| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,030.58 |
$10,043.68 |
5.1× |
| Abdomen 2 views (74019) |
$690.28 |
$986.12 |
6.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,097.28 |
$2,996.11 |
5.2× |
| Angiography extremity bilateral rs&i (75716) |
$5,728.98 |
$8,184.25 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$6,857.87 |
$9,796.96 |
2.2× |
| Ankle 2 views (73600) |
$647.34 |
$924.78 |
7.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,156.41 |
$1,652.02 |
3.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$15,508.65 |
$22,155.22 |
4.9× |
| Aortography abdominal serialography rs&i (75625) |
$4,518.96 |
$6,455.66 |
1.4× |
| Arthrogram hip (73525) |
$1,227.48 |
$1,753.54 |
3.5× |
| Arthrogram shoulder (73040) |
$1,586.62 |
$2,266.60 |
4.5× |
| Arthrogram wrist (73115) |
$1,066.84 |
$1,524.05 |
3.1× |
| Arthrography knee lt (73580) |
$1,252.31 |
$1,789.01 |
3.6× |
| Basic radiation dosimetry calculation (77300) |
$688.20 |
$983.14 |
5.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,793.84 |
$2,562.62 |
4.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,308.28 |
$1,868.97 |
3.3× |
| Bone &/joint imaging whole body (78306) |
$2,139.94 |
$3,057.06 |
5.3× |
| Bone age studies (77072) |
$401.62 |
$573.74 |
3.8× |
| Bone Imaging 3 Phase (78315) |
$2,857.01 |
$4,081.44 |
7.1× |
| Bone survey complete (77075) |
$1,384.45 |
$1,977.78 |
13.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,531.90 |
$2,188.43 |
3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,214.50 |
$7,449.29 |
3.6× |
| Brain Imaging Vascular Flow Only (78610) |
$1,057.70 |
$1,511 |
1.9× |
| Cervical spine 2 or 3 views (72040) |
$715.75 |
$1,022.50 |
8.2× |
| Chest 1 view (71045) |
$452.78 |
$646.83 |
5.2× |
| Chest 3 views (71047) |
$609.33 |
$870.47 |
7.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$887.79 |
$1,268.28 |
5.1× |
| Clavicle complete (73000) |
$557.60 |
$796.58 |
6.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$2,404.93 |
$3,435.62 |
23.0× |
| Continuing medical physics consltj pr wk (77336) |
$919.40 |
$1,313.42 |
6.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$8,044.42 |
$11,492.02 |
23.0× |
| CT abdomen and pelvis without contrast (74176) |
$5,323.82 |
$7,605.44 |
22.3× |
| CT abdomen w contrast (74160) |
$3,419.34 |
$4,884.78 |
19.5× |
| CT abdomen w wo contrast (74170) |
$4,058.62 |
$5,798.02 |
23.1× |
| CT abdomen w/o contrast (74150) |
$2,594.05 |
$3,705.78 |
24.8× |
| CT angio hrt w/3d image (75574) |
$4,578.94 |
$6,541.35 |
13.1× |
| CT angiography upper extremity lt (73206) |
$2,892.64 |
$4,132.35 |
16.5× |
| CT c-spine w/o contrast (72125) |
$2,909.72 |
$4,156.75 |
27.8× |
| CT cervical spine with contrast (72126) |
$3,254.76 |
$4,649.66 |
9.3× |
| CT chest w/wo contrast (71270) |
$3,646.51 |
$5,209.30 |
20.8× |
| CT chest with contrast (71260) |
$3,489.68 |
$4,985.26 |
19.9× |
| CT head/brain with contrast (70460) |
$2,326.97 |
$3,324.24 |
13.2× |
| CT head/brain without and with contrast (70470) |
$3,325.70 |
$4,751.01 |
18.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$3,815.92 |
$5,451.31 |
43.8× |
| CT iac w contrast (70481) |
$2,401.43 |
$3,430.61 |
13.7× |
| CT limited/localized follow up study (76380) |
$1,449 |
$2,069.99 |
16.6× |
| CT lower ext w/o (73700) |
$2,583.18 |
$3,690.26 |
24.7× |
| CT lower extremity w wo contrast (73702) |
$2,680.85 |
$3,829.79 |
15.3× |
| CT lower extremity with contrast (73701) |
$2,621.35 |
$3,744.79 |
14.9× |
| CT lumbar spine w & w/o contrast (72133) |
$3,344.58 |
$4,777.97 |
19.0× |
| CT lumbar spine w/o contrast (72131) |
$3,210.65 |
$4,586.64 |
30.7× |
| CT lumbar spine with contrast (72132) |
$3,711.20 |
$5,301.70 |
10.6× |
| CT maxillofacial w contrast (70487) |
$2,870.05 |
$4,100.07 |
16.3× |
| CT maxillofacial w/o contrast (70486) |
$2,341.56 |
$3,345.10 |
22.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,954.84 |
$4,221.21 |
16.8× |
| CT neck soft tissue w contrast (70491) |
$2,939.92 |
$4,199.90 |
16.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,475.47 |
$4,964.96 |
19.8× |
| CT orbits w/o contrast (70480) |
$2,457.18 |
$3,510.26 |
23.5× |
| CT pelvis w & w/o contrast (72194) |
$4,044.78 |
$5,778.26 |
23.0× |
| CT pelvis w/o contrast (72192) |
$2,729.92 |
$3,899.88 |
26.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,690.09 |
$5,271.55 |
21.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,683.96 |
$3,834.22 |
25.6× |
| CT thoracic spine w/contrast (72129) |
$3,660.88 |
$5,229.82 |
20.8× |
| CT thoracic spine w/o contrast (72128) |
$3,052.66 |
$4,360.95 |
29.2× |
| CT thoracic spine w/wo contrast (72130) |
$3,394.01 |
$4,848.58 |
19.3× |
| CT thorax w/o contrast (71250) |
$2,578.37 |
$3,683.38 |
24.6× |
| CT unlisted procedure (76497) |
$771.07 |
$1,101.53 |
8.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$3,200.08 |
$4,571.55 |
18.2× |
| CT upper extremity w/o contrast rt (73200) |
$2,424.72 |
$3,463.88 |
23.2× |
| CT upper extremity with contrast (73201) |
$2,614.93 |
$3,735.62 |
7.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$7,679.72 |
$10,971.04 |
43.7× |
| Cta Abdomen (74175) |
$4,522.52 |
$6,460.73 |
25.7× |
| CTA abdomen pelvis (74174) |
$6,952.58 |
$9,932.25 |
19.9× |
| CTA chest (71275) |
$4,384.16 |
$6,263.08 |
25.0× |
| Cta Head (70496) |
$3,976.02 |
$5,680.02 |
22.6× |
| CTA lwr ext w&w/o contrast (73706) |
$4,505.44 |
$6,436.33 |
25.6× |
| Cta Neck (70498) |
$3,830.98 |
$5,472.83 |
21.8× |
| Cta Pelvis (72191) |
$4,214.36 |
$6,020.52 |
24.0× |
| Diskogram cervical (72285) |
$4,583.12 |
$6,547.31 |
2.3× |
| Diskography lumbar (72295) |
$6,543.23 |
$9,347.47 |
3.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$843.72 |
$1,205.31 |
8.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$814.27 |
$1,163.24 |
7.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$555.28 |
$793.25 |
6.4× |
| Dxa bone density study axial skeleton (77085) |
$853.09 |
$1,218.70 |
8.1× |
| Echoencephalography real time imaging (76506) |
$941.91 |
$1,345.58 |
9.0× |
| Esophagus (74220) |
$817.14 |
$1,167.35 |
4.7× |
| Fetal biophysical profile non-stress testing (76818) |
$1,240.71 |
$1,772.44 |
11.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,240.71 |
$1,772.44 |
11.8× |
| Fluoroscopy up to 1 hr (76000) |
$982.06 |
$1,402.94 |
4.1× |
| Foot 2 views (73620) |
$571.75 |
$816.78 |
6.6× |
| Forearm 2 views (73090) |
$513.96 |
$734.24 |
5.9× |
| Hand 2 views (73120) |
$636.34 |
$909.04 |
6.1× |
| Hand 3 views (73130) |
$922.34 |
$1,317.64 |
10.6× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$5,359.03 |
$7,655.75 |
7.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,697.93 |
$9,568.47 |
9.6× |
| Heart Infarct Image (78466) |
$1,672.55 |
$2,389.35 |
4.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,357.57 |
$3,367.96 |
4.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,228.37 |
$3,183.39 |
5.6× |
| Ht muscle image spect sing (78451) |
$4,084.24 |
$5,834.62 |
3.1× |
| Humerus Min 2 Views Left (73060) |
$521.34 |
$744.78 |
6.0× |
| Hysterosalpingogram (74740) |
$756.67 |
$1,080.96 |
3.2× |
| Intracavitary radiation source applic simple (77761) |
$5,536.19 |
$7,908.84 |
10.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$569.24 |
$813.20 |
5.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,862.62 |
$2,660.88 |
3.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,498.69 |
$3,569.56 |
4.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,569.83 |
$3,671.18 |
4.7× |
| Knee 3 views (73562) |
$619.17 |
$884.53 |
7.1× |
| Lymphoscintigraphy (78195) |
$2,274.33 |
$3,249.04 |
4.2× |
| Mammary ductogram or galactogram single (77053) |
$941.76 |
$1,345.36 |
3.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$806.76 |
$1,152.52 |
9.3× |
| Meckels Diverticulum (78290) |
$1,479.91 |
$2,114.15 |
3.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$5,118.23 |
$7,311.76 |
13.6× |
| Mr safety determination physician/other qhp (76016) |
$128.70 |
$183.86 |
1.5× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$86.70 |
$123.86 |
1.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$36.05 |
$51.50 |
1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$133.92 |
$191.32 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$352.75 |
$503.93 |
1.5× |
| MRA head w & w/o contrast (70546) |
$4,434.62 |
$6,335.18 |
12.7× |
| MRA head w/o contrast (70544) |
$3,890.29 |
$5,557.56 |
16.3× |
| MRA head with contrast (70545) |
$3,996.72 |
$5,709.60 |
11.4× |
| MRA neck w contrast (70548) |
$3,826.93 |
$5,467.04 |
11.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,771.20 |
$5,387.42 |
10.8× |
| MRA neck w/o contrast (70547) |
$3,510.34 |
$5,014.76 |
14.7× |
| MRI abdomen w contrast (74182) |
$4,877.31 |
$6,967.59 |
14.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$6,188.40 |
$8,840.56 |
17.7× |
| MRI abdomen w/o contrast (74181) |
$4,121.74 |
$5,888.21 |
17.2× |
| MRI any jnt lwr ext with con lt (73722) |
$5,623.48 |
$8,033.54 |
7.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,877.31 |
$6,967.59 |
6.2× |
| MRI breast w/o contrast bilateral (77047) |
$5,574.71 |
$7,963.87 |
23.3× |
| MRI breast w/o contrast unilat (77046) |
$3,790.07 |
$5,414.38 |
15.9× |
| MRI c-spine with contrast (72142) |
$4,877.31 |
$6,967.59 |
14.0× |
| MRI cervical spine w/o contrast (72141) |
$4,617.92 |
$6,597.04 |
19.3× |
| MRI chest w/o & w/contrast material (71552) |
$5,119.54 |
$7,313.64 |
14.7× |
| MRI chest w/o contrast (71550) |
$4,213.20 |
$6,018.86 |
17.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,487.95 |
$6,411.35 |
12.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$4,109.78 |
$5,871.12 |
17.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,990.52 |
$5,700.74 |
16.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,398.11 |
$7,711.58 |
15.4× |
| MRI orbit/face/neck w/contrast (70542) |
$4,765.43 |
$6,807.75 |
13.6× |
| MRI pelvis w contrast (72196) |
$2,914.97 |
$4,164.24 |
8.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,410.12 |
$9,157.32 |
18.3× |
| MRI pelvis w/o contrast (72195) |
$4,612.96 |
$6,589.94 |
19.3× |
| MRI scan of arm joint before and after contrast (73223) |
$5,119.54 |
$7,313.64 |
14.7× |
| MRI scan of leg joint before and after contrast (73723) |
$5,678.28 |
$8,111.82 |
16.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,087.62 |
$8,696.60 |
17.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,877.31 |
$6,967.59 |
14.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,246.23 |
$8,923.19 |
17.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,611.52 |
$9,445.02 |
18.9× |
| MRI thoracic spine w/o contrast (72146) |
$4,288.36 |
$6,126.22 |
17.9× |
| MRI tmj (70336) |
$4,275.47 |
$6,107.81 |
17.9× |
| MRI upper ext joint w/o contrast (73221) |
$4,620.64 |
$6,600.92 |
19.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$5,939.94 |
$8,485.64 |
17.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,213.20 |
$6,018.86 |
17.6× |
| Myelogram Cervical (72240) |
$2,450.78 |
$3,501.11 |
3.1× |
| Myelogram Lumbar (72265) |
$2,450.78 |
$3,501.11 |
3.1× |
| Myelogram thoracic (72255) |
$2,389.64 |
$3,413.77 |
3.0× |
| Myocardial Spect Multiple Studies (78452) |
$5,493.45 |
$7,847.78 |
4.2× |
| Neck soft tissue (70360) |
$646.73 |
$923.90 |
7.4× |
| Nm cisternogram (78630) |
$2,330.95 |
$3,329.93 |
4.3× |
| Nm gastric emptying study (78264) |
$2,226.04 |
$3,180.06 |
5.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,552.60 |
$9,360.86 |
4.7× |
| Nuclear Rx Oral Admin (79005) |
$1,598.13 |
$2,283.04 |
6.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,203.62 |
$1,719.46 |
11.5× |
| Orthopantogram (70355) |
$783.60 |
$1,119.43 |
9.0× |
| Osseous survey infant (77076) |
$704.34 |
$1,006.20 |
6.7× |
| Osseous survey limited (77074) |
$1,341.56 |
$1,916.52 |
12.8× |
| Parathyrd planar w/wo subtrj (78071) |
$2,007.30 |
$2,867.57 |
5.0× |
| Parathyroid imaging (78070) |
$1,938.76 |
$2,769.65 |
4.8× |
| Pelvis 1 or 2 views (72170) |
$469.81 |
$671.15 |
4.5× |
| PET image w/CT, skull-thigh (78815) |
$5,864.41 |
$8,377.73 |
4.1× |
| PET imaging for CT attenuation whole body (78816) |
$6,072.09 |
$8,674.42 |
4.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$5,819.06 |
$8,312.95 |
16.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,464.03 |
$2,091.47 |
3.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,141.96 |
$3,059.95 |
3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$770.76 |
$1,101.09 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$824.52 |
$1,177.88 |
9.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$865.20 |
$1,236 |
8.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$670.80 |
$958.28 |
6.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,765.18 |
$16,807.40 |
1.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,246.46 |
$1,780.66 |
2.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$821.35 |
$1,173.35 |
8.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,033.91 |
$1,477.02 |
2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$918.46 |
$1,312.08 |
8.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$471.57 |
$673.68 |
5.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$523.28 |
$747.55 |
6.0× |
| Radiologic exam colon single contrast study (74270) |
$1,233.67 |
$1,762.38 |
7.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$817.14 |
$1,167.35 |
4.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,255.02 |
$1,792.90 |
7.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,312.01 |
$1,874.30 |
7.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$544.64 |
$778.06 |
6.2× |
| Radiological examination surgical specimen (76098) |
$1,189.49 |
$1,699.27 |
2.2× |
| Ribs bilateral 3 views (71110) |
$1,599.65 |
$2,285.21 |
15.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,484.58 |
$3,549.40 |
4.6× |
| Rp Therapy Intravenous Administration (79101) |
$937.14 |
$1,338.76 |
4.0× |
| Sacroiliac Joints < 3 Views (72200) |
$552.32 |
$789.02 |
5.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$895.56 |
$1,279.36 |
3.7× |
| Scanogram (77073) |
$623.28 |
$890.40 |
6.0× |
| Scapula complete (73010) |
$549.44 |
$784.92 |
5.2× |
| Screening digital breast tomosynthesis (77063) |
$69.38 |
$99.10 |
3.0× |
| Small bowel series (74250) |
$1,094 |
$1,562.86 |
6.2× |
| Spec medical radj physics consltj (77370) |
$1,420.62 |
$2,029.46 |
10.6× |
| Special treatment procedure (77470) |
$2,571.02 |
$3,672.90 |
4.6× |
| Spine thoracic 3 views (72072) |
$856.36 |
$1,223.36 |
8.2× |
| Stereotactic body radiation delivery (77373) |
$12,767.54 |
$18,239.34 |
7.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,239.48 |
$3,199.26 |
6.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,011.48 |
$2,873.54 |
5.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,742.43 |
$3,917.76 |
7.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,378.44 |
$1,969.20 |
10.2× |
| Thoracolumbar 2 views (72080) |
$681.10 |
$973 |
7.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,103.62 |
$3,005.16 |
3.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,698.65 |
$2,426.64 |
4.2× |
| Tmj unilateral (70328) |
$722.15 |
$1,031.64 |
8.3× |
| Treatment device intermediate (77333) |
$468.65 |
$669.50 |
3.5× |
| Treatment devices simple (77332) |
$911.85 |
$1,302.64 |
6.8× |
| Tx devices design & construction complex (77334) |
$1,648.30 |
$2,354.72 |
4.4× |
| Ultrasound, abdomen limited (76705) |
$1,211 |
$1,730 |
11.6× |
| Umbilical-artery Doppler (OB) (76820) |
$831.43 |
$1,187.76 |
7.9× |
| Unlisted magnetic resonance procedure (76498) |
$1,217.24 |
$1,738.91 |
14.0× |
| Unlisted Ultrasound Procedure (76999) |
$876.44 |
$1,252.05 |
10.1× |
| Upper Extremity Infant (73092) |
$468.78 |
$669.68 |
4.5× |
| Urethrocystography voiding (74455) |
$1,147.29 |
$1,638.98 |
4.8× |
| Us abdl aorta screen aaa (76706) |
$1,164.50 |
$1,663.58 |
11.1× |
| Us breast unilateral complete (76641) |
$872 |
$1,245.71 |
8.3× |
| Us breast unilateral limited (76642) |
$886.10 |
$1,265.86 |
10.2× |
| Us chest (76604) |
$1,405.64 |
$2,008.06 |
13.4× |
| Us compl joint r-t w/image documentation (76881) |
$1,113.48 |
$1,590.68 |
10.6× |
| Us guided compression repair (76936) |
$638.84 |
$912.63 |
3.0× |
| Us infant hips dynamic (76885) |
$1,458.35 |
$2,083.36 |
16.7× |
| Us infant hips limited static (76886) |
$888.88 |
$1,269.84 |
10.2× |
| Us ob detailed single fetus (76811) |
$1,433.44 |
$2,047.76 |
6.0× |
| Us ob transvaginal (76817) |
$1,133.82 |
$1,619.76 |
10.8× |
| Us pelvic non ob complete (76856) |
$1,257.35 |
$1,796.22 |
12.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,000.99 |
$1,429.98 |
9.6× |
| Us pregnancy ltd (76815) |
$1,000.99 |
$1,429.98 |
9.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,750.98 |
$2,501.40 |
16.7× |
| Us retroperitoneal complete (76770) |
$1,516.43 |
$2,166.32 |
14.5× |
| Us retroperitoneal limited (76775) |
$1,233.36 |
$1,761.95 |
11.8× |
| Us scrotum and contents (76870) |
$1,283.60 |
$1,833.71 |
12.3× |
| Us soft tissue head/neck (76536) |
$1,143 |
$1,632.85 |
10.9× |
| Us spinal canal and contents (76800) |
$1,641.81 |
$2,345.44 |
15.7× |
| Us transrectal (76872) |
$845.20 |
$1,207.44 |
8.1× |
| Us xtr non-vasc lmtd (76882) |
$709.23 |
$1,013.18 |
6.8× |
| Venogram extremity bilateral (75822) |
$2,050.34 |
$2,929.05 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$2,127.09 |
$3,038.70 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$3,031.67 |
$4,330.95 |
1.9× |
| Wrist 2 views (73100) |
$525.50 |
$750.72 |
6.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$822.66 |
$1,175.22 |
7.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$791.14 |
$1,130.20 |
9.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$673.82 |
$962.60 |
7.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,840.26 |
$2,628.94 |
10.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$502.17 |
$717.38 |
5.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$537.42 |
$767.74 |
6.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$970.64 |
$1,386.63 |
9.3× |
| X-ray exam hip uni 1 view (73501) |
$396.73 |
$566.76 |
4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$489.88 |
$699.83 |
5.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,039.02 |
$1,484.32 |
9.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$799.12 |
$1,141.60 |
7.6× |
| X-ray exam of femur 1 (73551) |
$511.32 |
$730.46 |
5.9× |
| X-ray eye for foreign body (70030) |
$633.36 |
$904.80 |
7.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$800.30 |
$1,143.28 |
7.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$711.63 |
$1,016.62 |
8.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$611.48 |
$873.55 |
7.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$534.62 |
$763.74 |
6.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$772.19 |
$1,103.13 |
8.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$755.96 |
$1,079.95 |
7.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$1,182.13 |
$1,688.76 |
13.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$434.74 |
$621.05 |
5.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$689.20 |
$984.56 |
6.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,178.24 |
$1,683.20 |
11.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$830.09 |
$1,185.84 |
7.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$800.30 |
$1,143.28 |
9.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$495.95 |
$708.50 |
5.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$888.88 |
$1,269.84 |
8.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$888.88 |
$1,269.84 |
8.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$582.79 |
$832.55 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$711.63 |
$1,016.62 |
8.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$933.06 |
$1,332.94 |
8.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,178.24 |
$1,683.20 |
11.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$888.88 |
$1,269.84 |
8.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$888.88 |
$1,269.84 |
10.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$570.40 |
$814.86 |
6.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$888.88 |
$1,269.84 |
10.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$711.63 |
$1,016.62 |
8.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$711.63 |
$1,016.62 |
6.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$694.24 |
$991.78 |
6.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$418.90 |
$598.43 |
4.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$691.14 |
$987.34 |
7.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$602.54 |
$860.78 |
6.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$651.24 |
$930.33 |
6.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$1,021.64 |
$1,459.49 |
9.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$534.62 |
$763.74 |
6.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$549.44 |
$784.92 |
6.3× |
| Xr c-spine 6 or more views (72052) |
$1,198.90 |
$1,712.71 |
11.4× |
| Xr chest 4+ views (71048) |
$688.59 |
$983.70 |
6.6× |
| Xr finger(s) 2+ views (73140) |
$484.39 |
$691.98 |
5.6× |
| Xr shoulder 1 view (73020) |
$484.39 |
$691.98 |
5.6× |
| Xr spine cervical 4 or 5 views (72050) |
$888.88 |
$1,269.84 |
8.5× |
| Xr tibia/fibula 2 views (73590) |
$542.52 |
$775.03 |
6.2× |
| Xr tmj bilateral (70330) |
$1,326.76 |
$1,895.37 |
15.2× |
| Xray knee 1 or 2 views rt (73560) |
$534.62 |
$763.74 |
6.1× |