| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,711.50 |
$4,890 |
1.0× |
| Abdomen 1 View (74018) |
$357 |
$1,020 |
3.2× |
| Abdomen 2 views (74019) |
$407.75 |
$1,165 |
3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$704.20 |
$2,012 |
1.4× |
| Adrenal Cortex & Medulla Img (78075) |
$955.50 |
$2,730 |
0.6× |
| Angio internal mammary (75756) |
$6,050.80 |
$17,288 |
1.5× |
| Angio pulmonary bilat (75743) |
$6,050.80 |
$17,288 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,425.50 |
$6,930 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$2,339.40 |
$6,684 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,123 |
$11,780 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$6,050.80 |
$17,288 |
1.5× |
| Ankle 2 views (73600) |
$247.10 |
$706 |
2.2× |
| Aortography thoracic serialography rs&i (75605) |
$4,402.30 |
$12,578 |
0.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,121.35 |
$6,061 |
0.5× |
| Artery X-Rays Abdomen (75726) |
$4,402.30 |
$12,578 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$4,402.30 |
$12,578 |
0.6× |
| Artery X-Rays Spine (75705) |
$4,402.30 |
$12,578 |
0.6× |
| Arthrogram ankle (73615) |
$842.10 |
$2,406 |
1.9× |
| Arthrogram hip (73525) |
$894.60 |
$2,556 |
2.0× |
| Arthrogram Wrist (73115) |
$682.15 |
$1,949 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$534.10 |
$1,526 |
3.1× |
| Bone age studies (77072) |
$297.85 |
$851 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$779.80 |
$2,228 |
1.5× |
| Bone Imaging Limited Area (78300) |
$518.70 |
$1,482 |
1.0× |
| Bone Imaging Whole Body (78306) |
$737.45 |
$2,107 |
1.4× |
| Bone marrow imaging; whole body (78104) |
$737.45 |
$2,107 |
1.4× |
| Bone survey infant (77076) |
$526.75 |
$1,505 |
3.9× |
| 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) |
$327.60 |
$936 |
0.5× |
| Brain Image W/Flow < 4 Views (78601) |
$378 |
$1,080 |
0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,490.65 |
$4,259 |
0.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,592.15 |
$4,549 |
3.5× |
| Cat Scan Follow-Up Study (76380) |
$231.35 |
$661 |
2.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$633.50 |
$1,810 |
0.9× |
| Cerebrospinal Fluid Scan (78630) |
$570.50 |
$1,630 |
0.8× |
| Chest 1 view (71045) |
$292.25 |
$835 |
2.6× |
| Chest 2 views (71046) |
$466.55 |
$1,333 |
4.2× |
| Chest 3 views (71047) |
$591.50 |
$1,690 |
5.3× |
| Chest 4 or more views (71048) |
$613.90 |
$1,754 |
4.6× |
| Clavicle complete (73000) |
$358.40 |
$1,024 |
3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$369.95 |
$1,057 |
2.8× |
| Continuing medical physics consltj pr wk (77336) |
$201.25 |
$575 |
1.2× |
| Contrast Exam Abdominl Aorta (75625) |
$2,121.35 |
$6,061 |
0.5× |
| Contrast X-Ray Bladder (74430) |
$604.80 |
$1,728 |
1.3× |
| Contrast X-Ray Of Elbow (73085) |
$647.15 |
$1,849 |
1.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$942.55 |
$2,693 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,339.80 |
$3,828 |
3.0× |
| CT abdomen and pelvis without contrast (74176) |
$768.60 |
$2,196 |
2.5× |
| CT abdomen w contrast (74160) |
$544.95 |
$1,557 |
2.4× |
| CT abdomen w wo contrast (74170) |
$700.35 |
$2,001 |
3.1× |
| CT abdomen w/o contrast (74150) |
$382.55 |
$1,093 |
2.8× |
| CT Angio Abdomen and Pelvis (74174) |
$1,073.10 |
$3,066 |
2.4× |
| CT Angio Chest (71275) |
$715.05 |
$2,043 |
3.2× |
| CT Angio Head (70496) |
$1,097.60 |
$3,136 |
4.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$715.05 |
$2,043 |
3.2× |
| CT Angio Neck (70498) |
$1,097.60 |
$3,136 |
4.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$715.75 |
$2,045 |
3.2× |
| CT cervical spine w/ contrast (72126) |
$775.25 |
$2,215 |
1.7× |
| CT cervical spine w/o contrast (72125) |
$626.50 |
$1,790 |
4.7× |
| CT cervical spine w/wo cont (72127) |
$974.75 |
$2,785 |
4.3× |
| CT chest w contrast (71260) |
$504.70 |
$1,442 |
2.2× |
| CT chest w/wo contrast (71270) |
$636.65 |
$1,819 |
2.8× |
| CT head/brain with contrast (70460) |
$623.70 |
$1,782 |
2.8× |
| CT head/brain without and with contrast (70470) |
$768.25 |
$2,195 |
3.4× |
| CT iac w contrast (70481) |
$900.55 |
$2,573 |
4.0× |
| CT l-spine w&w/o contrast (72133) |
$636.65 |
$1,819 |
2.8× |
| CT lower ext w/o (73700) |
$392.70 |
$1,122 |
2.9× |
| CT lower extremity w/contrast material (73701) |
$488.60 |
$1,396 |
2.2× |
| CT lumbar spine w contrast (72132) |
$504.70 |
$1,442 |
1.1× |
| CT lumbar spine w/o contrast (72131) |
$406.70 |
$1,162 |
3.0× |
| CT maxillofacial w contrast (70487) |
$770.70 |
$2,202 |
3.4× |
| CT maxillofacial wo contrast (70486) |
$627.90 |
$1,794 |
4.7× |
| CT neck tissue combo (70492) |
$933.80 |
$2,668 |
4.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,046.15 |
$2,989 |
4.6× |
| CT orbits w/o contrast (70480) |
$627.90 |
$1,794 |
4.7× |
| CT pelvis w&w/o contrast (72194) |
$639.80 |
$1,828 |
2.8× |
| CT pelvis w/o contrast (72192) |
$385.70 |
$1,102 |
2.9× |
| CT scan of leg combo (73702) |
$649.25 |
$1,855 |
2.9× |
| CT scans face/jaw combo (70488) |
$962.15 |
$2,749 |
4.3× |
| CT soft tissue neck w contrast (70491) |
$741.30 |
$2,118 |
3.3× |
| CT soft tissue neck w/o contrast (70490) |
$596.40 |
$1,704 |
4.4× |
| CT thoracic spine w contrast (72129) |
$505.75 |
$1,445 |
2.2× |
| CT thoracic spine w/o contrast (72128) |
$407.75 |
$1,165 |
3.0× |
| CT thoracic spine w/wo cont (72130) |
$638.05 |
$1,823 |
2.8× |
| CT thorax w/o contrast (71250) |
$406.70 |
$1,162 |
3.0× |
| CT upper ext wo (73200) |
$392 |
$1,120 |
2.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$648.20 |
$1,852 |
2.9× |
| CT upper extremity with contrast (73201) |
$485.10 |
$1,386 |
1.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$715.05 |
$2,043 |
3.2× |
| Cta Abdomen (74175) |
$715.05 |
$2,043 |
3.2× |
| CTA pelvis (72191) |
$715.05 |
$2,043 |
3.2× |
| Dilation ureters/urethra rs&i (74485) |
$1,725.50 |
$4,930 |
0.6× |
| Discography Cerv/Thor Spine (72285) |
$1,777.30 |
$5,078 |
0.7× |
| Diskography lumbar (72295) |
$1,777.30 |
$5,078 |
0.7× |
| Dxa Bone Density Axial (77080) |
$248.50 |
$710 |
1.8× |
| Dxa bone density study (77085) |
$400.40 |
$1,144 |
3.0× |
| Echo exam uterus (76831) |
$149.10 |
$426 |
0.5× |
| Echo Guide For Artery Repair (76936) |
$576.80 |
$1,648 |
2.1× |
| Echograp Trans R Pros Study (76873) |
$127.05 |
$363 |
0.9× |
| Esophagram (74220) |
$778.40 |
$2,224 |
3.5× |
| Fetal Biophys Profile W/Nst (76818) |
$449.75 |
$1,285 |
3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$367.85 |
$1,051 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$502.25 |
$1,435 |
1.6× |
| Follow-Up Angiography (75898) |
$844.90 |
$2,414 |
0.2× |
| Foot 2 views (73620) |
$247.10 |
$706 |
2.2× |
| Forearm 2 views (73090) |
$386.40 |
$1,104 |
3.5× |
| Gastric emptying imaging study (78264) |
$671.30 |
$1,918 |
1.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$671.30 |
$1,918 |
1.3× |
| Gastroesophageal Reflux Exam (78262) |
$463.05 |
$1,323 |
0.9× |
| Gated Heart Planar Single (78472) |
$753.55 |
$2,153 |
1.5× |
| Gated Heart, Multiple (78473) |
$753.55 |
$2,153 |
1.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$738.50 |
$2,110 |
1.1× |
| Hand 2 views (73120) |
$220.85 |
$631 |
1.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,050.80 |
$17,288 |
1.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,594.55 |
$7,413 |
0.6× |
| Hepatobil Syst Image W/Drug (78227) |
$651.70 |
$1,862 |
0.9× |
| Hepatobiliary System Imaging (78226) |
$595.35 |
$1,701 |
1.2× |
| Ht Muscle Image Spect Sing (78451) |
$2,002 |
$5,720 |
1.2× |
| Hysterosalpingogram (74740) |
$556.85 |
$1,591 |
1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$106.40 |
$304 |
1.0× |
| Infant hip ultrasound, limited static exam (76886) |
$102.20 |
$292 |
0.9× |
| K Flow/Funct Image W/Drug (78708) |
$602 |
$1,720 |
0.9× |
| K Flow/Funct Image W/O Drug (78707) |
$575.75 |
$1,645 |
0.8× |
| Kidney Imaging Morphol (78700) |
$362.60 |
$1,036 |
0.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$362.60 |
$1,036 |
0.7× |
| Knee 3 Views (73562) |
$475.30 |
$1,358 |
4.2× |
| Leveen/Shunt Patency Exam (78291) |
$709.45 |
$2,027 |
1.4× |
| Liver & Spleen Imaging Static Only (78215) |
$518.70 |
$1,482 |
1.0× |
| Liver imaging static only (78201) |
$463.05 |
$1,323 |
0.7× |
| Lung Perf&Ventilat Diferentl (78598) |
$838.95 |
$2,397 |
1.2× |
| Lung perfusion differential (78597) |
$433.30 |
$1,238 |
0.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$406 |
$1,160 |
0.6× |
| Lung Ventilation Imaging (78579) |
$362.60 |
$1,036 |
0.7× |
| Lymph System Imaging (78195) |
$877.80 |
$2,508 |
1.3× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$2,721.95 |
$7,777 |
1.3× |
| Magnetic Image Jaw Joint (70336) |
$783.65 |
$2,239 |
2.6× |
| Mammary ductogram or galactogram multiple (77054) |
$705.25 |
$2,015 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$705.25 |
$2,015 |
2.3× |
| Meckels Divert Exam (78290) |
$518.70 |
$1,482 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$835.10 |
$2,386 |
1.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,199.10 |
$3,426 |
2.7× |
| MRA head w/o contrast (70544) |
$783.65 |
$2,239 |
2.6× |
| MRA head with contrast (70545) |
$950.60 |
$2,716 |
2.1× |
| MRA neck w contrast (70548) |
$950.60 |
$2,716 |
2.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,199.10 |
$3,426 |
2.7× |
| MRA neck w/o contrast (70547) |
$783.65 |
$2,239 |
2.6× |
| MRI abdomen w contrast (74182) |
$950.60 |
$2,716 |
2.1× |
| MRI abdomen w/o contrast (74181) |
$783.65 |
$2,239 |
2.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$950.60 |
$2,716 |
0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,199.80 |
$3,428 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$950.60 |
$2,716 |
0.9× |
| MRI bone marrow blood supply (77084) |
$1,189.30 |
$3,398 |
3.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,551.90 |
$4,434 |
5.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,463 |
$4,180 |
4.8× |
| MRI cardiac w/o contrast (75557) |
$724.50 |
$2,070 |
2.4× |
| MRI cervical spine w contrast (72142) |
$950.60 |
$2,716 |
2.1× |
| MRI cervical spine w/o cont (72141) |
$783.65 |
$2,239 |
2.6× |
| MRI chest w/o contrast (71550) |
$783.65 |
$2,239 |
2.6× |
| MRI chest with contrast (71551) |
$950.60 |
$2,716 |
0.9× |
| MRI chest wo w contrast (71552) |
$1,199.10 |
$3,426 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$950.60 |
$2,716 |
2.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,199.80 |
$3,428 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$783.65 |
$2,239 |
2.6× |
| MRI lumbar spine w contrast (72149) |
$950.60 |
$2,716 |
2.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,199.80 |
$3,428 |
2.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$783.65 |
$2,239 |
2.6× |
| MRI orbit face neck w contrast (70542) |
$950.60 |
$2,716 |
2.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,199.80 |
$3,428 |
2.7× |
| MRI pelvis w contrast (72196) |
$950.60 |
$2,716 |
2.1× |
| MRI pelvis w/o & w contrast (72197) |
$1,199.80 |
$3,428 |
2.7× |
| MRI pelvis w/o contrast (72195) |
$783.65 |
$2,239 |
2.6× |
| MRI spectroscopy (76390) |
$587.65 |
$1,679 |
5.3× |
| MRI thoracic spine w/o contrast (72146) |
$783.65 |
$2,239 |
2.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$950.60 |
$2,716 |
2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$783.65 |
$2,239 |
2.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,199.80 |
$3,428 |
2.7× |
| MRI, abdomen, combo (74183) |
$1,199.80 |
$3,428 |
2.7× |
| MRI, dorsal spine combo (72157) |
$1,199.80 |
$3,428 |
2.7× |
| MRI, dorsal spine contrast (72147) |
$937.30 |
$2,678 |
2.1× |
| MRI, joint upper extrem (73221) |
$783.65 |
$2,239 |
2.6× |
| MRI, joint upper extrem combo (73223) |
$1,199.80 |
$3,428 |
2.7× |
| MRI, lumbar spine combo (72158) |
$1,199.80 |
$3,428 |
2.7× |
| Myelogram cervical (72240) |
$1,395.80 |
$3,988 |
1.4× |
| Myelogram Lumbar (72265) |
$1,395.80 |
$3,988 |
1.4× |
| Myelography thoracic (72255) |
$1,395.80 |
$3,988 |
1.4× |
| Myelograpy 2/more regions rs&i (72270) |
$2,644.25 |
$7,555 |
2.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$693 |
$1,980 |
0.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,931.25 |
$8,375 |
1.8× |
| Neck soft tissue (70360) |
$302.40 |
$864 |
2.7× |
| Nm csf leak detection (78650) |
$874.30 |
$2,498 |
0.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$728.35 |
$2,081 |
0.4× |
| Parathyroid Planar Imaging (78070) |
$402.85 |
$1,151 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$341.95 |
$977 |
2.5× |
| Peritoneogram Rs&I (74190) |
$710.50 |
$2,030 |
1.0× |
| PET image w/CT, full body (78816) |
$1,801.80 |
$5,148 |
1.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,801.80 |
$5,148 |
1.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,801.80 |
$5,148 |
1.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,839.70 |
$19,542 |
1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$434.35 |
$1,241 |
0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$680.40 |
$1,944 |
5.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$782.95 |
$2,237 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$418.60 |
$1,196 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$239.05 |
$683 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$418.60 |
$1,196 |
3.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$511 |
$1,460 |
3.8× |
| Radex fingr minimum 2 views (73140) |
$336.70 |
$962 |
3.0× |
| Radex foot complete minimum 3 views (73630) |
$418.60 |
$1,196 |
3.7× |
| Radex Hand Minimum 3 Views (73130) |
$358.40 |
$1,024 |
3.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$302.05 |
$863 |
2.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$583.80 |
$1,668 |
4.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$572.60 |
$1,636 |
5.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$391.30 |
$1,118 |
3.5× |
| Radex shoulder complete minimum 2 views (73030) |
$471.80 |
$1,348 |
4.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$144.20 |
$412 |
1.3× |
| Radex Spine 1 View Specify Level (72020) |
$336.70 |
$962 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$386.40 |
$1,104 |
3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$503.30 |
$1,438 |
4.5× |
| Radex Toe Minimum 2 Views (73660) |
$336.70 |
$962 |
3.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$302.05 |
$863 |
2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$441 |
$1,260 |
3.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$512.05 |
$1,463 |
3.8× |
| Radiation treatment delivery level 1 (77402) |
$167.30 |
$478 |
1.3× |
| Radiation treatment delivery level 2 (77407) |
$196.70 |
$562 |
0.4× |
| Radiation treatment delivery level 3 (77412) |
$221.90 |
$634 |
0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$572.60 |
$1,636 |
4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$440.30 |
$1,258 |
3.3× |
| Radiologic exam colon double contrast study (74280) |
$1,161.65 |
$3,319 |
5.1× |
| Radiologic exam colon single contrast study (74270) |
$1,038.80 |
$2,968 |
4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$394.45 |
$1,127 |
1.7× |
| Radiologic exam knee complete 4/more views (73564) |
$475.30 |
$1,358 |
3.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$499.45 |
$1,427 |
3.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$1,002.05 |
$2,863 |
4.4× |
| Radiologic exam swallow function contrast study (74230) |
$695.45 |
$1,987 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$882 |
$2,520 |
3.9× |
| Radiologic examination femur 1 view (73551) |
$446.95 |
$1,277 |
4.0× |
| Radiologic examination femur minimum 2 views (73552) |
$596.40 |
$1,704 |
5.3× |
| Radiologic examination knee 1/2 views (73560) |
$247.10 |
$706 |
2.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$596.40 |
$1,704 |
5.3× |
| Ribs bilateral 3 views (71110) |
$609.70 |
$1,742 |
4.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$452.55 |
$1,293 |
0.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$543.20 |
$1,552 |
1.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,069.25 |
$3,055 |
1.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$954.45 |
$2,727 |
1.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,209.95 |
$3,457 |
1.7× |
| Scapula (73010) |
$720.65 |
$2,059 |
5.4× |
| Shoulder 1 view (73020) |
$320.95 |
$917 |
2.9× |
| Shoulder Arthrography (73040) |
$647.15 |
$1,849 |
1.4× |
| Sialogram (70390) |
$930.65 |
$2,659 |
3.0× |
| Skull less than 4 views (70250) |
$441 |
$1,260 |
3.3× |
| Special dosimetry (77331) |
$243.95 |
$697 |
1.4× |
| Special Physics Consult (77370) |
$271.60 |
$776 |
1.6× |
| Special teletherapy port plan (77321) |
$245.35 |
$701 |
0.5× |
| Special treatment procedure (77470) |
$821.10 |
$2,346 |
1.2× |
| Stereotactic Body Radiation Delivery (77373) |
$1,115.10 |
$3,186 |
0.5× |
| Sternoclavicular joints (71130) |
$310.80 |
$888 |
2.8× |
| Superior sagittal sinus venogram (75870) |
$1,909.25 |
$5,455 |
0.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$162.05 |
$463 |
1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$518.70 |
$1,482 |
1.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$249.20 |
$712 |
0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$478.80 |
$1,368 |
1.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$343.70 |
$982 |
0.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$320.95 |
$917 |
1.9× |
| Thoracic spine 2 views (72070) |
$331.10 |
$946 |
2.5× |
| Thoracic spine 3 views (72072) |
$609.70 |
$1,742 |
4.5× |
| Thoracolumbar 2 views (72080) |
$441 |
$1,260 |
3.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$252.35 |
$721 |
0.5× |
| Thyroid Met Imaging Body (78018) |
$1,020.25 |
$2,915 |
1.5× |
| Thyroid Uptake Measurement (78012) |
$252.35 |
$721 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$383.60 |
$1,096 |
0.7× |
| Tx Devices Design & Construction Complex (77334) |
$514.85 |
$1,471 |
1.1× |
| Tx devices design & construction intermediate (77333) |
$372.40 |
$1,064 |
2.2× |
| Tx devices design & construction simple (77332) |
$222.25 |
$635 |
1.3× |
| Ultrasound Breast Limited (76642) |
$331.10 |
$946 |
3.0× |
| Ultrasound Exam Aaa Screen (76706) |
$166.95 |
$477 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$321.30 |
$918 |
2.4× |
| Umbilical-artery Doppler (OB) (76820) |
$230.65 |
$659 |
1.7× |
| Unlisted fluoroscopic procedure (76496) |
$171.50 |
$490 |
1.5× |
| Unlisted magnetic resonance procedure (76498) |
$166.60 |
$476 |
1.5× |
| Unlisted us procedure (76999) |
$113.40 |
$324 |
1.0× |
| Upper gi w/o kub (74240) |
$840.70 |
$2,402 |
3.7× |
| Urethrocystogram voiding (74455) |
$687.05 |
$1,963 |
2.2× |
| Urethrocystography retrograde (74450) |
$641.90 |
$1,834 |
2.1× |
| Us breast unilateral complete (76641) |
$442.05 |
$1,263 |
3.3× |
| Us chest (76604) |
$292.25 |
$835 |
2.2× |
| Us complete joint (76881) |
$403.20 |
$1,152 |
3.0× |
| Us exam, pelvic, limited (76857) |
$321.30 |
$918 |
2.4× |
| Us head (76506) |
$602 |
$1,720 |
4.5× |
| Us kidney transplant (76776) |
$602 |
$1,720 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$302.40 |
$864 |
2.2× |
| Us ob detailed single fetus (76811) |
$352.80 |
$1,008 |
1.1× |
| Us ob limited 1 or more fetuses (76815) |
$434.70 |
$1,242 |
3.2× |
| Us ob transvaginal (76817) |
$394.80 |
$1,128 |
2.9× |
| Us pelvic non ob complete (76856) |
$502.60 |
$1,436 |
3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$486.15 |
$1,389 |
3.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$231.35 |
$661 |
1.7× |
| Us retroperitoneal complete (76770) |
$502.60 |
$1,436 |
3.7× |
| Us retroperitoneal limited (76775) |
$442.05 |
$1,263 |
3.3× |
| Us scrotum and contents (76870) |
$531.30 |
$1,518 |
4.0× |
| Us spinal canal and contents (76800) |
$403.20 |
$1,152 |
3.0× |
| Us thyroid (76536) |
$442.05 |
$1,263 |
3.3× |
| Vein X-Ray Chest (75827) |
$991.55 |
$2,833 |
0.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$6,167.35 |
$17,621 |
1.5× |
| Venogram Sinus/Jugular (75860) |
$1,909.25 |
$5,455 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,909.25 |
$5,455 |
0.5× |
| Venography extremity bilateral rs&i (75822) |
$899.15 |
$2,569 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$575.40 |
$1,644 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,786.40 |
$5,104 |
0.4× |
| Venography Renal Unilateral (75831) |
$1,538.95 |
$4,397 |
0.4× |
| Venous sampling by catheter (75893) |
$4,402.30 |
$12,578 |
0.6× |
| Wrist 2 views (73100) |
$300.30 |
$858 |
2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$399 |
$1,140 |
3.6× |
| X-ray antegrade pyelogram tube (74425) |
$703.15 |
$2,009 |
1.6× |
| X-Ray Aorta Leg Arteries (75630) |
$2,165.45 |
$6,187 |
0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$293.30 |
$838 |
2.6× |
| X-Ray Exam Breast Specimen (76098) |
$844.20 |
$2,412 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$229.25 |
$655 |
2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$296.45 |
$847 |
2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$385.70 |
$1,102 |
2.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$158.20 |
$452 |
1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$546 |
$1,560 |
4.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$600.25 |
$1,715 |
4.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$609.70 |
$1,742 |
4.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$670.60 |
$1,916 |
5.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$737.80 |
$2,108 |
5.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$812.35 |
$2,321 |
6.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$294.35 |
$841 |
2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$774.55 |
$2,213 |
5.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$411.25 |
$1,175 |
3.1× |
| X-ray eye for foreign body (70030) |
$306.95 |
$877 |
2.7× |
| X-ray humerus (73060) |
$386.40 |
$1,104 |
3.5× |
| X-ray IV pyelogram (ivp) (74400) |
$1,020.60 |
$2,916 |
4.5× |
| X-ray IV pyelogram+tomography (74415) |
$1,419.60 |
$4,056 |
6.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$358.40 |
$1,024 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$176.05 |
$503 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$281.75 |
$805 |
2.1× |
| X-ray nose-rectum child f.b. (76010) |
$222.60 |
$636 |
2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$637.70 |
$1,822 |
4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$356.30 |
$1,018 |
2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$247.80 |
$708 |
1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$374.50 |
$1,070 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$620.90 |
$1,774 |
5.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$774.55 |
$2,213 |
5.8× |
| X-ray thoracic spine 4 vw (72074) |
$676.90 |
$1,934 |
5.0× |
| X-Ray Tmj Unilat (70328) |
$349.30 |
$998 |
3.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$891.80 |
$2,548 |
2.0× |
| X-Rays Bone Length Studies (77073) |
$586.25 |
$1,675 |
4.4× |
| X-Rays Bone Survey Complete (77075) |
$739.20 |
$2,112 |
5.5× |
| Xr c-spine 4 or 5 views (72050) |
$609.70 |
$1,742 |
4.5× |
| Xr facial bones less than 3 views (70140) |
$358.40 |
$1,024 |
3.2× |
| Xr orbits complete 4 views (70200) |
$435.40 |
$1,244 |
3.2× |