| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,157.30 |
$6,395.85 |
3.2× |
| Abdomen 2 views (74019) |
$390.12 |
$600.19 |
4.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,553.36 |
$2,389.78 |
4.1× |
| Angiography extremity bilateral rs&i (75716) |
$3,998.93 |
$6,152.20 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$3,998.93 |
$6,152.20 |
1.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,998.93 |
$6,152.20 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,415.20 |
$5,254.15 |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,998.93 |
$6,152.20 |
1.4× |
| Angiography Spinal Selective Rs&I (75705) |
$2,973.65 |
$4,574.85 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,998.93 |
$6,152.20 |
0.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$449.34 |
$691.30 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,296.10 |
$1,994 |
0.4× |
| Ankle 2 views (73600) |
$338.94 |
$521.44 |
4.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$409.32 |
$629.72 |
1.3× |
| Aortogram thoracic (75605) |
$7,059.84 |
$10,861.30 |
1.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,998.93 |
$6,152.20 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$4,539.66 |
$6,984.10 |
1.5× |
| Arthrogram elbow (73085) |
$303.15 |
$466.38 |
0.9× |
| Arthrogram hip (73525) |
$1,538.42 |
$2,366.80 |
4.7× |
| Arthrogram shoulder (73040) |
$1,052.58 |
$1,619.36 |
3.2× |
| Arthrogram wrist (73115) |
$662.84 |
$1,019.75 |
2.0× |
| Arthrography knee lt (73580) |
$1,042.05 |
$1,603.15 |
3.2× |
| Basic radiation dosimetry calculation (77300) |
$435.34 |
$669.75 |
3.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$989.72 |
$1,522.65 |
2.6× |
| Bone &/joint imaging whole body (78306) |
$1,271.88 |
$1,956.74 |
3.4× |
| Bone age studies (77072) |
$160.31 |
$246.63 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$761.17 |
$1,171.03 |
2.0× |
| Bone survey complete (77075) |
$224.97 |
$346.11 |
2.3× |
| Brachytx isodose complex (77318) |
$1,551.74 |
$2,387.30 |
4.4× |
| Brachytx isodose intermed (77317) |
$1,551.74 |
$2,387.30 |
4.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$558.28 |
$858.90 |
1.6× |
| Brain image w/flow 4 + views (78606) |
$869.08 |
$1,337.04 |
1.7× |
| Brain Imaging Minimum 4 Static Views (78605) |
$3,665.51 |
$5,639.25 |
7.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$262.08 |
$403.20 |
0.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,545.20 |
$5,454.15 |
10.9× |
| Cervical spine 2 or 3 views (72040) |
$275.72 |
$424.18 |
3.4× |
| Chest 1 view (71045) |
$23.87 |
$36.72 |
0.3× |
| Chest 3 views (71047) |
$616.69 |
$948.76 |
7.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$2,154.13 |
$3,314.04 |
13.1× |
| Clavicle complete (73000) |
$282.32 |
$434.34 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$78.65 |
$121 |
0.8× |
| Continuing medical physics consltj pr wk (77336) |
$696.77 |
$1,071.95 |
5.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,668.84 |
$8,721.30 |
17.4× |
| CT abdomen and pelvis without contrast (74176) |
$4,236.49 |
$6,517.68 |
19.0× |
| CT abdomen w contrast (74160) |
$2,522.29 |
$3,880.44 |
15.4× |
| CT abdomen w wo contrast (74170) |
$2,655.01 |
$4,084.63 |
16.2× |
| CT abdomen w/o contrast (74150) |
$1,904.77 |
$2,930.41 |
19.5× |
| CT angiography upper extremity lt (73206) |
$1,715.92 |
$2,639.87 |
10.4× |
| CT c-spine w/o contrast (72125) |
$3,073.66 |
$4,728.70 |
31.4× |
| CT cervical spine w&w/o contrast (72127) |
$4,091.08 |
$6,293.97 |
24.9× |
| CT cervical spine with contrast (72126) |
$4,220.93 |
$6,493.74 |
12.9× |
| CT chest w/wo contrast (71270) |
$1,951.70 |
$3,002.62 |
11.9× |
| CT chest with contrast (71260) |
$1,745.95 |
$2,686.08 |
10.6× |
| CT colonography w/dye (74262) |
$722.83 |
$1,112.05 |
4.4× |
| CT colonography w/o cntrst (74261) |
$474.76 |
$730.40 |
4.8× |
| CT head/brain with contrast (70460) |
$1,896.40 |
$2,917.54 |
11.5× |
| CT head/brain without and with contrast (70470) |
$2,037.46 |
$3,134.56 |
12.4× |
| CT iac w contrast (70481) |
$1,339.31 |
$2,060.48 |
8.2× |
| CT limited/localized follow up study (76380) |
$676.84 |
$1,041.30 |
8.3× |
| CT lower ext w/o (73700) |
$1,993.29 |
$3,066.60 |
20.4× |
| CT lower extremity w wo contrast (73702) |
$2,380.67 |
$3,662.58 |
14.5× |
| CT lower extremity with contrast (73701) |
$2,343.41 |
$3,605.24 |
14.3× |
| CT lumbar spine w & w/o contrast (72133) |
$3,206.32 |
$4,932.80 |
19.5× |
| CT lumbar spine w/o contrast (72131) |
$2,560.79 |
$3,939.67 |
26.2× |
| CT lumbar spine with contrast (72132) |
$3,068.32 |
$4,720.49 |
9.4× |
| CT maxillofacial w contrast (70487) |
$1,447.88 |
$2,227.50 |
8.8× |
| CT maxillofacial w/o contrast (70486) |
$1,847.74 |
$2,842.68 |
18.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,210.89 |
$3,401.37 |
13.5× |
| CT neck soft tissue w contrast (70491) |
$1,653.20 |
$2,543.39 |
10.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,575.56 |
$2,423.94 |
9.6× |
| CT orbits w/o contrast (70480) |
$1,161.37 |
$1,786.72 |
11.9× |
| CT pelvis w & w/o contrast (72194) |
$2,547.35 |
$3,919 |
15.5× |
| CT pelvis w/o contrast (72192) |
$1,943.60 |
$2,990.15 |
19.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,764.52 |
$2,714.64 |
10.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,197.90 |
$1,842.93 |
12.2× |
| CT thoracic spine w/contrast (72129) |
$3,079.44 |
$4,737.60 |
18.7× |
| CT thoracic spine w/o contrast (72128) |
$2,515.64 |
$3,870.22 |
25.7× |
| CT thoracic spine w/wo contrast (72130) |
$3,206.32 |
$4,932.80 |
19.5× |
| CT thorax w/o contrast (71250) |
$1,169.26 |
$1,798.86 |
11.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,380.67 |
$3,662.58 |
14.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,993.29 |
$3,066.60 |
20.4× |
| CT upper extremity with contrast (73201) |
$2,343.41 |
$3,605.24 |
7.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,715.92 |
$2,639.87 |
10.4× |
| Cta Abdomen (74175) |
$1,871.92 |
$2,879.88 |
11.4× |
| CTA abdomen pelvis (74174) |
$2,737.88 |
$4,212.13 |
8.4× |
| CTA chest (71275) |
$1,672.60 |
$2,573.24 |
10.2× |
| Cta Head (70496) |
$1,715.92 |
$2,639.87 |
10.4× |
| CTA lwr ext w&w/o contrast (73706) |
$1,515.18 |
$2,331.05 |
9.2× |
| Cta Neck (70498) |
$2,089.71 |
$3,214.94 |
12.7× |
| Cystography minimum 3 views rs&i (74430) |
$462.69 |
$711.82 |
1.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$264.16 |
$406.40 |
2.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$309.87 |
$476.73 |
3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$146.32 |
$225.10 |
1.8× |
| Dxa bone density study axial skeleton (77085) |
$309.88 |
$476.74 |
3.2× |
| Echoencephalography real time imaging (76506) |
$497.96 |
$766.10 |
5.1× |
| Esophagus (74220) |
$523.87 |
$805.95 |
3.2× |
| Fetal biophysical profile non-stress testing (76818) |
$417.95 |
$643 |
4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$452.27 |
$695.80 |
4.6× |
| Fluoroscopy up to 1 hr (76000) |
$270.30 |
$415.85 |
1.2× |
| Foot 2 views (73620) |
$390.73 |
$601.13 |
4.8× |
| Forearm 2 views (73090) |
$299.66 |
$461.02 |
3.7× |
| Gated Heart Planar Single (78472) |
$1,407.96 |
$2,166.10 |
3.8× |
| Hand 2 views (73120) |
$329.83 |
$507.43 |
3.4× |
| Hand 3 views (73130) |
$434.03 |
$667.74 |
5.3× |
| Heart Infarct Image (78466) |
$967.49 |
$1,488.45 |
2.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,233.62 |
$4,974.80 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,340.78 |
$3,601.20 |
4.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,125.94 |
$3,270.67 |
5.7× |
| Ht muscle image spect sing (78451) |
$3,807.41 |
$5,857.56 |
3.1× |
| Humerus Min 2 Views Left (73060) |
$265.69 |
$408.76 |
3.3× |
| Hysterosalpingogram (74740) |
$463.84 |
$713.60 |
2.1× |
| Image fusion (77399) |
$210.40 |
$323.70 |
1.7× |
| Intracavitary Radiation Source Applic Complex (77763) |
$650.52 |
$1,000.80 |
1.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$650.52 |
$1,000.80 |
1.3× |
| Intracavitary radiation source applic simple (77761) |
$650.52 |
$1,000.80 |
1.3× |
| Kidney imaging morphology (78700) |
$631.25 |
$971.15 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$827.03 |
$1,272.35 |
1.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$785.25 |
$1,208.08 |
1.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$819.60 |
$1,260.92 |
1.6× |
| Knee 3 views (73562) |
$200.07 |
$307.80 |
2.5× |
| Liver & spleen imaging static only (78215) |
$1,135.73 |
$1,747.28 |
3.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$967.49 |
$1,488.45 |
2.6× |
| Liver imaging static only (78201) |
$873.70 |
$1,344.15 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$2,630.56 |
$4,047.01 |
5.2× |
| Lung perfusion differential (78597) |
$1,275.27 |
$1,961.96 |
3.4× |
| Lung Ventilation Imaging (78579) |
$1,377.30 |
$2,118.92 |
3.7× |
| Lymphoscintigraphy (78195) |
$1,745.87 |
$2,685.95 |
3.4× |
| Mammary ductogram or galactogram single (77053) |
$1,416.06 |
$2,178.55 |
6.3× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$103.68 |
$159.50 |
1.3× |
| Meckels Diverticulum (78290) |
$918.71 |
$1,413.40 |
2.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$626.57 |
$963.95 |
1.8× |
| MRA head w & w/o contrast (70546) |
$5,765.79 |
$8,870.45 |
17.6× |
| MRA head w/o contrast (70544) |
$3,481.22 |
$5,355.73 |
15.6× |
| MRA head with contrast (70545) |
$3,724.94 |
$5,730.67 |
11.4× |
| MRA neck w contrast (70548) |
$3,259.23 |
$5,014.20 |
10.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,222.68 |
$9,573.36 |
19.0× |
| MRA neck w/o contrast (70547) |
$2,998.49 |
$4,613.06 |
13.4× |
| MRI abdomen w contrast (74182) |
$3,560.12 |
$5,477.10 |
10.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$6,262.37 |
$9,634.41 |
19.2× |
| MRI abdomen w/o contrast (74181) |
$3,256.97 |
$5,010.72 |
14.6× |
| MRI any jnt lwr ext with con lt (73722) |
$3,508.44 |
$5,397.60 |
4.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,030.58 |
$6,200.89 |
5.5× |
| MRI breast w/o contrast bilateral (77047) |
$1,086.25 |
$1,671.15 |
4.9× |
| MRI breast w/o contrast unilat (77046) |
$1,085.76 |
$1,670.40 |
4.9× |
| MRI c-spine with contrast (72142) |
$4,379.86 |
$6,738.25 |
13.4× |
| MRI cardiac w/o cont stress (75559) |
$1,359.54 |
$2,091.60 |
2.7× |
| MRI cardiac w/o contrast (75557) |
$1,359.54 |
$2,091.60 |
6.1× |
| MRI cervical spine w/o contrast (72141) |
$3,548.64 |
$5,459.44 |
15.9× |
| MRI chest w/o & w/contrast material (71552) |
$3,623.49 |
$5,574.60 |
11.1× |
| MRI chest w/o contrast (71550) |
$3,546.50 |
$5,456.15 |
15.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,259.86 |
$3,476.70 |
6.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,259.86 |
$3,476.70 |
6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,198.69 |
$3,382.60 |
9.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,619.14 |
$4,029.45 |
11.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$6,736.87 |
$10,364.42 |
20.6× |
| MRI orbit/face/neck w/contrast (70542) |
$2,828.67 |
$4,351.80 |
8.7× |
| MRI pelvis w contrast (72196) |
$3,135.10 |
$4,823.23 |
9.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,350.37 |
$9,769.80 |
19.4× |
| MRI pelvis w/o contrast (72195) |
$2,394.75 |
$3,684.23 |
10.7× |
| MRI scan of arm joint before and after contrast (73223) |
$6,306.27 |
$9,701.96 |
19.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$3,545.20 |
$5,454.15 |
4.8× |
| MRI scan of leg joint before and after contrast (73723) |
$6,224.19 |
$9,575.68 |
19.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,585.70 |
$10,131.85 |
20.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,379.86 |
$6,738.25 |
13.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,585.70 |
$10,131.85 |
20.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,379.86 |
$6,738.25 |
13.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,585.70 |
$10,131.85 |
20.2× |
| MRI thoracic spine w/o contrast (72146) |
$3,548.63 |
$5,459.44 |
15.9× |
| MRI tmj (70336) |
$2,877.97 |
$4,427.65 |
12.9× |
| MRI upper ext joint w/o contrast (73221) |
$3,725.26 |
$5,731.16 |
16.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,312.43 |
$5,096.05 |
10.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,198.69 |
$3,382.60 |
9.8× |
| Myelogram Cervical (72240) |
$2,065.67 |
$3,177.95 |
2.8× |
| Myelogram Lumbar (72265) |
$2,054.84 |
$3,161.30 |
2.8× |
| Myelogram thoracic (72255) |
$2,054.84 |
$3,161.30 |
2.8× |
| Myelography 2 or more regions (72270) |
$2,937.42 |
$4,519.10 |
4.0× |
| Myocardial infarct spect (78469) |
$925.40 |
$1,423.70 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,417.24 |
$6,795.75 |
3.6× |
| Neck soft tissue (70360) |
$123.96 |
$190.70 |
1.5× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$260.26 |
$400.40 |
0.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,174 |
$1,806.15 |
3.1× |
| Nm cisternogram (78630) |
$3,232.03 |
$4,972.35 |
6.4× |
| Nm gastric emptying study (78264) |
$954.04 |
$1,467.75 |
2.5× |
| Nm gastroesophageal reflux study (78262) |
$932.78 |
$1,435.05 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,029.56 |
$3,122.40 |
1.6× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,999.60 |
$3,076.30 |
1.5× |
| Nuclear medicine of heart pumping function (78473) |
$1,607.44 |
$2,472.98 |
4.3× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$2,096.87 |
$3,225.95 |
4.1× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$5,474.04 |
$8,421.60 |
4.1× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,999.60 |
$3,076.30 |
1.5× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,132.33 |
$1,742.05 |
3.0× |
| Nuclear Rx Oral Admin (79005) |
$700.28 |
$1,077.35 |
3.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$211.96 |
$326.10 |
2.2× |
| Orthopantogram (70355) |
$138.12 |
$212.50 |
1.7× |
| Osseous survey infant (77076) |
$104.26 |
$160.40 |
1.1× |
| Osseous survey limited (77074) |
$180.12 |
$277.10 |
1.8× |
| Parathyroid imaging (78070) |
$741.62 |
$1,140.95 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$324.34 |
$498.98 |
3.3× |
| PET image w/CT, skull-thigh (78815) |
$6,050.82 |
$9,308.95 |
4.5× |
| PET imaging CT for attenuation limited area (78814) |
$5,655 |
$8,700 |
4.2× |
| PET imaging for CT attenuation whole body (78816) |
$6,050.82 |
$9,308.95 |
4.5× |
| PET imaging limited area chest head/neck (78811) |
$5,474.04 |
$8,421.60 |
4.5× |
| PET whole body (78813) |
$5,474.04 |
$8,421.60 |
4.1× |
| Platelet survival study (78191) |
$6,979.93 |
$10,738.35 |
18.6× |
| Pr heart first pass single,planar (78481) |
$1,707.36 |
$2,626.70 |
3.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,312.43 |
$5,096.05 |
10.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$845.96 |
$1,301.48 |
2.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,317.38 |
$2,026.74 |
2.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$824.58 |
$1,268.58 |
1.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$143.46 |
$220.70 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$275.72 |
$424.19 |
2.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$418.29 |
$643.53 |
4.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$187.78 |
$288.90 |
1.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$817.26 |
$1,257.33 |
8.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,706.65 |
$27,241 |
2.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$602.13 |
$926.35 |
1.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$439.34 |
$675.90 |
4.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$520.84 |
$801.30 |
1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$164.30 |
$252.77 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$295.96 |
$455.33 |
3.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$616.69 |
$948.76 |
7.6× |
| Radiologic exam colon single contrast study (74270) |
$897.64 |
$1,380.98 |
5.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$449.15 |
$691 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$823.75 |
$1,267.30 |
5.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$422.18 |
$649.51 |
5.2× |
| Radiological examination surgical specimen (76098) |
$578.47 |
$889.95 |
1.1× |
| Ribs bilateral 3 views (71110) |
$344.12 |
$529.42 |
3.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,449.23 |
$3,768.05 |
4.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,942.23 |
$2,988.05 |
3.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,323.82 |
$2,036.65 |
1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,987.50 |
$3,057.70 |
9.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$602.78 |
$927.35 |
2.8× |
| Rp Therapy Intravenous Administration (79101) |
$602.78 |
$927.35 |
2.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$677.72 |
$1,042.65 |
3.0× |
| Scanogram (77073) |
$160.31 |
$246.63 |
1.6× |
| Scapula complete (73010) |
$274.49 |
$422.29 |
2.8× |
| Screening digital breast tomosynthesis (77063) |
$245.70 |
$378 |
10.5× |
| Sialogram (70390) |
$461.66 |
$710.24 |
2.1× |
| Simulation intermediate (77285) |
$1,220.38 |
$1,877.50 |
3.5× |
| Small bowel series (74250) |
$608.40 |
$936 |
3.7× |
| Spec medical radj physics consltj (77370) |
$210.40 |
$323.70 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$611.72 |
$941.10 |
1.7× |
| Special dosimetry (77331) |
$218.50 |
$336.15 |
1.7× |
| Special treatment procedure (77470) |
$865.77 |
$1,331.95 |
1.7× |
| Speech evaluation complex (70371) |
$497.58 |
$765.50 |
2.2× |
| Spine thoracic 3 views (72072) |
$266.56 |
$410.10 |
2.7× |
| Spleen imaging only (78185) |
$530.83 |
$816.66 |
1.4× |
| Stereotactic body radiation delivery (77373) |
$12,632.49 |
$19,434.60 |
7.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$162.73 |
$250.35 |
1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$558.28 |
$858.90 |
1.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$558.28 |
$858.90 |
1.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$497.58 |
$765.50 |
2.2× |
| Testicular Imaging With Vascular Flow (78761) |
$552.50 |
$850 |
1.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,383.10 |
$2,127.85 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$783.54 |
$1,205.45 |
6.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,756.16 |
$4,240.25 |
5.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$521.30 |
$802 |
1.4× |
| Thyroid uptake measurement (78012) |
$506.74 |
$779.60 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$926.98 |
$1,426.13 |
2.5× |
| Tomogram (76100) |
$840.06 |
$1,292.40 |
8.6× |
| Treatment device intermediate (77333) |
$651.07 |
$1,001.65 |
5.2× |
| Treatment devices simple (77332) |
$488.28 |
$751.20 |
3.9× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,852.56 |
$2,850.10 |
3.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$761.73 |
$1,171.89 |
2.0× |
| Tx devices design & construction complex (77334) |
$870.54 |
$1,339.30 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$690.24 |
$1,061.90 |
7.0× |
| Umbilical-artery Doppler (OB) (76820) |
$264.16 |
$406.40 |
2.7× |
| Unlisted fluoroscopic procedure (76496) |
$223.24 |
$343.45 |
2.7× |
| Unlisted Ultrasound Procedure (76999) |
$631.54 |
$971.60 |
7.7× |
| Upper Extremity Infant (73092) |
$179.78 |
$276.58 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$337.87 |
$519.80 |
1.5× |
| Urethrocystography voiding (74455) |
$741.81 |
$1,141.25 |
3.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$741.81 |
$1,141.25 |
4.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,732.35 |
$2,665.15 |
10.5× |
| Us abdl aorta screen aaa (76706) |
$461.96 |
$710.70 |
4.7× |
| Us breast unilateral complete (76641) |
$452.34 |
$695.90 |
4.6× |
| Us breast unilateral limited (76642) |
$452.34 |
$695.90 |
5.6× |
| Us chest (76604) |
$660.02 |
$1,015.42 |
6.7× |
| Us compl joint r-t w/image documentation (76881) |
$302.96 |
$466.09 |
3.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$229.55 |
$353.15 |
2.3× |
| Us guided compression repair (76936) |
$248.85 |
$382.85 |
1.2× |
| Us infant hips dynamic (76885) |
$557.47 |
$857.65 |
6.8× |
| Us infant hips limited static (76886) |
$451.13 |
$694.05 |
5.5× |
| Us kidney transplant (76776) |
$229.55 |
$353.15 |
2.3× |
| Us ob detailed single fetus (76811) |
$689.88 |
$1,061.35 |
3.1× |
| Us ob transvaginal (76817) |
$282 |
$433.84 |
2.9× |
| Us pelvic non ob complete (76856) |
$842.09 |
$1,295.53 |
8.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$368.30 |
$566.62 |
3.8× |
| Us pregnancy ltd (76815) |
$215.59 |
$331.67 |
2.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$288.39 |
$443.67 |
2.9× |
| Us retroperitoneal complete (76770) |
$677.72 |
$1,042.65 |
6.9× |
| Us retroperitoneal limited (76775) |
$596.28 |
$917.35 |
6.1× |
| Us scrotum and contents (76870) |
$652.46 |
$1,003.78 |
6.7× |
| Us soft tissue head/neck (76536) |
$535.16 |
$823.32 |
5.5× |
| Us spinal canal and contents (76800) |
$677.72 |
$1,042.65 |
6.9× |
| Us transrectal (76872) |
$622.44 |
$957.60 |
6.4× |
| Us transrectal prostate volume (76873) |
$91.58 |
$140.90 |
0.9× |
| Us xtr non-vasc lmtd (76882) |
$189.36 |
$291.32 |
1.9× |
| Venogram extremity bilateral (75822) |
$2,388.42 |
$3,674.50 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$3,998.93 |
$6,152.20 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$4,007.61 |
$6,165.55 |
2.7× |
| Venography extremity unilateral rs&i (75820) |
$1,346.48 |
$2,071.50 |
0.9× |
| Venography Renal Bilateral (75833) |
$3,586.28 |
$5,517.35 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$3,586.28 |
$5,517.35 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$7,135.67 |
$10,977.95 |
2.4× |
| Wrist 2 views (73100) |
$360.88 |
$555.20 |
4.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$692 |
$1,064.61 |
7.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$386.04 |
$593.90 |
4.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$428.81 |
$659.71 |
5.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,147.39 |
$1,765.21 |
7.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$267.13 |
$410.97 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$428.72 |
$659.57 |
5.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$817.26 |
$1,257.33 |
8.3× |
| X-ray exam hip uni 1 view (73501) |
$393.26 |
$605.02 |
4.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$488.29 |
$751.22 |
6.0× |
| X-ray exam hip uni 4/> views (73503) |
$732.44 |
$1,126.83 |
7.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$428.60 |
$659.39 |
4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,029.13 |
$1,583.28 |
10.5× |
| X-ray exam of femur 1 (73551) |
$322.56 |
$496.25 |
4.0× |
| X-ray eye for foreign body (70030) |
$100.56 |
$154.70 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$377.95 |
$581.46 |
3.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$378.20 |
$581.84 |
4.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$304.14 |
$467.91 |
3.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$295.07 |
$453.96 |
3.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$200.07 |
$307.80 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$179.78 |
$276.58 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$449.22 |
$691.11 |
4.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$312.73 |
$481.13 |
3.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$255.59 |
$393.22 |
3.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$130.98 |
$201.50 |
1.6× |
| X-ray of voice box or throat (70370) |
$310.12 |
$477.10 |
3.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$204.82 |
$315.10 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$522.50 |
$803.85 |
5.3× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$1,009.42 |
$1,552.95 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$357.03 |
$549.28 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$245.80 |
$378.16 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$303.40 |
$466.77 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$366.49 |
$563.83 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$227.08 |
$349.35 |
2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$233.97 |
$359.95 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$255.09 |
$392.45 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$234.20 |
$360.30 |
2.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$200.90 |
$309.07 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$297.90 |
$458.31 |
3.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$146.87 |
$225.95 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$146.63 |
$225.59 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$119.40 |
$183.70 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$233.97 |
$359.95 |
2.9× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$63.93 |
$98.35 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$293.22 |
$451.11 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$510.37 |
$785.18 |
6.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$442.96 |
$681.47 |
5.4× |
| Xr c-spine 6 or more views (72052) |
$349.64 |
$537.90 |
3.6× |
| Xr chest 4+ views (71048) |
$304.16 |
$467.94 |
3.1× |
| Xr Cholecystography Oral Contrast (74290) |
$520.55 |
$800.85 |
3.2× |
| Xr finger(s) 2+ views (73140) |
$390.61 |
$600.94 |
4.8× |
| Xr optic foramina (70190) |
$95.65 |
$147.15 |
1.2× |
| Xr shoulder 1 view (73020) |
$207.01 |
$318.47 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$772.96 |
$1,189.17 |
7.9× |
| Xr tibia/fibula 2 views (73590) |
$340.93 |
$524.51 |
4.2× |
| Xr tmj bilateral (70330) |
$201.30 |
$309.70 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$260.17 |
$400.26 |
3.2× |