| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,715.35 |
$7,285 |
1.9× |
| Abdomen 1 View (74018) |
$188.70 |
$370 |
1.5× |
| Abdomen 2 views (74019) |
$255.51 |
$501 |
1.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,056.21 |
$2,071 |
1.9× |
| Angio pulmonary bilat (75743) |
$3,191.58 |
$6,258 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$4,328.88 |
$8,488 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,729.12 |
$7,312 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,191.58 |
$6,258 |
0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,627.23 |
$9,073 |
1.0× |
| Ankle 2 views (73600) |
$402.39 |
$789 |
3.3× |
| Aortography thoracic serialography rs&i (75605) |
$5,847.66 |
$11,466 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,627.74 |
$9,074 |
1.0× |
| Artery X-Rays Abdomen (75726) |
$5,316.24 |
$10,424 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$4,624.68 |
$9,068 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$5,316.24 |
$10,424 |
0.7× |
| Artery X-Rays Spine (75705) |
$7,949.88 |
$15,588 |
1.0× |
| Arthrogram hip (73525) |
$451.86 |
$886 |
0.9× |
| Arthrogram Wrist (73115) |
$675.75 |
$1,325 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$1,083.75 |
$2,125 |
5.7× |
| Bone age studies (77072) |
$146.88 |
$288 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$2,315.91 |
$4,541 |
4.1× |
| Bone Imaging Limited Area (78300) |
$704.31 |
$1,381 |
1.2× |
| Bone Imaging Multiple Areas (78305) |
$728.28 |
$1,428 |
1.3× |
| Bone Imaging Whole Body (78306) |
$2,093.55 |
$4,105 |
3.7× |
| Bone survey infant (77076) |
$162.18 |
$318 |
1.1× |
| Brachytx isodose complex (77318) |
$5,224.44 |
$10,244 |
9.8× |
| Brachytx Isodose Plan Simple (77316) |
$2,429.13 |
$4,763 |
4.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$742.56 |
$1,456 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,218.72 |
$8,272 |
2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$525.30 |
$1,030 |
1.1× |
| Cat Scan Follow-Up Study (76380) |
$575.28 |
$1,128 |
4.7× |
| Cerebrospinal Fluid Scan (78630) |
$1,719.21 |
$3,371 |
2.2× |
| Chest 1 view (71045) |
$187.17 |
$367 |
1.5× |
| Chest 2 views (71046) |
$209.61 |
$411 |
1.7× |
| Chest 3 views (71047) |
$216.24 |
$424 |
1.8× |
| Chest 4 or more views (71048) |
$222.87 |
$437 |
1.5× |
| Cholecystography Oral Contrast (74290) |
$265.71 |
$521 |
1.1× |
| Clavicle complete (73000) |
$349.86 |
$686 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$606.39 |
$1,189 |
4.1× |
| Continuing medical physics consltj pr wk (77336) |
$1,735.02 |
$3,402 |
9.1× |
| Contrast Exam Abdominl Aorta (75625) |
$3,335.91 |
$6,541 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$637.50 |
$1,250 |
1.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$573.75 |
$1,125 |
1.2× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$328.44 |
$644 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,110.09 |
$8,059 |
8.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,720.34 |
$5,334 |
8.0× |
| CT abdomen w contrast (74160) |
$2,096.10 |
$4,110 |
8.4× |
| CT abdomen w wo contrast (74170) |
$2,512.26 |
$4,926 |
10.1× |
| CT abdomen w/o contrast (74150) |
$1,817.64 |
$3,564 |
12.2× |
| CT Angio Abdomen and Pelvis (74174) |
$4,679.76 |
$9,176 |
9.4× |
| CT Angio Chest (71275) |
$3,114.06 |
$6,106 |
12.5× |
| CT Angio Head (70496) |
$3,231.87 |
$6,337 |
13.0× |
| CT angio hrt w/3d image (75574) |
$2,595.39 |
$5,089 |
5.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$4,111.62 |
$8,062 |
16.5× |
| CT Angio Neck (70498) |
$3,300.21 |
$6,471 |
13.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,513.39 |
$6,889 |
14.1× |
| CT cervical spine w/ contrast (72126) |
$2,245.53 |
$4,403 |
4.5× |
| CT cervical spine w/o contrast (72125) |
$2,166.99 |
$4,249 |
14.6× |
| CT cervical spine w/wo cont (72127) |
$3,171.69 |
$6,219 |
12.7× |
| CT chest w contrast (71260) |
$2,373.03 |
$4,653 |
9.5× |
| CT chest w/wo contrast (71270) |
$2,598.96 |
$5,096 |
10.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$641.07 |
$1,257 |
4.3× |
| CT head/brain with contrast (70460) |
$1,812.54 |
$3,554 |
7.3× |
| CT head/brain without and with contrast (70470) |
$2,036.94 |
$3,994 |
8.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,790.61 |
$3,511 |
3.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$261.12 |
$512 |
2.1× |
| CT hrt w/3d image congen (75573) |
$266.73 |
$523 |
0.5× |
| CT iac w contrast (70481) |
$2,572.95 |
$5,045 |
10.3× |
| CT l-spine w&w/o contrast (72133) |
$4,329.39 |
$8,489 |
17.4× |
| CT lower ext w/o (73700) |
$1,885.98 |
$3,698 |
12.7× |
| CT lower extremity w/contrast material (73701) |
$2,925.87 |
$5,737 |
11.7× |
| CT lumbar spine w contrast (72132) |
$2,387.31 |
$4,681 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$1,995.63 |
$3,913 |
13.4× |
| CT maxillofacial w contrast (70487) |
$1,829.88 |
$3,588 |
7.3× |
| CT maxillofacial wo contrast (70486) |
$1,532.04 |
$3,004 |
10.3× |
| CT neck tissue combo (70492) |
$1,982.37 |
$3,887 |
8.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,778.99 |
$5,449 |
11.2× |
| CT orbits w/o contrast (70480) |
$1,997.16 |
$3,916 |
13.5× |
| CT pelvis w&w/o contrast (72194) |
$5,003.61 |
$9,811 |
20.1× |
| CT pelvis w/o contrast (72192) |
$2,001.75 |
$3,925 |
13.5× |
| CT scan of leg combo (73702) |
$3,219.12 |
$6,312 |
12.9× |
| CT scans face/jaw combo (70488) |
$2,097.12 |
$4,112 |
8.4× |
| CT soft tissue neck w contrast (70491) |
$1,924.23 |
$3,773 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,653.42 |
$3,242 |
11.1× |
| CT thoracic spine w contrast (72129) |
$2,288.37 |
$4,487 |
9.2× |
| CT thoracic spine w/o contrast (72128) |
$1,974.72 |
$3,872 |
13.3× |
| CT thoracic spine w/wo cont (72130) |
$3,479.22 |
$6,822 |
14.0× |
| CT thorax w/o contrast (71250) |
$1,689.63 |
$3,313 |
11.4× |
| CT upper ext wo (73200) |
$1,788.06 |
$3,506 |
12.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,512.26 |
$4,926 |
10.1× |
| CT upper extremity with contrast (73201) |
$2,034.90 |
$3,990 |
4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,420.06 |
$6,706 |
13.7× |
| Cta Abdomen (74175) |
$3,425.67 |
$6,717 |
13.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$1,885.47 |
$3,697 |
3.8× |
| CTA pelvis (72191) |
$2,580.60 |
$5,060 |
10.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$173.40 |
$340 |
1.2× |
| Dxa Bone Density Axial (77080) |
$617.61 |
$1,211 |
4.2× |
| Dxa bone density study (77085) |
$271.83 |
$533 |
1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$279.99 |
$549 |
2.3× |
| Echo exam uterus (76831) |
$482.46 |
$946 |
1.4× |
| Echo Guide For Artery Repair (76936) |
$640.56 |
$1,256 |
2.1× |
| Esophagram (74220) |
$624.24 |
$1,224 |
2.5× |
| Fetal Biophys Profile W/Nst (76818) |
$1,422.90 |
$2,790 |
9.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$310.08 |
$608 |
2.1× |
| Fluoroscopy up to 1 hr (76000) |
$1,064.88 |
$2,088 |
3.1× |
| Foot 2 views (73620) |
$376.38 |
$738 |
3.0× |
Forearm 2 views (73090)
range across 2 matching MRF lines |
$361.08–$361.59 |
$708–$709 |
varies |
| Gastric emptying imaging study (78264) |
$2,011.44 |
$3,944 |
3.5× |
| Gated Heart Planar Single (78472) |
$1,860.48 |
$3,648 |
3.3× |
| Gated Heart, Multiple (78473) |
$2,786.13 |
$5,463 |
4.9× |
| Hand 2 views (73120) |
$291.72 |
$572 |
2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$4,555.83 |
$8,933 |
4.6× |
| Heart first pass single,planar (78481) |
$742.56 |
$1,456 |
1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,624.68 |
$9,068 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,993.08 |
$3,908 |
2.6× |
| Hepatobiliary System Imaging (78226) |
$1,353.03 |
$2,653 |
2.4× |
| Ht Muscle Image Spect Sing (78451) |
$2,853.45 |
$5,595 |
1.6× |
| Hysterosalpingogram (74740) |
$487.05 |
$955 |
1.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$260.10 |
$510 |
2.1× |
| Infant hip ultrasound, limited static exam (76886) |
$222.87 |
$437 |
1.8× |
| Interstitial radiation source applic complex (77778) |
$2,240.94 |
$4,394 |
2.3× |
| Joint Survey Single View (77077) |
$159.63 |
$313 |
1.1× |
| K Flow/Funct Image W/Drug (78708) |
$1,972.68 |
$3,868 |
2.6× |
| K Flow/Funct Image W/O Drug (78707) |
$1,814.07 |
$3,557 |
2.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$572.22 |
$1,122 |
1.0× |
| Knee 3 Views (73562) |
$401.37 |
$787 |
3.2× |
| Liver & Spleen Imaging Static Only (78215) |
$572.22 |
$1,122 |
1.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,706.97 |
$3,347 |
2.2× |
| Lung Ventilation Imaging (78579) |
$810.90 |
$1,590 |
1.4× |
| Lymph System Imaging (78195) |
$2,310.30 |
$4,530 |
3.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,628.76 |
$9,076 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$2,523.99 |
$4,949 |
7.5× |
| Mammary ductogram or galactogram single (77053) |
$631.38 |
$1,238 |
1.9× |
| Meckels Divert Exam (78290) |
$1,277.55 |
$2,505 |
2.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,833.45 |
$3,595 |
3.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,944.34 |
$7,734 |
8.0× |
| MRA head w/o contrast (70544) |
$2,451.06 |
$4,806 |
7.2× |
| MRA neck w contrast (70548) |
$3,033.48 |
$5,948 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,043.28 |
$7,928 |
8.2× |
| MRA neck w/o contrast (70547) |
$2,608.14 |
$5,114 |
7.7× |
| MRI abdomen w contrast (74182) |
$3,386.40 |
$6,640 |
6.8× |
| MRI abdomen w/o contrast (74181) |
$2,299.59 |
$4,509 |
6.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,070.71 |
$6,021 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,580.71 |
$7,021 |
7.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,507.67 |
$4,917 |
2.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,950.24 |
$3,824 |
5.8× |
| MRI cervical spine w contrast (72142) |
$3,499.11 |
$6,861 |
7.1× |
| MRI cervical spine w/o cont (72141) |
$2,349.57 |
$4,607 |
6.9× |
| MRI chest w/o contrast (71550) |
$1,538.67 |
$3,017 |
4.5× |
| MRI chest with contrast (71551) |
$1,867.11 |
$3,661 |
1.7× |
| MRI chest wo w contrast (71552) |
$4,061.64 |
$7,964 |
8.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,507.67 |
$4,917 |
5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,347.13 |
$6,563 |
6.8× |
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 2 matching MRF lines |
$1,773.27–$2,240.94 |
$3,477–$4,394 |
varies |
| MRI lumbar spine w contrast (72149) |
$3,039.60 |
$5,960 |
6.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,850.50 |
$7,550 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,346 |
$4,600 |
6.9× |
| MRI orbit face neck w contrast (70542) |
$2,801.43 |
$5,493 |
5.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,877.53 |
$7,603 |
7.8× |
| MRI pelvis w contrast (72196) |
$2,758.59 |
$5,409 |
5.6× |
| MRI pelvis w/o & w contrast (72197) |
$3,397.62 |
$6,662 |
6.9× |
| MRI pelvis w/o contrast (72195) |
$2,406.69 |
$4,719 |
7.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,343.45 |
$4,595 |
6.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,259.81 |
$4,431 |
4.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,054.28 |
$4,028 |
6.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,793.27 |
$5,477 |
5.6× |
| MRI, abdomen, combo (74183) |
$3,648.03 |
$7,153 |
7.4× |
| MRI, dorsal spine combo (72157) |
$3,838.26 |
$7,526 |
7.7× |
| MRI, dorsal spine contrast (72147) |
$2,733.60 |
$5,360 |
5.5× |
| MRI, joint upper extrem (73221) |
$1,950.75 |
$3,825 |
5.8× |
| MRI, joint upper extrem combo (73223) |
$3,159.45 |
$6,195 |
6.4× |
| MRI, lumbar spine combo (72158) |
$3,507.27 |
$6,877 |
7.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$572.22 |
$1,122 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,081.02 |
$8,002 |
2.2× |
| N-invas est c ffr sw aly CTA (75580) |
$1,517.76 |
$2,976 |
1.2× |
| Neck soft tissue (70360) |
$314.16 |
$616 |
2.5× |
| Nonvascular Shunt X-Ray (75809) |
$171.36 |
$336 |
1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,475.07 |
$14,657 |
3.8× |
| Nuclear Rx Intra-Arterial (79445) |
$1,020 |
$2,000 |
3.1× |
| Ob us nuchal meas 1 gest (76813) |
$367.71 |
$721 |
2.5× |
| Parathyroid Planar Imaging (78070) |
$1,078.65 |
$2,115 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$264.18 |
$518 |
1.8× |
| Peritoneogram Rs&I (74190) |
$780.81 |
$1,531 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$5,462.61 |
$10,711 |
2.7× |
| PET image w/CT, full body (78816) |
$7,086.45 |
$13,895 |
3.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,954.76 |
$11,676 |
2.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,627.74 |
$9,074 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,692.18 |
$3,318 |
3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$394.74 |
$774 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$651.78 |
$1,278 |
0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$472.26 |
$926 |
3.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$247.35 |
$485 |
2.0× |
| Radex elbow complete minimum 3 views (73080) |
$357 |
$700 |
2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$407.49 |
$799 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$223.89 |
$439 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$377.91 |
$741 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$374.34 |
$734 |
3.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$109.14 |
$214 |
0.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$157.59 |
$309 |
1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$295.29 |
$579 |
2.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$312.63 |
$613 |
2.5× |
| Radex shoulder complete minimum 2 views (73030) |
$461.55 |
$905 |
3.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$247.86 |
$486 |
2.0× |
| Radex Spine 1 View Specify Level (72020) |
$297.84 |
$584 |
2.4× |
| Radex Sternum Minimum 2 Views (71120) |
$325.38 |
$638 |
2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$324.36 |
$636 |
2.6× |
| Radex Toe Minimum 2 Views (73660) |
$247.35 |
$485 |
2.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$146.88 |
$288 |
1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$359.55 |
$705 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$464.10 |
$910 |
3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$31,663.86 |
$62,086 |
3.0× |
| Radiation treatment delivery level 1 (77402) |
$997.05 |
$1,955 |
6.9× |
| Radiation treatment delivery level 3 (77412) |
$1,683.51 |
$3,301 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$332.01 |
$651 |
2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$264.18 |
$518 |
1.8× |
| Radiologic exam colon double contrast study (74280) |
$858.84 |
$1,684 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$748.17 |
$1,467 |
3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$800.70 |
$1,570 |
3.2× |
| Radiologic exam knee complete 4/more views (73564) |
$503.37 |
$987 |
3.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$275.40 |
$540 |
1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$794.58 |
$1,558 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$532.95 |
$1,045 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$646.68 |
$1,268 |
2.6× |
| Radiologic examination femur 1 view (73551) |
$216.24 |
$424 |
1.8× |
| Radiologic examination femur minimum 2 views (73552) |
$235.11 |
$461 |
1.9× |
| Radiologic examination knee 1/2 views (73560) |
$279.48 |
$548 |
2.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$219.81 |
$431 |
1.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$368.22 |
$722 |
3.0× |
| Radiopharm Dacryocystography (78660) |
$572.22 |
$1,122 |
1.0× |
| Ribs bilateral 3 views (71110) |
$364.65 |
$715 |
2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$803.25 |
$1,575 |
1.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,916.69 |
$5,719 |
3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,193.11 |
$6,261 |
4.1× |
| Rp Therapy Intravenous Administration (79101) |
$523.77 |
$1,027 |
1.6× |
| Scapula (73010) |
$374.85 |
$735 |
2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$61.20 |
$120 |
2.6× |
| Shoulder 1 view (73020) |
$295.80 |
$580 |
2.4× |
| Shoulder Arthrography (73040) |
$579.87 |
$1,137 |
1.2× |
| Skull less than 4 views (70250) |
$412.59 |
$809 |
2.8× |
| Special dosimetry (77331) |
$253.47 |
$497 |
1.3× |
| Special Physics Consult (77370) |
$1,371.39 |
$2,689 |
7.2× |
| Special teletherapy port plan (77321) |
$995.01 |
$1,951 |
1.9× |
| Special treatment procedure (77470) |
$2,100.18 |
$4,118 |
2.7× |
| Stereotactic Body Radiation Delivery (77373) |
$11,593.83 |
$22,733 |
4.6× |
| Sternoclavicular joints (71130) |
$254.49 |
$499 |
2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$6,722.31 |
$13,181 |
12.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$3,426.69 |
$6,719 |
6.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$5,005.14 |
$9,814 |
9.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$2,258.28 |
$4,428 |
4.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,751.34 |
$3,434 |
9.2× |
| Thoracic spine 2 views (72070) |
$266.73 |
$523 |
1.8× |
| Thoracic spine 3 views (72072) |
$296.31 |
$581 |
2.0× |
| Thoracolumbar 2 views (72080) |
$341.70 |
$670 |
2.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$572.22 |
$1,122 |
1.0× |
| Thyroid Met Imaging Body (78018) |
$2,253.18 |
$4,418 |
2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,302.03 |
$2,553 |
2.3× |
| Tx Devices Design & Construction Complex (77334) |
$2,356.20 |
$4,620 |
4.4× |
| Tx devices design & construction intermediate (77333) |
$911.88 |
$1,788 |
4.8× |
| Tx devices design & construction simple (77332) |
$911.88 |
$1,788 |
4.8× |
| Ultrasound Breast Limited (76642) |
$265.20 |
$520 |
2.1× |
| Ultrasound Exam Aaa Screen (76706) |
$385.05 |
$755 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$526.32 |
$1,032 |
3.5× |
| Umbilical-artery Doppler (OB) (76820) |
$285.60 |
$560 |
1.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$432.99 |
$849 |
3.5× |
| Unlisted fluoroscopic procedure (76496) |
$135.15 |
$265 |
1.1× |
| Unlisted magnetic resonance procedure (76498) |
$275.40 |
$540 |
2.2× |
| Unlisted us procedure (76999) |
$388.11 |
$761 |
3.1× |
| Upper gi w/o kub (74240) |
$646.68 |
$1,268 |
2.6× |
| Urethrocystogram voiding (74455) |
$1,258.68 |
$2,468 |
3.7× |
| Urethrocystography retrograde (74450) |
$770.61 |
$1,511 |
2.3× |
| Us breast unilateral complete (76641) |
$332.01 |
$651 |
2.2× |
| Us chest (76604) |
$556.41 |
$1,091 |
3.7× |
| Us complete joint (76881) |
$542.64 |
$1,064 |
3.7× |
| Us exam, pelvic, limited (76857) |
$329.46 |
$646 |
2.2× |
| Us head (76506) |
$232.05 |
$455 |
1.6× |
| Us kidney transplant (76776) |
$845.07 |
$1,657 |
5.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$443.70 |
$870 |
3.0× |
| Us ob detailed single fetus (76811) |
$703.29 |
$1,379 |
2.1× |
| Us ob limited 1 or more fetuses (76815) |
$352.92 |
$692 |
2.4× |
| Us ob transvaginal (76817) |
$403.41 |
$791 |
2.7× |
| Us pelvic non ob complete (76856) |
$565.59 |
$1,109 |
3.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$469.71 |
$921 |
3.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$300.39 |
$589 |
2.0× |
| Us retroperitoneal complete (76770) |
$628.83 |
$1,233 |
4.2× |
| Us retroperitoneal limited (76775) |
$488.07 |
$957 |
3.3× |
| Us scrotum and contents (76870) |
$580.89 |
$1,139 |
3.9× |
| Us spinal canal and contents (76800) |
$272.34 |
$534 |
1.8× |
| Us thyroid (76536) |
$492.66 |
$966 |
3.3× |
| Vascular Flow Imaging (78445) |
$572.22 |
$1,122 |
1.0× |
| Vein X-Ray Chest (75827) |
$3,893.34 |
$7,634 |
1.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$4,627.23 |
$9,073 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$4,012.17 |
$7,867 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,567.74 |
$3,074 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$1,567.74 |
$3,074 |
0.7× |
| Venography Renal Unilateral (75831) |
$3,191.58 |
$6,258 |
0.7× |
| Wrist 2 views (73100) |
$257.04 |
$504 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$146.88 |
$288 |
1.2× |
| X-ray antegrade pyelogram tube (74425) |
$621.69 |
$1,219 |
1.3× |
| X-Ray Aorta Leg Arteries (75630) |
$3,510.84 |
$6,884 |
0.8× |
| X-Ray Bend Only L-S Spine (72120) |
$329.46 |
$646 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$278.97 |
$547 |
2.3× |
| X-Ray Exam Breast Specimen (76098) |
$651.78 |
$1,278 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$187.17 |
$367 |
1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$309.06 |
$606 |
2.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$457.98 |
$898 |
3.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$496.74 |
$974 |
4.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$211.14 |
$414 |
1.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$286.11 |
$561 |
1.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$316.20 |
$620 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$388.62 |
$762 |
2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$460.02 |
$902 |
3.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$463.59 |
$909 |
3.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$351.90 |
$690 |
2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$687.48 |
$1,348 |
4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$375.36 |
$736 |
2.5× |
| X-ray eye for foreign body (70030) |
$282.54 |
$554 |
2.3× |
| X-ray humerus (73060) |
$382.50 |
$750 |
3.1× |
| X-ray IV pyelogram (ivp) (74400) |
$366.18 |
$718 |
1.5× |
| X-ray IV pyelogram+tomography (74415) |
$504.39 |
$989 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$170.34 |
$334 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$201.96 |
$396 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$330.99 |
$649 |
2.2× |
| X-ray nose-rectum child f.b. (76010) |
$120.87 |
$237 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,765.62 |
$3,462 |
11.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$419.22 |
$822 |
2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$199.92 |
$392 |
1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$409.02 |
$802 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$318.75 |
$625 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$554.88 |
$1,088 |
3.7× |
| X-Ray Stress View (77071) |
$108.12 |
$212 |
0.9× |
| X-ray thoracic spine 4 vw (72074) |
$396.27 |
$777 |
2.7× |
| X-Ray Tmj Unilat (70328) |
$109.65 |
$215 |
0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$759.39 |
$1,489 |
1.5× |
| X-Rays Bone Length Studies (77073) |
$392.19 |
$769 |
2.6× |
| X-Rays Bone Survey Complete (77075) |
$839.46 |
$1,646 |
5.7× |
| Xr c-spine 4 or 5 views (72050) |
$429.93 |
$843 |
2.9× |
| Xr facial bones less than 3 views (70140) |
$275.91 |
$541 |
2.2× |
| Xr orbits complete 4 views (70200) |
$309.06 |
$606 |
2.1× |