| 3-D radiotherapy plan dose-volume histograms (77295) |
$10,701.60 |
$16,464 |
8.2× |
| Abdomen 2 views (74019) |
$470.60 |
$724 |
4.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,288.30 |
$1,982 |
3.4× |
| Ankle 2 views (73600) |
$536.90 |
$826 |
6.6× |
| Aortography abdominal serialography rs&i (75625) |
$7,813.65 |
$12,021 |
2.6× |
| Arthrogram elbow (73085) |
$570.05 |
$877 |
1.7× |
| Arthrogram hip (73525) |
$1,186.90 |
$1,826 |
3.6× |
| Arthrogram shoulder (73040) |
$1,131 |
$1,740 |
3.5× |
| Arthrogram wrist (73115) |
$570.05 |
$877 |
1.7× |
| Arthrography knee lt (73580) |
$592.80 |
$912 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$1,061.45 |
$1,633 |
8.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,288.30 |
$1,982 |
3.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,311.70 |
$2,018 |
3.5× |
| Bone &/joint imaging whole body (78306) |
$2,122.90 |
$3,266 |
5.7× |
| Bone age studies (77072) |
$239.85 |
$369 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$2,225.60 |
$3,424 |
5.9× |
| Bone survey complete (77075) |
$820.30 |
$1,262 |
8.4× |
| Brachytx isodose complex (77318) |
$1,273.35 |
$1,959 |
3.6× |
| Brachytx isodose intermed (77317) |
$889.20 |
$1,368 |
2.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$609.70 |
$938 |
1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,186.95 |
$4,903 |
9.7× |
| Cervical spine 2 or 3 views (72040) |
$538.85 |
$829 |
6.6× |
| Chest 1 view (71045) |
$286.65 |
$441 |
3.5× |
| Chest 3 views (71047) |
$364 |
$560 |
4.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$808.60 |
$1,244 |
4.9× |
| Clavicle complete (73000) |
$571.68 |
$879.50 |
7.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$540.15 |
$831 |
5.5× |
| Continuing medical physics consltj pr wk (77336) |
$959.40 |
$1,476 |
7.6× |
| Corpora cavernosography (74445) |
$510.25 |
$785 |
5.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,241.30 |
$9,602 |
19.1× |
| CT abdomen and pelvis without contrast (74176) |
$3,607.50 |
$5,550 |
16.1× |
| CT abdomen w contrast (74160) |
$2,236.65 |
$3,441 |
13.6× |
| CT abdomen w wo contrast (74170) |
$2,739.75 |
$4,215 |
16.6× |
| CT abdomen w/o contrast (74150) |
$1,900.60 |
$2,924 |
19.4× |
| CT angio hrt w/3d image (75574) |
$2,642.90 |
$4,066 |
8.1× |
| CT angiography upper extremity lt (73206) |
$4,540.90 |
$6,986 |
27.6× |
| CT c-spine w/o contrast (72125) |
$2,139.80 |
$3,292 |
21.8× |
| CT cervical spine w&w/o contrast (72127) |
$3,056.30 |
$4,702 |
18.6× |
| CT cervical spine with contrast (72126) |
$2,536.30 |
$3,902 |
7.7× |
| CT chest w/wo contrast (71270) |
$2,847.65 |
$4,381 |
17.3× |
| CT chest with contrast (71260) |
$2,228.20 |
$3,428 |
13.5× |
| CT head/brain with contrast (70460) |
$2,559.70 |
$3,938 |
15.6× |
| CT head/brain without and with contrast (70470) |
$2,808 |
$4,320 |
17.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$67.60 |
$104 |
0.8× |
| CT iac w contrast (70481) |
$2,029.95 |
$3,123 |
12.3× |
| CT limited/localized follow up study (76380) |
$1,202.50 |
$1,850 |
14.7× |
| CT lower ext w/o (73700) |
$2,464.15 |
$3,791 |
25.1× |
| CT lower extremity w wo contrast (73702) |
$3,250 |
$5,000 |
19.7× |
| CT lower extremity with contrast (73701) |
$2,639 |
$4,060 |
16.0× |
| CT lumbar spine w & w/o contrast (72133) |
$3,325.40 |
$5,116 |
20.2× |
| CT lumbar spine w/o contrast (72131) |
$2,287.35 |
$3,519 |
23.3× |
| CT lumbar spine with contrast (72132) |
$3,007.55 |
$4,627 |
9.2× |
| CT maxillofacial w contrast (70487) |
$2,119 |
$3,260 |
12.9× |
| CT maxillofacial w/o contrast (70486) |
$1,810.90 |
$2,786 |
18.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,564.25 |
$3,945 |
15.6× |
| CT neck soft tissue w contrast (70491) |
$2,171.65 |
$3,341 |
13.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,492.10 |
$3,834 |
15.1× |
| CT orbits w/o contrast (70480) |
$1,795.30 |
$2,762 |
18.3× |
| CT pelvis w & w/o contrast (72194) |
$2,515.50 |
$3,870 |
15.3× |
| CT pelvis w/o contrast (72192) |
$1,891.50 |
$2,910 |
19.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,441.40 |
$3,756 |
14.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,906.45 |
$2,933 |
19.4× |
| CT thoracic spine w/contrast (72129) |
$2,351.05 |
$3,617 |
14.3× |
| CT thoracic spine w/o contrast (72128) |
$2,069.60 |
$3,184 |
21.1× |
| CT thoracic spine w/wo contrast (72130) |
$2,631.20 |
$4,048 |
16.0× |
| CT thorax w/o contrast (71250) |
$1,588.60 |
$2,444 |
16.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,035.82 |
$4,670.50 |
18.4× |
| CT upper extremity w/o contrast rt (73200) |
$2,181.08 |
$3,355.50 |
22.2× |
| CT upper extremity with contrast (73201) |
$2,474.55 |
$3,807 |
7.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,250 |
$5,000 |
19.7× |
| Cta Abdomen (74175) |
$2,737.80 |
$4,212 |
16.6× |
| CTA abdomen pelvis (74174) |
$4,085.25 |
$6,285 |
12.5× |
| CTA chest (71275) |
$2,709.20 |
$4,168 |
16.5× |
| Cta Head (70496) |
$2,263.95 |
$3,483 |
13.8× |
| CTA lwr ext w&w/o contrast (73706) |
$4,577.30 |
$7,042 |
27.8× |
| Cta Neck (70498) |
$2,331.55 |
$3,587 |
14.2× |
| Cta Pelvis (72191) |
$2,784.60 |
$4,284 |
16.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$443.30 |
$682 |
4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$505.70 |
$778 |
6.2× |
| Dxa bone density study axial skeleton (77085) |
$351.65 |
$541 |
3.6× |
| Echoencephalography real time imaging (76506) |
$416 |
$640 |
4.2× |
| Esophagus (74220) |
$740.35 |
$1,139 |
4.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$556.40 |
$856 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$536.25 |
$825 |
2.4× |
| Foot 2 views (73620) |
$472.55 |
$727 |
5.8× |
| Forearm 2 views (73090) |
$573.95 |
$883 |
7.0× |
| Gated Heart Planar Single (78472) |
$1,960.40 |
$3,016 |
5.2× |
| Hand 2 views (73120) |
$562.25 |
$865 |
5.7× |
| Hand 3 views (73130) |
$586.30 |
$902 |
7.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,523.30 |
$3,882 |
5.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,380.30 |
$3,662 |
6.3× |
| Ht muscle image spect sing (78451) |
$3,412.50 |
$5,250 |
2.8× |
| Humerus Min 2 Views Left (73060) |
$581.42 |
$894.50 |
7.1× |
| Hysterosalpingogram (74740) |
$1,010.10 |
$1,554 |
4.5× |
| Interstitial radiation source applic complex (77778) |
$3,037.45 |
$4,673 |
4.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$803.40 |
$1,236 |
1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$658.45 |
$1,013 |
1.3× |
| Intracavitary radiation source applic simple (77761) |
$367.90 |
$566 |
0.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$161.85 |
$249 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,408.55 |
$2,167 |
2.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,156.05 |
$3,317 |
4.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,337.70 |
$2,058 |
2.6× |
| Knee 3 views (73562) |
$556.08 |
$855.50 |
6.8× |
| Liver & spleen imaging static only (78215) |
$1,564.55 |
$2,407 |
4.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$843.05 |
$1,297 |
2.2× |
| Liver imaging static only (78201) |
$804.05 |
$1,237 |
1.6× |
| Liver imaging w/vascular flow (78202) |
$897 |
$1,380 |
1.8× |
| Lymphoscintigraphy (78195) |
$1,868.10 |
$2,874 |
3.7× |
| Meckels Diverticulum (78290) |
$549.25 |
$845 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$5,392.40 |
$8,296 |
15.3× |
| MRA head w & w/o contrast (70546) |
$3,460.60 |
$5,324 |
10.6× |
| MRA head w/o contrast (70544) |
$2,307.50 |
$3,550 |
10.3× |
| MRA head with contrast (70545) |
$2,674.75 |
$4,115 |
8.2× |
| MRA neck w contrast (70548) |
$2,360.48 |
$3,631.50 |
7.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,001.05 |
$4,617 |
9.2× |
| MRA neck w/o contrast (70547) |
$2,199.60 |
$3,384 |
9.8× |
| MRI abdomen w contrast (74182) |
$2,372.50 |
$3,650 |
7.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,979.60 |
$4,584 |
9.1× |
| MRI abdomen w/o contrast (74181) |
$2,376.08 |
$3,655.50 |
10.6× |
| MRI any jnt lwr ext with con lt (73722) |
$3,151.20 |
$4,848 |
4.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,770.95 |
$4,263 |
3.8× |
| MRI c-spine with contrast (72142) |
$2,886 |
$4,440 |
8.8× |
| MRI cervical spine w/o contrast (72141) |
$2,609.75 |
$4,015 |
11.7× |
| MRI chest w/o & w/contrast material (71552) |
$2,509 |
$3,860 |
7.7× |
| MRI chest w/o contrast (71550) |
$1,831.70 |
$2,818 |
8.2× |
| MRI chest with contrast (71551) |
$2,048.15 |
$3,151 |
2.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,471.30 |
$3,802 |
7.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,494.05 |
$3,837 |
7.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,363.40 |
$3,636 |
10.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,424.50 |
$3,730 |
10.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,958.80 |
$4,552 |
9.0× |
| MRI orbit/face/neck w/contrast (70542) |
$2,575.30 |
$3,962 |
7.9× |
| MRI pelvis w contrast (72196) |
$2,431.65 |
$3,741 |
7.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,933.45 |
$4,513 |
9.0× |
| MRI pelvis w/o contrast (72195) |
$2,256.80 |
$3,472 |
10.1× |
| MRI scan of arm joint before and after contrast (73223) |
$3,062.80 |
$4,712 |
9.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,157.38 |
$4,857.50 |
9.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,643.25 |
$5,605 |
11.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,906.15 |
$4,471 |
8.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,415.10 |
$5,254 |
10.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,852.85 |
$4,389 |
8.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,356.28 |
$5,163.50 |
10.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,519.40 |
$3,876 |
11.3× |
| MRI tmj (70336) |
$2,798.25 |
$4,305 |
12.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,515.50 |
$3,870 |
11.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,673.45 |
$4,113 |
8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,346.50 |
$3,610 |
10.5× |
| Myocardial Spect Multiple Studies (78452) |
$6,231.55 |
$9,587 |
5.1× |
| Neck soft tissue (70360) |
$386.75 |
$595 |
4.7× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$477.10 |
$734 |
1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$339.30 |
$522 |
0.9× |
| Nm adrenal scan (78075) |
$1,957.15 |
$3,011 |
1.6× |
| Nm gastric emptying study (78264) |
$1,937 |
$2,980 |
5.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$14,846 |
$22,840 |
11.4× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$864.50 |
$1,330 |
2.3× |
| Nuclear Rx Oral Admin (79005) |
$1,377.35 |
$2,119 |
6.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$408.85 |
$629 |
4.2× |
| Osseous survey infant (77076) |
$240.50 |
$370 |
2.5× |
| Parathyrd planar w/spect&CT (78072) |
$1,541.80 |
$2,372 |
3.0× |
| Parathyroid imaging (78070) |
$1,334.45 |
$2,053 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$456.30 |
$702 |
4.7× |
| PET image w/CT, skull-thigh (78815) |
$6,368.05 |
$9,797 |
4.7× |
| PET imaging for CT attenuation whole body (78816) |
$6,438.90 |
$9,906 |
4.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,803.45 |
$4,313 |
8.6× |
| Proton trmt simple w/comp (77522) |
$1,840.15 |
$2,831 |
1.6× |
| Proton tx delivery intermediate (77523) |
$2,651.35 |
$4,079 |
2.3× |
| Proton tx delivery simple w/o compensation (77520) |
$1,752.40 |
$2,696 |
3.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,272.70 |
$1,958 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$670.80 |
$1,032 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$388.05 |
$597 |
4.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$810.55 |
$1,247 |
8.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$605.15 |
$931 |
6.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$206.05 |
$317 |
2.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,256.50 |
$25,010 |
2.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,747.85 |
$2,689 |
3.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$564.85 |
$869 |
5.9× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$911.30 |
$1,402 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$664.30 |
$1,022 |
6.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$325.65 |
$501 |
4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$513.50 |
$790 |
5.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$313.95 |
$483 |
3.8× |
| Radiologic exam colon single contrast study (74270) |
$932.10 |
$1,434 |
5.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$842.40 |
$1,296 |
5.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$936 |
$1,440 |
5.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$505.70 |
$778 |
6.2× |
| Radiological examination surgical specimen (76098) |
$1,487.20 |
$2,288 |
2.9× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$855.40 |
$1,316 |
3.9× |
| Ribs bilateral 3 views (71110) |
$672.75 |
$1,035 |
6.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,007.50 |
$1,550 |
2.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$875.55 |
$1,347 |
1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,265.55 |
$1,947 |
0.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,773.20 |
$2,728 |
1.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$613.60 |
$944 |
2.8× |
| Rp Therapy Intravenous Administration (79101) |
$1,480.70 |
$2,278 |
6.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$474.50 |
$730 |
2.1× |
| Scanogram (77073) |
$250.58 |
$385.50 |
2.6× |
| Scapula complete (73010) |
$626.60 |
$964 |
6.4× |
| Screening digital breast tomosynthesis (77063) |
$81.25 |
$125 |
3.5× |
| Simulation intermediate (77285) |
$1,863.55 |
$2,867 |
5.3× |
| Small bowel series (74250) |
$874.90 |
$1,346 |
5.3× |
| Spec medical radj physics consltj (77370) |
$733.85 |
$1,129 |
5.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,498.25 |
$2,305 |
4.3× |
| Special dosimetry (77331) |
$536.90 |
$826 |
4.3× |
| Special treatment procedure (77470) |
$5,272.80 |
$8,112 |
10.2× |
| Spine thoracic 3 views (72072) |
$580.45 |
$893 |
5.9× |
| Stereotactic body radiation delivery (77373) |
$6,707.35 |
$10,319 |
4.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$658.45 |
$1,013 |
6.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,259.70 |
$1,938 |
3.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$562.25 |
$865 |
1.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,152.50 |
$4,850 |
9.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,602.25 |
$2,465 |
12.7× |
| Therapeutic Enema (74283) |
$343.85 |
$529 |
2.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,106 |
$3,240 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$477.75 |
$735 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,701.05 |
$2,617 |
4.5× |
| Treatment device intermediate (77333) |
$958.75 |
$1,475 |
7.6× |
| Treatment devices simple (77332) |
$692.90 |
$1,066 |
5.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,938 |
$4,520 |
5.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,506.70 |
$2,318 |
4.0× |
| Tx devices design & construction complex (77334) |
$2,295.80 |
$3,532 |
6.5× |
| Ultrasound, abdomen limited (76705) |
$746.85 |
$1,149 |
7.6× |
| Umbilical-artery Doppler (OB) (76820) |
$336.05 |
$517 |
3.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$658.78 |
$1,013.50 |
6.9× |
| Upper Extremity Infant (73092) |
$201.18 |
$309.50 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$618.15 |
$951 |
2.8× |
| Urethrocystography voiding (74455) |
$781.30 |
$1,202 |
3.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$805.35 |
$1,239 |
4.9× |
| Us abdl aorta screen aaa (76706) |
$497.25 |
$765 |
5.1× |
| Us breast unilateral complete (76641) |
$529.10 |
$814 |
5.4× |
| Us breast unilateral limited (76642) |
$479.70 |
$738 |
5.9× |
| Us chest (76604) |
$477.10 |
$734 |
4.9× |
| Us infant hips limited static (76886) |
$286.65 |
$441 |
3.5× |
| Us kidney transplant (76776) |
$619.45 |
$953 |
6.3× |
| Us ob detailed single fetus (76811) |
$664.95 |
$1,023 |
3.0× |
| Us ob transvaginal (76817) |
$690.30 |
$1,062 |
7.0× |
| Us pelvic non ob complete (76856) |
$771.55 |
$1,187 |
7.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$601.90 |
$926 |
6.1× |
| Us pregnancy ltd (76815) |
$670.15 |
$1,031 |
6.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$791.05 |
$1,217 |
8.1× |
| Us retroperitoneal complete (76770) |
$908.05 |
$1,397 |
9.3× |
| Us retroperitoneal limited (76775) |
$839.80 |
$1,292 |
8.6× |
| Us scrotum and contents (76870) |
$750.10 |
$1,154 |
7.6× |
| Us soft tissue head/neck (76536) |
$780.65 |
$1,201 |
8.0× |
| Us spinal canal and contents (76800) |
$184.60 |
$284 |
1.9× |
| Us transrectal (76872) |
$1,431.95 |
$2,203 |
14.6× |
| Us transrectal prostate volume (76873) |
$652.60 |
$1,004 |
6.7× |
| Us xtr non-vasc lmtd (76882) |
$455 |
$700 |
4.6× |
| Vertebral fracture assessment via dxa (77086) |
$235.95 |
$363 |
2.9× |
| Wrist 2 views (73100) |
$525.85 |
$809 |
6.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$635.05 |
$977 |
6.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$365.95 |
$563 |
4.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$653.58 |
$1,005.50 |
8.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,212.90 |
$1,866 |
7.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$472.55 |
$727 |
5.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$712.40 |
$1,096 |
8.7× |
| X-ray exam hip uni 1 view (73501) |
$258.05 |
$397 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$336.05 |
$517 |
4.1× |
| X-ray exam hip uni 4/> views (73503) |
$529.10 |
$814 |
5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$843.70 |
$1,298 |
8.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,016.60 |
$1,564 |
10.4× |
| X-ray exam of femur 1 (73551) |
$284.70 |
$438 |
3.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$479.05 |
$737 |
2.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$615.55 |
$947 |
6.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$432.90 |
$666 |
5.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$556.08 |
$855.50 |
6.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$554.45 |
$853 |
6.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$520.65 |
$801 |
6.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$694.85 |
$1,069 |
7.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$339.30 |
$522 |
4.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$156.65 |
$241 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$599.95 |
$923 |
6.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$920.40 |
$1,416 |
9.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$519.35 |
$799 |
5.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$479.70 |
$738 |
5.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$113.10 |
$174 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$449.80 |
$692 |
4.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$534.95 |
$823 |
5.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,649.70 |
$2,538 |
5.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$399.10 |
$614 |
4.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$536.90 |
$826 |
5.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$696.15 |
$1,071 |
7.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$585.65 |
$901 |
6.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$428.35 |
$659 |
5.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$512.20 |
$788 |
6.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$594.10 |
$914 |
7.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$328.90 |
$506 |
4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$779.35 |
$1,199 |
7.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$577.20 |
$888 |
5.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$356.85 |
$549 |
4.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$289.25 |
$445 |
3.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$512.20 |
$788 |
6.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$549.25 |
$845 |
5.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$382.20 |
$588 |
4.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$619.45 |
$953 |
7.6× |
| Xr arthrogram ankle (73615) |
$570.05 |
$877 |
1.7× |
| Xr c-spine 6 or more views (72052) |
$822.25 |
$1,265 |
8.4× |
| Xr chest 4+ views (71048) |
$497.25 |
$765 |
5.1× |
| Xr finger(s) 2+ views (73140) |
$383.18 |
$589.50 |
4.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$158.60 |
$244 |
1.6× |
| Xr shoulder 1 view (73020) |
$358.80 |
$552 |
4.4× |
| Xr spine cervical 4 or 5 views (72050) |
$741 |
$1,140 |
7.6× |
| Xr tibia/fibula 2 views (73590) |
$656.82 |
$1,010.50 |
8.0× |
| Xr tmj bilateral (70330) |
$384.80 |
$592 |
4.7× |
| Xray knee 1 or 2 views rt (73560) |
$459.88 |
$707.50 |
5.6× |