| Abdomen 2 views (74019) |
$361.20 |
$516 |
2.9× |
| Acute gi blood loss imaging (78278) |
$728 |
$1,040 |
1.5× |
| Angio Adrenal Bilat Select (75733) |
$4,146.10 |
$5,923 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$4,652.90 |
$6,647 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$5,814.20 |
$8,306 |
1.5× |
| Angiography internal mammary rs&i (75756) |
$4,146.10 |
$5,923 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,063.10 |
$7,233 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,146.10 |
$5,923 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,146.10 |
$5,923 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$7,094.50 |
$10,135 |
1.1× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,370.40 |
$7,672 |
0.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,797.60 |
$2,568 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,797.60 |
$2,568 |
0.5× |
| Ankle 2 views (73600) |
$218.40 |
$312 |
2.1× |
| Aortogram thoracic (75605) |
$7,094.50 |
$10,135 |
1.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,513.30 |
$5,019 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$5,880.70 |
$8,401 |
1.6× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$4,146.10 |
$5,923 |
1.1× |
| Artery X-Rays Adrenal Gland (75731) |
$1,019.20 |
$1,456 |
0.3× |
| Arthrogram shoulder (73040) |
$1,128.40 |
$1,612 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$1,400.70 |
$2,001 |
2.9× |
| Bone age studies (77072) |
$291.90 |
$417 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$1,598.80 |
$2,284 |
3.3× |
| Bone Marrow Imaging Limited Area (78102) |
$2,200.10 |
$3,143 |
4.6× |
| Bone survey complete (77075) |
$639.10 |
$913 |
5.1× |
| Bone survey infant (77076) |
$407.40 |
$582 |
3.3× |
| Bowel imaging (78290) |
$728 |
$1,040 |
1.5× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$1,138.20 |
$1,626 |
2.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$928.90 |
$1,327 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$263.20 |
$376 |
2.5× |
| Chest 1 view (71045) |
$256.90 |
$367 |
2.5× |
| Chest xray 3 views (71047) |
$397.60 |
$568 |
3.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$485.10 |
$693 |
2.3× |
| Clavicle complete (73000) |
$312.20 |
$446 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$118.30 |
$169 |
0.9× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Non-Facility (77078) |
$273.70 |
$391 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,847.50 |
$6,925 |
11.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,699.90 |
$3,857 |
9.4× |
| CT abdomen w contrast (74160) |
$2,178.40 |
$3,112 |
10.4× |
| CT abdomen w wo contrast (74170) |
$2,600.50 |
$3,715 |
12.4× |
| CT abdomen w/o contrast (74150) |
$1,477 |
$2,110 |
11.8× |
| CT angio hrt w/3d image (75574) |
$709.10 |
$1,013 |
1.7× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,182.20 |
$4,546 |
15.1× |
| CT angiography upper extremity lt (73206) |
$3,045 |
$4,350 |
14.5× |
| CT c-spine w/contrast (72126) |
$1,920.80 |
$2,744 |
4.6× |
| CT c-spine w/o contrast (72125) |
$1,674.40 |
$2,392 |
13.4× |
| CT cervical spine w&w/o contrast (72127) |
$2,170.70 |
$3,101 |
10.3× |
| CT chest w contrast (71260) |
$2,475.20 |
$3,536 |
11.8× |
| CT chest w/wo contrast (71270) |
$2,691.50 |
$3,845 |
12.8× |
| CT head/brain with contrast (70460) |
$1,759.80 |
$2,514 |
8.4× |
| CT head/brain without and with contrast (70470) |
$2,097.90 |
$2,997 |
10.0× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$96.60 |
$138 |
0.9× |
| CT iac w contrast (70481) |
$1,530.90 |
$2,187 |
7.3× |
| CT limited/localized follow up study (76380) |
$105 |
$150 |
1.0× |
| CT lower ext w/o (73700) |
$1,943.20 |
$2,776 |
15.5× |
| CT lower extremity w wo contrast (73702) |
$2,594.20 |
$3,706 |
12.3× |
| CT lower extremity w/contrast material (73701) |
$2,062.20 |
$2,946 |
9.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,284.10 |
$3,263 |
10.9× |
| CT lumbar spine w/contrast (72132) |
$2,022.30 |
$2,889 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$1,694.70 |
$2,421 |
13.5× |
| CT maxillofacial w contrast (70487) |
$1,530.90 |
$2,187 |
7.3× |
| CT maxillofacial w/wo contrast (70488) |
$1,680.70 |
$2,401 |
8.0× |
| CT maxillofacial wo contrast (70486) |
$1,353.80 |
$1,934 |
10.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,680.70 |
$2,401 |
8.0× |
| CT orbits w/o contrast (70480) |
$1,353.80 |
$1,934 |
10.8× |
| CT pelvis w/o contrast (72192) |
$1,540.70 |
$2,201 |
12.3× |
| CT pelvis w/wo contrast (72194) |
$2,620.80 |
$3,744 |
12.5× |
| CT scan of arm combo (73202) |
$2,594.20 |
$3,706 |
12.3× |
| CT soft tissue neck w contrast (70491) |
$1,974.70 |
$2,821 |
9.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,362.50 |
$3,375 |
11.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,353.80 |
$1,934 |
10.8× |
| CT thoracic spine w/contrast (72129) |
$2,022.30 |
$2,889 |
9.6× |
| CT thoracic spine w/o contrast (72128) |
$1,694.70 |
$2,421 |
13.5× |
| CT thoracic spine w/wo contrast (72130) |
$2,284.10 |
$3,263 |
10.9× |
| CT thorax w/o contrast (71250) |
$1,535.10 |
$2,193 |
12.3× |
| CT unlisted procedure (76497) |
$190.40 |
$272 |
1.8× |
| CT upper ext wo (73200) |
$1,766.10 |
$2,523 |
14.1× |
| CT upper extremity with contrast (73201) |
$1,874.60 |
$2,678 |
4.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,324.40 |
$1,892 |
6.3× |
| Cta Abdomen (74175) |
$1,919.40 |
$2,742 |
9.1× |
| CTA abdomen pelvis (74174) |
$1,862 |
$2,660 |
4.5× |
| CTA chest (71275) |
$2,587.90 |
$3,697 |
12.3× |
| Cta Head (70496) |
$1,570.10 |
$2,243 |
7.5× |
| Cta Neck (70498) |
$2,440.90 |
$3,487 |
11.6× |
| Cta Pelvis (72191) |
$3,045 |
$4,350 |
14.5× |
| Cystography minimum 3 views rs&i (74430) |
$728 |
$1,040 |
1.7× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$518.70 |
$741 |
0.2× |
| Diskography lumbar (72295) |
$4,098.50 |
$5,855 |
1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$340.20 |
$486 |
2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$419.30 |
$599 |
3.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$236.60 |
$338 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$455.70 |
$651 |
3.6× |
| Dxa bone density study axial skeleton (77085) |
$485.80 |
$694 |
3.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$646.80 |
$924 |
2.3× |
| Esophagus (74220) |
$485.10 |
$693 |
2.3× |
| Facial bones min 3 views (70150) |
$361.20 |
$516 |
2.9× |
| Fetal biophysical profile non-stress testing (76818) |
$740.60 |
$1,058 |
5.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$616.70 |
$881 |
4.9× |
| Fetal Echo (76825) |
$702.80 |
$1,004 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$455 |
$650 |
1.6× |
| Foot 2 views (73620) |
$227.50 |
$325 |
2.2× |
| Forearm 2 views (73090) |
$293.30 |
$419 |
2.8× |
| Hand 2 views (73120) |
$203 |
$290 |
1.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,146.10 |
$5,923 |
1.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,146.10 |
$5,923 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,122.80 |
$1,604 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,092 |
$1,560 |
2.3× |
| Hysterosalpingogram (74740) |
$1,171.80 |
$1,674 |
4.1× |
| Interstitial radiation source applic complex (77778) |
$2,664.20 |
$3,806 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,401.40 |
$2,002 |
2.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,564.50 |
$2,235 |
2.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,481.50 |
$3,545 |
3.8× |
| Knee 3 views (73562) |
$320.60 |
$458 |
3.1× |
| Liver & spleen imaging static only (78215) |
$916.30 |
$1,309 |
1.9× |
| Liver imaging static only (78201) |
$1,495.90 |
$2,137 |
2.3× |
| Lung perf&ventilat diferentl (78598) |
$1,432.20 |
$2,046 |
2.2× |
| Lung perfusion differential (78597) |
$818.30 |
$1,169 |
1.7× |
| Lung ventilation imaging (78579) |
$669.90 |
$957 |
1.4× |
| Lymphoscintigraphy (78195) |
$1,234.80 |
$1,764 |
1.9× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$2,254 |
$3,220 |
2.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$2,028.60 |
$2,898 |
4.9× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,121 |
$3,030 |
5.1× |
| Mammary ductogram or galactogram multiple (77054) |
$967.40 |
$1,382 |
3.4× |
| Mammary ductogram or galactogram single (77053) |
$570.50 |
$815 |
2.0× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$887.60 |
$1,268 |
2.0× |
| Mr safety determination physician/other qhp (76016) |
$197.40 |
$282 |
1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$55.30 |
$79 |
1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$205.80 |
$294 |
1.8× |
| Mr safety implt pos&/immoblj (76019) |
$133.70 |
$191 |
1.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$539.70 |
$771 |
1.9× |
| MRA head w & w/o contrast (70546) |
$4,371.50 |
$6,245 |
10.5× |
| MRA head w/o contrast (70544) |
$1,975.40 |
$2,822 |
6.9× |
| MRA head with contrast (70545) |
$2,254 |
$3,220 |
5.4× |
| MRA neck w contrast (70548) |
$2,010.40 |
$2,872 |
4.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,254 |
$3,220 |
5.4× |
| MRA neck w/o contrast (70547) |
$1,880.90 |
$2,687 |
6.6× |
| MRI abdomen w contrast (74182) |
$2,254 |
$3,220 |
5.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,163.60 |
$5,948 |
10.0× |
| MRI abdomen w/o contrast (74181) |
$1,953 |
$2,790 |
6.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,478.70 |
$3,541 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,163.60 |
$5,948 |
10.0× |
| MRI breast w/o contrast bilateral (77047) |
$3,556 |
$5,080 |
12.4× |
| MRI breast wo contrast unilateral (77046) |
$1,980.30 |
$2,829 |
6.9× |
| MRI c-spine with contrast (72142) |
$2,478.70 |
$3,541 |
5.9× |
| MRI cervical spine w/o contrast (72141) |
$2,041.90 |
$2,917 |
7.1× |
| MRI chest w/o & w/contrast material (71552) |
$4,163.60 |
$5,948 |
10.0× |
| MRI chest w/o contrast (71550) |
$1,880.90 |
$2,687 |
6.6× |
| MRI chest with contrast (71551) |
$2,140.60 |
$3,058 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,254 |
$3,220 |
5.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,121 |
$3,030 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,880.90 |
$2,687 |
6.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,975.40 |
$2,822 |
6.9× |
| MRI orbit face neck w contrast (70542) |
$931 |
$1,330 |
2.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,371.50 |
$6,245 |
10.5× |
| MRI pelvis w/contrast (72196) |
$2,254 |
$3,220 |
5.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,163.60 |
$5,948 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$1,880.90 |
$2,687 |
6.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,009.60 |
$5,728 |
9.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,691.50 |
$3,845 |
6.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,371.50 |
$6,245 |
10.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,373 |
$3,390 |
5.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,738.30 |
$6,769 |
11.3× |
| MRI temporomandibular joint (70336) |
$2,177.70 |
$3,111 |
7.6× |
| MRI thoracic spine w/o contrast (72146) |
$2,198.70 |
$3,141 |
7.7× |
| MRI up ext w/o contrast (73218) |
$1,880.90 |
$2,687 |
6.6× |
| MRI upper ext joint w/o contrast (73221) |
$1,880.90 |
$2,687 |
6.6× |
| MRI, joint upper extrem combo (73223) |
$4,163.60 |
$5,948 |
10.0× |
| Myelogram Cervical (72240) |
$1,522.50 |
$2,175 |
1.6× |
| Myelogram Lumbar (72265) |
$1,726.20 |
$2,466 |
1.8× |
| Myelogram thoracic (72255) |
$1,232 |
$1,760 |
1.3× |
| Myelography 2 or more regions (72270) |
$1,522.50 |
$2,175 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$4,111.10 |
$5,873 |
2.6× |
| Myocardial spect single study at rest or stress (78451) |
$2,412.20 |
$3,446 |
1.6× |
| Neck soft tissue (70360) |
$300.30 |
$429 |
2.9× |
| Nm bone marrow multi (78103) |
$2,200.10 |
$3,143 |
4.6× |
| Nm cardiac blood pool multiple (78473) |
$1,043.70 |
$1,491 |
2.2× |
| Nm cisternogram (78630) |
$1,022.70 |
$1,461 |
1.6× |
| Nm gastric emptying study (78264) |
$1,244.60 |
$1,778 |
2.6× |
| Nm peritoneal-venous shunt patency (78291) |
$943.60 |
$1,348 |
2.0× |
| Nm red cell sequestration (78140) |
$1,045.80 |
$1,494 |
2.2× |
| Noncardiac Vascular Flow Imaging (78445) |
$634.20 |
$906 |
1.3× |
| Nonvascular shunt X-ray (75809) |
$461.30 |
$659 |
3.7× |
| Nuclear Rx Oral Admin (79005) |
$746.20 |
$1,066 |
2.7× |
| Ob us nuchal meas 1 gest (76813) |
$725.90 |
$1,037 |
5.8× |
| Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution… (76513) |
$303.10 |
$433 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$1,209.60 |
$1,728 |
2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,623.30 |
$2,319 |
3.4× |
| Pelvis 1 or 2 views (72170) |
$263.20 |
$376 |
2.1× |
| Peritoneogram after injection (74190) |
$809.90 |
$1,157 |
1.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,146.10 |
$5,923 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,635.90 |
$2,337 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,264.90 |
$1,807 |
2.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,143.80 |
$1,634 |
1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$912.10 |
$1,303 |
1.4× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$257.60 |
$368 |
2.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$241.50 |
$345 |
2.3× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$255.50 |
$365 |
2.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$143.50 |
$205 |
1.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$234.50 |
$335 |
1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$417.90 |
$597 |
3.3× |
| Radex fingr minimum 2 views (73140) |
$218.40 |
$312 |
2.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$263.20 |
$376 |
2.5× |
| Radex Hand Minimum 3 Views (73130) |
$263.20 |
$376 |
2.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$152.60 |
$218 |
1.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$191.80 |
$274 |
1.5× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$282.80 |
$404 |
2.3× |
| Radex Humerus Minimum 2 Views (73060) |
$291.20 |
$416 |
2.8× |
| Radex Kne 1/2 Views (73560) |
$227.50 |
$325 |
2.2× |
| Radex Kne Compl 4/More Views (73564) |
$345.80 |
$494 |
2.8× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$361.20 |
$516 |
2.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$326.90 |
$467 |
3.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$247.80 |
$354 |
2.0× |
| Radex Sho Compl Minimum 2 Views (73030) |
$218.40 |
$312 |
2.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$359.80 |
$514 |
3.4× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$233.80 |
$334 |
1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$361.20 |
$516 |
3.5× |
| Radex Toe Minimum 2 Views (73660) |
$218.40 |
$312 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$284.20 |
$406 |
2.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$254.10 |
$363 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$501.20 |
$716 |
4.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$284.90 |
$407 |
2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$445.90 |
$637 |
3.6× |
| Radiologic exam chest 2 views (71046) |
$280 |
$400 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$884.80 |
$1,264 |
4.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$251.30 |
$359 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$755.30 |
$1,079 |
3.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$639.10 |
$913 |
3.0× |
| Radiologic examination femur 1 view (73551) |
$182.70 |
$261 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$293.30 |
$419 |
2.8× |
| Radiological examination surgical specimen (76098) |
$669.90 |
$957 |
1.0× |
| Ribs bilateral 3 views (71110) |
$448.70 |
$641 |
3.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$549.50 |
$785 |
1.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,902.60 |
$2,718 |
2.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,943.90 |
$2,777 |
3.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,465.80 |
$2,094 |
2.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$397.60 |
$568 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$169.40 |
$242 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$914.90 |
$1,307 |
3.2× |
| Scapula (73010) |
$284.20 |
$406 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$87.50 |
$125 |
3.7× |
| Shoulder 1 view (73020) |
$177.80 |
$254 |
1.7× |
| Small bowel series (74250) |
$602.70 |
$861 |
2.9× |
| Spine thoracic 3 views (72072) |
$433.30 |
$619 |
3.5× |
| Splenoportograpy rs&i (75810) |
$1,797.60 |
$2,568 |
0.5× |
| Superior sagittal sinus venogram (75870) |
$1,019.20 |
$1,456 |
0.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,008 |
$1,440 |
1.5× |
| Thyroid uptake measurement (78012) |
$429.80 |
$614 |
0.9× |
| Treatment devices simple (77332) |
$661.50 |
$945 |
4.1× |
| Ultrasound breast complete (76641) |
$170.10 |
$243 |
1.4× |
| Ultrasound elastography first target lesion (76982) |
$467.60 |
$668 |
3.7× |
| Ultrasound Exam Aaa Screen (76706) |
$419.30 |
$599 |
3.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$299.60 |
$428 |
0.7× |
| Ultrasound, abdomen limited (76705) |
$537.60 |
$768 |
4.3× |
| Umbilical-artery Doppler (OB) (76820) |
$284.90 |
$407 |
2.3× |
| Unlisted fluoroscopic procedure (76496) |
$105 |
$150 |
1.0× |
| Unlisted magnetic resonance procedure (76498) |
$484.40 |
$692 |
4.6× |
| Urethrocystogram voiding (74455) |
$725.90 |
$1,037 |
2.5× |
| Us breast unilateral limited (76642) |
$507.50 |
$725 |
4.9× |
| Us chest (76604) |
$242.90 |
$347 |
1.9× |
| Us compl joint r-t w/image documentation (76881) |
$582.40 |
$832 |
4.6× |
| Us elastography parenchyma (76981) |
$467.60 |
$668 |
3.7× |
| Us encephalogram (76506) |
$402.50 |
$575 |
3.2× |
| Us hips infant static (76886) |
$225.40 |
$322 |
2.2× |
| Us infant hips w manipulation (76885) |
$396.90 |
$567 |
3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$252 |
$360 |
2.0× |
| Us ob detailed single fetus (76811) |
$1,113 |
$1,590 |
3.9× |
| Us ob limited (76815) |
$521.50 |
$745 |
4.2× |
| Us ob transvaginal (76817) |
$521.50 |
$745 |
4.2× |
| Us pelvic non ob complete (76856) |
$672.70 |
$961 |
5.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$315 |
$450 |
2.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$693.70 |
$991 |
5.5× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$673.40 |
$962 |
5.4× |
| Us retroperitoneal complete (76770) |
$287.70 |
$411 |
2.3× |
| Us retroperitoneal limited (76775) |
$709.80 |
$1,014 |
5.7× |
| Us scrotum and contents (76870) |
$725.90 |
$1,037 |
5.8× |
| Us soft tissue head/neck (76536) |
$488.60 |
$698 |
3.9× |
| Us spinal canal and contents (76800) |
$387.80 |
$554 |
3.1× |
| Us, eye b-scan (76512) |
$385 |
$550 |
3.1× |
| Venogram adrenal unilat (75840) |
$4,146.10 |
$5,923 |
1.1× |
| Venogram extremity bilateral (75822) |
$1,797.60 |
$2,568 |
1.0× |
| Venogram Extremity Unilateral (75820) |
$1,643.60 |
$2,348 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,291.40 |
$4,702 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$1,893.50 |
$2,705 |
1.0× |
| Venography Orbital Rs&I (75880) |
$1,019.20 |
$1,456 |
1.4× |
| Venography Renal Bilateral (75833) |
$4,146.10 |
$5,923 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$4,146.10 |
$5,923 |
1.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,146.10 |
$5,923 |
1.1× |
| Venography, epidural, radiological supervision and interpretation Non-Facility (75872) |
$1,019.20 |
$1,456 |
1.4× |
| Venous sampling by catheter (75893) |
$7,094.50 |
$10,135 |
1.1× |
| Wrist 2 views (73100) |
$233.10 |
$333 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$488.60 |
$698 |
4.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$884.80 |
$1,264 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$227.50 |
$325 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$169.40 |
$242 |
1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$230.30 |
$329 |
1.8× |
| X-ray exam of femur 2/> (73552) |
$202.30 |
$289 |
1.9× |
| X-ray eye for foreign body (70030) |
$326.90 |
$467 |
3.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$246.40 |
$352 |
2.4× |
| X-ray IV pyelogram (ivp) (74400) |
$1,015 |
$1,450 |
4.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$303.10 |
$433 |
2.9× |
| X-ray leg, infant (73592) |
$284.20 |
$406 |
2.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$401.10 |
$573 |
3.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$634.20 |
$906 |
5.1× |
| X-ray nose-rectum child f.b. (76010) |
$306.60 |
$438 |
2.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$488.60 |
$698 |
3.9× |
| X-ray retrograde pyelogram (74420) |
$470.40 |
$672 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$169.40 |
$242 |
1.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$361.20 |
$516 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$470.40 |
$672 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$341.60 |
$488 |
2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$333.20 |
$476 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$433.30 |
$619 |
4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$433.30 |
$619 |
3.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$366.10 |
$523 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$218.40 |
$312 |
2.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$315.70 |
$451 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$263.20 |
$376 |
2.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$379.40 |
$542 |
3.0× |
| Xr bone length studies (77073) |
$407.40 |
$582 |
3.3× |
| Xr c-spine 4 or 5 views (72050) |
$413 |
$590 |
3.3× |
| Xr c-spine 6 or more views (72052) |
$519.40 |
$742 |
4.1× |
| Xr chest 4+ views (71048) |
$415.80 |
$594 |
3.3× |
| Xr urogram antegrade (74425) |
$494.90 |
$707 |
1.2× |