| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,108 |
$4,216 |
1.7× |
| Abdomen 1 View (74018) |
$212.50 |
$425 |
2.7× |
| Abdomen 2 views (74019) |
$220.50 |
$441 |
2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$796 |
$1,592 |
2.2× |
| Angio internal mammary (75756) |
$1,585 |
$3,170 |
0.6× |
| Angio pulmonary bilat (75743) |
$2,579.50 |
$5,159 |
0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,517 |
$3,034 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,868 |
$5,736 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,103.50 |
$4,207 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,280 |
$4,560 |
0.8× |
| Ankle 2 views (73600) |
$102 |
$204 |
1.3× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,232.50 |
$4,465 |
0.4× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$2,101.50 |
$4,203 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$1,659.50 |
$3,319 |
0.6× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$1,994.50 |
$3,989 |
0.4× |
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure |
$1,888 |
$3,776 |
0.4× |
| Arthrogram ankle (73615) |
$743 |
$1,486 |
2.4× |
| Arthrogram hip (73525) |
$875.50 |
$1,751 |
2.8× |
| Arthrogram Wrist (73115) |
$684 |
$1,368 |
2.2× |
| Basic radiation dosimetry calculation (77300) |
$139 |
$278 |
1.1× |
| Bone age studies (77072) |
$232.50 |
$465 |
2.5× |
| Bone Imaging 3 Phase (78315) |
$1,017 |
$2,034 |
2.8× |
| Bone Imaging Limited Area (78300) |
$505.50 |
$1,011 |
1.4× |
| Bone Imaging Multiple Areas (78305) |
$692.50 |
$1,385 |
1.9× |
| Bone Imaging Whole Body (78306) |
$911 |
$1,822 |
2.5× |
| Bone marrow imaging; multiple areas (78103) |
$314 |
$628 |
0.9× |
| Bone marrow imaging; whole body (78104) |
$404.50 |
$809 |
1.1× |
| Bone survey infant (77076) |
$92 |
$184 |
1.0× |
| Brain Image W/Flow < 4 Views (78601) |
$624 |
$1,248 |
1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,563 |
$7,126 |
2.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,697 |
$3,394 |
5.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$792.50 |
$1,585 |
1.6× |
| Cerebrospinal Fluid Scan (78630) |
$911 |
$1,822 |
1.9× |
| Chest 1 view (71045) |
$130 |
$260 |
1.6× |
| Chest 2 views (71046) |
$191.50 |
$383 |
2.4× |
| Chest 3 views (71047) |
$191.50 |
$383 |
2.4× |
| Chest 4 or more views (71048) |
$396 |
$792 |
4.2× |
| Clavicle complete (73000) |
$209 |
$418 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$159.50 |
$319 |
1.7× |
| Continuing medical physics consltj pr wk (77336) |
$309.50 |
$619 |
2.5× |
| Contrast Exam Abdominl Aorta (75625) |
$2,707.50 |
$5,415 |
0.9× |
| Contrast X-Ray Bladder (74430) |
$662 |
$1,324 |
2.1× |
| Contrast X-Ray Of Elbow (73085) |
$650 |
$1,300 |
2.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$684.50 |
$1,369 |
2.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,784.50 |
$5,569 |
8.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,193.50 |
$4,387 |
10.2× |
| CT abdomen w contrast (74160) |
$1,329.50 |
$2,659 |
8.4× |
| CT abdomen w wo contrast (74170) |
$1,529 |
$3,058 |
9.6× |
| CT abdomen w/o contrast (74150) |
$1,156 |
$2,312 |
12.2× |
| CT Angio Abdomen and Pelvis (74174) |
$3,591 |
$7,182 |
11.4× |
| CT Angio Chest (71275) |
$1,455.50 |
$2,911 |
9.2× |
| CT Angio Head (70496) |
$1,340 |
$2,680 |
8.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,133 |
$2,266 |
7.1× |
| CT Angio Neck (70498) |
$1,361 |
$2,722 |
8.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$640 |
$1,280 |
4.0× |
| CT cervical spine w/ contrast (72126) |
$1,363 |
$2,726 |
4.3× |
| CT cervical spine w/o contrast (72125) |
$930 |
$1,860 |
9.8× |
| CT cervical spine w/wo cont (72127) |
$1,509.50 |
$3,019 |
9.5× |
| CT chest w contrast (71260) |
$1,468 |
$2,936 |
9.2× |
| CT chest w/wo contrast (71270) |
$1,661.50 |
$3,323 |
10.5× |
| CT colonography screening (74263) |
$527 |
$1,054 |
2.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$278 |
$556 |
2.9× |
| CT head/brain with contrast (70460) |
$1,139 |
$2,278 |
7.2× |
| CT head/brain without and with contrast (70470) |
$1,229 |
$2,458 |
7.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$50.50 |
$101 |
0.6× |
| CT iac w contrast (70481) |
$1,319 |
$2,638 |
8.3× |
| CT l-spine w&w/o contrast (72133) |
$1,781 |
$3,562 |
11.2× |
| CT lower ext w/o (73700) |
$1,006.50 |
$2,013 |
10.6× |
| CT lower extremity w/contrast material (73701) |
$1,157.50 |
$2,315 |
7.3× |
| CT lumbar spine w contrast (72132) |
$1,685 |
$3,370 |
5.3× |
| CT lumbar spine w/o contrast (72131) |
$1,332.50 |
$2,665 |
14.1× |
| CT maxillofacial w contrast (70487) |
$1,181 |
$2,362 |
7.4× |
| CT maxillofacial wo contrast (70486) |
$1,012.50 |
$2,025 |
10.7× |
| CT neck tissue combo (70492) |
$1,382.50 |
$2,765 |
8.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,396.50 |
$2,793 |
8.8× |
| CT orbits w/o contrast (70480) |
$987.50 |
$1,975 |
10.4× |
| CT pelvis w&w/o contrast (72194) |
$1,561 |
$3,122 |
9.8× |
| CT pelvis w/o contrast (72192) |
$1,125.50 |
$2,251 |
11.9× |
| CT scan of leg combo (73702) |
$1,331 |
$2,662 |
8.4× |
| CT scans face/jaw combo (70488) |
$1,349.50 |
$2,699 |
8.5× |
| CT soft tissue neck w contrast (70491) |
$1,306 |
$2,612 |
8.2× |
| CT soft tissue neck w/o contrast (70490) |
$864 |
$1,728 |
9.1× |
| CT thoracic spine w contrast (72129) |
$1,088.50 |
$2,177 |
6.9× |
| CT thoracic spine w/o contrast (72128) |
$946.50 |
$1,893 |
10.0× |
| CT thoracic spine w/wo cont (72130) |
$1,251.50 |
$2,503 |
7.9× |
| CT thorax w/o contrast (71250) |
$1,069 |
$2,138 |
11.3× |
| CT upper ext wo (73200) |
$527.50 |
$1,055 |
5.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$698 |
$1,396 |
4.4× |
| CT upper extremity with contrast (73201) |
$607 |
$1,214 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,592.50 |
$3,185 |
10.0× |
| Cta Abdomen (74175) |
$1,825.50 |
$3,651 |
11.5× |
| CTA pelvis (72191) |
$2,039.50 |
$4,079 |
12.8× |
| Dilation ureters/urethra rs&i (74485) |
$1,009.50 |
$2,019 |
0.5× |
| Discography Cerv/Thor Spine (72285) |
$1,505 |
$3,010 |
0.9× |
| Diskography lumbar (72295) |
$1,565.50 |
$3,131 |
0.9× |
| Dxa Bone Density Axial (77080) |
$396.50 |
$793 |
4.2× |
| Dxa bone density study (77085) |
$301 |
$602 |
3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$350 |
$700 |
4.4× |
| Echo Guide For Artery Repair (76936) |
$459 |
$918 |
2.3× |
| Echograp Trans R Pros Study (76873) |
$348.50 |
$697 |
3.7× |
| Esophagram (74220) |
$147.50 |
$295 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$343.50 |
$687 |
1.6× |
| Follow-Up Angiography (75898) |
$1,153 |
$2,306 |
0.4× |
| Foot 2 views (73620) |
$183 |
$366 |
2.3× |
| Forearm 2 views (73090) |
$202 |
$404 |
2.6× |
| Gastric emptying imaging study (78264) |
$881 |
$1,762 |
2.4× |
| Gated Heart Planar Single (78472) |
$579.50 |
$1,159 |
1.6× |
| Hand 2 views (73120) |
$108.50 |
$217 |
1.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,216.50 |
$6,433 |
5.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,714.50 |
$3,429 |
0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,648.50 |
$3,297 |
0.6× |
| Hepatobil Syst Image W/Drug (78227) |
$1,070 |
$2,140 |
2.2× |
| Hepatobiliary System Imaging (78226) |
$1,070 |
$2,140 |
3.0× |
| Ht Muscle Image Spect Sing (78451) |
$1,184 |
$2,368 |
1.0× |
| Hysterosalpingogram (74740) |
$737.50 |
$1,475 |
3.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$484 |
$968 |
6.1× |
| Infusion Ivp (74410) |
$727 |
$1,454 |
4.6× |
| Interstitial radiation source applic complex (77778) |
$2,086 |
$4,172 |
3.3× |
| K Flow/Funct Image W/Drug (78708) |
$1,473 |
$2,946 |
3.0× |
| K Flow/Funct Image W/O Drug (78707) |
$1,232.50 |
$2,465 |
2.5× |
| Knee 3 Views (73562) |
$239.50 |
$479 |
3.0× |
| Liver & Spleen Imaging Static Only (78215) |
$836 |
$1,672 |
2.3× |
| Liver imaging static only (78201) |
$1,716 |
$3,432 |
3.5× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,061 |
$4,122 |
4.2× |
| Lung perfusion differential (78597) |
$2,061 |
$4,122 |
5.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,513 |
$3,026 |
3.1× |
| Lymph System Imaging (78195) |
$896.50 |
$1,793 |
1.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$1,181.50 |
$2,363 |
0.4× |
| Magnetic Image Jaw Joint (70336) |
$1,209.50 |
$2,419 |
5.6× |
| Magnetic Resonance Elastography (76391) |
$344 |
$688 |
1.6× |
| Meckels Divert Exam (78290) |
$586 |
$1,172 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$333 |
$666 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,430.50 |
$2,861 |
4.5× |
| MRA head w/o contrast (70544) |
$1,137.50 |
$2,275 |
5.3× |
| MRA neck w contrast (70548) |
$1,285.50 |
$2,571 |
4.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,478.50 |
$2,957 |
4.7× |
| MRA neck w/o contrast (70547) |
$1,118 |
$2,236 |
5.2× |
| MRI abdomen w contrast (74182) |
$1,655 |
$3,310 |
5.2× |
| MRI abdomen w/o contrast (74181) |
$1,433 |
$2,866 |
6.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,616.50 |
$3,233 |
2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,107 |
$4,214 |
6.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,607.50 |
$3,215 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$1,130 |
$2,260 |
5.2× |
| MRI cervical spine w contrast (72142) |
$1,484 |
$2,968 |
4.7× |
| MRI cervical spine w/o cont (72141) |
$1,133 |
$2,266 |
5.2× |
| MRI chest w/o contrast (71550) |
$1,246.50 |
$2,493 |
5.8× |
| MRI chest wo w contrast (71552) |
$1,647 |
$3,294 |
5.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,279.50 |
$2,559 |
4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,690 |
$3,380 |
5.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,244 |
$2,488 |
5.8× |
| MRI lumbar spine w contrast (72149) |
$1,455.50 |
$2,911 |
4.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,467.50 |
$4,935 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,282.50 |
$2,565 |
5.9× |
| MRI orbit face neck w contrast (70542) |
$1,809 |
$3,618 |
5.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,035 |
$4,070 |
6.4× |
| MRI pelvis w contrast (72196) |
$1,385.50 |
$2,771 |
4.4× |
| MRI pelvis w/o & w contrast (72197) |
$1,593.50 |
$3,187 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,205 |
$2,410 |
5.6× |
| MRI spectroscopy (76390) |
$1,347.50 |
$2,695 |
17.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,106 |
$2,212 |
5.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,379 |
$2,758 |
4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,199 |
$2,398 |
5.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,586 |
$3,172 |
5.0× |
| MRI, abdomen, combo (74183) |
$2,321 |
$4,642 |
7.3× |
| MRI, dorsal spine combo (72157) |
$2,203 |
$4,406 |
7.0× |
| MRI, dorsal spine contrast (72147) |
$1,229.50 |
$2,459 |
3.9× |
| MRI, joint upper extrem (73221) |
$1,573 |
$3,146 |
7.3× |
| MRI, joint upper extrem combo (73223) |
$1,931 |
$3,862 |
6.1× |
| MRI, lumbar spine combo (72158) |
$2,078.50 |
$4,157 |
6.6× |
| Myelogram cervical (72240) |
$1,334.50 |
$2,669 |
1.9× |
| Myelogram Lumbar (72265) |
$1,122.50 |
$2,245 |
1.6× |
| Myelography thoracic (72255) |
$1,419 |
$2,838 |
2.0× |
| Myelograpy 2/more regions rs&i (72270) |
$2,520.50 |
$5,041 |
3.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,312.50 |
$10,625 |
4.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,842.50 |
$5,685 |
2.4× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$5,065.50 |
$10,131 |
3.9× |
| Neck soft tissue (70360) |
$190.50 |
$381 |
2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$349.50 |
$699 |
1.0× |
| Nonvascular Shunt X-Ray (75809) |
$363.50 |
$727 |
3.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,656 |
$5,312 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$588.50 |
$1,177 |
2.8× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$268 |
$536 |
2.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$300 |
$600 |
3.2× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$85.50 |
$171 |
3.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$203 |
$406 |
2.1× |
| Optic foramina (70190) |
$233 |
$466 |
3.0× |
| Panoramic X-ray of jaws (70355) |
$263 |
$526 |
3.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$673 |
$1,346 |
1.4× |
| Parathyroid Planar Imaging (78070) |
$364.50 |
$729 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$510 |
$1,020 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$167.50 |
$335 |
1.8× |
| Peritoneogram Rs&I (74190) |
$528.50 |
$1,057 |
1.1× |
| Pet Image W/Ct Lmtd (78814) |
$3,212.50 |
$6,425 |
2.5× |
| PET image w/CT, full body (78816) |
$4,247.50 |
$8,495 |
3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,229 |
$6,458 |
2.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,763 |
$3,526 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$698 |
$1,396 |
1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$251 |
$502 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$587 |
$1,174 |
1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$220.50 |
$441 |
2.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$177.50 |
$355 |
2.3× |
| Radex elbow complete minimum 3 views (73080) |
$206 |
$412 |
2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$341 |
$682 |
3.6× |
| Radex fingr minimum 2 views (73140) |
$153 |
$306 |
1.9× |
| Radex foot complete minimum 3 views (73630) |
$217 |
$434 |
2.8× |
| Radex Hand Minimum 3 Views (73130) |
$203.50 |
$407 |
2.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$98.50 |
$197 |
1.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$226 |
$452 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$202 |
$404 |
2.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$259 |
$518 |
3.3× |
| Radex shoulder complete minimum 2 views (73030) |
$225 |
$450 |
2.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$193.50 |
$387 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$208.50 |
$417 |
2.6× |
| Radex Sternum Minimum 2 Views (71120) |
$280.50 |
$561 |
3.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$357.50 |
$715 |
4.5× |
| Radex Toe Minimum 2 Views (73660) |
$157.50 |
$315 |
2.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$98.50 |
$197 |
1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$202 |
$404 |
2.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$10,007 |
$20,014 |
1.5× |
| Radiation treatment delivery level 1 (77402) |
$390.50 |
$781 |
4.2× |
| Radiation treatment delivery level 2 (77407) |
$474.50 |
$949 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$287.50 |
$575 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$247.50 |
$495 |
2.6× |
| Radiologic exam colon double contrast study (74280) |
$576 |
$1,152 |
3.6× |
| Radiologic exam colon single contrast study (74270) |
$418 |
$836 |
2.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$275 |
$550 |
1.7× |
| Radiologic exam knee complete 4/more views (73564) |
$287.50 |
$575 |
3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$410 |
$820 |
2.6× |
| Radiologic exam swallow function contrast study (74230) |
$267 |
$534 |
1.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$100 |
$200 |
0.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$527 |
$1,054 |
3.3× |
| Radiologic examination femur 1 view (73551) |
$68 |
$136 |
0.9× |
| Radiologic examination femur minimum 2 views (73552) |
$184.50 |
$369 |
2.3× |
| Radiologic examination knee 1/2 views (73560) |
$196 |
$392 |
2.5× |
| Radiologic Examination Osseous Survey Limited (77074) |
$153.50 |
$307 |
1.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$202 |
$404 |
2.6× |
| Radiopharm Dacryocystography (78660) |
$506 |
$1,012 |
1.4× |
| Ribs bilateral 3 views (71110) |
$227 |
$454 |
2.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$591.50 |
$1,183 |
1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,151 |
$2,302 |
3.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,847.50 |
$9,695 |
9.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,695 |
$3,390 |
3.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,206.50 |
$2,413 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,170.50 |
$2,341 |
0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,031.50 |
$2,063 |
0.9× |
| Rp Therapy Intravenous Administration (79101) |
$404.50 |
$809 |
1.9× |
| Scapula (73010) |
$244.50 |
$489 |
2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$28 |
$56 |
1.2× |
| Shoulder 1 view (73020) |
$144 |
$288 |
1.8× |
| Shoulder Arthrography (73040) |
$708 |
$1,416 |
2.2× |
| Sialogram (70390) |
$752 |
$1,504 |
3.5× |
| Skull less than 4 views (70250) |
$204 |
$408 |
2.2× |
| Special Physics Consult (77370) |
$404 |
$808 |
3.3× |
| Special treatment procedure (77470) |
$639 |
$1,278 |
1.3× |
| Srs Multisource (77371) |
$30,579.50 |
$61,159 |
4.6× |
| Stereotactic Body Radiation Delivery (77373) |
$2,670 |
$5,340 |
1.6× |
| Sternoclavicular joints (71130) |
$252.50 |
$505 |
3.2× |
| Superior sagittal sinus venogram (75870) |
$1,018.50 |
$2,037 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$886.50 |
$1,773 |
2.6× |
| Testicular Imaging W/Flow (78761) |
$1,027 |
$2,054 |
2.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$516 |
$1,032 |
1.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$262 |
$524 |
2.2× |
| Thoracic spine 2 views (72070) |
$253 |
$506 |
2.7× |
| Thoracic spine 3 views (72072) |
$297.50 |
$595 |
3.1× |
| Thoracolumbar 2 views (72080) |
$436 |
$872 |
5.5× |
| Thyroid Met Imaging Body (78018) |
$1,208 |
$2,416 |
2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$633 |
$1,266 |
1.7× |
| Tx Devices Design & Construction Complex (77334) |
$527.50 |
$1,055 |
1.6× |
| Tx devices design & construction intermediate (77333) |
$488 |
$976 |
4.0× |
| Tx devices design & construction simple (77332) |
$199 |
$398 |
1.6× |
| Ultrasound Breast Limited (76642) |
$289 |
$578 |
3.7× |
| Ultrasound Elastography Parenchyma (76981) |
$252.50 |
$505 |
2.7× |
| Ultrasound Exam Aaa Screen (76706) |
$278 |
$556 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$545.50 |
$1,091 |
5.8× |
| Unlisted magnetic resonance procedure (76498) |
$387 |
$774 |
4.9× |
| Upper gi w/o kub (74240) |
$428.50 |
$857 |
2.7× |
| Ureteral Reflux Study (78740) |
$720 |
$1,440 |
2.0× |
| Urethrocystogram voiding (74455) |
$571 |
$1,142 |
2.6× |
| Urethrocystography retrograde (74450) |
$1,029 |
$2,058 |
4.8× |
| Us breast unilateral complete (76641) |
$289 |
$578 |
3.1× |
| Us chest (76604) |
$272.50 |
$545 |
2.9× |
| Us complete joint (76881) |
$399.50 |
$799 |
4.2× |
| Us exam, pelvic, limited (76857) |
$399.50 |
$799 |
4.2× |
| Us head (76506) |
$364.50 |
$729 |
3.9× |
| Us kidney transplant (76776) |
$143.50 |
$287 |
1.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$375 |
$750 |
4.0× |
| Us ob limited 1 or more fetuses (76815) |
$103.50 |
$207 |
1.1× |
| Us ob transvaginal (76817) |
$124 |
$248 |
1.3× |
| Us pelvic non ob complete (76856) |
$517.50 |
$1,035 |
5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$406.50 |
$813 |
4.3× |
| Us retroperitoneal complete (76770) |
$423.50 |
$847 |
4.5× |
| Us retroperitoneal limited (76775) |
$419 |
$838 |
4.4× |
| Us scrotum and contents (76870) |
$532 |
$1,064 |
5.6× |
| Us spinal canal and contents (76800) |
$226 |
$452 |
2.4× |
| Us thyroid (76536) |
$491.50 |
$983 |
5.2× |
| Us transrectal (76872) |
$636.50 |
$1,273 |
6.7× |
| Vein X-Ray Chest (75827) |
$1,603.50 |
$3,207 |
1.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,737 |
$3,474 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$2,044 |
$4,088 |
0.7× |
| Venography Adrenal Unilateral (75840) |
$1,716 |
$3,432 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,634.50 |
$3,269 |
0.6× |
| Venography extremity bilateral rs&i (75822) |
$1,213.50 |
$2,427 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$802.50 |
$1,605 |
0.6× |
| Venography Renal Bilateral (75833) |
$1,869.50 |
$3,739 |
0.7× |
| Venography Renal Unilateral (75831) |
$1,714.50 |
$3,429 |
0.6× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$1,681 |
$3,362 |
0.3× |
| Wrist 2 views (73100) |
$92.50 |
$185 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$289 |
$578 |
3.7× |
| X-ray antegrade pyelogram tube (74425) |
$790.50 |
$1,581 |
2.5× |
| X-Ray Aorta Leg Arteries (75630) |
$2,897 |
$5,794 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$280.50 |
$561 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$95.50 |
$191 |
1.2× |
| X-Ray Exam Breast Specimen (76098) |
$199.50 |
$399 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$254 |
$508 |
3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$541.50 |
$1,083 |
5.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$157 |
$314 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$188.50 |
$377 |
2.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$219.50 |
$439 |
2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$265 |
$530 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$296 |
$592 |
3.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$327.50 |
$655 |
3.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$335.50 |
$671 |
3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$271 |
$542 |
3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$339 |
$678 |
3.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$259 |
$518 |
2.7× |
| X-ray eye for foreign body (70030) |
$153.50 |
$307 |
1.9× |
| X-ray head for orthodontia (70350) |
$424 |
$848 |
5.4× |
| X-ray humerus (73060) |
$184 |
$368 |
2.3× |
| X-ray IV pyelogram (ivp) (74400) |
$837 |
$1,674 |
5.3× |
| X-ray IV pyelogram+tomography (74415) |
$2,153 |
$4,306 |
13.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$195.50 |
$391 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$102 |
$204 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$287.50 |
$575 |
3.0× |
| X-ray nose-rectum child f.b. (76010) |
$213 |
$426 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$330 |
$660 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$223.50 |
$447 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$219.50 |
$439 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$281.50 |
$563 |
3.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$335.50 |
$671 |
3.5× |
| X-Ray Tmj Unilat (70328) |
$174 |
$348 |
2.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$846 |
$1,692 |
2.7× |
| X-Rays Bone Length Studies (77073) |
$399.50 |
$799 |
4.2× |
| X-Rays Bone Survey Complete (77075) |
$253 |
$506 |
2.7× |
| Xr c-spine 4 or 5 views (72050) |
$317.50 |
$635 |
3.4× |
| Xr facial bones less than 3 views (70140) |
$214.50 |
$429 |
2.7× |
| Xr orbits complete 4 views (70200) |
$329 |
$658 |
3.5× |