| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,070.20 |
$10,117 |
4.6× |
| Abdomen 2 views (74019) |
$342.60 |
$571 |
3.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,135.20 |
$1,892 |
3.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,913.20 |
$6,522 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$3,543 |
$5,905 |
1.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,999.40 |
$4,999 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,983.20 |
$4,972 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,360.20 |
$7,267 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,586 |
$4,310 |
0.9× |
| Ankle 2 views (73600) |
$296.40 |
$494 |
3.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$442.12 |
$736.86 |
1.3× |
| Aortogram thoracic (75605) |
$3,700.80 |
$6,168 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,893.40 |
$6,489 |
1.3× |
| Aortography abdominal serialography rs&i (75625) |
$3,807.60 |
$6,346 |
1.3× |
| Arthrogram elbow (73085) |
$604.20 |
$1,007 |
1.8× |
| Arthrogram hip (73525) |
$853.20 |
$1,422 |
2.5× |
| Arthrogram shoulder (73040) |
$1,060.80 |
$1,768 |
3.2× |
| Arthrogram wrist (73115) |
$549.60 |
$916 |
1.6× |
| Arthrography knee lt (73580) |
$726.60 |
$1,211 |
2.2× |
| Basic radiation dosimetry calculation (77300) |
$712.80 |
$1,188 |
5.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$957.60 |
$1,596 |
2.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,083 |
$1,805 |
2.8× |
| Bone &/joint imaging whole body (78306) |
$1,797.60 |
$2,996 |
4.7× |
| Bone age studies (77072) |
$207.60 |
$346 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,926 |
$3,210 |
5.0× |
| Bone survey complete (77075) |
$763.80 |
$1,273 |
7.6× |
| Brain image w/flow 4 + views (78606) |
$1,365.60 |
$2,276 |
2.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,896.40 |
$6,494 |
2.8× |
| Cardiac shunt detection (78428) |
$925.20 |
$1,542 |
2.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$909.60 |
$1,516 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$372 |
$620 |
4.4× |
| Chest 1 view (71045) |
$241.80 |
$403 |
2.9× |
| Chest 3 views (71047) |
$201 |
$335 |
2.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$639 |
$1,065 |
3.8× |
| Cineradiography/videoradiography (76120) |
$211.20 |
$352 |
2.1× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,002 |
$1,670 |
1.3× |
| Clavicle complete (73000) |
$425.40 |
$709 |
5.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$873 |
$1,455 |
8.7× |
| Continuing medical physics consltj pr wk (77336) |
$870.60 |
$1,451 |
6.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,966.20 |
$8,277 |
14.8× |
| CT abdomen and pelvis without contrast (74176) |
$3,782.40 |
$6,304 |
16.5× |
| CT abdomen w contrast (74160) |
$2,433.60 |
$4,056 |
14.4× |
| CT abdomen w wo contrast (74170) |
$2,964.60 |
$4,941 |
17.6× |
| CT abdomen w/o contrast (74150) |
$2,341.80 |
$3,903 |
23.3× |
| CT angio hrt w/3d image (75574) |
$2,923.80 |
$4,873 |
8.7× |
| CT angiography upper extremity lt (73206) |
$1,465.80 |
$2,443 |
8.7× |
| CT c-spine w/o contrast (72125) |
$2,173.20 |
$3,622 |
21.6× |
| CT cervical spine w&w/o contrast (72127) |
$3,013.80 |
$5,023 |
17.9× |
| CT cervical spine with contrast (72126) |
$2,286 |
$3,810 |
6.8× |
| CT chest w/wo contrast (71270) |
$2,605.20 |
$4,342 |
15.4× |
| CT chest with contrast (71260) |
$2,340 |
$3,900 |
13.9× |
| CT head/brain with contrast (70460) |
$2,630.40 |
$4,384 |
15.6× |
| CT head/brain without and with contrast (70470) |
$2,663.40 |
$4,439 |
15.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,773.60 |
$2,956 |
5.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$310.20 |
$517 |
3.7× |
| CT iac w contrast (70481) |
$2,430.60 |
$4,051 |
14.4× |
| CT lower ext w/o (73700) |
$2,160.60 |
$3,601 |
21.5× |
| CT lower extremity w wo contrast (73702) |
$2,260.80 |
$3,768 |
13.4× |
| CT lower extremity with contrast (73701) |
$2,253 |
$3,755 |
13.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,665.20 |
$4,442 |
15.8× |
| CT lumbar spine w/o contrast (72131) |
$2,134.80 |
$3,558 |
21.2× |
| CT lumbar spine with contrast (72132) |
$2,512.80 |
$4,188 |
7.5× |
| CT maxillofacial w contrast (70487) |
$2,430.60 |
$4,051 |
14.4× |
| CT maxillofacial w/o contrast (70486) |
$2,049 |
$3,415 |
20.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,574 |
$4,290 |
15.3× |
| CT neck soft tissue w contrast (70491) |
$2,430.60 |
$4,051 |
14.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,574 |
$4,290 |
15.3× |
| CT orbits w/o contrast (70480) |
$2,041.20 |
$3,402 |
20.3× |
| CT pelvis w & w/o contrast (72194) |
$2,749.20 |
$4,582 |
16.3× |
| CT pelvis w/o contrast (72192) |
$2,092.20 |
$3,487 |
20.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$694.80 |
$1,158 |
8.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,574 |
$4,290 |
15.3× |
| CT soft tissue neck w/o contrast (70490) |
$2,192.40 |
$3,654 |
21.8× |
| CT thoracic spine w/contrast (72129) |
$2,113.20 |
$3,522 |
12.5× |
| CT thoracic spine w/o contrast (72128) |
$2,029.20 |
$3,382 |
20.2× |
| CT thoracic spine w/wo contrast (72130) |
$3,035.40 |
$5,059 |
18.0× |
| CT thorax w/o contrast (71250) |
$2,184.60 |
$3,641 |
21.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,116.20 |
$3,527 |
12.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,597.80 |
$2,663 |
15.9× |
| CT upper extremity with contrast (73201) |
$1,734.60 |
$2,891 |
5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,134.40 |
$5,224 |
18.6× |
| Cta Abdomen (74175) |
$2,853.60 |
$4,756 |
16.9× |
| CTA abdomen pelvis (74174) |
$507.75 |
$846.25 |
1.5× |
| CTA chest (71275) |
$2,923.80 |
$4,873 |
17.3× |
| Cta Head (70496) |
$2,314.80 |
$3,858 |
13.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,747.20 |
$2,912 |
10.4× |
| Cta Neck (70498) |
$1,578.60 |
$2,631 |
9.4× |
| Cta Pelvis (72191) |
$2,190 |
$3,650 |
13.0× |
| Cystography minimum 3 views rs&i (74430) |
$846.60 |
$1,411 |
2.5× |
| Diskogram cervical (72285) |
$3,559.20 |
$5,932 |
1.9× |
| Diskography lumbar (72295) |
$3,559.20 |
$5,932 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$426 |
$710 |
4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$265.80 |
$443 |
3.2× |
| Dxa bone density study axial skeleton (77085) |
$420 |
$700 |
4.2× |
| Echoencephalography real time imaging (76506) |
$985.20 |
$1,642 |
9.8× |
| Esophagus (74220) |
$568.80 |
$948 |
3.4× |
| Fetal biophysical profile non-stress testing (76818) |
$887.40 |
$1,479 |
8.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$685.80 |
$1,143 |
6.8× |
| Fluoroscopy up to 1 hr (76000) |
$715.20 |
$1,192 |
3.1× |
| Foot 2 views (73620) |
$324 |
$540 |
3.9× |
| Forearm 2 views (73090) |
$312 |
$520 |
3.7× |
| Gated Heart Planar Single (78472) |
$1,659.60 |
$2,766 |
4.3× |
| Hand 2 views (73120) |
$264.60 |
$441 |
2.6× |
| Hand 3 views (73130) |
$331.80 |
$553 |
4.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,948.80 |
$3,248 |
3.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,948.80 |
$3,248 |
5.1× |
| Ht muscle image spect sing (78451) |
$1,888.80 |
$3,148 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$307.20 |
$512 |
3.7× |
| Hysterosalpingogram (74740) |
$805.20 |
$1,342 |
3.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,527.60 |
$2,546 |
2.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,888.80 |
$3,148 |
3.6× |
| Knee 3 views (73562) |
$435.60 |
$726 |
5.2× |
| Liver & spleen imaging static only (78215) |
$1,119 |
$1,865 |
2.9× |
| Liver imaging static only (78201) |
$1,693.80 |
$2,823 |
3.2× |
| Lung perf&ventilat diferentl (78598) |
$2,064.60 |
$3,441 |
4.0× |
| Lung perfusion differential (78597) |
$1,975.80 |
$3,293 |
5.1× |
| Lung Ventilation Imaging (78579) |
$727.80 |
$1,213 |
1.9× |
| Lymphoscintigraphy (78195) |
$1,603.20 |
$2,672 |
3.1× |
| Mammary ductogram or galactogram multiple (77054) |
$509.40 |
$849 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$484.80 |
$808 |
2.1× |
| Meckels Diverticulum (78290) |
$930.60 |
$1,551 |
2.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,221.80 |
$3,703 |
6.2× |
| MRA head w & w/o contrast (70546) |
$2,848.80 |
$4,748 |
8.5× |
| MRA head w/o contrast (70544) |
$2,115.60 |
$3,526 |
9.2× |
| MRA head with contrast (70545) |
$2,714.40 |
$4,524 |
8.1× |
| MRA neck w contrast (70548) |
$1,894.80 |
$3,158 |
5.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,220 |
$3,700 |
6.6× |
| MRA neck w/o contrast (70547) |
$1,879.80 |
$3,133 |
8.2× |
| MRI abdomen w contrast (74182) |
$2,598.60 |
$4,331 |
7.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,955 |
$4,925 |
8.8× |
| MRI abdomen w/o contrast (74181) |
$2,050.80 |
$3,418 |
8.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,556 |
$4,260 |
3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,281.80 |
$3,803 |
3.0× |
| MRI c-spine with contrast (72142) |
$2,899.80 |
$4,833 |
8.6× |
| MRI cervical spine w/o contrast (72141) |
$2,411.40 |
$4,019 |
10.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,973.60 |
$4,956 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,362.20 |
$3,937 |
10.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,563.20 |
$4,272 |
7.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,344.80 |
$3,908 |
7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,926 |
$3,210 |
8.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,198.40 |
$3,664 |
9.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,136.20 |
$5,227 |
9.3× |
| MRI orbit/face/neck w/contrast (70542) |
$2,470.80 |
$4,118 |
7.4× |
| MRI pelvis w contrast (72196) |
$2,763 |
$4,605 |
8.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,891.40 |
$4,819 |
8.6× |
| MRI pelvis w/o contrast (72195) |
$872.48 |
$1,454.14 |
3.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,543.40 |
$4,239 |
7.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,672.40 |
$4,454 |
8.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,345.60 |
$5,576 |
10.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,539.80 |
$4,233 |
7.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,725.40 |
$6,209 |
11.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,598.60 |
$4,331 |
7.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,667.20 |
$6,112 |
10.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,347.20 |
$3,912 |
10.2× |
| MRI tmj (70336) |
$1,704 |
$2,840 |
7.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,050.80 |
$3,418 |
8.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,691.60 |
$4,486 |
8.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,281.80 |
$3,803 |
9.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,319.20 |
$5,532 |
2.7× |
| Neck soft tissue (70360) |
$321 |
$535 |
3.8× |
| Nm adrenal scan (78075) |
$1,676.40 |
$2,794 |
1.3× |
| Nm cisternogram (78630) |
$1,676.40 |
$2,794 |
3.2× |
| Nm gastric emptying study (78264) |
$1,467 |
$2,445 |
3.8× |
| Nm peritoneal-venous shunt patency (78291) |
$928.20 |
$1,547 |
2.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,821.80 |
$9,703 |
4.4× |
| Nuclear medicine of heart pumping function (78473) |
$1,680 |
$2,800 |
4.4× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,368.80 |
$3,948 |
1.7× |
| Nuclear Rx Oral Admin (79005) |
$1,153.20 |
$1,922 |
5.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$369 |
$615 |
3.7× |
| Osseous survey infant (77076) |
$348.60 |
$581 |
3.5× |
| Osseous survey limited (77074) |
$372.60 |
$621 |
3.7× |
| Parathyrd planar w/spect&CT (78072) |
$645.92 |
$1,076.54 |
1.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,297.20 |
$2,162 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$302.40 |
$504 |
3.0× |
| PET image w/CT, skull-thigh (78815) |
$4,470 |
$7,450 |
3.3× |
| PET imaging CT for attenuation limited area (78814) |
$3,845.40 |
$6,409 |
2.8× |
| PET imaging for CT attenuation whole body (78816) |
$4,974 |
$8,290 |
3.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,407.20 |
$4,012 |
7.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,323.60 |
$2,206 |
3.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,556.40 |
$2,594 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$673.20 |
$1,122 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$332.40 |
$554 |
4.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$466.80 |
$778 |
4.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$552 |
$920 |
5.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$297.60 |
$496 |
3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$945.60 |
$1,576 |
9.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$19,299.60 |
$32,166 |
2.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$916.20 |
$1,527 |
1.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$486.60 |
$811 |
5.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$506.40 |
$844 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$481.80 |
$803 |
4.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$263.40 |
$439 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$269.40 |
$449 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$841.20 |
$1,402 |
5.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$654 |
$1,090 |
3.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$744.60 |
$1,241 |
4.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$792 |
$1,320 |
4.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$429.60 |
$716 |
5.1× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$111.60 |
$186 |
1.3× |
| Radiological examination surgical specimen (76098) |
$396 |
$660 |
0.8× |
| Ribs bilateral 3 views (71110) |
$466.20 |
$777 |
4.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,148.40 |
$1,914 |
3.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,088.60 |
$3,481 |
4.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,223 |
$3,705 |
4.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,109.89 |
$3,516.48 |
1.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,566.58 |
$2,610.96 |
1.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$609.60 |
$1,016 |
2.7× |
| Scanogram (77073) |
$211.80 |
$353 |
2.1× |
| Scapula complete (73010) |
$351 |
$585 |
3.5× |
| Screening digital breast tomosynthesis (77063) |
$54.57 |
$90.95 |
2.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$171.60 |
$286 |
1.7× |
| Simulation intermediate (77285) |
$1,586.40 |
$2,644 |
4.4× |
| Small bowel series (74250) |
$786 |
$1,310 |
4.7× |
| Spec medical radj physics consltj (77370) |
$1,221 |
$2,035 |
9.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,167 |
$1,945 |
3.2× |
| Special dosimetry (77331) |
$820.80 |
$1,368 |
6.3× |
| Special treatment procedure (77470) |
$2,729.40 |
$4,549 |
5.1× |
| Spine thoracic 3 views (72072) |
$534 |
$890 |
5.3× |
| Stereotactic body radiation delivery (77373) |
$17,720.40 |
$29,534 |
10.3× |
| Tbs Technical Calculation Only (77091) |
$88.70 |
$147.83 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,505.60 |
$4,176 |
7.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$785.40 |
$1,309 |
2.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,240.40 |
$3,734 |
6.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,020.60 |
$1,701 |
7.9× |
| Thoracolumbar 2 views (72080) |
$403.80 |
$673 |
4.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,758.60 |
$2,931 |
3.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$585.60 |
$976 |
1.5× |
| Thyroid uptake measurement (78012) |
$655.80 |
$1,093 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,316.40 |
$2,194 |
3.4× |
| Tmj unilateral (70328) |
$184.80 |
$308 |
2.2× |
| Treatment device intermediate (77333) |
$885.60 |
$1,476 |
6.9× |
| Treatment devices simple (77332) |
$832.20 |
$1,387 |
6.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$643.80 |
$1,073 |
1.7× |
| Tx devices design & construction complex (77334) |
$1,740.60 |
$2,901 |
4.8× |
| Ultrasound elastography first target lesion (76982) |
$190.20 |
$317 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$752.40 |
$1,254 |
7.5× |
| Umbilical-artery Doppler (OB) (76820) |
$307.20 |
$512 |
3.1× |
| Unlisted Ultrasound Procedure (76999) |
$177.60 |
$296 |
2.1× |
| Upper Extremity Infant (73092) |
$234.60 |
$391 |
2.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$783.60 |
$1,306 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$611.40 |
$1,019 |
2.7× |
| Urethrocystography voiding (74455) |
$711.60 |
$1,186 |
3.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$777 |
$1,295 |
4.6× |
| Us abdl aorta screen aaa (76706) |
$298.80 |
$498 |
3.0× |
| Us breast unilateral complete (76641) |
$52.60 |
$87.68 |
0.5× |
| Us breast unilateral limited (76642) |
$57 |
$95 |
0.7× |
| Us chest (76604) |
$440.40 |
$734 |
4.4× |
| Us elastography parenchyma (76981) |
$312 |
$520 |
3.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$280.80 |
$468 |
2.8× |
| Us guided compression repair (76936) |
$413.40 |
$689 |
2.0× |
| Us ob transvaginal (76817) |
$662.40 |
$1,104 |
6.6× |
| Us pelvic non ob complete (76856) |
$924 |
$1,540 |
9.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$436.80 |
$728 |
4.3× |
| Us pregnancy ltd (76815) |
$597 |
$995 |
5.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$739.20 |
$1,232 |
7.4× |
| Us retroperitoneal complete (76770) |
$856.80 |
$1,428 |
8.5× |
| Us retroperitoneal limited (76775) |
$522.60 |
$871 |
5.2× |
| Us scrotum and contents (76870) |
$880.20 |
$1,467 |
8.8× |
| Us soft tissue head/neck (76536) |
$657 |
$1,095 |
6.5× |
| Us transrectal (76872) |
$557.40 |
$929 |
5.5× |
| Us transrectal prostate volume (76873) |
$939.60 |
$1,566 |
9.3× |
| Us xtr non-vasc lmtd (76882) |
$471.60 |
$786 |
4.7× |
| Us, eye b-scan (76512) |
$225 |
$375 |
2.2× |
| Venogram extremity bilateral (75822) |
$1,656.60 |
$2,761 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,172.20 |
$5,287 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,960.80 |
$3,268 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,152 |
$1,920 |
0.8× |
| Wrist 2 views (73100) |
$334.20 |
$557 |
4.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$244.80 |
$408 |
2.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$346.20 |
$577 |
4.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,116 |
$1,860 |
6.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$296.40 |
$494 |
3.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$309.60 |
$516 |
3.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$889.20 |
$1,482 |
8.8× |
| X-ray exam hip uni 1 view (73501) |
$229.80 |
$383 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$332.40 |
$554 |
4.0× |
| X-ray exam hip uni 4/> views (73503) |
$552 |
$920 |
5.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$552 |
$920 |
5.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$937.20 |
$1,562 |
9.3× |
| X-ray exam of femur 1 (73551) |
$369.60 |
$616 |
4.4× |
| X-ray eye for foreign body (70030) |
$307.80 |
$513 |
3.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$466.20 |
$777 |
4.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$270.60 |
$451 |
3.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$471.60 |
$786 |
5.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$310.20 |
$517 |
3.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$496.20 |
$827 |
4.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$227.40 |
$379 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$335.40 |
$559 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$375 |
$625 |
3.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$598.20 |
$997 |
5.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$340.20 |
$567 |
4.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$199.80 |
$333 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$381 |
$635 |
3.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$458.40 |
$764 |
4.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$882.60 |
$1,471 |
2.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$418.80 |
$698 |
5.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$445.80 |
$743 |
4.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$734.40 |
$1,224 |
7.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$395.40 |
$659 |
3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$354 |
$590 |
4.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$427.20 |
$712 |
5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$466.20 |
$777 |
5.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$186 |
$310 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$436.80 |
$728 |
4.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$319.20 |
$532 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$278.40 |
$464 |
3.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$156 |
$260 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$280.20 |
$467 |
3.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$309.60 |
$516 |
3.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$542.40 |
$904 |
5.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$267.60 |
$446 |
3.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$366 |
$610 |
4.4× |
| Xr arthrogram ankle (73615) |
$664.20 |
$1,107 |
2.0× |
| Xr c-spine 6 or more views (72052) |
$529.20 |
$882 |
5.3× |
| Xr chest 4+ views (71048) |
$414 |
$690 |
4.1× |
| Xr finger(s) 2+ views (73140) |
$292.80 |
$488 |
3.5× |
| Xr shoulder 1 view (73020) |
$264 |
$440 |
3.2× |
| Xr spine cervical 4 or 5 views (72050) |
$465.60 |
$776 |
4.6× |
| Xr tibia/fibula 2 views (73590) |
$326.40 |
$544 |
3.9× |
| Xr tmj bilateral (70330) |
$246 |
$410 |
2.9× |
| Xray knee 1 or 2 views rt (73560) |
$328.20 |
$547 |
3.9× |