| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,473.60 |
$3,092 |
1.7× |
| Abdomen 2 views (74019) |
$116.40 |
$145.50 |
1.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$540 |
$675 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$2,754 |
$3,442.50 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,189.60 |
$2,737 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,380 |
$4,225 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,100.40 |
$2,625.50 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,838.40 |
$2,298 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,351.20 |
$4,189 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,004 |
$1,255 |
0.3× |
| Ankle 2 views (73600) |
$103.20 |
$129 |
1.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$368.40 |
$460.50 |
1.0× |
| Aortogram thoracic (75605) |
$3,332.40 |
$4,165.50 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$947.20 |
$1,184 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$512 |
$640 |
0.2× |
| Arthrogram elbow (73085) |
$361.20 |
$451.50 |
1.0× |
| Arthrogram hip (73525) |
$514.80 |
$643.50 |
1.4× |
| Arthrogram shoulder (73040) |
$750.80 |
$938.50 |
2.1× |
| Arthrogram wrist (73115) |
$522.80 |
$653.50 |
1.5× |
| Arthrography knee lt (73580) |
$503.20 |
$629 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$197.60 |
$247 |
1.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$358 |
$447.50 |
0.9× |
| Bone &/joint imaging whole body (78306) |
$592 |
$740 |
1.4× |
| Bone age studies (77072) |
$42.40 |
$53 |
0.4× |
| Bone Imaging 3 Phase (78315) |
$604.40 |
$755.50 |
1.5× |
| Bone survey complete (77075) |
$192 |
$240 |
1.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$275.60 |
$344.50 |
0.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,643.20 |
$2,054 |
1.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$318.80 |
$398.50 |
0.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$416 |
$520 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$48 |
$60 |
0.5× |
| Chest 1 view (71045) |
$55.20 |
$69 |
0.6× |
| Chest 3 views (71047) |
$124.40 |
$155.50 |
1.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$201.20 |
$251.50 |
1.1× |
| Clavicle complete (73000) |
$97.60 |
$122 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$241.60 |
$302 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$425.60 |
$532 |
3.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,354.40 |
$1,693 |
3.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,123.60 |
$1,404.50 |
4.6× |
| CT abdomen w contrast (74160) |
$789.20 |
$986.50 |
4.4× |
| CT abdomen w wo contrast (74170) |
$902.80 |
$1,128.50 |
5.0× |
| CT abdomen w/o contrast (74150) |
$706.80 |
$883.50 |
6.6× |
| CT angio hrt w/3d image (75574) |
$536 |
$670 |
1.5× |
| CT angiography upper extremity lt (73206) |
$932.80 |
$1,166 |
5.2× |
| CT c-spine w/o contrast (72125) |
$709.20 |
$886.50 |
6.6× |
| CT cervical spine w&w/o contrast (72127) |
$908.80 |
$1,136 |
5.1× |
| CT cervical spine with contrast (72126) |
$795.60 |
$994.50 |
2.2× |
| CT chest w/wo contrast (71270) |
$922 |
$1,152.50 |
5.1× |
| CT chest with contrast (71260) |
$813.20 |
$1,016.50 |
4.5× |
| CT colonography screening (74263) |
$1,132.80 |
$1,416 |
4.6× |
| CT colonography w/o cntrst (74261) |
$676.40 |
$845.50 |
6.3× |
| CT head/brain with contrast (70460) |
$699.60 |
$874.50 |
3.9× |
| CT head/brain without and with contrast (70470) |
$802.40 |
$1,003 |
4.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,070.40 |
$1,338 |
3.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$97.60 |
$122 |
1.1× |
| CT hrt w/3d image congen (75573) |
$1,350 |
$1,687.50 |
3.8× |
| CT iac w contrast (70481) |
$728.80 |
$911 |
4.1× |
| CT limited/localized follow up study (76380) |
$516.80 |
$646 |
5.8× |
| CT lower ext w/o (73700) |
$671.60 |
$839.50 |
6.3× |
| CT lower extremity w wo contrast (73702) |
$816.80 |
$1,021 |
4.6× |
| CT lower extremity with contrast (73701) |
$753.20 |
$941.50 |
4.2× |
| CT lumbar spine w & w/o contrast (72133) |
$908.80 |
$1,136 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$702 |
$877.50 |
6.6× |
| CT lumbar spine with contrast (72132) |
$795.60 |
$994.50 |
2.2× |
| CT maxillofacial w contrast (70487) |
$699.60 |
$874.50 |
3.9× |
| CT maxillofacial w/o contrast (70486) |
$612.40 |
$765.50 |
5.7× |
| CT maxillofacial w/wo contrast (70488) |
$801.60 |
$1,002 |
4.5× |
| CT neck soft tissue w contrast (70491) |
$781.60 |
$977 |
4.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$821.20 |
$1,026.50 |
4.6× |
| CT orbits w/o contrast (70480) |
$660.40 |
$825.50 |
6.2× |
| CT pelvis w & w/o contrast (72194) |
$881.20 |
$1,101.50 |
4.9× |
| CT pelvis w/o contrast (72192) |
$712 |
$890 |
6.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$822.40 |
$1,028 |
4.6× |
| CT soft tissue neck w/o contrast (70490) |
$660.40 |
$825.50 |
6.2× |
| CT thoracic spine w/contrast (72129) |
$795.60 |
$994.50 |
4.4× |
| CT thoracic spine w/o contrast (72128) |
$702 |
$877.50 |
6.6× |
| CT thoracic spine w/wo contrast (72130) |
$908.80 |
$1,136 |
5.1× |
| CT thorax w/o contrast (71250) |
$704 |
$880 |
6.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$851.60 |
$1,064.50 |
4.8× |
| CT upper extremity w/o contrast rt (73200) |
$671.60 |
$839.50 |
6.3× |
| CT upper extremity with contrast (73201) |
$720 |
$900 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,010.40 |
$1,263 |
5.6× |
| Cta Abdomen (74175) |
$972.40 |
$1,215.50 |
5.4× |
| CTA abdomen pelvis (74174) |
$1,700.80 |
$2,126 |
4.8× |
| CTA chest (71275) |
$984 |
$1,230 |
5.5× |
| Cta Head (70496) |
$918.40 |
$1,148 |
5.1× |
| CTA lwr ext w&w/o contrast (73706) |
$947.60 |
$1,184.50 |
5.3× |
| Cta Neck (70498) |
$918.40 |
$1,148 |
5.1× |
| Cta Pelvis (72191) |
$945.20 |
$1,181.50 |
5.3× |
| Cystography minimum 3 views rs&i (74430) |
$387.20 |
$484 |
1.1× |
| Dacryocystography (70170) |
$230.40 |
$288 |
0.9× |
| Diskogram cervical (72285) |
$1,256 |
$1,570 |
0.6× |
| Diskography lumbar (72295) |
$1,227.20 |
$1,534 |
0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$111.20 |
$139 |
1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$233.60 |
$292 |
2.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$262 |
$327.50 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$131.20 |
$164 |
1.5× |
| Dxa bone density study axial skeleton (77085) |
$212 |
$265 |
2.0× |
| Echo exam of fetal heart (76825) |
$476.80 |
$596 |
0.9× |
| Echoencephalography real time imaging (76506) |
$239.20 |
$299 |
2.2× |
| Esophagus (74220) |
$268.80 |
$336 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$407.20 |
$509 |
3.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$267.60 |
$334.50 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$334.40 |
$418 |
1.4× |
| Foot 2 views (73620) |
$44.80 |
$56 |
0.5× |
| Forearm 2 views (73090) |
$98.40 |
$123 |
1.1× |
| Gated Heart Planar Single (78472) |
$217.60 |
$272 |
0.5× |
| Hand 2 views (73120) |
$103.20 |
$129 |
1.0× |
| Hand 3 views (73130) |
$50.40 |
$63 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$990.80 |
$1,238.50 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$865.60 |
$1,082 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$652.40 |
$815.50 |
1.6× |
| Ht muscle image spect sing (78451) |
$538.40 |
$673 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$102 |
$127.50 |
1.1× |
| Hysterosalpingogram (74740) |
$359.60 |
$449.50 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$506.80 |
$633.50 |
0.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$609.60 |
$762 |
1.1× |
| Liver & spleen imaging static only (78215) |
$343.20 |
$429 |
0.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$343.20 |
$429 |
0.8× |
| Lymphoscintigraphy (78195) |
$617.60 |
$772 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$335.20 |
$419 |
1.4× |
| Mammary ductogram or galactogram single (77053) |
$266 |
$332.50 |
1.1× |
| Meckels Diverticulum (78290) |
$407.60 |
$509.50 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$858 |
$1,072.50 |
2.2× |
| MRA head w & w/o contrast (70546) |
$1,311.20 |
$1,639 |
3.7× |
| MRA head w/o contrast (70544) |
$273.60 |
$342 |
1.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$408 |
$510 |
1.1× |
| MRI abdomen w contrast (74182) |
$1,062.40 |
$1,328 |
3.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,249.60 |
$1,562 |
3.5× |
| MRI abdomen w/o contrast (74181) |
$836.40 |
$1,045.50 |
3.4× |
| MRI any jnt lwr ext with con lt (73722) |
$981.20 |
$1,226.50 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$961.60 |
$1,202 |
1.2× |
| MRI c-spine with contrast (72142) |
$930.80 |
$1,163.50 |
2.6× |
| MRI cervical spine w/o contrast (72141) |
$337.60 |
$422 |
1.4× |
| MRI chest w/o & w/contrast material (71552) |
$1,185.20 |
$1,481.50 |
3.3× |
| MRI chest w/o contrast (71550) |
$214 |
$267.50 |
0.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$906.80 |
$1,133.50 |
3.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$305.60 |
$382 |
1.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$486.40 |
$608 |
1.4× |
| MRI pelvis w contrast (72196) |
$925.20 |
$1,156.50 |
2.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$513.60 |
$642 |
1.4× |
| MRI pelvis w/o contrast (72195) |
$332 |
$415 |
1.4× |
| MRI scan of arm joint before and after contrast (73223) |
$488.80 |
$611 |
1.4× |
| MRI scan of leg joint before and after contrast (73723) |
$487.20 |
$609 |
1.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$519.20 |
$649 |
1.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$932 |
$1,165 |
2.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$520.80 |
$651 |
1.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$849.20 |
$1,061.50 |
2.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$519.20 |
$649 |
1.5× |
| MRI thoracic spine w/o contrast (72146) |
$337.60 |
$422 |
1.4× |
| MRI upper ext joint w/o contrast (73221) |
$308 |
$385 |
1.3× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,233.20 |
$1,541.50 |
3.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$308 |
$385 |
1.3× |
| Myocardial infarct spect (78469) |
$794 |
$992.50 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,187.20 |
$442 |
0.9× |
| Neck soft tissue (70360) |
$93.60 |
$117 |
1.1× |
| Nm cisternogram (78630) |
$623.60 |
$779.50 |
1.1× |
| Nm gastric emptying study (78264) |
$574.40 |
$718 |
1.4× |
| Nm gastroesophageal reflux study (78262) |
$471.60 |
$589.50 |
1.2× |
| Nm red cell sequestration (78140) |
$384.40 |
$480.50 |
0.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,170 |
$3,962.50 |
2.2× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$361.20 |
$451.50 |
0.9× |
| Nuclear Rx Oral Admin (79005) |
$508 |
$635 |
2.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$286.40 |
$358 |
2.7× |
| Osseous survey infant (77076) |
$172.40 |
$215.50 |
1.6× |
| Osseous survey limited (77074) |
$141.60 |
$177 |
1.3× |
| Parathyroid imaging (78070) |
$648.80 |
$811 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$34.40 |
$43 |
0.3× |
| Perineogram (74775) |
$389.20 |
$486.50 |
1.6× |
| Peritoneogram rs&i (74190) |
$222.80 |
$278.50 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$2,364.40 |
$2,955.50 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$2,396.80 |
$2,996 |
1.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$487.20 |
$609 |
1.4× |
| Pr sono bone density measure,peripheral (76977) |
$255.20 |
$319 |
2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$413.20 |
$516.50 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$580 |
$725 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$196.40 |
$245.50 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$106.40 |
$133 |
1.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$136.80 |
$171 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$138.80 |
$173.50 |
1.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$126.80 |
$158.50 |
1.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$778.40 |
$973 |
1.4× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$577.60 |
$722 |
5.5× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$616.80 |
$771 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$113.60 |
$142 |
1.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$102.80 |
$128.50 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$49.60 |
$62 |
0.6× |
| Radiologic exam colon single contrast study (74270) |
$242.80 |
$303.50 |
1.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$197.60 |
$247 |
1.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$254 |
$317.50 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$50.40 |
$63 |
0.6× |
| Radiological examination surgical specimen (76098) |
$97.20 |
$121.50 |
0.2× |
| Ribs bilateral 3 views (71110) |
$144.40 |
$180.50 |
1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$590.40 |
$738 |
1.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$634 |
$792.50 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$766.80 |
$958.50 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$936 |
$1,170 |
3.9× |
| Rp Therapy Intravenous Administration (79101) |
$525.60 |
$657 |
2.2× |
| Sacroiliac Joints < 3 Views (72200) |
$98.80 |
$123.50 |
0.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$265.60 |
$332 |
1.1× |
| Salivary gland imaging serial images (78231) |
$431.20 |
$539 |
1.1× |
| Scanogram (77073) |
$125.20 |
$156.50 |
1.2× |
| Scapula complete (73010) |
$98.80 |
$123.50 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$99.20 |
$124 |
4.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$198.80 |
$248.50 |
1.9× |
| Sialogram (70390) |
$220.80 |
$276 |
0.9× |
| Simulation intermediate (77285) |
$976 |
$1,220 |
2.6× |
| Small bowel series (74250) |
$194 |
$242.50 |
1.1× |
| Spec medical radj physics consltj (77370) |
$810.40 |
$1,013 |
5.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$507.20 |
$634 |
1.3× |
| Special dosimetry (77331) |
$354 |
$442.50 |
2.6× |
| Special treatment procedure (77470) |
$1,354.80 |
$1,693.50 |
2.4× |
| Spine thoracic 3 views (72072) |
$47.20 |
$59 |
0.4× |
| Spleen imaging only (78185) |
$342.80 |
$428.50 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$500 |
$625 |
1.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$499.20 |
$624 |
1.3× |
| Testicular Imaging With Vascular Flow (78761) |
$457.20 |
$571.50 |
1.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$897.20 |
$1,121.50 |
2.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$440.80 |
$551 |
3.2× |
| Thoracolumbar 2 views (72080) |
$113.60 |
$142 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$666 |
$832.50 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$336 |
$420 |
0.8× |
| Thyroid uptake measurement (78012) |
$282.40 |
$353 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$538.40 |
$673 |
1.3× |
| Tmj unilateral (70328) |
$101.20 |
$126.50 |
1.1× |
| Treatment device intermediate (77333) |
$529.20 |
$661.50 |
3.9× |
| Treatment devices simple (77332) |
$391.20 |
$489 |
2.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$643.20 |
$804 |
1.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$153.60 |
$192 |
0.4× |
| Tx devices design & construction complex (77334) |
$538 |
$672.50 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$376 |
$470 |
3.5× |
| Umbilical-artery Doppler (OB) (76820) |
$290 |
$362.50 |
2.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$80 |
$100 |
0.9× |
| Unlisted fluoroscopic procedure (76496) |
$178.40 |
$223 |
2.0× |
| Upper Extremity Infant (73092) |
$96.80 |
$121 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$187.60 |
$234.50 |
0.8× |
| Urethrocystography voiding (74455) |
$193.60 |
$242 |
0.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$218.80 |
$273.50 |
1.2× |
| Us abdl aorta screen aaa (76706) |
$251.60 |
$314.50 |
2.4× |
| Us breast unilateral complete (76641) |
$272.40 |
$340.50 |
2.6× |
| Us breast unilateral limited (76642) |
$272.80 |
$341 |
3.1× |
| Us chest (76604) |
$234 |
$292.50 |
2.2× |
| Us fetal nuchal translucency 1st gestation (76813) |
$279.20 |
$349 |
2.6× |
| Us guided compression repair (76936) |
$501.20 |
$626.50 |
2.3× |
| Us infant hips limited static (76886) |
$158 |
$197.50 |
1.8× |
| Us kidney transplant (76776) |
$277.20 |
$346.50 |
2.6× |
| Us ob detailed single fetus (76811) |
$543.60 |
$679.50 |
2.2× |
| Us ob transvaginal (76817) |
$328.80 |
$411 |
3.1× |
| Us pelvic non ob complete (76856) |
$345.60 |
$432 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$276.40 |
$345.50 |
2.6× |
| Us pregnancy ltd (76815) |
$266.80 |
$333.50 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$261.20 |
$326.50 |
2.4× |
| Us retroperitoneal complete (76770) |
$308.80 |
$386 |
2.9× |
| Us retroperitoneal limited (76775) |
$234 |
$292.50 |
2.2× |
| Us scrotum and contents (76870) |
$268.80 |
$336 |
2.5× |
| Us soft tissue head/neck (76536) |
$420 |
$525 |
3.9× |
| Us spinal canal and contents (76800) |
$334.80 |
$418.50 |
3.1× |
| Us transrectal (76872) |
$222.40 |
$278 |
2.1× |
| Us xtr non-vasc lmtd (76882) |
$140.80 |
$176 |
1.3× |
| Venogram extremity bilateral (75822) |
$909.60 |
$1,137 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,957.20 |
$2,446.50 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$214.40 |
$268 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$239.20 |
$299 |
0.1× |
| Venography Renal Bilateral (75833) |
$1,985.60 |
$2,482 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,953.60 |
$2,442 |
0.6× |
| Wrist 2 views (73100) |
$103.20 |
$129 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$128.40 |
$160.50 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$138.40 |
$173 |
1.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$50.40 |
$63 |
0.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$304.80 |
$381 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$29.60 |
$37 |
0.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$40 |
$50 |
0.4× |
| X-ray exam hip uni 1 view (73501) |
$100.40 |
$125.50 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$108.40 |
$135.50 |
1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$149.60 |
$187 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$172.80 |
$216 |
1.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$409.60 |
$512 |
2.3× |
| X-ray eye for foreign body (70030) |
$37.60 |
$47 |
0.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$124.40 |
$155.50 |
1.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$108.40 |
$135.50 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$48 |
$60 |
0.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$421.20 |
$526.50 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$97.20 |
$121.50 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$91.60 |
$114.50 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$63.20 |
$79 |
0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$124.80 |
$156 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$96.80 |
$121 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$50.40 |
$63 |
0.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$154.80 |
$193.50 |
1.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$126.40 |
$158 |
1.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$98.80 |
$123.50 |
1.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$103.20 |
$129 |
1.2× |
| X-ray of voice box or throat (70370) |
$111.60 |
$139.50 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$124 |
$155 |
1.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$113.60 |
$142 |
1.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$313.60 |
$392 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$50.40 |
$63 |
0.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$62.40 |
$78 |
0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$93.60 |
$117 |
0.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$106.80 |
$133.50 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$103.20 |
$129 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$110 |
$137.50 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$124 |
$155 |
1.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$105.20 |
$131.50 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$141.20 |
$176.50 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$56.80 |
$71 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$35.20 |
$44 |
0.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$120.40 |
$150.50 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$110.40 |
$138 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$50.40 |
$63 |
0.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$28 |
$35 |
0.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$40 |
$50 |
0.4× |
| Xr arthrogram ankle (73615) |
$331.20 |
$414 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$156 |
$195 |
1.5× |
| Xr chest 4+ views (71048) |
$127.60 |
$159.50 |
1.2× |
| Xr Cholecystography Oral Contrast (74290) |
$209.60 |
$262 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$92.40 |
$115.50 |
1.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$104.40 |
$130.50 |
1.0× |
| Xr shoulder 1 view (73020) |
$96.80 |
$121 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$72 |
$90 |
0.7× |
| Xr tibia/fibula 2 views (73590) |
$98.80 |
$123.50 |
1.1× |
| Xr tmj bilateral (70330) |
$150.80 |
$188.50 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$44 |
$55 |
0.5× |