| Abdomen 2 views (74019) |
$408.65 |
$743 |
3.5× |
| Acute gi blood loss imaging (78278) |
$1,393.70 |
$2,534 |
3.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,971.55 |
$7,221 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,662.45 |
$6,659 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,960.35 |
$10,837 |
1.0× |
| Ankle 2 views (73600) |
$125.95 |
$229 |
1.3× |
| Aortography abdominal serialography rs&i (75625) |
$3,600.85 |
$6,547 |
1.0× |
| Arthrogram elbow (73085) |
$737 |
$1,340 |
1.9× |
| Arthrogram hip (73525) |
$661.65 |
$1,203 |
1.7× |
| Arthrogram shoulder (73040) |
$424.05 |
$771 |
1.1× |
| Basic dosimetry (77300) |
$435.60 |
$792 |
2.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$988.35 |
$1,797 |
2.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,393.70 |
$2,534 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$1,452.55 |
$2,641 |
3.3× |
| Bone age studies (77072) |
$97.35 |
$177 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$1,393.70 |
$2,534 |
3.1× |
| Bone survey complete (77075) |
$514.80 |
$936 |
4.4× |
| Bone survey infant (77076) |
$247.50 |
$450 |
2.1× |
| Bowel imaging (78290) |
$986.70 |
$1,794 |
2.2× |
| Brain imaging < 4 static views (78600) |
$762.30 |
$1,386 |
1.7× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$928.40 |
$1,688 |
2.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$63.25 |
$115 |
0.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,958.35 |
$7,197 |
2.5× |
| Brain Imaging Vascular Flow Only (78610) |
$992.75 |
$1,805 |
1.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,625.80 |
$2,956 |
3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,557.50 |
$4,650 |
6.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,134.10 |
$2,062 |
1.9× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$992.75 |
$1,805 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$191.95 |
$349 |
2.0× |
| Chest 1 view (71045) |
$260.15 |
$473 |
2.7× |
| Chest xray 3 views (71047) |
$426.80 |
$776 |
4.4× |
| Cholecystography, oral contrast Non-Facility (74290) |
$364.65 |
$663 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$514.25 |
$935 |
2.6× |
| Cineradiography/videoradiography (76120) |
$297.55 |
$541 |
2.6× |
| Clavicle complete (73000) |
$201.85 |
$367 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$164.45 |
$299 |
1.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,293.95 |
$5,989 |
8.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,519 |
$4,580 |
9.5× |
| CT abdomen w contrast (74160) |
$1,893.65 |
$3,443 |
9.7× |
| CT abdomen w wo contrast (74170) |
$2,412.30 |
$4,386 |
12.3× |
| CT abdomen w/o contrast (74150) |
$1,240.25 |
$2,255 |
10.6× |
| CT angio hrt w/3d image (75574) |
$2,203.85 |
$4,007 |
5.7× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,486.55 |
$4,521 |
12.7× |
| CT angiography upper extremity lt (73206) |
$2,451.35 |
$4,457 |
12.5× |
| CT c-spine w/contrast (72126) |
$2,050.40 |
$3,728 |
5.3× |
| CT c-spine w/o contrast (72125) |
$1,712.70 |
$3,114 |
14.7× |
| CT cervical spine w&w/o contrast (72127) |
$2,345.75 |
$4,265 |
12.0× |
| CT chest w contrast (71260) |
$1,712.70 |
$3,114 |
8.8× |
| CT chest w/wo contrast (71270) |
$2,420.55 |
$4,401 |
12.4× |
| CT colonography w/dye (74262) |
$2,304.50 |
$4,190 |
11.8× |
| CT colonography w/o cntrst (74261) |
$2,286.90 |
$4,158 |
19.6× |
| CT head/brain with contrast (70460) |
$1,748.45 |
$3,179 |
8.9× |
| CT head/brain without and with contrast (70470) |
$2,411.75 |
$4,385 |
12.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,487.20 |
$2,704 |
3.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$561 |
$1,020 |
5.8× |
| CT iac w contrast (70481) |
$1,788.60 |
$3,252 |
9.2× |
| CT limited/localized follow up study (76380) |
$612.70 |
$1,114 |
6.3× |
| CT lower ext w/o (73700) |
$1,646.15 |
$2,993 |
14.1× |
| CT lower extremity w wo contrast (73702) |
$1,447.60 |
$2,632 |
7.4× |
| CT lower extremity w/contrast material (73701) |
$1,410.75 |
$2,565 |
7.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,993.65 |
$5,443 |
15.3× |
| CT lumbar spine w/contrast (72132) |
$2,109.25 |
$3,835 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$1,734.70 |
$3,154 |
14.9× |
| CT maxillofacial w contrast (70487) |
$1,217.15 |
$2,213 |
6.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,492.15 |
$2,713 |
7.6× |
| CT maxillofacial wo contrast (70486) |
$1,317.80 |
$2,396 |
11.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,262.15 |
$4,113 |
11.6× |
| CT orbits w/o contrast (70480) |
$1,120.35 |
$2,037 |
9.6× |
| CT pelvis w/o contrast (72192) |
$1,948.10 |
$3,542 |
16.7× |
| CT pelvis w/wo contrast (72194) |
$2,345.20 |
$4,264 |
12.0× |
| CT scan of arm combo (73202) |
$1,962.95 |
$3,569 |
10.0× |
| CT soft tissue neck w contrast (70491) |
$1,785.85 |
$3,247 |
9.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,079 |
$3,780 |
10.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,505.35 |
$2,737 |
12.9× |
| CT thoracic spine w/contrast (72129) |
$2,109.25 |
$3,835 |
10.8× |
| CT thoracic spine w/o contrast (72128) |
$1,669.25 |
$3,035 |
14.3× |
| CT thoracic spine w/wo contrast (72130) |
$2,192.30 |
$3,986 |
11.2× |
| CT thorax w/o contrast (71250) |
$1,320 |
$2,400 |
11.3× |
| CT upper ext wo (73200) |
$1,399.75 |
$2,545 |
12.0× |
| CT upper extremity with contrast (73201) |
$1,430 |
$2,600 |
3.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,993.75 |
$3,625 |
10.2× |
| Cta Abdomen (74175) |
$3,286.25 |
$5,975 |
16.8× |
| CTA abdomen pelvis (74174) |
$3,272.50 |
$5,950 |
8.4× |
| CTA chest (71275) |
$2,340.80 |
$4,256 |
12.0× |
| Cta Head (70496) |
$1,910.70 |
$3,474 |
9.8× |
| Cta Neck (70498) |
$1,921.15 |
$3,493 |
9.8× |
| Cta Pelvis (72191) |
$3,570.60 |
$6,492 |
18.3× |
| Cystography minimum 3 views rs&i (74430) |
$608.85 |
$1,107 |
1.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$443.30 |
$806 |
3.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$504.90 |
$918 |
4.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$543.95 |
$989 |
4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$86.35 |
$157 |
0.9× |
| Dxa bone density study axial skeleton (77085) |
$605 |
$1,100 |
5.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$688.60 |
$1,252 |
2.6× |
| Esophageal motility (78258) |
$637.45 |
$1,159 |
1.4× |
| Esophagus (74220) |
$469.15 |
$853 |
2.4× |
| Facial bones min 3 views (70150) |
$333.30 |
$606 |
2.9× |
| Fetal biophysical profile non-stress testing (76818) |
$714.45 |
$1,299 |
6.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$540.65 |
$983 |
4.6× |
| Fetal Echo (76825) |
$909.15 |
$1,653 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$553.30 |
$1,006 |
2.1× |
| Foot 2 views (73620) |
$125.95 |
$229 |
1.3× |
| Forearm 2 views (73090) |
$190.30 |
$346 |
2.0× |
| Gastric mucosa imaging (78261) |
$256.85 |
$467 |
0.6× |
| Hand 2 views (73120) |
$119.90 |
$218 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,277.65 |
$2,323 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,117.60 |
$2,032 |
2.5× |
| Hysterosalpingogram (74740) |
$427.90 |
$778 |
1.6× |
| Interstitial radiation source applic complex (77778) |
$2,751.10 |
$5,002 |
3.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$229.35 |
$417 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,207.80 |
$2,196 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,267.20 |
$2,304 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,373.35 |
$2,497 |
2.3× |
| Knee 3 views (73562) |
$288.75 |
$525 |
3.0× |
| Liver & spleen imaging static only (78215) |
$976.80 |
$1,776 |
2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,005.40 |
$1,828 |
2.3× |
| Liver imaging static only (78201) |
$897.60 |
$1,632 |
1.5× |
| Liver imaging w/vascular flow (78202) |
$1,618.10 |
$2,942 |
2.7× |
| Lung perf&ventilat diferentl (78598) |
$1,055.45 |
$1,919 |
1.7× |
| Lung perfusion differential (78597) |
$988.90 |
$1,798 |
2.2× |
| Lung ventilation imaging (78579) |
$964.15 |
$1,753 |
2.2× |
| Lymphoscintigraphy (78195) |
$1,393.70 |
$2,534 |
2.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,213.75 |
$4,025 |
2.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,221.45 |
$4,039 |
5.7× |
| Mammary ductogram or galactogram multiple (77054) |
$690.80 |
$1,256 |
2.6× |
| Mammary ductogram or galactogram single (77053) |
$429.55 |
$781 |
1.6× |
| MRA head w & w/o contrast (70546) |
$2,792.90 |
$5,078 |
7.2× |
| MRA head w/o contrast (70544) |
$1,772.10 |
$3,222 |
6.7× |
| MRA head with contrast (70545) |
$2,230.80 |
$4,056 |
5.7× |
| MRA neck w contrast (70548) |
$2,059.20 |
$3,744 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,738.45 |
$4,979 |
7.0× |
| MRA neck w/o contrast (70547) |
$1,593.35 |
$2,897 |
6.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,648.25 |
$4,815 |
6.8× |
| MRI abdomen w/o contrast (74181) |
$1,586.20 |
$2,884 |
6.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,960.75 |
$3,565 |
2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,878.05 |
$7,051 |
10.0× |
| MRI bone marrow blood supply (77084) |
$2,192.85 |
$3,987 |
8.2× |
| MRI breast w/o contrast bilateral (77047) |
$2,283.60 |
$4,152 |
8.6× |
| MRI c-spine with contrast (72142) |
$2,913.35 |
$5,297 |
7.5× |
| MRI cardiac w/o contrast (75557) |
$2,693.35 |
$4,897 |
10.1× |
| MRI cervical spine w/o contrast (72141) |
$2,169.20 |
$3,944 |
8.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,919.95 |
$5,309 |
7.5× |
| MRI chest w/o contrast (71550) |
$2,033.90 |
$3,698 |
7.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,571.25 |
$4,675 |
6.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,097.70 |
$3,814 |
7.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,994.85 |
$3,627 |
7.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,819.75 |
$6,945 |
9.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,277.55 |
$4,141 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$1,847.45 |
$3,359 |
6.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,938 |
$7,160 |
10.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,366.65 |
$4,303 |
6.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,031.05 |
$5,511 |
7.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,534.95 |
$4,609 |
6.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,408.90 |
$6,198 |
8.8× |
| MRI temporomandibular joint (70336) |
$1,887.60 |
$3,432 |
7.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,250.60 |
$4,092 |
8.5× |
| MRI up ext w/o contrast (73218) |
$1,823.80 |
$3,316 |
6.9× |
| MRI upper ext joint w/o contrast (73221) |
$1,886.50 |
$3,430 |
7.1× |
| MRI, joint upper extrem combo (73223) |
$3,324.75 |
$6,045 |
8.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,007.85 |
$7,287 |
2.8× |
| Myocardial spect single study at rest or stress (78451) |
$3,077.80 |
$5,596 |
2.1× |
| Neck soft tissue (70360) |
$121.55 |
$221 |
1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$410.30 |
$746 |
0.9× |
| Nm adrenal scan (78075) |
$1,947.55 |
$3,541 |
1.3× |
| Nm bone marrow wb (78104) |
$786.50 |
$1,430 |
1.8× |
| Nm cisternogram (78630) |
$1,304.60 |
$2,372 |
2.2× |
| Nm csf leak detection (78650) |
$1,231.45 |
$2,239 |
0.9× |
| Nm gastric emptying study (78264) |
$1,277.65 |
$2,323 |
2.9× |
| Nm gastroesophageal reflux study (78262) |
$900.35 |
$1,637 |
2.0× |
| Nm kidney scan w/flow (78701) |
$1,053.80 |
$1,916 |
2.4× |
| Noncardiac Vascular Flow Imaging (78445) |
$534.05 |
$971 |
1.2× |
| Nonvascular shunt X-ray (75809) |
$430.10 |
$782 |
3.7× |
| Nuclear Rx Oral Admin (79005) |
$888.80 |
$1,616 |
3.4× |
| Ob us nuchal meas 1 gest (76813) |
$363 |
$660 |
3.1× |
| Osseous survey limited (77074) |
$510.40 |
$928 |
4.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,341.45 |
$2,439 |
2.2× |
| Parathyroid Planar Imaging (78070) |
$964.15 |
$1,753 |
2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,201.75 |
$2,185 |
2.7× |
| Pelvis 1 or 2 views (72170) |
$173.25 |
$315 |
1.5× |
| PET image w/CT, skull-thigh (78815) |
$4,400 |
$8,000 |
2.8× |
| PET imaging CT for attenuation limited area (78814) |
$4,198.15 |
$7,633 |
2.6× |
| PET imaging for CT attenuation whole body (78816) |
$4,576 |
$8,320 |
2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$964.15 |
$1,753 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,741.85 |
$3,167 |
2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$219.45 |
$399 |
0.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$260.70 |
$474 |
2.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$151.80 |
$276 |
1.6× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$221.10 |
$402 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$225.50 |
$410 |
2.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$261.80 |
$476 |
2.2× |
| Radex fingr minimum 2 views (73140) |
$161.15 |
$293 |
1.7× |
| Radex Foot Compl Minimum 3 Views (73630) |
$247.50 |
$450 |
2.6× |
| Radex Hand Minimum 3 Views (73130) |
$261.80 |
$476 |
2.7× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$119.90 |
$218 |
1.2× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$364.10 |
$662 |
3.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$320.65 |
$583 |
2.8× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$473 |
$860 |
4.1× |
| Radex Humerus Minimum 2 Views (73060) |
$173.25 |
$315 |
1.8× |
| Radex Kne 1/2 Views (73560) |
$151.80 |
$276 |
1.6× |
| Radex Kne Compl 4/More Views (73564) |
$299.20 |
$544 |
2.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$333.30 |
$606 |
2.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$219.45 |
$399 |
2.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$593.45 |
$1,079 |
5.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$378.40 |
$688 |
3.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$138.60 |
$252 |
1.4× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$323.95 |
$589 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$280.50 |
$510 |
2.9× |
| Radex Toe Minimum 2 Views (73660) |
$161.15 |
$293 |
1.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$177.10 |
$322 |
1.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$283.80 |
$516 |
2.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$362.45 |
$659 |
3.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$356.40 |
$648 |
3.1× |
| Radiologic exam chest 2 views (71046) |
$325.05 |
$591 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$408.65 |
$743 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$605 |
$1,100 |
3.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$329.45 |
$599 |
1.7× |
| Radiologic examination femur 1 view (73551) |
$190.30 |
$346 |
2.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$178.75 |
$325 |
1.8× |
| Radiological examination surgical specimen (76098) |
$511.50 |
$930 |
0.8× |
| Ribs bilateral 3 views (71110) |
$402.60 |
$732 |
3.5× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$986.15 |
$1,793 |
2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,300.20 |
$2,364 |
2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,148.30 |
$3,906 |
3.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,881 |
$3,420 |
3.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,801.25 |
$3,275 |
3.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,003 |
$5,460 |
1.9× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,648.80 |
$4,816 |
1.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$647.35 |
$1,177 |
2.5× |
| Rp Therapy Intravenous Administration (79101) |
$999.35 |
$1,817 |
3.8× |
| Sacroiliac Joints < 3 Views (72200) |
$226.60 |
$412 |
1.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$519.75 |
$945 |
2.0× |
| Scapula (73010) |
$221.10 |
$402 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$63.80 |
$116 |
2.7× |
| Shoulder 1 view (73020) |
$147.40 |
$268 |
1.5× |
| Small bowel series (74250) |
$435.60 |
$792 |
2.2× |
| Spine thoracic 3 views (72072) |
$310.75 |
$565 |
2.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,675.85 |
$3,047 |
4.0× |
| Thoracolumbar 2 views (72080) |
$164.45 |
$299 |
1.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,625.80 |
$2,956 |
2.7× |
| Thyroid imaging w/blood flow (78013) |
$667.15 |
$1,213 |
1.5× |
| Thyroid uptake measurement (78012) |
$614.35 |
$1,117 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,046.10 |
$1,902 |
2.3× |
| Tmj unilateral (70328) |
$384.45 |
$699 |
4.0× |
| Treatment devices simple (77332) |
$718.30 |
$1,306 |
4.8× |
| Ultrasound breast complete (76641) |
$441.10 |
$802 |
3.8× |
| Ultrasound elastography first target lesion (76982) |
$162.25 |
$295 |
1.4× |
| Ultrasound Exam Aaa Screen (76706) |
$617.65 |
$1,123 |
5.3× |
| Ultrasound, abdomen limited (76705) |
$440.55 |
$801 |
3.8× |
| Umbilical-artery Doppler (OB) (76820) |
$283.80 |
$516 |
2.4× |
| Unlisted fluoroscopic procedure (76496) |
$569.80 |
$1,036 |
5.9× |
| Urethrocystogram voiding (74455) |
$704 |
$1,280 |
2.6× |
| Urethrocystography retrograde rs&i (74450) |
$549.45 |
$999 |
2.1× |
| Us breast unilateral limited (76642) |
$337.70 |
$614 |
3.5× |
| Us chest (76604) |
$552.75 |
$1,005 |
4.7× |
| Us compl joint r-t w/image documentation (76881) |
$435.05 |
$791 |
3.7× |
| Us elastography parenchyma (76981) |
$277.20 |
$504 |
2.4× |
| Us encephalogram (76506) |
$493.35 |
$897 |
4.2× |
| Us hips infant static (76886) |
$397.65 |
$723 |
4.1× |
| Us infant hips w manipulation (76885) |
$459.25 |
$835 |
4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$358.88 |
$652.50 |
3.1× |
| Us ob detailed single fetus (76811) |
$763.40 |
$1,388 |
2.9× |
| Us ob limited (76815) |
$358.60 |
$652 |
3.1× |
| Us ob transvaginal (76817) |
$441.65 |
$803 |
3.8× |
| Us pelvic non ob complete (76856) |
$758.45 |
$1,379 |
6.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$459.25 |
$835 |
3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$462 |
$840 |
4.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$397.65 |
$723 |
3.4× |
| Us retroperitoneal complete (76770) |
$558.25 |
$1,015 |
4.8× |
| Us retroperitoneal limited (76775) |
$337.70 |
$614 |
2.9× |
| Us scrotum and contents (76870) |
$578.05 |
$1,051 |
5.0× |
| Us soft tissue head/neck (76536) |
$462 |
$840 |
4.0× |
| Us spinal canal and contents (76800) |
$522.50 |
$950 |
4.5× |
| Us transrectal (76872) |
$476.85 |
$867 |
4.1× |
| Us transrectal prostate volume (76873) |
$409.20 |
$744 |
3.5× |
| Us,transplanted kidney, real time/ doppler (76776) |
$607.75 |
$1,105 |
5.2× |
| Venogram extremity bilateral (75822) |
$1,291.95 |
$2,349 |
0.7× |
| Venogram Extremity Unilateral (75820) |
$1,190.20 |
$2,164 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$3,411.65 |
$6,203 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$427.35 |
$777 |
4.4× |
| Wrist 2 views (73100) |
$201.85 |
$367 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$494.45 |
$899 |
4.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$239.80 |
$436 |
2.5× |
| X-ray b.e. reductn intuss (74283) |
$789.80 |
$1,436 |
4.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$565.40 |
$1,028 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$136.95 |
$249 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$266.20 |
$484 |
2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$402.05 |
$731 |
3.5× |
| X-ray exam of femur 2/> (73552) |
$178.20 |
$324 |
1.8× |
| X-ray eye for foreign body (70030) |
$138.05 |
$251 |
1.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$201.85 |
$367 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$149.60 |
$272 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$125.95 |
$229 |
1.3× |
| X-ray leg, infant (73592) |
$155.10 |
$282 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$284.35 |
$517 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$370.70 |
$674 |
3.2× |
| X-ray nose-rectum child f.b. (76010) |
$123.20 |
$224 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$383.90 |
$698 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$224.40 |
$408 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$276.10 |
$502 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$432.30 |
$786 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$208.45 |
$379 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$237.60 |
$432 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$298.10 |
$542 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$402.05 |
$731 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$201.85 |
$367 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$134.20 |
$244 |
1.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$240.35 |
$437 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$213.95 |
$389 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$244.75 |
$445 |
2.1× |
| Xr bone length studies (77073) |
$227.70 |
$414 |
2.0× |
| Xr c-spine 4 or 5 views (72050) |
$366.30 |
$666 |
3.1× |
| Xr c-spine 6 or more views (72052) |
$382.80 |
$696 |
3.3× |
| Xr chest 4+ views (71048) |
$470.25 |
$855 |
4.0× |