| 3-D radiotherapy plan dose-volume histograms (77295) |
$10,073 |
$10,073 |
7.0× |
| Abdomen 1 View (74018) |
$623 |
$623 |
6.9× |
| Abdomen 2 views (74019) |
$726 |
$726 |
6.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,269 |
$2,269 |
5.4× |
| Angio internal mammary (75756) |
$5,877 |
$5,877 |
1.8× |
| Angio pulmonary bilat (75743) |
$11,978 |
$11,978 |
3.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$11,978 |
$11,978 |
3.6× |
| Angiography extremity bilateral rs&i (75716) |
$11,575 |
$11,575 |
3.5× |
| Angiography extremity unilateral rs&i (75710) |
$8,269 |
$8,269 |
2.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$11,978 |
$11,978 |
3.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,877 |
$5,877 |
1.8× |
| Ankle 2 views (73600) |
$500 |
$500 |
5.5× |
| Aortography thoracic serialography rs&i (75605) |
$11,978 |
$11,978 |
2.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$11,885 |
$11,885 |
3.6× |
| Artery X-Rays Abdomen (75726) |
$14,489 |
$14,489 |
2.5× |
| Artery X-Rays Adrenal Gland (75731) |
$11,978 |
$11,978 |
3.6× |
| Artery X-Rays Pelvis (75736) |
$7,188 |
$7,188 |
1.2× |
| Artery X-Rays Spine (75705) |
$11,978 |
$11,978 |
2.1× |
| Arthrogram ankle (73615) |
$1,480 |
$1,480 |
4.1× |
| Arthrogram hip (73525) |
$1,480 |
$1,480 |
4.1× |
| Arthrogram Wrist (73115) |
$1,469 |
$1,469 |
4.0× |
| Basic radiation dosimetry calculation (77300) |
$1,030 |
$1,030 |
7.3× |
| Bone age studies (77072) |
$485 |
$485 |
4.4× |
| Bone Imaging 3 Phase (78315) |
$2,998 |
$2,998 |
7.2× |
| Bone Imaging Multiple Areas (78305) |
$3,169 |
$3,169 |
7.6× |
| Bone Imaging Whole Body (78306) |
$2,826 |
$2,826 |
6.8× |
| Bone marrow imaging; multiple areas (78103) |
$2,398 |
$2,398 |
5.7× |
| Bone survey infant (77076) |
$840 |
$840 |
7.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,142 |
$2,142 |
3.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$3,424 |
$3,424 |
6.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$5,275 |
$5,275 |
14.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$6,087 |
$6,087 |
7.4× |
| Cardiac Shunt Detection (78428) |
$1,883 |
$1,883 |
4.5× |
| Cat Scan Follow-Up Study (76380) |
$1,896 |
$1,896 |
20.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,054 |
$2,054 |
3.6× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$2,784 |
$2,784 |
4.9× |
| Cerebrospinal Fluid Scan (78630) |
$3,555 |
$3,555 |
6.3× |
| Chest 1 view (71045) |
$623 |
$623 |
6.9× |
| Chest 2 views (71046) |
$797 |
$797 |
8.8× |
| Chest 3 views (71047) |
$829 |
$829 |
9.1× |
| Chest 4 or more views (71048) |
$861 |
$861 |
7.9× |
| Cholecystography Oral Contrast (74290) |
$536 |
$536 |
2.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$4,453 |
$4,453 |
5.4× |
| Clavicle complete (73000) |
$379 |
$379 |
4.2× |
| Contrast Exam Abdominl Aorta (75625) |
$9,630 |
$9,630 |
2.9× |
| Contrast X-Ray Bladder (74430) |
$760 |
$760 |
2.1× |
| Contrast X-Ray Of Elbow (73085) |
$1,469 |
$1,469 |
4.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,480 |
$1,480 |
4.1× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$1,175 |
$1,175 |
6.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,968 |
$3,968 |
10.9× |
| CT abdomen and pelvis without contrast (74176) |
$3,053 |
$3,053 |
12.3× |
| CT abdomen w contrast (74160) |
$3,870 |
$3,870 |
21.1× |
| CT abdomen w wo contrast (74170) |
$4,572 |
$4,572 |
25.0× |
| CT abdomen w/o contrast (74150) |
$3,518 |
$3,518 |
32.2× |
| CT Angio Abdomen and Pelvis (74174) |
$3,886 |
$3,886 |
10.7× |
| CT Angio Chest (71275) |
$4,474 |
$4,474 |
24.4× |
| CT Angio Head (70496) |
$6,187 |
$6,187 |
33.8× |
| CT angio hrt w/3d image (75574) |
$5,614 |
$5,614 |
15.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$4,334 |
$4,334 |
23.7× |
| CT Angio Neck (70498) |
$7,484 |
$7,484 |
40.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$4,334 |
$4,334 |
23.7× |
| CT cervical spine w/ contrast (72126) |
$5,229 |
$5,229 |
14.4× |
| CT cervical spine w/o contrast (72125) |
$4,754 |
$4,754 |
43.5× |
| CT cervical spine w/wo cont (72127) |
$6,180 |
$6,180 |
33.7× |
| CT chest w contrast (71260) |
$3,323 |
$3,323 |
18.1× |
| CT chest w/wo contrast (71270) |
$3,928 |
$3,928 |
21.4× |
| CT head/brain with contrast (70460) |
$4,081 |
$4,081 |
22.3× |
| CT head/brain without and with contrast (70470) |
$4,823 |
$4,823 |
26.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,756 |
$1,756 |
4.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,597 |
$1,597 |
17.6× |
| CT hrt w/3d image congen (75573) |
$2,078 |
$2,078 |
5.7× |
| CT iac w contrast (70481) |
$4,787 |
$4,787 |
26.1× |
| CT l-spine w&w/o contrast (72133) |
$5,817 |
$5,817 |
31.8× |
| CT lower ext w/o (73700) |
$2,900 |
$2,900 |
26.6× |
| CT lower extremity w/contrast material (73701) |
$3,192 |
$3,192 |
17.4× |
| CT lumbar spine w contrast (72132) |
$4,923 |
$4,923 |
13.5× |
| CT lumbar spine w/o contrast (72131) |
$4,475 |
$4,475 |
41.0× |
| CT maxillofacial w contrast (70487) |
$4,210 |
$4,210 |
23.0× |
| CT maxillofacial wo contrast (70486) |
$3,825 |
$3,825 |
35.0× |
| CT neck tissue combo (70492) |
$4,588 |
$4,588 |
25.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$5,660 |
$5,660 |
30.9× |
| CT orbits w/o contrast (70480) |
$4,353 |
$4,353 |
39.9× |
| CT pelvis w&w/o contrast (72194) |
$4,758 |
$4,758 |
26.0× |
| CT pelvis w/o contrast (72192) |
$3,658 |
$3,658 |
33.5× |
| CT scan of leg combo (73702) |
$3,771 |
$3,771 |
20.6× |
| CT scans face/jaw combo (70488) |
$4,976 |
$4,976 |
27.2× |
| CT soft tissue neck w contrast (70491) |
$3,880 |
$3,880 |
21.2× |
| CT soft tissue neck w/o contrast (70490) |
$3,529 |
$3,529 |
32.3× |
| CT thoracic spine w contrast (72129) |
$4,804 |
$4,804 |
26.2× |
| CT thoracic spine w/o contrast (72128) |
$4,367 |
$4,367 |
40.0× |
| CT thoracic spine w/wo cont (72130) |
$5,677 |
$5,677 |
31.0× |
| CT thorax w/o contrast (71250) |
$3,021 |
$3,021 |
27.7× |
| CT upper ext wo (73200) |
$2,834 |
$2,834 |
26.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,683 |
$3,683 |
20.1× |
| CT upper extremity with contrast (73201) |
$3,116 |
$3,116 |
8.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$7,148 |
$7,148 |
39.0× |
| Cta Abdomen (74175) |
$5,180 |
$5,180 |
28.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,412 |
$1,412 |
3.9× |
| CTA pelvis (72191) |
$3,861 |
$3,861 |
21.1× |
| Dilation ureters/urethra rs&i (74485) |
$6,459 |
$6,459 |
3.0× |
| Discography Cerv/Thor Spine (72285) |
$5,383 |
$5,383 |
2.6× |
| Diskography lumbar (72295) |
$4,733 |
$4,733 |
2.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$1,263 |
$1,263 |
11.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,391 |
$1,391 |
12.7× |
| Dxa Bone Density Axial (77080) |
$915 |
$915 |
8.4× |
| Echo exam of fetal heart (76825) |
$1,898 |
$1,898 |
3.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,643 |
$1,643 |
6.6× |
| Esophageal Motility Study (78258) |
$2,142 |
$2,142 |
5.1× |
| Esophagram (74220) |
$981 |
$981 |
5.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$4,058 |
$4,058 |
16.3× |
| Fluoroscopy up to 1 hr (76000) |
$840 |
$840 |
3.4× |
| Follow-Up Angiography (75898) |
$622 |
$622 |
0.2× |
| Foot 2 views (73620) |
$500 |
$500 |
5.5× |
| Forearm 2 views (73090) |
$485 |
$485 |
5.3× |
| Gastric emptying imaging study (78264) |
$2,535 |
$2,535 |
6.1× |
| Gastric Mucosa Imaging (78261) |
$1,489 |
$1,489 |
3.6× |
| Gastroesophageal Reflux Exam (78262) |
$2,357 |
$2,357 |
5.6× |
| Gated Heart, Multiple (78473) |
$3,255 |
$3,255 |
7.8× |
| Hand 2 views (73120) |
$586 |
$586 |
5.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,349 |
$6,349 |
1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$11,978 |
$11,978 |
3.6× |
| Hepatobil Syst Image W/Drug (78227) |
$2,092 |
$2,092 |
3.7× |
| Hepatobiliary System Imaging (78226) |
$1,623 |
$1,623 |
3.9× |
| Ht Musc Image Planar Mult (78454) |
$6,504 |
$6,504 |
4.8× |
| Ht Muscle Image Spect Sing (78451) |
$6,164 |
$6,164 |
4.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$2,030 |
$2,030 |
22.3× |
| Infant hip ultrasound, limited static exam (76886) |
$1,844 |
$1,844 |
20.3× |
| Infusion Ivp (74410) |
$1,023 |
$1,023 |
5.6× |
| Joint Survey Single View (77077) |
$504 |
$504 |
4.6× |
| K Flow/Funct Image Multiple (78709) |
$3,511 |
$3,511 |
6.2× |
| K Flow/Funct Image W/Drug (78708) |
$3,169 |
$3,169 |
5.6× |
| K Flow/Funct Image W/O Drug (78707) |
$2,909 |
$2,909 |
5.1× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$2,280 |
$2,280 |
5.5× |
| Kidney Imaging Morphol (78700) |
$2,568 |
$2,568 |
6.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$2,826 |
$2,826 |
6.8× |
| Knee 3 Views (73562) |
$586 |
$586 |
6.4× |
| Leveen/Shunt Patency Exam (78291) |
$2,054 |
$2,054 |
4.9× |
| Liver & Spleen Imaging Static Only (78215) |
$1,798 |
$1,798 |
4.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,970 |
$1,970 |
4.7× |
| Liver imaging static only (78201) |
$1,626 |
$1,626 |
2.9× |
| Liver imaging w/vascular flow (78202) |
$1,798 |
$1,798 |
3.2× |
| Lung perfusion differential (78597) |
$1,623 |
$1,623 |
3.9× |
| Lymph System Imaging (78195) |
$2,909 |
$2,909 |
5.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$2,511 |
$2,511 |
1.5× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,511 |
$2,511 |
3.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$2,511 |
$2,511 |
0.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,511 |
$2,511 |
0.8× |
| Magnetic Image Jaw Joint (70336) |
$4,174 |
$4,174 |
16.8× |
| Magnetic Resonance Elastography (76391) |
$1,059 |
$1,059 |
4.3× |
| Meckels Divert Exam (78290) |
$2,482 |
$2,482 |
5.9× |
| Mr safety determination physician/other qhp (76016) |
$359 |
$359 |
4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$100 |
$100 |
3.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$364 |
$364 |
3.7× |
| Mr safety implt pos&/immoblj (76019) |
$235 |
$235 |
3.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$986 |
$986 |
4.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,926 |
$4,926 |
13.5× |
| MRA head w/o contrast (70544) |
$3,789 |
$3,789 |
15.2× |
| MRA head with contrast (70545) |
$3,749 |
$3,749 |
10.3× |
| MRA neck w contrast (70548) |
$3,753 |
$3,753 |
10.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,613 |
$4,613 |
12.7× |
| MRA neck w/o contrast (70547) |
$3,547 |
$3,547 |
14.2× |
| MRI abdomen w contrast (74182) |
$4,458 |
$4,458 |
12.2× |
| MRI abdomen w/o contrast (74181) |
$3,796 |
$3,796 |
15.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,322 |
$4,322 |
5.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$5,106 |
$5,106 |
14.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,269 |
$4,269 |
5.2× |
| MRI bone marrow blood supply (77084) |
$4,174 |
$4,174 |
16.8× |
| MRI brain functional w/o physician admnistration (70554) |
$963 |
$963 |
3.9× |
| MRI brain functional w/physician admnistration (70555) |
$4,058 |
$4,058 |
16.3× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,059 |
$1,059 |
4.3× |
| MRI cardiac w/o cont stress (75559) |
$4,464 |
$4,464 |
7.8× |
| MRI cardiac w/o contrast (75557) |
$4,058 |
$4,058 |
16.3× |
| MRI cervical spine w contrast (72142) |
$4,849 |
$4,849 |
13.3× |
| MRI cervical spine w/o cont (72141) |
$4,408 |
$4,408 |
17.7× |
| MRI chest w/o contrast (71550) |
$4,058 |
$4,058 |
16.3× |
| MRI chest with contrast (71551) |
$4,398 |
$4,398 |
5.4× |
| MRI chest wo w contrast (71552) |
$5,275 |
$5,275 |
14.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$5,422 |
$5,422 |
14.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$6,475 |
$6,475 |
17.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,981 |
$4,981 |
20.0× |
| MRI lumbar spine w contrast (72149) |
$5,629 |
$5,629 |
15.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$5,732 |
$5,732 |
15.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,174 |
$4,174 |
16.8× |
| MRI orbit face neck w contrast (70542) |
$4,770 |
$4,770 |
13.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$5,637 |
$5,637 |
15.5× |
| MRI pelvis w contrast (72196) |
$4,776 |
$4,776 |
13.1× |
| MRI pelvis w/o & w contrast (72197) |
$5,788 |
$5,788 |
15.9× |
| MRI pelvis w/o contrast (72195) |
$4,297 |
$4,297 |
17.2× |
| MRI spectroscopy (76390) |
$4,174 |
$4,174 |
45.9× |
| MRI thoracic spine w/o contrast (72146) |
$4,191 |
$4,191 |
16.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$5,423 |
$5,423 |
14.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$5,037 |
$5,037 |
20.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$6,547 |
$6,547 |
18.0× |
| MRI, abdomen, combo (74183) |
$5,270 |
$5,270 |
14.5× |
| MRI, dorsal spine combo (72157) |
$5,451 |
$5,451 |
15.0× |
| MRI, dorsal spine contrast (72147) |
$4,612 |
$4,612 |
12.7× |
| MRI, joint upper extrem (73221) |
$3,880 |
$3,880 |
15.6× |
| MRI, joint upper extrem combo (73223) |
$5,045 |
$5,045 |
13.8× |
| MRI, lumbar spine combo (72158) |
$5,870 |
$5,870 |
16.1× |
| Myelogram cervical (72240) |
$2,379 |
$2,379 |
2.9× |
| Myelogram Lumbar (72265) |
$2,379 |
$2,379 |
2.9× |
| Myelography thoracic (72255) |
$2,379 |
$2,379 |
2.9× |
| Myelograpy 2/more regions rs&i (72270) |
$2,379 |
$2,379 |
2.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$6,504 |
$6,504 |
4.8× |
| Myocardial Spect Multiple Studies (78452) |
$6,504 |
$6,504 |
4.8× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$6,626 |
$6,626 |
4.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$6,626 |
$6,626 |
4.4× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$10,334 |
$10,334 |
4.5× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$11,481 |
$11,481 |
5.0× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$11,481 |
$11,481 |
7.2× |
| Neck soft tissue (70360) |
$445 |
$445 |
4.9× |
| Nm csf leak detection (78650) |
$3,255 |
$3,255 |
2.4× |
| Nonvascular Shunt X-Ray (75809) |
$1,242 |
$1,242 |
11.4× |
| Nuclear Rx Oral Admin (79005) |
$1,418 |
$1,418 |
5.8× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$1,531 |
$1,531 |
14.0× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$1,501 |
$1,501 |
13.7× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$1,569 |
$1,569 |
11.3× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$1,391 |
$1,391 |
12.7× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$1,715 |
$1,715 |
18.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$1,391 |
$1,391 |
12.7× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$1,391 |
$1,391 |
46.1× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$1,531 |
$1,531 |
14.0× |
| Optic foramina (70190) |
$386 |
$386 |
4.2× |
| Panoramic X-ray of jaws (70355) |
$279 |
$279 |
3.1× |
| Parathyroid Planar Imaging (78070) |
$2,226 |
$2,226 |
5.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,691 |
$1,691 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$485 |
$485 |
4.4× |
| Peritoneogram Rs&I (74190) |
$1,515 |
$1,515 |
2.7× |
| Pet Image W/Ct Lmtd (78814) |
$6,813 |
$6,813 |
4.6× |
| PET image w/CT, full body (78816) |
$6,646 |
$6,646 |
4.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,324 |
$7,324 |
4.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$11,978 |
$11,978 |
3.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,054 |
$2,054 |
4.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$1,206 |
$1,206 |
11.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,177 |
$1,177 |
2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$605 |
$605 |
6.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$485 |
$485 |
5.3× |
| Radex elbow complete minimum 3 views (73080) |
$672 |
$672 |
7.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$512 |
$512 |
4.7× |
| Radex fingr minimum 2 views (73140) |
$485 |
$485 |
5.3× |
| Radex foot complete minimum 3 views (73630) |
$605 |
$605 |
6.7× |
| Radex Hand Minimum 3 Views (73130) |
$672 |
$672 |
7.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$379 |
$379 |
4.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$570 |
$570 |
5.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$472 |
$472 |
5.2× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$478 |
$478 |
5.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$485 |
$485 |
5.3× |
| Radex shoulder complete minimum 2 views (73030) |
$485 |
$485 |
5.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$462 |
$462 |
5.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$820 |
$820 |
4.5× |
| Radex Spine 1 View Specify Level (72020) |
$470 |
$470 |
5.2× |
| Radex Sternum Minimum 2 Views (71120) |
$485 |
$485 |
5.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$672 |
$672 |
7.4× |
| Radex Toe Minimum 2 Views (73660) |
$500 |
$500 |
5.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$621 |
$621 |
5.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$733 |
$733 |
8.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$920 |
$920 |
8.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$561 |
$561 |
5.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$726 |
$726 |
6.7× |
| Radiologic exam colon double contrast study (74280) |
$1,091 |
$1,091 |
6.0× |
| Radiologic exam colon single contrast study (74270) |
$1,015 |
$1,015 |
5.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$820 |
$820 |
4.5× |
| Radiologic exam knee complete 4/more views (73564) |
$586 |
$586 |
5.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$570 |
$570 |
5.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$885 |
$885 |
4.8× |
| Radiologic exam swallow function contrast study (74230) |
$1,039 |
$1,039 |
5.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,034 |
$1,034 |
5.6× |
| Radiologic examination femur 1 view (73551) |
$290 |
$290 |
3.2× |
| Radiologic examination femur minimum 2 views (73552) |
$290 |
$290 |
3.2× |
| Radiologic examination knee 1/2 views (73560) |
$485 |
$485 |
5.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$1,170 |
$1,170 |
10.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$485 |
$485 |
5.3× |
| Renal Cyst Study (74470) |
$1,175 |
$1,175 |
2.1× |
| Ribs bilateral 3 views (71110) |
$536 |
$536 |
4.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,595 |
$3,595 |
8.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$5,643 |
$5,643 |
10.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,568 |
$2,568 |
4.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$5,841 |
$5,841 |
4.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$6,626 |
$6,626 |
4.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$5,841 |
$5,841 |
4.3× |
| Salivary Gland Function Study (78232) |
$2,872 |
$2,872 |
6.9× |
| Scapula (73010) |
$428 |
$428 |
3.9× |
| Sella turcica (70240) |
$310 |
$310 |
3.4× |
| Shoulder 1 view (73020) |
$484 |
$484 |
5.3× |
| Shoulder Arthrography (73040) |
$1,365 |
$1,365 |
3.7× |
| Sialogram (70390) |
$1,526 |
$1,526 |
6.1× |
| Skull less than 4 views (70250) |
$504 |
$504 |
4.6× |
| Speech evaluation, complex (70371) |
$1,014 |
$1,014 |
4.1× |
| Spleen Imaging (78185) |
$1,671 |
$1,671 |
4.0× |
| Sternoclavicular joints (71130) |
$496 |
$496 |
5.5× |
| Superior sagittal sinus venogram (75870) |
$4,395 |
$4,395 |
1.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$1,168 |
$1,168 |
4.7× |
| Testicular Imaging W/Flow (78761) |
$1,712 |
$1,712 |
4.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,183 |
$2,183 |
5.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,175 |
$1,175 |
8.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$1,060 |
$1,060 |
5.8× |
| Thoracic spine 2 views (72070) |
$485 |
$485 |
4.4× |
| Thoracic spine 3 views (72072) |
$561 |
$561 |
5.1× |
| Thoracolumbar 2 views (72080) |
$485 |
$485 |
5.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,690 |
$1,690 |
4.0× |
| Thyroid Met Imaging Body (78018) |
$1,933 |
$1,933 |
3.4× |
| Thyroid Uptake Measurement (78012) |
$1,690 |
$1,690 |
4.0× |
| Ultrasound Breast Limited (76642) |
$555 |
$555 |
6.1× |
| Ultrasound elastography first target lesion (76982) |
$553 |
$553 |
5.1× |
| Ultrasound Elastography Parenchyma (76981) |
$553 |
$553 |
5.1× |
| Ultrasound Exam Aaa Screen (76706) |
$935 |
$935 |
8.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$926 |
$926 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$832 |
$832 |
7.6× |
| Unlisted Dx Radiographic Procedure (76499) |
$359 |
$359 |
4.0× |
| Unlisted magnetic resonance procedure (76498) |
$4,793 |
$4,793 |
52.7× |
| Upper gi w/o kub (74240) |
$529 |
$529 |
2.9× |
| Ureteral Reflux Study (78740) |
$2,054 |
$2,054 |
4.9× |
| Urethrocystogram voiding (74455) |
$1,566 |
$1,566 |
6.3× |
| Urethrocystography retrograde (74450) |
$1,293 |
$1,293 |
5.2× |
| Us breast unilateral complete (76641) |
$555 |
$555 |
5.1× |
| Us chest (76604) |
$1,160 |
$1,160 |
10.6× |
| Us complete joint (76881) |
$1,344 |
$1,344 |
12.3× |
| Us exam, pelvic, limited (76857) |
$1,391 |
$1,391 |
12.7× |
| Us head (76506) |
$1,113 |
$1,113 |
10.2× |
| Us kidney transplant (76776) |
$1,887 |
$1,887 |
17.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$1,223 |
$1,223 |
11.2× |
| Us ob limited 1 or more fetuses (76815) |
$1,041 |
$1,041 |
9.5× |
| Us pelvic non ob complete (76856) |
$1,531 |
$1,531 |
14.0× |
| Us retroperitoneal complete (76770) |
$1,997 |
$1,997 |
18.3× |
| Us retroperitoneal limited (76775) |
$1,816 |
$1,816 |
16.6× |
| Us scrotum and contents (76870) |
$1,653 |
$1,653 |
15.1× |
| Us spinal canal and contents (76800) |
$1,316 |
$1,316 |
12.1× |
| Us thyroid (76536) |
$1,160 |
$1,160 |
10.6× |
| Us transrectal (76872) |
$741 |
$741 |
6.8× |
| Vascular Flow Imaging (78445) |
$2,909 |
$2,909 |
7.0× |
| Vasogram (74440) |
$1,175 |
$1,175 |
4.7× |
| Vein X-Ray Chest (75827) |
$4,361 |
$4,361 |
2.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$4,395 |
$4,395 |
1.3× |
| Vein X-Ray Skull Epidural (75872) |
$4,395 |
$4,395 |
6.7× |
| Vein X-Ray Spleen/Liver (75810) |
$6,601 |
$6,601 |
2.0× |
| Venogram Sinus/Jugular (75860) |
$4,395 |
$4,395 |
1.3× |
| Venography Adrenal Unilateral (75840) |
$11,978 |
$11,978 |
3.6× |
| Venography caval inferior serialography rs&i (75825) |
$6,551 |
$6,551 |
2.0× |
| Venography extremity bilateral rs&i (75822) |
$2,085 |
$2,085 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$2,069 |
$2,069 |
1.3× |
| Venography Orbital Rs&I (75880) |
$4,395 |
$4,395 |
6.7× |
| Venography Renal Bilateral (75833) |
$6,601 |
$6,601 |
2.0× |
| Venography Renal Unilateral (75831) |
$6,550 |
$6,550 |
2.0× |
| Venous sampling by catheter (75893) |
$11,978 |
$11,978 |
2.1× |
| Wrist 2 views (73100) |
$485 |
$485 |
5.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$462 |
$462 |
5.1× |
| X-ray antegrade pyelogram tube (74425) |
$1,023 |
$1,023 |
2.8× |
| X-Ray Aorta Leg Arteries (75630) |
$8,522 |
$8,522 |
2.6× |
| X-Ray Bend Only L-S Spine (72120) |
$593 |
$593 |
5.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$485 |
$485 |
5.3× |
| X-Ray Exam Breast Specimen (76098) |
$1,635 |
$1,635 |
2.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$372 |
$372 |
4.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$481 |
$481 |
4.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$920 |
$920 |
8.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$290 |
$290 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$290 |
$290 |
3.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$481 |
$481 |
4.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$481 |
$481 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$481 |
$481 |
4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$920 |
$920 |
8.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$621 |
$621 |
5.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$586 |
$586 |
6.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$781 |
$781 |
7.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$536 |
$536 |
4.9× |
| X-ray eye for foreign body (70030) |
$280 |
$280 |
3.1× |
| X-ray humerus (73060) |
$462 |
$462 |
5.1× |
| X-ray IV pyelogram (ivp) (74400) |
$856 |
$856 |
4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$472 |
$472 |
5.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$512 |
$512 |
5.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$485 |
$485 |
4.4× |
| X-ray nose-rectum child f.b. (76010) |
$504 |
$504 |
5.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$580 |
$580 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$548 |
$548 |
5.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$462 |
$462 |
4.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$462 |
$462 |
5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$570 |
$570 |
6.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$645 |
$645 |
5.9× |
| X-Ray Stress View (77071) |
$336 |
$336 |
3.7× |
| X-ray thoracic spine 4 vw (72074) |
$621 |
$621 |
5.7× |
| X-Ray Tmj Unilat (70328) |
$478 |
$478 |
5.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,023 |
$1,023 |
2.8× |
| X-Rays Bone Length Studies (77073) |
$655 |
$655 |
6.0× |
| X-Rays Bone Survey Complete (77075) |
$1,512 |
$1,512 |
13.8× |
| Xr c-spine 4 or 5 views (72050) |
$645 |
$645 |
5.9× |
| Xr facial bones less than 3 views (70140) |
$462 |
$462 |
5.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$496 |
$496 |
4.5× |
| Xr orbits complete 4 views (70200) |
$613 |
$613 |
5.6× |