| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,097.50 |
$10,195 |
3.4× |
| Abdomen 1 View (74018) |
$258 |
$516 |
2.8× |
| Abdomen 2 views (74019) |
$267 |
$534 |
2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$872.50 |
$1,745 |
2.0× |
| Angio internal mammary (75756) |
$2,461 |
$4,922 |
0.7× |
| Angio pulmonary bilat (75743) |
$2,544.50 |
$5,089 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$2,728 |
$5,456 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,461 |
$4,922 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,461 |
$4,922 |
0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,461 |
$4,922 |
0.7× |
| Ankle 2 views (73600) |
$180 |
$360 |
1.9× |
| Aortography thoracic serialography rs&i (75605) |
$4,226.50 |
$8,453 |
0.7× |
| Artery X-Rays Abdomen (75726) |
$4,226.50 |
$8,453 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$2,461 |
$4,922 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$4,226.50 |
$8,453 |
0.7× |
| Artery X-Rays Spine (75705) |
$4,226.50 |
$8,453 |
0.7× |
| Arthrogram hip (73525) |
$558.50 |
$1,117 |
1.5× |
| Arthrogram Wrist (73115) |
$379.50 |
$759 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$540 |
$1,080 |
3.7× |
| Bone age studies (77072) |
$312.50 |
$625 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,507.50 |
$3,015 |
3.5× |
| Bone Imaging Limited Area (78300) |
$653.50 |
$1,307 |
1.5× |
| Bone Imaging Whole Body (78306) |
$1,155 |
$2,310 |
2.7× |
| Bone marrow imaging limited area (78102) |
$665.50 |
$1,331 |
1.6× |
| Bone survey infant (77076) |
$206.50 |
$413 |
1.8× |
| Brachytx isodose intermed (77317) |
$1,017.50 |
$2,035 |
2.5× |
| Brachytx Isodose Plan Simple (77316) |
$747 |
$1,494 |
1.9× |
| Brain Image W/Flow < 4 Views (78601) |
$581 |
$1,162 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,159 |
$6,318 |
2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,067 |
$4,134 |
5.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,374.50 |
$4,749 |
2.8× |
| Cat Scan Follow-Up Study (76380) |
$537 |
$1,074 |
5.8× |
| Chest 1 view (71045) |
$198.50 |
$397 |
2.1× |
| Chest 2 views (71046) |
$283.50 |
$567 |
3.0× |
| Chest 3 views (71047) |
$293.50 |
$587 |
3.1× |
| Chest 4 or more views (71048) |
$373 |
$746 |
3.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$151 |
$302 |
1.3× |
| Clavicle complete (73000) |
$158.50 |
$317 |
1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,340.50 |
$2,681 |
12.0× |
| Continuing medical physics consltj pr wk (77336) |
$587.50 |
$1,175 |
4.1× |
| Contrast Exam Abdominl Aorta (75625) |
$2,461 |
$4,922 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$398 |
$796 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,081 |
$8,162 |
10.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,899.50 |
$5,799 |
11.3× |
| CT abdomen w contrast (74160) |
$1,374.50 |
$2,749 |
7.3× |
| CT abdomen w wo contrast (74170) |
$1,604.50 |
$3,209 |
8.5× |
| CT abdomen w/o contrast (74150) |
$1,032.50 |
$2,065 |
9.2× |
| CT Angio Abdomen and Pelvis (74174) |
$2,512 |
$5,024 |
6.7× |
| CT Angio Chest (71275) |
$1,682.50 |
$3,365 |
9.0× |
| CT Angio Head (70496) |
$1,523.50 |
$3,047 |
8.1× |
| CT angio hrt w/3d image (75574) |
$1,518 |
$3,036 |
4.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,682 |
$3,364 |
8.9× |
| CT Angio Neck (70498) |
$1,565.50 |
$3,131 |
8.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,668 |
$3,336 |
8.9× |
| CT cervical spine w/ contrast (72126) |
$1,403 |
$2,806 |
3.8× |
| CT cervical spine w/o contrast (72125) |
$1,224.50 |
$2,449 |
10.9× |
| CT cervical spine w/wo cont (72127) |
$1,566.50 |
$3,133 |
8.3× |
| CT chest w contrast (71260) |
$1,334 |
$2,668 |
7.1× |
| CT chest w/wo contrast (71270) |
$1,584 |
$3,168 |
8.4× |
| CT colonography screening (74263) |
$718 |
$1,436 |
2.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$624.50 |
$1,249 |
3.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$655.50 |
$1,311 |
5.9× |
| CT head/brain with contrast (70460) |
$1,242 |
$2,484 |
6.6× |
| CT head/brain without and with contrast (70470) |
$1,479.50 |
$2,959 |
7.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$927.50 |
$1,855 |
2.5× |
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines |
$24.50–$567.50 |
$49–$1,135 |
varies |
| CT hrt w/3d image congen (75573) |
$885 |
$1,770 |
2.4× |
| CT iac w contrast (70481) |
$1,280.50 |
$2,561 |
6.8× |
| CT l-spine w&w/o contrast (72133) |
$1,434 |
$2,868 |
7.6× |
| CT lower ext w/o (73700) |
$1,093.50 |
$2,187 |
9.8× |
| CT lower extremity w/contrast material (73701) |
$1,244.50 |
$2,489 |
6.6× |
| CT lumbar spine w contrast (72132) |
$1,333 |
$2,666 |
3.6× |
| CT lumbar spine w/o contrast (72131) |
$1,175.50 |
$2,351 |
10.5× |
| CT maxillofacial w contrast (70487) |
$1,101 |
$2,202 |
5.9× |
| CT maxillofacial wo contrast (70486) |
$991.50 |
$1,983 |
8.9× |
| CT neck tissue combo (70492) |
$1,487.50 |
$2,975 |
7.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,415.50 |
$2,831 |
7.5× |
| CT orbits w/o contrast (70480) |
$1,074 |
$2,148 |
9.6× |
| CT pelvis w&w/o contrast (72194) |
$1,827.50 |
$3,655 |
9.7× |
| CT pelvis w/o contrast (72192) |
$1,029 |
$2,058 |
9.2× |
| CT scan of leg combo (73702) |
$1,495 |
$2,990 |
8.0× |
| CT scans face/jaw combo (70488) |
$1,371 |
$2,742 |
7.3× |
| CT soft tissue neck w contrast (70491) |
$1,312.50 |
$2,625 |
7.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,150 |
$2,300 |
10.3× |
| CT thoracic spine w contrast (72129) |
$1,296 |
$2,592 |
6.9× |
| CT thoracic spine w/o contrast (72128) |
$1,088.50 |
$2,177 |
9.7× |
| CT thoracic spine w/wo cont (72130) |
$1,563.50 |
$3,127 |
8.3× |
| CT thorax w/o contrast (71250) |
$1,006 |
$2,012 |
9.0× |
| CT upper ext wo (73200) |
$969.50 |
$1,939 |
8.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,634.50 |
$3,269 |
8.7× |
| CT upper extremity with contrast (73201) |
$1,222 |
$2,444 |
3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,623.50 |
$3,247 |
8.6× |
| Cta Abdomen (74175) |
$2,159.50 |
$4,319 |
11.5× |
| CTA pelvis (72191) |
$1,744.50 |
$3,489 |
9.3× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$473.50 |
$947 |
1.9× |
| Diskography lumbar (72295) |
$2,014 |
$4,028 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$441 |
$882 |
3.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$705.50 |
$1,411 |
6.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$449.50 |
$899 |
4.0× |
| Dxa Bone Density Axial (77080) |
$364.50 |
$729 |
3.3× |
| Dxa bone density study (77085) |
$473.50 |
$947 |
4.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$360 |
$720 |
3.9× |
| Echo exam of fetal heart (76825) |
$732 |
$1,464 |
1.3× |
| Echo exam uterus (76831) |
$608 |
$1,216 |
2.4× |
| Echo Guide For Artery Repair (76936) |
$671.50 |
$1,343 |
2.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$655 |
$1,310 |
2.6× |
| Esophagram (74220) |
$240.50 |
$481 |
1.3× |
| Fetal Biophys Profile W/Nst (76818) |
$845.50 |
$1,691 |
7.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$748 |
$1,496 |
6.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,501 |
$3,002 |
5.9× |
| Fluoroscopy up to 1 hr (76000) |
$426.50 |
$853 |
1.7× |
| Follow-Up Angiography (75898) |
$2,461 |
$4,922 |
0.7× |
| Foot 2 views (73620) |
$175.50 |
$351 |
1.9× |
| Forearm 2 views (73090) |
$198 |
$396 |
2.1× |
| Gastric emptying imaging study (78264) |
$980.50 |
$1,961 |
2.3× |
| Gated Heart Planar Single (78472) |
$1,195.50 |
$2,391 |
2.8× |
| Hand 2 views (73120) |
$181 |
$362 |
1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$4,504.50 |
$9,009 |
6.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,841.50 |
$5,683 |
3.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,618.50 |
$3,237 |
2.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,485.50 |
$4,971 |
0.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,461 |
$4,922 |
0.7× |
| Hepatobil Syst Image W/Drug (78227) |
$1,237.50 |
$2,475 |
2.1× |
| Hepatobiliary System Imaging (78226) |
$1,099 |
$2,198 |
2.6× |
| Ht Muscle Image Spect Sing (78451) |
$1,776.50 |
$3,553 |
1.3× |
| Hysterosalpingogram (74740) |
$1,252 |
$2,504 |
4.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$400.50 |
$801 |
4.3× |
| Interstitial radiation source applic complex (77778) |
$2,834 |
$5,668 |
3.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$2,017 |
$4,034 |
2.7× |
| K Flow/Funct Image W/Drug (78708) |
$1,381.50 |
$2,763 |
2.4× |
| K Flow/Funct Image W/O Drug (78707) |
$889 |
$1,778 |
1.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$345.50 |
$691 |
0.8× |
| Knee 3 Views (73562) |
$302 |
$604 |
3.2× |
| Leveen/Shunt Patency Exam (78291) |
$493 |
$986 |
1.2× |
| Liver & Spleen Imaging Static Only (78215) |
$753 |
$1,506 |
1.8× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,010 |
$2,020 |
1.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$973.50 |
$1,947 |
1.7× |
| Lung Ventilation Imaging (78579) |
$419.50 |
$839 |
1.0× |
| Lymph System Imaging (78195) |
$1,519.50 |
$3,039 |
2.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,811.50 |
$3,623 |
0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$1,672 |
$3,344 |
0.5× |
| Magnetic Image Jaw Joint (70336) |
$1,513 |
$3,026 |
5.9× |
| Magnetic Resonance Elastography (76391) |
$1,092.50 |
$2,185 |
4.3× |
| Meckels Divert Exam (78290) |
$1,594.50 |
$3,189 |
3.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,783 |
$3,566 |
4.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,925 |
$3,850 |
5.1× |
| MRA head w/o contrast (70544) |
$1,243 |
$2,486 |
4.9× |
| MRA head with contrast (70545) |
$1,265 |
$2,530 |
3.4× |
| MRA neck w contrast (70548) |
$1,400.50 |
$2,801 |
3.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,607 |
$3,214 |
4.3× |
| MRA neck w/o contrast (70547) |
$1,251.50 |
$2,503 |
4.9× |
| MRI abdomen w/o contrast (74181) |
$1,545 |
$3,090 |
6.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,857.50 |
$3,715 |
2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,119 |
$4,238 |
5.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,012.50 |
$4,025 |
2.4× |
| MRI brain functional w/physician admnistration (70555) |
$1,271.50 |
$2,543 |
5.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,666 |
$3,332 |
6.5× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,080 |
$2,160 |
4.2× |
| MRI cardiac w/o contrast (75557) |
$1,280 |
$2,560 |
5.0× |
| MRI cervical spine w contrast (72142) |
$1,860.50 |
$3,721 |
5.0× |
| MRI cervical spine w/o cont (72141) |
$1,575 |
$3,150 |
6.2× |
| MRI chest w/o contrast (71550) |
$1,428.50 |
$2,857 |
5.6× |
| MRI chest with contrast (71551) |
$2,356 |
$4,712 |
2.8× |
| MRI chest wo w contrast (71552) |
$2,647.50 |
$5,295 |
7.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,083 |
$4,166 |
5.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,412 |
$2,824 |
5.5× |
| MRI lumbar spine w contrast (72149) |
$1,772.50 |
$3,545 |
4.7× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,269 |
$4,538 |
6.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,119 |
$2,238 |
4.4× |
| MRI orbit face neck w contrast (70542) |
$1,561 |
$3,122 |
4.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,976.50 |
$3,953 |
5.3× |
| MRI pelvis w/o & w contrast (72197) |
$1,965 |
$3,930 |
5.3× |
| MRI pelvis w/o contrast (72195) |
$1,602.50 |
$3,205 |
6.3× |
| MRI spectroscopy (76390) |
$968 |
$1,936 |
10.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,643 |
$3,286 |
6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,092.50 |
$2,185 |
4.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,240.50 |
$4,481 |
6.0× |
| MRI, abdomen, combo (74183) |
$2,142.50 |
$4,285 |
5.7× |
| MRI, dorsal spine combo (72157) |
$2,269 |
$4,538 |
6.1× |
| MRI, dorsal spine contrast (72147) |
$2,119 |
$4,238 |
5.7× |
| MRI, joint upper extrem (73221) |
$1,288.50 |
$2,577 |
5.0× |
| MRI, joint upper extrem combo (73223) |
$2,398.50 |
$4,797 |
6.4× |
| MRI, lumbar spine combo (72158) |
$2,359 |
$4,718 |
6.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,173 |
$6,346 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,723.50 |
$5,447 |
2.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,913.50 |
$5,827 |
1.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$3,325.50 |
$6,651 |
1.4× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$5,257 |
$10,514 |
2.2× |
| N-invas est c ffr sw aly CTA (75580) |
$2,191 |
$4,382 |
2.4× |
| Neck soft tissue (70360) |
$184 |
$368 |
2.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$413 |
$826 |
1.0× |
| Nonvascular Shunt X-Ray (75809) |
$322.50 |
$645 |
2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,590 |
$15,180 |
5.1× |
| Nuclear Rx Intra-Arterial (79445) |
$858 |
$1,716 |
3.4× |
| Nuclear Rx Oral Admin (79005) |
$966 |
$1,932 |
3.9× |
| Ob us nuchal meas 1 gest (76813) |
$405.50 |
$811 |
3.6× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$232 |
$464 |
2.1× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$363.50 |
$727 |
3.2× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$334 |
$668 |
2.3× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$140.50 |
$281 |
1.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$288 |
$576 |
2.6× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$313 |
$626 |
2.8× |
| Panoramic X-ray of jaws (70355) |
$196 |
$392 |
2.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$3,271 |
$6,542 |
5.6× |
| Parathyroid Planar Imaging (78070) |
$1,094.50 |
$2,189 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$218 |
$436 |
1.9× |
| Pet Image W/Ct Lmtd (78814) |
$3,271 |
$6,542 |
2.1× |
| PET image w/CT, full body (78816) |
$4,750 |
$9,500 |
3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,194.50 |
$8,389 |
2.7× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$2,250 |
$4,500 |
1.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,485.50 |
$4,971 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$717 |
$1,434 |
1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$300 |
$600 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$428.50 |
$857 |
0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$240 |
$480 |
2.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$146.50 |
$293 |
1.6× |
| Radex elbow complete minimum 3 views (73080) |
$238.50 |
$477 |
2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$214.50 |
$429 |
1.9× |
| Radex fingr minimum 2 views (73140) |
$306 |
$612 |
3.3× |
| Radex foot complete minimum 3 views (73630) |
$316 |
$632 |
3.4× |
| Radex Hand Minimum 3 Views (73130) |
$313 |
$626 |
3.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$133.50 |
$267 |
1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$187.50 |
$375 |
2.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$271 |
$542 |
2.9× |
| Radex shoulder complete minimum 2 views (73030) |
$337.50 |
$675 |
3.6× |
| Radex Spine 1 View Specify Level (72020) |
$134.50 |
$269 |
1.4× |
| Radex Sternum Minimum 2 Views (71120) |
$215.50 |
$431 |
2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$208.50 |
$417 |
2.2× |
| Radex Toe Minimum 2 Views (73660) |
$218.50 |
$437 |
2.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$143.50 |
$287 |
1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$155.50 |
$311 |
1.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$634 |
$1,268 |
5.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,415.50 |
$30,831 |
2.0× |
| Radiation treatment delivery level 1 (77402) |
$494.50 |
$989 |
4.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$207 |
$414 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$296 |
$592 |
2.6× |
| Radiologic exam colon double contrast study (74280) |
$399.50 |
$799 |
2.1× |
| Radiologic exam colon single contrast study (74270) |
$365.50 |
$731 |
1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$303 |
$606 |
1.6× |
| Radiologic exam knee complete 4/more views (73564) |
$346.50 |
$693 |
3.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$272 |
$544 |
2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$296 |
$592 |
1.6× |
| Radiologic exam swallow function contrast study (74230) |
$283 |
$566 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$517.50 |
$1,035 |
2.8× |
| Radiologic examination femur 1 view (73551) |
$169.50 |
$339 |
1.8× |
| Radiologic examination femur minimum 2 views (73552) |
$183.50 |
$367 |
2.0× |
| Radiologic examination knee 1/2 views (73560) |
$192 |
$384 |
2.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$225 |
$450 |
2.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$802.50 |
$1,605 |
1.4× |
| Ribs bilateral 3 views (71110) |
$294.50 |
$589 |
2.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$466 |
$932 |
1.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,144.50 |
$2,289 |
2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,129 |
$4,258 |
3.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,757.50 |
$3,515 |
3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,778 |
$3,556 |
3.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,141.50 |
$6,283 |
2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,948.50 |
$3,897 |
1.4× |
| Rp Therapy Intravenous Administration (79101) |
$1,031.50 |
$2,063 |
4.1× |
| Scapula (73010) |
$250.50 |
$501 |
2.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$140 |
$280 |
6.0× |
| Shoulder 1 view (73020) |
$128.50 |
$257 |
1.4× |
| Shoulder Arthrography (73040) |
$442.50 |
$885 |
1.2× |
| Skull less than 4 views (70250) |
$195 |
$390 |
1.7× |
| Special dosimetry (77331) |
$563 |
$1,126 |
3.9× |
| Special Physics Consult (77370) |
$612 |
$1,224 |
4.2× |
| Special teletherapy port plan (77321) |
$1,124 |
$2,248 |
2.8× |
| Special treatment procedure (77470) |
$2,022 |
$4,044 |
3.4× |
| Stereotactic Body Radiation Delivery (77373) |
$8,005.50 |
$16,011 |
4.2× |
| Sternoclavicular joints (71130) |
$220 |
$440 |
2.4× |
| Superior sagittal sinus venogram (75870) |
$2,461 |
$4,922 |
0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,594.50 |
$5,189 |
6.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,058 |
$4,116 |
5.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,260 |
$4,520 |
5.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,659.50 |
$3,319 |
4.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,233 |
$2,466 |
8.6× |
| Thoracic spine 2 views (72070) |
$221.50 |
$443 |
2.0× |
| Thoracic spine 3 views (72072) |
$225 |
$450 |
2.0× |
| Thoracolumbar 2 views (72080) |
$197 |
$394 |
2.1× |
| Thyroid Met Imaging Body (78018) |
$1,550.50 |
$3,101 |
2.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,629 |
$3,258 |
3.8× |
| Tx Devices Design & Construction Complex (77334) |
$1,347 |
$2,694 |
3.4× |
| Tx devices design & construction intermediate (77333) |
$776 |
$1,552 |
5.4× |
| Tx devices design & construction simple (77332) |
$555.50 |
$1,111 |
3.9× |
| Ultrasound Breast Limited (76642) |
$357 |
$714 |
3.8× |
| Ultrasound Elastography Parenchyma (76981) |
$412 |
$824 |
3.7× |
| Ultrasound Exam Aaa Screen (76706) |
$291 |
$582 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$531.50 |
$1,063 |
4.7× |
| Umbilical-artery Doppler (OB) (76820) |
$395.50 |
$791 |
3.5× |
| Unlisted Dx Radiographic Procedure (76499) |
$204.50 |
$409 |
2.2× |
| Unlisted fluoroscopic procedure (76496) |
$471 |
$942 |
5.1× |
| Unlisted us procedure (76999) |
$510 |
$1,020 |
5.5× |
| Upper gi w/o kub (74240) |
$269 |
$538 |
1.4× |
| Urethrocystogram voiding (74455) |
$462.50 |
$925 |
1.8× |
| Urethrocystography retrograde (74450) |
$441 |
$882 |
1.7× |
| Us breast unilateral complete (76641) |
$552 |
$1,104 |
4.9× |
| Us chest (76604) |
$342.50 |
$685 |
3.1× |
| Us complete joint (76881) |
$495 |
$990 |
4.4× |
| Us exam, pelvic, limited (76857) |
$490 |
$980 |
4.4× |
| Us head (76506) |
$366 |
$732 |
3.3× |
| Us kidney transplant (76776) |
$632 |
$1,264 |
5.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$394.50 |
$789 |
3.5× |
| Us ob detailed single fetus (76811) |
$547.50 |
$1,095 |
2.1× |
| Us ob limited 1 or more fetuses (76815) |
$410.50 |
$821 |
3.7× |
| Us ob transvaginal (76817) |
$399.50 |
$799 |
3.6× |
| Us pelvic non ob complete (76856) |
$662.50 |
$1,325 |
5.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$410.50 |
$821 |
3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$409 |
$818 |
3.7× |
| Us retroperitoneal complete (76770) |
$586 |
$1,172 |
5.2× |
| Us retroperitoneal limited (76775) |
$432 |
$864 |
3.9× |
| Us scrotum and contents (76870) |
$565 |
$1,130 |
5.0× |
| Us spinal canal and contents (76800) |
$399.50 |
$799 |
3.6× |
| Us thyroid (76536) |
$619 |
$1,238 |
5.5× |
| Us transrectal (76872) |
$631 |
$1,262 |
5.6× |
| Vein X-Ray Chest (75827) |
$1,749.50 |
$3,499 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,461 |
$4,922 |
0.7× |
| Vein X-Ray Spleen/Liver (75810) |
$2,461 |
$4,922 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$2,461 |
$4,922 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,461 |
$4,922 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,354 |
$2,708 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$1,214.50 |
$2,429 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,485.50 |
$4,971 |
0.7× |
| Venography Renal Unilateral (75831) |
$2,461 |
$4,922 |
0.7× |
| Venous sampling by catheter (75893) |
$4,226.50 |
$8,453 |
0.7× |
| Wrist 2 views (73100) |
$150 |
$300 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$190.50 |
$381 |
2.0× |
| X-Ray Aorta Leg Arteries (75630) |
$2,461 |
$4,922 |
0.7× |
| X-Ray Bend Only L-S Spine (72120) |
$269.50 |
$539 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$126.50 |
$253 |
1.4× |
| X-Ray Exam Breast Specimen (76098) |
$517 |
$1,034 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$251.50 |
$503 |
2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$283 |
$566 |
2.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$510 |
$1,020 |
4.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$164 |
$328 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$187 |
$374 |
2.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$273 |
$546 |
2.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$280.50 |
$561 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$302 |
$604 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$411.50 |
$823 |
3.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$780.50 |
$1,561 |
7.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$256.50 |
$513 |
2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$365.50 |
$731 |
3.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$288 |
$576 |
2.6× |
| X-ray eye for foreign body (70030) |
$79 |
$158 |
0.8× |
| X-ray humerus (73060) |
$199 |
$398 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$164 |
$328 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$215 |
$430 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$240.50 |
$481 |
2.1× |
| X-ray nose-rectum child f.b. (76010) |
$106.50 |
$213 |
1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$321.50 |
$643 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$461 |
$922 |
4.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$291.50 |
$583 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$236 |
$472 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$229.50 |
$459 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$232.50 |
$465 |
2.1× |
| X-ray thoracic spine 4 vw (72074) |
$341.50 |
$683 |
3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$500 |
$1,000 |
1.3× |
| X-Rays Bone Length Studies (77073) |
$144.50 |
$289 |
1.3× |
| X-Rays Bone Survey Complete (77075) |
$472.50 |
$945 |
4.2× |
| Xr c-spine 4 or 5 views (72050) |
$352.50 |
$705 |
3.1× |
| Xr facial bones less than 3 views (70140) |
$169 |
$338 |
1.8× |
| Xr orbits complete 4 views (70200) |
$234.50 |
$469 |
2.1× |