| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,486 |
$8,648 |
5.3× |
| Abdomen 2 views (74019) |
$302.25 |
$403 |
3.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$668.25 |
$891 |
1.9× |
| Angiography extremity bilateral rs&i (75716) |
$4,853.25 |
$6,471 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,979.25 |
$2,639 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$5,867.25 |
$7,823 |
2.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,786.75 |
$9,049 |
1.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$7,082.25 |
$9,443 |
2.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$7,051.50 |
$9,402 |
2.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,429.25 |
$7,239 |
1.1× |
| Ankle 2 views (73600) |
$351.75 |
$469 |
4.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$334.50 |
$446 |
1.1× |
| Aortogram thoracic (75605) |
$6,786.75 |
$9,049 |
1.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,801 |
$5,068 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$4,067.25 |
$5,423 |
1.5× |
| Arthrogram elbow (73085) |
$392.25 |
$523 |
1.3× |
| Arthrogram hip (73525) |
$402.75 |
$537 |
1.3× |
| Arthrogram shoulder (73040) |
$402.75 |
$537 |
1.3× |
| Arthrogram wrist (73115) |
$400.50 |
$534 |
1.3× |
| Arthrography knee lt (73580) |
$385.50 |
$514 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$295.50 |
$394 |
2.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,307.25 |
$1,743 |
3.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$930 |
$1,240 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$747.75 |
$997 |
2.1× |
| Bone age studies (77072) |
$368.25 |
$491 |
4.0× |
| Bone Imaging 3 Phase (78315) |
$1,166.25 |
$1,555 |
3.3× |
| Bone survey complete (77075) |
$414.75 |
$553 |
4.5× |
| Brain Imaging Vascular Flow Only (78610) |
$426.75 |
$569 |
0.9× |
| Cervical spine 2 or 3 views (72040) |
$507.75 |
$677 |
6.7× |
| Chest 1 view (71045) |
$166.88 |
$222.50 |
2.2× |
| Chest 3 views (71047) |
$174.75 |
$233 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$222 |
$296 |
1.4× |
| Clavicle complete (73000) |
$195 |
$260 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$114.38 |
$152.50 |
1.2× |
| Continuing medical physics consltj pr wk (77336) |
$276 |
$368 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,065 |
$9,420 |
23.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,152.75 |
$5,537 |
19.9× |
| CT abdomen w contrast (74160) |
$3,319.50 |
$4,426 |
21.6× |
| CT abdomen w wo contrast (74170) |
$3,749.62 |
$4,999.50 |
24.4× |
| CT abdomen w/o contrast (74150) |
$1,005.75 |
$1,341 |
11.0× |
| CT angiography upper extremity lt (73206) |
$1,839.75 |
$2,453 |
12.0× |
| CT c-spine w/o contrast (72125) |
$562.50 |
$750 |
6.1× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$288 |
$384 |
1.9× |
| CT cervical spine w&w/o contrast (72127) |
$1,931.25 |
$2,575 |
12.6× |
| CT cervical spine with contrast (72126) |
$2,286 |
$3,048 |
7.5× |
| CT chest w/wo contrast (71270) |
$2,372.25 |
$3,163 |
15.4× |
| CT chest with contrast (71260) |
$1,848 |
$2,464 |
12.0× |
| CT head/brain with contrast (70460) |
$1,915.50 |
$2,554 |
12.5× |
| CT head/brain without and with contrast (70470) |
$2,816.25 |
$3,755 |
18.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$367.50 |
$490 |
1.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$185.25 |
$247 |
2.4× |
| CT iac w contrast (70481) |
$1,570.50 |
$2,094 |
10.2× |
| CT lower ext w/o (73700) |
$955.50 |
$1,274 |
10.4× |
| CT lower extremity w wo contrast (73702) |
$1,321.50 |
$1,762 |
8.6× |
| CT lower extremity with contrast (73701) |
$375 |
$500 |
2.4× |
| CT lumbar spine w & w/o contrast (72133) |
$1,974.75 |
$2,633 |
12.8× |
| CT lumbar spine w/o contrast (72131) |
$473.25 |
$631 |
5.2× |
| CT lumbar spine with contrast (72132) |
$1,867.50 |
$2,490 |
6.1× |
| CT maxillofacial w contrast (70487) |
$2,055 |
$2,740 |
13.4× |
| CT maxillofacial w/o contrast (70486) |
$996 |
$1,328 |
10.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,493.25 |
$1,991 |
9.7× |
| CT neck soft tissue w contrast (70491) |
$1,712.25 |
$2,283 |
11.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,157.25 |
$1,543 |
7.5× |
| CT orbits w/o contrast (70480) |
$1,272 |
$1,696 |
13.9× |
| CT pelvis w & w/o contrast (72194) |
$2,574.75 |
$3,433 |
16.8× |
| CT pelvis w/o contrast (72192) |
$597 |
$796 |
6.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,410.50 |
$3,214 |
15.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,583.25 |
$2,111 |
17.3× |
| CT thoracic spine w/contrast (72129) |
$844.50 |
$1,126 |
5.5× |
| CT thoracic spine w/o contrast (72128) |
$610.50 |
$814 |
6.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,958.25 |
$2,611 |
12.7× |
| CT thorax w/o contrast (71250) |
$401.62 |
$535.50 |
4.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,321.50 |
$1,762 |
8.6× |
| CT upper extremity w/o contrast rt (73200) |
$934.50 |
$1,246 |
10.2× |
| CT upper extremity with contrast (73201) |
$1,445.25 |
$1,927 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$522.75 |
$697 |
3.4× |
| Cta Abdomen (74175) |
$2,299.50 |
$3,066 |
15.0× |
| CTA abdomen pelvis (74174) |
$606 |
$808 |
2.0× |
| CTA chest (71275) |
$4,387.50 |
$5,850 |
28.5× |
| Cta Head (70496) |
$4,492.50 |
$5,990 |
29.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$6,816.75 |
$9,089 |
22.3× |
| CTA lwr ext w&w/o contrast (73706) |
$5,042.25 |
$6,723 |
32.8× |
| Cta Neck (70498) |
$2,361.75 |
$3,149 |
15.4× |
| Cta Pelvis (72191) |
$2,232 |
$2,976 |
14.5× |
| Cystography minimum 3 views rs&i (74430) |
$495 |
$660 |
1.6× |
| Diskogram cervical (72285) |
$3,449.25 |
$4,599 |
2.0× |
| Diskography lumbar (72295) |
$4,155.75 |
$5,541 |
2.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$114 |
$152 |
1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$162 |
$216 |
2.1× |
| Echoencephalography real time imaging (76506) |
$310.50 |
$414 |
3.4× |
| Esophagus (74220) |
$206.25 |
$275 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$628.50 |
$838 |
6.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$632.25 |
$843 |
6.9× |
| Fluoroscopy up to 1 hr (76000) |
$613.50 |
$818 |
2.9× |
| Foot 2 views (73620) |
$201.75 |
$269 |
2.6× |
| Forearm 2 views (73090) |
$216.75 |
$289 |
2.8× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$156.75 |
$209 |
0.7× |
| Gated Heart Planar Single (78472) |
$470.25 |
$627 |
1.3× |
| Hand 2 views (73120) |
$351 |
$468 |
3.8× |
| Hand 3 views (73130) |
$374.25 |
$499 |
4.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,720.50 |
$2,294 |
3.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,499.25 |
$1,999 |
4.3× |
| Ht muscle image spect sing (78451) |
$2,580.75 |
$3,441 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$151.50 |
$202 |
2.0× |
| Hysterosalpingogram (74740) |
$603.75 |
$805 |
2.9× |
| Kidney funcj study non-img radioisotopic study (78725) |
$510.75 |
$681 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$946.50 |
$1,262 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$768 |
$1,024 |
1.6× |
| Knee 3 views (73562) |
$239.25 |
$319 |
3.1× |
| Liver & spleen imaging static only (78215) |
$1,021.50 |
$1,362 |
2.9× |
| Lung perf&ventilat diferentl (78598) |
$1,002 |
$1,336 |
2.1× |
| Lymphoscintigraphy (78195) |
$1,728.75 |
$2,305 |
3.6× |
| Mammary ductogram or galactogram multiple (77054) |
$278.25 |
$371 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$278.25 |
$371 |
1.3× |
| Meckels Diverticulum (78290) |
$1,006.50 |
$1,342 |
2.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$743.25 |
$991 |
2.3× |
| MRA head w & w/o contrast (70546) |
$3,267.75 |
$4,357 |
10.7× |
| MRA head w/o contrast (70544) |
$1,896 |
$2,528 |
9.1× |
| MRA head with contrast (70545) |
$2,056.50 |
$2,742 |
6.7× |
| MRA neck w contrast (70548) |
$2,252.25 |
$3,003 |
7.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,511 |
$3,348 |
8.2× |
| MRA neck w/o contrast (70547) |
$1,692 |
$2,256 |
8.1× |
| MRI abdomen w contrast (74182) |
$2,869.50 |
$3,826 |
9.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,347 |
$5,796 |
14.2× |
| MRI abdomen w/o contrast (74181) |
$4,334.25 |
$5,779 |
20.7× |
| MRI any jnt lwr ext with con lt (73722) |
$2,342.25 |
$3,123 |
3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,672.25 |
$3,563 |
3.9× |
| MRI breast w/o contrast bilateral (77047) |
$543.75 |
$725 |
2.6× |
| MRI breast w/o contrast unilat (77046) |
$519.75 |
$693 |
2.5× |
| MRI c-spine with contrast (72142) |
$2,025 |
$2,700 |
6.6× |
| MRI cervical spine w/o contrast (72141) |
$1,622.25 |
$2,163 |
7.8× |
| MRI chest w/o & w/contrast material (71552) |
$2,262 |
$3,016 |
7.4× |
| MRI chest w/o contrast (71550) |
$1,709.25 |
$2,279 |
8.2× |
| MRI chest with contrast (71551) |
$2,601 |
$3,468 |
3.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,289 |
$3,052 |
7.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,081.25 |
$2,775 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,342 |
$4,456 |
16.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,857.75 |
$2,477 |
8.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,535.75 |
$3,381 |
8.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,776.75 |
$2,369 |
5.8× |
| MRI pelvis w contrast (72196) |
$2,593.50 |
$3,458 |
8.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,958.62 |
$6,611.50 |
16.2× |
| MRI pelvis w/o contrast (72195) |
$3,881.25 |
$5,175 |
18.6× |
| MRI scan of arm joint before and after contrast (73223) |
$3,018.75 |
$4,025 |
9.9× |
| MRI scan of leg joint before and after contrast (73723) |
$3,017.25 |
$4,023 |
9.9× |
| MRI spectroscopy (76390) |
$155.25 |
$207 |
2.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,658.25 |
$6,211 |
15.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,507.25 |
$3,343 |
8.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,722 |
$6,296 |
15.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,480.25 |
$3,307 |
8.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$5,241 |
$6,988 |
17.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,781.25 |
$2,375 |
8.5× |
| MRI tmj (70336) |
$1,525.50 |
$2,034 |
7.3× |
| MRI upper ext joint w/o contrast (73221) |
$679.50 |
$906 |
3.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,886.75 |
$3,849 |
9.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$849 |
$1,132 |
4.1× |
| Myelogram Cervical (72240) |
$1,026 |
$1,368 |
1.5× |
| Myelogram Lumbar (72265) |
$1,032.75 |
$1,377 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,123.50 |
$1,498 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,774.12 |
$6,365.50 |
4.2× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,834.75 |
$5,113 |
2.0× |
| Neck soft tissue (70360) |
$267 |
$356 |
3.5× |
| Nm gastric emptying study (78264) |
$2,373.75 |
$3,165 |
6.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,400.25 |
$5,867 |
3.6× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,802 |
$3,736 |
2.2× |
| Nuclear Rx Oral Admin (79005) |
$817.88 |
$1,090.50 |
4.0× |
| Orthopantogram (70355) |
$109.50 |
$146 |
1.4× |
| Osseous survey infant (77076) |
$305.25 |
$407 |
3.3× |
| Osseous survey limited (77074) |
$219.75 |
$293 |
2.4× |
| Parathyrd planar w/wo subtrj (78071) |
$975 |
$1,300 |
2.8× |
| Parathyroid imaging (78070) |
$816 |
$1,088 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$81.75 |
$109 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$1,884 |
$2,512 |
1.5× |
| PET imaging CT for attenuation limited area (78814) |
$6,033.75 |
$8,045 |
4.8× |
| PET imaging for CT attenuation whole body (78816) |
$2,207.25 |
$2,943 |
1.8× |
| Pr gi endoscopic ultrasound (76975) |
$418.50 |
$558 |
2.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,769.50 |
$5,026 |
12.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$563.25 |
$751 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$854.25 |
$1,139 |
1.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$296.25 |
$395 |
3.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$561 |
$748 |
6.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$270.75 |
$361 |
3.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,966.25 |
$19,955 |
2.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,351.25 |
$3,135 |
4.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$176.25 |
$235 |
2.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$516 |
$688 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$269.25 |
$359 |
2.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$403.12 |
$537.50 |
5.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$115.12 |
$153.50 |
1.5× |
| Radiologic exam colon single contrast study (74270) |
$636.75 |
$849 |
4.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$378.75 |
$505 |
2.5× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$440.25 |
$587 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$483.75 |
$645 |
3.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$789.75 |
$1,053 |
5.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$179.62 |
$239.50 |
2.4× |
| Radiological examination surgical specimen (76098) |
$837 |
$1,116 |
1.7× |
| Ribs bilateral 3 views (71110) |
$369 |
$492 |
4.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$949.50 |
$1,266 |
2.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,514 |
$3,352 |
5.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,307.25 |
$1,743 |
2.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,376 |
$3,168 |
2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,808 |
$3,744 |
2.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,719.75 |
$2,293 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$409.50 |
$546 |
2.0× |
| Scanogram (77073) |
$194.25 |
$259 |
2.1× |
| Scapula complete (73010) |
$199.88 |
$266.50 |
2.2× |
| Screening digital breast tomosynthesis (77063) |
$160.12 |
$213.50 |
6.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$80.25 |
$107 |
0.9× |
| Small bowel series (74250) |
$387 |
$516 |
2.5× |
| Spec medical radj physics consltj (77370) |
$400.50 |
$534 |
3.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$849.75 |
$1,133 |
2.6× |
| Special dosimetry (77331) |
$818.25 |
$1,091 |
6.9× |
| Special treatment procedure (77470) |
$2,100 |
$2,800 |
4.3× |
| Spine thoracic 3 views (72072) |
$408 |
$544 |
4.5× |
| Stereotactic body radiation delivery (77373) |
$2,853 |
$3,804 |
1.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$288 |
$384 |
3.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,462.50 |
$1,950 |
4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$656.25 |
$875 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$766.50 |
$1,022 |
2.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,006.50 |
$1,342 |
8.5× |
| Therapeutic Enema (74283) |
$370.50 |
$494 |
2.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$699.75 |
$933 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$730.50 |
$974 |
2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,308 |
$1,744 |
3.7× |
| Treatment device intermediate (77333) |
$568.50 |
$758 |
4.8× |
| Treatment devices simple (77332) |
$867 |
$1,156 |
7.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$903 |
$1,204 |
2.6× |
| Tx devices design & construction complex (77334) |
$651.75 |
$869 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$846.75 |
$1,129 |
9.2× |
| Umbilical-artery Doppler (OB) (76820) |
$346.50 |
$462 |
3.8× |
| Upper Extremity Infant (73092) |
$142.50 |
$190 |
1.6× |
| Urethrocystography retrograde rs&i (74450) |
$557.25 |
$743 |
2.7× |
| Urethrocystography voiding (74455) |
$579 |
$772 |
2.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$822.75 |
$1,097 |
5.4× |
| Us abdl aorta screen aaa (76706) |
$188.25 |
$251 |
2.1× |
| Us breast unilateral complete (76641) |
$496.50 |
$662 |
5.4× |
| Us breast unilateral limited (76642) |
$459 |
$612 |
6.0× |
| Us chest (76604) |
$744 |
$992 |
8.1× |
| Us compl joint r-t w/image documentation (76881) |
$494.25 |
$659 |
5.4× |
| Us elastography parenchyma (76981) |
$1,181.25 |
$1,575 |
12.9× |
| Us guided compression repair (76936) |
$777.75 |
$1,037 |
4.1× |
| Us infant hips dynamic (76885) |
$327 |
$436 |
4.3× |
| Us infant hips limited static (76886) |
$279.75 |
$373 |
3.7× |
| Us kidney transplant (76776) |
$566.25 |
$755 |
6.2× |
| Us ob transvaginal (76817) |
$831 |
$1,108 |
9.1× |
| Us pelvic non ob complete (76856) |
$973.50 |
$1,298 |
10.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$549.75 |
$733 |
6.0× |
| Us pregnancy ltd (76815) |
$744 |
$992 |
8.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$853.50 |
$1,138 |
9.3× |
| Us retroperitoneal complete (76770) |
$483 |
$644 |
5.3× |
| Us retroperitoneal limited (76775) |
$931.50 |
$1,242 |
10.2× |
| Us scrotum and contents (76870) |
$976.50 |
$1,302 |
10.7× |
| Us soft tissue head/neck (76536) |
$970.50 |
$1,294 |
10.6× |
| Us spinal canal and contents (76800) |
$368.25 |
$491 |
4.0× |
| Us transrectal (76872) |
$1,149.75 |
$1,533 |
12.5× |
| Us xtr non-vasc lmtd (76882) |
$489.75 |
$653 |
5.3× |
| Venogram extremity bilateral (75822) |
$1,335 |
$1,780 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$4,952.62 |
$6,603.50 |
1.8× |
| Venography caval superior serialography rs&i (75827) |
$1,335 |
$1,780 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,241.25 |
$1,655 |
0.9× |
| Venography Renal Bilateral (75833) |
$6,745.50 |
$8,994 |
2.4× |
| Venography renal unilateral selective rs&i (75831) |
$5,310.75 |
$7,081 |
1.9× |
| Venography venous sinus/jugular cath rs&i (75860) |
$5,631.75 |
$7,509 |
2.0× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$9,184.50 |
$12,246 |
1.9× |
| Wrist 2 views (73100) |
$308.25 |
$411 |
4.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$532.50 |
$710 |
5.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$242.25 |
$323 |
3.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$405 |
$540 |
5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$164.62 |
$219.50 |
2.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$405 |
$540 |
5.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$366 |
$488 |
4.0× |
| X-ray exam hip uni 1 view (73501) |
$136.50 |
$182 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$80.25 |
$107 |
1.1× |
| X-ray exam hip uni 4/> views (73503) |
$279.75 |
$373 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$331.50 |
$442 |
3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$504 |
$672 |
5.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$371.25 |
$495 |
4.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$507.75 |
$677 |
6.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$177 |
$236 |
2.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$210.38 |
$280.50 |
2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$154.50 |
$206 |
2.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$189 |
$252 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$288 |
$384 |
3.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$450 |
$600 |
4.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$366 |
$488 |
4.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$353.25 |
$471 |
4.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$273.75 |
$365 |
3.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$206.25 |
$275 |
2.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$513.75 |
$685 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$103.50 |
$138 |
1.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$247.50 |
$330 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$320.25 |
$427 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$174 |
$232 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$398.25 |
$531 |
5.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$207.38 |
$276.50 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$344.25 |
$459 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$372.75 |
$497 |
4.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$413.25 |
$551 |
4.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$150.75 |
$201 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$210.75 |
$281 |
2.8× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$164.25 |
$219 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$598.50 |
$798 |
6.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$195 |
$260 |
2.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$372.75 |
$497 |
4.9× |
| Xr arthrogram ankle (73615) |
$513.75 |
$685 |
1.7× |
| Xr c-spine 6 or more views (72052) |
$732 |
$976 |
8.0× |
| Xr chest 4+ views (71048) |
$161.25 |
$215 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$302.25 |
$403 |
4.0× |
| Xr shoulder 1 view (73020) |
$103.88 |
$138.50 |
1.4× |
| Xr spine cervical 4 or 5 views (72050) |
$597 |
$796 |
6.5× |
| Xr tibia/fibula 2 views (73590) |
$181.50 |
$242 |
2.4× |
| Xr tmj bilateral (70330) |
$192 |
$256 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$184.50 |
$246 |
2.4× |