| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,771.75 |
$15,719 |
2.2× |
| Abdomen 1 View (74018) |
$52.19 |
$498 |
0.7× |
| Abdomen 2 views (74019) |
$249.46 |
$674 |
2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$819.35 |
$3,675 |
2.2× |
| Angio internal mammary (75756) |
$6,168.04 |
$19,579 |
2.1× |
| Angio pulmonary bilat (75743) |
$6,168.04 |
$19,579 |
2.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$6,168.04 |
$19,579 |
2.1× |
| Angiography extremity bilateral rs&i (75716) |
$6,168.04 |
$19,579 |
2.1× |
| Angiography extremity unilateral rs&i (75710) |
$6,168.04 |
$19,579 |
2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,168.04 |
$19,579 |
2.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,630.41 |
$11,525 |
1.3× |
| Ankle 2 views (73600) |
$177.63 |
$539 |
2.2× |
| Aortography thoracic serialography rs&i (75605) |
$10,229.74 |
$32,471 |
2.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$6,168.04 |
$19,579 |
2.1× |
| Artery X-Rays Abdomen (75726) |
$10,229.74 |
$32,471 |
2.0× |
| Artery X-Rays Adrenal Gland (75731) |
$3,630.41 |
$13,013 |
1.3× |
| Artery X-Rays Pelvis (75736) |
$10,229.74 |
$32,471 |
2.0× |
| Artery X-Rays Spine (75705) |
$10,229.74 |
$32,471 |
2.0× |
| Arthrogram ankle (73615) |
$849.88 |
$2,128 |
2.7× |
| Arthrogram hip (73525) |
$849.88 |
$2,233 |
2.7× |
| Arthrogram Wrist (73115) |
$849.88 |
$2,127 |
2.7× |
Basic radiation dosimetry calculation (77300)
range across 2 matching MRF lines |
$281.75 |
$1,195–$1,596 |
2.3× |
| Bone age studies (77072) |
$249.46 |
$793 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$819.35 |
$2,289 |
2.2× |
| Bone Imaging Limited Area (78300) |
$819.35 |
$2,540 |
2.2× |
| Bone Imaging Whole Body (78306) |
$819.35 |
$3,213 |
2.2× |
| Bone marrow imaging limited area (78102) |
$819.35 |
$2,432 |
2.2× |
| Bone survey infant (77076) |
$249.46 |
$869 |
2.6× |
| Brachytx isodose intermed (77317) |
$745.97 |
$3,343 |
2.2× |
| Brachytx Isodose Plan Simple (77316) |
$745.97 |
$2,600 |
2.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,050.49 |
$3,578 |
2.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,050.49 |
$3,337 |
2.1× |
| Cat Scan Follow-Up Study (76380) |
$177.63 |
$2,558 |
2.2× |
| Cerebrospinal Fluid Scan (78630) |
$1,050.49 |
$3,473 |
2.1× |
| Chest 1 view (71045) |
$177.63 |
$799 |
2.2× |
| Chest 2 views (71046) |
$177.63 |
$502 |
2.2× |
| Chest 3 views (71047) |
$177.63 |
$502 |
2.2× |
| Chest 4 or more views (71048) |
$249.46 |
$757 |
2.6× |
| Clavicle complete (73000) |
$177.63 |
$632 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$177.63 |
$3,030 |
1.9× |
| Continuing medical physics consltj pr wk (77336) |
$281.75 |
$1,909 |
2.3× |
| Contrast Exam Abdominl Aorta (75625) |
$6,168.04 |
$19,579 |
2.1× |
| Contrast X-Ray Bladder (74430) |
$849.88 |
$2,700 |
2.7× |
| Contrast X-Ray Of Elbow (73085) |
$849.88 |
$2,127 |
2.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$849.88 |
$2,127 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$849.88 |
$5,876 |
2.7× |
| CT abdomen and pelvis without contrast (74176) |
$518.68 |
$4,545 |
2.4× |
| CT abdomen w contrast (74160) |
$405.57 |
$2,634 |
2.5× |
| CT abdomen w wo contrast (74170) |
$405.57 |
$3,236 |
2.5× |
| CT abdomen w/o contrast (74150) |
$249.46 |
$1,632 |
2.6× |
| CT Angio Abdomen and Pelvis (74174) |
$849.88 |
$3,511 |
2.7× |
| CT Angio Chest (71275) |
$405.57 |
$4,457 |
2.5× |
| CT Angio Head (70496) |
$405.57 |
$3,547 |
2.5× |
| CT angio hrt w/3d image (75574) |
$405.57 |
$4,205 |
1.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$405.57 |
$2,361 |
2.5× |
| CT Angio Neck (70498) |
$405.57 |
$3,526 |
2.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$405.57 |
$2,193 |
2.5× |
| CT cervical spine w/ contrast (72126) |
$849.88 |
$4,661 |
2.7× |
| CT cervical spine w/o contrast (72125) |
$249.46 |
$3,927 |
2.6× |
| CT cervical spine w/wo cont (72127) |
$405.57 |
$5,266 |
2.5× |
| CT chest w contrast (71260) |
$405.57 |
$3,582 |
2.5× |
| CT chest w/wo contrast (71270) |
$405.57 |
$4,027 |
2.5× |
| CT head/brain with contrast (70460) |
$405.57 |
$2,374 |
2.5× |
| CT head/brain without and with contrast (70470) |
$405.57 |
$2,966 |
2.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$177.63 |
$1,011 |
2.2× |
| CT iac w contrast (70481) |
$405.57 |
$3,841 |
2.5× |
| CT l-spine w&w/o contrast (72133) |
$405.57 |
$5,498 |
2.5× |
| CT lower ext w/o (73700) |
$249.46 |
$3,168 |
2.6× |
| CT lower extremity w/contrast material (73701) |
$405.57 |
$4,109 |
2.5× |
| CT lumbar spine w contrast (72132) |
$849.88 |
$3,922 |
2.7× |
| CT lumbar spine w/o contrast (72131) |
$249.46 |
$3,787 |
2.6× |
| CT maxillofacial w contrast (70487) |
$405.57 |
$3,835 |
2.5× |
| CT maxillofacial wo contrast (70486) |
$249.46 |
$3,698 |
2.6× |
| CT neck tissue combo (70492) |
$405.57 |
$4,348 |
2.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$405.57 |
$4,563 |
2.5× |
| CT orbits w/o contrast (70480) |
$249.46 |
$3,142 |
2.6× |
| CT pelvis w&w/o contrast (72194) |
$405.57 |
$5,308 |
2.5× |
| CT pelvis w/o contrast (72192) |
$249.46 |
$1,935 |
2.6× |
| CT scan of leg combo (73702) |
$405.57 |
$5,539 |
2.5× |
| CT scans face/jaw combo (70488) |
$405.57 |
$4,012 |
2.5× |
| CT soft tissue neck w contrast (70491) |
$405.57 |
$3,851 |
2.5× |
| CT soft tissue neck w/o contrast (70490) |
$249.46 |
$3,239 |
2.6× |
| CT thoracic spine w contrast (72129) |
$405.57 |
$4,283 |
2.5× |
| CT thoracic spine w/o contrast (72128) |
$249.46 |
$4,143 |
2.6× |
| CT thoracic spine w/wo cont (72130) |
$405.57 |
$5,017 |
2.5× |
| CT thorax w/o contrast (71250) |
$249.46 |
$2,770 |
2.6× |
| CT upper ext wo (73200) |
$249.46 |
$3,201 |
2.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$405.57 |
$6,516 |
2.5× |
| CT upper extremity with contrast (73201) |
$849.88 |
$3,791 |
2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$405.57 |
$1,653 |
2.5× |
| Cta Abdomen (74175) |
$405.57 |
$2,161 |
2.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$3,075 |
$6,150 |
9.6× |
| CTA pelvis (72191) |
$405.57 |
$2,381 |
2.5× |
| Dilation ureters/urethra rs&i (74485) |
$3,942.94 |
$12,517 |
2.1× |
| Diskography lumbar (72295) |
$3,826.76 |
$12,147 |
2.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$249.46 |
$1,085 |
2.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$249.46 |
$1,466 |
2.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$249.46 |
$932 |
2.6× |
| Dxa Bone Density Axial (77080) |
$249.46 |
$764 |
2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$177.63 |
$727 |
2.2× |
| Echo exam of fetal heart (76825) |
$1,071.85 |
$2,837 |
2.1× |
| Echo exam uterus (76831) |
$518.68 |
$1,446 |
2.4× |
| Echo Guide For Artery Repair (76936) |
$563.32 |
$2,808 |
2.9× |
| Esophagram (74220) |
$405.57 |
$1,142 |
2.5× |
| Fetal Biophys Profile W/Nst (76818) |
$249.46 |
$1,036 |
2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$249.46 |
$810 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$518.68 |
$1,705 |
2.4× |
| Follow-Up Angiography (75898) |
$3,630.41 |
$11,525 |
1.3× |
| Foot 2 views (73620) |
$177.63 |
$592 |
2.2× |
| Forearm 2 views (73090) |
$177.63 |
$632 |
2.2× |
| Gastric emptying imaging study (78264) |
$819.35 |
$3,134 |
2.2× |
| Gastroesophageal Reflux Exam (78262) |
$819.35 |
$2,660 |
2.2× |
| Gated Heart Planar Single (78472) |
$819.35 |
$2,962 |
2.2× |
| Hand 2 views (73120) |
$249.46 |
$984 |
2.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,168.04 |
$19,579 |
2.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$6,168.04 |
$19,579 |
2.1× |
| Hepatobil Syst Image W/Drug (78227) |
$1,050.49 |
$2,889 |
2.1× |
| Hepatobiliary System Imaging (78226) |
$819.35 |
$2,889 |
2.2× |
| Ht Muscle Image Spect Sing (78451) |
$2,831.51 |
$7,616 |
2.4× |
| Hysterosalpingogram (74740) |
$518.68 |
$1,953 |
2.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$177.63 |
$1,240 |
2.2× |
| Infant hip ultrasound, limited static exam (76886) |
$177.63 |
$1,240 |
2.2× |
| Infusion Ivp (74410) |
$405.57 |
$2,036 |
2.5× |
| Joint Survey Single View (77077) |
$249.46 |
$783 |
2.6× |
| K Flow/Funct Image Multiple (78709) |
$1,050.49 |
$2,874 |
2.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,050.49 |
$2,874 |
2.1× |
| K Flow/Funct Image W/O Drug (78707) |
$1,050.49 |
$4,218 |
2.1× |
| Kidney Imaging Morphol (78700) |
$819.35 |
$2,607 |
2.2× |
| Knee 3 Views (73562) |
$177.63 |
$727 |
2.2× |
| Liver & Spleen Imaging Static Only (78215) |
$819.35 |
$2,699 |
2.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,050.49 |
$5,423 |
2.1× |
| Lung perfusion differential (78597) |
$819.35 |
$3,300 |
2.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,050.49 |
$4,049 |
2.1× |
| Lung Ventilation Imaging (78579) |
$819.35 |
$2,621 |
2.2× |
| Lymph System Imaging (78195) |
$1,050.49 |
$4,686 |
2.1× |
| Magnetic Image Jaw Joint (70336) |
$518.68 |
$2,585 |
2.4× |
| Mammary ductogram or galactogram multiple (77054) |
$518.68 |
$2,105 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$518.68 |
$2,105 |
2.4× |
| Meckels Divert Exam (78290) |
$819.35 |
$2,898 |
2.2× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$281.75 |
$896 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$745.97 |
$9,507 |
2.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$849.88 |
$7,848 |
2.7× |
| MRA head w/o contrast (70544) |
$518.68 |
$3,135 |
2.4× |
| MRA head with contrast (70545) |
$849.88 |
$4,711 |
2.7× |
| MRA neck w contrast (70548) |
$849.88 |
$3,535 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$849.88 |
$6,155 |
2.7× |
| MRA neck w/o contrast (70547) |
$518.68 |
$3,278 |
2.4× |
| MRI abdomen w contrast (74182) |
$849.88 |
$5,746 |
2.7× |
| MRI abdomen w/o contrast (74181) |
$518.68 |
$4,511 |
2.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,515.30 |
$4,770 |
2.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$849.88 |
$7,153 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,515.30 |
$5,288 |
2.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$518.68 |
$3,921 |
2.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$518.68 |
$3,071 |
2.4× |
| MRI cervical spine w contrast (72142) |
$849.88 |
$6,106 |
2.7× |
| MRI cervical spine w/o cont (72141) |
$518.68 |
$5,416 |
2.4× |
| MRI chest w/o contrast (71550) |
$518.68 |
$4,599 |
2.4× |
| MRI chest with contrast (71551) |
$1,515.30 |
$5,185 |
2.1× |
| MRI chest wo w contrast (71552) |
$849.88 |
$8,636 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$849.88 |
$5,217 |
2.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$849.88 |
$6,233 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$518.68 |
$4,233 |
2.4× |
| MRI lumbar spine w contrast (72149) |
$849.88 |
$5,707 |
2.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$849.88 |
$7,628 |
2.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$518.68 |
$3,350 |
2.4× |
| MRI orbit face neck w contrast (70542) |
$849.88 |
$3,568 |
2.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$849.88 |
$5,255 |
2.7× |
| MRI pelvis w contrast (72196) |
$849.88 |
$4,584 |
2.7× |
| MRI pelvis w/o & w contrast (72197) |
$849.88 |
$6,872 |
2.7× |
| MRI pelvis w/o contrast (72195) |
$518.68 |
$3,660 |
2.4× |
| MRI thoracic spine w/o contrast (72146) |
$518.68 |
$5,063 |
2.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$849.88 |
$5,287 |
2.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$518.68 |
$3,678 |
2.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$849.88 |
$7,929 |
2.7× |
| MRI, abdomen, combo (74183) |
$849.88 |
$7,504 |
2.7× |
| MRI, dorsal spine combo (72157) |
$849.88 |
$7,131 |
2.7× |
| MRI, dorsal spine contrast (72147) |
$849.88 |
$5,707 |
2.7× |
| MRI, joint upper extrem (73221) |
$518.68 |
$4,689 |
2.4× |
| MRI, joint upper extrem combo (73223) |
$849.88 |
$7,929 |
2.7× |
| MRI, lumbar spine combo (72158) |
$849.88 |
$7,132 |
2.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$819.35 |
$3,120 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,831.51 |
$7,898 |
2.4× |
| N-invas est c ffr sw aly CTA (75580) |
$805 |
$1,610 |
1.0× |
| Neck soft tissue (70360) |
$177.63 |
$589 |
2.2× |
| Nonvascular Shunt X-Ray (75809) |
$249.46 |
$4,620 |
2.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,771.75 |
$8,133 |
2.2× |
| Nuclear Rx Intra-Arterial (79445) |
$528.38 |
$2,274 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$528.38 |
$2,157 |
2.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$249.46 |
$837 |
2.6× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$177.63 |
$585 |
2.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$249.46 |
$889 |
2.6× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$51.17 |
$336 |
1.9× |
| Parathyroid Planar Imaging (78070) |
$819.35 |
$2,266 |
2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$819.35 |
$2,266 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$249.46 |
$922 |
2.6× |
| Peritoneogram Rs&I (74190) |
$1,071.85 |
$2,688 |
2.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,168.04 |
$19,579 |
2.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$819.35 |
$2,358 |
2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$249.46 |
$933 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,071.85 |
$3,403 |
2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$177.63 |
$632 |
2.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$177.63 |
$501 |
2.2× |
| Radex elbow complete minimum 3 views (73080) |
$177.63 |
$702 |
2.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$249.46 |
$791 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$177.63 |
$531 |
2.2× |
| Radex foot complete minimum 3 views (73630) |
$177.63 |
$713 |
2.2× |
| Radex Hand Minimum 3 Views (73130) |
$177.63 |
$691 |
2.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$177.63 |
$666 |
2.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$249.46 |
$1,046 |
2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$177.63 |
$594 |
2.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$177.63 |
$692 |
2.2× |
| Radex shoulder complete minimum 2 views (73030) |
$177.63 |
$657 |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$177.63 |
$583 |
2.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$405.57 |
$1,490 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$177.63 |
$524 |
2.2× |
| Radex Sternum Minimum 2 Views (71120) |
$177.63 |
$675 |
2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$177.63 |
$845 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$177.63 |
$496 |
2.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$249.46 |
$652 |
2.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$177.63 |
$632 |
2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$249.46 |
$1,586 |
2.6× |
| Radiation treatment delivery level 1 (77402) |
$273.12 |
$1,529 |
2.9× |
| Radiation treatment delivery level 3 (77412) |
$526.07 |
$2,653 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$249.46 |
$691 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$249.46 |
$674 |
2.6× |
| Radiologic exam colon double contrast study (74280) |
$405.57 |
$1,981 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$405.57 |
$1,135 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$405.57 |
$1,402 |
2.5× |
| Radiologic exam knee complete 4/more views (73564) |
$249.46 |
$841 |
2.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$249.46 |
$755 |
2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$405.57 |
$1,209 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$405.57 |
$2,203 |
2.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$405.57 |
$1,450 |
2.5× |
| Radiologic examination femur 1 view (73551) |
$177.63 |
$515 |
2.2× |
| Radiologic examination femur minimum 2 views (73552) |
$177.63 |
$607 |
2.2× |
| Radiologic examination knee 1/2 views (73560) |
$177.63 |
$585 |
2.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$249.46 |
$869 |
2.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$177.63 |
$607 |
2.2× |
| Radiopharm Dacryocystography (78660) |
$819.35 |
$2,023 |
2.2× |
| Renal Cyst Study (74470) |
$1,071.85 |
$3,403 |
2.1× |
| Ribs bilateral 3 views (71110) |
$249.46 |
$866 |
2.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$819.35 |
$2,541 |
2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$819.35 |
$3,684 |
2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,831.51 |
$9,075 |
5.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,831.51 |
$7,749 |
5.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,831.51 |
$8,989 |
5.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,831.51 |
$8,989 |
2.4× |
| Salivary Gland Imaging Serial Images (78231) |
$819.35 |
$2,480 |
2.2× |
| Scapula (73010) |
$249.46 |
$657 |
2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$49.43 |
$214 |
2.1× |
| Shoulder 1 view (73020) |
$177.63 |
$520 |
2.2× |
| Shoulder Arthrography (73040) |
$849.88 |
$2,580 |
2.7× |
| Skull less than 4 views (70250) |
$249.46 |
$992 |
2.6× |
| Special dosimetry (77331) |
$281.75 |
$1,540 |
2.3× |
| Special Physics Consult (77370) |
$281.75 |
$3,012 |
2.3× |
| Special treatment procedure (77470) |
$1,199.27 |
$6,428 |
2.4× |
| Sternoclavicular joints (71130) |
$177.63 |
$771 |
2.2× |
| Superior sagittal sinus venogram (75870) |
$3,630.41 |
$11,525 |
1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$745.97 |
$6,202 |
2.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$745.97 |
$3,651 |
2.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$518.68 |
$2,127 |
2.4× |
| Testicular Imaging W/Flow (78761) |
$819.35 |
$2,607 |
2.2× |
Ther Rad Simulaj-Aided Field Setting Complex (77290)
range across 2 matching MRF lines |
$745.97 |
$1,912–$4,293 |
2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$745.97 |
$4,077 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$281.75 |
$2,913 |
2.3× |
| Thoracic spine 2 views (72070) |
$249.46 |
$1,112 |
2.6× |
| Thoracic spine 3 views (72072) |
$249.46 |
$662 |
2.6× |
| Thoracolumbar 2 views (72080) |
$177.63 |
$595 |
2.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$819.35 |
$2,423 |
2.2× |
| Thyroid Met Imaging Body (78018) |
$1,050.49 |
$2,759 |
2.1× |
| Thyroid Uptake Measurement (78012) |
$819.35 |
$2,475 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$819.35 |
$3,338 |
2.2× |
| Tx Devices Design & Construction Complex (77334) |
$745.97 |
$3,398 |
2.2× |
| Tx devices design & construction intermediate (77333) |
$281.75 |
$1,944 |
2.3× |
| Tx devices design & construction simple (77332) |
$281.75 |
$1,620 |
2.3× |
| Ultrasound Breast Limited (76642) |
$177.63 |
$693 |
2.2× |
| Ultrasound Exam Aaa Screen (76706) |
$249.46 |
$746 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$249.46 |
$1,007 |
2.6× |
| Umbilical-artery Doppler (OB) (76820) |
$249.46 |
$996 |
2.6× |
| Upper gi w/o kub (74240) |
$405.57 |
$1,419 |
2.5× |
| Ureteral Reflux Study (78740) |
$819.35 |
$2,607 |
2.2× |
| Urethrocystogram voiding (74455) |
$518.68 |
$1,431 |
2.4× |
| Urethrocystography retrograde (74450) |
$518.68 |
$1,824 |
2.4× |
| Us breast unilateral complete (76641) |
$249.46 |
$726 |
2.6× |
| Us chest (76604) |
$249.46 |
$699 |
2.6× |
| Us exam, pelvic, limited (76857) |
$249.46 |
$1,002 |
2.6× |
| Us head (76506) |
$249.46 |
$962 |
2.6× |
| Us kidney transplant (76776) |
$249.46 |
$841 |
2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$249.46 |
$921 |
2.6× |
| Us ob detailed single fetus (76811) |
$518.68 |
$2,285 |
2.4× |
| Us ob limited 1 or more fetuses (76815) |
$249.46 |
$617 |
2.6× |
| Us ob transvaginal (76817) |
$249.46 |
$688 |
2.6× |
| Us pelvic non ob complete (76856) |
$249.46 |
$1,316 |
2.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$249.46 |
$845 |
2.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$249.46 |
$699 |
2.6× |
| Us retroperitoneal complete (76770) |
$249.46 |
$1,471 |
2.6× |
| Us retroperitoneal limited (76775) |
$249.46 |
$991 |
2.6× |
| Us scrotum and contents (76870) |
$249.46 |
$1,005 |
2.6× |
| Us spinal canal and contents (76800) |
$249.46 |
$830 |
2.6× |
| Us thyroid (76536) |
$249.46 |
$1,246 |
2.6× |
| Us transrectal (76872) |
$249.46 |
$1,555 |
2.6× |
| Vasogram (74440) |
$518.68 |
$1,829 |
2.4× |
| Vein X-Ray Chest (75827) |
$1,403.33 |
$3,797 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,630.41 |
$11,525 |
1.3× |
| Vein X-Ray Skull Epidural (75872) |
$1,403.33 |
$5,317 |
2.4× |
| Vein X-Ray Spleen/Liver (75810) |
$3,630.41 |
$9,427 |
1.3× |
| Venogram Sinus/Jugular (75860) |
$6,168.04 |
$19,579 |
2.1× |
| Venography Adrenal Unilateral (75840) |
$6,168.04 |
$19,579 |
2.1× |
| Venography caval inferior serialography rs&i (75825) |
$6,168.04 |
$19,579 |
2.1× |
| Venography extremity bilateral rs&i (75822) |
$3,630.41 |
$11,525 |
2.5× |
| Venography extremity unilateral rs&i (75820) |
$1,403.33 |
$4,489 |
1.0× |
| Venography Orbital Rs&I (75880) |
$1,403.33 |
$5,317 |
2.4× |
| Venography Renal Bilateral (75833) |
$6,168.04 |
$19,579 |
2.1× |
| Venography Renal Unilateral (75831) |
$6,168.04 |
$19,579 |
2.1× |
| Venous sampling by catheter (75893) |
$10,229.74 |
$32,471 |
2.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$819.35 |
$2,902 |
2.2× |
| Wrist 2 views (73100) |
$177.63 |
$504 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$177.63 |
$543 |
2.2× |
| X-Ray Aorta Leg Arteries (75630) |
$6,168.04 |
$19,579 |
2.1× |
| X-Ray Bend Only L-S Spine (72120) |
$249.46 |
$823 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$177.63 |
$537 |
2.2× |
| X-Ray Exam Breast Specimen (76098) |
$1,071.85 |
$3,403 |
2.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$177.63 |
$672 |
2.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$249.46 |
$1,220 |
2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$249.46 |
$1,322 |
2.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$177.63 |
$460 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$177.63 |
$794 |
2.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$249.46 |
$985 |
2.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$249.46 |
$747 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$249.46 |
$888 |
2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$249.46 |
$1,068 |
2.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$249.46 |
$1,023 |
2.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$177.63 |
$743 |
2.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$249.46 |
$1,340 |
2.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$249.46 |
$830 |
2.6× |
| X-ray humerus (73060) |
$177.63 |
$657 |
2.2× |
| X-ray IV pyelogram (ivp) (74400) |
$405.57 |
$1,952 |
2.5× |
| X-ray IV pyelogram+tomography (74415) |
$405.57 |
$2,483 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$177.63 |
$651 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$249.46 |
$1,221 |
2.6× |
| X-ray nose-rectum child f.b. (76010) |
$177.63 |
$561 |
2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$249.46 |
$1,161 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$249.46 |
$747 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$177.63 |
$548 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$177.63 |
$841 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$249.46 |
$880 |
2.6× |
| X-ray thoracic spine 4 vw (72074) |
$249.46 |
$822 |
2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$849.88 |
$2,594 |
2.7× |
| X-Rays Bone Length Studies (77073) |
$249.46 |
$770 |
2.6× |
| X-Rays Bone Survey Complete (77075) |
$249.46 |
$1,002 |
2.6× |
| Xr c-spine 4 or 5 views (72050) |
$249.46 |
$1,035 |
2.6× |
| Xr facial bones less than 3 views (70140) |
$177.63 |
$554 |
2.2× |
| Xr orbits complete 4 views (70200) |
$249.46 |
$832 |
2.6× |
| Xr Tomogram Single Plane (76100) |
$249.46 |
$1,788 |
2.6× |