| Abdomen 2 views (74019) |
$1,062.75 |
$1,062.75 |
9.4× |
| Acute gi blood loss imaging (78278) |
$2,957.50 |
$2,957.50 |
6.9× |
| Angio Adrenal Bilat Select (75733) |
$19,265.25 |
$19,265.25 |
5.7× |
| Angiography extremity bilateral rs&i (75716) |
$13,358.75 |
$13,358.75 |
3.9× |
| Angiography extremity unilateral rs&i (75710) |
$19,265.25 |
$19,265.25 |
5.7× |
| Angiography internal mammary rs&i (75756) |
$5,277 |
$5,277 |
1.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$19,737 |
$19,737 |
3.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$15,154.38 |
$15,154.38 |
4.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$19,265.25 |
$19,265.25 |
5.7× |
| Angiography Spinal Selective Rs&I (75705) |
$28,344.25 |
$28,344.25 |
4.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$32,021.75 |
$32,021.75 |
5.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$5,581.50 |
$5,581.50 |
1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$11,532.88 |
$11,532.88 |
3.4× |
| Ankle 2 views (73600) |
$831.25 |
$831.25 |
8.9× |
| Aortogram thoracic (75605) |
$32,021.75 |
$32,021.75 |
5.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$15,072 |
$15,072 |
4.4× |
| Aortography abdominal serialography rs&i (75625) |
$13,358.75 |
$13,358.75 |
3.9× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$17,014.75 |
$17,014.75 |
5.0× |
| Artery X-Rays Adrenal Gland (75731) |
$5,581.50 |
$5,581.50 |
1.6× |
| Arthrogram ankle (73615) |
$3,726 |
$3,726 |
9.9× |
| Arthrogram elbow (73085) |
$2,547 |
$2,547 |
6.8× |
| Arthrogram hip (73525) |
$3,836 |
$3,836 |
10.2× |
| Arthrogram knee (73580) |
$3,703.75 |
$3,703.75 |
9.9× |
| Arthrogram shoulder (73040) |
$2,613.50 |
$2,613.50 |
7.0× |
| Arthrogram wrist (73115) |
$3,472.50 |
$3,472.50 |
9.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,454 |
$2,454 |
5.7× |
| Bone &/joint imaging whole body (78306) |
$3,348.50 |
$3,348.50 |
7.8× |
| Bone age studies (77072) |
$946.50 |
$946.50 |
8.4× |
| Bone Imaging 3 Phase (78315) |
$5,240.75 |
$5,240.75 |
12.2× |
| Bone survey complete (77075) |
$935.25 |
$935.25 |
8.3× |
| Bone survey infant (77076) |
$1,267.88 |
$1,267.88 |
11.3× |
| Bowel imaging (78290) |
$2,055.75 |
$2,055.75 |
4.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$3,990.50 |
$3,990.50 |
6.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$11,544.12 |
$11,544.12 |
7.5× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$5,352.25 |
$5,352.25 |
12.4× |
| Cervical spine 2 or 3 views (72040) |
$993.50 |
$993.50 |
10.6× |
| Chest 1 view (71045) |
$549 |
$549 |
5.9× |
| Chest xray 3 views (71047) |
$538.75 |
$538.75 |
5.7× |
| Cholecystography, oral contrast Non-Facility (74290) |
$1,413.25 |
$1,413.25 |
7.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,578.25 |
$1,578.25 |
8.4× |
| Clavicle complete (73000) |
$947.75 |
$947.75 |
10.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$999.75 |
$999.75 |
8.9× |
| Corpora cavernosography (74445) |
$1,855.50 |
$1,855.50 |
16.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,802 |
$6,802 |
18.1× |
| CT abdomen and pelvis without contrast (74176) |
$6,813.50 |
$6,813.50 |
26.5× |
| CT abdomen w contrast (74160) |
$7,048 |
$7,048 |
37.3× |
| CT abdomen w wo contrast (74170) |
$4,505.25 |
$4,505.25 |
23.8× |
| CT abdomen w/o contrast (74150) |
$6,749.50 |
$6,749.50 |
59.9× |
| CT angio hrt w/3d image (75574) |
$12,264.50 |
$12,264.50 |
32.6× |
| CT angio lwr extr w/o&w/dye (73706) |
$9,607.50 |
$9,607.50 |
50.8× |
| CT angiography upper extremity lt (73206) |
$9,607.50 |
$9,607.50 |
50.8× |
| CT c-spine w/contrast (72126) |
$7,015.25 |
$7,015.25 |
18.7× |
| CT c-spine w/o contrast (72125) |
$7,015.25 |
$7,015.25 |
62.3× |
| CT cervical spine w&w/o contrast (72127) |
$7,215.75 |
$7,215.75 |
38.2× |
| CT chest w contrast (71260) |
$6,791.25 |
$6,791.25 |
35.9× |
| CT chest w/wo contrast (71270) |
$7,180.62 |
$7,180.62 |
38.0× |
| CT colonography screening (74263) |
$4,104 |
$4,104 |
16.0× |
| CT colonography w/dye (74262) |
$2,769.50 |
$2,769.50 |
14.7× |
| CT colonography w/o cntrst (74261) |
$4,104 |
$4,104 |
36.4× |
| CT head/brain with contrast (70460) |
$6,753 |
$6,753 |
35.7× |
| CT head/brain without and with contrast (70470) |
$6,850.25 |
$6,850.25 |
36.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$6,810.50 |
$6,810.50 |
18.1× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$6,579.75 |
$6,579.75 |
70.2× |
| CT hrt w/3d image congen (75573) |
$4,086.25 |
$4,086.25 |
10.9× |
| CT iac w contrast (70481) |
$6,761.25 |
$6,761.25 |
35.8× |
| CT limited/localized follow up study (76380) |
$3,406.50 |
$3,406.50 |
36.3× |
| CT lower ext w/o (73700) |
$6,749 |
$6,749 |
59.9× |
| CT lower extremity w wo contrast (73702) |
$1,967.75 |
$1,967.75 |
10.4× |
| CT lower extremity w/contrast material (73701) |
$6,869.50 |
$6,869.50 |
36.3× |
| CT lumbar spine w & w/o contrast (72133) |
$7,215 |
$7,215 |
38.2× |
| CT lumbar spine w/contrast (72132) |
$6,862.50 |
$6,862.50 |
18.3× |
| CT lumbar spine w/o contrast (72131) |
$6,815.25 |
$6,815.25 |
60.5× |
| CT maxillofacial w contrast (70487) |
$8,345.75 |
$8,345.75 |
44.2× |
| CT maxillofacial w/wo contrast (70488) |
$8,597 |
$8,597 |
45.5× |
| CT maxillofacial wo contrast (70486) |
$6,733.50 |
$6,733.50 |
59.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$9,619 |
$9,619 |
50.9× |
| CT orbits w/o contrast (70480) |
$6,889.50 |
$6,889.50 |
61.2× |
| CT pelvis w/o contrast (72192) |
$7,803.25 |
$7,803.25 |
69.3× |
| CT pelvis w/wo contrast (72194) |
$4,772 |
$4,772 |
25.2× |
| CT scan of arm combo (73202) |
$1,968.25 |
$1,968.25 |
10.4× |
| CT soft tissue neck w contrast (70491) |
$6,963.75 |
$6,963.75 |
36.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$9,694 |
$9,694 |
51.3× |
| CT soft tissue neck w/o contrast (70490) |
$6,732.88 |
$6,732.88 |
59.8× |
| CT thoracic spine w/contrast (72129) |
$2,230 |
$2,230 |
11.8× |
| CT thoracic spine w/o contrast (72128) |
$6,815.25 |
$6,815.25 |
60.5× |
| CT thoracic spine w/wo contrast (72130) |
$7,216 |
$7,216 |
38.2× |
| CT thorax w/o contrast (71250) |
$7,220.38 |
$7,220.38 |
64.1× |
| CT upper ext wo (73200) |
$6,758.25 |
$6,758.25 |
60.0× |
| CT upper extremity with contrast (73201) |
$6,869.50 |
$6,869.50 |
18.3× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$7,041 |
$7,041 |
37.3× |
| Cta Abdomen (74175) |
$6,982 |
$6,982 |
36.9× |
| CTA abdomen pelvis (74174) |
$6,766.50 |
$6,766.50 |
18.0× |
| CTA chest (71275) |
$6,984.38 |
$6,984.38 |
37.0× |
| Cta Head (70496) |
$4,864.75 |
$4,864.75 |
25.7× |
| Cta Neck (70498) |
$7,173.75 |
$7,173.75 |
38.0× |
| Cta Pelvis (72191) |
$10,777.50 |
$10,777.50 |
57.0× |
| Cystography minimum 3 views rs&i (74430) |
$1,724.38 |
$1,724.38 |
4.6× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$1,816.75 |
$1,816.75 |
7.1× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$1,892.75 |
$1,892.75 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,824.75 |
$1,824.75 |
16.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$1,552 |
$1,552 |
16.6× |
| Dxa bone density study axial skeleton (77085) |
$1,833 |
$1,833 |
16.3× |
| Esophagus (74220) |
$1,840.88 |
$1,840.88 |
9.7× |
| Facial bones min 3 views (70150) |
$1,212.25 |
$1,212.25 |
10.8× |
| Fetal biophysical profile non-stress testing (76818) |
$1,418.88 |
$1,418.88 |
12.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,884.50 |
$1,884.50 |
16.7× |
| Fluoroscopy up to 1 hr (76000) |
$824 |
$824 |
3.2× |
| Foot 2 views (73620) |
$831.25 |
$831.25 |
8.9× |
| Forearm 2 views (73090) |
$831.25 |
$831.25 |
8.9× |
| Gastric mucosa imaging (78261) |
$3,153.50 |
$3,153.50 |
7.3× |
| Hand 2 views (73120) |
$831.25 |
$831.25 |
7.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$19,265.25 |
$19,265.25 |
5.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$19,265.25 |
$19,265.25 |
5.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$5,074.75 |
$5,074.75 |
8.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$3,697.75 |
$3,697.75 |
8.6× |
| Hysterosalpingogram (74740) |
$2,028.50 |
$2,028.50 |
7.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$802.25 |
$802.25 |
7.1× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$2,198.25 |
$2,198.25 |
5.1× |
| Kidney imaging morphology (78700) |
$2,521 |
$2,521 |
5.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$5,633.75 |
$5,633.75 |
9.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$5,714.25 |
$5,714.25 |
9.8× |
| Knee 3 views (73562) |
$1,086.50 |
$1,086.50 |
11.6× |
| Liver & spleen imaging static only (78215) |
$2,523.75 |
$2,523.75 |
5.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,523.75 |
$2,523.75 |
5.9× |
| Liver imaging static only (78201) |
$2,855.50 |
$2,855.50 |
4.9× |
| Lung perf&ventilat diferentl (78598) |
$4,688.25 |
$4,688.25 |
8.0× |
| Lung ventilation imaging (78579) |
$2,922.25 |
$2,922.25 |
6.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$31,477.25 |
$31,477.25 |
9.3× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$17,014.75 |
$17,014.75 |
5.0× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$8,358.50 |
$8,358.50 |
4.9× |
| Lymphangiography, extremity only, unilateral, radiological supervision and interpretation Facility (75801) |
$3,213.25 |
$3,213.25 |
4.8× |
| Lymphoscintigraphy (78195) |
$3,523.75 |
$3,523.75 |
6.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$9,705.50 |
$9,705.50 |
11.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$8,431 |
$8,431 |
22.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$10,275 |
$10,275 |
27.3× |
| Mammary ductogram or galactogram multiple (77054) |
$3,156.50 |
$3,156.50 |
12.3× |
| Mammary ductogram or galactogram single (77053) |
$2,745 |
$2,745 |
10.7× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$1,309.50 |
$1,309.50 |
14.0× |
| Mr safety determination physician/other qhp (76016) |
$407 |
$407 |
4.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$113 |
$113 |
3.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$425 |
$425 |
4.1× |
| Mr safety implt pos&/immoblj (76019) |
$275 |
$275 |
4.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$1,117 |
$1,117 |
4.3× |
| MRA head w & w/o contrast (70546) |
$10,413.25 |
$10,413.25 |
27.7× |
| MRA head w/o contrast (70544) |
$8,431.25 |
$8,431.25 |
32.8× |
| MRA head with contrast (70545) |
$9,651.50 |
$9,651.50 |
25.7× |
| MRA neck w contrast (70548) |
$9,651.50 |
$9,651.50 |
25.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$10,413.25 |
$10,413.25 |
27.7× |
| MRA neck w/o contrast (70547) |
$8,430 |
$8,430 |
32.8× |
| MRI abdomen w contrast (74182) |
$8,430.75 |
$8,430.75 |
22.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$10,414.62 |
$10,414.62 |
27.7× |
| MRI abdomen w/o contrast (74181) |
$8,431.25 |
$8,431.25 |
32.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$8,431.75 |
$8,431.75 |
10.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$9,705.50 |
$9,705.50 |
25.8× |
| MRI breast w/o contrast bilateral (77047) |
$3,124.75 |
$3,124.75 |
12.2× |
| MRI breast wo contrast unilateral (77046) |
$1,689 |
$1,689 |
6.6× |
| MRI c-spine with contrast (72142) |
$10,414.62 |
$10,414.62 |
27.7× |
| MRI cervical spine w/o contrast (72141) |
$8,431.25 |
$8,431.25 |
32.8× |
| MRI chest w/o & w/contrast material (71552) |
$10,414.62 |
$10,414.62 |
27.7× |
| MRI chest w/o contrast (71550) |
$8,431.25 |
$8,431.25 |
32.8× |
| MRI chest with contrast (71551) |
$8,430.75 |
$8,430.75 |
10.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$8,431.75 |
$8,431.75 |
22.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$9,705.50 |
$9,705.50 |
25.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$8,431.75 |
$8,431.75 |
32.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$7,032.50 |
$7,032.50 |
27.4× |
| MRI orbit face neck w contrast (70542) |
$9,651.50 |
$9,651.50 |
25.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$8,430 |
$8,430 |
22.4× |
| MRI pelvis w/contrast (72196) |
$9,652 |
$9,652 |
25.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$10,414.62 |
$10,414.62 |
27.7× |
| MRI pelvis w/o contrast (72195) |
$8,431.25 |
$8,431.25 |
32.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$10,414.62 |
$10,414.62 |
27.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$10,414.62 |
$10,414.62 |
27.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$10,414.62 |
$10,414.62 |
27.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$10,414.62 |
$10,414.62 |
27.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$10,273.62 |
$10,273.62 |
27.3× |
| MRI temporomandibular joint (70336) |
$8,431.25 |
$8,431.25 |
32.8× |
| MRI thoracic spine w/o contrast (72146) |
$8,431.25 |
$8,431.25 |
32.8× |
| MRI up ext w/o contrast (73218) |
$8,431.75 |
$8,431.75 |
32.8× |
| MRI upper ext joint w/o contrast (73221) |
$9,705.50 |
$9,705.50 |
37.8× |
| MRI, joint upper extrem combo (73223) |
$9,705.50 |
$9,705.50 |
25.8× |
| Myelogram Cervical (72240) |
$3,637.50 |
$3,637.50 |
4.3× |
| Myelogram Lumbar (72265) |
$3,487.50 |
$3,487.50 |
4.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$19,176.50 |
$19,176.50 |
13.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$4,179.50 |
$4,179.50 |
3.0× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$7,568.25 |
$7,568.25 |
5.4× |
| Myocardial Spect Multiple Studies (78452) |
$16,609 |
$16,609 |
11.9× |
| Myocardial spect single study at rest or stress (78451) |
$10,857 |
$10,857 |
7.8× |
| Neck soft tissue (70360) |
$839.75 |
$839.75 |
9.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$2,328 |
$2,328 |
5.4× |
| Nm adrenal scan (78075) |
$6,185 |
$6,185 |
4.4× |
| Nm cisternogram (78630) |
$7,455.50 |
$7,455.50 |
12.7× |
| Nm gastric emptying study (78264) |
$3,153.50 |
$3,153.50 |
7.3× |
| Nm kidney scan w/flow (78701) |
$4,089.75 |
$4,089.75 |
9.5× |
| Nm red cell sequestration (78140) |
$6,104.75 |
$6,104.75 |
14.2× |
| Nonvascular shunt X-ray (75809) |
$2,028.50 |
$2,028.50 |
18.0× |
| Nuclear Rx Oral Admin (79005) |
$2,087 |
$2,087 |
8.3× |
| Ob us nuchal meas 1 gest (76813) |
$1,735 |
$1,735 |
15.4× |
| Parathyroid Planar Imaging (78070) |
$3,813.50 |
$3,813.50 |
8.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$3,813.50 |
$3,813.50 |
8.9× |
| Pelvis 1 or 2 views (72170) |
$606.75 |
$606.75 |
5.4× |
| PET image w/CT, skull-thigh (78815) |
$21,481.25 |
$21,481.25 |
13.9× |
| PET imaging CT for attenuation limited area (78814) |
$21,481.25 |
$21,481.25 |
13.9× |
| PET imaging for CT attenuation whole body (78816) |
$21,481.25 |
$21,481.25 |
13.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$19,265.25 |
$19,265.25 |
5.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$5,581.50 |
$5,581.50 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,406.50 |
$2,406.50 |
5.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,538.50 |
$3,538.50 |
6.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,725.75 |
$2,725.75 |
4.6× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$978.25 |
$978.25 |
10.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$936.75 |
$936.75 |
10.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$1,086.50 |
$1,086.50 |
11.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$507.25 |
$507.25 |
5.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$728.75 |
$728.75 |
6.5× |
| Radex fingr minimum 2 views (73140) |
$831.25 |
$831.25 |
8.9× |
| Radex Foot Compl Minimum 3 Views (73630) |
$1,086.50 |
$1,086.50 |
11.6× |
| Radex Hand Minimum 3 Views (73130) |
$1,086.50 |
$1,086.50 |
11.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$457.50 |
$457.50 |
4.9× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$526.50 |
$526.50 |
4.7× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$869.25 |
$869.25 |
7.7× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,659.88 |
$1,659.88 |
14.7× |
| Radex Humerus Minimum 2 Views (73060) |
$831.25 |
$831.25 |
8.9× |
| Radex Kne 1/2 Views (73560) |
$831.25 |
$831.25 |
8.9× |
| Radex Kne Compl 4/More Views (73564) |
$1,333 |
$1,333 |
11.8× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$1,122.50 |
$1,122.50 |
10.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$763.25 |
$763.25 |
8.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$778.75 |
$778.75 |
6.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$831.25 |
$831.25 |
8.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$760.75 |
$760.75 |
8.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$1,036.25 |
$1,036.25 |
9.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$1,395.25 |
$1,395.25 |
14.9× |
| Radex Toe Minimum 2 Views (73660) |
$831.25 |
$831.25 |
8.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$422.75 |
$422.75 |
3.8× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$1,086.50 |
$1,086.50 |
11.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$685.75 |
$685.75 |
6.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$612.25 |
$612.25 |
6.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$432.50 |
$432.50 |
3.8× |
| Radiologic exam chest 2 views (71046) |
$881.50 |
$881.50 |
9.4× |
| Radiologic exam colon single contrast study (74270) |
$1,834.50 |
$1,834.50 |
9.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,841.50 |
$1,841.50 |
9.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,573.25 |
$1,573.25 |
8.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,863.75 |
$1,863.75 |
9.9× |
| Radiologic examination femur 1 view (73551) |
$526.50 |
$526.50 |
5.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$831.25 |
$831.25 |
8.9× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$936.75 |
$936.75 |
8.3× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$849.50 |
$849.50 |
7.5× |
| Radiological examination surgical specimen (76098) |
$834.25 |
$834.25 |
1.4× |
| Renal Cyst Study (74470) |
$2,028.50 |
$2,028.50 |
3.4× |
| Ribs bilateral 3 views (71110) |
$1,383 |
$1,383 |
12.3× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$5,633.75 |
$5,633.75 |
13.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$11,443.25 |
$11,443.25 |
19.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$8,478.50 |
$8,478.50 |
14.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$8,478.50 |
$8,478.50 |
14.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,627.50 |
$6,627.50 |
4.8× |
| Sacroiliac Joints < 3 Views (72200) |
$828.75 |
$828.75 |
7.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,611.75 |
$1,611.75 |
6.3× |
| Scapula (73010) |
$947.75 |
$947.75 |
8.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$11.25 |
$11.25 |
0.5× |
| Sella turcica (70240) |
$577.75 |
$577.75 |
6.2× |
| Shoulder 1 view (73020) |
$422.50 |
$422.50 |
4.5× |
| Sialogram (70390) |
$1,435.50 |
$1,435.50 |
5.6× |
| Small bowel series (74250) |
$1,069.12 |
$1,069.12 |
5.7× |
| Spine thoracic 3 views (72072) |
$1,062.75 |
$1,062.75 |
9.4× |
| Splenoportograpy rs&i (75810) |
$5,581.50 |
$5,581.50 |
1.6× |
| Superior sagittal sinus venogram (75870) |
$17,014.75 |
$17,014.75 |
5.0× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$814.50 |
$814.50 |
3.2× |
| Thoracolumbar 2 views (72080) |
$991 |
$991 |
10.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$6,344 |
$6,344 |
10.8× |
| Thyroid uptake measurement (78012) |
$1,421.50 |
$1,421.50 |
3.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,695.25 |
$2,695.25 |
6.3× |
| Tmj unilateral (70328) |
$849.50 |
$849.50 |
9.1× |
| Tomogram (76100) |
$3,207.88 |
$3,207.88 |
28.5× |
| Ultrasound breast complete (76641) |
$939.25 |
$939.25 |
8.3× |
| Ultrasound Exam Aaa Screen (76706) |
$3,944 |
$3,944 |
35.0× |
| Ultrasound, abdomen limited (76705) |
$1,667 |
$1,667 |
14.8× |
| Umbilical-artery Doppler (OB) (76820) |
$1,165.25 |
$1,165.25 |
10.3× |
| Ureteral reflux study (78740) |
$4,464 |
$4,464 |
10.4× |
| Urethrocystogram voiding (74455) |
$1,851.50 |
$1,851.50 |
7.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,512.75 |
$1,512.75 |
5.9× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$2,044 |
$2,044 |
10.8× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$4,679.75 |
$4,679.75 |
24.8× |
| Us breast unilateral limited (76642) |
$906 |
$906 |
9.7× |
| Us chest (76604) |
$895 |
$895 |
7.9× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$2,490 |
$2,490 |
10.7× |
| Us compl joint r-t w/image documentation (76881) |
$1,100 |
$1,100 |
9.8× |
| Us encephalogram (76506) |
$1,935.62 |
$1,935.62 |
17.2× |
| Us hips infant static (76886) |
$479.25 |
$479.25 |
5.1× |
| Us infant hips w manipulation (76885) |
$866.25 |
$866.25 |
9.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$710.75 |
$710.75 |
6.3× |
| Us ob detailed single fetus (76811) |
$3,659.50 |
$3,659.50 |
14.2× |
| Us ob limited (76815) |
$1,876.88 |
$1,876.88 |
16.7× |
| Us ob transvaginal (76817) |
$1,391 |
$1,391 |
12.3× |
| Us pelvic non ob complete (76856) |
$1,975.12 |
$1,975.12 |
17.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$767.25 |
$767.25 |
6.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$2,078.50 |
$2,078.50 |
18.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$2,191.50 |
$2,191.50 |
19.5× |
| Us retroperitoneal complete (76770) |
$2,023.88 |
$2,023.88 |
18.0× |
| Us retroperitoneal limited (76775) |
$1,086 |
$1,086 |
9.6× |
| Us scrotum and contents (76870) |
$1,745.75 |
$1,745.75 |
15.5× |
| Us soft tissue head/neck (76536) |
$1,904.75 |
$1,904.75 |
16.9× |
| Us spinal canal and contents (76800) |
$978.25 |
$978.25 |
8.7× |
| Us transrectal (76872) |
$1,525.50 |
$1,525.50 |
13.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$647 |
$647 |
5.7× |
| Venogram adrenal unilat (75840) |
$19,265.25 |
$19,265.25 |
5.7× |
| Venogram extremity bilateral (75822) |
$3,990.12 |
$3,990.12 |
2.4× |
| Venogram Extremity Unilateral (75820) |
$5,581.50 |
$5,581.50 |
3.3× |
| Venography caval inferior serialography rs&i (75825) |
$13,381.75 |
$13,381.75 |
3.9× |
| Venography caval superior serialography rs&i (75827) |
$6,659.75 |
$6,659.75 |
3.9× |
| Venography Orbital Rs&I (75880) |
$3,213.25 |
$3,213.25 |
4.8× |
| Venography Renal Bilateral (75833) |
$19,265.25 |
$19,265.25 |
5.7× |
| Venography renal unilateral selective rs&i (75831) |
$19,265.25 |
$19,265.25 |
5.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$15,811 |
$15,811 |
4.6× |
| Venous sampling by catheter (75893) |
$7,621.25 |
$7,621.25 |
1.3× |
| Wrist 2 views (73100) |
$831.25 |
$831.25 |
8.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$684.75 |
$684.75 |
6.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$947.88 |
$947.88 |
10.1× |
| X-ray b.e. reductn intuss (74283) |
$1,061.25 |
$1,061.25 |
5.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,272.25 |
$2,272.25 |
12.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$826 |
$826 |
8.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$526.50 |
$526.50 |
5.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$799 |
$799 |
7.1× |
| X-ray exam of femur 2/> (73552) |
$714.25 |
$714.25 |
7.6× |
| X-ray eye for foreign body (70030) |
$760.75 |
$760.75 |
8.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$1,212.25 |
$1,212.25 |
12.9× |
| X-ray IV pyelogram (ivp) (74400) |
$2,244.75 |
$2,244.75 |
11.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$1,502.25 |
$1,502.25 |
16.0× |
| X-ray leg, infant (73592) |
$719 |
$719 |
7.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,033.75 |
$1,033.75 |
9.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,898.62 |
$1,898.62 |
16.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,089.50 |
$1,089.50 |
9.7× |
| X-ray retrograde pyelogram (74420) |
$2,282 |
$2,282 |
6.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,087.50 |
$1,087.50 |
11.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$750.75 |
$750.75 |
6.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$719 |
$719 |
6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$1,030.75 |
$1,030.75 |
9.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$853.50 |
$853.50 |
9.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$760.75 |
$760.75 |
8.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,265.25 |
$1,265.25 |
11.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$968.75 |
$968.75 |
8.6× |
| X-Ray Small Bowel Enteroclysis (74251) |
$1,309.50 |
$1,309.50 |
6.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$1,033.75 |
$1,033.75 |
11.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$947.75 |
$947.75 |
10.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$1,022.50 |
$1,022.50 |
10.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,033.75 |
$1,033.75 |
9.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$1,099 |
$1,099 |
9.8× |
| Xr bone length studies (77073) |
$978.25 |
$978.25 |
8.7× |
| Xr c-spine 4 or 5 views (72050) |
$1,498 |
$1,498 |
13.3× |
| Xr c-spine 6 or more views (72052) |
$1,737.50 |
$1,737.50 |
15.4× |
| Xr chest 4+ views (71048) |
$403.50 |
$403.50 |
3.6× |
| Xr urogram antegrade (74425) |
$1,796 |
$1,796 |
4.8× |