| Abdomen 1 View (74018) |
$208 |
$208 |
2.2× |
| Abdomen 2 views (74019) |
$249 |
$249 |
2.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,431 |
$2,431 |
5.7× |
| Adrenal Cortex & Medulla Img (78075) |
$3,473 |
$3,473 |
2.5× |
| Angiography extremity bilateral rs&i (75716) |
$13,468 |
$13,468 |
4.0× |
| Angiography extremity unilateral rs&i (75710) |
$6,734 |
$6,734 |
2.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$14,276 |
$14,276 |
4.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$13,468 |
$13,468 |
4.0× |
| Ankle 2 views (73600) |
$417 |
$417 |
4.5× |
| Aortography thoracic serialography rs&i (75605) |
$22,432 |
$22,432 |
3.8× |
| Artery X-Rays Abdomen (75726) |
$29,520 |
$29,520 |
5.0× |
| Artery X-Rays Pelvis (75736) |
$22,884 |
$22,884 |
3.9× |
| Artery X-Rays Spine (75705) |
$22,884 |
$22,884 |
3.9× |
| Arthrogram ankle (73615) |
$1,134 |
$1,134 |
3.1× |
| Arthrogram hip (73525) |
$2,351 |
$2,351 |
6.3× |
| Arthrogram Wrist (73115) |
$1,134 |
$1,134 |
3.1× |
| Bone age studies (77072) |
$376 |
$376 |
3.4× |
| Bone Imaging 3 Phase (78315) |
$2,585 |
$2,585 |
6.1× |
| Bone Imaging Multiple Areas (78305) |
$2,354 |
$2,354 |
5.5× |
| Bone Imaging Whole Body (78306) |
$3,704 |
$3,704 |
8.7× |
| Bone marrow imaging; multiple areas (78103) |
$5,855 |
$5,855 |
13.8× |
| Bone marrow imaging; whole body (78104) |
$1,773 |
$1,773 |
4.2× |
| Bone survey infant (77076) |
$1,116 |
$1,116 |
10.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,292 |
$2,292 |
4.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$3,592 |
$3,592 |
6.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,987 |
$7,987 |
5.2× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$6,611 |
$6,611 |
11.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,467 |
$4,467 |
12.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$4,909 |
$4,909 |
5.9× |
| Cardiac Shunt Detection (78428) |
$2,056 |
$2,056 |
4.8× |
| Cat Scan Follow-Up Study (76380) |
$1,737 |
$1,737 |
18.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,292 |
$2,292 |
4.0× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$2,894 |
$2,894 |
5.0× |
| Cerebrospinal Fluid Scan (78630) |
$3,844 |
$3,844 |
6.7× |
| Chest 1 view (71045) |
$174 |
$174 |
1.9× |
| Chest 2 views (71046) |
$417 |
$417 |
4.5× |
| Chest 3 views (71047) |
$440 |
$440 |
4.8× |
| Chest 4 or more views (71048) |
$509 |
$509 |
4.6× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$489 |
$489 |
4.4× |
| Cholecystography Oral Contrast (74290) |
$614 |
$614 |
3.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$545 |
$545 |
4.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$3,357 |
$3,357 |
4.0× |
| Clavicle complete (73000) |
$545 |
$545 |
5.9× |
| Contrast Exam Abdominl Aorta (75625) |
$13,468 |
$13,468 |
4.0× |
| Contrast X-Ray Bladder (74430) |
$974 |
$974 |
2.6× |
| Contrast X-Ray Of Elbow (73085) |
$2,351 |
$2,351 |
6.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$2,351 |
$2,351 |
6.3× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$695 |
$695 |
3.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,605 |
$2,605 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$4,272 |
$4,272 |
16.8× |
| CT abdomen w contrast (74160) |
$4,272 |
$4,272 |
22.9× |
| CT abdomen w wo contrast (74170) |
$5,430 |
$5,430 |
29.1× |
| CT abdomen w/o contrast (74150) |
$3,114 |
$3,114 |
28.0× |
| CT Angio Abdomen and Pelvis (74174) |
$4,805 |
$4,805 |
12.9× |
| CT Angio Chest (71275) |
$3,039 |
$3,039 |
16.3× |
| CT Angio Head (70496) |
$3,039 |
$3,039 |
16.3× |
| CT angio hrt w/3d image (75574) |
$2,490 |
$2,490 |
6.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$4,805 |
$4,805 |
25.7× |
| CT Angio Neck (70498) |
$3,039 |
$3,039 |
16.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$4,805 |
$4,805 |
25.7× |
| CT cervical spine w/ contrast (72126) |
$4,144 |
$4,144 |
11.2× |
| CT cervical spine w/o contrast (72125) |
$4,017 |
$4,017 |
36.1× |
| CT cervical spine w/wo cont (72127) |
$4,666 |
$4,666 |
25.0× |
| CT chest w contrast (71260) |
$2,113 |
$2,113 |
11.3× |
| CT chest w/wo contrast (71270) |
$2,691 |
$2,691 |
14.4× |
| CT head/brain with contrast (70460) |
$2,113 |
$2,113 |
11.3× |
| CT head/brain without and with contrast (70470) |
$2,691 |
$2,691 |
14.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,737 |
$1,737 |
4.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$2,200 |
$2,200 |
23.8× |
| CT hrt w/3d image congen (75573) |
$1,592 |
$1,592 |
4.3× |
| CT iac w contrast (70481) |
$2,200 |
$2,200 |
11.8× |
| CT l-spine w&w/o contrast (72133) |
$4,666 |
$4,666 |
25.0× |
| CT lower ext w/o (73700) |
$4,017 |
$4,017 |
36.1× |
| CT lower extremity w/contrast material (73701) |
$4,573 |
$4,573 |
24.5× |
| CT lumbar spine w contrast (72132) |
$4,144 |
$4,144 |
11.2× |
| CT lumbar spine w/o contrast (72131) |
$4,017 |
$4,017 |
36.1× |
| CT maxillofacial w contrast (70487) |
$2,113 |
$2,113 |
11.3× |
| CT maxillofacial wo contrast (70486) |
$1,187 |
$1,187 |
10.7× |
| CT neck tissue combo (70492) |
$2,691 |
$2,691 |
14.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,691 |
$2,691 |
14.4× |
| CT orbits w/o contrast (70480) |
$1,737 |
$1,737 |
15.6× |
| CT pelvis w&w/o contrast (72194) |
$4,017 |
$4,017 |
21.5× |
| CT pelvis w/o contrast (72192) |
$3,177 |
$3,177 |
28.5× |
| CT scan of leg combo (73702) |
$3,879 |
$3,879 |
20.8× |
| CT scans face/jaw combo (70488) |
$2,691 |
$2,691 |
14.4× |
| CT soft tissue neck w contrast (70491) |
$2,113 |
$2,113 |
11.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,187 |
$1,187 |
10.7× |
| CT thoracic spine w contrast (72129) |
$4,144 |
$4,144 |
22.2× |
| CT thoracic spine w/o contrast (72128) |
$4,017 |
$4,017 |
36.1× |
| CT thoracic spine w/wo cont (72130) |
$4,666 |
$4,666 |
25.0× |
| CT thorax w/o contrast (71250) |
$1,187 |
$1,187 |
10.7× |
| CT unlisted procedure (76497) |
$394 |
$394 |
4.3× |
| CT upper ext wo (73200) |
$4,017 |
$4,017 |
36.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,879 |
$3,879 |
20.8× |
| CT upper extremity with contrast (73201) |
$4,573 |
$4,573 |
12.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$13,468 |
$13,468 |
72.1× |
| Cta Abdomen (74175) |
$4,805 |
$4,805 |
25.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,412 |
$1,412 |
3.8× |
| CTA pelvis (72191) |
$4,805 |
$4,805 |
25.7× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$2,305 |
$2,305 |
9.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$1,371 |
$1,371 |
12.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$2,409 |
$2,409 |
21.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,371 |
$1,371 |
12.3× |
| Dxa Bone Density Axial (77080) |
$440 |
$440 |
4.0× |
| Dxa bone density study (77085) |
$651 |
$651 |
5.9× |
| Echo exam of fetal heart (76825) |
$3,728 |
$3,728 |
6.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,872 |
$1,872 |
7.4× |
| Esophageal Motility Study (78258) |
$2,554 |
$2,554 |
6.0× |
| Esophagram (74220) |
$1,264 |
$1,264 |
6.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$967 |
$967 |
8.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,794 |
$1,794 |
7.1× |
| Fluoroscopy up to 1 hr (76000) |
$1,077 |
$1,077 |
4.2× |
| Follow-Up Angiography (75898) |
$5,672 |
$5,672 |
1.7× |
| Foot 2 views (73620) |
$417 |
$417 |
4.5× |
| Forearm 2 views (73090) |
$417 |
$417 |
4.5× |
| Gastric emptying imaging study (78264) |
$2,734 |
$2,734 |
6.4× |
| Gastroesophageal Reflux Exam (78262) |
$2,554 |
$2,554 |
6.0× |
| Gated Heart, Multiple (78473) |
$5,855 |
$5,855 |
13.8× |
| Hand 2 views (73120) |
$371 |
$371 |
3.3× |
| Heart Image (Pet) Multiple (78492) |
$6,964 |
$6,964 |
4.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$17,711 |
$17,711 |
5.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$13,468 |
$13,468 |
4.0× |
| Hepatobil Syst Image W/Drug (78227) |
$2,472 |
$2,472 |
4.3× |
| Hepatobiliary System Imaging (78226) |
$1,771 |
$1,771 |
4.2× |
| Ht Musc Image Planar Mult (78454) |
$6,148 |
$6,148 |
4.5× |
| Ht Muscle Image Spect Sing (78451) |
$6,611 |
$6,611 |
4.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,008 |
$1,008 |
10.9× |
| Infant hip ultrasound, limited static exam (76886) |
$667 |
$667 |
7.2× |
| Joint Survey Single View (77077) |
$509 |
$509 |
4.6× |
| K Flow/Funct Image Multiple (78709) |
$3,638 |
$3,638 |
6.3× |
| K Flow/Funct Image W/Drug (78708) |
$3,418 |
$3,418 |
5.9× |
| K Flow/Funct Image W/O Drug (78707) |
$3,073 |
$3,073 |
5.3× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$2,292 |
$2,292 |
5.4× |
| Kidney Imaging Morphol (78700) |
$3,073 |
$3,073 |
7.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$6,148 |
$6,148 |
14.4× |
| Knee 3 Views (73562) |
$463 |
$463 |
5.0× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$3,126 |
$3,126 |
7.3× |
| Leveen/Shunt Patency Exam (78291) |
$2,200 |
$2,200 |
5.2× |
| Liver & Spleen Imaging Static Only (78215) |
$2,292 |
$2,292 |
5.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,084 |
$2,084 |
4.9× |
| Liver imaging static only (78201) |
$1,773 |
$1,773 |
3.1× |
| Liver imaging w/vascular flow (78202) |
$2,472 |
$2,472 |
4.3× |
| Lung perfusion differential (78597) |
$1,604 |
$1,604 |
3.8× |
| Lymph System Imaging (78195) |
$4,052 |
$4,052 |
7.0× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$6,252 |
$6,252 |
3.7× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,547 |
$2,547 |
3.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$13,468 |
$13,468 |
4.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$6,734 |
$6,734 |
2.0× |
| Magnetic Image Jaw Joint (70336) |
$4,201 |
$4,201 |
16.5× |
| Magnetic Resonance Elastography (76391) |
$1,505 |
$1,505 |
5.9× |
| Meckels Divert Exam (78290) |
$2,554 |
$2,554 |
6.0× |
| Mr safety determination physician/other qhp (76016) |
$366 |
$366 |
4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$102 |
$102 |
3.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$382 |
$382 |
3.8× |
| Mr safety implt pos&/immoblj (76019) |
$247 |
$247 |
3.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$1,005 |
$1,005 |
4.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,871 |
$2,871 |
7.7× |
| MRA head w/o contrast (70544) |
$2,547 |
$2,547 |
10.0× |
| MRA head with contrast (70545) |
$2,587 |
$2,587 |
7.0× |
| MRA neck w contrast (70548) |
$2,587 |
$2,587 |
7.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,871 |
$2,871 |
7.7× |
| MRA neck w/o contrast (70547) |
$2,547 |
$2,547 |
10.0× |
| MRI abdomen w contrast (74182) |
$2,200 |
$2,200 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,482 |
$1,482 |
5.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,200 |
$2,200 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,158 |
$1,158 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,200 |
$2,200 |
2.6× |
| MRI bone marrow blood supply (77084) |
$3,188 |
$3,188 |
12.6× |
| MRI brain functional w/o physician admnistration (70554) |
$1,733 |
$1,733 |
6.8× |
| MRI brain functional w/physician admnistration (70555) |
$1,733 |
$1,733 |
6.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,482 |
$1,482 |
5.8× |
| MRI cardiac w/o cont stress (75559) |
$3,300 |
$3,300 |
5.7× |
| MRI cardiac w/o contrast (75557) |
$2,969 |
$2,969 |
11.7× |
| MRI cervical spine w contrast (72142) |
$2,205 |
$2,205 |
5.9× |
| MRI cervical spine w/o cont (72141) |
$1,482 |
$1,482 |
5.8× |
| MRI chest w/o contrast (71550) |
$1,482 |
$1,482 |
5.8× |
| MRI chest with contrast (71551) |
$2,200 |
$2,200 |
2.6× |
| MRI chest wo w contrast (71552) |
$2,472 |
$2,472 |
6.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,505 |
$1,505 |
4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,737 |
$1,737 |
4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,482 |
$1,482 |
5.8× |
| MRI lumbar spine w contrast (72149) |
$2,205 |
$2,205 |
5.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,472 |
$2,472 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,482 |
$1,482 |
5.8× |
| MRI orbit face neck w contrast (70542) |
$2,200 |
$2,200 |
5.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,472 |
$2,472 |
6.7× |
| MRI pelvis w contrast (72196) |
$2,200 |
$2,200 |
5.9× |
| MRI pelvis w/o & w contrast (72197) |
$2,472 |
$2,472 |
6.7× |
| MRI pelvis w/o contrast (72195) |
$1,482 |
$1,482 |
5.8× |
| MRI spectroscopy (76390) |
$1,865 |
$1,865 |
20.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,482 |
$1,482 |
5.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,292 |
$2,292 |
6.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,482 |
$1,482 |
5.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,472 |
$2,472 |
6.7× |
| MRI, abdomen, combo (74183) |
$2,472 |
$2,472 |
6.7× |
| MRI, dorsal spine combo (72157) |
$2,472 |
$2,472 |
6.7× |
| MRI, dorsal spine contrast (72147) |
$2,205 |
$2,205 |
5.9× |
| MRI, joint upper extrem (73221) |
$1,482 |
$1,482 |
5.8× |
| MRI, joint upper extrem combo (73223) |
$2,472 |
$2,472 |
6.7× |
| MRI, lumbar spine combo (72158) |
$2,472 |
$2,472 |
6.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$6,611 |
$6,611 |
4.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$6,611 |
$6,611 |
4.8× |
| Myocardial Spect Multiple Studies (78452) |
$6,148 |
$6,148 |
4.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$6,946 |
$6,946 |
4.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$7,178 |
$7,178 |
4.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$10,998 |
$10,998 |
4.7× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$14,529 |
$14,529 |
6.2× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$14,181 |
$14,181 |
8.8× |
| N-invas est c ffr sw aly CTA (75580) |
$4,353 |
$4,353 |
4.8× |
| Neck soft tissue (70360) |
$314 |
$314 |
3.4× |
| Nm csf leak detection (78650) |
$3,473 |
$3,473 |
2.5× |
| Nonvascular Shunt X-Ray (75809) |
$458 |
$458 |
4.1× |
| Nuclear Rx Intra-Arterial (79445) |
$1,293 |
$1,293 |
5.2× |
| Nuclear Rx Oral Admin (79005) |
$1,785 |
$1,785 |
7.2× |
| Ob us nuchal meas 1 gest (76813) |
$2,409 |
$2,409 |
21.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$509 |
$509 |
4.6× |
| Optic foramina (70190) |
$353 |
$353 |
3.8× |
| Panoramic X-ray of jaws (70355) |
$353 |
$353 |
3.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,338 |
$2,338 |
4.0× |
| Parathyroid Planar Imaging (78070) |
$2,385 |
$2,385 |
5.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,773 |
$1,773 |
4.2× |
| Pelvis 1 or 2 views (72170) |
$295 |
$295 |
2.7× |
| Pet Image Skull-Thigh (78812) |
$6,946 |
$6,946 |
4.6× |
| Pet Image W/Ct Lmtd (78814) |
$6,946 |
$6,946 |
4.6× |
| PET image w/CT, full body (78816) |
$6,828 |
$6,828 |
4.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,524 |
$7,524 |
4.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$6,148 |
$6,148 |
4.5× |
| Pet Myocardial Sngl Study (78491) |
$6,964 |
$6,964 |
4.6× |
| PET whole body (78813) |
$7,524 |
$7,524 |
4.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$20,202 |
$20,202 |
6.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,585 |
$2,585 |
6.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$828 |
$828 |
7.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,200 |
$2,200 |
3.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$463 |
$463 |
5.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$417 |
$417 |
4.5× |
| Radex elbow complete minimum 3 views (73080) |
$509 |
$509 |
5.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$671 |
$671 |
6.0× |
| Radex fingr minimum 2 views (73140) |
$440 |
$440 |
4.8× |
| Radex foot complete minimum 3 views (73630) |
$463 |
$463 |
5.0× |
| Radex Hand Minimum 3 Views (73130) |
$353 |
$353 |
3.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$486 |
$486 |
5.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$625 |
$625 |
5.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$509 |
$509 |
5.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$522 |
$522 |
5.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$417 |
$417 |
4.5× |
| Radex shoulder complete minimum 2 views (73030) |
$417 |
$417 |
4.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$417 |
$417 |
4.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$671 |
$671 |
3.6× |
| Radex Spine 1 View Specify Level (72020) |
$382 |
$382 |
4.1× |
| Radex Sternum Minimum 2 Views (71120) |
$417 |
$417 |
4.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$707 |
$707 |
7.6× |
| Radex Toe Minimum 2 Views (73660) |
$417 |
$417 |
4.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$684 |
$684 |
6.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$394 |
$394 |
4.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$730 |
$730 |
6.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$579 |
$579 |
5.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$671 |
$671 |
6.0× |
| Radiologic exam colon double contrast study (74280) |
$1,448 |
$1,448 |
7.8× |
| Radiologic exam colon single contrast study (74270) |
$1,120 |
$1,120 |
6.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$941 |
$941 |
5.0× |
| Radiologic exam knee complete 4/more views (73564) |
$509 |
$509 |
4.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$509 |
$509 |
4.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,019 |
$1,019 |
5.5× |
| Radiologic exam swallow function contrast study (74230) |
$1,158 |
$1,158 |
6.2× |
| Radiologic exam teeth complete full mouth (70320) |
$1,448 |
$1,448 |
5.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$1,394 |
$1,394 |
5.5× |
| Radiologic examination femur 1 view (73551) |
$371 |
$371 |
4.0× |
| Radiologic examination femur minimum 2 views (73552) |
$417 |
$417 |
4.5× |
| Radiologic examination knee 1/2 views (73560) |
$348 |
$348 |
3.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$1,116 |
$1,116 |
10.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$417 |
$417 |
4.5× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$353 |
$353 |
3.8× |
| Renal Cyst Study (74470) |
$3,473 |
$3,473 |
6.0× |
| Ribs bilateral 3 views (71110) |
$532 |
$532 |
4.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,073 |
$3,073 |
7.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$6,148 |
$6,148 |
10.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$6,148 |
$6,148 |
10.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,073 |
$3,073 |
5.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,611 |
$6,611 |
4.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,409 |
$7,409 |
4.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$6,148 |
$6,148 |
4.5× |
| Salivary Gland Function Study (78232) |
$2,554 |
$2,554 |
6.0× |
| Scapula (73010) |
$545 |
$545 |
4.9× |
| Sella turcica (70240) |
$353 |
$353 |
3.8× |
| Shoulder 1 view (73020) |
$545 |
$545 |
5.9× |
| Shoulder Arthrography (73040) |
$1,134 |
$1,134 |
3.1× |
| Skull less than 4 views (70250) |
$555 |
$555 |
5.0× |
| Speech evaluation, complex (70371) |
$1,042 |
$1,042 |
4.1× |
| Sternoclavicular joints (71130) |
$545 |
$545 |
5.9× |
| Superior sagittal sinus venogram (75870) |
$13,656 |
$13,656 |
4.1× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$1,134 |
$1,134 |
4.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,143 |
$1,143 |
6.1× |
| Thoracic spine 2 views (72070) |
$417 |
$417 |
3.7× |
| Thoracic spine 3 views (72072) |
$509 |
$509 |
4.6× |
| Thoracolumbar 2 views (72080) |
$417 |
$417 |
4.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,773 |
$1,773 |
4.2× |
| Thyroid Met Imaging Body (78018) |
$2,472 |
$2,472 |
4.3× |
| Thyroid Uptake Measurement (78012) |
$830 |
$830 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,006 |
$2,006 |
4.7× |
| Ultrasound Breast Limited (76642) |
$486 |
$486 |
5.2× |
| Ultrasound elastography first target lesion (76982) |
$725 |
$725 |
6.5× |
| Ultrasound Elastography Parenchyma (76981) |
$609 |
$609 |
5.5× |
| Ultrasound Exam Aaa Screen (76706) |
$586 |
$586 |
5.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$1,094 |
$1,094 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$603 |
$603 |
5.4× |
| Umbilical-artery Doppler (OB) (76820) |
$1,371 |
$1,371 |
12.3× |
| Unlisted Dx Radiographic Procedure (76499) |
$371 |
$371 |
4.0× |
| Unlisted fluoroscopic procedure (76496) |
$579 |
$579 |
6.3× |
| Unlisted magnetic resonance procedure (76498) |
$2,472 |
$2,472 |
26.7× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$1,013 |
$1,013 |
2.4× |
| Unlisted respiratory px dx nuclear medicine (78599) |
$2,064 |
$2,064 |
4.9× |
| Upper gi w/o kub (74240) |
$1,024 |
$1,024 |
5.5× |
| Ureteral Reflux Study (78740) |
$2,200 |
$2,200 |
5.2× |
| Urethrocystogram voiding (74455) |
$1,467 |
$1,467 |
5.8× |
| Urethrocystography retrograde (74450) |
$1,783 |
$1,783 |
7.0× |
| Us breast unilateral complete (76641) |
$602 |
$602 |
5.4× |
| Us chest (76604) |
$1,100 |
$1,100 |
9.9× |
| Us complete joint (76881) |
$903 |
$903 |
8.1× |
| Us exam, pelvic, limited (76857) |
$643 |
$643 |
5.8× |
| Us head (76506) |
$1,158 |
$1,158 |
10.4× |
| Us kidney transplant (76776) |
$1,271 |
$1,271 |
11.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$579 |
$579 |
5.2× |
| Us ob detailed single fetus (76811) |
$2,409 |
$2,409 |
9.5× |
| Us ob limited 1 or more fetuses (76815) |
$1,077 |
$1,077 |
9.7× |
| Us ob transvaginal (76817) |
$967 |
$967 |
8.7× |
| Us pelvic non ob complete (76856) |
$1,287 |
$1,287 |
11.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,371 |
$1,371 |
12.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$967 |
$967 |
8.7× |
| Us retroperitoneal complete (76770) |
$815 |
$815 |
7.3× |
| Us retroperitoneal limited (76775) |
$799 |
$799 |
7.2× |
| Us scrotum and contents (76870) |
$1,120 |
$1,120 |
10.1× |
| Us spinal canal and contents (76800) |
$816 |
$816 |
7.3× |
| Us thyroid (76536) |
$883 |
$883 |
7.9× |
| Us transrectal (76872) |
$1,262 |
$1,262 |
11.3× |
| Vascular Flow Imaging (78445) |
$3,177 |
$3,177 |
7.5× |
| Vein X-Ray Chest (75827) |
$13,468 |
$13,468 |
8.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$13,468 |
$13,468 |
4.0× |
| Vein X-Ray Spleen/Liver (75810) |
$17,801 |
$17,801 |
5.3× |
| Venogram Sinus/Jugular (75860) |
$13,468 |
$13,468 |
4.0× |
| Venography caval inferior serialography rs&i (75825) |
$20,202 |
$20,202 |
6.0× |
| Venography extremity bilateral rs&i (75822) |
$13,468 |
$13,468 |
8.0× |
| Venography extremity unilateral rs&i (75820) |
$13,468 |
$13,468 |
8.0× |
| Venography Renal Unilateral (75831) |
$20,202 |
$20,202 |
6.0× |
| Venous sampling by catheter (75893) |
$18,499 |
$18,499 |
3.1× |
| Wrist 2 views (73100) |
$417 |
$417 |
4.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$532 |
$532 |
5.7× |
| X-Ray Aorta Leg Arteries (75630) |
$13,468 |
$13,468 |
4.0× |
| X-Ray Bend Only L-S Spine (72120) |
$440 |
$440 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$417 |
$417 |
4.5× |
| X-Ray Exam Breast Specimen (76098) |
$2,200 |
$2,200 |
3.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$382 |
$382 |
4.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$509 |
$509 |
4.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$602 |
$602 |
5.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$326 |
$326 |
3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$382 |
$382 |
4.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$579 |
$579 |
5.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$417 |
$417 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$509 |
$509 |
4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$532 |
$532 |
4.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$730 |
$730 |
6.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$440 |
$440 |
4.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$730 |
$730 |
6.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$545 |
$545 |
4.9× |
| X-ray eye for foreign body (70030) |
$353 |
$353 |
3.8× |
| X-ray humerus (73060) |
$417 |
$417 |
4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$555 |
$555 |
6.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$528 |
$528 |
5.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$440 |
$440 |
4.0× |
| X-ray nose-rectum child f.b. (76010) |
$532 |
$532 |
5.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$579 |
$579 |
5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$532 |
$532 |
4.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$417 |
$417 |
3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$417 |
$417 |
4.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$625 |
$625 |
6.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$579 |
$579 |
5.2× |
| X-Ray Stress View (77071) |
$373 |
$373 |
4.0× |
| X-ray thoracic spine 4 vw (72074) |
$579 |
$579 |
5.2× |
| X-Ray Tmj Unilat (70328) |
$522 |
$522 |
5.6× |
| X-Rays Bone Length Studies (77073) |
$1,094 |
$1,094 |
9.8× |
| X-Rays Bone Survey Complete (77075) |
$1,158 |
$1,158 |
10.4× |
| Xr c-spine 4 or 5 views (72050) |
$602 |
$602 |
5.4× |
| Xr facial bones less than 3 views (70140) |
$417 |
$417 |
4.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$417 |
$417 |
3.7× |
| Xr orbits complete 4 views (70200) |
$579 |
$579 |
5.2× |