| 3-D radiotherapy plan dose-volume histograms (77295) |
$247.14 |
$617.86 |
0.2× |
| Abdomen 2 views (74019) |
$237.56 |
$593.91 |
2.3× |
| Acute gi blood loss imaging (78278) |
$827.96 |
$2,069.88 |
2.1× |
| Angiography extremity bilateral rs&i (75716) |
$3,502.42 |
$8,756.06 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$999.96 |
$2,499.92 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$591.89 |
$1,479.72 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,055.03 |
$2,637.58 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$160.51 |
$401.28 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$821.37 |
$2,053.42 |
0.3× |
| Ankle 2 views (73600) |
$269.88 |
$674.71 |
3.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,826.80 |
$9,567 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,293.84 |
$8,234.60 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$177.23 |
$443.08 |
0.1× |
| Arthrogram hip (73525) |
$904.92 |
$2,262.30 |
2.7× |
| Arthrogram knee (73580) |
$1,459.33 |
$3,648.32 |
4.3× |
| Arthrogram shoulder (73040) |
$904.92 |
$2,262.30 |
2.7× |
| Arthrogram wrist (73115) |
$857.32 |
$2,143.30 |
2.5× |
| Basic dosimetry (77300) |
$156.44 |
$391.09 |
1.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$841.12 |
$2,102.80 |
2.2× |
| Bone &/joint imaging whole body (78306) |
$864.44 |
$2,161.08 |
2.2× |
| Bone age studies (77072) |
$242.77 |
$606.92 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$901.22 |
$2,253.05 |
2.3× |
| Bone Marrow Imaging Limited Area (78102) |
$412.78 |
$1,031.94 |
1.1× |
| Bone survey complete (77075) |
$409.73 |
$1,024.33 |
4.0× |
| Bowel imaging (78290) |
$827.96 |
$2,069.88 |
2.1× |
| Brachytx isodose complex (77318) |
$379.54 |
$948.86 |
1.0× |
| Brachytx isodose intermed (77317) |
$260.83 |
$652.08 |
0.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$176.82 |
$442.04 |
0.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$489.27 |
$1,223.18 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,187.91 |
$5,469.77 |
1.6× |
| Brain Imaging Vascular Flow Only (78610) |
$628.78 |
$1,571.94 |
1.2× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$945.52 |
$2,363.79 |
2.4× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$2,122.18 |
$5,305.46 |
2.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,899.81 |
$4,749.52 |
5.6× |
| Cervical spine 2 or 3 views (72040) |
$239.69 |
$599.23 |
2.8× |
| Chest 1 view (71045) |
$175.51 |
$438.78 |
2.1× |
| Chest xray 3 views (71047) |
$153.26 |
$383.14 |
1.8× |
| Cholecystography, oral contrast Non-Facility (74290) |
$190.19 |
$475.48 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$368.62 |
$921.54 |
2.2× |
| Clavicle complete (73000) |
$180.96 |
$452.40 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$804.44 |
$2,011.10 |
7.9× |
| Continuing medical physics consltj pr wk (77336) |
$64.40 |
$161 |
0.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,636.50 |
$4,091.26 |
4.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,694.84 |
$4,237.10 |
7.3× |
| CT abdomen w contrast (74160) |
$1,078.94 |
$2,697.36 |
6.3× |
| CT abdomen w wo contrast (74170) |
$1,174.06 |
$2,935.15 |
6.9× |
| CT abdomen w/o contrast (74150) |
$522.78 |
$1,306.94 |
5.1× |
| CT angio hrt w/3d image (75574) |
$941.17 |
$2,352.93 |
2.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,116.22 |
$2,790.54 |
6.5× |
| CT angiography upper extremity lt (73206) |
$1,363.04 |
$3,407.61 |
8.0× |
| CT c-spine w/contrast (72126) |
$1,165.10 |
$2,912.75 |
3.4× |
| CT c-spine w/o contrast (72125) |
$522.78 |
$1,306.94 |
5.1× |
| CT cervical spine w&w/o contrast (72127) |
$864.26 |
$2,160.65 |
5.1× |
| CT chest w contrast (71260) |
$1,048.59 |
$2,621.48 |
6.2× |
| CT chest w/wo contrast (71270) |
$1,117.95 |
$2,794.87 |
6.6× |
| CT head/brain with contrast (70460) |
$1,165.10 |
$2,912.75 |
6.8× |
| CT head/brain without and with contrast (70470) |
$1,174.06 |
$2,935.15 |
6.9× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$257.90 |
$644.76 |
3.0× |
| CT iac w contrast (70481) |
$1,048.59 |
$2,621.48 |
6.2× |
| CT limited/localized follow up study (76380) |
$294.03 |
$735.07 |
3.5× |
| CT lower ext w/o (73700) |
$553.07 |
$1,382.67 |
5.4× |
| CT lower extremity w wo contrast (73702) |
$1,273.34 |
$3,183.34 |
7.5× |
| CT lower extremity w/contrast material (73701) |
$1,109.29 |
$2,697.36 |
6.5× |
| CT lumbar spine w & w/o contrast (72133) |
$923.34 |
$2,308.35 |
5.4× |
| CT lumbar spine w/contrast (72132) |
$1,165.10 |
$2,912.75 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$537.92 |
$1,344.80 |
5.3× |
| CT maxillofacial w contrast (70487) |
$1,048.59 |
$2,621.48 |
6.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,242.16 |
$3,105.41 |
7.3× |
| CT maxillofacial wo contrast (70486) |
$1,076.04 |
$2,690.08 |
10.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,304.51 |
$3,261.28 |
7.7× |
| CT orbits w/o contrast (70480) |
$522.78 |
$1,306.94 |
5.1× |
| CT pelvis w/o contrast (72192) |
$522.78 |
$1,306.94 |
5.1× |
| CT pelvis w/wo contrast (72194) |
$1,174.06 |
$2,935.15 |
6.9× |
| CT scan of arm combo (73202) |
$844.34 |
$2,110.86 |
5.0× |
| CT soft tissue neck w contrast (70491) |
$1,694.49 |
$4,236.22 |
9.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,174.06 |
$2,935.15 |
6.9× |
| CT soft tissue neck w/o contrast (70490) |
$522.78 |
$1,306.94 |
5.1× |
| CT thoracic spine w/contrast (72129) |
$1,109.29 |
$2,773.23 |
6.5× |
| CT thoracic spine w/o contrast (72128) |
$1,512.89 |
$3,782.23 |
14.9× |
| CT thoracic spine w/wo contrast (72130) |
$923.34 |
$2,308.35 |
5.4× |
| CT thorax w/o contrast (71250) |
$1,779.61 |
$4,449.02 |
17.5× |
| CT upper ext wo (73200) |
$551.82 |
$1,379.54 |
5.4× |
| CT upper extremity with contrast (73201) |
$1,165.10 |
$2,912.75 |
3.4× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,226.74 |
$3,066.86 |
7.2× |
| Cta Abdomen (74175) |
$1,168.18 |
$2,920.44 |
6.9× |
| CTA abdomen pelvis (74174) |
$1,774.74 |
$4,436.85 |
5.2× |
| CTA chest (71275) |
$1,847.18 |
$4,617.96 |
10.8× |
| Cta Head (70496) |
$1,226.74 |
$3,066.86 |
7.2× |
| Cta Neck (70498) |
$1,226.74 |
$3,066.86 |
7.2× |
| Cta Pelvis (72191) |
$1,142.32 |
$2,855.80 |
6.7× |
| Cystography minimum 3 views rs&i (74430) |
$682.12 |
$1,705.31 |
2.0× |
| Diskography lumbar (72295) |
$3,204.60 |
$8,011.50 |
1.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$341.09 |
$852.72 |
3.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$479.44 |
$1,198.62 |
4.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$252.09 |
$630.22 |
2.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$341.09 |
$852.72 |
1.5× |
| Esophagus (74220) |
$396.79 |
$991.97 |
2.3× |
| Facial bones min 3 views (70150) |
$239.69 |
$599.23 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$429.46 |
$1,073.65 |
4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$345.68 |
$864.22 |
3.4× |
| Fetal Echo (76825) |
$453.11 |
$1,132.78 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$467.72 |
$1,169.30 |
2.0× |
| Foot 2 views (73620) |
$163.83 |
$409.57 |
1.9× |
| Forearm 2 views (73090) |
$177.45 |
$443.63 |
2.1× |
| Hand 2 views (73120) |
$270.32 |
$675.80 |
2.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$930.88 |
$2,327.22 |
1.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$930.88 |
$2,327.22 |
1.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$930.88 |
$2,327.22 |
1.4× |
| Heart Infarct Image (78466) |
$655.42 |
$1,638.56 |
1.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,132.86 |
$2,832.13 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$945.41 |
$2,363.53 |
2.4× |
| Hysterosalpingogram (74740) |
$865.90 |
$2,164.74 |
3.7× |
| Interstitial radiation source applic complex (77778) |
$1,595.09 |
$3,987.72 |
2.4× |
| Intracavitary Radiation Source Applic Complex (77763) |
$813.43 |
$2,033.57 |
1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$632.85 |
$1,582.13 |
1.2× |
| Intracavitary Radiation Source Applic Simple (77761) |
$416.33 |
$1,040.82 |
0.8× |
| Kidney imaging morphology (78700) |
$413.82 |
$1,034.55 |
1.1× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,064.96 |
$2,662.40 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,132.77 |
$2,831.92 |
2.1× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,227.56 |
$3,068.90 |
2.3× |
| Knee 3 views (73562) |
$245.14 |
$612.85 |
2.9× |
| Liver & spleen imaging static only (78215) |
$713.92 |
$1,784.78 |
1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$489.06 |
$1,222.65 |
1.3× |
| Liver imaging static only (78201) |
$343.60 |
$858.99 |
0.7× |
| Liver imaging w/vascular flow (78202) |
$1,039.15 |
$2,597.87 |
2.0× |
| Lung perf&ventilat diferentl (78598) |
$800.47 |
$2,001.18 |
1.5× |
| Lung perfusion differential (78597) |
$512.88 |
$1,282.22 |
1.3× |
| Lung ventilation imaging (78579) |
$512.88 |
$1,282.22 |
1.3× |
| Lymphoscintigraphy (78195) |
$526.47 |
$1,316.18 |
1.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,869.46 |
$4,673.65 |
2.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,971.70 |
$4,929.26 |
5.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,940.90 |
$4,852.25 |
5.7× |
| Mammary ductogram or galactogram multiple (77054) |
$160.28 |
$400.71 |
0.7× |
| Mammary ductogram or galactogram single (77053) |
$563.82 |
$1,409.55 |
2.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$10 |
$25 |
0.4× |
| MRA head w & w/o contrast (70546) |
$2,122.18 |
$5,305.46 |
6.3× |
| MRA head w/o contrast (70544) |
$1,150.60 |
$2,876.50 |
5.0× |
| MRA head with contrast (70545) |
$1,737.62 |
$4,344.06 |
5.1× |
| MRA neck w contrast (70548) |
$1,662.80 |
$4,157 |
4.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,904.02 |
$4,760.06 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,202.38 |
$3,005.94 |
5.2× |
| MRI abdomen w contrast (74182) |
$1,647.43 |
$4,118.57 |
4.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,940.90 |
$4,852.25 |
5.7× |
| MRI abdomen w/o contrast (74181) |
$1,150.60 |
$2,876.50 |
5.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,869.46 |
$4,673.65 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,115.58 |
$5,288.95 |
6.2× |
| MRI bone marrow blood supply (77084) |
$1,364.35 |
$3,410.88 |
5.9× |
| MRI breast w/o contrast bilateral (77047) |
$266.26 |
$665.66 |
1.1× |
| MRI breast wo contrast unilateral (77046) |
$266.26 |
$665.66 |
1.1× |
| MRI c-spine with contrast (72142) |
$1,579.42 |
$3,948.54 |
4.7× |
| MRI cardiac w/o cont stress (75559) |
$1,994.70 |
$4,986.74 |
3.8× |
| MRI cardiac w/o contrast (75557) |
$1,364.35 |
$3,410.88 |
5.9× |
| MRI cervical spine w/o contrast (72141) |
$1,588.92 |
$3,972.31 |
6.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,940.90 |
$4,852.25 |
5.7× |
| MRI chest w/o contrast (71550) |
$1,202.38 |
$3,005.94 |
5.2× |
| MRI chest with contrast (71551) |
$1,737.62 |
$4,344.06 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,737.62 |
$4,344.06 |
5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,028.24 |
$5,070.60 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,202.38 |
$3,005.94 |
5.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,128.74 |
$2,821.85 |
4.9× |
| MRI orbit face neck w contrast (70542) |
$1,737.62 |
$4,344.06 |
5.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,904.02 |
$4,760.06 |
5.6× |
| MRI pelvis w/contrast (72196) |
$1,737.62 |
$4,344.06 |
5.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,940.90 |
$4,852.25 |
5.7× |
| MRI pelvis w/o contrast (72195) |
$1,128.74 |
$2,821.85 |
4.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,904.02 |
$4,760.06 |
5.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,792.28 |
$4,480.70 |
5.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,904.02 |
$4,760.06 |
5.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,662.80 |
$4,157 |
4.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,940.90 |
$4,852.25 |
5.7× |
| MRI temporomandibular joint (70336) |
$1,202.38 |
$3,005.94 |
5.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,128.74 |
$2,821.85 |
4.9× |
| MRI up ext w/o contrast (73218) |
$1,150.60 |
$2,876.50 |
5.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,191.45 |
$2,978.62 |
5.1× |
| MRI, joint upper extrem combo (73223) |
$1,940.90 |
$4,852.25 |
5.7× |
| Myelogram Cervical (72240) |
$1,703.02 |
$4,257.54 |
2.2× |
| Myelogram Lumbar (72265) |
$1,577.88 |
$3,944.71 |
2.1× |
| Myelogram thoracic (72255) |
$397.63 |
$994.08 |
0.5× |
| Myelography 2 or more regions (72270) |
$1,703.02 |
$4,257.54 |
2.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$905.80 |
$2,264.52 |
0.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,324.08 |
$5,810.20 |
1.8× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$2,522.21 |
$6,305.53 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,975.84 |
$7,439.62 |
2.4× |
| Myocardial spect single study at rest or stress (78451) |
$2,888.90 |
$7,222.26 |
2.3× |
| Neck soft tissue (70360) |
$182.29 |
$455.72 |
2.2× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$207.33 |
$518.32 |
0.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$680.10 |
$1,700.25 |
1.8× |
| Nm bone marrow multi (78103) |
$708.93 |
$1,772.32 |
1.8× |
| Nm bone marrow wb (78104) |
$708.93 |
$1,772.32 |
1.8× |
| Nm cisternogram (78630) |
$574.33 |
$1,435.83 |
1.1× |
| Nm csf leak detection (78650) |
$755.74 |
$1,889.36 |
0.6× |
| Nm gastric emptying study (78264) |
$864.38 |
$2,160.94 |
2.2× |
| Nm gastroesophageal reflux study (78262) |
$700.15 |
$1,750.38 |
1.8× |
| Nm peritoneal-venous shunt patency (78291) |
$846.45 |
$2,116.12 |
2.2× |
| Noncardiac Vascular Flow Imaging (78445) |
$302.22 |
$755.54 |
0.8× |
| Nonvascular shunt X-ray (75809) |
$235.02 |
$587.55 |
2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,103.38 |
$5,258.44 |
1.6× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$624.91 |
$1,562.28 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$701.09 |
$1,752.72 |
3.1× |
| Osseous survey limited (77074) |
$256.12 |
$640.32 |
2.5× |
| Parathyroid Planar Imaging (78070) |
$771.75 |
$1,929.38 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$240.40 |
$600.99 |
2.4× |
| PET image w/CT, skull-thigh (78815) |
$3,137.52 |
$7,843.81 |
2.3× |
| PET imaging CT for attenuation limited area (78814) |
$2,769.60 |
$6,924 |
2.0× |
| PET imaging for CT attenuation whole body (78816) |
$3,137.45 |
$7,843.62 |
2.3× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,769.60 |
$6,924 |
2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$864.38 |
$2,160.94 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,116.06 |
$2,790.15 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$588.12 |
$1,470.32 |
1.1× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$245.14 |
$612.85 |
2.9× |
| Radex Calcaneus Minimum 2 Views (73650) |
$175.92 |
$439.82 |
2.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$188.15 |
$470.38 |
2.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$189.32 |
$473.30 |
2.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$229.10 |
$572.76 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$135.85 |
$339.62 |
1.3× |
| Radex fingr minimum 2 views (73140) |
$180.37 |
$450.92 |
2.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$188.16 |
$470.40 |
2.2× |
| Radex Hand Minimum 3 Views (73130) |
$196.26 |
$490.66 |
2.3× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$89 |
$222.50 |
1.1× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$44.52 |
$111.30 |
0.4× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$229.10 |
$572.76 |
2.3× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$279.80 |
$699.50 |
2.8× |
| Radex Humerus Minimum 2 Views (73060) |
$159.47 |
$398.67 |
1.9× |
| Radex Kne 1/2 Views (73560) |
$168.73 |
$421.83 |
2.0× |
| Radex Kne Compl 4/More Views (73564) |
$242.77 |
$606.92 |
2.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$239.69 |
$599.23 |
2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$180.70 |
$451.74 |
2.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$239.69 |
$599.23 |
2.4× |
| Radex Sho Compl Minimum 2 Views (73030) |
$245.14 |
$612.85 |
2.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$145.19 |
$362.97 |
1.7× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$249.39 |
$623.48 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$162.71 |
$406.78 |
1.9× |
| Radex Toe Minimum 2 Views (73660) |
$165.68 |
$414.20 |
2.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$245.14 |
$612.85 |
2.4× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$180.06 |
$450.15 |
2.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$135.85 |
$339.62 |
1.3× |
| Radiation treatment delivery level 1 (77402) |
$215.20 |
$538 |
2.2× |
| Radiation treatment delivery level 2 (77407) |
$253.20 |
$633 |
0.7× |
| Radiation treatment delivery level 3 (77412) |
$280.80 |
$702 |
0.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$197.48 |
$493.70 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$144.63 |
$361.57 |
1.4× |
| Radiologic exam chest 2 views (71046) |
$182.26 |
$455.64 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$388.37 |
$970.92 |
2.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$210.26 |
$525.64 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$443.08 |
$1,107.71 |
2.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$391.35 |
$978.38 |
2.3× |
| Radiologic examination femur 1 view (73551) |
$49.05 |
$122.62 |
0.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$183.08 |
$457.71 |
2.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$196.26 |
$490.66 |
2.3× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$202.30 |
$505.76 |
0.4× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$212.77 |
$531.92 |
2.1× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$143.32 |
$358.30 |
1.4× |
| Radiological examination surgical specimen (76098) |
$874 |
$2,185 |
1.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$260.83 |
$652.08 |
0.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$260.83 |
$652.08 |
0.7× |
| Ribs bilateral 3 views (71110) |
$240.40 |
$600.99 |
2.4× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$430.96 |
$1,077.40 |
1.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$864.42 |
$2,161.06 |
2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,235.46 |
$5,588.66 |
4.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,975.87 |
$7,439.68 |
5.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,184.70 |
$5,461.75 |
4.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,541.58 |
$3,853.96 |
1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,664.90 |
$4,162.24 |
1.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,541.58 |
$3,853.96 |
1.2× |
| Rp Therapy Intravenous Administration (79101) |
$2,935.20 |
$7,337.99 |
12.9× |
| Sacroiliac Joints < 3 Views (72200) |
$159.90 |
$399.76 |
1.6× |
| Salivary gland function study (78232) |
$765.78 |
$1,914.44 |
2.0× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$326.88 |
$817.19 |
0.8× |
| Scapula (73010) |
$193.10 |
$482.76 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$102.48 |
$256.20 |
4.4× |
| Sella turcica (70240) |
$160.88 |
$402.21 |
1.9× |
| Shoulder 1 view (73020) |
$152.63 |
$381.57 |
1.8× |
| Simulation intermediate (77285) |
$231.99 |
$579.98 |
0.6× |
| Small bowel series (74250) |
$368.51 |
$921.28 |
2.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$506.20 |
$1,265.50 |
1.4× |
| Special dosimetry (77331) |
$82.45 |
$206.12 |
0.6× |
| Special Physics Consult (77370) |
$381 |
$952.50 |
2.9× |
| Special treatment procedure (77470) |
$1,248.56 |
$3,121.42 |
2.3× |
| Speech evaluation complex (70371) |
$501.60 |
$1,254 |
2.2× |
| Spine thoracic 3 views (72072) |
$240.40 |
$600.99 |
2.4× |
| Stereotactic Body Radiation Delivery (77373) |
$1,391.20 |
$3,478 |
0.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$108.68 |
$271.70 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$325.62 |
$814.06 |
0.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$247.88 |
$619.68 |
0.7× |
| Testicular Imaging With Vascular Flow (78761) |
$486.55 |
$1,216.38 |
1.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$265.95 |
$664.88 |
0.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$156.44 |
$391.09 |
1.2× |
| Thoracolumbar 2 views (72080) |
$153.26 |
$383.14 |
1.8× |
| Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) |
$302.22 |
$755.54 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,132.88 |
$2,832.18 |
2.1× |
| Thyroid imaging w/blood flow (78013) |
$481.43 |
$1,203.58 |
1.2× |
| Thyroid uptake measurement (78012) |
$527.94 |
$1,319.84 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$864.42 |
$2,161.06 |
2.2× |
| Tmj unilateral (70328) |
$165.68 |
$414.20 |
2.0× |
| Tomogram (76100) |
$258.74 |
$646.86 |
2.5× |
| Treatment device complex (77334) |
$246.52 |
$616.29 |
0.7× |
| Treatment device intermediate (77333) |
$239.10 |
$597.74 |
1.8× |
| Treatment devices simple (77332) |
$166.36 |
$415.91 |
1.3× |
| Ultrasound breast complete (76641) |
$258.55 |
$646.37 |
2.5× |
| Ultrasound Exam Aaa Screen (76706) |
$176.04 |
$440.12 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$363.84 |
$909.61 |
3.6× |
| Umbilical-artery Doppler (OB) (76820) |
$235.54 |
$588.86 |
2.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$85.02 |
$212.55 |
1.0× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$285.60 |
$714 |
25.8× |
| Ureteral reflux study (78740) |
$354.46 |
$886.16 |
0.9× |
| Urethrocystogram voiding (74455) |
$682.12 |
$1,705.31 |
2.9× |
| Urethrocystography retrograde rs&i (74450) |
$735.97 |
$1,839.92 |
3.2× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$412.15 |
$1,030.37 |
2.4× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$568.48 |
$1,421.20 |
3.3× |
| Us breast unilateral limited (76642) |
$384.99 |
$962.47 |
4.6× |
| Us chest (76604) |
$344.11 |
$860.28 |
3.4× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$416.80 |
$1,042 |
2.0× |
| Us compl joint r-t w/image documentation (76881) |
$355.72 |
$889.30 |
3.5× |
| Us encephalogram (76506) |
$344.11 |
$860.28 |
3.4× |
| Us hips infant static (76886) |
$245.69 |
$614.22 |
2.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$240.40 |
$600.99 |
2.4× |
| Us ob detailed single fetus (76811) |
$475.68 |
$1,189.21 |
2.1× |
| Us ob limited (76815) |
$360.57 |
$901.43 |
3.5× |
| Us ob transvaginal (76817) |
$360.57 |
$901.43 |
3.5× |
| Us pelvic non ob complete (76856) |
$1,272.80 |
$3,182 |
12.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$672.71 |
$1,681.78 |
6.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$363.84 |
$909.61 |
3.6× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$227.16 |
$567.89 |
2.2× |
| Us retroperitoneal complete (76770) |
$363.84 |
$909.61 |
3.6× |
| Us retroperitoneal limited (76775) |
$360.57 |
$901.43 |
3.5× |
| Us scrotum and contents (76870) |
$346.84 |
$867.10 |
3.4× |
| Us soft tissue head/neck (76536) |
$344.11 |
$860.28 |
3.4× |
| Us spinal canal and contents (76800) |
$245.69 |
$614.22 |
2.4× |
| Us transrectal (76872) |
$399.61 |
$999.02 |
3.9× |
| Us,transplanted kidney, real time/ doppler (76776) |
$325.36 |
$813.41 |
3.2× |
| Venogram adrenal unilat (75840) |
$2,139.74 |
$5,349.36 |
0.7× |
| Venogram extremity bilateral (75822) |
$958.14 |
$2,395.35 |
0.6× |
| Venogram Extremity Unilateral (75820) |
$492.24 |
$1,230.61 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$2,816 |
$7,040 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$1,017.60 |
$2,544 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,221.60 |
$3,054 |
0.4× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$543.82 |
$1,359.54 |
0.1× |
| Venous thrombosis imaging, venogram; unilateral Non-Facility (78457) |
$2,032.40 |
$5,081 |
3.9× |
| Vertebral fracture assessment via dxa (77086) |
$95.72 |
$239.30 |
1.1× |
| Wrist 2 views (73100) |
$162.84 |
$407.10 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$239.69 |
$599.23 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$160.88 |
$402.21 |
1.9× |
| X-ray b.e. reductn intuss (74283) |
$290.51 |
$726.28 |
1.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$381.28 |
$953.21 |
2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$153.26 |
$383.14 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$186.90 |
$467.25 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$71.07 |
$177.67 |
0.7× |
| X-ray exam of femur 2/> (73552) |
$101.92 |
$254.79 |
1.2× |
| X-ray eye for foreign body (70030) |
$164.20 |
$410.49 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$150.42 |
$376.05 |
1.8× |
| X-ray IV pyelogram (ivp) (74400) |
$736.84 |
$1,842.10 |
4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$182.29 |
$455.72 |
2.2× |
| X-ray leg, infant (73592) |
$254.46 |
$636.15 |
3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$240.40 |
$600.99 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$240.40 |
$600.99 |
2.4× |
| X-ray nose-rectum child f.b. (76010) |
$279.60 |
$699 |
3.3× |
| X-ray optic foramen (70190) |
$160.88 |
$402.21 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$239.69 |
$599.23 |
2.4× |
| X-ray retrograde pyelogram (74420) |
$482.22 |
$1,205.54 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$196.27 |
$490.67 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$240.04 |
$600.11 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$239.69 |
$599.23 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$240.40 |
$600.99 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$150.42 |
$376.05 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$239.69 |
$599.23 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$240.40 |
$600.99 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$239.69 |
$599.23 |
2.4× |
| X-Ray Small Bowel Enteroclysis (74251) |
$401.70 |
$1,004.24 |
2.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$151.84 |
$379.60 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$167.86 |
$419.65 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$196.24 |
$490.60 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$239.69 |
$599.23 |
2.4× |
| Xr bone length studies (77073) |
$240.40 |
$600.99 |
2.4× |
| Xr c-spine 4 or 5 views (72050) |
$239.69 |
$599.23 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$240.40 |
$600.99 |
2.4× |
| Xr chest 4+ views (71048) |
$232.30 |
$580.74 |
2.3× |
| Xr urogram antegrade (74425) |
$230.21 |
$575.52 |
0.7× |