| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,352.40 |
$12,254 |
5.4× |
| Abdomen 2 views (74019) |
$418.80 |
$698 |
4.1× |
| Acute gi blood loss imaging (78278) |
$1,585.20 |
$2,642 |
4.0× |
| Angio Adrenal Bilat Select (75733) |
$7,097.40 |
$11,829 |
2.3× |
| Angiography extremity bilateral rs&i (75716) |
$5,134.08 |
$8,556.80 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$5,134.08 |
$8,556.80 |
1.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,052.16 |
$6,753.60 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,134.08 |
$8,556.80 |
1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,334.40 |
$12,224 |
2.4× |
| Angiography Spinal Selective Rs&I (75705) |
$11,472 |
$19,120 |
2.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$15,252 |
$25,420 |
2.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$7,347.60 |
$12,246 |
2.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,693.40 |
$4,489 |
0.9× |
| Ankle 2 views (73600) |
$533.25 |
$888.75 |
6.2× |
| Aortogram thoracic (75605) |
$5,134.08 |
$8,556.80 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$7,097.40 |
$11,829 |
2.3× |
| Aortography abdominal serialography rs&i (75625) |
$5,134.08 |
$8,556.80 |
1.6× |
| Artery X-Rays Adrenal Gland (75731) |
$2,938.80 |
$4,898 |
0.9× |
| Arthrogram hip (73525) |
$789 |
$1,315 |
2.3× |
| Arthrogram knee (73580) |
$970.20 |
$1,617 |
2.8× |
| Arthrogram shoulder (73040) |
$970.20 |
$1,617 |
2.8× |
| Arthrogram wrist (73115) |
$970.20 |
$1,617 |
2.8× |
| Basic dosimetry (77300) |
$721.80 |
$1,203 |
5.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,464 |
$2,440 |
3.7× |
| Bone &/joint imaging whole body (78306) |
$1,695.60 |
$2,826 |
4.3× |
| Bone age studies (77072) |
$273 |
$455 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,803 |
$3,005 |
4.6× |
| Bone survey complete (77075) |
$592.20 |
$987 |
5.7× |
| Bone survey infant (77076) |
$280.20 |
$467 |
2.7× |
| Bowel imaging (78290) |
$1,319.40 |
$2,199 |
3.3× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$764.40 |
$1,274 |
1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,454 |
$4,090 |
4.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$9,652.20 |
$16,087 |
6.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$919.20 |
$1,532 |
2.3× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,011.20 |
$3,352 |
5.1× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$4,947 |
$8,245 |
6.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$5,172.24 |
$8,620.40 |
15.0× |
| Cervical spine 2 or 3 views (72040) |
$325.80 |
$543 |
3.8× |
| Chest 1 view (71045) |
$239.40 |
$399 |
2.8× |
| Chest xray 3 views (71047) |
$363.60 |
$606 |
4.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$417.60 |
$696 |
2.4× |
| Clavicle complete (73000) |
$734.25 |
$1,223.75 |
8.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$241.20 |
$402 |
2.3× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$216.60 |
$361 |
2.5× |
| Continuing medical physics consltj pr wk (77336) |
$783.72 |
$1,306.20 |
5.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,179.80 |
$3,633 |
6.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,258.20 |
$2,097 |
5.3× |
| CT abdomen w contrast (74160) |
$1,178.58 |
$1,964.30 |
6.8× |
| CT abdomen w wo contrast (74170) |
$684.60 |
$1,141 |
4.0× |
| CT abdomen w/o contrast (74150) |
$822.60 |
$1,371 |
8.0× |
| CT angio hrt w/3d image (75574) |
$1,128.66 |
$1,881.10 |
3.3× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,351.25 |
$3,918.75 |
13.6× |
| CT angiography upper extremity lt (73206) |
$1,644.30 |
$2,740.50 |
9.5× |
| CT c-spine w/contrast (72126) |
$1,804.20 |
$3,007 |
5.2× |
| CT c-spine w/o contrast (72125) |
$2,233.92 |
$3,723.20 |
21.6× |
| CT cere prfu aly c+wo CT/CTA (70473) |
$322.80 |
$538 |
1.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,985.40 |
$3,309 |
11.5× |
| CT chest w contrast (71260) |
$906.60 |
$1,511 |
5.2× |
| CT chest w/wo contrast (71270) |
$978 |
$1,630 |
5.6× |
| CT head/brain with contrast (70460) |
$1,692.60 |
$2,821 |
9.8× |
| CT head/brain without and with contrast (70470) |
$1,257.48 |
$2,095.80 |
7.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$790.02 |
$1,316.70 |
2.3× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$75.18 |
$125.30 |
0.9× |
| CT iac w contrast (70481) |
$2,173.86 |
$3,623.10 |
12.5× |
| CT limited/localized follow up study (76380) |
$1,198.20 |
$1,997 |
13.9× |
| CT lower ext w/o (73700) |
$2,061 |
$3,435 |
20.0× |
| CT lower extremity w wo contrast (73702) |
$4,993.20 |
$8,322 |
28.8× |
| CT lower extremity w/contrast material (73701) |
$3,115.80 |
$5,193 |
18.0× |
| CT lumbar spine w & w/o contrast (72133) |
$2,440.80 |
$4,068 |
14.1× |
| CT lumbar spine w/contrast (72132) |
$2,883.66 |
$4,806.10 |
8.4× |
| CT lumbar spine w/o contrast (72131) |
$1,913.40 |
$3,189 |
18.5× |
| CT maxillofacial w contrast (70487) |
$1,800.60 |
$3,001 |
10.4× |
| CT maxillofacial w/wo contrast (70488) |
$459 |
$765 |
2.6× |
| CT maxillofacial wo contrast (70486) |
$1,796.34 |
$2,993.90 |
17.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,211 |
$3,685 |
12.8× |
| CT orbits w/o contrast (70480) |
$992.04 |
$1,653.40 |
9.6× |
| CT pelvis w/o contrast (72192) |
$822.60 |
$1,371 |
8.0× |
| CT pelvis w/wo contrast (72194) |
$978 |
$1,630 |
5.6× |
| CT scan of arm combo (73202) |
$3,132 |
$5,220 |
18.1× |
| CT soft tissue neck w contrast (70491) |
$1,791.60 |
$2,986 |
10.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,513.40 |
$4,189 |
14.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,341.60 |
$2,236 |
13.0× |
| CT thoracic spine w/contrast (72129) |
$1,733.40 |
$2,889 |
10.0× |
| CT thoracic spine w/o contrast (72128) |
$1,635.60 |
$2,726 |
15.8× |
| CT thoracic spine w/wo contrast (72130) |
$1,918.20 |
$3,197 |
11.1× |
| CT thorax w/o contrast (71250) |
$822.60 |
$1,371 |
8.0× |
| CT upper ext wo (73200) |
$2,678.52 |
$4,464.20 |
25.9× |
| CT upper extremity with contrast (73201) |
$1,891.26 |
$3,152.10 |
5.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$863.52 |
$1,439.20 |
5.0× |
| Cta Abdomen (74175) |
$1,233.60 |
$2,056 |
7.1× |
| CTA abdomen pelvis (74174) |
$1,456.20 |
$2,427 |
4.2× |
| CTA chest (71275) |
$1,233.60 |
$2,056 |
7.1× |
| Cta Head (70496) |
$2,275.20 |
$3,792 |
13.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,550.40 |
$7,584 |
13.2× |
| Cta Neck (70498) |
$2,275.20 |
$3,792 |
13.1× |
| Cta Pelvis (72191) |
$1,233.60 |
$2,056 |
7.1× |
| Cystography minimum 3 views rs&i (74430) |
$1,168.20 |
$1,947 |
3.4× |
| Diskography lumbar (72295) |
$4,330.20 |
$7,217 |
2.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$207.60 |
$346 |
2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$262.80 |
$438 |
2.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$280.80 |
$468 |
2.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$208.20 |
$347 |
2.4× |
| Esophagus (74220) |
$825 |
$1,375 |
4.8× |
| Facial bones min 3 views (70150) |
$384 |
$640 |
3.7× |
| Fetal biophysical profile non-stress testing (76818) |
$565.20 |
$942 |
5.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$303.60 |
$506 |
2.9× |
| Fetal Echo (76825) |
$1,054.80 |
$1,758 |
2.0× |
| Fluoroscopy up to 1 hr (76000) |
$457.20 |
$762 |
1.9× |
| Foot 2 views (73620) |
$441 |
$735 |
5.1× |
| Forearm 2 views (73090) |
$696 |
$1,160 |
8.1× |
| Hand 2 views (73120) |
$450.75 |
$751.25 |
4.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,916.80 |
$11,528 |
2.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$7,334.40 |
$12,224 |
2.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,135.64 |
$3,559.40 |
4.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,149.96 |
$1,916.60 |
2.9× |
| Hysterosalpingogram (74740) |
$1,485 |
$2,475 |
6.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,377.80 |
$3,963 |
3.5× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$919.20 |
$1,532 |
2.3× |
| Kidney imaging morphology (78700) |
$1,853.40 |
$3,089 |
4.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,954.89 |
$3,258.15 |
3.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,136.40 |
$1,894 |
2.1× |
| Knee 3 views (73562) |
$816 |
$1,360 |
9.5× |
| Liver & spleen imaging static only (78215) |
$881.40 |
$1,469 |
2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,686 |
$2,810 |
4.3× |
| Lung perf&ventilat diferentl (78598) |
$1,940.40 |
$3,234 |
3.6× |
| Lung perfusion differential (78597) |
$1,391.40 |
$2,319 |
3.5× |
| Lung ventilation imaging (78579) |
$1,391.40 |
$2,319 |
3.5× |
| Lymphoscintigraphy (78195) |
$1,916.46 |
$3,194.10 |
3.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$6,208.02 |
$10,346.70 |
8.0× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$4,627.80 |
$7,713 |
13.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$5,668.80 |
$9,448 |
16.4× |
| Mammary ductogram or galactogram single (77053) |
$415.20 |
$692 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,679 |
$4,465 |
7.2× |
| MRA head w & w/o contrast (70546) |
$2,299.20 |
$3,832 |
6.7× |
| MRA head w/o contrast (70544) |
$4,200 |
$7,000 |
17.8× |
| MRA head with contrast (70545) |
$4,847.85 |
$8,079.75 |
14.1× |
| MRA neck w contrast (70548) |
$4,395.60 |
$7,326 |
12.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,309.40 |
$8,849 |
15.4× |
| MRA neck w/o contrast (70547) |
$2,940 |
$4,900 |
12.5× |
| MRI abdomen w contrast (74182) |
$962.40 |
$1,604 |
2.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,250.20 |
$5,417 |
9.4× |
| MRI abdomen w/o contrast (74181) |
$1,878.24 |
$3,130.40 |
8.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$5,911.23 |
$9,852.05 |
7.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$7,537.80 |
$12,563 |
21.9× |
| MRI breast w/o contrast bilateral (77047) |
$582.60 |
$971 |
2.5× |
| MRI breast wo contrast unilateral (77046) |
$532.80 |
$888 |
2.3× |
| MRI c-spine with contrast (72142) |
$1,680.60 |
$2,801 |
4.9× |
| MRI cardiac w/o cont stress (75559) |
$1,104.60 |
$1,841 |
2.0× |
| MRI cardiac w/o contrast (75557) |
$582.60 |
$971 |
2.5× |
| MRI cervical spine w/o contrast (72141) |
$1,640.34 |
$2,733.90 |
7.0× |
| MRI chest w/o & w/contrast material (71552) |
$5,285.40 |
$8,809 |
15.3× |
| MRI chest w/o contrast (71550) |
$3,509.40 |
$5,849 |
14.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,927 |
$6,545 |
11.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,571.60 |
$4,286 |
10.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,882.20 |
$8,137 |
20.7× |
| MRI orbit face neck w contrast (70542) |
$5,257.80 |
$8,763 |
15.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$6,594.60 |
$10,991 |
19.1× |
| MRI pelvis w/contrast (72196) |
$962.40 |
$1,604 |
2.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,342 |
$5,570 |
9.7× |
| MRI pelvis w/o contrast (72195) |
$2,421 |
$4,035 |
10.3× |
| MRI spectroscopy (76390) |
$1,289.40 |
$2,149 |
15.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,096.40 |
$3,494 |
6.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,825.20 |
$3,042 |
5.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,277 |
$3,795 |
6.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,825.20 |
$3,042 |
5.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,960.10 |
$4,933.50 |
8.6× |
| MRI temporomandibular joint (70336) |
$4,794 |
$7,990 |
20.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,371 |
$2,285 |
5.8× |
| MRI up ext w/o contrast (73218) |
$2,259.60 |
$3,766 |
9.6× |
| MRI upper ext joint w/o contrast (73221) |
$4,342.50 |
$7,237.50 |
18.4× |
| MRI, joint upper extrem combo (73223) |
$3,875.34 |
$6,458.90 |
11.2× |
| Myelogram Cervical (72240) |
$1,760.40 |
$2,934 |
2.3× |
| Myelogram Lumbar (72265) |
$1,760.40 |
$2,934 |
2.3× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78433) |
$3,511.20 |
$5,852 |
1.6× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$4,051.20 |
$6,752 |
1.9× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$2,841 |
$4,735 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$4,204.80 |
$7,008 |
3.3× |
| Myocardial spect single study at rest or stress (78451) |
$2,136.12 |
$3,560.20 |
1.7× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$3,331.20 |
$5,552 |
2.2× |
| Neck soft tissue (70360) |
$376.80 |
$628 |
4.4× |
| Nm cisternogram (78630) |
$2,230.20 |
$3,717 |
4.2× |
| Nm gastric emptying study (78264) |
$1,788.54 |
$2,980.90 |
4.5× |
| Nm kidney scan w/flow (78701) |
$1,853.40 |
$3,089 |
4.7× |
| Nm peritoneal-venous shunt patency (78291) |
$1,440.60 |
$2,401 |
3.6× |
| Nonvascular shunt X-ray (75809) |
$654.60 |
$1,091 |
6.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,172 |
$13,620 |
6.0× |
| Nuclear Rx Oral Admin (79005) |
$2,004 |
$3,340 |
8.7× |
| Orthopantogram (70355) |
$168 |
$280 |
2.0× |
| Osseous survey limited (77074) |
$319.20 |
$532 |
3.1× |
| Parathyroid Planar Imaging (78070) |
$1,635 |
$2,725 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$273 |
$455 |
2.6× |
| PET image w/CT, skull-thigh (78815) |
$6,944.40 |
$11,574 |
4.9× |
| PET imaging CT for attenuation limited area (78814) |
$6,944.40 |
$11,574 |
4.9× |
| PET imaging for CT attenuation whole body (78816) |
$6,944.40 |
$11,574 |
4.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$7,334.40 |
$12,224 |
2.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$6,119.40 |
$10,199 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,301.40 |
$2,169 |
3.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,358.28 |
$2,263.80 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,485 |
$2,475 |
2.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$797.25 |
$1,328.75 |
9.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$438.75 |
$731.25 |
5.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$1,019.85 |
$1,699.75 |
11.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$189 |
$315 |
2.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$288.60 |
$481 |
2.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$550.20 |
$917 |
5.3× |
| Radex fingr minimum 2 views (73140) |
$543.75 |
$906.25 |
6.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$743.25 |
$1,238.75 |
8.6× |
| Radex Hand Minimum 3 Views (73130) |
$990.60 |
$1,651 |
11.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$189 |
$315 |
2.2× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$288.60 |
$481 |
2.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$202.02 |
$336.70 |
2.0× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$550.20 |
$917 |
5.3× |
| Radex Humerus Minimum 2 Views (73060) |
$690.75 |
$1,151.25 |
8.0× |
| Radex Kne 1/2 Views (73560) |
$520.50 |
$867.50 |
6.1× |
| Radex Kne Compl 4/More Views (73564) |
$1,680 |
$2,800 |
16.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$393.60 |
$656 |
3.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$285.60 |
$476 |
3.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$303.60 |
$506 |
2.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$867.75 |
$1,446.25 |
10.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$171 |
$285 |
2.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$400.20 |
$667 |
3.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$280.20 |
$467 |
3.3× |
| Radex Toe Minimum 2 Views (73660) |
$279.75 |
$466.25 |
3.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$273 |
$455 |
2.6× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$798.75 |
$1,331.25 |
9.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$756 |
$1,260 |
7.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,220.38 |
$25,367.30 |
2.1× |
| Radiation treatment delivery level 1 (77402) |
$664.20 |
$1,107 |
6.6× |
| Radiation treatment delivery level 2 (77407) |
$2,760 |
$4,600 |
7.2× |
| Radiation treatment delivery level 3 (77412) |
$3,660 |
$6,100 |
6.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$233.40 |
$389 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$865.20 |
$1,442 |
8.4× |
| Radiologic exam chest 2 views (71046) |
$295.20 |
$492 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$549.60 |
$916 |
3.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$547.20 |
$912 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$666 |
$1,110 |
3.8× |
| Radiologic examination femur 1 view (73551) |
$372 |
$620 |
4.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$774 |
$1,290 |
9.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$208.20 |
$347 |
2.4× |
| Radiological examination surgical specimen (76098) |
$1,485 |
$2,475 |
2.8× |
| Renal Cyst Study (74470) |
$647.40 |
$1,079 |
1.2× |
| Ribs bilateral 3 views (71110) |
$273 |
$455 |
2.6× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$872.40 |
$1,454 |
2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$5,235.60 |
$8,726 |
9.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,114 |
$5,190 |
5.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,179.80 |
$3,633 |
4.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$955.20 |
$1,592 |
4.1× |
| Rp Therapy Intravenous Administration (79101) |
$1,578.60 |
$2,631 |
6.8× |
| Sacroiliac Joints < 3 Views (72200) |
$141 |
$235 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,083 |
$1,805 |
4.6× |
| Scapula (73010) |
$358.20 |
$597 |
3.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$269.10 |
$448.50 |
11.5× |
| Shoulder 1 view (73020) |
$169.80 |
$283 |
2.0× |
| Sialogram (70390) |
$1,485 |
$2,475 |
6.3× |
| Small bowel series (74250) |
$305.76 |
$509.60 |
1.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,602 |
$2,670 |
4.3× |
| Special dosimetry (77331) |
$472.80 |
$788 |
3.6× |
| Special Physics Consult (77370) |
$1,146.60 |
$1,911 |
8.6× |
| Special treatment procedure (77470) |
$3,689.40 |
$6,149 |
6.8× |
| Spine thoracic 3 views (72072) |
$454.80 |
$758 |
4.4× |
| Stereotactic Body Radiation Delivery (77373) |
$10,648.80 |
$17,748 |
6.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,029.40 |
$5,049 |
8.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,461.60 |
$2,436 |
4.0× |
| Testicular Imaging With Vascular Flow (78761) |
$1,853.40 |
$3,089 |
4.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,977.20 |
$4,962 |
8.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,580.40 |
$2,634 |
11.9× |
| Thoracolumbar 2 views (72080) |
$186.48 |
$310.80 |
2.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,580.60 |
$4,301 |
4.8× |
| Thyroid imaging w/blood flow (78013) |
$837.60 |
$1,396 |
2.1× |
| Thyroid uptake measurement (78012) |
$833.40 |
$1,389 |
2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,242.60 |
$2,071 |
3.1× |
| Tmj unilateral (70328) |
$208.20 |
$347 |
2.4× |
| Treatment device complex (77334) |
$1,578 |
$2,630 |
4.3× |
| Treatment device intermediate (77333) |
$674.40 |
$1,124 |
5.1× |
| Treatment devices simple (77332) |
$1,578 |
$2,630 |
11.9× |
| Ultrasound breast complete (76641) |
$1,302 |
$2,170 |
12.6× |
| Ultrasound Exam Aaa Screen (76706) |
$594 |
$990 |
5.8× |
| Ultrasound, abdomen limited (76705) |
$594 |
$990 |
5.8× |
| Umbilical-artery Doppler (OB) (76820) |
$262.80 |
$438 |
2.5× |
| Unlisted fluoroscopic procedure (76496) |
$5,806.80 |
$9,678 |
67.5× |
| Urethrocystogram voiding (74455) |
$1,168.20 |
$1,947 |
5.0× |
| Urethrocystography retrograde rs&i (74450) |
$1,168.20 |
$1,947 |
5.0× |
| Us breast unilateral limited (76642) |
$1,302 |
$2,170 |
15.1× |
| Us chest (76604) |
$415.80 |
$693 |
4.0× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$285.60 |
$476 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$751.20 |
$1,252 |
7.3× |
| Us elastography parenchyma (76981) |
$207.60 |
$346 |
2.0× |
| Us encephalogram (76506) |
$385.56 |
$642.60 |
3.7× |
| Us hips infant static (76886) |
$156.60 |
$261 |
1.8× |
| Us infant hips w manipulation (76885) |
$416.40 |
$694 |
4.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$847.50 |
$1,412.50 |
8.2× |
| Us ob detailed single fetus (76811) |
$1,066.20 |
$1,777 |
4.5× |
| Us ob limited (76815) |
$780 |
$1,300 |
7.6× |
| Us ob transvaginal (76817) |
$1,024.80 |
$1,708 |
9.9× |
| Us pelvic non ob complete (76856) |
$594 |
$990 |
5.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$403.80 |
$673 |
3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$876.60 |
$1,461 |
8.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$580.86 |
$968.10 |
5.6× |
| Us retroperitoneal complete (76770) |
$658.80 |
$1,098 |
6.4× |
| Us retroperitoneal limited (76775) |
$594 |
$990 |
5.8× |
| Us scrotum and contents (76870) |
$917.28 |
$1,528.80 |
8.9× |
| Us soft tissue head/neck (76536) |
$772.20 |
$1,287 |
7.5× |
| Us spinal canal and contents (76800) |
$707.40 |
$1,179 |
6.8× |
| Us transrectal (76872) |
$594 |
$990 |
5.8× |
| Us, eye b-scan (76512) |
$594 |
$990 |
5.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$510 |
$850 |
4.9× |
| Venogram extremity bilateral (75822) |
$4,445.40 |
$7,409 |
2.9× |
| Venogram Extremity Unilateral (75820) |
$3,081.78 |
$5,136.30 |
2.0× |
| Venography caval inferior serialography rs&i (75825) |
$7,334.40 |
$12,224 |
2.4× |
| Venography caval superior serialography rs&i (75827) |
$1,487.22 |
$2,478.70 |
1.0× |
| Venography Renal Bilateral (75833) |
$6,582 |
$10,970 |
2.1× |
| Venography renal unilateral selective rs&i (75831) |
$5,806.80 |
$9,678 |
1.9× |
| Venous sampling by catheter (75893) |
$11,758.20 |
$19,597 |
2.1× |
| Wrist 2 views (73100) |
$636.68 |
$1,061.12 |
7.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$511.80 |
$853 |
5.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$297 |
$495 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,236 |
$2,060 |
7.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$635.70 |
$1,059.50 |
7.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$189 |
$315 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$288.60 |
$481 |
2.8× |
| X-ray exam of femur 2/> (73552) |
$604.50 |
$1,007.50 |
7.0× |
| X-ray eye for foreign body (70030) |
$435.60 |
$726 |
5.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$262.20 |
$437 |
3.0× |
| X-ray IV pyelogram (ivp) (74400) |
$1,168.20 |
$1,947 |
6.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$363 |
$605 |
4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$193.20 |
$322 |
2.2× |
| X-ray leg, infant (73592) |
$320.40 |
$534 |
3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$385.80 |
$643 |
3.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$784.20 |
$1,307 |
7.6× |
| X-ray nose-rectum child f.b. (76010) |
$174.60 |
$291 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$257.40 |
$429 |
2.5× |
| X-ray retrograde pyelogram (74420) |
$1,158 |
$1,930 |
3.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$171 |
$285 |
2.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$385.80 |
$643 |
3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$471.60 |
$786 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$273 |
$455 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$342.60 |
$571 |
4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$252.60 |
$421 |
2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$499.20 |
$832 |
4.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$288 |
$480 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$546 |
$910 |
6.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$375 |
$625 |
4.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$349.20 |
$582 |
4.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$250.80 |
$418 |
2.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$303.60 |
$506 |
2.9× |
| Xr bone length studies (77073) |
$366 |
$610 |
3.5× |
| Xr c-spine 4 or 5 views (72050) |
$404.40 |
$674 |
3.9× |
| Xr c-spine 6 or more views (72052) |
$644.40 |
$1,074 |
6.2× |
| Xr chest 4+ views (71048) |
$433.20 |
$722 |
4.2× |
| Xr urogram antegrade (74425) |
$1,168.20 |
$1,947 |
3.4× |