| 3-D radiotherapy plan dose-volume histograms (77295) |
$11,297.60 |
$24,560 |
7.9× |
| Abdomen 2 views (74019) |
$584.66 |
$1,271 |
5.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,644.50 |
$3,575 |
4.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,748.08 |
$8,148 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$2,946.30 |
$6,405 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,440.76 |
$5,306 |
0.7× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,646.84 |
$5,754 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,581.98 |
$5,613 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,221.80 |
$4,830 |
0.7× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,015.68 |
$2,208 |
0.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,945.42 |
$8,577 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,434.28 |
$3,118 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,653.24 |
$3,594 |
0.5× |
| Ankle 2 views (73600) |
$214.36 |
$466 |
2.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$592.94 |
$1,289 |
1.6× |
| Aortogram thoracic (75605) |
$3,122.48 |
$6,788 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,748.08 |
$8,148 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$3,748.08 |
$8,148 |
1.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,251.20 |
$2,720 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$1,551.58 |
$3,373 |
0.5× |
| Arthrogram elbow (73085) |
$359.49 |
$781.50 |
1.0× |
| Arthrogram hip (73525) |
$434.70 |
$945 |
1.2× |
| Arthrogram shoulder (73040) |
$681.72 |
$1,482 |
1.9× |
| Arthrogram wrist (73115) |
$562.81 |
$1,223.50 |
1.6× |
| Arthrography knee lt (73580) |
$607.20 |
$1,320 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$644.92 |
$1,402 |
4.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$774.41 |
$1,683.50 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,191.63 |
$2,590.50 |
2.9× |
| Bone age studies (77072) |
$568.79 |
$1,236.50 |
5.2× |
| Bone Imaging 3 Phase (78315) |
$1,340.21 |
$2,913.50 |
3.2× |
| Bone Marrow Imaging Limited Area (78102) |
$509.68 |
$1,108 |
1.2× |
| Bone survey complete (77075) |
$739.22 |
$1,607 |
6.8× |
| Brachytx isodose complex (77318) |
$6,467.14 |
$14,059 |
16.6× |
| Brachytx isodose intermed (77317) |
$1,602.64 |
$3,484 |
4.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,393.34 |
$3,029 |
3.6× |
| Brain image w/flow 4 + views (78606) |
$782.69 |
$1,701.50 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$9,125.94 |
$19,839 |
6.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,446.24 |
$3,144 |
4.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$773.95 |
$1,682.50 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$244.95 |
$532.50 |
2.7× |
| Chest 1 view (71045) |
$212.98 |
$463 |
2.4× |
| Chest 3 views (71047) |
$960.48 |
$2,088 |
10.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$546.02 |
$1,187 |
3.0× |
| Cineradiography/videoradiography (76120) |
$737.84 |
$1,604 |
6.8× |
| Clavicle complete (73000) |
$296.01 |
$643.50 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$85.56 |
$186 |
0.8× |
| Continuing medical physics consltj pr wk (77336) |
$1,119.18 |
$2,433 |
8.0× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$463.68 |
$1,008 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,860.28 |
$6,218 |
7.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,823.21 |
$3,963.50 |
7.4× |
| CT abdomen w contrast (74160) |
$1,100.32 |
$2,392 |
6.0× |
| CT abdomen w wo contrast (74170) |
$1,475.68 |
$3,208 |
8.1× |
| CT abdomen w/o contrast (74150) |
$915.63 |
$1,990.50 |
8.4× |
| CT angio hrt w/3d image (75574) |
$1,052.71 |
$2,288.50 |
2.9× |
| CT angiography upper extremity lt (73206) |
$1,325.03 |
$2,880.50 |
7.3× |
| CT c-spine w/o contrast (72125) |
$878.14 |
$1,909 |
8.1× |
| CT cervical spine w&w/o contrast (72127) |
$1,277.65 |
$2,777.50 |
7.0× |
| CT cervical spine with contrast (72126) |
$1,048.80 |
$2,280 |
2.9× |
| CT chest w/wo contrast (71270) |
$1,240.16 |
$2,696 |
6.8× |
| CT chest with contrast (71260) |
$1,057.08 |
$2,298 |
5.8× |
| CT head/brain with contrast (70460) |
$974.28 |
$2,118 |
5.4× |
| CT head/brain without and with contrast (70470) |
$1,180.13 |
$2,565.50 |
6.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$39.10 |
$85 |
0.4× |
| CT iac w contrast (70481) |
$1,330.32 |
$2,892 |
7.3× |
| CT limited/localized follow up study (76380) |
$801.78 |
$1,743 |
8.9× |
| CT lower ext w/o (73700) |
$905.05 |
$1,967.50 |
8.3× |
| CT lower extremity w wo contrast (73702) |
$1,392.19 |
$3,026.50 |
7.6× |
| CT lower extremity with contrast (73701) |
$1,091.35 |
$2,372.50 |
6.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,394.03 |
$3,030.50 |
7.7× |
| CT lumbar spine w/o contrast (72131) |
$953.58 |
$2,073 |
8.8× |
| CT lumbar spine with contrast (72132) |
$1,060.30 |
$2,305 |
2.9× |
| CT maxillofacial w contrast (70487) |
$1,171.39 |
$2,546.50 |
6.4× |
| CT maxillofacial w/o contrast (70486) |
$633.42 |
$1,377 |
5.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,425.08 |
$3,098 |
7.8× |
| CT neck soft tissue w contrast (70491) |
$1,150.46 |
$2,501 |
6.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,523.75 |
$3,312.50 |
8.4× |
| CT orbits w/o contrast (70480) |
$1,143.10 |
$2,485 |
10.5× |
| CT pelvis w & w/o contrast (72194) |
$1,384.14 |
$3,009 |
7.6× |
| CT pelvis w/o contrast (72192) |
$908.04 |
$1,974 |
8.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,397.25 |
$3,037.50 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$958.87 |
$2,084.50 |
8.8× |
| CT thoracic spine w/contrast (72129) |
$1,061.91 |
$2,308.50 |
5.8× |
| CT thoracic spine w/o contrast (72128) |
$954.27 |
$2,074.50 |
8.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,647.26 |
$3,581 |
9.1× |
| CT thorax w/o contrast (71250) |
$954.27 |
$2,074.50 |
8.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,387.59 |
$3,016.50 |
7.6× |
| CT upper extremity w/o contrast rt (73200) |
$904.13 |
$1,965.50 |
8.3× |
| CT upper extremity with contrast (73201) |
$1,084.68 |
$2,358 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,662.90 |
$3,615 |
9.1× |
| Cta Abdomen (74175) |
$1,462.80 |
$3,180 |
8.0× |
| CTA abdomen pelvis (74174) |
$2,717.22 |
$5,907 |
7.5× |
| CTA chest (71275) |
$1,318.13 |
$2,865.50 |
7.2× |
| Cta Head (70496) |
$1,763.87 |
$3,834.50 |
9.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,438.19 |
$3,126.50 |
7.9× |
| Cta Neck (70498) |
$1,771.23 |
$3,850.50 |
9.7× |
| Cta Pelvis (72191) |
$1,372.18 |
$2,983 |
7.5× |
| Cystography minimum 3 views rs&i (74430) |
$738.30 |
$1,605 |
2.0× |
| Diskogram cervical (72285) |
$767.28 |
$1,668 |
0.4× |
| Diskography lumbar (72295) |
$1,828.04 |
$3,974 |
0.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$229.54 |
$499 |
2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$288.88 |
$628 |
2.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$507.61 |
$1,103.50 |
4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$242.42 |
$527 |
2.7× |
| Echo exam of fetal heart (76825) |
$1,702 |
$3,700 |
3.0× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$931.50 |
$2,025 |
3.8× |
| Echoencephalography real time imaging (76506) |
$838.81 |
$1,823.50 |
7.7× |
| Esophagus (74220) |
$505.08 |
$1,098 |
2.8× |
| Fetal biophysical profile non-stress testing (76818) |
$359.03 |
$780.50 |
3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$354.20 |
$770 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$690 |
$1,500 |
2.8× |
| Foot 2 views (73620) |
$214.36 |
$466 |
2.4× |
| Forearm 2 views (73090) |
$297.16 |
$646 |
3.3× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$155.94 |
$339 |
0.6× |
| Gated Heart Planar Single (78472) |
$2,485.15 |
$5,402.50 |
6.0× |
| Hand 2 views (73120) |
$214.36 |
$466 |
2.0× |
| Hand 3 views (73130) |
$330.28 |
$718 |
3.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$5,538.86 |
$12,041 |
7.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$10,217.06 |
$22,211 |
14.1× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$11,391.90 |
$24,765 |
15.8× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$518.42 |
$1,127 |
1.3× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$518.42 |
$1,127 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$592.94 |
$1,289 |
0.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,369.92 |
$5,152 |
4.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,369.92 |
$5,152 |
5.7× |
| Ht muscle image spect sing (78451) |
$3,626.18 |
$7,883 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$329.82 |
$717 |
3.7× |
| Hysterosalpingogram (74740) |
$1,558.02 |
$3,387 |
6.3× |
| Interstitial radiation source applic complex (77778) |
$2,035.04 |
$4,424 |
2.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,157.36 |
$2,516 |
1.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$155.94 |
$339 |
1.4× |
| Kidney imaging morphology (78700) |
$912.64 |
$1,984 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,667.50 |
$3,625 |
3.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,834.25 |
$3,987.50 |
3.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,285.97 |
$4,969.50 |
4.1× |
| Knee 3 views (73562) |
$305.44 |
$664 |
3.4× |
| Liver & spleen imaging static only (78215) |
$2,324.38 |
$5,053 |
5.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,228.93 |
$4,845.50 |
5.4× |
| Liver imaging static only (78201) |
$2,196.50 |
$4,775 |
3.9× |
| Lung perfusion differential (78597) |
$615.02 |
$1,337 |
1.5× |
| Lung Ventilation Imaging (78579) |
$1,681.07 |
$3,654.50 |
4.1× |
| Lymphoscintigraphy (78195) |
$1,998.01 |
$4,343.50 |
3.5× |
| Mammary ductogram or galactogram multiple (77054) |
$595.01 |
$1,293.50 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$595.01 |
$1,293.50 |
2.4× |
| Meckels Diverticulum (78290) |
$756.70 |
$1,645 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,094.34 |
$2,379 |
2.8× |
| MRA head w & w/o contrast (70546) |
$1,701.08 |
$3,698 |
4.7× |
| MRA head w/o contrast (70544) |
$1,476.14 |
$3,209 |
6.0× |
| MRA head with contrast (70545) |
$1,609.31 |
$3,498.50 |
4.4× |
| MRA neck w contrast (70548) |
$1,536.63 |
$3,340.50 |
4.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,760.88 |
$3,828 |
4.9× |
| MRA neck w/o contrast (70547) |
$1,424.16 |
$3,096 |
5.8× |
| MRI abdomen w contrast (74182) |
$1,218.31 |
$2,648.50 |
3.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,544.91 |
$3,358.50 |
4.3× |
| MRI abdomen w/o contrast (74181) |
$918.62 |
$1,997 |
3.7× |
| MRI any jnt lwr ext with con lt (73722) |
$1,066.74 |
$2,319 |
1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,063.75 |
$2,312.50 |
1.3× |
| MRI breast w/o contrast bilateral (77047) |
$1,477.06 |
$3,211 |
6.0× |
| MRI breast w/o contrast unilat (77046) |
$1,480.28 |
$3,218 |
6.0× |
| MRI c-spine with contrast (72142) |
$1,278.11 |
$2,778.50 |
3.5× |
| MRI cardiac w/o cont stress (75559) |
$933.57 |
$2,029.50 |
1.6× |
| MRI cardiac w/o contrast (75557) |
$1,320.20 |
$2,870 |
5.3× |
| MRI cervical spine w/o contrast (72141) |
$978.88 |
$2,128 |
4.0× |
| MRI chest w/o & w/contrast material (71552) |
$781.77 |
$1,699.50 |
2.2× |
| MRI chest w/o contrast (71550) |
$573.39 |
$1,246.50 |
2.3× |
| MRI chest with contrast (71551) |
$700.35 |
$1,522.50 |
0.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,313.30 |
$2,855 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,411.05 |
$3,067.50 |
3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$994.98 |
$2,163 |
4.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$994.06 |
$2,161 |
4.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,841.38 |
$4,003 |
5.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,198.99 |
$2,606.50 |
3.3× |
| MRI pelvis w contrast (72196) |
$1,013.61 |
$2,203.50 |
2.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,543.53 |
$3,355.50 |
4.3× |
| MRI pelvis w/o contrast (72195) |
$629.97 |
$1,369.50 |
2.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,475.22 |
$3,207 |
4.1× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,775.14 |
$3,859 |
2.2× |
| MRI scan of leg joint before and after contrast (73723) |
$1,464.64 |
$3,184 |
4.0× |
| MRI spectroscopy (76390) |
$915.17 |
$1,989.50 |
10.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,693.72 |
$3,682 |
4.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,151.61 |
$2,503.50 |
3.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,523.29 |
$3,311.50 |
4.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,066.74 |
$2,319 |
2.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,467.86 |
$3,191 |
4.1× |
| MRI thoracic spine w/o contrast (72146) |
$897.46 |
$1,951 |
3.6× |
| MRI tmj (70336) |
$918.16 |
$1,996 |
3.7× |
| MRI upper ext joint w/o contrast (73221) |
$892.40 |
$1,940 |
3.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,533.64 |
$3,334 |
4.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,261.32 |
$2,742 |
5.1× |
| Myelogram Cervical (72240) |
$1,121.02 |
$2,437 |
1.4× |
| Myelogram Lumbar (72265) |
$1,251.66 |
$2,721 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,689.58 |
$3,673 |
2.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,196.50 |
$4,775 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,106.65 |
$8,927.50 |
3.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,414.54 |
$5,249 |
1.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,747.75 |
$5,973.37 |
1.2× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,716.76 |
$5,906 |
1.2× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,059.88 |
$4,478 |
2.3× |
| Neck soft tissue (70360) |
$143.52 |
$312 |
1.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$576.38 |
$1,253 |
1.4× |
| Nm adrenal scan (78075) |
$1,803.43 |
$3,920.50 |
1.3× |
| Nm bone marrow multiple (78103) |
$759.92 |
$1,652 |
1.8× |
| Nm bone marrow wb (78104) |
$932.88 |
$2,028 |
2.2× |
| Nm cisternogram (78630) |
$1,820.22 |
$3,957 |
3.2× |
| Nm csf leak detection (78650) |
$818.34 |
$1,779 |
0.6× |
| Nm gastric emptying study (78264) |
$1,738.80 |
$3,780 |
4.2× |
| Nm peritoneal-venous shunt patency (78291) |
$569.25 |
$1,237.50 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$12,980.28 |
$28,218 |
9.0× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$3,164.80 |
$6,880 |
2.1× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$2,538.28 |
$5,518 |
1.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$912.64 |
$1,984 |
2.2× |
| Nuclear Rx Oral Admin (79005) |
$776.02 |
$1,687 |
3.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$229.08 |
$498 |
2.1× |
| Orthopantogram (70355) |
$239.20 |
$520 |
2.6× |
| Osseous survey infant (77076) |
$189.06 |
$411 |
1.7× |
| Osseous survey limited (77074) |
$692.53 |
$1,505.50 |
6.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,712.58 |
$3,723 |
3.0× |
| Parathyrd planar w/wo subtrj (78071) |
$1,584.24 |
$3,444 |
3.8× |
| Parathyroid imaging (78070) |
$1,394.49 |
$3,031.50 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$314.41 |
$683.50 |
2.9× |
| Peritoneogram rs&i (74190) |
$438.84 |
$954 |
0.8× |
| PET image w/CT, skull-thigh (78815) |
$10,018.34 |
$21,779 |
6.8× |
| PET imaging CT for attenuation limited area (78814) |
$2,219.96 |
$4,826 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$10,018.34 |
$21,779 |
6.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,533.41 |
$3,333.50 |
4.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,348.30 |
$5,105 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$707.02 |
$1,537 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,389.89 |
$3,021.50 |
3.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,211.03 |
$6,980.50 |
5.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$329.59 |
$716.50 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$229.77 |
$499.50 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$459.54 |
$999 |
4.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$200.79 |
$436.50 |
1.9× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$344.08 |
$748 |
3.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$459.54 |
$999 |
4.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,110.96 |
$30,676 |
1.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,082.38 |
$2,353 |
1.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$681.26 |
$1,481 |
6.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$829.84 |
$1,804 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$440.22 |
$957 |
4.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$268.64 |
$584 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$717.14 |
$1,559 |
6.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$298.08 |
$648 |
3.3× |
| Radiologic exam colon single contrast study (74270) |
$1,172.31 |
$2,548.50 |
6.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$621.92 |
$1,352 |
3.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$448.96 |
$976 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$377.89 |
$821.50 |
4.2× |
| Radiological examination surgical specimen (76098) |
$190.90 |
$415 |
0.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$971.52 |
$2,112 |
0.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,045.58 |
$2,273 |
0.3× |
| Ribs bilateral 3 views (71110) |
$475.18 |
$1,033 |
4.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,193.01 |
$2,593.50 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,334.69 |
$2,901.50 |
2.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,026.07 |
$4,404.50 |
1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,343.70 |
$5,095 |
1.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,066.78 |
$4,493 |
1.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$413.08 |
$898 |
1.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,187.26 |
$2,581 |
4.9× |
| Sacroiliac Joints < 3 Views (72200) |
$419.52 |
$912 |
3.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$753.25 |
$1,637.50 |
3.0× |
| Scanogram (77073) |
$290.95 |
$632.50 |
2.7× |
| Scapula complete (73010) |
$390.31 |
$848.50 |
3.6× |
| Screening digital breast tomosynthesis (77063) |
$69.92 |
$152 |
3.0× |
| Sella turcica (70240) |
$157.32 |
$342 |
1.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$1,019.82 |
$2,217 |
9.4× |
| Simulation intermediate (77285) |
$1,541.46 |
$3,351 |
4.0× |
| Small bowel series (74250) |
$1,027.18 |
$2,233 |
5.6× |
| Spec medical radj physics consltj (77370) |
$1,055.24 |
$2,294 |
7.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,749.38 |
$3,803 |
4.5× |
| Special dosimetry (77331) |
$372.14 |
$809 |
2.7× |
| Special treatment procedure (77470) |
$3,397.56 |
$7,386 |
5.9× |
| Speech evaluation complex (70371) |
$318.78 |
$693 |
1.3× |
| Spine thoracic 3 views (72072) |
$804.08 |
$1,748 |
7.4× |
| Stereotactic body radiation delivery (77373) |
$5,874.66 |
$12,771 |
3.2× |
| Superior sagittal sinus venogram (75870) |
$2,212.60 |
$4,810 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$6,187.92 |
$13,452 |
15.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,382.76 |
$3,006 |
3.6× |
| Testicular Imaging With Vascular Flow (78761) |
$513.82 |
$1,117 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,495.04 |
$5,424 |
6.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,336.30 |
$2,905 |
9.6× |
| Therapeutic Enema (74283) |
$272.78 |
$593 |
1.5× |
| Thoracolumbar 2 views (72080) |
$480.70 |
$1,045 |
5.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,283.21 |
$4,963.50 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,710.97 |
$3,719.50 |
4.1× |
| Thyroid uptake measurement (78012) |
$362.25 |
$787.50 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,052.98 |
$4,463 |
4.9× |
| Tmj unilateral (70328) |
$107.18 |
$233 |
1.2× |
| Tomogram (76100) |
$420.21 |
$913.50 |
3.9× |
| Treatment device intermediate (77333) |
$492.20 |
$1,070 |
3.5× |
| Treatment devices simple (77332) |
$444.82 |
$967 |
3.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,193.01 |
$2,593.50 |
2.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$644 |
$1,400 |
1.6× |
| Tx devices design & construction complex (77334) |
$1,495.46 |
$3,251 |
3.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$445.28 |
$968 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$906.66 |
$1,971 |
8.4× |
| Umbilical-artery Doppler (OB) (76820) |
$311.19 |
$676.50 |
2.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$525.78 |
$1,143 |
5.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$2,082.88 |
$4,528 |
19.7× |
| Unlisted Ultrasound Procedure (76999) |
$1,786.18 |
$3,883 |
19.8× |
| Upper Extremity Infant (73092) |
$211.60 |
$460 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$375.59 |
$816.50 |
1.5× |
| Urethrocystography voiding (74455) |
$1,028.33 |
$2,235.50 |
4.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$801.55 |
$1,742.50 |
4.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,477.75 |
$3,212.50 |
8.1× |
| Us abdl aorta screen aaa (76706) |
$693.22 |
$1,507 |
6.4× |
| Us breast unilateral complete (76641) |
$195.50 |
$425 |
1.8× |
| Us breast unilateral limited (76642) |
$107.64 |
$234 |
1.2× |
| Us chest (76604) |
$690.46 |
$1,501 |
6.4× |
| Us compl joint r-t w/image documentation (76881) |
$212.06 |
$461 |
2.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$233.45 |
$507.50 |
2.2× |
| Us infant hips dynamic (76885) |
$158.93 |
$345.50 |
1.8× |
| Us infant hips limited static (76886) |
$117.07 |
$254.50 |
1.3× |
| Us kidney transplant (76776) |
$385.02 |
$837 |
3.5× |
| Us ob detailed single fetus (76811) |
$808.45 |
$1,757.50 |
3.3× |
| Us ob transvaginal (76817) |
$1,058.46 |
$2,301 |
9.8× |
| Us pelvic non ob complete (76856) |
$1,118.72 |
$2,432 |
10.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$491.74 |
$1,069 |
4.5× |
| Us pregnancy ltd (76815) |
$514.28 |
$1,118 |
4.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$742.44 |
$1,614 |
6.8× |
| Us retroperitoneal complete (76770) |
$978.88 |
$2,128 |
9.0× |
| Us retroperitoneal limited (76775) |
$748.42 |
$1,627 |
6.9× |
| Us scrotum and contents (76870) |
$906.66 |
$1,971 |
8.4× |
| Us soft tissue head/neck (76536) |
$666.77 |
$1,449.50 |
6.1× |
| Us spinal canal and contents (76800) |
$399.97 |
$869.50 |
3.7× |
| Us transrectal prostate volume (76873) |
$707.48 |
$1,538 |
6.5× |
| Us xtr non-vasc lmtd (76882) |
$229.54 |
$499 |
2.1× |
| Us, eye b-scan (76512) |
$177.56 |
$386 |
1.6× |
| Vasogram (74440) |
$523.02 |
$1,137 |
2.1× |
| Venogram extremity bilateral (75822) |
$1,227.74 |
$2,669 |
0.8× |
| Venogram orbital (75880) |
$855.14 |
$1,859 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$3,035.08 |
$6,598 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$2,307.82 |
$5,017 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$914.94 |
$1,989 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,775.18 |
$6,033 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$1,584.70 |
$3,445 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,075.94 |
$2,339 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,900.72 |
$4,132 |
0.3× |
| Wrist 2 views (73100) |
$308.89 |
$671.50 |
3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$720.13 |
$1,565.50 |
6.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$520.95 |
$1,132.50 |
5.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$341.55 |
$742.50 |
3.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,603.33 |
$3,485.50 |
8.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$262.20 |
$570 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$300.38 |
$653 |
3.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$459.54 |
$999 |
4.2× |
| X-ray exam hip uni 1 view (73501) |
$183.77 |
$399.50 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$244.95 |
$532.50 |
2.7× |
| X-ray exam hip uni 4/> views (73503) |
$244.95 |
$532.50 |
2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$211.60 |
$460 |
2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$402.04 |
$874 |
3.7× |
| X-ray exam of femur 1 (73551) |
$127.42 |
$277 |
1.4× |
| X-ray eye for foreign body (70030) |
$524.63 |
$1,140.50 |
5.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$455.17 |
$989.50 |
4.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$337.18 |
$733 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$244.95 |
$532.50 |
2.7× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$970.14 |
$2,109 |
0.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$276.23 |
$600.50 |
3.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$651.82 |
$1,417 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$94.07 |
$204.50 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$305.44 |
$664 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$266.57 |
$579.50 |
3.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$271.40 |
$590 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$480.93 |
$1,045.50 |
4.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$879.75 |
$1,912.50 |
8.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$472.42 |
$1,027 |
4.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$432.40 |
$940 |
4.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$180.55 |
$392.50 |
2.0× |
| X-ray of voice box or throat (70370) |
$143.52 |
$312 |
1.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$512.44 |
$1,114 |
4.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$440.22 |
$957 |
4.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$298.08 |
$648 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$509.22 |
$1,107 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$399.74 |
$869 |
4.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$480.93 |
$1,045.50 |
4.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$602.14 |
$1,309 |
5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$524.86 |
$1,141 |
4.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$355.35 |
$772.50 |
3.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$385.48 |
$838 |
4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$546.71 |
$1,188.50 |
6.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$376.74 |
$819 |
4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$568.79 |
$1,236.50 |
5.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$365.47 |
$794.50 |
3.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$167.44 |
$364 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$281.75 |
$612.50 |
3.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$377.89 |
$821.50 |
4.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$722.89 |
$1,571.50 |
6.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$882.74 |
$1,919 |
8.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$272.09 |
$591.50 |
3.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$370.30 |
$805 |
4.1× |
| Xr arthrogram ankle (73615) |
$986.93 |
$2,145.50 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$750.03 |
$1,630.50 |
6.9× |
| Xr chest 4+ views (71048) |
$1,069.50 |
$2,325 |
9.9× |
| Xr finger(s) 2+ views (73140) |
$308.89 |
$671.50 |
3.4× |
| Xr internal auditory meati complete (70134) |
$121.21 |
$263.50 |
0.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$69.69 |
$151.50 |
0.6× |
| Xr optic foramina (70190) |
$156.40 |
$340 |
1.7× |
| Xr shoulder 1 view (73020) |
$183.77 |
$399.50 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$614.56 |
$1,336 |
5.7× |
| Xr tibia/fibula 2 views (73590) |
$438.15 |
$952.50 |
4.9× |
| Xr tmj bilateral (70330) |
$394.45 |
$857.50 |
4.4× |
| Xray knee 1 or 2 views rt (73560) |
$214.36 |
$466 |
2.4× |