| 3-D radiotherapy plan dose-volume histograms (77295) |
$31,193.18 |
$47,989.50 |
22.5× |
| Abdomen 2 views (74019) |
$365.95 |
$563 |
3.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$952.25 |
$1,465 |
2.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,545.10 |
$5,454 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$4,898.40 |
$7,536 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$3,265.60 |
$5,024 |
1.0× |
| Angiography internal mammary rs&i (75756) |
$2,363.40 |
$3,636 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,677.75 |
$8,735 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,686.45 |
$4,133 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,791.40 |
$2,756 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$5,554.90 |
$8,546 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,808 |
$4,320 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,999.40 |
$3,076 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,383.95 |
$8,283 |
1.7× |
| Ankle 2 views (73600) |
$200.20 |
$308 |
2.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$515.78 |
$793.50 |
1.5× |
| Aortogram thoracic (75605) |
$5,752.50 |
$8,850 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,964 |
$4,560 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$3,213.60 |
$4,944 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,826.85 |
$4,349 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,917.85 |
$4,489 |
0.9× |
| Arthrogram elbow (73085) |
$960.70 |
$1,478 |
2.7× |
| Arthrogram hip (73525) |
$1,142.70 |
$1,758 |
3.3× |
| Arthrogram shoulder (73040) |
$1,074.45 |
$1,653 |
3.1× |
| Arthrogram wrist (73115) |
$857.35 |
$1,319 |
2.5× |
| Arthrography knee lt (73580) |
$987.35 |
$1,519 |
2.8× |
| Basic radiation dosimetry calculation (77300) |
$34,000.52 |
$52,308.50 |
252.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$3,289.32 |
$5,060.50 |
8.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$702.65 |
$1,081 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$2,077.24 |
$3,195.75 |
5.2× |
| Bone age studies (77072) |
$165.10 |
$254 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$972.08 |
$1,495.50 |
2.4× |
| Bone Marrow Imaging Limited Area (78102) |
$514.80 |
$792 |
1.3× |
| Bone survey complete (77075) |
$394.55 |
$607 |
3.8× |
| Brachytx isodose complex (77318) |
$2,133.30 |
$3,282 |
5.7× |
| Brachytx isodose intermed (77317) |
$7,760.35 |
$11,939 |
20.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,898 |
$2,920 |
5.1× |
| Brain image w/flow 4 + views (78606) |
$674.70 |
$1,038 |
1.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,857.70 |
$2,858 |
4.6× |
| Cervical spine 2 or 3 views (72040) |
$325 |
$500 |
3.7× |
| Chest 1 view (71045) |
$224.25 |
$345 |
2.6× |
| Chest 3 views (71047) |
$303.55 |
$467 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$386.10 |
$594 |
2.2× |
| Cineradiography/videoradiography (76120) |
$327.60 |
$504 |
3.1× |
| Cisternography Positive Contrast Rs&I (70015) |
$776.10 |
$1,194 |
1.0× |
| Clavicle complete (73000) |
$169.65 |
$261 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,110.85 |
$1,709 |
10.6× |
| Continuing medical physics consltj pr wk (77336) |
$25,292.80 |
$38,912 |
187.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,914.95 |
$6,023 |
11.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,327.65 |
$3,581 |
9.7× |
| CT abdomen w contrast (74160) |
$1,069.90 |
$1,646 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,366.62 |
$2,102.50 |
7.8× |
| CT abdomen w/o contrast (74150) |
$853.45 |
$1,313 |
8.2× |
| CT angio hrt w/3d image (75574) |
$1,270.10 |
$1,954 |
3.6× |
| CT angiography upper extremity lt (73206) |
$1,449.50 |
$2,230 |
8.3× |
| CT c-spine w/o contrast (72125) |
$1,725.75 |
$2,655 |
16.5× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$913.90 |
$1,406 |
5.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,206.10 |
$3,394 |
12.6× |
| CT cervical spine with contrast (72126) |
$1,756.95 |
$2,703 |
5.0× |
| CT chest w/wo contrast (71270) |
$1,480.70 |
$2,278 |
8.4× |
| CT chest with contrast (71260) |
$1,364.35 |
$2,099 |
7.8× |
| CT head/brain with contrast (70460) |
$1,222.65 |
$1,881 |
7.0× |
| CT head/brain without and with contrast (70470) |
$1,542.45 |
$2,373 |
8.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$84.50 |
$130 |
1.0× |
| CT iac w contrast (70481) |
$1,049.10 |
$1,614 |
6.0× |
| CT limited/localized follow up study (76380) |
$408.85 |
$629 |
4.7× |
| CT lower ext w/o (73700) |
$1,196.65 |
$1,841 |
11.4× |
| CT lower extremity w wo contrast (73702) |
$1,370.85 |
$2,109 |
7.8× |
| CT lower extremity with contrast (73701) |
$982.80 |
$1,512 |
5.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,441.70 |
$2,218 |
8.2× |
| CT lumbar spine w/o contrast (72131) |
$924.30 |
$1,422 |
8.8× |
| CT lumbar spine with contrast (72132) |
$1,358.50 |
$2,090 |
3.9× |
| CT maxillofacial w contrast (70487) |
$1,066 |
$1,640 |
6.1× |
| CT maxillofacial w/o contrast (70486) |
$916.82 |
$1,410.50 |
8.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,552.85 |
$2,389 |
8.8× |
| CT neck soft tissue w contrast (70491) |
$1,353.30 |
$2,082 |
7.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,509.95 |
$2,323 |
8.6× |
| CT orbits w/o contrast (70480) |
$826.80 |
$1,272 |
7.9× |
| CT pelvis w & w/o contrast (72194) |
$1,673.10 |
$2,574 |
9.5× |
| CT pelvis w/o contrast (72192) |
$1,248.65 |
$1,921 |
11.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,632.80 |
$2,512 |
9.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,114.10 |
$1,714 |
10.6× |
| CT thoracic spine w/contrast (72129) |
$1,194.70 |
$1,838 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$1,066.65 |
$1,641 |
10.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,817.40 |
$2,796 |
10.3× |
| CT thorax w/o contrast (71250) |
$1,036.10 |
$1,594 |
9.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,355.60 |
$3,624 |
13.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,004.90 |
$1,546 |
9.6× |
| CT upper extremity with contrast (73201) |
$1,017.25 |
$1,565 |
2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,244.10 |
$1,914 |
7.1× |
| Cta Abdomen (74175) |
$1,332.50 |
$2,050 |
7.6× |
| CTA abdomen pelvis (74174) |
$2,140.45 |
$3,293 |
6.1× |
| CTA chest (71275) |
$1,613.30 |
$2,482 |
9.2× |
| Cta Head (70496) |
$1,366.30 |
$2,102 |
7.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,366.30 |
$2,102 |
3.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,123.85 |
$1,729 |
6.4× |
| Cta Neck (70498) |
$1,318.85 |
$2,029 |
7.5× |
| Cta Pelvis (72191) |
$1,831.70 |
$2,818 |
10.4× |
| Cystography minimum 3 views rs&i (74430) |
$495.30 |
$762 |
1.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$546 |
$840 |
5.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$579.80 |
$892 |
5.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$202.15 |
$311 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$224.90 |
$346 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$146.90 |
$226 |
1.7× |
| Dxa bone density study axial skeleton (77085) |
$260 |
$400 |
2.5× |
| Echo exam of fetal heart (76825) |
$1,550.25 |
$2,385 |
2.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$995.80 |
$1,532 |
4.2× |
| Esophagus (74220) |
$283.40 |
$436 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$429 |
$660 |
4.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$453.70 |
$698 |
4.3× |
| Fluoroscopy up to 1 hr (76000) |
$615.55 |
$947 |
2.6× |
| Foot 2 views (73620) |
$167.70 |
$258 |
1.9× |
| Forearm 2 views (73090) |
$234 |
$360 |
2.7× |
| Gastric mucosa imaging (78261) |
$1,462.50 |
$2,250 |
3.7× |
| Gated Heart Planar Single (78472) |
$854.10 |
$1,314 |
2.1× |
| Hand 2 views (73120) |
$188.50 |
$290 |
1.8× |
| Hand 3 views (73130) |
$323.05 |
$497 |
3.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,623.10 |
$5,574 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,501.18 |
$2,309.50 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,032.52 |
$1,588.50 |
2.6× |
| Ht muscle image spect sing (78451) |
$1,440.08 |
$2,215.50 |
1.1× |
| Humerus Min 2 Views Left (73060) |
$237.90 |
$366 |
2.7× |
| Hysterosalpingogram (74740) |
$386.75 |
$595 |
1.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$332.15 |
$511 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,147.25 |
$1,765 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,188.85 |
$1,829 |
2.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,408.55 |
$2,167 |
2.6× |
| Knee 3 views (73562) |
$379.60 |
$584 |
4.4× |
| Liver & spleen imaging static only (78215) |
$1,212.90 |
$1,866 |
3.0× |
| Liver imaging static only (78201) |
$3,450.20 |
$5,308 |
6.3× |
| Lung perf&ventilat diferentl (78598) |
$1,186.90 |
$1,826 |
2.2× |
| Lung perfusion differential (78597) |
$1,200.55 |
$1,847 |
3.0× |
| Lung Ventilation Imaging (78579) |
$935.35 |
$1,439 |
2.3× |
| Lymphoscintigraphy (78195) |
$6,268.92 |
$9,644.50 |
11.5× |
| Meckels Diverticulum (78290) |
$835.90 |
$1,286 |
2.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$40,767.68 |
$62,719.50 |
108.7× |
| MRA head w & w/o contrast (70546) |
$1,738.75 |
$2,675 |
5.0× |
| MRA head w/o contrast (70544) |
$1,211.60 |
$1,864 |
5.1× |
| MRA head with contrast (70545) |
$1,650.35 |
$2,539 |
4.7× |
| MRA neck w contrast (70548) |
$1,303.25 |
$2,005 |
3.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,597.70 |
$2,458 |
4.6× |
| MRA neck w/o contrast (70547) |
$1,293.50 |
$1,990 |
5.4× |
| MRI abdomen w contrast (74182) |
$1,690 |
$2,600 |
4.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,055.30 |
$3,162 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,361.10 |
$2,094 |
5.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,686.10 |
$2,594 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,116.40 |
$3,256 |
2.7× |
| MRI breast w/o contrast bilateral (77047) |
$1,959.75 |
$3,015 |
8.2× |
| MRI breast w/o contrast unilat (77046) |
$1,306.50 |
$2,010 |
5.5× |
| MRI c-spine with contrast (72142) |
$1,881.75 |
$2,895 |
5.4× |
| MRI cervical spine w/o contrast (72141) |
$1,820 |
$2,800 |
7.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,996.80 |
$3,072 |
5.7× |
| MRI chest w/o contrast (71550) |
$1,516.45 |
$2,333 |
6.3× |
| MRI chest with contrast (71551) |
$1,639.30 |
$2,522 |
2.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,553.50 |
$2,390 |
4.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,511.90 |
$2,326 |
4.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,374.10 |
$2,114 |
5.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,246.70 |
$1,918 |
5.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,818.70 |
$2,798 |
5.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,844.70 |
$2,838 |
5.3× |
| MRI pelvis w contrast (72196) |
$2,439.45 |
$3,753 |
7.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,899.95 |
$2,923 |
5.4× |
| MRI pelvis w/o contrast (72195) |
$1,264.25 |
$1,945 |
5.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,464.80 |
$3,792 |
7.1× |
| MRI scan of leg joint before and after contrast (73723) |
$1,732.90 |
$2,666 |
5.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,047.50 |
$3,150 |
5.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,975.35 |
$3,039 |
5.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,074.15 |
$3,191 |
5.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,806.35 |
$2,779 |
5.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,963 |
$3,020 |
5.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,274 |
$1,960 |
5.3× |
| MRI tmj (70336) |
$1,201.20 |
$1,848 |
5.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,834.30 |
$2,822 |
7.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,567.15 |
$2,411 |
4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,176.50 |
$1,810 |
4.9× |
| Myelogram Cervical (72240) |
$2,068.95 |
$3,183 |
2.6× |
| Myelogram Lumbar (72265) |
$1,420.25 |
$2,185 |
1.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,971.15 |
$4,571 |
2.3× |
| Myocardial infarct spect (78469) |
$889.52 |
$1,368.50 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,046.58 |
$6,225.50 |
3.1× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$10,286.90 |
$15,826 |
6.8× |
| Neck soft tissue (70360) |
$267.15 |
$411 |
3.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,154.40 |
$1,776 |
3.0× |
| Nm cisternogram (78630) |
$1,012.05 |
$1,557 |
1.9× |
| Nm gastric emptying study (78264) |
$1,391.98 |
$2,141.50 |
3.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$42,969.88 |
$66,107.50 |
31.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$5,198.05 |
$7,997 |
4.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,528.15 |
$2,351 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$8,014.20 |
$12,329.54 |
34.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$429 |
$660 |
4.1× |
| Orthopantogram (70355) |
$219.70 |
$338 |
2.5× |
| Osseous survey infant (77076) |
$410.80 |
$632 |
3.9× |
| Osseous survey limited (77074) |
$357.50 |
$550 |
3.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,190.15 |
$1,831 |
2.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,113.45 |
$1,713 |
2.8× |
| Parathyroid imaging (78070) |
$973.05 |
$1,497 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$193.05 |
$297 |
1.8× |
| Peritoneogram rs&i (74190) |
$359.45 |
$553 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$4,370.92 |
$6,724.50 |
3.1× |
| PET imaging CT for attenuation limited area (78814) |
$5,172.05 |
$7,957 |
3.6× |
| PET imaging for CT attenuation whole body (78816) |
$3,291.28 |
$5,063.50 |
2.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,649.05 |
$2,537 |
4.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$741.65 |
$1,141 |
1.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,130.68 |
$1,739.50 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$481.65 |
$741 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$196.30 |
$302 |
2.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$289.90 |
$446 |
2.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$244.40 |
$376 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$198.25 |
$305 |
1.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$640.90 |
$986 |
6.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$15,867.15 |
$24,411 |
28.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$3,243.42 |
$4,989.87 |
31.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$28,728.05 |
$44,197 |
74.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$218.40 |
$336 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$289.90 |
$446 |
3.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$341.25 |
$525 |
3.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$282.10 |
$434 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$478.40 |
$736 |
2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$710.45 |
$1,093 |
4.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$383.50 |
$590 |
2.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$562.25 |
$865 |
3.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$152.10 |
$234 |
1.7× |
| Radiological examination surgical specimen (76098) |
$276.90 |
$426 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,379.35 |
$5,199 |
1.1× |
| Ribs bilateral 3 views (71110) |
$217.10 |
$334 |
2.1× |
| 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) |
$4,281.88 |
$6,587.50 |
7.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,202.82 |
$1,850.50 |
2.2× |
| 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) |
$7,120.60 |
$10,954.77 |
5.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,811.25 |
$4,325 |
2.2× |
| Rp Therapy Intravenous Administration (79101) |
$651.95 |
$1,003 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$146.25 |
$225 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$538.85 |
$829 |
2.3× |
| Scanogram (77073) |
$162.50 |
$250 |
1.6× |
| Scapula complete (73010) |
$170.30 |
$262 |
1.6× |
| Screening digital breast tomosynthesis (77063) |
$65 |
$100 |
2.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$463.45 |
$713 |
4.4× |
| Simulation intermediate (77285) |
$1,574.95 |
$2,423 |
4.2× |
| Small bowel series (74250) |
$442 |
$680 |
2.5× |
| Spec medical radj physics consltj (77370) |
$9,777.30 |
$15,042 |
72.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,038.70 |
$1,598 |
2.8× |
| Special dosimetry (77331) |
$539.50 |
$830 |
4.0× |
| Special treatment procedure (77470) |
$32,221.80 |
$49,572 |
58.2× |
| Spine thoracic 3 views (72072) |
$340.60 |
$524 |
3.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$24,132.88 |
$37,127.50 |
64.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,619.80 |
$2,492 |
4.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$383.50 |
$590 |
1.6× |
| Testicular Imaging With Vascular Flow (78761) |
$815.10 |
$1,254 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$30,726.69 |
$47,271.83 |
81.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$27,909.70 |
$42,938 |
207.3× |
| Thoracolumbar 2 views (72080) |
$175.50 |
$270 |
2.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$962 |
$1,480 |
1.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$498.55 |
$767 |
1.2× |
| Thyroid uptake measurement (78012) |
$472.55 |
$727 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$817.70 |
$1,258 |
2.0× |
| Tmj unilateral (70328) |
$138.45 |
$213 |
1.6× |
| Treatment device intermediate (77333) |
$907.40 |
$1,396 |
6.7× |
| Treatment devices simple (77332) |
$40,416.35 |
$62,179 |
300.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,011.10 |
$3,094 |
3.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$3,300.70 |
$5,078 |
8.2× |
| Tx devices design & construction complex (77334) |
$28,380.62 |
$43,662.50 |
75.7× |
| Ultrasound, abdomen limited (76705) |
$796.90 |
$1,226 |
7.6× |
| Umbilical-artery Doppler (OB) (76820) |
$238.55 |
$367 |
2.3× |
| Unlisted Ultrasound Procedure (76999) |
$362.70 |
$558 |
4.2× |
| Upper Extremity Infant (73092) |
$222.95 |
$343 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$696.15 |
$1,071 |
2.9× |
| Urethrocystography voiding (74455) |
$879.45 |
$1,353 |
3.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$719.55 |
$1,107 |
4.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$638.95 |
$983 |
3.6× |
| Us abdl aorta screen aaa (76706) |
$256.75 |
$395 |
2.5× |
| Us breast unilateral complete (76641) |
$362.70 |
$558 |
3.5× |
| Us breast unilateral limited (76642) |
$349.05 |
$537 |
4.0× |
| Us chest (76604) |
$399.10 |
$614 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$417.30 |
$642 |
4.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$419.25 |
$645 |
4.0× |
| Us guided compression repair (76936) |
$791.05 |
$1,217 |
3.7× |
| Us infant hips dynamic (76885) |
$616.85 |
$949 |
7.1× |
| Us infant hips limited static (76886) |
$387.40 |
$596 |
4.4× |
| Us kidney transplant (76776) |
$672.75 |
$1,035 |
6.4× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$585 |
$900 |
5.6× |
| Us ob detailed single fetus (76811) |
$775.78 |
$1,193.50 |
3.2× |
| Us ob transvaginal (76817) |
$499.20 |
$768 |
4.8× |
| Us pelvic non ob complete (76856) |
$762.45 |
$1,173 |
7.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$403 |
$620 |
3.8× |
| Us pregnancy ltd (76815) |
$461.50 |
$710 |
4.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$856.05 |
$1,317 |
8.2× |
| Us retroperitoneal complete (76770) |
$559 |
$860 |
5.3× |
| Us retroperitoneal limited (76775) |
$364.65 |
$561 |
3.5× |
| Us scrotum and contents (76870) |
$725.40 |
$1,116 |
6.9× |
| Us soft tissue head/neck (76536) |
$636.35 |
$979 |
6.1× |
| Us spinal canal and contents (76800) |
$824.20 |
$1,268 |
7.9× |
| Us transrectal (76872) |
$1,175.20 |
$1,808 |
11.2× |
| Us xtr non-vasc lmtd (76882) |
$241.80 |
$372 |
2.3× |
| Venogram extremity bilateral (75822) |
$2,379.65 |
$3,661 |
1.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,219.10 |
$3,414 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,439.75 |
$2,215 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,301.30 |
$2,002 |
0.8× |
| Venography Renal Bilateral (75833) |
$3,713.45 |
$5,713 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$2,883.40 |
$4,436 |
0.9× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,840.25 |
$8,985 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$174.20 |
$268 |
2.0× |
| Wrist 2 views (73100) |
$255.45 |
$393 |
2.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$280.15 |
$431 |
2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$183.95 |
$283 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$326.30 |
$502 |
3.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$534.30 |
$822 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$197.60 |
$304 |
2.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$346.45 |
$533 |
4.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$579.80 |
$892 |
5.5× |
| X-ray exam hip uni 1 view (73501) |
$136.50 |
$210 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$175.50 |
$270 |
2.0× |
| X-ray exam hip uni 4/> views (73503) |
$391.30 |
$602 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$280.15 |
$431 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$348.40 |
$536 |
3.3× |
| X-ray exam of femur 1 (73551) |
$135.85 |
$209 |
1.6× |
| X-ray eye for foreign body (70030) |
$157.95 |
$243 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$217.75 |
$335 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$149.50 |
$230 |
1.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$322.40 |
$496 |
3.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,973.72 |
$3,036.50 |
0.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$141.05 |
$217 |
1.6× |
| X-ray IV pyelogram+drip infusn (74410) |
$1,355.90 |
$2,086 |
7.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$243.10 |
$374 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$432.25 |
$665 |
4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$163.15 |
$251 |
1.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$296.40 |
$456 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$223.60 |
$344 |
2.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$340.60 |
$524 |
3.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$198.25 |
$305 |
1.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$159.25 |
$245 |
1.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$173.55 |
$267 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$224.90 |
$346 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$209.95 |
$323 |
2.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$178.10 |
$274 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$312.65 |
$481 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$292.50 |
$450 |
2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$180.05 |
$277 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$187.20 |
$288 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$281.45 |
$433 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$196.30 |
$302 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$122.20 |
$188 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$258.70 |
$398 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$198.25 |
$305 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$148.20 |
$228 |
1.7× |
| 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) |
$175.50 |
$270 |
2.0× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$180.05 |
$277 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$280.80 |
$432 |
2.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$419.25 |
$645 |
4.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$128.05 |
$197 |
1.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$276.90 |
$426 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$531.70 |
$818 |
5.1× |
| Xr chest 4+ views (71048) |
$343.85 |
$529 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$202.80 |
$312 |
2.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$382.20 |
$588 |
3.7× |
| Xr shoulder 1 view (73020) |
$131.30 |
$202 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$451.75 |
$695 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$241.15 |
$371 |
2.8× |
| Xr tmj bilateral (70330) |
$208 |
$320 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$227.50 |
$350 |
2.6× |