| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,902.20 |
$9,837 |
4.5× |
| Abdomen 2 views (74019) |
$259.80 |
$433 |
2.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$643.80 |
$1,073 |
1.7× |
| Angiography extremity bilateral rs&i (75716) |
$3,960 |
$6,600 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$3,880.80 |
$6,468 |
1.3× |
| Angiography internal mammary rs&i (75756) |
$2,348.40 |
$3,914 |
0.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,699.20 |
$7,832 |
0.9× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,699.20 |
$7,832 |
1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,699.20 |
$7,832 |
1.6× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,496 |
$4,160 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,846.80 |
$3,078 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,699.20 |
$7,832 |
1.6× |
| Ankle 2 views (73600) |
$259.80 |
$433 |
3.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$700.80 |
$1,168 |
2.1× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,834.80 |
$3,058 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,557.80 |
$9,263 |
1.8× |
| Aortography abdominal serialography rs&i (75625) |
$5,449.20 |
$9,082 |
1.8× |
| Arthrogram elbow (73085) |
$374.40 |
$624 |
1.1× |
| Arthrogram hip (73525) |
$459 |
$765 |
1.4× |
| Arthrogram shoulder (73040) |
$738 |
$1,230 |
2.2× |
| Arthrogram wrist (73115) |
$561.60 |
$936 |
1.7× |
| Arthrography knee lt (73580) |
$499.20 |
$832 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$511.20 |
$852 |
4.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,162.80 |
$1,938 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,530 |
$2,550 |
4.0× |
| Bone age studies (77072) |
$174 |
$290 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,744.20 |
$2,907 |
4.6× |
| Bone Marrow Imaging Limited Area (78102) |
$574.20 |
$957 |
1.5× |
| Bone survey complete (77075) |
$348.60 |
$581 |
3.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$786 |
$1,310 |
2.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,428.60 |
$2,381 |
1.0× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$389.40 |
$649 |
35.2× |
| Cervical spine 2 or 3 views (72040) |
$334.80 |
$558 |
4.0× |
| Chest 1 view (71045) |
$282 |
$470 |
3.4× |
| Chest 3 views (71047) |
$555.60 |
$926 |
6.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$340.80 |
$568 |
2.0× |
| Clavicle complete (73000) |
$234.60 |
$391 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$179.40 |
$299 |
1.8× |
| Continuing medical physics consltj pr wk (77336) |
$619.20 |
$1,032 |
4.8× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$262.80 |
$438 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,088.60 |
$8,481 |
15.3× |
| CT abdomen and pelvis without contrast (74176) |
$3,034.80 |
$5,058 |
13.3× |
| CT abdomen w contrast (74160) |
$2,364.60 |
$3,941 |
14.1× |
| CT abdomen w wo contrast (74170) |
$2,686.80 |
$4,478 |
16.0× |
| CT abdomen w/o contrast (74150) |
$1,558.20 |
$2,597 |
15.6× |
| CT angio hrt w/3d image (75574) |
$1,209.60 |
$2,016 |
3.6× |
| CT angiography upper extremity lt (73206) |
$936 |
$1,560 |
5.6× |
| CT c-spine w/o contrast (72125) |
$1,252.80 |
$2,088 |
12.5× |
| CT cervical spine w&w/o contrast (72127) |
$1,528.20 |
$2,547 |
9.1× |
| CT cervical spine with contrast (72126) |
$1,290.60 |
$2,151 |
3.9× |
| CT chest w/wo contrast (71270) |
$2,505.60 |
$4,176 |
14.9× |
| CT chest with contrast (71260) |
$1,681.80 |
$2,803 |
10.0× |
| CT colonography screening (74263) |
$430.80 |
$718 |
1.9× |
| CT colonography w/o cntrst (74261) |
$1,048.80 |
$1,748 |
10.5× |
| CT head/brain with contrast (70460) |
$1,515 |
$2,525 |
9.0× |
| CT head/brain without and with contrast (70470) |
$2,118.60 |
$3,531 |
12.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$84.60 |
$141 |
1.0× |
| CT iac w contrast (70481) |
$1,467 |
$2,445 |
8.8× |
| CT limited/localized follow up study (76380) |
$337.20 |
$562 |
4.1× |
| CT lower ext w/o (73700) |
$1,296.60 |
$2,161 |
13.0× |
| CT lower extremity w wo contrast (73702) |
$1,983.60 |
$3,306 |
11.8× |
| CT lower extremity with contrast (73701) |
$1,633.80 |
$2,723 |
9.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,224 |
$2,040 |
7.3× |
| CT lumbar spine w/o contrast (72131) |
$816 |
$1,360 |
8.2× |
| CT lumbar spine with contrast (72132) |
$1,036.20 |
$1,727 |
3.1× |
| CT maxillofacial w contrast (70487) |
$1,826.40 |
$3,044 |
10.9× |
| CT maxillofacial w/o contrast (70486) |
$1,304.40 |
$2,174 |
13.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,917.60 |
$3,196 |
11.4× |
| CT neck soft tissue w contrast (70491) |
$1,972.80 |
$3,288 |
11.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,752.60 |
$2,921 |
10.5× |
| CT orbits w/o contrast (70480) |
$1,358.40 |
$2,264 |
13.6× |
| CT pelvis w & w/o contrast (72194) |
$1,582.80 |
$2,638 |
9.4× |
| CT pelvis w/o contrast (72192) |
$884.40 |
$1,474 |
8.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,386.80 |
$3,978 |
14.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,637.40 |
$2,729 |
16.4× |
| CT thoracic spine w/contrast (72129) |
$1,464 |
$2,440 |
8.7× |
| CT thoracic spine w/o contrast (72128) |
$1,180.80 |
$1,968 |
11.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,605.60 |
$2,676 |
9.6× |
| CT thorax w/o contrast (71250) |
$1,395.60 |
$2,326 |
14.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,530 |
$2,550 |
9.1× |
| CT upper extremity w/o contrast rt (73200) |
$987 |
$1,645 |
9.9× |
| CT upper extremity with contrast (73201) |
$1,224 |
$2,040 |
3.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,233.60 |
$2,056 |
7.4× |
| Cta Abdomen (74175) |
$2,529 |
$4,215 |
15.1× |
| CTA abdomen pelvis (74174) |
$3,201.60 |
$5,336 |
9.6× |
| CTA chest (71275) |
$2,495.40 |
$4,159 |
14.9× |
| Cta Head (70496) |
$1,799.40 |
$2,999 |
10.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,455.60 |
$2,426 |
8.7× |
| Cta Neck (70498) |
$1,734 |
$2,890 |
10.3× |
| Cta Pelvis (72191) |
$769.20 |
$1,282 |
4.6× |
| Cystography minimum 3 views rs&i (74430) |
$391.80 |
$653 |
1.2× |
| Diskography lumbar (72295) |
$1,653.60 |
$2,756 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$401.40 |
$669 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$208.80 |
$348 |
2.5× |
| Esophagus (74220) |
$323.40 |
$539 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$530.40 |
$884 |
5.3× |
| Fluoroscopy up to 1 hr (76000) |
$375.60 |
$626 |
1.6× |
| Foot 2 views (73620) |
$238.80 |
$398 |
2.9× |
| Forearm 2 views (73090) |
$186.60 |
$311 |
2.2× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$707.40 |
$1,179 |
1.4× |
| Gated Heart Planar Single (78472) |
$1,140.60 |
$1,901 |
3.0× |
| Hand 2 views (73120) |
$238.80 |
$398 |
2.4× |
| Hand 3 views (73130) |
$268.80 |
$448 |
3.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,759.80 |
$2,933 |
3.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,513.80 |
$2,523 |
4.0× |
| Ht muscle image spect sing (78451) |
$3,609.60 |
$6,016 |
2.9× |
| Humerus Min 2 Views Left (73060) |
$234.60 |
$391 |
2.8× |
| Hysterosalpingogram (74740) |
$538.80 |
$898 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,039.20 |
$1,732 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,208.40 |
$2,014 |
2.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$990.60 |
$1,651 |
1.9× |
| Knee 3 views (73562) |
$262.80 |
$438 |
3.2× |
| Liver & spleen imaging static only (78215) |
$778.20 |
$1,297 |
2.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$633 |
$1,055 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$786 |
$1,310 |
1.5× |
| Lung perfusion differential (78597) |
$458.40 |
$764 |
1.2× |
| Lymphoscintigraphy (78195) |
$826.80 |
$1,378 |
1.6× |
| Mammary ductogram or galactogram multiple (77054) |
$352.80 |
$588 |
1.5× |
| Mammary ductogram or galactogram single (77053) |
$345.60 |
$576 |
1.5× |
| Meckels Diverticulum (78290) |
$707.40 |
$1,179 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,004.40 |
$1,674 |
2.8× |
| Mr safety determination physician/other qhp (76016) |
$158.40 |
$264 |
1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$44.40 |
$74 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$165 |
$275 |
1.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$435 |
$725 |
1.9× |
| MRA head w & w/o contrast (70546) |
$2,696.40 |
$4,494 |
8.1× |
| MRA head w/o contrast (70544) |
$1,899 |
$3,165 |
8.3× |
| MRA head with contrast (70545) |
$2,525.40 |
$4,209 |
7.6× |
| MRA neck w contrast (70548) |
$2,521.80 |
$4,203 |
7.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,833.80 |
$4,723 |
8.5× |
| MRA neck w/o contrast (70547) |
$1,785 |
$2,975 |
7.8× |
| MRI abdomen w contrast (74182) |
$2,175.60 |
$3,626 |
6.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,719.20 |
$4,532 |
8.2× |
| MRI abdomen w/o contrast (74181) |
$1,794.60 |
$2,991 |
7.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,287.20 |
$3,812 |
3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,614.80 |
$4,358 |
3.5× |
| MRI breast w/o contrast bilateral (77047) |
$1,883.40 |
$3,139 |
8.3× |
| MRI c-spine with contrast (72142) |
$2,424 |
$4,040 |
7.3× |
| MRI cervical spine w/o contrast (72141) |
$2,424 |
$4,040 |
10.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,872 |
$3,120 |
5.6× |
| MRI chest w/o contrast (71550) |
$1,232.40 |
$2,054 |
5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,061.60 |
$3,436 |
9.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$999 |
$1,665 |
4.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,611 |
$2,685 |
4.8× |
| MRI pelvis w contrast (72196) |
$2,693.40 |
$4,489 |
8.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,639.60 |
$6,066 |
10.9× |
| MRI pelvis w/o contrast (72195) |
$2,475 |
$4,125 |
10.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,978.40 |
$4,964 |
8.9× |
| MRI scan of leg joint before and after contrast (73723) |
$2,649.60 |
$4,416 |
7.9× |
| MRI spectroscopy (76390) |
$1,341.60 |
$2,236 |
16.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,273 |
$5,455 |
9.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,143.20 |
$3,572 |
6.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,767.20 |
$4,612 |
8.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,296.20 |
$3,827 |
6.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,982 |
$4,970 |
8.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,415.60 |
$4,026 |
10.6× |
| MRI tmj (70336) |
$1,002.60 |
$1,671 |
4.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,421.60 |
$4,036 |
10.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,907.60 |
$4,846 |
8.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,209.80 |
$3,683 |
9.7× |
| Myelogram Cervical (72240) |
$748.80 |
$1,248 |
1.0× |
| Myelogram Lumbar (72265) |
$1,236 |
$2,060 |
1.6× |
| Myelogram thoracic (72255) |
$748.80 |
$1,248 |
1.0× |
| Myelography 2 or more regions (72270) |
$998.40 |
$1,664 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$4,349.40 |
$7,249 |
3.5× |
| Neck soft tissue (70360) |
$234.60 |
$391 |
2.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$358.80 |
$598 |
0.9× |
| Nm cisternogram (78630) |
$802.80 |
$1,338 |
1.5× |
| Nm gastric emptying study (78264) |
$1,068.60 |
$1,781 |
2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,441.40 |
$14,069 |
6.4× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$3,578.40 |
$5,964 |
2.6× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$707.40 |
$1,179 |
1.9× |
| Nuclear Rx Oral Admin (79005) |
$661.20 |
$1,102 |
3.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$436.20 |
$727 |
4.4× |
| Osseous survey limited (77074) |
$233.40 |
$389 |
2.3× |
| Parathyrd planar w/wo subtrj (78071) |
$470.40 |
$784 |
1.2× |
| Pelvis 1 or 2 views (72170) |
$264 |
$440 |
2.6× |
| PET image w/CT, skull-thigh (78815) |
$5,520 |
$9,200 |
4.0× |
| PET imaging CT for attenuation limited area (78814) |
$2,625.60 |
$4,376 |
1.9× |
| PET imaging for CT attenuation whole body (78816) |
$5,520 |
$9,200 |
4.0× |
| PET imaging limited area chest head/neck (78811) |
$1,958.40 |
$3,264 |
1.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,272.40 |
$5,454 |
9.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,311.60 |
$2,186 |
3.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,093.20 |
$1,822 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$336.60 |
$561 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$234.60 |
$391 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$255 |
$425 |
2.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$303.60 |
$506 |
3.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$9,769.80 |
$16,283 |
1.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,054.20 |
$1,757 |
2.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$316.80 |
$528 |
3.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$429.60 |
$716 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$207.60 |
$346 |
2.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$240.60 |
$401 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$259.80 |
$433 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$434.40 |
$724 |
5.2× |
| Radiologic exam colon single contrast study (74270) |
$505.20 |
$842 |
3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$502.80 |
$838 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$679.80 |
$1,133 |
4.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$607.20 |
$1,012 |
3.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$211.20 |
$352 |
2.5× |
| Radiological examination surgical specimen (76098) |
$616.80 |
$1,028 |
1.2× |
| Ribs bilateral 3 views (71110) |
$391.80 |
$653 |
3.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,228.40 |
$3,714 |
4.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,750.20 |
$2,917 |
3.4× |
| Scanogram (77073) |
$222.60 |
$371 |
2.2× |
| Scapula complete (73010) |
$172.80 |
$288 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$69.60 |
$116 |
3.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$130.80 |
$218 |
1.3× |
| Sialogram (70390) |
$358.80 |
$598 |
1.6× |
| Simulation intermediate (77285) |
$1,182 |
$1,970 |
3.3× |
| Small bowel series (74250) |
$429.60 |
$716 |
2.6× |
| Spec medical radj physics consltj (77370) |
$594.60 |
$991 |
4.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$403.80 |
$673 |
1.1× |
| Special dosimetry (77331) |
$261.60 |
$436 |
2.0× |
| Special treatment procedure (77470) |
$1,663.80 |
$2,773 |
3.2× |
| Spine thoracic 3 views (72072) |
$289.80 |
$483 |
2.9× |
| Stereotactic body radiation delivery (77373) |
$1,991.40 |
$3,319 |
1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$747 |
$1,245 |
2.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$388.20 |
$647 |
1.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,359 |
$2,265 |
3.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$760.80 |
$1,268 |
5.9× |
| Thoracolumbar 2 views (72080) |
$271.80 |
$453 |
3.3× |
| Thyroid carcinoma metastases img addl study (78016) |
$852 |
$1,420 |
2.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$849 |
$1,415 |
1.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$897.60 |
$1,496 |
2.3× |
| Thyroid uptake measurement (78012) |
$243 |
$405 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,122.60 |
$1,871 |
2.9× |
| Treatment device intermediate (77333) |
$790.80 |
$1,318 |
6.2× |
| Treatment devices simple (77332) |
$478.80 |
$798 |
3.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,379 |
$3,965 |
4.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,367.40 |
$2,279 |
3.6× |
| Tx devices design & construction complex (77334) |
$1,041 |
$1,735 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$635.40 |
$1,059 |
6.4× |
| Unlisted magnetic resonance procedure (76498) |
$1,872 |
$3,120 |
22.5× |
| Unlisted Ultrasound Procedure (76999) |
$248.40 |
$414 |
3.0× |
| Upper Extremity Infant (73092) |
$127.80 |
$213 |
1.3× |
| Urethrocystography retrograde rs&i (74450) |
$349.20 |
$582 |
1.5× |
| Urethrocystography voiding (74455) |
$449.40 |
$749 |
2.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$910.80 |
$1,518 |
5.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$868.80 |
$1,448 |
5.2× |
| Us abdl aorta screen aaa (76706) |
$257.40 |
$429 |
2.6× |
| Us breast unilateral complete (76641) |
$333.60 |
$556 |
3.3× |
| Us breast unilateral limited (76642) |
$320.40 |
$534 |
3.9× |
| Us chest (76604) |
$269.40 |
$449 |
2.7× |
| Us compl joint r-t w/image documentation (76881) |
$611.40 |
$1,019 |
6.1× |
| Us guided compression repair (76936) |
$432.60 |
$721 |
2.1× |
| Us kidney transplant (76776) |
$465.60 |
$776 |
4.7× |
| Us ob detailed single fetus (76811) |
$363 |
$605 |
1.6× |
| Us ob transvaginal (76817) |
$623.40 |
$1,039 |
6.2× |
| Us pelvic non ob complete (76856) |
$658.80 |
$1,098 |
6.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$322.80 |
$538 |
3.2× |
| Us pregnancy ltd (76815) |
$542.40 |
$904 |
5.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$575.40 |
$959 |
5.8× |
| Us retroperitoneal complete (76770) |
$700.80 |
$1,168 |
7.0× |
| Us retroperitoneal limited (76775) |
$357.60 |
$596 |
3.6× |
| Us scrotum and contents (76870) |
$635.40 |
$1,059 |
6.4× |
| Us soft tissue head/neck (76536) |
$583.20 |
$972 |
5.8× |
| Us spinal canal and contents (76800) |
$246.60 |
$411 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$373.20 |
$622 |
3.7× |
| Venogram extremity bilateral (75822) |
$1,060.80 |
$1,768 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,307.20 |
$5,512 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$2,184 |
$3,640 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$994.80 |
$1,658 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$1,872 |
$3,120 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,699.20 |
$7,832 |
1.6× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,496 |
$4,160 |
0.5× |
| Wrist 2 views (73100) |
$295.80 |
$493 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$462 |
$770 |
4.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$137.40 |
$229 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$276.60 |
$461 |
3.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$515.40 |
$859 |
3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$259.20 |
$432 |
3.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$301.80 |
$503 |
3.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$336.60 |
$561 |
3.4× |
| X-ray exam hip uni 1 view (73501) |
$243.60 |
$406 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$333.60 |
$556 |
4.0× |
| X-ray exam hip uni 4/> views (73503) |
$417 |
$695 |
4.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$393.60 |
$656 |
3.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$456.60 |
$761 |
4.6× |
| X-ray exam of femur 1 (73551) |
$179.40 |
$299 |
2.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$429.60 |
$716 |
2.6× |
| X-ray eye for foreign body (70030) |
$173.40 |
$289 |
2.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$258.60 |
$431 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$186 |
$310 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$268.80 |
$448 |
3.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$811.20 |
$1,352 |
0.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$232.80 |
$388 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$184.80 |
$308 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$350.40 |
$584 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$231.60 |
$386 |
2.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$127.80 |
$213 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$243 |
$405 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$337.20 |
$562 |
3.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$332.40 |
$554 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$204.60 |
$341 |
2.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$130.80 |
$218 |
1.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$147.60 |
$246 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$298.80 |
$498 |
3.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$700.80 |
$1,168 |
2.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$324.60 |
$541 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$373.20 |
$622 |
3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$459 |
$765 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$273.60 |
$456 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$235.20 |
$392 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$299.40 |
$499 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$211.80 |
$353 |
2.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$196.80 |
$328 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$250.80 |
$418 |
2.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$207.60 |
$346 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$177 |
$295 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$207 |
$345 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$279.60 |
$466 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$268.20 |
$447 |
2.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$268.80 |
$448 |
3.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$321.60 |
$536 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$561 |
$935 |
5.6× |
| Xr chest 4+ views (71048) |
$595.20 |
$992 |
6.0× |
| Xr finger(s) 2+ views (73140) |
$234.60 |
$391 |
2.8× |
| Xr shoulder 1 view (73020) |
$234 |
$390 |
2.8× |
| Xr spine cervical 4 or 5 views (72050) |
$539.40 |
$899 |
5.4× |
| Xr tibia/fibula 2 views (73590) |
$237 |
$395 |
2.8× |
| Xr tmj bilateral (70330) |
$434.40 |
$724 |
5.2× |
| Xray knee 1 or 2 views rt (73560) |
$231.60 |
$386 |
2.8× |