| Abdomen 2 views (74019) |
$93 |
$1,368.42 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$356 |
$3,325.05 |
1.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,818 |
$5,857.94 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$2,818 |
$13,428.40 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,818 |
$13,428.40 |
1.0× |
| Angiography internal mammary rs&i (75756) |
$2,818 |
$2,849.22 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,966 |
$8,156.49 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,818 |
$5,349.95 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,818 |
$7,281.87 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,966 |
$8,470.26 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,818 |
$4,712.18 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,818 |
$13,594.20 |
1.0× |
| Ankle 2 views (73600) |
$77 |
$1,622.58 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$311 |
$1,758.55 |
1.0× |
| Aortogram thoracic (75605) |
$4,966 |
$23,151.10 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,818 |
$21,210.40 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$2,818 |
$13,428.40 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,818 |
$8,725.67 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$2,818 |
$4,234.33 |
1.0× |
| Arthrogram elbow (73085) |
$311 |
$2,744.04 |
1.0× |
| Arthrogram hip (73525) |
$311 |
$1,904.34 |
1.0× |
| Arthrogram shoulder (73040) |
$311 |
$4,555.76 |
1.0× |
| Arthrogram wrist (73115) |
$311 |
$3,018.40 |
1.0× |
| Arthrography knee lt (73580) |
$311 |
$1,963.21 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$119 |
$1,571.99 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$356 |
$1,737.55 |
1.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$356 |
$3,454.53 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$356 |
$4,093.52 |
1.0× |
| Bone age studies (77072) |
$93 |
$586.44 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$356 |
$4,984.85 |
1.0× |
| Bone Marrow Imaging Limited Area (78102) |
$356 |
$1,201.94 |
1.0× |
| Bone survey complete (77075) |
$93 |
$2,228.07 |
1.0× |
| Brain image w/flow 4 + views (78606) |
$484 |
$2,786.25 |
1.0× |
| Brain imaging < 4 static views (78600) |
$356 |
$2,400.79 |
1.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$356 |
$1,485.15 |
1.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$484 |
$1,879.57 |
1.0× |
| Brain Imaging Vascular Flow Only (78610) |
$484 |
$1,173.58 |
1.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$356 |
$2,300.75 |
1.0× |
| Cardiac shunt detection (78428) |
$356 |
$1,467.44 |
1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$484 |
$3,072.73 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$77 |
$1,181.14 |
1.0× |
| Chest 1 view (71045) |
$77 |
$900.46 |
1.0× |
| Chest 3 views (71047) |
$77 |
$985.24 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$156 |
$1,400.95 |
1.0× |
| Cineradiography/videoradiography (76120) |
$93 |
$590.11 |
1.0× |
| Clavicle complete (73000) |
$77 |
$2,203.58 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$93 |
$463.15 |
1.0× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$156 |
$580 |
1.0× |
| Corpora cavernosography (74445) |
$93 |
$1,278.29 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$311 |
$15,903.30 |
1.0× |
| CT abdomen and pelvis without contrast (74176) |
$212 |
$11,727.30 |
1.0× |
| CT abdomen w contrast (74160) |
$156 |
$6,234.04 |
1.0× |
| CT abdomen w wo contrast (74170) |
$156 |
$5,920.61 |
1.0× |
| CT abdomen w/o contrast (74150) |
$93 |
$5,482.54 |
1.0× |
| CT angio hrt w/3d image (75574) |
$311 |
$3,483.14 |
1.0× |
| CT angiography upper extremity lt (73206) |
$156 |
$5,121.82 |
1.0× |
| CT c-spine w/o contrast (72125) |
$93 |
$7,133.97 |
1.0× |
| CT cervical spine w&w/o contrast (72127) |
$156 |
$9,314.24 |
1.0× |
| CT cervical spine with contrast (72126) |
$311 |
$9,164.53 |
1.0× |
| CT chest w/wo contrast (71270) |
$156 |
$6,262.05 |
1.0× |
| CT chest with contrast (71260) |
$156 |
$6,433.38 |
1.0× |
| CT colonography screening (74263) |
$212 |
$2,043 |
1.0× |
| CT colonography w/o cntrst (74261) |
$93 |
$1,972 |
1.0× |
| CT head/brain with contrast (70460) |
$156 |
$4,180.02 |
1.0× |
| CT head/brain without and with contrast (70470) |
$156 |
$6,471.40 |
1.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$311 |
$2,490.95 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$77 |
$1,983.77 |
1.0× |
| CT hrt w/3d image congen (75573) |
$311 |
$2,670.25 |
1.0× |
| CT iac w contrast (70481) |
$156 |
$8,917.38 |
1.0× |
| CT limited/localized follow up study (76380) |
$77 |
$1,605.29 |
1.0× |
| CT lower ext w/o (73700) |
$93 |
$6,817.13 |
1.0× |
| CT lower extremity w wo contrast (73702) |
$156 |
$9,191.11 |
1.0× |
| CT lower extremity with contrast (73701) |
$156 |
$6,924.94 |
1.0× |
| CT lumbar spine w & w/o contrast (72133) |
$156 |
$11,123.30 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$93 |
$8,702.42 |
1.0× |
| CT lumbar spine with contrast (72132) |
$311 |
$7,921.51 |
1.0× |
| CT maxillofacial w contrast (70487) |
$156 |
$6,363.60 |
1.0× |
| CT maxillofacial w/o contrast (70486) |
$93 |
$6,542.05 |
1.0× |
| CT maxillofacial w/wo contrast (70488) |
$156 |
$7,500.96 |
1.0× |
| CT neck soft tissue w contrast (70491) |
$156 |
$7,194.77 |
1.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$156 |
$10,198.40 |
1.0× |
| CT orbits w/o contrast (70480) |
$93 |
$8,639.11 |
1.0× |
| CT pelvis w & w/o contrast (72194) |
$156 |
$6,673.34 |
1.0× |
| CT pelvis w/o contrast (72192) |
$93 |
$5,534.57 |
1.0× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$77 |
$581.02 |
1.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$156 |
$7,455.50 |
1.0× |
| CT soft tissue neck w/o contrast (70490) |
$93 |
$6,058.06 |
1.0× |
| CT thoracic spine w/contrast (72129) |
$156 |
$7,025.73 |
1.0× |
| CT thoracic spine w/o contrast (72128) |
$93 |
$5,648.98 |
1.0× |
| CT thoracic spine w/wo contrast (72130) |
$156 |
$11,120 |
1.0× |
| CT thorax w/o contrast (71250) |
$93 |
$5,534.57 |
1.0× |
| CT unlisted procedure (76497) |
$77 |
$6,249.55 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$156 |
$12,951.80 |
1.0× |
| CT upper extremity w/o contrast rt (73200) |
$93 |
$8,758 |
1.0× |
| CT upper extremity with contrast (73201) |
$311 |
$8,896.45 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$156 |
$7,723.06 |
1.0× |
| Cta Abdomen (74175) |
$156 |
$6,235.24 |
1.0× |
| CTA abdomen pelvis (74174) |
$311 |
$6,262.05 |
1.0× |
| CTA chest (71275) |
$156 |
$11,881.40 |
1.0× |
| Cta Head (70496) |
$156 |
$7,068.39 |
1.0× |
| CTA lwr ext w&w/o contrast (73706) |
$156 |
$5,121.82 |
1.0× |
| Cta Neck (70498) |
$156 |
$7,625.23 |
1.0× |
| Cta Pelvis (72191) |
$156 |
$6,952.19 |
1.0× |
| Cystography minimum 3 views rs&i (74430) |
$311 |
$1,064.70 |
1.0× |
| Diskogram cervical (72285) |
$1,742 |
$2,799.16 |
1.0× |
| Diskography lumbar (72295) |
$1,742 |
$4,513.33 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$93 |
$572.17 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$93 |
$759.71 |
1.0× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$93 |
$539 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$93 |
$1,233.71 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$77 |
$912 |
1.0× |
| Dxa bone density study axial skeleton (77085) |
$93 |
$665.14 |
1.0× |
| Echo exam of eye (76529) |
$77 |
$443 |
1.0× |
| Esophageal motility (78258) |
$356 |
$1,235 |
1.0× |
| Esophagus (74220) |
$156 |
$1,276.78 |
1.0× |
| Fetal biophysical profile non-stress testing (76818) |
$93 |
$1,603.08 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$93 |
$943.95 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$212 |
$1,060.41 |
1.0× |
| Foot 2 views (73620) |
$77 |
$1,819.79 |
1.0× |
| Forearm 2 views (73090) |
$77 |
$2,667.75 |
1.0× |
| Gastric mucosa imaging (78261) |
$356 |
$1,618.37 |
1.0× |
| Gastrointestinal Protein Loss (78282) |
$356 |
$6,267.75 |
1.0× |
| Gated Heart Planar Single (78472) |
$356 |
$2,816.50 |
1.0× |
| Hand 2 views (73120) |
$93 |
$1,819.79 |
1.0× |
| Hand 3 views (73130) |
$77 |
$2,528.53 |
1.0× |
| Heart Infarct Image (78466) |
$356 |
$5,463.87 |
1.0× |
| Heart infarct image w ef (78468) |
$484 |
$2,614.92 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,818 |
$4,308.07 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$484 |
$6,097.70 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$356 |
$4,802.98 |
1.0× |
| Ht muscle image spect sing (78451) |
$1,155 |
$5,923.68 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$77 |
$1,582.46 |
1.0× |
| Hysterosalpingogram (74740) |
$212 |
$2,234.10 |
1.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$93 |
$665.14 |
1.0× |
| Kidney funcj study non-img radioisotopic study (78725) |
$356 |
$1,252 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$484 |
$2,194.80 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$484 |
$2,797.55 |
1.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$484 |
$2,443 |
1.0× |
| Knee 3 views (73562) |
$77 |
$3,606.89 |
1.0× |
| Liver & spleen imaging static only (78215) |
$356 |
$2,149.44 |
1.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$356 |
$3,454.53 |
1.0× |
| Liver imaging static only (78201) |
$484 |
$1,502.31 |
1.0× |
| Liver imaging w/vascular flow (78202) |
$484 |
$1,751.88 |
1.0× |
| Lung perf&ventilat diferentl (78598) |
$484 |
$4,901.11 |
1.0× |
| Lung perfusion differential (78597) |
$356 |
$1,996.65 |
1.0× |
| Lung Ventilation Imaging (78579) |
$356 |
$2,180.01 |
1.0× |
| Lymphoscintigraphy (78195) |
$484 |
$3,916.64 |
1.0× |
| Mammary ductogram or galactogram multiple (77054) |
$212 |
$998 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$212 |
$1,685.15 |
1.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$77 |
$422.04 |
1.0× |
| Meckels Diverticulum (78290) |
$356 |
$1,827.27 |
1.0× |
| MRA head w & w/o contrast (70546) |
$311 |
$10,901.40 |
1.0× |
| MRA head w/o contrast (70544) |
$212 |
$6,732.97 |
1.0× |
| MRA head with contrast (70545) |
$311 |
$7,460.09 |
1.0× |
| MRA neck w contrast (70548) |
$311 |
$8,464.28 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$311 |
$10,824.30 |
1.0× |
| MRA neck w/o contrast (70547) |
$212 |
$6,634.07 |
1.0× |
| MRI abdomen w contrast (74182) |
$311 |
$10,259 |
1.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$311 |
$10,958.10 |
1.0× |
| MRI abdomen w/o contrast (74181) |
$212 |
$9,050.70 |
1.0× |
| MRI any jnt lwr ext with con lt (73722) |
$699 |
$19,569.30 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$699 |
$21,027.90 |
1.0× |
| MRI bone marrow blood supply (77084) |
$212 |
$3,230.91 |
1.0× |
| MRI breast w/o contrast bilateral (77047) |
$212 |
$2,721.10 |
1.0× |
| MRI breast w/o contrast unilat (77046) |
$212 |
$2,721.10 |
1.0× |
| MRI c-spine with contrast (72142) |
$311 |
$10,591.90 |
1.0× |
| MRI cardiac w/o contrast (75557) |
$212 |
$3,217.75 |
1.0× |
| MRI cervical spine w/o contrast (72141) |
$212 |
$12,414.80 |
1.0× |
| MRI chest w/o & w/contrast material (71552) |
$311 |
$9,479.57 |
1.0× |
| MRI chest w/o contrast (71550) |
$212 |
$6,746.86 |
1.0× |
| MRI chest with contrast (71551) |
$699 |
$8,552.33 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$311 |
$20,290.40 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$311 |
$19,817.60 |
1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$212 |
$18,860.20 |
1.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$212 |
$9,887.32 |
1.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$311 |
$13,440 |
1.0× |
| MRI orbit/face/neck w/contrast (70542) |
$311 |
$13,104.90 |
1.0× |
| MRI pelvis w contrast (72196) |
$311 |
$12,043.10 |
1.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$311 |
$13,641.80 |
1.0× |
| MRI pelvis w/o contrast (72195) |
$212 |
$10,388.60 |
1.0× |
| MRI scan of arm joint before and after contrast (73223) |
$311 |
$22,870.80 |
1.0× |
| MRI scan of leg joint before and after contrast (73723) |
$311 |
$20,791.60 |
1.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$311 |
$13,813.30 |
1.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$311 |
$11,158.10 |
1.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$311 |
$15,207.20 |
1.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$311 |
$9,789.08 |
1.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$311 |
$13,099 |
1.0× |
| MRI thoracic spine w/o contrast (72146) |
$212 |
$10,731.80 |
1.0× |
| MRI tmj (70336) |
$212 |
$4,791.88 |
1.0× |
| MRI upper ext joint w/o contrast (73221) |
$212 |
$20,791.60 |
1.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$311 |
$22,496.80 |
1.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$212 |
$14,993.90 |
1.0× |
| Myelogram Cervical (72240) |
$699 |
$3,339.65 |
1.0× |
| Myelogram Lumbar (72265) |
$699 |
$4,675.51 |
1.0× |
| Myelogram thoracic (72255) |
$699 |
$1,964 |
1.0× |
| Myelography 2 or more regions (72270) |
$699 |
$4,675.51 |
1.0× |
| Myocardial infarct spect (78469) |
$484 |
$1,521.18 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,155 |
$6,514.83 |
1.0× |
| Neck soft tissue (70360) |
$77 |
$625.25 |
1.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$344 |
$1,111.39 |
1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$356 |
$2,866.39 |
1.0× |
| Nm bone marrow multiple (78103) |
$356 |
$1,288.63 |
1.0× |
| Nm bone marrow wb (78104) |
$356 |
$1,866.58 |
1.0× |
| Nm cisternogram (78630) |
$484 |
$2,710.67 |
1.0× |
| Nm csf leak detection (78650) |
$1,155 |
$2,793.40 |
1.0× |
| Nm gastric emptying study (78264) |
$356 |
$3,459.34 |
1.0× |
| Nm gastroesophageal reflux study (78262) |
$356 |
$1,709.73 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$356 |
$3,072.73 |
1.0× |
| Nuclear medicine of heart pumping function (78473) |
$356 |
$2,494.92 |
1.0× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$1,276 |
$6,660.27 |
1.0× |
| Nuclear medicine study of kidney and blood flow (78701) |
$356 |
$1,667.30 |
1.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$356 |
$1,226 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$356 |
$1,756.56 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$484 |
$785.63 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$208 |
$2,390 |
1.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$93 |
$660.91 |
1.0× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$93 |
$366.78 |
1.0× |
| Osseous survey infant (77076) |
$93 |
$713.46 |
1.0× |
| Osseous survey limited (77074) |
$93 |
$1,919.51 |
1.0× |
| Parathyrd planar w/spect&CT (78072) |
$484 |
$2,746.67 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$356 |
$2,077.87 |
1.0× |
| Parathyroid imaging (78070) |
$356 |
$6,507.27 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$93 |
$752.35 |
1.0× |
| Peritoneogram rs&i (74190) |
$487 |
$1,055.13 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$1,276 |
$21,270 |
1.0× |
| PET imaging CT for attenuation limited area (78814) |
$1,276 |
$6,558.11 |
1.0× |
| PET imaging for CT attenuation whole body (78816) |
$1,276 |
$21,270 |
1.0× |
| PET imaging limited area chest head/neck (78811) |
$1,155 |
$5,714.24 |
1.0× |
| PET whole body (78813) |
$1,276 |
$3,855.51 |
1.0× |
| Pr csf ventriculography (78635) |
$484 |
$3,900.75 |
1.0× |
| Pr gi endoscopic ultrasound (76975) |
$212 |
$888.09 |
1.0× |
| Pr heart first pass single,planar (78481) |
$484 |
$2,114.58 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$311 |
$21,118.20 |
1.0× |
| Pr sono bone density measure,peripheral (76977) |
$93 |
$366.59 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$356 |
$2,082.89 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$484 |
$5,023.64 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$487 |
$1,055.13 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$77 |
$425.60 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$93 |
$722.45 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$93 |
$3,622.25 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$93 |
$885.50 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$93 |
$1,343.79 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$93 |
$1,017.83 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$77 |
$521.50 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$93 |
$576.61 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$77 |
$1,022.52 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$156 |
$1,954.10 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$156 |
$1,237.93 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$156 |
$1,886.17 |
1.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$77 |
$934.80 |
1.0× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$77 |
$266.10 |
1.0× |
| Radiological examination surgical specimen (76098) |
$487 |
$3,780.18 |
1.0× |
| Radiopharm Dacryocystography (78660) |
$356 |
$997.95 |
1.0× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$208 |
$1,873.67 |
1.0× |
| Radiopharmaceutical therapy, unlisted procedure UNSCHEDULED (79999) |
$208 |
$749.94 |
1.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,818 |
$5,203.27 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,818 |
$4,819.53 |
1.0× |
| Ribs bilateral 3 views (71110) |
$93 |
$1,080.27 |
1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$356 |
$2,736 |
1.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$484 |
$5,982.10 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$484 |
$5,237.29 |
1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$208 |
$5,185.74 |
1.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$208 |
$1,455 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$208 |
$1,455.50 |
1.0× |
| Sacroiliac Joints < 3 Views (72200) |
$93 |
$463.15 |
1.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$212 |
$1,064.07 |
1.0× |
| Salivary gland function study (78232) |
$356 |
$1,618.37 |
1.0× |
| Scanogram (77073) |
$93 |
$1,104.33 |
1.0× |
| Scapula complete (73010) |
$93 |
$1,469 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$20 |
$143.44 |
0.9× |
| Sella turcica (70240) |
$77 |
$260 |
1.0× |
| Sialogram (70390) |
$212 |
$1,950 |
1.0× |
| Small bowel series (74250) |
$156 |
$2,020.83 |
1.0× |
| Spec medical radj physics consltj (77370) |
$119 |
$1,192.92 |
1.0× |
| Special treatment procedure (77470) |
$493 |
$2,977.33 |
1.0× |
| Speech evaluation complex (70371) |
$212 |
$1,248.69 |
1.0× |
| Spine thoracic 3 views (72072) |
$93 |
$1,930.81 |
1.0× |
| Spleen imaging only (78185) |
$356 |
$1,122.99 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$2,818 |
$2,683.25 |
1.0× |
| Testicular Imaging With Vascular Flow (78761) |
$356 |
$1,735.83 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$119 |
$1,218 |
1.0× |
| Therapeutic Enema (74283) |
$156 |
$1,381.42 |
1.0× |
| Thoracolumbar 2 views (72080) |
$77 |
$710 |
1.0× |
| Thyroid carcinoma metastases img addl study (78016) |
$356 |
$1,233.73 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$484 |
$3,821.11 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$356 |
$1,908.50 |
1.0× |
| Thyroid uptake measurement (78012) |
$356 |
$3,916.64 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$356 |
$1,737.55 |
1.0× |
| Tmj unilateral (70328) |
$77 |
$374.24 |
1.0× |
| Tomogram (76100) |
$93 |
$1,564.72 |
1.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$484 |
$5,943.70 |
1.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$356 |
$3,081.72 |
1.0× |
| Ultrasound elastography first target lesion (76982) |
$93 |
$555.95 |
1.0× |
| Ultrasound scan of cornea to determine thickness (76514) |
$25 |
$204.68 |
1.0× |
| Ultrasound scan to determine eye length and lens power (76519) |
$93 |
$563.34 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$93 |
$1,292.37 |
1.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$77 |
$304 |
1.0× |
| Unlisted fluoroscopic procedure (76496) |
$77 |
$942.69 |
1.0× |
| Unlisted magnetic resonance procedure (76498) |
$77 |
$5,240.83 |
1.0× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$356 |
$997.95 |
1.0× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$356 |
$2,326.17 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$77 |
$2,630.38 |
1.0× |
| Upper Extremity Infant (73092) |
$93 |
$1,549.84 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$212 |
$1,650.56 |
1.0× |
| Urethrocystography voiding (74455) |
$212 |
$3,135.27 |
1.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$156 |
$1,691.82 |
1.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$156 |
$4,215.59 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$93 |
$555.95 |
1.0× |
| Us breast unilateral complete (76641) |
$93 |
$1,001.22 |
1.0× |
| Us breast unilateral limited (76642) |
$77 |
$986.82 |
1.0× |
| Us chest (76604) |
$93 |
$914.72 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$93 |
$1,195.86 |
1.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$93 |
$710.50 |
1.0× |
| Us guided compression repair (76936) |
$192 |
$2,690.50 |
1.0× |
| Us infant hips dynamic (76885) |
$77 |
$861.75 |
1.0× |
| Us infant hips limited static (76886) |
$77 |
$695.13 |
1.0× |
| Us kidney transplant (76776) |
$93 |
$1,104 |
1.0× |
| Us ob detailed single fetus (76811) |
$212 |
$2,215.01 |
1.0× |
| Us ob transvaginal (76817) |
$93 |
$2,324.02 |
1.0× |
| Us pelvic non ob complete (76856) |
$93 |
$3,724.37 |
1.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$93 |
$1,410.68 |
1.0× |
| Us pregnancy ltd (76815) |
$93 |
$2,229.52 |
1.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$93 |
$872.28 |
1.0× |
| Us retroperitoneal complete (76770) |
$93 |
$1,855.66 |
1.0× |
| Us retroperitoneal limited (76775) |
$93 |
$1,388.40 |
1.0× |
| Us scrotum and contents (76870) |
$93 |
$2,122.38 |
1.0× |
| Us soft tissue head/neck (76536) |
$93 |
$3,276.48 |
1.0× |
| Us spinal canal and contents (76800) |
$93 |
$792.73 |
1.0× |
| Us transrectal (76872) |
$93 |
$1,172.49 |
1.0× |
| Us transrectal prostate volume (76873) |
$93 |
$965 |
1.0× |
| Us xtr non-vasc lmtd (76882) |
$93 |
$896.90 |
1.0× |
| Vascular flow imaging (78445) |
$356 |
$1,079.09 |
1.0× |
| Vasogram (74440) |
$212 |
$3,528 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,404 |
$6,747.05 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$2,818 |
$5,787.95 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,404 |
$6,747.05 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,404 |
$2,790.42 |
1.0× |
| Venography Renal Bilateral (75833) |
$2,818 |
$4,603.45 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$2,818 |
$4,166.31 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,818 |
$13,594.20 |
1.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$4,966 |
$4,086.01 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$77 |
$420.62 |
1.0× |
| Wrist 2 views (73100) |
$77 |
$1,582.46 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$93 |
$1,457.91 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$77 |
$1,042.86 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$77 |
$1,877.78 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$156 |
$3,462.64 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$77 |
$1,851.87 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$77 |
$2,306.02 |
1.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$93 |
$1,343.79 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$77 |
$934.80 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$77 |
$997.12 |
1.0× |
| X-ray exam hip uni 4/> views (73503) |
$93 |
$704.83 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$93 |
$1,548.11 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$93 |
$2,951.54 |
1.0× |
| X-ray exam of femur 1 (73551) |
$77 |
$934.80 |
1.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$156 |
$3,349.68 |
1.0× |
| X-ray eye for foreign body (70030) |
$77 |
$260.10 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$93 |
$1,821.73 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$77 |
$847.71 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$77 |
$2,008.53 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,865 |
$1,691.49 |
1.0× |
| X-ray head for orthodontia (70350) |
$77 |
$415.59 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$77 |
$1,628.29 |
1.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$156 |
$1,123.65 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$77 |
$1,405.74 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$93 |
$4,043.85 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$77 |
$3,606.89 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$77 |
$1,648.92 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$93 |
$1,166.88 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$93 |
$1,813.90 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$93 |
$822 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$77 |
$1,438.17 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$77 |
$983.85 |
1.0× |
| X-ray of voice box or throat (70370) |
$77 |
$536.51 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$93 |
$1,780.27 |
1.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$93 |
$904.78 |
1.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$487 |
$1,097 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$311 |
$1,917.82 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$77 |
$1,458.32 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$93 |
$1,674.11 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$93 |
$2,156.67 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$93 |
$1,022.60 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$77 |
$863.98 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$77 |
$2,733.06 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$77 |
$1,446.05 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$77 |
$900.89 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$93 |
$2,149.44 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$93 |
$1,366.79 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$77 |
$670.61 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$77 |
$1,734.29 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$77 |
$1,560.24 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$93 |
$1,394.94 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$93 |
$1,796.76 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$77 |
$1,962.60 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$77 |
$3,149.54 |
1.0× |
| Xr arthrogram ankle (73615) |
$311 |
$2,370.55 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$93 |
$1,627.66 |
1.0× |
| Xr chest 4+ views (71048) |
$93 |
$2,379.34 |
1.0× |
| Xr Cholecystography Oral Contrast (74290) |
$156 |
$386.17 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$77 |
$2,556.45 |
1.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$93 |
$883.09 |
1.0× |
| Xr myelogram posterior fossa (70010) |
$311 |
$1,455 |
1.0× |
| Xr shoulder 1 view (73020) |
$77 |
$1,336.48 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$93 |
$1,889.68 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$77 |
$2,129.70 |
1.0× |
| Xr tmj bilateral (70330) |
$77 |
$1,792.34 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$77 |
$1,584.40 |
1.0× |