| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,461.80 |
$4,103 |
1.8× |
Abdomen 1 View (74018) range across 2 matching MRF lines |
$97.80–$304.80 |
$163–$508 |
varies |
| Abdomen 2 views (74019) |
$304.80 |
$508 |
2.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$462 |
$770 |
1.2× |
| Angio internal mammary (75756) |
$1,664.40 |
$2,774 |
0.5× |
| Angio pulmonary bilat (75743) |
$4,053 |
$6,755 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$2,676.60 |
$4,461 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,676.60 |
$4,461 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,478.40 |
$2,464 |
0.5× |
| Ankle 2 views (73600) |
$381 |
$635 |
4.4× |
Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,471.40 |
$4,119 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$2,127 |
$3,545 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$2,974.20 |
$4,957 |
0.5× |
| Arthrogram hip (73525) |
$420.60 |
$701 |
1.2× |
| Arthrogram Wrist (73115) |
$347.40 |
$579 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$967.20 |
$1,612 |
7.2× |
| Bone age studies (77072) |
$354.60 |
$591 |
3.4× |
| Bone Imaging 3 Phase (78315) |
$1,959 |
$3,265 |
4.9× |
| Bone Imaging Limited Area (78300) |
$646.20 |
$1,077 |
1.6× |
| Bone Imaging Whole Body (78306) |
$1,175.40 |
$1,959 |
3.0× |
| Bone survey infant (77076) |
$369 |
$615 |
3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,410 |
$7,350 |
3.1× |
| Cat Scan Follow-Up Study (76380) |
$490.80 |
$818 |
5.7× |
| Cerebrospinal Fluid Scan (78630) |
$885 |
$1,475 |
1.6× |
| Chest 1 view (71045) |
$219 |
$365 |
2.5× |
| Chest 2 views (71046) |
$534.60 |
$891 |
6.2× |
| Chest 3 views (71047) |
$267 |
$445 |
3.1× |
| Chest 4 or more views (71048) |
$210 |
$350 |
2.0× |
| Clavicle complete (73000) |
$393.60 |
$656 |
4.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$63.60 |
$106 |
0.6× |
| Continuing medical physics consltj pr wk (77336) |
$698.40 |
$1,164 |
5.2× |
| Contrast Exam Abdominl Aorta (75625) |
$2,593.80 |
$4,323 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$516.60 |
$861 |
1.5× |
| Contrast X-Ray Of Elbow (73085) |
$714 |
$1,190 |
2.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$463.80 |
$773 |
1.3× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$253.80 |
$423 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,331.60 |
$8,886 |
15.3× |
| CT abdomen and pelvis without contrast (74176) |
$4,362.60 |
$7,271 |
18.4× |
| CT abdomen w contrast (74160) |
$2,959.20 |
$4,932 |
16.9× |
| CT abdomen w wo contrast (74170) |
$3,082.20 |
$5,137 |
17.6× |
| CT abdomen w/o contrast (74150) |
$2,835.60 |
$4,726 |
27.2× |
| CT Angio Abdomen and Pelvis (74174) |
$3,670.80 |
$6,118 |
10.6× |
| CT Angio Chest (71275) |
$2,674.20 |
$4,457 |
15.3× |
| CT Angio Head (70496) |
$2,994 |
$4,990 |
17.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,709.40 |
$2,849 |
9.8× |
| CT Angio Neck (70498) |
$2,807.40 |
$4,679 |
16.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,737 |
$2,895 |
9.9× |
| CT cervical spine w/ contrast (72126) |
$2,316.60 |
$3,861 |
6.7× |
| CT cervical spine w/o contrast (72125) |
$2,271 |
$3,785 |
21.8× |
| CT cervical spine w/wo cont (72127) |
$2,338.80 |
$3,898 |
13.4× |
| CT chest w contrast (71260) |
$2,017.20 |
$3,362 |
11.6× |
| CT chest w/wo contrast (71270) |
$2,219.40 |
$3,699 |
12.7× |
| CT head/brain with contrast (70460) |
$1,864.20 |
$3,107 |
10.7× |
| CT head/brain without and with contrast (70470) |
$2,503.20 |
$4,172 |
14.3× |
| CT iac w contrast (70481) |
$2,872.80 |
$4,788 |
16.5× |
| CT l-spine w&w/o contrast (72133) |
$2,801.40 |
$4,669 |
16.0× |
| CT lower ext w/o (73700) |
$1,749.60 |
$2,916 |
16.8× |
| CT lower extremity w/contrast material (73701) |
$1,767 |
$2,945 |
10.1× |
| CT lumbar spine w contrast (72132) |
$2,523.60 |
$4,206 |
7.3× |
| CT lumbar spine w/o contrast (72131) |
$2,315.40 |
$3,859 |
22.2× |
| CT maxillofacial w contrast (70487) |
$4,311 |
$7,185 |
24.7× |
| CT maxillofacial wo contrast (70486) |
$832.20 |
$1,387 |
8.0× |
| CT neck tissue combo (70492) |
$2,632.20 |
$4,387 |
15.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,443.40 |
$5,739 |
19.7× |
| CT orbits w/o contrast (70480) |
$2,037.60 |
$3,396 |
19.6× |
| CT pelvis w&w/o contrast (72194) |
$2,567.40 |
$4,279 |
14.7× |
| CT pelvis w/o contrast (72192) |
$1,915.80 |
$3,193 |
18.4× |
| CT scan of leg combo (73702) |
$1,784.40 |
$2,974 |
10.2× |
| CT scans face/jaw combo (70488) |
$2,097 |
$3,495 |
12.0× |
| CT soft tissue neck w contrast (70491) |
$2,329.20 |
$3,882 |
13.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,770 |
$2,950 |
17.0× |
| CT thoracic spine w contrast (72129) |
$2,116.80 |
$3,528 |
12.1× |
| CT thoracic spine w/o contrast (72128) |
$1,941.60 |
$3,236 |
18.7× |
| CT thoracic spine w/wo cont (72130) |
$2,718.60 |
$4,531 |
15.6× |
| CT thorax w/o contrast (71250) |
$1,452.60 |
$2,421 |
14.0× |
| CT upper ext wo (73200) |
$1,791.60 |
$2,986 |
17.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,917 |
$3,195 |
11.0× |
| CT upper extremity with contrast (73201) |
$1,863 |
$3,105 |
5.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,732.80 |
$2,888 |
9.9× |
| Cta Abdomen (74175) |
$3,340.20 |
$5,567 |
19.1× |
| CTA pelvis (72191) |
$2,809.20 |
$4,682 |
16.1× |
| Dilation ureters/urethra rs&i (74485) |
$1,046.40 |
$1,744 |
0.5× |
| Dxa Bone Density Axial (77080) |
$419.40 |
$699 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$419.40 |
$699 |
4.8× |
| Esophagram (74220) |
$397.20 |
$662 |
2.3× |
| Fetal Biophys Profile W/Nst (76818) |
$385.80 |
$643 |
3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$385.80 |
$643 |
3.7× |
| Fluoroscopy up to 1 hr (76000) |
$742.80 |
$1,238 |
3.1× |
| Follow-Up Angiography (75898) |
$685.20 |
$1,142 |
0.2× |
| Foot 2 views (73620) |
$398.40 |
$664 |
4.6× |
| Forearm 2 views (73090) |
$531.60 |
$886 |
6.1× |
| Gastric emptying imaging study (78264) |
$1,470 |
$2,450 |
3.7× |
| Gated Heart Planar Single (78472) |
$1,218 |
$2,030 |
3.1× |
| Hand 2 views (73120) |
$394.20 |
$657 |
3.8× |
| Hepatobil Syst Image W/Drug (78227) |
$1,696.80 |
$2,828 |
3.1× |
| Hepatobiliary System Imaging (78226) |
$1,696.80 |
$2,828 |
4.3× |
| Ht Muscle Image Spect Sing (78451) |
$1,679.40 |
$2,799 |
1.3× |
| Hysterosalpingogram (74740) |
$886.80 |
$1,478 |
3.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$824.40 |
$1,374 |
9.5× |
| Infant hip ultrasound, limited static exam (76886) |
$140.40 |
$234 |
1.6× |
| K Flow/Funct Image Multiple (78709) |
$647.40 |
$1,079 |
1.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,294.20 |
$2,157 |
2.4× |
| K Flow/Funct Image W/O Drug (78707) |
$1,294.20 |
$2,157 |
2.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$608.40 |
$1,014 |
1.5× |
| Knee 3 Views (73562) |
$630 |
$1,050 |
7.3× |
| Liver & Spleen Imaging Static Only (78215) |
$1,216.80 |
$2,028 |
3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$463.80 |
$773 |
1.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,044 |
$1,740 |
1.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,345.20 |
$2,242 |
2.5× |
| Lung Ventilation Imaging (78579) |
$699.60 |
$1,166 |
1.8× |
| Lymph System Imaging (78195) |
$1,531.80 |
$2,553 |
2.8× |
| Mammary ductogram or galactogram single (77053) |
$544.80 |
$908 |
2.3× |
| Meckels Divert Exam (78290) |
$364.20 |
$607 |
0.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,513.80 |
$2,523 |
4.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,274 |
$3,790 |
6.5× |
| MRA head w/o contrast (70544) |
$1,943.40 |
$3,239 |
8.2× |
| MRA neck w contrast (70548) |
$1,963.80 |
$3,273 |
5.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,664 |
$4,440 |
7.7× |
| MRA neck w/o contrast (70547) |
$1,944.60 |
$3,241 |
8.2× |
| MRI abdomen w contrast (74182) |
$1,963.20 |
$3,272 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,870.80 |
$3,118 |
7.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,992.80 |
$4,988 |
3.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,586.20 |
$5,977 |
10.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,445 |
$4,075 |
3.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$832.80 |
$1,388 |
3.5× |
| MRI cervical spine w contrast (72142) |
$2,293.20 |
$3,822 |
6.6× |
| MRI cervical spine w/o cont (72141) |
$2,205 |
$3,675 |
9.3× |
| MRI chest w/o contrast (71550) |
$2,202 |
$3,670 |
9.3× |
| MRI chest wo w contrast (71552) |
$3,014.40 |
$5,024 |
8.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,017.40 |
$5,029 |
8.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,586.20 |
$5,977 |
10.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,473.20 |
$4,122 |
10.4× |
| MRI lumbar spine w contrast (72149) |
$2,655.60 |
$4,426 |
7.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,844.60 |
$4,741 |
8.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,145.60 |
$3,576 |
9.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,021.60 |
$5,036 |
8.7× |
| MRI pelvis w contrast (72196) |
$1,941.60 |
$3,236 |
5.6× |
| MRI pelvis w/o & w contrast (72197) |
$3,033.60 |
$5,056 |
8.7× |
| MRI pelvis w/o contrast (72195) |
$1,850.40 |
$3,084 |
7.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,298 |
$3,830 |
9.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,687.20 |
$2,812 |
7.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,721.60 |
$4,536 |
7.8× |
| MRI, abdomen, combo (74183) |
$3,067.20 |
$5,112 |
8.8× |
| MRI, dorsal spine combo (72157) |
$2,964.60 |
$4,941 |
8.5× |
| MRI, dorsal spine contrast (72147) |
$2,389.80 |
$3,983 |
6.9× |
| MRI, joint upper extrem (73221) |
$2,202.60 |
$3,671 |
9.3× |
| MRI, joint upper extrem combo (73223) |
$2,841.60 |
$4,736 |
8.2× |
| MRI, lumbar spine combo (72158) |
$3,294 |
$5,490 |
9.5× |
| Myelogram cervical (72240) |
$2,542.80 |
$4,238 |
3.3× |
| Myelogram Lumbar (72265) |
$2,288.40 |
$3,814 |
2.9× |
| Myelography thoracic (72255) |
$2,542.80 |
$4,238 |
3.3× |
| Myelograpy 2/more regions rs&i (72270) |
$871.80 |
$1,453 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,110.40 |
$5,184 |
2.4× |
| Neck soft tissue (70360) |
$427.80 |
$713 |
4.9× |
| Nm csf leak detection (78650) |
$1,602.60 |
$2,671 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,789.20 |
$2,982 |
1.3× |
| Nuclear Rx Oral Admin (79005) |
$1,324.80 |
$2,208 |
5.7× |
| Parathyroid Planar Imaging (78070) |
$1,072.80 |
$1,788 |
2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,312.80 |
$2,188 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$276.60 |
$461 |
2.7× |
| Peritoneogram Rs&I (74190) |
$487.80 |
$813 |
0.9× |
| Pet Image Skull-Thigh (78812) |
$1,818 |
$3,030 |
1.3× |
| PET image w/CT, full body (78816) |
$7,293 |
$12,155 |
5.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,293 |
$12,155 |
5.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$578.40 |
$964 |
1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$411.60 |
$686 |
4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$537.60 |
$896 |
1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$537 |
$895 |
6.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$262.80 |
$438 |
3.0× |
| Radex elbow complete minimum 3 views (73080) |
$582 |
$970 |
6.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$726.60 |
$1,211 |
7.0× |
| Radex fingr minimum 2 views (73140) |
$476.40 |
$794 |
5.5× |
| Radex foot complete minimum 3 views (73630) |
$569.40 |
$949 |
6.6× |
| Radex Hand Minimum 3 Views (73130) |
$562.80 |
$938 |
6.5× |
| Radex lower extremity infant minimum 2 views (73592) |
$161.40 |
$269 |
1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$446.40 |
$744 |
5.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$163.20 |
$272 |
1.9× |
| Radex shoulder complete minimum 2 views (73030) |
$559.20 |
$932 |
6.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$167.40 |
$279 |
1.9× |
| Radex Spine 1 View Specify Level (72020) |
$372.60 |
$621 |
4.3× |
| Radex Sternum Minimum 2 Views (71120) |
$586.20 |
$977 |
6.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$259.80 |
$433 |
3.0× |
| Radex Toe Minimum 2 Views (73660) |
$240 |
$400 |
2.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$144 |
$240 |
1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$574.20 |
$957 |
6.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$9,769.80 |
$16,283 |
1.3× |
| Radiation treatment delivery level 1 (77402) |
$369.60 |
$616 |
3.6× |
| Radiation treatment delivery level 2 (77407) |
$544.80 |
$908 |
1.4× |
| Radiation treatment delivery level 3 (77412) |
$1,375.20 |
$2,292 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$177 |
$295 |
1.7× |
| Radiologic exam colon double contrast study (74280) |
$1,490.40 |
$2,484 |
8.5× |
| Radiologic exam colon single contrast study (74270) |
$532.20 |
$887 |
3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$247.20 |
$412 |
1.4× |
| Radiologic exam knee complete 4/more views (73564) |
$365.40 |
$609 |
3.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$293.40 |
$489 |
2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$415.20 |
$692 |
2.4× |
| Radiologic exam swallow function contrast study (74230) |
$219 |
$365 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$588 |
$980 |
3.4× |
| Radiologic examination femur 1 view (73551) |
$68.40 |
$114 |
0.8× |
| Radiologic examination femur minimum 2 views (73552) |
$525 |
$875 |
6.1× |
| Radiologic examination knee 1/2 views (73560) |
$365.40 |
$609 |
4.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$276 |
$460 |
2.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$553.20 |
$922 |
6.4× |
| Ribs bilateral 3 views (71110) |
$384.60 |
$641 |
3.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$648.60 |
$1,081 |
1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,542.80 |
$4,238 |
4.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,621.80 |
$2,703 |
3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,621.80 |
$2,703 |
3.0× |
| Scapula (73010) |
$387 |
$645 |
3.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$75.60 |
$126 |
3.2× |
| Shoulder 1 view (73020) |
$234.60 |
$391 |
2.7× |
| Shoulder Arthrography (73040) |
$1,234.20 |
$2,057 |
3.6× |
| Skull less than 4 views (70250) |
$443.40 |
$739 |
4.3× |
| Special Physics Consult (77370) |
$356.40 |
$594 |
2.7× |
| Special teletherapy port plan (77321) |
$426 |
$710 |
1.1× |
| Special treatment procedure (77470) |
$556.20 |
$927 |
1.0× |
| Stereotactic Body Radiation Delivery (77373) |
$1,991.40 |
$3,319 |
1.1× |
| Sternoclavicular joints (71130) |
$199.20 |
$332 |
2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$750.60 |
$1,251 |
2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$270 |
$450 |
0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,704 |
$2,840 |
4.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,222.80 |
$2,038 |
3.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,002.60 |
$1,671 |
7.5× |
| Thoracic spine 2 views (72070) |
$556.20 |
$927 |
5.3× |
| Thoracic spine 3 views (72072) |
$350.40 |
$584 |
3.4× |
| Thoracolumbar 2 views (72080) |
$349.20 |
$582 |
4.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$836.40 |
$1,394 |
2.1× |
| Thyroid Met Imaging Body (78018) |
$570.60 |
$951 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,008 |
$1,680 |
2.5× |
| Tx Devices Design & Construction Complex (77334) |
$934.80 |
$1,558 |
2.5× |
| Tx devices design & construction intermediate (77333) |
$589.20 |
$982 |
4.4× |
| Tx devices design & construction simple (77332) |
$420.60 |
$701 |
3.1× |
| Ultrasound Breast Limited (76642) |
$425.40 |
$709 |
4.9× |
| Ultrasound Elastography Parenchyma (76981) |
$988.20 |
$1,647 |
9.5× |
| Ultrasound Exam Aaa Screen (76706) |
$313.20 |
$522 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$961.80 |
$1,603 |
9.2× |
| Unlisted fluoroscopic procedure (76496) |
$208.80 |
$348 |
2.4× |
| Unlisted magnetic resonance procedure (76498) |
$1,134 |
$1,890 |
13.1× |
| Unlisted us procedure (76999) |
$304.20 |
$507 |
3.5× |
| Upper gi w/o kub (74240) |
$456 |
$760 |
2.6× |
| Urethrocystogram voiding (74455) |
$517.20 |
$862 |
2.2× |
| Urethrocystography retrograde (74450) |
$293.40 |
$489 |
1.2× |
| Us breast unilateral complete (76641) |
$714.60 |
$1,191 |
6.9× |
| Us chest (76604) |
$196.20 |
$327 |
1.9× |
| Us complete joint (76881) |
$894.60 |
$1,491 |
8.6× |
| Us exam, pelvic, limited (76857) |
$145.20 |
$242 |
1.4× |
| Us head (76506) |
$670.20 |
$1,117 |
6.4× |
| Us kidney transplant (76776) |
$435.60 |
$726 |
4.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$410.40 |
$684 |
3.9× |
| Us ob limited 1 or more fetuses (76815) |
$732 |
$1,220 |
7.0× |
| Us ob transvaginal (76817) |
$703.80 |
$1,173 |
6.8× |
| Us pelvic non ob complete (76856) |
$969.60 |
$1,616 |
9.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$974.40 |
$1,624 |
9.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$907.80 |
$1,513 |
8.7× |
| Us retroperitoneal complete (76770) |
$674.40 |
$1,124 |
6.5× |
| Us retroperitoneal limited (76775) |
$418.20 |
$697 |
4.0× |
| Us scrotum and contents (76870) |
$903.60 |
$1,506 |
8.7× |
| Us spinal canal and contents (76800) |
$285.60 |
$476 |
2.7× |
| Us thyroid (76536) |
$783 |
$1,305 |
7.5× |
| Us transrectal (76872) |
$701.40 |
$1,169 |
6.7× |
| Vein X-Ray Chest (75827) |
$877.80 |
$1,463 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,888.80 |
$3,148 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$777 |
$1,295 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$801 |
$1,335 |
0.5× |
| Wrist 2 views (73100) |
$453.60 |
$756 |
5.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$233.40 |
$389 |
2.7× |
| X-ray antegrade pyelogram tube (74425) |
$1,401 |
$2,335 |
4.0× |
| X-Ray Aorta Leg Arteries (75630) |
$2,788.80 |
$4,648 |
0.9× |
| X-Ray Bend Only L-S Spine (72120) |
$274.20 |
$457 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$424.80 |
$708 |
4.9× |
| X-Ray Exam Breast Specimen (76098) |
$507.60 |
$846 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$338.40 |
$564 |
3.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$446.40 |
$744 |
4.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$493.80 |
$823 |
4.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$186.60 |
$311 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$222 |
$370 |
2.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$257.40 |
$429 |
2.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$348.60 |
$581 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$348.60 |
$581 |
3.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$304.80 |
$508 |
2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$534 |
$890 |
6.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$913.20 |
$1,522 |
8.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$651.60 |
$1,086 |
6.3× |
| X-ray eye for foreign body (70030) |
$100.80 |
$168 |
1.2× |
| X-ray humerus (73060) |
$449.40 |
$749 |
5.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$508.20 |
$847 |
4.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$671.40 |
$1,119 |
6.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$503.40 |
$839 |
4.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$430.20 |
$717 |
5.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$439.80 |
$733 |
5.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$563.40 |
$939 |
5.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$928.20 |
$1,547 |
2.7× |
| X-Rays Bone Length Studies (77073) |
$150 |
$250 |
1.4× |
| X-Rays Bone Survey Complete (77075) |
$226.20 |
$377 |
2.2× |
| Xr c-spine 4 or 5 views (72050) |
$283.20 |
$472 |
2.7× |
| Xr facial bones less than 3 views (70140) |
$327 |
$545 |
3.8× |
| Xr orbits complete 4 views (70200) |
$844.20 |
$1,407 |
8.1× |