| 3-D radiotherapy plan dose-volume histograms (77295) |
$409.50 |
$1,575 |
0.3× |
| Abdomen 1 View (74018) |
$31.20 |
$120 |
0.3× |
| Abdomen 2 views (74019) |
$37.96 |
$146 |
0.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$477.36 |
$1,836 |
1.1× |
| Angio internal mammary (75756) |
$1,243.84 |
$4,784 |
0.4× |
| Angio pulmonary bilat (75743) |
$1,243.84 |
$4,784 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$959.66 |
$3,691 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$959.66 |
$3,691 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,243.84 |
$4,784 |
0.4× |
| Ankle 2 views (73600) |
$36.40 |
$140 |
0.4× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$1,598.48 |
$6,148 |
0.3× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$1,969.24 |
$7,574 |
0.3× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$2,144.22 |
$8,247 |
0.4× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$1,641.12 |
$6,312 |
0.3× |
Basic radiation dosimetry calculation (77300)
range across 2 matching MRF lines |
$49.40–$52.78 |
$190–$203 |
varies |
| Bone age studies (77072) |
$42.90 |
$165 |
0.4× |
| Bone Imaging 3 Phase (78315) |
$471.64 |
$1,814 |
1.1× |
| Bone Imaging Limited Area (78300) |
$316.16 |
$1,216 |
0.8× |
| Bone Imaging Multiple Areas (78305) |
$373.36 |
$1,436 |
0.9× |
| Bone Imaging Whole Body (78306) |
$412.62 |
$1,587 |
1.0× |
| Bone marrow imaging limited area (78102) |
$192.40 |
$740 |
0.5× |
| Brachytx isodose intermed (77317) |
$295.88 |
$1,138 |
0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$471.64 |
$1,814 |
0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,517.36 |
$5,836 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$456.82 |
$1,757 |
1.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$547.04 |
$2,104 |
0.7× |
| Cat Scan Follow-Up Study (76380) |
$148.98 |
$573 |
1.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$469.04 |
$1,804 |
0.8× |
| Chest 1 view (71045) |
$25.48 |
$98 |
0.3× |
| Chest 2 views (71046) |
$34.06 |
$131 |
0.4× |
| Chest 3 views (71047) |
$42.64 |
$164 |
0.5× |
| Chest 4 or more views (71048) |
$43.94 |
$169 |
0.4× |
| Clavicle complete (73000) |
$35.62 |
$137 |
0.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$158.08 |
$608 |
1.4× |
| Continuing medical physics consltj pr wk (77336) |
$124.02 |
$477 |
0.9× |
| Contrast Exam Abdominl Aorta (75625) |
$1,243.84 |
$4,784 |
0.4× |
| Contrast X-Ray Bladder (74430) |
$150.28 |
$578 |
0.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$418.34 |
$1,609 |
1.1× |
| CT abdomen and pelvis without contrast (74176) |
$175.76 |
$676 |
0.7× |
| CT abdomen w contrast (74160) |
$286.26 |
$1,101 |
1.6× |
| CT abdomen w wo contrast (74170) |
$326.30 |
$1,255 |
1.8× |
| CT abdomen w/o contrast (74150) |
$139.88 |
$538 |
1.3× |
| CT Angio Abdomen and Pelvis (74174) |
$461.76 |
$1,776 |
1.3× |
| CT Angio Chest (71275) |
$331.24 |
$1,274 |
1.8× |
| CT Angio Head (70496) |
$326.82 |
$1,257 |
1.8× |
| CT angio hrt w/3d image (75574) |
$377 |
$1,450 |
1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$408.46 |
$1,571 |
2.2× |
| CT Angio Neck (70498) |
$326.30 |
$1,255 |
1.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$372.84 |
$1,434 |
2.0× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$166.66 |
$641 |
0.9× |
| CT cervical spine w/ contrast (72126) |
$209.82 |
$807 |
0.6× |
| CT cervical spine w/o contrast (72125) |
$164.32 |
$632 |
1.5× |
| CT cervical spine w/wo cont (72127) |
$258.18 |
$993 |
1.4× |
| CT chest w contrast (71260) |
$208.78 |
$803 |
1.1× |
| CT chest w/wo contrast (71270) |
$255.06 |
$981 |
1.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$637.78 |
$2,453 |
3.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$558.74 |
$2,149 |
5.1× |
| CT head/brain with contrast (70460) |
$166.66 |
$641 |
0.9× |
| CT head/brain without and with contrast (70470) |
$199.68 |
$768 |
1.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$253.24 |
$974 |
0.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$27.04 |
$104 |
0.3× |
| CT iac w contrast (70481) |
$261.04 |
$1,004 |
1.4× |
| CT l-spine w&w/o contrast (72133) |
$257.14 |
$989 |
1.4× |
| CT lower ext w/o (73700) |
$163.54 |
$629 |
1.5× |
| CT lower extremity w/contrast material (73701) |
$212.42 |
$817 |
1.2× |
| CT lumbar spine w contrast (72132) |
$210.60 |
$810 |
0.6× |
| CT lumbar spine w/o contrast (72131) |
$163.54 |
$629 |
1.5× |
| CT maxillofacial w contrast (70487) |
$172.64 |
$664 |
0.9× |
| CT maxillofacial wo contrast (70486) |
$150.28 |
$578 |
1.4× |
| CT neck tissue combo (70492) |
$255.06 |
$981 |
1.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$288.08 |
$1,108 |
1.6× |
| CT orbits w/o contrast (70480) |
$213.46 |
$821 |
1.9× |
| CT pelvis w&w/o contrast (72194) |
$326.82 |
$1,257 |
1.8× |
| CT pelvis w/o contrast (72192) |
$141.70 |
$545 |
1.3× |
| CT scan of leg combo (73702) |
$269.36 |
$1,036 |
1.5× |
| CT scans face/jaw combo (70488) |
$216.58 |
$833 |
1.2× |
| CT soft tissue neck w contrast (70491) |
$208.26 |
$801 |
1.1× |
| CT soft tissue neck w/o contrast (70490) |
$156.52 |
$602 |
1.4× |
| CT thoracic spine w contrast (72129) |
$212.42 |
$817 |
1.2× |
| CT thoracic spine w/o contrast (72128) |
$164.32 |
$632 |
1.5× |
| CT thoracic spine w/wo cont (72130) |
$258.44 |
$994 |
1.4× |
| CT thorax w/o contrast (71250) |
$156.52 |
$602 |
1.4× |
| CT unlisted procedure (76497) |
$90.48 |
$348 |
1.0× |
| CT upper ext wo (73200) |
$200.98 |
$773 |
1.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$335.92 |
$1,292 |
1.8× |
| CT upper extremity with contrast (73201) |
$256.88 |
$988 |
0.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$504.14 |
$1,939 |
2.7× |
| Cta Abdomen (74175) |
$363.22 |
$1,397 |
2.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$331.24 |
$1,274 |
0.9× |
| CTA pelvis (72191) |
$364 |
$1,400 |
2.0× |
| Dilation ureters/urethra rs&i (74485) |
$794.82 |
$3,057 |
0.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$86.58 |
$333 |
0.8× |
| Echo exam uterus (76831) |
$128.96 |
$496 |
0.5× |
| Echo Guide For Artery Repair (76936) |
$267.02 |
$1,027 |
1.2× |
| Esophagram (74220) |
$103.22 |
$397 |
0.6× |
| Fetal Biophys Profile W/Nst (76818) |
$102.18 |
$393 |
0.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$75.92 |
$292 |
0.7× |
| Fluoroscopy up to 1 hr (76000) |
$95.68 |
$368 |
0.4× |
| Follow-Up Angiography (75898) |
$1,119.56 |
$4,306 |
0.3× |
| Forearm 2 views (73090) |
$31.72 |
$122 |
0.3× |
| Gastric emptying imaging study (78264) |
$468.52 |
$1,802 |
1.1× |
| Hand 2 views (73120) |
$34.06 |
$131 |
0.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$627.38 |
$2,413 |
0.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$365.30 |
$1,405 |
0.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,243.84 |
$4,784 |
0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$1,243.84 |
$4,784 |
0.4× |
| Hepatobil Syst Image W/Drug (78227) |
$633.88 |
$2,438 |
1.1× |
| Hepatobiliary System Imaging (78226) |
$464.62 |
$1,787 |
1.1× |
| Ht Muscle Image Spect Sing (78451) |
$425.88 |
$1,638 |
0.3× |
| Hysterosalpingogram (74740) |
$111.28 |
$428 |
0.4× |
| Joint Survey Single View (77077) |
$43.94 |
$169 |
0.4× |
| K Flow/Funct Image W/Drug (78708) |
$188.76 |
$726 |
0.3× |
| K Flow/Funct Image W/O Drug (78707) |
$296.14 |
$1,139 |
0.5× |
| Lung perfusion differential (78597) |
$263.90 |
$1,015 |
0.6× |
| Lung Ventilat&Perfus Imaging (78582) |
$448.24 |
$1,724 |
0.8× |
| Lymph System Imaging (78195) |
$473.46 |
$1,821 |
0.8× |
| Meckels Divert Exam (78290) |
$470.34 |
$1,809 |
1.1× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$1,370.98 |
$5,273 |
3.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$408.46 |
$1,571 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$464.62 |
$1,787 |
1.3× |
| MRA head w/o contrast (70544) |
$289.64 |
$1,114 |
1.2× |
| MRA head with contrast (70545) |
$306.80 |
$1,180 |
0.8× |
| MRA neck w contrast (70548) |
$309.14 |
$1,189 |
0.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$468 |
$1,800 |
1.3× |
| MRA neck w/o contrast (70547) |
$290.42 |
$1,117 |
1.2× |
| MRI abdomen w contrast (74182) |
$410.28 |
$1,578 |
1.1× |
| MRI abdomen w/o contrast (74181) |
$236.86 |
$911 |
0.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$444.60 |
$1,710 |
0.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$537.42 |
$2,067 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$443.82 |
$1,707 |
0.5× |
| MRI Breast W/O Contrast Bilateral (77047) |
$267.80 |
$1,030 |
1.1× |
| MRI cardiac w/o contrast (75557) |
$318.50 |
$1,225 |
1.3× |
| MRI cervical spine w contrast (72142) |
$352.56 |
$1,356 |
1.0× |
| MRI cervical spine w/o cont (72141) |
$222.56 |
$856 |
0.9× |
| MRI chest w/o contrast (71550) |
$505.44 |
$1,944 |
2.0× |
| MRI chest with contrast (71551) |
$741.26 |
$2,851 |
0.9× |
| MRI chest wo w contrast (71552) |
$689.78 |
$2,653 |
1.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$345.80 |
$1,330 |
0.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$442 |
$1,700 |
1.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$296.92 |
$1,142 |
1.2× |
| MRI lumbar spine w contrast (72149) |
$345.80 |
$1,330 |
0.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$394.68 |
$1,518 |
1.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$303.16 |
$1,166 |
1.2× |
| MRI orbit face neck w contrast (70542) |
$353.08 |
$1,358 |
1.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$440.96 |
$1,696 |
1.2× |
| MRI pelvis w contrast (72196) |
$346.32 |
$1,332 |
0.9× |
| MRI pelvis w/o & w contrast (72197) |
$439.14 |
$1,689 |
1.2× |
| MRI pelvis w/o contrast (72195) |
$300.82 |
$1,157 |
1.2× |
| MRI thoracic spine w/o contrast (72146) |
$222.56 |
$856 |
0.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$477.36 |
$1,836 |
1.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$445.64 |
$1,714 |
1.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$580.84 |
$2,234 |
1.6× |
| MRI, abdomen, combo (74183) |
$440.18 |
$1,693 |
1.2× |
| MRI, dorsal spine combo (72157) |
$396.76 |
$1,526 |
1.1× |
| MRI, dorsal spine contrast (72147) |
$347.10 |
$1,335 |
0.9× |
| MRI, joint upper extrem (73221) |
$251.68 |
$968 |
1.0× |
| MRI, joint upper extrem combo (73223) |
$538.72 |
$2,072 |
1.5× |
| MRI, lumbar spine combo (72158) |
$393.90 |
$1,515 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$622.44 |
$2,394 |
0.5× |
| Neck soft tissue (70360) |
$33.54 |
$129 |
0.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$160.68 |
$618 |
0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,337.66 |
$8,991 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$78.52 |
$302 |
0.3× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$82.42 |
$317 |
0.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$33.02 |
$127 |
0.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$588.90 |
$2,265 |
1.0× |
| Parathyroid Planar Imaging (78070) |
$406.90 |
$1,565 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$471.12 |
$1,812 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$30.94 |
$119 |
0.3× |
| Perineogram (74775) |
$211.38 |
$813 |
0.8× |
| Peritoneogram Rs&I (74190) |
$215.02 |
$827 |
0.4× |
| PET image w/CT, full body (78816) |
$1,785.68 |
$6,868 |
1.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,752.36 |
$10,586 |
1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$319.80 |
$1,230 |
0.8× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$370.50 |
$1,425 |
0.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$215.02 |
$827 |
0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$40.30 |
$155 |
0.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$31.20 |
$120 |
0.3× |
| Radex elbow complete minimum 3 views (73080) |
$34.32 |
$132 |
0.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$50.96 |
$196 |
0.5× |
| Radex fingr minimum 2 views (73140) |
$44.20 |
$170 |
0.5× |
| Radex foot complete minimum 3 views (73630) |
$37.96 |
$146 |
0.4× |
| Radex Hand Minimum 3 Views (73130) |
$40.30 |
$155 |
0.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$42.90 |
$165 |
0.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$37.96 |
$146 |
0.4× |
| Radex shoulder complete minimum 2 views (73030) |
$37.18 |
$143 |
0.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$34.06 |
$131 |
0.4× |
Radex Spine 1 View Specify Level (72020)
range across 2 matching MRF lines |
$25.22–$89.70 |
$97–$345 |
varies |
| Radex Sternum Minimum 2 Views (71120) |
$34.84 |
$134 |
0.4× |
| Radex Toe Minimum 2 Views (73660) |
$33.54 |
$129 |
0.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$34.32 |
$132 |
0.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$47.06 |
$181 |
0.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$4,244.76 |
$16,326 |
0.6× |
Radiation treatment delivery level 1 (77402)
range across 2 matching MRF lines |
$89.70–$220.74 |
$345–$849 |
varies |
| Radiation treatment delivery level 2 (77407) |
$389.22 |
$1,497 |
1.0× |
Radiation treatment delivery level 3 (77412)
range across 2 matching MRF lines |
$262.34–$384.02 |
$1,009–$1,477 |
varies |
| Radiolog exam mandible compl minimum 4 views (70110) |
$46.54 |
$179 |
0.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$43.68 |
$168 |
0.4× |
| Radiologic exam colon double contrast study (74280) |
$245.70 |
$945 |
1.3× |
| Radiologic exam colon single contrast study (74270) |
$159.38 |
$613 |
0.9× |
| Radiologic exam knee complete 4/more views (73564) |
$50.18 |
$193 |
0.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$42.90 |
$165 |
0.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$125.06 |
$481 |
0.7× |
| Radiologic exam swallow function contrast study (74230) |
$161.20 |
$620 |
0.9× |
| Radiologic examination femur minimum 2 views (73552) |
$39.26 |
$151 |
0.4× |
| Radiologic examination knee 1/2 views (73560) |
$39 |
$150 |
0.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$63.44 |
$244 |
0.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$34.84 |
$134 |
0.4× |
| Ribs bilateral 3 views (71110) |
$43.94 |
$169 |
0.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$971.62 |
$3,737 |
1.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$432.38 |
$1,663 |
0.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$530.66 |
$2,041 |
0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,300 |
$5,000 |
0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$662.74 |
$2,549 |
0.5× |
| Rp Therapy Intravenous Administration (79101) |
$80.60 |
$310 |
0.3× |
| Shoulder 1 view (73020) |
$25.22 |
$97 |
0.3× |
| Skull less than 4 views (70250) |
$39.26 |
$151 |
0.4× |
| Special dosimetry (77331) |
$53.04 |
$204 |
0.4× |
| Special Physics Consult (77370) |
$193.96 |
$746 |
1.4× |
| Special teletherapy port plan (77321) |
$144.04 |
$554 |
0.4× |
| Stereotactic Body Radiation Delivery (77373) |
$2,270.58 |
$8,733 |
1.2× |
| Sternoclavicular joints (71130) |
$43.94 |
$169 |
0.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$213.72 |
$822 |
0.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$117 |
$450 |
0.3× |
Ther Rad Simulaj-Aided Field Setting Complex (77290)
range across 2 matching MRF lines |
$645.58–$651.82 |
$2,483–$2,507 |
varies |
| Ther rad simulaj-aided field setting simple (77280) |
$377 |
$1,450 |
2.7× |
| Thoracolumbar 2 views (72080) |
$36.40 |
$140 |
0.4× |
| Thyroid Met Imaging Body (78018) |
$433.16 |
$1,666 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$343.20 |
$1,320 |
0.8× |
Tx Devices Design & Construction Complex (77334)
range across 2 matching MRF lines |
$102.96–$104 |
$396–$400 |
varies |
| Tx devices design & construction simple (77332) |
$39 |
$150 |
0.3× |
| Ultrasound Breast Limited (76642) |
$84.76 |
$326 |
0.9× |
| Ultrasound Exam Aaa Screen (76706) |
$135.72 |
$522 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$97.24 |
$374 |
0.9× |
| Umbilical-artery Doppler (OB) (76820) |
$34.06 |
$131 |
0.3× |
| Unlisted fluoroscopic procedure (76496) |
$35.62 |
$137 |
0.4× |
| Unlisted magnetic resonance procedure (76498) |
$831.48 |
$3,198 |
9.1× |
| Unlisted us procedure (76999) |
$107.12 |
$412 |
1.2× |
| Upper gi w/o kub (74240) |
$124.80 |
$480 |
0.7× |
| Urethrocystogram voiding (74455) |
$125.84 |
$484 |
0.5× |
| Urethrocystography retrograde (74450) |
$307.32 |
$1,182 |
1.2× |
| Us breast unilateral complete (76641) |
$109.72 |
$422 |
1.0× |
| Us chest (76604) |
$78.26 |
$301 |
0.7× |
| Us complete joint (76881) |
$71.76 |
$276 |
0.7× |
| Us exam, pelvic, limited (76857) |
$37.44 |
$144 |
0.3× |
| Us head (76506) |
$130 |
$500 |
1.2× |
| Us kidney transplant (76776) |
$184.60 |
$710 |
1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$51.22 |
$197 |
0.5× |
| Us ob limited 1 or more fetuses (76815) |
$80.86 |
$311 |
0.7× |
| Us ob transvaginal (76817) |
$91.26 |
$351 |
0.8× |
| Us pelvic non ob complete (76856) |
$118.04 |
$454 |
1.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$113.88 |
$438 |
1.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$111.02 |
$427 |
1.0× |
| Us retroperitoneal complete (76770) |
$119.86 |
$461 |
1.1× |
| Us retroperitoneal limited (76775) |
$47.06 |
$181 |
0.4× |
| Us scrotum and contents (76870) |
$115.18 |
$443 |
1.1× |
| Us spinal canal and contents (76800) |
$131.30 |
$505 |
1.2× |
Us thyroid (76536)
range across 2 matching MRF lines |
$74.62–$137.54 |
$287–$529 |
varies |
| Venogram Sinus/Jugular (75860) |
$1,243.84 |
$4,784 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$624.78 |
$2,403 |
0.4× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,144.22 |
$8,247 |
0.4× |
| Wrist 2 views (73100) |
$37.96 |
$146 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$33.80 |
$130 |
0.4× |
| X-ray antegrade pyelogram tube (74425) |
$164.06 |
$631 |
0.4× |
| X-Ray Aorta Leg Arteries (75630) |
$959.66 |
$3,691 |
0.3× |
| X-Ray Bend Only L-S Spine (72120) |
$43.68 |
$168 |
0.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$31.20 |
$120 |
0.3× |
| X-Ray Exam Breast Specimen (76098) |
$215.02 |
$827 |
0.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$80.08 |
$308 |
0.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$34.32 |
$132 |
0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$52.78 |
$203 |
0.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$68.38 |
$263 |
0.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$42.12 |
$162 |
0.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$42.90 |
$165 |
0.4× |
| X-ray eye for foreign body (70030) |
$34.84 |
$134 |
0.4× |
X-ray humerus (73060)
range across 2 matching MRF lines |
$34.84–$35.62 |
$134–$137 |
varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$42.90 |
$165 |
0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$46.80 |
$180 |
0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$42.12 |
$162 |
0.4× |
| X-ray nose-rectum child f.b. (76010) |
$30.68 |
$118 |
0.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$54.86 |
$211 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$34.84 |
$134 |
0.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$40.56 |
$156 |
0.4× |
| X-Ray Stress View (77071) |
$82.68 |
$318 |
0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$150.28 |
$578 |
0.4× |
| X-Rays Bone Length Studies (77073) |
$47.06 |
$181 |
0.4× |
| X-Rays Bone Survey Complete (77075) |
$105.30 |
$405 |
1.0× |
| Xr facial bones less than 3 views (70140) |
$32.76 |
$126 |
0.4× |
| Xr orbits complete 4 views (70200) |
$46.80 |
$180 |
0.4× |