| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,554.84 |
$7,356 |
3.2× |
| Abdomen 1 View (74018) |
$97.22 |
$157 |
1.1× |
| Abdomen 2 views (74019) |
$217.34 |
$351 |
2.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$702.80 |
$1,135 |
1.7× |
| Angio pulmonary bilat (75743) |
$273.69 |
$442 |
0.1× |
| Angiography extremity bilateral rs&i (75716) |
$196.29 |
$317 |
0.1× |
| Angiography extremity unilateral rs&i (75710) |
$257.59 |
$416 |
0.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$209.91 |
$339 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$229.73 |
$371 |
0.1× |
| Ankle 2 views (73600) |
$112.08 |
$181 |
1.3× |
Aortography thoracic serialography rs&i (75605)
likely a partial charge, not the full procedure |
$240.87 |
$389 |
0.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$360.38 |
$582 |
0.1× |
Artery X-Rays Pelvis (75736)
likely a partial charge, not the full procedure |
$473.69 |
$765 |
0.1× |
| Arthrogram hip (73525) |
$275.55 |
$445 |
0.8× |
| Arthrogram Wrist (73115) |
$211.77 |
$342 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$146.76 |
$237 |
1.1× |
| Bone age studies (77072) |
$133.75 |
$216 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$743.04 |
$1,200 |
1.8× |
| Bone Imaging Limited Area (78300) |
$408.68 |
$660 |
1.0× |
| Bone Imaging Multiple Areas (78305) |
$454.50 |
$734 |
1.1× |
| Bone Imaging Whole Body (78306) |
$618.59 |
$999 |
1.5× |
| Bone marrow imaging; whole body (78104) |
$453.26 |
$732 |
1.1× |
| Bone survey infant (77076) |
$238.40 |
$385 |
2.2× |
| Brain Flow Imaging Only (78610) |
$358.52 |
$579 |
0.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$646.45 |
$1,044 |
1.2× |
| Brain Imaging Minimum 4 Static Views (78605) |
$357.90 |
$578 |
0.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,026.65 |
$4,888 |
2.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$455.12 |
$735 |
0.8× |
| Cat Scan Follow-Up Study (76380) |
$137.47 |
$222 |
1.5× |
| Cerebrospinal Fluid Scan (78630) |
$832.21 |
$1,344 |
1.5× |
| Chest 1 view (71045) |
$100.32 |
$162 |
1.1× |
| Chest 2 views (71046) |
$143.66 |
$232 |
1.6× |
| Chest 3 views (71047) |
$121.37 |
$196 |
1.4× |
| Chest 4 or more views (71048) |
$123.84 |
$200 |
1.2× |
| Cholecystography Oral Contrast (74290) |
$133.75 |
$216 |
0.7× |
| Clavicle complete (73000) |
$136.85 |
$221 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$227.87 |
$368 |
2.1× |
| Continuing medical physics consltj pr wk (77336) |
$341.80 |
$552 |
2.5× |
| Contrast X-Ray Bladder (74430) |
$221.68 |
$358 |
0.6× |
| Contrast X-Ray Of Elbow (73085) |
$243.97 |
$394 |
0.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$297.22 |
$480 |
0.8× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$239.02 |
$386 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,292.89 |
$2,088 |
3.6× |
| CT abdomen and pelvis without contrast (74176) |
$751.71 |
$1,214 |
3.1× |
| CT abdomen w contrast (74160) |
$926.33 |
$1,496 |
5.2× |
| CT abdomen w wo contrast (74170) |
$1,317.04 |
$2,127 |
7.3× |
| CT abdomen w/o contrast (74150) |
$738.71 |
$1,193 |
6.9× |
| CT Angio Abdomen and Pelvis (74174) |
$1,259.46 |
$2,034 |
3.5× |
| CT Angio Chest (71275) |
$1,426.64 |
$2,304 |
8.0× |
| CT Angio Head (70496) |
$1,287.32 |
$2,079 |
7.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$956.67 |
$1,545 |
5.3× |
| CT Angio Neck (70498) |
$1,269.36 |
$2,050 |
7.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$556.67 |
$899 |
3.1× |
| CT cervical spine w/ contrast (72126) |
$800.63 |
$1,293 |
2.2× |
| CT cervical spine w/o contrast (72125) |
$751.71 |
$1,214 |
7.0× |
| CT cervical spine w/wo cont (72127) |
$877.41 |
$1,417 |
4.9× |
| CT chest w contrast (71260) |
$933.76 |
$1,508 |
5.2× |
| CT chest w/wo contrast (71270) |
$1,096.61 |
$1,771 |
6.1× |
| CT head/brain with contrast (70460) |
$499.70 |
$807 |
2.8× |
| CT head/brain without and with contrast (70470) |
$898.46 |
$1,451 |
5.0× |
| CT iac w contrast (70481) |
$727.56 |
$1,175 |
4.1× |
| CT l-spine w&w/o contrast (72133) |
$1,507.14 |
$2,434 |
8.4× |
| CT lower ext w/o (73700) |
$778.34 |
$1,257 |
7.3× |
| CT lower extremity w/contrast material (73701) |
$804.96 |
$1,300 |
4.5× |
| CT lumbar spine w contrast (72132) |
$778.34 |
$1,257 |
2.2× |
| CT lumbar spine w/o contrast (72131) |
$764.72 |
$1,235 |
7.2× |
| CT maxillofacial w contrast (70487) |
$616.11 |
$995 |
3.4× |
| CT maxillofacial wo contrast (70486) |
$656.98 |
$1,061 |
6.2× |
| CT neck tissue combo (70492) |
$980.82 |
$1,584 |
5.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$845.83 |
$1,366 |
4.7× |
| CT orbits w/o contrast (70480) |
$744.90 |
$1,203 |
7.0× |
| CT pelvis w&w/o contrast (72194) |
$1,113.33 |
$1,798 |
6.2× |
| CT pelvis w/o contrast (72192) |
$647.07 |
$1,045 |
6.1× |
| CT scan of leg combo (73702) |
$913.32 |
$1,475 |
5.1× |
| CT scans face/jaw combo (70488) |
$726.33 |
$1,173 |
4.1× |
| CT soft tissue neck w contrast (70491) |
$915.80 |
$1,479 |
5.1× |
| CT soft tissue neck w/o contrast (70490) |
$700.94 |
$1,132 |
6.6× |
| CT thoracic spine w contrast (72129) |
$1,143.67 |
$1,847 |
6.4× |
| CT thoracic spine w/o contrast (72128) |
$751.71 |
$1,214 |
7.0× |
| CT thoracic spine w/wo cont (72130) |
$850.79 |
$1,374 |
4.7× |
| CT thorax w/o contrast (71250) |
$789.48 |
$1,275 |
7.4× |
| CT unlisted procedure (76497) |
$105.27 |
$170 |
1.2× |
| CT upper ext wo (73200) |
$759.76 |
$1,227 |
7.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$808.06 |
$1,305 |
4.5× |
| CT upper extremity with contrast (73201) |
$878.65 |
$1,419 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,195.68 |
$1,931 |
6.7× |
| Cta Abdomen (74175) |
$976.48 |
$1,577 |
5.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,556.68 |
$4,129 |
7.2× |
| CTA pelvis (72191) |
$1,014.87 |
$1,639 |
5.7× |
| Dilation ureters/urethra rs&i (74485) |
$154.19 |
$249 |
0.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$87.31 |
$141 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$213.01 |
$344 |
2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$78.02 |
$126 |
0.7× |
| Dxa Bone Density Axial (77080) |
$260.69 |
$421 |
2.4× |
| Dxa bone density study (77085) |
$156.04 |
$252 |
1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$63.78 |
$103 |
0.7× |
| Echo exam of fetal heart (76825) |
$339.95 |
$549 |
0.6× |
| Echo exam uterus (76831) |
$469.36 |
$758 |
1.9× |
| Echo Guide For Artery Repair (76936) |
$376.48 |
$608 |
1.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$204.34 |
$330 |
0.8× |
| Echograp Trans R Pros Study (76873) |
$187.62 |
$303 |
1.8× |
| Esophageal Motility Study (78258) |
$461.93 |
$746 |
1.1× |
| Esophagram (74220) |
$110.84 |
$179 |
0.6× |
| Fetal Biophys Profile W/Nst (76818) |
$248.30 |
$401 |
2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$408.06 |
$659 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$158.52 |
$256 |
0.7× |
| Foot 2 views (73620) |
$134.37 |
$217 |
1.5× |
| Forearm 2 views (73090) |
$202.48 |
$327 |
2.3× |
| Gastric emptying imaging study (78264) |
$789.48 |
$1,275 |
1.9× |
| Gastroesophageal Reflux Exam (78262) |
$505.27 |
$816 |
1.2× |
| Gated Heart Planar Single (78472) |
$627.25 |
$1,013 |
1.5× |
| Gated Heart, Multiple (78473) |
$570.91 |
$922 |
1.4× |
| Hand 2 views (73120) |
$121.37 |
$196 |
1.1× |
| Hepatobil Syst Image W/Drug (78227) |
$949.86 |
$1,534 |
1.7× |
| Hepatobiliary System Imaging (78226) |
$776.48 |
$1,254 |
1.9× |
| Ht Muscle Image Spect Sing (78451) |
$777.72 |
$1,256 |
0.6× |
Hyperthermia external generated superficial (77600)
range across 2 matching MRF lines |
$104.65–$596.29 |
$169–$963 |
varies |
| Hysterosalpingogram (74740) |
$202.48 |
$327 |
0.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$388.86 |
$628 |
4.4× |
| Infant hip ultrasound, limited static exam (76886) |
$185.76 |
$300 |
2.1× |
| Joint Survey Single View (77077) |
$66.26 |
$107 |
0.6× |
| K Flow/Funct Image W/Drug (78708) |
$452.02 |
$730 |
0.8× |
| K Flow/Funct Image W/O Drug (78707) |
$326.32 |
$527 |
0.6× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$313.94 |
$507 |
0.8× |
| Kidney Imaging Morphol (78700) |
$333.75 |
$539 |
0.8× |
| Knee 3 Views (73562) |
$150.47 |
$243 |
1.7× |
| Liver & Spleen Imaging Static Only (78215) |
$446.45 |
$721 |
1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$222.30 |
$359 |
0.5× |
| Liver imaging static only (78201) |
$370.91 |
$599 |
0.7× |
| Liver imaging w/vascular flow (78202) |
$396.29 |
$640 |
0.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$855.74 |
$1,382 |
1.5× |
| Lung Ventilation Imaging (78579) |
$575.86 |
$930 |
1.4× |
| Lymph System Imaging (78195) |
$881.75 |
$1,424 |
1.6× |
| Magnetic Image Jaw Joint (70336) |
$915.80 |
$1,479 |
3.8× |
| Mammary ductogram or galactogram multiple (77054) |
$207.44 |
$335 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$162.24 |
$262 |
0.7× |
| Meckels Divert Exam (78290) |
$612.39 |
$989 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$855.12 |
$1,381 |
2.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,752.96 |
$2,831 |
4.9× |
| MRA head w/o contrast (70544) |
$1,427.26 |
$2,305 |
5.9× |
| MRA head with contrast (70545) |
$1,028.50 |
$1,661 |
2.9× |
| MRA neck w contrast (70548) |
$944.28 |
$1,525 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,580.82 |
$2,553 |
4.4× |
| MRA neck w/o contrast (70547) |
$892.27 |
$1,441 |
3.7× |
| MRI abdomen w contrast (74182) |
$1,869.37 |
$3,019 |
5.2× |
| MRI abdomen w/o contrast (74181) |
$1,123.85 |
$1,815 |
4.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,848.94 |
$2,986 |
2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,556.05 |
$2,513 |
4.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,406.21 |
$2,271 |
1.8× |
| MRI bone marrow blood supply (77084) |
$929.42 |
$1,501 |
3.8× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,246.45 |
$2,013 |
5.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$564.72 |
$912 |
2.3× |
| MRI cardiac w/o contrast (75557) |
$969.67 |
$1,566 |
4.0× |
| MRI cervical spine w contrast (72142) |
$1,008.06 |
$1,628 |
2.8× |
| MRI cervical spine w/o cont (72141) |
$889.18 |
$1,436 |
3.6× |
| MRI chest w/o contrast (71550) |
$1,104.04 |
$1,783 |
4.5× |
| MRI chest wo w contrast (71552) |
$1,645.22 |
$2,657 |
4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,645.84 |
$2,658 |
4.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,025.41 |
$3,271 |
5.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,159.15 |
$1,872 |
4.8× |
| MRI lumbar spine w contrast (72149) |
$1,047.69 |
$1,692 |
2.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,965.96 |
$3,175 |
5.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$926.95 |
$1,497 |
3.8× |
| MRI orbit face neck w contrast (70542) |
$1,078.03 |
$1,741 |
3.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,956.68 |
$3,160 |
5.5× |
| MRI pelvis w contrast (72196) |
$1,050.17 |
$1,696 |
2.9× |
| MRI pelvis w/o & w contrast (72197) |
$2,057.61 |
$3,323 |
5.8× |
| MRI pelvis w/o contrast (72195) |
$1,181.44 |
$1,908 |
4.8× |
| MRI thoracic spine w/o contrast (72146) |
$957.91 |
$1,547 |
3.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,068.74 |
$1,726 |
3.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$928.19 |
$1,499 |
3.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,530.67 |
$2,472 |
4.3× |
| MRI, abdomen, combo (74183) |
$2,071.85 |
$3,346 |
5.8× |
| MRI, dorsal spine combo (72157) |
$1,990.11 |
$3,214 |
5.6× |
| MRI, dorsal spine contrast (72147) |
$987.63 |
$1,595 |
2.8× |
| MRI, joint upper extrem (73221) |
$993.82 |
$1,605 |
4.1× |
| MRI, joint upper extrem combo (73223) |
$1,546.77 |
$2,498 |
4.3× |
| MRI, lumbar spine combo (72158) |
$1,735.62 |
$2,803 |
4.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,198.78 |
$3,551 |
1.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,026.02 |
$1,657 |
0.8× |
| Neck soft tissue (70360) |
$69.97 |
$113 |
0.8× |
| Nm csf leak detection (78650) |
$660.69 |
$1,067 |
0.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,764.74 |
$6,080 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$201.86 |
$326 |
0.8× |
| Ob us nuchal meas 1 gest (76813) |
$81.74 |
$132 |
0.8× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$71.83 |
$116 |
0.7× |
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 3 matching MRF lines |
$24.15–$60.69 |
$39–$98 |
varies |
| Optic foramina (70190) |
$78.64 |
$127 |
0.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$907.13 |
$1,465 |
1.6× |
| Parathyroid Planar Imaging (78070) |
$328.80 |
$531 |
0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$743.66 |
$1,201 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$125.70 |
$203 |
1.2× |
| Pet Image W/Ct Lmtd (78814) |
$2,725.72 |
$4,402 |
1.9× |
| PET image w/CT, full body (78816) |
$3,023.56 |
$4,883 |
2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,956.07 |
$4,774 |
2.0× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$196.91 |
$318 |
0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$819.21 |
$1,323 |
2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$223.54 |
$361 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$125.70 |
$203 |
0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$150.47 |
$243 |
1.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$112.08 |
$181 |
1.3× |
| Radex elbow complete minimum 3 views (73080) |
$153.57 |
$248 |
1.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$190.72 |
$308 |
1.8× |
| Radex fingr minimum 2 views (73140) |
$98.46 |
$159 |
1.1× |
| Radex foot complete minimum 3 views (73630) |
$137.47 |
$222 |
1.5× |
| Radex Hand Minimum 3 Views (73130) |
$139.32 |
$225 |
1.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$124.46 |
$201 |
1.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$73.69 |
$119 |
0.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$138.09 |
$223 |
1.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$164.71 |
$266 |
1.9× |
| Radex shoulder complete minimum 2 views (73030) |
$139.32 |
$225 |
1.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$146.14 |
$236 |
1.6× |
| Radex Spine 1 View Specify Level (72020) |
$66.26 |
$107 |
0.7× |
| Radex Sternum Minimum 2 Views (71120) |
$139.94 |
$226 |
1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$86.07 |
$139 |
1.0× |
| Radex Toe Minimum 2 Views (73660) |
$97.84 |
$158 |
1.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$108.36 |
$175 |
1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$143.04 |
$231 |
1.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$243.35 |
$393 |
2.3× |
Radiation Delivery Stereotactic Cranial Linear (77372)
unusually low: confirm this is the full procedure |
$3,312.72 |
$5,350 |
0.4× |
| Radiation treatment delivery level 1 (77402) |
$3,461.33 |
$5,590 |
33.2× |
| Radiation treatment delivery level 2 (77407) |
$3,845.24 |
$6,210 |
9.8× |
| Radiation treatment delivery level 3 (77412) |
$4,229.14 |
$6,830 |
7.5× |
Radiolog exam mandible compl minimum 4 views (70110)
range across 2 matching MRF lines |
$56.35–$92.27 |
$91–$149 |
varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$59.45 |
$96 |
0.6× |
| Radiologic exam colon double contrast study (74280) |
$217.34 |
$351 |
1.2× |
| Radiologic exam colon single contrast study (74270) |
$400.63 |
$647 |
2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$219.82 |
$355 |
1.2× |
| Radiologic exam knee complete 4/more views (73564) |
$144.90 |
$234 |
1.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$66.26 |
$107 |
0.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$327.56 |
$529 |
1.8× |
| Radiologic exam swallow function contrast study (74230) |
$200.01 |
$323 |
1.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$172.76 |
$279 |
1.0× |
| Radiologic examination femur 1 view (73551) |
$79.26 |
$128 |
0.9× |
| Radiologic examination femur minimum 2 views (73552) |
$94.74 |
$153 |
1.1× |
| Radiologic examination knee 1/2 views (73560) |
$117.65 |
$190 |
1.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$136.23 |
$220 |
1.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$35.92 |
$58 |
0.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$115.18 |
$186 |
1.3× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$22.92 |
$37 |
0.3× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$191.96 |
$310 |
0.3× |
| Ribs bilateral 3 views (71110) |
$225.39 |
$364 |
2.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$395.05 |
$638 |
1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$505.89 |
$817 |
1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,640.88 |
$2,650 |
3.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$630.97 |
$1,019 |
1.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,197.54 |
$1,934 |
2.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$237.16 |
$383 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$175.86 |
$284 |
0.7× |
| Salivary Gland Imaging Serial Images (78231) |
$296.60 |
$479 |
0.7× |
| Scapula (73010) |
$66.26 |
$107 |
0.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$95.36 |
$154 |
4.1× |
| Sella turcica (70240) |
$55.11 |
$89 |
0.6× |
| Shoulder 1 view (73020) |
$55.11 |
$89 |
0.6× |
| Shoulder Arthrography (73040) |
$287.31 |
$464 |
0.8× |
| Sialogram (70390) |
$256.35 |
$414 |
1.1× |
| Skull less than 4 views (70250) |
$170.28 |
$275 |
1.6× |
| Special dosimetry (77331) |
$130.04 |
$210 |
0.9× |
| Special Physics Consult (77370) |
$363.48 |
$587 |
2.6× |
| Special treatment procedure (77470) |
$1,304.66 |
$2,107 |
2.3× |
| Spleen Imaging (78185) |
$417.35 |
$674 |
1.0× |
| Srs Multisource (77371) |
$6,653.93 |
$10,746 |
0.9× |
| Stereotactic Body Radiation Delivery (77373) |
$6,550.52 |
$10,579 |
3.6× |
| Sternoclavicular joints (71130) |
$97.84 |
$158 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$466.26 |
$753 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$258.83 |
$418 |
0.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$159.76 |
$258 |
0.7× |
| Testicular Imaging W/Flow (78761) |
$397.53 |
$642 |
1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,574.01 |
$2,542 |
4.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$842.74 |
$1,361 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$598.77 |
$967 |
4.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$156.04 |
$252 |
0.9× |
| Thoracic spine 2 views (72070) |
$146.14 |
$236 |
1.4× |
| Thoracic spine 3 views (72072) |
$169.05 |
$273 |
1.6× |
| Thoracolumbar 2 views (72080) |
$55.11 |
$89 |
0.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$390.72 |
$631 |
1.0× |
| Thyroid Met Imaging Body (78018) |
$465.02 |
$751 |
0.8× |
| Thyroid Uptake Measurement (78012) |
$157.90 |
$255 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$478.03 |
$772 |
1.2× |
| Tx Devices Design & Construction Complex (77334) |
$363.48 |
$587 |
1.0× |
| Tx devices design & construction intermediate (77333) |
$373.38 |
$603 |
2.7× |
Tx devices design & construction simple (77332)
range across 2 matching MRF lines |
$119.51–$282.36 |
$193–$456 |
varies |
| Ultrasound Breast Limited (76642) |
$175.24 |
$283 |
2.0× |
| Ultrasound Elastography Parenchyma (76981) |
$248.92 |
$402 |
2.3× |
| Ultrasound Exam Aaa Screen (76706) |
$112.08 |
$181 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$217.96 |
$352 |
2.0× |
| Umbilical-artery Doppler (OB) (76820) |
$112.70 |
$182 |
1.1× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$401.25 |
$648 |
1.0× |
| Unlisted us procedure (76999) |
$220.44 |
$356 |
2.5× |
| Upper gi w/o kub (74240) |
$228.49 |
$369 |
1.3× |
| Ureteral Reflux Study (78740) |
$774.62 |
$1,251 |
1.9× |
| Urethrocystogram voiding (74455) |
$279.88 |
$452 |
1.1× |
| Urethrocystography retrograde (74450) |
$112.08 |
$181 |
0.5× |
| Us breast unilateral complete (76641) |
$200.63 |
$324 |
1.9× |
| Us chest (76604) |
$185.15 |
$299 |
1.7× |
| Us complete joint (76881) |
$108.36 |
$175 |
1.0× |
| Us exam, pelvic, limited (76857) |
$220.44 |
$356 |
2.1× |
| Us head (76506) |
$312.70 |
$505 |
2.9× |
| Us kidney transplant (76776) |
$217.96 |
$352 |
2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$129.42 |
$209 |
1.2× |
| Us ob detailed single fetus (76811) |
$163.47 |
$264 |
0.7× |
| Us ob limited 1 or more fetuses (76815) |
$210.53 |
$340 |
2.0× |
| Us ob transvaginal (76817) |
$227.25 |
$367 |
2.1× |
| Us pelvic non ob complete (76856) |
$317.04 |
$512 |
3.0× |
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines |
$158.52–$220.44 |
$256–$356 |
varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$245.21 |
$396 |
2.3× |
| Us retroperitoneal complete (76770) |
$175.86 |
$284 |
1.6× |
| Us retroperitoneal limited (76775) |
$150.47 |
$243 |
1.4× |
| Us scrotum and contents (76870) |
$298.46 |
$482 |
2.8× |
| Us spinal canal and contents (76800) |
$153.57 |
$248 |
1.4× |
| Us thyroid (76536) |
$251.40 |
$406 |
2.4× |
| Us transrectal (76872) |
$268.74 |
$434 |
2.5× |
| Vascular Flow Imaging (78445) |
$186.38 |
$301 |
0.5× |
| Vein X-Ray Chest (75827) |
$265.02 |
$428 |
0.2× |
| Venogram Sinus/Jugular (75860) |
$264.40 |
$427 |
0.1× |
| Venography caval inferior serialography rs&i (75825) |
$263.78 |
$426 |
0.1× |
| Venography extremity bilateral rs&i (75822) |
$278.03 |
$449 |
0.2× |
| Venography extremity unilateral rs&i (75820) |
$217.96 |
$352 |
0.1× |
| Venography Renal Bilateral (75833) |
$320.13 |
$517 |
0.1× |
| Venography Renal Unilateral (75831) |
$284.84 |
$460 |
0.1× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$136.85 |
$221 |
0.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$286.69 |
$463 |
0.7× |
| Wrist 2 views (73100) |
$126.94 |
$205 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$55.11 |
$89 |
0.6× |
| X-ray antegrade pyelogram tube (74425) |
$104.03 |
$168 |
0.3× |
| X-Ray Aorta Leg Arteries (75630) |
$201.24 |
$325 |
0.1× |
| X-Ray Bend Only L-S Spine (72120) |
$115.18 |
$186 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$107.13 |
$173 |
1.2× |
| X-Ray Exam Breast Specimen (76098) |
$339.95 |
$549 |
0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$112.70 |
$182 |
1.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$144.28 |
$233 |
1.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$151.71 |
$245 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$115.18 |
$186 |
1.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$148.61 |
$240 |
1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$110.84 |
$179 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$123.23 |
$199 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$164.71 |
$266 |
1.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$179.57 |
$290 |
1.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$134.99 |
$218 |
1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$251.40 |
$406 |
2.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$139.94 |
$226 |
1.3× |
| X-ray eye for foreign body (70030) |
$63.16 |
$102 |
0.7× |
| X-ray humerus (73060) |
$112.70 |
$182 |
1.3× |
| X-ray IV pyelogram (ivp) (74400) |
$154.19 |
$249 |
0.9× |
| X-ray IV pyelogram+tomography (74415) |
$190.72 |
$308 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$71.83 |
$116 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$126.94 |
$205 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$150.47 |
$243 |
1.4× |
| X-ray nose-rectum child f.b. (76010) |
$68.74 |
$111 |
0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$193.81 |
$313 |
1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$92.88 |
$150 |
0.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$76.17 |
$123 |
0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$84.22 |
$136 |
0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$88.55 |
$143 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$218.58 |
$353 |
2.0× |
| X-Ray Stress View (77071) |
$78.02 |
$126 |
0.9× |
| X-ray thoracic spine 4 vw (72074) |
$75.55 |
$122 |
0.7× |
| X-Ray Tmj Unilat (70328) |
$58.83 |
$95 |
0.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$230.35 |
$372 |
0.6× |
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines |
$66.26–$422.30 |
$107–$682 |
varies |
| X-Rays Bone Survey Complete (77075) |
$239.64 |
$387 |
2.2× |
| Xr c-spine 4 or 5 views (72050) |
$241.49 |
$390 |
2.3× |
| Xr facial bones less than 3 views (70140) |
$88.55 |
$143 |
1.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$71.83 |
$116 |
0.7× |
| Xr orbits complete 4 views (70200) |
$101.55 |
$164 |
1.0× |
| Xr Tomogram Single Plane (76100) |
$79.88 |
$129 |
0.7× |