| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,827.64 |
$3,468 |
1.3× |
| Abdomen 2 views (74019) |
$138.07 |
$262 |
1.3× |
| Acute gi blood loss imaging (78278) |
$1,012.89 |
$1,922 |
2.4× |
| Angiography extremity bilateral rs&i (75716) |
$3,069.77 |
$5,825 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$3,100.87 |
$5,884 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$7,840.18 |
$14,877 |
1.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,107.19 |
$5,896 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,165.16 |
$6,006 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$4,803.08 |
$9,114 |
0.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,816.48 |
$12,934.50 |
1.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,675.58 |
$5,077 |
0.8× |
| Ankle 2 views (73600) |
$150.19 |
$285 |
1.6× |
| Aortogram thoracic (75605) |
$4,057.37 |
$7,699 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,069.77 |
$5,825 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$3,069.77 |
$5,825 |
0.9× |
| Arthrogram hip (73525) |
$476.41 |
$904 |
1.3× |
| Arthrogram shoulder (73040) |
$426.87 |
$810 |
1.2× |
| Arthrogram wrist (73115) |
$342.02 |
$649 |
0.9× |
| Basic dosimetry (77300) |
$173.91 |
$330 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$583.39 |
$1,107 |
1.4× |
| Bone age studies (77072) |
$120.16 |
$228 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$697.75 |
$1,324 |
1.7× |
| Bone survey complete (77075) |
$266.13 |
$505 |
2.4× |
| Bone survey infant (77076) |
$140.18 |
$266 |
1.3× |
| Bowel imaging (78290) |
$655.06 |
$1,243 |
1.6× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$688.26 |
$1,306 |
1.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$742.54 |
$1,409 |
1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,059.80 |
$2,011 |
2.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$682.99 |
$1,296 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$190.77 |
$362 |
2.1× |
| Chest 1 view (71045) |
$148.61 |
$282 |
1.6× |
| Chest xray 3 views (71047) |
$142.29 |
$270 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$242.42 |
$460 |
1.3× |
| Clavicle complete (73000) |
$177.60 |
$337 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$158.63 |
$301 |
1.4× |
| Continuing medical physics consltj pr wk (77336) |
$313.04 |
$594 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$649.26 |
$1,232 |
1.8× |
| CT abdomen and pelvis without contrast (74176) |
$488.53 |
$927 |
2.0× |
| CT abdomen w contrast (74160) |
$680.88 |
$1,292 |
3.7× |
| CT abdomen w wo contrast (74170) |
$649.26 |
$1,232 |
3.5× |
| CT abdomen w/o contrast (74150) |
$483.26 |
$917 |
4.4× |
| CT angio hrt w/3d image (75574) |
$656.11 |
$1,245 |
1.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,120.14 |
$2,125.50 |
6.1× |
| CT angiography upper extremity lt (73206) |
$706.71 |
$1,341 |
3.8× |
| CT c-spine w/contrast (72126) |
$591.82 |
$1,123 |
1.6× |
| CT c-spine w/o contrast (72125) |
$555.98 |
$1,055 |
5.1× |
| CT cervical spine w&w/o contrast (72127) |
$649.26 |
$1,232 |
3.5× |
| CT chest w contrast (71260) |
$598.14 |
$1,135 |
3.3× |
| CT chest w/wo contrast (71270) |
$727.26 |
$1,380 |
4.0× |
| CT head/brain with contrast (70460) |
$662.97 |
$1,258 |
3.6× |
| CT head/brain without and with contrast (70470) |
$656.11 |
$1,245 |
3.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$649.26 |
$1,232 |
1.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$147.82 |
$280.50 |
1.6× |
| CT hrt w/3d image congen (75573) |
$296.17 |
$562 |
0.8× |
| CT iac w contrast (70481) |
$609.21 |
$1,156 |
3.3× |
| CT lower ext w/o (73700) |
$833.98 |
$1,582.50 |
7.6× |
| CT lower extremity w wo contrast (73702) |
$649.26 |
$1,232 |
3.5× |
| CT lower extremity w/contrast material (73701) |
$966.78 |
$1,834.50 |
5.3× |
| CT lumbar spine w & w/o contrast (72133) |
$649.26 |
$1,232 |
3.5× |
| CT lumbar spine w/contrast (72132) |
$591.82 |
$1,123 |
1.6× |
| CT lumbar spine w/o contrast (72131) |
$498.01 |
$945 |
4.5× |
| CT maxillofacial w contrast (70487) |
$615.54 |
$1,168 |
3.4× |
| CT maxillofacial w/wo contrast (70488) |
$649.26 |
$1,232 |
3.5× |
| CT maxillofacial wo contrast (70486) |
$564.94 |
$1,072 |
5.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$649.26 |
$1,232 |
3.5× |
| CT orbits w/o contrast (70480) |
$509.61 |
$967 |
4.7× |
| CT pelvis w/o contrast (72192) |
$498.01 |
$945 |
4.5× |
| CT pelvis w/wo contrast (72194) |
$211.33 |
$401 |
1.2× |
| CT scan of arm combo (73202) |
$649.26 |
$1,232 |
3.5× |
| CT soft tissue neck w contrast (70491) |
$615.54 |
$1,168 |
3.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$649.26 |
$1,232 |
3.5× |
| CT soft tissue neck w/o contrast (70490) |
$549.13 |
$1,042 |
5.0× |
| CT thoracic spine w/contrast (72129) |
$591.82 |
$1,123 |
3.2× |
| CT thoracic spine w/o contrast (72128) |
$555.98 |
$1,055 |
5.1× |
| CT thoracic spine w/wo contrast (72130) |
$649.26 |
$1,232 |
3.5× |
| CT thorax w/o contrast (71250) |
$488.53 |
$927 |
4.5× |
| CT unlisted procedure (76497) |
$108.56 |
$206 |
1.2× |
| CT upper ext wo (73200) |
$833.98 |
$1,582.50 |
7.6× |
| CT upper extremity with contrast (73201) |
$897.22 |
$1,702.50 |
2.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$706.71 |
$1,341 |
3.8× |
| Cta Abdomen (74175) |
$746.76 |
$1,417 |
4.1× |
| CTA abdomen pelvis (74174) |
$656.11 |
$1,245 |
1.8× |
| CTA chest (71275) |
$727.26 |
$1,380 |
4.0× |
| Cta Head (70496) |
$668.76 |
$1,269 |
3.6× |
| Cta Neck (70498) |
$727.26 |
$1,380 |
4.0× |
| Cta Pelvis (72191) |
$746.76 |
$1,417 |
4.1× |
| Cystography minimum 3 views rs&i (74430) |
$368.90 |
$700 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$147.03 |
$279 |
1.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$156.52 |
$297 |
1.4× |
| Echo exam of eye (76529) |
$119.10 |
$226 |
1.3× |
| Esophagus (74220) |
$259.81 |
$493 |
1.4× |
| Facial bones min 3 views (70150) |
$161.26 |
$306 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$393.14 |
$746 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$221.34 |
$420 |
2.0× |
| Fetal Echo (76825) |
$699.33 |
$1,327 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$366.26 |
$695 |
1.5× |
| Foot 2 views (73620) |
$245.06 |
$465 |
2.7× |
| Forearm 2 views (73090) |
$218.97 |
$415.50 |
2.4× |
| Hand 2 views (73120) |
$131.75 |
$250 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$998.66 |
$1,895 |
1.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$816.32 |
$1,549 |
1.9× |
| Hysterosalpingogram (74740) |
$502.76 |
$954 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$708.81 |
$1,345 |
1.2× |
| Knee 3 views (73562) |
$316.20 |
$600 |
3.5× |
| Liver & spleen imaging static only (78215) |
$602.36 |
$1,143 |
1.4× |
| Lung perfusion differential (78597) |
$578.12 |
$1,097 |
1.4× |
| Lung ventilation imaging (78579) |
$529.63 |
$1,005 |
1.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,671.61 |
$6,967 |
1.1× |
| Lymphoscintigraphy (78195) |
$828.44 |
$1,572 |
1.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$933.84 |
$1,772 |
1.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,030.28 |
$1,955 |
2.8× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$120.68 |
$229 |
1.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$482.20 |
$915 |
1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$32.67 |
$62 |
1.1× |
| MRA head w & w/o contrast (70546) |
$351.51 |
$667 |
1.0× |
| MRA head w/o contrast (70544) |
$727.26 |
$1,380 |
2.9× |
| MRA head with contrast (70545) |
$933.84 |
$1,772 |
2.6× |
| MRA neck w contrast (70548) |
$933.84 |
$1,772 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,040.82 |
$1,975 |
2.8× |
| MRA neck w/o contrast (70547) |
$719.88 |
$1,366 |
2.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,040.82 |
$1,975 |
2.8× |
| MRI abdomen w/o contrast (74181) |
$741.49 |
$1,407 |
3.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,074.03 |
$2,038 |
1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,682.18 |
$3,192 |
4.6× |
| MRI breast w/o contrast bilateral (77047) |
$719.88 |
$1,366 |
2.9× |
| MRI breast wo contrast unilateral (77046) |
$310.93 |
$590 |
1.2× |
| MRI c-spine with contrast (72142) |
$933.84 |
$1,772 |
2.6× |
| MRI cardiac w/o contrast (75557) |
$719.88 |
$1,366 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$827.92 |
$1,571 |
3.3× |
| MRI chest w/o & w/contrast material (71552) |
$1,030.28 |
$1,955 |
2.8× |
| MRI chest w/o contrast (71550) |
$719.88 |
$1,366 |
2.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,030.28 |
$1,955 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,112.24 |
$2,110.50 |
4.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$719.88 |
$1,366 |
2.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,030.28 |
$1,955 |
2.8× |
| MRI pelvis w/contrast (72196) |
$933.84 |
$1,772 |
2.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,030.28 |
$1,955 |
2.8× |
| MRI pelvis w/o contrast (72195) |
$727.26 |
$1,380 |
2.9× |
| MRI spectroscopy (76390) |
$1,130.41 |
$2,145 |
12.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,030.28 |
$1,955 |
2.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$933.84 |
$1,772 |
2.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,040.82 |
$1,975 |
2.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$933.84 |
$1,772 |
2.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,040.82 |
$1,975 |
2.8× |
| MRI temporomandibular joint (70336) |
$719.88 |
$1,366 |
2.9× |
| MRI thoracic spine w/o contrast (72146) |
$741.49 |
$1,407 |
3.0× |
| MRI up ext w/o contrast (73218) |
$719.88 |
$1,366 |
2.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,112.24 |
$2,110.50 |
4.5× |
| MRI, joint upper extrem combo (73223) |
$1,030.28 |
$1,955 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$1,845.55 |
$3,502 |
1.4× |
| Myocardial spect single study at rest or stress (78451) |
$1,646.35 |
$3,124 |
1.2× |
| N-invas est c ffr sw aly CTA (75580) |
$1,339.63 |
$2,542 |
1.5× |
| Neck soft tissue (70360) |
$158.10 |
$300 |
1.7× |
| Nm cisternogram (78630) |
$1,039.77 |
$1,973 |
1.8× |
| Nm gastric emptying study (78264) |
$1,132 |
$2,148 |
2.7× |
| Nm gastroesophageal reflux study (78262) |
$880.62 |
$1,671 |
2.1× |
| Nm kidney scan w/flow (78701) |
$598.67 |
$1,136 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,808.66 |
$3,432 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$613.95 |
$1,165 |
2.5× |
| Ob us nuchal meas 1 gest (76813) |
$182.87 |
$347 |
1.7× |
| Osseous survey limited (77074) |
$287.21 |
$545 |
2.6× |
| Parathyrd planar w/spect&CT (78072) |
$717.25 |
$1,361 |
1.3× |
| Parathyroid Planar Imaging (78070) |
$874.82 |
$1,660 |
2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$535.43 |
$1,016 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$152.83 |
$290 |
1.4× |
| Peritoneogram after injection (74190) |
$518.57 |
$984 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$2,335.14 |
$4,431 |
1.6× |
| PET imaging CT for attenuation limited area (78814) |
$2,039.49 |
$3,870 |
1.4× |
| PET imaging for CT attenuation whole body (78816) |
$2,605.49 |
$4,944 |
1.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,069.77 |
$5,825 |
0.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,328.29 |
$4,418 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$529.63 |
$1,005 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$702.49 |
$1,333 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$523.84 |
$994 |
0.9× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$232.41 |
$441 |
2.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$134.38 |
$255 |
1.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$250.59 |
$475.50 |
2.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$117.52 |
$223 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$147.03 |
$279 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$145.45 |
$276 |
1.3× |
| Radex fingr minimum 2 views (73140) |
$141.76 |
$269 |
1.6× |
| Radex Foot Compl Minimum 3 Views (73630) |
$231.62 |
$439.50 |
2.5× |
| Radex Hand Minimum 3 Views (73130) |
$228.46 |
$433.50 |
2.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$97.49 |
$185 |
1.1× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$133.33 |
$253 |
1.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$137.55 |
$261 |
1.3× |
| Radex Humerus Minimum 2 Views (73060) |
$244.26 |
$463.50 |
2.7× |
| Radex Kne 1/2 Views (73560) |
$282.21 |
$535.50 |
3.1× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$178.13 |
$338 |
1.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$204.48 |
$388 |
2.2× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$193.94 |
$368 |
1.8× |
| Radex Sho Compl Minimum 2 Views (73030) |
$264.03 |
$501 |
2.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$128.59 |
$244 |
1.4× |
| Radex Toe Minimum 2 Views (73660) |
$206.32 |
$391.50 |
2.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$119.10 |
$226 |
1.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$249.80 |
$474 |
2.7× |
| Radiation treatment delivery level 1 (77402) |
$150.19 |
$285 |
1.4× |
| Radiation treatment delivery level 3 (77412) |
$300.39 |
$570 |
0.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$140.71 |
$267 |
1.5× |
| Radiologic exam chest 2 views (71046) |
$142.82 |
$271 |
1.6× |
| Radiologic exam colon single contrast study (74270) |
$280.89 |
$533 |
1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$261.39 |
$496 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$268.77 |
$510 |
1.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$225.56 |
$428 |
1.2× |
| Radiologic examination femur 1 view (73551) |
$113.83 |
$216 |
1.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$225.29 |
$427.50 |
2.5× |
| Radiological examination surgical specimen (76098) |
$533.85 |
$1,013 |
0.9× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$528.05 |
$1,002 |
1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,926.71 |
$3,656 |
3.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,431.33 |
$2,716 |
2.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,845.55 |
$3,502 |
3.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,739.63 |
$3,301 |
1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,943.58 |
$3,688 |
1.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,802.87 |
$3,421 |
1.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$603.41 |
$1,145 |
2.5× |
| Sacroiliac Joints < 3 Views (72200) |
$177.60 |
$337 |
1.6× |
| Scapula (73010) |
$162.32 |
$308 |
1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$51.12 |
$97 |
2.2× |
| Shoulder 1 view (73020) |
$164.42 |
$312 |
1.8× |
| Sialogram (70390) |
$231.88 |
$440 |
0.9× |
| Small bowel series (74250) |
$283 |
$537 |
1.5× |
| Spine thoracic 3 views (72072) |
$188.67 |
$358 |
1.7× |
| Stereotactic Body Radiation Delivery (77373) |
$2,409.44 |
$4,572 |
1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$482.20 |
$915 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$482.20 |
$915 |
1.2× |
| Thoracolumbar 2 views (72080) |
$160.21 |
$304 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$593.40 |
$1,126 |
1.4× |
| Treatment device complex (77334) |
$482.20 |
$915 |
1.2× |
| Ultrasound breast complete (76641) |
$244 |
$463 |
2.2× |
| Ultrasound Exam Aaa Screen (76706) |
$172.33 |
$327 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$225.03 |
$427 |
2.1× |
| Umbilical-artery Doppler (OB) (76820) |
$154.94 |
$294 |
1.4× |
| Unlisted fluoroscopic procedure (76496) |
$328.32 |
$623 |
3.6× |
| Unlisted magnetic resonance procedure (76498) |
$118.57 |
$225 |
1.3× |
| Urethrocystogram voiding (74455) |
$315.15 |
$598 |
1.3× |
| Urethrocystography retrograde rs&i (74450) |
$264.03 |
$501 |
1.1× |
| Us breast unilateral limited (76642) |
$271.94 |
$516 |
3.0× |
| Us chest (76604) |
$258.23 |
$490 |
2.4× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$387.34 |
$735 |
1.7× |
| Us compl joint r-t w/image documentation (76881) |
$339.91 |
$645 |
3.1× |
| Us elastography parenchyma (76981) |
$139.65 |
$265 |
1.3× |
| Us encephalogram (76506) |
$265.08 |
$503 |
2.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$339.91 |
$645 |
3.1× |
| Us ob detailed single fetus (76811) |
$359.41 |
$682 |
1.4× |
| Us ob limited (76815) |
$246.11 |
$467 |
2.2× |
| Us ob transvaginal (76817) |
$244.53 |
$464 |
2.2× |
| Us pelvic non ob complete (76856) |
$235.04 |
$446 |
2.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$249.80 |
$474 |
2.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$287.74 |
$546 |
2.6× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$167.06 |
$317 |
1.5× |
| Us retroperitoneal complete (76770) |
$226.61 |
$430 |
2.1× |
| Us retroperitoneal limited (76775) |
$280.36 |
$532 |
2.6× |
| Us scrotum and contents (76870) |
$254.01 |
$482 |
2.3× |
| Us soft tissue head/neck (76536) |
$259.28 |
$492 |
2.4× |
| Us spinal canal and contents (76800) |
$278.78 |
$529 |
2.5× |
| Us transrectal (76872) |
$187.61 |
$356 |
1.7× |
| Us, eye b-scan (76512) |
$156.52 |
$297 |
1.4× |
| Us,transplanted kidney, real time/ doppler (76776) |
$281.42 |
$534 |
2.6× |
| Venogram extremity bilateral (75822) |
$1,769.14 |
$3,357 |
1.1× |
| Venogram Extremity Unilateral (75820) |
$1,367.04 |
$2,594 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$3,151.99 |
$5,981 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,484.03 |
$2,816 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$2,784.14 |
$5,283 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,405.47 |
$6,462 |
1.0× |
| Wrist 2 views (73100) |
$157.05 |
$298 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$148.09 |
$281 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$136.49 |
$259 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$389.45 |
$739 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$169.17 |
$321 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$172.86 |
$328 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$242.95 |
$461 |
2.2× |
| X-ray exam of femur 2/> (73552) |
$201.58 |
$382.50 |
2.2× |
| X-ray leg, infant (73592) |
$113.30 |
$215 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$190.77 |
$362 |
1.7× |
| X-ray nose-rectum child f.b. (76010) |
$115.94 |
$220 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$173.91 |
$330 |
1.6× |
| X-ray retrograde pyelogram (74420) |
$485.37 |
$921 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$168.64 |
$320 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$180.23 |
$342 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$257.70 |
$489 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$131.22 |
$249 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$148.09 |
$281 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$249.27 |
$473 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$160.73 |
$305 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$210.80 |
$400 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$143.87 |
$273 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$188.67 |
$358 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$138.07 |
$262 |
1.3× |
| Xr bone length studies (77073) |
$212.38 |
$403 |
1.9× |
| Xr c-spine 4 or 5 views (72050) |
$206.58 |
$392 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$434.25 |
$824 |
4.0× |
| Xr urogram antegrade (74425) |
$398.41 |
$756 |
1.1× |