| 3-D radiotherapy plan dose-volume histograms (77295) |
$837.36 |
$2,326 |
0.7× |
| Abdomen 2 views (74019) |
$36.72 |
$102 |
0.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$261.36 |
$726 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,081.52 |
$5,782 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$2,081.52 |
$5,782 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$2,163.96 |
$6,011 |
0.8× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,099.24 |
$8,609 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,081.52 |
$5,782 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,081.52 |
$5,782 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,646.44 |
$10,129 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$668.16 |
$1,856 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,163.96 |
$6,011 |
0.8× |
| Ankle 2 views (73600) |
$19.44 |
$54 |
0.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$328.86 |
$913.50 |
1.1× |
| Aortogram thoracic (75605) |
$3,099.24 |
$8,609 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,081.52 |
$5,782 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,081.52 |
$5,782 |
0.7× |
| Arthrogram elbow (73085) |
$304.92 |
$847 |
1.0× |
| Arthrogram hip (73525) |
$270.36 |
$751 |
0.9× |
| Arthrogram shoulder (73040) |
$227.88 |
$633 |
0.7× |
| Arthrogram wrist (73115) |
$270.72 |
$752 |
0.9× |
| Arthrography knee lt (73580) |
$227.88 |
$633 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$93.24 |
$259 |
0.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$292.32 |
$812 |
0.8× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$292.32 |
$812 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$292.32 |
$812 |
0.8× |
| Bone age studies (77072) |
$36.36 |
$101 |
0.4× |
| Bone Imaging 3 Phase (78315) |
$292.32 |
$812 |
0.8× |
| Bone survey complete (77075) |
$87.84 |
$244 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,013.76 |
$2,816 |
0.8× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$10.44 |
$29 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$26.10 |
$72.50 |
0.3× |
| Chest 1 view (71045) |
$20.16 |
$56 |
0.3× |
| Chest 3 views (71047) |
$48.60 |
$135 |
0.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$221.76 |
$616 |
1.4× |
| Clavicle complete (73000) |
$20.16 |
$56 |
0.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$144 |
$400 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$140.40 |
$390 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$471.60 |
$1,310 |
1.5× |
| CT abdomen and pelvis without contrast (74176) |
$329.04 |
$914 |
1.5× |
| CT abdomen w contrast (74160) |
$418.32 |
$1,162 |
2.7× |
| CT abdomen w wo contrast (74170) |
$226.44 |
$629 |
1.4× |
| CT abdomen w/o contrast (74150) |
$251.28 |
$698 |
2.7× |
| CT angio hrt w/3d image (75574) |
$357.48 |
$993 |
1.1× |
| CT angiography upper extremity lt (73206) |
$274.99 |
$763.87 |
1.7× |
| CT c-spine w/o contrast (72125) |
$338.04 |
$939 |
3.6× |
| CT cervical spine w&w/o contrast (72127) |
$271.44 |
$754 |
1.7× |
| CT cervical spine with contrast (72126) |
$244.08 |
$678 |
0.8× |
| CT chest w/wo contrast (71270) |
$330.48 |
$918 |
2.1× |
| CT chest with contrast (71260) |
$305.64 |
$849 |
1.9× |
| CT head/brain with contrast (70460) |
$311.40 |
$865 |
2.0× |
| CT head/brain without and with contrast (70470) |
$457.56 |
$1,271 |
2.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$28.80 |
$80 |
0.4× |
| CT iac w contrast (70481) |
$302.40 |
$840 |
1.9× |
| CT limited/localized follow up study (76380) |
$198.72 |
$552 |
2.5× |
| CT lower ext w/o (73700) |
$200.16 |
$556 |
2.1× |
| CT lower extremity w wo contrast (73702) |
$339.84 |
$944 |
2.2× |
| CT lower extremity with contrast (73701) |
$320.04 |
$889 |
2.0× |
| CT lumbar spine w & w/o contrast (72133) |
$504.72 |
$1,402 |
3.2× |
| CT lumbar spine w/o contrast (72131) |
$338.04 |
$939 |
3.6× |
| CT lumbar spine with contrast (72132) |
$354.96 |
$986 |
1.1× |
| CT maxillofacial w contrast (70487) |
$424.44 |
$1,179 |
2.7× |
| CT maxillofacial w/o contrast (70486) |
$338.04 |
$939 |
3.6× |
| CT maxillofacial w/wo contrast (70488) |
$488.88 |
$1,358 |
3.1× |
| CT neck soft tissue w contrast (70491) |
$311.76 |
$866 |
2.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$248.58 |
$690.50 |
1.6× |
| CT orbits w/o contrast (70480) |
$277.92 |
$772 |
3.0× |
| CT pelvis w & w/o contrast (72194) |
$452.52 |
$1,257 |
2.9× |
| CT pelvis w/o contrast (72192) |
$225.36 |
$626 |
2.4× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$145.44 |
$404 |
1.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$453.24 |
$1,259 |
2.9× |
| CT soft tissue neck w/o contrast (70490) |
$225.36 |
$626 |
2.4× |
| CT thoracic spine w/contrast (72129) |
$477.72 |
$1,327 |
3.0× |
| CT thoracic spine w/o contrast (72128) |
$338.04 |
$939 |
3.6× |
| CT thoracic spine w/wo contrast (72130) |
$551.88 |
$1,533 |
3.5× |
| CT thorax w/o contrast (71250) |
$189.72 |
$527 |
2.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$339.84 |
$944 |
2.2× |
| CT upper extremity w/o contrast rt (73200) |
$239.76 |
$666 |
2.6× |
| CT upper extremity with contrast (73201) |
$324.72 |
$902 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$274.99 |
$763.87 |
1.7× |
| Cta Abdomen (74175) |
$274.99 |
$763.87 |
1.7× |
| CTA abdomen pelvis (74174) |
$565.92 |
$1,572 |
1.8× |
| CTA chest (71275) |
$305.64 |
$849 |
1.9× |
| Cta Head (70496) |
$274.99 |
$763.87 |
1.7× |
| CTA lwr ext w&w/o contrast (73706) |
$274.99 |
$763.87 |
1.7× |
| Cta Neck (70498) |
$274.99 |
$763.87 |
1.7× |
| Cta Pelvis (72191) |
$274.99 |
$763.87 |
1.7× |
| Cystography minimum 3 views rs&i (74430) |
$155.16 |
$431 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$82.80 |
$230 |
0.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$22.68 |
$63 |
0.3× |
| Echo exam of eye (76529) |
$107.64 |
$299 |
1.4× |
| Esophagus (74220) |
$79.92 |
$222 |
0.5× |
| Fetal biophysical profile non-stress testing (76818) |
$73.08 |
$203 |
0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$41.94 |
$116.50 |
0.4× |
| Fluoroscopy up to 1 hr (76000) |
$178.92 |
$497 |
0.8× |
| Foot 2 views (73620) |
$18.90 |
$52.50 |
0.2× |
| Forearm 2 views (73090) |
$19.44 |
$54 |
0.2× |
| Gated Heart Planar Single (78472) |
$262.80 |
$730 |
0.7× |
| Hand 2 views (73120) |
$20.88 |
$58 |
0.2× |
| Hand 3 views (73130) |
$22.50 |
$62.50 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$298.08 |
$828 |
0.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$298.08 |
$828 |
0.8× |
| Ht muscle image spect sing (78451) |
$911.16 |
$2,531 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$20.52 |
$57 |
0.3× |
| Hysterosalpingogram (74740) |
$192.24 |
$534 |
0.9× |
| Image fusion (77399) |
$108.36 |
$301 |
0.9× |
| Kidney imaging morphology (78700) |
$336.24 |
$934 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$336.24 |
$934 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$336.24 |
$934 |
0.7× |
| Liver & spleen imaging static only (78215) |
$298.08 |
$828 |
0.8× |
| Liver imaging static only (78201) |
$298.08 |
$828 |
0.6× |
| Lung perfusion differential (78597) |
$325.44 |
$904 |
0.9× |
| Lung Ventilation Imaging (78579) |
$252.36 |
$701 |
0.7× |
| Lymphoscintigraphy (78195) |
$295.20 |
$820 |
0.6× |
| Mammary ductogram or galactogram single (77053) |
$192.24 |
$534 |
0.9× |
| Meckels Diverticulum (78290) |
$261.36 |
$726 |
0.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$186.48 |
$518 |
0.6× |
| MRA head w & w/o contrast (70546) |
$1,208.88 |
$3,358 |
3.9× |
| MRA head w/o contrast (70544) |
$570.60 |
$1,585 |
2.7× |
| MRA head with contrast (70545) |
$684.72 |
$1,902 |
2.2× |
| MRA neck w contrast (70548) |
$684.72 |
$1,902 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$729.72 |
$2,027 |
2.3× |
| MRA neck w/o contrast (70547) |
$570.60 |
$1,585 |
2.7× |
| MRI abdomen w contrast (74182) |
$784.44 |
$2,179 |
2.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,343.52 |
$3,732 |
4.3× |
| MRI abdomen w/o contrast (74181) |
$459.54 |
$1,276.50 |
2.1× |
| MRI any jnt lwr ext with con lt (73722) |
$784.44 |
$2,179 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$784.44 |
$2,179 |
1.1× |
| MRI breast w/o contrast bilateral (77047) |
$686.16 |
$1,906 |
3.2× |
| MRI breast w/o contrast unilat (77046) |
$343.08 |
$953 |
1.6× |
| MRI c-spine with contrast (72142) |
$1,041.48 |
$2,893 |
3.3× |
| MRI cervical spine w/o contrast (72141) |
$738.36 |
$2,051 |
3.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,343.52 |
$3,732 |
4.3× |
| MRI chest w/o contrast (71550) |
$730.44 |
$2,029 |
3.4× |
| MRI chest with contrast (71551) |
$1,041.48 |
$2,893 |
1.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$776.52 |
$2,157 |
2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$784.44 |
$2,179 |
2.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$738.36 |
$2,051 |
3.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$738.36 |
$2,051 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,343.52 |
$3,732 |
4.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,041.48 |
$2,893 |
3.3× |
| MRI pelvis w contrast (72196) |
$1,041.48 |
$2,893 |
3.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,099.80 |
$3,055 |
3.5× |
| MRI pelvis w/o contrast (72195) |
$738.36 |
$2,051 |
3.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,343.52 |
$3,732 |
4.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,343.52 |
$3,732 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,343.52 |
$3,732 |
4.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,041.48 |
$2,893 |
3.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,343.52 |
$3,732 |
4.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,030.68 |
$2,863 |
3.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,343.52 |
$3,732 |
4.3× |
| MRI thoracic spine w/o contrast (72146) |
$738.36 |
$2,051 |
3.5× |
| MRI upper ext joint w/o contrast (73221) |
$738.36 |
$2,051 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,343.52 |
$3,732 |
4.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$730.44 |
$2,029 |
3.4× |
| Myocardial Spect Multiple Studies (78452) |
$546.48 |
$1,518 |
0.5× |
| Neck soft tissue (70360) |
$21.78 |
$60.50 |
0.3× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$314.64 |
$874 |
0.9× |
| Nm gastric emptying study (78264) |
$261.36 |
$726 |
0.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$829.44 |
$2,304 |
0.7× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$1,389.24 |
$3,859 |
1.1× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$264.60 |
$735 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$312.48 |
$868 |
1.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$55.62 |
$154.50 |
0.6× |
| Osseous survey infant (77076) |
$72 |
$200 |
0.8× |
| Osseous survey limited (77074) |
$36.36 |
$101 |
0.4× |
| Parathyroid imaging (78070) |
$225.36 |
$626 |
0.6× |
| Pelvis 1 or 2 views (72170) |
$20.52 |
$57 |
0.2× |
| PET image w/CT, skull-thigh (78815) |
$1,186.20 |
$3,295 |
0.9× |
| PET imaging CT for attenuation limited area (78814) |
$1,186.20 |
$3,295 |
0.9× |
| PET imaging for CT attenuation whole body (78816) |
$1,186.20 |
$3,295 |
0.9× |
| PET imaging limited area chest head/neck (78811) |
$1,389.24 |
$3,859 |
1.2× |
| PET whole body (78813) |
$1,389.24 |
$3,859 |
1.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,343.52 |
$3,732 |
4.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$660.96 |
$1,836 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$122.04 |
$339 |
0.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$351.72 |
$977 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$450.72 |
$1,252 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$18.90 |
$52.50 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$32.40 |
$90 |
0.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$19.26 |
$53.50 |
0.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$42.12 |
$117 |
0.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$124.20 |
$345 |
0.3× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$91.44 |
$254 |
1.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$93.96 |
$261 |
0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$31.32 |
$87 |
0.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$22.14 |
$61.50 |
0.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$88.02 |
$244.50 |
0.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$38.34 |
$106.50 |
0.5× |
| Radiologic exam colon single contrast study (74270) |
$106.92 |
$297 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$125.10 |
$347.50 |
0.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$117.90 |
$327.50 |
0.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$16.56 |
$46 |
0.2× |
| Radiological examination surgical specimen (76098) |
$345.24 |
$959 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,081.52 |
$5,782 |
0.7× |
| Ribs bilateral 3 views (71110) |
$37.98 |
$105.50 |
0.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,010.52 |
$2,807 |
2.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,072.80 |
$2,980 |
2.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$300.60 |
$835 |
1.4× |
| Scanogram (77073) |
$29.52 |
$82 |
0.3× |
| Scapula complete (73010) |
$18.72 |
$52 |
0.2× |
| Screening digital breast tomosynthesis (77063) |
$20.16 |
$56 |
0.9× |
| Sella turcica (70240) |
$36.72 |
$102 |
0.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$188.28 |
$523 |
2.0× |
| Simulation intermediate (77285) |
$251.64 |
$699 |
0.7× |
| Small bowel series (74250) |
$69.84 |
$194 |
0.4× |
| Spec medical radj physics consltj (77370) |
$135.72 |
$377 |
1.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$251.64 |
$699 |
0.7× |
| Special dosimetry (77331) |
$140.40 |
$390 |
1.2× |
| Special treatment procedure (77470) |
$334.08 |
$928 |
0.7× |
| Spine thoracic 3 views (72072) |
$26.82 |
$74.50 |
0.3× |
| Spleen imaging only (78185) |
$295.20 |
$820 |
0.8× |
| Stereotactic body radiation delivery (77373) |
$1,387.08 |
$3,853 |
0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$124.20 |
$345 |
0.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$105.66 |
$293.50 |
0.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$251.64 |
$699 |
0.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$199.80 |
$555 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$151.56 |
$421 |
0.4× |
| Thyroid uptake measurement (78012) |
$151.20 |
$420 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$225.36 |
$626 |
0.6× |
| Treatment device intermediate (77333) |
$172.80 |
$480 |
1.4× |
| Treatment devices simple (77332) |
$172.80 |
$480 |
1.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$949.68 |
$2,638 |
2.0× |
| Tx devices design & construction complex (77334) |
$216 |
$600 |
0.6× |
| Ultrasound, abdomen limited (76705) |
$107.64 |
$299 |
1.1× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$47.16 |
$131 |
0.6× |
| Unlisted Ultrasound Procedure (76999) |
$73.08 |
$203 |
0.9× |
| Upper Extremity Infant (73092) |
$44.64 |
$124 |
0.5× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$73.44 |
$204 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$132.48 |
$368 |
0.6× |
| Urethrocystography voiding (74455) |
$173.52 |
$482 |
0.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$216.36 |
$601 |
1.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$149.40 |
$415 |
0.9× |
| Us abdl aorta screen aaa (76706) |
$88.92 |
$247 |
0.9× |
| Us breast unilateral complete (76641) |
$88.20 |
$245 |
0.9× |
| Us breast unilateral limited (76642) |
$66.24 |
$184 |
0.8× |
| Us chest (76604) |
$107.64 |
$299 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$88.56 |
$246 |
0.9× |
| Us elastography parenchyma (76981) |
$112.68 |
$313 |
1.2× |
| Us guided compression repair (76936) |
$402.12 |
$1,117 |
2.1× |
| Us kidney transplant (76776) |
$130.32 |
$362 |
1.4× |
| Us ob transvaginal (76817) |
$80.82 |
$224.50 |
0.9× |
| Us pelvic non ob complete (76856) |
$83.16 |
$231 |
0.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$49.32 |
$137 |
0.5× |
| Us pregnancy ltd (76815) |
$107.64 |
$299 |
1.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$62.64 |
$174 |
0.7× |
| Us retroperitoneal complete (76770) |
$103.14 |
$286.50 |
1.1× |
| Us retroperitoneal limited (76775) |
$130.32 |
$362 |
1.4× |
| Us scrotum and contents (76870) |
$107.64 |
$299 |
1.1× |
| Us soft tissue head/neck (76536) |
$107.68 |
$299.12 |
1.1× |
| Us transrectal (76872) |
$107.64 |
$299 |
1.1× |
| Us xtr non-vasc lmtd (76882) |
$75.96 |
$211 |
0.8× |
| Us, eye b-scan (76512) |
$107.64 |
$299 |
1.1× |
| Venogram extremity bilateral (75822) |
$714.24 |
$1,984 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,081.52 |
$5,782 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$714.45 |
$1,984.58 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$714.24 |
$1,984 |
0.5× |
| Venography Renal Bilateral (75833) |
$2,081.52 |
$5,782 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$2,081.52 |
$5,782 |
0.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,163.96 |
$6,011 |
0.8× |
| Wrist 2 views (73100) |
$22.68 |
$63 |
0.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$40.68 |
$113 |
0.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$23.40 |
$65 |
0.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$36.90 |
$102.50 |
0.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$140.76 |
$391 |
0.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$19.44 |
$54 |
0.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$24.48 |
$68 |
0.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$36.54 |
$101.50 |
0.4× |
| X-ray exam hip uni 1 view (73501) |
$14.94 |
$41.50 |
0.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$21.60 |
$60 |
0.3× |
| X-ray exam hip uni 4/> views (73503) |
$27 |
$75 |
0.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$24.84 |
$69 |
0.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$28.44 |
$79 |
0.3× |
| X-ray exam of femur 1 (73551) |
$13.68 |
$38 |
0.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$152.64 |
$424 |
1.0× |
| X-ray eye for foreign body (70030) |
$36.36 |
$101 |
0.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$44.82 |
$124.50 |
0.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$36.36 |
$101 |
0.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$24.12 |
$67 |
0.3× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,298.88 |
$3,608 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$19.26 |
$53.50 |
0.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$36.36 |
$101 |
0.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$28.44 |
$79 |
0.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$30.42 |
$84.50 |
0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$27.72 |
$77 |
0.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$61.20 |
$170 |
0.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$37.44 |
$104 |
0.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$20.88 |
$58 |
0.3× |
| X-ray of voice box or throat (70370) |
$127.44 |
$354 |
1.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$32.76 |
$91 |
0.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$62.64 |
$174 |
0.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$23.40 |
$65 |
0.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$28.08 |
$78 |
0.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$37.08 |
$103 |
0.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$24.48 |
$68 |
0.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$20.52 |
$57 |
0.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$48.96 |
$136 |
0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$27.54 |
$76.50 |
0.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$28.08 |
$78 |
0.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$33.48 |
$93 |
0.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$44.64 |
$124 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$69.84 |
$194 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$21.60 |
$60 |
0.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$32.76 |
$91 |
0.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$20.52 |
$57 |
0.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$24.48 |
$68 |
0.3× |
| Xr c-spine 6 or more views (72052) |
$61.20 |
$170 |
0.7× |
| Xr chest 4+ views (71048) |
$93.24 |
$259 |
1.0× |
| Xr Cholecystography Oral Contrast (74290) |
$88.92 |
$247 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$18.72 |
$52 |
0.2× |
| Xr shoulder 1 view (73020) |
$16.56 |
$46 |
0.2× |
| Xr spine cervical 4 or 5 views (72050) |
$37.08 |
$103 |
0.4× |
| Xr tibia/fibula 2 views (73590) |
$19.44 |
$54 |
0.2× |
| Xray knee 1 or 2 views rt (73560) |
$33.84 |
$94 |
0.4× |