| Brachytx Isodose Plan Simple (77316) |
$103.28 |
$344.25 |
0.3× |
| Cat Scan Follow-Up Study (76380) |
$110.40 |
$368 |
1.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$60.60 |
$202 |
0.6× |
| Clavicle complete (73000) |
$69.96 |
$233.20 |
0.8× |
| Continuing medical physics consltj pr wk (77336) |
$103.28 |
$344.25 |
0.8× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$87 |
$290 |
0.5× |
| CT bone density (77078) |
$145.65 |
$485.50 |
1.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$81.99 |
$273.30 |
0.9× |
| CT maxillofacial wo contrast (70486) |
$383.13 |
$1,277.10 |
3.6× |
| CT orbits w/o contrast (70480) |
$94.50 |
$315 |
0.9× |
| CT thoracic spine w/o contrast (72128) |
$554.40 |
$1,848 |
5.3× |
| CT thorax w/o contrast (71250) |
$500.25 |
$1,667.50 |
4.8× |
| Echo Guide For Artery Repair (76936) |
$180.60 |
$602 |
0.8× |
| Echograp Trans R Pros Study (76873) |
$105.52 |
$351.75 |
1.0× |
Esophagram (74220)
range across 2 matching MRF lines |
$68.40–$91.74 |
$228–$305.80 |
varies |
| Fluoroscopy up to 1 hr (76000) |
$162.22 |
$540.75 |
0.7× |
| Forearm 2 views (73090) |
$59.40 |
$198 |
0.7× |
| Infusion Ivp (74410) |
$160.50 |
$535 |
0.9× |
| Neck soft tissue (70360) |
$68.97 |
$229.90 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$78.21 |
$260.70 |
0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$72.60 |
$242 |
0.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$54.90 |
$183 |
0.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$227.56 |
$758.52 |
2.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$133.56 |
$445.20 |
1.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$315 |
$1,050 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$83.16 |
$277.20 |
1.0× |
| Radex Toe Minimum 2 Views (73660) |
$52.80 |
$176 |
0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$69.96 |
$233.20 |
0.8× |
| Radiation treatment delivery level 2 (77407) |
$103.28 |
$344.25 |
0.3× |
| Radiation treatment delivery level 3 (77412) |
$112.20 |
$374 |
0.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$81 |
$270 |
0.8× |
| Radiologic exam swallow function contrast study (74230) |
$83.40 |
$278 |
0.5× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$151.20 |
$504 |
0.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$71.70 |
$239 |
0.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$69.96 |
$233.20 |
0.8× |
| Renal Cyst Study (74470) |
$61.80 |
$206 |
0.1× |
| Sella turcica (70240) |
$63.69 |
$212.30 |
0.7× |
| Sialogram (70390) |
$245.75 |
$819.16 |
1.0× |
| Special dosimetry (77331) |
$73.95 |
$246.50 |
0.5× |
Sternoclavicular joints (71130)
range across 2 matching MRF lines |
$54.45–$171.66 |
$181.50–$572.20 |
varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$48.45 |
$161.50 |
0.1× |
| Thoracic spine 3 views (72072) |
$97.35 |
$324.50 |
0.9× |
| Thoracolumbar 2 views (72080) |
$75.60 |
$252 |
0.9× |
| Us head (76506) |
$152.14 |
$507.15 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$487.86 |
$1,626.19 |
0.3× |
| Wrist 2 views (73100) |
$50.10 |
$167 |
0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$82.50 |
$275 |
0.9× |
| X-ray antegrade pyelogram tube (74425) |
$345.30 |
$1,151.01 |
1.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$95.70 |
$319 |
0.9× |
| X-ray eye for foreign body (70030) |
$126.35 |
$421.16 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$53.10 |
$177 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$95.70 |
$319 |
0.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$119.38 |
$397.95 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$85.80 |
$286 |
1.0× |
| X-Rays Bone Length Studies (77073) |
$94.05 |
$313.50 |
0.9× |
| X-Rays Bone Survey Complete (77075) |
$179.85 |
$599.50 |
1.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$119.38 |
$397.95 |
1.1× |