| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,885 |
$9,180 |
5.0× |
| Abdomen 2 views (74019) |
$1,016.25 |
$1,355 |
9.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,742.75 |
$3,657 |
6.8× |
| Angiography extremity bilateral rs&i (75716) |
$8,969.25 |
$11,959 |
2.8× |
| Angiography extremity unilateral rs&i (75710) |
$7,671.38 |
$10,228.50 |
2.4× |
| Angiography internal mammary rs&i (75756) |
$8,730.75 |
$11,641 |
2.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$24,009 |
$32,012 |
4.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,132.25 |
$2,843 |
0.7× |
| Ankle 2 views (73600) |
$1,563 |
$2,084 |
17.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$916.50 |
$1,222 |
2.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$21,759.75 |
$29,013 |
6.9× |
| Aortography abdominal serialography rs&i (75625) |
$21,759.75 |
$29,013 |
6.9× |
| Arthrogram elbow (73085) |
$3,636.75 |
$4,849 |
10.4× |
| Arthrogram hip (73525) |
$3,920.25 |
$5,227 |
11.2× |
| Arthrogram shoulder (73040) |
$1,499.25 |
$1,999 |
4.3× |
| Arthrogram wrist (73115) |
$4,202.25 |
$5,603 |
12.0× |
| Arthrography knee lt (73580) |
$2,999.25 |
$3,999 |
8.6× |
| Basic radiation dosimetry calculation (77300) |
$1,877.25 |
$2,503 |
13.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,360.50 |
$1,814 |
3.4× |
| Bone &/joint imaging whole body (78306) |
$2,799 |
$3,732 |
7.0× |
| Bone age studies (77072) |
$911.25 |
$1,215 |
8.7× |
| Bone Imaging 3 Phase (78315) |
$5,682 |
$7,576 |
14.1× |
| Bone survey complete (77075) |
$1,408.50 |
$1,878 |
13.4× |
| Brain Imaging Minimum 4 Static Views (78605) |
$8,889 |
$11,852 |
16.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$10,093.50 |
$13,458 |
7.0× |
| Brain Imaging Vascular Flow Only (78610) |
$2,363.25 |
$3,151 |
4.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$472.50 |
$630 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$1,594.50 |
$2,126 |
18.2× |
| Chest 1 view (71045) |
$907.88 |
$1,210.50 |
10.4× |
| Chest 3 views (71047) |
$1,802.25 |
$2,403 |
20.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$966.75 |
$1,289 |
5.5× |
| Clavicle complete (73000) |
$1,651.50 |
$2,202 |
18.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$474 |
$632 |
4.5× |
| Continuing medical physics consltj pr wk (77336) |
$3,911.25 |
$5,215 |
29.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$11,484.75 |
$15,313 |
32.8× |
| CT abdomen and pelvis without contrast (74176) |
$10,626.38 |
$14,168.50 |
44.3× |
| CT abdomen w contrast (74160) |
$5,115 |
$6,820 |
29.0× |
| CT abdomen w wo contrast (74170) |
$5,666.25 |
$7,555 |
32.2× |
| CT abdomen w/o contrast (74150) |
$5,217 |
$6,956 |
49.7× |
| CT angio hrt w/3d image (75574) |
$2,772 |
$3,696 |
7.9× |
| CT angiography upper extremity lt (73206) |
$5,153.25 |
$6,871 |
29.2× |
| CT c-spine w/o contrast (72125) |
$5,778 |
$7,704 |
55.0× |
| CT cervical spine w&w/o contrast (72127) |
$4,856.25 |
$6,475 |
27.6× |
| CT cervical spine with contrast (72126) |
$4,293.75 |
$5,725 |
12.3× |
| CT chest w/wo contrast (71270) |
$5,655.75 |
$7,541 |
32.1× |
| CT chest with contrast (71260) |
$6,303.75 |
$8,405 |
35.8× |
| CT head/brain with contrast (70460) |
$3,965.25 |
$5,287 |
22.5× |
| CT head/brain without and with contrast (70470) |
$6,149.62 |
$8,199.50 |
34.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$385.50 |
$514 |
4.4× |
| CT iac w contrast (70481) |
$5,752.12 |
$7,669.50 |
32.6× |
| CT limited/localized follow up study (76380) |
$1,233.75 |
$1,645 |
14.1× |
| CT lower ext w/o (73700) |
$3,046.50 |
$4,062 |
29.0× |
| CT lower extremity w wo contrast (73702) |
$3,225.75 |
$4,301 |
18.3× |
| CT lower extremity with contrast (73701) |
$3,551.25 |
$4,735 |
20.2× |
| CT lumbar spine w & w/o contrast (72133) |
$5,920.50 |
$7,894 |
33.6× |
| CT lumbar spine w/o contrast (72131) |
$6,158.25 |
$8,211 |
58.6× |
| CT lumbar spine with contrast (72132) |
$6,641.25 |
$8,855 |
19.0× |
| CT maxillofacial w contrast (70487) |
$3,955.50 |
$5,274 |
22.4× |
| CT maxillofacial w/o contrast (70486) |
$6,497.25 |
$8,663 |
61.9× |
| CT maxillofacial w/wo contrast (70488) |
$6,373.50 |
$8,498 |
36.2× |
| CT neck soft tissue w contrast (70491) |
$6,348.75 |
$8,465 |
36.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$6,312 |
$8,416 |
35.8× |
| CT orbits w/o contrast (70480) |
$4,229.25 |
$5,639 |
40.3× |
| CT pelvis w & w/o contrast (72194) |
$6,663 |
$8,884 |
37.8× |
| CT pelvis w/o contrast (72192) |
$5,042.25 |
$6,723 |
48.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,465.88 |
$5,954.50 |
25.3× |
| CT soft tissue neck w/o contrast (70490) |
$5,284.50 |
$7,046 |
50.3× |
| CT thoracic spine w/contrast (72129) |
$5,886 |
$7,848 |
33.4× |
| CT thoracic spine w/o contrast (72128) |
$5,342.25 |
$7,123 |
50.9× |
| CT thoracic spine w/wo contrast (72130) |
$6,261.75 |
$8,349 |
35.5× |
| CT thorax w/o contrast (71250) |
$4,108.50 |
$5,478 |
39.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$4,708.88 |
$6,278.50 |
26.7× |
| CT upper extremity w/o contrast rt (73200) |
$4,049.25 |
$5,399 |
38.6× |
| CT upper extremity with contrast (73201) |
$4,172.25 |
$5,563 |
11.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$9,200.25 |
$12,267 |
52.2× |
| Cta Abdomen (74175) |
$5,875.12 |
$7,833.50 |
33.3× |
| CTA abdomen pelvis (74174) |
$11,778.38 |
$15,704.50 |
33.6× |
| CTA chest (71275) |
$6,137.25 |
$8,183 |
34.8× |
| Cta Head (70496) |
$6,630.38 |
$8,840.50 |
37.6× |
| CTA lwr ext w&w/o contrast (73706) |
$3,886.12 |
$5,181.50 |
22.1× |
| Cta Neck (70498) |
$5,367 |
$7,156 |
30.5× |
| Cta Pelvis (72191) |
$5,739.75 |
$7,653 |
32.6× |
| Cystography minimum 3 views rs&i (74430) |
$1,211.25 |
$1,615 |
3.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,143 |
$1,524 |
10.9× |
| Echoencephalography real time imaging (76506) |
$1,139.25 |
$1,519 |
10.8× |
| Esophagus (74220) |
$2,722.50 |
$3,630 |
15.5× |
| Fetal biophysical profile non-stress testing (76818) |
$205.50 |
$274 |
2.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$686.62 |
$915.50 |
6.5× |
| Fluoroscopy up to 1 hr (76000) |
$1,051.50 |
$1,402 |
4.4× |
| Foot 2 views (73620) |
$1,368 |
$1,824 |
15.6× |
| Forearm 2 views (73090) |
$990 |
$1,320 |
11.3× |
| Gated Heart Planar Single (78472) |
$3,938.25 |
$5,251 |
9.8× |
| Hand 2 views (73120) |
$981 |
$1,308 |
9.3× |
| Hand 3 views (73130) |
$1,559.25 |
$2,079 |
17.8× |
| Heart Infarct Image (78466) |
$10,959.75 |
$14,613 |
27.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$10,975.50 |
$14,634 |
20.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,477.25 |
$3,303 |
6.2× |
| Humerus Min 2 Views Left (73060) |
$2,238 |
$2,984 |
25.6× |
| Hysterosalpingogram (74740) |
$2,469 |
$3,292 |
10.3× |
| Interstitial radiation source applic complex (77778) |
$9,165 |
$12,220 |
13.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,259.50 |
$4,346 |
6.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$6,372.75 |
$8,497 |
11.7× |
| Knee 3 views (73562) |
$1,158.75 |
$1,545 |
13.3× |
| Liver & spleen imaging static only (78215) |
$3,384.75 |
$4,513 |
8.4× |
| Liver imaging static only (78201) |
$8,774.25 |
$11,699 |
16.1× |
| Lung Ventilation Imaging (78579) |
$2,505 |
$3,340 |
6.2× |
| Lymphoscintigraphy (78195) |
$2,580.75 |
$3,441 |
4.7× |
| Mammary ductogram or galactogram multiple (77054) |
$2,089.50 |
$2,786 |
8.7× |
| Mammary ductogram or galactogram single (77053) |
$1,733.25 |
$2,311 |
7.2× |
| Meckels Diverticulum (78290) |
$3,463.50 |
$4,618 |
8.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$35,505.75 |
$47,341 |
94.4× |
| Mr safety determination physician/other qhp (76016) |
$339.75 |
$453 |
3.9× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$229.50 |
$306 |
3.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$94.50 |
$126 |
3.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$354.75 |
$473 |
3.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$933.75 |
$1,245 |
3.9× |
| MRA head w & w/o contrast (70546) |
$5,115 |
$6,820 |
14.6× |
| MRA head w/o contrast (70544) |
$4,547.25 |
$6,063 |
19.0× |
| MRA head with contrast (70545) |
$4,738.50 |
$6,318 |
13.5× |
| MRA neck w contrast (70548) |
$4,520.25 |
$6,027 |
12.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$7,333.50 |
$9,778 |
20.9× |
| MRA neck w/o contrast (70547) |
$7,467 |
$9,956 |
31.2× |
| MRI abdomen w contrast (74182) |
$4,214.25 |
$5,619 |
12.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$6,175.50 |
$8,234 |
17.6× |
| MRI abdomen w/o contrast (74181) |
$6,042.75 |
$8,057 |
25.2× |
| MRI any jnt lwr ext with con lt (73722) |
$9,143.25 |
$12,191 |
11.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$8,079 |
$10,772 |
10.3× |
| MRI breast w/o contrast bilateral (77047) |
$1,388.25 |
$1,851 |
5.8× |
| MRI breast w/o contrast unilat (77046) |
$1,388.25 |
$1,851 |
5.8× |
| MRI c-spine with contrast (72142) |
$6,420.75 |
$8,561 |
18.3× |
| MRI cervical spine w/o contrast (72141) |
$7,805.62 |
$10,407.50 |
32.6× |
| MRI chest w/o & w/contrast material (71552) |
$6,288.75 |
$8,385 |
17.9× |
| MRI chest w/o contrast (71550) |
$4,471.50 |
$5,962 |
18.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$4,989.75 |
$6,653 |
14.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$7,887.38 |
$10,516.50 |
32.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$9,837.75 |
$13,117 |
41.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$10,274.25 |
$13,699 |
29.3× |
| MRI orbit/face/neck w/contrast (70542) |
$13,019.25 |
$17,359 |
37.1× |
| MRI pelvis w contrast (72196) |
$5,688 |
$7,584 |
16.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,777.50 |
$6,370 |
13.6× |
| MRI pelvis w/o contrast (72195) |
$3,648.75 |
$4,865 |
15.2× |
| MRI scan of arm joint before and after contrast (73223) |
$10,510.50 |
$14,014 |
30.0× |
| MRI scan of leg joint before and after contrast (73723) |
$9,552.75 |
$12,737 |
27.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$7,521.75 |
$10,029 |
21.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$6,192 |
$8,256 |
17.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,627.75 |
$8,837 |
18.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$6,863.25 |
$9,151 |
19.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$7,347 |
$9,796 |
21.0× |
| MRI thoracic spine w/o contrast (72146) |
$5,607 |
$7,476 |
23.4× |
| MRI upper ext joint w/o contrast (73221) |
$8,733 |
$11,644 |
36.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$8,339.25 |
$11,119 |
23.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$6,934.50 |
$9,246 |
28.9× |
| Myelogram Cervical (72240) |
$2,590.50 |
$3,454 |
3.3× |
| Myelogram Lumbar (72265) |
$2,232.75 |
$2,977 |
2.8× |
| Myelography 2 or more regions (72270) |
$6,870.75 |
$9,161 |
8.7× |
| Myocardial Spect Multiple Studies (78452) |
$13,422 |
$17,896 |
10.3× |
| Neck soft tissue (70360) |
$1,491 |
$1,988 |
17.1× |
| Nm adrenal scan (78075) |
$4,398 |
$5,864 |
3.4× |
| Nm cisternogram (78630) |
$4,142.25 |
$5,523 |
7.6× |
| Nm gastric emptying study (78264) |
$3,516.75 |
$4,689 |
8.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$17,475.75 |
$23,301 |
12.6× |
| Nuclear Rx Oral Admin (79005) |
$1,950 |
$2,600 |
8.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$769.50 |
$1,026 |
7.3× |
| Orthopantogram (70355) |
$1,978.50 |
$2,638 |
22.6× |
| Parathyrd planar w/wo subtrj (78071) |
$3,806.25 |
$5,075 |
9.5× |
| Parathyroid imaging (78070) |
$2,262.75 |
$3,017 |
5.6× |
| Pelvis 1 or 2 views (72170) |
$699 |
$932 |
6.7× |
| PET image w/CT, skull-thigh (78815) |
$11,073.75 |
$14,765 |
7.7× |
| PET imaging for CT attenuation whole body (78816) |
$11,406 |
$15,208 |
7.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$8,274.75 |
$11,033 |
23.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,634.75 |
$3,513 |
6.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$5,487.75 |
$7,317 |
10.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,534.50 |
$2,046 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,097.25 |
$1,463 |
10.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$932.25 |
$1,243 |
8.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$777 |
$1,036 |
7.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$44,890.50 |
$59,854 |
6.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$5,150.25 |
$6,867 |
9.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$5,150.25 |
$6,867 |
13.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$807 |
$1,076 |
7.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$698.25 |
$931 |
8.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,490.25 |
$1,987 |
14.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$1,153.50 |
$1,538 |
13.2× |
| Radiologic exam colon single contrast study (74270) |
$2,670.75 |
$3,561 |
15.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,019.25 |
$1,359 |
5.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,284 |
$1,712 |
7.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,429.50 |
$1,906 |
8.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,382.25 |
$1,843 |
15.8× |
| Radiological examination surgical specimen (76098) |
$1,073.25 |
$1,431 |
2.0× |
| Ribs bilateral 3 views (71110) |
$642 |
$856 |
6.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,944.25 |
$5,259 |
9.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$4,654.50 |
$6,206 |
8.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$7,113.75 |
$9,485 |
13.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$7,113.75 |
$9,485 |
5.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$8,069.25 |
$10,759 |
5.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$7,113.75 |
$9,485 |
5.5× |
| Sacroiliac Joints < 3 Views (72200) |
$346.50 |
$462 |
3.3× |
| Salivary gland function study (78232) |
$3,705 |
$4,940 |
9.2× |
| Salivary gland imaging serial images (78231) |
$3,941.25 |
$5,255 |
9.8× |
| Scanogram (77073) |
$1,392.75 |
$1,857 |
13.3× |
| Scapula complete (73010) |
$769.12 |
$1,025.50 |
7.3× |
| Screening digital breast tomosynthesis (77063) |
$167.25 |
$223 |
7.2× |
| Simulation intermediate (77285) |
$3,676.50 |
$4,902 |
9.8× |
| Small bowel series (74250) |
$2,316 |
$3,088 |
13.1× |
| Spec medical radj physics consltj (77370) |
$3,942 |
$5,256 |
29.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$4,220.25 |
$5,627 |
11.2× |
| Special dosimetry (77331) |
$3,077.25 |
$4,103 |
22.8× |
| Special treatment procedure (77470) |
$2,939.25 |
$3,919 |
5.3× |
| Spine thoracic 3 views (72072) |
$614.25 |
$819 |
5.8× |
| Stereotactic body radiation delivery (77373) |
$17,098.50 |
$22,798 |
9.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$8,581.50 |
$11,442 |
22.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$5,001 |
$6,668 |
13.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$5,578.50 |
$7,438 |
14.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,853 |
$3,804 |
21.1× |
| Thoracolumbar 2 views (72080) |
$1,896.75 |
$2,529 |
21.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,804.25 |
$3,739 |
5.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$2,442 |
$3,256 |
6.1× |
| Thyroid uptake measurement (78012) |
$2,058.75 |
$2,745 |
5.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,042.25 |
$2,723 |
5.1× |
| Tmj unilateral (70328) |
$461.62 |
$615.50 |
5.3× |
| Treatment device intermediate (77333) |
$4,220.25 |
$5,627 |
31.3× |
| Treatment devices simple (77332) |
$2,419.50 |
$3,226 |
17.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$13,476.75 |
$17,969 |
24.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,860.50 |
$3,814 |
7.1× |
| Tx devices design & construction complex (77334) |
$7,176.75 |
$9,569 |
19.1× |
| Ultrasound, abdomen limited (76705) |
$2,550.75 |
$3,401 |
24.3× |
| Umbilical-artery Doppler (OB) (76820) |
$527.25 |
$703 |
5.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$2,948.25 |
$3,931 |
7.3× |
| Urethrocystography retrograde rs&i (74450) |
$2,774.25 |
$3,699 |
11.6× |
| Urethrocystography voiding (74455) |
$1,824 |
$2,432 |
7.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$3,381 |
$4,508 |
19.2× |
| Us abdl aorta screen aaa (76706) |
$1,344.75 |
$1,793 |
12.8× |
| Us breast unilateral complete (76641) |
$1,659.75 |
$2,213 |
15.8× |
| Us breast unilateral limited (76642) |
$1,904.25 |
$2,539 |
21.8× |
| Us chest (76604) |
$711.75 |
$949 |
6.8× |
| Us compl joint r-t w/image documentation (76881) |
$738.75 |
$985 |
7.0× |
| Us infant hips dynamic (76885) |
$2,480.25 |
$3,307 |
28.4× |
| Us ob detailed single fetus (76811) |
$2,582.62 |
$3,443.50 |
10.8× |
| Us ob transvaginal (76817) |
$4,526.25 |
$6,035 |
43.1× |
| Us pelvic non ob complete (76856) |
$3,687 |
$4,916 |
35.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,179 |
$1,572 |
11.2× |
| Us pregnancy ltd (76815) |
$760.50 |
$1,014 |
7.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,400.25 |
$1,867 |
13.3× |
| Us retroperitoneal complete (76770) |
$3,364.50 |
$4,486 |
32.0× |
| Us retroperitoneal limited (76775) |
$699.38 |
$932.50 |
6.7× |
| Us scrotum and contents (76870) |
$4,105.50 |
$5,474 |
39.1× |
| Us soft tissue head/neck (76536) |
$3,178.50 |
$4,238 |
30.3× |
| Us spinal canal and contents (76800) |
$1,139.25 |
$1,519 |
10.8× |
| Us transrectal (76872) |
$2,089.50 |
$2,786 |
19.9× |
| Us xtr non-vasc lmtd (76882) |
$698.25 |
$931 |
6.6× |
| Venogram extremity bilateral (75822) |
$4,223.62 |
$5,631.50 |
2.7× |
| Venography caval inferior serialography rs&i (75825) |
$15,006.75 |
$20,009 |
4.7× |
| Venography caval superior serialography rs&i (75827) |
$8,937 |
$11,916 |
5.7× |
| Venography extremity unilateral rs&i (75820) |
$4,174.12 |
$5,565.50 |
2.6× |
| Wrist 2 views (73100) |
$981 |
$1,308 |
11.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,975.12 |
$2,633.50 |
18.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$709.50 |
$946 |
8.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,707.38 |
$2,276.50 |
19.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$4,305.75 |
$5,741 |
24.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$763.50 |
$1,018 |
8.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$763.50 |
$1,018 |
8.7× |
| X-ray exam hip uni 1 view (73501) |
$624 |
$832 |
7.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$609 |
$812 |
7.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$932.25 |
$1,243 |
8.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,031.62 |
$1,375.50 |
9.8× |
| X-ray exam of femur 1 (73551) |
$627 |
$836 |
7.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$790.50 |
$1,054 |
7.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$157.50 |
$210 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$2,023.50 |
$2,698 |
23.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$483 |
$644 |
5.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$193.50 |
$258 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$756 |
$1,008 |
7.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$403.50 |
$538 |
4.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$2,193.38 |
$2,924.50 |
20.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$2,465.25 |
$3,287 |
23.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$552.75 |
$737 |
5.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$612 |
$816 |
7.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$624.75 |
$833 |
5.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,665 |
$2,220 |
4.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$2,046.75 |
$2,729 |
23.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$2,621.25 |
$3,495 |
25.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$2,023.50 |
$2,698 |
19.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$681 |
$908 |
6.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$2,991 |
$3,988 |
34.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$893.62 |
$1,191.50 |
10.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$2,418.75 |
$3,225 |
27.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$1,044.75 |
$1,393 |
12.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,098.75 |
$1,465 |
10.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$939.38 |
$1,252.50 |
8.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$874.50 |
$1,166 |
10.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$783.75 |
$1,045 |
9.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$504 |
$672 |
5.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$3,212.25 |
$4,283 |
30.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$600.38 |
$800.50 |
5.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$642 |
$856 |
7.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,538.25 |
$2,051 |
17.6× |
| Xr c-spine 6 or more views (72052) |
$3,313.50 |
$4,418 |
31.6× |
| Xr chest 4+ views (71048) |
$3,073.50 |
$4,098 |
29.3× |
| Xr finger(s) 2+ views (73140) |
$1,237.50 |
$1,650 |
14.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$569.25 |
$759 |
5.4× |
| Xr shoulder 1 view (73020) |
$401.25 |
$535 |
4.6× |
| Xr spine cervical 4 or 5 views (72050) |
$4,040.62 |
$5,387.50 |
38.5× |
| Xr tibia/fibula 2 views (73590) |
$2,238 |
$2,984 |
25.6× |
| Xr tmj bilateral (70330) |
$3,296.25 |
$4,395 |
37.7× |
| Xray knee 1 or 2 views rt (73560) |
$750.75 |
$1,001 |
8.6× |