| 3-D radiotherapy plan dose-volume histograms (77295) |
$20,488.43 |
$31,520.66 |
14.8× |
| Abdomen 2 views (74019) |
$326.95 |
$503 |
3.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$846.95 |
$1,303 |
2.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$7,221.50 |
$11,110 |
2.3× |
| Angiography extremity bilateral rs&i (75716) |
$3,863.60 |
$5,944 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$2,265.90 |
$3,486 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$2,068.95 |
$3,183 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,808.35 |
$5,859 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,399.50 |
$5,230 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,232.75 |
$3,435 |
0.7× |
| Angiography Spinal Selective Rs&I (75705) |
$2,843.75 |
$4,375 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,515.20 |
$5,408 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$887.25 |
$1,365 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$6,602.70 |
$10,158 |
2.1× |
| Ankle 2 views (73600) |
$281.78 |
$433.50 |
3.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$392.60 |
$604 |
1.1× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,624.05 |
$4,037 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,450.20 |
$5,308 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$2,146.95 |
$3,303 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,093.35 |
$4,759 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$6,072.95 |
$9,343 |
1.9× |
| Arthrogram elbow (73085) |
$817.05 |
$1,257 |
2.3× |
| Arthrogram hip (73525) |
$890.50 |
$1,370 |
2.5× |
| Arthrogram shoulder (73040) |
$1,040 |
$1,600 |
3.0× |
| Arthrogram wrist (73115) |
$988.65 |
$1,521 |
2.8× |
| Arthrography knee lt (73580) |
$962 |
$1,480 |
2.8× |
| Basic radiation dosimetry calculation (77300) |
$23,445.89 |
$36,070.60 |
174.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,264.58 |
$1,945.50 |
3.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,329.25 |
$2,045 |
3.3× |
| Bone &/joint imaging whole body (78306) |
$1,900.92 |
$2,924.50 |
4.7× |
| Bone age studies (77072) |
$194.35 |
$299 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$1,950.32 |
$3,000.50 |
4.9× |
| Bone Marrow Imaging Limited Area (78102) |
$824.20 |
$1,268 |
2.1× |
| Bone survey complete (77075) |
$559.65 |
$861 |
5.3× |
| Brachytx isodose complex (77318) |
$3,342.30 |
$5,142 |
8.9× |
| Brachytx isodose intermed (77317) |
$13,813.76 |
$21,251.94 |
36.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$15,175.22 |
$23,346.50 |
40.5× |
| Brain image w/flow 4 + views (78606) |
$2,260.05 |
$3,477 |
4.2× |
| Brain imaging < 4 static views (78600) |
$1,530.10 |
$2,354 |
3.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$663 |
$1,020 |
1.7× |
| Brain Imaging Minimum 4 Static Views (78605) |
$3,463.85 |
$5,329 |
6.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,064.15 |
$7,791 |
3.5× |
| Brain Imaging Vascular Flow Only (78610) |
$1,636.05 |
$2,517 |
3.0× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$412.75 |
$635 |
37.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,155.70 |
$1,778 |
2.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,048.80 |
$3,152 |
5.9× |
| Cardiac shunt detection (78428) |
$1,448.85 |
$2,229 |
3.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,536.60 |
$2,364 |
2.8× |
| Cervical spine 2 or 3 views (72040) |
$447.20 |
$688 |
5.1× |
| Chest 1 view (71045) |
$286 |
$440 |
3.3× |
| Chest 3 views (71047) |
$412.75 |
$635 |
4.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$482.30 |
$742 |
2.7× |
| Clavicle complete (73000) |
$401.05 |
$617 |
4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,129.70 |
$1,738 |
10.8× |
| Continuing medical physics consltj pr wk (77336) |
$22,641.12 |
$34,832.50 |
168.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,526.60 |
$6,964 |
13.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,736.20 |
$5,748 |
15.6× |
| CT abdomen w contrast (74160) |
$1,325.35 |
$2,039 |
7.5× |
| CT abdomen w wo contrast (74170) |
$1,879.15 |
$2,891 |
10.7× |
| CT abdomen w/o contrast (74150) |
$1,070.55 |
$1,647 |
10.2× |
| CT angio hrt w/3d image (75574) |
$1,907.75 |
$2,935 |
5.5× |
| CT angiography upper extremity lt (73206) |
$2,349.10 |
$3,614 |
13.4× |
| CT c-spine w/o contrast (72125) |
$2,314 |
$3,560 |
22.1× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$706.55 |
$1,087 |
4.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,722.20 |
$4,188 |
15.5× |
| CT cervical spine with contrast (72126) |
$2,450.50 |
$3,770 |
7.0× |
| CT chest w/wo contrast (71270) |
$1,858.35 |
$2,859 |
10.6× |
| CT chest with contrast (71260) |
$1,643.20 |
$2,528 |
9.4× |
| CT colonography w/dye (74262) |
$772.20 |
$1,188 |
4.4× |
| CT colonography w/o cntrst (74261) |
$639.60 |
$984 |
6.1× |
| CT head/brain with contrast (70460) |
$2,139.15 |
$3,291 |
12.2× |
| CT head/brain without and with contrast (70470) |
$2,357.55 |
$3,627 |
13.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$770.90 |
$1,186 |
2.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$35.75 |
$55 |
0.4× |
| CT hrt w/3d image congen (75573) |
$2,403.05 |
$3,697 |
6.9× |
| CT iac w contrast (70481) |
$1,605.50 |
$2,470 |
9.1× |
| CT limited/localized follow up study (76380) |
$657.80 |
$1,012 |
7.5× |
| CT lower ext w/o (73700) |
$1,947.40 |
$2,996 |
18.6× |
| CT lower extremity w wo contrast (73702) |
$2,299.05 |
$3,537 |
13.1× |
| CT lower extremity with contrast (73701) |
$2,146.30 |
$3,302 |
12.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,045.55 |
$3,147 |
11.6× |
| CT lumbar spine w/o contrast (72131) |
$1,670.50 |
$2,570 |
16.0× |
| CT lumbar spine with contrast (72132) |
$1,979.25 |
$3,045 |
5.7× |
| CT maxillofacial w contrast (70487) |
$1,863.55 |
$2,867 |
10.6× |
| CT maxillofacial w/o contrast (70486) |
$1,561.62 |
$2,402.50 |
14.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,018.90 |
$3,106 |
11.5× |
| CT neck soft tissue w contrast (70491) |
$1,192.75 |
$1,835 |
6.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,990.30 |
$3,062 |
11.3× |
| CT orbits w/o contrast (70480) |
$926.25 |
$1,425 |
8.8× |
| CT pelvis w & w/o contrast (72194) |
$2,460.25 |
$3,785 |
14.0× |
| CT pelvis w/o contrast (72192) |
$1,551.55 |
$2,387 |
14.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,418.95 |
$2,183 |
8.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,012.05 |
$1,557 |
9.7× |
| CT thoracic spine w/contrast (72129) |
$1,937 |
$2,980 |
11.0× |
| CT thoracic spine w/o contrast (72128) |
$1,700.40 |
$2,616 |
16.2× |
| CT thoracic spine w/wo contrast (72130) |
$2,994.55 |
$4,607 |
17.0× |
| CT thorax w/o contrast (71250) |
$1,448.20 |
$2,228 |
13.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,555.15 |
$3,931 |
14.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,964.30 |
$3,022 |
18.8× |
| CT upper extremity with contrast (73201) |
$2,148.25 |
$3,305 |
6.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,695.55 |
$4,147 |
15.3× |
| Cta Abdomen (74175) |
$2,162.55 |
$3,327 |
12.3× |
| CTA abdomen pelvis (74174) |
$3,564.60 |
$5,484 |
10.2× |
| CTA chest (71275) |
$1,774.50 |
$2,730 |
10.1× |
| Cta Head (70496) |
$2,841.15 |
$4,371 |
16.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,967.90 |
$4,566 |
8.5× |
| CTA lwr ext w&w/o contrast (73706) |
$2,156.70 |
$3,318 |
12.3× |
| Cta Neck (70498) |
$2,967.90 |
$4,566 |
16.9× |
| Cta Pelvis (72191) |
$1,419.60 |
$2,184 |
8.1× |
| Cystography minimum 3 views rs&i (74430) |
$793.65 |
$1,221 |
2.3× |
| Diskogram cervical (72285) |
$4,724.20 |
$7,268 |
2.4× |
| Diskography lumbar (72295) |
$7,066.80 |
$10,872 |
3.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$465.40 |
$716 |
4.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$498.55 |
$767 |
4.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$260.65 |
$401 |
2.5× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$85.15 |
$131 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$384.15 |
$591 |
3.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$183.30 |
$282 |
2.1× |
| Dxa bone density study axial skeleton (77085) |
$778.70 |
$1,198 |
7.4× |
| Echo exam of fetal heart (76825) |
$1,136.20 |
$1,748 |
2.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,184.30 |
$1,822 |
5.0× |
| Echoencephalography real time imaging (76506) |
$571.35 |
$879 |
5.5× |
| Esophageal motility (78258) |
$1,542.45 |
$2,373 |
3.9× |
| Esophagus (74220) |
$469.95 |
$723 |
2.7× |
| Fetal biophysical profile non-stress testing (76818) |
$845.65 |
$1,301 |
8.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$584.35 |
$899 |
5.6× |
| Fluoroscopy up to 1 hr (76000) |
$655.85 |
$1,009 |
2.7× |
| Foot 2 views (73620) |
$247 |
$380 |
2.8× |
| Forearm 2 views (73090) |
$343.20 |
$528 |
3.9× |
| Gated Heart Planar Single (78472) |
$1,299.35 |
$1,999 |
3.2× |
| Hand 2 views (73120) |
$236.60 |
$364 |
2.3× |
| Hand 3 views (73130) |
$405.60 |
$624 |
4.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,461.90 |
$5,326 |
5.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,031.95 |
$6,203 |
5.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$5,963.10 |
$9,174 |
8.5× |
| Heart Infarct Image (78466) |
$1,770.60 |
$2,724 |
4.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,409.25 |
$5,245 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,812.20 |
$2,788 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,989 |
$3,060 |
5.0× |
| Ht muscle image spect sing (78451) |
$1,287.65 |
$1,981 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$360.10 |
$554 |
4.1× |
| Hysterosalpingogram (74740) |
$786.50 |
$1,210 |
3.3× |
| Interstitial radiation source applic complex (77778) |
$5,378.75 |
$8,275 |
7.7× |
| Intracavitary Radiation Source Applic Complex (77763) |
$6,435 |
$9,900 |
9.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$5,141.50 |
$7,910 |
9.3× |
| Intracavitary radiation source applic simple (77761) |
$4,383.60 |
$6,744 |
7.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$193.70 |
$298 |
1.8× |
| Kidney imaging morphology (78700) |
$1,392.95 |
$2,143 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,390.68 |
$2,139.50 |
2.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,909.05 |
$2,937 |
3.5× |
| Knee 3 views (73562) |
$294.45 |
$453 |
3.4× |
| Liver & spleen imaging static only (78215) |
$1,244.10 |
$1,914 |
3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,865.50 |
$2,870 |
4.7× |
| Liver imaging static only (78201) |
$23,953.73 |
$36,851.89 |
44.0× |
| Liver imaging w/vascular flow (78202) |
$2,147.60 |
$3,304 |
3.9× |
| Lung perf&ventilat diferentl (78598) |
$1,845.35 |
$2,839 |
3.4× |
| Lung perfusion differential (78597) |
$834.60 |
$1,284 |
2.1× |
| Lung Ventilation Imaging (78579) |
$1,206.40 |
$1,856 |
3.0× |
| Lymphoscintigraphy (78195) |
$9,028.71 |
$13,890.32 |
16.6× |
| Mammary ductogram or galactogram multiple (77054) |
$991.25 |
$1,525 |
4.1× |
| Mammary ductogram or galactogram single (77053) |
$1,113.45 |
$1,713 |
4.7× |
| Meckels Diverticulum (78290) |
$1,071.85 |
$1,649 |
2.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$26,594.10 |
$40,914 |
70.9× |
| Mr elastography (76391) |
$1,420.25 |
$2,185 |
5.9× |
| MRA head w & w/o contrast (70546) |
$3,139.50 |
$4,830 |
9.0× |
| MRA head w/o contrast (70544) |
$1,875.25 |
$2,885 |
7.8× |
| MRA neck w contrast (70548) |
$2,301 |
$3,540 |
6.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,274.70 |
$5,038 |
9.4× |
| MRA neck w/o contrast (70547) |
$1,777.10 |
$2,734 |
7.4× |
| MRI abdomen w contrast (74182) |
$1,666.60 |
$2,564 |
4.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,087.80 |
$3,212 |
6.0× |
| MRI abdomen w/o contrast (74181) |
$1,381.90 |
$2,126 |
5.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,783.30 |
$4,282 |
3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,147.30 |
$4,842 |
4.0× |
| MRI breast w/o contrast bilateral (77047) |
$2,661.10 |
$4,094 |
11.1× |
| MRI breast w/o contrast unilat (77046) |
$2,152.80 |
$3,312 |
9.0× |
| MRI c-spine with contrast (72142) |
$2,916.55 |
$4,487 |
8.3× |
| MRI cardiac w/o cont stress (75559) |
$2,286.05 |
$3,517 |
4.2× |
| MRI cardiac w/o contrast (75557) |
$1,197.30 |
$1,842 |
5.0× |
| MRI cervical spine w/o contrast (72141) |
$2,731.30 |
$4,202 |
11.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,991.30 |
$4,602 |
8.6× |
| MRI chest w/o contrast (71550) |
$1,520.35 |
$2,339 |
6.4× |
| MRI fetal sngl/1st gestation (74712) |
$3,548.35 |
$5,459 |
14.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,349.10 |
$3,614 |
6.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,732.90 |
$2,666 |
5.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,470.95 |
$2,263 |
6.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,342.25 |
$2,065 |
5.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,012.42 |
$4,634.50 |
8.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,668.90 |
$4,106 |
7.6× |
| MRI pelvis w contrast (72196) |
$2,414.10 |
$3,714 |
6.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,056.60 |
$3,164 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$2,912 |
$4,480 |
12.2× |
| MRI scan of arm joint before and after contrast (73223) |
$3,339.70 |
$5,138 |
9.6× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,620.80 |
$4,032 |
3.3× |
| MRI scan of leg joint before and after contrast (73723) |
$3,025.10 |
$4,654 |
8.7× |
| MRI spectroscopy (76390) |
$3,474.90 |
$5,346 |
39.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,999.10 |
$4,614 |
8.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,893.45 |
$2,913 |
5.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,998.45 |
$4,613 |
8.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,948.70 |
$2,998 |
5.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,141.45 |
$4,833 |
9.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,665.95 |
$2,563 |
7.0× |
| MRI tmj (70336) |
$1,631.50 |
$2,510 |
6.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,925 |
$4,500 |
12.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,502.50 |
$3,850 |
7.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,211.30 |
$3,402 |
9.3× |
| Myelogram Cervical (72240) |
$2,481.70 |
$3,818 |
3.2× |
| Myelogram Lumbar (72265) |
$1,315.60 |
$2,024 |
1.7× |
| Myelogram thoracic (72255) |
$2,150.85 |
$3,309 |
2.7× |
| Myelography 2 or more regions (72270) |
$2,256.15 |
$3,471 |
2.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,478.50 |
$6,890 |
3.5× |
| Myocardial infarct spect (78469) |
$970.78 |
$1,493.50 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,035.04 |
$6,207.75 |
3.1× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$5,225.35 |
$8,039 |
3.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$5,651.75 |
$8,695 |
3.9× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$8,829.11 |
$13,583.25 |
4.0× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$7,919.60 |
$12,184 |
3.6× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$8,972.60 |
$13,804 |
5.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,226.60 |
$4,964 |
3.8× |
| Neck soft tissue (70360) |
$234.65 |
$361 |
2.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$733.20 |
$1,128 |
1.8× |
| Nm adrenal scan (78075) |
$2,867.15 |
$4,411 |
2.2× |
| Nm bone marrow multiple (78103) |
$1,424.15 |
$2,191 |
3.6× |
| Nm bone marrow wb (78104) |
$1,318.20 |
$2,028 |
3.3× |
| Nm cisternogram (78630) |
$1,588.60 |
$2,444 |
2.9× |
| Nm csf leak detection (78650) |
$1,271.40 |
$1,956 |
1.0× |
| Nm gastric emptying study (78264) |
$1,641.90 |
$2,526 |
4.1× |
| Nm gastroesophageal reflux study (78262) |
$1,602.25 |
$2,465 |
4.0× |
| Nm peritoneal-venous shunt patency (78291) |
$809.25 |
$1,245 |
2.0× |
| Nm whole blood volume (78122) |
$1,988.35 |
$3,059 |
3.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$28,104.38 |
$43,237.50 |
20.3× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$5,094.05 |
$7,837 |
3.9× |
| Nuclear medicine of heart pumping function (78473) |
$2,522.65 |
$3,881 |
6.3× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$4,589 |
$7,060 |
3.2× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$3,873.35 |
$5,959 |
3.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$1,279.85 |
$1,969 |
3.2× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,441.05 |
$2,217 |
3.6× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$1,143.35 |
$1,759 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$10,145.52 |
$15,608.50 |
43.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$347.10 |
$534 |
3.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$137.15 |
$211 |
1.0× |
| Orthopantogram (70355) |
$183.95 |
$283 |
2.1× |
| Osseous survey infant (77076) |
$399.75 |
$615 |
3.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,198.28 |
$1,843.50 |
3.0× |
| Parathyroid imaging (78070) |
$934.05 |
$1,437 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$348.40 |
$536 |
3.3× |
| Perineogram (74775) |
$496.60 |
$764 |
2.1× |
| Peritoneogram rs&i (74190) |
$871 |
$1,340 |
1.6× |
| PET image w/CT, skull-thigh (78815) |
$6,627.08 |
$10,195.50 |
4.6× |
| PET imaging CT for attenuation limited area (78814) |
$5,391.75 |
$8,295 |
3.8× |
| PET imaging for CT attenuation whole body (78816) |
$6,978.40 |
$10,736 |
4.9× |
| PET imaging limited area chest head/neck (78811) |
$6,535.75 |
$10,055 |
5.0× |
| PET whole body (78813) |
$4,824.30 |
$7,422 |
3.4× |
| Pr csf ventriculography (78635) |
$1,585.35 |
$2,439 |
2.9× |
| Pr heart first pass single,planar (78481) |
$1,780.35 |
$2,739 |
3.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,860.30 |
$2,862 |
5.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$626.92 |
$964.50 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,539.85 |
$2,369 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$529.10 |
$814 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$229.45 |
$353 |
2.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$333.45 |
$513 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$514.15 |
$791 |
4.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$278.85 |
$429 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$731.90 |
$1,126 |
7.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$28,012.72 |
$43,096.50 |
3.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$13,469.30 |
$20,722 |
24.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$5,574.72 |
$8,576.50 |
54.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$19,800.95 |
$30,463 |
51.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$270.40 |
$416 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$347.10 |
$534 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$352.95 |
$543 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$361.40 |
$556 |
4.1× |
| Radiologic exam colon single contrast study (74270) |
$755.30 |
$1,162 |
4.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$687.05 |
$1,057 |
3.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$458.90 |
$706 |
2.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$635.05 |
$977 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$345.15 |
$531 |
4.0× |
| Radiological examination surgical specimen (76098) |
$344.50 |
$530 |
0.6× |
| Radiopharm Dacryocystography (78660) |
$869.05 |
$1,337 |
2.2× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$2,573.35 |
$3,959 |
11.0× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$1,216.15 |
$1,871 |
3.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,210.65 |
$3,401 |
0.7× |
| Ribs bilateral 3 views (71110) |
$292.50 |
$450 |
2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,189.85 |
$3,369 |
5.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,600.32 |
$4,000.50 |
4.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,625.75 |
$8,655 |
10.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,162.90 |
$4,866 |
2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,284.80 |
$6,592 |
3.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,747.25 |
$5,765 |
2.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,131 |
$1,740 |
4.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$25,086.39 |
$38,594.45 |
107.3× |
| Rp Therapy Intravenous Administration (79101) |
$44,255.90 |
$68,086 |
189.4× |
| Sacroiliac Joints < 3 Views (72200) |
$291.20 |
$448 |
2.8× |
| Salivary gland imaging serial images (78231) |
$878.80 |
$1,352 |
2.2× |
| Scanogram (77073) |
$212.55 |
$327 |
2.0× |
| Scapula complete (73010) |
$305.50 |
$470 |
2.9× |
| Screening digital breast tomosynthesis (77063) |
$70.85 |
$109 |
3.0× |
| Sella turcica (70240) |
$224.25 |
$345 |
2.6× |
| Sialogram (70390) |
$789.75 |
$1,215 |
3.3× |
| Simulation intermediate (77285) |
$1,458.60 |
$2,244 |
3.9× |
| Small bowel series (74250) |
$426.40 |
$656 |
2.4× |
| Spec medical radj physics consltj (77370) |
$36,921.95 |
$56,803 |
274.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$5,195.78 |
$7,993.50 |
13.9× |
| Special dosimetry (77331) |
$419.90 |
$646 |
3.1× |
| Special treatment procedure (77470) |
$26,593.44 |
$40,912.98 |
48.1× |
| Spine thoracic 3 views (72072) |
$469.30 |
$722 |
4.5× |
| Spleen imaging only (78185) |
$1,515.15 |
$2,331 |
3.8× |
| Stereotactic body radiation delivery (77373) |
$42,871.40 |
$65,956 |
23.9× |
| Superior sagittal sinus venogram (75870) |
$2,284.75 |
$3,515 |
0.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$828.10 |
$1,274 |
8.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$12,708.15 |
$19,551 |
33.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,450.80 |
$2,232 |
3.9× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$2,522.65 |
$3,881 |
10.6× |
| Testicular Imaging With Vascular Flow (78761) |
$1,015.95 |
$1,563 |
2.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$18,574.08 |
$28,575.50 |
49.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$14,967.55 |
$23,027 |
111.2× |
| Therapeutic Enema (74283) |
$897.65 |
$1,381 |
5.1× |
| Thoracolumbar 2 views (72080) |
$302.90 |
$466 |
3.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,735.50 |
$2,670 |
3.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$577.20 |
$888 |
1.4× |
| Thyroid uptake measurement (78012) |
$420.55 |
$647 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,021.18 |
$3,109.50 |
5.0× |
| Tmj unilateral (70328) |
$175.50 |
$270 |
2.0× |
| Tomogram (76100) |
$702.65 |
$1,081 |
6.7× |
| Treatment device intermediate (77333) |
$15,725.12 |
$24,192.50 |
116.8× |
| Treatment devices simple (77332) |
$31,106.08 |
$47,855.50 |
231.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,866.15 |
$2,871 |
3.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,316.28 |
$3,563.50 |
5.8× |
| Tx devices design & construction complex (77334) |
$22,186.12 |
$34,132.50 |
59.2× |
| Ultrasound elastography first target lesion (76982) |
$748.80 |
$1,152 |
7.2× |
| Ultrasound scan of cornea to determine thickness (76514) |
$20.15 |
$31 |
0.7× |
| Ultrasound scan to determine eye length and lens power (76519) |
$79.95 |
$123 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$720.85 |
$1,109 |
6.9× |
| Umbilical-artery Doppler (OB) (76820) |
$241.80 |
$372 |
2.3× |
| Unlisted fluoroscopic procedure (76496) |
$672.10 |
$1,034 |
7.7× |
| Unlisted magnetic resonance procedure (76498) |
$1,298.70 |
$1,998 |
14.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$3,841.50 |
$5,910 |
37.6× |
| Unlisted Ultrasound Procedure (76999) |
$212.55 |
$327 |
2.4× |
| Upper Extremity Infant (73092) |
$377 |
$580 |
3.6× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$550.55 |
$847 |
5.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$832.65 |
$1,281 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$663 |
$1,020 |
2.8× |
| Urethrocystography voiding (74455) |
$949.65 |
$1,461 |
4.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,099.15 |
$1,691 |
6.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$989.95 |
$1,523 |
5.6× |
| Us abdl aorta screen aaa (76706) |
$274.30 |
$422 |
2.6× |
| Us breast unilateral complete (76641) |
$672.10 |
$1,034 |
6.4× |
| Us breast unilateral limited (76642) |
$485.55 |
$747 |
5.6× |
| Us chest (76604) |
$495.95 |
$763 |
4.7× |
| Us compl joint r-t w/image documentation (76881) |
$761.80 |
$1,172 |
7.3× |
| Us elastography parenchyma (76981) |
$377 |
$580 |
3.6× |
| Us guided compression repair (76936) |
$926.25 |
$1,425 |
4.3× |
| Us infant hips dynamic (76885) |
$538.20 |
$828 |
6.2× |
| Us infant hips limited static (76886) |
$258.70 |
$398 |
3.0× |
| Us kidney transplant (76776) |
$475.80 |
$732 |
4.5× |
| Us ob detailed single fetus (76811) |
$552.50 |
$850 |
2.3× |
| Us ob transvaginal (76817) |
$590.85 |
$909 |
5.6× |
| Us pelvic non ob complete (76856) |
$902.20 |
$1,388 |
8.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$573.95 |
$883 |
5.5× |
| Us pregnancy ltd (76815) |
$433.55 |
$667 |
4.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$830.05 |
$1,277 |
7.9× |
| Us retroperitoneal complete (76770) |
$769.60 |
$1,184 |
7.3× |
| Us retroperitoneal limited (76775) |
$365.30 |
$562 |
3.5× |
| Us scrotum and contents (76870) |
$867.75 |
$1,335 |
8.3× |
| Us soft tissue head/neck (76536) |
$433.22 |
$666.50 |
4.1× |
| Us spinal canal and contents (76800) |
$412.10 |
$634 |
3.9× |
| Us transrectal (76872) |
$395.20 |
$608 |
3.8× |
| Us transrectal prostate volume (76873) |
$910.65 |
$1,401 |
8.7× |
| Us xtr non-vasc lmtd (76882) |
$637.65 |
$981 |
6.1× |
| Us, eye b-scan (76512) |
$216.45 |
$333 |
2.1× |
| Vascular flow imaging (78445) |
$1,866.80 |
$2,872 |
4.7× |
| Venogram extremity bilateral (75822) |
$1,502.80 |
$2,312 |
1.0× |
| Venogram orbital (75880) |
$1,580.80 |
$2,432 |
2.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,178.80 |
$3,352 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,866.15 |
$2,871 |
1.2× |
| Venography epidural rs&i (75872) |
$1,465.75 |
$2,255 |
2.3× |
| Venography extremity unilateral rs&i (75820) |
$1,275.30 |
$1,962 |
0.8× |
| Venography Renal Bilateral (75833) |
$3,121.30 |
$4,802 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$2,106 |
$3,240 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,601.30 |
$4,002 |
0.8× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,000.40 |
$4,616 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$298.35 |
$459 |
3.4× |
| Wrist 2 views (73100) |
$314.60 |
$484 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$532.35 |
$819 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$293.80 |
$452 |
3.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$407.55 |
$627 |
4.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$633.75 |
$975 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$302.90 |
$466 |
3.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$319.15 |
$491 |
3.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$648.05 |
$997 |
6.2× |
| X-ray exam hip uni 1 view (73501) |
$262.60 |
$404 |
3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$310.70 |
$478 |
3.6× |
| X-ray exam hip uni 4/> views (73503) |
$365.95 |
$563 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$681.85 |
$1,049 |
6.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$871.65 |
$1,341 |
8.3× |
| X-ray exam of femur 1 (73551) |
$266.50 |
$410 |
3.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,157.65 |
$1,781 |
6.6× |
| X-ray eye for foreign body (70030) |
$339.95 |
$523 |
3.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$256.10 |
$394 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$214.50 |
$330 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$395.20 |
$608 |
4.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$16,588.65 |
$25,521 |
7.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$288.60 |
$444 |
3.3× |
| X-ray IV pyelogram+drip infusn (74410) |
$692.25 |
$1,065 |
3.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$212.55 |
$327 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$398.45 |
$613 |
3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$202.15 |
$311 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$178.10 |
$274 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$439.40 |
$676 |
4.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$384.80 |
$592 |
3.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$405.60 |
$624 |
3.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$193.70 |
$298 |
2.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$287.95 |
$443 |
3.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$288.60 |
$444 |
2.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$342.55 |
$527 |
3.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$793.65 |
$1,221 |
2.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$281.45 |
$433 |
3.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$486.20 |
$748 |
4.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$463.45 |
$713 |
4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$227.50 |
$350 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$289.90 |
$446 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$409.50 |
$630 |
4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$237.25 |
$365 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$185.25 |
$285 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$319.80 |
$492 |
3.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$322.40 |
$496 |
3.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$308.75 |
$475 |
3.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$338.65 |
$521 |
3.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$196.30 |
$302 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$377 |
$580 |
3.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$378.95 |
$583 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$315.25 |
$485 |
3.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$403 |
$620 |
4.6× |
| Xr arthrogram ankle (73615) |
$844.35 |
$1,299 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$491.40 |
$756 |
4.7× |
| Xr chest 4+ views (71048) |
$438.75 |
$675 |
4.2× |
| Xr finger(s) 2+ views (73140) |
$312 |
$480 |
3.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$350.35 |
$539 |
3.3× |
| Xr optic foramina (70190) |
$397.80 |
$612 |
4.6× |
| Xr shoulder 1 view (73020) |
$222.95 |
$343 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$592.15 |
$911 |
5.7× |
| Xr tibia/fibula 2 views (73590) |
$344.50 |
$530 |
4.0× |
| Xr tmj bilateral (70330) |
$319.80 |
$492 |
3.7× |
| Xray knee 1 or 2 views rt (73560) |
$291.20 |
$448 |
3.3× |