| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,157.10 |
$3,306 |
0.6× |
| Abdomen 1 View (74018) |
$304.15 |
$869 |
2.7× |
| Abdomen 2 views (74019) |
$361.90 |
$1,034 |
2.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$702.80 |
$2,008 |
1.4× |
| Angio internal mammary (75756) |
$2,356.20 |
$6,732 |
0.6× |
| Angio pulmonary bilat (75743) |
$1,812.30 |
$5,178 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$3,945.90 |
$11,274 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,587.50 |
$10,250 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,812.30 |
$5,178 |
0.4× |
| Ankle 2 views (73600) |
$318.85 |
$911 |
2.8× |
| Aortography thoracic serialography rs&i (75605) |
$5,975.55 |
$17,073 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,759.75 |
$7,885 |
0.7× |
| Artery X-Rays Abdomen (75726) |
$5,975.55 |
$17,073 |
0.8× |
| Artery X-Rays Pelvis (75736) |
$5,975.55 |
$17,073 |
0.8× |
| Arthrogram ankle (73615) |
$432.25 |
$1,235 |
1.0× |
| Arthrogram hip (73525) |
$427.35 |
$1,221 |
1.0× |
| Arthrogram Wrist (73115) |
$356.65 |
$1,019 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$119.70 |
$342 |
0.7× |
| Bone age studies (77072) |
$324.80 |
$928 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$847.70 |
$2,422 |
1.6× |
| Bone Imaging Limited Area (78300) |
$547.40 |
$1,564 |
1.1× |
| Bone Imaging Whole Body (78306) |
$792.40 |
$2,264 |
1.5× |
| Bone marrow imaging; multiple areas (78103) |
$620.20 |
$1,772 |
1.2× |
| Bone survey infant (77076) |
$313.95 |
$897 |
2.3× |
| Brachytx isodose complex (77318) |
$1,104.60 |
$3,156 |
2.3× |
| Brachytx isodose intermed (77317) |
$840 |
$2,400 |
1.7× |
| Brachytx Isodose Plan Simple (77316) |
$558.95 |
$1,597 |
1.2× |
| Brain Flow Imaging Only (78610) |
$509.60 |
$1,456 |
0.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$639.10 |
$1,826 |
1.2× |
| Cat Scan Follow-Up Study (76380) |
$556.85 |
$1,591 |
5.0× |
| Cerebrospinal Fluid Scan (78630) |
$1,025.85 |
$2,931 |
1.5× |
| Chest 1 view (71045) |
$292.60 |
$836 |
2.6× |
| Chest 2 views (71046) |
$412.65 |
$1,179 |
3.7× |
| Chest 3 views (71047) |
$452.90 |
$1,294 |
4.0× |
| Chest 4 or more views (71048) |
$497.70 |
$1,422 |
3.7× |
| Cholecystography Oral Contrast (74290) |
$263.90 |
$754 |
1.2× |
| Clavicle complete (73000) |
$560.35 |
$1,601 |
5.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$410.90 |
$1,174 |
3.1× |
| Continuing medical physics consltj pr wk (77336) |
$135.45 |
$387 |
0.8× |
| Contrast Exam Abdominl Aorta (75625) |
$3,587.50 |
$10,250 |
0.9× |
| Contrast X-Ray Bladder (74430) |
$362.95 |
$1,037 |
0.8× |
| Contrast X-Ray Of Elbow (73085) |
$573.65 |
$1,639 |
1.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$587.30 |
$1,678 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,353.45 |
$3,867 |
3.0× |
| CT abdomen and pelvis without contrast (74176) |
$776.30 |
$2,218 |
2.5× |
| CT abdomen w contrast (74160) |
$550.55 |
$1,573 |
2.4× |
| CT abdomen w wo contrast (74170) |
$707.35 |
$2,021 |
3.1× |
| CT abdomen w/o contrast (74150) |
$386.40 |
$1,104 |
2.9× |
| CT Angio Abdomen and Pelvis (74174) |
$1,083.95 |
$3,097 |
2.4× |
| CT Angio Chest (71275) |
$722.40 |
$2,064 |
3.2× |
| CT Angio Head (70496) |
$722.75 |
$2,065 |
3.2× |
| CT angio hrt w/3d image (75574) |
$570.85 |
$1,631 |
1.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$722.40 |
$2,064 |
3.2× |
| CT Angio Neck (70498) |
$722.75 |
$2,065 |
3.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$722.75 |
$2,065 |
3.2× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$525 |
$1,500 |
2.3× |
| CT cervical spine w/ contrast (72126) |
$510.65 |
$1,459 |
1.1× |
| CT cervical spine w/o contrast (72125) |
$412.30 |
$1,178 |
3.1× |
| CT cervical spine w/wo cont (72127) |
$642.25 |
$1,835 |
2.8× |
| CT chest w contrast (71260) |
$509.60 |
$1,456 |
2.3× |
| CT chest w/wo contrast (71270) |
$642.95 |
$1,837 |
2.9× |
| CT colonography screening (74263) |
$789.95 |
$2,257 |
2.6× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$630 |
$1,800 |
2.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$414.05 |
$1,183 |
3.1× |
| CT head/brain with contrast (70460) |
$410.90 |
$1,174 |
1.8× |
| CT head/brain without and with contrast (70470) |
$505.75 |
$1,445 |
2.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$377.30 |
$1,078 |
0.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$95.55 |
$273 |
0.9× |
| CT hrt w/3d image congen (75573) |
$534.45 |
$1,527 |
1.2× |
| CT iac w contrast (70481) |
$593.25 |
$1,695 |
2.6× |
| CT l-spine w&w/o contrast (72133) |
$642.95 |
$1,837 |
2.9× |
| CT lower ext w/o (73700) |
$396.55 |
$1,133 |
2.9× |
| CT lower extremity w/contrast material (73701) |
$493.50 |
$1,410 |
2.2× |
| CT lumbar spine w contrast (72132) |
$509.60 |
$1,456 |
1.1× |
| CT lumbar spine w/o contrast (72131) |
$410.90 |
$1,174 |
3.1× |
| CT maxillofacial w contrast (70487) |
$507.50 |
$1,450 |
2.2× |
CT maxillofacial wo contrast (70486)
range across 2 matching MRF lines |
$406.35–$414.05 |
$1,161–$1,183 |
varies |
| CT neck tissue combo (70492) |
$614.95 |
$1,757 |
2.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$689.15 |
$1,969 |
3.1× |
| CT orbits w/o contrast (70480) |
$414.05 |
$1,183 |
3.1× |
| CT pelvis w&w/o contrast (72194) |
$646.10 |
$1,846 |
2.9× |
| CT pelvis w/o contrast (72192) |
$389.55 |
$1,113 |
2.9× |
| CT scan of leg combo (73702) |
$655.90 |
$1,874 |
2.9× |
| CT scans face/jaw combo (70488) |
$633.85 |
$1,811 |
2.8× |
| CT soft tissue neck w contrast (70491) |
$488.25 |
$1,395 |
2.2× |
| CT soft tissue neck w/o contrast (70490) |
$392.70 |
$1,122 |
2.9× |
| CT thoracic spine w contrast (72129) |
$510.65 |
$1,459 |
2.3× |
| CT thoracic spine w/o contrast (72128) |
$411.60 |
$1,176 |
3.1× |
| CT thoracic spine w/wo cont (72130) |
$644.35 |
$1,841 |
2.9× |
| CT thorax w/o contrast (71250) |
$410.90 |
$1,174 |
3.1× |
| CT upper ext wo (73200) |
$395.85 |
$1,131 |
2.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$654.50 |
$1,870 |
2.9× |
| CT upper extremity with contrast (73201) |
$489.65 |
$1,399 |
1.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$722.40 |
$2,064 |
3.2× |
| Cta Abdomen (74175) |
$722.40 |
$2,064 |
3.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$525 |
$1,500 |
1.2× |
| CTA pelvis (72191) |
$722.40 |
$2,064 |
3.2× |
| Discography Cerv/Thor Spine (72285) |
$929.25 |
$2,655 |
0.4× |
| Diskography lumbar (72295) |
$929.25 |
$2,655 |
0.4× |
| Dxa Bone Density Axial (77080) |
$275.10 |
$786 |
2.0× |
| Dxa bone density study (77085) |
$316.40 |
$904 |
2.4× |
| Echo exam uterus (76831) |
$322 |
$920 |
1.0× |
| Echograp Trans R Pros Study (76873) |
$274.40 |
$784 |
2.0× |
| Esophageal Motility Study (78258) |
$569.10 |
$1,626 |
1.1× |
| Esophagram (74220) |
$305.20 |
$872 |
1.4× |
| Fetal Biophys Profile W/Nst (76818) |
$772.80 |
$2,208 |
5.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$772.80 |
$2,208 |
5.7× |
| Fluoroscopy up to 1 hr (76000) |
$288.75 |
$825 |
0.9× |
| Follow-Up Angiography (75898) |
$1,885.45 |
$5,387 |
0.5× |
| Foot 2 views (73620) |
$191.45 |
$547 |
1.7× |
| Forearm 2 views (73090) |
$301 |
$860 |
2.7× |
| Gastric emptying imaging study (78264) |
$842.10 |
$2,406 |
1.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$842.10 |
$2,406 |
1.6× |
| Gated Heart Planar Single (78472) |
$1,123.85 |
$3,211 |
2.2× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$927.15 |
$2,649 |
1.3× |
| Hand 2 views (73120) |
$466.90 |
$1,334 |
3.5× |
| Hepatobil Syst Image W/Drug (78227) |
$939.75 |
$2,685 |
1.3× |
| Hepatobiliary System Imaging (78226) |
$939.75 |
$2,685 |
1.8× |
| Ht Muscle Image Spect Sing (78451) |
$1,234.80 |
$3,528 |
0.7× |
| Hysterosalpingogram (74740) |
$693 |
$1,980 |
2.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$486.85 |
$1,391 |
4.3× |
| Infant hip ultrasound, limited static exam (76886) |
$243.25 |
$695 |
2.2× |
| Interstitial radiation source applic complex (77778) |
$1,524.25 |
$4,355 |
1.7× |
| Joint Survey Single View (77077) |
$211.40 |
$604 |
1.6× |
| K Flow/Funct Image W/Drug (78708) |
$1,253.35 |
$3,581 |
1.8× |
| K Flow/Funct Image W/O Drug (78707) |
$1,143.80 |
$3,268 |
1.6× |
| Kidney Imaging Morphol (78700) |
$636.65 |
$1,819 |
1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$708.75 |
$2,025 |
1.4× |
| Knee 3 Views (73562) |
$369.95 |
$1,057 |
3.3× |
| Leveen/Shunt Patency Exam (78291) |
$473.20 |
$1,352 |
0.9× |
| Liver & Spleen Imaging Static Only (78215) |
$678.30 |
$1,938 |
1.3× |
| Liver imaging static only (78201) |
$655.20 |
$1,872 |
0.9× |
| Liver imaging w/vascular flow (78202) |
$729.40 |
$2,084 |
1.0× |
| Lung Perf&Ventilat Diferentl (78598) |
$532.35 |
$1,521 |
0.8× |
| Lung perfusion differential (78597) |
$625.80 |
$1,788 |
1.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$625.80 |
$1,788 |
0.9× |
| Lung Ventilation Imaging (78579) |
$625.80 |
$1,788 |
1.2× |
| Lymph System Imaging (78195) |
$841.40 |
$2,404 |
1.2× |
| Magnetic Image Jaw Joint (70336) |
$742 |
$2,120 |
2.4× |
| Mammary ductogram or galactogram multiple (77054) |
$390.60 |
$1,116 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$355.95 |
$1,017 |
1.2× |
| Meckels Divert Exam (78290) |
$702.80 |
$2,008 |
1.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,340.10 |
$6,686 |
4.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,135.40 |
$3,244 |
2.5× |
| MRA head w/o contrast (70544) |
$742 |
$2,120 |
2.4× |
| MRA head with contrast (70545) |
$899.85 |
$2,571 |
2.0× |
| MRA neck w contrast (70548) |
$899.85 |
$2,571 |
2.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,135.40 |
$3,244 |
2.5× |
| MRA neck w/o contrast (70547) |
$742 |
$2,120 |
2.4× |
| MRI abdomen w contrast (74182) |
$899.85 |
$2,571 |
2.0× |
| MRI abdomen w/o contrast (74181) |
$742 |
$2,120 |
2.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$899.85 |
$2,571 |
0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,136.10 |
$3,246 |
2.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$899.85 |
$2,571 |
0.9× |
| MRI bone marrow blood supply (77084) |
$742 |
$2,120 |
2.4× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,469.30 |
$4,198 |
4.8× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,384.95 |
$3,957 |
4.5× |
| MRI cervical spine w contrast (72142) |
$899.85 |
$2,571 |
2.0× |
| MRI cervical spine w/o cont (72141) |
$742 |
$2,120 |
2.4× |
| MRI chest w/o contrast (71550) |
$742 |
$2,120 |
2.4× |
| MRI chest with contrast (71551) |
$899.85 |
$2,571 |
0.9× |
| MRI chest wo w contrast (71552) |
$1,135.40 |
$3,244 |
2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$899.85 |
$2,571 |
2.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,136.10 |
$3,246 |
2.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$742 |
$2,120 |
2.4× |
| MRI lumbar spine w contrast (72149) |
$899.85 |
$2,571 |
2.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,136.10 |
$3,246 |
2.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$742 |
$2,120 |
2.4× |
| MRI orbit face neck w contrast (70542) |
$899.85 |
$2,571 |
2.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,136.10 |
$3,246 |
2.5× |
| MRI pelvis w contrast (72196) |
$899.85 |
$2,571 |
2.0× |
| MRI pelvis w/o & w contrast (72197) |
$1,136.10 |
$3,246 |
2.5× |
| MRI pelvis w/o contrast (72195) |
$742 |
$2,120 |
2.4× |
| MRI spectroscopy (76390) |
$117.95 |
$337 |
1.1× |
| MRI thoracic spine w/o contrast (72146) |
$742 |
$2,120 |
2.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$899.85 |
$2,571 |
2.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$742 |
$2,120 |
2.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,136.10 |
$3,246 |
2.5× |
| MRI, abdomen, combo (74183) |
$1,136.10 |
$3,246 |
2.5× |
| MRI, dorsal spine combo (72157) |
$1,136.10 |
$3,246 |
2.5× |
| MRI, dorsal spine contrast (72147) |
$887.60 |
$2,536 |
2.0× |
| MRI, joint upper extrem (73221) |
$742 |
$2,120 |
2.4× |
| MRI, joint upper extrem combo (73223) |
$1,136.10 |
$3,246 |
2.5× |
| MRI, lumbar spine combo (72158) |
$1,136.10 |
$3,246 |
2.5× |
| Myelogram cervical (72240) |
$1,038.45 |
$2,967 |
1.0× |
| Myelogram Lumbar (72265) |
$996.80 |
$2,848 |
1.0× |
| Myelography thoracic (72255) |
$896.35 |
$2,561 |
0.9× |
| Myelograpy 2/more regions rs&i (72270) |
$1,245.30 |
$3,558 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,986.25 |
$5,675 |
1.2× |
| Neck soft tissue (70360) |
$200.55 |
$573 |
1.8× |
| Nonvascular Shunt X-Ray (75809) |
$434 |
$1,240 |
3.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$992.95 |
$2,837 |
0.6× |
| Nuclear Rx Oral Admin (79005) |
$329.70 |
$942 |
1.1× |
| Optic foramina (70190) |
$238 |
$680 |
2.1× |
| Parathyroid Planar Imaging (78070) |
$416.50 |
$1,190 |
0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,339.80 |
$3,828 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$267.05 |
$763 |
2.0× |
| Pet Image W/Ct Lmtd (78814) |
$1,713.60 |
$4,896 |
0.9× |
| PET image w/CT, full body (78816) |
$1,713.60 |
$4,896 |
0.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,713.60 |
$4,896 |
0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$668.50 |
$1,910 |
1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$553.70 |
$1,582 |
4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$389.55 |
$1,113 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$324.80 |
$928 |
2.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$278.95 |
$797 |
2.5× |
| Radex elbow complete minimum 3 views (73080) |
$383.95 |
$1,097 |
3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$467.60 |
$1,336 |
3.5× |
| Radex fingr minimum 2 views (73140) |
$260.40 |
$744 |
2.3× |
| Radex foot complete minimum 3 views (73630) |
$324.80 |
$928 |
2.9× |
| Radex Hand Minimum 3 Views (73130) |
$560.35 |
$1,601 |
5.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$166.25 |
$475 |
1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$370.65 |
$1,059 |
2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$445.20 |
$1,272 |
4.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$343.70 |
$982 |
3.1× |
| Radex shoulder complete minimum 2 views (73030) |
$343.70 |
$982 |
3.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$217.70 |
$622 |
1.9× |
| Radex Spine 1 View Specify Level (72020) |
$260.40 |
$744 |
2.3× |
| Radex Sternum Minimum 2 Views (71120) |
$301 |
$860 |
2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$342.30 |
$978 |
3.1× |
| Radex Toe Minimum 2 Views (73660) |
$260.40 |
$744 |
2.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$166.25 |
$475 |
1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$343.70 |
$982 |
3.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$482.65 |
$1,379 |
3.6× |
| Radiation treatment delivery level 1 (77402) |
$117.25 |
$335 |
0.9× |
| Radiation treatment delivery level 2 (77407) |
$124.25 |
$355 |
0.3× |
| Radiation treatment delivery level 3 (77412) |
$142.10 |
$406 |
0.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$445.20 |
$1,272 |
3.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$420.70 |
$1,202 |
3.1× |
| Radiologic exam colon double contrast study (74280) |
$696.15 |
$1,989 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$451.50 |
$1,290 |
2.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$276.85 |
$791 |
1.2× |
| Radiologic exam knee complete 4/more views (73564) |
$478.80 |
$1,368 |
3.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$273.70 |
$782 |
2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$379.05 |
$1,083 |
1.7× |
| Radiologic exam swallow function contrast study (74230) |
$831.95 |
$2,377 |
3.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$572.25 |
$1,635 |
2.5× |
| Radiologic examination femur 1 view (73551) |
$347.90 |
$994 |
3.1× |
| Radiologic examination femur minimum 2 views (73552) |
$463.40 |
$1,324 |
4.1× |
| Radiologic examination knee 1/2 views (73560) |
$191.45 |
$547 |
1.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$407.05 |
$1,163 |
3.0× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$313.95 |
$897 |
2.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$463.40 |
$1,324 |
4.1× |
| Ribs bilateral 3 views (71110) |
$291.90 |
$834 |
2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$665.70 |
$1,902 |
1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,588.30 |
$4,538 |
2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,420.65 |
$4,059 |
2.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,960.35 |
$5,601 |
2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,031.75 |
$5,805 |
1.2× |
| Salivary Gland Imaging (78230) |
$473.20 |
$1,352 |
0.9× |
| Scapula (73010) |
$218.40 |
$624 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$18.90 |
$54 |
0.8× |
| Sella turcica (70240) |
$166.25 |
$475 |
1.5× |
| Shoulder 1 view (73020) |
$128.45 |
$367 |
1.1× |
| Shoulder Arthrography (73040) |
$535.85 |
$1,531 |
1.2× |
| Sialogram (70390) |
$491.75 |
$1,405 |
1.6× |
| Skull less than 4 views (70250) |
$309.40 |
$884 |
2.3× |
| Special dosimetry (77331) |
$119.70 |
$342 |
0.7× |
| Special Physics Consult (77370) |
$119.70 |
$342 |
0.7× |
| Special teletherapy port plan (77321) |
$245.35 |
$701 |
0.5× |
| Special treatment procedure (77470) |
$406.35 |
$1,161 |
0.6× |
| Speech evaluation, complex (70371) |
$409.85 |
$1,171 |
1.3× |
| Spleen Imaging (78185) |
$427 |
$1,220 |
0.8× |
| Sternoclavicular joints (71130) |
$242.55 |
$693 |
2.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$162.40 |
$464 |
1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$671.30 |
$1,918 |
1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$321.30 |
$918 |
0.7× |
| Testicular Imaging W/Flow (78761) |
$546 |
$1,560 |
1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$481.60 |
$1,376 |
1.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$381.50 |
$1,090 |
0.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$243.95 |
$697 |
1.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$198.45 |
$567 |
0.9× |
| Thoracic spine 2 views (72070) |
$343.70 |
$982 |
2.6× |
| Thoracic spine 3 views (72072) |
$474.95 |
$1,357 |
3.5× |
| Thoracolumbar 2 views (72080) |
$343.70 |
$982 |
3.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$344.75 |
$985 |
0.7× |
| Thyroid Met Imaging Body (78018) |
$659.40 |
$1,884 |
0.9× |
| Thyroid Uptake Measurement (78012) |
$386.75 |
$1,105 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$469.70 |
$1,342 |
0.9× |
| Tx Devices Design & Construction Complex (77334) |
$667.80 |
$1,908 |
1.4× |
| Tx devices design & construction intermediate (77333) |
$479.15 |
$1,369 |
2.8× |
| Tx devices design & construction simple (77332) |
$286.65 |
$819 |
1.7× |
| Ultrasound Breast Limited (76642) |
$99.40 |
$284 |
0.9× |
| Ultrasound Exam Aaa Screen (76706) |
$397.95 |
$1,137 |
3.0× |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
$613.90–$629.65 |
$1,754–$1,799 |
varies |
| Umbilical-artery Doppler (OB) (76820) |
$998.90 |
$2,854 |
7.4× |
| Unlisted us procedure (76999) |
$149.80 |
$428 |
1.3× |
| Upper gi w/o kub (74240) |
$545.65 |
$1,559 |
2.4× |
| Ureteral Reflux Study (78740) |
$556.85 |
$1,591 |
1.1× |
| Urethrocystogram voiding (74455) |
$517.30 |
$1,478 |
1.7× |
| Urethrocystography retrograde (74450) |
$544.95 |
$1,557 |
1.8× |
| Us breast unilateral complete (76641) |
$131.95 |
$377 |
1.0× |
Us chest (76604)
range across 2 matching MRF lines |
$687.40–$705.25 |
$1,964–$2,015 |
varies |
| Us complete joint (76881) |
$1,041.95 |
$2,977 |
7.7× |
Us exam, pelvic, limited (76857)
range across 3 matching MRF lines |
$189–$193.90 |
$540–$554 |
varies |
| Us head (76506) |
$502.60 |
$1,436 |
3.7× |
| Us kidney transplant (76776) |
$835.80 |
$2,388 |
6.2× |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines |
$761.25–$780.85 |
$2,175–$2,231 |
varies |
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines |
$486.50–$499.10 |
$1,390–$1,426 |
varies |
| Us ob transvaginal (76817) |
$866.25 |
$2,475 |
6.4× |
| Us pelvic non ob complete (76856) |
$985.60 |
$2,816 |
7.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$498.05 |
$1,423 |
3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$499.10 |
$1,426 |
3.7× |
| Us retroperitoneal complete (76770) |
$866.25 |
$2,475 |
6.4× |
Us retroperitoneal limited (76775)
range across 2 matching MRF lines |
$568.75–$583.45 |
$1,625–$1,667 |
varies |
| Us scrotum and contents (76870) |
$1,041.95 |
$2,977 |
7.7× |
| Us spinal canal and contents (76800) |
$486.85 |
$1,391 |
3.6× |
Us thyroid (76536)
range across 2 matching MRF lines |
$844.55–$866.25 |
$2,413–$2,475 |
varies |
| Us transrectal (76872) |
$742.35 |
$2,121 |
5.5× |
| Vein X-Ray Chest (75827) |
$1,582 |
$4,520 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$3,587.50 |
$10,250 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,761.90 |
$5,034 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,761.90 |
$5,034 |
0.9× |
| Venography Renal Unilateral (75831) |
$8,212.05 |
$23,463 |
2.0× |
| Vertebral fracture assessment via dxa (77086) |
$124.25 |
$355 |
1.1× |
| Wrist 2 views (73100) |
$330.05 |
$943 |
2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$435.40 |
$1,244 |
3.9× |
| X-ray antegrade pyelogram tube (74425) |
$625.10 |
$1,786 |
1.4× |
| X-Ray Aorta Leg Arteries (75630) |
$3,587.50 |
$10,250 |
0.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$324.80 |
$928 |
2.9× |
| X-Ray Exam Breast Specimen (76098) |
$905.45 |
$2,587 |
1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$216.65 |
$619 |
1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$279.30 |
$798 |
2.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$363.65 |
$1,039 |
2.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$102.90 |
$294 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$474.95 |
$1,357 |
4.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$522.20 |
$1,492 |
3.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$504.70 |
$1,442 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$555.45 |
$1,587 |
4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$610.40 |
$1,744 |
4.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$632.80 |
$1,808 |
4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$360.85 |
$1,031 |
3.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$603.40 |
$1,724 |
4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$360.85 |
$1,031 |
2.7× |
| X-ray eye for foreign body (70030) |
$490.70 |
$1,402 |
4.4× |
| X-ray humerus (73060) |
$301 |
$860 |
2.7× |
| X-ray IV pyelogram (ivp) (74400) |
$736.05 |
$2,103 |
3.3× |
| X-ray IV pyelogram+tomography (74415) |
$694.40 |
$1,984 |
3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$304.85 |
$871 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$191.45 |
$547 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$328.30 |
$938 |
2.4× |
| X-ray nose-rectum child f.b. (76010) |
$275.80 |
$788 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$324.80 |
$928 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$388.50 |
$1,110 |
2.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$291.55 |
$833 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$324.80 |
$928 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$483.70 |
$1,382 |
4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$413.35 |
$1,181 |
3.1× |
| X-ray thoracic spine 4 vw (72074) |
$518.35 |
$1,481 |
3.9× |
| X-Ray Tmj Unilat (70328) |
$172.20 |
$492 |
1.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$554.05 |
$1,583 |
1.2× |
| X-Rays Bone Length Studies (77073) |
$326.20 |
$932 |
2.4× |
| X-Rays Bone Survey Complete (77075) |
$860.30 |
$2,458 |
6.4× |
| Xr c-spine 4 or 5 views (72050) |
$474.95 |
$1,357 |
3.5× |
| Xr facial bones less than 3 views (70140) |
$328.30 |
$938 |
2.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$326.90 |
$934 |
2.4× |
| Xr orbits complete 4 views (70200) |
$474.25 |
$1,355 |
3.5× |
| Xr Tomogram Single Plane (76100) |
$453.25 |
$1,295 |
3.4× |