| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,247 |
$4,494 |
1.8× |
| Abdomen 2 views (74019) |
$149 |
$298 |
1.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$428.50 |
$857 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$4,719 |
$9,438 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$4,719 |
$9,438 |
1.7× |
| Angiography internal mammary rs&i (75756) |
$4,719 |
$9,438 |
1.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$8,073.50 |
$16,147 |
1.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,719 |
$9,438 |
1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,719 |
$9,438 |
1.7× |
| Angiography Spinal Selective Rs&I (75705) |
$5,967.50 |
$11,935 |
1.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$8,073.50 |
$16,147 |
1.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$682 |
$1,364 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,010.50 |
$8,021 |
1.4× |
| Ankle 2 views (73600) |
$89 |
$178 |
1.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$684.50 |
$1,369 |
2.2× |
| Aortogram thoracic (75605) |
$8,073.50 |
$16,147 |
1.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,719 |
$9,438 |
1.7× |
| Aortography abdominal serialography rs&i (75625) |
$4,719 |
$9,438 |
1.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,591 |
$7,182 |
1.3× |
| Artery X-Rays Adrenal Gland (75731) |
$4,010.50 |
$8,021 |
1.4× |
| Arthrogram elbow (73085) |
$410 |
$820 |
1.3× |
| Arthrogram hip (73525) |
$410 |
$820 |
1.3× |
| Arthrogram shoulder (73040) |
$630 |
$1,260 |
2.0× |
| Arthrogram wrist (73115) |
$614 |
$1,228 |
1.9× |
| Arthrography knee lt (73580) |
$513 |
$1,026 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$251 |
$502 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$590 |
$1,180 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$590 |
$1,180 |
1.6× |
| Bone age studies (77072) |
$83.50 |
$167 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$1,093 |
$2,186 |
3.0× |
| Bone Marrow Imaging Limited Area (78102) |
$313.50 |
$627 |
0.9× |
| Bone survey complete (77075) |
$281 |
$562 |
3.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$666.50 |
$1,333 |
1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,578.50 |
$7,157 |
2.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$324.50 |
$649 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$156.50 |
$313 |
2.0× |
| Chest 1 view (71045) |
$112.50 |
$225 |
1.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$211 |
$422 |
1.3× |
| Clavicle complete (73000) |
$132.50 |
$265 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$62.50 |
$125 |
0.7× |
| Continuing medical physics consltj pr wk (77336) |
$253.50 |
$507 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,661 |
$3,322 |
5.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,195.50 |
$2,391 |
5.5× |
| CT abdomen w contrast (74160) |
$1,176 |
$2,352 |
7.4× |
| CT abdomen w wo contrast (74170) |
$1,461 |
$2,922 |
9.2× |
| CT abdomen w/o contrast (74150) |
$1,093 |
$2,186 |
11.5× |
| CT angiography upper extremity lt (73206) |
$1,011 |
$2,022 |
6.4× |
| CT c-spine w/o contrast (72125) |
$974.50 |
$1,949 |
10.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,411 |
$2,822 |
8.9× |
| CT cervical spine with contrast (72126) |
$1,005.50 |
$2,011 |
3.2× |
| CT chest w/wo contrast (71270) |
$1,218.50 |
$2,437 |
7.7× |
| CT chest with contrast (71260) |
$1,176 |
$2,352 |
7.4× |
| CT head/brain with contrast (70460) |
$562 |
$1,124 |
3.5× |
| CT head/brain without and with contrast (70470) |
$1,127 |
$2,254 |
7.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$31.50 |
$63 |
0.4× |
| CT iac w contrast (70481) |
$657.50 |
$1,315 |
4.1× |
| CT lower ext w/o (73700) |
$1,646 |
$3,292 |
17.4× |
| CT lower extremity w wo contrast (73702) |
$883 |
$1,766 |
5.6× |
| CT lower extremity with contrast (73701) |
$827 |
$1,654 |
5.2× |
| CT lumbar spine w & w/o contrast (72133) |
$1,411 |
$2,822 |
8.9× |
| CT lumbar spine w/o contrast (72131) |
$974.50 |
$1,949 |
10.3× |
| CT lumbar spine with contrast (72132) |
$1,031 |
$2,062 |
3.3× |
| CT maxillofacial w contrast (70487) |
$674.50 |
$1,349 |
4.2× |
| CT maxillofacial w/o contrast (70486) |
$883 |
$1,766 |
9.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,127 |
$2,254 |
7.1× |
| CT neck soft tissue w contrast (70491) |
$1,545.50 |
$3,091 |
9.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$638.50 |
$1,277 |
4.0× |
| CT orbits w/o contrast (70480) |
$883 |
$1,766 |
9.3× |
| CT pelvis w & w/o contrast (72194) |
$1,461 |
$2,922 |
9.2× |
| CT pelvis w/o contrast (72192) |
$1,093 |
$2,186 |
11.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,721.50 |
$3,443 |
10.8× |
| CT soft tissue neck w/o contrast (70490) |
$1,176 |
$2,352 |
12.4× |
| CT thoracic spine w/contrast (72129) |
$1,031 |
$2,062 |
6.5× |
| CT thoracic spine w/o contrast (72128) |
$919.50 |
$1,839 |
9.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,411 |
$2,822 |
8.9× |
| CT thorax w/o contrast (71250) |
$909.50 |
$1,819 |
9.6× |
| CT unlisted procedure (76497) |
$144 |
$288 |
1.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$872 |
$1,744 |
5.5× |
| CT upper extremity w/o contrast rt (73200) |
$751.50 |
$1,503 |
7.9× |
| CT upper extremity with contrast (73201) |
$827 |
$1,654 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,277 |
$2,554 |
8.0× |
| Cta Abdomen (74175) |
$1,412 |
$2,824 |
8.9× |
| CTA abdomen pelvis (74174) |
$1,760.50 |
$3,521 |
5.6× |
| CTA chest (71275) |
$1,412 |
$2,824 |
8.9× |
| Cta Head (70496) |
$1,206.50 |
$2,413 |
7.6× |
| CTA lwr ext w&w/o contrast (73706) |
$1,011 |
$2,022 |
6.4× |
| Cta Neck (70498) |
$1,584.50 |
$3,169 |
10.0× |
| Cta Pelvis (72191) |
$1,377.50 |
$2,755 |
8.7× |
| Cystography minimum 3 views rs&i (74430) |
$866.50 |
$1,733 |
2.7× |
| Diskogram cervical (72285) |
$3,049 |
$6,098 |
1.7× |
| Diskography lumbar (72295) |
$3,049 |
$6,098 |
1.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$97.50 |
$195 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$173 |
$346 |
2.2× |
| Echoencephalography real time imaging (76506) |
$257.50 |
$515 |
2.7× |
| Esophagus (74220) |
$169 |
$338 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$402 |
$804 |
4.2× |
| Fluoroscopy up to 1 hr (76000) |
$440 |
$880 |
2.0× |
| Foot 2 views (73620) |
$89 |
$178 |
1.1× |
| Forearm 2 views (73090) |
$132.50 |
$265 |
1.7× |
| Gated Heart Planar Single (78472) |
$560 |
$1,120 |
1.5× |
| Hand 2 views (73120) |
$89 |
$178 |
0.9× |
| Hand 3 views (73130) |
$132.50 |
$265 |
1.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,591 |
$7,182 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$840 |
$1,680 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$758 |
$1,516 |
2.1× |
| Ht muscle image spect sing (78451) |
$1,428 |
$2,856 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$132.50 |
$265 |
1.7× |
| Hysterosalpingogram (74740) |
$403.50 |
$807 |
1.9× |
| Kidney imaging morphology (78700) |
$656 |
$1,312 |
1.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$758 |
$1,516 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$758 |
$1,516 |
1.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$892 |
$1,784 |
1.8× |
| Knee 3 views (73562) |
$88.75 |
$177.50 |
1.1× |
| Liver & spleen imaging static only (78215) |
$492.50 |
$985 |
1.4× |
| Lung perf&ventilat diferentl (78598) |
$1,260 |
$2,520 |
2.6× |
| Lymphoscintigraphy (78195) |
$548.50 |
$1,097 |
1.1× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$49.50 |
$99 |
0.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,028 |
$2,056 |
3.0× |
| MRA head w & w/o contrast (70546) |
$1,636.50 |
$3,273 |
5.2× |
| MRA head w/o contrast (70544) |
$1,172 |
$2,344 |
5.4× |
| MRA head with contrast (70545) |
$1,390 |
$2,780 |
4.4× |
| MRA neck w contrast (70548) |
$1,425 |
$2,850 |
4.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,636.50 |
$3,273 |
5.2× |
| MRA neck w/o contrast (70547) |
$1,172 |
$2,344 |
5.4× |
| MRI abdomen w contrast (74182) |
$1,314 |
$2,628 |
4.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,599.50 |
$3,199 |
5.1× |
| MRI abdomen w/o contrast (74181) |
$1,094.50 |
$2,189 |
5.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,556.50 |
$3,113 |
2.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,556.50 |
$3,113 |
2.2× |
| MRI c-spine with contrast (72142) |
$1,378.50 |
$2,757 |
4.4× |
| MRI cervical spine w/o contrast (72141) |
$1,160.50 |
$2,321 |
5.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,560.50 |
$3,121 |
4.9× |
| MRI chest w/o contrast (71550) |
$1,067 |
$2,134 |
4.9× |
| MRI chest with contrast (71551) |
$1,314 |
$2,628 |
1.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$851.35 |
$1,702.70 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,556.50 |
$3,113 |
4.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,287 |
$2,574 |
6.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,067 |
$2,134 |
4.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,599.50 |
$3,199 |
5.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,214.50 |
$2,429 |
3.8× |
| MRI pelvis w contrast (72196) |
$1,314 |
$2,628 |
4.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,599.50 |
$3,199 |
5.1× |
| MRI pelvis w/o contrast (72195) |
$1,094.50 |
$2,189 |
5.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,931 |
$3,862 |
6.1× |
| MRI scan of leg joint before and after contrast (73723) |
$1,931 |
$3,862 |
6.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,667.50 |
$3,335 |
5.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,378.50 |
$2,757 |
4.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,667.50 |
$3,335 |
5.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,413 |
$2,826 |
4.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,667.50 |
$3,335 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,160.50 |
$2,321 |
5.4× |
| MRI tmj (70336) |
$1,038.50 |
$2,077 |
4.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,287 |
$2,574 |
6.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,032.50 |
$2,065.01 |
3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$710.14 |
$1,420.26 |
3.3× |
| Myocardial Spect Multiple Studies (78452) |
$1,527.50 |
$3,055 |
1.3× |
| Neck soft tissue (70360) |
$132.50 |
$265 |
1.7× |
| Nm bone marrow wb (78104) |
$1,023 |
$2,046 |
2.8× |
| Nm cisternogram (78630) |
$656 |
$1,312 |
1.3× |
| Nm csf leak detection (78650) |
$2,277 |
$4,554 |
1.9× |
| Nm gastric emptying study (78264) |
$967 |
$1,934 |
2.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,683 |
$11,366 |
4.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,428 |
$2,856 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$301 |
$602 |
1.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$165 |
$330 |
1.7× |
| Osseous survey limited (77074) |
$239.50 |
$479 |
2.5× |
| Parathyroid imaging (78070) |
$1,125 |
$2,250 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$110.50 |
$221 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$3,668 |
$7,336 |
2.8× |
| PET imaging for CT attenuation whole body (78816) |
$3,668 |
$7,336 |
2.8× |
| PET imaging limited area chest head/neck (78811) |
$3,131.50 |
$6,263 |
2.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,931 |
$3,862 |
6.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,010.50 |
$8,021 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$428.50 |
$857 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,260 |
$2,520 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$677 |
$1,354 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$160 |
$320 |
1.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$122.50 |
$245 |
1.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$108.50 |
$217 |
1.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$9,686 |
$19,372 |
1.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$329 |
$658 |
0.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$148 |
$296 |
1.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$166 |
$332 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$189 |
$378 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$131 |
$262 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$132.50 |
$265 |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$251 |
$502 |
1.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$235.50 |
$471 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$423.50 |
$847 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$287.50 |
$575 |
1.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$178 |
$356 |
2.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,591 |
$7,182 |
1.3× |
| Ribs bilateral 3 views (71110) |
$201 |
$402 |
2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$784 |
$1,568 |
2.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,463 |
$2,926 |
3.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,830 |
$3,660 |
3.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$330.50 |
$661 |
1.6× |
| Rp Therapy Intravenous Administration (79101) |
$327 |
$654 |
1.5× |
| Scanogram (77073) |
$280.50 |
$561 |
3.0× |
| Scapula complete (73010) |
$132.50 |
$265 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$47.50 |
$95 |
2.0× |
| Simulation intermediate (77285) |
$328.50 |
$657 |
1.0× |
| Small bowel series (74250) |
$328 |
$656 |
2.1× |
| Spec medical radj physics consltj (77370) |
$346 |
$692 |
2.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$318.50 |
$637 |
0.9× |
| Special dosimetry (77331) |
$200 |
$400 |
1.6× |
| Special treatment procedure (77470) |
$1,586.50 |
$3,173 |
3.2× |
| Stereotactic body radiation delivery (77373) |
$2,399.50 |
$4,799 |
1.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$639.50 |
$1,279 |
1.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$317.50 |
$635 |
0.9× |
| Testicular Imaging With Vascular Flow (78761) |
$273.50 |
$547 |
0.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$658.50 |
$1,317 |
1.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$240 |
$480 |
2.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$924.50 |
$1,849 |
1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$758 |
$1,516 |
2.1× |
| Treatment device intermediate (77333) |
$228.50 |
$457 |
1.9× |
| Treatment devices simple (77332) |
$259 |
$518 |
2.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$4,228.50 |
$8,457 |
8.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$537.50 |
$1,075 |
1.5× |
| Tx devices design & construction complex (77334) |
$422.50 |
$845 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$379 |
$758 |
4.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$79.50 |
$159 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$131 |
$262 |
1.7× |
| Upper Extremity Infant (73092) |
$72 |
$144 |
0.8× |
| Urethrocystography voiding (74455) |
$422.50 |
$845 |
2.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$336 |
$672 |
2.1× |
| Us abdl aorta screen aaa (76706) |
$379 |
$758 |
4.0× |
| Us breast unilateral complete (76641) |
$177 |
$354 |
1.9× |
| Us breast unilateral limited (76642) |
$148 |
$296 |
1.9× |
| Us chest (76604) |
$336.50 |
$673 |
3.6× |
| Us compl joint r-t w/image documentation (76881) |
$348 |
$696 |
3.7× |
| Us elastography parenchyma (76981) |
$251 |
$502 |
2.7× |
| Us guided compression repair (76936) |
$408.50 |
$817 |
2.1× |
| Us infant hips dynamic (76885) |
$317.50 |
$635 |
4.0× |
| Us kidney transplant (76776) |
$454.50 |
$909 |
4.8× |
| Us ob detailed single fetus (76811) |
$310 |
$620 |
1.4× |
| Us ob transvaginal (76817) |
$317.50 |
$635 |
3.4× |
| Us pelvic non ob complete (76856) |
$379 |
$758 |
4.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$379 |
$758 |
4.0× |
| Us pregnancy ltd (76815) |
$254 |
$508 |
2.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$379 |
$758 |
4.0× |
| Us retroperitoneal complete (76770) |
$592 |
$1,184 |
6.3× |
| Us retroperitoneal limited (76775) |
$379 |
$758 |
4.0× |
| Us scrotum and contents (76870) |
$379 |
$758 |
4.0× |
| Us soft tissue head/neck (76536) |
$257.50 |
$515 |
2.7× |
| Us spinal canal and contents (76800) |
$240 |
$480 |
2.5× |
| Us transrectal (76872) |
$296.50 |
$593 |
3.1× |
| Us xtr non-vasc lmtd (76882) |
$251 |
$502 |
2.7× |
| Venogram extremity bilateral (75822) |
$1,861 |
$3,722 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$4,719 |
$9,438 |
1.7× |
| Venography caval superior serialography rs&i (75827) |
$1,970.50 |
$3,941 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,970.50 |
$3,941 |
1.4× |
| Venography Renal Bilateral (75833) |
$3,591 |
$7,182 |
1.3× |
| Venography renal unilateral selective rs&i (75831) |
$4,719 |
$9,438 |
1.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,719 |
$9,438 |
1.7× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$8,073.50 |
$16,147 |
1.6× |
| Wrist 2 views (73100) |
$89 |
$178 |
1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$178.50 |
$357 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$132.50 |
$265 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$298.50 |
$597 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$132.50 |
$265 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$190 |
$380 |
2.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$131 |
$262 |
1.4× |
| X-ray exam hip uni 1 view (73501) |
$380.50 |
$761 |
4.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$134.50 |
$269 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$160 |
$320 |
1.7× |
| X-ray exam of femur 1 (73551) |
$110.50 |
$221 |
1.4× |
| X-ray eye for foreign body (70030) |
$126 |
$252 |
1.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$189 |
$378 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$132.50 |
$265 |
1.7× |
| X-ray head for orthodontia (70350) |
$110.50 |
$221 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$132.50 |
$265 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$167 |
$334 |
2.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$169 |
$338 |
1.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$73 |
$146 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$111 |
$222 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$320 |
$640 |
3.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$167 |
$334 |
1.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$161.50 |
$323 |
2.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$87.50 |
$175 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$125 |
$250 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$422.50 |
$845 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$169 |
$338 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$169 |
$338 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$285 |
$570 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$109.50 |
$219 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$161.50 |
$323 |
2.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$90 |
$180 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$211 |
$422 |
2.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$95.50 |
$191 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$211 |
$422 |
2.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$132.50 |
$265 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$67 |
$134 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$103.50 |
$207 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$132.50 |
$265 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$132.50 |
$265 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$132.50 |
$265 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$132.50 |
$265 |
1.7× |
| Xr arthrogram ankle (73615) |
$410 |
$820 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$269 |
$538 |
2.8× |
| Xr chest 4+ views (71048) |
$121.50 |
$243 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$132.50 |
$265 |
1.7× |
| Xr shoulder 1 view (73020) |
$73 |
$146 |
0.9× |
| Xr spine cervical 4 or 5 views (72050) |
$220 |
$440 |
2.3× |
| Xr tibia/fibula 2 views (73590) |
$132.50 |
$265 |
1.7× |
| Xr tmj bilateral (70330) |
$152 |
$304 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$130.50 |
$261 |
1.7× |