| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,706 |
$7,240 |
3.2× |
| Abdomen 1 View (74018) |
$355.55 |
$547 |
3.8× |
| Abdomen 2 views (74019) |
$442 |
$680 |
4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,970.80 |
$3,032 |
4.6× |
| Angio internal mammary (75756) |
$5,955.95 |
$9,163 |
1.8× |
| Angio pulmonary bilat (75743) |
$2,208.05 |
$3,397 |
0.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,823.60 |
$4,344 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$6,942.65 |
$10,681 |
2.1× |
| Angiography extremity unilateral rs&i (75710) |
$5,538 |
$8,520 |
1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,067.65 |
$3,181 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,284.10 |
$3,514 |
0.7× |
| Ankle 2 views (73600) |
$427.70 |
$658 |
4.6× |
| Aortography thoracic serialography rs&i (75605) |
$3,229.20 |
$4,968 |
0.5× |
| Artery X-Rays Abdomen (75726) |
$6,942.65 |
$10,681 |
1.2× |
| Artery X-Rays Adrenal Gland (75731) |
$2,258.10 |
$3,474 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$3,580.85 |
$5,509 |
0.6× |
| Artery X-Rays Spine (75705) |
$3,670.55 |
$5,647 |
0.6× |
| Arthrogram ankle (73615) |
$609.70 |
$938 |
1.6× |
| Arthrogram hip (73525) |
$965.90 |
$1,486 |
2.6× |
| Arthrogram Wrist (73115) |
$739.70 |
$1,138 |
2.0× |
| Basic radiation dosimetry calculation (77300) |
$584.35 |
$899 |
4.1× |
| Bone age studies (77072) |
$315.90 |
$486 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$3,101.15 |
$4,771 |
7.3× |
| Bone Imaging Limited Area (78300) |
$1,522.95 |
$2,343 |
3.6× |
| Bone Imaging Multiple Areas (78305) |
$1,586 |
$2,440 |
3.7× |
| Bone Imaging Whole Body (78306) |
$2,481.70 |
$3,818 |
5.8× |
| Bone marrow imaging limited area (78102) |
$796.90 |
$1,226 |
1.9× |
| Bone marrow imaging; multiple areas (78103) |
$926.90 |
$1,426 |
2.2× |
| Bone marrow imaging; whole body (78104) |
$1,024.40 |
$1,576 |
2.4× |
| Bone survey infant (77076) |
$453.70 |
$698 |
4.1× |
| Brachytx isodose complex (77318) |
$860.60 |
$1,324 |
2.2× |
| Brachytx isodose intermed (77317) |
$713.70 |
$1,098 |
1.8× |
| Brachytx Isodose Plan Simple (77316) |
$378.30 |
$582 |
0.9× |
| Brain Flow Imaging Only (78610) |
$1,044.55 |
$1,607 |
1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,704.30 |
$2,622 |
2.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,930.90 |
$7,586 |
3.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,642.25 |
$4,065 |
7.1× |
| Cat Scan Follow-Up Study (76380) |
$653.90 |
$1,006 |
7.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,168.70 |
$1,798 |
2.0× |
| Cerebrospinal Fluid Scan (78630) |
$1,450.15 |
$2,231 |
2.5× |
| Chest 1 view (71045) |
$358.80 |
$552 |
3.9× |
| Chest 2 views (71046) |
$399.10 |
$614 |
4.3× |
| Chest 3 views (71047) |
$440.70 |
$678 |
4.7× |
| Chest 4 or more views (71048) |
$533.65 |
$821 |
4.8× |
| Cholecystography Oral Contrast (74290) |
$484.25 |
$745 |
2.6× |
| Cisternography Positive Contrast Rs&I (70015) |
$982.15 |
$1,511 |
1.2× |
| Clavicle complete (73000) |
$426.40 |
$656 |
4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$293.15 |
$451 |
2.6× |
| Continuing medical physics consltj pr wk (77336) |
$650 |
$1,000 |
4.5× |
| Contrast Exam Abdominl Aorta (75625) |
$4,044.30 |
$6,222 |
1.2× |
| Contrast X-Ray Bladder (74430) |
$809.90 |
$1,246 |
2.2× |
| Contrast X-Ray Of Elbow (73085) |
$910 |
$1,400 |
2.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$975.65 |
$1,501 |
2.6× |
| Corpora cavernosography (74445) |
$236.60 |
$364 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,829.50 |
$7,430 |
13.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,761.55 |
$5,787 |
14.8× |
| CT abdomen w contrast (74160) |
$2,694.25 |
$4,145 |
14.4× |
| CT abdomen w wo contrast (74170) |
$2,945.80 |
$4,532 |
15.7× |
| CT abdomen w/o contrast (74150) |
$2,070.90 |
$3,186 |
18.6× |
| CT Angio Abdomen and Pelvis (74174) |
$3,874.65 |
$5,961 |
10.4× |
| CT Angio Chest (71275) |
$2,457 |
$3,780 |
13.1× |
| CT Angio Head (70496) |
$2,944.50 |
$4,530 |
15.7× |
| CT angio hrt w/3d image (75574) |
$2,230.80 |
$3,432 |
6.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,178.15 |
$3,351 |
11.6× |
| CT Angio Neck (70498) |
$2,709.85 |
$4,169 |
14.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,545.70 |
$2,378 |
8.3× |
| CT cervical spine w/ contrast (72126) |
$2,822.30 |
$4,342 |
7.6× |
| CT cervical spine w/o contrast (72125) |
$2,715.05 |
$4,177 |
24.3× |
| CT cervical spine w/wo cont (72127) |
$3,018.60 |
$4,644 |
16.1× |
| CT chest w contrast (71260) |
$2,479.75 |
$3,815 |
13.2× |
| CT chest w/wo contrast (71270) |
$2,642.25 |
$4,065 |
14.1× |
| CT colonography screening (74263) |
$904.80 |
$1,392 |
3.6× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,056.25 |
$1,625 |
5.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,465.10 |
$2,254 |
13.1× |
| CT head/brain with contrast (70460) |
$2,307.50 |
$3,550 |
12.3× |
| CT head/brain without and with contrast (70470) |
$2,689.70 |
$4,138 |
14.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,792.05 |
$2,757 |
4.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$990.60 |
$1,524 |
10.7× |
| CT hrt w/3d image congen (75573) |
$1,876.55 |
$2,887 |
5.0× |
| CT iac w contrast (70481) |
$2,633.80 |
$4,052 |
14.1× |
| CT l-spine w&w/o contrast (72133) |
$3,683.55 |
$5,667 |
19.7× |
| CT lower ext w/o (73700) |
$2,130.70 |
$3,278 |
19.1× |
| CT lower extremity w/contrast material (73701) |
$2,343.25 |
$3,605 |
12.5× |
| CT lumbar spine w contrast (72132) |
$3,553.55 |
$5,467 |
9.5× |
| CT lumbar spine w/o contrast (72131) |
$2,894.45 |
$4,453 |
25.9× |
| CT maxillofacial w contrast (70487) |
$2,397.85 |
$3,689 |
12.8× |
| CT maxillofacial wo contrast (70486) |
$1,523.60 |
$2,344 |
13.7× |
| CT neck tissue combo (70492) |
$2,790.45 |
$4,293 |
14.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,929.55 |
$4,507 |
15.7× |
| CT orbits w/o contrast (70480) |
$2,109.25 |
$3,245 |
18.9× |
| CT pelvis w&w/o contrast (72194) |
$3,122.60 |
$4,804 |
16.7× |
| CT pelvis w/o contrast (72192) |
$2,224.95 |
$3,423 |
19.9× |
| CT scan of leg combo (73702) |
$2,937.35 |
$4,519 |
15.7× |
| CT scans face/jaw combo (70488) |
$2,931.50 |
$4,510 |
15.7× |
| CT soft tissue neck w contrast (70491) |
$2,386.80 |
$3,672 |
12.8× |
| CT soft tissue neck w/o contrast (70490) |
$2,121.60 |
$3,264 |
19.0× |
| CT thoracic spine w contrast (72129) |
$3,316.30 |
$5,102 |
17.7× |
| CT thoracic spine w/o contrast (72128) |
$2,715.05 |
$4,177 |
24.3× |
| CT thoracic spine w/wo cont (72130) |
$3,413.80 |
$5,252 |
18.2× |
| CT thorax w/o contrast (71250) |
$1,726.40 |
$2,656 |
15.5× |
| CT unlisted procedure (76497) |
$228.15 |
$351 |
2.5× |
| CT upper ext wo (73200) |
$1,898 |
$2,920 |
17.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,006.25 |
$4,625 |
16.1× |
| CT upper extremity with contrast (73201) |
$2,181.40 |
$3,356 |
5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,933.10 |
$2,974 |
10.3× |
| Cta Abdomen (74175) |
$2,595.45 |
$3,993 |
13.9× |
| CTA pelvis (72191) |
$2,319.85 |
$3,569 |
12.4× |
| Dilation ureters/urethra rs&i (74485) |
$1,424.15 |
$2,191 |
0.6× |
| Discography Cerv/Thor Spine (72285) |
$2,298.40 |
$3,536 |
1.1× |
| Diskography lumbar (72295) |
$2,068.95 |
$3,183 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$123.50 |
$190 |
1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$274.30 |
$422 |
2.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$227.50 |
$350 |
2.0× |
| Dxa Bone Density Axial (77080) |
$650 |
$1,000 |
5.8× |
| Dxa bone density study (77085) |
$237.25 |
$365 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$356.85 |
$549 |
3.8× |
| Echo exam of fetal heart (76825) |
$655.20 |
$1,008 |
1.1× |
| Echo exam uterus (76831) |
$702 |
$1,080 |
2.8× |
| Echo Guide For Artery Repair (76936) |
$999.05 |
$1,537 |
4.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$393.90 |
$606 |
1.5× |
| Esophageal Motility Study (78258) |
$796.90 |
$1,226 |
1.9× |
| Esophagram (74220) |
$715 |
$1,100 |
3.8× |
| Fetal Biophys Profile W/Nst (76818) |
$888.55 |
$1,367 |
8.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$805.35 |
$1,239 |
7.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$651.30 |
$1,002 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$707.20 |
$1,088 |
2.8× |
| Follow-Up Angiography (75898) |
$2,497.95 |
$3,843 |
0.7× |
| Foot 2 views (73620) |
$358.80 |
$552 |
3.9× |
| Forearm 2 views (73090) |
$436.15 |
$671 |
4.7× |
| Gastric emptying imaging study (78264) |
$1,704.95 |
$2,623 |
4.0× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,638 |
$2,520 |
3.8× |
| Gated Heart Planar Single (78472) |
$2,464.80 |
$3,792 |
5.8× |
| Gated Heart, Multiple (78473) |
$1,517.10 |
$2,334 |
3.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,654.90 |
$2,546 |
2.9× |
| Hand 2 views (73120) |
$420.55 |
$647 |
3.8× |
| Heart first pass single,planar (78481) |
$1,286.35 |
$1,979 |
2.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,179.45 |
$3,353 |
0.6× |
| Hepatobil Syst Image W/Drug (78227) |
$2,674.75 |
$4,115 |
4.6× |
| Hepatobiliary System Imaging (78226) |
$1,831.05 |
$2,817 |
4.3× |
| Ht Musc Image Planar Mult (78454) |
$1,987.70 |
$3,058 |
1.4× |
| Ht Muscle Image Spect Sing (78451) |
$3,888.30 |
$5,982 |
2.8× |
| Hysterosalpingogram (74740) |
$742.95 |
$1,143 |
2.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$809.25 |
$1,245 |
8.7× |
| Infant hip ultrasound, limited static exam (76886) |
$564.20 |
$868 |
6.1× |
| Joint Survey Single View (77077) |
$755.30 |
$1,162 |
6.8× |
| K Flow/Funct Image Multiple (78709) |
$2,241.20 |
$3,448 |
3.9× |
| K Flow/Funct Image W/Drug (78708) |
$2,179.45 |
$3,353 |
3.8× |
| K Flow/Funct Image W/O Drug (78707) |
$1,855.75 |
$2,855 |
3.2× |
| Kidney Imaging Morphol (78700) |
$965.90 |
$1,486 |
2.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,001.65 |
$1,541 |
2.3× |
| Knee 3 Views (73562) |
$507.65 |
$781 |
5.5× |
| Leveen/Shunt Patency Exam (78291) |
$1,351.35 |
$2,079 |
3.2× |
| Liver & Spleen Imaging Static Only (78215) |
$796.90 |
$1,226 |
1.9× |
| Liver imaging static only (78201) |
$1,044.55 |
$1,607 |
1.8× |
| Liver imaging w/vascular flow (78202) |
$1,044.55 |
$1,607 |
1.8× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,370.20 |
$2,108 |
2.4× |
| Lung perfusion differential (78597) |
$902.20 |
$1,388 |
2.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,111.85 |
$3,249 |
3.6× |
| Lung Ventilation Imaging (78579) |
$796.90 |
$1,226 |
1.9× |
| Lymph System Imaging (78195) |
$2,120.95 |
$3,263 |
3.7× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,207.05 |
$1,857 |
0.7× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$929.50 |
$1,430 |
1.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,185.30 |
$3,362 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$1,682.85 |
$2,589 |
6.6× |
| Mammary ductogram or galactogram multiple (77054) |
$729.95 |
$1,123 |
2.9× |
| Mammary ductogram or galactogram single (77053) |
$510.90 |
$786 |
2.0× |
| Meckels Divert Exam (78290) |
$1,161.55 |
$1,787 |
2.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,098.20 |
$3,228 |
5.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,705.30 |
$4,162 |
7.3× |
| MRA head w/o contrast (70544) |
$2,180.10 |
$3,354 |
8.6× |
| MRA head with contrast (70545) |
$2,241.20 |
$3,448 |
6.0× |
| MRA neck w contrast (70548) |
$2,354.95 |
$3,623 |
6.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,402.75 |
$5,235 |
9.1× |
| MRA neck w/o contrast (70547) |
$1,854.45 |
$2,853 |
7.3× |
| MRI abdomen w contrast (74182) |
$3,409.25 |
$5,245 |
9.2× |
| MRI abdomen w/o contrast (74181) |
$2,580.50 |
$3,970 |
10.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,282.50 |
$5,050 |
3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,272.45 |
$6,573 |
11.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,627.95 |
$4,043 |
3.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,208.70 |
$3,398 |
8.7× |
| MRI cardiac w/o contrast (75557) |
$2,272.40 |
$3,496 |
8.9× |
| MRI cervical spine w contrast (72142) |
$3,103.10 |
$4,774 |
8.3× |
| MRI cervical spine w/o cont (72141) |
$2,863.25 |
$4,405 |
11.2× |
| MRI chest w/o contrast (71550) |
$1,957.15 |
$3,011 |
7.7× |
| MRI chest with contrast (71551) |
$2,068.95 |
$3,183 |
2.5× |
| MRI chest wo w contrast (71552) |
$2,664.35 |
$4,099 |
7.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,684.50 |
$4,130 |
7.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,612.05 |
$5,557 |
9.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,245.10 |
$3,454 |
8.8× |
| MRI lumbar spine w contrast (72149) |
$3,413.80 |
$5,252 |
9.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,821.35 |
$5,879 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,317.90 |
$3,566 |
9.1× |
| MRI orbit face neck w contrast (70542) |
$2,763.15 |
$4,251 |
7.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,555.50 |
$5,470 |
9.6× |
| MRI pelvis w contrast (72196) |
$2,380.95 |
$3,663 |
6.4× |
| MRI pelvis w/o & w contrast (72197) |
$3,753.10 |
$5,774 |
10.1× |
| MRI pelvis w/o contrast (72195) |
$2,320.50 |
$3,570 |
9.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,801.50 |
$4,310 |
11.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,278.90 |
$3,506 |
6.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,210 |
$3,400 |
8.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,177.85 |
$4,889 |
8.5× |
| MRI, abdomen, combo (74183) |
$3,801.20 |
$5,848 |
10.2× |
| MRI, dorsal spine combo (72157) |
$4,039.10 |
$6,214 |
10.8× |
| MRI, dorsal spine contrast (72147) |
$3,054.35 |
$4,699 |
8.2× |
| MRI, joint upper extrem (73221) |
$2,407.60 |
$3,704 |
9.5× |
| MRI, joint upper extrem combo (73223) |
$3,399.50 |
$5,230 |
9.1× |
| MRI, lumbar spine combo (72158) |
$3,871.40 |
$5,956 |
10.4× |
| Myelogram cervical (72240) |
$1,069.25 |
$1,645 |
1.3× |
| Myelogram Lumbar (72265) |
$897.65 |
$1,381 |
1.1× |
| Myelography thoracic (72255) |
$883.35 |
$1,359 |
1.1× |
| Myelograpy 2/more regions rs&i (72270) |
$1,430.65 |
$2,201 |
1.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$1,129.05 |
$1,737 |
2.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,706.30 |
$5,702 |
2.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,785.55 |
$2,747 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$5,123.30 |
$7,882 |
3.7× |
| N-invas est c ffr sw aly CTA (75580) |
$1,456 |
$2,240 |
1.6× |
| Neck soft tissue (70360) |
$388.05 |
$597 |
4.2× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,395.55 |
$2,147 |
3.4× |
| Nm csf leak detection (78650) |
$1,978.60 |
$3,044 |
1.4× |
| Nm myocard infarct spect (78469) |
$1,370.20 |
$2,108 |
2.4× |
| Nonvascular Shunt X-Ray (75809) |
$525.85 |
$809 |
4.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,871.45 |
$9,033 |
4.0× |
| Nuclear Rx Oral Admin (79005) |
$1,967.55 |
$3,027 |
7.9× |
| Ob us nuchal meas 1 gest (76813) |
$183.30 |
$282 |
1.6× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$102.70 |
$158 |
0.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$123.50 |
$190 |
1.1× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$30.55 |
$47 |
1.0× |
| Optic foramina (70190) |
$622.70 |
$958 |
6.7× |
| Panoramic X-ray of jaws (70355) |
$258.70 |
$398 |
2.8× |
| Parathyroid Planar Imaging (78070) |
$1,462.50 |
$2,250 |
3.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,463.15 |
$2,251 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$447.20 |
$688 |
4.0× |
| Perineogram (74775) |
$498.55 |
$767 |
2.0× |
| Peritoneogram Rs&I (74190) |
$549.90 |
$846 |
0.9× |
| PET image w/CT, full body (78816) |
$5,950.75 |
$9,155 |
3.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,396.30 |
$8,302 |
3.5× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,743.65 |
$4,221 |
2.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,624.70 |
$4,038 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$703.30 |
$1,082 |
1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$687.05 |
$1,057 |
6.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$748.80 |
$1,152 |
1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$535.60 |
$824 |
5.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$421.85 |
$649 |
4.5× |
| Radex elbow complete minimum 3 views (73080) |
$471.90 |
$726 |
5.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$670.80 |
$1,032 |
6.0× |
| Radex fingr minimum 2 views (73140) |
$327.60 |
$504 |
3.5× |
| Radex foot complete minimum 3 views (73630) |
$497.25 |
$765 |
5.4× |
| Radex Hand Minimum 3 Views (73130) |
$538.20 |
$828 |
5.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$494 |
$760 |
5.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$741.65 |
$1,141 |
6.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$398.45 |
$613 |
4.3× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$486.20 |
$748 |
5.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$450.45 |
$693 |
4.9× |
| Radex shoulder complete minimum 2 views (73030) |
$567.45 |
$873 |
6.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$281.45 |
$433 |
3.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$677.95 |
$1,043 |
3.6× |
| Radex Spine 1 View Specify Level (72020) |
$354.90 |
$546 |
3.8× |
| Radex Sternum Minimum 2 Views (71120) |
$519.35 |
$799 |
5.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$419.25 |
$645 |
4.5× |
| Radex Toe Minimum 2 Views (73660) |
$306.80 |
$472 |
3.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$243.75 |
$375 |
2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$507 |
$780 |
5.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$622.70 |
$958 |
5.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$6,826.95 |
$10,503 |
0.9× |
| Radiation treatment delivery level 1 (77402) |
$302.25 |
$465 |
2.8× |
| Radiation treatment delivery level 2 (77407) |
$453.05 |
$697 |
1.1× |
| Radiation treatment delivery level 3 (77412) |
$750.10 |
$1,154 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$663 |
$1,020 |
5.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$481 |
$740 |
4.3× |
| Radiologic exam colon double contrast study (74280) |
$1,051.05 |
$1,617 |
5.6× |
| Radiologic exam colon single contrast study (74270) |
$796.25 |
$1,225 |
4.3× |
| Radiologic exam knee complete 4/more views (73564) |
$553.80 |
$852 |
5.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$533 |
$820 |
4.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$851.50 |
$1,310 |
4.5× |
| Radiologic exam swallow function contrast study (74230) |
$732.55 |
$1,127 |
3.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$790.40 |
$1,216 |
4.2× |
| Radiologic examination femur 1 view (73551) |
$209.30 |
$322 |
2.3× |
| Radiologic examination femur minimum 2 views (73552) |
$409.50 |
$630 |
4.4× |
| Radiologic examination knee 1/2 views (73560) |
$407.55 |
$627 |
4.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$756.60 |
$1,164 |
6.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$132.60 |
$204 |
1.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$482.30 |
$742 |
5.2× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$516.10 |
$794 |
0.9× |
| Renal Cyst Study (74470) |
$560.30 |
$862 |
1.0× |
| Ribs bilateral 3 views (71110) |
$559.65 |
$861 |
5.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,279.20 |
$1,968 |
3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,150.85 |
$3,309 |
5.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,703.05 |
$5,697 |
6.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,694.90 |
$4,146 |
4.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,096.60 |
$4,764 |
5.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,171.35 |
$4,879 |
2.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,110.20 |
$1,708 |
4.5× |
| Salivary Gland Imaging Serial Images (78231) |
$880.75 |
$1,355 |
2.1× |
| Scapula (73010) |
$443.95 |
$683 |
4.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$98.15 |
$151 |
4.2× |
| Sella turcica (70240) |
$324.35 |
$499 |
3.5× |
| Shoulder 1 view (73020) |
$525.20 |
$808 |
5.7× |
| Shoulder Arthrography (73040) |
$833.30 |
$1,282 |
2.2× |
| Sialogram (70390) |
$737.75 |
$1,135 |
2.9× |
| Skull less than 4 views (70250) |
$500.50 |
$770 |
4.5× |
| Special dosimetry (77331) |
$452.40 |
$696 |
3.2× |
| Special Physics Consult (77370) |
$403.65 |
$621 |
2.8× |
| Special teletherapy port plan (77321) |
$1,051.70 |
$1,618 |
2.6× |
| Special treatment procedure (77470) |
$2,107.30 |
$3,242 |
3.6× |
| Spleen Imaging (78185) |
$796.90 |
$1,226 |
1.9× |
| Stereotactic Body Radiation Delivery (77373) |
$11,012.30 |
$16,942 |
5.8× |
| Sternoclavicular joints (71130) |
$376.35 |
$579 |
4.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,132.65 |
$3,281 |
5.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$484.25 |
$745 |
1.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$820.30 |
$1,262 |
3.2× |
| Testicular Imaging W/Flow (78761) |
$1,035.45 |
$1,593 |
2.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,050.75 |
$3,155 |
5.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$965.25 |
$1,485 |
2.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$813.15 |
$1,251 |
5.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$672.10 |
$1,034 |
3.6× |
| Thoracic spine 2 views (72070) |
$462.15 |
$711 |
4.1× |
| Thoracic spine 3 views (72072) |
$525.85 |
$809 |
4.7× |
| Thoracolumbar 2 views (72080) |
$456.95 |
$703 |
4.9× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$678.60 |
$1,044 |
1.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$646.75 |
$995 |
1.5× |
| Thyroid Met Imaging Body (78018) |
$2,111.85 |
$3,249 |
3.6× |
| Thyroid Uptake Measurement (78012) |
$464.75 |
$715 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,187.55 |
$1,827 |
2.8× |
| Tx Devices Design & Construction Complex (77334) |
$1,300.65 |
$2,001 |
3.3× |
| Tx devices design & construction simple (77332) |
$455.65 |
$701 |
3.2× |
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines |
$131.30–$404.95 |
$202–$623 |
varies |
| Ultrasound Exam Aaa Screen (76706) |
$303.55 |
$467 |
2.7× |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
$222.30–$901.55 |
$342–$1,387 |
varies |
| Umbilical-artery Doppler (OB) (76820) |
$312 |
$480 |
2.8× |
| Unlisted Dx Radiographic Procedure (76499) |
$369.85 |
$569 |
4.0× |
| Unlisted us procedure (76999) |
$227.50 |
$350 |
2.4× |
| Upper gi w/o kub (74240) |
$745.55 |
$1,147 |
4.0× |
| Ureteral Reflux Study (78740) |
$796.90 |
$1,226 |
1.9× |
| Urethrocystogram voiding (74455) |
$847.60 |
$1,304 |
3.3× |
| Urethrocystography retrograde (74450) |
$858.65 |
$1,321 |
3.4× |
| Us breast unilateral complete (76641) |
$873.60 |
$1,344 |
7.8× |
Us chest (76604)
range across 2 matching MRF lines |
$240.50–$618.80 |
$370–$952 |
varies |
| Us complete joint (76881) |
$783.25 |
$1,205 |
7.0× |
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines |
$221.65–$647.40 |
$341–$996 |
varies |
| Us head (76506) |
$1,331.85 |
$2,049 |
11.9× |
| Us kidney transplant (76776) |
$577.85 |
$889 |
5.2× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines |
$265.85–$433.55 |
$409–$667 |
varies |
| Us ob detailed single fetus (76811) |
$1,019.85 |
$1,569 |
4.0× |
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines |
$221.65–$639.60 |
$341–$984 |
varies |
Us ob transvaginal (76817)
range across 2 matching MRF lines |
$221.65–$791.70 |
$341–$1,218 |
varies |
| Us pelvic non ob complete (76856) |
$915.20 |
$1,408 |
8.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$778.05 |
$1,197 |
7.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$593.45 |
$913 |
5.3× |
| Us retroperitoneal complete (76770) |
$801.45 |
$1,233 |
7.2× |
Us retroperitoneal limited (76775)
range across 2 matching MRF lines |
$224.90–$536.90 |
$346–$826 |
varies |
| Us scrotum and contents (76870) |
$801.45 |
$1,233 |
7.2× |
| Us spinal canal and contents (76800) |
$629.85 |
$969 |
5.6× |
Us thyroid (76536)
range across 2 matching MRF lines |
$221.65–$713.70 |
$341–$1,098 |
varies |
| Us transrectal (76872) |
$809.90 |
$1,246 |
7.3× |
| Vascular Flow Imaging (78445) |
$796.90 |
$1,226 |
1.9× |
| Vein X-Ray Chest (75827) |
$1,448.85 |
$2,229 |
0.9× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,092.35 |
$3,219 |
0.6× |
| Vein X-Ray Skull Epidural (75872) |
$1,951.95 |
$3,003 |
2.9× |
| Vein X-Ray Spleen/Liver (75810) |
$2,185.30 |
$3,362 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$2,068.95 |
$3,183 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$2,161.25 |
$3,325 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,226.25 |
$3,425 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,181.05 |
$1,817 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$1,108.25 |
$1,705 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,241.20 |
$3,448 |
0.7× |
| Venography Renal Unilateral (75831) |
$2,161.25 |
$3,325 |
0.6× |
| Venous sampling by catheter (75893) |
$5,309.85 |
$8,169 |
0.9× |
| Venous thrombosis imaging (78457) |
$1,044.55 |
$1,607 |
1.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,310.40 |
$2,016 |
3.1× |
| Vertebral fracture assessment via dxa (77086) |
$170.95 |
$263 |
1.8× |
| Wrist 2 views (73100) |
$427.05 |
$657 |
4.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$341.90 |
$526 |
3.7× |
| X-ray antegrade pyelogram tube (74425) |
$977.60 |
$1,504 |
2.6× |
| X-Ray Aorta Leg Arteries (75630) |
$6,193.20 |
$9,528 |
1.8× |
| X-Ray Bend Only L-S Spine (72120) |
$427.70 |
$658 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$427.70 |
$658 |
4.6× |
| X-Ray Exam Breast Specimen (76098) |
$576.55 |
$887 |
1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$422.50 |
$650 |
4.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$525.20 |
$808 |
4.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$557.70 |
$858 |
5.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$373.75 |
$575 |
4.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$482.95 |
$743 |
5.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$482.95 |
$743 |
4.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$488.80 |
$752 |
4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$551.85 |
$849 |
4.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$586.30 |
$902 |
5.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$934.70 |
$1,438 |
8.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$538.20 |
$828 |
5.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$783.90 |
$1,206 |
7.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$488.15 |
$751 |
4.4× |
| X-ray eye for foreign body (70030) |
$416.65 |
$641 |
4.5× |
| X-ray humerus (73060) |
$479.05 |
$737 |
5.2× |
| X-ray IV pyelogram (ivp) (74400) |
$1,456.65 |
$2,241 |
7.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$319.80 |
$492 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$348.40 |
$536 |
3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$611 |
$940 |
5.5× |
| X-ray nose-rectum child f.b. (76010) |
$220.35 |
$339 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$666.90 |
$1,026 |
6.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$406.90 |
$626 |
3.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$240.50 |
$370 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$482.30 |
$742 |
5.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$741 |
$1,140 |
8.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$689.65 |
$1,061 |
6.2× |
| X-Ray Stress View (77071) |
$469.95 |
$723 |
5.1× |
| X-ray thoracic spine 4 vw (72074) |
$798.20 |
$1,228 |
7.2× |
| X-Ray Tmj Unilat (70328) |
$166.40 |
$256 |
1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$983.45 |
$1,513 |
2.6× |
| X-Rays Bone Length Studies (77073) |
$386.10 |
$594 |
3.5× |
| X-Rays Bone Survey Complete (77075) |
$852.15 |
$1,311 |
7.6× |
| Xr c-spine 4 or 5 views (72050) |
$632.45 |
$973 |
5.7× |
| Xr facial bones less than 3 views (70140) |
$358.80 |
$552 |
3.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$434.20 |
$668 |
3.9× |
| Xr orbits complete 4 views (70200) |
$679.25 |
$1,045 |
6.1× |
| Xr Tomogram Single Plane (76100) |
$713.05 |
$1,097 |
6.4× |