| Abdomen 1 View (74018) |
$267 |
$445 |
3.1× |
| Abdomen 2 views (74019) |
$732 |
$1,220 |
7.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$968.40 |
$1,614 |
2.4× |
| Angio internal mammary (75756) |
$5,572.20 |
$9,287 |
1.8× |
| Angio pulmonary bilat (75743) |
$7,749.60 |
$12,916 |
2.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$7,051.20 |
$11,752 |
2.2× |
| Angiography extremity bilateral rs&i (75716) |
$6,085.80 |
$10,143 |
1.9× |
| Angiography extremity unilateral rs&i (75710) |
$3,703.20 |
$6,172 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,749.60 |
$12,916 |
2.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,509.20 |
$4,182 |
0.8× |
| Ankle 2 views (73600) |
$542.40 |
$904 |
6.3× |
| Aortography thoracic serialography rs&i (75605) |
$6,165.60 |
$10,276 |
1.1× |
| Artery X-Rays Abdomen (75726) |
$3,731.40 |
$6,219 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$3,016.20 |
$5,027 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$5,236.80 |
$8,728 |
0.9× |
| Arthrogram hip (73525) |
$1,377 |
$2,295 |
4.0× |
| Arthrogram Wrist (73115) |
$1,837.20 |
$3,062 |
5.3× |
| Basic radiation dosimetry calculation (77300) |
$239.40 |
$399 |
1.8× |
| Bone age studies (77072) |
$267 |
$445 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$2,043 |
$3,405 |
5.1× |
| Bone Imaging Limited Area (78300) |
$797.40 |
$1,329 |
2.0× |
| Bone Imaging Multiple Areas (78305) |
$928.20 |
$1,547 |
2.3× |
| Bone Imaging Whole Body (78306) |
$1,088.40 |
$1,814 |
2.7× |
| Bone survey infant (77076) |
$511.80 |
$853 |
4.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,531.80 |
$2,553 |
2.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$519.60 |
$866 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$725.40 |
$1,209 |
2.1× |
| Cat Scan Follow-Up Study (76380) |
$973.80 |
$1,623 |
11.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$797.40 |
$1,329 |
1.5× |
| Cerebrospinal Fluid Scan (78630) |
$1,102.80 |
$1,838 |
2.0× |
| Chest 1 view (71045) |
$436.80 |
$728 |
5.0× |
| Chest 2 views (71046) |
$550.80 |
$918 |
6.4× |
| Chest 3 views (71047) |
$557.40 |
$929 |
6.4× |
| Chest 4 or more views (71048) |
$594.60 |
$991 |
5.7× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,261.20 |
$2,102 |
1.6× |
| Clavicle complete (73000) |
$465.60 |
$776 |
5.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$262.20 |
$437 |
2.5× |
| Contrast Exam Abdominl Aorta (75625) |
$4,471.20 |
$7,452 |
1.4× |
| Contrast X-Ray Bladder (74430) |
$388.80 |
$648 |
1.1× |
| Contrast X-Ray Of Elbow (73085) |
$704.40 |
$1,174 |
2.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$910.20 |
$1,517 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,585.80 |
$2,643 |
4.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,018.20 |
$1,697 |
4.3× |
| CT abdomen w contrast (74160) |
$783 |
$1,305 |
4.5× |
| CT abdomen w wo contrast (74170) |
$1,585.80 |
$2,643 |
9.1× |
| CT abdomen w/o contrast (74150) |
$1,197.60 |
$1,996 |
11.5× |
| CT Angio Abdomen and Pelvis (74174) |
$1,197.60 |
$1,996 |
3.5× |
| CT Angio Chest (71275) |
$1,018.20 |
$1,697 |
5.8× |
| CT Angio Head (70496) |
$1,273.80 |
$2,123 |
7.3× |
| CT angio hrt w/3d image (75574) |
$1,197.60 |
$1,996 |
3.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,197.60 |
$1,996 |
6.9× |
| CT Angio Neck (70498) |
$1,273.80 |
$2,123 |
7.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,197.60 |
$1,996 |
6.9× |
| CT cervical spine w/ contrast (72126) |
$1,464 |
$2,440 |
4.2× |
| CT cervical spine w/o contrast (72125) |
$1,083 |
$1,805 |
10.4× |
| CT cervical spine w/wo cont (72127) |
$1,686 |
$2,810 |
9.7× |
| CT chest w contrast (71260) |
$724.80 |
$1,208 |
4.2× |
| CT chest w/wo contrast (71270) |
$1,585.80 |
$2,643 |
9.1× |
| CT head/brain with contrast (70460) |
$1,464 |
$2,440 |
8.4× |
| CT head/brain without and with contrast (70470) |
$1,686 |
$2,810 |
9.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$595.20 |
$992 |
1.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$153 |
$153 |
1.8× |
| CT hrt w/3d image congen (75573) |
$1,197.60 |
$1,996 |
3.5× |
| CT iac w contrast (70481) |
$1,464 |
$2,440 |
8.4× |
| CT l-spine w&w/o contrast (72133) |
$1,585.80 |
$2,643 |
9.1× |
| CT lower ext w/o (73700) |
$1,197.60 |
$1,996 |
11.5× |
| CT lower extremity w/contrast material (73701) |
$1,376.40 |
$2,294 |
7.9× |
| CT lumbar spine w contrast (72132) |
$1,376.40 |
$2,294 |
4.0× |
| CT lumbar spine w/o contrast (72131) |
$1,197.60 |
$1,996 |
11.5× |
| CT maxillofacial w contrast (70487) |
$1,464 |
$2,440 |
8.4× |
| CT maxillofacial wo contrast (70486) |
$1,273.80 |
$2,123 |
12.3× |
| CT neck tissue combo (70492) |
$1,686 |
$2,810 |
9.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,686 |
$2,810 |
9.7× |
| CT orbits w/o contrast (70480) |
$1,273.80 |
$2,123 |
12.3× |
| CT pelvis w&w/o contrast (72194) |
$1,585.80 |
$2,643 |
9.1× |
| CT pelvis w/o contrast (72192) |
$1,197.60 |
$1,996 |
11.5× |
| CT scan of leg combo (73702) |
$1,585.80 |
$2,643 |
9.1× |
| CT scans face/jaw combo (70488) |
$1,686 |
$2,810 |
9.7× |
| CT soft tissue neck w contrast (70491) |
$1,464 |
$2,440 |
8.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,273.80 |
$2,123 |
12.3× |
| CT thoracic spine w contrast (72129) |
$1,376.40 |
$2,294 |
7.9× |
| CT thoracic spine w/o contrast (72128) |
$1,197.60 |
$1,996 |
11.5× |
| CT thoracic spine w/wo cont (72130) |
$1,585.80 |
$2,643 |
9.1× |
| CT thorax w/o contrast (71250) |
$1,018.20 |
$1,697 |
9.8× |
| CT unlisted procedure (76497) |
$1,197.60 |
$1,996 |
13.8× |
| CT upper ext wo (73200) |
$1,197.60 |
$1,996 |
11.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,585.80 |
$2,643 |
9.1× |
| CT upper extremity with contrast (73201) |
$1,376.40 |
$2,294 |
4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,197.60 |
$1,996 |
6.9× |
| Cta Abdomen (74175) |
$1,197.60 |
$1,996 |
6.9× |
| CTA pelvis (72191) |
$1,197.60 |
$1,996 |
6.9× |
| Dilation ureters/urethra rs&i (74485) |
$1,419 |
$2,365 |
0.7× |
| Discography Cerv/Thor Spine (72285) |
$2,490.60 |
$4,151 |
1.3× |
| Diskography lumbar (72295) |
$2,564.40 |
$4,274 |
1.3× |
| Dxa Bone Density Axial (77080) |
$289.80 |
$483 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$394.80 |
$658 |
4.6× |
| Echo exam uterus (76831) |
$676.20 |
$1,127 |
2.9× |
| Esophagram (74220) |
$634.80 |
$1,058 |
3.6× |
| Fetal Biophys Profile W/Nst (76818) |
$1,224 |
$2,040 |
11.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$796.20 |
$1,327 |
7.7× |
| Fluoroscopy up to 1 hr (76000) |
$471.60 |
$786 |
2.0× |
| Follow-Up Angiography (75898) |
$5,172.60 |
$8,621 |
1.6× |
| Foot 2 views (73620) |
$519 |
$865 |
6.0× |
| Forearm 2 views (73090) |
$615.60 |
$1,026 |
7.1× |
| Gastric emptying imaging study (78264) |
$1,592.40 |
$2,654 |
4.0× |
| Gated Heart Planar Single (78472) |
$1,876.20 |
$3,127 |
4.7× |
| Hand 2 views (73120) |
$466.20 |
$777 |
4.5× |
| Hepatobil Syst Image W/Drug (78227) |
$2,734.20 |
$4,557 |
5.1× |
| Hepatobiliary System Imaging (78226) |
$2,734.20 |
$4,557 |
6.9× |
| Ht Musc Image Planar Mult (78454) |
$2,433.60 |
$4,056 |
1.9× |
| Ht Muscle Image Spect Sing (78451) |
$4,551.60 |
$7,586 |
3.5× |
| Hysterosalpingogram (74740) |
$990 |
$1,650 |
4.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$502.20 |
$837 |
5.8× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$14,364 |
$23,940 |
2.0× |
| K Flow/Funct Image Multiple (78709) |
$3,421.20 |
$5,702 |
6.3× |
| K Flow/Funct Image W/Drug (78708) |
$2,089.20 |
$3,482 |
3.9× |
| K Flow/Funct Image W/O Drug (78707) |
$1,074.60 |
$1,791 |
2.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$987.60 |
$1,646 |
2.5× |
| Knee 3 Views (73562) |
$408.60 |
$681 |
4.7× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$1,114.20 |
$1,857 |
2.8× |
| Leveen/Shunt Patency Exam (78291) |
$900 |
$1,500 |
2.3× |
| Liver & Spleen Imaging Static Only (78215) |
$1,224 |
$2,040 |
3.1× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,763.40 |
$2,939 |
3.3× |
| Lung perfusion differential (78597) |
$1,483.80 |
$2,473 |
3.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,526.60 |
$4,211 |
4.7× |
| Lymph System Imaging (78195) |
$579 |
$965 |
1.1× |
| Magnetic Image Jaw Joint (70336) |
$846 |
$1,410 |
3.6× |
| Mammary ductogram or galactogram multiple (77054) |
$537 |
$895 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$516 |
$860 |
2.2× |
| Meckels Divert Exam (78290) |
$1,097.40 |
$1,829 |
2.8× |
| Mr safety determination physician/other qhp (76016) |
$138.60 |
$231 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$38.40 |
$64 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$144 |
$240 |
1.5× |
| Mr safety implt pos&/immoblj (76019) |
$93.60 |
$156 |
1.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$380.40 |
$634 |
1.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,848 |
$3,080 |
5.3× |
| MRA head w/o contrast (70544) |
$1,398.60 |
$2,331 |
5.9× |
| MRA head with contrast (70545) |
$1,606.80 |
$2,678 |
4.6× |
| MRA neck w contrast (70548) |
$1,606.80 |
$2,678 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,848 |
$3,080 |
5.3× |
| MRA neck w/o contrast (70547) |
$1,398.60 |
$2,331 |
5.9× |
| MRI abdomen w contrast (74182) |
$1,943.40 |
$3,239 |
5.6× |
| MRI abdomen w/o contrast (74181) |
$1,691.40 |
$2,819 |
7.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,943.40 |
$3,239 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,235 |
$3,725 |
6.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,943.40 |
$3,239 |
2.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,691.40 |
$2,819 |
7.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,691.40 |
$2,819 |
7.1× |
| MRI cardiac w/o contrast (75557) |
$676.20 |
$1,127 |
2.9× |
| MRI cervical spine w contrast (72142) |
$1,767 |
$2,945 |
5.1× |
| MRI cervical spine w/o cont (72141) |
$1,399.80 |
$2,333 |
5.9× |
| MRI chest w/o contrast (71550) |
$1,691.40 |
$2,819 |
7.1× |
| MRI chest with contrast (71551) |
$1,943.40 |
$3,239 |
2.5× |
| MRI chest wo w contrast (71552) |
$2,235 |
$3,725 |
6.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,943.40 |
$3,239 |
5.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,235 |
$3,725 |
6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,691.40 |
$2,819 |
7.1× |
| MRI lumbar spine w contrast (72149) |
$1,943.40 |
$3,239 |
5.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,031.60 |
$3,386 |
5.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,398.60 |
$2,331 |
5.9× |
| MRI orbit face neck w contrast (70542) |
$1,606.80 |
$2,678 |
4.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,848 |
$3,080 |
5.3× |
| MRI pelvis w contrast (72196) |
$1,943.40 |
$3,239 |
5.6× |
| MRI pelvis w/o & w contrast (72197) |
$2,235 |
$3,725 |
6.4× |
| MRI pelvis w/o contrast (72195) |
$1,691.40 |
$2,819 |
7.1× |
| MRI spectroscopy (76390) |
$1,088.40 |
$1,814 |
12.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,691.40 |
$2,819 |
7.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,943.40 |
$3,239 |
5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,691.40 |
$2,819 |
7.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,235 |
$3,725 |
6.4× |
| MRI, abdomen, combo (74183) |
$2,133 |
$3,555 |
6.2× |
| MRI, dorsal spine combo (72157) |
$2,235 |
$3,725 |
6.4× |
| MRI, dorsal spine contrast (72147) |
$1,943.40 |
$3,239 |
5.6× |
| MRI, joint upper extrem (73221) |
$1,129.20 |
$1,882 |
4.8× |
| MRI, joint upper extrem combo (73223) |
$2,235 |
$3,725 |
6.4× |
| MRI, lumbar spine combo (72158) |
$2,235 |
$3,725 |
6.4× |
| Myelogram cervical (72240) |
$1,550.40 |
$2,584 |
2.0× |
| Myelogram Lumbar (72265) |
$2,155.20 |
$3,592 |
2.8× |
| Myelography thoracic (72255) |
$1,286.40 |
$2,144 |
1.7× |
| Myelograpy 2/more regions rs&i (72270) |
$1,705.80 |
$2,843 |
2.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$722.40 |
$1,204 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$6,664.80 |
$11,108 |
5.2× |
| Neck soft tissue (70360) |
$456.60 |
$761 |
5.3× |
| Nonvascular Shunt X-Ray (75809) |
$433.20 |
$722 |
4.2× |
| Nuclear Rx Oral Admin (79005) |
$5,022.60 |
$8,371 |
21.7× |
| Optic foramina (70190) |
$218.40 |
$364 |
2.5× |
| Parathyroid Planar Imaging (78070) |
$1,234.80 |
$2,058 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$280.20 |
$467 |
2.7× |
| Peritoneogram Rs&I (74190) |
$798.60 |
$1,331 |
1.5× |
| Pet Image W/Ct Lmtd (78814) |
$1,691.40 |
$2,819 |
1.2× |
| PET image w/CT, full body (78816) |
$1,691.40 |
$2,819 |
1.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,383.40 |
$5,639 |
2.4× |
| PET whole body (78813) |
$2,969.40 |
$4,949 |
2.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,184.40 |
$1,974 |
3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$980.40 |
$1,634 |
9.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$406.20 |
$677 |
0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$662.40 |
$1,104 |
7.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$533.40 |
$889 |
6.2× |
| Radex elbow complete minimum 3 views (73080) |
$589.20 |
$982 |
6.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$887.40 |
$1,479 |
8.5× |
| Radex fingr minimum 2 views (73140) |
$565.80 |
$943 |
6.5× |
| Radex foot complete minimum 3 views (73630) |
$595.20 |
$992 |
6.9× |
| Radex Hand Minimum 3 Views (73130) |
$585 |
$975 |
6.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$392.40 |
$654 |
4.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$796.20 |
$1,327 |
9.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$529.20 |
$882 |
6.1× |
| Radex shoulder complete minimum 2 views (73030) |
$691.20 |
$1,152 |
8.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$294.60 |
$491 |
3.4× |
| Radex Spine 1 View Specify Level (72020) |
$558.60 |
$931 |
6.5× |
| Radex Sternum Minimum 2 Views (71120) |
$618.60 |
$1,031 |
7.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$439.80 |
$733 |
5.1× |
| Radex Toe Minimum 2 Views (73660) |
$452.40 |
$754 |
5.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$392.40 |
$654 |
3.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$583.80 |
$973 |
6.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,140.60 |
$1,901 |
11.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$785.40 |
$1,309 |
7.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$980.40 |
$1,634 |
9.4× |
| Radiologic exam colon double contrast study (74280) |
$846 |
$1,410 |
4.9× |
| Radiologic exam colon single contrast study (74270) |
$513.60 |
$856 |
2.9× |
| Radiologic exam knee complete 4/more views (73564) |
$636.60 |
$1,061 |
6.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$571.20 |
$952 |
5.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$927 |
$1,545 |
5.3× |
| Radiologic exam swallow function contrast study (74230) |
$1,107 |
$1,845 |
6.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$695.40 |
$1,159 |
4.0× |
| Radiologic examination femur 1 view (73551) |
$301.80 |
$503 |
3.5× |
| Radiologic examination femur minimum 2 views (73552) |
$603.60 |
$1,006 |
7.0× |
| Radiologic examination knee 1/2 views (73560) |
$348.60 |
$581 |
4.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$173.40 |
$289 |
1.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$1,059.60 |
$1,766 |
12.2× |
| Ribs bilateral 3 views (71110) |
$222 |
$370 |
2.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,974 |
$3,290 |
5.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,053.80 |
$3,423 |
5.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,619.60 |
$4,366 |
4.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,619.60 |
$4,366 |
4.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,304.60 |
$3,841 |
4.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,219.40 |
$3,699 |
1.7× |
| Scapula (73010) |
$718.20 |
$1,197 |
6.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$47.40 |
$79 |
2.0× |
| Shoulder 1 view (73020) |
$678.60 |
$1,131 |
7.8× |
| Shoulder Arthrography (73040) |
$1,557 |
$2,595 |
4.5× |
| Skull less than 4 views (70250) |
$730.80 |
$1,218 |
7.0× |
| Special Physics Consult (77370) |
$266.40 |
$444 |
2.0× |
| Sternoclavicular joints (71130) |
$189 |
$315 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$266.40 |
$444 |
2.0× |
| Thoracic spine 2 views (72070) |
$532.80 |
$888 |
5.1× |
| Thoracic spine 3 views (72072) |
$622.80 |
$1,038 |
6.0× |
| Thoracolumbar 2 views (72080) |
$150.60 |
$251 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,016.40 |
$1,694 |
2.6× |
| Thyroid Met Imaging Body (78018) |
$3,251.40 |
$5,419 |
6.0× |
| Thyroid Uptake Measurement (78012) |
$618.60 |
$1,031 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,684.80 |
$2,808 |
4.2× |
| Tx Devices Design & Construction Complex (77334) |
$682.20 |
$1,137 |
1.8× |
| Tx devices design & construction simple (77332) |
$266.40 |
$444 |
2.0× |
| Ultrasound Breast Limited (76642) |
$549.60 |
$916 |
6.4× |
| Ultrasound elastography first target lesion (76982) |
$238.20 |
$397 |
2.3× |
| Ultrasound Elastography Parenchyma (76981) |
$238.20 |
$397 |
2.3× |
| Ultrasound Exam Aaa Screen (76706) |
$498.60 |
$831 |
4.8× |
| Ultrasound, abdomen limited (76705) |
$591.60 |
$986 |
5.7× |
| Unlisted Dx Radiographic Procedure (76499) |
$141.60 |
$236 |
1.6× |
| Upper gi w/o kub (74240) |
$202.20 |
$337 |
1.2× |
| Urethrocystogram voiding (74455) |
$764.40 |
$1,274 |
3.2× |
| Urethrocystography retrograde (74450) |
$465.60 |
$776 |
2.0× |
| Us breast unilateral complete (76641) |
$633 |
$1,055 |
6.1× |
| Us chest (76604) |
$400.20 |
$667 |
3.9× |
| Us complete joint (76881) |
$388.20 |
$647 |
3.7× |
| Us exam, pelvic, limited (76857) |
$218.40 |
$364 |
2.1× |
| Us head (76506) |
$277.80 |
$463 |
2.7× |
| Us kidney transplant (76776) |
$716.40 |
$1,194 |
6.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$252 |
$420 |
2.4× |
| Us ob detailed single fetus (76811) |
$209.40 |
$349 |
0.9× |
| Us ob limited 1 or more fetuses (76815) |
$624.60 |
$1,041 |
6.0× |
| Us ob transvaginal (76817) |
$672 |
$1,120 |
6.5× |
| Us pelvic non ob complete (76856) |
$591.60 |
$986 |
5.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,007.40 |
$1,679 |
9.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$550.80 |
$918 |
5.3× |
| Us retroperitoneal complete (76770) |
$1,549.80 |
$2,583 |
14.9× |
| Us retroperitoneal limited (76775) |
$991.20 |
$1,652 |
9.5× |
| Us scrotum and contents (76870) |
$513 |
$855 |
4.9× |
| Us spinal canal and contents (76800) |
$420.60 |
$701 |
4.0× |
| Us thyroid (76536) |
$1,486.80 |
$2,478 |
14.3× |
| Vein X-Ray Chest (75827) |
$2,217.60 |
$3,696 |
1.4× |
| Venogram Sinus/Jugular (75860) |
$2,592 |
$4,320 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,592 |
$4,320 |
0.8× |
| Venography extremity bilateral rs&i (75822) |
$2,684.40 |
$4,474 |
1.7× |
| Venography extremity unilateral rs&i (75820) |
$1,279.80 |
$2,133 |
0.8× |
| Venography Renal Bilateral (75833) |
$5,259.60 |
$8,766 |
1.7× |
| Venography Renal Unilateral (75831) |
$2,592 |
$4,320 |
0.8× |
| Wrist 2 views (73100) |
$518.40 |
$864 |
6.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$441 |
$735 |
5.1× |
| X-ray antegrade pyelogram tube (74425) |
$334.80 |
$558 |
1.0× |
| X-Ray Aorta Leg Arteries (75630) |
$4,713 |
$7,855 |
1.5× |
| X-Ray Bend Only L-S Spine (72120) |
$273.60 |
$456 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$509.40 |
$849 |
5.9× |
| X-Ray Exam Breast Specimen (76098) |
$513 |
$855 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$325.80 |
$543 |
3.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$693.60 |
$1,156 |
6.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$945 |
$1,575 |
9.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$124.20 |
$207 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$387 |
$645 |
4.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$487.20 |
$812 |
4.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$750 |
$1,250 |
7.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,004.40 |
$1,674 |
9.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,085.40 |
$1,809 |
10.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$1,300.20 |
$2,167 |
12.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$716.40 |
$1,194 |
8.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$891 |
$1,485 |
8.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$534.60 |
$891 |
5.1× |
| X-ray humerus (73060) |
$603.60 |
$1,006 |
7.0× |
| X-ray IV pyelogram+tomography (74415) |
$1,142.40 |
$1,904 |
6.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$318.60 |
$531 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$208.20 |
$347 |
2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$688.20 |
$1,147 |
6.6× |
| X-ray nose-rectum child f.b. (76010) |
$183.60 |
$306 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$999.60 |
$1,666 |
9.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$721.20 |
$1,202 |
6.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$594.60 |
$991 |
6.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$618.60 |
$1,031 |
7.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$934.20 |
$1,557 |
9.0× |
| X-ray thoracic spine 4 vw (72074) |
$789.60 |
$1,316 |
7.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$937.80 |
$1,563 |
2.7× |
| X-Rays Bone Length Studies (77073) |
$259.80 |
$433 |
2.5× |
| X-Rays Bone Survey Complete (77075) |
$937.80 |
$1,563 |
9.0× |
| Xr c-spine 4 or 5 views (72050) |
$865.20 |
$1,442 |
8.3× |
| Xr facial bones less than 3 views (70140) |
$721.20 |
$1,202 |
8.3× |
| Xr orbits complete 4 views (70200) |
$721.20 |
$1,202 |
6.9× |