| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,009.80 |
$11,683 |
4.9× |
| Acute gi blood loss imaging (78278) |
$1,581 |
$2,635 |
3.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,234.60 |
$5,391 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,604.80 |
$11,008 |
1.1× |
| Angiography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75716) |
$4,651.20 |
$7,752 |
1.4× |
| Angiography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75710) |
$4,256.40 |
$7,094 |
1.3× |
| Angiography, pelvic, selective or supraselective, radiological supervision and interpretation Age Under 21 (75736) |
$5,563.80 |
$9,273 |
1.0× |
| Angiography, spinal, selective, radiological supervision and interpretation Age Under 21 (75705) |
$5,307.60 |
$8,846 |
0.9× |
| Angrph cath f-up std tcat other than thrombylsis (75898) |
$2,637 |
$4,395 |
0.8× |
| Ankle 2 views (73600) |
$314.64 |
$524.40 |
3.5× |
| Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision… (75630) |
$3,966 |
$6,610 |
1.2× |
| Aortography, abdominal, by serialography, radiological supervision and interpretation Age Under 21 (75625) |
$3,718.80 |
$6,198 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$624.60 |
$1,041 |
4.5× |
| Clavicle complete (73000) |
$333.72 |
$556.20 |
3.7× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$5,671.80 |
$9,453 |
15.7× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$2,977.20 |
$4,962 |
16.3× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$3,247.80 |
$5,413 |
17.8× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$2,982 |
$4,970 |
16.4× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$3,005.40 |
$5,009 |
16.5× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$2,570.40 |
$4,284 |
14.1× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,975.40 |
$4,959 |
16.3× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$2,194.80 |
$3,658 |
12.1× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$1,949.33 |
$3,248.87 |
10.7× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$2,899.80 |
$4,833 |
26.7× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$2,382 |
$3,970 |
13.1× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$2,380.80 |
$3,968 |
13.1× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,857.60 |
$3,096 |
17.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$2,577 |
$4,295 |
14.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$2,164.20 |
$3,607 |
19.9× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,594.64 |
$4,324.40 |
14.2× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$2,531.40 |
$4,219 |
13.9× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$2,554.80 |
$4,258 |
14.0× |
| Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose… (77336) |
$867.60 |
$1,446 |
6.2× |
| Csf shunt evaluation (78645) |
$1,670.76 |
$2,784.60 |
3.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,983.60 |
$8,306 |
13.8× |
| CT abdomen and pelvis without contrast (74176) |
$3,753.60 |
$6,256 |
15.2× |
| CT abdomen w & w/o contrast (74170) |
$3,239.40 |
$5,399 |
17.8× |
| CT abdomen w/contrast (74160) |
$2,600.40 |
$4,334 |
14.3× |
| CT abdomen w/o contrast (74150) |
$2,290.20 |
$3,817 |
21.1× |
| CT angio hrt w/3d image (75574) |
$2,221.80 |
$3,703 |
6.1× |
| CT cervical spine w/contrast (72126) |
$2,479.20 |
$4,132 |
6.8× |
| CT cervical spine w/o contrast (72125) |
$2,209.20 |
$3,682 |
20.4× |
| CT chest w/contrast (71260) |
$2,371.80 |
$3,953 |
13.0× |
| CT extremity upper w & w/o contrast (73202) |
$2,427 |
$4,045 |
13.3× |
| CT extremity upper w/o contrast (73200) |
$1,773.60 |
$2,956 |
16.3× |
| CT head/brain with contrast (70460) |
$2,067.60 |
$3,446 |
11.4× |
| CT head/brain without and with contrast (70470) |
$2,471.40 |
$4,119 |
13.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$382.38 |
$637.30 |
4.2× |
| CT l-spine w/contrast (72132) |
$2,534.40 |
$4,224 |
7.0× |
| CT lower extremity w/dye (73701) |
$2,184 |
$3,640 |
12.0× |
| CT lumbar spine w/o contrast (72131) |
$2,272.20 |
$3,787 |
20.9× |
| CT neck w/contrast (70491) |
$2,287.20 |
$3,812 |
12.6× |
| CT neck w/o contrast (70490) |
$2,192.40 |
$3,654 |
20.2× |
| CT pelvis w & w/o contrast (72194) |
$2,709.84 |
$4,516.40 |
14.9× |
| CT pelvis w/o contrast (72192) |
$2,337.66 |
$3,896.10 |
21.5× |
| CT thoracic spine w/contrast (72129) |
$2,325.24 |
$3,875.40 |
12.8× |
| CT thoracic spine w/o contrast (72128) |
$2,290.80 |
$3,818 |
21.1× |
| CT thorax lung cancer scr c- (71271) |
$618 |
$1,030 |
5.7× |
| CT thorax w/o contrast (71250) |
$2,116.80 |
$3,528 |
19.5× |
| CT upper extremity w/dye (73201) |
$2,220 |
$3,700 |
6.1× |
| CTA head w contrast (70496) |
$2,575.20 |
$4,292 |
14.1× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$920.88 |
$1,534.80 |
2.5× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$510.54 |
$850.90 |
4.7× |
| Dxa bone density/peripheral (77081) |
$178.76 |
$297.92 |
2.0× |
| Fetal biophys profile w/o nst (76819) |
$550.20 |
$917 |
5.1× |
| Fetal biophysical profile non-stress testing (76818) |
$502.80 |
$838 |
4.6× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$643.80 |
$1,073 |
2.6× |
| Gated heart planar single (78472) |
$1,822.07 |
$3,036.77 |
4.4× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,464.56 |
$4,107.60 |
3.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,076.20 |
$5,127 |
0.9× |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Age Under… (75889) |
$5,611.20 |
$9,352 |
1.7× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$2,289.60 |
$3,816 |
4.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,028.90 |
$3,381.50 |
4.9× |
| Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid… (78808) |
$1,265.77 |
$2,109.61 |
3.0× |
| Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial… (77301) |
$6,336 |
$10,560 |
4.4× |
| Isodose teletherapy plan complex multi tx w/cal (77307) |
$1,687.20 |
$2,812 |
4.3× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,876.68 |
$3,127.80 |
3.3× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$1,249.80 |
$2,083 |
2.2× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,897.20 |
$3,162 |
3.4× |
| Liver and spleen imaging (78215) |
$1,254.30 |
$2,090.50 |
3.0× |
| Lung perf&ventilat diferentl (78598) |
$2,847.66 |
$4,746.10 |
5.1× |
| Lung perfusion imaging (78580) |
$1,371.60 |
$2,286 |
3.3× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$2,866.80 |
$4,778 |
7.9× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$3,038.04 |
$5,063.40 |
8.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$2,344.80 |
$3,908 |
9.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$3,579 |
$5,965 |
9.9× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$2,653.20 |
$4,422 |
10.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$2,565.71 |
$4,276.17 |
7.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,579 |
$5,965 |
9.9× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$3,558 |
$5,930 |
9.8× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$4,160.40 |
$6,934 |
11.5× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$4,942.20 |
$8,237 |
13.6× |
| Mandible min 4v (70110) |
$465.54 |
$775.90 |
4.3× |
| MRA head w/o contrast (70544) |
$3,361.80 |
$5,603 |
13.6× |
| MRA neck w/o contrast (70547) |
$2,937 |
$4,895 |
11.9× |
| MRI abdomen w/contrast (74182) |
$2,886 |
$4,810 |
8.0× |
| MRI abdomen w/o contrast (74181) |
$2,610.60 |
$4,351 |
10.5× |
| MRI abdomen w/wo contrast (74183) |
$3,779.40 |
$6,299 |
10.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,683.80 |
$4,473 |
3.3× |
| MRI breast c- bilateral (77047) |
$2,293.98 |
$3,823.30 |
9.3× |
| MRI c-spine w&w/o cont (72156) |
$3,828.60 |
$6,381 |
10.6× |
| MRI cervical spine w/contrast (72142) |
$3,396.60 |
$5,661 |
9.4× |
| MRI chest w/o contrast (71550) |
$2,400 |
$4,000 |
9.7× |
| MRI chest w/wo contrast (71552) |
$4,395 |
$7,325 |
12.1× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,973.60 |
$4,956 |
8.2× |
| MRI joint upr extrem w/dye (73222) |
$2,550.60 |
$4,251 |
3.1× |
| MRI lumbar spine w/contrast (72149) |
$3,566.40 |
$5,944 |
9.8× |
| MRI lumbar spine w/wo contrast (72158) |
$4,009.20 |
$6,682 |
11.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,086.60 |
$6,811 |
11.3× |
| MRI pelvis w & w/o contrast (72197) |
$4,395 |
$7,325 |
12.1× |
| MRI pelvis w/contrast (72196) |
$3,496.26 |
$5,827.10 |
9.7× |
| MRI pelvis w/o contrast (72195) |
$3,263.40 |
$5,439 |
13.2× |
| MRI spectroscopy (76390) |
$2,689.80 |
$4,483 |
29.8× |
| MRI spine cervical w/o contrast (72141) |
$2,940 |
$4,900 |
11.9× |
| MRI t-spine w&w/o cont (72157) |
$3,972 |
$6,620 |
11.0× |
| MRI thoracic spine w/contrast (72147) |
$3,365.40 |
$5,609 |
9.3× |
| MRI thoracic spine w/o contrst (72146) |
$3,143.40 |
$5,239 |
12.7× |
| MRI tmj (70336) |
$2,978.64 |
$4,964.40 |
12.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,344.80 |
$3,908 |
9.5× |
| Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per… (77338) |
$2,319.60 |
$3,866 |
6.0× |
| Myocardial spect multiple studies (78452) |
$4,763.76 |
$7,939.60 |
3.5× |
| Nm bone 3 phase (78315) |
$2,030.40 |
$3,384 |
4.9× |
| Nm bone imaging whole body (78306) |
$1,818.60 |
$3,031 |
4.4× |
| Nm gastric emptying (78264) |
$1,895.28 |
$3,158.80 |
4.6× |
| Nm lymph system (78195) |
$1,906.14 |
$3,176.90 |
3.4× |
| Ob us limited fetus(s) (76815) |
$508.83 |
$848.05 |
4.7× |
| Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) Age Under 21 (76512) |
$502.80 |
$838 |
4.6× |
| Parathyroid planar imaging (78070) |
$1,405.74 |
$2,342.90 |
3.4× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,224.66 |
$2,041.10 |
3.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,989.80 |
$9,983 |
4.0× |
| PET imaging for CT attenuation whole body (78816) |
$6,912 |
$11,520 |
4.7× |
| Pulmonary ventilation & perfusion imaging (78582) |
$2,438.22 |
$4,063.70 |
4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,553.12 |
$2,588.53 |
2.7× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$78.60 |
$131 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$571.92 |
$953.20 |
5.3× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$628.32 |
$1,047.20 |
5.8× |
| Radex hip unilateral with pelvis 1 view (73501) |
$276.60 |
$461 |
3.1× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$315.60 |
$526 |
3.5× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$411.66 |
$686.10 |
3.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$336 |
$560 |
3.1× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$514.80 |
$858 |
4.7× |
| Radex spine cervical 2 or 3 views (72040) |
$347.76 |
$579.60 |
3.8× |
| Radex spine cervical 4 or 5 views (72050) |
$441.36 |
$735.60 |
4.1× |
| Radex spine cervical 6 or more views (72052) |
$612.54 |
$1,020.90 |
5.6× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$345 |
$575 |
3.8× |
| Radiation tx delivery lvl 1 (77402) |
$649.56 |
$1,082.60 |
6.1× |
| Radiation tx delivery lvl 2 (77407) |
$2,293.98 |
$3,823.30 |
5.7× |
| Radiation tx delivery lvl 3 (77412) |
$1,144.20 |
$1,907 |
2.0× |
| Radiologic exam chest 3 views (71047) |
$400.62 |
$667.70 |
4.4× |
| Radiologic exam colon double contrast study (74280) |
$1,042.56 |
$1,737.60 |
5.7× |
| Radiologic exam colon single contrast study (74270) |
$807.60 |
$1,346 |
4.4× |
| Radiologic exam esophagus single contrast study (74220) |
$731.40 |
$1,219 |
4.0× |
| Radiologic exam small int single contrast study (74250) |
$716.46 |
$1,194.10 |
3.9× |
| Radiologic exam swallow function contrast study (74230) |
$610.20 |
$1,017 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$833.64 |
$1,389.40 |
4.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$702 |
$1,170 |
3.9× |
| Radiologic examination femur 1 view (73551) |
$255.72 |
$426.20 |
2.8× |
| Radiologic examination femur minimum 2 views (73552) |
$307.80 |
$513 |
3.4× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$298.80 |
$498 |
3.3× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$351.18 |
$585.30 |
3.9× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$558.18 |
$930.30 |
5.1× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$315.36 |
$525.60 |
3.5× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$371.16 |
$618.60 |
4.1× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$348.24 |
$580.40 |
3.9× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$350.40 |
$584 |
3.9× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$362.46 |
$604.10 |
4.0× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$306.54 |
$510.90 |
3.4× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$333.72 |
$556.20 |
3.7× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$614.46 |
$1,024.10 |
5.7× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$510.84 |
$851.40 |
4.7× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$271.20 |
$452 |
2.5× |
| Radiologic examination, single plane body section (eg, tomography), other than with urography Age Under 21 (76100) |
$549.18 |
$915.30 |
5.1× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$287.04 |
$478.40 |
3.2× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$343.80 |
$573 |
3.2× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$416.04 |
$693.40 |
3.8× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$476.34 |
$793.90 |
4.4× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$654 |
$1,090 |
6.0× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$314.25 |
$523.75 |
2.9× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$364.62 |
$607.70 |
4.0× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$336.66 |
$561.10 |
3.7× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$336.84 |
$561.40 |
3.7× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$187.62 |
$312.70 |
2.1× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$455.88 |
$759.80 |
4.2× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$259.74 |
$432.90 |
2.9× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$302.10 |
$503.50 |
3.3× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$71.37 |
$118.95 |
0.7× |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) |
$2,121.60 |
$3,536 |
3.8× |
| Radiopharmaceutical therapy, by intravenous administration Age Under 21 (79101) |
$706.01 |
$1,176.68 |
2.9× |
| Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) |
$1,879.74 |
$3,132.90 |
7.8× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$1,083 |
$1,805 |
4.4× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) |
$3,665.82 |
$6,109.70 |
6.5× |
| Scapula complete (73010) |
$336.66 |
$561.10 |
3.1× |
| Screening digital breast tomosynthesis bi (77063) |
$176.82 |
$294.70 |
— |
| Special dosimetry (77331) |
$832.20 |
$1,387 |
6.0× |
| Special physics consult (77370) |
$859.80 |
$1,433 |
6.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,370.60 |
$3,951 |
6.1× |
| Thyroid imaging with vascular flow (78013) |
$691.56 |
$1,152.60 |
1.7× |
| Thyroid met imaging body (78018) |
$1,908 |
$3,180 |
3.4× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$1,321.50 |
$2,202.50 |
3.2× |
| Tr simulation simple (77280) |
$1,311 |
$2,185 |
9.4× |
| Treatment device complex (77334) |
$1,416.60 |
$2,361 |
3.6× |
| Treatment device simple (77332) |
$660.60 |
$1,101 |
4.7× |
| Ultrasound, abdomen limited (76705) |
$574.50 |
$957.50 |
5.3× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$381.42 |
$635.70 |
3.5× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$820.68 |
$1,367.80 |
7.6× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$564.12 |
$940.20 |
5.2× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$728.40 |
$1,214 |
6.7× |
| Umbilical-artery Doppler (OB) (76820) |
$282.90 |
$471.50 |
2.6× |
| Unlisted magnetic resonance procedure (eg, diagnostic, interventional) Age Under 21 (76498) |
$3,996.84 |
$6,661.38 |
44.2× |
| Urography antegrade rs&i (74425) |
$1,070.28 |
$1,783.80 |
3.0× |
| Us abdominal aorta real time screen study aaa (76706) |
$550.32 |
$917.20 |
5.1× |
| Us breast uni real time with image complete (76641) |
$670.92 |
$1,118.20 |
6.2× |
| Us chest (76604) |
$630 |
$1,050 |
5.8× |
| Us compl joint r-t w/image documentation (76881) |
$799.20 |
$1,332 |
7.4× |
| Us encephalogram (76506) |
$500.58 |
$834.30 |
4.6× |
| Us exam, pelvic, limited (76857) |
$488.62 |
$814.36 |
4.5× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$389.88 |
$649.80 |
4.3× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$422.64 |
$704.40 |
4.7× |
| US OB Follow-Up/Repeat (76816) |
$431.52 |
$719.20 |
4.0× |
| Us ob transvaginal (76817) |
$519.60 |
$866 |
4.8× |
| Us retroperitoneal complete (76770) |
$858.36 |
$1,430.60 |
7.9× |
| Us retroperitoneal ltd (76775) |
$549.96 |
$916.60 |
5.1× |
| Us scrotum (76870) |
$666 |
$1,110 |
6.1× |
| Us soft tissue head/neck (76536) |
$667.74 |
$1,112.90 |
6.2× |
| Us spinal canal (76800) |
$655.44 |
$1,092.40 |
6.0× |
| Venography renal unilateral selective rs&i (75831) |
$3,945.84 |
$6,576.40 |
1.2× |
| Venography, caval, inferior, with serialography, radiological supervision and interpretation Age Under 21 (75825) |
$3,945.84 |
$6,576.40 |
1.2× |
| Venography, caval, superior, with serialography, radiological supervision and interpretation Age Under 21 (75827) |
$2,514.60 |
$4,191 |
1.5× |
| Venography, extremity, bilateral, radiological supervision and interpretation Age Under 21 (75822) |
$2,364.36 |
$3,940.60 |
1.4× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$1,879.20 |
$3,132 |
1.1× |
| X-ray exam hips bi 3-4 views (73522) |
$466.20 |
$777 |
4.3× |
| X-ray exam of finger(s) (73140) |
$271.62 |
$452.70 |
3.0× |
| X-ray exam of knee 1 or 2 (73560) |
$320.70 |
$534.50 |
3.5× |
| X-ray exam ribs bil 3 views (71110) |
$453.12 |
$755.20 |
4.2× |
| X-ray exam ribs uni 2 views (71100) |
$432.30 |
$720.50 |
4.8× |
| X-ray heel (73650) |
$337.86 |
$563.10 |
3.7× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$405.78 |
$676.30 |
3.7× |
| X-ray retrograde pyelogram (74420) |
$978.50 |
$1,630.82 |
2.7× |
| Xr abdomen 1 view (74018) |
$307.92 |
$513.20 |
3.4× |
| Xr abdomen 2 views (74019) |
$388.20 |
$647 |
3.6× |
| Xr bone age studies (77072) |
$196.44 |
$327.40 |
1.8× |
| Xr bone length study (77073) |
$343.08 |
$571.80 |
3.2× |
| Xr bone survey infant (77076) |
$279.30 |
$465.50 |
2.6× |
| Xr chest 1 view (71045) |
$192 |
$320 |
2.1× |
| Xr chest 2 views (71046) |
$306 |
$510 |
3.4× |
| Xr eye foreign body (70030) |
$255 |
$425 |
2.8× |
| Xr facial bones 3+ views (70150) |
$461.52 |
$769.20 |
4.3× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$299.34 |
$498.90 |
3.3× |
| Xr forearm 2 views (73090) |
$335.64 |
$559.40 |
3.7× |
| Xr hand 2v (73120) |
$291 |
$485 |
2.7× |
| Xr hysterosalpingogram (74740) |
$696.78 |
$1,161.30 |
2.8× |
| Xr neck soft tissue (70360) |
$324.48 |
$540.80 |
3.6× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$382.98 |
$638.30 |
4.2× |
| Xr osseous survey complete (77075) |
$884.22 |
$1,473.70 |
8.1× |
| Xr pelvis 1-2 views (72170) |
$299.28 |
$498.80 |
2.8× |
| Xr pelvis min 3 view (72190) |
$425.58 |
$709.30 |
3.9× |
| Xr sacrum/coccyx 2+ views (72220) |
$346.68 |
$577.80 |
3.8× |
| Xr shoulder 1 view (73020) |
$293.76 |
$489.60 |
3.3× |
| Xr sinuses 3+ views (70220) |
$412.26 |
$687.10 |
4.6× |
| Xr skull min 4 view (70260) |
$551.40 |
$919 |
5.1× |
| Xr spine 1 view (72020) |
$321.36 |
$535.60 |
3.6× |
| Xr spine thoracic 3v (72072) |
$403.20 |
$672 |
3.7× |
| Xr sternum 2+ views (71120) |
$369.18 |
$615.30 |
4.1× |
| Xr surgical specimen (76098) |
$616.20 |
$1,027 |
1.1× |
| Xr t-spine 2 views (72070) |
$362.40 |
$604 |
3.3× |
| Xr tibia/fibula 2 views (73590) |
$347.04 |
$578.40 |
3.8× |
| Xr tmj bilateral (70330) |
$464.22 |
$773.70 |
5.1× |
| Xr wrist 2 views (73100) |
$314.52 |
$524.20 |
3.5× |