| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,607.75 |
$11,477 |
6.7× |
| Abdomen 2 views (74019) |
$1,611 |
$2,148 |
16.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,918.50 |
$2,558 |
5.2× |
| Angiography extremity bilateral rs&i (75716) |
$8,499.75 |
$11,333 |
2.9× |
| Angiography extremity unilateral rs&i (75710) |
$5,901.75 |
$7,869 |
2.0× |
| Angiography internal mammary rs&i (75756) |
$3,649.12 |
$4,865.50 |
1.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,397.75 |
$3,197 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,837.75 |
$5,117 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,518.50 |
$3,358 |
0.9× |
| Angiography Spinal Selective Rs&I (75705) |
$7,663.50 |
$10,218 |
1.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,057.12 |
$5,409.50 |
0.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,273.12 |
$1,697.50 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,714.25 |
$3,619 |
0.9× |
| Ankle 2 views (73600) |
$929.25 |
$1,239 |
11.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,874.25 |
$2,499 |
5.8× |
| Aortogram thoracic (75605) |
$3,371.25 |
$4,495 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$26,700 |
$35,600 |
9.1× |
| Aortography abdominal serialography rs&i (75625) |
$7,583.62 |
$10,111.50 |
2.6× |
| Artery X-Rays Adrenal Gland (75731) |
$19,834.50 |
$26,446 |
6.8× |
| Arthrogram elbow (73085) |
$799.50 |
$1,066 |
2.5× |
| Arthrogram hip (73525) |
$2,486.25 |
$3,315 |
7.7× |
| Arthrogram shoulder (73040) |
$4,020 |
$5,360 |
12.4× |
| Arthrogram wrist (73115) |
$2,082.75 |
$2,777 |
6.4× |
| Arthrography knee lt (73580) |
$688.12 |
$917.50 |
2.1× |
| Basic radiation dosimetry calculation (77300) |
$1,615.50 |
$2,154 |
13.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,602 |
$2,136 |
4.3× |
| Bone &/joint imaging whole body (78306) |
$4,045.12 |
$5,393.50 |
10.9× |
| Bone age studies (77072) |
$466.88 |
$622.50 |
4.8× |
| Bone Imaging 3 Phase (78315) |
$4,134.75 |
$5,513 |
11.2× |
| Bone Marrow Imaging Limited Area (78102) |
$2,094.75 |
$2,793 |
5.7× |
| Bone survey complete (77075) |
$1,038.75 |
$1,385 |
10.7× |
| Brachytx isodose complex (77318) |
$2,591.25 |
$3,455 |
7.5× |
| Brachytx isodose intermed (77317) |
$2,970.75 |
$3,961 |
8.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,324.50 |
$1,766 |
3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,817 |
$3,756 |
2.1× |
| Brain Imaging Vascular Flow Only (78610) |
$2,130.75 |
$2,841 |
4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,024.75 |
$4,033 |
9.4× |
| Cervical spine 2 or 3 views (72040) |
$1,212 |
$1,616 |
15.0× |
| Chest 1 view (71045) |
$834 |
$1,112 |
10.3× |
| Chest 3 views (71047) |
$1,077 |
$1,436 |
13.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,279.50 |
$1,706 |
7.9× |
| Clavicle complete (73000) |
$1,080.75 |
$1,441 |
13.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,470.75 |
$1,961 |
15.2× |
| Continuing medical physics consltj pr wk (77336) |
$1,919.25 |
$2,559 |
15.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$20,093.25 |
$26,791 |
62.2× |
| CT abdomen and pelvis without contrast (74176) |
$11,805 |
$15,740 |
53.4× |
| CT abdomen w contrast (74160) |
$7,561.50 |
$10,082 |
46.5× |
| CT abdomen w wo contrast (74170) |
$7,877.25 |
$10,503 |
48.5× |
| CT abdomen w/o contrast (74150) |
$5,434.50 |
$7,246 |
56.1× |
| CT angio hrt w/3d image (75574) |
$2,326.50 |
$3,102 |
7.2× |
| CT angiography upper extremity lt (73206) |
$6,339.75 |
$8,453 |
39.0× |
| CT c-spine w/o contrast (72125) |
$6,124.50 |
$8,166 |
63.2× |
| CT cervical spine w&w/o contrast (72127) |
$5,904.75 |
$7,873 |
36.3× |
| CT cervical spine with contrast (72126) |
$5,862 |
$7,816 |
18.1× |
| CT chest w/wo contrast (71270) |
$8,684.62 |
$11,579.50 |
53.4× |
| CT chest with contrast (71260) |
$7,467.75 |
$9,957 |
46.0× |
| CT head/brain with contrast (70460) |
$7,069.12 |
$9,425.50 |
43.5× |
| CT head/brain without and with contrast (70470) |
$8,250.75 |
$11,001 |
50.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$389.25 |
$519 |
4.8× |
| CT iac w contrast (70481) |
$6,647.25 |
$8,863 |
40.9× |
| CT limited/localized follow up study (76380) |
$1,965.38 |
$2,620.50 |
24.4× |
| CT lower ext w/o (73700) |
$5,453.62 |
$7,271.50 |
56.3× |
| CT lower extremity w wo contrast (73702) |
$6,927.75 |
$9,237 |
42.6× |
| CT lower extremity with contrast (73701) |
$6,803.25 |
$9,071 |
41.9× |
| CT lumbar spine w & w/o contrast (72133) |
$4,254.75 |
$5,673 |
26.2× |
| CT lumbar spine w/o contrast (72131) |
$6,131.25 |
$8,175 |
63.3× |
| CT lumbar spine with contrast (72132) |
$6,739.50 |
$8,986 |
20.8× |
| CT maxillofacial w contrast (70487) |
$6,045 |
$8,060 |
37.2× |
| CT maxillofacial w/o contrast (70486) |
$5,013.75 |
$6,685 |
51.8× |
| CT maxillofacial w/wo contrast (70488) |
$8,151.75 |
$10,869 |
50.2× |
| CT neck soft tissue w contrast (70491) |
$5,853.38 |
$7,804.50 |
36.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$6,577.50 |
$8,770 |
40.5× |
| CT orbits w/o contrast (70480) |
$5,019.75 |
$6,693 |
51.8× |
| CT pelvis w & w/o contrast (72194) |
$11,641.50 |
$15,522 |
71.6× |
| CT pelvis w/o contrast (72192) |
$4,923 |
$6,564 |
50.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$8,300.25 |
$11,067 |
51.1× |
| CT soft tissue neck w/o contrast (70490) |
$5,442.75 |
$7,257 |
56.2× |
| CT thoracic spine w/contrast (72129) |
$6,139.12 |
$8,185.50 |
37.8× |
| CT thoracic spine w/o contrast (72128) |
$6,124.50 |
$8,166 |
63.2× |
| CT thoracic spine w/wo contrast (72130) |
$6,479.25 |
$8,639 |
39.9× |
| CT thorax w/o contrast (71250) |
$5,774.25 |
$7,699 |
59.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$7,102.50 |
$9,470 |
43.7× |
| CT upper extremity w/o contrast rt (73200) |
$5,271 |
$7,028 |
54.4× |
| CT upper extremity with contrast (73201) |
$7,458.75 |
$9,945 |
23.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$6,424.50 |
$8,566 |
39.5× |
| Cta Abdomen (74175) |
$5,049.75 |
$6,733 |
31.1× |
| CTA abdomen pelvis (74174) |
$12,934.50 |
$17,246 |
40.0× |
| CTA chest (71275) |
$6,527.25 |
$8,703 |
40.2× |
| Cta Head (70496) |
$6,906.38 |
$9,208.50 |
42.5× |
| CTA lwr ext w&w/o contrast (73706) |
$6,647.25 |
$8,863 |
40.9× |
| Cta Neck (70498) |
$6,961.50 |
$9,282 |
42.8× |
| Cta Pelvis (72191) |
$6,521.25 |
$8,695 |
40.1× |
| Cystography minimum 3 views rs&i (74430) |
$1,120.88 |
$1,494.50 |
3.5× |
| Diskogram cervical (72285) |
$2,126.25 |
$2,835 |
1.2× |
| Diskography lumbar (72295) |
$1,956.75 |
$2,609 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,018.12 |
$1,357.50 |
10.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$884.25 |
$1,179 |
11.0× |
| Echoencephalography real time imaging (76506) |
$798.75 |
$1,065 |
8.2× |
| Esophagus (74220) |
$1,235.25 |
$1,647 |
7.6× |
| Fetal biophysical profile non-stress testing (76818) |
$1,138.50 |
$1,518 |
11.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$504.75 |
$673 |
5.2× |
| Fluoroscopy up to 1 hr (76000) |
$2,044.50 |
$2,726 |
9.2× |
| Foot 2 views (73620) |
$1,103.62 |
$1,471.50 |
13.7× |
| Forearm 2 views (73090) |
$1,108.88 |
$1,478.50 |
13.8× |
| Gated Heart Planar Single (78472) |
$4,015.50 |
$5,354 |
10.8× |
| Hand 2 views (73120) |
$1,010.25 |
$1,347 |
10.4× |
| Hand 3 views (73130) |
$1,188.75 |
$1,585 |
14.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,439.75 |
$3,253 |
3.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,866.25 |
$5,155 |
6.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,257.75 |
$5,677 |
6.6× |
| Heart infarct image w ef (78468) |
$6,554.25 |
$8,739 |
13.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,567.38 |
$4,756.50 |
7.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,967 |
$3,956 |
8.0× |
| Ht muscle image spect sing (78451) |
$6,816 |
$9,088 |
5.7× |
| Humerus Min 2 Views Left (73060) |
$1,086.75 |
$1,449 |
13.5× |
| Hysterosalpingogram (74740) |
$2,290.50 |
$3,054 |
10.4× |
| Interstitial radiation source applic complex (77778) |
$9,093.75 |
$12,125 |
14.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$3,176.25 |
$4,235 |
4.9× |
| Intracavitary radiation source applic simple (77761) |
$1,482 |
$1,976 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$290.25 |
$387 |
3.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,846.75 |
$5,129 |
7.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,040.88 |
$4,054.50 |
6.0× |
| Knee 3 views (73562) |
$1,154.25 |
$1,539 |
14.3× |
| Liver & spleen imaging static only (78215) |
$4,644 |
$6,192 |
12.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$888.38 |
$1,184.50 |
2.4× |
| Lung perf&ventilat diferentl (78598) |
$7,605.75 |
$10,141 |
15.1× |
| Lung perfusion differential (78597) |
$7,605.75 |
$10,141 |
20.5× |
| Lung Ventilation Imaging (78579) |
$5,002.50 |
$6,670 |
13.5× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$14,497.50 |
$19,330 |
5.0× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,150.25 |
$2,867 |
0.7× |
| Lymphoscintigraphy (78195) |
$1,387.50 |
$1,850 |
2.8× |
| Mammary ductogram or galactogram multiple (77054) |
$689.25 |
$919 |
3.1× |
| Mammary ductogram or galactogram single (77053) |
$521.25 |
$695 |
2.4× |
| Meckels Diverticulum (78290) |
$4,520.25 |
$6,027 |
12.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$9,549 |
$12,732 |
27.5× |
| Mr safety determination physician/other qhp (76016) |
$308.25 |
$411 |
3.8× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$639.75 |
$853 |
11.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$47.25 |
$63 |
1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$488.25 |
$651 |
5.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$965.25 |
$1,287 |
4.4× |
| MRA head w & w/o contrast (70546) |
$6,758.25 |
$9,011 |
20.9× |
| MRA head w/o contrast (70544) |
$3,924.38 |
$5,232.50 |
17.8× |
| MRA head with contrast (70545) |
$5,633.25 |
$7,511 |
17.4× |
| MRA neck w contrast (70548) |
$5,606.25 |
$7,475 |
17.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,220.50 |
$8,294 |
19.2× |
| MRA neck w/o contrast (70547) |
$3,609.75 |
$4,813 |
16.3× |
| MRI abdomen w contrast (74182) |
$7,146.75 |
$9,529 |
22.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$7,308.75 |
$9,745 |
22.6× |
| MRI abdomen w/o contrast (74181) |
$5,623.50 |
$7,498 |
25.4× |
| MRI any jnt lwr ext with con lt (73722) |
$6,366 |
$8,488 |
8.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$7,018.50 |
$9,358 |
9.7× |
| MRI c-spine with contrast (72142) |
$7,437.75 |
$9,917 |
23.0× |
| MRI cardiac w/o contrast (75557) |
$2,809.50 |
$3,746 |
12.7× |
| MRI cervical spine w/o contrast (72141) |
$6,729.38 |
$8,972.50 |
30.4× |
| MRI chest w/o & w/contrast material (71552) |
$3,444 |
$4,592 |
10.7× |
| MRI chest w/o contrast (71550) |
$2,836.50 |
$3,782 |
12.8× |
| MRI chest with contrast (71551) |
$3,332.25 |
$4,443 |
4.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$7,018.50 |
$9,358 |
21.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$6,615.38 |
$8,820.50 |
20.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,256.75 |
$7,009 |
23.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,343.25 |
$5,791 |
19.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,913.75 |
$7,885 |
18.3× |
| MRI orbit/face/neck w/contrast (70542) |
$7,128.38 |
$9,504.50 |
22.1× |
| MRI pelvis w contrast (72196) |
$4,083.75 |
$5,445 |
12.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$7,915.50 |
$10,554 |
24.5× |
| MRI pelvis w/o contrast (72195) |
$4,980 |
$6,640 |
22.5× |
| MRI scan of arm joint before and after contrast (73223) |
$7,654.12 |
$10,205.50 |
23.7× |
| MRI scan of leg joint before and after contrast (73723) |
$7,236.75 |
$9,649 |
22.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$7,805.25 |
$10,407 |
24.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$7,347.75 |
$9,797 |
22.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$8,673.75 |
$11,565 |
26.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$8,082.75 |
$10,777 |
25.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$7,993.88 |
$10,658.50 |
24.7× |
| MRI thoracic spine w/o contrast (72146) |
$6,352.50 |
$8,470 |
28.7× |
| MRI tmj (70336) |
$4,297.50 |
$5,730 |
19.4× |
| MRI upper ext joint w/o contrast (73221) |
$5,325.38 |
$7,100.50 |
24.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$6,446.25 |
$8,595 |
19.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,980 |
$6,640 |
22.5× |
| Myelogram Cervical (72240) |
$4,078.50 |
$5,438 |
5.6× |
| Myelogram Lumbar (72265) |
$4,113 |
$5,484 |
5.7× |
| Myelogram thoracic (72255) |
$4,422 |
$5,896 |
6.1× |
| Myelography 2 or more regions (72270) |
$7,446 |
$9,928 |
10.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,817 |
$3,756 |
2.3× |
| Myocardial Spect Multiple Studies (78452) |
$10,707.75 |
$14,277 |
8.9× |
| Neck soft tissue (70360) |
$352.88 |
$470.50 |
4.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$2,176.50 |
$2,902 |
5.9× |
| Nm adrenal scan (78075) |
$782.25 |
$1,043 |
0.7× |
| Nm cisternogram (78630) |
$1,755.75 |
$2,341 |
3.5× |
| Nm gastric emptying study (78264) |
$4,770 |
$6,360 |
12.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$21,966 |
$29,288 |
17.1× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$6,104.25 |
$8,139 |
4.6× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$2,937 |
$3,916 |
7.9× |
| Nuclear Rx Oral Admin (79005) |
$4,062.75 |
$5,417 |
18.8× |
| Orthopantogram (70355) |
$505.50 |
$674 |
6.3× |
| Osseous survey infant (77076) |
$558 |
$744 |
5.8× |
| Parathyrd planar w/wo subtrj (78071) |
$2,361.75 |
$3,149 |
6.4× |
| Parathyroid imaging (78070) |
$1,971.38 |
$2,628.50 |
5.3× |
| Pelvis 1 or 2 views (72170) |
$1,120.50 |
$1,494 |
11.6× |
| Peritoneogram rs&i (74190) |
$2,955 |
$3,940 |
5.8× |
| PET image w/CT, skull-thigh (78815) |
$3,240.75 |
$4,321 |
2.4× |
| PET whole body (78813) |
$6,104.25 |
$8,139 |
4.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$7,308.75 |
$9,745 |
22.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$6,213 |
$8,284 |
2.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$3,279.75 |
$4,373 |
8.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$8,745.75 |
$11,661 |
17.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,165.88 |
$1,554.50 |
2.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$1,482 |
$1,976 |
15.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$40,701 |
$54,268 |
6.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,385.75 |
$3,181 |
4.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$1,611.75 |
$2,149 |
17.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$2,096.25 |
$2,795 |
5.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$1,480.50 |
$1,974 |
15.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$994.50 |
$1,326 |
12.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,617.75 |
$2,157 |
16.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$992.25 |
$1,323 |
12.3× |
| Radiologic exam colon single contrast study (74270) |
$2,454.38 |
$3,272.50 |
15.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$1,138.50 |
$1,518 |
7.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$2,506.88 |
$3,342.50 |
15.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,337.25 |
$1,783 |
8.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$1,251 |
$1,668 |
15.5× |
| Radiological examination surgical specimen (76098) |
$1,122.38 |
$1,496.50 |
2.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$16,816.50 |
$22,422 |
5.7× |
| Ribs bilateral 3 views (71110) |
$1,488 |
$1,984 |
15.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$5,961.75 |
$7,949 |
16.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$6,781.50 |
$9,042 |
13.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$5,665.50 |
$7,554 |
11.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,937.50 |
$9,250 |
5.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,398.75 |
$5,865 |
3.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$2,052 |
$2,736 |
9.5× |
| Rp Therapy Intravenous Administration (79101) |
$1,492.50 |
$1,990 |
6.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$2,220 |
$2,960 |
10.0× |
| Scanogram (77073) |
$609 |
$812 |
6.3× |
| Scapula complete (73010) |
$1,194 |
$1,592 |
12.3× |
| Screening digital breast tomosynthesis (77063) |
$142.12 |
$189.50 |
6.1× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$825.75 |
$1,101 |
8.5× |
| Sialogram (70390) |
$1,271.25 |
$1,695 |
5.8× |
| Simulation intermediate (77285) |
$3,872.25 |
$5,163 |
11.2× |
| Small bowel series (74250) |
$2,290.50 |
$3,054 |
14.1× |
| Spec medical radj physics consltj (77370) |
$2,417.25 |
$3,223 |
19.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,908 |
$2,544 |
5.5× |
| Special dosimetry (77331) |
$200.25 |
$267 |
1.6× |
| Special treatment procedure (77470) |
$3,532.50 |
$4,710 |
6.9× |
| Speech evaluation complex (70371) |
$2,138.25 |
$2,851 |
9.7× |
| Spine thoracic 3 views (72072) |
$680.25 |
$907 |
7.0× |
| Stereotactic body radiation delivery (77373) |
$24,862.50 |
$33,150 |
15.0× |
| Superior sagittal sinus venogram (75870) |
$6,498 |
$8,664 |
2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,553.25 |
$2,071 |
4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$735 |
$980 |
2.1× |
| Testicular Imaging With Vascular Flow (78761) |
$4,542.75 |
$6,057 |
12.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$4,532.25 |
$6,043 |
13.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,308.50 |
$3,078 |
18.5× |
| Thoracolumbar 2 views (72080) |
$410.25 |
$547 |
5.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,669.50 |
$2,226 |
3.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,130.25 |
$1,507 |
3.1× |
| Tmj unilateral (70328) |
$394.50 |
$526 |
4.9× |
| Tomogram (76100) |
$2,651.25 |
$3,535 |
27.4× |
| Treatment device intermediate (77333) |
$2,262.75 |
$3,017 |
18.2× |
| Treatment devices simple (77332) |
$1,589.25 |
$2,119 |
12.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$7,330.12 |
$9,773.50 |
14.6× |
| Tx devices design & construction complex (77334) |
$3,778.50 |
$5,038 |
10.9× |
| Ultrasound, abdomen limited (76705) |
$2,054.25 |
$2,739 |
21.2× |
| Umbilical-artery Doppler (OB) (76820) |
$773.25 |
$1,031 |
8.0× |
| Unlisted fluoroscopic procedure (76496) |
$1,303.12 |
$1,737.50 |
16.2× |
| Unlisted magnetic resonance procedure (76498) |
$2,196.38 |
$2,928.50 |
27.2× |
| Unlisted Ultrasound Procedure (76999) |
$691.50 |
$922 |
8.6× |
| Urethrocystography retrograde rs&i (74450) |
$790.50 |
$1,054 |
3.6× |
| Urethrocystography voiding (74455) |
$1,410 |
$1,880 |
6.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$2,739.75 |
$3,653 |
16.9× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$3,126.38 |
$4,168.50 |
19.2× |
| Us abdl aorta screen aaa (76706) |
$971.25 |
$1,295 |
10.0× |
| Us breast unilateral complete (76641) |
$1,288.50 |
$1,718 |
13.3× |
| Us breast unilateral limited (76642) |
$702 |
$936 |
8.7× |
| Us chest (76604) |
$1,599.38 |
$2,132.50 |
16.5× |
| Us compl joint r-t w/image documentation (76881) |
$2,303.25 |
$3,071 |
23.8× |
| Us guided compression repair (76936) |
$2,599.50 |
$3,466 |
13.0× |
| Us ob detailed single fetus (76811) |
$907.50 |
$1,210 |
4.1× |
| Us ob transvaginal (76817) |
$378.75 |
$505 |
3.9× |
| Us pelvic non ob complete (76856) |
$2,749.12 |
$3,665.50 |
28.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$581.25 |
$775 |
6.0× |
| Us pregnancy ltd (76815) |
$490.50 |
$654 |
5.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$376.50 |
$502 |
3.9× |
| Us retroperitoneal complete (76770) |
$1,526.25 |
$2,035 |
15.8× |
| Us retroperitoneal limited (76775) |
$1,061.25 |
$1,415 |
11.0× |
| Us scrotum and contents (76870) |
$2,260.12 |
$3,013.50 |
23.3× |
| Us soft tissue head/neck (76536) |
$2,006.62 |
$2,675.50 |
20.7× |
| Us spinal canal and contents (76800) |
$768 |
$1,024 |
7.9× |
| Us transrectal (76872) |
$635.62 |
$847.50 |
6.6× |
| Us xtr non-vasc lmtd (76882) |
$956.25 |
$1,275 |
9.9× |
| Venogram extremity bilateral (75822) |
$6,645.75 |
$8,861 |
4.6× |
| Venography caval inferior serialography rs&i (75825) |
$7,670.62 |
$10,227.50 |
2.6× |
| Venography caval superior serialography rs&i (75827) |
$9,789 |
$13,052 |
6.7× |
| Venography extremity unilateral rs&i (75820) |
$3,396 |
$4,528 |
2.3× |
| Venography Renal Bilateral (75833) |
$6,429 |
$8,572 |
2.2× |
| Venography renal unilateral selective rs&i (75831) |
$5,229 |
$6,972 |
1.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,576.25 |
$3,435 |
0.9× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$20,025 |
$26,700 |
3.9× |
| Wrist 2 views (73100) |
$1,059 |
$1,412 |
13.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$627.75 |
$837 |
7.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,146 |
$1,528 |
14.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$3,384.75 |
$4,513 |
20.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$996 |
$1,328 |
12.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$2,000.25 |
$2,667 |
24.8× |
| X-ray exam hip uni 1 view (73501) |
$394.50 |
$526 |
4.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$847.50 |
$1,130 |
10.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$1,404.75 |
$1,873 |
14.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$2,601.75 |
$3,469 |
26.9× |
| X-ray eye for foreign body (70030) |
$744 |
$992 |
9.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$1,038.75 |
$1,385 |
12.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,193.25 |
$1,591 |
14.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,845 |
$2,460 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$1,078.50 |
$1,438 |
13.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$1,236.75 |
$1,649 |
15.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$963.75 |
$1,285 |
9.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,558.12 |
$2,077.50 |
16.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,859.25 |
$2,479 |
19.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$373.12 |
$497.50 |
4.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$555 |
$740 |
6.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$566.62 |
$755.50 |
5.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,813.50 |
$2,418 |
5.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,307.25 |
$1,743 |
16.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,434 |
$1,912 |
14.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,859.25 |
$2,479 |
19.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$474 |
$632 |
4.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,267.50 |
$1,690 |
15.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,197.75 |
$1,597 |
14.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$2,008.12 |
$2,677.50 |
24.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$492.75 |
$657 |
6.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,879.50 |
$2,506 |
19.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,278.75 |
$1,705 |
13.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$1,054.88 |
$1,406.50 |
13.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$454.50 |
$606 |
5.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$1,188 |
$1,584 |
14.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,536.75 |
$2,049 |
15.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$1,683.75 |
$2,245 |
17.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$423.75 |
$565 |
5.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,066.50 |
$1,422 |
13.2× |
| Xr c-spine 6 or more views (72052) |
$1,414.50 |
$1,886 |
14.6× |
| Xr chest 4+ views (71048) |
$984 |
$1,312 |
10.2× |
| Xr Cholecystography Oral Contrast (74290) |
$1,857 |
$2,476 |
11.4× |
| Xr finger(s) 2+ views (73140) |
$429.75 |
$573 |
5.3× |
| Xr shoulder 1 view (73020) |
$588 |
$784 |
7.3× |
| Xr spine cervical 4 or 5 views (72050) |
$1,488 |
$1,984 |
15.4× |
| Xr tibia/fibula 2 views (73590) |
$1,196.25 |
$1,595 |
14.8× |
| Xr tmj bilateral (70330) |
$439.88 |
$586.50 |
5.5× |
| Xray knee 1 or 2 views rt (73560) |
$1,017.75 |
$1,357 |
12.6× |