| Abdomen 2 views (74019) |
$732 |
$1,220 |
7.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$968.40 |
$1,614 |
2.4× |
| 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 internal mammary rs&i (75756) |
$5,572.20 |
$9,287 |
1.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,236.80 |
$8,728 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$7,749.60 |
$12,916 |
2.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,749.60 |
$12,916 |
2.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,731.40 |
$6,219 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$5,172.60 |
$8,621 |
1.6× |
| 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× |
| Antegrade urography radiological supvj & interpj (74425) |
$334.80 |
$558 |
1.0× |
| Aortogram thoracic (75605) |
$6,165.60 |
$10,276 |
1.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,713 |
$7,855 |
1.5× |
| Aortography abdominal serialography rs&i (75625) |
$4,471.20 |
$7,452 |
1.4× |
| Artery X-Rays Adrenal Gland (75731) |
$3,016.20 |
$5,027 |
1.0× |
| Arthrogram elbow (73085) |
$704.40 |
$1,174 |
2.0× |
| Arthrogram hip (73525) |
$1,377 |
$2,295 |
4.0× |
| Arthrogram shoulder (73040) |
$1,557 |
$2,595 |
4.5× |
| Arthrogram wrist (73115) |
$1,837.20 |
$3,062 |
5.3× |
| Arthrography knee lt (73580) |
$910.20 |
$1,517 |
2.6× |
| Basic radiation dosimetry calculation (77300) |
$239.40 |
$399 |
1.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$797.40 |
$1,329 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$928.20 |
$1,547 |
2.3× |
| Bone &/joint imaging whole body (78306) |
$1,088.40 |
$1,814 |
2.7× |
| Bone age studies (77072) |
$267 |
$445 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$2,043 |
$3,405 |
5.1× |
| Bone survey complete (77075) |
$937.80 |
$1,563 |
9.0× |
| Brain image w/flow 4 + views (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× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$797.40 |
$1,329 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$716.40 |
$1,194 |
8.3× |
| Chest 1 view (71045) |
$436.80 |
$728 |
5.0× |
| Chest 3 views (71047) |
$557.40 |
$929 |
6.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,107 |
$1,845 |
6.3× |
| 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× |
| 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 hrt w/3d image (75574) |
$1,197.60 |
$1,996 |
3.5× |
| CT angiography upper extremity lt (73206) |
$1,197.60 |
$1,996 |
6.9× |
| CT c-spine w/o contrast (72125) |
$1,083 |
$1,805 |
10.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,686 |
$2,810 |
9.7× |
| CT cervical spine with contrast (72126) |
$1,464 |
$2,440 |
4.2× |
| CT chest w/wo contrast (71270) |
$1,585.80 |
$2,643 |
9.1× |
| CT chest with contrast (71260) |
$724.80 |
$1,208 |
4.2× |
| 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 limited/localized follow up study (76380) |
$973.80 |
$1,623 |
11.3× |
| CT lower ext w/o (73700) |
$1,197.60 |
$1,996 |
11.5× |
| CT lower extremity w wo contrast (73702) |
$1,585.80 |
$2,643 |
9.1× |
| CT lower extremity with contrast (73701) |
$1,376.40 |
$2,294 |
7.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,585.80 |
$2,643 |
9.1× |
| CT lumbar spine w/o contrast (72131) |
$1,197.60 |
$1,996 |
11.5× |
| CT lumbar spine with contrast (72132) |
$1,376.40 |
$2,294 |
4.0× |
| CT maxillofacial w contrast (70487) |
$1,464 |
$2,440 |
8.4× |
| CT maxillofacial w/o contrast (70486) |
$1,273.80 |
$2,123 |
12.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,686 |
$2,810 |
9.7× |
| CT neck soft tissue w contrast (70491) |
$1,464 |
$2,440 |
8.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) |
$1,686 |
$2,810 |
9.7× |
| 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 contrast (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 extremity w/o & w/contrast material (73202) |
$1,585.80 |
$2,643 |
9.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,197.60 |
$1,996 |
11.5× |
| 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 abdomen pelvis (74174) |
$1,197.60 |
$1,996 |
3.5× |
| CTA chest (71275) |
$1,018.20 |
$1,697 |
5.8× |
| Cta Head (70496) |
$1,273.80 |
$2,123 |
7.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,197.60 |
$1,996 |
6.9× |
| Cta Neck (70498) |
$1,273.80 |
$2,123 |
7.3× |
| Cta Pelvis (72191) |
$1,197.60 |
$1,996 |
6.9× |
| Cystography minimum 3 views rs&i (74430) |
$388.80 |
$648 |
1.1× |
| Diskogram cervical (72285) |
$2,490.60 |
$4,151 |
1.3× |
| Diskography lumbar (72295) |
$2,564.40 |
$4,274 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$289.80 |
$483 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$394.80 |
$658 |
4.6× |
| Echoencephalography real time imaging (76506) |
$277.80 |
$463 |
2.7× |
| Esophagus (74220) |
$634.80 |
$1,058 |
3.6× |
| Fetal biophysical profile non-stress testing (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× |
| Foot 2 views (73620) |
$519 |
$865 |
6.0× |
| Forearm 2 views (73090) |
$615.60 |
$1,026 |
7.1× |
| Gated Heart Planar Single (78472) |
$1,876.20 |
$3,127 |
4.7× |
| Hand 2 views (73120) |
$466.20 |
$777 |
4.5× |
| Hand 3 views (73130) |
$585 |
$975 |
6.8× |
| Heart Infarct Image (78466) |
$722.40 |
$1,204 |
1.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,734.20 |
$4,557 |
5.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,734.20 |
$4,557 |
6.9× |
| Ht muscle image spect sing (78451) |
$4,551.60 |
$7,586 |
3.5× |
| Humerus Min 2 Views Left (73060) |
$603.60 |
$1,006 |
7.0× |
| Hysterosalpingogram (74740) |
$990 |
$1,650 |
4.2× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$14,364 |
$23,940 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,074.60 |
$1,791 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,089.20 |
$3,482 |
3.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,421.20 |
$5,702 |
6.3× |
| Knee 3 views (73562) |
$408.60 |
$681 |
4.7× |
| 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× |
| Lymphoscintigraphy (78195) |
$579 |
$965 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$537 |
$895 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$516 |
$860 |
2.2× |
| Meckels Diverticulum (78290) |
$1,097.40 |
$1,829 |
2.8× |
| Mr safety determination physician/other qhp (76016) |
$138.60 |
$231 |
1.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$93.60 |
$156 |
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 med physics xm customization plng&mntr (76017) |
$380.40 |
$634 |
1.6× |
| MRA head w & w/o contrast (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 & w/contrast material (74183) |
$2,133 |
$3,555 |
6.2× |
| MRI abdomen w/o contrast (74181) |
$1,691.40 |
$2,819 |
7.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,943.40 |
$3,239 |
2.5× |
| 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 w/o contrast unilat (77046) |
$1,691.40 |
$2,819 |
7.1× |
| MRI c-spine with contrast (72142) |
$1,767 |
$2,945 |
5.1× |
| MRI cardiac w/o contrast (75557) |
$676.20 |
$1,127 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$1,399.80 |
$2,333 |
5.9× |
| MRI chest w/o & w/contrast material (71552) |
$2,235 |
$3,725 |
6.4× |
| 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 Forearm w/ Contrast Bilateral 73219 (73219) |
$1,943.40 |
$3,239 |
5.6× |
| 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 contr matrl (73718) |
$1,691.40 |
$2,819 |
7.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,398.60 |
$2,331 |
5.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,848 |
$3,080 |
5.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,606.80 |
$2,678 |
4.6× |
| MRI pelvis w contrast (72196) |
$1,943.40 |
$3,239 |
5.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,235 |
$3,725 |
6.4× |
| MRI pelvis w/o contrast (72195) |
$1,691.40 |
$2,819 |
7.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,235 |
$3,725 |
6.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,235 |
$3,725 |
6.4× |
| MRI spectroscopy (76390) |
$1,088.40 |
$1,814 |
12.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,031.60 |
$3,386 |
5.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,943.40 |
$3,239 |
5.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,235 |
$3,725 |
6.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,943.40 |
$3,239 |
5.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,235 |
$3,725 |
6.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,691.40 |
$2,819 |
7.1× |
| MRI tmj (70336) |
$846 |
$1,410 |
3.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,129.20 |
$1,882 |
4.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,235 |
$3,725 |
6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,691.40 |
$2,819 |
7.1× |
| Myelogram Cervical (72240) |
$1,550.40 |
$2,584 |
2.0× |
| Myelogram Lumbar (72265) |
$2,155.20 |
$3,592 |
2.8× |
| Myelogram thoracic (72255) |
$1,286.40 |
$2,144 |
1.7× |
| Myelography 2 or more regions (72270) |
$1,705.80 |
$2,843 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$6,664.80 |
$11,108 |
5.2× |
| Neck soft tissue (70360) |
$456.60 |
$761 |
5.3× |
| Nm cisternogram (78630) |
$1,102.80 |
$1,838 |
2.0× |
| Nm gastric emptying study (78264) |
$1,592.40 |
$2,654 |
4.0× |
| Nm peritoneal-venous shunt patency (78291) |
$900 |
$1,500 |
2.3× |
| Nm red cell sequestration (78140) |
$1,114.20 |
$1,857 |
2.8× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,433.60 |
$4,056 |
1.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$987.60 |
$1,646 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$5,022.60 |
$8,371 |
21.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$550.80 |
$918 |
5.3× |
| Osseous survey infant (77076) |
$511.80 |
$853 |
4.9× |
| Osseous survey limited (77074) |
$173.40 |
$289 |
1.7× |
| Parathyroid 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, skull-thigh (78815) |
$3,383.40 |
$5,639 |
2.4× |
| PET imaging CT for attenuation limited area (78814) |
$1,691.40 |
$2,819 |
1.2× |
| PET imaging for CT attenuation whole body (78816) |
$1,691.40 |
$2,819 |
1.2× |
| PET whole body (78813) |
$2,969.40 |
$4,949 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,235 |
$3,725 |
6.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,184.40 |
$1,974 |
3.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,526.60 |
$4,211 |
4.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$406.20 |
$677 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$325.80 |
$543 |
3.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$693.60 |
$1,156 |
6.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$750 |
$1,250 |
7.2× |
| 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 1 View - Xr Abdomen 1 View (74018) |
$267 |
$445 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$980.40 |
$1,634 |
9.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$550.80 |
$918 |
6.4× |
| Radiologic exam colon single contrast study (74270) |
$513.60 |
$856 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$695.40 |
$1,159 |
4.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$202.20 |
$337 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$603.60 |
$1,006 |
7.0× |
| Radiological examination surgical specimen (76098) |
$513 |
$855 |
0.9× |
| Ribs bilateral 3 views (71110) |
$222 |
$370 |
2.1× |
| 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 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× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$676.20 |
$1,127 |
2.9× |
| Scanogram (77073) |
$259.80 |
$433 |
2.5× |
| Scapula complete (73010) |
$718.20 |
$1,197 |
6.9× |
| Screening digital breast tomosynthesis (77063) |
$47.40 |
$79 |
2.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$433.20 |
$722 |
4.2× |
| Small bowel series (74250) |
$927 |
$1,545 |
5.3× |
| Spec medical radj physics consltj (77370) |
$266.40 |
$444 |
2.0× |
| Spine thoracic 3 views (72072) |
$622.80 |
$1,038 |
6.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$266.40 |
$444 |
2.0× |
| Thoracolumbar 2 views (72080) |
$150.60 |
$251 |
1.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$3,251.40 |
$5,419 |
6.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,016.40 |
$1,694 |
2.6× |
| 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× |
| Treatment devices simple (77332) |
$266.40 |
$444 |
2.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,619.60 |
$4,366 |
4.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,974 |
$3,290 |
5.0× |
| Tx devices design & construction complex (77334) |
$682.20 |
$1,137 |
1.8× |
| Ultrasound elastography first target lesion (76982) |
$238.20 |
$397 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$591.60 |
$986 |
5.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$141.60 |
$236 |
1.6× |
| Upper Extremity Infant (73092) |
$392.40 |
$654 |
3.8× |
| Urethrocystography retrograde rs&i (74450) |
$465.60 |
$776 |
2.0× |
| Urethrocystography voiding (74455) |
$764.40 |
$1,274 |
3.2× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,142.40 |
$1,904 |
6.6× |
| Us abdl aorta screen aaa (76706) |
$498.60 |
$831 |
4.8× |
| Us breast unilateral complete (76641) |
$633 |
$1,055 |
6.1× |
| Us breast unilateral limited (76642) |
$549.60 |
$916 |
6.4× |
| Us chest (76604) |
$400.20 |
$667 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$388.20 |
$647 |
3.7× |
| Us elastography parenchyma (76981) |
$238.20 |
$397 |
2.3× |
| Us infant hips dynamic (76885) |
$502.20 |
$837 |
5.8× |
| Us kidney transplant (76776) |
$716.40 |
$1,194 |
6.9× |
| Us ob detailed single fetus (76811) |
$209.40 |
$349 |
0.9× |
| Us ob transvaginal (76817) |
$672 |
$1,120 |
6.5× |
| Us pelvic non ob complete (76856) |
$591.60 |
$986 |
5.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$218.40 |
$364 |
2.1× |
| Us pregnancy ltd (76815) |
$624.60 |
$1,041 |
6.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,007.40 |
$1,679 |
9.7× |
| 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 soft tissue head/neck (76536) |
$1,486.80 |
$2,478 |
14.3× |
| Us spinal canal and contents (76800) |
$420.60 |
$701 |
4.0× |
| Us xtr non-vasc lmtd (76882) |
$252 |
$420 |
2.4× |
| Venogram extremity bilateral (75822) |
$2,684.40 |
$4,474 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,592 |
$4,320 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$2,217.60 |
$3,696 |
1.4× |
| 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 selective rs&i (75831) |
$2,592 |
$4,320 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,592 |
$4,320 |
0.8× |
| Wrist 2 views (73100) |
$518.40 |
$864 |
6.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$980.40 |
$1,634 |
9.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$441 |
$735 |
5.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$662.40 |
$1,104 |
7.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$846 |
$1,410 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$509.40 |
$849 |
5.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$589.20 |
$982 |
6.8× |
| 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 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 of femur 1 (73551) |
$301.80 |
$503 |
3.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$887.40 |
$1,479 |
8.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$721.20 |
$1,202 |
8.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$595.20 |
$992 |
6.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,419 |
$2,365 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$533.40 |
$889 |
6.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$318.60 |
$531 |
3.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$636.60 |
$1,061 |
6.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$208.20 |
$347 |
2.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$392.40 |
$654 |
4.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$688.20 |
$1,147 |
6.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,300.20 |
$2,167 |
12.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$273.60 |
$456 |
2.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$796.20 |
$1,327 |
9.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$183.60 |
$306 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$721.20 |
$1,202 |
6.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$571.20 |
$952 |
5.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$937.80 |
$1,563 |
2.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$529.20 |
$882 |
6.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$534.60 |
$891 |
5.1× |
| 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 Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$691.20 |
$1,152 |
8.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$618.60 |
$1,031 |
7.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$294.60 |
$491 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$934.20 |
$1,557 |
9.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$730.80 |
$1,218 |
7.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$558.60 |
$931 |
6.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$189 |
$315 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$618.60 |
$1,031 |
7.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$532.80 |
$888 |
5.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$789.60 |
$1,316 |
7.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$452.40 |
$754 |
5.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$583.80 |
$973 |
6.7× |
| Xr c-spine 6 or more views (72052) |
$891 |
$1,485 |
8.6× |
| Xr chest 4+ views (71048) |
$594.60 |
$991 |
5.7× |
| Xr finger(s) 2+ views (73140) |
$565.80 |
$943 |
6.5× |
| Xr optic foramina (70190) |
$218.40 |
$364 |
2.5× |
| Xr shoulder 1 view (73020) |
$678.60 |
$1,131 |
7.8× |
| Xr spine cervical 4 or 5 views (72050) |
$865.20 |
$1,442 |
8.3× |
| Xr tibia/fibula 2 views (73590) |
$1,059.60 |
$1,766 |
12.2× |
| Xr tmj bilateral (70330) |
$439.80 |
$733 |
5.1× |
| Xray knee 1 or 2 views rt (73560) |
$348.60 |
$581 |
4.0× |