| 3-D radiotherapy plan dose-volume histograms (77295) |
$10,097.63 |
$10,097.63 |
7.0× |
| Abdomen 2 views (74019) |
$851.71 |
$851.71 |
7.8× |
| Acute gi blood loss imaging (78278) |
$1,728.88 |
$1,728.88 |
4.1× |
| Angiography extremity bilateral rs&i (75716) |
$4,758.47 |
$4,758.47 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$4,169.03 |
$4,169.03 |
1.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$14,336 |
$14,336 |
2.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,857.42 |
$4,857.42 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,645.36 |
$3,645.36 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$6,763.33 |
$6,763.33 |
1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$11,297.50 |
$11,297.50 |
1.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,867.72 |
$4,867.72 |
1.5× |
| Ankle 2 views (73600) |
$592.31 |
$592.31 |
6.5× |
| Aortogram thoracic (75605) |
$8,893.50 |
$8,893.50 |
1.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,488.20 |
$4,488.20 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$3,334.19 |
$3,334.19 |
1.0× |
| Arthrogram ankle (73615) |
$1,134.57 |
$1,134.57 |
3.1× |
| Arthrogram elbow (73085) |
$1,134.57 |
$1,134.57 |
3.1× |
| Arthrogram hip (73525) |
$1,340.49 |
$1,340.49 |
3.7× |
| Arthrogram knee (73580) |
$1,023.60 |
$1,023.60 |
2.8× |
| Arthrogram shoulder (73040) |
$986.99 |
$986.99 |
2.7× |
| Arthrogram wrist (73115) |
$995 |
$995 |
2.7× |
| Basic dosimetry (77300) |
$1,299.60 |
$1,299.60 |
9.3× |
| Bone &/joint imaging whole body (78306) |
$3,169.45 |
$3,169.45 |
7.6× |
| Bone age studies (77072) |
$297.73 |
$297.73 |
2.7× |
| Bone Imaging 3 Phase (78315) |
$4,344.34 |
$4,344.34 |
10.4× |
| Bone survey complete (77075) |
$1,595.03 |
$1,595.03 |
14.6× |
| Bowel imaging (78290) |
$2,222.22 |
$2,222.22 |
5.3× |
| Brachytx isodose complex (77318) |
$4,430.03 |
$4,430.03 |
11.3× |
| Brachytx isodose intermed (77317) |
$2,922.64 |
$2,922.64 |
7.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$3,046.93 |
$3,046.93 |
7.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,978.84 |
$1,978.84 |
3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,329.32 |
$5,329.32 |
3.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,163.30 |
$2,163.30 |
5.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,090.09 |
$2,090.09 |
5.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,236.52 |
$2,236.52 |
3.9× |
| Cervical spine 2 or 3 views (72040) |
$854.86 |
$854.86 |
9.4× |
| Chest 1 view (71045) |
$694.13 |
$694.13 |
7.6× |
| Chest xray 3 views (71047) |
$161.72 |
$161.72 |
1.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,311.60 |
$1,311.60 |
7.2× |
| Clavicle complete (73000) |
$757.62 |
$757.62 |
8.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,079.95 |
$1,079.95 |
9.9× |
| Continuing medical physics consltj pr wk (77336) |
$1,106.40 |
$1,106.40 |
7.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$9,574.40 |
$9,574.40 |
26.3× |
| CT abdomen and pelvis without contrast (74176) |
$7,701.78 |
$7,701.78 |
30.9× |
| CT abdomen w contrast (74160) |
$4,298.01 |
$4,298.01 |
23.5× |
| CT abdomen w wo contrast (74170) |
$4,727.87 |
$4,727.87 |
25.8× |
| CT abdomen w/o contrast (74150) |
$4,140.14 |
$4,140.14 |
37.9× |
| CT angio hrt w/3d image (75574) |
$4,087.53 |
$4,087.53 |
11.2× |
| CT angio lwr extr w/o&w/dye (73706) |
$5,040.46 |
$5,040.46 |
27.5× |
| CT angiography upper extremity lt (73206) |
$4,894.32 |
$4,894.32 |
26.7× |
| CT c-spine w/contrast (72126) |
$3,659.66 |
$3,659.66 |
10.0× |
| CT c-spine w/o contrast (72125) |
$3,467.39 |
$3,467.39 |
31.8× |
| CT cervical spine w&w/o contrast (72127) |
$4,027.45 |
$4,027.45 |
22.0× |
| CT chest w contrast (71260) |
$4,130.19 |
$4,130.19 |
22.5× |
| CT chest w/wo contrast (71270) |
$4,465.94 |
$4,465.94 |
24.4× |
| CT colonography w/o cntrst (74261) |
$3,082.20 |
$3,082.20 |
28.2× |
| CT head/brain with contrast (70460) |
$3,594.75 |
$3,594.75 |
19.6× |
| CT head/brain without and with contrast (70470) |
$3,965.22 |
$3,965.22 |
21.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$520 |
$520 |
1.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$1,178.50 |
$1,178.50 |
13.0× |
| CT iac w contrast (70481) |
$5,625.50 |
$5,625.50 |
30.7× |
| CT lower ext w/o (73700) |
$4,519.37 |
$4,519.37 |
41.4× |
| CT lower extremity w wo contrast (73702) |
$4,868.29 |
$4,868.29 |
26.6× |
| CT lower extremity w/contrast material (73701) |
$4,636.63 |
$4,636.63 |
25.3× |
| CT lumbar spine w & w/o contrast (72133) |
$4,015.44 |
$4,015.44 |
21.9× |
| CT lumbar spine w/contrast (72132) |
$3,685.97 |
$3,685.97 |
10.1× |
| CT lumbar spine w/o contrast (72131) |
$3,419.64 |
$3,419.64 |
31.3× |
| CT maxillofacial w contrast (70487) |
$3,674.53 |
$3,674.53 |
20.1× |
| CT maxillofacial w/wo contrast (70488) |
$4,082.36 |
$4,082.36 |
22.3× |
| CT maxillofacial wo contrast (70486) |
$3,311.88 |
$3,311.88 |
30.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$4,641.04 |
$4,641.04 |
25.3× |
| CT orbits w/o contrast (70480) |
$3,648.22 |
$3,648.22 |
33.4× |
| CT pelvis w/o contrast (72192) |
$3,561.27 |
$3,561.27 |
32.6× |
| CT pelvis w/wo contrast (72194) |
$4,846.56 |
$4,846.56 |
26.5× |
| CT scan of arm combo (73202) |
$5,266.40 |
$5,266.40 |
28.8× |
| CT soft tissue neck w contrast (70491) |
$3,870.15 |
$3,870.15 |
21.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,270.55 |
$4,270.55 |
23.3× |
| CT soft tissue neck w/o contrast (70490) |
$3,581.86 |
$3,581.86 |
32.8× |
| CT thoracic spine w/contrast (72129) |
$3,716.30 |
$3,716.30 |
20.3× |
| CT thoracic spine w/o contrast (72128) |
$3,458.72 |
$3,458.72 |
31.7× |
| CT thoracic spine w/wo contrast (72130) |
$3,934.79 |
$3,934.79 |
21.5× |
| CT thorax w/o contrast (71250) |
$3,718 |
$3,718 |
34.1× |
| CT upper ext wo (73200) |
$3,795.79 |
$3,795.79 |
34.8× |
| CT upper extremity with contrast (73201) |
$6,177.50 |
$6,177.50 |
17.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,013.44 |
$2,013.44 |
11.0× |
| Cta Abdomen (74175) |
$4,830.54 |
$4,830.54 |
26.4× |
| CTA abdomen pelvis (74174) |
$11,290.40 |
$11,290.40 |
31.0× |
| CTA chest (71275) |
$4,661.23 |
$4,661.23 |
25.4× |
| Cta Head (70496) |
$4,176.50 |
$4,176.50 |
22.8× |
| Cta Neck (70498) |
$4,387.79 |
$4,387.79 |
24.0× |
| Cta Pelvis (72191) |
$5,044.80 |
$5,044.80 |
27.5× |
| Cystography minimum 3 views rs&i (74430) |
$1,057.06 |
$1,057.06 |
2.9× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$2,979.55 |
$2,979.55 |
1.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$278.78 |
$278.78 |
2.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$625.50 |
$625.50 |
5.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$754.47 |
$754.47 |
6.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$230.81 |
$230.81 |
2.5× |
| Dxa bone density study axial skeleton (77085) |
$1,247.76 |
$1,247.76 |
11.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,045 |
$1,045 |
4.2× |
| Facial bones min 3 views (70150) |
$1,050.76 |
$1,050.76 |
9.6× |
| Fetal biophysical profile non-stress testing (76818) |
$298.48 |
$298.48 |
2.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$813.77 |
$813.77 |
7.5× |
| Fetal Echo (76825) |
$1,548.27 |
$1,548.27 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$1,217.79 |
$1,217.79 |
4.9× |
| Foot 2 views (73620) |
$657.52 |
$657.52 |
7.2× |
| Forearm 2 views (73090) |
$748.18 |
$748.18 |
8.2× |
| Hand 2 views (73120) |
$458.17 |
$458.17 |
4.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,962.39 |
$2,962.39 |
4.1× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,696.12 |
$4,696.12 |
6.5× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$6,951.81 |
$6,951.81 |
9.6× |
| Heart Infarct Image (78466) |
$1,794 |
$1,794 |
4.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,783.36 |
$4,783.36 |
1.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,344.48 |
$3,344.48 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,617.19 |
$2,617.19 |
6.3× |
| Hysterosalpingogram (74740) |
$566.57 |
$566.57 |
2.3× |
| Interstitial radiation source applic complex (77778) |
$2,885.10 |
$2,885.10 |
4.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,297.30 |
$1,297.30 |
1.8× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$3,153.67 |
$3,153.67 |
5.5× |
| Intracavitary Radiation Source Applic Simple (77761) |
$1,832 |
$1,832 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,416.42 |
$2,416.42 |
4.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,301.58 |
$3,301.58 |
5.8× |
| Knee 3 views (73562) |
$686.12 |
$686.12 |
7.5× |
| Liver & spleen imaging static only (78215) |
$1,774.92 |
$1,774.92 |
4.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,973.97 |
$1,973.97 |
4.7× |
| Lung perf&ventilat diferentl (78598) |
$2,957.81 |
$2,957.81 |
5.2× |
| Lung perfusion differential (78597) |
$2,957.81 |
$2,957.81 |
7.1× |
| Lung ventilation imaging (78579) |
$2,338.34 |
$2,338.34 |
5.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$6,481.80 |
$6,481.80 |
2.0× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,555.80 |
$2,555.80 |
0.8× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$1,592.69 |
$1,592.69 |
1.0× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$1,592.69 |
$1,592.69 |
2.4× |
| Lymphoscintigraphy (78195) |
$2,180.76 |
$2,180.76 |
3.8× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$5,912.19 |
$5,912.19 |
7.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$6,569.71 |
$6,569.71 |
18.0× |
| Magnetic Resonance Elastography (76391) |
$1,955.75 |
$1,955.75 |
7.8× |
| Mammary ductogram or galactogram single (77053) |
$402.31 |
$402.31 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,872.93 |
$2,872.93 |
7.3× |
| Mr safety determination physician/other qhp (76016) |
$220.95 |
$220.95 |
2.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$61.45 |
$61.45 |
2.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$230.35 |
$230.35 |
2.3× |
| Mr safety implt pos&/immoblj (76019) |
$149.05 |
$149.05 |
2.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$606.75 |
$606.75 |
2.4× |
| MRA head w & w/o contrast (70546) |
$5,681.40 |
$5,681.40 |
15.6× |
| MRA head w/o contrast (70544) |
$5,093.95 |
$5,093.95 |
20.4× |
| MRA neck w contrast (70548) |
$4,879.16 |
$4,879.16 |
13.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,464.89 |
$5,464.89 |
15.0× |
| MRA neck w/o contrast (70547) |
$4,350.63 |
$4,350.63 |
17.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,256.40 |
$5,256.40 |
14.4× |
| MRI abdomen w/o contrast (74181) |
$4,634.06 |
$4,634.06 |
18.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,569.71 |
$4,569.71 |
5.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,474.33 |
$5,474.33 |
15.0× |
| MRI breast w/o contrast bilateral (77047) |
$6,673.24 |
$6,673.24 |
26.8× |
| MRI breast wo contrast unilateral (77046) |
$2,495.06 |
$2,495.06 |
10.0× |
| MRI c-spine with contrast (72142) |
$5,614.47 |
$5,614.47 |
15.4× |
| MRI cardiac w/o contrast (75557) |
$1,367.37 |
$1,367.37 |
5.5× |
| MRI cervical spine w/o contrast (72141) |
$5,313.60 |
$5,313.60 |
21.3× |
| MRI chest w/o & w/contrast material (71552) |
$5,474.33 |
$5,474.33 |
15.0× |
| MRI chest w/o contrast (71550) |
$4,301.16 |
$4,301.16 |
17.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$5,213.50 |
$5,213.50 |
14.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$5,792.94 |
$5,792.94 |
15.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,569.71 |
$4,569.71 |
18.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,231.08 |
$4,231.08 |
17.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,324.75 |
$5,324.75 |
14.6× |
| MRI pelvis w/contrast (72196) |
$5,614.47 |
$5,614.47 |
15.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,073.41 |
$6,073.41 |
16.7× |
| MRI pelvis w/o contrast (72195) |
$4,918.78 |
$4,918.78 |
19.7× |
| MRI spectroscopy (76390) |
$5,232.38 |
$5,232.38 |
57.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$8,589.72 |
$8,589.72 |
23.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,614.47 |
$5,614.47 |
15.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$8,589.72 |
$8,589.72 |
23.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,614.47 |
$5,614.47 |
15.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$8,589.72 |
$8,589.72 |
23.6× |
| MRI temporomandibular joint (70336) |
$5,030.46 |
$5,030.46 |
20.2× |
| MRI thoracic spine w/o contrast (72146) |
$5,313.60 |
$5,313.60 |
21.3× |
| MRI up ext w/o contrast (73218) |
$5,319.60 |
$5,319.60 |
21.3× |
| MRI upper ext joint w/o contrast (73221) |
$5,320.17 |
$5,320.17 |
21.4× |
| MRI, joint upper extrem combo (73223) |
$4,770.48 |
$4,770.48 |
13.1× |
| Myelogram Cervical (72240) |
$1,378.70 |
$1,378.70 |
1.7× |
| Myelogram Lumbar (72265) |
$1,413.78 |
$1,413.78 |
1.7× |
| Myelogram thoracic (72255) |
$1,292.20 |
$1,292.20 |
1.6× |
| Myelography 2 or more regions (72270) |
$1,181.18 |
$1,181.18 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$7,523.50 |
$7,523.50 |
5.6× |
| Myocardial spect single study at rest or stress (78451) |
$6,542.63 |
$6,542.63 |
4.8× |
| N-invas est c ffr sw aly CTA (75580) |
$8,202 |
$8,202 |
9.1× |
| Neck soft tissue (70360) |
$770.48 |
$770.48 |
8.5× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$641 |
$641 |
1.6× |
| Nm cisternogram (78630) |
$2,050.34 |
$2,050.34 |
3.6× |
| Nm gastric emptying study (78264) |
$2,413.27 |
$2,413.27 |
5.8× |
| Noncardiac Vascular Flow Imaging (78445) |
$2,236.52 |
$2,236.52 |
5.4× |
| Nonvascular shunt X-ray (75809) |
$479.34 |
$479.34 |
4.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,370.66 |
$6,370.66 |
4.4× |
| Nuclear Rx Oral Admin (79005) |
$2,013.73 |
$2,013.73 |
8.3× |
| Osseous survey limited (77074) |
$1,392.82 |
$1,392.82 |
12.8× |
| Parathyrd planar w/spect&CT (78072) |
$2,761.88 |
$2,761.88 |
4.9× |
| Parathyroid Planar Imaging (78070) |
$2,449.88 |
$2,449.88 |
5.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,657.88 |
$2,657.88 |
6.4× |
| Pelvis 1 or 2 views (72170) |
$749.89 |
$749.89 |
6.9× |
| Peritoneogram after injection (74190) |
$809.67 |
$809.67 |
1.4× |
| PET image w/CT, skull-thigh (78815) |
$6,568 |
$6,568 |
4.4× |
| PET imaging CT for attenuation limited area (78814) |
$13,701.75 |
$13,701.75 |
9.2× |
| PET imaging for CT attenuation whole body (78816) |
$6,923.21 |
$6,923.21 |
4.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,897.62 |
$1,897.62 |
4.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,937.94 |
$1,937.94 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$945.52 |
$945.52 |
1.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$904.05 |
$904.05 |
9.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$633.50 |
$633.50 |
7.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$716.44 |
$716.44 |
7.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$318 |
$318 |
3.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,017.31 |
$1,017.31 |
9.3× |
| Radex fingr minimum 2 views (73140) |
$386.96 |
$386.96 |
4.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$775.35 |
$775.35 |
8.5× |
| Radex Hand Minimum 3 Views (73130) |
$823.11 |
$823.11 |
9.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$921.78 |
$921.78 |
10.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$921.78 |
$921.78 |
8.4× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$272.43 |
$272.43 |
2.5× |
| Radex Humerus Minimum 2 Views (73060) |
$824.54 |
$824.54 |
9.1× |
| Radex Kne 1/2 Views (73560) |
$593.74 |
$593.74 |
6.5× |
| Radex Kne Compl 4/More Views (73564) |
$780 |
$780 |
7.1× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$1,095.10 |
$1,095.10 |
10.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$832.55 |
$832.55 |
9.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$854.86 |
$854.86 |
9.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$1,279.86 |
$1,279.86 |
14.1× |
| Radex Toe Minimum 2 Views (73660) |
$408.98 |
$408.98 |
4.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$826.26 |
$826.26 |
9.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$38,751 |
$38,751 |
5.0× |
| Radiation treatment delivery level 1 (77402) |
$617.08 |
$617.08 |
5.8× |
| Radiation treatment delivery level 2 (77407) |
$781.48 |
$781.48 |
1.9× |
| Radiation treatment delivery level 3 (77412) |
$1,770 |
$1,770 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$359.34 |
$359.34 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$308.88 |
$308.88 |
2.8× |
| Radiologic exam chest 2 views (71046) |
$791.08 |
$791.08 |
8.7× |
| Radiologic exam colon single contrast study (74270) |
$1,125.42 |
$1,125.42 |
6.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$735.31 |
$735.31 |
4.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$2,153.28 |
$2,153.28 |
11.8× |
| Radiologic examination femur 1 view (73551) |
$1,018.02 |
$1,018.02 |
11.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$776.78 |
$776.78 |
8.5× |
| Radiological examination surgical specimen (76098) |
$927.36 |
$927.36 |
1.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$1,669.80 |
$1,669.80 |
4.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$1,300.80 |
$1,300.80 |
3.2× |
| Renal Cyst Study (74470) |
$850.28 |
$850.28 |
1.5× |
| Ribs bilateral 3 views (71110) |
$1,170.03 |
$1,170.03 |
10.7× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$2,546.83 |
$2,546.83 |
6.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,395.11 |
$3,395.11 |
6.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,301.58 |
$3,301.58 |
5.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$4,274.50 |
$4,274.50 |
7.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,744 |
$3,744 |
2.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,395.11 |
$3,395.11 |
2.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$677.25 |
$677.25 |
2.8× |
| Rp Therapy Intravenous Administration (79101) |
$1,246.39 |
$1,246.39 |
5.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$609.75 |
$609.75 |
2.4× |
| Scapula (73010) |
$768.77 |
$768.77 |
7.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$160.16 |
$160.16 |
6.9× |
| Shoulder 1 view (73020) |
$299.50 |
$299.50 |
3.3× |
| Simulation intermediate (77285) |
$2,030.88 |
$2,030.88 |
5.2× |
| Small bowel series (74250) |
$1,383.39 |
$1,383.39 |
7.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,339.94 |
$2,339.94 |
6.0× |
| Special dosimetry (77331) |
$1,843.33 |
$1,843.33 |
13.1× |
| Special Physics Consult (77370) |
$1,362.17 |
$1,362.17 |
9.7× |
| Special treatment procedure (77470) |
$4,466.06 |
$4,466.06 |
7.7× |
| Spine thoracic 3 views (72072) |
$1,200.35 |
$1,200.35 |
11.0× |
| Stereotactic Body Radiation Delivery (77373) |
$20,244.52 |
$20,244.52 |
10.8× |
| Superior sagittal sinus venogram (75870) |
$7,710.47 |
$7,710.47 |
2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$4,235.09 |
$4,235.09 |
10.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$3,396.31 |
$3,396.31 |
8.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$4,723.46 |
$4,723.46 |
12.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,007.38 |
$2,007.38 |
14.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,626.62 |
$2,626.62 |
4.6× |
| Thyroid imaging w/blood flow (78013) |
$1,833.12 |
$1,833.12 |
4.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,312.89 |
$2,312.89 |
5.5× |
| Treatment device complex (77334) |
$2,872.93 |
$2,872.93 |
7.3× |
| Treatment device intermediate (77333) |
$2,009.45 |
$2,009.45 |
14.3× |
| Treatment devices simple (77332) |
$1,424.96 |
$1,424.96 |
10.2× |
| Ultrasound breast complete (76641) |
$1,303.88 |
$1,303.88 |
11.9× |
| Ultrasound elastography first target lesion (76982) |
$277.98 |
$277.98 |
2.5× |
| Ultrasound Exam Aaa Screen (76706) |
$826.53 |
$826.53 |
7.6× |
| Ultrasound, abdomen limited (76705) |
$1,130.27 |
$1,130.27 |
10.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,297.30 |
$1,297.30 |
12.2× |
| Urethrocystogram voiding (74455) |
$1,410.27 |
$1,410.27 |
5.7× |
| Urethrocystography retrograde rs&i (74450) |
$1,534.68 |
$1,534.68 |
6.2× |
| Us breast unilateral limited (76642) |
$782.01 |
$782.01 |
8.6× |
| Us chest (76604) |
$705.28 |
$705.28 |
6.5× |
| Us compl joint r-t w/image documentation (76881) |
$1,010.72 |
$1,010.72 |
9.3× |
| Us elastography parenchyma (76981) |
$277.98 |
$277.98 |
2.5× |
| Us encephalogram (76506) |
$868.78 |
$868.78 |
8.0× |
| Us infant hips w manipulation (76885) |
$410.70 |
$410.70 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$606.61 |
$606.61 |
5.6× |
| Us ob limited (76815) |
$781.38 |
$781.38 |
7.2× |
| Us ob transvaginal (76817) |
$1,029.89 |
$1,029.89 |
9.4× |
| Us pelvic non ob complete (76856) |
$1,253.50 |
$1,253.50 |
11.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$985.28 |
$985.28 |
9.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,027 |
$1,027 |
9.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$480.77 |
$480.77 |
4.4× |
| Us retroperitoneal complete (76770) |
$1,442.30 |
$1,442.30 |
13.2× |
| Us retroperitoneal limited (76775) |
$1,291 |
$1,291 |
11.8× |
| Us scrotum and contents (76870) |
$1,077.65 |
$1,077.65 |
9.9× |
| Us soft tissue head/neck (76536) |
$1,113.50 |
$1,113.50 |
10.2× |
| Us spinal canal and contents (76800) |
$1,254 |
$1,254 |
11.5× |
| Us transrectal (76872) |
$1,466.04 |
$1,466.04 |
13.4× |
| Us transrectal prostate volume (76873) |
$924.92 |
$924.92 |
8.5× |
| Us, eye b-scan (76512) |
$293.28 |
$293.28 |
2.7× |
| Venogram extremity bilateral (75822) |
$3,379.38 |
$3,379.38 |
2.1× |
| Venogram Extremity Unilateral (75820) |
$1,981.13 |
$1,981.13 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$3,344.48 |
$3,344.48 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$3,154.01 |
$3,154.01 |
1.9× |
| Venography Renal Bilateral (75833) |
$6,763.33 |
$6,763.33 |
2.1× |
| Venography renal unilateral selective rs&i (75831) |
$3,344.48 |
$3,344.48 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$6,225.25 |
$6,225.25 |
1.9× |
| Venous sampling by catheter (75893) |
$6,116.12 |
$6,116.12 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$162 |
$162 |
1.8× |
| Wrist 2 views (73100) |
$553.99 |
$553.99 |
6.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$937.51 |
$937.51 |
8.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$921.78 |
$921.78 |
10.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,274.99 |
$1,274.99 |
7.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$625.49 |
$625.49 |
6.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$906.62 |
$906.62 |
10.0× |
| X-ray exam of femur 2/> (73552) |
$1,066.50 |
$1,066.50 |
11.7× |
| X-ray IV pyelogram (ivp) (74400) |
$1,646.19 |
$1,646.19 |
9.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$956.68 |
$956.68 |
8.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,593.59 |
$1,593.59 |
14.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,186.05 |
$1,186.05 |
10.9× |
| X-ray retrograde pyelogram (74420) |
$1,436.01 |
$1,436.01 |
3.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$948.67 |
$948.67 |
10.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,345.06 |
$1,345.06 |
12.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$420.14 |
$420.14 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$544.54 |
$544.54 |
5.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$841.98 |
$841.98 |
9.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,166.88 |
$1,166.88 |
12.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,464.61 |
$1,464.61 |
13.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$652.65 |
$652.65 |
6.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$934.37 |
$934.37 |
10.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$811.96 |
$811.96 |
8.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,200.35 |
$1,200.35 |
11.0× |
| Xr bone length studies (77073) |
$751.33 |
$751.33 |
6.9× |
| Xr c-spine 6 or more views (72052) |
$1,096.82 |
$1,096.82 |
10.0× |
| Xr chest 4+ views (71048) |
$1,682.54 |
$1,682.54 |
15.4× |
| Xr urogram antegrade (74425) |
$698.98 |
$698.98 |
1.9× |