| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,679.50 |
$7,359 |
2.6× |
| Abdomen 2 views (74019) |
$391 |
$782 |
3.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$655.50 |
$1,311 |
1.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,827 |
$3,654 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$3,583 |
$7,166 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$4,886.50 |
$9,773 |
1.5× |
| Angiography internal mammary rs&i (75756) |
$1,749.50 |
$3,499 |
0.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,607.50 |
$7,215 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,998.50 |
$3,997 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,831.50 |
$3,663 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$3,191.25 |
$6,382.50 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,132.50 |
$6,265 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,265 |
$2,530 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,104 |
$4,208 |
0.7× |
| Ankle 2 views (73600) |
$282.50 |
$565 |
3.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$505 |
$1,010 |
1.4× |
| Aortogram thoracic (75605) |
$3,490 |
$6,980 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,583 |
$7,166 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$3,583 |
$7,166 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$1,749.50 |
$3,499 |
0.6× |
| Arthrogram elbow (73085) |
$415.50 |
$831 |
1.2× |
| Arthrogram hip (73525) |
$416 |
$832 |
1.2× |
| Arthrogram shoulder (73040) |
$416 |
$832 |
1.2× |
| Arthrogram wrist (73115) |
$375.50 |
$751 |
1.1× |
| Arthrography knee lt (73580) |
$526 |
$1,052 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$3,679.50 |
$7,359 |
27.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$255.50 |
$511 |
0.6× |
| Bone &/joint imaging whole body (78306) |
$1,213 |
$2,426 |
3.0× |
| Bone age studies (77072) |
$269 |
$538 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,514.50 |
$3,029 |
3.8× |
| Bone Marrow Imaging Limited Area (78102) |
$460.50 |
$921 |
1.1× |
| Bone survey complete (77075) |
$1,170.50 |
$2,341 |
11.1× |
| Brain image w/flow 4 + views (78606) |
$780 |
$1,560 |
1.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$603 |
$1,206 |
1.5× |
| Brain Imaging Minimum 4 Static Views (78605) |
$651 |
$1,302 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,898 |
$15,796 |
5.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,683 |
$5,366 |
7.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$692 |
$1,384 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$420 |
$840 |
4.8× |
| Chest 1 view (71045) |
$300.50 |
$601 |
3.4× |
| Chest 3 views (71047) |
$348.50 |
$697 |
4.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$524.50 |
$1,049 |
3.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$564 |
$1,128 |
0.7× |
| Clavicle complete (73000) |
$269 |
$538 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$170.50 |
$341 |
1.6× |
| Continuing medical physics consltj pr wk (77336) |
$3,679.50 |
$7,359 |
27.3× |
| Corpora cavernosography (74445) |
$386 |
$772 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,006 |
$10,012 |
14.3× |
| CT abdomen and pelvis without contrast (74176) |
$3,769.50 |
$7,539 |
15.7× |
| CT abdomen w contrast (74160) |
$2,273 |
$4,546 |
12.9× |
| CT abdomen w wo contrast (74170) |
$2,569 |
$5,138 |
14.6× |
| CT abdomen w/o contrast (74150) |
$1,977 |
$3,954 |
18.8× |
| CT angio hrt w/3d image (75574) |
$1,130 |
$2,260 |
3.2× |
| CT angiography upper extremity lt (73206) |
$3,730.50 |
$7,461 |
21.2× |
| CT c-spine w/o contrast (72125) |
$2,112.50 |
$4,225 |
20.1× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$1,783 |
$3,566 |
10.1× |
| CT cervical spine w&w/o contrast (72127) |
$2,745.50 |
$5,491 |
15.6× |
| CT cervical spine with contrast (72126) |
$2,429 |
$4,858 |
6.9× |
| CT chest w/wo contrast (71270) |
$2,547.50 |
$5,095 |
14.5× |
| CT chest with contrast (71260) |
$2,252.50 |
$4,505 |
12.8× |
| CT head/brain with contrast (70460) |
$2,057.50 |
$4,115 |
11.7× |
| CT head/brain without and with contrast (70470) |
$2,325.50 |
$4,651 |
13.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,130 |
$2,260 |
3.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$129 |
$258 |
1.5× |
| CT hrt w/3d image congen (75573) |
$1,130 |
$2,260 |
3.2× |
| CT iac w contrast (70481) |
$2,049.50 |
$4,099 |
11.6× |
| CT limited/localized follow up study (76380) |
$1,422.50 |
$2,845 |
16.3× |
| CT lower ext w/o (73700) |
$1,819.50 |
$3,639 |
17.3× |
| CT lower extremity w wo contrast (73702) |
$2,365 |
$4,730 |
13.4× |
| CT lower extremity with contrast (73701) |
$2,092.50 |
$4,185 |
11.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,943 |
$5,886 |
16.7× |
| CT lumbar spine w/o contrast (72131) |
$2,263 |
$4,526 |
21.5× |
| CT lumbar spine with contrast (72132) |
$2,602 |
$5,204 |
7.4× |
| CT maxillofacial w contrast (70487) |
$1,952.50 |
$3,905 |
11.1× |
| CT maxillofacial w/o contrast (70486) |
$1,698.50 |
$3,397 |
16.2× |
| CT maxillofacial w/wo contrast (70488) |
$2,208 |
$4,416 |
12.5× |
| CT neck soft tissue w contrast (70491) |
$2,257 |
$4,514 |
12.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,316.50 |
$4,633 |
13.1× |
| CT orbits w/o contrast (70480) |
$1,782 |
$3,564 |
17.0× |
| CT pelvis w & w/o contrast (72194) |
$2,545 |
$5,090 |
14.4× |
| CT pelvis w/o contrast (72192) |
$1,958 |
$3,916 |
18.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,552 |
$5,104 |
14.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,962.50 |
$3,925 |
18.7× |
| CT thoracic spine w/contrast (72129) |
$2,577 |
$5,154 |
14.6× |
| CT thoracic spine w/o contrast (72128) |
$2,240.50 |
$4,481 |
21.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,912.50 |
$5,825 |
16.5× |
| CT thorax w/o contrast (71250) |
$1,959.50 |
$3,919 |
18.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,177 |
$4,354 |
12.4× |
| CT upper extremity w/o contrast rt (73200) |
$1,675 |
$3,350 |
15.9× |
| CT upper extremity with contrast (73201) |
$1,925.50 |
$3,851 |
5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,431 |
$4,862 |
13.8× |
| Cta Abdomen (74175) |
$3,111.50 |
$6,223 |
17.7× |
| CTA abdomen pelvis (74174) |
$4,607.50 |
$9,215 |
13.1× |
| CTA chest (71275) |
$2,835.50 |
$5,671 |
16.1× |
| Cta Head (70496) |
$2,824.50 |
$5,649 |
16.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,783 |
$3,566 |
5.1× |
| CTA lwr ext w&w/o contrast (73706) |
$3,210 |
$6,420 |
18.2× |
| Cta Neck (70498) |
$2,883 |
$5,766 |
16.4× |
| Cta Pelvis (72191) |
$2,808.50 |
$5,617 |
15.9× |
| Cystography minimum 3 views rs&i (74430) |
$536 |
$1,072 |
1.5× |
| Dacryocystography (70170) |
$181 |
$362 |
0.8× |
| Diskogram cervical (72285) |
$1,718 |
$3,436 |
0.9× |
| Diskography lumbar (72295) |
$1,718 |
$3,436 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$757 |
$1,514 |
7.2× |
| Echoencephalography real time imaging (76506) |
$715.50 |
$1,431 |
6.8× |
| Esophagus (74220) |
$442.50 |
$885 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$754 |
$1,508 |
7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$426.50 |
$853 |
4.1× |
| Fluoroscopy up to 1 hr (76000) |
$216.50 |
$433 |
0.9× |
| Foot 2 views (73620) |
$243 |
$486 |
2.8× |
| Forearm 2 views (73090) |
$324 |
$648 |
3.7× |
| Gated Heart Planar Single (78472) |
$914 |
$1,828 |
2.3× |
| Hand 2 views (73120) |
$277 |
$554 |
2.6× |
| Hand 3 views (73130) |
$283.50 |
$567 |
3.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,759 |
$5,518 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,759 |
$5,518 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,754 |
$5,508 |
3.9× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$2,754 |
$5,508 |
7.1× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$2,754 |
$5,508 |
7.1× |
| Heart Infarct Image (78466) |
$980 |
$1,960 |
2.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,083 |
$6,166 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,162.50 |
$2,325 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,162.50 |
$2,325 |
2.9× |
| Ht muscle image spect sing (78451) |
$3,524.50 |
$7,049 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$283.50 |
$567 |
3.2× |
| Hysterosalpingogram (74740) |
$673 |
$1,346 |
2.8× |
| Interstitial radiation source applic complex (77778) |
$867 |
$1,734 |
1.2× |
| Kidney funcj study non-img radioisotopic study (78725) |
$863 |
$1,726 |
2.1× |
| Kidney imaging morphology (78700) |
$602.50 |
$1,205 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$920 |
$1,840 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,098 |
$2,196 |
2.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,047 |
$2,094 |
1.9× |
| Knee 3 views (73562) |
$204 |
$408 |
2.3× |
| Liver & spleen imaging static only (78215) |
$892.50 |
$1,785 |
2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,200.50 |
$2,401 |
3.0× |
| Liver imaging static only (78201) |
$1,391.50 |
$2,783 |
2.6× |
| Lung perf&ventilat diferentl (78598) |
$1,890 |
$3,780 |
3.5× |
| Lung perfusion differential (78597) |
$824.50 |
$1,649 |
2.1× |
| Lung Ventilation Imaging (78579) |
$1,108 |
$2,216 |
2.8× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,516.50 |
$5,033 |
0.8× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$800.50 |
$1,601 |
1.3× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$946 |
$1,892 |
0.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$849 |
$1,698 |
0.3× |
| Lymphoscintigraphy (78195) |
$2,071.50 |
$4,143 |
3.8× |
| Mammary ductogram or galactogram single (77053) |
$534 |
$1,068 |
2.2× |
| Meckels Diverticulum (78290) |
$888.50 |
$1,777 |
2.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,679.50 |
$7,359 |
9.8× |
| Mr elastography (76391) |
$604 |
$1,208 |
2.5× |
| Mr safety determination physician/other qhp (76016) |
$81 |
$162 |
0.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$22.50 |
$45 |
0.8× |
| MRA head w & w/o contrast (70546) |
$2,644 |
$5,288 |
7.5× |
| MRA head w/o contrast (70544) |
$1,977.50 |
$3,955 |
8.3× |
| MRA head with contrast (70545) |
$2,273.50 |
$4,547 |
6.5× |
| MRA neck w contrast (70548) |
$2,338.50 |
$4,677 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,644 |
$5,288 |
7.5× |
| MRA neck w/o contrast (70547) |
$2,034 |
$4,068 |
8.5× |
| MRI abdomen w contrast (74182) |
$2,625 |
$5,250 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,967 |
$5,934 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$2,282.50 |
$4,565 |
9.5× |
| MRI any jnt lwr ext with con lt (73722) |
$2,805.50 |
$5,611 |
3.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,751.50 |
$5,503 |
3.5× |
| MRI breast w/o contrast bilateral (77047) |
$1,880 |
$3,760 |
7.8× |
| MRI breast w/o contrast unilat (77046) |
$1,880 |
$3,760 |
7.8× |
| MRI c-spine with contrast (72142) |
$2,783 |
$5,566 |
7.9× |
| MRI cardiac w/o cont stress (75559) |
$1,436.50 |
$2,873 |
2.6× |
| MRI cardiac w/o contrast (75557) |
$1,880 |
$3,760 |
7.8× |
| MRI cervical spine w/o contrast (72141) |
$2,419 |
$4,838 |
10.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,723.50 |
$5,447 |
7.8× |
| MRI chest w/o contrast (71550) |
$2,095 |
$4,190 |
8.7× |
| MRI chest with contrast (71551) |
$2,408.50 |
$4,817 |
3.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,192 |
$4,384 |
6.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,645.50 |
$5,291 |
7.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,300.50 |
$4,601 |
9.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,091 |
$4,182 |
8.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,717.50 |
$5,435 |
7.8× |
| MRI orbit/face/neck w/contrast (70542) |
$2,404 |
$4,808 |
6.9× |
| MRI pelvis w contrast (72196) |
$2,337.50 |
$4,675 |
6.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,642 |
$5,284 |
7.5× |
| MRI pelvis w/o contrast (72195) |
$2,032.50 |
$4,065 |
8.5× |
| MRI scan of arm joint before and after contrast (73223) |
$3,110 |
$6,220 |
8.9× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,193 |
$4,386 |
2.8× |
| MRI scan of leg joint before and after contrast (73723) |
$3,171.50 |
$6,343 |
9.0× |
| MRI spectroscopy (76390) |
$1,880 |
$3,760 |
21.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,146 |
$6,292 |
9.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,824 |
$5,648 |
8.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,191.50 |
$6,383 |
9.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,652.50 |
$5,305 |
7.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,998 |
$5,996 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,307 |
$4,614 |
9.6× |
| MRI tmj (70336) |
$1,890 |
$3,780 |
7.9× |
| MRI upper ext joint w/o contrast (73221) |
$2,392 |
$4,784 |
10.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,478.50 |
$4,957 |
7.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,906 |
$3,812 |
8.0× |
| Myocardial infarct spect (78469) |
$930.50 |
$1,861 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$4,548.50 |
$9,097 |
3.5× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$983.50 |
$1,967 |
1.1× |
| Neck soft tissue (70360) |
$187 |
$374 |
2.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$2,071.50 |
$4,143 |
5.2× |
| Nm bone marrow wb (78104) |
$703 |
$1,406 |
1.8× |
| Nm cisternogram (78630) |
$878 |
$1,756 |
1.6× |
| Nm csf leak detection (78650) |
$850 |
$1,700 |
0.7× |
| Nm gastric emptying study (78264) |
$888.50 |
$1,777 |
2.2× |
| Nm peritoneal-venous shunt patency (78291) |
$703 |
$1,406 |
1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,117 |
$10,234 |
3.7× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,680 |
$3,360 |
1.2× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,680 |
$3,360 |
1.2× |
| Nuclear medicine study of kidney and blood flow (78701) |
$657.50 |
$1,315 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$1,672.50 |
$3,345 |
7.1× |
| Nuclr Rx Interstit Colloid (79300) |
$1,669 |
$3,338 |
7.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$363 |
$726 |
3.5× |
| Osseous survey infant (77076) |
$629.50 |
$1,259 |
6.0× |
| Osseous survey limited (77074) |
$1,203.50 |
$2,407 |
11.5× |
| Parathyrd planar w/spect&CT (78072) |
$1,317.50 |
$2,635 |
2.4× |
| Parathyrd planar w/wo subtrj (78071) |
$2,100 |
$4,200 |
5.2× |
| Parathyroid imaging (78070) |
$1,400.50 |
$2,801 |
3.5× |
| Pelvis 1 or 2 views (72170) |
$334 |
$668 |
3.2× |
| Peritoneogram rs&i (74190) |
$600.50 |
$1,201 |
1.1× |
| PET image w/CT, skull-thigh (78815) |
$7,898 |
$15,796 |
5.5× |
| PET imaging CT for attenuation limited area (78814) |
$1,410 |
$2,820 |
1.0× |
| PET imaging for CT attenuation whole body (78816) |
$7,898 |
$15,796 |
5.5× |
| Pr csf ventriculography (78635) |
$877 |
$1,754 |
1.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,753.50 |
$5,507 |
7.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,895 |
$3,790 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,895 |
$3,790 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$825.50 |
$1,651 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,932 |
$3,864 |
3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$442.50 |
$885 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$251 |
$502 |
2.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$467 |
$934 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$501.50 |
$1,003 |
4.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$524.50 |
$1,049 |
5.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$706 |
$1,412 |
6.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,659 |
$23,318 |
1.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$3,679.50 |
$7,359 |
6.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$775 |
$1,550 |
7.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,052.50 |
$2,105 |
2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$364 |
$728 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$303.50 |
$607 |
3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$478.50 |
$957 |
4.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$324.50 |
$649 |
3.7× |
| Radiologic exam colon single contrast study (74270) |
$588.50 |
$1,177 |
3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$442.50 |
$885 |
2.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$707.50 |
$1,415 |
4.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$707.50 |
$1,415 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$355.50 |
$711 |
4.1× |
| Radiological examination surgical specimen (76098) |
$434.50 |
$869 |
0.8× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$1,669 |
$3,338 |
7.1× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$1,669 |
$3,338 |
7.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,749.50 |
$3,499 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,468.50 |
$6,937 |
1.1× |
| Ribs bilateral 3 views (71110) |
$493.50 |
$987 |
4.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$816 |
$1,632 |
2.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,717.50 |
$3,435 |
3.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,717.50 |
$3,435 |
3.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,717.50 |
$3,435 |
1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,831.50 |
$3,663 |
1.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,717.50 |
$3,435 |
1.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,565 |
$3,130 |
6.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,908 |
$3,816 |
8.1× |
| Rp Therapy Intravenous Administration (79101) |
$1,672.50 |
$3,345 |
7.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$705.50 |
$1,411 |
2.9× |
| Salivary gland function study (78232) |
$780 |
$1,560 |
1.9× |
| Scanogram (77073) |
$491 |
$982 |
4.7× |
| Scapula complete (73010) |
$263.50 |
$527 |
2.5× |
| Screening digital breast tomosynthesis (77063) |
$135 |
$270 |
5.8× |
| Sella turcica (70240) |
$501.50 |
$1,003 |
5.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$235 |
$470 |
2.2× |
| Sialogram (70390) |
$300.50 |
$601 |
1.3× |
| Small bowel series (74250) |
$584 |
$1,168 |
3.3× |
| Spec medical radj physics consltj (77370) |
$812.50 |
$1,625 |
6.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,166 |
$2,332 |
3.1× |
| Special dosimetry (77331) |
$346.50 |
$693 |
2.6× |
| Special treatment procedure (77470) |
$2,966 |
$5,932 |
5.3× |
| Spine thoracic 3 views (72072) |
$467 |
$934 |
4.4× |
| Splenoportograpy rs&i (75810) |
$1,749.50 |
$3,499 |
0.6× |
| Stereotactic body radiation delivery (77373) |
$2,921 |
$5,842 |
1.6× |
| Superior sagittal sinus venogram (75870) |
$1,749.50 |
$3,499 |
0.6× |
| Tbs Technical Calculation Only (77091) |
$89.50 |
$179 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,335.50 |
$4,671 |
6.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,606.50 |
$3,213 |
4.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$452 |
$904 |
1.9× |
| Testicular Imaging With Vascular Flow (78761) |
$837.50 |
$1,675 |
2.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,679.50 |
$7,359 |
9.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$3,679.50 |
$7,359 |
27.3× |
| Therapeutic Enema (74283) |
$981.50 |
$1,963 |
5.6× |
| Thoracolumbar 2 views (72080) |
$373 |
$746 |
4.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$816 |
$1,632 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$816 |
$1,632 |
2.0× |
| Thyroid uptake measurement (78012) |
$816 |
$1,632 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$816 |
$1,632 |
2.0× |
| Treatment device intermediate (77333) |
$1,226.50 |
$2,453 |
9.1× |
| Treatment devices simple (77332) |
$820 |
$1,640 |
6.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,632.50 |
$3,265 |
3.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,181.50 |
$2,363 |
2.9× |
| Tx devices design & construction complex (77334) |
$3,679.50 |
$7,359 |
9.8× |
| Ultrasound, abdomen limited (76705) |
$506.50 |
$1,013 |
4.8× |
| Umbilical-artery Doppler (OB) (76820) |
$357 |
$714 |
3.4× |
| Upper Extremity Infant (73092) |
$324 |
$648 |
3.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$475.50 |
$951 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$442.50 |
$885 |
1.8× |
| Urethrocystography voiding (74455) |
$547.50 |
$1,095 |
2.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$756.50 |
$1,513 |
4.3× |
| Us abdl aorta screen aaa (76706) |
$506.50 |
$1,013 |
4.8× |
| Us breast unilateral complete (76641) |
$388.50 |
$777 |
3.7× |
| Us breast unilateral limited (76642) |
$234.25 |
$468.50 |
2.7× |
| Us chest (76604) |
$188 |
$376 |
1.8× |
| Us elastography parenchyma (76981) |
$387 |
$774 |
3.7× |
| Us guided compression repair (76936) |
$825 |
$1,650 |
3.8× |
| Us infant hips dynamic (76885) |
$406 |
$812 |
4.6× |
| Us infant hips limited static (76886) |
$364 |
$728 |
4.2× |
| Us kidney transplant (76776) |
$595.50 |
$1,191 |
5.7× |
| Us ob detailed single fetus (76811) |
$1,023 |
$2,046 |
4.3× |
| Us ob transvaginal (76817) |
$414.50 |
$829 |
3.9× |
| Us pelvic non ob complete (76856) |
$629.50 |
$1,259 |
6.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$330.50 |
$661 |
3.1× |
| Us pregnancy ltd (76815) |
$478.50 |
$957 |
4.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$531.50 |
$1,063 |
5.1× |
| Us retroperitoneal complete (76770) |
$708 |
$1,416 |
6.7× |
| Us retroperitoneal limited (76775) |
$549.50 |
$1,099 |
5.2× |
| Us scrotum and contents (76870) |
$573.50 |
$1,147 |
5.5× |
| Us soft tissue head/neck (76536) |
$497 |
$994 |
4.7× |
| Us spinal canal and contents (76800) |
$463 |
$926 |
4.4× |
| Us transrectal (76872) |
$661.50 |
$1,323 |
6.3× |
| Us xtr non-vasc lmtd (76882) |
$506.50 |
$1,013 |
4.8× |
| Us, eye b-scan (76512) |
$145.50 |
$291 |
1.4× |
| Venogram extremity bilateral (75822) |
$1,441.50 |
$2,883 |
0.9× |
| Venogram orbital (75880) |
$629.50 |
$1,259 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,066 |
$6,132 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,749.50 |
$3,499 |
1.1× |
| Venography epidural rs&i (75872) |
$1,746.50 |
$3,493 |
2.8× |
| Venography extremity unilateral rs&i (75820) |
$1,163 |
$2,326 |
0.7× |
| Venography Renal Bilateral (75833) |
$1,917 |
$3,834 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$2,583.50 |
$5,167 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,810.50 |
$3,621 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,738.50 |
$7,477 |
0.7× |
| Wrist 2 views (73100) |
$318.50 |
$637 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$478.50 |
$957 |
4.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$351.50 |
$703 |
4.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$377.50 |
$755 |
4.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$814 |
$1,628 |
4.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$324 |
$648 |
3.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$154.50 |
$309 |
1.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$531 |
$1,062 |
5.1× |
| X-ray exam hip uni 1 view (73501) |
$250.50 |
$501 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$418 |
$836 |
4.8× |
| X-ray exam hip uni 4/> views (73503) |
$574 |
$1,148 |
5.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$574 |
$1,148 |
5.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$752 |
$1,504 |
7.2× |
| X-ray exam of femur 1 (73551) |
$251 |
$502 |
2.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$584 |
$1,168 |
3.3× |
| X-ray eye for foreign body (70030) |
$293.50 |
$587 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$442 |
$884 |
4.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$353 |
$706 |
4.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$324 |
$648 |
3.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$730 |
$1,460 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$258.50 |
$517 |
3.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$242.50 |
$485 |
2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$204 |
$408 |
2.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$410 |
$820 |
4.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$420 |
$840 |
4.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$428.50 |
$857 |
4.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$467 |
$934 |
4.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$283.50 |
$567 |
3.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$60.50 |
$121 |
0.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$442 |
$884 |
4.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$574 |
$1,148 |
5.5× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$534.50 |
$1,069 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$505 |
$1,010 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$334.50 |
$669 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$300.50 |
$601 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$589.50 |
$1,179 |
5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$353 |
$706 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$353 |
$706 |
4.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$339.50 |
$679 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$422 |
$844 |
4.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$263 |
$526 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$547.50 |
$1,095 |
5.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$501.50 |
$1,003 |
4.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$251 |
$502 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$347.50 |
$695 |
4.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$334.50 |
$669 |
3.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$373 |
$746 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$258.50 |
$517 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$311 |
$622 |
3.6× |
| Xr arthrogram ankle (73615) |
$452 |
$904 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$1,080 |
$2,160 |
10.3× |
| Xr chest 4+ views (71048) |
$373 |
$746 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$214 |
$428 |
2.4× |
| Xr shoulder 1 view (73020) |
$324 |
$648 |
3.7× |
| Xr spine cervical 4 or 5 views (72050) |
$706 |
$1,412 |
6.7× |
| Xr tibia/fibula 2 views (73590) |
$410 |
$820 |
4.7× |
| Xr tmj bilateral (70330) |
$442 |
$884 |
5.1× |
| Xray knee 1 or 2 views rt (73560) |
$135 |
$270 |
1.5× |