| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,195.40 |
$13,659 |
5.9× |
| Abdomen 2 views (74019) |
$208.20 |
$347 |
2.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$657 |
$1,095 |
1.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,006 |
$5,010 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,184.80 |
$5,308 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,006 |
$5,010 |
1.0× |
| Angiography internal mammary rs&i (75756) |
$3,006 |
$5,010 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,200.20 |
$8,667 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,006 |
$5,010 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,949.60 |
$4,916 |
0.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,200.20 |
$8,667 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,006 |
$5,010 |
1.0× |
| Ankle 2 views (73600) |
$148.20 |
$247 |
1.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$440.40 |
$734 |
1.3× |
| Aortogram thoracic (75605) |
$5,200.20 |
$8,667 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,262.20 |
$5,437 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,006 |
$5,010 |
1.0× |
| Arthrogram elbow (73085) |
$639 |
$1,065 |
1.8× |
| Arthrogram shoulder (73040) |
$411.60 |
$686 |
1.2× |
| Arthrogram wrist (73115) |
$637.80 |
$1,063 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$995.40 |
$1,659 |
7.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$480.60 |
$801 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$1,138.20 |
$1,897 |
2.8× |
| Bone age studies (77072) |
$192 |
$320 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,174.80 |
$1,958 |
2.9× |
| Bone Marrow Imaging Limited Area (78102) |
$604.80 |
$1,008 |
1.5× |
| Bone survey complete (77075) |
$301.20 |
$502 |
2.9× |
| Brachytx isodose complex (77318) |
$1,881.60 |
$3,136 |
5.0× |
| Brachytx isodose intermed (77317) |
$1,392.60 |
$2,321 |
3.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,052.40 |
$1,754 |
2.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$582.60 |
$971 |
1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,118 |
$8,530 |
3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$773.40 |
$1,289 |
2.2× |
| Cervical spine 2 or 3 views (72040) |
$236.40 |
$394 |
2.7× |
| Chest 1 view (71045) |
$261 |
$435 |
3.0× |
| Chest 3 views (71047) |
$288 |
$480 |
3.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$305.40 |
$509 |
1.7× |
| Clavicle complete (73000) |
$151.20 |
$252 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,148.40 |
$1,914 |
11.0× |
| Continuing medical physics consltj pr wk (77336) |
$966.60 |
$1,611 |
7.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,981.40 |
$4,969 |
8.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,744.20 |
$2,907 |
7.3× |
| CT abdomen w contrast (74160) |
$885.60 |
$1,476 |
5.0× |
| CT abdomen w wo contrast (74170) |
$1,063.20 |
$1,772 |
6.1× |
| CT abdomen w/o contrast (74150) |
$811.80 |
$1,353 |
7.8× |
| CT angio hrt w/3d image (75574) |
$726.60 |
$1,211 |
2.1× |
| CT angiography upper extremity lt (73206) |
$1,174.80 |
$1,958 |
6.7× |
| CT c-spine w/o contrast (72125) |
$907.20 |
$1,512 |
8.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,765.80 |
$2,943 |
10.1× |
| CT cervical spine with contrast (72126) |
$1,029.60 |
$1,716 |
2.9× |
| CT chest w/wo contrast (71270) |
$973.80 |
$1,623 |
5.5× |
| CT chest with contrast (71260) |
$925.80 |
$1,543 |
5.3× |
| CT colonography screening (74263) |
$767.40 |
$1,279 |
3.2× |
| CT colonography w/o cntrst (74261) |
$618 |
$1,030 |
5.9× |
| CT head/brain with contrast (70460) |
$1,023 |
$1,705 |
5.8× |
| CT head/brain without and with contrast (70470) |
$1,219.20 |
$2,032 |
6.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$258 |
$430 |
0.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$102 |
$170 |
1.2× |
| CT iac w contrast (70481) |
$881.40 |
$1,469 |
5.0× |
| CT limited/localized follow up study (76380) |
$511.20 |
$852 |
5.9× |
| CT lower ext w/o (73700) |
$905.40 |
$1,509 |
8.6× |
| CT lower extremity w wo contrast (73702) |
$1,290.60 |
$2,151 |
7.3× |
| CT lower extremity with contrast (73701) |
$1,048.80 |
$1,748 |
6.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,122 |
$1,870 |
6.4× |
| CT lumbar spine w/o contrast (72131) |
$691.20 |
$1,152 |
6.6× |
| CT lumbar spine with contrast (72132) |
$912 |
$1,520 |
2.6× |
| CT maxillofacial w contrast (70487) |
$915.60 |
$1,526 |
5.2× |
| CT maxillofacial w/o contrast (70486) |
$792.60 |
$1,321 |
7.6× |
| CT maxillofacial w/wo contrast (70488) |
$1,144.80 |
$1,908 |
6.5× |
| CT neck soft tissue w contrast (70491) |
$857.40 |
$1,429 |
4.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,107 |
$1,845 |
6.3× |
| CT orbits w/o contrast (70480) |
$723.60 |
$1,206 |
6.9× |
| CT pelvis w & w/o contrast (72194) |
$1,494 |
$2,490 |
8.5× |
| CT pelvis w/o contrast (72192) |
$705 |
$1,175 |
6.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$972.60 |
$1,621 |
5.5× |
| CT soft tissue neck w/o contrast (70490) |
$757.80 |
$1,263 |
7.2× |
| CT thoracic spine w/contrast (72129) |
$923.40 |
$1,539 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$754.80 |
$1,258 |
7.2× |
| CT thoracic spine w/wo contrast (72130) |
$1,423.20 |
$2,372 |
8.1× |
| CT thorax w/o contrast (71250) |
$708.60 |
$1,181 |
6.8× |
| CT unlisted procedure (76497) |
$890.40 |
$1,484 |
10.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,068 |
$1,780 |
6.1× |
| CT upper extremity w/o contrast rt (73200) |
$701.40 |
$1,169 |
6.7× |
| CT upper extremity with contrast (73201) |
$912.60 |
$1,521 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,112.40 |
$1,854 |
6.3× |
| Cta Abdomen (74175) |
$1,169.40 |
$1,949 |
6.7× |
| CTA abdomen pelvis (74174) |
$3,279.60 |
$5,466 |
9.4× |
| CTA chest (71275) |
$1,071 |
$1,785 |
6.1× |
| Cta Head (70496) |
$1,341 |
$2,235 |
7.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,419.60 |
$2,366 |
8.1× |
| Cta Neck (70498) |
$1,069.80 |
$1,783 |
6.1× |
| Cta Pelvis (72191) |
$1,643.40 |
$2,739 |
9.4× |
| Cystography minimum 3 views rs&i (74430) |
$410.40 |
$684 |
1.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$192 |
$320 |
1.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$336 |
$560 |
3.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$214.80 |
$358 |
2.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$229.20 |
$382 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$130.20 |
$217 |
1.5× |
| Dxa bone density study axial skeleton (77085) |
$261 |
$435 |
2.5× |
| Echo exam of eye (76529) |
$101.40 |
$169 |
1.2× |
| Echo exam of fetal heart (76825) |
$630 |
$1,050 |
1.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$385.80 |
$643 |
1.6× |
| Echoencephalography real time imaging (76506) |
$270 |
$450 |
2.6× |
| Esophagus (74220) |
$252 |
$420 |
1.4× |
| Fetal biophysical profile non-stress testing (76818) |
$523.80 |
$873 |
5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$309.60 |
$516 |
3.0× |
| Fluoroscopy up to 1 hr (76000) |
$299.40 |
$499 |
1.3× |
| Foot 2 views (73620) |
$155.40 |
$259 |
1.8× |
| Forearm 2 views (73090) |
$162 |
$270 |
1.9× |
| Functional MRI brain by tech (70554) |
$2,562.60 |
$4,271 |
10.7× |
| Gated Heart Planar Single (78472) |
$1,266 |
$2,110 |
3.2× |
| Hand 2 views (73120) |
$174 |
$290 |
1.7× |
| Hand 3 views (73130) |
$266.40 |
$444 |
3.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,602.20 |
$4,337 |
3.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,181.80 |
$5,303 |
4.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$3,769.20 |
$6,282 |
5.4× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$3,109.20 |
$5,182 |
8.0× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,564.20 |
$2,607 |
4.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,006 |
$5,010 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$880.20 |
$1,467 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$760.20 |
$1,267 |
1.9× |
| Ht muscle image spect sing (78451) |
$1,500 |
$2,500 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$168 |
$280 |
1.9× |
| Hysterosalpingogram (74740) |
$525.60 |
$876 |
2.2× |
| Interstitial radiation source applic complex (77778) |
$2,752.80 |
$4,588 |
3.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,519.20 |
$2,532 |
2.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,191.60 |
$1,986 |
2.2× |
| Intracavitary radiation source applic simple (77761) |
$1,023 |
$1,705 |
1.8× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$151.20 |
$252 |
1.4× |
| Kidney imaging morphology (78700) |
$462 |
$770 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$853.80 |
$1,423 |
1.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,060.20 |
$1,767 |
1.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,167.60 |
$1,946 |
2.1× |
| Knee 3 views (73562) |
$184.20 |
$307 |
2.1× |
| Liver & spleen imaging static only (78215) |
$828.60 |
$1,381 |
2.1× |
| Liver imaging static only (78201) |
$817.80 |
$1,363 |
1.5× |
| Lung perf&ventilat diferentl (78598) |
$945.60 |
$1,576 |
1.7× |
| Lung Ventilation Imaging (78579) |
$462 |
$770 |
1.2× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$3,006 |
$5,010 |
1.0× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,230.20 |
$3,717 |
0.7× |
| Lymphoscintigraphy (78195) |
$650.40 |
$1,084 |
1.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$143.40 |
$239 |
1.6× |
| Meckels Diverticulum (78290) |
$655.80 |
$1,093 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$7,182 |
$11,970 |
19.2× |
| Mr elastography (76391) |
$675.60 |
$1,126 |
2.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$35.40 |
$59 |
1.2× |
| MRA head w & w/o contrast (70546) |
$2,646.60 |
$4,411 |
7.6× |
| MRA head w/o contrast (70544) |
$1,758 |
$2,930 |
7.4× |
| MRA head with contrast (70545) |
$1,887 |
$3,145 |
5.4× |
| MRA neck w contrast (70548) |
$2,139.60 |
$3,566 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,452.20 |
$4,087 |
7.0× |
| MRA neck w/o contrast (70547) |
$989.40 |
$1,649 |
4.1× |
| MRI abdomen w contrast (74182) |
$1,725 |
$2,875 |
4.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,960.80 |
$3,268 |
5.6× |
| MRI abdomen w/o contrast (74181) |
$1,442.40 |
$2,404 |
6.0× |
| MRI any jnt lwr ext with con lt (73722) |
$1,748.40 |
$2,914 |
2.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,138 |
$5,230 |
4.0× |
| MRI breast w/o contrast bilateral (77047) |
$1,132.80 |
$1,888 |
4.7× |
| MRI breast w/o contrast unilat (77046) |
$746.40 |
$1,244 |
3.1× |
| MRI c-spine with contrast (72142) |
$1,696.80 |
$2,828 |
4.9× |
| MRI cardiac w/o contrast (75557) |
$612 |
$1,020 |
2.6× |
| MRI cervical spine w/o contrast (72141) |
$1,380.60 |
$2,301 |
5.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,149.20 |
$3,582 |
6.2× |
| MRI chest w/o contrast (71550) |
$1,578.60 |
$2,631 |
6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,321.20 |
$2,202 |
3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,170 |
$1,950 |
4.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,254 |
$2,090 |
5.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,895.40 |
$3,159 |
5.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,345.80 |
$2,243 |
3.9× |
| MRI pelvis w contrast (72196) |
$1,552.20 |
$2,587 |
4.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,928.40 |
$3,214 |
5.5× |
| MRI pelvis w/o contrast (72195) |
$1,446 |
$2,410 |
6.1× |
| MRI scan of arm joint before and after contrast (73223) |
$3,790.80 |
$6,318 |
10.8× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,120.80 |
$1,868 |
1.4× |
| MRI scan of leg joint before and after contrast (73723) |
$2,090.40 |
$3,484 |
6.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,907.40 |
$3,179 |
5.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,470 |
$2,450 |
4.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,668.60 |
$2,781 |
4.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,636.20 |
$2,727 |
4.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,909.80 |
$3,183 |
5.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,152.60 |
$1,921 |
4.8× |
| MRI tmj (70336) |
$1,287 |
$2,145 |
5.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,266 |
$2,110 |
5.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,672.80 |
$2,788 |
4.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,296 |
$2,160 |
5.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,061 |
$3,435 |
1.6× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$3,413.40 |
$5,689 |
2.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,721 |
$4,535 |
3.2× |
| Neck soft tissue (70360) |
$142.20 |
$237 |
1.6× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$535.20 |
$892 |
1.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$604.80 |
$1,008 |
1.5× |
| Nm cisternogram (78630) |
$666.60 |
$1,111 |
1.2× |
| Nm csf leak detection (78650) |
$1,500 |
$2,500 |
1.2× |
| Nm gastric emptying study (78264) |
$778.80 |
$1,298 |
1.9× |
| Nm peritoneal-venous shunt patency (78291) |
$559.80 |
$933 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$12,150 |
$20,250 |
8.8× |
| Nuclear medicine of heart pumping function (78473) |
$1,458.60 |
$2,431 |
3.6× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$830.40 |
$1,384 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$670.80 |
$1,118 |
2.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$329.40 |
$549 |
3.1× |
| Orthopantogram (70355) |
$168.60 |
$281 |
1.9× |
| Osseous survey infant (77076) |
$197.40 |
$329 |
1.9× |
| Osseous survey limited (77074) |
$267.60 |
$446 |
2.6× |
| Parathyrd planar w/spect&CT (78072) |
$737.40 |
$1,229 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$655.20 |
$1,092 |
1.6× |
| Parathyroid imaging (78070) |
$512.40 |
$854 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$169.80 |
$283 |
1.6× |
| Perineogram (74775) |
$277.80 |
$463 |
1.2× |
| Peritoneogram rs&i (74190) |
$630 |
$1,050 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$3,396.60 |
$5,661 |
2.4× |
| PET imaging CT for attenuation limited area (78814) |
$2,674.80 |
$4,458 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$4,395.60 |
$7,326 |
3.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,471.20 |
$2,452 |
4.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,006 |
$5,010 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$601.80 |
$1,003 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$756.60 |
$1,261 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$750 |
$1,250 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$181.80 |
$303 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$192 |
$320 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$197.40 |
$329 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$175.20 |
$292 |
1.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$306.60 |
$511 |
2.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$20,251.80 |
$33,753 |
2.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$3,961.80 |
$6,603 |
7.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$2,296.20 |
$3,827 |
22.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$3,547.80 |
$5,913 |
9.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$322.20 |
$537 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$159 |
$265 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$250.20 |
$417 |
2.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$274.20 |
$457 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$424.20 |
$707 |
2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$354.60 |
$591 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$439.20 |
$732 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$384.60 |
$641 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$125.40 |
$209 |
1.4× |
| Radiological examination surgical specimen (76098) |
$630 |
$1,050 |
1.2× |
| Radiopharm Dacryocystography (78660) |
$462 |
$770 |
1.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,006 |
$5,010 |
1.0× |
| Ribs bilateral 3 views (71110) |
$258 |
$430 |
2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$919.80 |
$1,533 |
2.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,500 |
$2,500 |
2.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,362 |
$2,270 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,622.60 |
$4,371 |
1.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,692 |
$2,820 |
1.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$714.60 |
$1,191 |
3.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$375 |
$625 |
1.6× |
| Rp Therapy Intravenous Administration (79101) |
$696.60 |
$1,161 |
3.0× |
| Sacroiliac Joints < 3 Views (72200) |
$123 |
$205 |
1.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$358.20 |
$597 |
1.5× |
| Scanogram (77073) |
$129 |
$215 |
1.2× |
| Scapula complete (73010) |
$192.60 |
$321 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$30 |
$50 |
1.3× |
| Simulation intermediate (77285) |
$2,163.60 |
$3,606 |
5.8× |
| Small bowel series (74250) |
$293.40 |
$489 |
1.7× |
| Spec medical radj physics consltj (77370) |
$1,416 |
$2,360 |
10.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$724.20 |
$1,207 |
1.9× |
| Special dosimetry (77331) |
$239.40 |
$399 |
1.8× |
| Special treatment procedure (77470) |
$2,168.40 |
$3,614 |
3.9× |
| Speech evaluation complex (70371) |
$277.80 |
$463 |
1.2× |
| Spine thoracic 3 views (72072) |
$274.80 |
$458 |
2.6× |
| Stereotactic body radiation delivery (77373) |
$21,266.40 |
$35,444 |
11.9× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$304.80 |
$508 |
3.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,769.40 |
$2,949 |
4.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$827.40 |
$1,379 |
2.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,106.20 |
$5,177 |
8.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,290.60 |
$2,151 |
9.6× |
| Thoracolumbar 2 views (72080) |
$190.80 |
$318 |
2.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,016.40 |
$1,694 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$475.80 |
$793 |
1.2× |
| Thyroid uptake measurement (78012) |
$462 |
$770 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$579.60 |
$966 |
1.4× |
| Tmj unilateral (70328) |
$127.80 |
$213 |
1.5× |
| Treatment device intermediate (77333) |
$625.20 |
$1,042 |
4.6× |
| Treatment devices simple (77332) |
$429.60 |
$716 |
3.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,989 |
$3,315 |
3.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$862.80 |
$1,438 |
2.2× |
| Tx devices design & construction complex (77334) |
$1,853.40 |
$3,089 |
4.9× |
| Ultrasound, abdomen limited (76705) |
$447.60 |
$746 |
4.3× |
| Umbilical-artery Doppler (OB) (76820) |
$162.60 |
$271 |
1.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$256.80 |
$428 |
2.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,151.70 |
$1,919.50 |
13.2× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$422.40 |
$704 |
1.1× |
| Unlisted Ultrasound Procedure (76999) |
$120 |
$200 |
1.4× |
| Upper Extremity Infant (73092) |
$194.40 |
$324 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$384.60 |
$641 |
1.6× |
| Urethrocystography voiding (74455) |
$411 |
$685 |
1.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$378 |
$630 |
2.2× |
| Us abdl aorta screen aaa (76706) |
$186 |
$310 |
1.8× |
| Us breast unilateral complete (76641) |
$681.30 |
$1,135.50 |
6.5× |
| Us breast unilateral limited (76642) |
$438 |
$730 |
5.0× |
| Us chest (76604) |
$341.40 |
$569 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$212.40 |
$354 |
2.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$168.60 |
$281 |
1.6× |
| Us guided compression repair (76936) |
$454.20 |
$757 |
2.1× |
| Us infant hips dynamic (76885) |
$226.80 |
$378 |
2.6× |
| Us infant hips limited static (76886) |
$174 |
$290 |
2.0× |
| Us kidney transplant (76776) |
$412.20 |
$687 |
3.9× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$212.40 |
$354 |
2.0× |
| Us ob detailed single fetus (76811) |
$402.60 |
$671 |
1.7× |
| Us ob transvaginal (76817) |
$296.40 |
$494 |
2.8× |
| Us pelvic non ob complete (76856) |
$614.40 |
$1,024 |
5.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$273.60 |
$456 |
2.6× |
| Us pregnancy ltd (76815) |
$237.60 |
$396 |
2.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$474 |
$790 |
4.5× |
| Us retroperitoneal complete (76770) |
$525.60 |
$876 |
5.0× |
| Us retroperitoneal limited (76775) |
$395.40 |
$659 |
3.8× |
| Us scrotum and contents (76870) |
$1,230.30 |
$2,050.50 |
11.7× |
| Us soft tissue head/neck (76536) |
$411 |
$685 |
3.9× |
| Us spinal canal and contents (76800) |
$244.20 |
$407 |
2.3× |
| Us transrectal prostate volume (76873) |
$334.80 |
$558 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$156.60 |
$261 |
1.5× |
| Us, eye b-scan (76512) |
$129 |
$215 |
1.2× |
| Venogram extremity bilateral (75822) |
$1,640.40 |
$2,734 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,006 |
$5,010 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,471.20 |
$2,452 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,471.20 |
$2,452 |
0.9× |
| Venography Renal Bilateral (75833) |
$3,427.20 |
$5,712 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$3,006 |
$5,010 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,006 |
$5,010 |
1.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,200.20 |
$8,667 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$101.40 |
$169 |
1.2× |
| Wrist 2 views (73100) |
$127.20 |
$212 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$289.20 |
$482 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$194.40 |
$324 |
2.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$166.20 |
$277 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$609.60 |
$1,016 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$139.20 |
$232 |
1.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$179.40 |
$299 |
2.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$259.80 |
$433 |
2.5× |
| X-ray exam hip uni 1 view (73501) |
$90.60 |
$151 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$115.20 |
$192 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$207.60 |
$346 |
2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$219 |
$365 |
2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$260.40 |
$434 |
2.5× |
| X-ray exam of femur 1 (73551) |
$101.40 |
$169 |
1.2× |
| X-ray eye for foreign body (70030) |
$101.40 |
$169 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$327.60 |
$546 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$115.80 |
$193 |
1.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$259.20 |
$432 |
3.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$134.40 |
$224 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$169.80 |
$283 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$233.40 |
$389 |
2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$178.80 |
$298 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$182.40 |
$304 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$184.80 |
$308 |
1.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$414 |
$690 |
4.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$191.40 |
$319 |
1.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$200.40 |
$334 |
2.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$183.60 |
$306 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$339.60 |
$566 |
3.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$203.40 |
$339 |
1.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$510 |
$850 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$256.80 |
$428 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$211.80 |
$353 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$313.20 |
$522 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$161.40 |
$269 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$163.20 |
$272 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$199.20 |
$332 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$320.40 |
$534 |
3.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$118.80 |
$198 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$305.40 |
$509 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$172.20 |
$287 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$157.20 |
$262 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$254.40 |
$424 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$199.20 |
$332 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$180.60 |
$301 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$313.20 |
$522 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$156 |
$260 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$171 |
$285 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$369.60 |
$616 |
3.5× |
| Xr chest 4+ views (71048) |
$302.40 |
$504 |
2.9× |
| Xr finger(s) 2+ views (73140) |
$141 |
$235 |
1.6× |
| Xr shoulder 1 view (73020) |
$101.40 |
$169 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$350.40 |
$584 |
3.3× |
| Xr tibia/fibula 2 views (73590) |
$208.80 |
$348 |
2.4× |
| Xr tmj bilateral (70330) |
$238.20 |
$397 |
2.7× |
| Xray knee 1 or 2 views rt (73560) |
$157.20 |
$262 |
1.8× |