| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,361 |
$11,148 |
4.8× |
| Abdomen 1 View (74018) |
$319.50 |
$426 |
2.9× |
| Abdomen 2 views (74019) |
$360 |
$480 |
2.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,884 |
$2,512 |
3.7× |
| Angio internal mammary (75756) |
$7,224 |
$9,632 |
1.8× |
| Angio pulmonary bilat (75743) |
$13,153.50 |
$17,538 |
3.3× |
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines |
$8,820–$13,153.50 |
$11,760–$17,538 |
varies |
Angiography extremity unilateral rs&i (75710)
range across 2 matching MRF lines |
$4,008.75–$8,742 |
$5,345–$11,656 |
varies |
Angiography pulmonary unilateral slctv rs&i (75741)
range across 2 matching MRF lines |
$7,224–$7,290 |
$9,632–$9,720 |
varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$8,742 |
$11,656 |
2.2× |
| Ankle 2 views (73600) |
$341.25 |
$455 |
3.1× |
| Aortography thoracic serialography rs&i (75605) |
$13,985.25 |
$18,647 |
2.0× |
Artery X-Rays Abdomen (75726)
range across 2 matching MRF lines |
$8,820–$15,315 |
$11,760–$20,420 |
varies |
| Artery X-Rays Adrenal Gland (75731) |
$7,445.25 |
$9,927 |
1.9× |
| Artery X-Rays Pelvis (75736) |
$8,742 |
$11,656 |
1.2× |
| Artery X-Rays Spine (75705) |
$13,985.25 |
$18,647 |
2.0× |
| Arthrogram hip (73525) |
$903 |
$1,204 |
2.0× |
| Arthrogram Wrist (73115) |
$667.50 |
$890 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$711.75 |
$949 |
4.2× |
| Bone age studies (77072) |
$255 |
$340 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$2,059.50 |
$2,746 |
4.1× |
| Bone Imaging Limited Area (78300) |
$1,212.75 |
$1,617 |
2.4× |
| Bone Imaging Multiple Areas (78305) |
$1,908 |
$2,544 |
3.8× |
| Bone Imaging Whole Body (78306) |
$1,984.50 |
$2,646 |
3.9× |
| Bone survey infant (77076) |
$679.50 |
$906 |
5.1× |
| Brachytx isodose complex (77318) |
$2,329.50 |
$3,106 |
4.9× |
| Brachytx isodose intermed (77317) |
$2,208.75 |
$2,945 |
4.7× |
| Brachytx Isodose Plan Simple (77316) |
$1,853.25 |
$2,471 |
3.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,544 |
$3,392 |
3.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,437.75 |
$1,917 |
2.1× |
| Chest 1 view (71045) |
$282.75 |
$377 |
2.6× |
| Chest 2 views (71046) |
$358.50 |
$478 |
3.3× |
| Chest 3 views (71047) |
$388.50 |
$518 |
3.5× |
| Chest 4 or more views (71048) |
$479.25 |
$639 |
3.6× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$360 |
$480 |
2.7× |
| Clavicle complete (73000) |
$292.50 |
$390 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$612.75 |
$817 |
4.6× |
| Continuing medical physics consltj pr wk (77336) |
$876 |
$1,168 |
5.1× |
| Contrast Exam Abdominl Aorta (75625) |
$8,742 |
$11,656 |
2.2× |
| Contrast X-Ray Bladder (74430) |
$867.75 |
$1,157 |
2.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,152.75 |
$1,537 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,286.25 |
$5,715 |
9.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,179.50 |
$2,906 |
7.2× |
| CT abdomen w contrast (74160) |
$2,171.25 |
$2,895 |
9.8× |
| CT abdomen w wo contrast (74170) |
$2,244 |
$2,992 |
10.1× |
| CT abdomen w/o contrast (74150) |
$1,537.50 |
$2,050 |
11.6× |
| CT Angio Abdomen and Pelvis (74174) |
$4,152 |
$5,536 |
9.4× |
| CT Angio Chest (71275) |
$2,510.25 |
$3,347 |
11.3× |
| CT Angio Head (70496) |
$2,264.25 |
$3,019 |
10.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,391.25 |
$1,855 |
6.3× |
| CT Angio Neck (70498) |
$2,268 |
$3,024 |
10.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,349.25 |
$1,799 |
6.1× |
| CT cervical spine w/ contrast (72126) |
$2,145 |
$2,860 |
4.9× |
| CT cervical spine w/o contrast (72125) |
$2,086.50 |
$2,782 |
15.8× |
| CT cervical spine w/wo cont (72127) |
$2,145 |
$2,860 |
9.7× |
| CT chest w contrast (71260) |
$2,263.50 |
$3,018 |
10.2× |
| CT chest w/wo contrast (71270) |
$2,541 |
$3,388 |
11.4× |
| CT head/brain with contrast (70460) |
$2,011.50 |
$2,682 |
9.1× |
| CT head/brain without and with contrast (70470) |
$2,093.25 |
$2,791 |
9.4× |
| CT iac w contrast (70481) |
$2,169 |
$2,892 |
9.8× |
| CT l-spine w&w/o contrast (72133) |
$2,388 |
$3,184 |
10.7× |
| CT lower ext w/o (73700) |
$1,972.50 |
$2,630 |
14.9× |
| CT lower extremity w/contrast material (73701) |
$2,008.50 |
$2,678 |
9.0× |
| CT lumbar spine w contrast (72132) |
$2,346 |
$3,128 |
5.3× |
| CT lumbar spine w/o contrast (72131) |
$2,134.50 |
$2,846 |
16.1× |
| CT maxillofacial w contrast (70487) |
$2,580 |
$3,440 |
11.6× |
| CT maxillofacial wo contrast (70486) |
$1,254.75 |
$1,673 |
9.5× |
| CT neck tissue combo (70492) |
$2,598.75 |
$3,465 |
11.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,745.75 |
$3,661 |
12.4× |
| CT orbits w/o contrast (70480) |
$1,956.75 |
$2,609 |
14.8× |
| CT pelvis w&w/o contrast (72194) |
$2,114.25 |
$2,819 |
9.5× |
| CT pelvis w/o contrast (72192) |
$1,362 |
$1,816 |
10.3× |
| CT scans face/jaw combo (70488) |
$2,957.25 |
$3,943 |
13.3× |
| CT soft tissue neck w contrast (70491) |
$2,304.75 |
$3,073 |
10.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,801.50 |
$2,402 |
13.6× |
| CT thoracic spine w contrast (72129) |
$2,346 |
$3,128 |
10.6× |
| CT thoracic spine w/o contrast (72128) |
$2,147.25 |
$2,863 |
16.2× |
| CT thoracic spine w/wo cont (72130) |
$2,346 |
$3,128 |
10.6× |
| CT thorax w/o contrast (71250) |
$1,983 |
$2,644 |
15.0× |
| CT upper ext wo (73200) |
$2,394 |
$3,192 |
18.1× |
| CT upper extremity with contrast (73201) |
$2,574 |
$3,432 |
5.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,343.75 |
$3,125 |
10.5× |
| Cta Abdomen (74175) |
$2,399.25 |
$3,199 |
10.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,162.50 |
$1,550 |
2.6× |
| CTA pelvis (72191) |
$1,751.25 |
$2,335 |
7.9× |
| Diskography lumbar (72295) |
$5,054.25 |
$6,739 |
2.0× |
| Dxa Bone Density Axial (77080) |
$492.75 |
$657 |
3.7× |
| Dxa bone density study (77085) |
$899.25 |
$1,199 |
6.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$150 |
$200 |
1.4× |
| Echo exam uterus (76831) |
$624 |
$832 |
2.1× |
| Echo Guide For Artery Repair (76936) |
$1,779 |
$2,372 |
6.5× |
| Esophagram (74220) |
$504.75 |
$673 |
2.3× |
| Fetal Biophys Profile W/Nst (76818) |
$806.25 |
$1,075 |
6.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$732 |
$976 |
5.5× |
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines |
$531–$1,167 |
$708–$1,556 |
varies |
| Follow-Up Angiography (75898) |
$2,805 |
$3,740 |
0.7× |
| Foot 2 views (73620) |
$264.75 |
$353 |
2.4× |
| Forearm 2 views (73090) |
$291 |
$388 |
2.6× |
| Gastric emptying imaging study (78264) |
$2,263.50 |
$3,018 |
4.5× |
| Hand 2 views (73120) |
$266.25 |
$355 |
2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$6,896.25 |
$9,195 |
7.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$6,754.50 |
$9,006 |
7.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$5,775.75 |
$7,701 |
6.5× |
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889)
range across 2 matching MRF lines |
$8,742–$8,820 |
$11,656–$11,760 |
varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$8,742 |
$11,656 |
2.2× |
| Hepatobil Syst Image W/Drug (78227) |
$2,114.25 |
$2,819 |
3.1× |
| Hepatobiliary System Imaging (78226) |
$1,989.75 |
$2,653 |
3.9× |
| Ht Muscle Image Spect Sing (78451) |
$3,653.25 |
$4,871 |
2.2× |
| Hysterosalpingogram (74740) |
$645 |
$860 |
2.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$352.50 |
$470 |
3.2× |
| Joint Survey Single View (77077) |
$124.50 |
$166 |
0.9× |
| K Flow/Funct Image W/Drug (78708) |
$1,956 |
$2,608 |
2.8× |
| Knee 3 Views (73562) |
$353.25 |
$471 |
3.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,273.50 |
$1,698 |
1.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,738.50 |
$2,318 |
2.5× |
| Lymph System Imaging (78195) |
$1,190.25 |
$1,587 |
1.7× |
| Meckels Divert Exam (78290) |
$1,449 |
$1,932 |
2.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,289 |
$3,052 |
4.8× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,450.75 |
$4,601 |
7.8× |
| MRA head w/o contrast (70544) |
$2,205 |
$2,940 |
7.3× |
| MRA head with contrast (70545) |
$2,269.50 |
$3,026 |
5.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,503.25 |
$4,671 |
7.9× |
| MRA neck w/o contrast (70547) |
$2,199.75 |
$2,933 |
7.3× |
| MRI abdomen w/o contrast (74181) |
$1,836.75 |
$2,449 |
6.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,721.25 |
$6,295 |
10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,969.25 |
$3,959 |
3.0× |
| MRI cervical spine w contrast (72142) |
$2,254.50 |
$3,006 |
5.1× |
| MRI cervical spine w/o cont (72141) |
$2,086.50 |
$2,782 |
6.9× |
| MRI chest wo w contrast (71552) |
$1,192.50 |
$1,590 |
2.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,719 |
$6,292 |
10.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,036.25 |
$2,715 |
6.7× |
| MRI lumbar spine w contrast (72149) |
$2,293.50 |
$3,058 |
5.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,983.50 |
$3,978 |
6.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$571.50 |
$762 |
1.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,636.50 |
$6,182 |
10.5× |
| MRI pelvis w/o & w contrast (72197) |
$4,164 |
$5,552 |
9.4× |
| MRI pelvis w/o contrast (72195) |
$2,055.75 |
$2,741 |
6.8× |
| MRI spectroscopy (76390) |
$1,428.75 |
$1,905 |
13.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,252.25 |
$3,003 |
7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,078.25 |
$2,771 |
6.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,121.50 |
$4,162 |
7.1× |
| MRI, abdomen, combo (74183) |
$3,123.75 |
$4,165 |
7.1× |
| MRI, dorsal spine combo (72157) |
$2,860.50 |
$3,814 |
6.5× |
| MRI, dorsal spine contrast (72147) |
$2,860.50 |
$3,814 |
6.5× |
| MRI, joint upper extrem (73221) |
$1,951.50 |
$2,602 |
6.5× |
| MRI, joint upper extrem combo (73223) |
$2,969.25 |
$3,959 |
6.7× |
| MRI, lumbar spine combo (72158) |
$3,036.75 |
$4,049 |
6.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,818.25 |
$5,091 |
2.3× |
| Neck soft tissue (70360) |
$298.50 |
$398 |
2.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,898.75 |
$11,865 |
5.1× |
| Nuclear Rx Intra-Arterial (79445) |
$840.75 |
$1,121 |
2.8× |
| Nuclear Rx Oral Admin (79005) |
$784.50 |
$1,046 |
2.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$255 |
$340 |
1.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,437.75 |
$1,917 |
2.1× |
| Parathyroid Planar Imaging (78070) |
$1,398.75 |
$1,865 |
2.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,398.75 |
$1,865 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$285 |
$380 |
2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,004.75 |
$2,673 |
4.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$480.75 |
$641 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$446.25 |
$595 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$390.75 |
$521 |
3.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$267 |
$356 |
2.4× |
| Radex elbow complete minimum 3 views (73080) |
$451.50 |
$602 |
4.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$540 |
$720 |
4.1× |
| Radex fingr minimum 2 views (73140) |
$237.75 |
$317 |
2.2× |
| Radex foot complete minimum 3 views (73630) |
$347.25 |
$463 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$345.75 |
$461 |
3.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$395.25 |
$527 |
3.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$358.50 |
$478 |
3.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$363 |
$484 |
3.3× |
| Radex shoulder complete minimum 2 views (73030) |
$300 |
$400 |
2.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$561.75 |
$749 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$300 |
$400 |
2.7× |
| Radex Sternum Minimum 2 Views (71120) |
$282.75 |
$377 |
2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$690 |
$920 |
6.3× |
| Radex Toe Minimum 2 Views (73660) |
$259.50 |
$346 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$229.50 |
$306 |
1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$358.50 |
$478 |
3.3× |
| Radiation treatment delivery level 1 (77402) |
$2,250 |
$3,000 |
17.4× |
| Radiation treatment delivery level 2 (77407) |
$2,700 |
$3,600 |
5.5× |
Radiation treatment delivery level 3 (77412)
range across 2 matching MRF lines |
$684–$3,075 |
$912–$4,100 |
varies |
| Radiolog exam mandible compl minimum 4 views (70110) |
$613.50 |
$818 |
4.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$399 |
$532 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$745.50 |
$994 |
3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$660 |
$880 |
3.0× |
| Radiologic exam knee complete 4/more views (73564) |
$513 |
$684 |
3.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$396 |
$528 |
3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$561.75 |
$749 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$514.50 |
$686 |
2.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$584.25 |
$779 |
2.6× |
| Radiologic examination femur 1 view (73551) |
$228.75 |
$305 |
2.1× |
| Radiologic examination femur minimum 2 views (73552) |
$228.75 |
$305 |
2.1× |
| Radiologic examination knee 1/2 views (73560) |
$318 |
$424 |
2.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$456.75 |
$609 |
3.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$249 |
$332 |
2.3× |
| Ribs bilateral 3 views (71110) |
$621 |
$828 |
4.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,429.50 |
$1,906 |
2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,461.75 |
$1,949 |
2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,733 |
$3,644 |
4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,493.25 |
$1,991 |
2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,733 |
$3,644 |
4.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$4,195.50 |
$5,594 |
2.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,459.50 |
$5,946 |
2.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,930.75 |
$5,241 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$609.75 |
$813 |
2.1× |
| Salivary Gland Imaging (78230) |
$951 |
$1,268 |
1.9× |
| Scapula (73010) |
$292.50 |
$390 |
2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$114.75 |
$153 |
4.9× |
| Shoulder 1 view (73020) |
$212.25 |
$283 |
1.9× |
| Shoulder Arthrography (73040) |
$1,161 |
$1,548 |
2.6× |
| Skull less than 4 views (70250) |
$270 |
$360 |
2.0× |
| Special dosimetry (77331) |
$597 |
$796 |
3.5× |
| Special Physics Consult (77370) |
$1,212 |
$1,616 |
7.1× |
| Special teletherapy port plan (77321) |
$1,603.50 |
$2,138 |
3.4× |
| Special treatment procedure (77470) |
$3,064.50 |
$4,086 |
4.4× |
| Stereotactic Body Radiation Delivery (77373) |
$9,670.50 |
$12,894 |
4.3× |
| Sternoclavicular joints (71130) |
$208.50 |
$278 |
1.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,785.50 |
$3,714 |
5.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,389 |
$1,852 |
2.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,381.25 |
$3,175 |
5.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,853.25 |
$2,471 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,170 |
$1,560 |
6.9× |
| Thoracic spine 2 views (72070) |
$427.50 |
$570 |
3.2× |
| Thoracic spine 3 views (72072) |
$490.50 |
$654 |
3.7× |
| Thoracolumbar 2 views (72080) |
$198.75 |
$265 |
1.8× |
| Thyroid Met Imaging Body (78018) |
$1,405.50 |
$1,874 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,306.50 |
$1,742 |
2.6× |
| Tx Devices Design & Construction Complex (77334) |
$1,539.75 |
$2,053 |
3.2× |
| Tx devices design & construction intermediate (77333) |
$1,158 |
$1,544 |
6.8× |
| Tx devices design & construction simple (77332) |
$787.50 |
$1,050 |
4.6× |
| Ultrasound Breast Limited (76642) |
$455.25 |
$607 |
4.1× |
| Ultrasound Exam Aaa Screen (76706) |
$573 |
$764 |
4.3× |
| Ultrasound, abdomen limited (76705) |
$473.25 |
$631 |
3.6× |
| Unlisted fluoroscopic procedure (76496) |
$301.50 |
$402 |
2.7× |
| Unlisted magnetic resonance procedure (76498) |
$1,137.75 |
$1,517 |
10.3× |
| Unlisted us procedure (76999) |
$364.50 |
$486 |
3.3× |
| Upper gi w/o kub (74240) |
$702 |
$936 |
3.2× |
| Urethrocystogram voiding (74455) |
$774.75 |
$1,033 |
2.6× |
| Urethrocystography retrograde (74450) |
$567 |
$756 |
1.9× |
| Us breast unilateral complete (76641) |
$290.25 |
$387 |
2.2× |
| Us chest (76604) |
$303.75 |
$405 |
2.3× |
| Us complete joint (76881) |
$504.75 |
$673 |
3.8× |
| Us exam, pelvic, limited (76857) |
$260.25 |
$347 |
2.0× |
| Us head (76506) |
$456.75 |
$609 |
3.4× |
| Us kidney transplant (76776) |
$981.75 |
$1,309 |
7.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$225 |
$300 |
1.7× |
| Us ob detailed single fetus (76811) |
$1,073.25 |
$1,431 |
3.6× |
| Us ob limited 1 or more fetuses (76815) |
$437.25 |
$583 |
3.3× |
| Us ob transvaginal (76817) |
$307.50 |
$410 |
2.3× |
| Us pelvic non ob complete (76856) |
$793.50 |
$1,058 |
6.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$502.50 |
$670 |
3.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$312 |
$416 |
2.4× |
| Us retroperitoneal complete (76770) |
$1,498.50 |
$1,998 |
11.3× |
| Us retroperitoneal limited (76775) |
$315.75 |
$421 |
2.4× |
| Us scrotum and contents (76870) |
$695.25 |
$927 |
5.2× |
| Us spinal canal and contents (76800) |
$341.25 |
$455 |
2.6× |
| Us thyroid (76536) |
$597.75 |
$797 |
4.5× |
| Vein X-Ray Chest (75827) |
$4,075.50 |
$5,434 |
2.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,318.25 |
$3,091 |
0.6× |
| Venogram Sinus/Jugular (75860) |
$2,805 |
$3,740 |
0.7× |
| Venography Adrenal Unilateral (75840) |
$8,111.25 |
$10,815 |
2.0× |
| Venography caval inferior serialography rs&i (75825) |
$8,742 |
$11,656 |
2.2× |
| Venography extremity bilateral rs&i (75822) |
$4,047.75 |
$5,397 |
2.0× |
| Venography extremity unilateral rs&i (75820) |
$2,805 |
$3,740 |
1.4× |
Venography Renal Unilateral (75831)
range across 2 matching MRF lines |
$8,111.25–$10,544.25 |
$10,815–$14,059 |
varies |
| Wrist 2 views (73100) |
$313.50 |
$418 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$456.75 |
$609 |
4.1× |
| X-Ray Aorta Leg Arteries (75630) |
$8,742 |
$11,656 |
2.2× |
| X-Ray Bend Only L-S Spine (72120) |
$363.75 |
$485 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$291 |
$388 |
2.6× |
| X-Ray Exam Breast Specimen (76098) |
$68.25 |
$91 |
0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$228.75 |
$305 |
2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$377.25 |
$503 |
2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$720 |
$960 |
5.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$192.75 |
$257 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$228.75 |
$305 |
2.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$377.25 |
$503 |
2.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$377.25 |
$503 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$377.25 |
$503 |
2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$657 |
$876 |
5.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$654.75 |
$873 |
4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$371.25 |
$495 |
3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$578.25 |
$771 |
4.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$400.50 |
$534 |
3.0× |
| X-ray eye for foreign body (70030) |
$143.25 |
$191 |
1.3× |
| X-ray humerus (73060) |
$312 |
$416 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$522 |
$696 |
4.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$411 |
$548 |
3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$371.25 |
$495 |
2.8× |
| X-ray nose-rectum child f.b. (76010) |
$197.25 |
$263 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$683.25 |
$911 |
5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$377.25 |
$503 |
2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$343.50 |
$458 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$384 |
$512 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$576 |
$768 |
5.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$270 |
$360 |
2.0× |
| X-ray thoracic spine 4 vw (72074) |
$512.25 |
$683 |
3.9× |
| X-Ray Tmj Unilat (70328) |
$254.25 |
$339 |
2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$825 |
$1,100 |
1.9× |
| X-Rays Bone Length Studies (77073) |
$297 |
$396 |
2.2× |
| X-Rays Bone Survey Complete (77075) |
$980.25 |
$1,307 |
7.4× |
| Xr c-spine 4 or 5 views (72050) |
$438 |
$584 |
3.3× |
| Xr facial bones less than 3 views (70140) |
$483.75 |
$645 |
4.4× |
| Xr orbits complete 4 views (70200) |
$373.50 |
$498 |
2.8× |