| 3-D radiotherapy plan dose-volume histograms (77295) |
$10,456.20 |
$17,427 |
7.7× |
| Abdomen 1 View (74018) |
$295.20 |
$492 |
3.4× |
| Abdomen 2 views (74019) |
$676.20 |
$1,127 |
6.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$732 |
$1,220 |
1.9× |
| Angio internal mammary (75756) |
$6,392.40 |
$10,654 |
2.1× |
| Angio pulmonary bilat (75743) |
$2,883.60 |
$4,806 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$6,624 |
$11,040 |
2.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,108 |
$5,180 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,883.60 |
$4,806 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,568 |
$4,280 |
0.8× |
| Ankle 2 views (73600) |
$316.20 |
$527 |
3.7× |
| Aortography thoracic serialography rs&i (75605) |
$6,537.60 |
$10,896 |
1.2× |
| Aortography thoracic w/o serialography rs&i (75600) |
$6,624 |
$11,040 |
2.1× |
| Artery X-Rays Abdomen (75726) |
$8,924.40 |
$14,874 |
1.6× |
| Artery X-Rays Adrenal Gland (75731) |
$2,308.80 |
$3,848 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$6,624 |
$11,040 |
1.2× |
| Artery X-Rays Spine (75705) |
$6,624 |
$11,040 |
1.2× |
| Arthrogram ankle (73615) |
$1,003.80 |
$1,673 |
2.9× |
| Arthrogram hip (73525) |
$948 |
$1,580 |
2.8× |
| Arthrogram Wrist (73115) |
$1,010.40 |
$1,684 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$461.40 |
$769 |
3.5× |
| Bone age studies (77072) |
$298.20 |
$497 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$1,704 |
$2,840 |
4.3× |
| Bone Imaging Limited Area (78300) |
$791.40 |
$1,319 |
2.0× |
| Bone Imaging Multiple Areas (78305) |
$1,143 |
$1,905 |
2.9× |
| Bone Imaging Whole Body (78306) |
$1,571.40 |
$2,619 |
4.0× |
| Bone marrow imaging limited area (78102) |
$501 |
$835 |
1.3× |
| Bone survey infant (77076) |
$443.40 |
$739 |
4.3× |
| Brachytx isodose complex (77318) |
$1,202.40 |
$2,004 |
3.3× |
| Brachytx isodose intermed (77317) |
$1,131.60 |
$1,886 |
3.1× |
| Brachytx Isodose Plan Simple (77316) |
$1,060.80 |
$1,768 |
2.9× |
| Brain Flow Imaging Only (78610) |
$781.20 |
$1,302 |
1.5× |
| Brain Image W/Flow < 4 Views (78601) |
$703.20 |
$1,172 |
1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,384.20 |
$2,307 |
2.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,263.80 |
$8,773 |
3.7× |
| Cat Scan Follow-Up Study (76380) |
$642 |
$1,070 |
7.5× |
| Cerebrospinal Fluid Scan (78630) |
$1,050 |
$1,750 |
2.0× |
| Chest 1 view (71045) |
$289.20 |
$482 |
3.4× |
| Chest 2 views (71046) |
$216.60 |
$361 |
2.5× |
| Chest 4 or more views (71048) |
$783 |
$1,305 |
7.6× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$69 |
$115 |
0.7× |
| Cholecystography Oral Contrast (74290) |
$772.20 |
$1,287 |
4.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$822.60 |
$1,371 |
1.1× |
| Clavicle complete (73000) |
$406.80 |
$678 |
4.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$229.20 |
$382 |
2.2× |
| Continuing medical physics consltj pr wk (77336) |
$1,925.40 |
$3,209 |
14.5× |
| Contrast Exam Abdominl Aorta (75625) |
$6,624 |
$11,040 |
2.1× |
| Contrast X-Ray Bladder (74430) |
$1,002.60 |
$1,671 |
2.9× |
| Contrast X-Ray Of Elbow (73085) |
$649.80 |
$1,083 |
1.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,003.80 |
$1,673 |
2.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,703.80 |
$6,173 |
10.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,845.20 |
$4,742 |
12.1× |
| CT abdomen w contrast (74160) |
$1,089 |
$1,815 |
6.3× |
| CT abdomen w wo contrast (74170) |
$1,926.60 |
$3,211 |
11.1× |
| CT abdomen w/o contrast (74150) |
$1,579.80 |
$2,633 |
15.3× |
| CT Angio Abdomen and Pelvis (74174) |
$1,065 |
$1,775 |
3.1× |
| CT Angio Chest (71275) |
$1,296 |
$2,160 |
7.5× |
| CT Angio Head (70496) |
$1,234.20 |
$2,057 |
7.1× |
| CT angio hrt w/3d image (75574) |
$518.40 |
$864 |
1.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,252.20 |
$2,087 |
7.2× |
| CT Angio Neck (70498) |
$1,126.80 |
$1,878 |
6.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,252.20 |
$2,087 |
7.2× |
| CT cervical spine w/ contrast (72126) |
$1,777.80 |
$2,963 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,422 |
$2,370 |
13.8× |
| CT cervical spine w/wo cont (72127) |
$1,926.60 |
$3,211 |
11.1× |
| CT chest w contrast (71260) |
$1,134.60 |
$1,891 |
6.6× |
| CT chest w/wo contrast (71270) |
$1,926.60 |
$3,211 |
11.1× |
| CT head/brain with contrast (70460) |
$117.60 |
$196 |
0.7× |
| CT head/brain without and with contrast (70470) |
$1,585.80 |
$2,643 |
9.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$450.60 |
$751 |
1.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$458 |
$458 |
5.3× |
| CT hrt w/3d image congen (75573) |
$453.60 |
$756 |
1.3× |
| CT iac w contrast (70481) |
$1,463.40 |
$2,439 |
8.5× |
| CT l-spine w&w/o contrast (72133) |
$1,926.60 |
$3,211 |
11.1× |
| CT lower ext w/o (73700) |
$1,579.80 |
$2,633 |
15.3× |
| CT lower extremity w/contrast material (73701) |
$1,817.40 |
$3,029 |
10.5× |
| CT lumbar spine w contrast (72132) |
$1,777.80 |
$2,963 |
5.2× |
| CT lumbar spine w/o contrast (72131) |
$1,579.80 |
$2,633 |
15.3× |
| CT maxillofacial w contrast (70487) |
$1,463.40 |
$2,439 |
8.5× |
| CT maxillofacial wo contrast (70486) |
$1,300.20 |
$2,167 |
12.6× |
| CT neck tissue combo (70492) |
$117.60 |
$196 |
0.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,585.80 |
$2,643 |
9.2× |
| CT orbits w/o contrast (70480) |
$1,300.20 |
$2,167 |
12.6× |
| CT pelvis w&w/o contrast (72194) |
$1,926.60 |
$3,211 |
11.1× |
| CT pelvis w/o contrast (72192) |
$1,579.80 |
$2,633 |
15.3× |
| CT scan of leg combo (73702) |
$1,714.80 |
$2,858 |
9.9× |
| CT scans face/jaw combo (70488) |
$1,585.80 |
$2,643 |
9.2× |
| CT soft tissue neck w contrast (70491) |
$1,463.40 |
$2,439 |
8.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,300.20 |
$2,167 |
12.6× |
| CT thoracic spine w contrast (72129) |
$1,777.80 |
$2,963 |
10.3× |
| CT thoracic spine w/o contrast (72128) |
$1,579.80 |
$2,633 |
15.3× |
| CT thoracic spine w/wo cont (72130) |
$1,926.60 |
$3,211 |
11.1× |
| CT thorax w/o contrast (71250) |
$1,422 |
$2,370 |
13.8× |
| CT upper ext wo (73200) |
$1,252.20 |
$2,087 |
12.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,656 |
$2,760 |
9.6× |
| CT upper extremity with contrast (73201) |
$1,441.20 |
$2,402 |
4.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,252.20 |
$2,087 |
7.2× |
| Cta Abdomen (74175) |
$2,026.20 |
$3,377 |
11.7× |
| CTA pelvis (72191) |
$1,926.60 |
$3,211 |
11.1× |
| Dilation ureters/urethra rs&i (74485) |
$1,403.40 |
$2,339 |
0.7× |
| Discography Cerv/Thor Spine (72285) |
$2,394.60 |
$3,991 |
1.2× |
| Diskography lumbar (72295) |
$2,394.60 |
$3,991 |
1.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$70.20 |
$117 |
0.7× |
| Dxa Bone Density Axial (77080) |
$237.60 |
$396 |
2.3× |
| Dxa bone density study (77085) |
$1,270.20 |
$2,117 |
12.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$106.20 |
$177 |
1.2× |
| Echo Guide For Artery Repair (76936) |
$436.20 |
$727 |
2.1× |
| Echograp Trans R Pros Study (76873) |
$69 |
$115 |
0.7× |
| Esophagram (74220) |
$642 |
$1,070 |
3.7× |
| Fetal Biophys Profile W/Nst (76818) |
$69 |
$115 |
0.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,516.20 |
$2,527 |
14.7× |
| Fluoroscopy up to 1 hr (76000) |
$515.40 |
$859 |
2.2× |
| Follow-Up Angiography (75898) |
$5,172.60 |
$8,621 |
1.7× |
| Foot 2 views (73620) |
$391.80 |
$653 |
4.6× |
| Forearm 2 views (73090) |
$445.80 |
$743 |
5.2× |
| Gastric emptying imaging study (78264) |
$878.40 |
$1,464 |
2.2× |
| Gastric Mucosa Imaging (78261) |
$703.20 |
$1,172 |
1.8× |
| Gated Heart Planar Single (78472) |
$2,235 |
$3,725 |
5.7× |
| Gated Heart, Multiple (78473) |
$810.60 |
$1,351 |
2.1× |
| Hand 2 views (73120) |
$250.20 |
$417 |
2.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$3,460.80 |
$5,768 |
5.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,147.60 |
$5,246 |
4.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$3,045 |
$5,075 |
4.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,535.60 |
$4,226 |
0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,535.60 |
$4,226 |
0.8× |
| Hepatobil Syst Image W/Drug (78227) |
$1,143 |
$1,905 |
2.1× |
| Hepatobiliary System Imaging (78226) |
$1,143 |
$1,905 |
2.9× |
| Ht Muscle Image Spect Sing (78451) |
$892.80 |
$1,488 |
0.7× |
| Hysterosalpingogram (74740) |
$1,255.20 |
$2,092 |
5.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,073.40 |
$1,789 |
12.5× |
| Infant hip ultrasound, limited static exam (76886) |
$541.80 |
$903 |
6.3× |
| Interstitial radiation source applic complex (77778) |
$3,403.20 |
$5,672 |
5.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$2,433 |
$4,055 |
4.5× |
| Intracavitary radiation source applic simple (77761) |
$2,353.80 |
$3,923 |
4.3× |
| Joint Survey Single View (77077) |
$184.20 |
$307 |
1.8× |
| K Flow/Funct Image Multiple (78709) |
$1,644.60 |
$2,741 |
3.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,281.60 |
$2,136 |
2.4× |
| K Flow/Funct Image W/O Drug (78707) |
$1,330.80 |
$2,218 |
2.5× |
| Knee 3 Views (73562) |
$589.80 |
$983 |
6.9× |
| Leveen/Shunt Patency Exam (78291) |
$921 |
$1,535 |
2.3× |
| Liver & Spleen Imaging Static Only (78215) |
$1,156.80 |
$1,928 |
2.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$703.20 |
$1,172 |
1.8× |
| Liver imaging static only (78201) |
$801.60 |
$1,336 |
1.5× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,663.80 |
$2,773 |
3.1× |
| Lung perfusion differential (78597) |
$1,045.80 |
$1,743 |
2.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,663.80 |
$2,773 |
3.1× |
| Lung Ventilation Imaging (78579) |
$1,045.80 |
$1,743 |
2.7× |
| Lymph System Imaging (78195) |
$1,308 |
$2,180 |
2.4× |
| Mammary ductogram or galactogram multiple (77054) |
$573.60 |
$956 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$525.60 |
$876 |
2.2× |
| Meckels Divert Exam (78290) |
$714.60 |
$1,191 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,043.40 |
$1,739 |
2.8× |
| Myelogram cervical (72240) |
$1,827 |
$3,045 |
2.4× |
| Myelogram Lumbar (72265) |
$2,627.40 |
$4,379 |
3.4× |
| Myelography thoracic (72255) |
$2,287.20 |
$3,812 |
3.0× |
| Myelograpy 2/more regions rs&i (72270) |
$2,857.80 |
$4,763 |
3.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,943 |
$4,905 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$4,296 |
$7,160 |
3.4× |
| N-invas est c ffr sw aly CTA (75580) |
$2,914.80 |
$4,858 |
3.4× |
| Neck soft tissue (70360) |
$476.40 |
$794 |
5.6× |
| Nm myocard infarct spect (78469) |
$1,449.60 |
$2,416 |
2.7× |
| Nonvascular Shunt X-Ray (75809) |
$1,857.60 |
$3,096 |
18.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,616.40 |
$7,694 |
3.4× |
| Nuclear Rx Intra-Arterial (79445) |
$491.40 |
$819 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$808.20 |
$1,347 |
3.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$173.40 |
$289 |
1.7× |
| Optic foramina (70190) |
$319.20 |
$532 |
3.7× |
| Panoramic X-ray of jaws (70355) |
$226.80 |
$378 |
2.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,024.20 |
$1,707 |
1.9× |
| Parathyroid Planar Imaging (78070) |
$689.40 |
$1,149 |
1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$883.80 |
$1,473 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$406.80 |
$678 |
3.9× |
| Peritoneogram Rs&I (74190) |
$790.20 |
$1,317 |
1.5× |
| Pet Image W/Ct Lmtd (78814) |
$8,151.60 |
$13,586 |
5.8× |
| PET image w/CT, full body (78816) |
$7,760.40 |
$12,934 |
5.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,822.20 |
$13,037 |
5.6× |
| PET whole body (78813) |
$4,570.20 |
$7,617 |
3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,535.60 |
$4,226 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,149 |
$1,915 |
2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$744 |
$1,240 |
7.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$832.20 |
$1,387 |
1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$401.40 |
$669 |
4.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$390.60 |
$651 |
4.6× |
| Radex elbow complete minimum 3 views (73080) |
$547.20 |
$912 |
6.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$70.20 |
$117 |
0.7× |
| Radex fingr minimum 2 views (73140) |
$406.80 |
$678 |
4.7× |
| Radex foot complete minimum 3 views (73630) |
$471 |
$785 |
5.5× |
| Radex Hand Minimum 3 Views (73130) |
$445.80 |
$743 |
5.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$334.80 |
$558 |
3.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$250.20 |
$417 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$57 |
$95 |
0.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$500.40 |
$834 |
5.8× |
| Radex shoulder complete minimum 2 views (73030) |
$466.20 |
$777 |
5.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$305.40 |
$509 |
3.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,029 |
$1,715 |
6.0× |
| Radex Spine 1 View Specify Level (72020) |
$415.80 |
$693 |
4.8× |
| Radex Sternum Minimum 2 Views (71120) |
$461.40 |
$769 |
5.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$818.40 |
$1,364 |
9.5× |
| Radex Toe Minimum 2 Views (73660) |
$292.20 |
$487 |
3.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$445.80 |
$743 |
4.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$499.80 |
$833 |
5.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$69 |
$115 |
0.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,964.80 |
$26,608 |
2.2× |
| Radiation treatment delivery level 1 (77402) |
$644.40 |
$1,074 |
6.4× |
| Radiation treatment delivery level 2 (77407) |
$1,722 |
$2,870 |
4.5× |
| Radiation treatment delivery level 3 (77412) |
$2,282.40 |
$3,804 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$654 |
$1,090 |
6.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$69 |
$115 |
0.7× |
| Radiologic exam colon double contrast study (74280) |
$1,314.60 |
$2,191 |
7.6× |
| Radiologic exam colon single contrast study (74270) |
$1,119 |
$1,865 |
6.5× |
| Radiologic exam knee complete 4/more views (73564) |
$645 |
$1,075 |
6.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$70.20 |
$117 |
0.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$832.20 |
$1,387 |
4.8× |
| Radiologic exam swallow function contrast study (74230) |
$862.20 |
$1,437 |
5.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,238.40 |
$2,064 |
7.2× |
| Radiologic examination femur minimum 2 views (73552) |
$556.80 |
$928 |
6.5× |
| Radiologic examination knee 1/2 views (73560) |
$471 |
$785 |
5.5× |
| Radiologic Examination Osseous Survey Limited (77074) |
$878.40 |
$1,464 |
8.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$401.40 |
$669 |
4.7× |
| Renal Cyst Study (74470) |
$1,463.40 |
$2,439 |
2.7× |
| Ribs bilateral 3 views (71110) |
$552 |
$920 |
5.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$2,158.20 |
$3,597 |
5.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$898.80 |
$1,498 |
2.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,364.40 |
$2,274 |
2.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,581.60 |
$2,636 |
3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,579.80 |
$2,633 |
3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,799.40 |
$2,999 |
1.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,901 |
$4,835 |
2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,556.60 |
$4,261 |
2.0× |
| Rp Therapy Intravenous Administration (79101) |
$4,638 |
$7,730 |
20.2× |
| Scapula (73010) |
$499.80 |
$833 |
4.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$25.20 |
$42 |
1.1× |
| Sella turcica (70240) |
$289.20 |
$482 |
3.4× |
| Shoulder 1 view (73020) |
$325.80 |
$543 |
3.8× |
| Shoulder Arthrography (73040) |
$1,010.40 |
$1,684 |
2.9× |
| Sialogram (70390) |
$1,428 |
$2,380 |
6.1× |
| Skull less than 4 views (70250) |
$323.40 |
$539 |
3.1× |
| Special dosimetry (77331) |
$382.80 |
$638 |
2.9× |
| Special Physics Consult (77370) |
$1,201.80 |
$2,003 |
9.1× |
| Special teletherapy port plan (77321) |
$2,883.60 |
$4,806 |
7.8× |
| Special treatment procedure (77470) |
$3,643.20 |
$6,072 |
6.7× |
| Stereotactic Body Radiation Delivery (77373) |
$3,555.60 |
$5,926 |
2.0× |
| Sternoclavicular joints (71130) |
$601.20 |
$1,002 |
7.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,700.20 |
$6,167 |
10.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$680.40 |
$1,134 |
1.8× |
| Testicular Imaging W/Flow (78761) |
$703.20 |
$1,172 |
1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,863.60 |
$3,106 |
5.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,327.80 |
$2,213 |
3.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,792.20 |
$2,987 |
13.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$513.60 |
$856 |
3.0× |
| Thoracic spine 2 views (72070) |
$445.80 |
$743 |
4.3× |
| Thoracic spine 3 views (72072) |
$526.20 |
$877 |
5.1× |
| Thoracolumbar 2 views (72080) |
$526.20 |
$877 |
6.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$1,040.40 |
$1,734 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$570 |
$950 |
1.4× |
| Thyroid Met Imaging Body (78018) |
$1,264.80 |
$2,108 |
2.4× |
| Thyroid Uptake Measurement (78012) |
$428.40 |
$714 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$873 |
$1,455 |
2.2× |
| Tx Devices Design & Construction Complex (77334) |
$1,659 |
$2,765 |
4.5× |
| Tx devices design & construction intermediate (77333) |
$1,043.40 |
$1,739 |
7.9× |
| Tx devices design & construction simple (77332) |
$688.80 |
$1,148 |
5.2× |
| Ultrasound Breast Limited (76642) |
$642.60 |
$1,071 |
7.5× |
| Ultrasound Exam Aaa Screen (76706) |
$166.80 |
$278 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$1,020 |
$1,700 |
9.9× |
| Umbilical-artery Doppler (OB) (76820) |
$1,734.60 |
$2,891 |
16.8× |
| Unlisted Dx Radiographic Procedure (76499) |
$515.40 |
$859 |
6.0× |
| Unlisted us procedure (76999) |
$462.60 |
$771 |
5.4× |
| Upper gi w/o kub (74240) |
$1,238.40 |
$2,064 |
7.2× |
| Ureteral Reflux Study (78740) |
$995.40 |
$1,659 |
2.5× |
| Urethrocystogram voiding (74455) |
$1,432.80 |
$2,388 |
6.1× |
| Urethrocystography retrograde (74450) |
$879 |
$1,465 |
3.7× |
| Us breast unilateral complete (76641) |
$105 |
$175 |
1.0× |
| Us chest (76604) |
$829.80 |
$1,383 |
8.1× |
| Us complete joint (76881) |
$69 |
$115 |
0.7× |
| Us exam, pelvic, limited (76857) |
$435.60 |
$726 |
4.2× |
| Us head (76506) |
$70.20 |
$117 |
0.7× |
| Us kidney transplant (76776) |
$894.60 |
$1,491 |
8.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$765 |
$1,275 |
7.4× |
| Us ob detailed single fetus (76811) |
$1,516.20 |
$2,527 |
6.4× |
| Us ob limited 1 or more fetuses (76815) |
$627.60 |
$1,046 |
6.1× |
| Us ob transvaginal (76817) |
$1,099.80 |
$1,833 |
10.7× |
| Us pelvic non ob complete (76856) |
$250.80 |
$418 |
2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,073.40 |
$1,789 |
10.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$238.20 |
$397 |
2.3× |
| Us retroperitoneal complete (76770) |
$1,073.40 |
$1,789 |
10.4× |
| Us retroperitoneal limited (76775) |
$964.20 |
$1,607 |
9.4× |
| Us scrotum and contents (76870) |
$1,073.40 |
$1,789 |
10.4× |
| Us spinal canal and contents (76800) |
$1,008.60 |
$1,681 |
9.8× |
| Us thyroid (76536) |
$1,073.40 |
$1,789 |
10.4× |
| Us transrectal (76872) |
$69 |
$115 |
0.7× |
| Vascular Flow Imaging (78445) |
$595.80 |
$993 |
1.5× |
| Vein X-Ray Chest (75827) |
$2,514.60 |
$4,191 |
1.6× |
| Vein X-Ray Skull Epidural (75872) |
$2,535.60 |
$4,226 |
4.1× |
| Venogram Sinus/Jugular (75860) |
$2,535.60 |
$4,226 |
0.8× |
| Venography Adrenal Unilateral (75840) |
$2,535.60 |
$4,226 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,845.80 |
$4,743 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,605 |
$2,675 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$2,583.60 |
$4,306 |
1.7× |
| Venography Renal Bilateral (75833) |
$2,535.60 |
$4,226 |
0.8× |
| Venography Renal Unilateral (75831) |
$2,535.60 |
$4,226 |
0.8× |
| Venous sampling by catheter (75893) |
$6,537.60 |
$10,896 |
1.2× |
| Vertebral fracture assessment via dxa (77086) |
$373.80 |
$623 |
4.4× |
| Wrist 2 views (73100) |
$445.80 |
$743 |
5.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$58.20 |
$97 |
0.7× |
| X-ray antegrade pyelogram tube (74425) |
$1,002.60 |
$1,671 |
2.9× |
| X-Ray Aorta Leg Arteries (75630) |
$6,624 |
$11,040 |
2.1× |
| X-Ray Bend Only L-S Spine (72120) |
$141 |
$235 |
1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$455.40 |
$759 |
5.3× |
| X-Ray Exam Breast Specimen (76098) |
$408.60 |
$681 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$406.80 |
$678 |
4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$69 |
$115 |
0.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$69 |
$115 |
0.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$446.40 |
$744 |
5.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$690.60 |
$1,151 |
8.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$1,000.80 |
$1,668 |
9.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$1,000.80 |
$1,668 |
9.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,000.80 |
$1,668 |
9.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$406.20 |
$677 |
3.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$702.60 |
$1,171 |
6.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$526.20 |
$877 |
6.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$712.80 |
$1,188 |
6.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$543 |
$905 |
5.3× |
| X-ray eye for foreign body (70030) |
$572.40 |
$954 |
6.7× |
| X-ray humerus (73060) |
$456.60 |
$761 |
5.3× |
| X-ray IV pyelogram (ivp) (74400) |
$1,015.20 |
$1,692 |
5.9× |
| X-ray IV pyelogram+tomography (74415) |
$1,194 |
$1,990 |
6.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$654 |
$1,090 |
7.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$298.20 |
$497 |
3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$526.20 |
$877 |
5.1× |
| X-ray nose-rectum child f.b. (76010) |
$382.20 |
$637 |
4.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$513.60 |
$856 |
5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$445.80 |
$743 |
4.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$171 |
$285 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$445.80 |
$743 |
5.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$639.60 |
$1,066 |
7.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$669 |
$1,115 |
6.5× |
| X-Ray Stress View (77071) |
$412.20 |
$687 |
4.8× |
| X-ray thoracic spine 4 vw (72074) |
$568.80 |
$948 |
5.5× |
| X-Ray Tmj Unilat (70328) |
$150 |
$250 |
1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$241.80 |
$403 |
0.7× |
| X-Rays Bone Length Studies (77073) |
$543 |
$905 |
5.3× |
| X-Rays Bone Survey Complete (77075) |
$559.20 |
$932 |
5.4× |
| Xr c-spine 4 or 5 views (72050) |
$722.40 |
$1,204 |
7.0× |
| Xr facial bones less than 3 views (70140) |
$150 |
$250 |
1.7× |
| Xr orbits complete 4 views (70200) |
$980.40 |
$1,634 |
9.5× |
| Xr Tomogram Single Plane (76100) |
$1,191.60 |
$1,986 |
11.6× |