| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,832.20 |
$4,046 |
1.9× |
| Abdomen 2 views (74019) |
$595 |
$850 |
5.2× |
| Acute gi blood loss imaging (78278) |
$3,976 |
$5,680 |
9.1× |
| Angio Adrenal Bilat Select (75733) |
$2,578.80 |
$3,684 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,203.60 |
$3,148 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$2,203.60 |
$3,148 |
0.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,784.20 |
$5,406 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,203.60 |
$3,148 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,203.60 |
$3,148 |
0.6× |
| Angiography Spinal Selective Rs&I (75705) |
$3,784.20 |
$5,406 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,784.20 |
$5,406 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$13,219.50 |
$18,885 |
3.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,203.60 |
$3,148 |
0.6× |
| Ankle 2 views (73600) |
$557.20 |
$796 |
5.9× |
| Aortogram thoracic (75605) |
$3,784.20 |
$5,406 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,203.60 |
$3,148 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$2,203.60 |
$3,148 |
0.6× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$3,441.20 |
$4,916 |
1.0× |
| Arthrogram ankle (73615) |
$2,228.10 |
$3,183 |
5.8× |
| Arthrogram hip (73525) |
$2,220.40 |
$3,172 |
5.8× |
| Arthrogram shoulder (73040) |
$2,349.90 |
$3,357 |
6.2× |
| Arthrogram wrist (73115) |
$2,380.70 |
$3,401 |
6.2× |
| Basic dosimetry (77300) |
$917.70 |
$1,311 |
6.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,589.30 |
$3,699 |
5.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$3,106.60 |
$4,438 |
7.1× |
| Bone &/joint imaging whole body (78306) |
$3,344.60 |
$4,778 |
7.7× |
| Bone age studies (77072) |
$381.50 |
$545 |
3.3× |
| Bone Imaging 3 Phase (78315) |
$3,921.40 |
$5,602 |
9.0× |
| Bone survey complete (77075) |
$1,670.90 |
$2,387 |
14.6× |
| Bone survey infant (77076) |
$1,686.30 |
$2,409 |
14.8× |
| Bowel imaging (78290) |
$3,931.20 |
$5,616 |
9.0× |
| Brachytx isodose complex (77318) |
$3,388.70 |
$4,841 |
8.3× |
| Brachytx isodose intermed (77317) |
$2,504.60 |
$3,578 |
6.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$3,956.40 |
$5,652 |
6.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$6,126.40 |
$8,752 |
3.9× |
| Brain Imaging Vascular Flow Only (78610) |
$2,177 |
$3,110 |
3.7× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,405.20 |
$3,436 |
5.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,103.50 |
$3,005 |
5.5× |
| Cardiovasc nucl exam unlisted (78499) |
$1,687.70 |
$2,411 |
3.9× |
| Cervical spine 2 or 3 views (72040) |
$663.60 |
$948 |
7.0× |
| Chest 1 view (71045) |
$396.90 |
$567 |
4.2× |
| Chest xray 3 views (71047) |
$663.60 |
$948 |
7.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$2,212.70 |
$3,161 |
11.5× |
| Cineradiography/videoradiography (76120) |
$2,083.20 |
$2,976 |
18.2× |
| Clavicle complete (73000) |
$564.90 |
$807 |
5.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$597.80 |
$854 |
5.2× |
| Continuing medical physics consltj pr wk (77336) |
$997.50 |
$1,425 |
6.8× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$1,488.20 |
$2,126 |
7.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,670.90 |
$2,387 |
4.4× |
| CT abdomen and pelvis without contrast (74176) |
$703.50 |
$1,005 |
2.7× |
| CT abdomen w contrast (74160) |
$1,171.80 |
$1,674 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,328.60 |
$1,898 |
6.9× |
| CT abdomen w/o contrast (74150) |
$555.80 |
$794 |
4.9× |
| CT angio hrt w/3d image (75574) |
$1,449 |
$2,070 |
3.8× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,605.80 |
$2,294 |
8.4× |
| CT angiography upper extremity lt (73206) |
$1,460.20 |
$2,086 |
7.6× |
| CT c-spine w/contrast (72126) |
$765.80 |
$1,094 |
2.0× |
| CT c-spine w/o contrast (72125) |
$573.30 |
$819 |
5.0× |
| CT cervical spine w&w/o contrast (72127) |
$940.80 |
$1,344 |
4.9× |
| CT chest w contrast (71260) |
$770.70 |
$1,101 |
4.0× |
| CT chest w/wo contrast (71270) |
$942.90 |
$1,347 |
4.9× |
| CT head/brain with contrast (70460) |
$656.60 |
$938 |
3.4× |
| CT head/brain without and with contrast (70470) |
$781.90 |
$1,117 |
4.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,008 |
$1,440 |
2.6× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$501.90 |
$717 |
5.3× |
| CT hrt w/3d image congen (75573) |
$1,285.90 |
$1,837 |
3.4× |
| CT iac w contrast (70481) |
$873.60 |
$1,248 |
4.6× |
| CT limited/localized follow up study (76380) |
$591.50 |
$845 |
6.2× |
| CT lower ext w/o (73700) |
$571.20 |
$816 |
5.0× |
| CT lower extremity w wo contrast (73702) |
$949.90 |
$1,357 |
5.0× |
| CT lower extremity w/contrast material (73701) |
$770.70 |
$1,101 |
4.0× |
| CT lumbar spine w/contrast (72132) |
$770.70 |
$1,101 |
2.0× |
| CT lumbar spine w/o contrast (72131) |
$569.10 |
$813 |
5.0× |
| CT maxillofacial w contrast (70487) |
$681.10 |
$973 |
3.6× |
| CT maxillofacial w/wo contrast (70488) |
$855.40 |
$1,222 |
4.5× |
| CT maxillofacial wo contrast (70486) |
$602.70 |
$861 |
5.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,032.50 |
$1,475 |
5.4× |
| CT orbits w/o contrast (70480) |
$679 |
$970 |
5.9× |
| CT pelvis w/o contrast (72192) |
$564.20 |
$806 |
4.9× |
| CT pelvis w/wo contrast (72194) |
$1,323.70 |
$1,891 |
6.9× |
| CT scan of arm combo (73202) |
$1,297.10 |
$1,853 |
6.8× |
| CT soft tissue neck w contrast (70491) |
$819.70 |
$1,171 |
4.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$996.80 |
$1,424 |
5.2× |
| CT soft tissue neck w/o contrast (70490) |
$618.10 |
$883 |
5.4× |
| CT thoracic spine w/contrast (72129) |
$774.90 |
$1,107 |
4.0× |
| CT thoracic spine w/o contrast (72128) |
$571.20 |
$816 |
5.0× |
| CT thorax w/o contrast (71250) |
$567 |
$810 |
5.0× |
| CT unlisted procedure (76497) |
$369.60 |
$528 |
3.9× |
| CT upper ext wo (73200) |
$781.90 |
$1,117 |
6.8× |
| CT upper extremity with contrast (73201) |
$996.80 |
$1,424 |
2.6× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,053.80 |
$2,934 |
10.7× |
| Cta Abdomen (74175) |
$1,512 |
$2,160 |
7.9× |
| CTA abdomen pelvis (74174) |
$1,897 |
$2,710 |
5.0× |
| CTA chest (71275) |
$1,348.20 |
$1,926 |
7.0× |
| Cta Head (70496) |
$1,334.90 |
$1,907 |
7.0× |
| Cta Neck (70498) |
$1,332.80 |
$1,904 |
7.0× |
| Cta Pelvis (72191) |
$1,509.90 |
$2,157 |
7.9× |
| Cystography minimum 3 views rs&i (74430) |
$602.70 |
$861 |
1.6× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$1,808.10 |
$2,583 |
0.8× |
| Diskography lumbar (72295) |
$1,633.10 |
$2,333 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$485.80 |
$694 |
4.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$686.70 |
$981 |
6.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,352.40 |
$1,932 |
5.2× |
| Esophagus (74220) |
$1,549.10 |
$2,213 |
8.1× |
| Facial bones min 3 views (70150) |
$786.10 |
$1,123 |
6.9× |
| Fetal biophysical profile non-stress testing (76818) |
$815.50 |
$1,165 |
7.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$583.80 |
$834 |
5.1× |
| Fetal Echo (76825) |
$2,093 |
$2,990 |
3.5× |
| Fluoroscopy up to 1 hr (76000) |
$641.20 |
$916 |
2.5× |
| Foot 2 views (73620) |
$480.90 |
$687 |
5.1× |
| Forearm 2 views (73090) |
$496.30 |
$709 |
5.2× |
| Hand 2 views (73120) |
$534.10 |
$763 |
4.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,672.90 |
$5,247 |
4.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$6,122.90 |
$8,747 |
8.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$9,403.10 |
$13,433 |
12.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,203.60 |
$3,148 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,203.60 |
$3,148 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$5,183.50 |
$7,405 |
8.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$3,812.20 |
$5,446 |
8.7× |
| Hysterosalpingogram (74740) |
$1,655.50 |
$2,365 |
6.3× |
| Interstitial radiation source applic complex (77778) |
$7,012.60 |
$10,018 |
9.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$686.70 |
$981 |
6.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,515.10 |
$3,593 |
4.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,794.10 |
$2,563 |
3.0× |
| Knee 3 views (73562) |
$725.20 |
$1,036 |
7.6× |
| Liver & spleen imaging static only (78215) |
$2,340.80 |
$3,344 |
5.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,620.50 |
$2,315 |
3.7× |
| Liver imaging static only (78201) |
$2,311.40 |
$3,302 |
3.9× |
| Lung perf&ventilat diferentl (78598) |
$3,439.10 |
$4,913 |
5.8× |
| Lymphoscintigraphy (78195) |
$3,911.60 |
$5,588 |
6.6× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,055.20 |
$2,936 |
2.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,692.20 |
$3,846 |
7.1× |
| Mammary ductogram or galactogram single (77053) |
$839.30 |
$1,199 |
3.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,715.30 |
$3,879 |
6.6× |
| Mr safety determination physician/other qhp (76016) |
$431.20 |
$616 |
4.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$119.70 |
$171 |
3.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$450.10 |
$643 |
4.3× |
| Mr safety implt pos&/immoblj (76019) |
$291.20 |
$416 |
4.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$1,185.10 |
$1,693 |
4.5× |
| MRA head w & w/o contrast (70546) |
$2,284.80 |
$3,264 |
6.0× |
| MRA head w/o contrast (70544) |
$1,400.70 |
$2,001 |
5.4× |
| MRA head with contrast (70545) |
$1,507.10 |
$2,153 |
4.0× |
| MRA neck w contrast (70548) |
$1,547 |
$2,210 |
4.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,293.20 |
$3,276 |
6.0× |
| MRA neck w/o contrast (70547) |
$1,403.50 |
$2,005 |
5.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,058 |
$2,940 |
5.4× |
| MRI abdomen w/o contrast (74181) |
$1,119.30 |
$1,599 |
4.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,069.20 |
$2,956 |
2.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,473.80 |
$3,534 |
6.5× |
| MRI bone marrow blood supply (77084) |
$2,106.30 |
$3,009 |
8.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,262.80 |
$1,804 |
4.8× |
| MRI breast wo contrast unilateral (77046) |
$1,268.40 |
$1,812 |
4.9× |
| MRI c-spine with contrast (72142) |
$1,675.80 |
$2,394 |
4.4× |
| MRI cardiac w/o contrast (75557) |
$1,474.90 |
$2,107 |
5.7× |
| MRI cervical spine w/o contrast (72141) |
$1,064.70 |
$1,521 |
4.1× |
| MRI chest w/o & w/contrast material (71552) |
$3,177.30 |
$4,539 |
8.3× |
| MRI chest w/o contrast (71550) |
$2,333.10 |
$3,333 |
8.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,638.70 |
$2,341 |
4.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,066.40 |
$2,952 |
5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,397.90 |
$1,997 |
5.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,429.40 |
$2,042 |
5.5× |
| MRI orbit face neck w contrast (70542) |
$1,679.30 |
$2,399 |
4.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,086.70 |
$2,981 |
5.5× |
| MRI pelvis w/contrast (72196) |
$1,647.10 |
$2,353 |
4.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,046.10 |
$2,923 |
5.4× |
| MRI pelvis w/o contrast (72195) |
$1,400.70 |
$2,001 |
5.4× |
| MRI spectroscopy (76390) |
$793.10 |
$1,133 |
8.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,862.70 |
$2,661 |
4.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,635.90 |
$2,337 |
4.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,857.10 |
$2,653 |
4.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,659 |
$2,370 |
4.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,868.30 |
$2,669 |
4.9× |
| MRI temporomandibular joint (70336) |
$1,693.30 |
$2,419 |
6.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,067.50 |
$1,525 |
4.1× |
| MRI up ext w/o contrast (73218) |
$2,081.10 |
$2,973 |
8.0× |
| MRI upper ext joint w/o contrast (73221) |
$1,231.30 |
$1,759 |
4.7× |
| MRI, joint upper extrem combo (73223) |
$2,482.90 |
$3,547 |
6.5× |
| Myelogram Cervical (72240) |
$1,556.80 |
$2,224 |
1.8× |
| Myelogram Lumbar (72265) |
$1,564.50 |
$2,235 |
1.8× |
| Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including… (78433) |
$8,192.10 |
$11,703 |
3.4× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$9,452.10 |
$13,503 |
3.9× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$6,126.40 |
$8,752 |
3.9× |
| Myocardial Spect Multiple Studies (78452) |
$5,173.70 |
$7,391 |
3.7× |
| Myocardial spect single study at rest or stress (78451) |
$3,623.20 |
$5,176 |
2.6× |
| Neck soft tissue (70360) |
$518.70 |
$741 |
5.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$506.80 |
$724 |
1.2× |
| Nm cisternogram (78630) |
$4,025.70 |
$5,751 |
6.8× |
| Nm csf leak detection (78650) |
$3,255.70 |
$4,651 |
2.3× |
| Nm gastric emptying study (78264) |
$3,866.80 |
$5,524 |
8.8× |
| Nm kidney scan w/flow (78701) |
$2,718.80 |
$3,884 |
6.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$15,604.40 |
$22,292 |
10.3× |
| Nuclear Rx Oral Admin (79005) |
$770.70 |
$1,101 |
3.0× |
| Ob us nuchal meas 1 gest (76813) |
$681.80 |
$974 |
6.0× |
| Orthopantogram (70355) |
$205.80 |
$294 |
2.2× |
| Osseous survey limited (77074) |
$1,022.70 |
$1,461 |
8.9× |
| Parathyroid Planar Imaging (78070) |
$3,389.40 |
$4,842 |
7.8× |
| Pelvis 1 or 2 views (72170) |
$450.10 |
$643 |
3.9× |
| Peritoneogram after injection (74190) |
$2,303 |
$3,290 |
3.9× |
| PET image w/CT, skull-thigh (78815) |
$6,126.40 |
$8,752 |
3.9× |
| PET imaging CT for attenuation limited area (78814) |
$6,126.40 |
$8,752 |
3.9× |
| PET imaging for CT attenuation whole body (78816) |
$6,126.40 |
$8,752 |
3.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,203.60 |
$3,148 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,203.60 |
$3,148 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,664.20 |
$3,806 |
6.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,687.60 |
$5,268 |
6.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$808.50 |
$1,155 |
1.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$641.20 |
$916 |
6.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$473.20 |
$676 |
5.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$557.20 |
$796 |
5.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$702.10 |
$1,003 |
7.4× |
| Radex fingr minimum 2 views (73140) |
$725.20 |
$1,036 |
7.6× |
| Radex Foot Compl Minimum 3 Views (73630) |
$595 |
$850 |
6.3× |
| Radex Hand Minimum 3 Views (73130) |
$663.60 |
$948 |
7.0× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$557.20 |
$796 |
5.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$702.10 |
$1,003 |
6.1× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,075.90 |
$1,537 |
9.4× |
| Radex Humerus Minimum 2 Views (73060) |
$557.20 |
$796 |
5.9× |
| Radex Kne 1/2 Views (73560) |
$595 |
$850 |
6.3× |
| Radex Kne Compl 4/More Views (73564) |
$831.60 |
$1,188 |
7.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$725.20 |
$1,036 |
6.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$671.30 |
$959 |
7.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$686.70 |
$981 |
6.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$587.30 |
$839 |
6.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$549.50 |
$785 |
5.8× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$686.70 |
$981 |
6.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$954.10 |
$1,363 |
10.0× |
| Radex Toe Minimum 2 Views (73660) |
$518.70 |
$741 |
5.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$541.80 |
$774 |
4.7× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$755.30 |
$1,079 |
7.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$10,173.80 |
$14,534 |
1.3× |
| Radiation treatment delivery level 1 (77402) |
$459.90 |
$657 |
4.1× |
| Radiation treatment delivery level 2 (77407) |
$1,104.60 |
$1,578 |
2.6× |
| Radiation treatment delivery level 3 (77412) |
$1,104.60 |
$1,578 |
1.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$488.60 |
$698 |
5.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$686.70 |
$981 |
6.0× |
| Radiologic exam chest 2 views (71046) |
$534.10 |
$763 |
5.6× |
| Radiologic exam colon single contrast study (74270) |
$2,342.20 |
$3,346 |
12.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,717.10 |
$2,453 |
9.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$2,159.50 |
$3,085 |
11.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,892.10 |
$2,703 |
9.9× |
| Radiologic examination femur 1 view (73551) |
$496.30 |
$709 |
5.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$549.50 |
$785 |
5.8× |
| Radiological examination surgical specimen (76098) |
$641.20 |
$916 |
1.1× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$2,947 |
$4,210 |
6.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$3,140.90 |
$4,487 |
7.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$7,807.80 |
$11,154 |
13.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$3,553.90 |
$5,077 |
6.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$4,304.30 |
$6,149 |
7.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$8,180.90 |
$11,687 |
5.8× |
| Rp therapy intra-arterial particulate admn (79445) |
$941.50 |
$1,345 |
3.7× |
| Rp Therapy Intravenous Administration (79101) |
$800.10 |
$1,143 |
3.1× |
| Sacroiliac Joints < 3 Views (72200) |
$579.60 |
$828 |
5.1× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$940.80 |
$1,344 |
3.6× |
| Scapula (73010) |
$350.70 |
$501 |
3.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$121.10 |
$173 |
5.2× |
| Shoulder 1 view (73020) |
$328.30 |
$469 |
3.5× |
| Sialogram (70390) |
$2,174.90 |
$3,107 |
8.3× |
| Simulation intermediate (77285) |
$4,237.10 |
$6,053 |
10.4× |
| Small bowel series (74250) |
$1,876.70 |
$2,681 |
9.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$491.40 |
$702 |
1.2× |
| Special dosimetry (77331) |
$211.40 |
$302 |
1.4× |
| Special Physics Consult (77370) |
$1,638 |
$2,340 |
11.1× |
| Special treatment procedure (77470) |
$425.60 |
$608 |
0.7× |
| Spine thoracic 3 views (72072) |
$655.90 |
$937 |
5.7× |
| Stereotactic Body Radiation Delivery (77373) |
$10,683.40 |
$15,262 |
5.5× |
| Superior sagittal sinus venogram (75870) |
$2,388.40 |
$3,412 |
0.7× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$68.60 |
$98 |
0.7× |
| Tbs technical calculation only (77091) |
$625.80 |
$894 |
6.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,507.10 |
$2,153 |
3.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$830.20 |
$1,186 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,909.50 |
$5,585 |
9.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,515.10 |
$3,593 |
17.1× |
| Thoracolumbar 2 views (72080) |
$564.90 |
$807 |
5.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$3,593.10 |
$5,133 |
6.1× |
| Thyroid imaging w/blood flow (78013) |
$2,256.10 |
$3,223 |
5.2× |
| Thyroid uptake measurement (78012) |
$1,078.70 |
$1,541 |
2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,842.70 |
$4,061 |
6.5× |
| Treatment device complex (77334) |
$721 |
$1,030 |
1.8× |
| Treatment device intermediate (77333) |
$1,059.10 |
$1,513 |
7.2× |
| Treatment devices simple (77332) |
$917.70 |
$1,311 |
6.2× |
| Ultrasound breast complete (76641) |
$791.70 |
$1,131 |
6.9× |
| Ultrasound Exam Aaa Screen (76706) |
$952.70 |
$1,361 |
8.3× |
| Ultrasound, abdomen limited (76705) |
$693.70 |
$991 |
6.1× |
| Umbilical-artery Doppler (OB) (76820) |
$242.90 |
$347 |
2.1× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$369.60 |
$528 |
3.9× |
| Unlisted fluoroscopic procedure (76496) |
$369.60 |
$528 |
3.9× |
| Unlisted ultrasound procedure (76999) |
$369.60 |
$528 |
3.9× |
| Ureteral reflux study (78740) |
$2,718.80 |
$3,884 |
6.2× |
| Urethrocystogram voiding (74455) |
$1,968.40 |
$2,812 |
7.5× |
| Urethrocystography retrograde rs&i (74450) |
$1,015 |
$1,450 |
3.9× |
| Us breast unilateral limited (76642) |
$615.30 |
$879 |
6.5× |
| Us chest (76604) |
$364.70 |
$521 |
3.2× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$1,936.20 |
$2,766 |
8.2× |
| Us compl joint r-t w/image documentation (76881) |
$125.30 |
$179 |
1.1× |
| Us elastography parenchyma (76981) |
$909.30 |
$1,299 |
8.0× |
| Us encephalogram (76506) |
$933.10 |
$1,333 |
8.2× |
| Us hips infant static (76886) |
$819 |
$1,170 |
8.6× |
| Us infant hips w manipulation (76885) |
$1,168.30 |
$1,669 |
12.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$372.40 |
$532 |
3.3× |
| Us ob detailed single fetus (76811) |
$1,038.80 |
$1,484 |
4.0× |
| Us ob limited (76815) |
$588 |
$840 |
5.1× |
| Us ob transvaginal (76817) |
$662.20 |
$946 |
5.8× |
| Us pelvic non ob complete (76856) |
$850.50 |
$1,215 |
7.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$313.60 |
$448 |
2.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$819 |
$1,170 |
7.2× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$803.60 |
$1,148 |
7.0× |
| Us retroperitoneal complete (76770) |
$858.20 |
$1,226 |
7.5× |
| Us retroperitoneal limited (76775) |
$392 |
$560 |
3.4× |
| Us scrotum and contents (76870) |
$819 |
$1,170 |
7.2× |
| Us soft tissue head/neck (76536) |
$972.30 |
$1,389 |
8.5× |
| Us spinal canal and contents (76800) |
$1,387.40 |
$1,982 |
12.1× |
| Us, eye b-scan (76512) |
$207.90 |
$297 |
1.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,297.80 |
$1,854 |
11.4× |
| Venogram adrenal unilat (75840) |
$2,203.60 |
$3,148 |
0.6× |
| Venogram extremity bilateral (75822) |
$1,480.50 |
$2,115 |
0.9× |
| Venogram Extremity Unilateral (75820) |
$1,327.90 |
$1,897 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,203.60 |
$3,148 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,480.50 |
$2,115 |
0.9× |
| Venography Renal Bilateral (75833) |
$2,203.60 |
$3,148 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$2,203.60 |
$3,148 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,203.60 |
$3,148 |
0.6× |
| Venous sampling by catheter (75893) |
$3,784.20 |
$5,406 |
0.6× |
| Wrist 2 views (73100) |
$587.30 |
$839 |
6.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$793.80 |
$1,134 |
6.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$457.80 |
$654 |
4.8× |
| X-ray b.e. reductn intuss (74283) |
$3,654.70 |
$5,221 |
19.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$3,570.70 |
$5,101 |
18.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$488.60 |
$698 |
5.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$847 |
$1,210 |
8.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$915.60 |
$1,308 |
8.0× |
| X-ray exam of femur 2/> (73552) |
$618.10 |
$883 |
6.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$511 |
$730 |
5.4× |
| X-ray IV pyelogram (ivp) (74400) |
$2,510.20 |
$3,586 |
13.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$686.70 |
$981 |
7.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$725.20 |
$1,036 |
7.6× |
| X-ray leg, infant (73592) |
$541.80 |
$774 |
5.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$663.60 |
$948 |
5.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,068.20 |
$1,526 |
9.3× |
| X-ray nose-rectum child f.b. (76010) |
$473.20 |
$676 |
5.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$786.10 |
$1,123 |
6.9× |
| X-ray retrograde pyelogram (74420) |
$1,228.50 |
$1,755 |
3.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$595 |
$850 |
6.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$671.30 |
$959 |
5.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$847 |
$1,210 |
7.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$655.90 |
$937 |
5.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$557.20 |
$796 |
5.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$625.80 |
$894 |
6.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$717.50 |
$1,025 |
6.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$625.80 |
$894 |
5.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$381.50 |
$545 |
4.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$702.10 |
$1,003 |
7.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$549.50 |
$785 |
5.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$534.10 |
$763 |
4.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$755.30 |
$1,079 |
6.6× |
| Xr bone length studies (77073) |
$739.90 |
$1,057 |
6.5× |
| Xr c-spine 4 or 5 views (72050) |
$938.70 |
$1,341 |
8.2× |
| Xr c-spine 6 or more views (72052) |
$1,091.30 |
$1,559 |
9.5× |
| Xr chest 4+ views (71048) |
$709.80 |
$1,014 |
6.2× |
| Xr urogram antegrade (74425) |
$2,502.50 |
$3,575 |
6.6× |