| Abdomen 2 views (74019) |
$104 |
$803.32 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$399 |
$1,818.40 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,156 |
$13,207.60 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,156 |
$13,207.60 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,156 |
$10,566.08 |
1.0× |
| Angiography internal mammary rs&i (75756) |
$3,156 |
$13,207.60 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,562 |
$21,882.60 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,156 |
$13,207.60 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,156 |
$13,207.60 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$5,562 |
$21,882.60 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,562 |
$21,882.60 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,156 |
$5,468.15 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,156 |
$7,172.34 |
1.0× |
| Ankle 2 views (73600) |
$86 |
$547.45 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$348 |
$1,929.40 |
1.0× |
| Aortogram thoracic (75605) |
$5,562 |
$21,882.60 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,156 |
$14,619.25 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,156 |
$13,630.55 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,156 |
$13,207.60 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$3,156 |
$5,468.15 |
1.0× |
| Arthrogram hip (73525) |
$348 |
$1,929.40 |
1.0× |
| Arthrogram shoulder (73040) |
$348 |
$1,929.40 |
1.0× |
| Arthrography knee lt (73580) |
$348 |
$1,929.40 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$134 |
$618.85 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$399 |
$1,818.40 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$399 |
$2,319.51 |
1.0× |
| Bone age studies (77072) |
$104 |
$803.32 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$399 |
$3,000.84 |
1.0× |
| Bone survey complete (77075) |
$104 |
$1,332.39 |
1.0× |
| Brain image w/flow 4 + views (78606) |
$542 |
$2,493.48 |
1.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$399 |
$1,767.45 |
1.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$542 |
$2,277.60 |
1.0× |
| Brain Imaging Vascular Flow Only (78610) |
$542 |
$2,277.60 |
1.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$399 |
$1,767.45 |
1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$542 |
$2,277.60 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$86 |
$851.08 |
1.0× |
| Chest 1 view (71045) |
$86 |
$544.20 |
1.0× |
| Chest 3 views (71047) |
$86 |
$311.50 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$175 |
$975.04 |
1.0× |
| Clavicle complete (73000) |
$86 |
$756.84 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$134 |
$548.92 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$348 |
$11,801.50 |
1.0× |
| CT abdomen and pelvis without contrast (74176) |
$238 |
$7,864.92 |
1.0× |
| CT abdomen w contrast (74160) |
$175 |
$3,807.22 |
1.0× |
| CT abdomen w wo contrast (74170) |
$175 |
$5,330.11 |
1.0× |
| CT abdomen w/o contrast (74150) |
$104 |
$3,527.96 |
1.0× |
| CT angio hrt w/3d image (75574) |
$348 |
$6,092 |
1.0× |
| CT angiography upper extremity lt (73206) |
$175 |
$1,683.95 |
1.0× |
| CT c-spine w/o contrast (72125) |
$104 |
$3,461.36 |
1.0× |
| CT cervical spine w&w/o contrast (72127) |
$175 |
$2,926 |
1.0× |
| CT cervical spine with contrast (72126) |
$348 |
$3,546.80 |
1.0× |
| CT chest w/wo contrast (71270) |
$175 |
$4,210.32 |
1.0× |
| CT chest with contrast (71260) |
$175 |
$4,558.29 |
1.0× |
| CT head/brain with contrast (70460) |
$175 |
$1,983.91 |
1.0× |
| CT head/brain without and with contrast (70470) |
$175 |
$4,786.21 |
1.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$348 |
$2,478 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$86 |
$557.82 |
1.0× |
| CT iac w contrast (70481) |
$175 |
$1,804.04 |
1.0× |
| CT limited/localized follow up study (76380) |
$86 |
$396.37 |
1.0× |
| CT lower ext w/o (73700) |
$104 |
$2,557.91 |
1.0× |
| CT lower extremity w wo contrast (73702) |
$175 |
$2,635.68 |
1.0× |
| CT lower extremity with contrast (73701) |
$175 |
$3,853.56 |
1.0× |
| CT lumbar spine w & w/o contrast (72133) |
$175 |
$3,796.95 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$104 |
$3,884.95 |
1.0× |
| CT lumbar spine with contrast (72132) |
$348 |
$3,881.88 |
1.0× |
| CT maxillofacial w contrast (70487) |
$175 |
$3,158.53 |
1.0× |
| CT maxillofacial w/o contrast (70486) |
$104 |
$3,693.27 |
1.0× |
| CT maxillofacial w/wo contrast (70488) |
$175 |
$2,963.10 |
1.0× |
| CT neck soft tissue w contrast (70491) |
$175 |
$3,273.90 |
1.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$175 |
$3,121.67 |
1.0× |
| CT orbits w/o contrast (70480) |
$104 |
$2,785.62 |
1.0× |
| CT pelvis w & w/o contrast (72194) |
$175 |
$5,223.05 |
1.0× |
| CT pelvis w/o contrast (72192) |
$104 |
$3,367.59 |
1.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$175 |
$4,204.17 |
1.0× |
| CT soft tissue neck w/o contrast (70490) |
$104 |
$3,637.34 |
1.0× |
| CT thoracic spine w/contrast (72129) |
$175 |
$4,845 |
1.0× |
| CT thoracic spine w/o contrast (72128) |
$104 |
$3,121.67 |
1.0× |
| CT thoracic spine w/wo contrast (72130) |
$175 |
$3,548.58 |
1.0× |
| CT thorax w/o contrast (71250) |
$104 |
$3,644.50 |
1.0× |
| CT unlisted procedure (76497) |
$86 |
$311.50 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$175 |
$1,709.49 |
1.0× |
| CT upper extremity w/o contrast rt (73200) |
$104 |
$2,266.31 |
1.0× |
| CT upper extremity with contrast (73201) |
$348 |
$1,967.99 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$175 |
$3,946.22 |
1.0× |
| Cta Abdomen (74175) |
$175 |
$4,034.10 |
1.0× |
| CTA abdomen pelvis (74174) |
$348 |
$1,947.44 |
1.0× |
| CTA chest (71275) |
$175 |
$3,100.18 |
1.0× |
| Cta Head (70496) |
$175 |
$3,771.75 |
1.0× |
| CTA lwr ext w&w/o contrast (73706) |
$175 |
$2,426.58 |
1.0× |
| Cta Neck (70498) |
$175 |
$2,601.90 |
1.0× |
| Cta Pelvis (72191) |
$175 |
$2,004.71 |
1.0× |
| Cystography minimum 3 views rs&i (74430) |
$348 |
$1,812.48 |
1.0× |
| Diskogram cervical (72285) |
$1,952 |
$8,157.40 |
1.0× |
| Diskography lumbar (72295) |
$1,952 |
$8,157.40 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$104 |
$562.55 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$104 |
$562.55 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$86 |
$353.39 |
1.0× |
| Dxa bone density study axial skeleton (77085) |
$104 |
$534.23 |
1.0× |
| Echo exam of fetal heart (76825) |
$546 |
$2,487.45 |
1.0× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$238 |
$1,152.80 |
1.0× |
| Echoencephalography real time imaging (76506) |
$104 |
$997.05 |
1.0× |
| Esophageal motility (78258) |
$399 |
$1,767.45 |
1.0× |
| Esophagus (74220) |
$175 |
$810.05 |
1.0× |
| Fetal biophysical profile non-stress testing (76818) |
$104 |
$1,181.95 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$104 |
$787.57 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$238 |
$1,080.35 |
1.0× |
| Foot 2 views (73620) |
$86 |
$580.62 |
1.0× |
| Forearm 2 views (73090) |
$86 |
$675.78 |
1.0× |
| Gastric mucosa imaging (78261) |
$399 |
$1,767.45 |
1.0× |
| Gated Heart Planar Single (78472) |
$399 |
$1,767.45 |
1.0× |
| Hand 2 views (73120) |
$104 |
$585.04 |
1.0× |
| Hand 3 views (73130) |
$86 |
$581.58 |
1.0× |
| Heart Infarct Image (78466) |
$399 |
$1,767.45 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,156 |
$13,207.60 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$542 |
$3,252.41 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$399 |
$2,547.20 |
1.0× |
| Ht muscle image spect sing (78451) |
$1,294 |
$6,260.50 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$86 |
$739.83 |
1.0× |
| Hysterosalpingogram (74740) |
$238 |
$1,182.96 |
1.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$696 |
$3,523.60 |
1.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$552 |
$2,599.25 |
1.0× |
| Intracavitary radiation source applic simple (77761) |
$552 |
$2,599.25 |
1.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$104 |
$562.55 |
1.0× |
| Kidney imaging morphology (78700) |
$399 |
$1,767.45 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$542 |
$2,277.60 |
1.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$542 |
$1,433.15 |
1.0× |
| Knee 3 views (73562) |
$86 |
$830.41 |
1.0× |
| Liver & spleen imaging static only (78215) |
$399 |
$1,914.52 |
1.0× |
| Lung Ventilation Imaging (78579) |
$399 |
$1,767.45 |
1.0× |
| Lymphoscintigraphy (78195) |
$542 |
$2,383.05 |
1.0× |
| Mammary ductogram or galactogram multiple (77054) |
$238 |
$1,152.80 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$238 |
$1,152.80 |
1.0× |
| Meckels Diverticulum (78290) |
$399 |
$1,767.45 |
1.0× |
| MRA head w & w/o contrast (70546) |
$348 |
$2,941.17 |
1.0× |
| MRA head w/o contrast (70544) |
$238 |
$4,391.03 |
1.0× |
| MRA head with contrast (70545) |
$348 |
$1,695.55 |
1.0× |
| MRA neck w contrast (70548) |
$348 |
$3,214.88 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$348 |
$5,034.67 |
1.0× |
| MRA neck w/o contrast (70547) |
$238 |
$3,864.32 |
1.0× |
| MRI abdomen w contrast (74182) |
$348 |
$1,929.40 |
1.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$348 |
$7,946.90 |
1.0× |
| MRI abdomen w/o contrast (74181) |
$238 |
$4,054.50 |
1.0× |
| MRI any jnt lwr ext with con lt (73722) |
$783 |
$3,458.75 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$783 |
$3,458.75 |
1.0× |
| MRI bone marrow blood supply (77084) |
$238 |
$1,152.80 |
1.0× |
| MRI breast w/o contrast bilateral (77047) |
$238 |
$4,108.30 |
1.0× |
| MRI breast w/o contrast unilat (77046) |
$238 |
$1,152.80 |
1.0× |
| MRI c-spine with contrast (72142) |
$348 |
$2,869.70 |
1.0× |
| MRI cervical spine w/o contrast (72141) |
$238 |
$6,381.67 |
1.0× |
| MRI chest w/o & w/contrast material (71552) |
$348 |
$4,995.13 |
1.0× |
| MRI chest w/o contrast (71550) |
$238 |
$3,802 |
1.0× |
| MRI chest with contrast (71551) |
$783 |
$3,458.75 |
1.0× |
| MRI fetal sngl/1st gestation (74712) |
$238 |
$1,152.80 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$348 |
$1,929.40 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$348 |
$1,202.22 |
1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$238 |
$5,090.27 |
1.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$238 |
$4,837.86 |
1.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$348 |
$4,678.82 |
1.0× |
| MRI pelvis w contrast (72196) |
$348 |
$1,198.50 |
1.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$348 |
$6,515.48 |
1.0× |
| MRI pelvis w/o contrast (72195) |
$238 |
$4,314.32 |
1.0× |
| MRI scan of arm joint before and after contrast (73223) |
$348 |
$3,342.36 |
1.0× |
| MRI scan of leg joint before and after contrast (73723) |
$348 |
$5,319.70 |
1.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$348 |
$6,590.08 |
1.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$348 |
$4,999.62 |
1.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$348 |
$6,956.82 |
1.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$348 |
$2,021.23 |
1.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$348 |
$6,158.01 |
1.0× |
| MRI thoracic spine w/o contrast (72146) |
$238 |
$5,016.90 |
1.0× |
| MRI tmj (70336) |
$238 |
$3,382.19 |
1.0× |
| MRI upper ext joint w/o contrast (73221) |
$238 |
$4,579.97 |
1.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$348 |
$5,768.52 |
1.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$238 |
$4,186.89 |
1.0× |
| Myelogram Cervical (72240) |
$783 |
$3,458.75 |
1.0× |
| Myelogram Lumbar (72265) |
$783 |
$2,613.34 |
1.0× |
| Myelogram thoracic (72255) |
$783 |
$3,458.75 |
1.0× |
| Myelography 2 or more regions (72270) |
$783 |
$3,458.75 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,294 |
$7,569.36 |
1.0× |
| Neck soft tissue (70360) |
$86 |
$672.38 |
1.0× |
| Nm cisternogram (78630) |
$542 |
$2,277.60 |
1.0× |
| Nm gastric emptying study (78264) |
$399 |
$2,681.07 |
1.0× |
| Nm gastroesophageal reflux study (78262) |
$399 |
$1,767.45 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$399 |
$1,767.45 |
1.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,294 |
$6,146.90 |
1.0× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$542 |
$1,455.41 |
1.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,294 |
$6,146.90 |
1.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$399 |
$1,792.92 |
1.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$399 |
$1,767.45 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$399 |
$1,767.45 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$542 |
$6,146.90 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$233 |
$1,154.45 |
1.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$104 |
$805.83 |
1.0× |
| Osseous survey infant (77076) |
$104 |
$803.32 |
1.0× |
| Osseous survey limited (77074) |
$104 |
$573.80 |
1.0× |
| Parathyroid imaging (78070) |
$399 |
$1,980.84 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$104 |
$689 |
1.0× |
| Perineogram (74775) |
$238 |
$1,152.80 |
1.0× |
| Peritoneogram rs&i (74190) |
$546 |
$2,487.45 |
1.0× |
| Pr heart first pass single,planar (78481) |
$542 |
$2,277.60 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$348 |
$6,846.15 |
1.0× |
| Pr sono bone density measure,peripheral (76977) |
$104 |
$562.55 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,156 |
$13,207.60 |
1.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,156 |
$5,468.15 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$399 |
$1,818.40 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$542 |
$3,245.47 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$546 |
$2,487.45 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$86 |
$783.71 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$104 |
$682.94 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$104 |
$803.32 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$104 |
$562.55 |
1.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$552 |
$1,122.30 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$104 |
$1,027.72 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$86 |
$720.92 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$86 |
$582.60 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$175 |
$1,440.42 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$175 |
$911.10 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$175 |
$1,008.70 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$175 |
$1,440.42 |
1.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$86 |
$575.65 |
1.0× |
| Radiological examination surgical specimen (76098) |
$546 |
$1,989.96 |
1.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,156 |
$13,207.60 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,156 |
$13,207.60 |
1.0× |
| Ribs bilateral 3 views (71110) |
$104 |
$1,098.75 |
1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$399 |
$1,818.40 |
1.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$542 |
$6,146.90 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$542 |
$2,277.60 |
1.0× |
| Scanogram (77073) |
$104 |
$803.32 |
1.0× |
| Scapula complete (73010) |
$104 |
$803.32 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$22 |
$103.99 |
0.9× |
| Sella turcica (70240) |
$86 |
$200.48 |
1.0× |
| Sialogram (70390) |
$238 |
$1,152.80 |
1.0× |
| Simulation intermediate (77285) |
$374 |
$1,609.10 |
1.0× |
| Small bowel series (74250) |
$175 |
$810.05 |
1.0× |
| Special dosimetry (77331) |
$134 |
$618.85 |
1.0× |
| Spine thoracic 3 views (72072) |
$104 |
$803.32 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$3,156 |
$5,468.15 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$374 |
$1,609.10 |
1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$374 |
$1,609.10 |
1.0× |
| Testicular Imaging With Vascular Flow (78761) |
$399 |
$1,767.45 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$374 |
$1,609.10 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$134 |
$618.85 |
1.0× |
| Thoracolumbar 2 views (72080) |
$86 |
$646.65 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$542 |
$2,277.60 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$399 |
$2,049 |
1.0× |
| Thyroid uptake measurement (78012) |
$399 |
$2,474.43 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$399 |
$2,474.43 |
1.0× |
| Tmj unilateral (70328) |
$86 |
$400.60 |
1.0× |
| Tomogram (76100) |
$104 |
$562.55 |
1.0× |
| Treatment device intermediate (77333) |
$134 |
$618.85 |
1.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$542 |
$6,260.50 |
1.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$399 |
$1,767.45 |
1.0× |
| Tx devices design & construction complex (77334) |
$374 |
$1,609.10 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$104 |
$1,127.63 |
1.0× |
| Umbilical-artery Doppler (OB) (76820) |
$104 |
$803.32 |
1.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$86 |
$224.93 |
1.0× |
| Unlisted magnetic resonance procedure (76498) |
$86 |
$721.59 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$86 |
$1,116.89 |
1.0× |
| Upper Extremity Infant (73092) |
$104 |
$787.57 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$238 |
$1,274.03 |
1.0× |
| Urethrocystography voiding (74455) |
$238 |
$1,646.20 |
1.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$175 |
$1,008.70 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$104 |
$484.70 |
1.0× |
| Us breast unilateral complete (76641) |
$104 |
$1,020.85 |
1.0× |
| Us breast unilateral limited (76642) |
$86 |
$706.86 |
1.0× |
| Us chest (76604) |
$104 |
$803.32 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$104 |
$835.86 |
1.0× |
| Us guided compression repair (76936) |
$215 |
$1,261.55 |
1.0× |
| Us infant hips dynamic (76885) |
$86 |
$953.70 |
1.0× |
| Us infant hips limited static (76886) |
$86 |
$885.36 |
1.0× |
| Us ob transvaginal (76817) |
$104 |
$791.14 |
1.0× |
| Us pelvic non ob complete (76856) |
$104 |
$1,379.18 |
1.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$104 |
$1,198.83 |
1.0× |
| Us pregnancy ltd (76815) |
$104 |
$828.40 |
1.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$104 |
$999.60 |
1.0× |
| Us retroperitoneal complete (76770) |
$104 |
$1,222.98 |
1.0× |
| Us retroperitoneal limited (76775) |
$104 |
$934.81 |
1.0× |
| Us scrotum and contents (76870) |
$104 |
$1,036.34 |
1.0× |
| Us soft tissue head/neck (76536) |
$104 |
$1,060.50 |
1.0× |
| Us spinal canal and contents (76800) |
$104 |
$929.07 |
1.0× |
| Us transrectal (76872) |
$104 |
$534.40 |
1.0× |
| Us xtr non-vasc lmtd (76882) |
$104 |
$1,307.60 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,573 |
$5,468.15 |
1.0× |
| Venogram orbital (75880) |
$627 |
$7,172.34 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,156 |
$13,207.60 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,573 |
$2,380.02 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,573 |
$3,100.05 |
1.0× |
| Venography Renal Bilateral (75833) |
$3,156 |
$13,207.60 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$3,156 |
$13,207.60 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,156 |
$7,924.56 |
1.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,562 |
$21,882.60 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$86 |
$311.50 |
1.0× |
| Wrist 2 views (73100) |
$86 |
$524.96 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$104 |
$852.51 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$86 |
$311.50 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$86 |
$739.83 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$175 |
$1,173.35 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$86 |
$522.31 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$86 |
$652.14 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$86 |
$552.67 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$86 |
$997.58 |
1.0× |
| X-ray exam of femur 1 (73551) |
$86 |
$492.66 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$104 |
$940.53 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$86 |
$534.48 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$86 |
$764.98 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,089 |
$8,698.75 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$86 |
$619.80 |
1.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$175 |
$1,659.54 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$86 |
$752.51 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$104 |
$804.81 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$86 |
$764.93 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$86 |
$315.14 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$104 |
$803.32 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$104 |
$622.04 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$104 |
$827.55 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$86 |
$715.29 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$86 |
$755.66 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$104 |
$803.32 |
1.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$104 |
$885.55 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$348 |
$1,695.55 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$86 |
$578.34 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$104 |
$890.50 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$104 |
$634.48 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$104 |
$803.32 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$86 |
$749.36 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$86 |
$855.93 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$86 |
$1,036.40 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$104 |
$902.91 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$104 |
$886.88 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$86 |
$414.39 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$86 |
$311.50 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$86 |
$659.89 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$104 |
$829.98 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$104 |
$860.84 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$86 |
$529.67 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$86 |
$704.48 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$104 |
$634.48 |
1.0× |
| Xr chest 4+ views (71048) |
$104 |
$776.45 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$86 |
$518.68 |
1.0× |
| Xr internal auditory meati complete (70134) |
$546 |
$2,487.45 |
1.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$104 |
$484.70 |
1.0× |
| Xr optic foramina (70190) |
$86 |
$311.50 |
1.0× |
| Xr shoulder 1 view (73020) |
$86 |
$746.94 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$104 |
$733.64 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$86 |
$732.32 |
1.0× |
| Xr tmj bilateral (70330) |
$86 |
$748.71 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$86 |
$728.37 |
1.0× |