| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,735.43 |
$5,746.81 |
2.7× |
| Abdomen 2 views (74019) |
$160.68 |
$247.20 |
1.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$663.22 |
$1,020.34 |
1.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,976.67 |
$4,579.49 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,531.61 |
$5,433.25 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$2,775.08 |
$4,269.35 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,971.64 |
$9,187.14 |
1.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,493.89 |
$3,836.75 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,495 |
$3,838.46 |
0.8× |
| Angiography Spinal Selective Rs&I (75705) |
$5,918.78 |
$9,105.81 |
1.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,816.15 |
$5,871 |
0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,863.98 |
$5,944.59 |
1.2× |
| Ankle 2 views (73600) |
$160.68 |
$247.20 |
1.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$468.65 |
$721 |
1.4× |
| Aortogram thoracic (75605) |
$5,971.64 |
$9,187.14 |
1.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,253.77 |
$5,005.80 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,016.10 |
$4,640.15 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,755.63 |
$4,239.44 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$3,461.13 |
$5,324.81 |
1.1× |
| Arthrogram elbow (73085) |
$353.24 |
$543.45 |
1.0× |
| Arthrogram hip (73525) |
$625.09 |
$961.68 |
1.8× |
| Arthrogram shoulder (73040) |
$596.95 |
$918.38 |
1.7× |
| Arthrogram wrist (73115) |
$350.10 |
$538.61 |
1.0× |
| Arthrography knee lt (73580) |
$640.72 |
$985.73 |
1.9× |
| Basic radiation dosimetry calculation (77300) |
$423.74 |
$651.90 |
3.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,472.86 |
$2,265.94 |
3.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$682.52 |
$1,050.03 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$1,472.86 |
$2,265.94 |
3.7× |
| Bone age studies (77072) |
$164.03 |
$252.35 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,472.86 |
$2,265.94 |
3.7× |
| Bone Marrow Imaging Limited Area (78102) |
$498.44 |
$766.83 |
1.3× |
| Bone survey complete (77075) |
$415.09 |
$638.60 |
4.0× |
| Brachytx isodose complex (77318) |
$1,394.11 |
$2,144.78 |
3.8× |
| Brachytx isodose intermed (77317) |
$1,394.11 |
$2,144.78 |
3.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$837.74 |
$1,288.83 |
2.3× |
| Brain image w/flow 4 + views (78606) |
$569.55 |
$876.23 |
1.1× |
| Brain Imaging Minimum 4 Static Views (78605) |
$582.90 |
$896.77 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,974.71 |
$7,653.40 |
3.5× |
| Brain Imaging Vascular Flow Only (78610) |
$564.79 |
$868.91 |
1.0× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$173.14 |
$266.37 |
15.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,022.40 |
$1,572.93 |
2.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$803.58 |
$1,236.27 |
2.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$677.79 |
$1,042.75 |
1.3× |
| Cervical spine 2 or 3 views (72040) |
$160.68 |
$247.20 |
1.9× |
| Chest 1 view (71045) |
$160.68 |
$247.20 |
1.9× |
| Chest 3 views (71047) |
$160.68 |
$247.20 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$241.02 |
$370.80 |
1.4× |
| Clavicle complete (73000) |
$160.68 |
$247.20 |
1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$519.68 |
$799.50 |
5.0× |
| Continuing medical physics consltj pr wk (77336) |
$644.25 |
$991.16 |
4.8× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$219.82 |
$338.19 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$803.58 |
$1,236.27 |
2.3× |
| CT abdomen and pelvis without contrast (74176) |
$803.58 |
$1,236.27 |
3.4× |
| CT abdomen w contrast (74160) |
$803.58 |
$1,236.27 |
4.6× |
| CT abdomen w wo contrast (74170) |
$803.58 |
$1,236.27 |
4.6× |
| CT abdomen w/o contrast (74150) |
$803.58 |
$1,236.27 |
7.8× |
| CT angio hrt w/3d image (75574) |
$803.58 |
$1,236.27 |
2.3× |
| CT angiography upper extremity lt (73206) |
$803.58 |
$1,236.27 |
4.6× |
| CT c-spine w/o contrast (72125) |
$803.58 |
$1,236.27 |
7.8× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$205.81 |
$316.63 |
1.2× |
| CT cervical spine w&w/o contrast (72127) |
$803.58 |
$1,236.27 |
4.6× |
| CT cervical spine with contrast (72126) |
$803.58 |
$1,236.27 |
2.3× |
| CT chest w/wo contrast (71270) |
$803.58 |
$1,236.27 |
4.6× |
| CT chest with contrast (71260) |
$803.58 |
$1,236.27 |
4.6× |
| CT colonography screening (74263) |
$463.81 |
$713.56 |
2.0× |
| CT colonography w/dye (74262) |
$204.87 |
$315.18 |
1.2× |
| CT colonography w/o cntrst (74261) |
$498.12 |
$766.34 |
4.8× |
| CT head/brain with contrast (70460) |
$803.58 |
$1,236.27 |
4.6× |
| CT head/brain without and with contrast (70470) |
$803.58 |
$1,236.27 |
4.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$803.58 |
$1,236.27 |
2.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$19.50 |
$30 |
0.2× |
| CT hrt w/3d image congen (75573) |
$792.12 |
$1,218.65 |
2.3× |
| CT iac w contrast (70481) |
$803.58 |
$1,236.27 |
4.6× |
| CT lower ext w/o (73700) |
$803.58 |
$1,236.27 |
7.8× |
| CT lower extremity w wo contrast (73702) |
$803.58 |
$1,236.27 |
4.6× |
| CT lower extremity with contrast (73701) |
$803.58 |
$1,236.27 |
4.6× |
| CT lumbar spine w & w/o contrast (72133) |
$803.58 |
$1,236.27 |
4.6× |
| CT lumbar spine w/o contrast (72131) |
$803.58 |
$1,236.27 |
7.8× |
| CT lumbar spine with contrast (72132) |
$803.58 |
$1,236.27 |
2.3× |
| CT maxillofacial w contrast (70487) |
$803.58 |
$1,236.27 |
4.6× |
| CT maxillofacial w/o contrast (70486) |
$803.58 |
$1,236.27 |
7.8× |
| CT maxillofacial w/wo contrast (70488) |
$803.58 |
$1,236.27 |
4.6× |
| CT neck soft tissue w contrast (70491) |
$803.58 |
$1,236.27 |
4.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$803.58 |
$1,236.27 |
4.6× |
| CT orbits w/o contrast (70480) |
$803.58 |
$1,236.27 |
7.8× |
| CT pelvis w & w/o contrast (72194) |
$803.58 |
$1,236.27 |
4.6× |
| CT pelvis w/o contrast (72192) |
$803.58 |
$1,236.27 |
7.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$219.92 |
$338.34 |
2.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$803.58 |
$1,236.27 |
4.6× |
| CT soft tissue neck w/o contrast (70490) |
$803.58 |
$1,236.27 |
7.8× |
| CT thoracic spine w/contrast (72129) |
$803.58 |
$1,236.27 |
4.6× |
| CT thoracic spine w/o contrast (72128) |
$803.58 |
$1,236.27 |
7.8× |
| CT thoracic spine w/wo contrast (72130) |
$803.58 |
$1,236.27 |
4.6× |
| CT thorax w/o contrast (71250) |
$803.58 |
$1,236.27 |
7.8× |
| CT unlisted procedure (76497) |
$792.12 |
$1,218.65 |
9.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$803.58 |
$1,236.27 |
4.6× |
| CT upper extremity w/o contrast rt (73200) |
$803.58 |
$1,236.27 |
7.8× |
| CT upper extremity with contrast (73201) |
$803.58 |
$1,236.27 |
2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$803.58 |
$1,236.27 |
4.6× |
| Cta Abdomen (74175) |
$803.58 |
$1,236.27 |
4.6× |
| CTA abdomen pelvis (74174) |
$803.58 |
$1,236.27 |
2.3× |
| CTA chest (71275) |
$803.58 |
$1,236.27 |
4.6× |
| Cta Head (70496) |
$803.58 |
$1,236.27 |
4.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$409.35 |
$629.77 |
1.2× |
| CTA lwr ext w&w/o contrast (73706) |
$803.58 |
$1,236.27 |
4.6× |
| Cta Neck (70498) |
$803.58 |
$1,236.27 |
4.6× |
| Cta Pelvis (72191) |
$803.58 |
$1,236.27 |
4.6× |
| Cystography minimum 3 views rs&i (74430) |
$324.71 |
$499.55 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$92.04 |
$141.60 |
0.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$420.71 |
$647.25 |
4.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$169.90 |
$261.39 |
1.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$411.74 |
$633.45 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$67.35 |
$103.62 |
0.8× |
| Echo exam of fetal heart (76825) |
$630.51 |
$970.01 |
1.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$345.38 |
$531.35 |
1.5× |
| Echoencephalography real time imaging (76506) |
$467.04 |
$718.53 |
4.5× |
| Esophagus (74220) |
$247.72 |
$381.10 |
1.4× |
| Fetal biophysical profile non-stress testing (76818) |
$372.16 |
$572.55 |
3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$727.47 |
$1,119.19 |
7.0× |
| Fluoroscopy up to 1 hr (76000) |
$535.60 |
$824 |
2.3× |
| Foot 2 views (73620) |
$160.68 |
$247.20 |
1.9× |
| Forearm 2 views (73090) |
$160.68 |
$247.20 |
1.9× |
| Gated Heart Planar Single (78472) |
$1,477.42 |
$2,272.95 |
3.7× |
| Hand 2 views (73120) |
$160.68 |
$247.20 |
1.6× |
| Hand 3 views (73130) |
$160.68 |
$247.20 |
1.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,743.97 |
$5,759.95 |
5.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,902.59 |
$4,465.53 |
4.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,836.28 |
$4,363.50 |
4.1× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$440.07 |
$677.03 |
1.2× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$396.07 |
$609.34 |
1.0× |
| Heart Infarct Image (78466) |
$533.55 |
$820.85 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,568.92 |
$5,490.65 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,093.05 |
$1,681.61 |
2.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,201.73 |
$1,848.82 |
3.0× |
| Ht muscle image spect sing (78451) |
$2,454.78 |
$3,776.58 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$160.68 |
$247.20 |
1.9× |
| Hysterosalpingogram (74740) |
$354.84 |
$545.90 |
1.5× |
| Interstitial radiation source applic complex (77778) |
$4,401.58 |
$6,771.66 |
6.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$160.68 |
$247.20 |
1.6× |
| Kidney imaging morphology (78700) |
$632.67 |
$973.34 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$761.36 |
$1,171.33 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$906.93 |
$1,395.28 |
1.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$894.33 |
$1,375.89 |
1.7× |
| Knee 3 views (73562) |
$160.68 |
$247.20 |
1.9× |
| Liver & spleen imaging static only (78215) |
$1,104.65 |
$1,699.46 |
2.8× |
| Liver imaging static only (78201) |
$587.45 |
$903.77 |
1.1× |
| Lung perf&ventilat diferentl (78598) |
$624.72 |
$961.10 |
1.2× |
| Lung perfusion differential (78597) |
$1,104.65 |
$1,699.46 |
2.8× |
| Lung Ventilation Imaging (78579) |
$998.22 |
$1,535.73 |
2.5× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$3,652.32 |
$5,618.96 |
1.2× |
| Lymphoscintigraphy (78195) |
$1,104.65 |
$1,699.46 |
2.1× |
| Mammary ductogram or galactogram multiple (77054) |
$249.50 |
$383.85 |
1.1× |
| Mammary ductogram or galactogram single (77053) |
$415.93 |
$639.89 |
1.8× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$113.02 |
$173.87 |
1.3× |
| Meckels Diverticulum (78290) |
$660.74 |
$1,016.53 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,334.08 |
$2,052.43 |
3.6× |
| Mr safety determination physician/other qhp (76016) |
$100.56 |
$154.71 |
1.2× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$67.83 |
$104.36 |
1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$27.96 |
$43.02 |
1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$104.84 |
$161.29 |
1.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$276.05 |
$424.69 |
1.2× |
| MRA head w & w/o contrast (70546) |
$780 |
$1,200 |
2.3× |
| MRA head w/o contrast (70544) |
$803.58 |
$1,236.27 |
3.4× |
| MRA head with contrast (70545) |
$792.12 |
$1,218.65 |
2.3× |
| MRA neck w contrast (70548) |
$792.12 |
$1,218.65 |
2.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$803.58 |
$1,236.27 |
2.3× |
| MRA neck w/o contrast (70547) |
$803.58 |
$1,236.27 |
3.4× |
| MRI abdomen w contrast (74182) |
$791.70 |
$1,218 |
2.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$803.58 |
$1,236.27 |
2.3× |
| MRI abdomen w/o contrast (74181) |
$803.58 |
$1,236.27 |
3.4× |
| MRI any jnt lwr ext with con lt (73722) |
$803.58 |
$1,236.27 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$803.58 |
$1,236.27 |
1.0× |
| MRI breast w/o contrast bilateral (77047) |
$780 |
$1,200 |
3.3× |
| MRI breast w/o contrast unilat (77046) |
$792.12 |
$1,218.65 |
3.3× |
| MRI c-spine with contrast (72142) |
$803.58 |
$1,236.27 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$791.70 |
$1,218 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$803.58 |
$1,236.27 |
3.4× |
| MRI chest w/o & w/contrast material (71552) |
$803.58 |
$1,236.27 |
2.3× |
| MRI chest w/o contrast (71550) |
$803.58 |
$1,236.27 |
3.4× |
| MRI chest with contrast (71551) |
$761.66 |
$1,171.78 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$792.12 |
$1,218.65 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$803.58 |
$1,236.27 |
2.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$803.58 |
$1,236.27 |
3.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$803.58 |
$1,236.27 |
3.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$803.58 |
$1,236.27 |
2.3× |
| MRI orbit/face/neck w/contrast (70542) |
$835.72 |
$1,285.72 |
2.4× |
| MRI pelvis w contrast (72196) |
$823.37 |
$1,266.72 |
2.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$803.58 |
$1,236.27 |
2.3× |
| MRI pelvis w/o contrast (72195) |
$803.58 |
$1,236.27 |
3.4× |
| MRI scan of arm joint before and after contrast (73223) |
$803.58 |
$1,236.27 |
2.3× |
| MRI scan of leg joint before and after contrast (73723) |
$803.58 |
$1,236.27 |
2.3× |
| MRI spectroscopy (76390) |
$792.12 |
$1,218.65 |
9.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$803.58 |
$1,236.27 |
2.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$803.58 |
$1,236.27 |
2.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$803.58 |
$1,236.27 |
2.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$803.58 |
$1,236.27 |
2.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$801.60 |
$1,233.23 |
2.3× |
| MRI thoracic spine w/o contrast (72146) |
$803.58 |
$1,236.27 |
3.4× |
| MRI tmj (70336) |
$780 |
$1,200 |
3.3× |
| MRI upper ext joint w/o contrast (73221) |
$803.58 |
$1,236.27 |
3.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$800.28 |
$1,231.20 |
2.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$803.58 |
$1,236.27 |
3.4× |
| Myelogram Cervical (72240) |
$1,230.27 |
$1,892.72 |
1.6× |
| Myelogram Lumbar (72265) |
$1,193.33 |
$1,835.89 |
1.5× |
| Myelogram thoracic (72255) |
$1,071.20 |
$1,648 |
1.4× |
| Myelography 2 or more regions (72270) |
$1,820.78 |
$2,801.20 |
2.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,974.71 |
$7,653.40 |
3.9× |
| Myocardial infarct spect (78469) |
$993.52 |
$1,528.50 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$2,272.76 |
$3,496.55 |
1.8× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,119.10 |
$1,721.70 |
1.3× |
| Neck soft tissue (70360) |
$160.68 |
$247.20 |
1.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$2,571.01 |
$3,955.40 |
6.7× |
| Nm cisternogram (78630) |
$1,284.35 |
$1,975.92 |
2.4× |
| Nm csf leak detection (78650) |
$1,046.17 |
$1,609.49 |
0.8× |
| Nm gastric emptying study (78264) |
$1,104.65 |
$1,699.46 |
2.8× |
| Nm gastroesophageal reflux study (78262) |
$474.56 |
$730.09 |
1.2× |
| Nm peritoneal-venous shunt patency (78291) |
$445.54 |
$685.44 |
1.1× |
| Nm whole blood volume (78122) |
$615.84 |
$947.45 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,735.43 |
$5,746.81 |
2.7× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$4,974.71 |
$7,653.40 |
3.5× |
| Nuclear medicine study of endocrine organs (78099) |
$374.44 |
$576.06 |
0.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$884.81 |
$1,361.25 |
2.2× |
| Nuclear Rx Oral Admin (79005) |
$1,136.47 |
$1,748.42 |
4.9× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$571.76 |
$879.63 |
5.5× |
| Orthopantogram (70355) |
$160.68 |
$247.20 |
1.9× |
| Osseous survey infant (77076) |
$164.03 |
$252.35 |
1.6× |
| Osseous survey limited (77074) |
$190.81 |
$293.55 |
1.8× |
| Parathyrd planar w/spect&CT (78072) |
$1,077.43 |
$1,657.59 |
2.0× |
| Parathyrd planar w/wo subtrj (78071) |
$1,077.43 |
$1,657.59 |
2.7× |
| Parathyroid imaging (78070) |
$561.52 |
$863.87 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$160.68 |
$247.20 |
1.6× |
| PET image w/CT, skull-thigh (78815) |
$4,810.47 |
$7,400.72 |
3.4× |
| PET imaging CT for attenuation limited area (78814) |
$4,974.71 |
$7,653.40 |
3.5× |
| PET imaging for CT attenuation whole body (78816) |
$4,699.05 |
$7,229.31 |
3.3× |
| PET imaging limited area chest head/neck (78811) |
$4,974.71 |
$7,653.40 |
3.9× |
| PET whole body (78813) |
$4,974.71 |
$7,653.40 |
3.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$803.58 |
$1,236.27 |
2.3× |
| Pr red cell survival study (78130) |
$475.76 |
$731.94 |
1.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,468.69 |
$5,336.44 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,461.13 |
$5,324.81 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,104.65 |
$1,699.46 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,225.42 |
$1,885.26 |
2.3× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$1,091.60 |
$1,679.38 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$393.31 |
$605.08 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$160.68 |
$247.20 |
1.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$160.68 |
$247.20 |
1.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$160.68 |
$247.20 |
1.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$158.67 |
$244.11 |
1.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$203.12 |
$312.50 |
2.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,804.89 |
$24,315.22 |
2.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$674.21 |
$1,037.24 |
1.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$536.51 |
$825.40 |
5.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$550.97 |
$847.65 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$160.68 |
$247.20 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$160.68 |
$247.20 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$160.68 |
$247.20 |
1.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$160.68 |
$247.20 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$311.32 |
$478.95 |
1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$230.98 |
$355.35 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$301.28 |
$463.50 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$241.02 |
$370.80 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$160.68 |
$247.20 |
1.9× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$171.68 |
$264.12 |
2.0× |
| Radiological examination surgical specimen (76098) |
$632.97 |
$973.80 |
1.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,574.23 |
$3,960.35 |
0.8× |
| Ribs bilateral 3 views (71110) |
$184.11 |
$283.25 |
1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,264.63 |
$3,484.05 |
5.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,428.17 |
$2,197.18 |
2.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,156.65 |
$1,779.46 |
2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,378.39 |
$5,197.52 |
2.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,670.13 |
$2,569.43 |
1.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$327.03 |
$503.13 |
1.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$302.38 |
$465.20 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$557.84 |
$858.21 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$160.68 |
$247.20 |
1.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$412.20 |
$634.16 |
1.7× |
| Scanogram (77073) |
$467.89 |
$719.84 |
4.5× |
| Scapula complete (73010) |
$160.68 |
$247.20 |
1.6× |
| Screening digital breast tomosynthesis (77063) |
$41.82 |
$64.34 |
1.8× |
| Sella turcica (70240) |
$101.42 |
$156.03 |
1.2× |
| Simulation intermediate (77285) |
$976.26 |
$1,501.94 |
2.6× |
| Small bowel series (74250) |
$267.80 |
$412 |
1.5× |
| Spec medical radj physics consltj (77370) |
$644.25 |
$991.16 |
4.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,459.86 |
$2,245.94 |
3.9× |
| Special dosimetry (77331) |
$371.86 |
$572.10 |
2.8× |
| Special treatment procedure (77470) |
$1,467.50 |
$2,257.70 |
2.7× |
| Spine thoracic 3 views (72072) |
$160.68 |
$247.20 |
1.6× |
| Spleen imaging only (78185) |
$429.45 |
$660.69 |
1.1× |
| Splenoportograpy rs&i (75810) |
$3,461.13 |
$5,324.81 |
1.1× |
| Stereotactic body radiation delivery (77373) |
$11,645.71 |
$17,916.47 |
6.6× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$345.63 |
$531.74 |
3.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,340.44 |
$3,600.67 |
6.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,093.94 |
$3,221.45 |
5.6× |
| Testicular Imaging With Vascular Flow (78761) |
$440.56 |
$677.78 |
1.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,287.63 |
$1,980.97 |
3.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$659.49 |
$1,014.60 |
4.9× |
| Thoracolumbar 2 views (72080) |
$160.68 |
$247.20 |
1.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,104.65 |
$1,699.46 |
2.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$424.49 |
$653.06 |
1.1× |
| Thyroid uptake measurement (78012) |
$260.01 |
$400.01 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$655.99 |
$1,009.22 |
1.7× |
| Tomogram (76100) |
$460.24 |
$708.06 |
4.4× |
| Treatment device intermediate (77333) |
$717.72 |
$1,104.18 |
5.4× |
| Treatment devices simple (77332) |
$727.83 |
$1,119.74 |
5.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,621.79 |
$2,495.06 |
3.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$582.22 |
$895.72 |
1.5× |
| Tx devices design & construction complex (77334) |
$917.90 |
$1,412.15 |
2.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$236.26 |
$363.48 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$537.31 |
$826.63 |
5.2× |
| Umbilical-artery Doppler (OB) (76820) |
$169.90 |
$261.39 |
1.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$85.18 |
$131.04 |
1.0× |
| Unlisted fluoroscopic procedure (76496) |
$103.19 |
$158.75 |
1.2× |
| Unlisted magnetic resonance procedure (76498) |
$803.58 |
$1,236.27 |
9.3× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$655.35 |
$1,008.23 |
1.7× |
| Unlisted Ultrasound Procedure (76999) |
$334.70 |
$514.93 |
3.9× |
| Upper Extremity Infant (73092) |
$160.68 |
$247.20 |
1.6× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$1,009.81 |
$1,553.56 |
10.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$457.51 |
$703.86 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$277.84 |
$427.45 |
1.2× |
| Urethrocystography voiding (74455) |
$100.42 |
$154.50 |
0.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$836.88 |
$1,287.50 |
4.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$328.06 |
$504.70 |
1.9× |
| Us abdl aorta screen aaa (76706) |
$393.06 |
$604.71 |
3.8× |
| Us breast unilateral complete (76641) |
$571.76 |
$879.63 |
5.5× |
| Us breast unilateral limited (76642) |
$571.76 |
$879.63 |
6.6× |
| Us chest (76604) |
$399.08 |
$613.98 |
3.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$335.32 |
$515.87 |
3.2× |
| Us guided compression repair (76936) |
$937.68 |
$1,442.59 |
4.4× |
| Us infant hips dynamic (76885) |
$393.95 |
$606.08 |
4.6× |
| Us infant hips limited static (76886) |
$399.51 |
$614.63 |
4.6× |
| Us kidney transplant (76776) |
$563.82 |
$867.41 |
5.4× |
| Us ob detailed single fetus (76811) |
$456.70 |
$702.62 |
1.9× |
| Us ob transvaginal (76817) |
$623.76 |
$959.63 |
6.0× |
| Us pelvic non ob complete (76856) |
$914.71 |
$1,407.24 |
8.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$571.76 |
$879.63 |
5.5× |
| Us pregnancy ltd (76815) |
$571.66 |
$879.48 |
5.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$823.34 |
$1,266.68 |
7.9× |
| Us retroperitoneal complete (76770) |
$753.47 |
$1,159.19 |
7.3× |
| Us retroperitoneal limited (76775) |
$571.76 |
$879.63 |
5.5× |
| Us scrotum and contents (76870) |
$623.76 |
$959.63 |
6.0× |
| Us soft tissue head/neck (76536) |
$623.74 |
$959.60 |
6.0× |
| Us spinal canal and contents (76800) |
$468.12 |
$720.19 |
4.5× |
| Us transrectal prostate volume (76873) |
$2,707.67 |
$4,165.65 |
26.1× |
| Us xtr non-vasc lmtd (76882) |
$519.73 |
$799.59 |
5.0× |
| Venogram extremity bilateral (75822) |
$1,505.02 |
$2,315.42 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,464.66 |
$5,330.25 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$1,023.42 |
$1,574.49 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$1,138.15 |
$1,751 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,435.07 |
$3,746.26 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,475.54 |
$3,808.52 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,461.14 |
$5,324.83 |
1.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,971.64 |
$9,187.14 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$79.57 |
$122.42 |
0.9× |
| Wrist 2 views (73100) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$401.70 |
$618 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$160.68 |
$247.20 |
1.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$378.27 |
$581.95 |
3.6× |
| X-ray exam hip uni 1 view (73501) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$160.68 |
$247.20 |
1.9× |
| X-ray exam hip uni 4/> views (73503) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$200.85 |
$309 |
1.9× |
| X-ray exam of femur 1 (73551) |
$160.68 |
$247.20 |
1.9× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,601.81 |
$2,464.33 |
9.2× |
| X-ray eye for foreign body (70030) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$158.67 |
$244.11 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$160.68 |
$247.20 |
1.9× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,708.58 |
$2,628.58 |
0.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$160.68 |
$247.20 |
1.9× |
| X-ray IV pyelogram+drip infusn (74410) |
$387.09 |
$595.53 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$162.69 |
$250.29 |
1.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$776.39 |
$1,194.45 |
2.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$133.18 |
$204.90 |
1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$160.68 |
$247.20 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$158.53 |
$243.89 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$160.68 |
$247.20 |
1.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$160.68 |
$247.20 |
1.9× |
| Xr arthrogram ankle (73615) |
$318.01 |
$489.25 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$160.68 |
$247.20 |
1.6× |
| Xr chest 4+ views (71048) |
$164.03 |
$252.35 |
1.6× |
| Xr Cholecystography Oral Contrast (74290) |
$182.46 |
$280.71 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$160.68 |
$247.20 |
1.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$158.67 |
$244.11 |
1.5× |
| Xr optic foramina (70190) |
$160.68 |
$247.20 |
1.9× |
| Xr shoulder 1 view (73020) |
$160.68 |
$247.20 |
1.9× |
| Xr spine cervical 4 or 5 views (72050) |
$160.68 |
$247.20 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$160.68 |
$247.20 |
1.9× |
| Xr tmj bilateral (70330) |
$162.69 |
$250.29 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$160.68 |
$247.20 |
1.9× |