| Abdomen 2 views (74019) |
$1,631.25 |
$2,175 |
14.9× |
| Acute gi blood loss imaging (78278) |
$1,418.25 |
$1,891 |
3.4× |
| Angio Adrenal Bilat Select (75733) |
$18,146.62 |
$24,195.50 |
5.5× |
| Angiography extremity bilateral rs&i (75716) |
$8,693.62 |
$11,591.50 |
2.6× |
| Angiography extremity unilateral rs&i (75710) |
$14,365.50 |
$19,154 |
4.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$12,537.38 |
$16,716.50 |
2.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,289.25 |
$5,719 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,578.50 |
$7,438 |
1.7× |
| Angiography Spinal Selective Rs&I (75705) |
$10,949.25 |
$14,599 |
1.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$10,987.88 |
$14,650.50 |
1.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$13,139.25 |
$17,519 |
4.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,978.25 |
$7,971 |
1.8× |
| Ankle 2 views (73600) |
$814.50 |
$1,086 |
9.0× |
| Aortogram thoracic (75605) |
$9,010.12 |
$12,013.50 |
1.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,248.50 |
$6,998 |
1.6× |
| Aortography abdominal serialography rs&i (75625) |
$4,741.50 |
$6,322 |
1.4× |
| Artery X-Rays Adrenal Gland (75731) |
$8,610 |
$11,480 |
2.6× |
| Arthrogram hip (73525) |
$1,196.25 |
$1,595 |
3.3× |
| Arthrogram knee (73580) |
$1,581 |
$2,108 |
4.3× |
| Arthrogram shoulder (73040) |
$1,815 |
$2,420 |
5.0× |
| Arthrogram wrist (73115) |
$2,377.50 |
$3,170 |
6.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,650.75 |
$2,201 |
4.0× |
| Bone &/joint imaging whole body (78306) |
$2,264.25 |
$3,019 |
5.4× |
| Bone age studies (77072) |
$315 |
$420 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$2,244.75 |
$2,993 |
5.4× |
| Bone survey complete (77075) |
$3,770.25 |
$5,027 |
34.5× |
| Bowel imaging (78290) |
$3,766.50 |
$5,022 |
9.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,933.25 |
$3,911 |
5.2× |
| Brain Imaging Vascular Flow Only (78610) |
$1,134.75 |
$1,513 |
2.0× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$3,630 |
$4,840 |
8.7× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$9,786 |
$13,048 |
12.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$7,086.75 |
$9,449 |
19.5× |
| Cervical spine 2 or 3 views (72040) |
$1,997.25 |
$2,663 |
22.0× |
| Chest 1 view (71045) |
$887.25 |
$1,183 |
9.8× |
| Chest xray 3 views (71047) |
$744.75 |
$993 |
8.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$966.75 |
$1,289 |
5.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$3,216 |
$4,288 |
3.9× |
| Clavicle complete (73000) |
$1,278 |
$1,704 |
14.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,025.25 |
$1,367 |
9.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$10,899.75 |
$14,533 |
29.9× |
| CT abdomen and pelvis without contrast (74176) |
$10,467.75 |
$13,957 |
42.0× |
| CT abdomen w contrast (74160) |
$9,396 |
$12,528 |
51.3× |
| CT abdomen w wo contrast (74170) |
$9,625.50 |
$12,834 |
52.5× |
| CT abdomen w/o contrast (74150) |
$8,890.50 |
$11,854 |
81.4× |
| CT angio hrt w/3d image (75574) |
$5,988 |
$7,984 |
16.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$7,741.12 |
$10,321.50 |
42.3× |
| CT angiography upper extremity lt (73206) |
$5,478 |
$7,304 |
29.9× |
| CT c-spine w/contrast (72126) |
$6,701.25 |
$8,935 |
18.4× |
| CT c-spine w/o contrast (72125) |
$10,533.75 |
$14,045 |
96.5× |
| CT cervical spine w&w/o contrast (72127) |
$7,717.50 |
$10,290 |
42.1× |
| CT chest w contrast (71260) |
$9,045.75 |
$12,061 |
49.4× |
| CT chest w/wo contrast (71270) |
$10,771.50 |
$14,362 |
58.8× |
| CT head/brain with contrast (70460) |
$9,049.50 |
$12,066 |
49.4× |
| CT head/brain without and with contrast (70470) |
$9,498.75 |
$12,665 |
51.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,558 |
$4,744 |
9.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$1,911 |
$2,548 |
21.0× |
| CT iac w contrast (70481) |
$10,184.25 |
$13,579 |
55.6× |
| CT lower ext w/o (73700) |
$7,405.50 |
$9,874 |
67.8× |
| CT lower extremity w wo contrast (73702) |
$15,540.75 |
$20,721 |
84.8× |
| CT lower extremity w/contrast material (73701) |
$11,128.50 |
$14,838 |
60.8× |
| CT lumbar spine w & w/o contrast (72133) |
$12,527.25 |
$16,703 |
68.4× |
| CT lumbar spine w/contrast (72132) |
$8,603.25 |
$11,471 |
23.6× |
| CT lumbar spine w/o contrast (72131) |
$9,289.50 |
$12,386 |
85.1× |
| CT maxillofacial w contrast (70487) |
$9,337.12 |
$12,449.50 |
51.0× |
| CT maxillofacial w/wo contrast (70488) |
$14,178 |
$18,904 |
77.4× |
| CT maxillofacial wo contrast (70486) |
$9,653.62 |
$12,871.50 |
88.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$8,466 |
$11,288 |
46.2× |
| CT orbits w/o contrast (70480) |
$7,454.25 |
$9,939 |
68.3× |
| CT pelvis w/o contrast (72192) |
$8,298.75 |
$11,065 |
76.0× |
| CT pelvis w/wo contrast (72194) |
$12,317.25 |
$16,423 |
67.2× |
| CT scan of arm combo (73202) |
$4,197.75 |
$5,597 |
22.9× |
| CT soft tissue neck w contrast (70491) |
$9,468.75 |
$12,625 |
51.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,377.75 |
$5,837 |
23.9× |
| CT soft tissue neck w/o contrast (70490) |
$8,091 |
$10,788 |
74.1× |
| CT thoracic spine w/contrast (72129) |
$5,922.75 |
$7,897 |
32.3× |
| CT thoracic spine w/o contrast (72128) |
$7,976.25 |
$10,635 |
73.1× |
| CT thoracic spine w/wo contrast (72130) |
$7,793.25 |
$10,391 |
42.5× |
| CT thorax w/o contrast (71250) |
$7,386.75 |
$9,849 |
67.7× |
| CT upper ext wo (73200) |
$3,951 |
$5,268 |
36.2× |
| CT upper extremity with contrast (73201) |
$4,323.75 |
$5,765 |
11.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$7,611.75 |
$10,149 |
41.6× |
| Cta Abdomen (74175) |
$6,641.25 |
$8,855 |
36.3× |
| CTA abdomen pelvis (74174) |
$9,913.50 |
$13,218 |
27.2× |
| CTA chest (71275) |
$8,757.38 |
$11,676.50 |
47.8× |
| Cta Head (70496) |
$14,142 |
$18,856 |
77.2× |
| Cta Neck (70498) |
$11,943.75 |
$15,925 |
65.2× |
| Cta Pelvis (72191) |
$6,314.25 |
$8,419 |
34.5× |
| Cystography minimum 3 views rs&i (74430) |
$2,060.25 |
$2,747 |
5.7× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$2,377.50 |
$3,170 |
1.1× |
| Diskography lumbar (72295) |
$3,831 |
$5,108 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,035.75 |
$1,381 |
9.5× |
| Esophagus (74220) |
$845.25 |
$1,127 |
4.6× |
| Facial bones min 3 views (70150) |
$1,078.50 |
$1,438 |
9.9× |
| Fetal biophysical profile non-stress testing (76818) |
$1,164 |
$1,552 |
10.7× |
| Fluoroscopy up to 1 hr (76000) |
$1,517.25 |
$2,023 |
6.1× |
| Foot 2 views (73620) |
$793.50 |
$1,058 |
8.7× |
| Forearm 2 views (73090) |
$1,293.75 |
$1,725 |
14.2× |
| Functional MRI brain by tech (70554) |
$7,780.50 |
$10,374 |
31.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$3,288.75 |
$4,385 |
7.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$4,578 |
$6,104 |
8.1× |
| Hand 2 views (73120) |
$952.50 |
$1,270 |
8.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$8,241 |
$10,988 |
2.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$7,535.25 |
$10,047 |
2.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$4,085.25 |
$5,447 |
7.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$4,701.75 |
$6,269 |
11.3× |
| Hysterosalpingogram (74740) |
$2,885.25 |
$3,847 |
11.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,418 |
$3,224 |
4.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,271.25 |
$1,695 |
2.2× |
| Knee 3 views (73562) |
$1,301.25 |
$1,735 |
14.3× |
| Liver & spleen imaging static only (78215) |
$4,023 |
$5,364 |
9.6× |
| Lymphoscintigraphy (78195) |
$4,187.25 |
$5,583 |
7.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$9,768 |
$13,024 |
26.8× |
| Mr safety determination physician/other qhp (76016) |
$360 |
$480 |
4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$99.75 |
$133 |
3.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$375 |
$500 |
3.8× |
| Mr safety implt pos&/immoblj (76019) |
$243 |
$324 |
3.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$987.75 |
$1,317 |
4.0× |
| MRA head w & w/o contrast (70546) |
$4,963.50 |
$6,618 |
13.6× |
| MRA head w/o contrast (70544) |
$4,501.50 |
$6,002 |
18.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,963.50 |
$6,618 |
13.6× |
| MRA neck w/o contrast (70547) |
$4,501.50 |
$6,002 |
18.1× |
| MRI abdomen w contrast (74182) |
$4,765.50 |
$6,354 |
13.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$6,649.50 |
$8,866 |
18.3× |
| MRI abdomen w/o contrast (74181) |
$4,238.25 |
$5,651 |
17.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$6,087 |
$8,116 |
7.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$6,127.50 |
$8,170 |
16.8× |
| MRI breast w/o contrast bilateral (77047) |
$3,175.50 |
$4,234 |
12.7× |
| MRI breast wo contrast unilateral (77046) |
$3,161.25 |
$4,215 |
12.7× |
| MRI c-spine with contrast (72142) |
$7,755 |
$10,340 |
21.3× |
| MRI cardiac w/o cont stress (75559) |
$7,388.25 |
$9,851 |
12.9× |
| MRI cardiac w/o contrast (75557) |
$6,257.25 |
$8,343 |
25.1× |
| MRI cervical spine w/o contrast (72141) |
$12,495.75 |
$16,661 |
50.1× |
| MRI chest w/o & w/contrast material (71552) |
$5,991.75 |
$7,989 |
16.4× |
| MRI chest w/o contrast (71550) |
$4,748.25 |
$6,331 |
19.1× |
| MRI chest with contrast (71551) |
$8,419.50 |
$11,226 |
10.3× |
| MRI fetal sngl/1st gestation (74712) |
$2,706 |
$3,608 |
10.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$7,593.75 |
$10,125 |
20.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,418.25 |
$5,891 |
12.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,848.50 |
$3,798 |
11.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$5,352.75 |
$7,137 |
21.5× |
| MRI orbit face neck w contrast (70542) |
$8,495.25 |
$11,327 |
23.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$6,737.25 |
$8,983 |
18.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$11,038.50 |
$14,718 |
30.3× |
| MRI pelvis w/o contrast (72195) |
$8,650.50 |
$11,534 |
34.7× |
| MRI spectroscopy (76390) |
$6,910.50 |
$9,214 |
76.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$15,152.25 |
$20,203 |
41.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$7,659.75 |
$10,213 |
21.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$10,084.50 |
$13,446 |
27.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$6,875.25 |
$9,167 |
18.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$13,745.25 |
$18,327 |
37.7× |
| MRI temporomandibular joint (70336) |
$6,478.50 |
$8,638 |
26.0× |
| MRI thoracic spine w/o contrast (72146) |
$11,911.50 |
$15,882 |
47.8× |
| MRI up ext w/o contrast (73218) |
$5,928 |
$7,904 |
23.8× |
| MRI upper ext joint w/o contrast (73221) |
$5,928 |
$7,904 |
23.8× |
| MRI, joint upper extrem combo (73223) |
$9,768 |
$13,024 |
26.8× |
| Myelogram Cervical (72240) |
$6,174.75 |
$8,233 |
7.5× |
| Myelogram Lumbar (72265) |
$5,253 |
$7,004 |
6.4× |
| Myelogram thoracic (72255) |
$7,503 |
$10,004 |
9.2× |
| Myelography 2 or more regions (72270) |
$6,140.62 |
$8,187.50 |
7.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$11,227.50 |
$14,970 |
8.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$9,342.75 |
$12,457 |
6.9× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$11,320.50 |
$15,094 |
8.4× |
| Myocardial Spect Multiple Studies (78452) |
$18,569.25 |
$24,759 |
13.7× |
| Myocardial spect single study at rest or stress (78451) |
$10,800 |
$14,400 |
8.0× |
| Neck soft tissue (70360) |
$1,098.75 |
$1,465 |
12.1× |
| Nm cisternogram (78630) |
$3,297.75 |
$4,397 |
5.8× |
| Nm gastric emptying study (78264) |
$3,136.50 |
$4,182 |
7.5× |
| Nonvascular shunt X-ray (75809) |
$1,404 |
$1,872 |
12.9× |
| Nuclear Rx Oral Admin (79005) |
$3,545.25 |
$4,727 |
14.5× |
| Ob us nuchal meas 1 gest (76813) |
$1,755.75 |
$2,341 |
16.1× |
| Orthopantogram (70355) |
$721.50 |
$962 |
7.9× |
| Parathyroid Planar Imaging (78070) |
$2,577 |
$3,436 |
6.2× |
| Pelvis 1 or 2 views (72170) |
$1,411.50 |
$1,882 |
12.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$3,307.50 |
$4,410 |
7.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$4,917 |
$6,556 |
8.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,255.25 |
$3,007 |
4.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$1,518 |
$2,024 |
16.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$1,191.75 |
$1,589 |
13.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$1,641.75 |
$2,189 |
18.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$1,047.75 |
$1,397 |
11.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,693.50 |
$2,258 |
15.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$2,001.75 |
$2,669 |
18.3× |
| Radex fingr minimum 2 views (73140) |
$1,161.75 |
$1,549 |
12.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$1,236.75 |
$1,649 |
13.6× |
| Radex Hand Minimum 3 Views (73130) |
$1,314 |
$1,752 |
14.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$804.38 |
$1,072.50 |
8.9× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$1,362 |
$1,816 |
12.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$1,595.25 |
$2,127 |
14.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,595.25 |
$2,127 |
14.6× |
| Radex Humerus Minimum 2 Views (73060) |
$1,502.25 |
$2,003 |
16.5× |
| Radex Kne 1/2 Views (73560) |
$1,227.75 |
$1,637 |
13.5× |
| Radex Kne Compl 4/More Views (73564) |
$1,888.50 |
$2,518 |
17.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$913.50 |
$1,218 |
8.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$1,190.25 |
$1,587 |
13.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$1,596.75 |
$2,129 |
14.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$1,619.25 |
$2,159 |
17.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$596.25 |
$795 |
6.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$957.75 |
$1,277 |
8.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$2,013.75 |
$2,685 |
22.2× |
| Radex Toe Minimum 2 Views (73660) |
$1,542 |
$2,056 |
17.0× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$1,433.25 |
$1,911 |
15.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$2,202 |
$2,936 |
20.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$1,191.75 |
$1,589 |
13.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,833.75 |
$2,445 |
16.8× |
| Radiologic exam chest 2 views (71046) |
$1,340.25 |
$1,787 |
14.7× |
| Radiologic exam colon single contrast study (74270) |
$1,771.50 |
$2,362 |
9.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,078.50 |
$1,438 |
5.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,374 |
$1,832 |
7.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,254.75 |
$1,673 |
6.9× |
| Radiologic examination femur 1 view (73551) |
$621.75 |
$829 |
6.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$1,159.50 |
$1,546 |
12.8× |
| Radiological examination surgical specimen (76098) |
$1,084.50 |
$1,446 |
1.9× |
| Ribs bilateral 3 views (71110) |
$1,025.25 |
$1,367 |
9.4× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$2,562 |
$3,416 |
6.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,198 |
$4,264 |
7.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$7,526.25 |
$10,035 |
13.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$4,593 |
$6,124 |
8.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,999 |
$5,332 |
7.1× |
| Scapula (73010) |
$1,102.50 |
$1,470 |
10.1× |
| Shoulder 1 view (73020) |
$689.25 |
$919 |
7.6× |
| Small bowel series (74250) |
$1,407 |
$1,876 |
7.7× |
| Spine thoracic 3 views (72072) |
$1,154.25 |
$1,539 |
10.6× |
| Testicular Imaging With Vascular Flow (78761) |
$3,621 |
$4,828 |
8.7× |
| Thyroid uptake measurement (78012) |
$2,585.25 |
$3,447 |
6.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$4,788 |
$6,384 |
11.5× |
| Tomogram (76100) |
$1,395.75 |
$1,861 |
12.8× |
| Ultrasound breast complete (76641) |
$693 |
$924 |
6.3× |
| Ultrasound, abdomen limited (76705) |
$3,018 |
$4,024 |
27.6× |
| Unlisted magnetic resonance procedure (76498) |
$6,951 |
$9,268 |
76.5× |
| Urethrocystogram voiding (74455) |
$2,149.50 |
$2,866 |
8.6× |
| Urethrocystography retrograde rs&i (74450) |
$1,520.25 |
$2,027 |
6.1× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$2,451.75 |
$3,269 |
13.4× |
| Us breast unilateral limited (76642) |
$420.75 |
$561 |
4.6× |
| Us chest (76604) |
$1,130.25 |
$1,507 |
10.4× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$2,967.75 |
$3,957 |
13.2× |
| Us compl joint r-t w/image documentation (76881) |
$1,274.25 |
$1,699 |
11.7× |
| Us encephalogram (76506) |
$1,742.25 |
$2,323 |
16.0× |
| Us infant hips w manipulation (76885) |
$1,700.25 |
$2,267 |
18.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$712.50 |
$950 |
6.5× |
| Us ob detailed single fetus (76811) |
$1,241.25 |
$1,655 |
5.0× |
| Us ob limited (76815) |
$399.75 |
$533 |
3.7× |
| Us ob transvaginal (76817) |
$2,224.50 |
$2,966 |
20.4× |
| Us pelvic non ob complete (76856) |
$2,299.50 |
$3,066 |
21.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,051.50 |
$1,402 |
9.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,324.50 |
$1,766 |
12.1× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$351 |
$468 |
3.2× |
| Us retroperitoneal complete (76770) |
$1,847.25 |
$2,463 |
16.9× |
| Us retroperitoneal limited (76775) |
$750 |
$1,000 |
6.9× |
| Us scrotum and contents (76870) |
$3,414 |
$4,552 |
31.3× |
| Us soft tissue head/neck (76536) |
$1,387.50 |
$1,850 |
12.7× |
| Us spinal canal and contents (76800) |
$2,017.50 |
$2,690 |
18.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,482 |
$1,976 |
13.6× |
| Venogram extremity bilateral (75822) |
$2,082 |
$2,776 |
1.3× |
| Venogram Extremity Unilateral (75820) |
$6,564.75 |
$8,753 |
4.0× |
| Venography caval inferior serialography rs&i (75825) |
$4,713.38 |
$6,284.50 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$3,805.50 |
$5,074 |
2.3× |
| Venography Renal Bilateral (75833) |
$13,708.50 |
$18,278 |
4.2× |
| Venography renal unilateral selective rs&i (75831) |
$13,708.50 |
$18,278 |
4.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,325.25 |
$5,767 |
1.3× |
| Venous sampling by catheter (75893) |
$9,426 |
$12,568 |
1.6× |
| Wrist 2 views (73100) |
$1,171.50 |
$1,562 |
12.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$2,343 |
$3,124 |
21.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$2,026.50 |
$2,702 |
22.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,802.25 |
$2,403 |
9.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,238.25 |
$1,651 |
13.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$1,238.62 |
$1,651.50 |
13.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,370.25 |
$1,827 |
12.6× |
| X-ray exam of femur 2/> (73552) |
$723.75 |
$965 |
8.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$861 |
$1,148 |
9.5× |
| X-ray IV pyelogram (ivp) (74400) |
$2,274.75 |
$3,033 |
12.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$913.50 |
$1,218 |
10.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$1,091.25 |
$1,455 |
12.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,631.62 |
$2,175.50 |
14.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,861.50 |
$2,482 |
17.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,301.25 |
$1,735 |
11.9× |
| X-ray retrograde pyelogram (74420) |
$2,250 |
$3,000 |
6.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$897.75 |
$1,197 |
9.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,319.25 |
$1,759 |
12.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,089.75 |
$1,453 |
10.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,077.75 |
$1,437 |
9.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,057.50 |
$1,410 |
11.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,393.50 |
$1,858 |
15.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,839 |
$2,452 |
16.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,078.50 |
$1,438 |
9.9× |
| X-Ray Small Bowel Enteroclysis (74251) |
$4,387.50 |
$5,850 |
24.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$1,042.50 |
$1,390 |
11.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$561 |
$748 |
6.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$863.25 |
$1,151 |
9.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,983.75 |
$2,645 |
18.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$2,026.50 |
$2,702 |
18.6× |
| Xr bone length studies (77073) |
$707.25 |
$943 |
6.5× |
| Xr c-spine 4 or 5 views (72050) |
$2,313 |
$3,084 |
21.2× |
| Xr c-spine 6 or more views (72052) |
$2,313 |
$3,084 |
21.2× |
| Xr chest 4+ views (71048) |
$1,134.75 |
$1,513 |
10.4× |
| Xr urogram antegrade (74425) |
$726 |
$968 |
2.0× |