| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,895.10 |
$7,237.76 |
2.2× |
| Abdomen 2 views (74019) |
$145.98 |
$364.94 |
1.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$619.28 |
$1,548.21 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,903.20 |
$7,257.98 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,316.68 |
$8,291.70 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$3,049.16 |
$7,622.91 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,370.42 |
$13,426.06 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,316.68 |
$8,291.70 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,365.69 |
$8,414.23 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$5,449.79 |
$13,624.47 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,370.42 |
$13,426.06 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,288.33 |
$5,720.83 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,398.47 |
$3,496.18 |
0.5× |
| Ankle 2 views (73600) |
$80.44 |
$201.09 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$491.78 |
$1,229.45 |
1.5× |
| Aortogram thoracic (75605) |
$5,499.56 |
$13,748.90 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,411.26 |
$8,528.15 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$2,903.20 |
$7,257.98 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,192.90 |
$7,982.24 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$2,668.94 |
$6,672.36 |
0.9× |
| Arthrogram elbow (73085) |
$487.46 |
$1,218.67 |
1.5× |
| Arthrogram hip (73525) |
$487.46 |
$1,218.67 |
1.5× |
| Arthrogram shoulder (73040) |
$487.46 |
$1,218.67 |
1.5× |
| Arthrogram wrist (73115) |
$557.43 |
$1,393.57 |
1.7× |
| Arthrography knee lt (73580) |
$634.28 |
$1,585.71 |
1.9× |
| Basic radiation dosimetry calculation (77300) |
$305.26 |
$763.16 |
2.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$610.26 |
$1,525.66 |
1.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$619.28 |
$1,548.21 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$610.26 |
$1,525.66 |
1.6× |
| Bone age studies (77072) |
$143.12 |
$357.82 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$610.26 |
$1,525.66 |
1.6× |
| Bone Marrow Imaging Limited Area (78102) |
$318.57 |
$796.43 |
0.8× |
| Bone survey complete (77075) |
$1,145.59 |
$2,863.98 |
11.4× |
| Brachytx isodose complex (77318) |
$1,262.83 |
$3,157.07 |
3.5× |
| Brachytx isodose intermed (77317) |
$782.10 |
$1,955.26 |
2.2× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$787.62 |
$1,969.04 |
2.2× |
| Brain image w/flow 4 + views (78606) |
$798.38 |
$1,995.95 |
1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,183.30 |
$2,958.24 |
3.5× |
| Cervical spine 2 or 3 views (72040) |
$79.26 |
$198.16 |
0.9× |
| Chest 1 view (71045) |
$79.66 |
$199.14 |
1.0× |
| Chest 3 views (71047) |
$80.84 |
$202.09 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$143.12 |
$357.82 |
0.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$898.86 |
$2,247.15 |
1.2× |
| Clavicle complete (73000) |
$79.26 |
$198.16 |
0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$86.94 |
$217.34 |
0.9× |
| Continuing medical physics consltj pr wk (77336) |
$300.82 |
$752.04 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$885.77 |
$2,214.42 |
2.6× |
| CT abdomen and pelvis without contrast (74176) |
$530.10 |
$1,325.24 |
2.3× |
| CT abdomen w contrast (74160) |
$464.35 |
$1,160.88 |
2.7× |
| CT abdomen w wo contrast (74170) |
$464.35 |
$1,160.88 |
2.7× |
| CT abdomen w/o contrast (74150) |
$258.70 |
$646.73 |
2.6× |
| CT angio hrt w/3d image (75574) |
$464.35 |
$1,160.88 |
1.4× |
| CT angiography upper extremity lt (73206) |
$464.35 |
$1,160.88 |
2.7× |
| CT c-spine w/o contrast (72125) |
$258.70 |
$646.73 |
2.6× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$168.97 |
$422.43 |
1.0× |
| CT cervical spine w&w/o contrast (72127) |
$465.94 |
$1,164.84 |
2.8× |
| CT cervical spine with contrast (72126) |
$887.92 |
$2,219.80 |
2.6× |
| CT chest w/wo contrast (71270) |
$399.34 |
$998.34 |
2.4× |
| CT chest with contrast (71260) |
$399.34 |
$998.34 |
2.4× |
| CT head/brain with contrast (70460) |
$464.35 |
$1,160.88 |
2.7× |
| CT head/brain without and with contrast (70470) |
$464.35 |
$1,160.88 |
2.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$464.35 |
$1,160.88 |
1.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$143.24 |
$358.10 |
1.7× |
| CT iac w contrast (70481) |
$464.35 |
$1,160.88 |
2.7× |
| CT limited/localized follow up study (76380) |
$76.53 |
$191.32 |
0.9× |
| CT lower ext w/o (73700) |
$258.70 |
$646.73 |
2.6× |
| CT lower extremity w wo contrast (73702) |
$1,225.57 |
$3,063.93 |
7.3× |
| CT lower extremity with contrast (73701) |
$464.35 |
$1,160.88 |
2.7× |
| CT lumbar spine w & w/o contrast (72133) |
$471.21 |
$1,178.03 |
2.8× |
| CT lumbar spine w/o contrast (72131) |
$258.70 |
$646.73 |
2.6× |
| CT lumbar spine with contrast (72132) |
$887.92 |
$2,219.80 |
2.6× |
| CT maxillofacial w contrast (70487) |
$464.35 |
$1,160.88 |
2.7× |
| CT maxillofacial w/o contrast (70486) |
$262.52 |
$656.29 |
2.6× |
| CT maxillofacial w/wo contrast (70488) |
$464.35 |
$1,160.88 |
2.7× |
| CT neck soft tissue w contrast (70491) |
$464.35 |
$1,160.88 |
2.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$465.94 |
$1,164.84 |
2.8× |
| CT orbits w/o contrast (70480) |
$258.70 |
$646.73 |
2.6× |
| CT pelvis w & w/o contrast (72194) |
$464.35 |
$1,160.88 |
2.7× |
| CT pelvis w/o contrast (72192) |
$258.70 |
$646.73 |
2.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$464.35 |
$1,160.88 |
2.7× |
| CT soft tissue neck w/o contrast (70490) |
$258.70 |
$646.73 |
2.6× |
| CT thoracic spine w/contrast (72129) |
$464.35 |
$1,160.88 |
2.7× |
| CT thoracic spine w/o contrast (72128) |
$258.70 |
$646.73 |
2.6× |
| CT thoracic spine w/wo contrast (72130) |
$471.21 |
$1,178.03 |
2.8× |
| CT thorax w/o contrast (71250) |
$262.52 |
$656.29 |
2.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,225.57 |
$3,063.93 |
7.3× |
| CT upper extremity w/o contrast rt (73200) |
$258.70 |
$646.73 |
2.6× |
| CT upper extremity with contrast (73201) |
$885.77 |
$2,214.42 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$464.35 |
$1,160.88 |
2.7× |
| Cta Abdomen (74175) |
$464.35 |
$1,160.88 |
2.7× |
| CTA abdomen pelvis (74174) |
$889.60 |
$2,224.01 |
2.6× |
| CTA chest (71275) |
$464.35 |
$1,160.88 |
2.7× |
| Cta Head (70496) |
$464.35 |
$1,160.88 |
2.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$336.09 |
$840.23 |
1.0× |
| CTA lwr ext w&w/o contrast (73706) |
$464.35 |
$1,160.88 |
2.7× |
| Cta Neck (70498) |
$464.35 |
$1,160.88 |
2.7× |
| Cta Pelvis (72191) |
$1,846.96 |
$4,617.40 |
10.9× |
| Cystography minimum 3 views rs&i (74430) |
$499.05 |
$1,247.62 |
1.5× |
| Diskography lumbar (72295) |
$1,398.68 |
$3,496.70 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$102.74 |
$256.86 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$83.52 |
$208.78 |
1.0× |
| Echoencephalography real time imaging (76506) |
$116.12 |
$290.29 |
1.2× |
| Esophagus (74220) |
$256.33 |
$640.83 |
1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$116.12 |
$290.29 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$293.32 |
$733.30 |
1.3× |
| Foot 2 views (73620) |
$117.14 |
$292.84 |
1.4× |
| Forearm 2 views (73090) |
$80.44 |
$201.09 |
1.0× |
| Gated Heart Planar Single (78472) |
$610.26 |
$1,525.66 |
1.6× |
| Hand 2 views (73120) |
$211.52 |
$528.80 |
2.1× |
| Hand 3 views (73130) |
$98.79 |
$246.96 |
1.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,739.88 |
$4,349.71 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,714.54 |
$4,286.36 |
2.6× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$576.01 |
$1,440.02 |
0.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,102.80 |
$7,757.01 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$786.76 |
$1,966.88 |
1.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$610.26 |
$1,525.66 |
1.6× |
| Ht muscle image spect sing (78451) |
$2,152.08 |
$5,380.21 |
1.7× |
| Humerus Min 2 Views Left (73060) |
$80.44 |
$201.09 |
1.0× |
| Hysterosalpingogram (74740) |
$293.32 |
$733.30 |
1.3× |
| Kidney imaging morphology (78700) |
$619.28 |
$1,548.21 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$786.76 |
$1,966.88 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$809.38 |
$2,023.44 |
1.5× |
| Knee 3 views (73562) |
$120.65 |
$301.63 |
1.4× |
| Liver & spleen imaging static only (78215) |
$804.79 |
$2,011.97 |
2.1× |
| Liver imaging static only (78201) |
$2,120.74 |
$5,301.86 |
4.1× |
| Lung perfusion differential (78597) |
$619.28 |
$1,548.21 |
1.6× |
| Lung Ventilation Imaging (78579) |
$619.28 |
$1,548.21 |
1.6× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$2,906.17 |
$7,265.42 |
1.0× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,451.49 |
$3,628.72 |
1.0× |
| Lymphoscintigraphy (78195) |
$591.29 |
$1,478.23 |
1.1× |
| Mammary ductogram or galactogram single (77053) |
$575.38 |
$1,438.45 |
2.5× |
| Meckels Diverticulum (78290) |
$610.26 |
$1,525.66 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$782.78 |
$1,956.95 |
2.2× |
| Mr safety determination physician/other qhp (76016) |
$85.41 |
$213.52 |
1.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$57.55 |
$143.87 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$23.72 |
$59.31 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$88.92 |
$222.30 |
1.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$234.17 |
$585.43 |
1.0× |
| MRA head w & w/o contrast (70546) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRA head w/o contrast (70544) |
$706.74 |
$1,766.83 |
3.1× |
| MRA head with contrast (70545) |
$1,199.39 |
$2,998.48 |
3.6× |
| MRA neck w contrast (70548) |
$1,181.92 |
$2,954.82 |
3.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,127.57 |
$7,818.92 |
9.3× |
| MRA neck w/o contrast (70547) |
$706.74 |
$1,766.83 |
3.1× |
| MRI abdomen w contrast (74182) |
$2,241.95 |
$5,604.87 |
6.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI abdomen w/o contrast (74181) |
$706.74 |
$1,766.83 |
3.1× |
| MRI any jnt lwr ext with con lt (73722) |
$2,120.30 |
$5,300.74 |
2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,120.30 |
$5,300.74 |
2.8× |
| MRI breast w/o contrast bilateral (77047) |
$398.61 |
$996.52 |
1.7× |
| MRI breast w/o contrast unilat (77046) |
$269.66 |
$674.16 |
1.2× |
| MRI c-spine with contrast (72142) |
$2,241.95 |
$5,604.87 |
6.7× |
| MRI cardiac w/o contrast (75557) |
$706.74 |
$1,766.83 |
3.1× |
| MRI cervical spine w/o contrast (72141) |
$706.74 |
$1,766.83 |
3.1× |
| MRI chest w/o & w/contrast material (71552) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI chest w/o contrast (71550) |
$706.74 |
$1,766.83 |
3.1× |
| MRI chest with contrast (71551) |
$810.04 |
$2,025.11 |
1.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,210.43 |
$5,526.07 |
6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,241.95 |
$5,604.87 |
6.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$717.18 |
$1,792.94 |
3.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$706.74 |
$1,766.83 |
3.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI pelvis w/o contrast (72195) |
$706.74 |
$1,766.83 |
3.1× |
| MRI scan of arm joint before and after contrast (73223) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI scan of leg joint before and after contrast (73723) |
$1,165.81 |
$2,914.52 |
3.5× |
| MRI spectroscopy (76390) |
$2,762.05 |
$6,905.12 |
32.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,200.78 |
$3,001.96 |
3.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,183.30 |
$2,958.24 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$706.74 |
$1,766.83 |
3.1× |
| MRI tmj (70336) |
$706.74 |
$1,766.83 |
3.1× |
| MRI upper ext joint w/o contrast (73221) |
$717.18 |
$1,792.94 |
3.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,200.78 |
$3,001.96 |
3.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$706.74 |
$1,766.83 |
3.1× |
| Myocardial Spect Multiple Studies (78452) |
$2,120.74 |
$5,301.86 |
1.7× |
| Neck soft tissue (70360) |
$79.26 |
$198.16 |
0.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$636.85 |
$1,592.12 |
1.7× |
| Nm cisternogram (78630) |
$2,106.78 |
$5,266.96 |
4.0× |
| Nm gastric emptying study (78264) |
$610.26 |
$1,525.66 |
1.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,895.10 |
$7,237.76 |
2.2× |
| Nuclear Rx Oral Admin (79005) |
$399.93 |
$999.82 |
1.8× |
| Osseous survey infant (77076) |
$145.24 |
$363.11 |
1.4× |
| Osseous survey limited (77074) |
$145.24 |
$363.11 |
1.4× |
| Parathyroid imaging (78070) |
$610.26 |
$1,525.66 |
1.6× |
| Pelvis 1 or 2 views (72170) |
$143.12 |
$357.82 |
1.4× |
| PET image w/CT, skull-thigh (78815) |
$2,695.19 |
$6,737.97 |
2.0× |
| PET imaging for CT attenuation whole body (78816) |
$2,695.19 |
$6,737.97 |
2.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,200.78 |
$3,001.96 |
3.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,207.80 |
$8,019.50 |
1.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,120.59 |
$7,801.48 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$351.53 |
$878.82 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$786.76 |
$1,966.88 |
1.5× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$896.26 |
$2,240.65 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$557.26 |
$1,393.16 |
1.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$79.26 |
$198.16 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$143.12 |
$357.82 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$143.12 |
$357.82 |
1.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$18,667.12 |
$46,667.80 |
2.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$545.10 |
$1,362.75 |
1.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$120.36 |
$300.88 |
1.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$237.33 |
$593.33 |
0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$143.12 |
$357.82 |
1.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$79.66 |
$199.14 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$80.84 |
$202.09 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$256.33 |
$640.83 |
1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$210.86 |
$527.14 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$256.33 |
$640.83 |
1.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$256.33 |
$640.83 |
1.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$117.14 |
$292.84 |
1.4× |
| Radiological examination surgical specimen (76098) |
$491.84 |
$1,229.60 |
0.9× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,128.12 |
$7,820.31 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,668.94 |
$6,672.36 |
0.9× |
| Ribs bilateral 3 views (71110) |
$118.90 |
$297.24 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$384.34 |
$960.86 |
1.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,152.08 |
$5,380.21 |
4.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,408.43 |
$3,521.08 |
2.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$284.04 |
$710.10 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$399.93 |
$999.82 |
1.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$255.17 |
$637.93 |
1.1× |
| Scanogram (77073) |
$616.13 |
$1,540.32 |
6.1× |
| Scapula complete (73010) |
$143.12 |
$357.82 |
1.4× |
| Screening digital breast tomosynthesis (77063) |
$30.92 |
$77.30 |
1.3× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$412.52 |
$1,031.29 |
4.1× |
| Simulation intermediate (77285) |
$556.43 |
$1,391.07 |
1.5× |
| Small bowel series (74250) |
$143.12 |
$357.82 |
0.8× |
| Spec medical radj physics consltj (77370) |
$300.82 |
$752.04 |
2.3× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$782.78 |
$1,956.95 |
2.2× |
| Special dosimetry (77331) |
$597.19 |
$1,492.98 |
4.6× |
| Special treatment procedure (77470) |
$1,264.46 |
$3,161.16 |
2.4× |
| Spine thoracic 3 views (72072) |
$143.12 |
$357.82 |
1.4× |
| Splenoportograpy rs&i (75810) |
$3,004.76 |
$7,511.90 |
1.0× |
| Stereotactic body radiation delivery (77373) |
$4,120.09 |
$10,300.23 |
2.4× |
| Superior sagittal sinus venogram (75870) |
$1,966.10 |
$4,915.24 |
0.6× |
| Tbs Technical Calculation Only (77091) |
$83.52 |
$208.78 |
1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$782.10 |
$1,955.26 |
2.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$778.06 |
$1,945.14 |
2.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$782.78 |
$1,956.95 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$300.82 |
$752.04 |
2.3× |
| Thoracolumbar 2 views (72080) |
$80.44 |
$201.09 |
1.0× |
| Thyroid carcinoma metastases img whole body (78018) |
$786.76 |
$1,966.88 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$619.28 |
$1,548.21 |
1.6× |
| Thyroid uptake measurement (78012) |
$526.54 |
$1,316.35 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$610.26 |
$1,525.66 |
1.6× |
| Tmj unilateral (70328) |
$79.26 |
$198.16 |
0.9× |
| Treatment device intermediate (77333) |
$308.60 |
$771.51 |
2.4× |
| Treatment devices simple (77332) |
$308.60 |
$771.51 |
2.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,152.08 |
$5,380.21 |
4.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$2,120.74 |
$5,301.86 |
5.5× |
| Tx devices design & construction complex (77334) |
$779.60 |
$1,949 |
2.2× |
| Ultrasound, abdomen limited (76705) |
$116.12 |
$290.29 |
1.2× |
| Umbilical-artery Doppler (OB) (76820) |
$349.14 |
$872.84 |
3.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$233.64 |
$584.10 |
2.8× |
| Unlisted fluoroscopic procedure (76496) |
$91.24 |
$228.09 |
1.1× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) |
$375.41 |
$938.53 |
1.0× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$630.93 |
$1,577.33 |
1.6× |
| Urethrocystography retrograde rs&i (74450) |
$293.32 |
$733.30 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$256.33 |
$640.83 |
1.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$260.12 |
$650.30 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$219.46 |
$548.63 |
2.2× |
| Us breast unilateral complete (76641) |
$144.72 |
$361.80 |
1.4× |
| Us breast unilateral limited (76642) |
$95.02 |
$237.55 |
1.1× |
| Us chest (76604) |
$164.96 |
$412.42 |
1.6× |
| Us guided compression repair (76936) |
$260.38 |
$650.95 |
1.3× |
| Us infant hips dynamic (76885) |
$64.29 |
$160.74 |
0.8× |
| Us infant hips limited static (76886) |
$64.29 |
$160.74 |
0.8× |
| Us kidney transplant (76776) |
$116.12 |
$290.29 |
1.2× |
| Us ob transvaginal (76817) |
$116.12 |
$290.29 |
1.2× |
| Us pelvic non ob complete (76856) |
$116.12 |
$290.29 |
1.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$116.12 |
$290.29 |
1.2× |
| Us pregnancy ltd (76815) |
$116.12 |
$290.29 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$116.12 |
$290.29 |
1.2× |
| Us retroperitoneal complete (76770) |
$217.50 |
$543.75 |
2.2× |
| Us retroperitoneal limited (76775) |
$167.40 |
$418.51 |
1.7× |
| Us scrotum and contents (76870) |
$167.40 |
$418.51 |
1.7× |
| Us soft tissue head/neck (76536) |
$116.12 |
$290.29 |
1.2× |
| Us spinal canal and contents (76800) |
$116.12 |
$290.29 |
1.2× |
| Us transrectal prostate volume (76873) |
$944.10 |
$2,360.26 |
9.4× |
| Us xtr non-vasc lmtd (76882) |
$116.12 |
$290.29 |
1.2× |
| Venogram extremity bilateral (75822) |
$1,337.56 |
$3,343.90 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,237.05 |
$8,092.62 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$761.27 |
$1,903.16 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$792.74 |
$1,981.85 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$3,102.80 |
$7,757.01 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,068.06 |
$7,670.15 |
1.0× |
| Wrist 2 views (73100) |
$209.13 |
$522.83 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$145.24 |
$363.11 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$120.65 |
$301.63 |
1.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$80.44 |
$201.09 |
1.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$260.12 |
$650.30 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$80.44 |
$201.09 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$98.79 |
$246.96 |
1.2× |
| X-ray exam hip uni 1 view (73501) |
$80.44 |
$201.09 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$80.44 |
$201.09 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$145.24 |
$363.11 |
1.4× |
| X-ray exam of femur 1 (73551) |
$79.26 |
$198.16 |
0.9× |
| X-ray eye for foreign body (70030) |
$79.26 |
$198.16 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$210.78 |
$526.97 |
2.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$79.26 |
$198.16 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$117.14 |
$292.84 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$98.79 |
$246.96 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$224.03 |
$560.08 |
2.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$211.52 |
$528.80 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$79.26 |
$198.16 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$143.12 |
$357.82 |
1.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$569.03 |
$1,422.58 |
5.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$143.12 |
$357.82 |
1.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$79.26 |
$198.16 |
0.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$83.71 |
$209.28 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$143.12 |
$357.82 |
1.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$143.12 |
$357.82 |
1.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$490.48 |
$1,226.21 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$79.26 |
$198.16 |
0.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$143.12 |
$357.82 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$79.26 |
$198.16 |
0.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$118.90 |
$297.24 |
1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$121.96 |
$304.90 |
1.5× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$196.74 |
$491.84 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$143.12 |
$357.82 |
1.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$224.03 |
$560.08 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$79.26 |
$198.16 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$208.24 |
$520.59 |
2.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$183.08 |
$457.72 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$143.12 |
$357.82 |
1.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$79.26 |
$198.16 |
0.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$98.79 |
$246.96 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$143.12 |
$357.82 |
1.4× |
| Xr chest 4+ views (71048) |
$303.10 |
$757.76 |
3.0× |
| Xr finger(s) 2+ views (73140) |
$80.44 |
$201.09 |
1.0× |
| Xr shoulder 1 view (73020) |
$80.44 |
$201.09 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$143.12 |
$357.82 |
1.4× |
| Xr tibia/fibula 2 views (73590) |
$80.44 |
$201.09 |
1.0× |
| Xr tmj bilateral (70330) |
$120.65 |
$301.63 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$98.79 |
$246.96 |
1.2× |