| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,362.50 |
$4,725 |
1.7× |
| Abdomen 2 views (74019) |
$378.50 |
$757 |
3.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,359 |
$2,718 |
3.4× |
| Angiography extremity bilateral rs&i (75716) |
$4,711.50 |
$9,423 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,943.50 |
$3,887 |
0.6× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,620.50 |
$5,241 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,639 |
$3,278 |
0.5× |
| Angiography Spinal Selective Rs&I (75705) |
$7,981 |
$15,962 |
1.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,436.50 |
$10,873 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$568.50 |
$1,137 |
0.2× |
| Ankle 2 views (73600) |
$269.50 |
$539 |
3.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$690 |
$1,380 |
2.0× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,216.50 |
$2,433 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,900 |
$5,800 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$4,224.75 |
$8,449.50 |
1.3× |
| Arthrogram elbow (73085) |
$837 |
$1,674 |
2.4× |
| Arthrogram hip (73525) |
$813 |
$1,626 |
2.3× |
| Arthrogram shoulder (73040) |
$1,090.50 |
$2,181 |
3.1× |
| Arthrogram wrist (73115) |
$444.50 |
$889 |
1.3× |
| Arthrography knee lt (73580) |
$1,042 |
$2,084 |
3.0× |
| Basic radiation dosimetry calculation (77300) |
$117.50 |
$235 |
0.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,622.50 |
$3,245 |
4.0× |
| Bone &/joint imaging whole body (78306) |
$2,200 |
$4,400 |
5.5× |
| Bone age studies (77072) |
$334 |
$668 |
3.2× |
| Bone Imaging 3 Phase (78315) |
$1,638.50 |
$3,277 |
4.1× |
| Bone Marrow Imaging Limited Area (78102) |
$631.50 |
$1,263 |
1.6× |
| Bone survey complete (77075) |
$500 |
$1,000 |
4.8× |
| Brachytx isodose complex (77318) |
$1,854 |
$3,708 |
4.9× |
| Brachytx isodose intermed (77317) |
$2,369.50 |
$4,739 |
6.3× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$474 |
$948 |
1.3× |
| Brain imaging < 4 static views w vascular flow (78601) |
$613 |
$1,226 |
1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,825.50 |
$5,651 |
2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,939.50 |
$3,879 |
5.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$953 |
$1,906 |
1.7× |
| Cervical spine 2 or 3 views (72040) |
$439.50 |
$879 |
5.0× |
| Chest 1 view (71045) |
$298.50 |
$597 |
3.4× |
| Chest 3 views (71047) |
$385 |
$770 |
4.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$640 |
$1,280 |
3.6× |
| Clavicle complete (73000) |
$392 |
$784 |
4.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$160.50 |
$321 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$244.50 |
$489 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,154.50 |
$6,309 |
9.0× |
| CT abdomen and pelvis without contrast (74176) |
$2,626.50 |
$5,253 |
11.0× |
| CT abdomen w contrast (74160) |
$2,531.50 |
$5,063 |
14.4× |
| CT abdomen w wo contrast (74170) |
$3,139.50 |
$6,279 |
17.8× |
| CT abdomen w/o contrast (74150) |
$2,352 |
$4,704 |
22.4× |
| CT angio hrt w/3d image (75574) |
$2,569 |
$5,138 |
7.3× |
| CT angiography upper extremity lt (73206) |
$2,041 |
$4,082 |
11.6× |
| CT c-spine w/o contrast (72125) |
$2,614.50 |
$5,229 |
24.9× |
| CT cervical spine w&w/o contrast (72127) |
$3,802 |
$7,604 |
21.6× |
| CT cervical spine with contrast (72126) |
$2,746 |
$5,492 |
7.8× |
| CT chest w/wo contrast (71270) |
$3,430 |
$6,860 |
19.5× |
| CT chest with contrast (71260) |
$2,746 |
$5,492 |
15.6× |
| CT head/brain with contrast (70460) |
$2,130 |
$4,260 |
12.1× |
| CT head/brain without and with contrast (70470) |
$2,746.50 |
$5,493 |
15.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$160.50 |
$321 |
1.8× |
| CT iac w contrast (70481) |
$1,617 |
$3,234 |
9.2× |
| CT limited/localized follow up study (76380) |
$1,094 |
$2,188 |
12.5× |
| CT lower ext w/o (73700) |
$2,224.50 |
$4,449 |
21.2× |
| CT lower extremity w wo contrast (73702) |
$2,900.50 |
$5,801 |
16.5× |
| CT lower extremity with contrast (73701) |
$2,900.50 |
$5,801 |
16.5× |
| CT lumbar spine w & w/o contrast (72133) |
$4,326.50 |
$8,653 |
24.6× |
| CT lumbar spine w/o contrast (72131) |
$2,964.50 |
$5,929 |
28.2× |
| CT lumbar spine with contrast (72132) |
$3,117.50 |
$6,235 |
8.9× |
| CT maxillofacial w contrast (70487) |
$3,106 |
$6,212 |
17.6× |
| CT maxillofacial w/o contrast (70486) |
$2,221 |
$4,442 |
21.1× |
| CT maxillofacial w/wo contrast (70488) |
$3,551.50 |
$7,103 |
20.2× |
| CT neck soft tissue w contrast (70491) |
$2,762 |
$5,524 |
15.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,106 |
$6,212 |
17.6× |
| CT orbits w/o contrast (70480) |
$2,221 |
$4,442 |
21.1× |
| CT pelvis w & w/o contrast (72194) |
$3,035.50 |
$6,071 |
17.2× |
| CT pelvis w/o contrast (72192) |
$2,179 |
$4,358 |
20.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$579.50 |
$1,159 |
6.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,493.50 |
$8,987 |
25.5× |
| CT soft tissue neck w/o contrast (70490) |
$2,591 |
$5,182 |
24.7× |
| CT thoracic spine w/contrast (72129) |
$2,450.50 |
$4,901 |
13.9× |
| CT thoracic spine w/o contrast (72128) |
$2,330.50 |
$4,661 |
22.2× |
| CT thoracic spine w/wo contrast (72130) |
$3,408.50 |
$6,817 |
19.3× |
| CT thorax w/o contrast (71250) |
$2,564.50 |
$5,129 |
24.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,668.50 |
$5,337 |
15.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,874.50 |
$3,749 |
17.8× |
| CT upper extremity with contrast (73201) |
$2,451 |
$4,902 |
7.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,973 |
$5,946 |
16.9× |
| Cta Abdomen (74175) |
$2,718 |
$5,436 |
15.4× |
| CTA abdomen pelvis (74174) |
$4,674 |
$9,348 |
13.3× |
| CTA chest (71275) |
$2,615 |
$5,230 |
14.8× |
| Cta Head (70496) |
$2,272 |
$4,544 |
12.9× |
| CTA lwr ext w&w/o contrast (73706) |
$2,904.50 |
$5,809 |
16.5× |
| Cta Neck (70498) |
$2,272 |
$4,544 |
12.9× |
| Cta Pelvis (72191) |
$2,532 |
$5,064 |
14.4× |
| Cystography minimum 3 views rs&i (74430) |
$552.50 |
$1,105 |
1.6× |
| Diskogram cervical (72285) |
$1,510 |
$3,020 |
0.8× |
| Diskography lumbar (72295) |
$1,510 |
$3,020 |
0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$302.50 |
$605 |
2.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$374 |
$748 |
3.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$340 |
$680 |
3.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$568.50 |
$1,137 |
5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$568.50 |
$1,137 |
6.5× |
| Dxa bone density study axial skeleton (77085) |
$211 |
$422 |
2.0× |
| Echo exam of fetal heart (76825) |
$1,189 |
$2,378 |
2.2× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$527 |
$1,054 |
2.2× |
| Echoencephalography real time imaging (76506) |
$337.50 |
$675 |
3.2× |
| Esophagus (74220) |
$525.50 |
$1,051 |
3.0× |
| Fetal biophysical profile non-stress testing (76818) |
$193.50 |
$387 |
1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$805 |
$1,610 |
7.7× |
| Fluoroscopy up to 1 hr (76000) |
$58.50 |
$117 |
0.2× |
| Foot 2 views (73620) |
$245 |
$490 |
2.8× |
| Forearm 2 views (73090) |
$363 |
$726 |
4.2× |
| Gated Heart Planar Single (78472) |
$1,741 |
$3,482 |
4.3× |
| Hand 2 views (73120) |
$235 |
$470 |
2.2× |
| Hand 3 views (73130) |
$331 |
$662 |
3.8× |
| Heart Infarct Image (78466) |
$1,162.50 |
$2,325 |
2.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$6,040.50 |
$12,081 |
1.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,843 |
$3,686 |
3.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$650.50 |
$1,301 |
1.6× |
| Ht muscle image spect sing (78451) |
$2,403.75 |
$4,807.50 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$392 |
$784 |
4.5× |
| Hysterosalpingogram (74740) |
$796.50 |
$1,593 |
3.3× |
| Kidney imaging morphology (78700) |
$957 |
$1,914 |
2.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,708 |
$3,416 |
3.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,708 |
$3,416 |
3.1× |
| Knee 3 views (73562) |
$333.50 |
$667 |
3.8× |
| Liver & spleen imaging static only (78215) |
$1,733 |
$3,466 |
4.3× |
| Liver imaging static only (78201) |
$1,672 |
$3,344 |
3.1× |
| Lung perf&ventilat diferentl (78598) |
$2,242 |
$4,484 |
4.1× |
| Lung Ventilation Imaging (78579) |
$1,554.50 |
$3,109 |
3.9× |
| Lymphoscintigraphy (78195) |
$1,365.50 |
$2,731 |
2.5× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$224 |
$448 |
2.6× |
| Meckels Diverticulum (78290) |
$1,359 |
$2,718 |
3.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,600 |
$5,200 |
6.9× |
| MRA head w & w/o contrast (70546) |
$2,414 |
$4,828 |
6.9× |
| MRA head w/o contrast (70544) |
$3,879 |
$7,758 |
16.2× |
| MRA head with contrast (70545) |
$4,210 |
$8,420 |
12.0× |
| MRA neck w contrast (70548) |
$4,210 |
$8,420 |
12.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,413.50 |
$10,827 |
15.4× |
| MRA neck w/o contrast (70547) |
$3,879 |
$7,758 |
16.2× |
| MRI abdomen w contrast (74182) |
$2,964.50 |
$5,929 |
8.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,405.50 |
$8,811 |
12.6× |
| MRI abdomen w/o contrast (74181) |
$3,325 |
$6,650 |
13.9× |
| MRI any jnt lwr ext with con lt (73722) |
$3,550.50 |
$7,101 |
4.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,986.50 |
$9,973 |
6.3× |
| MRI breast w/o contrast bilateral (77047) |
$431.50 |
$863 |
1.8× |
| MRI breast w/o contrast unilat (77046) |
$403 |
$806 |
1.7× |
| MRI c-spine with contrast (72142) |
$3,251.50 |
$6,503 |
9.3× |
| MRI cardiac w/o contrast (75557) |
$1,566 |
$3,132 |
6.5× |
| MRI cervical spine w/o contrast (72141) |
$2,733.50 |
$5,467 |
11.4× |
| MRI chest w/o & w/contrast material (71552) |
$3,286 |
$6,572 |
9.4× |
| MRI chest w/o contrast (71550) |
$1,898.50 |
$3,797 |
7.9× |
| MRI chest with contrast (71551) |
$4,273.50 |
$8,547 |
5.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,327 |
$6,654 |
9.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,550.50 |
$7,101 |
10.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,974.50 |
$5,949 |
12.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,319.50 |
$6,639 |
13.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,536.50 |
$11,073 |
15.8× |
| MRI orbit/face/neck w/contrast (70542) |
$4,502 |
$9,004 |
12.8× |
| MRI pelvis w contrast (72196) |
$3,298.50 |
$6,597 |
9.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,621.50 |
$9,243 |
13.2× |
| MRI pelvis w/o contrast (72195) |
$2,777.50 |
$5,555 |
11.6× |
| MRI scan of arm joint before and after contrast (73223) |
$4,087 |
$8,174 |
11.7× |
| MRI scan of leg joint before and after contrast (73723) |
$4,363.50 |
$8,727 |
12.5× |
| MRI spectroscopy (76390) |
$1,261 |
$2,522 |
14.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,777.50 |
$7,555 |
10.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,801.50 |
$7,603 |
10.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,489.50 |
$8,979 |
12.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,407.50 |
$6,815 |
9.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,180.50 |
$8,361 |
11.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,366.50 |
$4,733 |
9.9× |
| MRI tmj (70336) |
$572.50 |
$1,145 |
2.4× |
| MRI upper ext joint w/o contrast (73221) |
$2,786 |
$5,572 |
11.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,088.50 |
$8,177 |
11.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,786 |
$5,572 |
11.6× |
| Myelogram Cervical (72240) |
$1,513.50 |
$3,027 |
1.9× |
| Myelogram Lumbar (72265) |
$1,513.50 |
$3,027 |
1.9× |
| Myelogram thoracic (72255) |
$1,606.50 |
$3,213 |
2.0× |
| Myelography 2 or more regions (72270) |
$1,513.50 |
$3,027 |
1.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,397 |
$6,794 |
2.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,553.50 |
$7,107 |
4.1× |
| Neck soft tissue (70360) |
$351 |
$702 |
4.0× |
| Nm adrenal scan (78075) |
$553 |
$1,106 |
0.4× |
| Nm cisternogram (78630) |
$953 |
$1,906 |
1.7× |
| Nm csf leak detection (78650) |
$1,111.50 |
$2,223 |
0.9× |
| Nm gastric emptying study (78264) |
$1,797 |
$3,594 |
4.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,088.50 |
$8,177 |
2.9× |
| Nuclear medicine of heart pumping function (78473) |
$1,501 |
$3,002 |
3.7× |
| Nuclear medicine study of endocrine organs (78099) |
$843.50 |
$1,687 |
2.1× |
| Nuclear Rx Oral Admin (79005) |
$1,127 |
$2,254 |
4.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$885.50 |
$1,771 |
8.4× |
| Osseous survey infant (77076) |
$594 |
$1,188 |
5.7× |
| Osseous survey limited (77074) |
$838.50 |
$1,677 |
8.0× |
| Parathyrd planar w/wo subtrj (78071) |
$1,615.75 |
$3,231.50 |
4.0× |
| Parathyroid imaging (78070) |
$757.50 |
$1,515 |
1.9× |
| Pelvis 1 or 2 views (72170) |
$481 |
$962 |
4.6× |
| Perineogram (74775) |
$899.50 |
$1,799 |
3.8× |
| PET image w/CT, skull-thigh (78815) |
$3,249 |
$6,498 |
2.3× |
| PET imaging for CT attenuation whole body (78816) |
$3,249 |
$6,498 |
2.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,363 |
$8,726 |
12.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,187.50 |
$2,375 |
3.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,711 |
$3,422 |
3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,375 |
$2,750 |
2.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$611 |
$1,222 |
7.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$611 |
$1,222 |
5.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$331 |
$662 |
3.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$216 |
$432 |
2.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$610.50 |
$1,221 |
5.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$13,696.50 |
$27,393 |
1.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$419 |
$838 |
0.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$255.50 |
$511 |
2.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$508 |
$1,016 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$539 |
$1,078 |
5.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$363 |
$726 |
4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$378.50 |
$757 |
3.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$370 |
$740 |
4.2× |
| Radiologic exam colon single contrast study (74270) |
$906.50 |
$1,813 |
5.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,019.75 |
$2,039.50 |
5.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$501 |
$1,002 |
2.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$427 |
$854 |
4.9× |
| Radiological examination surgical specimen (76098) |
$265.50 |
$531 |
0.5× |
| Ribs bilateral 3 views (71110) |
$390.50 |
$781 |
3.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$9,159 |
$18,318 |
22.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,075 |
$2,150 |
2.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,079.50 |
$2,159 |
2.0× |
| Sacroiliac Joints < 3 Views (72200) |
$211.50 |
$423 |
2.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$674 |
$1,348 |
2.8× |
| Scanogram (77073) |
$372 |
$744 |
3.5× |
| Scapula complete (73010) |
$373 |
$746 |
3.6× |
| Screening digital breast tomosynthesis (77063) |
$59 |
$118 |
2.5× |
| Simulation intermediate (77285) |
$933.50 |
$1,867 |
2.5× |
| Small bowel series (74250) |
$791.50 |
$1,583 |
4.5× |
| Spec medical radj physics consltj (77370) |
$319.50 |
$639 |
2.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$638.50 |
$1,277 |
1.7× |
| Special dosimetry (77331) |
$638 |
$1,276 |
4.7× |
| Special treatment procedure (77470) |
$780 |
$1,560 |
1.4× |
| Spine thoracic 3 views (72072) |
$527.50 |
$1,055 |
5.0× |
| Stereotactic body radiation delivery (77373) |
$3,675 |
$7,350 |
2.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$336.50 |
$673 |
0.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$184.50 |
$369 |
0.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$901.50 |
$1,803 |
2.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$588 |
$1,176 |
4.4× |
| Therapeutic Enema (74283) |
$690 |
$1,380 |
3.9× |
| Thoracolumbar 2 views (72080) |
$123 |
$246 |
1.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,125.50 |
$2,251 |
2.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$927.50 |
$1,855 |
2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$927.50 |
$1,855 |
2.3× |
| Tmj unilateral (70328) |
$186 |
$372 |
2.1× |
| Tomogram (76100) |
$264.50 |
$529 |
2.5× |
| Treatment device intermediate (77333) |
$184.50 |
$369 |
1.4× |
| Treatment devices simple (77332) |
$143 |
$286 |
1.1× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,661 |
$5,322 |
4.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$895 |
$1,790 |
2.2× |
| Tx devices design & construction complex (77334) |
$273.50 |
$547 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$802 |
$1,604 |
7.6× |
| Umbilical-artery Doppler (OB) (76820) |
$421 |
$842 |
4.0× |
| Unlisted Ultrasound Procedure (76999) |
$327.50 |
$655 |
3.7× |
| Upper Extremity Infant (73092) |
$169 |
$338 |
1.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,079.50 |
$2,159 |
2.7× |
| Urethrocystography retrograde rs&i (74450) |
$707.50 |
$1,415 |
3.0× |
| Urethrocystography voiding (74455) |
$707.50 |
$1,415 |
3.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,037.50 |
$2,075 |
5.9× |
| Us abdl aorta screen aaa (76706) |
$151.50 |
$303 |
1.4× |
| Us breast unilateral complete (76641) |
$218 |
$436 |
2.1× |
| Us breast unilateral limited (76642) |
$218 |
$436 |
2.5× |
| Us chest (76604) |
$401 |
$802 |
3.8× |
| Us compl joint r-t w/image documentation (76881) |
$434.50 |
$869 |
4.1× |
| Us elastography parenchyma (76981) |
$468 |
$936 |
4.5× |
| Us fetal nuchal translucency 1st gestation (76813) |
$370.50 |
$741 |
3.5× |
| Us guided compression repair (76936) |
$696.50 |
$1,393 |
3.2× |
| Us infant hips dynamic (76885) |
$304 |
$608 |
3.5× |
| Us infant hips limited static (76886) |
$132.50 |
$265 |
1.5× |
| Us kidney transplant (76776) |
$269 |
$538 |
2.6× |
| Us ob detailed single fetus (76811) |
$1,300.50 |
$2,601 |
5.4× |
| Us ob transvaginal (76817) |
$547 |
$1,094 |
5.2× |
| Us pelvic non ob complete (76856) |
$786 |
$1,572 |
7.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$407.50 |
$815 |
3.9× |
| Us pregnancy ltd (76815) |
$885.50 |
$1,771 |
8.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$547 |
$1,094 |
5.2× |
| Us retroperitoneal complete (76770) |
$905 |
$1,810 |
8.6× |
| Us retroperitoneal limited (76775) |
$434.50 |
$869 |
4.1× |
| Us scrotum and contents (76870) |
$710 |
$1,420 |
6.8× |
| Us soft tissue head/neck (76536) |
$752.50 |
$1,505 |
7.2× |
| Us spinal canal and contents (76800) |
$323 |
$646 |
3.1× |
| Us transrectal (76872) |
$332 |
$664 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$346 |
$692 |
3.3× |
| Vascular flow imaging (78445) |
$842 |
$1,684 |
2.1× |
| Venogram extremity bilateral (75822) |
$1,307.50 |
$2,615 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,490.50 |
$4,981 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$2,440 |
$4,880 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$2,141.50 |
$4,283 |
1.4× |
| Venography Renal Bilateral (75833) |
$3,051 |
$6,102 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,141.50 |
$4,283 |
0.7× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$8,389 |
$16,778 |
1.5× |
| Vertebral fracture assessment via dxa (77086) |
$117.50 |
$235 |
1.3× |
| Wrist 2 views (73100) |
$286.50 |
$573 |
3.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$379.50 |
$759 |
3.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$202.50 |
$405 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$392 |
$784 |
4.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,107 |
$2,214 |
6.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$334.50 |
$669 |
3.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$407 |
$814 |
4.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$610.50 |
$1,221 |
5.8× |
| X-ray exam hip uni 1 view (73501) |
$313.50 |
$627 |
3.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$370 |
$740 |
4.2× |
| X-ray exam hip uni 4/> views (73503) |
$307.50 |
$615 |
2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$331 |
$662 |
3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$211 |
$422 |
2.0× |
| X-ray exam of femur 1 (73551) |
$357.50 |
$715 |
4.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$490 |
$980 |
2.8× |
| X-ray eye for foreign body (70030) |
$373 |
$746 |
4.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$495 |
$990 |
4.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$216.50 |
$433 |
2.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$358.50 |
$717 |
4.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$641.50 |
$1,283 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$323.50 |
$647 |
3.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$256 |
$512 |
2.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$469.50 |
$939 |
4.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$255 |
$510 |
2.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$313.50 |
$627 |
3.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$481.50 |
$963 |
4.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$895.50 |
$1,791 |
8.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$365 |
$730 |
3.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$392 |
$784 |
4.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$131.50 |
$263 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$562 |
$1,124 |
5.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$514 |
$1,028 |
4.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$846.50 |
$1,693 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$366 |
$732 |
4.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$256.25 |
$512.50 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$569 |
$1,138 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$216 |
$432 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$411 |
$822 |
4.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$427 |
$854 |
4.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$640 |
$1,280 |
7.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$277.50 |
$555 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$728 |
$1,456 |
6.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$404.50 |
$809 |
3.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$357.50 |
$715 |
4.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$289.50 |
$579 |
3.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$439.50 |
$879 |
5.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$299.50 |
$599 |
2.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$291.50 |
$583 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$514.50 |
$1,029 |
5.9× |
| Xr arthrogram ankle (73615) |
$837 |
$1,674 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$687 |
$1,374 |
6.5× |
| Xr chest 4+ views (71048) |
$522 |
$1,044 |
5.0× |
| Xr finger(s) 2+ views (73140) |
$302.50 |
$605 |
3.5× |
| Xr optic foramina (70190) |
$588.50 |
$1,177 |
6.7× |
| Xr shoulder 1 view (73020) |
$228 |
$456 |
2.6× |
| Xr spine cervical 4 or 5 views (72050) |
$553.50 |
$1,107 |
5.3× |
| Xr tibia/fibula 2 views (73590) |
$368 |
$736 |
4.2× |
| Xr tmj bilateral (70330) |
$132 |
$264 |
1.5× |
| Xray knee 1 or 2 views rt (73560) |
$349.50 |
$699 |
4.0× |