| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,914.40 |
$9,893 |
5.1× |
| Abdomen 2 views (74019) |
$350.40 |
$438 |
3.0× |
| Acute gi blood loss imaging (78278) |
$1,958.40 |
$2,448 |
4.4× |
| Angiography extremity bilateral rs&i (75716) |
$7,169.60 |
$8,962 |
2.0× |
| Angiography extremity unilateral rs&i (75710) |
$7,169.60 |
$8,962 |
2.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,923.20 |
$8,654 |
1.1× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$9,075.20 |
$11,344 |
2.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,546.40 |
$8,183 |
1.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,099.20 |
$11,374 |
1.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,740 |
$4,675 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,172 |
$6,465 |
1.5× |
| Ankle 2 views (73600) |
$321.60 |
$402 |
3.3× |
| Aortography abdominal serialography rs&i (75625) |
$7,511.20 |
$9,389 |
2.1× |
| Arthrogram elbow (73085) |
$520.80 |
$651 |
1.3× |
| Arthrogram hip (73525) |
$1,168 |
$1,460 |
3.0× |
| Arthrogram knee (73580) |
$1,221.60 |
$1,527 |
3.1× |
| Arthrogram shoulder (73040) |
$1,202 |
$1,502.50 |
3.1× |
| Arthrogram wrist (73115) |
$928.80 |
$1,161 |
2.4× |
| Basic dosimetry (77300) |
$580 |
$725 |
3.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,217.60 |
$2,772 |
5.0× |
| Bone &/joint imaging whole body (78306) |
$2,197.60 |
$2,747 |
4.9× |
| Bone age studies (77072) |
$140.80 |
$176 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$2,407.20 |
$3,009 |
5.4× |
| Bone survey complete (77075) |
$720.80 |
$901 |
6.2× |
| Bone survey infant (77076) |
$838.40 |
$1,048 |
7.2× |
| Bowel imaging (78290) |
$1,873.60 |
$2,342 |
4.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,997.60 |
$7,497 |
3.8× |
| Brain Imaging Vascular Flow Only (78610) |
$975.20 |
$1,219 |
1.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,434.40 |
$3,043 |
5.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,773.60 |
$3,467 |
7.1× |
| Cervical spine 2 or 3 views (72040) |
$382.40 |
$478 |
3.9× |
| Chest 1 view (71045) |
$302.40 |
$378 |
3.1× |
| Chest xray 3 views (71047) |
$340 |
$425 |
3.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$689.60 |
$862 |
3.5× |
| Clavicle complete (73000) |
$320 |
$400 |
3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$314.40 |
$393 |
2.7× |
| Continuing medical physics consltj pr wk (77336) |
$998.40 |
$1,248 |
6.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,988 |
$6,235 |
12.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,906.40 |
$3,633 |
10.9× |
| CT abdomen w contrast (74160) |
$2,586.40 |
$3,233 |
13.2× |
| CT abdomen w wo contrast (74170) |
$3,095.20 |
$3,869 |
15.8× |
| CT abdomen w/o contrast (74150) |
$1,965.60 |
$2,457 |
16.9× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,998.40 |
$2,498 |
10.2× |
| CT angiography upper extremity lt (73206) |
$2,841.60 |
$3,552 |
14.5× |
| CT c-spine w/contrast (72126) |
$2,647.20 |
$3,309 |
6.8× |
| CT c-spine w/o contrast (72125) |
$2,009.60 |
$2,512 |
17.2× |
| CT cervical spine w&w/o contrast (72127) |
$2,779.20 |
$3,474 |
14.2× |
| CT chest w contrast (71260) |
$2,524.40 |
$3,155.50 |
12.9× |
| CT chest w/wo contrast (71270) |
$2,640 |
$3,300 |
13.5× |
| CT head/brain with contrast (70460) |
$2,091.20 |
$2,614 |
10.7× |
| CT head/brain without and with contrast (70470) |
$2,679.20 |
$3,349 |
13.7× |
| CT iac w contrast (70481) |
$1,802.40 |
$2,253 |
9.2× |
| CT limited/localized follow up study (76380) |
$831.20 |
$1,039 |
8.6× |
| CT lower ext w/o (73700) |
$1,782.40 |
$2,228 |
15.3× |
| CT lower extremity w/contrast material (73701) |
$2,221.20 |
$2,776.50 |
11.4× |
| CT lumbar spine w & w/o contrast (72133) |
$2,857.60 |
$3,572 |
14.6× |
| CT lumbar spine w/contrast (72132) |
$2,514 |
$3,142.50 |
6.5× |
| CT lumbar spine w/o contrast (72131) |
$1,993.20 |
$2,491.50 |
17.1× |
| CT maxillofacial w contrast (70487) |
$2,124.40 |
$2,655.50 |
10.9× |
| CT maxillofacial wo contrast (70486) |
$1,822.80 |
$2,278.50 |
15.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,628.80 |
$3,286 |
13.4× |
| CT orbits w/o contrast (70480) |
$1,664.80 |
$2,081 |
14.3× |
| CT pelvis w/o contrast (72192) |
$1,720 |
$2,150 |
14.8× |
| CT pelvis w/wo contrast (72194) |
$2,992 |
$3,740 |
15.3× |
| CT soft tissue neck w contrast (70491) |
$2,403.60 |
$3,004.50 |
12.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,524 |
$3,155 |
12.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,974 |
$2,467.50 |
16.9× |
| CT thoracic spine w/contrast (72129) |
$2,537.20 |
$3,171.50 |
13.0× |
| CT thoracic spine w/o contrast (72128) |
$1,760.40 |
$2,200.50 |
15.1× |
| CT thoracic spine w/wo contrast (72130) |
$2,638.40 |
$3,298 |
13.5× |
| CT thorax w/o contrast (71250) |
$1,907.20 |
$2,384 |
16.4× |
| CT upper ext wo (73200) |
$1,843.20 |
$2,304 |
15.8× |
| CT upper extremity with contrast (73201) |
$2,294.80 |
$2,868.50 |
5.9× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,683.20 |
$3,354 |
13.7× |
| Cta Abdomen (74175) |
$2,440.80 |
$3,051 |
12.5× |
| CTA abdomen pelvis (74174) |
$3,454.40 |
$4,318 |
8.9× |
| CTA chest (71275) |
$3,094.40 |
$3,868 |
15.8× |
| Cta Head (70496) |
$2,868 |
$3,585 |
14.7× |
| Cta Neck (70498) |
$2,856 |
$3,570 |
14.6× |
| Cta Pelvis (72191) |
$2,308.80 |
$2,886 |
11.8× |
| Cystography minimum 3 views rs&i (74430) |
$861.60 |
$1,077 |
2.2× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$4,820.80 |
$6,026 |
2.1× |
| Diskography lumbar (72295) |
$2,715.20 |
$3,394 |
1.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$142.40 |
$178 |
1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$218.40 |
$273 |
2.3× |
| Esophagus (74220) |
$916.80 |
$1,146 |
4.7× |
| Facial bones min 3 views (70150) |
$491.20 |
$614 |
4.2× |
| Fetal biophysical profile non-stress testing (76818) |
$1,290.40 |
$1,613 |
11.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$634.40 |
$793 |
5.4× |
| Fluoroscopy up to 1 hr (76000) |
$769.60 |
$962 |
2.9× |
| Foot 2 views (73620) |
$309.60 |
$387 |
3.2× |
| Forearm 2 views (73090) |
$320 |
$400 |
3.3× |
| Hand 2 views (73120) |
$364.80 |
$456 |
3.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$5,943.20 |
$7,429 |
1.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,510.40 |
$3,138 |
4.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,396 |
$2,995 |
5.4× |
| Hysterosalpingogram (74740) |
$979.20 |
$1,224 |
3.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,733.60 |
$2,167 |
2.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,747.20 |
$2,184 |
2.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,528 |
$1,910 |
2.5× |
| Knee 3 views (73562) |
$369.20 |
$461.50 |
3.8× |
| Liver & spleen imaging static only (78215) |
$1,113.60 |
$1,392 |
2.5× |
| Lung perfusion differential (78597) |
$1,591.20 |
$1,989 |
3.6× |
| Lung ventilation imaging (78579) |
$1,032 |
$1,290 |
2.3× |
| Lymphoscintigraphy (78195) |
$2,016.80 |
$2,521 |
3.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,976 |
$3,720 |
3.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,996.80 |
$3,746 |
7.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,892.80 |
$4,866 |
10.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,535.20 |
$5,669 |
10.9× |
| MRA head w & w/o contrast (70546) |
$2,897.60 |
$3,622 |
7.5× |
| MRA head w/o contrast (70544) |
$2,966.40 |
$3,708 |
11.2× |
| MRA head with contrast (70545) |
$1,822.40 |
$2,278 |
4.7× |
| MRA neck w contrast (70548) |
$2,880 |
$3,600 |
7.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,199.20 |
$5,249 |
10.8× |
| MRA neck w/o contrast (70547) |
$2,127.20 |
$2,659 |
8.0× |
| MRI abdomen w contrast (74182) |
$2,930.40 |
$3,663 |
7.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,844 |
$4,805 |
9.9× |
| MRI abdomen w/o contrast (74181) |
$2,694.40 |
$3,368 |
10.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,895.20 |
$3,619 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,218.80 |
$5,273.50 |
10.9× |
| MRI bone marrow blood supply (77084) |
$1,540.80 |
$1,926 |
5.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,809.60 |
$2,262 |
6.8× |
| MRI c-spine with contrast (72142) |
$3,520 |
$4,400 |
9.1× |
| MRI cardiac w/o contrast (75557) |
$1,469.60 |
$1,837 |
5.5× |
| MRI cervical spine w/o contrast (72141) |
$2,755.20 |
$3,444 |
10.4× |
| MRI chest w/o & w/contrast material (71552) |
$4,032.80 |
$5,041 |
10.4× |
| MRI chest w/o contrast (71550) |
$2,862.40 |
$3,578 |
10.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,043.20 |
$3,804 |
7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,607.20 |
$4,509 |
9.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,434.40 |
$3,043 |
9.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,484.80 |
$3,106 |
9.3× |
| MRI orbit face neck w contrast (70542) |
$2,671.20 |
$3,339 |
6.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,086.40 |
$5,108 |
10.5× |
| MRI pelvis w/contrast (72196) |
$3,198.40 |
$3,998 |
8.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,891.20 |
$4,864 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$2,727.20 |
$3,409 |
10.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,700.80 |
$4,626 |
9.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,771.20 |
$4,714 |
9.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,234 |
$5,292.50 |
10.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,520 |
$4,400 |
9.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,694.40 |
$4,618 |
9.5× |
| MRI temporomandibular joint (70336) |
$2,128.80 |
$2,661 |
8.0× |
| MRI thoracic spine w/o contrast (72146) |
$2,811.20 |
$3,514 |
10.6× |
| MRI up ext w/o contrast (73218) |
$2,696 |
$3,370 |
10.1× |
| MRI upper ext joint w/o contrast (73221) |
$2,806 |
$3,507.50 |
10.6× |
| MRI, joint upper extrem combo (73223) |
$3,854.40 |
$4,818 |
9.9× |
| Myelogram Cervical (72240) |
$2,206.40 |
$2,758 |
2.5× |
| Myelogram Lumbar (72265) |
$1,760 |
$2,200 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,431.20 |
$5,539 |
3.1× |
| Myocardial spect single study at rest or stress (78451) |
$3,527.20 |
$4,409 |
2.4× |
| Neck soft tissue (70360) |
$310.40 |
$388 |
3.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$1,152.80 |
$1,441 |
2.6× |
| Nm bone marrow multi (78103) |
$803.20 |
$1,004 |
1.8× |
| Nm cisternogram (78630) |
$2,137.60 |
$2,672 |
3.5× |
| Nm gastric emptying study (78264) |
$1,600.40 |
$2,000.50 |
3.6× |
| Nm gastroesophageal reflux study (78262) |
$1,707.20 |
$2,134 |
3.8× |
| Noncardiac Vascular Flow Imaging (78445) |
$894.40 |
$1,118 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,086.40 |
$10,108 |
5.2× |
| Nuclear Rx Oral Admin (79005) |
$1,322.40 |
$1,653 |
5.1× |
| Osseous survey limited (77074) |
$587.20 |
$734 |
5.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,639.20 |
$3,299 |
5.9× |
| Pelvis 1 or 2 views (72170) |
$374.40 |
$468 |
3.2× |
| PET image w/CT, skull-thigh (78815) |
$6,124.80 |
$7,656 |
3.8× |
| PET imaging for CT attenuation whole body (78816) |
$6,066.40 |
$7,583 |
3.8× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$2,572 |
$3,215 |
1.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,838.40 |
$3,548 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,605.60 |
$2,007 |
3.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,044 |
$2,555 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,093.60 |
$1,367 |
1.8× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$329.60 |
$412 |
3.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$272 |
$340 |
2.8× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$373.60 |
$467 |
3.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$190.40 |
$238 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$343.20 |
$429 |
2.9× |
| Radex fingr minimum 2 views (73140) |
$336 |
$420 |
3.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$489.60 |
$612 |
5.0× |
| Radex Hand Minimum 3 Views (73130) |
$398.40 |
$498 |
4.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$354.40 |
$443 |
3.7× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$380 |
$475 |
3.3× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$330.40 |
$413 |
2.8× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$627.20 |
$784 |
5.4× |
| Radex Humerus Minimum 2 Views (73060) |
$331.20 |
$414 |
3.4× |
| Radex Kne 1/2 Views (73560) |
$319.20 |
$399 |
3.3× |
| Radex Kne Compl 4/More Views (73564) |
$420 |
$525 |
3.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$435.20 |
$544 |
3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$379.20 |
$474 |
3.9× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$462.40 |
$578 |
4.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$364.80 |
$456 |
3.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$331.20 |
$414 |
3.4× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$482.40 |
$603 |
4.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$528 |
$660 |
5.4× |
| Radex Toe Minimum 2 Views (73660) |
$288 |
$360 |
3.0× |
| Radex upper extremity infant minimum 2 views (73092) |
$405.60 |
$507 |
3.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$344 |
$430 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$252.80 |
$316 |
2.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$23,152.80 |
$28,941 |
2.8× |
| Radiation treatment delivery level 1 (77402) |
$724 |
$905 |
6.4× |
| Radiation treatment delivery level 2 (77407) |
$858.40 |
$1,073 |
2.0× |
| Radiation treatment delivery level 3 (77412) |
$1,072 |
$1,340 |
1.7× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$294.40 |
$368 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$372 |
$465 |
3.2× |
| Radiologic exam chest 2 views (71046) |
$332 |
$415 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$976.80 |
$1,221 |
5.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$440 |
$550 |
2.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$895.60 |
$1,119.50 |
4.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$737.60 |
$922 |
3.8× |
| Radiologic examination femur 1 view (73551) |
$270.40 |
$338 |
2.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$305.60 |
$382 |
3.2× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$288.80 |
$361 |
2.5× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$315.20 |
$394 |
2.7× |
| Radiologic examination, teeth; partial examination, less than full mouth Non-Facility (70310) |
$226.40 |
$283 |
0.9× |
| Radiological examination surgical specimen (76098) |
$927.20 |
$1,159 |
1.5× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,547.20 |
$1,934 |
3.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$4,508.80 |
$5,636 |
7.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,581.60 |
$3,227 |
4.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,575.20 |
$3,219 |
4.3× |
| Rp Therapy Intravenous Administration (79101) |
$1,286.40 |
$1,608 |
4.9× |
| Sacroiliac Joints < 3 Views (72200) |
$317.60 |
$397 |
2.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$828 |
$1,035 |
3.1× |
| Scapula (73010) |
$342.40 |
$428 |
2.9× |
| Shoulder 1 view (73020) |
$268.80 |
$336 |
2.8× |
| Sialogram (70390) |
$396.80 |
$496 |
1.5× |
| Simulation intermediate (77285) |
$1,779.20 |
$2,224 |
4.3× |
| Small bowel series (74250) |
$763.20 |
$954 |
3.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,644 |
$2,055 |
3.9× |
| Special dosimetry (77331) |
$653.20 |
$816.50 |
4.4× |
| Special Physics Consult (77370) |
$1,032.80 |
$1,291 |
6.9× |
| Special treatment procedure (77470) |
$3,236.80 |
$4,046 |
5.3× |
| Spine thoracic 3 views (72072) |
$417.60 |
$522 |
3.6× |
| Stereotactic Body Radiation Delivery (77373) |
$9,098.40 |
$11,373 |
4.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,573.60 |
$1,967 |
3.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,100 |
$1,375 |
2.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,232.80 |
$2,791 |
5.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,203.20 |
$1,504 |
8.0× |
| Thoracolumbar 2 views (72080) |
$380.40 |
$475.50 |
3.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,802 |
$2,252.50 |
3.0× |
| Thyroid imaging w/blood flow (78013) |
$752 |
$940 |
1.7× |
| Thyroid uptake measurement (78012) |
$620.80 |
$776 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,396.80 |
$1,746 |
3.1× |
| Tmj unilateral (70328) |
$263.20 |
$329 |
2.7× |
| Treatment device complex (77334) |
$1,721.60 |
$2,152 |
4.1× |
| Treatment device intermediate (77333) |
$1,184 |
$1,480 |
7.9× |
| Treatment devices simple (77332) |
$759.20 |
$949 |
5.1× |
| Ultrasound breast complete (76641) |
$576 |
$720 |
4.9× |
| Ultrasound Exam Aaa Screen (76706) |
$494.40 |
$618 |
4.2× |
| Ultrasound, abdomen limited (76705) |
$630.40 |
$788 |
5.4× |
| Umbilical-artery Doppler (OB) (76820) |
$620.80 |
$776 |
5.3× |
| Urethrocystogram voiding (74455) |
$1,029.60 |
$1,287 |
3.9× |
| Urethrocystography retrograde rs&i (74450) |
$1,078.40 |
$1,348 |
4.1× |
| Us breast unilateral limited (76642) |
$443.20 |
$554 |
4.6× |
| Us chest (76604) |
$575.20 |
$719 |
4.9× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$1,100 |
$1,375 |
4.6× |
| Us compl joint r-t w/image documentation (76881) |
$161.60 |
$202 |
1.4× |
| Us encephalogram (76506) |
$472 |
$590 |
4.1× |
| Us hips infant static (76886) |
$255.20 |
$319 |
2.6× |
| Us infant hips w manipulation (76885) |
$140 |
$175 |
1.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$147.20 |
$184 |
1.3× |
| Us ob detailed single fetus (76811) |
$1,136.80 |
$1,421 |
4.3× |
| Us ob limited (76815) |
$417.20 |
$521.50 |
3.6× |
| Us ob transvaginal (76817) |
$216.80 |
$271 |
1.9× |
| Us pelvic non ob complete (76856) |
$226.40 |
$283 |
1.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$569.60 |
$712 |
4.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$135.20 |
$169 |
1.2× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$198.40 |
$248 |
1.7× |
| Us retroperitoneal complete (76770) |
$741.60 |
$927 |
6.4× |
| Us retroperitoneal limited (76775) |
$610.40 |
$763 |
5.2× |
| Us scrotum and contents (76870) |
$185.60 |
$232 |
1.6× |
| Us soft tissue head/neck (76536) |
$655.20 |
$819 |
5.6× |
| Us spinal canal and contents (76800) |
$584.80 |
$731 |
5.0× |
| Us transrectal (76872) |
$96 |
$120 |
0.8× |
| Us,transplanted kidney, real time/ doppler (76776) |
$788.80 |
$986 |
6.8× |
| Venogram extremity bilateral (75822) |
$2,884 |
$3,605 |
1.6× |
| Venogram Extremity Unilateral (75820) |
$2,296.80 |
$2,871 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$5,988.80 |
$7,486 |
1.7× |
| Venography caval superior serialography rs&i (75827) |
$3,841.60 |
$4,802 |
2.2× |
| Venography Renal Bilateral (75833) |
$4,513.60 |
$5,642 |
1.3× |
| Venography renal unilateral selective rs&i (75831) |
$5,031.20 |
$6,289 |
1.4× |
| Vertebral fracture assessment via dxa (77086) |
$228 |
$285 |
2.4× |
| Wrist 2 views (73100) |
$346.40 |
$433 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$520.40 |
$650.50 |
4.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$304 |
$380 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,360 |
$1,700 |
7.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$296 |
$370 |
3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$368 |
$460 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$424 |
$530 |
3.6× |
| X-ray exam of femur 2/> (73552) |
$316 |
$395 |
3.3× |
| X-ray eye for foreign body (70030) |
$278.40 |
$348 |
2.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$390.40 |
$488 |
4.0× |
| X-ray IV pyelogram (ivp) (74400) |
$960 |
$1,200 |
4.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$315.20 |
$394 |
3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$291.20 |
$364 |
3.0× |
| X-ray leg, infant (73592) |
$136 |
$170 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$447.20 |
$559 |
3.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$810.40 |
$1,013 |
7.0× |
| X-ray nose-rectum child f.b. (76010) |
$142.40 |
$178 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$463.60 |
$579.50 |
4.0× |
| X-ray retrograde pyelogram (74420) |
$1,298.40 |
$1,623 |
3.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$322.40 |
$403 |
3.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$419.20 |
$524 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$484 |
$605 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$385.60 |
$482 |
3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$341.60 |
$427 |
3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$437.60 |
$547 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$670.40 |
$838 |
5.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$354.40 |
$443 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$286.40 |
$358 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$400.80 |
$501 |
4.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$355.20 |
$444 |
3.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$392 |
$490 |
3.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$499.60 |
$624.50 |
4.3× |
| Xr bone length studies (77073) |
$439.20 |
$549 |
3.8× |
| Xr c-spine 4 or 5 views (72050) |
$502.40 |
$628 |
4.3× |
| Xr c-spine 6 or more views (72052) |
$619.20 |
$774 |
5.3× |
| Xr chest 4+ views (71048) |
$358.40 |
$448 |
3.1× |
| Xr urogram antegrade (74425) |
$920.80 |
$1,151 |
2.4× |