| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,801.60 |
$9,504 |
2.4× |
| Abdomen 1 View (74018) |
$213.20 |
$533 |
2.1× |
| Abdomen 2 views (74019) |
$220.40 |
$551 |
1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$969.20 |
$2,423 |
2.1× |
| Angio internal mammary (75756) |
$6,698 |
$16,745 |
1.8× |
| Angio pulmonary bilat (75743) |
$2,981.20 |
$7,453 |
0.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,015.20 |
$5,038 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,492 |
$6,230 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$2,308 |
$5,770 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,264.40 |
$5,661 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,273.20 |
$3,183 |
0.3× |
| Ankle 2 views (73600) |
$200.40 |
$501 |
2.0× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$3,102 |
$7,755 |
0.5× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,110.80 |
$10,277 |
1.1× |
| Artery X-Rays Abdomen (75726) |
$4,383.20 |
$10,958 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$1,769.60 |
$4,424 |
0.5× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$2,889.20 |
$7,223 |
0.4× |
| Artery X-Rays Spine (75705) |
$4,784 |
$11,960 |
0.7× |
| Arthrogram ankle (73615) |
$564.80 |
$1,412 |
1.4× |
| Arthrogram hip (73525) |
$794.80 |
$1,987 |
2.0× |
| Arthrogram Wrist (73115) |
$699.20 |
$1,748 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$363.60 |
$909 |
2.3× |
| Bone age studies (77072) |
$225.60 |
$564 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$969.20 |
$2,423 |
2.1× |
| Bone Imaging Limited Area (78300) |
$950.40 |
$2,376 |
2.0× |
| Bone Imaging Whole Body (78306) |
$965.60 |
$2,414 |
2.1× |
| Bone marrow imaging limited area (78102) |
$942.40 |
$2,356 |
2.0× |
| Bone marrow imaging; multiple areas (78103) |
$941.60 |
$2,354 |
2.0× |
| Bone marrow imaging; whole body (78104) |
$999.20 |
$2,498 |
2.1× |
| Bone survey infant (77076) |
$309.20 |
$773 |
2.5× |
| Brachytx isodose complex (77318) |
$242 |
$605 |
0.6× |
| Brachytx Isodose Plan Simple (77316) |
$855.60 |
$2,139 |
2.0× |
| Brain Flow Imaging Only (78610) |
$592 |
$1,480 |
0.9× |
| Brain Image W/Flow < 4 Views (78601) |
$1,523.60 |
$3,809 |
3.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$385.60 |
$964 |
0.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,700 |
$9,250 |
2.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$999.20 |
$2,498 |
2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,542.80 |
$3,857 |
3.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,068.80 |
$5,172 |
2.3× |
| Cat Scan Follow-Up Study (76380) |
$406 |
$1,015 |
4.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,199.20 |
$2,998 |
1.9× |
| Cerebrospinal Fluid Scan (78630) |
$1,457.20 |
$3,643 |
2.3× |
| Chest 1 view (71045) |
$170 |
$425 |
1.7× |
| Chest 2 views (71046) |
$213.20 |
$533 |
2.1× |
| Chest 3 views (71047) |
$170 |
$425 |
1.7× |
| Chest 4 or more views (71048) |
$197.20 |
$493 |
1.6× |
| Cholecystography Oral Contrast (74290) |
$249.20 |
$623 |
1.2× |
| Clavicle complete (73000) |
$195.20 |
$488 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$265.60 |
$664 |
2.2× |
| Continuing medical physics consltj pr wk (77336) |
$345.60 |
$864 |
2.2× |
| Contrast Exam Abdominl Aorta (75625) |
$2,332.40 |
$5,831 |
0.6× |
| Contrast X-Ray Bladder (74430) |
$448.80 |
$1,122 |
1.1× |
| Contrast X-Ray Of Elbow (73085) |
$687.60 |
$1,719 |
1.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$737.20 |
$1,843 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,673.20 |
$4,183 |
4.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,148.40 |
$2,871 |
4.1× |
| CT abdomen w contrast (74160) |
$985.20 |
$2,463 |
4.8× |
| CT abdomen w wo contrast (74170) |
$1,270.40 |
$3,176 |
6.2× |
| CT abdomen w/o contrast (74150) |
$662.40 |
$1,656 |
5.4× |
| CT Angio Abdomen and Pelvis (74174) |
$1,781.20 |
$4,453 |
4.4× |
| CT Angio Chest (71275) |
$1,121.20 |
$2,803 |
5.5× |
| CT Angio Head (70496) |
$1,214.40 |
$3,036 |
5.9× |
| CT angio hrt w/3d image (75574) |
$1,006.40 |
$2,516 |
2.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,286 |
$3,215 |
6.3× |
| CT Angio Neck (70498) |
$1,202 |
$3,005 |
5.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,212.80 |
$3,032 |
5.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,450.40 |
$3,626 |
7.1× |
| CT cervical spine w/ contrast (72126) |
$1,052.80 |
$2,632 |
2.6× |
| CT cervical spine w/o contrast (72125) |
$713.20 |
$1,783 |
5.8× |
| CT cervical spine w/wo cont (72127) |
$1,136.80 |
$2,842 |
5.6× |
| CT chest w contrast (71260) |
$904.80 |
$2,262 |
4.4× |
| CT chest w/wo contrast (71270) |
$1,106 |
$2,765 |
5.4× |
| CT colonography screening (74263) |
$881.20 |
$2,203 |
3.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,177.60 |
$2,944 |
5.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$728.40 |
$1,821 |
6.0× |
| CT head/brain with contrast (70460) |
$866.40 |
$2,166 |
4.2× |
| CT head/brain without and with contrast (70470) |
$962.80 |
$2,407 |
4.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$876.80 |
$2,192 |
2.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$47.60 |
$119 |
0.5× |
| CT hrt w/3d image congen (75573) |
$911.20 |
$2,278 |
2.2× |
| CT iac w contrast (70481) |
$1,079.20 |
$2,698 |
5.3× |
| CT l-spine w&w/o contrast (72133) |
$1,143.20 |
$2,858 |
5.6× |
| CT lower ext w/o (73700) |
$696 |
$1,740 |
5.7× |
| CT lower extremity w/contrast material (73701) |
$900 |
$2,250 |
4.4× |
| CT lumbar spine w contrast (72132) |
$1,052.80 |
$2,632 |
2.6× |
| CT lumbar spine w/o contrast (72131) |
$707.20 |
$1,768 |
5.8× |
| CT maxillofacial w contrast (70487) |
$930.40 |
$2,326 |
4.5× |
| CT maxillofacial wo contrast (70486) |
$729.20 |
$1,823 |
6.0× |
| CT neck tissue combo (70492) |
$1,096 |
$2,740 |
5.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,226.80 |
$3,067 |
6.0× |
| CT orbits w/o contrast (70480) |
$729.20 |
$1,823 |
6.0× |
| CT pelvis w&w/o contrast (72194) |
$1,124 |
$2,810 |
5.5× |
| CT pelvis w/o contrast (72192) |
$664.80 |
$1,662 |
5.4× |
| CT scan of leg combo (73702) |
$1,161.60 |
$2,904 |
5.7× |
| CT scans face/jaw combo (70488) |
$1,125.20 |
$2,813 |
5.5× |
| CT soft tissue neck w contrast (70491) |
$888 |
$2,220 |
4.3× |
| CT soft tissue neck w/o contrast (70490) |
$691.60 |
$1,729 |
5.7× |
| CT thoracic spine w contrast (72129) |
$910 |
$2,275 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$710.40 |
$1,776 |
5.8× |
| CT thoracic spine w/wo cont (72130) |
$1,146 |
$2,865 |
5.6× |
| CT thorax w/o contrast (71250) |
$705.60 |
$1,764 |
5.8× |
| CT upper ext wo (73200) |
$692.80 |
$1,732 |
5.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,161.60 |
$2,904 |
5.7× |
| CT upper extremity with contrast (73201) |
$1,052.80 |
$2,632 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,286.40 |
$3,216 |
6.3× |
| Cta Abdomen (74175) |
$1,286.80 |
$3,217 |
6.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,416.40 |
$6,041 |
5.9× |
| CTA pelvis (72191) |
$1,286 |
$3,215 |
6.3× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$379.20 |
$948 |
1.4× |
| Dilation ureters/urethra rs&i (74485) |
$3,978 |
$9,945 |
1.6× |
| Discography Cerv/Thor Spine (72285) |
$4,056.40 |
$10,141 |
1.8× |
| Diskography lumbar (72295) |
$2,151.20 |
$5,378 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$249.60 |
$624 |
2.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$272 |
$680 |
2.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$287.20 |
$718 |
2.4× |
| Dxa Bone Density Axial (77080) |
$284 |
$710 |
2.3× |
| Dxa bone density study (77085) |
$290.80 |
$727 |
2.4× |
| Echo exam of fetal heart (76825) |
$1,003.20 |
$2,508 |
1.6× |
| Echo exam uterus (76831) |
$302 |
$755 |
1.1× |
| Echo Guide For Artery Repair (76936) |
$575.60 |
$1,439 |
2.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$833.20 |
$2,083 |
3.0× |
| Echograp Trans R Pros Study (76873) |
$374.40 |
$936 |
3.1× |
| Esophagram (74220) |
$454.80 |
$1,137 |
2.2× |
| Fetal Biophys Profile W/Nst (76818) |
$336.40 |
$841 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$287.20 |
$718 |
2.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,336.80 |
$3,342 |
4.8× |
| Fluoroscopy up to 1 hr (76000) |
$456.80 |
$1,142 |
1.6× |
| Follow-Up Angiography (75898) |
$743.60 |
$1,859 |
0.2× |
| Foot 2 views (73620) |
$195.20 |
$488 |
1.9× |
| Forearm 2 views (73090) |
$195.20 |
$488 |
1.9× |
| Gastric emptying imaging study (78264) |
$960 |
$2,400 |
2.1× |
| Gastroesophageal Reflux Exam (78262) |
$966.40 |
$2,416 |
2.1× |
| Gated Heart Planar Single (78472) |
$969.20 |
$2,423 |
2.1× |
| Gated Heart, Multiple (78473) |
$999.20 |
$2,498 |
2.1× |
| Hand 2 views (73120) |
$225.60 |
$564 |
1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$3,120.80 |
$7,802 |
3.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,600.40 |
$6,501 |
3.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,127.60 |
$5,319 |
2.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,359.20 |
$8,398 |
0.9× |
| Hepatobil Syst Image W/Drug (78227) |
$1,218.40 |
$3,046 |
1.9× |
| Hepatobiliary System Imaging (78226) |
$969.20 |
$2,423 |
2.1× |
| Ht Muscle Image Spect Sing (78451) |
$2,662.40 |
$6,656 |
1.8× |
| Hysterosalpingogram (74740) |
$488.40 |
$1,221 |
1.8× |
| Image fusion (77399) |
$363.60 |
$909 |
2.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$244.40 |
$611 |
2.4× |
| Interstitial radiation source applic complex (77778) |
$2,524 |
$6,310 |
3.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,718.80 |
$4,297 |
2.1× |
| Joint Survey Single View (77077) |
$179.20 |
$448 |
1.5× |
| K Flow/Funct Image Multiple (78709) |
$1,281.20 |
$3,203 |
2.0× |
| K Flow/Funct Image W/Drug (78708) |
$1,137.20 |
$2,843 |
1.8× |
| K Flow/Funct Image W/O Drug (78707) |
$1,115.20 |
$2,788 |
1.8× |
| Kidney Imaging Morphol (78700) |
$654 |
$1,635 |
1.4× |
| Knee 3 Views (73562) |
$200.40 |
$501 |
2.0× |
| Liver & Spleen Imaging Static Only (78215) |
$960 |
$2,400 |
2.1× |
| Liver imaging static only (78201) |
$983.20 |
$2,458 |
1.6× |
| Liver imaging w/vascular flow (78202) |
$1,123.60 |
$2,809 |
1.8× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,234 |
$3,085 |
1.9× |
| Lung perfusion differential (78597) |
$957.20 |
$2,393 |
2.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,234 |
$3,085 |
1.9× |
| Lung Ventilation Imaging (78579) |
$890.40 |
$2,226 |
1.9× |
| Lymph System Imaging (78195) |
$912.40 |
$2,281 |
1.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$5,193.60 |
$12,984 |
1.4× |
| Magnetic Image Jaw Joint (70336) |
$1,291.20 |
$3,228 |
4.6× |
| Mammary ductogram or galactogram multiple (77054) |
$662.40 |
$1,656 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$528.80 |
$1,322 |
1.9× |
| Meckels Divert Exam (78290) |
$960 |
$2,400 |
2.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$980.40 |
$2,451 |
2.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$66 |
$165 |
2.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,672.40 |
$4,181 |
4.1× |
| MRA head w/o contrast (70544) |
$1,434.40 |
$3,586 |
5.2× |
| MRA head with contrast (70545) |
$1,497.20 |
$3,743 |
3.7× |
| MRA neck w contrast (70548) |
$1,497.20 |
$3,743 |
3.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,544.80 |
$3,862 |
3.8× |
| MRA neck w/o contrast (70547) |
$1,452.40 |
$3,631 |
5.2× |
| MRI abdomen w contrast (74182) |
$1,452.40 |
$3,631 |
3.6× |
| MRI abdomen w/o contrast (74181) |
$1,402.80 |
$3,507 |
5.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,746 |
$4,365 |
1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,542.80 |
$3,857 |
3.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,746 |
$4,365 |
1.9× |
| MRI bone marrow blood supply (77084) |
$1,497.20 |
$3,743 |
5.4× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,158.40 |
$2,896 |
4.2× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,447.20 |
$3,618 |
5.2× |
| MRI cardiac w/o cont stress (75559) |
$1,475.20 |
$3,688 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$1,402.80 |
$3,507 |
5.0× |
| MRI cervical spine w contrast (72142) |
$1,516.40 |
$3,791 |
3.7× |
| MRI cervical spine w/o cont (72141) |
$1,362.40 |
$3,406 |
4.9× |
| MRI chest w/o contrast (71550) |
$1,402.80 |
$3,507 |
5.0× |
| MRI chest with contrast (71551) |
$1,694 |
$4,235 |
1.9× |
| MRI chest wo w contrast (71552) |
$1,590 |
$3,975 |
3.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,497.20 |
$3,743 |
3.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,542.80 |
$3,857 |
3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,402.80 |
$3,507 |
5.0× |
| MRI lumbar spine w contrast (72149) |
$1,516.40 |
$3,791 |
3.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,542.80 |
$3,857 |
3.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,402.80 |
$3,507 |
5.0× |
| MRI orbit face neck w contrast (70542) |
$1,452.40 |
$3,631 |
3.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,542.80 |
$3,857 |
3.8× |
| MRI pelvis w contrast (72196) |
$1,452.40 |
$3,631 |
3.6× |
| MRI pelvis w/o & w contrast (72197) |
$1,542.80 |
$3,857 |
3.8× |
| MRI pelvis w/o contrast (72195) |
$1,402.80 |
$3,507 |
5.0× |
| MRI spectroscopy (76390) |
$859.20 |
$2,148 |
8.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,402.80 |
$3,507 |
5.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,497.20 |
$3,743 |
3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,402.80 |
$3,507 |
5.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,590 |
$3,975 |
3.9× |
| MRI, abdomen, combo (74183) |
$1,542.80 |
$3,857 |
3.8× |
| MRI, dorsal spine combo (72157) |
$1,542.80 |
$3,857 |
3.8× |
| MRI, dorsal spine contrast (72147) |
$1,592 |
$3,980 |
3.9× |
| MRI, joint upper extrem (73221) |
$1,402.80 |
$3,507 |
5.0× |
| MRI, joint upper extrem combo (73223) |
$1,542.80 |
$3,857 |
3.8× |
| MRI, lumbar spine combo (72158) |
$1,542.80 |
$3,857 |
3.8× |
| Myelogram cervical (72240) |
$1,525.20 |
$3,813 |
1.7× |
| Myelogram Lumbar (72265) |
$1,346.80 |
$3,367 |
1.5× |
| Myelography thoracic (72255) |
$1,410 |
$3,525 |
1.5× |
| Myelograpy 2/more regions rs&i (72270) |
$1,889.60 |
$4,724 |
2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,049.20 |
$5,123 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,926.40 |
$7,316 |
1.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$5,770 |
$14,425 |
2.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$7,052.40 |
$17,631 |
2.7× |
| N-invas est c ffr sw aly CTA (75580) |
$2,293.20 |
$5,733 |
2.3× |
| Neck soft tissue (70360) |
$195.20 |
$488 |
1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$257.20 |
$643 |
0.6× |
| Nm csf leak detection (78650) |
$1,652.40 |
$4,131 |
1.1× |
| Nonvascular Shunt X-Ray (75809) |
$309.20 |
$773 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,067.60 |
$10,169 |
2.5× |
| Nuclear Rx Intra-Arterial (79445) |
$692 |
$1,730 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$692 |
$1,730 |
2.5× |
| Ob us nuchal meas 1 gest (76813) |
$287.20 |
$718 |
2.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,242.80 |
$3,107 |
2.0× |
| Parathyroid Planar Imaging (78070) |
$885.20 |
$2,213 |
1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$939.60 |
$2,349 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$225.60 |
$564 |
1.8× |
| Peritoneogram Rs&I (74190) |
$448.80 |
$1,122 |
0.7× |
| Pet Image W/Ct Lmtd (78814) |
$3,590 |
$8,975 |
2.2× |
| PET image w/CT, full body (78816) |
$3,700 |
$9,250 |
2.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,634 |
$9,085 |
2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,294.80 |
$15,737 |
1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$641.60 |
$1,604 |
1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$306.80 |
$767 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$768.40 |
$1,921 |
1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$200.40 |
$501 |
2.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$195.20 |
$488 |
1.9× |
| Radex elbow complete minimum 3 views (73080) |
$195.20 |
$488 |
1.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$229.60 |
$574 |
1.9× |
| Radex fingr minimum 2 views (73140) |
$182 |
$455 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$213.20 |
$533 |
2.1× |
| Radex Hand Minimum 3 Views (73130) |
$195.20 |
$488 |
1.9× |
| Radex lower extremity infant minimum 2 views (73592) |
$200.40 |
$501 |
2.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$220.40 |
$551 |
1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$195.20 |
$488 |
1.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$195.20 |
$488 |
1.9× |
| Radex shoulder complete minimum 2 views (73030) |
$200.40 |
$501 |
2.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$195.20 |
$488 |
1.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$518 |
$1,295 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$195.20 |
$488 |
1.9× |
| Radex Sternum Minimum 2 Views (71120) |
$195.20 |
$488 |
1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$197.60 |
$494 |
1.9× |
| Radex Toe Minimum 2 Views (73660) |
$178 |
$445 |
1.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$231.20 |
$578 |
1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$213.20 |
$533 |
2.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$12,774.40 |
$31,936 |
1.5× |
| Radiation treatment delivery level 1 (77402) |
$526.40 |
$1,316 |
4.4× |
| Radiation treatment delivery level 2 (77407) |
$1,404.80 |
$3,512 |
3.1× |
| Radiation treatment delivery level 3 (77412) |
$1,719.60 |
$4,299 |
2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$229.60 |
$574 |
1.9× |
| Radiologic exam colon double contrast study (74280) |
$518 |
$1,295 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$483.20 |
$1,208 |
2.4× |
| Radiologic exam knee complete 4/more views (73564) |
$299.60 |
$749 |
2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$225.60 |
$564 |
1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$464.80 |
$1,162 |
2.3× |
| Radiologic exam swallow function contrast study (74230) |
$452.80 |
$1,132 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$502.80 |
$1,257 |
2.5× |
| Radiologic examination femur minimum 2 views (73552) |
$180.80 |
$452 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$195.20 |
$488 |
1.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$291.60 |
$729 |
2.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$189.20 |
$473 |
1.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$195.20 |
$488 |
1.9× |
| Ribs bilateral 3 views (71110) |
$229.60 |
$574 |
1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$969.20 |
$2,423 |
2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$999.20 |
$2,498 |
2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,229.60 |
$5,574 |
3.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,035.20 |
$5,088 |
3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,176 |
$2,940 |
1.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,318.40 |
$8,296 |
2.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,877.60 |
$7,194 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$713.20 |
$1,783 |
2.6× |
| Scapula (73010) |
$198.40 |
$496 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$36.80 |
$92 |
1.6× |
| Sella turcica (70240) |
$160 |
$400 |
1.6× |
| Shoulder 1 view (73020) |
$195.20 |
$488 |
1.9× |
| Shoulder Arthrography (73040) |
$754 |
$1,885 |
1.9× |
| Sialogram (70390) |
$574.40 |
$1,436 |
2.1× |
| Skull less than 4 views (70250) |
$225.60 |
$564 |
1.8× |
| Special dosimetry (77331) |
$386.40 |
$966 |
2.5× |
| Special Physics Consult (77370) |
$466 |
$1,165 |
3.0× |
| Special teletherapy port plan (77321) |
$1,023.20 |
$2,558 |
2.3× |
| Special treatment procedure (77470) |
$1,454.40 |
$3,636 |
2.3× |
| Stereotactic Body Radiation Delivery (77373) |
$5,080.40 |
$12,701 |
2.4× |
| Sternoclavicular joints (71130) |
$195.20 |
$488 |
1.9× |
| Superior sagittal sinus venogram (75870) |
$2,318.80 |
$5,797 |
0.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$352.80 |
$882 |
3.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,023.20 |
$2,558 |
2.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$963.20 |
$2,408 |
2.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$662.40 |
$1,656 |
2.4× |
| Testicular Imaging W/Flow (78761) |
$841.60 |
$2,104 |
1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,023.20 |
$2,558 |
2.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$963.20 |
$2,408 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$386.40 |
$966 |
2.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$472.80 |
$1,182 |
2.3× |
| Thoracic spine 2 views (72070) |
$225.60 |
$564 |
1.8× |
| Thoracic spine 3 views (72072) |
$229.60 |
$574 |
1.9× |
| Thoracolumbar 2 views (72080) |
$195.20 |
$488 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$434 |
$1,085 |
0.9× |
| Thyroid Met Imaging Body (78018) |
$1,182.40 |
$2,956 |
1.9× |
| Thyroid Uptake Measurement (78012) |
$329.60 |
$824 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$551.60 |
$1,379 |
1.2× |
| Tx Devices Design & Construction Complex (77334) |
$829.60 |
$2,074 |
1.9× |
| Tx devices design & construction intermediate (77333) |
$466.40 |
$1,166 |
3.0× |
| Tx devices design & construction simple (77332) |
$386.40 |
$966 |
2.5× |
| Ultrasound Breast Limited (76642) |
$204.40 |
$511 |
2.0× |
| Ultrasound elastography first target lesion (76982) |
$287.20 |
$718 |
2.4× |
| Ultrasound Elastography Parenchyma (76981) |
$261.60 |
$654 |
2.1× |
| Ultrasound Exam Aaa Screen (76706) |
$287.20 |
$718 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$287.20 |
$718 |
2.4× |
| Umbilical-artery Doppler (OB) (76820) |
$240 |
$600 |
2.0× |
| Unlisted Dx Radiographic Procedure (76499) |
$37.20 |
$93 |
0.4× |
| Unlisted fluoroscopic procedure (76496) |
$220 |
$550 |
2.2× |
| Unlisted magnetic resonance procedure (76498) |
$5,513.20 |
$13,783 |
54.3× |
| Upper gi w/o kub (74240) |
$474.40 |
$1,186 |
2.3× |
| Ureteral Reflux Study (78740) |
$999.20 |
$2,498 |
2.1× |
| Urethrocystogram voiding (74455) |
$571.60 |
$1,429 |
2.1× |
| Urethrocystography retrograde (74450) |
$306 |
$765 |
1.1× |
| Us breast unilateral complete (76641) |
$277.60 |
$694 |
2.3× |
| Us chest (76604) |
$282.80 |
$707 |
2.3× |
| Us complete joint (76881) |
$325.60 |
$814 |
2.7× |
| Us exam, pelvic, limited (76857) |
$286.80 |
$717 |
2.4× |
| Us head (76506) |
$287.20 |
$718 |
2.4× |
| Us kidney transplant (76776) |
$371.60 |
$929 |
3.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$243.60 |
$609 |
2.0× |
| Us ob detailed single fetus (76811) |
$565.60 |
$1,414 |
2.0× |
| Us ob limited 1 or more fetuses (76815) |
$284.40 |
$711 |
2.3× |
| Us ob transvaginal (76817) |
$319.20 |
$798 |
2.6× |
| Us pelvic non ob complete (76856) |
$336 |
$840 |
2.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$287.20 |
$718 |
2.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$276.80 |
$692 |
2.3× |
| Us retroperitoneal complete (76770) |
$337.60 |
$844 |
2.8× |
| Us retroperitoneal limited (76775) |
$287.20 |
$718 |
2.4× |
| Us scrotum and contents (76870) |
$340.80 |
$852 |
2.8× |
| Us spinal canal and contents (76800) |
$312.80 |
$782 |
2.6× |
| Us thyroid (76536) |
$357.60 |
$894 |
2.9× |
| Us transrectal (76872) |
$348 |
$870 |
2.9× |
| Vein X-Ray Chest (75827) |
$2,218.40 |
$5,546 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,359.20 |
$5,898 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$2,818 |
$7,045 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$6,248.80 |
$15,622 |
1.7× |
| Venography extremity bilateral rs&i (75822) |
$2,040.40 |
$5,101 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$1,616.40 |
$4,041 |
0.9× |
| Venography Renal Bilateral (75833) |
$2,254.80 |
$5,637 |
0.6× |
| Venography Renal Unilateral (75831) |
$3,154 |
$7,885 |
0.9× |
| Venous sampling by catheter (75893) |
$3,354.40 |
$8,386 |
0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$710 |
$1,775 |
1.5× |
| Vertebral fracture assessment via dxa (77086) |
$193.20 |
$483 |
1.9× |
| Wrist 2 views (73100) |
$195.20 |
$488 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$200.40 |
$501 |
2.0× |
| X-ray antegrade pyelogram tube (74425) |
$636.40 |
$1,591 |
1.6× |
| X-Ray Aorta Leg Arteries (75630) |
$2,854 |
$7,135 |
0.8× |
| X-Ray Bend Only L-S Spine (72120) |
$229.60 |
$574 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$195.20 |
$488 |
1.9× |
| X-Ray Exam Breast Specimen (76098) |
$465.20 |
$1,163 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$180.80 |
$452 |
1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$277.20 |
$693 |
2.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$180.80 |
$452 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$213.20 |
$533 |
2.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$259.60 |
$649 |
2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$229.60 |
$574 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$258.80 |
$647 |
2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$309.60 |
$774 |
2.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$291.60 |
$729 |
2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$200.40 |
$501 |
2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$291.60 |
$729 |
2.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$229.60 |
$574 |
1.9× |
| X-ray eye for foreign body (70030) |
$195.20 |
$488 |
1.9× |
| X-ray humerus (73060) |
$195.20 |
$488 |
1.9× |
| X-ray IV pyelogram (ivp) (74400) |
$529.60 |
$1,324 |
2.6× |
| X-ray IV pyelogram+tomography (74415) |
$529.60 |
$1,324 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$195.20 |
$488 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$287.20 |
$718 |
2.4× |
| X-ray nose-rectum child f.b. (76010) |
$206.40 |
$516 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$291.60 |
$729 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$225.60 |
$564 |
1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$215.20 |
$538 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$195.20 |
$488 |
1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$200.40 |
$501 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$291.60 |
$729 |
2.4× |
| X-ray thoracic spine 4 vw (72074) |
$225.60 |
$564 |
1.8× |
| X-Ray Tmj Unilat (70328) |
$185.60 |
$464 |
1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$812 |
$2,030 |
2.0× |
| X-Rays Bone Length Studies (77073) |
$225.60 |
$564 |
1.8× |
| X-Rays Bone Survey Complete (77075) |
$309.20 |
$773 |
2.5× |
| Xr c-spine 4 or 5 views (72050) |
$291.60 |
$729 |
2.4× |
| Xr facial bones less than 3 views (70140) |
$195.20 |
$488 |
1.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$195.20 |
$488 |
1.6× |
| Xr orbits complete 4 views (70200) |
$225.60 |
$564 |
1.8× |
| Xr Tomogram Single Plane (76100) |
$318.80 |
$797 |
2.6× |