| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,706 |
$7,240 |
3.2× |
| Abdomen 2 views (74019) |
$442 |
$680 |
4.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,970.80 |
$3,032 |
4.6× |
| 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 internal mammary rs&i (75756) |
$5,955.95 |
$9,163 |
1.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,580.85 |
$5,509 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,208.05 |
$3,397 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,067.65 |
$3,181 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$3,670.55 |
$5,647 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,942.65 |
$10,681 |
1.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,497.95 |
$3,843 |
0.7× |
| 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× |
| Antegrade urography radiological supvj & interpj (74425) |
$977.60 |
$1,504 |
2.6× |
| Aortogram thoracic (75605) |
$3,229.20 |
$4,968 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$6,193.20 |
$9,528 |
1.8× |
| Aortography abdominal serialography rs&i (75625) |
$4,044.30 |
$6,222 |
1.2× |
| Artery X-Rays Adrenal Gland (75731) |
$2,258.10 |
$3,474 |
0.7× |
| Arthrogram elbow (73085) |
$910 |
$1,400 |
2.4× |
| Arthrogram hip (73525) |
$965.90 |
$1,486 |
2.6× |
| Arthrogram shoulder (73040) |
$833.30 |
$1,282 |
2.2× |
| Arthrogram wrist (73115) |
$739.70 |
$1,138 |
2.0× |
| Arthrography knee lt (73580) |
$975.65 |
$1,501 |
2.6× |
| Basic radiation dosimetry calculation (77300) |
$584.35 |
$899 |
4.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,522.95 |
$2,343 |
3.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,586 |
$2,440 |
3.7× |
| Bone &/joint imaging whole body (78306) |
$2,481.70 |
$3,818 |
5.8× |
| Bone age studies (77072) |
$315.90 |
$486 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$3,101.15 |
$4,771 |
7.3× |
| Bone Marrow Imaging Limited Area (78102) |
$796.90 |
$1,226 |
1.9× |
| Bone survey complete (77075) |
$852.15 |
$1,311 |
7.6× |
| Brachytx isodose complex (77318) |
$860.60 |
$1,324 |
2.2× |
| Brachytx isodose intermed (77317) |
$713.70 |
$1,098 |
1.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$378.30 |
$582 |
0.9× |
| Brain image w/flow 4 + views (78606) |
$1,704.30 |
$2,622 |
2.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,930.90 |
$7,586 |
3.2× |
| Brain Imaging Vascular Flow Only (78610) |
$1,044.55 |
$1,607 |
1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,642.25 |
$4,065 |
7.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,168.70 |
$1,798 |
2.0× |
| Cervical spine 2 or 3 views (72040) |
$538.20 |
$828 |
5.8× |
| Chest 1 view (71045) |
$358.80 |
$552 |
3.9× |
| Chest 3 views (71047) |
$440.70 |
$678 |
4.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$732.55 |
$1,127 |
3.9× |
| 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× |
| 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 hrt w/3d image (75574) |
$2,230.80 |
$3,432 |
6.0× |
| CT angiography upper extremity lt (73206) |
$1,545.70 |
$2,378 |
8.3× |
| CT c-spine w/o contrast (72125) |
$2,715.05 |
$4,177 |
24.3× |
| CT cervical spine w&w/o contrast (72127) |
$3,018.60 |
$4,644 |
16.1× |
| CT cervical spine with contrast (72126) |
$2,822.30 |
$4,342 |
7.6× |
| CT chest w/wo contrast (71270) |
$2,642.25 |
$4,065 |
14.1× |
| CT chest with contrast (71260) |
$2,479.75 |
$3,815 |
13.2× |
| CT colonography screening (74263) |
$904.80 |
$1,392 |
3.6× |
| CT colonography w/dye (74262) |
$1,056.25 |
$1,625 |
5.6× |
| CT colonography w/o cntrst (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 limited/localized follow up study (76380) |
$653.90 |
$1,006 |
7.0× |
| CT lower ext w/o (73700) |
$2,130.70 |
$3,278 |
19.1× |
| CT lower extremity w wo contrast (73702) |
$2,937.35 |
$4,519 |
15.7× |
| CT lower extremity with contrast (73701) |
$2,343.25 |
$3,605 |
12.5× |
| CT lumbar spine w & w/o contrast (72133) |
$3,683.55 |
$5,667 |
19.7× |
| CT lumbar spine w/o contrast (72131) |
$2,894.45 |
$4,453 |
25.9× |
| CT lumbar spine with contrast (72132) |
$3,553.55 |
$5,467 |
9.5× |
| CT maxillofacial w contrast (70487) |
$2,397.85 |
$3,689 |
12.8× |
| CT maxillofacial w/o contrast (70486) |
$1,523.60 |
$2,344 |
13.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,931.50 |
$4,510 |
15.7× |
| CT neck soft tissue w contrast (70491) |
$2,386.80 |
$3,672 |
12.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) |
$2,790.45 |
$4,293 |
14.9× |
| 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 contrast (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 extremity w/o & w/contrast material (73202) |
$3,006.25 |
$4,625 |
16.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,898 |
$2,920 |
17.0× |
| 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 abdomen pelvis (74174) |
$3,874.65 |
$5,961 |
10.4× |
| CTA chest (71275) |
$2,457 |
$3,780 |
13.1× |
| Cta Head (70496) |
$2,944.50 |
$4,530 |
15.7× |
| CTA lwr ext w&w/o contrast (73706) |
$2,178.15 |
$3,351 |
11.6× |
| Cta Neck (70498) |
$2,709.85 |
$4,169 |
14.5× |
| Cta Pelvis (72191) |
$2,319.85 |
$3,569 |
12.4× |
| Cystography minimum 3 views rs&i (74430) |
$809.90 |
$1,246 |
2.2× |
| Diskogram cervical (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 study 1/> sites axial skel (77080) |
$650 |
$1,000 |
5.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$356.85 |
$549 |
3.8× |
| Dxa bone density study axial skeleton (77085) |
$237.25 |
$365 |
2.1× |
| Echo exam of fetal heart (76825) |
$655.20 |
$1,008 |
1.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$393.90 |
$606 |
1.5× |
| Echoencephalography real time imaging (76506) |
$1,331.85 |
$2,049 |
11.9× |
| Esophageal motility (78258) |
$796.90 |
$1,226 |
1.9× |
| Esophagus (74220) |
$715 |
$1,100 |
3.8× |
| Fetal biophysical profile non-stress testing (76818) |
$888.55 |
$1,367 |
8.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$805.35 |
$1,239 |
7.2× |
| Fluoroscopy up to 1 hr (76000) |
$707.20 |
$1,088 |
2.8× |
| Foot 2 views (73620) |
$358.80 |
$552 |
3.9× |
| Forearm 2 views (73090) |
$436.15 |
$671 |
4.7× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,654.90 |
$2,546 |
2.9× |
| Gated Heart Planar Single (78472) |
$2,464.80 |
$3,792 |
5.8× |
| Hand 2 views (73120) |
$420.55 |
$647 |
3.8× |
| Hand 3 views (73130) |
$538.20 |
$828 |
5.8× |
| Heart Infarct Image (78466) |
$1,129.05 |
$1,737 |
2.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,674.75 |
$4,115 |
4.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,831.05 |
$2,817 |
4.3× |
| Ht muscle image spect sing (78451) |
$3,888.30 |
$5,982 |
2.8× |
| Humerus Min 2 Views Left (73060) |
$479.05 |
$737 |
5.2× |
| Hysterosalpingogram (74740) |
$742.95 |
$1,143 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$755.30 |
$1,162 |
6.8× |
| Kidney imaging morphology (78700) |
$965.90 |
$1,486 |
2.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,855.75 |
$2,855 |
3.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,179.45 |
$3,353 |
3.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,241.20 |
$3,448 |
3.9× |
| Knee 3 views (73562) |
$507.65 |
$781 |
5.5× |
| 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 Ventilation Imaging (78579) |
$796.90 |
$1,226 |
1.9× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$929.50 |
$1,430 |
1.4× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,207.05 |
$1,857 |
0.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,185.30 |
$3,362 |
0.6× |
| Lymphoscintigraphy (78195) |
$2,120.95 |
$3,263 |
3.7× |
| Mammary ductogram or galactogram multiple (77054) |
$729.95 |
$1,123 |
2.9× |
| Mammary ductogram or galactogram single (77053) |
$510.90 |
$786 |
2.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$469.95 |
$723 |
5.1× |
| Meckels Diverticulum (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 & w/o contrast (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 & w/contrast material (74183) |
$3,801.20 |
$5,848 |
10.2× |
| MRI abdomen w/o contrast (74181) |
$2,580.50 |
$3,970 |
10.1× |
| MRI any jnt lwr ext with con lt (73722) |
$3,282.50 |
$5,050 |
3.9× |
| 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 c-spine with contrast (72142) |
$3,103.10 |
$4,774 |
8.3× |
| MRI cardiac w/o contrast (75557) |
$2,272.40 |
$3,496 |
8.9× |
| MRI cervical spine w/o contrast (72141) |
$2,863.25 |
$4,405 |
11.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,664.35 |
$4,099 |
7.2× |
| 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 fetal sngl/1st gestation (74712) |
$651.30 |
$1,002 |
2.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,278.90 |
$3,506 |
6.1× |
| 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 contr matrl (73718) |
$2,245.10 |
$3,454 |
8.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,317.90 |
$3,566 |
9.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,555.50 |
$5,470 |
9.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,763.15 |
$4,251 |
7.4× |
| MRI pelvis w contrast (72196) |
$2,380.95 |
$3,663 |
6.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,753.10 |
$5,774 |
10.1× |
| MRI pelvis w/o contrast (72195) |
$2,320.50 |
$3,570 |
9.1× |
| MRI scan of arm joint before and after contrast (73223) |
$3,399.50 |
$5,230 |
9.1× |
| MRI scan of leg joint before and after contrast (73723) |
$4,272.45 |
$6,573 |
11.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,821.35 |
$5,879 |
10.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,413.80 |
$5,252 |
9.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,871.40 |
$5,956 |
10.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,054.35 |
$4,699 |
8.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,039.10 |
$6,214 |
10.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,801.50 |
$4,310 |
11.0× |
| MRI tmj (70336) |
$1,682.85 |
$2,589 |
6.6× |
| MRI upper ext joint w/o contrast (73221) |
$2,407.60 |
$3,704 |
9.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,177.85 |
$4,889 |
8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,210 |
$3,400 |
8.7× |
| Myelogram Cervical (72240) |
$1,069.25 |
$1,645 |
1.3× |
| Myelogram Lumbar (72265) |
$897.65 |
$1,381 |
1.1× |
| Myelogram thoracic (72255) |
$883.35 |
$1,359 |
1.1× |
| Myelography 2 or more regions (72270) |
$1,430.65 |
$2,201 |
1.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,706.30 |
$5,702 |
2.7× |
| Myocardial infarct spect (78469) |
$1,370.20 |
$2,108 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$5,123.30 |
$7,882 |
3.7× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (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 bone marrow multiple (78103) |
$926.90 |
$1,426 |
2.2× |
| Nm bone marrow wb (78104) |
$1,024.40 |
$1,576 |
2.4× |
| Nm cisternogram (78630) |
$1,450.15 |
$2,231 |
2.5× |
| Nm csf leak detection (78650) |
$1,978.60 |
$3,044 |
1.4× |
| Nm gastric emptying study (78264) |
$1,704.95 |
$2,623 |
4.0× |
| Nm peritoneal-venous shunt patency (78291) |
$1,351.35 |
$2,079 |
3.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,871.45 |
$9,033 |
4.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,987.70 |
$3,058 |
1.4× |
| Nuclear medicine of heart pumping function (78473) |
$1,517.10 |
$2,334 |
3.6× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,785.55 |
$2,747 |
1.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,001.65 |
$1,541 |
2.3× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$678.60 |
$1,044 |
1.6× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,638 |
$2,520 |
3.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$1,310.40 |
$2,016 |
3.1× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$1,044.55 |
$1,607 |
1.8× |
| Nuclear Rx Oral Admin (79005) |
$1,967.55 |
$3,027 |
7.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$593.45 |
$913 |
5.3× |
| Orthopantogram (70355) |
$258.70 |
$398 |
2.8× |
| Osseous survey infant (77076) |
$453.70 |
$698 |
4.1× |
| Osseous survey limited (77074) |
$756.60 |
$1,164 |
6.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,463.15 |
$2,251 |
3.4× |
| Parathyroid imaging (78070) |
$1,462.50 |
$2,250 |
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, skull-thigh (78815) |
$5,396.30 |
$8,302 |
3.5× |
| PET imaging for CT attenuation whole body (78816) |
$5,950.75 |
$9,155 |
3.9× |
| PET imaging limited area chest head/neck (78811) |
$2,743.65 |
$4,221 |
2.0× |
| Pr heart first pass single,planar (78481) |
$1,286.35 |
$1,979 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,612.05 |
$5,557 |
9.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,624.70 |
$4,038 |
0.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,092.35 |
$3,219 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$703.30 |
$1,082 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,111.85 |
$3,249 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$748.80 |
$1,152 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$422.50 |
$650 |
4.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$525.20 |
$808 |
4.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$488.80 |
$752 |
4.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$741.65 |
$1,141 |
6.6× |
| 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 1 mev >= complex (77412) |
$750.10 |
$1,154 |
1.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$302.25 |
$465 |
2.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$453.05 |
$697 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$663 |
$1,020 |
5.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$355.55 |
$547 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$481 |
$740 |
4.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$399.10 |
$614 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$796.25 |
$1,225 |
4.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$790.40 |
$1,216 |
4.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$745.55 |
$1,147 |
4.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$409.50 |
$630 |
4.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$132.60 |
$204 |
1.4× |
| Radiological examination surgical specimen (76098) |
$576.55 |
$887 |
1.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,161.25 |
$3,325 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,179.45 |
$3,353 |
0.6× |
| Ribs bilateral 3 views (71110) |
$559.65 |
$861 |
5.0× |
| 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 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× |
| Sacroiliac Joints < 3 Views (72200) |
$240.50 |
$370 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$702 |
$1,080 |
2.8× |
| Salivary gland imaging serial images (78231) |
$880.75 |
$1,355 |
2.1× |
| Scanogram (77073) |
$386.10 |
$594 |
3.5× |
| Scapula complete (73010) |
$443.95 |
$683 |
4.0× |
| Screening digital breast tomosynthesis (77063) |
$98.15 |
$151 |
4.2× |
| Sella turcica (70240) |
$324.35 |
$499 |
3.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$525.85 |
$809 |
4.7× |
| Sialogram (70390) |
$737.75 |
$1,135 |
2.9× |
| Simulation intermediate (77285) |
$965.25 |
$1,485 |
2.4× |
| Small bowel series (74250) |
$851.50 |
$1,310 |
4.5× |
| Spec medical radj physics consltj (77370) |
$403.65 |
$621 |
2.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,051.70 |
$1,618 |
2.6× |
| Special dosimetry (77331) |
$452.40 |
$696 |
3.2× |
| Special treatment procedure (77470) |
$2,107.30 |
$3,242 |
3.6× |
| Spine thoracic 3 views (72072) |
$525.85 |
$809 |
4.7× |
| Spleen imaging only (78185) |
$796.90 |
$1,226 |
1.9× |
| Splenoportograpy rs&i (75810) |
$2,185.30 |
$3,362 |
0.6× |
| Stereotactic body radiation delivery (77373) |
$11,012.30 |
$16,942 |
5.8× |
| 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 With Vascular 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 simple (77280) |
$813.15 |
$1,251 |
5.7× |
| Therapeutic Enema (74283) |
$672.10 |
$1,034 |
3.6× |
| Thoracolumbar 2 views (72080) |
$456.95 |
$703 |
4.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,111.85 |
$3,249 |
3.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$646.75 |
$995 |
1.5× |
| 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× |
| Tmj unilateral (70328) |
$166.40 |
$256 |
1.8× |
| Tomogram (76100) |
$713.05 |
$1,097 |
6.4× |
| Treatment devices simple (77332) |
$455.65 |
$701 |
3.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,703.05 |
$5,697 |
6.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,279.20 |
$1,968 |
3.0× |
| Tx devices design & construction complex (77334) |
$1,300.65 |
$2,001 |
3.3× |
| Ultrasound scan of cornea to determine thickness (76514) |
$30.55 |
$47 |
1.0× |
| Ultrasound scan to determine eye length and lens power (76519) |
$102.70 |
$158 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$561.92 |
$864.50 |
5.0× |
| Umbilical-artery Doppler (OB) (76820) |
$312 |
$480 |
2.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$369.85 |
$569 |
4.0× |
| Unlisted Ultrasound Procedure (76999) |
$227.50 |
$350 |
2.4× |
| Upper Extremity Infant (73092) |
$243.75 |
$375 |
2.2× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$796.90 |
$1,226 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$858.65 |
$1,321 |
3.4× |
| Urethrocystography voiding (74455) |
$847.60 |
$1,304 |
3.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,456.65 |
$2,241 |
7.8× |
| Us abdl aorta screen aaa (76706) |
$303.55 |
$467 |
2.7× |
| Us breast unilateral complete (76641) |
$873.60 |
$1,344 |
7.8× |
| Us breast unilateral limited (76642) |
$268.12 |
$412.50 |
2.9× |
| Us chest (76604) |
$429.65 |
$661 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$783.25 |
$1,205 |
7.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$183.30 |
$282 |
1.6× |
| Us guided compression repair (76936) |
$999.05 |
$1,537 |
4.3× |
| Us infant hips dynamic (76885) |
$809.25 |
$1,245 |
8.7× |
| Us infant hips limited static (76886) |
$564.20 |
$868 |
6.1× |
| Us kidney transplant (76776) |
$577.85 |
$889 |
5.2× |
| Us ob detailed single fetus (76811) |
$1,019.85 |
$1,569 |
4.0× |
| Us ob transvaginal (76817) |
$506.68 |
$779.50 |
4.5× |
| Us pelvic non ob complete (76856) |
$915.20 |
$1,408 |
8.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$434.52 |
$668.50 |
3.9× |
| Us pregnancy ltd (76815) |
$430.62 |
$662.50 |
3.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$778.05 |
$1,197 |
7.0× |
| Us retroperitoneal complete (76770) |
$801.45 |
$1,233 |
7.2× |
| Us retroperitoneal limited (76775) |
$380.90 |
$586 |
3.4× |
| Us scrotum and contents (76870) |
$801.45 |
$1,233 |
7.2× |
| Us soft tissue head/neck (76536) |
$467.68 |
$719.50 |
4.2× |
| Us spinal canal and contents (76800) |
$629.85 |
$969 |
5.6× |
| Us transrectal (76872) |
$809.90 |
$1,246 |
7.3× |
| Us xtr non-vasc lmtd (76882) |
$349.70 |
$538 |
3.1× |
| Us, eye b-scan (76512) |
$123.50 |
$190 |
1.1× |
| Vascular flow imaging (78445) |
$796.90 |
$1,226 |
1.9× |
| Venogram extremity bilateral (75822) |
$1,181.05 |
$1,817 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,226.25 |
$3,425 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,448.85 |
$2,229 |
0.9× |
| Venography epidural rs&i (75872) |
$1,951.95 |
$3,003 |
2.9× |
| 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 selective rs&i (75831) |
$2,161.25 |
$3,325 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,068.95 |
$3,183 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,309.85 |
$8,169 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$170.95 |
$263 |
1.8× |
| Wrist 2 views (73100) |
$427.05 |
$657 |
4.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$687.05 |
$1,057 |
6.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$341.90 |
$526 |
3.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$535.60 |
$824 |
5.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,051.05 |
$1,617 |
5.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$427.70 |
$658 |
4.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$471.90 |
$726 |
5.1× |
| 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 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 of femur 1 (73551) |
$209.30 |
$322 |
2.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$677.95 |
$1,043 |
3.6× |
| X-ray eye for foreign body (70030) |
$416.65 |
$641 |
4.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$670.80 |
$1,032 |
6.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$358.80 |
$552 |
3.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$497.25 |
$765 |
5.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,424.15 |
$2,191 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$421.85 |
$649 |
4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$319.80 |
$492 |
3.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$553.80 |
$852 |
5.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$348.40 |
$536 |
3.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$494 |
$760 |
5.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$611 |
$940 |
5.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$934.70 |
$1,438 |
8.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$427.70 |
$658 |
3.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$398.45 |
$613 |
4.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$220.35 |
$339 |
2.4× |
| X-ray of voice box or throat (70370) |
$486.20 |
$748 |
5.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$679.25 |
$1,045 |
6.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$533 |
$820 |
4.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$560.30 |
$862 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$983.45 |
$1,513 |
2.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$450.45 |
$693 |
4.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$488.15 |
$751 |
4.4× |
| 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 Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$482.30 |
$742 |
5.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$567.45 |
$873 |
6.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$741 |
$1,140 |
8.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$281.45 |
$433 |
3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$689.65 |
$1,061 |
6.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$500.50 |
$770 |
4.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$354.90 |
$546 |
3.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$376.35 |
$579 |
4.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$519.35 |
$799 |
5.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$462.15 |
$711 |
4.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$798.20 |
$1,228 |
7.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$306.80 |
$472 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$507 |
$780 |
5.5× |
| Xr arthrogram ankle (73615) |
$609.70 |
$938 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$783.90 |
$1,206 |
7.0× |
| Xr chest 4+ views (71048) |
$533.65 |
$821 |
4.8× |
| Xr Cholecystography Oral Contrast (74290) |
$484.25 |
$745 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$327.60 |
$504 |
3.5× |
| Xr internal auditory meati complete (70134) |
$516.10 |
$794 |
0.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$434.20 |
$668 |
3.9× |
| Xr optic foramina (70190) |
$622.70 |
$958 |
6.7× |
| Xr shoulder 1 view (73020) |
$525.20 |
$808 |
5.7× |
| Xr spine cervical 4 or 5 views (72050) |
$632.45 |
$973 |
5.7× |
| Xr tibia/fibula 2 views (73590) |
$482.30 |
$742 |
5.2× |
| Xr tmj bilateral (70330) |
$419.25 |
$645 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$407.55 |
$627 |
4.4× |