| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,104.80 |
$13,508 |
5.9× |
| Abdomen 1 View (74018) |
$216 |
$360 |
2.5× |
| Abdomen 2 views (74019) |
$417 |
$695 |
4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,080 |
$1,800 |
2.7× |
| Angio internal mammary (75756) |
$3,290.40 |
$5,484 |
1.1× |
| Angio pulmonary bilat (75743) |
$4,373.40 |
$7,289 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$4,732.80 |
$7,888 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$5,678.40 |
$9,464 |
1.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,595.60 |
$9,326 |
1.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$7,731.60 |
$12,886 |
2.5× |
| Ankle 2 views (73600) |
$357.60 |
$596 |
4.1× |
| Aortography thoracic serialography rs&i (75605) |
$4,543.80 |
$7,573 |
0.8× |
| Artery X-Rays Abdomen (75726) |
$5,575.80 |
$9,293 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$4,543.80 |
$7,573 |
0.8× |
| Artery X-Rays Spine (75705) |
$6,402 |
$10,670 |
1.2× |
| Arthrogram ankle (73615) |
$1,882.20 |
$3,137 |
5.4× |
| Arthrogram hip (73525) |
$2,671.20 |
$4,452 |
7.7× |
| Arthrogram Wrist (73115) |
$1,551 |
$2,585 |
4.5× |
| Basic radiation dosimetry calculation (77300) |
$946.20 |
$1,577 |
7.1× |
| Bone age studies (77072) |
$653.40 |
$1,089 |
6.3× |
| Bone Imaging 3 Phase (78315) |
$2,506.20 |
$4,177 |
6.3× |
| Bone Imaging Limited Area (78300) |
$1,571.40 |
$2,619 |
4.0× |
| Bone Imaging Whole Body (78306) |
$2,445.60 |
$4,076 |
6.2× |
| Bone marrow imaging limited area (78102) |
$905.40 |
$1,509 |
2.3× |
| Bone survey infant (77076) |
$493.80 |
$823 |
4.8× |
| Brachytx isodose complex (77318) |
$2,328.60 |
$3,881 |
6.3× |
| Brachytx isodose intermed (77317) |
$1,516.20 |
$2,527 |
4.1× |
| Brachytx Isodose Plan Simple (77316) |
$1,020 |
$1,700 |
2.7× |
| Brain Flow Imaging Only (78610) |
$944.40 |
$1,574 |
1.8× |
| Cardiac Shunt Detection (78428) |
$693 |
$1,155 |
1.7× |
| Cat Scan Follow-Up Study (76380) |
$678.60 |
$1,131 |
7.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,219.20 |
$2,032 |
2.3× |
| Cerebrospinal Fluid Scan (78630) |
$1,177.20 |
$1,962 |
2.2× |
| Chest 1 view (71045) |
$213.60 |
$356 |
2.5× |
| Chest 2 views (71046) |
$324 |
$540 |
3.8× |
| Chest 3 views (71047) |
$57 |
$95 |
0.7× |
| Chest 4 or more views (71048) |
$69 |
$115 |
0.7× |
| Clavicle complete (73000) |
$468.60 |
$781 |
5.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$192 |
$320 |
1.9× |
| Continuing medical physics consltj pr wk (77336) |
$1,372.20 |
$2,287 |
10.3× |
| Contrast Exam Abdominl Aorta (75625) |
$4,732.80 |
$7,888 |
1.5× |
| Contrast X-Ray Bladder (74430) |
$752.40 |
$1,254 |
2.2× |
| Contrast X-Ray Of Elbow (73085) |
$682.80 |
$1,138 |
2.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$2,859.60 |
$4,766 |
8.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,955.80 |
$6,593 |
11.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,828.20 |
$3,047 |
7.7× |
| CT abdomen w contrast (74160) |
$1,306.80 |
$2,178 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,857.60 |
$3,096 |
10.7× |
| CT abdomen w/o contrast (74150) |
$1,306.80 |
$2,178 |
12.6× |
| CT Angio Abdomen and Pelvis (74174) |
$1,300.20 |
$2,167 |
3.8× |
| CT Angio Chest (71275) |
$1,143 |
$1,905 |
6.6× |
| CT Angio Head (70496) |
$1,330.80 |
$2,218 |
7.7× |
| CT angio hrt w/3d image (75574) |
$1,865.40 |
$3,109 |
5.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,857.60 |
$3,096 |
10.7× |
| CT Angio Neck (70498) |
$1,168.20 |
$1,947 |
6.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,857.60 |
$3,096 |
10.7× |
| CT cervical spine w/ contrast (72126) |
$1,469.40 |
$2,449 |
4.2× |
| CT cervical spine w/o contrast (72125) |
$886.80 |
$1,478 |
8.6× |
| CT cervical spine w/wo cont (72127) |
$1,672.20 |
$2,787 |
9.6× |
| CT chest w contrast (71260) |
$979.20 |
$1,632 |
5.6× |
| CT chest w/wo contrast (71270) |
$1,857.60 |
$3,096 |
10.7× |
| CT head/brain with contrast (70460) |
$1,668.60 |
$2,781 |
9.6× |
| CT head/brain without and with contrast (70470) |
$1,900.80 |
$3,168 |
10.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$524.40 |
$874 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$192 |
$192 |
2.2× |
| CT iac w contrast (70481) |
$1,668.60 |
$2,781 |
9.6× |
| CT l-spine w&w/o contrast (72133) |
$1,857.60 |
$3,096 |
10.7× |
| CT lower ext w/o (73700) |
$1,408.20 |
$2,347 |
13.6× |
| CT lower extremity w/contrast material (73701) |
$1,633.20 |
$2,722 |
9.4× |
| CT lumbar spine w contrast (72132) |
$1,633.20 |
$2,722 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$985.80 |
$1,643 |
9.5× |
| CT maxillofacial w contrast (70487) |
$1,668.60 |
$2,781 |
9.6× |
| CT maxillofacial wo contrast (70486) |
$1,007.40 |
$1,679 |
9.7× |
| CT neck tissue combo (70492) |
$1,900.80 |
$3,168 |
10.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,900.80 |
$3,168 |
10.9× |
| CT orbits w/o contrast (70480) |
$1,441.20 |
$2,402 |
13.9× |
| CT pelvis w&w/o contrast (72194) |
$1,857.60 |
$3,096 |
10.7× |
| CT pelvis w/o contrast (72192) |
$1,408.20 |
$2,347 |
13.6× |
| CT scan of leg combo (73702) |
$1,857.60 |
$3,096 |
10.7× |
| CT scans face/jaw combo (70488) |
$1,900.80 |
$3,168 |
10.9× |
| CT soft tissue neck w contrast (70491) |
$1,168.20 |
$1,947 |
6.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,441.20 |
$2,402 |
13.9× |
| CT thoracic spine w contrast (72129) |
$1,633.20 |
$2,722 |
9.4× |
| CT thoracic spine w/o contrast (72128) |
$1,408.20 |
$2,347 |
13.6× |
| CT thoracic spine w/wo cont (72130) |
$1,857.60 |
$3,096 |
10.7× |
| CT thorax w/o contrast (71250) |
$915 |
$1,525 |
8.8× |
| CT upper ext wo (73200) |
$1,408.20 |
$2,347 |
13.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,857.60 |
$3,096 |
10.7× |
| CT upper extremity with contrast (73201) |
$1,633.20 |
$2,722 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,672.20 |
$2,787 |
9.6× |
| Cta Abdomen (74175) |
$1,857.60 |
$3,096 |
10.7× |
| CTA pelvis (72191) |
$1,857.60 |
$3,096 |
10.7× |
| Dilation ureters/urethra rs&i (74485) |
$1,460.40 |
$2,434 |
0.7× |
| Discography Cerv/Thor Spine (72285) |
$3,825.60 |
$6,376 |
2.0× |
| Diskography lumbar (72295) |
$2,615.40 |
$4,359 |
1.4× |
| Dxa Bone Density Axial (77080) |
$349.80 |
$583 |
3.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$303 |
$505 |
3.5× |
| Esophagram (74220) |
$471 |
$785 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$1,024.20 |
$1,707 |
4.3× |
| Follow-Up Angiography (75898) |
$5,172.60 |
$8,621 |
1.7× |
| Foot 2 views (73620) |
$319.80 |
$533 |
3.7× |
| Forearm 2 views (73090) |
$472.80 |
$788 |
5.5× |
| Gastric emptying imaging study (78264) |
$1,498.20 |
$2,497 |
3.8× |
| Gated Heart Planar Single (78472) |
$2,312.40 |
$3,854 |
5.8× |
| Hand 2 views (73120) |
$424.80 |
$708 |
4.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$2,789.40 |
$4,649 |
4.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,789.40 |
$4,649 |
4.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,789.40 |
$4,649 |
4.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$4,543.80 |
$7,573 |
1.5× |
| Hepatobil Syst Image W/Drug (78227) |
$2,530.80 |
$4,218 |
4.7× |
| Hepatobiliary System Imaging (78226) |
$2,232.60 |
$3,721 |
5.6× |
| Ht Musc Image Planar Mult (78454) |
$2,545.80 |
$4,243 |
2.0× |
| Ht Muscle Image Spect Sing (78451) |
$892.80 |
$1,488 |
0.7× |
| Hysterosalpingogram (74740) |
$750.60 |
$1,251 |
3.2× |
| Infant hip ultrasound, limited static exam (76886) |
$735 |
$1,225 |
8.5× |
| Interstitial radiation source applic complex (77778) |
$6,859.80 |
$11,433 |
9.9× |
| Joint Survey Single View (77077) |
$774 |
$1,290 |
7.5× |
| K Flow/Funct Image Multiple (78709) |
$2,580 |
$4,300 |
4.8× |
| K Flow/Funct Image W/Drug (78708) |
$2,294.40 |
$3,824 |
4.3× |
| K Flow/Funct Image W/O Drug (78707) |
$2,140.20 |
$3,567 |
4.0× |
| Kidney Imaging Morphol (78700) |
$814.20 |
$1,357 |
2.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$2,002.80 |
$3,338 |
5.1× |
| Knee 3 Views (73562) |
$463.20 |
$772 |
5.4× |
| Leveen/Shunt Patency Exam (78291) |
$723 |
$1,205 |
1.8× |
| Liver & Spleen Imaging Static Only (78215) |
$1,075.20 |
$1,792 |
2.7× |
| Liver imaging static only (78201) |
$1,009.80 |
$1,683 |
1.9× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,795.80 |
$2,993 |
3.3× |
| Lung perfusion differential (78597) |
$895.20 |
$1,492 |
2.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,316.60 |
$3,861 |
4.3× |
| Lung Ventilation Imaging (78579) |
$955.80 |
$1,593 |
2.4× |
| Lymph System Imaging (78195) |
$1,479.60 |
$2,466 |
2.7× |
| Mammary ductogram or galactogram multiple (77054) |
$1,942.20 |
$3,237 |
8.2× |
| Mammary ductogram or galactogram single (77053) |
$1,383 |
$2,305 |
5.8× |
| Meckels Divert Exam (78290) |
$391.80 |
$653 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,385.60 |
$3,976 |
6.4× |
| Myelogram cervical (72240) |
$2,655 |
$4,425 |
3.4× |
| Myelogram Lumbar (72265) |
$2,323.80 |
$3,873 |
3.0× |
| Myelography thoracic (72255) |
$1,188 |
$1,980 |
1.5× |
| Myelograpy 2/more regions rs&i (72270) |
$2,859.60 |
$4,766 |
3.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$930.60 |
$1,551 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$6,753.60 |
$11,256 |
5.3× |
| N-invas est c ffr sw aly CTA (75580) |
$1,647.60 |
$2,746 |
1.9× |
| Neck soft tissue (70360) |
$309 |
$515 |
3.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$786 |
$1,310 |
2.0× |
| Nm csf leak detection (78650) |
$1,303.20 |
$2,172 |
1.0× |
| Nm myocard infarct spect (78469) |
$1,076.40 |
$1,794 |
2.0× |
| Nonvascular Shunt X-Ray (75809) |
$349.20 |
$582 |
3.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,512.80 |
$9,188 |
4.0× |
| Nuclear Rx Oral Admin (79005) |
$2,178.60 |
$3,631 |
9.4× |
| Panoramic X-ray of jaws (70355) |
$447.60 |
$746 |
5.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,086.60 |
$1,811 |
2.0× |
| Parathyroid Planar Imaging (78070) |
$829.80 |
$1,383 |
2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$966.60 |
$1,611 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$339 |
$565 |
3.3× |
| Peritoneogram Rs&I (74190) |
$1,026 |
$1,710 |
1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,876.80 |
$8,128 |
3.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,360.20 |
$2,267 |
3.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$615.60 |
$1,026 |
5.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$636.60 |
$1,061 |
1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$417.60 |
$696 |
4.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$394.20 |
$657 |
4.6× |
| Radex elbow complete minimum 3 views (73080) |
$464.40 |
$774 |
5.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$656.40 |
$1,094 |
6.3× |
| Radex fingr minimum 2 views (73140) |
$385.80 |
$643 |
4.5× |
Radex foot complete minimum 3 views (73630)
range across 2 matching MRF lines |
$495.60–$720 |
$826–$1,200 |
varies |
| Radex Hand Minimum 3 Views (73130) |
$368.40 |
$614 |
4.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$446.40 |
$744 |
5.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$639.60 |
$1,066 |
6.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$472.80 |
$788 |
5.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$402.60 |
$671 |
4.7× |
| Radex shoulder complete minimum 2 views (73030) |
$427.20 |
$712 |
5.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$58.20 |
$97 |
0.7× |
| Radex Spine 1 View Specify Level (72020) |
$351.60 |
$586 |
4.1× |
| Radex Sternum Minimum 2 Views (71120) |
$430.80 |
$718 |
5.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$571.20 |
$952 |
6.6× |
| Radex Toe Minimum 2 Views (73660) |
$367.20 |
$612 |
4.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$440.40 |
$734 |
4.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$499.20 |
$832 |
5.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,255.20 |
$27,092 |
2.2× |
| Radiation treatment delivery level 1 (77402) |
$606 |
$1,010 |
6.0× |
| Radiation treatment delivery level 2 (77407) |
$1,290 |
$2,150 |
3.4× |
| Radiation treatment delivery level 3 (77412) |
$2,282.40 |
$3,804 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$738 |
$1,230 |
7.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$69 |
$115 |
0.7× |
| Radiologic exam colon double contrast study (74280) |
$1,015.20 |
$1,692 |
5.8× |
| Radiologic exam colon single contrast study (74270) |
$802.80 |
$1,338 |
4.6× |
| Radiologic exam knee complete 4/more views (73564) |
$448.20 |
$747 |
4.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$478.20 |
$797 |
4.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$691.80 |
$1,153 |
4.0× |
| Radiologic exam swallow function contrast study (74230) |
$564.60 |
$941 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$524.40 |
$874 |
3.0× |
| Radiologic examination femur minimum 2 views (73552) |
$512.40 |
$854 |
5.9× |
| Radiologic examination knee 1/2 views (73560) |
$418.20 |
$697 |
4.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$492 |
$820 |
5.7× |
| Renal Cyst Study (74470) |
$861 |
$1,435 |
1.6× |
| Ribs bilateral 3 views (71110) |
$450 |
$750 |
4.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$970.20 |
$1,617 |
2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,365 |
$2,275 |
3.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,053.80 |
$3,423 |
3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,720.80 |
$2,868 |
3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,506 |
$2,510 |
2.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,514.60 |
$4,191 |
2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,901 |
$4,835 |
2.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,556.60 |
$4,261 |
2.0× |
| Rp Therapy Intravenous Administration (79101) |
$1,614 |
$2,690 |
7.0× |
| Scapula (73010) |
$551.40 |
$919 |
5.3× |
| Sella turcica (70240) |
$388.80 |
$648 |
4.5× |
| Shoulder 1 view (73020) |
$273 |
$455 |
3.2× |
| Shoulder Arthrography (73040) |
$1,280.40 |
$2,134 |
3.7× |
| Sialogram (70390) |
$642 |
$1,070 |
2.7× |
| Skull less than 4 views (70250) |
$554.40 |
$924 |
5.3× |
| Special dosimetry (77331) |
$1,085.40 |
$1,809 |
8.1× |
| Special Physics Consult (77370) |
$1,362.60 |
$2,271 |
10.2× |
| Special teletherapy port plan (77321) |
$2,064.60 |
$3,441 |
5.6× |
| Special treatment procedure (77470) |
$3,379.20 |
$5,632 |
6.2× |
| Stereotactic Body Radiation Delivery (77373) |
$14,031 |
$23,385 |
7.9× |
| Sternoclavicular joints (71130) |
$174.60 |
$291 |
2.0× |
| Superior sagittal sinus venogram (75870) |
$5,330.40 |
$8,884 |
1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,901.40 |
$3,169 |
5.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$862.20 |
$1,437 |
2.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$806.40 |
$1,344 |
3.4× |
| Testicular Imaging W/Flow (78761) |
$1,263.60 |
$2,106 |
3.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,151 |
$3,585 |
5.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,786.20 |
$2,977 |
4.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,228.80 |
$2,048 |
9.2× |
| Thoracic spine 2 views (72070) |
$246 |
$410 |
2.4× |
| Thoracic spine 3 views (72072) |
$499.20 |
$832 |
4.8× |
| Thoracolumbar 2 views (72080) |
$406.80 |
$678 |
4.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,768.80 |
$2,948 |
4.5× |
| Thyroid Met Imaging Body (78018) |
$1,399.80 |
$2,333 |
2.6× |
| Thyroid Uptake Measurement (78012) |
$319.20 |
$532 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,040.60 |
$3,401 |
5.1× |
| Tx Devices Design & Construction Complex (77334) |
$2,004.60 |
$3,341 |
5.4× |
| Tx devices design & construction intermediate (77333) |
$1,387.80 |
$2,313 |
10.4× |
| Tx devices design & construction simple (77332) |
$958.20 |
$1,597 |
7.2× |
| Unlisted Dx Radiographic Procedure (76499) |
$187.80 |
$313 |
2.2× |
| Upper gi w/o kub (74240) |
$772.80 |
$1,288 |
4.4× |
| Urethrocystogram voiding (74455) |
$652.80 |
$1,088 |
2.8× |
| Urethrocystography retrograde (74450) |
$592.80 |
$988 |
2.5× |
| Vein X-Ray Chest (75827) |
$2,879.40 |
$4,799 |
1.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,524.20 |
$4,207 |
0.8× |
| Vein X-Ray Spleen/Liver (75810) |
$4,543.80 |
$7,573 |
1.5× |
| Venogram Sinus/Jugular (75860) |
$3,290.40 |
$5,484 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$4,543.80 |
$7,573 |
1.5× |
| Venography extremity bilateral rs&i (75822) |
$2,113.20 |
$3,522 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,622.40 |
$2,704 |
1.0× |
| Venography Renal Bilateral (75833) |
$4,543.80 |
$7,573 |
1.5× |
| Venography Renal Unilateral (75831) |
$4,543.80 |
$7,573 |
1.5× |
| Venous sampling by catheter (75893) |
$5,755.20 |
$9,592 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$750.60 |
$1,251 |
8.7× |
| Wrist 2 views (73100) |
$414.60 |
$691 |
4.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$58.20 |
$97 |
0.7× |
| X-ray antegrade pyelogram tube (74425) |
$241.80 |
$403 |
0.7× |
| X-Ray Aorta Leg Arteries (75630) |
$6,830.40 |
$11,384 |
2.2× |
| X-Ray Bend Only L-S Spine (72120) |
$450 |
$750 |
4.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$303.60 |
$506 |
3.5× |
| X-Ray Exam Breast Specimen (76098) |
$1,110.60 |
$1,851 |
2.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$114 |
$190 |
1.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$795 |
$1,325 |
7.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$69 |
$115 |
0.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$495 |
$825 |
5.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$379.80 |
$633 |
4.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$603.60 |
$1,006 |
5.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$690.60 |
$1,151 |
6.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$795 |
$1,325 |
7.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$783.60 |
$1,306 |
7.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$485.40 |
$809 |
5.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$891 |
$1,485 |
8.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$514.80 |
$858 |
5.0× |
| X-ray eye for foreign body (70030) |
$564.60 |
$941 |
6.5× |
| X-ray humerus (73060) |
$375.60 |
$626 |
4.4× |
| X-ray IV pyelogram (ivp) (74400) |
$1,041 |
$1,735 |
6.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$58.20 |
$97 |
0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$366 |
$610 |
4.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$339.60 |
$566 |
3.3× |
| X-ray nose-rectum child f.b. (76010) |
$260.40 |
$434 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$672 |
$1,120 |
6.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$475.20 |
$792 |
4.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$262.20 |
$437 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$464.40 |
$774 |
5.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$57 |
$95 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$767.40 |
$1,279 |
7.4× |
| X-Ray Stress View (77071) |
$146.40 |
$244 |
1.7× |
| X-ray thoracic spine 4 vw (72074) |
$559.80 |
$933 |
5.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$897.60 |
$1,496 |
2.6× |
| X-Rays Bone Length Studies (77073) |
$587.40 |
$979 |
5.7× |
| X-Rays Bone Survey Complete (77075) |
$1,081.20 |
$1,802 |
10.4× |
| Xr c-spine 4 or 5 views (72050) |
$834 |
$1,390 |
8.0× |
| Xr facial bones less than 3 views (70140) |
$313.20 |
$522 |
3.6× |
| Xr orbits complete 4 views (70200) |
$70.20 |
$117 |
0.7× |
| Xr Tomogram Single Plane (76100) |
$473.40 |
$789 |
4.6× |