| 3-D radiotherapy plan dose-volume histograms (77295) |
$893.18 |
$3,123 |
0.6× |
| Abdomen 2 views (74019) |
$705.28 |
$2,466 |
6.2× |
| Ankle 2 views (73600) |
$540.54 |
$1,890 |
5.7× |
| Arthrogram knee (73580) |
$582.58 |
$2,037 |
1.5× |
| Arthrogram shoulder (73040) |
$634.35 |
$2,218 |
1.7× |
| Arthrogram wrist (73115) |
$814.39 |
$2,847.50 |
2.1× |
| Basic dosimetry (77300) |
$142.15 |
$497 |
1.0× |
| Bone age studies (77072) |
$200.20 |
$700 |
1.8× |
| Bone survey complete (77075) |
$674.96 |
$2,360 |
5.9× |
| Bone survey infant (77076) |
$733.59 |
$2,565 |
6.4× |
| Cervical spine 2 or 3 views (72040) |
$523.10 |
$1,829 |
5.5× |
| Chest 1 view (71045) |
$305.88 |
$1,069.50 |
3.2× |
| Chest xray 3 views (71047) |
$674.11 |
$2,357 |
7.1× |
| Cholecystography, oral contrast Non-Facility (74290) |
$364.65 |
$1,275 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$696.99 |
$2,437 |
3.6× |
| Clavicle complete (73000) |
$450.88 |
$1,576.50 |
4.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$111.54 |
$390 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$142.15 |
$497 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,042.04 |
$21,126 |
15.8× |
| CT abdomen and pelvis without contrast (74176) |
$3,421.99 |
$11,965 |
13.1× |
| CT abdomen w contrast (74160) |
$2,550.84 |
$8,919 |
13.3× |
| CT abdomen w wo contrast (74170) |
$3,451.17 |
$12,067 |
18.0× |
| CT abdomen w/o contrast (74150) |
$1,380.53 |
$4,827 |
12.1× |
| CT angio hrt w/3d image (75574) |
$4,328.61 |
$15,135 |
11.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$2,470.04 |
$8,636.50 |
12.9× |
| CT angiography upper extremity lt (73206) |
$1,145.43 |
$4,005 |
6.0× |
| CT c-spine w/contrast (72126) |
$3,851.57 |
$13,467 |
10.1× |
| CT c-spine w/o contrast (72125) |
$2,203.63 |
$7,705 |
19.3× |
| CT chest w contrast (71260) |
$2,784.79 |
$9,737 |
14.5× |
| CT chest w/wo contrast (71270) |
$3,118.83 |
$10,905 |
16.3× |
| CT head/brain with contrast (70460) |
$2,666.10 |
$9,322 |
13.9× |
| CT head/brain without and with contrast (70470) |
$3,142.29 |
$10,987 |
16.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$4,328.61 |
$15,135 |
11.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$3,679.39 |
$12,865 |
38.7× |
| CT hrt w/3d image congen (75573) |
$4,328.61 |
$15,135 |
11.4× |
| CT iac w contrast (70481) |
$1,808.10 |
$6,322 |
9.4× |
| CT limited/localized follow up study (76380) |
$112.40 |
$393 |
1.2× |
| CT lower ext w/o (73700) |
$2,453.46 |
$8,578.50 |
21.5× |
| CT lower extremity w wo contrast (73702) |
$3,788.22 |
$13,245.50 |
19.8× |
| CT lower extremity w/contrast material (73701) |
$3,061.92 |
$10,706 |
16.0× |
| CT lumbar spine w & w/o contrast (72133) |
$4,341.20 |
$15,179 |
22.6× |
| CT lumbar spine w/contrast (72132) |
$3,878.16 |
$13,560 |
10.2× |
| CT lumbar spine w/o contrast (72131) |
$1,929.36 |
$6,746 |
16.9× |
| CT maxillofacial w contrast (70487) |
$2,675.25 |
$9,354 |
14.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,945.80 |
$10,300 |
15.4× |
| CT maxillofacial wo contrast (70486) |
$2,210.78 |
$7,730 |
19.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,970.83 |
$6,891 |
10.3× |
| CT orbits w/o contrast (70480) |
$1,536.68 |
$5,373 |
13.4× |
| CT pelvis w/o contrast (72192) |
$1,335.34 |
$4,669 |
11.7× |
| CT pelvis w/wo contrast (72194) |
$2,861.43 |
$10,005 |
14.9× |
| CT scan of arm combo (73202) |
$4,113.12 |
$14,381.50 |
21.5× |
| CT soft tissue neck w contrast (70491) |
$2,769.34 |
$9,683 |
14.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,267.84 |
$11,426 |
17.0× |
| CT soft tissue neck w/o contrast (70490) |
$2,270.84 |
$7,940 |
19.9× |
| CT thoracic spine w/contrast (72129) |
$4,046.33 |
$14,148 |
21.1× |
| CT thoracic spine w/o contrast (72128) |
$2,013.16 |
$7,039 |
17.6× |
| CT thorax w/o contrast (71250) |
$1,392.25 |
$4,868 |
12.2× |
| CT upper ext wo (73200) |
$2,643.36 |
$9,242.50 |
23.1× |
| CT upper extremity with contrast (73201) |
$3,246.10 |
$11,350 |
8.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$936.37 |
$3,274 |
4.9× |
| Cta Abdomen (74175) |
$1,502.36 |
$5,253 |
7.8× |
| CTA abdomen pelvis (74174) |
$1,901.90 |
$6,650 |
5.0× |
| CTA chest (71275) |
$3,461.46 |
$12,103 |
18.1× |
| Cta Head (70496) |
$3,274.42 |
$11,449 |
17.1× |
| Cta Neck (70498) |
$3,139.71 |
$10,978 |
16.4× |
| Cta Pelvis (72191) |
$1,330.76 |
$4,653 |
6.9× |
| Cystography minimum 3 views rs&i (74430) |
$726.16 |
$2,539 |
1.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$74.65 |
$261 |
0.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$78.94 |
$276 |
0.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$305.17 |
$1,067 |
1.2× |
| Esophagus (74220) |
$726.44 |
$2,540 |
3.8× |
| Facial bones min 3 views (70150) |
$405.55 |
$1,418 |
3.5× |
| Fetal Echo (76825) |
$515.38 |
$1,802 |
0.9× |
| Foot 2 views (73620) |
$525.24 |
$1,836.50 |
5.5× |
| Forearm 2 views (73090) |
$525.82 |
$1,838.50 |
5.5× |
| Hand 2 views (73120) |
$445.88 |
$1,559 |
3.9× |
| Hysterosalpingogram (74740) |
$306.02 |
$1,070 |
1.2× |
| Knee 3 views (73562) |
$591.16 |
$2,067 |
6.2× |
| Mammary ductogram or galactogram multiple (77054) |
$457.03 |
$1,598 |
1.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$30.03 |
$105 |
0.9× |
| Myelogram Cervical (72240) |
$442.73 |
$1,548 |
0.5× |
| Myelogram Lumbar (72265) |
$575.44 |
$2,012 |
0.7× |
| Myelogram thoracic (72255) |
$442.73 |
$1,548 |
0.5× |
| Myelography 2 or more regions (72270) |
$442.73 |
$1,548 |
0.5× |
| Neck soft tissue (70360) |
$467.61 |
$1,635 |
4.9× |
| Ob us nuchal meas 1 gest (76813) |
$198.49 |
$694 |
1.7× |
| Osseous survey limited (77074) |
$491.35 |
$1,718 |
4.3× |
| Pelvis 1 or 2 views (72170) |
$393.83 |
$1,377 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$568.29 |
$1,987 |
1.0× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$631.35 |
$2,207.50 |
6.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$430 |
$1,503.50 |
4.5× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$679.12 |
$2,374.50 |
7.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$96.10 |
$336 |
0.8× |
| Radex fingr minimum 2 views (73140) |
$359.51 |
$1,257 |
3.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$596.74 |
$2,086.50 |
6.3× |
| Radex Hand Minimum 3 Views (73130) |
$525.82 |
$1,838.50 |
5.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$374.38 |
$1,309 |
3.9× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$138.14 |
$483 |
1.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$704.42 |
$2,463 |
6.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$811.39 |
$2,837 |
7.1× |
| Radex Humerus Minimum 2 Views (73060) |
$400.98 |
$1,402 |
4.2× |
| Radex Kne 1/2 Views (73560) |
$490.36 |
$1,714.50 |
5.2× |
| Radex Kne Compl 4/More Views (73564) |
$681.26 |
$2,382 |
6.0× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$557.42 |
$1,949 |
4.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$343.20 |
$1,200 |
3.6× |
| Radex Sho Compl Minimum 2 Views (73030) |
$592.02 |
$2,070 |
6.2× |
| Radex Sinuses Paransl < 3 Views (70210) |
$253.40 |
$886 |
2.7× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$594.31 |
$2,078 |
5.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$425.29 |
$1,487 |
4.5× |
| Radex Toe Minimum 2 Views (73660) |
$387.82 |
$1,356 |
4.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$612.33 |
$2,141 |
6.4× |
| Radiation treatment delivery level 1 (77402) |
$72.08 |
$252 |
0.6× |
| Radiation treatment delivery level 3 (77412) |
$139.29 |
$487 |
0.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$449.31 |
$1,571 |
4.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$705.28 |
$2,466 |
6.2× |
| Radiologic exam chest 2 views (71046) |
$359.50 |
$1,257 |
3.8× |
| Radiologic exam colon single contrast study (74270) |
$878.60 |
$3,072 |
4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$755.90 |
$2,643 |
3.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$665.53 |
$2,327 |
3.5× |
| Radiologic examination femur 1 view (73551) |
$729.02 |
$2,549 |
7.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$534.82 |
$1,870 |
5.6× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$338.91 |
$1,185 |
0.6× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$398.40 |
$1,393 |
3.5× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$191.91 |
$671 |
1.7× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$191.91 |
$671 |
2.0× |
| Radiological examination surgical specimen (76098) |
$531.96 |
$1,860 |
0.9× |
| Ribs bilateral 3 views (71110) |
$520.24 |
$1,819 |
4.6× |
| Sacroiliac Joints < 3 Views (72200) |
$510.23 |
$1,784 |
4.5× |
| Scapula (73010) |
$584.44 |
$2,043.50 |
5.1× |
| Sella turcica (70240) |
$163.88 |
$573 |
1.7× |
| Shoulder 1 view (73020) |
$459.46 |
$1,606.50 |
4.8× |
| Sialogram (70390) |
$469.33 |
$1,641 |
1.8× |
| Small bowel series (74250) |
$546.84 |
$1,912 |
2.9× |
| Special dosimetry (77331) |
$142.15 |
$497 |
1.0× |
| Special treatment procedure (77470) |
$374.38 |
$1,309 |
0.6× |
| Spine thoracic 3 views (72072) |
$611.76 |
$2,139 |
5.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$108.97 |
$381 |
0.3× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$543.69 |
$1,901 |
2.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$357.50 |
$1,250 |
0.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$253.97 |
$888 |
1.7× |
| Thoracolumbar 2 views (72080) |
$391.54 |
$1,369 |
4.1× |
| Tomogram (76100) |
$379.24 |
$1,326 |
3.3× |
| Treatment device complex (77334) |
$266.27 |
$931 |
0.7× |
| Ultrasound breast complete (76641) |
$224.08 |
$783.50 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$141.57 |
$495 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$995.86 |
$3,482 |
8.7× |
| Urethrocystogram voiding (74455) |
$579.73 |
$2,027 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$579.73 |
$2,027 |
2.2× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$1,794.65 |
$6,275 |
9.4× |
| Us breast unilateral limited (76642) |
$224.08 |
$783.50 |
2.4× |
| Us chest (76604) |
$298.30 |
$1,043 |
2.6× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$318.32 |
$1,113 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$678.68 |
$2,373 |
5.9× |
| Us encephalogram (76506) |
$304.02 |
$1,063 |
2.7× |
| Us infant hips w manipulation (76885) |
$365.51 |
$1,278 |
3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$210.50 |
$736 |
1.8× |
| Us ob detailed single fetus (76811) |
$276.57 |
$967 |
1.1× |
| Us ob limited (76815) |
$944.38 |
$3,302 |
8.3× |
| Us ob transvaginal (76817) |
$1,085.37 |
$3,795 |
9.5× |
| Us pelvic non ob complete (76856) |
$1,114.83 |
$3,898 |
9.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$576.29 |
$2,015 |
5.0× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$1,280.71 |
$4,478 |
11.2× |
| Us retroperitoneal complete (76770) |
$1,025.89 |
$3,587 |
9.0× |
| Us retroperitoneal limited (76775) |
$523.38 |
$1,830 |
4.6× |
| Us scrotum and contents (76870) |
$1,016.45 |
$3,554 |
8.9× |
| Us soft tissue head/neck (76536) |
$947.52 |
$3,313 |
8.3× |
| Us spinal canal and contents (76800) |
$202.21 |
$707 |
1.8× |
| Us transrectal (76872) |
$342.92 |
$1,199 |
3.0× |
| Us,transplanted kidney, real time/ doppler (76776) |
$392.68 |
$1,373 |
3.4× |
| Venogram extremity bilateral (75822) |
$1,356.22 |
$4,742 |
0.8× |
| Venogram Extremity Unilateral (75820) |
$1,152.87 |
$4,031 |
0.7× |
| Wrist 2 views (73100) |
$509.52 |
$1,781.50 |
5.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$849.14 |
$2,969 |
7.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$258.83 |
$905 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,230.09 |
$4,301 |
6.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$579.44 |
$2,026 |
6.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$445.88 |
$1,559 |
4.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$704.42 |
$2,463 |
6.2× |
| X-ray exam of femur 2/> (73552) |
$770.34 |
$2,693.50 |
8.1× |
| X-ray eye for foreign body (70030) |
$271.42 |
$949 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$291.72 |
$1,020 |
3.1× |
| X-ray IV pyelogram (ivp) (74400) |
$1,470.90 |
$5,143 |
7.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$292.01 |
$1,021 |
2.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$919.78 |
$3,216 |
8.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$395.54 |
$1,383 |
3.5× |
| X-ray retrograde pyelogram (74420) |
$735.31 |
$2,571 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$505.08 |
$1,766 |
4.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$656.66 |
$2,296 |
5.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$586.02 |
$2,049 |
5.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$505.08 |
$1,766 |
5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$316.61 |
$1,107 |
3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$567.71 |
$1,985 |
5.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$450.45 |
$1,575 |
3.9× |
| X-Ray Small Bowel Enteroclysis (74251) |
$2,214.50 |
$7,743 |
11.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$374.38 |
$1,309 |
3.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$575.15 |
$2,011 |
6.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$467.61 |
$1,635 |
4.9× |
| Xr bone length studies (77073) |
$290.01 |
$1,014 |
2.5× |
| Xr c-spine 4 or 5 views (72050) |
$706.14 |
$2,469 |
6.2× |
| Xr c-spine 6 or more views (72052) |
$884.03 |
$3,091 |
7.7× |
| Xr chest 4+ views (71048) |
$696.41 |
$2,435 |
6.1× |
| Xr urogram antegrade (74425) |
$735.31 |
$2,571 |
1.9× |