| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,606.40 |
$2,008 |
1.1× |
| Abdomen 1 View (74018) |
$144.80 |
$181 |
1.6× |
| Abdomen 2 views (74019) |
$179.20 |
$224 |
1.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,587.20 |
$1,984 |
3.9× |
| Angio internal mammary (75756) |
$3,836 |
$4,795 |
1.2× |
| Angio pulmonary bilat (75743) |
$4,532 |
$5,665 |
1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,252.80 |
$5,316 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$4,136.80 |
$5,171 |
1.3× |
| Angiography extremity unilateral rs&i (75710) |
$4,323.20 |
$5,404 |
1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,487.20 |
$5,609 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,994.40 |
$2,493 |
0.6× |
| Ankle 2 views (73600) |
$160.80 |
$201 |
1.8× |
| Aortography thoracic serialography rs&i (75605) |
$5,267.20 |
$6,584 |
0.9× |
| Aortography thoracic w/o serialography rs&i (75600) |
$4,905.60 |
$6,132 |
1.5× |
| Artery X-Rays Abdomen (75726) |
$5,132 |
$6,415 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,377.60 |
$2,972 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$5,102.40 |
$6,378 |
0.9× |
| Artery X-Rays Spine (75705) |
$5,004 |
$6,255 |
0.9× |
| Arthrogram ankle (73615) |
$683.20 |
$854 |
1.9× |
| Arthrogram hip (73525) |
$720 |
$900 |
2.0× |
| Arthrogram Wrist (73115) |
$668 |
$835 |
1.9× |
| Basic radiation dosimetry calculation (77300) |
$112 |
$140 |
0.8× |
| Bone age studies (77072) |
$184 |
$230 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,572 |
$1,965 |
3.8× |
| Bone Imaging Limited Area (78300) |
$779.20 |
$974 |
1.9× |
| Bone Imaging Multiple Areas (78305) |
$966.40 |
$1,208 |
2.4× |
| Bone Imaging Whole Body (78306) |
$1,142.40 |
$1,428 |
2.8× |
| Bone marrow imaging limited area (78102) |
$818.40 |
$1,023 |
2.0× |
| Bone survey infant (77076) |
$332.80 |
$416 |
3.1× |
| Brachytx isodose complex (77318) |
$1,013.60 |
$1,267 |
2.6× |
| Brachytx isodose intermed (77317) |
$750.40 |
$938 |
2.0× |
| Brachytx Isodose Plan Simple (77316) |
$571.20 |
$714 |
1.5× |
| Brain Flow Imaging Only (78610) |
$749.60 |
$937 |
1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,332.80 |
$1,666 |
2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,492 |
$5,615 |
3.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,109.60 |
$5,137 |
11.5× |
| Cat Scan Follow-Up Study (76380) |
$770.40 |
$963 |
8.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,390.40 |
$1,738 |
2.5× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$1,330.40 |
$1,663 |
2.4× |
| Cerebrospinal Fluid Scan (78630) |
$1,539.20 |
$1,924 |
2.8× |
| Chest 1 view (71045) |
$147.20 |
$184 |
1.7× |
| Chest 2 views (71046) |
$172.80 |
$216 |
1.9× |
| Chest 3 views (71047) |
$201.60 |
$252 |
2.3× |
| Chest 4 or more views (71048) |
$251.20 |
$314 |
2.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$416.80 |
$521 |
0.5× |
| Clavicle complete (73000) |
$144.80 |
$181 |
1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$814.40 |
$1,018 |
7.6× |
| Continuing medical physics consltj pr wk (77336) |
$300.80 |
$376 |
2.2× |
Contrast Exam Abdominl Aorta (75625)
range across 2 matching MRF lines |
$4,679.20–$4,687.20 |
$5,849–$5,859 |
varies |
| Contrast X-Ray Bladder (74430) |
$616.80 |
$771 |
1.7× |
| Contrast X-Ray Of Elbow (73085) |
$647.20 |
$809 |
1.8× |
| Contrast X-Ray Of Knee Joint (73580) |
$668 |
$835 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,120.80 |
$5,151 |
11.6× |
| CT abdomen and pelvis without contrast (74176) |
$3,392.80 |
$4,241 |
13.9× |
| CT abdomen w contrast (74160) |
$1,778.40 |
$2,223 |
9.9× |
| CT abdomen w wo contrast (74170) |
$2,371.20 |
$2,964 |
13.2× |
| CT abdomen w/o contrast (74150) |
$1,481.60 |
$1,852 |
13.9× |
| CT Angio Abdomen and Pelvis (74174) |
$4,270.40 |
$5,338 |
12.0× |
| CT Angio Chest (71275) |
$2,560.80 |
$3,201 |
14.3× |
| CT Angio Head (70496) |
$2,441.60 |
$3,052 |
13.6× |
| CT angio hrt w/3d image (75574) |
$2,116.80 |
$2,646 |
5.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,330.40 |
$2,913 |
13.0× |
| CT Angio Neck (70498) |
$2,408 |
$3,010 |
13.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,180.80 |
$2,726 |
12.2× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$825.60 |
$1,032 |
4.6× |
| CT cervical spine w/ contrast (72126) |
$1,672 |
$2,090 |
4.7× |
| CT cervical spine w/o contrast (72125) |
$1,412.80 |
$1,766 |
13.2× |
| CT cervical spine w/wo cont (72127) |
$2,252 |
$2,815 |
12.6× |
| CT chest w contrast (71260) |
$1,855.20 |
$2,319 |
10.4× |
| CT chest w/wo contrast (71270) |
$2,184.80 |
$2,731 |
12.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$2,204 |
$2,755 |
12.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$2,036.80 |
$2,546 |
19.1× |
| CT head/brain with contrast (70460) |
$2,340 |
$2,925 |
13.1× |
| CT head/brain without and with contrast (70470) |
$2,612.80 |
$3,266 |
14.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,558.40 |
$1,948 |
4.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$263.20 |
$329 |
3.0× |
| CT hrt w/3d image congen (75573) |
$1,750.40 |
$2,188 |
4.9× |
| CT iac w contrast (70481) |
$1,847.20 |
$2,309 |
10.3× |
| CT l-spine w&w/o contrast (72133) |
$2,059.20 |
$2,574 |
11.5× |
| CT lower ext w/o (73700) |
$1,328 |
$1,660 |
12.4× |
| CT lower extremity w/contrast material (73701) |
$1,612 |
$2,015 |
9.0× |
| CT lumbar spine w contrast (72132) |
$1,589.60 |
$1,987 |
4.5× |
| CT lumbar spine w/o contrast (72131) |
$1,284 |
$1,605 |
12.0× |
| CT maxillofacial w contrast (70487) |
$1,597.60 |
$1,997 |
8.9× |
| CT maxillofacial wo contrast (70486) |
$1,339.20 |
$1,674 |
12.5× |
| CT neck tissue combo (70492) |
$2,003.20 |
$2,504 |
11.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,053.60 |
$2,567 |
11.5× |
| CT orbits w/o contrast (70480) |
$1,560.80 |
$1,951 |
14.6× |
| CT pelvis w&w/o contrast (72194) |
$2,065.60 |
$2,582 |
11.5× |
| CT pelvis w/o contrast (72192) |
$1,287.20 |
$1,609 |
12.1× |
| CT scan of leg combo (73702) |
$2,125.60 |
$2,657 |
11.9× |
| CT scans face/jaw combo (70488) |
$2,189.60 |
$2,737 |
12.2× |
| CT soft tissue neck w contrast (70491) |
$1,588 |
$1,985 |
8.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,284.80 |
$1,606 |
12.0× |
| CT thoracic spine w contrast (72129) |
$1,683.20 |
$2,104 |
9.4× |
| CT thoracic spine w/o contrast (72128) |
$1,360 |
$1,700 |
12.7× |
| CT thoracic spine w/wo cont (72130) |
$2,262.40 |
$2,828 |
12.6× |
| CT thorax w/o contrast (71250) |
$1,519.20 |
$1,899 |
14.2× |
| CT upper ext wo (73200) |
$1,328.80 |
$1,661 |
12.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,068 |
$2,585 |
11.5× |
| CT upper extremity with contrast (73201) |
$1,553.60 |
$1,942 |
4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,652 |
$3,315 |
14.8× |
| Cta Abdomen (74175) |
$2,558.40 |
$3,198 |
14.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$4,849.60 |
$6,062 |
13.6× |
| CTA pelvis (72191) |
$2,321.60 |
$2,902 |
13.0× |
| Dilation ureters/urethra rs&i (74485) |
$2,632 |
$3,290 |
1.2× |
| Discography Cerv/Thor Spine (72285) |
$3,023.20 |
$3,779 |
1.5× |
| Diskography lumbar (72295) |
$3,196.80 |
$3,996 |
1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$134.40 |
$168 |
1.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$418.40 |
$523 |
3.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$416.80 |
$521 |
3.9× |
| Dxa Bone Density Axial (77080) |
$230.40 |
$288 |
2.2× |
| Dxa bone density study (77085) |
$212.80 |
$266 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$138.40 |
$173 |
1.6× |
| Echo exam of fetal heart (76825) |
$1,050.40 |
$1,313 |
1.9× |
| Echo exam uterus (76831) |
$458.40 |
$573 |
1.9× |
| Echo Guide For Artery Repair (76936) |
$1,054.40 |
$1,318 |
4.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$465.60 |
$582 |
1.9× |
| Esophagram (74220) |
$415.20 |
$519 |
2.3× |
| Fetal Biophys Profile W/Nst (76818) |
$524.80 |
$656 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$401.60 |
$502 |
3.8× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,915.20 |
$3,644 |
12.0× |
| Fluoroscopy up to 1 hr (76000) |
$387.20 |
$484 |
1.6× |
| Follow-Up Angiography (75898) |
$1,924 |
$2,405 |
0.6× |
| Foot 2 views (73620) |
$160.80 |
$201 |
1.8× |
| Forearm 2 views (73090) |
$160.80 |
$201 |
1.8× |
| Gastric emptying imaging study (78264) |
$1,665.60 |
$2,082 |
4.1× |
| Gastroesophageal Reflux Exam (78262) |
$1,348 |
$1,685 |
3.3× |
| Gated Heart Planar Single (78472) |
$1,334.40 |
$1,668 |
3.3× |
| Hand 2 views (73120) |
$168.80 |
$211 |
1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$2,066.40 |
$2,583 |
2.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,342.40 |
$1,678 |
1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$806.40 |
$1,008 |
1.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$759.20 |
$949 |
0.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,320.80 |
$4,151 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$1,972 |
$2,465 |
3.6× |
| Hepatobiliary System Imaging (78226) |
$1,564.80 |
$1,956 |
3.8× |
| Ht Muscle Image Spect Sing (78451) |
$2,792 |
$3,490 |
2.1× |
| Hysterosalpingogram (74740) |
$528.80 |
$661 |
2.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$433.60 |
$542 |
4.9× |
| Infant hip ultrasound, limited static exam (76886) |
$392 |
$490 |
4.4× |
| Interstitial radiation source applic complex (77778) |
$1,520.80 |
$1,901 |
2.1× |
| Joint Survey Single View (77077) |
$236.80 |
$296 |
2.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,024 |
$1,280 |
1.8× |
| K Flow/Funct Image W/O Drug (78707) |
$1,428 |
$1,785 |
2.6× |
| Kidney Imaging Morphol (78700) |
$996 |
$1,245 |
2.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,368 |
$1,710 |
3.3× |
| Knee 3 Views (73562) |
$193.60 |
$242 |
2.2× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$920 |
$1,150 |
2.3× |
| Leveen/Shunt Patency Exam (78291) |
$789.60 |
$987 |
1.9× |
| Liver & Spleen Imaging Static Only (78215) |
$964 |
$1,205 |
2.4× |
| Liver imaging static only (78201) |
$2,368 |
$2,960 |
4.3× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,934.40 |
$2,418 |
3.5× |
| Lung perfusion differential (78597) |
$936 |
$1,170 |
2.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,988.80 |
$2,486 |
3.6× |
| Lung Ventilation Imaging (78579) |
$1,080.80 |
$1,351 |
2.6× |
| Lymph System Imaging (78195) |
$1,753.60 |
$2,192 |
3.2× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$3,048 |
$3,810 |
1.9× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$1,369.60 |
$1,712 |
2.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,261.60 |
$5,327 |
1.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$3,109.60 |
$3,887 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$2,067.20 |
$2,584 |
8.5× |
| Mammary ductogram or galactogram multiple (77054) |
$546.40 |
$683 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$531.20 |
$664 |
2.2× |
| Meckels Divert Exam (78290) |
$1,417.60 |
$1,772 |
3.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$815.20 |
$1,019 |
2.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,496.80 |
$4,371 |
9.8× |
| MRA head w/o contrast (70544) |
$2,216 |
$2,770 |
9.1× |
| MRA head with contrast (70545) |
$2,548.80 |
$3,186 |
7.2× |
| MRA neck w contrast (70548) |
$2,399.20 |
$2,999 |
6.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,281.60 |
$4,102 |
9.2× |
| MRA neck w/o contrast (70547) |
$2,185.60 |
$2,732 |
9.0× |
| MRI abdomen w contrast (74182) |
$2,579.20 |
$3,224 |
7.2× |
| MRI abdomen w/o contrast (74181) |
$2,191.20 |
$2,739 |
9.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,088 |
$3,860 |
3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,437.60 |
$4,297 |
9.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,353.60 |
$2,942 |
2.9× |
| MRI bone marrow blood supply (77084) |
$2,431.20 |
$3,039 |
10.0× |
| MRI Breast W/O Contrast Bilateral (77047) |
$3,567.20 |
$4,459 |
14.6× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$3,061.60 |
$3,827 |
12.6× |
| MRI cardiac w/o contrast (75557) |
$3,152.80 |
$3,941 |
12.9× |
| MRI cervical spine w contrast (72142) |
$2,623.20 |
$3,279 |
7.4× |
| MRI cervical spine w/o cont (72141) |
$2,218.40 |
$2,773 |
9.1× |
| MRI chest w/o contrast (71550) |
$2,322.40 |
$2,903 |
9.5× |
| MRI chest wo w contrast (71552) |
$3,215.20 |
$4,019 |
9.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,596 |
$3,245 |
7.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,172 |
$3,965 |
8.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,261.60 |
$2,827 |
9.3× |
| MRI lumbar spine w contrast (72149) |
$3,555.20 |
$4,444 |
10.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,570.40 |
$4,463 |
10.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,340.80 |
$2,926 |
9.6× |
| MRI orbit face neck w contrast (70542) |
$2,651.20 |
$3,314 |
7.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,626.40 |
$4,533 |
10.2× |
| MRI pelvis w contrast (72196) |
$2,519.20 |
$3,149 |
7.1× |
| MRI pelvis w/o & w contrast (72197) |
$3,496 |
$4,370 |
9.8× |
| MRI pelvis w/o contrast (72195) |
$2,403.20 |
$3,004 |
9.9× |
| MRI spectroscopy (76390) |
$2,139.20 |
$2,674 |
24.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,352.80 |
$2,941 |
9.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,471.20 |
$3,089 |
6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,247.20 |
$2,809 |
9.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,228 |
$4,035 |
9.1× |
| MRI, abdomen, combo (74183) |
$3,226.40 |
$4,033 |
9.1× |
| MRI, dorsal spine combo (72157) |
$3,253.60 |
$4,067 |
9.1× |
| MRI, dorsal spine contrast (72147) |
$2,558.40 |
$3,198 |
7.2× |
| MRI, joint upper extrem (73221) |
$2,228.80 |
$2,786 |
9.1× |
| MRI, joint upper extrem combo (73223) |
$3,189.60 |
$3,987 |
8.9× |
| MRI, lumbar spine combo (72158) |
$3,861.60 |
$4,827 |
10.8× |
| Myelogram cervical (72240) |
$1,095.20 |
$1,369 |
1.4× |
| Myelogram Lumbar (72265) |
$1,204.80 |
$1,506 |
1.5× |
| Myelography thoracic (72255) |
$1,095.20 |
$1,369 |
1.4× |
| Myelograpy 2/more regions rs&i (72270) |
$1,204.80 |
$1,506 |
1.5× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$845.60 |
$1,057 |
2.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,080 |
$5,100 |
3.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,233.60 |
$4,042 |
2.4× |
| Neck soft tissue (70360) |
$156 |
$195 |
1.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$560 |
$700 |
1.4× |
| Nonvascular Shunt X-Ray (75809) |
$359.20 |
$449 |
3.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,023.20 |
$6,279 |
3.6× |
| Nuclear Rx Intra-Arterial (79445) |
$998.40 |
$1,248 |
4.2× |
| Nuclear Rx Oral Admin (79005) |
$673.60 |
$842 |
2.8× |
| Ob us nuchal meas 1 gest (76813) |
$316 |
$395 |
3.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$377.60 |
$472 |
3.5× |
| Panoramic X-ray of jaws (70355) |
$156 |
$195 |
1.8× |
| Parathyroid Planar Imaging (78070) |
$1,356 |
$1,695 |
3.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,558.40 |
$1,948 |
3.8× |
| Pelvis 1 or 2 views (72170) |
$193.60 |
$242 |
1.8× |
| Perineogram (74775) |
$776.80 |
$971 |
3.2× |
| Peritoneogram Rs&I (74190) |
$852.80 |
$1,066 |
1.5× |
| PET image w/CT, full body (78816) |
$4,492 |
$5,615 |
3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,492 |
$5,615 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,320.80 |
$4,151 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,259.20 |
$1,574 |
3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$205.60 |
$257 |
1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$599.20 |
$749 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$193.60 |
$242 |
2.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$160.80 |
$201 |
1.8× |
| Radex elbow complete minimum 3 views (73080) |
$193.60 |
$242 |
2.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$218.40 |
$273 |
2.0× |
| Radex fingr minimum 2 views (73140) |
$160.80 |
$201 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$193.60 |
$242 |
2.2× |
| Radex Hand Minimum 3 Views (73130) |
$193.60 |
$242 |
2.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$172.80 |
$216 |
1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$244 |
$305 |
2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$218.40 |
$273 |
2.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$160.80 |
$201 |
1.8× |
| Radex shoulder complete minimum 2 views (73030) |
$172 |
$215 |
1.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$160 |
$200 |
1.8× |
| Radex Spine 1 View Specify Level (72020) |
$154.40 |
$193 |
1.7× |
| Radex Sternum Minimum 2 Views (71120) |
$160.80 |
$201 |
1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$212 |
$265 |
2.4× |
| Radex Toe Minimum 2 Views (73660) |
$160.80 |
$201 |
1.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$170.40 |
$213 |
1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$193.60 |
$242 |
2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$491.20 |
$614 |
4.6× |
Radiation Delivery Stereotactic Cranial Linear (77372)
unusually low: confirm this is the full procedure |
$3,042.40 |
$3,803 |
0.4× |
| Radiation treatment delivery level 1 (77402) |
$339.20 |
$424 |
3.3× |
| Radiation treatment delivery level 2 (77407) |
$1,025.60 |
$1,282 |
2.6× |
| Radiation treatment delivery level 3 (77412) |
$1,263.20 |
$1,579 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$251.20 |
$314 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$203.20 |
$254 |
1.9× |
| Radiologic exam colon double contrast study (74280) |
$833.60 |
$1,042 |
4.7× |
| Radiologic exam colon single contrast study (74270) |
$583.20 |
$729 |
3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$488.80 |
$611 |
2.7× |
| Radiologic exam knee complete 4/more views (73564) |
$223.20 |
$279 |
2.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$249.60 |
$312 |
2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$405.60 |
$507 |
2.3× |
| Radiologic exam swallow function contrast study (74230) |
$502.40 |
$628 |
2.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$492 |
$615 |
2.7× |
| Radiologic examination femur 1 view (73551) |
$154.40 |
$193 |
1.7× |
| Radiologic examination femur minimum 2 views (73552) |
$172 |
$215 |
1.9× |
| Radiologic examination knee 1/2 views (73560) |
$160.80 |
$201 |
1.8× |
| Radiologic Examination Osseous Survey Limited (77074) |
$255.20 |
$319 |
2.4× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$182.40 |
$228 |
2.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$160.80 |
$201 |
1.8× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$479.20 |
$599 |
0.9× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
$536.80 |
$671 |
2.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$625.60 |
$782 |
2.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$937.60 |
$1,172 |
2.4× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$620.80 |
$776 |
1.6× |
| Renal Cyst Study (74470) |
$862.40 |
$1,078 |
1.5× |
| Ribs bilateral 3 views (71110) |
$205.60 |
$257 |
1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$949.60 |
$1,187 |
2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,591.20 |
$1,989 |
3.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,719.20 |
$3,399 |
4.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,373.60 |
$2,967 |
4.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,660.80 |
$3,326 |
4.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,232 |
$4,040 |
2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$4,255.20 |
$5,319 |
2.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,231.20 |
$4,039 |
2.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$772 |
$965 |
3.2× |
| Rp Therapy Intravenous Administration (79101) |
$609.60 |
$762 |
2.6× |
| Scapula (73010) |
$184.80 |
$231 |
1.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$60 |
$75 |
2.6× |
| Sella turcica (70240) |
$156 |
$195 |
1.8× |
| Shoulder 1 view (73020) |
$144.80 |
$181 |
1.6× |
| Shoulder Arthrography (73040) |
$627.20 |
$784 |
1.8× |
| Sialogram (70390) |
$481.60 |
$602 |
2.0× |
| Skull less than 4 views (70250) |
$220.80 |
$276 |
2.1× |
| Special dosimetry (77331) |
$62.40 |
$78 |
0.5× |
| Special Physics Consult (77370) |
$492.80 |
$616 |
3.6× |
| Special teletherapy port plan (77321) |
$276.80 |
$346 |
0.7× |
| Special treatment procedure (77470) |
$291.20 |
$364 |
0.5× |
| Speech evaluation, complex (70371) |
$415.20 |
$519 |
1.7× |
| Stereotactic Body Radiation Delivery (77373) |
$5,528 |
$6,910 |
3.0× |
| Sternoclavicular joints (71130) |
$188 |
$235 |
2.1× |
| Superior sagittal sinus venogram (75870) |
$506.40 |
$633 |
0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$451.20 |
$564 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$248.80 |
$311 |
0.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$544 |
$680 |
2.2× |
| Testicular Imaging W/Flow (78761) |
$900 |
$1,125 |
2.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,170.40 |
$1,463 |
3.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,284 |
$1,605 |
3.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$753.60 |
$942 |
5.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$612.80 |
$766 |
3.4× |
| Thoracic spine 2 views (72070) |
$237.60 |
$297 |
2.2× |
| Thoracic spine 3 views (72072) |
$284 |
$355 |
2.7× |
| Thoracolumbar 2 views (72080) |
$172 |
$215 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$856 |
$1,070 |
2.1× |
| Thyroid Met Imaging Body (78018) |
$1,508.80 |
$1,886 |
2.7× |
| Thyroid Uptake Measurement (78012) |
$653.60 |
$817 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,148.80 |
$1,436 |
2.8× |
| Tx Devices Design & Construction Complex (77334) |
$303.20 |
$379 |
0.8× |
| Tx devices design & construction intermediate (77333) |
$321.60 |
$402 |
2.3× |
| Tx devices design & construction simple (77332) |
$95.20 |
$119 |
0.7× |
| Ultrasound Breast Limited (76642) |
$358.40 |
$448 |
4.0× |
| Ultrasound Exam Aaa Screen (76706) |
$456.80 |
$571 |
4.3× |
| Ultrasound, abdomen limited (76705) |
$493.60 |
$617 |
4.6× |
| Umbilical-artery Doppler (OB) (76820) |
$240 |
$300 |
2.2× |
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines |
$325.60–$766.40 |
$407–$958 |
varies |
| Unlisted fluoroscopic procedure (76496) |
$226.40 |
$283 |
2.5× |
| Unlisted magnetic resonance procedure (76498) |
$179.20 |
$224 |
2.0× |
| Unlisted respiratory px dx nuclear medicine (78599) |
$1,273.60 |
$1,592 |
3.1× |
Unlisted us procedure (76999)
range across 2 matching MRF lines |
$380.80–$624.80 |
$476–$781 |
varies |
| Upper gi w/o kub (74240) |
$421.60 |
$527 |
2.4× |
| Ureteral Reflux Study (78740) |
$884 |
$1,105 |
2.2× |
| Urethrocystogram voiding (74455) |
$464 |
$580 |
1.9× |
| Urethrocystography retrograde (74450) |
$797.60 |
$997 |
3.3× |
| Us breast unilateral complete (76641) |
$431.20 |
$539 |
4.0× |
| Us chest (76604) |
$374.40 |
$468 |
3.5× |
| Us complete joint (76881) |
$390.40 |
$488 |
3.7× |
| Us exam, pelvic, limited (76857) |
$454.40 |
$568 |
4.3× |
| Us head (76506) |
$488.80 |
$611 |
4.6× |
| Us kidney transplant (76776) |
$610.40 |
$763 |
5.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$242.40 |
$303 |
2.3× |
| Us ob detailed single fetus (76811) |
$653.60 |
$817 |
2.7× |
| Us ob limited 1 or more fetuses (76815) |
$410.40 |
$513 |
3.8× |
| Us ob transvaginal (76817) |
$430.40 |
$538 |
4.0× |
| Us pelvic non ob complete (76856) |
$575.20 |
$719 |
5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$560.80 |
$701 |
5.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$468.80 |
$586 |
4.4× |
| Us retroperitoneal complete (76770) |
$569.60 |
$712 |
5.3× |
| Us retroperitoneal limited (76775) |
$499.20 |
$624 |
4.7× |
| Us scrotum and contents (76870) |
$527.20 |
$659 |
4.9× |
| Us spinal canal and contents (76800) |
$429.60 |
$537 |
4.0× |
| Us thyroid (76536) |
$581.60 |
$727 |
5.4× |
| Us transrectal (76872) |
$588 |
$735 |
5.5× |
| Vasogram (74440) |
$383.20 |
$479 |
1.6× |
| Vein X-Ray Chest (75827) |
$1,859.20 |
$2,324 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,030.40 |
$1,288 |
0.3× |
| Vein X-Ray Spleen/Liver (75810) |
$2,490.40 |
$3,113 |
0.8× |
| Venogram Sinus/Jugular (75860) |
$1,788 |
$2,235 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$4,324.80 |
$5,406 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$4,319.20 |
$5,399 |
1.3× |
| Venography extremity bilateral rs&i (75822) |
$2,173.60 |
$2,717 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,798.40 |
$2,248 |
1.1× |
| Venography Renal Bilateral (75833) |
$4,688.80 |
$5,861 |
1.5× |
| Venography Renal Unilateral (75831) |
$4,469.60 |
$5,587 |
1.4× |
| Venous sampling by catheter (75893) |
$4,756 |
$5,945 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$153.60 |
$192 |
1.7× |
| Wrist 2 views (73100) |
$160.80 |
$201 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$160.80 |
$201 |
1.8× |
| X-ray antegrade pyelogram tube (74425) |
$1,440.80 |
$1,801 |
4.0× |
| X-Ray Aorta Leg Arteries (75630) |
$4,222.40 |
$5,278 |
1.3× |
| X-Ray Bend Only L-S Spine (72120) |
$263.20 |
$329 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$160.80 |
$201 |
1.8× |
| X-Ray Exam Breast Specimen (76098) |
$733.60 |
$917 |
1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$168.80 |
$211 |
1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$301.60 |
$377 |
2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$395.20 |
$494 |
3.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$144.80 |
$181 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$193.60 |
$242 |
2.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$223.20 |
$279 |
2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$228 |
$285 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$237.60 |
$297 |
2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$388 |
$485 |
3.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$306.40 |
$383 |
2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$205.60 |
$257 |
2.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$306.40 |
$383 |
2.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$205.60 |
$257 |
1.9× |
| X-ray eye for foreign body (70030) |
$166.40 |
$208 |
1.9× |
| X-ray humerus (73060) |
$160.80 |
$201 |
1.8× |
| X-ray IV pyelogram (ivp) (74400) |
$452 |
$565 |
2.5× |
| X-ray IV pyelogram+tomography (74415) |
$542.40 |
$678 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$170.40 |
$213 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$160.80 |
$201 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$193.60 |
$242 |
1.8× |
| X-ray nose-rectum child f.b. (76010) |
$160.80 |
$201 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$230.40 |
$288 |
2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$236.80 |
$296 |
2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$199.20 |
$249 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$160.80 |
$201 |
1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$212 |
$265 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$251.20 |
$314 |
2.4× |
| X-ray thoracic spine 4 vw (72074) |
$228.80 |
$286 |
2.1× |
| X-Ray Tmj Unilat (70328) |
$53.60 |
$67 |
0.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,440 |
$1,800 |
4.0× |
| X-Rays Bone Length Studies (77073) |
$184 |
$230 |
1.7× |
| X-Rays Bone Survey Complete (77075) |
$388.80 |
$486 |
3.6× |
| Xr c-spine 4 or 5 views (72050) |
$258.40 |
$323 |
2.4× |
| Xr facial bones less than 3 views (70140) |
$185.60 |
$232 |
2.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$212 |
$265 |
2.0× |
| Xr orbits complete 4 views (70200) |
$267.20 |
$334 |
2.5× |
| Xr Tomogram Single Plane (76100) |
$408 |
$510 |
3.8× |