| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,024.50 |
$9,366 |
4.6× |
| Abdomen 1 View (74018) |
$249.75 |
$333 |
2.6× |
| Abdomen 2 views (74019) |
$292.50 |
$390 |
2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,112 |
$2,816 |
4.8× |
| Adrenal Cortex & Medulla Img (78075) |
$2,838.75 |
$3,785 |
2.0× |
| Angio internal mammary (75756) |
$6,276 |
$8,368 |
1.8× |
| Angio pulmonary bilat (75743) |
$10,203 |
$13,604 |
2.9× |
| Angiography extremity bilateral rs&i (75716) |
$10,203 |
$13,604 |
2.9× |
Angiography extremity unilateral rs&i (75710)
range across 2 matching MRF lines |
$605.25–$6,802.50 |
$807–$9,070 |
varies |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,802.50 |
$9,070 |
1.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$6,276 |
$8,368 |
1.8× |
| Ankle 2 views (73600) |
$246.75 |
$329 |
2.6× |
Aortography thoracic serialography rs&i (75605)
range across 2 matching MRF lines |
$538.50–$6,802.50 |
$718–$9,070 |
varies |
| Artery X-Rays Abdomen (75726) |
$11,915.25 |
$15,887 |
1.9× |
| Artery X-Rays Pelvis (75736) |
$6,802.50 |
$9,070 |
1.1× |
| Artery X-Rays Spine (75705) |
$11,915.25 |
$15,887 |
1.9× |
| Arthrogram hip (73525) |
$768 |
$1,024 |
2.0× |
| Arthrogram Wrist (73115) |
$876.75 |
$1,169 |
2.3× |
| Basic radiation dosimetry calculation (77300) |
$665.25 |
$887 |
4.5× |
| Bone age studies (77072) |
$246.75 |
$329 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$2,027.25 |
$2,703 |
4.6× |
| Bone Imaging Multiple Areas (78305) |
$1,338 |
$1,784 |
3.0× |
| Bone Imaging Whole Body (78306) |
$1,483.50 |
$1,978 |
3.3× |
| Bone marrow imaging; multiple areas (78103) |
$1,338.75 |
$1,785 |
3.0× |
| Bone survey infant (77076) |
$635.25 |
$847 |
5.5× |
| Brachytx isodose complex (77318) |
$1,893.75 |
$2,525 |
4.6× |
| Brachytx isodose intermed (77317) |
$1,794.75 |
$2,393 |
4.3× |
| Brachytx Isodose Plan Simple (77316) |
$1,505.25 |
$2,007 |
3.6× |
| Brain Flow Imaging Only (78610) |
$442.50 |
$590 |
0.7× |
| Brain Image W/Flow < 4 Views (78601) |
$1,338.75 |
$1,785 |
3.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,100 |
$2,800 |
3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,208.50 |
$8,278 |
3.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,607.25 |
$2,143 |
4.1× |
| Cardiac Shunt Detection (78428) |
$1,236.75 |
$1,649 |
2.8× |
| Cat Scan Follow-Up Study (76380) |
$461.25 |
$615 |
4.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,112 |
$2,816 |
3.5× |
| Cerebrospinal Fluid Scan (78630) |
$1,779 |
$2,372 |
2.9× |
| Chest 1 view (71045) |
$175.50 |
$234 |
1.8× |
| Chest 2 views (71046) |
$198 |
$264 |
2.0× |
| Chest 3 views (71047) |
$198 |
$264 |
2.0× |
| Chest 4 or more views (71048) |
$237.75 |
$317 |
2.0× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$291.75 |
$389 |
2.5× |
| Cholecystography Oral Contrast (74290) |
$511.50 |
$682 |
2.6× |
| Clavicle complete (73000) |
$172.50 |
$230 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$271.50 |
$362 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$711.75 |
$949 |
4.8× |
Contrast Exam Abdominl Aorta (75625)
range across 2 matching MRF lines |
$519–$6,802.50 |
$692–$9,070 |
varies |
| Contrast X-Ray Bladder (74430) |
$613.50 |
$818 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,253.75 |
$3,005 |
5.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,628.25 |
$2,171 |
6.1× |
| CT abdomen w contrast (74160) |
$882.75 |
$1,177 |
4.5× |
| CT abdomen w wo contrast (74170) |
$1,227.75 |
$1,637 |
6.3× |
| CT abdomen w/o contrast (74150) |
$600 |
$800 |
5.2× |
| CT Angio Abdomen and Pelvis (74174) |
$2,331.75 |
$3,109 |
6.0× |
| CT Angio Chest (71275) |
$1,367.25 |
$1,823 |
7.0× |
| CT Angio Head (70496) |
$1,726.50 |
$2,302 |
8.9× |
| CT angio hrt w/3d image (75574) |
$1,143 |
$1,524 |
2.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,209.75 |
$1,613 |
6.2× |
| CT Angio Neck (70498) |
$1,733.25 |
$2,311 |
8.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,072.50 |
$1,430 |
5.5× |
| CT cervical spine w/ contrast (72126) |
$915.75 |
$1,221 |
2.4× |
| CT cervical spine w/o contrast (72125) |
$644.25 |
$859 |
5.5× |
| CT cervical spine w/wo cont (72127) |
$1,011.75 |
$1,349 |
5.2× |
| CT chest w contrast (71260) |
$803.25 |
$1,071 |
4.1× |
| CT chest w/wo contrast (71270) |
$1,014 |
$1,352 |
5.2× |
| CT head/brain with contrast (70460) |
$645.75 |
$861 |
3.3× |
| CT head/brain without and with contrast (70470) |
$793.50 |
$1,058 |
4.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$807 |
$1,076 |
2.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$75.75 |
$101 |
0.8× |
| CT iac w contrast (70481) |
$990 |
$1,320 |
5.1× |
| CT l-spine w&w/o contrast (72133) |
$1,012.50 |
$1,350 |
5.2× |
| CT lower ext w/o (73700) |
$635.25 |
$847 |
5.5× |
| CT lower extremity w/contrast material (73701) |
$796.50 |
$1,062 |
4.1× |
| CT lumbar spine w contrast (72132) |
$801 |
$1,068 |
2.1× |
| CT lumbar spine w/o contrast (72131) |
$640.50 |
$854 |
5.5× |
| CT maxillofacial w contrast (70487) |
$827.25 |
$1,103 |
4.2× |
| CT maxillofacial wo contrast (70486) |
$671.25 |
$895 |
5.8× |
| CT neck tissue combo (70492) |
$1,072.50 |
$1,430 |
5.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,139.25 |
$1,519 |
5.8× |
| CT orbits w/o contrast (70480) |
$837.75 |
$1,117 |
7.2× |
| CT pelvis w&w/o contrast (72194) |
$1,027.50 |
$1,370 |
5.3× |
| CT pelvis w/o contrast (72192) |
$601.50 |
$802 |
5.2× |
| CT scan of leg combo (73702) |
$1,070.25 |
$1,427 |
5.5× |
| CT scans face/jaw combo (70488) |
$1,035 |
$1,380 |
5.3× |
| CT soft tissue neck w contrast (70491) |
$1,072.50 |
$1,430 |
5.5× |
| CT soft tissue neck w/o contrast (70490) |
$636 |
$848 |
5.5× |
| CT thoracic spine w contrast (72129) |
$803.25 |
$1,071 |
4.1× |
| CT thoracic spine w/o contrast (72128) |
$642 |
$856 |
5.5× |
| CT thoracic spine w/wo cont (72130) |
$803.25 |
$1,071 |
4.1× |
| CT thorax w/o contrast (71250) |
$643.50 |
$858 |
5.5× |
| CT upper ext wo (73200) |
$633 |
$844 |
5.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,068.75 |
$1,425 |
5.5× |
| CT upper extremity with contrast (73201) |
$790.50 |
$1,054 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,248 |
$1,664 |
6.4× |
| Cta Abdomen (74175) |
$1,209.75 |
$1,613 |
6.2× |
| CTA pelvis (72191) |
$1,117.50 |
$1,490 |
5.7× |
| Diskography lumbar (72295) |
$8,630.25 |
$11,507 |
4.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$291.75 |
$389 |
2.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$519 |
$692 |
4.5× |
| Dxa Bone Density Axial (77080) |
$307.50 |
$410 |
2.6× |
| Dxa bone density study (77085) |
$410.25 |
$547 |
3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$155.25 |
$207 |
1.6× |
| Echo exam of fetal heart (76825) |
$777.75 |
$1,037 |
1.3× |
| Echo exam uterus (76831) |
$513 |
$684 |
1.9× |
| Echo Guide For Artery Repair (76936) |
$632.25 |
$843 |
2.6× |
| Esophagram (74220) |
$747 |
$996 |
3.8× |
| Fetal Biophys Profile W/Nst (76818) |
$775.50 |
$1,034 |
6.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$393 |
$524 |
3.4× |
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines |
$415.50–$635.25 |
$554–$847 |
varies |
| Follow-Up Angiography (75898) |
$2,181 |
$2,908 |
0.6× |
| Foot 2 views (73620) |
$165.75 |
$221 |
1.7× |
| Forearm 2 views (73090) |
$172.50 |
$230 |
1.8× |
| Gastric emptying imaging study (78264) |
$1,763.25 |
$2,351 |
4.0× |
| Gated Heart Planar Single (78472) |
$1,401 |
$1,868 |
3.2× |
| Hand 2 views (73120) |
$252.75 |
$337 |
2.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$5,605.50 |
$7,474 |
7.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$5,490 |
$7,320 |
7.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$4,695 |
$6,260 |
6.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,802.50 |
$9,070 |
1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$5,621.25 |
$7,495 |
1.6× |
| Hepatobil Syst Image W/Drug (78227) |
$2,310.75 |
$3,081 |
3.8× |
| Hepatobiliary System Imaging (78226) |
$2,079 |
$2,772 |
4.7× |
| Ht Muscle Image Spect Sing (78451) |
$1,353.75 |
$1,805 |
0.9× |
| Hysterosalpingogram (74740) |
$780 |
$1,040 |
2.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$600.75 |
$801 |
6.2× |
| Infant hip ultrasound, limited static exam (76886) |
$236.25 |
$315 |
2.4× |
| Joint Survey Single View (77077) |
$246.75 |
$329 |
2.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,338.75 |
$1,785 |
2.2× |
| K Flow/Funct Image W/O Drug (78707) |
$1,338.75 |
$1,785 |
2.2× |
| Knee 3 Views (73562) |
$246.75 |
$329 |
2.6× |
| Liver & Spleen Imaging Static Only (78215) |
$1,188 |
$1,584 |
2.7× |
| Liver imaging static only (78201) |
$1,093.50 |
$1,458 |
1.8× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,330.25 |
$3,107 |
3.9× |
| Lung perfusion differential (78597) |
$1,452 |
$1,936 |
3.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,100 |
$2,800 |
3.5× |
| Lung Ventilation Imaging (78579) |
$1,287.75 |
$1,717 |
2.9× |
| Lymph System Imaging (78195) |
$2,112 |
$2,816 |
3.5× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$2,768.25 |
$3,691 |
4.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$9,548.25 |
$12,731 |
2.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$6,366 |
$8,488 |
1.8× |
| Magnetic Image Jaw Joint (70336) |
$1,254 |
$1,672 |
4.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$1,487.25 |
$1,983 |
2.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$1,902.75 |
$2,537 |
9.8× |
| Meckels Divert Exam (78290) |
$2,092.50 |
$2,790 |
4.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,860 |
$2,480 |
4.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,449.50 |
$3,266 |
6.3× |
| MRA head w/o contrast (70544) |
$1,626 |
$2,168 |
6.1× |
| MRA head with contrast (70545) |
$1,635.75 |
$2,181 |
4.2× |
| MRA neck w contrast (70548) |
$1,716 |
$2,288 |
4.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,452.50 |
$3,270 |
6.3× |
| MRA neck w/o contrast (70547) |
$1,627.50 |
$2,170 |
6.1× |
| MRI abdomen w contrast (74182) |
$1,767 |
$2,356 |
4.6× |
| MRI abdomen w/o contrast (74181) |
$1,266 |
$1,688 |
4.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,467 |
$1,956 |
1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,803.75 |
$2,405 |
4.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,451.25 |
$1,935 |
1.7× |
| MRI bone marrow blood supply (77084) |
$1,407.75 |
$1,877 |
5.3× |
| MRI brain functional w/o physician admnistration (70554) |
$1,579.50 |
$2,106 |
6.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$432 |
$576 |
1.6× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$432 |
$576 |
1.6× |
| MRI cardiac w/o contrast (75557) |
$1,132.50 |
$1,510 |
4.3× |
| MRI cervical spine w contrast (72142) |
$1,598.25 |
$2,131 |
4.1× |
| MRI cervical spine w/o cont (72141) |
$1,278.75 |
$1,705 |
4.8× |
| MRI chest w/o contrast (71550) |
$1,662 |
$2,216 |
6.3× |
| MRI chest wo w contrast (71552) |
$2,283.75 |
$3,045 |
5.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,541.25 |
$2,055 |
4.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,947 |
$2,596 |
5.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,453.50 |
$1,938 |
5.5× |
| MRI lumbar spine w contrast (72149) |
$1,596.75 |
$2,129 |
4.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,860 |
$2,480 |
4.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,438.50 |
$1,918 |
5.4× |
| MRI orbit face neck w contrast (70542) |
$1,539 |
$2,052 |
4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,926 |
$2,568 |
5.0× |
| MRI pelvis w contrast (72196) |
$1,565.25 |
$2,087 |
4.0× |
| MRI pelvis w/o & w contrast (72197) |
$1,949.25 |
$2,599 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,464.75 |
$1,953 |
5.5× |
| MRI spectroscopy (76390) |
$981.75 |
$1,309 |
10.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,284 |
$1,712 |
4.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,565.25 |
$2,087 |
4.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,491.75 |
$1,989 |
5.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,948.50 |
$2,598 |
5.0× |
| MRI, abdomen, combo (74183) |
$1,951.50 |
$2,602 |
5.0× |
| MRI, dorsal spine combo (72157) |
$1,698 |
$2,264 |
4.4× |
| MRI, dorsal spine contrast (72147) |
$1,386.75 |
$1,849 |
3.6× |
| MRI, joint upper extrem (73221) |
$1,375.50 |
$1,834 |
5.2× |
| MRI, joint upper extrem combo (73223) |
$1,807.50 |
$2,410 |
4.7× |
| MRI, lumbar spine combo (72158) |
$1,857.75 |
$2,477 |
4.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,309 |
$4,412 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,422.25 |
$4,563 |
2.4× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$9,157.50 |
$12,210 |
3.7× |
| N-invas est c ffr sw aly CTA (75580) |
$2,091 |
$2,788 |
2.2× |
| Neck soft tissue (70360) |
$156.75 |
$209 |
1.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$749.25 |
$999 |
1.7× |
| Nm csf leak detection (78650) |
$2,134.50 |
$2,846 |
1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,233.75 |
$9,645 |
4.7× |
| Nuclear Rx Intra-Arterial (79445) |
$497.25 |
$663 |
1.9× |
| Nuclear Rx Oral Admin (79005) |
$756 |
$1,008 |
2.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$180 |
$240 |
1.5× |
| Panoramic X-ray of jaws (70355) |
$302.25 |
$403 |
3.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,470.75 |
$1,961 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$679.50 |
$906 |
1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,470.75 |
$1,961 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$246.75 |
$329 |
2.1× |
| Pet Image W/Ct Lmtd (78814) |
$4,238.25 |
$5,651 |
2.7× |
| PET image w/CT, full body (78816) |
$5,017.50 |
$6,690 |
3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,017.50 |
$6,690 |
3.2× |
| PET whole body (78813) |
$3,128.25 |
$4,171 |
2.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,802.50 |
$9,070 |
1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,257 |
$1,676 |
2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$338.25 |
$451 |
2.9× |
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines |
$780–$856.50 |
$1,040–$1,142 |
varies |
| Radex Ankle Complete Minimum 3 Views (73610) |
$246.75 |
$329 |
2.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$169.50 |
$226 |
1.8× |
| Radex elbow complete minimum 3 views (73080) |
$243.75 |
$325 |
2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$270 |
$360 |
2.3× |
| Radex fingr minimum 2 views (73140) |
$213 |
$284 |
2.2× |
| Radex foot complete minimum 3 views (73630) |
$201 |
$268 |
2.1× |
| Radex Hand Minimum 3 Views (73130) |
$252.75 |
$337 |
2.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$246.75 |
$329 |
2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$221.25 |
$295 |
2.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$194.25 |
$259 |
2.0× |
| Radex shoulder complete minimum 2 views (73030) |
$246.75 |
$329 |
2.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$187.50 |
$250 |
1.9× |
| Radex Spine 1 View Specify Level (72020) |
$155.25 |
$207 |
1.6× |
| Radex Sternum Minimum 2 Views (71120) |
$197.25 |
$263 |
2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$327 |
$436 |
3.4× |
| Radex Toe Minimum 2 Views (73660) |
$201 |
$268 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$246.75 |
$329 |
2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$242.25 |
$323 |
2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$216 |
$288 |
1.9× |
| Radiation treatment delivery level 1 (77402) |
$1,950 |
$2,600 |
17.2× |
| Radiation treatment delivery level 2 (77407) |
$2,437.50 |
$3,250 |
5.7× |
Radiation treatment delivery level 3 (77412)
range across 2 matching MRF lines |
$867.75–$2,925 |
$1,157–$3,900 |
varies |
| Radiolog exam mandible compl minimum 4 views (70110) |
$246.75 |
$329 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$338.25 |
$451 |
2.9× |
| Radiologic exam colon double contrast study (74280) |
$1,395 |
$1,860 |
7.2× |
| Radiologic exam colon single contrast study (74270) |
$1,014.75 |
$1,353 |
5.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$747 |
$996 |
3.8× |
| Radiologic exam knee complete 4/more views (73564) |
$275.25 |
$367 |
2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$270 |
$360 |
2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$705 |
$940 |
3.6× |
| Radiologic exam swallow function contrast study (74230) |
$538.50 |
$718 |
2.8× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$966 |
$1,288 |
3.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$780.75 |
$1,041 |
4.0× |
| Radiologic examination femur 1 view (73551) |
$294.75 |
$393 |
3.0× |
| Radiologic examination femur minimum 2 views (73552) |
$294.75 |
$393 |
3.0× |
| Radiologic examination knee 1/2 views (73560) |
$177.75 |
$237 |
1.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$440.25 |
$587 |
3.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$165.75 |
$221 |
1.7× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$287.25 |
$383 |
3.0× |
| Ribs bilateral 3 views (71110) |
$272.25 |
$363 |
2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,489.50 |
$1,986 |
3.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,042 |
$4,056 |
5.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,441.75 |
$4,589 |
5.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,804.50 |
$6,406 |
3.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,841.50 |
$5,122 |
2.7× |
| Rp Therapy Intravenous Administration (79101) |
$522 |
$696 |
2.0× |
| Scapula (73010) |
$177.75 |
$237 |
1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$87 |
$116 |
3.7× |
| Shoulder 1 view (73020) |
$155.25 |
$207 |
1.6× |
| Shoulder Arthrography (73040) |
$768 |
$1,024 |
2.0× |
| Skull less than 4 views (70250) |
$246.75 |
$329 |
2.1× |
| Special dosimetry (77331) |
$484.50 |
$646 |
3.2× |
| Special Physics Consult (77370) |
$1,188.75 |
$1,585 |
8.0× |
| Special teletherapy port plan (77321) |
$1,303.50 |
$1,738 |
3.1× |
| Special treatment procedure (77470) |
$3,003 |
$4,004 |
4.9× |
Srs Multisource (77371)
range across 4 matching MRF lines |
$61,916.25–$84,533.25 |
$82,555–$112,711 |
varies |
| Stereotactic Body Radiation Delivery (77373) |
$9,040.50 |
$12,054 |
4.5× |
| Sternoclavicular joints (71130) |
$236.25 |
$315 |
2.4× |
| Superior sagittal sinus venogram (75870) |
$1,541.25 |
$2,055 |
0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,264.25 |
$3,019 |
5.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,128.75 |
$1,505 |
2.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,935 |
$2,580 |
4.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,505.25 |
$2,007 |
3.6× |
Ther rad simulaj-aided field setting simple (77280)
range across 2 matching MRF lines |
$353.25–$951 |
$471–$1,268 |
varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$995.25 |
$1,327 |
5.1× |
| Thoracic spine 2 views (72070) |
$246.75 |
$329 |
2.1× |
| Thoracic spine 3 views (72072) |
$246.75 |
$329 |
2.1× |
| Thoracolumbar 2 views (72080) |
$215.25 |
$287 |
2.2× |
| Thyroid Met Imaging Body (78018) |
$1,980 |
$2,640 |
3.3× |
| Thyroid Uptake Measurement (78012) |
$567.75 |
$757 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,205.25 |
$1,607 |
2.7× |
| Tx Devices Design & Construction Complex (77334) |
$1,508.25 |
$2,011 |
3.6× |
| Tx devices design & construction intermediate (77333) |
$940.50 |
$1,254 |
6.3× |
| Tx devices design & construction simple (77332) |
$117.75 |
$157 |
0.8× |
| Ultrasound Breast Limited (76642) |
$319.50 |
$426 |
3.3× |
| Ultrasound Elastography Parenchyma (76981) |
$285.75 |
$381 |
2.5× |
| Ultrasound Exam Aaa Screen (76706) |
$402 |
$536 |
3.5× |
| Ultrasound, abdomen limited (76705) |
$327 |
$436 |
2.8× |
| Umbilical-artery Doppler (OB) (76820) |
$504.75 |
$673 |
4.3× |
| Unlisted Dx Radiographic Procedure (76499) |
$239.25 |
$319 |
2.5× |
| Unlisted fluoroscopic procedure (76496) |
$414 |
$552 |
4.3× |
| Unlisted magnetic resonance procedure (76498) |
$262.50 |
$350 |
2.7× |
| Unlisted us procedure (76999) |
$269.25 |
$359 |
2.8× |
| Upper gi w/o kub (74240) |
$631.50 |
$842 |
3.2× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$449.25 |
$599 |
40.6× |
| Urethrocystogram voiding (74455) |
$613.50 |
$818 |
2.3× |
| Urethrocystography retrograde (74450) |
$828 |
$1,104 |
3.1× |
| Us breast unilateral complete (76641) |
$357 |
$476 |
3.1× |
| Us chest (76604) |
$219 |
$292 |
1.9× |
| Us complete joint (76881) |
$523.50 |
$698 |
4.5× |
Us exam, pelvic, limited (76857)
range across 4 matching MRF lines |
$144–$471.75 |
$192–$629 |
varies |
| Us head (76506) |
$510 |
$680 |
4.4× |
| Us kidney transplant (76776) |
$536.25 |
$715 |
4.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$242.25 |
$323 |
2.1× |
| Us ob detailed single fetus (76811) |
$577.50 |
$770 |
2.2× |
Us ob limited 1 or more fetuses (76815)
range across 3 matching MRF lines |
$232.50–$332.25 |
$310–$443 |
varies |
| Us ob transvaginal (76817) |
$361.50 |
$482 |
3.1× |
| Us pelvic non ob complete (76856) |
$523.50 |
$698 |
4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$447.75 |
$597 |
3.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$428.25 |
$571 |
3.7× |
| Us retroperitoneal complete (76770) |
$465.75 |
$621 |
4.0× |
| Us retroperitoneal limited (76775) |
$228.75 |
$305 |
2.0× |
| Us scrotum and contents (76870) |
$531 |
$708 |
4.6× |
| Us spinal canal and contents (76800) |
$402.75 |
$537 |
3.5× |
Us thyroid (76536)
range across 3 matching MRF lines |
$315–$507.75 |
$420–$677 |
varies |
| Vascular Flow Imaging (78445) |
$825 |
$1,100 |
1.9× |
| Vein X-Ray Chest (75827) |
$2,181 |
$2,908 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,181 |
$2,908 |
0.6× |
| Vein X-Ray Spleen/Liver (75810) |
$8,277 |
$11,036 |
2.4× |
| Venogram Sinus/Jugular (75860) |
$6,276 |
$8,368 |
1.8× |
| Venography caval inferior serialography rs&i (75825) |
$6,802.50 |
$9,070 |
1.9× |
Venography extremity bilateral rs&i (75822)
range across 2 matching MRF lines |
$1,878–$3,272.25 |
$2,504–$4,363 |
varies |
Venography extremity unilateral rs&i (75820)
range across 2 matching MRF lines |
$1,878–$2,181 |
$2,504–$2,908 |
varies |
| Venography Renal Bilateral (75833) |
$8,553 |
$11,404 |
2.4× |
| Venography Renal Unilateral (75831) |
$6,802.50 |
$9,070 |
1.9× |
| Venous sampling by catheter (75893) |
$6,802.50 |
$9,070 |
1.1× |
| Vertebral fracture assessment via dxa (77086) |
$255 |
$340 |
2.6× |
| Wrist 2 views (73100) |
$184.50 |
$246 |
1.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$246.75 |
$329 |
2.6× |
| X-ray antegrade pyelogram tube (74425) |
$828 |
$1,104 |
2.1× |
| X-Ray Aorta Leg Arteries (75630) |
$6,802.50 |
$9,070 |
1.9× |
| X-Ray Bend Only L-S Spine (72120) |
$350.25 |
$467 |
3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$172.50 |
$230 |
1.8× |
| X-Ray Exam Breast Specimen (76098) |
$70.50 |
$94 |
0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$294.75 |
$393 |
3.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$485.25 |
$647 |
4.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$764.25 |
$1,019 |
6.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$243 |
$324 |
2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$294.75 |
$393 |
3.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$485.25 |
$647 |
4.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$485.25 |
$647 |
4.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$485.25 |
$647 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$925.50 |
$1,234 |
8.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$492 |
$656 |
4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$246.75 |
$329 |
2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$438.75 |
$585 |
3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$246.75 |
$329 |
2.1× |
| X-ray eye for foreign body (70030) |
$167.25 |
$223 |
1.7× |
| X-ray humerus (73060) |
$181.50 |
$242 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$197.25 |
$263 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$197.25 |
$263 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$246.75 |
$329 |
2.1× |
| X-ray nose-rectum child f.b. (76010) |
$147.75 |
$197 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$339 |
$452 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$246.75 |
$329 |
2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$184.50 |
$246 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$184.50 |
$246 |
1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$246.75 |
$329 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$274.50 |
$366 |
2.4× |
| X-ray thoracic spine 4 vw (72074) |
$309.75 |
$413 |
2.7× |
| X-Ray Tmj Unilat (70328) |
$327 |
$436 |
3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$816 |
$1,088 |
2.1× |
| X-Rays Bone Length Studies (77073) |
$246.75 |
$329 |
2.1× |
| X-Rays Bone Survey Complete (77075) |
$721.50 |
$962 |
6.2× |
| Xr c-spine 4 or 5 views (72050) |
$339 |
$452 |
2.9× |
| Xr facial bones less than 3 views (70140) |
$175.50 |
$234 |
1.8× |
| Xr orbits complete 4 views (70200) |
$274.50 |
$366 |
2.4× |