| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,021.50 |
$2,043 |
0.8× |
| Abdomen 1 View (74018) |
$653 |
$1,306 |
7.7× |
| Abdomen 2 views (74019) |
$699.50 |
$1,399 |
6.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,042 |
$2,084 |
2.7× |
| Adrenal Cortex & Medulla Img (78075) |
$4,881.50 |
$9,763 |
3.9× |
| Angio internal mammary (75756) |
$2,815 |
$5,630 |
0.9× |
| Angio pulmonary bilat (75743) |
$2,966 |
$5,932 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,103 |
$6,206 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,982 |
$7,964 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,966 |
$5,932 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,800 |
$5,600 |
0.9× |
| Ankle 2 views (73600) |
$972 |
$1,944 |
11.5× |
| Aortography thoracic serialography rs&i (75605) |
$2,998.50 |
$5,997 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$2,966 |
$5,932 |
0.5× |
| Artery X-Rays Pelvis (75736) |
$3,212 |
$6,424 |
0.6× |
| Artery X-Rays Spine (75705) |
$2,966 |
$5,932 |
0.5× |
| Arthrogram ankle (73615) |
$1,937.50 |
$3,875 |
5.7× |
| Arthrogram hip (73525) |
$1,864.50 |
$3,729 |
5.5× |
| Arthrogram Wrist (73115) |
$1,937.50 |
$3,875 |
5.7× |
| Basic radiation dosimetry calculation (77300) |
$92 |
$184 |
0.7× |
| Bone age studies (77072) |
$582.50 |
$1,165 |
5.7× |
| Bone Imaging 3 Phase (78315) |
$5,636.50 |
$11,273 |
14.5× |
| Bone Imaging Limited Area (78300) |
$2,852.50 |
$5,705 |
7.3× |
| Bone Imaging Whole Body (78306) |
$4,881.50 |
$9,763 |
12.6× |
| Bone survey infant (77076) |
$799 |
$1,598 |
7.9× |
| Brain Flow Imaging Only (78610) |
$3,239 |
$6,478 |
6.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$4,025 |
$8,050 |
7.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,550.50 |
$7,101 |
2.6× |
| Cat Scan Follow-Up Study (76380) |
$2,940.50 |
$5,881 |
34.8× |
| Cerebrospinal Fluid Scan (78630) |
$1,124.50 |
$2,249 |
2.1× |
| Chest 1 view (71045) |
$207 |
$414 |
2.4× |
| Chest 2 views (71046) |
$248 |
$496 |
2.9× |
| Chest 3 views (71047) |
$289.50 |
$579 |
3.4× |
| Chest 4 or more views (71048) |
$344.50 |
$689 |
3.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$96.50 |
$193 |
0.9× |
| Clavicle complete (73000) |
$582.50 |
$1,165 |
6.9× |
| Continuing medical physics consltj pr wk (77336) |
$268 |
$536 |
2.1× |
| Contrast Exam Abdominl Aorta (75625) |
$3,103 |
$6,206 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$1,237 |
$2,474 |
3.6× |
| Contrast X-Ray Of Elbow (73085) |
$1,583 |
$3,166 |
4.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,487.50 |
$2,975 |
4.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$9,514 |
$19,028 |
28.1× |
| CT abdomen and pelvis without contrast (74176) |
$7,090 |
$14,180 |
30.6× |
| CT abdomen w contrast (74160) |
$3,779 |
$7,558 |
22.2× |
| CT abdomen w wo contrast (74170) |
$5,056 |
$10,112 |
29.7× |
| CT abdomen w/o contrast (74150) |
$3,078.50 |
$6,157 |
30.3× |
| CT Angio Abdomen and Pelvis (74174) |
$9,109 |
$18,218 |
26.9× |
| CT Angio Chest (71275) |
$4,919 |
$9,838 |
28.9× |
| CT Angio Head (70496) |
$2,750.50 |
$5,501 |
16.1× |
| CT angio hrt w/3d image (75574) |
$4,271 |
$8,542 |
12.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$4,443 |
$8,886 |
26.1× |
| CT Angio Neck (70498) |
$3,279.50 |
$6,559 |
19.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$4,443 |
$8,886 |
26.1× |
| CT cervical spine w/ contrast (72126) |
$2,783.50 |
$5,567 |
8.2× |
| CT cervical spine w/o contrast (72125) |
$2,396 |
$4,792 |
23.6× |
| CT cervical spine w/wo cont (72127) |
$3,370.50 |
$6,741 |
19.8× |
| CT chest w contrast (71260) |
$3,596 |
$7,192 |
21.1× |
| CT chest w/wo contrast (71270) |
$3,596 |
$7,192 |
21.1× |
| CT head/brain with contrast (70460) |
$2,344 |
$4,688 |
13.8× |
| CT head/brain without and with contrast (70470) |
$2,504 |
$5,008 |
14.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$65 |
$130 |
0.8× |
| CT hrt w/3d image congen (75573) |
$4,271 |
$8,542 |
12.6× |
| CT iac w contrast (70481) |
$2,564 |
$5,128 |
15.0× |
| CT l-spine w&w/o contrast (72133) |
$5,056 |
$10,112 |
29.7× |
| CT lower ext w/o (73700) |
$3,072.50 |
$6,145 |
30.2× |
| CT lower extremity w/contrast material (73701) |
$3,072.50 |
$6,145 |
18.0× |
| CT lumbar spine w contrast (72132) |
$3,736.50 |
$7,473 |
11.0× |
| CT lumbar spine w/o contrast (72131) |
$3,599.50 |
$7,199 |
35.4× |
| CT maxillofacial w contrast (70487) |
$2,344 |
$4,688 |
13.8× |
| CT maxillofacial wo contrast (70486) |
$1,960 |
$3,920 |
19.3× |
| CT neck tissue combo (70492) |
$2,839 |
$5,678 |
16.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,204.50 |
$6,409 |
18.8× |
| CT orbits w/o contrast (70480) |
$2,218.50 |
$4,437 |
21.8× |
| CT pelvis w&w/o contrast (72194) |
$4,458 |
$8,916 |
26.2× |
| CT pelvis w/o contrast (72192) |
$3,599.50 |
$7,199 |
35.4× |
| CT scan of leg combo (73702) |
$3,072.50 |
$6,145 |
18.0× |
| CT scans face/jaw combo (70488) |
$2,839 |
$5,678 |
16.7× |
| CT soft tissue neck w contrast (70491) |
$2,344 |
$4,688 |
13.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,960 |
$3,920 |
19.3× |
| CT thoracic spine w contrast (72129) |
$3,525 |
$7,050 |
20.7× |
| CT thoracic spine w/o contrast (72128) |
$3,395.50 |
$6,791 |
33.4× |
| CT thoracic spine w/wo cont (72130) |
$4,769.50 |
$9,539 |
28.0× |
| CT thorax w/o contrast (71250) |
$3,105 |
$6,210 |
30.6× |
| CT upper ext wo (73200) |
$2,793 |
$5,586 |
27.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,072.50 |
$6,145 |
18.0× |
| CT upper extremity with contrast (73201) |
$3,351.50 |
$6,703 |
9.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$9,108.50 |
$18,217 |
53.4× |
| Cta Abdomen (74175) |
$4,919 |
$9,838 |
28.9× |
| CTA pelvis (72191) |
$4,919 |
$9,838 |
28.9× |
| Dilation ureters/urethra rs&i (74485) |
$1,150 |
$2,300 |
0.6× |
| Dxa Bone Density Axial (77080) |
$1,555 |
$3,110 |
15.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$1,189 |
$2,378 |
14.1× |
| Echo Guide For Artery Repair (76936) |
$1,245 |
$2,490 |
5.9× |
| Esophagram (74220) |
$1,467.50 |
$2,935 |
8.6× |
| Fetal Biophys Profile W/Nst (76818) |
$1,451 |
$2,902 |
14.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$273.50 |
$547 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$678 |
$1,356 |
2.9× |
| Follow-Up Angiography (75898) |
$696 |
$1,392 |
0.2× |
| Foot 2 views (73620) |
$1,107 |
$2,214 |
13.1× |
| Forearm 2 views (73090) |
$582.50 |
$1,165 |
6.9× |
| Gastric emptying imaging study (78264) |
$4,488 |
$8,976 |
11.6× |
| Gated Heart Planar Single (78472) |
$3,076 |
$6,152 |
7.9× |
| Hand 2 views (73120) |
$972 |
$1,944 |
9.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,775 |
$5,550 |
0.9× |
| Hepatobil Syst Image W/Drug (78227) |
$3,870 |
$7,740 |
7.3× |
| Hepatobiliary System Imaging (78226) |
$3,870 |
$7,740 |
10.0× |
| Ht Musc Image Planar Mult (78454) |
$5,370.50 |
$10,741 |
4.3× |
| Ht Muscle Image Spect Sing (78451) |
$3,927 |
$7,854 |
3.1× |
| Hysterosalpingogram (74740) |
$1,405 |
$2,810 |
6.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,414.50 |
$2,829 |
16.7× |
| Infant hip ultrasound, limited static exam (76886) |
$707.50 |
$1,415 |
8.4× |
| K Flow/Funct Image Multiple (78709) |
$4,717.50 |
$9,435 |
8.9× |
| K Flow/Funct Image W/Drug (78708) |
$4,717.50 |
$9,435 |
8.9× |
| K Flow/Funct Image W/O Drug (78707) |
$4,344 |
$8,688 |
8.2× |
| Kidney Imaging Morphol (78700) |
$2,499 |
$4,998 |
6.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$2,499 |
$4,998 |
6.4× |
| Knee 3 Views (73562) |
$681.50 |
$1,363 |
8.1× |
| Leveen/Shunt Patency Exam (78291) |
$347 |
$694 |
0.9× |
| Liver & Spleen Imaging Static Only (78215) |
$3,689 |
$7,378 |
9.5× |
| Lung Perf&Ventilat Diferentl (78598) |
$3,804 |
$7,608 |
7.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$4,108 |
$8,216 |
7.8× |
| Lung Ventilation Imaging (78579) |
$2,253 |
$4,506 |
5.8× |
| Lymph System Imaging (78195) |
$2,904.50 |
$5,809 |
5.5× |
| Magnetic Image Jaw Joint (70336) |
$2,517.50 |
$5,035 |
10.9× |
| Mammary ductogram or galactogram multiple (77054) |
$289.50 |
$579 |
1.2× |
| Mammary ductogram or galactogram single (77053) |
$248 |
$496 |
1.1× |
| Meckels Divert Exam (78290) |
$3,470.50 |
$6,941 |
8.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,850.50 |
$7,701 |
11.4× |
| MRA head w/o contrast (70544) |
$2,866 |
$5,732 |
12.4× |
| MRA head with contrast (70545) |
$3,615.50 |
$7,231 |
10.7× |
| MRA neck w contrast (70548) |
$3,615.50 |
$7,231 |
10.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,366.50 |
$8,733 |
12.9× |
| MRA neck w/o contrast (70547) |
$3,009.50 |
$6,019 |
13.0× |
| MRI abdomen w contrast (74182) |
$3,824 |
$7,648 |
11.3× |
| MRI abdomen w/o contrast (74181) |
$3,009.50 |
$6,019 |
13.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,287 |
$6,574 |
4.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,615.50 |
$7,231 |
10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,287 |
$6,574 |
4.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,615.50 |
$7,231 |
15.6× |
| MRI cardiac w/o contrast (75557) |
$2,605.50 |
$5,211 |
11.2× |
| MRI cervical spine w contrast (72142) |
$4,019 |
$8,038 |
11.9× |
| MRI cervical spine w/o cont (72141) |
$3,349 |
$6,698 |
14.4× |
| MRI chest w/o contrast (71550) |
$2,605.50 |
$5,211 |
11.2× |
| MRI chest with contrast (71551) |
$3,615.50 |
$7,231 |
4.7× |
| MRI chest wo w contrast (71552) |
$4,366.50 |
$8,733 |
12.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,287 |
$6,574 |
9.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,615.50 |
$7,231 |
10.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,009.50 |
$6,019 |
13.0× |
| MRI lumbar spine w contrast (72149) |
$3,615.50 |
$7,231 |
10.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,019 |
$8,038 |
11.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,735.50 |
$5,471 |
11.8× |
| MRI orbit face neck w contrast (70542) |
$3,287 |
$6,574 |
9.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,969.50 |
$7,939 |
11.7× |
| MRI pelvis w contrast (72196) |
$4,236 |
$8,472 |
12.5× |
| MRI pelvis w/o & w contrast (72197) |
$4,236 |
$8,472 |
12.5× |
| MRI pelvis w/o contrast (72195) |
$3,009.50 |
$6,019 |
13.0× |
| MRI spectroscopy (76390) |
$3,615.50 |
$7,231 |
42.8× |
| MRI thoracic spine w/o contrast (72146) |
$3,009.50 |
$6,019 |
13.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$3,287 |
$6,574 |
9.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,009.50 |
$6,019 |
13.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,287 |
$6,574 |
9.7× |
| MRI, abdomen, combo (74183) |
$3,824 |
$7,648 |
11.3× |
| MRI, dorsal spine combo (72157) |
$4,366.50 |
$8,733 |
12.9× |
| MRI, dorsal spine contrast (72147) |
$3,615.50 |
$7,231 |
10.7× |
| MRI, joint upper extrem (73221) |
$3,009.50 |
$6,019 |
13.0× |
| MRI, joint upper extrem combo (73223) |
$3,615.50 |
$7,231 |
10.7× |
| MRI, lumbar spine combo (72158) |
$4,366.50 |
$8,733 |
12.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$3,927 |
$7,854 |
3.1× |
| Myocardial Spect Multiple Studies (78452) |
$5,610 |
$11,220 |
4.5× |
| Neck soft tissue (70360) |
$466 |
$932 |
5.5× |
| Nonvascular Shunt X-Ray (75809) |
$766.50 |
$1,533 |
7.5× |
| Nuclear Rx Oral Admin (79005) |
$2,708 |
$5,416 |
11.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,168 |
$4,336 |
4.1× |
| Parathyroid Planar Imaging (78070) |
$1,629 |
$3,258 |
4.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,629 |
$3,258 |
4.2× |
| Pelvis 1 or 2 views (72170) |
$541.50 |
$1,083 |
5.3× |
| Pet Image W/Ct Lmtd (78814) |
$1,467.50 |
$2,935 |
1.1× |
| PET image w/CT, full body (78816) |
$1,043.50 |
$2,087 |
0.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,467.50 |
$2,935 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$3,804 |
$7,608 |
9.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$856 |
$1,712 |
8.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$296 |
$592 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$1,107 |
$2,214 |
13.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$984.50 |
$1,969 |
11.6× |
| Radex elbow complete minimum 3 views (73080) |
$1,188 |
$2,376 |
14.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$873.50 |
$1,747 |
8.6× |
| Radex fingr minimum 2 views (73140) |
$466 |
$932 |
5.5× |
| Radex foot complete minimum 3 views (73630) |
$1,107 |
$2,214 |
13.1× |
| Radex Hand Minimum 3 Views (73130) |
$1,107 |
$2,214 |
13.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$652.50 |
$1,305 |
7.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$342.50 |
$685 |
3.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$582.50 |
$1,165 |
6.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$671.50 |
$1,343 |
7.9× |
| Radex shoulder complete minimum 2 views (73030) |
$1,188 |
$2,376 |
14.0× |
| Radex Sinuses Paransl < 3 Views (70210) |
$675 |
$1,350 |
8.0× |
| Radex Spine 1 View Specify Level (72020) |
$466 |
$932 |
5.5× |
| Radex Sternum Minimum 2 Views (71120) |
$697 |
$1,394 |
8.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$911.50 |
$1,823 |
10.8× |
| Radex Toe Minimum 2 Views (73660) |
$466 |
$932 |
5.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$652.50 |
$1,305 |
6.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$1,107 |
$2,214 |
13.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$730 |
$1,460 |
7.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$699.50 |
$1,399 |
6.9× |
| Radiologic exam colon double contrast study (74280) |
$519 |
$1,038 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$1,821.50 |
$3,643 |
10.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,467.50 |
$2,935 |
8.6× |
| Radiologic exam knee complete 4/more views (73564) |
$1,188 |
$2,376 |
11.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$541.50 |
$1,083 |
5.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,405 |
$2,810 |
8.2× |
| Radiologic exam swallow function contrast study (74230) |
$1,467.50 |
$2,935 |
8.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$410 |
$820 |
2.4× |
| Radiologic examination femur 1 view (73551) |
$630.50 |
$1,261 |
7.5× |
| Radiologic examination femur minimum 2 views (73552) |
$652.50 |
$1,305 |
7.7× |
| Radiologic examination knee 1/2 views (73560) |
$681.50 |
$1,363 |
8.1× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$79.50 |
$159 |
0.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$582.50 |
$1,165 |
6.9× |
| Ribs bilateral 3 views (71110) |
$873.50 |
$1,747 |
8.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,019.50 |
$4,039 |
5.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,423 |
$4,846 |
4.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,423 |
$4,846 |
4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,423 |
$4,846 |
4.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,423 |
$4,846 |
1.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,423 |
$4,846 |
1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,423 |
$4,846 |
1.9× |
| Salivary Gland Imaging Serial Images (78231) |
$387.50 |
$775 |
1.0× |
| Scapula (73010) |
$563 |
$1,126 |
5.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$358 |
$716 |
15.3× |
| Shoulder 1 view (73020) |
$535.50 |
$1,071 |
6.3× |
| Shoulder Arthrography (73040) |
$1,638.50 |
$3,277 |
4.8× |
| Skull less than 4 views (70250) |
$812 |
$1,624 |
8.0× |
| Special treatment procedure (77470) |
$270 |
$540 |
0.5× |
| Sternoclavicular joints (71130) |
$719.50 |
$1,439 |
8.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$848.50 |
$1,697 |
2.3× |
| Testicular Imaging W/Flow (78761) |
$3,308 |
$6,616 |
8.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$848.50 |
$1,697 |
2.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$212 |
$424 |
1.6× |
| Thoracic spine 2 views (72070) |
$721.50 |
$1,443 |
7.1× |
| Thoracic spine 3 views (72072) |
$721.50 |
$1,443 |
7.1× |
| Thoracolumbar 2 views (72080) |
$155 |
$310 |
1.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,003.50 |
$2,007 |
2.6× |
| Thyroid Met Imaging Body (78018) |
$1,695 |
$3,390 |
3.2× |
| Thyroid Uptake Measurement (78012) |
$1,150 |
$2,300 |
3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,150 |
$2,300 |
3.0× |
| Tx Devices Design & Construction Complex (77334) |
$219 |
$438 |
0.6× |
| Ultrasound Breast Limited (76642) |
$745 |
$1,490 |
8.8× |
| Ultrasound Elastography Parenchyma (76981) |
$92.50 |
$185 |
0.9× |
| Ultrasound Exam Aaa Screen (76706) |
$218 |
$436 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$2,272 |
$4,544 |
22.4× |
| Umbilical-artery Doppler (OB) (76820) |
$170 |
$340 |
1.7× |
| Unlisted magnetic resonance procedure (76498) |
$368.50 |
$737 |
4.4× |
| Upper gi w/o kub (74240) |
$1,628.50 |
$3,257 |
9.6× |
| Urea breath test c-14 isotopic analysis (78268) |
$90 |
$180 |
1.0× |
| Ureteral Reflux Study (78740) |
$2,423 |
$4,846 |
6.2× |
| Urethrocystogram voiding (74455) |
$969.50 |
$1,939 |
4.2× |
| Us breast unilateral complete (76641) |
$852.50 |
$1,705 |
8.4× |
| Us chest (76604) |
$366.50 |
$733 |
3.6× |
| Us complete joint (76881) |
$1,414.50 |
$2,829 |
13.9× |
| Us exam, pelvic, limited (76857) |
$432.50 |
$865 |
4.3× |
| Us kidney transplant (76776) |
$192.50 |
$385 |
1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$861 |
$1,722 |
8.5× |
| Us ob detailed single fetus (76811) |
$276.50 |
$553 |
1.2× |
| Us ob limited 1 or more fetuses (76815) |
$1,106.50 |
$2,213 |
10.9× |
| Us ob transvaginal (76817) |
$1,496.50 |
$2,993 |
14.7× |
| Us pelvic non ob complete (76856) |
$1,862.50 |
$3,725 |
18.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$2,570.50 |
$5,141 |
25.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$559 |
$1,118 |
5.5× |
| Us retroperitoneal complete (76770) |
$2,404.50 |
$4,809 |
23.7× |
| Us retroperitoneal limited (76775) |
$471.50 |
$943 |
4.6× |
| Us scrotum and contents (76870) |
$1,496.50 |
$2,993 |
14.7× |
| Us spinal canal and contents (76800) |
$521.50 |
$1,043 |
5.1× |
| Us thyroid (76536) |
$1,740 |
$3,480 |
17.1× |
| Vein X-Ray Chest (75827) |
$831.50 |
$1,663 |
0.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,084 |
$4,168 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,103 |
$6,206 |
1.0× |
| Venography extremity bilateral rs&i (75822) |
$2,672.50 |
$5,345 |
1.7× |
| Venography extremity unilateral rs&i (75820) |
$1,781.50 |
$3,563 |
1.2× |
| Venography Renal Bilateral (75833) |
$2,434 |
$4,868 |
0.8× |
| Venography Renal Unilateral (75831) |
$1,930.50 |
$3,861 |
0.6× |
| Wrist 2 views (73100) |
$528 |
$1,056 |
6.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$783.50 |
$1,567 |
9.3× |
| X-ray antegrade pyelogram tube (74425) |
$2,674.50 |
$5,349 |
7.9× |
| X-Ray Aorta Leg Arteries (75630) |
$3,247.50 |
$6,495 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$677.50 |
$1,355 |
6.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,066.50 |
$2,133 |
12.6× |
| X-Ray Exam Breast Specimen (76098) |
$496 |
$992 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$347 |
$694 |
4.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$757 |
$1,514 |
7.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$580.50 |
$1,161 |
6.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$652.50 |
$1,305 |
7.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$1,403 |
$2,806 |
13.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$757 |
$1,514 |
7.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$2,194.50 |
$4,389 |
21.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$3,028.50 |
$6,057 |
29.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$243 |
$486 |
2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$675.50 |
$1,351 |
8.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$1,257 |
$2,514 |
12.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$873.50 |
$1,747 |
8.6× |
| X-ray eye for foreign body (70030) |
$56 |
$112 |
0.7× |
| X-ray humerus (73060) |
$652.50 |
$1,305 |
7.7× |
| X-ray IV pyelogram (ivp) (74400) |
$1,798.50 |
$3,597 |
10.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$364.50 |
$729 |
4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$484 |
$968 |
5.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$757 |
$1,514 |
7.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$873.50 |
$1,747 |
8.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$675 |
$1,350 |
6.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$675 |
$1,350 |
6.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$652.50 |
$1,305 |
7.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$873.50 |
$1,747 |
10.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$990 |
$1,980 |
9.7× |
| X-ray thoracic spine 4 vw (72074) |
$1,013 |
$2,026 |
10.0× |
| X-Ray Tmj Unilat (70328) |
$911.50 |
$1,823 |
10.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$2,897 |
$5,794 |
8.5× |
| X-Rays Bone Length Studies (77073) |
$767 |
$1,534 |
7.5× |
| X-Rays Bone Survey Complete (77075) |
$1,594.50 |
$3,189 |
15.7× |
| Xr c-spine 4 or 5 views (72050) |
$990 |
$1,980 |
9.7× |
| Xr facial bones less than 3 views (70140) |
$275.50 |
$551 |
3.3× |
| Xr orbits complete 4 views (70200) |
$1,160 |
$2,320 |
11.4× |