| 3-D radiotherapy plan dose-volume histograms (77295) |
$19,860.20 |
$19,860.20 |
12.4× |
| Abdomen 2 views (74019) |
$602.40 |
$602.40 |
5.0× |
| Acute gi blood loss imaging (78278) |
$3,470.50 |
$3,470.50 |
7.5× |
| Angio Adrenal Bilat Select (75733) |
$8,652 |
$8,652 |
2.4× |
| Angiography extremity bilateral rs&i (75716) |
$88,495.40 |
$10,595.30 |
24.1× |
| Angiography extremity unilateral rs&i (75710) |
$149,688.15 |
— |
40.8× |
| Angiography internal mammary rs&i (75756) |
$9,221.60 |
$9,221.60 |
2.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$9,234.80 |
$9,234.80 |
1.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,845.20 |
$9,845.20 |
2.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,792.20 |
$8,792.20 |
2.4× |
| Angiography Spinal Selective Rs&I (75705) |
$74,353.95 |
— |
11.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$89,354.75 |
$14,295.90 |
13.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$249,419.30 |
— |
68.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$8,653.60 |
$8,653.60 |
2.4× |
| Ankle 2 views (73600) |
$994.30 |
$994.30 |
9.8× |
| Aortogram thoracic (75605) |
$14,717.80 |
$14,717.80 |
2.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$10,311.10 |
$10,311.10 |
2.8× |
| Aortography abdominal serialography rs&i (75625) |
$74,078.15 |
$10,621.20 |
20.2× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$9,502.90 |
$9,502.90 |
2.6× |
| Artery X-Rays Adrenal Gland (75731) |
$8,051.30 |
$8,051.30 |
2.2× |
| Arthrogram ankle (73615) |
$1,403.70 |
$1,403.70 |
3.5× |
| Arthrogram elbow (73085) |
$28,202.25 |
— |
69.6× |
| Arthrogram hip (73525) |
$2,767.85 |
$2,767.85 |
6.8× |
| Arthrogram knee (73580) |
$2,003.20 |
$2,003.20 |
4.9× |
| Arthrogram shoulder (73040) |
$1,367.60 |
$1,367.60 |
3.4× |
| Basic dosimetry (77300) |
$1,664.20 |
$1,664.20 |
10.7× |
| Bone &/joint imaging whole body (78306) |
$4,400.20 |
$4,400.20 |
9.5× |
| Bone age studies (77072) |
$388.90 |
$388.90 |
3.2× |
| Bone survey complete (77075) |
$1,472.50 |
$1,472.50 |
12.1× |
| Bone survey infant (77076) |
$1,402.50 |
$1,402.50 |
11.6× |
| Bowel imaging (78290) |
$3,557.30 |
$3,557.30 |
7.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$8,997.80 |
$8,997.80 |
5.4× |
| Brain Imaging Vascular Flow Only (78610) |
$1,898.20 |
$1,898.20 |
3.0× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,677 |
$2,677 |
5.8× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$9,553.90 |
$9,553.90 |
10.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$5,586.75 |
$5,586.75 |
13.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,824 |
$2,824 |
4.5× |
| Cervical spine 2 or 3 views (72040) |
$765.90 |
$765.90 |
7.6× |
| Chest 1 view (71045) |
$627.80 |
$627.80 |
6.2× |
| Chest xray 3 views (71047) |
$700 |
$700 |
6.9× |
| Clavicle complete (73000) |
$840.45 |
$840.45 |
8.3× |
| Continuing medical physics consltj pr wk (77336) |
$2,043 |
$2,043 |
13.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,302.30 |
$7,302.30 |
18.0× |
| CT abdomen and pelvis without contrast (74176) |
$4,491.90 |
$4,491.90 |
16.2× |
| CT abdomen w contrast (74160) |
$3,848.20 |
$3,848.20 |
18.9× |
| CT abdomen w wo contrast (74170) |
$4,358.30 |
$4,358.30 |
21.4× |
| CT abdomen w/o contrast (74150) |
$2,812.10 |
$2,812.10 |
23.2× |
| CT angio hrt w/3d image (75574) |
$6,297.80 |
$6,297.80 |
15.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$4,165.60 |
$4,165.60 |
20.5× |
| CT angiography upper extremity lt (73206) |
$3,118.40 |
$3,118.40 |
15.3× |
| CT c-spine w/contrast (72126) |
$3,362.90 |
$3,362.90 |
8.3× |
| CT c-spine w/o contrast (72125) |
$2,898.90 |
$2,898.90 |
23.9× |
| CT cervical spine w&w/o contrast (72127) |
$4,316.10 |
$4,316.10 |
21.2× |
| CT chest w contrast (71260) |
$3,707.70 |
$3,707.70 |
18.2× |
| CT chest w/wo contrast (71270) |
$4,401 |
$4,401 |
21.6× |
| CT head/brain with contrast (70460) |
$2,732.60 |
$2,732.60 |
13.4× |
| CT head/brain without and with contrast (70470) |
$3,392.60 |
$3,392.60 |
16.7× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$1,921.30 |
$1,921.30 |
19.0× |
| CT hrt w/3d image congen (75573) |
$4,907.50 |
$4,907.50 |
12.1× |
| CT iac w contrast (70481) |
$3,586.20 |
$3,586.20 |
17.6× |
| CT limited/localized follow up study (76380) |
$1,358.90 |
$1,358.90 |
13.4× |
| CT lower ext w/o (73700) |
$3,345.20 |
$3,345.20 |
27.6× |
| CT lower extremity w wo contrast (73702) |
$3,671 |
$3,671 |
18.0× |
| CT lower extremity w/contrast material (73701) |
$4,083.30 |
$4,083.30 |
20.0× |
| CT lumbar spine w & w/o contrast (72133) |
$4,215.50 |
$4,215.50 |
20.7× |
| CT lumbar spine w/contrast (72132) |
$3,902.20 |
$3,902.20 |
9.6× |
| CT lumbar spine w/o contrast (72131) |
$3,181.60 |
$3,181.60 |
26.2× |
| CT maxillofacial w contrast (70487) |
$2,865 |
$2,865 |
14.1× |
| CT maxillofacial w/wo contrast (70488) |
$3,987.40 |
$3,987.40 |
19.6× |
| CT maxillofacial wo contrast (70486) |
$2,419.60 |
$2,419.60 |
19.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,965 |
$3,965 |
19.5× |
| CT orbits w/o contrast (70480) |
$2,869 |
$2,869 |
23.6× |
| CT pelvis w/o contrast (72192) |
$2,706.40 |
$2,706.40 |
22.3× |
| CT pelvis w/wo contrast (72194) |
$4,169.30 |
$4,169.30 |
20.5× |
| CT scan of arm combo (73202) |
$3,762.90 |
$3,762.90 |
18.5× |
| CT soft tissue neck w contrast (70491) |
$3,491.60 |
$3,491.60 |
17.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,192 |
$3,192 |
15.7× |
| CT soft tissue neck w/o contrast (70490) |
$2,572 |
$2,572 |
21.2× |
| CT thoracic spine w/contrast (72129) |
$3,076.20 |
$3,076.20 |
15.1× |
| CT thoracic spine w/o contrast (72128) |
$2,866.50 |
$2,866.50 |
23.6× |
| CT thoracic spine w/wo contrast (72130) |
$4,219.70 |
$4,219.70 |
20.7× |
| CT thorax w/o contrast (71250) |
$2,896.50 |
$2,896.50 |
23.9× |
| CT upper ext wo (73200) |
$3,342.80 |
$3,342.80 |
27.5× |
| CT upper extremity with contrast (73201) |
$3,369 |
$3,369 |
8.3× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$4,019.70 |
$4,019.70 |
19.7× |
| Cta Abdomen (74175) |
$4,706.90 |
$4,706.90 |
23.1× |
| CTA abdomen pelvis (74174) |
$7,255.30 |
$7,255.30 |
17.9× |
| CTA chest (71275) |
$4,393.50 |
$4,393.50 |
21.6× |
| Cta Head (70496) |
$5,385.40 |
$5,385.40 |
26.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$6,779 |
$6,779 |
16.7× |
| Cta Neck (70498) |
$4,757.20 |
$4,757.20 |
23.4× |
| Cta Pelvis (72191) |
$4,451.70 |
$4,451.70 |
21.9× |
| Cystography minimum 3 views rs&i (74430) |
$1,257.20 |
$1,257.20 |
3.1× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$4,034.80 |
$4,034.80 |
1.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$654.60 |
$654.60 |
5.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,031.10 |
$1,031.10 |
8.5× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$627 |
$627 |
5.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$775.40 |
$775.40 |
6.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$697.30 |
$697.30 |
6.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,166.70 |
$1,166.70 |
4.2× |
| Esophagus (74220) |
$1,008 |
$1,008 |
4.9× |
| Facial bones min 3 views (70150) |
$760.50 |
$760.50 |
6.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$623 |
$623 |
5.1× |
| Fetal Echo (76825) |
$2,076.90 |
$2,076.90 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$869.60 |
$869.60 |
3.1× |
| Foot 2 views (73620) |
$1,049.70 |
$1,049.70 |
10.4× |
| Forearm 2 views (73090) |
$1,186.40 |
$1,186.40 |
11.7× |
| Functional MRI brain by phys/psych (70555) |
$7,613.80 |
$7,613.80 |
27.5× |
| Functional MRI brain by tech (70554) |
$7,760.10 |
$7,760.10 |
28.0× |
| Hand 2 views (73120) |
$1,223.40 |
$1,223.40 |
10.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$55,451.70 |
— |
15.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$9,176.80 |
$9,176.80 |
2.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,203.10 |
$3,203.10 |
5.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,520 |
$2,520 |
5.4× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) |
$6,165 |
$6,165 |
9.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$459.80 |
$459.80 |
3.8× |
| Kidney imaging morphology (78700) |
$2,275.30 |
$2,275.30 |
4.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,182.80 |
$2,182.80 |
3.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,788.70 |
$2,788.70 |
4.4× |
| Knee 3 views (73562) |
$992.05 |
$992.05 |
9.8× |
| Liver & spleen imaging static only (78215) |
$2,028.50 |
$2,028.50 |
4.4× |
| Lung ventilation imaging (78579) |
$2,242.60 |
$2,242.60 |
4.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$78,040 |
— |
21.3× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$13,432.80 |
$13,432.80 |
3.7× |
| Lymphoscintigraphy (78195) |
$3,195.40 |
$3,195.40 |
5.1× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$4,920.80 |
$4,920.80 |
5.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$4,657.70 |
$4,657.70 |
11.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$9,310.70 |
$9,310.70 |
23.0× |
| Magnetic Resonance Elastography (76391) |
$5,046.30 |
$5,046.30 |
18.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$21,030.60 |
$21,030.60 |
48.4× |
| MRA head w & w/o contrast (70546) |
$6,791.10 |
$6,791.10 |
16.8× |
| MRA head w/o contrast (70544) |
$4,691.70 |
$4,691.70 |
16.9× |
| MRA head with contrast (70545) |
$5,746.30 |
$5,746.30 |
14.2× |
| MRA neck w contrast (70548) |
$4,782.80 |
$4,782.80 |
11.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$6,518.80 |
$6,518.80 |
16.1× |
| MRA neck w/o contrast (70547) |
$4,510.90 |
$4,510.90 |
16.3× |
| MRI abdomen w contrast (74182) |
$6,242.30 |
$6,242.30 |
15.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$7,651.30 |
$7,651.30 |
18.9× |
| MRI abdomen w/o contrast (74181) |
$4,815.90 |
$4,815.90 |
17.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,729.10 |
$4,729.10 |
5.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$9,079 |
$9,079 |
22.4× |
| MRI c-spine with contrast (72142) |
$2,291.40 |
$2,291.40 |
5.7× |
| MRI cardiac w/o contrast (75557) |
$4,679.50 |
$4,679.50 |
16.9× |
| MRI cervical spine w/o contrast (72141) |
$2,900.95 |
$2,900.95 |
10.5× |
| MRI chest w/o & w/contrast material (71552) |
$7,891.10 |
$7,891.10 |
19.5× |
| MRI chest w/o contrast (71550) |
$4,270.50 |
$4,270.50 |
15.4× |
| MRI chest with contrast (71551) |
$6,451.70 |
$6,451.70 |
7.1× |
| MRI fetal sngl/1st gestation (74712) |
$5,842.80 |
$5,842.80 |
21.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$5,110.70 |
$5,110.70 |
12.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$10,558.55 |
$10,558.55 |
26.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,692.30 |
$3,692.30 |
13.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$4,057.70 |
$4,057.70 |
14.6× |
| MRI orbit face neck w contrast (70542) |
$5,427.40 |
$5,427.40 |
13.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$7,597.10 |
$7,597.10 |
18.8× |
| MRI pelvis w/contrast (72196) |
$5,392.20 |
$5,392.20 |
13.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$7,330.80 |
$7,330.80 |
18.1× |
| MRI pelvis w/o contrast (72195) |
$2,920.25 |
$2,920.25 |
10.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$5,668.80 |
$5,668.80 |
14.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,206 |
$2,206 |
5.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$5,813.15 |
$5,813.15 |
14.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,370.40 |
$2,370.40 |
5.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,166 |
$6,166 |
15.2× |
| MRI temporomandibular joint (70336) |
$4,337.30 |
$4,337.30 |
15.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,554.80 |
$1,554.80 |
5.6× |
| MRI up ext w/o contrast (73218) |
$2,610.80 |
$2,610.80 |
9.4× |
| MRI upper ext joint w/o contrast (73221) |
$4,216.30 |
$4,216.30 |
15.2× |
| MRI, joint upper extrem combo (73223) |
$6,219.90 |
$6,219.90 |
15.4× |
| Myelogram Cervical (72240) |
$3,339.10 |
$3,339.10 |
3.7× |
| Myelogram Lumbar (72265) |
$2,941.80 |
$2,941.80 |
3.2× |
| Myelogram thoracic (72255) |
$3,162.70 |
$3,162.70 |
3.5× |
| Myelography 2 or more regions (72270) |
$4,163.20 |
$4,163.20 |
4.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$7,865.80 |
$7,865.80 |
5.2× |
| Myocardial Spect Multiple Studies (78452) |
$6,276.20 |
$6,276.20 |
4.2× |
| Myocardial spect single study at rest or stress (78451) |
$4,341.20 |
$4,341.20 |
2.9× |
| Neck soft tissue (70360) |
$552.60 |
$552.60 |
5.5× |
| Nm bone marrow wb (78104) |
$2,727.30 |
$2,727.30 |
5.9× |
| Nm cisternogram (78630) |
$2,812.10 |
$2,812.10 |
4.5× |
| Nm gastric emptying study (78264) |
$2,904.20 |
$2,904.20 |
6.3× |
| Nm gastroesophageal reflux study (78262) |
$2,465.50 |
$2,465.50 |
5.3× |
| Nonvascular shunt X-ray (75809) |
$25,376.75 |
— |
209.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$20,811 |
$20,811 |
12.9× |
| Nuclear Rx Oral Admin (79005) |
$1,293.50 |
$1,293.50 |
4.8× |
| Ob us nuchal meas 1 gest (76813) |
$500 |
$500 |
4.1× |
| Ophthalmic biometry by ultrasound echography, A-scan; Non-Facility (76516) |
$341.30 |
$341.30 |
2.8× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$783.70 |
$783.70 |
6.5× |
| Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter… (76510) |
$834.10 |
$834.10 |
5.4× |
| Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)… (76514) |
$670.30 |
— |
20.0× |
| Ophthalmic ultrasound, diagnostic; quantitative A-scan only Non-Facility (76511) |
$523.80 |
$523.80 |
4.3× |
| Osseous survey limited (77074) |
$971.40 |
$971.40 |
8.0× |
| Parathyrd planar w/spect&CT (78072) |
$2,961.60 |
$2,961.60 |
4.7× |
| Parathyroid Planar Imaging (78070) |
$2,093.70 |
$2,093.70 |
4.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,178.90 |
$2,178.90 |
4.7× |
| Pelvis 1 or 2 views (72170) |
$605.70 |
$605.70 |
5.0× |
| Perineogram (74775) |
$1,296.10 |
$1,296.10 |
4.7× |
| Peritoneogram after injection (74190) |
$1,201.80 |
$1,201.80 |
1.9× |
| PET image w/CT, skull-thigh (78815) |
$9,427.80 |
$9,427.80 |
5.7× |
| PET imaging CT for attenuation limited area (78814) |
$5,908.80 |
$5,908.80 |
3.6× |
| PET imaging for CT attenuation whole body (78816) |
$10,103.10 |
$10,103.10 |
6.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$93,036.75 |
— |
25.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$7,999.60 |
$7,999.60 |
2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,743.50 |
$2,743.50 |
5.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,508.40 |
$3,508.40 |
5.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,576.10 |
$1,602.25 |
2.5× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$1,034.70 |
$1,034.70 |
10.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$703.50 |
$703.50 |
7.0× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$920.55 |
$920.55 |
9.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$641.50 |
$641.50 |
6.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,021.10 |
$1,021.10 |
8.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$885.70 |
$885.70 |
7.3× |
| Radex fingr minimum 2 views (73140) |
$1,021.50 |
$1,021.50 |
10.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$873.90 |
$873.90 |
8.6× |
| Radex Hand Minimum 3 Views (73130) |
$1,241.95 |
$1,241.95 |
12.3× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$590.90 |
$590.90 |
5.8× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$641.50 |
$641.50 |
5.3× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$634 |
$634 |
5.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,164.80 |
$1,164.80 |
9.6× |
| Radex Humerus Minimum 2 Views (73060) |
$1,145.60 |
$1,145.60 |
11.3× |
| Radex Kne 1/2 Views (73560) |
$783.25 |
$783.25 |
7.8× |
| Radex Kne Compl 4/More Views (73564) |
$1,038.90 |
$1,038.90 |
8.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$814.50 |
$814.50 |
6.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$591.60 |
$591.60 |
5.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$739.10 |
$739.10 |
6.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$881.30 |
$881.30 |
8.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$504.60 |
$504.60 |
5.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$746.30 |
$746.30 |
6.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$852.70 |
$852.70 |
8.4× |
| Radex Toe Minimum 2 Views (73660) |
$749.70 |
$749.70 |
7.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$996.60 |
$996.60 |
8.2× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$1,025.10 |
$1,025.10 |
10.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$863.40 |
$863.40 |
7.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$53,178.70 |
$53,178.70 |
6.2× |
| Radiation treatment delivery level 1 (77402) |
$1,698.80 |
$1,698.80 |
14.3× |
| Radiation treatment delivery level 2 (77407) |
$1,976.50 |
$1,976.50 |
4.4× |
| Radiation treatment delivery level 3 (77412) |
$3,159.70 |
$3,159.70 |
4.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$487.30 |
$487.30 |
4.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$761.20 |
$761.20 |
6.3× |
| Radiologic exam chest 2 views (71046) |
$627.30 |
$627.30 |
6.2× |
| Radiologic exam colon single contrast study (74270) |
$1,673.20 |
$1,673.20 |
8.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,630.50 |
$1,630.50 |
8.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,173.20 |
$1,173.20 |
5.8× |
| Radiologic examination femur 1 view (73551) |
$636.55 |
$636.55 |
6.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$1,124.50 |
$1,124.50 |
11.1× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$967.70 |
$967.70 |
8.0× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$1,260.20 |
$1,260.20 |
12.5× |
| Renal Cyst Study (74470) |
$2,931.10 |
$2,931.10 |
4.6× |
| Ribs bilateral 3 views (71110) |
$725.80 |
$725.80 |
6.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,440.30 |
$2,440.30 |
5.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,607 |
$4,607 |
7.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$4,580.70 |
$4,580.70 |
7.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,353.70 |
$3,353.70 |
5.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$4,226.80 |
$4,226.80 |
2.8× |
| Rp Therapy Intravenous Administration (79101) |
$24,182.80 |
$24,182.80 |
89.2× |
| Sacroiliac Joints < 3 Views (72200) |
$552.60 |
$552.60 |
4.6× |
| Scapula (73010) |
$806.70 |
$806.70 |
6.6× |
| Shoulder 1 view (73020) |
$627.15 |
$627.15 |
6.2× |
| Sialogram (70390) |
$1,403.80 |
$1,403.80 |
5.1× |
| Simulation intermediate (77285) |
$5,134.10 |
$5,134.10 |
11.8× |
| Small bowel series (74250) |
$1,268.60 |
$1,268.60 |
6.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$4,287.40 |
$4,287.40 |
9.9× |
| Special dosimetry (77331) |
$1,436.60 |
$1,436.60 |
9.2× |
| Special Physics Consult (77370) |
$3,239 |
$3,239 |
20.8× |
| Special treatment procedure (77470) |
$8,268.30 |
$8,268.30 |
12.9× |
| Speech evaluation complex (70371) |
$1,191.90 |
$1,191.90 |
4.3× |
| Spine thoracic 3 views (72072) |
$766.70 |
$766.70 |
6.3× |
| Spleen imaging only (78185) |
$2,225.50 |
$2,225.50 |
4.8× |
| Splenoportograpy rs&i (75810) |
$122,015.50 |
— |
33.3× |
| Stereotactic Body Radiation Delivery (77373) |
$32,945.90 |
$32,945.90 |
15.9× |
| Superior sagittal sinus venogram (75870) |
$8,754.20 |
$8,754.20 |
2.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$5,609.10 |
$5,609.10 |
12.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$3,245.60 |
$3,245.60 |
20.8× |
| Thoracolumbar 2 views (72080) |
$584.80 |
$584.80 |
5.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$3,214.50 |
$3,214.50 |
5.1× |
| Thyroid imaging w/blood flow (78013) |
$1,855.50 |
$1,855.50 |
4.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,698.60 |
$2,698.60 |
5.8× |
| Treatment device complex (77334) |
$4,578 |
$4,578 |
10.5× |
| Treatment device intermediate (77333) |
$3,019.50 |
$3,019.50 |
19.3× |
| Treatment devices simple (77332) |
$2,021.80 |
$2,021.80 |
13.0× |
| Ultrasound, abdomen limited (76705) |
$1,039.20 |
$1,039.20 |
8.6× |
| Umbilical-artery Doppler (OB) (76820) |
$543 |
$543 |
4.5× |
| Unlisted fluoroscopic procedure (76496) |
$8,951.40 |
$8,951.40 |
88.6× |
| Unlisted magnetic resonance procedure (76498) |
$12,518.50 |
$12,518.50 |
123.9× |
| Unlisted ultrasound procedure (76999) |
$1,144.10 |
$1,144.10 |
11.3× |
| Ureteral reflux study (78740) |
$2,395.80 |
$2,395.80 |
5.2× |
| Urethrocystogram voiding (74455) |
$1,432.40 |
$1,432.40 |
5.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,320.80 |
$1,320.80 |
4.8× |
| Us breast unilateral limited (76642) |
$743.10 |
— |
7.4× |
| Us chest (76604) |
$973.60 |
$973.60 |
8.0× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$3,161.05 |
$3,161.05 |
12.6× |
| Us compl joint r-t w/image documentation (76881) |
$1,095 |
$1,095 |
9.0× |
| Us elastography parenchyma (76981) |
$365.40 |
$365.40 |
3.0× |
| Us encephalogram (76506) |
$1,137.80 |
$1,137.80 |
9.4× |
| Us hips infant static (76886) |
$1,131.30 |
$1,131.30 |
11.2× |
| Us infant hips w manipulation (76885) |
$1,389.10 |
$1,389.10 |
13.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$766.52 |
$618.90 |
6.3× |
| Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$682 |
$682 |
5.6× |
| Us ob detailed single fetus (76811) |
$1,261 |
$1,261 |
4.6× |
| Us ob limited (76815) |
$616 |
$616 |
5.1× |
| Us ob transvaginal (76817) |
$667 |
$667 |
5.5× |
| Us pelvic non ob complete (76856) |
$1,105.80 |
$1,105.80 |
9.1× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$901.40 |
$901.40 |
7.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$900 |
$900 |
7.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$578 |
$578 |
4.8× |
| Us retroperitoneal complete (76770) |
$1,326.30 |
$1,326.30 |
10.9× |
| Us retroperitoneal limited (76775) |
$956.80 |
$956.80 |
7.9× |
| Us scrotum and contents (76870) |
$1,053.70 |
$1,053.70 |
8.7× |
| Us soft tissue head/neck (76536) |
$1,289.55 |
$1,289.55 |
10.6× |
| Us spinal canal and contents (76800) |
$999 |
$999 |
8.2× |
| Us transrectal (76872) |
$1,684.40 |
$1,684.40 |
13.9× |
| Us, eye b-scan (76512) |
$865.40 |
$865.40 |
7.1× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,295.90 |
$1,295.90 |
10.7× |
| Venogram adrenal unilat (75840) |
$8,922.50 |
$8,922.50 |
2.4× |
| Venogram extremity bilateral (75822) |
$48,343.85 |
— |
26.4× |
| Venogram Extremity Unilateral (75820) |
$29,239.65 |
$3,826.30 |
16.0× |
| Venography caval inferior serialography rs&i (75825) |
$70,185.38 |
$10,543.90 |
19.1× |
| Venography caval superior serialography rs&i (75827) |
$190,603.55 |
— |
104.3× |
| Venography Orbital Rs&I (75880) |
$1,651.50 |
$1,651.50 |
2.3× |
| Venography Renal Bilateral (75833) |
$11,531.40 |
$11,531.40 |
3.1× |
| Venography renal unilateral selective rs&i (75831) |
$49,304.42 |
— |
13.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$9,764.70 |
$9,764.70 |
2.7× |
| Venography, epidural, radiological supervision and interpretation Non-Facility (75872) |
$8,922.50 |
$8,922.50 |
12.2× |
| Venous sampling by catheter (75893) |
$79,868.10 |
— |
12.4× |
| Wrist 2 views (73100) |
$1,123.80 |
$1,123.80 |
11.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$891.50 |
$891.50 |
7.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$639.10 |
$639.10 |
6.3× |
| X-ray b.e. reductn intuss (74283) |
$1,884.60 |
$1,884.60 |
9.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,357.80 |
$2,357.80 |
11.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,059.40 |
$1,059.40 |
10.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$548.20 |
$548.20 |
5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$730 |
$730 |
6.0× |
| X-ray exam of femur 2/> (73552) |
$874 |
$874 |
8.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$562.30 |
$562.30 |
5.6× |
| X-ray IV pyelogram (ivp) (74400) |
$1,640.20 |
$1,640.20 |
8.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$537.90 |
$537.90 |
5.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$496.50 |
$496.50 |
4.9× |
| X-ray leg, infant (73592) |
$693.35 |
$693.35 |
6.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$678.60 |
$678.60 |
5.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,261.90 |
$1,261.90 |
10.4× |
| X-ray nose-rectum child f.b. (76010) |
$672.70 |
$672.70 |
6.7× |
| X-ray optic foramen (70190) |
$535.80 |
$535.80 |
5.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$705.20 |
$705.20 |
5.8× |
| X-ray retrograde pyelogram (74420) |
$1,916.30 |
$1,916.30 |
4.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$542.40 |
$542.40 |
5.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$709 |
$709 |
5.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$854.40 |
$854.40 |
7.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$648.40 |
$648.40 |
5.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$674.40 |
$674.40 |
6.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$674.40 |
$674.40 |
6.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$782.90 |
$782.90 |
6.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$602.90 |
$602.90 |
5.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$507.50 |
$507.50 |
5.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$604.30 |
$604.30 |
6.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$720 |
$720 |
5.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$791.60 |
$791.60 |
6.5× |
| Xr bone length studies (77073) |
$641.50 |
$641.50 |
5.3× |
| Xr c-spine 4 or 5 views (72050) |
$920.80 |
$920.80 |
7.6× |
| Xr c-spine 6 or more views (72052) |
$1,141.60 |
$1,141.60 |
9.4× |
| Xr chest 4+ views (71048) |
$804.80 |
$804.80 |
6.6× |
| Xr urogram antegrade (74425) |
$1,569 |
$1,569 |
3.9× |