| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,475 |
$12,046 |
1.0× |
| Abdomen 1 View (74018) |
$92 |
$784 |
1.0× |
| Abdomen 2 views (74019) |
$111 |
$861 |
1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$426 |
$1,892 |
1.0× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$1,380 |
$2,921 |
1.0× |
| Angio internal mammary (75756) |
$3,367 |
$3,058 |
1.0× |
| Angio pulmonary bilat (75743) |
$3,367 |
$5,946 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,367 |
$9,916 |
1.0× |
Angiography extremity unilateral rs&i (75710)
range across 4 matching MRF lines |
$3,367 |
$5,857–$5,946 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,367 |
$3,949 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,367 |
$5,946 |
1.0× |
Ankle 2 views (73600)
range across 3 matching MRF lines |
$92 |
$636–$890 |
1.0× |
| Aortography thoracic serialography rs&i (75605) |
$5,933 |
$4,800 |
1.0× |
| Artery X-Rays Abdomen (75726) |
$5,933 |
$7,434 |
1.0× |
| Artery X-Rays Pelvis (75736) |
$5,933 |
$5,506 |
1.0× |
| Artery X-Rays Spine (75705) |
$5,933 |
$4,413 |
1.0× |
Arthrogram ankle (73615)
range across 3 matching MRF lines |
$372 |
$1,672–$2,507 |
1.0× |
| Arthrogram hip (73525) |
$372 |
$2,001 |
1.0× |
Arthrogram Wrist (73115)
range across 3 matching MRF lines |
$372 |
$1,591–$2,387 |
1.0× |
| Basic radiation dosimetry calculation (77300) |
$143 |
$924 |
1.0× |
| Bone age studies (77072) |
$111 |
$943 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$426 |
$4,223 |
1.0× |
| Bone Imaging Limited Area (78300) |
$426 |
$2,142 |
1.0× |
| Bone Imaging Multiple Areas (78305) |
$426 |
$2,721 |
1.0× |
| Bone Imaging Whole Body (78306) |
$426 |
$2,987 |
1.0× |
| Bone marrow imaging limited area (78102) |
$426 |
$1,630 |
1.0× |
| Bone marrow imaging; multiple areas (78103) |
$426 |
$2,720 |
1.0× |
| Bone marrow imaging; whole body (78104) |
$426 |
$3,018 |
1.0× |
| Bone survey infant (77076) |
$111 |
$477 |
1.0× |
| Brachytx isodose complex (77318) |
$399 |
$2,098 |
1.0× |
| Brachytx isodose intermed (77317) |
$399 |
$1,609 |
1.0× |
| Brachytx Isodose Plan Simple (77316) |
$399 |
$1,240 |
1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$579 |
$2,005 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,524 |
$6,730 |
1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$372 |
$4,411 |
1.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$835 |
$5,345 |
1.0× |
| Cat Scan Follow-Up Study (76380) |
$92 |
$1,490 |
1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$579 |
$1,609 |
1.0× |
| Cerebrospinal Fluid Scan (78630) |
$579 |
$1,891 |
1.0× |
| Chest 1 view (71045) |
$92 |
$784 |
1.0× |
| Chest 2 views (71046) |
$92 |
$861 |
1.0× |
| Chest 3 views (71047) |
$92 |
$949 |
1.0× |
| Chest 4 or more views (71048) |
$111 |
$1,044 |
1.0× |
| Clavicle complete (73000) |
$92 |
$763 |
1.0× |
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271)
range across 2 matching MRF lines |
$111 |
$99–$430 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$143 |
$1,106 |
1.0× |
| Contrast Exam Abdominl Aorta (75625) |
$3,367 |
$8,321 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$372 |
$1,551 |
1.0× |
Contrast X-Ray Of Elbow (73085)
range across 3 matching MRF lines |
$372 |
$1,469–$2,203 |
1.0× |
| Contrast X-Ray Of Knee Joint (73580) |
$372 |
$1,240 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$372 |
$11,133 |
1.0× |
| CT abdomen and pelvis without contrast (74176) |
$254 |
$9,951 |
1.0× |
| CT abdomen w contrast (74160) |
$187 |
$5,642 |
1.0× |
| CT abdomen w wo contrast (74170) |
$187 |
$6,484 |
1.0× |
| CT abdomen w/o contrast (74150) |
$111 |
$2,628 |
1.0× |
| CT Angio Abdomen and Pelvis (74174) |
$372 |
$6,401 |
1.0× |
| CT Angio Chest (71275) |
$187 |
$3,960 |
1.0× |
| CT Angio Head (70496) |
$187 |
$2,872 |
1.0× |
| CT angio hrt w/3d image (75574) |
$372 |
$4,389 |
1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$187 |
$2,694 |
1.0× |
| CT Angio Neck (70498) |
$187 |
$3,006 |
1.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$187 |
$2,268 |
1.0× |
| CT cervical spine w/ contrast (72126) |
$372 |
$3,490 |
1.0× |
| CT cervical spine w/o contrast (72125) |
$111 |
$3,028 |
1.0× |
| CT cervical spine w/wo cont (72127) |
$187 |
$4,035 |
1.0× |
| CT chest w contrast (71260) |
$187 |
$3,537 |
1.0× |
| CT chest w/wo contrast (71270) |
$187 |
$4,793 |
1.0× |
| CT colonography screening (74263) |
$254 |
$425 |
1.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$187 |
$906 |
1.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$111 |
$910 |
1.0× |
| CT head/brain with contrast (70460) |
$187 |
$4,691 |
1.0× |
| CT head/brain without and with contrast (70470) |
$187 |
$5,161 |
1.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$372 |
$2,587 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$92 |
$49 |
1.0× |
| CT iac w contrast (70481) |
$187 |
$2,862 |
1.0× |
| CT l-spine w&w/o contrast (72133) |
$187 |
$4,751 |
1.0× |
| CT lower ext w/o (73700) |
$111 |
$2,765 |
1.0× |
| CT lower extremity w/contrast material (73701) |
$187 |
$3,135 |
1.0× |
| CT lumbar spine w contrast (72132) |
$372 |
$3,851 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$111 |
$2,990 |
1.0× |
| CT maxillofacial w contrast (70487) |
$187 |
$2,764 |
1.0× |
| CT maxillofacial wo contrast (70486) |
$111 |
$2,402 |
1.0× |
| CT neck tissue combo (70492) |
$187 |
$6,395 |
1.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$187 |
$3,455 |
1.0× |
| CT orbits w/o contrast (70480) |
$111 |
$2,530 |
1.0× |
| CT pelvis w&w/o contrast (72194) |
$187 |
$3,768 |
1.0× |
| CT pelvis w/o contrast (72192) |
$111 |
$2,642 |
1.0× |
| CT scan of leg combo (73702) |
$187 |
$3,732 |
1.0× |
| CT scans face/jaw combo (70488) |
$187 |
$3,508 |
1.0× |
| CT soft tissue neck w contrast (70491) |
$187 |
$5,174 |
1.0× |
| CT soft tissue neck w/o contrast (70490) |
$111 |
$4,012 |
1.0× |
| CT thoracic spine w contrast (72129) |
$187 |
$3,475 |
1.0× |
| CT thoracic spine w/o contrast (72128) |
$111 |
$3,115 |
1.0× |
| CT thoracic spine w/wo cont (72130) |
$187 |
$4,458 |
1.0× |
| CT thorax w/o contrast (71250) |
$111 |
$2,823 |
1.0× |
CT upper ext wo (73200)
range across 3 matching MRF lines |
$111 |
$532–$2,995 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$187 |
$4,049 |
1.0× |
| CT upper extremity with contrast (73201) |
$372 |
$3,235 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$187 |
$3,361 |
1.0× |
| Cta Abdomen (74175) |
$187 |
$4,966 |
1.0× |
| CTA pelvis (72191) |
$187 |
$2,747 |
1.0× |
| Discography Cerv/Thor Spine (72285) |
$2,082 |
$5,946 |
1.0× |
| Diskography lumbar (72295) |
$2,082 |
$21,895 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$111 |
$487 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$111 |
$623 |
1.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$111 |
$286 |
1.0× |
| Dxa Bone Density Axial (77080) |
$111 |
$1,277 |
1.0× |
| Dxa bone density study (77085) |
$111 |
$1,651 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$92 |
$261 |
1.0× |
| Echo exam of fetal heart (76825) |
$582 |
$1,375 |
1.0× |
| Echo Guide For Artery Repair (76936) |
$230 |
$1,864 |
1.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$254 |
$1,014 |
1.0× |
| Esophagram (74220) |
$187 |
$712 |
1.0× |
| Fetal Biophys Profile W/Nst (76818) |
$111 |
$362 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$111 |
$1,821 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$254 |
$747 |
1.0× |
| Follow-Up Angiography (75898) |
$3,367 |
$1,663 |
1.0× |
| Foot 2 views (73620) |
$92 |
$758 |
1.0× |
Forearm 2 views (73090)
range across 3 matching MRF lines |
$92 |
$532–$805 |
1.0× |
| Gastric emptying imaging study (78264) |
$426 |
$4,285 |
1.0× |
| Gastroesophageal Reflux Exam (78262) |
$426 |
$2,512 |
1.0× |
| Gated Heart Planar Single (78472) |
$426 |
$4,176 |
1.0× |
| Hand 2 views (73120) |
$111 |
$688 |
1.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$742 |
$7,599 |
1.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$742 |
$6,960 |
1.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$742 |
$5,566 |
1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,367 |
$5,946 |
1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,367 |
$5,946 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$579 |
$4,860 |
1.0× |
| Hepatobiliary System Imaging (78226) |
$426 |
$2,909 |
1.0× |
| Ht Musc Image Planar Mult (78454) |
$1,380 |
$3,593 |
1.0× |
| Ht Muscle Image Spect Sing (78451) |
$1,380 |
$3,841 |
1.0× |
| Hysterosalpingogram (74740) |
$254 |
$2,875 |
1.0× |
| Infant hip ultrasound, limited static exam (76886) |
$92 |
$1,389 |
1.0× |
| Interstitial radiation source applic complex (77778) |
$742 |
$8,528 |
1.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$742 |
$4,687 |
1.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$589 |
$4,235 |
1.0× |
| Intracavitary radiation source applic simple (77761) |
$589 |
$2,985 |
1.0× |
| K Flow/Funct Image W/Drug (78708) |
$579 |
$4,818 |
1.0× |
| K Flow/Funct Image W/O Drug (78707) |
$579 |
$5,233 |
1.0× |
Knee 3 Views (73562)
range across 3 matching MRF lines |
$92 |
$440–$946 |
1.0× |
| Leveen/Shunt Patency Exam (78291) |
$426 |
$1,082 |
1.0× |
| Liver & Spleen Imaging Static Only (78215) |
$426 |
$1,767 |
1.0× |
| Lung Perf&Ventilat Diferentl (78598) |
$579 |
$2,642 |
1.0× |
| Lung perfusion differential (78597) |
$426 |
$1,253 |
1.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$579 |
$2,584 |
1.0× |
| Lung Ventilation Imaging (78579) |
$426 |
$2,168 |
1.0× |
| Lymph System Imaging (78195) |
$579 |
$4,357 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$254 |
$8,368 |
1.0× |
| Magnetic Resonance Elastography (76391) |
$254 |
$1,751 |
1.0× |
| Mammary ductogram or galactogram multiple (77054) |
$254 |
$1,503 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$254 |
$1,111 |
1.0× |
| Meckels Divert Exam (78290) |
$426 |
$1,985 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$399 |
$1,931 |
1.0× |
| Mr safety determination physician/other qhp (76016) |
$92 |
$309 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$30 |
$86 |
1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$101 |
$322 |
1.0× |
| Mr safety implt pos&/immoblj (76019) |
$62 |
$208 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$254 |
$847 |
1.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$372 |
$5,066 |
1.0× |
| MRA head w/o contrast (70544) |
$254 |
$3,766 |
1.0× |
| MRA head with contrast (70545) |
$372 |
$4,477 |
1.0× |
| MRA neck w contrast (70548) |
$372 |
$4,221 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$372 |
$4,507 |
1.0× |
| MRA neck w/o contrast (70547) |
$254 |
$4,006 |
1.0× |
| MRI abdomen w/o contrast (74181) |
$254 |
$4,220 |
1.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$835 |
$6,341 |
1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$372 |
$6,478 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$835 |
$7,238 |
1.0× |
| MRI brain functional w/o physician admnistration (70554) |
$254 |
$4,317 |
1.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$254 |
$2,626 |
1.0× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$254 |
$1,751 |
1.0× |
| MRI cardiac w/o cont stress (75559) |
$582 |
$1,512 |
1.0× |
| MRI cardiac w/o contrast (75557) |
$254 |
$1,407 |
1.0× |
| MRI cervical spine w contrast (72142) |
$372 |
$5,300 |
1.0× |
| MRI cervical spine w/o cont (72141) |
$254 |
$4,773 |
1.0× |
| MRI chest w/o contrast (71550) |
$254 |
$3,793 |
1.0× |
| MRI chest with contrast (71551) |
$835 |
$4,155 |
1.0× |
| MRI chest wo w contrast (71552) |
$372 |
$5,164 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$372 |
$3,829 |
1.0× |
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 3 matching MRF lines |
$372 |
$890–$4,670 |
1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$254 |
$3,514 |
1.0× |
| MRI lumbar spine w contrast (72149) |
$372 |
$5,238 |
1.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$372 |
$6,333 |
1.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$254 |
$3,885 |
1.0× |
MRI orbit face neck w contrast (70542)
range across 3 matching MRF lines |
$372 |
$4,624–$4,793 |
1.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$372 |
$7,463 |
1.0× |
| MRI pelvis w contrast (72196) |
$372 |
$5,748 |
1.0× |
MRI pelvis w/o & w contrast (72197)
range across 2 matching MRF lines |
$372 |
$8,198–$9,697 |
1.0× |
| MRI pelvis w/o contrast (72195) |
$254 |
$3,872 |
1.0× |
| MRI spectroscopy (76390) |
$92 |
$2,766 |
1.0× |
| MRI thoracic spine w/o contrast (72146) |
$254 |
$3,824 |
1.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$372 |
$4,137 |
1.0× |
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 4 matching MRF lines |
$254 |
$3,708–$3,793 |
1.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$372 |
$5,480 |
1.0× |
| MRI, abdomen, combo (74183) |
$372 |
$6,387 |
1.0× |
| MRI, dorsal spine combo (72157) |
$372 |
$5,799 |
1.0× |
| MRI, dorsal spine contrast (72147) |
$372 |
$6,778 |
1.0× |
MRI, joint upper extrem (73221)
range across 9 matching MRF lines |
$254 |
$440–$3,868 |
1.0× |
| MRI, joint upper extrem combo (73223) |
$372 |
$10,567 |
1.0× |
| MRI, lumbar spine combo (72158) |
$372 |
$5,768 |
1.0× |
| Myelogram Lumbar (72265) |
$835 |
$2,276 |
1.0× |
| Myelography thoracic (72255) |
$835 |
$2,034 |
1.0× |
| Myelograpy 2/more regions rs&i (72270) |
$835 |
$2,966 |
1.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,380 |
$6,092 |
1.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,380 |
$2,595 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,380 |
$9,157 |
1.0× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,524 |
$6,037 |
1.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,524 |
$6,037 |
1.0× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$2,348 |
$9,413 |
1.0× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$1,618 |
$9,413 |
1.0× |
| N-invas est c ffr sw aly CTA (75580) |
$915 |
$3,617 |
1.0× |
| Neck soft tissue (70360) |
$92 |
$726 |
1.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$411 |
$1,293 |
1.0× |
| Nm csf leak detection (78650) |
$1,380 |
$2,494 |
1.0× |
| Nm myocard infarct spect (78469) |
$579 |
$2,554 |
1.0× |
| Nonvascular Shunt X-Ray (75809) |
$111 |
$374 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,475 |
$9,310 |
1.0× |
| Nuclear Rx Intra-Arterial (79445) |
$248 |
$1,323 |
1.0× |
Nuclear Rx Oral Admin (79005)
range across 3 matching MRF lines |
$248 |
$841–$5,119 |
1.0× |
| Ob us nuchal meas 1 gest (76813) |
$111 |
$583 |
1.0× |
| Panoramic X-ray of jaws (70355) |
$92 |
$672 |
1.0× |
| Parathyroid Planar Imaging (78070) |
$426 |
$2,568 |
1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$426 |
$3,720 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$111 |
$425 |
1.0× |
| Perineogram (74775) |
$254 |
$973 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$1,524 |
$6,829 |
1.0× |
| PET image w/CT, full body (78816) |
$1,524 |
$14,148 |
1.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$1,524 |
$14,026 |
1.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$1,380 |
$4,895 |
1.0× |
| PET whole body (78813) |
$1,524 |
$8,543 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$426 |
$2,373 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$582 |
$1,129 |
1.0× |
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines |
$92 |
$440–$898 |
1.0× |
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines |
$92 |
$440–$650 |
1.0× |
| Radex elbow complete minimum 3 views (73080) |
$92 |
$806 |
1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$111 |
$761 |
1.0× |
| Radex fingr minimum 2 views (73140) |
$92 |
$577 |
1.0× |
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines |
$92 |
$440–$908 |
1.0× |
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines |
$92 |
$440–$834 |
1.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$92 |
$453 |
1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$111 |
$694 |
1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$92 |
$869 |
1.0× |
Radex shoulder complete minimum 2 views (73030)
range across 5 matching MRF lines |
$92 |
$978–$3,950 |
1.0× |
| Radex Spine 1 View Specify Level (72020) |
$92 |
$397 |
1.0× |
| Radex Sternum Minimum 2 Views (71120) |
$92 |
$523 |
1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$92 |
$617 |
1.0× |
| Radex Toe Minimum 2 Views (73660) |
$92 |
$735 |
1.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$111 |
$905 |
1.0× |
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines |
$92 |
$440–$888 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$111 |
$837 |
1.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,854 |
$15,774 |
1.0× |
| Radiation treatment delivery level 1 (77402) |
$108 |
$807 |
1.0× |
| Radiation treatment delivery level 2 (77407) |
$411 |
$1,129 |
1.0× |
| Radiation treatment delivery level 3 (77412) |
$589 |
$1,969 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$111 |
$1,405 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$111 |
$949 |
1.0× |
| Radiologic exam colon double contrast study (74280) |
$187 |
$1,766 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$187 |
$1,244 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$187 |
$763 |
1.0× |
Radiologic exam knee complete 4/more views (73564)
range across 5 matching MRF lines |
$111 |
$532–$1,076 |
1.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$111 |
$1,161 |
1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$187 |
$1,223 |
1.0× |
| Radiologic exam swallow function contrast study (74230) |
$187 |
$1,393 |
1.0× |
Radiologic exam upr gi trc double contrast study (74246)
range across 2 matching MRF lines |
$187 |
$1,763–$2,514 |
1.0× |
| Radiologic examination femur 1 view (73551) |
$92 |
$670 |
1.0× |
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines |
$92 |
$759–$1,136 |
1.0× |
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines |
$92 |
$440–$780 |
1.0× |
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines |
$92 |
$440–$862 |
1.0× |
| Radiopharm Dacryocystography (78660) |
$426 |
$1,693 |
1.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$411 |
$6,384 |
1.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$411 |
$5,805 |
1.0× |
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 7 matching MRF lines |
$426 |
$1,112–$1,956 |
1.0× |
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801)
range across 5 matching MRF lines |
$426 |
$1,112–$2,074 |
1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$579 |
$3,561 |
1.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$579 |
$2,731 |
1.0× |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 7 matching MRF lines |
$579 |
$1,908–$2,886 |
1.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,380 |
$5,320 |
1.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$248 |
$949 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$248 |
$699 |
1.0× |
| Scapula (73010) |
$111 |
$821 |
1.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$24 |
$206 |
1.0× |
| Shoulder 1 view (73020) |
$92 |
$255 |
1.0× |
| Shoulder Arthrography (73040) |
$372 |
$3,117 |
1.0× |
| Sialogram (70390) |
$254 |
$811 |
1.0× |
| Skull less than 4 views (70250) |
$111 |
$510 |
1.0× |
| Special dosimetry (77331) |
$143 |
$1,166 |
1.0× |
| Special Physics Consult (77370) |
$143 |
$1,596 |
1.0× |
| Special teletherapy port plan (77321) |
$399 |
$1,691 |
1.0× |
| Special treatment procedure (77470) |
$589 |
$3,258 |
1.0× |
| Stereotactic Body Radiation Delivery (77373) |
$1,906 |
$8,454 |
1.0× |
| Sternoclavicular joints (71130) |
$92 |
$570 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$3,367 |
$6,087 |
1.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$108 |
$810 |
1.0× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$92 |
$319 |
1.0× |
| Tbs technical calculation only (77091) |
$92 |
$319 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$399 |
$3,449 |
1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$399 |
$994 |
1.0× |
| Testicular Imaging W/Flow (78761) |
$426 |
$1,976 |
1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$399 |
$3,486 |
1.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$399 |
$2,180 |
1.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$143 |
$1,500 |
1.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$187 |
$1,588 |
1.0× |
| Thoracic spine 2 views (72070) |
$111 |
$979 |
1.0× |
| Thoracic spine 3 views (72072) |
$111 |
$1,130 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$426 |
$1,187 |
1.0× |
| Thyroid Met Imaging Body (78018) |
$579 |
$4,514 |
1.0× |
| Thyroid Uptake Measurement (78012) |
$426 |
$5,572 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$426 |
$4,005 |
1.0× |
| Tx Devices Design & Construction Complex (77334) |
$399 |
$1,655 |
1.0× |
| Tx devices design & construction intermediate (77333) |
$143 |
$1,114 |
1.0× |
| Tx devices design & construction simple (77332) |
$143 |
$962 |
1.0× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$92 |
$1,173–$1,670 |
1.0× |
| Ultrasound elastography first target lesion (76982) |
$111 |
$962 |
1.0× |
| Ultrasound Elastography Parenchyma (76981) |
$111 |
$962 |
1.0× |
| Ultrasound Exam Aaa Screen (76706) |
$111 |
$109 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$111 |
$2,267 |
1.0× |
| Umbilical-artery Doppler (OB) (76820) |
$111 |
$653 |
1.0× |
| Unlis px ther radiol clinical tx planning (77299) |
$143 |
$1,848 |
1.0× |
| Unlisted fluoroscopic procedure (76496) |
$92 |
$404 |
1.0× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$108 |
$4,058 |
1.0× |
Upper gi w/o kub (74240)
range across 3 matching MRF lines |
$187 |
$1,166–$1,790 |
1.0× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$11 |
$998 |
1.0× |
| Urea breath test c-14 isotopic analysis (78268) |
$94 |
$998 |
1.0× |
| Ureteral Reflux Study (78740) |
$426 |
$1,316 |
1.0× |
| Urethrocystogram voiding (74455) |
$254 |
$2,032 |
1.0× |
| Urethrocystography retrograde (74450) |
$254 |
$1,097 |
1.0× |
Us breast unilateral complete (76641)
range across 8 matching MRF lines |
$111 |
$1,290–$1,937 |
1.0× |
| Us chest (76604) |
$111 |
$1,380 |
1.0× |
| Us complete joint (76881) |
$111 |
$439 |
1.0× |
| Us exam, pelvic, limited (76857) |
$111 |
$1,299 |
1.0× |
| Us head (76506) |
$111 |
$1,208 |
1.0× |
| Us kidney transplant (76776) |
$111 |
$965 |
1.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$111 |
$303 |
1.0× |
| Us ob detailed single fetus (76811) |
$254 |
$742 |
1.0× |
| Us ob limited 1 or more fetuses (76815) |
$111 |
$761 |
1.0× |
| Us ob transvaginal (76817) |
$111 |
$1,378 |
1.0× |
| Us pelvic non ob complete (76856) |
$111 |
$2,221 |
1.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$111 |
$1,862 |
1.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$111 |
$1,059 |
1.0× |
| Us retroperitoneal complete (76770) |
$111 |
$2,168 |
1.0× |
| Us retroperitoneal limited (76775) |
$111 |
$1,201 |
1.0× |
| Us scrotum and contents (76870) |
$111 |
$1,736 |
1.0× |
| Us spinal canal and contents (76800) |
$111 |
$1,121 |
1.0× |
| Us thyroid (76536) |
$111 |
$1,935 |
1.0× |
| Us transrectal (76872) |
$111 |
$1,246 |
1.0× |
| Vascular Flow Imaging (78445) |
$426 |
$1,111 |
1.0× |
| Vein X-Ray Chest (75827) |
$1,678 |
$2,820 |
1.0× |
| Venogram Sinus/Jugular (75860) |
$3,367 |
$3,298 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,367 |
$8,027 |
1.0× |
| Venography extremity bilateral rs&i (75822) |
$1,678 |
$5,352 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,678 |
$2,875 |
1.0× |
| Venography Renal Bilateral (75833) |
$3,367 |
$5,946 |
1.0× |
| Venography Renal Unilateral (75831) |
$3,367 |
$3,148 |
1.0× |
| Venous sampling by catheter (75893) |
$5,933 |
$4,413 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$92 |
$223 |
1.0× |
| Wrist 2 views (73100) |
$92 |
$663 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$92 |
$786 |
1.0× |
| X-ray antegrade pyelogram tube (74425) |
$372 |
$1,222 |
1.0× |
| X-Ray Aorta Leg Arteries (75630) |
$3,367 |
$6,790 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$111 |
$1,146 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$92 |
$707 |
1.0× |
| X-Ray Exam Breast Specimen (76098) |
$582 |
$1,354 |
1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$111 |
$356 |
1.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$111 |
$642 |
1.0× |
| X-Ray Exam Hip Uni 1 View (73501) |
$92 |
$334 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$92 |
$773 |
1.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$111 |
$532 |
1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$111 |
$648 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$111 |
$778 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$111 |
$532 |
1.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$111 |
$1,669 |
1.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$92 |
$1,058 |
1.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$111 |
$1,561 |
1.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$111 |
$1,079 |
1.0× |
| X-ray eye for foreign body (70030) |
$92 |
$726 |
1.0× |
| X-ray humerus (73060) |
$92 |
$427 |
1.0× |
| X-ray IV pyelogram (ivp) (74400) |
$187 |
$2,344 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$92 |
$522 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$92 |
$1,023 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$111 |
$940 |
1.0× |
| X-ray nose-rectum child f.b. (76010) |
$92 |
$504 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$111 |
$1,606 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$111 |
$1,076 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$92 |
$1,105 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$92 |
$764 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$111 |
$532 |
1.0× |
| X-ray thoracic spine 4 vw (72074) |
$111 |
$1,209 |
1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$372 |
$2,075 |
1.0× |
| X-Rays Bone Length Studies (77073) |
$111 |
$844 |
1.0× |
| X-Rays Bone Survey Complete (77075) |
$111 |
$2,180 |
1.0× |
| Xr c-spine 4 or 5 views (72050) |
$111 |
$1,358 |
1.0× |
| Xr facial bones less than 3 views (70140) |
$92 |
$663 |
1.0× |
| Xr orbits complete 4 views (70200) |
$111 |
$1,137 |
1.0× |
| Xr Tomogram Single Plane (76100) |
$111 |
$1,316 |
1.0× |