |
$158.48 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$189.08 |
$270.10 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$149.04 |
$212.92 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$68.24 |
$97.50 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$175.81 |
$251.16 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$283.90 |
$405.58 |
2.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$27.01 |
$38.58 |
0.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$148.50 |
$212.14 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$74.57 |
$106.53 |
0.9× |
| X-ray of voice box or throat (70370) |
$53.22 |
$76.03 |
0.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$170.38 |
$243.40 |
1.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$28.60 |
$40.85 |
0.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$146.80 |
$209.72 |
1.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$232.10 |
$331.58 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$239.44 |
$342.05 |
2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$175.81 |
$251.16 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$155.29 |
$221.84 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$145.81 |
$208.30 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$182.38 |
$260.55 |
2.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$104.06 |
$148.66 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$234.70 |
$335.29 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$184.36 |
$263.38 |
1.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$131.62 |
$188.02 |
1.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$111.90 |
$159.85 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$118.08 |
$168.70 |
1.4× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$10.04 |
$14.34 |
0.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$176.08 |
$251.54 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$29.58 |
$42.26 |
0.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$128.40 |
$183.44 |
1.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$143.81 |
$205.44 |
1.6× |
| Xr arthrogram ankle (73615) |
$68.54 |
$97.92 |
0.2× |
| Xr c-spine 6 or more views (72052) |
$219.58 |
$313.68 |
2.1× |
| Xr Cholecystography Oral Contrast (74290) |
$160.13 |
$228.76 |
0.9× |
| Xr finger(s) 2+ views (73140) |
$118.12 |
$168.74 |
1.4× |
| Xr internal auditory meati complete (70134) |
$216.23 |
$308.90 |
0.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$71.14 |
$101.64 |
0.7× |
| Xr myelogram posterior fossa (70010) |
$44.25 |
$63.21 |
0.1× |
| Xr optic foramina (70190) |
$66.39 |
$94.84 |
0.8× |
| Xr shoulder 1 view (73020) |
$112.94 |
$161.34 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$32.48 |
$46.40 |
0.3× |
| Xr tibia/fibula 2 views (73590) |
$130.32 |
$186.18 |
1.5× |
| Xr tmj bilateral (70330) |
$229.80 |
$328.30 |
2.6× |
| Xray knee 1 or 2 views rt (73560) |
$127.48 |
$182.12 |
1.5× |