| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,497.10 |
$11,534 |
4.9× |
| Abdomen 2 views (74019) |
$444.92 |
$684.50 |
3.8× |
| Acute gi blood loss imaging (78278) |
$1,580.80 |
$2,432 |
3.5× |
| Angiography extremity bilateral rs&i (75716) |
$10,783.82 |
$16,590.50 |
3.1× |
| Angiography extremity unilateral rs&i (75710) |
$10,783.82 |
$16,590.50 |
3.1× |
| Angiography internal mammary rs&i (75756) |
$5,501.60 |
$8,464 |
1.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$35,153.62 |
$54,082.50 |
5.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,271.50 |
$8,110 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,525.65 |
$8,501 |
1.6× |
| Angiography Spinal Selective Rs&I (75705) |
$17,518.80 |
$26,952 |
2.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$18,044.65 |
$27,761 |
2.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,778.80 |
$7,352 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,648.15 |
$7,151 |
1.3× |
| Ankle 2 views (73600) |
$262.60 |
$404 |
2.7× |
| Aortogram thoracic (75605) |
$5,616.65 |
$8,641 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$10,890.75 |
$16,755 |
3.1× |
| Aortography abdominal serialography rs&i (75625) |
$10,890.75 |
$16,755 |
3.1× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$3,532.75 |
$5,435 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$5,749.90 |
$8,846 |
1.6× |
| Arthrogram elbow (73085) |
$1,123.20 |
$1,728 |
2.9× |
| Arthrogram hip (73525) |
$918.45 |
$1,413 |
2.4× |
| Arthrogram knee (73580) |
$854.10 |
$1,314 |
2.2× |
| Arthrogram shoulder (73040) |
$1,545.05 |
$2,377 |
4.0× |
| Basic dosimetry (77300) |
$5,609.50 |
$8,630 |
37.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$939.58 |
$1,445.50 |
2.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,174.55 |
$1,807 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,481.02 |
$2,278.50 |
3.3× |
| Bone age studies (77072) |
$359.12 |
$552.50 |
3.1× |
| Bone Imaging 3 Phase (78315) |
$1,301.62 |
$2,002.50 |
2.9× |
| Bone Marrow Imaging Limited Area (78102) |
$1,272.05 |
$1,957 |
2.9× |
| Bone survey complete (77075) |
$464.75 |
$715 |
4.0× |
| Bone survey infant (77076) |
$585 |
$900 |
5.0× |
| Bowel imaging (78290) |
$1,370.85 |
$2,109 |
3.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,426.10 |
$2,194 |
2.4× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,034.80 |
$1,592 |
2.3× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$8,485.75 |
$13,055 |
9.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,779.10 |
$5,814 |
9.7× |
| Cardiac shunt detection (78428) |
$1,030.25 |
$1,585 |
2.3× |
| Cervical spine 2 or 3 views (72040) |
$323.05 |
$497 |
3.3× |
| Chest 1 view (71045) |
$317.85 |
$489 |
3.3× |
| Chest xray 3 views (71047) |
$307.78 |
$473.50 |
3.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$466.70 |
$718 |
2.4× |
| Cineradiography/videoradiography (76120) |
$464.10 |
$714 |
4.0× |
| Clavicle complete (73000) |
$295.10 |
$454 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$270.72 |
$416.50 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$658.78 |
$1,013.50 |
4.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,020.60 |
$7,724 |
12.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,608.78 |
$4,013.50 |
9.8× |
| CT abdomen w contrast (74160) |
$2,282.80 |
$3,512 |
11.7× |
| CT abdomen w wo contrast (74170) |
$2,316.60 |
$3,564 |
11.9× |
| CT abdomen w/o contrast (74150) |
$1,464.12 |
$2,252.50 |
12.6× |
| CT angio hrt w/3d image (75574) |
$2,316.60 |
$3,564 |
6.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,316.60 |
$3,564 |
11.9× |
| CT angiography upper extremity lt (73206) |
$1,705.92 |
$2,624.50 |
8.7× |
| CT c-spine w/contrast (72126) |
$1,607.45 |
$2,473 |
4.1× |
| CT c-spine w/o contrast (72125) |
$1,291.55 |
$1,987 |
11.1× |
| CT cere prfu aly c+wo CT/CTA (70473) |
$2,881.45 |
$4,433 |
14.7× |
| CT cervical spine w&w/o contrast (72127) |
$2,026.05 |
$3,117 |
10.4× |
| CT chest w contrast (71260) |
$2,282.80 |
$3,512 |
11.7× |
| CT chest w/wo contrast (71270) |
$2,530.45 |
$3,893 |
12.9× |
| CT colonography screening (74263) |
$1,541.15 |
$2,371 |
5.8× |
| CT colonography w/dye (74262) |
$2,543.45 |
$3,913 |
13.0× |
| CT colonography w/o cntrst (74261) |
$1,274 |
$1,960 |
10.9× |
| CT head/brain with contrast (70460) |
$1,140.75 |
$1,755 |
5.8× |
| CT head/brain without and with contrast (70470) |
$1,489.15 |
$2,291 |
7.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,316.60 |
$3,564 |
6.0× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$173.55 |
$267 |
1.8× |
| CT hrt w/3d image congen (75573) |
$2,318.55 |
$3,567 |
6.0× |
| CT iac w contrast (70481) |
$1,357.85 |
$2,089 |
6.9× |
| CT limited/localized follow up study (76380) |
$655.85 |
$1,009 |
6.8× |
| CT lower ext w/o (73700) |
$1,291.55 |
$1,987 |
11.1× |
| CT lower extremity w wo contrast (73702) |
$1,479.08 |
$2,275.50 |
7.6× |
| CT lower extremity w/contrast material (73701) |
$2,316.60 |
$3,564 |
11.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,503.80 |
$3,852 |
12.8× |
| CT lumbar spine w/contrast (72132) |
$1,899.30 |
$2,922 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$1,516.78 |
$2,333.50 |
13.0× |
| CT maxillofacial w contrast (70487) |
$2,282.80 |
$3,512 |
11.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,275.95 |
$1,963 |
6.5× |
| CT maxillofacial wo contrast (70486) |
$1,272.70 |
$1,958 |
10.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,692.60 |
$2,604 |
8.7× |
| CT orbits w/o contrast (70480) |
$918.45 |
$1,413 |
7.9× |
| CT pelvis w/o contrast (72192) |
$1,477.12 |
$2,272.50 |
12.7× |
| CT pelvis w/wo contrast (72194) |
$1,602.25 |
$2,465 |
8.2× |
| CT scan of arm combo (73202) |
$1,712.75 |
$2,635 |
8.8× |
| CT soft tissue neck w contrast (70491) |
$2,282.80 |
$3,512 |
11.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,348.75 |
$2,075 |
6.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,285.70 |
$1,978 |
11.0× |
| CT thoracic spine w/contrast (72129) |
$1,466.08 |
$2,255.50 |
7.5× |
| CT thoracic spine w/o contrast (72128) |
$1,343.88 |
$2,067.50 |
11.5× |
| CT thoracic spine w/wo contrast (72130) |
$1,835.60 |
$2,824 |
9.4× |
| CT thorax w/o contrast (71250) |
$1,590.55 |
$2,447 |
13.7× |
| CT unlisted procedure (76497) |
$219.05 |
$337 |
2.3× |
| CT upper ext wo (73200) |
$1,291.55 |
$1,987 |
11.1× |
| CT upper extremity with contrast (73201) |
$4,365.72 |
$6,716.50 |
11.2× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,625.02 |
$4,038.50 |
13.4× |
| Cta Abdomen (74175) |
$2,625.02 |
$4,038.50 |
13.4× |
| CTA abdomen pelvis (74174) |
$4,365.72 |
$6,716.50 |
11.2× |
| CTA chest (71275) |
$2,316.60 |
$3,564 |
11.9× |
| Cta Head (70496) |
$3,698.50 |
$5,690 |
18.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$6,142.50 |
$9,450 |
15.8× |
| Cta Neck (70498) |
$2,625.02 |
$4,038.50 |
13.4× |
| Cta Pelvis (72191) |
$2,917.20 |
$4,488 |
14.9× |
| Cystography minimum 3 views rs&i (74430) |
$576.55 |
$887 |
1.5× |
| Diskogram cervical (72285) |
$3,382.60 |
$5,204 |
1.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$365.30 |
$562 |
3.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$451.10 |
$694 |
3.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$210.60 |
$324 |
2.2× |
| Dxa bone density study axial skeleton (77085) |
$451.10 |
$694 |
3.9× |
| Echo exam of eye (76529) |
$164.78 |
$253.50 |
1.7× |
| Esophagus (74220) |
$947.38 |
$1,457.50 |
4.8× |
| Facial bones min 3 views (70150) |
$405.28 |
$623.50 |
3.5× |
| Fetal biophysical profile non-stress testing (76818) |
$789.75 |
$1,215 |
6.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$585 |
$900 |
5.0× |
| Fluoroscopy up to 1 hr (76000) |
$1,019.20 |
$1,568 |
3.8× |
| Foot 2 views (73620) |
$295.10 |
$454 |
3.0× |
| Forearm 2 views (73090) |
$298.35 |
$459 |
3.1× |
| Functional MRI brain by phys/psych (70555) |
$1,178.45 |
$1,813 |
4.4× |
| Functional MRI brain by tech (70554) |
$1,547 |
$2,380 |
5.8× |
| Hand 2 views (73120) |
$459.55 |
$707 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,309.45 |
$3,553 |
3.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,887.95 |
$4,443 |
3.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$8,397.35 |
$12,919 |
2.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,753.05 |
$2,697 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,555.45 |
$2,393 |
3.5× |
| Hysterosalpingogram (74740) |
$581.75 |
$895 |
2.2× |
| Interstitial radiation source applic complex (77778) |
$3,261.05 |
$5,017 |
4.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$338.65 |
$521 |
2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,452.75 |
$2,235 |
2.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,351.02 |
$2,078.50 |
2.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,207.70 |
$1,858 |
2.0× |
| Knee 3 views (73562) |
$263.25 |
$405 |
2.7× |
| Lung perf&ventilat diferentl (78598) |
$1,846.65 |
$2,841 |
3.1× |
| Lung perfusion differential (78597) |
$1,096.55 |
$1,687 |
2.5× |
| Lung ventilation imaging (78579) |
$1,095.90 |
$1,686 |
2.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$5,633.55 |
$8,667 |
1.6× |
| Lymphoscintigraphy (78195) |
$1,432.92 |
$2,204.50 |
2.4× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,931.15 |
$2,971 |
2.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,362.75 |
$3,635 |
6.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$4,410.25 |
$6,785 |
11.3× |
| Mammary ductogram or galactogram multiple (77054) |
$1,062.10 |
$1,634 |
4.0× |
| Mammary ductogram or galactogram single (77053) |
$958.75 |
$1,475 |
3.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,394.58 |
$2,145.50 |
3.3× |
| MRA head w & w/o contrast (70546) |
$4,345.90 |
$6,686 |
11.2× |
| MRA head w/o contrast (70544) |
$2,259.08 |
$3,475.50 |
8.5× |
| MRA head with contrast (70545) |
$4,451.85 |
$6,849 |
11.5× |
| MRA neck w contrast (70548) |
$4,084.60 |
$6,284 |
10.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,410.25 |
$6,785 |
11.3× |
| MRA neck w/o contrast (70547) |
$2,259.08 |
$3,475.50 |
8.5× |
| MRI abdomen w contrast (74182) |
$5,315.05 |
$8,177 |
13.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,345.90 |
$6,686 |
11.2× |
| MRI abdomen w/o contrast (74181) |
$2,259.08 |
$3,475.50 |
8.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,423.20 |
$3,728 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,835 |
$5,900 |
9.9× |
| MRI bone marrow blood supply (77084) |
$1,111.18 |
$1,709.50 |
4.2× |
| MRI breast w/o contrast bilateral (77047) |
$688.02 |
$1,058.50 |
2.6× |
| MRI c-spine with contrast (72142) |
$2,324.40 |
$3,576 |
6.0× |
| MRI cardiac w/o cont stress (75559) |
$1,892.48 |
$2,911.50 |
3.1× |
| MRI cardiac w/o contrast (75557) |
$1,121.25 |
$1,725 |
4.2× |
| MRI cervical spine w/o contrast (72141) |
$2,259.08 |
$3,475.50 |
8.5× |
| MRI chest w/o & w/contrast material (71552) |
$2,544.75 |
$3,915 |
6.5× |
| MRI chest w/o contrast (71550) |
$2,148.90 |
$3,306 |
8.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,154.10 |
$3,314 |
5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,410.25 |
$6,785 |
11.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,292.55 |
$3,527 |
8.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,767.70 |
$4,258 |
10.4× |
| MRI orbit face neck w contrast (70542) |
$2,379 |
$3,660 |
6.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,490.18 |
$5,369.50 |
9.0× |
| MRI pelvis w/contrast (72196) |
$2,047.50 |
$3,150 |
5.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,345.90 |
$6,686 |
11.2× |
| MRI pelvis w/o contrast (72195) |
$2,259.08 |
$3,475.50 |
8.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,345.90 |
$6,686 |
11.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,202.20 |
$3,388 |
5.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,345.90 |
$6,686 |
11.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,981.20 |
$3,048 |
5.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,345.90 |
$6,686 |
11.2× |
| MRI temporomandibular joint (70336) |
$1,520.35 |
$2,339 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,259.08 |
$3,475.50 |
8.5× |
| MRI up ext w/o contrast (73218) |
$2,292.55 |
$3,527 |
8.6× |
| MRI upper ext joint w/o contrast (73221) |
$2,292.55 |
$3,527 |
8.6× |
| MRI, joint upper extrem combo (73223) |
$3,519.10 |
$5,414 |
9.1× |
| Myelogram Lumbar (72265) |
$1,168.05 |
$1,797 |
1.3× |
| Myocardial infarct spect (78469) |
$4,146.35 |
$6,379 |
6.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,988.70 |
$4,598 |
2.1× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$3,891.55 |
$5,987 |
2.7× |
| Myocardial Spect Multiple Studies (78452) |
$4,036.50 |
$6,210 |
2.8× |
| Myocardial spect single study at rest or stress (78451) |
$2,793.38 |
$4,297.50 |
1.9× |
| Neck soft tissue (70360) |
$292.18 |
$449.50 |
3.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,199.90 |
$1,846 |
2.7× |
| Nm cisternogram (78630) |
$1,610.05 |
$2,477 |
2.7× |
| Nm csf leak detection (78650) |
$4,046.25 |
$6,225 |
2.8× |
| Nm gastric emptying study (78264) |
$1,379.62 |
$2,122.50 |
3.1× |
| Nonvascular shunt X-ray (75809) |
$379.60 |
$584 |
3.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,359.65 |
$12,861 |
5.4× |
| Nuclear Rx Oral Admin (79005) |
$641.55 |
$987 |
2.5× |
| Ob us nuchal meas 1 gest (76813) |
$510.90 |
$786 |
4.4× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$510.90 |
$786 |
4.4× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter… (76510) |
$498.55 |
$767 |
3.4× |
| Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) |
$623.35 |
$959 |
5.4× |
| Osseous survey limited (77074) |
$495.30 |
$762 |
4.3× |
| Parathyroid Planar Imaging (78070) |
$1,447.55 |
$2,227 |
3.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,270.75 |
$1,955 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$392.28 |
$603.50 |
3.4× |
| Peritoneogram after injection (74190) |
$1,991.60 |
$3,064 |
3.3× |
| PET image w/CT, skull-thigh (78815) |
$5,035.55 |
$7,747 |
3.2× |
| PET imaging for CT attenuation whole body (78816) |
$5,461.95 |
$8,403 |
3.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,310.80 |
$6,632 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,248.35 |
$3,459 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,142.70 |
$1,758 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,677.65 |
$2,581 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,031.25 |
$3,125 |
3.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$436.80 |
$672 |
4.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$248.62 |
$382.50 |
2.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$389.68 |
$599.50 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$200.20 |
$308 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$278.20 |
$428 |
2.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$434.85 |
$669 |
3.7× |
| Radex fingr minimum 2 views (73140) |
$295.10 |
$454 |
3.0× |
| Radex Foot Compl Minimum 3 Views (73630) |
$263.25 |
$405 |
2.7× |
| Radex Hand Minimum 3 Views (73130) |
$256.75 |
$395 |
2.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$254.15 |
$391 |
2.6× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$345.15 |
$531 |
3.0× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$368.22 |
$566.50 |
3.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$669.50 |
$1,030 |
5.7× |
| Radex Humerus Minimum 2 Views (73060) |
$301.60 |
$464 |
3.1× |
| Radex Kne 1/2 Views (73560) |
$379.92 |
$584.50 |
3.9× |
| Radex Kne Compl 4/More Views (73564) |
$464.10 |
$714 |
4.0× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$317.20 |
$488 |
2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$250.58 |
$385.50 |
2.6× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$409.82 |
$630.50 |
3.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$321.10 |
$494 |
3.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$252.85 |
$389 |
2.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$418.28 |
$643.50 |
3.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$217.75 |
$335 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$289.25 |
$445 |
3.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$415.02 |
$638.50 |
3.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$321.10 |
$494 |
3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$529.10 |
$814 |
4.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$22,019.08 |
$33,875.50 |
2.7× |
| Radiation treatment delivery level 1 (77402) |
$421.20 |
$648 |
3.7× |
| Radiation treatment delivery level 2 (77407) |
$578.50 |
$890 |
1.3× |
| Radiation treatment delivery level 3 (77412) |
$1,135.55 |
$1,747 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$362.38 |
$557.50 |
3.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$362.70 |
$558 |
3.1× |
| Radiologic exam chest 2 views (71046) |
$314.60 |
$484 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$726.70 |
$1,118 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$699.08 |
$1,075.50 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$823.88 |
$1,267.50 |
4.2× |
| Radiologic examination femur 1 view (73551) |
$379.60 |
$584 |
3.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$295.10 |
$454 |
3.0× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$323.70 |
$498 |
2.8× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$248.30 |
$382 |
2.1× |
| Radiological examination surgical specimen (76098) |
$2,031.25 |
$3,125 |
3.3× |
| Ribs bilateral 3 views (71110) |
$451.42 |
$694.50 |
3.9× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,342.25 |
$2,065 |
3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,355.90 |
$2,086 |
3.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,853.85 |
$5,929 |
6.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,168.10 |
$4,874 |
5.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,434.88 |
$2,207.50 |
2.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,285.75 |
$5,055 |
2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,997.80 |
$4,612 |
1.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,778.45 |
$5,813 |
2.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$642.20 |
$988 |
2.5× |
| Rp Therapy Intravenous Administration (79101) |
$622.70 |
$958 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$252.20 |
$388 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$546 |
$840 |
2.1× |
| Scapula (73010) |
$396.82 |
$610.50 |
3.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$61.10 |
$94 |
2.6× |
| Shoulder 1 view (73020) |
$254.15 |
$391 |
2.6× |
| Small bowel series (74250) |
$522.60 |
$804 |
2.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$936.32 |
$1,440.50 |
2.2× |
| Special dosimetry (77331) |
$347.75 |
$535 |
2.3× |
| Special Physics Consult (77370) |
$752.70 |
$1,158 |
5.0× |
| Special treatment procedure (77470) |
$2,635.10 |
$4,054 |
4.3× |
| Spine thoracic 3 views (72072) |
$455 |
$700 |
3.9× |
| Stereotactic Body Radiation Delivery (77373) |
$7,611.50 |
$11,710 |
3.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,210.30 |
$1,862 |
2.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$598.65 |
$921 |
1.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,057.25 |
$3,165 |
4.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$865.15 |
$1,331 |
5.8× |
| Thoracolumbar 2 views (72080) |
$311.35 |
$479 |
3.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,418.30 |
$2,182 |
2.3× |
| Thyroid uptake measurement (78012) |
$982.15 |
$1,511 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$989.62 |
$1,522.50 |
2.2× |
| Treatment device complex (77334) |
$3,439.80 |
$5,292 |
8.2× |
| Treatment device intermediate (77333) |
$830.05 |
$1,277 |
5.5× |
| Treatment devices simple (77332) |
$548.60 |
$844 |
3.7× |
| Ultrasound breast complete (76641) |
$526.50 |
$810 |
4.5× |
| Ultrasound Exam Aaa Screen (76706) |
$389.35 |
$599 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$526.50 |
$810 |
4.5× |
| Umbilical-artery Doppler (OB) (76820) |
$603.20 |
$928 |
5.2× |
| Unlisted magnetic resonance procedure (76498) |
$721.50 |
$1,110 |
7.4× |
| Unlisted ultrasound procedure (76999) |
$707.20 |
$1,088 |
7.3× |
| Urethrocystogram voiding (74455) |
$590.85 |
$909 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$596.70 |
$918 |
2.2× |
| Us breast unilateral limited (76642) |
$338 |
$520 |
3.5× |
| Us chest (76604) |
$605.15 |
$931 |
5.2× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$876.52 |
$1,348.50 |
3.6× |
| Us compl joint r-t w/image documentation (76881) |
$799.82 |
$1,230.50 |
6.9× |
| Us elastography parenchyma (76981) |
$404.30 |
$622 |
3.5× |
| Us encephalogram (76506) |
$962.32 |
$1,480.50 |
8.3× |
| Us hips infant static (76886) |
$309.40 |
$476 |
3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$779.35 |
$1,199 |
6.7× |
| Us ob detailed single fetus (76811) |
$1,068.28 |
$1,643.50 |
4.0× |
| Us ob limited (76815) |
$521.30 |
$802 |
4.5× |
| Us ob transvaginal (76817) |
$521.30 |
$802 |
4.5× |
| Us pelvic non ob complete (76856) |
$554.78 |
$853.50 |
4.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$521.30 |
$802 |
4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$521.30 |
$802 |
4.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$493.35 |
$759 |
4.2× |
| Us retroperitoneal complete (76770) |
$594.10 |
$914 |
5.1× |
| Us retroperitoneal limited (76775) |
$526.50 |
$810 |
4.5× |
| Us scrotum and contents (76870) |
$599.30 |
$922 |
5.1× |
| Us soft tissue head/neck (76536) |
$521.30 |
$802 |
4.5× |
| Us spinal canal and contents (76800) |
$962.32 |
$1,480.50 |
8.3× |
| Us transrectal (76872) |
$234.65 |
$361 |
2.0× |
| Us, eye b-scan (76512) |
$542.75 |
$835 |
4.7× |
| Us,transplanted kidney, real time/ doppler (76776) |
$526.50 |
$810 |
4.5× |
| Venogram extremity bilateral (75822) |
$1,898.65 |
$2,921 |
1.1× |
| Venogram Extremity Unilateral (75820) |
$2,530.78 |
$3,893.50 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$4,568.20 |
$7,028 |
1.3× |
| Venography caval superior serialography rs&i (75827) |
$3,001.05 |
$4,617 |
1.7× |
| Venography Renal Bilateral (75833) |
$7,484.10 |
$11,514 |
2.1× |
| Venography renal unilateral selective rs&i (75831) |
$2,872.35 |
$4,419 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,316.30 |
$5,102 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$257.40 |
$396 |
2.7× |
| Wrist 2 views (73100) |
$256.75 |
$395 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$527.80 |
$812 |
4.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$292.82 |
$450.50 |
3.0× |
| X-ray b.e. reductn intuss (74283) |
$577.20 |
$888 |
3.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$735.48 |
$1,131.50 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$258.70 |
$398 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$376.35 |
$579 |
3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$337.35 |
$519 |
2.9× |
| X-ray exam of femur 2/> (73552) |
$256.75 |
$395 |
2.6× |
| X-ray eye for foreign body (70030) |
$260 |
$400 |
2.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$249.60 |
$384 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$271.70 |
$418 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$215.80 |
$332 |
2.2× |
| X-ray leg, infant (73592) |
$270.72 |
$416.50 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$464.10 |
$714 |
4.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$479.70 |
$738 |
4.1× |
| X-ray nose-rectum child f.b. (76010) |
$469.95 |
$723 |
4.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$274.95 |
$423 |
2.4× |
| X-ray retrograde pyelogram (74420) |
$1,591.20 |
$2,448 |
4.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$283.40 |
$436 |
2.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$404.95 |
$623 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$455 |
$700 |
3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$350.35 |
$539 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$221.98 |
$341.50 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$254.80 |
$392 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$452.72 |
$696.50 |
3.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$455 |
$700 |
3.9× |
| X-Ray Small Bowel Enteroclysis (74251) |
$563.55 |
$867 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$292.18 |
$449.50 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$251.55 |
$387 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$277.55 |
$427 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$384.48 |
$591.50 |
3.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$455 |
$700 |
3.9× |
| Xr bone length studies (77073) |
$473.20 |
$728 |
4.1× |
| Xr c-spine 4 or 5 views (72050) |
$492.70 |
$758 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$552.82 |
$850.50 |
4.7× |
| Xr chest 4+ views (71048) |
$457.60 |
$704 |
3.9× |
| Xr urogram antegrade (74425) |
$708.50 |
$1,090 |
1.8× |