| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$11,422.54 |
— |
| Abdomen 1 View (74018) |
— |
$709.05 |
— |
| Abdomen 2 views (74019) |
— |
$684.87 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$2,265.43 |
— |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
— |
$1,513.42 |
— |
| Adrenal Cortex & Medulla Img (78075) |
— |
$4,665.17 |
— |
| Angio pulmonary bilat (75743) |
— |
$8,366.14 |
— |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
— |
$5,278.86 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$8,366.14 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$8,366.14 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$8,366.14 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$2,321.84 |
— |
| Ankle 2 views (73600) |
— |
$612.35 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$8,366.14 |
— |
| Aortography thoracic w/o serialography rs&i (75600) |
— |
$5,278.86 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$8,366.14 |
— |
| Artery X-Rays Adrenal Gland (75731) |
— |
$5,278.86 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$8,366.14 |
— |
| Arthrogram ankle (73615) |
— |
$995.07 |
— |
| Arthrogram hip (73525) |
— |
$995.07 |
— |
| Arthrogram Wrist (73115) |
— |
$995.07 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$1,469.11 |
— |
| Bone age studies (77072) |
— |
$648.62 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,914.94 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$1,560.42 |
— |
| Bone Imaging Whole Body (78306) |
— |
$3,111.45 |
— |
| Bone survey infant (77076) |
— |
$835.27 |
— |
| Brachytx isodose complex (77318) |
— |
$930.62 |
— |
| Brachytx isodose intermed (77317) |
— |
$655.33 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$448.52 |
— |
| Brain Flow Imaging Only (78610) |
— |
$2,864.37 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$2,513.87 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$9,561.31 |
— |
| Cardiac Shunt Detection (78428) |
— |
$1,560.42 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$1,763.21 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$1,728.28 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$2,321.84 |
— |
| Chest 1 view (71045) |
— |
$676.81 |
— |
| Chest 2 views (71046) |
— |
$703.67 |
— |
| Chest 3 views (71047) |
— |
$684.87 |
— |
| Chest 4 or more views (71048) |
— |
$684.87 |
— |
| Cholecystography Oral Contrast (74290) |
— |
$653.98 |
— |
| Clavicle complete (73000) |
— |
$612.35 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$183.97 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$1,469.11 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$8,366.14 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$580.12 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$995.07 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$995.07 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$10,795.41 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$7,826.31 |
— |
| CT abdomen w contrast (74160) |
— |
$4,693.37 |
— |
| CT abdomen w wo contrast (74170) |
— |
$5,285.57 |
— |
| CT abdomen w/o contrast (74150) |
— |
$4,333.47 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$1,659.80 |
— |
| CT Angio Chest (71275) |
— |
$4,142.78 |
— |
| CT Angio Head (70496) |
— |
$5,285.57 |
— |
| CT angio hrt w/3d image (75574) |
— |
$5,911.35 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$3,895.69 |
— |
| CT Angio Neck (70498) |
— |
$5,285.57 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$4,085.04 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$4,647.71 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$4,647.71 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$5,332.57 |
— |
| CT chest w contrast (71260) |
— |
$4,595.33 |
— |
| CT chest w/wo contrast (71270) |
— |
$5,172.77 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$922.55 |
— |
| CT head/brain with contrast (70460) |
— |
$4,364.36 |
— |
| CT head/brain without and with contrast (70470) |
— |
$4,671.88 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$1,136.07 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$940.02 |
— |
| CT hrt w/3d image congen (75573) |
— |
$5,911.35 |
— |
| CT iac w contrast (70481) |
— |
$4,090.41 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$5,270.80 |
— |
| CT lower ext w/o (73700) |
— |
$3,926.58 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$4,471.79 |
— |
| CT lumbar spine w contrast (72132) |
— |
$5,179.48 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$4,548.33 |
— |
| CT maxillofacial w contrast (70487) |
— |
$4,145.47 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$4,145.47 |
— |
| CT neck tissue combo (70492) |
— |
$4,589.97 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$5,140.55 |
— |
| CT orbits w/o contrast (70480) |
— |
$3,871.53 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$6,306.16 |
— |
| CT pelvis w/o contrast (72192) |
— |
$3,895.69 |
— |
| CT scan of leg combo (73702) |
— |
$4,471.79 |
— |
| CT scans face/jaw combo (70488) |
— |
$4,383.16 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$4,510.74 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$3,958.81 |
— |
| CT thoracic spine w contrast (72129) |
— |
$4,806.17 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$4,595.33 |
— |
| CT thorax w/o contrast (71250) |
— |
$4,142.78 |
— |
| CT upper ext wo (73200) |
— |
$4,085.04 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$4,122.64 |
— |
| CT upper extremity with contrast (73201) |
— |
$4,122.64 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$5,285.57 |
— |
| Cta Abdomen (74175) |
— |
$5,285.57 |
— |
| CTA pelvis (72191) |
— |
$1,333.48 |
— |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
— |
$308.86 |
— |
| Doppler Echo Fetal Spectral Display Complete (76827) |
— |
$308.86 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
— |
$308.86 |
— |
| Dxa bone density study (77085) |
— |
$308.86 |
— |
| Echo exam of fetal heart (76825) |
— |
$1,358.99 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$863.48 |
— |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
— |
$648.62 |
— |
| Echograp Trans R Pros Study (76873) |
— |
$1,217.99 |
— |
| Esophagram (74220) |
— |
$756.05 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$1,490.60 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$1,490.60 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$1,400.63 |
— |
| Follow-Up Angiography (75898) |
— |
$1,375.11 |
— |
| Foot 2 views (73620) |
— |
$1,207.25 |
— |
| Forearm 2 views (73090) |
— |
$1,207.25 |
— |
| Gastric emptying imaging study (78264) |
— |
$2,473.58 |
— |
| Gastroesophageal Reflux Exam (78262) |
— |
$1,767.23 |
— |
| Gated Heart Planar Single (78472) |
— |
$3,396.15 |
— |
| Hand 2 views (73120) |
— |
$612.35 |
— |
| Heart first pass single,planar (78481) |
— |
$2,598.47 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$3,217.54 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$2,613.24 |
— |
| Ht Musc Image Planar Mult (78454) |
— |
$9,183.96 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$7,775.28 |
— |
| Hysterosalpingogram (74740) |
— |
$1,375.11 |
— |
| Image fusion (77399) |
— |
$1,628.92 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$835.27 |
— |
| Infant hip ultrasound, limited static exam (76886) |
— |
$835.27 |
— |
| Interstitial radiation source applic complex (77778) |
— |
$29,398.32 |
— |
| Intracavitary Radiation Source Applic Intermed (77762) |
— |
$6,111.44 |
— |
| Intracavitary radiation source applic simple (77761) |
— |
$6,111.44 |
— |
| Joint Survey Single View (77077) |
— |
$906.44 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$1,685.31 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$3,711.72 |
— |
| Kidney Imaging Morphol (78700) |
— |
$1,560.42 |
— |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
— |
$1,560.42 |
— |
| Knee 3 Views (73562) |
— |
$1,207.25 |
— |
| Leveen/Shunt Patency Exam (78291) |
— |
$1,560.42 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$2,337.95 |
— |
| Liver imaging static only (78201) |
— |
$1,126.68 |
— |
| Liver imaging w/vascular flow (78202) |
— |
$1,126.68 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$4,259.61 |
— |
| Lung perfusion differential (78597) |
— |
$580.12 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$1,560.42 |
— |
| Lung Ventilation Imaging (78579) |
— |
$2,594.44 |
— |
| Lymph System Imaging (78195) |
— |
$2,379.58 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$6,124.87 |
— |
| Meckels Divert Exam (78290) |
— |
$1,961.95 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$3,081.91 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$5,096.23 |
— |
| MRA head w/o contrast (70544) |
— |
$4,706.79 |
— |
| MRA head with contrast (70545) |
— |
$4,706.79 |
— |
| MRA neck w contrast (70548) |
— |
$4,706.79 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$5,096.23 |
— |
| MRA neck w/o contrast (70547) |
— |
$4,706.79 |
— |
| MRI abdomen w contrast (74182) |
— |
$2,652.19 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$2,652.19 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$9,593.54 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$14,806.59 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$6,522.36 |
— |
| MRI cervical spine w contrast (72142) |
— |
$5,865.70 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$5,865.70 |
— |
| MRI chest w/o contrast (71550) |
— |
$5,096.23 |
— |
| MRI chest with contrast (71551) |
— |
$5,096.23 |
— |
| MRI chest wo w contrast (71552) |
— |
$5,172.77 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$6,522.36 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$6,522.36 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$6,123.53 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$5,865.70 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$8,449.40 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$3,561.31 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$3,846.01 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$3,846.01 |
— |
| MRI pelvis w contrast (72196) |
— |
$5,858.99 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$5,858.99 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$5,473.58 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$5,865.70 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$6,522.36 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$5,501.78 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$6,910.46 |
— |
| MRI, abdomen, combo (74183) |
— |
$3,533.12 |
— |
| MRI, dorsal spine combo (72157) |
— |
$8,449.40 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$5,865.70 |
— |
| MRI, joint upper extrem (73221) |
— |
$4,568.47 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$7,536.24 |
— |
| MRI, lumbar spine combo (72158) |
— |
$7,067.58 |
— |
| Myelogram cervical (72240) |
— |
$3,568.03 |
— |
| Myelogram Lumbar (72265) |
— |
$3,568.03 |
— |
| Myelography thoracic (72255) |
— |
$3,568.03 |
— |
| Myelograpy 2/more regions rs&i (72270) |
— |
$2,515.22 |
— |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
— |
$2,151.29 |
— |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
— |
$9,561.31 |
— |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
— |
$7,775.28 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$10,438.21 |
— |
| Neck soft tissue (70360) |
— |
$420.33 |
— |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
— |
$2,159.36 |
— |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
— |
$647.26 |
— |
| Nm myocard infarct spect (78469) |
— |
$1,560.42 |
— |
| Nm unlisted gi procedure (78299) |
— |
$1,126.68 |
— |
| Nm whole blood volume (78122) |
— |
$1,560.42 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$11,422.54 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$2,513.87 |
— |
| Optic foramina (70190) |
— |
$612.35 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$2,305.72 |
— |
| Parathyroid planar imaging w/wo subtraction (78071) |
— |
$1,126.68 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$420.33 |
— |
| Pet Image Skull-Thigh (78812) |
— |
$9,561.31 |
— |
| Pet Image W/Ct Lmtd (78814) |
— |
$3,827.21 |
— |
| PET image w/CT, full body (78816) |
— |
$4,678.60 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$4,678.60 |
— |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
— |
$9,561.31 |
— |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) |
— |
$1,728.28 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$2,594.44 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$738.58 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$1,207.25 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$612.35 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$1,207.25 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$706.35 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$612.35 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$612.35 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$1,207.25 |
— |
| Radex lower extremity infant minimum 2 views (73592) |
— |
$796.33 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$612.35 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$398.83 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$295.43 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$1,207.25 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$612.35 |
— |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
— |
$621.76 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$420.33 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$604.30 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$612.35 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$580.12 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$796.33 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$1,207.25 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$962.84 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$57,251.01 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$346.47 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$1,047.96 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$1,501.29 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$612.35 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$684.87 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,383.17 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,219.34 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$541.19 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$612.35 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$612.35 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$621.76 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$1,212.63 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$612.35 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$612.35 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$612.35 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$835.27 |
— |
| Radiologic Examination Salivary Gland Calculus (70380) |
— |
$295.43 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$1,207.25 |
— |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
— |
$1,823.64 |
— |
| Radiologic examination, teeth; single view Non-Facility (70300) |
— |
$420.33 |
— |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
— |
$2,626.67 |
— |
| Ribs bilateral 3 views (71110) |
— |
$295.43 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$1,560.42 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$1,560.42 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$4,665.17 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$3,542.52 |
— |
| Salivary Gland Function Study (78232) |
— |
$1,226.05 |
— |
| Salivary Gland Imaging (78230) |
— |
$706.35 |
— |
| Salivary Gland Imaging Serial Images (78231) |
— |
$1,226.05 |
— |
| Scapula (73010) |
— |
$1,180.39 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$89.97 |
— |
| Sella turcica (70240) |
— |
$612.35 |
— |
| Shoulder 1 view (73020) |
— |
$1,207.25 |
— |
| Shoulder Arthrography (73040) |
— |
$1,492.61 |
— |
| Sialogram (70390) |
— |
$612.35 |
— |
| Skull less than 4 views (70250) |
— |
$612.35 |
— |
| Special dosimetry (77331) |
— |
$2,029.09 |
— |
| Special Physics Consult (77370) |
— |
$1,469.11 |
— |
| Special teletherapy port plan (77321) |
— |
$3,271.25 |
— |
| Special treatment procedure (77470) |
— |
$4,775.28 |
— |
| Spleen Imaging (78185) |
— |
$1,126.68 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$12,680.82 |
— |
| Sternoclavicular joints (71130) |
— |
$295.43 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$3,271.25 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$1,469.11 |
— |
| Testicular Imaging W/Flow (78761) |
— |
$2,691.13 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$3,271.25 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$2,904.65 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$1,469.11 |
— |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
— |
$1,219.34 |
— |
| Thoracic spine 2 views (72070) |
— |
$653.98 |
— |
| Thoracic spine 3 views (72072) |
— |
$653.98 |
— |
| Thoracolumbar 2 views (72080) |
— |
$653.98 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$2,317.81 |
— |
| Tx Devices Design & Construction Complex (77334) |
— |
$2,516.56 |
— |
| Tx devices design & construction intermediate (77333) |
— |
$2,410.47 |
— |
| Tx devices design & construction simple (77332) |
— |
$2,139.21 |
— |
| Ultrasound Breast Limited (76642) |
— |
$2,111 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$591.04 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$1,482.54 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$1,407.34 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$308.86 |
— |
| Unlisted fluoroscopic procedure (76496) |
— |
$183.97 |
— |
| Unlisted us procedure (76999) |
— |
$256.49 |
— |
| Urethrocystography retrograde (74450) |
— |
$1,024.62 |
— |
| Us breast unilateral complete (76641) |
— |
$2,111.01 |
— |
| Us chest (76604) |
— |
$1,407.34 |
— |
| Us complete joint (76881) |
— |
$1,498.65 |
— |
| Us exam, pelvic, limited (76857) |
— |
$743.96 |
— |
| Us head (76506) |
— |
$1,763.21 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$1,400.63 |
— |
| Us ob detailed single fetus (76811) |
— |
$648.62 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$743.96 |
— |
| Us ob transvaginal (76817) |
— |
$1,929.71 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,407.34 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$1,395.25 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$835.27 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,482.54 |
— |
| Us retroperitoneal limited (76775) |
— |
$1,482.54 |
— |
| Us scrotum and contents (76870) |
— |
$1,407.34 |
— |
| Us spinal canal and contents (76800) |
— |
$440.47 |
— |
| Us thyroid (76536) |
— |
$1,407.34 |
— |
| Us transrectal (76872) |
— |
$1,407.34 |
— |
| Vascular Flow Imaging (78445) |
— |
$1,513.42 |
— |
| Vein X-Ray Chest (75827) |
— |
$2,321.84 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$8,366.14 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$2,918.08 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$1,820.94 |
— |
| Venography Renal Bilateral (75833) |
— |
$8,366.14 |
— |
| Venography Renal Unilateral (75831) |
— |
$8,366.14 |
— |
| Venous thrombosis imaging (78457) |
— |
$1,513.42 |
— |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
— |
$1,513.42 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$230.97 |
— |
| Wrist 2 views (73100) |
— |
$796.33 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$612.35 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$1,024.62 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$8,366.14 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$796.33 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$612.35 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$653.98 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$870.19 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$870.19 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$612.35 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$612.35 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$692.92 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$612.35 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$612.35 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$692.92 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$508.95 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$653.98 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$756.05 |
— |
| X-ray eye for foreign body (70030) |
— |
$420.33 |
— |
| X-ray humerus (73060) |
— |
$1,207.25 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,150.84 |
— |
| X-ray IV pyelogram+tomography (74415) |
— |
$1,538.94 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$756.05 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$612.35 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$312.90 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$295.43 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$508.95 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$612.35 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$612.35 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$612.35 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$612.35 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$612.35 |
— |
| X-Ray Tmj Unilat (70328) |
— |
$612.35 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$679.50 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$742.62 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$835.27 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$706.35 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$420.33 |
— |
| Xr orbits complete 4 views (70200) |
— |
$621.76 |
— |
| Xr Tomogram Single Plane (76100) |
— |
$2,047.89 |
— |