| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,304 |
$12,079 |
1.0× |
| Abdomen 2 views (74019) |
$98 |
$869.27 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$376 |
$2,222.30 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$2,974 |
$5,149.33 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,974 |
$5,345.78 |
1.0× |
| Angiography internal mammary rs&i (75756) |
$2,974 |
$5,149.33 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,242 |
$14,290.20 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,974 |
$14,290.20 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,974 |
$14,290.20 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$5,242 |
$14,290.20 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,242 |
$4,701.21 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,974 |
$4,270.24 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,974 |
$5,057.27 |
1.0× |
| Ankle 2 views (73600) |
$81 |
$982.23 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$328 |
$1,621.91 |
1.0× |
| Aortogram thoracic (75605) |
$5,242 |
$5,747.27 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,974 |
$15,299.50 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$2,974 |
$15,299.50 |
1.0× |
| Arthrogram elbow (73085) |
$328 |
$1,754.51 |
1.0× |
| Arthrogram hip (73525) |
$328 |
$1,775.37 |
1.0× |
| Arthrogram shoulder (73040) |
$328 |
$2,137.59 |
1.0× |
| Arthrogram wrist (73115) |
$328 |
$1,775.37 |
1.0× |
| Arthrography knee lt (73580) |
$328 |
$2,455.57 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$126 |
$1,238.83 |
1.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$376 |
$1,499.13 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$376 |
$3,326.08 |
1.0× |
| Bone age studies (77072) |
$98 |
$688.78 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$376 |
$3,829.47 |
1.0× |
| Bone survey complete (77075) |
$98 |
$3,957.16 |
1.0× |
| Brachytx isodose complex (77318) |
$352 |
$7,344.62 |
1.0× |
| Brachytx isodose intermed (77317) |
$352 |
$6,001.43 |
1.0× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$352 |
$4,796.98 |
1.0× |
| Brain image w/flow 4 + views (78606) |
$511 |
$2,152.31 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$328 |
$5,994.06 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$81 |
$1,117.28 |
1.0× |
| Chest 1 view (71045) |
$81 |
$741.58 |
1.0× |
| Chest 3 views (71047) |
$81 |
$1,039.93 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$165 |
$1,845.36 |
1.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$738 |
$3,338.36 |
1.0× |
| Clavicle complete (73000) |
$81 |
$950.31 |
1.0× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$6,938 |
$41,161.60 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$98 |
$422.36 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$126 |
$1,673.48 |
1.0× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$165 |
$982.23 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$328 |
$5,196 |
1.0× |
| CT abdomen and pelvis without contrast (74176) |
$224 |
$3,521.25 |
1.0× |
| CT abdomen w contrast (74160) |
$165 |
$2,691.31 |
1.0× |
| CT abdomen w wo contrast (74170) |
$165 |
$2,990.89 |
1.0× |
| CT abdomen w/o contrast (74150) |
$98 |
$4,421.26 |
1.0× |
| CT angio hrt w/3d image (75574) |
$328 |
$4,535.44 |
1.0× |
| CT angiography upper extremity lt (73206) |
$165 |
$4,383.20 |
1.0× |
| CT c-spine w/o contrast (72125) |
$98 |
$5,537.32 |
1.0× |
| CT cervical spine w&w/o contrast (72127) |
$165 |
$6,469.21 |
1.0× |
| CT cervical spine with contrast (72126) |
$328 |
$5,117.42 |
1.0× |
| CT chest w/wo contrast (71270) |
$165 |
$5,855.31 |
1.0× |
| CT chest with contrast (71260) |
$165 |
$5,171.44 |
1.0× |
| CT head/brain with contrast (70460) |
$165 |
$5,371.57 |
1.0× |
| CT head/brain without and with contrast (70470) |
$165 |
$5,689.57 |
1.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$328 |
$2,652.02 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$81 |
$990.82 |
1.0× |
| CT hrt w/3d image congen (75573) |
$328 |
$2,652.02 |
1.0× |
| CT iac w contrast (70481) |
$165 |
$5,235.29 |
1.0× |
| CT limited/localized follow up study (76380) |
$81 |
$2,719.55 |
1.0× |
| CT lower ext w/o (73700) |
$98 |
$3,424.31 |
1.0× |
| CT lower extremity w wo contrast (73702) |
$165 |
$4,383.20 |
1.0× |
| CT lower extremity with contrast (73701) |
$165 |
$3,424.31 |
1.0× |
| CT lumbar spine w & w/o contrast (72133) |
$165 |
$6,730.74 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$98 |
$5,689.57 |
1.0× |
| CT lumbar spine with contrast (72132) |
$328 |
$6,276.45 |
1.0× |
| CT maxillofacial w contrast (70487) |
$165 |
$5,191.09 |
1.0× |
| CT maxillofacial w/o contrast (70486) |
$98 |
$5,118.64 |
1.0× |
| CT maxillofacial w/wo contrast (70488) |
$165 |
$6,062.81 |
1.0× |
| CT neck soft tissue w contrast (70491) |
$165 |
$5,327.38 |
1.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$165 |
$6,292.40 |
1.0× |
| CT orbits w/o contrast (70480) |
$98 |
$5,005.69 |
1.0× |
| CT pelvis w & w/o contrast (72194) |
$165 |
$2,990.89 |
1.0× |
| CT pelvis w/o contrast (72192) |
$98 |
$1,718.91 |
1.0× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$81 |
$659.32 |
1.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$165 |
$6,665.67 |
1.0× |
| CT soft tissue neck w/o contrast (70490) |
$98 |
$4,167.10 |
1.0× |
| CT thoracic spine w/contrast (72129) |
$165 |
$6,460.63 |
1.0× |
| CT thoracic spine w/o contrast (72128) |
$98 |
$5,552.06 |
1.0× |
| CT thoracic spine w/wo contrast (72130) |
$165 |
$6,449.58 |
1.0× |
| CT thorax w/o contrast (71250) |
$98 |
$4,614.03 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$165 |
$4,383.20 |
1.0× |
| CT upper extremity w/o contrast rt (73200) |
$98 |
$3,423.07 |
1.0× |
| CT upper extremity with contrast (73201) |
$328 |
$3,281.88 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$165 |
$5,663.79 |
1.0× |
| Cta Abdomen (74175) |
$165 |
$3,030.18 |
1.0× |
| CTA abdomen pelvis (74174) |
$328 |
$5,196 |
1.0× |
| CTA chest (71275) |
$165 |
$5,507.87 |
1.0× |
| Cta Head (70496) |
$165 |
$5,450.16 |
1.0× |
| CTA lwr ext w&w/o contrast (73706) |
$165 |
$4,383.20 |
1.0× |
| Cta Neck (70498) |
$165 |
$6,388.19 |
1.0× |
| Cta Pelvis (72191) |
$165 |
$3,030.18 |
1.0× |
| Cystography minimum 3 views rs&i (74430) |
$328 |
$1,506.49 |
1.0× |
| Diskogram cervical (72285) |
$1,839 |
$12,888.10 |
1.0× |
| Diskography lumbar (72295) |
$1,839 |
$12,888.10 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$98 |
$1,332.16 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$98 |
$1,833.09 |
1.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$98 |
$1,833.09 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$98 |
$721.93 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$81 |
$405.17 |
1.0× |
| Echo exam of eye (76529) |
$81 |
$427.28 |
1.0× |
| Echo exam of fetal heart (76825) |
$514 |
$1,833.09 |
1.0× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$224 |
$1,332.16 |
1.0× |
| Echoencephalography real time imaging (76506) |
$98 |
$1,501.57 |
1.0× |
| Esophagus (74220) |
$165 |
$1,312.50 |
1.0× |
| Fetal biophysical profile non-stress testing (76818) |
$98 |
$1,916.56 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$98 |
$1,501.57 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$224 |
$1,500.36 |
1.0× |
| Foot 2 views (73620) |
$81 |
$982.23 |
1.0× |
| Forearm 2 views (73090) |
$81 |
$1,006.79 |
1.0× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$224 |
$1,192.17 |
1.0× |
| Gated Heart Planar Single (78472) |
$376 |
$3,386.23 |
1.0× |
| Hand 2 views (73120) |
$98 |
$982.23 |
1.0× |
| Hand 3 views (73130) |
$81 |
$1,147.98 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$656 |
$5,838.14 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$656 |
$6,330.48 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$656 |
$6,824.04 |
1.0× |
| Heart Infarct Image (78466) |
$376 |
$2,252.99 |
1.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,974 |
$14,473.20 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$511 |
$2,795.68 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$376 |
$1,982.88 |
1.0× |
| Ht muscle image spect sing (78451) |
$1,219 |
$5,633.09 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$81 |
$963.82 |
1.0× |
| Hysterosalpingogram (74740) |
$224 |
$2,250.54 |
1.0× |
| Interstitial radiation source applic complex (77778) |
$656 |
$6,614.09 |
1.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$656 |
$2,335.24 |
1.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$520 |
$2,100.75 |
1.0× |
| Intracavitary radiation source applic simple (77761) |
$520 |
$1,639.10 |
1.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$98 |
$666.69 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$511 |
$3,571.63 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$511 |
$3,836.84 |
1.0× |
| Knee 3 views (73562) |
$81 |
$1,204.46 |
1.0× |
| Liver & spleen imaging static only (78215) |
$376 |
$2,136.36 |
1.0× |
| Lung perfusion differential (78597) |
$376 |
$1,370.21 |
1.0× |
| Lung Ventilation Imaging (78579) |
$376 |
$1,370.21 |
1.0× |
| Lymphoscintigraphy (78195) |
$511 |
$1,975.51 |
1.0× |
| Mammary ductogram or galactogram multiple (77054) |
$224 |
$2,432.24 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$224 |
$1,545.78 |
1.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$81 |
$940.49 |
1.0× |
| Meckels Diverticulum (78290) |
$376 |
$2,660.62 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$352 |
$1,373.90 |
1.0× |
| MRA head w & w/o contrast (70546) |
$328 |
$2,938.09 |
1.0× |
| MRA head w/o contrast (70544) |
$224 |
$2,428.56 |
1.0× |
| MRA head with contrast (70545) |
$328 |
$2,672.90 |
1.0× |
| MRA neck w contrast (70548) |
$328 |
$2,672.90 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$328 |
$2,938.09 |
1.0× |
| MRA neck w/o contrast (70547) |
$224 |
$2,428.56 |
1.0× |
| MRI abdomen w contrast (74182) |
$328 |
$5,926.53 |
1.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$328 |
$7,467.40 |
1.0× |
| MRI abdomen w/o contrast (74181) |
$224 |
$5,342.11 |
1.0× |
| MRI any jnt lwr ext with con lt (73722) |
$738 |
$9,144.57 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$738 |
$9,144.57 |
1.0× |
| MRI c-spine with contrast (72142) |
$328 |
$5,581.53 |
1.0× |
| MRI cardiac w/o contrast (75557) |
$224 |
$5,614.68 |
1.0× |
| MRI cervical spine w/o contrast (72141) |
$224 |
$5,342.11 |
1.0× |
| MRI chest w/o & w/contrast material (71552) |
$328 |
$6,513.40 |
1.0× |
| MRI chest w/o contrast (71550) |
$224 |
$5,342.11 |
1.0× |
| MRI chest with contrast (71551) |
$738 |
$5,926.53 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$328 |
$7,149.41 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$328 |
$4,808.01 |
1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$224 |
$4,370.92 |
1.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$224 |
$4,855.90 |
1.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$328 |
$5,873.75 |
1.0× |
| MRI orbit/face/neck w/contrast (70542) |
$328 |
$5,342.11 |
1.0× |
| MRI pelvis w contrast (72196) |
$328 |
$5,873.75 |
1.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$328 |
$6,460.63 |
1.0× |
| MRI pelvis w/o contrast (72195) |
$224 |
$5,342.11 |
1.0× |
| MRI scan of arm joint before and after contrast (73223) |
$328 |
$5,285.63 |
1.0× |
| MRI scan of leg joint before and after contrast (73723) |
$328 |
$10,058 |
1.0× |
| MRI spectroscopy (76390) |
$81 |
$6,308.38 |
1.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$328 |
$5,825.86 |
1.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$328 |
$5,581.53 |
1.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$328 |
$5,825.86 |
1.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$328 |
$5,581.53 |
1.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$328 |
$5,825.86 |
1.0× |
| MRI thoracic spine w/o contrast (72146) |
$224 |
$5,342.11 |
1.0× |
| MRI tmj (70336) |
$224 |
$5,342.11 |
1.0× |
| MRI upper ext joint w/o contrast (73221) |
$224 |
$8,312.13 |
1.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$328 |
$5,285.63 |
1.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$224 |
$7,149.41 |
1.0× |
| Myelogram Cervical (72240) |
$738 |
$3,569.18 |
1.0× |
| Myelogram Lumbar (72265) |
$738 |
$3,882.27 |
1.0× |
| Myelogram thoracic (72255) |
$738 |
$3,882.27 |
1.0× |
| Myocardial infarct spect (78469) |
$511 |
$2,252.99 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,219 |
$5,633.09 |
1.0× |
| Neck soft tissue (70360) |
$81 |
$994.51 |
1.0× |
| Nm cisternogram (78630) |
$511 |
$3,348.17 |
1.0× |
| Nm gastric emptying study (78264) |
$376 |
$3,081.76 |
1.0× |
| Nm gastroesophageal reflux study (78262) |
$376 |
$2,723.24 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$376 |
$3,085.43 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,304 |
$7,155.56 |
1.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$376 |
$3,040.01 |
1.0× |
| Nuclear Rx Oral Admin (79005) |
$219 |
$2,009.89 |
1.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$98 |
$1,161.48 |
1.0× |
| Orthopantogram (70355) |
$81 |
$1,271.98 |
1.0× |
| Osseous survey infant (77076) |
$98 |
$1,349.34 |
1.0× |
| Osseous survey limited (77074) |
$98 |
$2,699.90 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$376 |
$4,676.65 |
1.0× |
| Parathyroid imaging (78070) |
$376 |
$2,579.58 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$98 |
$834.89 |
1.0× |
| Peritoneogram rs&i (74190) |
$514 |
$1,465.97 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$1,347 |
$9,372.93 |
1.0× |
| PET imaging CT for attenuation limited area (78814) |
$1,347 |
$9,372.93 |
1.0× |
| PET imaging for CT attenuation whole body (78816) |
$1,347 |
$9,372.93 |
1.0× |
| Pr gi endoscopic ultrasound (76975) |
$224 |
$1,948.50 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$328 |
$5,285.63 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,974 |
$14,473.20 |
1.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,974 |
$2,346.30 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$376 |
$2,566.08 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$511 |
$4,458.10 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$514 |
$1,942.35 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$81 |
$405.17 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$98 |
$731.77 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$98 |
$897.52 |
1.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$98 |
$1,132.02 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$98 |
$1,016.61 |
1.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$6,938 |
$20,019.10 |
1.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$96 |
$839.82 |
1.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$363 |
$1,236.38 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$98 |
$1,364.07 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$81 |
$934.34 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$98 |
$1,060.82 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$81 |
$950.31 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$165 |
$1,087.31 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$165 |
$1,184.82 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$165 |
$2,031.99 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$165 |
$1,998.84 |
1.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$81 |
$963.82 |
1.0× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$81 |
$305.70 |
1.0× |
| Radiological examination surgical specimen (76098) |
$514 |
$2,787.08 |
1.0× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$219 |
$1,675.92 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,974 |
$14,473.20 |
1.0× |
| Ribs bilateral 3 views (71110) |
$98 |
$331.49 |
1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$376 |
$1,890.80 |
1.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$511 |
$3,745.98 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$511 |
$2,633.60 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$219 |
$1,597.36 |
1.0× |
| Sacroiliac Joints < 3 Views (72200) |
$98 |
$834.89 |
1.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$224 |
$2,223.53 |
1.0× |
| Scanogram (77073) |
$98 |
$1,330.93 |
1.0× |
| Scapula complete (73010) |
$98 |
$1,003.11 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$21 |
$83.49 |
0.9× |
| Sella turcica (70240) |
$81 |
$1,257.26 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$98 |
$676.52 |
1.0× |
| Sialogram (70390) |
$224 |
$1,570.35 |
1.0× |
| Simulation intermediate (77285) |
$352 |
$2,405.24 |
1.0× |
| Small bowel series (74250) |
$165 |
$1,441.43 |
1.0× |
| Spec medical radj physics consltj (77370) |
$126 |
$1,975.51 |
1.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$352 |
$2,427.34 |
1.0× |
| Special dosimetry (77331) |
$126 |
$965.05 |
1.0× |
| Special treatment procedure (77470) |
$520 |
$2,595.54 |
1.0× |
| Spine thoracic 3 views (72072) |
$98 |
$1,645.25 |
1.0× |
| Stereotactic body radiation delivery (77373) |
$1,684 |
$5,397.36 |
1.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$96 |
$768.58 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$352 |
$4,741.73 |
1.0× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$224 |
$4,821.52 |
1.0× |
| Testicular Imaging With Vascular Flow (78761) |
$376 |
$1,615.76 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$352 |
$3,237.67 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$126 |
$1,796.25 |
1.0× |
| Thoracolumbar 2 views (72080) |
$81 |
$1,371.44 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$376 |
$1,749.59 |
1.0× |
| Thyroid uptake measurement (78012) |
$376 |
$1,783.97 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$376 |
$2,444.53 |
1.0× |
| Tomogram (76100) |
$98 |
$1,680.84 |
1.0× |
| Treatment device intermediate (77333) |
$126 |
$1,666.11 |
1.0× |
| Treatment devices simple (77332) |
$126 |
$1,108.69 |
1.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$511 |
$7,103.98 |
1.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$376 |
$1,023.97 |
1.0× |
| Tx devices design & construction complex (77334) |
$352 |
$2,952.82 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$98 |
$1,948.50 |
1.0× |
| Umbilical-artery Doppler (OB) (76820) |
$98 |
$1,833.09 |
1.0× |
| Unlisted magnetic resonance procedure (76498) |
$81 |
$6,308.38 |
1.0× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$96 |
$3,485.70 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$81 |
$492.36 |
1.0× |
| Upper Extremity Infant (73092) |
$98 |
$569.70 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$224 |
$901.19 |
1.0× |
| Urethrocystography voiding (74455) |
$224 |
$1,783.97 |
1.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$165 |
$2,588.18 |
1.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$165 |
$1,242.52 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$98 |
$662.71 |
1.0× |
| Us breast unilateral complete (76641) |
$98 |
$860.68 |
1.0× |
| Us breast unilateral limited (76642) |
$81 |
$502.74 |
1.0× |
| Us chest (76604) |
$98 |
$1,948.50 |
1.0× |
| Us compl joint r-t w/image documentation (76881) |
$98 |
$1,225.33 |
1.0× |
| Us fetal nuchal translucency 1st gestation (76813) |
$98 |
$1,916.56 |
1.0× |
| Us guided compression repair (76936) |
$203 |
$1,948.50 |
1.0× |
| Us infant hips dynamic (76885) |
$81 |
$1,948.50 |
1.0× |
| Us infant hips limited static (76886) |
$81 |
$1,948.50 |
1.0× |
| Us kidney transplant (76776) |
$98 |
$1,317.42 |
1.0× |
| Us ob detailed single fetus (76811) |
$224 |
$1,916.56 |
1.0× |
| Us ob transvaginal (76817) |
$98 |
$1,161.48 |
1.0× |
| Us pelvic non ob complete (76856) |
$98 |
$2,038.13 |
1.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$98 |
$1,386.17 |
1.0× |
| Us pregnancy ltd (76815) |
$98 |
$1,290.41 |
1.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$98 |
$1,916.56 |
1.0× |
| Us retroperitoneal complete (76770) |
$98 |
$1,906.76 |
1.0× |
| Us retroperitoneal limited (76775) |
$98 |
$1,119.74 |
1.0× |
| Us scrotum and contents (76870) |
$98 |
$1,680.84 |
1.0× |
| Us soft tissue head/neck (76536) |
$98 |
$1,948.50 |
1.0× |
| Us spinal canal and contents (76800) |
$98 |
$1,427.92 |
1.0× |
| Us transrectal (76872) |
$98 |
$1,964.46 |
1.0× |
| Us transrectal prostate volume (76873) |
$98 |
$1,069.40 |
1.0× |
| Us xtr non-vasc lmtd (76882) |
$98 |
$995.73 |
1.0× |
| Us, eye b-scan (76512) |
$98 |
$978.55 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,483 |
$3,226.63 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$2,974 |
$4,287.44 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,483 |
$2,421.19 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,483 |
$2,027.09 |
1.0× |
| Venography Renal Bilateral (75833) |
$2,974 |
$4,617.70 |
1.0× |
| Venography renal unilateral selective rs&i (75831) |
$2,974 |
$4,282.53 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,974 |
$4,282.53 |
1.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$5,242 |
$14,473.20 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$81 |
$979.78 |
1.0× |
| Wrist 2 views (73100) |
$81 |
$982.23 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$98 |
$2,095.84 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$81 |
$1,147.98 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$81 |
$1,129.57 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$165 |
$2,013.58 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$81 |
$1,028.88 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$81 |
$1,147.98 |
1.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$98 |
$1,016.61 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$81 |
$1,597.36 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$81 |
$768.58 |
1.0× |
| X-ray exam hip uni 4/> views (73503) |
$98 |
$960.13 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$98 |
$1,016.61 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$98 |
$1,461.06 |
1.0× |
| X-ray exam of femur 1 (73551) |
$81 |
$963.82 |
1.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$165 |
$1,987.80 |
1.0× |
| X-ray eye for foreign body (70030) |
$81 |
$682.65 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$98 |
$1,364.07 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$81 |
$1,194.64 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$81 |
$1,129.57 |
1.0× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,969 |
$8,470.50 |
1.0× |
| X-ray head for orthodontia (70350) |
$81 |
$1,271.98 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$81 |
$982.23 |
1.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$165 |
$1,242.52 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$81 |
$1,192.17 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$98 |
$1,222.88 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$81 |
$605.29 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$81 |
$567.24 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$98 |
$1,391.08 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$98 |
$1,836.77 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$98 |
$1,423.01 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$81 |
$1,364.07 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$81 |
$682.65 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$98 |
$1,364.07 |
1.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$98 |
$1,030.12 |
1.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$514 |
$1,553.15 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$328 |
$3,550.76 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$81 |
$1,113.61 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$98 |
$1,322.33 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$98 |
$1,763.10 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$98 |
$1,117.28 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$81 |
$1,136.92 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$81 |
$982.23 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$81 |
$1,364.07 |
1.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$81 |
$682.65 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$98 |
$1,528.59 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$98 |
$950.31 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$81 |
$747.72 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$81 |
$1,322.33 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$81 |
$950.31 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$98 |
$1,117.28 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$98 |
$1,785.21 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$81 |
$405.17 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$81 |
$1,147.98 |
1.0× |
| Xr arthrogram ankle (73615) |
$328 |
$1,718.91 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$98 |
$1,785.21 |
1.0× |
| Xr chest 4+ views (71048) |
$98 |
$1,603.50 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$81 |
$405.17 |
1.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$98 |
$963.82 |
1.0× |
| Xr optic foramina (70190) |
$81 |
$1,364.07 |
1.0× |
| Xr shoulder 1 view (73020) |
$81 |
$822.61 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$98 |
$1,529.82 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$81 |
$982.23 |
1.0× |
| Xr tmj bilateral (70330) |
$81 |
$1,501.57 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$81 |
$982.23 |
1.0× |