| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,335.20 |
$4,169 |
2.2× |
| Abdomen 1 View (74018) |
$236.80 |
$296 |
2.4× |
| Abdomen 2 views (74019) |
$279.20 |
$349 |
2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,159.20 |
$1,449 |
2.6× |
| Ankle 2 views (73600) |
$233.60 |
$292 |
2.4× |
| Arthrogram hip (73525) |
$896.80 |
$1,121 |
2.3× |
| Arthrogram Wrist (73115) |
$707.20 |
$884 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$351.20 |
$439 |
2.3× |
| Bone age studies (77072) |
$248 |
$310 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$1,640 |
$2,050 |
3.7× |
| Bone Imaging Limited Area (78300) |
$788.80 |
$986 |
1.8× |
| Bone Imaging Multiple Areas (78305) |
$788.80 |
$986 |
1.8× |
| Bone Imaging Whole Body (78306) |
$1,424 |
$1,780 |
3.2× |
| Bone survey infant (77076) |
$346.40 |
$433 |
3.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,920 |
$2,400 |
3.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,660 |
$5,825 |
2.9× |
| Cat Scan Follow-Up Study (76380) |
$508.80 |
$636 |
5.2× |
| Cerebrospinal Fluid Scan (78630) |
$1,275.20 |
$1,594 |
2.1× |
| Chest 1 view (71045) |
$177.60 |
$222 |
1.8× |
| Chest 2 views (71046) |
$227.20 |
$284 |
2.3× |
| Chest 3 views (71047) |
$262.40 |
$328 |
2.7× |
| Chest 4 or more views (71048) |
$391.20 |
$489 |
3.4× |
| Cholecystography Oral Contrast (74290) |
$368 |
$460 |
1.9× |
| Clavicle complete (73000) |
$248 |
$310 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$315.20 |
$394 |
2.7× |
| Continuing medical physics consltj pr wk (77336) |
$472.80 |
$591 |
3.2× |
| Contrast X-Ray Bladder (74430) |
$772 |
$965 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,848 |
$3,560 |
7.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,655.20 |
$2,069 |
6.2× |
| CT abdomen w contrast (74160) |
$1,916 |
$2,395 |
9.8× |
| CT abdomen w wo contrast (74170) |
$2,160 |
$2,700 |
11.1× |
| CT abdomen w/o contrast (74150) |
$1,365.60 |
$1,707 |
11.7× |
| CT Angio Abdomen and Pelvis (74174) |
$2,120 |
$2,650 |
5.5× |
| CT Angio Chest (71275) |
$1,583.20 |
$1,979 |
8.1× |
| CT Angio Head (70496) |
$1,640 |
$2,050 |
8.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,160 |
$1,450 |
5.9× |
| CT Angio Neck (70498) |
$1,052 |
$1,315 |
5.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,160 |
$1,450 |
5.9× |
| CT cervical spine w/ contrast (72126) |
$1,680 |
$2,100 |
4.3× |
| CT cervical spine w/o contrast (72125) |
$1,207.20 |
$1,509 |
10.4× |
| CT cervical spine w/wo cont (72127) |
$1,932 |
$2,415 |
9.9× |
| CT chest w contrast (71260) |
$1,864 |
$2,330 |
9.5× |
| CT chest w/wo contrast (71270) |
$2,000 |
$2,500 |
10.2× |
| CT head/brain with contrast (70460) |
$1,640 |
$2,050 |
8.4× |
| CT head/brain without and with contrast (70470) |
$1,912 |
$2,390 |
9.8× |
| CT iac w contrast (70481) |
$1,052 |
$1,315 |
5.4× |
| CT l-spine w&w/o contrast (72133) |
$1,932 |
$2,415 |
9.9× |
| CT lower ext w/o (73700) |
$720.80 |
$901 |
6.2× |
| CT lower extremity w/contrast material (73701) |
$1,160 |
$1,450 |
5.9× |
| CT lumbar spine w contrast (72132) |
$1,680 |
$2,100 |
4.3× |
| CT lumbar spine w/o contrast (72131) |
$1,207.20 |
$1,509 |
10.4× |
| CT maxillofacial w contrast (70487) |
$1,052 |
$1,315 |
5.4× |
| CT maxillofacial wo contrast (70486) |
$674.40 |
$843 |
5.8× |
| CT neck tissue combo (70492) |
$1,480 |
$1,850 |
7.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,480 |
$1,850 |
7.6× |
| CT orbits w/o contrast (70480) |
$674.40 |
$843 |
5.8× |
| CT pelvis w&w/o contrast (72194) |
$2,160 |
$2,700 |
11.1× |
| CT pelvis w/o contrast (72192) |
$1,402.40 |
$1,753 |
12.0× |
| CT scan of leg combo (73702) |
$1,280 |
$1,600 |
6.5× |
| CT scans face/jaw combo (70488) |
$1,480 |
$1,850 |
7.6× |
| CT soft tissue neck w contrast (70491) |
$1,052 |
$1,315 |
5.4× |
| CT soft tissue neck w/o contrast (70490) |
$674.40 |
$843 |
5.8× |
| CT thoracic spine w contrast (72129) |
$1,680 |
$2,100 |
8.6× |
| CT thoracic spine w/o contrast (72128) |
$1,207.20 |
$1,509 |
10.4× |
| CT thoracic spine w/wo cont (72130) |
$1,860 |
$2,325 |
9.5× |
CT thorax w/o contrast (71250)
range across 2 matching MRF lines |
$315.20–$1,320 |
$394–$1,650 |
varies |
| CT upper ext wo (73200) |
$720.80 |
$901 |
6.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,280 |
$1,600 |
6.5× |
| CT upper extremity with contrast (73201) |
$1,160 |
$1,450 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,680 |
$2,100 |
8.6× |
| Cta Abdomen (74175) |
$1,916 |
$2,395 |
9.8× |
| CTA pelvis (72191) |
$1,680 |
$2,100 |
8.6× |
| Dxa Bone Density Axial (77080) |
$420 |
$525 |
3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$217.60 |
$272 |
2.2× |
| Esophagram (74220) |
$508 |
$635 |
2.6× |
| Fetal Biophys Profile W/Nst (76818) |
$668.80 |
$836 |
5.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$667.20 |
$834 |
5.7× |
| Foot 2 views (73620) |
$233.60 |
$292 |
2.4× |
| Forearm 2 views (73090) |
$248 |
$310 |
2.6× |
| Gastric emptying imaging study (78264) |
$1,760 |
$2,200 |
4.0× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,391.20 |
$1,739 |
3.1× |
| Gated Heart Planar Single (78472) |
$2,628 |
$3,285 |
5.9× |
| Gated Heart, Multiple (78473) |
$2,947.20 |
$3,684 |
6.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,739.20 |
$2,174 |
2.9× |
| Hand 2 views (73120) |
$233.60 |
$292 |
2.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,344 |
$1,680 |
2.2× |
Hepatobiliary System Imaging (78226)
range across 2 matching MRF lines |
$671.20–$1,000 |
$839–$1,250 |
varies |
| Ht Muscle Image Spect Sing (78451) |
$3,280 |
$4,100 |
2.3× |
| Hysterosalpingogram (74740) |
$613.60 |
$767 |
2.3× |
| Image fusion (77399) |
$522.40 |
$653 |
3.5× |
| Infusion Ivp (74410) |
$382.40 |
$478 |
2.0× |
| Joint Survey Single View (77077) |
$354.40 |
$443 |
3.0× |
| K Flow/Funct Image W/Drug (78708) |
$2,396 |
$2,995 |
4.0× |
| K Flow/Funct Image W/O Drug (78707) |
$1,275.20 |
$1,594 |
2.1× |
| Knee 3 Views (73562) |
$268.80 |
$336 |
2.8× |
| Liver & Spleen Imaging Static Only (78215) |
$692.80 |
$866 |
1.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,101.60 |
$1,377 |
1.8× |
| Lung perfusion differential (78597) |
$927.20 |
$1,159 |
2.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,560 |
$3,200 |
4.2× |
| Lymph System Imaging (78195) |
$2,216 |
$2,770 |
3.7× |
| Magnetic Image Jaw Joint (70336) |
$1,008 |
$1,260 |
3.8× |
| Mammary ductogram or galactogram multiple (77054) |
$1,110.40 |
$1,388 |
4.2× |
| Mammary ductogram or galactogram single (77053) |
$495.20 |
$619 |
1.9× |
| Meckels Divert Exam (78290) |
$1,740 |
$2,175 |
3.9× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$220.80 |
$276 |
0.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$723.20 |
$904 |
1.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,832 |
$3,540 |
7.3× |
| MRA head w/o contrast (70544) |
$1,797.60 |
$2,247 |
6.8× |
| MRA head with contrast (70545) |
$1,904 |
$2,380 |
4.9× |
| MRA neck w contrast (70548) |
$1,740 |
$2,175 |
4.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,200 |
$2,750 |
5.7× |
| MRA neck w/o contrast (70547) |
$1,113.60 |
$1,392 |
4.2× |
| MRI abdomen w/o contrast (74181) |
$1,676 |
$2,095 |
6.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,332 |
$2,915 |
2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,548 |
$3,185 |
6.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,332 |
$2,915 |
2.7× |
| MRI bone marrow blood supply (77084) |
$546.40 |
$683 |
2.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,680 |
$2,100 |
6.3× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,176 |
$1,470 |
4.4× |
| MRI cervical spine w contrast (72142) |
$2,672 |
$3,340 |
6.9× |
| MRI cervical spine w/o cont (72141) |
$2,012.80 |
$2,516 |
7.6× |
| MRI chest w/o contrast (71550) |
$1,676 |
$2,095 |
6.3× |
| MRI chest wo w contrast (71552) |
$2,548 |
$3,185 |
6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,904 |
$2,380 |
4.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,240 |
$2,800 |
5.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,096.80 |
$1,371 |
4.1× |
| MRI lumbar spine w contrast (72149) |
$2,672 |
$3,340 |
6.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,752 |
$3,440 |
7.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,096.80 |
$1,371 |
4.1× |
| MRI orbit face neck w contrast (70542) |
$1,584 |
$1,980 |
4.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,820 |
$2,275 |
4.7× |
| MRI pelvis w contrast (72196) |
$2,160 |
$2,700 |
5.6× |
| MRI pelvis w/o & w contrast (72197) |
$2,548 |
$3,185 |
6.6× |
| MRI pelvis w/o contrast (72195) |
$1,676 |
$2,095 |
6.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,012.80 |
$2,516 |
7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,096.80 |
$1,371 |
4.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,240 |
$2,800 |
5.8× |
| MRI, abdomen, combo (74183) |
$2,680 |
$3,350 |
6.9× |
| MRI, dorsal spine combo (72157) |
$2,752 |
$3,440 |
7.1× |
| MRI, dorsal spine contrast (72147) |
$2,672 |
$3,340 |
6.9× |
| MRI, joint upper extrem (73221) |
$1,676 |
$2,095 |
6.3× |
| MRI, joint upper extrem combo (73223) |
$2,680 |
$3,350 |
6.9× |
| MRI, lumbar spine combo (72158) |
$2,752 |
$3,440 |
7.1× |
| Myelogram cervical (72240) |
$2,233.60 |
$2,792 |
2.6× |
| Myelogram Lumbar (72265) |
$1,918.40 |
$2,398 |
2.2× |
| Myelography thoracic (72255) |
$2,233.60 |
$2,792 |
2.6× |
| Myelograpy 2/more regions rs&i (72270) |
$1,804 |
$2,255 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,440 |
$4,300 |
2.4× |
| Neck soft tissue (70360) |
$198.40 |
$248 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,836.80 |
$4,796 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$936 |
$1,170 |
3.6× |
| Optic foramina (70190) |
$278.40 |
$348 |
2.9× |
| Parathyroid Planar Imaging (78070) |
$1,120 |
$1,400 |
2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,420 |
$1,775 |
3.2× |
| Pelvis 1 or 2 views (72170) |
$248 |
$310 |
2.1× |
| PET image w/CT, full body (78816) |
$5,172.80 |
$6,466 |
3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,172.80 |
$6,466 |
3.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$855.20 |
$1,069 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$346.40 |
$433 |
3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$518.40 |
$648 |
0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$252 |
$315 |
2.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$222.40 |
$278 |
2.3× |
| Radex elbow complete minimum 3 views (73080) |
$268.80 |
$336 |
2.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$372 |
$465 |
3.2× |
| Radex fingr minimum 2 views (73140) |
$199.20 |
$249 |
2.1× |
| Radex foot complete minimum 3 views (73630) |
$252 |
$315 |
2.6× |
| Radex Hand Minimum 3 Views (73130) |
$252 |
$315 |
2.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$233.60 |
$292 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$248 |
$310 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$268 |
$335 |
2.8× |
| Radex shoulder complete minimum 2 views (73030) |
$268.80 |
$336 |
2.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$292 |
$365 |
3.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$613.60 |
$767 |
3.1× |
| Radex Spine 1 View Specify Level (72020) |
$198.40 |
$248 |
2.0× |
| Radex Sternum Minimum 2 Views (71120) |
$307.20 |
$384 |
3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$376.80 |
$471 |
3.9× |
| Radex Toe Minimum 2 Views (73660) |
$199.20 |
$249 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$233.60 |
$292 |
2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$252 |
$315 |
2.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$521.60 |
$652 |
4.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$10,804.80 |
$13,506 |
1.3× |
| Radiation treatment delivery level 1 (77402) |
$298.40 |
$373 |
2.6× |
| Radiation treatment delivery level 2 (77407) |
$347.20 |
$434 |
0.8× |
| Radiation treatment delivery level 3 (77412) |
$545.60 |
$682 |
0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$292 |
$365 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$329.60 |
$412 |
2.8× |
| Radiologic exam colon double contrast study (74280) |
$1,053.60 |
$1,317 |
5.4× |
| Radiologic exam colon single contrast study (74270) |
$801.60 |
$1,002 |
4.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$533.60 |
$667 |
2.7× |
| Radiologic exam knee complete 4/more views (73564) |
$292 |
$365 |
2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$346.40 |
$433 |
3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$613.60 |
$767 |
3.1× |
| Radiologic exam swallow function contrast study (74230) |
$168 |
$210 |
0.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$778.40 |
$973 |
4.0× |
| Radiologic examination femur 1 view (73551) |
$256.80 |
$321 |
2.6× |
| Radiologic examination femur minimum 2 views (73552) |
$256.80 |
$321 |
2.6× |
| Radiologic examination knee 1/2 views (73560) |
$248 |
$310 |
2.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$469.60 |
$587 |
4.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$248 |
$310 |
2.6× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$376.80 |
$471 |
3.9× |
| Ribs bilateral 3 views (71110) |
$372 |
$465 |
3.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,188.80 |
$3,986 |
5.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,739.20 |
$2,174 |
2.9× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 2 matching MRF lines |
$2,366.40–$2,760 |
$2,958–$3,450 |
varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,087.20 |
$2,609 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$936 |
$1,170 |
3.6× |
| Scapula (73010) |
$248 |
$310 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$44 |
$55 |
1.9× |
| Shoulder 1 view (73020) |
$268.80 |
$336 |
2.8× |
| Shoulder Arthrography (73040) |
$989.60 |
$1,237 |
2.5× |
| Skull less than 4 views (70250) |
$292 |
$365 |
2.5× |
| Special dosimetry (77331) |
$388.80 |
$486 |
2.6× |
| Special Physics Consult (77370) |
$557.60 |
$697 |
3.7× |
| Special teletherapy port plan (77321) |
$872 |
$1,090 |
2.1× |
| Special treatment procedure (77470) |
$1,092 |
$1,365 |
1.8× |
| Stereotactic Body Radiation Delivery (77373) |
$3,475.20 |
$4,344 |
1.7× |
| Sternoclavicular joints (71130) |
$357.60 |
$447 |
3.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$257.60 |
$322 |
2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$760.80 |
$951 |
1.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$669.60 |
$837 |
1.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,078.40 |
$1,348 |
2.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$669.60 |
$837 |
1.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$491.20 |
$614 |
3.3× |
| Thoracic spine 2 views (72070) |
$308 |
$385 |
2.6× |
| Thoracic spine 3 views (72072) |
$346.40 |
$433 |
3.0× |
| Thoracolumbar 2 views (72080) |
$316.80 |
$396 |
3.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,356 |
$1,695 |
3.0× |
| Thyroid Met Imaging Body (78018) |
$1,520 |
$1,900 |
2.5× |
| Thyroid Uptake Measurement (78012) |
$1,356 |
$1,695 |
3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,356 |
$1,695 |
3.0× |
| Tx Devices Design & Construction Complex (77334) |
$723.20 |
$904 |
1.7× |
| Tx devices design & construction intermediate (77333) |
$541.60 |
$677 |
3.6× |
| Tx devices design & construction simple (77332) |
$258.40 |
$323 |
1.7× |
| Ultrasound Breast Limited (76642) |
$340 |
$425 |
3.5× |
| Ultrasound Exam Aaa Screen (76706) |
$590.40 |
$738 |
5.1× |
| Ultrasound, abdomen limited (76705) |
$628 |
$785 |
5.4× |
| Umbilical-artery Doppler (OB) (76820) |
$614.40 |
$768 |
5.3× |
| Upper gi w/o kub (74240) |
$687.20 |
$859 |
3.5× |
| Urethrocystogram voiding (74455) |
$755.20 |
$944 |
2.8× |
| Urethrocystography retrograde (74450) |
$700.80 |
$876 |
2.6× |
| Us breast unilateral complete (76641) |
$428.80 |
$536 |
3.7× |
| Us chest (76604) |
$658.40 |
$823 |
5.7× |
| Us complete joint (76881) |
$430.40 |
$538 |
3.7× |
| Us exam, pelvic, limited (76857) |
$460.80 |
$576 |
4.0× |
| Us head (76506) |
$220.80 |
$276 |
1.9× |
| Us kidney transplant (76776) |
$620 |
$775 |
5.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$281.60 |
$352 |
2.4× |
| Us ob limited 1 or more fetuses (76815) |
$561.60 |
$702 |
4.8× |
| Us ob transvaginal (76817) |
$417.60 |
$522 |
3.6× |
| Us pelvic non ob complete (76856) |
$432 |
$540 |
3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$436 |
$545 |
3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$464 |
$580 |
4.0× |
| Us retroperitoneal complete (76770) |
$921.60 |
$1,152 |
7.9× |
| Us retroperitoneal limited (76775) |
$589.60 |
$737 |
5.1× |
| Us scrotum and contents (76870) |
$666.40 |
$833 |
5.7× |
| Us spinal canal and contents (76800) |
$536.80 |
$671 |
4.6× |
| Us thyroid (76536) |
$589.60 |
$737 |
5.1× |
| Us transrectal (76872) |
$206.40 |
$258 |
1.8× |
| Venography caval inferior serialography rs&i (75825) |
$3,473.60 |
$4,342 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,111.20 |
$1,389 |
0.6× |
| Wrist 2 views (73100) |
$233.60 |
$292 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$316.80 |
$396 |
3.3× |
| X-ray antegrade pyelogram tube (74425) |
$855.20 |
$1,069 |
2.2× |
| X-Ray Bend Only L-S Spine (72120) |
$401.60 |
$502 |
3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$255.20 |
$319 |
2.6× |
| X-Ray Exam Breast Specimen (76098) |
$636 |
$795 |
1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$256.80 |
$321 |
2.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$359.20 |
$449 |
3.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$464 |
$580 |
4.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$256.80 |
$321 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$342.40 |
$428 |
3.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$464 |
$580 |
4.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$367.20 |
$459 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$400.80 |
$501 |
3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$496.80 |
$621 |
4.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$560 |
$700 |
4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$283.20 |
$354 |
2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$533.60 |
$667 |
4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$268 |
$335 |
2.3× |
| X-ray eye for foreign body (70030) |
$216 |
$270 |
2.2× |
| X-ray humerus (73060) |
$268.80 |
$336 |
2.8× |
| X-ray IV pyelogram (ivp) (74400) |
$807.20 |
$1,009 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$248 |
$310 |
2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$191.20 |
$239 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$316.80 |
$396 |
2.7× |
| X-ray nose-rectum child f.b. (76010) |
$248 |
$310 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$372 |
$465 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$248 |
$310 |
2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$248 |
$310 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$268.80 |
$336 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$372 |
$465 |
3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$421.60 |
$527 |
3.6× |
| X-Ray Tmj Unilat (70328) |
$173.60 |
$217 |
1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,258.40 |
$1,573 |
3.2× |
| X-Rays Bone Length Studies (77073) |
$372 |
$465 |
3.2× |
| X-Rays Bone Survey Complete (77075) |
$677.60 |
$847 |
5.8× |
| Xr c-spine 4 or 5 views (72050) |
$421.60 |
$527 |
3.6× |
| Xr facial bones less than 3 views (70140) |
$292 |
$365 |
3.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$222.40 |
$278 |
1.9× |
| Xr orbits complete 4 views (70200) |
$372 |
$465 |
3.2× |