| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,094 |
$6,188 |
2.3× |
| Abdomen 2 views (74019) |
$282 |
$564 |
2.8× |
| Ankle 2 views (73600) |
$180.50 |
$361 |
2.2× |
| Arthrogram hip (73525) |
$730.50 |
$1,461 |
2.2× |
| Arthrogram shoulder (73040) |
$887.50 |
$1,775 |
2.6× |
| Arthrogram wrist (73115) |
$617 |
$1,234 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$318 |
$636 |
2.5× |
| Bone &/joint imaging whole body (78306) |
$1,164.50 |
$2,329 |
3.0× |
| Bone age studies (77072) |
$222.50 |
$445 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$1,148 |
$2,296 |
3.0× |
| Bone survey complete (77075) |
$1,100.50 |
$2,201 |
10.9× |
| Cervical spine 2 or 3 views (72040) |
$348 |
$696 |
4.1× |
| Chest 1 view (71045) |
$152.50 |
$305 |
1.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$389 |
$778 |
2.3× |
| Clavicle complete (73000) |
$230.50 |
$461 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$264.50 |
$529 |
2.6× |
| Continuing medical physics consltj pr wk (77336) |
$426 |
$852 |
3.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,415.50 |
$6,831 |
10.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,379.50 |
$4,759 |
10.3× |
| CT abdomen w contrast (74160) |
$1,730.50 |
$3,461 |
10.2× |
| CT abdomen w wo contrast (74170) |
$2,030.50 |
$4,061 |
12.0× |
| CT abdomen w/o contrast (74150) |
$1,330.50 |
$2,661 |
13.2× |
| CT angiography upper extremity lt (73206) |
$1,605.50 |
$3,211 |
9.5× |
| CT c-spine w/o contrast (72125) |
$1,478 |
$2,956 |
14.7× |
| CT chest w/wo contrast (71270) |
$1,541.50 |
$3,083 |
9.1× |
| CT chest with contrast (71260) |
$1,468 |
$2,936 |
8.7× |
| CT head/brain without and with contrast (70470) |
$1,583.50 |
$3,167 |
9.4× |
| CT iac w contrast (70481) |
$1,449 |
$2,898 |
8.6× |
| CT lower ext w/o (73700) |
$1,084 |
$2,168 |
10.8× |
| CT lower extremity w wo contrast (73702) |
$1,435.50 |
$2,871 |
8.5× |
| CT lower extremity with contrast (73701) |
$1,367 |
$2,734 |
8.1× |
| CT lumbar spine w/o contrast (72131) |
$1,459.50 |
$2,919 |
14.5× |
| CT lumbar spine with contrast (72132) |
$2,288.50 |
$4,577 |
6.8× |
| CT maxillofacial w contrast (70487) |
$1,464.50 |
$2,929 |
8.7× |
| CT maxillofacial w/o contrast (70486) |
$1,183.50 |
$2,367 |
11.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,392.50 |
$2,785 |
8.2× |
| CT neck soft tissue w contrast (70491) |
$1,605.50 |
$3,211 |
9.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,892 |
$3,784 |
11.2× |
| CT orbits w/o contrast (70480) |
$1,096 |
$2,192 |
10.9× |
| CT pelvis w & w/o contrast (72194) |
$1,483 |
$2,966 |
8.8× |
| CT pelvis w/o contrast (72192) |
$1,195 |
$2,390 |
11.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,691.50 |
$3,383 |
10.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,312.50 |
$2,625 |
13.0× |
| CT thoracic spine w/contrast (72129) |
$1,705.50 |
$3,411 |
10.1× |
| CT thoracic spine w/o contrast (72128) |
$1,365 |
$2,730 |
13.5× |
| CT thorax w/o contrast (71250) |
$1,164 |
$2,328 |
11.5× |
| CT upper extremity w/o contrast rt (73200) |
$1,149.50 |
$2,299 |
11.4× |
| CT upper extremity with contrast (73201) |
$1,666 |
$3,332 |
5.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,090 |
$4,180 |
12.4× |
| Cta Abdomen (74175) |
$2,194 |
$4,388 |
13.0× |
| CTA abdomen pelvis (74174) |
$3,226.50 |
$6,453 |
9.6× |
| CTA chest (71275) |
$2,014 |
$4,028 |
11.9× |
| Cta Head (70496) |
$2,080 |
$4,160 |
12.3× |
| CTA lwr ext w&w/o contrast (73706) |
$1,693.50 |
$3,387 |
10.0× |
| Cta Neck (70498) |
$2,001.50 |
$4,003 |
11.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$381.50 |
$763 |
3.8× |
| Echoencephalography real time imaging (76506) |
$458 |
$916 |
4.5× |
| Esophagus (74220) |
$382 |
$764 |
2.3× |
| Fetal biophysical profile non-stress testing (76818) |
$283.50 |
$567 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$339 |
$678 |
3.4× |
| Fluoroscopy up to 1 hr (76000) |
$615 |
$1,230 |
2.7× |
| Foot 2 views (73620) |
$221.50 |
$443 |
2.6× |
| Forearm 2 views (73090) |
$228 |
$456 |
2.7× |
| Hand 3 views (73130) |
$280 |
$560 |
3.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,023 |
$2,046 |
2.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$793.50 |
$1,587 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$210 |
$420 |
2.5× |
| Hysterosalpingogram (74740) |
$389 |
$778 |
1.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,138 |
$2,276 |
2.2× |
| Knee 3 views (73562) |
$250 |
$500 |
3.0× |
| Lymphoscintigraphy (78195) |
$901.50 |
$1,803 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$513.50 |
$1,027 |
1.4× |
| MRA head w & w/o contrast (70546) |
$2,179 |
$4,358 |
6.5× |
| MRA head w/o contrast (70544) |
$1,754.50 |
$3,509 |
7.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,709 |
$5,418 |
8.1× |
| MRA neck w/o contrast (70547) |
$1,641 |
$3,282 |
7.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,671.50 |
$5,343 |
7.9× |
| MRI abdomen w/o contrast (74181) |
$2,089.50 |
$4,179 |
9.1× |
| MRI any jnt lwr ext with con lt (73722) |
$2,004.50 |
$4,009 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,080 |
$4,160 |
2.8× |
| MRI c-spine with contrast (72142) |
$2,137.50 |
$4,275 |
6.4× |
| MRI cervical spine w/o contrast (72141) |
$2,035.50 |
$4,071 |
8.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,308 |
$4,616 |
6.9× |
| MRI chest w/o contrast (71550) |
$1,825 |
$3,650 |
7.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,876 |
$3,752 |
8.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,877 |
$5,754 |
8.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,518 |
$5,036 |
7.5× |
| MRI pelvis w/o contrast (72195) |
$1,859.50 |
$3,719 |
8.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,520.50 |
$5,041 |
7.5× |
| MRI scan of leg joint before and after contrast (73723) |
$2,328.50 |
$4,657 |
6.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,534.50 |
$5,069 |
7.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,609.50 |
$5,219 |
7.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,404.50 |
$4,809 |
7.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,737.50 |
$3,475 |
7.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,813.50 |
$3,627 |
7.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,308 |
$4,616 |
6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,912.50 |
$3,825 |
8.3× |
| Myocardial Spect Multiple Studies (78452) |
$2,612.50 |
$5,225 |
2.1× |
| Neck soft tissue (70360) |
$221 |
$442 |
2.6× |
| Nm gastric emptying study (78264) |
$968 |
$1,936 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,345.50 |
$6,691 |
2.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$355.50 |
$711 |
3.5× |
| Parathyroid imaging (78070) |
$881 |
$1,762 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$192.50 |
$385 |
1.9× |
| PET image w/CT, skull-thigh (78815) |
$3,481.50 |
$6,963 |
2.5× |
| PET imaging CT for attenuation limited area (78814) |
$3,432 |
$6,864 |
2.5× |
| PET imaging for CT attenuation whole body (78816) |
$3,610 |
$7,220 |
2.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,599.50 |
$5,199 |
7.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$757.50 |
$1,515 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$295.50 |
$591 |
2.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$568.50 |
$1,137 |
1.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$359.50 |
$719 |
3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$296.50 |
$593 |
2.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$215.50 |
$431 |
2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$296 |
$592 |
2.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$195 |
$390 |
2.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$561 |
$1,122 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$454 |
$908 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$210 |
$420 |
2.5× |
| Radiological examination surgical specimen (76098) |
$125.50 |
$251 |
0.2× |
| Ribs bilateral 3 views (71110) |
$326.50 |
$653 |
3.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,991.50 |
$3,983 |
3.8× |
| Scanogram (77073) |
$294 |
$588 |
2.9× |
| Screening digital breast tomosynthesis (77063) |
$47.50 |
$95 |
2.0× |
| Small bowel series (74250) |
$496.50 |
$993 |
2.9× |
| Spec medical radj physics consltj (77370) |
$596.50 |
$1,193 |
4.6× |
| Spine thoracic 3 views (72072) |
$240.50 |
$481 |
2.4× |
| Stereotactic body radiation delivery (77373) |
$3,854.50 |
$7,709 |
2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$992 |
$1,984 |
2.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,119.50 |
$2,239 |
3.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$563.50 |
$1,127 |
4.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$915.50 |
$1,831 |
2.4× |
| Treatment device intermediate (77333) |
$611 |
$1,222 |
4.7× |
| Treatment devices simple (77332) |
$443.50 |
$887 |
3.4× |
| Tx devices design & construction complex (77334) |
$853 |
$1,706 |
2.4× |
| Ultrasound, abdomen limited (76705) |
$453.50 |
$907 |
4.5× |
| Urethrocystography voiding (74455) |
$522.50 |
$1,045 |
2.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$777 |
$1,554 |
4.6× |
| Us abdl aorta screen aaa (76706) |
$330 |
$660 |
3.3× |
| Us breast unilateral complete (76641) |
$292.50 |
$585 |
2.9× |
| Us breast unilateral limited (76642) |
$238.50 |
$477 |
2.8× |
| Us chest (76604) |
$344.50 |
$689 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$431.50 |
$863 |
4.3× |
| Us ob transvaginal (76817) |
$418 |
$836 |
4.1× |
| Us pelvic non ob complete (76856) |
$495.50 |
$991 |
4.9× |
| Us pregnancy ltd (76815) |
$339 |
$678 |
3.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$405 |
$810 |
4.0× |
| Us retroperitoneal complete (76770) |
$507 |
$1,014 |
5.0× |
| Us retroperitoneal limited (76775) |
$388.50 |
$777 |
3.9× |
| Us scrotum and contents (76870) |
$484 |
$968 |
4.8× |
| Us soft tissue head/neck (76536) |
$486.50 |
$973 |
4.8× |
| Us spinal canal and contents (76800) |
$166 |
$332 |
1.6× |
| Us xtr non-vasc lmtd (76882) |
$369 |
$738 |
3.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$389.50 |
$779 |
3.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$253.50 |
$507 |
3.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$680.50 |
$1,361 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$229.50 |
$459 |
2.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$281.50 |
$563 |
3.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$321.50 |
$643 |
3.2× |
| X-ray exam hip uni 1 view (73501) |
$131.50 |
$263 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$269.50 |
$539 |
3.2× |
| X-ray exam hip uni 4/> views (73503) |
$356 |
$712 |
3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$354.50 |
$709 |
3.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$299.50 |
$599 |
3.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$284.50 |
$569 |
3.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$222.50 |
$445 |
2.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$294 |
$588 |
2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$356 |
$712 |
3.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$259.50 |
$519 |
3.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$487.50 |
$975 |
5.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$295.50 |
$591 |
2.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$259 |
$518 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$231.50 |
$463 |
2.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$268 |
$536 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$344.50 |
$689 |
4.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$354.50 |
$709 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$249 |
$498 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$175 |
$350 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$274.50 |
$549 |
2.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$204.50 |
$409 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$214 |
$428 |
2.6× |
| Xr c-spine 6 or more views (72052) |
$520 |
$1,040 |
5.2× |
| Xr finger(s) 2+ views (73140) |
$181.50 |
$363 |
2.2× |
| Xr shoulder 1 view (73020) |
$166.50 |
$333 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$435 |
$870 |
4.3× |
| Xr tibia/fibula 2 views (73590) |
$276 |
$552 |
3.3× |
| Xr tmj bilateral (70330) |
$277.50 |
$555 |
3.3× |
| Xray knee 1 or 2 views rt (73560) |
$252 |
$504 |
3.0× |