| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,113.50 |
$6,818 |
3.8× |
| Abdomen 2 views (74019) |
$687.75 |
$917 |
6.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,548.50 |
$3,398 |
6.6× |
| Angiography extremity bilateral rs&i (75716) |
$7,177.50 |
$9,570 |
2.3× |
| Angiography extremity unilateral rs&i (75710) |
$6,433.50 |
$8,578 |
2.1× |
| Angiography internal mammary rs&i (75756) |
$3,694.50 |
$4,926 |
1.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,996.50 |
$6,662 |
1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,158.25 |
$4,211 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$8,781 |
$11,708 |
1.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$10,755 |
$14,340 |
2.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,039.50 |
$5,386 |
1.3× |
| Ankle 2 views (73600) |
$683.25 |
$911 |
8.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,674 |
$2,232 |
4.9× |
| Aortogram thoracic (75605) |
$6,790.50 |
$9,054 |
1.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$8,565 |
$11,420 |
2.8× |
| Aortography abdominal serialography rs&i (75625) |
$6,386.25 |
$8,515 |
2.1× |
| Arthrogram elbow (73085) |
$1,801.50 |
$2,402 |
5.3× |
| Arthrogram hip (73525) |
$1,935 |
$2,580 |
5.7× |
| Arthrogram shoulder (73040) |
$1,540.50 |
$2,054 |
4.5× |
| Arthrogram wrist (73115) |
$1,645.50 |
$2,194 |
4.9× |
| Arthrography knee lt (73580) |
$1,738.50 |
$2,318 |
5.1× |
| Basic radiation dosimetry calculation (77300) |
$478.50 |
$638 |
3.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,797.75 |
$2,397 |
4.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$3,528 |
$4,704 |
9.1× |
| Bone &/joint imaging whole body (78306) |
$2,653.50 |
$3,538 |
6.8× |
| Bone age studies (77072) |
$819.75 |
$1,093 |
8.1× |
| Bone Imaging 3 Phase (78315) |
$2,297.25 |
$3,063 |
5.9× |
| Bone survey complete (77075) |
$1,156.50 |
$1,542 |
11.4× |
| Brain imaging < 4 static views w vascular flow (78601) |
$2,114.25 |
$2,819 |
5.4× |
| Brain Imaging Vascular Flow Only (78610) |
$1,215 |
$1,620 |
2.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,771.50 |
$6,362 |
14.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,524.50 |
$3,366 |
4.8× |
| Cervical spine 2 or 3 views (72040) |
$1,060.12 |
$1,413.50 |
12.5× |
| Chest 1 view (71045) |
$503.25 |
$671 |
6.0× |
| Chest 3 views (71047) |
$366 |
$488 |
4.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$834 |
$1,112 |
4.9× |
| Clavicle complete (73000) |
$969 |
$1,292 |
11.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,617.75 |
$2,157 |
15.9× |
| Continuing medical physics consltj pr wk (77336) |
$750 |
$1,000 |
5.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$11,587.50 |
$15,450 |
34.2× |
| CT abdomen and pelvis without contrast (74176) |
$4,665 |
$6,220 |
20.1× |
| CT abdomen w contrast (74160) |
$3,935.25 |
$5,247 |
23.1× |
| CT abdomen w wo contrast (74170) |
$4,014.75 |
$5,353 |
23.6× |
| CT abdomen w/o contrast (74150) |
$3,008.25 |
$4,011 |
29.6× |
| CT angio hrt w/3d image (75574) |
$5,085 |
$6,780 |
15.0× |
| CT angiography upper extremity lt (73206) |
$6,897 |
$9,196 |
40.5× |
| CT c-spine w/o contrast (72125) |
$3,217.50 |
$4,290 |
31.7× |
| CT cervical spine w&w/o contrast (72127) |
$5,032.50 |
$6,710 |
29.5× |
| CT cervical spine with contrast (72126) |
$3,524.25 |
$4,699 |
10.4× |
| CT chest w/wo contrast (71270) |
$4,616.25 |
$6,155 |
27.1× |
| CT chest with contrast (71260) |
$3,376.50 |
$4,502 |
19.8× |
| CT head/brain with contrast (70460) |
$2,572.50 |
$3,430 |
15.1× |
| CT head/brain without and with contrast (70470) |
$4,705.50 |
$6,274 |
27.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,488.50 |
$3,318 |
7.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$2,087.25 |
$2,783 |
24.7× |
| CT hrt w/3d image congen (75573) |
$4,308.75 |
$5,745 |
12.7× |
| CT iac w contrast (70481) |
$4,492.50 |
$5,990 |
26.4× |
| CT limited/localized follow up study (76380) |
$1,617.75 |
$2,157 |
19.1× |
| CT lower ext w/o (73700) |
$3,285 |
$4,380 |
32.3× |
| CT lower extremity w wo contrast (73702) |
$3,416.25 |
$4,555 |
20.0× |
| CT lower extremity with contrast (73701) |
$2,572.50 |
$3,430 |
15.1× |
| CT lumbar spine w & w/o contrast (72133) |
$4,122.75 |
$5,497 |
24.2× |
| CT lumbar spine w/o contrast (72131) |
$3,217.50 |
$4,290 |
31.7× |
| CT lumbar spine with contrast (72132) |
$3,524.25 |
$4,699 |
10.4× |
| CT maxillofacial w contrast (70487) |
$2,871 |
$3,828 |
16.8× |
| CT maxillofacial w/o contrast (70486) |
$3,155.25 |
$4,207 |
31.1× |
| CT maxillofacial w/wo contrast (70488) |
$3,961.50 |
$5,282 |
23.2× |
| CT neck soft tissue w contrast (70491) |
$3,747.75 |
$4,997 |
22.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$6,551.25 |
$8,735 |
38.4× |
| CT orbits w/o contrast (70480) |
$4,300.50 |
$5,734 |
42.3× |
| CT pelvis w & w/o contrast (72194) |
$4,491 |
$5,988 |
26.3× |
| CT pelvis w/o contrast (72192) |
$2,697.75 |
$3,597 |
26.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,573.75 |
$4,765 |
21.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,451.75 |
$3,269 |
24.1× |
| CT thoracic spine w/contrast (72129) |
$3,210 |
$4,280 |
18.8× |
| CT thoracic spine w/o contrast (72128) |
$2,572.50 |
$3,430 |
25.3× |
| CT thoracic spine w/wo contrast (72130) |
$5,032.50 |
$6,710 |
29.5× |
| CT thorax w/o contrast (71250) |
$3,668.25 |
$4,891 |
36.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$5,853 |
$7,804 |
34.3× |
| CT upper extremity w/o contrast rt (73200) |
$3,213.75 |
$4,285 |
31.6× |
| CT upper extremity with contrast (73201) |
$4,317 |
$5,756 |
12.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,815.75 |
$6,421 |
28.3× |
| Cta Abdomen (74175) |
$5,307 |
$7,076 |
31.1× |
| CTA abdomen pelvis (74174) |
$6,675.75 |
$8,901 |
19.7× |
| CTA chest (71275) |
$5,924.25 |
$7,899 |
34.8× |
| Cta Head (70496) |
$5,860.50 |
$7,814 |
34.4× |
| CTA lwr ext w&w/o contrast (73706) |
$5,780.25 |
$7,707 |
33.9× |
| Cta Neck (70498) |
$5,643.75 |
$7,525 |
33.1× |
| Cta Pelvis (72191) |
$5,784.38 |
$7,712.50 |
33.9× |
| Cystography minimum 3 views rs&i (74430) |
$850.50 |
$1,134 |
2.5× |
| Diskography lumbar (72295) |
$3,705.75 |
$4,941 |
2.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$819 |
$1,092 |
8.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,287 |
$1,716 |
12.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$906 |
$1,208 |
8.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$798.75 |
$1,065 |
7.9× |
| Dxa bone density study axial skeleton (77085) |
$1,136.25 |
$1,515 |
11.2× |
| Echo exam of fetal heart (76825) |
$1,770.75 |
$2,361 |
3.3× |
| Echoencephalography real time imaging (76506) |
$915 |
$1,220 |
9.0× |
| Esophagus (74220) |
$942 |
$1,256 |
5.5× |
| Fetal biophysical profile non-stress testing (76818) |
$701.25 |
$935 |
6.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$942.75 |
$1,257 |
9.3× |
| Fluoroscopy up to 1 hr (76000) |
$927 |
$1,236 |
4.0× |
| Foot 2 views (73620) |
$522.75 |
$697 |
6.2× |
| Forearm 2 views (73090) |
$1,086.75 |
$1,449 |
12.9× |
| Gated Heart Planar Single (78472) |
$2,572.50 |
$3,430 |
6.6× |
| Hand 2 views (73120) |
$521.25 |
$695 |
5.1× |
| Hand 3 views (73130) |
$1,083 |
$1,444 |
12.8× |
| Heart Infarct Image (78466) |
$2,722.50 |
$3,630 |
7.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,566.25 |
$4,755 |
6.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,937 |
$3,916 |
7.6× |
| Ht muscle image spect sing (78451) |
$3,754.50 |
$5,006 |
3.0× |
| Humerus Min 2 Views Left (73060) |
$1,047.75 |
$1,397 |
12.4× |
| Hysterosalpingogram (74740) |
$2,295.75 |
$3,061 |
9.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,569.50 |
$3,426 |
4.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,361 |
$3,148 |
4.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$3,218.25 |
$4,291 |
6.1× |
| Knee 3 views (73562) |
$1,167.75 |
$1,557 |
13.8× |
| Liver & spleen imaging static only (78215) |
$2,280.75 |
$3,041 |
5.9× |
| Liver imaging static only (78201) |
$1,893 |
$2,524 |
3.6× |
| Lung perf&ventilat diferentl (78598) |
$1,455.75 |
$1,941 |
2.8× |
| Lung Ventilation Imaging (78579) |
$1,995.75 |
$2,661 |
5.1× |
| Lymphoscintigraphy (78195) |
$2,769 |
$3,692 |
5.2× |
| Mammary ductogram or galactogram single (77053) |
$2,440.50 |
$3,254 |
10.5× |
| Meckels Diverticulum (78290) |
$1,872 |
$2,496 |
4.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$6,200.25 |
$8,267 |
17.0× |
| Mr safety determination physician/other qhp (76016) |
$342 |
$456 |
4.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$231 |
$308 |
4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$95.25 |
$127 |
3.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$357 |
$476 |
3.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$939.75 |
$1,253 |
4.1× |
| MRA head w & w/o contrast (70546) |
$5,745.38 |
$7,660.50 |
16.9× |
| MRA head w/o contrast (70544) |
$5,621.25 |
$7,495 |
24.2× |
| MRA head with contrast (70545) |
$4,731.75 |
$6,309 |
14.0× |
| MRA neck w contrast (70548) |
$5,031 |
$6,708 |
14.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,745.75 |
$7,661 |
16.9× |
| MRA neck w/o contrast (70547) |
$4,978.50 |
$6,638 |
21.5× |
| MRI abdomen w contrast (74182) |
$6,784.50 |
$9,046 |
20.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$8,019 |
$10,692 |
23.7× |
| MRI abdomen w/o contrast (74181) |
$5,709.75 |
$7,613 |
24.6× |
| MRI any jnt lwr ext with con lt (73722) |
$7,655.25 |
$10,207 |
10.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$6,747.75 |
$8,997 |
8.9× |
| MRI breast w/o contrast bilateral (77047) |
$4,176.75 |
$5,569 |
18.0× |
| MRI breast w/o contrast unilat (77046) |
$5,088 |
$6,784 |
21.9× |
| MRI c-spine with contrast (72142) |
$4,846.50 |
$6,462 |
14.3× |
| MRI cardiac w/o contrast (75557) |
$3,916.50 |
$5,222 |
16.9× |
| MRI cervical spine w/o contrast (72141) |
$6,805.50 |
$9,074 |
29.4× |
| MRI chest w/o & w/contrast material (71552) |
$5,721.75 |
$7,629 |
16.9× |
| MRI chest w/o contrast (71550) |
$6,332.25 |
$8,443 |
27.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$6,476.25 |
$8,635 |
19.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$7,131.75 |
$9,509 |
21.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,658.50 |
$8,878 |
28.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$5,284.50 |
$7,046 |
22.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,721.75 |
$7,629 |
16.9× |
| MRI pelvis w contrast (72196) |
$6,504.75 |
$8,673 |
19.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,851 |
$6,468 |
14.3× |
| MRI pelvis w/o contrast (72195) |
$4,688.25 |
$6,251 |
20.2× |
| MRI scan of arm joint before and after contrast (73223) |
$5,094 |
$6,792 |
15.0× |
| MRI scan of leg joint before and after contrast (73723) |
$7,902 |
$10,536 |
23.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,721.75 |
$7,629 |
16.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,846.50 |
$6,462 |
14.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,721.75 |
$7,629 |
16.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$5,223.75 |
$6,965 |
15.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,721.75 |
$7,629 |
16.9× |
| MRI thoracic spine w/o contrast (72146) |
$5,709.75 |
$7,613 |
24.6× |
| MRI tmj (70336) |
$4,718.25 |
$6,291 |
20.3× |
| MRI upper ext joint w/o contrast (73221) |
$7,138.50 |
$9,518 |
30.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,429.50 |
$5,906 |
13.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,996 |
$5,328 |
17.2× |
| Myelogram Cervical (72240) |
$2,851.50 |
$3,802 |
3.7× |
| Myelogram Lumbar (72265) |
$2,851.50 |
$3,802 |
3.7× |
| Myelogram thoracic (72255) |
$2,851.50 |
$3,802 |
3.7× |
| Myelography 2 or more regions (72270) |
$5,007 |
$6,676 |
6.6× |
| Myocardial infarct spect (78469) |
$3,667.50 |
$4,890 |
7.0× |
| Myocardial Spect Multiple Studies (78452) |
$5,847.75 |
$7,797 |
4.6× |
| Neck soft tissue (70360) |
$819.75 |
$1,093 |
9.7× |
| Nm cisternogram (78630) |
$1,501.50 |
$2,002 |
2.8× |
| Nm gastric emptying study (78264) |
$3,236.25 |
$4,315 |
8.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,564.75 |
$4,753 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$1,124.25 |
$1,499 |
5.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$1,613.25 |
$2,151 |
15.9× |
| Orthopantogram (70355) |
$348 |
$464 |
4.1× |
| Osseous survey infant (77076) |
$1,244.25 |
$1,659 |
12.2× |
| Parathyroid imaging (78070) |
$1,327.50 |
$1,770 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$605.25 |
$807 |
6.0× |
| Peritoneogram rs&i (74190) |
$1,819.50 |
$2,426 |
3.4× |
| PET image w/CT, skull-thigh (78815) |
$10,567.50 |
$14,090 |
7.6× |
| PET imaging CT for attenuation limited area (78814) |
$10,167 |
$13,556 |
7.3× |
| PET imaging for CT attenuation whole body (78816) |
$10,567.50 |
$14,090 |
7.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$6,213 |
$8,284 |
18.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,160.50 |
$8,214 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,534.50 |
$2,046 |
4.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,694.50 |
$4,926 |
7.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,408.50 |
$1,878 |
2.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$1,736.25 |
$2,315 |
20.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,747.50 |
$2,330 |
17.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$916.50 |
$1,222 |
9.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,818.75 |
$2,425 |
17.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$681.75 |
$909 |
1.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$420 |
$560 |
4.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$519 |
$692 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$1,108.50 |
$1,478 |
10.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$773.25 |
$1,031 |
9.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$735.75 |
$981 |
7.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$725.25 |
$967 |
8.6× |
| Radiologic exam colon single contrast study (74270) |
$1,491 |
$1,988 |
8.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,140.75 |
$1,521 |
6.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,357.50 |
$1,810 |
8.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,605 |
$2,140 |
9.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$765.75 |
$1,021 |
9.1× |
| Radiological examination surgical specimen (76098) |
$730.50 |
$974 |
1.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,913.50 |
$5,218 |
1.3× |
| Ribs bilateral 3 views (71110) |
$1,062.75 |
$1,417 |
10.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,440.25 |
$4,587 |
8.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,794.25 |
$5,059 |
7.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,921.25 |
$3,895 |
5.5× |
| Scanogram (77073) |
$686.25 |
$915 |
6.8× |
| Scapula complete (73010) |
$737.25 |
$983 |
7.3× |
| Screening digital breast tomosynthesis (77063) |
$213 |
$284 |
9.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$754.50 |
$1,006 |
7.4× |
| Simulation intermediate (77285) |
$2,796 |
$3,728 |
7.7× |
| Small bowel series (74250) |
$1,180.50 |
$1,574 |
6.9× |
| Spec medical radj physics consltj (77370) |
$1,617.75 |
$2,157 |
12.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,974.75 |
$2,633 |
5.4× |
| Special dosimetry (77331) |
$458.25 |
$611 |
3.5× |
| Special treatment procedure (77470) |
$2,909.25 |
$3,879 |
5.4× |
| Stereotactic body radiation delivery (77373) |
$8,438.25 |
$11,251 |
4.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,167.75 |
$1,557 |
3.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$897.75 |
$1,197 |
2.5× |
| Testicular Imaging With Vascular Flow (78761) |
$2,857.50 |
$3,810 |
7.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,995.75 |
$2,661 |
5.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,110.75 |
$1,481 |
8.5× |
| Thoracolumbar 2 views (72080) |
$870.75 |
$1,161 |
10.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$3,216 |
$4,288 |
6.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$871.50 |
$1,162 |
2.2× |
| Thyroid uptake measurement (78012) |
$871.50 |
$1,162 |
2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,542.75 |
$2,057 |
4.0× |
| Tomogram (76100) |
$1,086.75 |
$1,449 |
10.7× |
| Treatment device intermediate (77333) |
$1,128 |
$1,504 |
8.6× |
| Treatment devices simple (77332) |
$646.50 |
$862 |
4.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,014.25 |
$4,019 |
5.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,303.25 |
$3,071 |
5.9× |
| Tx devices design & construction complex (77334) |
$1,037.25 |
$1,383 |
2.9× |
| Ultrasound elastography first target lesion (76982) |
$508.50 |
$678 |
5.0× |
| Ultrasound, abdomen limited (76705) |
$1,907.25 |
$2,543 |
18.8× |
| Umbilical-artery Doppler (OB) (76820) |
$617.25 |
$823 |
6.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,644.75 |
$2,193 |
4.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,549.50 |
$2,066 |
6.7× |
| Urethrocystography voiding (74455) |
$1,589.25 |
$2,119 |
6.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$2,073 |
$2,764 |
12.2× |
| Us abdl aorta screen aaa (76706) |
$462 |
$616 |
4.5× |
| Us breast unilateral complete (76641) |
$738 |
$984 |
7.3× |
| Us breast unilateral limited (76642) |
$873.75 |
$1,165 |
10.3× |
| Us chest (76604) |
$1,110 |
$1,480 |
10.9× |
| Us compl joint r-t w/image documentation (76881) |
$1,410 |
$1,880 |
13.9× |
| Us elastography parenchyma (76981) |
$735 |
$980 |
7.2× |
| Us fetal nuchal translucency 1st gestation (76813) |
$681.75 |
$909 |
6.7× |
| Us guided compression repair (76936) |
$2,443.50 |
$3,258 |
11.6× |
| Us infant hips dynamic (76885) |
$485.25 |
$647 |
5.7× |
| Us infant hips limited static (76886) |
$624.75 |
$833 |
7.4× |
| Us kidney transplant (76776) |
$2,142.75 |
$2,857 |
21.1× |
| Us ob detailed single fetus (76811) |
$1,654.50 |
$2,206 |
7.1× |
| Us ob transvaginal (76817) |
$1,797.75 |
$2,397 |
17.7× |
| Us pelvic non ob complete (76856) |
$2,164.50 |
$2,886 |
21.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,191.75 |
$1,589 |
11.7× |
| Us pregnancy ltd (76815) |
$834 |
$1,112 |
8.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,938.75 |
$2,585 |
19.1× |
| Us retroperitoneal complete (76770) |
$1,688.25 |
$2,251 |
16.6× |
| Us retroperitoneal limited (76775) |
$1,524 |
$2,032 |
15.0× |
| Us scrotum and contents (76870) |
$1,570.50 |
$2,094 |
15.5× |
| Us soft tissue head/neck (76536) |
$1,326 |
$1,768 |
13.1× |
| Us spinal canal and contents (76800) |
$1,500.75 |
$2,001 |
14.8× |
| Us xtr non-vasc lmtd (76882) |
$1,279.50 |
$1,706 |
12.6× |
| Venogram extremity bilateral (75822) |
$1,698 |
$2,264 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,069.75 |
$4,093 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$5,141.25 |
$6,855 |
3.4× |
| Venography extremity unilateral rs&i (75820) |
$1,686 |
$2,248 |
1.1× |
| Venography Renal Bilateral (75833) |
$8,620.50 |
$11,494 |
2.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$5,013.15 |
$6,684.20 |
1.6× |
| Wrist 2 views (73100) |
$630.75 |
$841 |
7.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,494.75 |
$1,993 |
14.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$699.75 |
$933 |
8.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,028.25 |
$1,371 |
12.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,067 |
$2,756 |
12.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$564 |
$752 |
6.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$1,008 |
$1,344 |
11.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$1,747.50 |
$2,330 |
17.2× |
| X-ray exam hip uni 1 view (73501) |
$773.25 |
$1,031 |
9.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$1,509 |
$2,012 |
17.8× |
| X-ray exam hip uni 4/> views (73503) |
$1,673.25 |
$2,231 |
16.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,147.50 |
$1,530 |
11.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,181.25 |
$1,575 |
11.6× |
| X-ray exam of femur 1 (73551) |
$543 |
$724 |
6.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$1,792.50 |
$2,390 |
10.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$873.38 |
$1,164.50 |
8.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$474.75 |
$633 |
5.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,023 |
$1,364 |
12.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$4,508.25 |
$6,011 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$537.75 |
$717 |
6.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$754.50 |
$1,006 |
8.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,026.75 |
$1,369 |
10.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$730.50 |
$974 |
8.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,299 |
$1,732 |
12.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,177.50 |
$1,570 |
11.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$913.50 |
$1,218 |
9.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$1,033.50 |
$1,378 |
12.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$414.75 |
$553 |
4.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,093.50 |
$1,458 |
10.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$1,052.25 |
$1,403 |
10.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$2,115 |
$2,820 |
6.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$755.25 |
$1,007 |
8.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,180.50 |
$1,574 |
11.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,788.75 |
$2,385 |
17.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$768 |
$1,024 |
7.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$903 |
$1,204 |
10.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,130.25 |
$1,507 |
13.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,273.50 |
$1,698 |
15.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$488.25 |
$651 |
5.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,093.50 |
$1,458 |
10.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,154.25 |
$1,539 |
11.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$621.75 |
$829 |
7.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$417 |
$556 |
4.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$620.25 |
$827 |
7.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,147.50 |
$1,530 |
11.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$679.50 |
$906 |
6.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$754.50 |
$1,006 |
8.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,070.25 |
$1,427 |
12.7× |
| Xr arthrogram ankle (73615) |
$1,791 |
$2,388 |
5.3× |
| Xr c-spine 6 or more views (72052) |
$1,380.75 |
$1,841 |
13.6× |
| Xr chest 4+ views (71048) |
$675 |
$900 |
6.6× |
| Xr finger(s) 2+ views (73140) |
$783 |
$1,044 |
9.3× |
| Xr shoulder 1 view (73020) |
$719.62 |
$959.50 |
8.5× |
| Xr spine cervical 4 or 5 views (72050) |
$1,672.50 |
$2,230 |
16.5× |
| Xr tibia/fibula 2 views (73590) |
$675 |
$900 |
8.0× |
| Xr tmj bilateral (70330) |
$434.25 |
$579 |
5.1× |
| Xray knee 1 or 2 views rt (73560) |
$725.25 |
$967 |
8.6× |