| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,899.80 |
$13,692 |
5.8× |
| Abdomen 2 views (74019) |
$431.92 |
$664.50 |
3.7× |
| Acute gi blood loss imaging (78278) |
$1,594.45 |
$2,453 |
3.6× |
| Angiography extremity bilateral rs&i (75716) |
$10,775.70 |
$16,578 |
3.1× |
| Angiography extremity unilateral rs&i (75710) |
$10,670.08 |
$16,415.50 |
3.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$19,921.20 |
$30,648 |
3.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,271.50 |
$8,110 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,399.50 |
$5,230 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$36,059.40 |
$55,476 |
5.8× |
| Ankle 2 views (73600) |
$261.30 |
$402 |
2.7× |
| Aortogram thoracic (75605) |
$5,616.65 |
$8,641 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$10,775.70 |
$16,578 |
3.1× |
| Artery X-Rays Adrenal Gland (75731) |
$5,749.90 |
$8,846 |
1.6× |
| Arthrogram hip (73525) |
$918.45 |
$1,413 |
2.4× |
| Arthrogram knee (73580) |
$854.10 |
$1,314 |
2.2× |
| Arthrogram shoulder (73040) |
$2,486.90 |
$3,826 |
6.4× |
| Basic dosimetry (77300) |
$1,006.85 |
$1,549 |
6.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,197.95 |
$1,843 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$1,296.75 |
$1,995 |
2.9× |
| Bone age studies (77072) |
$514.15 |
$791 |
4.4× |
| Bone Imaging 3 Phase (78315) |
$1,510.92 |
$2,324.50 |
3.4× |
| Bone survey complete (77075) |
$493.02 |
$758.50 |
4.2× |
| Bone survey infant (77076) |
$512.20 |
$788 |
4.4× |
| Bowel imaging (78290) |
$1,382.55 |
$2,127 |
3.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,354.40 |
$9,776 |
4.0× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,250.60 |
$1,924 |
2.8× |
| Cervical spine 2 or 3 views (72040) |
$340.60 |
$524 |
3.5× |
| Chest 1 view (71045) |
$310.05 |
$477 |
3.2× |
| Chest xray 3 views (71047) |
$289.90 |
$446 |
3.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$493.02 |
$758.50 |
2.5× |
| Cineradiography/videoradiography (76120) |
$483.60 |
$744 |
4.1× |
| Clavicle complete (73000) |
$301.60 |
$464 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$270.72 |
$416.50 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$721.50 |
$1,110 |
4.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,730.72 |
$8,816.50 |
14.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,977.32 |
$4,580.50 |
11.2× |
| CT abdomen w contrast (74160) |
$2,605.20 |
$4,008 |
13.3× |
| CT abdomen w wo contrast (74170) |
$2,605.20 |
$4,008 |
13.3× |
| CT abdomen w/o contrast (74150) |
$1,671.15 |
$2,571 |
14.3× |
| CT angio hrt w/3d image (75574) |
$2,782.65 |
$4,281 |
7.1× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,643.55 |
$4,067 |
13.5× |
| CT angiography upper extremity lt (73206) |
$2,995.85 |
$4,609 |
15.3× |
| CT c-spine w/contrast (72126) |
$1,604.52 |
$2,468.50 |
4.1× |
| CT c-spine w/o contrast (72125) |
$1,474.20 |
$2,268 |
12.6× |
| CT cere prfu aly c+wo CT/CTA (70473) |
$2,881.45 |
$4,433 |
14.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,918.15 |
$2,951 |
9.8× |
| CT chest w contrast (71260) |
$2,643.55 |
$4,067 |
13.5× |
| CT chest w/wo contrast (71270) |
$2,662.08 |
$4,095.50 |
13.6× |
| CT colonography screening (74263) |
$1,541.15 |
$2,371 |
5.8× |
| CT colonography w/dye (74262) |
$2,990 |
$4,600 |
15.3× |
| CT colonography w/o cntrst (74261) |
$1,312.35 |
$2,019 |
11.3× |
| CT head/brain with contrast (70460) |
$1,179.75 |
$1,815 |
6.0× |
| CT head/brain without and with contrast (70470) |
$1,489.15 |
$2,291 |
7.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,662.08 |
$4,095.50 |
6.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$170.95 |
$263 |
1.8× |
| CT hrt w/3d image congen (75573) |
$2,701.40 |
$4,156 |
6.9× |
| CT iac w contrast (70481) |
$1,357.85 |
$2,089 |
6.9× |
| CT lower ext w/o (73700) |
$2,168.40 |
$3,336 |
18.6× |
| CT lower extremity w wo contrast (73702) |
$1,457.30 |
$2,242 |
7.4× |
| CT lower extremity w/contrast material (73701) |
$2,643.55 |
$4,067 |
13.5× |
| CT lumbar spine w & w/o contrast (72133) |
$2,370.88 |
$3,647.50 |
12.1× |
| CT lumbar spine w/contrast (72132) |
$1,899.30 |
$2,922 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$1,452.75 |
$2,235 |
12.5× |
| CT maxillofacial w contrast (70487) |
$2,605.20 |
$4,008 |
13.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,275.95 |
$1,963 |
6.5× |
| CT maxillofacial wo contrast (70486) |
$1,452.75 |
$2,235 |
12.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,667.90 |
$2,566 |
8.5× |
| CT orbits w/o contrast (70480) |
$918.45 |
$1,413 |
7.9× |
| CT pelvis w/o contrast (72192) |
$1,452.75 |
$2,235 |
12.5× |
| CT pelvis w/wo contrast (72194) |
$1,555.45 |
$2,393 |
7.9× |
| CT scan of arm combo (73202) |
$1,727.70 |
$2,658 |
8.8× |
| CT soft tissue neck w contrast (70491) |
$2,605.20 |
$4,008 |
13.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,489.15 |
$2,291 |
7.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,452.75 |
$2,235 |
12.5× |
| CT thoracic spine w/contrast (72129) |
$1,487.85 |
$2,289 |
7.6× |
| CT thoracic spine w/o contrast (72128) |
$1,574.95 |
$2,423 |
13.5× |
| CT thoracic spine w/wo contrast (72130) |
$1,835.60 |
$2,824 |
9.4× |
| CT thorax w/o contrast (71250) |
$1,452.75 |
$2,235 |
12.5× |
| CT upper ext wo (73200) |
$1,474.20 |
$2,268 |
12.6× |
| CT upper extremity with contrast (73201) |
$5,056.35 |
$7,779 |
13.0× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,995.85 |
$4,609 |
15.3× |
| Cta Abdomen (74175) |
$2,995.85 |
$4,609 |
15.3× |
| CTA abdomen pelvis (74174) |
$4,982.58 |
$7,665.50 |
12.8× |
| CTA chest (71275) |
$2,605.20 |
$4,008 |
13.3× |
| Cta Head (70496) |
$3,836.95 |
$5,903 |
19.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$6,040.78 |
$9,293.50 |
15.5× |
| Cta Neck (70498) |
$3,040.05 |
$4,677 |
15.5× |
| Cta Pelvis (72191) |
$2,943.20 |
$4,528 |
15.0× |
| Cystography minimum 3 views rs&i (74430) |
$571.02 |
$878.50 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$468 |
$720 |
4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$225.88 |
$347.50 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$427.70 |
$658 |
3.7× |
| Echo exam of eye (76529) |
$166.40 |
$256 |
1.7× |
| Esophagus (74220) |
$1,016.28 |
$1,563.50 |
5.2× |
| Facial bones min 3 views (70150) |
$416 |
$640 |
3.6× |
| Fetal biophysical profile non-stress testing (76818) |
$613.28 |
$943.50 |
5.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$846.30 |
$1,302 |
7.3× |
| Fluoroscopy up to 1 hr (76000) |
$969.15 |
$1,491 |
3.6× |
| Foot 2 views (73620) |
$301.60 |
$464 |
3.1× |
| Forearm 2 views (73090) |
$301.60 |
$464 |
3.1× |
| Hand 2 views (73120) |
$343.20 |
$528 |
2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,959.85 |
$9,169 |
1.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,005.58 |
$3,085.50 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,018.25 |
$3,105 |
4.5× |
| Hysterosalpingogram (74740) |
$575.90 |
$886 |
2.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$497.90 |
$766 |
4.3× |
| 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) |
$346.45 |
$533 |
3.6× |
| Liver & spleen imaging static only (78215) |
$1,283.10 |
$1,974 |
2.9× |
| Lymphoscintigraphy (78195) |
$1,327.95 |
$2,043 |
2.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,959.75 |
$3,015 |
2.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,383.55 |
$3,667 |
6.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$5,037.82 |
$7,750.50 |
12.9× |
| Mammary ductogram or galactogram multiple (77054) |
$1,188.85 |
$1,829 |
4.5× |
| Mammary ductogram or galactogram single (77053) |
$654.55 |
$1,007 |
2.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,444.95 |
$2,223 |
3.5× |
| MRA head w & w/o contrast (70546) |
$5,265.65 |
$8,101 |
13.5× |
| MRA head w/o contrast (70544) |
$2,695.22 |
$4,146.50 |
10.1× |
| MRA head with contrast (70545) |
$1,291.55 |
$1,987 |
3.3× |
| MRA neck w contrast (70548) |
$5,913.70 |
$9,098 |
15.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,188.95 |
$7,983 |
13.3× |
| MRA neck w/o contrast (70547) |
$3,167.45 |
$4,873 |
11.9× |
| MRI abdomen w contrast (74182) |
$2,200.90 |
$3,386 |
5.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$5,188.95 |
$7,983 |
13.3× |
| MRI abdomen w/o contrast (74181) |
$2,695.22 |
$4,146.50 |
10.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,660.78 |
$4,093.50 |
3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,350.72 |
$3,616.50 |
6.0× |
| MRI breast w/o contrast bilateral (77047) |
$657.80 |
$1,012 |
2.5× |
| MRI c-spine with contrast (72142) |
$2,324.40 |
$3,576 |
6.0× |
| MRI cervical spine w/o contrast (72141) |
$2,695.22 |
$4,146.50 |
10.1× |
| MRI chest w/o & w/contrast material (71552) |
$2,582.45 |
$3,973 |
6.6× |
| MRI chest w/o contrast (71550) |
$2,168.40 |
$3,336 |
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) |
$5,265.65 |
$8,101 |
13.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,735.20 |
$4,208 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,925.95 |
$2,963 |
7.2× |
| MRI orbit face neck w contrast (70542) |
$2,399.80 |
$3,692 |
6.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,653.35 |
$7,159 |
12.0× |
| MRI pelvis w/contrast (72196) |
$1,836.25 |
$2,825 |
4.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$5,188.95 |
$7,983 |
13.3× |
| MRI pelvis w/o contrast (72195) |
$2,695.22 |
$4,146.50 |
10.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,188.95 |
$7,983 |
13.3× |
| 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) |
$5,188.95 |
$7,983 |
13.3× |
| 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) |
$5,188.95 |
$7,983 |
13.3× |
| MRI temporomandibular joint (70336) |
$3,505.45 |
$5,393 |
13.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,695.22 |
$4,146.50 |
10.1× |
| MRI up ext w/o contrast (73218) |
$2,866.50 |
$4,410 |
10.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,735.20 |
$4,208 |
10.3× |
| MRI, joint upper extrem combo (73223) |
$3,150.55 |
$4,847 |
8.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,830.10 |
$4,354 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$5,411.90 |
$8,326 |
3.7× |
| Myocardial spect single study at rest or stress (78451) |
$2,834.65 |
$4,361 |
2.0× |
| N-invas est c ffr sw aly CTA (75580) |
$3,229.85 |
$4,969 |
3.4× |
| Neck soft tissue (70360) |
$301.60 |
$464 |
3.1× |
| Nm gastric emptying study (78264) |
$1,556.42 |
$2,394.50 |
3.5× |
| Nonvascular shunt X-ray (75809) |
$383.50 |
$590 |
3.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,688.85 |
$11,829 |
5.0× |
| Nuclear Rx Oral Admin (79005) |
$1,001.65 |
$1,541 |
3.8× |
| Ob us nuchal meas 1 gest (76813) |
$662.35 |
$1,019 |
5.7× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$650 |
$1,000 |
5.6× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter… (76510) |
$614.90 |
$946 |
4.1× |
| Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) |
$812.50 |
$1,250 |
7.0× |
| Orthopantogram (70355) |
$294.45 |
$453 |
3.0× |
| Osseous survey limited (77074) |
$495.30 |
$762 |
4.2× |
| Parathyroid Planar Imaging (78070) |
$2,154.75 |
$3,315 |
4.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,189.50 |
$1,830 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$472.55 |
$727 |
4.1× |
| Peritoneogram after injection (74190) |
$2,135.90 |
$3,286 |
3.5× |
| PET image w/CT, skull-thigh (78815) |
$6,354.40 |
$9,776 |
4.0× |
| PET imaging CT for attenuation limited area (78814) |
$7,263.75 |
$11,175 |
4.6× |
| PET imaging for CT attenuation whole body (78816) |
$6,230.25 |
$9,585 |
3.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,310.80 |
$6,632 |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,069.60 |
$3,184 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,396.20 |
$2,148 |
3.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,035.15 |
$3,131 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$2,090.40 |
$3,216 |
3.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$301.60 |
$464 |
3.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$292.82 |
$450.50 |
3.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$346.45 |
$533 |
3.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$234.98 |
$361.50 |
2.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$463.45 |
$713 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$434.85 |
$669 |
3.7× |
| Radex fingr minimum 2 views (73140) |
$301.60 |
$464 |
3.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$346.45 |
$533 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$627.90 |
$966 |
6.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$386.75 |
$595 |
4.0× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$345.15 |
$531 |
3.0× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$298.02 |
$458.50 |
2.6× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$557.70 |
$858 |
4.8× |
| Radex Humerus Minimum 2 Views (73060) |
$339.95 |
$523 |
3.5× |
| Radex Kne 1/2 Views (73560) |
$346.45 |
$533 |
3.6× |
| Radex Kne Compl 4/More Views (73564) |
$627.90 |
$966 |
5.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$317.20 |
$488 |
2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$252.85 |
$389 |
2.6× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$407.22 |
$626.50 |
3.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$346.45 |
$533 |
3.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$282.10 |
$434 |
2.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$492.70 |
$758 |
4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$215.48 |
$331.50 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$295.75 |
$455 |
3.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$430.30 |
$662 |
3.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$346.45 |
$533 |
3.6× |
| 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) |
$21,667.75 |
$33,335 |
2.6× |
| 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) |
$1,158.62 |
$1,782.50 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$286.32 |
$440.50 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$359.45 |
$553 |
3.1× |
| Radiologic exam chest 2 views (71046) |
$299.98 |
$461.50 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$786.82 |
$1,210.50 |
4.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$883.02 |
$1,358.50 |
4.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$891.80 |
$1,372 |
4.6× |
| Radiologic examination femur 1 view (73551) |
$443.30 |
$682 |
4.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$301.60 |
$464 |
3.1× |
| 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× |
| Radiologic examination, teeth; complete, full mouth Non-Facility (70320) |
$990.60 |
$1,524 |
3.7× |
| Radiological examination surgical specimen (76098) |
$1,423.82 |
$2,190.50 |
2.3× |
| Ribs bilateral 3 views (71110) |
$456.95 |
$703 |
3.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,609.15 |
$7,091 |
7.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,196.05 |
$4,917 |
5.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,892.20 |
$5,988 |
6.4× |
| 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× |
| Sacroiliac Joints < 3 Views (72200) |
$252.20 |
$388 |
2.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$540.80 |
$832 |
2.0× |
| Scapula (73010) |
$510.25 |
$785 |
4.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$54.60 |
$84 |
2.3× |
| Shoulder 1 view (73020) |
$346.45 |
$533 |
3.6× |
| Small bowel series (74250) |
$723.45 |
$1,113 |
3.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,251.25 |
$1,925 |
3.0× |
| Special dosimetry (77331) |
$346.45 |
$533 |
2.3× |
| Special Physics Consult (77370) |
$699.40 |
$1,076 |
4.7× |
| Special treatment procedure (77470) |
$2,309.45 |
$3,553 |
3.7× |
| Spine thoracic 3 views (72072) |
$485.22 |
$746.50 |
4.2× |
| Stereotactic Body Radiation Delivery (77373) |
$6,593.60 |
$10,144 |
3.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,708.20 |
$2,628 |
4.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$900.90 |
$1,386 |
2.2× |
| Testicular Imaging With Vascular Flow (78761) |
$1,255.15 |
$1,931 |
2.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,075.45 |
$3,193 |
5.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$840.12 |
$1,292.50 |
5.6× |
| Thoracolumbar 2 views (72080) |
$311.35 |
$479 |
3.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,421.55 |
$2,187 |
2.3× |
| Thyroid uptake measurement (78012) |
$724.75 |
$1,115 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,074.78 |
$1,653.50 |
2.4× |
| Treatment device complex (77334) |
$1,526.52 |
$2,348.50 |
3.7× |
| Treatment device intermediate (77333) |
$830.05 |
$1,277 |
5.5× |
| Treatment devices simple (77332) |
$678.92 |
$1,044.50 |
4.5× |
| Ultrasound breast complete (76641) |
$940.22 |
$1,446.50 |
8.1× |
| Ultrasound Exam Aaa Screen (76706) |
$547.95 |
$843 |
4.7× |
| Ultrasound, abdomen limited (76705) |
$628.88 |
$967.50 |
5.4× |
| Umbilical-artery Doppler (OB) (76820) |
$386.75 |
$595 |
3.3× |
| Urethrocystogram voiding (74455) |
$596.70 |
$918 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$596.70 |
$918 |
2.2× |
| Us breast unilateral limited (76642) |
$351.65 |
$541 |
3.6× |
| Us chest (76604) |
$723.45 |
$1,113 |
6.2× |
| Us compl joint r-t w/image documentation (76881) |
$628.88 |
$967.50 |
5.4× |
| Us elastography parenchyma (76981) |
$404.30 |
$622 |
3.5× |
| Us encephalogram (76506) |
$802.10 |
$1,234 |
6.9× |
| Us hips infant static (76886) |
$360.10 |
$554 |
3.7× |
| Us infant hips w manipulation (76885) |
$402.35 |
$619 |
4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$635.05 |
$977 |
5.4× |
| Us ob detailed single fetus (76811) |
$1,356.88 |
$2,087.50 |
5.1× |
| Us ob limited (76815) |
$728.65 |
$1,121 |
6.2× |
| Us ob transvaginal (76817) |
$628.88 |
$967.50 |
5.4× |
| Us pelvic non ob complete (76856) |
$628.88 |
$967.50 |
5.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$628.88 |
$967.50 |
5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$628.88 |
$967.50 |
5.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$628.88 |
$967.50 |
5.4× |
| Us retroperitoneal complete (76770) |
$635.05 |
$977 |
5.4× |
| Us retroperitoneal limited (76775) |
$635.05 |
$977 |
5.4× |
| Us scrotum and contents (76870) |
$723.45 |
$1,113 |
6.2× |
| Us soft tissue head/neck (76536) |
$628.88 |
$967.50 |
5.4× |
| Us spinal canal and contents (76800) |
$729.30 |
$1,122 |
6.3× |
| Us, eye b-scan (76512) |
$599.30 |
$922 |
5.1× |
| Us,transplanted kidney, real time/ doppler (76776) |
$536.90 |
$826 |
4.6× |
| Venogram extremity bilateral (75822) |
$1,898.65 |
$2,921 |
1.1× |
| Venogram Extremity Unilateral (75820) |
$1,792.05 |
$2,757 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$4,434.95 |
$6,823 |
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 venous sinus/jugular cath rs&i (75860) |
$3,316.30 |
$5,102 |
0.9× |
| Venous sampling by catheter (75893) |
$3,725.15 |
$5,731 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$174.85 |
$269 |
1.8× |
| Wrist 2 views (73100) |
$346.45 |
$533 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$538.85 |
$829 |
4.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$305.18 |
$469.50 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$868.40 |
$1,336 |
4.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$260.65 |
$401 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$384.15 |
$591 |
4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$465.40 |
$716 |
4.0× |
| X-ray exam of femur 2/> (73552) |
$349.05 |
$537 |
3.6× |
| X-ray eye for foreign body (70030) |
$260 |
$400 |
2.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$247 |
$380 |
2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$243.42 |
$374.50 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$213.52 |
$328.50 |
2.2× |
| X-ray leg, infant (73592) |
$274.30 |
$422 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$621.72 |
$956.50 |
5.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$575.58 |
$885.50 |
4.9× |
| X-ray nose-rectum child f.b. (76010) |
$509.60 |
$784 |
5.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$354.25 |
$545 |
3.0× |
| X-ray retrograde pyelogram (74420) |
$1,657.50 |
$2,550 |
4.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$286.65 |
$441 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$409.18 |
$629.50 |
3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$523.90 |
$806 |
4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$470.92 |
$724.50 |
4.0× |
| 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) |
$304.85 |
$469 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$548.92 |
$844.50 |
4.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$447.52 |
$688.50 |
3.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$290.22 |
$446.50 |
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) |
$272.35 |
$419 |
2.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$464.75 |
$715 |
4.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$400.40 |
$616 |
3.4× |
| Xr bone length studies (77073) |
$497.90 |
$766 |
4.3× |
| Xr c-spine 4 or 5 views (72050) |
$503.75 |
$775 |
4.3× |
| Xr c-spine 6 or more views (72052) |
$558.68 |
$859.50 |
4.8× |
| Xr chest 4+ views (71048) |
$391.95 |
$603 |
3.4× |
| Xr urogram antegrade (74425) |
$708.50 |
$1,090 |
1.8× |