| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,708 |
$13,975 |
3.8× |
| Abdomen 1 View (74018) |
$145.92 |
$304 |
1.3× |
| Abdomen 2 views (74019) |
$227.52 |
$474 |
1.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$560.16 |
$1,167 |
1.1× |
| Angio internal mammary (75756) |
$9,325.44 |
$19,428 |
2.3× |
| Angio pulmonary bilat (75743) |
$10,042.08 |
$20,921 |
2.5× |
| Angiography extremity bilateral rs&i (75716) |
$6,465.12 |
$13,469 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$5,172.48 |
$10,776 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,676.96 |
$11,827 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,223.20 |
$6,715 |
0.8× |
| Ankle 2 views (73600) |
$108.96 |
$227 |
1.0× |
| Aortography thoracic serialography rs&i (75605) |
$4,954.08 |
$10,321 |
0.7× |
| Artery X-Rays Abdomen (75726) |
$5,590.56 |
$11,647 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$4,046.88 |
$8,431 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$5,140.32 |
$10,709 |
0.7× |
| Artery X-Rays Spine (75705) |
$5,881.44 |
$12,253 |
0.8× |
| Arthrogram ankle (73615) |
$299.04 |
$623 |
0.7× |
| Arthrogram hip (73525) |
$520.32 |
$1,084 |
1.2× |
| Arthrogram Wrist (73115) |
$299.04 |
$623 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$825.60 |
$1,720 |
4.8× |
| Bone age studies (77072) |
$133.92 |
$279 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$904.80 |
$1,885 |
1.8× |
| Bone Imaging Limited Area (78300) |
$356.16 |
$742 |
0.7× |
| Bone Imaging Multiple Areas (78305) |
$374.40 |
$780 |
0.7× |
| Bone Imaging Whole Body (78306) |
$896.16 |
$1,867 |
1.7× |
| Bone marrow imaging limited area (78102) |
$321.12 |
$669 |
0.6× |
| Bone marrow imaging; multiple areas (78103) |
$727.68 |
$1,516 |
1.4× |
| Bone survey infant (77076) |
$259.68 |
$541 |
1.9× |
| Brachytx isodose complex (77318) |
$6,495.84 |
$13,533 |
13.5× |
| Brachytx isodose intermed (77317) |
$4,943.04 |
$10,298 |
10.3× |
| Brachytx Isodose Plan Simple (77316) |
$4,462.08 |
$9,296 |
9.3× |
| Brain Flow Imaging Only (78610) |
$749.76 |
$1,562 |
1.1× |
| Brain Image W/Flow < 4 Views (78601) |
$767.04 |
$1,598 |
1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$810.24 |
$1,688 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,456.16 |
$11,367 |
3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$563.04 |
$1,173 |
1.3× |
| Cat Scan Follow-Up Study (76380) |
$492 |
$1,025 |
4.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$761.76 |
$1,587 |
1.1× |
| Cerebrospinal Fluid Scan (78630) |
$985.92 |
$2,054 |
1.4× |
| Chest 1 view (71045) |
$132.48 |
$276 |
1.2× |
| Chest 2 views (71046) |
$194.40 |
$405 |
1.7× |
| Chest 3 views (71047) |
$200.16 |
$417 |
1.8× |
| Chest 4 or more views (71048) |
$213.60 |
$445 |
1.6× |
| Cholecystography Oral Contrast (74290) |
$272.64 |
$568 |
1.2× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,074.24 |
$2,238 |
1.1× |
| Clavicle complete (73000) |
$113.28 |
$236 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$143.52 |
$299 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$724.32 |
$1,509 |
4.2× |
| Contrast Exam Abdominl Aorta (75625) |
$5,590.56 |
$11,647 |
1.4× |
| Contrast X-Ray Bladder (74430) |
$478.56 |
$997 |
1.1× |
| Contrast X-Ray Of Elbow (73085) |
$520.32 |
$1,084 |
1.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$299.04 |
$623 |
0.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,460.96 |
$5,127 |
5.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,841.28 |
$3,836 |
6.0× |
| CT abdomen w contrast (74160) |
$1,377.60 |
$2,870 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,675.68 |
$3,491 |
7.4× |
| CT abdomen w/o contrast (74150) |
$1,053.60 |
$2,195 |
7.8× |
| CT Angio Abdomen and Pelvis (74174) |
$2,934.72 |
$6,114 |
6.5× |
| CT Angio Chest (71275) |
$1,551.84 |
$3,233 |
6.9× |
| CT Angio Head (70496) |
$2,005.44 |
$4,178 |
8.9× |
| CT angio hrt w/3d image (75574) |
$1,498.08 |
$3,121 |
3.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,437.12 |
$2,994 |
6.4× |
| CT Angio Neck (70498) |
$2,005.44 |
$4,178 |
8.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,437.12 |
$2,994 |
6.4× |
| CT cervical spine w/ contrast (72126) |
$1,674.24 |
$3,488 |
3.7× |
| CT cervical spine w/o contrast (72125) |
$1,611.84 |
$3,358 |
12.0× |
| CT cervical spine w/wo cont (72127) |
$2,948.64 |
$6,143 |
13.1× |
| CT chest w contrast (71260) |
$1,508.16 |
$3,142 |
6.7× |
| CT chest w/wo contrast (71270) |
$1,459.20 |
$3,040 |
6.5× |
| CT head/brain with contrast (70460) |
$1,626.24 |
$3,388 |
7.2× |
| CT head/brain without and with contrast (70470) |
$2,131.68 |
$4,441 |
9.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$242.88 |
$506 |
0.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$156.48 |
$326 |
1.4× |
| CT iac w contrast (70481) |
$1,480.80 |
$3,085 |
6.6× |
| CT l-spine w&w/o contrast (72133) |
$1,495.68 |
$3,116 |
6.6× |
| CT lower ext w/o (73700) |
$1,042.08 |
$2,171 |
7.8× |
| CT lower extremity w/contrast material (73701) |
$1,342.56 |
$2,797 |
6.0× |
| CT lumbar spine w contrast (72132) |
$1,200 |
$2,500 |
2.7× |
| CT lumbar spine w/o contrast (72131) |
$1,155.36 |
$2,407 |
8.6× |
| CT maxillofacial w contrast (70487) |
$759.84 |
$1,583 |
3.4× |
| CT maxillofacial wo contrast (70486) |
$658.08 |
$1,371 |
4.9× |
| CT neck tissue combo (70492) |
$2,004.96 |
$4,177 |
8.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,067.84 |
$4,308 |
9.2× |
| CT orbits w/o contrast (70480) |
$1,401.12 |
$2,919 |
10.4× |
| CT pelvis w&w/o contrast (72194) |
$1,274.40 |
$2,655 |
5.6× |
| CT pelvis w/o contrast (72192) |
$1,153.44 |
$2,403 |
8.6× |
| CT scan of leg combo (73702) |
$1,365.12 |
$2,844 |
6.1× |
| CT scans face/jaw combo (70488) |
$1,109.28 |
$2,311 |
4.9× |
| CT soft tissue neck w contrast (70491) |
$2,000.16 |
$4,167 |
8.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,785.60 |
$3,720 |
13.3× |
| CT thoracic spine w contrast (72129) |
$1,200 |
$2,500 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$1,155.36 |
$2,407 |
8.6× |
| CT thoracic spine w/wo cont (72130) |
$1,233.12 |
$2,569 |
5.5× |
CT thorax w/o contrast (71250)
range across 2 matching MRF lines |
$921.60–$932.64 |
$1,920–$1,943 |
varies |
| CT upper ext wo (73200) |
$1,042.08 |
$2,171 |
7.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,437.12 |
$2,994 |
6.4× |
| CT upper extremity with contrast (73201) |
$1,108.32 |
$2,309 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,790.88 |
$3,731 |
7.9× |
| Cta Abdomen (74175) |
$1,439.52 |
$2,999 |
6.4× |
| CTA pelvis (72191) |
$1,497.60 |
$3,120 |
6.6× |
| Diskography lumbar (72295) |
$990.72 |
$2,064 |
0.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$335.04 |
$698 |
2.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$396 |
$825 |
2.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$331.68 |
$691 |
2.5× |
| Dxa bone density study (77085) |
$308.16 |
$642 |
2.3× |
| Echo exam of fetal heart (76825) |
$481.44 |
$1,003 |
0.7× |
| Echo exam uterus (76831) |
$951.84 |
$1,983 |
3.1× |
| Echo Guide For Artery Repair (76936) |
$871.68 |
$1,816 |
3.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$384.48 |
$801 |
1.3× |
| Echograp Trans R Pros Study (76873) |
$576.48 |
$1,201 |
4.3× |
| Esophagram (74220) |
$282.72 |
$589 |
1.3× |
| Fetal Biophys Profile W/Nst (76818) |
$360.48 |
$751 |
2.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$253.92 |
$529 |
1.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,817.12 |
$5,869 |
9.2× |
| Fluoroscopy up to 1 hr (76000) |
$411.84 |
$858 |
1.3× |
| Follow-Up Angiography (75898) |
$2,126.40 |
$4,430 |
0.5× |
| Foot 2 views (73620) |
$104.16 |
$217 |
0.9× |
| Forearm 2 views (73090) |
$120.96 |
$252 |
1.1× |
| Gastric emptying imaging study (78264) |
$414.24 |
$863 |
0.8× |
| Gastroesophageal Reflux Exam (78262) |
$839.04 |
$1,748 |
1.6× |
| Gated Heart Planar Single (78472) |
$644.64 |
$1,343 |
1.3× |
| Gated Heart, Multiple (78473) |
$1,521.60 |
$3,170 |
3.0× |
| Hand 2 views (73120) |
$104.16 |
$217 |
0.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$4,552.32 |
$9,484 |
5.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$4,363.68 |
$9,091 |
4.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$3,071.52 |
$6,399 |
3.4× |
| Heart first pass single,planar (78481) |
$898.08 |
$1,871 |
1.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,500.80 |
$11,460 |
1.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$5,064.48 |
$10,551 |
1.2× |
| Hepatobil Syst Image W/Drug (78227) |
$1,507.68 |
$3,141 |
2.2× |
| Hepatobiliary System Imaging (78226) |
$551.04 |
$1,148 |
1.1× |
| Ht Musc Image Planar Mult (78454) |
$3,063.84 |
$6,383 |
1.8× |
| Ht Muscle Image Spect Sing (78451) |
$1,131.36 |
$2,357 |
0.7× |
| Hysterosalpingogram (74740) |
$299.52 |
$624 |
1.0× |
| Interstitial radiation source applic complex (77778) |
$1,763.52 |
$3,674 |
2.0× |
| Joint Survey Single View (77077) |
$404.16 |
$842 |
3.0× |
| K Flow/Funct Image Multiple (78709) |
$1,089.60 |
$2,270 |
1.6× |
| K Flow/Funct Image W/Drug (78708) |
$699.36 |
$1,457 |
1.0× |
| K Flow/Funct Image W/O Drug (78707) |
$535.68 |
$1,116 |
0.8× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$864 |
$1,800 |
1.7× |
| Kidney Imaging Morphol (78700) |
$363.84 |
$758 |
0.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$452.16 |
$942 |
0.9× |
| Knee 3 Views (73562) |
$122.40 |
$255 |
1.1× |
| Leveen/Shunt Patency Exam (78291) |
$308.64 |
$643 |
0.6× |
| Liver & Spleen Imaging Static Only (78215) |
$584.16 |
$1,217 |
1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,500 |
$3,125 |
2.9× |
| Liver imaging static only (78201) |
$410.40 |
$855 |
0.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,059.36 |
$2,207 |
1.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,118.88 |
$2,331 |
1.6× |
| Lung Ventilation Imaging (78579) |
$500.64 |
$1,043 |
1.0× |
| Lymph System Imaging (78195) |
$734.88 |
$1,531 |
1.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,046.88 |
$8,431 |
1.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$4,046.88 |
$8,431 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$2,471.52 |
$5,149 |
8.1× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$880.80 |
$1,835 |
3.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$611.52 |
$1,274 |
0.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$976.32 |
$2,034 |
4.3× |
| Mammary ductogram or galactogram single (77053) |
$355.20 |
$740 |
1.2× |
| Meckels Divert Exam (78290) |
$668.16 |
$1,392 |
1.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$641.76 |
$1,337 |
1.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,490.56 |
$7,272 |
7.8× |
| MRA head w/o contrast (70544) |
$2,568 |
$5,350 |
8.4× |
| MRA head with contrast (70545) |
$3,089.76 |
$6,437 |
6.9× |
| MRA neck w contrast (70548) |
$2,624.64 |
$5,468 |
5.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,303.84 |
$6,883 |
7.4× |
| MRA neck w/o contrast (70547) |
$2,196.96 |
$4,577 |
7.2× |
| MRI abdomen w contrast (74182) |
$3,504 |
$7,300 |
7.8× |
| MRI abdomen w/o contrast (74181) |
$3,287.04 |
$6,848 |
10.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,615.04 |
$5,448 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,576.32 |
$9,534 |
10.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,615.04 |
$5,448 |
2.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,982.72 |
$6,214 |
9.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,861.44 |
$3,878 |
6.1× |
| MRI cardiac w/o contrast (75557) |
$2,676 |
$5,575 |
8.7× |
| MRI cervical spine w contrast (72142) |
$3,476.64 |
$7,243 |
7.7× |
| MRI cervical spine w/o cont (72141) |
$3,096.96 |
$6,452 |
10.1× |
| MRI chest w/o contrast (71550) |
$2,964 |
$6,175 |
9.7× |
| MRI chest with contrast (71551) |
$3,535.68 |
$7,366 |
3.5× |
| MRI chest wo w contrast (71552) |
$4,228.80 |
$8,810 |
9.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,321.76 |
$4,837 |
5.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,321.76 |
$4,837 |
5.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,171.52 |
$4,524 |
7.1× |
| MRI lumbar spine w contrast (72149) |
$3,352.80 |
$6,985 |
7.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$4,022.40 |
$8,380 |
9.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,393.76 |
$4,987 |
7.8× |
| MRI orbit face neck w contrast (70542) |
$5,120.64 |
$10,668 |
11.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,966.24 |
$8,263 |
8.8× |
| MRI pelvis w contrast (72196) |
$2,918.40 |
$6,080 |
6.5× |
| MRI pelvis w/o & w contrast (72197) |
$4,584.48 |
$9,551 |
10.2× |
| MRI pelvis w/o contrast (72195) |
$2,560.32 |
$5,334 |
8.3× |
| MRI spectroscopy (76390) |
$522.24 |
$1,088 |
4.7× |
| MRI thoracic spine w/o contrast (72146) |
$3,248.64 |
$6,768 |
10.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,321.76 |
$4,837 |
5.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,473.44 |
$5,153 |
8.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,145.12 |
$4,469 |
4.8× |
| MRI, abdomen, combo (74183) |
$4,621.92 |
$9,629 |
10.3× |
| MRI, dorsal spine combo (72157) |
$4,218.72 |
$8,789 |
9.4× |
| MRI, dorsal spine contrast (72147) |
$3,902.88 |
$8,131 |
8.7× |
| MRI, joint upper extrem (73221) |
$2,249.28 |
$4,686 |
7.3× |
| MRI, joint upper extrem combo (73223) |
$4,576.32 |
$9,534 |
10.2× |
| MRI, lumbar spine combo (72158) |
$4,218.72 |
$8,789 |
9.4× |
| Myelogram cervical (72240) |
$1,114.08 |
$2,321 |
1.1× |
| Myelogram Lumbar (72265) |
$1,114.08 |
$2,321 |
1.1× |
| Myelograpy 2/more regions rs&i (72270) |
$1,427.04 |
$2,973 |
1.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,986.72 |
$10,389 |
3.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,475.52 |
$3,074 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$1,206.24 |
$2,513 |
0.7× |
| N-invas est c ffr sw aly CTA (75580) |
$1,719.36 |
$3,582 |
1.6× |
| Neck soft tissue (70360) |
$154.08 |
$321 |
1.4× |
| Nm csf leak detection (78650) |
$1,525.92 |
$3,179 |
0.9× |
| Nm whole blood volume (78122) |
$892.32 |
$1,859 |
1.3× |
| Nonvascular Shunt X-Ray (75809) |
$198.24 |
$413 |
1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,320 |
$15,250 |
4.1× |
| Nuclear Rx Intra-Arterial (79445) |
$702.24 |
$1,463 |
2.3× |
| Nuclear Rx Oral Admin (79005) |
$542.40 |
$1,130 |
1.8× |
| Ob us nuchal meas 1 gest (76813) |
$448.32 |
$934 |
3.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,075.20 |
$2,240 |
1.5× |
| Parathyroid Planar Imaging (78070) |
$440.64 |
$918 |
0.9× |
| Pelvis 1 or 2 views (72170) |
$108.96 |
$227 |
0.8× |
| Peritoneogram Rs&I (74190) |
$1,027.20 |
$2,140 |
1.5× |
| Pet Image W/Ct Lmtd (78814) |
$4,011.84 |
$8,358 |
2.2× |
| PET image w/CT, full body (78816) |
$6,133.92 |
$12,779 |
3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,154.72 |
$10,739 |
2.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$3,470.88 |
$7,231 |
2.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,086.56 |
$10,597 |
1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$648.96 |
$1,352 |
1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$277.44 |
$578 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$628.32 |
$1,309 |
0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$138.72 |
$289 |
1.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$102.24 |
$213 |
0.9× |
| Radex elbow complete minimum 3 views (73080) |
$144.96 |
$302 |
1.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$215.52 |
$449 |
1.6× |
| Radex fingr minimum 2 views (73140) |
$91.68 |
$191 |
0.8× |
| Radex foot complete minimum 3 views (73630) |
$124.80 |
$260 |
1.1× |
| Radex Hand Minimum 3 Views (73130) |
$137.28 |
$286 |
1.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$45.12 |
$94 |
0.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$232.32 |
$484 |
1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$141.60 |
$295 |
1.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$148.80 |
$310 |
1.3× |
| Radex shoulder complete minimum 2 views (73030) |
$143.52 |
$299 |
1.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$96 |
$200 |
0.9× |
| Radex Spine 1 View Specify Level (72020) |
$109.92 |
$229 |
1.0× |
| Radex Sternum Minimum 2 Views (71120) |
$135.36 |
$282 |
1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$168 |
$350 |
1.5× |
| Radex Toe Minimum 2 Views (73660) |
$91.68 |
$191 |
0.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$88.32 |
$184 |
0.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$144.96 |
$302 |
1.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$343.68 |
$716 |
2.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$8,881.44 |
$18,503 |
0.9× |
| Radiation treatment delivery level 1 (77402) |
$583.68 |
$1,216 |
4.4× |
| Radiation treatment delivery level 2 (77407) |
$588 |
$1,225 |
1.2× |
| Radiation treatment delivery level 3 (77412) |
$923.04 |
$1,923 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$207.36 |
$432 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$258.72 |
$539 |
1.9× |
| Radiologic exam colon double contrast study (74280) |
$545.76 |
$1,137 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$397.92 |
$829 |
1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$347.04 |
$723 |
1.5× |
| Radiologic exam knee complete 4/more views (73564) |
$144.96 |
$302 |
1.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$174.72 |
$364 |
1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$549.12 |
$1,144 |
2.4× |
| Radiologic exam swallow function contrast study (74230) |
$428.16 |
$892 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$422.88 |
$881 |
1.9× |
| Radiologic examination femur 1 view (73551) |
$102.72 |
$214 |
0.9× |
| Radiologic examination femur minimum 2 views (73552) |
$135.36 |
$282 |
1.2× |
| Radiologic examination knee 1/2 views (73560) |
$94.08 |
$196 |
0.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$212.64 |
$443 |
1.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$181.44 |
$378 |
1.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$119.52 |
$249 |
1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$382.56 |
$797 |
0.8× |
| Ribs bilateral 3 views (71110) |
$177.60 |
$370 |
1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,089.60 |
$2,270 |
2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,089.60 |
$2,270 |
2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,414.56 |
$2,947 |
2.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,199.04 |
$2,498 |
1.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,525.92 |
$3,179 |
2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,503.20 |
$5,215 |
1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,838.72 |
$5,914 |
1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,503.20 |
$5,215 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$558.24 |
$1,163 |
1.9× |
| Scapula (73010) |
$144.96 |
$302 |
1.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$196.32 |
$409 |
8.4× |
| Shoulder 1 view (73020) |
$103.68 |
$216 |
0.9× |
| Shoulder Arthrography (73040) |
$520.32 |
$1,084 |
1.2× |
| Skull less than 4 views (70250) |
$132.48 |
$276 |
1.0× |
| Special dosimetry (77331) |
$870.72 |
$1,814 |
5.0× |
| Special Physics Consult (77370) |
$1,940.64 |
$4,043 |
11.2× |
| Special teletherapy port plan (77321) |
$441.12 |
$919 |
0.9× |
| Special treatment procedure (77470) |
$2,467.68 |
$5,141 |
3.5× |
| Stereotactic Body Radiation Delivery (77373) |
$4,302.24 |
$8,963 |
1.9× |
| Sternoclavicular joints (71130) |
$87.36 |
$182 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,028.48 |
$4,226 |
4.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,432.80 |
$2,985 |
3.0× |
| Testicular Imaging W/Flow (78761) |
$604.80 |
$1,260 |
1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,985.28 |
$4,136 |
4.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,786.56 |
$3,722 |
3.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,318.56 |
$2,747 |
7.6× |
| Thoracic spine 2 views (72070) |
$141.12 |
$294 |
1.0× |
| Thoracic spine 3 views (72072) |
$165.12 |
$344 |
1.2× |
| Thoracolumbar 2 views (72080) |
$140.64 |
$293 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$440.64 |
$918 |
0.9× |
| Thyroid Met Imaging Body (78018) |
$390.72 |
$814 |
0.6× |
| Thyroid Uptake Measurement (78012) |
$428.64 |
$893 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$624.96 |
$1,302 |
1.2× |
| Tx Devices Design & Construction Complex (77334) |
$819.36 |
$1,707 |
1.7× |
| Tx devices design & construction intermediate (77333) |
$487.68 |
$1,016 |
2.8× |
| Tx devices design & construction simple (77332) |
$374.88 |
$781 |
2.2× |
| Ultrasound Breast Limited (76642) |
$234.72 |
$489 |
2.1× |
| Ultrasound elastography first target lesion (76982) |
$301.44 |
$628 |
2.2× |
| Ultrasound Elastography Parenchyma (76981) |
$301.44 |
$628 |
2.2× |
| Ultrasound Exam Aaa Screen (76706) |
$166.56 |
$347 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$350.40 |
$730 |
2.6× |
| Umbilical-artery Doppler (OB) (76820) |
$352.32 |
$734 |
2.6× |
| Unlisted Dx Radiographic Procedure (76499) |
$156.96 |
$327 |
1.4× |
| Unlisted fluoroscopic procedure (76496) |
$442.56 |
$922 |
4.0× |
| Unlisted magnetic resonance procedure (76498) |
$636.96 |
$1,327 |
5.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$638.88 |
$1,331 |
4.9× |
| Unlisted us procedure (76999) |
$320.16 |
$667 |
2.9× |
| Upper gi w/o kub (74240) |
$371.04 |
$773 |
1.6× |
| Urethrocystogram voiding (74455) |
$299.52 |
$624 |
1.0× |
| Urethrocystography retrograde (74450) |
$299.52 |
$624 |
1.0× |
| Us breast unilateral complete (76641) |
$261.12 |
$544 |
1.9× |
| Us chest (76604) |
$150.72 |
$314 |
1.1× |
| Us complete joint (76881) |
$344.64 |
$718 |
2.6× |
| Us exam, pelvic, limited (76857) |
$383.52 |
$799 |
2.9× |
| Us head (76506) |
$486.24 |
$1,013 |
3.6× |
| Us kidney transplant (76776) |
$471.84 |
$983 |
3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$234.24 |
$488 |
1.7× |
| Us ob detailed single fetus (76811) |
$850.56 |
$1,772 |
2.8× |
| Us ob limited 1 or more fetuses (76815) |
$408.96 |
$852 |
3.0× |
| Us ob transvaginal (76817) |
$356.64 |
$743 |
2.7× |
| Us pelvic non ob complete (76856) |
$510.24 |
$1,063 |
3.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$261.12 |
$544 |
1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$202.08 |
$421 |
1.5× |
| Us retroperitoneal complete (76770) |
$587.52 |
$1,224 |
4.4× |
| Us retroperitoneal limited (76775) |
$413.28 |
$861 |
3.1× |
| Us scrotum and contents (76870) |
$521.76 |
$1,087 |
3.9× |
| Us spinal canal and contents (76800) |
$355.20 |
$740 |
2.6× |
| Us thyroid (76536) |
$486.24 |
$1,013 |
3.6× |
| Us transrectal (76872) |
$1,010.40 |
$2,105 |
7.5× |
| Vascular Flow Imaging (78445) |
$440.64 |
$918 |
0.9× |
| Vein X-Ray Chest (75827) |
$4,096.32 |
$8,534 |
2.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,220.80 |
$6,710 |
0.8× |
| Vein X-Ray Spleen/Liver (75810) |
$4,046.88 |
$8,431 |
1.0× |
| Venogram Sinus/Jugular (75860) |
$4,510.56 |
$9,397 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$4,620.48 |
$9,626 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$2,478.72 |
$5,164 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$1,988.16 |
$4,142 |
1.0× |
| Venography Renal Bilateral (75833) |
$4,320 |
$9,000 |
1.1× |
| Venography Renal Unilateral (75831) |
$2,185.44 |
$4,553 |
0.5× |
| Venous sampling by catheter (75893) |
$5,064.48 |
$10,551 |
0.7× |
| Wrist 2 views (73100) |
$104.16 |
$217 |
0.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$134.40 |
$280 |
1.2× |
| X-ray antegrade pyelogram tube (74425) |
$478.56 |
$997 |
1.1× |
| X-Ray Aorta Leg Arteries (75630) |
$6,317.76 |
$13,162 |
1.6× |
| X-Ray Bend Only L-S Spine (72120) |
$197.28 |
$411 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$119.04 |
$248 |
1.1× |
| X-Ray Exam Breast Specimen (76098) |
$521.28 |
$1,086 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$113.76 |
$237 |
1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$162.24 |
$338 |
1.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$245.76 |
$512 |
1.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$96.96 |
$202 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$198.72 |
$414 |
1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$211.68 |
$441 |
1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$222.72 |
$464 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$311.04 |
$648 |
2.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$374.40 |
$780 |
2.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$283.68 |
$591 |
2.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$140.64 |
$293 |
1.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$275.52 |
$574 |
2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$148.80 |
$310 |
1.1× |
| X-ray eye for foreign body (70030) |
$205.92 |
$429 |
1.8× |
| X-ray humerus (73060) |
$114.72 |
$239 |
1.0× |
| X-ray IV pyelogram (ivp) (74400) |
$600 |
$1,250 |
2.7× |
| X-ray IV pyelogram+tomography (74415) |
$1,075.20 |
$2,240 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$135.36 |
$282 |
1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$79.68 |
$166 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$140.64 |
$293 |
1.0× |
| X-ray nose-rectum child f.b. (76010) |
$214.56 |
$447 |
1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$180.48 |
$376 |
1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$171.84 |
$358 |
1.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$88.32 |
$184 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$140.64 |
$293 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$198.24 |
$413 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$190.56 |
$397 |
1.4× |
| X-ray thoracic spine 4 vw (72074) |
$192.48 |
$401 |
1.4× |
| X-Ray Tmj Unilat (70328) |
$84.48 |
$176 |
0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$393.12 |
$819 |
0.9× |
| X-Rays Bone Length Studies (77073) |
$156.48 |
$326 |
1.2× |
| X-Rays Bone Survey Complete (77075) |
$305.28 |
$636 |
2.3× |
| Xr c-spine 4 or 5 views (72050) |
$233.76 |
$487 |
1.7× |
| Xr facial bones less than 3 views (70140) |
$129.12 |
$269 |
1.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$120.48 |
$251 |
0.9× |
| Xr orbits complete 4 views (70200) |
$212.16 |
$442 |
1.6× |