| 3-D radiotherapy plan dose-volume histograms (77295) |
$52,044.93 |
$80,069.12 |
37.5× |
| Abdomen 2 views (74019) |
$302.25 |
$465 |
2.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$734.50 |
$1,130 |
1.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,222.70 |
$4,958 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$4,236.05 |
$6,517 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$2,823.60 |
$4,344 |
0.9× |
| Angiography internal mammary rs&i (75756) |
$1,368.25 |
$2,105 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,063.45 |
$4,713 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,432.95 |
$3,743 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,621.75 |
$2,495 |
0.5× |
| Angiography Spinal Selective Rs&I (75705) |
$3,284.45 |
$5,053 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,829.15 |
$5,891 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,017.25 |
$1,565 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,436.50 |
$2,210 |
0.5× |
| Ankle 2 views (73600) |
$260 |
$400 |
3.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$480.68 |
$739.50 |
1.4× |
| Aortogram thoracic (75605) |
$3,425.50 |
$5,270 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,728.70 |
$4,198 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$3,168.75 |
$4,875 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,570.10 |
$3,954 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$2,652.65 |
$4,081 |
0.8× |
| Arthrogram elbow (73085) |
$515.45 |
$793 |
1.5× |
| Arthrogram hip (73525) |
$721.50 |
$1,110 |
2.1× |
| Arthrogram shoulder (73040) |
$678.60 |
$1,044 |
1.9× |
| Arthrogram wrist (73115) |
$551.85 |
$849 |
1.6× |
| Arthrography knee lt (73580) |
$587.60 |
$904 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$30,217.20 |
$46,488 |
224.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$727.68 |
$1,119.50 |
1.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$826.80 |
$1,272 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$1,038.05 |
$1,597 |
2.6× |
| Bone age studies (77072) |
$292.50 |
$450 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,328.28 |
$2,043.50 |
3.3× |
| Bone Marrow Imaging Limited Area (78102) |
$514.80 |
$792 |
1.3× |
| Bone survey complete (77075) |
$493.35 |
$759 |
4.7× |
| Brachytx isodose complex (77318) |
$2,015 |
$3,100 |
5.4× |
| Brachytx isodose intermed (77317) |
$21,230.68 |
$32,662.58 |
56.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$22,945.98 |
$35,301.50 |
61.2× |
| Brain image w/flow 4 + views (78606) |
$1,011.40 |
$1,556 |
1.9× |
| Brain imaging < 4 static views w vascular flow (78601) |
$668.20 |
$1,028 |
1.7× |
| Brain Imaging Minimum 4 Static Views (78605) |
$923.65 |
$1,421 |
1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,541.85 |
$5,449 |
2.5× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$331.50 |
$510 |
30.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,185.60 |
$1,824 |
3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,234.70 |
$3,438 |
6.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$750.75 |
$1,155 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$304.85 |
$469 |
3.5× |
| Chest 1 view (71045) |
$240.50 |
$370 |
2.8× |
| Chest 3 views (71047) |
$305.50 |
$470 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$438.75 |
$675 |
2.5× |
| Cineradiography/videoradiography (76120) |
$297.70 |
$458 |
2.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$705.25 |
$1,085 |
0.9× |
| Clavicle complete (73000) |
$265.20 |
$408 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$607.10 |
$934 |
5.8× |
| Continuing medical physics consltj pr wk (77336) |
$28,742.35 |
$44,219 |
213.5× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$327.60 |
$504 |
1.9× |
| Corpora cavernosography (74445) |
$518.70 |
$798 |
5.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,666.65 |
$5,641 |
10.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,724.80 |
$4,192 |
11.4× |
| CT abdomen w contrast (74160) |
$1,671.15 |
$2,571 |
9.5× |
| CT abdomen w wo contrast (74170) |
$1,907.75 |
$2,935 |
10.9× |
| CT abdomen w/o contrast (74150) |
$1,333.15 |
$2,051 |
12.7× |
| CT angio hrt w/3d image (75574) |
$1,270.10 |
$1,954 |
3.6× |
| CT angiography upper extremity lt (73206) |
$1,675.05 |
$2,577 |
9.5× |
| CT c-spine w/o contrast (72125) |
$1,717.30 |
$2,642 |
16.4× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$731.25 |
$1,125 |
4.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,252.90 |
$3,466 |
12.8× |
| CT cervical spine with contrast (72126) |
$1,964.30 |
$3,022 |
5.6× |
| CT chest w/wo contrast (71270) |
$1,851.20 |
$2,848 |
10.5× |
| CT chest with contrast (71260) |
$1,705.60 |
$2,624 |
9.7× |
| CT head/brain with contrast (70460) |
$1,527.50 |
$2,350 |
8.7× |
| CT head/brain without and with contrast (70470) |
$1,927.25 |
$2,965 |
11.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$798.20 |
$1,228 |
2.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$84.50 |
$130 |
1.0× |
| CT hrt w/3d image congen (75573) |
$740.35 |
$1,139 |
2.1× |
| CT iac w contrast (70481) |
$1,634.75 |
$2,515 |
9.3× |
| CT limited/localized follow up study (76380) |
$638.30 |
$982 |
7.3× |
| CT lower ext w/o (73700) |
$1,321.45 |
$2,033 |
12.6× |
| CT lower extremity w wo contrast (73702) |
$1,691.30 |
$2,602 |
9.6× |
| CT lower extremity with contrast (73701) |
$1,467.05 |
$2,257 |
8.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,911.65 |
$2,941 |
10.9× |
| CT lumbar spine w/o contrast (72131) |
$1,379.95 |
$2,123 |
13.2× |
| CT lumbar spine with contrast (72132) |
$1,621.75 |
$2,495 |
4.6× |
| CT maxillofacial w contrast (70487) |
$1,656.20 |
$2,548 |
9.4× |
| CT maxillofacial w/o contrast (70486) |
$1,297.72 |
$1,996.50 |
12.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,989.65 |
$3,061 |
11.3× |
| CT neck soft tissue w contrast (70491) |
$1,424.80 |
$2,192 |
8.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,881.75 |
$2,895 |
10.7× |
| CT orbits w/o contrast (70480) |
$1,288.30 |
$1,982 |
12.3× |
| CT pelvis w & w/o contrast (72194) |
$1,975.35 |
$3,039 |
11.2× |
| CT pelvis w/o contrast (72192) |
$1,473.55 |
$2,267 |
14.1× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$369.20 |
$568 |
4.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,719.90 |
$2,646 |
9.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,173.25 |
$1,805 |
11.2× |
| CT thoracic spine w/contrast (72129) |
$1,488.50 |
$2,290 |
8.5× |
| CT thoracic spine w/o contrast (72128) |
$1,328.60 |
$2,044 |
12.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,810.90 |
$2,786 |
10.3× |
| CT thorax w/o contrast (71250) |
$1,295.45 |
$1,993 |
12.4× |
| CT unlisted procedure (76497) |
$546 |
$840 |
6.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,629.55 |
$2,507 |
9.3× |
| CT upper extremity w/o contrast rt (73200) |
$1,196 |
$1,840 |
11.4× |
| CT upper extremity with contrast (73201) |
$1,434.55 |
$2,207 |
4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,944.15 |
$2,991 |
11.1× |
| Cta Abdomen (74175) |
$1,665.30 |
$2,562 |
9.5× |
| CTA abdomen pelvis (74174) |
$3,344.25 |
$5,145 |
9.6× |
| CTA chest (71275) |
$1,838.85 |
$2,829 |
10.5× |
| Cta Head (70496) |
$2,134.60 |
$3,284 |
12.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,134.60 |
$3,284 |
6.1× |
| CTA lwr ext w&w/o contrast (73706) |
$1,879.15 |
$2,891 |
10.7× |
| Cta Neck (70498) |
$2,060.50 |
$3,170 |
11.7× |
| Cta Pelvis (72191) |
$2,007.85 |
$3,089 |
11.4× |
| Cystography minimum 3 views rs&i (74430) |
$562.90 |
$866 |
1.6× |
| Dacryocystography (70170) |
$425.75 |
$655 |
1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$243.10 |
$374 |
2.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$351 |
$540 |
3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$230.10 |
$354 |
2.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$280.80 |
$432 |
2.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$152.75 |
$235 |
1.8× |
| Dxa bone density study axial skeleton (77085) |
$295.75 |
$455 |
2.8× |
| Echo exam of fetal heart (76825) |
$735.15 |
$1,131 |
1.3× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$448.50 |
$690 |
1.9× |
| Echoencephalography real time imaging (76506) |
$386.10 |
$594 |
3.7× |
| Esophagus (74220) |
$402.35 |
$619 |
2.3× |
| Fetal biophysical profile non-stress testing (76818) |
$609.05 |
$937 |
5.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$492.05 |
$757 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$630.50 |
$970 |
2.6× |
| Foot 2 views (73620) |
$263.25 |
$405 |
3.0× |
| Forearm 2 views (73090) |
$243.75 |
$375 |
2.8× |
| Functional MRI brain by phys/psych (70555) |
$1,313 |
$2,020 |
5.5× |
| Functional MRI brain by tech (70554) |
$1,998.75 |
$3,075 |
8.4× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,646.78 |
$2,533.50 |
3.0× |
| Gated Heart Planar Single (78472) |
$1,070.88 |
$1,647.50 |
2.7× |
| Hand 2 views (73120) |
$198.90 |
$306 |
1.9× |
| Hand 3 views (73130) |
$215.80 |
$332 |
2.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$4,662.45 |
$7,173 |
6.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$5,019.30 |
$7,722 |
7.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$5,729.75 |
$8,815 |
8.2× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$3,250 |
$5,000 |
8.4× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,240.20 |
$1,908 |
3.2× |
| Heart Infarct Image (78466) |
$1,063.40 |
$1,636 |
2.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,461.55 |
$3,787 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,378.52 |
$2,120.80 |
2.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,274 |
$1,960 |
3.2× |
| Ht muscle image spect sing (78451) |
$1,597.05 |
$2,457 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$247.65 |
$381 |
2.8× |
| Hysterosalpingogram (74740) |
$646.75 |
$995 |
2.7× |
| Interstitial radiation source applic complex (77778) |
$3,160.30 |
$4,862 |
4.5× |
| Intracavitary Radiation Source Applic Complex (77763) |
$3,266.90 |
$5,026 |
4.7× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$3,147.95 |
$4,843 |
5.7× |
| Intracavitary radiation source applic simple (77761) |
$2,947.10 |
$4,534 |
5.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$296.40 |
$456 |
2.8× |
| Kidney imaging morphology (78700) |
$803.40 |
$1,236 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,827.80 |
$2,812 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,345.82 |
$2,070.50 |
2.5× |
| Knee 3 views (73562) |
$258.70 |
$398 |
3.0× |
| Liver & spleen imaging static only (78215) |
$1,010.75 |
$1,555 |
2.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,808.30 |
$2,782 |
4.5× |
| Liver imaging static only (78201) |
$1,097.20 |
$1,688 |
2.0× |
| Lung perf&ventilat diferentl (78598) |
$1,186.90 |
$1,826 |
2.2× |
| Lung perfusion differential (78597) |
$1,109.16 |
$1,706.39 |
2.8× |
| Lung Ventilation Imaging (78579) |
$601.25 |
$925 |
1.5× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,543.10 |
$2,374 |
0.5× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,090.70 |
$1,678 |
0.3× |
| Lymphoscintigraphy (78195) |
$8,505.98 |
$13,086.12 |
15.6× |
| Mammary ductogram or galactogram multiple (77054) |
$642.85 |
$989 |
2.7× |
| Mammary ductogram or galactogram single (77053) |
$560.95 |
$863 |
2.3× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$284.05 |
$437 |
3.3× |
| Meckels Diverticulum (78290) |
$799.50 |
$1,230 |
2.0× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$279.50 |
$430 |
0.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$33,349.88 |
$51,307.50 |
88.9× |
| Mr elastography (76391) |
$419.90 |
$646 |
1.8× |
| MRA head w & w/o contrast (70546) |
$2,717 |
$4,180 |
7.8× |
| MRA head w/o contrast (70544) |
$1,892.80 |
$2,912 |
7.9× |
| MRA head with contrast (70545) |
$2,120.30 |
$3,262 |
6.1× |
| MRA neck w contrast (70548) |
$1,741.35 |
$2,679 |
5.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,004.60 |
$3,084 |
5.7× |
| MRA neck w/o contrast (70547) |
$1,623.05 |
$2,497 |
6.8× |
| MRI abdomen w contrast (74182) |
$2,524.60 |
$3,884 |
7.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,186.30 |
$4,902 |
9.1× |
| MRI abdomen w/o contrast (74181) |
$2,110.55 |
$3,247 |
8.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,950 |
$3,000 |
2.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,066.35 |
$3,179 |
2.6× |
| MRI bone marrow blood supply (77084) |
$1,248.65 |
$1,921 |
5.2× |
| MRI breast w/o contrast bilateral (77047) |
$3,062.15 |
$4,711 |
12.8× |
| MRI breast w/o contrast unilat (77046) |
$2,041.65 |
$3,141 |
8.5× |
| MRI c-spine with contrast (72142) |
$2,546.70 |
$3,918 |
7.3× |
| MRI cardiac w/o cont stress (75559) |
$1,688.05 |
$2,597 |
3.1× |
| MRI cardiac w/o contrast (75557) |
$1,556.75 |
$2,395 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$1,970.15 |
$3,031 |
8.2× |
| MRI chest w/o & w/contrast material (71552) |
$3,108.30 |
$4,782 |
8.9× |
| MRI chest w/o contrast (71550) |
$1,830.40 |
$2,816 |
7.7× |
| MRI chest with contrast (71551) |
$1,885.65 |
$2,901 |
2.4× |
| MRI fetal sngl/1st gestation (74712) |
$508.95 |
$783 |
2.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,131.35 |
$3,279 |
6.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,918.80 |
$2,952 |
8.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,558.05 |
$2,397 |
6.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,273.70 |
$3,498 |
6.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,844.70 |
$2,838 |
5.3× |
| MRI pelvis w contrast (72196) |
$2,465.45 |
$3,793 |
7.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,881.45 |
$4,433 |
8.2× |
| MRI pelvis w/o contrast (72195) |
$1,916.85 |
$2,949 |
8.0× |
| MRI scan of arm joint before and after contrast (73223) |
$2,406.30 |
$3,702 |
6.9× |
| MRI scan of leg joint before and after contrast (73723) |
$2,120.30 |
$3,262 |
6.1× |
| MRI spectroscopy (76390) |
$1,431.30 |
$2,202 |
16.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,199.95 |
$4,923 |
9.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,496 |
$3,840 |
7.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,086.85 |
$4,749 |
8.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,587 |
$3,980 |
7.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,067.35 |
$4,719 |
8.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,985.75 |
$3,055 |
8.3× |
| MRI tmj (70336) |
$1,501.50 |
$2,310 |
6.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,790.75 |
$2,755 |
7.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,449.20 |
$3,768 |
7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,837.55 |
$2,827 |
7.7× |
| Myelogram Cervical (72240) |
$1,007.50 |
$1,550 |
1.3× |
| Myelogram Lumbar (72265) |
$1,290.90 |
$1,986 |
1.6× |
| Myelogram thoracic (72255) |
$1,133.60 |
$1,744 |
1.4× |
| Myelography 2 or more regions (72270) |
$1,517.10 |
$2,334 |
1.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,468.40 |
$5,336 |
2.7× |
| Myocardial infarct spect (78469) |
$875.55 |
$1,347 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,285.93 |
$6,593.74 |
3.3× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$3,482.70 |
$5,358 |
2.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,803.80 |
$5,852 |
2.7× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$4,140.50 |
$6,370 |
1.9× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$4,915.30 |
$7,562 |
2.2× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$6,634.55 |
$10,207 |
4.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,825.85 |
$2,809 |
2.1× |
| Neck soft tissue (70360) |
$253.50 |
$390 |
2.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$858.65 |
$1,321 |
2.2× |
| Nm bone marrow multiple (78103) |
$1,039.35 |
$1,599 |
2.6× |
| Nm bone marrow wb (78104) |
$1,099.80 |
$1,692 |
2.7× |
| Nm cisternogram (78630) |
$828.10 |
$1,274 |
1.5× |
| Nm csf leak detection (78650) |
$6,066.12 |
$9,332.50 |
4.7× |
| Nm gastric emptying study (78264) |
$1,432.92 |
$2,204.50 |
3.6× |
| Nm gastroesophageal reflux study (78262) |
$943.80 |
$1,452 |
2.4× |
| Nm peritoneal-venous shunt patency (78291) |
$817.05 |
$1,257 |
2.0× |
| Nm whole blood volume (78122) |
$1,392.95 |
$2,143 |
2.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$33,394.24 |
$51,375.76 |
24.1× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$4,411.55 |
$6,787 |
3.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$11,279.34 |
$17,352.84 |
8.7× |
| Nuclear medicine of heart pumping function (78473) |
$1,922.05 |
$2,957 |
4.8× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$4,108.65 |
$6,321 |
2.9× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$3,764.15 |
$5,791 |
2.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,591.85 |
$2,449 |
1.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,085.50 |
$1,670 |
2.7× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,018.22 |
$1,566.50 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$4,766.45 |
$7,333 |
20.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$487.50 |
$750 |
4.7× |
| Orthopantogram (70355) |
$258.70 |
$398 |
3.0× |
| Osseous survey infant (77076) |
$256.10 |
$394 |
2.4× |
| Osseous survey limited (77074) |
$286 |
$440 |
2.7× |
| Parathyrd planar w/spect&CT (78072) |
$1,340.62 |
$2,062.50 |
2.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,113.78 |
$1,713.50 |
2.8× |
| Parathyroid imaging (78070) |
$1,060.15 |
$1,631 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$241.15 |
$371 |
2.3× |
| Perineogram (74775) |
$343.20 |
$528 |
1.4× |
| Peritoneogram rs&i (74190) |
$612.95 |
$943 |
1.1× |
| PET image w/CT, skull-thigh (78815) |
$3,728.40 |
$5,736 |
2.6× |
| PET imaging CT for attenuation limited area (78814) |
$5,619.25 |
$8,645 |
3.9× |
| PET imaging for CT attenuation whole body (78816) |
$4,868.50 |
$7,490 |
3.4× |
| PET whole body (78813) |
$5,261.10 |
$8,094 |
3.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,479.75 |
$3,815 |
7.1× |
| Proton tx delivery complex (77525) |
$4,992 |
$7,680 |
4.0× |
| Proton tx delivery intermediate (77523) |
$4,446 |
$6,840 |
3.6× |
| Proton tx delivery simple w/o compensation (77520) |
$2,964 |
$4,560 |
5.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,799.55 |
$4,307 |
0.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,664 |
$2,560 |
0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$818.35 |
$1,259 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,612.65 |
$2,481 |
3.0× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,950 |
$3,000 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$547.30 |
$842 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$245.70 |
$378 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$284.70 |
$438 |
2.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$305.50 |
$470 |
2.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$227.50 |
$350 |
2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$675.35 |
$1,039 |
6.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$35,919 |
$55,260 |
4.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$19,377.48 |
$29,811.50 |
35.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$12,533.30 |
$19,282 |
122.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$27,756.95 |
$42,703 |
71.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$273 |
$420 |
2.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$228.80 |
$352 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$353.60 |
$544 |
3.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$301.60 |
$464 |
3.5× |
| Radiologic exam colon single contrast study (74270) |
$543.40 |
$836 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$646.10 |
$994 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$435.50 |
$670 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$579.15 |
$891 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$212.55 |
$327 |
2.4× |
| Radiological examination surgical specimen (76098) |
$358.15 |
$551 |
0.7× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$830.05 |
$1,277 |
2.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,742 |
$2,680 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,531.75 |
$3,895 |
0.8× |
| Ribs bilateral 3 views (71110) |
$271.70 |
$418 |
2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,044.55 |
$1,607 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,485.30 |
$5,362 |
6.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,697.36 |
$5,688.25 |
6.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,988.70 |
$4,598 |
2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,927.95 |
$6,043 |
2.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,331.92 |
$6,664.50 |
3.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,398.80 |
$2,152 |
6.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$24,136.06 |
$37,132.40 |
103.3× |
| Rp Therapy Intravenous Administration (79101) |
$53,781.32 |
$82,740.50 |
230.1× |
| Sacroiliac Joints < 3 Views (72200) |
$182.65 |
$281 |
1.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$612.30 |
$942 |
2.6× |
| Salivary gland imaging (78230) |
$799.50 |
$1,230 |
2.0× |
| Scanogram (77073) |
$202.80 |
$312 |
1.9× |
| Scapula complete (73010) |
$212.55 |
$327 |
2.0× |
| Screening digital breast tomosynthesis (77063) |
$70.85 |
$109 |
3.0× |
| Sella turcica (70240) |
$131.30 |
$202 |
1.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$339.30 |
$522 |
3.2× |
| Sialogram (70390) |
$543.40 |
$836 |
2.3× |
| Simulation intermediate (77285) |
$1,060.15 |
$1,631 |
2.8× |
| Small bowel series (74250) |
$460.20 |
$708 |
2.6× |
| Spec medical radj physics consltj (77370) |
$60,360.95 |
$92,863 |
448.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$962 |
$1,480 |
2.6× |
| Special dosimetry (77331) |
$499.85 |
$769 |
3.7× |
| Special treatment procedure (77470) |
$49,841.68 |
$76,679.50 |
90.1× |
| Speech evaluation complex (70371) |
$436.80 |
$672 |
1.8× |
| Spine thoracic 3 views (72072) |
$284.70 |
$438 |
2.7× |
| Spleen imaging only (78185) |
$1,943.18 |
$2,989.50 |
4.9× |
| Splenoportograpy rs&i (75810) |
$2,250.95 |
$3,463 |
0.7× |
| Stereotactic body radiation delivery (77373) |
$69,326.08 |
$106,655.50 |
38.7× |
| Superior sagittal sinus venogram (75870) |
$1,506.70 |
$2,318 |
0.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$382.20 |
$588 |
3.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$21,002.80 |
$32,312 |
56.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,450.80 |
$2,232 |
3.9× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$469.95 |
$723 |
2.0× |
| Testicular Imaging With Vascular Flow (78761) |
$738.40 |
$1,136 |
1.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$31,333.90 |
$48,206 |
83.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$30,204.10 |
$46,467.84 |
224.3× |
| Therapeutic Enema (74283) |
$663.65 |
$1,021 |
3.8× |
| Thoracolumbar 2 views (72080) |
$274.95 |
$423 |
3.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,959.45 |
$4,553 |
5.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$498.55 |
$767 |
1.2× |
| Thyroid uptake measurement (78012) |
$441.35 |
$679 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$817.70 |
$1,258 |
2.0× |
| Tmj unilateral (70328) |
$170.95 |
$263 |
2.0× |
| Tomogram (76100) |
$771.55 |
$1,187 |
7.4× |
| Treatment device intermediate (77333) |
$814.45 |
$1,253 |
6.0× |
| Treatment devices simple (77332) |
$19,570.20 |
$30,108 |
145.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$8,360.78 |
$12,862.75 |
15.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,573.35 |
$3,959 |
6.4× |
| Tx devices design & construction complex (77334) |
$30,598.75 |
$47,075 |
81.6× |
| Ultrasound elastography first target lesion (76982) |
$335.40 |
$516 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$372.78 |
$573.50 |
3.6× |
| Umbilical-artery Doppler (OB) (76820) |
$338.65 |
$521 |
3.2× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$222.95 |
$343 |
2.6× |
| Unlisted fluoroscopic procedure (76496) |
$254.80 |
$392 |
2.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,567.80 |
$2,412 |
18.0× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$308.75 |
$475 |
0.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$2,799.55 |
$4,307 |
27.4× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$1,345.50 |
$2,070 |
3.4× |
| Unlisted Ultrasound Procedure (76999) |
$274.30 |
$422 |
3.1× |
| Upper Extremity Infant (73092) |
$123.50 |
$190 |
1.2× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$350.35 |
$539 |
3.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$837.85 |
$1,289 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$469.30 |
$722 |
2.0× |
| Urethrocystography voiding (74455) |
$765.05 |
$1,177 |
3.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$516.75 |
$795 |
2.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$581.10 |
$894 |
3.3× |
| Us abdl aorta screen aaa (76706) |
$290.55 |
$447 |
2.8× |
| Us breast unilateral complete (76641) |
$314.60 |
$484 |
3.0× |
| Us breast unilateral limited (76642) |
$435.50 |
$670 |
5.0× |
| Us chest (76604) |
$453.05 |
$697 |
4.3× |
| Us compl joint r-t w/image documentation (76881) |
$393.25 |
$605 |
3.8× |
| Us elastography parenchyma (76981) |
$287.95 |
$443 |
2.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$380.90 |
$586 |
3.6× |
| Us guided compression repair (76936) |
$899.60 |
$1,384 |
4.2× |
| Us infant hips dynamic (76885) |
$364.65 |
$561 |
4.2× |
| Us infant hips limited static (76886) |
$250.25 |
$385 |
2.9× |
| Us kidney transplant (76776) |
$495.30 |
$762 |
4.7× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$531.70 |
$818 |
5.1× |
| Us ob detailed single fetus (76811) |
$753.68 |
$1,159.50 |
3.2× |
| Us ob transvaginal (76817) |
$472.55 |
$727 |
4.5× |
| Us pelvic non ob complete (76856) |
$721.50 |
$1,110 |
6.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$445.90 |
$686 |
4.3× |
| Us pregnancy ltd (76815) |
$292.18 |
$449.50 |
2.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$537.55 |
$827 |
5.1× |
| Us retroperitoneal complete (76770) |
$794.95 |
$1,223 |
7.6× |
| Us retroperitoneal limited (76775) |
$313.30 |
$482 |
3.0× |
| Us scrotum and contents (76870) |
$687.05 |
$1,057 |
6.6× |
| Us soft tissue head/neck (76536) |
$342.55 |
$527 |
3.3× |
| Us spinal canal and contents (76800) |
$422.50 |
$650 |
4.0× |
| Us transrectal (76872) |
$477.10 |
$734 |
4.6× |
| Us transrectal prostate volume (76873) |
$577.20 |
$888 |
5.5× |
| Us xtr non-vasc lmtd (76882) |
$306.15 |
$471 |
2.9× |
| Us, eye b-scan (76512) |
$286 |
$440 |
2.7× |
| Vascular flow imaging (78445) |
$586.30 |
$902 |
1.5× |
| Vasogram (74440) |
$195 |
$300 |
0.8× |
| Venogram extremity bilateral (75822) |
$1,632.15 |
$2,511 |
1.0× |
| Venogram orbital (75880) |
$1,163.50 |
$1,790 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,017.60 |
$3,104 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$2,045.55 |
$3,147 |
1.3× |
| Venography epidural rs&i (75872) |
$1,428.70 |
$2,198 |
2.3× |
| Venography extremity unilateral rs&i (75820) |
$1,088.10 |
$1,674 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,344.55 |
$3,607 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,820.65 |
$2,801 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,722.50 |
$2,650 |
0.5× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,279.55 |
$3,507 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$131.30 |
$202 |
1.5× |
| Wrist 2 views (73100) |
$219.70 |
$338 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$397.80 |
$612 |
3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$287.95 |
$443 |
3.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$315.90 |
$486 |
3.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$607.10 |
$934 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$243.10 |
$374 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$313.95 |
$483 |
3.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$399.10 |
$614 |
3.8× |
| X-ray exam hip uni 1 view (73501) |
$211.90 |
$326 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$272.35 |
$419 |
3.1× |
| X-ray exam hip uni 4/> views (73503) |
$346.45 |
$533 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$350.35 |
$539 |
3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$435.50 |
$670 |
4.2× |
| X-ray exam of femur 1 (73551) |
$182.65 |
$281 |
2.1× |
| X-ray eye for foreign body (70030) |
$152.10 |
$234 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$272.35 |
$419 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$187.20 |
$288 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$291.20 |
$448 |
3.3× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,143.35 |
$1,759 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$200.20 |
$308 |
2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$202.80 |
$312 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$305.50 |
$470 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$204.10 |
$314 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$154.70 |
$238 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$349.70 |
$538 |
3.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$532.35 |
$819 |
5.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$247.65 |
$381 |
2.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$248.30 |
$382 |
2.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$237.25 |
$365 |
2.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$351 |
$540 |
3.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$328.25 |
$505 |
3.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$692.90 |
$1,066 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$222.95 |
$343 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$260.65 |
$401 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$365.30 |
$562 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$224.25 |
$345 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$233.35 |
$359 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$291.20 |
$448 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$245.70 |
$378 |
2.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$152.75 |
$235 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$404.30 |
$622 |
3.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$326.95 |
$503 |
3.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$231.40 |
$356 |
2.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$209.30 |
$322 |
2.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$219.70 |
$338 |
2.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$234.65 |
$361 |
2.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$350.35 |
$539 |
3.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$203.45 |
$313 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$295.75 |
$455 |
3.4× |
| Xr arthrogram ankle (73615) |
$638.30 |
$982 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$498.55 |
$767 |
4.8× |
| Xr chest 4+ views (71048) |
$327.60 |
$504 |
3.1× |
| Xr finger(s) 2+ views (73140) |
$211.90 |
$326 |
2.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$178.10 |
$274 |
1.7× |
| Xr optic foramina (70190) |
$163.80 |
$252 |
1.9× |
| Xr shoulder 1 view (73020) |
$184.60 |
$284 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$423.15 |
$651 |
4.0× |
| Xr tibia/fibula 2 views (73590) |
$260 |
$400 |
3.0× |
| Xr tmj bilateral (70330) |
$256.75 |
$395 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$228.15 |
$351 |
2.6× |