| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,477 |
$5,477 |
3.3× |
| Abdomen 2 views (74019) |
$428.50 |
$428.50 |
3.4× |
| Acute gi blood loss imaging (78278) |
$1,754 |
$1,754 |
3.7× |
| Angio Adrenal Bilat Select (75733) |
$8,911 |
$8,911 |
2.4× |
| Angiography extremity bilateral rs&i (75716) |
$8,771.50 |
$8,771.50 |
2.3× |
| Angiography extremity unilateral rs&i (75710) |
$9,342.50 |
$9,342.50 |
2.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,950.50 |
$5,950.50 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,911 |
$8,911 |
2.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,911 |
$8,911 |
2.4× |
| Angiography Spinal Selective Rs&I (75705) |
$14,639 |
$14,639 |
2.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$8,947 |
$8,947 |
1.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,708.50 |
$2,708.50 |
0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,710 |
$4,710 |
1.2× |
| Ankle 2 views (73600) |
$330.50 |
$330.50 |
3.2× |
| Aortogram thoracic (75605) |
$8,911 |
$8,911 |
1.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$8,911 |
$8,911 |
2.4× |
| Aortography abdominal serialography rs&i (75625) |
$8,911 |
$8,911 |
2.4× |
| Artery X-Rays Adrenal Gland (75731) |
$8,911 |
$8,911 |
2.4× |
| Arthrogram ankle (73615) |
$1,711 |
$1,711 |
4.1× |
| Arthrogram elbow (73085) |
$1,473 |
$1,473 |
3.5× |
| Arthrogram hip (73525) |
$1,473 |
$1,473 |
3.5× |
| Arthrogram knee (73580) |
$1,711 |
$1,711 |
4.1× |
| Arthrogram shoulder (73040) |
$1,473 |
$1,473 |
3.5× |
| Arthrogram wrist (73115) |
$1,577 |
$1,577 |
3.8× |
| Basic dosimetry (77300) |
$575 |
$575 |
3.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,825 |
$1,825 |
3.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,243 |
$2,243 |
4.7× |
| Bone &/joint imaging whole body (78306) |
$1,895 |
$1,895 |
4.0× |
| Bone age studies (77072) |
$392 |
$392 |
3.1× |
| Bone Imaging 3 Phase (78315) |
$1,926 |
$1,926 |
4.0× |
| Bone Marrow Imaging Limited Area (78102) |
$1,382 |
$1,382 |
2.9× |
| Bone survey complete (77075) |
$880 |
$880 |
7.0× |
| Bone survey infant (77076) |
$413.50 |
$413.50 |
3.3× |
| Bowel imaging (78290) |
$1,334.50 |
$1,334.50 |
2.8× |
| Brachytx isodose complex (77318) |
$1,161 |
$1,161 |
2.6× |
| Brain Imaging Vascular Flow Only (78610) |
$2,475 |
$2,475 |
3.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,879.50 |
$1,879.50 |
3.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,447.50 |
$2,447.50 |
5.1× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$2,591.50 |
$2,591.50 |
2.8× |
| Cardiac shunt detection (78428) |
$1,465.50 |
$1,465.50 |
3.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,313 |
$2,313 |
3.6× |
| Cervical spine 2 or 3 views (72040) |
$371.50 |
$371.50 |
3.6× |
| Chest 1 view (71045) |
$283 |
$283 |
2.7× |
| Chest xray 3 views (71047) |
$460 |
$460 |
4.4× |
| Cholecystography, oral contrast Non-Facility (74290) |
$701 |
$701 |
3.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$641 |
$641 |
3.0× |
| Clavicle complete (73000) |
$333 |
$333 |
3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,048.50 |
$1,048.50 |
8.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,152 |
$1,152 |
7.2× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$838.50 |
$838.50 |
4.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,326 |
$3,326 |
8.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,782 |
$1,782 |
6.2× |
| CT abdomen w contrast (74160) |
$2,798.50 |
$2,798.50 |
13.3× |
| CT abdomen w wo contrast (74170) |
$3,283.50 |
$3,283.50 |
15.6× |
| CT abdomen w/o contrast (74150) |
$1,642.50 |
$1,642.50 |
13.1× |
| CT angio hrt w/3d image (75574) |
$2,498 |
$2,498 |
6.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,443.50 |
$2,443.50 |
11.6× |
| CT angiography upper extremity lt (73206) |
$1,967 |
$1,967 |
9.4× |
| CT c-spine w/contrast (72126) |
$2,401 |
$2,401 |
5.7× |
| CT c-spine w/o contrast (72125) |
$1,384.50 |
$1,384.50 |
11.1× |
| CT cervical spine w&w/o contrast (72127) |
$3,016.50 |
$3,016.50 |
14.3× |
| CT chest w contrast (71260) |
$2,926 |
$2,926 |
13.9× |
| CT chest w/wo contrast (71270) |
$3,244.50 |
$3,244.50 |
15.4× |
| CT colonography screening (74263) |
$3,535.50 |
$3,535.50 |
12.4× |
| CT colonography w/o cntrst (74261) |
$1,334 |
$1,334 |
10.6× |
| CT head/brain with contrast (70460) |
$2,390 |
$2,390 |
11.4× |
| CT head/brain without and with contrast (70470) |
$2,974.50 |
$2,974.50 |
14.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,160 |
$1,160 |
2.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$317 |
$317 |
3.0× |
| CT iac w contrast (70481) |
$1,991 |
$1,991 |
9.5× |
| CT limited/localized follow up study (76380) |
$1,086 |
$1,086 |
10.4× |
| CT lower ext w/o (73700) |
$1,129 |
$1,129 |
9.0× |
| CT lower extremity w wo contrast (73702) |
$2,583 |
$2,583 |
12.3× |
| CT lower extremity w/contrast material (73701) |
$1,701.50 |
$1,701.50 |
8.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,999.50 |
$2,999.50 |
14.3× |
| CT lumbar spine w/contrast (72132) |
$2,193 |
$2,193 |
5.2× |
| CT lumbar spine w/o contrast (72131) |
$1,274.50 |
$1,274.50 |
10.2× |
| CT maxillofacial w contrast (70487) |
$2,414 |
$2,414 |
11.5× |
| CT maxillofacial w/wo contrast (70488) |
$2,483 |
$2,483 |
11.8× |
| CT maxillofacial wo contrast (70486) |
$2,166.50 |
$2,166.50 |
17.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,547 |
$1,547 |
7.4× |
| CT orbits w/o contrast (70480) |
$1,659 |
$1,659 |
13.2× |
| CT pelvis w/o contrast (72192) |
$1,276.50 |
$1,276.50 |
10.2× |
| CT pelvis w/wo contrast (72194) |
$3,366.50 |
$3,366.50 |
16.0× |
| CT scan of arm combo (73202) |
$1,444.50 |
$1,444.50 |
6.9× |
| CT soft tissue neck w contrast (70491) |
$2,603 |
$2,603 |
12.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,086.50 |
$3,086.50 |
14.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,166.50 |
$2,166.50 |
17.3× |
| CT thoracic spine w/contrast (72129) |
$2,295.50 |
$2,295.50 |
10.9× |
| CT thoracic spine w/o contrast (72128) |
$1,212 |
$1,212 |
9.7× |
| CT thoracic spine w/wo contrast (72130) |
$2,360 |
$2,360 |
11.2× |
| CT thorax w/o contrast (71250) |
$1,274.50 |
$1,274.50 |
10.2× |
| CT upper ext wo (73200) |
$1,129 |
$1,129 |
9.0× |
| CT upper extremity with contrast (73201) |
$1,870.50 |
$1,870.50 |
4.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,454.50 |
$2,454.50 |
11.7× |
| Cta Abdomen (74175) |
$2,009.50 |
$2,009.50 |
9.6× |
| CTA abdomen pelvis (74174) |
$2,770 |
$2,770 |
6.6× |
| CTA chest (71275) |
$1,802 |
$1,802 |
8.6× |
| Cta Head (70496) |
$1,867.50 |
$1,867.50 |
8.9× |
| Cta Neck (70498) |
$1,770.50 |
$1,770.50 |
8.4× |
| Cta Pelvis (72191) |
$2,094 |
$2,094 |
10.0× |
| Cystography minimum 3 views rs&i (74430) |
$1,123.50 |
$1,123.50 |
2.7× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$7,470 |
$7,470 |
3.0× |
| Diskography lumbar (72295) |
$12,203 |
$12,203 |
5.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,213 |
$1,213 |
9.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$796.50 |
$796.50 |
6.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$388 |
$388 |
3.7× |
| Dxa bone density study axial skeleton (77085) |
$340.50 |
$340.50 |
2.7× |
| Esophagus (74220) |
$540 |
$540 |
2.6× |
| Facial bones min 3 views (70150) |
$402.50 |
$402.50 |
3.2× |
| Fetal biophysical profile non-stress testing (76818) |
$819 |
$819 |
6.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$693 |
$693 |
5.5× |
| Fluoroscopy up to 1 hr (76000) |
$678 |
$678 |
2.4× |
| Foot 2 views (73620) |
$333 |
$333 |
3.2× |
| Forearm 2 views (73090) |
$391.50 |
$391.50 |
3.8× |
| Hand 2 views (73120) |
$390 |
$390 |
3.1× |
| Heart Infarct Image (78466) |
$2,474.50 |
$2,474.50 |
5.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$8,911 |
$8,911 |
2.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$8,209 |
$8,209 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,159.50 |
$2,159.50 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,159.50 |
$2,159.50 |
4.5× |
| Hysterosalpingogram (74740) |
$1,331.50 |
$1,331.50 |
4.7× |
| Interstitial radiation source applic complex (77778) |
$5,756 |
$5,756 |
6.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$523 |
$523 |
4.2× |
| Kidney imaging morphology (78700) |
$1,684.50 |
$1,684.50 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,431.50 |
$2,431.50 |
3.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,741 |
$2,741 |
4.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,122 |
$2,122 |
3.3× |
| Knee 3 views (73562) |
$326.50 |
$326.50 |
3.1× |
| Liver & spleen imaging static only (78215) |
$2,254 |
$2,254 |
4.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,838.50 |
$2,838.50 |
5.9× |
| Liver imaging static only (78201) |
$1,779 |
$1,779 |
2.7× |
| Liver imaging w/vascular flow (78202) |
$1,995 |
$1,995 |
3.1× |
| Lung perf&ventilat diferentl (78598) |
$2,323 |
$2,323 |
3.6× |
| Lung perfusion differential (78597) |
$1,362 |
$1,362 |
2.8× |
| Lung ventilation imaging (78579) |
$1,570.50 |
$1,570.50 |
3.3× |
| Lymphoscintigraphy (78195) |
$1,762.50 |
$1,762.50 |
2.7× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$5,453 |
$5,453 |
5.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,858 |
$1,858 |
4.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,825.50 |
$2,825.50 |
6.8× |
| Magnetic Resonance Elastography (76391) |
$8,268 |
$8,268 |
28.9× |
| Mammary ductogram or galactogram multiple (77054) |
$1,170 |
$1,170 |
4.1× |
| Mammary ductogram or galactogram single (77053) |
$1,426 |
$1,426 |
5.0× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$267 |
$267 |
2.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,569 |
$1,569 |
3.5× |
| Mr safety determination physician/other qhp (76016) |
$273 |
$273 |
2.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$76 |
$76 |
2.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$306 |
$306 |
2.7× |
| Mr safety implt pos&/immoblj (76019) |
$184 |
$184 |
2.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$750 |
$750 |
2.6× |
| MRA head w & w/o contrast (70546) |
$5,045 |
$5,045 |
12.1× |
| MRA head w/o contrast (70544) |
$3,056.50 |
$3,056.50 |
10.7× |
| MRA head with contrast (70545) |
$3,796 |
$3,796 |
9.1× |
| MRA neck w contrast (70548) |
$4,140 |
$4,140 |
9.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,645 |
$3,645 |
8.7× |
| MRA neck w/o contrast (70547) |
$3,056.50 |
$3,056.50 |
10.7× |
| MRI abdomen w contrast (74182) |
$3,586 |
$3,586 |
8.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,519.50 |
$4,519.50 |
10.8× |
| MRI abdomen w/o contrast (74181) |
$2,772 |
$2,772 |
9.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$5,093 |
$5,093 |
5.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,712 |
$3,712 |
8.9× |
| MRI breast w/o contrast bilateral (77047) |
$1,924 |
$1,924 |
6.7× |
| MRI breast wo contrast unilateral (77046) |
$1,749 |
$1,749 |
6.1× |
| MRI c-spine with contrast (72142) |
$4,481 |
$4,481 |
10.7× |
| MRI cervical spine w/o contrast (72141) |
$2,484.50 |
$2,484.50 |
8.7× |
| MRI chest w/o & w/contrast material (71552) |
$5,028 |
$5,028 |
12.0× |
| MRI chest w/o contrast (71550) |
$2,772 |
$2,772 |
9.7× |
| MRI chest with contrast (71551) |
$4,853.50 |
$4,853.50 |
5.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,858 |
$1,858 |
4.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,825.50 |
$2,825.50 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,726.50 |
$1,726.50 |
6.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,098.50 |
$2,098.50 |
7.3× |
| MRI orbit face neck w contrast (70542) |
$4,494 |
$4,494 |
10.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,555.50 |
$5,555.50 |
13.3× |
| MRI pelvis w/contrast (72196) |
$3,253 |
$3,253 |
7.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,050.50 |
$4,050.50 |
9.7× |
| MRI pelvis w/o contrast (72195) |
$1,729 |
$1,729 |
6.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,282.50 |
$3,282.50 |
7.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,168.50 |
$4,168.50 |
10.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,456.50 |
$3,456.50 |
8.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,325.50 |
$4,325.50 |
10.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,612 |
$3,612 |
8.6× |
| MRI temporomandibular joint (70336) |
$1,700.50 |
$1,700.50 |
5.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,133.50 |
$2,133.50 |
7.5× |
| MRI up ext w/o contrast (73218) |
$2,510 |
$2,510 |
8.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,871.50 |
$1,871.50 |
6.5× |
| MRI, joint upper extrem combo (73223) |
$3,686 |
$3,686 |
8.8× |
| Myelogram Cervical (72240) |
$2,234 |
$2,234 |
2.4× |
| Myelogram Lumbar (72265) |
$2,253.50 |
$2,253.50 |
2.4× |
| Myelogram thoracic (72255) |
$2,198.50 |
$2,198.50 |
2.3× |
| Myelography 2 or more regions (72270) |
$2,151.50 |
$2,151.50 |
2.3× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$1,767 |
$1,767 |
2.7× |
| Myocardial infarct spect (78469) |
$2,975.50 |
$2,975.50 |
4.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$4,969 |
$4,969 |
3.2× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$5,298 |
$5,298 |
3.4× |
| Myocardial Spect Multiple Studies (78452) |
$6,586 |
$6,586 |
4.2× |
| Myocardial spect single study at rest or stress (78451) |
$6,520.50 |
$6,520.50 |
4.2× |
| N-invas est c ffr sw aly CTA (75580) |
$3,625 |
$3,625 |
3.5× |
| Neck soft tissue (70360) |
$304.50 |
$304.50 |
2.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,342.50 |
$1,342.50 |
2.8× |
| Nm bone marrow wb (78104) |
$1,593 |
$1,593 |
3.3× |
| Nm cardiac blood pool multiple (78473) |
$3,033.50 |
$3,033.50 |
6.3× |
| Nm cisternogram (78630) |
$2,475 |
$2,475 |
3.8× |
| Nm gastric emptying study (78264) |
$2,577.50 |
$2,577.50 |
5.4× |
| Nm gastroesophageal reflux study (78262) |
$2,180.50 |
$2,180.50 |
4.6× |
| Nm kidney scan w/flow (78701) |
$1,766.50 |
$1,766.50 |
3.7× |
| Noncardiac Vascular Flow Imaging (78445) |
$2,038.50 |
$2,038.50 |
4.3× |
| Nonvascular shunt X-ray (75809) |
$742 |
$742 |
5.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,599 |
$4,599 |
2.8× |
| Nuclear Rx Oral Admin (79005) |
$1,980 |
$1,980 |
7.1× |
| Ob us nuchal meas 1 gest (76813) |
$776 |
$776 |
6.2× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$77.50 |
$77.50 |
2.2× |
| Osseous survey limited (77074) |
$572 |
$572 |
4.6× |
| Parathyrd planar w/spect&CT (78072) |
$1,957 |
$1,957 |
3.0× |
| Parathyroid Planar Imaging (78070) |
$1,507 |
$1,507 |
3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,509 |
$1,509 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$412.50 |
$412.50 |
3.3× |
| Perineogram (74775) |
$1,311 |
$1,311 |
4.6× |
| Peritoneogram after injection (74190) |
$4,438 |
$4,438 |
6.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$10,970 |
$10,970 |
2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,318 |
$1,318 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,389.50 |
$2,389.50 |
3.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,389 |
$1,389 |
2.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$343.50 |
$343.50 |
3.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$335 |
$335 |
3.2× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$380.50 |
$380.50 |
3.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$475.50 |
$475.50 |
4.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$793.50 |
$793.50 |
6.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$1,007.50 |
$1,007.50 |
8.0× |
| Radex fingr minimum 2 views (73140) |
$301.50 |
$301.50 |
2.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$363.50 |
$363.50 |
3.5× |
| Radex Hand Minimum 3 Views (73130) |
$341.50 |
$341.50 |
3.3× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$312.50 |
$312.50 |
3.0× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$485.50 |
$485.50 |
3.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$478.50 |
$478.50 |
3.8× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$894 |
$894 |
7.1× |
| Radex Humerus Minimum 2 Views (73060) |
$330.50 |
$330.50 |
3.2× |
| Radex Kne 1/2 Views (73560) |
$332.50 |
$332.50 |
3.2× |
| Radex Kne Compl 4/More Views (73564) |
$428 |
$428 |
3.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$483.50 |
$483.50 |
3.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$368 |
$368 |
3.5× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$453 |
$453 |
3.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$371 |
$371 |
3.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$326.50 |
$326.50 |
3.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$460.50 |
$460.50 |
3.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$443 |
$443 |
4.2× |
| Radex Toe Minimum 2 Views (73660) |
$307 |
$307 |
2.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$452 |
$452 |
3.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$403 |
$403 |
3.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,040 |
$1,040 |
8.3× |
| Radiation treatment delivery level 1 (77402) |
$412 |
$412 |
3.4× |
| Radiation treatment delivery level 2 (77407) |
$937 |
$937 |
2.0× |
| Radiation treatment delivery level 3 (77412) |
$1,044.50 |
$1,044.50 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$357 |
$357 |
3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$424 |
$424 |
3.4× |
| Radiologic exam chest 2 views (71046) |
$325 |
$325 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$936 |
$936 |
4.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$610.50 |
$610.50 |
2.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$744.50 |
$744.50 |
3.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$936 |
$936 |
4.5× |
| Radiologic examination femur 1 view (73551) |
$287 |
$287 |
2.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$797 |
$797 |
7.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$371 |
$371 |
3.6× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$350 |
$350 |
0.5× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$442.50 |
$442.50 |
3.5× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$388 |
$388 |
3.1× |
| Radiological examination surgical specimen (76098) |
$942 |
$942 |
1.4× |
| Renal Cyst Study (74470) |
$4,438 |
$4,438 |
6.8× |
| Ribs bilateral 3 views (71110) |
$437.50 |
$437.50 |
3.5× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$3,533 |
$3,533 |
7.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,997.50 |
$3,997.50 |
8.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$12,399 |
$12,399 |
19.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$5,794 |
$5,794 |
8.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$6,958.50 |
$6,958.50 |
10.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$6,822 |
$6,822 |
4.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,366.50 |
$1,366.50 |
4.9× |
| Rp Therapy Intravenous Administration (79101) |
$1,635 |
$1,635 |
5.8× |
| Sacroiliac Joints < 3 Views (72200) |
$414 |
$414 |
3.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$904 |
$904 |
3.2× |
| Salivary gland imaging (78230) |
$2,130 |
$2,130 |
4.4× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$2,236 |
$2,236 |
4.7× |
| Scapula (73010) |
$344 |
$344 |
2.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$87.50 |
$87.50 |
3.7× |
| Sella turcica (70240) |
$276 |
$276 |
2.6× |
| Shoulder 1 view (73020) |
$310 |
$310 |
3.0× |
| Sialogram (70390) |
$1,870 |
$1,870 |
6.5× |
| Small bowel series (74250) |
$733 |
$733 |
3.5× |
| Special Physics Consult (77370) |
$1,150 |
$1,150 |
7.1× |
| Special treatment procedure (77470) |
$3,757 |
$3,757 |
5.7× |
| Spine thoracic 3 views (72072) |
$622 |
$622 |
5.0× |
| Splenoportograpy rs&i (75810) |
$8,911 |
$8,911 |
2.4× |
| Testicular Imaging With Vascular Flow (78761) |
$2,347 |
$2,347 |
4.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,445 |
$2,445 |
5.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,098 |
$1,098 |
6.8× |
| Thoracolumbar 2 views (72080) |
$339 |
$339 |
3.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$4,715.50 |
$4,715.50 |
7.2× |
| Thyroid imaging w/blood flow (78013) |
$1,105 |
$1,105 |
2.3× |
| Thyroid uptake measurement (78012) |
$3,966 |
$3,966 |
8.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,505 |
$1,505 |
3.1× |
| Treatment device complex (77334) |
$1,565 |
$1,565 |
3.5× |
| Treatment devices simple (77332) |
$601 |
$601 |
3.7× |
| Ultrasound breast complete (76641) |
$642 |
$642 |
5.1× |
| Ultrasound elastography first target lesion (76982) |
$461 |
$461 |
3.7× |
| Ultrasound Exam Aaa Screen (76706) |
$613.50 |
$613.50 |
4.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$830 |
$830 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$741.50 |
$741.50 |
5.9× |
| Umbilical-artery Doppler (OB) (76820) |
$595 |
$595 |
4.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$225 |
$225 |
2.2× |
| Unlisted magnetic resonance procedure (76498) |
$313.50 |
$313.50 |
3.0× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$1,298 |
$1,298 |
2.7× |
| Unlisted ultrasound procedure (76999) |
$293.50 |
$293.50 |
2.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$456 |
$456 |
41.2× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$1,569 |
$1,569 |
16.6× |
| Ureteral reflux study (78740) |
$2,599.50 |
$2,599.50 |
5.4× |
| Urethrocystogram voiding (74455) |
$1,198.50 |
$1,198.50 |
4.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,106.50 |
$1,106.50 |
3.9× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$1,639 |
$1,639 |
7.8× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,639 |
$1,639 |
7.8× |
| Us breast unilateral limited (76642) |
$556 |
$556 |
5.3× |
| Us chest (76604) |
$751.50 |
$751.50 |
6.0× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$1,334 |
$1,334 |
5.2× |
| Us compl joint r-t w/image documentation (76881) |
$620.50 |
$620.50 |
5.0× |
| Us elastography parenchyma (76981) |
$461 |
$461 |
3.7× |
| Us encephalogram (76506) |
$650 |
$650 |
5.2× |
| Us hips infant static (76886) |
$1,019 |
$1,019 |
9.8× |
| Us infant hips w manipulation (76885) |
$373 |
$373 |
3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$397.50 |
$397.50 |
3.2× |
| Us ob detailed single fetus (76811) |
$1,020 |
$1,020 |
3.6× |
| Us ob limited (76815) |
$604 |
$604 |
4.8× |
| Us ob transvaginal (76817) |
$668 |
$668 |
5.3× |
| Us pelvic non ob complete (76856) |
$1,134 |
$1,134 |
9.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$599.50 |
$599.50 |
4.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$534 |
$534 |
4.3× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$507 |
$507 |
4.0× |
| Us retroperitoneal complete (76770) |
$588.50 |
$588.50 |
4.7× |
| Us retroperitoneal limited (76775) |
$509 |
$509 |
4.1× |
| Us scrotum and contents (76870) |
$1,091.50 |
$1,091.50 |
8.7× |
| Us soft tissue head/neck (76536) |
$1,012 |
$1,012 |
8.1× |
| Us spinal canal and contents (76800) |
$507 |
$507 |
4.0× |
| Us transrectal (76872) |
$419.50 |
$419.50 |
3.3× |
| Us transrectal prostate volume (76873) |
$363 |
$363 |
2.9× |
| Us, eye b-scan (76512) |
$372 |
$372 |
3.0× |
| Us,transplanted kidney, real time/ doppler (76776) |
$693 |
$693 |
5.5× |
| Vasogram (74440) |
$1,639 |
$1,639 |
5.7× |
| Venogram extremity bilateral (75822) |
$2,685.50 |
$2,685.50 |
1.4× |
| Venogram Extremity Unilateral (75820) |
$3,940.50 |
$3,940.50 |
2.1× |
| Venography caval inferior serialography rs&i (75825) |
$8,911 |
$8,911 |
2.4× |
| Venography caval superior serialography rs&i (75827) |
$4,766.50 |
$4,766.50 |
2.5× |
| Venography Renal Bilateral (75833) |
$8,911 |
$8,911 |
2.4× |
| Venography renal unilateral selective rs&i (75831) |
$8,911 |
$8,911 |
2.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,700.50 |
$3,700.50 |
1.0× |
| Venous sampling by catheter (75893) |
$8,911 |
$8,911 |
1.3× |
| Vertebral fracture assessment via dxa (77086) |
$291 |
$291 |
2.8× |
| Wrist 2 views (73100) |
$319 |
$319 |
3.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$482 |
$482 |
3.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$340 |
$340 |
3.3× |
| X-ray b.e. reductn intuss (74283) |
$715 |
$715 |
3.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,116 |
$1,116 |
5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$338 |
$338 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$403 |
$403 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$622.50 |
$622.50 |
5.0× |
| X-ray exam of femur 2/> (73552) |
$414 |
$414 |
4.0× |
| X-ray eye for foreign body (70030) |
$315 |
$315 |
3.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$272.50 |
$272.50 |
2.6× |
| X-ray IV pyelogram (ivp) (74400) |
$1,102 |
$1,102 |
5.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$465 |
$465 |
4.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$389 |
$389 |
3.7× |
| X-ray leg, infant (73592) |
$312 |
$312 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$432 |
$432 |
3.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$995.50 |
$995.50 |
7.9× |
| X-ray nose-rectum child f.b. (76010) |
$587 |
$587 |
5.6× |
| X-ray optic foramen (70190) |
$462 |
$462 |
4.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$427 |
$427 |
3.4× |
| X-ray retrograde pyelogram (74420) |
$1,571 |
$1,571 |
3.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$326.50 |
$326.50 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$474.50 |
$474.50 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$524.50 |
$524.50 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$368.50 |
$368.50 |
2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$322 |
$322 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$446.50 |
$446.50 |
4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$556 |
$556 |
4.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$366 |
$366 |
2.9× |
| X-Ray Small Bowel Enteroclysis (74251) |
$1,116 |
$1,116 |
5.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$277.50 |
$277.50 |
2.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$411 |
$411 |
3.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$428 |
$428 |
4.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$508.50 |
$508.50 |
4.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$495.50 |
$495.50 |
4.0× |
| Xr bone length studies (77073) |
$332.50 |
$332.50 |
2.7× |
| Xr c-spine 4 or 5 views (72050) |
$499 |
$499 |
4.0× |
| Xr c-spine 6 or more views (72052) |
$742 |
$742 |
5.9× |
| Xr chest 4+ views (71048) |
$275 |
$275 |
2.2× |
| Xr urogram antegrade (74425) |
$1,870 |
$1,870 |
4.5× |