| 3-D radiotherapy plan dose-volume histograms (77295) |
$19,677.78 |
$30,273.50 |
14.8× |
| Abdomen 2 views (74019) |
$347.10 |
$534 |
3.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$897 |
$1,380 |
2.3× |
| Angiography extremity bilateral rs&i (75716) |
$2,620.80 |
$4,032 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,346.50 |
$3,610 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$4,507.75 |
$6,935 |
1.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,402.10 |
$5,234 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,673.15 |
$5,651 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,398.20 |
$5,228 |
1.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,817.80 |
$7,412 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,488.50 |
$2,290 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,894.50 |
$7,530 |
1.6× |
| Ankle 2 views (73600) |
$235.95 |
$363 |
2.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$665.60 |
$1,024 |
2.0× |
| Aortogram thoracic (75605) |
$4,841.20 |
$7,448 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,012.45 |
$6,173 |
1.3× |
| Aortography abdominal serialography rs&i (75625) |
$1,973.40 |
$3,036 |
0.6× |
| Arthrogram hip (73525) |
$573.95 |
$883 |
1.7× |
| Arthrogram shoulder (73040) |
$761.15 |
$1,171 |
2.3× |
| Arthrogram wrist (73115) |
$560.30 |
$862 |
1.7× |
| Arthrography knee lt (73580) |
$753.35 |
$1,159 |
2.2× |
| Basic radiation dosimetry calculation (77300) |
$19,174.94 |
$29,499.91 |
148.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,488.50 |
$2,290 |
3.9× |
| Bone &/joint imaging whole body (78306) |
$3,853.78 |
$5,928.90 |
10.0× |
| Bone age studies (77072) |
$359.45 |
$553 |
3.6× |
| Bone Imaging 3 Phase (78315) |
$1,243.45 |
$1,913 |
3.2× |
| Bone Marrow Imaging Limited Area (78102) |
$4,070.30 |
$6,262 |
10.6× |
| Bone survey complete (77075) |
$614.25 |
$945 |
6.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,777.10 |
$2,734 |
4.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,070.30 |
$6,262 |
3.0× |
| Brain Imaging Vascular Flow Only (78610) |
$1,860.95 |
$2,863 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$427.70 |
$658 |
5.1× |
| Chest 1 view (71045) |
$218.40 |
$336 |
2.6× |
| Chest 3 views (71047) |
$444.60 |
$684 |
5.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$300.30 |
$462 |
1.8× |
| Clavicle complete (73000) |
$360.10 |
$554 |
4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$431.60 |
$664 |
4.3× |
| Continuing medical physics consltj pr wk (77336) |
$16,486.28 |
$25,363.50 |
127.5× |
| Corpora cavernosography (74445) |
$533.65 |
$821 |
5.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,087.55 |
$7,827 |
15.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,697.50 |
$4,150 |
11.8× |
| CT abdomen w contrast (74160) |
$2,596.10 |
$3,994 |
15.4× |
| CT abdomen w wo contrast (74170) |
$2,937.68 |
$4,519.50 |
17.4× |
| CT abdomen w/o contrast (74150) |
$1,994.85 |
$3,069 |
19.8× |
| CT angiography upper extremity lt (73206) |
$1,385.15 |
$2,131 |
8.2× |
| CT c-spine w/o contrast (72125) |
$2,156.70 |
$3,318 |
21.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,546.05 |
$3,917 |
15.1× |
| CT cervical spine with contrast (72126) |
$2,388.10 |
$3,674 |
7.1× |
| CT chest w/wo contrast (71270) |
$2,280.20 |
$3,508 |
13.5× |
| CT chest with contrast (71260) |
$1,919.45 |
$2,953 |
11.4× |
| CT head/brain with contrast (70460) |
$1,829.75 |
$2,815 |
10.8× |
| CT head/brain without and with contrast (70470) |
$2,145.65 |
$3,301 |
12.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$32.50 |
$50 |
0.4× |
| CT iac w contrast (70481) |
$1,138.15 |
$1,751 |
6.7× |
| CT limited/localized follow up study (76380) |
$1,752.40 |
$2,696 |
20.9× |
| CT lower ext w/o (73700) |
$1,060.15 |
$1,631 |
10.5× |
| CT lower extremity w wo contrast (73702) |
$1,990.95 |
$3,063 |
11.8× |
| CT lower extremity with contrast (73701) |
$1,835.60 |
$2,824 |
10.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,031.25 |
$3,125 |
12.0× |
| CT lumbar spine w/o contrast (72131) |
$1,557.40 |
$2,396 |
15.5× |
| CT lumbar spine with contrast (72132) |
$1,907.10 |
$2,934 |
5.7× |
| CT maxillofacial w contrast (70487) |
$2,395.90 |
$3,686 |
14.2× |
| CT maxillofacial w/o contrast (70486) |
$1,963.32 |
$3,020.50 |
19.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,614.95 |
$4,023 |
15.5× |
| CT neck soft tissue w contrast (70491) |
$2,335.45 |
$3,593 |
13.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,733.55 |
$2,667 |
10.3× |
| CT orbits w/o contrast (70480) |
$1,007.50 |
$1,550 |
10.0× |
| CT pelvis w & w/o contrast (72194) |
$1,918.15 |
$2,951 |
11.4× |
| CT pelvis w/o contrast (72192) |
$1,531.40 |
$2,356 |
15.2× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$828.10 |
$1,274 |
9.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,557.10 |
$3,934 |
15.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,946.10 |
$2,994 |
19.4× |
| CT thoracic spine w/contrast (72129) |
$1,415.70 |
$2,178 |
8.4× |
| CT thoracic spine w/o contrast (72128) |
$1,212.90 |
$1,866 |
12.1× |
| CT thoracic spine w/wo contrast (72130) |
$2,020.85 |
$3,109 |
12.0× |
| CT thorax w/o contrast (71250) |
$1,634.10 |
$2,514 |
16.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,946.10 |
$2,994 |
11.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,554.80 |
$2,392 |
15.5× |
| CT upper extremity with contrast (73201) |
$1,650.35 |
$2,539 |
4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,414.45 |
$5,253 |
20.2× |
| Cta Abdomen (74175) |
$2,614.30 |
$4,022 |
15.5× |
| CTA abdomen pelvis (74174) |
$2,948.40 |
$4,536 |
8.8× |
| CTA chest (71275) |
$2,195.05 |
$3,377 |
13.0× |
| Cta Head (70496) |
$3,498.95 |
$5,383 |
20.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,498.95 |
$5,383 |
10.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,065.05 |
$3,177 |
12.2× |
| Cta Neck (70498) |
$3,065.40 |
$4,716 |
18.2× |
| Cta Pelvis (72191) |
$2,367.95 |
$3,643 |
14.0× |
| Cystography minimum 3 views rs&i (74430) |
$458.90 |
$706 |
1.4× |
| Diskogram cervical (72285) |
$1,777.75 |
$2,735 |
0.9× |
| Diskography lumbar (72295) |
$2,872.35 |
$4,419 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$581.75 |
$895 |
5.8× |
| Dxa bone density study axial skeleton (77085) |
$464.10 |
$714 |
4.6× |
| Echoencephalography real time imaging (76506) |
$613.60 |
$944 |
6.1× |
| Esophagus (74220) |
$536.90 |
$826 |
3.2× |
| Fetal biophysical profile non-stress testing (76818) |
$543.40 |
$836 |
5.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$403 |
$620 |
4.0× |
| Fluoroscopy up to 1 hr (76000) |
$833.95 |
$1,283 |
3.6× |
| Foot 2 views (73620) |
$204.10 |
$314 |
2.4× |
| Forearm 2 views (73090) |
$363.35 |
$559 |
4.3× |
| Gated Heart Planar Single (78472) |
$2,271.10 |
$3,494 |
5.9× |
| Hand 2 views (73120) |
$247.65 |
$381 |
2.5× |
| Hand 3 views (73130) |
$382.85 |
$589 |
4.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,927.38 |
$2,965.21 |
3.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,492.75 |
$3,835 |
6.5× |
| Ht muscle image spect sing (78451) |
$2,017.28 |
$3,103.50 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$292.50 |
$450 |
3.5× |
| Hysterosalpingogram (74740) |
$419.25 |
$645 |
1.8× |
| Interstitial radiation source applic complex (77778) |
$5,769.40 |
$8,876 |
8.6× |
| Kidney funcj study non-img radioisotopic study (78725) |
$1,751.75 |
$2,695 |
4.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,279.52 |
$1,968.50 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,573.98 |
$2,421.50 |
3.0× |
| Knee 3 views (73562) |
$401.05 |
$617 |
4.8× |
| Liver & spleen imaging static only (78215) |
$1,236.30 |
$1,902 |
3.2× |
| Lymphoscintigraphy (78195) |
$11,136.04 |
$17,132.36 |
21.3× |
| Mammary ductogram or galactogram multiple (77054) |
$750.75 |
$1,155 |
3.3× |
| Mammary ductogram or galactogram single (77053) |
$537.55 |
$827 |
2.3× |
| Meckels Diverticulum (78290) |
$1,679.60 |
$2,584 |
4.4× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$663 |
$1,020 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$20,487.68 |
$31,519.50 |
56.9× |
| MRA head w & w/o contrast (70546) |
$3,029 |
$4,660 |
9.0× |
| MRA head w/o contrast (70544) |
$2,074.15 |
$3,191 |
9.0× |
| MRA head with contrast (70545) |
$2,578.55 |
$3,967 |
7.7× |
| MRA neck w contrast (70548) |
$2,421.25 |
$3,725 |
7.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,715.70 |
$4,178 |
8.1× |
| MRA neck w/o contrast (70547) |
$2,198.30 |
$3,382 |
9.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,737.85 |
$7,289 |
14.1× |
| MRI abdomen w/o contrast (74181) |
$3,546.40 |
$5,456 |
15.5× |
| MRI any jnt lwr ext with con lt (73722) |
$3,088.15 |
$4,751 |
4.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,053.70 |
$4,698 |
4.1× |
| MRI breast w/o contrast bilateral (77047) |
$2,181.40 |
$3,356 |
9.5× |
| MRI c-spine with contrast (72142) |
$2,951.65 |
$4,541 |
8.8× |
| MRI cervical spine w/o contrast (72141) |
$2,441.40 |
$3,756 |
10.6× |
| MRI chest w/o & w/contrast material (71552) |
$3,643.90 |
$5,606 |
10.9× |
| MRI chest w/o contrast (71550) |
$2,850.25 |
$4,385 |
12.4× |
| MRI chest with contrast (71551) |
$3,227.90 |
$4,966 |
4.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,468.40 |
$5,336 |
10.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,634.45 |
$4,053 |
7.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,357.55 |
$3,627 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,829.10 |
$2,814 |
8.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,682.25 |
$5,665 |
11.0× |
| MRI orbit/face/neck w/contrast (70542) |
$1,909.05 |
$2,937 |
5.7× |
| MRI pelvis w contrast (72196) |
$3,120.65 |
$4,801 |
9.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,732.30 |
$5,742 |
11.1× |
| MRI pelvis w/o contrast (72195) |
$2,653.30 |
$4,082 |
11.6× |
| MRI scan of arm joint before and after contrast (73223) |
$3,228.55 |
$4,967 |
9.6× |
| MRI scan of leg joint before and after contrast (73723) |
$3,677.70 |
$5,658 |
11.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,255.20 |
$5,008 |
9.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,129.75 |
$4,815 |
9.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,022.55 |
$7,727 |
15.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,215.55 |
$4,947 |
9.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,978 |
$6,120 |
11.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,796.95 |
$4,303 |
12.2× |
| MRI tmj (70336) |
$2,457 |
$3,780 |
10.7× |
| MRI upper ext joint w/o contrast (73221) |
$2,962.05 |
$4,557 |
12.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,818.10 |
$5,874 |
11.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,215.55 |
$4,947 |
14.0× |
| Myelogram Cervical (72240) |
$2,481.05 |
$3,817 |
3.3× |
| Myelogram Lumbar (72265) |
$2,316.60 |
$3,564 |
3.1× |
| Myelogram thoracic (72255) |
$2,734.55 |
$4,207 |
3.6× |
| Myelography 2 or more regions (72270) |
$4,443.40 |
$6,836 |
5.9× |
| Myocardial Spect Multiple Studies (78452) |
$4,826.25 |
$7,425 |
3.9× |
| Neck soft tissue (70360) |
$294.45 |
$453 |
3.5× |
| Nm cisternogram (78630) |
$1,587.60 |
$2,442.46 |
3.0× |
| Nm gastric emptying study (78264) |
$2,386.80 |
$3,672 |
6.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$20,958.60 |
$32,244 |
15.7× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$5,842.85 |
$8,989 |
4.2× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$3,073.85 |
$4,729 |
2.5× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,049.10 |
$1,614 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$1,662.70 |
$2,558 |
7.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$278.85 |
$429 |
2.8× |
| Orthopantogram (70355) |
$304.20 |
$468 |
3.6× |
| Osseous survey infant (77076) |
$318.50 |
$490 |
3.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,374.75 |
$2,115 |
3.6× |
| Parathyroid imaging (78070) |
$1,227.20 |
$1,888 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$154.70 |
$238 |
1.5× |
| PET image w/CT, skull-thigh (78815) |
$6,331.65 |
$9,741 |
4.6× |
| PET imaging CT for attenuation limited area (78814) |
$6,644.95 |
$10,223 |
4.8× |
| PET imaging for CT attenuation whole body (78816) |
$7,051.20 |
$10,848 |
5.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,929.55 |
$4,507 |
8.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$771.22 |
$1,186.50 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$4,361.45 |
$6,709.92 |
8.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$895.70 |
$1,378 |
1.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$278.20 |
$428 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$392.60 |
$604 |
3.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$399.75 |
$615 |
4.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$295.10 |
$454 |
2.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$11,011.32 |
$16,940.50 |
20.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$3,131.38 |
$4,817.50 |
31.9× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$19,718.40 |
$30,336 |
53.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$229.45 |
$353 |
2.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$317.20 |
$488 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$453.70 |
$698 |
4.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$338 |
$520 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$451.75 |
$695 |
2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$527.80 |
$812 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$479.05 |
$737 |
2.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$874.25 |
$1,345 |
5.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$274.30 |
$422 |
3.3× |
| Radiological examination surgical specimen (76098) |
$402.35 |
$619 |
0.8× |
| Ribs bilateral 3 views (71110) |
$534.95 |
$823 |
5.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,069.25 |
$1,645 |
2.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,399.80 |
$3,692 |
4.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,722.55 |
$5,727 |
3.0× |
| Scanogram (77073) |
$249.60 |
$384 |
2.5× |
| Scapula complete (73010) |
$364.65 |
$561 |
3.6× |
| Screening digital breast tomosynthesis (77063) |
$82.55 |
$127 |
3.5× |
| Sella turcica (70240) |
$205.40 |
$316 |
2.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$274.95 |
$423 |
2.7× |
| Sialogram (70390) |
$583.70 |
$898 |
2.5× |
| Simulation intermediate (77285) |
$1,387.75 |
$2,135 |
3.9× |
| Small bowel series (74250) |
$687.70 |
$1,058 |
4.1× |
| Spec medical radj physics consltj (77370) |
$17,006.92 |
$26,164.50 |
131.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$10,997.35 |
$16,919 |
30.5× |
| Special dosimetry (77331) |
$906.75 |
$1,395 |
7.0× |
| Special treatment procedure (77470) |
$20,388.49 |
$31,366.91 |
38.4× |
| Speech evaluation complex (70371) |
$642.85 |
$989 |
2.8× |
| Spine thoracic 3 views (72072) |
$403 |
$620 |
4.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$20,162.68 |
$31,019.50 |
56.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,119.30 |
$1,722 |
3.1× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$991.25 |
$1,525 |
4.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$18,349.07 |
$28,229.34 |
51.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$17,805.45 |
$27,393 |
137.7× |
| Thoracolumbar 2 views (72080) |
$552.50 |
$850 |
6.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$4,410.44 |
$6,785.28 |
8.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$421.20 |
$648 |
1.1× |
| Tmj unilateral (70328) |
$154.70 |
$238 |
1.8× |
| Tomogram (76100) |
$811.20 |
$1,248 |
8.1× |
| Treatment device intermediate (77333) |
$705.90 |
$1,086 |
5.5× |
| Treatment devices simple (77332) |
$9,880.65 |
$15,201 |
76.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,076.10 |
$3,194 |
4.0× |
| Tx devices design & construction complex (77334) |
$18,069.79 |
$27,799.68 |
50.2× |
| Ultrasound, abdomen limited (76705) |
$947.05 |
$1,457 |
9.4× |
| Umbilical-artery Doppler (OB) (76820) |
$778.70 |
$1,198 |
7.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$360.75 |
$555 |
4.3× |
| Unlisted Ultrasound Procedure (76999) |
$313.30 |
$482 |
3.7× |
| Upper Extremity Infant (73092) |
$178.75 |
$275 |
1.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$940.55 |
$1,447 |
2.4× |
| Urethrocystography retrograde rs&i (74450) |
$985.40 |
$1,516 |
4.3× |
| Urethrocystography voiding (74455) |
$525.20 |
$808 |
2.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$858.65 |
$1,321 |
5.1× |
| Us abdl aorta screen aaa (76706) |
$501.80 |
$772 |
5.0× |
| Us breast unilateral complete (76641) |
$607.10 |
$934 |
6.0× |
| Us breast unilateral limited (76642) |
$397.80 |
$612 |
4.8× |
| Us chest (76604) |
$610.68 |
$939.50 |
6.1× |
| Us compl joint r-t w/image documentation (76881) |
$464.75 |
$715 |
4.6× |
| Us infant hips limited static (76886) |
$404.95 |
$623 |
4.8× |
| Us ob detailed single fetus (76811) |
$624 |
$960 |
2.7× |
| Us ob transvaginal (76817) |
$529.10 |
$814 |
5.3× |
| Us pelvic non ob complete (76856) |
$1,086.80 |
$1,672 |
10.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$479.70 |
$738 |
4.8× |
| Us pregnancy ltd (76815) |
$440.05 |
$677 |
4.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$732.55 |
$1,127 |
7.3× |
| Us retroperitoneal complete (76770) |
$481.65 |
$741 |
4.8× |
| Us retroperitoneal limited (76775) |
$711.75 |
$1,095 |
7.1× |
| Us scrotum and contents (76870) |
$964.60 |
$1,484 |
9.6× |
| Us soft tissue head/neck (76536) |
$559.65 |
$861 |
5.6× |
| Us spinal canal and contents (76800) |
$861.90 |
$1,326 |
8.6× |
| Us transrectal prostate volume (76873) |
$1,186.90 |
$1,826 |
11.8× |
| Us xtr non-vasc lmtd (76882) |
$744.25 |
$1,145 |
7.4× |
| Venogram extremity bilateral (75822) |
$1,586.65 |
$2,441 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,783.65 |
$5,821 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$2,166.45 |
$3,333 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,221.35 |
$1,879 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,022.50 |
$4,650 |
1.0× |
| Wrist 2 views (73100) |
$325.65 |
$501 |
3.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$391.30 |
$602 |
3.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$200.85 |
$309 |
2.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$361.40 |
$556 |
4.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$564.85 |
$869 |
3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$331.50 |
$510 |
4.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$359.45 |
$553 |
4.3× |
| X-ray exam hip uni 1 view (73501) |
$140.40 |
$216 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$305.50 |
$470 |
3.6× |
| X-ray exam hip uni 4/> views (73503) |
$487.50 |
$750 |
4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$457.60 |
$704 |
4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$495.30 |
$762 |
4.9× |
| X-ray exam of femur 1 (73551) |
$245.05 |
$377 |
2.9× |
| X-ray eye for foreign body (70030) |
$142.35 |
$219 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$224.90 |
$346 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$388.70 |
$598 |
4.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$161.85 |
$249 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$471.25 |
$725 |
4.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$234 |
$360 |
2.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$215.15 |
$331 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$512.20 |
$788 |
5.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$661.70 |
$1,018 |
6.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$512.20 |
$788 |
5.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$248.95 |
$383 |
3.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$314.60 |
$484 |
3.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$201.50 |
$310 |
2.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$300.95 |
$463 |
3.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,593.80 |
$2,452 |
4.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$224.25 |
$345 |
2.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$476.45 |
$733 |
4.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$351.65 |
$541 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$300.95 |
$463 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$393.25 |
$605 |
4.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$385.45 |
$593 |
4.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$211.25 |
$325 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$552.50 |
$850 |
5.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$325 |
$500 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$245.70 |
$378 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$223.60 |
$344 |
2.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$245.70 |
$378 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$365.30 |
$562 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$197.60 |
$304 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$392.60 |
$604 |
4.7× |
| Xr c-spine 6 or more views (72052) |
$468.65 |
$721 |
4.7× |
| Xr chest 4+ views (71048) |
$457.60 |
$704 |
4.6× |
| Xr Cholecystography Oral Contrast (74290) |
$657.80 |
$1,012 |
3.9× |
| Xr finger(s) 2+ views (73140) |
$138.45 |
$213 |
1.7× |
| Xr shoulder 1 view (73020) |
$230.75 |
$355 |
2.8× |
| Xr spine cervical 4 or 5 views (72050) |
$440.05 |
$677 |
4.4× |
| Xr tibia/fibula 2 views (73590) |
$279.50 |
$430 |
3.3× |
| Xr tmj bilateral (70330) |
$254.80 |
$392 |
3.0× |
| Xray knee 1 or 2 views rt (73560) |
$383.50 |
$590 |
4.6× |